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Sample records for 1-year cumulative incidence

  1. Cumulative Use of Strong Anticholinergic Medications and Incident Dementia

    PubMed Central

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

    2015-01-01

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

  2. Nonimmunogenic hyperthyroidism: Cumulative hypothyroidism incidence after radioiodine and surgical treatment

    SciTech Connect

    Kinser, J.A.; Roesler, H.; Furrer, T.; Gruetter, D.Z.; Zimmermann, H. )

    1989-12-01

    During 1977, 246 hyperthyroid patients were seen in our departments, 140 (57%) with nonimmunogenic hyperthyroidism (NIH)--101 with a toxic adenoma (TA) and 39 with multifocal functional autonomy (MFA). All patients but one could be followed over 9 yr, 101 after 131I treatment (RIT), another 29 after surgery (S). Ten patients were left untreated. Thirty-four treated (24%) patients died, none as a result of thyroid or post-treatment complications. There was no hyperthyroidism later than 9 mo after therapy. Only 1% (RIT) and 24% (S) were hypothyroid 1 yr after treatment. But 19% of all treated NIH patients were hypothyroid after 9 yr or at the time of their death, 12% after RIT and 41% after S. The cumulative hypothyroidism incidences 1.4%/yr for RIT and 2.2%/yr for S, were not significantly different. Out of the five survivers without RIT or S, two TA patients were hypothyroid. The effect of RIT on goiter related loco-regional complications was not worse than after S. We conclude that RIT is the treatment for NIH, leaving surgery for exceptional cases.

  3. Comparison of the Cumulative Incidence Rates of Coal Workers' Pneumoconiosis between 1970 and 2013 among Four State-Owned Colliery Groups in China.

    PubMed

    Cui, Kai; Shen, Fuhai; Han, Bing; Yuan, Juxiang; Suo, Xia; Qin, Tianbang; Liu, Hongbo; Chen, Jie

    2015-07-01

    The purpose of this study was to identify differences in the incidence characteristics of coal workers' pneumoconiosis (CWP) based on data from four large state-owned colliery groups of China, by comparing the cumulative incidence rates of CWP. We investigated 87,904 coal workers from the Datong, Kailuan, Fuxin, and Tiefa Colliery Groups, who were exposed to dust for at least 1 year. The cumulative incidence rate of CWP was calculated with the life-table method and stratified analysis among coal workers with different occupational categories during different years of first dust exposure. Our results showed the cumulative incidence rate of Datong was higher than that of any other colliery group among workers with different occupational categories during different years of first dust exposure. For Datong workers who started their dust exposure in the 1970s, the cumulative incidence rates of CWP among tunneling, mining, combining, and helping workers were 34.77%, 10.20%, 34.59%, and 4.91% during the observed time of 34 years, respectively. For those in the 1980s, the cumulative incidence rates were 32.29%, 13.51%, 2.98%, and 0.47%, respectively. The cumulative incidence rates of Fuxin and Tiefa were the lowest. In conclusion, the Datong colliery has the highest cumulative incidence rate of CWP among the four studied collieries, followed by Kailuan. The cumulative incidence rates of Fuxin and Tiefa were the lowest. Additional dust-proofing measures for decreasing dust concentrations are still necessary. PMID:26133134

  4. Increased Cumulative Incidence of Dermatomyositis in Ulcerative Colitis: a Nationwide Cohort Study.

    PubMed

    Tseng, Chia-Chun; Chang, Shun-Jen; Liao, Wei-Ting; Chan, Ya-Ting; Tsai, Wen-Chan; Ou, Tsan-Teng; Wu, Cheng-Chin; Sung, Wan-Yu; Hsieh, Ming-Chia; Yen, Jeng-Hsien

    2016-01-01

    On a molecular level, two autoimmune diseases: ulcerative colitis (UC) and dermatomyositis share common genetic determinants. On a clinical level, case reports evidenced the co-occurrence of these two diseases. We therefore hypothesize that UC is potentially associated with increased cumulative incidence of dermatomyositis. The goals of this retrospective cohort study were to evaluate whether UC is associated with increased cumulative incidence of dermatomyositis independent of sex and age. For comparison, we also assessed the cumulative incidence of polymyositis in UC and control subjects. The study enrolled 3,133 UC subjects and 14,726 control subjects. The cumulative incidence of dermatomyositis was significantly higher in UC than that of control subjects (p = 0.026), but the cumulative incidence of polymyositis was comparable between UC and control subjects (p = 0.596). UC was independently associated with the increased incident dermatomyositis (hazard ratio: 6.19, 95% confidence interval = 1.77-21.59, p = 0.004) after adjusting for sex, age, and concomitant rheumatoid arthritis, systemic lupus erythematosus, and systemic sclerosis. Similar trends of increased dermatomyositis in UC were observed when patients were stratified based on sex and age. In conclusion, our findings suggest that UC is probably associated with increased cumulative incidence of dermatomyositis, independent of sex, age, and concomitant autoimmune diseases. PMID:27325143

  5. Increased Cumulative Incidence of Dermatomyositis in Ulcerative Colitis: a Nationwide Cohort Study

    PubMed Central

    Tseng, Chia-Chun; Chang, Shun-Jen; Liao, Wei-Ting; Chan, Ya-Ting; Tsai, Wen-Chan; Ou, Tsan-Teng; Wu, Cheng-Chin; Sung, Wan-Yu; Hsieh, Ming-Chia; Yen, Jeng-Hsien

    2016-01-01

    On a molecular level, two autoimmune diseases: ulcerative colitis (UC) and dermatomyositis share common genetic determinants. On a clinical level, case reports evidenced the co-occurrence of these two diseases. We therefore hypothesize that UC is potentially associated with increased cumulative incidence of dermatomyositis. The goals of this retrospective cohort study were to evaluate whether UC is associated with increased cumulative incidence of dermatomyositis independent of sex and age. For comparison, we also assessed the cumulative incidence of polymyositis in UC and control subjects. The study enrolled 3,133 UC subjects and 14,726 control subjects. The cumulative incidence of dermatomyositis was significantly higher in UC than that of control subjects (p = 0.026), but the cumulative incidence of polymyositis was comparable between UC and control subjects (p = 0.596). UC was independently associated with the increased incident dermatomyositis (hazard ratio: 6.19, 95% confidence interval = 1.77–21.59, p = 0.004) after adjusting for sex, age, and concomitant rheumatoid arthritis, systemic lupus erythematosus, and systemic sclerosis. Similar trends of increased dermatomyositis in UC were observed when patients were stratified based on sex and age. In conclusion, our findings suggest that UC is probably associated with increased cumulative incidence of dermatomyositis, independent of sex, age, and concomitant autoimmune diseases. PMID:27325143

  6. Cumulative Incidence of Cancer among HIV-infected Individuals in North America

    PubMed Central

    Silverberg, Michael J.; Lau, Bryan; Achenbach, Chad J.; Jing, Yuezhou; Althoff, Keri N.; D’Souza, Gypsyamber; Engels, Eric A.; Hessol, Nancy; Brooks, John T.; Burchell, Ann N.; Gill, M. John; Goedert, James J.; Hogg, Robert; Horberg, Michael A.; Kirk, Gregory D.; Kitahata, Mari M.; Korthuis, Phillip T.; Mathews, William C.; Mayor, Angel; Modur, Sharada P.; Napravnik, Sonia; Novak, Richard M.; Patel, Pragna; Rachlis, Anita R.; Sterling, Timothy R.; Willig, James H.; Justice, Amy C.; Moore, Richard D.; Dubrow, Robert

    2016-01-01

    Background Cancer is increasingly common among HIV patients given improved survival. Objective To examine calendar trends in cumulative cancer incidence and hazard rate by HIV status. Design Cohort study Setting North American AIDS Cohort Collaboration on Research and Design during 1996–2009 Patients 86,620 HIV-infected and 196,987 uninfected adults Measurements We estimated cancer-type-specific cumulative incidence by age 75 years by HIV status and calendar era, and examined calendar trends in cumulative incidence and hazard rates. Results Cumulative incidences (%) of cancer by age 75 (HIV+/HIV−) were: Kaposi sarcoma (KS), 4.4/0.01; non-Hodgkin’s lymphoma (NHL), 4.5/0.7; lung, 3.4/2.8; anal, 1.5/0.1; colorectal, 1.0/1.5; liver, 1.1/0.4; Hodgkin lymphoma (HL), 0.9/0.1; melanoma, 0.5/0.6; and oral cavity/pharyngeal, 0.8/0.8. Among HIV-infected subjects, we observed decreasing calendar trends in cumulative incidence and hazard rate for KS and NHL. For anal, colorectal and liver cancers, increasing cumulative incidence, but not hazard rate trends, were due to the decreasing mortality rate trend (−9% per year), allowing greater opportunity to be diagnosed with these cancer types. Despite decreasing hazard rate trends for lung, HL, and melanoma, we did not observe cumulative incidence trends due to the compensating effect of the declining mortality rate on cumulative incidence. Limitations Secular trends in screening, smoking, and viral co-infections were not evaluated. Conclusions Our analytic approach helped disentangle the effects of improved survival and changing cancer-specific hazard rates on cumulative incidence trends among HIV patients. Cumulative cancer incidence by age 75, approximating lifetime risk in HIV patients, may have clinical utility in this population. The high cumulative incidences by age 75 for KS, NHL, and lung cancer supports early and sustained ART and smoking cessation. Primary Funding Source National Institutes of Health PMID:26436616

  7. Cumulative Incidence of Osteochondritis Dissecans of the Capitellum in Child and Adolescent Baseball Players

    PubMed Central

    Iwame, Toshiyuki; Matsuura, Tetsuya; Suzue, Naoto; Sairyo, Koichi

    2016-01-01

    playing baseball, playing period of baseball, number of training hours per week, and history of elbow pain. Data were analyzed by multivariate logistic regression models and presented as odds ratio (OR) and profile likelihood 95% confidence interval (CI) values. Results: The mean age that players were introduced to baseball was 6.6 ±1.1 years; the mean duration of play baseball was 2.7 ±1.1 years; and the proportion of players with elbow pain when throwing was 24.1%. There were 138 (10.8%) pitchers, 114 (8.9%) catchers, 524 (41.2%) infielders, and 499 (39.1%) outfielders. The initial ultrasonographic screening revealed an irregularity of the subchondral bone in 33 players (2.6%). Of the 33 players, all the players agreed to undergo radiography. Of them, 23 players were confirmed OCD. These results showed that cumulative incidence of OCD was 1.8%. Univariate analysis showed that OCD occurrence was significantly associated with age of 11-12 years (p<.01) and more than 3 years of experimental year (p<.01). Beginning age of playing baseball, number of training hours per week, playing position, and history of elbow pain were not significantly associated with OCD. Multivariate analysis showed that age of 11-12 years (OR, 3.96; 95% CI, 1.10-18.97) was risk factors significantly associated with OCD. Experimental year was not significantly associated with OCD occurrence. Conclusion: It is expected that 1.8% of youth baseball players have OCD each year. The age of 11 and 12, increased training hours per week are risk factors for OCD.

  8. Covariate adjustment of cumulative incidence functions for competing risks data using inverse probability of treatment weighting.

    PubMed

    Neumann, Anke; Billionnet, Cécile

    2016-06-01

    In observational studies without random assignment of the treatment, the unadjusted comparison between treatment groups may be misleading due to confounding. One method to adjust for measured confounders is inverse probability of treatment weighting. This method can also be used in the analysis of time to event data with competing risks. Competing risks arise if for some individuals the event of interest is precluded by a different type of event occurring before, or if only the earliest of several times to event, corresponding to different event types, is observed or is of interest. In the presence of competing risks, time to event data are often characterized by cumulative incidence functions, one for each event type of interest. We describe the use of inverse probability of treatment weighting to create adjusted cumulative incidence functions. This method is equivalent to direct standardization when the weight model is saturated. No assumptions about the form of the cumulative incidence functions are required. The method allows studying associations between treatment and the different types of event under study, while focusing on the earliest event only. We present a SAS macro implementing this method and we provide a worked example. PMID:27084321

  9. Entering out-of-home care during childhood: Cumulative incidence study in Canada and Australia.

    PubMed

    O'Donnell, Melissa; Maclean, Miriam; Sims, Scott; Brownell, Marni; Ekuma, Okechukwu; Gilbert, Ruth

    2016-09-01

    Cumulative incidence provides a more accurate indicator than annual incidence rates of the number of children who experience out-of-home care during childhood. The study utilises a cohort of all children born in Western Australia (WA) 1994-2005 and Manitoba 1998-2008 using de-identified linked data. Life tables were used to calculate the age-specific cumulative incidence over time and for at-risk groups. Cox regression was used to compare risk factors for entry to care. Manitoba had a larger proportion of children entering care compared to WA (9.4% vs 1.5% by age 12). Over time children entered care at a younger age in both WA (HR=1.5, CI:1.4-1.5) and Manitoba (HR=1.5, CI:1.5-1.6). Similar factors were associated with earlier age care entries in both countries including: socioeconomic disadvantage, young maternal age, maternal hospital admissions for mental health issues, substance misuse and assault. Supplementary analysis for WA showed a time trend with young children (<3years of age) who entered care spending an increasing proportion of their early years in care. Whilst Manitoba had a larger proportion of children entering care, over time in Western Australia children have been entering care at a younger age and spending more time in care. These latter factors contribute to an increased burden on the out-of-home care system. Manitoba had over five times greater cumulative incidence than WA, however risk factors for entry to out-of-home care were consistent in both countries. Knowledge of the risk factors for entry to out-of-home care can inform targeted support and prevention programs. PMID:27521764

  10. Prevalence, Course, Incidence, and 1-Year Prediction of Deliberate Self-Harm and Suicide Attempts in Early Norwegian School Adolescents

    ERIC Educational Resources Information Center

    Larsson, Bo; Sund, Anne Mari

    2008-01-01

    In this survey of early Norwegian school adolescents, the prevalence, course, and incidence of self-harm behavior with or without suicide intent were examined, in addition to predictors of self-harm for a 1-year follow-up period. Lifetime prevalence rates of self-harm without suicide intent and suicide attempts were 2.9% and 3.0%, respectively,…

  11. Increased BOLD activation in the left parahippocampal cortex after 1 year of medical school: an association with cumulative verbal memory learning.

    PubMed

    Bernier, Michaël; Gauvreau, Claudie; Theriault, Denis; Madrolle, Stéphanie; Lepage, Jean-François; Whittingstall, Kevin

    2016-01-01

    Although several studies have shown left-right hippocampus asymmetry during learning, it is unclear whether such asymmetry also exists for the parahippocampal cortex, a structure within the limbic system that is also involved in memory and learning. Using a common mental navigation task known to activate the bilateral parahippocampal cortex, this study aimed at determining how BOLD activation in these two areas changes after 1 year of medical school, a program characterized by intensive verbal learning. Fifteen first-year medical students participated in this study and underwent two sessions of functional MRI, at a 1-year interval. In the first session, we observed marginal differences between left and right parahippocampal cortex activity. However, 1 year later, left parahippocampal activation significantly increased (+4.7%), whereas the right remained stable. These results bring new information as to how intensive learning can modify regional metabolism in the human brain and how the left parahippocampal region is particularly important for cumulative verbal memory. PMID:26606418

  12. [Cumulative annual incidence of disabling work-related musculoskeletal disorders in an urban area of Brazil].

    PubMed

    Souza, Norma Suely Souto; Santana, Vilma Sousa

    2011-11-01

    This study focused on the annual cumulative incidence (ACI) of disabling work-related musculoskeletal disorders affecting the neck and/or upper limbs (ULMSD) among workers covered by the National Social Insurance System in the city of Salvador, Bahia State, Brazil. Cases were workers who received disability compensation benefits when unable to work due to ULMSD, during the year 2008. The data were obtained from the administrative systems of the National Social Insurance Institute and Ministry of Labor and Employment. ACI was 15 per 10,000 workers. Increased ACI of ULMSD was associated with female gender, lower income, and work in financial activities or manufacturing. Women earning the minimum wage (US$ 64.00 per month) or less had the highest ACI of ULMSD (123 per 10,000), suggesting inequalities in the occurrence of these disorders. The study indicates the need to prioritize preventive actions focusing on ergonomics and work organization, early diagnosis, treatment, and rehabilitation. PMID:22124490

  13. Identifying Predictors of Cumulative Healthcare Costs in Incident Atrial Fibrillation: A Population‐Based Study

    PubMed Central

    Bennell, Maria C.; Qiu, Feng; Micieli, Andrew; Ko, Dennis T.; Dorian, Paul; Atzema, Clare L.; Singh, Sheldon M.; Wijeysundera, Harindra C.

    2015-01-01

    Background Atrial fibrillation (AF) has substantial impacts on healthcare resource utilization. Our objective was to understand the pattern and predictors of cumulative healthcare costs in AF patients after incident diagnosis in an emergency department (ED). Methods and Results Patients discharged after a first presentation of AF to an ED in Ontario, Canada, were identified from April 1, 2005, through March 31, 2010. Per‐patient cumulative healthcare costs were determined until death or March 31, 2012. Join‐point analyses identified clinically relevant cost phases. Hierarchical generalized linear models with a logarithmic link and gamma distribution determined predictors of cost per phase. Our cohort was 17 980 patients. During a mean follow‐up of 3.9 years, 17.1% of patients died. Three distinct cost phases were identified: 2‐month post–index ED visit phase, 12‐month predeath phase, and a stable/chronic phase. The mean cost per patient in the first month post–index ED visit was $1876 (95% CI $1822 to $1931), $8050 (95% CI $7666 to $8434) in the month before death, and $640 (95% CI $624 to $655) per month for the stable/chronic phase. The main cost component in the post‐index phase was physician services (32% of all costs) and hospitalizations for the predeath phase (72% of all costs). The CHA2DS2‐VASc clinical risk score was a strong predictor of costs (rate ratio 1.91 and 5.08 for score of 7 versus score of 0 in predeath phase and postindex phase, respectively). Conclusions There are distinct phases of resource utilization in AF, with highest costs in the predeath phase. PMID:25907124

  14. Five-year cumulative incidence of hypertension in adult Croatian population: the CroHort study.

    PubMed

    Erceg, Marijan; Ivicević-Uhernik, Ana; Kern, Josipa; Vuletić, Silvije

    2012-01-01

    The aim of this study was to establish a five-year cumulative incidence of arterial hypertension (hereinafter 5-CIAH) and its dependence on initial prehypertension, body weight, age and gender "Croatian Adult Health Cohort Study (CroHort)" data collected during 2003 and 2008 for the 1383 subjects aged 18 + with initially normal blood pressure (systolic < 140 mmHg and diastolic < 90 mmHg, and not taking medication) was analised. Methods of descriptive statistics, Student's t-test, chi2-test and logistic regression were used. The recorded 5-CIAH in male cohort was 36.9% [32.1 to 41.6] and 33.0% [30.1 to 36.0] in women and was higher in subjects with initial prehypertension (men 43.3% [37.5 to 49.0] versus 9.6% [12.1 to 27.2]; women (42 3% [38.1 to 46.6] versus 22.3% [18.5 to 26.1]). The development of arterial hypertension was affected by age (OR = 2.2168), initial prehypertension (OR = 2.1987) and overweight (OR = 1.9399). PMID:22338752

  15. Use of Cumulative Incidence of Novel Influenza A/H1N1 in Foreign Travelers to Estimate Lower Bounds on Cumulative Incidence in Mexico

    PubMed Central

    Lipsitch, Marc; Lajous, Martin; O'Hagan, Justin J.; Cohen, Ted; Miller, Joel C.; Goldstein, Edward; Danon, Leon; Wallinga, Jacco; Riley, Steven; Dowell, Scott F.; Reed, Carrie; McCarron, Meg

    2009-01-01

    Background An accurate estimate of the total number of cases and severity of illness of an emerging infectious disease is required both to define the burden of the epidemic and to determine the severity of disease. When a novel pathogen first appears, affected individuals with severe symptoms are more likely to be diagnosed. Accordingly, the total number of cases will be underestimated and disease severity overestimated. This problem is manifest in the current epidemic of novel influenza A/H1N1. Methods and Results We used a simple approach to leverage measures of incident influenza A/H1N1 among a relatively small and well observed group of US, UK, Spanish and Canadian travelers who had visited Mexico to estimate the incidence among a much larger and less well surveyed population of Mexican residents. We estimate that a minimum of 113,000 to 375,000 cases of novel influenza A/H1N1 have occurred in Mexicans during the month of April, 2009. Such an estimate serves as a lower bound because it does not account for underreporting of cases in travelers or for nonrandom mixing between Mexican residents and visitors, which together could increase the estimates by more than an order of magnitude. Conclusions We find that the number of cases in Mexican residents may exceed the number of confirmed cases by two to three orders of magnitude. While the extent of disease spread is greater than previously appreciated, our estimate suggests that severe disease is uncommon since the total number of cases is likely to be much larger than those of confirmed cases. PMID:19742302

  16. Incidence and Duration of Cumulative Bisphosphonate Use among Community-Dwelling Persons with or without Alzheimer's Disease.

    PubMed

    Tiihonen, Miia; Taipale, Heidi; Tanskanen, Antti; Tiihonen, Jari; Hartikainen, Sirpa

    2016-01-01

    We studied the incidence and duration of cumulative bisphosphonate use among older Finnish women and men with or without Alzheimer's disease (AD). The MEDALZ-2005 cohort is a nationwide sample of all persons with clinically diagnosed AD on 31 December 2005 and their age-, gender-, and region of residence-matched control persons without AD. Information on bisphosphonate use by persons with an AD diagnosis and their controls without AD during 2002-2009 was obtained from the prescription register database containing reimbursed medications. A total of 6,041 (11.8%) persons used bisphosphonates during the 8-year follow-up. Bisphosphonates were more commonly used among persons without AD (n = 3121, 12.3%) than among persons with AD (n = 2,920, 11.2%) (p = 0.001). The median duration of bisphosphonate use was 743 days (IQR). Among persons with AD, the median duration of use was 777 days (IQR) and among persons without AD, 701 days (IQR) (p = 0.011). People without AD more often used bisphosphonate combination preparations including vitamin D than did people with AD (p <  0.0001). Bisphosphonate use was more common among people without AD who had comorbidities, asthma/COPD, or rheumatoid arthritis compared with users with AD. Short-term users were more likely to be male, at least 80 years old, and not having AD. Although the incidence of bisphosphonate use was slightly higher among persons without AD, the cumulative duration of bisphosphonate use was longer in persons with AD. Short-term use was associated with male gender, older age, and not having AD. PMID:26967224

  17. Incidence and Duration of Cumulative Bisphosphonate Use among Community-Dwelling Persons with or without Alzheimer’s Disease

    PubMed Central

    Tiihonen, Miia; Taipale, Heidi; Tanskanen, Antti; Tiihonen, Jari; Hartikainen, Sirpa

    2016-01-01

    We studied the incidence and duration of cumulative bisphosphonate use among older Finnish women and men with or without Alzheimer’s disease (AD). The MEDALZ-2005 cohort is a nationwide sample of all persons with clinically diagnosed AD on 31 December 2005 and their age-, gender-, and region of residence-matched control persons without AD. Information on bisphosphonate use by persons with an AD diagnosis and their controls without AD during 2002–2009 was obtained from the prescription register database containing reimbursed medications. A total of 6,041 (11.8%) persons used bisphosphonates during the 8-year follow-up. Bisphosphonates were more commonly used among persons without AD (n = 3121, 12.3%) than among persons with AD (n = 2,920, 11.2%) (p = 0.001). The median duration of bisphosphonate use was 743 days (IQR). Among persons with AD, the median duration of use was 777 days (IQR) and among persons without AD, 701 days (IQR) (p = 0.011). People without AD more often used bisphosphonate combination preparations including vitamin D than did people with AD (p <  0.0001). Bisphosphonate use was more common among people without AD who had comorbidities, asthma/COPD, or rheumatoid arthritis compared with users with AD. Short-term users were more likely to be male, at least 80 years old, and not having AD. Although the incidence of bisphosphonate use was slightly higher among persons without AD, the cumulative duration of bisphosphonate use was longer in persons with AD. Short-term use was associated with male gender, older age, and not having AD. PMID:26967224

  18. Incidence, Predictors and Impact of Severe Periprocedural Bleeding According to VARC-2 Criteria on 1-Year Clinical Outcomes in Patients After Transcatheter Aortic Valve Implantation.

    PubMed

    Kochman, Janusz; Rymuza, Bartosz; Huczek, Zenon; Kołtowski, Łukasz; Ścisło, Piotr; Wilimski, Radosław; Ścibisz, Anna; Stanecka, Paulina; Filipiak, Krzysztof J; Opolski, Grzegorz

    2016-01-01

    There are differences in reporting bleeding complications after transcatheter aortic valve implantation (TAVI), which is a consequence of the lack of consensus for their definition. Furthermore, the amount of data on the impact of peri-procedural bleeding on the mid-term prognosis is still limited. The aim of this study was to investigate the incidence, predictors, and impact of life-threatening and major bleedings as defined by the Valve Academic Research Consortium 2 (VARC-2) in patients after TAVI over the mid-term prognosis.Consecutive patients who underwent TAVI from March 2010 to December 2013 were included. All data were classified according to the VARC-2 criteria. We assessed the incidence and the predictors of serious bleeding events (SBE), defined as life-threatening/disabling (LT/D) or major bleeding, and analyzed their impact on 30-day and 1-year clinical outcome.A total of 129 patients were included (79.1 ± 8.3 years; mean EuroSCORE = 17.8 ± 12.7). The SBE occurred in 25 patients (19.4%), of which 9 (7.0%) had LT/D and 16 (12.4%) had major bleeding. Trans-subclavian (TS) access (OR 4.38, 95% CI 2.13-14.29, P = 0.01) and diabetes (OR 2.93, 95% CI 1.08-7.93, P = 0.03) were identified as independent predictors of SBE. Patients with SBE had higher 30-day mortality (20.0% versus 4.0% P = 0.02) and 1-year mortality (40.0% versus 11.1%, P < 0.002). SBE independently predicted 1-year, all-cause mortality (HR 5.88, 95% CI 1.7319,94, P = 0.005).SBE are frequent after TAVI and are associated with decreased short and mid-term survival. Diabetes and TS access are independent risk factors for SBE. PMID:26673439

  19. Cumulative incidence of pandemic influenza A (H1N1) 2009 by a community‐based serological cohort study in Selenghe Province, Mongolia

    PubMed Central

    Burmaa, Alexanderyn; Tsatsral, Sosorbaramyn; Odagiri, Takashi; Suzuki, Akira; Oshitani, Hitoshi; Nymadawa, Pagbajabyn

    2012-01-01

    Please cite this paper as: Burmaa et al. (2012) Cumulative incidence of pandemic influenza A (H1N1) 2009 by a community‐based serological cohort study in Selenghe Province, Mongolia. Influenza and Other Respiratory Viruses 6(601), e97–e104. Background  Large community outbreaks of pandemic A (H1N1) 2009 occurred between October and December 2009 in Mongolia. A serological study was conducted among the general population by testing paired sera collected before and after the first wave of pandemic in Selenghe province, Mongolia. None of the study participants had been vaccinated for pandemic A (H1N1) 2009 before the second samples were collected. Objective  The objective of this study was to estimate cumulative incidence of pandemic A (H1N1) 2009 in different age‐groups of Selenghe province residents. Methods  After informed consent was obtained from apparently healthy volunteers, the paired sera and background information were collected. Antibody titers were measured using hemagglutinin inhibition (HI) and microneutralization (MN) assays for A/California/07/2009pdm. A fourfold rise in antibody titers was regarded as the evidence of infection. Results  The overall cumulative incidences in the study group for all ages were 28·8% (76/264) by HI, 35·2% (93/264) by MN, and 25·0% (66/264) by both HI and MN. Cumulative incidences of infection varied among age‐groups, with children aged 2–4 and 5–9 years having high cumulative incidence of infection. Overall cumulative incidences of infection in the whole population were estimated to be 23·0% (4946/21 460) by HI, 30·2% (6473/21 460) by MN, and 18·8% (4036/21 460) by both HI and MN. Conclusions  This study indicates that about one‐fourth of the total population in Selenghe province was infected with pandemic A (H1N1) 2009 virus during the first wave of the pandemic. PMID:22329794

  20. Prediction of long-term cumulative incidences based on short-term parametric model for competing risks: application in early breast cancer.

    PubMed

    Cabarrou, B; Belin, L; Somda, S M; Falcou, M C; Pierga, J Y; Kirova, Y; Delord, J P; Asselain, B; Filleron, T

    2016-04-01

    Use of parametric statistical models can be a solution to reduce the follow-up period time required to estimate long-term survival. Mould and Boag were the first to use the lognormal model. Competing risks methodology seems more suitable when a particular event type is of interest than classical survival analysis. The objective was to evaluate the ability of the Jeong and Fine model to predict long-term cumulative incidence. Survival data recorded by Institut Curie (Paris) from 4761 breast cancer patients treated and followed between 1981 and 2013 were used. Long-term cumulative incidence rates predicted by the model using short-term follow-up data were compared to non-parametric estimation using complete follow-up data. 20- or 25-year cumulative incidence rates for loco-regional recurrence and distant metastasis predicted by the model using a maximum of 10 years of follow-up data had a maximum difference of around 6 % compared to non-parametric estimation. Prediction rates were underestimated for the third and composite event (contralateral or second cancer or death). Predictive ability of Jeong and Fine model on breast cancer data was generally good considering the short follow-up period time used for the estimation especially when a proportion of patient did not experience loco-regional recurrence or distant metastasis. PMID:27075918

  1. Five-year cumulative incidence of invasive anal cancer among HIV-infected patients according to baseline anal cytology results: an inception cohort analysis

    PubMed Central

    Cachay, E.; Agmas, W.; Mathews, C.

    2015-01-01

    Objectives The aim of the study was to estimate the cumulative incidence of, and rates of progression to, invasive anal cancer (IAC) according to baseline anal cytology screening category in an unselected HIV clinical care cohort in the antiretroviral era. Methods A retrospective cohort analysis of HIV-infected patients under care at the University of California at San Diego Owen Clinic was carried out. Patients were eligible for this analysis if they had at least two anal cytohistological results available for longitudinal analysis. Kaplan-Meier analysis was used to estimate the cumulative incidence of IAC over time according to baseline cytology category [less than high-grade intraepithelial lesion (HSIL) versus HSIL]. Cox regression analysis was used to adjust for the following covariates: antiretroviral use, level of HIV viraemia, smoking status and infrared photocoagulation (IRC) ablation therapy. Results Between 2000 and 2012, we followed 2804 HIV-infected patients for a median of 4 years under a clinic protocol requiring baseline anal cytology screening. Incident IAC was diagnosed in 23 patients. Patients with a baseline HSIL anal cytology had an estimated 5-year probability of progression to IAC of 1.7% and an estimated annual progression risk of 1 in 263. None of the examined covariates was significantly associated with IAC incidence when examined in separate unadjusted Cox models. Conclusions HIV-infected patients with a baseline HSIL anal cytology had a 5-year cumulative incidence of IAC of 1.65%, with an upper 95% confidence bound of 4.5%. This population-based study provides quantitative risk estimates that may be used for counselling patients regarding management options for abnormal cytology results. PMID:25197003

  2. Reduction of pain and fracture incidence after kyphoplasty: 1-year outcomes of a prospective controlled trial of patients with primary osteoporosis.

    PubMed

    Grafe, Ingo A; Da Fonseca, Katharina; Hillmeier, Jochen; Meeder, Peter-Jürgen; Libicher, Martin; Nöldge, Gerd; Bardenheuer, Hubert; Pyerin, Walter; Basler, Linus; Weiss, Christel; Taylor, Rod S; Nawroth, Peter; Kasperk, Christian

    2005-12-01

    Previously, we reported significantly reduced pain and improved mobility persisting for 6 months after kyphoplasty of chronically painful osteoporotic vertebral fractures in the first prospective controlled trial. Since improvement of spinal biomechanics by restoration of vertebral morphology may affect the incidence of fracture, long-term clinical benefit and thereby cost-effectiveness, here we extend our previous work to assess occurrence of new vertebral fractures and clinical parameters 1 year after kyphoplasty compared with a conservatively treated control group. Sixty patients with osteoporotic vertebral fractures due to primary osteoporosis were included: 40 patients were treated with kyphoplasty, 20 served as controls. All patients received standard medical treatment. Morphological characteristics, new vertebral fractures, pain (visual analog scale), physical function [European Vertebral Osteoporosis Study (EVOS) score] (range 0-100 each) and back-pain-related doctors' visits were re-assessed 12 months after kyphoplasty. There were significantly fewer patients with new vertebral fractures of the thoracic and lumbar spine, after 12-months, in the kyphoplasty group than in the control group (P=0.0084). Pain scores improved from 26.2 to 44.4 in the kyphoplasty group and changed from 33.6 to 34.3 in the control group (P=0.008). Kyphoplasty treated patients required a mean of 5.3 back-pain-related doctors' visits per patient compared with 11.6 in the control group during 12 months follow-up (P=0.006). Kyphoplasty as an addition to medical treatment and when performed in appropriately selected patients by an interdisciplinary team persistently improves pain and reduces occurrence of new vertebral fractures and healthcare utilization for at least 12 months in individuals with primary osteoporosis. PMID:16078092

  3. A prospective study of the cumulative incidence and course of restless legs syndrome in de novo patients with Parkinson's disease during chronic dopaminergic therapy.

    PubMed

    Marchesi, Elena; Negrotti, Anna; Angelini, Monica; Goldoni, Matteo; Abrignani, Giorgia; Calzetti, Stefano

    2016-03-01

    The authors report the cumulative incidence of Restless Legs Syndrome (RLS) over a 3 years follow-up period in 92 de novo Parkinson's disease patients under chronic dopaminergic therapy and the clinical course of the sensory-motor disorder over 12 months as from its onset. The overall cumulative incidence of RLS was found by 15.3%, i.e. 14 incident cases, and by 11.9%, i.e. 11 incident cases, after the exclusion of possible "secondary" forms of the disorder. These figures are higher than those reported in general population in Germany (Study of Health in Pomerania), confirming our previous findings of incidence rate of the disorder. At the end of the 3 years follow-up period the prevalence of "current" RLS was significantly higher than that previously found in drug naïve Parkinson's disease patients and in controls, supporting the view that RLS emerging in the course of chronic dopaminergic therapy is the main determinant of the co-morbid association with Parkinson's disease. During the 12 months period of observation the RLS showed a frequency of occurrence of 6.08 episodes per month on average and a remittent clinical course was prevailing in the 11 incident cases, with a significant frequency decrease in the second as compared to the first 6 months, i.e. 3.26 versus 8.9 episodes per month, and none of the patients developed augmentation in the same period. It is hypothesized that the remittent course could be due to long-term adaptation (downregulation) of the hypersensitive post-synaptic dopamine receptors in the spinal cord to a continuous dopaminergic stimulation, possibly coupled with compensatory up-regulation of pre-synaptic dopamine re-uptake mechanism, in the patients in which the hypothalamic A11 area, site of origin of the dopamine-mediated diencephalo-spinal pathway, is involved in the neurodegenerative process. PMID:26566909

  4. The cumulative incidence of conventional risk factors of cardiovascular disease and their population attributable risk in an Iranian population: The Isfahan Cohort Study

    PubMed Central

    Sadeghi, Masoumeh; Talaei, Mohammad; Oveisgharan, Shahram; Rabiei, Katayoun; Dianatkhah, Minoo; Bahonar, Ahmad; Sarrafzadegan, Nizal

    2014-01-01

    Background: Cardiovascular diseases (CVDs) are the leading cause of death in Iran. The present study evaluated the 7-year incidence of CVD risk factors among the participants of Isfahan cohort study (ICS). Materials and Methods: ICS was a longitudinal study on adults over 35 years of age from the urban and rural areas in three counties in central Iran. Data on clinical examination and blood measurements were collected in 2001. Subjects were followed and similar data were collected in 2007. Cumulative incidence was calculated through dividing new cases of each risk factor by the population free of that risk factor at baseline. Incidence proportion was determined for major CVD risk factors including hypertension (HTN), hypercholesterolemia (HC), hypertriglyceridemia (HTg), obesity, diabetes mellitus (DM), metabolic syndrome (MetS), and smoking. Results: A total number of 6323 adults free of CVDs were recruited. After 7 years of follow-up, 3283 individuals were re-evaluated in 2007. The participants’ age was 49.2 ± 10.3 years in 2001 (mean ± SD). The 7-year cumulative incidence of HTN, HC, HTg, overweight, obesity, DM, MetS, and smoking was 22.8%, 37.4%, 28.0%, 26.3%, 7.4%, 9.5%, 23.9%, and 5.9% in men and 22.2%, 55.4%, 33.5%, 35.0%, 18.8%, 11.3%, 36.1%, and 0.7% in women, respectively. Among those with overweight or obesity, 14.7% of men and 7.9% of women decreased their weight up to the normal level. Conclusions: The present study revealed a high incidence of CVD risk factors especially dyslipidemia, obesity, MetS and HTN. Therefore, the application of life-style modification interventions seems necessary. PMID:25538928

  5. Markers of Inflammation, Oxidative Stress, and Endothelial Dysfunction and the 20-year Cumulative Incidence of Early Age-related Macular Degeneration: The Beaver Dam Eye Study

    PubMed Central

    Klein, Ronald; Myers, Chelsea E.; Cruickshanks, Karen J.; Gangnon, Ronald E.; Danforth, Lorraine G.; Sivakumaran, Theru A.; Iyengar, Sudha K.; Tsai, Michael Y.; Klein, Barbara E. K.

    2014-01-01

    Importance Modifying levels of factors associated with age-related macular degeneration (AMD) may decrease risk of visual impairment in older persons. Objective To examine the relationships of markers of inflammation, oxidative stress, and endothelial dysfunction to the 20-year cumulative incidence of early AMD. Design Longitudinal population-based cohort study. Setting Beaver Dam, Wisconsin. Participants A random sample of 975 persons in the Beaver Dam Eye Study without signs of AMD who participated in the baseline examination in 1988-1990 and up to four follow-up examinations in 1993-1995, 1998-2000, 2003-2005, and 2008-2010. Exposures Serum markers of inflammation (high sensitivity C-reactive protein [hsCRP], tumor necrosis factor-α receptor 2 [TNF-αR2], interleukin-6 [IL-6], and white blood cell count), oxidative stress (8-isoprostane and total carbonyl content), and endothelial dysfunction (soluble vascular cell adhesion molecule-1 [sVCAM-1] and soluble intercellular adhesion molecule-1) were measured. Interactions with Complement Factor H (rs1061170) and Age-Related Maculopathy Susceptibility 2 (rs10490924), C3 (rs2230199) and C2/CFB (rs4151667) were examined using multiplicative models. AMD was assessed from fundus photographs. Main Outcome Measure Early AMD defined by the presence of any size drusen and the presence of pigmentary abnormalities, or by the presence of large-sized drusen (≥125 μm diameter), in the absence of late AMD. Results The 20-year cumulative incidence of early AMD was 23.0%. Adjusting for age, sex, and other risk factors, hsCRP (odds ratio [OR] comparing 4th to 1st quartile 2.18, P=0.005), TNF-αR2 (1.78, P=0.04), and IL-6 (1.78, P=0.03) were associated with the incidence of early AMD. Increased incidence of early AMD was associated with sVCAM-1 (OR per standard deviation on the log ng/mL scale 1.21, P=0.04). Conclusions and Relevance We found modest evidence of relationships of serum hsCRP, TNF-αR2, and IL-6 and sVCAM-1 to the 20

  6. Second primary breast cancer in BRCA1 and BRCA2 mutation carriers: 10-year cumulative incidence in the Breast Cancer Family Registry.

    PubMed

    Menes, Tehillah S; Terry, Mary Beth; Goldgar, David; Andrulis, Irene L; Knight, Julia A; John, Esther M; Liao, Yuyan; Southey, Melissa; Miron, Alexander; Chung, Wendy; Buys, Saundra S

    2015-06-01

    BReast CAncer genes 1 and 2 (BRCA1 and BRCA2) mutation carriers diagnosed with breast cancer are at increased risk of developing a second primary breast cancer. Data from high-risk clinics may be subject to different biases which can cause both over and underestimation of this risk. Using data from a large multi-institutional family registry we estimated the 10-year cumulative risk of second primary breast cancer including more complete testing information on family members. We prospectively followed 800 women diagnosed with breast cancer from the Breast Cancer Family Registry (BCFR) who were carriers of a BRCA1 or BRCA2 pathogenic mutation or a variant of unknown clinical significance. In order to limit survival and ascertainment bias, cases were limited to those diagnosed with a first primary breast cancer from 1994 to 2001 and enrolled in the BCFR within 3 years after their cancer diagnosis. We excluded women enrolled after being diagnosed with a second breast cancer. We calculated 10-year incidence of second primary breast cancers. The 10-year incidence of a second primary breast cancer was highest in BRCA1 mutation carriers (17 %; 95 % CI 11-25 %), with even higher estimates in those first diagnosed under the age of 40 (21 %; 95 % CI 13-34 %). Lower rates were found in BRCA2 mutation carriers (7 %; 95 % CI 3-15 %) and women with a variant of unknown clinical significance (6 %; 95 % CI 4-9 %). Whereas the cumulative 10-year incidence of second primary breast cancer is high in BRCA1 mutation carriers, the estimates in BRCA2 mutation carriers and women with variants of unknown clinical significance are similar to those reported in women with sporadic breast cancer. PMID:25975955

  7. Second primary breast cancer in BRCA1 and BRCA2 mutation carriers: 10-year cumulative incidence in the Breast Cancer Family Registry

    PubMed Central

    Menes, Tehillah S.; Terry, Mary Beth; Goldgar, David; Andrulis, Irene L.; Knight, Julia A.; John, Esther M.; Liao, Yuyan; Southey, Melissa; Miron, Alexander; Chung, Wendy; Buys, Saundra S.

    2015-01-01

    Purpose BRCA1 and BRCA2 (BReast CAncer genes 1 and 2) mutation carriers diagnosed with breast cancer are at increased risk of developing a second primary breast cancer. Data from high risk clinics may be subject to different biases which can cause both over and underestimation of this risk. Using data from a large multi-institutional family registry we estimated the 10 year cumulative risk of second primary breast cancer including more complete testing information on family members. Patients and Methods We prospectively followed 800 women diagnosed with breast cancer from the Breast Cancer Family Registry (BCFR) who were carriers of a BRCA1 or BRCA2 pathogenic mutation or a variant of unknown clinical significance. In order to limit survival and ascertainment bias, cases were limited to those diagnosed with a first primary breast cancer from 1994 to 2001 and enrolled in the BCFR within 3 years after their cancer diagnosis; We excluded women enrolled after being diagnosed with a second breast cancer. We calculated 10 year incidence of second primary breast cancers. Results The 10-year incidence of a second primary breast cancer was highest in BRCA1 mutation carriers (17%; 95% CI 11-25%), with even higher estimates in those first diagnosed under the age of 40 (21%; 95% CI 13-34%). Lower rates were found in BRCA2 mutation carriers (7%; 95% CI 3-15%) and women with a variant of unknown clinical significance (6%; 95% CI 4-9%). Conclusions Whereas the cumulative 10-year incidence of second primary breast cancer is high in BRCA1 mutation carriers, the estimates in BRCA2 mutation carriers and women with variants of unknown clinical significance are similar to those reported in women with sporadic breast cancer. PMID:25975955

  8. A Prospective Study of Gynecological Cancer Risk in Relation to Adiposity Factors: Cumulative Incidence and Association with Plasma Adipokine Levels

    PubMed Central

    Wu, Meei-Maan; You, San-Lin; Cheng, Wen-Fang; Chen, Chi-An; Lee, Te-Chang; Chen, Chien-Jen

    2014-01-01

    Background Associations of obesity and obesity-related metabolic factors (adiposity factors) with uterine corpus cancer (UCC) and ovarian cancer (OVC) risk have been described. Still, a cause-effect relationship and the underlying mediators remain unclear, particularly for low-incidence populations. We aimed to prospectively determine whether adiposity factors could predict the development of UCC and OVC in Taiwanese women. To explore the biological mediators linking adiposity factors to cancer risk, we examined the association of two adipokines, leptin and adiponectin, with the gynecological cancers. Methods Totally, 11,258 women, aged 30–65, were recruited into the Community-Based Cancer Screening Program (CBCSP) study during 1991–1993, and were followed for UCC and OVC cases until December 31, 2011. Cox proportional hazard models were used to estimate hazard ratios (HRs). Adiposity factors and risk covariates were assessed at recruitment. Newly-developed cancer cases were determined from data in the government’s National Cancer Registry and Death Certification System. For adipokienes study, a nested case-control study was conducted within the cohort. Baseline plasma samples of 40 incident gynecological cancer cases and 240 age-menopause-matched controls were assayed for adipokines levels. Findings There were 38 and 30 incident cases of UCC and OVC, respectively, diagnosed during a median 19.9 years of follow-up. Multivariate analysis showed that alcohol intake (HR = 16.00, 95% = 4.83–53.00), high triglyceride levels (HR = 2.58, 95% = 1.28–5.17), and years of endogenous estrogen exposure per 5-year increment (HR = 1.91, 95% = 1.08–3.38) were associated with increased UCC risk. High body mass index (BMI≥27 kg/m2, HR = 2.90, 95% = 1.30–6.46) was associated with increased OVC risk. Analysis further showed an independent effect of adipokines on UCC and OVC risk after adjustment of the risk covariates. Conclusion We

  9. Prevalence, stability, 1-year incidence and predictors of depressive symptoms among Norwegian adolescents in the general population as measured by the Short Mood and Feelings Questionnaire.

    PubMed

    Larsson, Bo; Ingul, JoMagne; Jozefiak, Thomas; Leikanger, Einar; Sund, Anne Mari

    2016-01-01

    Background In numerous surveys the prevalence of depressive symptoms in adolescents has been examined in single sites and at one time point. Aims We examined depressive symptoms among adolescents aged 10-19 years in four different large school samples including two cohorts over a 10-year period in different locations in the same health region in central Norway including a total of 5804 adolescents. Two cohorts were retested within a 1-year time period to predict high versus low depressive symptom scores. Changes over a 6-year period in depressive symptom levels were examined in two of the samples of 12-14-year olds. Methods Depressive symptoms were estimated by the 13-item Short Mood and Feelings Questionnaire (SMFQ). Covariates were student age, sex, school size and location. Results "Miserable or unhappy", "Tired", "Restlessness" and "Poor concentration" were the most commonly reported depressive symptoms. Depressive symptom levels and proportions of high scoring students were consistently higher among girls, in particular in mid and late adolescence. Poisson regression analysis showed that all SMFQ items significantly predicted total scores for the whole sample, while sex (girls having a higher risk) emerged as a consistent 1-year predictor of high depressive symptom levels. Conclusions The SMFQ constitutes a short, practical and feasible measure. We recommend that this standardized measure should be used in the assessment of depressive symptoms among adolescents in school, primary care and clinical settings but also to evaluate treatment outcome. High scorers should be evaluated in subsequent clinical interviews for the presence of a depressive disorder. PMID:26817811

  10. Cumulative production of nucleons and extremely light nuclei in {sup 4}Hep interactions at an incident momentum of 5 GeV/c

    SciTech Connect

    Blinov, A. V. Chadeyeva, M. V.

    2006-09-15

    The invariant cross sections for the cumulative production of protons, neutrons, and extremely light nuclei (d, {sup 3}H, and {sup 3}He) are determined on the basis of experimental data obtained by exposing the 2-m liquid-hydrogen bubble chamber of the Institute of Theoretical and Experimental Physics (ITEP, Moscow) to a 5-GeV/c {alpha}-particle beam, the kinetic energy of primary protons in the rest frame of the nucleus involved being T{sub p} = 620 MeV. The results obtained in this way are compared with the predictions of the Frankfurt-Strikman model, which takes into account short-range few-nucleon correlations, and with the predictions of the nuclear coalescence model.

  11. Incidence of WHO Stage 3 and 4 Events, Tuberculosis, and Mortality in Untreated, HIV-Infected Children Enrolling in Care Before 1 Year of Age: An Iedea (International Epidemiologic Databases To Evaluate AIDS) East Africa Regional Analysis

    PubMed Central

    Ciaranello, Andrea; Lu, Zhigang; Ayaya, Samuel; Losina, Elena; Musick, Beverly; Vreeman, Rachel; Freedberg, Kenneth A.; Abrams, Elaine J.; Dillabaugh, Lisa; Doherty, Katie; Ssali, John; Yiannoutsos, Constantin T.; Wools-Kaloustian, Kara

    2014-01-01

    Background Few studies have reported CD4%- and age-stratified rates of WHO Stage 3 (WHO3) events, WHO Stage 4 (WHO4) events, tuberculosis (TB), and mortality in HIV-infected infants before initiation of antiretroviral therapy (ART). Methods HIV-infected children enrolled before 1 year of age in the International Epidemiologic Databases to Evaluate AIDS (IeDEA) East Africa region (10/01/2002-11/30/2008) were included. We estimated incidence rates of earliest clinical event (WHO3, WHO4, and TB), prior to ART initiation per local guidelines, stratified by current age (< or ≥6 months) and current CD4% (<15%, 15–24%, ≥25%). CD4%-stratified mortality rates were estimated separately for children who did not experience a clinical event (“background” mortality) and for children who experienced an event, including “acute” mortality (≤30 days post-event) and “later” mortality (>30 days post-event). Results Among 847 children (median enrollment age: 4.8 months; median pre-ART follow-up: 10.8 months; 603 (71%) with ≥1 CD4% recorded), event rates were comparable for those aged <6 and ≥6 months. Current CD4% was associated with risk of WHO4 events for children <6 months old, and with all evaluated events for children ≥6 months old (p<0.05). “Background” mortality was 3.7–8.4/100py. “Acute” mortality (≤30 days post-event) was 33.8/100py (after TB) and 41.1/100py (after WHO3 or WHO4). “Later” mortality (>30 days post-event) ranged by CD4% from 4.7–29.1/100py. Conclusions In treatment-naïve, HIV-infected infants, WHO3, WHO4, and TB events were common before and after 6 months of age and led to substantial increases in mortality. Early infant HIV diagnosis and treatment are critically important, regardless of CD4%. PMID:24378935

  12. Magnetic cumulation

    NASA Astrophysics Data System (ADS)

    Pavlovskij, A. I.

    1990-08-01

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

  13. Cumulants, free cumulants and half-shuffles

    PubMed Central

    Ebrahimi-Fard, Kurusch; Patras, Frédéric

    2015-01-01

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

  14. Emotional Development: 1 Year Olds

    MedlinePlus

    ... Español Text Size Email Print Share Emotional Development: 1 Year Olds Page Content Article Body Throughout her ... for shelter. She may seem to change from one moment to the next, or she may seem ...

  15. Social Development: 1 Year Olds

    MedlinePlus

    ... Stages Prenatal Baby Toddler Fitness Nutrition Toilet Training Preschool Gradeschool Teen Young Adult Healthy Children > Ages & Stages > Toddler > Social Development: 1 Year Olds Ages & Stages Listen Español ...

  16. Cumulative Poisson Distribution Program

    NASA Technical Reports Server (NTRS)

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

    1990-01-01

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

  17. Cumulative fatigue damage models

    NASA Technical Reports Server (NTRS)

    Mcgaw, Michael A.

    1988-01-01

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

  18. CUMBIN - CUMULATIVE BINOMIAL PROGRAMS

    NASA Technical Reports Server (NTRS)

    Bowerman, P. N.

    1994-01-01

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

  19. Cumulative Timers for Microprocessors

    NASA Technical Reports Server (NTRS)

    Battle, John O.

    2007-01-01

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

  20. CROSSER - CUMULATIVE BINOMIAL PROGRAMS

    NASA Technical Reports Server (NTRS)

    Bowerman, P. N.

    1994-01-01

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

  1. NEWTONP - CUMULATIVE BINOMIAL PROGRAMS

    NASA Technical Reports Server (NTRS)

    Bowerman, P. N.

    1994-01-01

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

  2. The Effect of Clozapine on Hematological Indices: A 1-Year Follow-Up Study.

    PubMed

    Lee, Jimmy; Takeuchi, Hiroyoshi; Fervaha, Gagan; Powell, Valerie; Bhaloo, Amaal; Bies, Robert; Remington, Gary

    2015-10-01

    Clozapine is the antipsychotic of choice for treatment-resistant schizophrenia and is linked to a need for mandatory hematological monitoring. Besides agranulocytosis, other hematological aberrations have resulted in premature termination in some cases. Considering clozapine's role in immunomodulation, we proceeded to investigate the impact of clozapine on the following 3 main hematological cell lines: red blood cells, platelets, white blood cells (WBCs), and its differential counts. Data were extracted from patients initiated on clozapine between January 2009 and December 2010 at a single hospital. Patients with a preclozapine complete blood count, who were receiving clozapine during the 1-year follow-up period, were included in the present investigation. Counts of red blood cells, platelets, WBC, and its differential including neutrophils, lymphocytes, monocytes, eosinophils, and basophils were extracted and trajectories plotted. One hundred one patients were included in this study and 66 remained on clozapine at the end of 1 year. There was a synchronized but transient increase in WBC, neutrophils, monocytes, eosinophils, basophils, and platelets beginning as early as the first week of clozapine treatment. There were no cases of agranulocytosis reported in this sample, and five developed neutropenia. A spike in neutrophils immediately preceded the onset of neutropenia in three of the five. The cumulative incidence rates were 48.9% for neutrophilia, 5.9% for eosinophilia, and 3% each for thrombocytosis and thrombocytopenia. Early hematological aberrations are visible across a range of cell lines, primarily of the myeloid lineage. These disturbances are transient and are probably related to clozapine's immunomodulatory properties. We do not suggest discontinuing clozapine as a consequence of the observed aberrations. PMID:26267420

  3. Aeronautical Engineering: 1983 cumulative index

    NASA Technical Reports Server (NTRS)

    1984-01-01

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

  4. CUMPOIS- CUMULATIVE POISSON DISTRIBUTION PROGRAM

    NASA Technical Reports Server (NTRS)

    Bowerman, P. N.

    1994-01-01

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

  5. Incidence of cardiac abnormalities in children with human immunodeficiency virus infection: The Prospective P2C2 HIV Study

    PubMed Central

    Starc, Thomas J.; Lipshultz, Steven E.; Easley, Kirk A.; Kaplan, Samuel; Bricker, J. Timothy; Colan, Steven D.; Lai, Wyman W.; Gersony, Welton M.; Sopko, George; Moodie, Douglas S.; Schluchter, Mark D.

    2015-01-01

    Objective To describe the 5-year cumulative incidence of cardiac dysfunction in human immunodeficiency virus (HIV)-infected children. Study design We used a prospective cohort design, enrolling children at 10 hospitals. Group I included 205 vertically HIV-infected children enrolled at a median age of 1.9 years. Group II consisted of 600 HIV-exposed children enrolled prenatally or as neonates, of whom 93 were ultimately HIV-infected. The main outcome measures were echocardiographic indexes of left ventricular dysfunction. Results In group I, the 5-year cumulative incidence of left ventricular fractional shortening ≤25% was 28.0%. The 5-year incidence of left ventricular end-diastolic dilatation was 21.7%, and heart failure and/or the use of cardiac medications 28.8%. The mortality rate 1 year after the diagnosis of heart failure was 52.5% [95% CI, 30.5-74.5]. Within group II, the 5-year cumulative incidence of decreased fractional shortening was 10.7% in the HIV-infected compared with 3.1% in the HIV-uninfected children (P = .01). Left ventricular dilation, heart failure, and/or the use of cardiac medications were more common in infected compared with uninfected children. Conclusions During 5 years of follow-up, cardiac dysfunction occurred in 18% to 39% of HIV-infected children and was associated with an increased risk of death. We recommend that HIV-infected children undergo routine echocardiographic surveillance for cardiac abnormalities. PMID:12219051

  6. DEFENSE FACILITIES CUMULATIVE INDEX ANALYSIS

    EPA Science Inventory

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

  7. Cumulative effects analysis (CEA) tools

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

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

    PubMed Central

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

    2015-01-01

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

  9. Cumulative life damage in dermatology

    PubMed Central

    Ibler, Kristina; Jemec, Gregor B.E.

    2011-01-01

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

  10. Varicella paediatric hospitalisations in Belgium: a 1-year national survey

    PubMed Central

    Blumental, Sophie; Sabbe, Martine; Lepage, Philippe

    2016-01-01

    Background Varicella universal vaccination (UV) has been implemented in many countries for several years. Nevertheless, varicella UV remains debated in Europe and few data are available on the real burden of infection. We assessed the burden of varicella in Belgium through analysis of hospitalised cases during a 1-year period. Methods Data on children admitted to hospital with varicella were collected through a national network from November 2011 to October 2012. Inclusion criteria were either acute varicella or related complications up to 3 weeks after the rash. Results Participation of 101 hospitals was obtained, covering 97.7% of the total paediatric beds in Belgium. 552 children were included with a median age of 2.1 years. Incidence of paediatric varicella hospitalisations reached 29.5/105 person-years, with the highest impact among those 0–4 years old (global incidence and odds of hospitalisation: 79/105 person-years and 1.6/100 varicella cases, respectively). Only 14% (79/552) of the cohort had an underlying chronic condition. 65% (357/552) of children had ≥1 complication justifying their admission, 49% were bacterial superinfections and 10% neurological disorders. Only a quarter of children (141/552) received acyclovir. Incidence of complicated hospitalised cases was 19/105 person-years. Paediatric intensive care unit admission and surgery were required in 4% and 3% of hospitalised cases, respectively. Mortality among Belgian paediatric population was 0.5/106 and fatality ratio 0.2% among our cohort. Conclusions Varicella demonstrated a substantial burden of disease in Belgian children, especially among the youngest. Our thorough nationwide study, run in a country without varicella UV, offers data to support varicella UV in Belgium. PMID:26130380

  11. Cumulant expansions for atmospheric flows

    NASA Astrophysics Data System (ADS)

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

    2016-02-01

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

  12. 40 CFR 1508.7 - Cumulative impact.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

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

  13. 40 CFR 1508.7 - Cumulative impact.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  14. A paradox of cumulative culture.

    PubMed

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

    2015-08-21

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

  15. Incidence of work-related hand eczema during apprenticeship: first results of a prospective cohort study in the car industry.

    PubMed

    Funke, U; Fartasch, M; Diepgen, T L

    2001-03-01

    Data on the incidence and prevalence of occupational contact dermatitis (OCD) are scarce, and most of our knowledge about OCD is derived from clinical case reports or clinical studies of in-and out-patients. Therefore, we investigated in the epidemiological, prospective Audi cohort study (PACO study) the incidences of work-related hand eczema in different apprenticeships of Audi AG. In total, 2078 apprentices were investigated at the start of their apprenticeship and systematically followed up over a 3-year period. At the end of the study, information on 2042 (98.2% follow-up) apprentices was available. The 1-year cumulative incidences of hand eczema were 9.2% (95%-confidence interval 7.8-10.7) in metalworkers, 8.8% (95%-CI 7.0-10.7) in other blue-collar workers, and 4.6% (95%-CI 2.3-8.1) in white-collar apprentices. The 3-year cumulative incidences of hand eczema were 15.3% (95%-CI 13.6-17.2) in metalworkers, 14.1% (95%-CI 11.8-16.5) in other blue-collar workers, and 6.9% (95%-CI 4.0-10.9) in white-collar apprentices. In females, the cumulative incidence of hand eczema was higher compared to men (1-year incidence 10.1%, 95%-CI 7.7-13.0, versus 8.3%, 95%-CI 7.1-9.5; 3-year incidence 16.1%, 95%-CI 13.1-19.5 versus 13.6%, 95%-CI 12.2-15.2). In some occupations, like cooks, tool mechanics, milling cutters and varnishers, the incidence of hand eczema was significantly increased. In those occupations, however, no job change was necessary, and no notifiable occupational contact dermatitis occurred. The incidence was not uniformly distributed over the 3-year period. Within the first 6 months, a particularly high rate of hand eczema occurred, which then declined and remained steady at a lower rate over the 2nd and the 3rd years. The results of our study give important suggestions for preventive measures at the workplace and effective occupational pre-employment advices. PMID:11217989

  16. Incidence and risk factors for hypogammaglobulinemia in pediatric patients following allo-SCT.

    PubMed

    Frangoul, H; Min, E; Wang, W; Chandrasekhar, R; Calder, C; Evans, M; Manes, B; Bruce, K; Brown, V; Ho, R; Domm, J

    2013-11-01

    We evaluated the incidence and risk factors for hypogammaglobulinemia after allogeneic hematopoietic SCT (HSCT) in pediatric patients. Ig levels were measured pre-transplant, every 2 weeks until day 100 and then monthly post SCT in 185 patients undergoing myeloablative HSCT. Median age was 9 years; 142 (77%) had malignant disease and 114 (62%) received stem cells from an unrelated source. Hypogammaglobulinemia (IgG <500 mg/dL) developed in 143 (77%) of the patients at a median of 56 days (range 15-339) post SCT. The cumulative incidence of hypogammaglobulinemia at 1 year was higher among patients who developed acute GVHD (97% vs 54%, P<0.001), and for those receiving stem cells from an unrelated source (94% vs 51%, P<0.001). The cumulative incidence of TRM was significantly higher for patients with hypogammaglobulinemia (P=0.026). In multivariable analysis, lower pre-transplant IgG level (P<0.001), younger age (P=0.012), diagnosis of malignant disease (P<0.001), receiving unrelated SCT (P<0.001) and development of acute GVHD (P<0.001) were all significantly associated with higher risk of hypogammaglobulinemia post HSCT. We conclude that hypogammaglobulinemia is common, following allogeneic HSCT in pediatric patients, especially in those with malignant diseases, those who receive an unrelated transplant or patients who develop GVHD. PMID:23708706

  17. Choking - unconscious adult or child over 1 year

    MedlinePlus

    Choking - unconscious adult or child over 1 year; First aid - choking - unconscious adult or child over 1 year; ... or the local emergency number while you begin first aid and CPR. If you are alone, shout for ...

  18. Choking - unconscious adult or child over 1 year

    MedlinePlus

    ... choking - unconscious adult or child over 1 year; CPR - choking - unconscious adult or child over 1 year ... emergency number while you begin first aid and CPR. If you are alone, shout for help and ...

  19. Incidence of Congenital Heart Disease: The 9-Year Experience of the Guangdong Registry of Congenital Heart Disease, China

    PubMed Central

    Zhuang, Jian; Chen, Guanchun; Mai, Jinzhuang; Guo, Xiaoling; Ou, Yanqiu; Chen, Jimei; Gong, Wei; Gao, Xiangmin; Wu, Yong; Nie, Zhiqiang

    2016-01-01

    There are 16.5 million newborns in China annually. However, the incidence of congenital heart disease (CHD) has not been evaluated. In 2004, we launched an active province-wide hospital-based CHD registry in the Guangdong Province of southern China. In this study, we examined the incidence of CHD and its subtypes from 2004 to 2012 and compared our findings to the literature. Our results indicate there is an increasing trend of CHD incidence. The increase in incidence occurred mainly for single lesion and the most common subtypes (e.g., ventricular or atrial septal defect, patent ductus arteriosus). There were no increases found for multiple lesions or more complex subtypes. The proportion of CHD cases that were detected early (e.g., 1 week) increased over time. The incidence of CHD stabilized in 2010–2012 with the average cumulative incidences of 9.7, 9.9, and 11.1 per 1,000 live births at 1 week, 1 month, and 1 year, respectively. The incidences of CHD subtypes were comparable with recent international results. The data did not support previous reports that Asian children have a higher incidence of pulmonary outflow obstructions and lower incidence of transposition of the great arteries. However, there was a lower incidence of left ventricular outflow tract obstructions observed in our series. The increase in CHD incidence observed over time was due to improved detection and diagnosis. The true incidence of CHD in China was approximately 11.1 per 1,000 live births, which is higher than previously reported. PMID:27409588

  20. Incidence of Congenital Heart Disease: The 9-Year Experience of the Guangdong Registry of Congenital Heart Disease, China.

