Science.gov

Sample records for selected high risk

  1. Patient Selection and Surgical Management of High-Risk Patients with Morbid Obesity.

    PubMed

    Daniel Guerron, A; Portenier, Dana D

    2016-08-01

    Bariatric surgery is the most effective way to improve comorbidities related to obesity. Since the introduction of minimally invasive laparoscopic surgery in the bariatric surgery techniques, the number of procedures has increased substantially; advances in techniques and the transition from open to minimally invasive procedures have decreased morbidity and mortality. Multidisciplinary teams in charge of the operative planning, surgical act, and postoperative recovery are determinant in the success of the management of high-risk bariatric patients; careful identification and preoperative management of these higher-risk patients is crucial in decreasing complications after weight loss surgery. PMID:27473799

  2. A Selected Review of the Literature on Factors and Conditions Driving the High Risk and Dropout Problem. Policy Studies in Language and Cross Cultural Education.

    ERIC Educational Resources Information Center

    Zachman, Jill M.

    This report presents the findings of a review of 45 selected references on issues associated with high risk students and dropouts. The literature was analyzed according to: (1) the manner in which high risk students and dropouts are characterized; (2) the suggested causes and conditions driving the problems of high risk and dropping out; (3) the…

  3. Impact of high-risk conjunctions on Active Debris Removal target selection

    NASA Astrophysics Data System (ADS)

    Lidtke, Aleksander A.; Lewis, Hugh G.; Armellin, Roberto

    2015-10-01

    Space debris simulations show that if current space launches continue unchanged, spacecraft operations might become difficult in the congested space environment. It has been suggested that Active Debris Removal (ADR) might be necessary in order to prevent such a situation. Selection of objects to be targeted by ADR is considered important because removal of non-relevant objects will unnecessarily increase the cost of ADR. One of the factors to be used in this ADR target selection is the collision probability accumulated by every object. This paper shows the impact of high-probability conjunctions on the collision probability accumulated by individual objects as well as the probability of any collision occurring in orbit. Such conjunctions cannot be predicted far in advance and, consequently, not all the objects that will be involved in such dangerous conjunctions can be removed through ADR. Therefore, a debris remediation method that would address such events at short notice, and thus help prevent likely collisions, is suggested.

  4. A Small Molecule Inhibitor Selectively Induces Apoptosis in Cells Transformed by High Risk Human Papilloma Viruses

    PubMed Central

    Lee, Min S.; Qi, Huilin; Chaniewski, Susan; Zheng, Xiaofan; Farr, Glen A.; Esposito, Kim; Harden, David; Lei, Ming; Schweizer, Liang; Friborg, Jacques; Agler, Michele; McPhee, Fiona; Gentles, Robert; Beno, Brett R.; Chupak, Lou; Mason, Stephen

    2016-01-01

    A phenotypic high-throughput cell culture screen was performed to identify compounds that prevented proliferation of the human Papilloma virus type 16 (HPV-16) transformed cell line Ca Ski. A series of quinoxaline compounds exemplified by Compound 1 was identified. Testing against a panel of cell lines demonstrated that Compound 1 selectively inhibited replication of all HPV-16, HPV-18, and HPV-31 transformed cell lines tested with 50% Inhibitory Concentration (IC50) values of 2 to 8 μM relative to IC50 values of 28 to 73 μM in HPV-negative cell lines. Treatment with Compound 1 resulted in a cascade of multiple apoptotic events, including selective activation of effector caspases 3 and 7, fragmentation of cellular DNA, and PARP (poly(ADP-ribose) polymerase) cleavage in HPV-positive cells relative to HPV-negative cells. Unregulated proliferation of HPV transformed cells is dependent on the viral oncogenes, E6 and E7. Treatment with Compound 1 resulted in a decrease in HPV E7 protein in Ca Ski cells. However, the timing of this reduction relative to other effects of compound treatment suggests that this was a consequence, rather than a cause, of the apoptotic cascade. Likewise, compound treatment resulted in no obvious effects on the E6- and E7- mediated down regulation of p53 and Rb, or their downstream effectors, p21 or PCNA. Further investigation of apoptotic signals induced by Compound 1 revealed cleavage of Caspase-8 in HPV-positive cells as early as 2 hours post-treatment, suggesting the compound initiates apoptosis through the extrinsic, death receptor-mediated, pathway of cell death. These studies provide proof of concept that cells transformed by oncogenic Papillomaviruses can be selectively induced to undergo apoptosis by compound treatment. PMID:27280728

  5. A Small Molecule Inhibitor Selectively Induces Apoptosis in Cells Transformed by High Risk Human Papilloma Viruses.

    PubMed

    Sheaffer, Amy K; Lee, Min S; Qi, Huilin; Chaniewski, Susan; Zheng, Xiaofan; Farr, Glen A; Esposito, Kim; Harden, David; Lei, Ming; Schweizer, Liang; Friborg, Jacques; Agler, Michele; McPhee, Fiona; Gentles, Robert; Beno, Brett R; Chupak, Lou; Mason, Stephen

    2016-01-01

    A phenotypic high-throughput cell culture screen was performed to identify compounds that prevented proliferation of the human Papilloma virus type 16 (HPV-16) transformed cell line Ca Ski. A series of quinoxaline compounds exemplified by Compound 1 was identified. Testing against a panel of cell lines demonstrated that Compound 1 selectively inhibited replication of all HPV-16, HPV-18, and HPV-31 transformed cell lines tested with 50% Inhibitory Concentration (IC50) values of 2 to 8 μM relative to IC50 values of 28 to 73 μM in HPV-negative cell lines. Treatment with Compound 1 resulted in a cascade of multiple apoptotic events, including selective activation of effector caspases 3 and 7, fragmentation of cellular DNA, and PARP (poly(ADP-ribose) polymerase) cleavage in HPV-positive cells relative to HPV-negative cells. Unregulated proliferation of HPV transformed cells is dependent on the viral oncogenes, E6 and E7. Treatment with Compound 1 resulted in a decrease in HPV E7 protein in Ca Ski cells. However, the timing of this reduction relative to other effects of compound treatment suggests that this was a consequence, rather than a cause, of the apoptotic cascade. Likewise, compound treatment resulted in no obvious effects on the E6- and E7- mediated down regulation of p53 and Rb, or their downstream effectors, p21 or PCNA. Further investigation of apoptotic signals induced by Compound 1 revealed cleavage of Caspase-8 in HPV-positive cells as early as 2 hours post-treatment, suggesting the compound initiates apoptosis through the extrinsic, death receptor-mediated, pathway of cell death. These studies provide proof of concept that cells transformed by oncogenic Papillomaviruses can be selectively induced to undergo apoptosis by compound treatment. PMID:27280728

  6. Montana Youth Risk Behavior Survey Report, 2005 for Montana High Schools: Statewide Analysis of Selected Behavior Risk Factors

    ERIC Educational Resources Information Center

    Montana Office of Public Instruction, 2005

    2005-01-01

    The 2005 Youth Risk Behavior Survey (YRBS) report is a continuation of the surveillance and reporting system for adolescent risk behaviors developed by the Division of Adolescent and School Health, National Center for Chronic Disease Prevention and Health Promotion, U.S. Centers for Disease Control and Prevention (CDC). The purpose of the Youth…

  7. Markov model for selection of aortic valve replacement versus transcatheter aortic valve implantation (without replacement) in high-risk patients.

    PubMed

    Gada, Hemal; Kapadia, Samir R; Tuzcu, E Murat; Svensson, Lars G; Marwick, Thomas H

    2012-05-01

    Comparisons between transcatheter aortic valve implantation without replacement (TAVI) and tissue aortic valve replacement (AVR) in clinical trials might not reflect the outcomes in standard clinical practice. This could have important implications for the relative cost-effectiveness of these alternatives for management of severe aortic stenosis in high-risk patients for whom surgery is an option. The mean and variance of risks, transition probabilities, utilities, and cost of TAVI, AVR, and medical management derived from observational studies were entered into a Markov model that examined the progression of patients between relevant health states. The outcomes and cost were derived from 10,000 simulations. Sensitivity analyses were based on variations in the likelihood of mortality, stroke, and other commonly observed outcomes. Both TAVI and AVR were cost-effective compared to medical management. In the reference case (age 80 years, the perioperative TAVI and AVR mortality was 6.9% vs 9.8%, and annual mortality was 21% vs 24%), the utility of TAVI was greater than that of AVR (1.78 vs 1.72 quality-adjusted life years) and the lifetime cost of TAVI exceeded that of AVR ($59,503 vs $56,339). The incremental cost-effectiveness ratio was $52,773/quality-adjusted life years. Threshold analyses showed that variation in the probabilities of perioperative and annual mortality after AVR and after TAVI and annual stroke after TAVI were important determinants of the favored strategy. Sensitivity analyses defined the thresholds at which TAVI or AVR was the preferred strategy with regard to health outcomes and cost. In conclusion, TAVI satisfies current metrics of cost-effectiveness relative to AVR and might provide net health benefits at acceptable cost for selected high-risk patients among whom AVR is the current procedure of choice. PMID:22335853

  8. Data Driven Identification and Selection Algorithms for At-Risk Students Likely to Benefit from High School Academic Support Services

    ERIC Educational Resources Information Center

    Lacefield, Warren E.; Applegate, E. Brooks; Zeller, Pamela J.; Van Kannel-Ray, Nancy; Carpenter, Shelly

    2011-01-01

    This study describes a well-defined data-driven diagnostic identification and selection procedure for choosing students at-risk of academic failure for appropriate academic support services. This algorithmic procedure has been validated both by historical quantitative studies of student precedents and outcomes as well as by current qualitative…

  9. The Number of High-Risk Factors and the Risk of Prostate Cancer-Specific Mortality After Brachytherapy: Implications for Treatment Selection

    SciTech Connect

    Wattson, Daniel A.; Chen Minghui; Moul, Judd W.; Moran, Brian J.; Dosoretz, Daniel E.; Robertson, Cary N.; Polascik, Thomas J.; Braccioforte, Michelle H.; Salenius, Sharon A.; D'Amico, Anthony V.

    2012-04-01

    Purpose: To determine whether an increasing number of high-risk factors is associated with higher prostate cancer-specific mortality (PCSM) among men treated with brachytherapy (BT)-based treatment, and whether supplemental therapy has an impact on this risk. Methods and Materials: We analyzed the cases of 2234 men with localized prostate cancer treated between 1991 and 2007 with low-dose rate BT monotherapy (n = 457) or BT with supplemental external-beam radiotherapy (EBRT, n = 229), androgen suppression therapy (AST, n = 424), or both (n = 1124). All men had at least one high-risk factor (prostate-specific antigen >20 ng/mL, biopsy Gleason score 8-10, or clinical stage {>=}T2c). Competing-risks multivariable regressions were performed to determine whether the presence of at least two high-risk factors was associated with an increased risk of PCSM, with adjustment for age, comorbidity, and the type of supplemental treatment. Results: The median follow-up time was 4.3 years. The number of men with at least two high-risk factors was highest in the group treated with BT, EBRT, and AST (21%), followed by BT plus EBRT or AST (13%), and BT alone (8%) (p{sub trend} < 0.001). The adjusted hazard ratio (AHR) for PCSM for those with at least two high-risk factors (as compared with one) was 4.8 (95% confidence interval [CI], 2.8-8.0; p < 0.001). The use of both supplemental EBRT and AST was associated with a decreased risk of PCSM (AHR 0.5; 95% CI, 0.2-0.9; p = 0.03) compared with BT alone. When the high-risk factors were analyzed separately, Gleason score 8-10 was most significantly associated with increased PCSM (AHR 6.2; 95% CI, 3.5-11.2; p < 0.001). Conclusions: Men with high-risk prostate adenocarcinoma treated with BT have decreased PCSM if they receive trimodailty therapy that includes EBRT and AST. This benefit is likely most important in men with multiple determinants of high risk.

  10. Selective reporting in trials of high risk cardiovascular devices: cross sectional comparison between premarket approval summaries and published reports

    PubMed Central

    Chang, Lee; Dhruva, Sanket S; Chu, Janet; Bero, Lisa A

    2015-01-01

    Objective To investigate characteristics of clinical trials and results on safety and effectiveness reported in US Food and Drug Administration (FDA) documents for recently approved high risk cardiovascular devices compared with the characteristics and results reported in peer reviewed publications. Design A search of the publicly available FDA database was performed for all cardiovascular devices that received premarket approval from 1 January 2000 to 31 December 2010. For each study listed in the premarket approval documents, a Medline search was conducted to obtain the corresponding publication. Main outcome measures Clinical trial characteristics, primary endpoints, and safety and efficacy results in the FDA documents and corresponding publications. Results 106 cardiovascular devices received premarket approval from 1 January 2000 to 31 December 2010. FDA premarket approval documents for these devices contained 177 studies, of which 86 (49%) had been published by 1 January 2013. These 86 publications corresponded to 60 distinct devices. The mean time from FDA approval to publication in a peer reviewed journal was 6.5 months (range −4.8-7.5 years). In 22 (26%) of the 86 compared studies the number of participants enrolled in the study differed in the FDA summary and the corresponding publications. Of 152 primary endpoints identified in the FDA documents, in the corresponding publications three (2%) were labeled as secondary, 43 (28%) were unlabeled, and 15 (10%) were not found. Among the primary results, 69 (45%) were identical, 35 (23%) were similar, 17 (11%) were substantially different, and 31 (20%) could not be compared. Conclusions Many clinical trials for high risk cardiovascular devices approved by the FDA remain unpublished. Even when trials are published, the study population, primary endpoints, and results can differ substantially from data submitted to the FDA. PMID:26063311

  11. High-School Dropouts in a Working-Class South African Community: Selected Characteristics and Risk-Taking Behaviour.

    ERIC Educational Resources Information Center

    Flisher, Alan J.; Chalton, Derek O.

    1995-01-01

    Project documented characteristics of teenage school dropouts and then compared the prevalence of risk-taking behavior of dropouts with those attending school. Of the sample (n=548), 15% had dropped out. Those still attending school engaged in suicide behavior more frequently than dropouts whereas the latter abused substances more. (RJM)

  12. At-Risk Youth: A Selected Bibliography.

    ERIC Educational Resources Information Center

    Crohn, Leslie

    This select bibliography lists books, articles, and reports, almost all of which were published since 1980, on at-risk youth. The following areas are included: (1) general; (2) dropouts; (3) drug and alcohol abusers; (4) youth offenders; (5) teen parents; (6) young children at risk; and (7) unemployed youth. For each item the following information…

  13. The role of routine cervical length screening in selected high- and low-risk women for preterm birth prevention.

    PubMed

    McIntosh, Jennifer; Feltovich, Helen; Berghella, Vincenzo; Manuck, Tracy

    2016-09-01

    Preterm birth remains a major cause of neonatal death and short and long-term disability in the US and across the world. The majority of preterm births are spontaneous and cervical length screening is one tool that can be utilized to identify women at increased risk who may be candidates for preventive interventions. The purpose of this document is to review the indications and rationale for CL screening to prevent preterm birth in various clinical scenarios. The Society for Maternal-Fetal Medicine recommends (1) routine transvaginal cervical length screening for women with singleton pregnancy and history of prior spontaneous preterm birth (grade 1A); (2) routine transvaginal cervical length screening not be performed for women with cervical cerclage, multiple gestation, preterm premature rupture of membranes, or placenta previa (grade 2B); (3) practitioners who decide to implement universal cervical length screening follow strict guidelines (grade 2B); (4) sonographers and/or practitioners receive specific training in the acquisition and interpretation of cervical imaging during pregnancy (grade 2B). PMID:27133011

  14. High Selectivity Oxygen Delignification

    SciTech Connect

    Lucian A. Lucia

    2005-11-15

    Project Objective: The objectives of this project are as follows: (1) Examine the physical and chemical characteristics of a partner mill pre- and post-oxygen delignified pulp and compare them to lab generated oxygen delignified pulps; (2) Apply the chemical selectivity enhancement system to the partner pre-oxygen delignified pulps under mill conditions (with and without any predetermined amounts of carryover) to determine how efficiently viscosity is preserved, how well selectivity is enhanced, if strength is improved, measure any yield differences and/or bleachability differences; and (3) Initiate a mill scale oxygen delignification run using the selectivity enhancement agent, collect the mill data, analyze it, and propose any future plans for implementation.

  15. High lift selected concepts

    NASA Technical Reports Server (NTRS)

    Henderson, M. L.

    1979-01-01

    The benefits to high lift system maximum life and, alternatively, to high lift system complexity, of applying analytic design and analysis techniques to the design of high lift sections for flight conditions were determined and two high lift sections were designed to flight conditions. The influence of the high lift section on the sizing and economics of a specific energy efficient transport (EET) was clarified using a computerized sizing technique and an existing advanced airplane design data base. The impact of the best design resulting from the design applications studies on EET sizing and economics were evaluated. Flap technology trade studies, climb and descent studies, and augmented stability studies are included along with a description of the baseline high lift system geometry, a calculation of lift and pitching moment when separation is present, and an inverse boundary layer technique for pressure distribution synthesis and optimization.

  16. Group Selection as Behavioral Adaptation to Systematic Risk

    PubMed Central

    Zhang, Ruixun; Brennan, Thomas J.; Lo, Andrew W.

    2014-01-01

    Despite many compelling applications in economics, sociobiology, and evolutionary psychology, group selection is still one of the most hotly contested ideas in evolutionary biology. Here we propose a simple evolutionary model of behavior and show that what appears to be group selection may, in fact, simply be the consequence of natural selection occurring in stochastic environments with reproductive risks that are correlated across individuals. Those individuals with highly correlated risks will appear to form “groups”, even if their actions are, in fact, totally autonomous, mindless, and, prior to selection, uniformly randomly distributed in the population. This framework implies that a separate theory of group selection is not strictly necessary to explain observed phenomena such as altruism and cooperation. At the same time, it shows that the notion of group selection does captures a unique aspect of evolution—selection with correlated reproductive risk–that may be sufficiently widespread to warrant a separate term for the phenomenon. PMID:25353167

  17. Selecting Students at Risk of Academic Difficulties

    ERIC Educational Resources Information Center

    Cummings, Kelli D.; Smolkowski, Keith

    2015-01-01

    This paper aims to translate for practitioners the principles and methods for evaluating screening measures in education, including benchmark goals and cut points, from our technical manuscript "Evaluation of Diagnostic Systems: The Selection of Students at Risk of Academic Difficulties" (this issue). We offer a brief description of…

  18. [Access to high-risk families through selected actors of the health care system. Results of an explorative questioning of early childhood intervention pilot projects].

    PubMed

    Renner, I

    2010-10-01

    A requirement for preventive child protection is an early and systematic access to high-risk families. Actors of the health care system, in particular doctors in private practice and midwives, are highly accepted within the population and therefore offer perfect requirements to provide this access. For this reason the aim in the context of early childhood intervention is a close cooperation of the Child and Youth Services with doctors and midwives. To what extent can these service providers of the health care system fulfill these expectations? The National Centre on Early Prevention tried to find an answer to this question with the support of 10 pilot projects which were set up within the framework of the action program "Early Prevention and Intervention for Parents and Children and Social Warning Systems". The comprehensive project presentation of selected results, insights and experiences concerning cooperation between agents of the Child and Youth Services and doctors in private practice and midwives is based on explorative written questioning of the 10 projects. The study shows from the point of view of the pilot projects that the cooperation with freelance midwives is promising. In contrast, the cooperation with doctors in private practice does not yet meet the hopes and expectations. To achieve an improvement of this situation, conditions have to be supported which promote a stronger commitment of the medical profession to early childhood intervention. PMID:20936448

  19. High Selectivity Oxygen Delignification

    SciTech Connect

    Arthur J. Ragauskas Lucian A. Lucia Hasan Jameel

    2005-09-30

    The overall objective of this program was to develop improved extended oxygen delignification (EOD) technologies for current U.S. pulp mill operations. This was accomplished by: (1) Identifying pulping conditions that optimize O and OO performance; (2) Identifying structural features of lignin that enhance reactivity towards EOD of high kappa pulps; (3) Identifying factors minimizing carbohydrate degradation and improve pulp strength of EOD high kappa pulps; (4) Developing a simple, reproducible method of quantifying yield gains from EOD; and (5) Developing process conditions that significantly reduce the capital requirements of EOD while optimizing the yield benefits. Key research outcomes included, demonstrating the use of a mini-O sequence such as (E+O)Dkf:0.05(E+O) or Dkf:0.05(E+O)(E+O) without interstage washing could capture approximately 60% of the delignification efficiency of a conventional O-stage without the major capital requirements associated with an O-stage for conventional SW kraft pulps. The rate of formation and loss of fiber charge during an O-stage stage can be employed to maximize net fiber charge. Optimal fiber charge development and delignification are two independent parameters and do not parallel each other. It is possible to utilize an O-stage to enhance overall cellulosic fiber charge of low and high kappa SW kraft pulps which is beneficial for physical strength properties. The application of NIR and multi-variant analysis was developed into a rapid and simple method of determining the yield of pulp from an oxygen delignification stage that has real-world mill applications. A focus point of this program was the demonstration that Kraft pulping conditions and oxygen delignification of high and low-kappa SW and HW pulps are intimately related. Improved physical pulp properties and yield can be delivered by controlling the H-factor and active alkali charge. Low AA softwood kraft pulp with a kappa number 30 has an average improvement of 2% in

  20. Career goals in the high risk adolescent.

    PubMed

    Fleming, Charlene; Woods, Charles; Barkin, Shari L

    2006-10-01

    Possessing a career goal might serve as a protective factor for an adolescent's healthy development. This could be especially important in adolescents who engage in high risk behaviors. The relationship between high risk adolescents' future career goals and selected predictor variables were examined. Almost half (49%) the students indicated a career goal. Students who reported a job were 5.1-fold more likely to have listed a future career goal. Females, those aged 18 years, and those whose mothers were employed were twice as likely to have a career goal. Considerations for fostering career goals for high risk students are warranted. PMID:16968962

  1. Selected Risk and Protective Factors Associated with Two or More Lifetime Sexual Intercourse Partners and Non-Condom Use during Last Coitus among U.S. Rural High School Students

    ERIC Educational Resources Information Center

    Yarber, William L.; Milhausen, Robin; Crosby, Richard A.; DiClemente, Ralph J.

    2002-01-01

    This analysis determined the association between 13 selected health risk and protective factors and reporting two or more lifetime sexual intercourse partners and non-condom use for last coitus among sexually experienced U.S. rural high school students. The sample was 569 sexually experienced adolescent females and 561 sexually experienced…

  2. SADA: Ecological Risk Based Decision Support System for Selective Remediation

    EPA Science Inventory

    Spatial Analysis and Decision Assistance (SADA) is freeware that implements terrestrial ecological risk assessment and yields a selective remediation design using its integral geographical information system, based on ecological and risk assessment inputs. Selective remediation ...

  3. Risk-based audit selection of dairy farms.

    PubMed

    van Asseldonk, M A P M; Velthuis, A G J

    2014-02-01

    Dairy farms are audited in the Netherlands on numerous process standards. Each farm is audited once every 2 years. Increasing demands for cost-effectiveness in farm audits can be met by introducing risk-based principles. This implies targeting subpopulations with a higher risk of poor process standards. To select farms for an audit that present higher risks, a statistical analysis was conducted to test the relationship between the outcome of farm audits and bulk milk laboratory results before the audit. The analysis comprised 28,358 farm audits and all conducted laboratory tests of bulk milk samples 12 mo before the audit. The overall outcome of each farm audit was classified as approved or rejected. Laboratory results included somatic cell count (SCC), total bacterial count (TBC), antimicrobial drug residues (ADR), level of butyric acid spores (BAB), freezing point depression (FPD), level of free fatty acids (FFA), and cleanliness of the milk (CLN). The bulk milk laboratory results were significantly related to audit outcomes. Rejected audits are likely to occur on dairy farms with higher mean levels of SCC, TBC, ADR, and BAB. Moreover, in a multivariable model, maxima for TBC, SCC, and FPD as well as standard deviations for TBC and FPD are risk factors for negative audit outcomes. The efficiency curve of a risk-based selection approach, on the basis of the derived regression results, dominated the current random selection approach. To capture 25, 50, or 75% of the population with poor process standards (i.e., audit outcome of rejected), respectively, only 8, 20, or 47% of the population had to be sampled based on a risk-based selection approach. Milk quality information can thus be used to preselect high-risk farms to be audited more frequently. PMID:24290823

  4. High temperature size selective membranes

    SciTech Connect

    Yates, S.F.; Swamikannu, A.X.

    1993-09-01

    The high temperature membrane, capable of operation above 550{degree}C, is designed to be a composite membrane composed of a thin layer of a size selective membrane supported by a microporous ceramic support. The kinetic diameters of H{sub 2} and CO{sub 2} are 2.96 {Angstrom} and 4.00 {Angstrom}. The thin layer will be made from CMS whose pore size will be controlled to be less than 4 {Angstrom}. The membrane will be truly size selective and be impermeable to carbon dioxide. The membrane will have higher selectivity than membranes which operate on Knudsen diffusion mechanism. The ceramic support will be fabricated from Allied Signal`s proprietary Blackglas{trademark} resin. The ceramic material, noted for its high thermal and oxidative resistance, has a coefficient of thermal expansion which matches closely that of CMS. The close match will insure mechanical integrity when the membrane is subjected to thermal cycles. The CMS layer will be produced by controlled pyrolysis of polymeric precursors. Pore size will be suitably modified by post-treatments to the carbon. The composite membrane will be tested for its permeation properties at 550{degree}C or higher. Thermal, mechanical and chemical stability of the membrane will be assessed. We have produced several samples of CMS from polymeric precursors. We have initiated work also on the preparation of microporous supports from Blackglas{trademark} resin. We have completed the design of the high temperature membrane pilot plant. The membrane cell was fabricated out of two kinds of stainless steel. The inner parts are made of SS 316 and the outer ring made of SS 420. The greater thermal expansion of the SS 316 will help obtain a leak free seal at the operating temperatures.

  5. Selective screening for lysosomal storage diseases with dried blood spots collected on filter paper in 4,700 high-risk colombian subjects.

    PubMed

    Uribe, Alfredo; Giugliani, Roberto

    2013-01-01

    Lysosomal storage disorders (LSDs) are a very heterogeneous group of hereditary disorders. The diagnostic process usually involves complex sampling, processing, testing, and validation procedures, performed by specialized laboratories only, which causes great limitations in reaching a diagnosis for patients affected by these diseases.There are few studies about LSDs in Colombia. The diagnostic limitations often make medical practitioners disregard the possibility of these disorders while diagnosing their patients. The current study documents the results of a 7-year screening in high-risk patients, aimed to detect LSDs using dried blood spots (DBS) collected on filter paper, with a micromethodology that facilitates diagnosis even with a large number of samples.The activities of α-galactosidase A, α glucosidase, α-L-iduronidase, arylsulfatase B, β-galactosidase, β-glucosidase, total hexosaminidase, iduronate sulfatase, and chitotriosidase were analyzed in high-risk patients for lysosomal disease. The catalytic activity was evaluated with fluorometric micromethods using artificial substrates marked with 4-methylumbelliferone.The reference values for a control population were established for the enzymes listed above, and 242 patients were found to have an enzyme deficiency, guiding to the following diagnoses: Fabry disease (n = 31), Pompe disease (n = 16), Hurler Syndrome (n = 15), Maroteaux-Lamy Syndrome (n = 34), GM1 Gangliosidosis (n = 10), Morquio B (n = 1), Gaucher disease (n = 101), Sandhoff disease (n = 1), Mucolipidosis (n = 2), and Hunter Syndrome (n = 31). In conclusion, this protocol provides a comprehensive diagnostic approach which could be carried out in Colombia and made it available to medical services spread around the country, enabling the identification of a large number of patients affected by LSDs, which could potentially benefit from the therapeutic tools already available for many of these diseases. PMID:23609959

  6. 42 CFR 425.600 - Selection of risk model.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Selection of risk model. 425.600 Section 425.600... Selection of risk model. (a) For its initial agreement period, an ACO may elect to operate under one of the following tracks: (1) Track 1. Under Track 1, the ACO operates under the one-sided model (as described...

  7. 42 CFR 425.600 - Selection of risk model.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Selection of risk model. 425.600 Section 425.600... Selection of risk model. (a) For its initial agreement period, an ACO may elect to operate under one of the following tracks: (1) Track 1. Under Track 1, the ACO operates under the one-sided model (as described...

  8. 42 CFR 425.600 - Selection of risk model.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Selection of risk model. 425.600 Section 425.600... Selection of risk model. (a) For its initial agreement period, an ACO may elect to operate under one of the following tracks: (1) Track 1. Under Track 1, the ACO operates under the one-sided model (as described...

  9. Selected Risk Factors in Adolescent Suicide Attempts.

    ERIC Educational Resources Information Center

    Adcock, Anthony G.; And Others

    1991-01-01

    Examined stress, depression, attempted suicide, and knowledge of common signs of potential suicide among 3,803 eighth and tenth graders. Found females at greater risk of suicide attempts than males. Both males and females who engaged in sexual intercourse and alcohol consumption were at greater risk than abstainers; such differences were more…

  10. Risk Factors for High Blood Pressure

    MedlinePlus

    ... the NHLBI on Twitter. Risk Factors for High Blood Pressure Anyone can develop high blood pressure; however, age, ... can increase your risk for developing high blood pressure. Age Blood pressure tends to rise with age. About 65 ...

  11. Risk Selection under Public Health Insurance with Opt-Out.

    PubMed

    Panthöfer, Sebastian

    2016-09-01

    This paper studies risk selection between public and private health insurance when some, but not all, individuals can opt out of otherwise mandatory public insurance. Using a theoretical model, I show that public insurance is adversely selected when insurers and insureds are symmetrically informed about health-related risks, and that there can be adverse or advantageous selection when insureds are privately informed. Using data from the German Socio-Economic Panel, I find that (i) public insurance is, on balance, adversely selected under the German public health insurance with opt out scheme, (ii) individuals advantageously select public insurance based on risk aversion and residential location, and (iii) there is suggestive evidence of asymmetric information in the market for private health insurance. Copyright © 2016 John Wiley & Sons, Ltd. PMID:27237082

  12. Use of IGHV3–21 in chronic lymphocytic leukemia is associated with high-risk disease and reflects antigen-driven, post–germinal center leukemogenic selection

    PubMed Central

    Ghia, Emanuela M.; Jain, Sonia; Widhopf, George F.; Rassenti, Laura Z.; Keating, Michael J.; Wierda, William G.; Gribben, John G.; Brown, Jennifer R.; Rai, Kanti R.; Byrd, John C.; Kay, Neil E.; Greaves, Andrew W.

