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Sample records for 1-year cumulative incidence

  1. Comparing center-specific cumulative incidence functions.

    PubMed

    Fan, Ludi; Schaubel, Douglas E

    2016-01-01

    The competing risks data structure arises frequently in clinical and epidemiologic studies. In such settings, the cumulative incidence function is often used to describe the ultimate occurrence of a particular cause of interest. If the objective of the analysis is to compare subgroups of patients with respect to cumulative incidence, imbalance with respect to group-specific covariate distributions must generally be factored out, particularly in observational studies. This report proposes a measure to contrast center- (or, more generally group-) specific cumulative incidence functions (CIF). One such application involves evaluating organ procurement organizations with respect to the cumulative incidence of kidney transplantation. In this case, the competing risks include (i) death on the wait-list and (ii) removal from the wait-list. The proposed method assumes proportional cause-specific hazards, which are estimated through Cox models stratified by center. The proposed center effect measure compares the average CIF for a given center to the average CIF that would have resulted if that particular center had covariate pattern-specific cumulative incidence equal to that of the national average. We apply the proposed methods to data obtained from a national organ transplant registry.

  2. Timing of increased autistic disorder cumulative incidence.

    PubMed

    McDonald, Michael E; Paul, John F

    2010-03-15

    Autistic disorder (AD) is a severe neurodevelopmental disorder typically identified in early childhood. Both genetic and environmental factors are implicated in its etiology. The number of individuals identified as having autism has increased dramatically in recent years, but whether some proportion of this increase is real is unknown. If real, susceptible populations may have exposure to controllable exogenous stressors. Using literature AD data from long-term (approximately 10-year) studies, we determined cumulative incidence of AD for each cohort within each study. These data for each study were examined for a changepoint year in which the AD cumulative incidence first increased. We used data sets from Denmark, California, Japan, and a worldwide composite of studies. In the Danish, California, and worldwide data sets, we found that an increase in AD cumulative incidence began about 1988-1989. The Japanese study (1988-1996) had AD cumulative incidence increasing continuously, and no changepoint year could be calculated. Although the debate about the nature of increasing autism continues, the potential for this increase to be real and involve exogenous environmental stressors exists. The timing of an increase in autism incidence may help in screening for potential candidate environmental stressors.

  3. Multiple imputation methods for nonparametric inference on cumulative incidence with missing cause of failure

    PubMed Central

    Lee, Minjung; Dignam, James J.; Han, Junhee

    2014-01-01

    We propose a nonparametric approach for cumulative incidence estimation when causes of failure are unknown or missing for some subjects. Under the missing at random assumption, we estimate the cumulative incidence function using multiple imputation methods. We develop asymptotic theory for the cumulative incidence estimators obtained from multiple imputation methods. We also discuss how to construct confidence intervals for the cumulative incidence function and perform a test for comparing the cumulative incidence functions in two samples with missing cause of failure. Through simulation studies, we show that the proposed methods perform well. The methods are illustrated with data from a randomized clinical trial in early stage breast cancer. PMID:25043107

  4. Cumulative Incidence Association Models for Bivariate Competing Risks Data.

    PubMed

    Cheng, Yu; Fine, Jason P

    2012-03-01

    Association models, like frailty and copula models, are frequently used to analyze clustered survival data and evaluate within-cluster associations. The assumption of noninformative censoring is commonly applied to these models, though it may not be true in many situations. In this paper, we consider bivariate competing risk data and focus on association models specified for the bivariate cumulative incidence function (CIF), a nonparametrically identifiable quantity. Copula models are proposed which relate the bivariate CIF to its corresponding univariate CIFs, similarly to independently right censored data, and accommodate frailty models for the bivariate CIF. Two estimating equations are developed to estimate the association parameter, permitting the univariate CIFs to be estimated either parametrically or nonparametrically. Goodness-of-fit tests are presented for formally evaluating the parametric models. Both estimators perform well with moderate sample sizes in simulation studies. The practical use of the methodology is illustrated in an analysis of dementia associations.

  5. 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.

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

    PubMed Central

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

    2015-01-01

    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

  7. 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

    2015-06-30

    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.

  8. 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

  9. 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

  10. Cumulative incidence of childhood autism: a total population study of better accuracy and precision.

    PubMed

    Honda, Hideo; Shimizu, Yasuo; Imai, Miho; Nitto, Yukari

    2005-01-01

    Most studies on the frequency of autism have had methodological problems. Most notable of these have been differences in diagnostic criteria between studies, degree of cases overlooked by the initial screening, and type of measurement. This study aimed to replicate the first report on childhood autism to address cumulative incidence as well as prevalence, as defined in the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10) Diagnostic Criteria for Research. Here, the same methodological accuracy (exactness of a measurement to the true value) as the first study was used, but population size was four times larger to achieve greater precision (reduction of random error). A community-oriented system of early detection and early intervention for developmental disorders was established in the northern part of Yokohama, Japan. The city's routine health checkup for 18-month-old children served as the initial mass screening, and all facilities that provided child care services aimed to detect all cases of childhood autism and refer them to the Yokohama Rehabilitation Center. Cumulative incidence up to age 5 years was calculated for childhood autism among a birth cohort from four successive years (1988 to 1991). Cumulative incidence of childhood autism was 27.2 per 10000. Cumulative incidences by sex were 38.4 per 10000 in males, and 15.5 per 10000 in females. The male:female ratio was 2.5:1. The proportions of children with high-functioning autism who had Binet IQs of 70 and over and those with Binet IQs of 85 and over were 25.3% and 13.7% respectively. Data on cumulative incidence of childhood autism derived from this study are the first to be drawn from an accurate, as well as precise, screening methodology.

  11. 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.

  12. 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

    2016-01-06

    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.

  13. Efficient Estimation of Semiparametric Transformation Models for the Cumulative Incidence of Competing Risks.

    PubMed

    Mao, Lu; Lin, D Y

    2017-03-01

    The cumulative incidence is the probability of failure from the cause of interest over a certain time period in the presence of other risks. A semiparametric regression model proposed by Fine and Gray (1999) has become the method of choice for formulating the effects of covariates on the cumulative incidence. Its estimation, however, requires modeling of the censoring distribution and is not statistically efficient. In this paper, we present a broad class of semiparametric transformation models which extends the Fine and Gray model, and we allow for unknown causes of failure. We derive the nonparametric maximum likelihood estimators (NPMLEs) and develop simple and fast numerical algorithms using the profile likelihood. We establish the consistency, asymptotic normality, and semiparametric efficiency of the NPMLEs. In addition, we construct graphical and numerical procedures to evaluate and select models. Finally, we demonstrate the advantages of the proposed methods over the existing ones through extensive simulation studies and an application to a major study on bone marrow transplantation.

  14. Incidence and Burden of Pertussis Among Infants Less Than 1 Year of Age

    PubMed Central

    Martin, Carolyn K.; Krishnarajah, Girishanthy; Becker, Laura K.; Buikema, Ami; Tan, Tina Q.

    2017-01-01

    Background: Infant-specific pertussis data, especially among neonates, are limited and variable. This study (NCT01890850) provides overall and age-specific pertussis incidence and associated health care utilization and costs among commercially insured infants in the US. Methods: Nearly 1.2 million infants born from 2005 to 2010 with commercial health plan coverage were followed during their first 12 months of life. Pertussis cases were identified from medical claims (International Classification of Diseases, 9th revision, Clinical Modification code: 033.0, 033.9, 484.3), and incidence rates were calculated. Each pertussis case was then matched to 10 comparators, so pertussis-related health care utilization and costs before and after the index date could be assessed. Results: The overall pertussis incidence rate among infants <12 months of age was 117.7/100,000 person-years; infants 3 months of age had the highest incidence rate (247.7/100,000 person-years). Infants diagnosed with pertussis were significantly more likely to have prior diagnoses of upper respiratory infection, cough and wheezing-related illnesses than comparators (P < 0.001). Pertussis cases were more likely to be hospitalized within 14 days after the index date (31.8% vs. 0.5%; P < 0.001) and their adjusted health care costs during follow-up were 2.82 times higher than comparators (P < 0.001; 95% confidence interval: 2.08–3.81). The incremental cost of pertussis during the 12-month follow-up period averaged $8271 (P < 0.001). The average incremental cost varied substantially by age, ranging from $18,781 (P < 0.001) to $3772 (P = 0.02) among infants 1 month and 7–12 months of age, respectively. Conclusions: The health burden of pertussis, particularly in the youngest infants, remains substantial, highlighting the need to intensify efforts to protect this most vulnerable population. PMID:27902648

  15. 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,…

  16. [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.

  17. Estimation of the cumulative incidence function under multiple dependent and independent censoring mechanisms.

    PubMed

    Lok, Judith J; Yang, Shu; Sharkey, Brian; Hughes, Michael D

    2017-02-25

    Competing risks occur in a time-to-event analysis in which a patient can experience one of several types of events. Traditional methods for handling competing risks data presuppose one censoring process, which is assumed to be independent. In a controlled clinical trial, censoring can occur for several reasons: some independent, others dependent. We propose an estimator of the cumulative incidence function in the presence of both independent and dependent censoring mechanisms. We rely on semi-parametric theory to derive an augmented inverse probability of censoring weighted (AIPCW) estimator. We demonstrate the efficiency gained when using the AIPCW estimator compared to a non-augmented estimator via simulations. We then apply our method to evaluate the safety and efficacy of three anti-HIV regimens in a randomized trial conducted by the AIDS Clinical Trial Group, ACTG A5095.

  18. Cumulative incidence and risk factors for limber tail in the Dogslife labrador retriever cohort

    PubMed Central

    de C. Bronsvoort, B. M.; Handel, I. G.; Rose, E.; Summers, K.; Clements, D. N.

    2016-01-01

    Limber tail is a condition that typically affects larger working breeds causing tail limpness and pain, resolving without veterinary intervention. It is poorly understood and the disease burden has not been well characterised. Data collected from owners of the Dogslife cohort of Labrador Retrievers have been used to describe incidents and a case–control study was undertaken to elucidate risk factors with 38 cases and 86 controls. The cumulative incidence of unexplained tail limpness was 9.7 per cent. Swimming is not a necessary precursor for limber tail, but it is a risk factor (OR=4.7) and working dogs were more susceptible than non-working dogs (OR=5.1). Higher latitudes were shown to be a risk factor for developing the condition and the case dogs were more related to each other than might be expected by chance. This suggests that dogs may have an underlying genetic predisposition to developing the condition. This study is the first, large-scale investigation of limber tail and the findings reveal an unexpectedly high illness burden. Anecdotally, accepted risk factors have been confirmed and the extent of their impact has been quantified. Identifying latitude and a potential underlying genetic predisposition suggests avenues for future work on this painful and distressing condition. PMID:27353875

  19. Regression modeling of the cumulative incidence function with missing causes of failure using pseudo-values.

    PubMed

    Moreno-Betancur, Margarita; Latouche, Aurélien

    2013-08-15

    Competing risks arise when patients may fail from several causes. Strategies for modeling event-specific quantities often assume that the cause of failure is known for all patients, but this is seldom the case. Several authors have addressed the problem of modeling the cause-specific hazard rates with missing causes of failure. In contrast, direct modeling of the cumulative incidence function has received little attention.We provide a general framework for regression modeling of this function in the missing cause setting, encompassing key models such as the Fine and Gray and additive models, by considering two extensions of the Andersen–Klein pseudo-value approach. The first extension is a novel inverse probability weighting method, whereas the second extension is based on a previously proposed multiple imputation procedure.We evaluated the gain in using these approaches with small samples in an extensive simulation study. We analyzed the data from an Eastern Cooperative Oncology Group breast cancer treatment clinical trial to illustrate the practical value and ease of implementation of the proposed methods.

  20. Constrained parametric model for simultaneous inference of two cumulative incidence functions.

    PubMed

    Shi, Haiwen; Cheng, Yu; Jeong, Jong-Hyeon

    2013-01-01

    We propose a parametric regression model for the cumulative incidence functions (CIFs) commonly used for competing risks data. The model adopts a modified logistic model as the baseline CIF and a generalized odds-rate model for covariate effects, and it explicitly takes into account the constraint that a subject with any given prognostic factors should eventually fail from one of the causes such that the asymptotes of the CIFs should add up to one. This constraint intrinsically holds in a nonparametric analysis without covariates, but is easily overlooked in a semiparametric or parametric regression setting. We hence model the CIF from the primary cause assuming the generalized odds-rate transformation and the modified logistic function as the baseline CIF. Under the additivity constraint, the covariate effects on the competing cause are modeled by a function of the asymptote of the baseline distribution and the covariate effects on the primary cause. The inference procedure is straightforward by using the standard maximum likelihood theory. We demonstrate desirable finite-sample performance of our model by simulation studies in comparison with existing methods. Its practical utility is illustrated in an analysis of a breast cancer dataset to assess the treatment effect of tamoxifen, adjusting for age and initial pathological tumor size, on breast cancer recurrence that is subject to dependent censoring by second primary cancers and deaths.

  1. Flexible parametric modelling of the cause-specific cumulative incidence function.

    PubMed

    Lambert, Paul C; Wilkes, Sally R; Crowther, Michael J

    2017-04-30

    Competing risks arise with time-to-event data when individuals are at risk of more than one type of event and the occurrence of one event precludes the occurrence of all other events. A useful measure with competing risks is the cause-specific cumulative incidence function (CIF), which gives the probability of experiencing a particular event as a function of follow-up time, accounting for the fact that some individuals may have a competing event. When modelling the cause-specific CIF, the most common model is a semi-parametric proportional subhazards model. In this paper, we propose the use of flexible parametric survival models to directly model the cause-specific CIF where the effect of follow-up time is modelled using restricted cubic splines. The models provide smooth estimates of the cause-specific CIF with the important advantage that the approach is easily extended to model time-dependent effects. The models can be fitted using standard survival analysis tools by a combination of data expansion and introducing time-dependent weights. Various link functions are available that allow modelling on different scales and have proportional subhazards, proportional odds and relative absolute risks as particular cases. We conduct a simulation study to evaluate how well the spline functions approximate subhazard functions with complex shapes. The methods are illustrated using data from the European Blood and Marrow Transplantation Registry showing excellent agreement between parametric estimates of the cause-specific CIF and those obtained from a semi-parametric model. We also fit models relaxing the proportional subhazards assumption using alternative link functions and/or including time-dependent effects. Copyright © 2016 John Wiley & Sons, Ltd.

  2. 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

  3. Cumulative ultraviolet radiation flux in adulthood and risk of incident skin cancers in women

    PubMed Central

    Wu, S; Han, J; Vleugels, R A; Puett, R; Laden, F; Hunter, D J; Qureshi, A A

    2014-01-01

    Background: Solar ultraviolet (UV) exposure estimated based on residential history has been used as a sun exposure indicator in previous case–control and descriptive studies. However, the associations of cumulative UV exposure based on residential history with different skin cancers, including melanoma, squamous cell carcinoma (SCC), and basal cell carcinoma (BCC), have not been evaluated simultaneously in prospective studies. Methods: We conducted a cohort study among 108 578 women in the Nurses' Health Study (1976–2006) to evaluate the relative risks of skin cancers with cumulative UV flux based on residential history in adulthood. Results: Risk of SCC and BCC was significantly lower for women in lower quintiles vs the highest quintile of cumulative UV flux (both P for trend <0.0001). The association between cumulative UV flux and risk of melanoma did not reach statistical significance. However, risk of melanoma appeared to be lower among women in lower quintiles vs the highest quintile of cumulative UV flux in lag analyses with 2–10 years between exposure and outcome. The multivariable-adjusted hazard ratios per 200 × 10−4 Robertson–Berger units increase in cumulative UV flux were 0.979 (95% confidence interval (CI): 0.933, 1.028) for melanoma, 1.072 (95% CI: 1.041, 1.103) for SCC, and 1.043 (95% CI: 1.034, 1.052) for BCC. Conclusions: Associations with cumulative UV exposure in adulthood among women differed for melanoma, SCC, and BCC, suggesting a potential variable role of UV radiation in adulthood in the carcinogenesis of the three major skin cancers. PMID:24595003

  4. Education, occupation, noise exposure history and the 10-yr cumulative incidence of hearing impairment in older adults.

    PubMed

    Cruickshanks, Karen J; Nondahl, David M; Tweed, Ted S; Wiley, Terry L; Klein, Barbara E K; Klein, Ronald; Chappell, Rick; Dalton, Dayna S; Nash, Scott D

    2010-06-01

    The purpose of this study was to determine the 10-yr cumulative incidence of hearing impairment and associations of education, occupation and noise exposure history with the incidence of hearing impairment in a population-based cohort study of 3753 adults ages 48-92 yr at the baseline examinations during 1993-1995 in Beaver Dam, WI. Hearing thresholds were measured at baseline, 2.5 yr-, 5 yr-, and 10-yr follow-up examinations. Hearing impairment was defined as a pure-tone average (PTA)>25 dB HL at 500, 1000, 2000, and 4000 Hz. Demographic characteristics and occupational histories were obtained by questionnaire. The 10-yr cumulative incidence of hearing impairment was 37.2%. Age (5 yr; Hazard Ratio (HR)=1.81), sex (M vs W; HR=2.29), occupation based on longest held job (production/operations/farming vs others; HR=1.34), marital status (unmarried vs married; HR=1.29) and education (<16 vs 16+yr; HR=1.40) were associated with the 10 yr incidence. History of noisy jobs was not associated with the 10-yr incidence of hearing impairment. The risk of hearing impairment was high, with women experiencing a slightly later onset. Markers of socioeconomic status were associated with hearing impairment, suggesting that hearing impairment in older adults may be associated with modifiable lifestyle and environmental factors, and therefore, at least partially preventable.

  5. Correlates of 1-year incidence of urinary incontinence in older Latino adults enrolled in a community-based physical activity trial.

    PubMed

    Morrisroe, Shelby N; Rodriguez, Larissa V; Wang, Pin-Chieh; Smith, Ariana L; Trejo, Laura; Sarkisian, Catherine A

    2014-04-01

    The prevalence of urinary incontinence (UI) among older urban Latinos is high. Insight into etiologies of and contributing factors to the development of this condition is needed. This longitudinal cohort study identified correlates of 1-year incidence of UI in older community-dwelling Latino adults participating in a senior center-based physical activity trial in Los Angeles, California. Three hundred twenty-eight Latinos aged 60 to 93 participating in Caminemos, a randomized trial to increase walking, were studied. Participants completed an in-person survey and physical performance measures at baseline and 1 year. UI was measured using the International Consultation on Incontinence item: "How often do you leak urine?" Potential correlates of 1-year incidence of UI included sociodemographic, behavioral, medical, physical, and psychosocial characteristics. The overall incidence of UI at 1 year was 17.4%. Incident UI was associated with age, baseline activity of daily living impairment, health-related quality of life (HRQoL), mean steps per day, and depressive symptoms. Multivariate logistic regression models revealed that improvement in physical performance score (odds ratio (OR) = 0.69, 95% confidence interval (CI) = 0.50-0.95) and high baseline physical (OR = 0.60, 95% CI = 0.40-0.89) and mental (OR = 0.62, 95% CI = 0.43-0.91) HRQoL were independently associated with lower rates of 1-year incident UI. An increase in depressive symptoms at 1 year (OR = 4.48, 95% CI = 1.02-19.68) was independently associated with a higher rate of incident UI. One-year UI incidence in this population of older urban Latino adults participating in a walking trial was high but was lower in those who improved their physical performance. Interventions aimed at improving physical performance may help prevent UI in older Latino adults.

  6. Lead-Related Genetic Loci, Cumulative Lead Exposure and Incident Coronary Heart Disease: The Normative Aging Study

    PubMed Central

    Weisskopf, Marc G.; Sparrow, David; Schwartz, Joel; Hu, Howard; Park, Sung Kyun

    2016-01-01

    Background Cumulative exposure to lead is associated with cardiovascular outcomes. Polymorphisms in the δ-aminolevulinic acid dehydratase (ALAD), hemochromatosis (HFE), heme oxygenase-1 (HMOX1), vitamin D receptor (VDR), glutathione S-transferase (GST) supergene family (GSTP1, GSTT1, GSTM1), apolipoprotein E (APOE),angiotensin II receptor-1 (AGTR1) and angiotensinogen (AGT) genes, are believed to alter toxicokinetics and/or toxicodynamics of lead. Objectives We assessed possible effect modification by genetic polymorphisms in ALAD, HFE, HMOX1, VDR, GSTP1, GSTT1, GSTM1, APOE, AGTR1 and AGT individually and as the genetic risk score (GRS) on the association between cumulative lead exposure and incident coronary heart disease (CHD) events. Methods We used K-shell-X-ray fluorescence to measure bone lead levels. GRS was calculated on the basis of 22 lead-related loci. We constructed Cox proportional hazard models to compute adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for incident CHD. We applied inverse probability weighting to account for potential selection bias due to recruitment into the bone lead sub-study. Results Significant effect modification was found by VDR, HMOX1, GSTP1, APOE, and AGT genetic polymorphisms when evaluated individually. Further, the bone lead-CHD associations became larger as GRS increases. After adjusting for potential confounders, a HR of CHD was 2.27 (95%CI: 1.50–3.42) with 2-fold increase in patella lead levels, among participants in the top tertile of GRS. We also detected an increasing trend in HRs across tertiles of GRS (p-trend = 0.0063). Conclusions Our findings suggest that lead-related loci as a whole may play an important role in susceptibility to lead-related CHD risk. These findings need to be validated in a separate cohort containing bone lead, lead-related genetic loci and incident CHD data. PMID:27584680

  7. Meta-analysis for aggregated survival data with competing risks: a parametric approach using cumulative incidence functions.

    PubMed

    Bonofiglio, Federico; Beyersmann, Jan; Schumacher, Martin; Koller, Michael; Schwarzer, Guido

    2016-09-01

    Meta-analysis of a survival endpoint is typically based on the pooling of hazard ratios (HRs). If competing risks occur, the HRs may lose translation into changes of survival probability. The cumulative incidence functions (CIFs), the expected proportion of cause-specific events over time, re-connect the cause-specific hazards (CSHs) to the probability of each event type. We use CIF ratios to measure treatment effect on each event type. To retrieve information on aggregated, typically poorly reported, competing risks data, we assume constant CSHs. Next, we develop methods to pool CIF ratios across studies. The procedure computes pooled HRs alongside and checks the influence of follow-up time on the analysis. We apply the method to a medical example, showing that follow-up duration is relevant both for pooled cause-specific HRs and CIF ratios. Moreover, if all-cause hazard and follow-up time are large enough, CIF ratios may reveal additional information about the effect of treatment on the cumulative probability of each event type. Finally, to improve the usefulness of such analysis, better reporting of competing risks data is needed. Copyright © 2015 John Wiley & Sons, Ltd.

  8. Comparison of the Postoperative Incidence Rate of Capsular Contracture among Different Breast Implants: A Cumulative Meta-Analysis

    PubMed Central

    Liu, Xing; Zhou, Liang; Pan, Fuqiang; Gao, Yang; Yuan, Xi; Fan, Dongli

    2015-01-01

    Background A large number of clinical studies have reported that the different materials used in breast implants were a possible cause of the different incidence rates of capsular contracture observed in patients after implantation. However, this theory lacks comprehensive support from evidence-based medicine, and considerable controversy remains. Objectives In this study, a cumulative systematic review examined breast augmentation that used implants with textured or smooth surfaces to analyze the effects of these two types of implants on the occurrence of postoperative capsular contracture. Methods We conducted a comprehensive search of literature databases, including PubMed and EMBASE, for clinical reports on the incidence of capsular contracture after the implantation of breast prostheses. We performed a cumulative meta-analysis on the incidence of capsular contracture in order from small to large sample sizes and conducted subgroup analyses according to the prosthetic material used, the implant pocket placement, the incision type and the duration of follow-up. Relative risks (RR) and 95% confidence intervals (CI) were used as the final pooled statistics. Results This meta-analysis included 16 randomized controlled trials (RCTs) and two retrospective studies. The cumulative comparison of textured and smooth breast implants showed statistical significance at 2.13 (95% CI, 1.18-3.86) when the fourth study was entered into the analysis. With the inclusion of more reports, the final results indicated that smooth breast implants were more likely to be associated with capsular contracture, with statistical significance at 3.10 (95% CI, 2.23-4.33). In the subgroup analyses, the subgroups based on implant materials included the silicone implant group and the saline implant group, with significant pooled statistical levels of 4.05 (95% CI, 1.97-8.31) and 3.12 (95% CI, 2.19-4.42), respectively. According to implant pocket placement, a subglandular group and a submuscular

  9. 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.

  10. Baseline higher peritoneal transport had been associated with worse nutritional status of incident continuous ambulatory peritoneal dialysis patients in Southern China: a 1-year prospective study.

    PubMed

    Liu, Yun; Huang, Rong; Guo, Qunying; Yang, Qiongqiong; Yi, Chunyan; Lin, Jianxiong; Yu, Xueqing; Yang, Xiao

    2015-08-14

    The aim of the present study was to investigate the relationship between baseline peritoneal transport types and nutritional status in Chinese continuous ambulatory peritoneal dialysis (CAPD) patients. In the present single-centre, prospective study, incident CAPD patients were included from 15 April 2010 to 31 December 2011 and were followed up for 12 months. According to the results of baseline peritoneal equilibration test, patients were divided into lower peritoneal transport group (lower transporters) and higher peritoneal transport group (higher transporters). Nutritional status was evaluated by both subjective global assessment (SGA) and protein-energy wasting (PEW) score. The body composition parameters were assessed by body impedance analysis. A total of 283 CAPD patients were included in the study, of which 171 (60.4 %) were males with a mean age of 47.0 (sd 14.9) years. Compared with lower transporters (n 92), higher transporters (n 181) had lower levels of serum albumin (37.1 (sd 4.3) v. 39.6 (sd 4.3) g/l, P< 0.001), serum pre-albumin (356 (sd 99) v. 384 (sd 90) mg/l, P= 0.035), phase angle (6.15 (sd 0.39) v. 6.27 (sd 0.47)°, P< 0.05) and higher rate of malnutrition defined by SGA (52.5 v. 25.0%, P< 0.001) and PEW score (37.0 v. 14.1 %, P< 0.001) at 1-year of follow-up. Baseline higher peritoneal transport, analysed by multivariate binary logistic regressions, was independently associated with malnutrition (SGA mild to moderate and severe malnutrition: OR 3.43, 95% CI 1.69, 6.96, P< 0.01; PEW: OR 2.40, 95% CI 1.08, 5.31, P= 0.03). It was concluded that baseline higher peritoneal transport was independently associated with worse nutritional status of CAPD patients in Southern China.

  11. 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.

  12. National Trends over One Decade in Hospitalization for Acute Myocardial Infarction among Spanish Adults with Type 2 Diabetes: Cumulative Incidence, Outcomes and Use of Percutaneous Coronary Intervention

    PubMed Central

    Lopez-de-Andres, Ana; Jimenez-Garcia, Rodrigo; Hernandez-Barrera, Valentin; Jimenez-Trujillo, Isabel; Gallardo-Pino, Carmen; de Miguel, Angel Gil; Carrasco-Garrido, Pilar

    2014-01-01

    Background This study aims to describe trends in the rate of acute myocardial infarction (AMI) and use of percutaneous coronary interventions (PCI) in patients with and without type 2 diabetes in Spain, 2001–2010. Methods We selected all patients with a discharge of AMI using national hospital discharge data. Discharges were grouped by diabetes status: type 2 diabetes and no diabetes. In both groups PCIs were identified. The cumulative incidence of discharges attributed to AMI were calculated overall and stratified by diabetes status and year. We calculated length of stay and in-hospital mortality (IHM). Use of PCI was calculated stratified by diabetes status. Multivariate analysis was adjusted by age, sex, year and comorbidity. Results: From 2001 to 2010, 513,517 discharges with AMI were identified (30.3% with type 2 diabetes). The cumulative incidence of discharges due to AMI in diabetics patients increased (56.3 in 2001 to 71 cases per 100,000 in 2004), then decreased to 61.9 in 2010. Diabetic patients had significantly higher IHM (OR, 1.14; 95%CI, 1.05–1.17). The proportion of diabetic patients that underwent PCI increased from 11.9% in 2001 to 41.6% in 2010. Adjusted incidence of discharge in patients with diabetes who underwent PCI increased significantly (IRR, 3.49; 95%CI, 3.30–3.69). The IHM among diabetics patients who underwent a PCI did not change significantly over time. Conclusions AMI hospitalization rates increased initially but declining slowly. From 2001 to 2010 the proportion of diabetic patients who undergo a PCI increased almost four-fold. Older age and more comorbidity may explain why IHM did not improve after a PCI. PMID:24454920

  13. 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

  14. Contested Cumulations:

    PubMed Central

    Pickstone, John V.

    2007-01-01

    Summary The treatment of cancer through the twentieth century may be seen as the successive addition of modalities: first surgery; then radiotherapy, especially between the world wars; and then chemotherapy, from the 1960s. This paper explores some of the systematic differences between the modalities, and how these additions were negotiated in different countries, with different long-term consequences for the development of services and specialization. It focuses chiefly on the United Kingdom and the United States, the former exemplifying a centralized health polity, and the latter, liberal markets combined with large and crucial postwar inputs from government. The differences between health polities were especially important for interwar radiotherapy, which in its centralized form appeared as paradigmatic of the analytical/rationalizing mode in modern medicine. Chemotherapy exemplified a more inventive and experimentalist mode that became common after World War II, and that, through the practice of trials, shaped the new subprofession of medical oncology. The interactions of the modalities, at various levels, are modeled as contested cumulations showing strong path dependency. The paper ends by reviewing the present situation, especially for Britain, and by underlining the relevance of history. PMID:17369667

  15. Cumulants, free cumulants and half-shuffles.

    PubMed

    Ebrahimi-Fard, Kurusch; Patras, Frédéric

    2015-04-08

    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.

  16. The MentDis_ICF65+ study protocol: prevalence, 1-year incidence and symptom severity of mental disorders in the elderly and their relationship to impairment, functioning (ICF) and service utilisation

    PubMed Central

    2013-01-01

    Background The EU currently lacks reliable data on the prevalence and incidence of mental disorders in older people. Despite the availability of several national and international epidemiological studies, the size and burden of mental disorders in the elderly remain unclear due to various reasons. Therefore, the aims of the MentDis_ICF65+ study are (1) to adapt existing assessment instruments, and (2) to collect data on the prevalence, the incidence, and the natural course and prognosis of mental disorders in the elderly. Method/design Using a cross-sectional and prospective longitudinal design, this multi-centre study from six European countries and associated states (Germany, Great Britain, Israel, Italy, Spain, and Switzerland) is based on age-stratified, random samples of elderly people living in the community. The study program consists of three phases: (1) a methodological phase devoted primarily to the adaptation of age- and gender-specific assessment tools for older people (e.g., the Composite International Diagnostic Interview, CIDI) as well as psychometric evaluations including translation, back translation; (2) a baseline community study in all participating countries to assess the lifetime, 12 month and 1 month prevalence and comorbidity of mental disorders, including prior course, quality of life, health care utilization and helpseeking, impairments and participation and, (3) a 12 month follow-up of all baseline participants to monitor course and outcome as well as examine predictors. Discussion The study is an essential step forward towards the further development and improvement of harmonised instruments for the assessment of mental disorders as well as the evaluation of activity impairment and participation in older adults. This study will also facilitate the comparison of cross-cultural results. These results will have bearing on mental health care in the EU and will offer a starting point for necessary structural changes to be initiated for

  17. Incidence of urinary retention during treatment with single tablet combinations of solifenacin+tamsulosin OCAS™ for up to 1 year in adult men with both storage and voiding LUTS: A subanalysis of the NEPTUNE/NEPTUNE II randomized controlled studies

    PubMed Central

    Drake, Marcus J.; Oelke, Matthias; Snijder, Robert; Klaver, Monique; Traudtner, Klaudia; van Charldorp, Karin; Bongaerts, Dominique; Van Kerrebroeck, Philip

    2017-01-01

    Introduction The emergence of urinary retention (UR), specifically acute urinary retention (AUR), has been a concern when treating men with lower urinary tract symptoms (LUTS) with antimuscarinic drugs. Materials and methods In NEPTUNE (12-week, double-blind), men (≥45 years) with LUTS were randomized to receive tamsulosin oral-controlled absorption system (TOCAS) 0.4 mg, fixed-dose combination (FDC) of solifenacin (Soli) 6 mg + TOCAS 0.4 mg, FDC Soli 9 mg + TOCAS 0.4 mg, or placebo. In NEPTUNE II (40-week, open-label extension of NEPTUNE), continuing patients received 4-week FDC Soli 6 mg + TOCAS, then FDC Soli 6 mg or 9 mg + TOCAS for the remainder of the study, switchable every 3 months. Results Across both studies, 1208 men received ≥1 dose of FDC Soli 6 mg or 9 mg + TOCAS for up to 52 weeks; 1199 men completed NEPTUNE and 1066 received ≥1 dose in NEPTUNE II. In total, 13 men (1.1%; 95% CI, 0.6%–1.8%) reported a UR event while receiving FDC, eight of which were AUR (0.7%; 95% CI, 0.3%–1.3%, incidence 7/1000 man-years). Six men reported UR events while taking Soli 6 mg + TOCAS (three AUR), and seven men reported a UR event while taking Soli 9 mg + TOCAS (five AUR). One man developed AUR while taking TOCAS alone and four reported UR (three AUR) during placebo run-in. Most AUR/UR events occurred within 4 months of treatment initiation. Conclusions FDC Soli and TOCAS was associated with a low rate of UR and AUR in men with LUTS. PMID:28166296

  18. Social Development: 1 Year Olds

    MedlinePlus

    ... Stages Listen Español Text Size Email Print Share Social Development: 1 Year Olds Page Content Article Body During his second year, your toddler will develop a very specific image of his social world, friends, and acquaintances. He ...

  19. 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.

  20. Language Development: 1 Year Olds

    MedlinePlus

    ... Stages Listen Español Text Size Email Print Share Language Development: 1 Year Olds Page Content Article Body ... assured, it’s not your imagination. He’s developing his language and comprehension skills right on schedule. This giant ...

  1. Individual, physical and psychological risk factors for neck pain in Australian office workers: a 1-year longitudinal study.

    PubMed

    Hush, Julia M; Michaleff, Zoe; Maher, Christopher G; Refshauge, Kathryn

    2009-10-01

    Neck pain is more prevalent in office workers than in the general community. To date, findings from prospective studies that investigated causal relationships between putative risk factors and the onset of neck pain in this population have been limited by high loss to follow-up. The aim of this research was to prospectively evaluate a range of risk factors for neck pain in office workers, using validated and reliable objective measures as well as attain an estimate of 1-year incidence. We assembled a cohort of 53 office workers without neck pain and measured individual, physical, workplace and psychological factors at baseline. We followed participants for 1 year to measure the incidence of neck pain. We achieved 100% participant follow-up. Cox regression analysis was applied to examine the relationship between the putative risk factors and the cumulative incidence of neck pain. The 1-year incidence proportion of neck pain in Australian office workers was estimated in this study to be 0.49 (95% CI 0.36-0.62). Predictors of neck pain with moderate to large effect sizes were female gender (HR: 3.07; 95% CI: 1.18-7.99) and high psychological stress (HR: 1.64; 95% CI: 0.66-4.07). Protective factors included increased mobility of the cervical spine (HR: 0.44; 95% CI: 0.19-1.05) and frequent exercise (HR: 0.64; 95% CI: 0.27-1.51). These results reveal that neck pain is common in Australian office workers and that there are risk factors that are potentially modifiable.

  2. 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.

  3. 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.

  4. Your Child's Development: 1 Year (12 Months)

    MedlinePlus

    ... Year-Old Your Child’s Development: 1 Year (12 Months) KidsHealth > For Parents > Your Child’s Development: 1 Year (12 Months) A A A Your little one is now ... THIS TOPIC Your Child's Checkup: 1 Year (12 Months) Your Baby's Growth: 12 Months Your Baby's Hearing, ...

  5. 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.

  6. [Antimicrobial susceptibility cumulative reports].

    PubMed

    Canut-Blasco, Andrés; Calvo, Jorge; Rodríguez-Díaz, Juan Carlos; Martínez-Martínez, Luis

    2016-10-01

    Cumulative reports on antimicrobial susceptibility tests data are important for selecting empirical treatments, as an educational tool in programs on antimicrobial use, and for establishing breakpoints defining clinical categories. These reports should be based on data validated by clinical microbiologists using diagnostic samples (not surveillance samples). In order to avoid a bias derived from including several isolates obtained from the same patient, it is recommended that, for a defined period, only the first isolate is counted. A minimal number of isolates per species should be presented: a figure of >=30 isolates is statistically acceptable. The report is usually presented in a table format where, for each cell, information on clinically relevant microorganisms-antimicrobial agents is presented. Depending on particular needs, multiple tables showing data related to patients, samples, services or special pathogens can be prepared.

  7. 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.

  8. UBIQUITOUS POLLUTANTS FROM CUMULATIVE ...

    EPA Pesticide Factsheets

    The occurrence of pharmaceuticals and personal care products (PPCPS) as environmental pollutants is a multifaceted issue whose scope continues to become better delineated since the escalation of concerted attention beginning in the 1980s. PPCPs typically occur as trace environmental pollutants (primarily in surface but also in ground waters) as a result of their widespread, continuous, combined usage in a broad range of human and veterinary therapeutic activities and practices. With respect to the risk-assessment paradigm, the growing body of published work has focused primarily on the origin and occurrence of these substances. Comparatively less is known about human and ecological exposure, and even less about the known or even potential hazards associated with exposure to these anthropogenic substances, many of which are highly bioactive. The continually growing, worldwide importance of freshwater resources underscores the need for ensuring that any aggregate or cumulative impacts on water supplies and resultant potential for human or ecological exposure be minimized. This has prompted the more recent investigations on waste treatment processes for one of the major sources of environmental disposition, namely sewage. Despite the paucity of health effects data for long-term, simultaneous exposure to multiple xenobiotics (particularly PPCPS) at low doses (a major toxicological issue that can be described by the

  9. 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.

  10. Algorithm Calculates Cumulative Poisson Distribution

    NASA Technical Reports Server (NTRS)

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

    1992-01-01

    Algorithm calculates accurate values of cumulative Poisson distribution under conditions where other algorithms fail because numbers are so small (underflow) or so large (overflow) that computer cannot process them. Factors inserted temporarily to prevent underflow and overflow. Implemented in CUMPOIS computer program described in "Cumulative Poisson Distribution Program" (NPO-17714).

  11. Cumulants of Hawkes point processes

    NASA Astrophysics Data System (ADS)

    Jovanović, Stojan; Hertz, John; Rotter, Stefan

    2015-04-01

    We derive explicit, closed-form expressions for the cumulant densities of a multivariate, self-exciting Hawkes point process, generalizing a result of Hawkes in his earlier work on the covariance density and Bartlett spectrum of such processes. To do this, we represent the Hawkes process in terms of a Poisson cluster process and show how the cumulant density formulas can be derived by enumerating all possible "family trees," representing complex interactions between point events. We also consider the problem of computing the integrated cumulants, characterizing the average measure of correlated activity between events of different types, and derive the relevant equations.

  12. Stability in the cumulative incidence, severity and mortality of 101 cases of invasive mucormycosis in high-risk patients from 1995 to 2011: a comparison of eras immediately before and after the availability of voriconazole and echinocandin-amphotericin combination therapies.

    PubMed

    Abidi, Maheen Z; Sohail, Muhammad R; Cummins, Nathan; Wilhelm, Mark; Wengenack, Nancy; Brumble, Lisa; Shah, Harshal; Jane Hata, Donna; McCullough, Ann; Wendel, Amy; Vikram, Holenarasipur R; Kusne, Shimon; Litzow, Mark; Letendre, Louis; Lahr, Brian D; Poeschla, Eric; Walker, Randall C

    2014-11-01

    As invasive mucormycosis (IM) numbers rise, clinicians suspect prior voriconazole worsens IM incidence and severity, and believe combination anti-fungal therapy improves IM survival. To compare the cumulative incidence (CI), severity and mortality of IM in eras immediately before and after the commercial availability of voriconazole all IM cases from 1995 to 2011 were analysed across four risk-groups (hematologic/oncologic malignancy (H/O), stem cell transplantation (SCT), solid organ transplantation (SOT) and other), and two eras, E1 (1995-2003) and E2, (2004-2011). Of 101 IM cases, (79 proven, 22 probable): 30 were in E1 (3.3/year) and 71 in E2 (8.9/year). Between eras, the proportion with H/O or SCT rose from 47% to 73%, while 'other' dropped from 33% to 11% (P = 0.036). Between eras, the CI of IM did not significantly increase in SCT (P = 0.27) or SOT (P = 0.30), and patterns of anatomic location (P = 0.122) and surgical debridement (P = 0.200) were similar. Significantly more patients received amphotericin-echinocandin combination therapy in E2 (31% vs. 5%, P = 0.01); however, 90-day survival did not improve (54% vs. 59%, P = 0.67). Since 2003, the rise of IM reflects increasing numbers at risk, not prior use of voriconazole. Frequent combination of anti-fungal therapy has not improved survival.

  13. 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.

  14. Incident psychosis in Subjects With Mild Cognitive Impairment and Alzheimer’s Disease

    PubMed Central

    Weamer, Elise A.; DeMichele-Sweet, Mary Ann A.; Cloonan, Yona K.; Lopez, Oscar L.; Sweet, Robert A.

    2017-01-01

    Objective To estimate the incidence of psychotic symptoms in Alzheimer disease. Methods The study consists of 776 elderly subjects presenting to the Alzheimer Disease Research Center at the University of Pittsburgh between May 9, 2000 and August 19, 2014. All participants were diagnosed with mild cognitive impairment (National Institute on Aging-Alzheimer’s Association workgroup criteria), possible, or probable Alzheimer disease (National Institute of Neurologic and Communicative Disorders and Stroke and the Alzheimer’s Disease and Related Disorders Association criteria) and were without psychosis at entry. Psychotic symptoms were evaluated using the Consortium to Establish a Registry for Alzheimer Disease Behavioral Rating Scale (BRS) every 6 months. 1-, 3- and 5-year cumulative incidences of psychosis were calculated. Results The 1-year psychosis incidence was 10% (95% CI, 8% – 12%) and this annual rate remained remarkably consistent at 3 and 5 years. Psychosis incidence was related to cognitive status at all time points. However, the incidence rate reached a plateau during the disease course. Cumulative psychosis incidence at 5 years was 61% (95% CI, 52% – 69%) in individuals with moderate to severe AD, not statistically significantly different from the cumulative incidence at 3 years in this group which was 48% (95% CI, 40% – 55%), or from the 5-year incidence in individuals who entered the study with mild AD which was 48% (95% CI, 41% – 56%). Conclusion Psychosis in AD has been associated with a number of adverse clinical outcomes. We provide estimates of the risk of psychosis onset within clinically defined subgroups of individuals, a tool clinicians can use in treatment planning. Anticipating which subjects are at high risk for psychosis and its associated poor outcomes can help with family education and support decisions to implement non-pharmacologic strategies that may reduce or prevent symptoms. PMID:28086011

  15. 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

  16. 32 CFR 651.16 - Cumulative impacts.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... analysis should identify the cause and effect relationships, determine the magnitude and significance of... § 651.16 Cumulative impacts. (a) NEPA analyses must assess cumulative effects, which are the impact on... cumulative effects analysis. (c) A suggested cumulative effects approach is as follows: (1) Identify...

