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Sample records for risk classification significantly

  1. Significance, definition, classification and risk factors of chronic kidney disease in South Africa.

    PubMed

    Meyers, A M

    2015-03-01

    Renal dysfunction or chronic kidney disease (CKD) is found in 10% of the global population and is classified into five stages according to the estimated glomerular filtration rate (eGFR). No matter where a patient lives, estimation of the GFR is mandatory for decision-making and obtained by the simple measurement of a serum creatinine level. The objective of diagnosing CKD lies in its future prevention, early detection and proper treatment, which will prevent or delay functional deterioration. Primary hypertension (PH) occurs in 25% of South Africa (SA)s black population and is the putative cause of stage 5 CKD in 40 - 60% of these patients. Moreover, in this group, stage 5 CKD occurs at a relatively young age (35 - 45 years) compared with other population groups in whom stage 5 CKD resulting from PH usually occurs between 60 and 70 years of age. In the cohort study, PH has been found in 12 - 16% of black school learners (mean age 17 years) compared with 1.8 - 2% of other ethnic groups (mixed race, Asian, white). End-stage renal failure (ESRF) is the fifth most common cause of death in SA, excluding post-traumatic cases. In addition, undiagnosed or poorly controlled PH is a potent risk factor for other cardiovascular disease (CVD), e.g. congestive cardiac failure, myocardial infarction, stroke. Significant protein is also associated with CVD and protein >1 g/d is a significant risk factor for ESRF. PMID:26294833

  2. Blood lactate levels differ significantly between surviving and nonsurviving patients within the same risk-adjusted Classification for Congenital Heart Surgery (RACHS-1) group after pediatric cardiac surgery.

    PubMed

    Molina Hazan, Vered; Gonen, Yael; Vardi, Amir; Keidan, Ilan; Mishali, David; Rubinshtein, Marina; Yakov, Yusim; Paret, Gideon

    2010-10-01

    This study aimed to examine the association between lactate levels in the first hours after surgery for congenital heart defects and the results of Risk-Adjusted Classification for Congenital Heart Surgery (RACHS-1) scoring and to evaluate serial lactate levels over time to determine whether they can serve as a supplementary tool for postoperative assessment within the same RACHS-1 group of patients. A retrospective cohort study was performed using data retrieved from a clinical database of 255 children who had surgery for congenital heart defects between 1999 and 2001 at Sheba Medical Center. Lactate levels were measured postoperatively four times (mg/dL units). The last sample was taken at the end of the surgical procedure, and lactate levels were measured at admission to the pediatrics critical care unit, then 6 and 12 h after admission. The lactate level was measured via arterial blood gases. A total of 27 deaths occurred, yielding a mortality rate of 7.4% when Norwood operations were excluded and 10.16% when they were included. The mean initial postoperative lactate level was significantly lower for survivors (42.2 ± 32.0 mg/dL) than for nonsurvivors (85.4 ± 54.1 mg/dL) (p < 0.01). The serial mean lactate levels decreased progressively for all surviving patients (r (2) = 0.96) compared with nonsurvivors (r (2) = 0.02). The lactate levels correlated with the RACHS-1 subgroups at each time point (r (2) > 0.96 for all). The Pearson correlations between postoperative lactate levels (last lactate measurement taken in the operating room) and cardiopulmonary bypass (CPB) duration (r = 0.549), clamp duration (r = 0.586), and the inotropic score (r = 0.466) (p < 0.001 for all) were significantly positive. The correlations between the maximum lactate levels (during the first 12 postoperative hours) and CPB duration (r = 0.496), clamp duration (r = 0.509), and the inotropic score (r = 0.633) (p < 0.001 for all) were extremely positive. The early elevation of lactate

  3. Macroscopic serosal classification of colorectal cancer and its clinical significance

    PubMed Central

    Wang, Yong-Peng; Guo, Peng-Tao; Zhu, Zhi; Zhang, Hao; Xu, Yan; Ma, Si-Ping; Wang, Zhen-Ning; Xu, Hui-Mian

    2015-01-01

    Background: Macroscopic serosal classification of gastric cancer has been reported in previous studies, but rarely reported about it of colorectal cancer. The purpose of this study was to propose a macroscopic serosal classification of colorectal cancer and to investigate clinical significance of this classification. Materials and methods: Morphologic features of colorectal cancer were analyzed according to the macroscopic serosal appearance and clinicopathologic characteristics of these patients were retrospectively reviewed. Microscopic serosal structure was compared between different types under light microscope and transmission electron microscope. Results: Macroscopic serosal classification was divided into normal type, reactive type, nodular type and colloid type according to the macroscopic serosal appearance and microscopic structure. There were significant differences in tumor size, tumor gross type, histological type, histological grade, tumor necrosis, pT stage, number of nodes metastasis, lymph node metastasis ratio, pN stage, M stage and peritoneal metastasis between patients with different serosal types. Univariate analysis of prognosis revealed macroscopic serosal classification as one of factors significantly correlated with patient survival. However, multivariate analysis only revealed TNM stage significantly correlated with patient survival, while macroscopic serosal classification did not, maybe due to insufficient samples. Conclusions: Macroscopic serosal classification of colorectal cancer is preliminarily defined and divided into four types. Different macroscopic serosal types indicate different clinicopathologic features and correlate with prognosis of patients with colorectal cancer, but still cannot be proven as an independent factor. PMID:26884925

  4. A classification scheme for risk assessment methods.

    SciTech Connect

    Stamp, Jason Edwin; Campbell, Philip LaRoche

    2004-08-01

    This report presents a classification scheme for risk assessment methods. This scheme, like all classification schemes, provides meaning by imposing a structure that identifies relationships. Our scheme is based on two orthogonal aspects--level of detail, and approach. The resulting structure is shown in Table 1 and is explained in the body of the report. Each cell in the Table represent a different arrangement of strengths and weaknesses. Those arrangements shift gradually as one moves through the table, each cell optimal for a particular situation. The intention of this report is to enable informed use of the methods so that a method chosen is optimal for a situation given. This report imposes structure on the set of risk assessment methods in order to reveal their relationships and thus optimize their usage.We present a two-dimensional structure in the form of a matrix, using three abstraction levels for the rows and three approaches for the columns. For each of the nine cells in the matrix we identify the method type by name and example. The matrix helps the user understand: (1) what to expect from a given method, (2) how it relates to other methods, and (3) how best to use it. Each cell in the matrix represent a different arrangement of strengths and weaknesses. Those arrangements shift gradually as one moves through the table, each cell optimal for a particular situation. The intention of this report is to enable informed use of the methods so that a method chosen is optimal for a situation given. The matrix, with type names in the cells, is introduced in Table 2 on page 13 below. Unless otherwise stated we use the word 'method' in this report to refer to a 'risk assessment method', though often times we use the full phrase. The use of the terms 'risk assessment' and 'risk management' are close enough that we do not attempt to distinguish them in this report. The remainder of this report is organized as follows. In Section 2 we provide context for this report

  5. Risk Classification and Risk-based Safety and Mission Assurance

    NASA Technical Reports Server (NTRS)

    Leitner, Jesse A.

    2014-01-01

    Recent activities to revamp and emphasize the need to streamline processes and activities for Class D missions across the agency have led to various interpretations of Class D, including the lumping of a variety of low-cost projects into Class D. Sometimes terms such as Class D minus are used. In this presentation, mission risk classifications will be traced to official requirements and definitions as a measure to ensure that projects and programs align with the guidance and requirements that are commensurate for their defined risk posture. As part of this, the full suite of risk classifications, formal and informal will be defined, followed by an introduction to the new GPR 8705.4 that is currently under review.GPR 8705.4 lays out guidance for the mission success activities performed at the Classes A-D for NPR 7120.5 projects as well as for projects not under NPR 7120.5. Furthermore, the trends in stepping from Class A into higher risk posture classifications will be discussed. The talk will conclude with a discussion about risk-based safety and mission assuranceat GSFC.

  6. Classification criteria and probability risk maps: limitations and perspectives.

    PubMed

    Saisana, Michaela; Dubois, Gregoire; Chaloulakou, Archontoula; Spyrellis, Nikolas

    2004-03-01

    Delineation of polluted zones with respect to regulatory standards, accounting at the same time for the uncertainty of the estimated concentrations, relies on classification criteria that can lead to significantly different pollution risk maps, which, in turn, can depend on the regulatory standard itself. This paper reviews four popular classification criteria related to the violation of a probability threshold or a physical threshold, using annual (1996-2000) nitrogen dioxide concentrations from 40 air monitoring stations in Milan. The relative advantages and practical limitations of each criterion are discussed, and it is shown that some of the criteria are more appropriate for the problem at hand and that the choice of the criterion can be supported by the statistical distribution of the data and/or the regulatory standard. Finally, the polluted area is estimated over the different years and concentration thresholds using the appropriate risk maps as an additional source of uncertainty. PMID:15046326

  7. Adiposity significantly modifies genetic risk for dyslipidemia.

    PubMed

    Cole, Christopher B; Nikpay, Majid; Lau, Paulina; Stewart, Alexandre F R; Davies, Robert W; Wells, George A; Dent, Robert; McPherson, Ruth

    2014-11-01

    Recent genome-wide association studies have identified multiple loci robustly associated with plasma lipids, which also contribute to extreme lipid phenotypes. However, these common genetic variants explain <12% of variation in lipid traits. Adiposity is also an important determinant of plasma lipoproteins, particularly plasma TGs and HDL cholesterol (HDLc) concentrations. Thus, interactions between genes and clinical phenotypes may contribute to this unexplained heritability. We have applied a weighted genetic risk score (GRS) for both plasma TGs and HDLc in two large cohorts at the extremes of BMI. Both BMI and GRS were strongly associated with these lipid traits. A significant interaction between obese/lean status and GRS was noted for each of TG (P(Interaction) = 2.87 × 10(-4)) and HDLc (P(Interaction) = 1.05 × 10(-3)). These interactions were largely driven by SNPs tagging APOA5, glucokinase receptor (GCKR), and LPL for TG, and cholesteryl ester transfer protein (CETP), GalNAc-transferase (GALNT2), endothelial lipase (LIPG), and phospholipid transfer protein (PLTP) for HDLc. In contrast, the GRSLDL cholesterol × adiposity interaction was not significant. Sexual dimorphism was evident for the GRSHDL on HDLc in obese (P(Interaction) = 0.016) but not lean subjects. SNP by BMI interactions may provide biological insight into specific genetic associations and missing heritability. PMID:25225679

  8. Neural network diagnostic system for dengue patients risk classification.

    PubMed

    Faisal, Tarig; Taib, Mohd Nasir; Ibrahim, Fatimah

    2012-04-01

    With the dramatic increase of the worldwide threat of dengue disease, it has been very crucial to correctly diagnose the dengue patients in order to decrease the disease severity. However, it has been a great challenge for the physicians to identify the level of risk in dengue patients due to overlapping of the medical classification criteria. Therefore, this study aims to construct a noninvasive diagnostic system to assist the physicians for classifying the risk in dengue patients. Systematic producers have been followed to develop the system. Firstly, the assessment of the significant predictors associated with the level of risk in dengue patients was carried out utilizing the statistical analyses technique. Secondly, Multilayer perceptron neural network models trained via Levenberg-Marquardt and Scaled Conjugate Gradient algorithms was employed for constructing the diagnostic system. Finally, precise tuning for the models' parameters was conducted in order to achieve the optimal performance. As a result, 9 noninvasive predictors were found to be significantly associated with the level of risk in dengue patients. By employing those predictors, 75% prediction accuracy has been achieved for classifying the risk in dengue patients using Scaled Conjugate Gradient algorithm while 70.7% prediction accuracy were achieved by using Levenberg-Marquardt algorithm. PMID:20703665

  9. DETERMINING SIGNIFICANT ENDPOINTS FOR ECOLOGICAL RISK ANALYSIS

    EPA Science Inventory

    Risk analyses, both human health and ecological, will be important factors in determining which DOE sites should be cleaned up and in deciding if acceptable performance standards have been met. Risk analysis procedures for humans use the individual as the 'unit' of observation, a...

  10. Using QA classification to guide design and manage risk

    SciTech Connect

    Lathrop, J.; DeKlever, R.; Petrie, E.H.

    1993-01-28

    Raytheon Services Nevada has developed a classification process based on probabilistic risk assessment, using accident/impact scenarios for each system classified. Initial classification analyses were performed for the 20 systems of Package IA of the Exploratory Studies Facility (ESF). The analyses demonstrated a solid, defensible methodological basis for classification which minimizes the use of direct engineering judgment. They provide guidance for ESF design and risk management through the identification of: The critical characteristics of each system that need to be controlled; and the parts of the information base that most need to be further developed through performance assessment or other efforts.

  11. Drug and Alcohol Use -- A Significant Risk Factor for HIV

    MedlinePlus

    ... A Significant Risk Factor for HIV Drug and Alcohol Use - A Significant Risk Factor for HIV Email ... with HIV currently use drugs or binge on alcohol. Many people are unaware that the increased risk ...

  12. Inherited Cholesterol Disorder Significantly Boosts Heart Risks

    MedlinePlus

    ... genetic disorder that causes high levels of "bad" LDL cholesterol have an increased risk for heart disease and ... in previous studies. Compared to people with average LDL cholesterol levels (less than 130 mg/dL), those with ...

  13. Significance of clustering and classification applications in digital and physical libraries

    NASA Astrophysics Data System (ADS)

    Triantafyllou, Ioannis; Koulouris, Alexandros; Zervos, Spiros; Dendrinos, Markos; Giannakopoulos, Georgios

    2015-02-01

    Applications of clustering and classification techniques can be proved very significant in both digital and physical (paper-based) libraries. The most essential application, document classification and clustering, is crucial for the content that is produced and maintained in digital libraries, repositories, databases, social media, blogs etc., based on various tags and ontology elements, transcending the traditional library-oriented classification schemes. Other applications with very useful and beneficial role in the new digital library environment involve document routing, summarization and query expansion. Paper-based libraries can benefit as well since classification combined with advanced material characterization techniques such as FTIR (Fourier Transform InfraRed spectroscopy) can be vital for the study and prevention of material deterioration. An improved two-level self-organizing clustering architecture is proposed in order to enhance the discrimination capacity of the learning space, prior to classification, yielding promising results when applied to the above mentioned library tasks.

  14. 21 CFR 812.66 - Significant risk device determinations.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Significant risk device determinations. 812.66... risk device determinations. If an IRB determines that an investigation, presented for approval under § 812.2(b)(1)(ii), involves a significant risk device, it shall so notify the investigator and,...

  15. 21 CFR 812.66 - Significant risk device determinations.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Significant risk device determinations. 812.66... risk device determinations. If an IRB determines that an investigation, presented for approval under § 812.2(b)(1)(ii), involves a significant risk device, it shall so notify the investigator and,...

  16. Risk-based Classification of Incidents

    NASA Technical Reports Server (NTRS)

    Greenwell, William S.; Knight, John C.; Strunk, Elisabeth A.

    2003-01-01

    As the penetration of software into safety-critical systems progresses, accidents and incidents involving software will inevitably become more frequent. Identifying lessons from these occurrences and applying them to existing and future systems is essential if recurrences are to be prevented. Unfortunately, investigative agencies do not have the resources to fully investigate every incident under their jurisdictions and domains of expertise and thus must prioritize certain occurrences when allocating investigative resources. In the aviation community, most investigative agencies prioritize occurrences based on the severity of their associated losses, allocating more resources to accidents resulting in injury to passengers or extensive aircraft damage. We argue that this scheme is inappropriate because it undervalues incidents whose recurrence could have a high potential for loss while overvaluing fairly straightforward accidents involving accepted risks. We then suggest a new strategy for prioritizing occurrences based on the risk arising from incident recurrence.

  17. [Changes of 2015 WHO Histological Classification of Lung Cancer 
and the Clinical Significance].

    PubMed

    Yang, Xin; Lin, Dongmei

    2016-06-20

    Due in part to remarkable advances over the past decade in our understanding of lung cancer, particularly in area of medical oncology, molecular biology, and radiology, there is a pressing need for a revised classification, based not on pathology alone, but rather on an integrated multidisciplinary approach to classification of lung cancer. The 2015 World Health Organization (WHO) Classification of Tumors of the Lung, Pleura, Thymus and Heart has just been published with numerous important changes from the 2004 WHO classification. The revised classification has been greatly improved in helping advance the field, increasing the impact of research, improving patient care and assisting in predicting outcome. The most significant changes will be summarized in this paper as follows: (1) main changes of lung adenocarcinoma as proposed by the 2011 International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society (IASLC/ATS/ERS) classification, (2) reclassifying squamous cell carcinomas into keratinizing, nonkeratinizing, and basaloid subtypes with the nonkeratinizing tumors requiring immunohistochemistry proof of squamous differentiation, (3) restricting the diagnosis of large cell carcinoma only to resected tumors that lack any clear morphologic or immunohistochemical differentiation with reclassification of the remaining former large cell carcinoma subtypes into different categories, (4) grouping of neuroendocrine tumors together in one category, (5) and the current viewpoint of histologic grading of lung cancer. PMID:27335291

  18. Advances in Risk Classification and Treatment Strategies for Neuroblastoma.

    PubMed

    Pinto, Navin R; Applebaum, Mark A; Volchenboum, Samuel L; Matthay, Katherine K; London, Wendy B; Ambros, Peter F; Nakagawara, Akira; Berthold, Frank; Schleiermacher, Gudrun; Park, Julie R; Valteau-Couanet, Dominique; Pearson, Andrew D J; Cohn, Susan L

    2015-09-20

    Risk-based treatment approaches for neuroblastoma have been ongoing for decades. However, the criteria used to define risk in various institutional and cooperative groups were disparate, limiting the ability to compare clinical trial results. To mitigate this problem and enhance collaborative research, homogenous pretreatment patient cohorts have been defined by the International Neuroblastoma Risk Group classification system. During the past 30 years, increasingly intensive, multimodality approaches have been developed to treat patients who are classified as high risk, whereas patients with low- or intermediate-risk neuroblastoma have received reduced therapy. This treatment approach has resulted in improved outcome, although survival for high-risk patients remains poor, emphasizing the need for more effective treatments. Increased knowledge regarding the biology and genetic basis of neuroblastoma has led to the discovery of druggable targets and promising, new therapeutic approaches. Collaborative efforts of institutions and international cooperative groups have led to advances in our understanding of neuroblastoma biology, refinements in risk classification, and stratified treatment strategies, resulting in improved outcome. International collaboration will be even more critical when evaluating therapies designed to treat small cohorts of patients with rare actionable mutations. PMID:26304901

  19. 21 CFR 812.66 - Significant risk device determinations.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... (CONTINUED) MEDICAL DEVICES INVESTIGATIONAL DEVICE EXEMPTIONS IRB Review and Approval § 812.66 Significant risk device determinations. If an IRB determines that an investigation, presented for approval under... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Significant risk device determinations....

  20. 21 CFR 812.66 - Significant risk device determinations.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... (CONTINUED) MEDICAL DEVICES INVESTIGATIONAL DEVICE EXEMPTIONS IRB Review and Approval § 812.66 Significant risk device determinations. If an IRB determines that an investigation, presented for approval under... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Significant risk device determinations....

  1. 21 CFR 812.66 - Significant risk device determinations.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... (CONTINUED) MEDICAL DEVICES INVESTIGATIONAL DEVICE EXEMPTIONS IRB Review and Approval § 812.66 Significant risk device determinations. If an IRB determines that an investigation, presented for approval under... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Significant risk device determinations....

  2. Validation Study of Oxford Classification of IgA Nephropathy: The Significance of Extracapillary Proliferation

    PubMed Central

    Ninomiya, Toshiharu; Nagata, Masaharu; Mitsuiki, Koji; Hirakata, Hideki

    2011-01-01

    Summary Background and objectives The Oxford classification of IgA nephropathy (IgAN) includes mesangial hypercellularity, endocapillary hypercellularity, segmental glomerulosclerosis (S), and tubular atrophy/interstitial fibrosis (T) as prognosticators. The value of extracapillary proliferation (Ex) was not addressed. Because the Oxford classification excludes patients with urinary protein <0.5 g/d and eGFR <30 ml/min per 1.73 m2 at biopsy, the significance of Ex should be confirmed by validation cohorts that include more rapidly progressive cases. We present such a study. Design, setting, participants, & measurements The significance of pathologic features for development end-stage renal failure (ESRF) was examined by multivariate analysis in 702 patients with IgAN. The association of Ex with kidney survival was examined by univariate analysis in 416 patients who met the Oxford criteria and 286 who did not, separately. Results In a multivariate model, S and T were significantly associated with ESRF. With addition of Ex, not S but Ex was significant for ESRF. In univariate analysis, kidney survival was significantly lower in patients with Ex than in those without, in patients who did not meet the Oxford criteria, but such a difference was not found in patients who met it. Conclusions The prognostic significance of Ex was evident in our cohort. It seems that Ex did not emerge from the Oxford classification as a prognosticator because of exclusion of severe cases (eGFR <30 ml/min per 1.73 m2). We suggest that extracapillary proliferation be included in the next version of the Oxford classification of IgAN to widen the scope of the classification. PMID:22157710

  3. Narrow-band imaging observation of colorectal lesions using NICE classification to avoid discarding significant lesions

    PubMed Central

    Hattori, Santa; Iwatate, Mineo; Sano, Wataru; Hasuike, Noriaki; Kosaka, Hidekazu; Ikumoto, Taro; Kotaka, Masahito; Ichiyanagi, Akihiro; Ebisutani, Chikara; Hisano, Yasuko; Fujimori, Takahiro; Sano, Yasushi

    2014-01-01

    AIM: To assess the risk of failing to detect diminutive and small colorectal cancers with the “resect and discard” policy. METHODS: Patients who received colonoscopy and polypectomy were recruited in the retrospective study. Probable histology of the polyps was predicted by six colonoscopists by the use of NICE classification. The incidence of diminutive and small colorectal cancers and their endoscopic features were assessed. RESULTS: In total, we found 681 cases of diminutive (1-5 mm) lesions in 402 patients and 197 cases of small (6-9 mm) lesions in 151 patients. Based on pathology of the diminutive and small polyps, 105 and 18 were non-neoplastic polyps, 557 and 154 were low-grade adenomas, 18 and 24 were high-grade adenomas or intramucosal/submucosal (SM) scanty invasive carcinomas, 1 and 1 were SM-d carcinoma, respectively. The endoscopic features of invasive cancer were classified as NICE type 3 endoscopically. CONCLUSION: The risk of failing to detect diminutive and small colorectal invasive cancer with the “resect and discard” strategy might be avoided through the use of narrow-band imaging observation with the NICE classification scheme and magnifying endoscopy. PMID:25512769

  4. Detection and Classification of Cancer from Microscopic Biopsy Images Using Clinically Significant and Biologically Interpretable Features

    PubMed Central

    Kumar, Rajesh; Srivastava, Subodh

    2015-01-01

    A framework for automated detection and classification of cancer from microscopic biopsy images using clinically significant and biologically interpretable features is proposed and examined. The various stages involved in the proposed methodology include enhancement of microscopic images, segmentation of background cells, features extraction, and finally the classification. An appropriate and efficient method is employed in each of the design steps of the proposed framework after making a comparative analysis of commonly used method in each category. For highlighting the details of the tissue and structures, the contrast limited adaptive histogram equalization approach is used. For the segmentation of background cells, k-means segmentation algorithm is used because it performs better in comparison to other commonly used segmentation methods. In feature extraction phase, it is proposed to extract various biologically interpretable and clinically significant shapes as well as morphology based features from the segmented images. These include gray level texture features, color based features, color gray level texture features, Law's Texture Energy based features, Tamura's features, and wavelet features. Finally, the K-nearest neighborhood method is used for classification of images into normal and cancerous categories because it is performing better in comparison to other commonly used methods for this application. The performance of the proposed framework is evaluated using well-known parameters for four fundamental tissues (connective, epithelial, muscular, and nervous) of randomly selected 1000 microscopic biopsy images. PMID:27006938

  5. Identification and Classification of Common Risks in Space Science Missions

    NASA Technical Reports Server (NTRS)

    Hihn, Jairus M.; Chattopadhyay, Debarati; Hanna, Robert A.; Port, Daniel; Eggleston, Sabrina

    2010-01-01

    Due to the highly constrained schedules and budgets that NASA missions must contend with, the identification and management of cost, schedule and risks in the earliest stages of the lifecycle is critical. At the Jet Propulsion Laboratory (JPL) it is the concurrent engineering teams that first address these items in a systematic manner. Foremost of these concurrent engineering teams is Team X. Started in 1995, Team X has carried out over 1000 studies, dramatically reducing the time and cost involved, and has been the model for other concurrent engineering teams both within NASA and throughout the larger aerospace community. The ability to do integrated risk identification and assessment was first introduced into Team X in 2001. Since that time the mission risks identified in each study have been kept in a database. In this paper we will describe how the Team X risk process is evolving highlighting the strengths and weaknesses of the different approaches. The paper will especially focus on the identification and classification of common risks that have arisen during Team X studies of space based science missions.

  6. The Mathematics of Risk Classification: Changing Data into Valid Instruments for Juvenile Courts. NCJ 209158

    ERIC Educational Resources Information Center

    Gottfredson, Don M.; Snyder, Howard N.

    2005-01-01

    This report is meant to help juvenile courts develop practical risk-screening instruments. Courts increasingly are using some method of risk classification to assist in assignment of youth to differential service/supervision programs. A comparison of commonly used or advocated risk classification methods may provide courts with guidance in…

  7. FINAL REPORT. DETERMINING SIGNIFICANT ENDPOINTS FOR ECOLOGICAL RISK ANALYSES

    EPA Science Inventory

    This research examines the ecological significance of radioactive and heavy metal contamination. Risks to non-human biota at higher levels of biological organization are assessed by using novel biological dosimeters in controlled, manipulative, dose/effects experiments, and by co...

  8. Significant Association Between Adiponutrin and Hepatocellular Carcinoma Risk.

    PubMed

    Li, Hong-Guang; Liu, Fang-Feng; Zhu, Hua-Qiang; Zhou, Xu; Lu, Jun; Chang, Hong; Hu, Jin-Hua

    2015-11-01

    ADPN I148M polymorphism has been consistently reported to play a role in liver-associated diseases, such as alcoholic liver disease, chronic hepatitis C, and liver fat and fibrosis in nonalcoholic fatty liver disease. This significant association was also indicated in a series of hepatocellular carcinoma (HCC) studies, where the significance may be affected due to the small sample sizes. The aim of this study was to reexamine the ADPN-HCC association by use of meta-analysis. Biweekly computer-based literature searches plus manual screening were undertaken in an effort to identify all studies that met the predefined inclusion criteria. The Mantel-Haenszel method was selected to estimate risk effects (odds ratio [OR] and 95% confidence interval [CI]). To examine reliability of the pooled risk effects, we additionally performed sensitivity analysis and publication bias tests. Ten studies (1335 HCC patients and 2927 HCC-free controls) were identified for the meta-analysis. We found significantly increased risk of HCC attributable to presence of ADPN I148M polymorphism, with the highest risk associated with the M/M genotype under the recessive model of inheritance (OR = 2.23, 95% CI = 1.87-2.67, between-study heterogeneity: P = 0.468). The significant increase persisted in Caucasian and African when data were stratified by ethnicity. Subgroup analysis according to source of controls revealed similar risk effects. Our meta-analysis indicates that I148M polymorphism in the ADPN gene may independently contribute to the progression of HCC irrespective of the etiologies. PMID:26632699

  9. External validation of risk classification in patients with docetaxel-treated castration-resistant prostate cancer

    PubMed Central

    2014-01-01

    Background Castration-resistant prostate cancer (CRPC) patients have poor prognoses, and docetaxel (DTX) is among the few treatment options. An accurate risk classification to identify CRPC patient groups for which DTX would be effective is urgently warranted. The Armstrong risk classification (ARC), which classifies CRPC patients into 3 groups, is superior; however, its usefulness remains unclear, and further external validation is required before clinical use. This study aimed to examine the clinical significance of the ARC through external validation in DTX-treated Japanese CRPC patients. Methods CRPC patients who received 2 or more DTX cycles were selected for this study. Patients were classified into good-, intermediate-, and poor-risk groups according to the ARC. Prostate-specific antigen (PSA) responses and overall survival (OS) were calculated and compared between the risk groups. A multivariate analysis was performed to clarify the relationship between the ARC and major patient characteristics. Results Seventy-eight CRPC patients met the inclusion criteria. Median PSA levels at DTX initiation was 20 ng/mL. Good-, intermediate-, and poor-risk groups comprised 51 (65%), 17 (22%), and 10 (13%) patients, respectively. PSA response rates ≥30% and ≥50% were 33%, 41%, and 30%, and 18%, 41%, and 20% in the good-, intermediate-, and poor-risk groups, respectivcixely, with no significant differences (p = 0.133 and 0.797, respectively). The median OS in the good-, intermediate-, and poor-risk groups were statistically significant (p < 0.001) at 30.1, 14.2, and 5.7 months, respectively. A multivariate analysis revealed that the ARC and PSA doubling time were independent prognostic factors. Conclusions Most of CRPC patients were classified into good-risk group according to the ARC and the ARC could predict prognosis in DTX-treated CRPC patients. Trial registration University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) number

  10. Reappraisal of risk factors for monoclonal gammopathy of undetermined significance.

    PubMed

    Boursi, Ben; Weiss, Brendan M; Haynes, Kevin; Mamtani, Ronac; Yang, Yu-Xiao

    2016-06-01

    A number of epidemiologic studies have demonstrated associations between obesity and diabetes and the risk of monoclonal gammopathy of undetermined significance (MGUS). However, since MGUS is an asymptomatic condition we evaluated whether these are true associations or the result of detection-bias. We conducted a nested case-control study using a large primary-care database. Cases were defined as those with incident diagnosis of MGUS. For every case, four eligible controls matched on age, sex, practice site, and duration of follow-up were selected. Exposure variables included obesity and diabetes (including antidiabetic therapies) as well as other metabolic risk factors. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using conditional logistic regression. The study included 2363 MGUS patients and 9193 matched controls. In the primary analysis, obesity and diabetes were associated with higher MGUS risk with an adjusted ORs of 1.15 (95% CI 1.02-1.29) and 1.30 (95% CI 1.13-1.50), respectively. However, after adjustment to the number of laboratory tests prior to the MGUS diagnosis, there was no association between obesity and diabetes and MGUS risk (ORs of 1.08, 95% CI 0.96-1.22 and 1.08, 95% CI 0.93-1.25, respectively). In an additional analysis of antidiabetic therapies and MGUS risk, there was a nonsignificant decrease in MGUS risk among diabetes patients treated with metformin alone compared to subjects without diabetes (OR 0.77, 95% CI 0.56-1.05). In summary, while previously described risk factors for MGUS might be the result of detection bias, metformin should be further evaluated as a possible chemoprevention modality. Am. J. Hematol. 91:581-584, 2016. © 2016 Wiley Periodicals, Inc. PMID:26953904

  11. Fracture risk in patients with monoclonal gammopathy of undetermined significance.

    PubMed

    Gregersen, Henrik; Jensen, Paw; Gislum, Mette; Jørgensen, Birgit; Sørensen, Henrik Toft; Nørgaard, Mette

    2006-10-01

    Little information is available on the risk of fractures in patients with monoclonal gammopathy of undetermined significance (MGUS). We identified 1535 patients with MGUS between 1978 and 2003 in North Jutland County, Denmark. The population control group consisted of 15 350 persons selected from the Danish Central Population Registry, matched by age and sex. Data on fractures in the two groups were obtained from the regional Hospital Discharge Registry. In the MGUS cohort, 187 first-time fractures were identified during 9754 person-years of follow-up, corresponding to an incidence rate of 19/1000 person-years. The adjusted relative risk for fractures among MGUS patients compared with population controls was 1.4 [95% confidence interval (CI), 1.2-1.6]. After 5 years of follow-up, the risk difference was 1.8% (95% CI, 0.5-3.0). Six of the 187 MGUS patients with fractures were later diagnosed with malignant transformation. Relative risks for fractures were increased in IgG-type MGUS [1.3 (95% CI,1.1-1.6)], IgM-type MGUS [1.6 (95% CI, 1.1-2.2)] and MGUS with kappa light chain [1.4 (95% CI, 1.1-1.7)]. MGUS patients had an increased risk of fractures, which could not be explained by comorbidity, advanced age, gender or malignant transformation. PMID:16925792

  12. Revealing Significant Relations between Chemical/Biological Features and Activity: Associative Classification Mining for Drug Discovery

    ERIC Educational Resources Information Center

    Yu, Pulan

    2012-01-01

    Classification, clustering and association mining are major tasks of data mining and have been widely used for knowledge discovery. Associative classification mining, the combination of both association rule mining and classification, has emerged as an indispensable way to support decision making and scientific research. In particular, it offers a…

  13. Ecological Significance of a Geomorphic Stream Classification: Species and Functional Group Composition of Riparian Plant Communities

    NASA Astrophysics Data System (ADS)

    Shaw, J. R.; Cooper, D. J.

    2014-12-01

    We tested the ecological significance of a geomorphic classification of Sonoran Desert ephemeral stream channels based on channel plan-form, degree of lateral confinement, and boundary material composition. This typology has been shown to discriminate among channel geometry and hydraulic characteristics for bedrock, bedrock with alluvium, incised alluvium, braided, and piedmont headwater channels. We examined stream reach-scale relationships of geomorphic stream types to the relative cover and density of perennial plant species and functional groups, and identified the dominant fluvial drivers, within riparian communities at 101 ephemeral stream reaches on the U.S. Army Yuma Proving Ground and Barry M. Goldwater Air Force Range in southwestern Arizona, USA. Nonparametric multivariate analysis of variance showed that species and functional group composition differed significantly among geomorphic stream types, both in terms of relative cover and density. Partitioning of among-site multivariate dissimilarity revealed that species compositional differences between stream types were caused largely by variation in the cover and density of the most common members of the regional flora. Distinctive functional group composition among reach types resulted from differences in the cover and density of drought-deciduous shrubs and subshrubs, evergreen trees and shrubs, and photosynthetic-stemmed trees. Comparison of environmental and biotic dissimilarity matrices highlighted the role of channel gradient as the dominant abiotic driver of riparian plant community composition, with stream channel elevation and width:depth providing additional explanatory power. Distinctive riparian plant community composition among the geomorphic stream types demonstrates the ecological significance of this a priori channel classification, and indicates its potential utility in understanding spatial patterns of ecological dynamics, sample stratification for process-based studies, and reference

  14. EPA`s program for risk assessment guidelines: Cancer classification issues

    SciTech Connect

    Wiltse, J.

    1990-12-31

    Issues presented are related to classification of weight of evidence in cancer risk assessments. The focus in this paper is on lines of evidence used in constructing a conclusion about potential human carcinogenicity. The paper also discusses issues that are mistakenly addressed as classification issues but are really part of the risk assessment process. 2 figs.

  15. Genome-wide significant risk associations for mucinous ovarian carcinoma

    PubMed Central

    Kelemen, Linda E.; Lawrenson, Kate; Tyrer, Jonathan; Li, Qiyuan; M. Lee, Janet; Seo, Ji-Heui; Phelan, Catherine M.; Beesley, Jonathan; Chen, Xiaoqin; Spindler, Tassja J.; Aben, Katja K.H.; Anton-Culver, Hoda; Antonenkova, Natalia; Baker, Helen; Bandera, Elisa V.; Bean, Yukie; Beckmann, Matthias W.; Bisogna, Maria; Bjorge, Line; Bogdanova, Natalia; Brinton, Louise A.; Brooks-Wilson, Angela; Bruinsma, Fiona; Butzow, Ralf; Campbell, Ian G.; Carty, Karen; Chang-Claude, Jenny; Chen, Y. Ann; Chen, Zhihua; Cook, Linda S.; Cramer, Daniel W.; Cunningham, Julie M.; Cybulski, Cezary; Dansonka-Mieszkowska, Agnieszka; Dennis, Joe; Dicks, Ed; Doherty, Jennifer A.; Dörk, Thilo; du Bois, Andreas; Dürst, Matthias; Eccles, Diana; Easton, Douglas T.; Edwards, Robert P.; Eilber, Ursula; Ekici, Arif B.; Engelholm, Svend Aage; Fasching, Peter A.; Fridley, Brooke L.; Gao, Yu-Tang; Gentry-Maharaj, Aleksandra; Giles, Graham G.; Glasspool, Rosalind; Goode, Ellen L.; Goodman, Marc T.; Grownwald, Jacek; Harrington, Patricia; Harter, Philipp; Hasmad, Hanis Nazihah; Hein, Alexander; Heitz, Florian; Hildebrandt, Michelle A.T.; Hillemanns, Peter; Hogdall, Estrid; Hogdall, Claus; Hosono, Satoyo; Iversen, Edwin S.; Jakubowska, Anna; Jensen, Allan; Ji, Bu-Tian; Karlan, Beth Y; Kellar, Melissa; Kelley, Joseph L.; Kiemeney, Lambertus A.; Krakstad, Camilla; Kjaer, Susanne K.; Kupryjanczyk, Jolanta; Lambrechts, Diether; Lambrechts, Sandrina; Le, Nhu D.; Lee, Alice W.; Lele, Shashi; Leminen, Arto; Lester, Jenny; Levine, Douglas A.; Liang, Dong; Lissowska, Jolanta; Lu, Karen; Lubinski, Jan; Lundvall, Lene; Massuger, Leon F.A.G.; Matsuo, Keitaro; McGuire, Valerie; McLaughlin, John R.; McNeish, Iain; Menon, Usha; Modugno, Francesmary; Moes-Sosnowska, Joanna; Moysich, Kirsten B.; Narod, Steven A.; Nedergaard, Lotte; Ness, Roberta B.; Nevanlinna, Heli; Azmi, Mat Adenan Noor; Odunsi, Kunle; Olson, Sara H.; Orlow, Irene; Orsulic, Sandra; Weber, Rachel Palmieri; Paul, James; Pearce, Celeste Leigh; Pejovic, Tanja; Pelttari, Liisa M.; Permuth-Wey, Jennifer; Pike, Malcolm C.; Poole, Elizabeth M.; Ramus, Susan J.; Risch, Harvey A.; Rosen, Barry; Rossing, Mary Anne; Rothstein, Joseph H.; Rudolph, Anja; Runnebaum, Ingo B.; Rzepecka, Iwona K.; Salvesen, Helga B.; Schildkraut, Joellen M.; Schwaab, Ira; Shu, Xiao-Ou; Shvetsov, Yurii B; Siddiqui, Nadeem; Sieh, Weiva; Song, Honglin; Southey, Melissa C.; Sucheston, Lara; Tangen, Ingvild L.; Teo, Soo-Hwang; Terry, Kathryn L.; Thompson, Pamela J; Tworoger, Shelley S.; van Altena, Anne M.; Van Nieuwenhuysen, Els; Vergote, Ignace; Vierkant, Robert A.; Wang-Gohrke, Shan; Walsh, Christine; Wentzensen, Nicolas; Whittemore, Alice S.; Wicklund, Kristine G.; Wilkens, Lynne R.; Wlodzimierz, Sawicki; Woo, Yin-Ling; Wu, Xifeng; Wu, Anna H.; Yang, Hannah; Zheng, Wei; Ziogas, Argyrios; Sellers, Thomas A.; Freedman, Matthew L.; Chenevix-Trench, Georgia; Pharoah, Paul D.; Gayther, Simon A.; Berchuck, Andrew

    2015-01-01

    Genome-wide association studies have identified several risk associations for ovarian carcinomas (OC) but not for mucinous ovarian carcinomas (MOC). Genotypes from OC cases and controls were imputed into the 1000 Genomes Project reference panel. Analysis of 1,644 MOC cases and 21,693 controls identified three novel risk associations: rs752590 at 2q13 (P = 3.3 × 10−8), rs711830 at 2q31.1 (P = 7.5 × 10−12) and rs688187 at 19q13.2 (P = 6.8 × 10−13). Expression Quantitative Trait Locus (eQTL) analysis in ovarian and colorectal tumors (which are histologically similar to MOC) identified significant eQTL associations for HOXD9 at 2q31.1 in ovarian (P = 4.95 × 10−4, FDR = 0.003) and colorectal (P = 0.01, FDR = 0.09) tumors, and for PAX8 at 2q13 in colorectal tumors (P = 0.03, FDR = 0.09). Chromosome conformation capture analysis identified interactions between the HOXD9 promoter and risk SNPs at 2q31.1. Overexpressing HOXD9 in MOC cells augmented the neoplastic phenotype. These findings provide the first evidence for MOC susceptibility variants and insights into the underlying biology of the disease. PMID:26075790

  16. Genome-wide significant risk associations for mucinous ovarian carcinoma.

    PubMed

    Kelemen, Linda E; Lawrenson, Kate; Tyrer, Jonathan; Li, Qiyuan; Lee, Janet M; Seo, Ji-Heui; Phelan, Catherine M; Beesley, Jonathan; Chen, Xiaoqing; Spindler, Tassja J; Aben, Katja K H; Anton-Culver, Hoda; Antonenkova, Natalia

    2015-08-01

    Genome-wide association studies have identified several risk associations for ovarian carcinomas but not for mucinous ovarian carcinomas (MOCs). Our analysis of 1,644 MOC cases and 21,693 controls with imputation identified 3 new risk associations: rs752590 at 2q13 (P = 3.3 × 10(-8)), rs711830 at 2q31.1 (P = 7.5 × 10(-12)) and rs688187 at 19q13.2 (P = 6.8 × 10(-13)). We identified significant expression quantitative trait locus (eQTL) associations for HOXD9 at 2q31.1 in ovarian (P = 4.95 × 10(-4), false discovery rate (FDR) = 0.003) and colorectal (P = 0.01, FDR = 0.09) tumors and for PAX8 at 2q13 in colorectal tumors (P = 0.03, FDR = 0.09). Chromosome conformation capture analysis identified interactions between the HOXD9 promoter and risk-associated SNPs at 2q31.1. Overexpressing HOXD9 in MOC cells augmented the neoplastic phenotype. These findings provide the first evidence for MOC susceptibility variants and insights into the underlying biology of the disease. PMID:26075790

  17. Coronary Artery Calcium Score and Risk Classification for Coronary Heart Disease Prediction: The Multi-Ethnic Study of Atherosclerosis

    PubMed Central

    Polonsky, Tamar S.; McClelland, Robyn L.; Jorgensen, Neal W.; Bild, Diane E.; Burke, Gregory L.; Guerci, Alan D.; Greenland, Philip

    2010-01-01

    Context Coronary artery calcium score (CACS) has been shown to predict future coronary heart disease (CHD) events. However, the extent to which adding CACS to traditional CHD risk factors improves classification of risk is unclear. Objective To determine whether adding CACS to a prediction model based on traditional risk factors improves classification of risk. Design, Setting and Participants CACS was measured by computed tomography on 6,814 participants from the Multi-Ethnic Study of Atherosclerosis (MESA), a population-based cohort without known cardiovascular disease. Recruitment spanned July 2000 to September 2002; follow-up extended through May 2008. Participants with diabetes were excluded for the primary analysis. Five-year risk estimates for incident CHD were categorized as 0-<3%, 3-<10%, and ≥10% using Cox proportional hazards models. Model 1 used age, gender, tobacco use, systolic blood pressure, antihypertensive medication use, total and high-density lipoprotein cholesterol, and race/ethnicity. Model 2 used these risk factors plus CACS. We calculated the net reclassification improvement (NRI) and compared the distribution of risk using Model 2 versus Model 1. Main Outcome Measures Incident CHD events Results Over 5.8 years median follow-up, 209 CHD events occurred, of which 122 were myocardial infarction, death from CHD, or resuscitated cardiac arrest. Model 2 resulted in significant improvements in risk prediction compared to Model 1 (NRI=0.25, 95% confidence interval 0.16-0.34, P<0.001). With Model 1, 69% of the cohort was classified in the highest or lowest risk categories, compared to 77% with Model 2. An additional 23% of those who experienced events were reclassified to high risk, and an additional 13% without events were reclassified to low risk using Model 2. Conclusions In the MESA cohort, addition of CACS to a prediction model based on traditional risk factors significantly improved the classification of risk and placed more individuals in

  18. Significance and limitation of the pathological classification of TDP-43 proteinopathy.

    PubMed

    Arai, Tetsuaki

    2014-12-01

    Based on the cerebral tans-activation response DNA protein 43 (TDP-43) immunohistochemistry, frontotemporal lobar degeneration with TDP-43 pathology (FTLD-TDP) is classified into four subtypes: type A has numerous neuronal cytoplasmic inclusions (NCIs) and dystrophic neurites (DNs); type B has numerous NCIs with few DNs; type C is characterized by DNs which are often longer and thicker than DNs in type A, with few NCIs; and type D has numerous neuronal intranuclear inclusions and DNs with few NCIs. The relevance of this classification system is supported by clinical, biochemical and genetic correlations, although there is still significant heterogeneity, especially in cases with type A pathology. The subtypes of TDP-43 pathology should be determined in cases with other neurodegenerative disorders, including Alzheimer's disease and dementia with Lewy bodies, to evaluate the pathological significance of TDP-43 abnormality in them. The results of the biochemical analyses of the diseased brains and the cellular models suggest that different strains of TDP-43 with different conformations may determine the clinicopathological phenotypes of TDP-43 proteinopathy, like prion disease. Clarifying the mechanism of the conformational changes of TDP-43 leading to the formation of multiple abnormal strains may be important for differential diagnosis and developing disease-modifying therapy for TDP-43 proteinopathy. PMID:25196969

  19. How significant is perceived environmental risk to business location decisions?

    SciTech Connect

    Allison, T.; Calzonetti, F.