    2008-01-01

    We examined the chronic lymphocytic leukemia (CLL) cells of 2457 patients evaluated by the CLL Research Consortium (CRC) and found that 63 (2.6%) expressed immunoglobulin (Ig) encoded by the Ig heavy-chain-variable-region gene (IGHV), IGHV3-21. We identified the amino acid sequence DANGMDV (motif-1) or DPSFYSSSWTLFDY (motif-2) in the Ig heavy-chain (IgH) third complementarity-determining region (HCDR3) of IgH, respectively, used by 25 or 3 cases. The IgH with HCDR3 motif-1 or motif-2, respectively, was paired with Ig light chains (IgL) encoded by IGLV3-21 or IGKV3-20, suggesting that these Ig had been selected for binding to conventional antigen(s). Cases that had HCDR3 motif-1 had a median time from diagnosis to initial therapy comparable with that of cases without a defined HCDR3 motif, as did cases that used mutated IGHV3-21 (n = 27) versus unmutated IGHV3-21 (n = 30). Of 7 examined cases that used Ig encoded by IGHV3-21/IGLV3-21, we found that 5 had a functionally rearranged IGKV allele that apparently had incurred antigendriven somatic mutations and subsequent rearrangement with KDE. This study reveals that CLL cells expressing IGHV3-21/IGLV3-21 most likely were derived from B cells that had experienced somatic mutation and germinal-center maturation in an apparent antigen-driven immune response before undergoing Ig-receptor editing and after germinal-center leukemogenic selection. PMID:18326815

  13. Risk Selection, Risk Adjustment and Choice: Concepts and Lessons from the Americas

    PubMed Central

    Ellis, Randall P.; Fernandez, Juan Gabriel

    2013-01-01

    Interest has grown worldwide in risk adjustment and risk sharing due to their potential to contain costs, improve fairness, and reduce selection problems in health care markets. Significant steps have been made in the empirical development of risk adjustment models, and in the theoretical foundations of risk adjustment and risk sharing. This literature has often modeled the effects of risk adjustment without highlighting the institutional setting, regulations, and diverse selection problems that risk adjustment is intended to fix. Perhaps because of this, the existing literature and their recommendations for optimal risk adjustment or optimal payment systems are sometimes confusing. In this paper, we present a unified way of thinking about the organizational structure of health care systems, which enables us to focus on two key dimensions of markets that have received less attention: what choices are available that may lead to selection problems, and what financial or regulatory tools other than risk adjustment are used to influence these choices. We specifically examine the health care systems, choices, and problems in four countries: the US, Canada, Chile, and Colombia, and examine the relationship between selection-related efficiency and fairness problems and the choices that are allowed in each country, and discuss recent regulatory reforms that affect choices and selection problems. In this sample, countries and insurance programs with more choices have more selection problems. PMID:24284351

  14. Risk selection, risk adjustment and choice: concepts and lessons from the Americas.

    PubMed

    Ellis, Randall P; Fernandez, Juan Gabriel

    2013-11-01

    Interest has grown worldwide in risk adjustment and risk sharing due to their potential to contain costs, improve fairness, and reduce selection problems in health care markets. Significant steps have been made in the empirical development of risk adjustment models, and in the theoretical foundations of risk adjustment and risk sharing. This literature has often modeled the effects of risk adjustment without highlighting the institutional setting, regulations, and diverse selection problems that risk adjustment is intended to fix. Perhaps because of this, the existing literature and their recommendations for optimal risk adjustment or optimal payment systems are sometimes confusing. In this paper, we present a unified way of thinking about the organizational structure of health care systems, which enables us to focus on two key dimensions of markets that have received less attention: what choices are available that may lead to selection problems, and what financial or regulatory tools other than risk adjustment are used to influence these choices. We specifically examine the health care systems, choices, and problems in four countries: the US, Canada, Chile, and Colombia, and examine the relationship between selection-related efficiency and fairness problems and the choices that are allowed in each country, and discuss recent regulatory reforms that affect choices and selection problems. In this sample, countries and insurance programs with more choices have more selection problems. PMID:24284351

  15. Use of selective chemical extractions as a strategy for the risk assessment in sites with a high level of potentially toxic elements

    NASA Astrophysics Data System (ADS)

    Pérez-Sirvent, Carmen; Martinez Sanchez, Maria Jose; Garcia Lorenzo, Maria Luz; Hernandez Perez, Carmen; Molina Ruiz, Jose; Bech, Jaume

    2016-04-01

    The present study deals with the geochemical fractions of Pb, Cd, Zn and As present on profiles using chemical simple extraction process. This work was conducted on Portman Bay, a site located in the SE Spain and strongly affected by mining activities. Four simple extractions were applied to selected samples in order to evaluate the potential mobility of metals. X-ray diffraction (XRD) and scanning electron microscopy coupled to with an energy-dispersion spectrometry (SEM-EDS) were applied for the characterisation of both the samples and the residues remaining after each extraction, providing additional information about the sediment phases carrying the elements studied. Soil pollution assessment was carried out using the contamination factor (CF) and the pollution load index (PLI) for total contents, and indicators of mobility for each extraction: natural mobility indicator (NMI), acid mine drainage mobility indicator (AMI), oxic mobility indicator (OMI) and anoxic mobility indicator (ANMI). The results obtained after the extractions suggested that the highest PTEs content were extracted in the acidic medium. The mineralogical composition is an important factor that should be taken into account in the evaluation of PTEs mobility, firstly because the mineral phases react differently in the proposed situations depending on their chemical nature, and secondly, because the presence of a particular phase (with different degree of reactivity) depends on the degree of weathering.

  16. Selection of technical risk responses for efficient contingencies

    SciTech Connect

    Kujawski, Edouard

    2002-02-28

    The primary goal of good project risk management should be to successfully deliver projects for the lowest cost at an acceptable level of risk. This requires the systematic development and implementation of a set of Risk Response Actions (RRA) that achieves the lowest total project cost for a given probability of success while meeting technical performance and schedule. We refer to this set as the ''efficient RRA set''. This work presents a practical and mathematically sound approach for determining the efficient RRA set. It builds on some of Markowitz's portfolio selection principles and introduces several conceptual and modeling differences to properly treat project technical risks. The set of RRAs is treated as whole and not just individual risks. The efficient RRA set is determined based on ''Outcome Cost Vs Probability of Success''. The risks and RRAs are characterized using scenarios, decision trees, and cumulative probability distributions. The analysis provides information that enables decision-makers to select the efficient RRA set that explicitly takes their attitude toward project risk into account. Decision-makers should find it both useful and practical for sound decision-making under uncertainty/risk and efficiently optimizing project success. The computations are readily performed using commercially available Monte Carlo simulation tools. The approach is detailed using a realistic but simplified case of a project with two technical risks.

  17. High temperature solar selective coatings

    DOEpatents

    Kennedy, Cheryl E

    2014-11-25

    Improved solar collectors (40) comprising glass tubing (42) attached to bellows (44) by airtight seals (56) enclose solar absorber tubes (50) inside an annular evacuated space (54. The exterior surfaces of the solar absorber tubes (50) are coated with improved solar selective coatings {48} which provide higher absorbance, lower emittance and resistance to atmospheric oxidation at elevated temperatures. The coatings are multilayered structures comprising solar absorbent layers (26) applied to the meta surface of the absorber tubes (50), typically stainless steel, topped with antireflective Savers (28) comprising at least two layers 30, 32) of refractory metal or metalloid oxides (such as titania and silica) with substantially differing indices of refraction in adjacent layers. Optionally, at least one layer of a noble metal such as platinum can be included between some of the layers. The absorbent layers cars include cermet materials comprising particles of metal compounds is a matrix, which can contain oxides of refractory metals or metalloids such as silicon. Reflective layers within the coating layers can comprise refractory metal silicides and related compounds characterized by the formulas TiSi. Ti.sub.3SiC.sub.2, TiAlSi, TiAN and similar compounds for Zr and Hf. The titania can be characterized by the formulas TiO.sub.2, Ti.sub.3O.sub.5. TiOx or TiO.sub.xN.sub.1-x with x 0 to 1. The silica can be at least one of SiO.sub.2, SiO.sub.2x or SiO.sub.2xN.sub.1-x with x=0 to 1.

  18. Sex selection, child welfare and risk: a critique of the HFEA's recommendations on sex selection.

    PubMed

    Tizzard, Juliet

    2004-03-01

    This paper will examine the recent Human Fertilisation and Embryology Authority public consultation on sex selection. It will review the current regulation on sex selection in the United Kingdom and critically examine the outcomes of the HFEA consultation. The paper will argue that the current ban on embryo sex selection for social reasons and a proposed ban on sperm selection are not justified. There is no evidence for sex selection causing an increase in sex discrimination; creating a slippery slope towards selection for other non-disease characteristics; or promoting a consunmerist attitude towards children. The HFEA recommendations to prohibit social sex selection techniques rely upon an unwarranted concern about the risk of the procedures used. Reproductive technologies should be made available to peoptle unless a substantial risk of harm--to the child, the parents or to society--can be identified. There is no such evidence of harm in this case. PMID:15186081

  19. Improving antenatal risk assessment in women exposed to high risks.

    PubMed

    Perry, Natasha; Newman, Louise K; Hunter, Mick; Dunlop, Adrian

    2015-01-01

    Antenatal substance use and related psychosocial risk factors are known to increase the likelihood of child protection involvement; less is known about the predictive nature of maternal reflective functioning (RF) in this population. This preliminary study assessed psychosocial and psychological risk factors for a group of substance dependent women exposed to high risks in pregnancy, and their impact on child protection involvement. Pregnant women on opiate substitution treatment (n = 11) and a comparison group (n = 15) were recruited during their third trimester to complete measures of RF (Pregnancy Interview), childhood trauma, mental health and psychosocial assessments. At postnatal follow-up, RF was reassessed (Parent Development Interview - Revised Short Version) and mother-infant dyads were videotaped to assess emotional availability (EA). Child protection services were contacted to determine if any concerns had been raised for infant safety. Significant between-group differences were observed for demographics, psychosocial factors, trauma and mental health symptoms. Unexpectedly, no significant differences were found for RF or EA between groups. Eight women in the 'exposed to high risks' group became involved with child protection services. Reflective functioning was not significantly associated with psychosocial risk factors, and therefore did not mediate the outcome of child protection involvement. Women 'exposed to high risks' were equally able to generate a model of their own and their infants' mental states and should not be seen within a deficit perspective. Further research is required to better understand the range of risk factors that predict child protection involvement in high risk groups. PMID:23982989

  20. Risk Factors and Levels of Risk for High School Dropouts

    ERIC Educational Resources Information Center

    Suh, Suhyun; Suh, Jingyo

    2007-01-01

    The study in this article identifies three major risk categories of high school dropouts and evaluates the impact of possible prevention strategies. As students accumulate these risks, they became more likely to drop out and prevention programs become less effective. Additionally, it was found that factors influencing the decision to drop out vary…

  1. High-risk sexual behaviors.

    PubMed

    Troussier, Thierry; Benghozi, Pierre; Ganem, Marc

    2012-01-01

    Adolescence is a time of life characterized by danger because of the many changes that occur, the many ties that are severed: ties to childhood, ties to the child's body as it begins to take on an adult appearance, ties to a once-familiar body image and psyche as hormones complete the transformation to adulthood, ties to an unconscious that is struggling to restructure itself anew. The creation of the romantic couple is a danger inherent in any human society. This text was written from the professional practices of each author in a multidisciplinary approach combining the approaches of public health, risk reduction, and sexual, psychological and clinical care of adolescents. How to help anticipate the dangers is to use preventive insurance verifying that security is guaranteed before committing. Risk-taking is accepting all the challenges that boost the self with oneself and with others. The risk is therefore also the commitment in love. It is still the risk to speak, to feel, to express feelings, choices, and refusal of unwanted sex. The ability of adolescents to play and defeat the risk by learning the ethical value not only to protect themselves from contracting AIDS, but also to protect others is part of the pedagogy of risk. This pedagogy of risk, as we have seen, includes three areas: information, care and initiation into love. Adolescents must be supported in their emergence by responsible people to protect them from the dangers ahead. The support is not only to prevent them from engaging in risky behavior, but to help them better manage their anxieties and support the fragility of their families in a network approach. Not knowing how to confront the risk stifles the chance of allowing the child to grow up to be independent and helps reassure parents who may resent being removed from the empowerment of their children. PMID:22846539

  2. Selection of Developmental Assessment Techniques for Infants at Risk.

    ERIC Educational Resources Information Center

    Parmelee, Arthur H.; And Others

    This report presents a cumulative risk score system designed to identify high-risk infants through multiple assessments over an extended period of time. The system scores prenatal, natal, and neonatal biological events and neonatal behavioral performance in an additive fashion. Infants are assessed in the first month of life to distinguish those…

  3. Risk-based selection of SSCs at Peach Bottom

    SciTech Connect

    Krueger, G.A.; Marie, A.J. )

    1993-01-01

    The purpose of identifying risk significant systems, structures, and components (SSCS) that are within the scope of the maintenance rule is to bring a higher level of attention to a subset of those SSCS. These risk-significant SSCs will have specific performance criteria established for them, and failure to meet this performance criteria will result in establishing goals to ensure the necessary improvement in performance. The Peach Bottom individual plant examination (IPE) results were used to provide insights for the verification of proposed probabilistic risk assessment (PRA) methods set forth in the Industry Maintenance Guidelines for Implementation of the Maintenance Rule. The objective of reviewing the methods for selection of SSCs that are considered risk significant was to ensure the methods used are logical, reproducible, and can be consistently applied.

  4. High Dimensional Variable Selection with Error Control.

    PubMed

    Kim, Sangjin; Halabi, Susan

    2016-01-01

    Background. The iterative sure independence screening (ISIS) is a popular method in selecting important variables while maintaining most of the informative variables relevant to the outcome in high throughput data. However, it not only is computationally intensive but also may cause high false discovery rate (FDR). We propose to use the FDR as a screening method to reduce the high dimension to a lower dimension as well as controlling the FDR with three popular variable selection methods: LASSO, SCAD, and MCP. Method. The three methods with the proposed screenings were applied to prostate cancer data with presence of metastasis as the outcome. Results. Simulations showed that the three variable selection methods with the proposed screenings controlled the predefined FDR and produced high area under the receiver operating characteristic curve (AUROC) scores. In applying these methods to the prostate cancer example, LASSO and MCP selected 12 and 8 genes and produced AUROC scores of 0.746 and 0.764, respectively. Conclusions. We demonstrated that the variable selection methods with the sequential use of FDR and ISIS not only controlled the predefined FDR in the final models but also had relatively high AUROC scores. PMID:27597974

  5. High Dimensional Variable Selection with Error Control

    PubMed Central

    2016-01-01

    Background. The iterative sure independence screening (ISIS) is a popular method in selecting important variables while maintaining most of the informative variables relevant to the outcome in high throughput data. However, it not only is computationally intensive but also may cause high false discovery rate (FDR). We propose to use the FDR as a screening method to reduce the high dimension to a lower dimension as well as controlling the FDR with three popular variable selection methods: LASSO, SCAD, and MCP. Method. The three methods with the proposed screenings were applied to prostate cancer data with presence of metastasis as the outcome. Results. Simulations showed that the three variable selection methods with the proposed screenings controlled the predefined FDR and produced high area under the receiver operating characteristic curve (AUROC) scores. In applying these methods to the prostate cancer example, LASSO and MCP selected 12 and 8 genes and produced AUROC scores of 0.746 and 0.764, respectively. Conclusions. We demonstrated that the variable selection methods with the sequential use of FDR and ISIS not only controlled the predefined FDR in the final models but also had relatively high AUROC scores. PMID:27597974

  6. Highly Selective Ruthenium Metathesis Catalysts for Ethenolysis

    PubMed Central

    Thomas, Renee M.; Keitz, Benjamin K.; Champagne, Timothy M.; Grubbs, Robert H.

    2011-01-01

    N-aryl, N-alkyl N-heterocyclic carbene (NHC) ruthenium metathesis catalysts are highly selective toward the ethenolysis of methyl oleate, giving selectivity as high as 95% for the kinetic, ethenolysis products over the thermodynamic, self-metathesis products. The examples described herein represent some of the most selective NHC-based ruthenium catalysts for ethenolysis reactions to date. Furthermore, many of these catalysts show unusual preference and stability toward propagating as a methylidene species, and provide good yields and turnover numbers (TONs) at relatively low catalyst loading (<500 ppm). A catalyst comparison showed that ruthenium complexes bearing sterically hindered NHC substituents afforded greater selectivity and stability, and exhibited longer catalyst lifetime during reactions. Comparative analysis of the catalyst preference for kinetic versus thermodynamic product formation was achieved via evaluation of their steady-state conversion in the cross-metathesis reaction of terminal olefins. These results coincided with the observed ethenolysis selectivities, in which the more selective catalysts reach a steady-state characterized by lower conversion to cross-metathesis products compared to less selective catalysts, which show higher conversion to cross-metathesis products. PMID:21510645

  7. Predation risk assessment by larval reef fishes during settlement-site selection

    NASA Astrophysics Data System (ADS)

    Dixson, D. L.

    2012-03-01

    Predation rates of marine species are often highest during the transition from the pelagic to the benthic life stage. Consequently, the ability to assess predation risk when selecting a settlement site can be critical to survival. In this study, pairwise choice trials were used to determine whether larvae of three species of anemonefish ( Amphiprion melanopus, A. percula and Premnas biaculeatus) are able to (1) assess the predation risk of potential anemone settlement sites through olfactory cues alone and (2) alter their settlement choices depending on the options available (host or non-host anemone). When predation risk was assessed with host and non-host anemone species independently, all species of anemonefish significantly chose the odor associated with the low-risk settlement option over the high-risk site. Most importantly, all species of anemonefish selected water with olfactory cues from their host anemone regardless of predation risk when paired against non-host anemone odor. These results demonstrate that larval reef fishes can use olfactory cues for complex risk assessment during settlement-site selection; however, locating the correct habitat is the most important factor when selecting a settlement site.

  8. Applying the partitioned multiobjective risk method (PMRM) to portfolio selection.

    PubMed

    Reyes Santos, Joost; Haimes, Yacov Y

    2004-06-01

    The analysis of risk-return tradeoffs and their practical applications to portfolio analysis paved the way for Modern Portfolio Theory (MPT), which won Harry Markowitz a 1992 Nobel Prize in Economics. A typical approach in measuring a portfolio's expected return is based on the historical returns of the assets included in a portfolio. On the other hand, portfolio risk is usually measured using volatility, which is derived from the historical variance-covariance relationships among the portfolio assets. This article focuses on assessing portfolio risk, with emphasis on extreme risks. To date, volatility is a major measure of risk owing to its simplicity and validity for relatively small asset price fluctuations. Volatility is a justified measure for stable market performance, but it is weak in addressing portfolio risk under aberrant market fluctuations. Extreme market crashes such as that on October 19, 1987 ("Black Monday") and catastrophic events such as the terrorist attack of September 11, 2001 that led to a four-day suspension of trading on the New York Stock Exchange (NYSE) are a few examples where measuring risk via volatility can lead to inaccurate predictions. Thus, there is a need for a more robust metric of risk. By invoking the principles of the extreme-risk-analysis method through the partitioned multiobjective risk method (PMRM), this article contributes to the modeling of extreme risks in portfolio performance. A measure of an extreme portfolio risk, denoted by f(4), is defined as the conditional expectation for a lower-tail region of the distribution of the possible portfolio returns. This article presents a multiobjective problem formulation consisting of optimizing expected return and f(4), whose solution is determined using Evolver-a software that implements a genetic algorithm. Under business-as-usual market scenarios, the results of the proposed PMRM portfolio selection model are found to be compatible with those of the volatility-based model

  9. Assessing risk to birds from industrial wind energy development via paired resource selection models.

    PubMed

    Miller, Tricia A; Brooks, Robert P; Lanzone, Michael; Brandes, David; Cooper, Jeff; O'Malley, Kieran; Maisonneuve, Charles; Tremblay, Junior; Duerr, Adam; Katzner, Todd

    2014-06-01

    When wildlife habitat overlaps with industrial development animals may be harmed. Because wildlife and people select resources to maximize biological fitness and economic return, respectively, we estimated risk, the probability of eagles encountering and being affected by turbines, by overlaying models of resource selection for each entity. This conceptual framework can be applied across multiple spatial scales to understand and mitigate impacts of industry on wildlife. We estimated risk to Golden Eagles (Aquila chrysaetos) from wind energy development in 3 topographically distinct regions of the central Appalachian Mountains of Pennsylvania (United States) based on models of resource selection of wind facilities (n = 43) and of northbound migrating eagles (n = 30). Risk to eagles from wind energy was greatest in the Ridge and Valley region; all 24 eagles that passed through that region used the highest risk landscapes at least once during low altitude flight. In contrast, only half of the birds that entered the Allegheny Plateau region used highest risk landscapes and none did in the Allegheny Mountains. Likewise, in the Allegheny Mountains, the majority of wind turbines (56%) were situated in poor eagle habitat; thus, risk to eagles is lower there than in the Ridge and Valley, where only 1% of turbines are in poor eagle habitat. Risk within individual facilities was extremely variable; on average, facilities had 11% (SD 23; range = 0-100%) of turbines in highest risk landscapes and 26% (SD 30; range = 0-85%) of turbines in the lowest risk landscapes. Our results provide a mechanism for relocating high-risk turbines, and they show the feasibility of this novel and highly adaptable framework for managing risk of harm to wildlife from industrial development. PMID:24405249

  10. Selected aspects of Mediterranean diet and cancer risk.

    PubMed

    Pelucchi, Claudio; Bosetti, Cristina; Rossi, Marta; Negri, Eva; La Vecchia, Carlo

    2009-01-01

    European Mediterranean populations have a high life expectancy. Several aspects of their diet are considered favorable on health. We considered the role of various aspects of the Mediterranean diet on cancer risk in a series of Italian case-control studies including about 10,000 cases of cancer at 13 different sites and over 17,000 controls. For most epithelial cancers, the risk decreased with increasing vegetable consumption. Allium vegetables were also favorably related to cancer risk. Fruit intake was inversely associated with digestive tract and laryngeal cancers. For digestive tract cancers, the population attributable risks for low intake of vegetables and fruit ranged between 15% and 40%. Olive oil and unsaturated fats, which are typical aspects of the Mediterranean diet, were inversely related to the risk of several cancers, particularly of the upper aerodigestive tract. Whole grain food (and hence possibly fiber) intake was also related to reduced risk of various cancers. In contrast, refined grains and, consequently, glycemic load and index were associated to increased risks. Several micronutrients and food components (including folate, flavonoids, and carotenoids) showed inverse relations with cancer risk, but the main component(s) responsible for the favorable effect of a diet rich in vegetables and fruit remain undefined. PMID:20155613

  11. Spatially-Correlated Risk in Nature Reserve Site Selection

    PubMed Central

    Albers, Heidi J.; Busby, Gwenlyn M.; Hamaide, Bertrand; Ando, Amy W.; Polasky, Stephen

    2016-01-01

    Establishing nature reserves protects species from land cover conversion and the resulting loss of habitat. Even within a reserve, however, many factors such as fires and defoliating insects still threaten habitat and the survival of species. To address the risk to species survival after reserve establishment, reserve networks can be created that allow some redundancy of species coverage to maximize the expected number of species that survive in the presence of threats. In some regions, however, the threats to species within a reserve may be spatially correlated. As examples, fires, diseases, and pest infestations can spread from a starting point and threaten neighboring parcels’ habitats, in addition to damage caused at the initial location. This paper develops a reserve site selection optimization framework that compares the optimal reserve networks in cases where risks do and do not reflect spatial correlation. By exploring the impact of spatially-correlated risk on reserve networks on a stylized landscape and on an Oregon landscape, this analysis demonstrates an appropriate and feasible method for incorporating such post-reserve establishment risks in the reserve site selection literature as an additional tool to be further developed for future conservation planning. PMID:26789127

  12. Spatially-Correlated Risk in Nature Reserve Site Selection.

    PubMed

    Albers, Heidi J; Busby, Gwenlyn M; Hamaide, Bertrand; Ando, Amy W; Polasky, Stephen

    2016-01-01

    Establishing nature reserves protects species from land cover conversion and the resulting loss of habitat. Even within a reserve, however, many factors such as fires and defoliating insects still threaten habitat and the survival of species. To address the risk to species survival after reserve establishment, reserve networks can be created that allow some redundancy of species coverage to maximize the expected number of species that survive in the presence of threats. In some regions, however, the threats to species within a reserve may be spatially correlated. As examples, fires, diseases, and pest infestations can spread from a starting point and threaten neighboring parcels' habitats, in addition to damage caused at the initial location. This paper develops a reserve site selection optimization framework that compares the optimal reserve networks in cases where risks do and do not reflect spatial correlation. By exploring the impact of spatially-correlated risk on reserve networks on a stylized landscape and on an Oregon landscape, this analysis demonstrates an appropriate and feasible method for incorporating such post-reserve establishment risks in the reserve site selection literature as an additional tool to be further developed for future conservation planning. PMID:26789127

  13. Targeting hunter distribution based on host resource selection and kill sites to manage disease risk

    PubMed Central

    Dugal, Cherie J; van Beest, Floris M; Vander Wal, Eric; Brook, Ryan K

    2013-01-01

    Endemic and emerging diseases are rarely uniform in their spatial distribution or prevalence among cohorts of wildlife. Spatial models that quantify risk-driven differences in resource selection and hunter mortality of animals at fine spatial scales can assist disease management by identifying high-risk areas and individuals. We used resource selection functions (RSFs) and selection ratios (SRs) to quantify sex- and age-specific resource selection patterns of collared (n = 67) and hunter-killed (n = 796) nonmigratory elk (Cervus canadensis manitobensis) during the hunting season between 2002 and 2012, in southwestern Manitoba, Canada. Distance to protected area was the most important covariate influencing resource selection and hunter-kill sites of elk (AICw = 1.00). Collared adult males (which are most likely to be infected with bovine tuberculosis (Mycobacterium bovis) and chronic wasting disease) rarely selected for sites outside of parks during the hunting season in contrast to adult females and juvenile males. The RSFs showed selection by adult females and juvenile males to be negatively associated with landscape-level forest cover, high road density, and water cover, whereas hunter-kill sites of these cohorts were positively associated with landscape-level forest cover and increasing distance to streams and negatively associated with high road density. Local-level forest was positively associated with collared animal locations and hunter-kill sites; however, selection was stronger for collared juvenile males and hunter-killed adult females. In instances where disease infects a metapopulation and eradication is infeasible, a principle goal of management is to limit the spread of disease among infected animals. We map high-risk areas that are regularly used by potentially infectious hosts but currently underrepresented in the distribution of kill sites. We present a novel application of widely available data to target hunter distribution based on host resource

  14. Prediction of risk for drug use in high school students.

    PubMed

    Climent, C E; de Aragon, L V; Plutchik, R

    1990-05-01

    On the basis of questionnaires administered to almost 2,000 high school students in Cali, Colombia, a subset of items was selected that deal primarily with parent--child relationships. This 53-item set, referred to as the Drug Risk Scale (DRS), was administered to two new cross-validation samples, one consisting of high school students and the other consisting of drug addicts attending drug rehabilitation centers. Significant differences in parent--child relations were found between these new groups. The DRS was also found to have reasonably high sensitivity and specificity. Its potential value as a risk-prediction instrument is discussed. PMID:2258260

  15. Prediction of risk for drug use in high school students.

    PubMed

    Climent, C E; de Aragón, L V; Plutchik, R

    1989-11-01

    On the basis of questionnaires administered to almost 2,000 high school students in Cali, Colombia, a subset of items was selected that deal primarily with parent-child relationships. This 53 item set, referred to as the Drug Risk Scale (DRS), was administered to two new cross-validation samples, one consisting of high school students and the other consisting of drug addicts attending drug rehabilitation centers. Significant differences in parent-child relations were found between these new groups. The DRS was also found to have reasonably high sensitivity and specificity. Its potential value as a risk-prediction instrument is discussed. PMID:2628355

  16. Understanding Suicide Risk: Identification of High Risk Groups during High Risk Times

    PubMed Central

    Overholser, James C.; Braden, Abby; Dieter, Lesa

    2012-01-01

    Background The assessment of suicide risk is a complex task for mental health professionals. Certain demographic groups are associated with completed suicide including males, divorced adults, and Caucasians. However, demographic variables alone provide a crude assessment of suicide risk. Psychiatric diagnosis and recent life events may improve the identification of high risk individuals. Method The current study evaluated 148 individuals who died by suicide compared to 257 adults who died suddenly from accidents or medical problems. Psychological autopsy was used to assess Axis I psychiatric diagnosis and recent stressful life events. Results Suicide completers were significantly more likely than comparison subjects to have a depressive disorder, a substance abuse disorder, and to have experienced interpersonal conflict in the months leading up to their death. A discriminant function analysis revealed that the combination of demographic variables, recent stressful life events, and psychiatric diagnoses best discriminated between suicide completers and comparison subjects. Conclusions Proper assessment of suicide risk should include a comprehensive evaluation of demographic characteristics, recent life stressors, and psychiatric diagnosis. PMID:22140004

  17. Teaching Art to High Risk Groups.

    ERIC Educational Resources Information Center

    Rossol, Monona

    The role of art therapy is considered in working with such high risk groups as the institutionalized, mentally retarded, elderly, visually impaired, physically handicapped, asthmatic, hyper- and hypo-active children, hearing impaired, and patients on mind altering drugs. The special risks of infectious diseases (such as serum hepatitis), and…

  18. Senior English in Selected High Schools.

    ERIC Educational Resources Information Center

    Trammell, Robert Thomas

    In this study, 50 teachers of senior English were surveyed regarding their academic preparation and the English programs and curricular practices in their schools (18 selected high schools in Alabama). An analysis of existing professional literature was made to determine the status of current senior English programs and to ascertain what criteria…

  19. Selecting Music for High School Pop Groups.

    ERIC Educational Resources Information Center

    Santy, Jeff

    1990-01-01

    Describes the criteria a high school music teacher used to select music for a new non-traditional class titled "Pop Band." Lists criteria that each song must have: playability, special feature, popular appeal, variety, artist's qualification, and appropriateness. Students took an active role in the decision-making process. (GG)

  20. Left ventricular assist device patient selection: do risk scores help?

    PubMed Central

    Cowger, Jennifer

    2015-01-01

    Mechanical circulatory support (MCS) and left ventricular assist device (LVAD) implantation is becoming increasingly utilized in the advanced heart failure (HF) population. Until further developments are made in this continually evolving field, the need for appropriate patient selection is fueled by our knowledge that the less sick do better. Due to the evolution of MCS technology, and the importance of patient selection to outcomes, risk scores and classification schemes have been developed to provide a structure for medical decision making. As clinical experience grows, technology improves, and further favorable clinical characteristics are identified, it is incumbent upon the HF community to continually hone these instruments. The magnitude of such tools cannot be understated when it comes to aiding in the informed consent and shared-decision making process for patients, families, and the healthcare team. Many risk models that have attempted to address which groups of patients will be successful focus on short term mortality and not long term survival or quality of life. The benefits and pitfalls of these models and their potential implications for patient selection and MCS therapy will be reviewed here. PMID:26793327

  1. High risk of permafrost thaw

    SciTech Connect

    Schuur, E.A.G.; Abbott, B.; Koven, C.D,; Riley, W.J.; Subin, Z.M.; al, et

    2011-11-01

    In the Arctic, temperatures are rising fast, and permafrost is thawing. Carbon released to the atmosphere from permafrost soils could accelerate climate change, but the likely magnitude of this effect is still highly uncertain. A collective estimate made by a group of permafrost experts, including myself, is that carbon could be released more quickly than models currently suggest, and at levels that are cause for serious concern. While our models of carbon emission from permafrost thaw are lacking, experts intimately familiar with these landscapes and processes have accumulated knowledge about what they expect to happen, based on both quantitative data and qualitative understanding of these systems. We (the authors of this piece) attempted to quantify this expertise through a survey developed over several years, starting in 2009. Our survey asked experts what percentage of surface permafrost they thought was likely to thaw, how much carbon would be released, and how much of that would be methane, for three time periods and under four warming scenarios that are part of the new IPCC Fifth Assessment Report.

  2. Solar Selective Coatings for High Temperature Applications

    NASA Technical Reports Server (NTRS)

    Jaworske, Donald A.; Shumway, Dean A.

    2003-01-01

    Solar selective coatings are envisioned for use on minisatellites, for applications where solar energy is to be used to power heat engines or to provide thermal energy for remote regions in the interior of the spacecraft. These coatings are designed to have the combined properties of high solar absorptance and low infrared emittance. The coatings must be durable at elevated temperatures. For thermal bus applications, the temperature during operation is likely to be near 100 C. For heat engine applications. the temperature is expected to be much greater. The objective of this work was to screen candidate solar selective coatings for their high temperature durability. Candidate solar selective coatings were composed of molecular mixtures of metal and dielectric, including: nickel and aluminum oxide, titanium and aluminum oxide, and platinum and aluminum oxide. To identify high temperature durability, the solar absorptance and infrared emittance of the candidate coatings were evaluated initially, and after heating to temperatures in the range of 400 C to 700 C. The titanium and aluminum oxide molecular mixture was found to be the most durable.

  3. Effects of Comprehensive, Multiple High-Risk Behaviors Prevention Program on High School Students

    ERIC Educational Resources Information Center

    Collier, Crystal

    2013-01-01

    The purpose of this mixed methods study was to examine the effect of a multiple high-risk behaviors prevention program applied comprehensively throughout an entire school-system involving universal, selective, and indicated levels of students at a local private high school during a 4-year period. The prevention program was created based upon the…

  4. Student Assistance Programs and High Risk Youth.

    ERIC Educational Resources Information Center

    Casale, Jenni

    This manual discusses a method for developing a comprehensive drug abuse prevention and intervention program for students in special education. The first section contains introductory material regarding high risk students in general and implications for special education. The second section outlines material on specific types of high-risk…

  5. Heterogeneous metasurface for high temperature selective emission

    SciTech Connect

    Woolf, D. Hensley, J.; Cederberg, J. G.; Bethke, D. T.; Grine, A. D.; Shaner, E. A.

