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Sample records for 3-year kaplan-meier estimates

  1. On an exponential bound for the Kaplan-Meier estimator.

    PubMed

    Wellner, Jon A

    2007-12-01

    We review limit theory and inequalities for the Kaplan-Meier Kaplan and Meier (J Am Stat Assoc 53:457-481, 1958) product limit estimator of a survival function on the whole line [Formula: see text] . Along the way we provide bounds for the constant in an interesting inequality due to Biotouzé et al. (Ann Inst H Poincaré Probab Stat 35:735-763, 1999), and provide some numerical evidence in support of one of their conjectures.

  2. A comparison between Kaplan-Meier and weighted Kaplan-Meier methods of five-year survival estimation of patients with gastric cancer.

    PubMed

    Zare, Ali; Mahmoodi, Mahmood; Mohammad, Kazem; Zeraati, Hojjat; Hosseini, Mostafa; Holakouie Naieni, Kourosh

    2014-01-01

    The 5-year survival rate is a good prognostic indicator for patients with Gastric cancer that is usually estimated based on Kaplan-Meier. In situations where censored observations are too many, this method produces biased estimations. This study aimed to compare estimations of Kaplan-Meier and Weighted Kaplan-Meier as an alternative method to deal with the problem of heavy-censoring. Data from 330 patients with Gastric cancer who had undergone surgery at Iran Cancer Institute from 1995- 1999 were analyzed. The Survival Time of these patients was determined after surgery, and the 5-year survival rate for these patients was evaluated based on Kaplan-Meier and Weighted Kaplan-Meier methods. A total of 239 (72.4%) patients passed away by the end of the study and 91(27.6%) patients were censored. The mean and median of survival time for these patients were 24.86±23.73 and 16.33 months, respectively. The one-year, two-year, three-year, four-year, and five-year survival rates of these patients with standard error estimation based on Kaplan-Meier were 0.66 (0.0264), 0.42 (0.0284), 0.31 (0.0274), 0.26 (0.0264) and 0.21 (0.0256) months, respectively. The estimations of Weighted Kaplan-Meier for these patients were 0.62 (0.0251), 0.35 (0.0237), 0.24 (0.0211), 0.17 (0.0172), and 0.10 (0.0125) months, consecutively. In cases where censoring assumption is not made, and the study has many censored observations, estimations obtained from the Kaplan-Meier are biased and are estimated higher than its real amount. But Weighted Kaplan-Meier decreases bias of survival probabilities by providing appropriate weights and presents more accurate understanding.

  3. A practical divergence measure for survival distributions that can be estimated from Kaplan-Meier curves.

    PubMed

    Cox, Trevor F; Czanner, Gabriela

    2016-06-30

    This paper introduces a new simple divergence measure between two survival distributions. For two groups of patients, the divergence measure between their associated survival distributions is based on the integral of the absolute difference in probabilities that a patient from one group dies at time t and a patient from the other group survives beyond time t and vice versa. In the case of non-crossing hazard functions, the divergence measure is closely linked to the Harrell concordance index, C, the Mann-Whitney test statistic and the area under a receiver operating characteristic curve. The measure can be used in a dynamic way where the divergence between two survival distributions from time zero up to time t is calculated enabling real-time monitoring of treatment differences. The divergence can be found for theoretical survival distributions or can be estimated non-parametrically from survival data using Kaplan-Meier estimates of the survivor functions. The estimator of the divergence is shown to be generally unbiased and approximately normally distributed. For the case of proportional hazards, the constituent parts of the divergence measure can be used to assess the proportional hazards assumption. The use of the divergence measure is illustrated on the survival of pancreatic cancer patients. Copyright © 2016 John Wiley & Sons, Ltd. PMID:26842429

  4. Asymptotic properties of mean survival estimate based on the Kaplan-Meier curve with an extrapolated tail.

    PubMed

    Gong, Qi; Fang, Liang

    2012-01-01

    Asymptotic distribution of the mean survival time based on the Kaplan-Meier curve with an extrapolated 'tail' is derived. A closed formula of the variance estimate is provided. Asymptotic properties of the estimator were studied in a simulation study, which showed that this estimator was unbiased with proper coverage probability and followed a normal distribution. An example is used to demonstrate the application of this estimator.

  5. The Kaplan-Meier Theatre

    ERIC Educational Resources Information Center

    Gerds, Thomas A.

    2016-01-01

    Survival is difficult to estimate when observation periods of individuals differ in length. Students imagine sailing the Titanic and then recording whether they "live" or "die." A clever algorithm is performed which results in the Kaplan-Meier estimate of survival.

  6. Kaplan-Meier survival analysis and Cox regression analyses regarding right ventricular septal pacing: Data from Japanese pacemaker cohort.

    PubMed

    Mizukami, Akira; Matsue, Yuya; Naruse, Yoshihisa; Kowase, Shinya; Kurosaki, Kenji; Suzuki, Makoto; Matsumura, Akihiko; Nogami, Akihiko; Aonuma, Kazutaka; Hashimoto, Yuji

    2016-09-01

    The presented data were obtained from 982 consecutive patients receiving their first pacemaker implantation with right ventricular (RV) lead placement between January 2008 and December 2013 at two centers in Japan. Patients were divided into RV apical and septal pacing groups. Data of Kaplan-Meier survival analysis and Cox regression analysis are presented. Refer to the research article "Implications of right ventricular septal pacing for medium-term prognosis: propensity-matched analysis" (Mizukami et al., in press) [1] for further interpretation and discussion. PMID:27570808

  7. Estimating differences and ratios in median times to event

    PubMed Central

    Rogawski, Elizabeth T.; Westreich, Daniel J.; Kang, Gagandeep; Ward, Honorine D.; Cole, Stephen R.

    2016-01-01

    Time differences and time ratios are often more interpretable estimates of effect than hazard ratios for time-to-event data, especially for common outcomes. We developed a SAS macro for estimating time differences and time ratios between baseline-fixed binary exposure groups based on inverse probability weighted Kaplan-Meier curves. The macro uses pooled logistic regression to calculate inverse probability of censoring and exposure weights, draws Kaplan-Meier curves based on the weighted data, and estimates the time difference and time ratio at a user-defined survival proportion. The macro also calculates the risk difference and risk ratio at a user-specified time. Confidence intervals are constructed by bootstrap. We provide an example assessing the effect of exclusive breastfeeding during diarrhea on the incidence of subsequent diarrhea in children followed from birth to 3 years in Vellore, India. The SAS macro provided here should facilitate the wider reporting of time differences and time ratios. PMID:27465526

  8. A Review and Comparison of Methods for Recreating Individual Patient Data from Published Kaplan-Meier Survival Curves for Economic Evaluations: A Simulation Study

    PubMed Central

    Wan, Xiaomin; Peng, Liubao; Li, Yuanjian

    2015-01-01

    Background In general, the individual patient-level data (IPD) collected in clinical trials are not available to independent researchers to conduct economic evaluations; researchers only have access to published survival curves and summary statistics. Thus, methods that use published survival curves and summary statistics to reproduce statistics for economic evaluations are essential. Four methods have been identified: two traditional methods 1) least squares method, 2) graphical method; and two recently proposed methods by 3) Hoyle and Henley, 4) Guyot et al. The four methods were first individually reviewed and subsequently assessed regarding their abilities to estimate mean survival through a simulation study. Methods A number of different scenarios were developed that comprised combinations of various sample sizes, censoring rates and parametric survival distributions. One thousand simulated survival datasets were generated for each scenario, and all methods were applied to actual IPD. The uncertainty in the estimate of mean survival time was also captured. Results All methods provided accurate estimates of the mean survival time when the sample size was 500 and a Weibull distribution was used. When the sample size was 100 and the Weibull distribution was used, the Guyot et al. method was almost as accurate as the Hoyle and Henley method; however, more biases were identified in the traditional methods. When a lognormal distribution was used, the Guyot et al. method generated noticeably less bias and a more accurate uncertainty compared with the Hoyle and Henley method. Conclusions The traditional methods should not be preferred because of their remarkable overestimation. When the Weibull distribution was used for a fitted model, the Guyot et al. method was almost as accurate as the Hoyle and Henley method. However, if the lognormal distribution was used, the Guyot et al. method was less biased compared with the Hoyle and Henley method. PMID:25803659

  9. Acetabular revision with impaction bone grafting and a cemented polyethylene acetabular component: comparison of the Kaplan-Meier analysis to the competing risk analysis in 62 revisions with 25 to 30 years follow-up.

    PubMed

    Te Stroet, M A J; Keurentjes, J C; Rijnen, W H C; Gardeniers, J W M; Verdonschot, N; Slooff, T J J H; Schreurs, B W

    2015-10-01

    We present the results of 62 consecutive acetabular revisions using impaction bone grafting and a cemented polyethylene acetabular component in 58 patients (13 men and 45 women) after a mean follow-up of 27 years (25 to 30). All patients were prospectively followed. The mean age at revision was 59.2 years (23 to 82). We performed Kaplan-Meier (KM) analysis and also a Competing Risk (CR) analysis because with long-term follow-up, the presence of a competing event (i.e. death) prevents the occurrence of the endpoint of re-revision. A total of 48 patients (52 hips) had died or had been re-revised at final review in March 2011. None of the deaths were related to the surgery. The mean Harris hip score of the ten surviving hips in ten patients was 76 points (45 to 99). The KM survivorship at 25 years for the endpoint 're-revision for any reason' was 58.0% (95% confidence interval (CI) 38 to 73) and for 're-revision for aseptic loosening' 72.1% (95% CI 51 to 85). With the CR analysis we calculated the KM analysis overestimates the failure rate with respectively 74% and 93% for these endpoints. The current study shows that acetabular impaction bone grafting revisions provide good clinical results at over 25 years.

  10. Final Report for Dynamic Models for Causal Analysis of Panel Data. Alternative Estimation Procedures for Event-History Analysis: A Monte Carlo Study. Part III, Chapter 5.

    ERIC Educational Resources Information Center

    Carroll, Glenn R.; And Others

    This document is part of a series of chapters described in SO 011 759. The chapter examines the merits of four estimators in the causal analysis of event-histories (data giving the number, timing, and sequence of changes in a categorical dependent variable). The four procedures are ordinary least squares, Kaplan-Meier least squares, maximum…

  11. Median nitrate concentrations in groundwater in the New Jersey Highlands Region estimated using regression models and land-surface characteristics

    USGS Publications Warehouse

    Baker, Ronald J.; Chepiga, Mary M.; Cauller, Stephen J.

    2015-01-01

    The Kaplan-Meier method of estimating summary statistics from left-censored data was applied in order to include nondetects (left-censored data) in median nitrate-concentration calculations. Median concentrations also were determined using three alternative methods of handling nondetects. Treatment of the 23 percent of samples that were nondetects had little effect on estimated median nitrate concentrations because method detection limits were mostly less than median values.

  12. Estimating survival of radio-tagged birds

    USGS Publications Warehouse

    Bunck, C.M.; Pollock, K.H.; Lebreton, J.-D.; North, P.M.

    1993-01-01

    Parametric and nonparametric methods for estimating survival of radio-tagged birds are described. The general assumptions of these methods are reviewed. An estimate based on the assumption of constant survival throughout the period is emphasized in the overview of parametric methods. Two nonparametric methods, the Kaplan-Meier estimate of the survival funcrion and the log rank test, are explained in detail The link between these nonparametric methods and traditional capture-recapture models is discussed aloag with considerations in designing studies that use telemetry techniques to estimate survival.

  13. Estimating Body Composition in Adolescent Sprint Athletes: Comparison of Different Methods in a 3 Years Longitudinal Design

    PubMed Central

    Aerenhouts, Dirk

    2015-01-01

    A recommended field method to assess body composition in adolescent sprint athletes is currently lacking. Existing methods developed for non-athletic adolescents were not longitudinally validated and do not take maturation status into account. This longitudinal study compared two field methods, i.e., a Bio Impedance Analysis (BIA) and a skinfold based equation, with underwater densitometry to track body fat percentage relative to years from age at peak height velocity in adolescent sprint athletes. In this study, adolescent sprint athletes (34 girls, 35 boys) were measured every 6 months during 3 years (age at start = 14.8 ± 1.5yrs in girls and 14.7 ± 1.9yrs in boys). Body fat percentage was estimated in 3 different ways: 1) using BIA with the TANITA TBF 410; 2) using a skinfold based equation; 3) using underwater densitometry which was considered as the reference method. Height for age since birth was used to estimate age at peak height velocity. Cross-sectional analyses were performed using repeated measures ANOVA and Pearson correlations between measurement methods at each occasion. Data were analyzed longitudinally using a multilevel cross-classified model with the PROC Mixed procedure. In boys, compared to underwater densitometry, the skinfold based formula revealed comparable values for body fatness during the study period whereas BIA showed a different pattern leading to an overestimation of body fatness starting from 4 years after age at peak height velocity. In girls, both the skinfold based formula and BIA overestimated body fatness across the whole range of years from peak height velocity. The skinfold based method appears to give an acceptable estimation of body composition during growth as compared to underwater densitometry in male adolescent sprinters. In girls, caution is warranted when interpreting estimations of body fatness by both BIA and a skinfold based formula since both methods tend to give an overestimation. PMID:26317426

  14. Some insight on censored cost estimators.

    PubMed

    Zhao, H; Cheng, Y; Bang, H

    2011-08-30

    Censored survival data analysis has been studied for many years. Yet, the analysis of censored mark variables, such as medical cost, quality-adjusted lifetime, and repeated events, faces a unique challenge that makes standard survival analysis techniques invalid. Because of the 'informative' censorship imbedded in censored mark variables, the use of the Kaplan-Meier (Journal of the American Statistical Association 1958; 53:457-481) estimator, as an example, will produce biased estimates. Innovative estimators have been developed in the past decade in order to handle this issue. Even though consistent estimators have been proposed, the formulations and interpretations of some estimators are less intuitive to practitioners. On the other hand, more intuitive estimators have been proposed, but their mathematical properties have not been established. In this paper, we prove the analytic identity between some estimators (a statistically motivated estimator and an intuitive estimator) for censored cost data. Efron (1967) made similar investigation for censored survival data (between the Kaplan-Meier estimator and the redistribute-to-the-right algorithm). Therefore, we view our study as an extension of Efron's work to informatively censored data so that our findings could be applied to other marked variables. PMID:21748774

  15. Field activity cost estimates for the first 3 years of the World Bank Loan Project for schistosomiasis control in China.

    PubMed

    Guo, J; Booth, M; Jenkins, J; Wang, H; Tanner, M

    1998-12-01

    The World Bank Loan Project for schistosomiasis in China commenced field activities in 1992. In this paper, we describe disease control strategies for levels of different endemicity, and estimate unit costs and total expenditure of screening, treatment (cattle and humans) and snail control for 8 provinces where Schistosoma japonicum infection is endemic. Overall, we estimate that more than 21 million US dollars were spent on field activities during the first three years of the project. Mollusciciding (43% of the total expenditure) and screening (28% of the total) are estimated to have the most expensive field activities. However, despite the expense of screening, a simple model predicts that selective chemotherapy could have been cheaper than mass chemotherapy in areas where infection prevalence was higher than 15%, which was the threshold for mass chemotherapy intervention. It is concluded that considerable cost savings could be made in the future by narrowing the scope of snail control activities, redefining the threshold infection prevalence for mass chemotherapy, defining smaller administrative units, and developing rapid assessment tools.

  16. Nonparametric Discrete Survival Function Estimation with Uncertain Endpoints Using an Internal Validation Subsample

    PubMed Central

    Zee, Jarcy; Xie, Sharon X.

    2015-01-01

    Summary When a true survival endpoint cannot be assessed for some subjects, an alternative endpoint that measures the true endpoint with error may be collected, which often occurs when obtaining the true endpoint is too invasive or costly. We develop an estimated likelihood function for the situation where we have both uncertain endpoints for all participants and true endpoints for only a subset of participants. We propose a nonparametric maximum estimated likelihood estimator of the discrete survival function of time to the true endpoint. We show that the proposed estimator is consistent and asymptotically normal. We demonstrate through extensive simulations that the proposed estimator has little bias compared to the naïve Kaplan-Meier survival function estimator, which uses only uncertain endpoints, and more efficient with moderate missingness compared to the complete-case Kaplan-Meier survival function estimator, which uses only available true endpoints. Finally, we apply the proposed method to a dataset for estimating the risk of developing Alzheimer's disease from the Alzheimer's Disease Neuroimaging Initiative. PMID:25916510

  17. [Number needed to treat: Interpretation and estimation in multivariable analyses and censored data].

    PubMed

    Gómez-Acebo, Inés; Dierssen-Sotos, Trinidad; Llorca, Javier

    2014-05-20

    Number needed to treat has been recommended as an easy way to transmit results from a trial, especially controlled clinical trials. Most articles estimate it from a 2×2 table, as the inverse of the absolute risk reduction. However, some limitations have been pointed out: The interpretation is not as easy as claimed, confidence intervals are frequently not estimated, and the estimation from 2×2 tables is inadequate when the main effect measure has been estimated adjusting for confounding factors. In this paper, we revise how to obtain point estimations and confidence intervals of number needed to treat in 4 situations: 2×2tables, logistic regression, Kaplan-Meier method, and Cox regression. PMID:23850150

  18. [Number needed to treat: Interpretation and estimation in multivariable analyses and censored data].

    PubMed

    Gómez-Acebo, Inés; Dierssen-Sotos, Trinidad; Llorca, Javier

    2014-05-20

    Number needed to treat has been recommended as an easy way to transmit results from a trial, especially controlled clinical trials. Most articles estimate it from a 2×2 table, as the inverse of the absolute risk reduction. However, some limitations have been pointed out: The interpretation is not as easy as claimed, confidence intervals are frequently not estimated, and the estimation from 2×2 tables is inadequate when the main effect measure has been estimated adjusting for confounding factors. In this paper, we revise how to obtain point estimations and confidence intervals of number needed to treat in 4 situations: 2×2tables, logistic regression, Kaplan-Meier method, and Cox regression.

  19. Developmental milestones record - 3 years

    MedlinePlus

    Normal childhood growth milestones - 3 years; Growth milestones for children - 3 years; Childhood growth milestones - 3 years ... milestones are typical for children in their third year of life. Always keep in mind that some ...

  20. TRMM 3-Year Anniversary

    NASA Technical Reports Server (NTRS)

    2002-01-01

    Ever wonder about the rain? Beyond the practicality of needing an umbrella, climate researchers have wondered about the science of rainfall for a long time. But it's only in the past few years that they've begun to roll back some of its secrets. One of their tools for doing so is a powerful satellite called the Tropical Rainfall Measuring Mission, or TRMM. Now, after three years of continual operation, project scientists have released dramatic new maps of rainfall patterns gathered across a wide band of the Earth. And with measurements from one of the satellite's advanced sensors, meteorologists are now able to calibrate ground-based rain monitoring systems with greater precision than ever before. A complete accounting of the world's total rainfall has long been a major goal of climate researchers. Rain acts as the atmosphere's fundamental engine for heat exchange; every time a raindrop falls, the atmosphere gets churned up and latent heat flows back into the total climate system. Considering that rainfall is the primary driving force of heat in the atmosphere, and that two thirds of all rain falls in the tropics, these measurements are significant for our understanding of overall climate. The above image shows a one month average of rainfall measurements taken by the TRMM's unique precipitation radar during January of 1998. Areas of low rainfall are colored light blue, while regions with heavy rainfal are colored orange and red. TRMM began collecting data in December of 1997, and continues today. For more information about TRMM's 3-year anniversary, read Maps of Falling Water To learn more about the TRMM mission or order TRMM data, see the TRMM Home Page. Image courtesy TRMM Science team and the NASA GSFC Scientific Visualization Studio.

  1. Robustness of survival estimates from radio-telemetry studies with uncertain relocation of individuals

    USGS Publications Warehouse

    Bunck, C.M.; Chen, C.-L.; Pollock, K.H.

    1995-01-01

    Traditional methods of estimating survival from radio-telemetry studies use either the Trent-Rongstad approach (Trent and Rongstad 1974, Heisey and Fuller 1985) or the Kaplan-Meier approach (Kaplan and Meier 1958; Pollock et al. 1989a,b). Both methods appear to require the assumption that relocation probability for animals with a functioning radio is 1. In practice this may not always be reasonable and, in fact, is unnecessary. The number of animals at risk (i.e., risk set) can be modified to account for uncertain relocation of individuals. This involves including only relocated animals in the risk set instead of also including animals not relocated but that were seen later. Simulation results show that estimators and tests for comparing survival curves should be based on this modification.

  2. Analysis of the magnitude and frequency of the 4-day annual low flow and regression equations for estimating the 4-day, 3-year low-flow frequency at ungaged sites on unregulated streams in New Mexico

    USGS Publications Warehouse

    Waltemeyer, Scott D.

    2002-01-01

    Two regression equations were developed for estimating the 4- day, 3-year (4Q3) low-flow frequency at ungaged sites on unregulated streams in New Mexico. The first, a statewide equation for estimating the 4Q3 low-flow frequency from drainage area and average basin mean winter precipitation, was developed from the data for 50 streamflow-gaging stations that had non-zero 4Q3 low-flow frequency. The 4Q3 low-flow frequency for the 50 gaging stations ranged from 0.08 to 18.7 cubic feet per second. For this statewide equation, the average standard error of estimate was 126 percent and the coefficient of determination was 0.48. The second, an equation for estimating the 4Q3 low-flow frequency in mountainous regions from drainage area, average basin mean winter precipitation, and average basin slope, was developed from the data for 40 gaging stations located above 7,500 feet in elevation. For this regression equation, the average standard error of estimate was 94 percent and the coefficient of determination was 0.66. A U.S. Geological Survey computer-program interface for a geographical information system (GIS), called the GIS Weasel, was used to determine basin and climatic characteristics for 84 gaging stations that were not affected by regulation. Mean monthly precipitation estimates from 1961 to 1990 were used in the GIS Weasel to compute the climatic characteristics of average basin winter precipitation and annual mean precipitation. The U.S. Geological Survey National Elevation Dataset, which currently consists of the 7.5-minute, 30-meter digital elevation model for each State, was used in the GIS Weasel to compute the basin characteristics of drainage area, average basin slope, average basin elevation, and average basin aspect. Basin and climatic characteristics that were statistically significant in the regression equation with the 4Q3 low-flow frequency were drainage area, which ranged from 1.62 to 5,900 square miles; average basin mean winter precipitation, which

  3. Robustness of survival estimates for radio-marked animals

    USGS Publications Warehouse

    Bunck, C.M.; Chen, C.-L.

    1992-01-01

    Telemetry techniques are often used to study the survival of birds and mammals; particularly whcn mark-recapture approaches are unsuitable. Both parametric and nonparametric methods to estimate survival have becn developed or modified from other applications. An implicit assumption in these approaches is that the probability of re-locating an animal with a functioning transmitter is one. A Monte Carlo study was conducted to determine the bias and variance of the Kaplan-Meier estimator and an estimator based also on the assumption of constant hazard and to eva!uate the performance of the two-sample tests associated with each. Modifications of each estimator which allow a re-Iocation probability of less than one are described and evaluated. Generallv the unmodified estimators were biased but had lower variance. At low sample sizes all estimators performed poorly. Under the null hypothesis, the distribution of all test statistics reasonably approximated the null distribution when survival was low but not when it was high. The power of the two-sample tests were similar.

  4. Survival estimation and the effects of dependency among animals

    USGS Publications Warehouse

    Schmutz, Joel A.; Ward, David H.; Sedinger, James S.; Rexstad, Eric A.

    1995-01-01

    Survival models assume that fates of individuals are independent, yet the robustness of this assumption has been poorly quantified. We examine how empirically derived estimates of the variance of survival rates are affected by dependency in survival probability among individuals. We used Monte Carlo simulations to generate known amounts of dependency among pairs of individuals and analyzed these data with Kaplan-Meier and Cormack-Jolly-Seber models. Dependency significantly increased these empirical variances as compared to theoretically derived estimates of variance from the same populations. Using resighting data from 168 pairs of black brant, we used a resampling procedure and program RELEASE to estimate empirical and mean theoretical variances. We estimated that the relationship between paired individuals caused the empirical variance of the survival rate to be 155% larger than the empirical variance for unpaired individuals. Monte Carlo simulations and use of this resampling strategy can provide investigators with information on how robust their data are to this common assumption of independent survival probabilities.

  5. Product limit estimation for capturing of pressure distribution dynamics.

    PubMed

    Wininger, Michael; Crane, Barbara A

    2016-05-01

    Measurement of contact pressures at the wheelchair-seating interface is a critically important approach for laboratory research and clinical application in monitoring risk for pressure ulceration. As yet, measures obtained from pressure mapping are static in nature: there is no accounting for changes in pressure distribution over time, despite the well-known interaction between time and pressure in risk estimation. Here, we introduce the first dynamic analysis for distribution of pressure data, based on the Kaplan-Meier (KM) Product Limit Estimator (PLE) a ubiquitous tool encountered in clinical trials and survival analysis. In this approach, the pressure array-over-time data set is sub-sampled two frames at a time (random pairing), and their similarity of pressure distribution is quantified via a correlation coefficient. A large number (here: 100) of these frame pairs is then sorted into descending order of correlation value, and visualized as a KM curve; we build confidence limits via a bootstrap computed over 1000 replications. PLEs and the KM have robust statistical support and extensive development: the opportunities for extended application are substantial. We propose that the KM-PLE in particular, and dynamic analysis in general, may provide key leverage on future development of seating technology, and valuable new insight into extant datasets. PMID:27021374

  6. Doubly-robust estimators of treatment-specific survival distributions in observational studies with stratified sampling.

    PubMed

    Bai, Xiaofei; Tsiatis, Anastasios A; O'Brien, Sean M

    2013-12-01

    Observational studies are frequently conducted to compare the effects of two treatments on survival. For such studies we must be concerned about confounding; that is, there are covariates that affect both the treatment assignment and the survival distribution. With confounding the usual treatment-specific Kaplan-Meier estimator might be a biased estimator of the underlying treatment-specific survival distribution. This article has two aims. In the first aim we use semiparametric theory to derive a doubly robust estimator of the treatment-specific survival distribution in cases where it is believed that all the potential confounders are captured. In cases where not all potential confounders have been captured one may conduct a substudy using a stratified sampling scheme to capture additional covariates that may account for confounding. The second aim is to derive a doubly-robust estimator for the treatment-specific survival distributions and its variance estimator with such a stratified sampling scheme. Simulation studies are conducted to show consistency and double robustness. These estimators are then applied to the data from the ASCERT study that motivated this research. PMID:24117096

  7. Doubly-robust Estimators of Treatment-specific Survival Distributions in Observational Studies with Stratified Sampling

    PubMed Central

    Bai, Xiaofei; Tsiatis, Anastasios A.; O'Brien, Sean M.

    2013-01-01

    Summary Observational studies are frequently conducted to compare the effects of two treatments on survival. For such studies we must be concerned about confounding; that is, there are covariates that affect both the treatment assignment and the survival distribution. With confounding the usual treatment-specific Kaplan-Meier estimator might be a biased estimator of the underlying treatment-specific survival distribution. This paper has two aims. In the first aim we use semiparametric theory to derive a doubly robust estimator of the treatment-specific survival distribution in cases where it is believed that all the potential confounders are captured. In cases where not all potential confounders have been captured one may conduct a substudy using a stratified sampling scheme to capture additional covariates that may account for confounding. The second aim is to derive a doubly-robust estimator for the treatment-specific survival distributions and its variance estimator with such a stratified sampling scheme. Simulation studies are conducted to show consistency and double robustness. These estimators are then applied to the data from the ASCERT study that motivated this research. PMID:24117096

  8. How Grammatical Are 3-Year-Olds?

    ERIC Educational Resources Information Center

    Eisenberg, Sarita L.; Guo, Ling-Yu; Germezia, Mor

    2012-01-01

    Purpose: This study investigated the level of grammatical accuracy in typically developing 3-year-olds and the types of errors they produce. Method: Twenty-two 3-year-olds participated in a picture description task. The percentage of grammatical utterances was computed and error types were analyzed. Results: The mean level of grammatical accuracy…

  9. Simultaneous marginal survival estimators when doubly censored data is present.

    PubMed

    Julià, Olga; Gómez, Guadalupe

    2011-07-01

    A doubly censoring scheme occurs when the lifetimes T being measured,from a well-known time origin, are exactly observed within a window [L, R] of observational time and are otherwise censored either from above (right-censored observations)or below (left-censored observations). Sample data consists on the pairs (U, δ)where U = min{R, max{T, L}} and δ indicates whether T is exactly observed (δ = 0),right-censored (δ = 1) or left-censored (δ = −1). We are interested in the estimation of the marginal behaviour of the three random variables T, L and R based on the observed pairs (U, δ).We propose new nonparametric simultaneous marginal estimators Ŝ(T) , Ŝ(L) and Ŝ(R) for the survival functions of T, L and R, respectively, by means of an inverse-probability-of-censoring approach. The proposed estimators Ŝ(T) , Ŝ(L) and Ŝ(R) are not computationally intensive, generalize the empirical survival estimator and reduce to the Kaplan-Meier estimator in the absence of left-censored data. Furthermore,Ŝ(T) is equivalent to a self-consistent estimator, is uniformly strongly consistent and asymptotically normal. The method is illustrated with data from a cohort of drug users recruited in a detoxification program in Badalona (Spain). For these data we estimate the survival function for the elapsed time from starting IV-drugs to AIDS diagnosis, as well as the potential follow-up time. A simulation study is discussed to assess the performance of the three survival estimators for moderate sample sizes and different censoring levels.

  10. Nested Cohort

    Cancer.gov

    NestedCohort is an R software package for fitting Kaplan-Meier and Cox Models to estimate standardized survival and attributable risks for studies where covariates of interest are observed on only a sample of the cohort.

  11. Estimation of the age at onset in spinocerebellar ataxia type 2 Cuban patients by survival analysis.

    PubMed

    Almaguer-Mederos, L E; Falcón, N S; Almira, Y R; Zaldivar, Y G; Almarales, D C; Góngora, E M; Herrera, M P; Batallán, K E; Armiñán, R R; Manresa, M V; Cruz, G S; Laffita-Mesa, J; Cyuz, T M; Chang, V; Auburger, G; Gispert, S; Pérez, L V

    2010-08-01

    Previous studies have investigated the close association that exists between CAG repeat number and the age at onset in SCA2 = spinocerebellar ataxia type 2. These studies have focused on affected individuals. To further characterize this association and estimate the risk of a carrier developing SCA2 at a particular age as a function of a specific CAG repeat size, we have analyzed a large group of 924 individuals, including 394 presymptomatic and 530 affected individuals with a CAG repeat length of 32-79 units. Using a Kaplan-Meier survival analysis, we obtained cumulative probability curves for disease manifestation at a particular age for each CAG repeat length in the 34-45 range. These curves were significantly different (p < 0.001) and showed small overlap. All these information may be very valuable in predictive-testing programs, in the planning of studies for the identification of other genetic and environmental factors as modifiers of age at onset, and in the design of clinical trials for people at enlarged risk for SCA2. PMID:20095980

  12. AID awards 3-year Guatemala contract.

    PubMed

    1984-01-01

    The US Agency for International Development (USAID) has awarded a 3-year US$593,036 grant to the Los Angeles firm of Juarez and Associates, Inc. to help implement a contraceptive social marketing project in Guatemala. The firm will provide marketing assistance to the for-profit organization. Importadora de Productos Farmaceuticos (PROFA), an offshoot of the nonprofit International Planned Parenthood Federation affiliate, Asociacion Pro-Bienestar de la Familia de Guatemala (APROFAM), created specifically to conduct the social marketing project. Juarez and Associates has previous market research experience in family planning in Guatemala. Contraceptive social marketing sales are projected to begin in early 1985. PMID:12313310

  13. AID awards 3-year Guatemala contract.

    PubMed

    1984-01-01

    The US Agency for International Development (USAID) has awarded a 3-year US$593,036 grant to the Los Angeles firm of Juarez and Associates, Inc. to help implement a contraceptive social marketing project in Guatemala. The firm will provide marketing assistance to the for-profit organization. Importadora de Productos Farmaceuticos (PROFA), an offshoot of the nonprofit International Planned Parenthood Federation affiliate, Asociacion Pro-Bienestar de la Familia de Guatemala (APROFAM), created specifically to conduct the social marketing project. Juarez and Associates has previous market research experience in family planning in Guatemala. Contraceptive social marketing sales are projected to begin in early 1985.

  14. A clinician's 3-year experience with perioscopy.

    PubMed

    Stambaugh, Roger V

    2002-11-01

    A medical endoscope has been modified for assisting the clinician in subgingival scaling and root planing. The dental endoscope provides real-time indirect visualization of the root surface for aiding the removal of root deposits and biofilm. When the majority of biofilm and visible calculus is removed from the root surface in a periodontal pocket, the pocket will most often close, resulting in a shallow sulcus. Many lesions on single-rooted teeth can be treated successfully with this technique, resulting in a significant reduction in probable pocket depth and a gain in the calibrated attachment level. Other sites, such as furcations and maxillary first bicuspids, may demonstrate significant improvement but not complete resolution of these parameters. Perioscopy is scaling and root planing aided by indirect vision with an endoscope. This technique can offer many patients an alternative to periodontal surgery in carefully selected sites. This article describes the clinical rationale for perioscopy, defines those sites that most predictably will respond to this mode of therapy, and offers some guidelines on integrating this technology into the dental practice. The observations and recommendations in this article are based on the author's 3-year experience with the dental endoscope in his periodontal practice, the experience of other periodontists and dental hygienists, and published reports. PMID:12789986

  15. A clinician's 3-year experience with perioscopy.

    PubMed

    Stambaugh, Roger V

    2002-11-01

    A medical endoscope has been modified for assisting the clinician in subgingival scaling and root planing. The dental endoscope provides real-time indirect visualization of the root surface for aiding the removal of root deposits and biofilm. When the majority of biofilm and visible calculus is removed from the root surface in a periodontal pocket, the pocket will most often close, resulting in a shallow sulcus. Many lesions on single-rooted teeth can be treated successfully with this technique, resulting in a significant reduction in probable pocket depth and a gain in the calibrated attachment level. Other sites, such as furcations and maxillary first bicuspids, may demonstrate significant improvement but not complete resolution of these parameters. Perioscopy is scaling and root planing aided by indirect vision with an endoscope. This technique can offer many patients an alternative to periodontal surgery in carefully selected sites. This article describes the clinical rationale for perioscopy, defines those sites that most predictably will respond to this mode of therapy, and offers some guidelines on integrating this technology into the dental practice. The observations and recommendations in this article are based on the author's 3-year experience with the dental endoscope in his periodontal practice, the experience of other periodontists and dental hygienists, and published reports.

  16. Biochemical Control With Radiotherapy Improves Overall Survival in Intermediate and High-Risk Prostate Cancer Patients Who Have an Estimated 10-Year Overall Survival of >90%

    SciTech Connect

    Herbert, Christopher; Liu, Mitchell; Tyldesley, Scott; Morris, W. James; Joffres, Michel; Khaira, Mandip; Kwan, Winkle; Moiseenko, Vitali; Pickles, Thomas

    2012-05-01

    Purpose: To identify subgroups of patients with carcinoma of the prostate treated with radical radiotherapy that have improved overall survival when disease is biochemically controlled. Methods and Materials: A cohort of 1,060 prostate cancer patients treated with radical radiotherapy was divided into nine subgroups based on National Comprehensive Cancer Network risk category and estimated 10-year overall survival (eOS 10y) derived from the age adjusted Charlson Comorbidity Index. Patients with and without biochemical control were compared with respect to overall survival. Actuarial estimates of overall survival were calculated using the Kaplan-Meier method. Univariate and multivariate Cox proportional hazards models were used for analysis of overall survival. Results: Median follow-up was 125 months (range, 51-176 months). Only the subgroups with high or intermediate risk disease and an eOS 10y of >90% had a statistically significantly improved overall survival when prostate cancer was biochemically controlled. In all other groups, biochemical control made no significant difference to overall survival. In the subgroup with high-risk disease and eOS 10y >90%, actuarial overall survival was 86.3% (95% confidence interval [CI] 78.5%-94.1%) and 62.1% (95% CI 52.9%-71.3%) for patients with biochemical control and biochemical relapse respectively (p = 0.002). In the intermediate risk group with eOS >90%, actuarial overall survival was 95.3% (95% CI 89.0%-100%) and 79.8% (95% CI 68.0%-91.6%) for biochemically controlled and biochemically relapsed patients (p = 0.033). On multivariate analysis, National Comprehensive Cancer Network risk group (p = 0.005), biochemical control (p = 0.033) and eOS 10y (p < 0.001) were statistically significant. Conclusion: Biochemical control translates into improved overall survival in patients with high or intermediate risk disease and an estimated 10-year overall survival of >90%.

  17. Growth and Your 2- to 3-Year-Old

    MedlinePlus

    ... to Know About Zika & Pregnancy Growth and Your 2- to 3-Year-Old KidsHealth > For Parents > Growth and Your 2- to 3-Year-Old Print A A A ... 4 pounds (1.8 kilograms) and grow about 2 to 3 inches (5 to 8 centimeters). They' ...

  18. Estimating the mean and standard deviation of environmental data with below detection limit observations: Considering highly skewed data and model misspecification.

    PubMed

    Shoari, Niloofar; Dubé, Jean-Sébastien; Chenouri, Shoja'eddin

    2015-11-01

    In environmental studies, concentration measurements frequently fall below detection limits of measuring instruments, resulting in left-censored data. Some studies employ parametric methods such as the maximum likelihood estimator (MLE), robust regression on order statistic (rROS), and gamma regression on order statistic (GROS), while others suggest a non-parametric approach, the Kaplan-Meier method (KM). Using examples of real data from a soil characterization study in Montreal, we highlight the need for additional investigations that aim at unifying the existing literature. A number of studies have examined this issue; however, those considering data skewness and model misspecification are rare. These aspects are investigated in this paper through simulations. Among other findings, results show that for low skewed data, the performance of different statistical methods is comparable, regardless of the censoring percentage and sample size. For highly skewed data, the performance of the MLE method under lognormal and Weibull distributions is questionable; particularly, when the sample size is small or censoring percentage is high. In such conditions, MLE under gamma distribution, rROS, GROS, and KM are less sensitive to skewness. Related to model misspecification, MLE based on lognormal and Weibull distributions provides poor estimates when the true distribution of data is misspecified. However, the methods of rROS, GROS, and MLE under gamma distribution are generally robust to model misspecifications regardless of skewness, sample size, and censoring percentage. Since the characteristics of environmental data (e.g., type of distribution and skewness) are unknown a priori, we suggest using MLE based on gamma distribution, rROS and GROS.

  19. Long-Term Outcomes With Intraoperative Radiotherapy as a Component of Treatment for Locally Advanced or Recurrent Uterine Sarcoma

    SciTech Connect

    Barney, Brandon M.; Petersen, Ivy A.; Dowdy, Sean C.; Bakkum-Gamez, Jamie N.; Haddock, Michael G.

    2012-05-01

    Purpose: To report our institutional experience with intraoperative radiotherapy (IORT) as a component of treatment for women with locally advanced or recurrent uterine sarcoma. Methods and Materials: From 1990 to 2010, 16 women with primary (n = 3) or locoregionally recurrent (n = 13) uterine sarcoma received IORT as a component of combined modality treatment. Tumor histology studies found leiomyosarcoma (n = 9), endometrial stromal sarcoma (n = 4), and carcinosarcoma (n = 3). Surgery consisted of gross total resection in 2 patients, subtotal resection in 6 patients, and resection with close surgical margins in 8 patients. The median IORT dose was 12.5 Gy (range, 10-20 Gy). All patients received perioperative external beam radiotherapy (EBRT; median dose, 50.4 Gy; range, 20-62.5 Gy), and 6 patients also received perioperative systemic therapy. Results: Seven of the 16 patients are alive at a median follow-up of 44 months (range, 11-203 months). The 3-year Kaplan-Meier estimate of local relapse (within the EBRT field) was 7%, and central control (within the IORT field) was 100%. No local failures occurred in any of the 6 patients who underwent subtotal resection. The 3-year freedom from distant relapse was 48%, with failures occurring most frequently in the lungs or mediastinum. Median survival was 18 months, and 3-year Kaplan-Meier estimates of cause-specific and overall survival were 58% and 53%, respectively. Three patients (19%) experienced late Grade 3 toxicity. Conclusions: A combined modality approach with perioperative EBRT, surgery, and IORT for locally advanced or recurrent uterine sarcoma resulted in excellent local disease control with acceptable toxicity, even in patients with positive resection margins. With this approach, some patients were able to experience long-term freedom from recurrence.

  20. Similarity Predicts Liking in 3-Year-Old Children

    ERIC Educational Resources Information Center

    Fawcett, Christine A.; Markson, Lori

    2010-01-01

    Two studies examined the influence of similarity on 3-year-old children's initial liking of their peers. Children were presented with pairs of childlike puppets who were either similar or dissimilar to them on a specified dimension and then were asked to choose one of the puppets to play with as a measure of liking. Children selected the puppet…

  1. The Structure of Executive Function in 3-Year-Olds

    ERIC Educational Resources Information Center

    Wiebe, Sandra A.; Sheffield, Tiffany; Nelson, Jennifer Mize; Clark, Caron A. C.; Chevalier, Nicolas; Espy, Kimberly Andrews

    2011-01-01

    Although the structure of executive function (EF) during adulthood is characterized by both unity and diversity, recent evidence suggests that preschool EF may be best described by a single factor. The latent structure of EF was examined in 228 3-year-olds using confirmatory factor analysis. Children completed a battery of executive tasks that…

  2. A Study of Differentiated Instructional Change over 3 Years

    ERIC Educational Resources Information Center

    VanTassel-Baska, Joyce; Feng, Annie Xuemei; Brown, Elissa; Bracken, Bruce; Stambaugh, Tamra; French, Heather; McGowan, Susan; Worley, Bess; Quek, Chwee; Bai, Wenyu

    2008-01-01

    This study examines Title 1 heterogeneous classroom teachers' instructional behavior change through implementing well-designed research-based curriculum units and attending regular professional development activities across 3 years. Employing an experimental design, this study compares experimental and comparison teachers' behavioral changes as…

  3. Developing Dialogic Argumentation Skills: A 3-Year Intervention Study

    ERIC Educational Resources Information Center

    Crowell, Amanda; Kuhn, Deanna

    2014-01-01

    Argumentation is increasingly recognized as a fundamental intellectual skill, but evidence suggests that few adolescents or adults are skilled arguers. This article reports on an extended (3-year, twice weekly) intervention designed to afford dense practice in dialogic argumentation to middle-school students from traditionally academically…

  4. Health Blogging and Social Support: A 3-Year Panel Study.

    PubMed

    Keating, David M; Rains, Stephen A

    2015-01-01

    The reported study explored the implications of informal computer-mediated social support for the well-being of individuals coping with illness over the course of 3 years. A panel study was conducted in which respondents--bloggers writing about their experiences living with a health condition--reported on their perceptions of social support and well-being during 2010 and again during 2013. Among respondents who completed both questionnaires (n = 49), increases in support availability from family and friends were related to improvements in bloggers' health self-efficacy as well as improvements in bloggers' loneliness, particularly among those who also experienced increased support availability from blog readers. Increased blog reader support availability was associated with improvements in bloggers' health-related uncertainty. Among respondents who completed the initial questionnaire (N = 121), a survival analysis showed that neither support available from family and friends nor support from blog readers predicted continued health blogging over the 3-year period.

  5. [Dermatobia hominis infection in a 3-year-old child].

    PubMed

    Meissner, M; Kippenberger, S; Valesky, E M; Kaufmann, R

    2012-04-01

    In the context of increasing travel to the tropics, outpatient services are more frequently confronted with non-domestic diseases in Europe. A 3-year old child presented with a painful tumor of the scalp. After incision of the furuncle-like lesion, we extracted a larva of the botfly Dermatobia hominis. Botflies are mainly encountered in Central and South America; they should be considered if patients demonstrate a furuncle-like lesion and have returned from a holiday in these endemic regions.

  6. Pulmonary nocardiosis in a 3-year-old child

    PubMed Central

    Holdaway, M. D.; Kennedy, J.; Ashcroft, T.; Kay-Butler, J. J.

    1967-01-01

    Until 1960, 179 cases of infection with Nocardia asteroides had been described in the world literature. Seventeen cases in children were reported by 1963. The organism is a common saprophyte in nature with probably a world-wide distribution. Infection can be primary but is more common in patients with underlying malignancy, auto-immune disease or preceding tuberculosis. Sulphonamides, particularly sulphadiazine, are the drugs of choice in treatment; the value of antibiotics is less clearly established. The indications for surgical treatment have not yet been defined. We record a further case of primary pulmonary nocardiosis in a 3-year-old child. Images PMID:6035802

  7. Extrinsic Rewards Diminish Costly Sharing in 3-Year-Olds.

    PubMed

    Ulber, Julia; Hamann, Katharina; Tomasello, Michael

    2016-07-01

    Two studies investigated the influence of external rewards and social praise in young children's fairness-related behavior. The motivation of ninety-six 3-year-olds' to equalize unfair resource allocations was measured in three scenarios (collaboration, windfall, and dictator game) following three different treatments (material reward, verbal praise, and neutral response). In all scenarios, children's willingness to engage in costly sharing was negatively influenced when they had received a reward for equal sharing during treatment than when they had received praise or no reward. The negative effect of material rewards was not due to subjects responding in kind to their partner's termination of rewards. These results provide new evidence for the intrinsic motivation of prosociality-in this case, costly sharing behavior-in preschool children. PMID:27084549

  8. GRB 030329: 3 years of radio afterglow monitoring.

    PubMed

    van der Horst, A J; Kamble, A; Wijers, R A M J; Resmi, L; Bhattacharya, D; Rol, E; Strom, R; Kouveliotou, C; Oosterloo, T; Ishwara-Chandra, C H

    2007-05-15

    Radio observations of gamma-ray burst (GRB) afterglows are essential for our understanding of the physics of relativistic blast waves, as they enable us to follow the evolution of GRB explosions much longer than the afterglows in any other wave band. We have performed a 3-year monitoring campaign of GRB 030329 with the Westerbork Synthesis Radio Telescopes and the Giant Metrewave Radio Telescope. Our observations, combined with observations at other wavelengths, have allowed us to determine the GRB blast wave physical parameters, such as the total burst energy and the ambient medium density, as well as to investigate the jet nature of the relativistic outflow. Further, by modelling the late-time radio light curve of GRB 030329, we predict that the Low-Frequency Array (30-240 MHz) will be able to observe afterglows of similar GRBs, and constrain the physics of the blast wave during its non-relativistic phase.

  9. Severe hypercholesterolemia and liver disease in a 3-year old.

    PubMed

    Patel, Amol M; Brautbar, Ariel; Desai, Nirav K; Wilson, Don P

    2016-01-01

    Lipoprotein-X, which is composed of phospholipids and non-esterified cholesterol, is an abnormal lipoprotein with a density range similar to LDL-C. The two most common ways which lipoprotein-X accumulates is from reflux of bile salts into plasma or deficiency in lecithin cholesterol acyltransferase. This is a case of severe hypercholesterolemia and liver disease in a 3- year old male that presented with pruritus, pale stool, scleral ictus, and abdominal distention. He was diagnosed with primary sclerosing cholangitis which was confirmed by liver biopsy. Our patient was treated with steroids and immunomodulator therapy which was associated with significant reduction in cholestasis and LDL-C levels. Lipoprotein-X has several properties that make it anti-atherogenic, which raises the question if treatment for hypercholesterolemia should be initiated. PMID:27206954

  10. GRB 030329: 3 years of radio afterglow monitoring.

    PubMed

    van der Horst, A J; Kamble, A; Wijers, R A M J; Resmi, L; Bhattacharya, D; Rol, E; Strom, R; Kouveliotou, C; Oosterloo, T; Ishwara-Chandra, C H

    2007-05-15

    Radio observations of gamma-ray burst (GRB) afterglows are essential for our understanding of the physics of relativistic blast waves, as they enable us to follow the evolution of GRB explosions much longer than the afterglows in any other wave band. We have performed a 3-year monitoring campaign of GRB 030329 with the Westerbork Synthesis Radio Telescopes and the Giant Metrewave Radio Telescope. Our observations, combined with observations at other wavelengths, have allowed us to determine the GRB blast wave physical parameters, such as the total burst energy and the ambient medium density, as well as to investigate the jet nature of the relativistic outflow. Further, by modelling the late-time radio light curve of GRB 030329, we predict that the Low-Frequency Array (30-240 MHz) will be able to observe afterglows of similar GRBs, and constrain the physics of the blast wave during its non-relativistic phase. PMID:17293318

  11. 3-year experience with US QML: lessons learned

    NASA Astrophysics Data System (ADS)

    Leseur, M.

    2002-12-01

    Based on its 20 years experience in manufacturing semiconductor devices, Atmel Nantes has chosen to apply QML concept to move from Product Qualification to Technology Qualification. Defense Supply Center Colombus granted Atmel Nantes QML Q & V (class Q = military quality level , class V = space quality level), in December 1999. A demonstration phase is on-going with draft ESA/SCC 25400 and 2549000 basic specifications for the definition of a European QML. Atmel is a candidate as an integrated microcircuits manufacturer. After 3 years producing QML devices, some optimisations of screening tests have been implemented. This appears to be a valid solution for reducing both cost and cycle time with no impact on product reliability.

  12. ISS ECLSS: 3 Years of Logistics for Maintenance

    NASA Technical Reports Server (NTRS)

    Shkedi, Brienne; Thompson, Dean

    2004-01-01

    The International Space Station (ISS) Environmental Control and Life Support System (ECLSS) is designed to be maintainable. During the 3 years since the ISS US Lab became operational, there have been numerous ECLSS Orbital Replacement Units (ORUs) launched and returned to Maintain the ECLSS operation in the US segments. The maintenance logistics have provided tools for maintenance, replaced limited life ORUs and failed ORUs, upgraded ECLSS hardware to improve reliability and placed critical spares onboard prior to need. In most cases, the removed ORUs have been returned for either failure analysis and repair or refurbishment. This paper describes the ECLSS manifesting history and maintenance events and quantifies the numbers of ECLSS items, weights, and volumes.

  13. ASURV: Astronomical SURVival Statistics

    NASA Astrophysics Data System (ADS)

    Feigelson, E. D.; Nelson, P. I.; Isobe, T.; LaValley, M.

    2014-06-01

    ASURV (Astronomical SURVival Statistics) provides astronomy survival analysis for right- and left-censored data including the maximum-likelihood Kaplan-Meier estimator and several univariate two-sample tests, bivariate correlation measures, and linear regressions. ASURV is written in FORTRAN 77, and is stand-alone and does not call any specialized libraries.

  14. An identifiable model for informative censoring

    USGS Publications Warehouse

    Link, W.A.; Wegman, E.J.; Gantz, D.T.; Miller, J.J.

    1988-01-01

    The usual model for censored survival analysis requires the assumption that censoring of observations arises only due to causes unrelated to the lifetime under consideration. It is easy to envision situations in which this assumption is unwarranted, and in which use of the Kaplan-Meier estimator and associated techniques will lead to unreliable analyses.

  15. SMOS Instrument Performance and Calibration after 3 Years in Orbit

    NASA Astrophysics Data System (ADS)

    Martin-Neira, Manuel; Corbella, Ignasi; Torres, Francesc; Kainulainen, Juha; Oliva, Roger; Closa, Josep; Cabot, François; Castro, Rita; Barbosa, Jose; Gutierrez, Antonio; Anterrieu, Eric; Tenerelli, Joe; Martin-Porqueras, Fernando; Buenadicha, Guillermo; Delwart, Steven; Crapolicchio, Raffaele; Suess, Martin

    2013-04-01

    ESA's Soil Moisture and Ocean Salinity (SMOS) mission has been in orbit for already over 3 years which has allowed the calibration and data processing team consolidating both the calibration strategy and the Level-1 processor which transforms the raw visibility samples into polarimetric brightness temperature images. The payload on board SMOS, MIRAS, is quite unique in that it is the first microwave radiometer in space ever capable to generate wide field of view images at every snapshot measurement. This means that most of the calibration as well as image processing techniques are being developed for the first time with little heritage from any previous space mission. Issues intrinsically attached to its wide field of view such as spatial ripples across the snapshot images are particular to MIRAS and to no other earlier radiometer. Even the fundamental theory behind the instrument was put at test, first on ground inside an electromagnetic compatibility chamber, and now in orbit when imaging the Cosmic Microwave Background Radiation of the cold sky. A groundbreaking effort is being carried out by the SMOS project team to understand and master all calibration and image reconstruction issues of this novel microwave interferometer payload. MIRAS in-orbit performance is driven by the amplitude of spatial ripples across the image and orbital and seasonal radiometer stability. Spatial ripples are unique to interferometric radiometers and are produced by (a) a limited knowledge of the antenna patterns and, in general, of the model of the instrument, (b) some fundamental limitations related to the inverse problem of image reconstruction in undetermined conditions and (c) subtle data processing inconsistencies which are discovered and corrected. To reduce the spatial ripples sea surface salinity retrievals are performed by first removing the brightness temperature spatial errors using a uniform region of the Pacific Ocean. However soil moisture retrievals cannot benefit of

  16. Sun tanning-related burns--a 3-year experience.

    PubMed

    Piccolo-Lobo, M S; Piccolo, N S; Piccolo-Daher, M T; Cardoso, V M

    1992-04-01

    A retrospective study has analyzed 562 sun-related burns out of 19,643 patients treated at our institution from 1 March 1988 to 28 February 1991. These patients were analysed according to sex, age, burn area, mode and length of treatment and outcome. Females, mainly adults, represented 60.8 per cent of all patients presenting burned due to sun bathing. There is a marked seasonal incidence, proportionally constant throughout these 3 years. The main causes of injury were sun only (36.7 per cent), sun plus fig leaf 'tea' tanning lotion (17.7 per cent) and lemon juice (17.7 per cent). Healing to normal skin appearance was achieved in 99.1 per cent, 0.7 per cent healed with scarring and one patient died due to massive sepsis. The effect of sunlight on skin and the process of 'sunburn' when using homemade plant-derived tanning lotions containing substances which can induce a photodermatitis reaction is also discussed.

  17. Understanding the gendered patterns of substance use initiation among adolescents living in rural, central Mexico

    PubMed Central

    Ayers, Stephanie; Marsiglia, Flavio; Hoffman, Steven; Urbaeva, Zhyldyz

    2012-01-01

    Background Little is known about the age of initiation and gender differences in substance use among adolescents in rural, central Mexico. Methods The cross-sectional data were collected from students enrolled in the Videobachillerato (VIBA) (video high school) program in Guanajuato, Mexico. Questionnaires asked students about the age at which they had used alcohol, cigarettes, or marijuana for the first time. Kaplan-Meier Survival Functions were used to estimate if males and females were significantly different in their cumulative probabilities of initiating substances over time. Results On average, alcohol is initiated at 14.7 years of age, cigarettes at 15.1 years of age, and marijuana at 16.5 years of age. Over time, males had a significantly higher probability of initiating alcohol (Kaplan-Meier Failure Curve: Χ2=26.35, p<0.001), cigarettes (Kaplan-Meier Failure Curve: Χ2=41.90, p<0.001), and marijuana (Kaplan-Meier Failure Curve: Χ2=38.01, p<0.001) compared to females. Conclusions These results highlight the gendered patterns of substance use initiation among adolescents in rural, central Mexico and underscore the need for gendered substance use prevention interventions with these adolescents. By putting forth efforts to understand substance use initiation patterns of adolescents living in rural, central Mexico, culturally specific and efficacious prevention efforts can be tailor-made to create lasting differences. PMID:22421555

  18. Vascular Calcification in Patients with Nondialysis CKD over 3 Years

    PubMed Central

    Molina, Pablo; Cerverón, M. Jesús; Vila, Rocío; Bover, Jordi; Nieto, Javier; Barril, Guillermina; Martínez-Castelao, Alberto; Fernández, Elvira; Escudero, Verónica; Piñera, Celestino; Adragao, Teresa; Navarro-Gonzalez, Juan F.; Molinero, Luis M.; Castro-Alonso, Cristina; Pallardó, Luis M.; Jamal, Sophie A.

    2015-01-01

    Background and objectives Vascular calcification (VC) is common in CKD, but little is known about its prognostic effect on patients with nondialysis CKD. The prevalence of VC and its ability to predict death, time to hospitalization, and renal progression were assessed. Design, setting, participants, & measurements The Study of Mineral and Bone Disorders in CKD in Spain is a prospective, observational, 3-year follow-up study of 742 patients with nondialysis CKD stages 3–5 from 39 centers in Spain from April to May 2009. VC was assessed using Adragao (AS; x-ray pelvis and hands) and Kauppila (KS; x-ray lateral lumbar spine) scores from 572 and 568 patients, respectively. The primary end point was death. Secondary outcomes were hospital admissions and appearance of a combined renal end point (beginning of dialysis or drop >30% in eGFR). Factors related to VC were assessed by logistic regression analysis. Survival analysis was assessed by Cox proportional models. Results VC was present in 79% of patients and prominent in 47% (AS≥3 or KS>6). Age (odds ratio [OR], 1.05; 95% confidence interval [95% CI], 1.02 to 1.07; P<0.001), phosphorous (OR, 1.68; 95% CI, 1.28 to 2.20; P<0.001), and diabetes (OR, 2.11; 95% CI, 1.32 to 3.35; P=0.002) were independently related to AS≥3. After a median follow-up of 35 months (interquartile range=17–36), there were 70 deaths (10%). After multivariate adjustment for age, smoking, diabetes, comorbidity, renal function, and level of phosphorous, AS≥3 but not KS>6 was independently associated with all-cause (hazard ratio [HR], 2.07; 95% CI, 1.07 to 4.01; P=0.03) and cardiovascular (HR, 3.46; 95% CI, 1.27 to 9.45; P=0.02) mortality as well as a shorter hospitalization event–free period (HR, 1.14; 95% CI, 1.06 to 1.22; P<0.001). VC did not predict renal progression. Conclusions VC is highly prevalent in patients with CKD. VC assessment using AS independently predicts death and time to hospitalization. Therefore, it could be a useful

  19. Deep Space 1 Ion Engine Completed a 3-Year Journey

    NASA Technical Reports Server (NTRS)

    Sovey, James S.; Patterson, Michael J.; Rawlin, Vincent K.; Hamley, John A.

    2001-01-01

    A xenon ion engine and power processor system, which was developed by the NASA Glenn Research Center in partnership with the Jet Propulsion Laboratory and Boeing Electron Dynamic Devices, completed nearly 3 years of operation aboard the Deep Space 1 spacecraft. The 2.3-kW ion engine, which provided primary propulsion and two-axis attitude control, thrusted for more than 16,000 hr and consumed more than 70 kg of xenon propellant. The Deep Space 1 spacecraft was launched on October 24, 1998, to validate 12 futuristic technologies, including the ion-propulsion system. After the technology validation process was successfully completed, the Deep Space 1 spacecraft flew by the small asteroid Braille on July 29, 1999. The final objective of this mission was to encounter the active comet Borrelly, which is about 6 miles long. The ion engine was on a thrusting schedule to navigate the Deep Space 1 spacecraft to within 1400 miles of the comet. Since the hydrazine used for spacecraft attitude control was in short supply, the ion engine also provided two-axis attitude control to conserve the hydrazine supply for the Borrelly encounter. The comet encounter took place on September 22, 2001. Dr. Marc Rayman, project manager of Deep Space 1 at the Jet Propulsion Laboratory said, "Deep Space 1 plunged into the heart of the comet Borrelly and has lived to tell every detail of its spinetingling adventure! The images are even better than the impressive images of comet Halley taken by Europe's Giotto spacecraft in 1986." The Deep Space 1 mission, which successfully tested the 12 high-risk, advanced technologies and captured the best images ever taken of a comet, was voluntarily terminated on December 18, 2001. The successful demonstration of the 2-kW-class ion propulsion system technology is now providing mission planners with off-the-shelf flight hardware. Higher power, next generation ion propulsion systems are being developed for large flagship missions, such as outer planet

  20. The Effectiveness of Child Restraint Systems for Children Aged 3 Years or Younger During Motor Vehicle Collisions: 1996 to 2005

    PubMed Central

    Anderson, Craig L.

    2009-01-01

    Objectives. We estimated the effectiveness of child restraints in preventing death during motor vehicle collisions among children 3 years or younger. Methods. We conducted a matched cohort study using Fatality Analysis Reporting System data from 1996 to 2005. We estimated death risk ratios using conditional Poisson regression, bootstrapping, multiple imputation, and a sensitivity analysis of misclassification bias. We examined possible effect modification by selected factors. Results. The estimated death risk ratios comparing child safety seats with no restraint were 0.27 (95% confidence interval [CI] = 0.21, 0.34) for infants, 0.24 (95% CI = 0.19, 0.30) for children aged 1 year, 0.40 (95% CI = 0.32, 0.51) for those aged 2 years, and 0.41 (95% CI = 0.33, 0.52) for those aged 3 years. Estimated safety seat effectiveness was greater during rollover collisions, in rural environments, and in light trucks. We estimated seat belts to be as effective as safety seats in preventing death for children aged 2 and 3 years. Conclusions. Child safety seats are highly effective in reducing the risk of death during severe traffic collisions and generally outperform seat belts. Parents should be encouraged to use child safety seats in favor of seat belts. PMID:19059860

  1. An Estimation of Mortality Risks among People Living with HIV in Karnataka State, India: Learnings from an Intensive HIV/AIDS Care and Support Programme

    PubMed Central

    Prakash, Ravi; Isac, Shajy; Washington, Reynold; Halli, Shiva S.

    2016-01-01

    Background In Indian context, limited attempts have been made to estimate the mortality risks among people living with HIV (PLHIV). We estimated the rates of mortality among PLHIV covered under an integrated HIV-prevention cum care and support programme implemented in Karnataka state, India, and attempted to identify the key programme components associated with the higher likelihood of their survival. Methods Retrospective programme data of 55,801 PLHIV registered with the Samastha programme implemented in Karnataka state during 2006–11 was used. Kaplan-Meier survival methods were used to estimate the ten years expected survival probabilities and Cox-proportional hazard model was used to examine the factors associated with risk of mortality among PLHIV. We also calculated mortality rates (per 1000 person-year) across selected demographic and clinical parameters. Results Of the total PLHIV registered with the programme, about nine percent died within the 5-years of programme period with an overall death rate of 38 per 1000 person-years. The mortality rate was higher among males, aged 18 and above, among illiterates, and those residing in rural areas. While the presence of co-infections such as Tuberculosis leads to higher mortality rate, adherence to ART was significantly associated with reduction in overall death rate. Cox proportional hazard model revealed that increase in CD4 cell counts and exposure to intensive care and support programme for at least two years can bring significant reduction in risk of death among PLHIV [(hazard ratio: 0.234; CI: 0.211–0.260) & (hazard ratio: 0.062; CI: 0.054–0.071), respectively] even after adjusting the effect of other socio-demographic, economic and health related confounders. Conclusion Study confirms that while residing in rural areas and presence of co-infection significantly increases the mortality risk among PLHIV, adherence to ART and improvement in CD4 counts led to significant reduction in their mortality risk

  2. Rates of mutation and host transmission for an Escherichia coli clone over 3 years.

    PubMed

    Reeves, Peter R; Liu, Bin; Zhou, Zhemin; Li, Dan; Guo, Dan; Ren, Yan; Clabots, Connie; Lan, Ruiting; Johnson, James R; Wang, Lei

    2011-01-01

    Although over 50 complete Escherichia coli/Shigella genome sequences are available, it is only for closely related strains, for example the O55:H7 and O157:H7 clones of E. coli, that we can assign differences to individual evolutionary events along specific lineages. Here we sequence the genomes of 14 isolates of a uropathogenic E. coli clone that persisted for 3 years within a household, including a dog, causing a urinary tract infection (UTI) in the dog after 2 years. The 20 mutations observed fit a single tree that allows us to estimate the mutation rate to be about 1.1 per genome per year, with minimal evidence for adaptive change, including in relation to the UTI episode. The host data also imply at least 6 host transfer events over the 3 years, with 2 lineages present over much of that period. To our knowledge, these are the first direct measurements for a clone in a well-defined host community that includes rates of mutation and host transmission. There is a concentration of non-synonymous mutations associated with 2 transfers to the dog, suggesting some selection pressure from the change of host. However, there are no changes to which we can attribute the UTI event in the dog, which suggests that this occurrence after 2 years of the clone being in the household may have been due to chance, or some unknown change in the host or environment. The ability of a UTI strain to persist for 2 years and also to transfer readily within a household has implications for epidemiology, diagnosis, and clinical intervention.

  3. NASA IKONOS Multispectral Radiometric Calibration and 3-Year Temporal Stability Assessment

    NASA Technical Reports Server (NTRS)

    Pagnutti, Mary; Carver, David; Holekamp, Kara; Ryan, Robert; Zanoni, Vicki; Thome, Kurtis; Schiller, Stephen; Aaran, David

    2003-01-01

    Radiometric calibration of commercial imaging satellite products is required to ensure that science and application communities can place confidence in the imagery they use and can fully understand its properties. Inaccurate radiometric calibrations can lead to erroneous decisions and invalid conclusions and can limit intercomparisons with other system. In addition, the user community has little or no insight into the design and operation of commercial sensors or into the methods involved in generating commercial products. To address this calibration need, the NASA Stennis Space Center (SSC) Earth Science Applications (ESA) Directorate established a commercial satellite imaging radiometric calibration team consisting of three independent groups: NASA, SSC,ESA, the University of Arizona Remote Sensing Group, and South Dacota State University. Each group determined the absolute radiometric calibration coefficients of the Space Imaging IKONOS 4-band, 4 m multispectral product covering the visible through near-infrared spectral region. For a three year period beginning in 2000, each team employed some variant of a reflectance-based vicarious calibration approach, requiring ground-based measurements coincident with IKONOS image acquisitions and radiative transfer calculations. Several study sites throughout the United States were employed that covered nearly the entire dynamic range of the IKONOS sensor. IKONOS at-sensor radiance values were compared to those estimated by each independent group to determine the IKONOS sensor's radiometric accuracy and stability. Over 10 individual vicariously determined at-sensor radiance estimates were used each year. When combined, these estimates provided a high-precision radiometric gain calibration coefficient. No significant calibration offset was observed. The results of this evaluation provide the scientific community with an independent assessment of the IKONOS sensor's absolute calibration and temporal stability over the 3

  4. The Megha-Tropiques Mission: Review and Status after 3 Years in Orbit

    NASA Astrophysics Data System (ADS)

    Roca, R.

    2014-12-01

    The Megha-Tropiques satellite is the indo-french contribution to the Global Precipitation Mission constellation.The operation of the MT mission has recently been formally extended for 2015 and 2016 after reaching in october this year its original 3 years duration. While the MADRAS instrument stopped data acquisition in January 2013, the SAPHIR multichannel 183 GHz sounder is up and running nominally. Real time distribution of SAPHIR is performed by EUMETSAT via the EUMETcast system since mid-2014.In this presentation, I will review the performances of the microwave radiometers on-board MT and illustrate thescientific outcome of the mission as well as the results of the extensive validation exercices which have been finalized. I will put the emphasis on the impact of the low inclinaison orbit on assimilation, convective systems monitoring and estimation of precipitation. In particular, I will show how the SAPHIR radiometer data are used in our GPM multiple platforms merged 1°-1day accumulated rainfall product to mitigate the loss of MADRAS.