    PubMed

    Qu, Yanji; Liu, Xiaoqing; Zhuang, Jian; Chen, Guanchun; Mai, Jinzhuang; Guo, Xiaoling; Ou, Yanqiu; Chen, Jimei; Gong, Wei; Gao, Xiangmin; Wu, Yong; Nie, Zhiqiang

    2016-01-01

    There are 16.5 million newborns in China annually. However, the incidence of congenital heart disease (CHD) has not been evaluated. In 2004, we launched an active province-wide hospital-based CHD registry in the Guangdong Province of southern China. In this study, we examined the incidence of CHD and its subtypes from 2004 to 2012 and compared our findings to the literature. Our results indicate there is an increasing trend of CHD incidence. The increase in incidence occurred mainly for single lesion and the most common subtypes (e.g., ventricular or atrial septal defect, patent ductus arteriosus). There were no increases found for multiple lesions or more complex subtypes. The proportion of CHD cases that were detected early (e.g., 1 week) increased over time. The incidence of CHD stabilized in 2010-2012 with the average cumulative incidences of 9.7, 9.9, and 11.1 per 1,000 live births at 1 week, 1 month, and 1 year, respectively. The incidences of CHD subtypes were comparable with recent international results. The data did not support previous reports that Asian children have a higher incidence of pulmonary outflow obstructions and lower incidence of transposition of the great arteries. However, there was a lower incidence of left ventricular outflow tract obstructions observed in our series. The increase in CHD incidence observed over time was due to improved detection and diagnosis. The true incidence of CHD in China was approximately 11.1 per 1,000 live births, which is higher than previously reported. PMID:27409588

  1. Cumulative Carbon and Anthropocene Climate

    NASA Astrophysics Data System (ADS)

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

    2010-12-01

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

  2. Cumulative Exams in the Introductory Psychology Course

    ERIC Educational Resources Information Center

    Lawrence, Natalie K.

    2013-01-01

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

  3. Moments from Cumulants and Vice Versa

    ERIC Educational Resources Information Center

    Withers, Christopher S.; Nadarajah, Saralees

    2009-01-01

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

  4. A Photographic View of Cumulative Distribution Functions

    ERIC Educational Resources Information Center

    Jernigan, Robert W.

    2008-01-01

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

  5. 32 CFR 651.16 - Cumulative impacts.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

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

  6. 32 CFR 651.16 - Cumulative impacts.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

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

  7. 32 CFR 651.16 - Cumulative impacts.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

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

  8. Cumulate Fragments in Silicic Ignimbrites

    NASA Astrophysics Data System (ADS)

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

    2014-12-01

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

  9. Rethinking cumulative exposure in epidemiology, again.

    PubMed

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

    2015-01-01

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

  10. EVALUATION PARADIGM FOR CUMULATIVE IMPACT ANALYSIS

    EPA Science Inventory

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

  11. Aerospace Medicine and Biology: Cumulative index, 1979

    NASA Technical Reports Server (NTRS)

    1980-01-01

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

  12. Cumulative human impacts on marine predators.

    PubMed

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

    2013-01-01

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

  13. DEVELOPMENT OF APPROACHES FOR CUMULATIVE RISK ASSESSMENT

    EPA Science Inventory

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

  14. Quantal Cumulant Dynamics for Dissipative Systems

    SciTech Connect

    Shigeta, Yasuteru

    2007-12-26

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

  15. Cumulative creep damage for polycarbonate and polysulfone

    NASA Technical Reports Server (NTRS)

    Zhang, M.; Brinson, H. F.

    1985-01-01

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

  16. Untangling the Relationship Between Antiretroviral Therapy Use and Incident Pregnancy: A Marginal Structural Model Analysis Using Data From 47,313 HIV-Positive Women in East Africa

    PubMed Central

    Wools-Kaloustian, Kara K.; Wu, Yingfeng; Musick, Beverly S.; Nuwagaba-Biribonwoha, Harriet; Nash, Denis; Ayaya, Samuel; Bukusi, Elizabeth; Okong, Pius; Otieno, Juliana; Wabwire, Deo; Kambugu, Andrew; Yiannoutsos, Constantin T.

    2016-01-01

    Background: Scale-up of triple-drug antiretroviral therapy (ART) in Africa has transformed the context of childbearing for HIV-positive women and may impact pregnancy incidence in HIV programs. Methods: Using observational data from 47,313 HIV-positive women enrolled at 26 HIV clinics in Kenya and Uganda between 2001 and 2009, we calculated the crude cumulative incidence of pregnancy for the pre-ART and on-ART periods. The causal effect of ART use on incident pregnancy was assessed using inverse probability weighted marginal structural models, and the relationship was further explored in multivariable Cox models. Results: Crude cumulative pregnancy incidence at 1 year after enrollment/ART initiation was 4.0% and 3.9% during the pre-ART and on-ART periods, respectively. In marginal structural models, ART use was not significantly associated with incident pregnancy [hazard ratio = 1.06; 95% confidence interval (CI): 0.99 to 1.12]. Similarly, in Cox models, there was no significant relationship between ART use and incident pregnancy (cause-specific hazard ratio: 0.98; 95% CI: 0.91 to 1.05), but effect modification was observed. Specifically, women who were pregnant at enrollment and on ART had an increased risk of incident pregnancy compared to those not pregnant at enrollment and not on ART (cause-specific hazard ratio: 1.11; 95% CI: 1.01 to 1.23). Conclusions: In this large cohort, ART initiation was not associated with incident pregnancy in the general population of women enrolling in HIV care but rather only among those pregnant at enrollment. This finding further highlights the importance of scaling up access to lifelong treatment for pregnant women. PMID:26910499

  17. Human cumulative culture: a comparative perspective.

    PubMed

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

    2014-05-01

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

  18. Choking first aid - adult or child over 1 year - slideshow

    MedlinePlus

    ... page: //medlineplus.gov/ency/presentations/100222.htm Choking first aid - adult or child over 1 year - series—Part ... occur in as little as 4 minutes. Rapid first aid for choking can save a life. The universal ...

  19. Choking first aid - infant under 1 year - slideshow

    MedlinePlus

    ... page: //medlineplus.gov/ency/presentations/100221.htm Choking first aid - infant under 1 year - series—Part 1 To ... Loss of consciousness if blockage is not cleared FIRST AID 1. DO NOT perform these steps if the ...

  20. A Screening Method for Assessing Cumulative Impacts

    PubMed Central

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

    2012-01-01

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

  1. Managing cumulative impacts: A key to sustainability?

    SciTech Connect

    Hunsaker, C.T.

    1994-12-31

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

  2. Two new constraints for the cumulant matrix

    SciTech Connect

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

    2014-12-21

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

  3. Exact cumulant Kramers-Moyal-like expansion

    NASA Astrophysics Data System (ADS)

    Morgado, W. A. M.

    2015-11-01

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

  4. Flow analysis with cumulants: Direct calculations

    SciTech Connect

    Bilandzic, Ante; Snellings, Raimond; Voloshin, Sergei

    2011-04-15

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  7. Phase Fluctuations at Goldstone Derived from 1-Year Site Testing Interferometer Data

    NASA Technical Reports Server (NTRS)

    Nessel, James A.; Acosta, Roberto J.; Morabito, David D.

    2009-01-01

    A two-element site test interferometer has been deployed at the NASA Deep Space Network (DSN) tracking complex in Goldstone, California, since May 2007. The interferometer system consists of two offset-fed 1.2 m parabolic reflectors which monitor atmospheric-induced amplitude and phase fluctuations on an unmodulated beacon signal (20.199 GHz) broadcast from a geostationary satellite (Anik F2). The geometry of the satellite and the ground-based infrastructure imposes a 48.5 elevation angle with a separation distance of 256 m along an east-west baseline. The interferometer has been recording phase fluctuation data, to date, for 1 yr with an overall system availability of 95 percent. In this paper, we provide the cumulative distribution functions (CDFs) for 1 year of recorded data, including phase rms, spatial structure function exponent, and surface meteorological measurements: surface wind speed, relative humidity, temperature, barometric pressure, and rain rate. Correlation between surface measurements, phase rms, and amplitude rms at different time scales are discussed. For 1 year, phase fluctuations at the DSN site in Goldstone, are better than 23 for 90 percent of the time (at 48.5 elevation). This data will be used to determine the suitability of the Goldstone site as a location for the Next Generation Deep Space Network.

  8. Efficient formulas for efficiency correction of cumulants

    NASA Astrophysics Data System (ADS)

    Kitazawa, Masakiyo

    2016-04-01

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

  9. Cumulative Intertrial Inhibition in Repeated Visual Search

    ERIC Educational Resources Information Center

    Takeda, Yuji

    2007-01-01

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

  10. CUMULATIVE RISK ASSESSMENT FOR QUANTITATIVE RESPONSE DATA

    EPA Science Inventory

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

  11. Cumulative creep damage for polycarbonate and polysulfone

    NASA Technical Reports Server (NTRS)

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

    1985-01-01

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

  12. LANDSAT 1 US cumulative catalog, 1975 - 1976

    NASA Technical Reports Server (NTRS)

    1976-01-01

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

  13. HUMAN EXPOSURE MODELING FOR CUMULATIVE RISK

    EPA Science Inventory

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

  14. Aerospace Medicine and Biology: 1983 cumulative index

    NASA Technical Reports Server (NTRS)

    1984-01-01

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

  15. Calculation of the Poisson cumulative distribution function

    NASA Technical Reports Server (NTRS)

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

    1990-01-01

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

  16. Cumulative Language Deficit Among Indian Children.

    ERIC Educational Resources Information Center

    Mickelson, Norma I.; Galloway, Charles G.

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

  17. CUMULATIVE RISK ANALYSIS FOR ORGANOPHOSPHORUS PESTICIDES

    EPA Science Inventory

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

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

  18. Sexual function 1-year after allogeneic hematopoietic stem cell transplantation.

    PubMed

    Noerskov, K H; Schjødt, I; Syrjala, K L; Jarden, M

    2016-06-01

    Treatment with allogeneic hematopoietic stem cell transplantation (HSCT) is associated with short and long-term toxicities that can result in alterations in sexual functioning. The aims of this prospective evaluation were to determine: (1) associations between HSCT and increased sexual dysfunction 1 year after treatment; and (2) associations between sexual dysfunction, body image, anxiety and depression. This controlled prospective cohort study was conducted from October 2010 to November 2013. Patients completed assessments 2-3 weeks before HSCT (N=124) and 1 year after treatment (N=63). Assessment included descriptive data, Sexual Functioning Questionnaire, Body Image Scale and Hospital Anxiety and Depression Scale. The results showed a significant decline in overall sexual function in both men and women (P=<0.001, P=0.010, respectively), although men generally scored higher than women. Forty-seven percent of men and 60% of women reported at least one physical sexual problem 1 year after HSCT. Patients with chronic GVHD trended toward reporting lower levels of sexual function. Finally, women with chronic GVHD scored lower than those without chronic GVHD on the sexual function problem subscale (P=0.008). Sexual dysfunction remains a major problem for men and women 1 year after HSCT and requires routine evaluation and treatment after HSCT. PMID:26878660

  19. Anxiety Sensitivity and Panic Attacks: A 1-Year Longitudinal Study

    ERIC Educational Resources Information Center

    Li, Wen; Zinbarg, Richard E.

    2007-01-01

    The hypothesis that anxiety sensitivity (AS) is a risk factor for panic genesis has obtained compelling support, but the clinical/practical importance of AS in panic genesis has been questioned. In addition, the association between panic experience and AS increase has not been clearly demonstrated. Through this 1-year longitudinal study among…

  20. An evaluation paradigm for cumulative impact analysis

    NASA Astrophysics Data System (ADS)

    Stakhiv, Eugene Z.

    1988-09-01

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

  1. Infectious complications more than 1 year after liver transplantation: a 3-decade nationwide experience.

    PubMed

    Aberg, F; Mäkisalo, H; Höckerstedt, K; Isoniemi, H

    2011-02-01

    Because few reports have addressed infections late (≥1 year) after liver transplantation (LT), we evaluated the incidence, risk factors and pathogens involved. Infection data were from the Finnish LT registry, with starting date, type and relevant pathogens for 501 Finnish adult LT patients surviving ≥1 year post-transplant. Follow-up end points were end of study, death or retransplantation. Logistic regression to assess risk factors was adjusted for age, gender and follow-up time. With 3923 person-years of follow-up, overall infection incidence was 66/1000 person-years; 155 (31%) suffered 259 infections, and two-thirds experienced only one infection. Cholangitis (20%), pneumonia (19%) and sepsis (14%) were most common. The most frequent bacteria were Enterococcus spp. and Escherichia coli, and the most frequent viruses cytomegalovirus and varicella zoster virus. Fungal infections were rare (n = 7). With 13 fatal infections, 17% of all late deaths involved infection. Primary sclerosing cholangitis (PSC) and Roux-en-Y-type biliary anastomosis were associated with cholangitis; 18% of PSC patients suffered late cholangitis. Late acute rejection was associated with sepsis. Age, gender or cytomegalovirus did not significantly influence late infections. In conclusion, although infection risk under maintenance immunosuppression therapy is relatively low, particular vigilance regarding cholangitis, pneumonia and sepsis seems appropriate. PMID:21219571

  2. High incidence of oral squamous cell carcinoma independent of HPV infection after allogeneic hematopoietic SCT in Taiwan.

    PubMed

    Chen, M H; Chang, P M; Li, W Y; Hsiao, L T; Hong, Y C; Liu, C Y; Gau, J P; Liu, J H; Chen, P M; Chiou, T J; Tzeng, C H

    2011-04-01

    Hematopoietic SCT (HSCT) is a well-recognized therapeutic procedure to prolong life and cure patients with life-threatening hematological malignancies; however, the risk of developing secondary carcinoma may increase in long-term survivors. The objective of this study was to determine the incidence and risk factors for secondary squamous carcinoma after HSCT. Between 1984 and 2004, 170 allogeneic HSCT recipients aged >15 years, who had survived for >5 years were enrolled. Demographic data and the characteristics of secondary carcinoma were collected and analyzed for the determination of the incidence and risk of developing secondary carcinoma. Eight patients developed secondary carcinoma, including five oral squamous cell carcinomas, one esophageal, one gastric and one ovarian carcinoma, but no cutaneous carcinomas were detected at a median follow-up of 14.1 years (range, 5.1-23.3 years) after HSCT. The accrual 10-year cumulative incidence of secondary carcinoma was 2.89%. In univariate and multivariate analyses, chronic GVHD and age >40 years at the time of HSCT were both significant risk factors independently associated with the development of secondary carcinoma. Thus, the occurrence of secondary carcinoma is one of the late complications in patients undergoing HSCT. Oral squamous cell carcinoma was more common in our patients after HSCT, indicating the need for lifelong surveillance of the oral cavity. Moreover, because of the relatively long latency in developing secondary carcinoma, extended follow-up is required for a thorough understanding of the incidence and characteristics of secondary carcinoma after HSCT. PMID:20622906

  3. The clinical outcome of scaphoid fracture malunion at 1 year.

    PubMed

    Forward, D P; Singh, H P; Dawson, S; Davis, T R C

    2009-02-01

    The aim of this study was to assess the effect of malunion of scaphoid fractures on the clinical outcome at 1 year. Forty-two consecutive patients with united scaphoid waist fractures which had been treated non-operatively underwent longitudinal CT scans to confirm union and assess malunion at 12 to 18 weeks after injury. A blind clinical assessment was made and the Patient Evaluation Measure (PEM) and DASH questionnaires were completed by all the patients 1 year after injury. The group consisted of 38 men and four women with a mean age of 31 years at the time of injury. Correlation analysis revealed no significant relationships between any of the outcome measures (range of motion, grip strength and PEM and DASH scores) and any of the three measures of malunion (height-to-length ratio, the dorsal cortical angle and the lateral intra-scaphoid angle). PMID:19129358

  4. Secondary preventive medication persistence and adherence 1 year after stroke

    PubMed Central

    Olson, D.M.; Zhao, X.; Pan, W.; Zimmer, L.O.; Goldstein, L.B.; Alberts, M.J.; Fagan, S.C.; Fonarow, G.C.; Johnston, S.C.; Kidwell, C.; LaBresh, K.A.; Ovbiagele, B.; Schwamm, L.; Peterson, E.D.

    2011-01-01

    Objective: Data on long-term use of secondary prevention medications following stroke are limited. The Adherence eValuation After Ischemic stroke–Longitudinal (AVAIL) Registry assessed patient, provider, and system-level factors influencing continuation of prevention medications for 1 year following stroke hospitalization discharge. Methods: Patients with ischemic stroke or TIA discharged from 106 hospitals participating in the American Heart Association Get With The Guidelines–Stroke program were surveyed to determine their use of warfarin, antiplatelet, antihypertensive, lipid-lowering, and diabetes medications from discharge to 12 months. Reasons for stopping medications were ascertained. Persistence was defined as continuation of all secondary preventive medications prescribed at hospital discharge, and adherence as continuation of prescribed medications except those stopped according to health care provider instructions. Results: Of the 2,880 patients enrolled in AVAIL, 88.4% (2,457 patients) completed 1-year interviews. Of these, 65.9% were regimen persistent and 86.6% were regimen adherent. Independent predictors of 1-year medication persistence included fewer medications prescribed at discharge, having an adequate income, having an appointment with a primary care provider, and greater understanding of why medications were prescribed and their side effects. Independent predictors of adherence were similar to those for persistence. Conclusions: Although up to one-third of stroke patients discontinued one or more secondary prevention medications within 1 year of hospital discharge, self-discontinuation of these medications is uncommon. Several potentially modifiable patient, provider, and system-level factors associated with persistence and adherence may be targets for future interventions. PMID:21900638

  5. Association of Cumulative Steroid Dose with Risk of Infection after Treatment for Severe Acute Graft-versus-Host Disease.

    PubMed

    Matsumura-Kimoto, Yayoi; Inamoto, Yoshihiro; Tajima, Kinuko; Kawajiri, Akihisa; Tanaka, Takashi; Hirakawa, Tsuneaki; Ino, Kazuko; Asao, Yu; Tamogami, Hiroyuki; Kono, Chika; Takeda, Wataru; Okinaka, Keiji; Fuji, Shigeo; Kurosawa, Saiko; Kim, Sung-Won; Tanosaki, Ryuji; Yamashita, Takuya; Fukuda, Takahiro

    2016-06-01

    This study aimed to characterize the incidence and risk factors of invasive fungal disease, cytomegalovirus infection, other viral diseases, and gram-negative rod infection after glucocorticoid treatment for severe acute graft-versus-host disease (GVHD) after allogeneic hematopoietic cell transplantation and to elucidate the associations of cumulative steroid dose with the risks of individual infections. The study cohort included 91 consecutive patients who developed maximum grades III and IV acute GVHD at our center. The mean cumulative prednisolone-equivalent dose was 41 mg/kg during the first 4 weeks. The cumulative incidence rates of fungal disease, cytomegalovirus disease, other viral diseases, and gram-negative rod infection at 6 months after glucocorticoid treatment were remarkably high, at 14%, 21%, 28%, and 20%, respectively. GVHD within 26 days after transplantation and low lymphocyte count at GVHD treatment were associated with increased risks of several infections. Cumulative prednisolone-equivalent steroid doses ≥ 55 mg/kg during the first 4 weeks were associated with an increased risk of fungal disease (hazard ratio, 3.65; P = .03) and cumulative doses ≥ 23 mg/kg were associated with an increased risk of non-cytomegalovirus viral diseases (hazard ratio, 4.14; P = .02). Strategies to reduce the risk of infectious complications are needed, particularly for patients who have risk factors and those who receive high cumulative steroid doses. PMID:26968790

  6. Modeling neural activity with cumulative damage distributions.

    PubMed

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

    2015-10-01

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

  7. Conceptual models for cumulative risk assessment.

    PubMed

    Linder, Stephen H; Sexton, Ken

    2011-12-01

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

  8. Experimental approaches to studying cumulative cultural evolution

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

  10. Localized and cumulative nonlinearity in wind instruments

    NASA Astrophysics Data System (ADS)

    Gilbert, Joel

    2003-10-01

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

  11. Incorporating Nonchemical Stressors Into Cumulative Risk Assessments

    PubMed Central

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

    2012-01-01

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

  12. Cumulative Index to NASA Tech Briefs

    NASA Technical Reports Server (NTRS)

    1969-01-01

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

  13. Expansive soil crack depth under cumulative damage.

    PubMed

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

    2014-01-01

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

  14. Expansive Soil Crack Depth under Cumulative Damage

    PubMed Central

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

    2014-01-01

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

  15. Orbital-optimized density cumulant functional theory

    SciTech Connect

    Sokolov, Alexander Yu. Schaefer, Henry F.

    2013-11-28

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

  16. Development of a Cumulative Psychosocial Factor Index for Problematic Recovery Following Work-Related Musculoskeletal Injuries

    PubMed Central

    Wideman, Timothy H.

    2012-01-01

    Background Psychosocial variables such as fear of movement, depression, and pain catastrophizing have been shown to be important prognostic factors for a wide range of pain-related outcomes. The potential for a cumulative relationship between different elevated psychosocial factors and problematic recovery following physical therapy has not been fully explored. Objective The purpose of this study was to determine whether the level of risk for problematic recovery following work-related injuries is associated with the number of elevated psychosocial factors. Design This was a prospective cohort study. Methods Two hundred two individuals with subacute, work-related musculoskeletal injuries completed a 7-week physical therapy intervention and participated in testing at treatment onset and 1 year later. An index of psychosocial risk was created from measures of fear of movement, depression, and pain catastrophizing. This index was used to predict the likelihood of experiencing problematic recovery in reference to pain intensity and return-to-work status at the 1-year follow-up. Results Logistic regression analysis revealed that the number of prognostic factors was a significant predictor of persistent pain and work disability at the 1-year follow-up. Chi-square analysis revealed that the risk for problematic recovery increased for patients with elevated levels on at least 1 psychosocial factor and was highest when patients had elevated scores on all 3 psychosocial factors. Limitations The physical therapy interventions used in this study were not standardized. This study did not include a specific measure for physical function. Conclusions The number of elevated psychosocial factors present in the subacute phase of recovery has a cumulative effect on the level of risk for problematic recovery 1 year later. This research suggests that a cumulative prognostic factor index could be used in clinical settings to improve prognostic accuracy and to facilitate clinical

  17. Association of race with cumulative exposure to statins in dialysis

    PubMed Central

    Wetmore, James B.; Mahnken, Jonathan D.; Rigler, Sally K.; Ellerbeck, Edward F.; Mukhopadhyay, Purna; Hou, Qingjiang; Shireman, Theresa I.

    2012-01-01

    Background Patients on dialysis have high rates of cardiovascular disease and are frequently treated with HMG-CoA reductase inhibitors. Given that these patients have insurance coverage for medications as well as regular contact with health care providers, differences by race in exposure to statins over time should be minimal among patients who are candidates for the drug. Methods We created a cohort of incident dialysis patients who were dually-eligible for Medicare and Medicaid services. We determined the proportion of days covered (or PDC, a marker of cumulative medication exposure) by a statin prescription over a mean of 2.0 ± 1.4 years. Ordinary least squares regression was used to determine the factors associated with cumulative drug exposure. Results Of the 18,727 patients who filled at least one prescription for a statin, mean PDC was 0.57 ± 0.32. The unadjusted PDC was higher for Caucasians (0.63 ± 0.31) than for African-Americans (0.51± 0.32), Hispanics (0.54 ± 0.31), and individuals of other race/ethnicity (0.58 ± 0.32). In multivariable modeling, Caucasian race was independently associated with greater exposure to statins. Relative to Caucasians, the adjusted odds ratios for the PDC for African-Americans was 0.47 (95% confidence intervals [CIs] 0.43 – 0.50), for Hispanics 0.52 (0.48 – 0.56) and for others, 0.72 (0.64 – 0.81). Conclusions Despite insurance coverage, regular contact with health care providers, and at least one prescription for a statin, there are large differences by race in statin exposure over time. The provider- and patient-associated factors related to this phenomenon should be further examined. PMID:22739257

  18. Practical management of cumulative anthropogenic impacts with working marine examples.

    PubMed

    Wright, Andrew J; Kyhn, Line A

    2015-04-01

    Human pressure on the environment is expanding and intensifying, especially in coastal and offshore areas. Major contributors to this are the current push for offshore renewable energy sources, which are thought of as environmentally friendly sources of power, as well as the continued demand for petroleum. Human disturbances, including the noise almost ubiquitously associated with human activity, are likely to increase the incidence, magnitude, and duration of adverse effects on marine life, including stress responses. Stress responses have the potential to induce fitness consequences for individuals, which add to more obvious directed takes (e.g., hunting or fishing) to increase the overall population-level impact. To meet the requirements of marine spatial planning and ecosystem-based management, many efforts are ongoing to quantify the cumulative impacts of all human actions on marine species or populations. Meanwhile, regulators face the challenge of managing these accumulating and interacting impacts with limited scientific guidance. We believe there is scientific support for capping the level of impact for (at a minimum) populations in decline or with unknown statuses. This cap on impact can be facilitated through implementation of regular application cycles for project authorization or improved programmatic and aggregated impact assessments that simultaneously consider multiple projects. Cross-company collaborations and a better incorporation of uncertainty into decision making could also help limit, if not reduce, cumulative impacts of multiple human activities. These simple management steps may also form the basis of a rudimentary form of marine spatial planning and could be used in support of future ecosystem-based management efforts. PMID:25439093

  19. Incidence and recovery of neurosensory disturbances after bilateral sagittal split osteotomy in different age groups: a retrospective study of 263 patients.

    PubMed

    Verweij, J P; Mensink, G; Fiocco, M; van Merkesteyn, J P R

    2016-07-01

    This study aimed to investigate the incidence of neurosensory disturbance (NSD) after bilateral sagittal split osteotomy (BSSO) in different age groups and to assess the probability of sensory recovery in patients aged <19 years, 19-30 years, and >30 years. Hypoaesthesia of the lower lip was assessed subjectively and objectively immediately after BSSO and at 1 week and 1, 6, and 12 months after BSSO. Hypoaesthesia was considered permanent if it was present 1 year after BSSO. The frequency of NSD immediately after surgery was significantly higher in older patients. The cumulative incidence of recovery at 1 year was lower and the mean time to recovery was longer in the older patients, although these differences were not statistically significant. Older age was a significant risk factor for permanent hypoaesthesia, with an incidence of 4.8% per patient aged <19 years, 7.9% per patient aged 19-30 years, and 15.2% per patient aged >30 years. These findings show that the risk of NSD after BSSO is significantly higher in older patients. These results may aid surgeons in preoperative patient counselling and in deciding the optimal age at which to perform BSSO. PMID:26846794

  20. Intracranial idiopathic hypertension: 1-year follow-up study.

    PubMed

    D'Amico, D; Curone, M; Erbetta, A; Farago', G; Bianchi-Marzoli, S; Ciasca, P; Bussone, G; Chiapparini, L

    2014-05-01

    Standard guidelines for ongoing management, as well as definitive data about the long-term course of idiopathic intracranial hypertension (IIH) are not available. The aim of this study was to compare several clinical and instrumental variables as assessed at the time of diagnosis and then after 1 year in a sample of IIH patients. A total of 21 patients were studied. Our results confirmed that headache and TVO are the most frequent symptoms in IIH patients, and that overweight is a very common feature. A trend towards a favorable outcome in patients followed for 1 year and treated by usual medical therapy was found: intracranial pressure was lower at follow-up; improvement of headache and transient visual obscurations, as well as of papilledema, was reported in most patients. On the other hand, neuroradiological findings (such as empty sella, perioptic subarachnoid space distension, narrowing of the transverse sinuses) were substantially stable at follow. These findings may be relevant for future research as far as understanding the role of different clinical and instrumental findings as diagnostic items as well as predictors of outcome in IIH. PMID:24867861

  1. Towards Greenland Glaciation: cumulative or abrupt transition?

    NASA Astrophysics Data System (ADS)

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

    2016-04-01

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

  2. Earth system responses to cumulative carbon emissions

    NASA Astrophysics Data System (ADS)

    Steinacher, M.; Joos, F.

    2015-07-01

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

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

    ERIC Educational Resources Information Center

    Asano, Toshio; Lattal, Kennon A.

    2012-01-01

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

  4. Critical concentrations of cumulative scattered damage

    SciTech Connect

    Ignatovich, S.R.

    1995-12-01

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

  5. Predicting abuse in adolescent dating relationships over 1 year: the role of child maltreatment and trauma.

    PubMed

    Wolfe, David A; Wekerle, Christine; Scott, Katreena; Straatman, Anna-Lee; Grasley, Carolyn

    2004-08-01

    Three mediators of the relationship between childhood maltreatment and dating violence perpetration during midadolescence (i.e., trauma-related symptoms, attitudes justifying dating violence, and empathy and self-efficacy in dating relationships) were tested over 1 year with a sample of students from 10 high schools (N = 1,317). Trauma-related symptoms had a significant cross-time effect on predicting incidents of dating violence for both boys and girls. Attitudes and empathy and self-efficacy did not predict dating violence over time, although they were correlated with such behavior at both time points. Child maltreatment is a distal risk factor for adolescent dating violence, and trauma-related symptoms act as a significant mediator of this relationship. The importance of longitudinal methodology that separates correlates from predictors is discussed. PMID:15311986

  6. Whooping cough in South-East Romania: a 1-year study.

    PubMed

    Dinu, Sorin; Guillot, Sophie; Dragomirescu, Cristiana Cerasella; Brun, Delphine; Lazăr, Stefan; Vancea, Geta; Ionescu, Biatrice Mariana; Gherman, Mariana Felicia; Bjerkestrand, Andreea-Florina-Dana; Ungureanu, Vasilica; Guiso, Nicole; Damian, Maria

    2014-03-01

    The incidence of whooping cough in Romania is substantially underestimated, and, as noted by the health authorities, this is mostly due to the lack of both awareness and biological diagnosis. We conducted a 1-year study in Bucharest in order to assess the circulation of Bordetella pertussis, the main etiological agent of whooping cough. Fifty-one subjects suspected of whooping cough were enrolled. Culture, real-time PCR, and enzyme-linked immunosorbent assay were used for laboratory diagnosis. Whooping cough patients (63%) were distributed among all age groups, and most were unvaccinated, incompletely vaccinated, or had been vaccinated more than 5 years previously. Bordetella holmesii DNA was detected in 22% of the bordetellosis cases; these patients included adults; teenagers; and, surprisingly, young children. B. pertussis isolates were similar to the clinical isolates currently circulating elsewhere in Europe. One isolate does not express pertactin, an antigen included in some acellular pertussis vaccines. PMID:24355701

  7. Otitis media with effusion in children younger than 1 year

    PubMed Central

    Di Francesco, Renata Cantisani; Barros, Vivian Boschesi; Ramos, Rafael

    2016-01-01

    Abstract Objective: To determine the prevalence of otitis media with effusion in children younger than 1 year and its association with the season of the year, artificial feeding, environmental and perinatal factors. Methods: Retrospective study of 184 randomly included medical records from a total of 982 healthy infants evaluated for hearing screening tests. Diagnosis of otitis media with effusion was based on otoscopy (amber-gold color, fluid level, handle of malleus position), type B tympanometric curves and absence of otoacoustic emissions. Incomplete medical records or those describing acute otitis media, upper respiratory tract infections on the assessment day or in the last 3 months, neuropathies and craniofacial anomalies were excluded. Data such as gestational age, birth weight, Apgar score, type of feeding and day care attendance were compared between children with and without otitis media with effusion through likelihood tests and multivariate analysis. Results: 25.3% of 184 infants had otitis media with bilateral effusion; 9.2% had unilateral. In infants with otitis media, the following were observed: chronological age of 9.6±1.7 months; gestational age >38 weeks in 43.4% and birth weight >2500g in 48.4%. Otitis media with effusion was associated with winter/fall, artificial feeding, Apgar score <7 and day care attendance. The multivariate analysis showed that artificial feeding is the factor most often associated to otitis media with effusion. Conclusions: Otitis media with effusion was found in about one third of children younger than 1 year and was mainly associated with artificial feeding. PMID:26559603

  8. Infant Aphakia Treatment Study: Effects of persistent fetal vasculature on outcome at 1 year of age

    PubMed Central

    Morrison, David G.; Wilson, M. Edward; Trivedi, Rupal H.; Lambert, Scott R.; Lynn, Michael J.

    2011-01-01

    Background The Infant Aphakia Treatment Study (IATS) is a randomized trial comparing the treatment of unilateral congenital cataract with primary intraocular lens (IOL) implantation versus aphakic contact lens (CL). The purpose of this study was to compare the outcomes for infants with lens opacity associated with persistent fetal vasculature (PFV) to those without. Methods Retrospective subgroup analysis of grating visual acuity at 1 year of age and adverse events up to 1 year after surgery in eyes identified intraoperatively as having evidence of mild PFV from the IATS. Results Of 83 infants, 18 (22%: 11 CL, 7 IOL) had PFV. Median logMAR visual acuity was 0.88 for patients with PFV and 0.80 for patients without PFV (P = 0.46). One or more adverse events up to one year after surgery occurred in 12 infants (67%) with PFV and 30 infants (46%) without PFV (P = 0.18). The incidence of adverse events was significantly higher in patients with PFV compared to patients without PFV in the CL group (55% vs 20%, P = 0.049) but not in the IOL group (86% vs 71%, P = 0.65), possibly because all children receiving IOLs had higher rates of adverse events when compared to aphakic children (73% vs 29%, P < 0.001). Conclusions Aphakic infants with mild PFV treated with CL had a higher incidence of adverse events following lensectomy compared to children with other forms of unilateral congenital cataract; nevertheless, similar visual outcomes at one year after surgery were obtained. PMID:22108353

  9. Incidence and Mortality after Distal Radius Fractures in Adults Aged 50 Years and Older in Korea

    PubMed Central

    2016-01-01

    The purpose of this study was to assess the incidence and mortality of distal radius fracture among patients 50 years of age and older with diagnosis code (ICD10; S52.5, S52.6) and treatment code using a nationwide claims database from 2008 to 2012. All patients were followed using patient identification code to identify deaths. Standardized mortality ratios (SMRs) of distal radius fracture were calculated based on age and gender-specific rates in the entire Korean population. The number of distal radius fractures increased by 54.2% over the 5-year study (48,145 in 2008 and 74,240 in 2012). The incidence of distal radius fracture increased from 367.4/100,000 in 2008 to 474.1/100,000 in 2012. The cumulative mortality rate over the first 12 months after distal radius fracture was decreased from 2.0% (968/48,145) in 2008 to 1.4% (1,045/74,240) in 2012. The mean year mortality over 5 years in men (2.6%, 1,279/50,128) over the first 12 months was 1.7-times higher than in women (1.5%, 3,952/257,045). The mean of SMR of distal radius fracture at 1 year post-fracture was 1.45 in men and 1.17 in women. This study using a nationwide database demonstrates that the distal radius fractures are increasing with a decreasing mortality in Korea. PMID:27051250

  10. Incidence, etiology, and outcome of pleural effusions in allogeneic hematopoietic stem cell transplantation.

    PubMed

    Modi, Dipenkumar; Jang, Hyejeong; Kim, Seongho; Deol, Abhinav; Ayash, Lois; Bhutani, Divaya; Lum, Lawrence G; Ratanatharathorn, Voravit; Manasa, Richard; Mellert, Kendra; Uberti, Joseph P

    2016-09-01

    Pleural effusion is a known entity in patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT); however, the incidence, risk factors, and morbidity-mortality outcomes associated with pleural effusions remain unknown. We retrospectively evaluated pleural effusions in 618 consecutive adult patients who underwent allogeneic HSCT from January 2008 to December 2013 at our institution. Seventy one patients developed pleural effusion at a median of 40 days (range, 1 - 869) post-HSCT with the cumulative incidence of 9.9% (95% CI, 7.7 - 12.5%) at 1 year. Infectious etiology was commonly associated with pleural effusions followed by volume overload and serositis type chronic GVHD. In multivariate analysis, higher comorbidity index (P = 0.03) and active GVHD (P = 0.018) were found to be significant independent predictors for pleural effusion development. Higher comorbidity index, very high disease risk index, ≤7/8 HLA matching, and unrelated donor were associated with inferior overall survival (OS) (P < 0.03). More importantly, patients with pleural effusion were noted to have poor OS in comparison to patients without pleural effusion (P < 0.001). Overall, pleural effusion is a frequently occurring complication after allogeneic HSCT, adding to morbidity and mortality and hence, early identification is required. Am. J. Hematol. 91:E341-E347, 2016. © 2016 Wiley Periodicals, Inc. PMID:27238902

  11. Safety and efficacy of nurse-controlled analgesia in patients less than 1 year of age

    PubMed Central

    Walia, Hina; Tumin, Dmitry; Wrona, Sharon; Martin, David; Bhalla, Tarun; Tobias, Joseph D

    2016-01-01

    Background The management of acute pain presents unique challenges in the younger pediatric population. Although patient-controlled devices are frequently used in patients ≥6 years of age, alternative modes of analgesic delivery are needed in infants. Objective To examine the safety and efficacy of nurse-controlled analgesia (NCA) in neonates less than 1 year of age. Methods Data from patients <1 year of age receiving NCA as ordered by the Acute Pain Service at our institution were collected over a 5-year period and reviewed retrospectively. The primary outcomes were activation of the institution’s Rapid Response Team (RRT) or Code Blue, signifying severe adverse events. Pain score after NCA initiation was a secondary outcome. Results Among 338 girls and 431 boys, the most common opioid used for NCA was fentanyl, followed by morphine and hydromorphone. There were 39 (5%) cases involving RRT or Code Blue activation, of which only one (Code Blue) was activated due to a complication of NCA (apnea). Multivariable logistic regression demonstrated morphine NCA to be associated with greater odds of RRT activation (OR=3.29, 95% CI=1.35, 8.03, P=0.009) compared to fentanyl NCA. There were no statistically significant differences in pain scores after NCA initiation across NCA agents. Conclusion NCA is safe in neonates and infants, with comparable efficacy demonstrated for the three agents used. The elevated incidence of RRT activation in patients receiving morphine suggests caution in its use and consideration of alternative agents in this population.

  12. The Effect of Body Mass Index on Pelvic Floor Support 1 Year Postpartum.

    PubMed

    Chen, Yi; Johnson, Benjamin; Li, Fangyong; King, William C; Connell, Kathleen A; Guess, Marsha K

    2016-02-01

    Elevated body mass index (BMI) is associated with the incidence, prevalence, and progression of pelvic organ prolapse (POP). This study investigated the effect of peripartum BMI on pelvic floor support 1 year postpartum (PP1y). One hundred eight nulliparous women had their BMI recorded and underwent POP assessments using the Pelvic Organ Prolapse Quantification System at baseline, third trimester (36th to 38th week of pregnancy [G36-38w]), and PP1y. Pelvic organ prolapse was defined as ≥stage II. Women gained on average 1.9 kg between baseline and PP1y. After adjustment, increasing BMI PP1y was associated with increasing anterior wall descent (P < .0001) and higher odds of having POP PP1y (odds ratio: 1.41, 95% confidence interval: 1.01-1.97, P = .045). Trial of labor compared to unlabored cesarean delivery, POP G36-38w, and decreased fetal weight were independently associated with anterior vaginal wall laxity PP1y. Our finding suggests that postpartum BMI influences pelvic floor laxity 1 year after delivery. Postpartum weight reduction may serve as a strategy for POP prevention in some women. PMID:26494698

  13. Cancer incidence among Finnish nuclear reactor workers.

    PubMed

    Auvinen, Anssi; Pukkala, Eero; Hyvönen, Hannu; Hakama, Matti; Rytömaa, Tapio

    2002-07-01

    Because of their well-documented exposures to repeated low doses of ionizing radiation, nuclear reactor workers offer an opportunity to assess cancer risk from low-dose radiation. A cohort of all 15,619 Finnish nuclear reactor workers was established through dose-monitoring records. A questionnaire survey revealed no substantial differences in consumption of tobacco or alcohol between different exposure groups nor between nuclear power company employees and contract workers. In the follow-up for cancer incidence, no clear excess in cancer incidence was observed overall, nor was any observed in any of the specific cancer types studied. There was little evidence for an association between cancer incidence and cumulative radiation dose, but the statistical power was limited. More precise estimates will be available from an international collaborative study of nuclear industry workers, including our cohort. PMID:12134527

  14. Trends of Incidence, Mortality, and Future Projection of Spinal Fractures in Korea Using Nationwide Claims Data.

    PubMed

    Kim, Tae-Young; Jang, Sunmee; Park, Chan-Mi; Lee, Ahreum; Lee, Young-Kyun; Kim, Ha-Young; Cho, Eun-Hee; Ha, Yong-Chan

    2016-05-01

    Spinal fractures have been recognized as a major health concern. Our purposes were to evaluate the trends in the incidence and mortality of spinal fractures between 2008 and 2012 and predict the number of spinal fractures that will occur in Korea up to 2025, using nationwide data from the National Health Insurance Service (NHIS). A nationwide data set was evaluated to identify all new visits to medical institutes for spinal fractures in men and women aged 50 years or older between 2008 and 2012. The incidence, mortality rates and estimates of the number of spinal fractures were calculated using Poisson regression. The number of spinal fractures increased over the time span studied. Men and women experienced 14,808 and 55,164 vertebral fractures in 2008 and 22,739 and 79,903 in 2012, respectively. This reflects an increase in the incidence of spinal fractures for both genders (men, 245.3/100,000 in 2008 and 312.5/100,000 in 2012; women, 780.6/100,000 in 2008 and 953.4/100,000 in 2012). The cumulative mortality rate in the first year after spinal fractures decreased from 8.51% (5,955/69,972) in 2008 to 7.0% (7,187/102,642) in 2012. The overall standardized mortality ratio (SMR) of spinal fractures at 1 year post-fracture was higher in men (7.76, 95% CI: 7.63-7.89) than in women (4.70, 95% CI: 4.63-4.76). The total number of spinal fractures is expected to reach 157,706 in 2025. The incidence of spinal fractures increased in Korea in the last 5 years, and the socioeconomic burden of spinal fractures will continue to increase in the near future. PMID:27134505

  15. Trends of Incidence, Mortality, and Future Projection of Spinal Fractures in Korea Using Nationwide Claims Data

    PubMed Central

    2016-01-01

    Spinal fractures have been recognized as a major health concern. Our purposes were to evaluate the trends in the incidence and mortality of spinal fractures between 2008 and 2012 and predict the number of spinal fractures that will occur in Korea up to 2025, using nationwide data from the National Health Insurance Service (NHIS). A nationwide data set was evaluated to identify all new visits to medical institutes for spinal fractures in men and women aged 50 years or older between 2008 and 2012. The incidence, mortality rates and estimates of the number of spinal fractures were calculated using Poisson regression. The number of spinal fractures increased over the time span studied. Men and women experienced 14,808 and 55,164 vertebral fractures in 2008 and 22,739 and 79,903 in 2012, respectively. This reflects an increase in the incidence of spinal fractures for both genders (men, 245.3/100,000 in 2008 and 312.5/100,000 in 2012; women, 780.6/100,000 in 2008 and 953.4/100,000 in 2012). The cumulative mortality rate in the first year after spinal fractures decreased from 8.51% (5,955/69,972) in 2008 to 7.0% (7,187/102,642) in 2012. The overall standardized mortality ratio (SMR) of spinal fractures at 1 year post-fracture was higher in men (7.76, 95% CI: 7.63-7.89) than in women (4.70, 95% CI: 4.63-4.76). The total number of spinal fractures is expected to reach 157,706 in 2025. The incidence of spinal fractures increased in Korea in the last 5 years, and the socioeconomic burden of spinal fractures will continue to increase in the near future. PMID:27134505

  16. Hydrocephalus in children less than 1 year of age in northern Mozambique

    PubMed Central

    Salvador, Sérgio F.; Henriques, João Carlos; Munguambe, Missael; Vaz, Rui M. C.; Barros, Henrique P.

    2014-01-01

    Background: In developed countries, the incidence of neonatal hydrocephalus ranges from 3 to 5 cases per 1000 live births, but little is known about the frequency of hydrocephalus in Africa. In Mozambique, there is no primary information related to this disorder, but using the above data, the expected incidence of neonatal hydrocephalus would range from 2900 to 4800 cases per year. Methods: This study is based on 122 children younger than 1 year with neonatal hydrocephalus, followed up between January 2010 and December 2012, their origin and treatment, and aims to evaluate difficulties with diagnosis, treatment, and follow-up in northern Mozambique. Results: Identified cases were mainly less than 6 months old (77%), with severe macrocephaly and the classic stigmata of this condition. A high rate of follow-up loss (44.3%) was detected, particularly among children from more distant locations. Our findings contrast with the expected 1000-1700 cases that would occur in the area during the study period, being considerably lower. Conclusions: Hydrocephalus is a serious problem in sub-Saharan Africa, whose effects can be minimized by a better organization of the health system in hydrocephalus prevention, referral, and follow-up. New management alternatives to provide treatment to more children with this disorder and reduction of the follow-up difficulties caused due to geographical reasons for the children undergoing treatment are essential. PMID:25593759

  17. Simulation of dependence of the cross section of deuterons beam fragmentation into cumulative pions and protons on the mass of the target nucleus

    SciTech Connect

    Litvinenko, A. G.; Litvinenko, E. I.

    2015-03-15

    We have studied the mechanisms influencing production of cumulative pions and protons in the fragmentation of the incident deuterons into cumulative pions and protons emitted at zero angle. We argue that the peripheral dependence on the atomic mass of the target nucleus, which was obtained in the experiments for medium and heavy nuclei, can be explained by scattering on target nucleons without introducing additional parameters.

  18. Incidences and risk factors of first-line HAART discontinuation: a limitation to the success of the "seek, test, treat, and retain" strategy?

    PubMed

    Keita, Momory; Perbost, Isabelle; Pugliese-Wehrlen, Sylvia; Abel, Sylvie; Pugliese, Pascal; Enel, Patricia; Cuzin, Lise; Lang, Thierry; Delpierre, Cyrille

    2014-01-01

    To evaluate the incidence and risk factors of first-highly active antiretroviral therapy (HAART) modifications/interruptions and their causes in a cohort of newly-treated patients by using a competing risk model. In nine centers of the French cohort Dat'AIDS, in 1 year and 2 years of censorship, a competing risk analysis was implemented in HIV1 patients aged 18 years or older first-treated between September 2002 and March 2012. In 4669 patients, 3628 modifications (77.7%) were observed (median: 13.5 months). Cumulative incidence in 1 year: 46.8% [45.4-48.3]; in 2 years: 65.3% [63.8-66.8]. Intolerance (n = 1167; 32.3%): in 1 year, except first-treated from 2002 to 2005, modifications were not different: 2002-2003 (24.6%) 2004-2005 (26.1%), 2006-2007 (19.4%), 2008-2009 (18.8%) and 2010-2011 (15.7%). Women, AIDS patients, and those aged 50 years and older had an excess risk. Therapeutic simplification (n = 1037; 28.6%): in 1 year, except first-treated from 2002 to 2003, modifications were not different: 2002-2003 (9.0%), 2004-2005 (16.0%), 2006-2007 (11.0%), 2008-2009 (15.7%) and 2010-2011 (10.0%). Conversely to injecting-drug-users and AIDS patients, women and first-treated with non-nucleosides had an excess risk. Therapeutic failure (n = 189; 5.2%): contrary to first-treated between 2002 and 2003 or 2008 and 2009, in 1 year as in 2 years, modifications were not different. In 1 year, 1.9% for 2004-2005, 1.6% for 2006-2007 and 1.2% for 2010-2011. Maximum viral load ≥5.0 log10 copies/ml and CD4 <200 cells/mm(3) had a high probability. The study of first-HAART modifications suggests that in 1-year follow-up, intolerance incidence in the recent calendar year is still as frequent as the previous period which may constitute a limitation to the success of the seek, test, treat, and retain. PMID:24517736

  19. A cumulative scale of severe sexual sadism.

    PubMed

    Nitschke, Joachim; Osterheider, Michael; Mokros, Andreas

    2009-09-01

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

  20. Elemental composition of two cumulate rocks

    SciTech Connect

    Naeem, A.; Almohandis, A.A.

    1983-04-01

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

  1. Implant failure: regional versus cumulative evaluation.

    PubMed

    Lauc, T; Krnić, D; Katanec, D

    2000-07-01

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

  2. Cumulative life course impairment in vitiligo.

    PubMed

    Krüger, Christian; Schallreuter, Karin Uta

    2013-01-01

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

  3. Health Care Costs 1 Year After Pediatric Traumatic Brain Injury

    PubMed Central

    Rivara, Frederick P.; Vavilala, Monica S.

    2015-01-01

    Objectives. This study sought to estimate total health care costs for mild, moderate, and severe pediatric traumatic brain injury (TBI) and to compare individual- and population-level costs across levels of TBI severity. Methods. Using 2007 to 2010 MarketScan Commercial Claims and Encounters data, we estimated total quarterly health care costs 1 year after TBI among enrollees (aged < 18 years). We compared costs across levels of TBI severity using generalized linear models. Results. Mild TBI accounted for 96.6% of the 319 103 enrollees with TBI; moderate and severe TBI accounted for 1.7% and 1.6%, respectively. Adjusted individual health care costs for moderate and severe TBI were significantly higher than mild TBI in the year after injury (P < .01). At the population level, moderate and severe TBI costs were 88% and 75% less than mild TBI, respectively. Conclusions. Individually, moderate and severe TBI initially generated costs that were markedly higher than those of mild TBI. At the population level, costs following mild TBI far exceeded those of more severe cases, a result of the extremely high population burden of mild TBI. PMID:26270293

  4. Caregiver burden at 1 year following severe traumatic brain injury.

    PubMed

    Marsh, N V; Kersel, D A; Havill, J H; Sleigh, J W

    1998-12-01

    Sixty-nine primary caregivers of adults with a severe traumatic brain injury (TBI) were assessed at 1-year post-injury. Caregivers completed questionnaires on the physical, cognitive, emotional, behavioural, and social functioning of the person with TBI. Caregiver objective burden, psychosocial functioning, and subjective burden were also assessed. Clinically significant levels of anxiety and depression were evident in over a third of the caregivers. Similarly, a quarter of the caregivers reported poor social adjustment. There was no consistent relationship between the prevalence of various types of objective burden and the level of subjective distress that resulted from these changes. The person with TBI's emotional difficulties, in particular their anger, apathy, and dependency, caused the greatest distress for caregivers. With regard to the impact that caregiving had on their own lives, caregivers were most distressed by the loss of personal free time. Results from a regression analysis indicated that the person with TBI's physical impairment, number of behavioural problems, and social isolation were the strongest predictors of caregiver burden. The impact that caring for a person with severe TBI can have on the extended family unit is discussed. PMID:9876864

  5. The incidence and prognosis of patients with bacteremia.

    PubMed

    Nielsen, Stig Lønberg

    2015-07-01

    remained more or less stable throughout the study period (p=0.17). The crude incidence rates decreased for Escherichia coli, Staphylococcus aureus, co-agulase-negative staphylococci and Streptococcus pneumoniae, and increased for Pseudomonas aeruginosa and enterococci species (p<0.05 for all the mentioned microorganisms). Regard-less of place of acquisition, the proportion of bacteremias caused by coagulase-negative staphylococci decreased while the proportion caused by Enterococcus species increased. Study II: In a multicenter hospital-based cohort study, we included 276,586 adult patients with 724,339 admissions to hospitals in Funen County for a total of 4,531,744 bed days. Among the hospitalized patients, we identified 10,281 first-time bacteremias per admission for an overall incidence of 14.2 per 1000 admissions and 23.6 per 10,000 bed days; highest for males, elderly individuals (> 65 years), and patients initially admitted to the Departments of Hematology, Nephrology, Internal Medicine, Urology or Oncology. The daily incidence was highest on the day of admission and declined rapidly to a low level on Day 3-7. Hereafter it increased steadily until Day 12 followed by more or less constant daily incidences. The daily incidences varied considerably with patient and clinical characteristics. Study III: In a population-based cohort study, we included 7783 patients with first-time bacteremia and 38,906 population controls matched on sex, year of birth and residency. We found that the cumulative mortality in bacteremia patients and population controls was 22.0% vs. 0.2% (30 days), 41.4% vs. 2.6% (1 year), and 75.8% vs. 36.6% (10 years). Bacteremia patients were consistently at increased risk of death compared with population controls throughout 12 years of follow-up and the risk of death remained 2-fold increased even among 5-year survivors of bacteremia (adjusted MRR: 2.1; 95% CI: 1.8-2.3). The most common causes of death after bacteremia were cancer and cardiovascular

  6. Analysis of grain boundary dynamics using event detection and cumulative averaging.

    PubMed

    Gautam, A; Ophus, C; Lançon, F; Denes, P; Dahmen, U

    2015-04-01

    To analyze extended time series of high resolution images, we have employed automated frame-by-frame comparisons that are able to detect dynamic changes in the structure of a grain boundary in Au. Using cumulative averaging of images between events allowed high resolution measurements of the atomic relaxation in the interface with sufficient accuracy for comparison with atomistic models. Cumulative averaging was also used to observe the structural rearrangement of atomic columns at a moving step in the grain boundary. The technique of analyzing changing features in high resolution images by averaging between incidents can be used to deconvolute stochastic events that occur at random intervals and on time scales well beyond that accessible to single-shot imaging. PMID:25498139

  7. Emergency contraception with a Copper IUD or oral levonorgestrel: an observational study of 1-year pregnancy rates

    PubMed Central

    Turok, David K.; Jacobson, Janet C.; Dermish, Amna I.; Simonsen, Sara E.; Gurtcheff, Shawn; McFadden, Molly; Murphy, Patricia A.

    2014-01-01

    Objective We investigated the one-year pregnancy rates for emergency contraception (EC) users who selected the copper T380 IUD or oral levonorgestrel (LNG) for EC. Study Design This prospective study followed women for 1 year after choosing either the copper T380 IUD or oral LNG for EC. The study was powered to detect a 6% difference in pregnancy rates within the year after presenting for EC. Results Of the 542 women who presented for EC, agreed to participate in the trial, and meet inclusion criteria, 215 (40%) chose the copper IUD and 327 (60%) chose oral LNG. In the IUD group, 127 (59%) were nulligravid. IUD insertion failed in 42 women (19%). The 1-year follow-up rate was 443/542 (82%); 64% of IUD users contacted at 1 year still had their IUDs in place. The 1-year cumulative pregnancy rate in women choosing the IUD was 6.5% vs. 12.2% in those choosing oral LNG (HR= 0.53, 95% CI: 0.29–0.97, p=0.041). By type of EC method actually received, corresponding values were 5.2% for copper IUD users vs. 12.3% for oral LNG users, HR 0.42 (95% CI: 0.20–0.85, p= 0.017). A multivariable logistic regression model controlling for demographic variables demonstrates that women who chose the IUD for EC had fewer pregnancies in the following year than those who chose oral LNG (HR 0.50, 95% CI: 0.26–0.96, p=0.037). Conclusion One year after presenting for EC women choosing the copper IUD for EC were half as likely to have a pregnancy compared to those choosing oral LNG. PMID:24332433

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

    PubMed

    Lattal, Kennon A

    2004-11-01

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

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

    PubMed Central

    Lattal, Kennon A

    2004-01-01

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

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

    SciTech Connect

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

    2011-09-15

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

  11. Weight changes in children in foster care for 1 year

    PubMed Central

    Schneiderman, Janet U.; Smith, Caitlin; Arnold, Janet S.; Fuentes, Jorge; Duan, Lei

    2013-01-01

    Objective The aims of this study of predominately racial/ethnic minority children in foster care (N = 360, birth to 19 years old) in Los Angeles, CA were to examine the (1) prevalence of obesity (≥ 95 percentile) and overweight/obese(≥ 85 percentile) upon entrance to foster care (T1) and after 1 year in foster care (T2); (2) comparison of high weight categories to national statistics; (3) relationship of changes in weight status to age, reason for entry into foster care, and placement. Methods Chi-square test and McNemar test comparing paired proportions were used to determine whether there were significant changes in the proportion of high weight categories between T1 and T2. Chi-square test or Fisher’s exact test were used to evaluated the association between age, placement, and reason for foster care with the change in weight category. Changes in weight were categorized as (1) decreased in weight, (2) remained at overweight or obese, (3) increased in weight, or (4) remained normal. Results The proportion of obese and obese/overweight children between age 2 and 5 were significantly lower at T2 than T1. There were no significant changes in the prevalence of obesity for the total population at T2. Children age 6 or older had a higher prevalence of obesity and overweight/obesity compared to national statistics. Of children at all ages, 64.7% of children of all ages entered foster care with a normal weight and stayed in the normal range during their first year in foster care, 12.2% decreased their weight, 15.4% remained overweight or obese, and 7.7% increased their weight. Age and parental substance use was related to change in weight category from T1 to T2. Conclusions Children did not become more overweight or obese in foster care; however 28% of the children were obese or overweight upon entry into foster care. Children who are 6 years or older and obese upon entering foster care should be targeted for weight reduction. The pediatric community and child

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

    ERIC Educational Resources Information Center

    Bandura, Albert; And Others

    1974-01-01

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

  13. Mission Availability for Bounded-Cumulative-Downtime System

    PubMed Central

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

    2013-01-01

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

  14. Incidence of bleb-associated endophthalmitis in the United States

    PubMed Central

    Vaziri, Kamyar; Kishor, Krishna; Schwartz, Stephen G; Maharaj, Arindel S; Moshfeghi, Darius M; Moshfeghi, Andrew A; Flynn, Harry W

    2015-01-01

    Purpose To evaluate the 5-year incidence rate of blebitis and bleb-associated endophthalmitis in the United States. Methods In this retrospective cross-sectional study, we utilized a large commercial health insurance claim-based database during 2007–2011 and identified all patients who had a record of trabeculectomy in 2007. These patients were followed until the end of 2011. During the follow-up period, all incidences of blebitis, confirmed bleb-associated endophthalmitis, and presumed bleb-associated endophthalmitis were recorded. Kaplan–Meier survival analysis was utilized to calculate 5-year cumulative incidence rates of blebitis and bleb-associated endophthalmitis following trabeculectomy procedures. Results Among the 1,461 trabeculectomies included in our analysis, eight cases of blebitis, five cases of confirmed bleb-associated endophthalmitis, and eight cases of presumed bleb-associated endophthalmitis were identified. We found that the 5-year cumulative incidence of blebitis was 0.55%±0.19%. The 5-year cumulative incidence of bleb-associated endophthalmitis was 0.45%±0.2% when only confirmed cases were included and 1.3%±0.34% when presumed cases were also added to the analysis. The mean time from procedure to diagnosis was 45 months for blebitis and 33 months for bleb-associated endophthalmitis. Conclusion Blebitis and bleb-related endophthalmitis are uncommon in the United States. The 5-year cumulative incidence was 0.55% for blebitis and 0.45%–1.3% for bleb-associated endophthalmitis. PMID:25709395

  15. Cumulative Doses of T-Cell Depleting Antibody and Cancer Risk after Kidney Transplantation

    PubMed Central

    Chen, Jenny H. C.; Wong, Germaine; Chapman, Jeremy R.; Lim, Wai H.

    2015-01-01

    T-cell depleting antibody is associated with an increased risk of cancer after kidney transplantation, but a dose-dependent relationship has not been established. This study aimed to determine the association between cumulative doses of T-cell depleting antibody and the risk of cancer after kidney transplantation. Using data from the Australian and New Zealand Dialysis and Transplant Registry between 1997–2012, we assessed the risk of incident cancer and cumulative doses of T-cell depleting antibody using adjusted Cox regression models. Of the 503 kidney transplant recipients with 2835 person-years of follow-up, 276 (55%), 209 (41%) and 18 (4%) patients received T-cell depleting antibody for induction, rejection or induction and rejection respectively. The overall cancer incidence rate was 1,118 cancers per 100,000 patient-years, with 975, 1093 and 1377 cancers per 100,000 patient-years among those who had received 1–5 doses, 6–10 doses and >10 doses, respectively. There was no association between cumulative doses of T cell depleting antibody and risk of incident cancer (1–5: referent, 6–10: adjusted hazard ratio (HR) 1.19, 95%CI 0.48–2.95, >10: HR 1.42, 95%CI 0.50–4.02, p = 0.801). This lack of association is contradictory to our hypothesis and is likely attributed to the low event rates resulting in insufficient power to detect significant differences. PMID:26555791

  16. Standardization of the cumulative absolute velocity

    SciTech Connect

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

    1991-12-01

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

  17. Children neglected: Where cumulative risk theory fails.

    PubMed

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

    2015-07-01

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

  18. SEVIRI Cloud mask by Cumulative Discriminant Analysis

    NASA Astrophysics Data System (ADS)

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

    2015-09-01

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

  19. The cumulative reaction probability as eigenvalue problem

    NASA Astrophysics Data System (ADS)

    Manthe, Uwe; Miller, William H.

    1993-09-01

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

  20. Continuously Cumulating Meta-Analysis and Replicability.

    PubMed

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

    2014-05-01

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

  1. Enteroaggregative Escherichia coli in Daycare—A 1-Year Dynamic Cohort Study

    PubMed Central

    Hebbelstrup Jensen, Betina; Stensvold, Christen R.; Struve, Carsten; Olsen, Katharina E. P.; Scheutz, Flemming; Boisen, Nadia; Röser, Dennis; Andreassen, Bente U.; Nielsen, Henrik V.; Schønning, Kristian; Petersen, Andreas M.; Krogfelt, Karen A.

    2016-01-01

    Enteroaggregative Escherichia coli (EAEC) has been associated with persistent diarrhea, reduced growth acceleration, and failure to thrive in children living in developing countries and with childhood diarrhea in general in industrialized countries. The clinical implications of an EAEC carrier-status in children in industrialized countries warrants clarification. To investigate the pathological significance of an EAEC carrier-state in the industrialized countries, we designed a 1-year dynamic cohort study and performed follow-up every second month, where the study participants submitted a stool sample and answered a questionnaire regarding gastrointestinal symptoms and exposures. Exposures included foreign travel, consumption of antibiotics, and contact with a diseased animal. In the capital area of Denmark, a total of 179 children aged 0–6 years were followed in a cohort study, in the period between 2009 and 2013. This is the first investigation of the incidence and pathological significance of EAEC in Danish children attending daycare facilities. Conventional microbiological detection of enteric pathogens was performed at Statens Serum Institute, Copenhagen, Denmark, and at Hvidovre Hospital, Copenhagen, Denmark. Parents completed questionnaires regarding gastrointestinal symptoms. The EAEC strains were further characterized by serotyping, phylogenetic analysis, and susceptibility testing. EAEC was detected in 25 (14%) of the children during the observational period of 1 year. One or more gastrointestinal symptoms were reported from 56% of the EAEC-positive children. Diarrhea was reported in six (24%) of the EAEC positive children, but no cases of weight loss, and general failure to thrive were observed. The EAEC strains detected comprised a large number of different serotypes, confirming the genetic heterogeneity of this pathotype. EAEC was highly prevalent (n = 25, 14%) in Danish children in daycare centers and was accompanied by gastrointestinal symptoms in

  2. Memantine and brain atrophy in Alzheimer's disease: a 1-year randomized controlled trial.

    PubMed

    Wilkinson, David; Fox, Nick C; Barkhof, Frederik; Phul, Ravinder; Lemming, Ole; Scheltens, Philip

    2012-01-01

    The primary objective of this study was to evaluate the rate of total brain atrophy (TBA) with serial magnetic resonance imaging (MRI), using the Brain Boundary Shift Integral (BBSI), in patients with probable Alzheimer's disease (AD) over the course of 52 weeks of treatment with memantine or placebo. This was a multi-national, randomized, double-blind, placebo-controlled, fixed-dose 1-year study. Patients were randomized (1 : 1) to treatment with placebo or memantine. Patients randomized to memantine were up-titrated to the target dose of 20 mg/day over 4 weeks. MRI scans were collected at screening and at Weeks 4, 42, and 52. Secondary efficacy assessments included several cognitive and behavioral scales. 518 patients were screened, 278 patients were randomized, and 217 patients completed the study. In the primary efficacy analysis, the differences in TBA rates between memantine (15.2 mL/year) and placebo (15.3 mL/year) were not statistically significant (-0.04 mL/year [(95% CI: -2.60, 2.52), p = 0.98]). There was a statistically significant correlation between change in TBA and change in most cognitive and behavioral scale scores. Patients who were not treated with acetyl cholinesterase inhibitors (AChEIs) showed a significantly lower TBA rate than patients treated with AChEIs. Memantine had a placebo-level incidence of adverse events. There were no statistically significant differences between memantine and placebo in total brain or hippocampal atrophy rates in patients with probable AD treated for 1 year. The biological relevance of cerebral atrophy was supported by a significant correlation between rate of atrophy and decline in cognitive and behavioral outcomes. PMID:22269160

  3. Cumulative impacts in environmental assessments: How well are they considered?

    SciTech Connect

    McCold, L.; Holman, J.