    2014-08-25

    We demonstrate selective emission from a heterogeneous metasurface that can survive repeated temperature cycling at 1300 K. Simulations, fabrication, and characterization were performed for a cross-over-a-backplane metasurface consisting of platinum and alumina layers on a sapphire substrate. The structure was stabilized for high temperature operation by an encapsulating alumina layer. The geometry was optimized for integration into a thermophotovoltaic (TPV) system, and was designed to have its emissivity matched to the external quantum efficiency spectrum of 0.6 eV InGaAs TPV material. We present spectral measurements of the metasurface that result in a predicted 22% optical-to-electrical power conversion efficiency in a simplified model at 1300 K. Furthermore, this broadly adaptable selective emitter design can be easily integrated into full-scale TPV systems.

  6. Candidate Risks Indicators for Bipolar Disorder: Early Intervention Opportunities in High-Risk Youth

    PubMed Central

    Jones, Steven; Goodday, Sarah; Bentall, Richard

    2016-01-01

    Background: Psychiatric illnesses like bipolar disorder are increasingly understood to be neurodevelopmental disorders with clinical, psychological, and biological indicators recognizable long before the emergence of the full-blown syndromes. Methods: This paper is a selective review of findings from studies of high-risk children of affected parents that inform the knowledge of illness risk and development markers of bipolar disorder. We specifically focus on candidate clinical, biological, and psychological risk indicators that could serve as targets for future early intervention and prevention studies. Results: There is convergent evidence from prospective studies that bipolar disorder typically debuts as depressive episodes after puberty. In some high-risk children, sleep and anxiety disorders precede mood disorders by several years and reflect an increased vulnerability. An association between early exposure to adversity (eg, exposure to parental illness, neglect from mother) and increased risk of psychopathology may be mediated through increased stress reactivity evident at both behavioral and biological levels. Inter-related psychological processes including reward sensitivity, unstable self-esteem, rumination, and positive self-appraisal are risk factors for mood disorders. Disturbances in circadian rhythm and immune dysfunction are associated with mood disorders and may be vulnerability markers influenced by these other risk factors. Conclusions: There is accruing evidence of a number of measurable and potentially modifiable markers of vulnerability and developing illness in youth at familial risk for bipolar disorder. Longitudinal studies of multiple biological and psychological risk processes in high-risk offspring, both individually and together, will improve our understanding of illness onset and lead to the development of specific early interventions. PMID:26116493

  7. Gynecological surveillance in high risk women.

    PubMed

    Dilley, James; Gentry-Maharaj, Aleksandra; Menon, Usha

    2016-10-01

    In high-risk women, risk reducing surgery remains the cornerstone of prevention. However, the resulting premature menopause has led to continued efforts to develop effective screening strategies for those who wish to delay or avoid surgery. This review describes how the screening of women at risk of ovarian and endometrial cancer has evolved to its current state. Serial monitoring of CA125 is core to ovarian cancer screening and most recent studies have used the Risk of Ovarian Cancer Algorithm (ROCA) to interpret CA125 profile. The additional use of a second tumour marker, HE4, is reviewed. The results to date of key ovarian cancer screening studies in high-risk women are summarised ahead of their concluding findings due later in 2016. The role of both ultrasound and endometrial sampling in the management of women at increased risk of endometrial cancer is outlined. Exciting new methodology, which could help shape the future of screening is investigated. The article summarises the current recommendations and guidelines from recognised international bodies to aid the clinician with management of these women. PMID:26930388

  8. Selective serotonin reuptake inhibitor use and risk of gestational hypertension

    PubMed Central

    Toh, Sengwee; Mitchell, Allen A.; Louik, Carol; Werler, Martha M.; Chambers, Christina D.; Hernández-Díaz, Sonia

    2009-01-01

    Objective To assess the effects of selective serotonin reuptake inhibitor (SSRI) use on risks of gestational hypertension (GHT) and preeclampsia. Method We used data from 5,731 women with non-malformed infants and no underlying hypertension who participated in the Slone Epidemiology Center Birth Defects Study in 1998-2007. GHT was defined as incident hypertension diagnosed after the 20th week of pregnancy with and without proteinuria (i.e., with and without preeclampsia). We compared the risks of GHT and preeclampsia between users and non-users of SSRIs during pregnancy. Relative risks (RR) and 95% confidence intervals (CI) were estimated by Cox proportional hazard models, adjusting for pre-pregnancy sociodemographic, reproductive, and medical factors. Results GHT was present in 9.0% of the 5,532 non-users and 19.1% of the 199 SSRI users; among users, GHT was present in 13.1% of the 107 women who used SSRIs only in the first trimester and in 26.1% of the 92 who continued SSRIs beyond the first trimester. For preeclampsia, the incidence was 2.4% among non-users, 3.7% among women who were exposed only in the first trimester and 15.2% among those who continued SSRIs beyond the first trimester. Compared with non-users, the adjusted RR of preeclampsia was 1.4 (95% CI: 0.5, 3.8) for women who discontinued and 4.9 (95% CI: 2.7, 8.8) for those who continued SSRIs. Conclusion Whether a causal factor or not, SSRI exposure late in pregnancy might identify women at increased risk for GHT and preeclampsia. Further investigation is required to separate the effects of SSRIs from those of underlying mood disorders. PMID:19122006

  9. The Psychosis High-Risk State

    PubMed Central

    Fusar-Poli, Paolo; Borgwardt, Stefan; Bechdolf, Andreas; Addington, Jean; Riecher-Rössler, Anita; Schultze-Lutter, Frauke; Keshavan, Matcheri; Wood, Stephen; Ruhrmann, Stephan; Seidman, Larry J.; Valmaggia, Lucia; Cannon, Tyrone; Velthorst, Eva; De Haan, Lieuwe; Cornblatt, Barbara; Bonoldi, Ilaria; Birchwood, Max; McGlashan, Thomas; Carpenter, William; McGorry, Patrick; Klosterkötter, Joachim; McGuire, Philip; Yung, Alison

    2014-01-01

    Context During the past 2 decades, a major transition in the clinical characterization of psychotic disorders has occurred. The construct of a clinical high-risk (HR) state for psychosis has evolved to capture the prepsychotic phase, describing people presenting with potentially prodromal symptoms. The importance of this HR state has been increasingly recognized to such an extent that a new syndrome is being considered as a diagnostic category in the DSM-5. Objective To reframe the HR state in a comprehensive state-of-the-art review on the progress that has been made while also recognizing the challenges that remain. Data Sources Available HR research of the past 20 years from PubMed, books, meetings, abstracts, and international conferences. Study Selection and Data Extraction Critical review of HR studies addressing historical development, inclusion criteria, epidemiologic research, transition criteria, outcomes, clinical and functional characteristics, neurocognition, neuroimaging, predictors of psychosis development, treatment trials, socioeconomic aspects, nosography, and future challenges in the field. Data Synthesis Relevant articles retrieved in the literature search were discussed by a large group of leading worldwide experts in the field. The core results are presented after consensus and are summarized in illustrative tables and figures. Conclusions The relatively new field of HR research in psychosis is exciting. It has the potential to shed light on the development of major psychotic disorders and to alter their course. It also provides a rationale for service provision to those in need of help who could not previously access it and the possibility of changing trajectories for those with vulnerability to psychotic illnesses. PMID:23165428

  10. Intake of selected minerals and risk of premenstrual syndrome.

    PubMed

    Chocano-Bedoya, Patricia O; Manson, Joann E; Hankinson, Susan E; Johnson, Susan R; Chasan-Taber, Lisa; Ronnenberg, Alayne G; Bigelow, Carol; Bertone-Johnson, Elizabeth R

    2013-05-15

    Iron, potassium, zinc, and other minerals might impact the development of premenstrual syndrome (PMS) through multiple mechanisms, but few studies have evaluated these relations. We conducted a case-control study nested within the prospective Nurses' Health Study II (1991-2001). Participants were free from PMS at baseline. After 10 years, 1,057 women were confirmed as PMS cases and 1,968 as controls. Mineral intake was assessed using food frequency questionnaires completed in 1991, 1995, and 1999. After adjustment for calcium intake and other factors, women in the highest quintile of nonheme iron intake had a relative risk of PMS of 0.64 (95% confidence interval (CI): 0.44, 0.92; P for trend = 0.04) compared with women in the lowest quintile. Women in the highest quintile of potassium intake had a relative risk of 1.46 (95% CI: 0.99, 2.15; P for trend = 0.04) compared with women in the lowest quintile. High intake of zinc from supplements was marginally associated with PMS (for intake of ≥25 mg/day vs. none, relative risk = 0.69, 95% CI: 0.46, 1.02; P for trend = 0.05). Intakes of sodium, magnesium, and manganese were unrelated to PMS risk. These findings suggest that dietary minerals may be useful in preventing PMS. Additional studies are needed to confirm these relations. PMID:23444100

  11. Detection of High-Risk Atherosclerotic Plaque

    PubMed Central

    Fleg, Jerome L.; Stone, Gregg W.; Fayad, Zahi A.; Granada, Juan F.; Hatsukami, Thomas S.; Kolodgie, Frank D.; Ohayon, Jacques; Pettigrew, Roderic; Sabatine, Marc S.; Tearney, Guillermo; Waxman, Sergio; Domanski, Michael J.; Srinivas, Pothur R.; Narula, Jagat

    2013-01-01

    The leading cause of major morbidity and mortality in most countries around the world is atherosclerotic cardiovascular disease, most commonly caused by thrombotic occlusion of a high-risk coronary plaque resulting in myocardial infarction or cardiac death, or embolization from a high-risk carotid plaque resulting in stroke. The lesions prone to result in such clinical events are termed vulnerable or high-risk plaques, and their identification may lead to the development of pharmacological and mechanical intervention strategies to prevent such events. Autopsy studies from patients dying of acute myocardial infarction or sudden death have shown that such events typically arise from specific types of atherosclerotic plaques, most commonly the thin-cap fibroatheroma. However, the search in human beings for vulnerable plaques before their becoming symptomatic has been elusive. Recently, the PROSPECT (Providing Regional Observations to Study Predictors of Events in the Coronary Tree) study demonstrated that coronary plaques that are likely to cause future cardiac events, regardless of angiographic severity, are characterized by large plaque burden and small lumen area and/or are thin-cap fibroatheromas verified by radiofrequency intravascular ultrasound imaging. This study opened the door to identifying additional invasive and noninvasive imaging modalities that may improve detection of high-risk atherosclerotic lesions and patients. Beyond classic risk factors, novel biomarkers and genetic profiling may identify those patients in whom noninvasive imaging for vulnerable plaque screening, followed by invasive imaging for risk confirmation is warranted, and in whom future pharmacological and/or device-based focal or regional therapies may be applied to improve long-term prognosis. PMID:22974808

  12. Determination of high-risk cargo

    NASA Astrophysics Data System (ADS)

    Morris, Leo A.; Smith, Douglas E.; Khan, Siraj M.

    1994-10-01

    The approach and methodology used in the determination of the type of cargo containing concealments of commercial quantities of narcotics such as cocaine and heroin is described. This high-risk cargo enters the United States through border crossings at land, seaports and airports. The volume and variety of cargos make it a complex and challenging task for the U.S. Customs Service.

  13. The High Risk Freshman Chemist Revisited

    ERIC Educational Resources Information Center

    Pickering, Miles

    1977-01-01

    Reports on the long term comparison between a group of "high risk" college freshmen who were given a supplemental chemistry course and another group who did not have the course. The supplemental course was found to produce only a short term rise in students' grades. (MR)

  14. Micronutrient requirements of high-risk infants

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Micronutrient requirements are well-established for healthy full-term infants. However, few such recommendations exist for high-risk infants, including full-term infants with a variety of medical disorders or very preterm infants. Key micronutrients considered in this review are calcium, phosphorus,...

  15. High risk groups in oil shale workforce

    SciTech Connect

    Gratt, L.B.; Perry, B.W.; Marine, W.M.; Savitz, D.A.

    1984-04-01

    The workforce risks of a hypothetical one million barrels-per-day oil shale industry were estimated. The risks for the different workforce segments were compared and high risk groups were identified. Accidents and injuries were statistically described by rates for fatalities, for accidents with days lost from work, and for accidents with no days lost from work. Workforce diseases analyzed were cancers, silicosia, pneumoconiosis, chronic bronchitis, chronic airway obstruction, and high frequency hearing loss. A comparison of the workforce groups under different risk measures (occurrence, fatality, and life-loss expectancy) was performed. The miners represented the group with the largest fatality and the most serious accident rate, although the estimated rates were below the average industry-wide underground mining experience. Lung disease from inhalation exposure of about the nuisance dust threshold limit value presents a significant risk for future concerns. If future environmental dust exposure is at the 100 ..mu..g/m/sup 3/ alpha-quartz level, safety improvements in the mining sector are of prime importance to reduce the oil shale worker's life-loss expectancy. 11 references, 1 figure, 11 tables.

  16. Selected micronutrient intake and the risk of colorectal cancer.

    PubMed Central

    Ferraroni, M.; La Vecchia, C.; D'Avanzo, B.; Negri, E.; Franceschi, S.; Decarli, A.

    1994-01-01

    The relationship between estimated intake of selected micronutrients and the risk of colorectal cancer was analysed using data from a case-control study conducted in northern Italy. The study was based on 828 patients with colon cancer, 498 with rectal cancer and 2,024 controls in hospital for acute, non-neoplastic, non-digestive tract diseases. Relative risks (RRs) of intake quintiles were computed after allowance for age, sex and other major potential confounding factors, including an estimate of total energy intake. No apparent trend in risk across intake quintiles was evident for retinol, vitamin D, methionine and calcium. For beta-carotene, ascorbic acid, vitamin E and folate there was a trend of a protective effect with increasing consumption: the RR for the highest versus the lowest quintile was 0.32 for beta-carotene, 0.40 for ascorbic acid, 0.60 for vitamin E and 0.52 for folate. These inverse associations were similar for colon and rectal cancer, and consistent across strata of sex and age. When simultaneous allowance was made for all these micronutrients, besides other covariates, the only persistent protective effects were for beta-carotene (RR = 0.38 for the highest quintile) and ascorbic acid (RR = 0.52). Whether this reflects a specific, or stronger, effect of these micronutrients, rather than problems of collinearity between micronutrients or other limitations of the data, remains open to discussion. Still, this study suggests that specific micronutrients may exert an independent protective effect against colorectal carcinogenesis. PMID:7981067

  17. Selected micronutrient intake and the risk of colorectal cancer.

    PubMed

    Ferraroni, M; La Vecchia, C; D'Avanzo, B; Negri, E; Franceschi, S; Decarli, A

    1994-12-01

    The relationship between estimated intake of selected micronutrients and the risk of colorectal cancer was analysed using data from a case-control study conducted in northern Italy. The study was based on 828 patients with colon cancer, 498 with rectal cancer and 2,024 controls in hospital for acute, non-neoplastic, non-digestive tract diseases. Relative risks (RRs) of intake quintiles were computed after allowance for age, sex and other major potential confounding factors, including an estimate of total energy intake. No apparent trend in risk across intake quintiles was evident for retinol, vitamin D, methionine and calcium. For beta-carotene, ascorbic acid, vitamin E and folate there was a trend of a protective effect with increasing consumption: the RR for the highest versus the lowest quintile was 0.32 for beta-carotene, 0.40 for ascorbic acid, 0.60 for vitamin E and 0.52 for folate. These inverse associations were similar for colon and rectal cancer, and consistent across strata of sex and age. When simultaneous allowance was made for all these micronutrients, besides other covariates, the only persistent protective effects were for beta-carotene (RR = 0.38 for the highest quintile) and ascorbic acid (RR = 0.52). Whether this reflects a specific, or stronger, effect of these micronutrients, rather than problems of collinearity between micronutrients or other limitations of the data, remains open to discussion. Still, this study suggests that specific micronutrients may exert an independent protective effect against colorectal carcinogenesis. PMID:7981067

  18. High Altitude Ballooning and Site Selection

    NASA Astrophysics Data System (ADS)

    Metcalf, John

    2008-10-01

    High altitude ballooning provides a near-space platform for amateur research projects in science and engineering. This venue allows new experiments, otherwise not conducted from costs or lack of transportation, from WSU and surrounding areas to be flown into the upper atmosphere. A highly skilled and motivated group of scientist and engineering students from WSU have contrived its own high altitude balloon to lift payload capsules filled with experiments and tracking equipment up to 120,000 feet where it then bursts and payload capsules are parachuted into a landing zone. Launch site selection is based upon the safety of those that come within the balloons projected flight path and terrain accessibility from the launch and landing zones. Restricted ground and airspace, mountainous regions, lakes and rivers, and densely populated or high air traffic areas were obstacles to be avoided. Computer flight simulations and region analysis show that there are several viable launch and recovery sites in Utah as well as SE Idaho, SW Wyoming, and NW Colorado.

  19. Selective Testing of At-Risk Blood Donors for Trypanosoma cruzi and Plasmodium spp. in Switzerland

    PubMed Central

    Niederhauser, Christoph; Gottschalk, Jochen; Tinguely, Caroline

    2016-01-01

    Summary Background Population migrations and overseas recreational travel to regions at risk for tropical diseases are increasing. A major challenge in non-endemic countries is to decrease the number of blood donor deferrals due those tropical disease pathogens, without compromising the high level of blood safety. The protozoans Trypanosoma cruzi and Plasmodium spp., the causative organisms of Chagas disease (CD) and malaria are becoming a major focus in the blood transfusion community. Methods: National guidelines of the Blood Transfusion Service of the Swiss Red Cross propose an algorithm for dealing with these pathogens, including a mandatory selective serological testing of donors at risk. Results 6,978 donors at risk for CD were tested. Three of them were confirmed anti-T. cruzi -positive, and in one case a transfusion-transmitted infection was highly possible. The specificity of the assay was 99.94%. For malaria 12,887 donors were at risk and 178 were confirmed positive. The specificity of the assays was 92.8%. Conclusion CD and malaria in non-endemic countries may represent a certain risk for blood transfusion. Switzerland chose a selective testing approach. The specificity of the assays is a crucial topic for this approach because it ensures a minimal loss of false-reactive donors and helps towards an easier counselling of implicated donors. PMID:27403088

  20. Predicting risk selection following major changes in Medicare.

    PubMed

    Pizer, Steven D; Frakt, Austin B; Feldman, Roger

    2008-04-01

    The Medicare Modernization Act of 2003 created several new types of private insurance plans within Medicare, starting in 2006. Some of these plan types previously did not exist in the commercial market and there was great uncertainty about their prospects. In this paper, we show that statistical models and historical data from the Medicare Current Beneficiary Survey can be used to predict the experience of new plan types with reasonable accuracy. This lays the foundation for the analysis of program modifications currently under consideration. We predict market share, risk selection, and stability for the most prominent new plan type, the stand-alone Medicare prescription drug plan (PDP). First, we estimate a model of consumer choice across Medicare insurance plans available in the data. Next, we modify the data to include PDPs and use the model to predict the probability of enrollment for each beneficiary in each plan type. Finally, we calculate mean-adjusted actual spending by plan type. We predict that adverse selection into PDPs will be substantial, but that enrollment and premiums will be stable. Our predictions correspond well to actual experience in 2006. PMID:17557273

  1. Stabilization of high-risk plaques

    PubMed Central

    Takata, Kohei; Zhang, Bo; Miura, Shin-ichiro; Saku, Keijiro

    2016-01-01

    The prevalence of atherosclerotic cardiovascular diseases (ASCVDs) is increasing globally and they have become the leading cause of death in most countries. Numerous experimental and clinical studies have been conducted to identify major risk factors and effective control strategies for ASCVDs. The development of imaging modalities with the ability to determine the plaque composition enables us to further identify high-risk plaque and evaluate the effectiveness of different treatment strategies. While intensive lipid-lowering by statins can stabilize or even regress plaque by various mechanisms, such as the reduction of lipid accumulation in a necrotic lipid core, the reduction of inflammation, and improvement of endothelial function, there are still considerable residual risks that need to be understood. We reviewed important findings regarding plaque vulnerability and some encouraging emerging approaches for plaque stabilization. PMID:27500090

  2. Selected anthropometric variables and aerobic fitness as predictors of cardiovascular disease risk in children.

    PubMed

    Gonçalves, R; Szmuchrowski, L A; Prado, L S; Couto, B P; Machado, Jcq; Damasceno, V O; Lamounier, J A

    2015-09-01

    The aim of this study was to assess the suitability of body mass index, waist circumference, waist-to-height ratio and aerobic fitness as predictors of cardiovascular risk factor clustering in children. A cross-sectional study was conducted with 290 school boys and girls from 6 to 10 years old, randomly selected. Blood was collected after a 12-hour fasting period. Blood pressure, waist circumference (WC), height and weight were evaluated according to international standards. Aerobic fitness (AF) was assessed by the 20-metre shuttle-run test. Clustering was considered when three of these factors were present: high systolic or diastolic blood pressure, high low-density lipoprotein (LDL) cholesterol, high triglycerides, high plasma glucose, high insulin concentrations and low high-density lipoprotein (HDL) cholesterol. A ROC curve identified the cut-off points of body mass index (BMI), WC, waist-to-height ratio (WHtR) and AF as predictors of risk factor clustering. BMI, WC and WHR resulted in significant areas under the ROC curves, which was not observed for AF. The anthropometric variables were good predictors of cardiovascular risk factor clustering in both sexes, whereas aerobic fitness should not be used to identify cardiovascular risk factor clustering in these children. PMID:26424930

  3. Selected anthropometric variables and aerobic fitness as predictors of cardiovascular disease risk in children

    PubMed Central

    Szmuchrowski, LA; Prado, LS; Couto, BP; Machado, JCQ; Damasceno, VO; Lamounier, JA

    2014-01-01

    The aim of this study was to assess the suitability of body mass index, waist circumference, waist-to-height ratio and aerobic fitness as predictors of cardiovascular risk factor clustering in children. A cross-sectional study was conducted with 290 school boys and girls from 6 to 10 years old, randomly selected. Blood was collected after a 12-hour fasting period. Blood pressure, waist circumference (WC), height and weight were evaluated according to international standards. Aerobic fitness (AF) was assessed by the 20-metre shuttle-run test. Clustering was considered when three of these factors were present: high systolic or diastolic blood pressure, high low-density lipoprotein (LDL) cholesterol, high triglycerides, high plasma glucose, high insulin concentrations and low high-density lipoprotein (HDL) cholesterol. A ROC curve identified the cut-off points of body mass index (BMI), WC, waist-to-height ratio (WHtR) and AF as predictors of risk factor clustering. BMI, WC and WHR resulted in significant areas under the ROC curves, which was not observed for AF. The anthropometric variables were good predictors of cardiovascular risk factor clustering in both sexes, whereas aerobic fitness should not be used to identify cardiovascular risk factor clustering in these children. PMID:26424930

  4. How I treat high-risk myeloma.

    PubMed

    Lonial, Sagar; Boise, Lawrence H; Kaufman, Jonathan

    2015-09-24

    The treatment of patients with myeloma has dramatically changed over the past decade due in part to the development of new agents and myeloma-specific targets. Despite these advancements, a group for whom the long-term benefit remains less clear are patients with genetically or clinically defined high-risk myeloma. In order to successfully treat these patients, it is important to first identify these patients, treat them with aggressive combination therapy, and employ the use of aggressive long-term maintenance therapy. Future directions include the use of new immune-based treatments (antibodies or cellular-based therapies) as well as target-driven approaches. Until these treatment approaches are better defined, this review will provide a potential treatment approach for standard- and high-risk myeloma that can be followed using agents and strategies that are currently available with the goal of improving progression-free and overall survival for these patients today. PMID:26272217

  5. The Effects of an Academic Alternative High School on Academically At-Risk Students

    ERIC Educational Resources Information Center

    Winningham, Mark L.

    2012-01-01

    In a causal-comparative research design, this study investigated the effectiveness of an academic alternative school in improving at-risk student outcomes in a selected county school system in the Upper Cumberland region of Tennessee. The academic alternative high school was compared to a traditional high school serving at-risk populations.…

  6. Interrupting the Inter-Generational Cycle in High Risk Adolescent Pregnancy.

    ERIC Educational Resources Information Center

    Stirtzinger, Ruth; McDermid, Stephanie; Grusec, Joan; Bernardini, Silvia; Quinlan, Kathy; Marshall, Michelle

    2002-01-01

    Describes the creation of a parenting course for high-risk adolescent mothers. This study supports direction away from 'knowledge-only' prevention/interventions with high risk adolescents and advocates the integration of this type of mental health/education parenting course with secondary school health class curricula using selected, trained…

  7. Blood lead levels among children in high-risk areas--California, 1987-1990

    SciTech Connect

    Not Available

    1992-05-01

    In the United States, elevated blood lead levels (BLLs) are a major health risk for children; this risk is totally preventable (1). To better characterize lead poisoning among children at high risk for lead exposure in California, the California Department of Health Services (CDHS) conducted lead-screening surveys that measured lead levels in children's blood, household paint, and soil in three selected high-risk areas in northern, southern, and central California. This report summarizes the survey findings and describes CDHS's efforts to reduce lead exposure among children in California, especially among those in high-risk areas.

  8. Selecting a risk-based tool to aid in decision making

    SciTech Connect

    Bendure, A.O.

    1995-03-01

    Selecting a risk-based tool to aid in decision making is as much of a challenge as properly using the tool once it has been selected. Failure to consider customer and stakeholder requirements and the technical bases and differences in risk-based decision making tools will produce confounding and/or politically unacceptable results when the tool is used. Selecting a risk-based decisionmaking tool must therefore be undertaken with the same, if not greater, rigor than the use of the tool once it is selected. This paper presents a process for selecting a risk-based tool appropriate to a set of prioritization or resource allocation tasks, discusses the results of applying the process to four risk-based decision-making tools, and identifies the ``musts`` for successful selection and implementation of a risk-based tool to aid in decision making.

  9. Selecting suitable solid organ transplant donors: Reducing the risk of donor-transmitted infections

    PubMed Central

    Jr, Christopher S Kovacs; Koval, Christine E; van Duin, David; de Morais, Amanda Guedes; Gonzalez, Blanca E; Avery, Robin K; Mawhorter, Steven D; Brizendine, Kyle D; Cober, Eric D; Miranda, Cyndee; Shrestha, Rabin K; Teixeira, Lucileia; Mossad, Sherif B

    2014-01-01

    Selection of the appropriate donor is essential to a successful allograft recipient outcome for solid organ transplantation. Multiple infectious diseases have been transmitted from the donor to the recipient via transplantation. Donor-transmitted infections cause increased morbidity and mortality to the recipient. In recent years, a series of high-profile transmissions of infections have occurred in organ recipients prompting increased attention on the process of improving the selection of an appropriate donor that balances the shortage of needed allografts with an approach that mitigates the risk of donor-transmitted infection to the recipient. Important advances focused on improving donor screening diagnostics, using previously excluded high-risk donors, and individualizing the selection of allografts to recipients based on their prior infection history are serving to increase the donor pool and improve outcomes after transplant. This article serves to review the relevant literature surrounding this topic and to provide a suggested approach to the selection of an appropriate solid organ transplant donor. PMID:25032095

  10. Selecting suitable solid organ transplant donors: Reducing the risk of donor-transmitted infections.

    PubMed

    Jr, Christopher S Kovacs; Koval, Christine E; van Duin, David; de Morais, Amanda Guedes; Gonzalez, Blanca E; Avery, Robin K; Mawhorter, Steven D; Brizendine, Kyle D; Cober, Eric D; Miranda, Cyndee; Shrestha, Rabin K; Teixeira, Lucileia; Mossad, Sherif B

    2014-06-24

    Selection of the appropriate donor is essential to a successful allograft recipient outcome for solid organ transplantation. Multiple infectious diseases have been transmitted from the donor to the recipient via transplantation. Donor-transmitted infections cause increased morbidity and mortality to the recipient. In recent years, a series of high-profile transmissions of infections have occurred in organ recipients prompting increased attention on the process of improving the selection of an appropriate donor that balances the shortage of needed allografts with an approach that mitigates the risk of donor-transmitted infection to the recipient. Important advances focused on improving donor screening diagnostics, using previously excluded high-risk donors, and individualizing the selection of allografts to recipients based on their prior infection history are serving to increase the donor pool and improve outcomes after transplant. This article serves to review the relevant literature surrounding this topic and to provide a suggested approach to the selection of an appropriate solid organ transplant donor. PMID:25032095

  11. High-risk sex offenders may not be high risk forever.

    PubMed

    Hanson, R Karl; Harris, Andrew J R; Helmus, Leslie; Thornton, David

    2014-10-01

    This study examined the extent to which sexual offenders present an enduring risk for sexual recidivism over a 20-year follow-up period. Using an aggregated sample of 7,740 sexual offenders from 21 samples, the yearly recidivism rates were calculated using survival analysis. Overall, the risk of sexual recidivism was highest during the first few years after release, and decreased substantially the longer individuals remained sex offense-free in the community. This pattern was particularly strong for the high-risk sexual offenders (defined by Static-99R scores). Whereas the 5-year sexual recidivism rate for high-risk sex offenders was 22% from the time of release, this rate decreased to 4.2% for the offenders in the same static risk category who remained offense-free in the community for 10 years. The recidivism rates of the low-risk offenders were consistently low (1%-5%) for all time periods. The results suggest that offense history is a valid, but time-dependent, indicator of the propensity to sexually reoffend. Further research is needed to explain the substantial rate of desistance by high-risk sexual offenders. PMID:24664250

  12. Using distance covariance for improved variable selection with application to learning genetic risk models.

    PubMed

    Kong, Jing; Wang, Sijian; Wahba, Grace

    2015-05-10

    Variable selection is of increasing importance to address the difficulties of high dimensionality in many scientific areas. In this paper, we demonstrate a property for distance covariance, which is incorporated in a novel feature screening procedure together with the use of distance correlation. The approach makes no distributional assumptions for the variables and does not require the specification of a regression model and hence is especially attractive in variable selection given an enormous number of candidate attributes without much information about the true model with the response. The method is applied to two genetic risk problems, where issues including uncertainty of variable selection via cross validation, subgroup of hard-to-classify cases, and the application of a reject option are discussed. PMID:25640961

  13. Principles for the selection of doses in chronic rodent bioassays. ILSI Risk Science Working Group on Dose Selection.