    1996-12-31

    It has been argued that adverse perceptions of risk associated with high-level nuclear waste (HLNW) facilities will have significant impacts on the attraction of new, and the maintenance of existing business activities in areas in which adverse perceptions develop. We examine this proposition by the considering the importance of environmental amenities and a range of other factors to business location decisions using evidence from surveys of more than 400 manufacturing and business service establishments in Colorado and Utah. We show that the importance of environmental amenities varies according to a number of factors, in particular the type of product (manufactured product or business service), type of establishment (single-establishment firm or establishment of a multilocational firm) and establishment employment size. Policies designed to offset the loss of business activity that might result from adverse risk perceptions associated with HLNW facilities must therefore take into account how sensitive various forms of business activity present or likely to locate in any particular area might be to environmental factors.

  20. A novel integrated cytogenetic and genomic classification refines risk stratification in pediatric acute lymphoblastic leukemia.

    PubMed

    Moorman, Anthony V; Enshaei, Amir; Schwab, Claire; Wade, Rachel; Chilton, Lucy; Elliott, Alannah; Richardson, Stacey; Hancock, Jeremy; Kinsey, Sally E; Mitchell, Christopher D; Goulden, Nicholas; Vora, Ajay; Harrison, Christine J

    2014-08-28

    Recent genomic studies have provided a refined genetic map of acute lymphoblastic leukemia (ALL) and increased the number of potential prognostic markers. Therefore, we integrated copy-number alteration data from the 8 most commonly deleted genes, subordinately, with established chromosomal abnormalities to derive a 2-tier genetic classification. The classification was developed using 809 ALL97/99 patients and validated using 742 United Kingdom (UK)ALL2003 patients. Good-risk (GR) genetic features included ETV6-RUNX1, high hyperdiploidy, normal copy-number status for all 8 genes, isolated deletions affecting ETV6/PAX5/BTG1, and ETV6 deletions with a single additional deletion of BTG1/PAX5/CDKN2A/B. All other genetic features were classified as poor risk (PR). Three-quarters of UKALL2003 patients had a GR genetic profile and a significantly improved event-free survival (EFS) (94%) compared with patients with a PR genetic profile (79%). This difference was driven by a lower relapse rate (4% vs 17%), was seen across all patient subgroups, and was independent of other risk factors. Even genetic GR patients with minimal residual disease (>0.01%) at day 29 had an EFS in excess of 90%. In conclusion, the integration of genomic and cytogenetic data defines 2 subgroups with distinct responses to treatment and identifies a large subset of children suitable for treatment deintensification. PMID:24957142

  1. A hazard and risk classification system for catastrophic rock slope failures in Norway

    NASA Astrophysics Data System (ADS)

    Hermanns, R.; Oppikofer, T.; Anda, E.; Blikra, L. H.; Böhme, M.; Bunkholt, H.; Dahle, H.; Devoli, G.; Eikenæs, O.; Fischer, L.; Harbitz, C. B.; Jaboyedoff, M.; Loew, S.; Yugsi Molina, F. X.

    2012-04-01

    The Geological Survey of Norway carries out systematic geologic mapping of potentially unstable rock slopes in Norway that can cause a catastrophic failure. As catastrophic failure we describe failures that involve substantial fragmentation of the rock mass during run-out and that impact an area larger than that of a rock fall (shadow angle of ca. 28-32° for rock falls). This includes therefore rock slope failures that lead to secondary effects, such as a displacement wave when impacting a water body or damming of a narrow valley. Our systematic mapping revealed more than 280 rock slopes with significant postglacial deformation, which might represent localities of large future rock slope failures. This large number necessitates prioritization of follow-up activities, such as more detailed investigations, periodic monitoring and permanent monitoring and early-warning. In the past hazard and risk were assessed qualitatively for some sites, however, in order to compare sites so that political and financial decisions can be taken, it was necessary to develop a quantitative hazard and risk classification system. A preliminary classification system was presented and discussed with an expert group of Norwegian and international experts and afterwards adapted following their recommendations. This contribution presents the concept of this final hazard and risk classification that should be used in Norway in the upcoming years. Historical experience and possible future rockslide scenarios in Norway indicate that hazard assessment of large rock slope failures must be scenario-based, because intensity of deformation and present displacement rates, as well as the geological structures activated by the sliding rock mass can vary significantly on a given slope. In addition, for each scenario the run-out of the rock mass has to be evaluated. This includes the secondary effects such as generation of displacement waves or landslide damming of valleys with the potential of later

  2. Comparing Sex Offender Risk Classification Using the Static-99 and LSI-R Assessment Instruments

    ERIC Educational Resources Information Center

    Gentry, Amanda L.; Dulmus, Catherine N.; Theriot, Matthew T.

    2005-01-01

    Objective: This study compares sex offender risk classification using two popular actuarial risk assessment instruments--the Static-99 and the Level of Service Inventory-Revised (LSI-R). Despite their extensive use, the two scales assess different types of risk factors and research has yet to compare them. Method: Static-99 and LSI-R risk…

  3. Classification

    ERIC Educational Resources Information Center

    Clary, Renee; Wandersee, James

    2013-01-01

    In this article, Renee Clary and James Wandersee describe the beginnings of "Classification," which lies at the very heart of science and depends upon pattern recognition. Clary and Wandersee approach patterns by first telling the story of the "Linnaean classification system," introduced by Carl Linnacus (1707-1778), who is…

  4. Incorporating Classification Uncertainty in Competing- risks Nest- failure Analysis

    EPA Science Inventory

    Nesting birds risk nest failure due to many causes. Though partitioning risk of failure among causes has long been of interest to ornithologists, formal methods for estimating competing risk have been lacking.

  5. Effect of Wound Classification on Risk-Adjustment in American College of Surgeons NSQIP

    PubMed Central

    Ju, Mila H.; Cohen, Mark E.; Bilimoria, Karl Y.; Latus, Melissa S.; Scholl, Lisa M.; Schwab, Bradley J.; Byrd, Claudia M.; Ko, Clifford Y.; Dellinger, E. Patchen; Hall, Bruce L.

    2014-01-01

    Background Surgical wound classification has been used in risk-adjustment models. However, it can be subjective and potentially improperly bias hospital quality comparisons. The objective is to examine the effect of wound classification on hospital performance risk-adjustment models. Study Design Retrospective review of the 2011 ACS NSQIP database was conducted for wound classification categories: clean, clean/contaminated, contaminated, and dirty/infected. To assess the influence of wound classification on risk-adjustment, two models were developed for each outcome: one including and one excluding wound classification. For each model, hospital postoperative complications were estimated using hierarchical multivariable regression methods. Absolute changes in hospital rank, correlations of odds-ratios, and outlier status agreement between models were examined. Results Of the 442,149 cases performed in 315 hospitals: 53.6% were classified as clean; 34.2% clean/contaminated; 6.7% contaminated; and 5.5% dirty/infected. The surgical site infection (SSI) rate was highest in dirty/infected (8.5%) and lowest in clean (1.8%) cases. For overall SSI, the absolute change in risk-adjusted hospital performance rank between models including vs. excluding wound classification was minimal (mean 4.5 out of 315 positions). The correlations between odds ratios of the two performance models were nearly perfect (R=0.9976, P<0.0001), and outlier status agreement was excellent (Kappa=0.9508, P<0.0001). Similar findings were observed in models of subgroups of SSI and other postoperative outcomes. Conclusions In circumstances where alternate information is available for risk-adjustment, there appear to be minimal differences in performance models that include vs. exclude wound classification. Therefore, ACS NSQIP is critically evaluating the continued use of wound classification in hospital performance risk-adjustment models. PMID:25053222

  6. THE USE OF GEOMORPHOLOGICAL CLASSIFICATION FOR RISK MANAGEMENT OF STREAMS

    EPA Science Inventory

    Changes in the amount and types of land use in a watershed can destabilize stream channel structure, increase sediment loading and degrade in-stream habitat. Stream classification systems (e.g., Rosgen) may be useful for determining the susceptibility of stream channel segments t...

  7. The large-scale landslide risk classification in catchment scale

    NASA Astrophysics Data System (ADS)

    Liu, Che-Hsin; Wu, Tingyeh; Chen, Lien-Kuang; Lin, Sheng-Chi

    2013-04-01

    The landslide disasters caused heavy casualties during Typhoon Morakot, 2009. This disaster is defined as largescale landslide due to the casualty numbers. This event also reflects the survey on large-scale landslide potential is so far insufficient and significant. The large-scale landslide potential analysis provides information about where should be focused on even though it is very difficult to distinguish. Accordingly, the authors intend to investigate the methods used by different countries, such as Hong Kong, Italy, Japan and Switzerland to clarify the assessment methodology. The objects include the place with susceptibility of rock slide and dip slope and the major landslide areas defined from historical records. Three different levels of scales are confirmed necessarily from country to slopeland, which are basin, catchment, and slope scales. Totally ten spots were classified with high large-scale landslide potential in the basin scale. The authors therefore focused on the catchment scale and employ risk matrix to classify the potential in this paper. The protected objects and large-scale landslide susceptibility ratio are two main indexes to classify the large-scale landslide risk. The protected objects are the constructions and transportation facilities. The large-scale landslide susceptibility ratio is based on the data of major landslide area and dip slope and rock slide areas. Totally 1,040 catchments are concerned and are classified into three levels, which are high, medium, and low levels. The proportions of high, medium, and low levels are 11%, 51%, and 38%, individually. This result represents the catchments with high proportion of protected objects or large-scale landslide susceptibility. The conclusion is made and it be the base material for the slopeland authorities when considering slopeland management and the further investigation.

  8. The false classification of extinction risk in noisy environments

    PubMed Central

    Connors, B. M.; Cooper, A. B.; Peterman, R. M.; Dulvy, N. K.

    2014-01-01

    Abundance trends are the basis for many classifications of threat and recovery status, but they can be a challenge to interpret because of observation error, stochastic variation in abundance (process noise) and temporal autocorrelation in that process noise. To measure the frequency of incorrectly detecting a decline (false-positive or false alarm) and failing to detect a true decline (false-negative), we simulated stable and declining abundance time series across several magnitudes of observation error and autocorrelated process noise. We then empirically estimated the magnitude of observation error and autocorrelated process noise across a broad range of taxa and mapped these estimates onto the simulated parameter space. Based on the taxa we examined, at low classification thresholds (30% decline in abundance) and short observation windows (10 years), false alarms would be expected to occur, on average, about 40% of the time assuming density-independent dynamics, whereas false-negatives would be expected to occur about 60% of the time. However, false alarms and failures to detect true declines were reduced at higher classification thresholds (50% or 80% declines), longer observation windows (20, 40, 60 years), and assuming density-dependent dynamics. The lowest false-positive and false-negative rates are likely to occur for large-bodied, long-lived animal species. PMID:24898368

  9. Constructing access in predictive medicine. Comparing classification for hereditary breast cancer risks in England, Germany and the Netherlands.

    PubMed

    Aarden, Erik; Van Hoyweghen, Ine; Horstman, Klasien

    2011-02-01

    In the first decade of the twenty-first century, predictive forms of medicine, largely associated with genetics, have become increasingly prominent. This has given rise to questions about the social consequences of this development, for example with regard to the distribution of health care access. Drawing on qualitative interviews with clinic staff and public officials and on document analyses, we analyse how access to risk assessment and monitoring for hereditary breast cancer predispositions in Germany, the Netherlands and England is produced through the interaction of risk classification and health care organisation. For each of the three countries, we show how particular combinations of genetic testing and family history data, classification of risks and allocation of monitoring services in practice contribute to specific forms of inclusion and exclusion. Thus, we show how risk assessment and monitoring in Germany attributes a large role to genetic testing; how family history information plays a large role in the Netherlands; and how regional differences in health care have a significant influence in England. On the basis of our case study, we argue that health care organisation is an important facet of the allocation of health care access, as it plays an important role in mediating the influence of risk assessment technologies and risk categories in health care access. We conclude that the allocation of risk assessment and monitoring in predictive medicine deserve more extensive political attention. PMID:21208700

  10. Credit Risk Evaluation Using a C-Variable Least Squares Support Vector Classification Model

    NASA Astrophysics Data System (ADS)

    Yu, Lean; Wang, Shouyang; Lai, K. K.

    Credit risk evaluation is one of the most important issues in financial risk management. In this paper, a C-variable least squares support vector classification (C-VLSSVC) model is proposed for credit risk analysis. The main idea of this model is based on the prior knowledge that different classes may have different importance for modeling and more weights should be given to those classes with more importance. The C-VLSSVC model can be constructed by a simple modification of the regularization parameter in LSSVC, whereby more weights are given to the lease squares classification errors with important classes than the lease squares classification errors with unimportant classes while keeping the regularized terms in its original form. For illustration purpose, a real-world credit dataset is used to test the effectiveness of the C-VLSSVC model.

  11. The ecology of prominences. [classification, morphology and significance to solar physics

    NASA Technical Reports Server (NTRS)

    Zirin, H.

    1979-01-01

    The paper discusses the roles of prominences in the solar scheme. Attention is given to classifications and the ways in which prominences exist: hydrostatic support, ballistic support, and magnetic support. In the case of ballistic support, surges are differentiated from sprays which involve the ejection of material that is already above the solar surface. Discussion also covers filimets and fibrils and the conditions for their appearance. It is proposed that most flares originate in prominence instabilities. In addition supergranulation is covered, noting the network is not seen on the boundary of unipolar regions. It is concluded that prominences play a critical role in flares and field reconnection, and the evolution of solar magnetic fields.

  12. Significance of rat mammary tumors for human risk assessment.

    PubMed

    Russo, Jose

    2015-02-01

    We have previously indicated that the ideal animal tumor model should mimic the human disease. This means that the investigator should be able to ascertain the influence of host factors on the initiation of tumorigenesis, mimic the susceptibility of tumor response based on age and reproductive history, and determine the response of the tumors induced to chemotherapy. The utilization of experimental models of mammary carcinogenesis in risk assessment requires that the influence of ovarian, pituitary, and placental hormones, among others, as well as overall reproductive events are taken into consideration, since they are important modifiers of the susceptibility of the organ to neoplastic development. Several species, such as rodents, dogs, cats, and monkeys, have been evaluated for these purposes; however, none of them fulfills all the criteria specified previously. Rodents, however, are the most widely used models; therefore, this work will concentrate on discussing the rat rodent model of mammary carcinogenesis. PMID:25714400

  13. A TEST OF WATERSHED CLASSIFICATION SYSTEMS FOR ECOLOGICAL RISK ASSESSMENT

    EPA Science Inventory

    To facilitate extrapolation among watersheds, ecological risk assessments should be based on a model of underlying factors influencing watershed response, particularly vulnerability. We propose a conceptual model of landscape vulnerability to serve as a basis for watershed classi...

  14. Identification of a 24-Gene Prognostic Signature That Improves the European LeukemiaNet Risk Classification of Acute Myeloid Leukemia: An International Collaborative Study

    PubMed Central

    Li, Zejuan; Herold, Tobias; He, Chunjiang; Valk, Peter J.M.; Chen, Ping; Jurinovic, Vindi; Mansmann, Ulrich; Radmacher, Michael D.; Maharry, Kati S.; Sun, Miao; Yang, Xinan; Huang, Hao; Jiang, Xi; Sauerland, Maria-Cristina; Büchner, Thomas; Hiddemann, Wolfgang; Elkahloun, Abdel; Neilly, Mary Beth; Zhang, Yanming; Larson, Richard A.; Le Beau, Michelle M.; Caligiuri, Michael A.; Döhner, Konstanze; Bullinger, Lars; Liu, Paul P.; Delwel, Ruud; Marcucci, Guido; Lowenberg, Bob; Bloomfield, Clara D.; Rowley, Janet D.; Bohlander, Stefan K.; Chen, Jianjun

    2013-01-01

    Purpose To identify a robust prognostic gene expression signature as an independent predictor of survival of patients with acute myeloid leukemia (AML) and use it to improve established risk classification. Patients and Methods Four independent sets totaling 499 patients with AML carrying various cytogenetic and molecular abnormalities were used as training sets. Two independent patient sets composed of 825 patients were used as validation sets. Notably, patients from different sets were treated with different protocols, and their gene expression profiles were derived using different microarray platforms. Cox regression and Kaplan-Meier methods were used for survival analyses. Results A prognostic signature composed of 24 genes was derived from a meta-analysis of Cox regression values of each gene across the four training sets. In multivariable models, a higher sum value of the 24-gene signature was an independent predictor of shorter overall (OS) and event-free survival (EFS) in both training and validation sets (P < .01). Moreover, this signature could substantially improve the European LeukemiaNet (ELN) risk classification of AML, and patients in three new risk groups classified by the integrated risk classification showed significantly (P < .001) distinct OS and EFS. Conclusion Despite different treatment protocols applied to patients and use of different microarray platforms for expression profiling, a common prognostic gene signature was identified as an independent predictor of survival of patients with AML. The integrated risk classification incorporating this gene signature provides a better framework for risk stratification and outcome prediction than the ELN classification. PMID:23382473

  15. Counterfeit phosphodiesterase type 5 inhibitors pose significant safety risks

    PubMed Central

    Jackson, G; Arver, S; Banks, I; Stecher, V J

    2010-01-01

    Counterfeit drugs are inherently dangerous and a growing problem; counterfeiters are becoming increasingly sophisticated. Growth of the counterfeit medication market is attributable in part to phosphodiesterase type 5 inhibitor (PDE5i) medications for erectile dysfunction (ED). Millions of counterfeit PDE5is are seized yearly and account for the bulk of all counterfeit pharmaceutical product seizures. It has been estimated that up to 2.5 million men in Europe are exposed to illicit sildenafil, suggesting that there may be as many illegal as legal users of sildenafil. Analysis of the contents of counterfeit PDE5is shows inconsistent doses of active pharmaceutical ingredients (from 0% to > 200% of labelled dose), contaminants (including talcum powder, commercial paint and printer ink) and alternative ingredients that are potentially hazardous. In one analysis, only 10.1% of samples were within 10% of the labelled tablet strength. Estimates place the proportion of counterfeit medications sold over the Internet from 44% to 90%. Of men who purchase prescription-only medication for ED without a prescription, 67% do so using the Internet. Counterfeit PDE5is pose direct and indirect risks to health, including circumvention of the healthcare system. More than 30% of men reported no healthcare interaction when purchasing ED medications. Because > 65% actually had ED, these men missed an opportunity for evaluation of comorbidities (e.g. diabetes and hypertension). Globally, increased obstacles for counterfeiters are necessary to combat pharmaceutical counterfeiting, including fines and penalties. The worldwide nature of the counterfeit problem requires proper coordination between countries to ensure adequate enforcement. Locally, physicians who treat ED need to inform patients of the dangers of ordering PDE5is via the Internet. PMID:20088883

  16. Counterfeit phosphodiesterase type 5 inhibitors pose significant safety risks.

    PubMed

    Jackson, G; Arver, S; Banks, I; Stecher, V J

    2010-03-01

    Counterfeit drugs are inherently dangerous and a growing problem; counterfeiters are becoming increasingly sophisticated. Growth of the counterfeit medication market is attributable in part to phosphodiesterase type 5 inhibitor (PDE5i) medications for erectile dysfunction (ED). Millions of counterfeit PDE5is are seized yearly and account for the bulk of all counterfeit pharmaceutical product seizures. It has been estimated that up to 2.5 million men in Europe are exposed to illicit sildenafil, suggesting that there may be as many illegal as legal users of sildenafil. Analysis of the contents of counterfeit PDE5is shows inconsistent doses of active pharmaceutical ingredients (from 0% to > 200% of labelled dose), contaminants (including talcum powder, commercial paint and printer ink) and alternative ingredients that are potentially hazardous. In one analysis, only 10.1% of samples were within 10% of the labelled tablet strength. Estimates place the proportion of counterfeit medications sold over the Internet from 44% to 90%. Of men who purchase prescription-only medication for ED without a prescription, 67% do so using the Internet. Counterfeit PDE5is pose direct and indirect risks to health, including circumvention of the healthcare system. More than 30% of men reported no healthcare interaction when purchasing ED medications. Because > 65% actually had ED, these men missed an opportunity for evaluation of comorbidities (e.g. diabetes and hypertension). Globally, increased obstacles for counterfeiters are necessary to combat pharmaceutical counterfeiting, including fines and penalties. The worldwide nature of the counterfeit problem requires proper coordination between countries to ensure adequate enforcement. Locally, physicians who treat ED need to inform patients of the dangers of ordering PDE5is via the Internet. PMID:20088883

  17. Classification

    NASA Astrophysics Data System (ADS)

    Oza, Nikunj

    2012-03-01

    A supervised learning task involves constructing a mapping from input data (normally described by several features) to the appropriate outputs. A set of training examples— examples with known output values—is used by a learning algorithm to generate a model. This model is intended to approximate the mapping between the inputs and outputs. This model can be used to generate predicted outputs for inputs that have not been seen before. Within supervised learning, one type of task is a classification learning task, in which each output is one or more classes to which the input belongs. For example, we may have data consisting of observations of sunspots. In a classification learning task, our goal may be to learn to classify sunspots into one of several types. Each example may correspond to one candidate sunspot with various measurements or just an image. A learning algorithm would use the supplied examples to generate a model that approximates the mapping between each supplied set of measurements and the type of sunspot. This model can then be used to classify previously unseen sunspots based on the candidate’s measurements. The generalization performance of a learned model (how closely the target outputs and the model’s predicted outputs agree for patterns that have not been presented to the learning algorithm) would provide an indication of how well the model has learned the desired mapping. More formally, a classification learning algorithm L takes a training set T as its input. The training set consists of |T| examples or instances. It is assumed that there is a probability distribution D from which all training examples are drawn independently—that is, all the training examples are independently and identically distributed (i.i.d.). The ith training example is of the form (x_i, y_i), where x_i is a vector of values of several features and y_i represents the class to be predicted.* In the sunspot classification example given above, each training example

  18. Classification, Identification, and Clinical Significance of Haemophilus and Aggregatibacter Species with Host Specificity for Humans

    PubMed Central

    2014-01-01

    SUMMARY The aim of this review is to provide a comprehensive update on the current classification and identification of Haemophilus and Aggregatibacter species with exclusive or predominant host specificity for humans. Haemophilus influenzae and some of the other Haemophilus species are commonly encountered in the clinical microbiology laboratory and demonstrate a wide range of pathogenicity, from life-threatening invasive disease to respiratory infections to a nonpathogenic, commensal lifestyle. New species of Haemophilus have been described (Haemophilus pittmaniae and Haemophilus sputorum), and the new genus Aggregatibacter was created to accommodate some former Haemophilus and Actinobacillus species (Aggregatibacter aphrophilus, Aggregatibacter segnis, and Aggregatibacter actinomycetemcomitans). Aggregatibacter species are now a dominant etiology of infective endocarditis caused by fastidious organisms (HACEK endocarditis), and A. aphrophilus has emerged as an important cause of brain abscesses. Correct identification of Haemophilus and Aggregatibacter species based on phenotypic characterization can be challenging. It has become clear that 15 to 20% of presumptive H. influenzae isolates from the respiratory tracts of healthy individuals do not belong to this species but represent nonhemolytic variants of Haemophilus haemolyticus. Due to the limited pathogenicity of H. haemolyticus, the proportion of misidentified strains may be lower in clinical samples, but even among invasive strains, a misidentification rate of 0.5 to 2% can be found. Several methods have been investigated for differentiation of H. influenzae from its less pathogenic relatives, but a simple method for reliable discrimination is not available. With the implementation of identification by matrix-assisted laser desorption ionization–time of flight mass spectrometry, the more rarely encountered species of Haemophilus and Aggregatibacter will increasingly be identified in clinical microbiology

  19. Classification

    NASA Technical Reports Server (NTRS)

    Oza, Nikunj C.

    2011-01-01

    A supervised learning task involves constructing a mapping from input data (normally described by several features) to the appropriate outputs. Within supervised learning, one type of task is a classification learning task, in which each output is one or more classes to which the input belongs. In supervised learning, a set of training examples---examples with known output values---is used by a learning algorithm to generate a model. This model is intended to approximate the mapping between the inputs and outputs. This model can be used to generate predicted outputs for inputs that have not been seen before. For example, we may have data consisting of observations of sunspots. In a classification learning task, our goal may be to learn to classify sunspots into one of several types. Each example may correspond to one candidate sunspot with various measurements or just an image. A learning algorithm would use the supplied examples to generate a model that approximates the mapping between each supplied set of measurements and the type of sunspot. This model can then be used to classify previously unseen sunspots based on the candidate's measurements. This chapter discusses methods to perform machine learning, with examples involving astronomy.

  20. Analytic estimation of statistical significance maps for support vector machine based multi-variate image analysis and classification

    PubMed Central

    Gaonkar, Bilwaj; Davatzikos, Christos

    2013-01-01

    Multivariate pattern analysis (MVPA) methods such as support vector machines (SVMs) have been increasingly applied to fMRI and sMRI analyses, enabling the detection of distinctive imaging patterns. However, identifying brain regions that significantly contribute to the classification/group separation requires computationally expensive permutation testing. In this paper we show that the results of SVM-permutation testing can be analytically approximated. This approximation leads to more than a thousand fold speed up of the permutation testing procedure, thereby rendering it feasible to perform such tests on standard computers. The speed up achieved makes SVM based group difference analysis competitive with standard univariate group difference analysis methods. PMID:23583748

  1. Classification of debtor credit status and determination amount of credit risk by using linier discriminant function

    NASA Astrophysics Data System (ADS)

    Aidi, Muhammad Nur; Sari, Resty Indah

    2012-05-01

    A decision of credit that given by bank or another creditur must have a risk and it called credit risk. Credit risk is an investor's risk of loss arising from a borrower who does not make payments as promised. The substantial of credit risk can lead to losses for the banks and the debtor. To minimize this problem need a further study to identify a potential new customer before the decision given. Identification of debtor can using various approaches analysis, one of them is by using discriminant analysis. Discriminant analysis in this study are used to classify whether belonging to the debtor's good credit or bad credit. The result of this study are two discriminant functions that can identify new debtor. Before step built the discriminant function, selection of explanatory variables should be done. Purpose of selection independent variable is to choose the variable that can discriminate the group maximally. Selection variables in this study using different test, for categoric variable selection of variable using proportion chi-square test, and stepwise discriminant for numeric variable. The result of this study are two discriminant functions that can identify new debtor. The selected variables that can discriminating two groups of debtor maximally are status of existing checking account, credit history, credit amount, installment rate in percentage of disposable income, sex, age in year, other installment plans, and number of people being liable to provide maintenance. This classification produce a classification accuracy rate is good enough, that is equal to 74,70%. Debtor classification using discriminant analysis has risk level that is small enough, and it ranged beetwen 14,992% and 17,608%. Based on that credit risk rate, using discriminant analysis on the classification of credit status can be used effectively.

  2. Toxic chemical hazard classification and risk acceptance guidelines for use in DOE facilities. Revision 2

    SciTech Connect

    Craig, D.K.; Davis, J.S.; Prowse, J.; Hoffman, P.W.

    1995-03-24

    The concentration-limit guidelines presented in this document apply to airborne releases of chemicals evaluated with respect to human health effects for the purposes of hazard classification and categorization, risk assessment and safety analysis. They apply to all DOE facilities and operations involving the use of potentially hazardous chemicals. The guidelines do not address other nonradiological hazards such as fire, pressure releases (including explosions), and chemical reactivity, but the guidelines are applicable to hazardous chemical releases resulting from these events. This report presents the subcommittee`s evaluation and recommendations regarding analyses of accidentally released toxic chemicals. The premise upon which these recommendations are based is that the mechanism of action of toxic chemicals is fundamentally different from that associated with radionuclides, with the exception of carcinogens. The recommendations reported herein are restricted to the airborne pathway because in an accident scenario this typically represents the most immediately significant route of public exposure. However, the subcommittee recognizes that exposure to chemicals through other pathways, in particular waterborne, can have significant impacts on human health and the environment. Although there are a number of chemicals for which absorption through the skin can contribute measurably to the total dose in chronic (e.g., occupational) exposure situations, this pathway has not been considered for the acute exposure scenarios considered in this report. Later studies. will address these issues if it appears desirable.

  3. Pharmacology of Ultrasonic Vocalizations in adult Rats: Significance, Call Classification and Neural Substrate

    PubMed Central

    Brudzynski, Stefan M.

    2015-01-01

    Pharmacological studies of emotional arousal and initiation of emotional states in rats measured by their ultrasonic vocalizations are reviewed. It is postulated that emission of vocalizations is an inseparable feature of emotional states and it evolved from mother-infant interaction. Positive emotional states are associated with emission of 50 kHz vocalizations that could be induced by rewarding situations and dopaminergic activation of the nucleus accumbens and are mediated by D1, D2, and partially D3 dopamine receptors. Three biologically significant subtypes of 50 kHz vocalizations have been identified, all expressing positive emotional states: (1) flat calls without frequency modulation that serve as contact calls during social interactions; (2) frequencymodulated calls without trills that signal rewarding and significantly motivated situation; and (3) frequency-modulated calls with trills or trills themselves that are emitted in highly emotional situations associated with intensive affective state. Negative emotional states are associated with emission of 22 kHz vocalizations that could be induced by aversive situations, muscarinic cholinergic activation of limbic areas of medial diencephalon and forebrain, and are mediated by M2 muscarinic receptors. Two biologically significant subtypes of 22 kHz vocalizations have been identified, both expressing negative emotional sates: (1) long calls that serve as alarm calls and signal external danger; and (2) short calls that express a state of discomfort without external danger. The positive and negative states with emission of vocalizations are initiated by two ascending reticular activating subsystems: the mesolimbic dopaminergic subsystem as a specific positive arousal system, and the mesolimbic cholinergic subsystem as a specific negative arousal system. PMID:26411761

  4. Differential Risk of Injury in Child Occupants by Passenger Car Classification

    PubMed Central

    Kallan, Michael J.; Durbin, Dennis R.; Elliott, Michael R.; Menon, Rajiv A.; Winston, Flaura K.

    2003-01-01

    In the United States, passenger cars are the most common passenger vehicle, yet they vary widely in size and crashworthiness. Using data collected from a population-based sample of crashes in State Farm-insured vehicles, we quantified the risk of injury to child occupants by passenger car size and classification. Injury risk is predicted by vehicle weight; however, there is an increased risk in both Large vs. Luxury and Sports vs. Small cars, despite similar average vehicle weights in both comparisons. Parents who are purchasing passenger cars should strongly consider the size of the vehicle and its crashworthiness. PMID:12941234

  5. Differential risk of injury in child occupants by passenger car classification.

    PubMed

    Kallan, Michael J; Durbin, Dennis R; Elliott, Michael R; Menon, Rajiv A; Winston, Flaura K

    2003-01-01

    In the United States, passenger cars are the most common passenger vehicle, yet they vary widely in size and crashworthiness. Using data collected from a population-based sample of crashes in State Farm-insured vehicles, we quantified the risk of injury to child occupants by passenger car size and classification. Injury risk is predicted by vehicle weight; however, there is an increased risk in both Large vs. Luxury and Sports vs. Small cars, despite similar average vehicle weights in both comparisons. Parents who are purchasing passenger cars should strongly consider the size of the vehicle and its crashworthiness. PMID:12941234

  6. Chronic inflammation of the placenta: definition, classification, pathogenesis, and clinical significance.

    PubMed

    Kim, Chong Jai; Romero, Roberto; Chaemsaithong, Piya; Kim, Jung-Sun

    2015-10-01

    Chronic inflammatory lesions of the placenta are characterized by the infiltration of the organ by lymphocytes, plasma cells, and/or macrophages and may result from infections (viral, bacterial, parasitic) or be of immune origin (maternal anti-fetal rejection). The 3 major lesions are villitis (when the inflammatory process affects the villous tree), chronic chorioamnionitis (which affects the chorioamniotic membranes), and chronic deciduitis (which involves the decidua basalis). Maternal cellular infiltration is a common feature of the lesions. Villitis of unknown etiology (VUE) is a destructive villous inflammatory lesion that is characterized by the infiltration of maternal T cells (CD8+ cytotoxic T cells) into chorionic villi. Migration of maternal T cells into the villi is driven by the production of T-cell chemokines in the affected villi. Activation of macrophages in the villi has been implicated in the destruction of the villous architecture. VUE has been reported in association with preterm and term fetal growth restriction, preeclampsia, fetal death, and preterm labor. Infants whose placentas have VUE are at risk for death and abnormal neurodevelopmental outcome at the age of 2 years. Chronic chorioamnionitis is the most common lesion in late spontaneous preterm birth and is characterized by the infiltration of maternal CD8+ T cells into the chorioamniotic membranes. These cytotoxic T cells can induce trophoblast apoptosis and damage the fetal membranes. The lesion frequently is accompanied by VUE. Chronic deciduitis consists of the presence of lymphocytes or plasma cells in the basal plate of the placenta. This lesion is more common in pregnancies that result from egg donation and has been reported in a subset of patients with premature labor. Chronic placental inflammatory lesions can be due to maternal anti-fetal rejection, a process associated with the development of a novel form of fetal systemic inflammatory response. The syndrome is characterized

  7. Classification System for Identifying Women at Risk for Altered Partial Breast Irradiation Recommendations After Breast Magnetic Resonance Imaging

    SciTech Connect

    Kowalchik, Kristin V.; Vallow, Laura A.; McDonough, Michelle; Thomas, Colleen S.; Heckman, Michael G.; Peterson, Jennifer L.; Adkisson, Cameron D.; Serago, Christopher; McLaughlin, Sarah A.

    2013-09-01

    Purpose: To study the utility of preoperative breast MRI for partial breast irradiation (PBI) patient selection, using multivariable analysis of significant risk factors to create a classification rule. Methods and Materials: Between 2002 and 2009, 712 women with newly diagnosed breast cancer underwent preoperative bilateral breast MRI at Mayo Clinic Florida. Of this cohort, 566 were retrospectively deemed eligible for PBI according to the National Surgical Adjuvant Breast and Bowel Project Protocol B-39 inclusion criteria using physical examination, mammogram, and/or ultrasound. Magnetic resonance images were then reviewed to determine their impact on patient eligibility. The patient and tumor characteristics were evaluated to determine risk factors for altered PBI eligibility after MRI and to create a classification rule. Results: Of the 566 patients initially eligible for PBI, 141 (25%) were found ineligible because of pathologically proven MRI findings. Magnetic resonance imaging detected additional ipsilateral breast cancer in 118 (21%). Of these, 62 (11%) had more extensive disease than originally noted before MRI, and 64 (11%) had multicentric disease. Contralateral breast cancer was detected in 28 (5%). Four characteristics were found to be significantly associated with PBI ineligibility after MRI on multivariable analysis: premenopausal status (P=.021), detection by palpation (P<.001), first-degree relative with a history of breast cancer (P=.033), and lobular histology (P=.002). Risk factors were assigned a score of 0-2. The risk of altered PBI eligibility from MRI based on number of risk factors was 0:18%; 1:22%; 2:42%; 3:65%. Conclusions: Preoperative bilateral breast MRI altered the PBI recommendations for 25% of women. Women who may undergo PBI should be considered for breast MRI, especially those with lobular histology or with 2 or more of the following risk factors: premenopausal, detection by palpation, and first-degree relative with a history of

  8. Biological meaning, statistical significance, and classification of local spatial similarities in nonhomologous proteins.

    PubMed Central

    Alexandrov, N. N.; Go, N.

    1994-01-01

    We have completed an exhaustive search for the common spatial arrangements of backbone fragments (SARFs) in nonhomologous proteins. This type of local structural similarity, incorporating short fragments of backbone atoms, arranged not necessarily in the same order along the polypeptide chain, appears to be important for protein function and stability. To estimate the statistical significance of the similarities, we have introduced a similarity score. We present several locally similar structures, with a large similarity score, which have not yet been reported. On the basis of the results of pairwise comparison, we have performed hierarchical cluster analysis of protein structures. Our analysis is not limited by comparison of single chains but also includes complex molecules consisting of several subunits. The SARFs with backbone fragments from different polypeptide chains provide a stable interaction between subunits in protein molecules. In many cases the active site of enzyme is located at the same position relative to the common SARFs, implying a function of the certain SARFs as a universal interface of the protein-substrate interaction. PMID:8069217

  9. Suicide Risk Assessments: Which Suicide Risk Factors Psychiatric Residents Consider Significant?

    PubMed Central

    Wang, Sheng-Min; Hwang, Sunyoung; Yeon, Bora; Choi, Kyoung Ho; Oh, Youngmin; Lee, Hae-Kook; Kweon, Yong-Sil; Lee, Chung Tai

    2015-01-01

    Objective Patients visiting the emergency department (ED) after a suicide attempt are generally assessed for suicide risk by psychiatric residents. Psychiatric residents' competence in evaluating the risk posed by the patients who attempted suicide is critical to preventing suicide. Methods We investigated factors considered important by psychiatric residents when evaluating suicide risk. This study included 140 patients admitted to the ED after attempting suicide. Psychiatric residents rated patients' severity of current and future suicide risk as low/moderate/high using the Brief Emergency Room Suicide Risk Assessment (BESRA). The association between each BESRA variable and level of suicide risk was analyzed. Results Many factors were commonly considered important in evaluating the severity of current and future suicide risk. However, the following factors were only associated with future suicide risk: female gender, having no religion, family psychiatric history, history of axis I disorders, having a will, harboring no regrets, and social isolation. Conclusion Psychiatric residents use diverse factors when assessing suicide risk. Psychiatric residents might put more emphasis on non-modifiable demographic and clinical factors, concrete evidence showing suicide determination, and social isolation to assess the risk of future suicide. PMID:26207124

  10. Dimension Reduction via Unsupervised Learning Yields Significant Computational Improvements for Support Vector Machine Based Protein Family Classification.

    SciTech Connect

    Webb-Robertson, Bobbie-Jo M.; Matzke, Melissa M.; Oehmen, Christopher S.

    2009-02-26

    Reducing the dimension of vectors used in training support vector machines (SVMs) results in a proportional speedup in training time. For large-scale problems this can make the difference between tractable and intractable training tasks. However, it is critical that classifiers trained on reduced datasets perform as reliably as their counterparts trained on high-dimensional data. We assessed principal component analysis (PCA) and sequential project pursuit (SPP) as dimension reduction strategies in the biology application of classifying proteins into well-defined functional ‘families’ (SVM-based protein family classification) by their impact on run-time, sensitivity and selectivity. Homology vectors of 4352 elements were reduced to approximately 2% of the original data size without significantly affecting accuracy using PCA and SPP, while leading to approximately a 28-fold speedup in run-time.

  11. Analysis of outcome following robotic assisted radical prostatectomy for patients with high risk prostate cancer as per D’Amico classification

    PubMed Central

    Gupta, Narmada Prasad; Murugesan, Anandan; Kumar, Anand; Yadav, Rajiv

    2016-01-01

    Introduction: Prognosis of prostate cancer depends on the risk stratification. D’Amico classification, the most commonly used risk stratification method is based on three factors, i.e., prostate specific antigen (PSA), Gleason grade and clinical stage. The impact of presence of multiple risk factors on prognosis after radical prostatectomy has not been studied in Indian patients. We analyzed the outcome of patients with high-risk disease undergoing robotic-assisted radical prostatectomy (RARP), as per D’Amico classification. Materials and Methods: Our study is a review of the data of all patients with high-risk prostate cancer who underwent RARP between July 2010 and January 2015. Preoperative, perioperative and outcome data were analyzed for patients with high-risk disease as per D’Amico classification. Results: Of 227 patients who underwent RARP, 90 (39.6%) were in the high-risk group. PSA > 20 ng/ml was the most common risk factor, present in 50 (55.6%) patients. All three risk factors were present in 3 patients, and single risk factor was present in 65 patients. Nine (10%) patients had lymphnode involvement, 18 (20%) had positive margin, and 38 (41.1%) had extraprostatic extension (EPE). Among these adverse outcomes, only EPE showed significant association with multiplicity of risk factors. At 12 months, 27.8% had biochemical recurrence (BCR). 92% of patients were continent at 12 months. Conclusion: About 92% of patients with high-risk disease were continent at 12 months, whereas less than one-third of the patients had BCR. EPE was the only outcome associated with multiplicity of risk factors. Adjuvant treatment is not required in two-thirds of patients. PMID:27127353

  12. Invasive endocervical adenocarcinoma: proposal for a new pattern-based classification system with significant clinical implications: a multi-institutional study.