  5. Gender Abuse, Depressive Symptoms, and Substance Use Among Transgender Women: A 3-Year Prospective Study

    PubMed Central

    Bockting, Walter; Rosenblum, Andrew; Hwahng, Sel; Mason, Mona; Macri, Monica; Becker, Jeffrey

    2014-01-01

    Objectives. We examined the effects of gender abuse (enacted stigma), depressive symptoms, and demographic, economic, and lifestyle factors on substance use among transgender women. Methods. We conducted a 3-year prospective study (December 2004 to September 2007) of 230 transgender women aged 19 to 59 years from the New York Metropolitan Area. Statistical techniques included generalized estimating equations with logistic and linear regression links. Results. Six-month prevalence of any substance use at baseline was 76.2%. Across assessment points, gender abuse was associated with alcohol, cannabis, cocaine, or any substance use during the previous 6 months, the number of days these substances were used during the previous month, and the number of substances used. Additional modeling associated changes in gender abuse with changes in substance use across time. Associations of gender abuse and substance use were mediated 55% by depressive symptoms. Positive associations of employment income, sex work, transgender identity, and hormone therapy with substance use were mediated 19% to 42% by gender abuse. Conclusions. Gender abuse, in conjunction with depressive symptoms, is a pervasive and moderately strong risk factor for substance use among transgender women. Improved substance abuse treatment is sorely needed for this population. PMID:25211716

  6. Urinary interleukin-6 as a predictor of radiographic progression in rheumatoid arthritis: A 3-year evaluation

    PubMed Central

    Park, Yune-Jung; Yoo, Seung-Ah; Kim, Ga-Ram; Cho, Chul-Soo; Kim, Wan-Uk

    2016-01-01

    Previously, we demonstrated that the urine proteome signature of patients with rheumatoid arthritis (RA) reflects inflammation-related cellular processes. Here, we measured interleukin (IL)-6, IL-8, and chemokine ligand 2 (CCL2) concentrations in the urine of RA patients and prospectively investigated their role in predicting RA activity and prognosis. One hundred seventy-three RA patients and 62 non-RA controls were recruited. Urinary IL-6, CCL2, and IL-8 levels were elevated in RA patients and correlated well with disease activity. Urinary IL-6 level at presentation was an independent risk factor of radiographic progression at 1 and 3 years. High urinary IL-6 level increased the risk ratio of radiographic progression by 2.9-fold, which was comparable to high serum CRP. Moreover, combination of urinary IL-6 and serum CRP measures synergistically increased the predictability of radiographic progression. In a subgroup with normal ESR, patients with the highest tertile of urinary IL-6 were at 6.4-fold greater risk of radiographic progression. Conclusively, high urinary IL-6 level at presentation is an independent risk factor for radiographic progression of RA, reflecting disease activity. Urinary IL-6 in combination with serum CRP may be a useful parameter for estimating RA prognosis. PMID:27731382

  7. Perception and Production of Lexical Tones by 3-Year-Old, Mandarin-Speaking Children

    ERIC Educational Resources Information Center

    Wong, Puisan; Schwartz, Richard G.; Jenkins, James J.

    2005-01-01

    The present study investigated 3-year-old children's perception and production of Mandarin lexical tones in monosyllabic words. Thirteen 3-year-old, Mandarin-speaking children participated in the study. Tone perception was examined by a picture-pointing task, and tone production was investigated by picture naming. To compare children's productions…

  8. Changes in Strength Abilities of Adolescent Girls: The Effect of a 3-Year Physical Education Curriculum

    ERIC Educational Resources Information Center

    Czarniecka, Renata; Milde, Katarzyna; Tomaszewski, Pawel

    2012-01-01

    Study aim: To evaluate changes in strength abilities of adolescent girls that underwent a 3-year physical education curriculum. Material and methods: The research participants comprised 141 girls aged 13.3 plus or minus 0.35 years who participated in a 3-year physical education curriculum (PEC). Evaluation was based on the following EUROFIT…

  9. Allocation of Resources to Collaborators and Free-Riders in 3-Year-Olds

    ERIC Educational Resources Information Center

    Melis, Alicia P.; Altrichter, Kristin; Tomasello, Michael

    2013-01-01

    Recent studies have shown that in situations where resources have been acquired collaboratively, children at around 3 years of age share mostly equally. We investigated 3-year-olds' sharing behavior with a collaborating partner and a free-riding partner who explicitly expressed her preference not to collaborate. Children shared more equally with…

  10. 3-years Occurrence Variability of Concentric Gravity Waves in the Mesopause Observed by IMAP/VISI

    NASA Astrophysics Data System (ADS)

    Perwitasari, S.; Sakanoi, T.; Otsuka, Y.; Yamazaki, A.; Miyoshi, Y.; Hozumi, Y.; Saito, A.

    2015-12-01

    We report a study of 3-years occurrence variability of concentric gravity waves (CGWs) in the mesopause observed by IMAP/VISI instrument. CGWs are fascinating to be studied because of its unique characteristic that shows the direct coupling between lower and upper atmosphere. The Visible and near-Infrared Spectral Imager (VISI) of the IMAP mission was launched successfully on July 21, 2012 with H-IIB/HTV-3 and installed onto the International Space Station (ISS). IMAP/VISI is now operated in the night side hemisphere with a range of +/- 51 deg. in geographic latitude and measuring three airglow emissions of OI (630 nm), OH Meinel (730 nm) and O2 (762 nm) with a typical spatial resolution of 16 - 50 km in the nadir direction. In this study, we analyzed 3 years data taken by IMAP/VISI from October 2012 to June 2015. We found total 172 CGWs events in the O2 (762nm) airglow emissions out of 4853 data paths in 2013, 92 events out of 4809 data paths in 2014 and 46 events from 2112 data paths in 2015. The monthly occurrence probability shows a similar trend for each year, a clear seasonal dependence with the peak around March-April and August-September. The weak background winds in the middle atmosphere during the equinoxes are likely responsible for the seasonal dependence. We calculated the horizontal wavelength and radius maximum by fitting the circular wavefronts to a circle. The source of CGWs then identified from meteorological satellite data around the estimated center. The horizontal wavelength was found varying from 44-300 km and radius maximum up to 3000 km, showing that CGWs can affect large area in mesopause. In most cases, the CGWs appeared as arc-like shape instead of full circle. It indicates that the background wind filter allows the wave to propagate in a particular direction and filter out the other directions. The detailed discussion on horizontal wavelength distribution, the sources and background profiles influence on the variability of the CGWs

  11. Global distribution of agricultural fires in croplands from 3 years of Moderate Resolution Imaging Spectroradiometer (MODIS) data

    NASA Astrophysics Data System (ADS)

    Korontzi, Stefania; McCarty, Jessica; Loboda, Tatiana; Kumar, Suresh; Justice, Chris

    2006-06-01

    The Moderate Resolution Imaging Spectroradiometer (MODIS) sensor offers an improved combination of spectral, temporal, and spatial resolution for global fire detection compared to previous sensors. The MODIS Terra active fire product was analyzed to investigate the spatial and temporal occurrence of fires in croplands from 2001 to 2003. Monthly fire counts were analyzed globally, within several regions and for important crop-producing countries. The annual global total number of fire counts ranged from 1,472,367 to 1,577,952 during the 3 years. Agricultural fires were found to account for 8-11% of the annual global fire activity during the 3 years, but the contribution of agricultural burning was significantly higher on a regional basis. The Russian Federation was the largest contributor to agricultural burning globally during the 3 years, producing 31-36% of all agricultural fires. The global spatial distribution of agricultural fires was fairly similar among the 3 years, but a notable interannual change was observed in the total number of global agricultural fire events. The majority of regions showed similar magnitude and seasonality in their year-to-year agricultural fire activity, but in some regions, significant differences were found. At the global scale, agricultural fire activity showed two peaks, the first occurring during April to May, and was associated primarily with burning in the croplands of Eastern Europe and European Russia, and the second in August from burning mainly in the croplands across central Asia and Asiatic Russia. This timing pattern was observed both in 2001 and 2002. The August 2003 fire peak was significantly affected by reduced agricultural fire activity in European Russia. The seasonal and interannual trends in agricultural fire activity are consistent with known national and regional agricultural practices and reported crop production estimates.

  12. Survival Analysis of Patients with End Stage Renal Disease

    NASA Astrophysics Data System (ADS)

    Urrutia, J. D.; Gayo, W. S.; Bautista, L. A.; Baccay, E. B.

    2015-06-01

    This paper provides a survival analysis of End Stage Renal Disease (ESRD) under Kaplan-Meier Estimates and Weibull Distribution. The data were obtained from the records of V. L. MakabaliMemorial Hospital with respect to time t (patient's age), covariates such as developed secondary disease (Pulmonary Congestion and Cardiovascular Disease), gender, and the event of interest: the death of ESRD patients. Survival and hazard rates were estimated using NCSS for Weibull Distribution and SPSS for Kaplan-Meier Estimates. These lead to the same conclusion that hazard rate increases and survival rate decreases of ESRD patient diagnosed with Pulmonary Congestion, Cardiovascular Disease and both diseases with respect to time. It also shows that female patients have a greater risk of death compared to males. The probability risk was given the equation R = 1 — e-H(t) where e-H(t) is the survival function, H(t) the cumulative hazard function which was created using Cox-Regression.

  13. Food insufficiency and women's mental health: findings from a 3-year panel of welfare recipients.

    PubMed

    Heflin, Colleen M; Siefert, Kristine; Williams, David R

    2005-11-01

    Household food insufficiency is a significant problem in the United States, and has been associated with poor outcomes on mental health indicators among low-income women. However, it is difficult to disentangle the mental health consequences of household food insufficiency from poverty and other shared risk factors. Drawing on theories of the social production of health and disease, research evidence linking food insufficiency with poor mental health, and high rates of food insufficiency among welfare recipients, we examined whether a change in household food insufficiency is associated with a change in women's self-reported mental health in a sample of current and recent welfare recipients over a 3-year period of time, controlling for common risk factors. Data were obtained from a prospective survey of women who were welfare recipients in an urban Michigan county in February 1997 (n=753). We estimated fixed effect models for changes in mental health status that make use of information on household food insufficiency gathered in the fall of 1997, 1998, and 1999. The relationship between household food insufficiency and respondents' meeting the diagnostic screening criteria for major depression remained highly significant even when controlling for factors known to confer increased risk of depression and time invariant unobserved heterogeneity. These findings add to growing evidence that household food insufficiency has potentially serious consequences for low-income women's mental health. If confirmed by further research, they suggest that the public health burden of depression in welfare recipients and other low-income women could be reduced by policy-level interventions to reduce their exposure to household food insufficiency.

  14. Long-term effectiveness of four pulpotomy techniques: 3-year randomised controlled trial.

    PubMed

    Huth, Karin Christine; Hajek-Al-Khatar, Niran; Wolf, Petra; Ilie, Nicoleta; Hickel, Reinhard; Paschos, Ekaterini

    2012-08-01

    A pulpotomy is the therapy for management of pulp exposures due to caries in symptom-free primary molars. The aim was to longitudinally compare the relative effectiveness of the Er:YAG laser, calcium hydroxide and ferric sulphate techniques with dilute formocresol in retaining symptom-free molars. Two hundred primary molars in 107 healthy children were included and randomly allocated to one technique. The treated teeth were blindly reevaluated after 6, 12, 18, 24 and 36 months. Descriptive data analysis and logistic regression analysis accounting for multiple observations per patient by generalised estimating equation were used. Additionally, various influences including tooth type, upper and lower jaws, type of anaesthesia, operator and the final restoration on treatment success were evaluated (Wald chi-square test). After 36 months, the following total (considering clinical and clinically symptom-free radiographic failures) and clinical success rates were determined (in percent): Formocresol 72 (92), laser 73 (89), calcium hydroxide 46 (75), ferric sulphate 76 (97). No significant differences were detected between formocresol and any other technique after 36 months. However, the odds ratio of failure appeared to be three times higher for calcium hydroxide than for formocresol. No significant differences in total success rates were seen regarding the aforementioned influencing clinical parameters. The correct diagnosis of the pulpal status, bleeding control and the specific technique are highly important for long-term success of pulpotomies in primary molars. According to the presented long-term data, pulpotomies using ferric sulphate revealed the best treatment outcome among the used techniques, while calcium hydroxide resulted in the lowest success rates after 3 years. Therefore, we can recommend ferric sulphate for easy and successful treatment of primary molars with caries-exposed pulps. PMID:21842145

  15. Enhancing the executive functions of 3-year-olds in the dimensional change card sort task

    PubMed Central

    Perone, Sammy; Molitor, Stephen; Buss, Aaron T.; Spencer, John P.; Samuelson, Larissa K.

    2015-01-01

    Executive functions (EFs) enable flexible thinking, something young children are notoriously bad at. For instance, in the dimensional change card sort (DCCS) task, 3-year-olds can sort cards by one dimension (shape), but continue to sort by this dimension when asked to switch (to color). This study tests a prediction of a Dynamic Neural Field (DNF) model that prior experience with the post-switch dimension can enhance 3-year-old’s performance in the DCCS task. In Experiment 1A, a matching game was used to pre-expose 3-year-olds (n=36) to color. This facilitated switching from sorting by shape to color. In Experiment 1B, 3-year-olds (n=18) were pre-exposed to shape. This did not facilitate switching from sorting by color to shape. The DNF model was used to provide a mechanistic explanation for this asymmetry. PMID:25441395

  16. Prediction of fat-free body mass from bioelectrical impedance and anthropometry among 3-year-old children using DXA.

    PubMed

    Ejlerskov, Katrine T; Jensen, Signe M; Christensen, Line B; Ritz, Christian; Michaelsen, Kim F; Mølgaard, Christian

    2014-01-27

    For 3-year-old children suitable methods to estimate body composition are sparse. We aimed to develop predictive equations for estimating fat-free mass (FFM) from bioelectrical impedance (BIA) and anthropometry using dual-energy X-ray absorptiometry (DXA) as reference method using data from 99 healthy 3-year-old Danish children. Predictive equations were derived from two multiple linear regression models, a comprehensive model (height(2)/resistance (RI), six anthropometric measurements) and a simple model (RI, height, weight). Their uncertainty was quantified by means of 10-fold cross-validation approach. Prediction error of FFM was 3.0% for both equations (root mean square error: 360 and 356 g, respectively). The derived equations produced BIA-based prediction of FFM and FM near DXA scan results. We suggest that the predictive equations can be applied in similar population samples aged 2-4 years. The derived equations may prove useful for studies linking body composition to early risk factors and early onset of obesity.

  17. Prediction of fat-free body mass from bioelectrical impedance and anthropometry among 3-year-old children using DXA

    PubMed Central

    Ejlerskov, Katrine T.; Jensen, Signe M.; Christensen, Line B.; Ritz, Christian; Michaelsen, Kim F.; Mølgaard, Christian

    2014-01-01

    For 3-year-old children suitable methods to estimate body composition are sparse. We aimed to develop predictive equations for estimating fat-free mass (FFM) from bioelectrical impedance (BIA) and anthropometry using dual-energy X-ray absorptiometry (DXA) as reference method using data from 99 healthy 3-year-old Danish children. Predictive equations were derived from two multiple linear regression models, a comprehensive model (height2/resistance (RI), six anthropometric measurements) and a simple model (RI, height, weight). Their uncertainty was quantified by means of 10-fold cross-validation approach. Prediction error of FFM was 3.0% for both equations (root mean square error: 360 and 356 g, respectively). The derived equations produced BIA-based prediction of FFM and FM near DXA scan results. We suggest that the predictive equations can be applied in similar population samples aged 2–4 years. The derived equations may prove useful for studies linking body composition to early risk factors and early onset of obesity. PMID:24463487

  18. Parental Styles and Religious Values among Teenagers: A 3-Year Prospective Analysis

    ERIC Educational Resources Information Center

    Heaven, Patrick C. L.; Ciarrochi, Joseph; Leeson, Peter

    2010-01-01

    The authors examined the effect of Grade 7 parental styles on Grade 10 religious values. The authors surveyed 784 participants (382 boys, 394 girls; 8 unreported) in Grade 7. The mean age of the group at Time 1 was 12.3 years (SD = 0.5 years). Time 2 occurred 3 years later when students were in Grade 10 (372 boys, 375 girls). In addition to…

  19. Survival and movements of molting male black ducks in Labrador

    USGS Publications Warehouse

    Bowman, T.D.; Longcore, J.R.

    1989-01-01

    We marked 26 flightless male American black ducks with transmitters during the post-nuptial molt in northern Labrabor to determine survival and movements. Twelve ducks remained in the watershed where marked and 11 ducks moved to different watersheds. The period survival rate (PSR) for these flightless males was 0.89 using the Kaplan-Meier estimator. Only 2 ducks were killed by predators. Death of these 2 ducks might have been influenced by our disturbance, thus we considered the PSR minimal.

  20. Early ipsilateral breast tumor recurrences after breast conservation affect survival: An analysis of the National Cancer Institute randomized trial

    SciTech Connect

    Brooks, Joseph P.; Danforth, David N.; Albert, Paul; Sciuto, Linda C. B.S.N.; Smith, Sharon L.; Camphausen, Kevin A.; Poggi, Matthew M. . E-mail: MMPoggi@Bethesda.med.navy.mil

    2005-07-01

    Purpose: To evaluate the effect of an ipsilateral breast tumor recurrence (IBTR) after breast-conservation therapy (BCT) on survival. Methods and Materials: One hundred twenty-one women were randomized to BCT. Patients with an IBTR were analyzed to determine survival. Analysis was performed with Kaplan-Meier estimates, log-rank tests, and time-dependent covariate Cox models. Results: At a median follow-up of 18.4 years, 27 patients had an IBTR. The median survival time after IBTR was 13.1 years. The 5-year survival rate was 91.8% (95% confidence interval [CI], 81.5-100%). The 10-year survival rate was 54.3% (95% CI, 35.8-82.6%). According to a Cox model with time-dependent covariates, the hazard ratio or relative risk of dying for those with an IBTR at <5.3 years after BCT relative to patients without an IBTR after BCT is 1.47 (95% CI, 1.02-2.12%; p = 0.04). The hazard ratio for those who relapse after 5.3 years is 0.59 (95% CI, 0.22-1.61%; p = 0.31). Age at randomization, original tumor size, and the presence of positive regional nodes at initial presentation were not found to be associated with decreased survival. Conclusions: There seems to be a significant association of early IBTR after BCT with decreased survival. Local control should be maximized.

  1. The impact of race and fractures on mortality in a postmenopausal Medicaid population.

    PubMed

    Kotzan, J A; Martin, B C; Reeves, J H; Wade, W

    1999-11-01

    The purpose of this study was to model fractures and survival by age and race in a large postmenopausal Medicaid population. All Georgia Medicaid claims were abstracted for the years 1992, 1993, and 1994. Claims for postmenopausal women (> or =50 years of age) were retained, and patients with fractures were identified by International Classification of Diseases, Ninth Revision codes for fracture. A survival analysis was conducted using Kaplan-Meier estimators to evaluate the effect of fracture, age, and race on 3-year survival. A total of 159,400 white and black postmenopausal women were identified. The cohort with fracture totaled 5933 patients, with femoral fractures constituting 46% of all fractures. Discounting those with fracture before the study, the fracture incidence was approximately 1.2% in this postmenopausal female cohort. The survival analysis suggested that after age was accounted for, black postmenopausal women had a 42% increased risk of death within 3 years of fracture, compared with 13% for white women. However, postmenopausal black women were approximately 50% less likely to experience a fracture, and postmenopausal black women without fracture had better survival rates than comparable white women. Mortality crossover and the diminished likelihood of fracture mask the true nature of fracture survival in postmenopausal black women. Postmenopausal black women with fracture are at greater risk of dying than their white counterparts.

  2. Delayed Complications in Patients Surviving at Least 3 Years After Stereotactic Radiosurgery for Brain Metastases

    SciTech Connect

    Yamamoto, Masaaki; Kawabe, Takuya; Higuchi, Yoshinori; Sato, Yasunori; Nariai, Tadashi; Barfod, Bierta E.; Kasuya, Hidetoshi; Urakawa, Yoichi

    2013-01-01

    Purpose: Little is known about delayed complications after stereotactic radiosurgery in long-surviving patients with brain metastases. We studied the actual incidence and predictors of delayed complications. Patients and Methods: This was an institutional review board-approved, retrospective cohort study that used our database. Among our consecutive series of 2000 patients with brain metastases who underwent Gamma Knife radiosurgery (GKRS) from 1991-2008, 167 patients (8.4%, 89 women, 78 men, mean age 62 years [range, 19-88 years]) who survived at least 3 years after GKRS were studied. Results: Among the 167 patients, 17 (10.2%, 18 lesions) experienced delayed complications (mass lesions with or without cyst in 8, cyst alone in 8, edema in 2) occurring 24.0-121.0 months (median, 57.5 months) after GKRS. The actuarial incidences of delayed complications estimated by competing risk analysis were 4.2% and 21.2% at the 60th month and 120th month, respectively, after GKRS. Among various pre-GKRS clinical factors, univariate analysis demonstrated tumor volume-related factors: largest tumor volume (hazard ratio [HR], 1.091; 95% confidence interval [CI], 1.018-1.154; P=.0174) and tumor volume {<=}10 cc vs >10 cc (HR, 4.343; 95% CI, 1.444-12.14; P=.0108) to be the only significant predictors of delayed complications. Univariate analysis revealed no correlations between delayed complications and radiosurgical parameters (ie, radiosurgical doses, conformity and gradient indexes, and brain volumes receiving >5 Gy and >12 Gy). After GKRS, an area of prolonged enhancement at the irradiated lesion was shown to be a possible risk factor for the development of delayed complications (HR, 8.751; 95% CI, 1.785-157.9; P=.0037). Neurosurgical interventions were performed in 13 patients (14 lesions) and mass removal for 6 lesions and Ommaya reservoir placement for the other 8. The results were favorable. Conclusions: Long-term follow-up is crucial for patients with brain metastases

  3. Allocation of resources to collaborators and free-riders in 3-year-olds.

    PubMed

    Melis, Alicia P; Altrichter, Kristin; Tomasello, Michael

    2013-02-01

    Recent studies have shown that in situations where resources have been acquired collaboratively, children at around 3 years of age share mostly equally. We investigated 3-year-olds' sharing behavior with a collaborating partner and a free-riding partner who explicitly expressed her preference not to collaborate. Children shared more equally with the collaborating partner than with the free rider. These results suggest that young children are sensitive to the contributions made by others to a collaborative effort (and possibly their reasons for not collaborating) and distribute resources accordingly.

  4. The influence of home-rearing environment on children's behavioral problems 3 years' later.

    PubMed

    Chen, Wencan; Tanaka, Emiko; Watanabe, Kumi; Tomisaki, Etuko; Watanabe, Taeko; Wu, Bailiang; Anme, Tokie

    2016-10-30

    Reduction of children's behavioral problems has the potential to ameliorate parental stress, mental health problems, and family dysfunction. The current study was designed as a 3-year longitudinal study with secondary data. A total of 99 caregivers with preschool aged children were required to complete two self-reported questionnaires: the Index of Child Care Environment and Strengths and Difficulties Questionnaire. It demonstrated that a positive home-rearing environment had a positive influence on children's behavioral problem 3 years' later. Our study suggests that we may reduce behavioral problems in children's later development by providing a positive home rearing environment.

  5. Percutaneous Cryoablation of Metastatic Lesions from Colorectal Cancer: Efficacy and Feasibility with Survival and Cost-Effectiveness Observations

    PubMed Central

    Bang, Hyun J.; Littrup, Peter J.; Currier, Brandt P.; Goodrich, Dylan J.; Choi, Minsig; Heilbrun, Lance K.; Goodman, Allen C.

    2014-01-01

    Purpose To assess feasibility, complications, local tumor recurrences, overall survival (OS) and estimates of cost-effectiveness for multi-site cryoablation (MCA) of oligo-metastatic colorectal cancer (mCRC) in a prospective study. Materials and Methods 111 CT and/or US-guided percutaneous MCA procedures were performed on 151 tumors in 59 oligo mCRC patients. Mean patient age was 63 years (range 21–92 years), consisting of 29 males and 30 females. Tumor location was grouped according to common metastatic sites. Median OS was determined using the Kaplan-Meier. Estimates of MCA costs per LYG were compared to historical values for systemic therapies. Results A mean 1.9 MCAs per patient were performed with a median clinical follow-up of 12 months. Major complication and local recurrence rates were 8% (9/111) and 12% (18/151), respectively. Median overall-survival (OS) was 23.6 months with an estimated 3-year survival rate of ~30%. Cryoablation remained cost effective with or without the presence of systemic therapies, with an adjunctive cost-effectiveness ratio (ACER) of $39,661–$85,580 per LYG. Conclusions Multi-site cryoablation had very low complication and local recurrence rates, and was able to provide local control even for diverse soft tissue locations. Even as an adjunct to systemic therapies, MCA appeared cost-effective, with apparent increased survival. PMID:25621178

  6. Paternal Psychosocial Characteristics and Corporal Punishment of Their 3-Year-Old Children

    ERIC Educational Resources Information Center

    Lee, Shawna J.; Perron, Brian E.; Taylor, Catherine A.; Guterman, Neil B.

    2011-01-01

    This study uses data from 2,309 biological fathers who participated in the Fragile Families and Child Well-Being Study (FFCWS) to examine associations between psychosocial characteristics and levels of corporal punishment (CP) toward their 3-year-old children over the past month. Results indicate that 61% of the fathers reported no CP over the…

  7. Children's Oral Narrative and Reading Skills in the First 3 Years of Reading Instruction

    ERIC Educational Resources Information Center

    Reese, Elaine; Suggate, Sebastian; Long, Jennifer; Schaughency, Elizabeth

    2010-01-01

    This research investigated the link between oral narrative and reading skills in the first 3 years of reading instruction. Study 1 consisted of 61 children (M = 6:1 years) who had experienced 1 year of reading instruction on average. Children's story retelling was scored for memory and narrative quality. The quality of children's narratives…

  8. Does Attention Constrain Developmental Trajectories in Fragile X Syndrome? A 3-Year Prospective Longitudinal Study

    ERIC Educational Resources Information Center

    Cornish, Kim; Cole, Victoria; Longhi, Elena; Karmiloff-Smith, Annette; Scerif, Gaia

    2012-01-01

    Basic attentional processes and their impact on developmental trajectories in fragile X syndrome were assessed in a 3-year prospective study. Although fragile X syndrome is a monogenic X-linked disorder, there is striking variability in outcomes even in young boys with the condition. Attention is a key factor constraining interactions with the…

  9. Behavioral and Emotional Problems among Turkish Children at Ages 2 to 3 Years.

    ERIC Educational Resources Information Center

    Erol, Nese; Simsek, Zeynep; Oner, Ozgur; Munir, Kerim

    2005-01-01

    Objective: Within the framework of the Mental Health Surveys of Turkey, the authors investigated the distribution and prevalence of parent-reported behavioral and emotional problems in a nationally representative sample of 2- to 3-year-old children. Method: A cross-sectional population-based survey from October 1996 through March 1997 using a…

  10. Interest and Agency in 2- and 3-Year-Olds' Participation in Emergent Writing

    ERIC Educational Resources Information Center

    Rowe, Deborah Wells; Neitzel, Carin

    2010-01-01

    This study investigated 2- and 3-year-olds' personal interests as a possible source of variation in preschool writing activities. Structured observations of the play behaviors of 11 preschool children in a childcare classroom were conducted one to two days per week for one school year. These data were analyzed to determine choices of play…

  11. Effects of tafluprost treatment for 3 years in patients with normal-tension glaucoma

    PubMed Central

    Inoue, Kenji; Tanaka, Ayumi; Tomita, Goji

    2013-01-01

    Purpose To evaluate the effects of tafluprost treatment for 3 years on intraocular pressure (IOP) and visual field performance. Methods The IOP of 55 patients with normal-tension glaucoma was monitored every 1–3 months for 3 years. The Humphrey visual field test was performed every 6 months after treatment and results compared with before-treatment results. Visual field performance was also evaluated by trend and event analysis. Results After 3 years’ tafluprost single-use vials treatment, the IOP (12.8 ± 2.8 mmHg [mean ± standard deviation]) was significantly lower than before treatment (15.7 ± 2.2 mmHg; P < 0.0001). When comparing before-treatment Humphrey visual field test findings with those after 3 years of treatment, no change was found in the mean deviation and pattern standard deviation. Visual field performance had worsened in four patients and three patients according to trend analysis and event analysis, respectively. Adverse reactions appeared in ten cases and one patient (1.8%) discontinued treatment due to an adverse reaction. Conclusion Tafluprost single-use vials treatment was effective in reducing IOP over the 3 years of this study, but visual field performance worsened by 10.3%–13.8% in patients with normal-tension glaucoma. Safety was satisfactory. PMID:23874082

  12. 3-Year-Old Children Make Relevance Inferences in Indirect Verbal Communication

    ERIC Educational Resources Information Center

    Schulze, Cornelia; Grassmann, Susanne; Tomasello, Michael

    2013-01-01

    Three studies investigated 3-year-old children's ability to determine a speaker's communicative intent when the speaker's overt utterance related to that intent only indirectly. Studies 1 and 2 examined children's comprehension of indirectly stated requests (e.g., "I find Xs good" can imply, in context, a request for…

  13. The Semiotic Landscape and 3-Year-Olds' Emerging Understanding of Multimodal Communication Practices

    ERIC Educational Resources Information Center

    Yamada-Rice, Dylan

    2014-01-01

    This article considers the impact of the increasing use of the visual mode in texts found in urban landscapes on two 3-year-olds' understanding of communication practices. The data discussed are taken from a study into a group of 3- to 6-year-olds' interaction with and emerging comprehension of the visual mode and its connection to…

  14. Basic Facts about Low-Income Children: Children under 3 Years, 2013. Fact Sheet

    ERIC Educational Resources Information Center

    Jiang, Yang; Ekono, Mercedes; Skinner, Curtis

    2015-01-01

    Children under 18 years represent 23 percent of the population, but they comprise 33 percent of all people in poverty. Among all children, 44 percent live in low-income families and approximately one in every five (22 percent) live in poor families. Our very youngest children--infants and toddlers under age 3 years--appear to be particularly…

  15. The Development of Inhibitory Control in Early Childhood: A Twin Study from 2-3 Years

    ERIC Educational Resources Information Center

    Gagne, Jeffrey R.; Saudino, Kimberly J.

    2016-01-01

    Parent- and lab-based observer ratings were employed to examine genetic and environmental influences on continuity and change in inhibitory control (IC) in over 300 twin-pairs assessed longitudinally at 2 and 3 years of age. Genetic influences accounted for approximately 60% of the variance in parent-rated IC at both ages. Although many of the…

  16. Risk of Mother-Reported Child Abuse in the First 3 Years of Life

    ERIC Educational Resources Information Center

    Windham, Amy M.; Rosenberg, Leon; Fuddy, Loretta; McFarlane, Elizabeth; Sia, Calvin; Duggan, Anne K

    2004-01-01

    Objective: The purpose of this research was to investigate, within an at-risk population, parent and child characteristics associated with a mother's self-reports of severe physical assault and assault on the self-esteem of the child in the first 3 years of life. Design: The study population consisted of a community-based sample of mothers of…

  17. Trajectories of Maternal Harsh Parenting in the First 3 Years of Life

    ERIC Educational Resources Information Center

    Kim, Hyoun K.; Pears, Katherine C.; Fisher, Philip A.; Connelly, Cynthia D.; Landsverk, John A.

    2010-01-01

    Objective: Despite the high prevalence rates of harsh parenting, the nature of developmental change in this domain early in life and the factors that contribute to changes in harsh parenting over time are not well understood. The present study examined developmental patterns in maternal harsh parenting behavior from birth to age 3 years and their…

  18. Young Children's Block Construction Activities: Findings from 3 Years of Observation.

    ERIC Educational Resources Information Center

    Hanline, Mary Frances; Milton, Sande; Phelps, Pamela

    2001-01-01

    A 3-year study explored the development of the complexity of block constructions of 65 preschool children. Results indicated that the complexity of block constructions increased with age, the time the child was involved with block construction activities had a positive effect on complexity, and gender did not influence block construction…

  19. Directly Observed Physical Activity among 3-Year-Olds in Finnish Childcare

    ERIC Educational Resources Information Center

    Soini, Anne; Villberg, Jari; Sääkslahti, Arja; Gubbels, Jessica; Mehtälä, Anette; Kettunen, Tarja; Poskiparta, Marita

    2014-01-01

    The main purpose of the study was to determine 3-year-olds' physical activity levels and how these vary across season, gender, time of day, location, and the physical and social environment in childcare settings in Finland. A modified version of the Observational System for Recording Physical Activity in Children-Preschool (OSRAC-P) was used…

  20. The Development of Core Cognitive Skills in Autism: A 3-Year Prospective Study

    ERIC Educational Resources Information Center

    Pellicano, Elizabeth

    2010-01-01

    This longitudinal study tested the veracity of one candidate multiple-deficits account of autism by assessing 37 children with autism (M age = 67.9 months) and 31 typical children (M age = 65.2 months) on tasks tapping components of theory of mind (ToM), executive function (EF), and central coherence (CC) at intake and again 3 years later. As a…

  1. Creppy Crawlies. Developing an Early Interest in Science: A Preschool Science Curriculum. (3-Year-Olds).

    ERIC Educational Resources Information Center

    Summer, Gail L.; Giovannini, Kathleen

    This science teaching guide on insects and animals for 3-year-olds is based on a modification of the "Plan, Do, Review" approach to education devised by High Scope in Ypsilanti, Michigan. First implemented as an outreach early childhood program in North Carolina, the science activities described in this guide can be adapted to various early…

  2. Enhancing the Executive Functions of 3-Year-Olds in the Dimensional Change Card Sort Task

    ERIC Educational Resources Information Center

    Perone, Sammy; Molitor, Stephen J.; Buss, Aaron T.; Spencer, John P.; Samuelson, Larissa K.

    2015-01-01

    Executive functions enable flexible thinking, something young children are notoriously bad at. For instance, in the dimensional change card sort (DCCS) task, 3-year-olds can sort cards by one dimension (shape), but continue to sort by this dimension when asked to switch (to color). This study tests a prediction of a dynamic neural field model that…

  3. Enhancing Students' Engagement: Report of a 3-Year Intervention with Middle School Teachers

    ERIC Educational Resources Information Center

    Turner, Julianne C.; Christensen, Andrea; Kackar-Cam, Hayal Z.; Trucano, Meg; Fulmer, Sara M.

    2014-01-01

    All teachers (N = 32) at one middle school participated in a university-led intervention to improve student engagement. Teachers discussed four principles of motivation and related instructional strategies. Teachers enacted instructional strategies in their classrooms. We observed six randomly selected teachers and their students over 3 years.…

  4. Words, Shape, Visual Search and Visual Working Memory in 3-Year-Old Children

    ERIC Educational Resources Information Center

    Vales, Catarina; Smith, Linda B.

    2015-01-01

    Do words cue children's visual attention, and if so, what are the relevant mechanisms? Across four experiments, 3-year-old children (N = 163) were tested in visual search tasks in which targets were cued with only a visual preview versus a visual preview and a spoken name. The experiments were designed to determine whether labels facilitated…

  5. Dimensions of Oppositional Defiant Disorder in 3-Year-Old Preschoolers

    ERIC Educational Resources Information Center

    Ezpeleta, Lourdes; Granero, Roser; de la Osa, Nuria; Penelo, Eva; Domenech, Josep M.

    2012-01-01

    Background: To test the factor structure of oppositional defiant disorder (ODD) symptoms and to study the relationships between the proposed dimensions and external variables in a community sample of preschool children. Method: A sample of 1,341 3-year-old preschoolers was randomly selected and screened for a double-phase design. In total, 622…

  6. How Selective Are 3-Year-Olds in Imitating Novel Linguistic Material?

    ERIC Educational Resources Information Center

    Bannard, Colin; Klinger, Jörn; Tomasello, Michael

    2013-01-01

    In 3 studies we explored when 3-year-olds would imitate novel words in utterances produced by adult speakers. Child and experimenter took turns in requesting objects from a game master. The experimenter always went first and always preceded the object's familiar name with a novel adjective (e.g., "the dilsige duck"). In the first 2…

  7. Two-and 3-Year-Olds Know What Others Have and Have Not Heard

    ERIC Educational Resources Information Center

    Moll, Henrike; Carpenter, Malinda; Tomasello, Michael

    2014-01-01

    Recent studies have established that even infants can determine what others know based on previous visual experience. In the current study, we investigated whether 2-and 3-year-olds know what others know based on previous auditory experience. A child and an adult heard the sound of one object together, but only the child heard the sound of another…

  8. A capture-recapture survival analysis model for radio-tagged animals

    USGS Publications Warehouse

    Pollock, K.H.; Bunck, C.M.; Winterstein, S.R.; Chen, C.-L.; North, P.M.; Nichols, J.D.

    1995-01-01

    In recent years, survival analysis of radio-tagged animals has developed using methods based on the Kaplan-Meier method used in medical and engineering applications (Pollock et al., 1989a,b). An important assumption of this approach is that all tagged animals with a functioning radio can be relocated at each sampling time with probability 1. This assumption may not always be reasonable in practice. In this paper, we show how a general capture-recapture model can be derived which allows for some probability (less than one) for animals to be relocated. This model is not simply a Jolly-Seber model because it is possible to relocate both dead and live animals, unlike when traditional tagging is used. The model can also be viewed as a generalization of the Kaplan-Meier procedure, thus linking the Jolly-Seber and Kaplan-Meier approaches to survival estimation. We present maximum likelihood estimators and discuss testing between submodels. We also discuss model assumptions and their validity in practice. An example is presented based on canvasback data collected by G. M. Haramis of Patuxent Wildlife Research Center, Laurel, Maryland, USA.

  9. Aggregate exposure approaches for parabens in personal care products: a case assessment for children between 0 and 3 years old

    PubMed Central

    Gosens, Ilse; Delmaar, Christiaan J E; ter Burg, Wouter; de Heer, Cees; Schuur, A Gerlienke

    2014-01-01

    In the risk assessment of chemical substances, aggregation of exposure to a substance from different sources via different pathways is not common practice. Focusing the exposure assessment on a substance from a single source can lead to a significant underestimation of the risk. To gain more insight on how to perform an aggregate exposure assessment, we applied a deterministic (tier 1) and a person-oriented probabilistic approach (tier 2) for exposure to the four most common parabens through personal care products in children between 0 and 3 years old. Following a deterministic approach, a worst-case exposure estimate is calculated for methyl-, ethyl-, propyl- and butylparaben. As an illustration for risk assessment, Margins of Exposure (MoE) are calculated. These are 991 and 4966 for methyl- and ethylparaben, and 8 and 10 for propyl- and butylparaben, respectively. In tier 2, more detailed information on product use has been obtained from a small survey on product use of consumers. A probabilistic exposure assessment is performed to estimate the variability and uncertainty of exposure in a population. Results show that the internal exposure for each paraben is below the level determined in tier 1. However, for propyl- and butylparaben, the percentile of the population with an exposure probability above the assumed “safe” MoE of 100, is 13% and 7%, respectively. In conclusion, a tier 1 approach can be performed using simple equations and default point estimates, and serves as a starting point for exposure and risk assessment. If refinement is warranted, the more data demanding person-oriented probabilistic approach should be used. This probabilistic approach results in a more realistic exposure estimate, including the uncertainty, and allows determining the main drivers of exposure. Furthermore, it allows to estimate the percentage of the population for which the exposure is likely to be above a specific value. PMID:23801276

  10. Censored Data Analysis Reveals Effects of Age and Hepatitis C Infection on C-Reactive Protein Levels in Healthy Adult Chimpanzees (Pan troglodytes)

    PubMed Central

    Ely, John J.; Zavaskis, Tony; Lammey, M. Lon

    2013-01-01

    C-reactive protein, a conserved acute-phase protein synthesized in the liver and involved in inflammation, infection, and tissue damage, is an informative biomarker for human cardiovascular disease. Out of 258 captive adult common chimpanzees (Pan troglodytes) assayed for CRP, 27.9% of the data were below the quantitation limit. Data were analyzed by the Kaplan-Meier method and results compared to other methods for handling censored data (including deletion, replacement, and imputation). Kaplan-Meier results demonstrated a modest age effect and a strong effect of HCV infection in reducing CRP but did not allow inference of reference intervals. Results of other methods varied considerably. Substitution schemes differed widely in statistical significance, with estimated group means biased by the size of the substitution constant, while inference of unbiased reference intervals was impossible. Single imputation gave reasonable statistical inferences but unreliable reference intervals. Multiple imputation gave reliable results, for both statistical inference and reference intervals, and was comparable to the Kaplan-Meier standard. Other methods should be avoided. CRP did not predict cardiovascular disease, but CRP levels were reduced by 50% in animals with hepatitis C infection and showed inverse relationships with 2 liver function enzymes. Results suggested that hsCRP can be an informative biomarker of chronic hepatic dysfunction. PMID:26317021

  11. Censored Data Analysis Reveals Effects of Age and Hepatitis C Infection on C-Reactive Protein Levels in Healthy Adult Chimpanzees (Pan troglodytes).

    PubMed

    Ely, John J; Zavaskis, Tony; Lammey, M Lon

    2013-01-01

    C-reactive protein, a conserved acute-phase protein synthesized in the liver and involved in inflammation, infection, and tissue damage, is an informative biomarker for human cardiovascular disease. Out of 258 captive adult common chimpanzees (Pan troglodytes) assayed for CRP, 27.9% of the data were below the quantitation limit. Data were analyzed by the Kaplan-Meier method and results compared to other methods for handling censored data (including deletion, replacement, and imputation). Kaplan-Meier results demonstrated a modest age effect and a strong effect of HCV infection in reducing CRP but did not allow inference of reference intervals. Results of other methods varied considerably. Substitution schemes differed widely in statistical significance, with estimated group means biased by the size of the substitution constant, while inference of unbiased reference intervals was impossible. Single imputation gave reasonable statistical inferences but unreliable reference intervals. Multiple imputation gave reliable results, for both statistical inference and reference intervals, and was comparable to the Kaplan-Meier standard. Other methods should be avoided. CRP did not predict cardiovascular disease, but CRP levels were reduced by 50% in animals with hepatitis C infection and showed inverse relationships with 2 liver function enzymes. Results suggested that hsCRP can be an informative biomarker of chronic hepatic dysfunction. PMID:26317021

  12. Parental styles and religious values among teenagers: a 3-year prospective analysis.

    PubMed

    Heaven, Patrick C L; Ciarrochi, Joseph; Leeson, Peter

    2010-01-01

    The authors examined the effect of Grade 7 parental styles on Grade 10 religious values. The authors surveyed 784 participants (382 boys, 394 girls; 8 unreported) in Grade 7. The mean age of the group at Time 1 was 12.3 years (SD = 0.5 years). Time 2 occurred 3 years later when students were in Grade 10 (372 boys, 375 girls). In addition to assessing parental styles at Time 1, we also controlled for a number of Time 1 variables thought to possibly influence Time 2 religious values, namely, self-esteem, trait hope, and students' levels of conscientiousness. Time 1 measures (except self-esteem) were significantly correlated with Time 2 religious values, but only parental authoritativeness and hope significantly predicted religious values. The authors discuss these results with reference to the nature of parental styles and hope and their impact on religious values. PMID:20333897

  13. A 3 Year-Old Male Child Ingested Approximately 750 Grams of Elemental Mercury

    PubMed Central

    Uysalol, Metin; Parlakgül, Güneş; Yılmaz, Yasin; Çıtak, Agop; Uzel, Nedret

    2016-01-01

    Background: The oral ingestion of elemental mercury is unlikely to cause systemic toxicity, as it is poorly absorbed through the gastrointestinal system. However, abnormal gastrointestinal function or anatomy may allow elemental mercury into the bloodstream and the peritoneal space. Systemic effects of massive oral intake of mercury have rarely been reported. Case Report: In this paper, we are presenting the highest single oral intake of elemental mercury by a child aged 3 years. A Libyan boy aged 3 years ingested approximately 750 grams of elemental mercury and was still asymptomatic. Conclusion: The patient had no existing disease or abnormal gastrointestinal function or anatomy. The physical examination was normal. His serum mercury level was 91 µg/L (normal: <5 µg/L), and he showed no clinical manifestations. Exposure to mercury in children through different circumstances remains a likely occurrence. PMID:27606146

  14. Probabilistic assessment of exposure to cosmetic products by French children aged 0-3 years.

    PubMed

    Ficheux, A S; Dornic, N; Bernard, A; Chevillotte, G; Roudot, A C

    2016-08-01

    Very few exposure data are available for children in Europe and worldwide. The aim of this study was to assess the exposure to cosmetic products used on children aged 0-3 years using recent consumption data generated for the French population. Exposure was assessed using a probabilistic method for 24 products including cleanser, skin care, fragrance, solar and bottom products. The exposure data obtained in this study for children aged 0-3 years were higher than the values fixed by the SCCS for all common products: liquid shampoo, face moisturizer cream, toothpaste, shower gel and body moisturizer cream. Exposure was assessed for the first time for many products such as sunscreens, Eau de toilette and massage products. These new French exposure values will be useful for safety assessors and for safety agencies. PMID:27255804

  15. Caries preventive effects of toothpastes containing monofluorophosphate and trimetaphosphate: a 3-year clinical trial.

    PubMed

    Andlaw, R J; Palmer, J D; King, J; Kneebone, S B

    1983-06-01

    The caries-preventive effects of two toothpastes were tested in a 3-year clinical trial involving 1319 children aged 11-13 years. The test toothpastes were: 1) a low abrasion paste containing 0.8% sodium monofluorophosphate (MFP), and 2) a paste containing 3% sodium trimetaphosphate (TMP). The control toothpaste was a conventional, moderately abrasive paste containing 0.8% sodium monofluorophosphate. The children were examined clinically and radiologically each year. Toothpaste was supplied to the children's homes, and its use was unsupervised. Caries increments after 3 years, in terms of DMF teeth and DMF surfaces, showed no significant differences between the MFP test group (444 children) and the MFP control group (450 children). However, the TMP test group (425 children) had significantly higher caries increments than the MFP control group. All three groups of children showed some improvement in oral hygiene and in gingival health, but there were no significant differences between the groups. PMID:6342928

  16. A 3-Year Longitudinal Study Examining the Effect of Resilience on Suicidality in Veterans

    PubMed Central

    Youssef, Nagy A.; Green, Kimberly T.; Beckham, Jean C.; Elbogen, Eric B.

    2013-01-01

    Background This study evaluated the correlation and role of resilience and resilience factors in predicting suicidal ideation and attempts in veterans. Methods In this 3-year longitudinal study, one hundred and seventy-six Iraq and Afghanistan War veterans were evaluated for a number of clinical and demographic variables. Longitudinal follow-up was performed approximately 3 years. Results Resilience at the initial assessment predicted lower suicidality at follow-up, controlling for suicidality at the initial assessment, suggesting a protective effect for resilience. With respect to specific domains of resilience, secure relationships and positive acceptance of change significantly predicted lower suicidality. Conclusions These findings have important implications for clinical care and for guiding future research efforts to increase resilience among returning soldiers. PMID:23376871

  17. Parental styles and religious values among teenagers: a 3-year prospective analysis.

    PubMed

    Heaven, Patrick C L; Ciarrochi, Joseph; Leeson, Peter

    2010-01-01

    The authors examined the effect of Grade 7 parental styles on Grade 10 religious values. The authors surveyed 784 participants (382 boys, 394 girls; 8 unreported) in Grade 7. The mean age of the group at Time 1 was 12.3 years (SD = 0.5 years). Time 2 occurred 3 years later when students were in Grade 10 (372 boys, 375 girls). In addition to assessing parental styles at Time 1, we also controlled for a number of Time 1 variables thought to possibly influence Time 2 religious values, namely, self-esteem, trait hope, and students' levels of conscientiousness. Time 1 measures (except self-esteem) were significantly correlated with Time 2 religious values, but only parental authoritativeness and hope significantly predicted religious values. The authors discuss these results with reference to the nature of parental styles and hope and their impact on religious values.

  18. The relation between personality and anxiety: findings from a 3-year prospective study.

    PubMed

    Gershuny, B S; Sher, K J

    1998-05-01

    The authors tested the extent to which the personality dimensions of neuroticism, extraversion, and psychoticism (H. J. Eysenck & S. B. G. Eysenck, 1975) prospectively predicted global anxiety (assessed by items from the Brief Symptom Inventory: L. R. Derogatis & M. S. Spencer, 1982). The authors also examined prospective relations among these personality dimensions and depression to evaluate the specificity of findings. Participants were 466 young adults, primarily undergraduate students, assessed twice over a 3-year interval. An interaction between neuroticism and extraversion predicted both global anxiety and depression 3 years later. Findings indicated that personality, in particular the combination of high neuroticism and low extraversion, may play an important predisposing, etiological role in anxiety. Interpretations and implications of the predictive importance of the Neuroticism x Extraversion interaction in anxiety are discussed, and further speculations about the relation between anxiety and depression are put forth.

  19. A 3 Year-Old Male Child Ingested Approximately 750 Grams of Elemental Mercury

    PubMed Central

    Uysalol, Metin; Parlakgül, Güneş; Yılmaz, Yasin; Çıtak, Agop; Uzel, Nedret

    2016-01-01

    Background: The oral ingestion of elemental mercury is unlikely to cause systemic toxicity, as it is poorly absorbed through the gastrointestinal system. However, abnormal gastrointestinal function or anatomy may allow elemental mercury into the bloodstream and the peritoneal space. Systemic effects of massive oral intake of mercury have rarely been reported. Case Report: In this paper, we are presenting the highest single oral intake of elemental mercury by a child aged 3 years. A Libyan boy aged 3 years ingested approximately 750 grams of elemental mercury and was still asymptomatic. Conclusion: The patient had no existing disease or abnormal gastrointestinal function or anatomy. The physical examination was normal. His serum mercury level was 91 µg/L (normal: <5 µg/L), and he showed no clinical manifestations. Exposure to mercury in children through different circumstances remains a likely occurrence.

  20. Traumatic brain injury in infants and toddlers, 0–3 years old

    PubMed Central

    Gorgan, MR; Tascu, A; Sandu, AM; Rizea, RE

    2011-01-01

    Object: Children 0–3 years old present a completely different neurotraumatic pathology. The growing and the development processes in this age group imply specific anatomical and pathophysiological features of the skull, subarachnoid space, CSF flow, and brain. Most common specific neurotraumatic entities in children 0–3 years old are cephalhematoma, subaponeurotic (subgaleal) hematoma, diastatic skull fracture, grow skull fracture, depressed (‘ping–pong’) skull fracture, and extradural hematoma. Methods: We present our 10 years experience in neuropediatric traumatic brain injuries, between 1999 and 2009, in the First Department of Neurosurgery and Pediatric Intensive Care Unit. Including criteria were children, 0–3 years old, presenting only traumatic brain injury. We excluded patients with politrauma, who require a different management. Results: We present the incidence of these specific head injuries, clinical and imagistic features, treatment, and outcome. We found 72 children with diastatic skull fracture, 61 cases with depressed (‘ping–pong’) skull fracture, 22 cases with grow skull fracture, 11 children harboring intrusive skull fracture, 58 cephalhematomas, 26 extradural hematomas, and 7 children with severe brain injury and major posttraumatic diffuse ischemia (‘black–brain’). Usually, infants and toddlers present with seizures, pallor, and rapid loss of consciousness. First choice examination, in all children was cerebral CT–scan, and for follow–up, we performed cerebral MRI. We emphasize on the importance of seizure prevention in this age group. Children presenting with extensive diffuse ischemia (‘black–brain’) had a poor outcome, death occurring in all 7 cases. Conclusion: Children 0–3 years old, present with a total distinctive pathology than adults. Children with head injury must be addressed to a pediatric department of neurosurgery and pediatric intensive care unit. Prophylaxis pays the most important role in

  1. Suspected disseminated histiocytic sarcoma in a 3-year-old Perro de Presa Canario dog.

    PubMed

    Denstedt, Emily

    2014-02-01

    A 3-year-old intact male Perro de Presa Canario dog was presented with acutely inflamed and edematous right hind limb, scrotum, prepuce, and an enlarged left carpus. Two weeks later the dog returned with weight loss, draining tracts in the right hind limb, dermal nodules, a palpable abdominal mass, and uveitis in the left eye. The dog succumbed to his illness 2 days later and a widely disseminated round cell tumor compatible with histiocytic sarcoma was diagnosed following postmortem examination.

  2. Changes in body composition in apparently healthy urban Indian women up to 3 years postpartum

    PubMed Central

    Kajale, Neha A.; Khadilkar, Anuradha V.; Chiplonkar, Shashi A.; Khadilkar, Vaman

    2015-01-01

    Introduction: Dietary and life style practices differ in postpartum (PP) and nonpregnant Indian women. Effect of these practices on postpartum weight retention (PPWR) and development of cardio-metabolic risk (CMR) has been scarcely studied in urban women. Aims of this study were to (i) compare anthropometry, biochemical parameters and body composition up to 3 years PP (ii) effect of PPWR, dietary fat intake and physical activity on CMR factors. Methods: Design: Cross-sectional, 300-fullterm, apparently healthy primi-parous women (28.6 ± 3.4 years) randomly selected. 128 women within 7-day of delivery (Group-A), 88 with 1–2 years (Group-B) and 84 with 3–4-year-old-children (Group-C) were studied. Anthropometry, sociodemographic status, physical activity, diet, clinical examination, biochemical tests, body composition, at total body (TB), by dual energy X-ray absorptiometry (GE-Lunar DPX) were collected. Results: Women at 3-year PP showed higher weight retention (6.5[10] kg) than at 1-year (3.0[7] kg) (median [IQR]). Android fat % (central obesity) increased (P < 0.05) at 1-year PP (47 ± 10.0%) when compared to 1-week PP (44.3 ± 6.7%) and remained elevated at 3-year PP (45.6 ± 10.2%). Regression analysis revealed that at 1-year PP, increase in PPWR (Odd Ratio [OR] 1.8, 95% confidence interval [CI] = [1.2, 2.5], P < 0.001) and inactivity (OR 1.4, 95% CI= (0.97, 2.0), P < 0.1) were predictors for CMR. At 3-year PP, only PPWR was responsible for increase in CMR parameters (OR 1.6, 95% CI = (1.3, 2.3), P < 0.001) and not inactivity (P > 0.1). Conclusion: Postdelivery, low physical activity and higher PPWR may increase CMR in Indian women. PMID:26180762

  3. Association between umbilical cord glucocorticoids and blood pressure at age 3 years

    PubMed Central

    Huh, Susanna Y; Andrew, Ruth; Rich-Edwards, Janet W; Kleinman, Ken P; Seckl, Jonathan R; Gillman, Matthew W

    2008-01-01

    Background Animal data show that decreased activity of placental 11-beta-hydroxysteroid dehydrogenase type 2 (11β-HSD2), which potently inactivates glucocorticoids (e.g. cortisol) to inert forms (cortisone), allows increased access of maternal glucocorticoids to the fetus and 'programs' hypertension. Data in humans are limited. We examined in humans the association between venous umbilical cord blood glucocorticoids, a potential marker for placental 11β-HSD2 enzyme activity, and blood pressure at age 3 years. Methods Among 286 newborns in Project Viva, a prospective pre-birth cohort study based in eastern Massachusetts, we measured cortisol (F) and cortisone (E) in venous cord blood and used the ratio of F/E as a marker for placental 11β-HSD2 activity. We measured blood pressure (BP) when the offspring reached age 3 years. Using mixed effects regression models to control for BP measurement conditions, maternal and child characteristics, we examined the association between the F/E ratio and child BP. Results At age 3 years, each unit increase in the F/E ratio was associated with a 1.6 mm Hg increase in systolic BP (95% CI 0.0 to 3.1). The F/E ratio was not associated with diastolic blood pressure or birth weight for gestational age z-score. Conclusion A higher F/E ratio in umbilical venous cord blood, likely reflecting reduced placental 11β-HSD2 activity, was associated with higher systolic blood pressure at age 3 years. Our data suggest that increased fetal exposure to active maternal glucocorticoids may program later systolic blood pressure. PMID:18755017

  4. Maternal experiences of racial discrimination and child weight status in the first 3 years of life.

    PubMed

    Dixon, B; Rifas-Shiman, S L; James-Todd, T; Ertel, K; Krieger, N; Kleinman, K P; Rich-Edwards, J W; Gillman, M W; Taveras, E M

    2012-12-01

    Among US racial/ethnic minority women, we examined associations between maternal experiences of racial discrimination and child growth in the first 3 years of life. We analyzed data from Project Viva, a pre-birth cohort study. We restricted analyses to 539 mother-infant pairs; 294 were Black, 127 Hispanic, 110 Asian and 8 from additional racial/ethnic groups. During pregnancy, mothers completed the Experiences of Discrimination survey that measured lifetime experiences of racial discrimination in diverse domains. We categorized responses as 0, 1-2 or ≥3 domains. Main outcomes were birth weight for gestational age z-score; weight for age (WFA) z-score at 6 months of age; and at 3 years of age, body mass index (BMI) z-score. In multivariable analyses, we adjusted for maternal race/ethnicity, nativity, education, age, pre-pregnancy BMI, household income and child sex and age. Among this cohort of mostly (58.2%) US-born and economically non-impoverished mothers, 33% reported 0 domains of discrimination, 33% reported discrimination in 1-2 domains and 35% reported discrimination in ≥3 domains. Compared with children whose mothers reported no discrimination, those whose mothers reported ≥3 domains had lower birth weight for gestational age z-score (β -0.25; 95% CI: -0.45, -0.04), lower 6 month WFA z-score (β -0.34; 95% CI: -0.65, -0.03) and lower 3-year BMI z-score (β -0.33; 95% CI: -0.66, 0.00). In conclusion, we found that among this cohort of US racial/ethnic minority women, mothers' report of experiencing lifetime discrimination in ⩾ 3 domains was associated with lower fetal growth, weight at 6 months and 3-year BMI among their offspring.

  5. Adherence to Competing Strategies for Colorectal Cancer Screening Over 3 Years

    PubMed Central

    Liang, Peter S.; Wheat, Chelle L.; Abhat, Anshu; Brenner, Alison T.; Fagerlin, Angela; Hayward, Rodney A.; Thomas, Jennifer P.; Vijan, Sandeep; Inadomi, John M.

    2016-01-01

    Objectives We have shown that, in a randomized trial comparing adherence to different colorectal cancer (CRC) screening strategies, participants assigned to either fecal occult blood testing (FOBT) or given a choice between FOBT and colonoscopy had significantly higher adherence than those assigned to colonoscopy during the first year. However, how adherence to screening changes over time is unknown. Methods In this trial, 997 participants were cluster randomized to one of the three screening strategies: (i) FOBT, (ii) colonoscopy, or (iii) a choice between FOBT and colonoscopy. Research assistants helped participants to complete testing only in the first year. Adherence to screening was defined as completion of three FOBT cards in each of 3 years after enrollment or completion of colonoscopy within the first year of enrollment. The primary outcome was adherence to assigned strategy over 3 years. Additional outcomes included identification of sociodemographic factors associated with adherence. Results Participants assigned to annual FOBT completed screening at a significantly lower rate over 3 years (14%) than those assigned to colonoscopy (38%, P<0.001) or choice (42%, P<0.001); however, completion of any screening test fell precipitously, indicating the strong effect of patient navigation. In multivariable logistic regression analysis, being randomized to the choice or colonoscopy group, Chinese language, homosexuality, being married/partnered, and having a non-nurse practitioner primary care provider were independently associated with greater adherence to screening (P<0.01). Conclusions In a 3-year follow-up of a randomized trial comparing competing CRC screening strategies, participants offered a choice between FOBT and colonoscopy continued to have relatively high adherence, whereas adherence in the FOBT group fell significantly below that of the choice and colonoscopy groups. Patient navigation is crucial to achieving adherence to CRC screening, and FOBT is

  6. Dystonia as acute adverse reaction to cough suppressant in a 3-year-old girl.

    PubMed

    Polizzi, A; Incorpora, G; Ruggieri, M

    2001-01-01

    Cough suppressant preparations containing mixtures of dextromethorphan or codeine with antihistamines, decongestants (sympathomimetic), expectorants and antipyretics with either sedative or anticholinergic activity have been associated with dystonic reactions in children. We report on a 3-year-old girl who presented with episodic stiffness and abnormal posturing with rigidity after arbitrary maternal administration of a mixture of methylcodeine and extract from Hedera plant. PMID:11587381

  7. Morganella morganii pericarditis 3 years after allogenic bone marrow transplantation for mantle cell lymphoma.

    PubMed

    Yang, Zhi-Tao; Lecuit, Marc; Suarez, Felipe; Carbonnelle, Etienne; Viard, Jean-Paul; Dupont, Bertrand; Buzyn, Agnès; Lortholary, Olivier

    2006-11-01

    We report herein a case of Morganella morganii-associated acute purulent pericarditis that developed 3 years after allogenic bone marrow transplantation. The patient was successfully treated with surgical drainage and cefotaxime for 6 weeks. Splenectomy and immunosuppression for chronic GVH-D are likely to have favored the development of this rare infectious complication after BMT. M. morganii should be added to the list of bacteria causing purulent pericarditis, especially in immunocompromised hosts.

  8. The Rapid Development of Explicit Gaze Judgment Ability at 3 years

    ERIC Educational Resources Information Center

    Doherty, Martin J.; Anderson, James R.; Howieson, Lynne

    2009-01-01

    Two studies examined development of the ability to judge what another person is looking at. In Study 1, 54 2- to 4-year-olds judged where someone was looking in real-life, photograph, and drawing formats. A minority of 2-year-olds, but a majority of older children, passed all tasks, suggesting that the ability arises at around 3 years of age.…

  9. The Neural Correlates of Processing Newborn and Adult Faces in 3-Year-Old Children

    ERIC Educational Resources Information Center

    Peykarjou, Stefanie; Westerlund, Alissa; Cassia, Viola Macchi; Kuefner, Dana; Nelson, Charles A.

    2013-01-01

    The current study examines the processing of upright and inverted faces in 3-year-old children (n = 35). Event-related potentials (ERPs) were recorded during a passive looking paradigm including adult and newborn face stimuli. We observed three face-sensitive components, the P1, the N170 and the P400. Inverted faces elicited shorter P1 latency and…

  10. Radiological evaluation of the Cresco system in combination with Osseospeed implants: a preliminary 3-year report

    PubMed Central

    BALDINI, N.; DE SANCTIS, M.; CAGIDIACO, M.C.; BALLERI, P.; VIGNOLETTI, F.; GORACCI, C.; FERRARI, M.

    2014-01-01

    SUMMARY Aim. In this preliminary study, the 3-year radiological outcomes of Osseospeed implant-supported fixed complete or partial prostheses made with two different laboratory protocols were compared. Methods. A convenience sample of 34 patients, who were either partially or completely edentulous in either jaw, were randomly assigned to two groups, of 17 patients each, using either a traditional laboratory protocol (control group) or the Cresco one (test group). The study’s objective was an assessment of marginal bone loss around implants, measured on intraoral radiographs at 3-year follow-up. Results. None of the implants inserted was lost during the study and radiological measurements of marginal bone level changes revealed that the mean marginal bone loss was respectively 0,73±0,33mm for test group and 0,88±1,13mm for control group. The differences between test and control groups were not statistically significant. Conclusion. This preliminary study did not demonstrate statistically significant differences in marginal bone loss around implant-prostheses prepared with the two different laboratory protocols, over the 3-year observational period. PMID:25694796

  11. Outcome 1 to 3 years after severe traumatic brain injury in children and adolescents.

    PubMed

    Boyer, M G; Edwards, P

    1991-07-01

    This study reports a consecutive series of 220 children and adolescents who sustained traumatic brain injury (BI) and were admitted to a comprehensive paediatric rehabilitation programme. Progress in areas of mobility, activities of daily living, education and cognitive function were documented for up to 3 years after the injury. Physical recovery was most rapid in the first years and cognitive and language gains generally occurred later, even up to 3 years after the injury. Cognitive assessment at the time of admission proved helpful in predicting outcome; of those patients admitted in a conscious state only one remained dependent for any aspect of self care. Even for those admitted unconscious at a median of 62 days after injury there was good potential for recovery with 27-43 per cent achieving independence in the activities of daily living. For those still unconscious at 6 months, 72 per cent remained vegetative and none achieved the highest cognitive level. Overall, 14 per cent returned to regular education while 25 per cent remained incapable of any educational programme. In a well planned and multidisciplinary rehabilitation programme, patients with severe BI have potential for continued recovery and measurable improvement for at least 3 years. The emphasis should be targeted on differing areas of the therapy programme at different phases of recovery. A realistic appraisal of the ultimate potential for recovery can usually be made by 6 months.

  12. Weight Loss and Health Status 3 Years after Bariatric Surgery in Adolescents

    PubMed Central

    Inge, Thomas H.; Courcoulas, Anita P.; Jenkins, Todd M.; Michalsky, Marc P.; Helmrath, Michael A.; Brandt, Mary L.; Harmon, Carroll M.; Zeller, Meg H.; Chen, Mike K.; Xanthakos, Stavra A.; Horlick, Mary; Buncher, C. Ralph

    2016-01-01

    BACKGROUND Bariatric surgery is increasingly considered for the treatment of adolescents with severe obesity, but few prospective adolescent-specific studies examining the efficacy and safety of weight-loss surgery are available to support clinical decision making. METHODS We prospectively enrolled 242 adolescents undergoing weight-loss surgery at five U.S. centers. Patients undergoing Roux-en-Y gastric bypass (161 participants) or sleeve gastrectomy (67) were included in the analysis. Changes in body weight, coexisting conditions, cardiometabolic risk factors, and weight-related quality of life and postoperative complications were evaluated through 3 years after the procedure. RESULTS The mean (±SD) baseline age of the participants was 17±1.6 years, and the mean body-mass index (the weight in kilograms divided by the square of the height in meters) was 53; 75% of the participants were female, and 72% were white. At 3 years after the procedure, the mean weight had decreased by 27% (95% confidence interval [CI], 25 to 29) in the total cohort, by 28% (95% CI, 25 to 30) among participants who underwent gastric bypass, and by 26% (95% CI, 22 to 30) among those who underwent sleeve gastrectomy. By 3 years after the procedure, remission of type 2 diabetes occurred in 95% (95% CI, 85 to 100) of participants who had had the condition at baseline, remission of abnormal kidney function occurred in 86% (95% CI, 72 to 100), remission of prediabetes in 76% (95% CI, 56 to 97), remission of elevated blood pressure in 74% (95% CI, 64 to 84), and remission of dyslipidemia in 66% (95% CI, 57 to 74). Weight-related quality of life also improved significantly. However, at 3 years after the bariatric procedure, hypoferritinemia was found in 57% (95% CI, 50 to 65) of the participants, and 13% (95% CI, 9 to 18) of the participants had undergone one or more additional intraabdominal procedures. CONCLUSIONS In this multicenter, prospective study of bariatric surgery in adolescents, we

  13. IQ Trajectory, Cognitive Reserve, and Clinical Outcome Following a First Episode of Psychosis: A 3-Year Longitudinal Study

    PubMed Central

    Leeson, Verity C.; Sharma, Pranev; Harrison, Masuma; Ron, Maria A.; Barnes, Thomas R. E.; Joyce, Eileen M.