    PubMed Central

    Foran, J A

    1997-01-01

    Dose selection in chronic rodent bioassays has been one of the most debated issues in risk assessment. The Committee on Risk Assessment Methods of the National Research Council attempted, but failed, in 1993 to reach consensus on how to select doses for chronic rodent bioassays. However, a more recent effort conducted by the ILSI Risk Science Institute has resulted in a consensus set of principles for dose selection, including selection of the highest dose for chronic rodent bioassays. The principles encourage a move away from sole reliance on a maximum tolerated dose (MTD), as it has been traditionally defined (primarily by body weight and histopathology), and toward the use of sound scientific and toxicologic principles for the selection of all doses in the chronic bioassay. Specifically, the principles recommend that dose selection for chronic studies must be based on sound toxicologic principles; dose selection should consider human exposure; dose selection should be based on a variety of endpoints and effects derived from prechronic studies; and dose selection should consider physicochemical and other factors. Implementation of the principles internationally will have two important benefits; improvement in the quality and consistency of the rodent bioassay and international harmonization of dose selection procedures. PMID:9074868

  14. High risk factors of pancreatic carcinoma.

    PubMed

    Camara, Soriba Naby; Yin, Tao; Yang, Ming; Li, Xiang; Gong, Qiong; Zhou, Jing; Zhao, Gang; Yang, Zhi-Yong; Aroun, Tajoo; Kuete, Martin; Ramdany, Sonam; Camara, Alpha Kabinet; Diallo, Aissatou Taran; Feng, Zhen; Ning, Xin; Xiong, Jiong-Xin; Tao, Jing; Qin, Qi; Zhou, Wei; Cui, Jing; Huang, Min; Guo, Yao; Gou, Shan-Miao; Wang, Bo; Liu, Tao; Olivier, Ohoya Etsaka Terence; Conde, Tenin; Cisse, Mohamed; Magassouba, Aboubacar Sidiki; Ballah, Sneha; Keita, Naby Laye Moussa; Souare, Ibrahima Sory; Toure, Aboubacar; Traore, Sadamoudou; Balde, Abdoulaye Korse; Keita, Namory; Camara, Naby Daouda; Emmanuel, Dusabe; Wu, He-Shui; Wang, Chun-You

    2016-06-01

    Over the past decades, cancer has become one of the toughest challenges for health professionals. The epidemiologists are increasingly directing their research efforts on various malignant tumor worldwide. Of note, incidence of cancers is on the rise more quickly in developed countries. Indeed, great endeavors have to be made in the control of the life-threatening disease. As we know it, pancreatic cancer (PC) is a malignant disease with the worst prognosis. While little is known about the etiology of the PC and measures to prevent the condition, so far, a number of risk factors have been identified. Genetic factors, pre-malignant lesions, predisposing diseases and exogenous factors have been found to be linked to PC. Genetic susceptibility was observed in 10% of PC cases, including inherited PC syndromes and familial PC. However, in the remaining 90%, their PC might be caused by genetic factors in combination with environmental factors. Nonetheless, the exact mechanism of the two kinds of factors, endogenous and exogenous, working together to cause PC remains poorly understood. The fact that most pancreatic neoplasms are diagnosed at an incurable stage of the disease highlights the need to identify risk factors and to understand their contribution to carcinogenesis. This article reviews the high risk factors contributing to the development of PC, to provide information for clinicians and epidemiologists. PMID:27376795

  15. Risk selection in a regulated health insurance market: a review of the concept, possibilities and effects.

    PubMed

    van Kleef, Richard C; van de Ven, Wynand P M M; van Vliet, René C J A

    2013-12-01

    The Dutch basic health insurance is based on the principles of regulated competition. This implies that insurers and providers compete on price and quality while the regulator sets certain rules to achieve public objectives such as solidarity. Two regulatory aspects of this scheme are that insurers are not allowed to risk rate their premiums and are compensated for predictable variation in individual medical expenses (i.e., risk equalization). Research, however, indicates that the current risk equalization is imperfect, which confronts insurers and consumers with incentives for risk selection. The goal of this paper is to review the concept, possibilities and potential effects of risk selection in the Dutch basic health insurance. We conclude that the possibilities for risk selection are numerous and a potential threat to solidarity, efficiency and quality of care. Regulators should be aware that measurement of risk selection is a methodological and data-demanding challenge. PMID:24219050

  16. Suicide risk assessment in high-risk adolescents.

    PubMed

    Gray, Barbara P; Dihigo, Sharolyn K

    2015-09-13

    A significant number of adolescents experience depression and other mental health disorders that may put them at risk for suicide. Mental health assessment is an important component of primary healthcare. Depression and suicide risk screening can assist healthcare providers in preventing suicides. PMID:26262455

  17. Fetal and umbilical Doppler ultrasound in high-risk pregnancies

    PubMed Central

    Alfirevic, Zarko; Stampalija, Tamara; Gyte, Gillian ML

    2014-01-01

    Background Abnormal blood flow patterns in fetal circulation detected by Doppler ultrasound may indicate poor fetal prognosis. It is also possible false positive Doppler ultrasound findings could encourage inappropriate early delivery. Objectives The objective of this review was to assess the effects of Doppler ultrasound used to assess fetal well-being in high-risk pregnancies on obstetric care and fetal outcomes. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (September 2009) and the reference lists of identified studies. Selection criteria Randomised and quasi-randomised controlled trials of Doppler ultrasound for the investigation of umbilical and fetal vessels waveforms in high-risk pregnancies compared to no Doppler ultrasound. Data collection and analysis Two authors independently assessed the studies for inclusion, assessed risk of bias and carried out data extraction. Data entry was checked. Main results Eighteen completed studies involving just over 10,000 women were included. The trials were generally of unclear quality with some evidence of possible publication bias. The use of Doppler ultrasound in high-risk pregnancy was associated a reduction in perinatal deaths (risk ratio (RR) 0.71, 95% confidence interval (CI) 0.52 to 0.98, 16 studies, 10,225 babies, 1.2% versus 1.7 %, numbers needed to treat = 203; 95%CI 103 to 4352). There were also fewer inductions of labour (average RR 0.89, 95% CI 0.80 to 0.99, 10 studies, 5633 women, random effects) and fewer caesarean sections (RR 0.90, 95% CI 0.84 to 0.97, 14 studies, 7918 women). No difference was found in operative vaginal births (RR 0.95, 95% CI 0.80 to 1.14, four studies, 2813 women) nor in Apgar scores less than seven at five minutes (RR 0.92, 95% CI 0.69 to 1.24, seven studies, 6321 babies). Authors’ conclusions Current evidence suggests that the use of Doppler ultrasound in high-risk pregnancies reduced the risk of perinatal deaths and resulted in less

  18. Youth Risk Behavior Surveillance National Alternative High School Youth Risk Behavior Survey, United States, 1998.

    ERIC Educational Resources Information Center

    Grunbaum, Jo Anne; Kann, Laura; Kinchen, Steven A.; Ross, James G.; Gowda, Vani R.; Collins, Janet L.; Kolbe, Lloyd J.

    2000-01-01

    The 1998 National Alternative High School Youth Risk Behavior Survey measured health risk behaviors at alternative high schools. Many alternative students engaged in behaviors that made them high-risk for serious problems (e.g., motor vehicle safety, violence, nutrition, sexuality, exercise, and substance abuse). Their prevalence of high risk…

  19. Contraception: Efficacy, Risks, Continuation Rates, and Use in High-Risk Women.

    PubMed

    Batur, Pelin; Bowersox, Natalie; McNamara, Megan

    2016-08-01

    The clinical update serves as a brief review of recently published, high-impact, and potentially practice-changing journal articles summarized for our readers. Topics include menopause, sexual dysfunction, breast health, contraception, osteoporosis, and cardiovascular disease. In this clinical update, we selected recent publications relevant to the use of contraceptive methods. We highlight articles on continuation rates of long-acting reversible contraception versus nonlong-acting methods, updated risks of intrauterine devices, use of estrogen-containing contraceptives during anticoagulation for venous thromboembolic events, and the efficacy of oral and emergency contraception in women with elevated body mass index. PMID:27438879

  20. Interferon-α Revisited: Individualized Treatment Management Eased the Selective Pressure of Tyrosine Kinase Inhibitors on BCR-ABL1 Mutations Resulting in a Molecular Response in High-Risk CML Patients.

    PubMed

    Polivkova, Vaclava; Rohon, Peter; Klamova, Hana; Cerna, Olga; Divoka, Martina; Curik, Nikola; Zach, Jan; Novak, Martin; Marinov, Iuri; Soverini, Simona; Faber, Edgar; Machova Polakova, Katerina

    2016-01-01

    Bone marrow transplantation or ponatinib treatment are currently recommended strategies for management of patients with chronic myeloid leukemia (CML) harboring the T315I mutation and compound or polyclonal mutations. However, in some individual cases, these treatment scenarios cannot be applied. We used an alternative treatment strategy with interferon-α (IFN-α) given solo, sequentially or together with TKI in a group of 6 cases of high risk CML patients, assuming that the TKI-independent mechanism of action may lead to mutant clone repression. IFN-α based individualized therapy decreases of T315I or compound mutations to undetectable levels as assessed by next-generation deep sequencing, which was associated with a molecular response in 4/6 patients. Based on the observed results from immune profiling, we assumed that the principal mechanism leading to the success of the treatment was the immune activation induced with dasatinib pre-treatment followed by restoration of immunological surveillance after application of IFN-α therapy. Moreover, we showed that sensitive measurement of mutated BCR-ABL1 transcript levels augments the safety of this individualized treatment strategy. PMID:27214026

  1. Interferon-α Revisited: Individualized Treatment Management Eased the Selective Pressure of Tyrosine Kinase Inhibitors on BCR-ABL1 Mutations Resulting in a Molecular Response in High-Risk CML Patients

    PubMed Central

    Polivkova, Vaclava; Rohon, Peter; Klamova, Hana; Cerna, Olga; Divoka, Martina; Curik, Nikola; Zach, Jan; Novak, Martin; Marinov, Iuri; Soverini, Simona; Faber, Edgar; Machova Polakova, Katerina

    2016-01-01

    Bone marrow transplantation or ponatinib treatment are currently recommended strategies for management of patients with chronic myeloid leukemia (CML) harboring the T315I mutation and compound or polyclonal mutations. However, in some individual cases, these treatment scenarios cannot be applied. We used an alternative treatment strategy with interferon-α (IFN-α) given solo, sequentially or together with TKI in a group of 6 cases of high risk CML patients, assuming that the TKI-independent mechanism of action may lead to mutant clone repression. IFN-α based individualized therapy decreases of T315I or compound mutations to undetectable levels as assessed by next-generation deep sequencing, which was associated with a molecular response in 4/6 patients. Based on the observed results from immune profiling, we assumed that the principal mechanism leading to the success of the treatment was the immune activation induced with dasatinib pre-treatment followed by restoration of immunological surveillance after application of IFN-α therapy. Moreover, we showed that sensitive measurement of mutated BCR-ABL1 transcript levels augments the safety of this individualized treatment strategy. PMID:27214026

  2. Gastro-intestinal haemorrhage risks of selective serotonin receptor antagonist therapy: a new look

    PubMed Central

    Opatrny, Lucie; Delaney, J A ‘Chris’; Suissa, Samy

    2008-01-01

    AIMS (i) To determine the effects of selective serotonin reuptake inhibitors (SSRI) and other classes of antidepressants on upper gastro-intestinal (GI) haemorrhage and (ii) to assess the drug–drug interaction effects of antidepressants and warfarin or clopidogrel on the risk of GI haemorrhage. METHODS This was a population-based case control study in the General Practice Research Database (GPRD). Cases with a first episode of upper GI haemorrhage between 2000 and 2005 were matched with up to 10 controls. Exposure to the study drugs was defined by a prescription issued in the 90 days before the index date. Rate ratios were estimated using conditional logistic regression. RESULTS Four thousand and twenty-eight cases of GI haemorrhage and 40 171 controls were identified. The excess risk of GI haemorrhage with SSRI use was small (Rate Ratio [RR]: 1.3; 95% confidence interval [CI]: 1.1, 1.6) and null with exposure to tricyclic antidepressants (TCAs) (RR 1.0; 95% CI: 0.8, 1.3). The risk of GI haemorrhage was highest with venlafaxine use (RR: 1.9; 95% CI: 1.3, 2.6). There was no drug–drug interaction between warfarin anticoagulation and antidepressant use. CONCLUSIONS This study supports a small increased risk of upper GI haemorrhage with the use of SSRI antidepressants compared with the older TCA drugs, but to a lesser extent than previously reported due to confounding by alcohol use. The small elevation in risk of GI haemorrhage with SSRI and venlafaxine should be weighed against the therapeutic benefit of their use. WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT The known biological effects of selective serotonin reuptake inhibitors (SSRI) on platelets are consistent with an increased risk of gastrointestinal haemorrhage in patients on SSRI therapy.Previous research supports this increased risk among SSRI users with a large increase in bleeding risk observed. WHAT THIS STUDY ADDS This large study was able to compare the effects of different classes of antidepressant as

  3. Selected Aspects Of The Risk In The Supply Chain In Context Of The Supplier Quality Management

    NASA Astrophysics Data System (ADS)

    Koblen, Ivan; Lestyánszka Škůrková, Katarína

    2015-06-01

    The introductory part of the paper underlines the importance of "Risk-based thinking" in the Quality Management System (QMS) and risk in the supply chain, as a principle part of the QMS. After introducing the key terms, the authors focused on the principle part of the article - explanation of the external and internal supply chain risks and the main factors concerning the supply risks, demand risks and environmental risks (as cardinal types of external supply chain risks) as well as the manufacturing and process risks, network/planning and control risks (as most important types of internal supply chain risks). The authors inform on the selected supply chain risk management tools, especially on those which are linked to the appropriate utilization of quality management tools.

  4. Selected studies of magnetism at high pressure

    SciTech Connect

    Hearne, G.R.; Pasternak, M.P.; Taylor, R.D.

    1995-09-01

    Most previous studies of magnetism in various compounds under extreme conditions have been conducted over a wide pressure range at room temperature or over a wide range of cryogenic temperatures at pressures below 20 GPa (200 kbar). We present some of the most recent studies of magnetism over an extended range of temperatures and pressures far beyond 20 GPa, i.e., in regions of pressure-temperature (P-T) where magnetism has been largely unexplored. Recent techniques have permitted investigations of magnetism in selected 3d transition metal compounds in regions of P-T where physical properties may be drastically modified; related effects have often been seen in selected doping studies at ambient pressures.

  5. [High Risk Federal Program Areas]: An Overview. High-Risk Series.

    ERIC Educational Resources Information Center

    Comptroller General of the U.S., Washington, DC.

    This report reviews the status of government agencies and operations that have been identified as at "high risk" for waste, fraud, abuse, and mismanagement; describes successful progress in some agencies; and looks at recent reform legislation. Six categories being targeted include accountability of defense programs, ensuring that all revenues are…

  6. Safety culture in high-risk industries.

    PubMed

    Martyka, Joanna; Lebecki, Kazimierz

    2014-01-01

    This paper addresses the question of whether adopting safety culture improves hazard prevention in enterprises characterized by high primary risk. To answer this question, sample underground coal mines were examined to investigate the basic elements of the safety culture of employees. This paper presents the results of a diagnosis of the basic elements of the safety culture of supervisors (midlevel managers) and blue-collar workers in 3 underground coal mines. The study used 2 techniques: a Likert-type scale and a questionnaire. The results indicate the need to introduce changes in the safety culture of underground coal mine employees. This study also presents the conditions for improvement. Special attention was paid to (a) the conditions for improving safety culture and (b) a programme for modifying risky behaviours. PMID:25513792

  7. Habitat selection and risk of predation: re-colonization by lynx had limited impact on habitat selection by roe deer.

    PubMed

    Samelius, Gustaf; Andrén, Henrik; Kjellander, Petter; Liberg, Olof

    2013-01-01

    Risk of predation is an evolutionary force that affects behaviors of virtually all animals. In this study, we examined how habitat selection by roe deer was affected by risk of predation by Eurasian lynx - the main predator of roe deer in Scandinavia. Specifically, we compared how habitat selection by roe deer varied (1) before and after lynx re-established in the study area and (2) in relation to habitat-specific risk of predation by lynx. All analyses were conducted at the spatial and temporal scales of home ranges and seasons. We did not find any evidence that roe deer avoided habitats in which the risk of predation by lynx was greatest and information-theoretic model selection showed that re-colonization by lynx had limited impact on habitat selection by roe deer despite lynx predation causing 65% of known mortalities after lynx re-colonized the area. Instead we found that habitat selection decreased when habitat availability increased for 2 of 5 habitat types (a pattern referred to as functional response in habitat selection). Limited impact of re-colonization by lynx on habitat selection by roe deer in this study differs from elk in North America altering both daily and seasonal patterns in habitat selection at the spatial scales of habitat patches and home ranges when wolves were reintroduced to Yellowstone National Park. Our study thus provides further evidence of the complexity by which animals respond to risk of predation and suggest that it may vary between ecosystems and predator-prey constellations. PMID:24069419

  8. Modeling HIV Risk in Highly Vulnerable Youth

    ERIC Educational Resources Information Center

    Huba, G. J.; Panter, A. T.; Melchior, Lisa A.; Trevithick, Lee; Woods, Elizabeth R.; Wright, Eric; Feudo, Rudy; Tierney, Steven; Schneir, Arlene; Tenner, Adam; Remafedi, Gary; Greenberg, Brian; Sturdevant, Marsha; Goodman, Elizabeth; Hodgins, Antigone; Wallace, Michael; Brady, Russell E.; Singer, Barney; Marconi, Katherine

    2003-01-01

    This article examines the structure of several HIV risk behaviors in an ethnically and geographically diverse sample of 8,251 clients from 10 innovative demonstration projects intended for adolescents living with, or at risk for, HIV. Exploratory and confirmatory factor analyses identified 2 risk factors for men (sexual intercourse with men and a…

  9. 42 CFR 73.10 - Restricting access to select agents and toxins; security risk assessments.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Restricting access to select agents and toxins; security risk assessments. 73.10 Section 73.10 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES QUARANTINE, INSPECTION, LICENSING SELECT AGENTS AND TOXINS § 73.10 Restricting access to select agents and toxins; security...

  10. Anthropic shadow: observation selection effects and human extinction risks.

    PubMed

    Cirković, Milan M; Sandberg, Anders; Bostrom, Nick

    2010-10-01

    We describe a significant practical consequence of taking anthropic biases into account in deriving predictions for rare stochastic catastrophic events. The risks associated with catastrophes such as asteroidal/cometary impacts, supervolcanic episodes, and explosions of supernovae/gamma-ray bursts are based on their observed frequencies. As a result, the frequencies of catastrophes that destroy or are otherwise incompatible with the existence of observers are systematically underestimated. We describe the consequences of this anthropic bias for estimation of catastrophic risks, and suggest some directions for future work. PMID:20626690

  11. Microhabitat Selection by Marine Mesoconsumers in a Thermally Heterogeneous Habitat: Behavioral Thermoregulation or Avoiding Predation Risk?

    PubMed Central

    Vaudo, Jeremy J.; Heithaus, Michael R.

    2013-01-01

    Habitat selection decisions by consumers has the potential to shape ecosystems. Understanding the factors that influence habitat selection is therefore critical to understanding ecosystem function. This is especially true of mesoconsumers because they provide the link between upper and lower tropic levels. We examined the factors influencing microhabitat selection of marine mesoconsumers – juvenile giant shovelnose rays (Glaucostegus typus), reticulate whiprays (Himantura uarnak), and pink whiprays (H. fai) – in a coastal ecosystem with intact predator and prey populations and marked spatial and temporal thermal heterogeneity. Using a combination of belt transects and data on water temperature, tidal height, prey abundance, predator abundance and ray behavior, we found that giant shovelnose rays and reticulate whiprays were most often found resting in nearshore microhabitats, especially at low tidal heights during the warm season. Microhabitat selection did not match predictions derived from distributions of prey. Although at a course scale, ray distributions appeared to match predictions of behavioral thermoregulation theory, fine-scale examination revealed a mismatch. The selection of the shallow nearshore microhabitat at low tidal heights during periods of high predator abundance (warm season) suggests that this microhabitat may serve as a refuge, although it may come with metabolic costs due to higher temperatures. The results of this study highlight the importance of predators in the habitat selection decisions of mesoconsumers and that within thermal gradients, factors, such as predation risk, must be considered in addition to behavioral thermoregulation to explain habitat selection decisions. Furthermore, increasing water temperatures predicted by climate change may result in complex trade-offs that might have important implications for ecosystem dynamics. PMID:23593501

  12. Microhabitat selection by marine mesoconsumers in a thermally heterogeneous habitat: behavioral thermoregulation or avoiding predation risk?

    PubMed

    Vaudo, Jeremy J; Heithaus, Michael R

    2013-01-01

    Habitat selection decisions by consumers has the potential to shape ecosystems. Understanding the factors that influence habitat selection is therefore critical to understanding ecosystem function. This is especially true of mesoconsumers because they provide the link between upper and lower tropic levels. We examined the factors influencing microhabitat selection of marine mesoconsumers - juvenile giant shovelnose rays (Glaucostegus typus), reticulate whiprays (Himantura uarnak), and pink whiprays (H. fai) - in a coastal ecosystem with intact predator and prey populations and marked spatial and temporal thermal heterogeneity. Using a combination of belt transects and data on water temperature, tidal height, prey abundance, predator abundance and ray behavior, we found that giant shovelnose rays and reticulate whiprays were most often found resting in nearshore microhabitats, especially at low tidal heights during the warm season. Microhabitat selection did not match predictions derived from distributions of prey. Although at a course scale, ray distributions appeared to match predictions of behavioral thermoregulation theory, fine-scale examination revealed a mismatch. The selection of the shallow nearshore microhabitat at low tidal heights during periods of high predator abundance (warm season) suggests that this microhabitat may serve as a refuge, although it may come with metabolic costs due to higher temperatures. The results of this study highlight the importance of predators in the habitat selection decisions of mesoconsumers and that within thermal gradients, factors, such as predation risk, must be considered in addition to behavioral thermoregulation to explain habitat selection decisions. Furthermore, increasing water temperatures predicted by climate change may result in complex trade-offs that might have important implications for ecosystem dynamics. PMID:23593501

  13. Spatial ecology of refuge selection by an herbivore under risk of predation

    USGS Publications Warehouse

    Wilson, Tammy L.; Rayburn, Andrew P.; Edwards, Thomas C., Jr.

    2012-01-01

    Prey species use structures such as burrows to minimize predation risk. The spatial arrangement of these resources can have important implications for individual and population fitness. For example, there is evidence that clustered resources can benefit individuals by reducing predation risk and increasing foraging opportunity concurrently, which leads to higher population density. However, the scale of clustering that is important in these processes has been ignored during theoretical and empirical development of resource models. Ecological understanding of refuge exploitation by prey can be improved by spatial analysis of refuge use and availability that incorporates the effect of scale. We measured the spatial distribution of pygmy rabbit (Brachylagus idahoensis) refugia (burrows) through censuses in four 6-ha sites. Point pattern analyses were used to evaluate burrow selection by comparing the spatial distribution of used and available burrows. The presence of food resources and additional overstory cover resources was further examined using logistic regression. Burrows were spatially clustered at scales up to approximately 25 m, and then regularly spaced at distances beyond ~40 m. Pygmy rabbit exploitation of burrows did not match availability. Burrows used by pygmy rabbits were likely to be located in areas with high overall burrow density (resource clusters) and high overstory cover, which together minimized predation risk. However, in some cases we observed an interaction between either overstory cover (safety) or understory cover (forage) and burrow density. The interactions show that pygmy rabbits will use burrows in areas with low relative burrow density (high relative predation risk) if understory food resources are high. This points to a potential trade-off whereby rabbits must sacrifice some safety afforded by additional nearby burrows to obtain ample forage resources. Observed patterns of clustered burrows and non-random burrow use improve

  14. Modeling biotic habitat high risk areas

    USGS Publications Warehouse

    Despain, D.G.; Beier, P.; Tate, C.; Durtsche, B.M.; Stephens, T.

    2000-01-01

    Fire, especially stand replacing fire, poses a threat to many threatened and endangered species as well as their habitat. On the other hand, fire is important in maintaining a variety of successional stages that can be important for approach risk assessment to assist in prioritizing areas for allocation of fire mitigation funds. One example looks at assessing risk to the species and biotic communities of concern followed by the Colorado Natural Heritage Program. One looks at the risk to Mexican spottled owls. Another looks at the risk to cutthroat trout, and a fourth considers the general effects of fire and elk.

  15. Maximize Benefits, Minimize Risk: Selecting the Right HVAC Firm.

    ERIC Educational Resources Information Center

    Golden, James T.

    1993-01-01

    An informal survey of 20 major urban school districts found that 40% were currently operating in a "break down" maintenance mode. A majority, 57.9%, also indicated they saw considerable benefits in contracting for heating, ventilating, and air conditioning (HVAC) maintenance services with outside firms. Offers guidelines in selecting HVAC…

  16. Risk assessment of selected priority pollutants coming from boating activities.

    PubMed

    Ansanelli, Giuliana; Parrella, Luisa; Di Landa, Giuseppe; Massanisso, Paolo; Schiavo, Simona; Manzo, Sonia

    2016-07-01

    In this work, we evaluated the risk posed to aquatic organisms in the coastal waters of Albania and Apulia (Italy) by two priority pollutants (PPs), Irgarol 1051 and Diuron, used as biocides in antifouling paints on boat hulls. With this aim, we carried out an extensive 3-year monitoring in ports and marinas along the coasts of both countries, which showed a widespread occurrence of both PPs, with Irgarol 1051 concentrations usually being lower than the Diuron ones. The measured concentrations were compared with regulatory Environmental Quality Standards (EQS) (Directive 2008/105/EC) and used to perform a probabilistic Ecological Risk Assessment (ERA), for a thorough evaluation of the potential adverse effects upon marine ecosystem. Irgarol 1051 amounts above the Annual Average Concentration (AA-EQS, 2.5 ng/L) were often detected in Apulia and, less frequently, in Albania. Moreover, in Apulia, sometimes the Maximum Allowable Concentrations (MAC-EQS, 16 ng/L) was exceeded. In Apulia, where levels exceeded MAC/AA-EQS, ERA found not negligible probabilities of exceeding the toxicity level (6-18 %). A less critical situation was observed for Diuron whose levels were always below the MAC-EQS (1800 ng/L) in both countries and, in Albania, also below the AA-EQS (200 ng/L). On the other hand, in Apulia, this limit was exceeded in some locations. Correspondingly, ERA determined a not negligible risk in these sites (probability of exceedance 4-7 %). PMID:27344560

  17. Evaluation of Risk Management Strategies for a Low-Cost, High-Risk Project

    NASA Technical Reports Server (NTRS)

    Shishko, Robert; Jorgensen, Edward J.

    1996-01-01

    This paper summarizes work in progress to define and implement a risk management process tailored to a low-cost, high-risk, NASA mission -the Microrover Flight Experiment (MFEX, commonly called the Mars microrover).

  18. Exemestane Reduces Breast Cancer Risk in High-Risk Postmenopausal Women

    Cancer.gov

    Clinical trial results presented at the 2011 ASCO annual meeting showed that the aromatase inhibitor exemestane—used to treat early and advanced breast cancer—substantially reduced the risk of invasive breast cancer in high-risk postmenopausal women.

  19. Risk Management in High Adventure Outdoor Pursuits.

    ERIC Educational Resources Information Center

    Cinnamon, Jerry

    This paper outlines management guidelines for outdoor adventure pursuits based on analysis of accident case studies in the literature. Managing risk, to a large degree, involves managing human errors related to natural environmental hazards. The knowledge needed to manage risk may be gained through personal experience (the most dangerous way),…

  20. A selection of high gradient cavity experiments

    SciTech Connect

    Peter Kneisel

    1998-01-01

    In the two years since the 7th SRF workshop, a variety of cavity tests have been carried out with the objective to reproducibly achieve surface electric rf fields above 40 MV/m with no or only very little electron loading. This paper reports about a collection of tests on single cell and multi-cell cavities, which received standard surface treatments such as buffered chemical polishing and high pressure ultrapure water rinsing, but no heat treatments. Often the cavities were limited by quenches, posting a limit of 700 to 1,000 Oersted on achievable peak magnetic fields of high purity niobium RRR values between 200 and 250. In a seamless single cell cavity fabricated by V. Palmieri of INFN Legnaro by spinning, a very promising gradient of E{sub acc}=25 MV/m was measured. In collaboration with CERN, several tests on sputtering niobium prepared at CERN were also carried out, and accelerating gradients up to 25 MV/m were achieved. A single cell cavity, electron beam welded after electrochemical buffing, showed only good performance--E{sub p} > 50 MV/m--after the removal of more than 100 {micro}m of material. However, this cavity showed rather heavy Q disease even when cooled down rapidly; the Q degradation could be partially reversed by diffusing the oxygen from an anodized Nb{sub 2}O{sub 5} layer into the niobium by heating the cavity in-situ at T=250 C.

  1. Selected Issues Associated with the Risk Assessment Process for Pesticides with Persistent, Bioaccumulative, and Toxic Characteristics

    EPA Science Inventory

    This Scientific Advisory Panel meeting will address selected scientific issues associated with assessing the potential ecological risks resulting from use of a pesticide active ingredient which has persistent, bioaccumulative, and toxic (PBT) characteristics. EPA will pose speci...

  2. Thromboembolism Prophylaxis in Hip Arthroplasty: Routine and High Risk Patients.

    PubMed

    Nam, Denis; Nunley, Ryan M; Johnson, Staci R; Keeney, James A; Clohisy, John C; Barrack, Robert L

    2015-12-01

    This study's purpose was to present the use of a risk stratification protocol in which "routine" risk patients receive a mobile compression device with aspirin and "high" risk patients receive warfarin for thromboprophylaxis after hip arthroplasty. 1859 hip arthroplasty patients were prospectively enrolled (1402 routine risk--75.4%, 457 high risk--24.6%). The cumulative rate of venous thromboembolism events was 0.5% in the routine versus 0.5% in the high-risk cohort within 6weeks postoperatively (P=1.00). Patients in the routine risk cohort had a lower rate of major bleeding (0.5% versus 2.0%, P=0.006) and wound complications (0.2% versus 1.2%, P=0.01). Use of our risk stratification protocol allowed the avoidance of more aggressive anticoagulation in 75% of patients while achieving a low overall incidence of symptomatic VTE. PMID:26182980

  3. Risk factors and effect of selective removal on retroviral infections prevalence in Belgian stray cats.

    PubMed

    Garigliany, M; Jolly, S; Dive, M; Bayrou, C; Berthemin, S; Robin, P; Godenir, R; Petry, J; Dahout, S; Cassart, D; Thiry, E; Desmecht, D; Saegerman, C

    2016-01-01

    The aim of this study was to evaluate the effect of several risk/protective factors and predictors on the prevalence of feline immunodeficiency virus (FIV) and feline leukaemia virus (FeLV) infections in 302 stray cats captured during a trap-neuter-release programme in a mixed urban-rural area from Belgium, from 2010 to 2012. The impact of selective removal of FIV-positive cats on the apparent prevalence in the remaining population over this three-year period was also assessed. The seroprevalences over three years were 18.8 per cent for FIV and 0.7 per cent for FeLV. For FIV, the seroprevalence decreased significantly from the first year of the programme (2010; 30.5 per cent) to the last (2012; 13.1 per cent). Sex (male) and age (adult and old cats) were risk factors, while the year of sampling (years 2011 and 2012) was a protective factor. Age, sex and location were the most relevant predictors of FIV status. The data presented in this study revealed a very high FIV seroprevalence in Belgian stray cats, while FeLV was almost absent. The selective removal of positive cats had a drastic effect on the FIV seroprevalence in the remaining cat population. PMID:26744011

  4. Tips for selecting highly efficient cyclones

    SciTech Connect

    Amrein, D.L.

    1995-05-01

    Cyclone dust collectors have been used--and misused--all over the world for more than 100 years. One reason for the misuse is a common perception among users that all cyclones are created equal--that is, as long as a cyclone resembles a cylinder with an attached cone, it will do its job. However, to maximize separation efficiency in a specific application requires a precise cyclone design, engineered to exact fit many possible variables. A well-designed cyclone, for instance, can achieve efficiencies as high s 99.9+% when operated properly within the envelope of its specifications. Nonetheless, cyclones are often used only as first-stage filters for performing crude separations, with final collections being carried out by more-costly baghouses and scrubbers. Compared with baghouses and scrubbers, cyclones have two important considerations in their favor. One, they are almost invariably safer--in terms of the potential for generating fires and explosions--than fabric filters. Second, cyclones have lower maintenance costs since there are no filter media to replace. The paper discusses the operation, design, and troubleshooting of cyclones.

  5. Linking habitat selection and predation risk to spatial variation in survival

    PubMed Central

    DeCesare, Nicholas J; Hebblewhite, Mark; Bradley, Mark; Hervieux, David; Neufeld, Lalenia; Musiani, Marco; Mysterud, Atle

    2014-01-01

    1. A central assumption underlying the study of habitat selection is that selected habitats confer enhanced fitness. Unfortunately, this assumption is rarely tested, and in some systems, gradients of predation risk may more accurately characterize spatial variation in vital rates than gradients described by habitat selection studies. 2. Here, we separately measured spatial patterns of both resource selection and predation risk and tested their relationships with a key demographic trait, adult female survival, for a threatened ungulate, woodland caribou (Rangifer tarandus caribou Gmelin). We also evaluated whether exposure to gradients in both predation risk and resource selection value was manifested temporally through instantaneous or seasonal effects on survival outcomes. 3. We used Cox proportional hazards spatial survival modelling to assess the relative support for 5 selection- and risk-based definitions of habitat quality, as quantified by woodland caribou adult female survival. These hypotheses included scenarios in which selection ideally mirrored survival, risk entirely drove survival, non-ideal selection correlated with survival but with additive risk effects, an ecological trap with maladaptive selection and a non-spatial effect of annual variation in weather. 4. Indeed, we found positive relationships between the predicted values of a resource selection function (RSF) and survival, yet subsequently incorporating an additional negative effect of predation risk greatly improved models further. This revealed a positive, but non-ideal relationship between selection and survival. Gradients in these covariates were also shown to affect individual survival probability at multiple temporal scales. Exposure to increased predation risk had a relatively instantaneous effect on survival outcomes, whereas variation in habitat suitability predicted by an RSF had both instantaneous and longer-term seasonal effects on survival. 5. Predation risk was an additive source

  6. Perceived Risk in College Selection: Differences in Evaluative Criteria Used by Students and Parents

    ERIC Educational Resources Information Center

    Warwick, Jacquelyn; Mansfield, Phylis M.