    PubMed

    Diaz De Vivar, Andrea; Roma, Andres A; Park, Kay J; Alvarado-Cabrero, Isabel; Rasty, Golnar; Chanona-Vilchis, Jose G; Mikami, Yoshiki; Hong, Sung R; Arville, Brent; Teramoto, Norihiro; Ali-Fehmi, Rouba; Rutgers, Joanne K L; Tabassum, Farah; Barbuto, Denise; Aguilera-Barrantes, Irene; Shaye-Brown, Alexandra; Daya, Dean; Silva, Elvio G

    2013-11-01

    The management of endocervical adenocarcinoma is largely based on tumor size and depth of invasion (DOI); however, DOI is difficult to measure accurately. The surgical treatment includes resection of regional lymph nodes, even though most lymph nodes are negative and lymphadenectomies can cause significant morbidity. We have investigated alternative parameters to better identify patients at risk of node metastases. Cases of invasive endocervical adenocarcinoma from 12 institutions were reviewed, and clinical/pathologic features assessed: patients' age, tumor size, DOI, differentiation, lymph-vascular invasion, lymph node metastases, recurrences, and stage. Cases were classified according to a new pattern-based system into Pattern A (well-demarcated glands), B (early destructive stromal invasion arising from well-demarcated glands), and C (diffuse destructive invasion). In total, 352 cases (FIGO Stages I-IV) were identified. Patients' age ranged from 20 to 83 years (mean 45), DOI ranged from 0.2 to 27 mm (mean 6.73), and lymph-vascular invasion was present in 141 cases. Forty-nine (13.9%) demonstrated lymph node metastases. Using this new system, 73 patients (20.7%) with Pattern A tumors (all Stage I) were identified. None had lymph node metastases and/or recurrences. Ninety patients (25.6%) had Pattern B tumors, of which 4 (4.4%) had positive nodes; whereas 189 (53.7%) had Pattern C tumors, of which 45 (23.8%) had metastatic nodes. The proposed classification system can spare 20.7% of patients (Pattern A) of unnecessary lymphadenectomy. Patients with Pattern B rarely present with positive nodes. An aggressive approach is justified in patients with Pattern C. This classification system is simple, easy to apply, and clinically significant. PMID:24071876

  13. A Serial Risk Score Approach to Disease Classification that Accounts for Accuracy and Cost

    PubMed Central

    Huynh, Dat; Laeyendecker, Oliver; Brookmeyer, Ron

    2016-01-01

    Summary The performance of diagnostic tests for disease classification is often measured by accuracy (e.g. sensitivity or specificity); however, costs of the diagnostic test are a concern as well. Combinations of multiple diagnostic tests may improve accuracy, but incur additional costs. Here we consider serial testing approaches that maintain accuracy while controlling costs of the diagnostic tests. We present a serial risk score classification approach. The basic idea is to sequentially test with additional diagnostic tests just until persons are classified. In this way, it is not necessary to test all persons with all tests. The methods are studied in simulations and compared with logistic regression. We applied the methods to data from HIV cohort studies to identify HIV infected individuals who are recently infected (< 1 year) by testing with assays for multiple biomarkers. We find that the serial risk score classification approach can maintain accuracy while achieving a reduction in cost compared to testing all individuals with all assays. PMID:25156309

  14. Rock slope instabilities in Norway: First systematic hazard and risk classification of 22 unstable rock slopes

    NASA Astrophysics Data System (ADS)

    Böhme, Martina; Hermanns, Reginald L.; Oppikofer, Thierry; Penna, Ivanna

    2016-04-01

    Unstable rock slopes that can cause large failures of the rock-avalanche type have been mapped in Norway for almost two decades. Four sites have earlier been characterized as high-risk objects based on expertise of few researchers. This resulted in installing continuous monitoring systems and set-up of an early-warning system for those four sites. Other unstable rock slopes have not been ranked related to their hazard or risk. There are ca. 300 other sites known of which 70 sites were installed for periodic deformation measurements using multiple techniques (Global Navigation Satellite Systems, extensometers, measurement bolts, and others). In 2012 a systematic hazard and risk classification system for unstable rock slopes was established in Norway and the mapping approach adapted to that in 2013. Now, the first 22 sites were classified for hazard, consequences and risk using this classification system. The selection of the first group of sites to be classified was based on an assumed high hazard or risk and importance given to the sites by Norwegian media and the public. Nine of the classified 22 unstable rock slopes are large sites that deform inhomogeneously or are strongly broken up in individual blocks. This suggests that different failure scenarios are possible that need to be analyzed individually. A total of 35 failure scenarios for those nine unstable rock slopes were considered. The hazard analyses were based on 9 geological parameters defined in the classification system. The classification system will be presented based on the Gamanjunni unstable rock slope. This slope has a well developed back scarp that exposes 150 m preceding displacement. The lateral limits of the unstable slope are clearly visible in the morphology and InSAR displacement data. There have been no single structures observed that allow sliding kinematically. The lower extend of the displacing rock mass is clearly defined in InSAR data and by a zone of higher rock fall activity. Yearly

  15. Adding carotid total plaque area to the Framingham risk score improves cardiovascular risk classification

    PubMed Central

    Perez, Hernan A.; Spence, John David; Armando, Luis J.

    2016-01-01

    Introduction Cardiovascular events (CE) due to atherosclerosis are preventable. Identification of high-risk patients helps to focus resources on those most likely to benefit from expensive therapy. Atherosclerosis is not considered for patient risk categorization, even though a fraction of CE are predicted by Framingham risk factors. Our objective was to assess the incremental value of combining total plaque area (TPA) with the Framingham risk score (FramSc) using post-test probability (Ptp) in order to categorize risk in patients without CE and identify those at high risk and requiring intensive treatment. Material and methods A descriptive cross-sectional study was performed in the primary care setting in an Argentine population aged 22–90 years without CE. Both FramSc based on body mass index and Ptp-TPA were employed in 2035 patients for risk stratification and the resulting reclassification was compared. Total plaque area was measured with a high-resolution duplex ultrasound scanner. Results 57% male, 35% hypertensive, 27% hypercholesterolemia, 14% diabetes. 20.1% were low, 28.5% moderate, and 51.5% high risk. When patients were reclassified, 36% of them changed status; 24.1% migrated to a higher and 13.6% to a lower risk level (κ index = 0.360, SE κ = 0.16, p < 0.05, FramSc vs. Ptp-TPA). With this reclassification, 19.3% were low, 18.9% moderate and 61.8% high risk. Conclusions Quantification of Ptp-TPA leads to higher risk estimation than FramSc, suggesting that Ptp-TPA may be more sensitive than FramSc as a screening tool. If our observation is confirmed with a prospective study, this reclassification would improve the long-term benefits related to CE prevention. PMID:27279842

  16. Precursor Analysis for Flight- and Ground-Based Anomaly Risk Significance Determination

    NASA Technical Reports Server (NTRS)

    Groen, Frank

    2010-01-01

    This slide presentation reviews the precursor analysis for flight and ground based anomaly risk significance. It includes information on accident precursor analysis, real models vs. models, and probabilistic analysis.

  17. Symptomatic Chiari malformation in adults: a new classification based on magnetic resonance imaging with clinical and prognostic significance.

    PubMed

    Pillay, P K; Awad, I A; Little, J R; Hahn, J F

    1991-05-01

    Thirty-five consecutive adults with Chiari malformation and progressive symptoms underwent surgical treatment at a single institution over a 3-year period. All patients underwent magnetic resonance imaging scan before and after surgery. Images of the craniovertebral junction confirmed tonsillar herniation in all cases and allowed the definition of two anatomically distinct categories of the Chiari malformation in this age group. Twenty of the 35 patients had concomitant syringomyelia and were classified as Type A. The remaining 15 patients had evidence of frank herniation of the brain stem below the foramen magnum without evidence of syringomyelia and were labeled Type B. Type A patients had a predominant central cord symptomatology; Type B patients exhibited signs and symptoms of brain stem or cerebellar compression. The principal surgical procedure consisted of decompression of the foramen magnum, opening of the fourth ventricular outlet, and plugging of the obex. Significant improvement in preoperative symptoms and signs was observed in 9 of the 20 patients (45%) with syringomyelia (Type A), as compared to 13 of the 15 patients (87%) without syringomyelia (Type B). Postoperative reduction in syrinx volume was observed in 11 of the 20 patients with syringomyelia, including all 9 patients with excellent results. Magnetic resonance imaging has allowed a classification of the adult Chiari malformation in adults based on objective anatomic criteria, with clinical and prognostic relevance. The presence of syringomyelia implies a less favorable response to surgical intervention. PMID:1876240

  18. Significant interarm blood pressure difference predicts cardiovascular risk in hypertensive patients: CoCoNet study.

    PubMed

    Kim, Su-A; Kim, Jang Young; Park, Jeong Bae

    2016-06-01

    There has been a rising interest in interarm blood pressure difference (IAD), due to its relationship with peripheral arterial disease and its possible relationship with cardiovascular disease. This study aimed to characterize hypertensive patients with a significant IAD in relation to cardiovascular risk. A total of 3699 patients (mean age, 61 ± 11 years) were prospectively enrolled in the study. Blood pressure (BP) was measured simultaneously in both arms 3 times using an automated cuff-oscillometric device. IAD was defined as the absolute difference in averaged BPs between the left and right arm, and an IAD ≥ 10 mm Hg was considered to be significant. The Framingham risk score was used to calculate the 10-year cardiovascular risk. The mean systolic IAD (sIAD) was 4.3 ± 4.1 mm Hg, and 285 (7.7%) patients showed significant sIAD. Patients with significant sIAD showed larger body mass index (P < 0.001), greater systolic BP (P = 0.050), more coronary artery disease (relative risk = 1.356, P = 0.034), and more cerebrovascular disease (relative risk = 1.521, P = 0.072). The mean 10-year cardiovascular risk was 9.3 ± 7.7%. By multiple regression, sIAD was significantly but weakly correlated with the 10-year cardiovascular risk (β = 0.135, P = 0.008). Patients with significant sIAD showed a higher prevalence of coronary artery disease, as well as an increase in 10-year cardiovascular risk. Therefore, accurate measurements of sIAD may serve as a simple and cost-effective tool for predicting cardiovascular risk in clinical settings. PMID:27310982

  19. Application of classification methods in assessment of NATO member countries' economic, security and political risks

    NASA Astrophysics Data System (ADS)

    Odehnal, Jakub

    2013-10-01

    The aim of this paper is to attempt possible quantification of determinants of military expenditure and their application to current NATO member countries. To analyse the economic, security and political risks of NATO member countries, author employ multivariate statistical techniques which take into consideration the multivariate properties of the data sets used as input variables. Classification of countries based on cluster analysis has made it possible to identify disparities between NATO member countries, and thus to describe diverse economic or security environment affecting the amount of military expenditure as a percentage of the respective countries' gross domestic product.

  20. Classification-based data mining for identification of risk patterns associated with hypertension in Middle Eastern population

    PubMed Central

    Ramezankhani, Azra; Kabir, Ali; Pournik, Omid; Azizi, Fereidoun; Hadaegh, Farzad

    2016-01-01

    Abstract Hypertension is a critical public health concern worldwide. Identification of risk factors using traditional multivariable models has been a field of active research. The present study was undertaken to identify risk patterns associated with hypertension incidence using data mining methods in a cohort of Iranian adult population. Data on 6205 participants (44% men) age > 20 years, free from hypertension at baseline with no history of cardiovascular disease, were used to develop a series of prediction models by 3 types of decision tree (DT) algorithms. The performances of all classifiers were evaluated on the testing data set. The Quick Unbiased Efficient Statistical Tree algorithm among men and women and Classification and Regression Tree among the total population had the best performance. The C-statistic and sensitivity for the prediction models were (0.70 and 71%) in men, (0.79 and 71%) in women, and (0.78 and 72%) in total population, respectively. In DT models, systolic blood pressure (SBP), diastolic blood pressure, age, and waist circumference significantly contributed to the risk of incident hypertension in both genders and total population, wrist circumference and 2-h postchallenge plasma glucose among women and fasting plasma glucose among men. In men, the highest hypertension risk was seen in those with SBP > 115 mm Hg and age > 30 years. In women those with SBP > 114 mm Hg and age > 33 years had the highest risk for hypertension. For the total population, higher risk was observed in those with SBP > 114 mm Hg and age > 38 years. Our study emphasizes the utility of DTs for prediction of hypertension and exploring interaction between predictors. DT models used the easily available variables to identify homogeneous subgroups with different risk pattern for the hypertension. PMID:27583845

  1. Transmission tower classification based on landslide risk Map generated by Geographical Information System (GIS) at Cameron Highlands

    NASA Astrophysics Data System (ADS)

    K, Hazwani N.; O, Rohayu C.; U, Fathoni; Baharuddin, I. N. Z.; A, Azwin Z.

    2013-06-01

    Transmission tower is usually locates at remote area which is covered by hilly topography. Landslide is mainly occurring at hilly area and causing failure to the tower structure. This phenomenon subsequently will affect the national electricity supply. A landslide risk hazard map is generated using Geographical Information System (GIS). Risk classification is introduced to initiate the monitoring process along Jor-Bintang transmission line, Cameron Highland, Pahang. The classification has been divided into three categories, which are low, medium and high. This method can be applied in slope monitoring activities since all towers have been classified based on their risk level. Therefore, maintenance schedule can be planned smoothly and efficiently.

  2. Transmission tower classification based on landslide risk map generated by Geographical Information System (GIS) at Cameron Highlands

    NASA Astrophysics Data System (ADS)

    K, Hazwani N.; O, Rohayu C.; U, Fathoni; Baharuddin, Inz

    2013-06-01

    Transmission tower is usually locates at remote area which is covered by hilly topography. Landslide is mainly occurring at hilly area and causing failure to the tower structure. This phenomenon subsequently will affect the national electricity supply. A landslide risk hazard map is generated using Geographical Information System (GIS). Risk classification is introduced to initiate the monitoring process along Jor-Bintang transmission line, Cameron Highland, Pahang. The classification has been divided into three categories, which are low, medium and high. This method can be applied in slope monitoring activities since all towers have been classified based on their risk level. Therefore, maintenance schedule can be planned smoothly and efficiently.

  3. Classification of worldwide bovine tuberculosis risk factors in cattle: a stratified approach

    PubMed Central

    Humblet, Marie-France; Boschiroli, Maria Laura; Saegerman, Claude

    2009-01-01

    The worldwide status of bovine tuberculosis (bTB) as a zoonosis remains of great concern. This article reviews the main risk factors for bTB in cattle based on a three-level classification: animal, herd and region/country level. A distinction is also made, whenever possible, between situations in developed and developing countries as the difference of context might have consequences in terms of risk of bTB. Recommendations are suggested to animal health professionals and scientists directly involved in the control and prevention of bTB in cattle. The determination of Millenium Development Goals for bTB is proposed to improve the control/eradication of the disease worldwide. PMID:19497258

  4. Carfilzomib significantly improves the progression-free survival of high-risk patients in multiple myeloma

    PubMed Central

    Fonseca, Rafael; Siegel, David; Dimopoulos, Meletios A.; Špička, Ivan; Masszi, Tamás; Hájek, Roman; Rosiñol, Laura; Goranova-Marinova, Vesselina; Mihaylov, Georgi; Maisnar, Vladimír; Mateos, Maria-Victoria; Wang, Michael; Niesvizky, Ruben; Oriol, Albert; Jakubowiak, Andrzej; Minarik, Jiri; Palumbo, Antonio; Bensinger, William; Kukreti, Vishal; Ben-Yehuda, Dina; Stewart, A. Keith; Obreja, Mihaela; Moreau, Philippe

    2016-01-01

    The presence of certain high-risk cytogenetic abnormalities, such as translocations (4;14) and (14;16) and deletion (17p), are known to have a negative impact on survival in multiple myeloma (MM). The phase 3 study ASPIRE (N = 792) demonstrated that progression-free survival (PFS) was significantly improved with carfilzomib, lenalidomide, and dexamethasone (KRd), compared with lenalidomide and dexamethasone (Rd) in relapsed MM. This preplanned subgroup analysis of ASPIRE was conducted to evaluate KRd vs Rd by baseline cytogenetics according to fluorescence in situ hybridization. Of 417 patients with known cytogenetic risk status, 100 patients (24%) were categorized with high-risk cytogenetics (KRd, n = 48; Rd, n = 52) and 317 (76%) were categorized with standard-risk cytogenetics (KRd, n = 147; Rd, n = 170). For patients with high-risk cytogenetics, treatment with KRd resulted in a median PFS of 23.1 months, a 9-month improvement relative to treatment with Rd. For patients with standard-risk cytogenetics, treatment with KRd led to a 10-month improvement in median PFS vs Rd. The overall response rates for KRd vs Rd were 79.2% vs 59.6% (high-risk cytogenetics) and 91.2% vs 73.5% (standard-risk cytogenetics); approximately fivefold as many patients with high- or standard-risk cytogenetics achieved a complete response or better with KRd vs Rd (29.2% vs 5.8% and 38.1% vs 6.5%, respectively). KRd improved but did not abrogate the poor prognosis associated with high-risk cytogenetics. This regimen had a favorable benefit-risk profile in patients with relapsed MM, irrespective of cytogenetic risk status, and should be considered a standard of care in these patients. This trial was registered at www.clinicaltrials.gov as #NCT01080391. PMID:27439911

  5. Validation study of Oxford Classification of IgA Nephropathy: the significance of extracapillary hypercellularity and mesangial IgG immunostaining.

    PubMed

    Ştefan, Gabriel; Ismail, Gener; Stancu, Simona; Zugravu, Adrian; Andronesi, Andreea; Mandache, Eugen; Mircescu, Gabriel

    2016-08-01

    The Oxford classification (OC) of IgA Nephropathy (IgAN) identified mesangial hypercellularity (M), endocapillary hypercellularity (E), segmental glomerulosclerosis (S), and tubular atrophy/interstitial fibrosis (T) as predictors of outcome. We aimed to validate the OC and to investigate the clinical significance of extracapillary hypercellularity and IgG immunostaining. We examined the renal outcome at December 31, 2014, of 121 adult patients with biopsy proven primary IgAN between 2003 and 2013. The primary endpoint was doubling of serum creatinine or renal replacement therapy initiation. The mean observation period was 59.7 months. Thirty-one percent of the patients presented with a grade of extracapillary hypercellularity. In comparison with the group with no crescents, they had higher grade of inflammation, lower eGFR and increased proteinuria. There were no differences between the IgA and IgA&IgG immunostaining groups regarding the disease progression risk factors. Mean kidney survival time for the entire cohort was 10.6 (9.1, 12.0) years. In the Cox regression model, the independent predictors of decreased renal survival were eGFR at time of biopsy, S1 and the presence of crescents. Our study showed that extracapillary proliferation and S1 had the greatest importance in establishing the renal prognosis of patients with IgAN. PMID:27439692

  6. Acute myeloid leukemia in the era of precision medicine: recent advances in diagnostic classification and risk stratification

    PubMed Central

    Kansal, Rina

    2016-01-01

    Acute myeloid leukemia (AML) is a genetically heterogeneous myeloid malignancy that occurs more commonly in adults, and has an increasing incidence, most likely due to increasing age. Precise diagnostic classification of AML requires clinical and pathologic information, the latter including morphologic, immunophenotypic, cytogenetic and molecular genetic analysis. Risk stratification in AML requires cytogenetics evaluation as the most important predictor, with genetic mutations providing additional necessary information. AML with normal cytogenetics comprises about 40%-50% of all AML, and has been intensively investigated. The currently used 2008 World Health Organization classification of hematopoietic neoplasms has been proposed to be updated in 2016, also to include an update on the classification of AML, due to the continuously increasing application of genomic techniques that have led to major advances in our knowledge of the pathogenesis of AML. The purpose of this review is to describe some of these recent major advances in the diagnostic classification and risk stratification of AML. PMID:27144061

  7. Balancing research and funding using value of information and portfolio tools for nanomaterial risk classification

    NASA Astrophysics Data System (ADS)

    Bates, Matthew E.; Keisler, Jeffrey M.; Zussblatt, Niels P.; Plourde, Kenton J.; Wender, Ben A.; Linkov, Igor

    2016-02-01

    Risk research for nanomaterials is currently prioritized by means of expert workshops and other deliberative processes. However, analytical techniques that quantify and compare alternative research investments are increasingly recommended. Here, we apply value of information and portfolio decision analysis—methods commonly applied in financial and operations management—to prioritize risk research for multiwalled carbon nanotubes and nanoparticulate silver and titanium dioxide. We modify the widely accepted CB Nanotool hazard evaluation framework, which combines nano- and bulk-material properties into a hazard score, to operate probabilistically with uncertain inputs. Literature is reviewed to develop uncertain estimates for each input parameter, and a Monte Carlo simulation is applied to assess how different research strategies can improve hazard classification. The relative cost of each research experiment is elicited from experts, which enables identification of efficient research portfolios—combinations of experiments that lead to the greatest improvement in hazard classification at the lowest cost. Nanoparticle shape, diameter, solubility and surface reactivity were most frequently identified within efficient portfolios in our results.

  8. Balancing research and funding using value of information and portfolio tools for nanomaterial risk classification.

    PubMed

    Bates, Matthew E; Keisler, Jeffrey M; Zussblatt, Niels P; Plourde, Kenton J; Wender, Ben A; Linkov, Igor

    2016-02-01

    Risk research for nanomaterials is currently prioritized by means of expert workshops and other deliberative processes. However, analytical techniques that quantify and compare alternative research investments are increasingly recommended. Here, we apply value of information and portfolio decision analysis-methods commonly applied in financial and operations management-to prioritize risk research for multiwalled carbon nanotubes and nanoparticulate silver and titanium dioxide. We modify the widely accepted CB Nanotool hazard evaluation framework, which combines nano- and bulk-material properties into a hazard score, to operate probabilistically with uncertain inputs. Literature is reviewed to develop uncertain estimates for each input parameter, and a Monte Carlo simulation is applied to assess how different research strategies can improve hazard classification. The relative cost of each research experiment is elicited from experts, which enables identification of efficient research portfolios-combinations of experiments that lead to the greatest improvement in hazard classification at the lowest cost. Nanoparticle shape, diameter, solubility and surface reactivity were most frequently identified within efficient portfolios in our results. PMID:26551015

  9. Classification tree for risk assessment in patients suffering from congestive heart failure via long-term heart rate variability.

    PubMed

    Melillo, Paolo; De Luca, Nicola; Bracale, Marcello; Pecchia, Leandro

    2013-05-01

    This study aims to develop an automatic classifier for risk assessment in patients suffering from congestive heart failure (CHF). The proposed classifier separates lower risk patients from higher risk ones, using standard long-term heart rate variability (HRV) measures. Patients are labeled as lower or higher risk according to the New York Heart Association classification (NYHA). A retrospective analysis on two public Holter databases was performed, analyzing the data of 12 patients suffering from mild CHF (NYHA I and II), labeled as lower risk, and 32 suffering from severe CHF (NYHA III and IV), labeled as higher risk. Only patients with a fraction of total heartbeats intervals (RR) classified as normal-to-normal (NN) intervals (NN/RR) higher than 80% were selected as eligible in order to have a satisfactory signal quality. Classification and regression tree (CART) was employed to develop the classifiers. A total of 30 higher risk and 11 lower risk patients were included in the analysis. The proposed classification trees achieved a sensitivity and a specificity rate of 93.3% and 63.6%, respectively, in identifying higher risk patients. Finally, the rules obtained by CART are comprehensible and consistent with the consensus showed by previous studies that depressed HRV is a useful tool for risk assessment in patients suffering from CHF. PMID:24592473

  10. Relationship between coronary calcium score and high-risk plaque/significant stenosis

    PubMed Central

    Iwasaki, Kohichiro; Matsumoto, Takeshi

    2016-01-01

    AIM To investigate the relationship between coronary calcium score (CCS) and vulnerable plaque/significant stenosis using coronary computed tomographic angiography (CCTA). METHODS CCTA was performed in 651 patients and these patients were divided into the four groups (CCS 0, 1-100, 101-400 and > 400). We studied the incidence of high-risk plaque, including positive remodeling, low attenuation plaque, spotty calcification, and napkin-ring sign, and significant stenosis in each group. RESULTS High-risk plaque was found in 1.3%, 10.1%, 13.3% and 13.4% of patients with CCS 0, 1-100, 101-400 and > 400, respectively (P < 0.001). The difference was only significant for patients with zero CCS. The incidence of significant stenosis was 0.6%, 7.6%, 13.3% and 26.9% for each patient group, respectively (P < 0.001), which represented a significant stepwise increase as CCS increased. The combined incidence of high-risk plaque and significant stenosis was 1.9%, 17.7%, 26.9% and 40.3% in each patient group, respectively (P < 0.001), again representing a significant stepwise increase with CCS. The rate of major coronary event was 0%, 4.0%, 7.9% and 17.2% in each patient group, respectively (P < 0.001), another significant stepwise increase as CCS increased. CONCLUSION Stepwise increased risk of coronary events associated with increasing CCS is caused by increasing incidence of significant stenosis, while that of high-risk plaque remains the same.

  11. Risk-Aware Planetary Rover Operation: Autonomous Terrain Classification and Path Planning

    NASA Technical Reports Server (NTRS)

    Ono, Masahiro; Fuchs, Thoams J.; Steffy, Amanda; Maimone, Mark; Yen, Jeng

    2015-01-01

    Identifying and avoiding terrain hazards (e.g., soft soil and pointy embedded rocks) are crucial for the safety of planetary rovers. This paper presents a newly developed groundbased Mars rover operation tool that mitigates risks from terrain by automatically identifying hazards on the terrain, evaluating their risks, and suggesting operators safe paths options that avoids potential risks while achieving specified goals. The tool will bring benefits to rover operations by reducing operation cost, by reducing cognitive load of rover operators, by preventing human errors, and most importantly, by significantly reducing the risk of the loss of rovers.

  12. Women and eating disorders, Part I: Significance and sociocultural risk factors.

    PubMed

    White, J H

    1992-01-01

    Eating disorders are a significant health problem for women today and therefore are a concern for the health professionals who work with women. The significance of this problem is addressed through epidemiological data from a Western cultural perspective. Many risk factors contribute to the development of these disorders. Broad categories including sociocultural, developmental, familial, and biological factors have been identified by clinicians and researchers. The sociocultural risk factors are the norms, standards, or values of a society. The sociocultural risk factors explored in this article are (a) the value of a thin physique, (b) the value of perfection, (c) the norm of dieting, (d) the influence of the media on these values, and (e) the choice of certain professions. The role of the health professional in prevention with respect to sociocultural factors is discussed. PMID:1478897

  13. Concomitant Sleep Disorders Significantly Increase the Risk of Cardiovascular Disease in Patients with Psoriasis

    PubMed Central

    Chiang, Yi-Ting; Tsai, Yi-Wen; Huang, Weng-Foung; Li, Cheng-Yuan; Wang, Ting-Shun; Tsai, Tsen-Fang

    2016-01-01

    Background The increased rates of cardiovascular morbidity and mortality in patients with psoriasis are not adequately explained by traditional risk factors. Whether concomitant sleep disorders (SDs) modify the risk of cardiovascular disease (CVD) in patients with psoriasis remains unknown. Methods Using the Taiwan National Health Insurance Research Database (NHIRD), we conducted a cohort study to investigate the association between concomitant SDs and CVD risk in patients with psoriasis. Data from 99,628 adults who received a psoriasis diagnosis during the period from 2004 to 2010 were analyzed. Cox proportional hazards regression analysis models were used to compare the risks of ischemic heart disease (IHD) and stroke between patients with and without SDs. Results Psoriasis patients with a concomitant SD had significantly higher risks of IHD (adjusted hazard ratio [aHR], 1.25; 95% confidence interval [CI], 1.22–1.28) and stroke (aHR, 1.24; 95% CI, 1.16–1.33) as compared with psoriasis patients without SDs. All psoriasis patient subgroups, including those with mild and severe psoriasis and those with and without arthritis, had increased HRs for IHD and stroke. The increases in IHD and stroke risks conferred by SDs were proportional to the dose of hypnotics used. The effect of SDs on the risks of IHD and stroke was greater in young adults than in middle-aged and older adults. Conclusions The risks of IHD and stroke were higher for psoriasis patients with SDs than for those without SDs. Clinicians should carefully evaluate CVD risk, particularly in young patients with psoriasis. PMID:26745869

  14. Risk Factors for Clinically Significant Intimate Partner Violence among Active-Duty Members

    ERIC Educational Resources Information Center

    Smith Slep, Amy M.; Foran, Heather M.; Heyman, Richard E.; Snarr, Jeffery D.

    2011-01-01

    Hypothesized risk factors for men's and women's clinically significant intimate partner violence (CS-IPV) from four ecological levels (i.e., individual, family, workplace, community) were tested in a representative sample of active-duty U.S. Air Force members (N = 42,744). When considered together, we expected only individual and family factors to…

  15. An Ecological-Transactional Model of Significant Risk Factors for Child Psychopathology in Outer Mongolia

    ERIC Educational Resources Information Center

    Kohrt, Holbrook E.; Kohrt, Brandon A.; Waldman, Irwin; Saltzman, Kasey; Carrion, Victor G.

    2004-01-01

    The present study examined significant risk factors, including child maltreatment, for child psychopathology in a cross-cultural setting. Ninety-nine Mongolian boys, ages 3-10 years, were assessed. Primary caregivers (PCG) completed structured interviews including the Emory Combined Rating Scale (ECRS) and the Mood and Feelings Questionnaire…

  16. Classification of electrical problems detected by infrared thermography using a risk assessment process

    NASA Astrophysics Data System (ADS)

    McIntosh, Gregory B.; Huff, Roy

    2016-05-01

    For more than 40 years thermography has been used for electrical problem detection. In addition, since radiometric infrared cameras can establish apparent surface temperature of the problem, a classification system is often utilized based upon surface temperature, or temperature rise above normal operating temperature or ambient air temperature. This however can be an extremely unreliable classification method for a number of reasons including: emissivity and background energy; a lack of regard for failure modes and stressors; surface temperature variability with load and ambient conditions; temperature gradient from internal source to surface; and the presence of convection, just to name a few. Standards, such as NFPA 70B, try to address some of these issues by having very low threshold temperature limits, but this as well has issues including identifying an over-abundance of non-critical problems for immediate repair. This paper will present a risk assessment process and matrix which classifies electrical problems based upon a variety of factors affecting both probability and consequence of electrical component failure. Inherent in this process will be a discussion of understanding and analysing electrical connection failure modes and failure stressors, as well as consideration of both heat energy flow and stored energy rather than only considering surface temperature as a single point predictor of catastrophic failure.

  17. The Usefulness of the TOAST Classification and Prognostic Significance of Pyramidal Symptoms During the Acute Phase of Cerebellar Ischemic Stroke.

    PubMed

    Dziadkowiak, Edyta; Chojdak-Łukasiewicz, Justyna; Guziński, Maciej; Noga, Leszek; Paradowski, Bogusław

    2016-04-01

    Cerebellar stroke is a rare condition with very nonspecific clinical features. The symptoms in the acute phase could imitate acute peripheral vestibular disorders or a brainstem lesion. The aim of this study was to assess the usefulness of the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification in cerebellar stroke and the impact of clinical features on the prognosis. We retrospectively analyzed 107 patients with diagnosed ischemic cerebellar infarction. We studied the clinical features and compared them based on the location of the ischemic lesion and its distribution in the posterior interior cerebellar artery (PICA), superior cerebellar artery (SCA), and anterior inferior cerebellar artery (AICA) territories. According to the TOAST classification, stroke was more prevalent in atrial fibrillation (26/107) and when the lesion was in the PICA territory (39/107). Pyramidal signs occurred in 29/107 of patients and were more prevalent when the lesion was distributed in more than two vascular regions (p = 0.00640). Mortality was higher among patients with ischemic lesion caused by cardiac sources (p = 0.00094) and with pyramidal signs (p = 0.00640). The TOAST classification is less useful in assessing supratentorial ischemic infarcts. Cardioembolic etiology, location of the ischemic lesion, and pyramidal signs support a negative prognosis. PMID:26041073

  18. Multicenter study on caries risk assessment in adults using survival Classification and Regression Trees.

    PubMed

    Arino, Masumi; Ito, Ataru; Fujiki, Shozo; Sugiyama, Seiichi; Hayashi, Mikako

    2016-01-01

    Dental caries is an important public health problem worldwide. This study aims to prove how preventive therapies reduce the onset of caries in adult patients, and to identify patients with high or low risk of caries by using Classification and Regression Trees based survival analysis (survival CART). A clinical data set of 732 patients aged 20 to 64 years in nine Japanese general practices was analyzed with the following parameters: age, DMFT, number of mutans streptococci (SM) and Lactobacilli (LB), secretion rate and buffer capacity of saliva, and compliance with a preventive program. Results showed the incidence of primary carious lesion was affected by SM, LB and compliance with a preventive program; secondary carious lesion was affected by DMFT, SM and LB. Survival CART identified high-risk patients for primary carious lesion according to their poor compliance with a preventive program and SM (≥10(6) CFU/ml) with a hazard ratio of 3.66 (p = 0.0002). In the case of secondary caries, patients with LB (≥10(5) CFU/ml) and DMFT (>15) were identified as high risk with a hazard ratio of 3.50 (p < 0.0001). We conclude that preventive programs can be effective in limiting the incidence of primary carious lesion. PMID:27381750

  19. Multicenter study on caries risk assessment in adults using survival Classification and Regression Trees

    PubMed Central

    Arino, Masumi; Ito, Ataru; Fujiki, Shozo; Sugiyama, Seiichi; Hayashi, Mikako

    2016-01-01

    Dental caries is an important public health problem worldwide. This study aims to prove how preventive therapies reduce the onset of caries in adult patients, and to identify patients with high or low risk of caries by using Classification and Regression Trees based survival analysis (survival CART). A clinical data set of 732 patients aged 20 to 64 years in nine Japanese general practices was analyzed with the following parameters: age, DMFT, number of mutans streptococci (SM) and Lactobacilli (LB), secretion rate and buffer capacity of saliva, and compliance with a preventive program. Results showed the incidence of primary carious lesion was affected by SM, LB and compliance with a preventive program; secondary carious lesion was affected by DMFT, SM and LB. Survival CART identified high-risk patients for primary carious lesion according to their poor compliance with a preventive program and SM (≥106 CFU/ml) with a hazard ratio of 3.66 (p = 0.0002). In the case of secondary caries, patients with LB (≥105 CFU/ml) and DMFT (>15) were identified as high risk with a hazard ratio of 3.50 (p < 0.0001). We conclude that preventive programs can be effective in limiting the incidence of primary carious lesion. PMID:27381750

  20. Assessment and risk classification protocol for patients in emergency units1

    PubMed Central

    Silva, Michele de Freitas Neves; Oliveira, Gabriela Novelli; Pergola-Marconato, Aline Maino; Marconato, Rafael Silva; Bargas, Eliete Boaventura; Araujo, Izilda Esmenia Muglia

    2014-01-01

    Objective to develop, validate the contents and verify the reliability of a risk classification protocol for an Emergency Unit. Method the content validation was developed in a University Hospital in a country town located in the state of Sao Paulo and was carried out in two stages: the first with the individual assessment of specialists and the second with the meeting between the researchers and the specialists. The use of the protocol followed a specific guide. Concerning reliability, the concordance or equivalent method among observers was used. Results the protocol developed showed to have content validity and, after the suggested changes were made, there were excellent results concerning reliability. Conclusion the assistance flow chart was shown to be easy to use, and facilitate the search for the complaint in each assistance priority. PMID:26107828

  1. Exploring the color feature power for psoriasis risk stratification and classification: A data mining paradigm.

    PubMed

    Shrivastava, Vimal K; Londhe, Narendra D; Sonawane, Rajendra S; Suri, Jasjit S

    2015-10-01

    A large percentage of dermatologist׳s decision in psoriasis disease assessment is based on color. The current computer-aided diagnosis systems for psoriasis risk stratification and classification lack the vigor of color paradigm. The paper presents an automated psoriasis computer-aided diagnosis (pCAD) system for classification of psoriasis skin images into psoriatic lesion and healthy skin, which solves the two major challenges: (i) fulfills the color feature requirements and (ii) selects the powerful dominant color features while retaining high classification accuracy. Fourteen color spaces are discovered for psoriasis disease analysis leading to 86 color features. The pCAD system is implemented in a support vector-based machine learning framework where the offline image data set is used for computing machine learning offline color machine learning parameters. These are then used for transformation of the online color features to predict the class labels for healthy vs. diseased cases. The above paradigm uses principal component analysis for color feature selection of dominant features, keeping the original color feature unaltered. Using the cross-validation protocol, the above machine learning protocol is compared against the standalone grayscale features with 60 features and against the combined grayscale and color feature set of 146. Using a fixed data size of 540 images with equal number of healthy and diseased, 10 fold cross-validation protocol, and SVM of polynomial kernel of type two, pCAD system shows an accuracy of 99.94% with sensitivity and specificity of 99.93% and 99.96%. Using a varying data size protocol, the mean classification accuracies for color, grayscale, and combined scenarios are: 92.85%, 93.83% and 93.99%, respectively. The reliability of the system in these three scenarios are: 94.42%, 97.39% and 96.00%, respectively. We conclude that pCAD system using color space alone is compatible to grayscale space or combined color and grayscale

  2. Significantly increased risk of carotid atherosclerosis with arsenic exposure and polymorphisms in arsenic metabolism genes

    SciTech Connect

    Hsieh, Yi-Chen; Lien, Li-Ming; Chung, Wen-Ting; Hsieh, Fang-I; Hsieh, Pei-Fan; Wu, Meei-Maan; Tseng, Hung-Pin; Chiou, Hung-Yi; Chen, Chien-Jen

    2011-08-15

    Individual susceptibility to arsenic-induced carotid atherosclerosis might be associated with genetic variations in arsenic metabolism. The purpose of this study is to explore the interaction effect on risk of carotid atherosclerosis between arsenic exposure and risk genotypes of purine nucleoside phosphorylase (PNP), arsenic (+3) methyltransferase (As3MT), and glutathione S-transferase omega 1 (GSTO1) and omega 2 (GSTO2). A community-based case-control study was conducted in northeastern Taiwan to investigate the arsenic metabolic-related genetic susceptibility to carotid atherosclerosis. In total, 863 subjects, who had been genotyped and for whom the severity of carotid atherosclerosis had been determined, were included in the present study. Individual well water was collected and arsenic concentration determined using hydride generation combined with flame atomic absorption spectrometry. The result showed that a significant dose-response trend (P=0.04) of carotid atherosclerosis risk associated with increasing arsenic concentration. Non-significant association between genetic polymorphisms of PNP Gly51Ser, Pro57Pro, As3MT Met287Thr, GSTO1 Ala140Asp, and GSTO2 A-183G and the risk for development of carotid atherosclerosis were observed. However, the significant interaction effect on carotid atherosclerosis risk was found for arsenic exposure (>50 {mu}g/l) and the haplotypes of PNP (p=0.0115). A marked elevated risk of carotid atherosclerosis was observed in subjects with arsenic exposure of >50 {mu}g/l in drinking water and those who carried the PNP A-T haplotype and at least either of the As3MT risk polymorphism or GSTO risk haplotypes (OR, 6.43; 95% CI, 1.79-23.19). In conclusion, arsenic metabolic genes, PNP, As3MT, and GSTO, may exacerbate the formation of atherosclerosis in individuals with high levels of arsenic concentration in well water (>50 {mu}g/l). - Highlights: {yields}Arsenic metabolic genes might be associated with carotid atherosclerosis. {yields

  3. Geotechnical Risk Classification for Underground Mines / Klasyfikacja Poziomu Zagrożenia Geotechnicznego W Kopalniach Podziemnych

    NASA Astrophysics Data System (ADS)

    Mishra, Ritesh Kumar; Rinne, Mikael

    2015-03-01

    Underground mining activities are prone to major hazards largely owing to geotechnical reasons. Mining combined with the confined working space and uncertain geotechnical data leads to hazards having the potential of catastrophic consequences. These incidents have the potential of causing multiple fatalities and large financial damages. Use of formal risk assessment in the past has demonstrated an important role in the prediction and prevention of accidents in risk prone industries such as petroleum, nuclear and aviation. This paper proposes a classification system for underground mining operations based on their geotechnical risk levels. The classification is done based on the type of mining method employed and the rock mass in which it is carried out. Mining methods have been classified in groups which offer similar geotechnical risk. The rock mass classification has been proposed based on bulk rock mass properties which are collected as part of the routine mine planning. This classification has been subdivided for various stages of mine planning to suit the extent of available data. Alpha-numeric coding has been proposed to identify a mining operation based on the competency of rock and risk of geotechnical failures. This alpha numeric coding has been further extended to identify mining activity under `Geotechnical Hazard Potential (GHP)'. GHP has been proposed to be used as a preliminary tool of risk assessment and risk ranking for a mining activity. The aim of such classification is to be used as a guideline for the justification of a formal geotechnical risk assessment. Górnictwo podziemne pociąga za sobą różnorakie zagrożenia spowodowane przez uwarunkowania geotechniczne. Urabianie złoża w połączeniu z pracą w zamkniętej przestrzeni oraz z niepewnymi danymi geotechnicznymi powodować może zagrożenia, które w konsekwencji prowadzić mogą do wypadków, a te potencjalnie powodować mogą skutki śmiertelne dla osób oraz

  4. Case-control study of risk factors of myelodysplastic syndromes according to World Health Organization classification in a Chinese population.