    2011-01-01

    Comparison of current and estimated premorbid IQ in schizophrenia suggests that there are subgroups with low IQ, deteriorated IQ (DIQ), or preserved IQ and that this is established by psychosis onset. There are no controlled studies examining the trajectory of these IQ subgroups longitudinally or their relationship with clinical and social outcomes. Of 129 individuals with first-episode schizophrenia or schizoaffective disorder, 25% showed stable low IQ, 31% showed stable IQ in the average/high range, and 44% demonstrated intellectual deterioration by 10 points or more. Patients in the low and deteriorated groups were equally impaired on tests of memory and executive function compared with the preserved average/high-IQ group and controls and showed more negative and disorganization symptoms than the preserved average/high-IQ group. Sixty patients and 27 controls were assessed again 1 and 3 years later. There was no evidence that those with IQ deterioration at baseline continued on a declining cognitive trajectory or that those with preserved average/high IQ experienced subsequent IQ decline. The low IQ group showed no change in IQ, whereas both the DIQ and the preserved IQ groups improved. However, the rate of improvement of these 2 subgroups was no greater than that of the healthy controls, suggesting that this reflected practice effects. Both the low and the deteriorated groups had longer index admissions, more core negative symptoms, and worse occupational outcomes at 3 years. These data suggest that following psychosis onset, IQ is stable and that it is IQ at psychosis onset rather than premorbid IQ predicts a more severe illness. PMID:19934212

  14. IQ trajectory, cognitive reserve, and clinical outcome following a first episode of psychosis: a 3-year longitudinal study.

    PubMed

    Leeson, Verity C; Sharma, Pranev; Harrison, Masuma; Ron, Maria A; Barnes, Thomas R E; Joyce, Eileen M

    2011-07-01

    Comparison of current and estimated premorbid IQ in schizophrenia suggests that there are subgroups with low IQ, deteriorated IQ (DIQ), or preserved IQ and that this is established by psychosis onset. There are no controlled studies examining the trajectory of these IQ subgroups longitudinally or their relationship with clinical and social outcomes. Of 129 individuals with first-episode schizophrenia or schizoaffective disorder, 25% showed stable low IQ, 31% showed stable IQ in the average/high range, and 44% demonstrated intellectual deterioration by 10 points or more. Patients in the low and deteriorated groups were equally impaired on tests of memory and executive function compared with the preserved average/high-IQ group and controls and showed more negative and disorganization symptoms than the preserved average/high-IQ group. Sixty patients and 27 controls were assessed again 1 and 3 years later. There was no evidence that those with IQ deterioration at baseline continued on a declining cognitive trajectory or that those with preserved average/high IQ experienced subsequent IQ decline. The low IQ group showed no change in IQ, whereas both the DIQ and the preserved IQ groups improved. However, the rate of improvement of these 2 subgroups was no greater than that of the healthy controls, suggesting that this reflected practice effects. Both the low and the deteriorated groups had longer index admissions, more core negative symptoms, and worse occupational outcomes at 3 years. These data suggest that following psychosis onset, IQ is stable and that it is IQ at psychosis onset rather than premorbid IQ predicts a more severe illness. PMID:19934212

  15. NutricheQ Questionnaire assesses the risk of dietary imbalances in toddlers from 1 through 3 years of age

    PubMed Central

    Morino, Giuseppe S.; Cinelli, Giulia; Pietro, Ilaria Di; Papa, Vittoria; Spreghini, Nicola; Manco, Melania

    2015-01-01

    Background Although a nutrient-poor diet may affect children's growth, especially early in life, few tools to assess dietary imbalances in 1- to 3-year-old children have been developed. Objectives To investigate the accuracy and test–retest reliability of the NutricheQ Questionnaire in the identification of toddlers with the risk of inadequate intake of micro- and macronutrients in a sample of Italian toddlers. Design A 3-day weighed food record was performed, and results were compared with outcomes of the NutricheQ Questionnaire in 201 toddlers (training set: 1–3 years old). The accuracy of NutricheQ in the identification of categories of nutritional risk was evaluated using the receiver operating characteristic (ROC) curves. Test–retest of the tool was estimated using the intraclass correlation coefficient (ICC) and the Cronbach's alpha statistic, in a validation set of 50 toddlers. Results The NutricheQ Questionnaire is a valid tool for the identification of toddlers at risk for dietary imbalances. Significant differences in nutrient intake (p<0.005) were found among the three groups of risk identified by the questionnaire: toddlers included in the high-risk group had a lower intake of key nutrients such as iron, vitamin D and other vitamins, and fibre compared to those included in the low-risk group. NutricheQ is also reliable between administrations, as demonstrated by its test–retest reliability. ICC and Cronbach's alpha were 0.73 and 0.83, respectively, for Section 1 of NutricheQ, and 0.55 and 0.70 for Section 2. Conclusions The NutricheQ Questionnaire is a reliable and consistent tool for the assessment of possible dietary risk factors in Italian toddlers. It consistently identifies toddlers with a high probability of having poor iron and vitamin D intake, and other dietary imbalances. PMID:26689315

  16. Clinical Characteristics and Outcomes of Pediatric Patients with Desmoplastic Small Round Cell Tumor

    PubMed Central

    Bent, Melissa A.; Padilla, Benjamin E.; Goldsby, Robert E.; DuBois, Steven G.

    2016-01-01

    Desmoplastic small round cell tumor (DSRCT) is a rare malignancy that typically affects pediatric and young adult patients. There are limited data on the clinical features of pediatric DSRCT. We selected patients aged 0-21 years reported to the Surveillance, Epidemiology and End Results Program from 1991-2011. We estimated overall survival using Kaplan-Meier approaches and compared outcomes using the log rank test. The median age of the 95 pediatric patients was 15.3 years (range: 0-21). The majority of tumors originated in the abdomen and pelvis (84.4%) and the majority of patients had distant metastasis (72.6%). A minority of patients received radiation (34%). Overall survival at 5 years was poor (18.1%; 95% confidence interval 10.1-27.9%). Radiation therapy was associated with superior survival. Pediatric patients with DSRCT have significant disease burden. Outcomes for children are poor, though patients selected for radiation appear to have improved survival. PMID:27134714

  17. Multiple sclerosis, brain radiotherapy, and risk of neurotoxicity: The Mayo Clinic experience

    SciTech Connect

    Miller, Robert C. . E-mail: miller.robert@mayo.edu; Lachance, Daniel H.; Lucchinetti, Claudia F.; Keegan, B. Mark; Gavrilova, Ralitza H.; Brown, Paul D.; Weinshenker, Brian G.; Rodriguez, Moses

    2006-11-15

    Purpose: The aim of this study was a retrospective assessment of neurotoxicity in patients with multiple sclerosis (MS) receiving external beam radiotherapy (EBRT) to the brain. Methods and Materials: We studied 15 consecutively treated patients with MS who received brain EBRT. Neurologic toxicity was assessed with the Common Toxicity Criteria v.3.0. Results: Median follow-up for the 5 living patients was 6.0 years (range, 3.3-27.4 years). No exacerbation of MS occurred in any patient during EBRT. Five patients had Grade 4 neurologic toxicity and 1 had possible Grade 5 toxicity. Kaplan-Meier estimated risk of neurotoxicity greater than Grade 4 at 5 years was 57% (95% confidence interval, 27%-82%). Toxicity occurred at 37.5 to 54.0 Gy at a median of 1.0 year (range, 0.2-4.3 years) after EBRT. Univariate analysis showed an association between opposed-field irradiation of the temporal lobes, central white matter, and brainstem and increased risk of neurotoxicity (p < 0.04). Three of 6 cases of toxicity occurred in patients treated before 1986. Conclusions: External beam radiotherapy of the brain in patients with MS may be associated with an increased risk of neurotoxicity compared with patients without demyelinating illnesses. However, this risk is associated with treatment techniques that may not be comparable to modern, conformal radiotherapy.

  18. Preoperative Radiation Therapy Followed by Reexcision May Improve Local Control and Progression-Free Survival in Unplanned Excisions of Soft Tissue Sarcomas of the Extremity and Chest-Wall

    PubMed Central

    Saeed, Hina; Johnstone, Candice A.; Charlson, John A.; Hackbarth, Donald A.; Neilson, John C.

    2016-01-01

    Background. The management for unplanned excision (UE) of soft tissue sarcomas (STS) has not been established. In this study, we compare outcomes of UE versus planned excision (PE) and determine an optimal treatment for UE in STS. Methods. From 2000 to 2014 a review was performed on all patients treated with localized STS. Clinical outcomes including local recurrence-free survival (LRFS), progression-free survival (PFS), and overall survival (OS) were evaluated using the Kaplan-Meier estimate. Univariate (UVA) and multivariate (MVA) analyses were performed to determine prognostic variables. For MVA, Cox proportional hazards model was used. Results. 245 patients were included in the analysis. 14% underwent UE. Median follow-up was 2.8 years. The LR rate was 8.6%. The LR rate in UE was 35% versus 4.2% in PE patients (p < 0.0001). 2-year PFS in UE versus PE patients was 4.2 years and 9.3 years, respectively (p = 0.08). Preoperative radiation (RT) (p = 0.01) and use of any RT for UE (p = 0.003) led to improved PFS. On MVA, preoperative RT (p = 0.04) and performance status (p = 0.01) led to improved PFS. Conclusions. UEs led to decreased LC and PFS versus PE in patients with STS. The use of preoperative RT followed by reexcision improved LC and PFS in patients who had UE of their STS. PMID:27803813

  19. Stavudine- and nevirapine-related drug toxicity while on generic fixed-dose antiretroviral treatment: incidence, timing and risk factors in a three-year cohort in Kigali, Rwanda.

    PubMed

    van Griensven, Johan; Zachariah, Rony; Rasschaert, Freya; Mugabo, Jules; Atté, Edi F; Reid, Tony

    2010-02-01

    This cohort study was conducted to report on the incidence, timing and risk factors for stavudine (d4T)- and nevirapine (NVP)-related severe drug toxicity (requiring substitution) with a generic fixed-dose combination under program conditions in Kigali, Rwanda. Probability of 'time to first toxicity-related drug substitution' was estimated using the Kaplan-Meier method and Cox-proportional hazards modeling was used to identify risk factors. Out of 2190 adults (median follow-up: 1.5 years), d4T was replaced in 175 patients (8.0%) for neuropathy, 69 (3.1%) for lactic acidosis and 157 (7.2%) for lipoatrophy, which was the most frequent toxicity by 3 years of antiretroviral treatment (ART). NVP was substituted in 4.9 and 1.3% of patients for skin rash and hepatotoxicity, respectively. Use of d4T 40 mg was associated with increased risk of lipoatrophy and early (<6 months) neuropathy. Significant risk factors associated with lactic acidosis and late neuropathy included higher baseline body weight. Older age and advanced HIV disease increased the risk of neuropathy. Elevated baseline liver tests and older age were identified as risk factors for NVP-related hepatotoxicity. d4T is associated with significant long-term toxicity. d4T-dose reduction, increased access to safer ART in low-income countries and close monitoring for those at risk are all relevant strategies.

  20. MyoRing Implantation in Keratoconic Patients: 3 years Follow-up Data

    PubMed Central

    Janani, Leila; Jadidi, Khosrow; Mosavi, Seyed Aliasghar; Nejat, Farhad; Naderi, Mostafa; Nourijelyani, Keramat

    2016-01-01

    Purpose: To evaluate long-term follow-up data on implantation of a full-ring intra-corneal implant (MyoRing) for management of keratoconus. Methods: A total of 40 keratoconic eyes of 37 consecutive patients who had undergone MyoRing implantation using the Pocket Maker microkeratome (Dioptex, GmbH, Linz, Austria) and completed 3 years of follow-up appointments were included in this retrospective study. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refraction and keratometry (K) readings were measured and evaluated preoperatively, and 3 years, postoperatively. Results: No intraoperative complications were observed in this case series. Three years postoperatively, there was a significant improvement in UDVA, CDVA, K readings, spherical equivalent (SE), and manifest sphere and cylinder (P < 0.05 for all comparisons). UDVA was significantly improved from 1.14 ± 0.27 to 0.30 ± 0.21 LogMAR (P = 0.001), CDVA was also improved from 0.52 ± 0.23 to 0.18 ± 0.12 LogMAR (P = 0.001), SE was decreased by 4.35 diopters (D) and average keratometric values were reduced by 2.34 D (P = 0.001). Overall, 81% of subjects were moderately to highly satisfied 3 years after surgery and 64.90% agreed to have the fellow eye implanted with MyoRing. Conclusion: MyoRing implantation using the Pocket Maker microkeratome was found to be a minimally invasive procedure for improving visual acuity and refraction in the majority of the patients with keratoconus. PMID:27195081

  1. Malignant hyperthermia in a 3-year-old child with microstomia.

    PubMed

    Evans, Tyler A; Flores, Roberto L; Tholpady, Sunil S; Dierdorf, Stephen

    2015-01-01

    Freeman-Sheldon syndrome is a congenital disorder that has been suggested to be associated with malignant hyperthermia. Clinical features of the Freeman-Sheldon syndrome include flexion contractures and characteristic facial features, including microstomia and a whistling shape to the lips. We report a case of malignant hyperthermia in a 3-year-old girl with microstomia but no other features of Freeman-Sheldon syndrome. The purpose of this report was to review the diagnosis and treatment of malignant hyperthermia as craniofacial surgeons have an increased exposure to this rare and potentially fatal condition. PMID:25478978

  2. Axial Length/Corneal Radius of Curvature Ratio and Myopia in 3-Year-Old Children

    PubMed Central

    Foo, Valencia Hui Xian; Verkicharla, Pavan Kumar; Ikram, Mohammad Kamran; Chua, Sharon Yu Lin; Cai, Shirong; Tan, Chuen Seng; Chong, Yap-Seng; Kwek, Kenneth; Gluckman, Peter; Wong, Tien-Yin; Ngo, Cheryl; Saw, Seang-Mei; on behalf of the GUSTO study group

    2016-01-01

    Purpose This study investigated the association of axial length (AL) to corneal radius of curvature (CRC) ratio with spherical equivalent (SE) in a 3-year old Asian cohort. Methods Three-hundred forty-nine 3-year old Asian children from The Growing Up in Singapore towards Healthy Outcomes (GUSTO) birth cohort study underwent AL and CRC measurements with a noncontact ocular biometer and cycloplegic refraction using an autorefractor. The ratio of AL to CRC (AL/CRC) was calculated for all the participants, and subsequently AL, CRC, and AL/CRC were analyzed in relationship to SE. Results The SE showed better correlation with AL/CRC (Spearman's correlation coefficient, ρ = −0.53; 95% confidence interval [CI]: −0.66; −0.49; P < 0.001) compared to either AL or CRC alone ([ρ = −0.36; 95% CI: −0.51 to 0.51; P = 0.01] and [ρ = 0.05; 95% CI: −0.04 to 0.17; P = 0.34], respectively). Mean AL/CRC was 2.91 ± 0.06 among myopes and decreased to 2.79 ± 0.06 among hyperopes. Axial length to corneal radius of curvature was strongly correlated with SE in myopes (ρ = −0.78; 95% CI: −3.76; −0.79; P = < 0.001), but not in emmetropes and hyperopes ([ρ = −0.39; 95% CI: −10.73; −0.57; P = 0.01] and [ρ = −0.18; 95% CI: −17.28; 12.42; P = 0.38], respectively). Linear regression adjusted for gender and ethnicity showed a 0.74-diopter shift in SE towards myopia with every 0.1 increase in AL/CRC ratio (P < 0.001, r2 = 0.33). Conclusion The correlation between SE and AL/CRC is stronger than that between AL or CRC alone. This suggests that in a research setting, when cycloplegic refraction is difficult to perform on 3-year-old children, AL/CRC may be the next best reference for refractive error. Translational Relevance In the research setting, AL/CRC may be the next best reference for refractive error over AL alone when cycloplegic refraction is unavailable in 3-year old children. PMID:26929885

  3. Suspected disseminated histiocytic sarcoma in a 3-year-old Perro de Presa Canario dog

    PubMed Central

    Denstedt, Emily

    2014-01-01

    A 3-year-old intact male Perro de Presa Canario dog was presented with acutely inflamed and edematous right hind limb, scrotum, prepuce, and an enlarged left carpus. Two weeks later the dog returned with weight loss, draining tracts in the right hind limb, dermal nodules, a palpable abdominal mass, and uveitis in the left eye. The dog succumbed to his illness 2 days later and a widely disseminated round cell tumor compatible with histiocytic sarcoma was diagnosed following postmortem examination. PMID:24489399

  4. Early epileptic encephalopathies including West syndrome: a 3-year retrospective study from Klang Hospital, Malaysia.

    PubMed

    Thambyayah, M

    2001-11-01

    It is difficult to give a country report from Malaysia. A study done in 1999 reported the incidence of West Syndrome to be 3% among newly diagnosed cases of epilepsy. In this 3 year retrospective hospital-based study (1997-1999), the prevalence of early epileptic encephalopathy (EEE) and West Syndrome were 4.1 and 2.5% respectively. There is difficulty classifying EEE cases into distinct sub-groups of EIEE (early infantile epileptic encephalopathy), WS (West Syndrome) and SMEI (severe myoclonic epilepsy of infancy), using a combination of clinical features, EEG and CT/MRI findings.

  5. [Atypical presentation of hepatosplenic cat scratch disease in a 3-year-old child].

    PubMed

    Boiron, E; Soto, B; Zimmermann, B; Jullien, M

    2012-06-01

    Cat scratch disease is caused by a facultative intracellular Gram-negative bacteria, Bartonella henselae. This disease is transmitted by cat scratches or bites. The typical form is a large and rough adenopathy, with no general signs. In a few cases, the symptoms are aspecific and various, which makes the diagnosis difficult. A 3-year-old child presented a prolonged fever with an aspecific skin eruption and hepatosplenic lesions seen 1 month after the beginning of the disease, which led to the diagnosis of hepatosplenic cat scratch disease. An adapted antibiotic therapy completely cured the disease.

  6. Suspected disseminated histiocytic sarcoma in a 3-year-old Perro de Presa Canario dog.

    PubMed

    Denstedt, Emily

    2014-02-01

    A 3-year-old intact male Perro de Presa Canario dog was presented with acutely inflamed and edematous right hind limb, scrotum, prepuce, and an enlarged left carpus. Two weeks later the dog returned with weight loss, draining tracts in the right hind limb, dermal nodules, a palpable abdominal mass, and uveitis in the left eye. The dog succumbed to his illness 2 days later and a widely disseminated round cell tumor compatible with histiocytic sarcoma was diagnosed following postmortem examination. PMID:24489399

  7. Status of natural disaster victims' health and recovery 1 and 3 years later.

    PubMed

    Murphy, S A

    1986-12-01

    Bereaved, property loss, and control groups (N = 155) studied 11 months following the 1980 volcanic eruption of Mt. St. Helens were recontacted 35 months postdisaster to test the hypotheses that the greater the loss experienced, the higher the stress, and the poorer the health. In general, the hypotheses were supported. Even though mental distress decreased between the two data collection periods, the mental health of the bereaved group remained poorer than both the property loss and control groups. At 3 years postdisaster, only 4% of the study participants reported complete recovery from disaster loss. Findings are compared with those of other recent disasters and clinical and theoretical implications are discussed.

  8. Acute dapsone poisoning in a 3-year-old child: Case report with review of literature

    PubMed Central

    Sunilkumar, Menon Narayanankutty; Ajith, Thekkuttuparambil Ananthanarayanan; Parvathy, Vadakut Krishnan

    2015-01-01

    Dapsone (DDS-diamino diphenyl sulphone) is a sulfone antibiotic being used for a variety of clinical conditions. Poisoning in children by DDS is rarely reported. Poisoning in acute cases will be frequently unrecognized due to relative lack of severe signs and symptoms. Methemoglobinemia is the major life-threatening situation associated with poisoning of DDS. Hence, any delay for medical attention can lead to increased rate of mortality. In this case, we describe acute DDS poisoning in a 3-year-old child and the successful management using intravenous methylene blue. PMID:26488029

  9. Discoid medial meniscus with a horizontal cleavage tear: a juvenile who suffered for 3 years.

    PubMed

    Chen, Jingqing; Gao, Shijun; Chen, Baicheng

    2012-09-01

    It is very rare to see medial discoid meniscus, and there have been only 82 knees in 61 cases reported to date. The investigators found discoid medial meniscus with horizontal cleavage tear in a 13-year-old juvenile who had been injured while playing basketball, and endured for 3 years. Both magnetic resonance images and the arthroscopic findings were presented. Saucerization of the torn discoid medial meniscus was performed successfully, and the clinical outcomes were satisfying according to the follow-up of 14 months.

  10. Effects of prosthetic limb prescription on 3-year mortality among lower extremity veteran amputees

    PubMed Central

    Kurichi, Jibby E.; Kwong, Pui; Vogel, W. Bruce; Xie, Dawei; Ripley, Diane Cowper; Bates, Barbara E.

    2015-01-01

    Our objective was to determine the relationship between receipt of a prescription for a prosthetic limb and three-year mortality post-surgery among veterans with lower extremity amputation. We conducted a retrospective observational study that included 4,578 veterans hospitalized for lower extremity amputation and discharged in Fiscal Years 2003 and 2004. The outcome was time to all-cause mortality from the amputation surgical date up to the 3-year anniversary of the surgical date. There were 1,300 (28.4%) veterans with lower extremity amputations who received a prescription for a prosthetic limb within a year after the surgical amputation. About 46% (n=2086) died within three-years of the surgical anniversary. Among those who received a prescription for a prosthetic limb, only 25.2% died within 3 years of the surgical anniversary. After adjustment, veterans who received a prescription for a prosthetic limb were less likely to die after the surgery than veterans without a prescription with a hazard ratio of 0.68 (95% CI, 0.60-0.77). Findings demonstrated that veterans with lower extremity amputations who received a prescription for a prosthetic limb within a year after the surgical amputation were less likely to die within three years of the surgical amputation after controlling for patient-, treatment-, and facility-level characteristics. PMID:26348602

  11. Tsunami-exposed tourist survivors: signs of recovery in a 3-year perspective.

    PubMed

    Johannesson, Kerstin Bergh; Lundin, Tom; Fröjd, Thomas; Hultman, Christina M; Michel, Per-Olof

    2011-03-01

    Long-term follow-up after disaster exposure indicates increased rates of psychological distress. However, trajectories and rates of recovery in large samples of disaster-exposed survivors are largely lacking. A group of 3457 Swedish survivors temporarily on vacation in Southeast Asia during the 2004 tsunami were assessed by postal questionnaire at 14 months and 3 years after the tsunami regarding post-traumatic stress reactions (IES-R) and general mental health (GHQ-12). There was a general pattern of resilience and recovery 3 years postdisaster. Severe exposure and traumatic bereavement were associated with increased post-traumatic stress reactions and heightened risk for impaired mental health. The rate of recovery was lower among respondents exposed to life threat and among bereaved. Severe trauma exposure and bereavement seem to have considerable long-term impact on psychological distress and appear to slow down the recovery process. Readiness among health agencies for identification of symptoms and provision of interventions might facilitate optimal recovery. PMID:21346486

  12. Preventing Pregnancy in High School Students: Observations From a 3-Year Longitudinal, Quasi-Experimental Study

    PubMed Central

    Dierschke, Nicole; Lowe, Diana; Plastino, Kristen

    2016-01-01

    Objectives. To assess whether a sexual health education intervention reduces pregnancy rates in high school students. Methods. We performed a secondary analysis of a 3-year quasi-experimental study performed in South Texas from 2011 to 2015 in which 1437 students without a history of pregnancy at baseline were surveyed each fall and spring. Potentially confounding risk factors considered included sexual behaviors, intentions, and demographics. The outcome measure was self-reported pregnancy status for male and female students. We performed analyses for male and female students using separate discrete time-to-event models. Results. We found no difference in pregnancy rates between intervention and comparison students within the first 3 years of high school. Female and male students in the intervention groups had pregnancy hazard ratios of, respectively, 1.62 (95% CI = 0.9, 2.61; P = .1) and 0.78 (95% CI = 0.44, 1.48; P = .4) relative to the comparison groups. Conclusions. The educational intervention had no impact on the pregnancy rate. Social media tools in pregnancy prevention programs should be adaptive to new technologies and rapidly changing adolescent preferences for these services. PMID:27689503

  13. Tsunami-exposed tourist survivors: signs of recovery in a 3-year perspective.

    PubMed

    Johannesson, Kerstin Bergh; Lundin, Tom; Fröjd, Thomas; Hultman, Christina M; Michel, Per-Olof

    2011-03-01

    Long-term follow-up after disaster exposure indicates increased rates of psychological distress. However, trajectories and rates of recovery in large samples of disaster-exposed survivors are largely lacking. A group of 3457 Swedish survivors temporarily on vacation in Southeast Asia during the 2004 tsunami were assessed by postal questionnaire at 14 months and 3 years after the tsunami regarding post-traumatic stress reactions (IES-R) and general mental health (GHQ-12). There was a general pattern of resilience and recovery 3 years postdisaster. Severe exposure and traumatic bereavement were associated with increased post-traumatic stress reactions and heightened risk for impaired mental health. The rate of recovery was lower among respondents exposed to life threat and among bereaved. Severe trauma exposure and bereavement seem to have considerable long-term impact on psychological distress and appear to slow down the recovery process. Readiness among health agencies for identification of symptoms and provision of interventions might facilitate optimal recovery.

  14. The relation between student motivation and student grades in physical education: A 3-year investigation.

    PubMed

    Barkoukis, V; Taylor, I; Chanal, J; Ntoumanis, N

    2014-10-01

    Enhancing students' academic engagement is the key element of the educational process; hence, research in this area has focused on understanding the mechanisms that can lead to increased academic engagement. The present study investigated the relation between motivation and grades in physical education (PE) employing a 3-year longitudinal design. Three hundred fifty-four Greek high school students participated in the study. Students completed measures of motivation to participate in PE on six occasions; namely, at the start and the end of the school year in the first, second, and third year of junior high school. Students' PE grades were also recorded at these time points. The results of the multilevel growth models indicated that students' PE grades increased over the 3 years and students had better PE grades at the end of each year than at the beginning of the subsequent year. In general, students and classes with higher levels of controlling motivation achieved lower PE grades, whereas higher levels of autonomous motivation were associated with higher PE grades. These findings provide new insight on the associations between class- and individual-level motivation with objectively assessed achievement in PE.

  15. Mental Health Diagnoses 3 Years After Receiving or Being Denied an Abortion in the United States

    PubMed Central

    Neuhaus, John M.; Foster, Diana G.

    2015-01-01

    Objectives. We set out to assess the occurrence of new depression and anxiety diagnoses in women 3 years after they sought an abortion. Methods. We conducted semiannual telephone interviews of 956 women who sought abortions from 30 US facilities. Adjusted multivariable discrete-time logistic survival models examined whether the study group (women who obtained abortions just under a facility’s gestational age limit, who were denied abortions and carried to term, who were denied abortions and did not carry to term, and who received first-trimester abortions) predicted depression or anxiety onset during seven 6-month time intervals. Results. The 3-year cumulative probability of professionally diagnosed depression was 9% to 14%; for anxiety it was 10% to 15%, with no study group differences. Women in the first-trimester group and women denied abortions who did not give birth had greater odds of new self-diagnosed anxiety than did women who obtained abortions just under facility gestational limits. Conclusions. Among women seeking abortions near facility gestational limits, those who obtained abortions were at no greater mental health risk than were women who carried an unwanted pregnancy to term. PMID:26469674

  16. Spatial but not verbal cognitive deficits at age 3 years in persistently antisocial individuals.

    PubMed

    Raine, Adrian; Yaralian, Pauline S; Reynolds, Chandra; Venables, Peter H; Mednick, Sarnoff A

    2002-01-01

    Previous studies have repeatedly shown verbal intelligence deficits in adolescent antisocial individuals, but it is not known whether these deficits are in place prior to kindergarten or, alternatively, whether they are acquired throughout childhood. This study assesses whether cognitive deficits occur as early as age 3 years and whether they are specific to persistently antisocial individuals. Verbal and spatial abilities were assessed at ages 3 and 11 years in 330 male and female children, while antisocial behavior was assessed at ages 8 and 17 years. Persistently antisocial individuals (N = 47) had spatial deficits in the absence of verbal deficits at age 3 years compared to comparisons (N = 133), and also spatial and verbal deficits at age 11 years. Age 3 spatial deficits were independent of social adversity, early hyperactivity, poor test motivation, poor test comprehension, and social discomfort during testing, and they were found in females as well as males. Findings suggest that early spatial deficits contribute to persistent antisocial behavior whereas verbal deficits are developmentally acquired. An early-starter model is proposed whereby early spatial impairments interfere with early bonding and attachment, reflect disrupted right hemisphere affect regulation and expression, and predispose to later persistent antisocial behavior.

  17. Joint action modulates motor system involvement during action observation in 3-year-olds.

    PubMed

    Meyer, Marlene; Hunnius, Sabine; van Elk, Michiel; van Ede, Freek; Bekkering, Harold

    2011-06-01

    When we are engaged in a joint action, we need to integrate our partner's actions with our own actions. Previous research has shown that in adults the involvement of one's own motor system is enhanced during observation of an action partner as compared to during observation of an individual actor. The aim of this study was to investigate whether similar motor system involvement is present at early stages of joint action development and whether it is related to joint action performance. In an EEG experiment with 3-year-old children, we assessed the children's brain activity and performance during a joint game with an adult experimenter. We used a simple button-pressing game in which the two players acted in turns. Power in the mu- and beta-frequency bands was compared when children were not actively moving but observing the experimenter's actions when (1) they were engaged in the joint action game and (2) when they were not engaged. Enhanced motor involvement during action observation as indicated by attenuated sensorimotor mu- and beta-power was found when the 3-year-olds were engaged in the joint action. This enhanced motor activation during action observation was associated with better joint action performance. The findings suggest that already in early childhood the motor system is differentially activated during action observation depending on the involvement in a joint action. This motor system involvement might play an important role for children's joint action performance. PMID:21479943

  18. Job embeddedness factors and retention of nurses with 1 to 3 years of experience.

    PubMed

    Halfer, Diana

    2011-10-01

    An aging work force, predictions of job growth in health care, and an eventual economic recovery suggest that the current reprieve from the national nursing shortage is temporary. New graduate nurses are an important part of the work force and are needed to replace nurses who will retire in the next decade. Organizational leaders can address the forecasted work force demand by proactively investing in programs for workplace development and retention. Recent literature reports an increased focus on understanding the work experience and career support needed for new graduate nurses. Several studies report improvements in job satisfaction and retention after implementation of structured mentoring programs for new graduate nurses. However, despite successful transition programs, turnover for these same nurses after 1 to 3 years of organizational tenure remains high. Studying factors that contribute to retention and supporting careers beyond the first year of practice may have a significant effect on improving retention and will contribute new knowledge to the nursing literature. This study, undertaken at a Midwestern pediatric academic medical center, examined job factors and career development support that lead to retention of nurses with 1 to 3 years of experience. Understanding these issues may guide nursing leaders and staff development educators in investing in focused retention and career development plans during an economic recession. PMID:21667873

  19. Neurodevelopment of children under 3 years of age with Smith-Magenis syndrome.

    PubMed

    Wolters, Pamela L; Gropman, Andrea L; Martin, Staci C; Smith, Michaele R; Hildenbrand, Hanna L; Brewer, Carmen C; Smith, Ann C M

    2009-10-01

    Systematic data regarding early neurodevelopmental functioning in Smith-Magenis syndrome are limited. Eleven children with Smith-Magenis syndrome less than 3 years of age (mean, 19 months; range, 5-34 months) received prospective multidisciplinary assessments using standardized measures. The total sample scored in the moderately to severely delayed range in cognitive functioning, expressive language, and motor skills and exhibited generalized hypotonia, oral-motor abnormalities, and middle ear dysfunction. Socialization skills were average, and significantly higher than daily living, communication, and motor abilities, which were below average. Mean behavior ratings were in the nonautistic range. According to exploratory analyses, the toddler subgroup scored significantly lower than the infant subgroup in cognition, expressive language, and adaptive behavior, suggesting that the toddlers were more delayed than the infants relative to their respective peers. Infants aged approximately 1 year or younger exhibited cognitive, language, and motor skills that ranged from average to delayed, but with age-appropriate social skills and minimal maladaptive behaviors. At ages 2 to 3 years, the toddlers consistently exhibited cognitive, expressive language, adaptive behavior, and motor delays and mildly to moderately autistic behaviors. Combining age groups in studies may mask developmental and behavioral differences. Increased knowledge of these early neurodevelopmental characteristics should facilitate diagnosis and appropriate intervention.

  20. The effect of sodium trimetaphosphate on caries: a 3-year clinical toothpaste trial.

    PubMed

    Städtler, P; Müller-Bruckschwaiger, K; Schäfer, F; Huntington, E

    1996-01-01

    The objective of this study was to assess the anticaries efficacy of a toothpaste containing 3% sodium trimetaphosphate (TMP; test) relative to a toothpaste containing no caries-preventive agent (control). The study was designed as a 3-year double-blind caries incidence study involving about 2,500 subjects aged 11 years at baseline. After a clinical examination, subjects were stratified by sex, presence of supragingival calculus and caries status and randomly assigned to either the control or the test group. Clinical examinations then took place at annual intervals. At baseline and at the final examination bite-wing radiographs were taken of subjects not radiographed within the previous 6 months. The change in caries between baseline and the 3-year examination was calculated as DMFS increments. The results showed a statistically significant difference of 8% between the test and control groups (p < 0.05). In subjects brushing twice daily the difference between the test and control group was 11% (p < 0.01). It is concluded that, when used regularly, a toothpaste containing 3% TMP will be effective against caries. PMID:8946103

  1. The vocal quality in female student teachers during the 3 years of study.

    PubMed

    Van Lierde, K M; Claeys, S; Dhaeseleer, E; Deley, S; Derde, K; Herregods, I; Strybol, I; Wuyts, F

    2010-09-01

    The purpose of the present cross-sectional study was to determine the objective vocal quality and the vocal characteristics (vocal risk factors, vocal and corporal complaints) in 143 female student teachers during the 3 years of study. The objective vocal quality was measured by means of the Dysphonia Severity Index (DSI). Perceptual voice assessment, the Voice Handicap Index, questionnaires addressing vocal risks, and vocal and corporal complaints during and/or after voice usage were performed. Student teachers have a normal perceptual and objective vocal quality corresponding with a DSI% of 76. The analysis of variance revealed a significant improvement of the vocal quality between the first and the third year of study. No psychosocial handicapping effect of the voice was observed, though there are some vocal complaints and almost all student teachers reported the presence of corporal pain during and/or after speaking. Especially sore throat and headache were mentioned as the most present corporal pain symptoms. Due to the decreased awareness and the multifactorial genesis of the potential vocal risk factors, the student teachers are at risk for developing an occupational dysphonia during their teaching career. Because teaching is a high-risk profession for the development of voice problems, the incorporation of a direct vocal training technique to increase vocal endurance during teaching together with a vocal hygiene program, dietetics, and a stress management training program during the 3 years of study is needed to prevent occupational dysphonia.

  2. A 3-year follow-up of temporomandibular disorders in rheumatoid arthritis and ankylosing spondylitis.

    PubMed

    Tegelberg, A; Kopp, S

    1996-02-01

    Sixteen individuals with rheumatoid arthritis (RA) and 19 individuals with ankylosing spondylitis (AS) participated in this 3-year follow-up study. The individuals in each disease group were allocated to an experimental group (E group) and a comparison group (C group). They were investigated by questionnaire, clinical examination of the stomatognathic system, and laboratory tests. The individuals of the two E groups had performed a physical training program of the stomatognathic system during 3 weeks. After 3 years most of the patients in the E groups reported an unaltered or decreased severity of symptoms and signs from the stomatognathic system compared with the initial status. The clinical dysfunction score according to Helkimo (CDS) was lower in the RA group, and the mouth opening capacity was larger than before training. In the AS group there was no long-term change in the CDS but an increase of mouth opening capacity. The general inflammatory disease process in the RA group showed an increased activity during this follow-up period as assessed by erythrocyte sedimentation rate. This study suggests that local physical training of the stomatognathic system has a positive effect in individuals with RA.

  3. Adiposity is Associated with Endothelial Activation in Healthy 2- to 3-Year-Old Children

    PubMed Central

    Castro, Cecilia; Tracy, Russell P.; Deckelbaum, Richard J.; Basch, Charles E.; Shea, Steven

    2013-01-01

    Adiposity is associated with C-reactive protein level in healthy 2–3 year old children and with other markers of endothelial activation adults, but data are lacking in very young children. Data from 491 healthy Hispanic children were analyzed. Mean age was 2.7 years (S.D. 0.5, range 2 to 3 years); mean body mass index (BMI) was 17.2 kg/m2 (S.D. 1.9) among boys and 17.1 kg/m2 (S.D. 2.1) among girls. E-selectin level was associated with BMI (R =0.11; p < 0.02), ponderal index (p < 0.02), waist circumference (p = 0.02), fasting insulin (p < 0.02), and insulin resistance (p ≤ 0.05); these associations remained significant after adjustment for age, sex and fasting glucose. sVCAM was also associated with BMI (R = 0.12; P<0.05). These observations indicate that adiposity is associated with inflammation and endothelial activation in very early childhood. PMID:20020578

  4. Neurodevelopment of children under 3 years of age with Smith-Magenis syndrome.

    PubMed

    Wolters, Pamela L; Gropman, Andrea L; Martin, Staci C; Smith, Michaele R; Hildenbrand, Hanna L; Brewer, Carmen C; Smith, Ann C M

    2009-10-01

    Systematic data regarding early neurodevelopmental functioning in Smith-Magenis syndrome are limited. Eleven children with Smith-Magenis syndrome less than 3 years of age (mean, 19 months; range, 5-34 months) received prospective multidisciplinary assessments using standardized measures. The total sample scored in the moderately to severely delayed range in cognitive functioning, expressive language, and motor skills and exhibited generalized hypotonia, oral-motor abnormalities, and middle ear dysfunction. Socialization skills were average, and significantly higher than daily living, communication, and motor abilities, which were below average. Mean behavior ratings were in the nonautistic range. According to exploratory analyses, the toddler subgroup scored significantly lower than the infant subgroup in cognition, expressive language, and adaptive behavior, suggesting that the toddlers were more delayed than the infants relative to their respective peers. Infants aged approximately 1 year or younger exhibited cognitive, language, and motor skills that ranged from average to delayed, but with age-appropriate social skills and minimal maladaptive behaviors. At ages 2 to 3 years, the toddlers consistently exhibited cognitive, expressive language, adaptive behavior, and motor delays and mildly to moderately autistic behaviors. Combining age groups in studies may mask developmental and behavioral differences. Increased knowledge of these early neurodevelopmental characteristics should facilitate diagnosis and appropriate intervention. PMID:19748044

  5. Noise increment detection in children 1 to 3 years of age.

    PubMed

    Berg, K M; Boswell, A E

    2000-05-01

    Studies using burst comparison procedures to examine age-related changes in intensity discrimination have reported that the ability to discriminate differences in intensity does not reach maturity until late childhood. In the present study, developmental changes in intensity discrimination were examined in 1- to 3-year-old children, using an increment detection paradigm. Children and adults detected increments in a continuous standard presented at three levels ranging from 35 to 55 dB SPL. Adults were also tested at lower levels of the standard in order to permit age comparisons at equivalent sensation levels. Standard stimuli were two-octave bands of noise centered at either 400 or 4000 Hz, and increments were 200 msec in duration. Discrimination performance improved significantly with both age and level of the standard. For all age groups, performance was significantly better for high- than for low-frequency stimuli, but frequency-dependent differences in increment thresholds did not vary reliably with age. Age differences were largest at low levels of the standard. At the highest level (approximately 30 dB nHL), children's difference limens for both low- and high-frequency noise bands were adultlike by 3 years of age. These results suggest that the developmental time course of increment detection is more rapid than that previously reported in burst comparison studies.

  6. Red blood cell distribution width and 3-year outcome in patients undergoing cardiac catheterization.

    PubMed

    Arbel, Yaron; Birati, Edo Y; Finkelstein, Ariel; Halkin, Amir; Berliner, Shlomo; Katz, Ben-Zion; Revivo, Miri; Saranga, Hila; Herz, Itzhak; Keren, Gad; Banai, Shmuel

    2014-05-01

    Red blood cell distribution width (RDW), which is routinely reported in complete blood counts, is a measure of the variability in size of circulating erythrocytes. RDW is a novel, independent predictor of prognosis in patients with cardiovascular diseases. The aim of the present study was to evaluate the significance of this biomarker in a relatively large cohort of patients, and to assess its association with a more severe underlying cardiovascular disease. A cohort of 3,222 consecutive patients undergoing coronary angiography was divided according RDW median. The association between RDW and 3-year outcome in the context of other predictors was assessed using Cox's proportional hazards analysis. Patients with elevated RDWs were older, had higher body mass indices, and had more cardiovascular risk factors and more cardiovascular diseases. The total rate of mortality, MI and stroke (MACE) was 7.7% (120 events) in the lower RDW group, and 18.2% (303 events) in the higher RDW group, p < 0.001. Following adjustment for multiple background risk factors, medications, and laboratory results, the RDW value was independently associated with worse outcome (HR = 1.12, 95% CI 1.07-1.18, p < 0.001, for each 1% increase in RDW). Elevated RDW values are independently associated with adverse 3-year outcome in patients undergoing coronary angiography. PMID:23836454

  7. Sustaining 'truth': changes in youth tobacco attitudes and smoking intentions after 3 years of a national antismoking campaign.

    PubMed

    Farrelly, Matthew C; Davis, Kevin C; Duke, Jennifer; Messeri, Peter

    2009-02-01

    This study examines how the American Legacy Foundation's 'truth' campaign and Philip Morris's 'Think. Don't Smoke' (TDS) campaign have influenced youth's tobacco-related attitudes, beliefs and intentions during the first 3 years of the truth campaign. We use data from eight nationally representative cross-sectional telephone surveys of 35 074 12- to 17-year olds to estimate cross-sectional time series logistic regressions that assess the association between recall of truth and TDS and attitudes, beliefs, and intentions toward smoking. An alternative measure of exposure to TDS was also used. Findings indicate that exposure to truth advertisements (ads) was associated with steady positive changes in attitudes, beliefs and intentions to smoke, whereas exposure to Philip Morris ads was associated with more favorable beliefs and attitudes toward the tobacco industry. Our findings suggest that well-executed antismoking campaigns can positively and consistently change youth's beliefs and attitudes, whereas a tobacco industry-sponsored campaign can have a counterproductive influence. PMID:18203679

  8. Paternal psychosocial characteristics and corporal punishment of their 3-year-old children.

    PubMed

    Lee, Shawna J; Perron, Brian E; Taylor, Catherine A; Guterman, Neil B

    2011-01-01

    This study uses data from 2,309 biological fathers who participated in the Fragile Families and Child Well-Being Study (FFCWS) to examine associations between psychosocial characteristics and levels of corporal punishment (CP) toward their 3-year-old children over the past month. Results indicate that 61% of the fathers reported no CP over the past month, 23% reported using CP once or twice, and 16% reported using CP a few times in the past month or more. In multivariate models controlling for important sociodemographic factors as well as characteristics of the child, fathers' parenting stress, major depression, heavy alcohol use, and drug use were significantly associated with greater use of CP, whereas involvement with the child and generalized anxiety disorder were not. Girls were less likely to be the recipient of CP than were boys, and child externalizing behavior problems but not internalizing behavior problems were associated with more CP.

  9. Prenatal diagnosis of trisomy 12 mosaicism: normal development of a 3 years old female child.

    PubMed

    Staals, J E A; Schrander-Stumpel, C T R M; Hamers, G; Fryns, J P

    2003-01-01

    Trisomy 12 mosaicism is a rare chromosomal mosaicism in prenatal diagnosis by amniocentesis. In the literature we found at least 27 cases. 13 Pregnancies were terminated, with multiple congenital anomalies (MCA) in 2 out of 13. Of the 12 liveborns with follow-up ranging from 0 to 5 years, 5 presented MCA and died within the first weeks. 2 Fetus died during pregnancy and further data are lacking. A normal outcome, with limited follow up however, was reported in 7/12 liveborns without congenital anomalies and is well demonstrated in the presently reported girl. We describe the 3-years follow up in a girl with trisomy 12 mosaicism, detected by amniocentesis for advanced maternal age. She is a healthy girl with normal physical and psychomotor development.

  10. Unicystic ameloblastoma in 3 year old paediatric patient - A rare entity.

    PubMed

    Arora, Shelly; Kumar, Priya; Urs, Aadithya B; Augustine, Jeyaseelan

    2013-02-01

    Unicystic ameloblastoma (UA) is a benign epithelial odontogenic tumor of the jaws that commonly occurs in 2nd and 3rd decade of life. In fact, this entity is rare in children under 12 years of age. It is characterised as a distinct variant of ameloblastoma, exhibiting a less aggressive behaviour and a lower rate of recurrence than solid conventional ameloblastoma. There are very few reported cases of UA occurring in children below five years of age. The purpose of this case report is to describe a case of UA involving the crown of an unerupted maxillary second premolar in a 3 year old girl. The pathogenesis, clinical appearance, radiographic presentation, histological findings and management of the tumour have also been discussed.

  11. The SWAP EUV imager onboard PROBA2: 3 years of observations

    NASA Astrophysics Data System (ADS)

    West, Matthew; Berghmans, David; Seaton, Daniel

    The Sun Watcher with Active Pixels and Image Processing (SWAP) imager is an EUV solar telescope on board ESA's Project for Onboard Autonomy 2 (PROBA2) mission launched on 2 November 2009. SWAP has a spectral bandpass centered on 17.4 nm and provides images of the low solar corona over a 54x54 arcmin field-of-view with 3.2 arcsec pixels and an imaging cadence of about two minutes. SWAP is designed to monitor all space-weather-relevant events and features in the low solar corona. The SWAP telescope is designed with various innovative technologies, including an off-axis optical design and a CMOS-APS detector. I will present what has been learnt from 3 years of SWAP operations, the advantages of the CMOS detector and SWAPs setup, and a few unique PROBA2/SWAP observations.

  12. Development, Validation and Parametric study of a 3-Year-Old Child Head Finite Element Model

    NASA Astrophysics Data System (ADS)

    Cui, Shihai; Chen, Yue; Li, Haiyan; Ruan, ShiJie

    2015-12-01

    Traumatic brain injury caused by drop and traffic accidents is an important reason for children's death and disability. Recently, the computer finite element (FE) head model has been developed to investigate brain injury mechanism and biomechanical responses. Based on CT data of a healthy 3-year-old child head, the FE head model with detailed anatomical structure was developed. The deep brain structures such as white matter, gray matter, cerebral ventricle, hippocampus, were firstly created in this FE model. The FE model was validated by comparing the simulation results with that of cadaver experiments based on reconstructing the child and adult cadaver experiments. In addition, the effects of skull stiffness on the child head dynamic responses were further investigated. All the simulation results confirmed the good biofidelity of the FE model.

  13. Extraosseous Thoracic Foraminal Osteoblastoma: Diagnostic Dilemma and Management with 3 Year Follow-Up

    PubMed Central

    Hadgaonkar, Shailesh Ramakant; Shah, Kunal Chandrakant; Khurjekar, Ketan Shripad; Sancheti, Parag Kantilal

    2014-01-01

    Osteoblastomas are bone forming lesions arising mainly from posterior elements of the vertebra. They are commonly encountered in the cervical and lumbar regions. We present a case of a thoracic osteoblastoma which is extra osseous and is not communicating with any part of the vertebra present intraforaminally. This is a rare presentation of an osteoblastoma. Imaging studies do not accurately diagnose the osteiod lesion. The size of the lesion and cortical erosion seen on the computed tomography scan help in differentiating the osteoid osteoma and osteoblastoma, but they are less sensitive and specific. Thus a histopathology is the investigation of choice to diagnose the osteoblastoma. Early and adequate removal of mass prevents malignant transformation, metastasis, and recurrence. In our case we excised the pars interarticularis unilaterally, removed the osteoid mass intact, and performed unilateral instrumented fusion. There was no recurrence and solid fusion was seen at 3 years follow up. PMID:25346825

  14. Sharing memories and telling stories: American and Chinese mothers and their 3-year-olds.

    PubMed

    Wang, Q; Leichtman, M D; Davies, K I

    2000-05-01

    American and Chinese mothers were asked to talk with their 3-year-old children at home about two shared past events and a story (41 mother-child dyads). Results revealed between-culture variation in the content and style of mother-child conversations when sharing memories and telling stories. American mothers and children showed a high-elaborative, independently oriented conversational style in which they co-constructed their memories and stories by elaborating on each other's responses and focusing on the child's personal predilections and opinions. In contrast, Chinese Mother-child dyads employed a low-elaborative, interdependently oriented conversational style where mothers frequently posed and repeated factual questions and showed great concern with moral rules and behavioural standards with their children. Findings suggest that children's early social-linguistic environments shape autobiographical remembering and contribute to cultural differences in the age and content of earliest childhood memories.

  15. Hemiconvulsion-hemiplegia-epilepsy syndrome. Magnetic resonance findings in a 3-year-old boy.

    PubMed

    Salafia, Stefania; Praticò, Andrea D; Pizzo, Enza; Greco, Filippo; Di Bella, Domenico

    2013-01-01

    The term 'hemiconvulsion-hemiplegia-epilepsy syndrome' (HHE) was first used by Gastaut et al. to describe the se-quential combination of unilateral or predominantly unilateral clonic seizures (hemiconvulsion), occurring during the first 2 years of life, immediately followed by an ipsilateral flaccid hemiplegia lasting 7 or more days. In the following phase partial epileptic seizures occur. We report a case of HHE syndrome in a 3-year-old boy with partial seizures (hemiconvulsion lasting 15-30 minutes) followed by left hemiplegia and hyporeflexia. Magnetic resonance imaging showed diffuse and high signal hyperintensity of the whole right cerebral hemisphere. Diffusion-weighted images showed a reduction of the apparent diffusion coefficient in the subcortical region. Magnetic resonance arterio-graphy showed a narrow flow signal in the distal territory of the right middle cerebral artery. The authors emphasize the importance of neuroradiological findings in early diagnosis and in the follow-up of HHE syndrome. PMID:24375005

  16. The development of inhibitory control in early childhood: A twin study from 2-3 years

    PubMed Central

    Gagne, Jeffrey R.; Saudino, Kimberly J.

    2015-01-01

    Parent and lab-based observer ratings were employed to examine genetic and environmental influences on continuity and change in inhibitory control (IC) in over 300 twin-pairs assessed longitudinally at 2 and 3 years of age. Genetic influences accounted for approximately 60% of the variance in parent-rated IC at both ages. Although many of the same genetic effects on parent-rated IC were stable across age, there were also novel genetic effects that emerged at age 3 (i.e., genetic factors contributed to both continuity and change in parent ratings of IC). Observed IC displayed a different developmental pattern. Genetic influences were moderate at age 2 (38%) and nonsignificant at age 3 (6%). Change in observed IC across early childhood was due to shared and nonshared environmental factors. Findings indicate that it is important to consider the measurement of IC when interpreting developmental and etiological findings. PMID:26784384

  17. A case of localized juvenile periodontitis: treatment and 3 years follow-up with superimposable radiographs.

    PubMed

    Dubrez, B; Baehni, P; Cimasoni, G

    1996-06-01

    A 17-year-old male patient with localized juvenile periodontitis was treated by subgingival instrumentation with full thickness flap on the lower molars, combined with a 3-week course of systemic tetracycline, and a programme of supervised oral hygiene. The treatment was rapidly followed by dramatic clinical and microbiological improvement. However, despite good oral hygiene, gingival inflammation recurred at regular intervals. It was necessary to maintain the clinical results by periodic subgingival instrumentation with an ultrasonic scaler. Healing of alveolar bone was monitored in the lower 1st molar regions over 3 years by using superimposable radiographs. Quantitative analysis of bone density performed with a high-resolution digitalisation technique showed a considerable improvement 1 year after therapy. However, continuous remodelling, probably related to variations in inflammation, occurred during the 3 postoperative years. PMID:8811475

  18. An unlikely cause of severe malnutrition in a 3-year-old girl with previous gastroschisis.

    PubMed

    Ashton, J J; Blackburn, S; Burge, D; Beattie, R M

    2014-01-01

    A 3-year-old girl with previous gastroschisis associated with jejunal and colonic atresia presented with severe oedema, abdominal pain and diarrhoea. Clinically she was malnourished. Serum albumin and concentrations of micronutrients were low. A barium meal examination showed jejunal dilation. A stricture was suspected and the patient was taken to theatre where an 8 cm length of bowel was resected including a jejunal stricture at the point of previous atresia repair. Inside the proximal dilated jejunum was a large trichobezoar (hairball), thought to be acting as a ball valve inside the bowel. This girl made a rapid recovery after surgery. Her nutritional state improved, symptoms resolved and serum biochemistry normalised. She remains well at follow-up with normal blood results, normal albumin and no diarrhoea. PMID:25183805

  19. An unlikely cause of severe malnutrition in a 3-year-old girl with previous gastroschisis

    PubMed Central

    Ashton, J J; Blackburn, S; Burge, D; Beattie, R M

    2014-01-01

    A 3-year-old girl with previous gastroschisis associated with jejunal and colonic atresia presented with severe oedema, abdominal pain and diarrhoea. Clinically she was malnourished. Serum albumin and concentrations of micronutrients were low. A barium meal examination showed jejunal dilation. A stricture was suspected and the patient was taken to theatre where an 8 cm length of bowel was resected including a jejunal stricture at the point of previous atresia repair. Inside the proximal dilated jejunum was a large trichobezoar (hairball), thought to be acting as a ball valve inside the bowel. This girl made a rapid recovery after surgery. Her nutritional state improved, symptoms resolved and serum biochemistry normalised. She remains well at follow-up with normal blood results, normal albumin and no diarrhoea. PMID:25183805

  20. Epidermoid cyst in the floor of the mouth of a 3-year-old.

    PubMed

    Pascual Dabán, Rossana; García Díez, Eloy; González Navarro, Beatriz; López-López, José

    2015-01-01

    Epidermoid cysts are a rare entity in the oral cavity and are even less frequent in the floor of the mouth, representing less than 0.01% of all the cases. We present the case of a 3-year-old girl with a growth in the floor of the mouth with 2 months of evolution and without changes since it was discovered by her parents. The lesion was asymptomatic; it did not cause dysphagia, dyspnea, or any other alteration. A CT scan with contrast was done which revealed the location and exact size of the lesion, allowing an intraoral approach for its excision. The histological examination confirmed the clinical speculation of an epidermoid cyst. PMID:25694831

  1. Trajectories of maternal harsh parenting in the first 3 years of life

    PubMed Central

    Pears, Katherine C.; Fisher, Philip A.; Connelly, Cynthia D.; Landsverk, John L.

    2010-01-01

    Objective Despite the high prevalence rates of harsh parenting, the nature of developmental change in this domain early in life and the factors that contribute to changes in harsh parenting over time are not well understood. The present study examined developmental patterns in maternal harsh parenting behavior from birth to age 3 years and their related longitudinal risk factors (contextual and intrapersonal). Partner aggression was also tested as a time-varying predictor to examine its time-specific influence on maternal harsh parenting. Methods Longitudinal data from four assessments of a community sample of 488 at-risk mothers were analyzed using latent growth curve modeling. Maternal risk factors and harsh parenting behaviors were assessed at birth and at ages 1, 2, and 3 years. Results There was a significant increase in maternal harsh parenting from birth to age 3, particularly between ages 1 and 2. There was a significant direct effect of maternal alcohol use and abuse history on maternal harsh parenting at age 3, and maternal age was positively associated with change in maternal harsh parenting over time. In addition, partner aggression was significantly and positively associated with maternal harsh parenting at each time point. Conclusions The findings suggest possible developmental trends in the emergence of maternal harsh parenting during infancy and toddlerhood. Further investigation is needed to elucidate individual differences in the developmental patterns and to differentiate predictive factors that persist across time and factors that are unique to specific developmental stages. Practice implications The overall high prevalence rates of harsh parenting behavior and growth of such behavior in infancy and toddlerhood support the need for developmentally sensitive early intervention programs. PMID:21030081

  2. Living with diabetes—Development of learning patterns over a 3-year period

    PubMed Central

    Kneck, Åsa; Fagerberg, Ingegerd; Eriksson, Lars E.; Lundman, Berit

    2014-01-01

    Background Learning involves acquiring new knowledge and skills, and changing our ways of thinking, acting, and feeling. Learning in relation to living with diabetes is a lifelong process where there is limited knowledge of how it is experienced and established over time. It was considered important to explore how learning was developed over time for persons living with diabetes. Aim The aim of the study was to identify patterns in learning when living with diabetes, from recently being diagnosed, and over a 3-year period. Materials and methods A longitudinal qualitative descriptive design was used. Thirteen participants, with both type I and type II diabetes, were interviewed at three different occasions during a 3-year period. Qualitative content analysis was used in different steps in order to distinguish patterns. Findings Five main patterns of learning were identified. Two of the patterns (I and II) were characterized by gradually becoming comfortable living with diabetes, whereas for one pattern (IV) living with diabetes became gradually more difficult. For pattern V living with diabetes was making only a limited impact on life, whereas for Pattern III there was a constant management of obstacles related to illness. The different patterns in the present study showed common and different ways of learning and using different learning strategies at different timespans. Conclusion The present study showed that duration of illness is not of importance for how far a person has come in his own learning process. A person-centered care is needed to meet the different and changing needs of persons living with diabetes in relation to learning to live with a lifelong illness. PMID:25030359

  3. Susceptibility to tulathromycin in Mannheimia haemolytica isolated from feedlot cattle over a 3-year period

    PubMed Central

    Alexander, Trevor W.; Cook, Shaun; Klima, Cassidy L.; Topp, Ed; McAllister, Tim A.

    2013-01-01

    Mannheimia haemolytica isolated from feedlot cattle were tested for tulathromycin resistance. Cattle were sampled over a 3-year period, starting 12 months after approval of tulathromycin for prevention and treatment of bovine respiratory disease. Nasopharyngeal samples from approximately 5,814 cattle were collected when cattle entered feedlots (N = 4) and again from the same cattle after ≥60 days on feed. The antimicrobial use history for each animal was recorded. Mannheimia haemolytica was isolated from 796 (13.7%) entry samples and 1,038 (20.6%) ≥ 60 days samples. Of the cattle positive for M. haemolytica, 18.5, 2.9, and 2.4% were administered therapeutic concentrations of tulathromycin, tilmicosin, or tylosin tartrate, respectively. In addition, 13.2% were administered subtherapeutic concentrations of tylosin phosphate in feed. In years one and two, no tulathromycin-resistant M. haemolytica were detected, whereas five isolates (0.4%) were resistant in year three. These resistant isolates were collected from three cattle originating from a single pen, were all serotype 1, and were genetically related (≥89% similarity) according to pulsed-field gel electrophoreses patterns. The five tulathromycin-resistant isolates were multi-drug resistant also exhibiting resistance to oxytetracycline, tilmicosin, ampicillin, or penicillin. The macrolide resistance genes erm(42), erm(A), erm(B), erm(F), erm(X) and msr(E)-mph(E), were not detected in the tulathromycin-resistant M. haemolytica. This study showed that tulathromycin resistance in M. haemolytica from a general population of feedlot cattle in western Canada was low and did not change over a 3-year period after tulathromycin was approved for use in cattle. PMID:24130555

  4. Patient with liver epithelioid hemangioendothelioma treated by transplantation: 3 years' observation.

    PubMed

    Mucha, K; Foroncewicz, B; Zieniewicz, K; Nyckowski, P; Krawczyk, M; Cyganek, A; Paczek, L

    2006-01-01

    Epithelioid hemangioendothelioma (EHE) is a rare neoplasm of vascular origin, but unknown etiology that occurs in the liver, lungs and other organs. Its hepatic form (HEHE) generally behaves as a low-grade malignant tumor with a slowly progressive phenotype. Surgical resection or liver transplantation (OLT) has been recommended after diagnosis. We present a 30-year-old woman with primary HEHE of the liver treated by OLT in 2002. Her medical history started 3 years prior when an abdominal ultrasound examination revealed multiple focal changes in the liver. The histopathological diagnosis from a needle biopsy was carcinoma cholangiogenes desmoplasticum. For 2 years the patient was treated with chemotherapy combinations. To explain the lack of efficacy of chemotherapy, a laparoscopic biopsy was performed and HEHE diagnosed. Immunohistochemistry revealed positive staining for the factor VIII-related antigens, CD34 and CD31, which have been previously described as HEHE markers. The patient underwent OLT in March 2002. In the first month after OLT, the thyroid stimulating hormone concentration was elevated but they continuously decreased from 11.4 to 2.4 uIU/mL in May 2002 and thereafter remains normal. After 3 years observation the patient presented with good liver function and no signs of tumor recurrence. We concluded that immunohistochemical staining for characteristic endothelial cell markers may facilitate the correct diagnosis of HEHE. After diagnosis, OLT followed by immunosuppressive therapy, consisting of basiliximab, corticoids, low doses of tacrolimus and temporary administration of rapamycin, may be safe and effective. Monitoring of thyroid-stimulating hormone concentrations should be performed in patients with HEHE. PMID:16504710

  5. Environmental controls on fungal community composition and abundance over 3 years in native and degraded shrublands.

    PubMed

    Glinka, Clare; Hawkes, Christine V

    2014-11-01

    Soil fungal communities have high local diversity and turnover, but the relative contribution of environmental and regional drivers to those patterns remains poorly understood. Local factors that contribute to fungal diversity include soil properties and the plant community, but there is also evidence for regional dispersal limitation in some fungal communities. We used different plant communities with different soil conditions and experimental manipulations of both vegetation and dispersal to distinguish among these factors. Specifically, we compared native shrublands with former native shrublands that had been disturbed or converted to pasture, resulting in soils progressively more enriched in carbon and nutrients. We tested the role of vegetation via active removal, and we manipulated dispersal by adding living soil inoculum from undisturbed native sites. Soil fungi were tracked for 3 years, with samples taken at ten time points from June 2006 to June 2009. We found that soil fungal abundance, richness, and community composition responded primarily to soil properties, which in this case were a legacy of plant community degradation. In contrast, dispersal had no effect on soil fungi. Temporal variation in soil fungi was partly related to drought status, yet it was much broader in native sites compared to pastures, suggesting some buffering due to the increased soil resources in the pasture sites. The persistence of soil fungal communities over 3 years in this study suggests that soil properties can act as a strong local environmental filter. Largely persistent soil fungal communities also indicate the potential for strong biotic resistance and soil legacies, which presents a challenge for both the prediction of how fungi respond to environmental change and our ability to manipulate fungi in efforts such as ecosystem restoration.

  6. Susceptibility to tulathromycin in Mannheimia haemolytica isolated from feedlot cattle over a 3-year period.

    PubMed

    Alexander, Trevor W; Cook, Shaun; Klima, Cassidy L; Topp, Ed; McAllister, Tim A

    2013-01-01

    Mannheimia haemolytica isolated from feedlot cattle were tested for tulathromycin resistance. Cattle were sampled over a 3-year period, starting 12 months after approval of tulathromycin for prevention and treatment of bovine respiratory disease. Nasopharyngeal samples from approximately 5,814 cattle were collected when cattle entered feedlots (N = 4) and again from the same cattle after ≥60 days on feed. The antimicrobial use history for each animal was recorded. Mannheimia haemolytica was isolated from 796 (13.7%) entry samples and 1,038 (20.6%) ≥ 60 days samples. Of the cattle positive for M. haemolytica, 18.5, 2.9, and 2.4% were administered therapeutic concentrations of tulathromycin, tilmicosin, or tylosin tartrate, respectively. In addition, 13.2% were administered subtherapeutic concentrations of tylosin phosphate in feed. In years one and two, no tulathromycin-resistant M. haemolytica were detected, whereas five isolates (0.4%) were resistant in year three. These resistant isolates were collected from three cattle originating from a single pen, were all serotype 1, and were genetically related (≥89% similarity) according to pulsed-field gel electrophoreses patterns. The five tulathromycin-resistant isolates were multi-drug resistant also exhibiting resistance to oxytetracycline, tilmicosin, ampicillin, or penicillin. The macrolide resistance genes erm(42), erm(A), erm(B), erm(F), erm(X) and msr(E)-mph(E), were not detected in the tulathromycin-resistant M. haemolytica. This study showed that tulathromycin resistance in M. haemolytica from a general population of feedlot cattle in western Canada was low and did not change over a 3-year period after tulathromycin was approved for use in cattle.