    2003-01-01

    Students and parents base college selection on how well the college will overcome the perceived financial, social, psychological, physical, and functional risks associated with the college experience. Nineteen criteria associated with these risks were evaluated for significant differences between students and parents as well as for their level of…

  7. Risk-Taking, Safety and Older People. Selected Bibliographies on Ageing 3.

    ERIC Educational Resources Information Center

    Jackson, Wendy, Comp.

    This annotated bibliography, which was developed as part of a series of selected bibliographies on aging for Great Britain's Centre for Policy on Ageing, contains a total of 368 entries organized under the following subject headings: risk (identification, nature, responsibilities, risk taking, security); environmental safety (hazards, design,…

  8. High Throughput Screening and Selection Methods for Directed Enzyme Evolution

    PubMed Central

    2015-01-01

    Successful evolutionary enzyme engineering requires a high throughput screening or selection method, which considerably increases the chance of obtaining desired properties and reduces the time and cost. In this review, a series of high throughput screening and selection methods are illustrated with significant and recent examples. These high throughput strategies are also discussed with an emphasis on compatibility with phenotypic analysis during directed enzyme evolution. Lastly, certain limitations of current methods, as well as future developments, are briefly summarized. PMID:26074668

  9. Understanding high magnitude flood risk: evidence from the past

    NASA Astrophysics Data System (ADS)

    MacDonald, N.

    2009-04-01

    The average length of gauged river flow records in the UK is ~25 years, which presents a problem in determining flood risk for high-magnitude flood events. Severe floods have been recorded in many UK catchments during the past 10 years, increasing the uncertainty in conventional flood risk estimates based on river flow records. Current uncertainty in flood risk has implications for society (insurance costs), individuals (personal vulnerability) and water resource managers (flood/drought risk). An alternative approach is required which can improve current understanding of the flood frequency/magnitude relationship. Historical documentary accounts are now recognised as a valuable resource when considering the flood frequency/magnitude relationship, but little consideration has been given to the temporal and spatial distribution of these records. Building on previous research based on British rivers (urban centre): Ouse (York), Trent (Nottingham), Tay (Perth), Severn (Shrewsbury), Dee (Chester), Great Ouse (Cambridge), Sussex Ouse (Lewes), Thames (Oxford), Tweed (Kelso) and Tyne (Hexham), this work considers the spatial and temporal distribution of historical flooding. The selected sites provide a network covering many of the largest river catchments in Britain, based on urban centres with long detailed documentary flood histories. The chronologies offer an opportunity to assess long-term patterns of flooding, indirectly determining periods of climatic variability and potentially increased geomorphic activity. This research represents the first coherent large scale analysis undertaken of historical multi-catchment flood chronologies, providing an unparalleled network of sites, permitting analysis of the spatial and temporal distribution of historical flood patterns on a national scale.

  10. Fostering Resilience in At-Risk High School Students

    ERIC Educational Resources Information Center

    Tepovich, Ann

    2012-01-01

    There is a large volume of literature that discusses the at-risk high school student. This literature tends to focus on the factors that create the at-risk student whether those are environmental factors or perhaps the failure of schools in general that create the at-risk problem in the United States. Although the causes are important to…

  11. Who takes risks in high-risk sports? A typological personality approach.

    PubMed

    Castanier, Carole; Le Scanff, Christine; Woodman, Tim

    2010-12-01

    We investigated the risk-taking behaviors of 302 men involved in high-risk sports (downhill skiing mountaineering rock climbing, paragliding, or skydiving). The sportsmen were classified using a typological approach to personality based on eight personality types, which were constructed from combinations of neuroticism, extraversion, and conscientiousness. Results showed that personality types with a configuration of low conscientiousness combined with high extraversion and/or high neuroticism (impulsive, hedonistic, insecure) were greater risk-takers. Conversely, personality types with a configuration of high conscientiousness combined with low extraversion and/or high extraversion (skeptic, brooder, entrepreneur) were lower risk-takers. Results are discussed in the context of typology and other approaches to understanding who takes risks in high-risk domains. PMID:21268472

  12. Youth Risk Behavior Surveillance System: Selected 2011 National Health Risk Behaviors and Health Outcomes by Sex

    ERIC Educational Resources Information Center

    Centers for Disease Control and Prevention, 2011

    2011-01-01

    The national Youth Risk Behavior Survey (YRBS) monitors priority health risk behaviors that contribute to the leading causes of death, disability, and social problems among youth and adults in the United States. The national YRBS is conducted every two years during the spring semester and provides data representative of 9th through 12th grade…

  13. A Model for Investigating Predictive Validity at Highly Selective Institutions.

    ERIC Educational Resources Information Center

    Gross, Alan L.; And Others

    A statistical model for investigating predictive validity at highly selective institutions is described. When the selection ratio is small, one must typically deal with a data set containing relatively large amounts of missing data on both criterion and predictor variables. Standard statistical approaches are based on the strong assumption that…

  14. 78 FR 15746 - Compendium of Analyses To Investigate Select Level 1 Probabilistic Risk Assessment End-State...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-12

    ... COMMISSION Compendium of Analyses To Investigate Select Level 1 Probabilistic Risk Assessment End-State... document entitled: Compendium of Analyses to Investigate Select Level 1 Probabilistic Risk Assessment End..., select ``ADAMS Public Documents'' and then select ``Begin Web- based ADAMS Search.'' For problems...

  15. Risk factors in selected patients undergoing femoral embolectomy.

    PubMed Central

    Scott, D. J.; Davies, A. H.; Horrocks, M.

    1989-01-01

    Mortality rates after femoral embolectomy (FE) in patients with an acutely ischaemic leg vary from 20-40%. In the last 3 years we have adopted a policy of proceeding directly to femoral embolectomy in those patients with a strong clinical suspicion of an embolus. Where doubt exists about the diagnosis, arteriography is performed in combination with local streptokinase, balloon dilatation and/or reconstruction. In a prospective study between September 1984 and March 1987, 43 patients underwent femoral embolectomy with a limb salvage rate of 87%. The early mortality (within 30 days) was 16%, the late mortality was 26%, with a mean follow-up of 22 months. Of the seven patients who died within 30 days, one had a successful embolectomy but died from a cerebrovascular accident. The remaining six failed to improve clinically, all had poor backbleeding and no return of the peripheral pulses. None of these patients had an amputation. We recommend that femoral embolectomy be performed in those patients with a short history of ischaemia (less than 72 h), a risk factor suggesting an embolic source and no past history of intermittent claudication. If all three criteria are not met, arteriography should be performed with a view to fibrinolytic therapy or vascular reconstruction. In those patients who have had a failed embolectomy or where the circulation cannot be restored promptly, despite fibrinolytic therapy and/or distal reconstruction, early major amputation may be life-saving. PMID:2774451

  16. Risk-Informed Decision Making; Application to the Technology Development Alternative Selection

    NASA Astrophysics Data System (ADS)

    Dezfuli, Homayoon; Maggio, Gaspare; Everett, Christopher

    2010-09-01

    NASA NPR 8000.4A, Agency Risk Management Procedural Requirements, defines risk management in terms of two complementary processes: Risk-informed Decision Making(RIDM) and Continuous Risk Management(CRM). The RIDM process is used to inform decision making by emphasizing proper use of risk analysis to make decisions that impact all mission execution domains(e.g., safety, technical, cost, and schedule) for program/projects and mission support organizations. The RIDM process supports the selection of an alternative prior to program commitment. The CRM process is used to manage risk associated with the implementation of the selected alternative. The two processes work together to foster proactive risk management at NASA. The Office of Safety and Mission Assurance at NASA Headquarters has developed a technical handbook to provide guidance for implementing the RIDM process in the context of NASA risk management and systems engineering. This paper summarizes the key concepts and procedures of the RIDM process as presented in the handbook, and also illustrates how the RIDM process can be applied to the selection of technology investments as NASA’s new technology development programs are initiated.

  17. Risk-Informed Decision Making: Application to Technology Development Alternative Selection

    NASA Technical Reports Server (NTRS)

    Dezfuli, Homayoon; Maggio, Gaspare; Everett, Christopher

    2010-01-01

    NASA NPR 8000.4A, Agency Risk Management Procedural Requirements, defines risk management in terms of two complementary processes: Risk-informed Decision Making (RIDM) and Continuous Risk Management (CRM). The RIDM process is used to inform decision making by emphasizing proper use of risk analysis to make decisions that impact all mission execution domains (e.g., safety, technical, cost, and schedule) for program/projects and mission support organizations. The RIDM process supports the selection of an alternative prior to program commitment. The CRM process is used to manage risk associated with the implementation of the selected alternative. The two processes work together to foster proactive risk management at NASA. The Office of Safety and Mission Assurance at NASA Headquarters has developed a technical handbook to provide guidance for implementing the RIDM process in the context of NASA risk management and systems engineering. This paper summarizes the key concepts and procedures of the RIDM process as presented in the handbook, and also illustrates how the RIDM process can be applied to the selection of technology investments as NASA's new technology development programs are initiated.

  18. Women at High Risk for Diabetes

    MedlinePlus

    ... 173-199. 3 Dabelea D, Crume T. Maternal environment and the transgenerational cycle of obesity and diabetes. Diabetes Care , 2011;60:1849-1855. 4 Kitzmiller JL, Dang-Kilduff L, Taslimi MM. Gestational diabetes after delivery: short-term management and long-term risks. Diabetes Care. 2007;30: ...

  19. Selective high affinity polydentate ligands and methods of making such

    SciTech Connect

    DeNardo, Sally; DeNardo, Gerald; Balhorn, Rodney

    2010-02-16

    This invention provides novel polydentate selective high affinity ligands (SHALs) that can be used in a variety of applications in a manner analogous to the use of antibodies. SHALs typically comprise a multiplicity of ligands that each bind different region son the target molecule. The ligands are joined directly or through a linker thereby forming a polydentate moiety that typically binds the target molecule with high selectivity and avidity.

  20. Management of High-Risk Cutaneous Squamous Cell Carcinoma

    PubMed Central

    Jennings, Lorraine

    2010-01-01

    Cutaneous squamous cell carcinoma is an increasing public health concern, representing the second most common cancer in the United States. High-risk cutaneous squamous cell carcinoma represents a subgroup of this disease, where patients are at higher risk of metastasis and death. To date, there are no accepted criteria for defining or managing these patients. This review discusses the current state of knowledge of high-risk cutaneous squamous cell carcinoma and outlines reasonable management strategies based on available data. PMID:20725546

  1. The Dark Side of the Moon: Meta-analytical Impact of Recruitment Strategies on Risk Enrichment in the Clinical High Risk State for Psychosis

    PubMed Central

    Fusar-Poli, Paolo; Schultze-Lutter, Frauke; Cappucciati, Marco; Rutigliano, Grazia; Bonoldi, Ilaria; Stahl, Daniel; Borgwardt, Stephan; Riecher-Rössler, Anita; Addington, Jean; Perkins, Diana O.; Woods, Scott W.; McGlashan, Thomas; Lee, Jimmy; Klosterkötter, Joachim; Yung, Alison R.; McGuire, Philip

    2016-01-01

    Background: The individual risk of developing psychosis after being tested for clinical high-risk (CHR) criteria (posttest risk of psychosis) depends on the underlying risk of the disease of the population from which the person is selected (pretest risk of psychosis), and thus on recruitment strategies. Yet, the impact of recruitment strategies on pretest risk of psychosis is unknown. Methods: Meta-analysis of the pretest risk of psychosis in help-seeking patients selected to undergo CHR assessment: total transitions to psychosis over the pool of patients assessed for potential risk and deemed at risk (CHR+) or not at risk (CHR−). Recruitment strategies (number of outreach activities per study, main target of outreach campaign, and proportion of self-referrals) were the moderators examined in meta-regressions. Results: 11 independent studies met the inclusion criteria, for a total of 2519 (CHR+: n = 1359; CHR−: n = 1160) help-seeking patients undergoing CHR assessment (mean follow-up: 38 months). The overall meta-analytical pretest risk for psychosis in help-seeking patients was 15%, with high heterogeneity (95% CI: 9%–24%, I 2 = 96, P < .001). Recruitment strategies were heterogeneous and opportunistic. Heterogeneity was largely explained by intensive (n = 11, β = −.166, Q = 9.441, P = .002) outreach campaigns primarily targeting the general public (n = 11, β = −1.15, Q = 21.35, P < .001) along with higher proportions of self-referrals (n = 10, β = −.029, Q = 4.262, P = .039), which diluted pretest risk for psychosis in patients undergoing CHR assessment. Conclusions: There is meta-analytical evidence for overall risk enrichment (pretest risk for psychosis at 38monhts = 15%) in help-seeking samples selected for CHR assessment as compared to the general population (pretest risk of psychosis at 38monhts=0.1%). Intensive outreach campaigns predominantly targeting the general population and a higher proportion of self-referrals diluted the pretest risk

  2. 15 CFR 14.14 - High risk special award conditions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 15 Commerce and Foreign Trade 1 2011-01-01 2011-01-01 false High risk special award conditions. 14.14 Section 14.14 Commerce and Foreign Trade Office of the Secretary of Commerce UNIFORM...-PROFIT, AND COMMERCIAL ORGANIZATIONS Pre-Award Requirements § 14.14 High risk special award...

  3. 15 CFR 14.14 - High risk special award conditions.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 15 Commerce and Foreign Trade 1 2013-01-01 2013-01-01 false High risk special award conditions. 14.14 Section 14.14 Commerce and Foreign Trade Office of the Secretary of Commerce UNIFORM...-PROFIT, AND COMMERCIAL ORGANIZATIONS Pre-Award Requirements § 14.14 High risk special award...

  4. 15 CFR 14.14 - High risk special award conditions.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 15 Commerce and Foreign Trade 1 2012-01-01 2012-01-01 false High risk special award conditions. 14.14 Section 14.14 Commerce and Foreign Trade Office of the Secretary of Commerce UNIFORM...-PROFIT, AND COMMERCIAL ORGANIZATIONS Pre-Award Requirements § 14.14 High risk special award...

  5. 15 CFR 14.14 - High risk special award conditions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 15 Commerce and Foreign Trade 1 2014-01-01 2014-01-01 false High risk special award conditions. 14.14 Section 14.14 Commerce and Foreign Trade Office of the Secretary of Commerce UNIFORM...-PROFIT, AND COMMERCIAL ORGANIZATIONS Pre-Award Requirements § 14.14 High risk special award...

  6. 15 CFR 14.14 - High risk special award conditions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false High risk special award conditions. 14.14 Section 14.14 Commerce and Foreign Trade Office of the Secretary of Commerce UNIFORM...-PROFIT, AND COMMERCIAL ORGANIZATIONS Pre-Award Requirements § 14.14 High risk special award...

  7. 40 CFR 35.6790 - High risk recipients.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... described in 40 CFR 31.12. Requirements for Administering a Superfund State Contract (SSC) ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false High risk recipients. 35.6790 Section... Actions Other Administrative Requirements for Cooperative Agreements § 35.6790 High risk recipients....

  8. Social work services in a high-risk nursery.

    PubMed

    Sheridan, M S; Johnson, D R

    1976-05-01

    Why should a social worker be on the team of a neonatal intensive-care nursery? Helping parents cope with the crises that arise with high-risk births is only one important reason. Ameliorating staff stress is another. Also, by following up the high-risk babies, the social worker has an opportunity to play a preventive role. PMID:185126

  9. 40 CFR 35.6790 - High risk recipients.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... described in 40 CFR 31.12. Requirements for Administering a Superfund State Contract (SSC) ... 40 Protection of Environment 1 2014-07-01 2014-07-01 false High risk recipients. 35.6790 Section... Actions Other Administrative Requirements for Cooperative Agreements § 35.6790 High risk recipients....

  10. 40 CFR 35.6790 - High risk recipients.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... described in 40 CFR 31.12. Requirements for Administering a Superfund State Contract (SSC) ... 40 Protection of Environment 1 2012-07-01 2012-07-01 false High risk recipients. 35.6790 Section... Actions Other Administrative Requirements for Cooperative Agreements § 35.6790 High risk recipients....

  11. 40 CFR 35.6790 - High risk recipients.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... described in 40 CFR 31.12. Requirements for Administering a Superfund State Contract (SSC) ... 40 Protection of Environment 1 2011-07-01 2011-07-01 false High risk recipients. 35.6790 Section... Actions Other Administrative Requirements for Cooperative Agreements § 35.6790 High risk recipients....

  12. 40 CFR 35.6790 - High risk recipients.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... described in 40 CFR 31.12. Requirements for Administering a Superfund State Contract (SSC) ... 40 Protection of Environment 1 2013-07-01 2013-07-01 false High risk recipients. 35.6790 Section... Actions Other Administrative Requirements for Cooperative Agreements § 35.6790 High risk recipients....

  13. Risk of cardiovascular disease? A qualitative study of risk interpretation among patients with high cholesterol

    PubMed Central

    2013-01-01

    Background Previous studies have shown the importance of paying attention to lay peoples’ interpretations of risk of disease, in order to explain health-related behavior. However, risk interpretations interplay with social context in complex ways. The objective was to explore how asymptomatic patients with high cholesterol interpret risk of cardiovascular disease. Methods Fourteen patients with high cholesterol and risk of cardiovascular disease were interviewed, and patterns across patient accounts were identified and analysed from an ethnographic approach. Results Information from the general practitioner about high cholesterol and risk of cardiovascular disease was reinterpreted in everyday social life. The risk associated with fatty foods was weighed against the pleasures of social and cultural events in which this type of food was common and cherished. A positive mindset was applied as a strategy to lower the risk of having high cholesterol, but knowledge about risk was viewed as a cause of anxiety and self-absorption, and this anxiety made the body susceptible to disease, hampering the chances for healthy life. Conclusion Interpretations of high cholesterol and risk of cardiovascular disease are embedded in social relations and everyday life concerns. This should be addressed in general practice in preference-sensitive cases about risk-reducing medication. Trial registration ClinicalTrials.gov: NCT01187056 PMID:24040920

  14. Rates of violence in patients classified as high risk by structured risk assessment instruments

    PubMed Central

    Singh, Jay P.; Fazel, Seena; Gueorguieva, Ralitza; Buchanan, Alec

    2014-01-01

    Background Rates of violence in persons identified as high risk by structured risk assessment instruments (SRAIs) are uncertain and frequently unreported by validation studies. Aims To analyse the variation in rates of violence in individuals identified as high risk by SRAIs. Method A systematic search of databases (1995-2011) was conducted for studies on nine widely used assessment tools. Where violence rates in high-risk groups were not published, these were requested from study authors. Rate information was extracted, and binomial logistic regression was used to study heterogeneity. Results Information was collected on 13 045 participants in 57 samples from 47 independent studies. Annualised rates of violence in individuals classified as high risk varied both across and within instruments. Rates were elevated when population rates of violence were higher, when a structured professional judgement instrument was used and when there was a lower proportion of men in a study. Conclusions After controlling for time at risk, the rate of violence in individuals classified as high risk by SRAIs shows substantial variation. In the absence of information on local base rates, assigning predetermined probabilities to future violence risk on the basis of a structured risk assessment is not supported by the current evidence base. This underscores the need for caution when such risk estimates are used to influence decisions related to individual liberty and public safety. PMID:24590974

  15. Human health risk assessment: selected Internet and world wide web resources.

    PubMed

    Patterson, Jacqueline; Hakkinen, P J Bert; Wullenweber, Andrea E

    2002-04-25

    The world wide web (WWW) has become a valuable source of 24 hour-a-day access to information needed by human health risk assessors. Various web sites and other Internet resources provide information needed for human hazard identification, dose-response evaluation, exposure assessment, risk characterization, and risk management. Information on risk communication is also available. Substantial collections of information on multiple aspects of risk assessment are found in sites sponsored by RiskWorld, the (US) EPA's National Center for Environmental Assessment (NCEA), the (US) National Library of Medicine's TOXNET, the (US) Agency for Toxic Substances and Disease Registry (ATSDR), and the International Programme on Chemical Safety (IPCS). Also valuable are various web sites providing information on the physical and chemical properties of chemicals, the environmental fate and transport of chemicals, government regulations, and guidance and training for performing risk assessments. Several professional societies and other organizations have web sites addressing risk assessment issues and information, and there are Internet mailing lists for online help and for sharing information and perspectives. We classify selected web sites according to user needs and provide the reader with a collection of selected sites that can serve as entry points to risk assessment-related web resources. PMID:11955689

  16. Toddlers at High Risk of Chemical Eye Burns

    MedlinePlus

    ... fullstory_160258.html Toddlers at High Risk of Chemical Eye Burns: Study Access to household cleaning products ... and 2 years have relatively high rates of chemical eye burns, with everyday cleaners a common cause, ...

  17. Automated frame selection process for high-resolution microendoscopy

    NASA Astrophysics Data System (ADS)

    Ishijima, Ayumu; Schwarz, Richard A.; Shin, Dongsuk; Mondrik, Sharon; Vigneswaran, Nadarajah; Gillenwater, Ann M.; Anandasabapathy, Sharmila; Richards-Kortum, Rebecca

    2015-04-01

    We developed an automated frame selection algorithm for high-resolution microendoscopy video sequences. The algorithm rapidly selects a representative frame with minimal motion artifact from a short video sequence, enabling fully automated image analysis at the point-of-care. The algorithm was evaluated by quantitative comparison of diagnostically relevant image features and diagnostic classification results obtained using automated frame selection versus manual frame selection. A data set consisting of video sequences collected in vivo from 100 oral sites and 167 esophageal sites was used in the analysis. The area under the receiver operating characteristic curve was 0.78 (automated selection) versus 0.82 (manual selection) for oral sites, and 0.93 (automated selection) versus 0.92 (manual selection) for esophageal sites. The implementation of fully automated high-resolution microendoscopy at the point-of-care has the potential to reduce the number of biopsies needed for accurate diagnosis of precancer and cancer in low-resource settings where there may be limited infrastructure and personnel for standard histologic analysis.

  18. A Selective Overview of Variable Selection in High Dimensional Feature Space.

    PubMed

    Fan, Jianqing; Lv, Jinchi

    2010-01-01

    High dimensional statistical problems arise from diverse fields of scientific research and technological development. Variable selection plays a pivotal role in contemporary statistical learning and scientific discoveries. The traditional idea of best subset selection methods, which can be regarded as a specific form of penalized likelihood, is computationally too expensive for many modern statistical applications. Other forms of penalized likelihood methods have been successfully developed over the last decade to cope with high dimensionality. They have been widely applied for simultaneously selecting important variables and estimating their effects in high dimensional statistical inference. In this article, we present a brief account of the recent developments of theory, methods, and implementations for high dimensional variable selection. What limits of the dimensionality such methods can handle, what the role of penalty functions is, and what the statistical properties are rapidly drive the advances of the field. The properties of non-concave penalized likelihood and its roles in high dimensional statistical modeling are emphasized. We also review some recent advances in ultra-high dimensional variable selection, with emphasis on independence screening and two-scale methods. PMID:21572976

  19. A Selective Overview of Variable Selection in High Dimensional Feature Space

    PubMed Central

    Fan, Jianqing

    2010-01-01

    High dimensional statistical problems arise from diverse fields of scientific research and technological development. Variable selection plays a pivotal role in contemporary statistical learning and scientific discoveries. The traditional idea of best subset selection methods, which can be regarded as a specific form of penalized likelihood, is computationally too expensive for many modern statistical applications. Other forms of penalized likelihood methods have been successfully developed over the last decade to cope with high dimensionality. They have been widely applied for simultaneously selecting important variables and estimating their effects in high dimensional statistical inference. In this article, we present a brief account of the recent developments of theory, methods, and implementations for high dimensional variable selection. What limits of the dimensionality such methods can handle, what the role of penalty functions is, and what the statistical properties are rapidly drive the advances of the field. The properties of non-concave penalized likelihood and its roles in high dimensional statistical modeling are emphasized. We also review some recent advances in ultra-high dimensional variable selection, with emphasis on independence screening and two-scale methods. PMID:21572976

  20. Recent Positive Selection Drives the Expansion of a Schizophrenia Risk Nonsynonymous Variant at SLC39A8 in Europeans.

    PubMed

    Li, Ming; Wu, Dong-Dong; Yao, Yong-Gang; Huo, Yong-Xia; Liu, Jie-Wei; Su, Bing; Chasman, Daniel I; Chu, Audrey Y; Huang, Tao; Qi, Lu; Zheng, Yan; Luo, Xiong-Jian

    2016-01-01

    Natural selection has played important roles in optimizing complex human adaptations. However, schizophrenia poses an evolutionary paradox during human evolution, as the illness has strongly negative effects on fitness, but persists with a prevalence of ~0.5% across global populations. Recent studies have identified numerous risk variations in diverse populations, which might be able to explain the stable and high rate of schizophrenia morbidity in different cultures and regions, but the questions about why the risk alleles derived and maintained in human gene pool still remain unsolved. Here, we studied the evolutionary pattern of a schizophrenia risk variant rs13107325 (P < 5.0 × 10(-8) in Europeans) in the SLC39A8 gene. We found the SNP is monomorphic in Asians and Africans with risk (derived) T-allele totally absent, and further evolutionary analyses showed the T-allele has experienced recent positive selection in Europeans. Subsequent exploratory analyses implicated that the colder environment in Europe was the likely selective pressures, ie, when modern humans migrated "out of Africa" and moved to Europe mainland (a colder and cooler continent than Africa), new alleles derived due to positive selection and protected humans from risk of hypertension and also helped them adapt to the cold environment. The hypothesis was supported by our pleiotropic analyses with hypertension and energy intake as well as obesity in Europeans. Our data thus provides an intriguing example to illustrate a possible mechanism for maintaining schizophrenia risk alleles in the human gene pool, and further supported that schizophrenia is likely a product caused by pleiotropic effect during human evolution. PMID:26006263

  1. Preoperative patient assessment: Identifying patients at high risk.

    PubMed

    Boehm, O; Baumgarten, G; Hoeft, A

    2016-06-01

    Postoperative mortality remains alarmingly high with a mortality rate ranging between 0.4% and 4%. A small subgroup of multimorbid and/or elderly patients undergoing different surgical procedures naturally confers the highest risk of complications and perioperative death. Therefore, preoperative assessment should identify these high-risk patients and stratify them to individualized monitoring and treatment throughout all phases of perioperative care. A "tailored" perioperative approach might help further reduce perioperative morbidity and mortality. This article aims to elucidate individual morbidity-specific risks. It further suggests approaches to detect patients at the risk of perioperative complications. PMID:27396802

  2. Heading for the hills: risk avoidance drives den site selection in African wild dogs.

    PubMed

    Jackson, Craig R; Power, R John; Groom, Rosemary J; Masenga, Emmanuel H; Mjingo, Ernest E; Fyumagwa, Robert D; Røskaft, Eivin; Davies-Mostert, Harriet

    2014-01-01

    Compared to their main competitors, African wild dogs (Lycaon pictus) have inferior competitive abilities and interspecific competition is a serious fitness-limiting factor. Lions (Panthera leo) are the dominant large carnivore in African savannah ecosystems and wild dogs avoid them both spatially and temporally. Wild dog young are particularly vulnerable and suffer high rates of mortality from lions. Since lions do not utilize all parts of the landscape with an equal intensity, spatial variation in lion densities can be exploited by wild dogs both during their general ranging behaviour, but more specifically when they are confined to a den with vulnerable young. Since patches of rugged terrain are associated with lower lion densities, we hypothesized that these comparatively safe habitats should be selected by wild dogs for denning. We investigated the relationship between the distribution of 100 wild dog den sites and the occurrence of rugged terrain in four wild dog populations located in Tanzania, Zimbabwe and South Africa. A terrain ruggedness index was derived from a 90 m digital elevation model and used to map terrain ruggedness at each site. We compared characteristics of actual and potential (random) den sites to determine how wild dogs select den sites. The distributions of wild dog dens were strongly associated with rugged terrain and wild dogs actively selected terrain that was more rugged than that available on average. The likelihood of encountering lions is reduced in these habitats, minimizing the risk to both adults and pups. Our findings have important implications for the conservation management of the species, especially when assessing habitat suitability for potential reintroductions. The simple technique used to assess terrain ruggedness may be useful to investigate habitat suitability, and even predict highly suitable denning areas, across large landscapes. PMID:24918935

  3. Mitigating the effects of preferentially selected monitoring sites for environmental policy and health risk analysis.

    PubMed

    Shaddick, Gavin; Zidek, James V; Liu, Yi

    2016-08-01

    The potential effects of air pollution are a major concern both in terms of the environment and in relation to human health. In order to support both environmental and health policy there is a need for accurate estimates of the exposures that populations might experience. The information for this typically comes from environmental monitoring networks but often the locations of monitoring sites are preferentially located in order to detect high levels of pollution. Using the information from such networks has the potential to seriously affect the estimates of pollution that are obtained and that might be used in health risk analyses. In this context, we explore the topic of preferential sampling within a long-standing network in the UK that monitored black smoke due to concerns about its effect on public health, the extent of which came to prominence during the famous London fog of 1952. Abatement measures led to a decline in the levels of black smoke and a subsequent reduction in the number of monitoring locations that were thought necessary to provide the information required for policy support. There is evidence of selection bias during this process with sites being kept in the most polluted areas. We assess the potential for this to affect the estimates of risk associated air pollution and show how using Bayesian spatio-temporal exposure models may be used to attempt to mitigate the effects of preferential sampling in this case. PMID:27494959

  4. High level waste interim storge architecture selection - decision report

    SciTech Connect

    Calmus, R.B.

    1996-09-27

    The U.S. Department of Energy (DOE) has embarked upon a course to acquire Hanford Site tank waste treatment and immobilization services using privatized facilities (RL 1996a). This plan contains a two-phased approach. Phase I is a proof-of-principle/connnercial demonstration- scale effort and Phase II is a fiill-scale production effort. In accordance with the planned approach, interim storage and disposal of various products from privatized facilities are to be DOE fumished. The high-level waste (BLW) interim storage options, or alternative architectures, were identified and evaluated to provide the framework from which to select the most viable method of Phase I BLW interim storage (Calmus 1996). This evaluation, hereafter referred to as the Alternative Architecture Evaluation, was performed to established performance and risk criteria (technical merit, cost, schedule, etc.). Based on evaluation results, preliminary architectures and path forward reconunendations were provided for consideration in the architecture decision- maldng process. The decision-making process used for selection of a Phase I solidified BLW interim storage architecture was conducted in accordance with an approved Decision Plan (see the attachment). This decision process was based on TSEP-07,Decision Management Procedure (WHC 1995). The established decision process entailed a Decision Board, consisting of Westinghouse Hanford Company (VY`HC) management staff, and included appointment of a VTHC Decision Maker. The Alternative Architecture Evaluation results and preliminary recommendations were presented to the Decision Board members for their consideration in the decision-making process. The Alternative Architecture Evaluation was prepared and issued before issuance of @C-IP- 123 1, Alternatives Generation and Analysis Procedure (WI-IC 1996a), but was deemed by the Board to fully meet the intent of WHC-IP-1231. The Decision Board members concurred with the bulk of the Alternative Architecture

  5. ANDROS: A code for Assessment of Nuclide Doses and Risks with Option Selection

    SciTech Connect

    Begovich, C.L.; Sjoreen, A.L.; Ohr, S.Y.; Chester, R.O.

    1986-11-01

    ANDROS (Assessment of Nuclide Doses and Risks with Option Selection) is a computer code written to compute doses and health effects from atmospheric releases of radionuclides. ANDROS has been designed as an integral part of the CRRIS (Computerized Radiological Risk Investigation System). ANDROS reads air concentrations and environmental concentrations of radionuclides to produce tables of specified doses and health effects to selected organs via selected pathways (e.g., ingestion or air immersion). The calculation may be done for an individual at a specific location or for the population of the whole assessment grid. The user may request tables of specific effects for every assessment grid location. Along with the radionuclide concentrations, the code requires radionuclide decay data, dose and risk factors, and location-specific data, all of which are available within the CRRIS. This document is a user manual for ANDROS and presents the methodology used in this code.

  6. Super-surface selective nanomembranes providing simultaneous high permeation flux and high selectivity

    DOEpatents

    Hu, Michael Z.; Simpson, John T.; Aytug, Tolga; Paranthaman, Mariappan Parans; Sturgeon, Matthew R.

    2016-04-12

    Superhydrophobic membrane structures having a beneficial combination of throughput and a selectivity. The membrane structure can include a porous support substrate; and a membrane layer adherently disposed on and in contact with the porous support substrate. The membrane layer can include a nanoporous material having a superhydrophobic surface. The superhydrophobic surface can include a textured surface, and a modifying material disposed on the textured surface. Methods of making and using the membrane structures.