    PubMed

    Lv, Ling; Lin, Guowei; Gao, Xiang; Wu, Cuie; Dai, Junmin; Yang, Yongchen; Zou, Hejian; Sun, Hengjuan; Gu, Minghua; Chen, Xi; Fu, Hua; Bao, Liming

    2011-02-01

    Risk factors of mydelodysplastic syndromes (MDS) remain largely unknown. We conducted a hospital-based case-control study consisting of 403 newly diagnosed MDS patients according to World Health Organization classification and 806 individually gender and age-matched patient controls from 27 major hospitals in Shanghai, China, to examine relation of lifestyle, environmental, and occupational factors to risk of MDS. The study showed that all MDS (all subtypes combined) risk factors included anti tuberculosis drugs [odds ratio (OR)(adj) = 3.15; 95% confidence interval (CI) = 1.22-8.12] as an independent risk factor, benzene (OR(adj) = 3.73; 95% CI = 1.32-10.51), hair dye use (OR = 1.46; 95% CI = 1.03-2.07), new building and renovations (OR = 1.69; 95% CI = 1.11-2.00), pesticides (OR = 2.16; 95% CI = 1.22-3.82), and herbicides (OR = 5.33; 95% CI = 1.41-20.10) as relative risk factors. Risk factors of MDS subtype refractory cytopenia with multiple dysplasia (RCMD) were benzene (OR(adj) = 5.99; 95% CI = 1.19-30.16) and gasoline (OR(adj) = 11.44; 95% CI = 1.31-100.03) as independent risk factors, and traditional Chinese medicines (OR = 2.17; 95% CI = 1.15-4.07), pesticides (OR = 2.92; 95% CI = 1.37-6.25), and herbicides (OR = 12.00; 95% CI = 1.44-99.67) as relative risk factors. Smoking tobacco was significantly associated with refractory anemia with excess of blasts (RAEB) (OR(adj) = 2.43; 95% CI = 1.02-5.77). Education is shown as an independent protective factor against all MDS (OR(adj) = 0.90; 95% CI = 0.83-0.99) and RCMD (OR(adj) = 0.89; 95% CI = 0.79-0.99). These findings suggest that multiple modifiable behavioral, environmental, and occupational factors play a role in MDS etiology, and various MDS subtypes may have different susceptibility. PMID:21264898

  5. An ecological-transactional model of significant risk factors for child psychopathology in outer mongolia.

    PubMed

    Kohrt, Holbrook E; Kohrt, Brandon A; Waldman, Irwin; Saltzman, Kasey; Carrion, Victor G

    2004-01-01

    The present study examined significant risk factors, including child maltreatment, for child psychopathology in a cross-cultural setting. Ninety-nine Mongolian boys, ages 3-10 years, were assessed. Primary caregivers (PCG) completed structured interviews including the Emory Combined Rating Scale (ECRS) and the Mood and Feelings Questionnaire (MFQ). Structural equation modeling identifies eight risk factors affecting child psychopathology: Three with direct effects (severity of physical punishment, PCG's MFQ score, and PCG's education), three with indirect effects (cultural acceptance of violence as discipline, presence of community violence, and contact with extended family), and two with direct and indirect effects (quality of marriage/presence of spousal abuse, and household size). Results support the ecological-transactional theory of developmental psychopathology in a cross-cultural setting. Structural equation modeling provides a useful technique to isolate specific sites for intervention, while maintaining a comprehensive perspective of risk factor interaction. PMID:15577280

  6. Bioinformatics analyses of significant prognostic risk markers for thyroid papillary carcinoma.

    PubMed

    Min, Xiao-Shan; Huang, Peng; Liu, Xu; Dong, Chao; Jiang, Xiao-Lin; Yuan, Zheng-Tai; Mao, Lin-Feng; Chang, Shi

    2015-09-01

    This study was aimed to identify the prognostic risk markers for thyroid papillary carcinoma (TPC) by bioinformatics. The clinical data of TPC and their microRNAs (miRNAs) and genes expression profile data were downloaded from The Cancer Genome Atlas. Elastic net-Cox's proportional regression hazards model (EN-COX) was used to identify the prognostic associated factors. The receiver operating characteristic (ROC) curve and Kaplan-Meier (KM) curve were used to screen the significant prognostic risk miRNA and genes. Then, the target genes of the obtained miRNAs were predicted followed by function prediction. Finally, the significant risk genes were performed literature mining and function analysis. Total 1046 miRNAs and 20531 genes in 484 cases samples were identified after data preprocessing. From the EN-COX model, 30 prognostic risk factors were obtained. Based on the 30 risk factors, 3 miRNAs and 11 genes were identified from the ROC and KM curves. The target genes of miRNA-342 such as B-cell CLL/lymphoma 2 (BCL2) were mainly enriched in the biological process related to cellular metabolic process and Disease Ontology terms of lymphoma. The target genes of miRNA-93 were mainly enriched in the pathway of G1 phase. Among the 11 prognostic risk genes, v-maf avian musculoaponeurotic fibrosarcoma oncogene homologue F (MAFF), SRY (sex-determining region Y)-box 4 (SOX4), and retinoic acid receptor, alpha (RARA) encoded transcription factors. Besides, RARA was enriched in four pathways. These prognostic markers such as miRNA-93, miRNA-342, RARA, MAFF, SOX4, and BCL2 may be used as targets for TPC chemoprevention. PMID:25908172

  7. Determination of the health of Lunyangwa wetland using Wetland Classification and Risk Assessment Index

    NASA Astrophysics Data System (ADS)

    Wanda, Elijah M. M.; Mamba, Bhekie B.; Msagati, Titus A. M.; Msilimba, Golden

    2016-04-01

    Wetlands are major sources of various ecological goods and services including storage and distribution of water in space and time which help in ensuring the availability of surface and groundwater throughout the year. However, there still remains a poor understanding of the range of values of water quality parameters that occur in wetlands either in its impacted state or under natural conditions. It was thus imperative to determine the health of Lunyangwa wetland in Mzuzu City in Malawi in order to classify and determine its state. This study used the Escom's Wetland Classification and Risk Assessment Index Field Guide to determine the overall characteristics of Lunyangwa wetland and to calculate its combined Wetland Index Score. Data on site information, field measurements (i.e. EC, pH, temperature and DO) and physical characteristics of Lunyangwa wetland were collected from March, 2013 to February, 2014. Results indicate that Lunyangwa wetland is a largely open water zone which is dominated by free-floating plants on the water surface, beneath surface and emergent in substrate. Furthermore, the wetland can be classified as of a C ecological category (score = 60-80%), which has been moderately modified with moderate risks of the losses and changes occurring in the natural habitat and biota in the wetland. It was observed that the moderate modification and risk were largely because of industrial, agricultural, urban/social catchment stressors on the wetland. This study recommends an integrated and sustainable management approach coupled with continuous monitoring and evaluation of the health of the wetland for all stakeholders in Mzuzu City. This would help to maintain the health of Lunyangwa wetland which is currently at risk of being further modified due to the identified catchment stressors.

  8. Interpretation of risk significance of passive component aging using probabilistic structural analysis

    SciTech Connect

    Phillips, J.H. ); Atwood, C.L. )

    1993-01-01

    The probabilistic risk assessments (PRAs) being developed at most nuclear power plants to calculate the risk of core damage generally focus on the possible failure of active components. Except as initiating events, the possible failure of passive components is given little consideration. The NRC is sponsoring a project at INEL to investigate the risk significance of passive components as they age. For this project, we developed a technique to calculate the failure probability of passive components over time, and demonstrated the technique by applying it to a weld in the auxiliary feedwater (AFW) system. A decreasing yearly rupture rate for this weld was calculated instead of the increasing rupture rate trend one might expect. We attribute this result to infant mortality; that is, most of those initial flaws that will eventually lead to rupture will do so early in life. This means that although each weld in a population may be wearing out, the population as a whole can exhibit a decreasing rupture rate. This observation has implications for passive components in commercial nuclear plants and other facilities where aging is a concern. For the population of passive components that exhibit a decreasing failure rate, risk increase is not a concern. The next step of the work is to identify the attributes that contribute to this decreasing rate, and to determine any attributes that would contribute to an increasing failure rate and thus to an increased risk.

  9. Interpretation of risk significance of passive component aging using probabilistic structural analysis

    SciTech Connect

    Phillips, J.H.; Atwood, C.L.

    1993-05-01

    The probabilistic risk assessments (PRAs) being developed at most nuclear power plants to calculate the risk of core damage generally focus on the possible failure of active components. Except as initiating events, the possible failure of passive components is given little consideration. The NRC is sponsoring a project at INEL to investigate the risk significance of passive components as they age. For this project, we developed a technique to calculate the failure probability of passive components over time, and demonstrated the technique by applying it to a weld in the auxiliary feedwater (AFW) system. A decreasing yearly rupture rate for this weld was calculated instead of the increasing rupture rate trend one might expect. We attribute this result to infant mortality; that is, most of those initial flaws that will eventually lead to rupture will do so early in life. This means that although each weld in a population may be wearing out, the population as a whole can exhibit a decreasing rupture rate. This observation has implications for passive components in commercial nuclear plants and other facilities where aging is a concern. For the population of passive components that exhibit a decreasing failure rate, risk increase is not a concern. The next step of the work is to identify the attributes that contribute to this decreasing rate, and to determine any attributes that would contribute to an increasing failure rate and thus to an increased risk.

  10. Chronic Disease Disparities by County Economic Status and Metropolitan Classification, Behavioral Risk Factor Surveillance System, 2013

    PubMed Central

    Theis, Kristina A.; Self-Brown, Shannon; Roblin, Douglas W.; Barker, Lawrence

    2016-01-01

    Introduction Racial/ethnic disparities have been studied extensively. However, the combined influence of geographic location and economic status on specific health outcomes is less well studied. This study’s objective was to examine 1) the disparity in chronic disease prevalence in the United States by county economic status and metropolitan classification and 2) the social gradient by economic status. The association of hypertension, arthritis, and poor health with county economic status was also explored. Methods We used 2013 Behavioral Risk Factor Surveillance System data. County economic status was categorized by using data on unemployment, poverty, and per capita market income. While controlling for sociodemographics and other covariates, we used multivariable logistic regression to evaluate the relationship between economic status and hypertension, arthritis, and self-rated health. Results Prevalence of hypertension, arthritis, and poor health in the poorest counties was 9%, 13%, and 15% higher, respectively, than in the most affluent counties. After we controlled for covariates, poor counties still had a higher prevalence of the studied conditions. Conclusion We found that residents of poor counties had a higher prevalence of poor health outcomes than affluent counties, even after we controlled for known risk factors. Further, the prevalence of poor health outcomes decreased as county economics improved. Findings suggest that poor counties would benefit from targeted public health interventions, better access to health care services, and improved food and built environments. PMID:27584875

  11. Diagnosis, risk stratification and management of monoclonal gammopathy of undetermined significance and smoldering multiple myeloma.

    PubMed

    van de Donk, N W C J; Mutis, T; Poddighe, P J; Lokhorst, H M; Zweegman, S

    2016-05-01

    Monoclonal gammopathy of undetermined significance (MGUS) is one of the most common premalignant disorders. IgG and IgA MGUS are precursor conditions of multiple myeloma (MM), whereas light-chain MGUS is a precursor condition of light-chain MM. Smoldering MM (SMM) is a precursor condition with higher tumor burden and higher risk of progression to symptomatic MM compared to MGUS. Assessment of the risk of progression of patients with asymptomatic monoclonal gammopathies is based on various factors including clonal burden, as well as biological characteristics, such as cytogenetic abnormalities and light-chain production. Several models have been constructed that are useful in daily practice for predicting risk of progression of MGUS or SMM. Importantly, the plasma cell clone may occasionally be responsible for severe organ damage through the production of a M-protein which deposits in tissues or has autoantibody activity. These disorders are rare and often require therapy directed at eradication of the underlying clone. Importantly, recent studies have shown that asymptomatic patients with a bone marrow plasma cell percentage ≥60%, free light-chain ratio ≥100, or >1 focal lesion on MRI (myeloma-defining events) have a 80% risk of developing symptomatic MM within 2 years. These patients are now considered to have MM requiring therapy, similar to patients with symptomatic disease. In this review, we provide an overview of the new diagnostic criteria of the monoclonal gammopathies and discuss risk of progression to active MM. We also provide recommendations for the management of patients with MGUS and SMM including risk-adapted follow-up. PMID:27161311

  12. A novel subtype classification and risk of breast cancer by histone modification profiling.

    PubMed

    Chen, Xiaohua; Hu, Hanyang; He, Lin; Yu, Xueyuan; Liu, Xiangyu; Zhong, Rong; Shu, Maoguo

    2016-06-01

    Breast cancer has been classified into several intrinsic molecular subtypes on the basis of genetic and epigenetic factors. However, knowledge about histone modifications that contribute to the classification and development of biologically distinct breast cancer subtypes remains limited. Here we compared the genome-wide binding patterns of H3K4me3 and H3K27me3 between human mammary epithelial cells and three breast cancer cell lines representing the luminal, HER2, and basal subtypes. We characterized thousands of unique binding events as well as bivalent chromatin signatures unique to each cancer subtype, which were involved in different epigenetic regulation programs and signaling pathways in breast cancer progression. Genes linked to the unique histone mark features exhibited subtype-specific expression patterns, both in cancer cell lines and primary tumors, some of which were confirmed by qPCR in our primary cancer samples. Finally, histone mark-based gene classifiers were significantly correlated with relapse-free survival outcomes in patients. In summary, we have provided a valuable resource for the identification of novel biomarkers of subtype classification and clinical prognosis evaluation in breast cancers. PMID:27178334

  13. Risk of abnormal triple screen for Down syndrome is significantly higher in patients with female fetuses.

    PubMed

    Spong, C Y; Ghidini, A; Stanley-Christian, H; Meck, J M; Seydel, F D; Pezzullo, J C

    1999-04-01

    Previous studies have shown that mid-trimester maternal serum alpha-fetoprotein (AFP) levels are significantly higher and human chorionic gonadotrophin (hCG) levels significantly lower in women with male compared with female fetuses. We have evaluated whether triple-screen criteria are more likely to identify women with female fetuses as at risk for Down syndrome. From the Georgetown University genetics database we obtained the absolute values and corresponding multiples of the median (MoM) for AFP, hCG and unconjugated oestriol (uE3) in singleton gestations for the period database November 1992 July 1996. A Down syndrome risk of 1/270 or greater at mid-trimester was considered as high risk. A total of 977 patients with triple screen and outcome information were identified, including 502 female and 475 male fetuses. Patients with female fetuses were significantly more likely to have lower serum AFP (p=0.003) and a positive triple screen for Down syndrome (72 (14 per cent) versus 45 (9 per cent), p<0.02) than those with male fetuses. The gestational age at triple screen, maternal serum hCG and uE3, race and diabetes were not significantly different between the two groups. Since Down syndrome is less common in female than male fetuses, and the rates of female and male Down syndrome fetuses detected by triple screen and subsequent amniocentesis are not significantly different, the excess of positive mid-trimester maternal serum triple screen in women with female fetuses is likely due to false-positive results. PMID:10327139

  14. Risk classification in mild cognitive impairment patients for developing Alzheimer's disease.

    PubMed

    Zhou, Bin; Nakatani, Eiji; Teramukai, Satoshi; Nagai, Yoji; Fukushima, Masanori

    2012-01-01

    The objective of this study was to develop new risk classifications for conversion to Alzheimer's disease (AD) by comparing the relative reliability of classifiers in patients with mild cognitive impairment (MCI). The 397 MCI subjects and all baseline data, including characteristics, neuropsychological tests, cerebrospinal fluid biomarkers and MRI findings in Alzheimer's Disease Neuroimaging Initiative (ADNI), were used for analysis by Cox proportional hazard regression, bootstrap sampling, and c-index. Multivariate Cox regression analysis revealed the following factors to be associated with increased risk of conversion from MCI to AD during the 53-month follow-up period: AVLT 30-minute delayed recall, AVLT trial 1, Boston naming, logical delayed recall, trail-making B, CDR-sob, ADAS13, the cortical thickness of the right inferior temporal lobe (st91ta), and the left hippocampus volume. The combinations of ADAS13 at a cutoff point of 15.67 with CDR-sob at 1.5 or with the cortical thickness of the right inferior temporal lobe at 2.56 mm3 produced high conversion rates of 92.7% (82.4%-100.0%) and 88.8% (77.3%-100.0%), respectively, at 48 months. The discriminative ability based on c-index for the proposed combination was 0.68. The sample size was estimated as 504 in the group with a combination of ADAS13 and CDR-sob whose conversion rate is highest. The combination of ADAS13 with CDR-sob at an optimal cutoff point has a high reliability in classifying the MCI patients into high- and low-risk conversion to AD and will be benefit for patients' assessment and potentially facilitate the clinical development of novel therapeutics. PMID:22426014

  15. PERSONAL AND ENVIRONMENTAL RISK FACTORS SIGNIFICANTLY ASSOCIATED WITH ELEVATED BLOOD LEAD LEVELS IN RURAL THAI CHILDREN.

    PubMed

    Swaddiwudhipong, Witaya; Kavinum, Suporn; Papwijitsil, Ratchadaporn; Tontiwattanasap, Worawit; Khunyotying, Wanlee; Umpan, Jiraporn; BoonthuM, Ratchaneekorn; Kaewnate, Yingyot; Boonmee, Sasis; Thongchub, Winai; Rodsung, Thassanee

    2014-11-01

    A community-based study was conducted to determine personal risk factors and environmental sources of lead exposure for elevated blood lead levels (≥ 10 µg/dl, EBLLs) among rural children living at the Thailand-Myanmar border in Tak Province, northwestern Thailand. Six hundred ninety-five children aged 1-14 years old were screened for BLLs. Environmental specimens for lead measurements included samples of water from the streams, taps, and household containers, house floor dust, and foods. Possible lead release from the cooking ware was determined using the leaching method with acetic acid. The overall prevalence of EBLLs was 47.1% and the geometric mean level of blood lead was 9.16 µg/dl. Personal risk factors significantly associated with EBLLs included being male, younger age, anemia, and low weight-for-age. Significant environmental risk factors were exposure to a lead-acid battery of solar energy system and use of a non-certified metal cooking pot. Some families whose children had high BLLs reported production of lead bullets from the used batteries at home. About one-third of the house dust samples taken near batteries contained lead content above the recommended value, compared with none of those taken from other areas and from the houses with no batteries. The metal pots were safe for cooking rice but might be unsafe for acidic food preparation. Both nutritional intervention and lead exposure prevention programs are essential to reduce EBLLs in this population. PMID:26466436

  16. Prognostic significance of neurological signs in high-risk infants - a systematic review.

    PubMed

    Hamer, Elisa G; Hadders-Algra, Mijna

    2016-03-01

    The aim of this paper was to systematically review the literature on the significance of specific neurological signs in infancy, in particular in infants at risk for developmental problems such as cerebral palsy (CP). A literature search was performed using the databases PubMed, Embase, Web of Science, and AMED. Papers on infantile reactions ('primitive reflexes') and postural reactions were included if data were available allowing for calculation of sensitivity, specificity, or positive and negative predictive value for CP or atypical developmental outcome. Our search identified 23 articles on 20 different neurological signs. Properties of six neurological signs were reported in at least three different papers. The data indicated that, in early infancy, an absent Moro or plantar grasp response may be predictive for adverse developmental outcome. After early infancy, persistence of the Moro response and asymmetric tonic neck reflex was clinically significant. Prediction of a delayed emergence of the parachute reaction increases with age. Abnormal performances on the pull-to-sit manoeuvre and vertical suspension test have predictive significance throughout infancy. The neurological signs reviewed have some predictive value in infants at risk. For most of the signs, criteria for abnormality and significance are age-dependent. PMID:27027608

  17. Hazard interaction analysis for multi-hazard risk assessment: a systematic classification based on hazard-forming environment

    NASA Astrophysics Data System (ADS)

    Liu, B.; Siu, Y. L.; Mitchell, G.

    2015-12-01

    This paper develops a systematic hazard interaction classification based on the geophysical environment that natural hazards arise from - the hazard-forming environment. According to their contribution to natural hazards, geophysical environmental factors in the hazard-forming environment were categorized into two types. The first are relatively stable factors which construct the precondition for the occurrence of natural hazards, whilst the second are trigger factors, which determine the frequency and magnitude of hazards. Different combinations of geophysical environmental factors induce different hazards. Based on these geophysical environmental factors for some major hazards, the stable factors are used to identify which kinds of natural hazards influence a given area, and trigger factors are used to classify the relationships between these hazards into four types: independent, mutex, parallel and series relationships. This classification helps to ensure all possible hazard interactions among different hazards are considered in multi-hazard risk assessment. This can effectively fill the gap in current multi-hazard risk assessment methods which to date only consider domino effects. In addition, based on this classification, the probability and magnitude of multiple interacting natural hazards occurring together can be calculated. Hence, the developed hazard interaction classification provides a useful tool to facilitate improved multi-hazard risk assessment.

  18. Hazard interaction analysis for multi-hazard risk assessment: a systematic classification based on hazard-forming environment

    NASA Astrophysics Data System (ADS)

    Liu, Baoyin; Siu, Yim Ling; Mitchell, Gordon

    2016-03-01

    This paper develops a systematic hazard interaction classification based on the geophysical environment that natural hazards arise from - the hazard-forming environment. According to their contribution to natural hazards, geophysical environmental factors in the hazard-forming environment were categorized into two types. The first are relatively stable factors which construct the precondition for the occurrence of natural hazards, whilst the second are trigger factors, which determine the frequency and magnitude of hazards. Different combinations of geophysical environmental factors induce different hazards. Based on these geophysical environmental factors for some major hazards, the stable factors are used to identify which kinds of natural hazards influence a given area, and trigger factors are used to classify the relationships between these hazards into four types: independent, mutex, parallel and series relationships. This classification helps to ensure all possible hazard interactions among different hazards are considered in multi-hazard risk assessment. This can effectively fill the gap in current multi-hazard risk assessment methods which to date only consider domino effects. In addition, based on this classification, the probability and magnitude of multiple interacting natural hazards occurring together can be calculated. Hence, the developed hazard interaction classification provides a useful tool to facilitate improved multi-hazard risk assessment.

  19. Low level of basal testosterone: a significant risk factor for poor oocyte yield after ovulation induction.

    PubMed

    Guo, Jing; Zhang, Qingxue; Li, Yu; Wang, Wenjun; Yang, Dongzi

    2016-03-01

    The objective of this study was to further investigate the association of low androgen levels and poor ovarian response or negative pregnancy outcome in in vitro fertilisation treatment using a retrospective cohort study. Chinese women (n=1950) of relatively young age, with normal range of basal FSH and antral follicle count undergoing an in vitro fertilisation cycle were selected and testosterone and dehydroepiandrosterone sulfate levels were measured on Day 3 of the menstrual cycle before subsequent in vitro fertilisation treatment. The main outcome measures of the study were ovarian stimulation parameters and clinical pregnancy. Basal testosterone levels of poor responders and non-pregnant women were significantly lower than normal responders and pregnant women, respectively. Patients with low basal testosterone levels had significantly lower number of mature oocytes, cleavage-stage embryos, frozen embryos, lower fertilisation and pregnancy rates and required higher doses of gonadotrophins. Androgen levels had no correlation with early spontaneous abortion rates. Multivariable logistic analysis revealed that low basal testosterone (<0.88nmolL(-1)) was an independent risk factor for poor oocyte yield (odds ratio: 1.61; 95% confidence interval: 1.01-2.57; P=0.045). In conclusion, a low level of basal testosterone was a significant risk factor for poor oocyte yield after ovarian stimulation and might negatively influence pregnancy chances with in vitro fertilisation. Basal dehydroepiandrosterone sulfate levels were not predictive for poor ovarian response or negative pregnancy outcome in this population. PMID:25023952

  20. [Assessment of the significance of climatogeographic conditions as health risk factors].

    PubMed

    Rakhmanov, R S; Gadzhiibragimov, D A; Medzhikova, M A; Kudriavtseva, O A

    2010-01-01

    Under the conditions of hot and mountain-continental climate, the morbidity rates in the inhabitants were estimated to be significantly lower than those in young men who had not been acclimatized or adapted to living conditions and in non-acclimatized men. A role of individual physical environmental factors (temperature, relative humidity, barometric pressure, average and maximum air speed) and integral exposure by the wind chill index (a combined impact of an air speed and ambient temperature) as risk factors to human health was defined, The mountain-continental climate showed a relationship of the influence of these factors to habitation at different altitudes above sea level. PMID:20491267

  1. Excessive occupational heat exposure: a significant ergonomic challenge and health risk for current and future workers

    PubMed Central

    2014-01-01

    Occupational heat exposure threatens the health of a worker not only when heat illness occurs but also when a worker’s performance and work capacity is impaired. Occupational contexts that involve hot and humid climatic conditions, heavy physical workloads and/or protective clothing create a strenuous and potentially dangerous thermal load for a worker. There are recognized heat prevention strategies and international thermal ergonomic standards to protect the worker. However, such standards have been developed largely in temperate western settings, and their validity and relevance is questionable for some geographical, cultural and socioeconomic contexts where the risk of excessive heat exposure can be high. There is evidence from low- and middle-income tropical countries that excessive heat exposure remains a significant issue for occupational health. Workers in these countries are likely to be at high risk of excessive heat exposure as they are densely populated, have large informal work sectors and are expected to experience substantial increases in temperature due to global climate change. The aim of this paper is to discuss current and future ergonomic risks associated with working in the heat as well as potential methods for maintaining the health and productivity of workers, particularly those most vulnerable to excessive heat exposure. PMID:25057350

  2. C9ORF72 Intermediate Repeat Copies Are a Significant Risk Factor for Parkinson Disease

    PubMed Central

    Nuytemans, Karen; Bademci, Güney; Kohli, Martin M; Beecham, Gary W; Wang, Liyong; Young, Juan I; Nahab, Fatta; Martin, Eden R; Gilbert, John R; Benatar, Michael; Haines, Jonathan L; Scott, William K; Züchner, Stephan; Pericak-Vance, Margaret A; Vance, Jeffery M

    2013-01-01

    We set out to determine whether expansions in the C9ORF72 repeat found in amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) families are associated with Parkinson disease (PD). We determined the repeat size in a total of 889 clinically ascertained patients (including PD and essential tremor plus Parkinsonism (ETP)) and 1144 controls using a repeat-primed PCR assay. We found that large C9ORF72 repeat expansions (>30 repeats) were not contributing to PD risk. However, PD and ETP cases had a significant increase in intermediate (>20 to 30+) repeat copies compared to controls. Overall, 14 cases (13 PD, 1 ETP) and three controls had >20 repeat copies (Fisher's exact test p = 0.002). Further, seven cases and no controls had >23 repeat copies (p = 0.003). Our results suggest that intermediate copy numbers of the C9ORF72 repeat contribute to risk for PD and ETP. This also suggests that PD, ALS and FTD share some pathophysiological mechanisms of disease. Further studies are needed to elucidate the contribution of the C9ORF72 repeat in the overall PD population and to determine whether other common genetic risk factors exist between these neurodegenerative disorders. PMID:23845100

  3. Excessive occupational heat exposure: a significant ergonomic challenge and health risk for current and future workers.

    PubMed

    Lucas, Rebekah A I; Epstein, Yoram; Kjellstrom, Tord

    2014-01-01

    Occupational heat exposure threatens the health of a worker not only when heat illness occurs but also when a worker's performance and work capacity is impaired. Occupational contexts that involve hot and humid climatic conditions, heavy physical workloads and/or protective clothing create a strenuous and potentially dangerous thermal load for a worker. There are recognized heat prevention strategies and international thermal ergonomic standards to protect the worker. However, such standards have been developed largely in temperate western settings, and their validity and relevance is questionable for some geographical, cultural and socioeconomic contexts where the risk of excessive heat exposure can be high. There is evidence from low- and middle-income tropical countries that excessive heat exposure remains a significant issue for occupational health. Workers in these countries are likely to be at high risk of excessive heat exposure as they are densely populated, have large informal work sectors and are expected to experience substantial increases in temperature due to global climate change. The aim of this paper is to discuss current and future ergonomic risks associated with working in the heat as well as potential methods for maintaining the health and productivity of workers, particularly those most vulnerable to excessive heat exposure. PMID:25057350

  4. Performance analysis of wavelet transforms and morphological operator-based classification of epilepsy risk levels

    NASA Astrophysics Data System (ADS)

    Harikumar, Rajaguru; Vijayakumar, Thangavel

    2014-12-01

    The objective of this paper is to compare the performance of singular value decomposition (SVD), expectation maximization (EM), and modified expectation maximization (MEM) as the postclassifiers for classifications of the epilepsy risk levels obtained from extracted features through wavelet transforms and morphological filters from electroencephalogram (EEG) signals. The code converter acts as a level one classifier. The seven features such as energy, variance, positive and negative peaks, spike and sharp waves, events, average duration, and covariance are extracted from EEG signals. Out of which four parameters like positive and negative peaksand spike and sharp waves, events and average duration are extracted using Haar, dB2, dB4, and Sym 8 wavelet transforms with hard and soft thresholding methods. The above said four features are also extracted through morphological filters. Then, the performance of the code converter and classifiers are compared based on the parameters such as performance index (PI) and quality value (QV).The performance index and quality value of code converters are at low value of 33.26% and 12.74, respectively. The highest PI of 98.03% and QV of 23.82 are attained at dB2 wavelet with hard thresholding method for SVD classifier. All the postclassifiers are settled at PI value of more than 90% at QV of 20.

  5. Which oropharyngeal factors are significant risk factors for obstructive sleep apnea? An age-matched study and dentist perspectives

    PubMed Central

    Ruangsri, Supanigar; Jorns, Teekayu Plangkoon; Puasiri, Subin; Luecha, Thitisan; Chaithap, Chariya; Sawanyawisuth, Kittisak

    2016-01-01

    Objective Obstructive sleep apnea (OSA) is a common sleep breathing disorder. Untreated OSA may lead to a number of cardiovascular complications. Dentists may play an important role in OSA detection by conducting careful oral examinations. This study focused on the correlation of oral anatomical features in Thai patients who presented with OSA. Methods We conducted a prospective comparative study at a sleep/hypertension clinic and a dental clinic at Khon Kaen University in Thailand. Patients with OSA were enrolled in the study, along with age-matched patients with non-OSA (controls). Baseline characteristics, clinical data, and oropharyngeal data of all patients were compared between the two groups. Oropharyngeal measurements included tongue size, torus mandibularis, Mallampati classification, palatal space, and lateral pharyngeal wall area. Multivariate logistic regression analysis was used to identify the factors associated with OSA. Results During the study period, there were 156 patients who met the study criteria; 78 were patients with OSA and the other 78 were healthy control subjects. In the OSA group, there were 43 males with a mean age of 53 (standard deviation 12.29) years and a mean BMI of 30.86 kg/mm2. There were 37 males in the control group with a mean age of 50 (standard deviation 12.04) years and a mean BMI of 24.03 kg/mm2. According to multivariate logistic analysis, three factors were perfectly associated with OSA, including torus mandibularis class 6, narrow lateral pharyngeal wall, and Mallampati class 4. There were two other significant factors associated with having OSA, namely, BMI and Mallampati classification. The adjusted odds ratios (95% confidence interval) of these two factors were 1.445 (1.017, 2.052) and 5.040 (1.655, 15.358), respectively. Conclusion Dentists may play an important role in the detection of OSA in patients with high BMI through careful oropharyngeal examination in routine dental treatment. A large torus mandibularis

  6. [Naming and classification of steroids and human stress ulcers. Articles of historic significance published by Hans Selye 70 years ago].

    PubMed

    Szabó, Sándor; Gyires, Klára

    2015-08-30

    The name of Hans Selye is mostly known worldwide as the discoverer of stress reaction. Yet, he made numerous other seminal and clinically relevant discoveries. Namely, since he had a focused research on steroid hormones originating from the adrenal cortex that play a crucial role in stress response, he was the first who introduced about 70 years ago the first classification of steroids that is still valid nowadays. This is based on three objective facts: (a) the names of steroid groups are identical with their organ of origin (e.g., corticoids from the adrenal cortex, testoids/androgens from the testis); (b) chemical structures of the steroids are identical within a group (e.g., all corticoids have pregnane nucleus with 21 carbon atoms); and (c) the biological effects are homogenous within a group (e.g., all glucocorticoids exert catabolic effect, while androgens are anabolic). It should be emphasized that Selye also discovered in animal models the pro-inflammmatory effect of mineralocorticoids and the anti-inflammatory properties of glucocorticoids, about 8-10 years before Nobel Prize was awarded to a physician for the first clinical use of adrenocorticotrop hormone and cortisone. Last, but not least, Selye was the first who recognized about 70 years ago the occurence of stress ulcers in humans, based on clinical reports on the huge increase in the number of perforated gastric anti-duodenal ulcers during bombings of London in World War II. The subsequent ulcer research by Selye`s former students and their contemporaries resulted in the recognition of anti-duodenal ulcer effect of dopamine, and the central gastroprotective actions of thyreotrop releasing hormone and endogenous opioids. Thus, Hans Selye made much more contributions to medical science and clinical practice than 'just' the discoverer of biologic stress response. PMID:26299832

  7. The APC I1307K allele conveys a significant increased risk for cancer.

    PubMed

    Leshno, Ari; Shapira, Shiran; Liberman, Eliezer; Kraus, Sarah; Sror, Miri; Harlap-Gat, Amira; Avivi, Doran; Galazan, Lior; David, Maayan; Maharshak, Nitsan; Moanis, Serhan; Arber, Nadir; Moshkowitz, Menachem

    2016-03-15

    This study is the first attempt to evaluate the association between the APC I1307K variant and overall cancer risk. It is unique in both its large sample size and in the reliability of data in the control group. The findings described in this article have major implications in terms of identifying asymptomatic individuals who are at increased risk to harbor cancer and therefore targeted to be enrolled in specific early detection and prevention programs. The prevalence of the APC I1307K missense mutation among Ashkenazi Jews is ∼ 6%. Carriers are at an increased risk for colorectal neoplasia. In this study, we examined the association of this variant with non-colorectal cancers. Consecutive 13,013 healthy subjects who underwent screening at the Integrated Cancer Prevention Center between 2006 and 2014 were enrolled. This population was supplemented with 1,611 cancer patients from the same institution. Demographics, medical history, and pathological data were recorded. Mortality data were obtained from the Ministry of Health's registry. The prevalence of APC I1307K in cancer patients and healthy subjects was compared. The APC I1307K variant was detected in 189 (11.8%) cancer patients compared to 614 (4.7%) healthy subjects, reflecting an adjusted age and sex odds ratio (OR) of 2.53 (p < 0.0001). History of two or more cancer types was associated with a positive carrier prevalence (OR = 4.38 p < 0.0001). Males had significantly increased carrier prevalence in lung, urologic, pancreatic, and skin cancers. The carrier prevalence among females was significantly higher only in breast and skin cancers. Female carriers developed cancer at a significantly older age compared to non-carriers (average 62.7 years vs. 57.8, respectively, p = 0.027), had better survival rates (HR = 0.58, p = 0.022) and overall increased longevity (average age of death 78.8 vs. 70.4 years, respectively, p = 0.003). In conclusion, the APC I1307K variant is a reliable marker for overall cancer risk

  8. Sarcopenia and sarcopenic obesity classifications and cardiometabolic risks in older women.

    PubMed

    dos Santos, Enivaldo Pereira; Gadelha, André Bonadias; Safons, Marisete Peralta; Nóbrega, Otávio Toledo; Oliveira, Ricardo Jacó; Lima, Ricardo Moreno

    2014-01-01

    The purpose of this study was to examine the association between sarcopenia and sarcopenic obesity (SO) with cardiometabolic risk factors in postmenopausal women. 149 volunteers (67.17±6.12 years) underwent body composition assessment using dual energy X-ray absorptiometry (DXA) and had analyzed blood samples collected for lipid profile, glucose metabolism and C-reactive protein (CRP). Sarcopenia was defined as an appendicular fat-free mass (AFFM) divided by height squared ≤5.45 kg/m(2) while SO was classified based on the residuals of a regression. Waist circumference (WC) and arterial blood pressure were also measured. Student's t-tests and correlations were used for analyses. Prevalence of sarcopenia and SO were respectively 16.8 and 21.5%. WC was significantly correlated with all the examined risk factors. AFFM relative to height squared was positively correlated with systolic blood pressure (SBP) and diastolic blood pressure (DBP), CRP, insulinaemia, HOMA score, and those classified as sarcopenic presented lower HOMA score when compared to nonsarcopenic. Regarding SO, although volunteers classified presented significantly higher fat mass (FM) and lower AFFM, it was not observed association with the examined risk factors. These findings support the association between WC and cardiometabolic risk factors in older women. In contrast, the approaches used to define sarcopenia and SO are not associated with cardiometabolic impairments. PMID:24766993

  9. Ecological status classification of the Taizi River Basin, China: a comparison of integrated risk assessment approaches.

    PubMed

    Fan, Juntao; Semenzin, Elena; Meng, Wei; Giubilato, Elisa; Zhang, Yuan; Critto, Andrea; Zabeo, Alex; Zhou, Yun; Ding, Sen; Wan, Jun; He, Mengchang; Lin, Chunye

    2015-10-01

    Integrated risk assessment approaches allow to achieve a sound evaluation of ecological status of river basins and to gain knowledge about the likely causes of impairment, useful for informing and supporting the decision-making process. In this paper, the integrated risk assessment (IRA) methodology developed in the EU MODELKEY project (and implemented in the MODELKEY Decision Support System) is applied to the Taizi River (China), in order to assess its Ecological and Chemical Status according to EU Water Framework Directive (WFD) requirements. The available dataset is derived by an extensive survey carried out in 2009 and 2010 across the Taizi River catchment, including the monitoring of physico-chemical (i.e. DO, EC, NH3-_N, chemical oxygen demand (COD), biological oxygen demand in 5 days (BOD5) and TP), chemical (i.e. polycyclic aromatic hydrocarbons (PAHs) and metals), biological (i.e. macroinvertebrates, fish, and algae), and hydromorphological parameters (i.e. water quantity, channel change and morphology diversity). The results show a negative trend in the ecological status from the highland to the lowland of the Taizi River Basin. Organic pollution from agriculture and domestic sources (i.e. COD and BOD5), unstable hydrological regime (i.e. water quantity shortage) and chemical pollutants from industry (i.e. PAHs and metals) are found to be the main stressors impacting the ecological status of the Taizi River Basin. The comparison between the results of the IRA methodology and those of a previous study (Leigh et al. 2012) indicates that the selection of indicators and integrating methodologies can have a relevant impact on the classification of the ecological status. The IRA methodology, which integrates information from five lines of evidence (i.e., biology, physico-chemistry, chemistry, ecotoxicology and hydromorphology) required by WFD, allows to better identify the biological communities that are potentially at risk and the stressors that are most

  10. Significant Impact of the MTHFR Polymorphisms and Haplotypes on Male Infertility Risk

    PubMed Central

    Gupta, Nishi; Sarkar, Saumya; David, Archana; Gangwar, Pravin Kumar; Gupta, Richa; Khanna, Gita; Sankhwar, Satya Narayan; Khanna, Anil; Rajender, Singh

    2013-01-01

    Background Methylenetetrahydrofolate reductase (MTHFR) converts 5,10-methylene tetrahydrofolate to 5-methyl tetrahydrofolate and affects the activity of cellular cycles participating in nucleotide synthesis, DNA repair, genome stability, maintenance of methyl pool, and gene regulation. Genetically compromised MTHFR activity has been suggested to affect male fertility. The objective of the present study was to find the impact on infertility risk of c.203G>A, c.1298A>C, and c.1793G>A polymorphisms in the MTHFR gene. Methods PCR-RFLP and DNA sequencing were used to genotype the common SNPs in the MTHFR gene in 630 infertile and 250 fertile males. Chi-square test was applied for statistical comparison of genotype data. Linkage disequilibrium between the SNPs and the frequency of common haplotypes were assessed using Haploview software. Biochemical levels of total homocysteine (tHcy) and folic acid were measured. Meta-analysis on c.1298A>C polymorphism was performed using data from ten studies, comprising 2734 cases and 2737 controls. Results c.203G>A and c.1298A>C were found to be unrelated to infertility risk. c.1793G>A was protective against infertility (P = 0.0008). c.677C>T and c.1793G>A were in significant LD (D’ = 0.9). Folic acid and tHcy level did not correlate with male infertility. Pooled estimate on c.1298A>C data from all published studies including our data showed no association of this polymorphism with male infertility (Odds ratio = 1.035, P = 0.56), azoospermia (Odds ratio = 0.97, P = 0.74), or oligoasthenoteratozoospermia (Odds ratio = 0.92, p = 0.29). Eight haplotypes with more than 1% frequency were detected, of which CCGA was protective against infertility (p = 0.02), but the significance of the latter was not seen after applying Bonferroni correction. Conclusion Among MTHFR polymorphisms, c.203G>A and c.1298A>C do not affect infertility risk and c.1793G>A is protective against infertility. Haplotype analysis

  11. Interpretation of fish biomarker data for identification, classification, risk assessment and testing of endocrine disrupting chemicals.

    PubMed

    Dang, ZhiChao

    2016-01-01

    Chemical induced changes in fish biomarkers vitellogenin (VTG), secondary sex characteristics (SSC), and sex ratio indicate modes/mechanisms of action (MOAs) of EAS (estrogen, androgen and steroidogenesis) pathways. These biomarkers could be used for defining MOAs and the causal link between MOAs and adverse effects in fish for the identification of endocrine disrupting chemicals (EDCs). This paper compiled data sets of 150 chemicals for VTG, 57 chemicals for SSC and 38 chemicals for sex ratio in fathead minnow, medaka and zebrafish. It showed 1) changes in fish biomarkers can indicate the MOAs as anticipated; 2) in addition to EAS pathways, chemicals with non-EAS pathways induced changes in fish biomarkers; 3) responses of fish biomarkers did not always follow the anticipated patterns of EAS pathways. These responses may result from the interaction of chemical-induced multiple MOAs and confounding factors like fish diet, infection, culture conditions, general toxicity and stress response. The complex response of fish biomarkers to a chemical of interest requires EDC testing at multiple biological levels. Interpretation of fish biomarker data should be combined with relevant information at different biological levels, which is critical for defining chemical specific MOAs. The utility of fish biomarker data for identification, classification, PBT assessment, risk assessment, and testing of EDCs in the regulatory context was discussed. This paper emphasizes the importance of fish biomarker data in the regulatory context, a weight of evidence approach for the interpretation of fish biomarker data and the need for defining levels of evidence for the identification of EDCs. PMID:27155823

  12. Significance of Pre-Radiographic MRI Lesions in Persons at Higher Risk for Knee Osteoarthritis

    PubMed Central

    Sharma, Leena; Chmiel, Joan S.; Almagor, Orit; Dunlop, Dorothy; Guermazi, Ali; Bathon, Joan; Eaton, Charles; Hochberg, Marc; Jackson, Rebecca; Kwoh, Kent; Mysiw, W. Jerry; Crema, Michel; Roemer, Frank; Nevitt, Michael

    2014-01-01

    Objective Little is known about early knee osteoarthritis (OA). The significance of MRI lesions in older persons without radiographic OA is unclear. Our objectives were to determine extent of tissue pathology by MRI and evaluate its significance by testing the hypotheses: cartilage damage, bone marrow lesions (BMLs), and meniscal damage are associated with prevalent frequent knee symptoms and incident persistent symptoms; BMLs and meniscal damage are associated with incident tibiofemoral cartilage damage; BMLs are associated with incident patellofemoral cartilage damage. Methods In a cohort study of 849 OAI (Osteoarthritis Initiative) participants who had bilateral K/L 0, we assessed cartilage, BMLs, and meniscal damage using MOAKS, as well as prevalent frequent knee symptoms, incident persistent symptoms, and incident cartilage damage. Multiple logistic regression (one knee/person) was used to evaluate associations between MRI lesions and each of these outcomes. Results 76% had cartilage damage, 61% BMLs, 21% meniscal tears, and 14% meniscal extrusion. Cartilage damage (any; tibiofemoral and patellofemoral), BMLs (any; tibiofemoral and patellofemoral), meniscal extrusion, and BMI were associated with prevalent frequent symptoms. Cartilage damage (isolated patellofemoral; tibiofemoral and patellofemoral), BMLs (any; isolated patellofemoral; tibiofemoral and patellofemoral), meniscal tears, and BMI were associated with incident persistent symptoms. Hand OA but no individual lesion type was associated with incident tibiofemoral cartilage damage, and BMLs (any; any patellofemoral) with incident patellofemoral damage. Having more lesion types was associated with a greater risk of outcomes. Conclusions MRI-detected lesions are not incidental and may represent early disease in persons at higher risk for knee OA. PMID:24974824

  13. Clinically Significant Depressive Symptoms as a Risk Factor for HIV Infection Among Black MSM in Massachusetts

    PubMed Central

    Reisner, Sari L.; Skeer, Margie; Bright, Donna; Cranston, Kevin; Isenberg, Deborah; Bland, Sean; Barker, Thomas A.; Mayer, Kenneth H.