  7. Predictability of persistent frequent attendance: a historic 3-year cohort study

    PubMed Central

    Smits, Frans ThM; Brouwer, Henk J; van Weert, Henk CP; Schene, Aart H; ter Riet, Gerben

    2009-01-01

    Background Few patients who attend GP consultations frequently continue to do so long term. While transient frequent attendance may be readily explicable, persistent frequent attendance often is not. It increases GPs' workload while reducing work satisfaction. It is neither reasonable, nor efficient to target diagnostic assessment and intervention at transient frequent attenders. Aim To develop a prediction rule for selecting persistent frequent attenders, using readily available information from GPs' electronic medical records. Design of study A historic 3-year cohort study. Method Data of 28 860 adult patients from 2003 to 2005 were examined. Frequent attenders were patients whose attendance rate ranked in the (age- and sex-adjusted) top 10% during 1 year (1-year frequent attenders) or 3 years (persistent frequent attenders). Bootstrapped multivariable logistic regression analysis was used to determine which predictors contained information on persistent frequent attendance. Results Of 3045 1-year frequent attenders, 470 (15.4%) became persistent frequent attenders. The prediction rule could update this prior probability to 3.3% (lowest value) or 43.3% (highest value). However, the 10th and 90th centiles of the posterior probability distribution were 7.4% and 26.3% respectively, indicating that the model performs modestly. The area under the receiver operating characteristic curve was 0.67 (95% confidence limits 0.64 and 0.69). Conclusion Among 1-year frequent attenders, six out of seven are transient frequent attenders. With the present indicators, the rule developed performs modestly in selecting those more likely to become persistent frequent attenders. PMID:19192367

  8. Environmental controls on fungal community composition and abundance over 3 years in native and degraded shrublands.

    PubMed

    Glinka, Clare; Hawkes, Christine V

    2014-11-01

    Soil fungal communities have high local diversity and turnover, but the relative contribution of environmental and regional drivers to those patterns remains poorly understood. Local factors that contribute to fungal diversity include soil properties and the plant community, but there is also evidence for regional dispersal limitation in some fungal communities. We used different plant communities with different soil conditions and experimental manipulations of both vegetation and dispersal to distinguish among these factors. Specifically, we compared native shrublands with former native shrublands that had been disturbed or converted to pasture, resulting in soils progressively more enriched in carbon and nutrients. We tested the role of vegetation via active removal, and we manipulated dispersal by adding living soil inoculum from undisturbed native sites. Soil fungi were tracked for 3 years, with samples taken at ten time points from June 2006 to June 2009. We found that soil fungal abundance, richness, and community composition responded primarily to soil properties, which in this case were a legacy of plant community degradation. In contrast, dispersal had no effect on soil fungi. Temporal variation in soil fungi was partly related to drought status, yet it was much broader in native sites compared to pastures, suggesting some buffering due to the increased soil resources in the pasture sites. The persistence of soil fungal communities over 3 years in this study suggests that soil properties can act as a strong local environmental filter. Largely persistent soil fungal communities also indicate the potential for strong biotic resistance and soil legacies, which presents a challenge for both the prediction of how fungi respond to environmental change and our ability to manipulate fungi in efforts such as ecosystem restoration. PMID:24935902

  9. Impact of Cigarette Smoking: a 3-Year Clinical Outcome of Vasospastic Angina Patients

    PubMed Central

    Choi, Byoung Geol; Park, Taeshik; Choi, Se Yeon; Byun, Jae Kyeong; Shim, Min Suk; Xu, Shaopeng; Li, Hu; Park, Sang-Ho; Park, Ji Young; Choi, Woong Gil; Cho, Yun-Hyeong; Lee, Sunki; Na, Jin Oh; Choi, Cheol Ung; Lim, Hong Euy; Kim, Jin Won; Kim, Eung Ju; Park, Chang Gyu; Seo, Hong Seog; Oh, Dong Joo

    2016-01-01

    Background and Objectives Cigarette smoking is a risk significant factor in coronary artery disease (CAD) and vasospastic angina (VSA). However, it is largely unknown whether smoking adds to any long-term clinical risk in VSA patients. Subjects and Methods A total of 2797 patients without significant CAD underwent acetylcholine (Ach) provocation test between November 2004 and October 2010. Patients were divided into three groups, based on the presence of coronary artery spasm (CAS) and smoking habits (non-CAS group: n=1188, non-smoking CAS group: n=1214, smoking CAS group: n=395). All CAS patients were prescribed with anti-anginal medications for at least 6 months. The incidence of major clinical outcomes and recurrent angina of these groups were compared up to 3 years. Results There were considerable differences in the baseline clinical and angiographic characteristics among the three groups, but there was no difference in the endpoints among the three groups (including individual and composite hard endpoints) such as death, myocardial infarction, de novo percutaneous coronary intervention, cerebrovascular accident, and major adverse cardiac events. However, there was a higher incidence of recurrent angina in both the non-smoking CAS group and smoking CAS group, as compared to the non-CAS group. In multivariable adjusted Cox-proportional hazards regression analysis, smoking CAS group exhibited a higher incidence of recurrent angina compared with the non-CAS group (hazard ratio [HR]; 2.46, 95% confidence interval [CI]; 1.46-4.14, p=0.001) and non-smoking CAS group (HR; 1.76, 95% CI; 1.08-2.87, p=0.021). Conclusion Cigarette smoking CAS group exhibited higher incidence of recurrent angina during the 3-year clinical follow-up compared with both the non-CAS group and non-smoking CAS group. Quitting of smoking, paired with intensive medical therapy and close clinical follow-up, can help to prevent recurrent angina. PMID:27721853

  10. Nitrous oxide emissions from Chinese maize-wheat rotation systems: A 3-year field measurement

    NASA Astrophysics Data System (ADS)

    Cai, Yanjiang; Ding, Weixin; Luo, Jiafa

    2013-02-01

    Nitrous oxide (N2O) fluxes were measured over a 3-year period (2004-2007) in a long-term experimental field. The objectives of the study were to evaluate the interannual variation of N2O emissions from a maize-wheat rotation, under different fertilizer regimes and to determine the key controlling factors. The study involved four treatments: compost (OM), half compost N plus half inorganic fertilizer-N (HOM), inorganic fertilizer-N (NPK), and control (CK) where no N application. The mean annual N2O emission over a 3-year period was 0.30 ± 0.11 kg N2O-N ha-1 in the CK treatment, but increased to 1.61 ± 0.10 kg N2O-N ha-1 in the HOM treatment, 2.13 ± 0.15 kg N2O-N ha-1 in the OM treatment, and 2.76 ± 0.19 kg N2O-N ha-1 in the NPK treatment. Differences were significant among treatments. The N2O emission factors of the applied OM, NPK and HOM were 0.61 ± 0.02, 0.82 ± 0.10 and 0.44 ± 0.04%, respectively, at a rate of 300 kg N ha-1 year-1, indicating that the combined application of compost with inorganic fertilizer significantly reduced N2O emission. Over a maize-wheat rotation year, more than 65% of the annual N2O emission occurred during the maize growing season. There was a large interannual variation in N2O emission in all treatments, albeit not significant either during the maize growing season or at an inter-year scale. This interannual variation was mainly attributable to differences in soil moisture after basal fertilizer application, and irrigation and/or heavy rainfall events immediately following basal fertilization could induce more N2O production than pre-irrigation before plowing. The HOM treatment had higher N fertilizer use efficiency and lowest yield-scaled N2O emissions compared with the OM and NPK treatments. We therefore argue that the combined application of half compost N plus half fertilizer-N will mitigate N2O emissions from soils in the North China plain.

  11. Very low birth weight infants: effects of brain growth during infancy on intelligence quotient at 3 years of age.

    PubMed

    Hack, M; Breslau, N

    1986-02-01

    To evaluate the role of postnatal growth on IQ at 3 years of age, 139 appropriate for gestational age, very low birth weight infants (less than 1.5 kg) born in 1977 and 1978 were studied at 40 weeks (term), and at 8, 20, and 33 months (corrected) of age. Weight, height, and head circumference were measured at each age, neurologic status was measured at 20 months, and Stanford Binet IQ at 33 months. Multiple regression analysis revealed that head circumference at 8 months of age is the best growth predictor of IQ at 3 years of age. Path analysis was performed to measure the effects of biologic and social factors measured earlier in life on IQ at 3 years. These factors explained 43% of the variance in IQ at 3 years of age. Head circumference at 8 months had a direct effect on IQ at 3 years, controlling for all other variables in the model. Neonatal risk had an indirect effect via head circumference. Neurologic impairment had direct and indirect (via head circumference) effects; race and socioeconomic status had direct effects on IQ but no effects on growth at 8 months of age. Thus, brain growth at 8 months significantly influenced 3 year IQ at 3 years of age among very low birth weight infants, even when medical and sociodemographic variables were controlled.

  12. A 3 year case study of alcohol related psychotic disorders at Hospital Seremban.

    PubMed

    George, S; Chin, C N

    1998-09-01

    This paper reports the characteristics and psychopathology of alcohol dependents with alcohol induced psychotic disorder admitted to the Seremban Hospital. The method is that of a case study of all alcohol dependents with alcohol induced psychotic disorder admitted to the Psychiatric Ward, Hospital Seremban over 3 years (1993-1995). There were 34 subjects, 30 Indians, 3 Chinese and 1 Malay with a mean age of 43 years. 32 were men and predominantly of Social Class IV and V (91%). They had a mean duration of drinking of 14.2 years and had a mean weekly consumption of 69.5 units of alcohol. There was a family history of alcohol dependence in (44%). The majority (68%) consumed samsu with beer the second choice. Auditory hallucinations (26) and delusions (16) were common while visual hallucinations (3) and depression (2) were less frequent. Speech disorder occurred in 4 subjects. 2 developed delirium tremens and 1 died. Liver function test was normal in 55%. All except the death from delirium tremens responded to treatment with a combination of anxiolytics, thiamine and antipsychotics and were rapidly discharged. The mean stay was 7 days. However, (68%) did not return for follow up and only 4 were abstinent from alcohol at the time of follow up.

  13. A 3-year longitudinal analysis of changes in Body Mass Index.

    PubMed

    Aires, L; Mendonça, D; Silva, G; Gaya, A R; Santos, M P; Ribeiro, J C; Mota, J

    2010-02-01

    The aim of this study was to analyse whether Physical Activity Index (PAI), Physical Fitness, Screen Time (watching TV and computer use), Socio-economic Status and Commuting to School made a significant contribution to longitudinal changes in Body Mass Index (BMI) in youth. This longitudinal study was carried out over a period of 3 years with 345 students (147 boys) who were between 11 and 16 years old at the beginning of the study. Students were invited to perform tests from FITNESSGRAM Battery for Curl-Ups, Push-Ups, Back-Saver Sit and Reach, and 20 m Shuttle-Run (CRF). Fitness tests were categorized in "Healthy Zone" (HZ) and "Under Healthy Zone" (UHZ), PAI in "less active" and "active"; Socio-economic Status, in low, middle and high education level, and Commuting in active and passive. BMI was corrected for age and gender meaning that we subtracted the age-and-sex-specific cut points for overweight. Corrected body mass index was used as dependent variable in a Linear Mixed Model. The main result was the strong positive and independent association of individuals with CRF performances UHZ with corrected body mass index. In conclusion, the results of this longitudinal study showed markedly an important relationship of lower fitness levels with the risk of being overweight/obese, in particular CRF and abdominal strength.

  14. A 3 year case study of alcohol related psychotic disorders at Hospital Seremban.

    PubMed

    George, S; Chin, C N

    1998-09-01

    This paper reports the characteristics and psychopathology of alcohol dependents with alcohol induced psychotic disorder admitted to the Seremban Hospital. The method is that of a case study of all alcohol dependents with alcohol induced psychotic disorder admitted to the Psychiatric Ward, Hospital Seremban over 3 years (1993-1995). There were 34 subjects, 30 Indians, 3 Chinese and 1 Malay with a mean age of 43 years. 32 were men and predominantly of Social Class IV and V (91%). They had a mean duration of drinking of 14.2 years and had a mean weekly consumption of 69.5 units of alcohol. There was a family history of alcohol dependence in (44%). The majority (68%) consumed samsu with beer the second choice. Auditory hallucinations (26) and delusions (16) were common while visual hallucinations (3) and depression (2) were less frequent. Speech disorder occurred in 4 subjects. 2 developed delirium tremens and 1 died. Liver function test was normal in 55%. All except the death from delirium tremens responded to treatment with a combination of anxiolytics, thiamine and antipsychotics and were rapidly discharged. The mean stay was 7 days. However, (68%) did not return for follow up and only 4 were abstinent from alcohol at the time of follow up. PMID:10968157

  15. Effects of sewage sludge compost application on crops and cropland in a 3-year field study.

    PubMed

    Wei, Yongjie; Liu, Yangsheng

    2005-06-01

    Composted sewage sludge can be applied to cropland to supply nutrients and improve soil physical properties. However, farmers are much concerned about heavy metal accumulation in cropland and heavy metal availability for crops. A 3-year field study was carried out in this study to investigate the effects of sewage sludge compost (SSC) application on the heavy metal accumulation in cropland soil, rapeseed germination and plumelet development, and yields of barley and Chinese cabbage, compared with conventional mineral fertilization. In addition, the availability of heavy metals for barley and Chinese cabbage was examined. Experimental results showed that SSC application produced little effects on rapeseed germination and stimulated the rape plumelet development at lower application rates (<150 ton ha(-1)). Heavy metals (Cu and Zn) were accumulated in the topsoil (0-20 cm), the barley grains and the cabbage leaves. The yields of barley and Chinese cabbage generated positive response to the SSC application. Addition of mineral N-P-K fertilizers into SSC could further increase the crop yield. Considering the heavy metals accumulation in cropland soil and their availability for crops, SSC should be applied to cropland at a limited application rate (<150 ton ha(-1)).

  16. Dutch and German 3-Year-Olds' Representations of Voicing Alternations.

    PubMed

    Buckler, Helen; Fikkert, Paula

    2016-06-01

    The voicing contrast is neutralized syllable and word finally in Dutch and German, leading to alternations within the morphological paradigm (e.g., Dutch 'bed(s)', be[t]-be[d]en, German 'dog(s)', Hun[t]-Hun[d]e). Despite structural similarity, language-specific morphological, phonological and lexical properties impact on the distribution of this alternation in the two languages. Previous acquisition research has focused on one language only, predominantly focusing on children's production accuracy, concluding that alternations are not acquired until late in the acquisition process in either language. This paper adapts a perceptual method to investigate how voicing alternations are represented in the mental lexicon of Dutch and German 3-year-olds. Sensitivity to mispronunciations of voicing word-medially in plural forms was measured using a visual fixation procedure. Dutch children exhibited evidence of overgeneralizing the voicing alternation, whereas German children consistently preferred the correct pronunciation to mispronunciations. Results indicate that the acquisition of voicing alternations is influenced by language-specific factors beyond the alternation itself. PMID:27363255

  17. A statistical skull geometry model for children 0-3 years old.

    PubMed

    Li, Zhigang; Park, Byoung-Keon; Liu, Weiguo; Zhang, Jinhuan; Reed, Matthew P; Rupp, Jonathan D; Hoff, Carrie N; Hu, Jingwen

    2015-01-01

    Head injury is the leading cause of fatality and long-term disability for children. Pediatric heads change rapidly in both size and shape during growth, especially for children under 3 years old (YO). To accurately assess the head injury risks for children, it is necessary to understand the geometry of the pediatric head and how morphologic features influence injury causation within the 0-3 YO population. In this study, head CT scans from fifty-six 0-3 YO children were used to develop a statistical model of pediatric skull geometry. Geometric features important for injury prediction, including skull size and shape, skull thickness and suture width, along with their variations among the sample population, were quantified through a series of image and statistical analyses. The size and shape of the pediatric skull change significantly with age and head circumference. The skull thickness and suture width vary with age, head circumference and location, which will have important effects on skull stiffness and injury prediction. The statistical geometry model developed in this study can provide a geometrical basis for future development of child anthropomorphic test devices and pediatric head finite element models.

  18. Parent-Reported Distress in Children Under 3-years Old During Preventive Medical and Dental Care

    PubMed Central

    Nelson, Travis M.; Huebner, Colleen E.; Kim, Amy; Scott, JoAnna M.; Pickrell, Jacqueline E.

    2014-01-01

    Purpose This study examined factors related to young children’s distress during preventive oral health visits. Additionally, associations between parent-reported child behavior during the dental visit and during prior medical visits were tested. Methods One hundred twenty two children under 3 years of age enrolled in a government insurance program for low-income children were seen for examination, prophylaxis, and fluoride application at a university-based dental clinic. Child distress was rated by parents on a numerical rating scale. Results The average age of children enrolled was 23.5 ± 7.3 months. The majority (55.7%) were judged to have little or no distress pre-examination. Mild or no distress during the examination was reported for 42.6% of the children and severe distress was reported for 39.4%. Intensity of distress during the examination was not associated with the child’s age, gender, dental health, or prior experience with dental care. Distress was also unrelated to the caregiver’s education level or own dental health. Intensity of distress was associated with the child’s pre-dental examination distress and distress during prior medical examinations and injections. Conclusions Dental professionals can better anticipate child distress by assessing children before examination and inquiring about previous medical experiences. Strategies to prepare parents and alleviate distress may help children cope with the preventive dental visit. PMID:25514877

  19. Caries-inhibiting effects of different modes of Duraphat varnish reapplication: a 3-year radiographic study.

    PubMed

    Petersson, L G; Arthursson, L; Ostberg, C; Jönsson, G; Gleerup, A

    1991-01-01

    One hundred and sixty 11-year-olds were randomly allocated to two experimental groups, one test (group 1) and one control group (group 2), for a 3-year clinical test comparing different modes of fluoride varnish treatment. In the test group, children received Duraphat varnish treatments 3 times a week, once a year. The children in group 2 were treated with Duraphat every 6 months. During the experimental period, children in group 1 received 9 fluoride varnish applications, and in group 2, 6 applications. Four bitewing radiographs were taken in each child each year for the measurements of the incidence and progression of proximal caries. Repeated fluoride varnish treatment with Duraphat, 3 times a week once a year, appears to inhibit proximal caries progression and development since the children in this group showed even a lower caries status, 1.3 +/- 0.3 DS, at the end of the study compared to 1.6 +/- 0.2 DS at the outset. In group 2, the children increased their caries status from 1.7 +/- 0.2 to 2.4 +/- 0.4 DS during the experimental period. The caries difference was statistically significant (p less than 0.05) between the two groups. A health economic comparison of the two modes of application showed 30% lower costs for the children in the test group based on time used for preventive measures and assumed filling therapy.

  20. Urinary 1-Hydroxypyrene as a Biomarker of PAH Exposure in 3-Year-Old Ukrainian Children

    PubMed Central

    Mucha, Amy Pelka; Hryhorczuk, Daniel; Serdyuk, Andrij; Nakonechny, Joseph; Zvinchuk, Alexander; Erdal, Serap; Caudill, Motria; Scheff, Peter; Lukyanova, Elena; Shkiryak-Nyzhnyk, Zoreslava; Chislovska, Natalia

    2006-01-01

    Urinary 1-hydroxypyrene (1-OHP) is a biomarker of polycyclic aromatic hydrocarbon (PAH) exposure. We measured urinary 1-OHP in 48 children 3 years of age in Mariupol, Ukraine, who lived near a steel mill and coking facility and compared these with 1-OHP concentrations measured in 42 children of the same age living in the capital city of Kiev, Ukraine. Children living in Mariupol had significantly higher urinary 1-OHP and creatinine-adjusted urinary 1-OHP than did children living in Kiev (adjusted: 0.69 vs. 0.34 μmol/mol creatinine, p < 0.001; unadjusted: 0.42 vs. 0.30 ng/mL, p = 0.002). Combined, children in both cities exposed to environmental tobacco smoke in their homes had higher 1-OHP than did children not exposed (0.61 vs. 0.42 μmol/mol creatinine; p = 0.04; p = 0.07 after adjusting for city). In addition, no significant differences were seen with sex of the children. Our sample of children in Mariupol has the highest reported mean urinary 1-OHP concentrations in children studied to date, most likely due to their proximity to a large industrial point source of PAHs. PMID:16581553

  1. Dutch and German 3-Year-Olds' Representations of Voicing Alternations.

    PubMed

    Buckler, Helen; Fikkert, Paula

    2016-06-01

    The voicing contrast is neutralized syllable and word finally in Dutch and German, leading to alternations within the morphological paradigm (e.g., Dutch 'bed(s)', be[t]-be[d]en, German 'dog(s)', Hun[t]-Hun[d]e). Despite structural similarity, language-specific morphological, phonological and lexical properties impact on the distribution of this alternation in the two languages. Previous acquisition research has focused on one language only, predominantly focusing on children's production accuracy, concluding that alternations are not acquired until late in the acquisition process in either language. This paper adapts a perceptual method to investigate how voicing alternations are represented in the mental lexicon of Dutch and German 3-year-olds. Sensitivity to mispronunciations of voicing word-medially in plural forms was measured using a visual fixation procedure. Dutch children exhibited evidence of overgeneralizing the voicing alternation, whereas German children consistently preferred the correct pronunciation to mispronunciations. Results indicate that the acquisition of voicing alternations is influenced by language-specific factors beyond the alternation itself.

  2. The Cultural and Linguistic Diversity of 3-Year-Old Children with Hearing Loss

    PubMed Central

    Crowe, Kathryn

    2012-01-01

    Understanding the cultural and linguistic diversity of young children with hearing loss informs the provision of assessment, habilitation, and education services to both children and their families. Data describing communication mode, oral language use, and demographic characteristics were collected for 406 children with hearing loss and their caregivers when children were 3 years old. The data were from the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study, a prospective, population-based study of children with hearing loss in Australia. The majority of the 406 children used spoken English at home; however, 28 other languages also were spoken. Compared with their caregivers, the children in this study used fewer spoken languages and had higher rates of oral monolingualism. Few children used a spoken language other than English in their early education environment. One quarter of the children used sign to communicate at home and/or in their early education environment. No associations between caregiver hearing status and children’s communication mode were identified. This exploratory investigation of the communication modes and languages used by young children with hearing loss and their caregivers provides an initial examination of the cultural and linguistic diversity and heritage language attrition of this population. The findings of this study have implications for the development of resources and the provision of early education services to the families of children with hearing loss, especially where the caregivers use a language that is not the lingua franca of their country of residence. PMID:22942315

  3. World`s longest sulfur pipeline operating smoothly after 3 years

    SciTech Connect

    King, G.G.; Lawrence, J.E.; Baron, J.J.

    1997-01-20

    More than 3 years of trouble-free operation on the world`s longest liquid-sulfur pipelines have affirmed the attention to detail and the early engineering effort that solved the problems of transporting liquid sulfur in a buried pipeline at temperatures greater than 120 C. Careful engineering and project planning led to completion on time and under budget of the 41 km long line. Sulfur is extracted from sour gas at Shell Canada Ltd.`s Caroline gas plant, Alta. It is carried cross-country as a liquid to the nearest railhead to the south. The pipeline is built from two coaxial pipes. The inner pipe carries liquid sulfur, while the annular space between the inner and outer pipes carries circulating hot water under pressure. A return line completes the loop for the circulation of hot water. The system employs two water heaters, one at each end of the line. It can carry continuously up to 5,100 tons/day (t/d) of liquid sulfur. The route winds through hilly terrain in the foothills of the Rocky Mountains and crosses under three major rivers. The paper describes the sour gas field, flow properties, hot water heat tracing, design options, pipe anchorage, prototype tests, preheating, construction, and operation.

  4. Negative cognitive styles synergistically predict suicidal ideation in bipolar spectrum disorders: a 3-year prospective study.

    PubMed

    Stange, Jonathan P; Hamilton, Jessica L; Burke, Taylor A; Kleiman, Evan M; O'Garro-Moore, Jared K; Seligman, Nicole D; Abramson, Lyn Y; Alloy, Lauren B

    2015-03-30

    Rates of suicidal ideation and behavior are extremely high in bipolar spectrum disorders (BSDs). However, relatively little work has evaluated potentially synergistic relationships between cognitive and emotion-regulatory processes proposed by theoretical models of suicidality in BSDs. The present study evaluated whether negative cognitive style and subtypes of rumination would exacerbate the impact of self-criticism on suicidal ideation in a prospective study of individuals with BSDs. Seventy-two young adults with BSDs (bipolar II, bipolar NOS, or cyclothymia) completed diagnostic interviews and trait measures of self-criticism, negative cognitive style, and brooding and reflective rumination at a baseline assessment. The occurrence of suicidal ideation was assessed as part of diagnostic interviews completed every 4 months for an average of 3 years of follow-up. Negative cognitive style and reflective rumination strengthened the association between self-criticism and the prospective occurrence of suicidal ideation across follow-up. Individuals with high levels of self-criticism in conjunction with negative cognitive style or reflective rumination were most likely to experience the onset of suicidal ideation. Self-criticism may work synergistically with negative cognitive style and rumination to confer risk for suicidal ideation in bipolar spectrum disorders. These results support theoretical models of suicidality in BSDs and indicate that evaluating and understanding negative cognitive styles may help to identify individuals who are at risk of suicide.

  5. Words, shape, visual search and visual working memory in 3-year-old children

    PubMed Central

    Vales, Catarina; Smith, Linda B.

    2014-01-01

    Do words cue children’s visual attention, and if so, what are the relevant mechanisms? Across four experiments, 3-year-old children (N = 163) were tested in visual search tasks in which targets were cued with only a visual preview versus a visual preview and a spoken name. The experiments were designed to determine whether labels facilitated search times and to examine one route through which labels could have their effect: By influencing the visual working memory representation of the target. The targets and distractors were pictures of instances of basic-level known categories and the labels were the common name for the target category. We predicted that the label would enhance the visual working memory representation of the target object, guiding attention to objects that better matched the target representation. Experiments 1 and 2 used conjunctive search tasks, and Experiment 3 varied shape discriminability between targets and distractors. Experiment 4 compared the effects of labels to repeated presentations of the visual target, which should also influence the working memory representation of the target. The overall pattern fits contemporary theories of how the contents of visual working memory interact with visual search and attention, and shows that even in very young children heard words affect the processing of visual information. PMID:24720802

  6. Pyogenic liver abscess: a retrospective analysis of 107 patients during a 3-year period.

    PubMed

    Chan, Khee-Siang; Chen, Chin-Ming; Cheng, Kuo-Chen; Hou, Ching-Cheng; Lin, Hung-Jung; Yu, Wen-Liang

    2005-12-01

    Pyogenic liver abscess (PLA) is a potentially life-threatening disease, and early diagnosis may be difficult. In order to provide diagnostic clues and to enhance the prompt management of such cases, we retrospectively investigated the clinical characteristics of PLA during a 3-year period in a tertiary-care hospital. The crude incidence rate of PLA in our study was 446.1 per 100,000 hospital admissions. Male predominance and a mean age of 57.6 +/- 14.4 years were observed. Diabetes mellitus was the most common concomitant disease, and biliary pathologies were the most common predisposing cause of this type of abscess. The most common clinical features were fever, chills, and abdominal pain. Leukocytosis was found in 67.3% of the patients, and the observed C-reactive protein (CRP) values were high. The most common pathogen was Klebsiella pneumoniae. The mortality rate was 6.5%. A complete history, physical examination, evaluation of the white blood cell count and CRP, and the prompt arrangement of imaging studies may lead to an earlier diagnosis. The aggressive performance of image-guided catheter drainage and the appropriate administration of antibiotics may reduce the mortality rate of PLA. PMID:16377869

  7. A 3-Year Longitudinal Study of Risk for Bipolar Spectrum Psychopathology.

    PubMed

    Walsh, Molly A; DeGeorge, Daniella P; Barrantes-Vidal, Neus; Kwapil, Thomas R

    2015-08-01

    Current clinical and epidemiological research provides support for a continuum of bipolar psychopathology: a bipolar spectrum that ranges from subthreshold characteristics to clinical disorders. The present research examined risk for bipolar spectrum psychopathology at a 3-year follow-up assessment in a nonclinically ascertained sample of 112 young adults identified by the Hypomanic Personality Scale (HPS). Participants completed diagnostic interviews assessing bipolar psychopathology, borderline personality traits, substance use disorders, impulsivity, and psychosocial functioning. At the original assessment, 18 of the 112 participants met criteria for a bipolar spectrum disorder. At the follow-up, an additional 13 had developed bipolar spectrum disorders. A total of 58% of participants scoring in the upper quartile of the HPS qualified for bipolar spectrum disorders at the follow-up, including 27% with DSM–IV–TR disorders. The HPS predicted new cases and total number of cases of bipolar spectrum disorders, as well as total number of DSM–IV–TR bipolar disorders. The HPS also predicted hyperthymic temperament or history of hypomania, grandiose traits, impulsivity, substance use disorders, psychosocial impairment, and borderline traits. The majority of these effects were significant after removing participants with DSM–IV–TR bipolar disorders from the analyses, suggesting that the results were not driven by a subset of participants with clinical disorders. Overall, these results offer further support for the bipolar spectrum construct and the predictive validity of the HPS as a measure of bipolar spectrum psychopathology.

  8. Acquired unilateral pulmonary vein atresia in a 3-year-old boy.

    PubMed

    Firdouse, Mohammed; Agarwal, Arnav; Grosse-Wortmann, Lars; Mondal, Tapas K

    2015-03-01

    While unilateral pulmonary venous atresia (UPVA) most commonly presents as an extremely rare late embryological defect resulting in complete occlusion or absence of the PV pathway, it may also be an acquired pathology. We present a 3-year-old boy who presented with mild respiratory distress. Neonatal echocardiographic investigations revealed normal mediastinal anatomy and pulmonary vasculature with a bicuspid aortic valve. However, follow-up Doppler investigation revealed a pulmonary artery size difference with minimal forward flow and reverse flow during diastole. Absence of the left pulmonary veins and the presence of collaterals draining to the innominate vein confirmed the diagnosis of acquired UPVA. Our case represents the first case of acquired UPVA in conjunction with a normally functioning bicuspid aortic valve. The Doppler flow patterns discussed might be of significant interest to pediatricians, cardiologists and imaging specialists. These findings suggest that acquired UPVA should be considered in the differential diagnosis of such patients when radiographic and echocardiographic findings may rule out other more common diagnoses. While the management of such a condition remains unclear and conservative management was agreed upon for our patient, the vulnerability of such cases warrants timely diagnosis and routine monitoring.

  9. A statistical skull geometry model for children 0-3 years old.

    PubMed

    Li, Zhigang; Park, Byoung-Keon; Liu, Weiguo; Zhang, Jinhuan; Reed, Matthew P; Rupp, Jonathan D; Hoff, Carrie N; Hu, Jingwen

    2015-01-01

    Head injury is the leading cause of fatality and long-term disability for children. Pediatric heads change rapidly in both size and shape during growth, especially for children under 3 years old (YO). To accurately assess the head injury risks for children, it is necessary to understand the geometry of the pediatric head and how morphologic features influence injury causation within the 0-3 YO population. In this study, head CT scans from fifty-six 0-3 YO children were used to develop a statistical model of pediatric skull geometry. Geometric features important for injury prediction, including skull size and shape, skull thickness and suture width, along with their variations among the sample population, were quantified through a series of image and statistical analyses. The size and shape of the pediatric skull change significantly with age and head circumference. The skull thickness and suture width vary with age, head circumference and location, which will have important effects on skull stiffness and injury prediction. The statistical geometry model developed in this study can provide a geometrical basis for future development of child anthropomorphic test devices and pediatric head finite element models. PMID:25992998

  10. How selective are 3-year-olds in imitating novel linguistic material?

    PubMed

    Bannard, Colin; Klinger, Jörn; Tomasello, Michael

    2013-12-01

    In 3 studies we explored when 3-year-olds would imitate novel words in utterances produced by adult speakers. Child and experimenter took turns in requesting objects from a game master. The experimenter always went first and always preceded the object's familiar name with a novel adjective (e.g., "the dilsige duck"). In the first 2 experiments, we found that children were more likely to reproduce the adjective when there were 2 different instances of the same object present in the situation than when there was only 1 or when there were 2 objects of different types present. Thus, children seemed to be sensitive to the descriptive and contrastive function of the adjectives in determining which parts of the utterances to reproduce. Nonetheless, replication of even redundant material was over 50%, suggesting a strategy of somewhat blind copying. In the 3rd experiment, we found that children were less likely to reproduce a redundant adjective when the speaker indicated gesturally that he did not intend to produce it than when he clearly produced it intentionally. We distinguish insightful imitation (the copying of a speaker's goal and means when motivated by insight into why those particular means were chosen) and blind imitation (the copying of a speaker's goal and means with no awareness of why those specific means were chosen) from mimicry. We explore the roles that these modes of imitation might play in language development. PMID:23458663

  11. Intestinal Obstruction in a 3-Year-Old Girl by Ascaris lumbricoides Infestation

    PubMed Central

    Andrade, Angel Medina; Perez, Yeudiel; Lopez, Cecilia; Collazos, Stephanie Serrano; Andrade, Alejandro Medina; Ramirez, Grecia Ortiz; Andrade, Laura Medina

    2015-01-01

    Abstract Ascaris lumbricoides infection affects approximately 1.5 billion people globally. Children with environmental and socio-economic risk factors are more susceptible to infestation, with serious complications such as intestinal obstruction (IO), volvulus, intussusception, and intestinal necrosis. We present the case of a 3-year-old girl who arrived at emergency department with abdominal pain and diarrhea for the last 3 days. The previous day she took an unspecified anthelmintic. Symptoms worsened with vomiting and diarrhea, with expulsion of roundworms through mouth and anus. Physical examination revealed bloating, absence of bowel sounds, abdominal tenderness, and a palpable mass in right hemi-abdomen. Abdominal radiographs showed air-fluid levels with mild bowel distention and shadows of roundworms. The diagnosis of IO by A lumbricoides. infestation was established and surgical approach scheduled. During exploratory laparotomy an intraluminal bolus of roundworms from jejunum to ascendant colon was evident. An ileum enterotomy was performed and worms were removed. Fluid therapy and antibiotics for 72 hours were administered, with posterior albendazol treatment for 3 days. Patient was uneventfully discharged on the tenth day. Reduction in parasitic load by means of improvements in sanitation, health education, and anthelmintic treatment must be implemented in endemic zones to prevent serious life-threatening complications by A lumbricoides. infestation, because some of them require urgent surgical treatment. PMID:25906092

  12. Conservative management of external root resorption after tooth reimplantation: a 3-year follow-up.

    PubMed

    Ionta, Franciny Querobim; de Oliveira, Gabriela Cristina; de Alencar, Catarina Ribeiro Barros; Gonçalves, Priscilla Santana Pinto; Alcalde, Murilo Priori; Minotti, Paloma Gagliardi; Machado, Maria Aparecida de Andrade Moreira; Rios, Daniela

    2016-01-01

    The aim of this case report is to describe the treatment of a 9-year-old patient who suffered external root resorption of the permanent maxillary left lateral incisor following reimplantation of the avulsed left central and lateral incisors. Sixteen days after reimplantation and splinting of the incisors in a hospital emergency department, the patient was brought to the pediatric department of a dental school for further treatment. Root canal access was created in the maxillary left lateral and central incisors, and calcium hydroxide paste was used as intracanal dressing. At the 5-month follow-up, a radiograph revealed extensive external root resorption, a communicating root canal, and a periodontal lesion affecting the left lateral incisor. Management of the root resorption included obturation of the apical third of the canal with gutta percha and the middle third with mineral trioxide aggregate (MTA). At the 3-year recall examination, the patient was asymptomatic, and no mobility or soft tissue alterations were observed clinically. There was no radiographic sign that resorption had progressed. Despite the success of treatment, observation is still required. The use of MTA may be considered an alternative treatment for external root resorption after tooth reimplantation. The technique may allow tooth preservation in children until skeletal growth and development are completed and implant treatment may be considered. PMID:27367632

  13. A Statistical Skull Geometry Model for Children 0-3 Years Old

    PubMed Central

    Li, Zhigang; Park, Byoung-Keon; Liu, Weiguo; Zhang, Jinhuan; Reed, Matthew P.; Rupp, Jonathan D.; Hoff, Carrie N.; Hu, Jingwen

    2015-01-01

    Head injury is the leading cause of fatality and long-term disability for children. Pediatric heads change rapidly in both size and shape during growth, especially for children under 3 years old (YO). To accurately assess the head injury risks for children, it is necessary to understand the geometry of the pediatric head and how morphologic features influence injury causation within the 0–3 YO population. In this study, head CT scans from fifty-six 0–3 YO children were used to develop a statistical model of pediatric skull geometry. Geometric features important for injury prediction, including skull size and shape, skull thickness and suture width, along with their variations among the sample population, were quantified through a series of image and statistical analyses. The size and shape of the pediatric skull change significantly with age and head circumference. The skull thickness and suture width vary with age, head circumference and location, which will have important effects on skull stiffness and injury prediction. The statistical geometry model developed in this study can provide a geometrical basis for future development of child anthropomorphic test devices and pediatric head finite element models. PMID:25992998

  14. Words, shape, visual search and visual working memory in 3-year-old children.

    PubMed

    Vales, Catarina; Smith, Linda B

    2015-01-01

    Do words cue children's visual attention, and if so, what are the relevant mechanisms? Across four experiments, 3-year-old children (N = 163) were tested in visual search tasks in which targets were cued with only a visual preview versus a visual preview and a spoken name. The experiments were designed to determine whether labels facilitated search times and to examine one route through which labels could have their effect: By influencing the visual working memory representation of the target. The targets and distractors were pictures of instances of basic-level known categories and the labels were the common name for the target category. We predicted that the label would enhance the visual working memory representation of the target object, guiding attention to objects that better matched the target representation. Experiments 1 and 2 used conjunctive search tasks, and Experiment 3 varied shape discriminability between targets and distractors. Experiment 4 compared the effects of labels to repeated presentations of the visual target, which should also influence the working memory representation of the target. The overall pattern fits contemporary theories of how the contents of visual working memory interact with visual search and attention, and shows that even in very young children heard words affect the processing of visual information. PMID:24720802

  15. Successful Medical Treatment of Adult Nesidioblastosis With Pasireotide over 3 Years

    PubMed Central

    Schwetz, Verena; Horvath, Karl; Kump, Patrizia; Lackner, Carolin; Perren, Aurel; Forrer, Flavio; Pieber, Thomas R.; Treiber, Gerlies; Sourij, Harald; Mader, Julia K.

    2016-01-01

    Abstract Nesidioblastosis is a rare cause of endogenous hyperinsulinemic hypoglycemia in adults. Diagnosis is often challenging and therapeutic options are scarce. In 2009, a 46-year-old female patient presented with recurrent severe hypoglycemia and immediate recovery after glucose ingestion. Although 72-h-fasting test was positive, various imaging technologies (sonography, computed tomography, somatostatin receptor scintigraphy, dopamine receptor positron emission tomography [DOPA-PET]) were negative. Endoscopic ultrasound revealed a lesion in the pancreatic corpus, whereas selective arterial calcium stimulation test, portal venous sampling and GLP-1-receptor scintigraphy were indicative of a lesion in the pancreatic tail, which was surgically removed. The histopathologic examination revealed beta cell hyperplasia and microadenomas expressing glucagon. After surgery, the patient was free of symptoms for 6 months, after which hypoglycemic episodes recurred. After unsuccessful treatment with corticosteroids and somatostatin analogs, treatment with pasireotide, a novel somatostatin analog with high affinity to somatostatin receptor 5 and a possible side effect of hyperglycemia, was initiated (0.6 mg BID). To date, our patient has been free of severe hypoglycemic episodes ever since. Yearly repeated imaging procedures have shown no abnormities over the last 3 years. We report for the first time that pasireotide was successfully used in the treatment of adult nesidioblastosis. PMID:27057885

  16. Effect of Parental Bereavement on Health Risk Behaviors in Youth: A 3-Year Follow-up

    PubMed Central

    Hamdan, Sami; Mazariegos, David; Melhem, Nadine M.; Porta, Giovanna; Payne, Monica Walker; Brent, David A.

    2013-01-01

    Objective To examine the course of health risk behaviors (HRBs) during a 3-year period after a parent’s death in bereaved youth compared with nonbereaved youth (control subjects). Design A longitudinal population-based study. Setting Bereaved families were recruited through coroner records and by advertisement. Control families were recruited using random-digit dialing and by advertisement. Participants Two hundred forty parentally bereaved offspring were compared with 183 nonbereaved control offspring. Main Exposure Sudden parental death due to accident, suicide, or sudden disease-related (natural) death. Main Outcome Measures The sum of the total number of HRBs at a clinically significant frequency threshold assessed 9, 21, and 33 months after the parent’s death. Results The bereaved group showed a higher number of HRBs over time compared with the nonbereaved group (univariate effect sizes, 0.22–0.52; P<.04), even after taking into account correlates of bereavement and of HRBs, such as youth aggression, as well as antisocial and anxiety disorders of the deceased parent. Conclusions Parental bereavement is associated with higher HRBs in youth over time, even after controlling for other covariates associated with bereavement and HRBs. Clinicians should be aware that bereaved youth may be vulnerable to HRBs. Further work is warranted on interventions to attenuate the negative effect of bereavement on HRBs. PMID:22393180

  17. Words, shape, visual search and visual working memory in 3-year-old children.

    PubMed

    Vales, Catarina; Smith, Linda B

    2015-01-01

    Do words cue children's visual attention, and if so, what are the relevant mechanisms? Across four experiments, 3-year-old children (N = 163) were tested in visual search tasks in which targets were cued with only a visual preview versus a visual preview and a spoken name. The experiments were designed to determine whether labels facilitated search times and to examine one route through which labels could have their effect: By influencing the visual working memory representation of the target. The targets and distractors were pictures of instances of basic-level known categories and the labels were the common name for the target category. We predicted that the label would enhance the visual working memory representation of the target object, guiding attention to objects that better matched the target representation. Experiments 1 and 2 used conjunctive search tasks, and Experiment 3 varied shape discriminability between targets and distractors. Experiment 4 compared the effects of labels to repeated presentations of the visual target, which should also influence the working memory representation of the target. The overall pattern fits contemporary theories of how the contents of visual working memory interact with visual search and attention, and shows that even in very young children heard words affect the processing of visual information.

  18. A 3-Year Climatology of Cloud and Radiative Properties Derived from GOES-8 Data Over the Southern Great Plains

    NASA Technical Reports Server (NTRS)

    Khaiyer, M. M.; Rapp, A. D.; Doelling, D. R.; Nordeen, M. L.; Minnis, P.; Smith, W. L., Jr.; Nguyen, L.

    2001-01-01

    While the various instruments maintained at the Atmospheric Radiation Measurement (ARM) Program Southern Great Plains (SGP) Central Facility (CF) provide detailed cloud and radiation measurements for a small area, satellite cloud property retrievals provide a means of examining the large-scale properties of the surrounding region over an extended period of time. Seasonal and inter-annual climatological trends can be analyzed with such a dataset. For this purpose, monthly datasets of cloud and radiative properties from December 1996 through November 1999 over the SGP region have been derived using the layered bispectral threshold method (LBTM). The properties derived include cloud optical depths (ODs), temperatures and albedos, and are produced on two grids of lower (0.5 deg) and higher resolution (0.3 deg) centered on the ARM SGP CF. The extensive time period and high-resolution of the inner grid of this dataset allows for comparison with the suite of instruments located at the ARM CF. In particular, Whole-Sky Imager (WSI) and the Active Remote Sensing of Clouds (ARSCL) cloud products can be compared to the cloud amounts and heights of the LBTM 0.3 deg grid box encompassing the CF site. The WSI provides cloud fraction and the ARSCL computes cloud fraction, base, and top heights using the algorithms by Clothiaux et al. (2001) with a combination of Belfort Laser Ceilometer (BLC), Millimeter Wave Cloud Radar (MMCR), and Micropulse Lidar (MPL) data. This paper summarizes the results of the LBTM analysis for 3 years of GOES-8 data over the SGP and examines the differences between surface and satellite-based estimates of cloud fraction.

  19. Conditional Probability of Survival Nomogram for 1-, 2-, and 3-Year Survivors After an R0 Resection for Gastric Cancer

    PubMed Central

    Dikken, Johan L.; Baser, Raymond E.; Gonen, Mithat; Kattan, Michael W.; Shah, Manish A.; Verheij, Marcel; van de Velde, Cornelis J. H.; Brennan, Murray F.; Coit, Daniel G.

    2014-01-01

    Background Survival estimates after curative surgery for gastric cancer are based on AJCC staging, or on more accurate multivariable nomograms. However, the risk of dying of gastric cancer is not constant over time, with most deaths occurring in the first 2 years after resection. Therefore, the prognosis for a patient who survives this critical period improves. This improvement over time is termed conditional probability of survival (CPS). Objectives of this study were to develop a CPS nomogram predicting 5-year disease-specific survival (DSS) from the day of surgery for patients surviving a specified period of time after a curative gastrectomy and to explore whether variables available with follow-up improve the nomogram in the follow-up setting. Methods A CPS nomogram was developed from a combined US-Dutch dataset, containing 1,642 patients who underwent an R0 resection with or without chemotherapy/ radiotherapy for gastric cancer. Weight loss, performance status, hemoglobin, and albumin 1 year after resection were added to the baseline variables of this nomogram. Results The CPS nomogram was highly discriminating (concordance index: 0.772). Surviving 1, 2, or 3 years gives a median improvement of 5-year DSS from surgery of 7.2, 19.1, and 31.6 %, compared with the baseline prediction directly after surgery. Introduction of variables available at 1-year follow-up did not improve the nomogram. Conclusions A robust gastric cancer nomogram was developed to predict survival for patients alive at time points after surgery. Introduction of additional variables available after 1 year of follow-up did not further improve this nomogram. PMID:23143591

  20. Evaluation of a pre-existing, 3-year household water treatment and handwashing intervention in rural Guatemala

    PubMed Central

    Arnold, Benjamin; Arana, Byron; Mäusezahl, Daniel; Hubbard, Alan; Colford, John M

    2009-01-01

    Background The promotion of household water treatment and handwashing with soap has led to large reductions in child diarrhoea in randomized efficacy trials. Currently, we know little about the health effectiveness of behaviour-based water and hygiene interventions after the conclusion of intervention activities. Methods We present an extension of previously published design (propensity score matching) and analysis (targeted maximum likelihood estimation) methods to evaluate the behavioural and health impacts of a pre-existing but non-randomized intervention (a 3-year, combined household water treatment and handwashing campaign in rural Guatemala). Six months after the intervention, we conducted a cross-sectional cohort study in 30 villages (15 intervention and 15 control) that included 600 households, and 929 children <5 years of age. Results The study design created a sample of intervention and control villages that were comparable across more than 30 potentially confounding characteristics. The intervention led to modest gains in confirmed water treatment behaviour [risk difference = 0.05, 95% confidence interval (CI) 0.02–0.09]. We found, however, no difference between the intervention and control villages in self-reported handwashing behaviour, spot-check hygiene conditions, or the prevalence of child diarrhoea, clinical acute lower respiratory infections or child growth. Conclusions To our knowledge this is the first post-intervention follow-up study of a combined household water treatment and handwashing behaviour change intervention, and the first post-intervention follow-up of either intervention type to include child health measurement. The lack of child health impacts is consistent with unsustained behaviour adoption. Our findings highlight the difficulty of implementing behaviour-based household water treatment and handwashing outside of intensive efficacy trials. PMID:19574492

  1. Maternal fish intake during pregnancy, blood mercury levels, and child cognition at age 3 years in a US cohort.

    PubMed

    Oken, Emily; Radesky, Jenny S; Wright, Robert O; Bellinger, David C; Amarasiriwardena, Chitra J; Kleinman, Ken P; Hu, Howard; Gillman, Matthew W

    2008-05-15

    The balance of contaminant risk and nutritional benefit from maternal prenatal fish consumption for child cognitive development is not known. Using data from a prospective cohort study of 341 mother-child pairs in Massachusetts enrolled in 1999-2002, the authors studied associations of maternal second-trimester fish intake and erythrocyte mercury levels with children's scores on the Peabody Picture Vocabulary Test (PPVT) and Wide Range Assessment of Visual Motor Abilities (WRAVMA) at age 3 years. Mean maternal total fish intake was 1.5 (standard deviation, 1.4) servings/week, and 40 (12%) mothers consumed >2 servings/week. Mean maternal mercury level was 3.8 (standard deviation, 3.8) ng/g. After adjustment using multivariable linear regression, higher fish intake was associated with better child cognitive test performance, and higher mercury levels with poorer test scores. Associations strengthened with inclusion of both fish and mercury: effect estimates for fish intake of >2 servings/week versus never were 2.2 (95% confidence interval (CI): -2.6, 7.0) for the PPVT and 6.4 (95% CI: 2.0, 10.8) for the WRAVMA; for mercury in the top decile, they were -4.5 (95% CI: -8.5, -0.4) for the PPVT and -4.6 (95% CI: -8.3, -0.9) for the WRAVMA. Fish consumption of < or =2 servings/week was not associated with a benefit. Dietary recommendations for pregnant women should incorporate the nutritional benefits as well as the risks of fish intake.

  2. Gender-specific factors associated with shorter sleep duration at age 3 years.

    PubMed

    Plancoulaine, Sabine; Lioret, Sandrine; Regnault, Nolwenn; Heude, Barbara; Charles, Marie-Aline

    2015-12-01

    Total sleep duration has been decreasing among children in the last decades. Short sleep duration (SSD) has been associated with deleterious health consequences, such as excess weight/obesity. Risk factors for SSD have already been studied among school-aged children and adolescents, but inconsistent results have been reported regarding possible gender differences. Studies reporting such relationships are scarce in preschoolers, despite the importance of this period for adopting healthy behaviour. We aimed to investigate factors associated with SSD in 3-year-old boys (n = 546) and girls (n = 482) in a French Mother-Child Cohort (EDEN Study). Children were born between 2003 and 2006 in two French university hospitals. Clinical examinations and parent self-reported questionnaires allowed us to collect sociodemographic (e.g. income, education, family situation, child-minding system), maternal [e.g. body mass index (BMI), parity, depression, breastfeeding duration] and child's characteristics (e.g. gender, birth weight, term, physical activity and TV viewing duration, food consumption, usual sleep time). Sleep duration/24-h period was calculated and SSD was defined as <12 h. Analyses were performed using logistic regression. The mean sleep duration was 12 h 35 ± 56 min, with 91% of the children napping. Patterns of risk factors associated with SSD differed according to gender. In addition to parental presence when falling asleep, short sleep duration was associated strongly positively with high BMI Z-score and TV viewing duration among boys and with familial home child-minding and lower scores on the 'fruits and vegetables' dietary pattern among girls. These results suggest either a patterning of parental behaviours that differs according to gender, or a gender-specific sleep physiology, or both.

  3. Summary of Medipix Technology's 3-Years in Space and Plans for Future Developments

    NASA Astrophysics Data System (ADS)

    Pinsky, Lawrence

    2016-07-01

    NASA has evaluated 7 Timepix-based radiation imaging detectors from the CERN-based Medipix2 collaboration on the International Space Station (ISS), collecting more than 3-years of data, as well on the December, 2014 EFT-1 mission testing the new Orion Multi-Purpose Crew Vehicle. These data along with data collected at ground-based accelerator facilities including the NASA Space Radiation Lab (NSRL) at Brookhaven in the US, as well as at the HIMAC facility at the National Institute for Radiological Sciences in Japan, have allowed the development of software analysis techniques sufficient to provide a stand-alone accurate assessment of the space radiation environment for dosimetric purposes. Recent comparisons of the performance of the Timepix with both n-on-p and p-on-n Si sensors will be presented. The further evolution of the Timepix technology by the Medipix3 collaboration in the form of the Timepix3 chip, which employs a continuous data-driven readout scheme, is being evaluated for possible use in future space research applications. Initial performance evaluations at accelerators will be reported. The Medipix2 Collaboration is also in the process of designing an updated version of the Timepix chip, called the Timepix2, which will continue the frame-based readout scheme of the current Timepix chip, but add simultaneous charge encoding using the Time-Over-Threshold (TOT) and first-hit Time-of-Arrival (TOA) encoding. Current plans are to replace the Timepix by the Timepix2 with minimal reconfiguration of the supporting electronics. Longer-term plans include participation in the currently forming Medipix4 collaboration. A summary of these prospects will also be included.

  4. Pragmatic inference, not semantic competence, guides 3-year-olds' interpretation of unknown number words.

    PubMed

    Brooks, Neon; Audet, Jennifer; Barner, David

    2013-06-01

    Before children learn the specific meanings of numerals like six, do they know that they represent precise quantities? Previous studies have reported conflicting evidence and have found that children expect numerals to label precise quantities in some tasks but not in others (Condry & Spelke, 2008; Sarnecka & Gelman, 2004). In this article, we present evidence that some of children's apparent successes are best explained not by domain-specific semantic understanding of number but instead by language-general pragmatic abilities. In Experiment 1, we replicated the findings of the previous studies in a within-subject design. When 3-year-olds saw a set labeled with a number (e.g., five) and an item was added, they preferred a new label (six) over the old one, as though they believed that number words have precise meanings. However, when 1 of 2 sets was labeled (e.g., as five) and children were asked to find the same quantity (five) or a new quantity (six), they performed identically whether the original set was changed in quantity or merely rearranged. Thus, when 2 numerals were offered as alternative labels for 1 set, children behaved as though they had precise meanings, whereas when they were asked to determine which of 2 sets a single numeral referred to, they did not. In Experiment 2, children were tested using similar methods but with novel nouns and objects that were transformed, instead of sets. Children showed the identical pattern of results despite lacking meanings for these words, suggesting that their judgments for numerals may not have relied on semantic knowledge that numerals have precise meanings. We propose that children's behavior can be explained by the use of domain-general pragmatic inference and does not require positing domain-specific numerical knowledge.

  5. A 3 year update on the influence of noise on performance and behavior.

    PubMed

    Clark, Charlotte; Sörqvist, Patrik

    2012-01-01

    The effect of noise exposure on human performance and behavior continues to be a focus for research activities. This paper reviews developments in the field over the past 3 years, highlighting current areas of research, recent findings, and ongoing research in two main research areas: Field studies of noise effects on children's cognition and experimental studies of auditory distraction. Overall, the evidence for the effects of external environmental noise on children's cognition has strengthened in recent years, with the use of larger community samples and better noise characterization. Studies have begun to establish exposure-effect thresholds for noise effects on cognition. However, the evidence remains predominantly cross-sectional and future research needs to examine whether sound insulation might lessen the effects of external noise on children's learning. Research has also begun to explore the link between internal classroom acoustics and children's learning, aiming to further inform the design of the internal acoustic environment. Experimental studies of the effects of noise on cognitive performance are also reviewed, including functional differences in varieties of auditory distraction, semantic auditory distraction, individual differences in susceptibility to auditory distraction, and the role of cognitive control on the effects of noise on understanding and memory of target speech materials. In general, the results indicate that there are at least two functionally different types of auditory distraction: One due to the interruption of processes (as a result of attention being captured by the sound), another due to interference between processes. The magnitude of the former type is related to individual differences in cognitive control capacities (e.g., working memory capacity); the magnitude of the latter is not. Few studies address noise effects on behavioral outcomes, emphasizing the need for researchers to explore noise effects on behavior in more

  6. Blood Lead Concentrations in 1–3 Year Old Lebanese Children: A Cross-sectional study

    PubMed Central

    Nuwayhid, Iman; Nabulsi, Mona; Muwakkit, Samar; Kouzi, Sarah; Salem, George; Mikati, Mohamed; Ariss, Majd

    2003-01-01

    Background Childhood lead poisoning has not made the list of national public health priorities in Lebanon. This study aims at identifying the prevalence and risk factors for elevated blood lead concentrations (B-Pb ≥ 100 μg/L) among 1–3 year old children. It also examines the need for universal blood lead screening. Methods This is a cross-sectional study of 281 well children, presenting to the pediatric ambulatory services at the American University of Beirut Medical Center in 1997–98. Blood was drawn on participating children for lead analysis and a structured questionnaire was introduced to mothers asking about social, demographic, and residence characteristics, as well as potential risk factors for lead exposure. Children with B-Pb ≥ 100 μg/L were compared to those with B-Pb < 100 μg/L. Results Mean B-Pb was 66.0 μg/L (median 60.0; range 10–160; standard deviation 26.3) with 39 (14%) children with B-Pb ≥ 100 μg/L. Logistic regression analysis showed that elevated B-Pb was associated with paternal manual jobs (odds ratio [OR]: 4.74), residence being located in high traffic areas (OR: 4.59), summer season (OR: 4.39), using hot tap water for cooking (OR: 3.96), exposure to kohl (OR: 2.40), and living in older buildings (OR: 2.01). Conclusion Lead screening should be offered to high-risk children. With the recent ban of leaded gasoline in Lebanon, emphasis should shift to other sources of exposure in children. PMID:12780938

  7. Thyrotoxicosis after a massive levothyroxine ingestion in a 3-year-old patient.

    PubMed

    Hays, Hannah L; Jolliff, Heath A; Casavant, Marcel J

    2013-11-01

    Most children with exploratory levothyroxine ingestions remain asymptomatic or suffer only minor effects, and most patients can be managed in the home or with supportive care in the hospital. We present a case of a 3-year-old girl who was found after a witnessed massive ingestion of levothyroxine. The patient was initially seen in an emergency department and discharged in stable condition, only to return 4 days after ingestion with thyrotoxicosis, hypertension, tachycardia, 24 hours of persistent vomiting, and clinical and laboratory evidence of dehydration. On the day of hospital admission, her thyroid-stimulating hormone was 0.018 µIU/mL (reference range, 0.6-4.5 µIU/mL); free T4 (tetraiodothyronine) was greater than 6.0 ng/dL (reference range, 0.7-2.1 ng/dL); and T3 (triiodothyronine) total was 494 ng/dL (reference range, 100-200 ng/dL). During a 3-day hospital admission, she was managed with supportive care, including intravenous fluid rehydration and antiemetics, and was ultimately discharged in good condition. The patient was followed up until 2 months after ingestion and remained asymptomatic. Although most exploratory levothyroxine ingestions suffer little to no clinical effects, serious symptoms can occur. Because serious symptoms can occur in a delayed fashion, it is important for clinicians to give proper anticipatory guidance regarding home symptom monitoring, follow-up, and reasons to return to the emergency department when patients present for medical evaluation. PMID:24196094

  8. Acute Undifferentiated Febrile Illness in Rural Cambodia: A 3-Year Prospective Observational Study

    PubMed Central

    Mueller, Tara C.; Siv, Sovannaroth; Khim, Nimol; Kim, Saorin; Fleischmann, Erna; Ariey, Frédéric; Buchy, Philippe; Guillard, Bertrand; González, Iveth J.; Christophel, Eva-Maria; Abdur, Rashid; von Sonnenburg, Frank; Bell, David; Menard, Didier

    2014-01-01

    In the past decade, malaria control has been successfully implemented in Cambodia, leading to a substantial decrease in reported cases. Wide-spread use of malaria rapid diagnostic tests (RDTs) has revealed a large burden of malaria-negative fever cases, for which no clinical management guidelines exist at peripheral level health facilities. As a first step towards developing such guidelines, a 3-year cross-sectional prospective observational study was designed to investigate the causes of acute malaria-negative febrile illness in Cambodia. From January 2008 to December 2010, 1193 febrile patients and 282 non-febrile individuals were recruited from three health centers in eastern and western Cambodia. Malaria RDTs and routine clinical examination were performed on site by health center staff. Venous samples and nasopharyngeal throat swabs were collected and analysed by molecular diagnostic tests. Blood cultures and blood smears were also taken from all febrile individuals. Molecular testing was applied for malaria parasites, Leptospira, Rickettsia, O. tsutsugamushi, Dengue- and Influenza virus. At least one pathogen was identified in 73.3% (874/1193) of febrile patient samples. Most frequent pathogens detected were P. vivax (33.4%), P. falciparum (26.5%), pathogenic Leptospira (9.4%), Influenza viruses (8.9%), Dengue viruses (6.3%), O. tsutsugamushi (3.9%), Rickettsia (0.2%), and P. knowlesi (0.1%). In the control group, a potential pathogen was identified in 40.4%, most commonly malaria parasites and Leptospira. Clinic-based diagnosis of malaria RDT-negative cases was poorly predictive for pathogen and appropriate treatment. Additional investigations are needed to understand their impact on clinical disease and epidemiology, and the possible role of therapies such as doxycycline, since many of these pathogens were seen in non-febrile subjects. PMID:24755844

  9. Acute undifferentiated febrile illness in rural Cambodia: a 3-year prospective observational study.

    PubMed

    Mueller, Tara C; Siv, Sovannaroth; Khim, Nimol; Kim, Saorin; Fleischmann, Erna; Ariey, Frédéric; Buchy, Philippe; Guillard, Bertrand; González, Iveth J; Christophel, Eva-Maria; Abdur, Rashid; von Sonnenburg, Frank; Bell, David; Menard, Didier

    2014-01-01

    In the past decade, malaria control has been successfully implemented in Cambodia, leading to a substantial decrease in reported cases. Wide-spread use of malaria rapid diagnostic tests (RDTs) has revealed a large burden of malaria-negative fever cases, for which no clinical management guidelines exist at peripheral level health facilities. As a first step towards developing such guidelines, a 3-year cross-sectional prospective observational study was designed to investigate the causes of acute malaria-negative febrile illness in Cambodia. From January 2008 to December 2010, 1193 febrile patients and 282 non-febrile individuals were recruited from three health centers in eastern and western Cambodia. Malaria RDTs and routine clinical examination were performed on site by health center staff. Venous samples and nasopharyngeal throat swabs were collected and analysed by molecular diagnostic tests. Blood cultures and blood smears were also taken from all febrile individuals. Molecular testing was applied for malaria parasites, Leptospira, Rickettsia, O. tsutsugamushi, Dengue- and Influenza virus. At least one pathogen was identified in 73.3% (874/1193) of febrile patient samples. Most frequent pathogens detected were P. vivax (33.4%), P. falciparum (26.5%), pathogenic Leptospira (9.4%), Influenza viruses (8.9%), Dengue viruses (6.3%), O. tsutsugamushi (3.9%), Rickettsia (0.2%), and P. knowlesi (0.1%). In the control group, a potential pathogen was identified in 40.4%, most commonly malaria parasites and Leptospira. Clinic-based diagnosis of malaria RDT-negative cases was poorly predictive for pathogen and appropriate treatment. Additional investigations are needed to understand their impact on clinical disease and epidemiology, and the possible role of therapies such as doxycycline, since many of these pathogens were seen in non-febrile subjects.

  10. Predictors of child-to-parent aggression: A 3-year longitudinal study.

    PubMed

    Calvete, Esther; Orue, Izaskun; Gamez-Guadix, Manuel; Bushman, Brad J

    2015-05-01

    Although we rarely hear about it, children sometimes aggress against their parents. This is a difficult topic to study because abused parents and abusive children are both reluctant to admit the occurrence of child-to-parent aggression. There are very few research studies on this topic, and even fewer theoretical explanations of why it occurs. We predicted that exposure to violence in the home (e.g., parents aggressing against each other) and ineffective parenting (i.e., parenting that is overly permissive or lacks warmth) influences cognitive schemas of how children perceive themselves and the world around them (i.e., whether aggression is normal, whether they develop grandiose self-views, and whether they feel disconnected and rejected), which, in turn, predicts child-to-parent aggression. In a 3-year longitudinal study of 591 adolescents and their parents, we found that exposure to violence in Year 1 predicted child-to-parent aggression in Year 3. In addition, parenting characterized by lack of warmth in Year 1 was related to narcissistic and entitled self-views and disconnection and rejection schemas in Year 2, which, in turn, predicted child-to-mother and child-to-father aggression in Year 3. Gender comparisons indicated that narcissism predicted child-to-parent aggression only in boys and that exposure to violence was a stronger predictor of child-to-father violence in boys. This longitudinal study increases our understanding of the understudied but important topic of child-to-parent aggression, and will hopefully stimulate future research.

  11. Gender-specific factors associated with shorter sleep duration at age 3 years.

    PubMed

    Plancoulaine, Sabine; Lioret, Sandrine; Regnault, Nolwenn; Heude, Barbara; Charles, Marie-Aline

    2015-12-01

    Total sleep duration has been decreasing among children in the last decades. Short sleep duration (SSD) has been associated with deleterious health consequences, such as excess weight/obesity. Risk factors for SSD have already been studied among school-aged children and adolescents, but inconsistent results have been reported regarding possible gender differences. Studies reporting such relationships are scarce in preschoolers, despite the importance of this period for adopting healthy behaviour. We aimed to investigate factors associated with SSD in 3-year-old boys (n = 546) and girls (n = 482) in a French Mother-Child Cohort (EDEN Study). Children were born between 2003 and 2006 in two French university hospitals. Clinical examinations and parent self-reported questionnaires allowed us to collect sociodemographic (e.g. income, education, family situation, child-minding system), maternal [e.g. body mass index (BMI), parity, depression, breastfeeding duration] and child's characteristics (e.g. gender, birth weight, term, physical activity and TV viewing duration, food consumption, usual sleep time). Sleep duration/24-h period was calculated and SSD was defined as <12 h. Analyses were performed using logistic regression. The mean sleep duration was 12 h 35 ± 56 min, with 91% of the children napping. Patterns of risk factors associated with SSD differed according to gender. In addition to parental presence when falling asleep, short sleep duration was associated strongly positively with high BMI Z-score and TV viewing duration among boys and with familial home child-minding and lower scores on the 'fruits and vegetables' dietary pattern among girls. These results suggest either a patterning of parental behaviours that differs according to gender, or a gender-specific sleep physiology, or both. PMID:26041449

  12. Emergency Department Opioid Prescribing Practices for Chronic Pain: a 3-Year Analysis.

    PubMed

    Ganem, Victoria J; Mora, Alejandra G; Varney, Shawn M; Bebarta, Vikhyat S

    2015-09-01

    Chronic pain is a common reason for emergency department (ED) visits. Our objective was to describe opioid prescribing practices of ED providers when treating patients with chronic pain. We retrospectively evaluated opioid prescriptions from EDs at two tertiary care military hospitals. We queried the outpatient record database to obtain a list of opioid medications prescribed and ICD-9 codes associated with visits for chronic pain. We collected provider type and gender, number of pills, opioid type, and refills. We compared the incidence with chi-square or Fisher's exact tests. Wilcoxon test was used for non-parametric continuous variables. Over 3 years, 28,103 visits generated an opioid prescription. One thousand three hundred twenty-two visits were associated with chronic pain, and 443 (33 %) visits were associated with an opioid prescription. Providers were 79 % physicians, 19 % physician assistants (PAs), 81 % male, and 69 % active duty military. Medications were 43 % oxycodone, 30 % hydrocodone, 9.5 % tramadol, 2.5 % codeine, and 15 % other. The number of pills was 20 [interquartile range (IQR) 15-30] (range 1-240), morphine equivalents (M.E.) per pill was 7.5 [7.5-7.5] (2.5-120) and total M.E. per prescription was 150 [112.5-270] (15-6000). Physicians were more likely to prescribe a non-opioid than PAs (77 vs 45 %, p < 0.0001). Civilian providers were more likely to prescribe an opioid than active duty providers (58 vs 42 %, p < 0.0001). Providers prescribed a median of 20 pills per prescription and most commonly prescribed oxycodone. PAs were more likely to prescribe an opioid for chronic pain than physicians. Civilian providers were more likely to prescribe an opioid than active duty providers. PMID:25468314

  13. Molecular diagnosis of toxoplasmosis in immunocompromised patients: a 3-year multicenter retrospective study.

    PubMed

    Robert-Gangneux, Florence; Sterkers, Yvon; Yera, Hélène; Accoceberry, Isabelle; Menotti, Jean; Cassaing, Sophie; Brenier-Pinchart, Marie-Pierre; Hennequin, Christophe; Delhaes, Laurence; Bonhomme, Julie; Villena, Isabelle; Scherer, Emeline; Dalle, Frédéric; Touafek, Feriel; Filisetti, Denis; Varlet-Marie, Emmanuelle; Pelloux, Hervé; Bastien, Patrick

    2015-05-01

    Toxoplasmosis is a life-threatening infection in immunocompromised patients (ICPs). The definitive diagnosis relies on parasite DNA detection, but little is known about the incidence and burden of disease in HIV-negative patients. A 3-year retrospective study was conducted in 15 reference laboratories from the network of the French National Reference Center for Toxoplasmosis, in order to record the frequency of Toxoplasma gondii DNA detection in ICPs and to review the molecular methods used for diagnosis and the prevention measures implemented in transplant patients. During the study period, of 31,640 PCRs performed on samples from ICPs, 610 were positive (323 patients). Blood (n = 337 samples), cerebrospinal fluid (n = 101 samples), and aqueous humor (n = 100 samples) were more frequently positive. Chemoprophylaxis schemes in transplant patients differed between centers. PCR follow-up of allogeneic hematopoietic stem cell transplant (allo-HSCT) patients was implemented in 8/15 centers. Data from 180 patients (13 centers) were further analyzed regarding clinical setting and outcome. Only 68/180 (38%) patients were HIV(+); the remaining 62% consisted of 72 HSCT, 14 solid organ transplant, and 26 miscellaneous immunodeficiency patients. Cerebral toxoplasmosis and disseminated toxoplasmosis were most frequently observed in HIV and transplant patients, respectively. Of 72 allo-HSCT patients with a positive PCR result, 23 were asymptomatic; all were diagnosed in centers performing systematic blood PCR follow-up, and they received specific treatment. Overall survival of allo-HSCT patients at 2 months was better in centers with PCR follow-up than in other centers (P < 0.01). This study provides updated data on the frequency of toxoplasmosis in HIV-negative ICPs and suggests that regular PCR follow-up of allo-HSCT patients could guide preemptive treatment and improve outcome.