  7. Coordinating perioperative care for the 'high risk' general surgical patient using risk prediction scoring.

    PubMed

    Hafiz, Shaziz; Lees, Nicholas Peter

    2016-01-01

    Identifying 'high risk' (> 5% mortality score) emergency general surgical patients early, allows appropriate perioperative care to be allocated by securing critical care beds and ensuring the presence of senior surgeons and senior anesthetists intraoperatively. Scoring systems can be used to predict perioperative risk and coordinate resources perioperatively. Currently it is unclear which estimate of risk correlates with current resource deployment. A retrospective study was undertaken assessing the relationship between deployment of perioperative resources: senior surgeon, senior anesthetist and critical care bed. The study concluded that almost all high risk patients with high POSSUM mortality and morbidity scores had a consultant senior surgeon present intraoperatively. Critically unwell patients with higher operative severity and perioperative morbidity scores received higher care (HDU/ICU) beds postoperatively, ensuring that they received appropriate care if their condition deteriorated. Therefore POSSUM scoring should be used perioperatively in emergency cases to coordinate appropriate perioperative care for high risk general surgical patients. PMID:26901929

  8. Use of selective serotonin reuptake inhibitor antidepressants in pregnancy does carry risks, but the risks are small.

    PubMed

    Casper, Regina C

    2015-03-01

    The paper by Robinson posits that risks from prenatal exposure to selective serotonin reuptake inhibitor (SSRI) antidepressants are not different from the risks encountered in the general population and that untoward effects of SSRIs are difficult to distinguish from those of the mood disorder. Indeed, maternal depression and anxiety can have negative consequences for fetal and postnatal development. Fortunately, experimental evidence suggests that mood and anxiety disorder symptoms often respond to psychosocial interventions. If pharmacotherapy becomes necessary, it is, however, important to know that even if SSRI drugs have been shown to be safe overall, research has shown that fetal development can be adversely affected by in utero exposure to SSRIs in a subgroup of neonates. Examples would be the transient neonatal adaptation syndrome, an increased risk of persistent pulmonary hypertension of the newborn, and small, albeit measurable, changes in motor and social adaptability in infancy and childhood. PMID:25714254

  9. Patterns of Population Differentiation and Natural Selection on the Celiac Disease Background Risk Network

    PubMed Central

    Sams, Aaron; Hawks, John

    2013-01-01

    Celiac disease is a common small intestinal inflammatory condition induced by wheat gluten and related proteins from rye and barley. Left untreated, the clinical presentation of CD can include failure to thrive, malnutrition, and distension in juveniles. The disease can additionally lead to vitamin deficiencies, anemia, and osteoporosis. Therefore, CD potentially negatively affected fitness in past populations utilizing wheat, barley, and rye. Previous analyses of CD risk variants have uncovered evidence for positive selection on some of these loci. These studies also suggest the possibility that risk for common autoimmune conditions such as CD may be the result of positive selection on immune related loci in the genome to fight infection. Under this evolutionary scenario, disease phenotypes may be a trade-off from positive selection on immunity. If this hypothesis is generally true, we can expect to find a signal of natural selection when we survey across the network of loci known to influence CD risk. This study examines the non-HLA autosomal network of gene loci associated with CD risk in Europe. We reject the null hypothesis of neutrality on this network of CD risk loci. Additionally, we can localize evidence of selection in time and space by adding information from the genome of the Tyrolean Iceman. While we can show significant differentiation between continental regions across the CD network, the pattern of evidence is not consistent with primarily recent (Holocene) selection across this network in Europe. Further localization of ancient selection on this network may illuminate the ecological pressures acting on the immune system during this critically interesting phase of our evolution. PMID:23936230

  10. High prevalence of suicide risk in people living with HIV: who is at higher risk?

    PubMed

    Passos, Susane Müller Klug; Souza, Luciano Dias de Mattos; Spessato, Bárbara Coiro

    2014-01-01

    A cross-sectional study was developed to evaluate suicide risk and associated factors in HIV/AIDS patients at a regional reference center for the treatment of HIV/AIDS in southern Brazil. We assessed 211 patients in regard to suicide risk, clinical and sociodemographic characteristics, drug use, depression, and anxiety. Suicide risk was assessed with Mini International Neuropsychiatric Interview, Module C. Multivariate analysis was performed using Poisson regression. Of the total sample, 34.1% were at risk of suicide. In the multivariate analysis, the following variables were independently associated with suicide risk: female gender; age up to 47 years; unemployment; indicative of anxiety; indicative of depression; and abuse or addiction on psychoactive substances. Suicide risk is high in this population. Psychosocial factors should be included in the physical and clinical evaluation, given their strong association with suicide risk. PMID:24797027

  11. Incisional Reinforcement in High-Risk Patients

    PubMed Central

    Feldmann, Timothy F.; Young, Monica T.; Pigazzi, Alessio

    2014-01-01

    Hernia formation after surgical procedures continues to be an important cause of surgical morbidity. Incisional reinforcement at the time of the initial operation has been used in some patient populations to reduce the risk of subsequent hernia formation. In this article, reinforcement techniques in different surgical wounds are examined to identify situations in which hernia formation may be prevented. Mesh use for midline closure, pelvic floor reconstruction, and stoma site reinforcement is discussed. Additionally, the use of retention sutures, closure of the open abdomen, and reinforcement after component separation are examined using current literature. Although existing studies do not support the routine use of mesh reinforcement for all surgical incisions, certain patient populations appear to benefit from reinforcement with lower rates of subsequent hernia formation. The identification and characterization of these groups will guide the future use of mesh reinforcement in surgical incisions. PMID:25435823

  12. Understand Your Risk for High Cholesterol

    MedlinePlus

    ... or trans fats also increases the amount of LDL cholesterol in your blood. If high blood cholesterol runs ... may not be enough to help lower your LDL blood cholesterol. View an animation of cholesterol . More information: Women ...

  13. The use of breast imaging to screen women at high risk for cancer.

    PubMed

    Sickles, Edward A

    2010-09-01

    Although there currently is no evidence of reduced breast cancer mortality for screening women at high risk with mammography, magnetic resonance (MR) imaging, or ultrasonography (US), the presumptive evidence of early cancer detection provided by numerous observational studies has led to the publication of guidelines and recommendations for the selective use of these imaging modalities. In general, annual screening mammography is recommended for women of appropriately high risk beginning at age 30 years, supplemental screening with MR imaging is recommended for a subset of women at very high risk, and screening US is suggested for women for whom MR imaging is appropriate but unavailable, impractical, or poorly tolerated. The use of screening US remains controversial among women who have no substantial risk factors other than dense breasts. PMID:20868890

  14. Use of Selective Cyclooxygenase-2 Inhibitors, Other Analgesics, and Risk of Glioma

    PubMed Central

    Seliger, Corinna; Meier, Christoph R.; Becker, Claudia; Jick, Susan S.; Bogdahn, Ulrich; Hau, Peter; Leitzmann, Michael F.

    2016-01-01

    Background Selective cyclooxygenase-2 (COX-2) inhibitors are analgesic, antipyretic, and anti-inflammatory drugs. They have been found to inhibit the development of glioma in laboratory investigations. Whether these drugs reduce the risk of glioma incidence in humans is unknown. Methods We conducted a matched case-control analysis using the U.K.-based Clinical Practice Research Datalink (CPRD). We identified 2,469 cases matched to 24,690 controls on age, sex, calendar time, general practice, and number of years of active history in the CPRD prior to the index date. We conducted conditional logistic regression analyses to determine relative risks, estimated as odds ratios (ORs) with 95% confidence intervals (CIs) of glioma in relation to use of selective COX-2 inhibitors, adjusted for several confounding variables. Results Use of selective COX-2 inhibitors was unrelated to risk of glioma (adjusted OR for 1–9 versus 0 prescriptions = 1.02; 95% CI = 0.92–1.13, 10–29 versus 0 prescriptions = 1.01; 95% CI = 0.80–1.28, ≥30 versus 0 prescriptions = 1.16; 95% CI = 0.86–1.55). Trends for increasing numbers of prescriptions for other non-steroidal anti-inflammatory drugs (NSAIDs), and non-NSAID analgesics were also not associated with glioma risk. Conclusion Further epidemiologic studies are needed to confirm the null relation of use of selective COX-2 inhibitors to glioma risk and to explain the discrepancy between laboratory investigations and our observational study. Impact: Use of selective COX-2 inhibitors is unrelated to glioma risk. PMID:26871579

  15. The challenge of HIV prevention among high-risk adolescents.

    PubMed

    Sullivan, T R

    1996-02-01

    This article reports findings from an exploratory study of HIV knowledge and risk behaviors among 60 teenagers and young men engaged in the street life of Hollywood, California. The sample was composed largely of youths of homosexual or bisexual orientation who were substance abusers, prostitutes, or both. The data suggest that although community-based education efforts may be associated with lower-risk behavior among this population, the overall risk profiles of these socially marginalized youths remained high. Inferences are drawn about the cofactors of risk that must be addressed and the education needed to enhance the health prospects of these youths. PMID:8626159

  16. Factoring attitudes towards armed conflict risk into selection of protected areas for conservation.

    PubMed

    Hammill, E; Tulloch, A I T; Possingham, H P; Strange, N; Wilson, K A

    2016-01-01

    The high incidence of armed conflicts in biodiverse regions poses significant challenges in achieving international conservation targets. Because attitudes towards risk vary, we assessed different strategies for protected area planning that reflected alternative attitudes towards the risk of armed conflicts. We find that ignoring conflict risk will deliver the lowest return on investment. Opting to completely avoid conflict-prone areas offers limited improvements and could lead to species receiving no protection. Accounting for conflict by protecting additional areas to offset the impacts of armed conflicts would not only increase the return on investment (an effect that is enhanced when high-risk areas are excluded) but also increase upfront conservation costs. Our results also demonstrate that fine-scale estimations of conflict risk could enhance the cost-effectiveness of investments. We conclude that achieving biodiversity targets in volatile regions will require greater initial investment and benefit from fine-resolution estimates of conflict risk. PMID:27025894

  17. Factoring attitudes towards armed conflict risk into selection of protected areas for conservation

    PubMed Central

    Hammill, E.; Tulloch, A. I. T.; Possingham, H. P.; Strange, N.; Wilson, K. A.

    2016-01-01

    The high incidence of armed conflicts in biodiverse regions poses significant challenges in achieving international conservation targets. Because attitudes towards risk vary, we assessed different strategies for protected area planning that reflected alternative attitudes towards the risk of armed conflicts. We find that ignoring conflict risk will deliver the lowest return on investment. Opting to completely avoid conflict-prone areas offers limited improvements and could lead to species receiving no protection. Accounting for conflict by protecting additional areas to offset the impacts of armed conflicts would not only increase the return on investment (an effect that is enhanced when high-risk areas are excluded) but also increase upfront conservation costs. Our results also demonstrate that fine-scale estimations of conflict risk could enhance the cost-effectiveness of investments. We conclude that achieving biodiversity targets in volatile regions will require greater initial investment and benefit from fine-resolution estimates of conflict risk. PMID:27025894

  18. Brachytherapy boost and cancer-specific mortality in favorable high-risk versus other high-risk prostate cancer

    PubMed Central

    Muralidhar, Vinayak; Xiang, Michael; Orio, Peter F.; Martin, Neil E.; Beard, Clair J.; Feng, Felix Y.; Hoffman, Karen E.

    2016-01-01

    Purpose Recent retrospective data suggest that brachytherapy (BT) boost may confer a cancer-specific survival benefit in radiation-managed high-risk prostate cancer. We sought to determine whether this survival benefit would extend to the recently defined favorable high-risk subgroup of prostate cancer patients (T1c, Gleason 4 + 4 = 8, PSA < 10 ng/ml or T1c, Gleason 6, PSA > 20 ng/ml). Material and methods We identified 45,078 patients in the Surveillance, Epidemiology, and End Results database with cT1c-T3aN0M0 intermediate- to high-risk prostate cancer diagnosed 2004-2011 treated with external beam radiation therapy (EBRT) only or EBRT plus BT. We used multivariable competing risks regression to determine differences in the rate of prostate cancer-specific mortality (PCSM) after EBRT + BT or EBRT alone in patients with intermediate-risk, favorable high-risk, or other high-risk disease after adjusting for demographic and clinical factors. Results EBRT + BT was not associated with an improvement in 5-year PCSM compared to EBRT alone among patients with favorable high-risk disease (1.6% vs. 1.8%; adjusted hazard ratio [AHR]: 0.56; 95% confidence interval [CI]: 0.21-1.52, p = 0.258), and intermediate-risk disease (0.8% vs. 1.0%, AHR: 0.83, 95% CI: 0.59-1.16, p = 0.270). Others with high-risk disease had significantly lower 5-year PCSM when treated with EBRT + BT compared with EBRT alone (3.9% vs. 5.3%; AHR: 0.73; 95% CI: 0.55-0.95; p = 0.022). Conclusions Brachytherapy boost is associated with a decreased rate of PCSM in some men with high-risk prostate cancer but not among patients with favorable high-risk disease. Our results suggest that the recently-defined “favorable high-risk” category may be used to personalize therapy for men with high-risk disease. PMID:26985191

  19. Predicting the Unpredictable? Identifying High-Risk versus Low-Risk Parents with Intellectual Disabilities

    ERIC Educational Resources Information Center

    McGaw, Sue; Scully, Tamara; Pritchard, Colin

    2010-01-01

    Objectives: This study set out to identify risk factors affecting parents with intellectual disabilities (IDs) by determining: (i) whether perception of family support differs between parents with IDs, referring professionals, and a specialist parenting service; (ii) whether multivariate familial and demographic factors differentiates "high-risk"…

  20. Who Takes Risks in High-Risk Sports? A Typological Personality Approach

    ERIC Educational Resources Information Center

    Castanier, Carole; Le Scanff, Christine; Woodman, Tim

    2010-01-01

    We investigated the risk-taking behaviors of 302 men involved in high-risk sports (downhill skiing, mountaineering, rock climbing, paragliding, or skydiving). The sportsmen were classified using a typological approach to personality based on eight personality types, which were constructed from combinations of neuroticism, extraversion, and…

  1. Adolescents with high periodontal risk in Public Dental Service.

    PubMed

    Jansson, Leif; Adler, Lottie; Jonés, Catarina

    2013-01-01

    The purpose of the present study was to investigate the prevalence of adolescents with high periodontal risk and to identify factors with influence on the decision to refer a patient to a specialist clinic of Periodontology, on compliance rate and on treatment outcome. The investigation was conducted as a retrospective study on adolescents at age 13-17. In total, clinical examinations and risk evaluations according to caries- and periodontal risk were performed on 50347 adolescents in general dentistry at ages 13, 15 and 17 in 2007. Individuals with a high periodontal risk were included in the present investigation. A high periodontal risk was defined as presence of sites with periodontal pocket depths >6mm and loss of periodontal tissue support. Multiple logistic regression analyses were adopted to calculate the influence of the potential predictors on the investigated dependent variables. In total, 0.5% of the adolescents were found to have high periodontal risk. The diagnosis local periodontitis and the number of periodontal pockets with probing depths >6 mm were positively and significantly correlated to referral to a periodontist. Eighteen percent dropped out before the treatment was completed. Smokers had a significantly lower compliance than non-smokers. The success rate was significantly lower for individuals with many periodontal pockets and for those with the diagnosis local periodontitis. The prevalence of adolescents classified as having high periodontal risk was low. A large frequency of subjects dropped out before the periodontal treatment was completed, especially at the specialist clinics. PMID:24620506

  2. Identification of the high risk emergency surgical patient: Which risk prediction model should be used?

    PubMed Central

    Stonelake, Stephen; Thomson, Peter; Suggett, Nigel

    2015-01-01

    Introduction National guidance states that all patients having emergency surgery should have a mortality risk assessment calculated on admission so that the ‘high risk’ patient can receive the appropriate seniority and level of care. We aimed to assess if peri-operative risk scoring tools could accurately calculate mortality and morbidity risk. Methods Mortality risk scores for 86 consecutive emergency laparotomies, were calculated using pre-operative (ASA, Lee index) and post-operative (POSSUM, P-POSSUM and CR-POSSUM) risk calculation tools. Morbidity risk scores were calculated using the POSSUM predicted morbidity and compared against actual morbidity according to the Clavien–Dindo classification. Results The actual mortality was 10.5%. The average predicted risk scores for all laparotomies were: ASA 26.5%, Lee Index 2.5%, POSSUM 29.5%, P-POSSUM 18.5%, CR-POSSUM 10.5%. Complications occurred following 67 laparotomies (78%). The majority (51%) of complications were classified as Clavien–Dindo grade 2–3 (non-life-threatening). Patients having a POSSUM morbidity risk of greater than 50% developed significantly more life-threatening complications (CD 4–5) compared with those who predicted less than or equal to 50% morbidity risk (P = 0.01). Discussion Pre-operative risk stratification remains a challenge because the Lee Index under-predicts and ASA over-predicts mortality risk. Post-operative risk scoring using the CR-POSSUM is more accurate and we suggest can be used to identify patients who require intensive care post-operatively. Conclusions In the absence of accurate risk scoring tools that can be used on admission to hospital it is not possible to reliably audit the achievement of national standards of care for the ‘high-risk’ patient. PMID:26468369

  3. Treating Patients with High-Risk Smoldering Myeloma

    Cancer.gov

    In this phase III clinical trial, patients with smoldering myeloma classified as high risk for progression will be randomly assigned to undergo standard observation or six 4-week courses of treatment with the drug lenalidomide.

  4. Assessment of high cardiovascular risk profiles for the clinician.

    PubMed

    Whayne, Thomas F

    2013-07-01

    Diabetes mellitus (DM) is a major cardiovascular (CV) risk factor. General Framingham Risk Profile (GFRP) and World Health Organization/International Society of Hypertension (WHO/ISH) charts were used to assess CV risk in DM in Oman. The GFRP identified more patients with medium-risk DM; GFRP and WHO/ISH identified essentially equal numbers at very high risk. These were then used to evaluate statin usage in Oman, including economics. Google lists innumerable tools from organizations, hospitals, practitioners, magazines, societies, clinics, and medical associations. The GFRP and WHO/ISH calculations provided useful DM assessment of populations in Oman. Other major risk models are Adult Treatment Panel III, based on Framingham, and Reynolds Risk Score; the latter incorporates other factors such as family history, high-sensitivity C-reactive protein, and hemoglobin A(1c) (in DM). These models are useful in assessing specific populations. Individual practitioners with limited time may just evaluate patients as low, medium, and high CV risk based on general knowledge and then treat. PMID:23299171

  5. Learning Disability Characteristics of High Risk Freshmen.

    ERIC Educational Resources Information Center

    Dikitanan, Rosefren C.

    Noting that the existence of learning disabilities after high school is considered problematical, a study determined the presence of learning disabilities among freshmen at Kean College of New Jersey and whether a specific set of learning characteristics exist which interfere with the successful completion of the college curricula. Subjects, 404…

  6. Factors Influencing Cancer Risk Perception in High Risk Populations: A Systematic Review

    PubMed Central

    2011-01-01

    Background Patients at higher than average risk of heritable cancer may process risk information differently than the general population. However, little is known about clinical, demographic, or psychosocial predictors that may impact risk perception in these groups. The objective of this study was to characterize factors associated with perceived risk of developing cancer in groups at high risk for cancer based on genetics or family history. Methods We searched Ovid MEDLINE, Ovid Embase, Ovid PsycInfo, and Scopus from inception through April 2009 for English-language, original investigations in humans using core concepts of "risk" and "cancer." We abstracted key information and then further restricted articles dealing with perceived risk of developing cancer due to inherited risk. Results Of 1028 titles identified, 53 articles met our criteria. Most (92%) used an observational design and focused on women (70%) with a family history of or contemplating genetic testing for breast cancer. Of the 53 studies, 36 focused on patients who had not had genetic testing for cancer risk, 17 included studies of patients who had undergone genetic testing for cancer risk. Family history of cancer, previous prophylactic tests and treatments, and younger age were associated with cancer risk perception. In addition, beliefs about the preventability and severity of cancer, personality factors such as "monitoring" personality, the ability to process numerical information, as well as distress/worry also were associated with cancer risk perception. Few studies addressed non-breast cancer or risk perception in specific demographic groups (e.g. elderly or minority groups) and few employed theory-driven analytic strategies to decipher interrelationships of factors. Conclusions Several factors influence cancer risk perception in patients at elevated risk for cancer. The science of characterizing and improving risk perception in cancer for high risk groups, although evolving, is still

  7. High risk groups in an oil shale workforce

    SciTech Connect

    Gratt, L.B.; Marine, W.M.; Perry, B.W.; Savitz, D.A.

    1984-04-01

    The workforce risks of a hypothetical one million barrels-per-day oil shale industry were estimated. The risks for the different workforce segments were compared and high risk groups were identified. Accidents and injuries were statistically described by rates for fatalities, for accidents with days lost from work, and for accidents with no days lost from work. Workforce diseases analyzed were cancers, silicosis, pneumoconiosis, chronic bronchitis, chronic airway obstruction, and high frequency hearing loss. A comparison of the workforce groups under different risk measures (occurrence, fatality, and life-loss expectancy) was performed. The miners represented the group with the largest fatality and the most serious accident rate, although the estimated rates were below the average industry-wide underground mining experience. Lung disease from inhalation exposure of about the nuisance dust threshold limit value presents a significant risk for future concerns.

  8. In Utero Exposure to Selective Serotonin Reuptake Inhibitors and Risk for Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Gidaya, Nicole B.; Lee, Brian K.; Burstyn, Igor; Yudell, Michael; Mortensen, Erik L.; Newschaffer, Craig J.

    2014-01-01

    We investigated whether there is an association between increased risk for autism spectrum disorders (ASD) and selective serotonin reuptake inhibitors (SSRIs) used during pregnancy. This study used Denmark's health and population registers to obtain information regarding prescription drugs, ASD diagnosis, and health and socioeconomic status.…

  9. 9 CFR 121.10 - Restricting access to select agents and toxins; security risk assessments.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Restricting access to select agents and toxins; security risk assessments. 121.10 Section 121.10 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE VIRUSES, SERUMS, TOXINS, AND ANALOGOUS PRODUCTS; ORGANISMS AND VECTORS POSSESSION, USE,...

  10. 9 CFR 121.10 - Restricting access to select agents and toxins; security risk assessments.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Restricting access to select agents and toxins; security risk assessments. 121.10 Section 121.10 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE VIRUSES, SERUMS, TOXINS, AND ANALOGOUS PRODUCTS; ORGANISMS AND VECTORS POSSESSION, USE,...

  11. High-risk corneal allografts: A therapeutic challenge.

    PubMed

    Yu, Tian; Rajendran, Vijayalakshmi; Griffith, May; Forrester, John V; Kuffová, Lucia

    2016-03-24

    Corneal transplantation is the most common surgical procedure amongst solid organ transplants with a high survival rate of 86% at 1-year post-grafting. This high success rate has been attributed to the immune privilege of the eye. However, mechanisms originally thought to promote immune privilege, such as the lack of antigen presenting cells and vessels in the cornea, are challenged by recent studies. Nevertheless, the immunological and physiological features of the cornea promoting a relatively weak alloimmune response is likely responsible for the high survival rate in "low-risk" settings. Furthermore, although corneal graft survival in "low-risk" recipients is favourable, the prognosis in "high-risk" recipients for corneal graft is poor. In "high-risk" grafts, the process of indirect allorecognition is accelerated by the enhanced innate and adaptive immune responses due to pre-existing inflammation and neovascularization of the host bed. This leads to the irreversible rejection of the allograft and ultimately graft failure. Many therapeutic measures are being tested in pre-clinical and clinical studies to counter the immunological challenge of "high-risk" recipients. Despite the prevailing dogma, recent data suggest that tissue matching together with use of systemic immunosuppression may increase the likelihood of graft acceptance in "high-risk" recipients. However, immunosuppressive drugs are accompanied with intolerance/side effects and toxicity, and therefore, novel cell-based therapies are in development which target host immune cells and restore immune homeostasis without significant side effect of treatment. In addition, developments in regenerative medicine may be able to solve both important short comings of allotransplantation: (1) graft rejection and ultimate graft failure; and (2) the lack of suitable donor corneas. The advances in technology and research indicate that wider therapeutic choices for patients may be available to address the worldwide

  12. Comparison of risk assessment strategies for not-high-risk pulmonary embolism.

    PubMed

    Hobohm, Lukas; Hellenkamp, Kristian; Hasenfuß, Gerd; Münzel, Thomas; Konstantinides, Stavros; Lankeit, Mareike

    2016-04-01

    We compared the prognostic performance of the 2014 European Society of Cardiology (ESC) risk stratification algorithm with the previous 2008 ESC algorithm, the Bova score and the modified FAST score (based on a positive heart-type fatty acid-binding protein (H-FABP) test, syncope and tachycardia, modified using high-sensitivity troponin T instead of H-FABP) in 388 normotensive pulmonary embolism patients included in a single-centre cohort study.Overall, 25 patients (6.4%) had an adverse 30-day outcome. Regardless of the score or algorithm used, the rate of an adverse outcome was highest in the intermediate-high-risk classes, while all patients classified as low-risk had a favourable outcome (no pulmonary embolism-related deaths, 0-1.4% adverse outcome). The area under the curve for predicting an adverse outcome was higher for the 2014 ESC algorithm (0.76, 95% CI 0.68-0.84) compared with the 2008 ESC algorithm (0.65, 95% CI 0.56-0.73) and highest for the modified FAST score (0.82, 95% CI 0.75-0.89). Patients classified as intermediate-high-risk by the 2014 ESC algorithm had a 8.9-fold increased risk for an adverse outcome (3.2-24.2, p<0.001 compared with intermediate-low- and low-risk patients), while the highest OR was observed for a modified FAST score ≥3 points (OR 15.9, 95% CI 5.3-47.6, p<0.001).The 2014 ESC algorithm improves risk stratification of not-high-risk pulmonary embolism compared with the 2008 ESC algorithm. All scores and algorithms accurately identified low-risk patients, while the modified FAST score appears more suitable to identify intermediate-high-risk patients. PMID:26743479

  13. Automating Risk Assessments of Hazardous Material Shipments for Transportation Routes and Mode Selection

    SciTech Connect

    Barbara H. Dolphin; William D. RIchins; Stephen R. Novascone

    2010-10-01

    The METEOR project at Idaho National Laboratory (INL) successfully addresses the difficult problem in risk assessment analyses of combining the results from bounding deterministic simulation results with probabilistic (Monte Carlo) risk assessment techniques. This paper describes a software suite designed to perform sensitivity and cost/benefit analyses on selected transportation routes and vehicles to minimize risk associated with the shipment of hazardous materials. METEOR uses Monte Carlo techniques to estimate the probability of an accidental release of a hazardous substance along a proposed transportation route. A METEOR user selects the mode of transportation, origin and destination points, and charts the route using interactive graphics. Inputs to METEOR (many selections built in) include crash rates for the specific aircraft, soil/rock type and population densities over the proposed route, and bounding limits for potential accident types (velocity, temperature, etc.). New vehicle, materials, and location data are added when available. If the risk estimates are unacceptable, the risks associated with alternate transportation modes or routes can be quickly evaluated and compared. Systematic optimizing methods will provide the user with the route and vehicle selection identified with the lowest risk of hazardous material release. The effects of a selected range of potential accidents such as vehicle impact, fire, fuel explosions, excessive containment pressure, flooding, etc. are evaluated primarily using hydrocodes capable of accurately simulating the material response of critical containment components. Bounding conditions that represent credible accidents (i.e; for an impact event, velocity, orientations, and soil conditions) are used as input parameters to the hydrocode models yielding correlation functions relating accident parameters to component damage. The Monte Carlo algorithms use random number generators to make selections at the various decision

  14. Subtractive Cell-SELEX Selection of DNA Aptamers Binding Specifically and Selectively to Hepatocellular Carcinoma Cells with High Metastatic Potential

    PubMed Central

    Chen, Hao; Yuan, Chun-Hui; Yang, Yi-Fei; Yin, Chang-Qing; Guan, Qing; Wang, Fu-Bing; Tu, Jian-Cheng

    2016-01-01

    Relapse and metastasis are two key risk factors of hepatocellular carcinoma (HCC) prognosis; thus, it is emergent to develop an early and accurate detection method for prognostic evaluation of HCC after surgery. In this study, we sought to acquire oligonucleotide DNA aptamers that specifically bind to HCC cells with high metastatic potential. Two HCC cell lines derived from the same genetic background but with different metastatic potential were employed: MHCC97L (low metastatic properties) as subtractive targets and HCCLM9 (high metastatic properties) as screening targets. To mimic a fluid combining environment, initial DNA aptamers library was firstly labelled with magnetic nanoparticles using biotin-streptavidin system and then applied for aptamers selection. Through 10-round selection with subtractive Cell-SELEX, six aptamers, LY-1, LY-13, LY-46, LY-32, LY-27/45, and LY-7/43, display high affinity to HCCLM9 cells and do not bind to MHCC97L cells, as well as other tumor cell lines, including breast cancer, lung cancer, colon adenocarcinoma, gastric cancer, and cervical cancer, suggesting high specificity for HCCLM9 cells. Thus, the aptamers generated here will provide solid basis for identifying new diagnostic targets to detect HCC metastasis and also may provide valuable clues for developing new targeted therapeutics. PMID:27119081

  15. Outcomes of parental investment in high-risk children.

    PubMed

    Bugental, Daphne Blunt; Corpuz, Randy; Samec, Rachel

    2013-09-01

    This study assesses the combined effects of children's early medical risk (e.g., preterm status) and parental investment levels (time spent in provision of care to target children as opposed to other family members) on children's response to novel, potentially distressing stimuli. While engaged in play activities, children were exposed to stimuli that were either neutral (a speaker on television with a calm voice) or threatening (a speaker with an angry voice). A significant interaction between children's risk status and parental investment was found only for threatening stimuli. High-risk children with high-investing parents showed high visual engagement with potentially threatening responses, whereas high-risk children with low-investing parents were more likely to show visual avoidance. No comparable effects were found for low-risk children. Findings were interpreted as showing that high-risk children with a history of high parental investment are more likely to attend to potentially threatening events, an adaptive response in the presence of reliable support. PMID:23465334

  16. [Secondary prevention of osteoporosis and identification of high risk patients].

    PubMed

    Lehmann, R; Pfeifer, M; Minne, H; Allolio, B

    2000-08-01

    Low bone mass is a major determinant of bone fragility. With respect to hip fracture risk however, there is limited contribution of BMD to the exponential age-related increase in hip fracture incidence. Large prospective studies have identified a number of additional risk factors for hip fractures independent of bone density. These can be classified as skeletal factors and fall-related factors. Body height and hip axis length are positively correlated with fracture risk. Neuromuscular impairment with low gait speed, difficulty in doing a tandem walk, lower limb dysfunction, body sway or inability to rise from a chair without using one's arms predict future fracture risk. According to the concept of evidence-based medicine (EBM) preventive strategies are now available. Supplementation with calcium and vitamin D restores bone quality through suppression of secondary hyperparathyroidism and decreases the risk of falling through improvement of neuromuscular co-ordination and body sway. Treatment with the bisphosphonates alendronate and risedronate increase bone strength and result in a significant reduction of vertebral as well as non-vertebral fractures. Hip protectors absorb energy during a fall and reduce hip fracture risk by 56%. Risk factor based patient selection may improve the cost-effectiveness of therapy. PMID:10996933

  17. Selecting Reading Materials for High School Students. ERIC Research Summary.

    ERIC Educational Resources Information Center

    Smith, Carl B., Ed.

    This topical bibliography and commentary discusses resource aids that help educators evaluate and select high quality reading materials for young adults. It discusses general resource articles as aids. Examples are: specific themes, booklists, and school system aids. It concludes that there are no succinct lists of criteria or resources; rather,…

  18. Activities Selected from the High School Geography Project.

    ERIC Educational Resources Information Center

    Natoli, Salvatore J., Ed.; And Others

    Out of approximately 50 activities which were, for a variety of reasons, not included in the final version of the High School Geography Project course, Geography in an Urban Age, the HSGP staff selected eight which would be useful in many secondary school classrooms. The activities included here are: 1) Operation Bigger Beef (on themes of cultural…

  19. High-flow frequencies for selected streams in Oklahoma

    USGS Publications Warehouse

    Huntzinger, Thomas L.