    2013-01-01

    High rates of depression have been observed among men who have sex with men (MSM) relative to the general adult male population; however, a dearth of research has explored depression among Black MSM. Black MSM (n = 197) recruited via modified respondent-driven sampling between January and July 2008 completed an interviewer-administered quantitative assessment and voluntary HIV counseling and testing. Bivariate and multivariable logistic regression procedures examined the associations of demographics, behavioral HIV risk factors, and psychosocial variables with depressive symptoms by severity, using the 20-item Center for Epidemiologic Studies Depression Scale (CES-D). Adjusting for demographic and behavioral variables, significant factors associated with (1) clinically significant depressive symptoms (33%; CES-D score ≥ 16): being publicly insured by Medicaid, having serodiscordant anal sex with a casual male partner, and being diagnosed with an STD in the prior 12 months; (2) moderate depressive symptoms (19%; CES-D score 16–26): having serodiscordant unprotected anal sex with a casual male partner and being diagnosed with an STD in the prior 12 months; (3) severe depressive symptoms (14%; CES-D score 27+): being publicly insured by Medicaid and reporting difficulty accessing healthcare in the past 12 months. Moderately depressed Black MSM may be more likely to engage in behaviors that place them at increased risk for HIV and other STDs. HIV prevention interventions for Black MSM may benefit from incorporating screening and/or treatment for depression, allowing MSM who are depressed to respond more effectively to behavioral change approaches. PMID:19462228

  14. Identifying Adult Dengue Patients at Low Risk for Clinically Significant Bleeding

    PubMed Central

    Wong, Joshua G. X.; Thein, Tun Linn; Leo, Yee-Sin; Pang, Junxiong; Lye, David C.

    2016-01-01

    Background Clinically significant bleeding is important for subsequent optimal case management in dengue patients, but most studies have focused on dengue severity as an outcome. Our study objective was to identify differences in admission parameters between patients who developed clinically significant bleeding and those that did not. We sought to develop a model for discriminating between these patients. Methods We conducted a retrospective study of 4,383 adults aged >18 years who were hospitalized with dengue infection at Tan Tock Seng Hospital, Singapore from 2005 to 2008. Patients were divided into those with clinically significant bleeding (n = 188), and those without (n = 4,195). Demographic, clinical, and laboratory variables on admission were compared between groups to determine factors associated with clinically significant bleeding during hospitalization. Results On admission, female gender (p<0.001); temperature >38°C (p<0.001); nausea/vomiting (p = 0.009) and abdominal pain/tenderness (p = 0.005); lower systolic blood pressure (p<0.001); higher pulse rate (p<0.001); increased absolute neutrophil count (ANC; p<0.001); reduced absolute lymphocyte count (ALC; p<0.001), haematocrit percentage (p<0.001) and platelet count (p = 0.04), and increased prothrombin time (p = 0.003) were significantly associated with clinically significant bleeding on univariate analysis. Multivariate analysis showed that independent variables in the final model were female gender (aOR 2.85; 95% CI: 1.9–4.33); temperature >38°C (aOR 1.81; 95% CI: 1.27–2.61), nausea/vomiting (aOR 1.39; 95% CI: 0.94–2.12), ANC (aOR 1.3; 95% CI: 1.15–1.46), ALC (aOR 0.4; 95% CI: 0.25–0.64), hematocrit percentage (aOR 0.96; 95% CI: 0.92–1.002) and platelet count (aOR 0.993; 95% CI: 0.988–0.998). At the cutoff of -3.919, the model achieved an AUC of 0.758 (sensitivity:0.87, specificity: 0.38, PPV: 0.06, NPV: 0.98). Conclusion Clinical risk factors associated with clinically significant

  15. Early Recognition and Disease Prediction in the At-Risk Mental States for Psychosis Using Neurocognitive Pattern Classification

    PubMed Central

    Koutsouleris, Nikolaos; Davatzikos, Christos; Bottlender, Ronald; Patschurek-Kliche, Katja; Scheuerecker, Johanna; Decker, Petra; Gaser, Christian; Möller, Hans-Jürgen; Meisenzahl, Eva M.

    2012-01-01

    Background: Neuropsychological deficits predate overt psychosis and overlap with the impairments in the established disease. However, to date, no single neurocognitive measure has shown sufficient power for a prognostic test. Thus, it remains to be determined whether multivariate neurocognitive pattern classification could facilitate the diagnostic identification of different at-risk mental states (ARMS) for psychosis and the individualized prediction of illness transition. Methods: First, classification of 30 healthy controls (HC) vs 48 ARMS individuals subgrouped into 20 “early,” 28 “late” ARMS subjects was performed based on a comprehensive neuropsychological test battery. Second, disease prediction was evaluated by categorizing the neurocognitive baseline data of those ARMS individuals with transition (n = 15) vs non transition (n = 20) vs HC after 4 years of follow-up. Generalizability of classification was estimated by repeated double cross-validation. Results: The 3-group cross-validated classification accuracies in the first analysis were 94.2% (HC vs rest), 85.0% (early at-risk subjects vs rest), and, 91.4% (late at-risk subjects vs rest) and 90.8% (HC vs rest), 90.8% (converters vs rest), and 89.0% (nonconverters vs rest) in the second analysis. Patterns distinguishing the early or late ARMS from HC primarily involved the verbal learning/memory domains, while executive functioning and verbal IQ deficits were particularly characteristic of the late ARMS. Disease transition was mainly predicted by executive and verbal learning impairments. Conclusions: Different ARMS and their clinical outcomes may be reliably identified on an individual basis by evaluating neurocognitive test batteries using multivariate pattern recognition. These patterns may have the potential to substantially improve the early recognition of psychosis. PMID:21576280

  16. Significance of DNA adduct studies in animal models for cancer molecular dosimetry and risk assessment.

    PubMed Central

    Beland, F A; Poirier, M C

    1993-01-01

    To elucidate the relationship between DNA adduct formation and tumorigenesis, a number of experiments have been conducted to measure DNA adducts in target tissues from experimental animals during continuous exposure to carcinogens. With aflatoxins, aromatic amines, and polycyclic aromatic hydrocarbons, tumor induction appears to be associated with the major DNA adduct detected, whereas with N-nitrosamines the response is normally correlated with minor forms of DNA damage. During continuous carcinogen administration, steady-state adduct concentrations are generally obtained in the target tissues, and there is often a linear correlation between the carcinogen concentration and the steady-state DNA adduct level. Exceptions exist when the mechanism of activation changes or with the onset of significant toxicity. Steady-state DNA adduct levels are often linearly related to the tumorigenic response. Carcinogen-induced cell proliferation occurs when significant deviations from linearity are observed. Because DNA adducts detected in humans are chemically identical to those found in experimental animals, DNA adduct data in animals may contribute to our understanding of human cancer risk. PMID:8319658

  17. [Classification, significance and sequelae of posttraumatic "occult" bone and cartilage fractures of the knee. The role of magnetic resonance].

    PubMed

    Macarini, L; Zaccheo, N; Garribba, A P; Angelelli, G; Rotondo, A

    1995-12-01

    Magnetic Resonance Imaging (MRI) shows, in the post-traumatic knee, a fairly high number of bone and cartilage injuries missed by conventional radiography and therefore called occult. Our aim is to classify these injuries, to correlate their site and distribution with associated menisco-ligamentous injuries and with trauma mechanisms. Thirty-eight patients with a history of acute knee trauma and negative X-ray findings were examined with MRI within 15 days of trauma. 1.5- and 0.5-T units and SE T1-weighted GE T2*-weighted and SE T2-weighted sequences were used. The injuries were classified as intraosseous and osteochondral bruises or fractures. Twenty-three patients with menisco-ligamentous injuries were submitted to therapeutic arthroscopy; the sites of bone and cartilage injuries depicted with MRI were studied with arthroscopy. Seven patients were followed-up with MRI at 6-12 months to investigate subchondral injury evolution: 5 of 7 patients were also submitted to arthroscopy. MRI showed a statistically significant correlation between site and distribution of bone and cartilage injuries and between internal derangement and trauma mechanisms, i.e., contusion, distortion, stress. In our experience, MRI could identify and characterize occult subchondral injuries, thus allowing appropriate treatment. PMID:8685452

  18. Reassessing the cultural and psychopharmacological significance of Banisteriopsis caapi: preparation, classification and use among the Piaroa of Southern Venezuela.

    PubMed

    Rodd, Robin

    2008-09-01

    Recent attention to the monoamine oxidase inhibiting properties of Banisteriopsis caapi's harmala alkaloids has precluded a balanced assessment of B. caapi's overall significance to indigenous South American societies. Relatively little attention has been paid to the cultural contexts, local meanings and patterns of use of B. caapi among snuff-using societies, such as the Piaroa, who do not prepare decoctions containing N,N-dimethyltryptamine (DMT) admixtures. This article reviews the psychopharmacological literature on B. caapi in light of recent ethnographic work conducted among the Piaroa of southern Venezuela. Piaroa shamans use only B. caapi's cambium, identify at least five distinct varieties of B. caapi, and emphasise the plant's importance for heightening empathy. Some Piaroa people also attribute a range of extra-shamanic uses to B. caapi, including as a stimulant and hunting aid. In light of the psychopharmacological complexity of harmala alkaloids, and ethnographic evidence for a wide range of B. caapi uses,future research should reconsider B. caapi's cultural heritage and psychopharmacological potential as a stimulant and antidepressant-like substance. PMID:19004422

  19. Classification of Non-Small Cell Lung Cancer Using Significance Analysis of Microarray-Gene Set Reduction Algorithm

    PubMed Central

    Zhang, Lei; Wang, Linlin; Du, Bochuan; Wang, Tianjiao; Tian, Pu

    2016-01-01

    Among non-small cell lung cancer (NSCLC), adenocarcinoma (AC), and squamous cell carcinoma (SCC) are two major histology subtypes, accounting for roughly 40% and 30% of all lung cancer cases, respectively. Since AC and SCC differ in their cell of origin, location within the lung, and growth pattern, they are considered as distinct diseases. Gene expression signatures have been demonstrated to be an effective tool for distinguishing AC and SCC. Gene set analysis is regarded as irrelevant to the identification of gene expression signatures. Nevertheless, we found that one specific gene set analysis method, significance analysis of microarray-gene set reduction (SAMGSR), can be adopted directly to select relevant features and to construct gene expression signatures. In this study, we applied SAMGSR to a NSCLC gene expression dataset. When compared with several novel feature selection algorithms, for example, LASSO, SAMGSR has equivalent or better performance in terms of predictive ability and model parsimony. Therefore, SAMGSR is a feature selection algorithm, indeed. Additionally, we applied SAMGSR to AC and SCC subtypes separately to discriminate their respective stages, that is, stage II versus stage I. Few overlaps between these two resulting gene signatures illustrate that AC and SCC are technically distinct diseases. Therefore, stratified analyses on subtypes are recommended when diagnostic or prognostic signatures of these two NSCLC subtypes are constructed. PMID:27446945

  20. Clinically occult interstitial fibrosis in smokers: classification and significance of a surprisingly common finding in lobectomy specimens.

    PubMed

    Katzenstein, Anna-Luise A; Mukhopadhyay, Sanjay; Zanardi, Conrado; Dexter, Elizabeth

    2010-03-01

    This study reports the presence of surprisingly frequent and often severe interstitial fibrosis in cigarette smokers with no clinical evidence of interstitial lung disease. Twenty-three lobectomy specimens excised for neoplasms, including 20 from smokers, were extensively sampled, and examined semi-quantitatively for interstitial fibrosis, fibroblast foci, peribronchiolar metaplasia, honey-comb change, emphysema, and respiratory bronchiolitis. Interstitial fibrosis involving greater than 25% of slides was identified in 12 of 20 smokers (60%), but in none of the three never-smokers. Three cases were classified as specific forms of interstitial lung disease, including one each of usual interstitial pneumonia, Langerhans cell histiocytosis, and asbestosis. The remaining 9 cases did not fit with a named interstitial lung disease and were considered to represent examples of smoking-related interstitial fibrosis. This lesion was characterized by varying degrees of alveolar septal widening by collagen deposition along with emphysema and respiratory bronchiolitis. The fibrosis occurred both in subpleural and in deeper parenchyma. It surrounded enlarged airspaces of emphysema, but it also involved non-emphysematous parenchyma. Clinical progression was not documented in any case, although follow-up was short. These observations highlight the spectrum of unexpected fibrosis that is frequently encountered in lobectomy specimens from cigarette smokers. Additional investigation will be required to determine the clinical significance of smoking-related interstitial fibrosis and its relationship, if any, to other smoking-related diseases. It is important, however, that smoking-related interstitial fibrosis be distinguished from specific forms of fibrosing lung disease that may be associated with poor prognoses, especially usual interstitial pneumonia. PMID:20004953

  1. Identifying HIV most-at-risk groups in Malawi for targeted interventions. A classification tree model

    PubMed Central

    Emina, Jacques B O; Madise, Nyovani; Kuepie, Mathias; Zulu, Eliya M; Ye, Yazoume

    2013-01-01

    Objectives To identify HIV-socioeconomic predictors as well as the most-at-risk groups of women in Malawi. Design A cross-sectional survey. Setting Malawi Participants The study used a sample of 6395 women aged 15–49 years from the 2010 Malawi Health and Demographic Surveys. Interventions N/A Primary and secondary outcome measures Individual HIV status: positive or not. Results Findings from the Pearson χ2 and χ2 Automatic Interaction Detector analyses revealed that marital status is the most significant predictor of HIV. Women who are no longer in union and living in the highest wealth quintiles households constitute the most-at-risk group, whereas the less-at-risk group includes young women (15–24) never married or in union and living in rural areas. Conclusions In the light of these findings, this study recommends: (1) that the design and implementation of targeted interventions should consider the magnitude of HIV prevalence and demographic size of most-at-risk groups. Preventive interventions should prioritise couples and never married people aged 25–49 years and living in rural areas because this group accounts for 49% of the study population and 40% of women living with HIV in Malawi; (2) with reference to treatment and care, higher priority must be given to promoting HIV test, monitoring and evaluation of equity in access to treatment among women in union disruption and never married or women in union aged 30–49 years and living in urban areas; (3) community health workers, households-based campaign, reproductive-health services and reproductive-health courses at school could be used as canons to achieve universal prevention strategy, testing, counselling and treatment. PMID:23793677

  2. Derivation of a No-significant-risk-level (NSRL) for dermal exposures to diethanolamine.

    PubMed

    Kirman, C R; Hughes, B; Becker, R A; Hays, S M

    2016-04-01

    Diethanolamine (DEA) has been found to produce liver and kidney tumors in mice following lifetime dermal exposures. Data regarding the mode of action by which DEA produces these tumors were used to support a dose-response assessment that resulted in a no-significant-risk-level (NSRL) for dermal exposures to DEA. DEA and its metabolites are structural analogs to endogenous agents important to choline homeostasis. Sufficient information is available to support an epigenetic MOA involving the perturbation of choline homeostasis and hepatic methylation reactions in the formation of mouse liver tumors. This MOA may also apply to mouse kidney tumors, but direct measurements for key events in kidney are lacking. For both tumor types, dose-response data were pooled across four cancer bioassays conducted for DEA and DEA-containing condensates in order to provide a more robust characterization of the dose-response relationships. Doses were expressed in terms of dermally absorbed dose so that the dose-dependency and species differences in the dermal absorption of DEA were addressed. The resulting NSRL value of 3400 ug/day for dermal exposures to DEA is considered to be protective of human health for both tumor endpoints. PMID:26850685

  3. Factors associated with an increased risk of vertebral fracture in monoclonal gammopathies of undetermined significance.

    PubMed

    Piot, J M; Royer, M; Schmidt-Tanguy, A; Hoppé, E; Gardembas, M; Bourrée, T; Hunault, M; François, S; Boyer, F; Ifrah, N; Renier, G; Chevailler, A; Audran, M; Chappard, D; Libouban, H; Mabilleau, G; Legrand, E; Bouvard, B

    2015-01-01

    Monoclonal gammopathies of undetermined significance (MGUS) have been shown to be associated with an increased risk of fractures. This study describes prospectively the bone status of MGUS patients and determines the factors associated with vertebral fracture. We included prospectively 201 patients with MGUS, incidentally discovered, and with no known history of osteoporosis: mean age 66.6±12.5 years, 48.3% women, 51.7% immunoglobulin G (IgG), 33.3% IgM and 10.4% IgA. Light chain was kappa in 64.2% patients. All patients had spinal radiographs and bone mineral density measurement in addition to gammopathy assessment. At least one prevalent non-traumatic vertebral fracture was discovered in 18.4% patients and equally distributed between men and women. Fractured patients were older, had a lower bone density and had also more frequently a lambda light chain isotype. Compared with patients with κ light chain, the odds ratio of being fractured for patients with λ light chain was 4.32 (95% confidence interval 1.80-11.16; P=0.002). These results suggest a high prevalence of non-traumatic vertebral fractures in MGUS associated with lambda light chain isotype and not only explained by low bone density. PMID:26314987

  4. Factors associated with an increased risk of vertebral fracture in monoclonal gammopathies of undetermined significance

    PubMed Central

    Piot, J M; Royer, M; Schmidt-Tanguy, A; Hoppé, E; Gardembas, M; Bourrée, T; Hunault, M; François, S; Boyer, F; Ifrah, N; Renier, G; Chevailler, A; Audran, M; Chappard, D; Libouban, H; Mabilleau, G; Legrand, E; Bouvard, B

    2015-01-01

    Monoclonal gammopathies of undetermined significance (MGUS) have been shown to be associated with an increased risk of fractures. This study describes prospectively the bone status of MGUS patients and determines the factors associated with vertebral fracture. We included prospectively 201 patients with MGUS, incidentally discovered, and with no known history of osteoporosis: mean age 66.6±12.5 years, 48.3% women, 51.7% immunoglobulin G (IgG), 33.3% IgM and 10.4% IgA. Light chain was kappa in 64.2% patients. All patients had spinal radiographs and bone mineral density measurement in addition to gammopathy assessment. At least one prevalent non-traumatic vertebral fracture was discovered in 18.4% patients and equally distributed between men and women. Fractured patients were older, had a lower bone density and had also more frequently a lambda light chain isotype. Compared with patients with κ light chain, the odds ratio of being fractured for patients with λ light chain was 4.32 (95% confidence interval 1.80–11.16; P=0.002). These results suggest a high prevalence of non-traumatic vertebral fractures in MGUS associated with lambda light chain isotype and not only explained by low bone density. PMID:26314987

  5. Anabolic steroids detected in bodybuilding dietary supplements - a significant risk to public health.

    PubMed

    Abbate, V; Kicman, A T; Evans-Brown, M; McVeigh, J; Cowan, D A; Wilson, C; Coles, S J; Walker, C J

    2015-07-01

    Twenty-four products suspected of containing anabolic steroids and sold in fitness equipment shops in the United Kingdom (UK) were analyzed for their qualitative and semi-quantitative content using full scan gas chromatography-mass spectrometry (GC-MS), accurate mass liquid chromatography-mass spectrometry (LC-MS), high pressure liquid chromatography with diode array detection (HPLC-DAD), UV-Vis, and nuclear magnetic resonance (NMR) spectroscopy. In addition, X-ray crystallography enabled the identification of one of the compounds, where reference standard was not available. Of the 24 products tested, 23 contained steroids including known anabolic agents; 16 of these contained steroids that were different to those indicated on the packaging and one product contained no steroid at all. Overall, 13 different steroids were identified; 12 of these are controlled in the UK under the Misuse of Drugs Act 1971. Several of the products contained steroids that may be considered to have considerable pharmacological activity, based on their chemical structures and the amounts present. This could unwittingly expose users to a significant risk to their health, which is of particular concern for naïve users. PMID:25284752

  6. Methodology to identify risk-significant components for inservice inspection and testing

    SciTech Connect

    Anderson, M.T.; Hartley, R.S.; Jones, J.L. Jr.; Kido, C.; Phillips, J.H.

    1992-08-01

    Periodic inspection and testing of vital system components should be performed to ensure the safe and reliable operation of Department of Energy (DOE) nuclear processing facilities. Probabilistic techniques may be used to help identify and rank components by their relative risk. A risk-based ranking would allow varied DOE sites to implement inspection and testing programs in an effective and cost-efficient manner. This report describes a methodology that can be used to rank components, while addressing multiple risk issues.

  7. The International Classification of Functioning, Disability and Health as a Framework for Providing Patient- and Family-Centered Audiological Care for Older Adults and Their Significant Others.

    PubMed

    Grenness, Caitlin; Meyer, Carly; Scarinci, Nerina; Ekberg, Katie; Hickson, Louise

    2016-08-01

    Hearing impairment is highly prevalent in the older population, and it impacts communication and quality of life for both the people with the hearing difficulties and their significant others. In this article, typical audiological assessment and management of an older adult is contrasted with a best practice approach wherein the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework is applied. The aim of the comparison is to demonstrate how the ICF expands our focus: rather than merely focusing on impairment, we also consider the activities, participation, and contextual factors for both the person with the hearing impairment and his or her family. A case example of an older patient and her spouse is provided, and their shared experience of the patient's hearing impairment is mapped onto the ICF framework. Family-centered hearing care is recommended for individualizing care and improving outcomes for older patients and their families. PMID:27489398

  8. Effect of Adding McKenzie Syndrome, Centralization, Directional Preference, and Psychosocial Classification Variables to a Risk-Adjusted Model Predicting Functional Status Outcomes for Patients With Lumbar Impairments.

    PubMed

    Werneke, Mark W; Edmond, Susan; Deutscher, Daniel; Ward, Jason; Grigsby, David; Young, Michelle; McGill, Troy; McClenahan, Brian; Weinberg, Jon; Davidow, Amy L

    2016-09-01

    Study Design Retrospective cohort. Background Patient-classification subgroupings may be important prognostic factors explaining outcomes. Objectives To determine effects of adding classification variables (McKenzie syndrome and pain patterns, including centralization and directional preference; Symptom Checklist Back Pain Prediction Model [SCL BPPM]; and the Fear-Avoidance Beliefs Questionnaire subscales of work and physical activity) to a baseline risk-adjusted model predicting functional status (FS) outcomes. Methods Consecutive patients completed a battery of questionnaires that gathered information on 11 risk-adjustment variables. Physical therapists trained in Mechanical Diagnosis and Therapy methods classified each patient by McKenzie syndromes and pain pattern. Functional status was assessed at discharge by patient-reported outcomes. Only patients with complete data were included. Risk of selection bias was assessed. Prediction of discharge FS was assessed using linear stepwise regression models, allowing 13 variables to enter the model. Significant variables were retained in subsequent models. Model power (R(2)) and beta coefficients for model variables were estimated. Results Two thousand sixty-six patients with lumbar impairments were evaluated. Of those, 994 (48%), 10 (<1%), and 601 (29%) were excluded due to incomplete psychosocial data, McKenzie classification data, and missing FS at discharge, respectively. The final sample for analyses was 723 (35%). Overall R(2) for the baseline prediction FS model was 0.40. Adding classification variables to the baseline model did not result in significant increases in R(2). McKenzie syndrome or pain pattern explained 2.8% and 3.0% of the variance, respectively. When pain pattern and SCL BPPM were added simultaneously, overall model R(2) increased to 0.44. Although none of these increases in R(2) were significant, some classification variables were stronger predictors compared with some other variables included in

  9. Polychlorinated biphenyls still pose significant health risks to northwest Atlantic harbor seals.

    PubMed

    Shaw, Susan D; Berger, Michelle L; Weijs, Liesbeth; Päpke, Olaf; Covaci, Adrian

    2014-08-15

    Polychlorinated biphenyls (PCBs) have been detected at relatively high concentrations in harbor seals, apex predators in the northwest Atlantic. As part of an ongoing assessment of the effects of PCBs on population health, we analyzed tri- to deca-PCBs in the liver of 56 harbor seals (6 adult males, 50 pups) and in 11 blubber samples (4 adult males, 7 pups) and examined tissue-specific accumulation patterns, biomagnification potential, and toxic implications of current PCB concentrations. Hepatic ∑30PCB concentrations (overall mean±standard deviation: 76,860±111,800 ng/g lipid weight, lw) were higher than blubber concentrations (48,180±69,420 ng/g lw). Regional trends were suggestive of fresh PCB inputs from the industrialized, densely populated southern coast of New England versus the rural north. The lack of temporal trends confirmed that tissue concentrations of PCBs have plateaued since the early 1990s. Tissue distribution of PCBs varied significantly by age and, surprisingly by gender among the pups. Principal Component Analysis (PCA) revealed that lighter PCBs are selectively transferred from mother to pup blubber in relation to lipid solubility (log Kow), but heavier PCBs may be efficiently transferred during late lactation from mother to pup liver. Biomagnification factors (BMFs) for ∑6PCBs from prey fish to adult male seals ranged from 90 to 547 in the liver and 88 to 532 in the blubber, and suggested that molecular structure and metabolic capacity were more important influences than log Kow on the retention of PCBs. Blubber concentrations of ∑30PCBs in 87% of the pups were an order of magnitude higher than recent toxic reference values (TRVs) calculated for ∑154PCBs in nursing harbor seals, suggesting that the pups are at risk for PCB-mediated toxicity at a vulnerable stage of development. Given the recurring pattern of epizootics in these seals, the health of the population is of concern. PMID:24875260

  10. Viral respiratory diseases in children: classification, etiology, epidemiology, and risk factors.

    PubMed

    Hemming, V G

    1994-05-01

    The epidemiology, molecular structure, cell tropism, and pathophysiology of many human disease-causing viruses have been painstakingly and elegantly characterized during the past 50 years. Vaccines and antiviral drugs of varying efficacy were developed and tested. Despite the relegation of smallpox to a freezer chest and the progress in the control of measles and hepatitis B, the viruses that cause respiratory tract infections remain significant causes of illness and death in pediatric populations worldwide. This discussion surveys the virus groups that contain nearly 200 distinct viruses that cause sporadic and epidemic respiratory infections in children. The epidemiology of infection with the influenza A and B, parainfluenza, and respiratory syncytial viruses and adenoviruses and their impact on infants and children and the groups at highest risk for morbid outcomes are discussed. PMID:8169752

  11. USUING STREAM MORPHOLOGY CLASSIFICATION TO MANAGE ECOLOGICAL RISKS FROM LAND USE CHANGES IN THE LMR WATERSHED

    EPA Science Inventory

    Changes in the amount and types of land use in a watershed can destabilize stream channel structure, increase sediment loading and degrade in-stream habitat. Stream classification systems (e.g. Rosgen) may be useful for determining the susceptibility of stream channel segments t...

  12. USING STREAM MORPHOLOGY CLASSIFICATION TO MANAGE ECOLOGICAL RISKS FROM LAND USE CHANGES IN THE LMR WATERSHED

    EPA Science Inventory

    Changes in the amount and types of land use in a watershed can destabilize stream channel structure, increase sediment loading and degrade in-stream habitat. Stream classification systems (e.g. Rosgen) may be useful for determining the susceptibility of stream channel segments t...

  13. Classification-based data mining for identification of risk patterns associated with hypertension in Middle Eastern population: A 12-year longitudinal study.

    PubMed

    Ramezankhani, Azra; Kabir, Ali; Pournik, Omid; Azizi, Fereidoun; Hadaegh, Farzad

    2016-08-01

    Hypertension is a critical public health concern worldwide. Identification of risk factors using traditional multivariable models has been a field of active research. The present study was undertaken to identify risk patterns associated with hypertension incidence using data mining methods in a cohort of Iranian adult population.Data on 6205 participants (44% men) age > 20 years, free from hypertension at baseline with no history of cardiovascular disease, were used to develop a series of prediction models by 3 types of decision tree (DT) algorithms. The performances of all classifiers were evaluated on the testing data set.The Quick Unbiased Efficient Statistical Tree algorithm among men and women and Classification and Regression Tree among the total population had the best performance. The C-statistic and sensitivity for the prediction models were (0.70 and 71%) in men, (0.79 and 71%) in women, and (0.78 and 72%) in total population, respectively. In DT models, systolic blood pressure (SBP), diastolic blood pressure, age, and waist circumference significantly contributed to the risk of incident hypertension in both genders and total population, wrist circumference and 2-h postchallenge plasma glucose among women and fasting plasma glucose among men. In men, the highest hypertension risk was seen in those with SBP > 115 mm Hg and age > 30 years. In women those with SBP > 114 mm Hg and age > 33 years had the highest risk for hypertension. For the total population, higher risk was observed in those with SBP > 114 mm Hg and age > 38 years.Our study emphasizes the utility of DTs for prediction of hypertension and exploring interaction between predictors. DT models used the easily available variables to identify homogeneous subgroups with different risk pattern for the hypertension. PMID:27583845

  14. Automatic Classification of Structured Product Labels for Pregnancy Risk Drug Categories, a Machine Learning Approach

    PubMed Central

    Rodriguez, Laritza M.; Fushman, Dina Demner

    2015-01-01

    With regular expressions and manual review, 18,342 FDA-approved drug product labels were processed to determine if the five standard pregnancy drug risk categories were mentioned in the label. After excluding 81 drugs with multiple-risk categories, 83% of the labels had a risk category within the text and 17% labels did not. We trained a Sequential Minimal Optimization algorithm on the labels containing pregnancy risk information segmented into standard document sections. For the evaluation of the classifier on the testing set, we used the Micromedex drug risk categories. The precautions section had the best performance for assigning drug risk categories, achieving Accuracy 0.79, Precision 0.66, Recall 0.64 and F1 measure 0.65. Missing pregnancy risk categories could be suggested using machine learning algorithms trained on the existing publicly available pregnancy risk information. PMID:26958248

  15. [The significance of high sensitive C reactive protein as a risk factor for cardiovascular diseases].

    PubMed

    Meguro, Shu; Ishibashi, Midori; Takei, Izumi

    2012-04-01

    Chronic inflammation is involved in the pathogenesis of cardiovascular diseases (CVD). Several prospective studies have indicated that an elevated high sensitive C-reactive protein (hs-CRP) level is a risk factor for CVD. These results were also confirmed by prospective studies in Japan both for primary and secondary prevention. A randomized control study using statins also revealed that lower levels of both LDL cholesterol and hs-CRP were independently related to the incidence of CVD. Recent meta-analysis revealed that hs-CRP was a risk factor not only for CVD but for other diseases including cancers. It revealed that the absolute value of hs-CRP varied among the study populations. The mechanism of how hs-CRP is associated with the pathogenesis of CVD is not fully understood. Generally, inflammation in the vascular wall and the release of inflammatory cytokines from macrophages was considered to the main mechanism, but infection with such as chlamydia or Helicobacter pylori, and periodontal disease have been postulated as the causes of systemic inflammation. Recently, visceral fat accumulation and its cross-interaction with inflammatory cells have been proposed as the cause of systemic inflammation as "innate inflammation". Our original cross sectional studies also showed the correlations of hs-CRP with BMI and triglyceride. Although there is no specific therapy for the reduction of hs-CRP, we have to consider hs-CRP as a risk factor for CVD which complements other classical risk factors. PMID:22686046

  16. Relationship between obesity and the risk of clinically significant depression: Mendelian randomisation study

    PubMed Central

    Hung, Chi-Fa; Rivera, Margarita; Craddock, Nick; Owen, Michael J.; Gill, Michael; Korszun, Ania; Maier, Wolfgang; Mors, Ole; Preisig, Martin; Rice, John P.; Rietschel, Marcella; Jones, Lisa; Middleton, Lefkos; Aitchison, Kathy J.; Davis, Oliver S. P.; Breen, Gerome; Lewis, Cathryn; Farmer, Anne; McGuffin, Peter

    2014-01-01

    Background Obesity has been shown to be associated with depression and it has been suggested that higher body mass index (BMI) increases the risk of depression and other common mental disorders. However, the causal relationship remains unclear and Mendelian randomisation, a form of instrumental variable analysis, has recently been employed to attempt to resolve this issue. Aims To investigate whether higher BMI increases the risk of major depression. Method Two instrumental variable analyses were conducted to test the causal relationship between obesity and major depression in RADIANT, a large case-control study of major depression. We used a single nucleotide polymorphism (SNP) in FTO and a genetic risk score (GRS) based on 32 SNPs with well-established associations with BMI. Results Linear regression analysis, as expected, showed that individuals carrying more risk alleles of FTO or having higher score of GRS had a higher BMI. Probit regression suggested that higher BMI is associated with increased risk of major depression. However, our two instrumental variable analyses did not support a causal relationship between higher BMI and major depression (FTO genotype: coefficient –0.03, 95% CI –0.18 to 0.13, P = 0.73; GRS: coefficient –0.02, 95% CI –0.11 to 0.07, P = 0.62). Conclusions Our instrumental variable analyses did not support a causal relationship between higher BMI and major depression. The positive associations of higher BMI with major depression in probit regression analyses might be explained by reverse causality and/or residual confounding. PMID:24809401

  17. An assessment of the risk significance of human errors in selected PSAs and operating events

    SciTech Connect

    Palla, R.L. Jr.; El-Bassioni, A. . Office of Nuclear Reactor Regulation); Higgins, J. )

    1991-01-01

    Sensitivity studies based on Probabilistic Safety Assessments (PSAs) for a pressurized water reactor and a boiling water reactor are described. In each case human errors modeled in the PSAs were categorized according to such factors as error type, location, timing, and plant personnel involved. Sensitivity studies were then conducted by varying the error rates in each category and evaluating the corresponding change in total core damage frequency and accident sequence frequency. Insights obtained are discussed and reasons for differences in risk sensitivity between plants are explored. A separate investigation into the role of human error in risk-important operating events is also described. This investigation involved the analysis of data from the USNRC Accident Sequence Precursor program to determine the effect of operator-initiated events on accident precursor trends, and to determine whether improved training can be correlated to current trends. The findings of this study are also presented. 5 refs., 15 figs., 1 tab.

  18. Constructing a holistic approach to disaster risk reduction: the significance of focusing on vulnerability reduction.

    PubMed

    Palliyaguru, Roshani; Amaratunga, Dilanthi; Baldry, David

    2014-01-01

    As a result of the increase in natural disaster losses, policy-makers, practitioners, and members of the research community around the world are seeking effective and efficient means of overcoming or minimising them. Although various theoretical constructs are beneficial to understanding the disaster phenomenon and the means of minimising losses, the disaster risk management process becomes less effective if theory and practice are set apart from one another. Consequently, this paper seeks to establish a relationship between two theoretical constructs, 'disaster risk reduction (DRR)' and 'vulnerability reduction', and to develop a holistic approach to DRR with particular reference to improving its applicability in practical settings. It is based on a literature review and on an overall understanding gained through two case studies of post-disaster infrastructure reconstruction projects in Sri Lanka and three expert interviews in Sri Lanka and the United Kingdom. PMID:24325238

  19. Relative significance of heat transfer processes to quantify tradeoffs between complexity and accuracy of energy simulations with a building energy use patterns classification

    NASA Astrophysics Data System (ADS)

    Heidarinejad, Mohammad

    This dissertation develops rapid and accurate building energy simulations based on a building classification that identifies and focuses modeling efforts on most significant heat transfer processes. The building classification identifies energy use patterns and their contributing parameters for a portfolio of buildings. The dissertation hypothesis is "Building classification can provide minimal required inputs for rapid and accurate energy simulations for a large number of buildings". The critical literature review indicated there is lack of studies to (1) Consider synoptic point of view rather than the case study approach, (2) Analyze influence of different granularities of energy use, (3) Identify key variables based on the heat transfer processes, and (4) Automate the procedure to quantify model complexity with accuracy. Therefore, three dissertation objectives are designed to test out the dissertation hypothesis: (1) Develop different classes of buildings based on their energy use patterns, (2) Develop different building energy simulation approaches for the identified classes of buildings to quantify tradeoffs between model accuracy and complexity, (3) Demonstrate building simulation approaches for case studies. Penn State's and Harvard's campus buildings as well as high performance LEED NC office buildings are test beds for this study to develop different classes of buildings. The campus buildings include detailed chilled water, electricity, and steam data, enabling to classify buildings into externally-load, internally-load, or mixed-load dominated. The energy use of the internally-load buildings is primarily a function of the internal loads and their schedules. Externally-load dominated buildings tend to have an energy use pattern that is a function of building construction materials and outdoor weather conditions. However, most of the commercial medium-sized office buildings have a mixed-load pattern, meaning the HVAC system and operation schedule dictate

  20. Determining significant endpoints for ecological risk analyses. 1997 annual progress report

    SciTech Connect

    Hinton, T.G.; Congdon, J.; Rowe, C.; Scott, D.; Bedford, J.; Whicker, F.W.

    1997-11-01

    'This report summarizes the first year''s progress of research funded under the Department of Energy''s Environmental Management Science Program. The research was initiated to better determine ecological risks from toxic and radioactive contaminants. More precisely, the research is designed to determine the relevancy of sublethal cellular damage to the performance of individuals and to identify characteristics of non-human populations exposed to chronic, low-level radiation, as is typically found on many DOE sites. The authors propose to establish a protocol to assess risks to non-human species at higher levels of biological organization by relating molecular damage to more relevant responses that reflect population health. They think that they can achieve this by coupling changes in metabolic rates and energy allocation patterns to meaningful population response variables, and by using novel biological dosimeters in controlled, manipulative dose/effects experiments. They believe that a scientifically defensible endpoint for measuring ecological risks can only be determined once its understood the extent to which molecular damage from contaminant exposure is detrimental at the individual and population levels of biological organization.'

  1. Prognostic Significance of Serial Q/ST-T Changes by the Minnesota Code and Novacode In the Atherosclerosis Risk in Communities (ARIC) Study

    PubMed Central

    Zhang, Zhu-ming; Prineas, Ronald J.; Soliman, Elsayed Z.; Baggett, Chris; Heiss, Gerardo

    2016-01-01

    Aims To compare the value of serial electrocardiographic (ECG) changes by the 2 most widely used ECG classification systems--the Minnesota Code (MC) and Novacode (Nova) for the prediction of subsequent coronary heart disease (CHD) and total mortality. Methods and Result We studied 12-lead ECGs from 12,477 participants (average age 54 years at baseline; 58% women; 76% non-Hispanic white) in the Atherosclerosis Risk in Communities (ARIC) Study, who were free of CHD at baseline in 1987, had both good quality ECGs at baseline and at first study-scheduled follow up visit, and had ECG QRS duration < 120ms. A total 2,119 participants died (17%), including 280 CHD deaths during an average of 17 years follow-up. Cox regression models assessed outcome associated with significant serial ECG changes by MC and Nova separately. For CHD death the Hazard ratio was 6.8 (95% confidence interval 3.5-13.3) for incident Nova myocardial infarction (MI), and 5.7 (95% confidence interval 2.7-11.9) for MC-MI in a multivariable model adjusted for clinical, demographic characteristics, and ECG left ventricular hypertrophy. The increased risk for total mortality doubled for both Nova and MC serial ECG MI. Major evolving ST-T wave abnormalities alone were associated with a ≥132% increased risk for CHD death and a 50% increased risk for total mortality by either Nova or MC. Conclusion ECG serial change by both MC and Nova are equally valuable predictors for future fatal cardiac events and total mortality and hence equally useful prognostic indicators in clinical trials and epidemiologic studies. PMID:21997257

  2. Identifying unique and shared risk factors for physical intimate partner violence and clinically-significant physical intimate partner violence.

    PubMed

    Slep, Amy M Smith; Foran, Heather M; Heyman, Richard E; Snarr, Jeffery D; Usaf Family Advocacy Research Program

    2014-12-01

    Intimate partner violence (IPV) is a significant public health concern. To date, risk factor research has not differentiated physical violence that leads to injury and/or fear (i.e., clinically significant IPV; CS-IPV) from general physical IPV. Isolating risk relations is necessary to best inform prevention and treatment efforts. The current study used an ecological framework and evaluated relations of likely risk factors within individual, family, workplace, and community levels with both CS-IPV and general IPV to determine whether they were related to one type of IPV, both, or neither for both men and women. Probable risk and promotive factors from multiple ecological levels of influence were selected from the literature and assessed, along with CS-IPV and general IPV, via an anonymous, web-based survey. The sample comprised US Air Force (AF) active duty members and civilian spouses (total N = 36,861 men; 24,331 women) from 82 sites worldwide. Relationship satisfaction, age, and alcohol problems were identified as unique risk factors (in the context of the 23 other risk factors examined) across IPV and CS-IPV for men and women. Other unique risk factors were identified that differed in prediction of IPV and CS-IPV. The results suggest a variety of both established and novel potential foci for indirectly targeting partner aggression and clinically-significant IPV by improving people's risk profiles at the individual, family, workplace, and community levels. Aggr. Behav. 9999:XX-XX, 2014. © 2014 Wiley Periodicals, Inc. PMID:25474230

  3. Identifying unique and shared risk factors for physical intimate partner violence and clinically-significant physical intimate partner violence.