  14. Docosahexaenoic acid status at 9 months is inversely associated with communicative skills in 3-year-old girls.

    PubMed

    Engel, Sara; Tronhjem, Kathrine Marie Hagerup; Hellgren, Lars I; Michaelsen, Kim F; Lauritzen, Lotte

    2013-10-01

    The objective of the present observational study was to investigate if the docosahexaenoic acid (DHA) status assessed in infant erythrocytes (RBC) at 9 months was associated with the age when the infants reach developmental milestones and their psychomotor function at 3 years of age. Three hundred eleven healthy Danish children were followed from 9 months to 3 years of age (the SKOT cohort). RBC fatty acid composition was analysed by gas chromatography in 272 of the children. Milestone age was collected by questionnaires at 9 and 18 months and psychomotor development at 3 years of age was assessed by the parents using third edition of the Ages and Stages Questionnaire (ASQ-3). RBC DHA levels ranged from 2.2% to 12.6% of the RBC fatty acids. The age of reaching milestones correlated with psychomotor development, particularly with gross motor function at 3 years. An association between milestones and later personal and social skills was also observed, but only for girls. In girls, RBC-DHA was found to be inversely correlated with communication at 3 years of age (odds ratio = 0.69, 95% confidence interval: 0.56-0.86, P = 0.001), but no other associations with psychomotor development or milestones were found. The results from study indicate that DHA status at 9 months may not have a pronounced beneficial effect on psychomotor development in early childhood and that communicative skills at 3 years of age may even be inversely associated with early RBC-DHA levels in girls.

  15. Long-Term Outcome and Toxicities of Intraoperative Radiotherapy for High-Risk Neuroblastoma

    SciTech Connect

    Gillis, Amy M.; Sutton, Elizabeth; DeWitt, Kelly D.; Matthay, Katherine K.; Weinberg, Vivian; Fisch, Benjamin M.; Chan, Albert; Gooding, Charles; Daldrup-Link, Heike; Wara, William M.; Farmer, Diana L.; Harrison, Michael R.; Haas-Kogan, Daphne

    2007-11-01

    Purpose: To review a historical cohort of consecutively accrued patients with high-risk neuroblastoma treated with intraoperative radiotherapy (IORT) to determine the therapeutic effect and late complications of this treatment. Methods and Materials: Between 1986 and 2002, 31 patients with newly diagnosed high-risk neuroblastoma were treated with IORT as part of multimodality therapy. Their medical records were reviewed to determine the outcome and complications. Kaplan-Meier probability estimates of local control, progression-free survival, and overall survival at 36 months after diagnosis were recorded. Results: Intraoperative radiotherapy to the primary site and associated lymph nodes achieved excellent local control at a median follow-up of 44 months. The 3-year estimate of the local recurrence rate was 15%, less than that of most previously published series. Only 1 of 22 patients who had undergone gross total resection developed recurrence at the primary tumor site. The 3-year estimate of local control, progression-free survival, and overall survival was 85%, 47%, and 60%, respectively. Side effects attributable to either the disease process or multimodality treatment were observed in 7 patients who developed either hypertension or vascular stenosis. These late complications resulted in the death of 2 patients. Conclusions: Intraoperative radiotherapy at the time of primary resection offers effective local control in patients with high-risk neuroblastoma. Compared with historical controls, IORT achieved comparable control and survival rates while avoiding many side effects associated with external beam radiotherapy in young children. Although complications were observed, additional analysis is needed to determine the relative contributions of the disease process and specific components of the multimodality treatment to these adverse events.

  16. Reforming the Israeli health system: findings of a 3-year evaluation.

    PubMed

    Gross, R; Rosen, B; Shirom, A

    2001-04-01

    Israel, like many other European countries, has recently reformed its health care system. The regulated market created by the National Health Insurance (NHI) law embodies many of the principles of managed competition. The purpose of this paper is to present initial findings from an evaluation of the first 3 years of the reform (1995-1997) regarding the implementation of the reform and the extent to which it has achieved its main goals. The evaluation was conducted using multiple quantitative and qualitative research tools: interviews with key informants; analysis of documents and sick fund financial statements; analysis of trends in sick fund membership; and population surveys conducted in 1995 and 1997 to assess the impact of the reform on outcome measures related to level of services to the public. Data from the evaluation show that the NHI law achieved a considerable number of its goals: to provide insurance coverage for the entire population, to ensure freedom of movement among sick funds, and to standardize the way resources are allocated to sick funds. The incentives that are embodied in the law have encouraged the sick funds to improve the level of services provided to the average insuree, and to develop services in the periphery and for some of the weaker populations. From the financial perspective, concerns that NHI would lead to a rise in the national health expenditure were not realized as of 1997. In the wake of NHI, there has been a decline in the age adjusted per capita expenditure in three sick funds, with no reports by insurees, at least through 1997, on a decline in satisfaction or level of service. However, the Israeli experience shows that regulating competition does not necessarily lead to economic stability and equality. Regulating the competition also did not solve some of the major policy issues in the Israeli health system including level of resources allocated to health, organizational structure of the hospital system, manpower planning and

  17. Determinants of physician antibiotic prescribing behavior: a 3 year cohort study in Portugal.

    PubMed

    Teixeira Rodrigues, António; Ferreira, Mónica; Piñeiro-Lamas, Maria; Falcão, Amílcar; Figueiras, Adolfo; Herdeiro, Maria T

    2016-05-01

    Objectives Antibiotic misprescription is a major driver of resistance, which is a worldwide public health problem. Therefore, our aim is to assess the influence of the determinants of physician prescribing on the quality of antibiotic use. Methods A 3 year cohort study including all primary-care physicians working in Portugal's Central Regional Health Administration (n = 1094) was conducted. We assessed the determinants of prescribing using a pre-validated, personally addressed, reply-paid, self-administered questionnaire (sent four times to non-responders, between September 2011 and February 2012) designed to collect information on physicians' attitudes to and knowledge of antibiotic prescribing as well as their socio-demographic and professional data. To evaluate antibiotic prescribing, we've calculated ESAC 12 quality indicators per physician per year, allowing us to stratify them as good or poor prescribers according to their performance on those indicators. Associations between determinants and outcomes were fitted with generalized linear mixed models. Results The overall response rate was 46.1%. Emergency activity (OR [95% CI] = 0.29 [0.16-0.54]; p < 0.05) and workload (number of patients seen per day: OR [95% CI] = 0.97 [0.94-1.00]; p < 0.05; number of patients seen per week in emergencies: OR [95% CI] = 0.98 [0.97-0.99]; p < 0.05) were both related to poor quality of antibiotic prescribing. Statistically significant odds ratios were also obtained for ignorance (IqOR [95% CI] = 2.14 [1.31-3.52]), complacency (1/IqOR [95% CI] = 1.19 [1.01-1.41]) and responsibility of others (1/IqOR [95% CI] = 1.78 [1.10-3.06]). Conclusions The above results serve to emphasize workload, working at emergency departments and physicians' attitudes identified as critical factors affecting antibiotic prescribing. This provides new insights for clinicians, researchers and policy makers when it comes to developing and improving the clinical and

  18. Development and implementation of the Clinical Tooth Shade Differentiation Course – an evaluation over 3 years

    PubMed Central

    Olms, Constanze; Haak, Rainer; Jakstat, Holger A.

    2016-01-01

    Objective: Tooth shade differentiation concerns the identification and classification of tooth shades. The objective of this project was to implement the Clinical Tooth Shade Differentiation Course in the preclinical stage of studies and to evaluate the students' perspective over a period of 3 years. Methodology: The course is planned for a duration of 10 weeks with two 45-minute sessions per semester week. The entire attendance time was 10:15 h. 2 lectures of 90 minutes each, 2 seminars of 60 min each and 2 teaching units with the phantom head and role playing took place. In addition to the various parameters of tooth shade, changes in tooth shade and the basics of dental esthetics, clinical procedures for manual and digital tooth shade determination were explained and practiced. 96% (69 of 72) of the students participated in the first evaluation in 2012/2013 (T1), and 68% of these were women. In the following year, 2013/2014 (T2), 92% (45 of 48 students) took part; 62% of these were women and 38% men. The 2014/2015 evaluation (T3) comprised 94% (45 of 48 students). Of these, 67% were women. Results: In the evaluation, the students gave the course a positive grade. The questions in "General/Organization" were given a mean (M) of 1.5 (SD=0.7) in T1 and T2 , and 1.2 (SD=0.3) in T3. The "Overall Assessment" yielded MT1=1.6 (SD=0.6), MT2=1.5 (SD=0.5) and MT3=1.1 (SD=0.3). In T1 and T2, the item "The instructor actively involved the students in the course" was given a mean of 2.1 (SD=0.9), and in T3 a mean of 1.2 (SD=0.5). Conclusions: The course presented here conceptually shows how practical dental skills can be taught in a theoretical and clinical context. Educational objectives from the role of a dental expert were taken from the national competence-based catalog of educational objectives for dentistry and can also be supplemented. The objectives can be transferred to other dental faculties. PMID:26958650

  19. Postoperative Mortality after Hip Fracture Surgery: A 3 Years Follow Up

    PubMed Central

    Un, Canan; Sacan, Ozlem; Gamli, Mehmet; Baskan, Semih; Baydar, Mustafa

    2016-01-01

    Background and Aims To determine mortality rates and predisposing factors in patients operated for a hip fracture in a 3-year follow-up period. Methods The study included patients who underwent primary surgery for a hip fracture.The inclusion criteria were traumatic, non-traumatic, osteoporotic and pathological hip fractures requiring surgery in all age groups and both genders. Patients with periprosthetic fractures or previous contralateral hip fracture surgery and patients who could not be contacted by telephone were excluded. At 36 months after surgery, evaluation was made using a structured telephone interview and a detailed examination of the hospital medical records, especially the documents written during anesthesia by the anesthesiologists and the documents written at the time of follow-up visits by the orthopaedic surgeons. A total of 124 cases were analyzed and 4 patients were excluded due to exclusion criteria. The collected data included demographics, type of fracture, co-morbidities, American Society of Anesthesiologists (ASA) scores, anesthesia techniques, operation type (intramedullary nailing or arthroplasty; cemented-noncemented), peroperative complications, refracture during the follow-up period, survival period and mortality causes. Results The total 120 patients evaluated comprised 74 females(61.7%) and 46 males(38.3%) with a mean age of 76.9±12.8 years (range 23–95 years). The ASA scores were ASA I (0.8%), ASA II (21.7%), ASA III (53.3%) and ASA IV (24.2%). Mortality was seen in 44 patients (36.7%) and 76 patients (63.3%) survived during the 36-month follow-up period. Of the surviving patients, 59.1% were female and 40.9% were male.The survival period ranged between 1–1190 days. The cumulative mortality rate in the first, second and third years were 29.17%, 33.33% and 36.67% respectively. The factors associated with mortality were determined as increasing age, high ASA score, coronary artery disease, congestive heart failure, Alzheimer

  20. High-dose immunosuppressive therapy and autologous peripheral blood stem cell transplantation for severe multiple sclerosis

    PubMed Central

    Nash, Richard A.; Bowen, James D.; McSweeney, Peter A.; Pavletic, Steven Z.; Maravilla, Kenneth R.; Park, Man-soo; Storek, Jan; Sullivan, Keith M.; Al-Omaishi, Jinan; Corboy, John R.; DiPersio, John; Georges, George E.; Gooley, Theodore A.; Holmberg, Leona A.; LeMaistre, C. Fred; Ryan, Kate; Openshaw, Harry; Sunderhaus, Julie; Storb, Rainer; Zunt, Joseph; Kraft, George H.

    2010-01-01

    There were 26 patients enrolled in a pilot study of high-dose immunosuppressive therapy (HDIT) for severe multiple sclerosis (MS). Median baseline expanded disability status scale (EDSS) was 7.0 (range, 5.0–8.0). HDIT consisted of total body irradiation, cyclophosphamide, and antithymocyte globulin (ATG) and was followed by transplantation of autologous, granulocyte colony-stimulating factor (G-CSF)-mobilized CD34-selected stem cells. Regimen-related toxicities were mild. Because of bladder dysfunction, there were 8 infectious events of the lower urinary tract. One patient died from Epstein-Barr virus (ESV)-related posttransplantation lymphoproliferative disorder (PTLD) associated with a change from horse-derived to rabbit-derived ATG in the HDIT regimen. An engraftment syndrome characterized by noninfectious fever with or without rash developed in 13 of the first 18 patients and was associated in some cases with transient worsening of neurologic symptoms. There were 2 significant adverse neurologic events that occurred, including a flare of MS during mobilization and an episode of irreversible neurologic deterioration after HDIT associated with fever. With a median follow-up of 24 (range, 3–36) months, the Kaplan-Meier estimate of progression (≥ 1.0 point EDSS) at 3 years was 27%. Of 12 patients who had oligoclonal bands in the cerebrospinal fluid at baseline, 9 had persistence after HDIT. After HDIT, 4 patients developed new enhancing lesions on magnetic resonance imaging of the brain. The estimate of survival at 3 years was 91%. Important clinical issues in the use of HDIT and stem cell transplantation for MS were identified; however, modifications of the initial approaches appear to reduce treatment risks. This was a heterogeneous high-risk group, and a phase 3 study is planned to fully assess efficacy. PMID:12763935

  1. A 3-year dataset of sensible and latent heat fluxes from the Tibetan Plateau, derived using eddy covariance measurements

    NASA Astrophysics Data System (ADS)

    Li, Maoshan; Babel, Wolfgang; Chen, Xuelong; Zhang, Lang; Sun, Fanglin; Wang, Binbin; Ma, Yaoming; Hu, Zeyong; Foken, Thomas

    2015-11-01

    The Tibetan Plateau (TP) has become a focus of strong scientific interest due to its role in the global water cycle and its reaction to climate change. Regional flux estimates of sensible and latent heat are important variables for linking the energy and hydrological cycles at the TP's surface. Within this framework, a 3-year dataset (2008-2010) of eddy covariance measured turbulent fluxes was compiled from four stations on the TP into a standardised workflow: corrections and quality tests were applied using an internationally comparable software package. Second, the energy balance closure ( C EB) was determined and two different closure corrections applied. The four stations (Qomolangma, Linzhi, NamCo and Nagqu) represent different locations and typical land surface types on the TP (high altitude alpine steppe with sparse vegetation, a densely vegetated alpine meadow, and bare soil/gravel, respectively). We show that the C EB differs between each surface and undergoes seasonal changes. Typical differences in the turbulent energy fluxes occur between the stations at Qomolangma, Linzhi and NamCo, while Nagqu is quite similar to NamCo. Specific investigation of the pre-monsoon, the Tibetan Plateau summer monsoon, post-monsoon and winter periods within the annual cycle reinforces these findings. The energy flux of the four sites is clearly influenced by the Tibetan Plateau monsoon. In the pre-monsoon period, sensible heat flux is the major energy source delivering heat to the atmosphere, whereas latent heat flux is greater than sensible heat flux during the monsoon season. Other factors affecting surface energy flux are topography and location. Land cover type also affects surface energy flux. The energy balance residuum indicates a typically observed overall non-closure in winter, while closure (or `turbulent over-closure') is achieved during the Tibetan Plateau summer monsoon at the Nagqu site. The latter seems to depend on ground heat flux, which is higher in the

  2. Weight change and incident metabolic syndrome in Iranian men and women; a 3 year follow-up study

    PubMed Central

    Zabetian, Azadeh; Hadaegh, Farzad; Sarbakhsh, Parvin; Azizi, Fereidoun

    2009-01-01

    Background Although the association of weight gain and developing metabolic syndrome (MetS) has been reported in the Western and Asian populations, data on the gender-stratified effects of weight change (including weight loss) on incident MetS and its components in the Middle East Caucasians is still scarce. Methods A total of 1431 men and 2036 women aged ≥ 20 years with BMI > 18.5 kg/m2 were followed over 3 years. Multivariate logistic regression analysis was used to estimate the relative risk (RR) of MetS and its components (the Adult Treatment Panel III definition) associated with gender-stratified quintiles of percent weight change. Subjects with MetS at baseline were excluded for analyzing the RR of MetS. Results There was 20.4% (95% CI, 19.6–21.2) age-adjusted incident MetS (18.4% male vs. 23.1% women). In men, mild weight gain (WG) predicted high waist circumference (WC) and high triglyceride; moderate WG predicted MetS (RR 2.5, 95% CI 1.4–4.3), high WC and high blood pressure (BP); large WG predicted MetS (RR 3.2, 95% CI 1.8–5.7) and its components, except for high fasting plasma glucose. In women, mild WG predicted MetS (RR 2.5, 95% CI 1.4–4.3), high WC and high BP; moderate WG predicted Mets (RR 4.6, 95% CI 2.7–8.0), high WC and high triglyceride; large WG predicted MetS (RR 6.6, 95% CI 3.8–11.3) and its components except for low HDL-cholesterol. Mild weight loss had protective effect on high WC in both genders and MetS in men (RR 0.5, 95% CI 0.26–0.97, P = 0.04). Conclusion Weight change showed different effects on MetS in men and women. In women, mild WG predicted MetS; however, mild weight loss was protective against MetS in men and high WC in both genders. PMID:19435528

  3. Sticking out and fitting in: culture-specific predictors of 3-year-olds' autobiographical memories during joint reminiscing.

    PubMed

    Schröder, Lisa; Kärtner, Joscha; Keller, Heidi; Chaudhary, Nandita

    2012-12-01

    The present study investigates the relationship between mother-child interaction styles with 19 months and children's autobiographical memory with 3 years of age in two cultural contexts: New Delhi, India (n = 25) and Berlin, Germany (n = 33). Results demonstrate similarities as well as culture specificities. In both contexts, maternal elaborations during reminiscing were related to children's memory contributions. Over time, maternal support for toddlers' self-expression during free play at 19 months predicted their children's memory elaborations at 3 years in the Berlin context. In the Delhi context, toddlers' willingness to carry out their mothers' requests at 19 months predicted their memory elaborations at 3 years. These results suggest different motivational bases underlying children's autobiographical memory contributions during mother-child reminiscing related to different cultural orientations.

  4. Association of Perioperative Plasma Neutrophil Gelatinase-Associated Lipocalin Levels with 3-Year Mortality after Cardiac Surgery: A Prospective Observational Cohort Study

    PubMed Central

    Moledina, Dennis G.; Parikh, Chirag R.; Garg, Amit X.; Thiessen-Philbrook, Heather; Koyner, Jay L.; Patel, Uptal D.; Devarajan, Prasad; Shlipak, Michael G.; Coca, Steven G.

    2015-01-01

    Background Higher levels of plasma neutrophil gelatinase-associated lipocalin (pNGAL) are an early marker of acute kidney injury and are associated with increased risk of short-term adverse outcomes. The independent association between pNGAL and long-term mortality is unknown. Methods In this prospective observational cohort study, we studied 1191 adults who underwent cardiac surgery between 2007 and 2009 at 6 centers in the TRIBE-AKI cohort. We measured the pNGAL on the pre-operative and first 3 post-operative days and assessed the relationship of peri-operative pNGAL concentrations with all-cause mortality. Results During a median follow-up of 3.0 years, 139 participants died (50/1000 person-years). Pre-operative levels of pNGAL were associated with 3-year mortality (unadjusted HR 1.96, 95% CI 1.34,2.85) and the association persisted after adjustment for pre-operative variables including estimated glomerular filtration rate (adjusted HR 1.48, 95% CI 1.04–2.12). After adjustment for pre- and intra-operative variables, including pre-operative NGAL levels, the highest tertiles of first post-operative and peak post-operative pNGAL were also independently associated with 3-year mortality risk (adjusted HR 1.31, 95% CI 1.0–1.7 and adjusted HR 1.78, 95% CI 1.2–2.7, respectively). However, after adjustment for peri-operative changes in serum creatinine, there was no longer an independent association between the first post-operative and peak post-operative pNGAL and long-term mortality (adjusted HR 0.98,95% CI 0.79–1.2 for first pNGAL and adjusted HR 1.19, 95% CI 0.87–1.61 for peak pNGAL). Conclusions Pre-operative pNGAL levels were independently associated with 3-year mortality after cardiac surgery. While post-operative pNGAL levels were also associated with 3-year mortality, this relationship was not independent of changes in serum creatinine. These findings suggest that while pre-operative pNGAL adds prognostic value for mortality beyond routinely available

  5. A 3-year study of high-cost users of health care

    PubMed Central

    Wodchis, Walter P.; Austin, Peter C.; Henry, David A.

    2016-01-01

    Background: Characterizing high-cost users of health care resources is essential for the development of appropriate interventions to improve the management of these patients. We sought to determine the concentration of health care spending, characterize demographic characteristics and clinical diagnoses of high-cost users and examine the consistency of their health care consumption over time. Methods: We conducted a retrospective analysis of all residents of Ontario, Canada, who were eligible for publicly funded health care between 2009 and 2011. We estimated the total attributable government health care spending for every individual in all health care sectors. Results: More than $30 billion in annual health expenditures, representing 75% of total government health care spending, was attributed to individual costs. One-third of high-cost users (individuals with the highest 5% of costs) in 2009 remained in this category in the subsequent 2 years. Most spending among high-cost users was for institutional care, in contrast to lower-cost users, among whom spending was predominantly for ambulatory care services. Costs were far more concentrated among children than among older adults. The most common reasons for hospital admissions among high-cost users were chronic diseases, infections, acute events and palliative care. Interpretation: Although high health care costs were concentrated in a small minority of the population, these related to a diverse set of patient health care needs and were incurred in a wide array of health care settings. Improving the sustainability of the health care system through better management of high-cost users will require different tactics for different high-cost populations. PMID:26755672

  6. Systemic Reactions to Dust Mite Subcutaneous Immunotherapy: A 3-Year Follow-up Study

    PubMed Central

    Dong, Xiang; Huang, Nan; Li, Wenjing; Hu, Lintao; Wang, Xiaolong; Wang, Yin; Xiang, Ning; Liu, Guanghui

    2016-01-01

    Purpose The incidence of allergen specific immunotherapy-related systemic reactions (SRs) varies among different studies, and many factors are likely to contribute to SRs. This study aims to investigate the incidence, characteristics, and risk factors of SRs to standardize dust mite-specific subcutaneous immunotherapy (SCIT) in Central China. Methods All patients receiving standardized dust mites (100-100,000 SQ-U/mL; Alutard SQ, Hørsholn, Denmark) immunotherapy were followed up. Recorded data included demographics, diagnosis, patient status, pulmonary function testing results before and after each injection, allergen dosage, and details of SRs. Results From June 2011 to August 2014, a total of 208 patients received 4,369 injections; 27 (13.0%) patients experienced 48 (1.1%) systemic reactions. Most of the SRs were grade 2 reactions (n=30, 62.5%), followed by grade 1 (n=11, 22.9%), grade 3 (n=7, 14.6%), and no fatal reactions occurred. Forty-six SRs (95.8%) occurred within 30 minutes. Higher SR rates were associated with high concentration extracts (100,000 SQ-U/mL), injections with concomitant local reactions (LRs), children, asthma and high sensitivity (skin prick test 3+/4+ and/or sIgE≥17.5 kUA/L) (P<0.05). The estimated odds of SRs increased in children (OR=6.57; 95% CI: 1.88-22.97, P=0.003), asthmatic patients (OR=4.10; 95% CI: 1.72-9.80, P=0.002), and injections with LRs (OR=2.41; 95% CI: 1.33-4.36, P=0.004). Conclusions The incidence of SRs to dust mite SCIT was low, and multiple factors were associated with the increased incidence of SRs. Children, asthmatics and patients with concomitant LR may be prone to develop SRs. PMID:27334780

  7. Determinants of Imitation of Hand-to-Body Gestures in 2- and 3-Year-Old Children

    ERIC Educational Resources Information Center

    Erjavec, Mihela; Horne, Pauline J.

    2008-01-01

    Twenty children, ten 2-year-olds and ten 3-year-olds, participated in an AB procedure. In the baseline phase, each child was trained the same four matching relations to criterion under intermittent reinforcement. During the subsequent imitation test, the experimenter modeled a total of 20 target gestures (six trials each) interspersed with…

  8. Poorly differentiated cutaneous carcinoma of non-sebaceous origin in a 3-year-old Mongolian gerbil (Meriones unguiculatus)

    PubMed Central

    Fenton, Heather; Forzán, María J.; Desmarchelier, Marion; Woodland, Meghan; Sayi, Soraya; Gilroy, Cornelia V.

    2016-01-01

    A 3-year-old female gerbil developed a non-healing skin wound due to a malignant neoplasm. Histology, immunohistochemistry (cytokeratin 19 positive; vimentin, estrogen, and progesterone receptor negative), and electron microscopy (no desmosomes or melanosomes) revealed an undifferentiated carcinoma with pulmonary metastasis. Unlike in previous reports, it did not arise from the abdominal pad’s sebaceous gland. PMID:26740704

  9. Aligning Teaching to Learning: A 3-Year Study Examining the Embedding of Language and Argumentation into Elementary Science Classrooms

    ERIC Educational Resources Information Center

    Hand, Brian; Norton-Meier, Lori A.; Gunel, Murat; Akkus, Recai

    2016-01-01

    How can classrooms become communities of inquiry that connect intellectually challenging science content with language-based activities (opportunities to talk, listen, read, and write) especially in settings with diverse populations? This question guided a 3-year mixed-methods research study using the Science Writing Heuristic (SWH) approach in…

  10. Preventing Adolescent Drug Abuse through a Multimodal Cognitive-Behavioral Approach: Results of a 3-Year Study.

    ERIC Educational Resources Information Center

    Botvin, Gilbert J.; And Others

    1990-01-01

    Students (N=4,466) in 56 schools participated in 3-year study on effectiveness of cognitive-behavioral approach to substance abuse prevention. Students who received at least 60 percent of prevention program (N=3,684) were included in analyses of program effectiveness. Significant prevention effects were found for cigarette smoking, marijuana use,…

  11. Cryoplasty Versus Conventional Angioplasty in Femoropopliteal Arterial Recanalization: 3-Year Analysis of Reintervention-Free Survival by Treatment Received

    SciTech Connect

    Diaz, Maria Lourdes; Urtasun, Fermin Barberena, Javier; Aranzadi, Carlos; Guillen-Grima, Francisco; Bilbao, Jose Ignacio

    2011-10-15

    Purpose: To compare long-term efficacy of cryoplasty therapy versus conventional angioplasty in the treatment of peripheral arterial atherosclerotic stenosis on the basis of our 3-year clinical experience. Materials and Methods: From January 2006 to December 2008, a total of 155 patients with 192 lesions of the femoropopliteal sector were randomized to receive either cryoplasty or conventional balloon angioplasty. The primary study end point was lesion target patency. Follow-up with clinical evaluation of patient's symptoms, ankle-brachial index, and Doppler ultrasound was scheduled at 1, 6, 9, 12, 24, and 36 months. Results: For the cryoplasty group (n = 86), technical immediate success was achieved in 74.4% of lesions. Rate of significant dissection was 13.5% and rate of stent placement of 22%. In the long term, target lesion patency rate at 6 months was 59.4%, with rates of 55.9, 52.6, and 49.1% at 1, 2, and 3 years, respectively. For the conventional angioplasty group (n = 69), the immediate technical success rate was 83.7%. Rate of significant dissection was 19%, and rate of stent placement was 72.9%. Patency rates at 6 months and at 1, 2, and 3 years were 71.5, 61.2, 60, and 56%, respectively. Conclusion: Compared with conventional angioplasty, cryoplasty showed good immediate success rates with lower stent placement rates. During the 3-year follow-up, patency rates tended to equalize between the two modalities.

  12. Results of a 3-Year, Nutrition and Physical Activity Intervention for Children in Rural, Low-Socioeconomic Status Elementary Schools

    ERIC Educational Resources Information Center

    King, Kristi McClary; Ling, Jiying

    2015-01-01

    Improving children's nutrition and physical activity have become priorities in the United States. This quasi-experimental study evaluated the longitudinal effects of a 3-year, school-based, health promotion intervention (i.e. nutrition and physical education, classroom physical activity, professional development and health promotion for teachers…

  13. 1 to 3-Year-Old Children in Day Care Centres in Finland: An Overview of Eight Doctoral Dissertations

    ERIC Educational Resources Information Center

    Hannikainen, Maritta

    2010-01-01

    This article gives a general picture of the policy and main structural features of early childhood education services for the younger children in Finland. It also provides an overview of the research on 1 to 3-year-old children in day care centres carried out in Finland during the last 15 years, the focus being on a review of all the eight…

  14. Impacts of a Violence Prevention Program for Middle Schools: Findings after 3 Years of Implementation. NCEE 2011-4017

    ERIC Educational Resources Information Center

    Silvia, Suyapa; Blitstein, Jonathan; Williams, Jason; Ringwalt, Chris; Dusenbury, Linda; Hansen, William

    2011-01-01

    This is the second and final report summarizing findings from an impact evaluation of a violence prevention intervention for middle schools. This report provides findings from the second and third years of the 3-year intervention. The U.S. Department of Education (ED) contracted with RTI International and its subcontractors, Pacific Institute for…

  15. The Magic Shrinking Machine Revisited: The Presence of Props at Recall Facilitates Memory in 3-Year-Olds

    ERIC Educational Resources Information Center

    Dahl, Jonna J.; Kingo, Osman S.; Krøjgaard, Peter

    2015-01-01

    In a seminal study Simcock and Hayne (2002) showed that 3-year-olds were unable to use newly acquired words to describe a "magic" event experienced 6 or 12 months earlier. In the reference study the children's verbal recall was tested without props being present. Inspired by recent evidence, the original design was replicated, testing…

  16. Eudaimonic growth: Narrative growth goals predict increases in ego development and subjective well-being 3 years later.

    PubMed

    Bauer, Jack J; McAdams, Dan P

    2010-07-01

    We examine (a) the normative course of eudaimonic well-being in emerging adulthood and (b) whether people's narratives of major life goals might prospectively predict eudaimonic growth 3 years later. We define eudaimonic growth as longitudinal increases in eudaimonic well-being, which we define as the combination of psychosocial maturity and subjective well-being (SWB). College freshmen and seniors took measures of ego development (ED; to assess maturity; Loevinger, 1976) and SWB at Time 1 (T1) and again 3 years later (Time 2). ED levels increased longitudinally across that time for men and T1 freshmen, but SWB levels did not change. Participants also wrote narratives of 2 major life goals at T1 that were coded for an explicit emphasis on specific kinds of personal growth. Participants' intellectual-growth goals (especially agentic ones) predicted increases in ED 3 years later, whereas participants' socioemotional-growth goals (especially communal ones) predicted increases in SWB 3 years later. These findings were independent of the effects of Big Five personality traits-notably conscientiousness, which on its own predicted increases in SWB. We discuss (a) emerging adulthood as the last stop for normative eudaimonic growth in modern society and (b) empirical and theoretical issues surrounding the relations among narrative identity, life planning, dispositional traits, eudaimonia, and 2 paths of personal growth.

  17. Rational Action Selection in 1 1/2- to 3-Year-Olds Following an Extended Training Experience

    ERIC Educational Resources Information Center

    Klossek, Ulrike M. H.; Dickinson, Anthony

    2012-01-01

    Previous studies failed to find evidence for rational action selection in children under 2 years of age. The current study investigated whether younger children required more training to encode the relevant causal relationships. Children between 1 1/2 and 3 years of age were trained over two sessions to perform actions on a touch-sensitive screen…

  18. The Lights Pre-Project: Implementation of the Project Approach with Children under 3 Years of Age

    ERIC Educational Resources Information Center

    Grzegorzewska, Katarzyna; Konieczna-Blicharz, Jagoda

    2011-01-01

    A group of children 18 months to 3 years old and their parents studied lights in a preschool program at the Astrid Lindgren Institute for Early Childhood Development in Poland. The goal of the preschool program is to help children gain positive social experience through safe and interesting contact with a new group of children and adults in the…

  19. Effectiveness of Video Self-Modeling to Promote Social Initiations by 3-Year-Olds with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Buggey, Tom

    2012-01-01

    Video Self-Modeling (VSM) provides individuals the opportunity to view themselves performing a task beyond their present functioning level through the careful editing of videos. In this study, a single-case multiple-baseline design was used to determine whether VSM would facilitate social initiations across three young children (M = 3 years 10…

  20. "No Shoes; They Walked Away?": Effects of Enhancements on Learning and Using Blissymbols by Normal 3-Year-Old Children.

    ERIC Educational Resources Information Center

    Raghavendra, Parimala; Fristoe, Macalyne

    1995-01-01

    Forty 3-year-olds learned either 12 standard Blissymbols (SBS) or their enhanced forms (EBS). Results demonstrated that the subjects learned EBS faster than SBS, remembered more EBS than SBS, did not differ in the communicative use of SBS and EBS, and were affected more negatively when presented with the untrained SBS than EBS. (Author/JDD)

  1. Combined Individual Cognitive Behavior Therapy and Parent Training for Childhood Depression: 2- to 3-Year Follow-up

    ERIC Educational Resources Information Center

    Eckshtain, Dikla; Gaynor, Scott T.

    2013-01-01

    Fourteen children with significant depressive symptoms from an open clinical trial of Primary and Secondary Control Enhancement Training augmented with Caregiver-Child Relationship Enhancement Training, participated in a 2- to 3-year follow-up assessment. The results suggested that the significant decreases in depressive symptoms observed at…

  2. Intergenerational Transmission of Warm-Sensitive-Stimulating Parenting: A Prospective Study of Mothers and Fathers of 3-Year-Olds

    ERIC Educational Resources Information Center

    Belsky, Jay; Jaffee, Sara R.; Sligo, Judith; Woodward, Lianne; Silva, Phil A.

    2005-01-01

    More than 200 New Zealand men and women studied repeatedly since age 3 were videotaped interacting with their own 3-year-old children to determine (a) whether childrearing and family climate experienced in 3 distinct developmental periods while growing up (i.e., early childhood, middle childhood, early adolescence) predicted parenting and (b)…

  3. Mothers and Fathers Teaching 3-Year-Olds: Authoritative Parenting and Adult Scaffolding of Young Children's Learning.

    ERIC Educational Resources Information Center

    Pratt, Michael W.; And Others

    1988-01-01

    Data from 24 mothers and fathers who worked separately with their 3-year-old children on difficult block construction, matrix classification, and story retelling tasks were consistent with the hypothesis that authoritative parents may obtain some of their reported success in cognitive skill socialization by using a tutoring style that is more…

  4. Emotion Situation Knowledge and Autobiographical Memory in Chinese, Immigrant Chinese, and European American 3-Year-Olds

    ERIC Educational Resources Information Center

    Wang, Qi; Hutt, Rachel; Kulkofsky, Sarah; McDermott, Melissa; Wei, Ruohong

    2006-01-01

    This study examined the influence of children's emotion situation knowledge (EK) on their autobiographical memory ability at both group and individual levels. Native Chinese, Chinese immigrant, and European American 3-year-old children participated (N = 189). During a home visit, children recounted 2 personal memories of recent, 1-time events with…

  5. Phonological Whole-Word Measures in 3-Year-Old Bilingual Children and Their Age-Matched Monolingual Peers

    ERIC Educational Resources Information Center

    Bunta, Ferenc; Fabiano-Smith, Leah; Goldstein, Brian; Ingram, David

    2009-01-01

    The present study investigated phonological whole-word measures and consonant accuracy in bilingual and monolingual children to investigate how target approximations drive phonological acquisition. The study included eight bilingual Spanish- and English-speaking 3-year-olds and their monolingual peers (eight Spanish and eight American English).…

  6. "This Way!", "No! That Way!"--3-Year Olds Know that Two People Can Have Mutually Incompatible Desires

    ERIC Educational Resources Information Center

    Rakoczy, Hannes; Warneken, Felix; Tomasello, Michael

    2007-01-01

    In theory of mind research, there is a long standing dispute about whether children come to understand the subjectivity of both desires and beliefs at the same time (around age 4), or whether there is an asymmetry such that desires are understood earlier. To address this issue, 3-year olds' understanding of situations in which two persons have…

  7. The First Year Inventory: A Longitudinal Follow-Up of 12-Month-Old to 3-Year-Old Children

    ERIC Educational Resources Information Center

    Turner-Brown, Lauren M.; Baranek, Grace T.; Reznick, J Steven; Watson, Linda R.; Crais, Elizabeth R.

    2013-01-01

    The First Year Inventory is a parent-report measure designed to identify 12-month-old infants at risk for autism spectrum disorder. First Year Inventory taps behaviors that indicate risk in the developmental domains of sensory--regulatory and social--communication functioning. This longitudinal study is a follow-up of 699 children at 3 years of…

  8. "A Spinach with a V on It": What 3-Year-Olds See in Standard and Enhanced Blissymbols.

    ERIC Educational Resources Information Center

    Raghavendra, Parimala; Fristoe, Macalyne

    1990-01-01

    Standard or enhanced Blissymbols, designed to represent familiar actions, attributes, and objects, were shown to 20 3 year olds, who guessed their meaning. The number of their guesses that referred to the enhancements was twice as great as the number that referred to the standard Blissymbol base. (Author/JDD)

  9. Sustaining "Truth": Changes in Youth Tobacco Attitudes and Smoking Intentions after 3 Years of a National Antismoking Campaign

    ERIC Educational Resources Information Center

    Farrelly, Matthew C.; Davis, Kevin C.; Duke, Jennifer; Messeri, Peter

    2009-01-01

    This study examines how the American Legacy Foundation's "truth[R]" campaign and Philip Morris's "Think. Don't Smoke" (TDS) campaign have influenced youth's tobacco-related attitudes, beliefs and intentions during the first 3 years of the truth campaign. We use data from eight nationally representative cross-sectional telephone surveys of 35,074…

  10. Eudaimonic Growth: Narrative Growth Goals Predict Increases in Ego Development and Subjective Well-Being 3 Years Later

    ERIC Educational Resources Information Center

    Bauer, Jack J.; McAdams, Dan P.

    2010-01-01

    We examine (a) the normative course of eudaimonic well-being in emerging adulthood and (b) whether people's narratives of major life goals might prospectively predict eudaimonic growth 3 years later. We define eudaimonic growth as longitudinal increases in eudaimonic well-being, which we define as the combination of psychosocial maturity and…

  11. Qualitative Feasibility of Using Three Accelerometers With 2-3-Year-Old Children and Both Parents

    ERIC Educational Resources Information Center

    Costa, Silvia; Barber, Sally E.; Griffiths, Paula L.; Cameron, Noël; Clemes, Stacy A.

    2013-01-01

    Purpose: This study assessed mothers' opinions about the feasibility and acceptability of using the ActiGraph GT3X+, Actiheart, and activPAL3 with their 2- to 3-year-old children, as well as with themselves and their husbands/partners, for an 8-day period. Method: Six focus groups were run with Pakistani and White British mothers…

  12. The Internal Validity and Acceptability of the Danish SI-3: A Language-Screening Instrument for 3-Year-Olds

    ERIC Educational Resources Information Center

    Bleses, Dorthe; Vach, Werner; Jorgensen, Rune N.; Worm, Torben

    2010-01-01

    Purpose: To document the development of a new parent- and day care-administered screening instrument (the Screening Instrument for 3-Year-Olds [SI-3]) to be used in a newly implemented, educationally motivated population language screening in Denmark. The authors investigated whether the basic principles of the SI-3 were working satisfactorily and…

  13. Professional Learning Communities in Partnership: A 3-Year Journey of Action and Advocacy to Bridge the Achievement Gap

    ERIC Educational Resources Information Center

    Hoffman, Patricia; Dahlman, Anne; Zierdt, Ginger

    2009-01-01

    This article details a strategic planning model and concurrent 3-year research study focusing on the benefits of preK-16 professional development school learning communities for the participating preK-16 educational leaders in a midwestern school-university partnership network. Results of the study, along with the strategic plan's success at…

  14. Paclitaxel-Based Chemoradiotherapy in the Treatment of Patients With Operable Esophageal Cancer

    SciTech Connect

    Kelsey, Chris R. Chino, Junzo P.; Willett, Christopher G.; Clough, Robert W.; Hurwitz, Herbert I.; Morse, Michael A.; Bendell, Johanna C.; D'Amico, Thomas A.; Czito, Brian G.

    2007-11-01

    Purpose: To compare a neoadjuvant regimen of cisplatin/5-fluorouracil (5-FU) and concurrent radiation therapy (RT) with paclitaxel-based regimens and RT in the management of operable esophageal (EC)/gastroesophageal junction (GEJ) cancer. Methods and Materials: All patients receiving neoadjuvant chemotherapy (CT) and RT for EC/GEJ cancer at Duke University between January 1995 and December 2004 were included. Clinical end points were compared for patients receiving paclitaxel-based regimens (TAX) vs. alternative regimens (non-TAX). Local control (LC), disease-free survival (DFS), and overall survival (OS) were estimated using the Kaplan-Meier method. Chi-square analysis was performed to test the effect of TAX on pathologic complete response (pCR) rates and toxicity. Results: A total of 109 patients received CT-RT followed by esophagectomy (95 M; 14 F). Median RT dose was 45 Gy (range, 36-66 Gy). The TAX and non-TAX groups comprised 47% and 53% of patients, respectively. Most (83%) TAX patients received three drug regimens including platinum and a fluoropyrimidine. In the non-TAX group, 89% of the patients received cisplatin and 5-FU. The remainder received 5-FU or capecitabine alone. Grade 3-4 toxicity occurred in 41% of patients receiving TAX vs. 24% of those receiving non-TAX (p = 0.19). Overall pCR rate was 39% (39% with TAX vs. 40% with non-TAX, p = 0.9). Overall LC, DFS, and OS at 3 years were 80%, 34%, and 37%, respectively. At 3 years, there were no differences in LC (75% vs. 85%, p = 0.33) or OS (37% vs. 37%, p = 0.32) between TAX and non-TAX groups. Conclusions: In this large experience, paclitaxel-containing regimens did not improve pCR rates or clinical end points compared to non-paclitaxel-containing regimens.

  15. Modular stem fixed-bearing total ankle replacement: prospective results of 23 consecutive cases with 3-year follow-up.

    PubMed

    Brigido, Stephen A; Galli, Melissa M; Bleazey, Scott T; Protzman, Nicole M

    2014-01-01

    In the present report, the 3-year outcomes of 23 consecutive patients treated with a modular stem fixed-bearing total ankle replacement are described. Pain, functional impairment, and disability were assessed annually using a visual analog scale. Complications and additional procedures also were recorded. Compared with preoperative pain (8.4 ± 1.4), functional impairment (8.7 ± 2.3), and disability (3.0 ± 2.5), there were statistically significant postoperative improvements at 1 year (pain, 2.6 ± 1.6; functional impairment, 3.1 ± 2.1; disability, 0.9 ± 1.2), 2 years (pain, 1.5 ± 1.3; functional impairment, 1.9 ± 1.4; disability, 0.6 ± 1.4), and 3 years (pain, 1.3 ± 1.3; functional impairment, 1.9 ± 1.9; disability, 0.4 ± 0.9; p ≤ .001). Pain, function, and disability significantly improved postoperatively from 1 to 2 years (p ≤ .008) and from 1 to 3 years (p ≤ .008). The reductions in pain, functional impairment, and disability were maintained from 2 to 3 years (p ≥ .08). Nine complications (39.1%) were encountered: 1 deep infection, 2 pulmonary embolisms, 3 wounds, 1 ectopic bone formation, 1 stiff joint, and 1 talar subsidence. In the 3-year follow-up period, 3 patients (13.0%) required additional procedures after the immediate postoperative phase. Our results have demonstrated that modular stem fixed-bearing prostheses can be implanted in a predictable and consistent fashion with resultant improvements in pain, function, and disability. Future studies evaluating the clinical outcomes after modular stem fixed-bearing total ankle replacement are warranted.

  16. Comparison of two all-in-one adhesives bonded to non-carious cervical lesions--results at 3 years.

    PubMed

    Burrow, Michael F; Tyas, Martin J

    2012-08-01

    The aim of this study was to evaluate the clinical performance of S(3) Bond (Kuraray Corp., Japan) and G-Bond (GC Corp., Japan) all-in-one bonding agents, over 3 years in non-carious cervical lesions (NCCLs). Ethics Committee approval was obtained, and 60 restorations were placed in 11 patients aged 45-84 years (mean 60.5 years), using either Clearfil ST resin composite (Kuraray) and S(3) Bond or Gradia resin composite (GC) and G-Bond alternately, without phosphoric acid etch on the uncut enamel margins. Patients were recalled at 6 months, 1 year, 2 years and 3 years, and photographs were taken for assessment of colour match and marginal discoloration. One patient was not available at 3 years, resulting in 54 restorations being available for evaluation. One restoration of S(3)/Clearfil ST was lost at 2 years, giving retention rates of 97% for S(3) and 100% for G-Bond. At 3 years, six restorations for S(3)/Clearfil ST showed slight marginal discoloration and one restoration pronounced marginal staining. For G-Bond/Gradia at 3 years, 11 restorations exhibited slight marginal staining and one restoration pronounced marginal staining. Most restorations were bonded to sclerotic dentin. Statistical analysis of marginal staining showed no significant difference between the two restoration groups. The degree of marginal staining was almost identical for both materials and tended to be in larger restorations. Both S(3) and G-Bond all-in-one bonding systems appear to be good adhesives for the restoration of NCCL for the length of the current study. Restoration of NCCLs with the newer all-in-one adhesives appears to be a viable alternative technique to more complicated adhesive materials. PMID:21789590

  17. The macrofaunal communities in the shallow subtidal areas for the first 3 years after the Hebei Spirit oil spill.

    PubMed

    Seo, Jin-Young; Kim, Moonkoo; Lim, Hyun-Sig; Choi, Jin-Woo

    2014-05-15

    In order to detect the early impact of the Hebei Spirit oil spill on the shallow subtidal macrozoobenthic communities, macrobenthic fauna were collected seasonally for 3 years. The alkylated PAHs concentrations within sediments near Mallipo beach remained as high as 129 ng g(-)(1) DW one month after the oil spill, but the concentration decreased below the background level thereafter. The number of species and density decreased in 4 months compared to those before the oil spill. An opportunistic polychaete, Prionospio paradisea, occurred as a dominant species at subtidal area near Mallipo beach in 10 months after the oil spill. Any mass mortality of amphipods and any clear dominance of opportunistic species were not detected except for the stations near Mallipo and Hagampo beaches. The macrobenthic communities at the shallow subtidal stations seemed to have a relatively stable faunal composition, even not fully recovered, in 3 years after the Hebei Spirit oil spill.

  18. Change in messa di voce characteristics during 3 years of classical singing training at the tertiary level.

    PubMed

    Ferguson, Sam; Kenny, Dianna T; Mitchell, Helen F; Ryan, Maree; Cabrera, Densil

    2013-07-01

    A 3-year longitudinal study was conducted to investigate changes in vocal quality as a result of singing training at a tertiary level conservatorium in Australia. Singers performed a messa di voce (MDV) at intervals of 6 months over the 3-year period of training. The study investigated the evolving acoustic features of the singers' voices exhibited during the MDV, including sound pressure level (SPL), short-term energy ratio (STER), duration, and vibrato parameters of the fundamental frequency (F0), SPL, and STER. The maximum SPL exhibited a marginal systematic increase over the training period, but the maximum STER did not systematically change. F0 vibrato extent increased significantly, whereas the extent of SPL and STER vibrato did not change significantly. PMID:23769004

  19. The 3-Year Clinical and Functional Course of Schizophrenia Among Individuals With and Without Diabetes at Study Entry

    PubMed Central

    Ascher-Svanum, Haya; Zhu, Baojin; Ernst, Frank R.; Faries, Douglas E.; Jacobson, Jennie G.; Doebbeling, Caroline C.

    2007-01-01

    Objective: This prospective observational study compared the 3-year clinical and functional course of schizophrenia among individuals with and without diabetes at study entry. Method: Data were drawn from a large, 3-year, multisite, prospective, naturalistic study of treatment for schizophrenia-related disorders. The study was conducted in the United States between July 1997 and September 2003 and represented treatment practices in diverse systems of care. Participants were diagnosed with schizophrenia or schizoaffective or schizophreniform disorders based on DSM-IV criteria. Clinical and functional outcomes were assessed at study enrollment and at 12-month intervals using standard psychiatric measures, medical records, and a validated patient-reported questionnaire. Diabetes status was determined by participant interview at enrollment. Statistical analyses used mixed models with repeated measures. Results: Of 594 participants queried about comorbid medical conditions at enrollment, 76 (12.8%) reported having diabetes. Other comor-bid conditions were reported by 79% of the diabetes group (N = 60) and 50% of the nondiabetes group (N = 259). Across the 3-year study, participants with diabetes differed significantly from participants without diabetes on 2 of 36 outcome measures: more contacts with nonpsychiatrist physicians (p < .001) and poorer physical health (p = .015). Groups did not differ significantly on mental health symptomatology, mental health resource utilization, legal and safety issues, substance use, productivity, activities and relationships, or quality of life. Conclusions: In this 3-year, prospective, naturalistic study, the course of schizophrenia did not differ significantly between participants with and without diabetes, although persons with diabetes did have poorer physical health and more contacts with nonpsychiatrist physicians. Findings highlight the need for better medical treatment for people with schizophrenia, both with and without

  20. Increasing Fruit, Vegetable and Water Consumption in Summer Day Camps-3-Year Findings of the Healthy Lunchbox Challenge

    ERIC Educational Resources Information Center

    Beets, Michael W.; Tilley, Falon; Weaver, Robert G.; Turner-McGrievy, Gabrielle M.; Moore, Justin B.

    2014-01-01

    The objective of this study was to describe the 3-year outcomes (2011-2013) from the healthy lunchbox challenge (HLC) delivered in the US-based summer day camps (SDC) (8-10 hours day-1, 10-11 weeks summer-1, SDC) to increase children and staff bringing fruit, vegetables and water (FVW) each day. A single group pre- with multiple post-test design…

  1. [Oncologucal results after surgical and radio-surgical treatment in patients with cervical cancer stage Ib1].

    PubMed

    Ismail, E; Kornovski, Y; Ivanov, S; Kovachev, E; Slavchev, S; Tzonev, A

    2013-01-01

    One hundred thirty two patients with cervical cancer stage IB1 were evaluated for desease free (DFS) and overall survival (OS). All women were submitted to surgery-radical hysterectomy class III and pelvic and/or paraaortic lymph node dissection. Ninety three women were irradiated after surgery-telegamma therapy (TGT) 50-52 Gy. After median period of follow-up 44 months (from 1 to 114) OS and DFS were estimated using Kaplan-Meier method. Five-year OS and DFS were 83% and 82%, respectively. PMID:24294743

  2. Triage in opioid replacement therapy: what's the wait?

    PubMed

    Harlow, Warren; Happell, Brenda Mary; Browne, Graeme; Choudhury, Jahar; Pinchin, David

    2013-01-01

    In Australia, a wait for Opioid Replacement Therapy (ORT) has been reported although the magnitude is unknown. This study examined data recorded by one urban publicly funded ORT clinic (from 2009 to 2011) to identify if people (n = 803) were waiting for ORT assessment appointments and to explore how triage influences access to ORT. Data analysis incorporated descriptive methods and the use of Kaplan-Meier estimator of the cumulative incidence function. The implications and limitations of this study are included with further research suggestions.

  3. A Hospital Based Study to Establish the Correlation between Recurrent Wheeze and Vitamin D Deficiency Among Children of Age Group Less than 3 Years in Indian Scenario

    PubMed Central

    Prasad, Santosh; Sheth, Ronak; Mauskar, Anupama V

    2016-01-01

    Introduction Early childhood wheezing is a heterogeneous condition, which has several phenotypic expressions and a complex relationship with the development of asthma later in life. New studies indicate the prevalence of recurrent wheeze to be associated with Vitamin D deficiency. This has not been explored in Indian settings widely, mandating this exploration. Aim To determine the severity of Vitamin D deficiency and its association with recurrent wheeze in children less than 3 years of age. Materials and Methods Consecutive type of non-probability sampling was followed for selection of study subjects with a total sample size to be 122 children in the Hospital setting. A pre- formed, pre- tested, structured interview schedule was used to obtain information. Estimation of 25 (OH) Vitamin D was done using ELISA method. Kit used for estimation was DLD Diagnostika GMBH 25(OH) Vitamin D ELISA from Germany. Standard statistical tools were used including Logistic regression analysis, and ROC curve, p value <0.05 was considered to be statistically significant. SPSS software version 17.0 was used. Results Each 10ng/ml decrease in Vitamin D level is associated with 7.25% greater odds of wheezing. Our study also suggests, exclusive breast feeding and delaying of complementary feeding beyond 6 months of age are significant predictors of Vitamin D deficiency and have indirect association with increased incidence of wheezing in children. Conclusion The study concluded that Vitamin D deficiency is associated with increased risk of recurrent wheezing. PMID:27042548

  4. Polymorphism in the IL4R gene and clinical features are associated with glioma prognosis: Analyses of case-cohort studies.

    PubMed

    Jin, Tian Bo; Du, Shuli; Zhu, Xi Kai; Li, Gang; Ouyang, Yongri; He, Na; Zhang, Zhiying; Zhang, Yuan; Kang, Longli; Yuan, Dongya

    2016-08-01

    Inflammatory gene polymorphisms may be associated with glioma risk. The purpose of this study was to analyze effects of certain inflammatory gene and some clinical factors on patient survival.The clinical information of 269 glioma patients conceived operation from September 2010 to May 2014 to decide the 1-, 3-year survival rates according to follow-up results and analyze age, gender, the WHO classification, extent of surgical resection, radiotherapy and chemotherapy factors effects on prognosis. Survival distributions were estimated by using the Kaplan-Meier method and difference in the survival was tested using the log-rank test. To estimate the association between the IL4, IL13, IL10, IL4R SNPs, and PFS and OS in glioma, the HR and 95% CI were calculated by univariate Cox proportional hazards model. Multivariate Cox model were performed to compute adjusted HR and 95% CI. All data was analyzed with SPSS17.0 package. Extent of surgical resection, chemotherapy, and age are an important factor in glioma overall survival and progression-free survival overall. Extent of surgery and chemotherapy are important factors in astrocytoma overall survival. Univariate analysis showed that IL4R rs1801275 was significantly associated with overall survival of glioma and astrocytoma patients (P < 0.05). Multivariate Cox regression analysis showed that IL4R rs1801275 GG genotype could increase the death risk of glioma and astrocytoma patients (Glioma: hazard ratio [HR]: 4.897, 95% confidence limits [95% CI]: 1.962-12.222, P = 0.001; Astrocytoma: HR: 15.944, 95% CI: 4.019-63.253, P < 0.05).Our research results showed that extent of surgical resection, age, and chemotherapy affect the prognosis of glioma. The IL4R gene may affect the survival of glioma patients. PMID:27495027

  5. A comparative study of complications and outcomes associated with radical retropubic prostatectomy and robot assisted radical prostatectomy

    NASA Astrophysics Data System (ADS)

    Gettman, Matthew T.

    2008-02-01

    Purpose: To evaluate outcomes among a matched cohort of prostate cancer patients treated with radical retropubic prostatectomy (RRP) and robot assisted radical prostatectomy (RARP). Materials and methods: Between 2002 and 2005, 294 patients underwent RARP at our institution. Comparison RRP patients were matched 2:1 for surgical year, age, PSA, clinical stage, and biopsy grade (n=588). Outcomes among groups were compared. From an oncologic standpoint, pathologic features among groups were assessed and Kaplan-Meier estimates of PSA recurrence free survival were compared. Results: Overall margin positivity was not significantly different between groups (RARP, 15.6%, RRP, 17%), yet risk of apical margin was significantly less with RARP. RARP was associated with significantly shorter hospitalization (p<0.01) and lower incidence of blood transfusion (p < 0.01). Early complications were higher in the RARP group (16% vs 10%, p<0.01). Among late complications, risk of bladder neck contracture was lower with RARP (1.2%, p=0.02). Adjuvant hormonal therapy was significantly higher in the RRP group (6.6% p<0.01). Continence at 1 year among groups was equivalent (p=0.15). Potency at 1 year was better among RARP patients (p=0.02). At a median followup of 1.3 years, PSA recurrence free estimates were not significantly different (92% vs 92%, p=0.69). Conclusions: Early complications were higher in this RARP group, but this experience includes cases performed in the learning curve. Oncologic, quality of life, and functional data in this study revealed encouraging results for RARP when compared to RRP.

  6. Enteral Feeding During Chemoradiotherapy for Advanced Head-and-Neck Cancer: A Single-Institution Experience Using a Reactive Approach

    SciTech Connect

    Clavel, Sebastien; Fortin, Bernard; Despres, Philippe; Donath, David; Soulieres, Denis; Khaouam, Nader; Charpentier, Danielle; Belair, Manon; Guertin, Louis; Nguyen-Tan, Phuc Felix

    2011-03-01

    Purpose: The optimal method for providing enteral nutrition to patients with head-and-neck cancer is unclear. The purpose of the present study was to evaluate the safety and efficacy of our reactive policy, which consists of the installation of a nasogastric (NG) feeding tube only when required by the patient's nutritional status. Methods and Materials: The records of all patients with Stage III and IV head-and-neck cancer treated with concomitant chemotherapy and radiotherapy between January 2003 and December 2006 were reviewed. The overall and disease-free survival rates were estimated using the Kaplan-Meier method and compared with the log-rank test. Results: The present study included 253 patients, and the median follow-up was 33 months. At 3 years, the estimated overall survival and disease-free survival rate was 82.8% and 77.8%, respectively, for the whole population. No survival difference was observed when the patients were compared according to the presence and absence of a NG tube or stratified by weight loss quartile. The mean weight loss during treatment for all patients was 10.4%. The proportion of patients requiring a NG tube was 49.8%, and the NG tube remained in place for a median duration of 40 days. No major complications were associated with NG tube installation. Only 3% of the patients were still dependent on enteral feeding at 6 months. Conclusion: These results suggest that the use of a reactive NG tube with an interdisciplinary team approach is a safe and effective method to manage malnutrition in patients treated with concomitant chemotherapy and radiotherapy for head-and-neck cancer.

  7. Impact of Neoadjuvant Radiation on Survival in Stage III Non-Small-Cell Lung Cancer

    SciTech Connect

    Koshy, Matthew; Goloubeva, Olga; Suntharalingam, Mohan

    2011-04-01

    Purpose: The role of surgery in Stage III non-small-cell lung cancer (NSCLC) is controversial. This study was undertaken to assess the impact of neoadjuvant radiation therapy for Stage III NSCLC. Methods and Materials: This was a retrospective study from the Surveillance, Epidemiology, and End Results (SEER) database that included patients who were 18 years and older with NSCLC classified as Stage III and who underwent definitive therapy from 1988 to 2004. Patients were characterized by type of treatment received. Survival functions were estimated by the Kaplan-Meier method, and Cox regression model was used to analyze trends in overall (OS) and cause-specific survival (CSS). Results: A total of 48,131 patients were selected, with a median follow-up of 10 months (range, 0-203 months). By type of treatment, the 3-year OS was 10% with radiation therapy (RT), 37% with surgery (S), 34% with surgery and postoperative radiation (S-RT), and 45% with neoadjuvant radiation followed by surgery (Neo-RT) (p = 0.0001). Multivariable Cox model identified sex, race, laterality, T stage, N stage, and type of treatment as factors affecting survival. Estimated hazard ratios (HR) adjusted for other variables in regression model showed the types of treatment: S (HR, 1.3; 95% confidence interval [CI], 1.2-1.4), S-RT (HR, 1.2; 95% CI, 1.1-1.3), and RT (HR, 2.3; 95% CI, 2.15-2.53) were associated with significantly worse overall survival when compared with Neo-RT (p = 0.0001). Conclusion: This population based study demonstrates that patients with Stage III NSCLC receiving Neo-RT had significantly improved overall survival when compared with other treatment groups.

  8. Long-Term Survivors Using Intraoperative Radiotherapy for Recurrent Gynecologic Malignancies

    SciTech Connect

    Tran, Phuoc T.; Su Zheng; Hara, Wendy; Husain, Amreen; Teng, Nelson; Kapp, Daniel S.

    2007-10-01

    Purpose: To analyze the outcomes of therapy and identify prognostic factors for patients treated with surgery followed by intraoperative radiotherapy (IORT) for gynecologic malignancies at a single institution. Methods and Materials: We performed a retrospective review of 36 consecutive patients treated with IORT to 44 sites with mean follow-up of 50 months. The primary site was the cervix in 47%, endometrium in 31%, vulva in 14%, vagina in 6%, and fallopian tubes in 3%. Previous RT had failed in 72% of patients, and 89% had recurrent disease. Of 38 IORT sessions, 84% included maximal cytoreductive surgery, including 18% exenterations. The mean age was 52 years (range, 30-74), mean tumor size was 5 cm (range, 0.5-12), previous disease-free interval was 32 months (range, 0-177), and mean IORT dose was 1,152 cGy (range, 600-1,750). RT and systemic therapy after IORT were given to 53% and 24% of the cohort, respectively. The outcomes measured were locoregional control (LRC), distant metastasis-free survival (DMFS), disease-specific survival (DSS), and treatment-related complications. Results: The Kaplan-Meier 5-year LRC, DMFS, and DSS probability for the whole group was 44%, 51%, and 47%, respectively. For cervical cancer patients, the Kaplan-Meier 5-year LRC, DMFS, and DSS estimate was 45%, 60%, and 46%, respectively. The prognostic factors found on multivariate analysis (p {<=} 0.05) were the disease-free interval for LRC, tumor size for DMFS, and cervical primary, previous surgery, and locoregional relapse for DSS. Our cohort had 10 Grade 3-4 complications associated with treatment (surgery and IORT) and a Kaplan-Meier 5-year Grade 3-4 complication-free survival rate of 72%. Conclusions: Survival for pelvic recurrence of gynecologic cancer is poor (range, 0-25%). IORT after surgery seems to confer long-term local control in carefully selected patients.

  9. Methodological Issues in the Assessment of Antimalarial Drug Treatment: Analysis of 13 Studies in Eight African Countries from 2001 to 2004▿

    PubMed Central

    Guthmann, Jean-Paul ; Pinoges, Loretxu; Checchi, Francesco; Cousens, Simon; Balkan, Suna; van Herp, Michel ; Legros, Dominique; Olliaro, Piero

    2006-01-01

    The objectives of these analyses were to assess the feasibility of the latest WHO recommendations (28-day follow-up with PCR genotyping) for the assessment of antimalarial drug efficacy in vivo and to examine how different statistical approaches affect results. We used individual-patient data from 13 studies of uncomplicated pediatric falciparum malaria conducted in sub-Saharan Africa, using chloroquine (CQ), sulfadoxine/pyrimethamine (SP), or amodiaquine (AQ). We assessed the use effectiveness and test performance of PCR genotyping in distinguishing recurrent infections. In analyzing data, we compared (i) the risk of failure on target days (days 14 and 28) by using Kaplan-Meier and per-protocol evaluable patient analyses, (ii) PCR-corrected results allowing (method 1) or excluding (method 2) new infections, (iii) and day 14 versus day 28 results. Of the 2,576 patients treated, 2,287 (89%) were evaluable on day 28. Of the 695 recurrences occurring post-day 14, 650 could be processed and 584 were resolved (PCR use effectiveness, 84%; test performance, 90%). The risks of failure on day 28 with Kaplan-Meier and evaluable-patient analyses tended to be generally close (except in smaller studies) because the numbers of dropouts were minimal, but attrition rates on day 28 were higher with the latter method. Method 2 yielded higher risks of failure than method 1. Extending observation to 28 days produced higher estimated risks of failure for SP and AQ but not for CQ (high failure rates by day 14). Results support the implementation of the current WHO protocol and favor analyzing PCR-corrected outcomes by Kaplan-Meier analysis (which allows for dropouts) and retaining new infections (which minimizes losses). PMID:16954313

  10. Protease inhibitor monotherapy for long-term management of HIV infection: a randomised, controlled, open-label, non-inferiority trial

    PubMed Central

    Paton, Nicholas I; Stöhr, Wolfgang; Arenas-Pinto, Alejandro; Fisher, Martin; Williams, Ian; Johnson, Margaret; Orkin, Chloe; Chen, Fabian; Lee, Vincent; Winston, Alan; Gompels, Mark; Fox, Julie; Scott, Karen; Dunn, David T

    2015-01-01

    Summary Background Standard-of-care antiretroviral therapy (ART) uses a combination of drugs deemed essential to minimise treatment failure and drug resistance. Protease inhibitors are potent, with a high genetic barrier to resistance, and have potential use as monotherapy after viral load suppression is achieved with combination treatment. We aimed to assess clinical risks and benefits of protease inhibitor monotherapy in long-term clinical use: in particular, the effect on drug resistance and future treatment options. Methods In this pragmatic, parallel-group, randomised, controlled, open-label, non-inferiority trial, we enrolled adults (≥18 years of age) positive for HIV attending 43 public sector treatment centres in the UK who had suppressed viral load (<50 copies per mL) for at least 24 weeks on combination ART with no change in the previous 12 weeks and a CD4 count of more than 100 cells per μL. Participants were randomly allocated (1:1) to maintain ongoing triple therapy (OT) or to switch to a strategy of physician-selected ritonavir-boosted protease inhibitor monotherapy (PI-mono); we recommended ritonavir (100 mg)-boosted darunavir (800 mg) once daily or ritonavir (100 mg)-boosted lopinavir (400 mg) twice daily, with prompt return to combination treatment if viral load rebounded. All treatments were oral. Randomisation was with permuted blocks of varying size and stratified by centre and baseline ART; we used a computer-generated, sequentially numbered randomisation list. The primary outcome was loss of future drug options, defined as new intermediate-level or high-level resistance to one or more drugs to which the patient's virus was deemed sensitive at trial entry (assessed at 3 years; non-inferiority margin of 10%). We estimated probability of rebound and resistance with Kaplan-Meier analysis. Analyses were by intention to treat. This trial is registered with the International Standard Randomised Controlled Trial Number registry, number ISRCTN

  11. Impacts of 3 years of elevated atmospheric CO2 on rhizosphere carbon flow and microbial community dynamics.

    PubMed

    Drigo, Barbara; Kowalchuk, George A; Knapp, Brigitte A; Pijl, Agata S; Boschker, Henricus T S; van Veen, Johannes A

    2013-02-01

    Carbon (C) uptake by terrestrial ecosystems represents an important option for partially mitigating anthropogenic CO2 emissions. Short-term atmospheric elevated CO2 exposure has been shown to create major shifts in C flow routes and diversity of the active soil-borne microbial community. Long-term increases in CO2 have been hypothesized to have subtle effects due to the potential adaptation of soil microorganism to the increased flow of organic C. Here, we studied the effects of prolonged elevated atmospheric CO2 exposure on microbial C flow and microbial communities in the rhizosphere. Carex arenaria (a nonmycorrhizal plant species) and Festuca rubra (a mycorrhizal plant species) were grown at defined atmospheric conditions differing in CO2 concentration (350 and 700 ppm) for 3 years. During this period, C flow was assessed repeatedly (after 6 months, 1, 2, and 3 years) by (13) C pulse-chase experiments, and label was tracked through the rhizosphere bacterial, general fungal, and arbuscular mycorrhizal fungal (AMF) communities. Fatty acid biomarker analyses and RNA-stable isotope probing (RNA-SIP), in combination with real-time PCR and PCR-DGGE, were used to examine microbial community dynamics and abundance. Throughout the experiment the influence of elevated CO2 was highly plant dependent, with the mycorrhizal plant exerting a greater influence on both bacterial and fungal communities. Biomarker data confirmed that rhizodeposited C was first processed by AMF and subsequently transferred to bacterial and fungal communities in the rhizosphere soil. Over the course of 3 years, elevated CO2 caused a continuous increase in the (13) C enrichment retained in AMF and an increasing delay in the transfer of C to the bacterial community. These results show that, not only do elevated atmospheric CO2 conditions induce changes in rhizosphere C flow and dynamics but also continue to develop over multiple seasons, thereby affecting terrestrial ecosystems C utilization processes.