  17. Adaptive strategies for cumulative cultural learning.

    PubMed

    Ehn, Micael; Laland, Kevin

    2012-05-21

    The demographic and ecological success of our species is frequently attributed to our capacity for cumulative culture. However, it is not yet known how humans combine social and asocial learning to generate effective strategies for learning in a cumulative cultural context. Here we explore how cumulative culture influences the relative merits of various pure and conditional learning strategies, including pure asocial and social learning, critical social learning, conditional social learning and individual refiner strategies. We replicate the Rogers' paradox in the cumulative setting. However, our analysis suggests that strategies that resolved Rogers' paradox in a non-cumulative setting may not necessarily evolve in a cumulative setting, thus different strategies will optimize cumulative and non-cumulative cultural learning.

  18. The Algebra of the Cumulative Percent Operation.

    ERIC Educational Resources Information Center

    Berry, Andrew J.

    2002-01-01

    Discusses how to help students avoid some pervasive reasoning errors in solving cumulative percent problems. Discusses the meaning of ."%+b%." the additive inverse of ."%." and other useful applications. Emphasizes the operational aspect of the cumulative percent concept. (KHR)

  19. 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

  20. Incidence and Progression of Diabetic Retinopathy During 17 Years of a Population-Based Screening Program in England

    PubMed Central

    Jones, Colin D.; Greenwood, Richard H.; Misra, Aseema; Bachmann, Max O.

    2012-01-01

    OBJECTIVE To estimate the incidence of diabetic retinopathy in relation to retinopathy grade at first examination and other prognostic characteristics. RESEARCH DESIGN AND METHODS This was a dynamic cohort study of 20,686 people with type 2 diabetes who had annual retinal photography up to 14 times between 1990 and 2006. Cumulative and annual incidence rates were estimated using life tables, and risk factors for progression were identified using Cox regression analysis. RESULTS Of 20,686 patients without proliferative diabetic retinopathy (PDR) or sight-threatening maculopathy at their first retinal examination (baseline), 16,444 (79%) did not have retinopathy, 3,632 (18%) had nonproliferative retinopathy, and 610 (2.9%) had preproliferative retinopathy. After 5 years, few patients without retinopathy at baseline developed preproliferative retinopathy (cumulative incidence 4.0%), sight-threatening maculopathy (0.59%), or PDR (0.68%); after 10 years, the respective cumulative incidences were 16.4, 1.2, and 1.5%. Among those with nonproliferative (background) retinopathy at baseline, after 1 year 23% developed preproliferative retinopathy, 5.2% developed maculopathy, and 6.1% developed PDR; after 10 years, the respective cumulative incidences were 53, 9.6, and 11%. Patients with nonproliferative retinopathy at baseline were five times more likely to develop preproliferative, PDR, or maculopathy than those without retinopathy at baseline (adjusted hazard ratio 5.0 [95% CI 4.4–5.6]). CONCLUSIONS Few patients without diabetic retinopathy at the initial screening examination developed preproliferative retinopathy, PDR, or sight-threatening maculopathy after 5–10 years of follow-up. Screening intervals longer than a year may be appropriate for such patients. PMID:22279031

  1. A nationwide study of asthma incidence rate and its determinants in Swedish pre-school children.

    PubMed

    Bröms, Kristina; Norbäck, Dan; Sundelin, Claes; Eriksson, Margaretha; Svärdsudd, Kurt

    2012-09-01

    While many studies on asthma prevalence have been published, the number of studies on asthma incidence in pre-school children is limited. In this project, a nationwide sample of pre-school children was followed with the aim of estimating cumulative 5-year asthma incidence and its determinants. Parents of 5,886 children 1-6 years of age, sampled from day-care centres in 62 municipalities all over Sweden, responded in 2002 to a baseline postal questionnaire with questions regarding symptoms indicating possible asthma or atopic conditions, and a number of other variables. In 2007, parents of 4,255 children responded to an almost identical follow-up questionnaire. Of these, the 3,715 children who were free from asthma at baseline constitute the study population for this report. A large number of potential baseline determinants for cumulative 5-year asthma incidence were identified. Of these, food allergy, rhinitis, incomplete asthma diagnosis criteria (wheezing last 12 months, and ever had asthma but no current symptoms), parental rhinitis, parental asthma, age, and eczema, in ranking order of importance, remained significant in multivariate logistic regression analysis. The asthma incidence rate was highly dependent on presence or absence of these variables, the average annual rate ranging from 2/1,000/year in 6-year-olds with no determinants to 154/1,000/year in 1-year-olds with all determinants, corresponding to 11/1,000/year based on the whole study population.

  2. Long-term Survival and Late Effects among 1-year Survivors of Second Allogeneic Hematopoietic Cell Transplantation for Relapsed Acute Leukemia and Myelodysplastic Syndromes

    PubMed Central

    Duncan, Christine N.; Majhail, Navneet S.; Brazauskas, Ruta; Wang, Zhiwei; Cahn, Jean-Yves; Frangoul, Haydar A.; Hayashi, Robert J.; Hsu, Jack W.; Kamble, Rammurti T.; Kasow, Kimberly A.; Khera, Nandita; Lazarus, Hillard M.; Loren, Alison W.; Marks, David I.; Maziarz, Richard T.; Mehta, Paulette; Myers, Kasiani C.; Norkin, Maxim; Pidala, Joseph A.; Porter, David L.; Reddy, Vijay; Saber, Wael; Savani, Bipin N.; Schouten, Harry C.; Steinberg, Amir; Wall, Donna A.; Warwick, Anne B.; Wood, William A.; Yu, Lolie C.; Jacobsohn, David A.; Sorror, Mohamed L.

    2014-01-01

    We analyzed the outcomes of patients who survived disease-free for 1-year or more following second allogeneic hematopoietic cell transplantation (HCT) for relapsed acute leukemia or myelodysplastic syndromes between 1980 and 2009. A total of 1285 patients received a second allogeneic transplant following disease relapse; among these 325 survived relapse-free at 1-year after the second HCT. The median time from first to second HCT was 17 and 24 months for children and adults, respectively. A myeloablative preparative regimen was used in the second transplant in 62% of children and 45% of adult patients. The overall 10-year conditional survival rates after second transplantation in this cohort of patients who had survived disease-free for at least one year were 55% in children and 39% in adults. Relapse was the leading cause of mortality (77% and 54% of deaths in children and adults, respectively). In multivariate analyses, only disease status prior to second HCT was significantly associated with higher risk for overall mortality (HR 1.71 for patients with disease not in complete remission prior to second HCT, P<0.01). Chronic graft-versus-host disease (GVHD) developed in 43% and 75% of children and adults following second transplant. Chronic GVHD was the leading cause of non-relapse mortality followed by organ failure and infection. The cumulative incidence of developing at least one of the studied late effects at 10-years after second HCT was 63% in children and 55% in adults. The most frequent late effects in children were growth disturbance (10-year cumulative incidence 22%) and cataracts (20%), and in adults were cataracts (20%) and avascular necrosis (13%). Among patients with acute leukemia and myelodysplastic syndromes who receive a second allogeneic HCT for relapse and survive disease-free for at least 1-year, many can be expected to survive long term. However, they continue to be at risk for relapse and non-relapse morbidity and mortality. Novel approaches

  3. 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 1508.7 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY TERMINOLOGY AND INDEX § 1508.7 Cumulative impact. Cumulative impact is the impact on the environment which results from the...

  4. Acute lymphoblastic leukemia with t(4;11) in children 1 year and older: The 'big sister' of the infant disease?

    PubMed

    Mann, G; Cazzaniga, G; van der Velden, V H J; Flohr, T; Csinady, E; Paganin, M; Schrauder, A; Dohnal, A M; Schrappe, M; Biondi, A; Gadner, H; van Dongen, J J M; Panzer-Grümayer, E R

    2007-04-01

    The t(4;11)-positive acute lymphoblastic leukemia (ALL) is a rare disease in children above the age of 1 year. We studied the clinical and biological characteristics in 32 consecutively diagnosed childhood cases (median age 10.0 years, range 1.0-17.1 years). Immunophenotyping revealed a pro-B and a pre-B stage in 24 and eight cases, respectively. IGH genes were rearranged in 84% of leukemias with a predominance of incomplete DJ(H) joints. Whereas IGK-Kde and TCRD rearrangements were rare, TCRG rearrangements were present in 50% of cases and involved mainly Vgamma11 or Vgamma9 together with a Jgamma1.3./2.3 gene segment, an unusual combination among t(4;11)-negative B-cell precursor ALL. Oligoclonality was found in about 30% as assessed by heterogeneous IGH and TCRG rearrangements. Our data are in line with transformation of a precursor cell at an early stage of B-cell development but retaining the potential to differentiate to the pre-B cell stage in vivo. Although a distinct difference between infant and older childhood cases with t(4;11) became evident, no age-related biological features were found within the childhood age group. In contrast to infants with t(4;11)-positive ALL, childhood cases had a relatively low cumulative incidence of relapse of 25% at 3.5 years with BFM-based high-risk protocols.

  5. 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.

  6. 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

  7. 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

  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. System-Reliability Cumulative-Binomial Program

    NASA Technical Reports Server (NTRS)

    Scheuer, Ernest M.; Bowerman, Paul N.

    1989-01-01

    Cumulative-binomial computer program, NEWTONP, one of set of three programs, calculates cumulative binomial probability distributions for arbitrary inputs. NEWTONP, CUMBIN (NPO-17555), and CROSSER (NPO-17557), used independently of one another. Program finds probability required to yield given system reliability. Used by statisticians and users of statistical procedures, test planners, designers, and numerical analysts. Program written in C.

  10. Common-Reliability Cumulative-Binomial Program

    NASA Technical Reports Server (NTRS)

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

    1989-01-01

    Cumulative-binomial computer program, CROSSER, one of set of three programs, calculates cumulative binomial probability distributions for arbitrary inputs. CROSSER, CUMBIN (NPO-17555), and NEWTONP (NPO-17556), used independently of one another. Point of equality between reliability of system and common reliability of components found. Used by statisticians and users of statistical procedures, test planners, designers, and numerical analysts. Program written in C.

  11. 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.

  12. Cumulative Student Loan Debt in Minnesota, 2015

    ERIC Educational Resources Information Center

    Williams-Wyche, Shaun

    2016-01-01

    To better understand student debt in Minnesota, the Minnesota Office of Higher Education (the Office) gathers information on cumulative student loan debt from Minnesota degree-granting institutions. These data detail the number of students with loans by institution, the cumulative student loan debt incurred at that institution, and the percentage…

  13. Coronary heart disease incidence in women by waist circumference within categories of body mass index.

    PubMed

    Canoy, Dexter; Cairns, Benjamin J; Balkwill, Angela; Wright, F Lucy; Green, Jane; Reeves, Gillian; Beral, Valerie

    2013-10-01

    High body mass index (BMI) and large waist circumference are separately associated with increased coronary heart disease (CHD) risk but these measures are highly correlated. Their separate associations with incident CHD, cross-classifying one variable by the other, are less investigated in large-scale studies. We examined these associations in a large UK cohort (the Million Women Study), which is a prospective population-based study. We followed 496,225 women (mean age 60 years) with both waist circumference and BMI measurements who had no vascular disease or cancer. Adjusted relative risk and 20-year cumulative CHD incidence (first coronary hospitalization or death) from age 55 to 74 years were calculated using Cox regression. Plasma apolipoproteins were assayed in 6295 randomly selected participants. There were 10,998 incident coronary events after mean follow up of 5.1 years. Within each BMI category (<25, 25-29.9, ≥30 kg/m(2)), CHD risk increased with increasing waist circumference; within each waist circumference category (<70, 70-79.9, ≥79 cm), CHD risk increased with increasing BMI. The cumulative CHD incidence was lowest in women with BMI <25 kg/m(2) and waist circumference <70 cm, with 1 in 14 (95% confidence interval 1 in 12 to 16) women developing CHD in the 20 years from age 55 to 74 years, and highest in women with BMI ≥30 kg/m(2) and waist circumference ≥80 cm, with 1 in 8 (95% confidence interval 1 in 7 to 9) women developing CHD over the same period. Similar associations for apolipoprotein B to A1 ratio across adiposity categories were observed, particularly in non-obese women. Our conclusions were that both waist circumference and BMI are independently associated with incident CHD.

  14. Cumulative frequency fit for particle size distribution.

    PubMed

    Xu, Zhuyun; Gautam, Mridul; Mehta, Sandeep

    2002-08-01

    A cumulative frequency distribution fit method is presented for analyzing particle size distributions by minimizing the summation of the square of cumulative frequency errors. Compared to the frequency fit method, the cumulative frequency fit method yields a more accurate solution. Based upon this, a spreadsheet was developed for analyzing multi-modal particle size distribution. The motivation for the work presented in this article was the current interest in ultra-fine and nano-sized particle exhaust emissions from heavy-duty diesel engines. The new spreadsheet provides a quick and convenient way to conduct particle size distribution analysis.

  15. 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.

  16. 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.

  17. Calculating Cumulative Binomial-Distribution Probabilities

    NASA Technical Reports Server (NTRS)

    Scheuer, Ernest M.; Bowerman, Paul N.

    1989-01-01

    Cumulative-binomial computer program, CUMBIN, one of set of three programs, calculates cumulative binomial probability distributions for arbitrary inputs. CUMBIN, NEWTONP (NPO-17556), and CROSSER (NPO-17557), used independently of one another. Reliabilities and availabilities of k-out-of-n systems analyzed. Used by statisticians and users of statistical procedures, test planners, designers, and numerical analysts. Used for calculations of reliability and availability. Program written in C.

  18. 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.

  19. Improved cumulative survival in fistulas requiring surgical interventions to promote fistula maturation compared with endovascular interventions.

    PubMed

    Lee, Timmy; Tindni, Arshdeep; Roy-Chaudhury, Prabir

    2013-01-01

    Due to high nonmaturation rates, arteriovenous fistulas (AVF) frequently require intervention(s) to promote maturation. Endovascular or surgical interventions are often undertaken to salvage nonmaturing AVFs. The objective of this study was to compare the impact of surgical versus endovascular interventions to promote AVF maturation on cumulative AVF survival. We evaluated 89 patients with new AVF placement from a Veterans Affairs population over a 5-year period. Of these, 46 (52%) required intervention(s) to achieve successful maturation for dialysis: 31 patients had surgical revisions and 15 patients had endovascular repairs. We compared cumulative survival between AVFs requiring no intervention, surgical revision, and endovascular intervention to promote AVF maturation. Cumulative survival was longer in AVFs receiving surgical intervention compared with angioplasty to promote AVF maturation (p = 0.05). One-year cumulative survival was 86% vs. 83% vs. 40% for no intervention vs. surgery vs. angioplasty, respectively. In AVFs that required interventions to promote maturation, AVFs with surgical intervention had longer cumulative survival compared with those AVFs with endovascular intervention. AVFs with surgical intervention to promote maturation had similar 1-year cumulative survival to those AVFs that did not require intervention to promote maturation.

  20. 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}〉.

  1. Cumulative achievement testing: progress testing in reverse.

    PubMed

    Swanson, D B; Holtzman, K Z; Butler, A

    2010-01-01

    This collaborative project between the National Board of Medical Examiners (NBME) and Case Western Reserve University (CWRU) School of Medicine explored the design and use of cumulative achievement tests in basic science education. In cumulative achievement testing, integrative end-of-unit tests are deliberately constructed to systematically retest topics covered in previous units as well as material from the just-completed unit. CWRU faculty developed and administered a series of six web-based cumulative achievement tests using retired United States Medical Licensing Examination (USMLE) step 1 test material and tools provided by NBME's Customized Assessment Services, and trends in student performance were examined as the new CWRU basic science curriculum unfolded. This article provides the background information about test design and administration, as well as samples of score reporting information for students and faculty. While firm conclusions about the effectiveness of cumulative achievement testing are not warranted after a pilot test at a single school, preliminary results suggest that cumulative achievement testing may be an effective complement to progress testing, with the former used to encourage retention of already-covered material and the latter used to assess growth toward the knowledge and skills expected of a graduating student.

  2. 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 ...

  3. 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 ...

  4. 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.

  5. [Critical incidents].

    PubMed

    Scheidegger, D

    2005-03-01

    In medicine real severe mishaps are rare. On the other hand critical incidents are frequent. Anonymous critical incident reporting systems allow us to learn from these mishaps. This learning process will make our daily clinical work safer Unfortunately, before these systems can be used efficiently our professional culture has to be changed. Everyone in medicine has to admit that errors do occur to see the need for an open discussion. If we really want to learn from errors, we cannot punish the individual, who reported his or her mistake. The interest is primarily in what has happened and why it has happened and not who has committed this mistake. The cause for critical incidents in medicine is in over 80% the human factor Poor communication, work under enormous stress, conflicts and hierarchies are the main cause. This has been known for many years, therefore have already 15 years ago high-tech industries, like e.g. aviation, started to invest in special courses on team training. Medicine is a typical profession were until now only the individual performance decided about the professional career Communication, conflict management, stress management, decision making, risk management, team and team resource management were subjects that have never been taught during our preor postgraduate education. These points are the most important ones for an optimal teamwork. A multimodular course designed together with Swissair (Human Aspect Development medical, HADmedical) helps to cover, as in aviation, the soft factor and behavioural education in medicine and to prepare professionals in health care to work as a real team.

  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. 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…

  8. Origin of 78235, a lunar norite cumulate

    NASA Technical Reports Server (NTRS)

    Winzer, S. R.; Nava, D. F.; Lum, R. K. L.; Schuhmann, S.; Schuhmann, P.; Philpotts, J. A.

    1975-01-01

    A chemical and petrographic study is reported of the phases from the rock 78235 which was returned on the Apollo 17 mission. Petrographic analysis of the thin sections from the bounder confirm its cumulate origin. In order to develop further the crystallization history for 78235, its subsequent shock history, and its relationship to other lunar crustal rocks, orthopyroxene, plagioclase, glass, and whole-rock samples were prepared and analyzed for major, minor, and trace elements. It is speculated that an early fractional crystallization event producing a layer of orthopyroxene-plagioclase cumulate with varying amounts of trapped liquid took place within 20 km of the surface of the moon.

  9. [Cumulative radiation dosage and epidemiological research in the Chernobyl region].

    PubMed

    Vorob'ev, A I; Domracheva, E V; Klevezal', G A; Meshcheriakova, L M; Moiseeva, T N; Osechinskiĭ, I V; Serezhenkov, V A; Shklovskiĭ-Kordi, N E

    1994-01-01

    Individual biological dosimetry covering chromosomal analysis and electronic paramagnetic resonance spectrometry has been performed in 1300 subjects exposed to ionizing radiation after the Chernobyl accident. Cumulative radiation doses above 40 ImC were registered in 5%, about 100 ImC in 1% of the examinees. In 1% of cytogenetic investigations there appeared multiaberrant cells indicative of hot particle incorporation. Regional epidemiologists do not record changes in the incidence of hematological diseases. This may be explained by a small percent of the dose carriers, rare occurrence of hematological disorders and the time of radiation-induced oncogenic effects. The above representative group exposed to definite radiation doses may serve the subject of epidemiological surveys on the role of low-dose and low-rate radiation in pathogenesis of human diseases.

  10. Constipation and Incident CKD.

    PubMed

    Sumida, Keiichi; Molnar, Miklos Z; Potukuchi, Praveen K; Thomas, Fridtjof; Lu, Jun Ling; Matsushita, Kunihiro; Yamagata, Kunihiro; Kalantar-Zadeh, Kamyar; Kovesdy, Csaba P

    2017-04-01

    Constipation is one of the most prevalent conditions in primary care settings and increases the risk of cardiovascular disease, potentially through processes mediated by altered gut microbiota. However, little is known about the association of constipation with CKD. In a nationwide cohort of 3,504,732 United States veterans with an eGFR ≥60 ml/min per 1.73 m(2), we examined the association of constipation status and severity (absent, mild, or moderate/severe), defined using diagnostic codes and laxative use, with incident CKD, incident ESRD, and change in eGFR in Cox models (for time-to-event analyses) and multinomial logistic regression models (for change in eGFR). Among patients, the mean (SD) age was 60.0 (14.1) years old; 93.2% of patients were men, and 24.7% were diabetic. After multivariable adjustments, compared with patients without constipation, patients with constipation had higher incidence rates of CKD (hazard ratio, 1.13; 95% confidence interval [95% CI], 1.11 to 1.14) and ESRD (hazard ratio, 1.09; 95% CI, 1.01 to 1.18) and faster eGFR decline (multinomial odds ratios for eGFR slope <-10, -10 to <-5, and -5 to <-1 versus -1 to <0 ml/min per 1.73 m(2) per year, 1.17; 95% CI, 1.14 to 1.20; 1.07; 95% CI, 1.04 to 1.09; and 1.01; 95% CI, 1.00 to 1.03, respectively). More severe constipation associated with an incrementally higher risk for each renal outcome. In conclusion, constipation status and severity associate with higher risk of incident CKD and ESRD and with progressive eGFR decline, independent of known risk factors. Further studies should elucidate the underlying mechanisms.

  11. Zonisamide for Weight Reduction in Obese Adults A 1-Year Randomized Controlled Trial

    PubMed Central

    Gadde, Kishore M.; Kopping, Mariko F.; Wagner, H. Ryan; Yonish, Gretchen M.; Allison, David B.; Bray, George A.

    2013-01-01

    SUMMARY Background Obese individuals who have failed to achieve adequate weight loss with lifestyle changes have limited non-surgical therapeutic options. We evaluated the efficacy and tolerability of zonisamide, an antiepileptic drug, for enhancing weight loss in obese patients receiving diet and lifestyle guidance. Methods This was a 1-year randomized, double-blind, placebo-controlled trial conducted between January 2006 and September 2011 at Duke University Medical Center. Patients were 225 obese (mean [SD] body mass index 37.6 [4.9]) women (134 [59.6%]) and men (91 [40.4%]) without diabetes. Interventions were daily dosing with placebo (n=74), zonisamide 200 mg (n=76), orzonisamide 400 mg (n=75), in addition to diet and lifestyle counseling by a dietitian for 1 year. Primary outcome was change in body weight at 1-year. Results Of the 225 randomized patients, 218 (97%) provided 1-year follow-up assessments. Change(least-squares mean) in body weight was -4.0 kg (−3.7%; 95% CI, −5.8 kg to −2.3 kg) for placebo, −4.4 kg (−3.9%; −6.1 to −2.6, P=.79vs placebo) for zonisamide 200 mg, and −7.3 kg (−6.8%; −9.0 to −5.6, P=.009vs placebo) for zonisamide 400 mg. In the categorical analysis,23 (31%) on placebo, 26 (34%; P=.71) on zonisamide 200 mg, and 41 (55%; P=.007) onzonisamide 400 mg achieved ≥5% weight loss; for ≥10% weight loss, the corresponding numbers were 6 (8%), 17 (22%; P=.022), and 24 (32%; P=.001). Gastrointestinal, nervous system and psychiatric adverse events occurred at a higher incidence with zonisamide than with placebo. Conclusion Zonisamide 400 mg/d moderately enhanced weight loss achieved with diet and lifestyle counseling, but had a high incidence of adverse events. PMID:23147455

  12. 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.

  13. 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...

  14. 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.

  15. Pavlovian conditioning and cumulative reinforcement rate.

    PubMed

    Harris, Justin A; Patterson, Angela E; Gharaei, Saba

    2015-04-01

    In 5 experiments using delay conditioning of magazine approach with rats, reinforcement rate was varied either by manipulating the mean interval between onset of the conditioned stimulus (CS) and unconditioned stimulus (US) or by manipulating the proportion of CS presentations that ended with the US (trial-based reinforcement rate). Both manipulations influenced the acquisition of responding. In each experiment, a specific comparison was made between 2 CSs that differed in their mean CS-US interval and in their trial-based reinforcement rate, such that the cumulative reinforcement rate-the cumulative duration of the CS between reinforcements-was the same for the 2 CSs. For example, a CS reinforced on 100% of trials with a mean CS-US interval of 60 s was compared with a CS reinforced on 33% of trials and a mean duration of 20 s. Across the 5 experiments, conditioning was virtually identical for the 2 CSs with matched cumulative reinforcement rate. This was true as long as the timing of the US was unpredictable and, thus, response rates were uniform across the length of the CS. We conclude that the effects of CS-US interval and of trial-based reinforcement rate are reducible entirely to their common effect on cumulative reinforcement rate. We discuss the implications of this for rate-based, trial-based, and real-time associative models of conditioning.

  16. 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...

  17. 32 CFR 651.16 - Cumulative impacts.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 4 2013-07-01 2013-07-01 false Cumulative impacts. 651.16 Section 651.16 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) ENVIRONMENTAL QUALITY ENVIRONMENTAL ANALYSIS OF ARMY ACTIONS (AR 200-2) National Environmental Policy Act and the Decision...

  18. 32 CFR 651.16 - Cumulative impacts.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 4 2012-07-01 2011-07-01 true Cumulative impacts. 651.16 Section 651.16 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) ENVIRONMENTAL QUALITY ENVIRONMENTAL ANALYSIS OF ARMY ACTIONS (AR 200-2) National Environmental Policy Act and the Decision...

  19. 32 CFR 651.16 - Cumulative impacts.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Cumulative impacts. 651.16 Section 651.16 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) ENVIRONMENTAL QUALITY ENVIRONMENTAL ANALYSIS OF ARMY ACTIONS (AR 200-2) National Environmental Policy Act and the Decision...

  20. 32 CFR 651.16 - Cumulative impacts.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 4 2014-07-01 2013-07-01 true Cumulative impacts. 651.16 Section 651.16 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) ENVIRONMENTAL QUALITY ENVIRONMENTAL ANALYSIS OF ARMY ACTIONS (AR 200-2) National Environmental Policy Act and the Decision...

  1. 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.

  2. The Safe Dates program: 1-year follow-up results.

    PubMed Central

    Foshee, V A; Bauman, K E; Greene, W F; Koch, G G; Linder, G F; MacDougall, J E

    2000-01-01

    OBJECTIVES: An earlier report described desirable 1-month follow-up effects of the Safe Dates program on psychological, physical, and sexual dating violence. Mediators of the program-behavior relationship also were identified. The present report describes the 1-year follow-up effects of the Safe Dates program. METHODS: Fourteen schools were in the randomized experiment. Data were gathered by questionnaires in schools before program activities and 1 year after the program ended. RESULTS: The short-term behavioral effects had disappeared at 1 year, but effects on mediating variables such as dating violence norms, conflict management skills, and awareness of community services for dating violence were maintained. CONCLUSIONS: The findings are considered in the context of why program effects might have decayed and the possible role of boosters for effect maintenance. PMID:11029999

  3. An evaluation paradigm for cumulative impact analysis

    NASA Astrophysics Data System (ADS)

    Stakhiv, Eugene Z.

    1988-09-01

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

  4. The incidence and risk of osteoporosis in patients with anxiety disorder

    PubMed Central

    Hong-Jhe, Chen; Chin-Yuan, Kuo; Ming-Shium, Tu; Fu-Wei, Wang; Ru-Yih, Chen; Kuang-Chieh, Hsueh; Hsiang-Ju, Pan; Ming-Yueh, Chou; Pan-Ming, Chen; Chih-Chuan, Pan

    2016-01-01

    Abstract The purpose of this study was to investigate the relationship between anxiety disorder (AD) and the subsequent development of osteoporosis. We conducted a population-based retrospective cohort analysis according to the data in the Longitudinal Health Insurance Database 2000 of Taiwan. We included 7098 patients in both the AD and no-anxiety cohort who were matched according to age and sex between January 1, 2000, and December 31, 2013. The incidence rate and the risk ratios (RRs) of subsequent new-onset osteoporosis were calculated for both cohorts. We used Cox proportional hazards models to assess the effect of AD. The Kaplan–Meier method was applied to estimate the cumulative osteoporosis incidence curves. The AD cohort consisted of 7098 patients, and the comparison cohort comprised the same matched control patients without anxiety. The risk of osteoporosis was higher in the AD cohort than in the comparison cohort. In addition, the incidence of newly diagnosed osteoporosis remained significantly increased in all of the stratified follow-up durations (0–1, 1–5, 5–10, ≥10years). Patients with AD were 1.79 times more likely to get osteoporosis than those without AD. We also observed a significant increase in osteoporotic risk in AD patients who are comorbid with hypertension, diabetes mellitus, and chronic liver disease. The incidence of osteoporosis in Taiwan is associated with an a priori AD history. The risk ratios are the highest for osteoporosis within 1 year of AD diagnosis, but the risk remains statistically significant for >1 year. Clinicians should pay particular attention to osteoporotic comorbidities in AD patients. PMID:27661037

  5. Effect of Peritoneal Dialysis Modality on the 1-Year Rate of Decline of Residual Renal Function

    PubMed Central

    Kim, Chan Ho; Oh, Hyung Jung; Lee, Mi Jung; Kwon, Young Eun; Kim, Yung Ly; Nam, Ki Heon; Park, Kyoung Sook; An, Seong Yeong; Ko, Kwang Il; Koo, Hyang Mo; Doh, Fa Mee; Han, Seung Hyeok; Yoo, Tae-Hyun; Kim, Beom Seok; Kang, Shin-Wook

    2014-01-01

    Purpose The effect of different peritoneal dialysis (PD) modalities on the decline in residual renal function (RRF) is unclear due to inconsistencies among studies. In particular, the effect of automated peritoneal dialysis (APD) modalities [continuous cyclic peritoneal dialysis (CCPD) and nightly intermittent peritoneal dialysis (NIPD)] on RRF has not been examined in a large cohort. Materials and Methods We conducted a single-center retrospective study to investigate the association between PD modalities and decline in RRF in 142 incident PD patients [34 on CCPD, 36 on NIPD, and 72 on continuous ambulatory peritoneal dialysis (CAPD)]. RRF was measured within 2 months from PD start and at 1 year after PD initiation. Results The RRF at 1 year after PD initiation was 1.98±2.20 mL/min/1.73 m2 in CCPD patients and 3.63±3.67 mL/min/1.73 m2 in NIPD patients, which were moderately lower than 4.23±3.51 mL/min/1.73 m2 in CAPD patients (p=0.064). Moreover, there was no significant difference in the 1-year rate of decline of RRF between CCPD and NIPD patients, although APD patients had a faster 1-year RRF decline rate than CAPD patients (CCPD and NIPD vs. CAPD: -45.68 and -36.69 vs. 1.17%/year, p=0.045). APD was associated with a more rapid decline in RRF in patients with end-stage renal disease undergoing PD, although multivariate analysis attenuated the significance of this finding (β=-31.50; 95% CI, -63.61 to 0.62; p=0.052). Conclusion Our results suggest that CAPD might be more helpful than APD for preserving RRF during the first year of dialysis therapy, although there was no significant difference in the 1-year rate of decline of RRF between the two APD modalities. PMID:24339299

  6. Otitis Media and Language Development at 1 Year of Age.

    ERIC Educational Resources Information Center

    Wallace, Ina F.; And Others

    1988-01-01

    Fifteen 1-year-olds without otitis media were compared to 12 babies who were otitis positive. No significant differences were detected on the Bayley Scales of Infant Development or the Sequenced Inventory of Communication Development (SICD) Receptive scale. However, the otitis-positive group exhibited lower SICD Expressive scores than the…

  7. 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…

  8. Gait Asymmetries Persist 1 Year After Anterior Cruciate Ligament Reconstruction

    PubMed Central

    White, Kathleen; Logerstedt, David; Snyder-Mackler, Lynn

    2013-01-01

    Background: After anterior cruciate ligament reconstruction (ACLR), motivation to return to previous levels of activity is high. Very few studies have used return-to-activity criteria to determine when to permit athletic play. Return-to-activity measures objectively evaluate functional limb symmetry; however, previous biomechanical studies have found gait deviations in these individuals that persist up to 2 years after surgery. Purpose: To evaluate gait biomechanics in a specific cohort of ACL patients 1 year after surgery and retrospectively compare individuals who pass return-to-activity criteria 6 months after surgery with those who fail. Study Design: Prospective analysis. Methods: A total of 40 athletes who participated regularly (>50 h/y) in cutting, jumping, and pivoting activities and who sustained an isolated, unilateral ACL rupture were included in this study. All participants underwent reconstruction by the same surgeon and received individualized postoperative rehabilitation. Performance-based and self-report data were measured 6 months after surgery to assess readiness to return to activity (90% outcome required to pass); 20 subjects passed return-to-activity criteria and 20 subjects did not. Motion analysis was performed 1 year after surgery, and knee flexion angles, moments, and excursions were measured during gait and evaluated for all subjects. Results: There was no limb × group interaction or effect of group for all measures. Decreased knee measures were seen on the involved limb compared with the uninvolved limb for all subjects, and failed subjects demonstrated larger differences between limbs. Conclusion: Patients continued to demonstrate biomechanical limb asymmetries 1 year after ACLR, regardless of performance-based measures at 6 months. Early return to activity did not ensure limb symmetry at 1 year. Clinical Relevance: Gait asymmetries were seen in all subjects 1 year after surgery regardless of status at 6 months. Potentially prolonging

  9. Incidence of hepatocellular carcinoma in outpatients with cirrhosis in Brazil: A 10-year retrospective cohort study

    PubMed Central

    Appel-da-Silva, Marcelo Campos; Miozzo, Suelen Aparecida da Silva; Dossin, Isabella de Azevedo; Tovo, Cristiane Valle; Branco, Fernanda; de Mattos, Angelo Alves

    2016-01-01

    AIM To determine the incidence of hepatocellular carcinoma (HCC) and the impact of HCC surveillance on early diagnosis and survival of cirrhotic outpatients. METHODS In this retrospective cohort study, cirrhotic outpatients undergoing HCC surveillance between March 2005 and March 2014 were analyzed. Exclusion criteria were HIV coinfection; previous organ transplantation; diagnosis of HCC at first consultation; missing data in the medical chart; and less than 1 year of follow-up. Surveillance was carried out every six months using ultrasound and serum alpha-fetoprotein determination. Ten-year cumulative incidence and survival were estimated through Kaplan-Meier analysis. RESULTS Four hundred and fifty-three patients were enrolled, of which 57.6% were male. Mean age was 55 years. Hepatitis C virus and heavy use of alcohol were the main etiologic agents of cirrhosis. HCC was diagnosed in 75 patients (16.6%), with an estimated cumulative incidence of 2.6% in the 1st year, 15.4% in the 5th year, and 28.8% in the 10th year. Median survival was estimated at 17.6 mo in HCC patients compared to 234 mo in non-HCC patients (P < 0.001). Early-stage HCC was more often detected in patients who underwent surveillance every 6 mo or less (P = 0.05). However, survival was not different between patients with early stage vs non-early stage tumors [HR = 0.54 (0.15-1.89), P = 0.33]. CONCLUSION HCC is a frequent complication in patients with cirrhosis and adherence to surveillance programs favors early diagnosis. PMID:28028370

  10. 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.

  11. 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.

  12. Experimental approaches to studying cumulative cultural evolution

    PubMed Central

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

    2016-01-01

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

  13. Sharing a quota on cumulative carbon emissions

    NASA Astrophysics Data System (ADS)

    Raupach, Michael R.; Davis, Steven J.; Peters, Glen P.; Andrew, Robbie M.; Canadell, Josep G.; Ciais, Philippe; Friedlingstein, Pierre; Jotzo, Frank; van Vuuren, Detlef P.; Le Quéré, Corinne

    2014-10-01

    Any limit on future global warming is associated with a quota on cumulative global CO2 emissions. We translate this global carbon quota to regional and national scales, on a spectrum of sharing principles that extends from continuation of the present distribution of emissions to an equal per-capita distribution of cumulative emissions. A blend of these endpoints emerges as the most viable option. For a carbon quota consistent with a 2 °C warming limit (relative to pre-industrial levels), the necessary long-term mitigation rates are very challenging (typically over 5% per year), both because of strong limits on future emissions from the global carbon quota and also the likely short-term persistence in emissions growth in many regions.

  14. Cumulative knowledge and progress in human factors.

    PubMed

    Proctor, Robert W; Vu, Kim-Phuong L

    2010-01-01

    This review provides a cumulative perspective on current human factors research by first briefly acknowledging previous Annual Review articles. We show that several recent conceptual advances are an outgrowth of the information-processing approach adopted by the field and present several areas of current research that are built directly on prior work. Topic areas that provide fundamental tools for human factors analyses are summarized, and several current application areas are reviewed. We end by considering alternatives to the information-processing approach that have been proposed and placing those alternatives in context. We argue that the information-processing language provides the foundation that has enabled much of the growth in human factors. This growth reflects a cumulative development of concepts and methods that continues today.

  15. 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.

  16. EPA Workshop on Epigenetics and Cumulative Risk ...

    EPA Pesticide Factsheets

    Agenda Download the Workshop Agenda (PDF) The workshop included presentations and discussions by scientific experts pertaining to three topics (i.e., epigenetic changes associated with diverse stressors, key science considerations in understanding epigenetic changes, and practical application of epigenetic tools to address cumulative risks from environmental stressors), to address several questions under each topic, and included an opportunity for attendees to participate in break-out groups, provide comments and ask questions. Workshop Goals The workshop seeks to examine the opportunity for use of aggregate epigenetic change as an indicator in cumulative risk assessment for populations exposed to multiple stressors that affect epigenetic status. Epigenetic changes are specific molecular changes around DNA that alter expression of genes. Epigenetic changes include DNA methylation, formation of histone adducts, and changes in micro RNAs. Research today indicates that epigenetic changes are involved in many chronic diseases (cancer, cardiovascular disease, obesity, diabetes, mental health disorders, and asthma). Research has also linked a wide range of stressors including pollution and social factors with occurrence of epigenetic alterations. Epigenetic changes have the potential to reflect impacts of risk factors across multiple stages of life. Only recently receiving attention is the nexus between the factors of cumulative exposure to environmental

  17. Phthalates and Cumulative Risk Assessment (NAS Final ...

    EPA Pesticide Factsheets

    On December 18, 2008, the National Academy of Sciences' National Research Council released a final report, requested and sponsored by the EPA, entitled Phthalates and Cumulative Risk Assessment: The Task Ahead. Risk assessment has become a dominant public policy tool for making choices, based on limited resources, to protect public health and the environment. It has been instrumental to the mission of the U.S. Environmental Protection Agency (EPA) as well as other federal agencies in evaluating public health concerns, informing regulatory and technological decisions, prioritizing research needs and funding, and in developing approaches for cost-benefit analysis. People are exposed to a variety of chemicals throughout their daily lives. To protect public health, regulators use risk assessments to examine the effects of chemical exposures. This book provides guidance for assessing the risk of phthalates, chemicals found in many consumer products that have been shown to affect the development of the male reproductive system of laboratory animals. Because people are exposed to multiple phthalates and other chemicals that affect male reproductive development, a cumulative risk assessment should be conducted that evaluates the combined effects of exposure to all these chemicals. The book suggests an approach for cumulative risk assessment that can serve as a model for evaluating the health risks of other types of chemicals.

  18. Pulmonary toxicity of cyclophosphamide: a 1-year study

    SciTech Connect

    Morse, C.C.; Sigler, C.; Lock, S.; Hakkinen, P.J.; Haschek, W.M.; Witschi, H.P.

    1985-01-01

    The development of cyclophosphamide-induced pulmonary lesions over a 1-year period was studied in mice. Male BALB/c mice received a single intraperitoneal injection of 100 mg/kg of cyclophosphamide. Within 3 weeks there were scattered foci of intraalveolar foamy macrophages. With time, these foci increased in size and, 1 year later, occupied large areas in all lung lobes. There was also diffuse interstitial fibrosis. Chemical determination done 3, 12, 24, and 52 weeks after cyclophosphamide showed that lungs of animals treated with cyclophosphamide had significantly more hydroxyproline per lung than controls. One year after cyclophosphamide pressure - volume curves measured in vivo were shifted down and to the right and total lung volumes were decreased. A single injection of cyclophosphamide produced an irreversible and progressive pulmonary lesion. 16 references, 5 figures, 3 tables.

  19. Efficacy of risedronate in men with primary and secondary osteoporosis: results of a 1-year study.

    PubMed

    Ringe, J D; Faber, H; Farahmand, P; Dorst, A

    2006-03-01

    Osteoporosis is prevalent in men with an estimated one in eight men older than 50 years suffering from osteoporotic fracture, and a higher mortality rate after fracture among men compared with women. There are few approved therapies for osteoporosis in men. This observational study assesses the efficacy and safety of risedronate in the treatment of men with primary and secondary osteoporosis. A single-center, open label, randomized, prospective 1-year study was conducted in men with primary or secondary osteoporosis. Patients were randomized to risedronate (risedronate 5 mg/day plus calcium 1,000 mg/day and vitamin D 800 IU/day) or control groups (alfacalcidol 1 mug/day plus calcium 500 mg/day or vitamin D 1,000 IU/day plus calcium 800 mg/day). Bone mineral density (BMD) measurements, X-rays of the spine, a medical history and physical exam, and patient self-assessments of back pain were performed at baseline and 12 months. Blinded semi-quantitative fracture assessment was conducted by a radiologist. A total of 316 men with osteoporosis were enrolled in the trial (risedronate, n=158; control, n=158). At 1 year lumbar spine BMD increased by 4.7% in the risedronate group versus an increase of 1.0% in the control group (P<0.001). Significant increases in BMD at the total hip and femoral neck were also observed with risedronate compared with the control group. The incidence of new vertebral fracture in the risedronate group was reduced by 60% versus the control group (P=0.028). Daily treatment with risedronate for 12 months significantly increased BMD at the lumbar spine, femoral neck and total hip and significantly reduced the incidence of new vertebral fractures. This is the first prospective, randomized, controlled trial to demonstrate a significant reduction in vertebral fractures in 1 year in men with primary or secondary osteoporosis.

  20. 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

  1. Stability of physical assessment of older drivers over 1 year.

    PubMed

    Smith, Andrew; Marshall, Shawn; Porter, Michelle; Ha, Linda; Bédard, Michel; Gélinas, Isabelle; Man-Son-Hing, Malcolm; Mazer, Barbara; Rapoport, Mark; Tuokko, Holly; Vrkljan, Brenda

    2013-12-01

    Older adults represent the fastest-growing population of drivers with a valid driver's licence. Also common in this age group are multiple chronic medical conditions that may have an effect on physical function and driving ability. Determining the reliability of physical measures used to assess older drivers' functional ability is important to identifying those who are safe to continue driving. Most previous reliability studies of clinical physical measures of health used test-retest intervals shorter than those between patient visits with a clinician. In the present study we examined a more clinically representative interval of 1 year to determine the stability of commonly used physical measures collected during the Candrive II prospective cohort study of older drivers. Reliability statistics indicate that the sequential finger-thumb opposition, rapid pace walk and the Pelli-Robson contrast sensitivity tests have adequate stability over 1 year. Poor stability was observed for the one-legged stance and Snellen visual acuity test. Several assessments with nominal data (Marottoli method [functional neck range of motion], whispered voice test, range of motion and strength testing) lacked sufficient variability to conduct reliability analyses; however, a lack of variability between test days suggests consistency over a 1-year time frame. Our results provide evidence that specific physical measures are stable in monitoring functional ability over the course of a year.

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

    PubMed

    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.

  3. 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.

  4. 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.

  5. Climate mitigation: sustainable preferences and cumulative carbon

    NASA Astrophysics Data System (ADS)

    Buckle, Simon

    2010-05-01

    We develop a stylized AK growth model with both climate damages to ecosystem goods and services and sustainable preferences that allow trade-offs between present discounted utility and long-run climate damages. The simplicity of the model permits analytical solutions. Concern for the long-term provides a strong driver for mitigation action. One plausible specification of sustainable preferences leads to the result that, for a range of initial parameter values, an optimizing agent would choose a level of cumulative carbon dioxide (CO2) emissions independent of initial production capital endowment and CO2 levels. There is no technological change so, for economies with sufficiently high initial capital and CO2 endowments, optimal mitigation will lead to disinvestment. For lower values of initial capital and/or CO2 levels, positive investment can be optimal, but still within the same overall level of cumulative emissions. One striking aspect of the model is the complexity of possible outcomes, in addition to these optimal solutions. We also identify a resource constrained region and several regions where climate damages exceed resources available for consumption. Other specifications of sustainable preferences are discussed, as is the case of a hard constraint on long-run damages. Scientists are currently highlighting the potential importance of the cumulative carbon emissions concept as a robust yet flexible target for climate policymakers. This paper shows that it also has an ethical interpretation: it embodies an implicit trade off in global welfare between present discounted welfare and long-term climate damages. We hope that further development of the ideas presented here might contribute to the research and policy debate on the critical areas of intra- and intergenerational welfare.