    PubMed

    Slep, Amy M Smith; Foran, Heather M; Heyman, Richard E; Snarr, Jeffery D; Usaf Family Advocacy Research Program

    2015-05-01

    Intimate partner violence (IPV) is a significant public health concern. To date, risk factor research has not differentiated physical violence that leads to injury and/or fear (i.e., clinically significant IPV; CS-IPV) from general physical IPV. Isolating risk relations is necessary to best inform prevention and treatment efforts. The current study used an ecological framework and evaluated relations of likely risk factors within individual, family, workplace, and community levels with both CS-IPV and general IPV to determine whether they were related to one type of IPV, both, or neither for both men and women. Probable risk and promotive factors from multiple ecological levels of influence were selected from the literature and assessed, along with CS-IPV and general IPV, via an anonymous, web-based survey. The sample comprised US Air Force (AF) active duty members and civilian spouses (total N = 36,861 men; 24,331 women) from 82 sites worldwide. Relationship satisfaction, age, and alcohol problems were identified as unique risk factors (in the context of the 23 other risk factors examined) across IPV and CS-IPV for men and women. Other unique risk factors were identified that differed in prediction of IPV and CS-IPV. The results suggest a variety of both established and novel potential foci for indirectly targeting partner aggression and clinically-significant IPV by improving people's risk profiles at the individual, family, workplace, and community levels. Aggr. Behav. 41:227-241, 2015. © 2014 Wiley Periodicals, Inc. PMID:27541201

  4. Brief Report: Classification of Adolescent Suicide and Risk-Taking Deaths

    ERIC Educational Resources Information Center

    Sankey, Melissa; Lawrence, Ruth

    2005-01-01

    This study examined the suicide and risk-taking deaths of adolescents aged 12-17 years between January 1996 and December 2000. The methodology consisted of a case file review of government records. One hundred and eighty-seven adolescents (133 males, 54 females) died by suicide and risk-taking and could be classified into three distinct groups:…

  5. Determining significant endpoints for ecological risk analyses. 1998 annual progress report

    SciTech Connect

    Hinton, T.G.; Congdon, J.; Scott, D.; Rowe, C.; Bedford, J.; Whicker, W.

    1998-06-01

    'The goal of this report is to establish a protocol for assessing risks to non-human populations exposed to environmental stresses typically found on many DOE sites. The authors think that they can achieve this by using novel biological dosimeters in controlled, manipulative dose/effects experiments, and by coupling changes in metabolic rates and energy allocation patterns to meaningful population response variables (such as age-specific survivorship, reproductive output, age at maturity and longevity). This research is needed to determine the relevancy of sublethal cellular damage to the performance of individuals and populations exposed to chronic, low-level radiation, and radiation with concomitant exposure to chemicals. They believe that a scientifically defensible endpoint for measuring ecological risks can only be determined once its understood the extent to which molecular damage from contaminant exposure is detrimental at the individual and population levels of biological organization. The experimental facility will allow them to develop a credible assessment tool for appraising ecological risks, and to evaluate the effects of radionuclide/chemical synergisms on non-human species. This report summarizes work completed midway of a 3-year project that began in November 1996. Emphasis to date has centered on three areas: (1) developing a molecular probe to measure stable chromosomal aberrations known as reciprocal translocations, (2) constructing an irradiation facility where the statistical power inherent in replicated mesocosms can be used to address the response of non-human organisms to exposures from low levels of radiation and metal contaminants, and (3) quantifying responses of organisms living in contaminated mesocosms and field sites.'

  6. Risk factors and clinical significance of ertapenem-resistant Klebsiella pneumoniae in hospitalised patients.

    PubMed

    Orsi, G B; García-Fernández, A; Giordano, A; Venditti, C; Bencardino, A; Gianfreda, R; Falcone, M; Carattoli, A; Venditti, M

    2011-05-01

    Ertapenem-resistant Klebsiella pneumoniae (ER-Kp) is an emerging healthcare-associated pathogen. In order to identify risk factors associated with ER-Kp acquisition, the records of 100 patients from whom K. pneumoniae had been isolated between July 2008 and December 2009 were reviewed. These comprised 38 with ER-Kp (28 infected, 10 colonised) and 62 with ertapenem-susceptible K. pneumoniae (ES-Kp) (43 infected, 19 colonised). Multilocus sequence typing (MSLT) and porin gene investigation performed on 25 ER-Kp strains showed that 24 belonged to the ST37 lineage, expressing a novel OmpK36 variant and not expressing OmpK35. Breakthrough bacteraemia occurred in 13 (52%) of 25 bloodstream infections (BSIs). Among nine ER-Kp BSIs, five were complicated by breakthrough bacteraemia, of which four developed during carbapenem therapy. Among 16 ES-Kp BSIs, breakthrough bacteraemia developed in eight patients (50%), but only one occurred (12%) during carbapenem therapy. Logistic regression analysis showed that carbapenems (odds ratio: 12.9; 95% confidence interval: 3.09-53.7; P < 0.001), second generation cephalosporins (11.8; 1.87-74.4; P < 0.01), endoscopy (5.59; 1.32-23.6; P < 0.02), acute renal failure (5.32; 1.13-25.1; P=0.034) and third generation cephalosporins (4.15; 1.09-15.8; P < 0.01) were independent risk factors for acquisition of ER-Kp. Our findings confirm that prior use of certain antimicrobials, specifically carbapenems and cephalosporins, are primary independent risk factors for colonisation or infection with ER-Kp. PMID:21450365

  7. Brief Communication: Newly developing rift in Larsen C Ice Shelf presents significant risk to stability

    NASA Astrophysics Data System (ADS)

    Jansen, D.; Luckman, A. J.; Cook, A.; Bevan, S.; Kulessa, B.; Hubbard, B.; Holland, P. R.

    2015-06-01

    An established rift in the Larsen C Ice Shelf, formerly constrained by a suture zone containing marine ice, grew rapidly during 2014 and is likely in the near future to generate the largest calving event since the 1980s and result in a new minimum area for the ice shelf. Here we investigate the recent development of the rift, quantify the projected calving event and, using a numerical model, assess its likely impact on ice shelf stability. We find that the ice front is at risk of becoming unstable when the anticipated calving event occurs.

  8. 100-years of Australian bushfire property losses: is the risk significant and is it increasing?

    PubMed

    McAneney, John; Chen, Keping; Pitman, Andy

    2009-06-01

    This study examines the bushfire (wildland fire) risk to the built environment in Australia. The most salient result is that the annual probability of building destruction has remained almost constant over the last century despite large demographic and social changes as well as improvements in fire fighting technique and resources. Most historical losses have taken place in a few extreme fires which if repeated are likely to overwhelm even the most professional of fire services. We also calculate the average annual probability of a random home on the urban-bushland interface being destroyed by a bushfire to be of the order of 1 in 6500, a factor 6.5 times lower than the ignition probability of a structural house fire. Thus on average and if this risk was perceived rationally, the incentive for individual homeowners to mitigate and reduce the bushfire danger even further is low. This being the case and despite predictions of an increasing likelihood of conditions favouring bushfires under global climate change, we suspect that building losses due to bushfires are unlikely to alter materially in the near future. PMID:19410362

  9. Significant factors of aviation insurance and risk management strategy: an empirical study of Taiwanese airline carriers.

    PubMed

    Lin, Yi Hsin; Chang, Yu Hern

    2008-04-01

    Aviation insurance premiums have become a heavy burden for the airline industry since September 11, 2001. Although the industry must constantly balance its operations between profitability and safety, the reality is that airlines are in the business of making money. Therefore, their ability to reduce cost and manage risk is a key factor for success. Unlike past research, which used subjective judgment methods, this study applied quantitative historical data (1999-2000) and gray relation analysis to identify the primary factors influencing ratemaking for aviation insurance premiums. An empirical study of six airlines in Taiwan was conducted to determine these factors and to analyze the management strategies used to deal with them. Results showed that the loss experience and performance of individual airlines were the key elements associated with aviation insurance premiums paid by each airline. By identifying and understanding the primary factors influencing ratemaking for aviation insurance, airlines will better understand their relative operational strengths and weaknesses, and further help top management identify areas for further improvement. Knowledge of these factors combined with effective risk management strategies, may result in lower premiums and operating costs for airline companies. PMID:18419661

  10. Assessment on the classification of landslide risk level using Genetic Algorithm of Operation Tree in central Taiwan

    NASA Astrophysics Data System (ADS)

    Wei, Chiang; Yeh, Hui-Chung; Chen, Yen-Chang

    2015-04-01

    This study assessed the classification of landslide areas by Genetic Algorithm of Operation Tree (GAOT) of Chen-Yu-Lan River upstream watershed of National Taiwan University Experimental Forest (NTUEF) after the Typhoon Morakot in 2009 using remotely and geological data. Landslides of 624.5 ha which accounting for 1.9% of total area were delineated with the threshold of slope (22°) and area size (1 hectare), 48 landslide sites were located in the upstream Chen-Yu-Lan watershed using FORMOSAT-II satellite imagery, the aerial photo and GIS related coverage. The five risk levels of these landslide areas was classified by the area, elevation, slope order, aspect, erosion order and geological factor order using the Simplicity Method suggested in the Technical Regulations for Soil and Water Conservation of Taiwan. If all the landslide sites were considered, the accuracy of classification using GAOT is 97.9%, superior than the K-means, Ward method, Shared Nearest Neighbor method, Maximum Likelihood Classifier and Bayesian Classifier; if 36 sites were used as training samples and the rest 12 sites were tested, the accuracy still can reach 81.3%. More geological data, anthropogenic influence and hydrological factors may be necessary for clarifying the landside area and the results benefit the assessment for future correction and management of the authorities.

  11. Motion Analysis and the Anterior Cruciate Ligament: Classification of Injury Risk.

    PubMed

    Bates, Nathaniel A; Hewett, Timothy E

    2016-02-01

    Anterior cruciate ligament (ACL) injuries are common, catastrophic events that incur large expense and lead to degradation of the knee. As such, various motion capture techniques have been applied to identify athletes who are at increased risk for suffering ACL injuries. The objective of this clinical commentary was to synthesize information related to how motion capture analyses contribute to the identification of risk factors that may predict relative injury risk within a population. Individuals employ both active and passive mechanisms to constrain knee joint articulation during motion. There is strong evidence to indicate that athletes who consistently classify as high-risk loaders during landing suffer from combined joint stability deficits in both the active and passive knee restraints. Implementation of prophylactic neuromuscular interventions and biofeedback can effectively compensate for some of the deficiencies that result from poor control of the active knee stabilizers and reduce the incidence of ACL injuries. PMID:26383143

  12. Radioactive and mixed waste - risk as a basis for waste classification. Symposium proceedings No. 2

    SciTech Connect

    1995-06-21

    The management of risks from radioactive and chemical materials has been a major environmental concern in the United states for the past two or three decades. Risk management of these materials encompasses the remediation of past disposal practices as well as development of appropriate strategies and controls for current and future operations. This symposium is concerned primarily with low-level radioactive wastes and mixed wastes. Individual reports were processed separately for the Department of Energy databases.

  13. Significance of model credibility in estimating climate projection distributions for regional hydroclimatological risk assessments

    USGS Publications Warehouse

    Brekke, L.D.; Dettinger, M.D.; Maurer, E.P.; Anderson, M.

    2008-01-01

    Ensembles of historical climate simulations and climate projections from the World Climate Research Programme's (WCRP's) Coupled Model Intercomparison Project phase 3 (CMIP3) multi-model dataset were investigated to determine how model credibility affects apparent relative scenario likelihoods in regional risk assessments. Methods were developed and applied in a Northern California case study. An ensemble of 59 twentieth century climate simulations from 17 WCRP CMIP3 models was analyzed to evaluate relative model credibility associated with a 75-member projection ensemble from the same 17 models. Credibility was assessed based on how models realistically reproduced selected statistics of historical climate relevant to California climatology. Metrics of this credibility were used to derive relative model weights leading to weight-threshold culling of models contributing to the projection ensemble. Density functions were then estimated for two projected quantities (temperature and precipitation), with and without considering credibility-based ensemble reductions. An analysis for Northern California showed that, while some models seem more capable at recreating limited aspects twentieth century climate, the overall tendency is for comparable model performance when several credibility measures are combined. Use of these metrics to decide which models to include in density function development led to local adjustments to function shapes, but led to limited affect on breadth and central tendency, which were found to be more influenced by 'completeness' of the original ensemble in terms of models and emissions pathways. ?? 2007 Springer Science+Business Media B.V.

  14. The significance of the subchronic toxicity in the dietary risk assessment of pesticides.

    PubMed

    Zarn, Jürg A; Hänggi, Emanuel; Kuchen, Arnold; Schlatter, Josef R

    2010-10-01

    Based on 289 public pesticide evaluations, geometric means of subchronic/chronic No Observed Adverse Effect Level (NOAEL) ratios of 2.6, 2.5 and 1.6 in mice, rats and dogs were calculated. The 75th percentiles are 5.5, 5.1 and 3.2. Higher ratios correlate with increased dose spacing in chronic studies and may be mainly explained therewith. In rats fed at constant pesticide concentrations in feed, the mean chronic dose decreases by 1.7- and 2.7-fold compared to the subchronic and subacute phase. These dose decreases match the subchronic/chronic NOAEL ratios. The ratio of predicted rat chronic NOAEL (dose decrement adjusted subchronic NOAEL) to experimental chronic NOAEL is 1.5 and the 75th percentile is 3.0. In dietary risk assessment, the Acute Reference Dose and the Acceptable Daily Intake (derived from acute and chronic NOAEL) are compared to acute (IESTI) or mean (TMDI) exposure estimates. Because IESTI and TMDI base on acute or mean food consumption they differ by orders of magnitude for certain commodities. As subchronic and chronic NOAEL are similar, it remains to be shown whether pesticide intake estimates based on mean food consumption are adequate measures to compare against the ADI if repeated daily exposures considerably higher than mean exposures may occur. PMID:20406660

  15. Parkinson syndrome. A significant risk factor in the patient with acute surgical disorder.

    PubMed

    Simon, D; Shapira, O M; Mor, E; Pfefferman, R

    1992-01-01

    Ten Parkinsonic patients presenting with acute surgical disease were studied to determine the effects of both conditions on each other and the patient's outcome. Severe motion and communication disturbances led, invariably, to a delay in seeking medical assistance, with most of the patients' presenting symptoms and signs being non-specific and misleading. As a result half the patients presented already in a state of septic shock, and a correct preoperative diagnosis could be achieved in three patients only. The functional status significantly deteriorated in six patients, in four of whom a prolonged rehabilitation course was necessary. Although there was no immediate perioperative mortality, morbidity was significant as 50% and 100% major "surgery-related" and "Parkinson-related" complications accordingly. It is concluded that the coexistence of acute surgical disease with Parkinson syndrome has a profound adverse effect on the patient's outcome. High index of suspicion, early mobilisation, intense physiotherapy and early resumption of the anti-Parkinson drugs are the key points in the management of these patients. PMID:1478816

  16. A significant association between BDNF promoter methylation and the risk of drug addiction.

    PubMed

    Xu, Xuting; Ji, Huihui; Liu, Guili; Wang, Qinwen; Liu, Huifen; Shen, Wenwen; Li, Longhui; Xie, Xiaohu; Zhou, Wenhua; Duan, Shiwei

    2016-06-10

    As a member of the neurotrophic factor family, brain derived neurotrophic factor (BDNF) plays an important role in the survival and differentiation of neurons. The aim of our work was to evaluate the role of BDNF promoter methylation in drug addiction. A total of 60 drug abusers (30 heroin and 30 methylamphetamine addicts) and 52 healthy age- and gender-matched controls were recruited for the current case control study. Bisulfite pyrosequencing technology was used to determine the methylation levels of five CpGs (CpG1-5) on the BDNF promoter. Among the five CpGs, CpG5 methylation was significantly lower in drug abusers than controls. Moreover, significant associations were found between CpG5 methylation and addictive phenotypes including tension-anxiety, anger-hostility, fatigue-inertia, and depression-dejection. In addition, luciferase assay showed that the DNA fragment of BDNF promoter played a key role in the regulation of gene expression. Our results suggest that BDNF promoter methylation is associated with drug addiction, although further studies are needed to understand the mechanisms by which BDNF promoter methylation contributes to the pathophysiology of drug addiction. PMID:26976342

  17. A Prolonged Time Interval Between Trauma and Prophylactic Radiation Therapy Significantly Increases the Risk of Heterotopic Ossification

    SciTech Connect

    Mourad, Waleed F.; Packianathan, Satyaseelan; Shourbaji, Rania A.; Zhang Zhen; Graves, Mathew; Khan, Majid A.; Baird, Michael C.; Russell, George; Vijayakumar, Srinivasan

    2012-03-01

    Purpose: To ascertain whether the time from injury to prophylactic radiation therapy (RT) influences the rate of heterotopic ossification (HO) after operative treatment of displaced acetabular fractures. Methods and Materials: This is a single-institution, retrospective analysis of patients referred for RT for the prevention of HO. Between January 2000 and January 2009, 585 patients with displaced acetabular fractures were treated surgically followed by RT for HO prevention. We analyzed the effect of time from injury on prevention of HO by RT. In all patients, 700 cGy was prescribed in a single fraction and delivered within 72 hours postsurgery. The patients were stratified into five groups according to time interval (in days) from the date of their accident to the date of RT: Groups A {<=}3, B {<=}7, C {<=}14, D {<=}21, and E >21days. Results: Of the 585 patients with displaced acetabular fractures treated with RT, (18%) 106 patients developed HO within the irradiated field. The risk of HO after RT increased from 10% for RT delivered {<=}3 days to 92% for treatment delivered >21 days after the initial injury. Wilcoxon test showed a significant correlation between the risk of HO and the length of time from injury to RT (p < 0.0001). Chi-square test and multiple logistic regression analysis showed no significant association between all other factors and the risk of HO (race, gender, cause and type of fracture, surgical approach, or the use of indomethacin). Conclusions: Our data suggest that there is higher incidence and risk of HO if prophylactic RT is significantly delayed after a displaced acetabular fracture. Thus, RT should be administered as early as clinically possible after the trauma. Patients undergoing RT >3 weeks from their displaced acetabular fracture should be informed of the higher risk (>90%) of developing HO despite prophylaxis.

  18. Risk of significant cytopenias after treatment with tocilizumab in systemic juvenile arthritis patients with a history of macrophage activation syndrome

    PubMed Central

    2012-01-01

    Tocilizumab (TCZ) is the first FDA- approved treatment for systemic juvenile idiopathic arthritis (sJIA). We report 3 cases of cytopenias in children with sJIA treated with TCZ. Two of the children who developed significant cytopenias shortly after initiation of TCZ had a history of macrophage activation syndrome. We raise the possibility that patients with a tendency towards MAS have an increased risk of developing cytopenias when treated with tocilizumab. PMID:22931129

  19. Severe Obesity and Cardiometabolic Risk in Children: Comparison from Two International Classification Systems

    PubMed Central

    Valerio, Giuliana; Maffeis, Claudio; Balsamo, Antonio; Del Giudice, Emanuele Miraglia; Brufani, Claudia; Grugni, Graziano; Licenziati, Maria Rosaria; Brambilla, Paolo; Manco, Melania

    2013-01-01

    Objectives There is no agreed-upon definition for severe obesity (Sev-OB) in children. We compared estimates of Sev-OB as defined by different cut-points of body mass index (BMI) from the Centers for Disease Control and Prevention (CDC) or the World Health Organization (WHO) curves and the ability of each set of cut-points to screen for the presence of cardiometabolic risk factors. Research Design and Methods Cross-sectional, multicenter study involving 3,340 overweight/obese young subjects. Sev-OB was defined as BMI ≥99th percentile or ≥1.2 times the 95th percentile of the CDC or the WHO curves. High blood pressure, hypertriglyceridemia, low High Density Lipoprotein -cholesterol and impaired fasting glucose were considered as cardiometabolic risk factors. Results The estimated prevalence of Sev-OB varied widely between the two reference systems. Either using the cut-point ≥99th percentile or ≥1.2 times the 95th percentile, less children were defined as Sev-OB by CDC than WHO (46.8 vs. 89.5%, and 63.3 vs. 80.4%, respectively p<0.001). The CDC 99th percentile had lower sensitivity (58.5 vs 94.2), higher specificity (57.6 vs 12.3) and higher positive predictive value (34.4 vs 28.9) than WHO in identifying obese children with ≥2 cardiometabolic risk factors. These differences were mitigated using the 1.2 times the 95th percentile (sensitivity 73.9 vs. 88.1; specificity 40.7 vs. 22.5; positive predictive value 32.1 vs. 30.1). Substantial agreement between growth curves was found using the 1.2 times the 95th percentile, in particular in children ≤10 years. Conclusions Estimates of Sev-OB and cardiometabolic risk as defined by different cut-points of BMI are influenced from the reference systems used. The 1.2 times the 95th percentile of BMI of either CDC or WHO standard has a discriminatory advantage over the 99th percentile for identifying severely obese children at increased cardiometabolic risk, particularly under 10 years of age. PMID:24386280

  20. [Significance of subjective evaluation of life events as risk factors for predicting future suicide attempts].

    PubMed

    Chrostek Maj, J; Polewka, A; Kroch, S; Mikołaszek-Boba, M; Rachel, W; Datka, W

    2001-01-01

    Among the total population of 180 patients undergoing medical examination between March and December 2000, hospitalized for suicide attempts (drug intoxication) in the Department of Clinical Toxicology CM UJ in Kraków, 159 persons were examined by means of modified questionnaire of life events based on a scale elaborated by Thomas Holmes and Richard Rache. The patients were divided into 2 groups--first group comprised patients after first suicide attempt and second group consisted of those who had reattempted suicide. In regard to sex and age there were no significant differences between these two groups and the total population of 180 patients. In order to obtain the patients' subjective evaluation of the influence of their course of life on their attempting suicide, we asked the patients to select from the list of life events those that had affected their mental and physical state during of whole their life. Objectivization of life events was based on the 'units of life change' by T. Holmes and R. Rache. The sum of units of life events was 373 scores (SD +/- 200, in the range of 39-1042 units). From the total list of life events (max. score--1513) we selected the events estimated at 40 and more units of life change. Those were; marriage, divorce, separation, marital reconciliation, patient's illness, change of behavior and illness of a close relative, death of a husband/wife, child, close relative, imprisonment, pregnancy, unemployment, retirement. In the patients' subjective evaluation part, the events most frequently selected by the patients as those that had affected their mental state were: death of a close relative (56.6%), illness of a relative (40.8%), patient's illness (37.7%). A high number of patients stated events testifying to a conflict in marriage--45.7% of patients stated marital separation, and reconciliation, and 27% of patients stated unemployment as a fact that had influenced their mental state. 30.6% of these patients belonged to the first

  1. Atherosclerotic plaque tissue characterization in 2D ultrasound longitudinal carotid scans for automated classification: a paradigm for stroke risk assessment.

    PubMed

    Acharya, U Rajendra; Mookiah, Muthu Rama Krishnan; Vinitha Sree, S; Afonso, David; Sanches, Joao; Shafique, Shoaib; Nicolaides, Andrew; Pedro, L M; Fernandes E Fernandes, J; Suri, Jasjit S

    2013-05-01

    In the case of carotid atherosclerosis, to avoid unnecessary surgeries in asymptomatic patients, it is necessary to develop a technique to effectively differentiate symptomatic and asymptomatic plaques. In this paper, we have presented a data mining framework that characterizes the textural differences in these two classes using several grayscale features based on a novel combination of trace transform and fuzzy texture. The features extracted from the delineated plaque regions in B-mode ultrasound images were used to train several classifiers in order to prepare them for classification of new test plaques. Our CAD system was evaluated using two different databases consisting of 146 (44 symptomatic to 102 asymptomatic) and 346 (196 symptomatic and 150 asymptomatic) images. Both these databases differ in the way the ground truth was determined. We obtained classification accuracies of 93.1 and 85.3 %, respectively. The techniques are low cost, easily implementable, objective, and non-invasive. For more objective analysis, we have also developed novel integrated indices using a combination of significant features. PMID:23292291

  2. Can I be sued for that? Liability risk and the disclosure of clinically significant genetic research findings

    PubMed Central

    McGuire, Amy L.; Knoppers, Bartha Maria; Zawati, Ma’n H.; Clayton, Ellen Wright

    2014-01-01

    Genomic researchers increasingly are faced with difficult decisions about whether, under what circumstances, and how to return research results and significant incidental findings to study participants. Many have argued that there is an ethical—maybe even a legal—obligation to disclose significant findings under some circumstances. At the international level, over the last decade there has begun to emerge a clear legal obligation to return significant findings discovered during the course of research. However, there is no explicit legal duty to disclose in the United States. This creates legal uncertainty that may lead to unmanaged variation in practice and poor quality care. This article discusses liability risks associated with the disclosure of significant research findings for investigators in the United States. PMID:24676095

  3. Evaluation and applications of the clinically significant change method with the Violence Risk Scale-Sexual Offender version: implications for risk-change communication.

    PubMed

    Olver, Mark E; Beggs Christofferson, Sarah M; Wong, Stephen C P

    2015-02-01

    We examined the use of the clinically significant change (CSC) method with the Violence Risk Scale-Sexual Offender version (VRS-SO), and its implications for risk communication, in a combined sample of 945 treated sexual offenders from three international settings, followed up for a minimum 5 years post-release. The reliable change (RC) index was used to identify thresholds of clinically meaningful change and to create four CSC groups (already okay, recovered, improved, unchanged) based on VRS-SO dynamic scores and amount of change made. Outcome analyses demonstrated important CSC-group differences in 5-year rates of sexual and violent recidivism. However, when baseline risk was controlled via Cox regression survival analysis, the pattern and magnitude of CSC-group differences in sexual and violent recidivism changed to suggest that observed variation in recidivism base rates could be at least partly explained by pre-existing group differences in risk level. Implications for communication of risk-change information and applications to clinical practice are discussed. PMID:25693953

  4. Redefining ALL classification: toward detecting high-risk ALL and implementing precision medicine.

    PubMed

    Hunger, Stephen P; Mullighan, Charles G

    2015-06-25

    Acute lymphoblastic leukemia (ALL) is the commonest childhood tumor and remains a leading cause of cancer death in the young. In the last decade, microarray and sequencing analysis of large ALL cohorts has revolutionized our understanding of the genetic basis of this disease. These studies have identified new ALL subtypes, each characterized by constellations of structural and sequence alterations that perturb key cellular pathways, including lymphoid development, cell-cycle regulation, and tumor suppression; cytokine receptor, kinase, and Ras signaling; and chromatin modifications. Several of these pathways, particularly kinase-activating lesions and epigenetic alterations, are logical targets for new precision medicine therapies. Genomic profiling has also identified important interactions between inherited genetic variants that influence the risk of leukemia development and the somatic genetic alterations that are required to establish the leukemic clone. Moreover, sequential sequencing studies at diagnosis, remission, and relapse have provided important insights into the relationship among genetic variants, clonal heterogeneity, and the risk of relapse. Ongoing studies are extending our understanding of coding and noncoding genetic alterations in B-progenitor and T-lineage ALL and using these insights to inform the development of faithful experimental models to test the efficacy of new treatment approaches. PMID:25999453

  5. Redefining ALL classification: toward detecting high-risk ALL and implementing precision medicine

    PubMed Central

    Hunger, Stephen P.

    2015-01-01

    Acute lymphoblastic leukemia (ALL) is the commonest childhood tumor and remains a leading cause of cancer death in the young. In the last decade, microarray and sequencing analysis of large ALL cohorts has revolutionized our understanding of the genetic basis of this disease. These studies have identified new ALL subtypes, each characterized by constellations of structural and sequence alterations that perturb key cellular pathways, including lymphoid development, cell-cycle regulation, and tumor suppression; cytokine receptor, kinase, and Ras signaling; and chromatin modifications. Several of these pathways, particularly kinase-activating lesions and epigenetic alterations, are logical targets for new precision medicine therapies. Genomic profiling has also identified important interactions between inherited genetic variants that influence the risk of leukemia development and the somatic genetic alterations that are required to establish the leukemic clone. Moreover, sequential sequencing studies at diagnosis, remission, and relapse have provided important insights into the relationship among genetic variants, clonal heterogeneity, and the risk of relapse. Ongoing studies are extending our understanding of coding and noncoding genetic alterations in B-progenitor and T-lineage ALL and using these insights to inform the development of faithful experimental models to test the efficacy of new treatment approaches. PMID:25999453

  6. The Society for Vascular Surgery Lower Extremity Threatened Limb Classification System: risk stratification based on wound, ischemia, and foot infection (WIfI).

    PubMed

    Mills, Joseph L; Conte, Michael S; Armstrong, David G; Pomposelli, Frank B; Schanzer, Andres; Sidawy, Anton N; Andros, George

    2014-01-01

    Critical limb ischemia, first defined in 1982, was intended to delineate a subgroup of patients with a threatened lower extremity primarily because of chronic ischemia. It was the intent of the original authors that patients with diabetes be excluded or analyzed separately. The Fontaine and Rutherford Systems have been used to classify risk of amputation and likelihood of benefit from revascularization by subcategorizing patients into two groups: ischemic rest pain and tissue loss. Due to demographic shifts over the last 40 years, especially a dramatic rise in the incidence of diabetes mellitus and rapidly expanding techniques of revascularization, it has become increasingly difficult to perform meaningful outcomes analysis for patients with threatened limbs using these existing classification systems. Particularly in patients with diabetes, limb threat is part of a broad disease spectrum. Perfusion is only one determinant of outcome; wound extent and the presence and severity of infection also greatly impact the threat to a limb. Therefore, the Society for Vascular Surgery Lower Extremity Guidelines Committee undertook the task of creating a new classification of the threatened lower extremity that reflects these important considerations. We term this new framework, the Society for Vascular Surgery Lower Extremity Threatened Limb Classification System. Risk stratification is based on three major factors that impact amputation risk and clinical management: Wound, Ischemia, and foot Infection (WIfI). The implementation of this classification system is intended to permit more meaningful analysis of outcomes for various forms of therapy in this challenging, but heterogeneous population. PMID:24126108

  7. Incidence of and significant risk factors for aminoglycoside-associated nephrotoxicity in patients dosed by using individualized pharmacokinetic monitoring.

    PubMed

    Bertino, J S; Booker, L A; Franck, P A; Jenkins, P L; Franck, K R; Nafziger, A N

    1993-01-01

    Incidence of and risk factors for aminoglycoside-associated nephrotoxicity (AAN) were evaluated in 1489 patients prospectively monitored with individualized pharmacokinetic monitoring (IPM). Incidence of AAN was 7.9% with individual (univariate) risk factors including advanced age, decreased albumin, poor nutritional status, pneumonia, concurrent furosemide, amphotericin B, vancomycin, cephalosporin, or piperacillin, intensive care unit treatment, leukemia, rapidly fatal illness, liver or renal disease, reduced aminoglycoside clearance, elevated initial steady-state trough concentration (Cminss), volume of distribution or half-life, duration of therapy, total dose, fever, male gender, shock, pleural effusion, and ascites. Multiple logistic regression revealed that Cminss, concurrent clindamycin, vancomycin, piperacillin, or cephalosporin, ascites, advanced age, male gender, decreased albumin, duration of therapy, and leukemia were significant independent risk factors for AAN. Positive predictive value of the model was 30.8%; negative predictive value was 91.7%. No identifiable risk factor alone or in combination was of sufficient sensitivity to reliably predict AAN, but use of IPM may lower the incidence of AAN. PMID:8418164

  8. Radial Artery Coursing Behind the Biceps Brachii Tendon: Significance for the Transradial Catheterization and a Clinically Oriented Classification of the Radial Artery Variations

    SciTech Connect

    Jelev, L. Surchev, L.

    2008-09-15

    In routine clinical practice the variations of the radial artery are the main reason for technical failure during transradial catheterization. If these variations are well documented, however, they do not represent a problem in the transradial approach. Therefore, we report here a rare case of the radial artery which is very strange but potentially valuable for the clinical practice: it arises at a right angle from the brachial artery and passes behind the biceps brachii tendon. Based on our findings and on an extensive literature review, we propose for the first time a clinically oriented classification of the variations of the radial artery. This classification is related to the catheterization success at the usual access site of the radial artery at the wrist.

  9. Silica dust, diesel exhaust, and painting work are the significant occupational risk factors for lung cancer in nonsmoking Chinese men

    PubMed Central

    Tse, L A; Yu, IT-s; Au, J S K; Qiu, H; Wang, X-r

    2011-01-01

    Background: Few epidemiological studies have explored the associations between occupational exposures and lung cancer in lifelong nonsmoking men. Methods: We obtained lifetime occupational history and other relevant information for 132 newly diagnosed lung cancer cases among nonsmoking Chinese men and 536 nonsmoking community referents. Unconditional multiple logistic regression analysis was performed to estimate the odds ratio (OR) of lung cancer for specific occupational exposures. Results: Significantly increased lung cancer risk was found for nonsmoking workers occupationally exposed to silica dust (OR=2.58, 95% confidence interval (CI): 1.11, 6.01), diesel exhaust (OR=3.47, 95% CI: 1.08, 11.14), spray painting (OR=2.81, 95% CI: 1.14, 6.93), and nonspray painting work (OR=2.36, 95% CI: 1.04, 5.37). Silica dust exposure was associated with a significantly increased risk of adenocarcinoma (OR=2.91, 95% CI: 1.10, 7.68). We observed a positive gradient of all lung cancers and of adenocarcinoma with duration of employment for workers exposed to silica dust and spray painting. Conclusion: This study found an increased risk of lung cancer among nonsmoking Chinese men occupationally exposed to silica dust, diesel exhaust, and painting work. PMID:21102581

  10. Review of temporomandibular joint pathology. Part I: classification, epidemiology and risk factors.

    PubMed

    Poveda Roda, Rafael; Bagan, José V; Díaz Fernández, José María; Hernández Bazán, Sergio; Jiménez Soriano, Yolanda

    2007-08-01

    Pathology of the temporomandibular joint (TMJ) affects an important part of the population, though it is not viewed as a public health problem. Between 3-7% of the population seeks treatment for pain and dysfunction of the ATM or related structures. The literature reports great variability in the prevalence of the clinical symptoms (6-93%) and signs (0-93%), probably as a result of the different clinical criteria used. In imaging studies it is common to observe alterations that have no clinical expression of any kind. Radiographic changes corresponding to osteoarthrosis are observed in 14-44% of the population. Age is a risk factor, though with some particularities. In elderly patients there is an increased prevalence of clinical and radiological signs, though also a lesser prevalence of symptoms and of treatment demands than in younger adults. Approximately 7% of the population between 12 and 18 years of age is diagnosed with mandibular pain-dysfunction. Temporomandibular dysfunction (TMD) is more frequent in females. No clear relationship has been established between occlusal alterations and TMJ disease. Only disharmony between centric relation and maximum intercuspidation, and unilateral crossbite, have demonstrated a certain TMJ disease-predictive potential. Both local and systemic hyperlaxity has been postulated as a possible cause of TMD. Parafunctional habits and bruxism are considered risk factors of TMD with odds ratios (ORs) of up to 4.8. Psychophysiological theory holds stress as a determinant factor in myofascial pain. Genetic factors and orthodontic treatment have not been shown to cause TMD. PMID:17664915

  11. Low RBM3 Protein Expression Correlates with Clinical Stage, Prognostic Classification and Increased Risk of Treatment Failure in Testicular Non-Seminomatous Germ Cell Cancer

    PubMed Central

    Olofsson, Sven-Erik; Nodin, Björn; Gaber, Alexander; Eberhard, Jakob; Uhlén, Mathias; Jirström, Karin; Jerkeman, Mats

    2015-01-01

    Background Expression of the RNA-binding motif protein 3 (RBM3) has been shown to correlate with favourable clinicopathological parameters and prognosis in several cancer diseases. The aim of this study was to examine the expression and prognostic ability of RBM3 in patients with testicular non-seminomatous germ cell tumours (NSGCT). Patients and Methods Immunohistochemical RBM3 expression was analysed in tissue microarrays with tumours from 206 patients. Chi-square test was applied to analyze associations between RBM3 expression and clinicopathological parameters. Kaplan-Meier analysis was used to assess the impact of RBM3 expression on cancer-specific survival (CSS) and failure-free survival (FFS). Cox regression proportional hazards models were used to estimate the relative risk for failure. Results In the entire cohort, there was a significant association between clinical stage (p=0.044) and RBM3 expression. Weak RBM3 expression correlated with a significantly reduced FFS [79.3% versus 90.4% (p=0.019)] and CSS [87.5% versus 97.3% (p=0.047)]. For patients with metastatic disease (n = 88), significant associations were found between RBM3 expression and IGCCC group (p=0.007). The FFS was significantly inferior for patients with low tumour-specific RBM3 expression [59.3% versus 79.0% (p=0.013)], and this association remained significant in a multivariable model for patients with metastatic disease (HR=3.67; 95% CI 1.14, 11.89). Conclusion Low RBM3 expression is an independent predictor of treatment failure in metastatic NSGCT, in relation to the prognostic factors included in the International Germ Cell Consensus Classification (IGCCC). These findings suggest that RBM3 may be a potential biomarker for treatment stratification in patients with metastatic non-seminomatous germ cell tumours, and therefore merit further validation. PMID:25811459

  12. The Risk Factors for Failure of an Upper Extremity Replantation: Is the Use of Cigarettes/Tobacco a Significant Factor?

    PubMed Central

    He, Ji-Yin; Chen, Shih-Heng; Tsai, Tsu-Min

    2015-01-01

    Background The purpose of this study was to explore the potential risk factors associated with the failure of an upper extremity replantation with a focus on cigarette or tobacco use. Patients and Methods A cohort of 102 patients with 149 replants (6 extremities, 143 digits) and a mean age of 41 years (range 5 to 72 years) was enrolled in this study. The data collected included age, gender, tobacco/cigarettes use, trauma mechanism, underlying disease (e.g., hypertension (HTN), diabetes mellitus (DM), etc.), and vein graft use. An analysis with a multivariable regression was conducted to identify the risk factors of replant failure and their respective odds ratios (ORs). Results Multilevel generalized linear mixed models (GLMMs) with a binomial distribution and logit link showed that smoking did not increase the risk of replant failure (p = 0.234). In addition, the survival of replants was not affected by DM or HTN (p = 0.285 and 0.938, respectively). However, the replantation results were significantly affected by the age of the patients and the mechanism of injury. Patients older than 50 years and those with avulsion or crush injuries tended to have a higher risk of replant failure (OR = 2.29, 6.45, and 5.42, respectively; p = 0.047, 0.028, and 0.032, respectively). Conclusions This study showed that the use of cigarettes/tobacco did not affect the replantation outcome. The main risks for replant failure included being older than 50 years and the trauma mechanism (avulsion or crush injuries). PMID:26513147

  13. Significant associations between hemostatic/fibrinolytic systems and accumulation of cardiovascular risk factors in Japanese elementary schoolchildren.

    PubMed

    Lin, Lisheng; Horigome, Hitoshi; Kato, Yoshiaki; Kikuchi, Toshihiro; Nakahara, Satoko; Sumazaki, Ryo

    2015-01-01

    The aim of this study was to establish the reference values of hemostatic/fibrinolytic markers and investigate their relationship with physical constitution and cardiovascular risk factors in a normal schoolchildren population. This study comprised 148 healthy Japanese children aged 9-10 years (males 73; females 75). We performed laboratory tests including blood levels of leptin, high-sensitive C-reactive protein (hs-CRP), hemostatic and fibrinolytic markers [plasminogen activator inhibitor 1 (PAI-1), coagulation factor VII (FVII), coagulation factor X (FX), fibrinogen (Fbg), protein C, protein S], as well as common biochemical markers in the morning after an overnight fast. We investigated the mean, 10th, 50th and 90th percentile values of these markers. All parameters were compared between two groups, that is those with body mass index (BMI) 90th percentile or higher and BMI less than 90th percentile, and between subgroups based on the number of cardiovascular risk factors. Multiple-linear regression was used to assess associations between these hematological parameters and the components related to metabolic syndrome (MetS). Alanine aminotransferase (ALT), uric acid, leptin, hs-CRP, and all hemostatic/fibrinolytic markers (PAI-1, FVII, FX, Fbg, protein C, protein S) tested were significantly higher in the group with BMI 90th percentile or higher, and increased with accumulation of cardiovascular risk factors. Multiple-linear regression analysis showed that these values were associated with one or more components related to MetS. Reference values of hemostatic/fibrinolytic markers in Japanese schoolchildren were obtained. Many hemostatic/fibrinolytic markers showed significant association with BMI and accumulation of cardiovascular risk factors in normal Japanese schoolchildren. PMID:25185676

  14. Favorable vs Unfavorable Intermediate-Risk Prostate Cancer: A Review of the New Classification System and Its Impact on Treatment Recommendations.

    PubMed

    Serrano, Nicholas A; Anscher, Mitchell S

    2016-03-01

    The population of patients with intermediate-risk prostate cancer are a large and heterogeneous group with highly variable prognoses, which present a challenge to efforts to develop standardized treatment recommendations. New classification systems have been proposed that modify the existing National Comprehensive Cancer Network guidelines and that subdivide men with intermediate-risk prostate cancer into favorable and unfavorable subgroups. This review will examine the changing landscape of intermediate-risk prostate cancer and the effects on treatment decisions that may result from this new classification. The literature provides evidence that men with favorable intermediate-risk prostate cancer have prostate cancer-specific mortality and all-cause mortality rates similar to the rates in patients with low-risk prostate cancer and thus may be candidates for active surveillance, dose-escalated radiation therapy without short-term androgen deprivation therapy (ADT), or, interestingly, standard-dose radiation therapy plus short-term ADT. Conversely, patients with unfavorable intermediate-risk prostate cancer have prostate cancer-specific mortality and all-cause mortality rates similar to the rates in patients with high-risk prostate cancer. These patients would not be candidates for active surveillance and may in fact require long-term ADT in addition to standard-dose or dose-escalated radiation therapy instead of 4 to 6 months of ADT. PMID:26984216

  15. Significance of Travel to Rural Areas as a Risk Factor for Malarial Anemia in an Urban Setting

    PubMed Central

    Siri, Jose G.; Wilson, Mark L.; Murray, Susan; Rosen, Daniel H.; Vulule, John M.; Slutsker, Laurence; Lindblade, Kim A.

    2010-01-01

    The epidemiology of malaria in urban environments is poorly characterized, yet increasingly problematic. We conducted an unmatched case–control study of risk factors for malarial anemia with high parasitemia in urban Kisumu, Kenya, from June 2002 through February 2003. Cases (n = 80) were hospital patients with a hemoglobin level ≤ 8 g/dL and a Plasmodium parasite density ≥ 10,000/μL. Controls (n = 826) were healthy respondents to a concurrent citywide knowledge, attitude, and practice survey. Children who reported spending at least one night per month in a rural area were especially at risk (35% of cases; odds ratio = 9.3, 95% confidence interval [CI] = 4.4–19.7, P < 0.0001), and use of mosquito coils, bed net ownership, and house construction were non-significant, potentially indicating that malaria exposure during rural travel comprises an important element of risk. Control of severe malaria in an urban setting may be complicated by Plasmodium infections acquired elsewhere. Epidemiologic studies of urban malaria in low transmission settings should take travel history into account. PMID:20207862

  16. Significant association between FasL gene -844T/C polymorphism and risk to hepatocellular carcinoma in Egyptian patients.