    1995-03-01

    The usual reason for preparing an environmental assessment (EA) is to ``provide sufficient evidence and analysis to determine whether to prepare a finding of no significant impact or an environmental impact statement`` (40 CFR 1508.9). Significant impacts may result from direct, indirect, or cumulative impacts. Thus, in addition to assessing direct and indirect impacts, EAs should give enough evidence and analysis to determine whether or not the action contributes to a cumulatively significant impact. Consideration of cumulative impacts in NEPA documents in general, and EAs in particular, is less fully developed than consideration of impacts resulting solely from the proposed action. The authors analyzed 89 EAs to determine the extent to which their treatment of cumulative impacts met the requirements of 40 CFR 1508. Only 35 EAs (39 %) mentioned cumulative impacts. Of these, 8 stated that there were no cumulative impacts without supporting evidence; 5 identified a potential for cumulative impacts and concluded they were insignificant but presented no evidence or analysis to support the conclusion; 19 addressed cumulative impacts of some resources but not others; and 18 EAs identified past, present, and future actions that could, with the proposed action, contribute to cumulative impacts, but only actions of a similar type were identified, usually those in the agency`s area of responsibility. The paper presents several recommendations: (1) Past, present, and reasonably foreseeable actions that could affect resources affected by the proposed action should be identified at the same time as, and listed with, the proposed action. (2) For each resource, the discussion of cumulative impacts should follow immediately after the discussion of direct impacts to that resource. (3) Conclusions about cumulative impacts should be supported by data and analyses. (4) Agencies need a central review function to ensure the quality of their EAs.

  4. Incidents of Security Concern

    SciTech Connect

    Atencio, Julian J.

    2014-05-01

    This presentation addresses incidents of security concern and an incident program for addressing them. It addresses the phases of an inquiry, and it divides incidents into categories based on severity and interest types based on whether security, management, or procedural interests are involved. A few scenarios are then analyzed according to these breakdowns.

  5. A Framework for Treating Cumulative Trauma with Art Therapy

    ERIC Educational Resources Information Center

    Naff, Kristina

    2014-01-01

    Cumulative trauma is relatively undocumented in art therapy practice, although there is growing evidence that art therapy provides distinct benefits for resolving various traumas. This qualitative study proposes an art therapy treatment framework for cumulative trauma derived from semi-structured interviews with three art therapists and artistic…

  6. Cumulative Estrogen Exposure and Prospective Memory in Older Women

    ERIC Educational Resources Information Center

    Hesson, Jacqueline

    2012-01-01

    This study looked at cumulative lifetime estrogen exposure, as estimated with a mathematical index (Index of Cumulative Estrogen Exposure (ICEE)) that included variables (length of time on estrogen therapy, age at menarche and menopause, postmenopausal body mass index, time since menopause, nulliparity and duration of breastfeeding) known to…

  7. CUMULATIVE AND AGGREGATE RISK EVALUATION SYSTEM (CARES) MODEL REVIEW

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The 1996 Food Quality Protection Act (FQPA) changed the way the U.S. Environmental Protection Agency (USEPA) assesses risks of pesticide use. Both cumulative and aggregate exposures must now be considered. They are cumulative since consumption of residues in food and drinking water and incidental co...

  8. A cumulative index to Aeronautical Engineering: A special bibliography

    NASA Technical Reports Server (NTRS)

    1978-01-01

    This publication is a cumulative index to the abstracts contained in NASA SP-7037 (80) through NASA SP-7037 (91) of Aeronautical Engineering: A Special Bibliography. NASA SP-7037 and its supplements have been compiled through the cooperative efforts of the American Institute of Aeronautics (AIAA) and Space Administration (NASA). This cumulative index includes subject, personal author, corporate source, contract, and report number indexes.

  9. Concussion Incidence in Professional Football

    PubMed Central

    Nathanson, John T.; Connolly, James G.; Yuk, Frank; Gometz, Alex; Rasouli, Jonathan; Lovell, Mark; Choudhri, Tanvir

    2016-01-01

    Background: In the United States alone, millions of athletes participate in sports with potential for head injury each year. Although poorly understood, possible long-term neurological consequences of repetitive sports-related concussions have received increased recognition and attention in recent years. A better understanding of the risk factors for concussion remains a public health priority. Despite the attention focused on mild traumatic brain injury (mTBI) in football, gaps remain in the understanding of the optimal methodology to determine concussion incidence and position-specific risk factors. Purpose: To calculate the rates of concussion in professional football players using established and novel metrics on a group and position-specific basis. Study Design: Case-control study; Level of evidence, 3. Methods: Athletes from the 2012-2013 and 2013-2014 National Football League (NFL) seasons were included in this analysis of publicly available data. Concussion incidence rates were analyzed using established (athlete exposure [AE], game position [GP]) and novel (position play [PP]) metrics cumulatively, by game unit and position type (offensive skill players and linemen, defensive skill players and linemen), and by position. Results: In 480 games, there were 292 concussions, resulting in 0.61 concussions per game (95% CI, 0.54-0.68), 6.61 concussions per 1000 AEs (95% CI, 5.85-7.37), 1.38 concussions per 100 GPs (95% CI, 1.22-1.54), and 0.17 concussions per 1000 PPs (95% CI, 0.15-0.19). Depending on the method of calculation, the relative order of at-risk positions changed. In addition, using the PP metric, offensive skill players had a significantly greater rate of concussion than offensive linemen, defensive skill players, and defensive linemen (P < .05). Conclusion: For this study period, concussion incidence by position and unit varied depending on which metric was used. Compared with AE and GP, the PP metric found that the relative risk of concussion for

  10. Cumulative impacts in environmental assessments: How well are they considered

    SciTech Connect

    McCold, L. ); Holman, J. )

    1993-01-01

    The authors analyzed 89 environmental assessments published in the Federal Register from January 1 through June 30, 1992, to determine the extent to which their treatment of cumulative impacts met the requirements of 40 CFR 1500-1508. Only 35 (39%) EAs mentioned cumulative impacts. Nineteen EAs addressed cumulative impacts of some resources, but not others. The paper presents several recommendations: (1) past, present and reasonable foreseeable actions that could affect resources affected by the proposed action should be identified at the same time as, and be listed with, the proposed action. (2) for each resource, the discussion of cumulative impacts should follow immediately after the discussion of direct impacts to that resource. (3) conclusions about cumulative impacts should be supported by data and analyses. (4) agencies need a central review function to ensure the quality of their EAs.

  11. Cumulative frequency distribution of past species extinctions

    NASA Technical Reports Server (NTRS)

    Raup, D. M.

    1991-01-01

    Analysis of Sepkoski's compendium of the time ranges of 30,000+ taxa yields a mean duration of 28.4 ma for genera of fossil invertebrates. This converts to an average extinction rate of 3.5 percent per million years or about one percent every 286,000 years. Using survivorship techniques, these estimates can be converted to the species level, yielding a Phanerozoic average of one percent species extinction every 40,000 years. Variation in extinction rates through time is far greater than the null expectation of a homogeneous birth-death model and this reflects the well-known episodicity of extinction ranging from a few large mass extinctions to so-called background extinction. The observed variation in rates can be used to construct a cumulative frequency distribution of extinction intensity, and this distribution, in the form of a kill curve for species, shows the expected waiting times between extinction events of a given intensity. The kill curve is an average description of the extinction events of a given intensity. The kill curve is an average description of the extinction record and does not imply any cause or causes of extinction. The kill curve shows, among other things, that only about five percent of total species extinctions in the Phanerozoic were involved in the five largest mass extinctions. The other 95 percent were distributed among large and small events not normally called mass extinctions. As an exploration of the possibly absurd proposition that most past extinctions were produced by the effects of large-body impact, the kill curve for species was mapped on the comparable distribution for comet and asteroid impacts. The result is a curve predicting the species kill for a given size of impacting object (expressed as crater size). The results are reasonable in that impacts producing craters less than 30 km (diameter) cause negligible extinction but those producing craters 100-150 km (diameter) cause extinction of species in the range of 45

  12. Lack of Cumulative Toxicity Associated With Cabazitaxel Use in Prostate Cancer

    PubMed Central

    Di Lorenzo, Giuseppe; Bracarda, Sergio; Gasparro, Donatello; Gernone, Angela; Messina, Caterina; Zagonel, Vittorina; Puglia, Livio; Bosso, Davide; Dondi, Davide; Sonpavde, Guru; Lucarelli, Giuseppe; De Placido, Sabino; Buonerba, Carlo

    2016-01-01

    Abstract Cabazitaxel provided a survival advantage compared with mitoxantrone in patients with castration-resistant prostate cancer refractory to docetaxel. Grade 3 to 4 (G3–4) neutropenia and febrile neutropenia were relatively frequent in the registrative XRP6258 Plus Prednisone Compared to Mitoxantrone Plus Prednisone in Hormone Refractory Metastatic Prostate Cancer (TROPIC) trial, but their incidence was lower in the Expanded Access Program (EAP). Although cumulative doses of docetaxel are associated with neuropathy, the effect of cumulative doses of cabazitaxel is unknown. In this retrospective review of prospectively collected data, the authors assessed “per cycle” incidence and predictors of toxicity in the Italian cohort of the EAP, with a focus on the effect of cumulative doses of cabazitaxel. The study population consisted of 218 Italian patients enrolled in the cabazitaxel EAP. The influence of selected variables on the most relevant adverse events identified was assessed using a Generalized Estimating Equations model at univariate and multivariate analysis. “Per cycle” incidence of G 3 to 4 neutropenia was 8.7%, whereas febrile neutropenia was reported in 0.9% of cycles. All events of febrile neutropenia occurred during the first 3 cycles. Multivariate logistic regression analysis showed that higher prior dose of cabazitaxel was associated with decreased odds of having G3 to 4 neutropenia (OR = 0.90; 95% CI: 0.86–0.93; P < 0.01), febrile neutropenia (OR = 0.52; 95% CI: 0.34–0.81; P < 0.01) and G3 to 4 anemia (OR = 0.93; 95% CI: 0.86–1; P = 0.07). Patients with a body surface area >2 m2 presented increased odds of having G 3 to 4 neutropenia (OR = 0.93; 95% CI: 0.86–1; P = 0.07), but decreased odds of having G3 to 4 anemia. Among the toxicities assessed, the authors did not identify any that appeared to be associated with a higher number of cabazitaxel cycles delivered. Prior cumulative dose was

  13. Incidence, Morbidity and Mortality in Patients Older than 50 Years with Second Hip Fracture in a Jeju Cohort Study

    PubMed Central

    Park, Yong-Geun; Jang, Sunmee

    2014-01-01

    Purpose Although the incidence of a second hip fracture is relatively well described, mortality and morbidity after a second hip fracture are seldom evaluated. The purpose of this study was to determine the incidence, morbidity, and mid-term mortality of a second hip fracture and evaluate the cause of death after a second hip fracture. Materials and Methods Information on patients older than 50 years, who sustained a subsequent hip fracture, were obtained from the records of eight Jeju Island hospitals between 2002 and 2011 to calculate the incidence, morbidity, and mortality of hip fractures in this age group. All patients were followed a minimum of 2 years. A systemic search for death certificates at the National Statistical Office was conducted for patients who were lost to follow-up. Results Of 2,055 hip fractures (419 men and 1,636 women), 98 were second hip fractures (13 men and 85 women) during the study period. The mean ages of the patients at the time of the first and second fractures were 78.8 and 80.8 years, respectively. The incidence of a subsequent hip fracture among the first hip fracture was 4.8%. Mean mortality rates at 6 months, 1 year, 2 years, and 5 years were 10.5%, 15.2%, 23.5%, and 42.0% respectively. Cumulative mortality after the second hip fracture at the 5 years follow-up was 41.8%. Conclusion Our results demonstrate that a secondary fracture prevention program is necessary to prevent second hip fractures in elderly patients.

  14. Incidence of Chromosome Disorders

    PubMed Central

    Valentine, G. H.

    1979-01-01

    A minority of conceptions result in live births. Of recognized conceptions, 15% result in spontaneous abortions, up to 60% of which are due to chromosome abnormalities. The incidence of the different disorders is given. Of live births, one in 200 suffers a chromosome abnormality. The common abnormalities are described with their incidence. The effect of maternal age on this incidence is pronounced, but even so must be kept in proportion for counselling purposes.

  15. Emergency re-admissions to hospital due to adverse drug reactions within 1 year of the index admission

    PubMed Central

    Davies, Emma C; Green, Christopher F; Mottram, David R; Rowe, Philip H; Pirmohamed, Munir

    2010-01-01

    AIM The proportion of re-admissions to hospital caused by ADRs is poorly documented in the UK. The aim of this study was to evaluate the impact of ADRs on re-admission to hospital after a period as an inpatient. METHODS One thousand patients consecutively admitted to 12 wards were included. All subsequent admissions for this cohort within 1 year of discharge from the index admission were retrospectively reviewed. RESULTS Of the 1000 patients included, 403 (40.3%, 95% CI 39.1, 45.4%) were re-admitted within 1 year. Complete data were available for 290 (70.2%) re-admitted patients, with an ADR contributing to admission in 60 (20.8%, 95% CI 16.4, 25.6%) patients. Presence of an ADR in the index admission did not predict for an ADR-related re-admission (10.5% vs. 7.2%, P = 0.25), or re-admission overall (47.2% vs. 41.2%, P = 0.15). The implicated drug was commenced in the index admission in 33/148 (22.3%) instances, with 37/148 (25%) commenced elsewhere since the index admission. Increasing age and an index admission in a medical ward were associated with a higher incidence of re-admission ADR. The most frequent causative drugs were anti-platelets and loop diuretics, with bleeding and renal impairment the most frequent ADRs. Over half (52/91, 57.1%) of the ADRs were judged to be definitely or possibly avoidable. CONCLUSIONS One fifth of patients re-admitted to hospital within 1 year of discharge from their index admission are re-admitted due to an ADR. Our data highlight drug and patient groups where interventions are needed to reduce the incidence of ADRs leading to re-admission. PMID:21039769

  16. Cumulative Weight Exposure Is Associated with Different Weight Loss Strategies and Weight Loss Success in Adults Age 50 or Above

    PubMed Central

    Sénéchal, Martin; Slaght, Jana; Bouchard, Danielle R.

    2015-01-01

    Objectives. To evaluate if cumulative weight exposure is associated with weight loss strategy choices and weight loss success. Methods. Data from the National Health and Nutrition Examination Survey were used; a total of 4,562 people age 50 years or older who reported trying to lose weight in the last year were studied. Cumulative weight exposure (CWE) score was defined as the sum of body mass index points above 25 kg/m2 at the age of 25, 10 years ago, 1 year ago, and now. Weight loss strategies were self-reported and weight loss success was defined as reaching a 5% weight loss in the last year. Results. Chosen strategies for weight loss vary across tertiles of CWE. Participants in the highest CWE tertile were about 4 to 20 times more likely to lose at least 5% of body weight in the past year compared to those in the lowest CWE tertile (P < 0.05).  Discussion. Strategies used to lose weight and weight loss success using different weight loss strategies vary considerably across cumulative weight exposure. Thus, cumulative weight exposure might be a variable worth considering when intervening with this population. PMID:26161269

  17. A missing link in the evolution of the cumulative recorder.

    PubMed

    Asano, Toshio; Lattal, Kennon A

    2012-09-01

    A recently recovered cumulative recorder provides a missing link in the evolution of the cumulative recorder from a modified kymograph to a reliably operating, scientifically and commercially successful instrument. The recorder, the only physical evidence of such an early precommercial cumulative recorder yet found, was sent to Keio University in Tokyo, Japan, in 1952 at the behest of B. F. Skinner at Harvard University. Last used in research in the late 1960s, the cumulative recorder remained locked in a storage room until 2007, when it was found again. A historical context for the recorder is followed by a description of the recorder and a comparison between it and the commercially successful Gerbrands Model C-1 recorder. Labeled the Keio recorder, it is a testament to Skinner's persistence in developing a reliable means of quantifying the behavior of living organisms in real time. PMID:23008524

  18. Petrology of the Cumulate Eucrite Serra de Magi

    NASA Technical Reports Server (NTRS)

    Treiman, A. H.; Goldman, K.

    2002-01-01

    Serra de Magi is a cumulate eucrite, with bizarrely shaped pyroxene crystals. One section contains a veinlet of fine-grained silica, probably chalcedony. Additional information is contained in the original extended abstract.

  19. Effect of Cumulative Damage on Rocket Motor Service Life

    NASA Astrophysics Data System (ADS)

    Gligorijević, Nikola; Živković, Saša; Subotić, Sredoje; Rodić, Vesna; Gligorijević, Ivan

    2015-10-01

    Two series of antihail rocket propellant grains failed only 3 months after production, due to the appearance of cracks in the grain channel. Structural integrity analysis demonstrated sufficient reliability at the beginning of service life. Further analysis showed that under temperature loads, cumulative damage during the short period in field stocks caused the grain failure, despite the established opinion that such failure can become significant only after lengthy storage. A linear cumulative damage law is evaluated by exposing a number of hydroxyl-terminated polybutadiene (HTPB) composite propellant specimens to different but constant stress levels. The analysis showed that cumulative damage must not be overlooked at the design stage. Further, a positive correlation between the propellant cumulative damage law and tensile strength is strongly indicated.

  20. GENERAL CONCEPTS FOR MEASURING CUMULATIVE IMPACTS ON WETLAND ECOSYSTEMS

    EPA Science Inventory

    Because environmental impacts accumulate over space and time, their analysis is difficult, and we must incorporate the most recent scientifically defensible information and methods into the process. Methods designed to deal specifically with cumulative impacts have included check...

  1. Cumulative Environmental Impacts: Science and Policy to Protect Communities.

    PubMed

    Solomon, Gina M; Morello-Frosch, Rachel; Zeise, Lauren; Faust, John B

    2016-03-18

    Many communities are located near multiple sources of pollution, including current and former industrial sites, major roadways, and agricultural operations. Populations in such locations are predominantly low-income, with a large percentage of minorities and non-English speakers. These communities face challenges that can affect the health of their residents, including limited access to health care, a shortage of grocery stores, poor housing quality, and a lack of parks and open spaces. Environmental exposures may interact with social stressors, thereby worsening health outcomes. Age, genetic characteristics, and preexisting health conditions increase the risk of adverse health effects from exposure to pollutants. There are existing approaches for characterizing cumulative exposures, cumulative risks, and cumulative health impacts. Although such approaches have merit, they also have significant constraints. New developments in exposure monitoring, mapping, toxicology, and epidemiology, especially when informed by community participation, have the potential to advance the science on cumulative impacts and to improve decision making. PMID:26735429

  2. A MISSING LINK IN THE EVOLUTION OF THE CUMULATIVE RECORDER

    PubMed Central

    Asano, Toshio; Lattal, Kennon A

    2012-01-01

    A recently recovered cumulative recorder provides a missing link in the evolution of the cumulative recorder from a modified kymograph to a reliably operating, scientifically and commercially successful instrument. The recorder, the only physical evidence of such an early precommercial cumulative recorder yet found, was sent to Keio University in Tokyo, Japan, in 1952 at the behest of B. F. Skinner at Harvard University. Last used in research in the late 1960s, the cumulative recorder remained locked in a storage room until 2007, when it was found again. A historical context for the recorder is followed by a description of the recorder and a comparison between it and the commercially successful Gerbrands Model C-1 recorder. Labeled the Keio recorder, it is a testament to Skinner's persistence in developing a reliable means of quantifying the behavior of living organisms in real time. PMID:23008524

  3. Cumulative Risk: Toxicity and Interactions of Physical and Chemical Stressors

    EPA Science Inventory

    ABSTRACT Recent efforts to update cumulative risk assessment procedures to incorporate nonchemical stressors ranging from physical to psychosocial, reflect increased interest in consideratio of the totality of variables affecting human health and the growing desire to develop co...

  4. REGION 6 EPA CUMULATIVE RISK SCREENING ASSESSMENT SYSTEM USING GIS

    EPA Science Inventory

    Region 6 EPA has developed a GIS based System to address cumulative risk. The System evaluates data for human health, ecological vulnerability, habitat fragmentation, industry regulatory compliance, and socio-economics. All criteria are mathematically associated allowing the dat...

  5. Considering Environmental and Occupational Stressors in Cumulative Risk Assessments

    EPA Science Inventory

    While definitions vary across the global scientific community, cumulative risk assessments (CRAs) typically are described as exhibiting a population focus and analyzing the combined risks posed by multiple stressors. CRAs also may consider risk management alternatives as an anal...

  6. Tools to Assess Community-Based Cumulative Risk and Exposures

    EPA Science Inventory

    Multiple agents and stressors can interact in a given community to adversely affect human and ecological conditions. A cumulative risk assessment (CRA) analyzes, characterizes, and potentially quantifies the effects from multiple stressors, which include chemical agents (for exam...

  7. Long-Term Predictors of Clinical Events after Off-Label Use of Drug-Eluting Stent beyond 1 Year

    PubMed Central

    Ko, Jum Suk; Rhee, Sang Jae; Lee, Eun Mi; Yoo, Nam Jin; Kim, Nam-Ho; Oh, Seok Kyu; Jeong, Jin-Won

    2013-01-01

    Background and Objectives We evaluated the long-term outcomes and predictors of clinical events after off-label use of drug-eluting stents (DES) beyond 1 year after procedure. Subjects and Methods A total of 518 patients who underwent DES implantation for off-label indications and did not have any major adverse cardiac events (MACE) during the first year were analyzed. The occurrence of MACE, including cardiac death, myocardial infarction (MI), stent thrombosis and target vessel revascularization, were evaluated for a median 1179 days (interquartile range 769-1541) after the first year. Results Major adverse cardiac events occurred in 43 patients (8.3%) including 8 cases (1.5%) of cardiac death, 9 cases (1.7%) of MI, 24 cases (4.6%) of target vessel revascularization, and 11 cases (2.1%) of stent thrombosis. Patients with MACE had a higher serum creatinine level, higher incidence of in-stent restenosis lesion, more overlapping stents, a greater number of stents, and longer stents than did patients without MACE. Multivariate analysis revealed that serum creatinine level >1.5 mg/dL {hazard ratio (HR) 2.3, p=0.019}, stent length >33 mm (HR 2.4, p=0.035), and in-stent restenosis lesions (HR 2.4, p=0.040) were independent risk factors for MACE. Patients with DES length >33 mm had a higher incidence of MACE than those with DES length ≤33 mm (HR 2.7, log rank p=0.002). Conclusion The risk of stent thrombosis and target vessel revascularization persisted in patients undergoing off-label DES implantation beyond 1-year follow-up. A total DES length >33 mm was a significant procedural predictor associated with the incidence of MACE. PMID:23613692

  8. A cumulative index to a continuing bibliography on aeronautical engineering

    NASA Technical Reports Server (NTRS)

    1986-01-01

    This bibliography is a cumulative index to the abstracts contained in NASA-SP-7037(184) through NASA-SP-7037(195) of Aeronautical Engineering: A Continuing Bibliography. NASA SP-7037 and its supplements have been compiled through the cooperative efforts of the American Institute of Aeronautics and Astronautics (AIAA) and the National Aeronautics and Space Administration (NASA). This cumulative index includes subject, personal author, corporate source, foreign technology, contract, report number, and accession number indexes.

  9. Aeronautical engineering: A cumulative index to a continuing bibliography

    NASA Technical Reports Server (NTRS)

    1988-01-01

    This bibliography is a cumulative index to the abstracts contained in NASA SP-7037(210) through NASA SP-7037(221) of Aeronautical Engineering: A Continuing Bibliography. NASA SP-7037 and its supplements have been compiled through the cooperative efforts of the American Institute of Aeronautics and Astronautics (AIAA) and the National Aeronautics and Space Administration (NASA). This cumulative index includes subject, personal author, corporate source, foreign technology, contract number, report number, and accession number indexes.

  10. Cumulative Query Method for Influenza Surveillance Using Search Engine Data

    PubMed Central

    Seo, Dong-Woo; Sohn, Chang Hwan; Shin, Soo-Yong; Lee, JaeHo; Yu, Maengsoo; Kim, Won Young; Lim, Kyoung Soo; Lee, Sang-Il

    2014-01-01

    Background Internet search queries have become an important data source in syndromic surveillance system. However, there is currently no syndromic surveillance system using Internet search query data in South Korea. Objectives The objective of this study was to examine correlations between our cumulative query method and national influenza surveillance data. Methods Our study was based on the local search engine, Daum (approximately 25% market share), and influenza-like illness (ILI) data from the Korea Centers for Disease Control and Prevention. A quota sampling survey was conducted with 200 participants to obtain popular queries. We divided the study period into two sets: Set 1 (the 2009/10 epidemiological year for development set 1 and 2010/11 for validation set 1) and Set 2 (2010/11 for development Set 2 and 2011/12 for validation Set 2). Pearson’s correlation coefficients were calculated between the Daum data and the ILI data for the development set. We selected the combined queries for which the correlation coefficients were .7 or higher and listed them in descending order. Then, we created a cumulative query method n representing the number of cumulative combined queries in descending order of the correlation coefficient. Results In validation set 1, 13 cumulative query methods were applied, and 8 had higher correlation coefficients (min=.916, max=.943) than that of the highest single combined query. Further, 11 of 13 cumulative query methods had an r value of ≥.7, but 4 of 13 combined queries had an r value of ≥.7. In validation set 2, 8 of 15 cumulative query methods showed higher correlation coefficients (min=.975, max=.987) than that of the highest single combined query. All 15 cumulative query methods had an r value of ≥.7, but 6 of 15 combined queries had an r value of ≥.7. Conclusions Cumulative query method showed relatively higher correlation with national influenza surveillance data than combined queries in the development and validation

  11. Aeronautical Engineering: A continuing bibliography, 1982 cumulative index

    NASA Technical Reports Server (NTRS)

    1983-01-01

    This bibliography is a cumulative index to the abstracts contained in NASA SP-7037 (145) through NASA SP-7037 (156) of Aeronautical Engineering: A Continuing Bibliography. NASA SP-7037 and its supplements have been compiled through the cooperative efforts of the American Institute of Aeronautics and Astronautics (AIAA) and the National Aeronautics and Space Administration (NASA). This cumulative index includes subject, personal author, corporate source, contract, and report number indexes.

  12. Cumulant moments in hadron-nucleus collisions and stochastic processes

    NASA Astrophysics Data System (ADS)

    Suzuki, N.; Biyajima, M.; Wilk, G.; Wlodarczyk, Z.

    1998-09-01

    Cumulant moments of negatively charged particles observed in hadron-nulceus collisions are analyzed by a leading particle cascade model. A modified negative binomial distribution (MNBD) or a negative binomial distribution (NBD) is used for multiplicity distribution from each participant hadron. If multiplicity distributions are truncated, both calculated results with the MNBD and the NBD can explain the oscillation of cumulant moments obtained from the data.

  13. A cumulative index to Aeronautical Engineering: A continuing bibliography

    NASA Technical Reports Server (NTRS)

    1982-01-01

    This bibliography is a cumulated index to the abstracts contained in NASA SP-7037(132) through NASA SP-7037(143) of Aeronautical Engineering: A continuing bibliography. NASA SP-7037 and its supplements have been compiled through the cooperative efforts of the American Institute of Aeronautics and Astronautics (AIAA) and the National Aeronautics and Space Administration (NASA). This cumulative index includes subject, personal author, corporate source, contract, and report number indexes.

  14. Aeronautical engineering: A cumulative index to a continuing bibliography

    NASA Technical Reports Server (NTRS)

    1987-01-01

    This bibliography is a cumulative index to the abstracts contained in NASA SP-7037 (197) through NASA SP-7037 (208) of Aeronautical Engineering: A Continuing Bibliography. NASA SP-7037 and its supplements have been compiled through the cooperative efforts of the American Institute of Aeronautics and Astronautics (AIAA) and the National Aeronautics and Space Administration (NASA). This cumulative index includes subject, personal author, corporate source, foreign technology, contract, report number, and accession number indexes.

  15. Childhood Cumulative Risk Exposure and Adult Amygdala Volume and Function.

    PubMed

    Evans, Gary W; Swain, James E; King, Anthony P; Wang, Xin; Javanbakht, Arash; Ho, S Shaun; Angstadt, Michael; Phan, K Luan; Xie, Hong; Liberzon, Israel

    2016-06-01

    Considerable work indicates that early cumulative risk exposure is aversive to human development, but very little research has examined the neurological underpinnings of these robust findings. This study investigates amygdala volume and reactivity to facial stimuli among adults (mean 23.7 years of age, n = 54) as a function of cumulative risk exposure during childhood (9 and 13 years of age). In addition, we test to determine whether expected cumulative risk elevations in amygdala volume would mediate functional reactivity of the amygdala during socioemotional processing. Risks included substandard housing quality, noise, crowding, family turmoil, child separation from family, and violence. Total and left hemisphere adult amygdala volumes were positively related to cumulative risk exposure during childhood. The links between childhood cumulative risk exposure and elevated amygdala responses to emotionally neutral facial stimuli in adulthood were mediated by the corresponding amygdala volumes. Cumulative risk exposure in later adolescence (17 years of age), however, was unrelated to subsequent adult amygdala volume or function. Physical and socioemotional risk exposures early in life appear to alter amygdala development, rendering adults more reactive to ambiguous stimuli such as neutral faces. These stress-related differences in childhood amygdala development might contribute to the well-documented psychological distress as a function of early risk exposure. © 2015 Wiley Periodicals, Inc. PMID:26469872

  16. Cumulative exposure to traumatic events in older adults

    PubMed Central

    Ogle, Christin M.; Rubin, David C.; Siegler, Ilene C.

    2014-01-01

    Objectives The present study examined the impact of cumulative trauma exposure on current posttraumatic stress disorder (PTSD) symptom severity in a nonclinical sample of adults in their 60s. The predictive utility of cumulative trauma exposure was compared to other known predictors of PTSD, including trauma severity, personality traits, social support, and event centrality. Method Community-dwelling adults (n = 2,515) from the crest of the Baby Boom generation completed the Traumatic Life Events Questionnaire, the PTSD Checklist, the NEO Personality Inventory, the Centrality of Event Scale, and rated their current social support. Results Cumulative trauma exposure predicted greater PTSD symptom severity in hierarchical regression analyses consistent with a dose-response model. Neuroticism and event centrality also emerged as robust predictors of PTSD symptom severity. In contrast, the severity of individuals’ single most distressing life event, as measured by self-report ratings of the A1 PTSD diagnostic criterion, did not add explanatory variance to the model. Analyses concerning event categories revealed that cumulative exposure to childhood violence and adulthood physical assaults were most strongly associated with PTSD symptom severity in older adulthood. Moreover, cumulative self-oriented events accounted for a larger percentage of variance in symptom severity compared to events directed at others. Conclusion Our findings suggest that the cumulative impact of exposure to traumatic events throughout the life course contributes significantly to post-traumatic stress in older adulthood above and beyond other known predictors of PTSD. PMID:24011223

  17. Potential allergy and irritation incidents among health care workers.

    PubMed

    Alamgir, Hasanat; Yu, Shicheng; Chavoshi, Negar; Ngan, Karen

    2008-07-01

    This study describes the types, causes, and outcomes of potential irritation and allergy incidents among workers in British Columbia's health care industry. Data on occupation-induced allergy and irritation incidents were extracted from a standardized database using the number of productive hours obtained from payroll data as a denominator during a 1-year period from three British Columbia health regions. Younger workers, female workers, facility support service workers, laboratory assistants and technicians, and maintenance and acute care workers were found to be at higher risk for allergy and irritation incidents. Major causes of allergy and irritation incidents included chemicals, blood and body fluids, food and objects, communicable diseases, air quality, and latex. A larger proportion of chemically induced incidents resulted in first aid care only, whereas non-chemical incidents required more emergency room visits. PMID:18669179

  18. 76 FR 69726 - Pyrethrins/Pyrethroid Cumulative Risk Assessment; Notice of Availability

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-09

    ... AGENCY Pyrethrins/Pyrethroid Cumulative Risk Assessment; Notice of Availability AGENCY: Environmental... cumulative risk assessment for the naturally occurring pyrethrins and synthetic pyrethroid pesticides (often... synthetic pyrethroid pesticides, and has conducted a screening-level cumulative risk assessment for...

  19. The Amphiolite Layers In The Cumulate Gabbros, (Northern-Turkey)

    NASA Astrophysics Data System (ADS)

    Özkan, Mutlu; Faruk Çelik, Ömer; Altıntaş, İsmail Emir; Sherlock, Sarah; Chelle-Michou, Cyril; Marzoli, Andrea; Ulianov, Alexey; Melih Çörtük, Rahmi; Topuz, Gültekin

    2016-04-01

    The Early-Middle Jurassic SSZ type dismembered ophiolite sequence, which is remnants of the Tethyan oceanic lithosphere, crop out in the accretionary complex around Tokat-Çamlıbel region (Northern Turkey). The main lithology of the ophiolite sequence are cumulate gabbros, isotropic gabbros and basalts. The amphibolite layers, which their thickness are up to 2 m, are observed in the cumulate gabbros. In this study, we aim to discuss a possible formation mechanism of the amphibolitic rocks in the cumulate gabbros, based on the field, mineralogical, geochemical and geochronological data. The cumulate gabbros (olivine-gabbro, gabbro-norite and gabbro) have generally well developed magmatic layers and they show cumulate texture. They are cross cut by pegmatite gabbros, dolerites and plagiogranite dikes. In terms of the mechanism of formation, the amphibolite layers in the cumulate gabbros are different from dolerite, pegmatite gabbro and plagiogranite dikes crosscutting the cumulate gabbros. Although the cumulate gabbros, the mafic and felsic dikes have not undergone any metamorphism (except the hydrothermal metamorphism), the amphibolite layers show well developed foliation and banded structure. Moreover, field and petrographic observations showed that the amphibolitic rocks were highly subjected to shearing. The amphibolitic rocks are mainly composed of magnesio-hornblende + plagioclase (andesine), ± biotite and opaque minerals and they exhibit nematoblastic texture. The amphibolite layers in the cumulate gabbros are crosscut by the plagiogranite dikes. The plagiogranites consist mainly of quartz, plagioclase, biotite and opaque minerals and they show granular texture. Undulose extinction and sub-grain formation in quartz minerals indicate to the presence of deformation phase affecting the plagiogranite dikes. LA-ICP-MS dating on zircon from plagiogranite dikes which is cross-cutting of the amphibolite layers, yielded Middle Jurassic ages. 40Ar/39Ar dating of

  20. Cumulative disease activity predicts incidental hearing impairment in patients with rheumatoid arthritis (RA).

    PubMed

    Pascual-Ramos, Virginia; Contreras-Yáñez, Irazú; Rivera-Hoyos, Paula; Enríquez, Lorena; Ramírez-Anguiano, Jaqueline

    2014-03-01

    We previously reported that 24% of 113 rheumatoid arthritis (RA) patients had hearing impairment (HI). We investigated if disease activity was a predictor of incidental HI. One hundred and four patients completed three consecutive 6 months-apart rheumatic evaluations and concomitant audiometric evaluations which included at least an interview, an otoscopic evaluation, and a pure tone audiometry. HI was defined if the average thresholds for at least one of low-, mid-, or high-frequency ranges were ≥25 decibels (dB) hearing level in one or both ears. Appropriated statistics was used. Internal review board approval was obtained. Patients were most frequently middle-aged (43.4 ± 13.3 years), female (89.4%), and had median disease duration of 5 years and low disease activity. All were receiving RA treatment. At inclusion, 24 patients had HI which was sensorineural in 91.7% of them. Among the 80 patients without HI at baseline, 10 (12.5%) developed incidental HI, and they had more disease activity either at baseline ([median, range] disease activity score-28 joints evaluated-C-reactive protein [DAS28-CRP], 3.9 [1.6-7.3] vs. 2.1 [1-8.7], p = 0.006) or cumulative previous incidental HI (3.4 [1.8-4.8] vs. 2 [1-6.2], p = 0.007) and were more frequently on combined methotrexate and sulfasalazine (20 vs. 1.4%, p = 0.05) than their counterparts. In the adjusted Cox proportional model, cumulative DAS28-CRP was the only variable to predict incidental HI (odds ratio, 1.8; 95% confidence interval, 1.1-2.7; p = 0.01). Almost 13% of RA patients with short disease duration and low disease activity developed incidental HI during 1 year. Cumulative disease activity predicted incidental HI. PMID:24435352

  1. Incidence of syndesmotic injury.

    PubMed

    Vosseller, J Turner; Karl, John W; Greisberg, Justin K

    2014-03-01

    Injury to the tibiofibular syndesmosis can occur with ankle sprain or fracture. The incidence of syndesmotic injury has not been specifically studied at a population level. Data on syndesmotic injury were obtained from the Healthcare Cost and Utilization Project (HCUP), a federal-state-private partnership. It is administered by the Agency for Healthcare Research and Quality, a division of the US Department of Health and Human Services. Two HCUP databases were queried for 8 states: the State Inpatient Database and the State Emergency Department Database. The first 6 International Classification of Diseases, Ninth Edition (ICD-9) code diagnoses were searched for codes that are used for syndesmotic injury (ie, 845.03). These data, along with data from the 2010 US census, were used to yield incidence rates for syndesmosis injury, as well as for various demographic groups. National estimates of injury totals were also calculated. In the 8 states, there were a total of 1821 syndesmotic injuries. Given the population of these states, the incidence rate of syndesmotic injury was 2.09 syndesmotic injuries per 100,000 person-years. This incidence correlates to an estimated 6445 syndesmotic injuries per year in the United States. These data provide some baseline numbers as to the incidence of syndesmotic injury in the United States. Although the incidence was low relative to some other injuries, the fact that syndesmotic injuries tend to occur in younger patients may have a greater effect in terms of productive years of life lost. PMID:24762148

  2. Comparing single and cumulative dosing procedures in human triazolam discriminators.

    PubMed Central

    Smith, B J; Bickel, W K

    1999-01-01

    This study evaluated a cumulative dosing procedure for drug discrimination with human participants. Four participants learned to discriminate triazolam (0.35 mg/70 kg) from placebo. A crossover design was used to compare the results under a single dosing procedure with results obtained under a cumulative dosing procedure. Under the single dosing procedure, a dose of triazolam (0, 0.05, 0.15, or 0.35 mg/70 kg) or secobarbital (0, 25, 75, or 175 mg/70 kg) was administered 45 min before assessment. Determining each dose-effect curve thus required four sessions. Under the cumulative dosing procedure, four doses of triazolam (0, 0.05, 0.10, and 0.20 mg/70 kg) or secobarbital (0, 25, 50, and 100 mg/70 kg) were administered approximately 55 min apart, producing a complete dose-effect curve in one four-trial session. Regardless of procedure, triazolam and secobarbital produced discriminative stimulus and self-reported effects similar to previous single dosing studies in humans. Shifts to the right in cumulative dose-effect curves compared to single dose-effect curves occurred on several self-report measures. When qualitative stimulus functions rather than quantitative functions are of interest, application of cumulative dosing may increase efficiency in human drug discrimination. PMID:10344022

  3. The Incidence of Infant Physical Abuse in Alaska

    ERIC Educational Resources Information Center

    Gessner, Bradford D.; Moore, Martha; Hamilton, Bernita; Muth, Pam T.

    2004-01-01

    Objectives: To determine the incidence of and risk factors associated with infant (less than 1 year of age) physical abuse in Alaska. Methods: A population-based retrospective cohort study for the 1994-2000 resident birth cohort was conducted by linking data from birth certificates, Child Protective Services, a statewide hospital-based trauma…

  4. Conjugated Equine Estrogens and Colorectal Cancer Incidence and Survival: The Women’s Health Initiative Randomized Clinical Trial

    PubMed Central

    Ritenbaugh, Cheryl; Stanford, Janet L.; Wu, LieLing; Shikany, James M.; Schoen, Robert E.; Stefanick, Marcia L.; Taylor, Vicky; Garland, Cedric; Frank, Gail; Lane, Dorothy; Mason, Ellen; McNeeley, S. Gene; Ascensao, Joao; Chlebowski, Rowan T.

    2010-01-01

    Background In separate Women’s Health Initiative randomized trials, combined hormone therapy with estrogen plus progestin reduced colorectal cancer incidence but estrogen alone in women with hysterectomy did not. We now analyze features of the colorectal cancers that developed and examine survival of women following colorectal cancer diagnosis in the latter trial. Participants and Methods 10,739 postmenopausal women who were 50 to 79 years of age and had undergone hysterectomy were randomized to conjugated equine estrogens (0.625 mg/day) or matching placebo. Colorectal cancer incidence was a component of the study’s monitoring global index but was not a primary study endpoint. Colorectal cancers were verified by central medical record and pathology report review. Bowel exam frequency was not protocol defined but information on their use was collected. Results After a median 7.1 years, there were 58 invasive colorectal cancers in the hormone group and 53 in the placebo group (hazard ratio [HR] 1.12, 95% Confidence Interval [CI] 0.77–1.63). Tumor size, stage, and grade were comparable in the two randomization groups. Bowel exam frequency was also comparable in the two groups. The cumulative mortality following colorectal cancer diagnosis among women in the conjugated equine estrogen group was 34 % compared to 30 % in the placebo group (HR 1.34, 95% CI 0.58–3.19). Conclusions In contrast to the preponderance of observational studies, conjugated equine estrogens in a randomized clinical trial did not reduce colorectal cancer incidence nor improve survival after diagnosis. PMID:18829444

  5. Electronic Medical Record Cancer Incidence over Six Years Comparing New Users of Glargine with New Users of NPH Insulin

    PubMed Central

    He, Wei; Bianca, Porneala C.; Yelibi, Carine; Marquis, Alison; Stürmer, Til; Buse, John B.; Meigs, James B.

    2014-01-01

    Background Recent studies suggested that insulin glargine use could be associated with increased risk of cancer. We compared the incidence of cancer in new users of glargine versus new users of NPH in a longitudinal clinical cohort with diabetes for up to 6 years. Methods and Findings From all patients who had been regularly followed at Massachusetts General Hospital from 1/01/2005 to 12/31/2010, 3,680 patients who had a medication record for glargine or NPH usage were obtained from the electronic medical record (EMR). From those we selected 539 new glargine users (age: 60.1±13.6 years, BMI: 32.7±7.5 kg/m2) and 343 new NPH users (61.5±14.1 years, 32.7±8.3 kg/m2) who had no prevalent cancer during 19 months prior to glargine or NPH initiation. All incident cancer cases were ascertained from the EMR requiring at least 2 ICD-9 codes within a 2 month period. Insulin exposure time and cumulative dose were validated. The statistical analysis compared the rates of cancer in new glargine vs. new NPH users while on treatment, adjusted for the propensity to receive one or the other insulin. There were 26 and 28 new cancer cases in new glargine and new NPH users for 1559 and 1126 person-years follow-up, respectively. There were no differences in the propensity-adjusted clinical characteristics between groups. The adjusted hazard ratio for the cancer incidence comparing glargine vs. NPH use was 0.65 (95% CI: 0.36–1.19). Conclusions Insulin glargine is not associated with development of cancers when compared with NPH in this longitudinal and carefully retrieved EMR data. PMID:25329887

  6. Cumulative effects of repeated exposure to pO2 = 200 kPa (2 atm).

    PubMed

    Shykoff, Barbara E

    2014-01-01

    Even asymptomatic exposures to elevated oxygen partial pressure (pO2) can influence subsequent exposures. Dry chamber dives of three hours' duration at pO2 of 200 kPa were conducted to examine cumulative effects. Experiments were single (n = 27), or paired exposures with surface intervals (SIs) 15 to 17 hours (n = 30), six hours (n = 33), or three hours (n = 36). Flow-volume loops, diffusing capacity, and symptoms were recorded before and after exposures. Immediately after surfacing from second exposures, some significant (p < 0.05) mean changes from baseline in pulmonary function indices occurred for all SIs and persisted for two days for three-hour SIs and for one day for 15-hour SIs. Incidences of symptoms were 15% immediately after one exposure and 28%, 38% and 31% immediately after a second exposure following 15-, six- , or three-hour SIs, respectively. Incidences of changes in pulmonary function indices (deltaPF) were 5%, 11%, 12% and 14% for single exposures or two with 15-, six-, or three-hour SIs, respectively. Two days following the second exposure, resolution of symptoms was incomplete after six- or 15-hour SIs, as was resolution of deltaPF after 15-hour SIs. The incidences indicate non-linear superposition of effects of a first and second exposure, and are not readily explained by delayed-onset injury. PMID:25109082

  7. Nonalcoholic Fatty Liver Disease Is Associated With Higher 1-year All-Cause Rehospitalization Rates in Patients Admitted for Acute Heart Failure.

    PubMed

    Valbusa, Filippo; Bonapace, Stefano; Grillo, Cristina; Scala, Luca; Chiampan, Andrea; Rossi, Andrea; Zoppini, Giacomo; Lonardo, Amedeo; Arcaro, Guido; Byrne, Christopher D; Targher, Giovanni

    2016-02-01

    Repeat hospitalization due to acute heart failure (HF) is a global public health problem that markedly impacts on health resource use. Identifying novel predictors of rehospitalization would help physicians to determine the optimal postdischarge plan for preventing HF rehospitalization. Nonalcoholic fatty liver disease (NAFLD) is an emerging risk factor for many heart diseases, including HF. We assessed whether NAFLD at hospital admission predicts 1-year all-cause rehospitalization in patients with acute HF. We enrolled all patients consecutively admitted for acute HF to our General Medicine Division, from January 2013 to April 2014, after excluding patients with acute myocardial infarction, severe heart valve diseases, malignancy, known liver diseases, and those with volume overload related to extracardiac causes. NAFLD was diagnosed by ultrasonography and exclusion of competing etiologies. The primary outcome of the study was the 1-year all-cause rehospitalization rate. Among the 107 patients enrolled in the study, the cumulative rehospitalization rate was 12.1% at 1 month, 25.2% at 3 months, 29.9% at 6 months, and 38.3% at 1 year. Patients with NAFLD had markedly higher 1-year rehospitalization rates than those without NAFLD (58% vs 21% at 1 y; P < 0.001 by the log-rank test). Cox regression analysis revealed that NAFLD was associated with a 5.5-fold increased risk of rehospitalization (adjusted hazard ratio 5.56, 95% confidence interval 2.46-12.1, P < 0.001) after adjustment for multiple HF risk factors and potential confounders. In conclusion, NAFLD was independently associated with higher 1-year rehospitalization in patients hospitalized for acute HF. PMID:26886619

  8. Nonalcoholic Fatty Liver Disease Is Associated With Higher 1-year All-Cause Rehospitalization Rates in Patients Admitted for Acute Heart Failure

    PubMed Central

    Valbusa, Filippo; Bonapace, Stefano; Grillo, Cristina; Scala, Luca; Chiampan, Andrea; Rossi, Andrea; Zoppini, Giacomo; Lonardo, Amedeo; Arcaro, Guido; Byrne, Christopher D.; Targher, Giovanni

    2016-01-01

    Abstract Repeat hospitalization due to acute heart failure (HF) is a global public health problem that markedly impacts on health resource use. Identifying novel predictors of rehospitalization would help physicians to determine the optimal postdischarge plan for preventing HF rehospitalization. Nonalcoholic fatty liver disease (NAFLD) is an emerging risk factor for many heart diseases, including HF. We assessed whether NAFLD at hospital admission predicts 1-year all-cause rehospitalization in patients with acute HF. We enrolled all patients consecutively admitted for acute HF to our General Medicine Division, from January 2013 to April 2014, after excluding patients with acute myocardial infarction, severe heart valve diseases, malignancy, known liver diseases, and those with volume overload related to extracardiac causes. NAFLD was diagnosed by ultrasonography and exclusion of competing etiologies. The primary outcome of the study was the 1-year all-cause rehospitalization rate. Among the 107 patients enrolled in the study, the cumulative rehospitalization rate was 12.1% at 1 month, 25.2% at 3 months, 29.9% at 6 months, and 38.3% at 1 year. Patients with NAFLD had markedly higher 1-year rehospitalization rates than those without NAFLD (58% vs 21% at 1 y; P < 0.001 by the log-rank test). Cox regression analysis revealed that NAFLD was associated with a 5.5-fold increased risk of rehospitalization (adjusted hazard ratio 5.56, 95% confidence interval 2.46–12.1, P < 0.001) after adjustment for multiple HF risk factors and potential confounders. In conclusion, NAFLD was independently associated with higher 1-year rehospitalization in patients hospitalized for acute HF. PMID:26886619

  9. Wick polynomials and time-evolution of cumulants

    NASA Astrophysics Data System (ADS)

    Lukkarinen, Jani; Marcozzi, Matteo

    2016-08-01

    We show how Wick polynomials of random variables can be defined combinatorially as the unique choice, which removes all "internal contractions" from the related cumulant expansions, also in a non-Gaussian case. We discuss how an expansion in terms of the Wick polynomials can be used for derivation of a hierarchy of equations for the time-evolution of cumulants. These methods are then applied to simplify the formal derivation of the Boltzmann-Peierls equation in the kinetic scaling limit of the discrete nonlinear Schödinger equation (DNLS) with suitable random initial data. We also present a reformulation of the standard perturbation expansion using cumulants, which could simplify the problem of a rigorous derivation of the Boltzmann-Peierls equation by separating the analysis of the solutions to the Boltzmann-Peierls equation from the analysis of the corrections. This latter scheme is general and not tied to the DNLS evolution equations.

  10. Session: What do we know about cumulative or population impacts

    SciTech Connect

    Kerlinger, Paul; Manville, Al; Kendall, Bill

    2004-09-01

    This session at the Wind Energy and Birds/Bats workshop consisted of a panel discussion followed by a discussion/question and answer period. The panelists were Paul Kerlinger, Curry and Kerlinger, LLC, Al Manville, U.S. Fish and Wildlife Service, and Bill Kendall, US Geological Service. The panel addressed the potential cumulative impacts of wind turbines on bird and bat populations over time. Panel members gave brief presentations that touched on what is currently known, what laws apply, and the usefulness of population modeling. Topics addressed included which sources of modeling should be included in cumulative impacts, comparison of impacts from different modes of energy generation, as well as what research is still needed regarding cumulative impacts of wind energy development on bird and bat populations.

  11. Cumulant t-expansion for strongly correlated fermions

    NASA Astrophysics Data System (ADS)

    Zhuravlev, A. K.

    2016-05-01

    A systematic nonperturbative scheme is implemented to calculate the ground state energy for a wide class of strongly correlated fermion models. The scheme includes: (a) a method of automatic calculations of the cumulants of the model Hamiltonian, (b) a method of the ground state energy calculation from these cumulants using the t-expansion proposed by Horn and Weinstein (1984) [9] with new procedure of its extrapolation to t → ∞. As an example of application of the scheme all cumulants up to the 8-th order for spinless fermion model are calculated exactly, and converging sequences of approximations to the ground state energy are obtained for one-, two- and three-dimensional versions of the model.

  12. Triggering of major eruptions recorded by actively forming cumulates

    PubMed Central

    Stock, Michael J.; Taylor, Rex N.; Gernon, Thomas M.

    2012-01-01

    Major overturn within a magma chamber can bring together felsic and mafic magmas, prompting de-volatilisation and acting as the driver for Plinian eruptions. Until now identification of mixing has been limited to analysis of lavas or individual crystals ejected during eruptions. We have recovered partially developed cumulate material (‘live’ cumulate mush) from pyroclastic deposits of major eruptions on Tenerife. These samples represent “frozen” clumps of diverse crystalline deposits from all levels in the developing reservoir, which are permeated with the final magma immediately before eruptions. Such events therefore record the complete disintegration of the magma chamber, leading to caldera collapse. Chemical variation across developing cumulus crystals records changes in melt composition. Apart from fluctuations reflecting periodic influxes of mafic melt, crystal edges consistently record the presence of more felsic magmas. The prevalence of this felsic liquid implies it was able to infiltrate the entire cumulate pile immediately before each eruption. PMID:23066500

  13. Triggering of major eruptions recorded by actively forming cumulates.

    PubMed

    Stock, Michael J; Taylor, Rex N; Gernon, Thomas M

    2012-01-01

    Major overturn within a magma chamber can bring together felsic and mafic magmas, prompting de-volatilisation and acting as the driver for Plinian eruptions. Until now identification of mixing has been limited to analysis of lavas or individual crystals ejected during eruptions. We have recovered partially developed cumulate material ('live' cumulate mush) from pyroclastic deposits of major eruptions on Tenerife. These samples represent "frozen" clumps of diverse crystalline deposits from all levels in the developing reservoir, which are permeated with the final magma immediately before eruptions. Such events therefore record the complete disintegration of the magma chamber, leading to caldera collapse. Chemical variation across developing cumulus crystals records changes in melt composition. Apart from fluctuations reflecting periodic influxes of mafic melt, crystal edges consistently record the presence of more felsic magmas. The prevalence of this felsic liquid implies it was able to infiltrate the entire cumulate pile immediately before each eruption. PMID:23066500

  14. Cumulative impacts on water-quality functions of wetlands

    SciTech Connect

    Hemond, H.F.; Benoit, J.

    1988-01-01

    Cumulative impacts on the water-quality function of wetlands are impacts whose total effect cannot be predicted from the sum of the effects of individual impacts. The wetland is not a simple filter; it embodies chemical, physical, and biotic processes that can detain, transform, release, or produce a wide variety of substances. Because wetland water-quality functions result from the operation of many individual, distinct, and quite dissimilar mechanisms, it is necessary to consider the nature of each individual process. Given knowledge of the various wetland processes, it is possible to make more-guided judgments about the effects a suite of impacts is likely to have. When considered in this light, many common wetland alterations seem likely to involve cumulative impact. The wetland manager may be guided further by appropriate field measurements at specific sites; such data can aid in predicting cumulative impact or assessing the results of past wetland management.

  15. Effect of correlations on cumulants in heavy-ion collisions

    NASA Astrophysics Data System (ADS)

    Mishra, D. K.; Garg, P.; Netrakanti, P. K.

    2016-02-01

    We study the effects of correlations on cumulants and their ratios of net-proton multiplicity distributions which have been measured for central (0%-5%) Au+Au collisions at the Relativistic Heavy Ion Collider (RHIC). This effect has been studied by assuming individual proton and antiproton distributions as a Poisson or negative binomial distribution (NBD). In spite of significantly correlated production due to baryon number, electric charge conservation, and kinematical correlations of protons and antiprotons, the measured cumulants of the net-proton distribution follow the independent-production model. In the present work we demonstrate how the introduction of the correlations will affect the cumulants and their ratios for the difference distributions. We have also demonstrated this study using the proton and antiproton distributions obtained from the hijing event generator.

  16. Anatomy of an incident

    DOE PAGESBeta

    Cournoyer, Michael E.; Trujillo, Stanley; Lawton, Cindy M.; Land, Whitney M.; Schreiber, Stephen B.

    2016-03-23

    A traditional view of incidents is that they are caused by shortcomings in human competence, attention, or attitude. It may be under the label of “loss of situational awareness,” procedure “violation,” or “poor” management. A different view is that human error is not the cause of failure, but a symptom of failure – trouble deeper inside the system. In this perspective, human error is not the conclusion, but rather the starting point of investigations. During an investigation, three types of information are gathered: physical, documentary, and human (recall/experience). Through the causal analysis process, apparent cause or apparent causes are identifiedmore » as the most probable cause or causes of an incident or condition that management has the control to fix and for which effective recommendations for corrective actions can be generated. A causal analysis identifies relevant human performance factors. In the following presentation, the anatomy of a radiological incident is discussed, and one case study is presented. We analyzed the contributing factors that caused a radiological incident. When underlying conditions, decisions, actions, and inactions that contribute to the incident are identified. This includes weaknesses that may warrant improvements that tolerate error. Measures that reduce consequences or likelihood of recurrence are discussed.« less

  17. A study of cumulative fatigue damage in AISI 4130 steel

    NASA Technical Reports Server (NTRS)

    Jeelani, S.; Musial, M.

    1986-01-01

    Experimental data were obtained using AISI 4130 steel under stress ratios of -1 and 0. A study of cumulative fatigue damage using Miner's and Kramer's equations for stress ratios of -1 and 0 for low-high, low-high-mixed, high-low, and high-low-mixed stress sequences has revealed that there is a close agreement between the theoretical and experimental values of fatigue damage and fatigue life. Kramer's equation predicts less conservative and more realistic cumulative fatigue damage than the popularly used Miner's rule does.

  18. Model for Cumulative Solar Heavy Ion Energy and LET Spectra

    NASA Technical Reports Server (NTRS)

    Xapsos, Mike; Barth, Janet; Stauffer, Craig; Jordan, Tom; Mewaldt, Richard

    2007-01-01

    A probabilistic model of cumulative solar heavy ion energy and lineary energy transfer (LET) spectra is developed for spacecraft design applications. Spectra are given as a function of confidence level, mission time period during solar maximum and shielding thickness. It is shown that long-term solar heavy ion fluxes exceed galactic cosmic ray fluxes during solar maximum for shielding levels of interest. Cumulative solar heavy ion fluences should therefore be accounted for in single event effects rate calculations and in the planning of space missions.

  19. Physical Inactivity and Incidence of Obesity among South Australian Adults

    PubMed Central

    Montgomerie, Alicia M.; Chittleborough, Catherine R.; Taylor, Anne W.

    2014-01-01

    The aim of this paper is to examine the association of physical inactivity with incidence of obesity in the South Australian adult population. Two representative data sources were used – the South Australian Monitoring and Surveillance System (SAMSS), a monthly surveillance system, and the North West Adelaide Health Study (NWAHS), a biomedical cohort study. There were 75.3% (n = 12873) SAMSS participants and 72.8% (n = 1521) of NWAHS participants that were not obese at baseline. The cumulative incidence of obesity for SAMSS participants from the previous year to the current year was 2.7%. The cumulative incidence of obesity for NWAHS participants between baseline and stage 3 was 14.4%. Physical inactivity was associated with incident obesity (RR 1.48, 95% CI 1.14–1.90 [SAMSS] and RR 1.41, 95% CI 1.03–1.93 [NWAHS]). This association remained, but was attenuated after adjustment for chronic conditions, risk factors and socio-demographic factors. However, physical activity should be continued to be encouraged in the population for its known additional health benefits. PMID:25383626

  20. Trajectories of Depressive Symptomatology in Rural Memory Clinic Patients between Baseline Diagnosis and 1-Year Follow-Up

    PubMed Central

    Kosteniuk, Julie G.; Morgan, Debra G.; O'Connell, Megan E.; Kirk, Andrew; Crossley, Margaret; Stewart, Norma J.; Karunanayake, Chandima P.

    2016-01-01

    Background/Aims To investigate the prevalence and trajectories of depressive symptomatology at 1-year follow-up, and the severity of depressive symptoms, by dementia diagnostic group, as well as to determine the predictors of depressive symptomatology at 1-year follow-up. Methods In rural and remote patients of an interdisciplinary memory clinic between 2004 and 2014, 144 patients diagnosed with no cognitive impairment (NCI), mild cognitive impairment, dementia due to Alzheimer's disease (AD), or non-AD dementia completed the Center for Epidemiologic Studies of Depression Scale to assess depressive symptomatology at both time points. Results Among patients with data at both time points, persistence of depressive symptomatology at follow-up occurred in 22.2%, remission in 17.4%, incidence in 13.2%, and absence in 47.2%. The prevalence of depressive symptomatology at baseline and persistence at follow-up were significantly greater in the NCI group than in the other diagnostic groups, but there were no differences in severity. Depressive symptomatology at follow-up was independently associated with depressive symptomatology, lower independence in activities of daily living, and lower self-rating of memory at baseline, as well as with decreased independence in activities of daily living between time points. Conclusion Future studies should further examine short-term postdiagnostic trajectories in depressive symptomatology in multiple dementia diagnostic groups to inform prognoses and treatment decisions. PMID:27350776

  1. Clinical Significance of the Edema Index in Incident Peritoneal Dialysis Patients

    PubMed Central

    Kang, Seok Hui; Choi, Eun Woo; Park, Jong Won; Cho, Kyu Hyang; Do, Jun Young

    2016-01-01

    Background Proper monitoring for volume overload is important to improve prognosis in peritoneal dialysis (PD) patients. The association between volume status and residual renal function (RRF) remains an unresolved issue. The aim of the present study was to evaluate the association between the edema index and survival or RRF in incident PD patients. Patients and Methods We identified all adults who underwent PD. The edema index was defined as the ratio of extracellular fluid to total body fluid. Participants with available data regarding survivorship or non-survivorship during the first year after PD initiation were included in the area under the receiver operating characteristic curve analysis. The cutoff value of the edema index for 1-year mortality was >0.371 in men and >0.372 in women. Participants were divided into two groups according to the cutoff value of their baseline edema indices: High (>cutoff value) and Low (≤cutoff value). Survivors during the first year after PD initiation were divided into two groups according to the initial and 1-year edema index: Non-improvement (maintenance of criteria in the initial Low group during the year) and Other (all participants except those in the Non-improvement group). Results In total, 631 patients were enrolled in the present study. The cutoff value of the edema index for 1-year mortality was >0.371 in men and >0.372 in women. The respective mean initial RRF values (mL·min-1·1.73 m-2) in the Low and High groups, respectively, were 4.88 ± 4.09 and 4.21 ± 3.28 in men (P = 0.108), and 3.19 ± 2.57 and 2.98 ± 2.70 in women (P = 0.531). There were no significant differences between groups in either sex. The respective mean RRF values at 1 year after PD initiation in the Low and High groups, respectively, were 3.56 ± 4.35 and 2.73 ± 2.53 in men, and 2.80 ± 2.36 and 1.85 ± 1.51 in women. RRF at 1 year after PD initiation was higher in the Low group than in the High group (men: P = 0.027; women: P = 0.001). In

  2. Novel genetic variants in differentiated thyroid cancer and assessment of the cumulative risk

    PubMed Central

    Figlioli, Gisella; Chen, Bowang; Elisei, Rossella; Romei, Cristina; Campo, Chiara; Cipollini, Monica; Cristaudo, Alfonso; Bambi, Franco; Paolicchi, Elisa; Hoffmann, Per; Herms, Stefan; Kalemba, Michał; Kula, Dorota; Pastor, Susana; Marcos, Ricard; Velázquez, Antonia; Jarząb, Barbara; Landi, Stefano; Hemminki, Kari; Gemignani, Federica; Försti, Asta

    2015-01-01

    A genome-wide association study (GWAS) performed on a high-incidence Italian population followed by replications on low-incidence cohorts suggested a strong association of differentiated thyroid cancer (DTC) with single nucleotide polymorphisms (SNPs) at 9q22.33, 2q35, 20q11.22-q12 and 14q24.3. Moreover, six additional susceptibility loci were associated with the disease only among Italians. The present study had two aims, first to identify loci involved in DTC risk and then to assess the cumulative effect of the SNPs identified so far in the Italian population. The combined analysis of the previous GWAS and the present Italian study provided evidence of association with rs7935113 (GALNTL4, OR = 1.36, 95%CI 1.20–1.53, p-value = 7.41 × 10−7) and rs1203952 (FOXA2, OR = 1.29, 95%CI 1.16–1.44, p-value = 4.42 × 10−6). Experimental ENCODE and eQTL data suggested that both SNPs may influence the closest genes expression through a differential recruitment of transcription factors. The assessment of the cumulative risk of eleven SNPs showed that DTC risk increases with an increasing number of risk alleles (p-trend = 3.13 × 10−47). Nonetheless, only a small fraction (about 4% on the disease liability scale) of DTC is explained by these SNPs. These data are consistent with a polygenic model of DTC predisposition and highlight the importance of association studies in the discovery of the disease hereditability. PMID:25753578

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

    ERIC Educational Resources Information Center

    Guttentag, Robert E.

    1984-01-01

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

  4. Modeling of cumulative ash curve in hard red spring wheat

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Analysis of cumulative ash curves (CAC) is very important for evaluation of milling quality of wheat and blending different millstreams for specific applications. The aim of this research was to improve analysis of CAC. Five hard red spring wheat genotype composites from two regions were milled on...

  5. The Use of the Cumulative Rehearsal Strategy: A Developmental Study.

    ERIC Educational Resources Information Center

    Allik, Judith P.; Siegel, Alexander W.

    This study was designed to address two issues: "At what age do children spontaneously use a cumulative rehearsal strategy?" and "What effect does the use of the strategy have on their performance?" The subjects, 28 children at each of five grade levels (nursery, kindergarten, first, third, and fifth), were tested in a serial-position recall task.…

  6. Aeronautical Engineering: A cumulative index to the 1980 issue

    NASA Technical Reports Server (NTRS)

    1981-01-01

    This bibliography is a cumulative index to reports, articles, and other documents introduced into the NASA scientific and technical information system. Abstracts for the entries cited appeared in issues 119 through 130 of Aeronautical Engineering: A Continuing Bibliography (NASA SP-7037). Subject, personal author, corporate author, contract number, and report/accession number indexes are provided.

  7. The effects of cumulative practice on mathematics problem solving.

    PubMed Central

    Mayfield, Kristin H; Chase, Philip N

    2002-01-01

    This study compared three different methods of teaching five basic algebra rules to college students. All methods used the same procedures to teach the rules and included four 50-question review sessions interspersed among the training of the individual rules. The differences among methods involved the kinds of practice provided during the four review sessions. Participants who received cumulative practice answered 50 questions covering a mix of the rules learned prior to each review session. Participants who received a simple review answered 50 questions on one previously trained rule. Participants who received extra practice answered 50 extra questions on the rule they had just learned. Tests administered after each review included new questions for applying each rule (application items) and problems that required novel combinations of the rules (problem-solving items). On the final test, the cumulative group outscored the other groups on application and problem-solving items. In addition, the cumulative group solved the problem-solving items significantly faster than the other groups. These results suggest that cumulative practice of component skills is an effective method of training problem solving. PMID:12102132

  8. LANDSAT 1 cumulative US standard catalog, 1976/1977

    NASA Technical Reports Server (NTRS)

    1977-01-01

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

  9. Steps and Pips in the History of the Cumulative Recorder

    ERIC Educational Resources Information Center

    Lattal, Kennon A.