  6. Is there any cumulative dose for trastuzumab?

    PubMed

    Mutlu, Hasan; Coşkun, Hasan Şenol

    2015-12-01

    Trastuzumab is one of the most important agents that target human epidermal growth factor receptor 2, but its cardiotoxic effect limits to use it. The mechanism of cardiac dysfunction-related trastuzumab is still unclear. In literature, there is no definite information about the cumulative dose of trastuzumab for cardiotoxicity. In presented case, we reported a breast cancer patient who has been receiving long-term trastuzumab. We have not found any cardiac problems for duration of over four years. According to our case and literature review, we may say that trastuzumab is safely used with periodically echocardiographic control in patients with breast cancer.

  7. 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…

  8. Acquired childhood aphasia. Outcome 1 year after onset.

    PubMed

    Loonen, M C; van Dongen, H R

    1990-12-01

    The effects of the variables age at onset, cause, severity and bilaterality of lesion, and type of aphasia on course and outcome were investigated in a group of 28 aphasic children. Analysis of spontaneous speech and tests of auditory verbal comprehension were used to determine the presence of aphasia. The severity of the cerebral lesion was assessed using a rating scale for computed tomographic scans. Most of the children had not recovered completely 1 year after onset. Recovery was significantly different according to etiological categories. Complete recovery was seen in the majority of traumatic cases.

  9. Innovativeness, population size and cumulative cultural evolution.

    PubMed

    Kobayashi, Yutaka; Aoki, Kenichi

    2012-08-01

    Henrich [Henrich, J., 2004. Demography and cultural evolution: how adaptive cultural processes can produce maladaptive losses-the Tasmanian case. Am. Antiquity 69, 197-214] proposed a model designed to show that larger population size facilitates cumulative cultural evolution toward higher skill levels. In this model, each newborn attempts to imitate the most highly skilled individual of the parental generation by directly-biased social learning, but the skill level he/she acquires deviates probabilistically from that of the exemplar (cultural parent). The probability that the skill level of the imitator exceeds that of the exemplar can be regarded as the innovation rate. After reformulating Henrich's model rigorously, we introduce an overlapping-generations analog based on the Moran model and derive an approximate formula for the expected change per generation of the highest skill level in the population. For large population size, our overlapping-generations model predicts a much larger effect of population size than Henrich's discrete-generations model. We then investigate by way of Monte Carlo simulations the case where each newborn chooses as his/her exemplar the most highly skilled individual from among a limited number of acquaintances. When the number of acquaintances is small relative to the population size, we find that a change in the innovation rate contributes more than a proportional change in population size to the cumulative cultural evolution of skill level.

  10. Interplanetary proton cumulated fluence model update

    NASA Astrophysics Data System (ADS)

    Glover, A.; Hilgers, A.; Rosenqvist, L.; Bourdarie, S.

    2008-11-01

    Solar particle events leading to important increase of particle fluxes at energies of order of magnitude ranging from MeV to GeV constitute an important hazard for space missions. They may lead to effects seen in microelectronics or damage to solar cells and constitute a potential hazard for manned missions. Cumulative damage is commonly expressed as a function of fluence which is defined as the integral of the flux over time. A priori deterministic estimates of the expected fluence cannot be made because over the time scale of a space mission, the fluence can be dominated by the contribution of a few rare and unpredictable high intensity events. Therefore, statistical approaches are required in order to estimate fluences likely to be encountered by a space mission in advance. This paper extends work done by Rosenqvist et al. [Rosenqvist, L., Hilgers, A., Evans, H., Daly, E., Hapgood, M., Stamper, R., Zwickl, R., Bourdarie, S., Boscher, D. Toolkit for updating interplanetary proton-cumulated fluence models. J. Spacecraft Rockets, 42(6), 1077 1090, 2005] to describe an updated predictive engineering model for the proton interplanetary fluence with energies >30 MeV. This model is derived from a complete list of solar proton fluences based on data from a number of calibrated sources covering almost three solar cycles.

  11. Prognosis of stroke in the south of Greece: 1 year mortality, functional outcome and its determinants: the Arcadia Stroke Registry

    PubMed Central

    Vemmos, K; Bots, M; Tsibouris, P; Zis, V; Takis, C; Grobbee, D; Stamatelopoulos, S

    2000-01-01

    OBJECTIVES—For Greece, data on incidence of stroke, type of stroke, and prognosis of stroke is limited. Recently, results on incidence of stroke were published. Here 1 year mortality, functional outcome after a first ever stroke, and determinants of the prognosis are described.
METHODS—A population based registry was established in the Arcadia area, located in eastern central Peloponessos in southern Greece. Between 1 November 1993 and 31 October 1995, 555 patients with a first ever stroke were identified using information from death certificates, hospital records, public health centres and general practitioners. Extensive information on cardiovascular risk factors and stroke characteristics was obtained. After 1 year a modified Rankin score was determined in all surviving patients.
RESULTS—After 1 year of follow up, 204 (36.8%) patients died. The probability of survival 1 year after stroke was higher for cerebral infarction than for intracerebral haemorrhage; 67.8% (95% confidence interval (95% CI) 64-72) and 46.4% (35-57), respectively. Of the survivors, 68.9% had either no symptoms or symptoms that would not interfere with their capacity to look after themselves (Rankin score 0 to 2). Increasing age and low Glasgow coma scale score were the most powerful predictors of death within 1 year (p<0.01), whereas increasing age, atrial fibrillation, and low Glasgow coma scale score were the most important predictors of functional outcome 1 year after a stroke (p<0.01).
CONCLUSIONS—One year mortality from stroke in Greece is similar to that of other industrialised countries. The most important factors that affect the prognosis of a patient with a first ever stroke are increasing age, stroke severity, and atrial fibrillation.

 PMID:11032610

  12. 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.

  13. Highly-cited estimates of the cumulative incidence and recurrence of vulvovaginal candidiasis are inadequately documented

    PubMed Central

    2014-01-01

    Background Available literature concerning the epidemiologic or clinical features of vulvovaginal candidiasis commonly reports that: 75% of women will experience an episode of vulvovaginal candidiasis in their lifetimes, 50% of whom will experience at least a second episode, and 5-10% of all women will experience recurrent vulvovaginal candidiasis (≥4 episodes/1 year). In this debate we traced the three commonly cited statistics to their presumed origins. Discussion It is apparent that these figures were inadequately documented and lacked supporting epidemiologic evidence. Population-based studies are needed to make reliable estimates of the lifetime risk of vulvovaginal candidiasis and the proportion of women who experience recurrent candidiasis. Summary The extent to which vulvovaginal candidiasis is a source of population-level morbidity remains uncertain. PMID:24612727

  14. Brain drain: the cost of neglected responsibilities in evaluating cumulative effects of environmental chemicals.

    PubMed

    Maffini, Maricel V; Neltner, Thomas G

    2015-05-01

    Developmental disabilities affect millions of people and have a great impact on their lives, their families and the societies where they live. The prevalence of disorders such as autism, attention deficit hyperactivity disorder as well as subclinical decrements in brain function cannot be explained solely as genetic diseases. Exposures to environmental chemicals, especially during prenatal and early postnatal life, are one likely explanation for some of the decrements. The current chemical risk assessment approach is typically based on the toxicity caused by a single chemical on a variety of organs without acknowledging additional exposures to other chemicals also affecting the same organ or system. We identified more than 300 chemicals allowed in food that may have potential harmful effects on the developing brain. Each individual chemical may or may not have a harmful effect if it were the only one present, but we know next to nothing about their cumulative biological effects on the brain. An expanded cumulative risk assessment approach is needed, and it should focus on health outcomes, like developmental disabilities, arising from the accumulation of effects of multiple chemicals on the brain. The laws regulating the safety of additives already require that regulators in Europe and the USA consider cumulative effects; so far, they seem to have neglected the mandate. We must move beyond treating chemical exposures as isolated incidents and look at their cumulative biological effects on organs and their role in the onset of chronic diseases. The time has come to overhaul chemical risk assessment.

  15. Introduction to Pesticide Incidents

    EPA Pesticide Factsheets

    Pesticides incidents must be reported by pesticide registrants. Others, such as members of the public and environmental professionals, would like to report pesticide incidents. This website will explain and facilitate such incident reporting.

  16. Evolution model with a cumulative feedback coupling

    NASA Astrophysics Data System (ADS)

    Trimper, Steffen; Zabrocki, Knud; Schulz, Michael

    2002-05-01

    The paper is concerned with a toy model that generalizes the standard Lotka-Volterra equation for a certain population by introducing a competition between instantaneous and accumulative, history-dependent nonlinear feedback the origin of which could be a contribution from any kind of mismanagement in the past. The results depend on the sign of that additional cumulative loss or gain term of strength λ. In case of a positive coupling the system offers a maximum gain achieved after a finite time but the population will die out in the long time limit. In this case the instantaneous loss term of strength u is irrelevant and the model exhibits an exact solution. In the opposite case λ<0 the time evolution of the system is terminated in a crash after ts provided u=0. This singularity after a finite time can be avoided if u≠0. The approach may well be of relevance for the qualitative understanding of more realistic descriptions.

  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. 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

  19. 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.

  20. Why Veterinary Medical Educators Should Embrace Cumulative Final Exams.

    PubMed

    Royal, Kenneth D

    2017-01-03

    The topic of cumulative final examinations often elicits polarizing opinions from veterinary medical educators. While some faculty prefer cumulative finals, there are many who perceive these types of examinations as problematic. Specifically, faculty often cite cumulative examinations are more likely to cause students' greater stress, which may in turn result in negative student evaluations of teaching. Cumulative finals also restrict the number of items one may present to students on most recent material. While these cited disadvantages may have some merit, the advantages of cumulative examinations far exceed the disadvantages. The purpose of this article is to discuss the advantages of cumulative examinations with respect to learning evidence, grade/score validity, fairness issues, and implications for academic policy.

  1. 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

  2. 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.

  3. Towards Greenland Glaciation: Cumulative or Abrupt Transition?

    NASA Astrophysics Data System (ADS)

    Tan, N.; Ramstein, G.; Contoux, C.; Ladant, J. B.; Dumas, C.; Donnadieu, Y.

    2014-12-01

    The insolation evolution [Laskar 2004] from 4 to 2.5 Ma depicts a series of three summer solstice insolation minima between 2.7 and 2.6 Ma, but there are other more important summer solstice minima notably around 3.82 and 3.05 Ma. On such a time span of more than 1 Ma, data shows that there are variations in the evolution of atmospheric CO2 concentration with a local maximum around 3 Ma [Seki et al.2010; Bartoli et al. 2011], before a decrease between 3 and 2.6 Ma. The latter, suggesting an abrupt ice sheet inception around 2.7 Ma, has been shown to be a major culprit for the full Greenland Glaciation [Lunt et al. 2008]. However, a recent study [Contoux et al. 2014, in review] suggests that a lowering of CO2 is not sufficient to initiate a glaciation on Greenland and must be combined to low summer insolation, with surviving ice during insolation maximum, suggesting a cumulative process in the first place, which could further lead to full glaciation at 2.7 Ma. Through a new tri-dimensional interpolation method implemented within the asynchronous coupling between an atmosphere ocean general circulation model (IPSL-CM5A) and an ice sheet model (GRISLI), we investigate the transient evolution of Greenland ice sheet during the Pliocene to diagnose whether the ice sheet inception is an abrupt event or rather a cumulative process, involving waxing and waning of the ice sheet during several orbital cycles. ReferencesBartoli, G., Hönisch, B., & Zeebe, R. E. (2011). Atmospheric CO2 decline during the Pliocene intensification of Northern Hemisphere glaciations. Paleoceanography, 26(4). Contoux C, Dumas C, Ramstein G, Jost A, Dolan A. M. (2014) Modelling Greenland Ice sheet inception and sustainability during the late Pliocene. (in review for Earth and Planetary Science Letters.).Laskar, J., Robutel, P., Joutel, F., Gastineau, M., Correia, A. C. M., & Levrard, B. (2004). A long-term numerical solution for the insolation quantities of the Earth. Astronomy & Astrophysics, 428

  4. 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)

  5. 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.

  6. Quantitative cumulative biodistribution of antibodies in mice

    PubMed Central

    Yip, Victor; Palma, Enzo; Tesar, Devin B; Mundo, Eduardo E; Bumbaca, Daniela; Torres, Elizabeth K; Reyes, Noe A; Shen, Ben Q; Fielder, Paul J; Prabhu, Saileta; Khawli, Leslie A; Boswell, C Andrew

    2014-01-01

    The neonatal Fc receptor (FcRn) plays an important and well-known role in antibody recycling in endothelial and hematopoietic cells and thus it influences the systemic pharmacokinetics (PK) of immunoglobulin G (IgG). However, considerably less is known about FcRn’s role in the metabolism of IgG within individual tissues after intravenous administration. To elucidate the organ distribution and gain insight into the metabolism of humanized IgG1 antibodies with different binding affinities FcRn, comparative biodistribution studies in normal CD-1 mice were conducted. Here, we generated variants of herpes simplex virus glycoprotein D-specific antibody (humanized anti-gD) with increased and decreased FcRn binding affinity by genetic engineering without affecting antigen specificity. These antibodies were expressed in Chinese hamster ovary cell lines, purified and paired radiolabeled with iodine-125 and indium-111. Equal amounts of I-125-labeled and In-111-labeled antibodies were mixed and intravenously administered into mice at 5 mg/kg. This approach allowed us to measure both the real-time IgG uptake (I-125) and cumulative uptake of IgG and catabolites (In-111) in individual tissues up to 1 week post-injection. The PK and distribution of the wild-type IgG and the variant with enhanced binding for FcRn were largely similar to each other, but vastly different for the rapidly cleared low-FcRn-binding variant. Uptake in individual tissues varied across time, FcRn binding affinity, and radiolabeling method. The liver and spleen emerged as the most concentrated sites of IgG catabolism in the absence of FcRn protection. These data provide an increased understanding of FcRn’s role in antibody PK and catabolism at the tissue level. PMID:24572100

  7. 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…

  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. 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…

  10. 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

  11. Persistent problems 1 year after mild traumatic brain injury: a longitudinal population study in New Zealand

    PubMed Central

    Theadom, Alice; Parag, Varsha; Dowell, Tony; McPherson, Kathryn; Starkey, Nicola; Barker-Collo, Suzanne; Jones, Kelly; Ameratunga, Shanthi; Feigin, Valery L

    2016-01-01

    Background Mild traumatic brain injury (mTBI) is a common problem in general practice settings, yet previous research does not take into account those who do not attend hospital after injury. This is important as there is evidence that effects may be far from mild. Aim To determine whether people sustain any persistent effects 1 year after mTBI, and to identify the predictors of health outcomes. Design and setting A community-based, longitudinal population study of an mTBI incidence cohort (n = 341) from a mixed urban and rural region (Hamilton and Waikato Districts) of the North Island of New Zealand (NZ). Method Adults (>16 years) completed assessments of cognitive functioning, global functioning, post-concussion symptoms, mood, and quality of life over the year after injury. Results Nearly half of participants (47.9%) reported experiencing four or more post-concussion symptoms 1 year post-injury. Additionally, 10.9% of participants revealed very low cognitive functioning. Levels of anxiety, depression, or reduced quality of life were comparable with the general population. Having at least one comorbidity, history of brain injury, living alone, non-white ethnic group, alcohol and medication use, and being female were significant predictors of poorer outcomes at 12 months. Conclusion Although some people make a spontaneous recovery after mTBI, nearly half continue to experience persistent symptoms linked to their injury. Monitoring of recovery from mTBI may be needed and interventions provided for those experiencing persistent difficulties. Demographic factors and medical history should be taken into account in treatment planning. PMID:26719482

  12. 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. PMID:27358574

  13. Considerations for Developing a Dosimetry-Based Cumulative ...

    EPA Pesticide Factsheets

    EPA announced the availability of the final report, Considerations for Developing a Dosimetry-Based Cumulative Risk Assessment Approach for Mixtures of Environmental Contaminants. This report describes a process that can be used to determine the potential value of developing physiologically based pharmacokinetic (PBPK) modeling to support a cumulative risk assessment. It also addresses the justification for developing physiologically based pharmacokinetic (PBPK) models for cumulative risk assessment. Chemical interactions in the body can alter the response observed, but the likelihood of an interactions is often most dependent on exposure. Results from these models can explain the basis for chemical interactions and can predict their likelihood at low, environmental exposures. This report identifies some key points to be considered when deciding whether to use PBPK modeling in a cumulative risk assessment. This report develops a framework to guide decisions whether to incorporate physiologically-based pharmacokinetic (PBPK) modeling into the cumulative risk assessment process.

  14. Lattice QCD results on cumulant ratios at freeze-out

    NASA Astrophysics Data System (ADS)

    Karsch, Frithjof

    2017-01-01

    Ratios of cumulants of net proton-number fluctuations measured by the STAR Collaboration show strong deviations from a skellam distribution, which should describe thermal properties of cumulant ratios, if proton-number fluctuations are generated in equilibrium and a hadron resonance gas (HRG) model would provide a suitable description of thermodynamics at the freeze-out temperature. We present some results on 6 th order cumulants entering the calculation of the QCD equation of state at non-zero values of the baryon chemical potential (μB ) and discuss limitations on the applicability of HRG thermodynamics deduced from a comparison between QCD and HRG model calculations of cumulants of conserved charge fluctuations. We show that basic features of the μB -dependence of skewness and kurtosis ratios of net proton-number fluctuations measured by the STAR Collaboration resemble those expected from a QCD calculation of the corresponding net baryon-number cumulant ratios.

  15. Critical incident reporting systems.

    PubMed

    Ahluwalia, Jag; Marriott, Lin

    2005-02-01

    Approximately 10% of all hospital admissions are complicated by critical incidents in which harm is caused to the patient - this amounts to more than 850,000 incidents annually. Critical incident reporting (CIR) systems refer to the structured reporting, collation and analysis of such incidents. This article describes the attributes required for an effective CIR system. Example neonatal trigger events and a management pathway for handling a critical incident report are described. The benefits and limitations of CIR systems, reactive and prospective approaches to the analysis of actual or potential critical incidents and the assessment of risk are also reviewed. Individual human error is but one contributor in the majority of critical incidents. Recognition of this and the fostering of an organisational culture that views critical incident reports as an opportunity to learn and to improve future patient care is vital if CIR systems are to be effective.

  16. Effect of a fish oil diet on asthma: results of a 1-year double-blind study.

    PubMed

    Dry, J; Vincent, D

    1991-01-01

    Airway inflammation is a major component of asthma. Food intake of N-3 fatty acids (FA) is associated with a low incidence of inflammatory diseases, such as asthma. We treated 12 asthmatic patients with FA and report the positive results of this 1-year double-blind study. A positive effect on forced expiratory volume in 1 s was observed after the 9 month of treatment. Our results are in favor of the use of FA, but have to be confirmed by other studies.

  17. 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

  18. 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.

  19. Risk profile of cumulative trauma disorders of the arm and hand in the US mining industry

    SciTech Connect

    Hudock, S.D.; Keran, C.M. )

    1993-01-01

    A review of all upper extremity cumulative trauma disorder (UECTD) injuries was conducted by the US Bureau of Mines for 1985 through 1989. This review was performed by analyzing each injury, as reported by law and maintained on the US Mine Safety and Health Administration's accident data base. This analysis found that incidence rates in mining were lower than in private sector industry, although the number of reported UECTD injuries increased sevenfold and their percentage of all mining injuries increased fivefold from 1985 and 1989. Metal-nonmetal mines accounted for 80 pct of UECTD injuries, while coal mines accounted for 20 pct. Nearly 63 pct of UECTD injuries were accounted for by only four occupations -- mechanics, laborers, boney (crusher) operators, and miners not elsewhere classified (NEC) -- with an incidence rate well above the private sector industry rate.

  20. Longhi Games, Internal Reservoirs, and Cumulate Porosity

    NASA Astrophysics Data System (ADS)

    Morse, S. A.

    2009-05-01

    Fe in plagioclase at an early age, T-rollers (or not) on the Di-Trid boundary in Fo-Di-Sil, the mantle solidus, origins of anorthosites, esoteric uses of Schreinemakers rules and many more topics are all fresh and pleasant memories of John Longhi's prolific and creative work. The Fram-Longhi experimental effect of pressure on plagioclase partitioning with liquid in mafic rocks became essential to an understanding of multiphase Rayleigh fractionation of plagioclase in big layered intrusions. Only by using the pressure effect could I find a good equation through the data for the Kiglapait intrusion, and that result among others required the existence with probability 1.0 of an internal reservoir (Morse, JPet 2008). Knowledge of cumulate porosity is a crucial key to the understanding of layered igneous rocks. We seek both the initial (inverse packing fraction) and residual porosity to find the time and process path from sedimentation to solidification. In the Kiglapait Lower Zone we have a robust estimate of mean residual porosity from the modes of the excluded phases augite, oxides, sulfide, and apatite. To this we apply the maximum variance of plagioclase composition (the An range) to find an algorithm that extends through the Upper Zone and to other intrusions. Of great importance is that all these measurements were made in grain mounts concentrated from typically about 200 g of core or hand specimen, hence the represented sample volume is thousands of times greater than for a thin section. The resulting distribution and scatter of the An range is novel and remarkable. It is V-shaped in the logarithmic representation of stratigraphic height, running from about 20 mole % at both ends (base to top of the Layered Series) to near-zero at 99 PCS. The intercept of the porosity-An range relation gives An range = 3.5 % at zero residual porosity. Petrographic analysis reveals that for PCS less than 95 and greater than 99.9, the An range is intrinsic, i.e. pre-cumulus, for

  1. 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

  2. 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

  3. 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...

  4. 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.

  5. 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...

  6. 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...

  7. 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

  8. 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.

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

    PubMed

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

    2016-01-01

    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.

  10. Cumulative stress and autonomic dysregulation in a community sample.

    PubMed

    Lampert, Rachel; Tuit, Keri; Hong, Kwang-Ik; Donovan, Theresa; Lee, Forrester; Sinha, Rajita

    2016-05-01

    Whether cumulative stress, including both chronic stress and adverse life events, is associated with decreased heart rate variability (HRV), a non-invasive measure of autonomic status which predicts poor cardiovascular outcomes, is unknown. Healthy community dwelling volunteers (N = 157, mean age 29 years) participated in the Cumulative Stress/Adversity Interview (CAI), a 140-item event interview measuring cumulative adversity including major life events, life trauma, recent life events and chronic stressors, and underwent 24-h ambulatory ECG monitoring. HRV was analyzed in the frequency domain and standard deviation of NN intervals (SDNN) calculated. Initial simple regression analyses revealed that total cumulative stress score, chronic stressors and cumulative adverse life events (CALE) were all inversely associated with ultra low-frequency (ULF), very low-frequency (VLF) and low-frequency (LF) power and SDNN (all p < 0.05). In hierarchical regression analyses, total cumulative stress and chronic stress each was significantly associated with SDNN and ULF even after the highly significant contributions of age and sex, with no other covariates accounting for additional appreciable variance. For VLF and LF, both total cumulative stress and chronic stress significantly contributed to the variance alone but were not longer significant after adjusting for race and health behaviors. In summary, total cumulative stress, and its components of adverse life events and chronic stress were associated with decreased cardiac autonomic function as measured by HRV. Findings suggest one potential mechanism by which stress may exert adverse effects on mortality in healthy individuals. Primary preventive strategies including stress management may prove beneficial.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

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

    PubMed Central

    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

    2015-01-01

    Considerable work indicates that early cumulative risk exposure is aversive to human development, but very little research has examined neurological underpinnings of these robust findings. We investigated amygdala volume and reactivity to facial stimuli among adults (M = 23.7 years, n = 54) as a function of cumulative risk exposure during childhood (ages 9 and 13). In addition, we tested whether expected, cumulative risk elevations in amygdala volume would mediate functional reactivity of the amygdala during socio-emotional processing. Risks included substandard housing quality, noise, crowding, family turmoil, child separation from family, and violence. Total and left hemisphere adult amygdala volumes, respectively 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 respective amygdala volumes. Cumulative risk exposure in later adolescence (17 years), 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 well-documented psychological distress as a function of early risk exposure. PMID:26469872

  17. Diversification and cumulative evolution in New Caledonian crow tool manufacture.

    PubMed

    Hunt, Gavin R; Gray, Russell D

    2003-04-22

    Many animals use tools but only humans are generally considered to have the cognitive sophistication required for cumulative technological evolution. Three important characteristics of cumulative technological evolution are: (i) the diversification of tool design; (ii) cumulative change; and (iii) high-fidelity social transmission. We present evidence that crows have diversified and cumulatively changed the design of their pandanus tools. In 2000 we carried out an intensive survey in New Caledonia to establish the geographical variation in the manufacture of these tools. We documented the shapes of 5550 tools from 21 sites throughout the range of pandanus tool manufacture. We found three distinct pandanus tool designs: wide tools, narrow tools and stepped tools. The lack of ecological correlates of the three tool designs and their different, continuous and overlapping geographical distributions make it unlikely that they evolved independently. The similarities in the manufacture method of each design further suggest that pandanus tools have gone through a process of cumulative change from a common historical origin. We propose a plausible scenario for this rudimentary cumulative evolution.

  18. Incidence of herpes zoster, 1997-2002.

    PubMed Central

    Mullooly, J. P.; Riedlinger, K.; Chun, C.; Weinmann, S.; Houston, H.

    2005-01-01

    We estimated age-specific herpes zoster (HZ) incidence rates in the Kaiser Permanente Northwest Health Plan (KPNW) during 1997-2002 and tested for secular trends and differences between residents of two states with different varicella vaccine coverage rates. The cumulative proportions of 2-year-olds vaccinated increased from 35% in 1997 to 85% in 2002 in Oregon, and from 25% in 1997 to 82% in 2002 in Washington. Age-specific HZ incidence rates in KPNW during 1997-2002 were compared with published rates in the Harvard Community Health Plan (HCHP) during 1990-1992. The overall HZ incidence rate in KPNW during 1997-2002 (369/100,000 person-years) was slightly higher than HCHP's 1990-1992 rate when adjusted for age differences. For children 6-14 years old, KPNW's rates (182 for females, 123 for males) were more than three times HCHP's rates (54 for females, 39 for males). This increase appears to be associated with increased exposure of children to oral corticosteroids. The percentage of KPNW children exposed to oral corticosteroids increased from 2.2% in 1991 to 3.6% in 2002. Oregon residents had slightly higher steroid exposure rates during 1997-2002 than Washington residents. There were significant increases in HZ incidence rates in Oregon and Washington during 1997-2002 among children aged 10-17 years, associated with increased exposure to oral steroids. PMID:15816149

  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. 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... announced the availability of EPA's cumulative risk assessment for the pyrethroids. Based on this assessment... of concern. Because this cumulative risk assessment uses a number of very conservative...

  1. Decreased Cumulative Access Survival in Arteriovenous Fistulas Requiring Interventions to Promote Maturation

    PubMed Central

    Ullah, Ahsan; Allon, Michael; Succop, Paul; El-Khatib, Mahmoud; Munda, Rino; Roy-Chaudhury, Prabir

    2011-01-01

    Summary Background and objectives New arteriovenous fistulas (AVF) are frequently unsuitable for hemodialysis because of AVF nonmaturation. Aggressive endovascular or surgical interventions are often undertaken to salvage nonmaturing AVFs. The effect of early interventions to promote AVF maturation on subsequent long-term AVF outcomes is unknown. Design, setting, participants, & measurements We evaluated 173 hemodialysis patients from two academic centers who received a new AVF. Of these, 96 (56%) required no further intervention, 54 (31%) required one intervention, and 23 (13%) required two or more interventions to achieve suitability for dialysis. We calculated AVF survival and frequency of postmaturation interventions in each group. Results Cumulative AVF survival (access cannulation to permanent failure) in patients with two or more versus one versus zero interventions before maturation was 68% versus 78% versus 92% at 1 year, 57% versus 71% versus 85% at 2 years, and 42% versus 57% versus 75% at 3 years. Using Cox regression analysis with interventions before maturation, age, sex, race, diabetes, peripheral vascular disease, access site, and obesity in the model, intervention before maturation (two or more) was the only factor associated with cumulative AVF survival. The number of interventions required to maintain patency after maturation was 3.51 ± 2.20 versus 1.37 ± 0.31 versus 0.76 ± 0.10 per year in patients with two or more versus one versus zero interventions before maturation. Conclusions Compared with AVF that mature without interventions, AVF that require interventions have decreased cumulative survival and require more interventions to maintain their patency for hemodialysis. PMID:21088288

  2. Incident analysis report

    SciTech Connect

    Gregg, D.W.; Buerer, A.; Leeds, S.

    1996-02-20

    This document presents information about a fire that occurred in January 1996 at Lawrence Livermore National Laboratory. This fire was caused by the spontaneous combustion of 100% fuming nitric acid. Topics discussed include: Summary of the incident; technical background; procedural background; supervision; previous incidents with 100% fuming nitric acid; and judgment of potential hazards.

  3. Incidence of Menkes disease.

    PubMed

    Tønnesen, T; Kleijer, W J; Horn, N

    1991-02-01

    We have calculated the incidence of Menkes disease for Denmark, France, The Netherlands, the United Kingdom and West Germany, based on known Menkes patients born during the time period 1976-87. Considering live-born Menkes patients, the combined incidence for these five countries is 1 Menkes patient per 298,000 live-born babies. If the number of affected aborted fetuses are taken into account, the incidence is 1 Menkes per 254,000 live-born babies. This incidence, which is 2-4 times lower than earlier published incidence figures, places Menkes disease as an extremely rare disease. The mutation rate for Menkes disease is estimated to be 1.96 x 10(-6), based on the number of isolated Menkes cases born during the time period 1976-87 and the total number of newborn males during this time.

  4. Impact of universal varicella vaccination on 1-year-olds in Uruguay: 1997–2005

    PubMed Central

    Quian, J; Rüttimann, R; Romero, C; Dall’Orso, P; Cerisola, A; Breuer, T; Greenberg, M; Verstraeten, T

    2008-01-01

    Objective: Varicella vaccination was introduced at the end of 1999 into the Uruguayan immunisation schedule for children aged 12 months. Varilrix (Oka strain; GlaxoSmithKline Biologicals) has been the only vaccine used since then and coverage has been estimated to exceed 90% since the start of the universal varicella vaccination programme. We assessed the impact of the Uruguayan varicella vaccination programme during 2005, 6 years after its introduction. Methods: Information on hospitalisations was collected from the main paediatric referral hospital and information on medical consultations for varicella was collected from two private health insurance systems in Montevideo. The proportion of hospitalisations due to varicella and the proportion of ambulatory visits for varicella since the introduction of the vaccine were compared between 1999 and 2005 and 1997 and 1999 in the following age groups: <1 year, 1–4 years, 5–9 years and 10–14 years. Results: By 2005, the proportion of hospitalisations due to varicella among children, was reduced by 81% overall and by 63%, 94%, 73% and 62% in the <1, 1–4, 5–9 and 10–14 years age groups, respectively. The incidence of ambulatory visits for varicella among children was reduced by 87% overall and by 80%, 97%, 81% and 65% in the <1, 1–4, 5–9 and 10–14 years age groups, respectively. Conclusions: The burden of varicella has decreased substantially in Uruguayan children since the introduction of the varicella vaccination, including those groups outside the recommended vaccination age. It is expected to decrease further as more cohorts of children are vaccinated and herd immunity increases. PMID:18456699

  5. Cumulative Risks of Foster Care Placement for Danish Children

    PubMed Central

    Fallesen, Peter; Emanuel, Natalia; Wildeman, Christopher

    2014-01-01

    Although recent research suggests that the cumulative risk of foster care placement is far higher for American children than originally suspected, little is known about the cumulative risk of foster care placement in other countries, which makes it difficult to gauge the degree to which factor foster care placement is salient in other contexts. In this article, we provide companion estimates to those provided in recent work on the US by using Danish registry data and synthetic cohort life tables to show how high and unequally distributed the cumulative risk of foster care placement is for Danish children. Results suggest that at the beginning of the study period (in 1998) the cumulative risk of foster care placement for Danish children was roughly in line with the risk for American children. Yet, by the end of the study period (2010), the risk had declined to half the risk for American children. Our results also show some variations by parental ethnicity and sex, but these differences are small. Indeed, they appear quite muted relative to racial/ethnic differences in these risks in the United States. Last, though cumulative risks are similar between Danish and American children (especially at the beginning of the study period), the age-specific risk profiles are markedly different, with higher risks for older Danish children than for older American children. PMID:25299657

  6. Cumulative risks of foster care placement for Danish children.

    PubMed

    Fallesen, Peter; Emanuel, Natalia; Wildeman, Christopher

    2014-01-01

    Although recent research suggests that the cumulative risk of foster care placement is far higher for American children than originally suspected, little is known about the cumulative risk of foster care placement in other countries, which makes it difficult to gauge the degree to which factor foster care placement is salient in other contexts. In this article, we provide companion estimates to those provided in recent work on the US by using Danish registry data and synthetic cohort life tables to show how high and unequally distributed the cumulative risk of foster care placement is for Danish children. Results suggest that at the beginning of the study period (in 1998) the cumulative risk of foster care placement for Danish children was roughly in line with the risk for American children. Yet, by the end of the study period (2010), the risk had declined to half the risk for American children. Our results also show some variations by parental ethnicity and sex, but these differences are small. Indeed, they appear quite muted relative to racial/ethnic differences in these risks in the United States. Last, though cumulative risks are similar between Danish and American children (especially at the beginning of the study period), the age-specific risk profiles are markedly different, with higher risks for older Danish children than for older American children.

  7. Mortality and cancer incidence in aluminum reduction plant workers

    SciTech Connect

    Spinelli, J.J.; Band, P.R.; Svirchev, L.M.; Gallagher, R.P. )

    1991-11-01

    An historical cohort study was conducted among 4,213 men who worked for 5 or more years at a Soderberg aluminum reduction plant in British Columbia (BC), Canada. Standardized mortality and incidence ratios were used to compare the mortality and cancer incidence of the cohort with that of the BC population and to examine risk by cumulative exposure to coal-tar pitch volatiles (CTPV) and electromagnetic fields. Significantly elevated rates were observed for bladder cancer incidence (standardized incidence ratio (SIR) = 1.69) and brain cancer mortality (standardized mortality ratio = 2.17). The risk of bladder cancer was strongly related to cumulative exposure to CTPV (P less than .01). The risk for non-Hodgkin's lymphoma also increased with increasing exposure (P less than .05), although the overall rate was similar to that of the general population (SIR = 1.06). The lung cancer rate was as expected (SIR = 0.97), but showed a weak association with CTPV exposure that was not statistically significant. No individual cause of death or incident cancer site was related to exposure to electromagnetic fields. Analysis of the joint effect of smoking and CTPV exposure on lung and bladder cancer showed the exposure response relationships to be independent of smoking.

  8. Cumulative childhood maltreatment and its dose-response relation with adult symptomatology: Findings in a sample of adult survivors of sexual abuse.

    PubMed

    Steine, Iris M; Winje, Dagfinn; Krystal, John H; Bjorvatn, Bjørn; Milde, Anne Marita; Grønli, Janne; Nordhus, Inger Hilde; Pallesen, Ståle

    2017-03-01

    In the present study, we examined the role of cumulative childhood maltreatment experiences for several health related outcomes in adulthood, including symptoms of psychological distress as well as perceived social support and hardiness. The sample comprised adult survivors of sexual abuse (N=278, 95.3% women, mean age at first abusive incident=6.4 years). One-way ANOVAs revealed a statistically significant dose-response relation between cumulative childhood maltreatment scores and self-reported symptoms of posttraumatic stress (PTSS), anxiety, depression, eating disorders, dissociation, insomnia, nightmare related distress, physical pain, emotional pain, relational problems, self-harm behaviors as well as on a measure of symptom complexity. Cumulative childhood maltreatment was also associated with lower levels of work functioning. An inverse dose-response relation was found for perceived social support and hardiness. Using a Bonferroni corrected alpha level, cumulative childhood maltreatment remained significantly associated with all outcome measures with the exception of eating disorder symptoms after controlling for abuse-related independent variables in hierarchical regression analyses. Results add to previous literature by showing that dose-response relation between cumulative childhood adversities and adult symptom outcomes could also be identified in a sample characterized by high exposure to adversities, and lends support to the notion put forth by previous authors that cumulative childhood adversities seem to be related to the severity of adult health outcomes in a rule-governed way.

  9. Triggering of major eruptions recorded by actively forming cumulates

    PubMed Central

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

    2012-01-01

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

  10. Inverse counting statistics based on generalized factorial cumulants

    NASA Astrophysics Data System (ADS)

    Stegmann, Philipp; König, Jürgen

    2017-02-01

    We propose a procedure to reconstruct characteristic features of an unknown stochastic system from the long-time full counting statistics of some of the system’s transitions that are monitored by a detector. The full counting statistics is conveniently parametrized by so-called generalized factorial cumulants. Taking only a few of them as input information is sufficient to reconstruct important features such as the lower bound of the system dimension and the full spectrum of relaxation rates. The use of generalized factorial cumulants reveals system dimensions and rates that are hidden for ordinary cumulants. We illustrate the inverse counting-statistics procedure for two model systems: a single-level quantum dot in a Zeeman field and a single-electron box subjected to sequential and Andreev tunneling.

  11. 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.

  12. Cumulative Trauma Among Mayas Living in Southeast Florida.

    PubMed

    Millender, Eugenia I; Lowe, John

    2016-01-04

    Mayas, having experienced genocide, exile, and severe poverty, are at high risk for the consequences of cumulative trauma that continually resurfaces through current fear of an uncertain future. Little is known about the mental health and alcohol use status of this population. This correlational study explored t/he relationship of cumulative trauma as it relates to social determinants of health (years in the United States, education, health insurance status, marital status, and employment), psychological health (depression symptoms), and health behaviors (alcohol use) of 102 Guatemalan Mayas living in Southeast Florida. The results of this study indicated that, as specific social determinants of health and cumulative trauma increased, depression symptoms (particularly among women) and the risk for harmful alcohol use (particularly among men) increased. Identifying risk factors at an early stage before serious disease or problems are manifest provides room for early screening leading to early identification, early treatment, and better outcomes.

  13. 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.

  14. Cumulative carbon as a policy framework for achieving climate stabilization.

    PubMed

    Matthews, H Damon; Solomon, Susan; Pierrehumbert, Raymond

    2012-09-13

    The primary objective of the United Nations Framework Convention on Climate Change is to stabilize greenhouse gas concentrations at a level that will avoid dangerous climate impacts. However, greenhouse gas concentration stabilization is an awkward framework within which to assess dangerous climate change on account of the significant lag between a given concentration level and the eventual equilibrium temperature change. By contrast, recent research has shown that global temperature change can be well described by a given cumulative carbon emissions budget. Here, we propose that cumulative carbon emissions represent an alternative framework that is applicable both as a tool for climate mitigation as well as for the assessment of potential climate impacts. We show first that both atmospheric CO(2) concentration at a given year and the associated temperature change are generally associated with a unique cumulative carbon emissions budget that is largely independent of the emissions scenario. The rate of global temperature change can therefore be related to first order to the rate of increase of cumulative carbon emissions. However, transient warming over the next century will also be strongly affected by emissions of shorter lived forcing agents such as aerosols and methane. Non-CO(2) emissions therefore contribute to uncertainty in the cumulative carbon budget associated with near-term temperature targets, and may suggest the need for a mitigation approach that considers separately short- and long-lived gas emissions. By contrast, long-term temperature change remains primarily associated with total cumulative carbon emissions owing to the much longer atmospheric residence time of CO(2) relative to other major climate forcing agents.

  15. Cumulative carbon as a policy framework for achieving climate stabilization

    PubMed Central

    Matthews, H. Damon; Solomon, Susan; Pierrehumbert, Raymond

    2012-01-01

    The primary objective of the United Nations Framework Convention on Climate Change is to stabilize greenhouse gas concentrations at a level that will avoid dangerous climate impacts. However, greenhouse gas concentration stabilization is an awkward framework within which to assess dangerous climate change on account of the significant lag between a given concentration level and the eventual equilibrium temperature change. By contrast, recent research has shown that global temperature change can be well described by a given cumulative carbon emissions budget. Here, we propose that cumulative carbon emissions represent an alternative framework that is applicable both as a tool for climate mitigation as well as for the assessment of potential climate impacts. We show first that both atmospheric CO2 concentration at a given year and the associated temperature change are generally associated with a unique cumulative carbon emissions budget that is largely independent of the emissions scenario. The rate of global temperature change can therefore be related to first order to the rate of increase of cumulative carbon emissions. However, transient warming over the next century will also be strongly affected by emissions of shorter lived forcing agents such as aerosols and methane. Non-CO2 emissions therefore contribute to uncertainty in the cumulative carbon budget associated with near-term temperature targets, and may suggest the need for a mitigation approach that considers separately short- and long-lived gas emissions. By contrast, long-term temperature change remains primarily associated with total cumulative carbon emissions owing to the much longer atmospheric residence time of CO2 relative to other major climate forcing agents. PMID:22869803

  16. Cycles in finite samples and cumulative processes of higher orders

    NASA Astrophysics Data System (ADS)

    Klemeš, VíT.; Klemeš, Ivo

    1988-01-01

    The process formed by a sequence of cumulative departures from the mean or from some other constant (residual mass curve, cusum chart) is a popular tool for the representation and analysis of time series in many sciences, for example, in hydrology, climatology, economics, game theory. In these and other natural and social sciences, similar cumulative processes also often arise naturally; examples include fluctuations of storage in a dam with a constant release rate, lake levels, volume of glaciers, biomass, inventories, and bank accounts. Moreover, many natural economic and other phenomena may represent, or contain, components of cumulative processes of higher orders, i.e., cumulative processes of cumulative processes. In this paper we show that for a sample {yt(0)}≡{xt} of any finite size N, the pure cumulative process of nth order, yt(n)≡∑i=1t(yi(n-1) - μ(n-1)), where μ(n-1) is the sample mean of {yt(n-1)} and t=1, 2, …, N, converges for n→∞ to a sine wave with a period equal to an integral fraction of the sample size N. This happens for any initial sample {yt(0)} and the convergence is of an exponential order. For samples from most stochastic as well as deterministic processes, the period of the limiting sine wave is equal to the sample size N. This behavior is demonstrated by examples involving samples from various processes ranging from pure random series to various deterministic series and including time series of some natural processes such as streamflow, lake levels, and glacier volumes. The paper includes a demonstration of effects of noise superimposed on, and of error in the value of, sample mean on the rate of convergence, and a discussion of some practical implications of the phenomenon described; it brings together some aspects of the work of Slutzky (1937), Hurst (1951), and Yule (1926).