    1978-01-01

    Streamflow records are analyzed statistically to determine high-flow characteristics of selected streams in Oklahoma. Tables are included which show the 2-, 5-, 10-, 25-, 50-, and 100-year high-flow frequencies for durations of 1, 3, 7, 30, 90, and 365 days. The log-Pearson Type III frequency distribution was used in the computations. Streamflow records used include data extending from 1903 to 1974.

  20. Improved results in high risk cadaveric kidney transplantation

    SciTech Connect

    Toledo-Pereyra, L.H.; Baskin, S.; McNichol, L.; Edford, G.; Whitten, J.; Allaben, R.

    1980-01-01

    In general, cadaver kidney transplantation survival remains at 40-50% for the first year after transplantation. To compare the beneficial effect of a new immunosuppressive protocol to standard therapy (azathioprine and prednisone), we have studied 30 high risk first cadaveric renal allograft recipients who were randomly selected before (Group A, n.15) and after (Group B, n.15) 10/79. At 12 mos, actuarial graft survival of Group B is 75% compared to 46% in Group A. Actuarial patient survival for Group B is 94% for one year compared to 60% in Group A. We feel that these improved results are related to basic changes in our immunosuppressive protocol. These changes consist of: 1. Low doses of azathioprine and prednisolone (less than 1 mg/kg) with rapid reduction to very low levels (less than 0.3 mg/kg); 2. ALG administration at 30 mg/kg/day for 14 times; 3. Rapid placement (one month) on alternate day steroid therapy; 4. Elimination of steroids for the treatment of rejection; 5. Use of ALG (20 mg/kg/day for 10 days) for the treatment of rejection; 6. Use of ALG combined with modified lymph node irradiation for third rejection episodes; and 7. Long-term intermittent ALG administration provided that kidney function continues to be normal. The best immunosuppressive protocol is clearly the one associated with less morbidity and improved quality of life after transplantation. Our current protocol (Group B) provides the best results.

  1. Pharmacological Management of High-risk Neuroblastoma in Children

    PubMed Central

    Ganeshan, Veena R.; Schor, Nina F.

    2015-01-01

    BACKGROUND Neuroblastoma is the most common extracranial solid tumor of childhood. It accounts for 15% of pediatric cancer deaths. Children with high-risk disease have a 3-year event-free survival rate of only 20%. Chemotherapy is the mainstay of the treatment of children with advanced neuroblastoma. OBJECTIVE To review and critically evaluate the pharmacotherapy of neuroblastoma. DATA SOURCES Peer-reviewed and review literature, 2000–2011. STUDY SELECTION All peer-reviewed, published human subjects studies of therapy for neuroblastoma in children were included. Animal model and in vitro studies were included only if they added to the understanding of the mechanism of a proposed or existing human neuroblastoma therapy. DATA SYNTHESIS Current therapeutic options for neuroblastoma involve insufficient differentiation of normal from neoplastic tissue. Critically needed new approaches will increasingly exploit targeting of therapy for unique characteristics of the neuroblastoma cell. CONCLUSIONS Pharmacotherapy for neuroblastoma still suffers from an inadequate therapeutic window. Enhancement of toxicity for tumor and safety for normal tissues will entail innovation in targeting neuroblastoma cells and rescuing or protecting normal tissue elements. PMID:21692548

  2. Disease Risk Assessments Involving Companion Animals: an Overview for 15 Selected Pathogens Taking a European Perspective.

    PubMed

    Rijks, J M; Cito, F; Cunningham, A A; Rantsios, A T; Giovannini, A

    2016-07-01

    Prioritization of companion animal transmissible diseases was performed by the Companion Animals multisectoriaL interprofessionaL Interdisciplinary Strategic Think tank On zoonoses (CALLISTO) project. The project considered diseases occurring in domesticated species commonly kept as pets, such as dogs and cats, but also included diseases occurring in captive wild animals and production animal species. The prioritization process led to the selection of 15 diseases of prime public health relevance, agricultural economic importance, or both. An analysis was made of the current knowledge on the risk of occurrence and transmission of these diseases among companion animals, and from companion animals to man (zoonoses) or to livestock. The literature was scanned for risk assessments for these diseases. Studies were classified as import risk assessments (IRAs) or risk factor analyses (RFAs) in endemic areas. For those pathogens that are absent from Europe, only IRAs were considered; for pathogens present throughout Europe, only RFAs were considered. IRAs were identified for seven of the eight diseases totally or partially absent from Europe. IRAs for classical rabies and alveolar echinococcosis found an increased risk for introduction of the pathogen into officially disease-free areas as a consequence of abandoning national rules and adopting the harmonized EU rules for pet travel. IRAs for leishmaniosis focused on risk associated with the presence of persistently infected dogs in new geographical areas, taking into consideration the risk of disease establishment should a competent vector arise. IRAs for Crimean-Congo haemorrhagic fever and West Nile fever indicated that the likelihood of introduction via companion animals was low. IRAs for bluetongue paid no attention to the risk of introduction via companion animals, which was also the case for IRAs for foot-and-mouth disease, the only disease considered to be absent from Europe. RFAs dealing with the risk factors for

  3. A study of Minnesota's high-risk health insurance pool.

    PubMed

    Zellner, B B; Haugen, D K; Dowd, B

    1993-01-01

    This is a report of a study of Minnesota's high-risk health insurance pool for "medically uninsurable" persons. The study consisted of a survey of current and past enrollees carried out in the Spring of 1990 and an analysis of the claims and membership files for 1988 and 1989. The main policy conclusion we reached is that Minnesota's high-risk pool is an adequate approach to the problem raised by risk segmentation on the basis of health status, providing that enrollment remains a small fraction of the population. The recent high, enrollment growth rates the Minnesota risk pool has experienced raise the possibility that basic structural reforms of the nongroup and small-group health insurance markets are needed. PMID:8314605

  4. High risk cohort study for psychiatric disorders in childhood: rationale, design, methods and preliminary results.

    PubMed

    Salum, Giovanni Abrahão; Gadelha, Ary; Pan, Pedro Mario; Moriyama, Tais Silveira; Graeff-Martins, Ana Soledade; Tamanaha, Ana Carina; Alvarenga, Pedro; Valle Krieger, Fernanda; Fleitlich-Bilyk, Bacy; Jackowski, Andrea; Sato, João Ricardo; Brietzke, Elisa; Polanczyk, Guilherme Vanoni; Brentani, Helena; de Jesus Mari, Jair; Do Rosário, Maria Conceição; Manfro, Gisele Gus; Bressan, Rodrigo Affonseca; Mercadante, Marcos Tomanik; Miguel, Eurípedes Constantino; Rohde, Luis Augusto

    2015-03-01

    The objective of this study is to present the rationale, methods, design and preliminary results from the High Risk Cohort Study for the Development of Childhood Psychiatric Disorders. We describe the sample selection and the components of each phases of the study, its instruments, tasks and procedures. Preliminary results are limited to the baseline phase and encompass: (i) the efficacy of the oversampling procedure used to increase the frequency of both child and family psychopathology; (ii) interrater reliability and (iii) the role of differential participation rate. A total of 9937 children from 57 schools participated in the screening procedures. From those 2512 (random = 958; high risk = 1554) were further evaluated with diagnostic instruments. The prevalence of any child mental disorder in the random strata and high-risk strata was 19.9% and 29.7%. The oversampling procedure was successful in selecting a sample with higher family rates of any mental disorders according to diagnostic instruments. Interrater reliability (kappa) for the main diagnostic instrument range from 0.72 (hyperkinetic disorders) to 0.84 (emotional disorders). The screening instrument was successful in selecting a sub-sample with "high risk" for developing mental disorders. This study may help advance the field of child psychiatry and ultimately provide useful clinical information. PMID:25469819

  5. Quantitative selection of DNA aptamers through microfluidic selection and high-throughput sequencing

    PubMed Central

    Cho, Minseon; Xiao, Yi; Nie, Jeff; Stewart, Ron; Csordas, Andrew T.; Oh, Seung Soo; Thomson, James A.; Soh, H. Tom

    2010-01-01

    We describe the integration of microfluidic selection with high-throughput DNA sequencing technology for rapid and efficient discovery of nucleic acid aptamers. The Quantitative Selection of Aptamers through Sequencing method tracks the copy number and enrichment-fold of more than 10 million individual sequences through multiple selection rounds, enabling the identification of high-affinity aptamers without the need for the pool to fully converge to a small number of sequences. Importantly, this method allows the discrimination of sequences that arise from experimental biases rather than true high-affinity target binding. As a demonstration, we have identified aptamers that specifically bind to PDGF-BB protein with Kd < 3 nM within 3 rounds. Furthermore, we show that the aptamers identified by Quantitative Selection of Aptamers through Sequencing have ∼3–8-fold higher affinity and ∼2–4-fold higher specificity relative to those discovered through conventional cloning methods. Given that many biocombinatorial libraries are encoded with nucleic acids, we extrapolate that our method may be extended to other types of libraries for a range of molecular functions. PMID:20705898

  6. Effects of surface diffusion on high temperature selective emitters.

    PubMed

    Peykov, Daniel; Yeng, Yi Xiang; Celanovic, Ivan; Joannopoulos, John D; Schuh, Christopher A

    2015-04-20

    Using morphological and optical simulations of 1D tantalum photonic crystals at 1200K, surface diffusion was determined to gradually reduce the efficiency of selective emitters. This was attributed to shifting resonance peaks and declining emissivity caused by changes to the cavity dimensions and the aperture width. Decreasing the structure's curvature through larger periods and smaller cavity widths, as well as generating smoother transitions in curvature through the introduction of rounded cavities, was found to alleviate this degradation. An optimized structure, that shows both high efficiency selective emissivity and resistance to surface diffusion, was presented. PMID:25969039

  7. Development and Testing of High-Temperature Solar Selective Coatings

    SciTech Connect

    Kennedy, C.; Price, H.

    2005-01-01

    The Solar Energy Technologies Program is working to reduce the cost of parabolic trough solar power technology. System studies show that increasing the operating temperature of the solar field from 390 to >450 C will result in improved performance and cost reductions. This requires the development of new more-efficient selective coatings that have both high solar absorptance (>0.96) and low thermal emittance (<0.07) and are thermally stable above 450 C, ideally in air. Potential selective coatings were modeled, identified for laboratory prototyping, and manufactured at NREL. Optimization of the samples and high-temperature durability testing will be performed. Development of spectrally selective materials depends on reliable characterization of their optical properties. Protocols for testing the thermal/optical properties of selective coatings were developed and a round-robin experiment was conducted to verify and document the reflectance and high-temperature emittance measurements. The development, performance, and durability of these materials and future work will be described.

  8. Selective changes of resting-state networks in individuals at risk for Alzheimer's disease

    PubMed Central

    Sorg, Christian; Riedl, Valentin; Mühlau, Mark; Calhoun, Vince D.; Eichele, Tom; Läer, Leonhard; Drzezga, Alexander; Förstl, Hans; Kurz, Alexander; Zimmer, Claus; Wohlschläger, Afra M.

    2007-01-01

    Alzheimer's disease (AD) is a neurodegenerative disorder that prominently affects cerebral connectivity. Assessing the functional connectivity at rest, recent functional MRI (fMRI) studies reported on the existence of resting-state networks (RSNs). RSNs are characterized by spatially coherent, spontaneous fluctuations in the blood oxygen level-dependent signal and are made up of regional patterns commonly involved in functions such as sensory, attention, or default mode processing. In AD, the default mode network (DMN) is affected by reduced functional connectivity and atrophy. In this work, we analyzed functional and structural MRI data from healthy elderly (n = 16) and patients with amnestic mild cognitive impairment (aMCI) (n = 24), a syndrome of high risk for developing AD. Two questions were addressed: (i) Are any RSNs altered in aMCI? (ii) Do changes in functional connectivity relate to possible structural changes? Independent component analysis of resting-state fMRI data identified eight spatially consistent RSNs. Only selected areas of the DMN and the executive attention network demonstrated reduced network-related activity in the patient group. Voxel-based morphometry revealed atrophy in both medial temporal lobes (MTL) of the patients. The functional connectivity between both hippocampi in the MTLs and the posterior cingulate of the DMN was present in healthy controls but absent in patients. We conclude that in individuals at risk for AD, a specific subset of RSNs is altered, likely representing effects of ongoing early neurodegeneration. We interpret our finding as a proof of principle, demonstrating that functional brain disorders can be characterized by functional-disconnectivity profiles of RSNs. PMID:18003904

  9. Predicting high-risk versus higher-risk substance use during late adolescence from early adolescent risk factors using Latent Class Analysis

    PubMed Central

    Lamont, Andrea E.; Woodlief, Darren; Malone, Patrick S.

    2013-01-01

    Much of the existing risk factor literature focuses on identifying predictors of low-levels of substance use versus higher-levels of substance use. In this paper, we explore more nuanced patterns of alcohol, tobacco, and other drug (ATOD) use during late adolescence. Our aims were to: 1) identify subgroups of youth with qualitatively different patterns of ATOD use; and 2) explore whether membership among qualitatively distinct, high-risk classes could be predicted based on early adolescent risk factors. Data came from a selected subsample of the National Longitudinal Survey of Youth (n = 1,689). Predictors were measured when youth were about 12 years old; ATOD use was assessed when youth were aged 17 years. Results showed that adolescent ATOD use is not a homogenous behavior. Four distinct classes of adolescent ATOD users were derived. Each class had a qualitatively distinct and discriminable pattern of ATOD use. Ecological predictors were shown to differentiate between latent classes, with peer factors playing a particularly important role in differentiating between high-risk and higher-risk users. Implications for prevention and limitations are discussed. PMID:24511308

  10. ULTRASENSITIVE HIGH-TEMPERATURE SELECTIVE GAS DETECTION USING PIEZOELECTRIC MICROCANTILEVERS

    SciTech Connect

    Wan Y. Shih; Tejas Patil; Qiang Zhao; Yi-Shi Chiu; Wei-Heng Shih

    2004-03-05

    We have obtained very promising results in the Phase I study. Specifically, for temperature effects, we have established that piezoelectric cantilever sensors could retain their resonance peak strength at high temperatures, i.e., the Q values of the resonance peaks remained above 10 even when the temperature was very close to the Curie temperature. This confirms that a piezoelectric cantilever sensor can be used as a sensor up to its Curie temperature. Furthermore, we have shown that the mass detection sensitivity remained unchanged at different temperatures. For selective gas detection, we have demonstrated selective NH{sub 3} detection using piezoelectric cantilever sensors coated with mesoporous SiO{sub 2}. For high-temperature sensor materials development, we have achieved highly oriented Sr-doped lead titanate thin films that possessed superior dielectric and ferroelectric properties. Such highly oriented films can be microfabricated into high-performance piezoelectric microcantilever sensors that can be used up to 490 C. We have accomplished the goal of Phase I study in exploring the various aspects of a high-temperature gas sensor. We propose to continue the study in Phase II to develop a sensor that is suitable for high-temperature applications using piezoelectrics with a high Curie temperature and by controlling the effects of temperature. The lead titanate based thin film developed in Phase I is good for applications up to 490 C. In phase II, we will develop lithium niobate thin film based cantilevers for applications up to 1000 C.

  11. Prospective study of surveillance testing for metastasis in 100 high-risk uveal melanoma patients.

    PubMed

    Piperno-Neumann, S; Servois, V; Mariani, P; Plancher, C; Lévy-Gabriel, C; Lumbroso-Le Rouic, L; Couturier, J; Asselain, B; Desjardins, L; Cassoux, N

    2015-06-01

    Despite advances in the local treatment of UM, half of patients develop metastases typically to the liver with poor survival. Microscopic complete surgical resection (R0) of liver metastases improves survival in high selected patients. Early identification of high-risk patients might allow detection of asymptomatic metastases, and increase R0 liver surgery rate. From October 2006 to December 2009, we conducted a prospective study to detect early minimal lesions with 6-monthly liver function tests (LFTs) and liver MRI in 100 high-risk patients. High risk was defined by primary tumor clinical or genomic criteria: thickness>8mm or diameter>15 mm, or extra-scleral extension, or monosomy 3 by FISH or aCGH. With a median follow-up of 49 months, the 5-year metastasis-free survival and overall survival were 47 and 33%, respectively. Of the 60 patients who became metastatic, 50 (83%) had exclusive liver metastasis. LFTs screening had no sufficient accurary, but biannual MRI showed high predictive value to detect metastasis and select patients eligible for curative surgery: 25/50 underwent laparotomy and among them, 8/25 (32%) had a R0 surgery. Median survival after metastasis was 14 months, mean survival reached 40 months in the R0 resected population. Six-monthly liver MRI screening is recommended in patients with large tumors or genomic high risk in order to detect early patient candidates to complete resection of liver metastases. PMID:25978872

  12. Multivariate prediction of emerging psychosis in adolescents at high risk for schizophrenia

    PubMed Central

    Shah, Jai; Eack, Shaun M; Montrose, Debra M; Tandon, Neeraj; Miewald, Jean M; Prasad, Konsale M; Keshavan, Matcheri S

    2012-01-01

    Background Accurate prediction of psychosis development in high-risk populations is an important but thus far elusive goal. Of the many diverse etiologic and risk factors identified thus far, few have been combined into prospective risk ascertainment models. We tested the predictive power of familial, neurobiological, socioenvironmental, cognitive and clinical risk factors through an integrative biopsychosocial model for emerging psychosis in young relatives at familial risk for schizophrenia. Methods 96 young first- and second- degree relatives of schizophrenia probands were followed for an average of 2.38 (SD = 0.98) years to examine their trajectory towards psychosis. Iterative structural equation modelling utilizing multiple etiologic and risk factors was employed to estimate their joint contribution to prediction of psychosis development. Results The rate of conversion to psychosis over the study period was 12.5%. In the final model, clinical measures of schizotypy were directly predictive of conversion, with early (familial, biological, socioenvironmental) and cognitive risk factors indirectly predictive of psychosis through increased baseline clinical symptomatology. Our model provided an excellent fit to the observed data, with sensitivity of 0.17, specificity of 0.99, positive predictive value of 0.67 and negative predictive value of 0.89. Conclusions Integrative modeling of multivariate data from familial, neurobiological, socioenvironmental, cognitive and clinical domains represents a powerful approach to prediction of psychosis development. The high specificity and low sensitivity found using a combination of such variables suggests that their utility may be in confirmatory testing among already selected high-risk individuals, rather than for initial screening. These findings also highlight the importance of data from a broad array of etiologic and risk factors, even within a familial high-risk population. With further refinement and validation, such

  13. Global transcription network incorporating distal regulator binding reveals selective cooperation of cancer drivers and risk genes

    PubMed Central

    Kim, Kwoneel; Yang, Woojin; Lee, Kang Seon; Bang, Hyoeun; Jang, Kiwon; Kim, Sang Cheol; Yang, Jin Ok; Park, Seongjin; Park, Kiejung; Choi, Jung Kyoon

    2015-01-01

    Global network modeling of distal regulatory interactions is essential in understanding the overall architecture of gene expression programs. Here, we developed a Bayesian probabilistic model and computational method for global causal network construction with breast cancer as a model. Whereas physical regulator binding was well supported by gene expression causality in general, distal elements in intragenic regions or loci distant from the target gene exhibited particularly strong functional effects. Modeling the action of long-range enhancers was critical in recovering true biological interactions with increased coverage and specificity overall and unraveling regulatory complexity underlying tumor subclasses and drug responses in particular. Transcriptional cancer drivers and risk genes were discovered based on the network analysis of somatic and genetic cancer-related DNA variants. Notably, we observed that the risk genes were functionally downstream of the cancer drivers and were selectively susceptible to network perturbation by tumorigenic changes in their upstream drivers. Furthermore, cancer risk alleles tended to increase the susceptibility of the transcription of their associated genes. These findings suggest that transcriptional cancer drivers selectively induce a combinatorial misregulation of downstream risk genes, and that genetic risk factors, mostly residing in distal regulatory regions, increase transcriptional susceptibility to upstream cancer-driving somatic changes. PMID:26001967

  14. A risk index for multicriterial selection of a logging system with low environmental impact

    SciTech Connect

    Horodnic, Sergiu Andrei

    2015-02-15

    Setting up the working stages in forest operations is conditioned by environmental protection and forest health requirements. This paper exposes a method for improving the decision-making process by choosing the most environmentally effective logging systems according to terrain configuration and stand characteristics. Such a methodology for selecting machines or logging systems accounting for environment, safety as well as economics, becomes mandatory in the context of sustainable management of forest with multiple functions. Based on analytic hierarchy process analysis the following classification of the environmental performance for four considered alternatives was obtained: skyline system (42.43%), forwarder system (20.22%), skidder system (19.92%) and horse logging system (17.43%). Further, an environmental risk matrix for the most important 28 risk factors specific to any work equipment used in forest operations was produced. In the end, a multicriterial analysis generated a risk index RI ranging between 1.0 and 3.5, which could help choosing the optimal combination of logging system and logging equipment with low environmental impact. In order to demonstrate the usefulness of the proposed approach, a simple application in specific conditions of a harvesting site is presented. - Highlights: • We propose a decision-making algorithm to select eco-friendly logging systems. • Analytic hierarchy process was applied for ranking 4 types of logging systems. • An environmental risk matrix with 28 risk factors in forest operations was made up.

  15. Bone Mineral Density and Fracture Risk Assessment to Optimize Prosthesis Selection in Total Hip Replacement.

    PubMed

    Pétursson, Þröstur; Edmunds, Kyle Joseph; Gíslason, Magnús Kjartan; Magnússon, Benedikt; Magnúsdóttir, Gígja; Halldórsson, Grétar; Jónsson, Halldór; Gargiulo, Paolo

    2015-01-01

    The variability in patient outcome and propensity for surgical complications in total hip replacement (THR) necessitates the development of a comprehensive, quantitative methodology for prescribing the optimal type of prosthetic stem: cemented or cementless. The objective of the research presented herein was to describe a novel approach to this problem as a first step towards creating a patient-specific, presurgical application for determining the optimal prosthesis procedure. Finite element analysis (FEA) and bone mineral density (BMD) calculations were performed with ten voluntary primary THR patients to estimate the status of their operative femurs before surgery. A compilation model of the press-fitting procedure was generated to define a fracture risk index (FRI) from incurred forces on the periprosthetic femoral head. Comparing these values to patient age, sex, and gender elicited a high degree of variability between patients grouped by implant procedure, reinforcing the notion that age and gender alone are poor indicators for prescribing prosthesis type. Additionally, correlating FRI and BMD measurements indicated that at least two of the ten patients may have received nonideal implants. This investigation highlights the utility of our model as a foundation for presurgical software applications to assist orthopedic surgeons with selecting THR prostheses. PMID:26417376

  16. Bone Mineral Density and Fracture Risk Assessment to Optimize Prosthesis Selection in Total Hip Replacement

    PubMed Central

    Pétursson, Þröstur; Edmunds, Kyle Joseph; Gíslason, Magnús Kjartan; Magnússon, Benedikt; Magnúsdóttir, Gígja; Halldórsson, Grétar; Jónsson, Halldór; Gargiulo, Paolo

    2015-01-01

    The variability in patient outcome and propensity for surgical complications in total hip replacement (THR) necessitates the development of a comprehensive, quantitative methodology for prescribing the optimal type of prosthetic stem: cemented or cementless. The objective of the research presented herein was to describe a novel approach to this problem as a first step towards creating a patient-specific, presurgical application for determining the optimal prosthesis procedure. Finite element analysis (FEA) and bone mineral density (BMD) calculations were performed with ten voluntary primary THR patients to estimate the status of their operative femurs before surgery. A compilation model of the press-fitting procedure was generated to define a fracture risk index (FRI) from incurred forces on the periprosthetic femoral head. Comparing these values to patient age, sex, and gender elicited a high degree of variability between patients grouped by implant procedure, reinforcing the notion that age and gender alone are poor indicators for prescribing prosthesis type. Additionally, correlating FRI and BMD measurements indicated that at least two of the ten patients may have received nonideal implants. This investigation highlights the utility of our model as a foundation for presurgical software applications to assist orthopedic surgeons with selecting THR prostheses. PMID:26417376

  17. Clinical Risk Prediction by Exploring High-Order Feature Correlations

    PubMed Central

    Wang, Fei; Zhang, Ping; Wang, Xiang; Hu, Jianying

    2014-01-01

    Clinical risk prediction is one important problem in medical informatics, and logistic regression is one of the most widely used approaches for clinical risk prediction. In many cases, the number of potential risk factors is fairly large and the actual set of factors that contribute to the risk is small. Therefore sparse logistic regression is proposed, which can not only predict the clinical risk but also identify the set of relevant risk factors. The inputs of logistic regression and sparse logistic regression are required to be in vector form. This limits the applicability of these models in the problems when the data cannot be naturally represented vectors (e.g., medical images are two-dimensional matrices). To handle the cases when the data are in the form of multi-dimensional arrays, we propose HOSLR: High-Order Sparse Logistic Regression, which can be viewed as a high order extension of sparse logistic regression. Instead of solving one classification vector as in conventional logistic regression, we solve for K classification vectors in HOSLR (K is the number of modes in the data). A block proximal descent approach is proposed to solve the problem and its convergence is guaranteed. Finally we validate the effectiveness of HOSLR on predicting the onset risk of patients with Alzheimer’s disease and heart failure. PMID:25954428

  18. High-risk prostate cancer: the role of surgical management.

    PubMed

    Morlacco, Alessandro; Karnes, R Jeffrey

    2016-06-01

    High-risk prostate cancer (HR Pca) is a highly heterogeneous disease from a biological and clinical standpoint, and it carries a significant chance of morbidity and mortality. Despite the impact of PSA screening, a significant number of men continue to present with high risk disease and need adequate management: clinical evidence shows that a considerable fraction on men with HR PCa can be actually cured with either uni- or multi-modality approaches. Surgical treatment, once considered unfeasible in this setting, is acquiring more and more diffusion in modern clinical practice. Herein we discuss the main treatment strategies for high-risk prostate cancer, providing an expert opinion on the role of surgical management and its outcomes in the most recent literature. PMID:27155934

  19. Telomerase activation by genomic rearrangements in high-risk neuroblastoma

    PubMed Central

    Peifer, Martin; Hertwig, Falk; Roels, Frederik; Dreidax, Daniel; Gartlgruber, Moritz; Menon, Roopika; Krämer, Andrea; Roncaioli, Justin L.; Sand, Frederik; Heuckmann, Johannes M.; Ikram, Fakhera; Schmidt, Rene; Ackermann, Sandra; Engesser, Anne; Kahlert, Yvonne; Vogel, Wenzel; Altmüller, Janine; Nürnberg, Peter; Thierry-Mieg, Jean; Thierry-Mieg, Danielle; Mariappan, Aruljothi; Heynck, Stefanie; Mariotti, Erika; Henrich, Kai-Oliver; Glöckner, Christian; Bosco, Graziella; Leuschner, Ivo; Schweiger, Michal R.; Savelyeva, Larissa; Watkins, Simon C.; Shao, Chunxuan; Bell, Emma; Höfer, Thomas; Achter, Viktor; Lang, Ulrich; Theissen, Jessica; Volland, Ruth; Saadati, Maral; Eggert, Angelika; de Wilde, Bram; Berthold, Frank; Peng, Zhiyu; Zhao, Chen; Shi, Leming; Ortmann, Monika; Büttner, Reinhard; Perner, Sven; Hero, Barbara; Schramm, Alexander; Schulte, Johannes H.; Herrmann, Carl; O’Sullivan, Roderick J.; Westermann, Frank; Thomas, Roman K.; Fischer, Matthias

    2016-01-01

    Neuroblastoma is a malignant paediatric tumour of the sympathetic nervous system1. Roughly half of these tumours regress spontaneously or are cured by limited therapy. By contrast, high-risk neuroblastomas have an unfavourable clinical course despite intensive multimodal treatment, and their molecular basis has remained largely elusive2–4. Here we have performed whole-genome sequencing of 56 neuroblastomas (high-risk, n = 39; low-risk, n = 17) and discovered recurrent genomic rearrangements affecting a chromosomal region at 5p15.33 proximal of the telomerase reverse transcriptase gene (TERT). These rearrangements occurred only in high-risk neuroblastomas (12/39, 31%) in a mutually exclusive fashion with MYCN amplifications and ATRX mutations, which are known genetic events in this tumour type1,2,5. In an extended case series (n = 217), TERT rearrangements defined a subgroup of high-risk tumours with particularly poor outcome. Despite a large structural diversity of these rearrangements, they all induced massive transcriptional upregulation of TERT. In the remaining high-risk tumours, TERT expression was also elevated in MYCN-amplified tumours, whereas alternative lengthening of telomeres was present in neuroblastomas without TERT or MYCN alterations, suggesting that telomere lengthening represents a central mechanism defining this subtype. The 5p15.33 rearrangements juxtapose the TERT coding sequence to strong enhancer elements, resulting in massive chromatin remodelling and DNA methylation of the affected region. Supporting a functional role of TERT, neuroblastoma cell lines bearing rearrangements or amplified MYCN exhibited both upregulated TERT expression and enzymatic telomerase activity. In summary, our findings show that remodelling of the genomic context abrogates transcriptional silencing of TERT in high-risk neuroblastoma and places telomerase activation in the centre of transformation in a large fraction of these tumours. PMID:26466568

  20. Telomerase activation by genomic rearrangements in high-risk neuroblastoma.

    PubMed

    Peifer, Martin; Hertwig, Falk; Roels, Frederik; Dreidax, Daniel; Gartlgruber, Moritz; Menon, Roopika; Krämer, Andrea; Roncaioli, Justin L; Sand, Frederik; Heuckmann, Johannes M; Ikram, Fakhera; Schmidt, Rene; Ackermann, Sandra; Engesser, Anne; Kahlert, Yvonne; Vogel, Wenzel; Altmüller, Janine; Nürnberg, Peter; Thierry-Mieg, Jean; Thierry-Mieg, Danielle; Mariappan, Aruljothi; Heynck, Stefanie; Mariotti, Erika; Henrich, Kai-Oliver; Gloeckner, Christian; Bosco, Graziella; Leuschner, Ivo; Schweiger, Michal R; Savelyeva, Larissa; Watkins, Simon C; Shao, Chunxuan; Bell, Emma; Höfer, Thomas; Achter, Viktor; Lang, Ulrich; Theissen, Jessica; Volland, Ruth; Saadati, Maral; Eggert, Angelika; de Wilde, Bram; Berthold, Frank; Peng, Zhiyu; Zhao, Chen; Shi, Leming; Ortmann, Monika; Büttner, Reinhard; Perner, Sven; Hero, Barbara; Schramm, Alexander; Schulte, Johannes H; Herrmann, Carl; O'Sullivan, Roderick J; Westermann, Frank; Thomas, Roman K; Fischer, Matthias

    2015-10-29

    Neuroblastoma is a malignant paediatric tumour of the sympathetic nervous system. Roughly half of these tumours regress spontaneously or are cured by limited therapy. By contrast, high-risk neuroblastomas have an unfavourable clinical course despite intensive multimodal treatment, and their molecular basis has remained largely elusive. Here we have performed whole-genome sequencing of 56 neuroblastomas (high-risk, n = 39; low-risk, n = 17) and discovered recurrent genomic rearrangements affecting a chromosomal region at 5p15.33 proximal of the telomerase reverse transcriptase gene (TERT). These rearrangements occurred only in high-risk neuroblastomas (12/39, 31%) in a mutually exclusive fashion with MYCN amplifications and ATRX mutations, which are known genetic events in this tumour type. In an extended case series (n = 217), TERT rearrangements defined a subgroup of high-risk tumours with particularly poor outcome. Despite a large structural diversity of these rearrangements, they all induced massive transcriptional upregulation of TERT. In the remaining high-risk tumours, TERT expression was also elevated in MYCN-amplified tumours, whereas alternative lengthening of telomeres was present in neuroblastomas without TERT or MYCN alterations, suggesting that telomere lengthening represents a central mechanism defining this subtype. The 5p15.33 rearrangements juxtapose the TERT coding sequence to strong enhancer elements, resulting in massive chromatin remodelling and DNA methylation of the affected region. Supporting a functional role of TERT, neuroblastoma cell lines bearing rearrangements or amplified MYCN exhibited both upregulated TERT expression and enzymatic telomerase activity. In summary, our findings show that remodelling of the genomic context abrogates transcriptional silencing of TERT in high-risk neuroblastoma and places telomerase activation in the centre of transformation in a large fraction of these tumours. PMID:26466568

  1. Risk analysis for truck transportation of high consequence cargo.

    SciTech Connect

    Waters, Robert David

    2010-09-01

    The fixed facilities control everything they can to drive down risk. They control the environment, work processes, work pace and workers. The transportation sector drive the State and US highways with high kinetic energy and less-controllable risks such as: (1) other drivers (beginners, impaired, distracted, etc.); (2) other vehicles (tankers, hazmat, super-heavies); (3) road environments (bridges/tunnels/abutments/construction); and (4) degraded weather.