    PubMed

    Khalifa, Rania H; Bahgat, Dina M Rasheed; Darwish, Hatem Abdel Hamid; Shahin, Rasha Mohamad Hosny

    2016-04-01

    Fas/Fas ligand (FasL) system is the most critical apoptotic signaling entity in the extrinsic apoptotic pathway; hence mutations affecting this pathway may prevent the immune system from the removal of newly-formed tumor cells, and thus lead to tumor formation. The present study investigated the association between the FasL -844T/C polymorphism and the risk of hepatocellular carcinoma (HCC) in a cohort of Egyptian patients and explored the relationship of various clinical and pathological parameters with this single nucleotide polymorphism (SNP). Blood samples were withdrawn from hundred HCC patients and 100 age-, sex- and ethnically matched controls. The FasL -844T/C (rs763110) gene polymorphism was typed from genomic DNA using polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) assay. Genotype distributions and allelic frequencies between patients and control subjects showed that the TT homozygous patients were two times more likely to develop HCC (p=0.011). Also, the T allele was found to be a significant risk factor for the disease (OR 1.970, 95% CI 1.250-3.105, p=0.003). No association was detected between different parameters of the disease and the SNP. For the first time, our results suggest that the -844T/C polymorphism in the FasL gene confers risk to HCC. The alarming increase in the incidence of HCC in Egypt encourages further studies to document our results in a larger sample, and recommends more genetic studies hoping to define a genomic risk prediction specific to this cancer in our population. PMID:26891954

  17. Trihalomethanes in Lisbon indoor swimming pools: occurrence, determining factors, and health risk classification.

    PubMed

    Silva, Zelinda Isabel; Rebelo, Maria Helena; Silva, Manuela Manso; Alves, Ana Martins; Cabral, Maria da Conceição; Almeida, Ana Cristina; Aguiar, Fátima Rôxo; de Oliveira, Anabela Lopes; Nogueira, Ana Cruz; Pinhal, Hermínia Rodrigues; Aguiar, Pedro Manuel; Cardoso, Ana Sofia

    2012-01-01

    Characterization of water quality from indoor swimming pools, using chorine-based disinfection techniques, was performed during a 6-mo period to study the occurrence, distribution, and concentration factors of trihalomethanes (THM). Several parameters such as levels of water THM, water and air chloroform, water bromodichloromethane (BDCM), water dibromochloromethane (DBCM), water bromoform (BF), free residual chlorine (FrCl), pH, water and air temperature, and permanganate water oxidizability (PWO) were determined in each pool during that period. Chloroform (CF(W)) was the THM detected at higher concentrations in all pools, followed by BDCM, DBCM, and BF detected at 99, 34, and 6% of the samples, respectively. Water THM concentrations ranged from 10.1 to 155 μg/L, with 6.5% of the samples presenting values above 100 μg/L (parametric value established in Portuguese law DL 306/2007). In this study, air chloroform (CF(Air)) concentrations ranged from 45 to 373 μg/m³ with 24% of the samples presenting values above 136 μg/m³ (considered high exposure value). Several significant correlations were observed between total THM and other parameters, namely, CF(W), CF(Air), FrCl, water temperature (T(W)), and PWO. These correlations indicate that FrCl, T(W) and PWO are parameters that influence THM formation. The exposure criterion established for water THM enabled the inclusion of 67% of Lisbon pools in the high exposure group, which reinforces the need for an improvement in pool water quality. PMID:22788374

  18. The Clinical Significance of Separate Measurements of Carotid Arterial Wall to Assess the Risk Factor for Atherosclerosis

    PubMed Central

    Kim, Ji-Hoon; Kim, Gee-Hee; Moon, Keon-Woong; Yoo, Ki-Dong; Kim, Chul-Min

    2016-01-01

    Background Carotid intima-media thickness (CIMT) is associated with several risk factors for atherosclerosis and has been consistently linked to cardiovascular and cerebrovascular disease. The clinical significance of separate measurements of CIMT, which is the sum of the intima (IT) and media thickness (MT), to use as an assessment of risk for atherosclerosis has not yet been fully established. Methods Among 3377 patients who underwent B-mode ultrasound of carotid arteries and coronary angiography in the Medical Department of St. Mary's Hospital from September 2003 to March 2009, 1146 subjects (M:F = 616:530; mean age, 57.7 ± 12.1 years) who were diagnosed with normal coronary arteries were enrolled in this study. IT, MT, and CIMT of the enrolled patients were manually measured using high-frequency ultrasonography (15 MHz linear array transducer). Results In multivariate logistic regression analysis, age (β = 0.063, p < 0.0001), body mass index (BMI) (β = 0.028, p = 0.018), and hypertension (HTN) (β = 0.046, p = 0.0002) were associated with MT (R2 = 0.256) and the IT/MT ratio (R2 = 0.209). Age (β = 0.065, p < 0.0001), BMI (β = 0.025, p = 0.038), hemoglobin A1c (β = 0.045, p = 0.045), and HTN (β = 0.043, p = 0.0006) correlated with mean CIMT (R2 = 0.230). Age (β = -0.071, p < 0.0001) and BMI (β = -0.046, p = 0.002) were associated with the IT/MT ratio (R2 = 0.219) on the left side. Age (β = 0.093, p < 0.0001) was related to MT (R2 = 0.265) and mean CIMT (R2 = 0.243) on the left side. Conclusion We noted different atherosclerotic risk factors were related to measurements of the arterial wall in different ways. Therefore, separate measurements of CIMT might be a useful method to assess the risk for atherosclerosis. PMID:27081444

  19. Security classification of information

    SciTech Connect

    Quist, A.S.

    1993-04-01

    This document is the second of a planned four-volume work that comprehensively discusses the security classification of information. The main focus of Volume 2 is on the principles for classification of information. Included herein are descriptions of the two major types of information that governments classify for national security reasons (subjective and objective information), guidance to use when determining whether information under consideration for classification is controlled by the government (a necessary requirement for classification to be effective), information disclosure risks and benefits (the benefits and costs of classification), standards to use when balancing information disclosure risks and benefits, guidance for assigning classification levels (Top Secret, Secret, or Confidential) to classified information, guidance for determining how long information should be classified (classification duration), classification of associations of information, classification of compilations of information, and principles for declassifying and downgrading information. Rules or principles of certain areas of our legal system (e.g., trade secret law) are sometimes mentioned to .provide added support to some of those classification principles.

  20. NT-proBNP: Is It a More Significant Risk Factor for Mortality Than Troponin T in Incident Hemodialysis Patients?

    PubMed Central

    Oh, Hyung Jung; Lee, Mi Jung; Lee, Hye Sun; Park, Jung Tak; Han, Seung Hyeok; Yoo, Tae-Hyun; Kim, Yong-Lim; Kim, Yon Su; Yang, Chul Woo; Kim, Nam-Ho; Kang, Shin-Wook

    2014-01-01

    Abstract Numerous studies have demonstrated that cardiac biomarkers are significant predictors of cardiovascular (CV) and all-cause mortality in ESRD patients, but most of the studies were retrospective or included small numbers of patients, only prevalent dialysis patients, or measured 1 or 2 biomarkers. This study was to analyze the association between 3 cardiac biomarkers and mortality in incident HD patients. A prospective cohort of 864 incident HD patients was followed for 30 months. Based on the median values of baseline NT-proBNP, cTnT, and hsCRP, the patients were divided into “high” and “low” groups, and CV and all-cause mortality were compared between each group. Additionally, time-dependent ROC curves were constructed, and the NRI and IDI of the models with various biomarkers were calculated. The CV survival rates were significantly lower in the “high” NT-proBNP and cTnT groups compared to the corresponding “low” groups, while there was no significant difference in CV survival rate between the 2 hsCRP groups. However, all-cause mortality rates were significantly higher in all 3 “high” groups compared to each lower group. In multivariate analyses, only Ln NT-proBNP was found to be an independent predictor of mortality. Moreover, NT-proBNP was a more prognostic marker for mortality compared to cTnT. In conclusion, NT-proBNP is the biomarker that results in the most added prognostic value on top of traditional risk factors for CV and all-cause mortality in incident HD patients. PMID:25501091

  1. Polymorphism of adhesion molecule CD31 is not a significant risk factor for graft-versus-host disease.

    PubMed

    Nichols, W C; Antin, J H; Lunetta, K L; Terry, V H; Hertel, C E; Wheatley, M A; Arnold, N D; Siemieniak, D R; Boehnke, M; Ginsburg, D

    1996-12-15

    Mismatch between bone marrow transplant (BMT) patient and donor for an amino acid polymorphism within the adhesion molecule CD31 has recently been reported to increase risk for the development of graft-versus-host disease (GVHD). We further examined this association in a larger series of 301 BMT patients (227 with grade III/IV GVHD and 74 with grade 0 GVHD) and their HLA-identical sibling donors. CD31 genotypes were determined by polymerase chain reaction and restriction endonuclease digestion. The role of mismatch at the CD31 locus in the development of GVHD was assessed by analyzing the extent of CD31 identity and CD31 compatibility among the grade 0 GVHD and grade III/IV GVHD sibling pairs. No significant association between CD31 mismatch and the development of severe GVHD was detected in our overall patient population. Sixty-three percent of grade III/IV GVHD sibling pairs and 69% of grade 0 GVHD sibling pairs had CD31 genotypes that were identical (P = .36, odds ratio = 1.30). In addition, neither the grade 0 GVHD group (P = .10) nor the grade III/IV GVHD group (P = .27) differed significantly from the expected probability of identity between sibling pairs. Mismatch at the CD31 polymorphism between recipients and donors showed no consistent association with the development of GVHD. Current evidence does not support the value of CD31 mismatch in the selection of BMT donors. PMID:8977234

  2. Clinical Application of Revised Laboratory Classification Criteria for Antiphospholipid Antibody Syndrome: Is the Follow-Up Interval of 12 Weeks Instead of 6 Weeks Significantly Useful?

    PubMed Central

    Park, Sang Hyuk; Park, Chan-Jeoung; Chi, Hyun-Sook

    2016-01-01

    Background. According to revised classification criteria of true antiphospholipid antibody syndrome, at least one of three antiphospholipid antibodies should be present on two or more occasions at least 12 weeks apart. However, it can be inconvenient to perform follow-up tests with interval of 12 weeks. We investigated clinical application of follow-up tests with interval of 12 weeks. Method. Totals of 67, 199, and 332 patients tested positive initially for the lupus anticoagulants confirm, the anti-β2 glycoprotein-I antibody, and the anti-cardiolipin antibody test, respectively, from Jan 2007 to Jul 2009. We investigated clinical symptoms of patients, follow-up interval, and results of each test. Results. Among patients with initial test positive, 1.5%–8.5% were subjected to follow-up tests at interval of more than 12 weeks. Among 25 patients with negative conversion in tests, patients with interval of more than 12 weeks showed clinical symptom positivity of 33.3%, which was higher than that of 12.5% with 6–12 weeks. Among 34 patients with persistent test positive, clinical symptoms positivity trended to be more evident in patients at interval of 6–12 weeks (47.4% versus 26.7%, P = 0.191) than more than 12 weeks. Conclusion. Less than 10% of patients with initial test positive had follow-up tests at interval of more than 12 weeks and the patients with persistent test positive at interval of more than 12 weeks showed trends toward having lower clinical symptoms than 6–12 weeks. More research is needed focused on the evidence that follow-up test at interval of more than 12 weeks should be performed instead of 6 weeks. PMID:27610369

  3. Clinical Application of Revised Laboratory Classification Criteria for Antiphospholipid Antibody Syndrome: Is the Follow-Up Interval of 12 Weeks Instead of 6 Weeks Significantly Useful?

    PubMed

    Park, Sang Hyuk; Jang, Seongsoo; Park, Chan-Jeoung; Chi, Hyun-Sook

    2016-01-01

    Background. According to revised classification criteria of true antiphospholipid antibody syndrome, at least one of three antiphospholipid antibodies should be present on two or more occasions at least 12 weeks apart. However, it can be inconvenient to perform follow-up tests with interval of 12 weeks. We investigated clinical application of follow-up tests with interval of 12 weeks. Method. Totals of 67, 199, and 332 patients tested positive initially for the lupus anticoagulants confirm, the anti-β 2 glycoprotein-I antibody, and the anti-cardiolipin antibody test, respectively, from Jan 2007 to Jul 2009. We investigated clinical symptoms of patients, follow-up interval, and results of each test. Results. Among patients with initial test positive, 1.5%-8.5% were subjected to follow-up tests at interval of more than 12 weeks. Among 25 patients with negative conversion in tests, patients with interval of more than 12 weeks showed clinical symptom positivity of 33.3%, which was higher than that of 12.5% with 6-12 weeks. Among 34 patients with persistent test positive, clinical symptoms positivity trended to be more evident in patients at interval of 6-12 weeks (47.4% versus 26.7%, P = 0.191) than more than 12 weeks. Conclusion. Less than 10% of patients with initial test positive had follow-up tests at interval of more than 12 weeks and the patients with persistent test positive at interval of more than 12 weeks showed trends toward having lower clinical symptoms than 6-12 weeks. More research is needed focused on the evidence that follow-up test at interval of more than 12 weeks should be performed instead of 6 weeks. PMID:27610369

  4. Predicting the Risk for Central Pain Using the Sensory Components of the International Standards for Neurological Classification of Spinal Cord Injury.

    PubMed

    Levitan, Yuval; Zeilig, Gabi; Bondi, Moshe; Ringler, Erez; Defrin, Ruth

    2015-11-01

    Central neuropathic pain (CP) after spinal cord injury (SCI) is excruciating and difficult to manage. Pre-emptive treatment could be initiated in patients at risk for CP providing that it can be predicted. A combination of psychophysical tests could predict CP, but the process necessitates sophisticated equipment and constant monitoring. A simple predictive tool for CP is required. The aim of this study was to test the predictability for CP of the sensory component of the International Standards for Neurological Classification of Spinal Cord Injury (SC-ISNCSCI), routinely performed on all SCI patients. In an historical-prospective study, the SC-ISNCSCI and background variables were extracted from medical records of 115 SCI patients. In a prospective study, 20 SCI patients underwent the SC-ISNCSCI at admission and were followed-up for 12 months. In both studies, pinprick (PP) and light touch (LT) scores from the SC-ISNCSCI and the difference between them (LT-PP) were compared between those who eventually developed CP and those who did not. Heat-pain and touch thresholds were measured and correlated with the SC-ISNCSCI to test its validity. In both studies, patients who developed CP had, prior to CP, lower PP than LT scores, and lower PP scores than those who did not develop CP. At-level delta LT-PP score>1 best predicted CP; the odds of developing CP with LT-PP>1 was 24.4 times that of the reverse category (LT-PP<1). Heat-pain and touch thresholds significantly correlated with PP and LT. We conclude that the SC-ISNCSCI can be used as a clinical biomarker of CP with high probability. PMID:26244708

  5. Lack of Significant Effects of Chlamydia trachomatis Infection on Cervical Adenocarcinoma Risk: Nested Case-Control Study

    PubMed Central

    Smelov, Vitaly; Gheit, Tarik; Sundström, Karin; Ploner, Alexander; McKay-Chopin, Sandrine; Eklund, Carina; Tommasino, Massimo; Dillner, Joakim

    2016-01-01

    Background A role of Chlamydia trachomatis in HPV-induced cervical carcinogenesis has been reported for cervical cancer but studies on cervical adenocarcinoma are limited. Methods A total of 1,553 cervical smears taken up to 26 years before diagnosis in a large population-based nested case-control study of cervical adenocarcinoma (AC, 132 cases with matched controls), and adenocarcinoma in situ (AIS, 159 cases with matched controls) were tested for C. trachomatis and HPV DNA by a type-specific PCR bead-based multiplex genotyping (TS-MPG) assay. Results Only 1.7% of samples were positive for C. trachomatis, with no significant differences between AC/AIS cases and controls. HPV-positivity was detected in 49.3% of C. trachomatis-negative and 65.4% C. trachomatis-positive samples, respectively. Conclusions A large prospective study did not find any risk for cervical adenocarcinoma and/or AIS conferred by C. trachomatis infection. Impact C. trachomatis appears not to be involved in cervical adenocarcinomas. PMID:27227411

  6. Urine phyto-oestrogen metabolites are not significantly associated with risk of type 2 diabetes: the Singapore Chinese health study.

    PubMed

    Talaei, Mohammad; Lee, Bee L; Ong, Choon N; van Dam, Rob M; Yuan, Jian M; Koh, Woon P; Pan, An

    2016-05-01

    We evaluated the relationship between urine concentrations of phyto-oestrogens (isoflavones and lignans) and risk of incident type 2 diabetes in middle-aged and elderly Chinese residing in Singapore. Urine metabolites of isoflavones and lignans were assayed by HPLC among 564 diabetes cases and 564 matched controls in a case-control study nested within the Singapore Chinese Health Study cohort. Participants were free of diagnosed diabetes, CVD and cancer at morning urine collections during 1999-2004. Cases were participants who reported to have physician-diagnosed diabetes at follow-up visits during 2006-2010, whereas controls were randomly selected among those who remained free of diabetes and were matched to the index cases by age, sex, dialect group and date of urine collection. Conditional logistic regression models were used to calculate OR and 95 % CI with adjustment for potential confounders. The mean age of the participants at the time of urine collection was 59·8 years, and the average interval between urine collection and diabetes diagnosis was 4·0 years. The multivariate-adjusted OR for diabetes were 1·00 (reference), 0·76 (95 % CI 0·52, 1·11), 0·78 (95 % CI 0·53, 1·14) and 0·79 (95 % CI 0·54, 1·15) across quartiles of urine isoflavones (P for trend=0·54), and were 1·00 (reference), 0·87 (95 % CI 0·60, 1·27), 1·10 (95 % CI 0·77, 1·56) and 0·93 (95 % CI 0·63, 1·37) for lignans (P for trend=0·93). The results were similar in men and women, as well as for individual metabolites of isoflavones (genistein, daidzein, glycitin and equol) or lignans (enterodiol and enterolactone). The present study did not find a significant association between urine phyto-oestrogen metabolites and risk of type 2 diabetes in Chinese adults. PMID:26949260

  7. Application of linear graph embedding as a dimensionality reduction technique and sparse representation classifier as a post classifier for the classification of epilepsy risk levels from EEG signals

    NASA Astrophysics Data System (ADS)

    Prabhakar, Sunil Kumar; Rajaguru, Harikumar

    2015-12-01

    The most common and frequently occurring neurological disorder is epilepsy and the main method useful for the diagnosis of epilepsy is electroencephalogram (EEG) signal analysis. Due to the length of EEG recordings, EEG signal analysis method is quite time-consuming when it is processed manually by an expert. This paper proposes the application of Linear Graph Embedding (LGE) concept as a dimensionality reduction technique for processing the epileptic encephalographic signals and then it is classified using Sparse Representation Classifiers (SRC). SRC is used to analyze the classification of epilepsy risk levels from EEG signals and the parameters such as Sensitivity, Specificity, Time Delay, Quality Value, Performance Index and Accuracy are analyzed.

  8. ECOLOGICAL CLASSIFICATION OF RIVERS FOR ENVIRONMENTAL ASSESSMENT: DEMONSTRATION, VALIDATION, AND APPLICATION TO REGIONAL RISK ASSESSMENT ACROSS ILLINOIS, MICHIGAN, AND WISCONSIN

    EPA Science Inventory

    Our goal is to couple landscape-based modeling from large, regional data sets and regional Land Transformation Models with a valley segment ecological classification approach already being employed in several Midwestern states. Objectives include completion of a GI...

  9. Identification of Sexually Abused Female Adolescents at Risk for Suicidal Ideations: A Classification and Regression Tree Analysis

    ERIC Educational Resources Information Center

    Brabant, Marie-Eve; Hebert, Martine; Chagnon, Francois

    2013-01-01

    This study explored the clinical profiles of 77 female teenager survivors of sexual abuse and examined the association of abuse-related and personal variables with suicidal ideations. Analyses revealed that 64% of participants experienced suicidal ideations. Findings from classification and regression tree analysis indicated that depression,…

  10. Evaluation of diet quality and weight status of children from a low socioeconomic urban environment supports "at risk" classification.

    PubMed

    Langevin, Denise D; Kwiatkowski, Cynthia; McKay, M Geraldine; Maillet, Julie O'Sullivan; Touger-Decker, Riva; Smith, Jeffrey K; Perlman, Adam

    2007-11-01

    This cross-sectional study evaluated diet quality and weight status in 248 randomly selected low-income urban children, aged 7 to 13 years, who were participating in a larger study on the effectiveness of multivitamin supplementation on school performance. Food frequency questionnaires were used to determine intake of total calories and food groups, selected micronutrients, and amount and percent of calories from sweets. Results were compared to age-appropriate recommendations of the Food Guide Pyramid and to the Dietary Reference Intakes. Height, weight, and ages obtained from current-year student health records were used to calculate body mass index (calculated as kg/m(2)) percentile for age. Of 193 participants with usable food frequencies and available weight, height, sex, and age, 22% (n=43) were at risk for overweight and 36% (n=69) were overweight. More than 75% of participants failed to meet recommended servings for grains, vegetables, dairy, and fruit groups, and mean intake of each of these food groups was significantly less than recommendations (P<0.001). Twenty-five percent or more of subjects did not meet Recommended Dietary Allowances for iron and folate. Mean intake of calcium was below the Adequate Intake for calcium and 76% of children 8 years old and younger and 93% of children 9 years old and older did not meet the Adequate Intake for calcium. Mean calorie intake was 1,723 kcal (standard deviation+/-924) and mean percent of calories from carbohydrate, protein, and fat was 57%, 13%, and 32%, respectively. No correlation was found between total calories, total dietary sugar, or percent of calories from sweets and body mass index. Results of this study suggest that these urban children may be "at risk," based on the high percentage who are overweight and have insufficient food group consumption and micronutrient intake. PMID:17964318

  11. Short-term weight gain and breast cancer risk by hormone receptor classification among pre- and postmenopausal women.

    PubMed

    Rosner, Bernard; Eliassen, A Heather; Toriola, Adetunji T; Hankinson, Susan E; Willett, Walter C; Natarajan, Loki; Colditz, Graham A

    2015-04-01

    Obesity is well established as a cause of postmenopausal breast cancer incidence and mortality. In contrast, adiposity in early life reduces breast cancer incidence. However, whether short-term weight change influences breast cancer risk is not well known. We followed a cohort of 77,232 women from 1980 to 2006 (1,445,578 person-years), with routinely updated risk factor information, documenting 4196 incident cases of invasive breast cancer. ER and PR status were obtained from pathology reports and medical records yielding a total of 2033 ER+/PR+ tumors, 595 ER-/PR- tumors, 512 ER+/PR- tumors. The log incidence breast cancer model was used to assess the association of short-term weight gain (over past 4 years) while controlling for average BMI before and after menopause. Short-term weight change was significantly associated with breast cancer risk (RR 1.20; 95 % CI 1.09-1.33) for a 4-year weight gain of ≥15 lbs versus no change (≤5 lbs) (P_trend < 0.001). The association was stronger for premenopausal women (RR 1.38; 95 % CI 1.13-1.69) (P_trend = 0.004) than for postmenopausal women (RR 1.10; 95 % CI 0.97-1.25) (P_trend = 0.063). Short-term weight gain during premenopause had a stronger association for ER+/PR- (RR per 25 lb weight gain = 2.19; 95 % CI 1.33-3.61, P = 0.002) and ER-/PR- breast cancer (RR per 25 lb weight gain = 1.61; 95 % CI 1.09-2.38, P = 0.016) than for ER+/PR+ breast cancer (RR per 25 lb weight gain = 1.13; 95 % CI 0.89-1.43, P = 0.32). There are deleterious effects of short-term weight gain, particularly during pre-menopause, even after controlling for average BMI before and after menopause. The association was stronger for ER+/PR- and ER-/PR- than for ER+/PR+ breast cancer. PMID:25796612

  12. Integrating Epidermal Growth Factor Receptor Assay With Clinical Parameters Improves Risk Classification for Relapse and Survival in Head-and-Neck Squamous Cell Carcinoma

    SciTech Connect

    Chung, Christine H.; Hammond, Elizabeth M.; Trotti, Andy M.; Wang Huijun; Spencer, Sharon; Zhang Huazhong; Cooper, Jay; Jordan, Richard; Rotman, Marvin H.; Ang, K. Kian

    2011-10-01

    Purpose: Epidermal growth factor receptor (EGFR) overexpression has been consistently found to be an independent predictor of local-regional relapse (LRR) after radiotherapy. We assessed the extent by which it can refine risk classification for overall survival (OS) and LRR in patients with head-and-neck squamous cell carcinoma (HNSCC). Methods and Materials: EGFR expression in locally advanced HNSCC was measured by immunohistochemistry in a series of patients randomized to receive accelerated or conventional radiation regimens in a Phase III trial. Subsequently, data of the two series were pooled (N = 533) for conducting a recursive partitioning analysis that incorporated clinical parameters (e.g., performance status, primary site, T and N categories) and four molecular markers (EGFR, p53, Ki-67, and microvessel density). Results: This study confirmed that patients with higher than median levels of tumor EGFR expression had a lower OS (relative risk [RR]: 1.90, p = 0.0010) and a higher LRR (RR: 1.91, p = 0.0163). Of the four markers analyzed, only EGFR was found to contribute to refining classification of patients into three risk classes with distinct OS and LRR outcomes. The addition of EGFR to three clinical parameters could identify patients having up to a fivefold difference in the risk of LRR. Conclusions: Adding pretreatment EGFR expression data to known robust clinical prognostic variables improved the estimation of the probability for OS and LRR after radiotherapy. Its use for stratifying or selecting patients with defined tumor feature and pattern of relapse for enrollment into clinical trials testing specific therapeutic strategy warrants further investigation.

  13. An integrated framework for safety, quality and risk management: an information and incident management system based on a universal patient safety classification

    PubMed Central

    Runciman, W B; Williamson, J A H; Deakin, A; Benveniste, K A; Bannon, K; Hibbert, P D

    2006-01-01

    More needs to be done to improve safety and quality and to manage risks in health care. Existing processes are fragmented and there is no single comprehensive source of information about what goes wrong. An integrated framework for the management of safety, quality and risk is needed, with an information and incident management system based on a universal patient safety classification. The World Alliance for Patient Safety provides a platform for the development of a coherent approach; 43 desirable attributes for such an approach are discussed. An example of an incident management and information system serving a patient safety classification is presented, with a brief account of how and where it is currently used. Any such system is valueless unless it improves safety and quality. Quadruple‐loop learning (personal, local, national and international) is proposed with examples of how an exemplar system has been successfully used at the various levels. There is currently an opportunity to “get it right” by international cooperation via the World Health Organization to develop an integrated framework incorporating systems that can accommodate information from all sources, manage and monitor things that go wrong, and allow the worldwide sharing of information and the dissemination of tools for the implementation of strategies which have been shown to work. PMID:17142615

  14. The Association of Pediatric LDL-cholesterol and HDL-cholesterol Dyslipidemia Classifications and Change in Dyslipidemia Status with Carotid Intima-Media Thickness in Adulthood: Evidence from the Cardiovascular Risk in Young Finns Study, the Bogalusa Heart Study, and the Childhood Determinants of Adult Health (CDAH) Study

    PubMed Central

    Magnussen, Costan G.; Venn, Alison; Thomson, Russell; Juonala, Markus; Srinivasan, Sathanur R.; Viikari, Jorma S.A.; Berenson, Gerald S.; Dwyer, Terence; Raitakari, Olli T.

    2009-01-01

    Objectives – To determine which of the National Cholesterol Education Program (NCEP) or National Health and Nutrition Examination Survey (NHANES) LDL-cholesterol and HDL-cholesterol classifications of dyslipidemia status in adolescents is most effective at predicting high common carotid artery intima-media thickness (IMT) in adulthood. Background – Two classifications of pediatric dyslipidemia status have been proposed. No study has assessed which of these is most effective for predicting adolescents who will develop preclinical atherosclerosis in adulthood. Methods – Three population-based, prospective cohort studies that collected lipoprotein measurements on 1711 adolescents aged 12–18 years who were re-measured as young adults aged 29–39 years. Lipoproteins in adolescence were classified according to NCEP and NHANES cut-points, while high IMT in adulthood was defined as those at or above the age, sex, race, and cohort specific 90th percentile of IMT. Results – Independent of the classification employed, adolescents with dyslipidemia were at significantly increased risk of having high IMT in adulthood (relative risks from 1.6 to 2.5). Differences in predictive capacity between both classifications were minimal. Overweight or obese adolescents with dyslipidemia had increased carotid IMT (males, 0.11mm; females, 0.08mm) in adulthood compared with those who did not have both risk factors. Adolescent dyslipidemia status was more strongly associated with high IMT in adulthood than change in dyslipidemia status. Conclusions – Pediatric dyslipidemia classifications perform equally in the prediction of adolescents who are at increased risk of high IMT in young adulthood. Our data suggest that dyslipidemia screening could be limited to overweight or obese adolescents. PMID:19264243

  15. A hospital-based case-control study of acute myeloid leukemia in Shanghai: analysis of environmental and occupational risk factors by subtypes of the WHO classification.

    PubMed

    Wong, Otto; Harris, Fran; Armstrong, Thomas W; Hua, Fu

    2010-03-19

    The objectives were: (1) to investigate potential environmental and occupational risk factors of acute myeloid leukemia (AML), and (2) to explore the relationships between risk factors and AML subtypes according to the World Health Organization (WHO) classification. The investigation was a hospital-based case-control study consisting of 722 newly diagnosed AML cases (August 2003 through June 2007) and 1444 individually gender-age-matched patient controls at 29 hospitals in Shanghai. A 17-page questionnaire was used to obtain information on demographics, medical history, family history, lifestyle risk factors, employment history, residential history, and occupational and non-occupational exposures. Certain occupations of interest triggered a second questionnaire, which was occupation-specific and asked for more details about jobs, tasks, materials used and work environment. Exposure assessments were based on the questionnaires, on-site workplace investigations, data published in the Chinese literature, historical exposure measurements maintained by government health agencies, and expert opinions of a panel of local scientists who were familiar with workplaces in Shanghai. Risk estimates (odds ratios and 95% confidence intervals) of individual risk factors were calculated using conditional logistic regression models. A number of potential environmental and occupational risk factors were associated with an increased risk of AML (all subtypes combined) and/or individual subtypes; including home or workplace renovation, living on a farm, planting crops, raising livestock or animals, farm workers, metal workers, rubber and plastic workers, wood and furniture workers, printers, loading and unloading workers, automobile manufacturing, general construction, and food and beverage industry (restaurants and other eateries). Exposures associated with an increased risk of AML (all subtypes combined) and/or individual subtypes included benzene, diesel fuel, metals, insecticides

  16. A clinically applicable molecular-based classification for endometrial cancers

    PubMed Central

    Talhouk, A; McConechy, M K; Leung, S; Li-Chang, H H; Kwon, J S; Melnyk, N; Yang, W; Senz, J; Boyd, N; Karnezis, A N; Huntsman, D G; Gilks, C B; McAlpine, J N

    2015-01-01

    Background: Classification of endometrial carcinomas (ECs) by morphologic features is inconsistent, and yields limited prognostic and predictive information. A new system for classification based on the molecular categories identified in The Cancer Genome Atlas is proposed. Methods: Genomic data from the Cancer Genome Atlas (TCGA) support classification of endometrial carcinomas into four prognostically significant subgroups; we used the TCGA data set to develop surrogate assays that could replicate the TCGA classification, but without the need for the labor-intensive and cost-prohibitive genomic methodology. Combinations of the most relevant assays were carried forward and tested on a new independent cohort of 152 endometrial carcinoma cases, and molecular vs clinical risk group stratification was compared. Results: Replication of TCGA survival curves was achieved with statistical significance using multiple different molecular classification models (16 total tested). Internal validation supported carrying forward a classifier based on the following components: mismatch repair protein immunohistochemistry, POLE mutational analysis and p53 immunohistochemistry as a surrogate for ‘copy-number' status. The proposed molecular classifier was associated with clinical outcomes, as was stage, grade, lymph-vascular space invasion, nodal involvement and adjuvant treatment. In multivariable analysis both molecular classification and clinical risk groups were associated with outcomes, but differed greatly in composition of cases within each category, with half of POLE and mismatch repair loss subgroups residing within the clinically defined ‘high-risk' group. Combining the molecular classifier with clinicopathologic features or risk groups provided the highest C-index for discrimination of outcome survival curves. Conclusions: Molecular classification of ECs can be achieved using clinically applicable methods on formalin-fixed paraffin-embedded samples, and provides

  17. Does the use of salmon frames as bait for lobster/crab creel fishing significantly increase the risk of disease in farmed salmon in Scotland?

    PubMed

    Murray, Alexander G

    2015-07-01

    Salmon farming is an important economic activity, and employer, particularly for remoter areas of Scotland; crustacean fisheries are also significant small businesses in these areas. Salmon frames (the head and spine that remain after evisceration and filleting) are sometimes used to bait the creel pots used to catch lobsters and crabs. These frames may contain pathogens that could potentially be spread to salmon farms in the vicinity of creel fisheries. Therefore, an analysis has been carried out for key pathogens of farmed salmon to assess the risks associated with this process. Infection of farms via creel bait requires that: (1) pathogens are present in salmon at harvest; (2) they are not removed from the salmon that used for bait during processing; (3) they transmit from creel pot baits to salmon farms. This last step is critical and leads to most of the uncertainty in results. Risk were assessed for 7 viruses, 3 bacteria, and 3 eukaryotic parasites of importance to salmon farming. A potentially significant risk was identified in association with disease control programmes if fish were filleted at a secondary processor; such a situation should arise only rarely. A very low risk, per event, was identified from imports, however, because of large numbers of Norwegian imports processed in the UK this risk is always present. Risks were at worst of low (disease control) or very low (imports) probability and are significant only because of the magnitude of consequences. PMID:25980750

  18. Which Measures of Health Status Assessment are the Most Significant in Organized Cohorts with Low Current Cardiovascular Risk? The Screening Study of Penitentiary Staff in Saratov Region, Russia

    PubMed Central

    Kiselev, Anton R.; Balashov, Sergey V.; Posnenkova, Olga M.; Prokhorov, Mikhail D.; Gridnev, Vladimir I.

    2016-01-01

    Objective: The aim of the present study was to compare different methods of health status assessment in organized cohort of penitentiary employees in Saratov Region, Russian Federation. Materials and Methods: 1,014 penitentiary employees (81.8% male) aged 33.4±6.8 years were included in the cohort study. All participants underwent an annual preventive health examination in the Center of Medical and Social Rehabilitation of Russian Federal Penitentiary Service in Saratov Region. The prevalence of common cardiovascular risk factors was assessed. Risk Score and the number of fulfilled health metrics proposed by American Heart Association (AHA) were calculated for each participant. Results: It is shown that penitentiary staff in Saratov Region is characterized by low current risk score (1.2±0.8%), but high prevalence of such risk factors as increased body weight and obesity (51%), tobacco use or passive smoking (81%), and unhealthy diet (55%). 98.4% of participants had the Score level of ≤5%, but only 4.5% of penitentiary staff met the ideal cardiovascular health (they met all seven AHA health metrics). One fifth of the participants met three or less AHA health metrics. A statistically significant correlation between the risk Score and the number of fulfilled AHA health metrics is revealed (Chi-square = 5.1, p=0.024). The probability of fulfilment of less than 5 AHA health metrics in subjects with medium risk score is shown to be almost twofold greater than in subjects with low risk Score. However, there are a lot of differences in the assessment of cardiovascular health by risk Score and AHA health metrics. Conclusion: AHA health metrics are more preferable than the risk Score or assessment of separate cardiovascular risk factors for preventive management in organized cohorts with low current cardiovascular risk such as penitentiary staff in Saratov Region. PMID:27026764

  19. Improving the Significance of MM/SD Risk Analysis by Application of the SRL Ballistic Limit Equation

    NASA Astrophysics Data System (ADS)

    Schafer, Frank; Putzar, Robin; Ryan, Shannon; Lambert, Michel

    2009-03-01

    In this paper, a new ballistic limit equation (BLE) for satellite equipment placed behind satellite structure walls is presented. Application of this equation in micrometeoroid and space debris (MM/SD) risk analysis (RA) tools for satellites can lead to a more realistic quantitative assessment of the actual failure risk of satellite equipment from hypervelocity impacts (HVI) and hence, of the failure risk of a satellite. This is because in contrast to the BLEs that are currently in use in RA tools, in the new equation the intrinsic shielding capabilities of the satellite equipment are considered explicitly.The BLE has been developed for application to configurations consisting of a Whipple shield or a honeycomb sandwich panel placed in front of a backwall. It considers explicitly the thickness, material and spacing of each of the three involved plates. The backwall represents the cover plate or the external wall of spacecraft equipment that is placed behind the spacecraft's structure wall. The BLE has been experimentally calibrated to the most common spacecraft equipment: fuel and heat pipes, pressure vessels, electronics boxes, harness, and batteries. Further, suitable failure criteria have been defined for each equipment type. The critical projectile masses calculated with the new BLE for satellite equipment placed behind satellite structure walls are considerably larger than the critical projectile masses calculated for the standalone structure wall of the satellite.

  20. A significantly joint effect between arsenic and occupational exposures and risk genotypes/diplotypes of CYP2E1, GSTO1 and GSTO2 on risk of urothelial carcinoma

    SciTech Connect

    Wang, Y.-H.; Yeh, S.-D.; Shen, K.-H.; Shen, Cheng-Huang; Juang, G.-D.; Hsu, L.-I; Chiou, H.-Y.; Chen, C.-J.

    2009-11-15

    Cigarette smoking, arsenic and occupational exposures are well-known risk factors for the development of urothelial carcinoma (UC). Therefore, the aim of this study is to investigate whether the effect of cigarette smoking, alcohol consumption, arsenic and occupational exposures on risk of UC could be modified by genetic polymorphisms of cytochrome P450 2E1 and glutathione S-transferase omega. A hospital-based case-control study consisted of 520 histologically confirmed UC cases, and 520 age- and gender-matched cancer-free controls were carried out from September 1998 to December 2007. Genotyping of CYP2E1, GSTO1 and GSTO2 was determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Subjects with both of cigarette smoking and alcohol consumption have a significantly increased UC risk (odds ratio [OR] = 2.9; 95% confidence interval [CI] = 1.9-4.4). Significantly increased UC risks of 1.5 and 1.9 were found for study subjects with high arsenic exposure and those who have been exposed to two or more occupational exposures, respectively. A significantly increased UC risk of 3.9 was observed in study subjects with H2-H2 diplotype of GSTO1 and GSTO2. The significantly highest UC risk of 9.0 was found for those with all environmental risk factors of cigarette smoking, alcohol consumption, arsenic and occupational exposures and two or more risk genotypes/diplotypes of CYP2E1, GSTO1 and GSTO2. Our findings suggest that a significantly joint effect of cigarette smoking, alcohol consumption, arsenic and occupational exposures and risk genotypes/diplotypes of CYP2E1, GSTO1 and GSTO2 on risk of UC was found.

  1. High Dose Atorvastatin Associated with Increased Risk of Significant Hepatotoxicity in Comparison to Simvastatin in UK GPRD Cohort

    PubMed Central

    Clarke, Alan T.; Johnson, Paul C. D.; Hall, Gillian C.; Ford, Ian; Mills, Peter R.

    2016-01-01

    Background & Aims Occasional risk of serious liver dysfunction and autoimmune hepatitis during atorvastatin therapy has been reported. We compared the risk of hepatotoxicity in atorvastatin relative to simvastatin treatment. Methods The UK GPRD identified patients with a first prescription for simvastatin [164,407] or atorvastatin [76,411] between 1997 and 2006, but with no prior record of liver disease, alcohol-related diagnosis, or liver dysfunction. Incident liver dysfunction in the following six months was identified by biochemical value and compared between statin groups by Cox regression model adjusting for age, sex, year treatment started, dose, alcohol consumption, smoking, body mass index and comorbid conditions. Results Moderate to severe hepatotoxicity [bilirubin >60μmol/L, AST or ALT >200U/L or alkaline phosphatase >1200U/L] developed in 71 patients on atorvastatin versus 101 on simvastatin. Adjusted hazard ratio [AHR] for all atorvastatin relative to simvastatin was 1.9 [95% confidence interval 1.4–2.6]. High dose was classified as 40–80mg daily and low dose 10–20mg daily. Hepatotoxicity occurred in 0.44% of 4075 patients on high dose atorvastatin [HDA], 0.07% of 72,336 on low dose atorvastatin [LDA], 0.09% of 44,675 on high dose simvastatin [HDS] and 0.05% of 119,732 on low dose simvastatin [LDS]. AHRs compared to LDS were 7.3 [4.2–12.7] for HDA, 1.4 [0.9–2.0] for LDA and 1.5 [1.0–2.2] for HDS. Conclusions The risk of hepatotoxicity was increased in the first six months of atorvastatin compared to simvastatin treatment, with the greatest difference between high dose atorvastatin and low dose simvastatin. The numbers of events in the analyses were small. PMID:26983033

  2. Classification Options

    ERIC Educational Resources Information Center

    Exceptional Children, 1978

    1978-01-01

    The interview presents opinions of Nicholas Hobbs on the classification of exceptional children, including topics such as ecologically oriented classification systems, the role of parents, and need for revision of teacher preparation programs. (IM)

  3. Identification of sexually abused female adolescents at risk for suicidal ideations: a classification and regression tree analysis.

    PubMed

    Brabant, Marie-Eve; Hébert, Martine; Chagnon, François

    2013-01-01

    This study explored the clinical profiles of 77 female teenager survivors of sexual abuse and examined the association of abuse-related and personal variables with suicidal ideations. Analyses revealed that 64% of participants experienced suicidal ideations. Findings from classification and regression tree analysis indicated that depression, posttraumatic stress symptoms, and hopelessness discriminated profiles of suicidal and nonsuicidal survivors. The elevated prevalence of suicidal ideations among adolescent survivors of sexual abuse underscores the importance of investigating the presence of suicidal ideations in sexual abuse survivors. However, suicidal ideation is not the sole variable that needs to be investigated; depression, hopelessness and posttraumatic stress symptoms are also related to suicidal ideations in survivors and could therefore guide interventions. PMID:23428149

  4. Significance of Lymph Node Ratio in Defining Risk Category in Node-positive Early Stage Cervical Cancer

    PubMed Central

    Fleming, Nicole D.; Frumovitz, Michael; Schmeler, Kathleen M.; dos Reis, Ricardo; Munsell, Mark F.; Eifel, Patricia J.; Soliman, Pamela T.; Nick, Alpa M.; Westin, Shannon N.; Ramirez, Pedro T.