    2004-01-01

    From its inception in the 1930s until very recent times, the cumulative recorder was the most widely used measurement instrument in the experimental analysis of behavior. It was an essential instrument in the discovery and analysis of schedules of reinforcement, providing the first real-time analysis of operant response rates and patterns. This…

  10. 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…

  11. 1980 Cumulative Supplement, "Higher Education and the Law".

    ERIC Educational Resources Information Center

    Edwards, Harry T.; Nordin, Virginia Davis

    A 1980 cumulative supplement to the basic text, "Higher Education and the Law," is presented. Contents include: edited reports of five United States Supreme Court cases, important lower court cases, regulations and reports; and citations to numerous law review articles, additional cases, and other secondary sources. The following broad topics are…

  12. Cumulative creep damage for unidirectional composites under step loading

    NASA Astrophysics Data System (ADS)

    Guedes, Rui Miranda

    2012-11-01

    The creep lifetime prediction of unidirectional composite materials under step loading, based on constant loading durability diagram, is analyzed for the two-step creep loading condition. For this purpose different nonlinear cumulative-damage laws are revisited and applied to predict creep lifetime. One possible approach to accounting for damage accumulation is provided by the continuum-damage mechanics (CDM). However, the CDM lifetime expression obtained for constant loading condition presents some drawbacks. Specifically, the upper stress range is not accommodated by CDM form. A modification of CDM is proposed, forcing the CDM to capture the short-term creep failure. It is proven that this modified CDM (MCDM) does not yield the same predictions as the Linear Cumulative-damage law (Miner's law). Predictions obtained from the nonlinear cumulative-damage laws are compared against synthetic lifetime generated by a micromechanical model that simulates unidirectional composites under two-step creep loading condition. Comparable deviations from Miner's law are obtained by the nonlinear cumulative-damage laws.

  13. HESI EXPOSURE FACTORS DATABASE FOR AGGREGATE AND CUMULATIVE RISK ASSESSMENT

    EPA Science Inventory

    In recent years, the risk analysis community has broadened its use of complex aggregate and cumulative residential exposure models (e.g., to meet the requirements of the 1996 Food Quality Protection Act). The value of these models is their ability to incorporate a range of inp...

  14. NATURE OF CUMULATIVE IMPACTS ON BIOTIC DIVERSITY OF WETLAND VERTEBRATES

    EPA Science Inventory

    There is no longer any doubt that cumulative impacts have important effects on wetland vertebrates. he interactions of species diversity and community structure produce a complex pattern in which environmental impacts can play a highly significant role. ariety of examples shows h...

  15. Cumulative Risk, Maternal Responsiveness, and Allostatic Load among Young Adolescents

    ERIC Educational Resources Information Center

    Evans, Gary W.; Kim, Pilyoung; Ting, Albert H.; Tesher, Harris B.; Shannis, Dana

    2007-01-01

    The purpose of this study was to examine the impact of cumulative risk exposure in concert with maternal responsiveness on physiological indicators of chronic stress in children and youth. Middle-school children exposed to greater accumulated psychosocial (e.g., family turmoil, poverty) and physical (e.g., crowding, substandard housing) risk…

  16. Physical intelligence does matter to cumulative technological culture.

    PubMed

    Osiurak, François; De Oliveira, Emmanuel; Navarro, Jordan; Lesourd, Mathieu; Claidière, Nicolas; Reynaud, Emanuelle

    2016-08-01

    Tool-based culture is not unique to humans, but cumulative technological culture is. The social intelligence hypothesis suggests that this phenomenon is fundamentally based on uniquely human sociocognitive skills (e.g., shared intentionality). An alternative hypothesis is that cumulative technological culture also crucially depends on physical intelligence, which may reflect fluid and crystallized aspects of intelligence and enables people to understand and improve the tools made by predecessors. By using a tool-making-based microsociety paradigm, we demonstrate that physical intelligence is a stronger predictor of cumulative technological performance than social intelligence. Moreover, learners' physical intelligence is critical not only in observational learning but also when learners interact verbally with teachers. Finally, we show that cumulative performance is only slightly influenced by teachers' physical and social intelligence. In sum, human technological culture needs "great engineers" to evolve regardless of the proportion of "great pedagogues." Social intelligence might play a more limited role than commonly assumed, perhaps in tool-use/making situations in which teachers and learners have to share symbolic representations. (PsycINFO Database Record PMID:27454039

  17. Administrative Promotion within a University: The Cumulative Impact of Gender.

    ERIC Educational Resources Information Center

    Johnsrud, Linda K.; Heck, Ronald H.

    1994-01-01

    A study explored the relative importance of three explanations for gender stratification in college administrative employment by modeling their separate and cumulative effects on increase in status, responsibility, and salary achieved with promotion. Findings indicate gender has a substantial negative impact on women's attainment, and the impact…

  18. RAPID INCIDENT RESPONSE FRAMEWORK

    EPA Science Inventory

    Will discuss WERF Contract (RFP# 03-HHE-5PP), Protocols for the Timely Investigation of Potential Health Incidents Associated with Biosolids Land Application, as a member of the project advisory committee. The contractor, University of North Carolina, started work in early June, ...

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

    PubMed

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

    2014-12-01

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

  20. Evolution of costly explicit memory and cumulative culture.

    PubMed

    Nakamaru, Mayuko

    2016-06-21

    Humans can acquire new information and modify it (cumulative culture) based on their learning and memory abilities, especially explicit memory, through the processes of encoding, consolidation, storage, and retrieval. Explicit memory is categorized into semantic and episodic memories. Animals have semantic memory, while episodic memory is unique to humans and essential for innovation and the evolution of culture. As both episodic and semantic memory are needed for innovation, the evolution of explicit memory influences the evolution of culture. However, previous theoretical studies have shown that environmental fluctuations influence the evolution of imitation (social learning) and innovation (individual learning) and assume that memory is not an evolutionary trait. If individuals can store and retrieve acquired information properly, they can modify it and innovate new information. Therefore, being able to store and retrieve information is essential from the perspective of cultural evolution. However, if both storage and retrieval were too costly, forgetting and relearning would have an advantage over storing and retrieving acquired information. In this study, using mathematical analysis and individual-based simulations, we investigate whether cumulative culture can promote the coevolution of costly memory and social and individual learning, assuming that cumulative culture improves the fitness of each individual. The conclusions are: (1) without cumulative culture, a social learning cost is essential for the evolution of storage-retrieval. Costly storage-retrieval can evolve with individual learning but costly social learning does not evolve. When low-cost social learning evolves, the repetition of forgetting and learning is favored more than the evolution of costly storage-retrieval, even though a cultural trait improves the fitness. (2) When cumulative culture exists and improves fitness, storage-retrieval can evolve with social and/or individual learning, which

  1. Measurement of cumulative-neutron and cumulative-proton spectra in 1-GeV proton-nucleus interactions

    SciTech Connect

    Baturin, V.N.; Vikhrov, V.V.; Makarov, M.M.; Nelyubin, V.V.; Naberezhnov, A.A.; Sulimov, V.V.; Uvarov, L.N.

    1982-11-20

    A comparative study has been made of the spectra of cumulative neutrons and protons produced at an angle of 114/sup 0/ in collisions of 1-GeV protons with /sup 9/Be and /sup 12/C nuclei. The slope parameters of the inclusive neutron spectra are similar to those of the proton spectra.

  2. Long-term incidence and prognostic factors of the progression of new coronary lesions in Japanese coronary artery disease patients after percutaneous coronary intervention.

    PubMed

    Kaneko, Hidehiro; Yajima, Junji; Oikawa, Yuji; Tanaka, Shingo; Fukamachi, Daisuke; Suzuki, Shinya; Sagara, Koichi; Otsuka, Takayuki; Matsuno, Shunsuke; Kano, Hiroto; Uejima, Tokuhisa; Koike, Akira; Nagashima, Kazuyuki; Kirigaya, Hajime; Sawada, Hitoshi; Aizawa, Tadanori; Yamashita, Takeshi

    2014-07-01

    Revascularization of an initially non-target site due to its progression as a new culprit lesion has emerged as a new therapeutic target of coronary artery disease (CAD) in the era of drug-eluting stents. Using the Shinken database, a single-hospital-based cohort, we aimed to clarify the incidence and prognostic factors for progression of previously non-significant coronary portions after prior percutaneous coronary intervention (PCI) in Japanese CAD patients. We selected from the Shinken database a single-hospital-based cohort of Japanese patients (n = 15227) who visited the Cardiovascular Institute between 2004 and 2010 to undergo PCI. This study included 1,214 patients (median follow-up period, 1,032 ± 704 days). Additional clinically driven PCI to treat previously non-significant lesions was performed in 152 patients. The cumulative rate of new-lesion PCI was 9.5 % at 1 year, 14.4 % at 3 years, and 17.6 % at 5 years. There was no difference in background clinical characteristics between patients with and without additional PCI. Prevalence of multi-vessel disease (MVD) (82 vs. 57 %, p < 0.001) and obesity (47 vs. 38 %, p = 0.028) were significantly higher and high-density lipoprotein cholesterol (HDL) level (51 ± 15 vs. 47 ± 12 mg/dl, p < 0.001) was significantly lower in patients with additional PCI than those without. Patients using insulin (6 vs. 3 %, p = 0.035) were more common in patients with additional PCI. Multivariate analysis showed that MVD, lower HDL, and insulin use were independent determinants of progression of new culprit coronary lesions. In conclusion, progression of new coronary lesions was common and new-lesion PCI continued to occur beyond 1 year after PCI without attenuation of their annual incidences up to 5 years. Greater coronary artery disease burden, low HDL, and insulin-dependent DM were independent predictors of progression of new culprit coronary lesions. PMID:23807613

  3. Risk of Recurrent Helicobacter pylori Infection 1 Year After Initial Eradication Therapy in 7 Latin American Communities

    PubMed Central

    Morgan, Douglas R.; Torres, Javier; Sexton, Rachael; Herrero, Rolando; Salazar-Martínez, Eduardo; Robert Greenberg, E.; Bravo, Luis Eduardo; Dominguez, Ricardo L.; Ferreccio, Catterina; Lazcano-Ponce, Eduardo C.; Meza-Montenegro, Maria Mercedes; Peña, Edgar M.; Peña, Rodolfo; Correa, Pelayo; Martínez, María Elena; Chey, William D.; Valdivieso, Manuel; Anderson, Garnet L.; Goodman, Gary E.; Crowley, John J.; Baker, Laurence H.

    2013-01-01

    single-treatment course analysis that ignored the effects of re-treatment, the percentage of UBT-negative results at 1 year was 72.4% (95% CI, 69.9%–74.8%) and was significantly associated with study site (P<.001), adherence to initial therapy (AOR, 0.26; 95% CI, 0.15–0.42; P<.001), male sex (AOR, 1.63; 95% CI, 1.25–2.13; P<.001), and age (AOR, 1.14; 95% CI, 1.02–1.27 per decade; P=.02). One-year effectiveness among all 1463 enrolled participants, considering all missing UBT results as positive, was 72.7% (95% CI, 70.3%–74.9%). Conclusions and Relevance One year after treatment for H pylori infection, recurrence occurred in 11.5% of participants who had negative posttreatment UBT results. Recurrence determinants (ie, nonadherence and demographics) may be as important as specific antibiotic regimen in determining the long-term success of H pylori eradication interventions. Study findings are relevant to the feasibility of programs for the primary prevention of gastric cancer in high-incidence regions of Latin America. Trial Registration clinicaltrials.gov Identifier: NCT01061437 PMID:23403682

  4. Increased inhibitor incidence in severe haemophilia A since 1990 attributable to more low titre inhibitors.

    PubMed

    van den Berg, H Marijke; Hashemi, S Mojtaba; Fischer, Kathelijn; Petrini, Pia; Ljung, Rolf; Rafowicz, Anne; Carcao, Manuel; Auerswald, Günter; Kurnik, Karin; Kenet, Gili; Santagostino, Elena

    2016-04-01

    Many studies have reported an increased incidence of inhibitors in previously untreated patients (PUPs) with severe haemophilia A after the introduction of recombinant products. It was the objective of this study to investigate whether the inhibitor incidence has increased between 1990 and 2009 in an unselected cohort of PUPs with severe haemophilia A (FVIII< 1 %). Patients were consecutively recruited from 31 haemophilia treatment centres in 16 countries and followed until 50 exposure days or until inhibitor development. Inhibitor development was studied in five-year birth cohorts comparing cumulative incidences. Furthermore the risk for inhibitor development per five-year birth cohort was studied using multivariable Cox regression, adjusting for potential genetic and treatment-related confounders. A total of 926 PUPs were included with a total cumulative inhibitor incidence of 27.5 %. The inhibitor incidence increased from 19.5 % in 1990-1994 (lowest) to 30.9 % in 2000-2004 (highest; p-value 0.011). Low titre inhibitor incidence increased from 3.1 % in 1990-1994 to 10.5 % in 2005-2009 (p-value 0.009). High titre inhibitor incidences remained stable over time. After 2000, risk of all inhibitor development was increased with adjusted hazard ratios 1.96 (95 % CI 1.06-2.83) in 2000-2004 and 2.34 (1.42-4.92) in 2005-2009. Screening for inhibitors was intensified over this 20-year study period from a median of 1.9 to 2.9 tests/year before 2000 to 2.7 to 4.3 tests/year after 2000. In conclusion, the cumulative inhibitor incidence has significantly increased between 1990 and 2009. The high titre inhibitor incidence has remained stable. PMID:26632988

  5. A normal cumulative conception rate after human pituitary gonadotropin.

    PubMed

    Healy, D L; Kovacs, G T; Pepperell, R J; Burger, H G

    1980-10-01

    Forty consecutive women were treated with human pituitary gonadotropin to induce ovulation. Thirty-seven patients (93%) ovulated and thirty (75%) conceived on at least one occasion. The cumulative conception rate for the series equaled that of the general population. Women with a past history of anorexia nervosa had the shortest average time to pregnancy. Of patients who did not conceive, four represented failures of patient selection in that they withdrew from treatment for a variety of psychiatric and social reasons, and six represented failures of treatment, not becoming pregnant despite the induction of ovulation. It is concluded that realistic goals for a contemporary human gonadotropin program include induction of ovulation in all patients and a cumulative conception rate equal to that of the general community. PMID:6252067

  6. A cumulative entropy method for distribution recognition of model error

    NASA Astrophysics Data System (ADS)

    Liang, Yingjie; Chen, Wen

    2015-02-01

    This paper develops a cumulative entropy method (CEM) to recognize the most suitable distribution for model error. In terms of the CEM, the Lévy stable distribution is employed to capture the statistical properties of model error. The strategies are tested on 250 experiments of axially loaded CFT steel stub columns in conjunction with the four national building codes of Japan (AIJ, 1997), China (DL/T, 1999), the Eurocode 4 (EU4, 2004), and United States (AISC, 2005). The cumulative entropy method is validated as more computationally efficient than the Shannon entropy method. Compared with the Kolmogorov-Smirnov test and root mean square deviation, the CEM provides alternative and powerful model selection criterion to recognize the most suitable distribution for the model error.

  7. Helical magneto-cumulative generator 280 mm in diameter

    NASA Astrophysics Data System (ADS)

    Demidov, V. A.; Kazakov, S. A.; Boriskin, A. S.; Vlasov, Yu. V.; Yanenko, V. A.; Nikolaev, N. I.; Volodchenkov, S. I.

    2015-01-01

    Several possibilities of preamplifier energy and power increasing are considered: using a more powerful (HMX-based) conical HE-charge in the central tube of the magneto-cumulative generator, using a magnetic flux finish pressing out device with axial initiation of the HE charge, and increasing the inner diameter of the helix. A magneto-cumulative generator (MCG) with a helix 280 mm in diameter (MCG-280) is developed. The new preamplifier has a power of ≈400 GW and is able to power a ten-element DMCG480 with an initial inductance of ≈0.2 µH by a current of ≈10 MA with a characteristic current rise time (by a factor of e at the final stage of its operation) τ e = 32 µs.

  8. Determination of radionuclides and pathways contributing to cumulative dose

    SciTech Connect

    Napier, B.A.

    1992-12-01

    A series of scoping calculations has been undertaken to evaluate the absolute and relative contributions of different radionuclides and exposure pathways to doses that may have been received by individuals living in the vicinity of the Hanford Site. This scoping calculation (Calculation 004) examined the contributions of numerous radionuclides to cumulative dose via environmental exposures and accumulation in foods. Addressed in this calculation were the contributions to organ and effective dose of infants and adults from (1) air submersion and groundshine external dose, (2) inhalation, (3) ingestion of soil by humans, (4) ingestion of leafy vegetables, (5) ingestion of other vegetables and fruits, (6) ingestion of meat, (7) ingestion of eggs, and (8) ingestion of cows' milk from Feeding Regime 1, as described in calculation 002. This calculation specifically addresses cumulative radiation doses to infants and adults resulting from releases occurring over the period 1945 through 1972.

  9. Cumulative Chemical Exposures During Pregnancy and Early Development.

    PubMed

    Mitro, Susanna D; Johnson, Tyiesha; Zota, Ami R

    2015-12-01

    Industrial and consumer product chemicals are widely used, leading to ubiquitous human exposure to the most common classes. Because these chemicals may affect developmental milestones, exposures in pregnant women and developing fetuses are of particular interest. In this review, we discuss the prevalence of chemical exposures in pregnant women, the chemical class-specific relationships between maternal and fetal exposures, and the major sources of exposures for six chemical classes of concern: phthalates, phenols, perfluorinated compounds (PFCs), flame retardants, polychlorinated biphenyls (PCBs), and organochlorine pesticides (OCs). Additionally, we describe the current efforts to characterize cumulative exposures to synthetic chemicals during pregnancy. We conclude by highlighting gaps in the literature and discussing possible applications of the findings to reduce the prevalence of cumulative exposures during pregnancy. PMID:26341623

  10. Erupted cumulate fragments in rhyolites from Lipari (Aeolian Islands)

    NASA Astrophysics Data System (ADS)

    Forni, Francesca; Ellis, Ben S.; Bachmann, Olivier; Lucchi, Federico; Tranne, Claudio A.; Agostini, Samuele; Dallai, Luigi

    2015-12-01

    Over the last ~267 ky, the island of Lipari has erupted magmas ranging in compositions from basaltic andesites to rhyolites, with a notable compositional gap in the dacite field. Bulk geochemical and isotopic compositions of the volcanic succession, in conjunction with major and trace elemental compositions of minerals, indicate that the rhyolites were dominantly generated via crystal fractionation processes, with subordinate assimilation. Radiogenic (Sr, Nd, and Pb) and stable (O) isotopes independently suggest ≤30 % of crustal contamination with the majority of it occurring in mafic compositions, likely relatively deep in the system. Within the rhyolites, crystal-rich, K2O-rich enclaves are common. In contrast to previous interpretations, we suggest that these enclaves represent partial melting, remobilization and eruption of cumulate fragments left-over from rhyolite melt extraction. Cumulate melting and remobilization is supported by the presence of (1) resorbed, low-temperature minerals (biotite and sanidine), providing the potassic signature to these clasts, (2) reacted Fo-rich olivine, marking the presence of mafic recharge, (3) An38-21 plagioclase, filling the gap in feldspar composition between the andesites and the rhyolites and (4) strong enrichment in Sr and Ba in plagioclase and sanidine, suggesting crystallization from a locally enriched melt. Based on Sr-melt partitioning, the high-Sr plagioclase would require ~2300 ppm Sr in the melt, a value far in excess of Sr contents in Lipari and Vulcano magmas (50-1532 ppm) but consistent with melting of a feldspar-rich cumulate. Due to the presence of similar crystal-rich enclaves within the rhyolites from Vulcano, we propose that the eruption of remobilized cumulates associated with high-SiO2 rhyolites may be a common process at the Aeolian volcanoes, as already attested for a variety of volcanic systems around the world.

  11. Cumulants and the moment algebra: Tools for analyzing weak measurements

    SciTech Connect

    Aaberg, Johan; Mitchison, Graeme

    2009-04-15

    Recently it has been shown that cumulants significantly simplify the analysis of multipartite weak measurements. Here we consider the mathematical structure that underlies this and find that it can be formulated in terms of what we call the moment algebra. Apart from resulting in simpler proofs, the flexibility of this structure allows generalizations of the original results to a number of weak measurement scenarios, including one where the weakly interacting pointers reach thermal equilibrium with the probed system.

  12. Cumulative effects from repeated exposures to ultraviolet radiation

    SciTech Connect

    Kaidbey, K.H.; Kligman, A.M.

    1981-05-01

    Repeated exposures to subliminal doses of UVR, given at 24-hr intervals, resulted in a lowering of the erythema threshold dose. At erythemogenically equivalent doses, UV-A was the most effective and UV-C the least. A similar and more pronounced effect was observed following repeated exposures to subthreshold doses of UV-A and topically applied 8-methoxypsoralen. These findings provide quantitative evidence for the cumulative nature of acute UVR damage in human skin.

  13. Cumulative Index to NASA Tech Briefs 1963-1969

    NASA Technical Reports Server (NTRS)

    1970-01-01

    Tech Briefs are short announcements of new technology derived from the research and development activities of the National Aeronautics and Space Administration. These briefs emphasize information considered likely to be transferrable across industrial, regional, or disciplinary lines and are issued to encourage commercial application. This Cumulative index to NASA Tech Briefs lists those published from 1963 through 1969. The main listing is divided into six categokies: Electrical (Electronic), Physical Sciences (Energy Sources), Materials (Chemistry), Life Sciences, Mechanical, and Computer Programs.

  14. Cumulative assessment: strategic choices to influence students’ study effort

    PubMed Central

    2013-01-01

    Background It has been asserted that assessment can and should be used to drive students’ learning. In the current study, we present a cumulative assessment program in which test planning, repeated testing and compensation are combined in order to influence study effort. The program is aimed at helping initially low-scoring students improve their performance during a module, without impairing initially high-scoring students’ performance. We used performance as a proxy for study effort and investigated whether the program worked as intended. Methods We analysed students’ test scores in two second-year (n = 494 and n = 436) and two third-year modules (n = 383 and n = 345) in which cumulative assessment was applied. We used t-tests to compare the change in test scores of initially low-scoring students with that of initially high-scoring students between the first and second subtest and again between the combined first and second subtest and the third subtest. During the interpretation of the outcomes we took regression to the mean and test difficulty into account. Results Between the first and the second subtest in all four modules, the scores of initially low-scoring students increased more than the scores of initially high-scoring students decreased. Between subtests two and three, we found a similar effect in one module, no significant effect in two modules and the opposite effect in another module. Conclusion The results between the first two subtests suggest that cumulative assessment may positively influence students’ study effort. The inconsistent outcomes between subtests two and three may be caused by differences in perceived imminence, impact and workload between the third subtest and the first two. Cumulative assessment may serve as an example of how several evidence-based assessment principles can be integrated into a program for the benefit of student learning. PMID:24370117

  15. Finite-volume cumulant expansion in QCD-colorless plasma

    NASA Astrophysics Data System (ADS)

    Ladrem, M.; Ahmed, M. A. A.; Alfull, Z. Z.; Cherif, S.

    2015-09-01

    Due to the finite-size effects, the localization of the phase transition in finite systems and the determination of its order, become an extremely difficult task, even in the simplest known cases. In order to identify and locate the finite-volume transition point T0(V) of the QCD deconfinement phase transition to a colorless QGP, we have developed a new approach using the finite-size cumulant expansion of the order parameter and the L_{mn}-method. The first six cumulants C_{1,2,3,4,5,6} with the corresponding under-normalized ratios (skewness Σ kurtosis κ , pentosis \\varPi _{± }, and hexosis {H}_{1,2,3}) and three unnormalized combinations of them, ({O}={{σ }2 {κ } }{{Σ }^{-1} }, {U} ={{σ }^{-2} {Σ }^{-1} }, {N} = {σ }2 {κ }) are calculated and studied as functions of ( T, V). A new approach, unifying in a clear and consistent way the definitions of cumulant ratios, is proposed. A numerical FSS analysis of the obtained results has allowed us to locate accurately the finite-volume transition point. The extracted transition temperature value T0(V) agrees with that expected T0N(V) from the order parameter and the thermal susceptibility χ T( T,V) , according to the standard procedure of localization to within about 2 %. In addition to this, a very good correlation factor is obtained proving the validity of our cumulants method. The agreement of our results with those obtained by means of other models is remarkable.

  16. Cumulative Risk: Toxicity and Interactions of Physical and Chemical Stressors

    PubMed Central

    Rider, Cynthia V.

    2014-01-01

    Recent efforts to update cumulative risk assessment procedures to incorporate nonchemical stressors ranging from physical to psychosocial reflect increased interest in consideration of the totality of variables affecting human health and the growing desire to develop community-based risk assessment methods. A key roadblock is the uncertainty as to how nonchemical stressors behave in relationship to chemical stressors. Physical stressors offer a reasonable starting place for measuring the effects of nonchemical stressors and their modulation of chemical effects (and vice versa), as they clearly differ from chemical stressors; and “doses” of many physical stressors are more easily quantifiable than those of psychosocial stressors. There is a commonly held belief that virtually nothing is known about the impact of nonchemical stressors on chemically mediated toxicity or the joint impact of coexposure to chemical and nonchemical stressors. Although this is generally true, there are several instances where a substantial body of evidence exists. A workshop titled “Cumulative Risk: Toxicity and Interactions of Physical and Chemical Stressors” held at the 2013 Society of Toxicology Annual Meeting provided a forum for discussion of research addressing the toxicity of physical stressors and what is known about their interactions with chemical stressors, both in terms of exposure and effects. Physical stressors including sunlight, heat, radiation, infectious disease, and noise were discussed in reference to identifying pathways of interaction with chemical stressors, data gaps, and suggestions for future incorporation into cumulative risk assessments. PMID:24154487

  17. Stakeholder attitudes towards cumulative and aggregate exposure assessment of pesticides.

    PubMed

    Verbeke, Wim; Van Loo, Ellen J; Vanhonacker, Filiep; Delcour, Ilse; Spanoghe, Pieter; van Klaveren, Jacob D

    2015-05-01

    This study evaluates the attitudes and perspectives of different stakeholder groups (agricultural producers, pesticide manufacturers, trading companies, retailers, regulators, food safety authorities, scientists and NGOs) towards the concepts of cumulative and aggregate exposure assessment of pesticides by means of qualitative in-depth interviews (n = 15) and a quantitative stakeholder survey (n = 65). The stakeholders involved generally agreed that the use of chemical pesticides is needed, primarily for meeting the need of feeding the growing world population, while clearly acknowledging the problematic nature of human exposure to pesticide residues. Current monitoring was generally perceived to be adequate, but the timeliness and consistency of monitoring practices across countries were questioned. The concept of cumulative exposure assessment was better understood by stakeholders than the concept of aggregate exposure assessment. Identified pitfalls were data availability, data limitations, sources and ways of dealing with uncertainties, as well as information and training needs. Regulators and food safety authorities were perceived as the stakeholder groups for whom cumulative and aggregate pesticide exposure assessment methods and tools would be most useful and acceptable. Insights obtained from this exploratory study have been integrated in the development of targeted and stakeholder-tailored dissemination and training programmes that were implemented within the EU-FP7 project ACROPOLIS. PMID:25455887

  18. Cumulative Risk Assessment Toolbox: Methods and Approaches for the Practitioner

    PubMed Central

    MacDonell, Margaret M.; Haroun, Lynne A.; Teuschler, Linda K.; Rice, Glenn E.; Hertzberg, Richard C.; Butler, James P.; Chang, Young-Soo; Clark, Shanna L.; Johns, Alan P.; Perry, Camarie S.; Garcia, Shannon S.; Jacobi, John H.; Scofield, Marcienne A.

    2013-01-01

    The historical approach to assessing health risks of environmental chemicals has been to evaluate them one at a time. In fact, we are exposed every day to a wide variety of chemicals and are increasingly aware of potential health implications. Although considerable progress has been made in the science underlying risk assessments for real-world exposures, implementation has lagged because many practitioners are unaware of methods and tools available to support these analyses. To address this issue, the US Environmental Protection Agency developed a toolbox of cumulative risk resources for contaminated sites, as part of a resource document that was published in 2007. This paper highlights information for nearly 80 resources from the toolbox and provides selected updates, with practical notes for cumulative risk applications. Resources are organized according to the main elements of the assessment process: (1) planning, scoping, and problem formulation; (2) environmental fate and transport; (3) exposure analysis extending to human factors; (4) toxicity analysis; and (5) risk and uncertainty characterization, including presentation of results. In addition to providing online access, plans for the toolbox include addressing nonchemical stressors and applications beyond contaminated sites and further strengthening resource accessibility to support evolving analyses for cumulative risk and sustainable communities. PMID:23762048

  19. Cumulative risk hypothesis: Predicting and preventing child maltreatment recidivism.

    PubMed

    Solomon, David; Åsberg, Kia; Peer, Samuel; Prince, Gwendolyn

    2016-08-01

    Although Child Protective Services (CPS) and other child welfare agencies aim to prevent further maltreatment in cases of child abuse and neglect, recidivism is common. Having a better understanding of recidivism predictors could aid in preventing additional instances of maltreatment. A previous study identified two CPS interventions that predicted recidivism: psychotherapy for the parent, which was related to a reduced risk of recidivism, and temporary removal of the child from the parent's custody, which was related to an increased recidivism risk. However, counter to expectations, this previous study did not identify any other specific risk factors related to maltreatment recidivism. For the current study, it was hypothesized that (a) cumulative risk (i.e., the total number of risk factors) would significantly predict maltreatment recidivism above and beyond intervention variables in a sample of CPS case files and that (b) therapy for the parent would be related to a reduced likelihood of recidivism. Because it was believed that the relation between temporary removal of a child from the parent's custody and maltreatment recidivism is explained by cumulative risk, the study also hypothesized that that the relation between temporary removal of the child from the parent's custody and recidivism would be mediated by cumulative risk. After performing a hierarchical logistic regression analysis, the first two hypotheses were supported, and an additional predictor, psychotherapy for the child, also was related to reduced chances of recidivism. However, Hypothesis 3 was not supported, as risk did not significantly mediate the relation between temporary removal and recidivism. PMID:27352090

  20. The cumulative semantic interference effect in normal and pathological ageing.

    PubMed

    Mulatti, Claudio; Calia, Clara; De Caro, Maria Fara; Della Sala, Sergio

    2014-12-01

    People affected by mild cognitive impairment (MCI), a precursor of Alzheimer's Disease, present with impairments in picture naming, a lexical/semantic task which rests on the activation of perceptual, semantic, and phonological representations. The poor performance of MCI individuals in picture naming has been accounted for in terms of deficits of either the perceptual, semantic, or phonological stages. To disentangle the source of this deficit we compared the cumulative semantic interference effect (Howard et al., 2006. Cognition. 100, 464-482.) and the repetition priming effect of a group of people with MCI to that of a group of healthy elderly participants and with a group of healthy young participants. The cumulative semantic interference effect defines a linear increase in the picture naming reaction times which is function of the already named pictures belonging to the same semantic category to which the named picture belongs. The repetition priming effect refers to an increase in performance for repeated items compared to unrepeated items. Results showed that whereas the cumulative semantic interference effect was present in the healthy elderly and young samples, it was absent in the MCI sample; instead, all groups showed comparable repetition priming effects. This pattern of results suggests that the impairment in picture naming exhibited by MCI individuals is due to an inefficient semantic access. PMID:25447069

  1. Using exposomics to assess cumulative risks and promote health.

    PubMed

    Smith, Martyn T; de la Rosa, Rosemarie; Daniels, Sarah I

    2015-12-01

    Under the exposome paradigm all nongenetic factors contributing to disease are considered to be 'environmental' including chemicals, drugs, infectious agents, and psychosocial stress. We can consider these collectively as environmental stressors. Exposomics is the comprehensive analysis of exposure to all environmental stressors and should yield a more thorough understanding of chronic disease development. We can operationalize exposomics by studying all the small molecules in the body and their influence on biological pathways that lead to impaired health. Here, we describe methods by which this may be achieved and discuss the application of exposomics to cumulative risk assessment in vulnerable populations. Since the goal of cumulative risk assessment is to analyze, characterize, and quantify the combined risks to health from exposures to multiple agents or stressors, it seems that exposomics is perfectly poised to advance this important area of environmental health science. We should therefore support development of tools for exposomic analysis and begin to engage impacted communities in participatory exposome research. A first step may be to apply exposomics to vulnerable populations already studied by more conventional cumulative risk approaches. We further propose that recent migrants, low socioeconomic groups with high environmental chemical exposures, and pregnant women should be high priority populations for study by exposomics. Moreover, exposomics allows us to study interactions between chronic stress and environmental chemicals that disrupt stress response pathways (i.e., 'stressogens'). Exploring the impact of early life exposures and maternal stress may be an interesting and accessible topic for investigation by exposomics using biobanked samples. PMID:26475350

  2. Bringing science into river systems cumulative effects assessment practice

    SciTech Connect

    Seitz, Nicole E.; Westbrook, Cherie J.; Noble, Bram F.

    2011-04-15

    Fast-paced watershed change, driven by anthropogenic development, is threatening the sustainability of freshwater resources across the globe. Developments within watersheds interact in a manner that is additive and synergistic over space and time. Such cumulative environmental effects are defined as the results of actions that are individually minor but collectively significant when added to other past, present, and reasonably foreseeable future actions. Cumulative effects assessment (CEA) then is broadly defined as the process of evaluating the potential impacts of such collective actions on the environment and is a requirement in many countries, including in Canada at the federal level under the Canadian Environmental Assessment Act. However, current approaches to CEA for river systems are proving to be ineffective, which is largely attributed to the disconnect between CEA science and practice. We highlight this gap herein by discussing contradictions in the CEA literature, challenges in quantifying cumulative interactions, including overcoming spatiotemporal scale issues, multiple hydrologic and ecological pathways, and lack of predictive analysis. Our analysis shows there is a need for improved CEA for river systems, and in responding to this need we propose a conceptual framework for better integrating science and practice for improved CEA for river systems using one of the most adversely affected rivers basins in Canada, the Athabasca River, as our model. We conclude by addressing the challenges inherent to CEA with the intent of providing scientists with ways to help improve CEA of river systems.

  3. Incidence of hypothyroidism occurring long after iodine-131 therapy for hyperthyroidism

    SciTech Connect

    Holm, L.E.; Lundell, G.; Israelsson, A.; Dahlqvist, I.

    1982-02-01

    We have studied the long-term incidence of hypothyroidism in 4,473 formerly hyperthyroid patients given I-131 therapy between 1951 and 1975. The mean age at the first I-131 treatment was 56 yr. Six percent developed hypothyroidism within one year of therapy, and 72% within 26 yr. Prior antithyroid medication did not affect the incidence of hypothyroidism. Patients cured with one dose of I-131 had a lower cumulative long-term incidence of hypothyroidism than those requiring more than one dose.

  4. Evaluating hospital performance based on excess cause-specific incidence.

    PubMed

    Van Rompaye, Bart; Eriksson, Marie; Goetghebeur, Els

    2015-04-15

    Formal evaluation of hospital performance in specific types of care is becoming an indispensable tool for quality assurance in the health care system. When the prime concern lies in reducing the risk of a cause-specific event, we propose to evaluate performance in terms of an average excess cumulative incidence, referring to the center's observed patient mix. Its intuitive interpretation helps give meaning to the evaluation results and facilitates the determination of important benchmarks for hospital performance. We apply it to the evaluation of cerebrovascular deaths after stroke in Swedish stroke centers, using data from Riksstroke, the Swedish stroke registry. PMID:25640288

  5. Restoration of the Ellipsoid Zone and Visual Prognosis at 1 Year after Surgical Macular Hole Closure

    PubMed Central

    Hasebe, Hiruma; Matsuoka, Naoki; Terashima, Hiroko; Sasaki, Ryo; Ueda, Eriko; Fukuchi, Takeo

    2016-01-01

    Purpose. To evaluate the restoration of the ellipsoid zone (EZ) and its influence on visual prognosis 1 year after surgical macular hole (MH) closure. Method. Subjects were patients with stage 2, 3, or 4 idiopathic MH who underwent primary vitrectomy that resulted in successful hole closure. Nineteen eyes with both EZ disruption with foveal detachment and a continuous external limiting membrane on optical coherence tomography during the early postoperative period were included in this study. Result. EZ disruption was restored in 10 eyes (53%, Group A) and remained in 9 eyes (47%, Group B) at 1 year after surgery. In Group B, the diameter of the residual EZ disruption was 54.7 ± 33.1 μm. LogMAR visual acuity (VA) 1 year after surgery was significantly better than preoperative VA in each group (Group A: −0.007 ± 0.102; P < 0.001; Group B: 0.051 ± 0.148; P < 0.001), but there was no significant difference between the 2 groups (P = 0.332). There was no significant correlation between logMAR VA and EZ disruption diameter at 1 year after surgery. Conclusion. EZ was restored in 53% of eyes at 1 year after surgical closure of idiopathic MH. Mean residual EZ disruption diameter was 54.7 ± 33.1 μm. Neither resolved nor residual EZ disruption influenced postoperative VA. PMID:26941999

  6. The Effect of Total Cumulative Dose, Number of Treatment Cycles, Interval between Injections, and Length of Treatment on the Frequency of Occurrence of Antibodies to Botulinum Toxin Type A in the Treatment of Muscle Spasticity

    ERIC Educational Resources Information Center

    Bakheit, Abdel Magid O.; Liptrot, Anthea; Newton, Rachel; Pickett, Andrew M.

    2012-01-01

    A large cumulative dose of botulinum toxin type A (BoNT-A), frequent injections, a short interval between treatment cycles, and a long duration of treatment have all been suggested, but not confirmed, to be associated with a high incidence of neutralizing antibodies to the neurotoxin. The aim of this study was to investigate whether these…

  7. Incident Management: Process into Practice

    ERIC Educational Resources Information Center

    Isaac, Gayle; Moore, Brian

    2011-01-01

    Tornados, shootings, fires--these are emergencies that require fast action by school district personnel, but they are not the only incidents that require risk management. The authors have introduced the National Incident Management System (NIMS) and the Incident Command System (ICS) and assured that these systems can help educators plan for and…

  8. Racist Incident-Based Trauma

    ERIC Educational Resources Information Center

    Bryant-Davis, Thema; Ocampo, Carlota

    2005-01-01

    Racist incidents are potentially traumatizing forms of victimization that may lead to increased psychiatric and psychophysiological symptoms in targets. The magnitude of the problem of racist incidents in the United States is difficult to estimate; however, data from several sources permit the inference that the prevalence of racist incidents,…

  9. Evaluation of the management of Hr-HPV+/PapTest- women: results at 1-year recall

    PubMed Central

    Chiappetta, Caterina; Puggioni, Chiara; Lendaro, Eugenio; Cacciotti, Jessica; Zaralli, Roberto; Migliore, Giovanna; Bellardini, Paola; Petrozza, Vincenzo; Della Rocca, Carlo; Di Cristofano, Claudio

    2015-01-01

    With cervical cancer screening the choice of 1-year as a period of follow-up in positive high-risk HPV women without cytological lesions is still under discussion. We evaluated the management of these women and the role of HPV genotyping test. We did a cervical cancer screening study of women aged 35-64 with primary high-risk HPV test. Women positive for high-risk HPV with negative cytology were followed-up after 1 year. In this study we selected women with high-risk HPV+/PapTest- resulted high-risk HPV+ at recall and performed the PapTest and HPV genotyping test. The detection rate of squamous high grade (CIN2+) relative to the total screened cohort was 2.1‰, and it was 0.2‰ at the 1-year recall. The colposcopy performed in women referred at the 1-year recall accounted for 48.8% of the total (baseline + 1-year recall), and 84.3% of these women had no cytological lesions. The most frequent hr-HPV genotype detected was HPV16 and 66.7% of co-infections were due to HPV16 and HPV18. 54.5% of women presented a persistent infection at 1-year recall with the same HPV subtype, 50% of persistent infections was due to HPV16 and 16.7% of these were determined to be CIN2+ histological lesions. Our data show that it may be useful to extend the period of follow-up for women hr-HPV+/PapTest- so as to reduce the number of unnecessary colposcopies due to the transitory infections and that the genotyping test could help to identify the persistent infections in which HPV16 is involved. PMID:26884886

  10. Pregnancy Incidence in Female Nasopharyngeal Carcinoma Survivors of Reproductive Age

    PubMed Central

    Lee, Bo-Ching; Yen, Ruoh-Fang; Lin, Cheng-Li; Liang, Ji-An; Lin, Ming-Chia; Kao, Chia-Hung

    2016-01-01

    Abstract This study evaluated the pregnancy incidence in female nasopharyngeal carcinoma (NPC) survivors of reproductive age. In a nationwide cohort, 2816 female patients 15 to 50 years of age from 1998 to 2010 were identified from the Taiwan National Health Insurance Research database. Comorbidities, complications during pregnancy, and delivery status were recorded. All patients were followed up until a diagnosis of pregnancy, withdrawal from the National Health Insurance system, or December 31, 2011. Overall, 155 patients (incidence rate [IR] = 9.50) were pregnant in the NPC group, whereas 251 patients (IR = 12.80) were pregnant in the non-NPC group. The cumulative incidence of pregnancy in the NPC group was lower than that in the non-NPC group (incidence rate ratio = 0.74, 95% CI = 0.61–0.91). The adjusted hazard ratio of pregnancy in the NPC group was 0.79 with 95% CI = 0.61–0.96, compared with the non-NPC group. The incidence of pregnancy is significantly lower among female NPC survivors of reproductive age than among those without NPC. PMID:27196495

  11. Clinical differences between opioid abuse classes ameliorated after 1 year of buprenorphine-medication assisted treatment.

    PubMed

    Tkacz, Joseph; Severt, Jamie; Kassed, Cheryl; Ruetsch, Charles

    2012-01-01

    This study compared the clinical and demographic profiles of three opioid-dependent user groups, and measured their response to 1 year of buprenorphine-medication assisted treatment. Opioid prescription, street, and combination (street + prescription) users completed the Addiction Severity Index multiple times over the course of one treatment year. Although groups differed on all measured demographics (P values <.05) and on six of seven Addiction Severity Index composite scores at induction (P values <.05), differences were ameliorated after 1 year. Findings highlight the disparities between the various opioid-dependent patient subpopulations and suggest that buprenorphine-medication assisted treatment is an effective treatment across user subtypes. PMID:22540432

  12. Total lymphoid irradiation in kidney and liver transplantation in the baboon: prolonged graft survival and alterations in T cell subsets with low cumulative dose regimens

    SciTech Connect

    Myburgh, J.A.; Smith, J.A.; Stark, J.H.; Browde, S.

    1984-02-01

    Prolonged kidney and liver allograft survival was produced in baboons by low cumulative doses (500 to 1200 rad) of total lymphoid irradiation (TLI). Continuing normal graft function for more than 1 year after transplantation was seen in 10 animals in this series. The longest survivor (> 4 years) rejected a third party kidney allograft in typically acute fashion 1 yr after the original transplantation. The dose-response effect was parabolic, with a cumulative dose of 800 rad given as twice weekly fractions of 100 rad each being the most effective. With smaller cumulative doses (500 or 600 rad) results were improved if TLI was administered as a large number of smaller fractions. These regimens are free of the radiation related mortality observed in earlier studies with larger cumulative doses. Alterations in T cell subpopulations were studied in these baboons with the use of the anti-human monoclonal antibodies OKT11 (anti-total T cells), OKT4 (anti-T helper cells; Th), and OKT8 (anti-T suppressor/cytotoxic cells, Tsc), which cross-react with baboon lymphocytes. After completion of TLI but before transplantation, the relative percentage of Tsc cells fell and the percentage of Th and the Th/Tsc ratio rose. Transplantation was followed by an inversion of this ratio due to reciprocal changes in the percentages of Th and Tsc cells. This pattern persisted and increased until 6 mo after transplantation, when it reverted to that seen in untreated control animals.

  13. Incidence Trends and Geographical Distribution of Nasopharyngeal Carcinoma in Iran

    PubMed Central

    Safavi-Naini, Ali; Raad, Nasim; Ghorbani, Jahangir; Chaibakhsh, Samira; Ramezani-Daryasar, Rashid

    2015-01-01

    Background Nasopharyngeal carcinoma (NPC) has known as a highly distinct kind of head and neck cancer. This distinction has been due to its clinical presentation, epidemiology, outcome, and treatment. There have not been any reports of epidemiological analysis of NPC in Iran. This study has evaluated the incidence rates and trends of nasopharyngeal carcinoma in the Iranian population during 2004 to 2009. Methods The data have collected from the Iranian national cancer data system registry. All the cases of nasopharyngeal carcinoma (with the topography code 11 and histology of carcinoma) have retrieved and analyzed from an overall cancer database during a 6-year period. The data have analyzed by using the SPSS, version 16. Results To determine the current incidence of NPC in Iran, we have examined the NPC cases from 2004 to 2009. A total of 1431 cases (981 male and 450 female NPC patients) have analyzed epidemiologically in this study. The mean age of the patients was 47.1 years. The incidence was 0.33 per 100000 persons. The overall incidence rate have increased annually (p<0.05). The incidence of NPC gradually increased with age. Prefectures that bordering the Caspian Sea have proved to have a higher incidence than the other studied areas. Conclusion Our study has indicated an increasing trend in the incidence of nasopharyngeal carcinoma. Therefore; attempts should be precipitated for prevention. PMID:26396710

  14. The incidence of postoperative pain and analgesic usage in children.

    PubMed

    Acs, G; Drazner, E

    1992-01-01

    The purpose of this study is to report the incidence of post-restorative dental pain and analgesic usage in children. A questionnaire completed by parents was employed. The mean age of the patients was 8.1 years; and all patients were in the six- to thirteen-year-old range. Pain following routine restorative procedures was reported by 31.5 percent of the patients. Additionally, 52.9 percent of these patients required analgesic relief. PMID:1537941

  15. Grazing incidence beam expander

    SciTech Connect

    Akkapeddi, P.R.; Glenn, P.; Fuschetto, A.; Appert, Q.; Viswanathan, V.K.

    1985-01-01

    A Grazing Incidence Beam Expander (GIBE) telescope is being designed and fabricated to be used as an equivalent end mirror in a long laser resonator cavity. The design requirements for this GIBE flow down from a generic Free Electron Laser (FEL) resonator. The nature of the FEL gain volume (a thin, pencil-like, on-axis region) dictates that the output beam be very small. Such a thin beam with the high power levels characteristic of FELs would have to travel perhaps hundreds of meters or more before expanding enough to allow reflection from cooled mirrors. A GIBE, on the other hand, would allow placing these optics closer to the gain region and thus reduces the cavity lengths substantially. Results are presented relating to optical and mechanical design, alignment sensitivity analysis, radius of curvature analysis, laser cavity stability analysis of a linear stable concentric laser cavity with a GIBE. Fabrication details of the GIBE are also given.

  16. Incidence, risk factors, and outcome of cytomegalovirus viremia and gastroenteritis in patients with gastrointestinal graft-versus-host disease.

    PubMed

    Bhutani, Divaya; Dyson, Gregory; Manasa, Richard; Deol, Abhinav; Ratanatharathorn, Voravit; Ayash, Lois; Abidi, Muneer; Lum, Lawrence G; Al-Kadhimi, Zaid; Uberti, Joseph P

    2015-01-01

    Gastrointestinal (GI) graft-versus-host disease (GVHD) is one of the most common causes of morbidity and mortality after allogeneic stem cell transplantation. In addition, cytomegalovirus (CMV) infection of the gastrointestinal tract can complicate the post-transplantation course of these patients and it can be difficult to differentiate the 2 diagnoses given that they can present with similar symptoms. We retrospectively analyzed 252 patients who were diagnosed with GI GVHD to evaluate the incidence, risk factors, and outcomes of CMV viremia and CMV gastroenteritis in these patients. The median age at the time of transplantation was 51 years, 35% were related donor transplantations, and 65% were unrelated donor transplantations. A total of 114 (45%) patients developed CMV viremia at a median of 34 days (range, 14 to 236 days) after transplantation. Only recipient CMV IgG serostatus was significantly associated with development of CMV viremia (P < .001). The incidence of CMV viremia with relation to donor (D) and recipient (R) CMV serostatus subgroups was as follows: D+/R+, 73%; D-/R+, 67%; D+/R-, 19%; and D-/R-, 0. A total of 31 patients were diagnosed with a biopsy-proven CMV gastroenteritis; 2 patients had evidence of CMV gastroenteritis and GVHD on the first biopsy and 29 on the second biopsy. Median time to development of CMV gastroenteritis was 52 days (range, 19 to 236 days) after transplantation. Using death as a competing risk, the cumulative incidence of CMV gastroenteritis at 1 year was 16.4%. The incidence of CMV gastroenteritis in relation to the donor/recipient serostatus was as follows: D+/R+, 22%; D-/R+, 31%; D+/R-, 12%; and D-/R-, 0. Median follow-up time for the 252 patients was 35.4 (95% CI 23.8 to 44.8) months. The estimated overall survival rate at 1 and 2 years was .45 (95% confidence interval [CI], .39 to .52) and .39 (95% CI, .33 to .46), respectively. Of the examined variables, those related to the overall survival were maximal clinical

  17. Incidence, Risk Factors, and Outcome of Cytomegalovirus Viremia and Gastroenteritis in Patients with Gastrointestinal Graft-versus-Host Disease

    PubMed Central

    Bhutani, Divaya; Dyson, Gregory; Manasa, Richard; Deol, Abhinav; Ratanatharathorn, Voravit; Ayash, Lois; Abidi, Muneer; Lum, Lawrence G.; Al-Kadhimi, Zaid; Uberti, Joseph P.

    2014-01-01

    Gastrointestinal (GI) graft-versus-host disease (GVHD) is 1 of the most common causes of morbidity and mortality after allogeneic stem cell transplantation. In addition, cytomegalovirus (CMV) infection of the gastrointestinal tract can complicate the post-transplantation course of these patients and it can be difficult to differentiate the 2 diagnoses given that they can present with similar symptoms. We retrospectively analyzed 252 patients who were diagnosed with GI GVHD to evaluate the incidence, risk factors, and outcomes of CMV viremia and CMV gastroenteritis in these patients. The median age at the time of transplantation was 51 years, 35% were related donor transplantations, and 65% were unrelated donor transplantations. A total of 114 (45%) patients developed CMV viremia a median of 34 days (range, 14 to 236 days) after transplantation. Only recipient CMV IgG serostatus was significantly associated with development of CMV viremia (P < .001). The incidence of CMV viremia with relation to donor (D) and recipient (R) CMV serostatus subgroups was as follows: D+/R+, 73%; D−/R+, 67%; D+/R−, 19%; and D−/R−, 0. A total of 31 patients were diagnosed with a biopsy-proven CMV gastroenteritis; 2 patients had evidence of CMV gastroenteritis and GVHD on the first biopsy and 29 on the second biopsy. Median time to development of CMV gastroenteritis was 52 days (range, 19 to 236 days) after transplantation. Using death as a competing risk, the cumulative incidence of CMV gastroenteritis at 1 year was 16.4%. The incidence of CMV gastroenteritis in relation to the donor/recipient serostatus was as follows: D+/R+, 22%; D−/R+, 31%; D+/R−, 12%; and D−/R−, 0. Median overall survival of the 252 patients was 35.4 (range, 23.8 to 44.8) months. The estimated overall survival rate at 1 and 2 years was .45 (95% confidence interval [CI], .39 to .52) and .39 (95% CI, .33 to .46), respectively. Of the examined variables, those related to the overall survival were maximal

  18. Health inputs and cumulative health deficits among the older Chinese.

    PubMed

    Gu, Danan; Sautter, Jessica; Huang, Cheng; Zeng, Yi

    2011-03-01

    Using a health economics framework, we examined how both individual level investments at different life stages and current community-level environmental factors affect individual health stock and flows at old ages. We used a nationwide dataset from the 2002 and 2005 waves of the Chinese Longitudinal Healthy Longevity Survey, which included more than 15,000 adults aged 65 and older from 22 provinces in mainland China. We measured health stock with a cumulative health deficit index, a measure developed in geriatrics and gerontology that reflects deficits, illnesses, and functional impairment in numerous domains of health. The cumulative health deficit index has not been used in health economics before, but is a significant contribution because it captures the health stock concept very well and overcomes the problems of inconsistency resulting from the use of different measures of health stock in research. Our results show that several proxy measures for individual health investments in both childhood (nutritional status and parental survival status) and adulthood (family financial condition and access to healthcare) yielded positive returns to health stock measured by the cumulative health deficit index. Investments in social connections and healthy behaviors (religious involvement, alcohol use, and exercise) also produced positive returns in health stock. Current community-level factors such as air quality and labor force participation rate were significantly associated with levels of health deficits in old age as well. Yet, most of these individual investment and community environment variables did not significantly affect short-term health flows (improvement or deterioration in health status over three years). Our findings have important implications for developing preventive health programs in the context of population aging by focusing on policy-relevant predictors and a comprehensive indicator of health status in later life. PMID:21306808

  19. Cumulative silvicultural impacts on watersheds: a hydrologic and regulatory dilemma

    SciTech Connect

    Coats, R.M.; Miller, T.O.

    1981-03-01

    Because of the nature of watersheds, the hydrologic and erosional impacts of logging and related road-building activities may move offsite, affecting areas downslope and downstream from the operation. The degree to which this occurs depends on the interaction of many variables, including soils, bedrock geology, vegetation, the timing, and size of storm events, logging technology, and operator performance. In parts of northwestern California, these variables combine to produce significant water quality degradation, with resulting damage to anadromous fish habitat. Examination of recent aerial photographs, combined with a review of public records, shows that many timber harvest operations were concentrated in a single 83 sq km watershed in the lower Klamath River Basin within the past decade. The resulting soil disturbance in this case seems likely to result in cumulative off-site water quality degradation in the lower portion of the Basin. In California, both state and federal laws require consideration of possible cumulative effects of multiple timber harvest operations. In spite of recent reforms that have given the state a larger role in regulating forest practices on private land, each timber harvest plan is still evaluated in isolation from other plans in the same watershed. A process of collaborative state-private watershed planning with increased input of geologic information offers the best long-term approach to the problem of assessing cumulative effects of multiple timber harvest operations. Such a reform could ultimately emerge from the ongoing water quality planning process under Section 208 of the amended Federal Water Pollution Control Act. (Refs. 51).

  20. Canadian and international EIA frameworks as they apply to cumulative effects

    SciTech Connect

    Connelly, Robert

    2011-09-15

    This paper presents a brief history of the development of cumulative effects, the current requirements in North America and elsewhere in the world, challenges at the project level, thoughts on how emerging concepts of strategic environmental assessment and regional assessment may offer means to improve the examination of cumulative effects and offers suggestions for current and future needs in cumulative effects assessment.

  1. 30 CFR 250.921 - How do I analyze my platform for cumulative fatigue?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 2 2011-07-01 2011-07-01 false How do I analyze my platform for cumulative fatigue? 250.921 Section 250.921 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT, REGULATION, AND... analyze my platform for cumulative fatigue? (a) If you are required to analyze cumulative fatigue on...

  2. Neutron source capability assessment for cumulative fission yields measurements

    SciTech Connect

    Descalle, M A; Dekin, W; Kenneally, J

    2011-04-06

    A recent analysis of high-quality cumulative fission yields data for Pu-239 published in the peer-reviewed literature showed that the quoted experimental uncertainties do not allow a clear statement on how the fission yields vary as a function of energy. [Prussin2009] To make such a statement requires a set of experiments with well 'controlled' and understood sources of experimental errors to reduce uncertainties as low as possible, ideally in the 1 to 2% range. The Inter Laboratory Working Group (ILWOG) determined that Directed Stockpile Work (DSW) would benefit from an experimental program with the stated goal to reduce the measurement uncertainties significantly in order to make a definitive statement of the relationship of energy dependence to the cumulative fission yields. Following recent discussions between Lawrence Livermore National Laboratory (LLNL) and Los Alamos National Laboratory (LANL), there is a renewed interest in developing a concerted experimental program to measure fission yields in a neutron energy range from thermal energy (0.025 eV) to 14 MeV with an emphasis on discrete energies from 0.5 to 4 MeV. Ideally, fission yields would be measured at single energies, however, in practice there are only 'quasi-monoenergetic' neutrons sources of finite width. This report outlines a capability assessment as of June 2011 of available neutron sources that could be used as part of a concerted experimental program to measure cumulative fission yields. In a framework of international collaborations, capabilities available in the United States, at the Atomic Weapons Establishment (AWE) in the United Kingdom and at the Commissariat Energie Atomique (CEA) in France are listed. There is a need to develop an experimental program that will reduce the measurement uncertainties significantly in order to make a definitive statement of the relationship of energy dependence to the cumulative fission yields. Fission and monoenergetic neutron sources are available that

  3. Quasi-linear theory via the cumulant expansion approach

    NASA Technical Reports Server (NTRS)

    Jones, F. C.; Birmingham, T. J.

    1974-01-01

    The cumulant expansion technique of Kubo was used to derive an intergro-differential equation for f , the average one particle distribution function for particles being accelerated by electric and magnetic fluctuations of a general nature. For a very restricted class of fluctuations, the f equation degenerates exactly to a differential equation of Fokker-Planck type. Quasi-linear theory, including the adiabatic assumption, is an exact theory for this limited class of fluctuations. For more physically realistic fluctuations, however, quasi-linear theory is at best approximate.

  4. Cumulative plastic deformation for fine-grained subgrade soils

    SciTech Connect

    Li, D.Q.; Selig, E.T.

    1996-12-01

    Improvements to existing methods in the literature have been made for predicting cumulative plastic deformation for fine-grained subgrade soils. The soil deviator stress, number of stress applications, soil physical state, and soil type are considered. The improved method incorporates multilevels of deviator stresses and multisoil physical states that result from load-level variations, as well as seasonal and weather changes throughout traffic. Measurements of plastic deformation for a railroad-track subgrade are presented and show a significant influence of soil physical state, soil type, traffic tonnage, and wheel loads on the accumulation of plastic deformation. Comparisons between predicted and experimental results show good applicability of the improved method.

  5. Cumulative beam breakup in radio-frequency linacs

    SciTech Connect

    Bohn, C.L.; Delayen, J.R.

    1990-01-01

    An analytic model of cumulative beam breakup has been developed which is applicable to both low-velocity ion and high-energy electron linear accelerators. The model includes arbitrary velocity, acceleration, focusing, initial conditions, beam-cavity resonances, and variable cavity geometry and spacing along the accelerator. The model involves a continuum approximation'' in which the transverse kicks in momentum imparted by the cavities are smoothed over the length of the linac. The resulting equation of transverse motion is solved via the WKBJ method. Specific examples are discussed which correspond to limiting cases of the solution. 16 refs.

  6. 1-year retention rates and performance ratings: comparing associate degree, baccalaureate, and accelerated baccalaureate degree nurses.

    PubMed

    Weathers, Suzanne M; Raleigh, Edith D Hunt

    2013-09-01

    The purpose of this study was to examine 1-year retention and managerial performance ratings of newly licensed RNs (NLRNs) according to nursing education program types (associate degree, traditional baccalaureate, and accelerated 2nd degree baccalaureate). Findings revealed retention and performance differences, suggesting the possibility of tradeoffs related to educational program type when selecting NLRNs for open positions. PMID:23958525

  7. Randomized Trial of a Gatekeeper Program for Suicide Prevention: 1-Year Impact on Secondary School Staff

    ERIC Educational Resources Information Center

    Wyman, Peter A.; Brown, C. Hendricks; Inman, Jeff; Cross, Wendi; Schmeelk-Cone, Karen; Guo, Jing; Pena, Juan B.

    2008-01-01

    Gatekeeper-training programs, designed to increase identification and referral of suicidal individuals, are widespread but largely untested. A group-based randomized trial with 32 schools examined impact of Question, Persuade, Refer (QPR) training on a stratified random sample of 249 staff with 1-year average follow-up. To test QPR impact, the…

  8. Thai Adolescent Survivors 1 Year after the 2004 Tsunami: A Mixed Methods Study

    ERIC Educational Resources Information Center

    Tuicomepee, Arunya; Romano, John L.

    2008-01-01

    This study examined the impact of the 2004 Asian tsunami on 400 Thai adolescents 1 year after the disaster. Quantitative analyses showed that youth behavior problems were positively associated with tsunami experiences and negatively associated with positive family functioning. Tsunami exposure, school connectedness, religious beliefs and…

  9. The Stability and Structure of Career Decision-Making Profiles: A 1-Year Follow-Up

    ERIC Educational Resources Information Center

    Gati, Itamar; Levin, Nimrod

    2012-01-01

    The Career Decision-Making Profile (CDMP) questionnaire is a multidimensional measure of the way individuals make career decisions, developed as an alternative to the single, most-dominant trait approach. Using a sample of freshmen students, the 2-week reliability (N = 273) and 1-year stability (N = 182) of the CDMP was tested for each of the 12…

  10. A Program To Promote Positive Body Image: A 1-Year Follow-Up Evaluation.

    ERIC Educational Resources Information Center

    McVey, Gail L.; Davis, Ron

    2002-01-01

    Evaluated the effectiveness of a program designed to promote body image satisfaction and prevent eating problems in young adolescent girls over a 1-year period. Found no program effect. Found instead, significant increases in body image satisfaction and decreases in eating problem scores over time for participants in both the prevention and…

  11. An Analysis of 1-Year Impacts of Youth Transition Demonstration Projects

    ERIC Educational Resources Information Center

    Fraker, Thomas M.; Luecking, Richard G.; Mamun, Arif A.; Martinez, John M.; Reed, Deborah S.; Wittenburg, David C.

    2016-01-01

    This article examines the impacts of the Youth Transition Demonstration, an initiative of the Social Security Administration (SSA) to improve employment outcomes for youth with disabilities. Based on a random assignment design, the analysis uses data from a 1-year follow-up survey and SSA administrative records for 5,203 youth in six research…

  12. Participation as a leader in immersion weight loss treatment: a 1-year follow-up study.

    PubMed

    Anderson, L M; Schaumberg, K; Anderson, D A; Kirschenbaum, D S

    2016-02-01

    Non-overweight individuals may follow aggressive weight management approaches alongside overweight/obese friends or family members; thus, research has begun to evaluate subsequent effects among non-overweight populations. A prior study evaluated the short-term effects of an immersion weight loss programme on healthy young adult staff leaders. Results indicated that participation seemed to benefit, not harm, the young adults. The current investigation examined 1-year eating disorder and weight trajectories in this sample. The total sample (N = 244) consisted of staff leaders (44.3%) and demographically similar comparison participants who completed eating disorder and weight assessments across four time points: baseline, end of summer, 6-week follow-up and 1-year follow-up. Forty-seven per cent of the original sample responded to all time points (staff leaders n = 60; comparison n = 55). Over the course of 1 year, risk trajectories did not differ between groups. Staff leaders did not report significant changes in body mass index, suggesting that they maintained healthy weight over the course of 1 year. Participation as an immersion weight loss programme leader appeared to be protective against weight gain, without increasing eating disorder risk, for healthy young adults. This provides further support for using weight management interventions across a wide range of individuals. PMID:26638779

  13. A rare case of peripheral T-cell lymphoma in 1-year-old child

    PubMed Central

    Kandakumar, Vignesh; Ganesan, Prasanth; Bajpai, Peush; Rajendranath, Rejiv; Tenali, Sagar; Majhi, Urmila; Sivaprakasam, Ponni

    2011-01-01

    Peripheral T-cell lymphoma (PTCL) represents approximately 12% of lymphoid neoplasms. They are even rarer in children and represent only 1% of Non-Hodgkin's lymphoma in this age group. We report a case of PTCL in a 1-year-old female child for its rarity. PMID:22563159

  14. Dialectical Behavior Therapy for Adolescents with Bipolar Disorder: A 1-Year Open Trial

    ERIC Educational Resources Information Center

    Goldstein, Tina R.; Axelson, David A.; Birmaher, Boris; Brent, David A.