  17. Case-control study of cumulative cigarette tar exposure and lung and upper aerodigestive tract cancers.

    PubMed

    Meyers, Travis J; Chang, Shen-Chih; Chang, Po-Yin; Morgenstern, Hal; Tashkin, Donald P; Rao, Jian-Yu; Cozen, Wendy; Mack, Thomas M; Zhang, Zuo-Feng

    2017-05-01

    The development of comprehensive measures for tobacco exposure is crucial to specify effects on disease and inform public health policy. In this population-based case-control study, we evaluated the associations between cumulative lifetime cigarette tar exposure and cancers of the lung and upper aerodigestive tract (UADT). The study included 611 incident cases of lung cancer; 601 cases of UADT cancers (oropharyngeal, laryngeal and esophageal cancers); and 1,040 cancer-free controls. We estimated lifetime exposure to cigarette tar based on tar concentrations abstracted from government cigarette records and self-reported smoking histories derived from a standardized questionnaire. We analyzed the associations for cumulative tar exposure with lung and UADT cancer, overall and according to histological subtype. Cumulative tar exposure was highly correlated with pack-years among ever smoking controls (Pearson coefficient = 0.90). The adjusted odds ratio (95% confidence limits) for the estimated effect of about 1 kg increase in tar exposure (approximately the interquartile range in all controls) was 1.61 (1.50, 1.73) for lung cancer and 1.21 (1.13, 1.29) for UADT cancers. In general, tar exposure was more highly associated with small, squamous and large cell lung cancer than adenocarcinoma. With additional adjustment for pack-years, positive associations between tar and lung cancer were evident, particularly for small cell and large cell subtypes. Therefore, incorporating the composition of tobacco carcinogens in lifetime smoking exposure may improve lung cancer risk estimation. This study does not support the claim of a null or inverse association between "low exposure" to tobacco smoke and risk of these cancer types.

  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. Incidence of Posttraumatic Shoulder Dislocation in Poland

    PubMed Central

    Szyluk, Karol J.; Jasiński, Andrzej; Mielnik, Michał; Koczy, Bogdan

    2016-01-01

    Background The incidence of shoulder joint dislocation has been estimated at 11–26 per 100 000 population per year. In our opinion, basic epidemiological data need to be continually updated in studies of large populations. To study the incidence of posttraumatic dislocation of the shoulder joint in the Polish population. Material/Methods We retrospectively investigated the entire Polish population between 1 January 2010 and 1 January 2015. To identify the study group, data collected in the electronic database of the National Health Fund were used. The study group was divided into subgroups to detect possible differences in the incidence of shoulder dislocation with regard to age, sex, and season of the year (month) when the dislocation occurred. Results The cumulative size of the study sample was 192.72 million over the 5 years of the study. We identified 51 409 patients with first posttraumatic shoulder dislocation, at a mean age of 50.83 years (SD 21.12), from 0 to 104 years. The incidence of traumatic shoulder dislocations for the entire study group ranged from 24.75/100 000/year (number of posttraumatic shoulder dislocations per 100 000 persons per year) to 29.09/100 000/year, for a mean of 26.69/100 000/year. Conclusions In this study, the overall incidence of first-time posttraumatic shoulder dislocations in the Polish general population was 26.69 per 100 000 persons per year. These results are higher than estimates presented by other authors. It is necessary to study, regularly update, and monitor this problem in the general population. PMID:27777396

  20. 2011 Japanese Nuclear Incident

    EPA Pesticide Factsheets

    EPA’s RadNet system monitored the environmental radiation levels in the United States and parts of the Pacific following the Japanese Nuclear Incident. Learn about EPA’s response and view historical laboratory data and news releases.

  1. Increasing incidence of coeliac disease in Sweden.

    PubMed Central

    Ascher, H; Krantz, I; Kristiansson, B

    1991-01-01

    Changes in the incidence of coelic disease was studied among children born in Göteborg, Sweden, between 1970 and 1988. A total of 188 patients with coeliac disease were found. Of these, 83% were less than 2 years old at the time of their first duodenal biopsy and 74% of them have so far been verified according to the criteria of the European Society for Gastroenterology and Nutrition (ESPGAN). The cumulative incidence at 2 years of age/1000 liveborn infants increased significantly from 0.31 in the first birth cohort to 2.93 in the last. This increase could only partly be explained by improvements in detection. Weight for age at diagnosis was generally considerably below the reference value, but was slightly less affected towards the end of the period. The increase in incidence of coeliac disease is the first reported since the middle 1970s and makes the disease one of the most common chronic diseases among Swedish children. PMID:2039251

  2. INCIDENCE OF ENDOMETRIAL HYPERPLASIA

    PubMed Central

    REED, Susan D.; NEWTON, Katherine M.; CLINTON, Walter L.; EPPLEIN, Meira; GARCIA, Rochelle; ALLISON, Kimberly; VOIGT, Lynda F.; Weiss, Noel S.

    2009-01-01

    Objective Estimate age-specific incidence of endometrial hyperplasia: simple, complex, and atypical, in order of increasing likelihood of progression to carcinoma. Study design Women ages 18–90 years with endometrial pathology specimens (1985–2003) at a large integrated health plan were identified using automated data. Incidence rates were obtained by dividing the number of cases by the estimated number of female health plan enrollees who retained a uterus. Results Endometrial hyperplasia peak incidence was: simple-142/100,000 woman-years, complex-213/100,000 woman-years, both in the early 50s; and atypical-56/100,000 woman-years in the early 60s. Age-adjusted incidence decreased over the study period, especially for atypical hyperplasia. Conclusions Endometrial hyperplasia incidence without and with atypia peaks in the early postmenopausal years and in the early 60s, respectively. Given that some cases of endometrial hyperplasia likely go undiagnosed, the figures provided should be viewed as minimum estimates of the true incidence. PMID:19393600

  3. Twenty-two survivors over the age of 1 year with full trisomy 18: presenting and current medical conditions.

    PubMed

    Bruns, Deborah; Campbell, Emily

    2014-03-01

    The purpose of the study is to provide data about 22 survivors over the age of 1 year with full trisomy 18 (12-59 months). Mothers completed the online, mixed method Tracking Rare Incidence Syndrome (TRIS) Survey provides data on birth information (e.g., gestational age, birth weight) and medical conditions identified at birth and at the time of survey completion. Data indicate similar birth characteristics to other studies and presence of syndrome related medical conditions including cardiac conditions, use of a variety of feeding methods, apnea, respiratory difficulties, and kidney issues. Associated interventions, sometimes considered "aggressive" or "intensive" treatments including cardiac surgeries were noted in the sample. Implications for treatment are provided and the need for additional research with this clinical subgroup is needed.

  4. Biomarker responses in pelagic and benthic fish over 1 year following the Hebei Spirit oil spill (Taean, Korea).

    PubMed

    Jung, Jee-Hyun; Kim, Moonkoo; Yim, Un Hyuk; Ha, Sung Yong; An, Joon Geon; Won, Jong Ho; Han, Gi Myung; Kim, Nam Sook; Addison, Richard F; Shim, Won Joon

    2011-08-01

    After the Hebei Spirit oil spill incident (7th December, 2007) in the west coast of Korea, contamination of biliary PAH metabolite and hepatic biomarkers in a pelagic and a benthic fish was monitored for 1 year. Concentrations of 16 PAHs and alkylated PAHs in fish muscle were highest (22.0 ng/g d.w. for 16 PAHs and 284 ng/g d.w. for alkylated PAHs) at 5 days after the spill and then decreased rapidly to background levels at 11 months after the spill. Fish from the oiled site had elevated biliary PAH metabolite concentrations immediately after the spill; these declined steadily in both species, but were still above reference site concentrations 2 months after the spill. Oiled-site fish showed hepatic CYP 1A induction whose trend closely followed those of biliary PAH metabolite concentrations, implying continuous exposure to PAHs. Brain acetylcholinesterase activity was not related to oil exposure.

  5. 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…

  6. 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

  7. 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

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

    PubMed

    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

    2015-03-10

    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.

  9. 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…

  10. Variable Cultural Acquisition Costs Constrain Cumulative Cultural Evolution

    PubMed Central

    Mesoudi, Alex

    2011-01-01

    One of the hallmarks of the human species is our capacity for cumulative culture, in which beneficial knowledge and technology is accumulated over successive generations. Yet previous analyses of cumulative cultural change have failed to consider the possibility that as cultural complexity accumulates, it becomes increasingly costly for each new generation to acquire from the previous generation. In principle this may result in an upper limit on the cultural complexity that can be accumulated, at which point accumulated knowledge is so costly and time-consuming to acquire that further innovation is not possible. In this paper I first review existing empirical analyses of the history of science and technology that support the possibility that cultural acquisition costs may constrain cumulative cultural evolution. I then present macroscopic and individual-based models of cumulative cultural evolution that explore the consequences of this assumption of variable cultural acquisition costs, showing that making acquisition costs vary with cultural complexity causes the latter to reach an upper limit above which no further innovation can occur. These models further explore the consequences of different cultural transmission rules (directly biased, indirectly biased and unbiased transmission), population size, and cultural innovations that themselves reduce innovation or acquisition costs. PMID:21479170

  11. 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.

  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. 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.

  14. A Parametric Cumulative Sum Statistic for Person Fit

    ERIC Educational Resources Information Center

    Armstrong, Ronald D.; Shi, Min

    2009-01-01

    This article develops a new cumulative sum (CUSUM) statistic to detect aberrant item response behavior. Shifts in behavior are modeled with quadratic functions and a series of likelihood ratio tests are used to detect aberrancy. The new CUSUM statistic is compared against another CUSUM approach as well as traditional person-fit statistics. A…

  15. 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...

  16. 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...

  17. CUMULATIVE RISK ASSESSMENT: GETTING FROM TOXICOLOGY TO QUANTITATIVE ANALYSIS

    EPA Science Inventory

    INTRODUCTION: GETTING FROM TOXICOLOGY TO QUANTITATIVE ANALYSIS FOR CUMULATIVE RISK

    Hugh A. Barton1 and Carey N. Pope2
    1US EPA, Office of Research and Development, National Health and Environmental Effects Research Laboratory, Research Triangle Park, NC
    2Department of...

  18. Phthalates and Cumulative Risk Assessment (NAS Final Report)

    EPA Science Inventory

    On December 18, 2008, the National Academy of Sciences' National Research Council released a final report, requested and sponsored by the EPA, entitled Phthalates and Cumulative Risk Assessment: The Task Ahead.

    Risk assessment has become a dominant public policy ...

  19. 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…

  20. Cumulative Risk and Low-Income Children's Language Development

    ERIC Educational Resources Information Center

    Stanton-Chapman, Tina L.; Chapman, Derek A.; Kaiser, Ann P.; Hancock, Terry B.

    2004-01-01

    This study utilized an electronic data linkage method to examine the effects of risk factors present at birth on language development in preschool. The Preschool Language Scale-3 (PLS-3) was administered to 853 low-income children, and cumulative risk data were abstracted from linked birth records. At least one risk factor was present in 94% of…

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

    PubMed

    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.

  2. 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…

  3. 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…

  4. A SYNOPTIC APPROACH FOR ASSESSING CUMULATIVE IMPACTS TO WETLANDS

    EPA Science Inventory

    The US Environmental Protection Agency's Wetlands Research Program has developed the synoptic approach as a proposed method for assessing cumulative impacts to wetlands by providing both a general and a comprehensive view of the environment. It can also be applied more broadly to...

  5. Predictors of re-entry into the child protection system in Singapore: a cumulative ecological-transactional risk model.

    PubMed

    Li, Dongdong; Chu, Chi Meng; Ng, Wei Chern; Leong, Wai

    2014-11-01

    This study examines the risk factors of re-entry for 1,750 child protection cases in Singapore using a cumulative ecological-transactional risk model. Using administrative data, the present study found that the overall percentage of Child Protection Service (CPS) re-entry in Singapore is 10.5% based on 1,750 cases, with a range from 3.9% (within 1 year) to 16.5% (within 8 years after case closure). One quarter of the re-entry cases were observed to occur within 9 months from case closure. Seventeen risk factors, as identified from the extant literature, were tested for their utility to predict CPS re-entry in this study using a series of Cox regression analyses. A final list of seven risk factors (i.e., children's age at entry, case type, case closure result, duration of case, household income, family size, and mother's employment status) was used to create a cumulative risk score. The results supported the cumulative risk model in that higher risk score is related to higher risk of CPS re-entry. Understanding the prevalence of CPS re-entry and the risk factors associated with re-entry is the key to informing practice and policy in a culturally relevant way. The results from this study could then be used to facilitate critical case management decisions in order to enhance positive outcomes of families and children in Singapore's care system.

  6. Anatomy of an incident

    SciTech Connect

    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 identified 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.

  7. Anatomy of an incident

    DOE PAGES

    Cournoyer, Michael E.; Trujillo, Stanley; Lawton, Cindy M.; ...

    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

  8. The challenges and opportunities in cumulative effects assessment

    USGS Publications Warehouse

    Foley, Melissa M.; Mease, Lindley A; Martone, Rebecca G; Prahler, Erin E; Morrison, Tiffany H; Clarke Murray, Cathryn; Wojcik, Deborah

    2016-01-01

    The cumulative effects of increasing human use of the ocean and coastal zone have contributed to a rapid decline in ocean and coastal resources. As a result, scientists are investigating how multiple, overlapping stressors accumulate in the environment and impact ecosystems. These investigations are the foundation for the development of new tools that account for and predict cumulative effects in order to more adequately prevent or mitigate negative effects. Despite scientific advances, legal requirements, and management guidance, those who conduct assessments—including resource managers, agency staff, and consultants—continue to struggle to thoroughly evaluate cumulative effects, particularly as part of the environmental assessment process. Even though 45 years have passed since the United States National Environmental Policy Act was enacted, which set a precedent for environmental assessment around the world, defining impacts, baseline, scale, and significance are still major challenges associated with assessing cumulative effects. In addition, we know little about how practitioners tackle these challenges or how assessment aligns with current scientific recommendations. To shed more light on these challenges and gaps, we undertook a comparative study on how cumulative effects assessment (CEA) is conducted by practitioners operating under some of the most well-developed environmental laws around the globe: California, USA; British Columbia, Canada; Queensland, Australia; and New Zealand. We found that practitioners used a broad and varied definition of impact for CEA, which led to differences in how baseline, scale, and significance were determined. We also found that practice and science are not closely aligned and, as such, we highlight opportunities for managers, policy makers, practitioners, and scientists to improve environmental assessment.

  9. Ideal cardiovascular health and incident hypertension

    PubMed Central

    Zhao, Hai Yan; Liu, Xiao Xue; Wang, An Xin; Wu, Yun Tao; Zheng, Xiao Ming; Zhao, Xiao Hong; Cui, Kai; Ruan, Chun Yu; Lu, Cheng Zhi; Jonas, Jost B.; Wu, Shou Ling

    2016-01-01

    Abstract Ideal cardiovascular health (CVH) has been defined by the American Heart Association as the absence of disease and presence of 7 key health factors. Since it is unknown whether cumulative exposure to CVH reduces the risk of developing arterial hypertension, we prospectively examined the potential association between cumulative CVH (cumCVH) score (except for blood pressure metrics) and incident hypertension. Of the 101,510 participants with an age range of 18 to 98 years in this longitudinal community-based Kailuan study, our cohort included those 15,014 participants without hypertension at baseline and who had follow-up examinations 2, 4, and 6 years later. CumCVH was calculated as the summed CVH score for each examination multiplied by the time between the 2 examinations (points × year). Based on the cumCVH score, the study population was stratified into groups of <44 points, 44 to 48 points, 49 to 54 points, 55 to 59 points, and ≥60 points. Incidence of hypertension ranged from 16.76% in the lowest cumCVH category to 11.52% in the highest cumCVH category. After adjusting for age, sex, education level, income level, high-sensitivity C-reactive protein concentration, uric acid concentration, resting heart rate, parental history of hypertension at baseline, and medication usage before the third follow-up examination, participants in the highest cumCVH category had a significantly reduced risk of incident hypertension compared with those in the lowest cumCVH category (adjusted odds ratio 0.60, 95% confidence interval 0.50–0.71). For every increase in category based on the cumCVH score, the risk of hypertension decreased by approximately 2% (odds ratio 0.98, 95% confidence interval 0.97–0.98). The effect was consistent across sex and age groups. A higher cumCVH score is associated with a lower risk of incident hypertension. PMID:27977580

  10. Increasing incidence of hip fracture in Chiang Mai, Thailand.

    PubMed

    Wongtriratanachai, Prasit; Luevitoonvechkij, Sirichai; Songpatanasilp, Thawee; Sribunditkul, Siripoj; Leerapun, Taninnit; Phadungkiat, Sompant; Rojanasthien, Sattaya

    2013-01-01

    Hip fracture is a major health problem in Thailand. This study attempted to examine the incidence, related factors, and trends of hip fracture in Chiang Mai, Thailand. All hip fracture data among patients aged 50 yr or older were collected from hospitals in Chiang Mai, Thailand from August 1, 2006 to July 3, 2007. Data from the 1997 Chiang Mai hip fracture study were used for comparison. In the study period, 690 hip fractures were reported: 203 males and 487 females (male to female ratio was 1 to 2.4), with a mean age of 76.7 yr. The estimated cumulative incidence was 181.0 per 100,000, and the adjusted incidence was 253.3 (males: 135.9; females: 367.9). A simple fall was the most common mechanism (79%) of fracture, and 80% of the hip fractures occurred in patients aged 70 yr or older. The highest incidence of hip fracture was observed in patients older than 85 yr (1239). At 6 mo postfracture, most patients (61%) used a walking aid. Compared with the 1997 data, hip fracture incidence had increased by an average of 2% per yr, and the incidence of hip fracture had increased significantly from August 1, 2006 to July 31, 2007, especially in patients older than 75 yr. In patients older than 84 yr, the incidence increased by a factor of 2. Urgent strategies for the prevention and treatment of osteoporosis, and hence hip fracture, are needed.

  11. Nonalcoholic fatty liver disease and increased risk of 1-year all-cause and cardiac hospital readmissions in elderly patients admitted for acute heart failure

    PubMed Central

    Valbusa, Filippo; Bonapace, Stefano; Agnoletti, Davide; Scala, Luca; Grillo, Cristina; Arduini, Pietro; Turcato, Emanuela; Mantovani, Alessandro; Zoppini, Giacomo; Arcaro, Guido; Byrne, Christopher; Targher, Giovanni

    2017-01-01

    Nonalcoholic fatty liver disease (NAFLD) is an emerging risk factor for heart failure (HF). Although some progress has been made in improving survival among patients admitted for HF, the rates of hospital readmissions and the related costs continue to rise dramatically. We sought to examine whether NAFLD and its severity (diagnosed at hospital admission) was independently associated with a higher risk of 1-year all-cause and cardiac re-hospitalization in patients admitted for acute HF. We studied 212 elderly patients who were consecutively admitted with acute HF to the Hospital of Negrar (Verona) over a 1-year period. Diagnosis of NAFLD was based on ultrasonography, whereas the severity of advanced NAFLD fibrosis was based on the fibrosis (FIB)-4 score and other non-invasive fibrosis scores. Patients with acute myocardial infarction, severe valvular heart diseases, end-stage renal disease, cancer, known liver diseases or decompensated cirrhosis were excluded. Cox regression was used to estimate hazard ratios (HR) for the associations between NAFLD and the outcome(s) of interest. The cumulative rate of 1-year all-cause re-hospitalizations was 46.7% (n = 99, mainly due to cardiac causes). Patients with NAFLD (n = 109; 51.4%) had remarkably higher 1-year all-cause and cardiac re-hospitalization rates compared with their counterparts without NAFLD. Both event rates were particularly increased in those with advanced NAFLD fibrosis. NAFLD was associated with a 5-fold increased risk of 1-year all-cause re-hospitalization (adjusted-hazard ratio 5.05, 95% confidence intervals 2.78–9.10, p<0.0001) after adjustment for established risk factors and potential confounders. Similar results were found for 1-year cardiac re-hospitalization (adjusted-hazard ratio 8.05, 95% confidence intervals 3.77–15.8, p<0.0001). In conclusion, NAFLD and its severity were strongly and independently associated with an increased risk of 1-year all-cause and cardiac re-hospitalization in elderly

  12. Meteorite incidence angles

    NASA Astrophysics Data System (ADS)

    Hughes, D. W.

    1993-06-01

    Think about an asteroid smashing into the surface of the Moon and excavating a crater; or hitting Earth and scattering meteorite fragments over a strewn field. Imagine a fragment of cometary dust burning out in the Earth's atmosphere and producing a meteor. These bodies have paths that are inclined at some angle to the vertical. But what is the predominant value of this angle of incidence, i? How does the number of incident bodies vary as a function of angle i? And how do both these affect the prevalence of non- circular lunar craters and the ellipticity of meteorite strewn fields?

  13. Incidence of renal stones among cadmium exposed battery workers.

    PubMed Central

    Järup, L; Elinder, C G

    1993-01-01

    The health effects of occupational exposure to cadmium were studied in a group of 902 workers employed for at least one year in a Swedish battery factory between 1931 and 1982. Data on air cadmium concentrations for different periods were combined with company employment records to obtain individual cumulative exposure estimates. A questionnaire including questions on the occurrence of kidney stones was sent to all 601 living workers and to the next of kin of 267 of the deceased workers. The response rate was 88%. 73 workers reported renal calculi that appeared after initial employment. A dose-response relation was found between cumulative exposure to cadmium and age standardised cumulative incidence. Incidence rate ratios (IRRs) were then computed for three exposure categories (< 250, 250- < 5000, and 5000 micrograms/m3 x years) standardised for calendar time, age, and smoking with the low exposure group as reference level. The IRRs were 1.0, 1.6 [95% confidence interval (95% CI) 0.7-3.4], and 3.0 (95% CI 1.3-6.8) respectively. beta 2 Microglobulin measurements were available for 33 workers who formed stones; 13 of these workers had tubular proteinuria (beta 2 microglobulin > or = 34 micrograms/mmole creatinine)--that is, a prevalence of 39%. There was also an indication of a steeper dose-response relation among workers with tubular proteinuria. PMID:8343420

  14. Prognostic role of the cumulative toxicity in patients affected by metastatic renal cells carcinoma and treated with first-line tyrosine kinase inhibitors.

    PubMed

    Iacovelli, Roberto; Verri, Elena; Cossu Rocca, Maria; Aurilio, Gaetano; Cullurà, Daniela; de Cobelli, Ottavio; Nolè, Franco

    2017-02-01

    Tyrosine kinase inhibitor-related toxicities have been reported to be predictive and/or prognostic factors in patients affected by metastatic renal cell carcinoma (mRCC). We aim to investigate the incidence of cumulative toxicity and its prognostic role in mRCC patients treated with sunitinib or pazopanib. mRCC patients treated with sunitinib or pazopanib at the European Institute of Oncology in Milan were reviewed for the incidence of adverse events. Cumulative toxicity was defined as the presence of more than one selected adverse event of any grade. Prognoses were evaluated by the International mRCC Database Consortium criteria. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method and Cox analysis. A total of 104 patients were included in the final analysis. Only 18.3% did not experience any of the selected toxicities: 26.9% had one, 35.6% had two and 19.2% all three toxicities. Accordingly, 54.8% of patients experienced cumulative toxicity. In those with or without cumulative toxicity, the median PFS was 27.6 versus 7.2 months and the median OS was 61.2 versus 18.7 months, respectively. When cumulative toxicity was adjusted for International mRCC Database Consortium prognostic groups, it maintained its prognostic role for both PFS (hazard ratio: 0.31, 95% confidence interval, 0.20-0.49; P<0.001) and OS (hazard ratio: 0.27, 95% confidence interval, 0.15-0.48; P<0.001). A major limitation was the retrospective and monocentric nature of the analysis. We reported the prognostic role of cumulative toxicity because of hypertension, hypothyroidism and hand-foot syndrome in patients affected by mRCC and treated with sunitinib or pazopanib.

  15. 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, ...

  16. Ecosystem assessment methods for cumulative effects at the regional scale

    SciTech Connect

    Hunsaker, C.T.

    1989-01-01

    Environmental issues such as nonpoint-source pollution, acid rain, reduced biodiversity, land use change, and climate change have widespread ecological impacts and require an integrated assessment approach. Since 1978, the implementing regulations for the National Environmental Policy Act (NEPA) have required assessment of potential cumulative environmental impacts. Current environmental issues have encouraged ecologists to improve their understanding of ecosystem process and function at several spatial scales. However, management activities usually occur at the local scale, and there is little consideration of the potential impacts to the environmental quality of a region. This paper proposes that regional ecological risk assessment provides a useful approach for assisting scientists in accomplishing the task of assessing cumulative impacts. Critical issues such as spatial heterogeneity, boundary definition, and data aggregation are discussed. Examples from an assessment of acidic deposition effects on fish in Adirondack lakes illustrate the importance of integrated data bases, associated modeling efforts, and boundary definition at the regional scale.

  17. Cumulative Chemical Exposures During Pregnancy and Early Development

    PubMed Central

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

    2015-01-01

    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

  18. 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.

  19. Cumulants of heat transfer across nonlinear quantum systems

    NASA Astrophysics Data System (ADS)

    Li, Huanan; Agarwalla, Bijay Kumar; Li, Baowen; Wang, Jian-Sheng

    2013-12-01

    We consider thermal conduction across a general nonlinear phononic junction. Based on two-time observation protocol and the nonequilibrium Green's function method, heat transfer in steady-state regimes is studied, and practical formulas for the calculation of the cumulant generating function are obtained. As an application, the general formalism is used to study anharmonic effects on fluctuation of steady-state heat transfer across a single-site junction with a quartic nonlinear on-site pinning potential. An explicit nonlinear modification to the cumulant generating function exact up to the first order is given, in which the Gallavotti-Cohen fluctuation symmetry is found still valid. Numerically a self-consistent procedure is introduced, which works well for strong nonlinearity.

  20. Volume dependence of baryon number cumulants and their ratios

    NASA Astrophysics Data System (ADS)

    Almási, Gábor A.; Pisarski, Robert D.; Skokov, Vladimir V.

    2017-03-01

    We explore the influence of finite-volume effects on cumulants of baryon/quark number fluctuations in a nonperturbative chiral model. In order to account for soft modes, we use the functional renormalization group in a finite volume, using a smooth regulator function in momentum space. We compare the results for a smooth regulator with those for a sharp (or Litim) regulator, and show that in a finite volume, the latter produces spurious artifacts. In a finite volume there are only apparent critical points, about which we compute the ratio of the fourth- to the second-order cumulant of quark number fluctuations. When the volume is sufficiently small the system has two apparent critical points; as the system size decreases, the location of the apparent critical point can move to higher temperature and lower chemical potential.

  1. Cumulative HOM Excitation and Transition Effects in LCLS-II

    NASA Astrophysics Data System (ADS)

    Vostrikov, A.; Sukhanov, A.; Yakovlev, V.; Solyak, N.

    LCLS-II is a proposed upgrade of the most powerful X-ray laser in the world built at SLAC National Accelerator Laboratory. When complete, multiple free electron laser (FEL) sections will be powered by a continuous wave superconducting radio frequency (SRF) electron linac. The vital parameters for FEL radiation quality are beam emittance and beam transverse position stability. Excitation of high order modes (HOM) in SRF niobium cavities leads to additional beam power dissipation through incoherent and coherent losses. Energy stored in HOM may cause cumulative effects - transverse and longitudinal position displacement of the center of bunches, which leads to transverse and longitudinal emittance dilution. Cumulative effects due to dipole HOM excitation in LCLS-II are analyzed. Transition HOM effects are caused by sudden changes (periodic or single case) in the beam bunch structure. Bunch center position disturbance due to transition HOM effects is estimated.

  2. Petrogenesis of the nakhlite meteorites - Evidence from cumulate mineral zoning

    NASA Technical Reports Server (NTRS)

    Harvey, Ralph P.; Mcsween, Harry Y., Jr.

    1992-01-01

    Attention is given to a simple igneous petrogenesis for the meteorite Nakhla, which was previously called into question because Mg/Fe ratios in olivine indicate substantial disequilibrium between the predominant cumulus minerals (olivine and augite). Comparative analyses of simulated diffusive zoning and the observed cumulus mineral zoning for all three nakhlites (Nakhla, Governador Valadares, and Lafayette) show that their current compositions do not necessarily reflect parental magma compositions. Diffusion has altered primary cumulus compositions to varying degrees, Nakhla being the least affected, and Lafayette being almost completely reequilibrated. Since mineral zoning in each meteorite is strongly concentric around mesostasis areas, it is inferred that reaction with intercumulus liquid has controlled the observed zoning. It is argued that the nakhlites appear to be a series of relatively simple cumulate rocks which have undergone various amounts of late-magmatic and subsolidus diffusion, possibly reflecting their relative positions in a cooling cumulate pile.

  3. Cumulative impacts of oil fields on northern Alaskan landscapes

    USGS Publications Warehouse

    Walker, D.A.; Webber, P.J.; Binnian, Emily F.; Everett, K.R.; Lederer, N.D.; Nordstrand, E.A.; Walker, M.D.

    1987-01-01

    Proposed further developments on Alaska's Arctic Coastal Plain raise questions about cumulative effects on arctic tundra ecosystems of development of multiple large oil fields. Maps of historical changes to the Prudhoe Bay Oil Field show indirect impacts can lag behind planned developments by many years and the total area eventually disturbed can greatly exceed the planned area of construction. For example, in the wettest parts of the oil field (flat thaw-lake plains), flooding and thermokarst covered more than twice the area directly affected by roads and other construction activities. Protecting critical wildlife habitat is the central issue for cumulative impact analysis in northern Alaska. Comprehensive landscape planning with the use of geographic information system technology and detailed geobotanical maps can help identify and protect areas of high wildlife use.

  4. Disclusion time measurement studies: stability of disclusion time--a 1-year follow-up.

    PubMed

    Kerstein, R

    1994-08-01

    Six of seven women were recalled after 1 year to remeasure their right- and left-side working disclusion times. Before the occlusal adjustment technique known as immediate complete anterior guidance development (ICAGD), these patients presented lengthy mean disclusion times (> 1.0 second) and multiple chronic myofascial pain dysfunction syndrome (MPDS) symptoms. After ICAGD, these patients presented with short mean disclusion times (< 0.7 second) and no chronic MPDS symptoms were observed. At 1-year follow-up, there was no statistical difference between present measurements of disclusion time and those of 1 year earlier. In addition, all six posttreatment patients demonstrated no observed chronic MPDS symptoms. However, the symptom of nocturnal bruxism appeared to recur with some chronic regularity. These results suggest that, for this population, disclusion time was stable over the 1-year period of observation, and the short disclusion time appears to allow normal daily muscle function with significantly lessened appearance of chronic myofacial pain dysfunction symptoms.

  5. Reduced incidence of interstitial pneumonitis after allogeneic hematopoietic stem cell transplantation using a modified technique of total body irradiation

    PubMed Central

    Chiang, Yun; Tsai, Cheng-Hong; Kuo, Sung-Hsin; Liu, Chieh-Yu; Yao, Ming; Li, Chi-Cheng; Huang, Shang-Yi; Ko, Bor-Sheng; Lin, Chien-Ting; Hou, Hsin-An; Chou, Wen-Chien; Liu, Jia-Hau; Lin, Chien-Chin; Wu, Shang-Ju; Hsu, Szu-Chun; Chen, Yao-Chang; Lin, Kai-Hsin; Lin, Dong-Tsamn; Chou, Hsien-Tang; Lu, Meng-Yu; Yang, Yung-Li; Chang, Hsiu-Hao; Liu, Ming-Chih; Liao, Xiu-Wen; Wu, Jian-Kuen; Chou, Sheng-Chieh; Cheng, Chieh-Lung; Chen, Chien-Yuan; Tsay, Woei; Tien, Hwei-Fang; Tang, Jih-Luh; Chen, Yu-Hsuan

    2016-01-01

    Allogeneic hematopoietic stem cell transplantation is a curative-intent treatment for patients with high-risk hematologic diseases. However, interstitial pneumonitis (IP) and other toxicities remain major concerns after total body irradiation (TBI). We have proposed using linear accelerators with rice-bag compensators for intensity modulation (IM-TBI), as an alternative to the traditional cobalt-60 teletherapy with lung-shielding technique (Co-TBI). Patients who received a TBI-based myeloablative conditioning regimen between 1995 and 2014 were recruited consecutively. Before March 2007, TBI was delivered using Co-TBI (n = 181); afterward, TBI was administered using IM-TBI (n = 126). Forty-four patients developed IP; of these cases, 19 were idiopathic. The IP-related mortality rate was 50% in the total IP cohort and 63% in the idiopathic subgroup. The 1-year cumulative incidences of IP and idiopathic IP were 16.5% and 7.4%, respectively; both rates were significantly higher in the Co-TBI group than in the IM-TBI group. Multivariate analysis revealed that Co-TBI was an independent prognostic factor for both total and idiopathic IP. In the acute myeloid leukemia subgroup, patients with different TBI techniques had similar outcomes for both overall and relapse-free survival. In conclusion, IM-TBI is an easy and effective TBI technique that could substantially reduce the complication rate of IP without compromising treatment efficacy. PMID:27830767

  6. DESIGNING STUDIES AND COLLECTING DATA USEFUL FOR CUMULATIVE RISK ASSESSMENT

    EPA Science Inventory

    DESIGNING STUDIES AND COLLECTING DATA USEFUL FOR CUMULATIVE RISK ASSESSMENT. J E Simmons1, C Gennings2, M Casey2, M J Plewa3, E D Wagner3, W H Carter, Jr.2, A McDonald1,Y M Sey1, L K Teuschler3 1NHEERL, ORD, U.S. EPA, RTP NC, USA; 2VCU, Richmond, VA, USA;3Univ. Illinois, Urba...

  7. 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.

  8. Cumulative Reconstructor: fast wavefront reconstruction algorithm for Extremely Large Telescopes.

    PubMed

    Rosensteiner, Matthias

    2011-10-01

    The Cumulative Reconstructor (CuRe) is a new direct reconstructor for an optical wavefront from Shack-Hartmann wavefront sensor measurements. In this paper, the algorithm is adapted to realistic telescope geometries and the transition from modified Hudgin to Fried geometry is discussed. After a discussion of the noise propagation, we analyze the complexity of the algorithm. Our numerical tests confirm that the algorithm is very fast and accurate and can therefore be used for adaptive optics systems of Extremely Large Telescopes.

  9. 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.

  10. Revisit the 21-day cumulative irritation test - statistical considerations.

    PubMed

    Zhang, Paul; Li, Qing

    2017-03-01

    The 21-day cumulative irritation test is widely used for evaluating the irritation potential of topical skin-care products. This test consists of clinician's assessment of skin reaction of the patch sites and a classification system to categorize the test product's irritation potential. A new classification system is proposed which enables us to control the estimation error and provides a statistical confidence with regard to the repeatability of the classification.

  11. 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.

  12. [Cumulative effect of Coriolis acceleration on coronary hemodynamics].

    PubMed

    Lapaev, E V; Bednenko, V S

    1985-01-01

    Time-course variations in coronary circulation and cardiac output were measured in 29 healthy test subjects who performed tests with a continuous cumulation of Coriolis accelerations and in 12 healthy test subjects who were exposed to Coriolis accelerations combined with acute hypoxia. Adaptive changes in coronary circulation were seen. It is recommended to monitor coronary circulation during vestibulometric tests as part of medical expertise of the flying personnel.

  13. Cumulative blood lead levels and neurobehavioral test performance.

    PubMed

    Chia, S E; Chia, H P; Ong, C N; Jeyaratnam, J

    1997-01-01

    The current scientific literature provides inadequate evidence to conclude whether or not cumulative exposure to or absorption of lead adversely affects performance in neurobehavioral tests in adults. One of reasons for this controversy is the lack of studies with good cumulative exposure to or dose of lead. The aims of this study are to compare the neurobehavioral test performances of a group of lead-exposed workers and a referent group, and to study the association of the neurobehavioral test performances with concurrent blood lead levels and cumulative blood lead levels. Fifty lead battery workers and 97 non-exposed (referent) workers from a vehicle maintenance workshop were evaluated on their neurobehavioral performance using the World Health Organization Neurobehavioral Core Test Battery (WHO-NCTB). The geometric mean concurrent blood lead (ConPb) of the exposed and referent groups were 37.1 (range 13.2-64.6) microg/100 ml and 6.1 (range 2.4-12.4) microg/100 ml, respectively. Cumulative blood lead (CumPb) was defined as area under the curve for the number of years each worker was exposed to lead (three workers previous blood lead results were not available). ConPb and CumPb were used to study the association with the neurobehavioral test results. The exposed group had significantly poorer manual dexterity, perceptual-motor speed, and motor steadiness compared with the referents. The standardized partial regression coefficients were higher for CumPb than ConPb for most of the neurobehavioral test results. In the group >35 years old, there were significantly stronger associations between CumPb and Digit Symbol and Trail Making Part A results than for ConPb which are tests of perceptual and motor skills. CumPb was a better predictor than ConPb of the effects of lead on neurobehavioral performances.

  14. 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.

  15. New model for predicting freeway incidents and incident delays

    SciTech Connect

    Sullivan, E.C.

    1997-08-01

    This paper presents a new model that predicts the number of freeway incidents and associated delays based on general freeway segment characteristics, traffic volumes, and incident management procedures. The model is intended to be used in planning capacity-enhancing freeway improvements and incident management programs. Estimates of incident frequencies, severity, durations, and delays are provided for seven standard incident types, each of which represents a significant fraction of total unplanned incidents and has severity and/or duration characteristics substantially different from the others. In addition to describing the incident prediction model, the paper addresses the need for a coordinated national strategy for collecting incident data, with particular attention to urban freeways. It concludes that the incident data systems that have evolved in several urban areas, often in connection with freeway service patrols and incident response team activities, already provide a valuable nationwide data resource for understanding incident patterns and their variations. However, better national coordination of locally collected incident data would be helpful for addressing issues beyond the scope of the local concerns for which virtually all current systems were originally designed. Specific areas for improvement include the definitions of incident types, descriptions of incident locations (relative to both the length and breadth of the highway), and data recording the critical times during incidents such as when detection, response, and clearing occur.

  16. Cumulative Heat Diffusion Using Volume Gradient Operator for Volume Analysis.

    PubMed

    Gurijala, K C; Wang, Lei; Kaufman, A

    2012-12-01

    We introduce a simple, yet powerful method called the Cumulative Heat Diffusion for shape-based volume analysis, while drastically reducing the computational cost compared to conventional heat diffusion. Unlike the conventional heat diffusion process, where the diffusion is carried out by considering each node separately as the source, we simultaneously consider all the voxels as sources and carry out the diffusion, hence the term cumulative heat diffusion. In addition, we introduce a new operator that is used in the evaluation of cumulative heat diffusion called the Volume Gradient Operator (VGO). VGO is a combination of the LBO and a data-driven operator which is a function of the half gradient. The half gradient is the absolute value of the difference between the voxel intensities. The VGO by its definition captures the local shape information and is used to assign the initial heat values. Furthermore, VGO is also used as the weighting parameter for the heat diffusion process. We demonstrate that our approach can robustly extract shape-based features and thus forms the basis for an improved classification and exploration of features based on shape.

  17. Warming caused by cumulative carbon emissions towards the trillionth tonne.

    PubMed

    Allen, Myles R; Frame, David J; Huntingford, Chris; Jones, Chris D; Lowe, Jason A; Meinshausen, Malte; Meinshausen, Nicolai

    2009-04-30

    Global efforts to mitigate climate change are guided by projections of future temperatures. But the eventual equilibrium global mean temperature associated with a given stabilization level of atmospheric greenhouse gas concentrations remains uncertain, complicating the setting of stabilization targets to avoid potentially dangerous levels of global warming. Similar problems apply to the carbon cycle: observations currently provide only a weak constraint on the response to future emissions. Here we use ensemble simulations of simple climate-carbon-cycle models constrained by observations and projections from more comprehensive models to simulate the temperature response to a broad range of carbon dioxide emission pathways. We find that the peak warming caused by a given cumulative carbon dioxide emission is better constrained than the warming response to a stabilization scenario. Furthermore, the relationship between cumulative emissions and peak warming is remarkably insensitive to the emission pathway (timing of emissions or peak emission rate). Hence policy targets based on limiting cumulative emissions of carbon dioxide are likely to be more robust to scientific uncertainty than emission-rate or concentration targets. Total anthropogenic emissions of one trillion tonnes of carbon (3.67 trillion tonnes of CO(2)), about half of which has already been emitted since industrialization began, results in a most likely peak carbon-dioxide-induced warming of 2 degrees C above pre-industrial temperatures, with a 5-95% confidence interval of 1.3-3.9 degrees C.

  18. 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

  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.

  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.

  1. 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.

  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. 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

  4. 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

  5. The Citrus Flavanone Naringenin Produces Cardioprotective Effects in Hearts from 1 Year Old Rat, through Activation of mitoBK Channels

    PubMed Central

    Testai, Lara; Da Pozzo, Eleonora; Piano, Ilaria; Pistelli, Luisa; Gargini, Claudia; Breschi, Maria Cristina; Braca, Alessandra; Martini, Claudia; Martelli, Alma; Calderone, Vincenzo

    2017-01-01

    Background and Purpose: Incidence of cardiovascular disorders increases with age, because of a dramatic fall of endogenous self-defense mechanisms and increased vulnerability of myocardium. Conversely, the effectiveness of many cardioprotective drugs is blunted in hearts of 1 year old rat. The Citrus flavanone naringenin (NAR) was reported to promote cardioprotective effects against ischemia/reperfusion (I/R) injury, through the activation of mitochondrial large conductance calcium-activated potassium channel (mitoBK). These effects were observed in young adult rats, but no data are available about the possible cardioprotective effects of NAR in aged animals. Experimental Approach: This study aimed at evaluating the potential cardioprotective effects of NAR against I/R damage in 1 year old rats, and the possible involvement of mitoBK. Key Results: Naringenin protected the hearts of 1 year old rats in both ex vivo and in vivo I/R protocols. Noteworthy, these effects were antagonized by paxilline, a selective BK-blocker. The cardioprotective effects of NAR were also observed in senescent H9c2 cardiomyoblasts. In isolated mitochondria from hearts of 1 year old, NAR exhibited the typical profile of a mitoBK opener. Finally, Western Blot analysis confirmed a significant (albeit reduced) presence of BK-forming alpha and beta subunits, both in cardiac tissue of 1 year old rats and in senescent H9c2 cells. Conclusion and Implications: This is the first work reporting cardioprotective effects of NAR in 1 year old rats. Although further studies are needed to better understand the whole pathway involved in the NAR-mediated cardioprotection, these preliminary data represent a promising perspective for a rational nutraceutical use of NAR in aging. PMID:28289383

  6. Comparing the predictive accuracy of frailty, comorbidity, and disability for mortality: a 1-year follow-up in patients hospitalized in geriatric wards

    PubMed Central

    Ritt, Martin; Ritt, Julia Isabel; Sieber, Cornel Christian; Gaßmann, Karl-Günter

    2017-01-01

    Background Studies evaluating and comparing the power of frailty, comorbidity, and disability instruments, together and in parallel, for predicting mortality are limited. Objective This study aimed to evaluate and compare the measures of frailty, comorbidity, and disability in predicting 1-year mortality in geriatric inpatients. Design Prospective cohort study. Patients and setting A total of 307 inpatients aged ≥65 years in geriatric wards of a general hospital participated in the study. Measurements The patients were evaluated in relation to different frailty, comorbidity, and disability instruments during their hospital stays. These included three frailty (the seven-category Clinical Frailty Scale [CFS-7], a 41-item frailty index [FI], and the FRAIL scale), two comorbidity (the Cumulative Illness Rating Scale for Geriatrics [CIRS-G] and the comorbidity domain of the FI [Comorbidity-D-FI]), and two disability instruments (disability in basic activities of daily living [ADL-Katz] and the instrumental and basic activities of daily living domains of the FI [IADL/ADL-D-FI]). The patients were followed-up over 1 year. Results Using FI, CIRS-G, Comorbidity-D-FI, and ADL-Katz, this study identified a patient group with a high (≥50%) 1-year mortality rate in all of the patients and the two patient subgroups (ie, patients aged 65–82 years and ≥83 years). The CFS-7, FI, FRAIL scale, CIRS-G, Comorbidity-D-FI, and IADL/ADL-D-FI (analyzed as full scales) revealed useful discriminative accuracy for 1-year mortality (ie, an area under the curve >0.7) in all the patients and the two patient subgroups (all P<0.001). Thereby, CFS-7 (in all patients and the two patient subgroups) and FI (in the subgroup of patients aged ≥83 years) showed greater discriminative accuracy for 1-year mortality compared to other instruments (all P<0.05). Conclusion All the different instruments emerged as suitable tools for risk stratification in geriatric inpatients. Among them, CFS-7, and in

  7. Prevalence and incidence of gout in southern Sweden from the socioeconomic perspective

    PubMed Central

    Kapetanovic, Meliha C; Hameed, Mohaned; Turkiewicz, Aleksandra; Saxne, Tore; Jacobsson, Lennart; Englund, Martin

    2016-01-01

    Objectives To estimate the prevalence and cumulative incidence of gout in southern Sweden with respect to socioeconomic status. Methods Among residents of Skåne region in the year 2013 (total population 1.3 million), adult persons (age 18 years +) who between 1998 and 2013 received a diagnosis of gout (International Classification of Disease 10th Edition (ICD-10) code M10) by any physician were identified using the Skåne Healthcare Register. We calculated the point prevalence by end of 2013 and annual cumulative incidence in 2013 standardised to the whole Skåne population according to sex, individual information on occupation (white collar/blue collar), income (low/middle/high) and level of education (primary school/high school/university). Results The crude 2013 point prevalence of gout and 2013 cumulative incidence (95% CI) were 1.69% (1.66% to 1.71%) and 24 cases per 10 000 persons (23–25), respectively. Compared to women, men had higher point prevalence (2.44% (2.40% to 2.49%) vs 0.96% (0.93% to 0.98%)) and higher annual cumulative incidence (33 cases per 10 000 (32–35)) versus 15 (14–16)). These figures increased with higher age but decreased with higher level of education, being the lowest in individuals with a university degree. Persons with middle income had highest point prevalence and cumulative incidence of gout, while those with white collar occupations had the lowest. Conclusions Gout is the most common inflammatory arthritis in southern Sweden with a prevalence of ∼1.7% in the adult population. There is a socioeconomic gradient with more gout present in the lower level of education and with more manual labour. PMID:27933209

  8. Introduction to cumulative meta-analysis in dentistry: lessons learned from undertaking a cumulative meta-analysis in periodontology.