  12. 46,XY/47,XYY/48,XYYY karyotype in a 3-year-old boy ascertained because of radioulnar synostosis

    SciTech Connect

    James, C.; Robson, L.; Jackson, J.

    1995-05-08

    Chromosome analysis was performed on a 3-year-old boy because of bilateral radioulnar synostosis and demonstrated a mosaic karyotype 46,XY/47,XYY/48,XYYY. He had minor facial anomalies and mild intellectual delay. He appears to be the youngest patient reported with this rare chromosome complement. His father, mother, and brother had normal chromosomes. Fluorescence in situ hybridization (FISH) was performed on the propositus and his father with the Y chromosome heterochromatic probe (pHY3.4) to add to the evaluation of mosaicism. 17 refs., 3 figs., 2 tabs.

  13. Anesthesia mumps resulting in temporary facial nerve paralysis after the auditory brainstem implantation in a 3-year-old child.

    PubMed

    Özdek, Ali; Bayır, Ömer; Işık, Murat Eray; Tatar, Emel Çadallı; Saylam, Güleser; Korkmaz, Hakan

    2014-01-01

    An acute transient sialadenitis of the major salivary glands in the early postoperative period is called 'anesthesia mumps'. It has been reported in different surgical procedures especially in neurosurgical procedures. Anesthesia mumps develops very fast after the extubation period but it usually regresses with no sequelae within a few hours. However, sometimes serious complication can occur such as respiratory distress. In this report, we present a 3-year-old girl with an anesthesia mumps and facial palsy occurring after successful auditory brainstem implantation and we discuss the cause and the management of this rare complication in this report.

  14. [Bevacizumab as first-line therapy in metastatic renal cell carcinoma: Progression-free survival for 3 years].

    PubMed

    Pichler, R; Horninger, W; Aigner, F; Heidegger, I

    2016-03-01

    We report the case of a 72-year-old woman who was diagnosed in 2006 with renal cell cancer (RCC) and had undergone consecutive tumor nephrectomy (clear-cell RCC, Fuhrmann grade II, stage pT3a, R0). Over the years, the patient underwent several surgical and radiological interventions due to various metastatic lesions. This case report describes the 3-year progression-free survival in a patient who underwent first-line therapy with the monoclonal antibody bevacizumab. Except for hypertension, the patient does not suffer currently from any other side effects of bevacizumab therapy.

  15. [Potential effects of screen media on cognitive development among children under 3 years old: review of literature].

    PubMed

    Brzozowska, Inga; Sikorska, Iwona

    2016-01-01

    The literature review regarding potential effects of screen media on cognitive development among children under 3 years old, is presented. In this article, cognitive aspects of development include acquisition of language, attention, learning and later school performance. The constant increase of children's access to television is noted, indicating that 60% of infants and toddlers watch TV regularly for 1-2 hours per day. The review included 40 articles and book chapters of significant such as Anderson, Barr, Christakis, Zimmerman, Meltzoff, Courage, Setliff, Troseth. The data was selected from electronic databases of scientific publications: Psychology & Behavioral Sciences Collection, Social Sciences Full Text (H.W. Wilson) and Humanities Full Text (H.W. Wilson) available in Poland. Cited articles provide evidence of the negative impact of exposure to television, media and video on the cognitive functioning of children under 3 years old. The potential impact of watching TV for difficulties in ability to focus attention appears as a core danger. Furthermore, studies suggest a possible connection between early exposure to television and ADHD as well as difficulties with language acquisition, learning and poorer school results.

  16. Family function of the families consisting of Asian immigrant women living in South Korea: a 3-year longitudinal study.

    PubMed

    Kim, Yeon-Pyo; Joh, Ju-Youn; Shin, Il-Seon

    2015-03-01

    Marriages between Korean men and immigrant women from elsewhere in Asia have increased rapidly during recent years. The aim of this study was to analyze the relationship within families consisting of immigrant women and to identify the relevant factors. The study subjects were 62 Asian immigrant women married to South Korean men living in South Korea. In a baseline study in August 2008, the socioeconomic factors and family APGAR (adaptation, partnership, growth, affection, and resolve) scores were measured. Family APGAR has been widely used to study the relationship of family function and health problems in the busy clinician's office. A 3-year follow-up study was then conducted in August 2011, and the results were compared with the baseline study results. Family APGAR scores were higher at the 3-year follow-up than those at baseline. Changes in family APGAR scores were found to be influenced by the birthplace, reported subjective ability to read Korean, and Center for Epidemiologic Studies-Depression Scale score.

  17. Determinants of imitation of hand-to-body gestures in 2- and 3-year-old children.

    PubMed

    Erjavec, Mihela; Horne, Pauline J

    2008-03-01

    Twenty children, ten 2-year-olds and ten 3-year-olds, participated in an AB procedure. In the baseline phase, each child was trained the same four matching relations to criterion under intermittent reinforcement. During the subsequent imitation test, the experimenter modeled a total of 20 target gestures (six trials each) interspersed with intermittently reinforced baseline trials. In each session, target gestures were selected in a pre-randomized sequence from: Set 1--ear touches; Set 2--shoulder touches; Set 3--midarm touches; and Set 4--wrist touches; subjects' responses to targets were not reinforced. In each target set, half the gestures featured in nursery matching games and were termed common targets whereas the remainder, which were topographically similar but did not feature in the games, served as uncommon targets. The children produced significantly more matching responses to common target models than to uncommon ones. Common responses were also produced as mismatches to uncommon target models more often than vice versa. Response accuracy did not improve over trials, suggesting that "parity" did not serve as a conditioned reinforcer. All children showed a strong bias for "mirroring"--responding in the same hemispace as the modeler. The 2-year-olds produced more matching errors than the 3-year-olds and most children showed a bias for responding with their right hands. The strong effects of training environment (nursery matching games) are consistent with a Skinnerian account, but not a cognitive goal theory account, of imitation in young children.

  18. Predictors of Obesity in a Cohort of Children Enrolled in WIC as Infants and Retained to 3 Years of Age.

    PubMed

    Chiasson, M A; Scheinmann, R; Hartel, D; McLeod, N; Sekhobo, J; Edmunds, L S; Findley, S

    2016-02-01

    This longitudinal study of children enrolled as infants in the New York State (NYS) Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) examined predictors of obesity (body mass index ≥ 95th percentile) at 3 years of age. NYS WIC administrative data which included information from parent interviews and measured heights and weights for children were used. All 50,589 children enrolled as infants in WIC between July to December 2008 and July to December 2009 and retained in WIC through age three were included. At 3 years of age, 15.1% of children were obese. Multiple logistic regression analysis showed that children of mothers who received the Full Breastfeeding Food Package when their infant was enrolled in WIC (adjusted OR = 0.52) and children with ≤2 h screen time daily at age 3 (adjusted OR = 0.88) were significantly less likely to be obese (p < 0.001) controlling for race/ethnicity, birth weight, and birthplace. In this cohort of NYS WIC participants, maternal receipt of the Full Breastfeeding Food Package (a surrogate measure of exclusive breastfeeding) is associated with lower levels of obesity in their children at age 3. The relationships between participation in WIC, exclusive breastfeeding, and obesity prevention merit further study.

  19. Lung adenocarcinoma presenting with isolated ‘chronic cough’ of 3 years duration-a cautionary tale

    PubMed Central

    Pannu, Bibek S.; Iyer, Vivek N.

    2015-01-01

    Chronic cough that is dry, non-productive and without constitutional symptoms is often thought to have a non-malignant etiology such as asthma, post-nasal drip or gastroesophageal reflux disease (GERD). We present a case of a patient with a 3 year history of ‘chronic cough’ that was dry, non-productive cough and without any constitutional symptoms. Initial chest x-ray (CXR) done 3 years ago showed some streaky atelectasis in the right middle lobe along with some volume loss on that side. Another CXR performed one and half years later showed progression to a complete right middle lobe collapse. She ultimately presented to our facility a year later with stable CXR findings, but persistent cough. A chest CT scan was suspicious for a right lower lobe mass. A PET scan subsequently confirmed a hypermetabolic right hilar mass causing extrinsic compression of the bronchus intermedius. She ultimately required a complete right pneumonectomy with partial pericardiectomy and had complete resolution of her cough. This case highlights the fact that ‘chronic cough’ should always be thoroughly investigated and should remain a diagnosis of exclusion until all sinister pathologies have been ruled out. PMID:26744688

  20. Partner aggression in high-risk families from birth to age 3 years: associations with harsh parenting and child maladjustment.

    PubMed

    Graham, Alice M; Kim, Hyoun K; Fisher, Philip A

    2012-02-01

    Aggression between partners represents a potential guiding force in family dynamics. However, research examining the influence of partner aggression (physically and psychologically aggressive acts by both partners) on harsh parenting and young child adjustment has been limited by a frequent focus on low-risk samples and by the examination of partner aggression at a single time point. Especially in the context of multiple risk factors and around transitions such as childbirth, partner aggression might be better understood as a dynamic process. In the present study, longitudinal trajectories of partner aggression from birth to age 3 years in a large, high-risk, and ethnically diverse sample (N = 461) were examined. Specific risk factors were tested as predictors of aggression over time, and the longitudinal effects of partner aggression on maternal harsh parenting and child maladjustment were examined. Partner aggression decreased over time, with higher maternal depression and lower maternal age predicting greater decreases in partner aggression. While taking into account contextual and psychosocial risk factors, higher partner aggression measured at birth and a smaller decrease over time independently predicted higher levels of maternal harsh parenting at age 3 years. Initial level of partner aggression and change over time predicted child maladjustment indirectly (via maternal harsh parenting). The implications of understanding change in partner aggression over time as a path to harsh parenting and young children's maladjustment in the context of multiple risk factors are discussed.

  1. Lead exposure among 3-year-old children and their mothers living in a pottery-producing area.

    PubMed

    Katagiri, Y; Toriumi, H; Kawai, M

    1983-01-01

    The present study's aim was to compare the levels of lead exposure between 3-year-old children and their mothers in a pottery-producing area, and to assess the levels of lead exposure for 3-year-old children of the parents engaged in pottery-manufacturing work. For these purposes urinary lead, coproporphyrin, and delta-aminolevulinic acid were determined for the children and their mothers, living in a pottery-producing area and in a control area. The mean urinary lead was 9.3 to 10.8 micrograms/1 for the mothers in the pottery-producing area and 10.6 micrograms/1 for the children in the control area. In contrast, among the children in the pottery-producing area, those whose parents had been engaged in the pottery production had a much higher mean urinary lead of 13.6 to 15.8 micrograms/1. These results suggest that parental work related to lead contributes appreciably to lead exposure for children.

  2. [Potential effects of screen media on cognitive development among children under 3 years old: review of literature].

    PubMed

    Brzozowska, Inga; Sikorska, Iwona

    2016-01-01

    The literature review regarding potential effects of screen media on cognitive development among children under 3 years old, is presented. In this article, cognitive aspects of development include acquisition of language, attention, learning and later school performance. The constant increase of children's access to television is noted, indicating that 60% of infants and toddlers watch TV regularly for 1-2 hours per day. The review included 40 articles and book chapters of significant such as Anderson, Barr, Christakis, Zimmerman, Meltzoff, Courage, Setliff, Troseth. The data was selected from electronic databases of scientific publications: Psychology & Behavioral Sciences Collection, Social Sciences Full Text (H.W. Wilson) and Humanities Full Text (H.W. Wilson) available in Poland. Cited articles provide evidence of the negative impact of exposure to television, media and video on the cognitive functioning of children under 3 years old. The potential impact of watching TV for difficulties in ability to focus attention appears as a core danger. Furthermore, studies suggest a possible connection between early exposure to television and ADHD as well as difficulties with language acquisition, learning and poorer school results. PMID:27416629

  3. Hospital Organization and Importance of an Interventional Radiology Inpatient Admitting Service: Italian Single-Center 3-Year Experience

    SciTech Connect

    Simonetti, Giovanni; Bollero, Enrico; Ciarrapico, Anna Micaela; Gandini, Roberto; Konda, Daniel Bartolucci, Alberto; Di Primio, Massimiliano; Mammucari, Matteo; Chiocchi, Marcello; D'Alba, Fabrizio; Masala, Salvatore

    2009-03-15

    In June 2005 a Complex Operating Unit of Interventional Radiology (COUIR), consisting of an outpatient visit service, an inpatient admitting service with four beds, and a day-hospital service with four beds was installed at our department. Between June 2005 and May 2008, 1772 and 861 well-screened elective patients were admitted to the inpatient ward of the COUIR and to the Internal Medicine Unit (IMU) or Surgery Unit (SU) of our hospital, respectively, and treated with IR procedures. For elective patients admitted to the COUIR's inpatient ward, hospital stays were significantly shorter and differences between reimbursements and costs were significantly higher for almost all IR procedures compared to those for patients admitted to the IMU and SU (Student's t-test for unpaired data, p < 0.05). The results of the 3-year activity show that the activation of a COUIR with an inpatient admitting service, and the better organization of the patient pathway that came with it, evidenced more efficient use of resources, with the possibility for the hospital to save money and obtain positive margins (differences between reimbursements and costs). During 3 years of activity, the inpatient admitting service of our COUIR yielded a positive difference between reimbursements and effective costs of Euro 1,009,095.35. The creation of an inpatient IR service and the admission of well-screened elective patients allowed short hospitalization times, reduction of waiting lists, and a positive economic outcome.

  4. The Natural Course of Intermittent Exotropia over a 3-year Period and the Factors Predicting the Control Deterioration.

    PubMed

    Kwok, Jeremy J S W; Chong, Gabriela S L; Ko, Simon T C; Yam, Jason C S

    2016-01-01

    The natural course of intermittent exotropia and the factors affecting its control has been unclear. We aim to report the natural course of our cohort of 117 Chinese children with intermittent exotropia and to identify baseline parameters that may have predictive value in the control deterioration of the disease. The visual acuity, spherical equivalent, compliance to orthoptic exercise, angle of deviation fusional convergence parameters and Newcastle Control Score were recorded for all children at baseline and at 3 years apart. Patients were divided into two groups according to the change in control over the 3 years: group 1 included patients who had no deterioration or had improvement in disease control; and group 2 were those who had deteriorated control or had undergone surgery. There were 77 patients (66%) in group 1 and 40 (34%) patients in group 2. Comparing the baseline parameters of the two groups, group 1 had statistically significantly smaller angle of deviation, larger fusional reserve, larger fusional recovery, and higher fusional reserve ratio (p < 0.05). Other baseline parameters were similar between the two groups. The baseline fusional parameters may have predictive value in determining the control of intermittent exotropia.

  5. The Natural Course of Intermittent Exotropia over a 3-year Period and the Factors Predicting the Control Deterioration

    PubMed Central

    Kwok, Jeremy J. S. W.; Chong, Gabriela S. L.; Ko, Simon T. C.; Yam, Jason C.S.

    2016-01-01

    The natural course of intermittent exotropia and the factors affecting its control has been unclear. We aim to report the natural course of our cohort of 117 Chinese children with intermittent exotropia and to identify baseline parameters that may have predictive value in the control deterioration of the disease. The visual acuity, spherical equivalent, compliance to orthoptic exercise, angle of deviation fusional convergence parameters and Newcastle Control Score were recorded for all children at baseline and at 3 years apart. Patients were divided into two groups according to the change in control over the 3 years: group 1 included patients who had no deterioration or had improvement in disease control; and group 2 were those who had deteriorated control or had undergone surgery. There were 77 patients (66%) in group 1 and 40 (34%) patients in group 2. Comparing the baseline parameters of the two groups, group 1 had statistically significantly smaller angle of deviation, larger fusional reserve, larger fusional recovery, and higher fusional reserve ratio (p < 0.05). Other baseline parameters were similar between the two groups. The baseline fusional parameters may have predictive value in determining the control of intermittent exotropia. PMID:27257120

  6. Parental use of restrictive feeding practices and child BMI z-score. A 3-year prospective cohort study.

    PubMed

    Campbell, Karen; Andrianopoulos, Nick; Hesketh, Kylie; Ball, Kylie; Crawford, David; Brennan, Leah; Corsini, Nadia; Timperio, Anna

    2010-08-01

    This study examines associations between parental feeding restriction at baseline and child body mass index (BMI) z-score at 3-year follow-up. Parents of 204 5-6-year-old and 188 10-12-year-old children completed the Child Feeding Questionnaire at baseline (2002/3). In 2002/3 and 2005/6, children's BMI z-score was calculated from measured height and weight. Analyses were stratified by age-group. The association of follow-up zBMI and baseline feeding restriction score was explored using (i) linear regression with adjustment for baseline zBMI and (ii) with further adjustments for baseline maternal BMI, maternal education level and child sex. Baseline restriction was associated with follow-up zBMI at 3 years in 5-6-year-old children and was largely unchanged when adjusting for child sex, maternal BMI and education. Restriction was not associated with follow-up zBMI in 10-12-year-old children. This longitudinal study adds important depth to our understanding of associations between restrictive feeding and change in zBMI, suggesting that restriction of energy-dense foods and drinks may be protective of unhealthy weight gain in younger children but may have no effect among older children. These findings support a reconsideration of the notion that restriction is likely to result in increased child weight. PMID:20420869

  7. Parental use of restrictive feeding practices and child BMI z-score. A 3-year prospective cohort study.

    PubMed

    Campbell, Karen; Andrianopoulos, Nick; Hesketh, Kylie; Ball, Kylie; Crawford, David; Brennan, Leah; Corsini, Nadia; Timperio, Anna

    2010-08-01

    This study examines associations between parental feeding restriction at baseline and child body mass index (BMI) z-score at 3-year follow-up. Parents of 204 5-6-year-old and 188 10-12-year-old children completed the Child Feeding Questionnaire at baseline (2002/3). In 2002/3 and 2005/6, children's BMI z-score was calculated from measured height and weight. Analyses were stratified by age-group. The association of follow-up zBMI and baseline feeding restriction score was explored using (i) linear regression with adjustment for baseline zBMI and (ii) with further adjustments for baseline maternal BMI, maternal education level and child sex. Baseline restriction was associated with follow-up zBMI at 3 years in 5-6-year-old children and was largely unchanged when adjusting for child sex, maternal BMI and education. Restriction was not associated with follow-up zBMI in 10-12-year-old children. This longitudinal study adds important depth to our understanding of associations between restrictive feeding and change in zBMI, suggesting that restriction of energy-dense foods and drinks may be protective of unhealthy weight gain in younger children but may have no effect among older children. These findings support a reconsideration of the notion that restriction is likely to result in increased child weight.

  8. Neoadjuvant chemoradiotherapy followed by surgery in locally advanced squamous cell carcinoma of the vulva

    PubMed Central

    GAUDINEAU, A.; WEITBRUCH, D.; QUETIN, P.; HEYMANN, S.; PETIT, T.; VOLKMAR, P.; BODIN, F.; VELTEN, M.; RODIER, J.F.

    2012-01-01

    Alternative therapies have been sought to alleviate mutilation and morbidity associated with surgery for vulvar neoplasms. Our prime objective was to assess tumor absence in pathological vulvar and nodal specimens following neoadjuvant chemoradiotherapy in locally advanced vulvar neoplasms. Data were retrospectively collected from January 2001 to May 2009 from 22 patients treated with neoadjuvant therapy for locally advanced squamous cell carcinoma of the vulva. Neoadjuvant treatment consisted of inguino-pelvic radiotherapy (50 Gy) in association with chemotherapy when possible. Surgery occurred at intervals of between 5 to 8 weeks. The median age of patients at diagnosis was 74.1 years. All patients were primarily treated with radiotherapy and 15 received a concomitant chemotherapy. Additionally, all patients underwent radical vulvectomy and bilateral inguino-femoral lymphadenectomy. Tumor absence in the vulvar and nodal pathological specimens was achieved for 6 (27%) patients, while absence in the vulvar pathological specimens was only achieved for 10 (45.4%) patients. Postoperative follow-up revealed breakdown of groin wounds, vulvar wounds and chronic lymphedema in 3 (14.3%), 7 (31.8%) and 14 cases (63.6%), respectively. Within a median follow-up time of 2.3 years [interquartile range (IQR), 0.6–4.6], 12 (54.6%) patients experienced complete remission and 6 cases succumbed to metastatic evolution within a median of 2.2 years (IQR, 0.6–4.6), with 1 case also experiencing perineal recurrence. Median survival time, estimated using the Kaplan-Meier method, was 5.1 years (IQR, 1.0–6.8). We suggest that neoadjuvant chemoradiotherapy may represent a reliable and promising strategy in locally advanced squamous cell carcinoma of the vulva. PMID:23205089

  9. Factors for tumor progression in patients with skull base chordoma.

    PubMed

    Wang, Liang; Tian, Kaibing; Wang, Ke; Ma, Junpeng; Ru, Xiaojuan; Du, Jiang; Jia, Guijun; Zhang, Liwei; Wu, Zhen; Zhang, Junting

    2016-09-01

    Skull base chordoma is a rare and fatal disease, recurrence of which is inevitable, albeit variable. We aimed to investigate the clinicopathologic features of disease progression, identify prognostic factors, and construct a nomogram for predicting progression in individual patients. Data of 229 patients with skull base chordoma treated by one institution between 2005 and 2014 were retrieved and grouped as primary and recurrent. Kaplan-Meier survival of progression was estimated, taking competing risks into account. Multivariable Cox regression was used to investigate survival predictors. The primary group consisted by 183 cases, gained more benefits on 5-year progression-free survival (PFS) (51%) and mean PFS time (66.9 months) than the recurrent group (46 cases), in which 5-year postrecurrent PFS was 14%, and mean postrecurrent PFS time was 29.5 months. In the primary group, visual deficits, pathological subtypes, extent of bone invasion, preoperative Karnofsky performance scale (KPS) score, and variation in perioperative KPS were identified as independent predictors of PFS. A nomogram to predict 3-year and 5-year PFS consisted of these factors, was well calibrated and had good discriminative ability (adjusted Harrell C statistic, 0.68). In the recurrent group, marginal resection (P = 0.018) and adjuvant radiotherapy (P = 0.043) were verified as protective factors associated with postrecurrent PFS. Factors for tumor progression demonstrated some differences between primary and recurrent cases. The nomogram appears useful for risk stratification of tumor progression in primary cases. Further studies will be necessary to identify the rapid-growth histopathological subtype as an independent predictor of rapid progression.

  10. Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer: Recommendations of the RTOG-ASTRO Phoenix Consensus Conference

    SciTech Connect

    Roach, Mack . E-mail: roach@radonc17.ucsf.edu; Hanks, Gerald; Thames, Howard; Schellhammer, Paul; Shipley, William U.; Sokol, Gerald H.; Sandler, Howard

    2006-07-15

    In 1996 the American Society for Therapeutic Radiology and Oncology (ASTRO) sponsored a Consensus Conference to establish a definition of biochemical failure after external beam radiotherapy (EBRT). The ASTRO definition defined prostate specific antigen (PSA) failure as occurring after three consecutive PSA rises after a nadir with the date of failure as the point halfway between the nadir date and the first rise or any rise great enough to provoke initiation of therapy. This definition was not linked to clinical progression or survival; it performed poorly in patients undergoing hormonal therapy (HT), and backdating biased the Kaplan-Meier estimates of event-free survival. A second Consensus Conference was sponsored by ASTRO and the Radiation Therapy Oncology Group in Phoenix, Arizona, on January 21, 2005, to revise the ASTRO definition. The panel recommended: (1) a rise by 2 ng/mL or more above the nadir PSA be considered the standard definition for biochemical failure after EBRT with or without HT; (2) the date of failure be determined 'at call' (not backdated). They recommended that investigators be allowed to use the ASTRO Consensus Definition after EBRT alone (no hormonal therapy) with strict adherence to guidelines as to 'adequate follow-up.' To avoid the artifacts resulting from short follow-up, the reported date of control should be listed as 2 years short of the median follow-up. For example, if the median follow-up is 5 years, control rates at 3 years should be cited. Retaining a strict version of the ASTRO definition would allow comparisons with a large existing body of literature.

  11. Targeted intraoperative radiotherapy (TARGIT) yields very low recurrence rates when given as a boost

    SciTech Connect

    Vaidya, Jayant S. . E-mail: j.s.vaidya@dundee.ac.uk; Baum, Michael; Tobias, Jeffrey S.; Massarut, Samuele; Wenz, Frederik; Murphy, Olive; Hilaris, Basil; Houghton, Joan B.Sc.; Saunders, Christobel; Corica, Tammy; Roncadin, Mario; Kraus-Tiefenbacher, Uta; Melchaert, Frank; Keshtgar, Mohammed; Sainsbury, Richard; Douek, Michael; Harrison, Elly; Thompson, Alastair; Joseph, David

    2006-12-01

    Purpose: Patients undergoing breast-conserving surgery were offered boost radiotherapy with targeted intraoperative radiotherapy (TARGIT) using the Intrabeam system to test the feasibility, safety, and efficacy of the new approach. Methods and Materials: We treated 302 cancers in 301 unselected patients. This was not a low-risk group. One-third of patients (98/301) were younger than 51 years of age. More than half of the tumors (172, 57%) were between 1 cm and 2 cm, and one-fifth (62, 21%) were >2 cm; 29% (86) had a Grade 3 tumor and, in 29% (87), axillary lymph nodes contained metastasis. After primary surgery, 20 Gy was delivered intraoperatively to the surface of the tumor bed, followed by external-beam radiotherapy (EBRT), but excluding the usual boost. Results: The treatment was well tolerated. The follow-up ranged from 3 to 80 months (164 and 90 patients completed 2 and 3 years follow-up, respectively). Four patients (1.3%) had local recurrence. The Kaplan-Meier estimate of local recurrence is 2.6% (SE = 1.7) at 5 years. This compares favorably with the 4.3% recurrence rate in boosted patients from the EORTC boost study, in which only 8.1% patients were node-positive, as opposed to 29% in our series. Conclusion: Targeted intraoperative radiotherapy combined with EBRT results in a low local recurrence rate. This could be attributed to both accurate targeting and timeliness of the treatment. These data support the need for a randomized trial to test whether the TARGIT boost is superior to conventional external boost, especially in high-risk women.

  12. Intestinal obstruction: predictor of poor prognosis in colorectal carcinoma?

    PubMed Central

    Mohd Suan, Mohd Azri; Tan, Wei Leong; Soelar, Shahrul Aiman; Ismail, Ibtisam; Abu Hassan, Muhammad Radzi

    2015-01-01

    OBJECTIVES: The goal of this study was to assess the relationship between intestinal obstruction and the prognosis of colorectal carcinoma. METHODS: Data pertaining to 4,501 colorectal carcinoma patients were extracted from the national colorectal registry and analysed. Survival analysis was performed using the Kaplan-Meier method. The log-rank test was used to compare the survival rate between patients with intestinal obstruction and those without intestinal obstruction. The p-values<0.05 were considered to indicate statistical significance. Simple Cox proportional hazards regression analysis was used to estimate the crude hazard ratio of mortality from colorectal cancer. RESULTS: Intestinal obstruction was reported in more than 13% of patients. The 3-year survival rate after treatment was 48.3% (95% confidence interval [CI], 43.9 to 52.8) for patients with intestinal obstruction (n=593) and 54.9% (95% CI, 53.1 to 56.6) for patients without intestinal obstruction (n=3,908). The 5-year survival rate for patients with intestinal obstruction was 37.3% (95% CI, 31.9 to 42.8), which was lower than that of patients without intestinal obstruction (45.6%; 95% CI, 43.5 to 47.7). After adjusting the hazard ratio for other prognostic variables, intestinal obstruction had a statistically significant negative correlation with the survival rate of colorectal cancer patients, with an adjusted hazard ratio of 1.22 (p=0.008). CONCLUSIONS: The presence of intestinal obstruction is associated with a lower survival rate among colorectal cancer patients. PMID:25868638

  13. Factors for tumor progression in patients with skull base chordoma.

    PubMed

    Wang, Liang; Tian, Kaibing; Wang, Ke; Ma, Junpeng; Ru, Xiaojuan; Du, Jiang; Jia, Guijun; Zhang, Liwei; Wu, Zhen; Zhang, Junting

    2016-09-01

    Skull base chordoma is a rare and fatal disease, recurrence of which is inevitable, albeit variable. We aimed to investigate the clinicopathologic features of disease progression, identify prognostic factors, and construct a nomogram for predicting progression in individual patients. Data of 229 patients with skull base chordoma treated by one institution between 2005 and 2014 were retrieved and grouped as primary and recurrent. Kaplan-Meier survival of progression was estimated, taking competing risks into account. Multivariable Cox regression was used to investigate survival predictors. The primary group consisted by 183 cases, gained more benefits on 5-year progression-free survival (PFS) (51%) and mean PFS time (66.9 months) than the recurrent group (46 cases), in which 5-year postrecurrent PFS was 14%, and mean postrecurrent PFS time was 29.5 months. In the primary group, visual deficits, pathological subtypes, extent of bone invasion, preoperative Karnofsky performance scale (KPS) score, and variation in perioperative KPS were identified as independent predictors of PFS. A nomogram to predict 3-year and 5-year PFS consisted of these factors, was well calibrated and had good discriminative ability (adjusted Harrell C statistic, 0.68). In the recurrent group, marginal resection (P = 0.018) and adjuvant radiotherapy (P = 0.043) were verified as protective factors associated with postrecurrent PFS. Factors for tumor progression demonstrated some differences between primary and recurrent cases. The nomogram appears useful for risk stratification of tumor progression in primary cases. Further studies will be necessary to identify the rapid-growth histopathological subtype as an independent predictor of rapid progression. PMID:27546605

  14. Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer: recommendations of the RTOG-ASTRO Phoenix Consensus Conference.

    PubMed

    Roach, Mack; Hanks, Gerald; Thames, Howard; Schellhammer, Paul; Shipley, William U; Sokol, Gerald H; Sandler, Howard

    2006-07-15

    In 1996 the American Society for Therapeutic Radiology and Oncology (ASTRO) sponsored a Consensus Conference to establish a definition of biochemical failure after external beam radiotherapy (EBRT). The ASTRO definition defined prostate specific antigen (PSA) failure as occurring after three consecutive PSA rises after a nadir with the date of failure as the point halfway between the nadir date and the first rise or any rise great enough to provoke initiation of therapy. This definition was not linked to clinical progression or survival; it performed poorly in patients undergoing hormonal therapy (HT), and backdating biased the Kaplan-Meier estimates of event-free survival. A second Consensus Conference was sponsored by ASTRO and the Radiation Therapy Oncology Group in Phoenix, Arizona, on January 21, 2005, to revise the ASTRO definition. The panel recommended: (1) a rise by 2 ng/mL or more above the nadir PSA be considered the standard definition for biochemical failure after EBRT with or without HT; (2) the date of failure be determined "at call" (not backdated). They recommended that investigators be allowed to use the ASTRO Consensus Definition after EBRT alone (no hormonal therapy) with strict adherence to guidelines as to "adequate follow-up." To avoid the artifacts resulting from short follow-up, the reported date of control should be listed as 2 years short of the median follow-up. For example, if the median follow-up is 5 years, control rates at 3 years should be cited. Retaining a strict version of the ASTRO definition would allow comparisons with a large existing body of literature.

  15. Prognostic Impact of External Beam Radiation Therapy in Patients Treated With and Without Extended Surgery and Intraoperative Electrons for Locally Recurrent Rectal Cancer: 16-Year Experience in a Single Institution

    SciTech Connect

    Calvo, Felipe A.; Sole, Claudio V.; Alvarez de Sierra, Pedro; Gómez-Espí, Marina; Blanco, Jose; and others

    2013-08-01

    Purpose: To analyze prognostic factors associated with survival in patients after intraoperative electrons containing resective surgical rescue of locally recurrent rectal cancer (LRRC). Methods and Materials: From January 1995 to December 2011, 60 patients with LRRC underwent extended surgery (n=38: multiorgan [43%], bone [28%], soft tissue [38%]) or nonextended (n=22) surgical resection, including a component of intraoperative electron-beam radiation therapy (IOERT) to the pelvic recurrence tumor bed. Twenty-eight (47%) of these patients also received external beam radiation therapy (EBRT) (range, 30.6-50.4 Gy). Survival outcomes were estimated by the Kaplan-Meier method, and risk factors were identified by univariate and multivariate analyses. Results: The median follow-up time was 36 months (range, 2-189 months), and the 1-year, 3-year, and 5-year rates for locoregional control (LRC) and overall survival (OS) were 86%, 52%, and 44%; and 78%, 53%, 43%, respectively. On multivariate analysis, R1 resection, EBRT at the time of pelvic rerecurrence, no tumor fragmentation, and non-lymph node metastasis retained significance with regard to LRR. R1 resection and no tumor fragmentation showed a significant association with OS after adjustment for other covariates. Conclusions: EBRT treatment integrated for rescue, resection radicality, and not involved fragmented resection specimens are associated with improved LRC in patients with locally recurrent rectal cancer. Additionally, tumor fragmentation could be compensated by EBRT. Present results suggest that a significant group of patients with LRRC may benefit from EBRT treatment integrated with extended surgery and IOERT.

  16. Right-Side Colon Ischemia: Clinical Features, Large Visceral Artery Occlusion, and Long-Term Follow-Up

    PubMed Central

    Longstreth, George F; Hye, Robert J

    2015-01-01

    Context: Large visceral artery occlusion (LVAO) could underlie right-side colon ischemia (RSCI) but is little known. Objective: To assess patients with RSCI through long-term follow-up, including features and management of LVAO. Main Outcome Measures: Mesenteric ischemia and mortality. Design: Retrospective observational study in an integrated health care system. Results: Of 49 patients (30 women [61.2%]; mean [standard deviation] age, 69.4 [11.9] years), 19 (38.8%) underwent surgery—that is, 5 (83.3%) of 6 who developed RSCI in hospital following surgical procedures and 14 (32.6%) of 43 who had RSCI before hospitalization (p value = 0.03); overall, 5 (10.2%) died. Among 44 survivors with a median (range) follow-up of 5.19 (0.03–14.26) years, 5 (11.4%), including 3 (20.0%) of 15 operated cases, had symptomatic LVAO and underwent angioplasty and stent placement: 2 for abdominal angina that preceded RSCI, 1 for acute mesenteric ischemia 1 week after resection of RSCI, 1 for RSCI 6 weeks after resection of left-side ischemia, and 1 for abdominal angina that began 3 years after spontaneous recovery from RSCI. None had further mesenteric ischemia until death from nonintestinal disease or the end of follow-up (1.6 to 10.2 years later). Kaplan-Meier survival estimates for all 44 survivors at 1, 3, 5, and 10 years were 88.6%, 72.3%, 57.6%, and 25.9%, respectively. Thirty-one patients (70.4%) died during follow-up, 19 (61.3%) of a known cause; the 39 patients not treated for LVAO lacked mesenteric ischemia. Conclusion: Patients with RSCI may have symptomatic LVAO; therefore, we advise they undergo careful query for symptoms of abdominal angina and routine visceral artery imaging. PMID:26263388

  17. Analysis of recurrence and survival rates in grade 3 endometrioid endometrial carcinoma

    PubMed Central

    Wang, Jieyu; Jia, Nan; Li, Qing; Wang, Chao; Tao, Xiang; Hua, Keqin; Feng, Weiwei

    2016-01-01

    The aim of the present study was to determine risk factors associated with recurrence and survival in patients with grade 3 endometrioid endometrial carcinoma (G3EEC). A retrospective analysis of 117 patients with G3EEC, who were admitted to the Obstetrics and Gynecology Hospital of Fudan University between January 2000 and December 2011, was performed. The χ2 test or Fisher's exact test were used for the comparison of categorical variables. Kaplan-Meier method was used for estimating recurrence-free survival (RFS), disease-specific survival (DSS) and overall survival (OS) rates. Univariate and multivariate Cox proportional hazards model were used to assess the prognostic significance of various patient characteristics. In 117 patients, 16 patients (13.7%) had tumor recurrence, of which 6 (37.5%) developed local-regional recurrence and 10 (62.5%) developed distant recurrence. Out of the 16 patients with tumor recurrence, 14 (87.5%) had a recurrence within 3 years of surgery. Statistically significant characteristics affecting RFS, DSS and OS rates were outer half myometrial invasion (MI ≥50%), advanced International Federation of Gynecology and Obstetrics stage, positive lymph node metastasis (PLNM), lymph vascular space invasion, adnexal involvement and characterization as a high-risk group, according to the Gynecologic Oncology Group 99 stratification algorithm. RFS was associated with the depth of cervical mucosa (stromal) involvement. Furthermore, in the multivariate Cox proportional hazards model, significant independent adverse factors for RFS and DSS included MI ≥50% and adnexal involvement. For OS, there were no statistically significant prognostic factors. In conclusion, MI ≥50% and adnexal involvement are independent prognostic factors for RFS and DSS in G3EEC patients.

  18. Phenylbutyrate Mouthwash Mitigates Oral Mucositis During Radiotherapy or Chemoradiotherapy in Patients With Head-and-Neck Cancer

    SciTech Connect

    Yen, Sang-Hue; Wang, Ling-Wei; Lin, Yi-Hsien; Jen, Yee-Min; Chung, Yih-Lin

    2012-03-15

    Purpose: Deleterious oral mucositis (OM) develops during radiotherapy (RT) or chemoradiotherapy for head-and-neck cancer (HNC) patients. There are currently no effective cytoprotective treatments for OM without a potential risk of tumor protection. This randomized, double-blind, placebo-controlled pilot study aimed to determine the therapeutic safety and efficacy of phenylbutyrate (an antitumor histone deacetylase inhibitor and chemical chaperone) 5% mouthwash for treating OM caused by cancer therapy. Methods and Materials: Between September 2005 and June 2006, 36 HNC patients were randomized to standard oral care plus 5 mL of either phenylbutyrate 5% mouthwash (n = 17) or placebo (mouthwash vehicle, n = 19) taken four times daily (swish and spit). Treatment began when mild mucositis (Radiation Therapy Oncology Group Grade 1) occurred, and ended 4 weeks after RT completion. Safety and efficacy were based on adverse events, physical examination, laboratory determinations, vital signs, Oral Mucosa Assessment Scale (OMAS) and World Health Organization scores, the ability to eat, body weight change, local control, and survival. Results: We found no severe drug-related side effect. At RT doses of 5500-7500 cGy, phenylbutyrate significantly mitigated the severity of mucositis compared with placebo, based on both the WHO score (severity {>=} 3; p = 0.0262) and the OMAS scale (ulceration score {>=} 2; p = 0.0049). The Kaplan-Meier estimates for 2- and 3-year local control, and overall survival were 100% and 80.8%, and 78.6% and 64.3%, respectively, in the phenylbutyrate group and 74.2% and 74.2%, and 57.4% and 50.2%, respectively, in the placebo group. Conclusions: This pilot trial suggested that phenylbutyrate mouthwash significantly decreased the impact of OM in HNC patients receiving RT or chemoradiotherapy and did not confront the tumor control. Larger Phase II randomized trials are needed to confirm these results.

  19. Increase in Fracture Risk Following Unintentional Weight Loss in Postmenopausal Women: The Global Longitudinal Study of Osteoporosis in Women†

    PubMed Central

    Compston, Juliet E.; Wyman, A; FitzGerald, Gordon; Adachi, Jonathan D.; Chapurlat, Roland D.; Cooper, Cyrus; Díez-Pérez, Adolfo; Gehlbach, Stephen H; Greenspan, Susan L.; Hooven, Frederick H.; LaCroix, Andrea Z.; March, Lyn; Coen Netelenbos, J.; Nieves, Jeri W.; Pfeilschifter, Johannes; Rossini, Maurizio; Roux, Christian; Saag, Kenneth G.; Siris, Ethel S.; Silverman, Stuart; Watts, Nelson B.; Anderson, Frederick A.

    2016-01-01

    Increased fracture risk has been associated with weight loss in postmenopausal women but the time course over which this occurs has not been established. The aim of this study was to examine the effects of unintentional weight loss of ≥10 lb (4.5 kg) in postmenopausal women on fracture risk at multiple sites up to 5 years following weight loss. Using data from the Global Longitudinal Study of Osteoporosis in Women (GLOW) we analyzed the relationships between self-reported unintentional weight loss of ≥10 lb at baseline, year 2, or year 3 and incident clinical fracture in the years following weight loss. Complete data were available in 40,179 women (mean age ± SD 68 ± 8.3 years). Five-year cumulative fracture rate was estimated using the Kaplan-Meier method, and adjusted hazard ratios for weight loss as a time-varying covariate were calculated from Cox multiple regression models. Unintentional weight loss at baseline was associated with a significantly increased risk of fracture of the clavicle, wrist, spine, rib, hip, and pelvis for up to 5 years following weight loss. Adjusted hazard ratios showed a significant association between unintentional weight loss and fracture of the hip, spine, and clavicle within 1 year of weight loss, and these associations were still present at 5 years. These findings demonstrate increased fracture risk at several sites after unintentional weight loss in postmenopausal women. This increase is seen as early as 1 year following weight loss, emphasizing the need for prompt fracture risk assessment and appropriate management to reduce fracture risk in this population. PMID:26861139

  20. Treatment and survival of supratentorial and posterior fossa ependymomas in adults.

    PubMed

    Nuño, Miriam; Yu, Jeffrey J; Varshneya, Kunal; Alexander, Julia; Mukherjee, Debraj; Black, Keith L; Patil, Chirag G

    2016-06-01

    Ependymoma is a rare primary brain or spinal cord tumor that arises from the ependyma, a tissue of the central nervous system. This study analyzed a large cohort of adult supratentorial and posterior fossa ependymoma tumors in order to elucidate factors associated with overall survival. We utilized the USA National Cancer Database to study adult World Health Organization grade II/III supratentorial and posterior fossa ependymoma patients treated between 1998 and 2011. Overall survival was estimated by the Kaplan-Meier method and factors associated with survival were determined using a multivariate Cox proportional hazards model. Among 1318 patients, 1055 (80.0%) had grade II and 263 (20.0%) anaplastic tumors located in the posterior fossa (64.3%) and supratentorial region (35.7%). Overall average age was 44.3years, 48.0% of patients were female, 86.5% were Caucasian, and 36.8% underwent near/gross total surgical resection. Radiotherapy was given to 662 patients (50.8%) and 75 (5.9%) received chemotherapy. Older age at diagnosis (hazard ratio [HR] 1.51, p<0.0001), high tumor grade (HR 1.82, p=0.005), and large tumor size (HR 1.66, p=0.008) were associated with poor survival. Females compared to males (HR 0.67, p=0.03) and patients with posterior fossa tumors versus supratentorial (HR 0.64, p=0.04) had a survival advantage. Our study showed that older patients, with supratentorial tumors, and high histological grade had an increased risk of mortality. A survival benefit was captured in females and patients with posterior fossa tumors. Adjuvant radiotherapy and chemotherapy did not confer a survival benefit among all patients, even after stratification by tumor grade or anatomical location. PMID:26810473

  1. Peripheral blood lymphocyte/monocyte ratio predicts outcome for patients with diffuse large B cell lymphoma after standard first-line regimens.

    PubMed

    Li, Yan-Li; Pan, Yue-Yin; Jiao, Yang; Ning, Jie; Fan, Yin-Guang; Zhai, Zhi-Min

    2014-04-01

    To determine whether peripheral blood absolute lymphocyte/absolute monocyte counts ratio (ALC/AMC ratio) at diagnosis predicts survival of diffuse large B cell lymphoma (DLBCL) patients treated with standard first-line regimens, we retrospectively analyzed 244 patients with DLBCL who were treated with standard cyclophosphamide, hydroxydaunorubicin, vincristine, and prednisone, or rituximab-cyclophosphamide, hydroxydaunorubicin, vincristine, and prednisone. Progression-free survival and overall survival (PFS and OS) were estimated using the Kaplan-Meier method and two-tailed log-rank; The Cox proportional hazards model was used to evaluate ALC/AMC ratio as prognostic factors when adjusting for the International Prognostic Index (IPI). On univariate and multivariate analyses performed with factors included in the IPI, the ALC/AMC ratio at diagnosis remained an independent predictor of OS and PFS (OS: P < 0.001; PFS: P < 0.001). Patients with lower ALC/AMC ratio (<3.8) seemed to have lower complete remission rate, 2-year PFS and 3-year OS when compared to patients with ALC/AMC ratio ≥3.8, respectively (26 versus 90 %, P < 0.001; 18 versus 82 %, P < 0.001; 24 versus 86 %; P < 0.001, respectively). Moreover, the ALC/AMC ratio was able to further risk-stratify IPI 0-2 and three-five risk patient groups, respectively. The ALC/AMC ratio at the time of diagnosis may provide additional prognostic information beyond that of the IPI for patients with DLBCL who receive standard first-line regimens.

  2. HIV-Associated Lung Cancer in the Era of Highly Active Antiretroviral Therapy (HAART)

    PubMed Central

    Pakkala, Suchita; Chen, Zhengjia; Rimland, David; Owonikoko, Taofeek K.; Gunthel, Clifford; Brandes, Johann R.; Saba, Nabil R.; Shin, Dong M.; Curran, Walter J.; Khuri, Fadlo R.; Ramalingam, Suresh S.

    2011-01-01

    Background Lung cancer is the leading cause of death among non-acquired immunodeficiency syndrome (AIDS) defining malignancies. Since highly active anti-retroviral therapy (HAART) has improved survival for human immunodeficiency virus (HIV) patients, we evaluated lung cancer outcomes in the HAART era. Methods HIV-positive patients diagnosed with lung cancer in our institution during the HAART era (1995-2008) were analyzed. Patient charts were reviewed for clinical and laboratory data. CD4 count at diagnosis was treated as a continuous variable and subcategorized into distinct variables with 3 cut-off points (50, 200, & 500 μl). Pearson’s correlation coefficients were estimated for each covariate studied. Survival was determined by the Kaplan-Meier method. Results Out of 80 patients, 73 had non-small cell lung cancer. Baseline characteristics were: median age-52 yrs; male-80%; African American-84%; injection drug use-25%; smokers-100%; and prior exposure to antiretroviral agents-55%. Mean CD4 count and viral load were 304 μL and 82,420 copies/ml, respectively at cancer diagnosis. The latency between diagnosis of HIV and lung cancer was significantly shorter in women (4.1 yrs vs. 7.7 yrs, P=0.02) and 71% of the patients received anti-cancer therapy. The 1- and 3-year survival rates were 31% and 4% overall. Grade 3/4 toxicities occurred in 60% with chemo-radiation vs. 36% with chemotherapy. Cancer-related survival was better for patients with CD4 count >200 (P=0.0298) and >500 (P=0.0076). Conclusions The latency from diagnosis of HIV to lung cancer was significantly shorter for women. Although outcomes for lung cancer patients with HIV remain poor, high CD4 count is associated with an improved lung cancer-related survival. PMID:21713759

  3. Analysis of recurrence and survival rates in grade 3 endometrioid endometrial carcinoma

    PubMed Central

    Wang, Jieyu; Jia, Nan; Li, Qing; Wang, Chao; Tao, Xiang; Hua, Keqin; Feng, Weiwei

    2016-01-01

    The aim of the present study was to determine risk factors associated with recurrence and survival in patients with grade 3 endometrioid endometrial carcinoma (G3EEC). A retrospective analysis of 117 patients with G3EEC, who were admitted to the Obstetrics and Gynecology Hospital of Fudan University between January 2000 and December 2011, was performed. The χ2 test or Fisher's exact test were used for the comparison of categorical variables. Kaplan-Meier method was used for estimating recurrence-free survival (RFS), disease-specific survival (DSS) and overall survival (OS) rates. Univariate and multivariate Cox proportional hazards model were used to assess the prognostic significance of various patient characteristics. In 117 patients, 16 patients (13.7%) had tumor recurrence, of which 6 (37.5%) developed local-regional recurrence and 10 (62.5%) developed distant recurrence. Out of the 16 patients with tumor recurrence, 14 (87.5%) had a recurrence within 3 years of surgery. Statistically significant characteristics affecting RFS, DSS and OS rates were outer half myometrial invasion (MI ≥50%), advanced International Federation of Gynecology and Obstetrics stage, positive lymph node metastasis (PLNM), lymph vascular space invasion, adnexal involvement and characterization as a high-risk group, according to the Gynecologic Oncology Group 99 stratification algorithm. RFS was associated with the depth of cervical mucosa (stromal) involvement. Furthermore, in the multivariate Cox proportional hazards model, significant independent adverse factors for RFS and DSS included MI ≥50% and adnexal involvement. For OS, there were no statistically significant prognostic factors. In conclusion, MI ≥50% and adnexal involvement are independent prognostic factors for RFS and DSS in G3EEC patients. PMID:27698871

  4. Feasibility of Economic Analysis of Radiation Therapy Oncology Group (RTOG) 91-11 Using Medicare Data

    SciTech Connect

    Konski, Andre; Bhargavan, Mythreyi; Owen, Jean; Paulus, Rebecca; Cooper, Jay; Forastiere, Arlene; Ang, K. Kian; Watkins-Bruner, Deborah

    2011-02-01

    Purpose: The specific aim of this analysis was to evaluate the feasibility of performing a cost-effectiveness analysis using Medicare data from patients treated on a randomized Phase III clinical trial. Methods and Materials: Cost data included Medicare Part A and Part B costs from all providers-inpatient, outpatient, skilled nursing facility, home health, hospice, and physicians-and were obtained from the Centers for Medicare and Medicaid Services for patients eligible for Medicare, treated on Radiation Therapy Oncology Group (RTOG) 9111 between 1992 and 1996. The 47-month expected discounted (annual discount rate of 3%) cost for each arm of the trial was calculated in 1996 dollars, with Kaplan-Meier sampling average estimates of survival probabilities for each month and mean monthly costs. Overall and disease-free survival was also discounted 3%/year. The analysis was performed from a payer's perspective. Incremental cost-effectiveness ratios were calculated comparing the chemotherapy arms to the radiation alone arm. Results: Of the 547 patients entered, Medicare cost data and clinical outcomes were available for 66 patients. Reasons for exclusion included no RTOG follow-up, Medicare HMO enrollment, no Medicare claims since trial entry, and trial entry after 1996. Differences existed between groups in tumor characteristics, toxicity, and survival, all which could affect resource utilization. Conclusions: Although we were able to test the methodology of economic analysis alongside a clinical trial using Medicare data, the results may be difficult to translate to the entire trial population because of non-random missing data. Methods to improve Medicare data capture and matching to clinical trial samples are required.

  5. Pathologic response with neoadjuvant chemotherapy and stereotactic body radiotherapy for borderline resectable and locally-advanced pancreatic cancer

    PubMed Central

    2013-01-01

    Background Neoadjuvant stereotactic body radiotherapy (SBRT) has potential applicability in the management of borderline resectable and locally-advanced pancreatic adenocarcinoma. In this series, we report the pathologic outcomes in the subset of patients who underwent surgery after neoadjuvant SBRT. Methods Patients with borderline resectable or locally-advanced pancreatic adenocarcinoma who were treated with SBRT followed by resection were included. Chemotherapy was to the discretion of the medical oncologist and preceded SBRT for most patients. Results Twelve patients met inclusion criteria. Most (92%) received neoadjuvant chemotherapy, and gemcitabine/capecitabine was most frequently utilized (n = 7). Most were treated with fractionated SBRT to 36 Gy/3 fractions (n = 7) and the remainder with single fraction to 24 Gy (n = 5). No grade 3+ acute toxicities attributable to SBRT were found. Two patients developed post-surgical vascular complications and one died secondary to this. The mean time to surgery after SBRT was 3.3 months. An R0 resection was performed in 92% of patients (n = 11/12). In 25% (n = 3/12) of patients, a complete pathologic response was achieved, and an additional 16.7% (n = 2/12) demonstrated <10% viable tumor cells. Kaplan-Meier estimated median progression free survival is 27.4 months. Overall survival is 92%, 64% and 51% at 1-, 2-, and 3-years. Conclusions This study reports the pathologic response in patients treated with neoadjuvant chemotherapy and SBRT for borderline resectable and locally-advanced pancreatic cancer. In our experience, 92% achieved an R0 resection and 41.7% of patients demonstrated either complete or extensive pathologic response to treatment. The results of a phase II study of this novel approach will be forthcoming. PMID:24175982

  6. Treatment of isolated testicular relapse in childhood acute lymphoblastic leukemia: an Italian multicenter study. Associazione Italiana Ematologia ed Oncologia Pediatrica.

    PubMed

    Uderzo, C; Grazia Zurlo, M; Adamoli, L; Zanesco, L; Aricò, M; Calculli, G; Comelli, A; Cordero di Montezemolo, L; Di Tullio, M T; Guazzelli, C

    1990-04-01

    Between May 1980 and April 1987, 49 children with acute lymphoblastic leukemia (ALL) in isolated testicular and first leukemia relapse (ITR) were enrolled in the Associazione Italiana Ematologia ed Oncologia Pediatrica (AIEOP) multicenter study REC80-ITR. According to the Rome Workshop criteria, 77% were at standard and 23% at high initial prognostic risk. In 33% of the cases, ITR occurred during first treatment. The REC80-ITR protocol consisted of an induction phase regimen of vincristine (VCR), cytarabine (ARA-C), methotrexate (MTX), and asparaginase (L-asp), and bilateral testicular irradiation, and CNS prophylaxis with intrathecal MTX and a maintenance phase with a multidrug rotating regimen. Total treatment duration was 30 months. The median time of observation after ITR was 51 months. The Kaplan-Meier estimates of survival and disease-free survival (DFS) at 4 years were 67.7% and 41%, respectively. Patients who had an ITR on therapy or within the first off-therapy year showed the poorest outcome. The DFS at 3 years was 20%, 47.6%, and 100%, respectively, for children who had an ITR on treatment (n = 16), within the first year of treatment withdrawal (n = 22), or later (n = 10) (P = .001). Patients with an asymptomatic occult testicular infiltrate at treatment discontinuation had a very unfavorable prognosis. Eighty-one percent of second relapses involved the bone marrow. In our experience, children presenting an early ITR (ie, within 6 months of treatment withdrawal) need a very aggressive treatment because of the high probability of an underlying systemic disease. On the other hand, patients with a late ITR seem to have a truly local recurrence and can apparently be cured by standard protocols, as shown in protocol REC80-ITR.

  7. Endovascular abdominal aortic aneurysm repair in the octogenarian.

    PubMed

    Brinkman, William T; Terramani, Thomas T; Najibi, Sasan; Weiss, Victor J; Salam, Atef A; Dodson, Thomas F; Smith, Robert B; Chaikof, Elliot L

    2004-07-01

    The aim of this study was to analyze patient outcomes following endovascular repair of infrarenal abdominal aortic aneurysms (EAR) among patients 80 years of age or older. In this study, reporting standards of the Ad Hoc Committee for Standardized Reporting Practices for Endovascular Aortic Aneurysm Repair of the Society of Vascular Surgery/American Association for Vascular Surgery (SVS/AAVS) were followed. Between August 8, 1996 and February 12, 2001 EAR was performed in 31 patients (29 male and 2 female) with an average age of 83 +/- 3 years and an average maximum aneurysm diameter of 59 +/- 7 mm. Overall technical success was 90% (28/31) with a single acute conversion and a 6% (2/32) incidence of major morbidity. There were no in-hospital deaths, but two patients (6%) died within 30 days of intervention. Four endoleaks, two type I and two type II, were observed within the first 30 days after endograft implantation and three new type II endoleaks were noted after implant periods that exceeded 1 month. Average follow-up was 16 months, with a single aneurysm-related death that occurred after late conversion to open repair, 2 years following initial endovascular treatment. Kaplan-Meier analysis revealed 3-, 12-, and 24-month estimated survivals of 93% (+/-5), 75% (+/-8), and 68% (+/-10), respectively. Clinical success rates were 90% (+/-5), 90% (+/-5), and 72% (+/-17) at 12, 24, and 36 months, respectively. We conclude that, in the octogenarian with mild to moderate medical comorbidities, endovascular aneurysm repair provides an alternative to open AAA repair with low operative morbidity and good clinical success rates. Elevated SVS/AAVS medical comorbidity scores were not associated with increased operative mortality rates, but they did show a trend toward decreased mid-term survival. Careful consideration of life expectancy and the probability of rupture, as with traditional AAA repair, should dictate necessity for intervention. PMID:15175935

  8. Similar patient survival following kidney allograft failure compared with non-transplanted patients.

    PubMed

    Mourad, Georges; Minguet, Johanna; Pernin, Vincent; Garrigue, Valérie; Peraldi, Marie-Noelle; Kessler, Michèle; Jacquelinet, Christian; Couchoud, Cécile; Duny, Yohan; Daurès, Jean-Pierre

    2014-07-01

    Data from the national French Renal Epidemiology and Information Network (REIN) registry were used to compare survival between transplant recipients under age 65 who resumed dialysis after graft failure during 2007-2009 and transplant-naïve incident dialysis patients matched for age, gender, diabetes mellitus, and year of starting dialysis. Among 911 transplant patients who returned to dialysis, 103 had died by 1 January 2011. Multivariate analysis showed that age over 48 years, coronary artery disease, peripheral artery disease, and inability to walk unassisted were significant predictors of death. In the case-control analysis, the observed mortality rates in 778 transplant failure and 778 transplant-naïve dialysis patients were 11.8 and 10.8%, respectively. Kaplan-Meier estimates of survival after transplant failure vs. the transplant-naïve controls were 95.2 vs. 94.1% at 1 year, 90.3 vs. 88.8% at 2 years, and 84.2 vs. 80.2% at 3 years (log rank P=0.197 overall). Dialysis in transplant failure vs. transplant-naïve patients was not associated with significantly increased mortality. At the start of dialysis, the serum creatinine levels and the rate of unplanned dialysis were significantly lower in transplant failure patients compared with transplant-naïve controls. Thus, in patients under 65 years of age in France, survival of dialysis patients after graft loss is similar to that of incident dialysis patients who have not undergone transplantation.

  9. Introduction to the Analysis of Survival Data in the Presence of Competing Risks.

    PubMed

    Austin, Peter C; Lee, Douglas S; Fine, Jason P

    2016-02-01

    Competing risks occur frequently in the analysis of survival data. A competing risk is an event whose occurrence precludes the occurrence of the primary event of interest. In a study examining time to death attributable to cardiovascular causes, death attributable to noncardiovascular causes is a competing risk. When estimating the crude incidence of outcomes, analysts should use the cumulative incidence function, rather than the complement of the Kaplan-Meier survival function. The use of the Kaplan-Meier survival function results in estimates of incidence that are biased upward, regardless of whether the competing events are independent of one another. When fitting regression models in the presence of competing risks, researchers can choose from 2 different families of models: modeling the effect of covariates on the cause-specific hazard of the outcome or modeling the effect of covariates on the cumulative incidence function. The former allows one to estimate the effect of the covariates on the rate of occurrence of the outcome in those subjects who are currently event free. The latter allows one to estimate the effect of covariates on the absolute risk of the outcome over time. The former family of models may be better suited for addressing etiologic questions, whereas the latter model may be better suited for estimating a patient's clinical prognosis. We illustrate the application of these methods by examining cause-specific mortality in patients hospitalized with heart failure. Statistical software code in both R and SAS is provided. PMID:26858290

  10. Using multiple timescale models for the evaluation of a time-dependent treatment.

    PubMed

    Rebora, Paola; Galimberti, Stefania; Valsecchi, Maria Grazia

    2015-12-10

    In survival analysis, the absolute measure of cumulative risk provided by the Kaplan-Meier estimator is still the most used quantity for its easy calculation and direct interpretability. However, for describing the survival after an intervention that may occur at different times from baseline observation, the Kaplan-Meier estimator generally yields to biased results if intervention is considered as fixed at baseline. The main focus of the present paper is to extend the use of a multiple timescale model in the presence of a time dependent intervention. The aim is to obtain 1) an estimate of treatment effect in terms of hazard ratios by flexible modeling, 2) a valid prediction tool, i.e. estimate of prognosis for a patient who changes treatment later in time, and 3) an appropriate graphical representation of survival in the presence of a time dependent treatment change, accounting for different timescales. We will show the advantages of this approach on the comparison of chemotherapy versus transplant in children with high-risk acute lymphoblastic leukemia in first remission. We considered a model with two timescales that accounts for the change in treatment at different times in the disease course. An alternative approach to survival estimates is also proposed which has some advantages over the traditional landmark approach: it uses all the data available to plot survival from the date of remission, it avoids the arbitrary choice of a landmark time and explicitly models the change in hazard due to transplant.

  11. Effect of Coffee Consumption on the Progression of Type 2 Diabetes Mellitus among Prediabetic Individuals

    PubMed Central

    Lee, Ji-Ho; Lim, Jun-Tae; Kim, Haa-Gyoung; Lee, Won-Joon

    2016-01-01

    Background A previous large-scale cohort study investigated the relationship between coffee intake and the progression of diabetes mellitus in the United States. However, studies on the effects of coffee on diabetes are rare in South Korea. Therefore, this study assessed the amount and method of coffee intake in Koreans in order to determine if coffee intake has a prophylactic effect on diabetes progression. Methods This study included 3,497 prediabetic patients from a single medical institution, with glycated hemoglobin levels ranging from 5.7% to 6.4%. Cross-tabulation and Kaplan-Meier survival analyses were performed to compare patients with and without diabetes progression based on the frequency and method of coffee intake. Cox proportional hazard analysis was performed to correct for confounding variables. Results The observation period (mean±standard deviation) was 3.7±2.3 years. Kaplan-Meier survival analysis revealed that the risk of diabetes progression was lowest in patients who drank black coffee three or more times per day (P=0.036). However, correction for confounding variables in Cox proportional hazard analysis revealed that, while the risk was lower for the patients who typically consumed black coffee than for those who mixed creamer and sugar into their coffees, the difference was not significant. Conclusion The results of this study suggest that drinking coffee without sugar and creamer at least three times daily has the greatest preventive effect on diabetes onset. PMID:26885316

  12. The Results of Long-term Follow-up of Total Hip Arthroplasty Using Hydroxyapatite-coated Cups

    PubMed Central

    Han, Chang-Dong; Shin, Keun-Young; Lee, Hyun-Hee; Park, Kwan-Kyu; Yang, Ick-Hwan

    2015-01-01

    Purpose The aim of this study was to report the long-term outcome and the failure mechanism of cementless total hip arthroplasty (THA) using hydroxyapatite (HA)-coated acetabular cup. Materials and Methods From January 1992 to May 1994, a total of 123 consecutive cementless primary THAs were performed using a HA-coated acetabular cup with metal-on-polyethylene articulation. We retrospectively evaluated 66 hips available for follow-up at a mean 18.3 years (range, 10.4-23.6 years). The survival analysis was performed by the Kaplan-Meier method. We defined end point as any failure that required a reoperation of acetabular component. Results Thirty-nine of 66 hips (59.1%) were defined as a failure for progressive acetabular osteolysis or aseptic loosening of the cup. Acetabular osteolysis was observed in 47 hips (71.2%) and 33 hips (50.0%) were revised because of cup loosening. The Kaplan-Meier method showed the survival rate of the acetabular cup to be 46.3% at 15 years and 34.8% at 20 years for any failure that required a reoperation of acetabular component. Conclusion The long-term survival rate of THA using HA-coated acetabular cup was unsatisfactory, and it was attributed to vulnerable property of HA coating and progressive osteolysis. PMID:27536628

  13. Maternal Use of Corporal Punishment for 3-year-old Children and Subsequent Risk for Child Aggressive Behavior

    PubMed Central

    Taylor, Catherine A.; Manganello, Jennifer A.; Lee, Shawna J.; Rice, Janet C.

    2016-01-01

    OBJECTIVE To examine the association between maternal use of corporal punishment (CP) against their 3-year-old children and subsequent aggressive behavior among those children two years later. METHODS Respondents participated in waves 1, 3, and 5 of the Fragile Families and Child Wellbeing Study (1998–2005), a population-based longitudinal birth cohort study of children (and their parents) born in one of 20 large U.S. cities (n=2,461), with oversampling of unmarried couples. Maternal reports of CP, children’s aggressive behaviors at 3 and 5 years of age, and a host of key demographics and potential confounding factors were assessed including: child physical maltreatment, psychological maltreatment, and neglect, intimate partner aggression and violence, and maternal stress, depression, substance use, and consideration of abortion. RESULTS Multiple logistic regression analyses revealed that frequent use of CP (i.e., maternal use of spanking more than twice in the prior month) when the child was 3 years-old was associated with increased risk for higher levels of child aggression when the child was 5 years-old (adjusted odds ratio = 1.49 [CI=1.2–1.8] p<0.0001), even after simultaneously controlling for the child’s level of aggression at 3 years of age as well as all of the aforementioned confounding factors and key demographics. CONCLUSIONS Despite American Academy of Pediatrics recommendations to the contrary, most parents in the U.S. approve of and have used CP as a form of child discipline. The current findings support a growing body of evidence that even minor forms of CP, such as spanking, raise risk for increased subsequent child aggressive behavior. Importantly, these findings cannot be attributed to the possible confounding effects of a host of other maternal parenting risk factors. Increased and improved efforts to reduce the use of CP and promote the use of alternative, effective non-physical forms of child discipline among U.S. parents are warranted

  14. Restoration of Anterior Dental Erosion with a Combination of Veneers and Crowns: A 3-Year Case Report.

    PubMed

    Abreu, Amara; Rucker, M Bryan; Loza, María A; Brackett, William W

    2015-12-01

    This report describes the conservative management of a 40-year-old female patient with smooth, eroded facial enamel affecting her maxillary anterior and some posterior teeth. Using conventional enamel bonding, pressed leucite-reinforced laminate veneers were used to restore the length, contour, and esthetics of the maxillary right canine, as well as of the right lateral and both central incisors; at the same time, it was necessary to restore the maxillary left lateral incisor, canine, and first premolar of the same quadrant with all-ceramic crowns of the same material. The patient has been followed for 3 years and demonstrates a good esthetic outcome with no shade discrepancy between the two types of restoration. Apparently, the tooth structure, though eroded, was able to provide an adequate bonding substrate for these adhesive restorations.

  15. Fifty-four-month survival in a 3-year-old child presenting with an aggressive metastatic dedifferentiated clival chordoma.

    PubMed

    Kearns, Ciléin; Kearns, Cónail

    2016-01-01

    Dedifferentiated chordoma is a rare, aggressive, chemoresistant and radioresistant malignancy arising from notochord remnants that can occur anywhere along the spine. Incidence in patients under 20 years of age is 1 per 250 million. We report a case of dedifferentiated clival chordoma presenting in a 3-year-old boy with pulmonary metastasis, which responded unusually well to chemotherapy, achieving complete metastatic clearance and debulking of the primary tumour. Proton beam therapy achieved further tumour control, with excellent quality of life for multiple years. On disease relapse, an atypical lateral transcondylar surgical approach achieved complete macroscopic clearance but there was cutaneous seeding. This, and continued primary site activity, failed to be controlled with targeted therapy, traditional chemotherapy and photon radiation, resulting in gradual neurological decline and death. Intensive management resulted in above-average survival despite diagnosis late in the disease course, which may be of value directing investigation into optimal management.