    2007-01-01

    Objective: To describe an adapted version of dialectical behavior therapy for adolescents with bipolar disorder. Method: The dialectical behavior therapy intervention is delivered over 1 year and consists of two modalities: family skills training (conducted with individual family units) and individual therapy. The acute treatment period (6 months)…

  15. Levels of Phonological Awareness in Korean and English: A 1-Year Longitudinal Study

    ERIC Educational Resources Information Center

    Cho, Jeung-Ryeul; McBride-Chang, Catherine

    2005-01-01

    The present study examined associations of levels of phonological awareness to word recognition in Korean and English in a 1-year longitudinal study of 91 children from Masan, Korea. With performances on tasks of speeded naming, vocabulary, and Korean Hangul in 2nd grade statistically controlled, only Korean syllable deletion predicted unique…

  16. Verbal Labels Modulate Perceptual Object Processing in 1-Year-Old Children

    ERIC Educational Resources Information Center

    Gliga, Teodora; Volein, Agnes; Csibra, Gergely

    2010-01-01

    Whether verbal labels help infants visually process and categorize objects is a contentious issue. Using electroencephalography, we investigated whether possessing familiar or novel labels for objects directly enhances 1-year-old children's neural processes underlying the perception of those objects. We found enhanced gamma-band (20-60 Hz)…

  17. Latent Classes of Adolescent Posttraumatic Stress Disorder Predict Functioning and Disorder after 1 Year

    ERIC Educational Resources Information Center

    Ayer, Lynsay; Danielson, Carla Kmett; Amstadter, Ananda B.; Ruggiero, Ken; Saunders, Ben; Kilpatrick, Dean

    2011-01-01

    Objective: To identify latent classes of posttraumatic stress disorder (PTSD) symptoms in a national sample of adolescents, and to test their associations with PTSD and functional impairment 1 year later. Method: A total of 1,119 trauma-exposed youth aged 12 through 17 years (mean = 14.99 years, 51% female and 49% male) participating in the…

  18. The relationship between herd level disease incidence and a return over feed index in Ontario dairy herds

    PubMed Central

    McLaren, Chris J.; Lissemore, Kerry D.; Duffield, Todd F.; Leslie, Ken E.; Kelton, David F.; Grexton, Bill

    2006-01-01

    The objective of the current research was to examine the association of herd level disease incidence with the return over feed (ROF) (milk income minus feed cost) herd profit index offered through Canwest Dairy Herd Improvement. The lactational incidence risks (LIR) for displaced abomasum, retained placenta, clinical mastitis, milk fever, clinical ketosis, and lameness submitted by producers (n = 48) were similar to previous reports. However, there was no negative association of clinical disease LIR’s with ROF. Subclinical ketosis and subclinical mastitis cumulative incidence were determined during the early postpartum period by using a cow-side test for betahydroxybutyrate in milk and the California Mastitis Test, respectively. Subclinical mastitis was not associated with ROF. However, a unit increase in the cumulative incidence of subclinical ketosis was associated with a decrease of $0.015/cow/day in the ROF. The results highlight the economic significance that subclinical ketosis may have in Ontario dairy herds. PMID:16933554

  19. Lymphoid neoplasm incidence by WHO subtype in Australia 1982-2006.

    PubMed

    van Leeuwen, Marina T; Turner, Jennifer J; Joske, David J; Falster, Michael O; Srasuebkul, Preeyaporn; Meagher, Nicola S; Grulich, Andrew E; Giles, Graham G; Vajdic, Claire M

    2014-11-01

    There are limited data characterizing the subtype-specific incidence of lymphoid neoplasms in the World Health Organization (WHO) Classification era. Data were obtained on all incident lymphoid neoplasms registered in Australia during 1982-2006. Subtypes were grouped using the InterLymph nested hierarchical classification, based on the 2008 WHO Classification. Temporal trends were examined using Joinpoint regression; average annual percentage change in incidence was computed. Multiple Poisson regression was used to compare incidence by sex and age. The incidence of all non-Hodgkin lymphoma (NHL) increased by 2.5%/year during 1982-1996 and was stable thereafter. During 1997-2006, several mature B- and natural killer (NK)-/T-cell NHL subtypes increased in incidence, including diffuse large B-cell (1.3%/year), follicular (2.5%/year), Burkitt (6.8%/year), marginal zone (13.2%/year), mantle cell (4.2%/year), peripheral T-cell lymphoma (4.7%/year) and plasmacytoma (7.1%/year). While chronic lymphocytic leukemia incidence was stable, small lymphocytic lymphoma incidence declined (8.1%/year). Hodgkin lymphoma (HL) incidence increased during 1997-2006 (2.2%/year), both classical (4.3%/year) and nodular lymphocyte predominant (12.1%/year) HL. Diagnostic artifact, evidenced by a sustained decline in the incidence of NHL not otherwise specified (NOS; 5.8%/year) and lymphoid neoplasms NOS (5.6%/year), limits the interpretation of temporal trends for some subtypes. A marked male predominance was observed for almost all subtypes. Incidence of mature B- and NK-/T-cell NHL subtypes increased sharply with age, except for Burkitt lymphoma/leukemia. For HL subtypes, a bimodal age distribution was only evident for nodular sclerosis HL. Variation in incidence patterns over time and by sex and age supports etiological differences between lymphoid neoplasm subtypes. PMID:24639369

  20. Spiritual absence and 1-year mortality after hematopoietic stem cell transplant.

    PubMed

    Pereira, Deidre B; Christian, Lisa M; Patidar, Seema; Bishop, Michelle M; Dodd, Stacy M; Athanason, Rebecca; Wingard, John R; Reddy, Vijay S

    2010-08-01

    Religiosity and spirituality have been associated with better survival in large epidemiologic studies. This study examined the relationship between spiritual absence and 1-year all-cause mortality in allogeneic hematopoietic stem cell transplant (HSCT) recipients. Depression and problematic compliance were examined as possible mediators of a significant spiritual absence-mortality relationship. Eighty-five adults (mean = 46.85 years old, SD = 11.90 years) undergoing evaluation for allogeneic HSCT had routine psychologie evaluation prior to HSCT admission. The Millon Behavioral Medicine Diagnostic was used to assess spiritual absence, depression, and problematic compliance, the psychosocial predictors of interest. Patient status at 1 year and survival time in days were abstracted from medical records. Cox regression analysis was used to examine the relationship between the psychosocial factors of interest and mortality after adjusting for relevant biobehavioral factors. Twenty-nine percent (n = 25) of participants died within 1 year of HSCT. After covarying for disease type, individuals with the highest spiritual absence and problematic compliance scores were significantly more likely to die 1-year post-HSCT (hazard ratio [HR] = 2.49, P = .043 and HR = 3.74, P = .029, respectively), particularly secondary to infection, sepsis, or graft-versus-host disease (GVHD) (HR = 4.56, P = .01 and HR = 5.61, P = .014), relative to those without elevations on these scales. Depression was not associated with 1-year mortality, and problematic compliance did not mediate the relationship between spiritual absence and mortality. These preliminary results suggest that both spiritual absence and problematic compliance may be associated with poorer survival following HSCT. Future research should examine these relations in a larger sample using a more comprehensive assessment of spirituality. PMID:20227510

  1. Endoscopic sleeve gastroplasty with 1-year follow-up: factors predictive of success

    PubMed Central

    Lopez-Nava, G.; Galvao, M.; Bautista-Castaño, I.; Fernandez-Corbelle, J. P.; Trell, M.

    2016-01-01

    Background and study aims: Bariatric endoscopy has emerged as an aid in the nonsurgical treatment of obesity. The objective of this study is to critically provide the results and follow-up of endoscopic sleeve gastroplasty 1 year after the procedure. Patients and methods: Prospective single-center follow-up study of 25 patients (5 men, 20 women) who underwent flexible endoscopic suturing for endoluminal gastric volume reduction. A multidisciplinary team provided post-procedure care. Patient outcomes were recorded at 1 year after the procedure. Linear regression analysis was done to evaluate the variables associated with best results at 1 year of follow-up. Results: Mean body mass index (BMI) was 38.5 ± 4.6 kg/m2 (range 30 – 47) and mean age 44.5 ± 8.2 years (range 29 – 60). At 1 year, 22 patients continued with the follow-up (2 dropped out at 6 months and 1 at 3 months). There were no major intra-procedural, early, or delayed adverse events. Mean BMI loss was 7.3 ± 4.2 kg/m2, and mean percentage of total body weight loss was 18.7 ± 10.7 at 1 year. In the linear regression analysis, adjusted by initial BMI, variables associated with %TBWL involved the frequency of nutritional (β = 0.563, P = 0.014) and psychological contacts (β = 0.727, P = 0.025). The number of nutritional and psychological contacts were predictive of good weight loss results. Conclusions: Endoscopic sleeve gastroplasty is a feasible, reproducible, and effective procedure to treat obesity. Nutritional and psychological interaction are predictive of success. PMID:26878054

  2. Subclinical Rejection Phenotypes at 1 Year Post-Transplant and Outcome of Kidney Allografts.

    PubMed

    Loupy, Alexandre; Vernerey, Dewi; Tinel, Claire; Aubert, Olivier; Duong van Huyen, Jean-Paul; Rabant, Marion; Verine, Jérôme; Nochy, Dominique; Empana, Jean-Philippe; Martinez, Frank; Glotz, Denis; Jouven, Xavier; Legendre, Christophe; Lefaucheur, Carmen

    2015-07-01

    Kidney allograft rejection can occur in clinically stable patients, but long-term significance is unknown. We determined whether early recognition of subclinical rejection has long-term consequences for kidney allograft survival in an observational prospective cohort study of 1307 consecutive nonselected patients who underwent ABO-compatible, complement-dependent cytotoxicity-negative crossmatch kidney transplantation in Paris (2000-2010). Participants underwent prospective screening biopsies at 1 year post-transplant, with concurrent evaluations of graft complement deposition and circulating anti-HLA antibodies. The main analysis included 1001 patients. Three distinct groups of patients were identified at the 1-year screening: 727 (73%) patients without rejection, 132 (13%) patients with subclinical T cell-mediated rejection (TCMR), and 142 (14%) patients with subclinical antibody-mediated rejection (ABMR). Patients with subclinical ABMR had the poorest graft survival at 8 years post-transplant (56%) compared with subclinical TCMR (88%) and nonrejection (90%) groups (P<0.001). In a multivariate Cox model, subclinical ABMR at 1 year was independently associated with a 3.5-fold increase in graft loss (95% confidence interval, 2.1 to 5.7) along with eGFR and proteinuria (P<0.001). Subclinical ABMR was associated with more rapid progression to transplant glomerulopathy. Of patients with subclinical TCMR at 1 year, only those who further developed de novo donor-specific antibodies and transplant glomerulopathy showed higher risk of graft loss compared with patients without rejection. Our findings suggest that subclinical TCMR and subclinical ABMR have distinct effects on long-term graft loss. Subclinical ABMR detected at the 1-year screening biopsy carries a prognostic value independent of initial donor-specific antibody status, previous immunologic events, current eGFR, and proteinuria. PMID:25556173

  3. Sinusoidal obstruction syndrome after allogeneic hematopoietic stem cell transplantation: Incidence, risk factors and outcomes.

    PubMed

    Yakushijin, K; Atsuta, Y; Doki, N; Yokota, A; Kanamori, H; Miyamoto, T; Ohwada, C; Miyamura, K; Nawa, Y; Kurokawa, M; Mizuno, I; Mori, T; Onizuka, M; Taguchi, J; Ichinohe, T; Yabe, H; Morishima, Y; Kato, K; Suzuki, R; Fukuda, T

    2016-03-01

    This retrospective study was conducted in Japan to determine the incidence, risk factors and outcomes of sinusoidal obstruction syndrome (SOS) after allogeneic hematopoietic stem cell transplantation (HSCT). Among 4290 patients undergoing allogeneic HSCT between 1999 and 2010, 462 were diagnosed with SOS according to the Seattle criteria (cumulative incidence, 10.8%). The cumulative incidence of SOS diagnosed by the modified Seattle criteria was 9.3%. Of 462 patients, 107 met the Baltimore criteria and 168 had severe SOS with renal and/or respiratory failure. The median onset for SOS was 12 days after HSCT (range, -2-30). Overall survival at day 100 was 32% for SOS and 15% for severe SOS. Multivariate analyses showed that significant independent risk factors for SOS were the number of HSCTs, age, performance status, hepatitis C virus-seropositivity, advanced disease status and myeloablative regimen. SOS was highly associated with overall mortality (hazard ratio, 2.09; P<0.001). Our retrospective survey showed that the cumulative incidence of SOS in Japan was 10.8%, similar to that previously reported in Western countries, and that the overall survival of patients who developed SOS was low. Furthermore, several risk factors were identified. Preventive and therapeutic strategies for high-risk SOS patients must be established to improve overall survival. PMID:26595082

  4. Hypoparathyroidism after Total Thyroidectomy: Incidence and Resolution

    PubMed Central

    Ritter, Kathryn; Elfenbein, Dawn; Schneider, David; Chen, Herbert; Sippel, Rebecca S.

    2015-01-01

    Background Parathyroid hormone (PTH) levels are often measured after thyroid surgery and are used to detect patients at risk for postoperative hypoparathyroidism. However, there is a lack of consensus in the literature about how to define the recovery of parathyroid gland function and when to classify hypoparathyroidism as permanent. The goals of this study were to determine the incidence of low postoperative PTH in total thyroidectomy patients and to monitor their time course to recovery of parathyroid gland function. Methods We identified 1054 consecutive patients who underwent a total or completion thyroidectomy from 1/2006 to 12/2013. Low PTH was defined as a PTH measurement <10 pg/mL immediately after surgery. Patients were considered to be permanently hypoparathyroid if they had not recovered within 1 year. Recovery of parathyroid gland function was defined as PTH ≥10 pg/mL and no need for therapeutic calcium or activated vitamin D (calcitriol) supplementation to prevent hypocalcemic symptoms. Results Of 1054 total thyroidectomy patients, 189 (18%) had a postoperative PTH <10 pg/mL. Of those 189 patients, 132 (70%) showed resolution within 2 months of surgery. Notably, 9 (5%) resolved between 6–12 months. At 1 year, 20 (1.9%) were considered to have permanent hypoparathyroidism. Surprisingly, 50% of those patients had recovery of PTH levels yet still required supplementation to avoid symptoms. Conclusions Most patients with a low postoperative PTH recover function quickly, but it can take up to 1 year for full resolution. Hypoparathyroidism needs to be defined not only by PTH levels, but also by medication requirements. PMID:25982044

  5. The three-year incidence of fracture in chronic kidney disease.

    PubMed

    Naylor, Kyla L; McArthur, Eric; Leslie, William D; Fraser, Lisa-Ann; Jamal, Sophie A; Cadarette, Suzanne M; Pouget, Jennie G; Lok, Charmaine E; Hodsman, Anthony B; Adachi, Jonathan D; Garg, Amit X

    2014-10-01

    Knowing a person's fracture risk according to their kidney function, gender, and age may influence clinical management and decision-making. Using healthcare databases from Ontario, Canada, we conducted a cohort study of 679,114 adults of 40 years and over (mean age 62 years) stratified at cohort entry by estimated glomerular filtration rate ((eGFR) 60 and over, 45-59, 30-44, 15-29, and under 15 ml/min per 1.73 m(2)), gender, and age (40-65 and over 65 years). The primary outcome was the 3-year cumulative incidence of fracture (proportion of adults who fractured (hip, forearm, pelvis, or proximal humerus) at least once within 3-years of follow-up). Additional analyses examined the fracture incidence per 1000 person-years, hip fracture alone, stratification by prior fracture, stratification by eGFR and proteinuria, and 3-year cumulative incidence of falls with hospitalization. The 3-year cumulative incidence of fracture significantly increased in a graded manner in adults with a lower eGFR for both genders and both age groups. The 3-year cumulative incidence of fracture in women over 65 years of age across the 5 eGFR groups were 4.3%, 5.8%, 6.5%, 7.8%, and 9.6%, respectively. Corresponding estimates for men over 65 years were 1.6%, 2.0%, 2.7%, 3.8%, and 5.0%, respectively. Similar graded relationships were found for falls with hospitalization and additional analyses. Thus, many adults with chronic kidney disease will fall and fracture. Results can be used for prognostication and guidance of sample size requirements for fracture prevention trials. PMID:24429401

  6. Is uveitis associated with topiramate use? A cumulative review

    PubMed Central

    Goldberg, Jeffrey L; Lau, Amy G; Fan, Bo; Ford, Lisa; Greenberg, Howard E

    2016-01-01

    Occasional reports of uveitis following topiramate use necessitated an investigation of relevant cases from safety databases and published biomedical literature. Data mining of the Food and Drug Administration Adverse Event Reporting System and cumulative review of cases from the global safety database (sponsor database) and published literature were conducted to assess association between topiramate use and uveitis. The Food and Drug Administration Adverse Event Reporting System search identified disproportional reporting of uveitis (n=23) and related terms (choroidal detachment, n=25; iridocyclitis, n=17). The postmarketing reporting frequency of uveitis and related events from the global safety database and based on an estimated topiramate exposure of 11,185,740 person-years from launch to April 2015 was 0.38 per 100,000 person-years and assigned as very rare. A total of 14 potential uveitis cases were identified from the cumulative review. Seven of these 14 cases were complicated by inadequate documentation, appearance of uveitic signs following drug withdrawal, or concurrent use of other sulfonamides. In acute angle-closure glaucoma and uveal effusions cases, insufficient evidence for underlying inflammation suggested that uveitis was not a component. Only seven of 14 cases were well documented, potentially topiramate-associated uveitis cases. Uveitis may occur in the setting of topiramate use only in very rare instances. Current evidence did not reveal a dose- or duration-dependent relationship between uveitis and topiramate use. PMID:27536060

  7. Estimating cumulative effects of clearcutting on stream temperatures

    USGS Publications Warehouse

    Bartholow, J.M.

    2000-01-01

    The Stream Segment Temperature Model was used to estimate cumulative effects of large-scale timber harvest on stream temperature. Literature values were used to create parameters for the model for two hypothetical situations, one forested and the other extensively clearcut. Results compared favorably with field studies of extensive forest canopy removal. The model provided insight into the cumulative effects of clearcutting. Change in stream shading was, as expected, the most influential factor governing increases in maximum daily water temperature, accounting for 40% of the total increase. Altered stream width was found to be more influential than changes to air temperature. Although the net effect from clearcutting was a 4oC warming, increased wind and reduced humidity tended to cool the stream. Temperature increases due to clearcutting persisted 10 km downstream into an unimpacted forest segment of the hypothetical stream, but those increases were moderated by cooler equilibrium conditions downstream. The model revealed that it is a complex set of factors, not single factors such as shade or air temperature, that governs stream temperature dynamics.

  8. Documentation of cumulative impacts in environmental impact statements

    SciTech Connect

    Cooper, T.A.; Canter, L.W.

    1997-11-01

    The National Environmental Policy Act (NEPA) of 1969 and the Council on Environmental Quality (CEQ) regulations in the United States require federal agencies to apply an environmental impact assessment (EIA) in decision-making related to their actions. One aspect requires an examination of direct, indirect and cumulative impacts (CIs). Historically, cumulative impact assessment (CIA) has been given limited attention in EIA and resultant environmental impact statements (EISs), not because of its lack of importance, but owing to limitations in methodologies and procedures, including documentation consistency. The objectives of this study were to identify deficiencies in the documentation of CIs and CIA in EISs and to formulate appropriate recommendations (potential solutions) related to such deficiencies. The study involved the systematic review of 33 EISs. The results indicate that improvements have been made in documentation practices since 1990; however, inconsistencies and inadequacies still exist. Therefore, the following recommendations were developed: (1) CIs should be reported in a separate part of the Environmental Consequences section, and they should be addressed for each pertinent environmental resource; (2) a summary of CIs should be included; (3) any CIs considered not significant should be mentioned plus the reason(s) for their non-significance; (4) spatial and temporal boundaries addressed within the CIA process should be defined for pertinent environmental resources; and (5) utilized guidelines and methodologies should be described.

  9. Fatigue Life Estimation under Cumulative Cyclic Loading Conditions

    NASA Technical Reports Server (NTRS)

    Kalluri, Sreeramesh; McGaw, Michael A; Halford, Gary R.

    1999-01-01

    The cumulative fatigue behavior of a cobalt-base superalloy, Haynes 188 was investigated at 760 C in air. Initially strain-controlled tests were conducted on solid cylindrical gauge section specimens of Haynes 188 under fully-reversed, tensile and compressive mean strain-controlled fatigue tests. Fatigue data from these tests were used to establish the baseline fatigue behavior of the alloy with 1) a total strain range type fatigue life relation and 2) the Smith-Wastson-Topper (SWT) parameter. Subsequently, two load-level multi-block fatigue tests were conducted on similar specimens of Haynes 188 at the same temperature. Fatigue lives of the multi-block tests were estimated with 1) the Linear Damage Rule (LDR) and 2) the nonlinear Damage Curve Approach (DCA) both with and without the consideration of mean stresses generated during the cumulative fatigue tests. Fatigue life predictions by the nonlinear DCA were much closer to the experimentally observed lives than those obtained by the LDR. In the presence of mean stresses, the SWT parameter estimated the fatigue lives more accurately under tensile conditions than under compressive conditions.

  10. A cumulant functional for static and dynamic correlation.

    PubMed

    Hollett, Joshua W; Hosseini, Hessam; Menzies, Cameron

    2016-08-28

    A functional for the cumulant energy is introduced. The functional is composed of a pair-correction and static and dynamic correlation energy components. The pair-correction and static correlation energies are functionals of the natural orbitals and the occupancy transferred between near-degenerate orbital pairs, rather than the orbital occupancies themselves. The dynamic correlation energy is a functional of the statically correlated on-top two-electron density. The on-top density functional used in this study is the well-known Colle-Salvetti functional. Using the cc-pVTZ basis set, the functional effectively models the bond dissociation of H2, LiH, and N2 with equilibrium bond lengths and dissociation energies comparable to those provided by multireference second-order perturbation theory. The performance of the cumulant functional is less impressive for HF and F2, mainly due to an underestimation of the dynamic correlation energy by the Colle-Salvetti functional. PMID:27586903

  11. The Cumulative Effect of Vacuum Radiation on Particle Coordinates

    SciTech Connect

    Burns, Jean E.

    2010-12-22

    The action principle can predict the trajectories of a system of particles as determined by the dynamical forces acting on them. However, its predictions do not include the results of quantum fluctuations in the coordinates of the particles. It is proposed that quantum fluctuations shift the particles from one dynamical trajectory to another and that the change in action due to a root mean square shift in an individual coordinate is the same, regardless of which coordinate is shifted. This assumption, together with the uncertainty principle, implies that the cumulative effect of changes in energy and momentum varies as t{sup -1/2}, where t is time, so that these quantities tend to be conserved. However, the cumulative effect of changes in spatial coordinate varies as t{sup 1/2}, so this coordinate shows a Brownian drift over time. An example is given in which this stochastic drift, with its characteristic t{sup 1/2} dependence, could be experimentally observed at the beginning of a highly collimated particle beam.

  12. Cumulative phase delay imaging for contrast-enhanced ultrasound tomography.

    PubMed

    Demi, Libertario; van Sloun, Ruud J G; Wijkstra, Hessel; Mischi, Massimo

    2015-11-01

    Standard dynamic-contrast enhanced ultrasound (DCE-US) imaging detects and estimates ultrasound-contrast-agent (UCA) concentration based on the amplitude of the nonlinear (harmonic) components generated during ultrasound (US) propagation through UCAs. However, harmonic components generation is not specific to UCAs, as it also occurs for US propagating through tissue. Moreover, nonlinear artifacts affect standard DCE-US imaging, causing contrast to tissue ratio reduction, and resulting in possible misclassification of tissue and misinterpretation of UCA concentration. Furthermore, no contrast-specific modality exists for DCE-US tomography; in particular speed-of-sound changes due to UCAs are well within those caused by different tissue types. Recently, a new marker for UCAs has been introduced. A cumulative phase delay (CPD) between the second harmonic and fundamental component is in fact observable for US propagating through UCAs, and is absent in tissue. In this paper, tomographic US images based on CPD are for the first time presented and compared to speed-of-sound US tomography. Results show the applicability of this marker for contrast specific US imaging, with cumulative phase delay imaging (CPDI) showing superior capabilities in detecting and localizing UCA, as compared to speed-of-sound US tomography. Cavities (filled with UCA) which were down to 1 mm in diameter were clearly detectable. Moreover, CPDI is free of the above mentioned nonlinear artifacts. These results open important possibilities to DCE-US tomography, with potential applications to breast imaging for cancer localization. PMID:26459771

  13. Challenges in Preparation of Cumulative Antibiogram Reports for Community Hospitals

    PubMed Central

    Hazen, Kevin C.; Hawkins, Myra R.; Drew, Richard H.; Sexton, Daniel J.; Anderson, Deverick J.

    2015-01-01

    Knowledge of local antimicrobial resistance is critical for management of infectious diseases. Community hospitals' compliance with Clinical and Laboratory Standards Institute (CLSI) guidance for creation of cumulative antibiograms is uncertain. This descriptive cohort study of antibiogram reporting practices included community hospitals enrolled in the Duke Infection Control Outreach Network. Cumulative antibiograms from 2012 were reviewed for criteria on reporting practices and compliance with CLSI guidelines. Microbiology personnel were sent a voluntary, electronic survey on antibiogram preparation practices. Data were compiled using descriptive statistics. Thirty-two of 37 (86%) hospitals provided antibiograms; 26 of 37 (70%) also provided survey responses. Twelve (38%) antibiograms specified methods used for compiling data and exclusion of duplicates. Eight (25%) reported only species with >30 isolates. Of the 24 that did not follow the 30-isolate rule, 3 (13%) included footnotes to indicate impaired statistical validity. Twenty (63%) reported at least 1 pathogen-drug combination not recommended for primary or supplemental testing per CLSI. Thirteen (41%) separately reported methicillin-resistant and -susceptible Staphylococcus aureus. Complete compliance with CLSI guidelines was observed in only 3 (9%) antibiograms. Survey respondents' self-assessment of full or partial compliance with CLSI guidelines was 50% and 15%, respectively; 33% reported uncertainty with CLSI guidelines. Full adherence to CLSI guidelines for hospital antibiograms was uncommon. Uncertainty about CLSI guidelines was common. Alternate strategies, such as regional antibiograms using pooled data and educational outreach efforts, are needed to provide reliable and appropriate susceptibility estimates for community hospitals. PMID:26179303

  14. Cumulative theoretical uncertainties in lithium depletion boundary age

    NASA Astrophysics Data System (ADS)

    Tognelli, E.; Prada Moroni, P. G.; Degl'Innocenti, S.

    2015-06-01

    We performed a detailed analysis of the main theoretical uncertainties affecting the age at the lithium depletion boundary (LDB). To do that we computed almost 12 000 pre-main-sequence models with mass in the range [0.06, 0.4] M⊙ by varying input physics (nuclear reaction cross-sections, plasma electron screening, outer boundary conditions, equation of state, and radiative opacity), initial chemical elements abundances (total metallicity, helium and deuterium abundances, and heavy elements mixture), and convection efficiency (mixing length parameter, αML). As a first step, we studied the effect of varying these quantities individually within their extreme values. Then, we analysed the impact of simultaneously perturbing the main input/parameters without an a priori assumption of independence. Such an approach allowed us to build for the first time the cumulative error stripe, which defines the edges of the maximum uncertainty region in the theoretical LDB age. We found that the cumulative error stripe is asymmetric and dependent on the adopted mixing length value. For αML = 1.00, the positive relative age error ranges from 5 to 15 per cent, while for solar-calibrated mixing length, the uncertainty reduces to 5-10 per cent. A large fraction of such an error (≈40 per cent) is due to the uncertainty in the adopted initial chemical elements abundances.

  15. Cumulative phase delay imaging for contrast-enhanced ultrasound tomography

    NASA Astrophysics Data System (ADS)

    Demi, Libertario; van Sloun, Ruud J. G.; Wijkstra, Hessel; Mischi, Massimo

    2015-11-01

    Standard dynamic-contrast enhanced ultrasound (DCE-US) imaging detects and estimates ultrasound-contrast-agent (UCA) concentration based on the amplitude of the nonlinear (harmonic) components generated during ultrasound (US) propagation through UCAs. However, harmonic components generation is not specific to UCAs, as it also occurs for US propagating through tissue. Moreover, nonlinear artifacts affect standard DCE-US imaging, causing contrast to tissue ratio reduction, and resulting in possible misclassification of tissue and misinterpretation of UCA concentration. Furthermore, no contrast-specific modality exists for DCE-US tomography; in particular speed-of-sound changes due to UCAs are well within those caused by different tissue types. Recently, a new marker for UCAs has been introduced. A cumulative phase delay (CPD) between the second harmonic and fundamental component is in fact observable for US propagating through UCAs, and is absent in tissue. In this paper, tomographic US images based on CPD are for the first time presented and compared to speed-of-sound US tomography. Results show the applicability of this marker for contrast specific US imaging, with cumulative phase delay imaging (CPDI) showing superior capabilities in detecting and localizing UCA, as compared to speed-of-sound US tomography. Cavities (filled with UCA) which were down to 1 mm in diameter were clearly detectable. Moreover, CPDI is free of the above mentioned nonlinear artifacts. These results open important possibilities to DCE-US tomography, with potential applications to breast imaging for cancer localization.

  16. Cumulative impacts of mountaintop mining on an Appalachian watershed.

    PubMed

    Lindberg, T Ty; Bernhardt, Emily S; Bier, Raven; Helton, A M; Merola, R Brittany; Vengosh, Avner; Di Giulio, Richard T

    2011-12-27

    Mountaintop mining is the dominant form of coal mining and the largest driver of land cover change in the central Appalachians. The waste rock from these surface mines is disposed of in the adjacent river valleys, leading to a burial of headwater streams and dramatic increases in salinity and trace metal concentrations immediately downstream. In this synoptic study we document the cumulative impact of more than 100 mining discharge outlets and approximately 28 km(2) of active and reclaimed surface coal mines on the Upper Mud River of West Virginia. We measured the concentrations of major and trace elements within the tributaries and the mainstem and found that upstream of the mines water quality was equivalent to state reference sites. However, as eight separate mining-impacted tributaries contributed their flow, conductivity and the concentrations of selenium, sulfate, magnesium, and other inorganic solutes increased at a rate directly proportional to the upstream areal extent of mining. We found strong linear correlations between the concentrations of these contaminants in the river and the proportion of the contributing watershed in surface mines. All tributaries draining mountaintop-mining-impacted catchments were characterized by high conductivity and increased sulfate concentration, while concentrations of some solutes such as Se, Sr, and N were lower in the two tributaries draining reclaimed mines. Our results demonstrate the cumulative impact of multiple mines within a single catchment and provide evidence that mines reclaimed nearly two decades ago continue to contribute significantly to water quality degradation within this watershed. PMID:22160676

  17. A Cumulant-based Analysis of Nonlinear Magnetospheric Dynamics

    SciTech Connect

    Jay R. Johnson; Simon Wing

    2004-01-28

    Understanding magnetospheric dynamics and predicting future behavior of the magnetosphere is of great practical interest because it could potentially help to avert catastrophic loss of power and communications. In order to build good predictive models it is necessary to understand the most critical nonlinear dependencies among observed plasma and electromagnetic field variables in the coupled solar wind/magnetosphere system. In this work, we apply a cumulant-based information dynamical measure to characterize the nonlinear dynamics underlying the time evolution of the Dst and Kp geomagnetic indices, given solar wind magnetic field and plasma input. We examine the underlying dynamics of the system, the temporal statistical dependencies, the degree of nonlinearity, and the rate of information loss. We find a significant solar cycle dependence in the underlying dynamics of the system with greater nonlinearity for solar minimum. The cumulant-based approach also has the advantage that it is reliable even in the case of small data sets and therefore it is possible to avoid the assumption of stationarity, which allows for a measure of predictability even when the underlying system dynamics may change character. Evaluations of several leading Kp prediction models indicate that their performances are sub-optimal during active times. We discuss possible improvements of these models based on this nonparametric approach.

  18. Increasing Parity Is Associated with Cumulative Effects on Memory

    PubMed Central

    2012-01-01

    Abstract Background The purpose of this investigation was to determine if reproductive experience is associated with cumulative effects on human memory performance during pregnancy and if these effects persist into the postpartum period. Methods Verbal recall memory performance was assessed in 254 women four times during pregnancy and at 3 months postpartum. The relation between parity and memory function was evaluated with hierarchical linear modeling and analysis of covariance (ANCOVA). Results The data indicate that the previously documented adverse effects of pregnancy on memory performance are compounded with successive pregnancies. During gestation and postpartum, multiparity was associated with poorer memory function, and these effects did not appear to be due to differences in maternal demographics, depressive symptoms, or sleep quality. Conclusions Animal models demonstrate that the effects of reproduction on brain structure and function are both cumulative and enduring. However, little is known about the influence of reproductive experience on the human female brain. These findings provide evidence that in humans, reproduction is associated with striking and perhaps persisting changes in cognitive function. PMID:23036056

  19. Cumulative impacts of mountaintop mining on an Appalachian watershed

    PubMed Central

    Lindberg, T. Ty; Bernhardt, Emily S.; Bier, Raven; Helton, A. M.; Merola, R. Brittany; Vengosh, Avner; Di Giulio, Richard T.

    2011-01-01

    Mountaintop mining is the dominant form of coal mining and the largest driver of land cover change in the central Appalachians. The waste rock from these surface mines is disposed of in the adjacent river valleys, leading to a burial of headwater streams and dramatic increases in salinity and trace metal concentrations immediately downstream. In this synoptic study we document the cumulative impact of more than 100 mining discharge outlets and approximately 28 km2 of active and reclaimed surface coal mines on the Upper Mud River of West Virginia. We measured the concentrations of major and trace elements within the tributaries and the mainstem and found that upstream of the mines water quality was equivalent to state reference sites. However, as eight separate mining-impacted tributaries contributed their flow, conductivity and the concentrations of selenium, sulfate, magnesium, and other inorganic solutes increased at a rate directly proportional to the upstream areal extent of mining. We found strong linear correlations between the concentrations of these contaminants in the river and the proportion of the contributing watershed in surface mines. All tributaries draining mountaintop-mining-impacted catchments were characterized by high conductivity and increased sulfate concentration, while concentrations of some solutes such as Se, Sr, and N were lower in the two tributaries draining reclaimed mines. Our results demonstrate the cumulative impact of multiple mines within a single catchment and provide evidence that mines reclaimed nearly two decades ago continue to contribute significantly to water quality degradation within this watershed. PMID:22160676

  20. Is uveitis associated with topiramate use? A cumulative review.

    PubMed

    Goldberg, Jeffrey L; Lau, Amy G; Fan, Bo; Ford, Lisa; Greenberg, Howard E

    2016-01-01

    Occasional reports of uveitis following topiramate use necessitated an investigation of relevant cases from safety databases and published biomedical literature. Data mining of the Food and Drug Administration Adverse Event Reporting System and cumulative review of cases from the global safety database (sponsor database) and published literature were conducted to assess association between topiramate use and uveitis. The Food and Drug Administration Adverse Event Reporting System search identified disproportional reporting of uveitis (n=23) and related terms (choroidal detachment, n=25; iridocyclitis, n=17). The postmarketing reporting frequency of uveitis and related events from the global safety database and based on an estimated topiramate exposure of 11,185,740 person-years from launch to April 2015 was 0.38 per 100,000 person-years and assigned as very rare. A total of 14 potential uveitis cases were identified from the cumulative review. Seven of these 14 cases were complicated by inadequate documentation, appearance of uveitic signs following drug withdrawal, or concurrent use of other sulfonamides. In acute angle-closure glaucoma and uveal effusions cases, insufficient evidence for underlying inflammation suggested that uveitis was not a component. Only seven of 14 cases were well documented, potentially topiramate-associated uveitis cases. Uveitis may occur in the setting of topiramate use only in very rare instances. Current evidence did not reveal a dose- or duration-dependent relationship between uveitis and topiramate use. PMID:27536060

  1. Assessing the cumulative effects of projects using geographic information systems

    SciTech Connect

    Atkinson, Samuel F.; Canter, Larry W.

    2011-09-15

    Systems that allow users to store and retrieve spatial data, provide for analyses of spatial data, and offer highly detailed display of spatial data are referred to as geographic information systems, or more typically, GIS. Since their initial usage in the 1960s, GISs have evolved as a means of assembling and analyzing diverse data pertaining to specific geographical areas, with spatial locations of the data serving as the organizational basis for the information systems. The structure of GISs is built around spatial identifiers and the methods used to encode data for storage and manipulation. This paper examines how GIS has been used in typical environmental assessment, its use for cumulative impact assessment, and explores litigation that occurred in the United States Federal court system where GIS was used in some aspect of cumulative effects. The paper also summarizes fifteen case studies that range from area wide transportation planning to wildlife and habitat impacts, and draws together a few lessons learned from this review of literature and litigation.

  2. Cumulative genetic risk and prefrontal activity in patients with schizophrenia.

    PubMed

    Walton, Esther; Turner, Jessica; Gollub, Randy L; Manoach, Dara S; Yendiki, Anastasia; Ho, Beng-Choon; Sponheim, Scott R; Calhoun, Vince D; Ehrlich, Stefan

    2013-05-01

    The lack of consistency of genetic associations in highly heritable mental illnesses, such as schizophrenia, remains a challenge in molecular psychiatry. Because clinical phenotypes for psychiatric disorders are often ill defined, considerable effort has been made to relate genetic polymorphisms to underlying physiological aspects of schizophrenia (so called intermediate phenotypes), that may be more reliable. Given the polygenic etiology of schizophrenia, the aim of this work was to form a measure of cumulative genetic risk and study its effect on neural activity during working memory (WM) using functional magnetic resonance imaging. Neural activity during the Sternberg Item Recognition Paradigm was measured in 79 schizophrenia patients and 99 healthy controls. Participants were genotyped, and a genetic risk score (GRS), which combined the additive effects of 41 single-nucleotide polymorphisms (SNPs) from 34 risk genes for schizophrenia, was calculated. These risk SNPs were chosen according to the continuously updated meta-analysis of genetic studies on schizophrenia available at www.schizophreniaresearchforum.org. We found a positive relationship between GRS and left dorsolateral prefrontal cortex inefficiency during WM processing. GRS was not correlated with age, performance, intelligence, or medication effects and did not differ between acquisition sites, gender, or diagnostic groups. Our study suggests that cumulative genetic risk, combining the impact of many genes with small effects, is associated with a known brain-based intermediate phenotype for schizophrenia. The GRS approach could provide an advantage over studying single genes in studies focusing on the genetic basis of polygenic conditions such as neuropsychiatric disorders. PMID:22267534

  3. Bladder cancer incidence among workers exposed to o-toluidine, aniline and nitrobenzene at a rubber chemical manufacturing plant

    PubMed Central

    Carreón, Tania; Hein, Misty J; Hanley, Kevin W; Viet, Susan M; Ruder, Avima M

    2015-01-01

    Background An earlier investigation found increased bladder cancer incidence among workers at a rubber chemical manufacturing plant that used o-toluidine, aniline and nitrobenzene. The cohort was expanded to include additional workers (n=1875) and updated through 2007 to assess bladder cancer with improved exposure characterisation. Methods Work histories were updated and exposure categories and ranks were developed for o-toluidine, aniline and nitrobenzene combined. Incident cancers were identified by linkage to six state cancer registries. Residency in time-dependent cancer registry catchment areas was determined. SIR and standardised rate ratios for bladder cancer were calculated by exposure category and cumulative rank quartiles for different lag periods. Cox regression was used to model bladder cancer incidence with estimated cumulative rank, adjusting for confounders. Indirect methods were used to control for smoking. Results Excess bladder cancer was observed compared to the New York State population (SIR=2.87, 95% CI 2.02 to 3.96), with higher elevations among workers definitely exposed (moderate/high) (SIR=3.90, 95% CI 2.57 to 5.68), and in the highest cumulative rank quartile (SIR=6.13, 95% CI 2.80 to 11.6, 10-year lag). Bladder cancer rates increased significantly with estimated cumulative rank (10-year lag). Smoking only accounted for an estimated 8% elevation in bladder cancer incidence. Conclusions Bladder cancer incidence remains elevated in this cohort and significantly associated with estimated cumulative exposure. Results are consistent with earlier findings in this and other cohorts. Despite other concurrent chemical exposures, we consider o-toluidine most likely responsible for the bladder cancer incidence elevation and recommend a re-examination of occupational exposure limits. PMID:24368697

  4. Differences in Autism Spectrum Disorders Incidence by Sub-Populations in Israel 1992-2009: A Total Population Study

    ERIC Educational Resources Information Center

    Raz, Raanan; Weisskopf, Marc G.; Davidovitch, Michael; Pinto, Ofir; Levine, Hagai

    2015-01-01

    We analyzed data from the Israeli National Insurance Institute (NII). Autism Spectrum Disorder (ASD) incidence was calculated for all children born in Israel 1992-2009, and by population groups. Overall, 9,109 ASD cases among 2,431,649 children were identified. ASD cumulative incidence by age 8 years increased 10-fold during 2000-2011, from 0.49 %…

  5. Incidence and predictors of smokeless tobacco use among US youth.

    PubMed Central

    Tomar, S L; Giovino, G A

    1998-01-01

    OBJECTIVES: The purpose of this study was to provide estimates of the cumulative incidence of initiation of smokeless tobacco use in a cohort of young persons and to explore sociodemographic, environmental, behavioral, and personal predictors of experimentation with and regular use of snuff or chewing tobacco. METHODS: The data for this cohort study were derived from the 1989 Teenage Attitudes and Practices Survey and its 1993 follow-up. The study included 7830 young people 11 through 19 years of age at baseline. RESULTS: During the 4 years, 12.7% of participants (20.9% of male participants) first tried smokeless tobacco, and 4.0% (8.0% of male participants) became self-classified regular users. This suggests that, each year, approximately 824000 young people in the United States 11 to 19 years of age experiment with smokeless tobacco and about 304 000 become regular users. Cumulative incidence was highest for male non-Hispanic Whites. Predictors of regular use included age, geographic region, cigarette smoking, participation in organized sports, and perceived friends' approval or indifference. CONCLUSIONS: Public health approaches to preventing use of smokeless tobacco should include development of skills for responding to pressures to use tobacco. PMID:9584028

  6. The 10-year Incidence of Tinnitus Among Older Adults

    PubMed Central

    Nondahl, DM; Cruickshanks, KJ; Wiley, TL; Klein, BEK; Klein, R; Chappell, R; Tweed, TS

    2010-01-01

    As part of a population-based study in Beaver Dam, Wisconsin, we estimated the 10-year cumulative incidence of tinnitus and its risk factors. Participants (n = 2922, aged 48–92 years) not reporting tinnitus at baseline (1993–1995) were followed for up to ten years. In addition to audiometric testing and anthropometric measures, data on tinnitus, health and other history were obtained via questionnaire. Potential risk factors were assessed with discrete-time proportional hazards models. The 10-year cumulative incidence of tinnitus was 12.7%. The risk of developing tinnitus was significantly associated with: history of arthritis (Hazard ratio (HR) = 1.37), history of head injury (HR = 1.76), history of ever smoking (HR = 1.40), and among women, hearing loss (HR = 2.59). Alcohol consumption (HR = 0.63 for ≥ 141 grams/week vs. < 15 grams/week), age (among women, HR = 0.90 for each 5-year increase in age), and among men, obesity (HR = 0.55), were associated with decreased risk. The risk of developing tinnitus was high for older adults and associated with modifiable health and behavioral factors. PMID:20560859

  7. Oral cancer incidence and mortality in China, 2011

    PubMed Central

    Zhang, Shao-Kai; Zheng, Rongshou; Chen, Qiong; Zhang, Siwei

    2015-01-01

    Objective To descript the incidence and mortality rates of oral cancer among Chinese population in 2011, and provide valuable data for oral cancer prevention and research. Methods Data from 177 population-based cancer registries distributed in 28 provinces were accepted for this study after evaluation based on quality control criteria, covering a total of 175,310,169 populations and accounting for 13.01% of the overall national population in 2011. Incidence and mortality rates were calculated by area, gender and age groups. The numbers of new cases and deaths were estimated using the 5-year age-specific cancer incidence/mortality rates and the corresponding populations. The Chinese population in 2000 and World Segi’s population were used for age-standardized rates. Results The estimate of new cases diagnosed with oral cancer was 39,450 including 26,160 males and 13,290 females. The overall crude incidence rate for oral cancer was 2.93/100,000. The age-standardized rates by China (ASRCN) population and by World population (ASRwld) were 2.22/100,000 and 2.17/100,000, respectively. Among subjects aged 0-74 years, the cumulative incidence rate was 0.25%. The estimated number of oral cancer deaths of China in 2011 was 16,933, including 11,794 males and 5,139 females. The overall crude mortality rate was 1.26/100,000, accounting for 0.80% of all cancer deaths. The ASRCN and ASRwld for mortality were 0.90/100,000 and 0.89/100,000, respectively. Among subjects aged 0-74 years, the cumulative mortality rate was 0.10%. The incidence and mortality rates of oral cancer were much higher in males and urban areas than in females and rural areas. In addition, the incidence and mortality rates were increased by the raising of ages. Conclusions Results in the study may have important roles for oral cancer prevention and research. Although oral cancer burden of China is not high, we must pay attention to this malignancy as well. In addition, further researches need to be done for

  8. Delay Adjusted Incidence Infographic

    Cancer.gov

    This Infographic shows the National Cancer Institute SEER Incidence Trends. The graphs show the Average Annual Percent Change (AAPC) 2002-2011. For Men, Thyroid: 5.3*,Liver & IBD: 3.6*, Melanoma: 2.3*, Kidney: 2.0*, Myeloma: 1.9*, Pancreas: 1.2*, Leukemia: 0.9*, Oral Cavity: 0.5, Non-Hodgkin Lymphoma: 0.3*, Esophagus: -0.1, Brain & ONS: -0.2*, Bladder: -0.6*, All Sites: -1.1*, Stomach: -1.7*, Larynx: -1.9*, Prostate: -2.1*, Lung & Bronchus: -2.4*, and Colon & Rectum: -3/0*. For Women, Thyroid: 5.8*, Liver & IBD: 2.9*, Myeloma: 1.8*, Kidney: 1.6*, Melanoma: 1.5, Corpus & Uterus: 1.3*, Pancreas: 1.1*, Leukemia: 0.6*, Brain & ONS: 0, Non-Hodgkin Lymphoma: -0.1, All Sites: -0.1, Breast: -0.3, Stomach: -0.7*, Oral Cavity: -0.7*, Bladder: -0.9*, Ovary: -0.9*, Lung & Bronchus: -1.0*, Cervix: -2.4*, and Colon & Rectum: -2.7*. * AAPC is significantly different from zero (p<.05). Rates were adjusted for reporting delay in the registry. www.cancer.gov Source: Special section of the Annual Report to the Nation on the Status of Cancer, 1975-2011.

  9. Incidence and risk factors of chronic thromboembolic pulmonary hypertension in patients after acute pulmonary embolism

    PubMed Central

    Yang, Suqiao; Yang, Yuanhua; Zhai, Zhenguo; Kuang, Tuguang; Gong, Juanni; Zhang, Shuai; Zhu, Jianguo; Liang, Lirong; Shen, Ying H.

    2015-01-01

    Background Early identification and treatment of chronic thromboembolic pulmonary hypertension (CTEPH) are critical to prevent disease progression. We determined the incidence and risk factors for CTEPH in patients with a first episode of acute pulmonary embolism (PE). Methods In this study, consecutive patients with first-episode acute PE were followed for ≤5 years. Pulmonary hypertension (PH) was screened for by echocardiography. Suspected cases were evaluated by right heart catheterization (RHC) and pulmonary angiography (PA). If invasive procedures were not permitted, PH was diagnosed by systolic pulmonary artery pressure (SPAP) >50 mmHg. Diagnosis of CTEPH was confirmed by PA, ventilation/perfusion (V/Q) lung scan, or computed tomography (CT) PA (CTPA). Results Overall, 614 patients with acute PE were included (median follow-up, 3.3 years). Ten patients were diagnosed with CTEPH: cumulative incidence 0.8% [95% confidence interval (CI), 0.0-1.6%] at 1 year, 1.3% (95% CI, 0.3-2.3%) at 2 years, and 1.7% (95% CI, 0.7-2.7%) at 3 years. No cases of CTEPH developed after 3 years. History of lower-limb varicose veins [hazard ratio (HR), 4.3; 95% CI, 1.2-15.4; P=0.024], SPAP >50 mmHg at initial PE episode (HR, 23.5; 95% CI, 2.7-207.6; P=0.005), intermediate-risk PE (HR, 1.2; 95% CI, 1.0-1.4; P=0.030), and CT obstruction index over 30% at 3 months after acute PE (HR, 42.5; 95% CI, 4.4-409.8; P=0.001) were associated with increased risk of CTEPH. Conclusions CTEPH was not rare after acute PE in this Chinese population, especially within 3 years of diagnosis. Lower-limb varicose veins, intermediate-risk PE with elevated SPAP in the acute phase, and residual emboli during follow-up might increase the risk of CTEPH. PMID:26716031

  10. Head impact exposure in youth football: high school ages 14 to 18 years and cumulative impact analysis.

    PubMed

    Urban, Jillian E; Davenport, Elizabeth M; Golman, Adam J; Maldjian, Joseph A; Whitlow, Christopher T; Powers, Alexander K; Stitzel, Joel D

    2013-12-01

    Sports-related concussion is the most common athletic head injury with football having the highest rate among high school athletes. Traditionally, research on the biomechanics of football-related head impact has been focused at the collegiate level. Less research has been performed at the high school level, despite the incidence of concussion among high school football players. The objective of this study is to twofold: to quantify the head impact exposure in high school football, and to develop a cumulative impact analysis method. Head impact exposure was measured by instrumenting the helmets of 40 high school football players with helmet mounted accelerometer arrays to measure linear and rotational acceleration. A total of 16,502 head impacts were collected over the course of the season. Biomechanical data were analyzed by team and by player. The median impact for each player ranged from 15.2 to 27.0 g with an average value of 21.7 (±2.4) g. The 95th percentile impact for each player ranged from 38.8 to 72.9 g with an average value of 56.4 (±10.5) g. Next, an impact exposure metric utilizing concussion injury risk curves was created to quantify cumulative exposure for each participating player over the course of the season. Impacts were weighted according to the associated risk due to linear acceleration and rotational acceleration alone, as well as the combined probability (CP) of injury associated with both. These risks were summed over the course of a season to generate risk weighted cumulative exposure. The impact frequency was found to be greater during games compared to practices with an average number of impacts per session of 15.5 and 9.4, respectively. However, the median cumulative risk weighted exposure based on combined probability was found to be greater for practices vs. games. These data will provide a metric that may be used to better understand the cumulative effects of repetitive head impacts, injury mechanisms, and head impact exposure of

  11. Comparison of Phonic Analysis and Whole Word-Reading on First Graders' Cumulative Words Read and Cumulative Reading Rate: An Extension in Examining Instructional Effectiveness and Efficiency

    ERIC Educational Resources Information Center

    Schmidgall, Melissa; Joseph, Laurice M.

    2007-01-01

    This study compared the instructional effectiveness and efficiency of three word-reading interventions on cumulative number of words read accurately and cumulative learning rate. Participants were six first graders who needed intensive intervention services. Alternating treatment designs were used to compare the effects of interspersal drill, a…

  12. Incidence of digoxin toxicity in outpatients.

    PubMed Central

    Steiner, J F; Robbins, L J; Hammermeister, K E; Roth, S C; Hammond, W S

    1994-01-01

    The incidence of digoxin toxicity among patients in hospitals has declined in recent years. To evaluate whether a similar decline has occurred in ambulatory care, we reviewed randomly selected medical records for 183 outpatients receiving ongoing treatment with digoxin at 10 urban and rural Department of Veterans Affairs Medical Centers in the Rocky Mountain region. The prevalence of traditional risk factors for digoxin toxicity--elevated serum digoxin and serum creatinine levels, hypokalemia, and a new prescription of an interacting drug-was established from computerized laboratory and pharmacy records. Of the 183 patients, 50 (27.3%) had one or more risk factors for digoxin toxicity: serum digoxin levels were elevated in 13.6% of patients in whom a level was obtained, with hypokalemia in 14.3%, elevated creatinine levels in 17.9%, and possible drug interactions in 5.5% of patients over a 1-year period. Nevertheless, digoxin toxicity occurred in only 2 persons (1.1% or 1.4 per 100 patient-years of treatment). We conclude that digoxin toxicity was rare in this group of outpatients, even in persons presumed to be at high risk because of metabolic abnormalities, increased digoxin concentrations, or the use of interacting drugs. The low rate of digoxin toxicity in outpatients parallels the decline in the incidence of toxicity observed in hospital-based studies. PMID:7810124

  13. Early Neuropsychological Tests as Correlates of Productivity 1 Year after Traumatic Brain Injury: A Preliminary Matched Case-Control Study

    ERIC Educational Resources Information Center

    Ryu, Won Hyung A.; Cullen, Nora K.; Bayley, Mark T.

    2010-01-01

    This study explored the relative strength of five neuropsychological tests in correlating with productivity 1 year after traumatic brain injury (TBI). Six moderate-to-severe TBI patients who returned to work at 1-year post-injury were matched with six controls who were unemployed after 1 year based on age, severity of injury, and Functional…

  14. Cumulative Cardiovascular Polypharmacy Is Associated With the Risk of Acute Kidney Injury in Elderly Patients.

    PubMed

    Chao, Chia-Ter; Tsai, Hung-Bin; Wu, Chia-Yi; Lin, Yu-Feng; Hsu, Nin-Chieh; Chen, Jin-Shin; Hung, Kuan-Yu

    2015-08-01

    Polypharmacy is common in the elderly due to multimorbidity and interventions. However, the temporal association between polypharmacy and renal outcomes is rarely addressed and recognized. We investigated the association between cardiovascular (CV) polypharmacy and the risk of acute kidney injury (AKI) in elderly patients.We used the Taiwan National Health Insurance PharmaCloud system to investigate the relationship between cumulative CV medications in the 3 months before admission and risk of AKI in the elderly at their admission to general medical wards in a single center. Community-dwelling elderly patients (>60 years) were prospectively enrolled and classified according to the number of preadmission CV medications. CV polypharmacy was defined as use of 2 or more CV medications.We enrolled 152 patients, 48% with AKI (based upon Kidney Disease Improving Global Outcomes [KDIGO] classification) and 64% with CV polypharmacy. The incidence of AKI was higher in patients taking more CV medications (0 drugs: 33%; 1 drug: 50%; 2 drugs: 57%; 3 or more drugs: 60%; P = 0.05) before admission. Patients with higher KDIGO grades also took more preadmission CV medications (P = 0.04). Multiple regression analysis showed that patients who used 1 or more CV medications before admission had increased risk of AKI at admission (1 drug: odds ratio [OR] = 1.63, P = 0.2; 2 drugs: OR = 4.74, P = 0.03; 3 or more drugs: OR = 5.92, P = 0.02), and that CV polypharmacy is associated with higher risk of AKI (OR 2.58; P = 0.02). Each additional CV medication increased the risk for AKI by 30%.We found that elderly patients taking more CV medications are associated with risk of adverse renal events. Further study to evaluate whether interventions that reduce polypharmacy could reduce the incidence of geriatric AKI is urgently needed. PMID:26252287

  15. Intestinal and extraintestinal complications of Crohn's disease: predictors and cumulative probability of complications.

    PubMed

    Maeda, K; Okada, M; Yao, T; Sakurai, T; Iida, M; Fuchigami, T; Yoshinaga, K; Imamura, K; Okada, Y; Sakamoto, K

    1994-10-01

    Of 238 patients with Crohn's disease seen at our clinics from April 1973 to August 1988, 203 patients were selected for this study, since they fulfilled the following criteria: they had been followed up for more than 6 months as outpatients or had been treated as inpatients for more than 1 month. They were studied to elucidate: (a) the different types and incidence of various complications, (b) the factors related to complications present at the time of diagnosis, (c) predictors of new complications arising after diagnosis, and (d) the cumulative incidence of complications occurring during the course of the disease from the times of onset and diagnosis. Of the intestinal complications, perianal fistula was most common (33%), followed by strictures with dilatations of the proximal bowel (21%), and internal fistula (14%). Of the extraintestinal complications, menstrual disturbance was the most common (18% of the female patients), followed by arthritis (10%), and aphthous stomatitis (10%). As for the factors influencing complications present at the time of diagnosis, the pattern of bowel involvement was significantly correlated with the presence of intestinal stricture, while the erythrocyte sedimentation rate was significantly correlated with the presence of perianal fistula. A significant predictor of new complications arising after diagnosis was the general well-being of patients at the time of diagnosis. Patients who, at diagnosis, already have complications such as stricture, abdominal abscess, internal or external fistula, massive hemorrhage, and free perforation or anal lesions are more likely to develop new complications in addition to those present at diagnosis, compared with patients without any complications at diagnosis (P = 0.055). PMID:8000504

  16. A 1-year trial of repeated high-dose intravenous iron isomaltoside 1000 to maintain stable hemoglobin levels in inflammatory bowel disease

    PubMed Central

    Reinisch, Walter; Altorjay, Istvan; Zsigmond, Ferenc; Primas, Christian; Vogelsang, Harald; Novacek, Gottfried; Reinisch, Sieglinde; Thomsen, Lars L.

    2015-01-01

    Abstract Objective. Iron isomaltoside 1000 (Monofer®) is a high-dose intravenous (IV) iron, which in a recent 8 weeks trial in inflammatory bowel disease (IBD) subjects with iron deficiency anemia (IDA) demonstrated good tolerability and efficacy. The present trial is an extension to this trial, which evaluates the need for additional high IV iron doses to maintain a stable hemoglobin (Hb) ≥12.0 g/dl. Material and methods. This was a prospective, open-label, 12 months trial of European IBD subjects willing to participate after completing the lead-in trial. Subjects were allowed re-dosing with 500–2000 mg single doses of iron isomaltoside 1000 infused over ∼15 min at 3 months intervals depending on a predefined algorithm. Outcome measures included Hb, safety parameters and need for additional iron dosing. Results. A total of 39 subjects were enrolled of which 34 subjects required re-dosing with a median cumulative 1-year dose of 1.8 g (mean cumulative dose 2.2 g). The mean (SD) Hb was 12.3 (1.5) g/dl at baseline, 12.8 (1.6) g/dl at 3 months, 12.8 (1.6) g/dl at 6 months, 12.9 (1.4) g/dl at 9 months and 12.9 (1.6) g/dl at 12 months. Seventy-four percent of subjects who had an Hb ≥12.0 g/dl at baseline were able to maintain Hb ≥12.0 g/dl till the end of the trial at 12 months. Nonserious probably related hypersensitivity reactions without significant hypotension were reported at the beginning of the infusion in two subjects, who recovered without sequelae. Conclusion. Repeated treatment of iron deficiency with iron isomaltoside 1000 could avoid episodes of IDA without major safety issues. PMID:25900645

  17. Less is still more: maintenance of the very brief exposure effect 1 year later.

    PubMed

    Siegel, Paul; Warren, Richard

    2013-04-01

    This study tested the hypothesis that an immediate effect of exposure to masked phobic stimuli on avoidance of the corresponding feared object would be maintained 1 year later. Fifty-three spider-phobic participants were identified with a questionnaire and a Behavioral Avoidance Test (BAT) with a live tarantula. One week later, they were administered 1 of 3 types of exposure: very brief (25-ms, masked) or clearly visible (125-ms, unmasked) images of spiders, or very brief images of flowers. They engaged in the BAT again immediately thereafter. One year later, they returned for a follow-up BAT. The immediate effect of exposure to very brief spiders on reducing avoidance of the tarantula was still evident 1 year later. Endurance of an effect by masked stimuli of this duration has not been reported before. Potential theoretical implications are discussed. PMID:23527506

  18. Cumulative effects in Swedish EIA practice - difficulties and obstacles

    SciTech Connect

    Waernbaeck, Antoienette Hilding-Rydevik, Tuija

    2009-02-15

    The importance of considering cumulative effects (CE) in the context of environmental assessment is manifested in the EU regulations. The demands on the contents of Environmental Impact Assessment (EIA) and Strategic Environmental Assessment (SEA) documents explicitly ask for CE to be described. In Swedish environmental assessment documents CE are rarely described or included. The aim of this paper is to look into the reasons behind this fact in the Swedish context. The paper describes and analyse how actors implementing the EIA and SEA legislation in Sweden perceive the current situation in relation to the legislative demands and the inclusion of cumulative effects. Through semi-structured interviews the following questions have been explored: Is the phenomenon of CE discussed and included in the EIA/SEA process? What do the actors include in and what is their knowledge of the term and concept of CE? Which difficulties and obstacles do these actors experience and what possibilities for inclusion of CE do they see in the EIA/SEA process? A large number of obstacles and hindrances emerged from the interviews conducted. It can be concluded from the analysis that the will to act does seem to exist. A lack of knowledge in respect of how to include cumulative effects and a lack of clear regulations concerning how this should be done seem to be perceived as the main obstacles. The knowledge of the term and the phenomenon is furthermore quite narrow and not all encompassing. They experience that there is a lack of procedures in place. They also seem to lack knowledge of methods in relation to how to actually work, in practice, with CE and how to include CE in the EIA/SEA process. It can be stated that the existence of this poor picture in relation to practice concerning CE in the context of impact assessment mirrors the existing and so far rather vague demands in respect of the inclusion and assessment of CE in Swedish EIA and SEA legislation, regulations, guidelines and

  19. The Relationship Between Amphibole Cumulates and Adakite Magma

    NASA Astrophysics Data System (ADS)

    Rooney, T. O.

    2009-12-01

    Amphibole, while uncommon as a primary fractioning phase is increasingly recognized as a key constituent in the petrogenesis of arc magmas. Fractional crystallization of water-saturated arc magmas in the lower crust can yield substantial volumes amphibole cumulates that, depending on the pressure of crystallization, may also contain garnet. Fractionation of this higher pressure assemblage has been invoked as a possible mechanism in the production adakite magmas. The origin of adakites, defined by their heavy REE and Y depletion and Sr enrichments, have vigorously debated since their re-discovery in Panama two decades ago. In addition to widespread modern adakitic volcanism, the Panamanian portion of the Central American Arc preserves the magmatic record of arc development in close spatial association with younger magmatism. Late-Oligocene hypabyssal crystal-rich andesites from Cerro Patacon are preserved near the Panama Canal region. These contain nodules of amphibole cumulates, and may be used to examine the amphibole-fractionation model for adakite origin. The cumulate nodules are ~6 cm in diameter and are almost entirely composed of 5-10mm amphibole crystals (dominantly ferri-tschermakite), and are accompanied in the host andesites by amphibole phenocrysts, antecrysts and megacryts. Cerro Patacon andesites have REE concentrations that plot at the most depleted end of the array defined by similarly differentiated (58-60% SiO2) Central American Arc magmas, and exhibit a distinctive depletion in the middle REE. These geochemical and petrographic observations strongly support significant amphibole fractionation during formation of the Cerro Patacon andesite. Sr/Y which is used as a geochemical tool for discriminating adakites from other arc magams, is transitional in the Cerro Patcon andesites. However La/Yb is within the range for ‘normal’ arc magmas and shows that amphibole fractionation alone is insufficient to generate adakite magmas - some garnet

  20. Results with SynCardia total artificial heart beyond 1 year.

    PubMed

    Torregrossa, Gianluca; Morshuis, Michiel; Varghese, Robin; Hosseinian, Leila; Vida, Vladimiro; Tarzia, Vincenzo; Loforte, Antonio; Duveau, Daniel; Arabia, Francisco; Leprince, Pascal; Kasirajan, Vigneshwa; Beyersdorf, Friedhelm; Musumeci, Francesco; Hetzer, Roland; Krabatsch, Thoamas; Gummert, Jan; Copeland, Jack; Gerosa, Gino

    2014-01-01

    Mechanical circulatory support devices have been increasingly used for long-term support. We reviewed outcomes in all patients supported with a SynCardia total artificial heart (TAH) for more than 1 year to assess its safety in long-term support. As of December 2011, all 47 patients who received the TAH from 10 centers worldwide were included in this retrospective study. Clinical data were collected on survival, infections, thromboembolic and hemorrhagic events, device failures, and antithrombotic therapy. The mean age of patients was 50 ± 1.57 years, the median support time was 554 days (range 365-1373 days). The primary diagnosis was dilated cardiomiopathy in 23 patients, ischemic in 15, and "other" in 9. After a minimum of 1 year of support, 34 patients (72%) were successfully transplanted, 12 patients (24%) died while on device support, and 1 patient (2%) is still supported. Five patients (10%) had a device failure reported. Major complications were as follows: systemic infections in 25 patients (53%), driveline infections in 13 patients (27%), thromboembolic events in 9 patients (19%), and hemorrhagic events in 7 patients (14%). SynCardia TAH has proven to be a reliable and effective device in replacing the entire heart. In patients who reached a minimum of 1 year of support, device failure rate is acceptable and only in two cases was the leading cause of death. Infections and hemorrhagic events were the major causes of death. Patients who remain supported beyond 1 year are still likely to survive to transplantation. PMID:25158888

  1. Cognitive and affective assessment in day care versus institutionalized elderly patients: a 1-year longitudinal study

    PubMed Central

    Maseda, Ana; Balo, Aránzazu; Lorenzo–López, Laura; Lodeiro–Fernández, Leire; Rodríguez–Villamil, José Luis; Millán–Calenti, José Carlos

    2014-01-01

    Purpose Cognitive decline and depression are two common mental health problems that may create a need for long-term care among the elderly. In the last decade, the percentage of older adults who receive health care in nursing homes, day care centers, or home support services has increased in Europe. The objectives of this descriptive and nonrandomized longitudinal study were to evaluate and to compare the cognitive and affective evolution of day care versus institutionalized older patients through a 1-year period, and to assess the presence of cognitive and affective impairment as a function of the care setting. Patients and methods Ninety-four patients were assessed at baseline, and 63 (67.0%) were reassessed 1 year later. Neuropsychological assessment included measures of cognitive performance (general cognitive status, visuospatial, and language abilities) and affective status (depressive symptoms). Results Our findings indicated that the majority of the participants (day care and institutionalized patients) had mild–moderate cognitive impairment at baseline, which significantly increased in both groups after 1-year follow-up. However, the rate of change in global cognitive function did not significantly differ between groups over time. Regarding language abilities, naming function maintained among day care patients in comparison with institutionalized patients, who showed worse performance at follow-up. As regards to affective status, results revealed that institutionalized patients had a significant reduction in depressive symptoms at follow-up, when compared to day care patients. Results also highlight the high frequency of cognitive impairment and depressive symptoms regardless of the care setting. Conclusion Our findings revealed a similar global cognitive decline rate between patients receiving day care services and those residing in a nursing home at the 1-year follow-up, and slightly different trajectories in other outcomes such as naming function and

  2. Fathers' Depression Related to Positive and Negative Parenting Behaviors With 1-Year-Old Children

    PubMed Central

    Davis, Matthew M.; Freed, Gary L.; Clark, Sarah J.