    2015-01-01

    Objective The ratio of positive to negative lymph nodes, or lymph node ratio (LNR), is an important prognostic factor in several solid tumors. The objective of this study was to determine if LNR can be used to define a high-risk category of patients with node-positive early stage cervical cancer. Methods We performed a retrospective review of patients diagnosed with node-positive stage I or II cervical cancer who underwent radical hysterectomy and pelvic +/− para-aortic lymphadenectomy at MD Anderson from January 1990 through December 2011. Univariate and multivariate analysis was used to identify prognostic factors for progression-free (PFS) and overall survival (OS). Results Ninety-five patients met inclusion criteria and were included in the analysis. Median total nodes removed were 19 (range 1–58), and median number of positive nodes was 1 (range 1–12). Fifty-eight patients (61%) received radiation with concurrent cisplatin and 27 patients (28%) received radiotherapy alone. Twenty-one (22%) patients recurred. On multivariate analysis, a LNR > 6.6% was associated with a worse PFS (HR=2.97, 95% CI 1.26–7.02, p=0.01), and a LNR > 7.6% with a worse OS (HR=3.96, 95% CI 1.31–11.98, p=0.01). On multivariate analysis, positive margins were associated with worse PFS (p=0.001) and OS (p=0.002), and adjuvant radiotherapy (p=0.01) with improved OS. Conclusions LNR appears to be a useful tool to identify patients with worse prognosis in node-positive early stage cervical cancer. LNR may be used in addition to pathologic risk factors to tailor adjuvant treatment in this population. PMID:25451695

  5. Effectiveness of Computer-Assisted Instruction on Enhancing the Classification Skill in Second-Graders at Risk for Learning Disabilities

    ERIC Educational Resources Information Center

    Mohammed, Adel Abdulla; Kanpolat, Yavuz Erhan

    2010-01-01

    Introduction: Computers and other technological instruments in general have become a more common practice in our schools nowadays, and Computer-assisted instruction (CAI) has been recently provided in various formats from kindergartens on. It can help children at-risk for learning disabilities. Method: This study investigated the effectiveness of…

  6. Interaction between ALOX5AP and CYP3A5 gene variants significantly increases the risk for cerebral infarctions in Chinese.

    PubMed

    Chi, Li-Fen; Yi, Xing-Yang; Shao, Min-Jie; Lin, Jing; Zhou, Qiang

    2014-05-01

    In this study, we investigated associations between susceptibility genes and cerebral infarctions in a Chinese population, and whether gene-gene interactions increase the risk of cerebral infarctions. Overall, 292 patients with cerebral infarctions and 259 healthy control individuals were included. Eight variants in five candidate genes were examined for the risk of stroke, including the SG13S32 (rs9551963), SG13S42 (rs4769060), SG13S89 (rs4769874), and SG13S114 (rs10507391) variants of the 5-lipoxygenase activating protein (ALOX5AP) gene, the G860A (rs751141) variant of the soluble epoxide hydrolase (EPHX2) gene, the A1075C (rs1057910) variant of the CYP2C9*2 gene, the C430T (rs1799853) variant of the CYP2C9*3 gene, and the A6986G (rs776746) variant of the CYP3A5 gene. Gene-gene interactions were explored using generalized multifactor dimensionality reduction methods. There were no statistically significant differences in the frequencies of the genotypes of the eight candidate genes. The generalized multifactor dimensionality reduction analysis showed a significant gene-gene interaction between SG13S114 and A6986G, with scores of 10 for cross-validation consistency and 9 for the sign test (P=0.0107). These gene-gene interactions predicted a significantly higher risk of cerebral infarction (adjusted for age, hypertension, and diabetes mellitus; odds ratio=1.80495%, confidence interval: 1.180-2.759, P=0.006). A two-loci gene interaction confers a significantly higher risk for cerebral infarction. The combinational analysis used in this study may be helpful in the elucidation of genetic risk factors for common and complex diseases. PMID:24368493

  7. Mechanisms and genetic determinants regulating sterol absorption, circulating LDL levels, and sterol elimination: implications for classification and disease risk

    PubMed Central

    Calandra, Sebastiano; Tarugi, Patrizia; Speedy, Helen E.; Dean, Andrew F.; Bertolini, Stefano; Shoulders, Carol C.

    2011-01-01

    This review integrates historical biochemical and modern genetic findings that underpin our understanding of the low-density lipoprotein (LDL) dyslipidemias that bear on human disease. These range from life-threatening conditions of infancy through severe coronary heart disease of young adulthood, to indolent disorders of middle- and old-age. We particularly focus on the biological aspects of those gene mutations and variants that impact on sterol absorption and hepatobiliary excretion via specific membrane transporter systems (NPC1L1, ABCG5/8); the incorporation of dietary sterols (MTP) and of de novo synthesized lipids (HMGCR, TRIB1) into apoB-containing lipoproteins (APOB) and their release into the circulation (ANGPTL3, SARA2, SORT1); and receptor-mediated uptake of LDL and of intestinal and hepatic-derived lipoprotein remnants (LDLR, APOB, APOE, LDLRAP1, PCSK9, IDOL). The insights gained from integrating the wealth of genetic data with biological processes have important implications for the classification of clinical and presymptomatic diagnoses of traditional LDL dyslipidemias, sitosterolemia, and newly emerging phenotypes, as well as their management through both nutritional and pharmaceutical means. PMID:21862702

  8. Mechanisms and genetic determinants regulating sterol absorption, circulating LDL levels, and sterol elimination: implications for classification and disease risk.

    PubMed

    Calandra, Sebastiano; Tarugi, Patrizia; Speedy, Helen E; Dean, Andrew F; Bertolini, Stefano; Shoulders, Carol C

    2011-11-01

    This review integrates historical biochemical and modern genetic findings that underpin our understanding of the low-density lipoprotein (LDL) dyslipidemias that bear on human disease. These range from life-threatening conditions of infancy through severe coronary heart disease of young adulthood, to indolent disorders of middle- and old-age. We particularly focus on the biological aspects of those gene mutations and variants that impact on sterol absorption and hepatobiliary excretion via specific membrane transporter systems (NPC1L1, ABCG5/8); the incorporation of dietary sterols (MTP) and of de novo synthesized lipids (HMGCR, TRIB1) into apoB-containing lipoproteins (APOB) and their release into the circulation (ANGPTL3, SARA2, SORT1); and receptor-mediated uptake of LDL and of intestinal and hepatic-derived lipoprotein remnants (LDLR, APOB, APOE, LDLRAP1, PCSK9, IDOL). The insights gained from integrating the wealth of genetic data with biological processes have important implications for the classification of clinical and presymptomatic diagnoses of traditional LDL dyslipidemias, sitosterolemia, and newly emerging phenotypes, as well as their management through both nutritional and pharmaceutical means. PMID:21862702

  9. Atrial fibrillation burden and atrial fibrillation type: Clinical significance and impact on the risk of stroke and decision making for long-term anticoagulation.

    PubMed

    Boriani, Giuseppe; Pettorelli, Daniele

    2016-08-01

    Atrial fibrillation (AF) is a common arrhythmia increasing the risk of morbidity and adverse outcomes (stroke, heart failure, death). AF is found in 1-2% of the general population, with increasing prevalence with aging. Its exact epidemiological profile is incomplete and underestimated, because 10-40% of AF patients (particularly the elderly) can be asymptomatic ("clinically silent or subclinical AF"), with occasional electrocardiographic diagnosis. The research interest on silent AF has increased by the evidence that its outcome is no less severe, in terms of risks of stroke and death, than that for symptomatic patients. Data collected from more than 18,000 patients indicate that cardiac implantable electrical devices (CIEDs) are validated tools for detecting silent AF and measuring the time spent in AF, defined as "AF burden." A maximum daily AF burden of ≥5-6min, but particularly ≥1h, is associated with a significant increase in the risk of stroke, and may be clinically relevant to improve current risk stratification based on risk scores and for "personalizing" prescription of oral anticoagulants. An in-depth study of the temporal relationship between AF and ischemic stroke showed that data from CIEDs reveal a complex scenario, by which AF is certainly a risk factor for cardioembolic stroke, with a cause-effect relationship related to atrial thrombi, but can also be a simple "marker of risk," with a noncausal association with stroke. In such cases, stroke is possibly related to atheroemboli from the aorta, the carotid arteries, or other sources. PMID:27196706

  10. Remote sensing (normalized difference vegetation index) classification of risk versus minimal risk habitats for human exposure to Ixodes pacificus (Acari: Ixodidae) nymphs in Mendocino County, California.

    PubMed

    Eisen, Rebecca J; Eisen, Lars; Lane, Robert S

    2005-01-01

    In California, Ixodes pacificus Cooley & Kohls nymphs have been implicated as the primary bridging vectors to humans of the spirochetal bacterium causing Lyme disease (Borrelia burgdorferi). Because the nymphs typically do not ascend emergent vegetation, risk of human exposure is minimal in grasslands, chaparral, and woodland-grass. Instead, woodlands with a ground cover dominated by leaf litter (hereinafter referred to as woodland-leaf) have emerged as a primary risk habitat for exposure to B. burgdorferi-infected nymphs. As a means of differentiating woodland-leaf habitats from others with minimal risk (e.g., chaparral, grassland, and woodland-grass), we constructed a maximum likelihood model of these habitat types within a 7,711-ha area in southeastern Mendocino County based on the normalized difference vegetation index derived from Landsat 5 Thematic Mapper imagery (based on a 30 by 30-m pixel size) over four seasons. The overall accuracy of the model to discriminate woodland-leaf, woodland-grass, open grassland, and chaparral was 83.85% (Kappa coefficient of 0.78). Validation of the accuracy of the model to classify woodland-leaf yielded high values both for producer accuracy (93.33% of validated woodland-leaf pixels correctly classified by the model) and user accuracy (96.55% of model-classified validation pixels correctly categorized as woodland-leaf). Woodland-leaf habitats were found to be highly aggregated within the examined area. In conclusion, our model successfully used remotely sensed data as a predictor of habitats where humans are at risk for Lyme disease in the far-western United States. PMID:15691012

  11. Risk Factors at Time of Primary ACL Reconstruction that Contribute to Significant Chondral Surface Change at Time of Revision ACL Reconstruction

    PubMed Central

    Kaeding, Christopher C.; Group, Mars

    2016-01-01

    Objectives: Articular cartilage health is an important issue following primary anterior cruciate ligament reconstruction (ACLR). It is not clear what risk factors at the time of primary reconstruction affect future articular cartilage health. The purpose of this study was to examine risk factors affecting chondral surface change in a cohort from the time of primary ACLR to revision ACLR. Methods: Subjects who had both primary and revision data contained in the MOON and MARS registries were included. Data included chondral surface status (grade and size) at time of primary and revision, meniscal status (no treatment/repair, ≤33% excision, >33% excision) at time of primary, time from primary to revision ACLR, and age, sex, BMI, Marx, KOOS, and IKDC at time of revision. Significant chondral surface change was defined as >25% deterioration between time of primary and revision in the femoral condyle, tibial plateau, patella, or trochlea. Logistic regression was used to test each variable’s contribution to significant chondral surface change in the medial compartment, lateral compartment, and patellofemoral compartment. Results: 134 subjects met our inclusion criteria. 34/134 (25.4%) had significant lateral compartment chondral surface change, 32/134 (23.9%) had significant medial compartment chondral surface change, and 31/134 (23.1%) had significant patellofemoral chondral surface change. Median age at time of revision was 19.5 years [IQ range 17-25] and median time from primary to revision was 462.5 days [IQ range 292-1049]. KOOS and IKDC at revision were not associated with significant chondral surface change in any compartment. Patients with >33% of their lateral meniscus excised had 13.5 times the odds of having significant lateral compartment surface change compared to subjects who either did not have lateral meniscal damage, had it repaired, or had an excision of ≤33% controlling for age (p<0.001). Patients with ≤33% excision of their medial meniscus had

  12. Heterogeneous methodology of racial/ethnic classification may be responsible for the different risk assessments for prostate cancer between Black and White men in Brazil

    PubMed Central

    Romero, Frederico R.; Xavier, Luiz Ricardo T. P.; Romero, Antonio W.; de Almeida, Rui Manuel S.; Matias, Jorge Eduardo F; Tambara, Renato

    2015-01-01

    Objectives To evaluate if the different results of prostate cancer risk between black and white Brazilian men may be associated with the varying methodology used to define participants as either Blacks or Whites. Patients and Methods We evaluated median PSA values, rate of PSA level ≥4.0 ng/mL, indications for prostate biopsy, prostate cancer detection rate, biopsy/cancer rate, cancer/biopsy rate, and the relative risk of cancer between blacks versus whites, blacks versus non-blacks (browns and whites), non-whites (browns and blacks) versus whites, African versus non-African descendants, and African descendants or blacks versus non-African descendants and non-blacks. Results From 1544 participants, there were 51.4% whites, 37.2% browns, 11.4% blacks, and 5.4% African descendants. Median PSA level was 0.9 ng/mL in whites, browns, and non-African descendants, compared to 1.2 ng/mL in blacks, and African descendants or blacks, and 1.3 ng/mL in African descendants. Indications for prostate biopsy were present in 16.9% for African descendants, 15.9% of black, 12.3% of white, 11.4% for non-African descendants, and 9.9% of brown participants. Prostate cancer was diagnosed in 30.3% of performed biopsies: 6.2% of African descendants, 5.1% of blacks, 3.3% of whites, 3.0% of non-African descendants, and 2.6% of browns. Conclusions Median PSA values were higher for Blacks versus Whites in all classification systems, except for non-white versus white men. The rate of prostate biopsy, prostate cancer detection rate, and relative risk for cancer was increased in African descendants, and African descendants or blacks, compared to non-African descendants, and non-African descendants and non-blacks, respectively. PMID:26005980

  13. Prognostic significance of L1CAM expression and its association with mutant p53 expression in high-risk endometrial cancer.

    PubMed

    Van Gool, Inge C; Stelloo, Ellen; Nout, Remi A; Nijman, Hans W; Edmondson, Richard J; Church, David N; MacKay, Helen J; Leary, Alexandra; Powell, Melanie E; Mileshkin, Linda; Creutzberg, Carien L; Smit, Vincent T H B M; Bosse, Tjalling

    2016-02-01

    Studies in early-stage, predominantly low- and intermediate-risk endometrial cancer have demonstrated that L1 cell adhesion molecule (L1CAM) overexpression identifies patients at increased risk of recurrence, yet its prognostic significance in high-risk endometrial cancer is unclear. To evaluate this, its frequency, and the relationship of L1CAM with the established endometrial cancer biomarker p53, we analyzed the expression of both markers by immunohistochemistry in a pilot series of 116 endometrial cancers (86 endometrioid, 30 non-endometrioid subtype) with high-risk features (such as high tumor grade and deep myometrial invasion) and correlated results with clinical outcome. We used The Cancer Genome Atlas (TCGA) endometrial cancer series to validate our findings. Using the previously reported cutoff of 10% positive staining, 51/116 (44%) tumors were classified as L1CAM-positive, with no significant association between L1CAM positivity and the rate of distant metastasis (P=0.195). However, increasing the threshold for L1CAM positivity to 50% resulted in a reduction of the frequency of L1CAM-positive tumors to 24% (28/116), and a significant association with the rate of distant metastasis (P=0.018). L1CAM expression was strongly associated with mutant p53 in the high-risk and TCGA series (P<0.001), although a substantial fraction (36% of endometrioid, 10% of non-endometrioid morphology) of p53-mutant endometrial cancers displayed <10% L1CAM positivity. Moreover, 30% of p53-wild-type non-endometrioid endometrial cancers demonstrated diffuse L1CAM staining, suggesting p53-independent mechanisms of L1CAM overexpression. In conclusion, the previously proposed threshold for L1CAM positivity of >10% does not predict prognosis in high-risk endometrial cancer, whereas an alternative threshold (>50%) does. L1CAM expression is strongly, but not universally, associated with mutant p53, and may be strong enough for clinical implementation as prognostic marker in combination

  14. Distribution of Ticks and the Risk of Lyme Disease and Other Tick-Borne Pathogens of Public Health Significance in Ontario, Canada.

    PubMed

    Clow, Katie M; Ogden, Nicholas H; Lindsay, L Robbin; Michel, Pascal; Pearl, David L; Jardine, Claire M

    2016-04-01

    Over the past two decades, the northward spread of Ixodes scapularis across Ontario, Canada, has accelerated and the risk of Lyme disease has increased. Active surveillance is a recognized and effective method for detecting reproducing populations of I. scapularis. In this study, we conducted field sampling consistent with an active surveillance approach from May to October 2014 at 104 sites in central, eastern, and southern Ontario to determine the current distribution of I. scapularis and other tick species, and enhance our understanding of the geographic risk associated with Borrelia burgdorferi and other tick-borne pathogens of public health significance in this region. I. scapularis was present at 20 of the 104 sites visited. Individuals of the tick species Dermacentor variabilis, Haemaphysalis leporispalustris, and Ixodes dentatus were also collected. I. scapularis was positive by PCR for B. burgdorferi at five sites. These sites formed a significant spatial cluster in eastern Ontario. No ticks were PCR positive for Borrelia miyamotoi, Anaplasma phagocytophilum, and Babesia microti. This study provides an up-to-date picture of the distribution of I. scapularis and other tick species, and the risk of B. burgdorferi and other pathogens of public health significance in central, eastern, and southern Ontario. This information may allow for more effective surveillance efforts and public health interventions for Lyme disease and other tick-borne diseases in this region. PMID:26870937

  15. Genome-wide association study of alcohol dependence:significant findings in African- and European-Americans including novel risk loci.

    PubMed

    Gelernter, J; Kranzler, H R; Sherva, R; Almasy, L; Koesterer, R; Smith, A H; Anton, R; Preuss, U W; Ridinger, M; Rujescu, D; Wodarz, N; Zill, P; Zhao, H; Farrer, L A

    2014-01-01

    We report a GWAS of alcohol dependence (AD) in European-American (EA) and African-American (AA) populations, with replication in independent samples of EAs, AAs and Germans. Our sample for discovery and replication was 16 087 subjects, the largest sample for AD GWAS to date. Numerous genome-wide significant (GWS) associations were identified, many novel. Most associations were population specific, but in several cases were GWS in EAs and AAs for different SNPs at the same locus,showing biological convergence across populations. We confirmed well-known risk loci mapped to alcohol-metabolizing enzyme genes, notably ADH1B (EAs: Arg48His, P=1.17 × 10(-31); AAs: Arg369Cys, P=6.33 × 10(-17)) and ADH1C in AAs (Thr151Thr, P=4.94 × 10(-10)), and identified novel risk loci mapping to the ADH gene cluster on chromosome 4 and extending centromerically beyond it to include GWS associations at LOC100507053 in AAs (P=2.63 × 10(-11)), PDLIM5 in EAs (P=2.01 × 10(-8)), and METAP in AAs (P=3.35 × 10(-8)). We also identified a novel GWS association (1.17 × 10(-10)) mapped to chromosome 2 at rs1437396, between MTIF2 and CCDC88A, across all of the EA and AA cohorts, with supportive gene expression evidence, and population-specific GWS for markers on chromosomes 5, 9 and 19. Several of the novel associations implicate direct involvement of, or interaction with, genes previously identified as schizophrenia risk loci. Confirmation of known AD risk loci supports the overall validity of the study; the novel loci are worthy of genetic and biological follow-up. The findings support a convergence of risk genes (but not necessarily risk alleles) between populations, and, to a lesser extent, between psychiatric traits. PMID:24166409

  16. Endodontic classification.

    PubMed

    Morse, D R; Seltzer, S; Sinai, I; Biron, G

    1977-04-01

    Clinical and histopathologic findings are mixed in current endodontic classifications. A new system, based on symptomatology, may be more useful in clincial practice. The classifications are vital asymptomatic, hypersensitive dentin, inflamed-reversible, inflamed/dengenerating without area-irreversible, inflamed/degenerating with area-irreversible, necrotic without area, and necrotic with area. PMID:265327

  17. Monoclonal gammopathy of undetermined significance (MGUS) and smoldering (asymptomatic) multiple myeloma: IMWG consensus perspectives risk factors for progression and guidelines for monitoring and management.

    PubMed

    Kyle, R A; Durie, B G M; Rajkumar, S V; Landgren, O; Blade, J; Merlini, G; Kröger, N; Einsele, H; Vesole, D H; Dimopoulos, M; San Miguel, J; Avet-Loiseau, H; Hajek, R; Chen, W M; Anderson, K C; Ludwig, H; Sonneveld, P; Pavlovsky, S; Palumbo, A; Richardson, P G; Barlogie, B; Greipp, P; Vescio, R; Turesson, I; Westin, J; Boccadoro, M

    2010-06-01

    Monoclonal gammopathy of undetermined significance (MGUS) was identified in 3.2% of 21 463 residents of Olmsted County, Minnesota, 50 years of age or older. The risk of progression to multiple myeloma, Waldenstrom's macroglobulinemia, AL amyloidosis or a lymphoproliferative disorder is approximately 1% per year. Low-risk MGUS is characterized by having an M protein <15 g/l, IgG type and a normal free light chain (FLC) ratio. Patients should be followed with serum protein electrophoresis at six months and, if stable, can be followed every 2-3 years or when symptoms suggestive of a plasma cell malignancy arise. Patients with intermediate and high-risk MGUS should be followed in 6 months and then annually for life. The risk of smoldering (asymptomatic) multiple myeloma (SMM) progressing to multiple myeloma or a related disorder is 10% per year for the first 5 years, 3% per year for the next 5 years and 1-2% per year for the next 10 years. Testing should be done 2-3 months after the initial recognition of SMM. If the results are stable, the patient should be followed every 4-6 months for 1 year and, if stable, every 6-12 months. PMID:20410922

  18. JAK2 p.V617F allele burden in myeloproliferative neoplasms one month after allogeneic stem cell transplantation significantly predicts outcome and risk of relapse

    PubMed Central

    Lange, Thoralf; Edelmann, Anja; Siebolts, Udo; Krahl, Rainer; Nehring, Claudia; Jäkel, Nadja; Cross, Michael; Maier, Jacqueline; Niederwieser, Dietger; Wickenhauser, Claudia

    2013-01-01

    The risk profile and prognosis of patients with myelofibrosis is well described by the Dynamic International Prognostic Scoring System risk categorization. Allogeneic stem cell transplantation is considered for intermediate-2/high risk disease. However, indicators of prognosis after transplantation are still lacking. Seventy simultaneously collected pairs of trephine and blood samples were quantified for JAK2 p.V617F allele burden to compare test sensitivity. The course of 30 patients with JAK2 p.V617F-positive myeloproliferative neoplasia was correlated with allele burden after transplantation. Monitoring can be performed on full blood samples as well as trephine biopsies, provided that techniques with ample sensitivity (0.01% to 0.001%) are available. Measurement of allele burden on day 28 after transplantation discriminates two prognostic groups: patients with a JAK2 p.V617F allele burden >1% have a significantly higher risk of relapse of JAK2 p.V617F positive neoplasia (P=0.04) and a poorer overall survival (P<0.01). In conclusion, measurement of JAK2 p.V617F allele burden early after transplantation is an important predictive parameter in monitoring patients following this treatment. As this might provide an important tool in early management of imminent early relapse it will be important to define consensus guidelines for optimal monitoring. PMID:23300178

  19. The Clinical Significance and Risk Factors of Anti-Platelet Factor 4/heparin Antibody on Maintenance Hemodialysis Patients: A Two-Year Prospective Follow-up

    PubMed Central

    Yao, Li; Lin, Hongli; Li, Jijun; Zhao, Jiuyang; Zhang, Zhimin; Lun, Lide; Zhang, Jianrong; Li, Mingxu; Huang, Qi; Yang, Yang; Jiang, Shimin; Wang, Yong; Zhu, Hanyu; Chen, Xiangmei

    2013-01-01

    Background Heparin-induced thrombocytopenia is an immune response mediated by anti-PF4/heparin antibody, which is clinically characterized by thrombocytopenia and thromboembolic events. In this study, a prospective and multi-center clinical investigation determined the positive rate of anti-PF4/heparin antibody in maintenance hemodialysis patients in China, identified the related risk factors, and further explored the effect of the anti-PF4/heparin antibody on bleeding, thromboembolic events, and risk of death in the patients. Methods The serum anti-PF4/heparin antibody was measured in 661 patients from nine hemodialysis centers, detected by IgG-specific ELISA and followed by confirmation with excess heparin. Risk factors of these patients were analyzed. Based on a two-year follow-up, the association between the anti-PF4/heparin antibody and bleeding, thromboembolic events, and risk of death in the patients was investigated. Results The positivity rate of the anti-PF4/heparin antibody in maintenance hemodialysis patients was 5.6%. With diabetes as an independent risk factor, the positivity rate of the anti-PF4/heparin antibody decreased in the patients undergoing weekly dialyses ≥3 times. The positivity rate of the anti-PF4/heparin antibody was not related to the occurrence of clinical thromboembolic events and was not a risk factor for death within two years in maintenance hemodialysis patients. Negativity for the anti-PF4/heparin antibody combined with a reduction of the platelet count or combined with the administration of antiplatelet drugs yielded a significant increase in bleeding events. However, the composite determination of the anti-PF4/heparin antibody and thrombocytopenia, as well as the administration of antiplatelet drugs, was not predictive for the risk of thromboembolic events in the maintenance hemodialysis patients. Conclusions A single detection of the anti-PF4/heparin antibody did not predict the occurrence of clinical bleeding, thromboembolic

  20. Direct targeting of risk factors significantly increases the detection of liver cirrhosis in primary care: a cross-sectional diagnostic study utilising transient elastography

    PubMed Central

    Harman, David J; Ryder, Stephen D; James, Martin W; Jelpke, Matthew; Ottey, Dominic S; Wilkes, Emilie A; Card, Timothy R; Aithal, Guruprasad P; Guha, Indra Neil

    2015-01-01

    Objectives To assess the feasibility of a novel diagnostic algorithm targeting patients with risk factors for chronic liver disease in a community setting. Design Prospective cross-sectional study. Setting Two primary care practices (adult patient population 10 479) in Nottingham, UK. Participants Adult patients (aged 18 years or over) fulfilling one or more selected risk factors for developing chronic liver disease: (1) hazardous alcohol use, (2) type 2 diabetes or (3) persistently elevated alanine aminotransferase (ALT) liver function enzyme with negative serology. Interventions A serial biomarker algorithm, using a simple blood-based marker (aspartate aminotransferase:ALT ratio for hazardous alcohol users, BARD score for other risk groups) and subsequently liver stiffness measurement using transient elastography (TE). Main outcome measures Diagnosis of clinically significant liver disease (defined as liver stiffness ≥8 kPa); definitive diagnosis of liver cirrhosis. Results We identified 920 patients with the defined risk factors of whom 504 patients agreed to undergo investigation. A normal blood biomarker was found in 62 patients (12.3%) who required no further investigation. Subsequently, 378 patients agreed to undergo TE, of whom 98 (26.8% of valid scans) had elevated liver stiffness. Importantly, 71/98 (72.4%) patients with elevated liver stiffness had normal liver enzymes and would be missed by traditional investigation algorithms. We identified 11 new patients with definite cirrhosis, representing a 140% increase in the number of diagnosed cases in this population. Conclusions A non-invasive liver investigation algorithm based in a community setting is feasible to implement. Targeting risk factors using a non-invasive biomarker approach identified a substantial number of patients with previously undetected cirrhosis. Trial registration number The diagnostic algorithm utilised for this study can be found on clinicaltrials.gov (NCT02037867), and is

  1. Moderate Weight Reduction in an Outpatient Obesity Intervention Program Significantly Reduces Insulin Resistance and Risk Factors for Cardiovascular Disease in Severely Obese Adolescents

    PubMed Central

    Grulich-Henn, J.; Lichtenstein, S.; Hörster, F.; Hoffmann, G. F.; Nawroth, P. P.; Hamann, A.

    2011-01-01

    Background. Metabolic risk factors like insulin resistance and dyslipidemia are frequently observed in severly obese children. We investigated the hypothesis that moderate weight reduction by a low-threshold intervention is already able to reduce insulin resistance and cardiovascular risk factors in severely obese children. Methods. A group of 58 severely obese children and adolescents between 8 and 17 years participating in a six-month-long outpatient program was studied before and after treatment. The program included behavioral treatment, dietary education and specific physical training. Metabolic parameters were measured in the fasting state, insulin resistance was evaluated in an oral glucose tolerance test. Results. Mean standard deviation score of the body mass index (SDS-BMI) in the study group dropped significantly from +2.5 ± 0.5 to 2.3 ± 0.6 (P < 0.0001) after participation in the program. A significant decrease was observed in HOMA (6.3 ± 4.2 versus 4.9 ± 2.4, P < 0.03, and in peak insulin levels (232.7 ± 132.4 versus 179.2 ± 73.3 μU/mL, P < 0.006). Significant reductions were also observed in mean levels of hemoglobin A1c, total cholesterol and LDL cholesterol. Conclusions. These data demonstrate that already moderate weight reduction is able to decrease insulin resistance and dyslipidemia in severely obese children and adolescents. PMID:21904547

  2. CFH, C3 and ARMS2 Are Significant Risk Loci for Susceptibility but Not for Disease Progression of Geographic Atrophy Due to AMD

    PubMed Central

    Fritsche, Lars G.; Schmitz-Valckenberg, Steffen; Göbel, Arno; Adrion, Christine; Herold, Christine; Keilhauer, Claudia N.; Mackensen, Friederike; Mößner, Andreas; Pauleikhoff, Daniel; Weinberger, Andreas W. A.; Mansmann, Ulrich; Holz, Frank G.; Becker, Tim; Weber, Bernhard H. F.

    2009-01-01

    Background Age-related macular degeneration (AMD) is a prevalent cause of blindness in Western societies. Variants in the genes encoding complement factor H (CFH), complement component 3 (C3) and age-related maculopathy susceptibility 2 (ARMS2) have repeatedly been shown to confer significant risks for AMD; however, their role in disease progression and thus their potential relevance for interventional therapeutic approaches remains unknown. Methodology/Principal Findings Here, we analyzed association between variants in CFH, C3 and ARMS2 and disease progression of geographic atrophy (GA) due to AMD. A quantitative phenotype of disease progression was computed based on longitudinal observations by fundus autofluorescence imaging. In a subset of 99 cases with pure bilateral GA, variants in CFH (Y402H), C3 (R102G), and ARMS2 (A69S) are associated with disease (P = 1.6×10−9, 3.2×10−3, and P = 2.6×10−12, respectively) when compared to 612 unrelated healthy control individuals. In cases, median progression rate of GA over a mean follow-up period of 3.0 years was 1.61 mm2/year with high concordance between fellow eyes. No association between the progression rate and any of the genetic risk variants at the three loci was observed (P>0.13). Conclusions/Significance This study confirms that variants at CFH, C3, and ARMS2 confer significant risks for GA due to AMD. In contrast, our data indicate no association of these variants with disease progression which may have important implications for future treatment strategies. Other, as yet unknown susceptibilities may influence disease progression. PMID:19823576

  3. Areca Nut Chewing and an Impaired Estimated Glomerular Filtration Rate as Significant Risk Factors for Non-Muscle-Invasive Bladder Cancer Recurrence

    PubMed Central

    Cao, Jian; Xu, Ran; Zhao, Xiaokun; Zhong, Zhaohui; Zhang, Lei; Zhu, Xuan; Wu, Shuiqing; Ai, Kai

    2016-01-01

    The present study sought to investigate the predictive value of preoperative clinicopathological variables, with a special focus on areca nut chewing, on disease recurrence and progression in patients with non-muscle-invasive bladder cancer (NMIBC). Data from 242 patients diagnosed with NMIBC between 2008 and 2013 were analyzed retrospectively. Fifteen clinicopathological variables were analyzed to evaluate their prognostic value. During a mean observation period of 21 months, disease recurrence occurred in 140 patients (57.9%). On multivariate analysis, heavy-areca nut chewing (HR = 2.18, 95% CI: 1.37–3.47), current smoking (HR = 3.09, 95% CI: 1.99–4.80), moderately impaired estimated glomerular filtration rate (eGFR) (HR = 1.76, 95% CI: 1.09–2.83), severely impaired eGFR (HR = 3.32, 95% CI: 1.70–6.48) and tumor grade (HR = 1.94, 95% CI: 1.36–2.77) were independent factors for recurrence, based on which a risk factor model was developed to stratify patients into high, medium and low risk groups. In conclusion, our study suggests that in addition to quitting smoking, quitting areca nut chewing may also reduce the risk of first recurrence in NMBIC patients, monitoring and preserving their renal function may be beneficial as well. Further prospective studies are needed to verify the prognostic significance of these factors and the risk stratification model in this population. PMID:27385379

  4. Cardiac magnetic resonance and computed tomography angiography for clinical imaging of stable coronary artery disease. Diagnostic classification and risk stratification

    PubMed Central

    Korosoglou, Grigorios; Giusca, Sorin; Gitsioudis, Gitsios; Erbel, Christian; Katus, Hugo A.

    2014-01-01

    Despite advances in the pharmacologic and interventional treatment of coronary artery disease (CAD), atherosclerosis remains the leading cause of death in Western societies. X-ray coronary angiography has been the modality of choice for diagnosing the presence and extent of CAD. However, this technique is invasive and provides limited information on the composition of atherosclerotic plaque. Coronary computed tomography angiography (CCTA) and cardiac magnetic resonance (CMR) have emerged as promising non-invasive techniques for the clinical imaging of CAD. Hereby, CCTA allows for visualization of coronary calcification, lumen narrowing and atherosclerotic plaque composition. In this regard, data from the CONFIRM Registry recently demonstrated that both atherosclerotic plaque burden and lumen narrowing exhibit incremental value for the prediction of future cardiac events. However, due to technical limitations with CCTA, resulting in false positive or negative results in the presence of severe calcification or motion artifacts, this technique cannot entirely replace invasive angiography at the present time. CMR on the other hand, provides accurate assessment of the myocardial function due to its high spatial and temporal resolution and intrinsic blood-to-tissue contrast. Hereby, regional wall motion and perfusion abnormalities, during dobutamine or vasodilator stress, precede the development of ST-segment depression and anginal symptoms enabling the detection of functionally significant CAD. While CT generally offers better spatial resolution, the versatility of CMR can provide information on myocardial function, perfusion, and viability, all without ionizing radiation for the patients. Technical developments with these 2 non-invasive imaging tools and their current implementation in the clinical imaging of CAD will be presented and discussed herein. PMID:25147526

  5. Transplant outcomes of the triple-negative NPM1/FLT3-ITD/CEBPA mutation subgroup are equivalent to those of the favourable ELN risk group, but significantly better than the intermediate-I risk group after allogeneic transplant in normal-karyotype AML.

    PubMed

    Ahn, Jae-Sook; Kim, Hyeoung-Joon; Kim, Yeo-Kyeoung; Jung, Sung-Hoon; Yang, Deok-Hwan; Lee, Je-Jung; Kim, Nan Young; Choi, Seung Hyun; Jung, Chul Won; Jang, Jun-Ho; Kim, Hee Je; Moon, Joon Ho; Sohn, Sang Kyun; Won, Jong-Ho; Kim, Sung-Hyun; Kim, Dennis Dong Hwan

    2016-03-01

    The prognostic significance of molecular mutations (FLT3-ITD, NPM1, and CEBPA mutations) was examined in patients with normal-karyotype acute myeloid leukaemia (NK-AML) after allogeneic haematopoietic cell transplantation (HCT). In total, 115 patients received allogeneic HCT for NK-AML and were evaluated for FLT3-ITD, NPM1, and CEBPA mutations in diagnostic samples and for long-term outcomes following HCT, retrospectively. The prevalences of FLT3-ITD(pos), NPM1 (mut), and CEBPA (dm) (double mutations) were 32.2, 43.5, and 24.6 %, respectively. The triple-negative group (NPM1 (wild)/FLT3-ITD(neg)/non-CEBPA (dm)) showed a similar transplant outcome to those in the favourable European LeukemiaNet (ELN) risk group for overall survival (OS) (60.9 vs. 63.7 %; p = 0.810), but a more favourable OS than others in the intermediate-I risk group (40.0 %; p = 0.034). Also, the triple-negative group showed a similar relapse rate at 5 years compared with those in the favourable risk group (9.7 vs. 15.5 %; p = 0.499), but a lower rate of relapse than the others in the intermediate-I risk group (15.5 vs. 48.6 %; p = 0.004). The 5-year relapse incidences were 4.0 % (NPM1 (mut)/FLT3-ITD(neg)), 14.7 % (CEBPA (dm)), 15.5 % (NPM1 (wild)/FLT3-ITD(neg)/non-CEBPA (dm)), 39.1 % (NPM1 (mut)/FLT3-ITD(pos)/non-CEBPA (dm)), and 66.7 % (NPM1 (wild)/FLT3-ITD(pos)/non-CEBPA (dm)). Thus, the triple-negative (NPM1 (wild)/FLT3-ITD(neg)/non-CEBPA (dm)) group showed favourable long-term outcomes after allogeneic HCT in NK-AML, similar to those of the favourable risk group by the ELN risk classification. PMID:26692090

  6. Automatic Classification of Marine Mammals with Speaker Classification Methods.

    PubMed

    Kreimeyer, Roman; Ludwig, Stefan

    2016-01-01

    We present an automatic acoustic classifier for marine mammals based on human speaker classification methods as an element of a passive acoustic monitoring (PAM) tool. This work is part of the Protection of Marine Mammals (PoMM) project under the framework of the European Defense Agency (EDA) and joined by the Research Department for Underwater Acoustics and Geophysics (FWG), Bundeswehr Technical Centre (WTD 71) and Kiel University. The automatic classification should support sonar operators in the risk mitigation process before and during sonar exercises with a reliable automatic classification result. PMID:26611006

  7. Form classification

    NASA Astrophysics Data System (ADS)

    Reddy, K. V. Umamaheswara; Govindaraju, Venu

    2008-01-01

    The problem of form classification is to assign a single-page form image to one of a set of predefined form types or classes. We classify the form images using low level pixel density information from the binary images of the documents. In this paper, we solve the form classification problem with a classifier based on the k-means algorithm, supported by adaptive boosting. Our classification method is tested on the NIST scanned tax forms data bases (special forms databases 2 and 6) which include machine-typed and handwritten documents. Our method improves the performance over published results on the same databases, while still using a simple set of image features.

  8. Extreme-Risk Prostate Adenocarcinoma Presenting With Prostate-Specific Antigen (PSA) >40 ng/ml: Prognostic Significance of the Preradiation PSA Nadir

    SciTech Connect

    Alexander, Abraham S.; Mydin, Aminudin; Jones, Stuart O.; Christie, Jennifer; Lim, Jan T.W.; Truong, Pauline T.; Ludgate, Charles M.

    2011-12-01

    Purpose: To examine the impact of patient, disease, and treatment characteristics on survival outcomes in patients treated with neoadjuvant androgen deprivation therapy (ADT) and radical external-beam radiotherapy (RT) for clinically localized, extreme-risk prostate adenocarcinoma with a presenting prostate-specific antigen (PSA) concentration of >40 ng/ml. Methods and Materials: A retrospective chart review was conducted of 64 patients treated at a single institution between 1991 and 2000 with ADT and RT for prostate cancer with a presenting PSA level of >40 ng/ml. The effects of patient age, tumor (presenting PSA level, Gleason score, and T stage), and treatment (total ADT duration and pre-RT PSA level) characteristics on rates of biochemical disease-free survival (bDFS), prostate cancer-specific survival (PCSS), and overall survival (OS) were examined. Results: Median follow-up time was 6.45 years (range, 0.09-15.19 years). Actuarial bDFS, PCSS, and OS rates at 5 years were 39%, 87%, and 78%, respectively, and 17%, 64%, and 45%, respectively, at 10 years. On multivariate analysis, the pre-RT PSA level ({<=}0.1 versus >0.1 ng/ml) was the single most significant prognostic factor for bDFS (p = 0.033) and OS (p = 0.018) rates, whereas age, T stage, Gleason score, and ADT duration ({<=}6 versus >6 months) were not predictive of outcomes. Conclusion: In prostate cancer patients with high presenting PSA levels, >40 ng/ml, treated with combined modality, neoadjuvant ADT, and RT, the pre-RT PSA nadir, rather than ADT duration, was significantly associated with improved survival. This observation supports the use of neoadjuvant ADT to drive PSA levels to below 0.1 ng/ml before initiation of RT, to optimize outcomes for patients with extreme-risk disease.

  9. Developmental trajectories of clinically significant attention-deficit/hyperactivity disorder (ADHD) symptoms from grade 3 through 12 in a high-risk sample: Predictors and outcomes.

    PubMed

    Sasser, Tyler R; Kalvin, Carla B; Bierman, Karen L

    2016-02-01

    Developmental trajectories of clinically significant attention-deficit/hyperactivity (ADHD) symptoms were explored in a sample of 413 children identified as high risk because of elevated kindergarten conduct problems. Symptoms of inattention and hyperactivity-impulsivity were modeled simultaneously in a longitudinal latent class analyses, using parent reports collected in Grades 3, 6, 9, and 12. Three developmental trajectories emerged: (1) low levels of inattention and hyperactivity (low), (2) initially high but then declining symptoms (declining), and (3) continuously high symptoms that featured hyperactivity in childhood and early adolescence and inattention in adolescence (high). Multinomial logistic regressions examined child characteristics and family risk factors as predictors of ADHD trajectories. Relative to the low class, children in the high and declining classes displayed similar elevations of inattention and hyperactivity in early childhood. The high class was distinguished from the declining class by higher rates of aggression and hyperactivity at school and emotion dysregulation at home. In contrast, the declining class displayed more social isolation at home and school, relative to the low class. Families of children in both high and declining trajectory classes experienced elevated life stressors, and parents of children in the high class were also more inconsistent in their discipline practices relative to the low class. By late adolescence, children in the high class were significantly more antisocial than those in the low class, with higher rates of arrests, school dropout, and unemployment, whereas children in the declining class did not differ from those in the low trajectory class. The developmental and clinical implications of these findings are discussed. PMID:26854506

  10. Landscape Risk Factors for Lyme Disease in the Eastern Broadleaf Forest Province of the Hudson River Valley and the Effect of Explanatory Data Classification Resolution

    EPA Science Inventory

    This study assessed how landcover classification affects associations between landscape characteristics and Lyme disease rate. Landscape variables were derived from the National Land Cover Database (NLCD), including native classes (e.g., deciduous forest, developed low intensity)...