  2. Best self visualization method with high-risk youth.

    PubMed

    Schussel, Lorne; Miller, Lisa

    2013-08-01

    The healing process of the Best Self Visualization Method (BSM) is described within the framework of meditation, neuroscience, and psychodynamic theory. Cases are drawn from the treatment of high-risk youth, who have histories of poverty, survival of sexual and physical abuse, and/or current risk for perpetrating abuse. Clinical use of BSM is demonstrated in two case illustrations, one of group psychotherapy and another of individual therapy. PMID:23775428

  3. Cumulative Experiences of Violence among High-Risk Urban Youth

    ERIC Educational Resources Information Center

    Taylor, Catherine A.; Boris, Neil W.; Heller, Sherryl Scott; Clum, Gretchen A.; Rice, Janet C.; Zeanah, Charles H.

    2008-01-01

    This study examines type-specific and cumulative experiences of violence among a vulnerable population of youth. Sixty high-risk, shelter-dwelling, urban youth were interviewed regarding their history of childhood maltreatment, exposure to community violence (ECV), and experience with intimate partner violence (IPV). Results show a high prevalence…

  4. CAI and At-Risk Minority Urban High School Students.

    ERIC Educational Resources Information Center

    Signer, Barbara R.

    1991-01-01

    The Microcomputer Adaptive Testing High-Risk-Urban Students (MATH-R-US) project made computerized assessment an integral part of remedial high school mathematics at an inner-city school with predominantly African-American students. Results suggest that the girls exhibited greater self-esteem toward using computers than did boys and that…

  5. Underreporting High-Risk Prescribing Among Medicare Advantage Plans

    PubMed Central

    Cooper, Alicia L.; Kazis, Lewis E.; Dore, David D.; Mor, Vincent; Trivedi, Amal N.

    2016-01-01

    Background Although Medicare Advantage plans are required to report clinical performance using Healthcare Effectiveness Data and Information Set (HEDIS) quality indicators, the accuracy of plan-reported performance rates is unknown. Objective To compare calculated and reported rates of high-risk prescribing among Medicare Advantage plans. Design Cross-sectional comparison. Setting 172 Medicare Advantage plans. Patients A random sample of beneficiaries in 172 Medicare Advantage plans in 2006 (n = 177 227) and 2007 (n = 173 655). Measurements Plan-reported HEDIS rates of high-risk prescribing among elderly persons were compared with rates calculated from Medicare Advantage plans’ Part D claims by using the same measure specifications and source population. Results The mean rate of high-risk prescribing derived from Part D claims was 26.9% (95% CI, 25.9% to 28.0%), whereas the mean plan-reported rate was 21.1% (CI, 20.0% to 22.3%). Approximately 95% of plans underreported rates of high-risk prescribing relative to calculated rates derived from Part D claims. The differences in the calculated and reported rates negatively affected quality rankings for the plans that most accurately reported rates. For example, the 9 plans that reported rates of high-risk prescribing within 1 percentage point of calculated rates were ranked 43.4 positions lower when reported rates were used instead of calculated rates. Among 103 680 individuals present in both the sample of Part D claims and HEDIS data in 2006, Medicare Advantage plans incorrectly excluded 10.3% as ineligible for the HEDIS high-risk prescribing measure. Among those correctly included in the high-risk prescribing denominator, the reported rate of high-risk prescribing was 21.9% and the calculated rate was 26.2%. Limitation A single quality measure was assessed. Conclusion Medicare Advantage plans underreport rates of high-risk prescribing, suggesting a role for routine audits to ensure the validity of publicly reported

  6. Antenatal Care Utilisation and Content between Low-Risk and High-Risk Pregnant Women

    PubMed Central

    Yeoh, Ping Ling; Hornetz, Klaus; Dahlui, Maznah

    2016-01-01

    Background The purpose of antenatal care is to monitor and improve the wellbeing of the mother and foetus. The World Health Organization recommends risk-oriented strategy that includes: (i) routine care to all women, (ii) additional care for women with moderately severe diseases and complications, (iii) specialised obstetrical and neonatal care for women with severe diseases and complications. Antenatal care is concerned with adequate care in order to be effective. Measurement for adequacy of antenatal care often applies indexes that assess initiation of care and number of visits. In addition, adequacy of care content should also be assessed. Results of studies in developed settings demonstrate that women without risk factors use antenatal services more frequently than recommended. Such over-utilisation is problematic for low-resourced settings. Moreover, studies show that a substantial proportion of high-risk women had utilisation or content of care below the recommended standard. Yet studies in developing countries have seldom included a comparison between low-risk and high-risk women. The purpose of the study was therefore to assess adequacy of care and pregnancy outcomes for the different risk groups. Methods A retrospective study using a multistage sampling technique, at public-funded primary health care clinics was conducted. Antenatal utilisation level was assessed using a modified Adequacy of Prenatal Care Utilisation index that measures the timing for initiation of care and observed-to-expected visits ratio. Adequacy of antenatal care content assessed compliance to routine care based on the local guidelines. Results Intensive or “adequate-plus” antenatal care utilisation as defined by the modified index was noted in over half of the low-risk women. On the other hand, there were 26% of the high-risk women without the expected intensive utilisation. Primary- or non-educated high-risk women were less likely to have a higher antenatal care utilisation

  7. Evaluation and selection of candidate high-level waste forms

    SciTech Connect

    Bernadzikowski, T. A.; Allender, J. S.; Butler, J. L.; Gordon, D. E.; Gould, Jr., T. H.; Stone, J. A.

    1982-03-01

    Seven candidate waste forms being developed under the direction of the Department of Energy's National High-Level Waste (HLW) Technology Program, were evaluated as potential media for the immobilization and geologic disposal of high-level nuclear wastes. The evaluation combined preliminary waste form evaluations conducted at DOE defense waste-sites and independent laboratories, peer review assessments, a product performance evaluation, and a processability analysis. Based on the combined results of these four inputs, two of the seven forms, borosilicate glass and a titanate based ceramic, SYNROC, were selected as the reference and alternative forms for continued development and evaluation in the National HLW Program. Both the glass and ceramic forms are viable candidates for use at each of the DOE defense waste-sites; they are also potential candidates for immobilization of commercial reprocessing wastes. This report describes the waste form screening process, and discusses each of the four major inputs considered in the selection of the two forms.

  8. Development of second generation EP2 antagonists with high selectivity

    PubMed Central

    Ganesh, Thota; Jiang, Jianxiong; Dingledine, Ray

    2014-01-01

    EP2 receptor has emerged as an important biological target for therapeutic intervention. In particular, it has been shown to exacerbate disease progression of a variety of CNS and peripheral diseases. Deletion of the EP2 receptor in mouse models recapitulates several features of the COX-2 inhibition, thus presenting a new avenue for anti-inflammatory therapy which could bypass some of the adverse side effects observed by the COX-2 inhibition therapy. We have recently reported a cinnamic amide class of EP2 antagonists with high potency, but these compounds exhibited a moderate selectivity against prostanoid receptor DP1. Moreover they possess acrylamide moiety in the structure, which may result in liver toxicity over longer period of use in a chronic disease model. Thus, we now developed a second generation compounds that devoid of the acrylamide functionality and possess high potency and improved (>1000-fold) selectivity to EP2 over other prostanoid receptors. PMID:24937185

  9. Selection of quiescent Escherichia coli with high metabolic activity.

    PubMed

    Sonderegger, Marco; Schümperli, Michael; Sauer, Uwe

    2005-01-01

    Sustained metabolic activity in non-growing, quiescent cells can increase the operational life-span of bio-processes and improve process economics by decoupling production from cell growth. Because of the ill-defined molecular nature of this phenotype, we developed selection protocols for the evolution of quiescent Escherichia coli mutants that exhibit high metabolic activity in ammonium starvation-induced stationary phase. The best enrichment procedures were continuously or discontinuously fed ammonium-limited chemostat cultures with a very low dilution rate of 0.03 h(-1). After 40 generations of selection, improved mutants with up to doubled catabolic rates in stationary phase were isolated. The metabolically most active clones were identified by screening for high specific glucose uptake rates during ammonium starvation-induced stationary phase in deep-well microtiter plates. PMID:15721805

  10. Health and environmental risk-related impacts of actinide burning on high-level waste disposal

    SciTech Connect

    Forsberg, C.W.

    1992-05-01

    The potential health and environmental risk-related impacts of actinide burning for high-level waste disposal were evaluated. Actinide burning, also called waste partitioning-transmutation, is an advanced method for radioactive waste management based on the idea of destroying the most toxic components in the waste. It consists of two steps: (1) selective removal of the most toxic radionuclides from high-level/spent fuel waste and (2) conversion of those radionuclides into less toxic radioactive materials and/or stable elements. Risk, as used in this report, is defined as the probability of a failure times its consequence. Actinide burning has two potential health and environmental impacts on waste management. Risks and the magnitude of high-consequence repository failure scenarios are decreased by inventory reduction of the long-term radioactivity in the repository. (What does not exist cannot create risk or uncertainty.) Risk may also be reduced by the changes in the waste characteristics, resulting from selection of waste forms after processing, that are superior to spent fuel and which lower the potential of transport of radionuclides from waste form to accessible environment. There are no negative health or environmental impacts to the repository from actinide burning; however, there may be such impacts elsewhere in the fuel cycle.

  11. Using Frequent Item Set Mining and Feature Selection Methods to Identify Interacted Risk Factors - The Atrial Fibrillation Case Study.

    PubMed

    Li, Xiang; Liu, Haifeng; Du, Xin; Hu, Gang; Xie, Guotong; Zhang, Ping

    2016-01-01

    Disease risk prediction is highly important for early intervention and treatment, and identification of predictive risk factors is the key point to achieve accurate prediction. In addition to original independent features in a dataset, some interacted features, such as comorbidities and combination therapies, may have non-additive influence on the disease outcome and can also be used in risk prediction to improve the prediction performance. However, it is usually difficult to manually identify the possible interacted risk factors due to the combination explosion of features. In this paper, we propose an automatic approach to identify predictive risk factors with interactions using frequent item set mining and feature selection methods. The proposed approach was applied in the real world case study of predicting ischemic stroke and thromboembolism for atrial fibrillation patients on the Chinese atrial fibrillation registry dataset, and the results show that our approach can not only improve the prediction performance, but also identify the comorbidities and combination therapies that have potential influences on TE occurrence for AF. PMID:27577446

  12. Developmental Pathways to Sexual Risk Behavior in High-Risk Adolescent Boys

    PubMed Central

    Brennan, Lauretta M.; Forbes, Erika; Shaw, Daniel S.

    2014-01-01

    OBJECTIVE: Adolescent boys’ involvement in pregnancy and sexual risk behavior is a public health concern. Although research has identified predictors of sexual risk behavior during adolescence, few studies have investigated precursors to boys’ sexual risk behavior beginning in early childhood, the identification of which could serve to inform interventions and help reduce involvement in pregnancy. Our goal was to identify early developmental pathways associated with sexual risk behavior in a sample of low-income adolescent boys. METHODS: Data from a prospective longitudinal study in 310 at-risk boys were used to examine externalizing problems, mothers’ depressive symptoms, and low-nurturant parenting in early childhood (1.5, 2, and 3.5 years old) and daring, externalizing, parental monitoring, and deviant peer affiliation during emerging adolescence (11 and 12 years old) as precursors of sexual risk behavior between the ages 15 and 20 years. Structural equation modeling was used to explore pathways associated with later high-risk sexual behavior (HRSB). RESULTS: In multivariate analyses, adolescent daring and deviant peer affiliation at age 12 were associated with later HRSB. Furthermore, deviant peer affiliation during emerging adolescence mediated the relationship between mothers’ depressive symptoms and nurturant parenting during early childhood and later adolescent HRSB. CONCLUSIONS: Family-based risk factors in early childhood are predictive of HRSB in adolescence but are also influenced, and in some cases mediated, by relationships with peers and child characteristics during emerging adolescence. PMID:24819568

  13. High-temperature corrosion: Issues in alloy selection

    NASA Astrophysics Data System (ADS)

    Lai, George Y.

    1991-11-01

    This article examines the modes of high-temperature corrosion that are often responsible for equipment failures in a variety of industries, including aerospace and gas turbines; heat treating; mineral and metallurgical processing; chemical processing; refining and petrochemical processing; ceramic, electronic, and glass manufacturing; automotive; pulp and paper; waste incineration; and power generation and energy conversion. Corrosion data related to each corrosion mode are reviewed to provide readers with a brief materials selection guide.

  14. Highly selective vagotomy in the treatment of peptic ulcer diathesis.

    PubMed

    Kaushik, S P; Kohli, P; Kumar, P; Pradeep, R; Saxena, R; Choudhary, S R; Suresh, A

    1990-09-01

    The results of highly selective vagotomy in 174 Indian patients have been analysed. Compared to other procedures on the stomach, HSV has a definite advantage both on long term as well as on short term basis. HSV has therefore become the procedure of choice in the treatment of duodenal ulcer disease provided the expertise is available locally. HSV has also been used now in the treatment of ulcer complications and benign gastric ulcer disease. PMID:2092027

  15. Highly hydrophobic and oleophilic foam for selective absorption

    NASA Astrophysics Data System (ADS)

    Su, Changhong

    2009-12-01

    In this article, both highly hydrophobic and oleophilic foam were fabricated by coating inner surface of polyurethane (PU) foam with a super-hydrophobic film. The contact angle of the foam is large as 152.2° for water, and 0° for kerosene. The foam can absorb kerosene selectively from kerosene-water mixture and be regenerated easily. The foam may be used to reclaim oil from polluted natural water area resulted from shipwreck or leakage.

  16. Does high sugar consumption exacerbate cardiometabolic risk factors and increase the risk of type 2 diabetes and cardiovascular disease?

    PubMed Central

    Sonestedt, Emily; Øverby, Nina Cecilie; Laaksonen, David E.; Birgisdottir, Bryndis Eva

    2012-01-01

    Consumption of sugar has been relatively high in the Nordic countries; the impact of sugar intake on metabolic risk factors and related diseases has been debated. The objectives were to assess the effect of sugar intake (sugar-sweetened beverages, sucrose and fructose) on association with type 2 diabetes, cardiovascular disease and related metabolic risk factors (impaired glucose tolerance, insulin sensitivity, dyslipidemia, blood pressure, uric acid, inflammation markers), and on all-cause mortality, through a systematic review of prospective cohort studies and randomised controlled intervention studies published between January 2000 and search dates. The methods adopted were as follows: the first search was run in PubMed in October 2010. A second search with uric acid as risk marker was run in April 2011. The total search strategy was rerun in April 2011 in SveMed+. An update was run in PubMed in January 2012. Two authors independently selected studies for inclusion from the 2,743 abstracts according to predefined eligibility criteria. The outcome was that out of the 17 studies extracted, 15 were prospective cohort studies and two were randomised controlled crossover trials. All of the studies included only adults. With respect to incident type 2 diabetes (nine studies), four of six prospective cohort studies found a significant positive association for sugar-sweetened beverage intake. In general, larger cohort studies with longer follow-up more often reported positive associations, and BMI seemed to mediate part of the increased risk. For other metabolic or cardiovascular risk factors or outcomes, too few studies have been published to draw conclusions. In conclusion, data from prospective cohort studies published in the years 2000–2011 suggest that sugar-sweetened beverages probably increase the risk of type 2 diabetes. For related metabolic risk factors, cardiovascular disease or all-cause mortality and other types of sugars, too few studies were available

  17. Do high risk patients alter their lifestyle to reduce risk of colorectal cancer?

    PubMed Central

    2014-01-01

    Background Colorectal cancer (CRC) may be reduced by healthy lifestyle behaviours. We determined the extent of self-reported lifestyle changes in people at increased risk of CRC, and the association of these reports with anxiety, risk and knowledge-based variables. Methods We randomly selected 250 participants who had undergone surveillance colonoscopy for family history of CRC. A telephone interview was conducted, recording demographics and family history. Self-reported lifestyle change due to thoughts about CRC across a range of dietary and lifestyle variables was assessed on a four-point scale. Participants’ perceptions of the following were recorded: risk factor knowledge, personal risk, and worry due to family history. General anxiety was assessed using the GAD-7 scale. Ordinal logistic regression was used to calculate adjusted results. Results There were 148 participants (69% response). 79.7% reported at least one healthy change. Change in diet and physical activity were most frequently reported (fiber, 63%; fruit and vegetables, 54%; red meat, 47%; physical activity, 45%), with consumption of tobacco, alcohol, and body weight less likely (tobacco, 25%; alcohol, 26%; weight 31%). People were more likely to report healthy change with lower levels of generalized anxiety, higher worry due to family history, or greater perceived knowledge of CRC risk factors. Risk perception and risk due to family history were not associated with healthy changes. Conclusions Self-reported lifestyle changes due to thoughts about CRC were common. Lower general anxiety levels, worries due to family history, and perceived knowledge of risk factors may stimulate healthy changes. PMID:24507382

  18. High density transcriptional mapping of chromosome 21 by hybridization selection

    SciTech Connect

    Tassone, F.; Wade, H.; Gardiner, K.

    1994-09-01

    A transcriptional map of human chromosome 21 is important for the study of Down syndrome, development processes and genome organization. To construct a high density transcriptional map, the technique of cDNA hybrid selection is being applied to a minimal tiling path of YAC clones that span 21q. The cDNA used for selection represents a complex pool of sequences obtained from a variety of fetal and adult tissues and cell lines. Approximately 70-80 YAC clones are sufficient to span 21q; each is individually processed through the selection procedure to obtain a YAC-specific {open_quotes}selected cDNA library{close_quotes}. Survey analysis of each library includes determination of levels of ribosomal contamination, verification of enrichment of control genes, identification of a preliminary number of novel unique sequences, and verification that novel sequences map to the correct YAC and chromosomal regions. This analysis has been completed for 19 YACs that together comprise approximately 10 Mb of non-overlapping DNA, 25% of the long arm. Ribosomal cDNA contamination is low (<10%) and all known genes of appropriate tissue specificity of expression have been recovered, as well as new genes from each YAC. Libraries of expression have been recovered, as well as new genes from each YAC. Libraries from 8 of these YACs are now being subjected to exhaustive analysis to identify all novel genes contained within them and to obtain complete cDNAs and expression analysis for each. Not all regions of the chromosome, however, are equally amenable to these analyses. Selected cDNA libraries from the centromeric YACs are yielding apparently novel genes, but confirmation of map position is problematic. Also of interest is a region of several megabases within the Giemsa dark band, 21q21. Selected cDNA libraries from these YACs so far have yielded no novel genes and support the idea of a genuinely very gene-poor region.

  19. Pregnancy is not a risk factor for gallstone disease: Results of a randomly selected population sample

    PubMed Central

    Walcher, Thomas; Haenle, Mark Martin; Kron, Martina; Hay, Birgit; Mason, Richard Andrew; von Schmiesing, Alexa Friederike Alice; Imhof, Armin; Koenig, Wolfgang; Kern, Peter; Boehm, Bernhard Otto; Kratzer, Wolfgang

    2005-01-01

    AIM: To investigate the prevalence, risk factors, and selection of the study population for cholecystolithiasis in an urban population in Germany, in relation to our own findings and to the results in the international literature. METHODS: A total of 2 147 persons (1 111 females, age 42.8 ± 12.7 years; 1 036 males, age 42.3 ± 13.1 years) participating in an investigation on the prevalence of Echinococcus multilocularis were studied for risk factors and prevalence of gallbladder stone disease. Risk factors were assessed by means of a standardized interview and calculation of body mass index (BMI). A diagnostic ultrasound examination of the gallbladder was performed. Data were analyzed by multiple logistic regression, using the SAS statistical software package. RESULTS: Gallbladder stones were detected in 171 study participants (8.0%, n = 2 147). Risk factors for the development of gallbladder stone disease included age, sex, BMI, and positive family history. In a separate analysis of female study participants, pregnancy (yes/no) and number of pregnancies did not exert any influence. CONCLUSION: Findings of the present study confirm that age, female sex, BMI, and positive family history are risk factors for the development of gallbladder stone disease. Pregnancy and the number of pregnancies, however, could not be shown to be risk factors. There seem to be no differences in the respective prevalence for gallbladder stone disease in urban and rural populations. PMID:16425387

  20. The Violence Risk Scale: Predictive Validity and Linking Changes in Risk with Violent Recidivism in a Sample of High-Risk Offenders with Psychopathic Traits

    ERIC Educational Resources Information Center

    Lewis, Kathy; Olver, Mark E.; Wong, Stephen C. P.

    2013-01-01

    The Violence Risk Scale (VRS) uses ratings of static and dynamic risk predictors to assess violence risk, identify targets for treatment, and assess changes in risk following treatment. The VRS was rated pre- and posttreatment on a sample of 150 males, mostly high-risk violent offenders many with psychopathic personality traits. These individuals…

  1. Identification of high-risk communities for unattended out-of-hospital cardiac arrests using GIS.

    PubMed

    Semple, Hugh M; Cudnik, Michael T; Sayre, Michael; Keseg, David; Warden, Craig R; Sasson, Comilla

    2013-04-01

    Improving survival rates for out of hospital cardiac arrest (OHCA) at the neighborhood level is increasingly seen as priority in US cities. Since wide disparities exist in OHCA rates at the neighborhood level, it is necessary to locate neighborhoods where people are at elevated risk for cardiac arrest and target these for educational outreach and other mitigation strategies. This paper describes a GIS-based methodology that was used to identify communities with high risk for cardiac arrests in Franklin County, Ohio during the period 2004-2009. Prior work in this area used a single criterion, i.e., the density of OHCA events, to define the high-risk areas, and a single analytical technique, i.e., kernel density analysis, to identify the high-risk communities. In this paper, two criteria are used to identify the high-risk communities, the rate of OHCA incidents and the level of bystander CPR participation. We also used Local Moran's I combined with traditional map overlay techniques to add robustness to the methodology for identifying high-risk communities for OHCA. Based on the criteria established for this study, we successfully identified several communities that were at higher risk for OHCA than neighboring communities. These communities had incidence rates of OHCA that were significantly higher than neighboring communities and bystander rates that were significantly lower than neighboring communities. Other risk factors for OHCA were also high in the selected communities. The methodology employed in this study provides for a measurement conceptualization of OHCA clusters that is much broader than what has been previously offered. It is also statistically reliable and can be easily executed using a GIS. PMID:22983677

  2. Risk by use of hearing protectors--expert programme supports SMEs in appropriate selection and use.

    PubMed

    Liedtke, M

    2005-01-01

    Comprehensive protection by use of PPE against the hazards at work requires more than proper selection based on the protection level needed: The PPE user directive (Council Directive 89/656/EEC, Official Journal of the European Communities L 393, 30/12/1989 p.0018 - 0028) requires an assessment of personal protective equipment itself, which has to consider the risks which may be introduced by use of PPE or use of combinations of PPE. As an example risks which may be introduced by use of hearing protectors are described. Assistance in the assessment required by PPE user directive (Council Directive 89/656/EEC, Official Journal of the European Communities L 393, 30/12/1989 p. 0018 - 0028) and in selection and use of hearing protectors with regard to this assessment is presented. PMID:16053603

  3. Risk selection and cost shifting in a prospective physician payment system: evidence from Ontario.

    PubMed

    Kantarevic, Jasmin; Kralj, Boris

    2014-04-01

    We study the risk-selection and cost-shifting behavior of physicians in a unique capitation payment model in Ontario, using the incentive to enroll and care for complex and vulnerable patients as a case study. This incentive, which is incremental to the regular capitation payment, ceases after the first year of patient enrollment and may therefore impact on the physician's decision to continue to enroll the patient. Furthermore, because the enrolled patients in Ontario can seek care from any provider, the enrolling physician may shift some treatment costs to other providers. Using longitudinal administrative data and a control group of physicians in the fee-for-service model who were eligible for the same incentive, we find no evidence of either patient 'dumping' or cost shifting. These results highlight the need to re-examine the conventional wisdom about risk selection for physician payment models that significantly deviate from the stylized capitation model. PMID:24210763

  4. Applying the lessons of high risk industries to health care.

    PubMed

    Hudson, P

    2003-12-01

    High risk industries such as commercial aviation and the oil and gas industry have achieved exemplary safety performance. This paper reviews how they have managed to do that. The primary reasons are the positive attitudes towards safety and the operation of effective formal safety management systems. The safety culture provides an important explanation of why such organisations perform well. An evolutionary model of safety culture is provided in which there is a range of cultures from the pathological through the reactive to the calculative. Later, the proactive culture can evolve towards the generative organisation, an alternative description of the high reliability organisation. The current status of health care is reviewed, arguing that it has a much higher level of accidents and has a reactive culture, lagging behind both high risk industries studied in both attitude and systematic management of patient risks. PMID:14645741

  5. A Primer on High-Throughput Computing for Genomic Selection

    PubMed Central

    Wu, Xiao-Lin; Beissinger, Timothy M.; Bauck, Stewart; Woodward, Brent; Rosa, Guilherme J. M.; Weigel, Kent A.; Gatti, Natalia de Leon; Gianola, Daniel

    2011-01-01

    High-throughput computing (HTC) uses computer clusters to solve advanced computational problems, with the goal of accomplishing high-throughput over relatively long periods of time. In genomic selection, for example, a set of markers covering the entire genome is used to train a model based on known data, and the resulting model is used to predict the genetic merit of selection candidates. Sophisticated models are very computationally demanding and, with several traits to be evaluated sequentially, computing time is long, and output is low. In this paper, we present scenarios and basic principles of how HTC can be used in genomic selection, implemented using various techniques from simple batch processing to pipelining in distributed computer clusters. Various scripting languages, such as shell scripting, Perl, and R, are also very useful to devise pipelines. By pipelining, we can reduce total computing time and consequently increase throughput. In comparison to the traditional data processing pipeline residing on the central processors, performing general-purpose computation on a graphics processing unit provide a new-generation approach to massive parallel computing in genomic selection. While the concept of HTC may still be new to many researchers in animal breeding, plant breeding, and genetics, HTC infrastructures have already been built in many institutions, such as the University of Wisconsin–Madison, which can be leveraged for genomic selection, in terms of central processing unit capacity, network connectivity, storage availability, and middleware connectivity. Exploring existing HTC infrastructures as well as general-purpose computing environments will further expand our capability to meet increasing computing demands posed by unprecedented genomic data that we have today. We anticipate that HTC will impact genomic selection via better statistical models, faster solutions, and more competitive products (e.g., from design of marker panels to realized

  6. Biological effects of static magnetic fields: a selective review with emphasis on risk assessment

    SciTech Connect

    Easterly, C. E.

    1982-04-01

    Rather than focusing on literature per se, the current study determines the status of magnetic field information that is applicable to risk assessment. Hence, an attempt is made to identify both the literature that is useful to the goal of risk assessment and a framework within which risk assessment methodologies can be derived. From this selected review, it is concluded that three areas exist for which adequate information can be found to begin modelling: disease induction, reproduction and development, and cardiovascular response. The first two are supported by a combination of positive and negative findings and the last by a calculational technique which utilizes the physically well-known principle of flow retardation for a conducting fluid moving through a magnetic field.

  7. Endocrine therapy for breast cancer prevention in high-risk women: clinical and economic considerations.

    PubMed

    Groom, Amy G; Younis, Tallal

    2016-04-01

    The global burden of breast cancer highlights the need for primary prevention strategies that demonstrate both favorable clinical benefit/risk profile and good value for money. Endocrine therapy with selective estrogen-receptor modulators (SERMs) or aromatase inhibitors (AIs) has been associated with a favorable clinical benefit/risk profile in the prevention of breast cancer in women at high risk of developing the disease. The available endocrine therapy strategies differ in terms of their relative reductions of breast cancer risk, potential side effects, and upfront drug acquisition costs, among others. This review highlights the clinical trials of SERMs and AIs for the primary prevention of breast cancer, and the cost-effectiveness /cost-utility studies that have examined their "value for money" in various health care jurisdictions. PMID:26923683

  8. Variable selection in subdistribution hazard frailty models with competing risks data

    PubMed Central

    Do Ha, Il; Lee, Minjung; Oh, Seungyoung; Jeong, Jong-Hyeon; Sylvester, Richard; Lee, Youngjo

    2014-01-01

    The proportional subdistribution hazards model (i.e. Fine-Gray model) has been widely used for analyzing univariate competing risks data. Recently, this model has been extended to clustered competing risks data via frailty. To the best of our knowledge, however, there has been no literature on variable selection method for such competing risks frailty models. In this paper, we propose a simple but unified procedure via a penalized h-likelihood (HL) for variable selection of fixed effects in a general class of subdistribution hazard frailty models, in which random effects may be shared or correlated. We consider three penalty functions (LASSO, SCAD and HL) in our variable selection procedure. We show that the proposed method can be easily implemented using a slight modification to existing h-likelihood estimation approaches. Numerical studies demonstrate that the proposed procedure using the HL penalty performs well, providing a higher probability of choosing the true model than LASSO and SCAD methods without losing prediction accuracy. The usefulness of the new method is illustrated using two actual data sets from multi-center clinical trials. PMID:25042872

  9. Alcoholic Liver Disease: High Risk or Low Risk for Developing Hepatocellular Carcinoma?

    PubMed

    Joshi, Kartik; Kohli, Anita; Manch, Richard; Gish, Robert

    2016-08-01

    In this review we critically assess the literature to evaluate the level of risk posed by alcohol as both a primary etiology of hepatocellular carcinoma (HCC) and as a cofactor in its development. Although there have been conflicting findings, based on the body of evidence to date, it appears that the linkage between compensated alcoholic liver disease-associated cirrhosis and HCC is best characterized as medium-high risk, with the risk increasing with age and with quantity and duration of alcohol consumption and is more pronounced in females. While abstinence is the most effective way to reduce HCC risk, its effect seems largely dependent on the severity of liver damage at the point of cessation. Alcohol clearly interacts with other etiologies and conditions including viral hepatitis B and C, hereditary hemochromatosis, diabetes, and obesity to increase the risk for developing HCC, either synergistically or additively. Continued progress in genetics, especially through mechanistic-based and genome-wide association studies may ultimately identify which single nucleotide polymorphisms are risk factors for the onset of alcoholic liver disease and its progression to HCC and lead to the development of targeted therapeutics which may help providers better manage at-risk patients. PMID:27373617

  10. AKI in Low-Risk versus High-Risk Patients in Intensive Care

    PubMed Central

    Sileanu, Florentina E.; Murugan, Raghavan; Lucko, Nicole; Clermont, Gilles; Kane-Gill, Sandra L.; Handler, Steven M.

    2015-01-01

    Background and objectives AKI in critically ill patients is usually part of multiorgan failure. However, nonrenal organ failure may not always precede AKI and patients without evidence of these organ failures may not be at low risk for AKI. This study examined the risk and outcomes associated with AKI in critically ill patients with and without cardiovascular or respiratory organ failures at presentation to the intensive care unit (ICU). Design, setting, participants, & measurements A large, academic medical center database, with records from July 2000 through October 2008, was used and the authors identified a low-risk cohort as patients without cardiovascular and respiratory organ failures defined as not receiving vasopressor support or mechanical ventilation within the first 24 hours of ICU admission. AKI was defined using Kidney Disease Improving Global Outcomes criteria. The primary end points were moderate to severe AKI (stages 2–3) and risk-adjusted hospital mortality. Results Of 40,152 critically ill patients, 44.9% received neither vasopressors nor mechanical ventilation on ICU day 1. Stages 2–3 AKI occurred less frequently in the low-risk patients versus high-risk patients within 24 hours (14.3% versus 29.1%) and within 1 week (25.7% versus 51.7%) of ICU admission. Patients developing AKI in both risk groups had higher risk of death before hospital discharge. However, the adjusted odds of hospital mortality were greater (odds ratio, 2.99; 95% confidence interval, 2.62 to 3.41) when AKI occurred in low-risk patients compared with those with respiratory or cardiovascular failures (odds ratio, 1.19; 95% confidence interval, 1.09 to 1.3); interaction P<0.001. Conclusions Patients admitted to ICU without respiratory or cardiovascular failure have a substantial likelihood of developing AKI. Although survival for low-risk patients is better than for high-risk patients, the relative increase in mortality associated with AKI is actually greater for low-risk