    2011-01-01

    OBJECTIVE: To examine the associations between depression in fathers of 1-year-old children and specific positive and negative parenting behaviors discussed by pediatric providers at well-child visits. METHODS: We performed a cross-sectional secondary analysis by using interview data from 1746 fathers of 1-year-old children in the Fragile Families and Child Wellbeing Study. Positive parenting behaviors included fathers' reports of playing games, singing songs, and reading stories to their children ≥3 days in a typical week. Negative parenting behavior included fathers' reports of spanking their 1-year-old children in the previous month. Depression was assessed by using the World Health Organization Composite International Diagnostic Interview Short Form. Weighted bivariate and multivariate analyses of parenting behaviors were performed while controlling for demographics and paternal substance abuse. RESULTS: Overall, 7% of fathers had depression. In bivariate analyses, depressed fathers were more likely than nondepressed fathers to report spanking their 1-year-old children in the previous month (41% compared with 13%; P < .01). In multivariate analyses, depressed fathers were less likely to report reading to their children ≥3 days in a typical week (adjusted odds ratio: 0.38 [95% confidence interval: 0.15–0.98]) and much more likely to report spanking (adjusted odds ratio: 3.92 [95% confidence interval: 1.23–12.5]). Seventy-seven percent of depressed fathers reported talking to their children's doctor in the previous year. CONCLUSIONS: Paternal depression is associated with parenting behaviors relevant to well-child visits. Pediatric providers should consider screening fathers for depression, discussing specific parenting behaviors (eg, reading to children and appropriate discipline), and referring for treatment if appropriate. PMID:21402627

  3. Increased 1-year survival and discharge to independent living in overweight hip fracture patients.

    PubMed

    Flodin, Lena; Laurin, Agnes; Lökk, Johan; Cederholm, Tommy; Hedström, Margareta

    2016-04-01

    Background and purpose - Hip fracture patients usually have low body mass index (BMI), and suffer further postoperative catabolism. How BMI relates to outcome in relatively healthy hip fracture patients is not well investigated. We investigated the association between BMI, survival, and independent living 1 year postoperatively. Patients and methods - This prospective multicenter study involved 843 patients with a hip fracture (mean age 82 (SD 7) years, 73% women), without severe cognitive impairment and living independently before admission. We investigated the relationship between BMI and both 1-year mortality and ability to return to independent living. Results - Patients with BMI > 26 had a lower mortality rate than those with BMI < 22 and those with BMI 22-26 (6%, 16%, and 18% respectively; p = 0.006). The odds ratio (OR) for 1-year survival in the group with BMI > 26 was 2.6 (95% CI: 1.2-5.5) after adjustment for age, sex, and physical status. Patients with BMI > 26 were also more likely to return to independent living after the hip fracture (OR = 2.6, 95% CI: 1.4-5.0). Patients with BMI < 22 had similar mortality and a similar likelihood of independent living to those with BMI 22-26. Interpretation - In this selected group of patients with hip fracture, the overweight and obese patients (BMI > 26) had a higher survival rate at 1 year, and returned to independent living to a higher degree than those of normal (healthy) weight. The obesity paradox and the recommendations for optimal BMI need further consideration in patients with hip fracture. PMID:26986549

  4. A Simple Tool to Predict ESRD Within 1 Year in Elderly Patients with Advanced CKD

    PubMed Central

    Drawz, Paul E.; Goswami, Puja; Azem, Reem; Babineau, Denise C.; Rahman, Mahboob

    2013-01-01

    BACKGROUND/OBJECTIVES Chronic kidney disease (CKD) is common in older patients; currently, no tools are available to predict the risk of end-stage renal disease (ESRD) within 1 year. The goal of this study was to develop and validate a model to predict the 1 year risk for ESRD in elderly subjects with advanced CKD. DESIGN Retrospective study SETTING Veterans Affairs Medical Center PARTICIPANTS Patients over 65 years of age with CKD with an estimated (eGFR) less than 30mL/min/1.73m2. MEASUREMENTS The outcome was ESRD within 1 year of the index eGFR. Cox regression was used to develop a predictive model (VA risk score) which was validated in a separate cohort. RESULTS Of the 1,866 patients in the developmental cohort, 77 developed ESRD. Risk factors for ESRD in the final model were age, congestive heart failure, systolic blood pressure, eGFR, potassium, and albumin. In the validation cohort, the C index for the VA risk score was 0.823. The risk for developing ESRD at 1 year from lowest to highest tertile was 0.08%, 2.7%, and 11.3% (P<0.001). The C-index for the recently published Tangri model in the validation cohort was 0.780. CONCLUSION A new model using commonly available clinical measures shows excellent ability to predict the onset of ESRD within the next year in elderly subjects. Additionally, the Tangri model had very good predictive ability. Patients and physicians can use these risk models to inform decisions regarding preparation for renal replacement therapy in patients with advanced CKD. PMID:23617782

  5. Increased 1-year survival and discharge to independent living in overweight hip fracture patients

    PubMed Central

    Flodin, Lena; Laurin, Agnes; Lökk, Johan; Cederholm, Tommy; Hedström, Margareta

    2016-01-01

    Background and purpose — Hip fracture patients usually have low body mass index (BMI), and suffer further postoperative catabolism. How BMI relates to outcome in relatively healthy hip fracture patients is not well investigated. We investigated the association between BMI, survival, and independent living 1 year postoperatively. Patients and methods — This prospective multicenter study involved 843 patients with a hip fracture (mean age 82 (SD 7) years, 73% women), without severe cognitive impairment and living independently before admission. We investigated the relationship between BMI and both 1-year mortality and ability to return to independent living. Results — Patients with BMI > 26 had a lower mortality rate than those with BMI < 22 and those with BMI 22–26 (6%, 16%, and 18% respectively; p = 0.006). The odds ratio (OR) for 1-year survival in the group with BMI > 26 was 2.6 (95% CI: 1.2–5.5) after adjustment for age, sex, and physical status. Patients with BMI > 26 were also more likely to return to independent living after the hip fracture (OR = 2.6, 95% CI: 1.4–5.0). Patients with BMI < 22 had similar mortality and a similar likelihood of independent living to those with BMI 22–26. Interpretation — In this selected group of patients with hip fracture, the overweight and obese patients (BMI > 26) had a higher survival rate at 1 year, and returned to independent living to a higher degree than those of normal (healthy) weight. The obesity paradox and the recommendations for optimal BMI need further consideration in patients with hip fracture. PMID:26986549

  6. Perceived Discrimination and Incident Cardiovascular Events

    PubMed Central

    Everson-Rose, Susan A.; Lutsey, Pamela L.; Roetker, Nicholas S.; Lewis, Tené T.; Kershaw, Kiarri N.; Alonso, Alvaro; Diez Roux, Ana V.

    2015-01-01

    Perceived discrimination is positively related to cardiovascular disease (CVD) risk factors; its relationship with incident CVD is unknown. Using data from the Multi-Ethnic Study of Atherosclerosis, a population-based multiethnic cohort study of 6,508 adults aged 45–84 years who were initially free of clinical CVD, we examined lifetime discrimination (experiences of unfair treatment in 6 life domains) and everyday discrimination (frequency of day-to-day occurrences of perceived unfair treatment) in relation to incident CVD. During a median 10.1 years of follow-up (2000–2011), 604 incident events occurred. Persons reporting lifetime discrimination in ≥2 domains (versus none) had increased CVD risk, after adjustment for race/ethnicity and sociodemographic factors, behaviors, and traditional CVD risk factors (hazard ratio (HR) = 1.36, 95% confidence interval (CI): 1.09, 1.70) and after control for chronic stress and depressive symptoms (HR = 1.28, 95% CI: 1.01, 1.60). Reported discrimination in 1 domain was unrelated to CVD (HR = 1.05, 95% CI: 0.86, 1.30). There were no differences by race/ethnicity, age, or sex. In contrast, everyday discrimination interacted with sex (P = 0.03). Stratified models showed increased risk only among men (for each 1–standard deviation increase in score, adjusted HR = 1.14, 95% CI: 1.03, 1.27); controlling for chronic stress and depressive symptoms slightly reduced this association (HR = 1.11, 95% CI: 0.99, 1.25). This study suggests that perceived discrimination is adversely related to CVD risk in middle-aged and older adults. PMID:26085044

  7. Percutaneous coronary intervention in the elderly: procedural success and 1-year outcomes.

    PubMed

    Eckart, Robert E; Shry, Eric A; Simpson, Daniel E; Stajduhar, Karl C

    2003-01-01

    Clinical trials have found increased morbidity in elderly persons presenting for percutaneous coronary intervention for chronic stable angina. Long-term follow-up is limited for the elderly following percutaneous coronary intervention. The authors reviewed all coronary interventions performed from January 1998 to August 2001. One year following the procedure, subjects were screened for death, need for revascularization, and myocardial infarction. There were 401 subjects aged >/=65 years (mean 73.4+/-6.0 years) and 479 subjects aged <65 years (mean 55.6+/-6.7 years). Although there was no difference in 1-year rate of subsequent myocardial infarction or in revascularization, the elderly were more likely to die during hospitalization (4.7% vs. 1.0%, p<0.01), and at 1 year (10.2% vs. 4.0%, p<0.01). When controlled for ejection fraction, age was no longer significant in either predischarge mortality or in 1-year mortality. Excess postpercutaneous coronary intervention mortality in the elderly may be due to underlying comorbidities and not due to subsequent myocardial infarction or revascularization. PMID:14610387

  8. Infants under 1 year of age have a significant risk of burn injury.

    PubMed

    Nguyen, Dai Q A; Tobin, Sean; Dickson, William A; Potokar, Tom S

    2008-09-01

    A wealth of data exists concerning paediatric burn epidemiology in general, but very little exists specifically in infants under 1 year of age, a special group in which mobility begins to develop. A retrospective study of all burn admissions of infants under 1 year old to The Welsh Centre for Burns from January 2003 to January 2006 was performed. During the 3-year period there were 104 new burns cases identified which represents 11.8% of all paediatric admissions. 63.5% (66) were treated as inpatients and 36.5% (38) treated as out-patients. Burns increased in frequency with increasing age and occurred mainly in the home. Scalds were the commonest type of burn in 65% (68) whilst the second most common was contact burns which accounted for 30% (31). The most common source of scald was from cups containing hot drinks (39%) and the most common source of contact burn was radiators/hot water pipes (30%). The mean TBSA was 2.3%, (range 0.5-38%). The frequency of burns in the under 1 year old population highlights a need for emphasis of burn prevention directed to this group. Special attention is needed to look at the specific aetiology of these burns. Starting points for prevention should address the number of burns surrounding hot drinks and bottle warming practices in the case of scalds and the dangers of household radiators and hot water pipes in the case of contact burns. PMID:18378092

  9. Association of Postpartum Depression With Weight Retention 1 Year After Childbirth

    PubMed Central

    Herring, Sharon J.; Rich-Edwards, Janet W.; Oken, Emily; Rifas-Shiman, Sheryl L.; Kleinman, Ken P.; Gillman, Matthew W.

    2009-01-01

    Objective To examine the extent to which early postpartum depression is associated with weight retention 1 year after childbirth. Methods and Procedures In a prospective cohort study of 850 women enrolled in Project Viva, mothers reported depressive symptoms on the Edinburgh Postnatal Depression Scale (EPDS) at midpregnancy and 6 months postpartum. A score >12 indicated probable depression. We assessed associations of antenatal and postpartum depression with risk of substantial weight retention (at least 5 kg) 1 year after childbirth. Results Seven-hundred thirty-six women (87%) were not depressed during or after pregnancy, 55 (6%) experienced antenatal depression only, 22 (3%) experienced both antenatal and postpartum depression, and 37 (4%) experienced postpartum depression only. At 1 year, participants retained a mean of 0.6 kg (range −16.4 to 25.5), and 12% retained at least 5 kg. In multivariate logistic regression analyses, after adjustment for weight-related covariates, maternal sociodemographics, and parity, new-onset postpartum depression was associated with more than a doubling of risk of retaining at least 5 kg (odds ratio (OR): 2.54, 95% confidence interval (CI): 1.06, 6.09). Antenatal depression, either alone or in combination with postpartum depression, was not associated with substantial weight retention. Discussion New-onset postpartum depression was associated with substantial weight retention in the first postpartum year. Interventions to manage depressive symptoms may help reduce excess weight retained postpartum and aid in the prevention of obesity among women. PMID:18369338

  10. Cumulative radiation exposure from diagnostic imaging in intensive care unit patients

    PubMed Central

    Moloney, Fiachra; Fama, Daniel; Twomey, Maria; O’Leary, Ruth; Houlihane, Conor; Murphy, Kevin P; O’Neill, Siobhan B; O’Connor, Owen J; Breen, Dorothy; Maher, Michael M

    2016-01-01

    AIM: To quantify cumulative effective dose of intensive care unit (ICU) patients attributable to diagnostic imaging. METHODS: This was a prospective, interdisciplinary study conducted in the ICU of a large tertiary referral and level 1 trauma center. Demographic and clinical data including age, gender, date of ICU admission, primary reason for ICU admission, APACHE II score, length of stay, number of days intubated, date of death or discharge, and re-admission data was collected on all patients admitted over a 1-year period. The overall radiation exposure was quantified by the cumulative effective radiation dose (CED) in millisieverts (mSv) and calculated using reference effective doses published by the United Kingdom National Radiation Protection Board. Pediatric patients were selected for subgroup-analysis. RESULTS: A total of 2737 studies were performed in 421 patients. The total CED was 1704 mSv with a median CED of 1.5 mSv (IQR 0.04-6.6 mSv). Total CED in pediatric patients was 74.6 mSv with a median CED of 0.07 mSv (IQR 0.01-4.7 mSv). Chest radiography was the most commonly performed examination accounting for 83% of all studies but only 2.7% of total CED. Computed tomography (CT) accounted for 16% of all studies performed and contributed 97% of total CED. Trauma patients received a statistically significant higher dose [median CED 7.7 mSv (IQR 3.5-13.8 mSv)] than medical [median CED 1.4 mSv (IQR 0.05-5.4 mSv)] and surgical [median CED 1.6 mSv (IQR 0.04-7.5 mSv)] patients. Length of stay in ICU [OR = 1.12 (95%CI: 1.079-1.157)] was identified as an independent predictor of receiving a CED greater than 15 mSv. CONCLUSION: Trauma patients and patients with extended ICU admission times are at increased risk of higher CEDs. CED should be minimized where feasible, especially in young patients. PMID:27158429

  11. Mathematical modeling of detonation initiation via flow cumulation effects

    NASA Astrophysics Data System (ADS)

    Semenov, I.; Utkin, P.; Akhmedyanov, I.

    2016-07-01

    The paper concerns two problems connected with the idea of gaseous detonation initiation via flow cumulation effects and convergence of relatively weak shock waves (SW). The first one is the three-dimensional (3D) numerical investigation of shock-to-detonation transition (SDT) in methane-air mixture in a tube with parabolic contraction followed by the tube section of narrow diameter and conical expansion. The second problem is the numerical study of the start-up of the model small-scale hydrogen electrochemical pulse detonation engine with the use of electrical discharge generating the toroidal SW. The investigation is performed by means of numerical simulation with the use of modern high-performance computing systems.

  12. Cumulative growth of minor hysteresis loops in the Kolmogorov model

    SciTech Connect

    Meilikhov, E. Z. Farzetdinova, R. M.

    2013-01-15

    The phenomenon of nonrepeatability of successive remagnetization cycles in Co/M (M = Pt, Pd, Au) multilayer film structures is explained in the framework of the Kolmogorov crystallization model. It is shown that this model of phase transitions can be adapted so as to adequately describe the process of magnetic relaxation in the indicated systems with 'memory.' For this purpose, it is necessary to introduce some additional elements into the model, in particular, (i) to take into account the fact that every cycle starts from a state 'inherited' from the preceding cycle and (ii) to assume that the rate of growth of a new magnetic phase depends on the cycle number. This modified model provides a quite satisfactory qualitative and quantitative description of all features of successive magnetic relaxation cycles in the system under consideration, including the surprising phenomenon of cumulative growth of minor hysteresis loops.

  13. Cumulative Muscle Protein Synthesis and Protein Intake Requirements.

    PubMed

    Simmons, Erin; Fluckey, James D; Riechman, Steven E

    2016-07-17

    Muscle protein synthesis (MPS) fluctuates widely over the course of a day and is influenced by many factors. The time course of MPS responses to exercise and the influence of training and nutrition can only be pieced together from several different investigations and methods, many of which create unnatural experimental conditions. Measurements of cumulative MPS, the sum synthesis over an extended period, using deuterium oxide have been shown to accurately reflect muscle responses and may allow investigations of the response to exercise, total protein intake requirements, and interaction with protein timing in free-living experimental conditions; these factors have yet to be carefully integrated. Such studies could include clinical and athletic populations to integrate nutritional and exercise recommendations and help guide their revisions to optimize the skeletal muscle function that is so important to overall health. PMID:27215586

  14. Ultrasonic assessment of cumulative internal damage in filled polymers (II)

    SciTech Connect

    Knollman, G.C.; Martinson, R.H.; Bellin, J.L.

    1980-06-01

    An ultrasonic technique previously developed for studying dewetting and cumulative internal damage in filled polymers, such as solid rocket propellents, has been improved. The previous theoretical treatment is here expanded to include internal vacuoles of general spheroidal (rather than spherical) shape. Experimental measurements of sound speed and attenuation in a solid propellant material are utilized together with the modified theoretical model to calculate the internal damage parameters of effective vacuole size and number density as functions of applied uniaxial tensile strain. Results obtained from the model near the point of material failure are in excellent agreement with those provided by independent microscopic observations made on several rupture surfaces of propellant samples stressed to failure.

  15. Cumulative early life adversity predicts longevity in wild baboons

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

  17. Cumulative Violence Exposures: Black Women's Responses and Sources of Strength.

    PubMed

    Sabri, Bushra; Holliday, Charvonne N; Alexander, Kamila A; Huerta, Julia; Cimino, Andrea; Callwood, Gloria B; Campbell, Jacquelyn C

    2016-01-01

    Black women with cumulative violence exposures (CVE) may have unique needs for health care and safety. Qualitative data was analyzed from interviews with nine Black women with CVE to explore factors that motivated women to leave abusive relationships, women's sources of strengths, and their responses to abuse. Quantitative data (N = 163) was analyzed to examine relationships between CVEs by intimate partner and health among Black women to further characterize the challenges these women face in making changes and finding their sources of strengths. Findings highlight the need to assess for CVE and identify multiple motivators for change, sources of strengths and coping strategies that could be potential points of intervention for women with CVE. PMID:26954765

  18. Cumulative dermatologic toxicity with ipilimumab and vemurafenib responsive to corticosteroids.

    PubMed

    Ludlow, Steven P; Pasikhova, Yanina

    2013-12-01

    Dermatologic toxicity is a known reaction of ipilimumab and vemurafenib. Because of the lack of effective treatments and aggressive nature of melanoma, treatments are often discontinued and new treatments are initiated in rapid succession. We report what we believe to be the first case of cumulative dermatologic toxicity secondary to rapid-sequential treatment with ipilimumab and vemurafenib for metastatic melanoma that responded to high-dose steroids. This case highlights the combined toxicity of these two drugs that can occur as a result of overlapping toxicity. It also illustrates the need for a substantial wash out period between rapid cycling of these two drugs secondary to ipilimumab's long half-life. PMID:24025700

  19. Cumulative Impact Damage Evaluation of Automotive Aluminum Bumper Beam

    NASA Astrophysics Data System (ADS)

    Kim, Heon Young; Choi, Jong Gil; Kim, Min Gun; Lee, Kang Wook; Ha, Dae Yul; Yeo, Tae Jung

    We performed numerical analyses using an explicit code to evaluate the cumulative impact damage of an automotive aluminum front-end bumper back beam during low-speed crash events, as described by CMVSS215. we used a coupled numerical analysis scheme and considered the several fracture criterion such as EWK rupture model and plastic strain limit in the PAM-CRASH code to improve our damage and fracture estimates. Tensile test experiments for the notched and un-notched specimens were conducted to tune the performance of the EWK rupture model; The resulting material properties and fracture criterion were incorporated into the numerical analyses of the low-speed crash events. The simulation results were compared with the impact test.

  20. Probabilistic downscaling approaches: Application to wind cumulative distribution functions

    NASA Astrophysics Data System (ADS)

    Michelangeli, P.-A.; Vrac, M.; Loukos, H.

    2009-06-01

    A statistical method is developed to generate local cumulative distribution functions (CDFs) of surface climate variables from large-scale fields. Contrary to most downscaling methods producing continuous time series, our “probabilistic downscaling methods” (PDMs), named “CDF-transform”, is designed to deal with and provide local-scale CDFs through a transformation applied to large-scale CDFs. First, our PDM is compared to a reference method (Quantile-matching), and validated on a historical time period by downscaling CDFs of wind intensity anomalies over France, for reanalyses and simulations from a general circulation model (GCM). Then, CDF-transform is applied to GCM output fields to project changes in wind intensity anomalies for the 21st century under A2 scenario. Results show a decrease in wind anomalies for most weather stations, ranging from less than 1% (in the South) to nearly 9% (in the North), with a maximum in the Brittany region.

  1. Cumulative Impact of Marinas on Estuarine Water Quality

    PubMed

    McAllister; Overton; Brill

    1996-05-01

    The purpose of this work is to present a modeling approach for assessing and managing the cumulative impact of marinas on estuarine systems. In doing so, both a water-quality model and a planning and management model are developed. The water-quality model predicts biochemical oxygen demand (BOD) and fecal coliform (FC) loadings from marina sources in a hypothetical North Carolina estuary. By running the water-quality model repeatedly with varied loading input, impact coefficients are determined. These impact coefficients are used in the planning and management model, the output of which gives the sizes and locations of marinas in the estuarine system such that dissolved oxygen (DO) and FC water-quality standards are maintained.Five different estuarine development scenarios are considered. Each scenario is evaluated with respect to both maximum and uniform land development constraints. In addition, two alternative fecal coliform standards are used with each of the development options. PMID:8661609

  2. Cumulative Interference to Aircraft Radios from Multiple Portable Electronic Devices

    NASA Technical Reports Server (NTRS)

    Nguyen, Truong X.

    2005-01-01

    Cumulative interference effects from portable electronic devices (PEDs) located inside a passenger cabin are conservatively estimated for aircraft radio receivers. PEDs' emission powers in an aircraft radio frequency band are first scaled according to their locations' interference path loss (IPL) values, and the results are summed to determine the total interference power. The multiple-equipment-factor (MEF) is determined by normalizing the result against the worst case contribution from a single device. Conservative assumptions were made and MEF calculations were performed for Boeing 737's Localizer, Glide-slope, Traffic Collision Avoidance System, and Very High Frequency Communication radio systems where full-aircraft IPL data were available. The results show MEF for the systems to vary between 10 and 14 dB. The same process was also used on the more popular window/door IPL data, and the comparison show the multiple-equipment-factor results came within one decibel (dB) of each other.

  3. Action recognition via cumulative histogram of multiple features

    NASA Astrophysics Data System (ADS)

    Yan, Xunshi; Luo, Yupin

    2011-01-01

    Spatial-temporal interest points (STIPs) are popular in human action recognition. However, they suffer from difficulties in determining size of codebook and losing much information during forming histograms. In this paper, spatial-temporal interest regions (STIRs) are proposed, which are based on STIPs and are capable of marking the locations of the most ``shining'' human body parts. In order to represent human actions, the proposed approach takes great advantages of multiple features, including STIRs, pyramid histogram of oriented gradients and pyramid histogram of oriented optical flows. To achieve this, cumulative histogram is used to integrate dynamic information in sequences and to form feature vectors. Furthermore, the widely used nearest neighbor and AdaBoost methods are employed as classification algorithms. Experiments on public datasets KTH, Weizmann and UCF sports show that the proposed approach achieves effective and robust results.

  4. Ratcheting up the ratchet: on the evolution of cumulative culture

    PubMed Central

    Tennie, Claudio; Call, Josep; Tomasello, Michael

    2009-01-01

    Some researchers have claimed that chimpanzee and human culture rest on homologous cognitive and learning mechanisms. While clearly there are some homologous mechanisms, we argue here that there are some different mechanisms at work as well. Chimpanzee cultural traditions represent behavioural biases of different populations, all within the species’ existing cognitive repertoire (what we call the ‘zone of latent solutions’) that are generated by founder effects, individual learning and mostly product-oriented (rather than process-oriented) copying. Human culture, in contrast, has the distinctive characteristic that it accumulates modifications over time (what we call the ‘ratchet effect’). This difference results from the facts that (i) human social learning is more oriented towards process than product and (ii) unique forms of human cooperation lead to active teaching, social motivations for conformity and normative sanctions against non-conformity. Together, these unique processes of social learning and cooperation lead to humans’ unique form of cumulative cultural evolution. PMID:19620111

  5. Cumulative semantic interference for associative relations in language production.

    PubMed

    Rose, Sebastian Benjamin; Abdel Rahman, Rasha

    2016-07-01

    Associations between conceptual representations and thematic relations play an important role in the organization of semantic memory. However, language production research on semantic context effects shows that associative (e.g., dog and bone) and categorical relations (dog and horse) seem to diverge. While categorical contexts typically induce semantic interference that has traditionally been taken to reflect competitive lexical selection, evidence for comparable associative modulations is rare. In three experiments we tested whether thematic associations between objects induce cumulative interference in the continuous naming paradigm, assuming that this paradigm hampers lexical selection via the activation of highly active lexical cohorts steadily increasing in size. Indeed, naming times increased linearly with each newly named member of thematic contexts irrespective of the pre-activation of associations before the naming task (Experiment 1), and irrespective of whether categorical links were partially included (Experiments 1 and 2) or entirely absent (Experiment 3). These findings demonstrate that different types of semantic relations induce interference. PMID:27015349

  6. Data analysis techniques: a tool for cumulative exposure assessment.

    PubMed

    Lalloué, Benoît; Monnez, Jean-Marie; Padilla, Cindy; Kihal, Wahida; Zmirou-Navier, Denis; Deguen, Séverine

    2015-01-01

    Everyone is subject to environmental exposures from various sources, with negative health impacts (air, water and soil contamination, noise, etc.or with positive effects (e.g. green space). Studies considering such complex environmental settings in a global manner are rare. We propose to use statistical factor and cluster analyses to create a composite exposure index with a data-driven approach, in view to assess the environmental burden experienced by populations. We illustrate this approach in a large French metropolitan area. The study was carried out in the Great Lyon area (France, 1.2 M inhabitants) at the census Block Group (BG) scale. We used as environmental indicators ambient air NO2 annual concentrations, noise levels and proximity to green spaces, to industrial plants, to polluted sites and to road traffic. They were synthesized using Multiple Factor Analysis (MFA), a data-driven technique without a priori modeling, followed by a Hierarchical Clustering to create BG classes. The first components of the MFA explained, respectively, 30, 14, 11 and 9% of the total variance. Clustering in five classes group: (1) a particular type of large BGs without population; (2) BGs of green residential areas, with less negative exposures than average; (3) BGs of residential areas near midtown; (4) BGs close to industries; and (5) midtown urban BGs, with higher negative exposures than average and less green spaces. Other numbers of classes were tested in order to assess a variety of clustering. We present an approach using statistical factor and cluster analyses techniques, which seem overlooked to assess cumulative exposure in complex environmental settings. Although it cannot be applied directly for risk or health effect assessment, the resulting index can help to identify hot spots of cumulative exposure, to prioritize urban policies or to compare the environmental burden across study areas in an epidemiological framework. PMID:25248936

  7. Young child socioemotional/behavioral problems and cumulative psychosocial risk.

    PubMed

    Weitzman, Carol; Edmonds, Diana; Davagnino, Judith; Briggs-Gowan, Margaret J

    2014-01-01

    Limited information is available about the rates and risk correlates of socioemotional/behavioral problems in young children in pediatric primary care settings serving low-income families. Our objective was to determine rates of clinically significant socioemotional/behavior problems in 12- to 48-month-olds from low-income families and identify associations between problems and individual and cumulative demographic and psychosocial risks. In this study, 378 Spanish- and English-speaking mothers attending a pediatric primary care practice serving low-income families were surveyed before well-child visits to assess socioemotional/behavioral problems (Brief Infant-Toddler Social-Emotional Assessment; M.J. Briggs-Gowan & A.S. Carter, ) and psychosocial and demographic risks (e.g., unemployment, low social support) (Parent Risk Questionnaire; D.I. Lowell, A.S. Carter, L. Godoy, B. Paulicin, & M.J. Briggs-Gowan, ). We found that 19.8% of children had clinically significant problems, and 53.2% experienced one or more psychosocial risks. Clinically significant socioemotional/behavioral problems were modestly to strongly associated with individual psychosocial risks, with the strongest associations with parental medical problems, parent depression/anxiety, and extreme parental distress, Adjusted Relative Risk (ARR) = 4.8-6.6, p < .0001. Cumulative demographic and psychosocial risk were uniquely associated with clinically significant problems, particularly among children experiencing three to four psychosocial risks, ARR = 3.0-11.6, p < .05. Psychosocial risks affect the majority of low-income families with young children, with a steep increase in likelihood of clinically significant socioemotional/behavioral problems as risks accumulate, underscoring the need to address both socioemotional/behavioral issues and psychosocial risk in young children. PMID:25424401

  8. Economic and policy implications of the cumulative carbon budget

    NASA Astrophysics Data System (ADS)

    Allen, M. R.; Otto, F. E. L.; Otto, A.; Hepburn, C.

    2014-12-01

    The importance of cumulative carbon emissions in determining long-term risks of climate change presents considerable challenges to policy makers. The traditional notion of "total CO2-equivalent emissions", which forms the backbone of agreements such as the Kyoto Protocol and the European Emissions Trading System, is fundamentally flawed. Measures to reduce short-lived climate pollutants benefit the current generation, while measures to reduce long-lived climate pollutants benefit future generations, so there is no sense in which they can ever be considered equivalent. Debates over the correct metric used to compute CO2-equivalence are thus entirely moot: both long-lived and short-lived emissions will need to be addressed if all generations are to be protected from dangerous climate change. As far as long-lived climate pollutants are concerned, the latest IPCC report highlights the overwhelming importance of carbon capture and storage in determining the cost of meeting the goal of limiting anthropogenic warming to two degrees. We will show that this importance arises directly from the cumulative carbon budget and the role of CCS as the technology of last resort before economic activity needs to be restricted to meet ambitious climate targets. It highlights the need to increase the rate of CCS deployment by orders of magnitude if the option of avoiding two degrees is to be retained. The difficulty of achieving this speed of deployment through conventional incentives and carbon-pricing mechanisms suggests a need for a much more direct mandatory approach. Despite their theoretical economic inefficiency, the success of recent regulatory measures in achieving greenhouse gas emissions reductions in jurisdictions such as the United States suggests an extension of the regulatory approach could be a more effective and politically acceptable means of achieving adequately rapid CCS deployment than conventional carbon taxes or cap-and-trade systems.

  9. Altitude Modulates Concussion Incidence

    PubMed Central

    Smith, David W.; Myer, Gregory D.; Currie, Dustin W.; Comstock, R. Dawn; Clark, Joseph F.; Bailes, Julian E.

    2013-01-01

    Background: Recent research indicates that the volume and/or pressure of intracranial fluid, a physiology affected by one’s altitude (ie, elevation above sea level), may be associated with the likelihood and/or severity of a concussion. The objective was to employ an epidemiological field investigation to evaluate the relationship between altitude and concussion rate in high school sports. Hypothesis: Because of the physiologies that occur during acclimatization, including a decline in intracranial compliance (a “tighter fit”), increased altitude may be related to a reduction in concussion rates in high school athletes. Study Design: Cohort study; Level of evidence, 3. Methods: Data on concussions and athlete exposures (AEs) between 2005-2006 and 2011-2012 were obtained from a large national sample of high schools (National High School Sports-Related Injury Surveillance System [High School RIO]) and were used to calculate total, competition, and practice concussion rates for aggregated sports and for football only. Results: Altitude of participating schools ranged from 7 to 6903 ft (median, 600 ft), and a total of 5936 concussions occurred in 20,618,915 exposures (2.88 per 10,000 AEs). When concussion rates were dichotomized by altitude using the median, elevated altitude was associated with a reduction in concussion rates overall (rate ratio [RR], 1.31; P < .001), in competition (RR, 1.31; P < .001), and in practice (RR, 1.29; P < .001). Specifically, high school sports played at higher altitude demonstrated a 31% reduction (95% confidence interval [CI], 25%-38%) in the incidence of total reported concussions. Likewise, concussion rates at increased altitude were reduced 30% for overall exposures, 27% for competition exposures, and 28% for practice exposures in football players (P < .001). Conclusion: The results of this epidemiological investigation indicate increased physiological responses to altitude may be associated with a reduction in sports

  10. The efficacy and safety of weekly 35-mg risedronate dosing regimen for Chinese postmenopausal women with osteoporosis or osteopenia: 1-year data

    PubMed Central

    Gu, Jie-mei; Wang, Li; Lin, Hua; Chen, De-cai; Tang, Hai; Jin, Xiao-lan; Xia, Wei-bo; Hu, Yun-qiu; Fu, Wen-zhen; He, Jin-wei; Zhang, Hao; Wang, Chun; Yue, Hua; Hu, Wei-wei; Liu, Yu-juan; Zhang, Zhen-lin

    2015-01-01

    Aim: Oral risedronate is effective in the treatment of postmenopausal osteoporosis when administered daily, weekly, or monthly. In this 1-year, randomized, double-blind, multicenter study we compared the weekly 35-mg and daily 5-mg risedronate dosing regimens in the treatment of Chinese postmenopausal women with osteoporosis or osteopenia. Methods: Postmenopausal women with primary osteoporosis or osteopenia were randomly assigned to the weekly group or daily group (n=145 for each) that received oral risedronate 35 mg once a week or 5 mg daily, respectively, for 1 year. The subjects' bone mineral densities (BMDs), bone turnover markers (P1NP and β-CTX), new vertebral fractures, and adverse events were assessed at baseline and during the treatments. Results: All subjects in the weekly group and 144 subjects in the daily group completed the study. The primary efficacy endpoint after 1 year, ie the mean percent changes in the lumbar spine BMD (95% CI) were 4.87% (3.92% to 5.81%) for the weekly group and 4.35% (3.31% to 5.39%) for the daily group. The incidences of clinical adverse events were 48.3% in the weekly group and 54.2% in the daily group. Conclusion: The weekly 35-mg and daily 5-mg risedronate dosing regimens during 1 year of follow-up show similar efficacy in improving BMDs and biochemical markers of bone turnover in Chinese postmenopausal women with osteoporosis or osteopenia. Moreover, the two dosing regimens exhibit similar safety and tolerability. PMID:26051110

  11. Hospitalization for Pneumonia is Associated With Decreased 1-Year Survival in Patients With Type 2 Diabetes: Results From a Prospective Cohort Study.

    PubMed

    Falcone, Marco; Tiseo, Giusy; Russo, Alessandro; Giordo, Laura; Manzini, Elisa; Bertazzoni, Giuliano; Palange, Paolo; Taliani, Gloria; Cangemi, Roberto; Farcomeni, Alessio; Vullo, Vincenzo; Violi, Francesco; Venditti, Mario

    2016-02-01

    Diabetes mellitus is a frequent comorbid conditions among patients with pneumonia living in the community.The aim of our study is to evaluate the impact of hospitalization for pneumonia on early (30 day) and late mortality (1 year) in patients with type 2 diabetes mellitus.Prospective comparative cohort study of 203 patients with type 2 diabetes hospitalized for pneumonia versus 206 patients with diabetes hospitalized for other noninfectious causes from January 2012 to December 2013 at Policlinico Umberto I (Rome). Enrolled patients were followed up to discharge and up to 1 year after initial hospital admission or death.Overall, 203 patients with type 2 diabetes admitted to hospital for pneumonia were compared to 206 patients with type 2 diabetes admitted for other causes (39.3% decompensated diabetes, 21.4% cerebrovascular diseases, 9.2% renal failure, 8.3% acute myocardial infarction, and 21.8% other causes). Compared to control patients, those admitted for pneumonia showed a higher 30-day (10.8% vs 1%, P < 0.001) and 1-year mortality rate (30.3% vs 16.8%, P < 0.001). Compared to survivors, nonsurvivor patients with pneumonia had a higher incidence of moderate to severe chronic kidney disease, hemodialysis, and malnutrition were more likely to present with a mental status deterioration, and had a higher number of cardiovascular events during the follow-up period. Cox regression analysis found age, Charlson comorbidity index, pH < 7.35 at admission, hemodialysis, and hospitalization for pneumonia as variables independently associated with mortality.Hospitalization for pneumonia is associated with decreased 1-year survival in patients with type 2 diabetes, and appears to be a major determinant of long-term outcome in these patients. PMID:26844461

  12. Troponin T in Prediction of Culprit Lesion Coronary Artery Disease and 1-Year Major Adverse Cerebral and Cardiovascular Events in Patients with Acute Stroke.

    PubMed

    Zeus, Tobias; Ketterer, Ulrike; Leuf, Daniela; Dannenberg, Lisa; Wagstaff, Rabea; Bönner, Florian; Gliem, Michael; Jander, Sebastian; Kelm, Malte; Polzin, Amin

    2016-06-01

    Troponin T (TnT) elevation above the 99th percentile upper reference limit (URL) is considered diagnostic of acute myocardial infarction (MI). Non-specific increases of TnT are frequent in acute stroke patients. However, in these patients, correct diagnosis of MI is crucial because the antithrombotic medications used to treat acute MI might be harmful and produce intracranial bleeding. In this study, we aimed to associate enhanced TnT levels defined by different cutoff values with occurrence of culprit lesion coronary artery disease (CAD) as well as 1-year major adverse cerebral and cardiovascular events (MACCEs). In this cohort study, we investigated 84 consecutive patients with acute ischemic stroke and concomitant MI. TnT levels were measured using a fourth-generation TnT assay. The incidence of culprit lesion CAD was determined by coronary angiography. MACCEs were recorded during 1-year follow-up. Culprit lesion CAD occurred in 55 % of patients, and 1-year MACCE in 37 %. TnT levels above the manufacturers' provided 99th URL (TnT > 0.01) were not associated with culprit lesion CAD (relative risk [RR], 1.3; 95 % confidence interval [CI] 0.96-1.8; P = 0.09). Slightly increased cutoff level (TnT > 0.03) increased specificity and was associated with culprit lesion CAD without decreasing sensitivity (RR, 1.5; 95 % CI 1.1-2.2; P = 0.021) and 1-year MACCE (RR, 1.7; 95 % CI 1.3-2.3; P < 0.001). Slightly increasement of the TnT cutoff level predicted MACCEs and is superior in prediction of culprit lesion CAD in stroke patients without being less sensitive. This finding has to be confirmed in large-scale clinical trials. PMID:26899027

  13. COMPLEMENTARY FEEDING WITH FORTIFIED SPREAD IS LIKELY TO REDUCE THE INCIDENCE OF SEVERE STUNTING AMONG 6–18 MONTH OLD RURAL MALAWIAN INFANTS

    PubMed Central

    Phuka, John C.; Maleta, Kenneth; Thakwalakwa, Chrissie; Cheung, Yin Bun; Briend, André; Manary, Mark J.; Ashorn, Per

    2013-01-01

    Objective To compare growth and incidence of malnutrition among infants receiving long-term dietary complementation with ready-to-use fortified spread (FS) or micronutrient fortified maize-soy flour (LP). Design Randomized, controlled, single-blind trial Setting Rural Malawian population with high incidence of malnutrition Participants 182 six-month-old infants. Intervention Participants were randomized to receive 1-year-long daily supplementation with either 71g of LP (282 kcal energy / day), 50g FS50 (256 kcal), or 25g FS25 (127 kcal). Main outcome measures Weight and length gain, incidence of severe stunting, underweight, and wasting. Results The mean weight and length gains in LP, FS50 and FS25 groups were 2.37, 2.47, and 2.37 kg (p= 0.658) and 12.7, 13.5, and 13.2 cm (p=0.234), respectively. In the same groups, cumulative 12-month incidence of severe stunting was 14.0%, 0.0% and 4.0% (p=0.011), severe underweight 15.0%, 22.5% and 16.9% (p=0.706), and severe wasting 1.8%, 1.9% and 1.8% (p=0.999). Compared to LP-supplemented infants, those given FS50 gained on average (95%CI;p) 100 g (−143 to 343; p=0.419) more weight and 0.8 cm (−0.1 to 1.7; p=0.091) more length. There was a significant interaction between baseline length and intervention (p=0.042); among children with below-median length at enrolment, those given FS50 gained on average 1.9 cm (0.3 to 3.5; p=0.020) more than individuals receiving LP. Conclusions One-year-long complementary feeding with FS does not have significantly larger effect than maize-soy flour on the average weight gain of all infants, but it seems to boost linear growth in the disadvantaged individuals and hence decrease the incidence of severe stunting. PMID:18606932

  14. Idiot savants: rate of incidence.

    PubMed

    Hill, A L

    1977-02-01

    Based on the replies to a survey of 300 public residential facilities for the mentally retarded, an incidence rate for idiot savants was established. This rate of .06% is based on the reporting of 54 idiot savants within a population of 90,000 residents. Several reasons for caution in the acceptance of this incidence rate are discussed. PMID:840586

  15. Harnessing Critical Incidents for Learning

    ERIC Educational Resources Information Center

    Patahuddin, Sitti Maesuri; Lowrie, Tom

    2015-01-01

    A critical incident is a situation or event that holds significance for learning, both for the students and teachers. This paper presents four examples of critical incidents from a Year 7 teacher's lesson excerpts in Indonesia involving teaching of fractions, to show how they shaped classroom situation, brought forward elements of conflict, and…

  16. Low 25-Hydroxyvitamin D Concentrations Predict Incident Depression in Well-Functioning Older Adults: The Health, Aging, and Body Composition Study

    PubMed Central

    Sink, Kaycee M.; Tooze, Janet A.; Atkinson, Hal H.; Cauley, Jane A.; Yaffe, Kristine; Tylavsky, Frances A.; Rubin, Susan M.; Simonsick, Eleanor M.; Kritchevsky, Stephen B.; Houston, Denise K.

    2015-01-01

    Background. Cross-sectional studies suggest that low 25-hydroxyvitamin D (25[OH]D) may be a risk factor for depression; however, there are few prospective studies. We examined the association between 25(OH)D and depressive symptoms in community-dwelling persons aged 70–79 years in the Health, Aging, and Body Composition (Health ABC) Study (n = 2598). Methods. Depressive symptoms were assessed using the Center for Epidemiologic Studies-Depression Scale (CES-D) at baseline and 2-, 3- and 4-year follow-up. Serum 25(OH)D was measured at 1-year follow-up and categorized as <20, 20–<30, and ≥30 ng/mL. Mixed models were used to examine change in CES-D scores according to 25(OH)D categories. The association between 25(OH)D categories and incident depression (CES-D short score ≥10 or antidepressant medication use) were assessed using Cox proportional hazards models. Analyses were adjusted for socio-demographic and behavioral characteristics, season, and chronic conditions. Results. Thirty-three percent of participants had 25(OH)D <20ng/mL. Serum 25(OH)D was not associated with CES-D scores at baseline (p = .51); however, CES-D scores increased over time and were significantly associated with 25(OH)D at 2-year (p = .003) and 4-year follow-up (p < .001). Among 2,156 participants free of depression at the 1-year follow-up, the cumulative incidence of depression was 26.9%. Participants with 25(OH)D <20ng/mL were at greater risk of developing depression (HR [95% CI]: 1.65 [1.23–2.22]) over 4 years of follow-up compared with those with 25(OH)D ≥30ng/mL. Conclusion. Low 25(OH)D was independently associated with a greater increase in depressive symptom scores and incident depression in community-dwelling older adults. PMID:25326643

  17. Obliquely incident ion beam figuring

    NASA Astrophysics Data System (ADS)

    Zhou, Lin; Dai, Yifan; Xie, Xuhui; Li, Shengyi

    2015-10-01

    A new ion beam figuring (IBF) technique, obliquely incident IBF (OI-IBF), is proposed. In OI-IBF, the ion beam bombards the optical surface obliquely with an invariable incident angle instead of perpendicularly as in the normal IBF. Due to the higher removal rate in oblique incidence, the process time in OI-IBF can be significantly shortened. The removal rates at different incident angles were first tested, and then a test mirror was processed by OI-IBF. Comparison shows that in the OI-IBF technique with a 30 deg incident angle, the process time was reduced by 56.8%, while keeping the same figure correcting ability. The experimental results indicate that the OI-IBF technique is feasible and effective to improve the surface correction process efficiency.

  18. Estimated cancer incidence and mortality in Hebei province, 2012

    PubMed Central

    He, Yutong; Liang, Di; Li, Daojuan; Zhai, Jingbo; Zhu, Junqing; Jin, Jing; Wen, Denggui

    2016-01-01

    Objective This study estimates the numbers of new cancer cases and cancer deaths in Hebei province using incidence and mortality data from 9 population-based cancer registries in 2012. Methods The data of new diagnosed cancer cases and cancer deaths in 2012 were collected from 9 population-based cancer registries of Hebei province in 2015. All the data met the National Central Cancer Registry of China (NCCR) criteria of data quality. The pooled data analysis was stratified by areas (urban/rural), gender, age group (0, 1.4, 5.9, 10.14, …, 85+) and cancer type. New cancer cases and deaths in Hebei province were estimated using age-specific rates and corresponding provincial population in 2012. The 10 most common cancers in different groups and the cumulative rates were calculated. Chinese population census in 2000 and Segi’s population were used for age-standardized incidence/mortality rates. Results All cancer registries covered 4,986,847 populations, 6.84% of Hebei provincial population (2,098,547 in urban and 2,888,300 in rural areas). The percentage of cases morphologically verified (MV%) and death certificate-only cases (DCO%) were 76.40% and 4.72%, respectively. The mortality to incidence rate ratio (M/I) was 0.64. In 2012, it is estimated that there were about 187,900 new diagnosed cancer cases and 119,800 cancer deaths in Hebei province. The incidence rate of cancer was 258.12/100,000 (275.75/100,000 in males, 239.78/100,000 in females), and the age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 210.65/100,000 and 208.50/100,000, with the cumulative incidence rates (0.74 years old) of 24.46%. The cancer incidence and ASIRC were 256.99/100,000 and 211.32/100,000 in urban areas and 258.94/100,000 and 209.99/100,000 in rural areas, respectively. The cancer mortality rate was 164.63/100,000 (201.85/100,000 in males, 125.92/100,000 in females). Agestandardized mortality rates by Chinese

  19. Risk factors for the onset and persistence of neck pain in undergraduate students: 1-year prospective cohort study

    PubMed Central

    2011-01-01

    Background Although neck pain is common in young adulthood, studies on predictive factors for its onset and persistence are scarce. It is therefore important to identify possible risk factors among young adults so as to prevent the development of neck pain later in life. Methods A prospective study was carried out in healthy undergraduate students. At baseline, a self-administered questionnaire and standardized physical examination were used to collect data on biopsychosocial factors. At 3, 6, 9, and 12 months thereafter, follow-up data were collected on the incidence of neck pain. Those who reported neck pain on ≥ 2 consecutive follow-ups were categorized as having persistent neck pain. Two regression models were built to analyze risk factors for the onset and persistence of neck pain. Results Among the recruited sample of 684 students, 46% reported the onset of neck pain between baseline and 1-year follow-up, of whom 33% reported persistent neck pain. The onset of neck pain was associated with computer screen position not being level with the eyes and mouse position being self-rated as suitable. Factors that predicted persistence of neck pain were position of the keyboard being too high, use of computer for entertainment < 70% of total computer usage time, and students being in the second year of their studies. Conclusion Neck pain is quite common among undergraduate students. This study found very few proposed risk factors that predicted onset and persistence of neck pain. The future health of undergraduate students deserves consideration. However, there is still much uncertainty about factors leading to neck pain and more research is needed on this topic. PMID:21756362

  20. Neurodevelopment at 1 year of age in infants with congenital heart disease

    PubMed Central

    Dittrich, H; Bührer, C; Grimmer, I; Dittrich, S; Abdul-Khaliq, H; Lange, P E

    2003-01-01

    Objective: To assess psychomotor development and neurological sequelae in infants after surgery for congenital heart defects. Design and setting: Single institution prospective cohort study. Patients: 90 of 112 consecutive surviving infants of less than 1 year of age, without brain anomalies, conditions, or syndromes associated with delayed mental development, who underwent cardiac surgery during an 18 month period; 20 control infants with minor or no congenital heart defects. Main outcome measures: Griffiths developmental scales and standardised neurological examination at 1 year. Results: Mean (SD) developmental quotient (DQ) in index infants was 99 (10.6), compared with 106.7 (6.6) in controls (p < 0.001). DQ was lower in infants after palliative surgery (n = 16; 88 (12.2)) than after corrective surgery (n = 74; 101.4 (8.6)) (p < 0.001). Of the 90 index infants, 24 (27%) had a DQ below 93.5 (more than 2 SD below the mean of controls). Developmental delay (DQ < 93.5) was more common after palliative surgery (10/16, 63%) than after corrective surgery (14/74, 19%) (p < 0.001). Of the 90 index infants, 29 (32%) had neurological abnormalities, compared with only one of the 20 controls (5%) (p = 0.013). Neurological abnormalities were more frequent after palliative surgery (11/16, 69%) than after corrective surgery (18/74, 24%) (p < 0.001). Conclusions: There is a considerable rate of neurodevelopmental impairment at 1 year of age in infants after cardiac surgery. Psychomotor impairment and neurological sequelae are apparently more severe in infants in whom only palliative surgery is possible. PMID:12639876

  1. The value of pre-operative multicompartment pelvic floor ultrasonography: a 1-year prospective study

    PubMed Central

    Lone, F; Stankiewicz, A; Thakar, R

    2014-01-01

    Objective: Comprehensive assessment of the pelvic floor (PF) provides information and diagnoses of coexisting abnormalities that may affect operative decisions. Our aim was to establish if pre-operative PF ultrasonography (PFUS) in patients complaining of PF dysfunction can complement clinical findings and contribute to additional management strategies. Methods: Females were recruited from the urogynaecology/gynaecology clinics between July and October 2009 and underwent pelvic organ prolapse quantification (POPQ) by an independent examiner. PFUS was performed using two-dimensional (2D) transperineal ultrasound (TPUS), high-frequency 2D/three-dimensional (3D) endovaginal ultrasound (EVUS) using a biplane probe with linear and transverse arrays and a 360° rotational 3D-EVUS. The clinician performing PFUS was blinded to POPQ results. POPQ and PFUS were repeated at 1 year. Two clinicians analysed the scans independently. Results: 158 of 160 females had a POPQ and PFUS. 105 females had pelvic organ prolapse and/or incontinence and 53 asymptomatic females were controls. 26 additional ultrasound diagnoses were noted at baseline and 46 at 1 year using 2D-TPUS and EVUS. Only one female with additional diagnoses on PFUS needed surgical intervention for this condition. Conclusion: Multicompartment PFUS identifies additional conditions to that diagnosed on clinical assessment. However, it neither changes the initial surgical management nor the management at 1-year follow-up and therefore clinical assessment should not be substituted by PFUS. Advances in knowledge: PFUS can be helpful in providing additional information; however, it does not change the initial management of the patient and therefore should not replace clinical assessment. PMID:24959953

  2. Brucella arthritis of the knee, 1 year after revision of anterior cruciate ligament reconstruction.

    PubMed

    Papastergiou, S G; Koukoulias, N E; Koumis, P; Kyparlis, D; Santas, R

    2011-01-01

    Brucellosis is a zoonotic infection with a broad spectrum of clinical manifestations. The authors report the first case in the literature of septic arthritis of the knee 1 year after revision of anterior cruciate ligament reconstruction. Brucella melitensis biotype 3 was found in both synovial fluid and blood cultures. The patient was treated initially with arthroscopic debridement. After the diagnosis was confirmed, a second arthroscopic lavage and metal work removal was applied leaving the graft in place. Antimicrobial chemotherapy was prescribed for 3 months. The infection was fully eradicated and the patient is still asymptomatic, 4 years after the treatment. PMID:22700607

  3. Brucella arthritis of the knee, 1 year after revision of anterior cruciate ligament reconstruction

    PubMed Central

    Papastergiou, S G; Koukoulias, N E; Koumis, P; Kyparlis, D; Santas, R

    2011-01-01

    Brucellosis is a zoonotic infection with a broad spectrum of clinical manifestations. The authors report the first case in the literature of septic arthritis of the knee 1 year after revision of anterior cruciate ligament reconstruction. Brucella melitensis biotype 3 was found in both synovial fluid and blood cultures. The patient was treated initially with arthroscopic debridement. After the diagnosis was confirmed, a second arthroscopic lavage and metal work removal was applied leaving the graft in place. Antimicrobial chemotherapy was prescribed for 3 months. The infection was fully eradicated and the patient is still asymptomatic, 4 years after the treatment. PMID:22700607

  4. Traumatic spinal epidural hematoma in a 1-year-old boy.

    PubMed

    Tarbé de Saint Hardouin, A-L; Grévent, D; Sainte-Rose, C; Angoulvant, F; Chéron, G

    2016-07-01

    Traumatic spinal epidural hematoma is uncommon in children, making rapid diagnosis difficult. In this report, we present a case of traumatic cervical epidural hematoma in a 1-year-old boy, diagnosed with computed tomography scanning and magnetic resonance imaging (MRI). Management was conservative and the lesion regressed spontaneously. The presentation in childhood is often nonspecific. MRI is the imaging modality of choice for diagnosing these lesions. Conservative treatment has to be considered in cases with a benign clinical course and provided that the patient is followed up neurologically with repeated MRI. PMID:27266638

  5. Necessity and Opportunity: the 1-Year Master's ABA Program at Auburn University.

    PubMed

    Johnston, James M

    2016-05-01

    The Auburn University Master of Science program in Applied Behavior Analysis was designed to accommodate not only the requirements of the Behavior Analyst Certification Board for approved course sequences and practicum training, but unavoidable limitations in faculty and other resources. These limitations were incompatible with the more traditional 2-year curriculum model, so a 1-year program was designed that met the necessary conditions. This article describes the resulting academic and practicum curriculum, the key funding mechanisms that allowed the program to develop, and the opportunities and benefits that this model afforded. PMID:27606193

  6. Rapidity window dependences of higher order cumulants and diffusion master equation

    NASA Astrophysics Data System (ADS)

    Kitazawa, Masakiyo

    2015-10-01

    We study the rapidity window dependences of higher order cumulants of conserved charges observed in relativistic heavy ion collisions. The time evolution and the rapidity window dependence of the non-Gaussian fluctuations are described by the diffusion master equation. Analytic formulas for the time evolution of cumulants in a rapidity window are obtained for arbitrary initial conditions. We discuss that the rapidity window dependences of the non-Gaussian cumulants have characteristic structures reflecting the non-equilibrium property of fluctuations, which can be observed in relativistic heavy ion collisions with the present detectors. It is argued that various information on the thermal and transport properties of the hot medium can be revealed experimentally by the study of the rapidity window dependences, especially by the combined use, of the higher order cumulants. Formulas of higher order cumulants for a probability distribution composed of sub-probabilities, which are useful for various studies of non-Gaussian cumulants, are also presented.

  7. Incidence and prevalence of idiopathic pulmonary fibrosis in US adults 18-64 years old.

    PubMed

    Raghu, Ganesh; Chen, Shih-Yin; Hou, Qiang; Yeh, Wei-Shi; Collard, Harold R

    2016-07-01

    We sought to present the epidemiology of idiopathic pulmonary fibrosis (IPF) in adults 18-64 years old in the USA.From adults aged 18-64 years in a large administrative claims data in 2004-2010, patients with IPF were identified using diagnosis codes. We estimated annual incidence and cumulative prevalence of IPF over time, and examined potential risk factors for the IPF diagnosis.The annual cumulative prevalence increased steadily in the first few years (from 13.4 cases per 100 000 persons in 2005 to 18.2 cases in 2010 per 100 000 persons), which is likely due to a methodological reason, while the annual incidence of IPF decreased over time (from 7.9 cases per 100 000 person-years in 2005 to 5.8 cases in 2010 per 100 000 person-years). The overall decrease was mainly driven by a decreasing trend in the younger patients (aged 18-44 years), while the incidence in older patients remained stable. Consistent trends were observed in subgroups defined by previously published more restrictive algorithms for diagnosis. Older age and male sex were associated with a higher incidence of disease (p<0.05).In US adults younger than 65 years, we observed a decreasing incidence of IPF over time which may partially explain the plateau of cumulative prevalence in the last few years of our data. PMID:27126689

  8. Analysis of the cumulative exergy consumption of an integrated oxy-fuel combustion power plant

    NASA Astrophysics Data System (ADS)

    Ziębik, Andrzej; Gładysz, Paweł

    2013-09-01

    In order to analyze the cumulative exergy consumption of an integrated oxy-fuel combustion power plant the method of balance equations was applied based on the principle that the cumulative exergy consumption charging the products of this process equals the sum of cumulative exergy consumption charging the substrates. The set of balance equations of the cumulative exergy consumption bases on the `input-output method' of the direct energy consumption. In the structure of the balance we distinguished main products (e.g. electricity), by-products (e.g. nitrogen) and external supplies (fuels). In the balance model of cumulative exergy consumption it has been assumed that the cumulative exergy consumption charging the supplies from outside is a quantity known a priori resulting from the analysis of cumulative exergy consumption concerning the economy of the whole country. The byproducts are charged by the cumulative exergy consumption resulting from the principle of a replaced process. The cumulative exergy consumption of the main products is the final quantity.

  9. Induction of Maturogenesis by Partial Pulpotomy: 1 Year Follow-Up

    PubMed Central

    Bacaksiz, A.; Alaçam, A.

    2013-01-01

    In cariously exposed immature permanent teeth, the treatment choice is controversial in pediatric dentistry. Radical root canal treatment usually appears to be the solution for these teeth. Even partial pulpotomy is a vital treatment for traumatically exposed immature permanent teeth; extending the borders of indication towards cariously exposed immature permanent teeth with reversible pulpitis may abolish the necessity of pulpectomy. This article describes the partial pulpotomy of a cariously affected immature permanent teeth and the follow-up for 1 year. A healthy 11-year-old male patient was referred to Gazi University Faculty of Dentistry Department of Pediatric Dentistry. The patient had reversible pulpitis symptoms on teeth numbered 45. At radiographic examination, immature apex and deep caries lesion were observed and partial pulpotomy was performed by using calcium hydroxide to maintain vitality of the pulp and allow continued development of root dentin expecting the root will attain full maturity. Clinical and radiographic follow-up demonstrated a vital pulp besides not only closure of the apex (apexogenesis), but also physiologic root development (maturogenesis) after 1 year. Partial pulpotomy is an optional treatment for cariously exposed immature permanent teeth for preserving vitality and physiological root development. PMID:24324899

  10. Parental spanking of 1-year-old children and subsequent child protective services involvement✩

    PubMed Central

    Lee, Shawna J.; Grogan-Kaylor, Andrew; Berger, Lawrence M.

    2015-01-01

    The majority of U.S. parents spank their children, often beginning when their children are very young. We examined families (N=2,788) who participated in a longitudinal community-based study of new births in urban areas. Prospective analyses examined whether spanking by the child's mother, father, or mother's current partner when the child was 1-year-old was associated with household CPS involvement between age 1 and age 5. Results indicated that 30% of 1-year-olds were spanked at least once in the past month. Spanking at age 1 was associated with increased odds of subsequent CPS involvement (adjusted odds ratio=1.36, 95% CI [1.08, 1.71], p<.01). When compared to non-spanked children, there was a 33% greater probability of subsequent CPS involvement for children who were spanked at age 1. Given the undesirable consequences of spanking children and a lack of empirical evidence to suggest positive effects of physical punishment, professionals who work with families should counsel parents not to spank infants and toddlers. For optimal benefits, efforts to educate parents regarding alternative forms of discipline should begin during the child's first year of life. PMID:24602690

  11. Parental spanking of 1-year-old children and subsequent child protective services involvement.

    PubMed

    Lee, Shawna J; Grogan-Kaylor, Andrew; Berger, Lawrence M

    2014-05-01

    The majority of U.S. parents spank their children, often beginning when their children are very young. We examined families (N=2,788) who participated in a longitudinal community-based study of new births in urban areas. Prospective analyses examined whether spanking by the child's mother, father, or mother's current partner when the child was 1-year-old was associated with household CPS involvement between age 1 and age 5. Results indicated that 30% of 1-year-olds were spanked at least once in the past month. Spanking at age 1 was associated with increased odds of subsequent CPS involvement (adjusted odds ratio=1.36, 95% CI [1.08, 1.71], p<.01). When compared to non-spanked children, there was a 33% greater probability of subsequent CPS involvement for children who were spanked at age 1. Given the undesirable consequences of spanking children and a lack of empirical evidence to suggest positive effects of physical punishment, professionals who work with families should counsel parents not to spank infants and toddlers. For optimal benefits, efforts to educate parents regarding alternative forms of discipline should begin during the child's first year of life. PMID:24602690

  12. Immediate Implant Placement in a Patient With Osteoporosis Undergoing Bisphosphonate Therapy: 1-Year Preliminary Prospective Study.