    PubMed

    Moles, D R; Needleman, I G; Niederman, R; Lau, J

    2005-04-01

    Improving health and well-being from the consideration of isolated studies is problematic. Systematic reviews have been developed to address this problem and may include a quantitative data synthesis in the form of a meta-analysis, or a cumulative meta-analysis. The value of systematic reviews depends greatly on the availability and quality of the results of primary research. The objective of the current project was to demonstrate the technique of cumulative meta-analysis in dentistry using data from a previously published systematic review. The process highlights an issue that some trials could not be synthesized due to the lack of reporting of measures of variation. This represents a potential source of bias. Investigators are encouraged to consider their trials as part of an information continuum and to report sufficient detail to permit the trials' incorporation into subsequent syntheses.

  9. Prevalence Incidence Mixture Models

    Cancer.gov

    The R package and webtool fits Prevalence Incidence Mixture models to left-censored and irregularly interval-censored time to event data that is commonly found in screening cohorts assembled from electronic health records. Absolute and relative risk can be estimated for simple random sampling, stratified sampling, and two-phase stratified sampling. Non-parametric (absolute risks only), semi-parametric, weakly-parametric (using B-splines), and some fully parametric (such as the logistic-Weibull) models are supported.

  10. Cumulative risk assessment of pesticide residues in food.

    PubMed

    Boobis, Alan R; Ossendorp, Bernadette C; Banasiak, Ursula; Hamey, Paul Y; Sebestyen, Istvan; Moretto, Angelo

    2008-08-15

    There is increasing need to address the potential risks of combined exposures to multiple residues from pesticides in the diet. The available evidence suggests that the main concern is from dose addition of those compounds that act by the same mode of action. The possibility of synergy needs to be addressed on a case-by-case basis, where there is a biologically plausible hypothesis that it may occur at the levels of residues occurring in the diet. Cumulative risk assessment is a resource-intense activity and hence a tiered approach to both toxicological evaluation and intake estimation is recommended, and the European Food Safety Authority (EFSA) has recently published such a proposal. Where assessments have already been undertaken by some other authority, full advantage should be taken of these, subject of course to considerations of quality and relevance. Inclusion of compounds in a cumulative assessment group (CAG) should be based on defined criteria, which allow for refinement in a tiered approach. These criteria should include chemical structure, mechanism of pesticidal action, target organ and toxic mode of action. A number of methods are available for cumulating toxicity. These are all inter-related, but some are mathematically more complex than others. The most useful methods, in increasing levels of complexity and refinement, are the hazard index, the reference point index, the Relative Potency Factor method and physiologically based toxicokinetic modelling, although this last method would only be considered should a highly refined assessment be necessary. Four possible exposure scenarios are of relevance for cumulative risk assessment, acute and chronic exposure in the context of maximum residue level (MRL)-setting, and in relation to exposures from the actual use patterns, respectively. Each can be addressed either deterministically or probabilistically. Strategies for dealing with residues below the limit of detection, limit of quantification or limit

  11. Incidence and mortality of bullous pemphigoid in France.

    PubMed

    Joly, Pascal; Baricault, Sophie; Sparsa, Agnès; Bernard, Philippe; Bédane, Christophe; Duvert-Lehembre, Sophie; Courville, Philippe; Bravard, Pierre; Rémond, Brigitte; Doffoel-Hantz, Valérie; Bénichou, Jacques

    2012-08-01

    A major increase in the incidence of BP has been recently reported in the United Kingdom. In addition, there are some controversies about the over-mortality of BP patients. The primary objective was to reevaluate the incidence of BP in France as compared with that we estimated 15 years ago. The secondary objective was to assess mortality of BP patients. BP incidence was retrospectively estimated from all BP cases diagnosed between January 2000 and December 2005 in three French regions with a total population of 3.858 million inhabitants. BP mortality was assessed from a prospective cohort accrued during the same time period. A total of 502 incident BP patients (mean age: 82.6±8.8 years) were identified. Overall estimated incidence was 21.7 cases per million persons per year (95%CI:19.8-23.7 cases per million persons per year), which is about 3-fold higher than the incidence that we estimated 15 years ago. In the population aged 70 years or above, BP incidence was 162 cases per million per year (95%CI:147-177 cases per million per year). The overall 1-year survival rate was 62% (95% CI: 56-67%). The risk of death for BP patients was more than six times greater than that for the general population (SMR:6.60; 95%CI:5.47-7.90). The incidence of BP in France has increased 3-fold in the last 15 years. BP is associated with high mortality.

  12. Vitamin D Status, Insulin Resistance, Leptin-To-Adiponectin Ratio in Adolescents: Results of a 1-Year Lifestyle Intervention

    PubMed Central

    Rambhojan, Christine; Larifla, Laurent; Clepier, Josiane; Bouaziz-Amar, Elodie; Velayoudom-Cephise, Fritz-Line; Blanchet-Deverly, Anne; Armand, Christophe; Plumasseau, Jean; Lacorte, Jean-Marc; Foucan, Lydia

    2016-01-01

    AIM: We aimed to study the relationships between circulating 25-hydroxyvitamin D [25(OH)D], insulin resistance and leptin-to-adiponectin (L/A) ratio in Guadeloupean children and adolescents and to analyse the changes in 25(OH)D levels after a 1-year lifestyle intervention program. METHODS: 25(OH)D concentrations were measured via a chemiluminescence assay. Cardiometabolic risk factors, homoeostasis model assessment of insulin resistance (HOMA-IR), and adipokines were measured. The lifestyle intervention included dietary counselling, regular physical activity. RESULTS: Among 117 girls and boys (11–15 years old, 31.6% obese), 40% had vitamin D deficiency (25(OH)D levels < 20 ng/mL). With linear regression models where 25(OH)D and HOMA-IR acted as independent variables and age, sex, BMI, L/A ratio as covariates, 25(OH)D was significantly associated with HOMA-IR alone (P = 0.036). HOMA-IR was also associated with BMI z-score ≥ 2, L/A ratio and an interaction term BMI z-score ≥ 2*L/A ratio (P < 0.001 for all). After one year, in 78 children/adolescent, mean serum 25(OH)D increased significantly from 21.4 ± 4.9 ng/mL at baseline to 23.2 ± 6.0 after 1 year; P = 0.003 whereas BMI z-score, HOMA-IR and L/A ratio decreased significantly (P = 0.003, P < 0.001 and P = 0.012; respectively). CONCLUSION: The association between 25(OH)D and HOMA-IR, independently of obesity and the high prevalence of vitamin D deficiency should be considered in order to prevent the later incidence of T2DM. A healthy lifestyle including non-sedentary and outdoor activities could be a way for improving vitamin D status. PMID:28028397

  13. Tacrolimus with mycophenolate mofetil (MMF) or sirolimus vs. cyclosporine with MMF in cardiac transplant patients: 1-year report.

    PubMed

    Kobashigawa, J A; Miller, L W; Russell, S D; Ewald, G A; Zucker, M J; Goldberg, L R; Eisen, H J; Salm, K; Tolzman, D; Gao, J; Fitzsimmons, W; First, R

    2006-06-01

    The most advantageous combination of immunosuppressive agents for cardiac transplant recipients has not yet been established. Between November 2001 and June 2003, 343 de novo cardiac transplant recipients were randomized to receive steroids and either tacrolimus (TAC) + sirolimus (SRL), TAC + mycophenolate mofetil (MMF) or cyclosporine (CYA) + MMF. Antilymphocyte induction therapy was allowed for up to 5 days. The primary endpoint of >/=3A rejection or hemodynamic compromise rejection requiring treatment showed no significant difference at 6 months (TAC/MMF 22.4%, TAC/SRL 24.3%, CYA/MMF 31.6%, p = 0.271) and 1 year (p = 0.056), but it was significantly lower in the TAC/MMF group when compared only to the CYA/MMF group at 1 year (23.4% vs. 36.8%; p = 0.029). Differences in the incidence of any treated rejection were significant (TAC/SRL = 35%, TAC/MMF = 42%, CYA/MMF = 59%; p < 0.001), as were median levels of serum creatinine (TAC/SRL = 1.5 mg/dL, TAC/MMF = 1.3 mg/dL, CYA/MMF = 1.5 mg/dL; p = 0.032) and triglycerides (TAC/SRL = 162 mg/dL, TAC/MMF = 126 mg/dL, CYA/MMF = 154 mg/dL; p = 0.028). The TAC/SRL group encountered fewer viral infections but more fungal infections and impaired wound healing. These secondary endpoints suggest that the TAC/MMF combination appears to offer more advantages than TAC/SRL or CYA/MMF in cardiac transplant patients, including fewer >/=3A rejections or hemodynamic compromise rejections and an improved side-effect profile.

  14. The interaction between constituent year and within-1-year effects in elite German youth basketball.

    PubMed

    Steingröver, C; Wattie, N; Baker, J; Helsen, W F; Schorer, J

    2016-03-19

    The current state of research on relative age effects in basketball shows an uneven picture. These mixed results might be caused by the interaction of constituent year and within-year effects. Our aim was to examine constituent and within-1-year effects in elite German youth basketball. The sample (n = 4400) included players competing in the JBBL (Under-16 first division) and the NBBL (Under-19 first division) from 2011/2012 until 2013/2014. A multi-way frequency analysis revealed an interaction of constituent year effects and within-1-year effects for the JBBL, χ(2) (6, 2590) = 12.76, P < 0.05. NBBL data showed significant constituent year effects, χ(2) (2, n = 1810) = 25.32, P < 0.01, and within-1-year effects for all three age bands but no interaction. The interaction between constituent year and within-1-year effects in the JBBL showed reduced within-1-year effects with increasing age. Once players enter the system in the JBBL, relatively younger players seem less likely to drop out of the system. Results offer new insight regarding how the regulations of this talent development system may influence athletes' opportunities to enter the system and their likelihood of staying at the highest levels of competition.

  15. 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.

  16. Compaction of Chromite Cumulates applying a Centrifuging Piston-Cylinder

    NASA Astrophysics Data System (ADS)

    Manoochehri, S.; Schmidt, M. W.

    2012-12-01

    Stratiform accumulations of chromite cumulates, such as the UG2 chromitite layer in the Bushveld Complex, is a common feature in most of the large layered mafic intrusions. The time scales and mechanics of gravitationally driven crystal settling and compaction and the feasibility of these processes for the formation of such cumulate layers is investigated through a series of high temperature (1280-1300 °C) centrifuge-assisted experiments at 100-2000 g, 0.4-0.6 GPa. A mixture of natural chromite, with defined grain sizes (means of 5 μm, 13 μm, and 52 μm), and a melt with a composition thought to represent the parental magma of the Bushveld Complex, was first chemically and texturally equilibrated at static conditions and then centrifuged. Centrifugation leads to a single cumulate layer formed at the gravitational bottom of the capsule. This layer was analysed for porosity, mean grain size, size distribution and also travelling distance of chromite crystals. The experimentally observed mechanical settling velocity of chromite grains in a suspension with ~ 24 vol% crystals is calculated to be about half (~ 0.53) of the Stokes settling velocity, consistent with a sedimentation exponent n of 2.35±0.3. The settling leads to a porosity of about 52 % in the chromite layer. Formation times of chromite orthocumulates with initial crystal content in the melt of 1 % and grain sizes of 2 mm are thus around 0.6 m/day. To achieve more compacted chromite piles, centrifugation times and acceleration were increased. Within each experiment the crystal content of the cumulate layer increases downward almost linearly at least in the lower 2/3 of the cumulate pile. Although porosity in the lowermost segment of the chromite layer decreases with increasing effective stress integrated over time, the absolute decrease is smaller than for experiments with olivine (from a previous study). Formation times of a ½ meter single chromite layer with 70 vol% chromite, is calculated to be

  17. 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.

  18. Using Exposomics to Assess Cumulative Risks and Promote Health

    PubMed Central

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

    2015-01-01

    Under the exposome paradigm all non-genetic factors contributing to disease are considered to be ‘environmental’ including chemicals, drugs, infectious agents and psycho-social 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

  19. 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…

  20. 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.

  1. 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.

  2. Cumulative effects of repetitive mild traumatic brain injury.

    PubMed

    Bailes, Julian E; Dashnaw, Matthew L; Petraglia, Anthony L; Turner, Ryan C

    2014-01-01

    The majority of traumatic brain injuries (TBI) in the USA are mild in severity. Sports, particularly American football, and military experience are especially associated with repetitive, mild TBI (mTBI). The consequences of repetitive brain injury have garnered increasing scientific and public attention following reports of altered mood and behavior, as well as progressive neurological dysfunction many years after injury. This report provides an up-to-date review of the clinical, pathological, and pathophysiological changes associated with repetitive mTBI, and their potential for cumulative effects in certain individuals.

  3. Mapping cumulative noise from shipping to inform marine spatial planning.

    PubMed

    Erbe, Christine; MacGillivray, Alexander; Williams, Rob

    2012-11-01

    Including ocean noise in marine spatial planning requires predictions of noise levels on large spatiotemporal scales. Based on a simple sound transmission model and ship track data (Automatic Identification System, AIS), cumulative underwater acoustic energy from shipping was mapped throughout 2008 in the west Canadian Exclusive Economic Zone, showing high noise levels in critical habitats for endangered resident killer whales, exceeding limits of "good conservation status" under the EU Marine Strategy Framework Directive. Error analysis proved that rough calculations of noise occurrence and propagation can form a basis for management processes, because spending resources on unnecessary detail is wasteful and delays remedial action.

  4. Faculty Forum--Introductory Psychology Student Performance: Weekly Quizzes Followed by a Cumulative Final Exam

    ERIC Educational Resources Information Center

    Landrum, R. Eric

    2007-01-01

    Students in an introductory psychology course took a quiz a week over each textbook chapter, followed by a cumulative final exam. Students missing a quiz in class could make up a quiz at any time during the semester, and answers to quiz items were available to students prior to the cumulative final exam. The cumulative final exam consisted of half…

  5. 30 CFR 250.921 - How do I analyze my platform for cumulative fatigue?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 2 2014-07-01 2014-07-01 false How do I analyze my platform for cumulative fatigue? 250.921 Section 250.921 Mineral Resources BUREAU OF SAFETY AND ENVIRONMENTAL ENFORCEMENT... platform for cumulative fatigue? (a) If you are required to analyze cumulative fatigue on your...

  6. 30 CFR 250.921 - How do I analyze my platform for cumulative fatigue?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 2 2013-07-01 2013-07-01 false How do I analyze my platform for cumulative fatigue? 250.921 Section 250.921 Mineral Resources BUREAU OF SAFETY AND ENVIRONMENTAL ENFORCEMENT... platform for cumulative fatigue? (a) If you are required to analyze cumulative fatigue on your...

  7. 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...

  8. 30 CFR 250.921 - How do I analyze my platform for cumulative fatigue?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 2 2012-07-01 2012-07-01 false How do I analyze my platform for cumulative fatigue? 250.921 Section 250.921 Mineral Resources BUREAU OF SAFETY AND ENVIRONMENTAL ENFORCEMENT... platform for cumulative fatigue? (a) If you are required to analyze cumulative fatigue on your...

  9. Economic evaluation and 1-year survival analysis of MARS in patients with alcoholic liver disease.

    PubMed

    Hessel, Franz P; Mitzner, Steffen R; Rief, Jana; Guellstorff, Britta; Steiner, Susanne; Wasem, Jürgen

    2003-01-01

    Objective of this study was to determine 1-year survival, costs and cost-effectiveness of the artificial liver support system Molecular Adsorbent Recirculating System (MARS) in patients with acute-on-chronic liver failure (ACLF) and an underlying alcoholic liver disease. In a case-control study, 13 patients treated with MARS were compared to 23 controls of similar age, sex and severity of disease. Inpatient hospital costs data were extracted from patients' files and hospital's internal costing. Patients and treating GPs were contacted, thus determining resource use and survival 1-year after treatment. Mean 1-year survival time in MARS group was 261 days and 148 days in controls. Kaplan-Meier analysis shows advantages of MARS patients (Logrank: P=0.057). Direct medical costs per patient for initial hospital stay and 1-year follow-up from a payer's perspective were Euro 18,792 for MARS patients and Euro 9638 for controls. The costs per life-year gained are Euro 29,719 (time horizon 1 year). From a societal perspective, the numbers are higher (costs per life-year gained: Euro 79,075), mainly because of the fact that there is no regular reimbursement of MARS and therefore intervention costs were not calculated from payer's perspective. A trade-off between medical benefit and higher costs has to be made, but 1-year results suggest an acceptable cost-effectiveness of MARS. Prolonging the time horizon and including indirect costs, which will be done in future research, would probably improve cost-effectiveness.

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

    PubMed

    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.

  11. XEN Glaucoma Implant with Mitomycin C 1-Year Follow-Up: Result and Complications

    PubMed Central

    Bilgic, Alper; Eltanamly, Rasha

    2017-01-01

    Purpose. To evaluate gel microstent (XEN, Aquesys, Inc) for treatment of primary open angle glaucoma (POAG). Methods. In this prospective interventional study, 13 eyes with POAG underwent XEN implantation with subconjunctival mitomycin-C. Of those eyes, 3 were pseudophakic and 10 underwent simultaneous phacoemulsification and XEN. Patients had uncontrolled IOP, had intolerance to therapy, or had maximal therapy but undergoing cataract extraction. Follow-up visits included IOP, number of medications, vision, and complications and lasted for 1 year. Complete success was defined as IOP reduction ≥20% from preoperative baseline at 1 year without any glaucoma medications while partial success as IOP reduction of ≥20% at 1 year with medications. Results. IOP dropped from 16 ± 4 mmHg pre-op to 9 ± 5, 11 ± 6, 12 ± 5, 12 ± 4, and 12 ± 3 mmHg at 1 week, 1, 3, 6, and 12 months (p = 0.004, 0.026, 0.034, 0.01, and 0.01, Wilcoxon Signed Ranks) consecutively. BCVA (LogMAR) was 0.33 ± 0.34 and improved to 0.13 ± 0.11 at 1 year. Mean number of medications dropped from 1.9 ± 1 preoperatively to 0.3 ± 0.49 (p = 0.003) at 1 year. 42% of eyes achieved complete success and 66% qualified success. Complications included choroidal detachment in 2 eyes, and implant extrusion in 1 eye, and 2 eyes underwent trabeculectomy. Conclusion. XEN implant is an effective surgical treatment for POAG, with significant reduction in IOP and glaucoma medications at 1 year follow-up. PMID:28348884

  12. Cancer incidence in airline cabin crew: experience from Sweden

    PubMed Central

    Linnersjo, A; Hammar, N; Dammstrom, B; Johansson, M; Eliasch, H

    2003-01-01

    Aims: To determine the cancer incidence in Swedish cabin crew. Methods: Cancer incidence of cabin crew at the Swedish Scandinavian Airline System (SAS) (2324 women and 632 men) employed from 1957 to 1994 was determined during 1961–96 from the Swedish National Cancer Register. The cancer incidence in cabin crew was compared with that of the general Swedish population by comparing observed and expected number of cases through standardised incidence ratios (SIR). A nested case-control study was performed, including cancer cases diagnosed after 1979 and four controls per case matched by gender, age, and calendar year. Results: The SIR for cancer overall was 1.01 (95% CI 0.78 to 1.24) for women and 1.16 (95% CI 0.76 to 1.55) for men. Both men and women had an increased incidence of malignant melanoma of the skin (SIR 2.18 and 3.66 respectively) and men of non-melanoma skin cancer (SIR 4.42). Female cabin attendants had a non-significant increase of breast cancer (SIR 1.30; 95% CI 0.85 to 1.74). No clear associations were found between length of employment or cumulative block hours and cancer incidence. Conclusions: Swedish cabin crew had an overall cancer incidence similar to that of the general population. An increased incidence of malignant melanoma and non-melanoma skin cancer may be associated with exposure to UV radiation, either at work or outside work. An increased risk of breast cancer in female cabin crew is consistent with our results and may in part be due to differences in reproductive history. PMID:14573710

  13. Incident trends for a hazardous waste cleanup company.

    PubMed

    Akbar-Khanzadeh, F; Rejent, G M

    1999-01-01

    Published reports to assess incidents in hazardous waste operations are scarce. This study was designed to evaluate incident trends in a relatively large hazardous waste cleanup company. The data for 6.5 years, winter 1990 through spring 1996, provided 1848 incident reports with 87% involving injury/illness cases. Over 75% of injury/illness incidents were due to mechanical agents, 10% occurred because of chemical exposure, 5% involved poisonous plants and insect bites, 2% resulted from temperature extremes, 1% were from cumulative injuries/illnesses, and in 7% the agent was not recorded. Almost 31% of injuries were related to the upper extremities, with the fingers most often injured, followed by the hands. Lower back strain cases constituted 11% of injuries, ankle/foot/toe cases 9%, and knee cases 5%. Recovery technicians (laborers) had the highest frequency of injury/illness incidents (52%), followed by supervisors (15%) and heavy machinery operators (10%). The incidence rates (IRs) for all recordable incidents ranged from 11.9 for the second quarter of 1990 down to 1.2 for the fourth quarter of 1995 with a mean (SD) and median of 6.3 (3.0) and 6.1, respectively. For the time period studied, IRs decreased significantly (p < 0.01). It was concluded that hands-on experience in the field and improvements in the health and safety program of the company--including expanding its focus (originally the prevention of chemical exposure) to include construction safety--reduced the incidents considerably. Introduction of new regulations has also contributed to this trend.

  14. Common Causes of Pesticide Incidents

    EPA Pesticide Factsheets

    There are many types of pesticide incidents. EPA staff analyze pesticide incident reports involving people (including children and farm workers), pets, domestic animals, wildlife including bees and other pollinators, and the environment.

  15. Cumulative dietary exposure of the population of Denmark to pesticides.

    PubMed

    Jensen, Bodil Hamborg; Petersen, Annette; Nielsen, Elsa; Christensen, Tue; Poulsen, Mette Erecius; Andersen, Jens Hinge

    2015-09-01

    We used the Hazard Index (HI) method to carry out a cumulative risk assessment after chronic dietary exposure to all monitored pesticides in fruit, vegetables and cereals for various consumer groups in Denmark. Residue data for all the pesticides were obtained from the Danish monitoring programme during the period 2004-2011. Food consumption data were obtained from DANSDA (the DAnish National Survey of Diet and physical Activity) for the period 2005-2008. The calculations were made using three different models to cope with residues below the limit of reporting (LOR). We concluded that a model that included processing factors and set non-detects to ½ LOR, but limited the correction (Model 3), gave the most realistic exposure estimate. With Model 3 the HI was calculated to be 0.44 for children and 0.18 for adults, indicating that there is no risk of adverse health effects following chronic cumulative exposure to the pesticides found in fruit, vegetables and cereals on the Danish market. The HI was below 1 even for consumers who eat more than 550 g of fruit and vegetables per day, corresponding to 1/3 of the population. Choosing Danish-produced commodities whenever possible could reduce the HI by a factor of 2.

  16. 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

  17. The seven-year cumulative survival rate of Osstem implants

    PubMed Central

    Kim, Young-Kyun; Kim, Bum-Su; Yun, Pil-Young; Mun, Sang-Un; Yi, Yang-Jin; Jeong, Kyung-In

    2014-01-01

    Objectives This study was performed to analyze the cumulative survival rate of Osstem implants (Osstem Implant Co., Ltd.) over a seven-year period. Materials and Methods A total of 105 patients who had 467 Osstem implants that were placed at the Section of Dentistry, Seoul National University Bundang Hospital (Seongnam, Korea) from June 2003 through December 2005 were analyzed. The life table method and a cross-tubulation analysis, log rank test were used to evaluate the survival curve and the influence that the prognostic factors. The prognostic factors, i.e., age and gender of patients, diameter and length, type of implants, bone graft history and loading time were determined with a Cox proportional hazard model based on logistic regression analysis. Results The seven-year cumulative survival rate of Osstem implants was 95.37%. The Cox proportional hazard model revealed that the following factors had a significant influence on survival rate; increased diameter, reduced prosthetic loading period and performance of bone grafting. Conclusion The osstem implants showed satisfactory results over the seven-year study period. PMID:24868503

  18. Is learning in problem-based learning cumulative?

    PubMed

    Yew, Elaine H J; Chng, Esther; Schmidt, Henk G

    2011-10-01

    Problem-based learning (PBL) is generally organized in three phases, involving collaborative and self-directed learning processes. The hypothesis tested here is whether learning in the different phases of PBL is cumulative, with learning in each phase depending on that of the previous phase. The scientific concepts recalled by 218 students at the end of each PBL phase were used to estimate the extent of students' learning. The data were then analyzed using structural equation modeling. Results show that our hypothesized model fits the data well. Alternative hypotheses according to which achievement is predicted either by collaborative learning alone or by self-directed learning alone did not fit the data. We conclude that the learning in each PBL phase is cumulative, and strongly influenced by the earlier phase, thus providing support for the PBL cycle of problem analysis, self-directed learning, and a subsequent reporting phase. We also demonstrate an efficient method to capture and quantify students' learning during the PBL process.

  19. 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.

  20. 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.

  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. 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.

  3. 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…

  4. 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…

  5. 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…

  6. Colles' fracture treated with non-bridging external fixation: a 1-year follow-up.

    PubMed

    Andersen, J K; Høgh, A; Gantov, J; Vaesel, M T; Hansen, T Baek

    2009-08-01

    The results in 75 of 105 patients with Older type II/III (AO type A2.2, A3.1, A3.2) Colles' fractures, treated with non-bridging external fixation are presented. The mean age was 67.8 years, and all patients were followed prospectively for 12 months with radiological and functional assessment. No statistically significant loss of radial length, angulation or inclination was seen between the postoperative reduction and the 1-year follow-up examination. The clinical results after 1 year were 66 (88%) excellent/good, nine (12%) fair and 0 (0%) poor according to the modified Gartland and Werley score. Mean visual analogue scale pain score after 1 year was 0.8. In three patients (4%), re-displacement of the fracture occurred and was treated with plating. Non-bridging external fixation offers a reliable method of maintaining radiological reduction of Older type II/III fractures of the distal radius and gives a good functional outcome after 1 year.

  7. 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)…

  8. 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…

  9. 29 CFR 2530.204-1 - Year of participation for benefit accrual.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... ADMINISTRATION, DEPARTMENT OF LABOR MINIMUM STANDARDS FOR EMPLOYEE PENSION BENEFIT PLANS UNDER THE EMPLOYEE... BENEFIT PLANS Participation, Vesting and Benefit Accrual § 2530.204-1 Year of participation for benefit... requirements relating to benefit accrual under a defined benefit pension plan. Some of these requirements...

  10. 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…

  11. 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)…

  12. 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…

  13. Outpatient treated burns in infants younger than 1 year in Helsinki during 2005-2009.

    PubMed

    Laitakari, Elina; Koljonen, Virve; Pyörälä, Sari; Rintala, Risto

    2014-05-01

    In general, voluminous data exists concerning burns in children, but the data focusing specially on children less than 1 year of age is sporadic. We therefore focused on examining the special features of burns in children less than 1 year of age. A retrospective study of all outpatient treated burn patients <1 year old at the Hospital for Children and Adolescents, Helsinki, Finland, from January 2005 to December 2009 was performed. During the 5-year period we identified 106 outpatient treated infants with burns, representing 15% of all pediatric burns during the study period. The majority was male and aged 9-12 months. Most of the burns occurred at home, and in most cases a caregiver was present in the injury room. Scalds were the most common type of injury followed by contact burns. The most common source of scald was from cups containing hot drink, and the most common source of contact burn was hot stoves or oven doors. Special attention needs to be targeted toward the prevention of burns in children less than 1 year of age. The majority of the injuries could have been prevented with more vigilance.

  14. Relationship between tongue strength and 1-year life expectancy in elderly people needing nursing care.

    PubMed

    Yajima, Yuri; Kikutani, Takeshi; Tamura, Fumiyo; Yoshida, Mitsuyoshi

    2017-01-05

    Tongue strength is a useful indicator of oral function and has been found to decrease with aging and reduced physical functioning. The present study aimed to assess the relationships of tongue strength with physical function, mental function, and nutritional status, and also between these factors and 1-year outcomes, to determine whether tongue strength is related to life expectancy in elderly people needing nursing care. The subjects were 140 elderly individuals requiring needing nursing care (49 men and 91 women; ≥65 years). The investigated items included sex, age, activities of daily living (ADL), comorbidity, cognitive function, nutritional status, eating function, occlusal support, and tongue strength. Furthermore, a follow-up study was conducted 1 year later, and factors related to death were identified. The mean tongue strength of the total 140 subjects was 20.3 ± 8.6 kPa. Tongue strength was assessed relative to each of the investigated items, using the t test and one-way analysis of variance. Tongue strength was significantly related to ADL, comorbidity, cognitive function, calf circumference, food intake, and occlusal support. Fifteen subjects were found to have died at the 1-year follow-up study. We assessed the relationships of 1-year outcomes with each of the factors examined, and 1-year outcomes were found to be significantly related to ADL and tongue strength.

  15. Incidence and public health burden of sunburn among ...

    EPA Pesticide Factsheets

    Sunburn, a preventable skin condition, is a major risk factor for skin cancer. Severe burns can result in emergency department visits and in some cases hospitalization. Many people spend hours in direct sunlight while at the beach, which could lead to sunburn. We pooled data from 13 prospective cohorts of beachgoers in the United States (n=84,411) to describe incidence of sunburn, risk factors associated with an increased risk of sunburn, and the health burden resulting from time lost from work or school, visits to the doctor, and medication use. The incidence of sunburn in this population in the 10-12 days after the beach visit was 14% (n=9,882), excluding those with sunburn at enrollment. Sunburn incidence increased with greater time spent in the sun. Approximately 8% of beachgoers only exposed for <1 hour reported sunburn, whereas almost 20% spending ≥5 hours in the sun reported sunburn (p<0.001). Those with any water contact were also more likely to report sunburn (15% versus 11%, p<0.001). Among all participants, 66% applied sunblock. When skin type was considered, the highest incidence was noted among those who report repeated sunburns (17%) or freckles when in the sun (13%) compared to 11% who typically get dark tans. The incidence of sunburn varied considerably by age group. Children ages <1 year had the lowest incidence of sunburn (2%) whereas adults between the ages of 19-35 had the highest incidence of sunburn (18%). Preliminary analyses indicate t

  16. Grazing incidence beam expander

    NASA Astrophysics Data System (ADS)

    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.

  17. 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.

  18. 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

  19. Understanding Trends in Kidney Function 1 Year after Kidney Transplant in the United States.

    PubMed

    Huang, Yihung; Tilea, Anca; Gillespie, Brenda; Shahinian, Vahakn; Banerjee, Tanushree; Grubbs, Vanessa; Powe, Neil; Rios-Burrows, Nilka; Pavkov, Meda; Saran, Rajiv

    2017-03-07

    Lower eGFR 1 year after kidney transplant is associated with shorter allograft and patient survival. We examined how practice changes in the past decade correlated with time trends in average eGFR at 1 year after kidney transplant in the United States in a cohort of 189,944 patients who received a kidney transplant between 2001 and 2013. We calculated the average eGFR at 1 year after transplant for the recipient cohort of each year using the appropriate Modification of Diet in Renal Disease equation depending on the prevailing methodology of creatinine measurement, and used linear regression to model the effects of practice changes on the national post-transplant eGFR trend. Between the 2001-2005 period and the 2011-2013 period, average 1-year post-transplant eGFR remained essentially unchanged, with differences of 1.34 (95% confidence interval, 1.03 to 1.65) ml/min per 1.73 m(2) and 0.66 (95% confidence interval, 0.32 to 1.01) ml/min per 1.73 m(2) among deceased and living donor kidney transplant recipients, respectively. Over time, the mean age of recipients increased and more marginal organs were used; adjusting for these trends unmasked a larger temporal improvement in post-transplant eGFR. However, changes in immunosuppression practice had a positive effect on average post-transplant eGFR and balanced out the negative effect of recipient/donor characteristics. In conclusion, average 1-year post-transplant eGFR remained stable, despite increasingly unfavorable attributes in recipients and donors. With an aging ESRD population and continued organ shortage, preservation of average post-transplant eGFR will require sustained improvement in immunosuppression and other aspects of post-transplant care.

  20. Cancer incidence in kidney transplant recipients: a study protocol

    PubMed Central

    2009-01-01

    risk survival analysis methods will be applied to estimate the cumulative incidence of cancer and to identify variables associated to its occurrence. Discussion Information about cancer incidence in kidney transplant patients could be useful to adapt the guidelines on post-kidney transplant follow-up on tumour screening, and evaluate the impact of intervention measures for the prevention of cancer in these patients. PMID:19698143

  1. 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…

  2. 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

  3. Variability in Cumulative Habitual Sleep Duration Predicts Waking Functional Connectivity

    PubMed Central

    Khalsa, Sakh; Mayhew, Stephen D.; Przezdzik, Izabela; Wilson, Rebecca; Hale, Joanne; Goldstone, Aimee; Bagary, Manny; Bagshaw, Andrew P.

    2016-01-01

    Study Objectives: We examined whether interindividual differences in habitual sleep patterns, quantified as the cumulative habitual total sleep time (cTST) over a 2-w period, were reflected in waking measurements of intranetwork and internetwork functional connectivity (FC) between major nodes of three intrinsically connected networks (ICNs): default mode network (DMN), salience network (SN), and central executive network (CEN). Methods: Resting state functional magnetic resonance imaging (fMRI) study using seed-based FC analysis combined with 14-d wrist actigraphy, sleep diaries, and subjective questionnaires (N = 33 healthy adults, mean age 34.3, standard deviation ± 11.6 y). Data were statistically analyzed using multiple linear regression. Fourteen consecutive days of wrist actigraphy in participant's home environment and fMRI scanning on day 14 at the Birmingham University Imaging Centre. Seed-based FC analysis on ICNs from resting-state fMRI data and multiple linear regression analysis performed for each ICN seed and target. cTST was used to predict FC (controlling for age). Results: cTST was specific predictor of intranetwork FC when the mesial prefrontal cortex (MPFC) region of the DMN was used as a seed for FC, with a positive correlation between FC and cTST observed. No significant relationship between FC and cTST was seen for any pair of nodes not including the MPFC. Internetwork FC between the DMN (MPFC) and SN (right anterior insula) was also predicted by cTST, with a negative correlation observed between FC and cTST. Conclusions: This study improves understanding of the relationship between intranetwork and internetwork functional connectivity of intrinsically connected networks (ICNs) in relation to habitual sleep quality and duration. The cumulative amount of sleep that participants achieved over a 14-d period was significantly predictive of intranetwork and inter-network functional connectivity of ICNs, an observation that may underlie the link

  4. 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

  5. Comparison of 2 Interventions for Liquid Aspiration on Pneumonia Incidence A Randomized Trial

    PubMed Central

    Robbins, JoAnne; Gensler, Gary; Hind, Jacqueline; Logemann, Jeri A.; Lindblad, Anne S.; Brand, Diane; Baum, Herbert; Lilienfeld, David; Kosek, Steven; Lundy, Donna; Dikeman, Karen; Kazandjian, Marta; Gramigna, Gary D.; McGarvey-Toler, Susan; Gardner, Patricia J. Miller

    2008-01-01

    Background Aspiration pneumonia is common among frail elderly persons with dysphagia. Although interventions to prevent aspiration in these patients are routinely used in these patients, little is known about the effectiveness of those interventions. Objective To compare the effectiveness of chin-down posture and 2 consistencies (nectar or honey) of thickened liquids on the 3-month cumulative incidence of pneumonia in participants with dementia or Parkinson disease. Design Randomized, controlled, parallel-design trial in which patients were enrolled from 9 June 1998 to 19 September 2005. Setting 47 hospitals and 79 subacute facilities. Patients 515 patients age 50 years or older with dementia or Parkinson disease who aspirated thin liquids (demonstrated videofluoroscopically). Of these, 504 were followed until death or 3 months. Interventions Participants were randomly assigned to drink all liquids in a chin-down posture (n = 259) or to drink nectar-thick (n = 133) or honey-thick (n = 123) liquids in a head-neutral position. Measurements The primary outcome was pneumonia diagnosed by chest radiography or by the presence of 3 respiratory indicators. Results 52 participants had pneumonia, yielding an overall estimated 3-month cumulative incidence of 11%. The 3-month cumulative incidence of pneumonia was 0.098 and 0.116 in the chin-down posture and thickened-liquid groups, respectively (hazard ratio [HR], 0.84 [95% CI, 0.49 to 1.45]; P = 0.53). The 3-month cumulative incidence of pneumonia was 0.084 in the nectar-thick liquid group compared with 0.150 in the honey-thick liquid group (HR, 0.50 [CI, 0.23 to 1.09]; P = 0.083). More patients assigned to thickened liquids than those assigned to the chin-down posture intervention had dehydration (6% vs. 2%), urinary tract infection (6% vs. 3%), and fever (4% vs. 2%). Limitations A no-treatment control group was not included. Follow-up was limited to 3 months. Care providers were not blinded, and differences in cumulative

  6. Three-dimensional assessment of mandibular advancement 1 year after surgery

    PubMed Central

    de Assis Ribeiro Carvalho, Felipe; Cevidanes, Lucia Helena Soares; Motta, Alexandre Trindade Simões da; de Oliveira Almeida, Marco Antonio; Phillips, Ceib

    2010-01-01

    Introduction This prospective observational study evaluated changes in the 3-dimensional position and remodeling of the mandibular rami, condyles, and chin at splint removal and 1 year after mandibular advancement surgery. Methods Presurgery, splint removal (4–6 weeks postsurgery), and 1-year postsurgery cone-beam computed tomography scans of 27 subjects were used. Superimposition on the cranial base was used to assess positional or remodeling changes in the anatomic regions of interest. Surface distance displacements were visually displayed and quantified by 3-dimensional color maps. A 1-sample t test was used to assess the average postsurgical changes of each region of interest. The level of significance was set at 0.05. Results After antero-inferior chin displacement with surgery (mean, 6.81 ± 3.2 mm at splint removal), the average 1-year post-surgery displacement was not statistically significant (P = 0.44). Postsurgical adaptations greater than 2 mm were observed in 48% of the patients: 16% with an additional anterior-inferior displacement of the chin of 2 to 4 mm, and 4% with ≥4 mm; 20% had postero-superior movement of 2 to 4 mm, and 8% had postero-superior movement of ≥4 mm. The condyles tended to move, on average, ≤2 mm supero-posteriorly with surgery, and this small positional displacement was maintained 1 year postsurgery (right condyle, P = 0.58; left, P = 0.88). The rami exhibited outward (lateral) movements with surgery, with greater displacement of the inferior part of the rami (≥2 mm in 65% of the subjects). This torque of the ramus with surgery was stable 1 year postsurgery. Conclusions Three-dimensional assessment of skeletal changes with mandibular advancement surgery shows that nearly half of the patients have >2 mm change in chin position from splint removal to the 1-year follow-up, with approximately equal chances of anterior and posterior movement. Torque of the rami usually occurs with mandibular advancement surgery. PMID:20381760

  7. 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

  8. Renormalized cumulants and velocity derivative skewness in Kolmogorov turbulence

    NASA Astrophysics Data System (ADS)

    Singha, Tapas; Dutta, Kishore; Nandy, Malay K.

    2017-03-01

    We apply a renormalized perturbative scheme to the Navier–Stokes equation for an incompressible isotropic turbulent velocity field. This allows us to obtain the renormalized expressions for second- and third-order cumulants of the velocity derivative directly from the corresponding Feynman diagrams. The resulting expressions are integrated numerically by excluding and including the dissipation range assuming Kolmogorov and Pao’s phenomenological expressions for the energy spectrum. The ensuing values for skewness are found to be S  =  ‑0.647 (when the dissipation range is excluded) and S=-0.682 (when the dissipation is included). These estimated values are compared with various experimental, numerical and theoretical results.

  9. 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.

  10. X-boson cumulant approach to the periodic Anderson model

    NASA Astrophysics Data System (ADS)

    Franco, R.; Figueira, M. S.; Foglio, M. E.

    2002-07-01

    The periodic Anderson model can be studied in the limit U=∞ by employing the Hubbard X operators to project out the unwanted states. We had already studied this problem by employing the cumulant expansion with the hybridization as perturbation, but the probability conservation of the local states (completeness) is not usually satisfied when partial expansions like the ``chain approximation'' (CHA) are employed. To rectify this situation, we modify the CHA by employing a procedure that was used in the mean-field approximation of Coleman's slave-boson method. Our technique reproduces the features of that method in its region of validity, but avoids the unwanted phase transition that appears in the same method both when μ>>Ef at low T and for all values of the parameters at intermediate temperatures. Our method also has a dynamic character that is absent from the mean-field slave-boson method.

  11. Ratcheting up the ratchet: on the evolution of cumulative culture.

    PubMed

    Tennie, Claudio; Call, Josep; Tomasello, Michael

    2009-08-27

    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.

  12. The modified cumulant expansion for two-dimensional isotropic turbulence

    NASA Astrophysics Data System (ADS)

    Tatsumi, T.; Yanase, S.