  16. Acute Corneal Hydrops 3 Years after Intra-corneal Ring Segments and Corneal Collagen Cross-linking

    PubMed Central

    Antonios, Rafic; Dirani, Ali; Fadlallah, Ali; Chelala, Elias; Hamadeh, Adib; Jarade, Elias

    2016-01-01

    This case report describes a 15-year-old male with allergic conjunctivitis and keratoconus, who underwent uneventful intra-corneal ring segment (ICRS) implantation and corneal collagen cross-linking (CXL) in the right eye. During the follow-up periods, the patient was noted to have several episodes of allergic conjunctivitis that were treated accordingly. At the 2 years postoperatively, he presented with another episode of allergic conjunctivitis and progression of keratoconus was suspected on topography. However, the patient was lost to follow-up, until he presented with acute hydrops at 3 years postoperatively. There are no reported cases of acute corneal hydrops in cross-linked corneas. We suspect the young age, allergic conjunctivitis and eye rubbing may be a risk factors associated with possible progression of keratoconus after CXL. Prolonged follow-up and aggressive control of the allergy might be necessary in similar cases. PMID:26957859

  17. [Video-based teaching in pathology. Experience gained in the last 3 years at the RWTH Aachen University].

    PubMed

    Perez-Bouza, A; Merk, M; Rieck, I; Knuechel, R

    2011-05-01

    Modern computer technology provides students with easier access to learning materials. Basic knowledge of pathological findings in organs is essential in medical education. We have produced didactic videos for teaching pathology in a clinical context in addition to regular lectures at the university. Didactic material includes macroscopic and histological findings, as well as cartoons explaining pathophysiology and clinical links. Videos can be downloaded in mv4 format as podcasts to a local hard disk or to an iPhone or iPod via iTunes University and are designed to improve classical medical literature. Analysis over 3 years of server traffic and subjective impressions by the students revealed regular use and high acceptance by users. Didactic material in clinical pathology can be successfully integrated in videos to complement lectures and practical training. Modern teaching methods in pathology make the specialty more understandable and therefore more attractive for students.

  18. Frontal Sled Tests Comparing Rear and Forward Facing Child Restraints with 1–3 Year Old Dummies

    PubMed Central

    Sherwood, C. P.; Crandall, J. R.

    2007-01-01

    Although most countries recommend transitioning children from rear facing (RF) to forward facing (FF) child restraints at one year of age, Swedish data suggests that RF restraints are more effective. The objective of this study was to compare RF and FF orientations in frontal sled tests. Four dummies (CRABI 12mo, Q1.5, Hybrid III 3yr, and Q3) were used to represent children from 1 to 3 years of age. Restraint systems tested included both 1) LATCH and 2) rigid ISOFIX with support leg designs. Rear facing restraints with support legs provided the best results for all injury measures, while RF restraints in general provided the lowest chest displacements and neck loads. PMID:18184491

  19. The magic shrinking machine revisited: The presence of props at recall facilitates memory in 3-year-olds.

    PubMed

    Dahl, Jonna J; Kingo, Osman S; Krøjgaard, Peter

    2015-12-01

    In a seminal study Simcock and Hayne (2002) showed that 3-year-olds were unable to use newly acquired words to describe a "magic" event experienced 6 or 12 months earlier. In the reference study the children's verbal recall was tested without props being present. Inspired by recent evidence, the original design was replicated, testing 33-and 39-month-olds (n = 180), but with props present at recall while controlling for potential online reasoning. The results revealed that the children did use newly acquired words to describe their preverbal memory. Thus, the present study shows that nonverbal memories can be verbalized if the recall setting provides a high level of contextual support, a finding relevant to researchers investigating the offset of childhood amnesia. PMID:26436869

  20. Anxiety symptoms, cerebral amyloid burden and memory decline in healthy older adults without dementia: 3-year prospective cohort study.

    PubMed

    Pietrzak, Robert H; Scott, J Cobb; Neumeister, Alexander; Lim, Yen Ying; Ames, David; Ellis, Kathryn A; Harrington, Karra; Lautenschlager, Nicola T; Szoeke, Cassandra; Martins, Ralph N; Masters, Colin L; Villemagne, Victor L; Rowe, Christopher C; Maruff, Paul

    2014-01-01

    Although beta-amyloid, anxiety and depression have linked cross-sectionally to reduced memory function in healthy older adults without dementia, prospective data evaluating these associations are lacking. Using data an observational cohort study of 178 healthy older adults without dementia followed for 3 years, we found that anxiety symptoms significantly moderated the relationship between beta-amyloid level and decline in verbal (Cohen's d = 0.65) and episodic (Cohen's d = 0.38) memory. Anxiety symptoms were additionally linked to greater decline in executive function, irrespective of beta-amyloid and other risk factors. These findings suggest that interventions to mitigate anxiety symptoms may help delay memory decline in otherwise healthy older adults with elevated beta-amyloid.

  1. A peripheral ameloblastic fibro-odontoma in a 3-year-old girl: case report, immunohistochemical analysis, and literature review.

    PubMed

    Lin, Yi-Chun; Hsu, Hsiu-Ming; Liu, Chiang-Shin; Yuan, Kuo

    2014-01-01

    Ameloblastic fibro-odontoma (AFO) predominantly occurs in the jaw bones of children and young adults. Extraosseous AFO is extremely rare. We describe a peripheral ameloblastic fibro-odontoma in the maxillary gingiva of a 3-year-old girl. The clinical appearance resembled fiery red reactive gingival lesions. The histopathological examination of the excised lesion showed small islands and cords of odontogenic epithelium with cellular myxoid stroma in the subepithelial tissue. The mass contained calcified material and an enamel-like deposit. Many small blood vessels appeared in the connective tissue surrounding the odontogenic epithelium. The immunohistochemical assays showed strong reactivity for amelogenin, β-catenin, CD44, and CD31 in the tissue sections. There was no recurrence after the 1-year follow-up. Because this lesion clinically resembles other nonneoplastic lesions and is very rare in gingiva, establishing a correct diagnosis is achieved only based on specific histological characteristics. Conservative excision of the tumor is the treatment of choice.

  2. Frontal sled tests comparing rear and forward facing child restraints with 1-3 year old dummies.

    PubMed

    Sherwood, C P; Crandall, J R

    2007-01-01

    Although most countries recommend transitioning children from rear facing (RF) to forward facing (FF) child restraints at one year of age, Swedish data suggests that RF restraints are more effective. The objective of this study was to compare RF and FF orientations in frontal sled tests. Four dummies (CRABI 12 mo, Q1.5, Hybrid III 3 yr, and Q3) were used to represent children from 1 to 3 years of age. Restraint systems tested included both 1) LATCH and 2) rigid ISOFIX with support leg designs. Rear facing restraints with support legs provided the best results for all injury measures, while RF restraints in general provided the lowest chest displacements and neck loads.

  3. Hypoparathyroidism in a 3-year-old Korean boy with Sotos syndrome and a novel mutation in NSD1.

    PubMed

    Wejaphikul, Karn; Cho, Sung Yoon; Huh, Rimm; Kwun, Younghee; Lee, Jieun; Ki, Chang-Seok; Jin, Dong-Kyu

    2015-01-01

    Sotos syndrome is a common genetic overgrowth syndrome caused by a mutation of the NSD1 gene, which is located at chromosome 5q35 and normally encodes a histone methyltransferase protein. The general characteristics of this syndrome include a characteristic facial appearance, developmental delay, and overgrowth, resulting in macrocephaly and tall stature. We describe rhabdomyolysis and hypocalcemia due to hypoparathyroidism in a 3-year-old Korean boy with Sotos syndrome. He was diagnosed with Sotos syndrome based on the typical phenotype and has a heterozygous nonsense mutation (c.4710C>A [p.Cys1570*]) of the NSD1 gene, which causes a premature stop codon and a truncating protein mutation. Hypoparathyroidism has never been described in Sotos syndrome. This report may therefore expand the phenotypic spectrum of this syndrome.

  4. Restoration of Anterior Dental Erosion with a Combination of Veneers and Crowns: A 3-Year Case Report.

    PubMed

    Abreu, Amara; Rucker, M Bryan; Loza, María A; Brackett, William W

    2015-12-01

    This report describes the conservative management of a 40-year-old female patient with smooth, eroded facial enamel affecting her maxillary anterior and some posterior teeth. Using conventional enamel bonding, pressed leucite-reinforced laminate veneers were used to restore the length, contour, and esthetics of the maxillary right canine, as well as of the right lateral and both central incisors; at the same time, it was necessary to restore the maxillary left lateral incisor, canine, and first premolar of the same quadrant with all-ceramic crowns of the same material. The patient has been followed for 3 years and demonstrates a good esthetic outcome with no shade discrepancy between the two types of restoration. Apparently, the tooth structure, though eroded, was able to provide an adequate bonding substrate for these adhesive restorations. PMID:26602583

  5. Phonological whole-word measures in 3-year-old bilingual children and their age-matched monolingual peers.

    PubMed

    Bunta, Ferenc; Fabiano-Smith, Leah; Goldstein, Brian; Ingram, David

    2009-02-01

    The present study investigated phonological whole-word measures and consonant accuracy in bilingual and monolingual children to investigate how target approximations drive phonological acquisition. The study included eight bilingual Spanish- and English-speaking 3-year-olds and their monolingual peers (eight Spanish and eight American English). Phonological whole-word measures (pMLU and Proximity) and consonant accuracy (PCC) were calculated on elicited single words. Differences were found on each measure between bilinguals and monolinguals in English, but in Spanish, only the PCC displayed differences between bilinguals and monolinguals. Bilinguals displayed language separation on the pMLU and the PCC but not the Proximity, indicating structural phonological differences between the Spanish and English of bilinguals but commensurate target approximations. This suggests that maintaining a consistent level of phonological proximity to the target is an important factor in phonological acquisition. The measures and their relationships are also discussed.

  6. Periurethral and vulval condylomata acuminata: an unusual juvenile venereal disease in a 3-year-old girl

    PubMed Central

    Patel, Ramnik V; Desai, Divyesh; Cherian, Abraham; Martyn-Simmons, Claire

    2014-01-01

    We present a case of giant condyloma acuminatum (CA) in a 3-year-old girl with rapidly growing vulval and periurethral lesions, which was investigated thoroughly and successfully treated with excision biopsy. Genital warts in the form of giant alarming vestibular, vulval and periurethral lesions of CA are very rare in children. There is need for a multidisciplinary approach with potential sociomedicolegal implications. Surgical excision is safe, effective and provides an opportunity to assess the extent of the lesion and tissue for accurate diagnosis. Genital warts in the form of giant alarming vestibular, vulval and periurethral lesions of CA are very rare in children. Indications for surgical treatment include large, recurrent or refractory lesions, as well as the need for histological identification and acquiring tissue for immunotherapy when necessary. The strategy of an extended follow-up is recommended so as to ensure identification of any risk situations. PMID:25199183

  7. A 3-years full-scale mechanical ice deformation test from the artificial drainages of the Tête Rousse cavity

    NASA Astrophysics Data System (ADS)

    Gagliardini, Olivier; Krug, Jean; Gillet-Chaulet, Fabien; Durand, Gaël; Gilbert, Adrien; Thibert, Emmanuel; Vincent, Christian; Weiss, Jérôme

    2013-04-01

    History of the city of Saint Gervais Mont Blanc, in the french Alps, is deeply marked by the 1892 disaster which killed 175 persons, after the unexpected release of 100000 m3 of water contained in a hidden cavity inside the Tête-Rousse glacier. During summer 2010, a pressurised water-filled cavity of at least 50000 m3 was again discovered within the glacier. To avoid a repetition of the 1892 disaster, an unprecedented initiative has been risen up to drain the water cavity under this high altitude glacier. This procedure was further repeated in Autumns 2011 and 2012 since the cavity was permanently refiled in-between two drainages. However, as the cavity was decreasing in size due to the creep of ice when the water level was low, the total water volume drained out of the cavity was decreased each Autumn. At the same time, a dense network of stakes was deployed to survey the glacier surface displacements above the cavity during the pumping. Record of the water level evolution within the cavity together with the surface displacement measurements along an almost 3-years period constitute a very well documented full-scale experiment to characterise ice deformation. When the water level is low, the cavity is shrinking, whereas when the cavity is full of pressurised water, the cavity is growing. Because of the density ratio between ice and water, closing is approximately 9 time faster than opening. This dataset is completed by recently acquired surface and bedrock DEMs, as well as an image of the cavity geometry from sonar and radar measurements. This unique dataset was then used to constraint the finite-element ice flow model Elmer/Ice and perform transient simulations over the 3-years period. Both the evolution of the surface displacements and of the cavity volume are compared to measurements. We show the importance of accounting for ice damage to reproduce the observed surface displacements.

  8. Pattern of sensitization to common environmental allergens amongst atopic Singapore children in the first 3 years of life.

    PubMed

    Khoo, J; Shek, L P; Shek, L; Khor, E S; Wang, D Y; Lee, B W

    2001-12-01

    This study was aimed to investigate the sensitization pattern to a range of common allergens in young Singaporean children. A cross-sectional study involving 75 children aged below 3 years was carried out. They presented between December 1995 and April 2000 with symptoms of asthma, rhinitis, eczema, or food allergy. Their levels of allergen-specific serum IgE to a panel of foods (egg white, milk, soy protein, shrimp, wheat and peanut), pet dander, dust mites and cockroaches were measured with Pharmacia CAP System radioallergosorbent test kits. Serum IgE levels greater than 0.35 kU/l represented a positive result. Four children could not be tested with the complete panel because of insufficient serum. The prevalence of sensitization was highest for cow's milk (45.9%) followed by egg white (38.7%), dust mites Dermatophagoides pteronyssinus (31.4%) and Blomia tropicalis (25.5%). Sensitization to ingested allergens was significantly more prevalent in children aged 1 year or younger than in the older children (70.4% of those below 1 year, and 50% of those aged 1-3 years; p < 0.02). Sensitization to inhaled allergens, such as dust mites, was more likely to manifest as respiratory symptoms (allergic rhinitis and asthma), while ingested allergens were associated with gastrointestinal symptoms and eczema (p < 0.001). It was concluded that infants and young children are at high risk of sensitization to common environmental substances. Allergen avoidance is therefore important even in the very young. The prevalence of sensitization to food allergens is higher compared to inhalant allergens in young children. PMID:12009071

  9. Mitochondrial compromise in 3-year old patas monkeys exposed in utero to human-equivalent antiretroviral therapies.

    PubMed

    Liu, Yongmin; Shim Park, Eunwoo; Gibbons, Alexander T; Shide, Eric D; Divi, Rao L; Woodward, Ruth A; Poirier, Miriam C

    2016-08-01

    Antiretroviral (ARV) drug therapy, given during pregnancy for prevention of mother-to-child transmission of human immunodeficiency virus 1 (HIV-1), induces fetal mitochondrial dysfunction in some children. However, the persistence/reversibility of that dysfunction is unclear. Here we have followed Erythrocebus patas (patas) monkey offspring for up to 3 years of age (similar in development to a 15-year old human) after exposure of the dams to human-equivalent in utero ARV exposure protocols. Pregnant patas dams (3-5/exposure group) were given ARV drug combinations that included zidovudine (AZT)/lamivudine (3TC)/abacavir (ABC), or AZT/3TC/nevirapine (NVP), for the last 10 weeks (50%) of gestation. Infants kept for 1 and 3 years also received drug for the first 6 weeks of life. In offpsring at birth, 1 and 3 years of age mitochondrial morphology, examined by electron microscopy (EM), was compromised compared to the unexposed controls. Mitochondrial DNA (mtDNA), measured by hybrid capture chemiluminescence assay (HCCA) was depleted in hearts of patas exposed to AZT/3TC/NVP at all ages (P < 0.05), but not in those exposed to AZT/3TC/ABC at any age. Compared to unexposed controls, mitochondrial reserve capacity oxygen consumption rate (OCR by Seahorse) in cultured bone marrow mesenchymal fibroblasts from 3-year-old patas offspring was ∼50% reduced in AZT/3TC/ABC-exposed patas (P < 0.01), but not in AZT/3TC/NVP-exposed patas. Overall the data show that 3-year-old patas sustain persistent mitochondrial dysfunction as a result of perinatal ARV drug exposure. Environ. Mol. Mutagen. 57:526-534, 2016. © 2016 Wiley Periodicals, Inc.

  10. Mitochondrial compromise in 3-year old patas monkeys exposed in utero to human-equivalent antiretroviral therapies.

    PubMed

    Liu, Yongmin; Shim Park, Eunwoo; Gibbons, Alexander T; Shide, Eric D; Divi, Rao L; Woodward, Ruth A; Poirier, Miriam C

    2016-08-01

    Antiretroviral (ARV) drug therapy, given during pregnancy for prevention of mother-to-child transmission of human immunodeficiency virus 1 (HIV-1), induces fetal mitochondrial dysfunction in some children. However, the persistence/reversibility of that dysfunction is unclear. Here we have followed Erythrocebus patas (patas) monkey offspring for up to 3 years of age (similar in development to a 15-year old human) after exposure of the dams to human-equivalent in utero ARV exposure protocols. Pregnant patas dams (3-5/exposure group) were given ARV drug combinations that included zidovudine (AZT)/lamivudine (3TC)/abacavir (ABC), or AZT/3TC/nevirapine (NVP), for the last 10 weeks (50%) of gestation. Infants kept for 1 and 3 years also received drug for the first 6 weeks of life. In offpsring at birth, 1 and 3 years of age mitochondrial morphology, examined by electron microscopy (EM), was compromised compared to the unexposed controls. Mitochondrial DNA (mtDNA), measured by hybrid capture chemiluminescence assay (HCCA) was depleted in hearts of patas exposed to AZT/3TC/NVP at all ages (P < 0.05), but not in those exposed to AZT/3TC/ABC at any age. Compared to unexposed controls, mitochondrial reserve capacity oxygen consumption rate (OCR by Seahorse) in cultured bone marrow mesenchymal fibroblasts from 3-year-old patas offspring was ∼50% reduced in AZT/3TC/ABC-exposed patas (P < 0.01), but not in AZT/3TC/NVP-exposed patas. Overall the data show that 3-year-old patas sustain persistent mitochondrial dysfunction as a result of perinatal ARV drug exposure. Environ. Mol. Mutagen. 57:526-534, 2016. © 2016 Wiley Periodicals, Inc. PMID:27452341

  11. Bone Mineral Density as a Marker of Cumulative Estrogen Exposure in Psychotic Disorder: A 3 Year Follow-Up Study

    PubMed Central

    van der Leeuw, Christine; Peeters, Sanne; Domen, Patrick; van Kroonenburgh, Marinus; van Os, Jim; Marcelis, Machteld

    2015-01-01

    Altered estrogen-induced neuroprotection has been implicated in the etiology of psychotic disorders. Using bone mineral density as a marker of lifetime estrogen exposure, a longitudinal family study was conducted to discriminate between etiological mechanisms and secondary effects of disease and treatment. Dual X-ray absorptiometry scans were acquired twice, with an interval of 3 years, in 30 patients with psychotic disorder (male (M)/female (F): 24/6, mean age of 32 years at second measurement), 44 non-psychotic siblings of patients with a psychotic disorder (M/F: 26/18, mean age 32) and 27 controls (M/F: 7/20, mean age 35). Total bone mineral density, Z-scores and T-scores were measured in the lumbar spine and proximal femur. Associations between group and bone mineral density changes were investigated with multilevel random regression analyses. The effect of prolactin-raising antipsychotic medication was evaluated. (Increased risk of) psychotic disorder was not associated with disproportionate bone mineral density loss over a three year period. Instead, femoral bone mineral density measures appeared to decrease less in the patient versus control comparison (total BMD: B = 0.026, 95% CI 0.002 to 0.050, p = 0.037; Z-score: B = 0.224, 95% CI 0.035 to 0.412, p = 0.020; and T-score: B = 0.193, 95% CI 0.003 to 0.382, p = 0.046). Current or past use of a prolactin-raising antipsychotic medication was not associated with bone mineral density changes. In this small longitudinal study, there was no evidence of ongoing estrogen deficiency in psychotic disorder as there was no excessive loss of bone mineral density over a 3-year period in patients using antipsychotic medication. PMID:26309037

  12. Screening for inborn errors of metabolism in high-risk children: a 3-year pilot study in Zhejiang Province, China

    PubMed Central

    2012-01-01

    Background Tandem mass spectrometry (MS/MS) has been available in China for 8 years. This technique makes it possible to screen for a wide range of previously unscreened inborn errors of metabolism (IEM) using a single test. This 3-year pilot study investigated the screening, diagnosis, treatment and outcomes of IEM in symptomatic infants and children. Methods All children encountered in the Newborn Screening Center of Zhejiang Province during a 3-year period with symptoms suspicious for IEM were screened for metabolic diseases. Dried blood spots were collected and analyzed by tandem mass spectrometry. The diagnoses were further confirmed by clinical symptoms and biochemical analysis. Neonatal intrahepatic cholestasis caused by citrin deficiency, ornithine transcarbamylase deficiency and primary carnitine deficiency were confirmed by DNA analysis. Results A total of 11,060 symptomatic patients (6,720 boys, 4,340 girls) with a median age of 28.8 months (range: 0.04-168.2 months) were screened. Among these, 62 were diagnosed with IEM, with a detection rate of 0.56%. Thirty-five were males and 27 females and the median age was 3.55 months (range 0.07-143.9 months). Of the 62 patients, 27 (43.5%) had aminoacidemias, 26 (41.9%) had organic acidemias and nine (14.5%) had fatty acid oxidation disorders. Conclusions Because most symptomatic patients are diagnosed at an older age, mental retardation and motor delay are difficult to reverse. Additionally, poor medication compliance reduces the efficacy of treatment. More extensive newborn screening is thus imperative for ensuring early diagnosis and enhancing the treatment efficacy of IEM. PMID:22364411

  13. The Influence of Phonotactic Probability on Nonword Repetition and Fast Mapping in 3-Year-Olds with a History of Expressive Language Delay

    ERIC Educational Resources Information Center

    MacRoy-Higgins, Michelle; Dalton, Kevin Patrick

    2015-01-01

    Purpose: The purpose of this study was to examine the influence of phonotactic probability on sublexical (phonological) and lexical representations in 3-year-olds who had a history of being late talkers in comparison with their peers with typical language development. Method: Ten 3-year-olds who were late talkers and 10 age-matched typically…

  14. Sample Length Affects the Reliability of Language Sample Measures in 3-Year-Olds: Evidence from Parent-Elicited Conversational Samples

    ERIC Educational Resources Information Center

    Guo, Ling-Yu; Eisenberg, Sarita

    2015-01-01

    Purpose: The goal of this study was to investigate the extent to which sample length affected the reliability of total number of words (TNW), number of different words (NDW), and mean length of C-units in morphemes (MLCUm) in parent-elicited conversational samples for 3-year-olds. Method: Participants were sixty 3-year-olds. A 22-min language…

  15. Do Autistic Symptoms Persist across Time? Evidence of Substantial Change in Symptomatology over a 3-Year Period in Cognitively Able Children with Autism

    ERIC Educational Resources Information Center

    Pellicano, Elizabeth

    2012-01-01

    This study investigated the extent and nature of changes in symptomatology in cognitively able children with autism over a 3-year period. Thirty-seven children diagnosed with an autism spectrum condition involved in an earlier study (M age = 5 years, 7 months) were followed and reassessed 3 years later (M age = 8 years, 4 months). Scores on the…

  16. Evaluation of a Program to Teach Phonemic Awareness to Young Children: A 2- and 3-Year Follow-Up and a New Preschool Trial.

    ERIC Educational Resources Information Center

    Byrne, Brian; Fielding-Barnsley, Ruth

    1995-01-01

    A follow-up study of 62 children in grades 1 and 2 instructed in phonemic awareness in preschool showed that, compared with 53 controls, trained children were superior in nonword reading 2 and 3 years later and in reading comprehension at 3 years. A supplemental study supported these results. (SLD)

  17. Monosyllabic Mandarin Tone Productions by 3-Year-Olds Growing up in Taiwan and in the United States: Interjudge Reliability and Perceptual Results

    ERIC Educational Resources Information Center

    Wong, Puisan

    2012-01-01

    Purpose: The author compared monosyllabic Mandarin lexical tones produced by 3-year-old Mandarin-speaking children growing up in Taiwan and in the United States. Method: Following the procedures in Wong, Schwartz, and Jenkins (2005), the author collected monosyllabic tone productions from 3-year-old Mandarin-speaking children in Taiwan and…

  18. Emergence and evolution of social self-management of Parkinson’s disease: study protocol for a 3-year prospective cohort study

    PubMed Central

    2014-01-01

    Background Parkinson’s disease affects facial, vocal and trunk muscles. As symptoms progress, facial expression becomes masked, limiting the person’s ability to communicate emotions and intentions to others. As people with the disease live and reside in their homes longer, the burden of caregiving is unmitigated by social and emotional rewards provided by an expressive individual. Little is known about how adults living with Parkinson’s disease manage their social lives and how an inability to be emotionally expressive can affect social connections and health. Because social networks have been shown to be crucial to the overall well-being of people living with chronic diseases, research is needed on how expressive capacity affects life trajectories and health. Methods/Design The overall objective is to understand the emergence and evolution of the trajectories of the self-management of the social lives of people living with Parkinson’s disease. The central hypothesis is that expressive capacity predicts systematic change in the pattern of social self-management and quality of life outcomes. The specific aims of this 3-year longitudinal study of 120 people with the disease and a maximum of 120 care partners are: 1) characterize social self-management trajectories over a 3-year period; 2) estimate the degree to which expressive nonverbal capacity predicts the trajectory; and 3) determine the moderating effect of gender on the association between expressive capacity and change in social self-management. Each participant will be assessed 14 times to detect rapid and non-linear changes in social participation and management of social activities; social network; and social comfort, general health and well-being. Discussion This project will provide evidence to guide the development of interventions for supporting social integration of those living with Parkinson’s disease, thus leading to improved overall health. It focuses on the novel construct of social self

  19. Final Report for 3-year grant no. DE-FG05-85ER40226. Investigations in Elementary Particle Theory.

    SciTech Connect

    Kephart, Thomas W.; Scherrer, Robert J.; Weiler, Thomas J.

    2014-11-23

    The research interests of our three Co-PI’s complement each other very well. Kephart works mainly on models of particle unification in four or higher dimensions, on aspects of gravity such as inflation, black-holes, and the very early Universe, and on applications of knot theory and topology to various physical systems (including gluon dynamics). Scherrer works mainly on aspects of the intermediate-aged Universe, including dark matter and dark energy, and particle physics in the early Universe. Weiler works mainly on neutrino physics, dark matter signatures, and extreme particle-astrophysics in the late Universe, including origins of the highest-energy cosmic-rays and gamma-rays, and the future potential of neutrino astrophysics. Kephart and Weiler have lately devoted some research attention to the LHC and its reach for probing physics beyond the Standard Model. During the 3-year funding period, our grant supported one postdoc (Chiu Man Ho) and partially supported two students, Peter Denton and Lingjun Fu. Chiu Man collaborated with all three of the Co-PI’s during the 3-year funding period and published 16 refereed papers. Chiu Man has gone on to a postdoc with Steve Hsu at Michigan State University. Denton and Fu will both receive their PhDs during the 2014-15 academic year. The total number of our papers published in refereed journals by the three co-PIs during the period of this grant (2011-present) is 54. The total number of talks given by the group members during this time period, including seminars, colloquia, and conference presentations, is 47. Some details of the accomplishments of our DOE funded researchers during the grant period include Weiler being named a Simons Fellow in 2013. He presented an invited TEDx talk in 2012. His paper on closed timelike curves (2013) garnered a great deal of national publicity. Scherrer’s paper on the “little rip” (2011) fostered a new area of cosmological research, and the name “little rip” has now entered

  20. Risk factors for unintentional poisoning in children aged 1–3 years in NSW Australia: a case–control study

    PubMed Central

    2013-01-01

    Background Unintentional poisoning in young children is an important public health issue. Age pattern studies have demonstrated that children aged 1–3 years have the highest levels of poisoning risk among children aged 0–4 years, yet little research has been conducted regarding risk factors specific to this three-year age group and the methodologies employed varied greatly. The purpose of the current study is to investigate a broad range of potential risk factors for unintentional poisoning in children aged 1–3 years using appropriate methodologies. Methods Four groups of children, one case group (children who had experienced a poisoning event) and three control groups (children who had been ‘injured’, ‘sick’ or who were ‘healthy’), and their mothers (mother-child dyads) were enrolled into a case–control study. All mother-child dyads participated in a 1.5-hour child developmental screening and observation, with mothers responding to a series of questionnaires at home. Data were analysed as three case–control pairs with multivariate analyses used to control for age and sex differences between child cases and controls. Results Five risk factors were included in the final multivariate models for one or more case–control pairs. All three models found that children whose mothers used more positive control in their interactions during a structured task had higher odds of poisoning. Two models showed that maternal psychiatric distress increased poisoning risk (poisoning-injury and poisoning-healthy). Individual models identified the following variables as risk factors: less proximal maternal supervision during risk taking activities (poisoning-injury), medicinal substances stored in more accessible locations in bathrooms (poisoning-sick) and lower total parenting stress (poisoning-healthy). Conclusions The findings of this study indicate that the nature of the caregiver-child relationship and caregiver attributes play an important role in

  1. Progression of cardiovascular risk factors in black Africans: 3 year follow up of the SABPA cohort study

    PubMed Central

    Hamer, Mark; von Känel, Roland; Reimann, Manja; Malan, Nico T.; Schutte, Alta E.; Huisman, Hugo W.; Malan, Leone

    2015-01-01

    Recent work identified a high prevalence of modifiable risk factors for cardiovascular disease (CVD) among urban black South Africans. The aim was to track the progression of CVD risk factors in a multi-ethnic sample of South Africans. Participants were 173 black (aged 47.5 ± 7.8 yrs) and 186 white teachers (aged 49.6 ± 9.9 yrs) that were examined at baseline and 3 years follow-up. Blacks demonstrated a substantially higher prevalence of composite CVD burden (defined as history of physician diagnosed heart disease, use of anti-hypertensives, anti-diabetic, or statin medications at either time point) compared to whites (49.1 vs. 32.0%, p = 0.012) respectively. After controlling for baseline, the black participants demonstrated greater increases in 24 h systolic and diastolic blood pressure, total cholesterol, fasting glucose, fibrinogen, D-dimer, and waist circumference in comparison with whites. In summary, an adverse progression of CVD risk factors was observed in the whole sample, although to a larger degree in black participants. Aggressive treatment strategies for controlling risk factors in black Africans are needed to reduce the increasing burden of CVD in South Africa. PMID:25437890

  2. Educational outcomes from a novel house call curriculum for internal medicine residents: report of a 3-year experience.

    PubMed

    Hayashi, Jennifer; Christmas, Colleen; Durso, Samuel C

    2011-07-01

    Physician house calls are an important mode of healthcare delivery to frail homebound older adults and positively affect patient outcomes and learner education, but most physicians receive scant training in home care medicine. A novel longitudinal curriculum in house call medicine for internal medicine residents was implemented in July 2006, and educational outcomes were evaluated over the following 3 years. The 2-year curriculum included didactic and experiential components. Residents made house calls with preceptors and alone and completed a series of computer modules outlining knowledge essential to providing home-based care. They discussed the important features of the modules in regularly scheduled small groups throughout the 2-year experience, and each taught a "house call morning report" in their senior resident year. Evaluation methods included surveys before, during, and at the end of the 2-year curriculum (knowledge and attitudes); direct observation by preceptors during house calls (skills); and an online, anonymous survey at the end of each year (attitudes). Results show statistically significant increases in residents' knowledge, skills, and attitudes relevant to home care medicine. Residents describe educationally significant and positive effects from their house call experiences. This novel curriculum improved medical residents' knowledge, attitudes, and skills in performing house calls for frail elderly individuals. The longer-term outcomes of this intervention will continue to be studied, with the hope that it may be used to help provide educational opportunities to prepare the physician workforce to meet the service needs of a growing segment of the population.

  3. Revascularization of an Immature Tooth with Apical Periodontitis Using Calcium Hydroxide: A 3-year Follow-up

    PubMed Central

    Silva, Mauro Henrique Chagas; Campos, Celso Neiva; Coelho, Marcelo Santos

    2015-01-01

    Root canal treatment of teeth presenting immature development is a great challenge for both the patient and the professional. The thinness of the root canal walls of immature teeth may lead to root fracture and thus the outcomes of such treatments are uncertain. Revascularization is based on root canal decontamination followed by the induction of blood migration from the periapical tissues and the development of new vascular tissue in the canal space. The principle of disinfection in regenerative endodontics is that it should be achieved with minimum root canal instrumentation; an intracanal medication is used to inhibit bacterial growth and appropriate sealing of the coronal portion is performed. The American Association of Endodontists (AAE) considerations for regenerative endodontics include calcium hydroxide as an alternative intracanal dressing. This material has also been claimed to diminish the possibility of dental staining during revascularization procedures. The relatively new treatment protocol has been widely reported in the last few years; however it should be performed only when other alternatives are not reasonable. This case report presents a 3-year follow-up of a case of revascularization of a maxillary central incisor using calcium hydroxide as a root canal disinfection dressing. PMID:26962377

  4. Children Born After Unplanned Pregnancies and Cognitive Development at 3 Years: Social Differentials in the United Kingdom Millennium Cohort

    PubMed Central

    de La Rochebrochard, Elise; Joshi, Heather

    2013-01-01

    Children born after an unplanned pregnancy have poorer developmental scores. This could arise from less favorable parenting but also could reflect confounding from the socioeconomic circumstances. In a large representative sample in the United Kingdom, the Millennium Cohort Study (2001–2005), cognitive delay at 3 years was explored with the Bracken Assessment. Its association with unplanned pregnancy was studied in logistic models controlling for demographic and socioeconomic characteristics of the family, the child's characteristics, and parenting behavior. Stratification by the mother's educational level (grouped into 3 categories) was explored. Of 12,182 children included in the analysis, 41% were born after a pregnancy reported by the mother to have been a “surprise.” Such unplanned pregnancies were associated in univariate analysis with more cognitive delay. Among mothers with a low or middle level of education, this association vanished when socioeconomic circumstances were controlled. Among mothers with a high level of education, the risk of cognitive delay remained significantly and unexplainedly raised after unplanned pregnancies, despite controlling for socioeconomic characteristics and parental behavior. In conclusion, for socially disadvantaged children, having resulted from an unplanned pregnancy does not seem to increase their already disproportionate risk of cognitive delay. Births after unplanned conceptions are mainly a symptom rather than a source of disadvantage. PMID:23887043

  5. VanA-type vancomycin-resistant enterococci (VRE) remain prevalent in poultry carcasses 3 years after avoparcin was banned.

    PubMed

    Borgen, K; Sørum, M; Wasteson, Y; Kruse, H

    2001-02-28

    Avoparcin was used as a growth promoting feed additive in Norwegian broiler and turkey production from 1986 until it was banned in 1995, when an association between vancomycin-resistant enterococci (VRE) and avoparcin use became apparent. A recent study regarding faecal samples documented a continuing high prevalence of VRE among Norwegian poultry 3 years after avoparcin was banned. In the present study, carcasses of broilers and turkeys from farms where avoparcin had previously been in use and carcasses of layer chickens from farms where avoparcin had never been used were examined for the presence of VRE. One carcass from each of 150 different farms was included. By a direct plating method, VRE were isolated from 30 of 100 samples of broilers and turkeys, but not from any samples of layer chickens. When an enrichment step was included, VRE were isolated from a total of 81 of the 100 samples of broilers and turkeys and from nine of the 50 samples of layer chickens. All VRE isolated were highly resistant to vancomycin (MIC > or = 256 microg/ml) and possessed the vanA gene. These results correspond to the prevalence of VRE recently documented in faecal samples from Norwegian poultry. The present study reveals a high prevalence of VRE in broiler and turkey carcasses. Consequently, consumers are exposed to VRE when handling raw poultry meat, although the public health significance of such exposure is unclear. PMID:11252515

  6. Ocular biometric parameters among 3-year-old Chinese children: testability, distribution and association with anthropometric parameters.

    PubMed

    Huang, Dan; Chen, Xuejuan; Gong, Qi; Yuan, Chaoqun; Ding, Hui; Bai, Jing; Zhu, Hui; Fu, Zhujun; Yu, Rongbin; Liu, Hu

    2016-01-01

    This survey was conducted to determine the testability, distribution and associations of ocular biometric parameters in Chinese preschool children. Ocular biometric examinations, including the axial length (AL) and corneal radius of curvature (CR), were conducted on 1,688 3-year-old subjects by using an IOLMaster in August 2015. Anthropometric parameters, including height and weight, were measured according to a standardized protocol, and body mass index (BMI) was calculated. The testability was 93.7% for the AL and 78.6% for the CR overall, and both measures improved with age. Girls performed slightly better in AL measurements (P = 0.08), and the difference in CR was statistically significant (P < 0.05). The AL distribution was normal in girls (P = 0.12), whereas it was not in boys (P < 0.05). For CR1, all subgroups presented normal distributions (P = 0.16 for boys; P = 0.20 for girls), but the distribution varied when the subgroups were combined (P < 0.05). CR2 presented a normal distribution (P = 0.11), whereas the AL/CR ratio was abnormal (P < 0.001). Boys exhibited a significantly longer AL, a greater CR and a greater AL/CR ratio than girls (all P < 0.001).

  7. Airway accidents in critical care unit: A 3-year retrospective study in a Public Teaching Hospital of Eastern India

    PubMed Central

    Dasgupta, Sugata; Singh, Shipti Shradha; Chaudhuri, Arunima; Bhattacharya, Dipasri; Choudhury, Sourav Das

    2016-01-01

    Background: Although tracheal tubes are essential devices to control and protect airway in a critical care unit (CCU), they are not free from complications. Aims: To document the incidence and nature of airway accidents in the CCU of a government teaching hospital in Eastern India. Methods: Retrospective analysis of all airway accidents in a 5-bedded (medical and surgical) CCU. The number, types, timing, and severity of airway accidents were analyzed. Results: The total accident rate was 19 in 233 intubated and/or tracheostomized patients over 1657 tube days (TDs) during 3 years. Fourteen occurred in 232 endotracheally intubated patients over 1075 endotracheal tube (ETT) days, and five occurred in 44 tracheostomized patients over 580 tracheostomy TDs. Fifteen accidents were due to blocked tubes. Rest four were unplanned extubations (UEs), all being accidental extubations. All blockages occurred during night shifts and all UEs during day shifts. Five accidents were mild, the rest moderate. No major accident led to cardiorespiratory arrest or death. All blockages occurred after 7th day of intubation. The outcome of accidents were more favorable in tracheostomy group compared to ETT group (P = 0.001). Conclusions: The prevalence of airway accidents was 8.2 accidents per 100 patients. Blockages were the most common accidents followed by UEs. Ten out of the 15 blockages and all 4 UEs were in endotracheally intubated patients. Tracheostomized patients had 5 blockages and no UEs. PMID:27076709

  8. Predictive Factors for Subjective Improvement in Lumbar Spinal Stenosis Patients with Nonsurgical Treatment: A 3-Year Prospective Cohort Study

    PubMed Central

    Matsudaira, Ko; Hara, Nobuhiro; Oka, Hiroyuki; Kunogi, Junichi; Yamazaki, Takashi; Takeshita, Katsushi; Atsushi, Seichi; Tanaka, Sakae

    2016-01-01

    Objective To assess the predictive factors for subjective improvement with nonsurgical treatment in consecutive patients with lumbar spinal stenosis (LSS). Materials and Methods Patients with LSS were enrolled from 17 medical centres in Japan. We followed up 274 patients (151 men; mean age, 71 ± 7.4 years) for 3 years. A multivariable logistic regression model was used to assess the predictive factors for subjective symptom improvement with nonsurgical treatment. Results In 30% of patients, conservative treatment led to a subjective improvement in the symptoms; in 70% of patients, the symptoms remained unchanged, worsened, or required surgical treatment. The multivariable analysis of predictive factors for subjective improvement with nonsurgical treatment showed that the absence of cauda equina symptoms (only radicular symptoms) had an odds ratio (OR) of 3.31 (95% confidence interval [CI]: 1.50–7.31); absence of degenerative spondylolisthesis/scoliosis had an OR of 2.53 (95% CI: 1.13–5.65); <1-year duration of illness had an OR of 3.81 (95% CI: 1.46–9.98); and hypertension had an OR of 2.09 (95% CI: 0.92–4.78). Conclusions The predictive factors for subjective symptom improvement with nonsurgical treatment in LSS patients were the presence of only radicular symptoms, absence of degenerative spondylolisthesis/scoliosis, and an illness duration of <1 year. PMID:26863214

  9. Ocular biometric parameters among 3-year-old Chinese children: testability, distribution and association with anthropometric parameters

    PubMed Central

    Huang, Dan; Chen, Xuejuan; Gong, Qi; Yuan, Chaoqun; Ding, Hui; Bai, Jing; Zhu, Hui; Fu, Zhujun; Yu, Rongbin; Liu, Hu

    2016-01-01

    This survey was conducted to determine the testability, distribution and associations of ocular biometric parameters in Chinese preschool children. Ocular biometric examinations, including the axial length (AL) and corneal radius of curvature (CR), were conducted on 1,688 3-year-old subjects by using an IOLMaster in August 2015. Anthropometric parameters, including height and weight, were measured according to a standardized protocol, and body mass index (BMI) was calculated. The testability was 93.7% for the AL and 78.6% for the CR overall, and both measures improved with age. Girls performed slightly better in AL measurements (P = 0.08), and the difference in CR was statistically significant (P < 0.05). The AL distribution was normal in girls (P = 0.12), whereas it was not in boys (P < 0.05). For CR1, all subgroups presented normal distributions (P = 0.16 for boys; P = 0.20 for girls), but the distribution varied when the subgroups were combined (P < 0.05). CR2 presented a normal distribution (P = 0.11), whereas the AL/CR ratio was abnormal (P < 0.001). Boys exhibited a significantly longer AL, a greater CR and a greater AL/CR ratio than girls (all P < 0.001). PMID:27384307

  10. Progression of cardiovascular risk factors in black Africans: 3 year follow up of the SABPA cohort study.

    PubMed

    Hamer, Mark; von Känel, Roland; Reimann, Manja; Malan, Nico T; Schutte, Alta E; Huisman, Hugo W; Malan, Leone

    2015-01-01

    Recent work identified a high prevalence of modifiable risk factors for cardiovascular disease (CVD) among urban black South Africans. The aim was to track the progression of CVD risk factors in a multi-ethnic sample of South Africans. Participants were 173 black (aged 47.5 ± 7.8 yrs) and 186 white teachers (aged 49.6 ± 9.9 yrs) that were examined at baseline and 3 years follow-up. Blacks demonstrated a substantially higher prevalence of composite CVD burden (defined as history of physician diagnosed heart disease, use of anti-hypertensives, anti-diabetic, or statin medications at either time point) compared to whites (49.1 vs. 32.0%, p = 0.012) respectively. After controlling for baseline, the black participants demonstrated greater increases in 24 h systolic and diastolic blood pressure, total cholesterol, fasting glucose, fibrinogen, D-dimer, and waist circumference in comparison with whites. In summary, an adverse progression of CVD risk factors was observed in the whole sample, although to a larger degree in black participants. Aggressive treatment strategies for controlling risk factors in black Africans are needed to reduce the increasing burden of CVD in South Africa.

  11. Ocular biometric parameters among 3-year-old Chinese children: testability, distribution and association with anthropometric parameters.

    PubMed

    Huang, Dan; Chen, Xuejuan; Gong, Qi; Yuan, Chaoqun; Ding, Hui; Bai, Jing; Zhu, Hui; Fu, Zhujun; Yu, Rongbin; Liu, Hu

    2016-01-01

    This survey was conducted to determine the testability, distribution and associations of ocular biometric parameters in Chinese preschool children. Ocular biometric examinations, including the axial length (AL) and corneal radius of curvature (CR), were conducted on 1,688 3-year-old subjects by using an IOLMaster in August 2015. Anthropometric parameters, including height and weight, were measured according to a standardized protocol, and body mass index (BMI) was calculated. The testability was 93.7% for the AL and 78.6% for the CR overall, and both measures improved with age. Girls performed slightly better in AL measurements (P = 0.08), and the difference in CR was statistically significant (P < 0.05). The AL distribution was normal in girls (P = 0.12), whereas it was not in boys (P < 0.05). For CR1, all subgroups presented normal distributions (P = 0.16 for boys; P = 0.20 for girls), but the distribution varied when the subgroups were combined (P < 0.05). CR2 presented a normal distribution (P = 0.11), whereas the AL/CR ratio was abnormal (P < 0.001). Boys exhibited a significantly longer AL, a greater CR and a greater AL/CR ratio than girls (all P < 0.001). PMID:27384307

  12. The 3-year evolution of a preschool physical activity intervention through a collaborative partnership between research interventionists and preschool teachers

    PubMed Central

    Howie, E. K.; Brewer, A.; Brown, W. H.; Pfeiffer, K. A.; Saunders, R. P.; Pate, R. R.

    2014-01-01

    Despite evidence that preschoolers spend the majority of their time in sedentary activities, few physical activity interventions have focused on preschool-age children. Health promotion interventions that can be integrated into the daily routines of a school or other setting are more likely to be implemented. The Study of Health and Activity in Preschool Environments employed a flexible approach to increasing physical activity opportunities in preschools’ daily schedules through recess, indoor physical activity and physical activity integrated into academic lessons. Eight preschools were randomly assigned to receive the study’s physical activity intervention. Teachers in these schools partnered with university-based interventionists across 3 years to design and implement a flexible and adaptive intervention. The intervention approach included trainings and workshops, site visits and feedback from intervention personnel, newsletters, and physical activity equipment and materials. Teachers reported a high acceptability of the intervention. The purpose of this article is to describe the evolution of a multi-component physical activity intervention in preschools, including (i) a description of the intervention components, (ii) an explanation of the intervention process and approach, and (iii) a report of teachers’ perceptions of barriers to implementation. PMID:24659421

  13. Maxillary Overdentures Supported by Four Splinted Direct Metal Laser Sintering Implants: A 3-Year Prospective Clinical Study

    PubMed Central

    Mangano, Francesco; Shibli, Jamil Awad; Anil, Sukumaran

    2014-01-01

    Purpose. Nowadays, the advancements in direct metal laser sintering (DMLS) technology allow the fabrication of titanium dental implants. The aim of this study was to evaluate implant survival, complications, and peri-implant marginal bone loss of DMLS implants used to support bar-retained maxillary overdentures. Materials and Methods. Over a 2-year period, 120 implants were placed in the maxilla of 30 patients (18 males, 12 females) to support bar-retained maxillary overdentures (ODs). Each OD was supported by 4 implants splinted by a rigid cobalt-chrome bar. At each annual follow-up session, clinical and radiographic parameters were assessed. The outcome measures were implant failure, biological and prosthetic complications, and peri-implant marginal bone loss (distance between the implant shoulder and the first visible bone-to-implant contact, DIB). Results. The 3-year implant survival rate was 97.4% (implant-based) and 92.9% (patient-based). Three implants failed. The incidence of biological complication was 3.5% (implant-based) and 7.1% (patient-based). The incidence of prosthetic complication was 17.8% (patient-based). No detrimental effects on marginal bone level were evidenced. Conclusions. The use of 4 DMLS titanium implants to support bar-retained maxillary ODs seems to represent a safe and successful procedure. Long-term clinical studies on a larger sample of patients are needed to confirm these results. PMID:25580124

  14. Intestinal Obstruction in a 3-Year-Old Girl by Ascaris lumbricoides Infestation: Case Report and Review of the Literature.

    PubMed

    Andrade, Angel Medina; Perez, Yeudiel; Lopez, Cecilia; Collazos, Stephanie Serrano; Andrade, Alejandro Medina; Ramirez, Grecia Ortiz; Andrade, Laura Medina

    2015-04-01

    Ascaris lumbricoides infection affects approximately 1.5 billion people globally. Children with environmental and socio-economic risk factors are more susceptible to infestation, with serious complications such as intestinal obstruction (IO), volvulus, intussusception, and intestinal necrosis.We present the case of a 3-year-old girl who arrived at emergency department with abdominal pain and diarrhea for the last 3 days. The previous day she took an unspecified anthelmintic. Symptoms worsened with vomiting and diarrhea, with expulsion of roundworms through mouth and anus. Physical examination revealed bloating, absence of bowel sounds, abdominal tenderness, and a palpable mass in right hemi-abdomen. Abdominal radiographs showed air-fluid levels with mild bowel distention and shadows of roundworms. The diagnosis of IO by A lumbricoides. infestation was established and surgical approach scheduled. During exploratory laparotomy an intraluminal bolus of roundworms from jejunum to ascendant colon was evident. An ileum enterotomy was performed and worms were removed. Fluid therapy and antibiotics for 72  hours were administered, with posterior albendazol treatment for 3 days. Patient was uneventfully discharged on the tenth day.Reduction in parasitic load by means of improvements in sanitation, health education, and anthelmintic treatment must be implemented in endemic zones to prevent serious life-threatening complications by A lumbricoides. infestation, because some of them require urgent surgical treatment.

  15. Automated peritoneal dialysis as the modality of choice: a single-center, 3-year experience with 458 children in Mexico.

    PubMed

    Fabian Velasco, Rosaura; Lagunas Muñoz, Jesus; Sanchez Saavedra, Veronica; Mena Brito Trejo, Jorge E; Qureshi, Abdul Rashid; García-López, Elvia; Divino Filho, Jose C

    2008-03-01

    Automated peritoneal dialysis (APD) has been considered as the ideal dialysis modality for pediatric patients. This study reports the 3-year APD experience with 458 end-stage renal disease (ESRD) children who started APD in a single pediatric center in Mexico City between June 2003 and June 2006. By June 2003, there were 310 patients being treated with continuous ambulatory peritoneal dialysis (CAPD). At that time, these patients were gradually switched to APD, with priority being given to those prescribed more than four exchanges per day, younger than 6 years of age, or presenting complications [hernias or decreased ultrafiltration (UF)]. An improvement of daily UF was observed when the patients were switched from CAPD (590 +/- 340 ml/day) to APD (846 +/- 335 ml/day). The presence of edema decreased (from 67% to 8%) as well as the percentage of patients requiring antihypertensive drugs (from 83% to 38%), the peritonitis rate improved from one episode every 35 patient/month to one episode every 47 patient/month, the total number of hospitalizations decreased (from 384 to 51), and 85% of children attended school. While waiting for renal transplant, APD is the dialysis modality of choice for ESRD children at the La Raza Medical Center in Mexico City.

  16. The impact of remedial intervention on 3-year recidivism among first-time DUI offenders in Mississippi.

    PubMed

    Robertson, Angela A; Gardner, Sheena; Xu, Xiaohe; Costello, Humphrey

    2009-09-01

    This study examines the impact of the Mississippi Alcohol Safety Education Program (MASEP), a court-mandated intervention program, on 3-year recidivism rates among first-time DUI offenders (i.e. those convicted of a first offense for driving under the influence of alcohol or another drug). It also examines whether a new version of the curriculum that incorporates activities to enhance motivation for change further ameliorates recidivism. Cox proportional hazard regression models are used to compare recidivism rates among DUI offenders who completed MASEP with those who did not complete or who failed to enroll in the program. Recidivism rates were also compared for MASEP participants across time periods during which curriculum revisions were introduced. The hazard of recidivism was lower for individuals who completed the program than for individuals who did not complete or did not enroll in the program. Recidivism rates were further reduced following the introduction of curriculum revisions. Attendance of court-mandated remedial intervention programs lower subsequent DUI arrests and program content is associated with lower rates.

  17. Acute hamstring strain injury in track-and-field athletes: A 3-year observational study at the Penn Relay Carnival.

    PubMed

    Opar, D A; Drezner, J; Shield, A; Williams, M; Webner, D; Sennett, B; Kapur, R; Cohen, M; Ulager, J; Cafengiu, A; Cronholm, P F

    2014-08-01

    This study aimed to observe the incidence rates of hamstring strain injuries (HSIs) across different competition levels and ages during the Penn Relays Carnival. Over a 3-year period, all injuries treated by the medical staff were recorded. The type of injury, anatomic location, event in which the injury occurred, competition level, and demographic data were documented. Absolute and relative HSI (per 1000 participants) were determined, and odds ratios (ORs) were calculated between sexes, competition levels, and events. Throughout the study period 48,473 athletes registered to participate in the Penn Relays Carnival, with 118 HSIs treated by the medical team. High school girls displayed lesser risk of HSI than high school boys (OR = 0.55, P = 0.021), and masters athletes were more likely than high school- (OR = 4.26, P < 0.001) and college-level (OR = 3.55, P = 0.001) athletes to suffer HSI. The 4 × 400-m relay displayed a greater likelihood of HSI compared with the 4 × 100-m relay (OR = 1.77, P = 0.008). High school boys and masters-level athletes are most likely to suffer HSI, and there is higher risk in 400-m events compared with 100-m events.

  18. Experience and outcome of 3 years of a European EQA scheme for genetic testing of the spinocerebellar ataxias.

    PubMed

    Seneca, Sara; Morris, Michael A; Patton, Simon; Elles, Rob; Sequeiros, Jorge

    2008-08-01

    The European Molecular Genetics Quality Network (EMQN) has been organizing an external quality assessment (EQA) scheme for molecular genetic testing of trinucleotide repeat mutations in the spinocerebellar ataxias (SCAs) since 2004. DNA samples were validated by at least two independent labs and two different methods. Together with mock clinical case descriptions and requests for specific SCA gene analyses, these were sent to registered participants each year. Laboratories were asked to use their routine procedures and protocols. A panel of assessors reviewed the final returns, including genotype results and reports, to assess the quality of (1) genotyping and (2) interpretation and reporting. A description of methods and raw data were also requested and were very useful for the final analysis. Altogether, during 3 years, 239 reports were received from the laboratories. Overall genotype error rate ranged 1.1-5.2%, a significant cause of concern. Scores for interpretation and reporting also showed that there is still much room for progress, although performance has improved over this period of assessment. The consequences of suboptimal laboratory practices, genotyping errors and misdiagnosis and of incorrect or incomplete interpretation and reporting have wide implications for patient lives, as well as for health management and counselling of relatives. EQA schemes are an important part of quality assurance in molecular genetic laboratories, and their use should become a routine part of laboratory diagnostic practice. Current evidence shows also that it is important that laboratories participate on a yearly basis and that this becomes mandatory for reference laboratories.

  19. Severe Periodontal Disease Manifested in Chronic Disseminated Type of Langerhans Cell Histiocytosis in a 3-Year Old Child

    PubMed Central

    Srivastava, Vinay Kumar; Bansal, Rajesh; Gupta, Vineeta; Bansal, Manish; Patne, Shashikant

    2014-01-01

    ABSTRACT% Langerhans cell histiocytosis (LCH), previously known as histio-cytosis X, is a rare idiopathic disorder of reticulo-endothelial system with abnormal proliferation of bone marrow derived Langerhans cells along with a variable number of leukocytes, such as eosinophils, neutrophils, lymphocytes and plasma cells. Three years old male child presented with multifocal osteolytic lesions and papulosquamous skin lesions. Clinical and radio-graphic features, such as severe alveolar bone loss, mobility of teeth, precocious eruption of teeth, foating appearance of teeth in orthopantomogram (OPG), osteolytic lesion in skull and cutaneous lesions were highly suggestive of LCH disease. Skin biopsy confirmed a diagnosis of LCH. Induction chemotherapy with oral prednisolone and intravenous vinblastine was started. Child responded well to chemotherapy. The clinical significance of the presented case is to diagnose the case of LCH on the basis of the manifestation of severe periodontal disease as this can be first or only manifestation of LCH. A dentist plays a major role in the multidisciplinary treatment of LCH through routine examination and periodic follow-up. How to cite this article: Bansal M, Srivastava VK, Bansal R, Gupta V, Bansal M, Patne S. Severe Periodontal Disease Manifested in Chronic Disseminated Type of Langerhans Cell Histiocytosis in a 3-Year Old Child. Int J Clin Pediatr Dent 2014;7(3):217-219. PMID:25709306

  20. Reduction in overweight and obesity from a 3-year community-based intervention in Australia: the 'It's Your Move!' project.

    PubMed

    Millar, L; Kremer, P; de Silva-Sanigorski, A; McCabe, M P; Mavoa, H; Moodie, M; Utter, J; Bell, C; Malakellis, M; Mathews, L; Roberts, G; Robertson, N; Swinburn, B A

    2011-11-01

    'It's Your Move!' was a 3-year intervention study implemented in secondary schools in Australia as part of the Pacific Obesity Prevention In Communities Project. This paper reports the outcome results of anthropometric indices and relevant obesity-related behaviours. The interventions focused on building the capacity of families, schools and communities to promote healthy eating and physical activity. Baseline response rates and follow-up rates were 53% and 69% respectively for the intervention group (n=5 schools) and 47% and 66% respectively for the comparison group (n=7 schools). Statistically significant relative reductions in the intervention versus comparison group were observed: weight (-0.74 kg, P < 0.04), and standardized body mass index (-0.07, P<0.03), and non-significant reductions in prevalence of overweight and obesity (0.75 odds ratio, P=0.12) and body mass index (-0.22, P=0.06). Obesity-related behavioural variables showed mixed results with no pattern of positive intervention outcomes. In conclusion, this is the first study to show that long-term, community-based interventions using a capacity-building approach can prevent unhealthy weight gain in adolescents. Obesity prevention efforts in this important transitional stage of life can be successful and these findings need to be translated to scale for a national effort to reverse the epidemic in children and adolescents.

  1. Effects of organic fertilizers on soil physicochemistry and on the yield and botanical composition of forage over 3 years.

    PubMed

    Matos-Moreira, Mariana; López-Mosquera, M Elvira; Cunha, Mario; Sáinz Osés, María Jesús; Rodríguez, Teresa; Carral, Emilio V

    2011-07-01

    Organic wastes have been reported to reduce saturation of the exchange complex by Al in Al-rich acid soils. For 3 years, the main soil fertility properties were studied in plots sown with mixed pasture species. These plots were fertilized with cattle slurry, dairy sludge (DS), or granulated broiler litter (BL) in comparison with mineral fertilizer. Al saturation levels were low after the initial inorganic liming treatment (19.00-33.71%) but tended to rise under all treatments (21.09-61.37%) except BL (8.45-30.98%), which was also associated with the highest average soil pH and the highest average levels of exchangeable Ca2+, Mg2+, and K+. Treatment DS performed similarly to mineral fertilizer in most respects, but it led to greater available P levels. Under the dry conditions of the second and third years of the study, BL and DS treatments were associated with significantly greater forage yields than the other treatments. Under DS treatment, available P levels were too low to allow the maintenance of mixed pasture, clover being eliminated by the less P-dependent species.

  2. Production of Mandarin tones by 3-year-old children acquiring L1 (Mandarin) in an L2 (English) environment

    NASA Astrophysics Data System (ADS)

    Wong, Puisan; Schwartz, Richard G.

    2001-05-01

    Thirteen monolingual Mandarin-speaking children residing in the U.S. were recruited to examine their production of the four Mandarin lexical tones in monosyllabic words. A picture-naming task was used to elicit the children's productions of lexical tones in isolated words and in sentence final position. Four mothers were asked to say the same set of words to their children in a picture reading activity. The children's and the mothers' productions were recorded and low-pass filtered at 500 and 400 Hz, respectively, to eliminate phonemic and semantic information. Ten Mandarin-speaking judges were recruited to identify the children's and adults' tone productions from the filtered stimuli. Contrary to the findings of L1 research conducted in countries where Mandarin is the language of the environment, the present results revealed that the lexical tones produced by 3-year-old children acquiring Mandarin as their first language in the U.S. were not yet adultlike. Children's tone productions were more difficult to categorize than the mothers' productions. The judges had significantly more difficulty identifying children's dipping tones than the children's level tones, rising tones, or falling tones, suggesting that the dipping tone posed the most difficulties for the children.

  3. Persistence of antibodies 3 years after booster vaccination of adults with combined acellular pertussis, diphtheria and tetanus toxoids vaccine.

    PubMed

    Weston, Wayde; Messier, Marc; Friedland, Leonard R; Wu, Xiangfeng; Howe, Barbara

    2011-11-01

    The duration of protection after vaccination with reduced antigen content diphtheria, tetanus and acellular pertussis vaccines (Tdap) is not known. Long-term post-vaccination serological data will help to improve understanding of the duration of humoral immunity and guide vaccination policy for the timing of repeat dose administration. The persistence of antibodies to Tdap antigens was measured 3 years after vaccination of adults 19-64 years of age with one of 2 Tdap vaccines (Boostrix(®), GlaxoSmithKline Biologicals; Tdap-B: or Adacel(®), Sanofi Pasteur; Tdap-A). In both groups, geometric mean concentrations for antibodies to diphtheria, tetanus, and pertussis vaccine antigens were decreased at year 3 relative to levels observed 1 month and 1 year following vaccination, but remained higher than pre-vaccination levels. Seroprotection rates for diphtheria and tetanus remained high for both Tdap vaccines (for diphtheria, 96.9% and 97.8% for the Tdap-B and Tdap-A groups, respectively; for tetanus, 98.1% and 99.6%, respectively).

  4. Molecular epidemiology of Mycobacterium tuberculosis strains isolated during a 3-year period (1993 to 1995) in Seville, Spain.

    PubMed Central

    Safi, H; Aznar, J; Palomares, J C

    1997-01-01

    The genetic polymorphism of Mycobacterium tuberculosis strains isolated in Seville, Spain, was studied by using computer-assisted analysis of the IS6110 fingerprint in order to determine the current situation and to evaluate the human-to-human transmission of this pathogen. One hundred seventy-six isolates from 175 patients among the 205 patients diagnosed with tuberculosis (TB) during a 3-year period (1993 to 1995) were cultured and analyzed. One hundred nine patients (62%) were infected with genetically different isolates, and 67 isolates (38%) were grouped into 19 clusters. These results demonstrate that the level of clustering of strains in Seville is intermediate between those in developed and developing countries. Epidemiological relatedness was shown for isolates from only 10 of these clusters. Active and high transmission rates exist in children and in human immunodeficiency virus (HIV)-infected adults, while in non-HIV-infected adults this transmission rate is moderate. Although transmission from children to adults is uncommon, the probability of transmission from HIV-infected patients to young adults not infected with HIV may be higher. On the basis of these observations, we predict a constant rise in the rate of TB transmission among HIV-infected patients and probably in young adult patients not infected with HIV if measures for the effective prevention of TB among the HIV-infected population are not implemented. PMID:9316891

  5. Dairy and plant based food intakes are associated with altered faecal microbiota in 2 to 3 year old Australian children

    PubMed Central

    Smith-Brown, P.; Morrison, M.; Krause, L.; Davies, P. S. W.

    2016-01-01

    The first 1000 days (conception to 24 months) is when gut microbiota composition and eating patterns are established, and a critical period influencing lifelong health. The aim of this study is to examine the associations between food intakes and microbiota composition at the end of this period. Diet was quantified for 37 well-nourished Australian children aged between 2 to 3 years by using a food frequency questionnaire and 24 hr recalls. Both dairy and plant-based (fruit, vegetables, soy, pulses and nuts) food intakes were associated with distinct microbiota profiles. Dairy intake was positively associated with the Firmicutes:Bacteroidetes ratio, and in particular Erysipelatoclostridium spp., but negatively associated with species richness and diversity. Vegetable intake was positively associated with the relative abundance of the Lachnospira genus, while soy, pulse and nut intake was positively associated with the relative abundance of bacteria related to Bacteroides xylanisolvens. Fruit intake, especially apples and pears, were negatively associated with the relative abundance of bacteria related to Ruminococcus gnavus. In this cohort of young children dairy and plant based food intakes were found to be associated with altered microbiota composition. Further exploration is needed to elucidate the effect of these dietary and microbial differences on host phenotype. PMID:27694811

  6. Prehospital care of burns: an analysis of 3 years use of the emergency physician system (EPS) Cologne.

    PubMed

    Lechleuthner, A; Schmidt-Barbo, A; Bouillon, B; Perbix, W; Holzki, J; Spilker, G

    1993-04-01

    Little information is available about the vital parameters of burns victims shortly after the accident. Therefore cases of burns, electrical and caustic injuries presenting to the Cologne Emergency Physician System over 3 years (n = 262) were prospectively studied and analysed. The average incidence in Cologne, Germany (population 1 million), of burns victims attended by the Emergency Medical System and emergency physicians at the scene was 74 adults and 14 children per year. Children are mainly injured by scalds (41.4 per cent); adults by fire accidents (43 per cent). A classification of the victims at the site of the accident according to their vital signs (Trauma Score (TS) after Champion H. R., Sacco W. J. and Carnazzo A. J. et al. (1981) Trauma Score. Crit. Care Med. 9, 672) showed, that in spite of a major burn injury, the vital signs were usually not or only slightly impaired. Subsequent measurements instituted by the emergency physician at the scene increased with decreasing initial TS. With TS = 14, 50 per cent of the patients were intubated; below 14 points nearly 100 per cent. The fluid administered also increased with a decreasing TS.

  7. An electronic health record-enabled obesity database

    PubMed Central

    2012-01-01

    Background The effectiveness of weight loss therapies is commonly measured using body mass index and other obesity-related variables. Although these data are often stored in electronic health records (EHRs) and potentially very accessible, few studies on obesity and weight loss have used data derived from EHRs. We developed processes for obtaining data from the EHR in order to construct a database on patients undergoing Roux-en-Y gastric bypass (RYGB) surgery. Methods Clinical data obtained as part of standard of care in a bariatric surgery program at an integrated health delivery system were extracted from the EHR and deposited into a data warehouse. Data files were extracted, cleaned, and stored in research datasets. To illustrate the utility of the data, Kaplan-Meier analysis was used to estimate length of post-operative follow-up. Results Demographic, laboratory, medication, co-morbidity, and survey data were obtained from 2028 patients who had undergone RYGB at the same institution since 2004. Pre-and post-operative diagnostic and prescribing information were available on all patients, while survey laboratory data were available on a majority of patients. The number of patients with post-operative laboratory test results varied by test. Based on Kaplan-Meier estimates, over 74% of patients had post-operative weight data available at 4 years. Conclusion A variety of EHR-derived data related to obesity can be efficiently obtained and used to study important outcomes following RYGB. PMID:22640398

  8. Incident and prevalent cohorts with pulmonary arterial hypertension: insight from SERAPHIN.

    PubMed

    Simonneau, Gérald; Channick, Richard N; Delcroix, Marion; Galiè, Nazzareno; Ghofrani, Hossein-Ardeschir; Jansa, Pavel; Le Brun, Franck-Olivier; Mehta, Sanjay; Perchenet, Loic; Pulido, Tomás; Sastry, B K S; Sitbon, Olivier; Souza, Rogério; Torbicki, Adam; Rubin, Lewis J

    2015-12-01

    In SERAPHIN, a long-term, randomised, controlled trial (NCT00660179) in pulmonary arterial hypertension (PAH), macitentan significantly reduced the risk of morbidity/mortality and PAH-related death/hospitalisation. We evaluated disease progression and the effect of macitentan in treatment-naïve incident and prevalent cohorts.Patients allocated to placebo, or macitentan 3 mg or 10 mg were classified by time from diagnosis to enrolment as incident (≤6 months; n=110) or prevalent (>6 months; n=157). The risk of morbidity/mortality and PAH-related death/hospitalisation was determined using Cox regression.The risk of morbidity/mortality (Kaplan-Meier estimates at month 12: 54.4% versus 26.7%; p=0.006) and PAH-related death/hospitalisation (Kaplan-Meier estimates at month 12: 47.3% versus 19.9%; p=0.006) were significantly higher for incident versus prevalent patients receiving placebo, respectively. There was no significant difference in the risk of all-cause death between incident and prevalent cohorts (p=0.587). Macitentan 10 mg significantly reduced the risk of morbidity/mortality and PAH-related death/hospitalisation versus placebo in incident and prevalent cohorts.Incident patients had a higher risk for PAH progression compared with prevalent patients but not a higher risk of death. Macitentan delayed disease progression in both incident and prevalent PAH patients.