    PubMed

    Siebert, Tomas; Jurkovic, Richard; Statelova, Dagmar; Strecha, Juraj

    2015-07-01

    The purposes of this preliminary study are to assess the risk of developing bisphosphonate-related osteonecrosis of the jaw (BRONJ) in a patient with osteoporosis using zoledronic acid and to report the results of a 1-year prospective clinical study regarding 5 immediately inserted implants in the anterior mandible. For this comparative prospective study, 24 female patients, aged ≥54 years, were chosen, all with partially edentulous mandibles. Group A consisted of 12 patients with osteoporosis taking zoledronic acid receiving a once-yearly intravenous infusion of zoledronic acid (5 mg). Control group B consisted of 12 other patients without osteoporosis and not taking drugs. In both groups, the remaining teeth were extracted before 120 implants, 3.7-mm wide and 16-mm long, were immediately installed in the interforaminal region of the mandibles. The 1-year implant survival rate was 100%. No apparent necrotic bone was observed among patients receiving zoledronic acid (group A) after implant surgery. Immediate implant osseointegration can be successful in a patient with osteoporosis using bisphosphonates, suggesting the safety of implantology as a treatment modality. PMID:24041299

  13. BDNF mediates improvements in executive function following a 1-year exercise intervention.

    PubMed

    Leckie, Regina L; Oberlin, Lauren E; Voss, Michelle W; Prakash, Ruchika S; Szabo-Reed, Amanda; Chaddock-Heyman, Laura; Phillips, Siobhan M; Gothe, Neha P; Mailey, Emily; Vieira-Potter, Victoria J; Martin, Stephen A; Pence, Brandt D; Lin, Mingkuan; Parasuraman, Raja; Greenwood, Pamela M; Fryxell, Karl J; Woods, Jeffrey A; McAuley, Edward; Kramer, Arthur F; Erickson, Kirk I

    2014-01-01

    Executive function declines with age, but engaging in aerobic exercise may attenuate decline. One mechanism by which aerobic exercise may preserve executive function is through the up-regulation of brain-derived neurotropic factor (BDNF), which also declines with age. The present study examined BDNF as a mediator of the effects of a 1-year walking intervention on executive function in 90 older adults (mean age = 66.82). Participants were randomized to a stretching and toning control group or a moderate intensity walking intervention group. BDNF serum levels and performance on a task-switching paradigm were collected at baseline and follow-up. We found that age moderated the effect of intervention group on changes in BDNF levels, with those in the highest age quartile showing the greatest increase in BDNF after 1-year of moderate intensity walking exercise (p = 0.036). The mediation analyses revealed that BDNF mediated the effect of the intervention on task-switch accuracy, but did so as a function of age, such that exercise-induced changes in BDNF mediated the effect of exercise on task-switch performance only for individuals over the age of 71. These results demonstrate that both age and BDNF serum levels are important factors to consider when investigating the mechanisms by which exercise interventions influence cognitive outcomes, particularly in elderly populations. PMID:25566019

  14. Determinants of telomere attrition over 1 year in healthy older women: stress and health behaviors matter.

    PubMed

    Puterman, E; Lin, J; Krauss, J; Blackburn, E H; Epel, E S

    2015-04-01

    Telomere length, a reliable predictor of disease pathogenesis, can be affected by genetics, chronic stress and health behaviors. Cross-sectionally, highly stressed postmenopausal women have shorter telomeres, but only if they are inactive. However, no studies have prospectively examined telomere length change over a short period, and if rate of attrition is affected by naturalistic factors such as stress and engagement in healthy behaviors, including diet, exercise, and sleep. Here we followed healthy women over 1 year to test if major stressors that occurred over the year predicted telomere shortening, and whether engaging in healthy behaviors during this period mitigates this effect. In 239 postmenopausal, non-smoking, disease-free women, accumulation of major life stressors across a 1-year period predicted telomere attrition over the same period-for every major life stressor that occurred during the year, there was a significantly greater decline in telomere length over the year of 35 bp (P<0.05). Yet, these effects were moderated by health behaviors (interaction B=0.19, P=0.04). Women who maintained relatively higher levels of health behaviors (1 s.d. above the mean) appeared to be protected when exposed to stress. This finding has implications for understanding malleability of telomere length, as well as expectations for possible intervention effects. This is the first study to identify predictors of telomere length change over the short period of a year. PMID:25070535

  15. Residual skin damage in rats 1 year after exposure to x rays or accelerated heavy ions

    SciTech Connect

    Leith, J.T.; McDonald, M.; Howard, J.

    1982-01-01

    In conjunction with a study on the biological effects of accelerated heavy ions on rat spinal cord, we were able to assess the residual skin damage remaining 1 year postirradiation. In this study, rats were irradiated with 230-kVp fractionated doses of either X rays, carbon ions, or neon ions. Four radiation fractions were given at daily intervals. For the carbon and neon ion exposures, rats were irradiated in both the plateau and spread Bragg peak (4 cm) regions of ionization. Comparing doses that produced complete epilation with a slight suggestion of a residual radiation scar, it was found that the relative biological effectivesness (RBE) values 1 year postirradiation for the four fraction irradiations were: carbon ions (plateau ionization region), 1.06; carbon ions (spread Bragg peak ionization region), 1.88; neon ions (plateau region of ionization), 1.55; and neon ions (spread Bragg peak ionization region), 2.26. RBE values for production of paralysis after spinal cord irradiation (using the same X-ray total dose levels for comparison purposes) were in all cases higher than the RBE values obtained from assessment of residual skin injury.

  16. Enhancing Coparenting, Parenting, and Child Self-Regulation: Effects of Family Foundations 1 Year after Birth

    PubMed Central

    Feinberg, Mark E.; Kan, Marni L.; Goslin, Megan C.

    2011-01-01

    This study investigated whether a psycho-educational program with modest dosage (eight sessions), delivered in a universal framework through childbirth education programs and targeting the coparenting relationship would have a positive impact on observed family interaction and child behavior at 6-month follow-up (child age 1 year). One hundred sixty-nine couples, randomized to intervention and control conditions, participated in videotaped family observation tasks at pretest (during pregnancy) and at child age 1 year (2003–2007). Coparenting, parenting, couple relationship, and child self-regulatory behaviors were coded by teams of raters. Intent-to-treat analyses of program effects controlled for age, education, and social desirability. Evidence of significant (p<0.05) program effects at follow-up emerged in all four domains. Effect sizes ranged from 0.28 to 1.01. Targeting the coparenting relationship at the transition to parenthood represents an effective, non-stigmatizing means of promoting parenting quality and child adjustment. PMID:19381809

  17. Incidence of dementia in a Kashmiri migrant population

    PubMed Central

    Raina, Sunil Kumar; Pandita, Kamal Kishore; Razdan, Sushil

    2009-01-01

    Background: Mishriwala is one of five exclusive clusters of Kashmiri migrants established in 1990 to accommodate Kashmiri Pandit families who left Kashmir valley in the wake of militancy. Mishriwala migrant camp has seen minimal immigration and out-migration since its establishment. In an earlier study we reported on the prevalence of dementia amongst a Kashmiri migrant population. That study was conducted in the migrant camp at Mishriwala, 12 km west of Jammu city, the winter capital of Jammu and Kashmir State. We have developed standardized study methods and instruments for use in the Kashmiri-speaking population, which we used for screening for dementia during the prevalence study. We now report the results of a 1-year prospective study carried out to find out the incidence of dementia in the same population. Aim: To ascertain the incidence of dementiain the Kashmiri Pandit population aged 60 years and above. Materials and Methods: A 1-year, prospective, epidemiological study of 186 subjects aged 60 years and above, using cognitive and functional ability screening and clinical evaluation. Results: The incidence of dementia in this population was 5.34 cases per 1000 person-years. PMID:20174494

  18. Standardization of the cumulative absolute velocity. Final report

    SciTech Connect

    O`Hara, T.F.; Jacobson, J.P.

    1991-12-01

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

  19. Soil test phosphorus and cumulative phosphorus budgets in fertilized grassland.

    PubMed

    Messiga, Aimé Jean; Ziadi, Noura; Jouany, Claire; Virkajärvi, Perttu; Suomela, Raija; Sinaj, Sokrat; Bélanger, Gilles; Stroia, Ciprian; Morel, Christian

    2015-03-01

    We analyzed the linearity of relationships between soil test P (STP) and cumulative phosphorus (P) budget using data from six long-term fertilized grassland sites in four countries: France (Ercé and Gramond), Switzerland (Les Verrières), Canada (Lévis), and Finland (Maaninka and Siikajoki). STP was determined according to existing national guidelines. A linear-plateau model was used to determine the presence of deflection points in the relationships. Deflection points with (x, y) coordinates were observed everywhere but Maaninka. Above the deflection point, a significant linear relationship was obtained (0.33 < r (2) < 0.72) at four sites, while below the deflection point, the relationship was not significant, with a negligible rate of STP decrease. The relationship was not linear over the range of STP encountered at most sites, suggesting a need for caution when using the P budget approach to predict STP changes in grasslands, particularly in situations of very low P fertilization. Our study provides insights and description of a tool to improve global P strategies aimed at maintaining STP at levels adequate for grassland production while reducing the risk of P pollution of water. PMID:25681982

  20. A high prevalence of cumulative trauma disorders in Iranian instrumentalists

    PubMed Central

    Sadeghi, Shahram; Kazemi, Behrooz; Shooshtari, Seyed Mostafa Jazayeri; Bidari, Ali; Jafari, Peyman

    2004-01-01

    Background Cumulative trauma disorders (CTDs) are common in musicians and their prevalence has been the subject of a number of studies in most western countries. Such studies are scarce in developing countries despite the possibility that CTDs may have a different prevalence in these countries, especially when considering traditional musical instruments and different methods of playing. Although not formally studied before, according to our experience the prevalence of CTDs seemed to be high among Iranian instrumentalists. We proposed this study to determine the prevalence of CTDs in amateur music students playing one of the two traditional Iranian instruments: Daf and Setar. Methods In a prospective cross sectional study, we interviewed and examined the students of three music training centers in Iran. Seventy eight instrumentalists, who were playing Daf or Setar and twelve students who had not started playing yet were regarded as case and control groups respectively. Some of them also underwent electrodiagnostic studies. Results Forty-seven percent (17 of 36) of the Setar players and 57% (24 of 42) of the Daf players and fifty-three percent (41 of 78) of the instrumentalists as a whole had CTDs. None of them had carpal tunnel syndrome. Conclusions Our study revealed that the prevalence of CTDs in Iranian instrumentalists was unusually high. In addition to age, other variables may be contributory. This needs to be further studied. PMID:15485578

  1. Discerning mechanistically rewired biological pathways by cumulative interaction heterogeneity statistics

    PubMed Central

    Cotton, Travis B.; Nguyen, Hien H.; Said, Joseph I.; Ouyang, Zhengyu; Zhang, Jinfa; Song, Mingzhou

    2015-01-01

    Changes in response of a biological pathway could be a consequence of either pathway rewiring, changed input, or a combination of both. Most pathway analysis methods are not designed for mechanistic rewiring such as regulatory element variations. This limits our understanding of biological pathway evolution. Here we present a Q-method to discern whether changed pathway response is caused by mechanistic rewiring of pathways due to evolution. The main innovation is a cumulative pathway interaction heterogeneity statistic accounting for rewiring-specific effects on the rate of change of each molecular variable across conditions. The Q-method remarkably outperformed differential-correlation based approaches on data from diverse biological processes. Strikingly, it also worked well in differentiating rewired chaotic systems, whose dynamics are notoriously difficult to predict. Applying the Q-method on transcriptome data of four yeasts, we show that pathway interaction heterogeneity for known metabolic and signaling pathways is indeed a predictor of interspecies genetic rewiring due to unbalanced TATA box-containing genes among the yeasts. The demonstrated effectiveness of the Q-method paves the way to understanding network evolution at the resolution of functional biological pathways. PMID:25921728

  2. The cumulative energy effect for improved ignition timing

    SciTech Connect

    Markhotok, A.

    2015-04-15

    A technique capable of improving timing in ignition applications is proposed. It is based on the use of shock waves propagating in a specific medium that allows achieving extremely high speeds and energies. The model uses the energy cumulation effect in the presence of the shock wave refraction on an interface with plasma. The problem was solved analytically and the effects were demonstrated for a cylindrically symmetrical geometry. Numerical results show very quick and uneven acceleration of different portions of the shock front. Its strong distortions lead to formation of a sharply focused jet near the axis of symmetry. The ability of the shock to achieve extremely high speeds and energies can be useful in design of efficient combustors for hypersonic systems, and possibly offers an alternative way of construction of a nuclear fusion reactor. Recommendations are given in terms of adjustment parameters and can be applied at any problem scale and for various combinations of the strengths of the effects involved in the problem.

  3. Cumulative sum quality control for calibrated breast density measurements

    SciTech Connect

    Heine, John J.; Cao Ke; Beam, Craig

    2009-12-15

    Purpose: Breast density is a significant breast cancer risk factor. Although various methods are used to estimate breast density, there is no standard measurement for this important factor. The authors are developing a breast density standardization method for use in full field digital mammography (FFDM). The approach calibrates for interpatient acquisition technique differences. The calibration produces a normalized breast density pixel value scale. The method relies on first generating a baseline (BL) calibration dataset, which required extensive phantom imaging. Standardizing prospective mammograms with calibration data generated in the past could introduce unanticipated error in the standardized output if the calibration dataset is no longer valid. Methods: Sample points from the BL calibration dataset were imaged approximately biweekly over an extended timeframe. These serial samples were used to evaluate the BL dataset reproducibility and quantify the serial calibration accuracy. The cumulative sum (Cusum) quality control method was used to evaluate the serial sampling. Results: There is considerable drift in the serial sample points from the BL calibration dataset that is x-ray beam dependent. Systematic deviation from the BL dataset caused significant calibration errors. This system drift was not captured with routine system quality control measures. Cusum analysis indicated that the drift is a sign of system wear and eventual x-ray tube failure. Conclusions: The BL calibration dataset must be monitored and periodically updated, when necessary, to account for sustained system variations to maintain the calibration accuracy.

  4. Femtosecond writing of depressed cladding waveguides in strongly cumulative regime

    NASA Astrophysics Data System (ADS)

    Bukharin, Mikhail A.; Khudyakov, Dmitriy V.; Vartapetov, Sergey K.

    2015-05-01

    We proposed a novel approach for direct femtosecond inscription of waveguides. It consisted in formation of cladding with reduced refractive index in fused silica. Depressed cladding was based on peripheral regions of individually written neighbored tracks, which should be inscribed in strongly cumulative regime. It was shown, that due to shot time interval between femtosecond laser pulses and relatively slow thermal diffusion, the exposed focal region surrounds by significantly wide cladding with reduced refracted index. Based on proposed approach we demonstrated depressed cladding waveguide inscription in fused silica using emission directly from commercially available femtosecond oscillator without correcting optical systems and second harmonic generation. It was shown, that the new approach provides formation of easily adjustable single mode waveguides with desired mode field diameter. Such depressed cladding waveguides exploit both advantages of fused silica material and depressed cladding geometry. We also verified our suggestion by experiment and inscribed depressed cladding waveguides with two different mode field diameters at similar femtosecond pulse characteristics. The obtained structures provided low propagation losses and good coupling with Gaussian mode. The waveguides supported propagation of both polarizations with nearly identical characteristics. Obtained experimental results were in good agreement with numerical simulation.

  5. Cumulative Causation, Market Transition, and Emigration from China

    PubMed Central

    Liang, Zai; Chunyu, Miao David; Zhuang, Guotu; Ye, Wenzhen

    2009-01-01

    In this paper, we report findings from a recent survey of international migration from China's Fujian province to the United States. We take advantage of the ethnosurvey approach as used in the Mexican Migration Project. Surveys were done in migrant-sending communities in China as well as in destination communities of New York City. We derive hypotheses from two strands of recent studies-the international migration literature and the market transition debate. Our results are in general consistent with hypotheses derived from cumulative causation of migration. However, because of the geographical location of China as compared to Mexico, there are some differences between the two countries in terms of particular migration patterns to the United States. As expected, at the community level, migration prevalence ratio (measuring migration networks) increases the propensity of migration for other members in the community. In contrast, having a household member migrated previously does not increase the propensity of migration of other household members until debt for previous migration is paid off. Our research clearly demonstrates the value of bringing the case of China into the comparative study of international migration. With respect to market transition theory, we find that political power continues to be an important factor in the order of social stratification in the coastal Fujian province. PMID:19569396

  6. Cumulative biological impacts of The Geysers geothermal development

    SciTech Connect

    Brownell, J.A.

    1981-10-01

    The cumulative nature of current and potential future biological impacts from full geothermal development in the steam-dominated portion of The Geysers-Calistoga KGRA are identified by the California Energy Commission staff. Vegetation, wildlife, and aquatic resources information have been reviewed and evaluated. Impacts and their significance are discussed and staff recommendations presented. Development of 3000 MW of electrical energy will result in direct vegetation losses of 2790 acres, based on an estimate of 11.5% loss per lease-hold of 0.93 acres/MW. If unmitigated, losses will be greater. Indirect vegetation losses and damage occur from steam emissions which contain elements (particularly boron) toxic to vegetation. Other potential impacts include chronic low-level boron exposure, acid rain, local climate modification, and mechanical damage. A potential exists for significant reduction and changes in wildlife from direct habitat loss and development influences. Highly erosive soils create the potential for significant reduction of aquatic resources, particularly game fish. Toxic spills have caused some temporary losses of aquatic species. Staff recommends monitoring and implementation of mitigation measures at all geothermal development stages.

  7. Cumulative creep fatigue damage in 316 stainless steel

    NASA Technical Reports Server (NTRS)

    Mcgaw, Michael A.

    1989-01-01

    The cumulative creep-fatigue damage behavior of 316 stainless steel at 1500 F was experimentally established for the two-level loading cases of fatigue followed by fatigue, creep fatigue followed by fatigue, and fatigue followed by creep fatigue. The two-level loadings were conducted such that the lower life (high strain) cycling was applied first for a controlled number of cycles and the higher life (low strain) cycling was conducted as the second level to failure. The target life levels in this study were 100 cycles to failure for both the fatigue and creep-fatigue lowlife loading, 5000 cycles to failure for the higher life fatigue loading and 10,000 cycles to failure for the higher life creep-fatigue loading. The failed specimens are being examined both fractographically and metallographically to ascertain the nature of the damaging mechanisms that produced failure. Models of creep-fatigue damage accumulation are being evaluated and knowledge of the various damaging mechanisms is necessary to ensure that predictive capability is instilled in the final failure model.

  8. SeaWiFS Postlaunch Technical Report Series Cumulative Index

    NASA Technical Reports Server (NTRS)

    Hooker, Stanford B. (Editor); Firestone, Elaine R. (Editor)

    2001-01-01

    The Sea-viewing Wide Field-of-view Sensor (SeaWiFS) is the follow-on ocean color instrument to the Coastal Zone Color Scanner (CZCS), which ceased operations in 1986, after an eight-year mission. SeaWiFS was launched on 1 August 1997, onboard the OrbView-2 satellite, built by Orbital Sciences Corporation (OSC). The SeaWiFS Project at the National Aeronautics and Space Administration (NASA) Goddard Space Flight Center (GSFC), undertook the responsibility of documenting all aspects of this mission, which is critical to the ocean color and marine science communities. The start of this documentation was titled the SeaWiFS Technical Report Series, which ended after 43 volumes were published. A follow-on series was started, titled the SeaWiFS Postlaunch Technical Report Series. This particular volume of the so-called "Postlaunch Series" serves as a reference, or guidebook, to the previous 11 volumes and consists of 5 sections including an errata, an addendum, an index to key words and phrases, a list of acronyms used, and a list of all references cited. The editors will publish a cumulative index of this type after every five volumes.

  9. Microcanonical thermostatistics analysis without histograms: Cumulative distribution and Bayesian approaches

    NASA Astrophysics Data System (ADS)

    Alves, Nelson A.; Morero, Lucas D.; Rizzi, Leandro G.

    2015-06-01

    Microcanonical thermostatistics analysis has become an important tool to reveal essential aspects of phase transitions in complex systems. An efficient way to estimate the microcanonical inverse temperature β(E) and the microcanonical entropy S(E) is achieved with the statistical temperature weighted histogram analysis method (ST-WHAM). The strength of this method lies on its flexibility, as it can be used to analyse data produced by algorithms with generalised sampling weights. However, for any sampling weight, ST-WHAM requires the calculation of derivatives of energy histograms H(E) , which leads to non-trivial and tedious binning tasks for models with continuous energy spectrum such as those for biomolecular and colloidal systems. Here, we discuss two alternative methods that avoid the need for such energy binning to obtain continuous estimates for H(E) in order to evaluate β(E) by using ST-WHAM: (i) a series expansion to estimate probability densities from the empirical cumulative distribution function (CDF), and (ii) a Bayesian approach to model this CDF. Comparison with a simple linear regression method is also carried out. The performance of these approaches is evaluated considering coarse-grained protein models for folding and peptide aggregation.

  10. Shape memory polymer sensors for tracking cumulative environmental exposure

    NASA Astrophysics Data System (ADS)

    Snyder, Ryan; Rauscher, Michael; Vining, Ben; Havens, Ernie; Havens, Teresa; McFerran, Jace

    2010-04-01

    Cornerstone Research Group Inc. (CRG) has developed environmental exposure tracking (EET) sensors using shape memory polymers (SMP) to monitor the degradation of perishable items, such as munitions, foods and beverages, or medicines, by measuring the cumulative exposure to temperature and moisture. SMPs are polymers whose qualities have been altered to give them dynamic shape "memory" properties. Under thermal or moisture stimuli, the SMP exhibits a radical change from a rigid thermoset to a highly flexible, elastomeric state. The dynamic response of the SMP can be tailored to match the degradation profile of the perishable item. SMP-based EET sensors require no digital memory or internal power supply and provide the capability of inexpensive, long-term life cycle monitoring of thermal and moisture exposure over time. This technology was developed through Phase I and Phase II SBIR efforts with the Navy. The emphasis of current research centers on transitioning SMP materials from the lab bench to a production environment. Here, CRG presents the commercialization progress of thermally-activated EET sensors, focusing on fabrication scale-up, process refinements, and quality control. In addition, progress on the development of vapor pressure-responsive SMP (VPR-SMP) will be discussed.

  11. Cumulative Activation of Voltage-Dependent KVS-1 Potassium Channels

    PubMed Central

    Rojas, Patricio; Garst-Orozco, Jonathan; Baban, Beravan; de Santiago-Castillo, Jose Antonio; Covarrubias, Manuel; Salkoff, Lawrence

    2008-01-01

    In this study, we reveal the existence of a novel use-dependent phenomenon in potassium channels, which we refer to as cumulative activation (CA). CA consists of an increase in current amplitude in response to repetitive depolarizing step pulses to the same potential. CA persists for up to 20 s and is similar to a phenomenon called “voltage-dependent facilitation” observed in some calcium channels. The KVS-1 K+ channel, which exhibits CA, is a rapidly activating and inactivating voltage-dependent potassium channel expressed in chemosensory and other neurons of Caenorhabditis elegans. It is unusual in being most closely related to the Shab (Kv2) family of potassium channels, which typically behave like delayed rectifier K+ channels in other species. The magnitude of CA depends on the frequency, voltage, and duration of the depolarizing step pulse. CA also radically changes the activation and inactivation kinetics of the channel, suggesting that the channel may undergo a physical modification in a use-dependent manner; thus, a model that closely simulates the behavior of the channel postulates the existence of two populations of channels, unmodified and modified. Use-dependent changes in the behavior of potassium channels, such as CA observed in KVS-1, could be involved in functional mechanisms of cellular plasticity such as synaptic depression that represent the cellular basis of learning and memory. PMID:18199775

  12. The cumulative energy effect for improved ignition timing

    NASA Astrophysics Data System (ADS)

    Markhotok, A.

    2015-04-01

    A technique capable of improving timing in ignition applications is proposed. It is based on the use of shock waves propagating in a specific medium that allows achieving extremely high speeds and energies. The model uses the energy cumulation effect in the presence of the shock wave refraction on an interface with plasma. The problem was solved analytically and the effects were demonstrated for a cylindrically symmetrical geometry. Numerical results show very quick and uneven acceleration of different portions of the shock front. Its strong distortions lead to formation of a sharply focused jet near the axis of symmetry. The ability of the shock to achieve extremely high speeds and energies can be useful in design of efficient combustors for hypersonic systems, and possibly offers an alternative way of construction of a nuclear fusion reactor. Recommendations are given in terms of adjustment parameters and can be applied at any problem scale and for various combinations of the strengths of the effects involved in the problem.

  13. Discerning mechanistically rewired biological pathways by cumulative interaction heterogeneity statistics.

    PubMed

    Cotton, Travis B; Nguyen, Hien H; Said, Joseph I; Ouyang, Zhengyu; Zhang, Jinfa; Song, Mingzhou

    2015-01-01

    Changes in response of a biological pathway could be a consequence of either pathway rewiring, changed input, or a combination of both. Most pathway analysis methods are not designed for mechanistic rewiring such as regulatory element variations. This limits our understanding of biological pathway evolution. Here we present a Q-method to discern whether changed pathway response is caused by mechanistic rewiring of pathways due to evolution. The main innovation is a cumulative pathway interaction heterogeneity statistic accounting for rewiring-specific effects on the rate of change of each molecular variable across conditions. The Q-method remarkably outperformed differential-correlation based approaches on data from diverse biological processes. Strikingly, it also worked well in differentiating rewired chaotic systems, whose dynamics are notoriously difficult to predict. Applying the Q-method on transcriptome data of four yeasts, we show that pathway interaction heterogeneity for known metabolic and signaling pathways is indeed a predictor of interspecies genetic rewiring due to unbalanced TATA box-containing genes among the yeasts. The demonstrated effectiveness of the Q-method paves the way to understanding network evolution at the resolution of functional biological pathways. PMID:25921728

  14. Model-checking techniques based on cumulative residuals.

    PubMed

    Lin, D Y; Wei, L J; Ying, Z

    2002-03-01

    Residuals have long been used for graphical and numerical examinations of the adequacy of regression models. Conventional residual analysis based on the plots of raw residuals or their smoothed curves is highly subjective, whereas most numerical goodness-of-fit tests provide little information about the nature of model misspecification. In this paper, we develop objective and informative model-checking techniques by taking the cumulative sums of residuals over certain coordinates (e.g., covariates or fitted values) or by considering some related aggregates of residuals, such as moving sums and moving averages. For a variety of statistical models and data structures, including generalized linear models with independent or dependent observations, the distributions of these stochastic processes tinder the assumed model can be approximated by the distributions of certain zero-mean Gaussian processes whose realizations can be easily generated by computer simulation. Each observed process can then be compared, both graphically and numerically, with a number of realizations from the Gaussian process. Such comparisons enable one to assess objectively whether a trend seen in a residual plot reflects model misspecification or natural variation. The proposed techniques are particularly useful in checking the functional form of a covariate and the link function. Illustrations with several medical studies are provided. PMID:11890304

  15. Idiot Savants: Rate of Incidence

    ERIC Educational Resources Information Center

    Hill, A. Lewis

    1977-01-01

    A survey of 300 public residential facilities for the mentally retarded revealed a .06 percent incidence rate for idiot savants, persons of low intelligence who possess an unusually high skill in some special task. (CL)

  16. Incidence of Narcolepsy in Germany

    PubMed Central

    Oberle, Doris; Drechsel-Bäuerle, Ursula; Schmidtmann, Irene; Mayer, Geert; Keller-Stanislawski, Brigitte

    2015-01-01

    Study Objectives: Following the 2009 pandemic, reports of an association between an AS03 adjuvanted H1N1 pandemic influenza vaccine and narcolepsy were published. Besides determining background incidence rates for narcolepsy in Germany this study aimed at investigating whether there was a change in incidence rates of narcolepsy between the pre-pandemic, pandemic, and the post-pandemic period on the population level. Design: Retrospective epidemiological study on the incidence of narcolepsy with additional capture-recapture analysis. Setting: German sleep centers. Patients or Participants: Eligible were patients with an initial diagnosis of narcolepsy (ICD10 Code G47.4) within the period from January 1, 2007 to December 31, 2011. Interventions: None; observational study. Measurements and Results: A total of 342 sleep centers were invited to participate in the study. Adequate and suitable data were provided by 233 sleep centers (68.1%). A total of 1,198 patients with an initial diagnosis of narcolepsy within the observed period were included, of whom 106 (8.8%) were children and adolescents under the age of 18 years and 1,092 (91.2%) were adults. In children and adolescents, the age-standardized adjusted incidence rate significantly increased from 0.14/100,000 person-years in the pre-pandemic period to 0.50/100,000 person-years in the post-pandemic period (incidence density ratio, IDR 3.57; 95% CI 1.94–7.00). In adults, no significant change was detectable. This increase started in spring 2009. Conclusions: For the years 2007–2011, valid estimates for the incidence of narcolepsy in Germany were provided. In individuals under 18, the incidence rates continuously increased from spring 2009. Citation: Oberle D, Drechsel-Bäuerle U, Schmidtmann I, Mayer G, Keller-Stanislawski B. Incidence of narcolepsy in Germany. SLEEP 2015;38(10):1619–1628. PMID:25902804

  17. Near anastigmatic grazing incidence telescope

    NASA Technical Reports Server (NTRS)

    Korsch, D.

    1984-01-01

    A performance capability assessment is presently conducted for short versus long grazing incidence telescope designs, in view of the observation that the field curvature and astigmatism that are the primary residual aberrations of a Wolter-type incidence telescope can be substantially reduced through mirror length reduction. A major advantage of the short element telescope is that, if sufficiently short, both the paraboloid and hyperboloid surfaces may be fabricated as a single piece; this significantly facilitates the task of alignment.

  18. Neonatal Incidence of Hip Dysplasia

    PubMed Central

    Peled, Eli; Eidelman, Mark; Katzman, Alexander

    2008-01-01

    The advantages of sonographic examination are well known, but its main disadvantage is that it might lead to overdiagnosis, which might cause overtreatment. Variations in the incidence of developmental dysplasia of the hip are well known. We ascertained the incidence of neonatal sonographic developmental dysplasia of the hip without considering the development of those joints during followup. All 45,497 neonates (90,994 hips) born in our institute between January 1992 and December 2001 were examined clinically and sonographically during the first 48 hours of life. Sonography was performed according to Graf’s method, which considers mild hip sonographic abnormalities as Type IIa. We evaluated the different severity type incidence pattern and its influence on the total incidence during and between the investigated years. According to our study, sonographic Type IIa has major effects on the incidence of overall developmental dysplasia of the hip with a correlation coefficient of 0.95, whereas more severe sonographic abnormalities show relatively stable incidence patterns. Level of Evidence: Level I, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18288551

  19. Decline in Cardiorespiratory Fitness and Odds of Incident Sleep Complaints

    PubMed Central

    Dishman, Rodney K.; Sui, Xuemei; Church, Timothy S.; Kline, Christopher E.; Youngstedt, Shawn D.; Blair, Steven N.

    2014-01-01

    Purpose To examine longitudinal change in cardiorespiratory fitness and odds of incident sleep problems. Methods A cohort of 7368 men and 1155 women, aged 20–85 years, from the Aerobics Center Longitudinal Study. The cohort did not complain of sleep problems, depression, or anxiety at their first clinic visit. Cardiorespiratory fitness assessed at 4 clinic visits between 1971–2006, each separated by an average of 2–3 years, was used as a proxy measure of cumulative physical activity exposure. Sleep complaints were made to a physician during follow-up. Results Across visits, there were 784 incident cases of sleep complaints in men and 207 cases in women. After adjustment for age, time between visits, body mass index, smoking, alcohol use, chronic medical conditions, complaints of depression or anxiety at each visit, and fitness at Visit 1, each minute decline in treadmill endurance (i.e., a decline in cardiorespiratory fitness of approximately one-half MET) between ages 51 to 56 increased the odds of incident sleep complaints by 1.7% (1.0–2.4%) in men and 1.3% (0.0–2.8%) in women. Odds were ~8% higher per minute decline in people with sleep complaints at 2 or 3 visits. Conclusion The results indicate that maintenance of cardiorespiratory fitness during middle-age, when decline in fitness typically accelerates and risk of sleep problems is elevated, helps protect against the onset of sleep complaints made to a physician. PMID:25207930

  20. Cyber Incidents Involving Control Systems

    SciTech Connect

    Robert J. Turk

    2005-10-01

    The Analysis Function of the US-CERT Control Systems Security Center (CSSC) at the Idaho National Laboratory (INL) has prepared this report to document cyber security incidents for use by the CSSC. The description and analysis of incidents reported herein support three CSSC tasks: establishing a business case; increasing security awareness and private and corporate participation related to enhanced cyber security of control systems; and providing informational material to support model development and prioritize activities for CSSC. The stated mission of CSSC is to reduce vulnerability of critical infrastructure to cyber attack on control systems. As stated in the Incident Management Tool Requirements (August 2005) ''Vulnerability reduction is promoted by risk analysis that tracks actual risk, emphasizes high risk, determines risk reduction as a function of countermeasures, tracks increase of risk due to external influence, and measures success of the vulnerability reduction program''. Process control and Supervisory Control and Data Acquisition (SCADA) systems, with their reliance on proprietary networks and hardware, have long been considered immune to the network attacks that have wreaked so much havoc on corporate information systems. New research indicates this confidence is misplaced--the move to open standards such as Ethernet, Transmission Control Protocol/Internet Protocol, and Web technologies is allowing hackers to take advantage of the control industry's unawareness. Much of the available information about cyber incidents represents a characterization as opposed to an analysis of events. The lack of good analyses reflects an overall weakness in reporting requirements as well as the fact that to date there have been very few serious cyber attacks on control systems. Most companies prefer not to share cyber attack incident data because of potential financial repercussions. Uniform reporting requirements will do much to make this information available to

  1. Substance use disorder counselors' job performance and turnover after 1 year: linear or curvilinear relationship?

    PubMed

    Laschober, Tanja C; de Tormes Eby, Lillian Turner

    2013-07-01

    The main goals of the current study were to investigate whether there are linear or curvilinear relationships between substance use disorder counselors' job performance and actual turnover after 1 year utilizing four indicators of job performance and three turnover statuses (voluntary, involuntary, and no turnover as the reference group). Using longitudinal data from 440 matched counselor-clinical supervisor dyads, results indicate that overall, counselors with lower job performance are more likely to turn over voluntarily and involuntarily than not to turn over. Further, one of the job performance measures shows a significant curvilinear effect. We conclude that the negative consequences often assumed to be "caused" by counselor turnover may be overstated because those who leave both voluntarily and involuntarily demonstrate generally lower performance than those who remain employed at their treatment program. PMID:22527711

  2. Cognitive dysfunction at baseline predicts symptomatic 1-year outcome in first-episode schizophrenics.

    PubMed

    Moritz, S; Krausz, M; Gottwalz, E; Lambert, M; Perro, C; Ganzer, S; Naber, D

    2000-01-01

    The present study addresses the consequences of cognitive disturbances on symptomatic outcome. Fifty-three first-episode schizophrenics were reassessed (n = 32) 1 year after admission. Simple regression analyses revealed that several self-perceived cognitive deficits at baseline as measured with the Frankfurt Complaint Questionnaire significantly predicted increased Brief Psychiatric Rating Scale global scores at follow-up (p = 0.05 to p = 0.005). A stepwise regression analysis proved memory dysfunction to be the strongest predictor of symptomatic worsening (p = 0.005). It is suggested that the exploration and treatment of neuropsychological deficits in schizophrenia is of great clinical importance with regard to its impact on both functional and symptomatic outcome in schizophrenia. PMID:10601828

  3. [Interferon beta 1-a in multiple sclerosis: 1-year experience in 62 patients].

    PubMed

    Tilbery, C P; Felipe, E; Moreira, M A; Mendes, M F; França, A S

    2000-06-01

    We report the results of a trial of interferon beta 1-a in 62 ambulatory patients with relapsing-remitting multiple sclerosis. Entry criteria included EDSS of 0 to 5.5 and at least two exacerbations in the previous 2 years. The patients received 3 million international units by subcutaneous injections three times a week. The end points were differences in exacerbation rate and treatment effect on disease progression. The annual exacerbation rate for patients that did not take the interferon beta 1-a was 1.32 and for the patients under medication 0.63. The EDSS score in patients that did not take the mediaction was 4.7 and 2.0 for the patients with interferon beta 1-a. Interferon beta 1-a was well tolerated and 85% of patients completed 1 year treatment. PMID:10920406

  4. Substance Use Disorder Counselors’ Job Performance and Turnover after 1 Year: Linear or Curvilinear Relationship?1

    PubMed Central

    Laschober, Tanja C.; de Tormes Eby, Lillian Turner

    2013-01-01

    The main goals of the current study were to investigate whether there are linear or curvilinear relationships between substance use disorder counselors’ job performance and actual turnover after 1 year utilizing four indicators of job performance and three turnover statuses (voluntary, involuntary, and no turnover as the reference group). Using longitudinal data from 440 matched counselor-clinical supervisor dyads, results indicate that overall, counselors with lower job performance are more likely to turn over voluntarily and involuntarily than not to turn over. Further, one of the job performance measures shows a significant curvilinear effect. We conclude that the negative consequences often assumed to be “caused” by counselor turnover may be overstated because those who leave both voluntarily and involuntarily demonstrate generally lower performance than those who remain employed at their treatment program. PMID:22527711

  5. Anhedonia Predicts Major Adverse Cardiac Events and Mortality in Patients 1 Year After Acute Coronary Syndrome

    PubMed Central

    Davidson, Karina W.; Burg, Matthew M.; Kronish, Ian M.; Shimbo, Daichi; Dettenborn, Lucia; Mehran, Roxana; Vorchheimer, David; Clemow, Lynn; Schwartz, Joseph E.; Lespérance, Francois; Rieckmann, Nina

    2010-01-01

    Context Depression is a consistent predictor of recurrent events and mortality in ACS patients, but it has 2 core diagnostic criteria with distinct biological correlates—depressed mood and anhedonia. Objective To determine if depressed mood and/or anhedonia (loss of pleasure or interest) predict 1-year medical outcomes for patients with Acute Coronary Syndrome (ACS). Design Observational cohort study of post-ACS patients hospitalized between May 2003 and June 2005. Within one week of admission, patients underwent a structured psychiatric interview to assess clinically impairing depressed mood, anhedonia, and major depressive episode (MDE); also assessed were the Global Registry of Acute Coronary Events risk score, Charlson comorbidity index, left ventricular ejection fraction, antidepressant use, and depressive symptom severity. Setting Coronary care and cardiac care step-down units of 3 university hospitals in New York and Connecticut. Participants Consecutive sample of 453 ACS patients (aged 25–93 years; 42% women). Main Outcomes Measures All-cause mortality (ACM) and documented major adverse cardiac events (MACE; myocardial infarction, hospitalization for unstable angina, or urgent revascularization) were actively surveyed for 1 year after admission. Results There were 67 events (16 deaths and 51 MACE; 14.8%). 108 (24%) and 77 (17%) patients with anhedonia and depressed mood, respectively. After controlling for sex, age, and medical covariates, anhedonia (adjusted hazard ratio, 1.58; 95% confidence interval, 1.16–2.14; P<.01) and MDE (adjusted hazard ratio, 1.48; 95% confidence interval, 1.07–2.04; P=.02) were significant predictors of combined MACE/ACM, but depressed mood was not. Anhedonia continued to significantly predict outcomes controlling for MDE diagnosis and depressive symptom severity, each of which were no longer significant. Conclusions Anhedonia identifies risk for MACE/ACM beyond that of established medical prognostic indicators

  6. Factors Associated with Caregiver Burden in Dementia: 1-Year Follow-Up Study

    PubMed Central

    Shim, Sang Hong; Kang, Hyo Shin; Kim, Ji Hae

    2016-01-01

    Objective Dementia symptoms (cognitive function, daily-living function, and neuropsychiatric symptoms) become more serious over time, which is likely to increase caregiver burden. The aim of this study is to investigate which dementia-related symptoms, and how the progression of these symptoms, have influenced caregiver burden during a 1-year follow-up assessment. Methods A total of 110 patients with dementia were assessed for their cognitive function, daily-living function, and neuropsychiatric symptoms. Caregivers were assessed for their caregiver burden. Bivariate analyses were conducted between caregiver burden and dementia patients' symptoms, in order to examine which particular symptoms were significantly associated with caregiver burden at the baseline. A multiple regression analysis was then conducted with each significantly associated variable with a view to identifying determinants, influencing caregiver burden. Additionally, bivariate analyses were conducted between the changes in caregiver burden and the changes in patients' symptoms, to investigate which patient variable could best describe caregiver burden from baseline to the 1-year follow-up. A multiple regression analysis was conducted with each significantly-associated change in symptom, in order to identify determinants that influence a change in caregiver burden. Results Neuropsychiatric symptoms, such as irritability, aberrant motor-behavior, delusions and disinhibition were found to be significant predictors of caregiver burden at baseline, according to multiple regression analysis. In addition, changes in neuropsychiatric symptoms, such as delusions, agitation and memory-related functioning in daily-living significantly predict a change in caregiver burden. Conclusion Our results demonstrate that neuropsychiatric symptoms and memory impairment in daily-living functions are significant predictors of an increase in caregiver burden. PMID:26766945

  7. Glomerular filtration rate in patients with atrial fibrillation and 1-year outcomes

    PubMed Central

    Boriani, Giuseppe; Laroche, Cécile; Diemberger, Igor; Popescu, Mircea Ioachim; Rasmussen, Lars Hvilsted; Petrescu, Lucian; Crijns, Harry J. G. M.; Tavazzi, Luigi; Maggioni, Aldo P.; Lip, Gregory Y. H.

    2016-01-01

    We assessed 1-year outcomes in patients with atrial fibrillation enrolled in the EurObservational Research Programme AF General Pilot Registry (EORP-AF), in relation to kidney function, as assessed by glomerular filtration rate (eGFR). In a cohort of 2398 patients (median age 69 years; 61% male), eGFR (ml/min/1.73 m2) calculated using the CKD-EPI formula was ≥80 in 35.1%, 50–79 in 47.2%, 30–49 in 13.9% and <30 in 3.7% of patients. In a logistic regression analysis, eGFR category was an independent predictor of stroke/TIA or death, with elevated odds ratios associated with severe to mild renal impairment, ie. eGFR < 30 ml/min/1.73 m2 [OR 3.641, 95% CI 1.572–8.433, p < 0.0001], 30–49 ml/min/1.73 m2 [OR 3.303, 95% CI 1.740–6.270, p = 0.0026] or 50–79 ml/min/1.73 m2 [OR 2.094, 95% CI 1.194–3.672, p = 0.0003]. The discriminant capability for the risk of death was tested among various eGFR calculation algorithms: the best was the Cockcroft-Gault equation adjusted for BSA, followed by Cockcroft-Gault equation, and CKD-EPI equation, while the worst was the MDRD equation. In conclusion in this prospective observational registry, renal function was a major determinant of adverse outcomes at 1 year, and even mild or moderate renal impairments were associated with an increased risk of stroke/TIA/death. PMID:27466080

  8. Perinatal dioxin exposure and the neurodevelopment of Vietnamese toddlers at 1 year of age.

    PubMed

    Pham, Tai The; Nishijo, Muneko; Nguyen, Anh Thi Nguyet; Tran, Nghi Ngoc; Van Hoang, Luong; Tran, Anh Hai; Nguyen, Trung Viet; Nishijo, Hisao

    2015-12-01

    Dioxin concentrations remain elevated in both the environment and in humans residing near former US Air Force bases in South Vietnam. This may potentially have adverse health effects, particularly on infant neurodevelopment. We followed 214 infants whose mothers resided in a dioxin-contaminated area in Da Nang, Vietnam, from birth until 1 year of age. Perinatal exposure to dioxins was estimated from toxic equivalent (TEQ) levels of polychlorinated dibenzodioxins and polychlorinated dibenzofurans (PCDDs/Fs-TEQ), and 2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8-TetraCDD) concentrations in breast milk. In infants, daily dioxin intake (DDI) was used as an index of postnatal exposure through breastfeeding. Neurodevelopment of toddlers was assessed using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). No significant differences in neurodevelopmental scores were exhibited for cognitive, language or motor functions between four exposure groups of PCDDs/Fs-TEQ or 2,3,7,8-TetraCDD. However, social-emotional scores were decreased in the high PCDDs/Fs-TEQ group and the high 2,3,7,8-TetraCDD group compared with those with mild exposure, after adjusting for confounding factors. Cognitive scores in the mild, moderate, and high DDI groups were significantly higher than those in low DDI group, but there were no differences in cognitive scores among the three higher DDI groups. These results suggest that perinatal exposure to dioxins may affect social-emotional development of 1-year-old toddlers, without diminishing global neurodevelopmental function. PMID:26247686

  9. Metabolic Changes Following a 1-Year Diet and Exercise Intervention in Patients With Type 2 Diabetes

    PubMed Central

    Albu, Jeanine B.; Heilbronn, Leonie K.; Kelley, David E.; Smith, Steven R.; Azuma, Koichiro; Berk, Evan S.; Pi-Sunyer, F. Xavier; Ravussin, Eric

    2010-01-01

    OBJECTIVE To characterize the relationships among long-term improvements in peripheral insulin sensitivity (glucose disposal rate [GDR]), fasting glucose, and free fatty acids (FFAs) and concomitant changes in weight and adipose tissue mass and distribution induced by lifestyle intervention in obese individuals with type 2 diabetes. RESEARCH DESIGN AND METHODS We measured GDR, fasting glucose, and FFAs during a euglycemic clamp and adipose tissue mass and distribution, organ fat, and adipocyte size by dual-energy X-ray absorptiometry, CT scan, and adipose tissue biopsy in 26 men and 32 women in the Look-AHEAD trial before and after 1 year of diet and exercise aimed at weight loss. RESULTS Weight and fasting glucose decreased significantly (P < 0.0001) and significantly more in men than in women (−12 vs. −8% and −16 vs. −7%, respectively; P < 0.05), while FFAs during hyperinsulinemia decreased and GDR increased significantly (P < 0.00001) and similarly in both sexes (−53 vs. −41% and 63 vs. 43%; P = NS). Men achieved a more favorable fat distribution by losing more from upper compared with lower and from deeper compared with superficial adipose tissue depots (P < 0.01). Decreases in weight and adipose tissue mass predicted improvements in GDR but not in fasting glucose or fasting FFAs; however, decreases in FFAs during hyperinsulinemia significantly determined GDR improvements. Hepatic fat was the only regional fat measure whose change contributed independently to changes in metabolic variables. CONCLUSIONS Patients with type 2 diabetes undergoing a 1-year lifestyle intervention had significant improvements in GDR, fasting glucose, FFAs and adipose tissue distribution. However, changes in overall weight (adipose tissue mass) and hepatic fat were the most important determinants of metabolic improvements. PMID:20028945

  10. Glomerular filtration rate in patients with atrial fibrillation and 1-year outcomes.

    PubMed

    Boriani, Giuseppe; Laroche, Cécile; Diemberger, Igor; Popescu, Mircea Ioachim; Rasmussen, Lars Hvilsted; Petrescu, Lucian; Crijns, Harry J G M; Tavazzi, Luigi; Maggioni, Aldo P; Lip, Gregory Y H

    2016-01-01

    We assessed 1-year outcomes in patients with atrial fibrillation enrolled in the EurObservational Research Programme AF General Pilot Registry (EORP-AF), in relation to kidney function, as assessed by glomerular filtration rate (eGFR). In a cohort of 2398 patients (median age 69 years; 61% male), eGFR (ml/min/1.73 m(2)) calculated using the CKD-EPI formula was ≥80 in 35.1%, 50-79 in 47.2%, 30-49 in 13.9% and <30 in 3.7% of patients. In a logistic regression analysis, eGFR category was an independent predictor of stroke/TIA or death, with elevated odds ratios associated with severe to mild renal impairment, ie. eGFR < 30 ml/min/1.73 m(2) [OR 3.641, 95% CI 1.572-8.433, p < 0.0001], 30-49 ml/min/1.73 m(2) [OR 3.303, 95% CI 1.740-6.270, p = 0.0026] or 50-79 ml/min/1.73 m2 [OR 2.094, 95% CI 1.194-3.672, p = 0.0003]. The discriminant capability for the risk of death was tested among various eGFR calculation algorithms: the best was the Cockcroft-Gault equation adjusted for BSA, followed by Cockcroft-Gault equation, and CKD-EPI equation, while the worst was the MDRD equation. In conclusion in this prospective observational registry, renal function was a major determinant of adverse outcomes at 1 year, and even mild or moderate renal impairments were associated with an increased risk of stroke/TIA/death. PMID:27466080

  11. Endovascular stents in children under 1 year of age: acute impact and late results.

    PubMed Central

    Hatai, Y.; Nykanen, D. G.; Williams, W. G.; Freedom, R. M.; Benson, L. N.

    1995-01-01

    OBJECTIVES--To review efficacy and safety of endovascular stent implants in children < 1 year of age with congenital heart lesions. DESIGN--Retrospective study of patients in a tertiary care setting. PATIENTS--26 children (median age of 4.7 months, range 2 days to 1 year) with various vascular obstructive lesions. INTERVENTION--Percutaneous or intraoperative implantation of balloon expandable endovascular stents. RESULTS--Optimal stent placement was obtained in 31 of the 37 deployed implants. Complications resulted primarily from stent malpositioning and one episode of bleeding at a puncture site. Stent implantation in three patients with a restrictive arterial duct allowed for patency and five patients with conduit stenosis had mean (SD) right ventricule to systemic artery pressure ratios falling from 0.99 (0.20) to 0.52 (0.18) (P < 0.05). In 10 patients with pulmonary artery stenosis, the mean vessel diameter increased from 2.8 (0.9) mm to 5.8 (1.4) mm (P << 0.001). No clinical improvement was seen in two patients because of diffuse hypoplasia of the pulmonary vessels. Nine of 10 patients with miscellaneous obstructive lesions improved clinically. Recatheterisation was performed in 19 patients (median 8 months, range 12 days to 28 months) and 11 patients required redilatation (17 stents). CONCLUSIONS--Stent implantation is technically feasible in infants and under specific circumstances may provide an alternative to surgical palliation or avoid reoperation. The long term impact on clinical course, however, involves further interventions directed at stent management. Images PMID:8541180

  12. A longitudinal study of back dimension changes over 1 year in sports horses.

    PubMed

    Greve, Line; Dyson, Sue

    2015-01-01

    Major back dimension changes over time have been observed in some horses, the speed of which may be influenced by work type, skeletal maturity, nutrition and saddle fit. Currently, there are no longitudinal data quantifying changes in back dimensions. The objectives of this study were to quantify back dimension changes over time, to identify the effects of horse, saddle and rider on these dimensions, and to determine their association with season, weight, work and saddle management. A prospective, longitudinal study was performed, using stratified random sampling within a convenience sample of 104 sports horses in normal work. Thoracolumbar dimensions/symmetry were measured at predetermined sites every second month over 1 year; weight, work and saddle management changes were recorded. Descriptive statistics, and univariable and multiple mixed effects linear regression were performed to assess the association between management changes, horse-saddle-rider factors and back dimension changes. Complete data was available for 63/104 horses, including horses used for dressage (n= 26), showjumping (n= 26), eventing (n= 26) and general purpose (n= 26), with age groups 3-5 years (n = 24), 6-8 years (n = 28), 9-12 years (n = 24) and ≥ 13 years (n = 28). There were considerable variations in back dimensions over 1 year. In the multivariable analysis, the presence of gait abnormalities at initial examination and back asymmetry were significant and had a negative effect on changes in back dimensions. Subsequent improved saddle fit, similar or increased work intensity, season (summer versus winter) and increased bodyweight retained significance, having positive effects on changes in back dimensions. In conclusion, quantifiable changes in back dimensions occur throughout the year. Saddle fit should be reassessed professionally several times a year, especially if there has been a change in work intensity. PMID:25510314

  13. The Incidence of Conditional Statements in the Natural Speech of Young Children.

    ERIC Educational Resources Information Center

    McCabe, Ann; Evely, Susan

    This study examines the incidence and character of conditional statements ("if...then") in the spontaneous speech of young children. Twenty-four pairs of siblings, ranging in age from 2.1 years to 7.3 years, were observed and recorded while interacting in their homes for a period of 1 hour. Sixty-nine statements including "if" were selected from…

  14. Report of cancer incidence and mortality in China, 2010

    PubMed Central

    Zheng, Rongshou; Zhang, Siwei; Zhao, Ping; Zeng, Hongmei; Zou, Xiaonong

    2014-01-01

    Purpose To estimate the cancer incidences and mortalities in China in 2010. Methods On basis of the evaluation procedures and data quality criteria described in the National Central Cancer Registry (NCCR), data from 219 cancer registries were evaluated. Data from 145 registries were identified as qualified and then accepted for the 2010 cancer registry report. The incidences and mortalities of major cancers and the overall incidence and mortality were stratified by residency (urban or rural), areas (eastern, middle, and western), gender, and age. The cancer cases and deaths were estimated based on age-specific rate and national population in 2010. The China 2010 Population Census data and Segi’s world population data were used for calculating the age-standardized cancer incidence/mortality rates. Results Data were obtained from a total of 145 cancer registries (63 in urban areas and 82 in rural areas) covering 158,403,248 people (92,433,739 in urban areas and 65,969,509 in rural areas). The percentage of morphologically verified cases (MV%) were 67.11%; 2.99% of incident cases were identified through proportion of death certification only (DCO%), with the mortality to incidence ratio of (M/I) 0.61. The estimates of new cancer cases and cancer deaths were 3,093,039 and 1,956,622 in 2010, respectively. The crude incidence was 235.23/105 (268.65/105 in males and 200.21/105 in females), the age-standardized rates by Chinese standard population (ASR China) and by world standard population (ASR world) were 184.58/105 and 181.49/105, and the cumulative incidence rate (0-74 age years old) was 21.11%. The cancer incidence and ASR China were 256.41/105 and 187.53/105 in urban areas and 213.71/105 and 181.10/105 in rural areas. The crude cancer mortality in China was 148.81/105 (186.37/105 in males and 109.42/105 in females), the age-standardized mortalities by Chinese standard population and by world standard population were 113.92/105 and 112.86/105, and the cumulative

  15. National cancer incidence and mortality in China, 2012

    PubMed Central

    Chen, Wanqing; Zheng, Rongshou; Zuo, Tingting; Zeng, Hongmei; Zhang, Siwei

    2016-01-01

    Background Population-based cancer registration data in 2012 from all available cancer registries were collected by the National Central Cancer Registry (NCCR). NCCR estimated the numbers of new cancer cases and cancer deaths in China with compiled cancer incidence and mortality rates. Methods In 2015, there were 261 cancer registries submitted cancer incidence and deaths occurred in 2012. All the data were checked and evaluated based on the NCCR criteria of data quality. Qualified data from 193 registries were used for cancer statistics analysis as national estimation. The pooled data were stratified by area (urban/rural), gender, age group [0, 1–4, 5–9, 10–14, …, 85+] and cancer type. New cancer cases and deaths were estimated using age-specific rates and corresponding national population in 2012. The Chinese census data in 2000 and Segi’s population were applied for age-standardized rates. All the rates were expressed per 100,000 person-year. Results Qualified 193 cancer registries (74 urban and 119 rural registries) covered 198,060,406 populations (100,450,109 in urban and 97,610,297 in rural areas). The percentage of cases morphologically verified (MV%) and death certificate-only cases (DCO%) were 69.13% and 2.38%, respectively, and the mortality to incidence rate ratio (M/I) was 0.62. A total of 3,586,200 new cancer cases and 2,186,600 cancer deaths were estimated in China in 2012. The incidence rate was 264.85/100,000 (289.30/100,000 in males, 239.15/100,000 in females), the age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 191.89/100,000 and 187.83/100,000 with the cumulative incidence rate (0–74 age years old) of 21.82%. The cancer incidence, ASIRC and ASIRW in urban areas were 277.17/100,000, 195.56/100,000 and 190.88/100,000 compared to 251.20/100,000, 187.10/100,000 and 183.91/100,000 in rural areas, respectively. The cancer mortality was 161.49/100,000 (198.99/100,000 in

  16. Cost-Effectiveness of Coal Workers' Pneumoconiosis Prevention Based on Its Predicted Incidence within the Datong Coal Mine Group in China

    PubMed Central

    Yuan, Juxiang; Han, Bing; Cui, Kai; Ding, Yu; Fan, Xueyun; Cao, Hong; Yao, Sanqiao; Suo, Xia; Sun, Zhiqian; Yun, Xiang; Hua, Zhengbing; Chen, Jie

    2015-01-01

    We aimed to estimate the economic losses currently caused by coal workers’ pneumoconiosis (CWP) and, on the basis of these measurements, confirm the economic benefit of preventive measures. Our cohort study included 1,847 patients with CWP and 43,742 coal workers without CWP who were registered in the employment records of the Datong Coal Mine Group. We calculated the cumulative incidence rate of pneumoconiosis using the life-table method. We used the dose-response relationship between cumulative incidence density and cumulative dust exposure to predict the future trend in the incidence of CWP. We calculate the economic loss caused by CWP and economic effectiveness of CWP prevention by a step-wise model. The cumulative incidence rates of CWP in the tunneling, mining, combining, and helping cohorts were 58.7%, 28.1%, 21.7%, and 4.0%, respectively. The cumulative incidence rates increased gradually with increasing cumulative dust exposure (CDE). We predicted 4,300 new CWP cases, assuming the dust concentrations remained at the levels of 2011. If advanced dustproof equipment was adopted, 537 fewer people would be diagnosed with CWP. In all, losses of 1.207 billion Renminbi (RMB, official currency of China) would be prevented and 4,698.8 healthy life years would be gained. Investments in advanced dustproof equipment would be total 843 million RMB, according to our study; the ratio of investment to restored economic losses was 1:1.43. Controlling workplace dust concentrations is critical to reduce the onset of pneumoconiosis and to achieve economic benefits. PMID:26098706

  17. Short- and Long-Term Effects of Cumulative Finals on Student Learning

    ERIC Educational Resources Information Center

    Khanna, Maya M.; Brack, Amy S. Badura; Finken, Laura L.

    2013-01-01

    In two experiments, we examined the benefits of cumulative and noncumulative finals on students' short- and long-term course material retention. In Experiment 1, we examined results from course content exams administered immediately after course finals. Course sections including cumulative finals had higher content exam scores than sections…

  18. A Multimethodological Analysis of Cumulative Risk and Allostatic Load among Rural Children.

    ERIC Educational Resources Information Center

    Evans, Gary W.

    2003-01-01

    This study modeled physical and psychosocial aspects of home environment and personal characteristics in a cumulative risk heuristic. Found that elevated cumulative risk was associated with heightened cardiovascular and neuroendocrine parameters, increased deposition of body fat, and higher summary index of total allostatic load. Replicated…

  19. 76 FR 82296 - Pyrethrins/Pyrethroid Cumulative Risk Assessment; Extension of Comment Period

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-30

    ... AGENCY Pyrethrins/Pyrethroid Cumulative Risk Assessment; Extension of Comment Period AGENCY... established in the Federal Register of November 9, 2011 (76 FR 69726) (FRL-8888-9). In that notice, the Agency announced the availability of EPA's cumulative risk assessment for the pyrethroids. Based on this...

  20. The Validity of the SAT for Predicting Cumulative Grade Point Average by College Major

    ERIC Educational Resources Information Center

    Shaw, Emily J.; Kobrin, Jennifer L.; Patterson, Brian F.; Mattern, Krista D.

    2011-01-01

    Presented at the Annual Meeting of the American Educational Research Association (AERA) in New Orleans, LA in April 2011. The current study examined the differential validity of the SAT for predicting cumulative GPA through the second-year of college by college major, as well as the differential prediction of cumulative GPA by college major among…

  1. The Relations among Cumulative Risk, Parenting, and Behavior Problems during Early Childhood

    ERIC Educational Resources Information Center

    Trentacosta, Christopher J.; Hyde, Luke W.; Shaw, Daniel S.; Dishion, Thomas J.; Gardner, Frances; Wilson, Melvin

    2008-01-01

    Background: This study examined relations among cumulative risk, nurturant and involved parenting, and behavior problems across early childhood. Methods: Cumulative risk, parenting, and behavior problems were measured in a sample of low-income toddlers participating in a family-centered program to prevent conduct problems. Results: Path analysis…

  2. 30 CFR 250.921 - How do I analyze my platform for cumulative fatigue?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false How do I analyze my platform for cumulative fatigue? 250.921 Section 250.921 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR... fatigue? (a) If you are required to analyze cumulative fatigue on your platform because of the results...

  3. 18 CFR 2.23 - Use of reserved authority in hydropower licenses to ameliorate cumulative impacts.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... authority in hydropower licenses to ameliorate cumulative impacts. 2.23 Section 2.23 Conservation of Power... § 2.23 Use of reserved authority in hydropower licenses to ameliorate cumulative impacts. The... opportunity for hearing by the licensee and all interested parties. Hydropower licenses also contain...

  4. 18 CFR 2.23 - Use of reserved authority in hydropower licenses to ameliorate cumulative impacts.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... authority in hydropower licenses to ameliorate cumulative impacts. 2.23 Section 2.23 Conservation of Power... § 2.23 Use of reserved authority in hydropower licenses to ameliorate cumulative impacts. The... opportunity for hearing by the licensee and all interested parties. Hydropower licenses also contain...

  5. 18 CFR 2.23 - Use of reserved authority in hydropower licenses to ameliorate cumulative impacts.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... authority in hydropower licenses to ameliorate cumulative impacts. 2.23 Section 2.23 Conservation of Power... § 2.23 Use of reserved authority in hydropower licenses to ameliorate cumulative impacts. The... opportunity for hearing by the licensee and all interested parties. Hydropower licenses also contain...

  6. 18 CFR 2.23 - Use of reserved authority in hydropower licenses to ameliorate cumulative impacts.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... authority in hydropower licenses to ameliorate cumulative impacts. 2.23 Section 2.23 Conservation of Power... § 2.23 Use of reserved authority in hydropower licenses to ameliorate cumulative impacts. The... opportunity for hearing by the licensee and all interested parties. Hydropower licenses also contain...

  7. College Students' Memory for Unannounced Cumulative Items on the Final Exam

    ERIC Educational Resources Information Center

    Aagaard, Lola; Templeton, Jenny; Conner, Timothy W., II; Skidmore, Ronald L.

    2014-01-01

    Although there has been much published research on the benefits of distributed practice (Cepeda, Pashler, Vul, Wixted, & Rohrer, 2006) and the testing effect (Eisenkraemer, Jaeger, & Stein, 2013), very few studies are available regarding cumulative testing in college courses. Those available show a benefit to cumulative testing (Lawrence,…

  8. The Scarring Effects of Bankruptcy: Cumulative Disadvantage across Credit and Labor Markets

    ERIC Educational Resources Information Center

    Maroto, Michelle

    2012-01-01

    As the recent economic crisis has demonstrated, inequality often spans credit and labor markets, supporting a system of cumulative disadvantage. Using data from the National Longitudinal Survey of Youth, this research draws on stigma, cumulative disadvantage and status characteristics theories to examine whether credit and labor markets intersect…

  9. The Application of the Cumulative Logistic Regression Model to Automated Essay Scoring

    ERIC Educational Resources Information Center

    Haberman, Shelby J.; Sinharay, Sandip

    2010-01-01

    Most automated essay scoring programs use a linear regression model to predict an essay score from several essay features. This article applied a cumulative logit model instead of the linear regression model to automated essay scoring. Comparison of the performances of the linear regression model and the cumulative logit model was performed on a…

  10. INTERPRETING BIOMARKER DATA FOR ASSESSING CUMULATIVE RISKS FROM EXPOSURES TO ENVIRONMENTAL POLLUTANTS

    EPA Science Inventory

    Congress, the public, the National Academy of Sciences (NAS) and other expert panels have urged EPA to rationally address aggregate exposure and cumulative risk. Of special concern are estimates of cumulative risk resulting from aggregate exposure of sensitive sub-populations (i...

  11. 78 FR 25440 - Request for Information and Citations on Methods for Cumulative Risk Assessment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-01

    ...The United States Environmental Protection Agency (EPA) is requesting information and citations on approaches and methods for the planning, analysis, assessment, and characterization of cumulative risks to human populations and the environment. The EPA is developing guidelines for the assessment of cumulative risk as defined and characterized in the EPA 2003 publication Framework for......

  12. Ten-Year Cumulative Author Index Volume 2001, 36(1) through 2010, 45(4)

    ERIC Educational Resources Information Center

    Zucker, Stanley H.; Hassert, Silva

    2011-01-01

    This cumulative author index was developed as a service for the readership of Education and Training in Autism and Developmental Disabilities. It was prepared as a resource for scholars wishing to access the 391 articles published in volumes 36-45 of this journal. It also serves as a timely supplement to the 25-year (1966-1990) cumulative author…

  13. Aging and Cumulative Inequality: How Does Inequality Get Under the Skin?

    ERIC Educational Resources Information Center

    Ferraro, Kenneth F.; Shippee, Tetyana Pylypiv

    2009-01-01

    Purpose: This article draws from cumulative disadvantage and life course theories to develop a new theory for the social scientific study of aging. Design and Methods: Five axioms of "cumulative inequality (CI) theory" are articulated to identify how life course trajectories are influenced by early and accumulated inequalities but can be modified…

  14. When More Is Not Better: The Role of Cumulative Risk in Child Behavior Outcomes

    ERIC Educational Resources Information Center

    Appleyard, Karen; Egeland, Byron; van Dulmen, Manfred H. M.; Sroufe, L. Alan

    2005-01-01

    Background: Cumulative risk research has established the deleterious effects of co-occurring risk factors on child behavior outcomes. However, extant literature has not addressed potential differential effects of cumulative risk at different points in development and has left open questions about whether a threshold model or a linear risk model…

  15. Measuring a fair and ambitious climate agreement using cumulative emissions

    NASA Astrophysics Data System (ADS)

    Peters, Glen P.; Andrew, Robbie M.; Solomon, Susan; Friedlingstein, Pierre

    2015-10-01

    Policy makers have called for a ‘fair and ambitious’ global climate agreement. Scientific constraints, such as the allowable carbon emissions to avoid exceeding a 2 °C global warming limit with 66% probability, can help define ambitious approaches to climate targets. However, fairly sharing the mitigation challenge to meet a global target involves human values rather than just scientific facts. We develop a framework based on cumulative emissions of carbon dioxide to compare the consistency of countries’ current emission pledges to the ambition of keeping global temperatures below 2 °C, and, further, compare two alternative methods of sharing the remaining emission allowance. We focus on the recent pledges and other official statements of the EU, USA, and China. The EU and US pledges are close to a 2 °C level of ambition only if the remaining emission allowance is distributed based on current emission shares, which is unlikely to be viewed as ‘fair and ambitious’ by others who presently emit less. China’s stated emissions target also differs from measures of global fairness, owing to emissions that continue to grow into the 2020s. We find that, combined, the EU, US, and Chinese pledges leave little room for other countries to emit CO2 if a 2 °C limit is the objective, essentially requiring all other countries to move towards per capita emissions 7 to 14 times lower than the EU, USA, or China by 2030. We argue that a fair and ambitious agreement for a 2 °C limit that would be globally inclusive and effective in the long term will require stronger mitigation than the goals currently proposed. Given such necessary and unprecedented mitigation and the current lack of availability of some key technologies, we suggest a new diplomatic effort directed at ensuring that the necessary technologies become available in the near future.