    1981-09-01

    The two-dimensional isotropic turbulence in an incompressible fluid is investigated using the modified zero fourth-order cumulant approximation. The dynamical equation for the energy spectrum obtained under this approximation is solved numerically and the similarity laws governing the solution in the energy-containing and enstrophy-dissipation ranges are derived analytically. At large Reynolds numbers the numerical solutions yield the k to the -3rd power inertial subrange spectrum which was predicted by Kraichnan (1967), Leith (1968) and Batchelor (1969), assuming a finite enstrophy dissipation in the inviscid limit. The energy-containing range is found to satisfy an inviscid similarity while the enstrophy-dissipation range is governed by the quasi-equilibrium similarity with respect to the enstrophy dissipation as proposed by Batchelor (1969). There exists a critical time which separates the initial period and the similarity period in which the enstrophy dissipation vanishes and remains non-zero respectively in the inviscid limit.

  13. Monitoring paired binary surgical outcomes using cumulative sum charts.

    PubMed

    Steiner, S H; Cook, R J; Farewell, V T

    1999-01-15

    Correlated binary data are encountered in many areas of medical research, system reliability and quality control. For monitoring failures rates in such situations, simultaneous bivariate cumulative sum (CUSUM) charts with the addition of secondary control limits are proposed. Using an approach based on a Markov chain model, the run length properties of such a monitoring scheme can be determined for sudden, or gradual, changes in the failure rates. The proposed control charts are easy to implement, and are shown to be very effective at detecting small changes in the rate of undesirable outcomes, especially when the changes are gradual. This procedure is illustrated using bivariate outcome data arising from a series of paediatric surgeries. The methodology is sufficiently general that it may be adapted for multivariate normal, binomial or Poisson responses.

  14. Modelling the evolution and diversity of cumulative culture.

    PubMed

    Enquist, Magnus; Ghirlanda, Stefano; Eriksson, Kimmo

    2011-02-12

    Previous work on mathematical models of cultural evolution has mainly focused on the diffusion of simple cultural elements. However, a characteristic feature of human cultural evolution is the seemingly limitless appearance of new and increasingly complex cultural elements. Here, we develop a general modelling framework to study such cumulative processes, in which we assume that the appearance and disappearance of cultural elements are stochastic events that depend on the current state of culture. Five scenarios are explored: evolution of independent cultural elements, stepwise modification of elements, differentiation or combination of elements and systems of cultural elements. As one application of our framework, we study the evolution of cultural diversity (in time as well as between groups).

  15. Modelling the evolution and diversity of cumulative culture

    PubMed Central

    Enquist, Magnus; Ghirlanda, Stefano; Eriksson, Kimmo

    2011-01-01

    Previous work on mathematical models of cultural evolution has mainly focused on the diffusion of simple cultural elements. However, a characteristic feature of human cultural evolution is the seemingly limitless appearance of new and increasingly complex cultural elements. Here, we develop a general modelling framework to study such cumulative processes, in which we assume that the appearance and disappearance of cultural elements are stochastic events that depend on the current state of culture. Five scenarios are explored: evolution of independent cultural elements, stepwise modification of elements, differentiation or combination of elements and systems of cultural elements. As one application of our framework, we study the evolution of cultural diversity (in time as well as between groups). PMID:21199845

  16. 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.

  17. 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

  18. The cumulative influence of conflict on nursing home staff.

    PubMed

    Abrahamson, Kathleen; Anderson, James G; Anderson, Marilyn M; Suitor, J Jill; Pillemer, Karl

    2010-01-01

    Nursing staff burnout is a significant challenge in the delivery of nursing home care. Using a representative sample of nursing staff working within the nursing home setting, our analysis addressed the influence of conflict with residents' families on the burnout experience of staff. Through the use of computer simulation modeling we were able to assess the cumulative effects of conflict between staff and families. Findings indicated that conflict with the residents' families increased both burnout and dissatisfaction among nursing staff. The burnout experience of nursing staff peaked with initial episodes of conflict, then leveled off as simulated conflict with family members continued. Because previous research has indicated that burnout tends to peak early in nurses' career cycle, the finding that initial episodes of conflict have a strong influence on nursing staff burnout highlights the importance of interpersonal conflict within nursing homes in both individual and institutional outcomes.

  19. Implantable magnetic relaxation sensors measure cumulative exposure to cardiac biomarkers.

    PubMed

    Ling, Yibo; Pong, Terrence; Vassiliou, Christophoros C; Huang, Paul L; Cima, Michael J

    2011-03-01

    Molecular biomarkers can be used as objective indicators of pathologic processes. Although their levels often change over time, their measurement is often constrained to a single time point. Cumulative biomarker exposure would provide a fundamentally different kind of measurement to what is available in the clinic. Magnetic resonance relaxometry can be used to noninvasively monitor changes in the relaxation properties of antibody-coated magnetic particles when they aggregate upon exposure to a biomarker of interest. We used implantable devices containing such sensors to continuously profile changes in three clinically relevant cardiac biomarkers at physiological levels for up to 72 h. Sensor response differed between experimental and control groups in a mouse model of myocardial infarction and correlated with infarct size. Our prototype for a biomarker monitoring device also detected doxorubicin-induced cardiotoxicity and can be adapted to detect other molecular biomarkers with a sensitivity as low as the pg/ml range.

  20. Ergonomic risk factors for cumulative trauma disorders in VDU operators.

    PubMed

    Turhan, Nur; Akat, Celil; Akyüz, Müfit; Cakci, Aytül

    2008-01-01

    The objectives of this study were to investigate the rate of cumulative trauma disorders (CTDs) in the upper body and to describe the associations of such disorders with ergonomic parameters in a group of data entry operators. A total of 173 data entry operators volunteered to take part in the study. Questionnaires were used to investigate their medical history. Diagnoses of CTDs were made with clinical tests. A visual posture analysis of the workers and an ergonomic analysis of workstations and workload were used to reveal risk factors. Neck and shoulder pain, extensor tendonitis of the wrists and De Quervain's disease were common in the study population. An assessment of risk factors showed that leaning wrists on the keyboard, hard keystrokes, extreme wrist joint and thumb positions and working in poor ergonomic design were correlated to pain and development of CTDs.

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

    PubMed

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

    2016-04-19

    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.

  2. 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.

  3. 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…

  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. The proportionality of global warming to cumulative carbon emissions.

    PubMed

    Matthews, H Damon; Gillett, Nathan P; Stott, Peter A; Zickfeld, Kirsten

    2009-06-11

    The global temperature response to increasing atmospheric CO(2) is often quantified by metrics such as equilibrium climate sensitivity and transient climate response. These approaches, however, do not account for carbon cycle feedbacks and therefore do not fully represent the net response of the Earth system to anthropogenic CO(2) emissions. Climate-carbon modelling experiments have shown that: (1) the warming per unit CO(2) emitted does not depend on the background CO(2) concentration; (2) the total allowable emissions for climate stabilization do not depend on the timing of those emissions; and (3) the temperature response to a pulse of CO(2) is approximately constant on timescales of decades to centuries. Here we generalize these results and show that the carbon-climate response (CCR), defined as the ratio of temperature change to cumulative carbon emissions, is approximately independent of both the atmospheric CO(2) concentration and its rate of change on these timescales. From observational constraints, we estimate CCR to be in the range 1.0-2.1 degrees C per trillion tonnes of carbon (Tt C) emitted (5th to 95th percentiles), consistent with twenty-first-century CCR values simulated by climate-carbon models. Uncertainty in land-use CO(2) emissions and aerosol forcing, however, means that higher observationally constrained values cannot be excluded. The CCR, when evaluated from climate-carbon models under idealized conditions, represents a simple yet robust metric for comparing models, which aggregates both climate feedbacks and carbon cycle feedbacks. CCR is also likely to be a useful concept for climate change mitigation and policy; by combining the uncertainties associated with climate sensitivity, carbon sinks and climate-carbon feedbacks into a single quantity, the CCR allows CO(2)-induced global mean temperature change to be inferred directly from cumulative carbon emissions.

  6. 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.

  7. Correlation between caries incidence and frequency of chewing gum sweetened with sucrose or xylitol.

    PubMed

    Rekola, M

    1989-01-01

    The effect on caries incidence of the daily consumption of chewing gum sweetened with sucrose or xylitol was measured in 100 subjects included in the 1-year chewing gum study (Scheinin et al. 1975, Turku sugar Studies XVIII). The subjects were divided retrospectively into groups consuming 2-8 chewing gum pieces per day and their caries incidence was compared. With chewing gum sweetened with sucrose, the caries incidence increased in relation to the daily consumption of gum. In contrast, chewing gum sweetened with xylitol reduced the incidence of caries with increasing consumption.

  8. 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

  9. 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

  10. Delay Adjusted Incidence

    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.

  11. 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

  12. Corneal Aberrations, Contrast Sensitivity, and Light Distortion in Orthokeratology Patients: 1-Year Results

    PubMed Central

    2016-01-01

    Purpose. To evaluate the corneal higher-order aberrations (HOA), contrast sensitivity function (CSF), and light distortion (LD) in patients undergoing orthokeratology (OK). Methods. Twenty healthy subjects (mean age: 21.40 ± 8 years) with mean spherical equivalent refractive error M = −2.19 ± 0.97 D were evaluated at 1 day, 1 month, and 1 year after starting OK treatment. Monocular LD, photopic monocular CSF, and corneal HOA for 6 mm pupil size were measured. Results. LD showed an increase after the first night (p < 0.05) and recovery to baseline after 1 month, remaining stable after 1 year (p > 0.05). Spherical-like, coma-like, and secondary astigmatism HOA RMS increased significantly (p ≤ 0.022) from baseline to 1-month visit, remaining unchanged over the follow-up. Contrast sensitivity for medium frequencies (3.0, 4.24, and 6.00 cpd) was significantly correlated with LD parameters at baseline (r ≤ −0.529, p < 0.001). However, after 1 year of treatment, this correlation was only statistically significant for 12 cpd spatial frequency (r ≤ −0.565, p < 0.001). Spherical-like RMS for 6 mm pupil size correlated with irregularity of the LD (r = −0.420, p < 0.05) at the 1-year visit. Conclusion. LD experienced by OK patients recovers after one month of treatment and remains stable in the long term while optical aberrations remain significantly higher than baseline. PMID:27867660

  13. Project FLAVOR: 1-Year Outcomes of a Multicultural, School-Based Smoking Prevention Curriculum for Adolescents.

    PubMed

    Unger, Jennifer B; Chou, Chih-Ping; Palmer, Paula H; Ritt-Olson, Anamara; Gallaher, Peggy; Cen, Steven; Lichtman, Kara; Azen, Stanley; Johnson, C Anderson

    2004-02-01

    To evaluate a multicultural smoking prevention curriculum, 16 schools were randomized to receive the multicultural curriculum or a standard curriculum and program effects on 1-year smoking initiation among 1430 never smokers were assessed. Hispanic boys who received the multicultural curriculum were less likely to initiate smoking than were those who received the standard curriculum; effects were insignificant among other groups. The prevention effect among Hispanic boys is encouraging, but additional research is needed to improve prevention effects among other groups.

  14. Corneal Aberrations, Contrast Sensitivity, and Light Distortion in Orthokeratology Patients: 1-Year Results.

    PubMed

    Santolaria-Sanz, Elena; Cerviño, Alejandro; González-Méijome, José M

    2016-01-01

    Purpose. To evaluate the corneal higher-order aberrations (HOA), contrast sensitivity function (CSF), and light distortion (LD) in patients undergoing orthokeratology (OK). Methods. Twenty healthy subjects (mean age: 21.40 ± 8 years) with mean spherical equivalent refractive error M = -2.19 ± 0.97 D were evaluated at 1 day, 1 month, and 1 year after starting OK treatment. Monocular LD, photopic monocular CSF, and corneal HOA for 6 mm pupil size were measured. Results. LD showed an increase after the first night (p < 0.05) and recovery to baseline after 1 month, remaining stable after 1 year (p > 0.05). Spherical-like, coma-like, and secondary astigmatism HOA RMS increased significantly (p ≤ 0.022) from baseline to 1-month visit, remaining unchanged over the follow-up. Contrast sensitivity for medium frequencies (3.0, 4.24, and 6.00 cpd) was significantly correlated with LD parameters at baseline (r ≤ -0.529, p < 0.001). However, after 1 year of treatment, this correlation was only statistically significant for 12 cpd spatial frequency (r ≤ -0.565, p < 0.001). Spherical-like RMS for 6 mm pupil size correlated with irregularity of the LD (r = -0.420, p < 0.05) at the 1-year visit. Conclusion. LD experienced by OK patients recovers after one month of treatment and remains stable in the long term while optical aberrations remain significantly higher than baseline.

  15. 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

  16. Correlations of smoking with cumulative total dust exposure and cumulative abnormal rate of pulmonary function in coal-mine workers

    PubMed Central

    Qian, Qing-Zeng; Cao, Xiang-Ke; Shen, Fu-Hai; Wang, Qian

    2016-01-01

    The present study aimed to investigate the correlation of smoking with cumulative total dust exposure (CTE) and cumulative abnormal rate of pulmonary function in coal-mine workers. A total of 376 coal-mine workers were recruited as the observational group, while 179 healthy workers in other industries were selected as the control group. All the workers underwent pulmonary function testing to determine their forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1) and FEV1/FVC, in order to compare the abnormal pulmonary function between the two groups. A markedly higher number of smokers was observed in the observational group (200/376, 53.19%) when compared with the control group (72/179, 40.22%). In smokers, the abnormal rate of pulmonary function in the observational group (102/200, 51.00%) was evidently higher compared with that in the control group (19/72, 26.39%), whereas no significant difference was detected between the two groups of non-smokers (P=0.077). In addition, FVC, FEV1 and FEV1/FVC of the observational group were found to be lower compared with those in the control group, in both the smoking and non-smoking subgroups. In the smoking subgroup, FVC and FEV1 in subjects working at the coal mine for different number of years showed significant differences (all P<0.05), whereas comparison of FEV1/FVC in workers with different working durations showed no significant difference (P=0.169). However, in the non-smoking subgroup, the comparison of FVC, FEV1 and FEV1/FVC in different working duration groups also showed no significant difference (all P>0.05). Furthermore, FVC, FEV1 and FEV1/FVC in smoking coal-mine workers were negatively correlated with the dust-exposure working duration (P<0.05). CTE was also positively correlated with cumulative abnormal rate of pulmonary function in the smoking and non-smoking subgroups, while FEV1 was negatively correlated with CTE in the smoking subgroup (P=0.009). In conclusion, smoking is an important

  17. How hot is too hot? Live-trapped gray wolf rectal temperatures and 1-year survival

    USGS Publications Warehouse

    Barber-Meyer, Shannon M.; Mech, L. David

    2014-01-01

    The ability of physically restrained and anesthetized wolves to thermoregulate is lessened and could lead to reduced survival, yet no information is available about this subject. Therefore, we analyzed rectal temperatures related to survival 1 year post-capture from 173 adult (non-pup) gray wolves (Canis lupus) captured in modified foot-hold traps for radiocollaring during June–August, 1988–2011, in the Superior National Forest of northeastern Minnesota, USA. The maximum observed rectal temperature (“maxtemp,” ° F, ° C) in each wolf during capture (x = 104.0, 40.0; SD = 2.0, 1.1; min. = 95.9, 35.5; max. = 108, 42.2) was not a significant predictor of survival to 1 year post-capture. Although no weather or morphometric variable was a significant predictor of maxtemps, wolves initially anesthetized with ketamine–xylazine rather than telazol®–xylazine averaged higher maxtemps. This information does not fully address possible effects of high body temperatures related to live-capture and handling of wolves, but it does provide a useful waypoint for future assessments of this relationship and a reassurance to wildlife practitioners that the maxtemps observed in our study did not appear to affect 1-year survival.

  18. Predictors of Relapse after Inpatient Opioid Detoxification during 1-Year Follow-Up

    PubMed Central

    2016-01-01

    Introduction. Relapse rate after opioid detoxification is very high. We studied the possibility that predetoxification patient characteristics might predict relapse at follow-up and thus conducted this 1-year follow-up study to assess the predictors of relapse after inpatient opioid detoxification. Materials and Methods. We conducted this study in our tertiary care institute in India over two-year time period (1 Jan 2014 to 31 Dec 2015). Out of 581 patients admitted, 466 patients were considered for study. Results and Discussion. No significant difference was found between relapsed and nonrelapsed patients regarding sociodemographic profile; however substance abuse pattern and forensic history showed significant differences. Relapsed patients abused greater amount and used injections more commonly, as compared to nonrelapsed group. Longer duration of abuse was also a significant risk factor. Patients with past attempt of opioid detoxification and family history (parental or first degree) of alcohol abuse had decreased possibility of maintaining remission during 1-year follow-up. Relapsed patients were found to abuse their spouse or parents. Conclusion. Our study compared profiles of relapsed and nonrelapsed patients after inpatient detoxification and concluded predictors of relapse during 1-year follow-up period. Early identification of predictors of relapse and hence high risk patients might be helpful in designing more effective and focused treatment plan. PMID:27722007

  19. Trajectory of Cognitive Decline after Incident Stroke

    PubMed Central

    Levine, Deborah A.; Galecki, Andrzej T.; Langa, Kenneth M.; Unverzagt, Frederick W.; Kabeto, Mohammed U.; Giordani, Bruno; Wadley, Virginia G.

    2015-01-01

    Importance Cognitive decline is a major cause of disability in stroke survivors. The magnitude of survivors’ cognitive changes after stroke is uncertain. Objective To measure changes in cognitive function among survivors of incident stroke, controlling for their prestroke cognitive trajectories. Design, Setting, and Participants Prospective study of 23,572 participants aged ≥45 years without baseline cognitive impairment from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort, residing in the continental United States, enrolled 2003–2007 and followed through March 31, 2013. Over a median follow-up of 6.1 years (25th–75th percentile: 5.0–7.1 years), 515 participants survived expert-adjudicated incident stroke and 23,057 remained stroke-free. Exposure Time-dependent incident stroke. Outcome Measures The primary outcome was change in global cognition (Six-Item Screener, SIS; range 0–6). Secondary outcomes were change in new learning (Consortium to Establish a Registry for Alzheimer’s Disease Word List Learning; range 0–30), verbal memory (Word List Delayed Recall; range 0–10), and executive function (Animal Fluency Test; range ≥0), and cognitive impairment (SIS<5/impaired vs. ≥5/unimpaired). For all tests, higher scores indicate better performance. Results Stroke was associated with acute decline in global cognition (0.10 points; 95% CI, 0.04–0.17), new learning (1.80 points; 95% CI, 0.73–2.86), and verbal memory (0.60 points; 95% CI, 0.13–1.07). Participants with stroke, compared to those without stroke, demonstrated faster declines in global cognition (0.06 points per year faster; 95% CI, 0.03–0.08) and executive function (0.63 points per year faster; 95% CI, 0.12–1.15), but not in new learning and verbal memory, compared to prestroke slopes. Among survivors, the difference in risk of cognitive impairment acutely after stroke was not statistically significant (odds ratio, 1.32; 95% CI, 0.95–1.83; P=0

  20. 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.

  1. 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.

  2. 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

  3. 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

  4. 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

  5. Accelerated Gastric Emptying but No Carbohydrate Malabsorption 1 Year After Gastric Bypass Surgery (GBP)

    PubMed Central

    Wang, Gary; Agenor, Keesandra; Pizot, Justine; Kotler, Donald P.; Harel, Yaniv; Van Der Schueren, Bart J.; Quercia, Iliana; McGinty, James

    2013-01-01

    Background Following gastric bypass surgery (GBP), there is a post-prandial rise of incretin and satiety gut peptides. The mechanisms of enhanced incretin release in response to nutrients after GBP is not elucidated and may be in relation to altered nutrient transit time and/or malabsorption. Methods Seven morbidly obese subjects (BMI=44.5±2.8 kg/m2) were studied before and 1 year after GBP with a d-xylose test. After ingestion of 25 g of d-xylose in 200 mL of non-carbonated water, blood samples were collected at frequent time intervals to determine gastric emptying (time to appearance of d-xylose) and carbohydrate absorption using standard criteria. Results One year after GBP, subjects lost 45.0±9.7 kg and had a BMI of 27.1±4.7 kg/m2. Gastric emptying was more rapid after GBP. The mean time to appearance of d-xylose in serum decreased from 18.6±6.9 min prior to GBP to 7.9±2.7 min after GBP (p=0.006). There was no significant difference in absorption before (serum d-xylose concentrations=35.6±12.6 mg/dL at 60 min and 33.9±9.1 mg/dL at 180 min) or 1 year after GBP (serum d-xylose=31.5± 18.1 mg/dL at 60 min and 27.2±11.9 mg/dL at 180 min). Conclusions These data confirm the acceleration of gastric emptying for liquid and the absence of carbohydrate malabsorption 1 year after GBP. Rapid gastric emptying may play a role in incretin response after GBP and the resulting improved glucose homeostasis. PMID:22527599

  6. Environmental exposures and respiratory morbidity among very low birth weight infants at 1 year of life

    PubMed Central

    Halterman, J S; Lynch, K A; Conn, K M; Hernandez, T E; Perry, T T; Stevens, T P

    2016-01-01

    Introduction Preterm infants have a substantially increased risk of developing respiratory illnesses. The goal of this study was to consider the impact of modifiable postnatal exposures on respiratory morbidity among a cohort of very low birth weight (VLBW) infants. Objectives (1) Assess the rates of respiratory morbidity and exposure to indoor respiratory triggers in a population of VLBW infants at 1 year; (2) determine the association between exposures and respiratory morbidity. Methods We enrolled 124 VLBW infants into a prospective cohort study. Parents were called at 1 year to assess respiratory outcomes and environmental exposures. We used bivariate and multivariate analyses to assess the relationship between environmental exposures and acute care for respiratory illnesses. Results At 1 year, 9% of infants had physician-diagnosed asthma, 47% required ≥1 acute visit and 11% required hospitalisation for respiratory illness. The majority of infants (82%) were exposed to at least one indoor respiratory trigger. Infants living with a smoker (61% vs 40%) and infants exposed to pests (62% vs 39%) were more likely than unexposed infants to require acute care for respiratory problems. In a multivariate regression controlling for demographics, birth weight, bronchopulmonary dysplasia, and family history of asthma or allergies, both living with a smoker (OR 2.62; CI 1.09 to 6.29) and exposure to pests (OR 4.41; CI 1.22 to 15.94) were independently associated with the need for acute care for respiratory illnesses. Conclusions In this sample, respiratory morbidity and exposure to triggers were common. VLBW infants may benefit from interventions that decrease exposure to respiratory triggers. PMID:18703545

  7. For Diabetes Shared Savings Programs, 1 Year of Data Is Not Enough.

    PubMed

    VanArsdale, Lynne; Curran-Everett, Douglas; Haugen, Heather; Smith, Nancy; Atherly, Adam

    2017-04-01

    Fee-for-service payment models are moving toward pay-for-performance designs, many of which rely on shared savings for financial sustainability. Shared savings programs divide the cost savings between health care purchaser and provider based on provider performance. Often, these programs measure provider performance as the delivery of agreed-upon clinical practice guidelines that usually are represented as evidence-based medicine (EBM). Multiyear studies show a negative relationship between total cost and EBM, indicating that long-term shared savings can be substantial. This study explores expectations for the rewards in the first year of a shared savings program. It also indicates the effectiveness of using 1 year of claims to assess cost savings from evidence-based care, especially in a patient population with high turnover. This study analyzed 1956 adults with diabetes insured through Medicaid. Results of linear regression showed that the relationship between total cost of care and each element of evidence-based medical care during a 1-year period was positive (higher cost) or insignificant. The results indicate that diabetes EBM programs cannot expect to see significant cost savings if the evaluation lasts only 1 year or less. The study concludes that improvements in EBM incentive programs could come from investigating the length of time needed to realize cost savings from each element of diabetes EBM. Investigating other factors that could affect the expected amount of cost savings also would benefit these programs, especially factors derived from sources external to insurance program information such as the medical record and care management data.

  8. A comparison of emission calculations using different modeled indicators with 1-year online measurements.

    PubMed

    Lengers, Bernd; Schiefler, Inga; Büscher, Wolfgang

    2013-12-01

    The overall measurement of farm level greenhouse gas (GHG) emissions in dairy production is not feasible, from either an engineering or administrative point of view. Instead, computational model systems are used to generate emission inventories, demanding a validation by measurement data. This paper tests the GHG calculation of the dairy farm-level optimization model DAIRYDYN, including methane (CH₄) from enteric fermentation and managed manure. The model involves four emission calculation procedures (indicators), differing in the aggregation level of relevant input variables. The corresponding emission factors used by the indicators range from default per cow (activity level) emissions up to emission factors based on feed intake, manure amount, and milk production intensity. For validation of the CH₄ accounting of the model, 1-year CH₄ measurements of an experimental free-stall dairy farm in Germany are compared to model simulation results. An advantage of this interdisciplinary study is given by the correspondence of the model parameterization and simulation horizon with the experimental farm's characteristics and measurement period. The results clarify that modeled emission inventories (2,898, 4,637, 4,247, and 3,600 kg CO₂-eq. cow(-1) year(-1)) lead to more or less good approximations of online measurements (average 3,845 kg CO₂-eq. cow(-1) year(-1) (±275 owing to manure management)) depending on the indicator utilized. The more farm-specific characteristics are used by the GHG indicator; the lower is the bias of the modeled emissions. Results underline that an accurate emission calculation procedure should capture differences in energy intake, owing to milk production intensity as well as manure storage time. Despite the differences between indicator estimates, the deviation of modeled GHGs using detailed indicators in DAIRYDYN from on-farm measurements is relatively low (between -6.4% and 10.5%), compared with findings from the literature.

  9. Predictors of fatigue over 1 year among people with rheumatoid arthritis.

    PubMed

    Treharne, G J; Lyons, A C; Hale, E D; Goodchild, C E; Booth, D A; Kitas, G D

    2008-08-01

    Fatigue is a systemic feeling of exhaustion that is a common symptom of many chronic illnesses, including the autoimmune inflammatory disease rheumatoid arthritis (RA). We examined predictors of levels of fatigue among people with RA using Leventhal's Common-Sense Model (CSM), which states that cognitive representations of an illness spur (or halt) people's efforts to cope and thereby influence outcomes of the illness. Our use of the CSM was designed in the light of evidence in the literature specific to fatigue in RA. Current fatigue was reported on a 100 mm visual analogue scale (with anchors "No fatigue" and "Unbearable fatigue") by 114 people (73.7% women) with RA at baseline and 1 year later. Baseline employment status, pain, impact of disability, sleep disruption frequency, depressed mood, perceptions of consequences, arthritis self-efficacy and attempts to cope by praying/hoping were also self-reported. Duration of RA and a haematological measure of systemic inflammation (erythrocyte sedimentation rate; ESR) were obtained from hospital records. Unexpectedly, RA duration did not predict fatigue after 1 year, although lower baseline inflammation did (controlling for baseline fatigue and other disease impact variables). This may be due to sampling flares of RA at baseline. Baseline perceptions that RA has severe consequences and is uncontrollable also predicted greater fatigue after 1 year but this relationship was not mediated by praying/hoping. Targeted psychological care to modify perceptions of severe consequences may therefore improve later fatigue for people with RA even when the condition is longstanding, but the mechanisms of any benefit require further investigation.

  10. 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.

  11. 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…

  12. Incidence of cervical human papillomavirus infection in systemic lupus erythematosus women.

    PubMed

    Mendoza-Pinto, C; García-Carrasco, M; Vallejo-Ruiz, V; Méndez-Martínez, S; Taboada-Cole, A; Etchegaray-Morales, I; Muñóz-Guarneros, M; Reyes-Leyva, J; López-Colombo, A

    2017-01-01

    Objectives Our objective was to study the incidence, persistence and clearance of human papillomavirus infection in systemic lupus erythematosus women and assess risk factors for persistence of human papillomavirus infection. Methods We carried out a prospective, observational cohort study of 127 systemic lupus erythematosus women. Patients were evaluated at baseline and at three years. Traditional and systemic lupus erythematosus women-related disease risk factors were collected. Gynaecological evaluations and cervical cytology screening were made. Human papillomavirus detection and genotyping were made by polymerase chain reaction and linear array. Results The cumulative prevalence of human papillomavirus infection increased from 22.8% at baseline to 33.8% at three years; p = < 0.001: 20.1% of patients experienced 43 incident infections. The risk of any human papillomavirus infection was 10.1 per 1000 patient-months. At three years, 47 (88.6%) prevalent infections were cleared. Independent risk factors associated with incident human papillomavirus infection included more lifetime sexual partners (odds ratio = 1.8, 95% confidence interval = 1.11-3.0) and cumulative cyclophosphamide dose (odds ratio = 3.9, 95% confidence interval = 1.2-12.8). Conclusions In systemic lupus erythematosus women, the cumulative prevalence of human papillomavirus infection, including high risk-human papillomavirus and multiple human papillomavirus infections, may increase over time. Most persistent infections were low risk-human papillomavirus. The number of lifetime sexual partners and the cumulative cyclophosphamide dose were independently associated with incident human papillomavirus infection.

  13. 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.

  14. Benchmark Study of Density Cumulant Functional Theory: Thermochemistry and Kinetics.

    PubMed

    Copan, Andreas V; Sokolov, Alexander Yu; Schaefer, Henry F

    2014-06-10

    We present an extensive benchmark study of density cumulant functional theory (DCFT) for thermochemistry and kinetics of closed- and open-shell molecules. The performance of DCFT methods (DC-06, DC-12, ODC-06, and ODC-12) is compared to that of coupled-electron pair methods (CEPA0 and OCEPA0) and coupled-cluster theory (CCSD and CCSD(T)) for the description of noncovalent interactions (A24 database), barrier heights of hydrogen-transfer reactions (HTBH38), radical stabilization energies (RSE30), adiabatic ionization energies (AIE), and covalent bond stretching in diatomic molecules. Our results indicate that out of four DCFT methods the ODC-12 method is the most reliable and accurate DCFT formulation to date. Compared to CCSD, ODC-12 shows superior results for all benchmark tests employed in our study. With respect to coupled-pair theories, ODC-12 outperforms CEPA0 and shows similar accuracy to the orbital-optimized CEPA0 variant (OCEPA0) for systems at equilibrium geometries. For covalent bond stretching, ODC-12 is found to be more reliable than OCEPA0. For the RSE30 and AIE data sets, ODC-12 shows competitive performance with CCSD(T). In addition to benchmark results, we report new reference values for the RSE30 data set computed using coupled cluster theory with up to perturbative quadruple excitations.

  15. 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.

  16. Intertemporal cumulative radiative forcing effects of photovoltaic deployments.

    PubMed

    Ravikumar, Dwarakanath; Seager, Thomas P; Chester, Mikhail V; Fraser, Matthew P

    2014-09-02

    Current policies accelerating photovoltaics (PV) deployments are motivated by environmental goals, including reducing greenhouse gas (GHG) emissions by displacing electricity generated from fossil-fuels. Existing practice assesses environmental benefits on a net life-cycle basis, where displaced GHG emissions offset those generated during PV production. However, this approach does not consider that the environmental costs of GHG release during production are incurred early, while environmental benefits accrue later. Thus, where policy targets suggest meeting GHG reduction goals established by a certain date, rapid PV deployment may have counterintuitive, albeit temporary, undesired consequences. On a cumulative radiative forcing (CRF) basis, the environmental improvements attributable to PV might be realized much later than is currently understood, particularly when PV manufacturing utilizes GHG-intensive energy sources (e.g., coal), but deployment occurs in areas with less GHG-intensive electricity sources (e.g., hydroelectric). This paper details a dynamic CRF model to examine the intertemporal warming impacts of PV deployments in California and Wyoming. CRF payback times are longer than GHG payback times by 6-12 years in California and 6-11 years in Wyoming depending on the PV technology mix and deployment strategy. For the same PV capacity being deployed, early installations yield greater CRF benefits (calculated over 10 and 25 years) than installations occurring later in time. Further, CRF benefits are maximized when PV technologies with the lowest manufacturing GHG footprint (cadmium telluride) are deployed in locations with the most GHG-intensive grids (i.e., Wyoming).

  17. Cumulative Family Risk Predicts Sibling Adjustment to Childhood Cancer

    PubMed Central

    Long, Kristin A.; Marsland, Anna L.; Alderfer, Melissa A.

    2013-01-01

    Background Prolonged, intensive treatment regimens often disrupt families of children with cancer. Siblings are at increased risk for distress, but factors underlying this risk have received limited empirical attention. This study examined associations between the family context and sibling distress. Methods Siblings of children with cancer (ages 8–18, N=209) and parents (186 mothers, 70 fathers) completed measures of sibling distress, family functioning, parenting, and parent posttraumatic stress. Associations between sibling distress and each family risk factor were evaluated. Then, family risks were considered simultaneously by calculating cumulative family risk index scores. Results After controlling for socio-demographic covariates, greater sibling distress was associated with more sibling-reported problems with family functioning and parental psychological control, lower sibling-reported maternal acceptance, and lower paternal self-reported acceptance. When risk factors were considered together, results supported a quadratic model in which associations between family risk and sibling distress were stronger at higher levels of risk. Conclusions Findings support a contextual model of sibling adjustment to childhood cancer in which elevated distress is predicted by family risk factors, alone and in combination. PMID:23576115

  18. 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.

  19. 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.

  20. 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.

  1. Cumulative causation, market transition, and emigration from China.

    PubMed

    Liang, Zai; Chunyu, Miao David; Zhuang, Guotu; Ye, Wenzhen

    2008-11-01

    This article reports findings from a recent survey of international migration from China's Fujian Province to the United States. Using the ethnosurvey approach developed in the Mexican Migration Project, the authors conducted surveys in migrant-sending communities in China as well as in destination communities in New York City. Hypotheses are derived from the international migration literature and the market transition debate. The results are generally consistent with hypotheses derived from cumulative causation of migration; however, geographical location creates some differences in migration patterns to the United States. In China as in Mexico, the existence of migration networks increases the propensity of migration for others in the community. In contrast to the Mexican case, among Chinese immigrants, having a previously migrated household member increases the propensity of other household members to migrate only after the debt for previous migration is paid off. In step with market transition theory, the authors also find that political power influences the migration experience from the coastal Fujian Province.

  2. 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

  3. 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.

  4. Cumulative life course impairment in melanoma and nonmelanoma skin cancer.

    PubMed

    Piaserico, Stefano

    2013-01-01

    Patients with skin cancer remain at risk for disease progression or relapse for many years. Therefore, skin cancer may be considered a chronic, life-threatening disease. It could impact on patients lifestyles and social and professional activities. Although no direct study of cumulative life course impairment (CLCI) in skin cancer patients has been carried out, a few studies suggest that skin cancer may strongly impair quality of life and eventually determine a significant CLCI (melanoma more than nonmelanoma skin cancer). Obviously, the life course of patients with melanoma at an advanced stage of the disease may change considerably. A number of cancer-associated problems may determine a CLCI, including familial or professional changes and a reduction of life expectancy may eventually lead to social withdrawal and depressive disorders. Even patients with a low stage disease may experience an important impairment of quality of life and in some cases a CLCI. Some skin cancer patients may have physical and psychological after effects from their cancer surgery. Several patients complain about lymphedema, discomfort experienced from wearing surgical stockings, and diminished range of physical motion postsurgery. A few are concerned about their body image due to surgical scars, and they may consider changing their job position because of the supposed negative impact of scars in visible sites on their ability to perform their job. Some female melanoma survivors may have a reduced desire of having children in the future.

  5. 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.

  6. Robust modulation classification techniques using cumulants and hierarchical neural networks

    NASA Astrophysics Data System (ADS)

    DeClouet, John A.; Naraghi-Pour, Mort

    2007-04-01

    The problem of automatic modulation classification is to identify the modulation type of a received signal from the signal parameters. Modulation classification has both military and civilian applications and has been the subject of intensive research for more than two decades. In this paper we use a hierarchical neural network in which the first network identifies the modulation class while a second set of networks identify the constellation size (order) of that modulation class. The set of features we use include normalized standard deviations of amplitude, phase and frequency, as well as the fourth and sixth order cumulants of the signal samples. Identifying the constellation size of quadrature amplitude modulation (QAM) has been particularly difficult in the past. In this paper we introduce two new approaches for computing the features of a QAM signal. The first uses the concatenated in- phase and quadrature components of the signal to compute the features. The second method maps the in-phase and quadrature components to the first quadrant of the constellation by calculating the absolute value of each separately. The mean of the resulting constellation points is then subtracted before calculating the features. Simulation results are presented for classification of several digital modulation schemes including FSK, PSK, ASK and QAM. Our results show that the proposed method significantly improves the classification error.

  7. The incidence and mortality rates of neuroblastoma cases before and after the cessation of the mass screening program in Japan: A descriptive study.

    PubMed

    Shinagawa, Takafumi; Kitamura, Tetsuhisa; Katanoda, Kota; Matsuda, Tomohiro; Ito, Yuri; Sobue, Tomotaka

    2017-02-01

    In 2003, Japan's Ministry of Health, Labour and Welfare halted the neuroblastoma (NB) mass screening program, running since 1985. This study aimed to examine whether NB incidence and mortality changed before and after the program halted. This is a descriptive population-based study. We used data from the Monitoring of Cancer Incidence in Japan (MCIJ) project, Vital Statistics of Japan, and Japanese CANcer Survival Information for Society (J-CANSIS). Incidence rate, cumulative incidence rate, mortality rate, cumulative mortality rate, and relative 5-year survival for NB were calculated. Children were divided into two birth cohort groups, consisting of children born before, or after the cessation of the NB mass screening program. We compared the two cohorts, with regards to the cumulative incidence and mortality rates at 5 years old. The incidence rate was lower after the cessation of the NB mass screening program. There was no substantial change in the mortality rate, and no significant variation in the relative 5-year survival between groups. The cumulative incidence rate in the latter cohort was significantly lower than that in the former cohort (rate ratio: 0.39, 95% CI: 0.25-0.61, p < 0.001). No significant difference in the cumulative mortality rate between the two cohorts was observed (rate ratio: 0.99, 95% CI: 0.80-1.22, p = 0.93). The NB incidence rate decreased markedly and the mortality rate did not substantially change after the cessation of the NB mass screening program. The NB mass screening program probably caused overdiagnosis, and its effectiveness was not clear.

  8. Modelling Gaucher disease progression: long-term enzyme replacement therapy reduces the incidence of splenectomy and bone complications

    PubMed Central

    2014-01-01

    Long-term complications and associated conditions of type 1 Gaucher Disease (GD) can include splenectomy, bone complications, pulmonary hypertension, Parkinson disease and malignancies. Enzyme replacement therapy (ERT) reverses cytopenia and reduces organomegaly. To study the effects of ERT on long-term complications and associated conditions, the course of Gaucher disease was modelled. The cohort consisted of all diagnosed GD patients in the Netherlands. Mutually exclusive disease states were defined as ‘asymptomatic’, ‘signs/symptoms’, ‘recovery’, ‘splenectomy’, ‘bone complication’, ‘multiple complications’ and ‘malignancy’. A natural history (NH) cohort was delineated based upon historical data on Dutch patients before ERT was available. Cumulative incidence curves were composed for progression from each disease state to the next. Two scenarios were applied for the ERT cohort: time to complications was calculated from A. start of ERT; B. entering the previous disease state. Median time for the development of signs and/or symptoms was 30.1 years (N = 73). In the NH cohort (N = 42), 9% had developed a bone complication after 10 years in the signs/symptoms phase, while 21% had undergone a splenectomy. In the ERT cohort (N = 29 (A), N = 28 (B)), 12% (A) or 4% (B) had developed a bone complication after 10 years in this phase and no patient was splenectomized. No patients in the NH cohort recovered, compared to 50% in the ERT cohort after 3.6 years (N = 28 (A)) or 22.4 years (N = 27 (B)) of treatment. Median time from a first to a second complication was 11 years in the NH cohort (N = 31), whereas 16 respectively 14 percent had developed a second complication after 10 years in the ERT cohort (N = 17, scenario A/B). Fourteen percent (scenario A/B) developed an associated malignancy after 10 years in the phase ‘multiple complications’ (N = 23). Associated malignancies occurred almost exclusively in advanced disease stages, therefore it

  9. Relaxation of quantum systems weakly coupled to a bath. II. Formal analysis of the total-time-ordering-cumulant and partial-time-ordering-cumulant spectral line shapes

    NASA Astrophysics Data System (ADS)

    Bretón, J.; Hardisson, A.; Mauricio, F.; Velasco, S.

    1984-07-01

    Given a quantum system of a few degrees of freedom in weak interaction with a bath, the expressions which connect its total-time-ordering-cumulant and partial-time-ordering-cumulant relaxation with the corresponding spectral line shapes of dipolar absorption are deduced. For simplicity we consider a system with a nondegenerate and nonequidistant energy spectrum. A special study in the cases of isolated resonances and of a weak interference effect between resonances is made.

  10. 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

  11. 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

  12. Induction of maturogenesis by partial pulpotomy: 1 year follow-up.

    PubMed

    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.

  13. 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.

  14. Prediction of depression and anxiety 1 year after moderate-severe traumatic brain injury.

    PubMed

    Demakis, George J; Hammond, Flora M; Knotts, Allison

    2010-07-01

    This study examined three scales of the Personality Assessment Inventory (PAI; Anxiety, Anxiety-Related Disorders, and Depression) in 88 participants 1 year after they suffered a moderate-severe traumatic brain injury (TBI). Participants were all enrolled in the federally funded Traumatic Brain Injury Model System project at Carolinas Rehabilitation. The following variables were assessed at the time of injury: age, sex, employment and marital status, and length of loss of consciousness. Disability status, using the Disability Rating Scale (DRS), was assessed at the time of discharge from the rehabilitation hospital. A series of three linear regression analyses found that these variables significantly predicted scores on the Anxiety and Anxiety-Related Disorders scales, which accounted for 14% and 17.7% of the variance, respectively. The variables did not significantly predict scores on the Depression scale. Within each regression analysis, DRS was consistently and negatively related to each PAI scale, such that greater disability was associated with better psychological functioning. Such seemingly paradoxical findings are discussed in terms of anosognosia or poor awareness of psychological functioning among those with greater disability 1 year after TBI.

  15. Dialectical Behavior Therapy for Adolescents With Bipolar Disorder: A 1-Year Open Trial

    PubMed Central

    GOLDSTEIN, TINA R.; AXELSON, DAVID A.; BIRMAHER, BORIS; BRENT, DAVID A.

    2010-01-01

    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) includes 24 weekly sessions; sessions alternate between the two treatment modalities. Continuation treatment consists of 12 additional sessions tapering in frequency through 1 year. We conducted an open pilot trial of the treatment, designed as an adjunct to pharmacological management, to establish feasibility and acceptability of the treatment for this population. Participants included 10 patients (mean age 15.8 ± 1.5 years, range 14–18) receiving treatment in an outpatient pediatric bipolar specialty clinic. Symptom severity and functioning were assessed quarterly by an independent evaluator. Consumer satisfaction was also assessed posttreatment. Results Feasibility and acceptability of the intervention were high, with 9 of 10 patients completing treatment, 90% of scheduled sessions attended, and high treatment satisfaction ratings. Patients exhibited significant improvement from pre- to posttreatment in suicidality, nonsuicidal self-injurious behavior, emotional dysregulation, and depressive symptoms. Conclusions Dialectical behavior therapy may offer promise as an approach to the psychosocial treatment of adolescent bipolar disorder. PMID:17581446

  16. Steroid hormone levels in pregnancy and 1 year postpartum using isotope dilution tandem mass spectrometry

    PubMed Central

    Soldin, Offie P.; Guo, Tiedong; Weiderpass, Elisabete; Tractenberg, Rochelle E.; Hilakivi-Clarke, Leena; Soldin, Steven J.

    2013-01-01

    Objective To establish normal, trimester-specific reference intervals for serum 17β-estradiol, progesterone (P), 17α-hydroxyprogesterone, cortisol, 11-deoxycortisol, androstenedione, DHEA, and DHEAS, measured simultaneously using isotope dilution tandem mass spectrometry. Design Sequential cohort study. Patient(s) Healthy women undergoing a normal pregnancy (age, 25–38 years; mean, 30 years) attending a prenatal well clinic at gestation weeks 12, 22, and 32 and approximately 1 year postpartum. Main Outcome Measure(s) Trimester-specific reference intervals of endogenous steroid hormones analyzed using an isotope dilution tandem mass spectrometer equipped with an atmospheric pressure photoionization source with deuterium-labeled internal standards. Result(s) Serum estradiol, P, 17α-hydroxyprogesterone, and 11-deoxycortisol increased throughout pregnancy; cortisol increased up to the second trimester and then remained steady, while androstenedione increased by 80 percent by gestation week 12, then remained constant. Serum DHEA-S decreased by 50% by the third trimester. Conclusion(s) Trimester-specific reference intervals are reported for eight serum steroids. The ratios of individual serum hormone concentrations during pregnancy relative to their 1-year postpartum concentrations illustrate the expected normal trends of changes in hormone concentrations during pregnancy. PMID:16169406

  17. Does antibiotic elution from PMMA beads deteriorate after 1-year shelf storage?

    PubMed

    Balsamo, Luke H; Whiddon, David R; Simpson, R Bruce

    2007-09-01

    Antibiotic-impregnated polymethylmethacrylate beads are widely used as an adjunct in the treatment of orthopaedic infections. Because there is no commercially available bead in the United States, surgeons must manufacture bead sets at the time of implantation. This can be time consuming and wasteful. We hypothesized antibiotic-impregnated beads would maintain consistent elution for up to 1 year after manufacturing and storage. Tobramycin-impregnated antibiotic beads were manufactured using a bead mold. The antibiotic was either hand-mixed into the polymethylmethacrylate powder (1.2 g/40 g) or came premixed from the factory (1 g/40 g). Packages of beads were gas-sterilized and stored at room temperature. Beads were tested at 0, 1, 2, 3, 6, and 12 months. Antibiotic levels in the eluent from each day of the month were measured. We were unable to detect any difference in the amount of antibiotic elution between beads tested immediately after manufacture and beads manufactured and stored for 6 or 12 months. Beads with hand-mixed antibiotics eluted higher levels of antibiotics than the beads prepared with factory-mixed antibiotics. We conclude antibiotic beads can be made, sterilized, and used after 1 year of storage with no deleterious effect on antibiotic elution characteristics.

  18. Impact of APOE4-CSF Aβ interaction on hippocampal volume loss over 1 year in MCI

    PubMed Central

    Chiang, G.C.; Insel, P.S.; Tosun, D.; Schuff, N.; Truran-Sacrey, D.; Raptentsetsang, S.T.; Thompson, P.M.; Reiman, E.M.; Jack, C.R.; Fox, N.C.; Jagust, W.J.; Harvey, D.J.; Beckett, L.A.; Gamst, A.; Aisen, P.S.; Petersen, R.C.; Weiner, M.W.

    2011-01-01

    Background The majority of studies relating amyloid pathology with brain volumes have been cross-sectional. Apolipoprotein E4 (APOE4), a genetic risk factor for Alzheimer’s disease (AD), is also associated with hippocampal volume loss. No studies have considered the effects of amyloid pathology and APOE4 together on longitudinal volume loss. Methods We evaluated whether an abnormal level of cerebrospinal fluid beta-amyloid (CSF Aβ) and APOE4 carrier status were independently associated with greater hippocampal volume loss over 1 year. We then assessed whether APOE4 status and CSF Aβ acted synergistically, testing the significance of an interaction term in the regression analysis. We included 297 participants: 77 cognitively normal (NC), 144 with mild cognitive impairment (MCI), and 76 with AD. Results An abnormal CSF Aβ level was found to be associated with greater hippocampal volume loss over 1 year in each group. APOE4 was associated with hippocampal volume loss only in the NC and MCI groups. APOE4 carriers with abnormal CSF Aβ in the MCI group acted synergistically to produce disproportionately greater volume loss than noncarriers. Conclusion Baseline CSF Aβ predicts progression of hippocampal volume loss. APOE4 carrier status amplifies the degree of neurodegeneration in MCI. Understanding the effect of interactions between genetic risk and amyloid pathology will be important in clinical trials and our understanding of the disease process. PMID:21889115

  19. Cognitive Predictors of Academic Achievement in Young Children 1 Year Following Traumatic Brain Injury

    PubMed Central

    Fulton, John B.; Yeates, Keith Owen; Taylor, H. Gerry; Walz, Nicolay C.; Wade, Shari L.

    2012-01-01

    Objective To examine cognitive predictors of academic achievement in young children with traumatic brain injury (TBI) and orthopedic injury (OI) shortly after injury and 1 year post-injury. Methods Participants included 3 to 6 year old children, 63 with TBI (46 with moderate TBI and 17 with severe TBI) and a comparison group of 80 children with OI. Academic achievement was assessed approximately 1 month and 12 months post injury, using three subtests from the Woodcock-Johnson Tests of Achievement-Third Edition and the School Readiness Composite from the Bracken Basic Concepts Scale-Revised. General intellectual functioning, memory, and executive functions were measured at the initial assessment using standardized tests. Results Hierarchical linear regression was used to predict academic achievement at the initial and 1-year follow-up assessments. Memory and executive functions were significant predictors of academic achievement at both assessments, after controlling for group membership and demographic variables. Executive function remained a significant predictor of some outcomes after taking general intellectual functioning into account. Predictive relationships did not vary across the TBI and OI groups. Similar results were obtained when regression analyses were completed with only TBI participants using the Glasgow Coma Scale (GCS) score as a predictor, although memory and executive functioning were somewhat less robust in predicting academic achievement than before. Conclusions Both memory and executive function predict academic achievement following TBI in preschool children, although some of the associations may be accounted for by general intellectual functioning. PMID:22563873

  20. Cumulative head impact burden in high school football.

    PubMed

    Broglio, Steven P; Eckner, James T; Martini, Douglas; Sosnoff, Jacob J; Kutcher, Jeffrey S; Randolph, Christopher

    2011-10-01

    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/sec(2) 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.

  1. 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

  2. Cumulate inclusions from K-rich magmas, Roccamonfina volcano, Italy

    NASA Astrophysics Data System (ADS)

    Giannetti, Bernardino

    1982-02-01

    Over 200 plutonic xenoliths have been collected from the pyroclastic deposits of Roccamonfina volcano. Twenty-nine representative specimens have been analyzed for major and trace elements, and the main mineral phases probed in 20 of these. The nodules belong to two cumulate fractionation series: a pyroxenite-gabbro- anorthosite-monzonite syenite-foidal syenite series, and an olivine pyroxenite- phlogopite pyroxenite series. The various nodule types are not simply related to the stratigraphic position of their host pyroclastics. Olivine, clinopyroxene, plagioclase, mica (biotite and phlogopite), K-feldspar, magnetite, apatite and sphene, occurring in various proportions and textures, represent the cumulus minerals. Amphibole appears as a secondary product pseudomorphing pyroxene and biotite. Intercumulus nepheline, sodalite-haüyne, garnet and cancrinite(?) appear in foidal syenites, Modal and chemical relations suggest that pyroxenites, gabbros, monzonites, syenites and foidal syenites correspond to accumulative material from Stage I (High-K Series) lavas with respective phenocryst associations cpx ± trace ol, cpx + pl ± trace ol, cpx + pl + trace K-spar, K-spar + cpx + pl and K-spar+ cpx +pl + sod. The olivine pyroxenites and a single phlogopite pyroxenite specimen appear to be related to Stage II (K Series) ol+cpx+pl-bearing quartz-normative trachybasahs. The inferred genetic connections, however, are only partially supported by comparison of phenocryst and cumulus mineral compositions. The discrepancies may reflect: (1) disequilibrium of nodule and individual lava mineral assemblages due to the contrary motion of different crystal species during fractionation, (2) mixing in minor fractionation chambers of crystalline material (nodule) and magmatic fluids during the eruption of the main magmatic system, (3) lower equilibration temperature and higher equilibration pressures of the nodules relative to cogenetic lavas, and (4) nodule fractionation from separate

  3. 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.

  4. 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.

  5. 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.

  6. 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

  7. 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.

  8. Patient-centeredness and quality management in Dutch diabetes care organizations after a 1-year intervention

    PubMed Central

    Campmans-Kuijpers, Marjo JE; Lemmens, Lidwien C; Baan, Caroline A; Rutten, Guy EHM

    2016-01-01

    Background More focus on patient-centeredness in care for patients with type 2 diabetes requests increasing attention to diabetes quality management processes on patient-centeredness by managers in primary care groups and outpatient clinics. Although patient-centered care is ultimately determined by the quality of interactions between patients and clinicians at the practice level, it should be facilitated at organizational level too. This nationwide study aimed to assess the state of diabetes quality management on patient-centeredness at organizational level and its possibilities to improve after a tailored intervention. Methods This before–after study compares the quality management on patient-centeredness within Dutch diabetes care groups and outpatient clinics before and after a 1-year stepwise intervention. At baseline, managers of 51 diabetes primary care groups and 28 outpatient diabetes clinics completed a questionnaire about the organization’s quality management program. Patient-centeredness (0%–100%) was operationalized in six subdomains: facilitating self-management support, individualized care plan support, patients’ access to medical files, patient education policy, safeguarding patients’ interests, and formal patient involvement. The intervention consisted of feedback and benchmark and if requested a telephone call and/or a consultancy visit. After 1 year, the managers completed the questionnaire again. The 1-year changes were examined by dependent (non) parametric tests. Results Care groups improved significantly on patient-centeredness (from 47.1% to 53.3%; P=0.002), and on its subdomains “access to medical files” (from 42.0% to 49.4%), and “safeguarding patients’ interests” (from 58.1% to 66.2%). Outpatient clinics, which scored higher at baseline (66.7%) than care groups, did not improve on patient-centeredness (65.6%: P=0.54) or its subdomains. “Formal patient involvement” remained low in both care groups (23.2%) and

  9. Body mass index and incident coronary heart disease in women: a population-based prospective study

    PubMed Central

    2013-01-01

    Background A high body mass index (BMI) is associated with an increased risk of mortality from coronary heart disease (CHD); however, a low BMI may also be associated with an increased mortality risk. There is limited information on the relation of incident CHD risk across a wide range of BMI, particularly in women. We examined the relation between BMI and incident CHD overall and across different risk factors of the disease in the Million Women Study. Methods 1.2 million women (mean age = 56 years) participants without heart disease, stroke, or cancer (except non-melanoma skin cancer) at baseline (1996 to 2001) were followed prospectively for 9 years on average. Adjusted relative risks and 20-year cumulative incidence from age 55 to 74 years were calculated for CHD using Cox regression. Results After excluding the first 4 years of follow-up, we found that 32,465 women had a first coronary event (hospitalization or death) during follow-up. The adjusted relative risk for incident CHD per 5 kg/m2 increase in BMI was 1.23 (95% confidence interval (CI) 1.22 to 1.25). The cumulative incidence of CHD from age 55 to 74 years increased progressively with BMI, from 1 in 11 (95% CI 1 in10 to 12) for BMI of 20 kg/m2, to 1 in 6(95% CI 1 in 5 to 7) for BMI of 34 kg/m2. A 10 kg/m2 increase in BMI conferred a similar risk to a 5-year increment in chronological age. The 20 year cumulative incidence increased with BMI in smokers and non-smokers, alcohol drinkers and non-drinkers, physically active and inactive, and in the upper and lower socioeconomic classes. In contrast to incident disease, the relation between BMI and CHD mortality (n = 2,431) was J-shaped. For the less than 20 kg/m2 and ≥35 kg/m2 BMI categories, the respective relative risks were 1.27 (95% CI 1.06 to 1.53) and 2.84 (95% CI 2.51 to 3.21) for CHD deaths, and 0.89 (95% CI 0.83 to 0.94) and 1.85 (95% CI 1.78 to 1.92) for incident CHD. Conclusions CHD incidence in women increases progressively with BMI, an

  10. 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…

  11. 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...

  12. 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...

  13. 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…

  14. 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…

  15. Origin of path independence between cumulative CO2 emissions and global warming

    NASA Astrophysics Data System (ADS)

    Seshadri, Ashwin K.

    2017-02-01

    Observations and GCMs exhibit approximate proportionality between cumulative carbon dioxide (CO2 ) emissions and global warming. Here we identify sufficient conditions for the relationship between cumulative CO2 emissions and global warming to be independent of the path of CO2 emissions; referred to as "path independence". Our starting point is a closed form expression for global warming in a two-box energy balance model (EBM), which depends explicitly on cumulative emissions, airborne fraction and time. Path independence requires that this function can be approximated as depending on cumulative emissions alone. We show that path independence arises from weak constraints, occurring if the timescale for changes in cumulative emissions (equal to ratio between cumulative emissions and emissions rate) is small compared to the timescale for changes in airborne fraction (which depends on CO2 uptake), and also small relative to a derived climate model parameter called the damping-timescale, which is related to the rate at which deep-ocean warming affects global warming. Effects of uncertainties in the climate model and carbon cycle are examined. Large deep-ocean heat capacity in the Earth system is not necessary for path independence, which appears resilient to climate modeling uncertainties. However long time-constants in the Earth system carbon cycle are essential, ensuring that airborne fraction changes slowly with timescale much longer than the timescale for changes in cumulative emissions. Therefore path independence between cumulative emissions and warming cannot arise for short-lived greenhouse gases.

  16. 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…

  17. 40 CFR 91.508 - Cumulative Sum (CumSum) procedure.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 21 2013-07-01 2013-07-01 false Cumulative Sum (CumSum) procedure. 91.508 Section 91.508 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... Program § 91.508 Cumulative Sum (CumSum) procedure. (a) Manufacturers must construct the following...

  18. 40 CFR 91.508 - Cumulative Sum (CumSum) procedure.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 21 2012-07-01 2012-07-01 false Cumulative Sum (CumSum) procedure. 91.508 Section 91.508 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... Program § 91.508 Cumulative Sum (CumSum) procedure. (a) Manufacturers must construct the following...

  19. 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…

  20. 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…

  1. 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…

  2. 14 CFR Section 18 - Objective Classification-Cumulative Effect of Changes in Accounting Principles

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... of Changes in Accounting Principles Section 18 Section 18 Aeronautics and Space OFFICE OF THE... Objective Classification—Cumulative Effect of Changes in Accounting Principles 98Cumulative Effect of Changes in Accounting Principles. Record here the difference between the amount of retained earnings...

  3. 43 CFR 46.115 - Consideration of past actions in the analysis of cumulative effects.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Environmental Quality § 46.115 Consideration of past actions in the analysis of cumulative effects. When... Memorandum on Consideration of Past Actions in Cumulative Effects Analysis” dated June 24, 2005, or any... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Consideration of past actions in...

  4. 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...

  5. The Relationship between Frontal Lobe Lesions, Course of Post-Stroke Depression, and 1-year Prognosis in Patients with First-Ever Ischemic Stroke

    PubMed Central

    Shi, Yu-Zhi; Xiang, Yu-Tao; Wu, Shuo-Lin; Zhang, Ning; Zhou, Juan; Bai, Ying; Wang, Shuo; Wang, Yi-Long; Zhao, Xing-Quan; Ungvari, Gabor S.; Chiu, Helen F. K.; Wang, Yong-Jun; Wang, Chun-Xue

    2014-01-01

    Background and Purpose Most studies on post-stroke depression (PSD) have focused on a certain time point after stroke instead of the time course of PSD. The aim of this study was to determine the relationship between frontal lobe lesions, course of PSD over a year following the stroke onset, and the 1-year prognosis in patients with first-ever ischemic stroke. Methods A total of 1067 patients from the prospective cohort study on the incidence and outcome of patients with post stroke depression in China who were diagnosed with first-ever ischemic stroke and attended 4 follow-up visits at 14±2 days, 3 months, 6 months, and 1 year after stroke onset, were enrolled in the study. PSD was diagnosed according to DSM-IV. The course of PSD was divided into the following two categories: persistent/recurrent depression and no/transient depression. Patients with any ischemic lesion responsible for the indexed stroke event located in the frontal lobe were defined as patients with frontal lobe lesions. Modified Rankin Scale (mRS) ≥2 at 1-year was considered to be poor prognosis. Results There were 109 patients with and 958 patients without frontal lobe lesions that formed the frontal lobe (FL) and no-frontal lobe (NFL) groups, respectively. After adjusting for confounding variables, frontal lobe lesion was significantly associated with persistent/recurrent PSD (OR 2.025, 95%CI 1.039–3.949). Overall, 32.7% of patients in the FL group had poor prognosis at 1- year compared with 22.7% in the NFL group (P = 0.021). Compared with no/transient depression, persistent/recurrent depression was found to be an independent predictor of poor prognosis at 1-year both in FL and NFL groups. Conclusions Long-term and periodical screening, evaluation and treatment are needed for PSD after the onset of ischemic stroke, particularly for patients with frontal lobe infarction. PMID:25003990

  6. Diversion Alert: 1-Year Evaluation Across Northern New England, 2013–2014

    PubMed Central

    Desrosiers, Clare

    2016-01-01

    This report describes Diversion Alert, a unique online tool aimed at reducing misuse and diversion of prescription drugs, and reports the results of a 1-year evaluation of Diversion Alert’s impact in Maine. We used a quasi-experimental research design to compare survey data in Maine with those of neighboring states (New Hampshire and Vermont, 2013 and 2014). Compared with their counterparts in New Hampshire and Vermont who did not use Diversion Alert, prescribers and pharmacists in Maine who used Diversion Alert increased their communication with patients and other providers involved in their patients’ care, became aware of patients arrested for prescription drugs possession or diversion, used best practices associated with prevention or detection of addiction and diversion more frequently, and attributed positive changes in their prescribing practices to Diversion Alert. In combination with other state and federal programs, Diversion Alert may be an effective tool to help prevent the misuse of opioid medications. PMID:27880633

  7. 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.

  8. Shock-wave therapy for tennis and golfer's elbow--1 year follow-up.

    PubMed

    Krischek, O; Hopf, C; Nafe, B; Rompe, J D

    1999-01-01

    Thirty patients with chronic medial epicondylitis were treated with low-energy shock waves. They received 500 impulses of 0.08 mJ/mm2 three times at weekly intervals. At 1 year follow-up examinations were performed. According to the Verhaar criteria, only seven patients reached excellent or good results. In eight cases a fair outcome was recorded, and in 14 patients the outcome was poor. Only six patients were satisfied with the treatment. The average relief of pain was 32%. These data were significantly worse than for identically treated patients with chronic tennis elbow. Thus, the question arises as to whether extracorporal shock-wave therapy is indicated in medial epicondylitis.

  9. Transverse momentum dependence of spectra of cumulative particles produced from droplets of dense nuclear matter

    SciTech Connect

    Vechernin, Vladimir

    2016-01-22

    The transverse momentum dependence of the yields of particles produced from the clusters of dense cold nuclear matter in nuclei is calculated in the approach based on perturbative QCD calculations of the corresponding quark diagrams near the thresholds. It is shown that the transverse momentum dependence of the pion and proton spectra at different values of the Feynman variable x in the cumulative region, x > 1, can be described by the only parameter - the constituent quark mass, taken to be equal 300 MeV. It is found that the cumulative protons are formed predominantly via a coherent coalescence of three fast cluster quarks, whereas the production of cumulative pions is dominated by one fast cluster quark hadronization. This enabled to explain the experimentally observed more slow increase of the mean transverse momentum of cumulative protons with the increase of the cumulative variable x, compared to pions.

  10. Sustained sympathetic and blood pressure reduction 1 year after renal denervation in patients with resistant hypertension.

    PubMed

    Hering, Dagmara; Marusic, Petra; Walton, Antony S; Lambert, Elisabeth A; Krum, Henry; Narkiewicz, Krzysztof; Lambert, Gavin W; Esler, Murray D; Schlaich, Markus P

    2014-07-01

    Renal denervation (RDN) reduces muscle sympathetic nerve activity (MSNA) and blood pressure (BP) in resistant hypertension. Although a persistent BP-lowering effect has been demonstrated, the long-term effect on MSNA remains elusive. We investigated whether RDN influences MSNA over time. Office BP and MSNA were obtained at baseline, 3, 6, and 12 months after RDN in 35 patients with resistant hypertension. Office BP averaged 166±22/88±19 mm Hg, despite the use of an average of 4.8±2.1 antihypertensive drugs. Baseline MSNA was 51±11 bursts/min ≈2- to 3-fold higher than the level observed in healthy controls. Mean office systolic and diastolic BP significantly decreased by -12.6±18.3/-6.5±9.2, -16.1±25.6/-8.6±12.9, and -21.2±29.1/-11.1±12.9 mm Hg (P<0.001 for both systolic BP and diastolic BP) with RDN at 3-, 6-, and 12-month follow-up, respectively. MSNA was reduced by -8±12, -6±12, and -6±11 bursts/min (P<0.01) at 3-, 6-, and 12-month follow-up. The reduction in MSNA was maintained, despite a progressive fall in BP over time. No such changes were observed in 7 control subjects at 6-month follow-up. These findings confirm previous reports on the favorable effects of RDN on elevated BP and demonstrate sustained reduction of central sympathetic outflow ≤1-year follow-up in patients with resistant hypertension and high baseline MSNA. These observations are compatible with the hypothesis of a substantial contribution of afferent renal nerve signaling to increased BP in resistant hypertension and argue against a relevant reinnervation at 1 year after procedure.

  11. Minimally invasive facet restoration implant for chronic lumbar zygapophysial pain: 1-year outcomes

    PubMed Central

    2014-01-01

    Background The zygapophysial (facet) joint is the primary pain generator in one third of chronic low back pain cases. Current treatment options include temporarily palliative nonsurgical approaches, facet injections, radiofrequency denervation, and, rarely, lumbar arthrodesis. The purpose of this study was to assess the safety and effectiveness of a minimally invasive implant intended to restore facet joint function in patients with chronic lumbar facetogenic pain. Methods This prospective, multi-center feasibility study enrolled patients with confirmed lumbar facetogenic joint pain at 1 or 2 levels who underwent at least 6 months of unsuccessful nonoperative care. Patients received a minimally invasive implant (Glyder® Facet Restoration Device, Zyga Technology, Inc., Minnetonka, MN) intended to restore facet joint function while preserving the native anatomy. Main outcomes included back pain severity using a visual analogue scale, back-specific disability using the Oswestry Disability Index (ODI), and adverse events adjudicated by an independent Clinical Events Committee. Results Of 40 enrolled patients, 37 patients received the facet restoration implant and 34 patients had complete 1-year follow-up data available. Over the 1-year follow-up period, back pain severity decreased 41% and ODI decreased 34%, on average. Freedom from a device- or procedure-related serious adverse event through 1 year was 84%. Implant migration was observed in 3 patients and implant expulsion from the facet joint occurred in 3 patients. In total, 2 (5.4%) patients underwent implant removal through 1 year post-treatment. Conclusions A minimally invasive facet restoration implant is a promising treatment option in select patients with chronic lumbar zygapophysial pain who have exhausted nonsurgical treatments, with therapeutic benefit persisting at 1 year follow-up. PMID:26628910

  12. 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.

  13. Identifying groups at risk for 1-year membership termination from a fitness center at enrollment.

    PubMed

    Hooker, Stephanie A; Ross, Kaile M; Ranby, Krista W; Masters, Kevin S; Peters, John C; Hill, James O

    2016-12-01

    The vast majority of Americans do not engage in adequate regular physical activity despite its well-known health benefits. Even when individuals attempt to become more active by joining a fitness center, estimates suggest that nearly half terminate their membership within the first 6 months. A better understanding of who is at risk for early membership termination upon joining may help researchers develop targeted interventions to improve the likelihood that individuals will successfully maintain memberships and physical activity. This study's purpose was to identify, based on a wellness assessment (WA) used in fitness centers, individuals at risk for fitness membership termination prior to 1-year. Center members (N = 441; Mage = 41.9, SD = 13.1; 74.4% female) completed a comprehensive WA of stress, life satisfaction, physical fitness, metabolic health, and sleep quality at the beginning of their memberships and were followed for one year. Latent class analyses utilized the WA to identify four groups: (a) healthy, (b) unhealthy, (c) poor psychological wellness, and (d) poor physical wellness. Participants in the poor psychological wellness group (OR = 2.24, p = 0.007) and the unhealthy group (OR = 2.40, p = 0.037) were significantly more likely to terminate their memberships at 1-year as compared to the healthy group. Participants with poor physical wellness visited the fitness center less frequently than healthy participants (p < 0.01). Results suggest that poor psychological wellness is a risk factor for terminating memberships, whereas poor physical wellness is not. Future studies should replicate these latent classes and develop targeted interventions to address psychological wellness as a method to improve fitness membership retention.

  14. 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

  15. Evaluation of orthodontic treatment after 1 year of retention--a randomized controlled trial.

    PubMed

    Edman Tynelius, G; Bondemark, L; Lilja-Karlander, E

    2010-10-01

    The aim of this study was to use a randomized controlled trial methodology to evaluate and compare three different retention methods. The capacity of the retention methods to retain orthodontic treatment results was in this first phase analysed on a short-term basis, i.e. after 1 year of retention. The subjects were recruited from adolescents undergoing fixed appliance treatment at an orthodontic clinic in the National Health Service (NHS) in Sweden between 2001 and 2007. Seventy-five patients (45 girls and 30 boys with a mean age of 14.4 years at the start of retention) were randomized into three retention systems; a vacuum-formed retainer in the maxilla and bonded canine-to-canine retainer in the mandible (group V-CTC), a vacuum-formed retainer in the maxilla combined with stripping of the 10 proximal surfaces of the lower mandibular anterior teeth (group V-S), and a prefabricated positioner covering the teeth in the maxilla and mandible (group P). The main outcome measures were: Little's irregularity index (LII), intercanine and intermolar width, arch length, overjet, and overbite. Registrations were made before orthodontic treatment, when the fixed orthodontic appliance was removed, and after 12 months in retention. Differences in means between groups were tested by one-way analysis of variance. After 1 year of retention, no clinically significant difference in retention capacity was found between the three retention methods. Small but significant differences (P < 0.05) were observed between the V-CTC and V-S groups regarding mandibular canine width, mandibular arch length, and overbite. In group P, two patients failed to co-operate.

  16. SEX WORK AND HIV INCIDENCE AMONG PEOPLE WHO INJECT DRUGS

    PubMed Central

    Kerr, Thomas; Shannon, Kate; Ti, Lianping; Strathdee, Steffanie; Hayashi, Kanna; Nguyen, Paul; Montaner, Julio; Wood, Evan

    2016-01-01

    Objective Although the global burden of HIV infection among sex workers (SW) has been well recognized, HIV-related risks among sex workers who inject drugs (SW-IDU) have received less attention. We investigated the relationship between sex work and HIV incidence among people who inject drugs (IDU) in a Canadian setting. Design Prospective cohort study. Methods Using Kaplan–Meier methods and the extended Cox regression, we compared HIV incidence among SW-IDU and non-SW-IDU in Vancouver, Canada, after adjusting for potential confounders. Results Between 1996 and 2012, 1647 participants were included in the study, including 512 (31.1%) IDU engaged in sex work. At 5 years the HIV cumulative incidence was higher among SW-IDU in comparison to other IDU (12 vs. 7%, P = 0.001). In unadjusted Cox regression analyses, HIV incidence among SW-IDU was also elevated [relative hazard: 1.69; 95% confidence interval (CI): 1.13–2.53]. However, in a multivariable analysis, sex work did not remain associated with HIV infection (adjusted relative hazard: 0.74; 95% CI: 0.45–1.20), with cocaine injection appearing to account for the elevated risk for HIV infection among SW-IDU. Conclusion These data suggest that local SW-IDU have elevated rates of HIV infection. However, our exploration of risk factors among SW-IDU demonstrated that drug use patterns and environmental factors, rather than sexual risks, may explain the elevated HIV incidence among SW-IDU locally. Our findings highlight the need for social and structural interventions, including increased access to harm reduction programs and addiction treatment. PMID:26558725

  17. Increased Incidence of Atrial Fibrillation in Patients with Rheumatoid Arthritis

    PubMed Central

    Crowson, Cynthia S.; Roger, Véronique L.; Gabriel, Sherine E.; Matteson, Eric L.

    2015-01-01

    Objective. To investigate the incidence of atrial fibrillation (AF) among patients with rheumatoid arthritis (RA) compared to the general population. Methods. A population-based inception cohort of Olmsted County, Minnesota, residents with incident RA in 1980–2007 and a cohort of non-RA subjects from the same population base were assembled and followed until 12/31/2008. The occurrence of AF was ascertained by medical record review. Results. The study included 813 patients with RA and 813 non-RA subjects (mean age 55.9 (SD:15.7) years, 68% women in both cohorts). The prevalence of AF was similar in the RA and non-RA cohorts at RA incidence/index date (4% versus 3%; P = 0.51). The cumulative incidence of AF during follow-up was higher among patients with RA compared to non-RA subjects (18.3% versus 16.3% at 20 years; P = 0.048). This difference persisted after adjustment for age, sex, calendar year, smoking, and hypertension (hazard ratio: 1.46; 95% CI: 1.07, 2.00). There was no evidence of a differential impact of AF on mortality in patients with RA compared to non-RA subjects (hazard ratio 2.5 versus 2.8; interaction P = 0.31). Conclusion. The incidence of AF is increased in patients with RA, even after adjustment for AF risk factors. AF related mortality risk did not differ between patients with and without RA. PMID:25815336

  18. 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.

  19. Perioperative Hypothermia: Incidence and Prevention

    DTIC Science & Technology

    1990-01-01

    1990 Thesis/" Perioperative Hypothermia: Incidence and Prevention CRodney L. Fisher AFIT Student at: Columbia University AFIT/CI/CIA 90-120 AFT/I/I...Civilian Institution Programs DTIC CTELECTE 0 36 UNCLASSIFIFD 4 PERIOPERATIVE HYPOTHERMIA: INCIDENCE AND PREVENTION By Rodney L. Fisher, CAPT., USAF...Availability Codes Avall and/or Dit Special ABSTRACT Perioperative thermal regulation is discussed. A retrospective audit was conducted to identify the

  20. 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

  1. 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

  2. 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

  3. Effects of lifestyle intervention and meal replacement on glycaemic and body-weight control in Chinese subjects with impaired glucose regulation: a 1-year randomised controlled trial.

    PubMed

    Xu, Dan-Feng; Sun, Jian-Qin; Chen, Min; Chen, Yan-Qiu; Xie, Hua; Sun, Wei-Jia; Lin, Yi-Fan; Jiang, Jing-Jing; Sun, Wei; Chen, Ai-Fang; Tang, Qian-Ru

    2013-02-14

    The purpose of the present study was to evaluate the impact of a lifestyle intervention programme, combined with a daily low-glycaemic index meal replacement, on body-weight and glycaemic control in subjects with impaired glucose regulation (IGR). Subjects with IGR were randomly assigned to an intervention group (n 46) and a control group (n 42). Both groups received health counselling at baseline. The intervention group also received a daily meal replacement and intensive lifestyle intervention to promote healthy eating habits during the first 3 months of the study, and follow-up visits performed monthly until the end of the 1-year study. Outcome measurements included changes in plasma glucose, glycated Hb (HbA1c), plasma lipids, body weight, blood pressure and body composition (such as body fat mass and visceral fat area). The results showed that body-weight loss after 1 year was significant in the intervention group compared with the control group (-1·8 (SEM 0·35) v. -0·6 (SEM 0·40) 2·5 kg, P<0·05). The 2 h plasma glucose concentration decreased 1·24 mmol/l in the intervention group and increased 0·85 mmol/l in the control group (P<0·05) compared with their baseline, respectively. A 5 kg body-weight loss at 1 year was associated with a decrease of 1·49 mmol/l in 2 h plasma glucose (P<0·01). The incidence of normal glucose regulation (NGR) in the two groups was significantly different (P=0·001). In conclusion, the combination of regular contact, lifestyle advice and meal replacement is beneficial in promoting IGR to NGR.

  4. 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

  5. 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"…

  6. Cost-Effectiveness of Coal Workers' Pneumoconiosis Prevention Based on Its Predicted Incidence within the Datong Coal Mine Group in China.

    PubMed

    Shen, Fuhai; Liu, Hongbo; 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.

  7. 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

  8. True rise in anaphylaxis incidence

    PubMed Central

    Yang, Min-Suk; Kim, Ju-Young; Kim, Byung-Keun; Park, Heung-Woo; Cho, Sang-Heon; Min, Kyung-Up; Kang, Hye-Ryun

    2017-01-01

    Abstract The incidence trend of anaphylaxis in Asia is not well investigated. The aim of this study is to estimate the entire population-based incidence of anaphylaxis in Korea using a nationwide administrative database. Data over a 7-year period (2008–2014) was obtained from the Korean National Health Insurance (NHI) claims database which covers 97.9% of the entire Korean population. Using diagnosis codes from the International Classification of Diseases-10 for anaphylaxis (T78.0, T78.2, T80.5, and T88.6), we identified the annual number of patients who had visited any hospital with a primary diagnosis of anaphylaxis. Incidence rates were calculated using the population distribution data of all NHI beneficiaries. The incidence of anaphylaxis in Korea was 32.19 episodes per 100,000 person-years in 2014, which nearly doubled from 2008 (16.02 episodes per 100,000 person-years). The incidence of anaphylaxis increased continuously throughout these years regardless of gender and age groups (P for trend < 0.001). Female was significantly less predisposed than male (adjusted odds ratio [OR], 0.69; 95% confident interval [CI], 0.66–0.72; P < 0.001). The incidence was the lowest in 0 to 19 age group and the highest in 40 to 69 age group (adjusted OR, 2.41; 95% CI, 2.29–2.54; P < 0.001). In conclusion, we report the increasing time trend of anaphylaxis incidence rates using nationwide claims database for the first time in Asia. PMID:28151851

  9. Experience with cinacalcet in primary hyperparathyroidism: results after 1 year of treatment

    PubMed Central

    García-Martín, Antonia; Luque-Pazos, Alessandra

    2013-01-01

    Objectives: To assess the characteristics of patients with primary hyperparathyroidism (PHPT) treated with cinacalcet and to evaluate its efficacy in reducing serum calcium and parathyroid hormone (PTH) concentrations after 1 year of treatment. Methods: The study included 20 patients with PHPT who had completed at least 12 months of treatment with cinacalcet (eight patients for refusal of parathyroidectomy, three for surgery not possible due to comorbidities and nine for progressive hypercalcemia prior to surgery). We recorded clinical and biochemical data at baseline, and after 3, 6 and 12 months of treatment. We also monitored adverse events. Cinacalcet was administered in increasing doses until normal serum calcium was reached or side effects preventing a further increase occurred. Results: After 3 months of treatment, serum calcium significantly decreased (11.73 ± 0.85 versus 10.71 ± 1.63 mg/dl, p < 0.001) and serum phosphorus significantly increased (2.41 ± 0.48 versus 2.63 ± 0.70 mg/dl, p = 0.004) while no significant change occurred in PTH (181.91 ± 102.37 versus 195.47 ± 111.71 pg/ml, p = 0.695). No further variation was observed after 6 months compared with 3 months of follow up. However, after 12 months of treatment, there was a significant decrease in PTH concentrations compared with baseline (181.91 ± 102.37 versus 152.47± 70.16 pg/ml, p = 0.028) as well as serum calcium (11.73 ± 0.85 versus 10.20± 0.95 mg/dl, p < 0.001); serum phosphorus significantly increased (2.41 ± 0.48 versus 2.71 ± 0.43 mg/dl, p = 0.01). Normocalcemia (S-Ca < 10.2 mg/dl) was achieved in 55% of patients. The medication was usually well tolerated (83.4%). Most common adverse events were nausea and vomiting, especially at the beginning of therapy. Conclusion: Cinacalcet rapidly reduced serum calcium in patients with PHPT and this reduction remained stable after 1 year of treatment. We also observed a decrease in PTH. Cinacalcet is an effective alternative in nonsurgical

  10. The cumulative semantic cost does not reflect lexical selection by competition☆

    PubMed Central

    Navarrete, Eduardo; Mahon, Bradford Z.; Caramazza, Alfonso

    2010-01-01

    The cumulative semantic cost describes a phenomenon in which picture naming latencies increase monotonically with each additional within-category item that is named in a sequence of pictures. Here we test whether the cumulative semantic cost requires the assumption of lexical selection by competition. In Experiment 1 participants named a sequence of pictures, while in Experiment 2 participants named words instead of pictures, preceded by a gender marked determiner. We replicate the basic cumulative semantic cost with pictures (Exp. 1) and show that there is no cumulative semantic cost for word targets (Exp. 2). This pattern was replicated in Experiment 3 in which pictures and words were named along with their gender marked definite determiner, and were intermingled within the same experimental design. In addition, Experiment 3 showed that while picture naming induces a cumulative semantic cost for subsequently named words, word naming does not induce a cumulative semantic cost for subsequently named pictures. These findings suggest that the cumulative semantic cost arises prior to lexical selection and that the effect arises due to incremental changes to the connection weights between semantic and lexical representations. PMID:20347062

  11. If Cumulative Risk Assessment Is the Answer, What Is the Question?

    PubMed Central

    Callahan, Michael A.; Sexton, Ken

    2007-01-01

    Cumulative risk refers to the combined threats from exposure via all relevant routes to multiple stressors including biological, chemical, physical, and psychosocial entities. Cumulative risk assessment is a tool for organizing and analyzing information to examine, characterize, and possibly quantify the combined adverse effects on human health or ecologic resources from multiple environmental stressors. The U.S. Environmental Protection Agency (EPA) has initiated a long-term effort to develop future guidelines for cumulative risk assessment, including publication in 2003 of a framework that describes important features of the process and discusses theoretical issues, technical matters, and key definitions. The framework divides the process of cumulative risk assessment into three interrelated phases: a) planning, scoping, and problem formulation; b) analysis; and c) interpretation and risk characterization. It also discusses the additional complexities introduced by attempts to analyze cumulative risks from multiple stressors and describes some of the theoretical approaches that can be used. The development of guidelines for cumulative risk assessment is an essential element in the transition of the U.S. EPA risk assessment methodology from a narrow focus on a single stressor, end point, source, pathway, and exposure route to a broader, more holistic approach involving analysis of combined effects of cumulative exposure to multiple stressors via all relevant sources, pathways, and routes. PMID:17520071

  12. Oil spill characterization in the hybrid polarity SAR domain using log-cumulants

    NASA Astrophysics Data System (ADS)

    Espeseth, Martine M.; Skrunes, Stine; Brekke, Camilla; Salberg, Arnt-Børre; Jones, Cathleen E.; Holt, Benjamin

    2016-10-01

    Log-cumulants have proven to be an interesting tool for evaluating the statistical properties of potential oil spills in polarimetric Synthetic Aperture Radar (SAR) data within the common horizontal (H) and vertical (V) polarization basis. The use of first, second, and third order sample log-cumulants has shown potential for evaluating the texture and the statistical distributions, as well as discriminating oil from look-alikes. Log-cumulants are cumulants derived in the log-domain and can be applied to both single-polarization and multipolarization SAR data. This study is the first to investigate the differences between hybrid-polarity (HP) and full-polarimetric (FP) modes based on the sample log-cumulants of various oil slicks and open water from nine Uninhabited Aerial Vehicle Synthetic Aperture Radar (UAVSAR) scenes acquired off the coast of Norway in 2015. The sample log-cumulants calculated from the HP intensities show similar statistical behavior to the FP ones, resulting in a similar interpretation of the sample log-cumulants from HP and FP. Approximately eight hours after release the sample log-cumulants representing emulsion slicks have become more similar to the open water compared to plant oil. We find that the sample log-cumulants of the various oil slicks and open water varies between the scenes and also between the slicks and open water. This might be due to changes in ocean and wind condition, the initial slick properties, and/or the difference in the weathering process of the oil slicks.

  13. 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.

  14. The first simultaneous kidney-adrenal gland-pancreas transplantation: outcome at 1 year.

    PubMed

    Vouillarmet, J; Buron, F; Houzard, C; Carlier, M C; Chauvet, C; Brunet, M; Thivolet, C; Morelon, E; Badet, L

    2013-07-01

    Adrenal insufficiency is a rare but life-threatening disease. Replacement therapy sometimes fails to prevent an acute adrenal crisis and most often does not lead to restoration of well-being. We report here the 1-year outcome of the first simultaneous kidney-adrenal gland-pancreas transplantation in a 33-year-old patient with type 1 diabetes and concomitant autoimmune adrenal insufficiency. En bloc left adrenal gland and kidney grafts were anastomosed on the left iliac vessels in normal vascular conditions and the pancreas graft was anastomosed on the right iliac vessels. The immunosuppressive regimen was not modified by the addition of the adrenal gland. We observed no additional morbidity due to the adrenal gland transplantation, as there were no surgical complications. One-year kidney and pancreas graft functions were satisfactory (estimated glomerular filtration rate: 55 mL/min/1.73 m(2) and HbA1c: 4.8%). The adrenal graft functioned well at 12 months with a normalization of cortisol and aldosterone baseline levels. Functional imaging at 3 months showed good uptake of [(123) I]-metaiodobenzylguanidine by the adrenal graft. Transplantation of the adrenal gland en bloc with the left kidney appears to be a good therapeutic option in patients with adrenal insufficiency awaiting kidney or kidney-pancreas transplantation.

  15. Neurophysiological findings in patients 1 year after snake bite induced neurotoxicity in Sri Lanka.

    PubMed

    Bell, D J; Wijegunasinghe, D; Samarakoon, S; Palipana, H; Gunasekera, S; de Silva, H A; Lalloo, D G; Ranawaka, U K; de Silva, H J

    2010-05-01

    Snake bite causes significant morbidity and mortality in Sri Lanka. Snake venoms contain neurotoxins that block neuromuscular junction transmission. Presynaptic neurotoxicity most commonly causes destruction of nerve terminals with recovery by regrowth, whilst postsynaptic neurotoxicity usually involves competition at the acetylcholine receptor. The aim of this study was to investigate whether there were long-term clinical or neurophysiological changes in snake bite survivors 1 year after their envenoming. Detailed neurophysiological tests and clinical examinations were performed on 26 snake bite victims who had presented with neurotoxicity 12 months previously, and their results were compared with controls recruited from the same communities. Significant differences were observed in some nerve conduction parameters in some snake bite victims compared with controls, predominantly in those thought to have elapid bites, including prolongation of sensory, motor and F-wave latencies and reduction of conduction velocities. There was no evidence of any residual deficits in neuromuscular junction transmission. These results suggest a possible demyelinating type polyneuropathy. None of the cases or controls had abnormalities on clinical examination. This is one of the few studies to report possible long-term neurological damage following systemic neurotoxicity after snake bite. The clinical significance of these neurophysiological abnormalities is uncertain and further studies are required to investigate whether the abnormalities persist and to see whether clinical consequences develop.

  16. 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.

  17. Latent transition models to study women's changing of dietary patterns from pregnancy to 1 year postpartum.

    PubMed

    Sotres-Alvarez, Daniela; Herring, Amy H; Siega-Riz, Anna-Maria

    2013-04-15

    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.

  18. Attenuated hypothalamic-pituitary-adrenal axis functioning predicts accelerated pubertal development in girls 1 year later.