  16. On the duration and intensity of cumulative advantage competitions

    NASA Astrophysics Data System (ADS)

    Jiang, Bo; Sun, Liyuan; Figueiredo, Daniel R.; Ribeiro, Bruno; Towsley, Don

    2015-11-01

    Network growth can be framed as a competition for edges among nodes in the network. As with various other social and physical systems, skill (fitness) and luck (random chance) act as fundamental forces driving competition dynamics. In the context of networks, cumulative advantage (CA)—the rich-get-richer effect—is seen as a driving principle governing the edge accumulation process. However, competitions coupled with CA exhibit non-trivial behavior and little is formally known about duration and intensity of CA competitions. By isolating two nodes in an ideal CA competition, we provide a mathematical understanding of how CA exacerbates the role of luck in detriment of skill. We show, for instance, that when nodes start with few edges, an early stroke of luck can place the less skilled in the lead for an extremely long period of time, a phenomenon we call ‘struggle of the fittest’. We prove that duration of a simple skill and luck competition model exhibit power-law tails when CA is present, regardless of skill difference, which is in sharp contrast to the exponential tails when fitness is distinct but CA is absent. We also prove that competition intensity is always upper bounded by an exponential tail, irrespective of CA and skills. Thus, CA competitions can be extremely long (infinite mean, depending on fitness ratio) but almost never very intense. The theoretical results are corroborated by extensive numerical simulations. Our findings have important implications to competitions not only among nodes in networks but also in contexts that leverage socio-physical models embodying CA competitions.

  17. Downstream cumulative effects of land use on freshwater communities

    NASA Astrophysics Data System (ADS)

    Kuglerová, L.; Kielstra, B. W.; Moore, D.; Richardson, J. S.

    2015-12-01

    Many streams and rivers are subject to disturbance from intense land use such as urbanization and agriculture, and this is especially obvious for small headwaters. Streams are spatially organized into networks where headwaters represent the tributaries and provide water, nutrients, and organic material to the main stems. Therefore perturbations within the headwaters might be cumulatively carried on downstream. Although we know that the disturbance of headwaters in urban and agricultural landscapes poses threats to downstream river reaches, the magnitude and severity of these changes for ecological communities is less known. We studied stream networks along a gradient of disturbance connected to land use intensity, from urbanized watersheds to watersheds placed in agricultural settings in the Greater Toronto Area. Further, we compared the patterns and processes found in the modified watershed to a control watershed, situated in a forested, less impacted landscape. Preliminary results suggest that hydrological modifications (flash floods), habitat loss (drainage and sewer systems), and water quality issues of small streams in urbanized and agricultural watersheds represent major disturbances and threats for aquatic and riparian biota on local as well as larger spatial scales. For example, communities of riparian plants are dominated by species typical of the land use on adjacent uplands as well as the dominant land use on the upstream contributing area, instead of riparian obligates commonly found in forested watersheds. Further, riparian communities in disturbed environments are dominated by invasive species. The changes in riparian communities are vital for various functions of riparian vegetation. Bank erosion control is suppressed, leading to severe channel transformations and sediment loadings in urbanized watersheds. Food sources for instream biota and thermal regimes are also changed, which further triggers alterations of in-stream biological communities

  18. Cumulative phase delay imaging - A new contrast enhanced ultrasound modality

    SciTech Connect

    Demi, Libertario Sloun, Ruud J. G. van; Mischi, Massimo; Wijkstra, Hessel

    2015-10-28

    Recently, a new acoustic marker for ultrasound contrast agents (UCAs) has been introduced. A cumulative phase delay (CPD) between the second harmonic and fundamental pressure wave field components is in fact observable for ultrasound propagating through UCAs. This phenomenon is absent in the case of tissue nonlinearity and is dependent on insonating pressure and frequency, UCA concentration, and propagation path length through UCAs. In this paper, ultrasound images based on this marker are presented. The ULA-OP research platform, in combination with a LA332 linear array probe (Esaote, Firenze Italy), were used to image a gelatin phantom containing a PVC plate (used as a reflector) and a cylindrical cavity measuring 7 mm in diameter (placed in between the observation point and the PVC plate). The cavity contained a 240 µL/L SonoVueO{sup ®} UCA concentration. Two insonating frequencies (3 MHz and 2.5 MHz) were used to scan the gelatine phantom. A mechanical index MI = 0.07, measured in water at the cavity location with a HGL-0400 hydrophone (Onda, Sunnyvale, CA), was utilized. Processing the ultrasound signals backscattered from the plate, ultrasound images were generated in a tomographic fashion using the filtered back-projection method. As already observed in previous studies, significantly higher CPD values are measured when imaging at a frequency of 2.5 MHz, as compared to imaging at 3 MHz. In conclusion, these results confirm the applicability of the discussed CPD as a marker for contrast imaging. Comparison with standard contrast-enhanced ultrasound imaging modalities will be the focus of future work.

  19. Cumulative Childhood Stress and Autoimmune Diseases in Adults

    PubMed Central

    Dube, Shanta R.; Fairweather, DeLisa; Pearson, William S.; Felitti, Vincent J.; Anda, Robert F.; Croft, Janet B.

    2012-01-01

    Objective To examine whether childhood traumatic stress increased the risk of developing autoimmune diseases as an adult. Methods Retrospective cohort study of 15,357 adult health maintenance organization members enrolled in the Adverse Childhood Experiences (ACEs) Study from 1995 to 1997 in San Diego, California, and eligible for follow-up through 2005. ACEs included childhood physical, emotional, or sexual abuse; witnessing domestic violence; growing up with household substance abuse, mental illness, parental divorce, and/or an incarcerated household member. The total number of ACEs (ACE Score range = 0–8) was used as a measure of cumulative childhood stress. The outcome was hospitalizations for any of 21 selected autoimmune diseases and 4 immunopathology groupings: T- helper 1 (Th1) (e.g., idiopathic myocarditis); T-helper 2 (Th2) (e.g., myasthenia gravis); Th2 rheumatic (e.g., rheumatoid arthritis); and mixed Th1/Th2 (e.g., autoimmune hemolytic anemia). Results Sixty-four percent reported at least one ACE. The event rate (per 10,000 person-years) for a first hospitalization with any autoimmune disease was 31.4 in women and 34.4 in men. First hospitalizations for any autoimmune disease increased with increasing number of ACEs (p < .05). Compared with persons with no ACEs, persons with ≥2 ACEs were at a 70% increased risk for hospitalizations with Th1, 80% increased risk for Th2, and 100% increased risk for rheumatic diseases (p < .05). Conclusions Childhood traumatic stress increased the likelihood of hospitalization with a diagnosed autoimmune disease decades into adulthood. These findings are consistent with recent biological studies on the impact of early life stress on subsequent inflammatory responses. PMID:19188532

  20. Cumulative Head Impact Burden in High School Football

    PubMed Central

    Eckner, James T.; Martini, Douglas; Sosnoff, Jacob J.; Kutcher, Jeffrey S.; Randolph, Christopher

    2011-01-01

    Abstract Impacts to the head are common in collision sports such as football. Emerging research has begun to elucidate concussion tolerance levels, but sub-concussive impacts that do not result in clinical signs or symptoms of concussion are much more common, and are speculated to lead to alterations in cerebral structure and function later in life. We investigated the cumulative number of head impacts and their associated acceleration burden in 95 high school football players across four seasons of play using the Head Impact Telemetry System (HITS). The 4-year investigation resulted in 101,994 impacts collected across 190 practice sessions and 50 games. The number of impacts per 14-week season varied by playing position and starting status, with the average player sustaining 652 impacts. Linemen sustained the highest number of impacts per season (868); followed by tight ends, running backs, and linebackers (619); then quarterbacks (467); and receivers, cornerbacks, and safeties (372). Post-impact accelerations of the head also varied by playing position and starting status, with a seasonal linear acceleration burden of 16,746.1g, while the rotational acceleration and HIT severity profile burdens were 1,090,697.7 rad/sec2 and 10,021, respectively. The adolescent athletes in this study clearly sustained a large number of impacts to the head, with an impressive associated acceleration burden as a direct result of football participation. These findings raise concern about the relationship between sub-concussive head impacts incurred during football participation and late-life cerebral pathogenesis, and justify consideration of ways to best minimize impacts and mitigate cognitive declines. PMID:21787201

  1. Cumulative phase delay imaging - A new contrast enhanced ultrasound modality

    NASA Astrophysics Data System (ADS)

    Demi, Libertario; van Sloun, Ruud J. G.; Wijkstra, Hessel; Mischi, Massimo

    2015-10-01

    Recently, a new acoustic marker for ultrasound contrast agents (UCAs) has been introduced. A cumulative phase delay (CPD) between the second harmonic and fundamental pressure wave field components is in fact observable for ultrasound propagating through UCAs. This phenomenon is absent in the case of tissue nonlinearity and is dependent on insonating pressure and frequency, UCA concentration, and propagation path length through UCAs. In this paper, ultrasound images based on this marker are presented. The ULA-OP research platform, in combination with a LA332 linear array probe (Esaote, Firenze Italy), were used to image a gelatin phantom containing a PVC plate (used as a reflector) and a cylindrical cavity measuring 7 mm in diameter (placed in between the observation point and the PVC plate). The cavity contained a 240 µL/L SonoVueO® UCA concentration. Two insonating frequencies (3 MHz and 2.5 MHz) were used to scan the gelatine phantom. A mechanical index MI = 0.07, measured in water at the cavity location with a HGL-0400 hydrophone (Onda, Sunnyvale, CA), was utilized. Processing the ultrasound signals backscattered from the plate, ultrasound images were generated in a tomographic fashion using the filtered back-projection method. As already observed in previous studies, significantly higher CPD values are measured when imaging at a frequency of 2.5 MHz, as compared to imaging at 3 MHz. In conclusion, these results confirm the applicability of the discussed CPD as a marker for contrast imaging. Comparison with standard contrast-enhanced ultrasound imaging modalities will be the focus of future work.

  2. Toward Computational Cumulative Biology by Combining Models of Biological Datasets

    PubMed Central

    Faisal, Ali; Peltonen, Jaakko; Georgii, Elisabeth; Rung, Johan; Kaski, Samuel

    2014-01-01

    A main challenge of data-driven sciences is how to make maximal use of the progressively expanding databases of experimental datasets in order to keep research cumulative. We introduce the idea of a modeling-based dataset retrieval engine designed for relating a researcher's experimental dataset to earlier work in the field. The search is (i) data-driven to enable new findings, going beyond the state of the art of keyword searches in annotations, (ii) modeling-driven, to include both biological knowledge and insights learned from data, and (iii) scalable, as it is accomplished without building one unified grand model of all data. Assuming each dataset has been modeled beforehand, by the researchers or automatically by database managers, we apply a rapidly computable and optimizable combination model to decompose a new dataset into contributions from earlier relevant models. By using the data-driven decomposition, we identify a network of interrelated datasets from a large annotated human gene expression atlas. While tissue type and disease were major driving forces for determining relevant datasets, the found relationships were richer, and the model-based search was more accurate than the keyword search; moreover, it recovered biologically meaningful relationships that are not straightforwardly visible from annotations—for instance, between cells in different developmental stages such as thymocytes and T-cells. Data-driven links and citations matched to a large extent; the data-driven links even uncovered corrections to the publication data, as two of the most linked datasets were not highly cited and turned out to have wrong publication entries in the database. PMID:25427176

  3. Impact of Libido at 2 Weeks after Stroke on Risk of Stroke Recurrence at 1-Year in a Chinese Stroke Cohort Study

    PubMed Central

    Li, Jing-Jing; Yuan, Huai-Wu; Wang, Chun-Xue; Luo, Ben-Yan; Ruan, Jie; Zhang, Ning; Shi, Yu-Zhi; Zhou, Yong; Wang, Yi-Long; Zhang, Tong; Zhou, Juan; Zhao, Xing-Quan; Wang, Yong-Jun

    2015-01-01

    Background: There were few studies on the relation between changes in libido and incidence of stroke recurrence. The aim of this study was to investigate the relationship between libido decrease at 2 weeks after stroke and recurrent stroke at 1-year. Methods: It is a multi-centered, prospective cohort study. The 14th item of the Hamilton Depression Rating Scale-17 was used to evaluate changes of libido in poststroke patients at 2 weeks. Stroke recurrence was defined as an aggravation of former neurological functional deficit, new local or overall symptoms, or stroke diagnosed at re-admission. Results: Among 2341 enrolled patients, 1757 patients had completed follow-up data, 533 (30.34%) patients had decreased libido at 2 weeks, and 166 (9.45%) patients had recurrent stroke at 1-year. Multivariate logistic regression analysis showed that, compared with patients with normal libido, the odds ratio (OR) of recurrent stroke in patients with decreased libido was reduced by 41% (OR = 0.59, 95% confidence interval [CI]: 0.40–0.87). The correlation was more prominent among male patients (OR = 0.52, 95% CI: 0.31–0.85) and patients of ≥60 years of age (OR = 0.57, 95% CI: 0.35–0.93). Conclusions: One out of three stroke patients in mainland China has decreased libido at 2 weeks after stroke. Decreased libido is a protective factor for stroke recurrence at 1-year, which is more prominent among older male patients. PMID:25963346

  4. Effects of 1-Year Intervention with a Mediterranean Diet on Plasma Fatty Acid Composition and Metabolic Syndrome in a Population at High Cardiovascular Risk

    PubMed Central

    Chisaguano, Maribel; Castellote, Ana I.; Estruch, Ramón; Covas, María Isabel; Fitó, Montserrat; Salas-Salvadó, Jordi; Martínez-González, Miguel A.; Lamuela-Raventós, Rosa; Ros, Emilio; López-Sabater, M. Carmen

    2014-01-01

    Background & Aims Metabolic syndrome (MetS) has become an important public concern due to its increasing prevalence. An altered fatty acid composition has been associated with MetS, but the Mediterranean diet has been shown to have a protective effect. The aim of the present study was to analyze the influence of a Mediterranean dietary pattern, as assessed by the biomarkers of food supplied, on the plasma fatty acid composition and its relation with MetS after 1 year of intervention. Methods A total of 424 subjects were randomly selected from the PREDIMED randomized dietary trial after completing a 1-year intervention program. Participants aged 55 to 80 years and at high risk of cardiovascular disease were randomly assigned to three dietary interventions: Mediterranean diet supplemented with virgin olive oil or nuts, or a low-fat diet. Results After 1 year of intervention participants in the virgin olive oil group showed significantly increased plasma concentrations of palmitic and oleic acids, but reduced proportions of margaric, stearic, and linoleic acids. In turn, subjects in the nut group showed significantly increased levels of palmitic, linoleic, and α-linolenic acids, but reduced proportions of myristic, margaric, palmitoleic, and dihommo-γ-linoleic acids. Increases in the biomarkers of foods supplied to the Mediterranean diet groups, i.e., oleic and α-linolenic acids, were beneficially associated with the incidence, reversion and prevalence of MetS. No weight changes were observed among participants. Conclusions The nut and olive oil diets induced a fatty acid composition that has been shown to be beneficial in the face of MetS. Therefore, a Mediterranean diet rich in fats of vegetable origin may be a useful tool for the management of MetS without the need for concerns over weight gain due to its high fat content. Trial Registration Controlled-Trials.com ISRCTN35739639 PMID:24651160

  5. Evaluating hospital performance based on excess cause-specific incidence

    PubMed Central

    Van Rompaye, Bart; Eriksson, Marie; Goetghebeur, Els

    2015-01-01

    Formal evaluation of hospital performance in specific types of care is becoming an indispensable tool for quality assurance in the health care system. When the prime concern lies in reducing the risk of a cause-specific event, we propose to evaluate performance in terms of an average excess cumulative incidence, referring to the center's observed patient mix. Its intuitive interpretation helps give meaning to the evaluation results and facilitates the determination of important benchmarks for hospital performance. We apply it to the evaluation of cerebrovascular deaths after stroke in Swedish stroke centers, using data from Riksstroke, the Swedish stroke registry. © 2015 The Authors. Statistics in Medicine Published by John Wiley & Sons Ltd. PMID:25640288

  6. Short-term predictions of HIV prevalence and AIDS incidence.

    PubMed Central

    Hendriks, J. C.; Medley, G. F.; Heisterkamp, S. H.; Van Griensven, G. J.; Bindels, P. J.; Coutinho, R. A.; Van Druten, J. A.

    1992-01-01

    Reports of AIDS cases in Amsterdam up to February 1990 were used to make predictions of future cases up to 1993. Two published methods were applied, which make extrapolations from current cases and simultaneously estimate the extent of delay in reporting. The choice of the exact model greatly influenced the predictions, as did predictions for distinct transmission groups. We present results for the homo/bisexual male group, and the total population of Amsterdam. The AIDS case predictions are used to predict the HIV prevalence using the ratio of HIV prevalence to AIDS incidence and through 'back calculation'. We suggest that the ratio is a simple technique that may be used to estimate HIV prevalence. The estimated number of cumulative HIV infected homo/bisexual males in Amsterdam in January 1990 was between 2100 and 4100 in a total of 2200-4600 infected people. PMID:1499669

  7. A multimethodological analysis of cumulative risk and allostatic load among rural children.

    PubMed

    Evans, Gary W

    2003-09-01

    This study merged two theoretical constructs: cumulative risk and allostatic load. Physical (crowding, noise, housing quality) and psychosocial (child separation, turmoil, violence) aspects of the home environment and personal characteristics (poverty, single parenthood, maternal highschool dropout status) were modeled in a cumulative risk heuristic. Elevated cumulative risk was associated with heightened cardiovascular and neuroendocrine parameters, increased deposition of body fat, and a higher summary index of total allostatic load. Previous findings that children who face more cumulative risk have greater psychological distress were replicated among a sample of rural children and shown to generalize to lower perceptions of self-worth. Prior cumulative risk research was further extended through demonstration of self-regulatory behavior problems and elevated learned helplessness. PMID:12952404

  8. Time-Integrated Fluorescence Cumulant Analysis and Its Application in Living Cells

    PubMed Central

    Wu, Bin; Singer, Robert H.; Mueller, Joachim D.

    2014-01-01

    Time-integrated fluorescence cumulant analysis (TIFCA) is a data analysis technique for fluorescence fluctuation spectroscopy (FFS) that extracts information from the cumulants of the integrated fluorescence intensity. It is the first exact theory that describes the effect of sampling time on FFS experiment. Rebinning of data to longer sampling times helps to increase the signal/noise ratio of the experimental cumulants of the photon counts. The sampling time dependence of the cumulants encodes both brightness and diffusion information of the sample. TIFCA analysis extracts this formation by fitting the cumulants to model functions. Generalization of TIFCA to multicolor FFS experiment is straightforward. Here, we present an overview of the theory, its implementation, as well as the benefits and requirements of TIFCA. The questions of why, when, and how to use TIFCA will be discussed. We give several examples of practical applications of TIFCA, particularly focused on measuring molecular interaction in living cells. PMID:23276537

  9. Methamphetamine Lab Incidents, 2004-2014

    MedlinePlus

    ... Liderazgo de la DEA Resource Center » Statistics & Facts » Methamphetamine Lab Incidents Methamphetamine Lab Incidents, 2004-2014 NOTE: These maps include all meth incidents, including labs, "dumpsites" or "chemical and glassware" ...

  10. Skin cancer incidence is highly associated with ultraviolet-B radiation history.

    PubMed

    Chang, Ni-Bin; Feng, Rui; Gao, Zhiqiang; Gao, Wei

    2010-09-01

    Recently, the increased amount of ultraviolet-B (UV-B) exposure due to ozone depletion has been found to be associated with increased incidence of skin cancer across the world. The quantification of individual, regional, and historical UV exposure directly affects establishment of the association between skin cancer and UV exposure, but accurate assessment and measurement have been challenging for decades. As a sequence, cumulative studies using different metrics reported conflicting results on whether UV radiation, including sunburns, early childhood sun exposure, and chronic exposure, increases melanoma risk. This paper aims to establish the relationship between UV-B and melanoma incidence across the continental U.S. using an ecological approach that incorporate more accurate UV-B exposure measured by the National Aeronautical and Space Administration Nimbus-7 total ozone mapping spectrometer, and the United State Department of Agriculture ground-based network. Using statistical linear mixed models, we found strong positive associations between the skin cancer and the past UV exposure or the past cumulative 3-year UV exposure 3 or 4 years ago. UV has regional distributions and its regional effects on the skin cancer incidence are still significant after adjusting the effect of UV exposure. Research findings yield deepened understanding of spatiotemporal distribution of melanoma incidence rates and a greater appreciation for the complexity and heterogeneity of melanoma risk factors especially the UV-B exposure at different temporal and spatial scales. PMID:20619731

  11. Cumulative Risk of Guillain–Barré Syndrome Among Vaccinated and Unvaccinated Populations During the 2009 H1N1 Influenza Pandemic

    PubMed Central

    Iqbal, Shahed; Stewart, Brock; Tokars, Jerome; DeStefano, Frank

    2014-01-01

    Objectives. We sought to assess risk of Guillain–Barré syndrome (GBS) among influenza A (H1N1) 2009 monovalent (pH1N1) vaccinated and unvaccinated populations at the end of the 2009 pandemic. Methods. We applied GBS surveillance data from a US population catchment area of 45 million from October 15, 2009, through May 31, 2010. GBS cases meeting Brighton Collaboration criteria were included. We calculated the incidence density ratio (IDR) among pH1N1 vaccinated and unvaccinated populations. We also estimated cumulative GBS risk using life table analysis. Additionally, we used vaccine coverage data and census population estimates to calculate denominators. Results. There were 392 GBS cases; 64 (16%) occurred after pH1N1vaccination. The vaccinated population had lower average risk (IDR = 0.83, 95% confidence interval = 0.63, 1.08) and lower cumulative risk (6.6 vs 9.2 cases per million persons, P = .012) of GBS. Conclusions. Our findings suggest that at the end of the influenza season cumulative GBS risk was less among the pH1N1vaccinated than the unvaccinated population, suggesting the benefit of vaccination as it relates to GBS. The observed potential protective effect on GBS attributed to vaccination warrants further study. PMID:24524517

  12. Incidence and Outcomes of Acute Respiratory Distress Syndrome

    PubMed Central

    Chen, Wei; Chen, Yih-Yuan; Tsai, Ching-Fang; Chen, Solomon Chih-Cheng; Lin, Ming-Shian; Ware, Lorraine B.; Chen, Chuan-Mu

    2015-01-01

    Abstract Most epidemiological studies of acute respiratory distress syndrome (ARDS) have been conducted in western countries, and studies in Asia are limited. The aim of our study was to evaluate the incidence, in-hospital mortality, and 1-year mortality of ARDS in Taiwan. We conducted a nationwide inpatient cohort study based on the Taiwan National Health Insurance Research Database between 1997 and 2011. A total of 40,876 ARDS patients (68% male; mean age 66 years) were identified by International Classification of Diseases, 9th edition coding and further analyzed for clinical characteristics, medical costs, and mortality. The overall crude incidence of ARDS was 15.74 per 100,000 person-years, and increased from 2.53 to 19.26 per 100,000 person-years during the study period. The age-adjusted incidence of ARDS was 15.19 per 100,000 person-years. The overall in-hospital mortality was 57.8%. In-hospital mortality decreased from 59.7% in 1997 to 47.5% in 2011 (P < 0.001). The in-hospital mortality rate was lowest (33.5%) in the youngest patients (age 18–29 years) and highest (68.2%) in the oldest patients (>80 years, P < 0.001). The overall 1-year mortality rate was 72.1%, and decreased from 75.8% to 54.7% during the study period. Patients who died during hospitalization were older (69 ± 17 versus 62 ± 19, P < 0.001) and predominantly male (69.8% versus 65.3%, P < 0.001). In addition, patients who died during hospitalization had significantly higher medical costs (6421 versus 5825 US Dollars, P < 0.001) and shorter lengths of stay (13 versus 19 days, P < 0.001) than patients who survived. We provide the first large-scale epidemiological analysis of ARDS incidence and outcomes in Asia. Although the overall incidence was lower than has been reported in a prospective US study, this may reflect underdiagnosis by International Classification of Diseases, 9th edition code and identification of only patients with more severe ARDS in this

  13. Observational Study of 1-Year Mortality Rates Before and After a Major Earthquake Among Chinese Nonagenarians

    PubMed Central

    Dong, Birong; Wu, Hongmei; Zhang, Yanling; Guralnik, Jack M.; Malmstrom, Theodore K.; Morley, John E.

    2011-01-01

    Background. Little is known about mortality among nonagenarians after an earthquake. Methods. Using secondary data analyses from the 2005 study called the Project of Longevity and Aging in Dujiangyan(n = 870), 1-year mortality rates were compared among a pre-earthquake group and a post-earthquake group of nonagenarians. All participants were from Dujiangyan, 50 km from the epicenter of the May 12, 2008 earthquake, in China. The pre-earthquake group was a subset of the 870 Project of Longevity and Aging in Dujiangyan participants, ages 93–95 years at the beginning of “Time Frame 1” (July 2005 through June 2006; n = 228). The post-earthquake group was a different subset of the 870 Project of Longevity and Aging in Dujiangyan participants, ages 93–95 years and alive at the beginning of Time Frame 2 (July 2008 through June 2009; n = 235). Time Frame 2 excluded a 7-week period following the earthquake in order to account for deaths due to trauma. Pre-earthquake health assessment data from the 2005 Project of Longevity and Aging in Dujiangyan study were used to calculate unadjusted/adjusted hazard ratios (HRs) for mortality. Results. One-year mortality rates were 8.3% (19/228) and 16.2% (38/235) in the pre-earthquake group and the post-earthquake group, respectively (p =.01). In unadjusted analyses, only “being in the post-earthquake group” was associated with death (HR = 2.04; 95% confidence interval [CI], 1.17–3.53; p = .011). In the multivariable Cox regression model, being in the post-earthquake group continued to be the strongest risk factor associated with mortality (HR = 2.47; 95% CI, 1.39–4.40; p = .002). Other significant risk factors included impaired cognition (HR = 1.97; 95% CI, 1.10–3.53; p = .024), serum albumin (HR = 0.90; 95% CI, 0.82–0.98; p < .015), and serum triglycerides (HR = 1.51; 95% CI, 1.15–1.99; p = .003). Conclusion. The May 12, 2008 earthquake in Wenchuan, China, was associated with a twofold increase in the 1-year

  14. Prevalence and 1-year prognosis of transient heart failure following coronary revascularization.

    PubMed

    Ambrosetti, Marco; Griffo, Raffaele; Tramarin, Roberto; Fattirolli, Francesco; Temporelli, Pier Luigi; Faggiano, Pompilio; De Feo, Stefania; Vestri, Anna Rita; Giallauria, Francesco; Greco, Cesare

    2014-09-01

    The occurrence of heart failure during the whole pre-discharge course of coronary revascularization, as far as its influence on subsequent prognosis, is poorly understood. The present study examined the effect of transient heart failure (THF) developing in the acute and rehabilitative phase on survival after coronary artery bypass graft surgery (CABG) and percutaneous coronary intervention (PCI). Patients in the Italian survey on cardiac rehabilitation and secondary prevention after cardiac revascularization (ICAROS) were analyzed for THF, the latter being defined either as signs and symptoms consistent with decompensation or cardiogenic shock. ICAROS was a prospective, multicenter registry of 1,262 consecutive patients discharged from 62 cardiac rehabilitation (CR) facilities, providing data on risk factors, lifestyle habits, drug treatments, and major cardiovascular events (MACE) during a 1-year follow-up. Records were linked to the official website of the Italian Association of Cardiovascular Prevention and Rehabilitation (GICR-IACPR). The overall prevalence of pre-discharge THF was 7.6%, with 69.8% of cases in acute wards, 22.9% during CR, and 7.3% in both settings. THF affected more frequently patients with chronic cardiac condition (42.7 vs. 30.6%; p < 0.05), age ≥75 years (33.3 vs. 23.1%; p < 0.005), COPD (19.8 vs. 12.3%; p < 0.05), and chronic kidney disease (17.7 vs. 7%; p < 0.001). After discharge, THF patients showed good maintenance rates of RAAS modulators (90.6%) and beta-blockers (83.3%), while statin therapy significantly decreased from 81.3 to 64.6% (p < 0.05). The pursuit of secondary prevention targets, as far as self-reported drug adherence, was not different among groups. Patients with THF had increased 1-year mortality (8.3 vs. 1.6%, p < 0.001). Moreover, THF independently predicted adverse outcome with OR for recurrent events (mainly further episodes of decompensation) of 2.4 (CI 1.4-4.3). Patients who experienced THF after coronary

  15. The incidence of scarlet fever.

    PubMed Central

    Perks, E. M.; Mayon-White, R. T.

    1983-01-01

    This study attempted to find the incidence of scarlet fever in the Oxford region, including the proportion of patients from whom Streptococcus pyogenes could be isolated. General practitioners collected throat swabs from patients with suspected scarlet fever. The swabs were examined for viral and bacterial pathogens. Children admitted to hospital were used as controls. Twenty-five of 105 patients with suspected scarlet fever grew Str. pyogenes; M type 4 was the commonest type. The clinical diagnosis of scarlet fever was not always confirmed by throat culture. The annual incidence of scarlet fever was estimated to be 0.3 cases per 1000 per year. PMID:6358344

  16. Low CoO grazing incidence collectors for EUVL HVM

    NASA Astrophysics Data System (ADS)

    Bianucci, G.; Cassol, G. L.; Ceglio, N. M.; Valsecchi, G.; Zocchi, F.

    2012-03-01

    Media Lario Technologies (MLT) uses its proprietary replication by electroforming technology to manufacture grazing incidence collectors in support of the EUVL technology roadmap. With the experience of more than 20 alpha and preproduction collectors installed to date, and with the development results of the Advanced Cooling Architecture (ACA) for High Volume Manufacturing (HVM) collector generation, we present optical, lifetime, and thermo-optical performance of the grazing incidence collectors, meeting the requirements of HVM scanners for a throughput target of more than 100 wafers per hour. The ruthenium reflective layer of the grazing incidence collector is very forgiving to the hostile environment of the plasma sources, as proven by the installed base with 1-year lifetime expectancy. On the contrary, the multilayer-based collector is vulnerable to Sn deposition and ion bombardment, and the need to mitigate this issue has led to a steady increase of the complexity of the LPP source architecture. With the awareness that the source and collector module is the major risk against the timely adoption of EUVL in HVM, we propose a new paradigm that, by using the field-proven design simplicity and robustness of the grazing incidence collector in both LDP and LPP sources, effectively reduces the risk of both source architectures and improves their reliability.

  17. Residential property values predict prevalent obesity but do not predict 1 year weight change

    PubMed Central

    Drewnowski, Adam; Aggarwal, Anju; Tang, Wesley; Moudon, Anne Vernez

    2014-01-01

    Objective Lower socioeconomic status (SES) has been linked with higher obesity rates but not with weight gain. This study examined whether SES can predict short-term weight change. Design and Methods The Seattle Obesity Study II was based on an observational cohort of 440 adults. Weights and heights were measured at baseline and at 1 y. Self-reported education and incomes were obtained by questionnaire. Home addresses were linked to tax parcel property values from the King Co. tax assessor. Associations among SES variables, prevalent obesity, and 1 y weight change were examined using multivariable linear regressions. Results Low residential property values at tax parcel predicted prevalent obesity at baseline and at 1 y. Living in the top quartile of house prices reduced obesity risk by 80% at both time points. At 1 year, about 38% of the sample lost >1kg body weight; 32% maintained (± 1kg), and 30% gained >1kg. In adjusted models, none of the baseline SES measures had any impact on 1 y weight change. Conclusions SES variables, including tax parcel property values predicted prevalent obesity but did not predict short-term weight change. These findings, based on longitudinal cohort data, suggest other mechanisms are involved in short-term weight change. PMID:25684713

  18. Effect of iodine supplementation during pregnancy on infant neurodevelopment at 1 year of age.

    PubMed

    Murcia, Mario; Rebagliato, Marisa; Iñiguez, Carmen; Lopez-Espinosa, Maria-Jose; Estarlich, Marisa; Plaza, Belén; Barona-Vilar, Carmen; Espada, Mercedes; Vioque, Jesús; Ballester, Ferran

    2011-04-01

    Iodine is the main constituent of thyroid hormones, which in turn are required for fetal brain development. However, the relation between iodine intake during pregnancy, thyroid function, and child neurodevelopment needs further evaluation. The authors assessed the association of maternal iodine intake from diet and supplements during pregnancy and of maternal and neonatal thyroid function with infant neurodevelopment. The Mental Development Index and Psychomotor Development Index (PDI) for 691 children were obtained between 2005 and 2007 using the Bayley Scales of Infant Development at age 1 year in a prebirth cohort in Valencia, Spain. In multivariate analyses, a maternal thyrotropin level >4 μU/mL was associated with an increased risk of a PDI <85 (odds ratio = 3.5, P = 0.02). Maternal intake of ≥150 μg/day, compared with <100 μg/day, of iodine from supplements was associated with a 5.2-point decrease in PDI (95% confidence interval: -8.1, -2.2) and a 1.8-fold increase in the odds of a PDI <85 (95% confidence interval: 1.0, 3.3). When analyses were stratified by sex, this association was intensified for girls but was not observed for boys. Further evidence on the safety and effectiveness of iodine supplementation during pregnancy is needed before it is systematically recommended in iodine-sufficient or mildly deficient areas. PMID:21385833

  19. Ablation for atrial fibrillation during mitral valve surgery: 1-year results through continuous subcutaneous monitoring.

    PubMed

    Bogachev-Prokophiev, Alexandr; Zheleznev, Sergey; Romanov, Alexander; Pokushalov, Evgeny; Pivkin, Alexey; Corbucci, Giorgio; Karaskov, Alexander

    2012-07-01

    Continuous monitoring of cardiac rhythm may play an important role in measuring the true symptomatic/asymptomatic atrial fibrillation (AF) burden and improve the management of anti-arrhythmic and anti-thrombotic therapies. Forty-seven patients with mitral valve disease and longstanding persistent AF (LSPAF) underwent a left atrial maze procedure with bipolar radiofrequency and valve surgery. The follow-up data recorded by an implanted loop recorder were analysed after 3, 6 and 12 months. On discharge, 40 (85.1%) patients were in stable sinus rhythm, as documented by in-office electrocardiography (ECG), 4 (8.5%) were in pacemaker rhythm and 3 (6.4%) were in AF. One (2.1%) patient died after 7 months. On 12-month follow-up examination, 30 (65.2%) patients had an AF burden <0.5% and were classified as responders. Three (6.5%) of the 16 non-responders had atrial flutter and 13 (27.7%) had documented AF recurrences with an AF burden >0.5%. Two (4.3%) patients with AF recurrences were completely asymptomatic. Among the symptomatic events stored by the patients, only 27.6% was confirmed as genuine AF recurrences according to the concomitant ECG recorded by the implanted loop recorder. A concomitant bipolar maze procedure during mitral valve surgery is effective in treating AF, as proved by detailed 1-year continuous monitoring. PMID:22514258

  20. A 1-year follow-up of implants of differing surface roughness placed in rabbit bone.

    PubMed

    Wennerberg, A; Ektessabi, A; Albrektsson, T; Johansson, C; Andersson, B

    1997-01-01

    Screw-shaped implants were prepared with three different surface topographies: One was left as machined, ie, a turned surface, and two were blasted surfaces with differing degrees of surface roughness. The surface topography was measured with a confocal laser scanning profilometer and the surface roughness was characterized using height and spatial descriptive parameters. The turned surface had an average surface roughness of 0.96 micron and an average peak spacing of 8.6 microns. The two blasted surfaces had surface roughness values of 1.16 microns and 1.94 microns, respectively; the corresponding values for the peak spacing parameter were 10.00 microns and 13.22 microns, respectively. After 1 year in rabbit bone, the bone response to the turned implants was compared with the response to the two blasted implant surfaces. Firmer bone fixation was found for the two blasted surfaces, with statistically significant increases in removal torque and percentage of bone-to-metal contact. Furthermore, about 2 mm from the implant surface, the titanium release was similar for the turned and the 25-micron aluminum oxide-blasted implants. PMID:9274077

  1. Effectiveness of sealing active proximal caries lesions with an adhesive system: 1-year clinical evaluation.

    PubMed

    Abuchaim, Clarisse; Rotta, Marina; Grande, Rosa Helena Miranda; Loguercio, Alessandro Dourado; Reis, Alessandra

    2010-01-01

    The objective of this study was to evaluate the effectiveness of a therapeutic sealant to arrest non-cavitated proximal carious lesion progression. The study population comprised 44 adolescents who had bitewing radiographs taken for caries diagnosis. Non-cavitated lesions extending up to half of dentin thickness were included in the sample. In the experimental group (n = 33), the proximal caries-lesion surfaces were sealed with an adhesive (OptiBond Solo, Kerr) after tooth separation. The control group (n = 11) received no treatment, except for oral hygiene instructions including use of dental floss. Follow-up radiographs were taken after one year and were analyzed in comparison with baseline radiographs. In a blind study setting, visual readings were performed by two examiners, blinded to whether the examined radiograph was baseline or follow-up, and whether it concerned a test or control lesion. The efficacy of sealing treatment was evaluated by the McNemar test (0.05). About 22% of the sealed lesions showed reduction, 61% showed no change and 16% showed progression. For the control lesions, the corresponding values were 27%, 36% and 36% respectively. The number of lesions that showed reduction and no changes were merged and therefore 83.3% of the sealed lesions and 63.6% of the control lesions were considered clinically successful. No statistical significance was detected (p > 0.05). In the course of 1 year, sealing proximal caries lesions was not shown to be superior to lesion monitoring. PMID:20877976

  2. Temporal associations between disordered eating and nonsuicidal self-injury: examining symptom overlap over 1 year.

    PubMed

    Turner, Brianna J; Yiu, Angelina; Layden, Brianne K; Claes, Laurence; Zaitsoff, Shannon; Chapman, Alexander L

    2015-01-01

    Disordered eating (DE) and nonsuicidal self-injury (NSSI) commonly co-occur. This study compared several models of the longitudinal relationship between DE and NSSI, including concurrent and prospective models, and examined the possible moderating roles of self-objectification, impulsivity, and emotion dysregulation in these relationships. Individuals with NSSI (N=197) recruited from online forums completed measures of NSSI and DE every 3 months for 1 year. We tested the associations between NSSI and DE using hierarchical linear models. Results supported a concurrent relationship, wherein frequency of NSSI positively covaried with concurrent DE severity. Body surveillance moderated the concurrent relationship between NSSI and DE. Individuals who engaged in more body surveillance endorsed high levels of DE pathology, whereas those lower in body surveillance engaged in more frequent NSSI only at higher levels of DE. In addition, whereas DE did not prospectively predict NSSI, frequency of NSSI predicted more severe DE 3 months later. The prospective relationship between DE and later NSSI was moderated by emotion dysregulation, such that highly dysregulated individuals had a stronger relationship between DE and later NSSI, whereas this relationship was not significant among individuals low in emotion dysregulation. These findings add valuable information regarding the co-occurrence of self-damaging behaviors. PMID:25526840

  3. Congenital abnormality of the vagina complicated by haemato-pyocolpos in a 1-year labrador retriever.

    PubMed

    Alonge, S; Romussi, S; Grieco, V; Luvoni, G C

    2015-06-01

    A 1-year-old female Labrador retriever was referred with a few days history of haematic-like vulvar discharge. Physical examination, vaginal inspection and palpation did not reveal any remarkable finding. Transabdominal ultrasound showed echogenic fluid accumulation in the vagina suggesting haemato-pyocolpos. An exploratory laparotomy was performed: a well-delimited ectasic vagina was identified. Ovariohysterectomy and partial vaginectomy and vaginoplasty were performed to spay the bitch and to remove the ectasic vagina. Post-operative recovery and 12-month follow-up were uneventful. Clinical, morphological and histological findings were consistent with a congenital abnormality of the muscular layer of the vagina complicated by haemato-pyocolpos. The disorganization of the vaginal tunica muscularis may have acted as locus minoris resistentiae in the vaginal wall. The organ was dilated and atonic due to the gradual accumulation of physiological fluids complicated by an overgrowth of genital bacteria. This congenital disorder has to be taken into account as differential diagnosis of haemato-pyocolpos with vaginal discharge in young bitches. PMID:25661902

  4. Laboratory Tests Ordered By a Chiropractic Sports Physician on Elite Athletes Over a 1-Year Period

    PubMed Central

    Nabhan, Dustin C.; Moreau, William J.; Barylski, Chad

    2015-01-01

    Objective The purpose of this study is to describe and discuss laboratory tests ordered on elite athletes in an interdisciplinary sports medicine clinic by a doctor of chiropractic over 1 calendar year. Methods A retrospective review of laboratory tests ordered during routine clinical practice as standard screening and diagnostic tests from November 1, 2009, to November 1, 2010 was performed. Data were collected during clinical encounters at one sports medicine clinic and entered into a database for analysis. Descriptive and frequency statistics were used to describe the tests ordered and the frequency of abnormal findings. Results Five hundred and thirty-nine studies were ordered for diagnostic and routine screenings on 137 athlete patients (86 males, 51 females), representing 49 types of tests. Sample sources included blood, urine, skin lesions, and fecal matter. The most commonly ordered tests were complete blood count, comprehensive metabolic panel, serum ferritin, creatine kinase, serum iron and total iron binding capacity, total cortisol, thyroid stimulating hormone, and lipid panels. There were 217 studies (40%) flagged as abnormal by the reporting laboratory. Conclusion This report provides greater insight into the diverse array of laboratory studies ordered over a 1-year period for diagnosis and screening of elite athletes. A high percentage of the results were flagged as abnormal by the laboratory. These findings show that the unique physiology of the elite athlete must be considered when interpreting laboratory findings in this population. PMID:26257590

  5. Global distribution of deep convection reaching tropopause in 1 year GPM observations

    NASA Astrophysics Data System (ADS)

    Liu, Nana; Liu, Chuntao

    2016-04-01

    To characterize and quantify tropopause-reaching deep convection, 1 year of Global Precipitation Mission (GPM) Ku band radar echoes are surveyed in relation to several reference levels derived from the ERA-Interim reanalysis data set. Consistent with the observations of the Tropical Rainfall Measuring Mission over the tropics, the GPM has detected tropopause-reaching deep convection dominantly over tropical land, especially over Panama and Central Africa. At middle and high latitudes, tropopause-reaching convective storms are mainly found over land in the Northern Hemisphere during the summer. Compared to those in the tropics, convective cores at middle and high latitudes have relatively larger sizes at the tropopause, especially those over central North America. The zonal distributions of the occurrences of 15 dBZ and 20 dBZ radar echoes at the tropopause show two comparable maxima, one in the tropics and the other in northern middle-high latitudes. This implies that the convection penetrating the tropopause at northern middle-high latitudes is as frequent as those over the tropics. It is important to understand their role in the vertical transport of trace gases between the troposphere and the stratosphere.

  6. Hippocampal Neuron Number Is Unchanged 1 Year After Fractionated Whole-Brain Irradiation at Middle Age

    SciTech Connect

    Shi Lei Molina, Doris P.; Robbins, Michael E.; Wheeler, Kenneth T.; Brunso-Bechtold, Judy K.

    2008-06-01

    Purpose: To determine whether hippocampal neurons are lost 12 months after middle-aged rats received a fractionated course of whole-brain irradiation (WBI) that is expected to be biologically equivalent to the regimens used clinically in the treatment of brain tumors. Methods and Materials: Twelve-month-old Fischer 344 X Brown Norway male rats were divided into WBI and control (CON) groups (n = 6 per group). Anesthetized WBI rats received 45 Gy of {sup 137}Cs {gamma} rays delivered as 9 5-Gy fractions twice per week for 4.5 weeks. Control rats were anesthetized but not irradiated. Twelve months after WBI completion, all rats were anesthetized and perfused with paraformaldehyde, and hippocampal sections were immunostained with the neuron-specific antibody NeuN. Using unbiased stereology, total neuron number and the volume of the neuronal and neuropil layers were determined in the dentate gyrus, CA3, and CA1 subregions of hippocampus. Results: No differences in tissue integrity or neuron distribution were observed between the WBI and CON groups. Moreover, quantitative analysis demonstrated that neither total neuron number nor the volume of neuronal or neuropil layers differed between the two groups for any subregion. Conclusions: Impairment on a hippocampal-dependent learning and memory test occurs 1 year after fractionated WBI at middle age. The same WBI regimen, however, does not lead to a loss of neurons or a reduction in the volume of hippocampus.

  7. Depression and posttraumatic stress disorder in temporary settlement residents 1 year after the Sichuan earthquake.

    PubMed

    Cheng, Zhang; Ma, Ning; Yang, Lei; Agho, Kingsley; Stevens, Garry; Raphael, Beverley; Cui, Lijun; Liu, Yongqiao; Yan, Baoping; Ma, Hong; Yu, Xin

    2015-03-01

    The authors sought to determine the prevalence and risk factors for major depressive disorder and posttraumatic stress disorder (PTSD) among survivors living in temporary accommodation in the Yongxing settlement in Mianyang city 1 year after the Sichuan earthquake for further interventions. They interviewed 182 residents, using the Structured Clinical Interview for DSM-IV Axis I Disorders and a self-report questionnaire. The 12-month prevalence of depressive disorder and PTSD were 48.9% and 39.6%, respectively. Multivariate analysis indicated that bereaved survivors were 5.51 times (adjusted odds ratio [AOR] = 5.51; 95% confidence interval [CI] =2.14-14.22) more likely to report PTSD and 2.42 times (AOR = 2.42; 95%CI =1.00-5.48) more likely to report depressive disorder than nonbereaved survivors. Older age and receipt of government financial support were significantly associated with 12-month PTSD. Depressive disorder 12 months after the earthquake was associated with receipt of government financial support, pre-earthquake physical illness, single marital status, being currently employed, and Han ethnicity. PMID:23666829

  8. De novo gastric adenocarcinoma 1 year after sleeve gastrectomy in a transplant patient

    PubMed Central

    Masrur, M.; Elli, E.; Gonzalez-Ciccarelli, L.F.; Giulianotti, P.C.

    2016-01-01

    Introduction It has been reported in the literature that upper gastrointestinal malignancies after bariatric surgery are mostly gastro-esophageal, although it is not clear whether bariatric surgery represents a risk factor for the development of esophageal and/or gastric cancer. We report a case of a de novo gastric adenocarcinoma occurring in a transplant patient 1 year after a laparoscopic sleeve gastrectomy. Presentation of case A 44 year-old woman with a BMI of 38 kg/m2, hypertension, type 1 diabetes mellitus, multiple malignancies and a pancreas transplant underwent laparoscopic sleeve gastrectomy. The patient presented with intense dysphagias during the follow up. Studies were performed and the diagnoses of grade 2/3 adenocarcinoma were made. The patient underwent a robotic assisted total gastrectomy with a roux-en-y intracorporeal esophagojejunostomy. The procedure resulted in multiple metastasic lymph nodes, focal and transmural invasions to multiple organs with a tumor free margin resection. The patient presented with a postoperative pleural effusion, with no further complications. Discussion The diagnosis of gastroesophageal cancer after bariatric surgery is usually late since these patients have common upper gastrointestinal symptoms related to the procedure that could delay the diagnosis. De novo gastric cancer after sleeve gastrectomy has only been reported in one instance, in contrast with other bariatric surgery procedures. Conclusions No direct relation has been established between sleeve gastrectomy and the development of gastric cancer. Robotic procedures allow for complex multiorgan resections, while preserving the benefits of minimally invasive surgery. PMID:26774417

  9. Beyond Earth: Weaving Science and Indigenous Culture - A 1-year NSF Planning Grant

    NASA Astrophysics Data System (ADS)

    Young, Timothy; Guy, M.; Baker Big-Back, C.; Froelich, K.

    2011-01-01

    We present results of a 1-year NSF planning grant called Beyond Earth. The project is designed to engage Native American, urban, and rural families in science learning while piloting curriculum development and implementation that incorporates both Native and Western epistemologies. Physical, earth, and space science content is juxtaposed with indigenous culture, stories, language and epistemology in after-school programs and teacher training. Project partners include the Dakota Science Center, Fort Berthold Community College, and Sitting Bull College. The Native American tribes represented in this initiative illustrate partnerships between the Dakota, Lakota, Nakota, Hidatsa, Mandan, and Arikara. Over the past year the primary project deliverables include a culturally responsive curriculum Beyond Earth Moon Module, teacher training workshops, a project website. The curriculum module introduces students to the moon's appearance, phases, and positions in the sky using the Night Sky Planetarium Experience Station to explore core concepts underlying moon phases and eclipses using the interactive Nature Experience Station before engaging in the culminating Mission Challenge in which they apply their knowledge to problem solving situations and projects. The Native Science and Western Science activities developed, planetarium explorations created, and website toolkit utilizations are presented.

  10. Latent Transition Models to Study Women's Changing of Dietary Patterns From Pregnancy to 1 Year Postpartum

    PubMed Central

    Sotres-Alvarez, Daniela; Herring, Amy H.; Siega-Riz, Anna-Maria

    2013-01-01

    Latent class models are useful for classifying subjects by dietary patterns. Our goals were to use latent transition models to identify dietary patterns during pregnancy and postpartum, to estimate the prevalence of these dietary patterns, and to model transition probabilities between dietary patterns as a function of covariates. Women who were enrolled in the Pregnancy, Infection, and Nutrition Study (University of North Carolina, 2000–2005) were followed for 1 year postpartum, and their diets were assessed in the second trimester and at 3 and 12 months postpartum (n = 519, 484, and 374, respectively) by using a food frequency questionnaire. After adjusting for energy intake, parity, smoking status, race, and education, we identified 3 dietary patterns and named them “prudent,” “health conscious Western,” and “Western.” Nulliparas were 2.9 and 2.1 times more likely to be in the “prudent” class than the “health conscious Western” or the “Western” class, respectively. The 3 dietary patterns were very stable, with the “health conscious Western” class being the least stable; the probability for staying in the same class was 0.74 and 0.87 at 3 and 12 months postpartum, respectively. Breastfeeding mothers were more likely than nonbreastfeeding mothers to switch dietary pattern class (P = 0.0286). Except for breastfeeding mothers, most women did not switch dietary patterns from pregnancy to postpartum. PMID:23538942

  11. Mortality and cancer incidence among Lithuanian cement producing workers

    PubMed Central

    Smailyte, G; Kurtinaitis, J; Andersen, A

    2004-01-01

    Aims: To investigate mortality and cancer incidence of cement producing workers. Methods: A total of 2498 cement workers who have been employed at Portland cement producing departments for at least one year from 1956 to 2000 were followed up from 1 January 1978 to 31 December 2000. The cohort contributed 43 490 person-years to the study. Standardised incidence ratios (SIR) and standardised mortality ratios (SMR) were calculated as ratios between observed and expected numbers of cancers and deaths. The expected numbers were based on sex specific incidence and mortality rates for the total Lithuanian population. Results: Significantly increased SMRs were found for all malignant neoplasms (SMR 1.3, 95% CI 1.0 to 1.5) and for lung cancer (SMR 1.4, 95% CI 1.0 to 1.9) among male cement workers. SIR for all cancer sites was 1.2 (95% CI 1.0 to 1.4). Excess risk was found for cancer of the lung (SIR 1.5, 95% CI 1.1 to 2.1). The SIR for urinary bladder cancer was also increased (SIR 1.8, 95% CI 0.9 to 3.5). The overall cancer incidence was not increased among females (SIR 0.8, 95% CI 0.6 to 1.1). With increasing cumulated exposure to cement dust, there were indications of an increasing risk of lung and stomach cancers among males. Conclusions: This study supported the hypothesis that exposure to cement dust may increase the lung and bladder cancer risk. A dose related risk was found for stomach cancer, but no support was found for an increased risk of colorectal cancer. PMID:15150393

  12. Use of a Cumulative Risk Scale to Predict Poor Intellectual and Academic Outcomes in Childhood Epilepsy.

    PubMed

    Kavanaugh, Brian C; Scarborough, Vanessa Ramos; Salorio, Cynthia F

    2016-06-01

    Discrete risk factors for poor outcomes in childhood epilepsy have been identified, but it is unclear whether the combined effect of several risk factors better predicts outcome. The Epilepsy Cumulative Risk Scale was developed to quantify cumulative risk for poor outcomes in childhood epilepsy. Participants included 156 clinic-referred children with epilepsy. The Epilepsy Cumulative Risk Scale was developed using variables previously associated with functional outcomes. Scale utility was examined through its association with intellectual and academic functioning. All Epilepsy Cumulative Risk Scale variables were significantly associated with functioning. The Total Score (ie, cumulative effect) was most strongly correlated with cognition and academic skills. A Total Score ≥ 5 had the best sensitivity and specificity for differentiating those at high risk for poor outcomes. The Epilepsy Cumulative Risk Scale shows promise as a practical, data-driven tool for quantification of cumulative risk for poor outcomes in childhood epilepsy and may be helpful in detecting those needing referral for additional services. PMID:26747083

  13. Do solar cycles influence giant cell arteritis and rheumatoid arthritis incidence?

    SciTech Connect

    Wing, Simon; Rider, Lisa G.; Johnson, Jay R.; Miller, Federick W.; Matteson, Eric L.; Crowson, C. S.; Gabriel, S. E.

    2015-05-15

    Our objective was to examine the influence of solar cycle and geomagnetic effects on the incidence of giant cell arteritis (GCA) and rheumatoid arthritis (RA). Methods: We used data from patients with GCA (1950-2004) and RA (1955-2007) obtained from population-based cohorts. Yearly trends in age-adjusted and sex-adjusted incidence were correlated with the F10.7 index (solar radiation at 10.7 cm wavelength, a proxy for the solar extreme ultraviolet radiation) and AL index (a proxy for the westward auroral electrojet and a measure of geomagnetic activity). Fourier analysis was performed on AL, F10.7, and GCA and RA incidence rates. Results: The correlation of GCA incidence with AL is highly significant: GCA incidence peaks 0-1 year after the AL reaches its minimum (ie, auroral electrojet reaches a maximum). The correlation of RA incidence with AL is also highly significant. RA incidence rates are lowest 5-7 years after AL reaches maximum. AL, GCA and RA incidence power spectra are similar: they have a main peak (periodicity) at about 10 years and a minor peak at 4-5 years. However, the RA incidence power spectrum main peak is broader (8-11 years), which partly explains the lower correlation between RA onset and AL. The auroral electrojets may be linked to the decline of RA incidence more strongly than the onset of RA. The incidences of RA and GCA are aligned in geomagnetic latitude. Conclusions: AL and the incidences of GCA and RA all have a major periodicity of about 10 years and a secondary periodicity at 4-5 years. Geomagnetic activity may explain the temporal and spatial variations, including east-west skewness in geographic coordinates, in GCA and RA incidence, although the mechanism is unknown. Lastly, the link with solar, geospace and atmospheric parameters need to be investigated. These novel findings warrant examination in other populations and with other autoimmune diseases.

  14. Serious Incident Management in Australia

    ERIC Educational Resources Information Center

    Ellis, Ike; Thorley-Smith, Sara

    2007-01-01

    As part of its efforts to ensure school safety, the government of New South Wales, Australia, has developed simulation exercises to better prepare principals to manage serious incidents, in collaboration with police. This article describes two initiatives implemented across NSW. The exercises provide principals in both secondary and primary…

  15. Benefit Incidence Analysis in Education

    ERIC Educational Resources Information Center

    Lassibille, Gerard; Tan, Jee-Peng

    2007-01-01

    The standard benefit incidence algebra generally produces biased estimates of the distribution of public spending on education when students from poor and rich families are enrolled in schools that receive different levels of public spending per student. Except in very rare instances, removing these biases entails combining several sources of…

  16. [Incidence of cancer in Navarre].

    PubMed

    Ardanaz, E; Moreno, C; Pérez de Rada Arístegui, M E; Ezponda, C; Navaridas, N

    2004-01-01

    Between 1998 and 2000 an annual average of 3,303 cases of invasive cancer were registered in Navarre, 58% of them in men. If we except non melanoma skin tumours, the annual number of cases was 2,495, with gross incidence rates of 559 and 372 per 100,000 in men and women, and rates adjusted to the world population of 312 and 203 per 100,000 respectively. Amongst men, the four most frequently diagnosed tumoural localisations were the prostate, lung, colorectal and bladder, accounting for 57% of all cases. The most notable due to their frequency amongst women were tumours of the breast, colorectal, uterus body and ovary, accounting for 54% of all cases. With respect to the five year period from 1993 to 1997, the global incidence of cancer in the three year period from 1998 to 2000 has increased 4.2% in men and 7.4% in women. The incidence of lung cancer and non-Hodgkin lymphomas in both sexes and of breast cancer in women and prostate cancer in men are notable. There continues to be a fall in the incidence rates of stomach cancer in both sexes, following the tendency begun in the 1970s. PMID:15644889

  17. Emotion Dysregulation Mediates the Relationship between Lifetime Cumulative Adversity and Depressive Symptomatology

    PubMed Central

    Abravanel, Benjamin T.; Sinha, Rajita

    2014-01-01

    Repeated exposure to stressful events across the lifespan, referred to as cumulative adversity, is a potent risk factor for depression. Research indicates that cumulative adversity detrimentally affects emotion regulation processes, which may represent a pathway linking cumulative adversity to vulnerability to depression. However, empirical evidence that emotion dysregulation mediates the relationship between cumulative adversity and depression is limited, particularly in adult populations. We examined the direct and indirect effects of cumulative adversity on depressive symptomatology in a large community sample of adults (n = 745) who were further characterized by risk status: never-depressed (n = 638) and “at-risk” remitted mood-disordered (n = 107). All participants completed the Cumulative Adversity Inventory (CAI), the Difficulties in Emotion Regulation Scale (DERS), and the Center for Epidemiologic Studies Depression Scale (CES-D). Bootstrapped confidence intervals were computed to estimate the indirect effect of emotion dysregulation on the relationship between cumulative adversity and depressive symptomatology and to test whether this indirect effect was moderated by risk status. Emotion dysregulation partially and significantly mediated the relationship between cumulative adversity and depressive symptomatology independent of risk status. Overall, cumulative adversity and emotion dysregulation accounted for 50% of the variance in depressive symptomatology. These findings support the hypothesis that disruption of adaptive emotion regulation processes associated with repeated exposure to stressful life events represents an intrapersonal mechanism linking the experience of adverse events to depression. Our results support the utility of interventions that simultaneously emphasize stress reduction and emotion regulation to treat and prevent depressive vulnerability and pathology. PMID:25528603

  18. CUMULATE ROCKS ASSOCIATED WITH CARBONATE ASSIMILATION, HORTAVÆR COMPLEX, NORTH-CENTRAL NORWAY

    NASA Astrophysics Data System (ADS)

    Barnes, C. G.; Prestvik, T.; Li, Y.

    2009-12-01

    The Hortavær igneous complex intruded high-grade metamorphic rocks of the Caledonian Helgeland Nappe Complex at ca. 466 Ma. The complex is an unusual mafic-silicic layered intrusion (MASLI) because the principal felsic rock type is syenite and because the syenite formed in situ rather than by deep-seated partial melting of crustal rocks. Magma differentiation in the complex was by assimilation, primarily of calc-silicate rocks and melts with contributions from marble and semi-pelites, plus fractional crystallization. The effect of assimilation of calcite-rich rocks was to enhance stability of fassaitic clinopyroxene at the expense of olivine, which resulted in alkali-rich residual melts and lowering of silica activity. This combination of MASLI-style emplacement and carbonate assimilation produced three types of cumulate rocks: (1) Syenitic cumulates formed by liquid-crystal separation. As sheets of mafic magma were loaded on crystal-rich syenitic magma, residual liquid was expelled, penetrating the overlying mafic sheets in flame structures, and leaving a cumulate syenite. (2) Reaction cumulates. Carbonate assimilation, illustrated by a simple assimilation reaction: olivine + calcite + melt = clinopyroxene + CO2 resulted in cpx-rich cumulates such as clinopyroxenite, gabbro, and mela-monzodiorite, many of which contain igneous calcite. (3) Magmatic skarns. Calc-silicate host rocks underwent partial melting during assimilation, yielding a Ca-rich melt as the principal assimilated material and permitting extensive reaction with surrounding magma to form Kspar + cpx + garnet-rich ‘cumulate’ rocks. Cumulate types (2) and (3) do not reflect traditional views of cumulate rocks but instead result from a series of melt-present discontinuous (peritectic) reactions and partial melting of calc-silicate xenoliths. In the Hortavær complex, such cumulates are evident because of the distinctive peritectic cumulate assemblages. It is unclear whether assimilation of

  19. Incident Vertebral Fractures in Children with Leukemia During the Four Years Following Diagnosis

    PubMed Central

    Cummings, Elizabeth A; Ma, Jinhui; Fernandez, Conrad V; Halton, Jacqueline; Alos, Nathalie; Miettunen, Paivi M; Jaremko, Jacob L; Ho, Josephine; Shenouda, Nazih; Matzinger, Mary Ann; Lentle, Brian; Stephure, David; Stein, Robert; Sbrocchi, Ann Marie; Rodd, Celia; Lang, Bianca; Israels, Sara; Grant, Ronald M; Couch, Robert; Barr, Ronald; Hay, John; Rauch, Frank; Siminoski, Kerry; Ward, Leanne M

    2016-01-01

    Objectives The purpose of this article was to determine the incidence and predictors of vertebral fractures (VF) during the four years following diagnosis in pediatric acute lymphoblastic leukemia (ALL). Patients and Methods Children were enrolled within 30 days of chemotherapy initiation, with incident VF assessed annually on lateral spine radiographs according to the Genant method. Extended Cox’s models were used to assess the association between incident VF and clinical predictors. Results 186 children with ALL completed the baseline evaluation (median age 5.3 years, interquartile range 3.4 to 9.7, 58% boys). The VF incidence rate was 8.7 per 100 person-years, with a four-year cumulative incidence of 26.4%. The highest annual incidence occurred at 12 months (16.1%; 95% confidence interval (CI) 11.2 – 22.7), falling to 2.9% at four years (95% CI, 1.1 – 7.3). Half of the children with incident VF had moderate or severe VF and 39% of those with incident VF were asymptomatic. Every 10 mg/m2 increase in average daily glucocorticoid dose (prednisone equivalents) was associated with a 5.9-fold increased VF risk (95% CI, 3.0–11.8; p < 0.01). Other predictors of increased VF risk included: VF at diagnosis, younger age, and lower spine bone mineral density Z-scores at baseline and each annual assessment. Conclusions One quarter of children with ALL developed incident VF in the four years following diagnosis; most of the VF burden was in the first year. Over one third of children with incident VF were asymptomatic. Discrete clinical predictors of VF were evident early in the patient’s clinical course, including VF at diagnosis. PMID:26171800

  20. Representation to the accident and emergency department within 1-year of a fractured neck of femur

    PubMed Central

    2011-01-01

    Background The fractured neck of femur (NOF) is a leading cause of morbidity and mortality. The mortality attendant upon such fractures is 10% at 1 month and 30% at one year with a cost to the NHS of £1.4 billion annually. This retrospective study sought to examine rates and prevailing trends in representation to A&E in the year following a NOF fracture in an attempt to identify the leading causes behind the morbidity and mortality associated with this fracture. Methods 1108 patients who suffered a fractured NOF between 1 January 2002 and 31 December 2007 were identified from a University Hospital A&E database. This database was then used to identify those patients who represented within 1-year following the initial fracture. The presenting complaint, provisional diagnosis and the outcome of this presentation were identified at this time. Results 234 patients (21%) returned to A&E on 368 occasions in the year following a hip fracture. 77% (284/368) of these presentations necessitated admission. Falls, infection and fracture were the leading causes of representation. Falls accounted for 20% (57/284) of admissions; 20.7% of patients were admitted because of a fracture, while 56.6% of admissions were for medical ailments of which infection was the chief precipitant (28% (45/161)). Discussion The causes for representation are varied and multifactorial. The results of this study suggest that some of those events or ailments necessitating readmission may be obviated and potentially reduced by interventions that can be instituted during the primary admission and continued following discharge. PMID:22189063