    PubMed

    Saxbe, Darby E; Negriff, Sonya; Susman, Elizabeth J; Trickett, Penelope K

    2015-08-01

    Accelerated pubertal development has been linked to adverse early environments and may heighten subsequent mental and physical health risks. Hypothalamic-pituitary-adrenal axis functioning has been posited as a mechanism whereby stress may affect pubertal development, but the literature lacks prospective tests of this mechanism. The current study assessed 277 youth (M = 10.84 years, SD = 1.14), 138 boys and 139 girls, who reported on their pubertal development and underwent the Trier Social Stress Test for Children at baseline and returned to the laboratory approximately 1 year later (M = 1.12 years, range = 0.59-1.98 years). For girls, lower cortisol area under the curve (with respect to ground) at Time 1 predicted more advanced pubertal development at Time 2, controlling for Time 1 pubertal development. This association persisted after additional covariates including age, body mass index, race, and maltreatment history were introduced, and was driven by adrenal rather than gonadal development. Cortisol was not linked to boys' subsequent pubertal development, and no interaction by gender or by maltreatment appeared. These results suggest that attenuated cortisol, reported in other studies of children exposed to early adversity, may contribute to accelerated pubertal tempo in girls.

  19. 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.

  20. Results of 1 year of clinical experience with independent dose calculation software for VMAT fields

    PubMed Central

    Colodro, Juan Fernando Mata; Berna, Alfredo Serna; Puchades, Vicente Puchades; Amores, David Ramos; Baños, Miguel Alcaraz

    2014-01-01

    It is widely accepted that a redundant independent dose calculation (RIDC) must be included in any treatment planning verification procedure. Specifically, volumetric modulated arc therapy (VMAT) technique implies a comprehensive quality assurance (QA) program in which RIDC should be included. In this paper, the results obtained in 1 year of clinical experience are presented. Eclipse from Varian is the treatment planning system (TPS), here in use. RIDC were performed with the commercial software; Diamond® (PTW) which is capable of calculating VMAT fields. Once the plan is clinically accepted, it is exported via Digital Imaging and Communications in Medicine (DICOM) to RIDC, together with the body contour, and then a point dose calculation is performed, usually at the isocenter. A total of 459 plans were evaluated. The total average deviation was -0.3 ± 1.8% (one standard deviation (1SD)). For higher clearance the plans were grouped by location in: Prostate, pelvis, abdomen, chest, head and neck, brain, stereotactic radiosurgery, lung stereotactic body radiation therapy, and miscellaneous. The highest absolute deviation was -0.8 ± 1.5% corresponding to the prostate. A linear fit between doses calculated by RIDC and by TPS produced a correlation coefficient of 0.9991 and a slope of 1.0023. These results are very close to those obtained in the validation process. This agreement led us to consider this RIDC software as a valuable tool for QA in VMAT plans. PMID:25525309

  1. Results of 1 year of clinical experience with independent dose calculation software for VMAT fields.

    PubMed

    Colodro, Juan Fernando Mata; Berna, Alfredo Serna; Puchades, Vicente Puchades; Amores, David Ramos; Baños, Miguel Alcaraz

    2014-10-01

    It is widely accepted that a redundant independent dose calculation (RIDC) must be included in any treatment planning verification procedure. Specifically, volumetric modulated arc therapy (VMAT) technique implies a comprehensive quality assurance (QA) program in which RIDC should be included. In this paper, the results obtained in 1 year of clinical experience are presented. Eclipse from Varian is the treatment planning system (TPS), here in use. RIDC were performed with the commercial software; Diamond(®) (PTW) which is capable of calculating VMAT fields. Once the plan is clinically accepted, it is exported via Digital Imaging and Communications in Medicine (DICOM) to RIDC, together with the body contour, and then a point dose calculation is performed, usually at the isocenter. A total of 459 plans were evaluated. The total average deviation was -0.3 ± 1.8% (one standard deviation (1SD)). For higher clearance the plans were grouped by location in: Prostate, pelvis, abdomen, chest, head and neck, brain, stereotactic radiosurgery, lung stereotactic body radiation therapy, and miscellaneous. The highest absolute deviation was -0.8 ± 1.5% corresponding to the prostate. A linear fit between doses calculated by RIDC and by TPS produced a correlation coefficient of 0.9991 and a slope of 1.0023. These results are very close to those obtained in the validation process. This agreement led us to consider this RIDC software as a valuable tool for QA in VMAT plans.

  2. Efficacy and safety of tiotropium Respimat SMI in COPD in two 1-year randomized studies.

    PubMed

    Bateman, Eric; Singh, Dave; Smith, David; Disse, Bernd; Towse, Lesley; Massey, Dan; Blatchford, Jon; Pavia, Demetri; Hodder, Rick

    2010-08-09

    Two 1-year studies evaluated the long-term efficacy and safety of tiotropium 5 or 10 microg versus placebo, inhaled via the Respimat Soft Mist Inhaler (SMI). The two studies were combined and had 4 co-primary endpoints (trough FEV(1) response, Mahler Transition Dyspnea Index [TDI] and St George's Respiratory Questionnaire scores all at week 48, and COPD exacerbations per patient-year). A total of 1990 patients with COPD participated (mean FEV(1): 1.09 L). The mean trough FEV(1) response of tiotropium 5 or 10 microg relative to placebo was 127 or 150 mL, respectively (both P < 0.0001). The COPD exacerbation rate was significantly lower with tiotropium 5 microg (RR = 0.78; P = 0.002) and tiotropium 10 microg (RR = 0.73; P = 0.0008); the health-related quality of life and Mahler TDI co-primary endpoints were significantly improved with both doses (both P < 0.0001). Adverse events were generally balanced except anticholinergic class effects, which were more frequent with active treatment. Fatal events occurred in 2.4% (5 microg), 2.7% (10 microg), and 1.6% (placebo) of patients; these differences were not significant. Tiotropium Respimat SMI 5 microg demonstrated sustained improvements in patients with COPD relative to placebo and similar to the 10 microg dose but with a lower frequency of anticholinergic adverse events.

  3. Recovery of aphasia after stroke: a 1-year follow-up study.

    PubMed

    El Hachioui, Hanane; Lingsma, Hester F; van de Sandt-Koenderman, Mieke E; Dippel, Diederik W J; Koudstaal, Peter J; Visch-Brink, Evy G

    2013-01-01

    Semantics, phonology, and syntax are essential elements of aphasia diagnosis and treatment. Until now, these linguistic components have not been specifically addressed in follow-up studies of aphasia recovery after stroke. The aim of this observational prospective follow-up study was to investigate semantic, phonological, and syntactic recovery in aphasic stroke patients. In addition, we investigated the recovery of verbal communication and of aphasia severity. We assessed 147 aphasic patients at 1, 2, and 6 weeks, 3 and 6 months, and 1 year after stroke with the ScreeLing, a screening test for detecting deficits on the three main linguistic components, the aphasia severity rating scale (ASRS), a measure of verbal communication, and the Token test, a measure of aphasia severity. We investigated the differences in scores between the six time points with mixed models. Semantics and syntax improved up to 6 weeks (p < 0.001) after stroke, and phonology up to 3 months (p ≤ 0.001). ASRS improved up to 6 months (p < 0.05) and the Token test up to 3 months (p < 0.001). We conclude that in aphasia after stroke, various linguistic components have a different recovery pattern, with phonology showing the longest period of recovery that paralleled aphasia severity, as measured with the Token test. The improvement of verbal communication continues after the stabilization of the recovery of the linguistic components.

  4. 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.

  5. Ablation for atrial fibrillation during mitral valve surgery: 1-year results through continuous subcutaneous monitoring†

    PubMed Central

    Bogachev-Prokophiev, Alexandr; Zheleznev, Sergey; Romanov, Alexander; Pokushalov, Evgeny; Pivkin, Alexey; Corbucci, Giorgio; Karaskov, Alexander

    2012-01-01

    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

  6. 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.

  7. Assessing cumulative impacts to elk and mule deer in the Salmon River Basin, Idaho

    SciTech Connect

    O'Neil, T.A.; Witmer, G.W.

    1988-01-01

    In this paper, we illustrate the method, using the potential for cumulative impacts to elk and mule deer from multiple hydroelectric development in the Salmon River Basin of Idaho. We attempted to incorporate knowledge of elk and mule deer habitat needs into a paradigm to assess cumulative impacts and aid in the regulatory decision making process. Undoubtedly, other methods could be developed based on different needs or constraints, but we offer this technique as a means to further refine cumulative impact assessment. Our approach is divided into three phases: analysis, evaluation, and documentation. 36 refs., 2 figs., 3 tabs.

  8. Cumulative Measurement Errors for Dynamic Testing of Space Flight Hardware

    NASA Technical Reports Server (NTRS)

    Winnitoy, Susan

    2012-01-01

    measurements during hardware motion and contact. While performing dynamic testing of an active docking system, researchers found that the data from the motion platform, test hardware and two external measurement systems exhibited frame offsets and rotational errors. While the errors were relatively small when considering the motion scale overall, they substantially exceeded the individual accuracies for each component. After evaluating both the static and dynamic measurements, researchers found that the static measurements introduced significantly more error into the system than the dynamic measurements even though, in theory, the static measurement errors should be smaller than the dynamic. In several cases, the magnitude of the errors varied widely for the static measurements. Upon further investigation, researchers found the larger errors to be a consequence of hardware alignment issues, frame location and measurement technique whereas the smaller errors were dependent on the number of measurement points. This paper details and quantifies the individual and cumulative errors of the docking system and describes methods for reducing the overall measurement error. The overall quality of the dynamic docking tests for flight hardware verification was improved by implementing these error reductions.

  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. Cancer incidence in the workers cohort of textile manufacturing factory in Alytus, Lithuania.

    PubMed

    Kuzmickiene, Irena; Didziapetris, Remigijus; Stukonis, Mecys

    2004-02-01

    Altogether 14,650 workers employed at least for 1 year a the textile factory in Alytus, Lithuania, were included in the cohort and followed during the period from 1978 to 1997. The standardized incidence ratio (SIR) for men was 1.28. The incidence of esophagus cancer was significant higher (SIR 3.42). It increased only slightly for lung (SIR 1.35). In the women cohort, SIR was 1.05. However, there was a significant increase of the incidence of gallbladder cancer (SIR 3.19). Among textile-processing (spinning and weaving departments) women workers, we found elevated total cancer incidence (SIR 1.35), incidence of breast cancer (SIR 1.49), and cervical cancer (SIR 1.82). In this cohort increased SIR values were observed for more than 10 years since first exposure for all cancer (SIR 1.70) and cervical cancer (SIR 2.44).

  11. Cumulative Risk of Colon Cancer up to Age 70 Years by Risk Factor Status Using Data From the Nurses’ Health Study

    PubMed Central

    Colditz, Graham A.; Giovannucci, Edward L.; Fuchs, Charles S.; Rosner, Bernard A.

    2009-01-01

    The authors developed a comprehensive model of colon cancer incidence that allows for nonproportional hazards and accounts for the temporal nature of risk factors. They estimated relative risk based on cumulative incidence of colon cancer by age 70 years. Using multivariate, nonlinear Poisson regression, they determined colon cancer risk among 83,767 participants in the Nurses’ Health Study. The authors observed 701 cases of colon cancer between 1980 and June 1, 2004. There was increased risk for a positive family history of colon or rectal cancer (55%), 10 or more pack-years of cigarette smoking before age 30 years (16%), and tallness (67 inches (170 cm) vs. 61 inches (155 cm): 19%). Reduced risk was observed for current postmenopausal hormone use (−23%), being physically active (21 metabolic equivalent (MET)-hours/week vs. 2 MET-hours/week: −49%), taking aspirin (7 tablets/week vs. none: −29%), and being screened (−24%). Women who smoked, had a consistently high relative weight, had a low physical activity level, consumed red or processed meat daily, were never screened, and consumed low daily amounts of folate had almost a 4-fold higher cumulative risk of colon cancer by age 70 years. For women with a high risk factor profile, adopting a healthier lifestyle could dramatically reduce colon cancer risk. PMID:19723749

  12. FTY720 versus MMF with cyclosporine in de novo renal transplantation: a 1-year, randomized controlled trial in Europe and Australasia.

    PubMed

    Salvadori, M; Budde, K; Charpentier, B; Klempnauer, J; Nashan, B; Pallardo, L M; Eris, J; Schena, F P; Eisenberger, U; Rostaing, L; Hmissi, A; Aradhye, S

    2006-12-01

    FTY720 is a novel immunomodulator investigated in de novo renal transplantation and other therapeutic areas including multiple sclerosis. This 1-year multicenter, randomized, phase III study in 668 de novo renal transplant patients compared FTY720 2.5 mg plus full-dose cyclosporine (FDC) or FTY720 5.0 mg plus reduced-dose cyclosporine (RDC), with mycophenolate mofetil (MMF) plus FDC. The primary efficacy endpoint was the composite incidence of first treated biopsy-proven acute rejection (BPAR), graft loss, death or premature study discontinuation at month 12. Primary efficacy with FTY720 2.5 mg and MMF (32.4% and 30.2%; p = NS), plus mortality and BPAR incidence, were comparable. Patients receiving FTY720 5.0 mg plus RDC were discontinued from treatment due to increased risk of acute rejection (primary endpoint incidence 47.3%). FTY720 was associated with lower creatinine clearance (month 12: 53.1, 56.0 vs. 65.1 mL/min; p < 0.001) and more macular edema cases (2.2% and 1.3% vs. 0%), whereas cytomegalovirus infections were higher with MMF (6.2% and 10.6% vs. 18.1% p < 0.0001 and p = 0.0139, respectively). FTY720 2.5 mg provided comparable rejection prophylaxis over 12 months versus MMF; however, FTY720 5.0 mg did not support a 50% reduction in cyclosporine exposure. The cause of macular edema cases and lower creatinine clearance with FTY720 in de novo transplantation needs further investigation.

  13. Long-term cumulative survival and mechanical complications of single-tooth Ankylos Implants: focus on the abutment neck fractures

    PubMed Central

    2015-01-01

    PURPOSE To evaluate the cumulative survival rate (CSR) and mechanical complications of single-tooth Ankylos® implants. MATERIALS AND METHODS This was a retrospective clinical study that analyzed 450 single Ankylos® implants installed in 275 patients between December 2005 and December 2012. The main outcomes were survival results CSR and implant failure) and mechanical complications (screw loosening, fracture, and cumulative fracture rate [CFR]). The main outcomes were analyzed according to age, sex, implant length or diameter, bone graft, arch, and position. RESULTS The 8-year CSR was 96.9%. Thirteen (2.9%) implants failed because of early osseointegration failure in 3, marginal bone loss in 6, and abutment fracture in 4. Screw loosening occurred in 10 implants (2.2%), and 10 abutment fractures occurred. All abutment fractures were located in the neck, and concurrent screw fractures were observed. The CSR and rate of screw loosening did not differ significantly according to factors. The CFR was higher in middle-aged patients (5.3% vs 0.0% in younger and older patients); for teeth in a molar position (5.8% vs 0.0% for premolar or 1.1% for anterior position); and for larger-diameter implants (4.5% for 4.5 mm and 6.7% for 5.5 mm diameter vs 0.5% for 3.5 mm diameter) (all P<.05). CONCLUSION The Ankylos® implant is suitable for single-tooth restoration in Koreans. However, relatively frequent abutment fractures (2.2%) were observed and some fractures resulted in implant failures. Middle-aged patients, the molar position, and a large implant diameter were associated with a high incidence of abutment fracture. PMID:26813443

  14. Characteristics and Incidence of Traumatic Brain Injury in Older Adults Using Home Care in Ontario from 2003–2013

    PubMed Central

    McGuire, Connor; Kristman, Vicki L.; Martin, Lynn; Bédard, Michel

    2017-01-01

    Objectives Describe the characteristics and determine the annual cumulative incidence of traumatic brain injury (TBI) in older adults receiving home care in Ontario from 2003 to 2013. Methods A retrospective cohort study of longitudinal data from the Ontario Association of Community Care Access Centers (N = 554,313). TBI, demographic variables, depression, neurological conditions, and recent falls were measured from the Resident Assessment Instrument–Home Care. Comparisons were made between service users with and without TBI using odds ratios. Standardized incidence rates were calculated and the 10-year trend of annual cumulative incidence rates was examined. Results Characteristics associated with TBI: male sex (OR: 1.54), aboriginal origin (OR: 1.98), increasing age (low of OR: 1.22, in 70–74 years; high of OR: 2.31, in 90 years and older; comparison 65–69 years), being widowed (OR: 1.59), having one or more falls (OR: 2.31), the use of antidepressants (OR: 1.49) and the presence of depression (OR: 1.57), dementia (OR: 1.65), hemiplegia (OR: 4.34), multiple sclerosis (OR: 3.19) or parkinsonism (OR: 1.22). TBI incidence was significantly higher than rates previously reported in the literature. There was no change in the overall annual cumulative incidence over the 10-year period (p = .13). Conclusions Certain demographic characteristics, neurological diseases, antidepressant use, and a recent fall are associated with TBI. Incidence of TBI is higher than previous estimates and the overall incidence is not changing over time. These results can be used to improve care of the elderly and to generate hypotheses for future research regarding TBI in the home care setting.

  15. Decline in Cardiorespiratory Fitness and Odds of Incident Depression

    PubMed Central

    Dishman, Rodney K.; Sui, Xuemei; Church, Timothy S.; Hand, Gregory A.; Trivedi, Madhukar H.; Blair, Steven N.

    2012-01-01

    Background Studies of physical activity and incidence of physician-diagnosed depression have been limited to a single estimate of self-reported physical activity exposure, despite follow-up periods lasting many years. Purpose To examine longitudinal change in cardiorespiratory fitness, an objective marker of habitual physical activity, and incident depression complaints made to a physician. Methods Cardiorespiratory fitness assessed at four clinic visits between 1971 and 2006, each separated by an average of 2–3 years, was used to objectively measure cumulative physical activity exposure in cohorts of 7936 men and 1261 women, aged 20–85 years, from the Aerobics Center Longitudinal Study who did not complain of depression at their first clinic visit in 1971–2003. Data were analyzed in August 2010. Results Across subsequent visits, there were 446 incident cases in men and 153 cases in women. After adjustment for age, time between visits, BMI at each visit, and fitness at Visit 1, each 1-minute decline in treadmill endurance (i.e., a decline in cardiorespiratory fitness of approximately 1 half-MET) between ages 51 and 55 years in men and ages 53 and 56 years in women, increased the odds of incident depression complaints by approximately 2% and 9.5%, respectively. The increased odds remained significant but were attenuated to 1.3% and 5.4% after further adjustment at each visit for smoking, alcohol use, chronic medical conditions, anxiety, and sleep problems. Conclusions Maintenance of cardiorespiratory fitness during late middle-age, when decline in fitness typically accelerates, helps protect against the onset of depression complaints made to a physician. PMID:22992353

  16. 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

  17. Increased Cardiovascular Events and Subclinical Atherosclerosis in Rheumatoid Arthritis Patients: 1 Year Prospective Single Centre Study

    PubMed Central

    Ruscitti, Piero; Cipriani, Paola; Masedu, Francesco; Romano, Silvio; Berardicurti, Onorina; Liakouli, Vasiliki; Carubbi, Francesco; Di Benedetto, Paola; Alvaro, Saverio; Penco, Maria; Valenti, Marco; Giacomelli, Roberto

    2017-01-01

    Objectives Several studies showed the close relationship between Rheumatoid Arthritis (RA) and cerebro-cardiovascular events (CVEs) and subclinical atherosclerosis. In this study, we investigated the occurrence of CVEs and subclinical atherosclerosis during the course of RA and we evaluated the possible role of both traditional cardiovascular (CV) and disease related risk factors to predict the occurrence of new CVEs and the onset of subclinical atherosclerosis. Methods We designed a single centre, bias-adjusted, prospective, observational study to investigate, in a homogeneous subset of RA patients, the occurrence of new onset of CVEs and subclinical atherosclerosis. Statistical analyses were performed to evaluate the role of traditional CV and disease-related risk factors to predict the occurrence of new CVEs and subclinical atherosclerosis. Results We enrolled 347 RA patients prospectively followed for 12 months. An increased percentage of patients experienced CVEs, developed subclinical atherosclerosis and was affected by systemic arterial hypertension (SAH), type 2 diabetes mellitus and metabolic syndrome (MS), at the end of follow up. Our analysis showed that the insurgence of both SAH and MS, during the follow up, the older age, the CVE familiarity and the lack of clinical response, were associated with a significantly increased risk to experience CVEs and to develop subclinical atherosclerosis. Conclusions Our study quantifies the increased expected risk for CVEs in a cohort of RA patients prospectively followed for 1 year. The occurrence of both new CVEs and subclinical atherosclerosis in RA patients may be explained by inflammatory burden as well as traditional CV risk factors. PMID:28103312

  18. Enzyme Replacement Therapy in Mucopolysaccharidosis II Patients Under 1 Year of Age.

    PubMed

    Lampe, Christina; Atherton, Andrea; Burton, Barbara K; Descartes, Maria; Giugliani, Roberto; Horovitz, Dafne D G; Kyosen, Sandra O; Magalhães, Tatiana S P C; Martins, Ana Maria; Mendelsohn, Nancy J; Muenzer, Joseph; Smith, Laurie D

    2014-01-01

    Mucopolysaccharidosis (MPS) II, or Hunter syndrome, is a lysosomal storage disease characterized by multi-systemic involvement and a progressive clinical course. Enzyme replacement therapy with idursulfase has been approved in more than 50 countries worldwide; however, safety and efficacy data from clinical studies are currently only available for patients 1.4 years of age and older. Sibling case studies of infants with MPS I, II, and VI who initiated ERT in the first weeks or months of life have reported no new safety concerns and a more favorable clinical course for the sibling treated in infancy than for the later-treated sibling. Here we describe our experiences with a case series of eight MPS II patients for whom idursulfase treatment was initiated at under 1 year of age. The majority of the patients were diagnosed because of a family history of disease. All of the infants displayed abnormalities consistent with MPS II at diagnosis. The youngest age at treatment start was 10 days and the oldest was 6.5 months, with duration of treatment varying between 6 weeks and 5.5 years. No new safety concerns were observed, and none of the patients experienced an infusion-related reaction. All of the patients treated for more than 6 weeks showed improvements and/or stabilization of some somatic manifestations while on treatment. In some cases, caregivers made comparisons with other affected family members and reported that the early-treated patients experienced a less severe clinical course, although a lack of medical records for many family members precluded a rigorous comparison.

  19. Encouraging responses in sexual and relationship violence prevention: what program effects remain 1 year later?

    PubMed

    Moynihan, Mary M; Banyard, Victoria L; Cares, Alison C; Potter, Sharyn J; Williams, Linda M; Stapleton, Jane G

    2015-01-01

    Colleges and universities are high-risk settings for sexual and relationship violence. To address these problems, institutions of higher education have implemented prevention programs, many of which train students as potential bystanders who can step in to help diffuse risky situations, identify and challenge perpetrators, and assist victims. The impact of bystander sexual and relationship violence prevention programs on long-term behavior of bystanders has remained a key unanswered question for those who seek to offer the most effective programs as well as for policy makers. In this study, the researchers experimentally evaluated the effectiveness of the Bringing in the Bystander® in-person program. Participants were 948 1st-year college students of whom 47.8% were women and 85.2% identified as White (15% also identified as Hispanic in a separate question) between the ages of 18 and 24 at two universities (one a rural, primarily residential campus and the other an urban, highly commuter campus) in the northeastern United States. To date, this is the first study to have found positive behavior changes as long-lasting as 1 year following an educational workshop focusing on engaging bystanders in preventing sexual and relationship violence. Even so, many questions remain to be answered about prevention and intervention of this type. More prospective research is needed on bystander-focused prevention of these forms of violence to help understand and better predict the complicated relationships both between and among the attitudes and behaviors related to preventing sexual and relationship violence. In this regard, we make specific recommendations for designing and evaluating programs based on our findings relating to the importance of moderators, especially two key understudied ones, readiness to help and opportunity to intervene.

  20. Robot-assisted laparoscopic pyeloplasty: minimum 1-year follow-up

    NASA Astrophysics Data System (ADS)

    Patel, Vipul; Thaly, Rahul; Shah, Ketul

    2007-02-01

    Objectives: To evaluate the feasibility and efficacy of robotic-assisted laparoscopic pyeloplasty. Laparoscopic pyeloplasty has been shown to have a success rate comparable to that of the open surgical approach. However, the steep learning curve has hindered its acceptance into mainstream urologic practice. The introduction of robotic assistance provides advantages that have the potential to facilitate precise dissection and intracorporeal suturing. Methods: A total of 50 patients underwent robotic-assisted laparoscopic dismembered pyeloplasty. A four-trocar technique was used. Most patients were discharged home on day 1, with stent removal at 3 weeks. Patency of the ureteropelvic junction was assessed in all patients with mercaptotriglycylglycine Lasix renograms at 1, 3, 6, 9, and 12 months, then every 6 months for 1 year, and then yearly. Results: Each patient underwent a successful procedure without open conversion or transfusion. The average estimated blood loss was 40 ml. The operative time averaged 122 minutes (range 60 to 330) overall. Crossing vessels were present in 30% of the patients and were preserved in all cases. The time for the anastomosis averaged 20 minutes (range 10 to 100). Intraoperatively, no complications occurred. Postoperatively, the average hospital stay was 1.1 days. The stents were removed at an average of 20 days (range 14 to 28) postoperatively. The average follow-up was 11.7 months; at the last follow-up visit, each patient was doing well. Of the 50 patients, 48 underwent one or more renograms, demonstrating stable renal function, improved drainage, and no evidence of recurrent obstruction. Conclusions: Robotic-assisted laparoscopic pyeloplasty is a feasible technique for ureteropelvic junction reconstruction. The procedure provides a minimally invasive alternative with good short-term results.

  1. Aerosol source apportionment from 1-year measurements at the CESAR tower in Cabauw, the Netherlands

    NASA Astrophysics Data System (ADS)

    Schlag, Patrick; Kiendler-Scharr, Astrid; Blom, Marcus Johannes; Canonaco, Francesco; Sebastiaan Henzing, Jeroen; Moerman, Marcel; Prévôt, André Stephan Henry; Holzinger, Rupert

    2016-07-01

    Intensive measurements of submicron aerosol particles and their chemical composition were performed with an Aerosol Chemical Speciation Monitor (ACSM) at the Cabauw Experimental Site for Atmospheric Research (CESAR) in Cabauw, the Netherlands, sampling at 5 m height above ground. The campaign lasted nearly 1 year from July 2012 to June 2013 as part of the EU-FP7-ACTRIS project (Q-ACSM Network). Including equivalent black carbon an average particulate mass concentration of 9.50 µg m-3 was obtained during the whole campaign with dominant contributions from ammonium nitrate (45 %), organic aerosol (OA, 29 %), and ammonium sulfate (19 %). There were 12 exceedances of the World Health Organization (WHO) PM2.5 daily mean limit (25 µg m-3) observed at this rural site using PM1 instrumentation only. Ammonium nitrate and OA represented the largest contributors to total particulate matter during periods of exceedance. Source apportionment of OA was performed season-wise by positive matrix factorization (PMF) using the multilinear engine 2 (ME-2) controlled via the source finder (SoFi). Primary organic aerosols were attributed mainly to traffic (8-16 % contribution to total OA, averaged season-wise) and biomass burning (0-23 %). Secondary organic aerosols (SOAs, 61-84 %) dominated the organic fraction during the whole campaign, particularly on days with high mass loadings. A SOA factor which is attributed to humic-like substances (HULIS) was identified as a highly oxidized background aerosol in Cabauw. This shows the importance of atmospheric aging processes for aerosol concentration at this rural site. Due to the large secondary fraction, the reduction of particulate mass at this rural site is challenging on a local scale.

  2. Effectiveness of a multidisciplinary heart failure disease management programme on 1-year mortality: Prospective cohort study.

    PubMed

    Laborde-Castérot, Hervé; Agrinier, Nelly; Zannad, Faiez; Mebazaa, Alexandre; Rossignol, Patrick; Girerd, Nicolas; Alla, François; Thilly, Nathalie

    2016-09-01

    We performed a multicenter prospective observational cohort study (Epidémiologie et Pronostic de l'Insuffisance Cardiaque Aiguë en Lorraine, Epidemiology and Prognosis of Acute Heart Failure in Lorraine [EPICAL2]) to evaluate the effectiveness on mortality of a community-based multidisciplinary disease management programme (DMP) for heart failure (HF) patients.Between October 2011 and October 2012, 1816 patients, who were hospitalized for acute HF or who developed acute HF during a hospitalization, were included from 21 hospitals in a northeast region of France. At hospital admission, their mean age was 77.3 (standard deviation [SD] 11.6) years and mean left ventricular ejection fraction was 45.0 (SD 16.0)%. A subset of patients were enrolled in a multidimensional DMP for HF (n = 312, 17.2%), based on structured patient education, home monitoring visits by HF-trained nurses, and automatic alerts triggered by significant clinical and biological changes to the patient. The DMP involved general practitioners, nurses, and cardiologists collaborating via an individual web-based medical electronic record. The outcome was all-cause mortality from the 3rd to the 12th month after discharge. During the follow-up, a total of 377 (20.8%) patients died: 321 (21.3%) in the control group and 56 (17.9%) in the DMP group. In a propensity score analysis, DMP was associated with lower 1-year all-cause mortality (hazard ratio 0.65, 95% CI 0.46-0.92). Instrumental variable analysis gave similar results (hazard ratio 0.56, 0.27-1.16).In a real world setting, a multidimensional DMP for HF with structured patient education, home nurse monitoring, and appropriate physician alerts may improve survival when implemented after discharge from hospitalization due to worsening HF.

  3. Selective laser trabeculoplasty (SLT): 1-year results in early and advanced open angle glaucoma.

    PubMed

    Schlote, Torsten; Kynigopoulos, Myron

    2016-02-01

    The purpose of this study was to examine the efficacy of selective laser trabeculoplasty (SLT) in eyes with early and more advanced stages of open angle glaucoma within 1 year of follow-up. Retrospective chart review in a consecutive series of patients treated by SLT to reduce intraocular pressure (IOP) or decrease number of topical medications in cases of discomfort and allergy. The cup-to-disc ratio of the optic nerve and the GSS 2 (glaucoma staging system 2) was used to differentiate between early (group 1) and more advanced (group 2) stages of glaucoma. At the time of SLT treatment, no new signs of glaucoma progression were seen. Only the first treated eye of every patient was included in the analysis. In group 1 (early glaucoma), 27 eyes were included. IOP reduction <21 mmHg/>20 % of the preoperative IOP-value and reduction of medication were achieved in 17 eyes (62.96 %). Successful re-treatment was necessary in 2 eyes (7.4 %). In group 2 (advanced glaucoma), 44 eyes underwent SLT. In eight eyes (18.18 %), filtrating surgery was necessary after initial SLT. In the remaining 36 eyes, IOP reduction <21 mmHg/>20 % of the baseline IOP was achieved in 26 eyes (59.09 % of 44 eyes) and IOP reduction <18 mmHg/> 30 % of the baseline IOP in 22 eyes (50 % of 44 eyes). SLT was safe and effective in nearly 2/3 of early glaucoma patients and also in 50 % of advanced glaucoma patients using stronger criteria of success. Failure of SLT in advanced glaucoma should lead to immediate filtrating surgery, which seems not to be associated with higher risk of fibrosis.

  4. PM2.5 chemical composition in five European Mediterranean cities: A 1-year study

    NASA Astrophysics Data System (ADS)

    Salameh, Dalia; Detournay, Anais; Pey, Jorge; Pérez, Noemi; Liguori, Francesca; Saraga, Dikaia; Bove, Maria Chiara; Brotto, Paolo; Cassola, Federico; Massabò, Dario; Latella, Aurelio; Pillon, Silvia; Formenton, Gianni; Patti, Salvatore; Armengaud, Alexandre; Piga, Damien; Jaffrezo, Jean Luc; Bartzis, John; Tolis, Evangelos; Prati, Paolo; Querol, Xavier; Wortham, Henri; Marchand, Nicolas

    2015-03-01

    The seasonal and spatial characteristics of PM2.5 and its chemical composition in the Mediterranean Basin have been studied over a 1-year period (2011-2012) in five European Mediterranean cities: Barcelona (BCN), Marseille (MRS), Genoa (GEN), Venice (VEN), and Thessaloniki (THE). During the year under study, PM10 annual mean concentration ranged from 23 to 46 μg m- 3, while the respective PM2.5 ranged from 14 to 37 μg m- 3, with the highest concentrations observed in THE and VEN. Both cities presented an elevated number of exceedances of the PM10 daily limit value, as 32% and 20% of the days exceeded 50 μg m- 3, respectively. Similarly, exceedances of the WHO guidelines for daily PM2.5 concentrations (25 μg m- 3) were also more frequent in THE with 78% of the days during the period, followed by VEN with 39%. The lowest PM levels were measured in GEN. PM2.5 exhibited significant seasonal variability, with much higher winter concentrations for VEN and MRS, in fall for THE and in spring for BCN. PM2.5 chemical composition was markedly different even for similar PM2.5 levels. On annual average, PM2.5 was dominated by OM except in THE. OM contribution was higher in Marseille (42%), while mineral matter was the most abundant constituent in THE (32%). Moreover, PM2.5 relative mean composition during pollution episodes (PM2.5 > 25 μg m- 3) as well as the origins of the exceedances were also investigated. Results outline mainly the effect of NO3- being the most important driver and highlight the non-negligible impact of atmospheric mixing and aging processes during pollution episodes.

  5. Deep Sclerectomy With a New Nonabsorbable Uveoscleral Implant (Esnoper-Clip): 1-Year Outcomes

    PubMed Central

    Parera-Arranz, Angels; Romera-Romera, Pau; Castellvi-Manent, Jordi; Sabala-Llopart, Antoni; de la Cámara-Hermoso, Julio

    2015-01-01

    Purpose: To report the safety and the effectiveness of deep sclerectomy (DS) with a new nonabsorbable uveoscleral hema implant (Esnoper-Clip) designed to increase trabecular and uveoscleral outflow and to achieve higher intrascleral blebs. Materials and Methods: Twenty-seven eyes of 27 patients with open-angle glaucoma, who underwent DS with an Esnoper-Clip implant, were included in this study. All patients were followed up after 12 months. Results: A significant decrease in intraocular pressure was observed after surgery, changing from a preoperative mean of 26.6±5.2 mm Hg to a postoperative mean of 15.3±5 mm Hg (P<0.001) at 12 months. There was also a significant reduction in the number of glaucoma drugs needed, varying from 2.5 per patient to 0.3 (P<0.001) 1 year after surgery. The main intrascleral lake height and volume at 12 months was 0.7±0.1 mm and 3.9±1.3 mm3, respectively. No intraoperative complications occurred. The main postoperative complications were a positive Seidel test result at 24 hours in 2 eyes (7.4%), hyphema in 2 eyes (7.4%), and choroidal detachment in 1 eye (3.7%). All these complications resolved successfully. The need for additional mitomycin-C injections was recorded in 4 eyes (14.8%), twice in 2 of them. Twelve eyes (44.4%) underwent postsurgical Nd:YAG laser goniopuncture with a mean time between surgery and this procedure of 4.3 months. Mean intraocular pressure after Nd:YAG laser goniopuncture decreased from 19.2 to 15.5 mm Hg (P<0.001). Conclusion: DS with an uveoscleral hema implant (Esnoper-Clip) is a safe and effective technique for the management of open-angle glaucoma. PMID:25836660

  6. Cancer incidence among glyphosate-exposed pesticide applicators in the Agricultural Health Study.

    PubMed

    De Roos, Anneclaire J; Blair, Aaron; Rusiecki, Jennifer A; Hoppin, Jane A; Svec, Megan; Dosemeci, Mustafa; Sandler, Dale P; Alavanja, Michael C

    2005-01-01

    Glyphosate is a broad-spectrum herbicide that is one of the most frequently applied pesticides in the world. Although there has been little consistent evidence of genotoxicity or carcinogenicity from in vitro and animal studies, a few epidemiologic reports have indicated potential health effects of glyphosate. We evaluated associations between glyphosate exposure and cancer incidence in the Agricultural Health Study (AHS), a prospective cohort study of 57,311 licensed pesticide applicators in Iowa and North Carolina. Detailed information on pesticide use and other factors was obtained from a self-administered questionnaire completed at time of enrollment (1993-1997). Among private and commercial applicators, 75.5% reported having ever used glyphosate, of which > 97% were men. In this analysis, glyphosate exposure was defined as a) ever personally mixed or applied products containing glyphosate; b) cumulative lifetime days of use, or "cumulative exposure days" (years of use times days/year); and c) intensity-weighted cumulative exposure days (years of use times days/year times estimated intensity level). Poisson regression was used to estimate exposure-response relations between glyphosate and incidence of all cancers combined and 12 relatively common cancer subtypes. Glyphosate exposure was not associated with cancer incidence overall or with most of the cancer subtypes we studied. There was a suggested association with multiple myeloma incidence that should be followed up as more cases occur in the AHS. Given the widespread use of glyphosate, future analyses of the AHS will allow further examination of long-term health effects, including less common cancers.

  7. Cancer Incidence among Glyphosate-Exposed Pesticide Applicators in the Agricultural Health Study

    PubMed Central

    De Roos, Anneclaire J.; Blair, Aaron; Rusiecki, Jennifer A.; Hoppin, Jane A.; Svec, Megan; Dosemeci, Mustafa; Sandler, Dale P.; Alavanja, Michael C.

    2005-01-01

    Glyphosate is a broad-spectrum herbicide that is one of the most frequently applied pesticides in the world. Although there has been little consistent evidence of genotoxicity or carcinogenicity from in vitro and animal studies, a few epidemiologic reports have indicated potential health effects of glyphosate. We evaluated associations between glyphosate exposure and cancer incidence in the Agricultural Health Study (AHS), a prospective cohort study of 57,311 licensed pesticide applicators in Iowa and North Carolina. Detailed information on pesticide use and other factors was obtained from a self-administered questionnaire completed at time of enrollment (1993–1997). Among private and commercial applicators, 75.5% reported having ever used glyphosate, of which > 97% were men. In this analysis, glyphosate exposure was defined as a) ever personally mixed or applied products containing glyphosate; b) cumulative lifetime days of use, or “cumulative exposure days” (years of use × days/year); and c) intensity-weighted cumulative exposure days (years of use × days/year × estimated intensity level). Poisson regression was used to estimate exposure–response relations between glyphosate and incidence of all cancers combined and 12 relatively common cancer subtypes. Glyphosate exposure was not associated with cancer incidence overall or with most of the cancer subtypes we studied. There was a suggested association with multiple myeloma incidence that should be followed up as more cases occur in the AHS. Given the widespread use of glyphosate, future analyses of the AHS will allow further examination of long-term health effects, including less common cancers. PMID:15626647

  8. Evaluating Cumulative Ecosystem Response to Restoration Projects in the Columbia River Estuary, Annual Report 2007

    SciTech Connect

    Johnson, Gary E.; Diefenderfer, Heida L.; Borde, Amy B.; Dawley, Earl M.; Ebberts, Blaine D.; Putman, Douglas A.; Roegner, G. C.; Russell, Micah; Skalski, John R.; Thom, Ronald M.; Vavrinec, John

    2008-10-01

    The goal of this multi-year study (2004-2010) is to develop a methodology to evaluate the cumulative effects of multiple habitat restoration projects intended to benefit ecosystems supporting juvenile salmonids in the lower Columbia River and estuary. Literature review in 2004 revealed no existing methods for such an evaluation and suggested that cumulative effects could be additive or synergistic. Field research in 2005, 2006, and 2007 involved intensive, comparative studies paired by habitat type (tidal swamp vs. marsh), trajectory (restoration vs. reference site), and restoration action (tide gate vs. culvert vs. dike breach). The field work established two kinds of monitoring indicators for eventual cumulative effects analysis: core and higher-order indicators. Management implications of limitations and applications of site-specific effectiveness monitoring and cumulative effects analysis were identified.

  9. Modeling Joint Exposures and Health Outcomes for Cumulative Risk Assessment: the Case of Radon and Smoking

    EPA Science Inventory

    Community-based cumulative risk assessment requires characterization of exposures to multiple chemical and non-chemical stressors, with consideration of how the non-chemical stressors may influence risks from chemical stressors. Residential radon provides an interesting case exam...

  10. EXPOSURE ASSESSMENT TOOLS FOR CUMULATIVE RISK ASSESSMENT: MEASUREMENT OF ENDOGENOUS BIOMARKERS

    EPA Science Inventory

    Direct assessment of cumulative risks is a difficult task due to combinations of multiple chemicals, exposure pathways, and concentration profiles using suites of environmental measurements. We are investigating the use of endogenous compounds commonly present in biological medi...

  11. Aerospace Medicine and Biology: A cumulative index to the 1980 issues

    NASA Technical Reports Server (NTRS)

    1981-01-01

    A cumulative index to the abstracts contained in the Supplements 203 through 214 of Aerospace Medicine and Biology: A Continuing Bibliography is presented. It includes three indexes--subject, personal author, and corporate source.

  12. Aerospace Medicine and Biology: A cumulative index to a continuing bibliography

    NASA Technical Reports Server (NTRS)

    1976-01-01

    This publication is a cumulative index to the abstracts contained in Supplements 138 through 149 of AEROSPACE MEDICINE AND BIOLOGY: A CONTINUING BIBLIOGRAPHY. It includes three indexes -- subject, personal author, and corporate source.

  13. A cumulative index to the 1977 issues of a continuing bibliography on aerospace medicine and biology

    NASA Technical Reports Server (NTRS)

    1978-01-01

    This publication is a cumulative index to the abstracts contained in the Supplements 164 through 175 of Aerospace Medicine and Biology: A Continuing Bibliography. It includes three indexes-- subject, personal author, and corporate source.

  14. A cumulative index to the 1976 issues of a continuing bibliography on Aerospace Medicine and Biology

    NASA Technical Reports Server (NTRS)

    1977-01-01

    This publication is a cumulative index to the abstracts contained in Supplements 151 through 162 of Aerospace Medicine and Biology: A continuing bibliography. It includes three indexes - subject, personal author, and corporate source.

  15. Community, State, and Federal Approaches to Cumulative Risk Assessment: Challenges and Opportunities for Integration

    EPA Science Inventory

    Community, state, and federal approaches to conventional and cumulative risk assessment (CRA) were described and compared to assess similarities and differences, and develop recommendations for a consistent CRA approach, acceptable across each level as a rigorous scientific metho...

  16. A Summary of Publications on Methods and Tools for Assessing Cumulative Risk, Project Summary

    EPA Science Inventory

    This collection of eight publications on cumulative risk assessment was developed collaboratively among scientists within EPA’s Office of Research and Development and three other organizations. These include scientific collaborations through an Interagency Agreement with Argonne...

  17. TESTING FOR DIFFERENCES BETWEEN CUMULATIVE DISTRIBUTION FUNCTIONS FROM COMPLEX ENVIRONMENTAL SAMPLING SURVEYS

    EPA Science Inventory

    The U.S. Environmental Protection Agency's Environmental Monitoring and Assessment Program (EMAP) employs the cumulative distribution function (cdf) to measure the status of quantitative variables for resources of interest. The ability to compare cdf's for a resource from, say,...

  18. A cumulative index to the 1972 issues of a continuing bibliography on aerospace medicine and biology

    NASA Technical Reports Server (NTRS)

    1973-01-01

    This publication is a cumulative index to the abstracts contained in Supplements 99 through 110 of Aerospace Medicine and Biology: A Continuing Bibliography. It includes three indexes - subject, personal author, and corporate source.

  19. A cumulative index to Aeronautical Engineering: A continuing bibliography, supplement 118

    NASA Technical Reports Server (NTRS)

    1980-01-01

    Subject, personal author, corporate author, contract, and report number cumulative indexes are provided for documents cited in Aeronautical Engineering: A Continuing Bibliography from February 1979 through January 1980. (NASA SP 7037 supplements 106 through 117).

  20. 30 CFR 1204.202 - What is the cumulative royalty reports and payments relief option?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... production) is 1,000 BOE or less during the base period. (b) To use the cumulative royalty reports and... contain; (2) Submit your royalty report and payment in accordance with 30 CFR 1218.51(g) by the end...