  9. Preoperative Underweight Patients with Upper Tract Urothelial Carcinoma Survive Less after Radical Nephroureterectomy.

    PubMed

    Kang, Ho Won; Jung, Hae Do; Ha, Yun-Sok; Kim, Tae-Hwan; Kwon, Tae Gyun; Byun, Seok-Soo; Yun, Seok-Joong; Kim, Wun-Jae; Choi, Young Deuk

    2015-10-01

    The prognostic impact of body mass index (BMI) in patients with upper tract urothelial carcinoma (UTUC) is an ongoing debate. Our study aimed to investigate the prognostic role of BMI in patients treated with radical nephroureterectomy (RNU) for UTUC from a multi-institutional Korean collaboration. We retrospectively reviewed data from 440 patients who underwent RNU for UTUC at four institutions in Korea. To avoid biasing the survival estimates, patients who had previous or concomitant muscle-invasive bladder tumors were excluded. BMI was categorized into approximate quartiles with the lowest quartile assigned to the reference group. Kaplan-Meier and multivariate Cox regression analyses were performed to assess the influence of BMI on survival. The lower quartile BMI group showed significantly increased overall mortality (OM) and cancer specific mortality (CSM) compared to the 25%-50% quartiles and upper quartile BMI groups. Kaplan-Meier estimates showed similar results. Based on multivariate Cox regression analysis, preoperative BMI as a continuous variable was an independent predictor for OM and CSM. In conclusion, preoperative underweight patients with UTUC in Korea survive less after RNU. Preoperative BMI may provide additional prognostic information to establish risk factors.

  10. First Results of 3 Year Monitoring of Red Wood Ants' Behavioural Changes and Their Possible Correlation with Earthquake Events

    NASA Astrophysics Data System (ADS)

    Berberich, Gabriele; Berberich, Martin; Grumpe, Arne; Wöhler, Christian; Schreiber, Ulrich

    2013-04-01

    Short-term earthquake predictions with an advance warning of several hours or days can currently not be performed reliably and remain limited to only a few minutes before the event. Abnormal animal behaviours prior to earthquakes have been reported previously but their detection creates problems in monitoring and reliability. A different situation is encountered for red wood ants (RWA; Formica rufa-group (Hymenoptera: Formicidae). They have stationary nest sites on tectonically active, gas-bearing fault systems. These faults may be potential earthquake areas and are simultaneously information channels deeply reaching into the crust. A particular advantage of monitoring RWA is their high sensitivity to environmental changes. Besides an evolutionarily developed extremely strong temperature sensitivity of 0.25 K, they have chemoreceptors for the detection of CO2 concentrations and a sensitivity for electromagnetic fields. Changes of the electromagnetic field are discussed or short-lived "thermal anomalies" are reported as trigger mechanisms for bioanomalies of impending earthquakes. For 3 years, we have monitored two Red Wood Ant mounds (Formica rufa-group), located at the seismically active Neuwied Basin (Eifel, Germany), 24/7 by high-resolution cameras equipped with a colour and infrared sensor. In the Neuwied Basin, an average of about 100 earthquakes per year with magnitudes up to M 3.9 occur located on different tectonic fault regimes (strike-slip faults and/or normal or thrust faults). The RWA mounds are located on two different fault regimes approximately 30 km apart. First results show that the ants have a well-identifiable standard daily routine. Correlation with local seismic events suggests changes in the ants' behaviour hours before the earthquake event: The nocturnal rest phase and daily activity are suppressed, and standard daily routine is continued not before the next day. Additional parameters that might have an effect on the ants' daily routine

  11. Younger adults with acute myeloid leukemia in remission for ≥3 years have a high likelihood of cure: the ECOG experience in over 1200 patients

    PubMed Central

    Watts, Justin M.; Wang, Xin Victoria; Litzow, Mark R.; Luger, Selina M.; Lazarus, Hillard M.; Cassileth, Peter A.; Fernandez, Hugo F.; Douer, Dan; Zickl, Lynette; Paietta, Elisabeth; Rowe, Jacob M.; Tallman, Martin S.

    2015-01-01

    We examined 1229 younger patients with acute myeloid leukemia who achieved CR1 on Eastern Cooperative Oncology Group trials. We defined late relapse as occurring after ≥3 years of CR1. With median follow-up of 11.3 years, there were 14 late relapses (1.1% of CR1 patients; 3.3% of 3-year CR1 patients). Eight achieved second CR and median overall survival after late relapse was 3.2 years. Most patients tested (9/11) had a normal karyotype at diagnosis; none had new cytogenetic abnormalities at relapse. Late relapse is rare and nearly all 3-year CR1 patients are cured. If late relapse occurs, outcomes are relatively favorable. PMID:24986381

  12. Research on 2041 Cases of High Inpatient Expenditure and Influence Factors during 3 Years in a Single Center

    PubMed Central

    Wu, Suo-Wei; Pan, Qi; Wei, Liang-Yu; Li, Chao; Wang, Qin; Song, Jing-Chen; Chen, Tong

    2016-01-01

    Background: The study was to explore the causes of high inpatient expenditure through analyzing the distribution characteristics as well as the influence factors of high inpatient expenditure cases during 3 years within a Grade-A tertiary hospital through various aspects and multiple angles, thus identifying the major influence factors for high medical expenditure to develop further research. Methods: We retrospectively studied 2041 inpatient cases which cost more than RMB 100,000 Yuan per case in a Grade-A tertiary hospital from 2013 to 2015. We analyzed the compositions of the medical cost to evaluate the major factors that cause the high inpatient expenditure. All the data and materials were collected from medical record system, and the statistical methods included t-test, variance of analysis, and multivariate linear regression. Results: The average cost of the 2,041 cases was RMB 152,173 Yuan for medicines and materials of medical costs, which respectively accounted for 33.03% and 32.32% of the total cost; and the average length of hospital stay was 28.39 days/person. Diseases of skeletal and muscular system, circulatory system, and tumor were the top three disease categories of high inpatient expenditure, which accounted for 39.00%, 33.46%, and 18.03%, respectively. Complications, criticality of the disease, gender of the patients, the occurrence of death, and the excessive length of hospital stay all had great impacts on average medical expenditure, while age, hospital infection, and surgery showed no significant impact on average medical cost. Conclusions: The main factors for high inpatient expenditure included the inadequate use of high-value medicines and materials, lacking cost control measures within the hospital, the excessive length of hospital stay for inpatients, and the unnecessary treatment for the patients. PMID:27647192

  13. Regional Mapping and Resource Assessment of Shallow Gas Hydrates of Japan Sea - METI Launched 3 Years Project in 2013.

    NASA Astrophysics Data System (ADS)

    Matsumoto, R.

    2014-12-01

    Agency of Natural Resources and Energy of METI launched a 3 years shallow gas hydrate exploration project in 2013 to make a precise resource assessment of shallow gas hydrates in the eastern margin of Japan Sea and around Hokkaido. Shallow gas hydrates of Japan Sea occur in fine-grained muddy sediments of shallow subsurface of mounds and gas chimneys in the form of massive nodular to platy accumulation. Gas hydrate bearing mounds are often associated with active methane seeps, bacterial mats and carbonate concretions and pavements. Gases of gas hydrates are derived either from deep thermogenic, shallow microbial or from the mixed gases, contrasting with totally microbial deep-seated stratigraphically controlled hydrates. Shallow gas hydrates in Japan Sea have not been considered as energy resource due to its limited distribution in narrow Joetsu basin. However recently academic research surveys have demonstrated regional distribution of gas chimney and hydrate mound in a number of sedimentary basins along the eastern margin of Japan Sea. Regional mapping of gas chimney and hydrate mound by means of MBES and SBP surveys have confirmed that more than 200 gas chimneys exist in 100 km x 100 km area. ROV dives have identified dense accumulation of hydrates on the wall of half collapsed hydrate mound down to 30 mbsf. Sequential LWD and shallow coring campaign in the Summer of 2014, R/V Hakurei, which is equipped with Fugro Seacore R140 drilling rig, drilled through hydrate mounds and gas chimneys down to the BGHS (base of gas hydrate stability) level and successfully recovered massive gas hydrates bearing sediments from several horizons.

  14. Florida Initiative for Quality Cancer Care: Improvements on Colorectal Cancer Quality of Care Indicators during a 3-Year Interval

    PubMed Central

    Siegel, Erin M; Jacobsen, Paul B; Lee, Ji-Hyun; Malafa, Mokenge; Fulp, William; Fletcher, Michelle; Smith, Jesusa Corazon R; Brown, Richard; Levine, Richard; Cartwright, Thomas; Abesada-Terk, Guillermo; Kim, George; Alemany, Carlos; Faig, Douglas; Sharp, Philip; Markham, Merry-Jennifer; Shibata, David

    2015-01-01

    BACKGROUND The quality of cancer care has become a national priority; however, there are few ongoing efforts to assist medical oncology practices in identifying areas for improvement. The Florida Initiative for Quality Cancer Care is a consortium of 11 medical oncology practices that evaluates the quality of cancer care across Florida. Within this practice-based system of self-assessment, we determined adherence to colorectal cancer quality of care indicators (QCIs) in 2006, disseminated results to each practice and reassessed adherence in 2009. The current report focuses on evaluating the direction and magnitude of change in adherence to QCIs for colorectal cancer patients between the 2 assessments. STUDY DESIGN Medical records were reviewed for all colorectal cancer patients seen by a medical oncologist in 2006 (n = 489) and 2009 (n = 511) at 10 participating practices. Thirty-five indicators were evaluated individually and changes in QCI adherence over time and by site were examined. RESULTS Significant improvements were noted from 2006 to 2009, with large gains in surgical/pathological QCIs (eg, documenting rectal radial margin status, lymphovascular invasion, and the review of ≥12 lymph nodes) and medical oncology QCIs (documenting planned treatment regimen and providing recommended neoadjuvant regimens). Documentation of perineural invasion and radial margins significantly improved; however, adherence remained low (47% and 71%, respectively). There was significant variability in adherence for some QCIs across institutions at follow-up. CONCLUSIONS The Florida Initiative for Quality Cancer Care practices conducted self-directed quality-improvement efforts during a 3-year interval and overall adherence to QCIs improved. However, adherence remained low for several indicators, suggesting that organized improvement efforts might be needed for QCIs that remained consistently low over time. Findings demonstrate how efforts such as the Florida Initiative for

  15. Early end-tidal carbon monoxide levels and neurodevelopmental outcome at 3 years 6 months of age in preterm infants

    PubMed Central

    Blok, Cornelie A; Krediet, Tannette G; Kavelaars, Annemiek; Koopman-Esseboom, Corine; Vreman, Hendrik J; Van Bel, Frank

    2011-01-01

    Aim Increased end-tidal carbon monoxide (ETCOc) and cytokines in preterm infants are related to bronchopulmonary dysplasia and intraventricular haemorrhages. The aim was to study the predictive value of ETCOc and cytokine levels for long-term outcome. Methods This study comprised 105 very preterm infants (57 males, 48 females; gestational age range 25wk 5d–31wk 4d; birthweight 610–2100g) who were admitted to a neonatal intensive care unit between 1 February and 31 December 2002. ETCOc, plasma tumour necrosis factor alpha (TNF-α) and interleukins (IL) 6 and 8, and malondialdehyde (MDA, a marker of lipid peroxidation), were measured at days 1, 3, and 5 of life and related to outcome at 3 years 6 months of age (Griffiths Mental Developmental Scales). Results Of the 105 infants, 69 were eligible for follow-up (37 male; 32 female; bronchopulmonary dysplasia, n=12). ETCOc at 0 to 24 hours was higher in infants with adverse outcome (Griffiths developmental quotient <85, n=15) compared with favourable outcome (2.7 SD 0.7 vs 2.0 SD 0.5; p<0.05). MDA and cytokines did not differ between groups. Regression analysis with bootstrapping of independent variables (gestational age, birthweight, ETCOc, TNF-α, IL-6, IL-8, and bronchopulmonary dysplasia) showed that ETCOc was the only parameter that correlated with outcome. The sensitivity and negative predictive value of ETCOc for adverse outcome were 93% and 85% respectively. Interpretation Adverse neurodevelopmental outcome is associated with increased endogenous carbon monoxide. ETCOc less than 2.0ppm during the first day indicates a favourable outcome. PMID:21933176

  16. Scalable technology for the extraction of pharmaceutics: outcomes from a 3 year collaborative industry/academia research programme.

    PubMed

    Sutherland, Ian; Thickitt, Chris; Douillet, Nathalie; Freebairn, Keith; Johns, David; Mountain, Clive; Wood, Philip; Edwards, Neil; Rooke, David; Harris, Guy; Keay, David; Mathews, Ben; Brown, Roland; Garrard, Ian; Hewitson, Peter; Ignatova, Svetlana

    2013-03-22

    This paper reports on some of the key outcomes of a 3 year £1.5m Technology Strategy Board (TSB) funded research programme to develop a small footprint, versatile, counter-current chromatography purification technology and methodology which can be operated at a range of scales in both batch and continuous modes and that can be inserted into existing process plant and systems. Our consortium, integrates technology providers (Dynamic Extractions) and the scientific development team (Brunel) with end user needs (GSK & Pfizer), addressing major production challenges aimed at providing flexible, low capital platform technology driving substantial cost efficiency in both drug development and drug manufacturing processes. The aims of the Technology Strategy Board's high value manufacturing programme are described and how the academic/industry community were challenged to instigate step changes in the manufacturing of high value pharmaceuticals. This paper focusses on one of the themes of the TSB research programme, "Generate a Comprehensive Applications Portfolio". It outlines 15 applications from this portfolio that can be published in the public domain and gives four detailed case studies illustrating the range of application of the technology on the separation of (1) isomers, (2) polar compounds, (3) crude mixtures and (4) on the removal of impurities. Two of these case studies that were scaled up demonstrate between 10 and 20% lower solvent usage and were projected to have significant cost savings compared to conventional solid phase silica gel chromatography at procss scale demonstrating that the latest high performance countercurrent chromatography technology is a competitive platform technolgy for the pharmaceutical industry.

  17. Objective Assessment of Changes in Physical Activity and Sedentary Behavior: Pre-through 3-Years Post- Bariatric Surgery

    PubMed Central

    King, Wendy C; Chen, Jia-Yuh; Bond, Dale S; Belle, Steven H; Courcoulas, Anita P; Patterson, Emma J; Mitchell, James E; Inabnet, William B; Dakin, George F; Flum, David R; Cook, Brian; Wolfe, Bruce M

    2015-01-01

    Objective To evaluate change in sedentary behavior (SB) and physical activity (PA) over three years following bariatric surgery. Methods A subset of participants in an observational study (n=473 of 2458; 79% female, median body mass index 45kg/m2) wore an activity monitor pre-surgery and at 1–3 annual post-surgery assessments. Results Over the first year, on average, sedentary time decreased from 573 (95%CI 563–582) to 545 (95%CI 534–555) min/d and moderate-to-vigorous intensity PA (MVPA) increased from 77 (95%CI: 71–84) to 106 (95%CI: 98–116) min/wk, or 7 (95%CI: 5–10) to 24 (95%CI: 18–29) min/wk in MVPA bouts ≥10 minutes. There were no changes in these parameters from years 1 to 3 (P for all>.05). The percentage of participants achieving ≥150 min/wk of bout-related MVPA was not different at year 3 [6.5% (95%CI: 3.1–12.7)] vs. pre-surgery [3.4% (95%CI: 1.8–5.0); p=.45]. Most participants followed SB and PA trajectories that paralleled mean change and were consistent with their pre-surgery position in relation to the group. Conclusions On average, bariatric surgical patients make small reductions in SB and increases in PA during the first post-surgery year, which are maintained through 3 years. Still, post-surgery PA levels fall short of PA guidelines for general health or weight control. PMID:26010326

  18. Validation of long-term survival prediction for scheduled abdominal aortic aneurysm repair with an independent calculator using only pre-operative variables.

    PubMed

    Carlisle, J B; Danjoux, G; Kerr, K; Snowden, C; Swart, M

    2015-06-01

    We observed survival after scheduled repair of abdominal aortic aneurysm in 1096 patients for a median (IQR [range]) of 3.0 (1.5-5.8 [0-15]) years: 943 patients had complete data, 250 of whom died. We compared discrimination and calibration of an external model with the Kaplan-Meier model generated from the study data. Integrated Brier misclassification scores for both models at 1-5 postoperative years were 0.04, 0.08, 0.11, 0.13 and 0.16, respectively. Harrel's concordance index at 1-5 postoperative years was 0.73, 0.71, 0.68, 0.67 and 0.66, respectively. Groups with median 5-year predicted mortality of 40% (n = 251), 18% (n = 414) and 8% (n = 164) had lower observed mortality than 114 patients with 70% predicted mortality, hazard ratio (95% CI): 0.58 (0.37-0.76), p = 0.0031; 0.30 (0.19-0.48), p = 1.7 × 10(-12) and 0.19 (0.13-0.27), p = 1.3 × 10(-10) , respectively, test for trend p = 5.6 × 10(-15) . Survival predicted by the external calculator was similar to the Kaplan-Meier estimate.

  19. Survival analysis in total joint replacement: an alternative method of accounting for the presence of competing risk.

    PubMed

    Fennema, P; Lubsen, J

    2010-05-01

    Survival analysis is an important tool for assessing the outcome of total joint replacement. The Kaplan-Meier method is used to estimate the incidence of revision of a prosthesis over time, but does not account appropriately for competing events which preclude revision. In the presence of competing death, this method will lead to statistical bias and the curve will lose its interpretability. A valid comparison of survival results between studies using the method is impossible without accounting for different rates of competing events. An alternative and easily applicable approach, the cumulative incidence of competing risk, is proposed. Using three simulated data sets and realistic data from a cohort of 406 consecutive cementless total hip prostheses, followed up for a minimum of ten years, both approaches were compared and the magnitude of potential bias was highlighted. The Kaplan-Meier method overestimated the incidence of revision by almost 4% (60% relative difference) in the simulations and more than 1% (31.3% relative difference) in the realistic data set. The cumulative incidence of competing risk approach allows for appropriate accounting of competing risk and, as such, offers an improved ability to compare survival results across studies.

  20. Population Pharmacokinetics Analysis To Inform Efavirenz Dosing Recommendations in Pediatric HIV Patients Aged 3 Months to 3 Years.

    PubMed

    Luo, Man; Chapel, Sunny; Sevinsky, Heather; Savant, Ishani; Cirincione, Brenda; Bertz, Richard; Roy, Amit

    2016-06-01

    Efavirenz (EFV) is a nonnucleoside reverse transcriptase inhibitor approved worldwide for the treatment of HIV in adults and children over 3 years of age or weighing over 10 kg. Only recently EFV was approved in children over 3 months and weighing at least 3.5 kg in the United States and the European Union. The objective of this analysis was to support the selection of an appropriate dose for this younger pediatric population and to explore the impact of CYP2B6 genetic polymorphisms on EFV systemic exposures. A population pharmacokinetic (PPK) model was developed using data from three studies in HIV-1-infected pediatric subjects (n = 168) and one study in healthy adults (n = 24). The EFV concentration-time profile was best described by a two-compartment model with first-order absorption and elimination. Body weight was identified as a significant predictor of efavirenz apparent clearance (CL), oral central volume of distribution (VC), and absorption rate constant (Ka). The typical values of efavirenz apparent CL, VC, oral peripheral volume of distribution (VP), and Ka for a reference pediatric patient were 4.8 liters/h (4.5 to 5.1 liters/h), 84.9 liters (76.8 to 93.0 liters), 287 liters (252.6 to 321.4 liters), and 0.414 h(-1) (0.375 to 0.453 h(-1)), respectively. The final model was used to simulate steady-state efavirenz concentrations in pediatric patients weighing <10 kg to identify EFV doses that produce comparable exposure to adult and pediatric patients weighing ≥10 kg. Results suggest that administration of EFV doses of 100 mg once daily (QD) to children weighing ≥3.5 to <5 kg, 150 mg QD to children weighing ≥5 to <7.5 kg, and 200 mg QD to children weighing ≥7.5 to <10 kg produce exposures within the target range. Further evaluation of the impact of CYP2B6 polymorphisms on EFV PK showed that the identification of CYP2B6 genetic status is not predictive of EFV exposure and thus not informative to guide pediatric dosing regimens. PMID:27067333

  1. A prospective 3-year follow-up trial of implantation of two trabecular microbypass stents in open-angle glaucoma

    PubMed Central

    Donnenfeld, Eric D; Solomon, Kerry D; Voskanyan, Lilit; Chang, David F; Samuelson, Thomas W; Ahmed, Iqbal Ike K; Katz, L Jay

    2015-01-01

    Purpose To evaluate 3-year safety and intraocular pressure (IOP) following two trabecular microbypass stents in phakic and pseudophakic subjects with open-angle glaucoma (OAG) not controlled on preoperative medication. Patients and methods In this prospective pilot study, phakic or pseudophakic subjects with OAG and IOP between 18 mmHg and 30 mmHg on one preoperative topical ocular hypotensive medication underwent medication washout. Thirty-nine qualified subjects with preoperative unmedicated IOP ≥22 mmHg and ≤38 mmHg received two stents. Postoperative examinations were scheduled at Day 1, Week 1, Months 1, 3, 6, and 12, and semiannually through Month 60. Ocular hypotensive medication was considered if postoperative IOP exceeded 21 mmHg. IOP, medication use, and safety were assessed at each visit. Subject follow-up through Month 36 was completed. Results Thirty-six eyes (92.3%; 95% confidence interval [CI] 79.1%, 98.4%) achieved the primary efficacy end point of Month 12 reduction in IOP ≥20% from baseline (unmedicated IOP) without ocular hypotensive medication. Four subjects required medication during the Month 36 follow-up period. Mean IOP at 36 months for subjects not taking medication was 15.2 mmHg. At 36 months, subjects sustained mean IOP decrease of 9.1±2.7 mmHg (95% CI 8.0 mmHg, 10.14 mmHg), or 37% IOP reduction, from unmedicated baseline IOP. Compared to preoperative medicated IOP, subjects had mean reduction at Month 36 of 5.5±2.7 mmHg (95% CI 4.5 mmHg, 6.6 mmHg), or 26% reduction. Both measures of IOP reduction were highly significant (P<0.001). Other than one case of early postoperative hyphema that resolved at 1 week, no postoperative adverse events were attributed to stent implantation. Conclusion In a pilot study, two trabecular microbypass stents to treat OAG subjects on one preoperative medication provided statistically significant, sustained, and safe reduction of IOP to ≤15 mmHg without medication through 36 months. PMID:26604675

  2. Population Pharmacokinetics Analysis To Inform Efavirenz Dosing Recommendations in Pediatric HIV Patients Aged 3 Months to 3 Years.

    PubMed

    Luo, Man; Chapel, Sunny; Sevinsky, Heather; Savant, Ishani; Cirincione, Brenda; Bertz, Richard; Roy, Amit

    2016-06-01

    Efavirenz (EFV) is a nonnucleoside reverse transcriptase inhibitor approved worldwide for the treatment of HIV in adults and children over 3 years of age or weighing over 10 kg. Only recently EFV was approved in children over 3 months and weighing at least 3.5 kg in the United States and the European Union. The objective of this analysis was to support the selection of an appropriate dose for this younger pediatric population and to explore the impact of CYP2B6 genetic polymorphisms on EFV systemic exposures. A population pharmacokinetic (PPK) model was developed using data from three studies in HIV-1-infected pediatric subjects (n = 168) and one study in healthy adults (n = 24). The EFV concentration-time profile was best described by a two-compartment model with first-order absorption and elimination. Body weight was identified as a significant predictor of efavirenz apparent clearance (CL), oral central volume of distribution (VC), and absorption rate constant (Ka). The typical values of efavirenz apparent CL, VC, oral peripheral volume of distribution (VP), and Ka for a reference pediatric patient were 4.8 liters/h (4.5 to 5.1 liters/h), 84.9 liters (76.8 to 93.0 liters), 287 liters (252.6 to 321.4 liters), and 0.414 h(-1) (0.375 to 0.453 h(-1)), respectively. The final model was used to simulate steady-state efavirenz concentrations in pediatric patients weighing <10 kg to identify EFV doses that produce comparable exposure to adult and pediatric patients weighing ≥10 kg. Results suggest that administration of EFV doses of 100 mg once daily (QD) to children weighing ≥3.5 to <5 kg, 150 mg QD to children weighing ≥5 to <7.5 kg, and 200 mg QD to children weighing ≥7.5 to <10 kg produce exposures within the target range. Further evaluation of the impact of CYP2B6 polymorphisms on EFV PK showed that the identification of CYP2B6 genetic status is not predictive of EFV exposure and thus not informative to guide pediatric dosing regimens.

  3. Population Pharmacokinetics Analysis To Inform Efavirenz Dosing Recommendations in Pediatric HIV Patients Aged 3 Months to 3 Years

    PubMed Central

    Luo, Man; Chapel, Sunny; Sevinsky, Heather; Savant, Ishani; Cirincione, Brenda; Bertz, Richard

    2016-01-01

    Efavirenz (EFV) is a nonnucleoside reverse transcriptase inhibitor approved worldwide for the treatment of HIV in adults and children over 3 years of age or weighing over 10 kg. Only recently EFV was approved in children over 3 months and weighing at least 3.5 kg in the United States and the European Union. The objective of this analysis was to support the selection of an appropriate dose for this younger pediatric population and to explore the impact of CYP2B6 genetic polymorphisms on EFV systemic exposures. A population pharmacokinetic (PPK) model was developed using data from three studies in HIV-1-infected pediatric subjects (n = 168) and one study in healthy adults (n = 24). The EFV concentration-time profile was best described by a two-compartment model with first-order absorption and elimination. Body weight was identified as a significant predictor of efavirenz apparent clearance (CL), oral central volume of distribution (VC), and absorption rate constant (Ka). The typical values of efavirenz apparent CL, VC, oral peripheral volume of distribution (VP), and Ka for a reference pediatric patient were 4.8 liters/h (4.5 to 5.1 liters/h), 84.9 liters (76.8 to 93.0 liters), 287 liters (252.6 to 321.4 liters), and 0.414 h−1 (0.375 to 0.453 h−1), respectively. The final model was used to simulate steady-state efavirenz concentrations in pediatric patients weighing <10 kg to identify EFV doses that produce comparable exposure to adult and pediatric patients weighing ≥10 kg. Results suggest that administration of EFV doses of 100 mg once daily (QD) to children weighing ≥3.5 to <5 kg, 150 mg QD to children weighing ≥5 to <7.5 kg, and 200 mg QD to children weighing ≥7.5 to <10 kg produce exposures within the target range. Further evaluation of the impact of CYP2B6 polymorphisms on EFV PK showed that the identification of CYP2B6 genetic status is not predictive of EFV exposure and thus not informative to guide pediatric dosing regimens. PMID:27067333

  4. First Results of 3 Year Monitoring of Red Wood Ants' Behavioural Changes and Their Possible Correlation with Earthquake Events

    NASA Astrophysics Data System (ADS)

    Berberich, Gabriele; Berberich, Martin; Grumpe, Arne; Wöhler, Christian; Schreiber, Ulrich

    2013-04-01

    Short-term earthquake predictions with an advance warning of several hours or days can currently not be performed reliably and remain limited to only a few minutes before the event. Abnormal animal behaviours prior to earthquakes have been reported previously but their detection creates problems in monitoring and reliability. A different situation is encountered for red wood ants (RWA; Formica rufa-group (Hymenoptera: Formicidae). They have stationary nest sites on tectonically active, gas-bearing fault systems. These faults may be potential earthquake areas and are simultaneously information channels deeply reaching into the crust. A particular advantage of monitoring RWA is their high sensitivity to environmental changes. Besides an evolutionarily developed extremely strong temperature sensitivity of 0.25 K, they have chemoreceptors for the detection of CO2 concentrations and a sensitivity for electromagnetic fields. Changes of the electromagnetic field are discussed or short-lived "thermal anomalies" are reported as trigger mechanisms for bioanomalies of impending earthquakes. For 3 years, we have monitored two Red Wood Ant mounds (Formica rufa-group), located at the seismically active Neuwied Basin (Eifel, Germany), 24/7 by high-resolution cameras equipped with a colour and infrared sensor. In the Neuwied Basin, an average of about 100 earthquakes per year with magnitudes up to M 3.9 occur located on different tectonic fault regimes (strike-slip faults and/or normal or thrust faults). The RWA mounds are located on two different fault regimes approximately 30 km apart. First results show that the ants have a well-identifiable standard daily routine. Correlation with local seismic events suggests changes in the ants' behaviour hours before the earthquake event: The nocturnal rest phase and daily activity are suppressed, and standard daily routine is continued not before the next day. Additional parameters that might have an effect on the ants' daily routine

  5. Estimating Eggs

    ERIC Educational Resources Information Center

    Lindsay, Margaret; Scott, Amanda

    2005-01-01

    The authors discuss mass as one of the three fundamental measurements (the others being length and time), noting that estimation of mass is little taught and assessed in primary schools. This article briefly explores the reasons for this in terms of culture, practice, and the difficulty of assessing estimation of mass. An activity using the…

  6. Cumulative risk assessment of the exposure to pyrethroids through fruits consumption in China - Based on a 3-year investigation.

    PubMed

    Li, Zhixia; Nie, Jiyun; Lu, Zeqi; Xie, Hanzhong; Kang, Lu; Chen, Qiusheng; Li, An; Zhao, Xubo; Xu, Guofeng; Yan, Zhen

    2016-10-01

    In the present study, the long-term and short-term cumulative risks of pyrethroids exposured for the Chinese general population and children through fruits consumption were evaluated. A total of 1450 fruit samples and seven pyrethroids were included based on the pesticide residues monitoring programme of China from 2013 to 2015. The exposure was estimated using both deterministic approach and semi-probabilistic model for comparison. The hazard index approach was used to assess cumulative risk. 26% of samples contained pyrethroid residues with concentrations ranged from 0.0050 mg/kg to 1.2 mg/kg, of which 30% simultaneously with 2-4 mixture residues. Results demonstrated that the cumulative health risks were extremely low for both general population and children (1-6 years old) of China in the long term. Acute risk estimations calculated by deterministic method were several or many times overestimated than the results based on semi-probabilistic method. Acute cumulative exposure of children to pyrethroid compounds in 0.76% samples were exceeded 1 in worst case scenario. More detailed assessments with adequate data in the future use probabilistic method is expected to reduce the uncertainties of cumulative dietary exposure. PMID:27515867

  7. Regional background aerosols over the Balearic Islands over the last 3 years: ground-based concentrations, atmospheric deposition and sources

    NASA Astrophysics Data System (ADS)

    Cerro, Jose Carlos; Pey, Jorge; Bujosa, Carles; Caballero, Sandra; Alastuey, Andres; Sicard, Michael; Artiñano, Begoña; Querol, Xavier

    2013-04-01

    In the context of the ChArMEx (The Chemistry-Aerosol Mediterranean Experiment, https://charmex.lsce.ipsl.fr) initiative, a 3-year study over a regional background environment (Can Llompart, CLP) in Mallorca has been conducted. Ground-based PM mass concentrations, gaseous pollutants and meteorological parameters were continuously registered from 2010 to 2012. Since the beginning of the campaign, PM10 daily samples for chemical determinations were obtained every 4 days, and dry and wet deposition samples were collected every week. Moreover, additional instruments (condensation particle counter, multi-angle absorption photometer, airpointer, sequential high and low volume samplers) were deployed during intensive filed campaigns in 2011 and 2012, as well as the sampling frequency was intensified. In the laboratory, PM samples were analyzed for inorganic compounds, and organic and elemental carbon following different approaches. In addition, n-alkanes, iso-alkanes, antiso-alkanes, levoglucosan, alkanoic acids and cholesterol were determined by GC-MS chromatography in a selection of 30 samples. Mean PM10, PM2.5 and PM1 concentrations in the period 2010-2012 reached 17, 11, and 8 µg/m3 respectively. Mass concentrations displayed marked seasonal trends, with much higher background levels in summer due to stagnant conditions over the western Mediterranean and increased frequency of Saharan dust events. Likewise, diverse-intensity peaks of coarse PM due to African dust inputs were observed along the year. On average, African dust in PM10 accounted for 1.0-1.5 µg/m3. Sporadic pollution events, characterized by most of the particles in the fine mode, were related to the transport of anthropogenic polluted air masses from central and eastern Europe. Wet and dry atmospheric deposition samples are being analyzed to quantify the deposition fluxes for different soluble and insoluble compounds. On average, PM10 composition is made up of organic matter (23%), mineral components (17

  8. The nitrogen efficiency of MSW composts as measured by triticale uptake in a 3-year field experiment

    NASA Astrophysics Data System (ADS)

    Weber, Jerzy; Licznar, Michal; Bekier, Jakub; Drozd, Jerzy; Jamroz, Elzbieta; Kocowicz, Andrzej; Parylak, Danuta; Kordas, Leszek; Licznar, Stanislawa

    2010-05-01

    This paper presents results of three year field experiment, where two different composts produced from municipal solid wastes were applied to sandy soil. The experiment was established on soil developed from loam sand, according to U.S.D.A. textural classes (81% of sand, 12% of silt, and 7% of clay), of a slightly acidic reaction (pH KCl 6.05 - 6.44). The plough layer (0 - 25 cm) contained about 5.0 g/kg of organic carbon. Both composts were alkaline in reaction and contained high amounts of plant available forms of phosphorus, potassium and magnesium. Composts were used non-recurrently in rates of 18, 36, and 72 t/ha, calculated on dry matter basis. Control objects (0 and NPK) were plots without fertilization, as well as plots fertilized each year with mineral forms of NPK. Field experiment was conducted in 15 m2 plots, using five replications in a randomized block design. Spring triticale (x Triticosecale Wittm.) cultivated in a 3-year monoculture was used as the experiment plant. Soil samples were collected each year after harvesting. Changes in triticale yield were considered in relation to soil properties and nitrogen content in triticale straw and grain. Application of composts caused beneficial changes in soil fertility, connected mainly with an increase of soil organic matter and content of available forms of P, K, and Mg. These effects were observed throughout three years of the experiment. However, significantly higher values of organic carbon - as compared to control (0 and NPK) - were observed only in plots with medium and highest compost doses. This effect was very clear in the first year, while significant differences in soil carbon content were still observed in next two years. The yield of triticale straw and grain depended significantly on fertilization with composts, but beneficial effect of compost was observed only in the first year. Yield similar to NPK control was found only on plots where the highest dose of compost was applied. Next two

  9. Overview of 3 years of ChemCam' chemical compositions along the Curiosity's traverse at Gale Crater.

    NASA Astrophysics Data System (ADS)

    Cousin, Agnès; Wiens, Roger; Maurice, Sylvestre; Gasnault, Olivier

    2016-04-01

    Curiosity rover has been in Gale crater for more than3 years now. It drove ~12 km from its landing point up to the Bagnold Dunes. The ChemCam instrument is widely used to assess the chemistry of rocks and soils at the submillimeter scale. As of sol 1200, ChemCam sampled >1000 targets, corresponding to >300000 laser shots, >6000 images, and many passive spectra. The Bradbury landing site, a plain located at a distal portion of the alluvial fan from Peace Vallis, exposed several float rocks presenting igneous compositions ranging from mafic up to a trachytic end-member. These observations provided an important clue concerning the diversity of early Mars magmatism that was not previously recognized. More igneous float rocks have been observed all along the traverse, being more felsic closer to the landing site, and more mafic near the cratered unit, after the Kimberley formation. The Sheepbed area is essentially composed of mudstones that show a very homogeneous composition, close to the average Martian crust, providing evidence of aqueous episodes with little alteration in this area. ChemCam showed that the bedrock host experienced other diagenetic events with Mg- and Fe-rich clays in erosion-resistant raised ridges on one hand, and calcium sulfate veins on the other hand. The nearby Shaler fluvial sandstone outcrop, the first outcrop of potential deltaic foreset beds, shows K enrichment. This enrichment is also observed at the Kimberley formation (another drill site flanked by foreset beds), located 7 km SW of Shaler, with up to 5.3 wt % at the Mount Remarkable member. Conglomerates have been analyzed in detail all along the traverse as they represent a link between the source rocks and the finer-grained sediments such as the sandstones and mudstones. They have shown an average composition that is enriched in alkalis, Al, and Si compared to the average Martian crust, with a clear enrichment in K2O in the vicinity of the Kimberley formation. Enrichment in K2O at

  10. 3D Printing/Additive Manufacturing Single Titanium Dental Implants: A Prospective Multicenter Study with 3 Years of Follow-Up.

    PubMed

    Tunchel, Samy; Blay, Alberto; Kolerman, Roni; Mijiritsky, Eitan; Shibli, Jamil Awad

    2016-01-01

    This prospective 3-year follow-up clinical study evaluated the survival and success rates of 3DP/AM titanium dental implants to support single implant-supported restorations. After 3 years of loading, clinical, radiographic, and prosthetic parameters were assessed; the implant survival and the implant-crown success were evaluated. Eighty-two patients (44 males, 38 females; age range 26-67 years) were enrolled in the present study. A total of 110 3DP/AM titanium dental implants (65 maxilla, 45 mandible) were installed: 75 in healed alveolar ridges and 35 in postextraction sockets. The prosthetic restorations included 110 single crowns (SCs). After 3 years of loading, six implants failed, for an overall implant survival rate of 94.5%; among the 104 surviving implant-supported restorations, 6 showed complications and were therefore considered unsuccessful, for an implant-crown success of 94.3%. The mean distance between the implant shoulder and the first visible bone-implant contact was 0.75 mm (±0.32) and 0.89 (±0.45) after 1 and 3 years of loading, respectively. 3DP/AM titanium dental implants seem to represent a successful clinical option for the rehabilitation of single-tooth gaps in both jaws, at least until 3-year period. Further, long-term clinical studies are needed to confirm the present results.

  11. 3D Printing/Additive Manufacturing Single Titanium Dental Implants: A Prospective Multicenter Study with 3 Years of Follow-Up

    PubMed Central

    2016-01-01

    This prospective 3-year follow-up clinical study evaluated the survival and success rates of 3DP/AM titanium dental implants to support single implant-supported restorations. After 3 years of loading, clinical, radiographic, and prosthetic parameters were assessed; the implant survival and the implant-crown success were evaluated. Eighty-two patients (44 males, 38 females; age range 26–67 years) were enrolled in the present study. A total of 110 3DP/AM titanium dental implants (65 maxilla, 45 mandible) were installed: 75 in healed alveolar ridges and 35 in postextraction sockets. The prosthetic restorations included 110 single crowns (SCs). After 3 years of loading, six implants failed, for an overall implant survival rate of 94.5%; among the 104 surviving implant-supported restorations, 6 showed complications and were therefore considered unsuccessful, for an implant-crown success of 94.3%. The mean distance between the implant shoulder and the first visible bone-implant contact was 0.75 mm (±0.32) and 0.89 (±0.45) after 1 and 3 years of loading, respectively. 3DP/AM titanium dental implants seem to represent a successful clinical option for the rehabilitation of single-tooth gaps in both jaws, at least until 3-year period. Further, long-term clinical studies are needed to confirm the present results. PMID:27313616

  12. 3D Printing/Additive Manufacturing Single Titanium Dental Implants: A Prospective Multicenter Study with 3 Years of Follow-Up.

    PubMed

    Tunchel, Samy; Blay, Alberto; Kolerman, Roni; Mijiritsky, Eitan; Shibli, Jamil Awad

    2016-01-01

    This prospective 3-year follow-up clinical study evaluated the survival and success rates of 3DP/AM titanium dental implants to support single implant-supported restorations. After 3 years of loading, clinical, radiographic, and prosthetic parameters were assessed; the implant survival and the implant-crown success were evaluated. Eighty-two patients (44 males, 38 females; age range 26-67 years) were enrolled in the present study. A total of 110 3DP/AM titanium dental implants (65 maxilla, 45 mandible) were installed: 75 in healed alveolar ridges and 35 in postextraction sockets. The prosthetic restorations included 110 single crowns (SCs). After 3 years of loading, six implants failed, for an overall implant survival rate of 94.5%; among the 104 surviving implant-supported restorations, 6 showed complications and were therefore considered unsuccessful, for an implant-crown success of 94.3%. The mean distance between the implant shoulder and the first visible bone-implant contact was 0.75 mm (±0.32) and 0.89 (±0.45) after 1 and 3 years of loading, respectively. 3DP/AM titanium dental implants seem to represent a successful clinical option for the rehabilitation of single-tooth gaps in both jaws, at least until 3-year period. Further, long-term clinical studies are needed to confirm the present results. PMID:27313616

  13. Early management of type 2 diabetes based on a SMBG strategy: the way to diabetes regression--the St Carlos study : a 3-year, prospective, randomized, clinic-based, interventional study with parallel groups.

    PubMed

    García de la Torre, Nuria; Durán, Alejandra; Del Valle, Laura; Fuentes, Manuel; Barca, Idoya; Martín, Patricia; Montañez, Carmen; Perez-Ferre, Natalia; Abad, Rosario; Sanz, Fuencisla; Galindo, Mercedes; Rubio, Miguel A; Calle-Pascual, Alfonso L

    2013-08-01

    The aims are to define the regression rate in newly diagnosed type 2 diabetes after lifestyle intervention and pharmacological therapy based on a SMBG (self-monitoring of blood glucose) strategy in routine practice as compared to standard HbA1c-based treatment and to assess whether a supervised exercise program has additional effects. St Carlos study is a 3-year, prospective, randomized, clinic-based, interventional study with three parallel groups. Hundred and ninety-five patients were randomized to the SMBG intervention group [I group; n = 130; Ia: SMBG (n = 65) and Ib: SMBG + supervised exercise (n = 65)] and to the HbA1c control group (C group) (n = 65). The primary outcome was to estimate the regression rate of type 2 diabetes (HbA1c <6 % on metformin treatment). After 3 years of follow-up, diabetes regression was achieved by 56 patients, 6 (9.2 %) from the C group, 21 (32.3 %) from the Ia group and 29 (44.6 %) from the Ib group. RR (95 % CI) for diabetes regression in the intervention group (Ia + Ib) was 4.5 (2.1-9); p < 0.001 and remained after stratification by gender, age and BMI. This difference was associated with healthier changes in lifestyle and greater weight loss. RR for a weight loss >4 kg was 3.6 (1.8-7); p < 0.001. This study shows that the use of SMBG in an educational program effectively increases the regression rate in newly diagnosed type 2 diabetic patients after 3 years of follow-up. These data suggest that SMBG-based programs should be extended to primary care settings where diabetic patients are usually attended.

  14. Dose–Volume Relationships Associated With Temporal Lobe Radiation Necrosis After Skull Base Proton Beam Therapy

    SciTech Connect

    McDonald, Mark W.; Linton, Okechukwu R.; Calley, Cynthia S.J.

    2015-02-01

    Purpose: We evaluated patient and treatment parameters correlated with development of temporal lobe radiation necrosis. Methods and Materials: This was a retrospective analysis of a cohort of 66 patients treated for skull base chordoma, chondrosarcoma, adenoid cystic carcinoma, or sinonasal malignancies between 2005 and 2012, who had at least 6 months of clinical and radiographic follow-up. The median radiation dose was 75.6 Gy (relative biological effectiveness [RBE]). Analyzed factors included gender, age, hypertension, diabetes, smoking status, use of chemotherapy, and the absolute dose:volume data for both the right and left temporal lobes, considered separately. A generalized estimating equation (GEE) regression analysis evaluated potential predictors of radiation necrosis, and the median effective concentration (EC50) model estimated dose–volume parameters associated with radiation necrosis. Results: Median follow-up time was 31 months (range 6-96 months) and was 34 months in patients who were alive. The Kaplan-Meier estimate of overall survival at 3 years was 84.9%. The 3-year estimate of any grade temporal lobe radiation necrosis was 12.4%, and for grade 2 or higher radiation necrosis was 5.7%. On multivariate GEE, only dose–volume relationships were associated with the risk of radiation necrosis. In the EC50 model, all dose levels from 10 to 70 Gy (RBE) were highly correlated with radiation necrosis, with a 15% 3-year risk of any-grade temporal lobe radiation necrosis when the absolute volume of a temporal lobe receiving 60 Gy (RBE) (aV60) exceeded 5.5 cm{sup 3}, or aV70 > 1.7 cm{sup 3}. Conclusions: Dose–volume parameters are highly correlated with the risk of developing temporal lobe radiation necrosis. In this study the risk of radiation necrosis increased sharply when the temporal lobe aV60 exceeded 5.5 cm{sup 3} or aV70 > 1.7 cm{sup 3}. Treatment planning goals should include constraints on the volume of temporal lobes receiving

  15. A Novel Approach to Evaluating the Iron and Folate Status of Women of Reproductive Age in Uzbekistan after 3 Years of Flour Fortification with Micronutrients

    PubMed Central

    Hund, Lauren; Northrop-Clewes, Christine A.; Nazario, Ronald; Suleymanova, Dilora; Mirzoyan, Lusine; Irisova, Munira; Pagano, Marcello; Valadez, Joseph J.

    2013-01-01

    Background The Uzbekistan 1996 Demographic Health Survey reported 60.4% of women of reproductive age (WRA) had low hemoglobin concentrations (<120 g/L), and anemia was an important public health problem. Fortification of wheat flour was identified as an appropriate intervention to address anemia due to the ubiquitous consumption of wheat flour. A National Flour Fortification Program (NFFP) was implemented in 2005. Methodology/Principal Findings After 3-years of the NFFP, a national survey using large country-lot quality assurance sampling was carried out to assess iron, folate, hemoglobin and inflammation status of WRA; the coverage and knowledge of the fortified first grade UzDonMakhsulot (UDM) flour/grey loaf program; and consumption habits of women to investigate the dietary factors associated with anemia. Estimated anemia prevalence was 34.4% (95% CI: 32.0, 36.7), iron depletion 47.5% (95% CI: 45.1, 49.9) and folate deficiency 28.8% (95% CI: 26.8, 30.8); the effect of inflammation was minimal (4% with CRP >5 mg/L). Severe anemia was more prevalent among folate deficient than iron depleted WRA. Presence of UDM first grade flour or the grey loaf was reported in 71.3% of households. Among WRA, 32.1% were aware of UDM fortification; only 3.7% mentioned the benefits of fortification and 12.5% understood causes of anemia. Consumption of heme iron-containing food (91%) and iron absorption enhancers (97%) was high, as was the consumption of iron absorption inhibitors (95%). Conclusions/Significance The NFFP coincided with a substantial decline in the prevalence of anemia. Folate deficiency was a stronger predictor of severe anemia than iron depletion. However, the prevalence of iron depletion was high, suggesting that women are not eating enough iron or iron absorption is inhibited. Fortified products were prevalent throughout Uzbekistan, though UDM flour must be adequately fortified and monitored in the future. Knowledge of fortification and anemia was low, suggesting

  16. Adolescents' awareness of HPV infections and attitudes towards HPV vaccination 3 years following the introduction of the HPV vaccine in Hungary.

    PubMed

    Marek, Erika; Dergez, Timea; Rebek-Nagy, Gabor; Kricskovics, Antal; Kovacs, Krisztina; Bozsa, Szabolcs; Kiss, Istvan; Ember, Istvan; Gocze, Peter

    2011-11-01

    Hungary takes the fourth place regarding the incidence and the fifth regarding the mortality of cervical cancer among the member countries of the European Union, with 500 deaths due to this preventable illness and nearly 1200 new cases diagnosed every year. Although the vaccines have been available for 3 years, the estimated rate of the female population vaccinated against HPV is approximately 10% in the 12-26-year-age cohort. The aim of this study was to determine factors and motivations affecting the uptake of HPV vaccination among Hungarian adolescents. Examining the effects of some possible sociodemographic predictors (age and gender) and the exposure to health information on HPV vaccine acceptability were also focused on, as well as assessing the most trusted sources of information about sexually transmitted diseases (STDs). A nationwide anonymous questionnaire survey with a sample of 1769 students attending public primary or secondary schools was organised by the authors in 16 Hungarian cities and towns. Data were analysed using the Statistical Package for the Social Sciences (SPSS). Adolescents' awareness of HPV was relatively low. Only 35% of the participants reported they had heard about HPV prior to the survey. Almost 70% of the potentially affected study population had not heard about the vaccine previously. Every fourth student did not believe that vaccination against HPV can prevent cervical cancer. If the vaccination was available free of charge, almost 80% of respondents would request it, but in case they had to pay for it, this number would significantly decrease. Significantly better knowledge and also more positive attitudes towards HPV vaccination was found in relation to the number of information sources. The majority of respondents (62-83%) were open for further information about STDs. The main trusted mediators were school-health services (61.3%), education on health at school (49.2%), health professionals (42.2%) and electronic media (24

  17. Extralevator Abdominoperineal Excision for Low Rectal Cancer—Extensive Surgery to Be Used With Discretion Based on 3-Year Local Recurrence Results

    PubMed Central

    Prytz, Mattias; Angenete, Eva; Bock, David; Haglind, Eva

    2016-01-01

    Objectives: The aim of this prospective registry-based population study was to investigate the efficacy of extralevator abdominoperineal excision (ELAPE) regarding local recurrence rates within 3 years after surgery. Background: Local recurrence of rectal cancer is more common after abdominoperineal excision (APE) than after anterior resection. Extralevator abdominoperineal excision was introduced to address this problem. No large-scale studies with long-term oncological outcomes have been published. Methods: All Swedish patients operated on with an APE and registered in the Swedish ColoRectal Cancer Registry 2007 to 2009 were included (n = 1397) and analyzed with emphasis on the perineal part of the operation. Local recurrence at 3 years was collected from the registry. Results: The local recurrence rates at 3 years [median follow-up, 3.43 years (APE, 3.37 years; ELAPE, 3.41 years; not stated: 3.43 years)] were significantly higher for ELAPE compared with APE (relative risk, 4.91). Perioperative perforation was also associated with an increased risk of local recurrence (relative risk, 3.62). There was no difference in 3-year overall survival between APE and ELAPE. In the subgroup of patients with very low tumors (≤4 cm from the anal verge), no significant difference in the local recurrence rate could be observed. Conclusions: Extralevator abdominoperineal excision results in a significantly increased 3-year local recurrence rate as compared with standard APE. Intraoperative perforation seems to be an important risk factor for local recurrence. In addition to significantly increased 3-year local recurrence rates, the significantly increased incidence of wound complications leads to the conclusion that ELAPE should only be considered in selected patients at risk of intraoperative perforation. PMID:25906414

  18. Attitude Estimation or Quaternion Estimation?

    NASA Technical Reports Server (NTRS)

    Markley, F. Landis

    2003-01-01

    The attitude of spacecraft is represented by a 3x3 orthogonal matrix with unity determinant, which belongs to the three-dimensional special orthogonal group SO(3). The fact that all three-parameter representations of SO(3) are singular or discontinuous for certain attitudes has led to the use of higher-dimensional nonsingular parameterizations, especially the four-component quaternion. In attitude estimation, we are faced with the alternatives of using an attitude representation that is either singular or redundant. Estimation procedures fall into three broad classes. The first estimates a three-dimensional representation of attitude deviations from a reference attitude parameterized by a higher-dimensional nonsingular parameterization. The deviations from the reference are assumed to be small enough to avoid any singularity or discontinuity of the three-dimensional parameterization. The second class, which estimates a higher-dimensional representation subject to enough constraints to leave only three degrees of freedom, is difficult to formulate and apply consistently. The third class estimates a representation of SO(3) with more than three dimensions, treating the parameters as independent. We refer to the most common member of this class as quaternion estimation, to contrast it with attitude estimation. We analyze the first and third of these approaches in the context of an extended Kalman filter with simplified kinematics and measurement models.

  19. Islet isolation and GMP, ISO 9001:2000: what do we need--a 3-year experience.

    PubMed

    Hengster, P; Hermann, M; Pirkebner, D; Draxl, A; Margreiter, R

    2005-10-01

    Pancreatic islet cell isolation and transplantation has been performed for many years at several institutions. Although all institutions aim to produce high-quality islets, applied standards widely deviate from standards in the pharmaceutical industry. The legal situation within the European Union has changed requirements for setting up and running such a laboratory. The process is now clearly defined as a production of a pharmaceutical and therefore must be licensed by federal authorities. Analysis of workload for establishing an islet isolation program that fulfil GMP and ISO 9001 criteria including an estimation of costs and the impact of such a system on the isolation process. The definition of quality parameters and documentation is a central issue of all islet isolation laboratories. Therefore, GMP and ISO 9001:2000 do not add additional work per se. On the other hand, clear guidelines, a clear policy, working place descriptions, forms, checklists, and, particularly standard operating procedures, are instrumental for smooth functioning within the department. Collection of data such as errors, improvement measures, and preventive measures reduces subsequent costs. A clear definition of responsibilities minimizes organizational problems. Steering of inspection devices prevents bias errors and validating the processes clearly points out incorrect assumptions. Documentation helps to prove the correctness of the production at any time and is of use also for scientific evaluations. We strongly feel that GMP criteria are mandatory and together with an ISO 9001:2000 quality management system offers significant advantages for the process of islet isolation and a continuous improvement process.

  20. Analysis of weather regime dependent wind biases over the east coast of China using 3 year WRF simulations

    NASA Astrophysics Data System (ADS)

    Lin, N.; Zhao, Y.; Xue, W.; Lin, Y.

    2015-12-01

    Reliable wind power resource estimates required by wind energy industry can be achieved by long term wind tower measurements or mesoscale model simulations. However, how to quantify and investigate the characteristics of wind bias of mesoscale modeling remain a challenge.Three-year simulations using WRF over the east coast of China have been conducted. A K-means cluster analysis is used to categorize the dominant weather regimes over this area.A systematic overestimate of wind speed over the coastal area is found during the daytime within the sea breeze dominant regime. Further analysis indicates that the positive bias is closely related to the strength of mixing within the boundary layer and land surface temperature bias. A typical sea breeze case is analyzed in terms of its evolution with a focus on the vertical and inland intrusion extent. A good simulation of local land sea breeze is critical for offshore and onshore wind farm design and operations over the east coast of China.

  1. Increasing Radiation Therapy Dose Is Associated With Improved Survival in Patients Undergoing Stereotactic Body Radiation Therapy for Stage I Non–Small-Cell Lung Cancer

    SciTech Connect

    Koshy, Matthew; Malik, Renuka; Weichselbaum, Ralph R.; Sher, David J.

    2015-02-01

    Purpose: To determine the comparative effectiveness of different stereotactic body radiation therapy (SBRT) dosing regimens for early-stage non–small-cell lung cancer, using a large national database, focusing on the relative impact of dose as a function of tumor stage. Methods and Materials: The study included patients in the National Cancer Database from 2003 to 2006 with T1-T2N0M0 inoperable lung cancer (n=498). The biologically effective dose (BED) was calculated according to the linear quadratic formula using an α/β ratio of 10. High versus lower-dose (HD vs LD) SBRT was defined as a calculated BED above or below 150 Gy. Overall survival was estimated using Kaplan-Meier methods and Cox proportional hazard regression. Results: The 5 most common dose fractionation schemes (percentage of cohort) used were 20 Gy × 3 (34%), 12 Gy × 4 (16%), 18 Gy × 3 (10%), 15 Gy × 3 (10%), and 16 Gy × 3 (4%). The median calculated BED was 150 Gy (interquartile range 106-166 Gy). The 3-year overall survival (OS) for patients who received HD versus LD was 55% versus 46% (log–rank P=.03). On subset analysis of the T1 cohort there was no association between calculated BED and 3-year OS (61% vs 60% with HD vs LD, P=.9). Among the T2 cohort, patients receiving HD experienced superior 3-year OS (37% vs 24%, P=.01). On multivariable analysis, factors independently prognostic for mortality were female gender (hazard ratio [HR] 0.76, P=.01), T2 tumor (HR 1.99, P=.0001), and HD (HR 0.68, P=.001). Conclusions: This comparative effectiveness analysis of SBRT dose for patients with stage I non–small-cell lung cancer suggests that higher doses (>150 Gy BED) are associated with a significant survival benefit in patients with T2 tumors.

  2. Detecting Children with Arithmetic Disabilities from Kindergarten: Evidence from a 3-Year Longitudinal Study on the Role of Preparatory Arithmetic Abilities

    ERIC Educational Resources Information Center

    Stock, Pieter; Desoete, Annemie; Roeyers, Herbert

    2010-01-01

    In a 3-year longitudinal study, 471 children were classified, based on their performances on arithmetic tests in first and second grade, as having persistent arithmetic disabilities (AD), persistent low achieving (LA), persistent typical achieving, inconsistent arithmetic disabilities (DF1), or inconsistent low achieving in arithmetic. Significant…

  3. Acting and Planning on the Basis of a False Belief: Its Effects on 3-Year-Old Children's Reasoning About Their Own False Beliefs

    ERIC Educational Resources Information Center

    Atance, Cristina M.; O'Neill, Daniela K.

    2004-01-01

    This study examined 3-year-olds' explanations for actions of theirs that were premised on a false belief. In Experiment 1, children stated what they thought was inside a crayon box. After stating "crayons," they went to retrieve some paper to draw on. Children were then shown that the box contained candles and were asked to (a) state their initial…

  4. Impacts of a Violence Prevention Program for Middle Schools: Findings after 3 Years of Implementation. Executive Summary. NCEE 2011-4018

    ERIC Educational Resources Information Center

    Silvia, Suyapa; Blitstein, Jonathan; Williams, Jason; Ringwalt, Chris; Dusenbury, Linda; Hansen, William

    2011-01-01

    This is the second and final report summarizing findings from an impact evaluation of a violence prevention intervention for middle schools. This report provides findings from the second and third years of the 3-year intervention. The U.S. Department of Education (ED) contracted with RTI International and its subcontractors, Pacific Institute for…

  5. Bidirectional Relations between Parenting Practices and Child Externalizing Behavior: A Cross-Lagged Panel Analysis in the Context of a Psychosocial Treatment and 3-Year Follow-up

    ERIC Educational Resources Information Center

    Shaffer, Anne; Lindhiem, Oliver; Kolko, David J.; Trentacosta, Christopher J.

    2013-01-01

    In the current study, we examined longitudinal changes in, and bidirectional effects between, parenting practices and child behavior problems in the context of a psychosocial treatment and 3-year follow-up period. The sample comprised 139 parent-child dyads (child ages 6-11) who participated in a modular treatment protocol for early-onset ODD or…

  6. The Impact of Body-Part-Naming Training on the Accuracy of Imitative Performances in 2- to 3-Year-Old Children

    ERIC Educational Resources Information Center

    Camoes-Costa, Vera; Erjavec, Mihela; Horne, Pauline J.

    2011-01-01

    A series of three experiments explored the relationship between 3-year-old children's ability to name target body parts and their untrained matching of target hand-to-body touches. Nine participants, 3 per experiment, were presented with repeated generalized imitation tests in a multiple-baseline procedure, interspersed with step-by-step training…

  7. Predictive value of health-related quality of life in progression of disability and depression in persons with multiple sclerosis: a 3-year study.

    PubMed

    Kisic Tepavcevic, Darija; Pekmezovic, Tatjana; Stojsavljevic, Nebojsa; Kostic, Jelena; Dujmovic Basuroski, Irena; Mesaros, Sarlota; Drulovic, Jelena

    2013-12-01

    In our study, we examined whether health-related quality of life (HRQoL) could predict changes in disability, depression, and fatigue in patients with multiple sclerosis (MS) over a 3-year follow-up period. A group of 109 consecutive MS patients (McDonald's criteria) referring to the Institute of Neurology, Belgrade were enrolled in the study. At two time points during the study (baseline, and after a 3-year period) an HRQoL (measured by MSQoL-54), EDSS, Hamilton Rating Scale for Depression (HDRS) and Fatigue Severity Scale (FSS) were assessed. At the end of a 3-year follow-up, 12 out of 109 patients (11%) had dropped out. Multiple linear regression analysis showed that Physical Health scale of MSQoL-54 is significant independent predictor of change in EDSS after 3 years (p = 0.035). Mental health composite score of MSQoL-54 was predictor of change in HDRS score (p = 0.049). In separate regression analysis, only social function was independent predictor of the development of depression (p = 0.041). None of the HRQoL domains had predictive effect on the change of FSS. Our study suggests that baseline HRQoL scores, measured by MSQoL-54, could be applied as a prognostic marker for progression of both, disability, and severity of depressive symptoms in MS. PMID:23460394

  8. Relationships among performance, residual feed intake, and temperament assessed in growing beef heifers and subsequently as 3-year-old, lactating beef cows

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Seventy-four beef heifers were used to evaluate the relationships among performance, residual feed intake (RFI), and temperament measured as growing heifers (Phase 1) and subsequently as 3-year-old lactating beef cows (Phase 2) in the same cohort. In both phases, females were housed in a covered fac...

  9. Reading Intervention Outcomes for Adults with Disabilities in a Vocational Rehabilitation Setting: Results of a 3-Year Research and Demonstration Grant

    ERIC Educational Resources Information Center

    Vanderberg, Laura E.; Pierce, Margaret E.; Disney, Laurel J.

    2011-01-01

    This study reports on an examination of the effectiveness of a reading intervention for adults with disabilities in a vocational rehabilitation setting. Participants were 57 adults with disabilities and low reading skills enrolled at the Reading Clinic at the Michigan Career and Technical Institute. As part of a 3-year research and demonstration…

  10. Can Severely Language Delayed 3-Year-Olds Be Identified at 18 Months? Evaluation of a Screening Version of the MacArthur-Bates Communicative Development Inventories

    ERIC Educational Resources Information Center

    Westerlund, Monica; Berglund, Eva; Eriksson, Marten

    2006-01-01

    Purpose: To evaluate the effectiveness of a screening instrument (the Swedish Communication Screening at 18 months of age; SCS18), derived from the Swedish MacArthur-Bates Communicative Development Inventory, in identification of 18-month-old children who will be severely language disabled by 3 years of age, the authors (a) analyzed which SCS18's…

  11. Is the Movement Assessment Battery for Children-2nd Edition a Reliable Instrument to Measure Motor Performance in 3 Year Old Children?

    ERIC Educational Resources Information Center

    Smits-Engelsman, Bouwien C. M.; Niemeijer, Anuschka S.; van Waelvelde, Hilde

    2011-01-01

    Formal testing of 3 year old children is a new feature in the revised version of the Movement Assessment Battery for Children (Movement ABC-2). Our study evaluated the reliability and explored the clinical applicability of the Movement ABC-2 Test in this young age group. A total of 50 typically children were given two trials of the test within a…

  12. Lifestyle, Dwelling Conditions and Daily Routine as Qualitative Indicators of Infant Development: A Study of 0-3 Years Old Children from Rural Brazilian Northeast.

    ERIC Educational Resources Information Center

    Rabinovich, Elaine Pedreira

    The developing child and his/her eco-social-cultural context is the focus of study of 28 children ages 0-3 years in the rural area of Cocal, Piaui in Northeast Brazil. Ethnographic methods, naturalistic observations and semi-structured interviews were used to ascertain the physical context (the house and its surroundings), as well as maternal…

  13. No Own-Age Bias in 3-Year-Old Children: More Evidence for the Role of Early Experience in Building Face-Processing Biases

    ERIC Educational Resources Information Center

    Cassia, Viola Macchi; Pisacane, Antonella; Gava, Lucia

    2012-01-01

    This study aimed to investigate the presence of an own-age bias in young children who accumulated different amounts of early experience with child faces. Discrimination abilities for upright and inverted adult and child faces were tested using a delayed two-alternative, forced-choice matching-to-sample task in two groups of 3-year-old children,…

  14. Attachment-Based Intervention for Enhancing Sensitive Discipline in Mothers of 1- to 3-Year-Old Children at Risk for Externalizing Behavior Problems: A Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Van Zeijl, Jantien; Mesman, Judi; Van IJzendoorn, Marinus H.; Bakermans-Kranenburg, Marian J.; Juffer, Femmie; Stolk, Mirjam N.; Koot, Hans M.; Alink, Lenneke R. A.

    2006-01-01

    The home-based intervention program Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) was tested in a randomized controlled trial with 237 families screened for their 1- to 3-year-old children's relatively high scores on externalizing behavior. VIPP-SD, based on attachment theory and coercion theory,…

  15. Prediction of Cognitive Abilities at the Age of 5 Years Using Developmental Follow-Up Assessments at the Age of 2 and 3 Years in Very Preterm Children

    ERIC Educational Resources Information Center

    Potharst, Eva S.; Houtzager, Bregje A.; van Sonderen, Loekie; Tamminga, Pieter; Kok, Joke H.; Last, Bob F.; van Wassenaer, Aleid G.

    2012-01-01

    Aim: This study investigated prediction of separate cognitive abilities at the age of 5 years by cognitive development at the ages of both 2 and 3 years, and the agreement between these measurements, in very preterm children. Methods: Preterm children (n=102; 44 males; 58 females) with a gestational age less than 30 weeks and/or birthweight less…

  16. The Predictive Value of Cognitive Impairments Measured at the Start of Clinical Rehabilitation for Health Status 1 Year and 3 Years Poststroke

    ERIC Educational Resources Information Center

    Verhoeven, Clara L.; Schepers, Vera P.; Post, Marcel W.; van Heugten, Caroline M.

    2011-01-01

    The objective of this study was to investigate the value of screening for cognitive functions at the start of an inpatient rehabilitation programme to predict the health status 1 and 3 years poststroke. In this longitudinal cohort study of stroke patients in inpatient rehabilitation data of 134 participants were analysed. Cognitive and clinical…

  17. Estimating risk.

    PubMed

    2016-07-01

    A free mobile phone app has been launched providing nurses and other hospital clinicians with a simple way to identify high-risk surgical patients. The app is a phone version of the Surgical Outcome Risk Tool (SORT), originally developed for online use with computers by researchers from the National Confidential Enquiry into Patient Outcome and Death and the University College London Hospital Surgical Outcomes Research Centre. SORT uses information about patients' health and planned surgical procedures to estimate the risk of death within 30 days of an operation. The percentages are only estimates, taking into account the general risks of the procedures and some information about patients, and should not be confused with patient-specific estimates in individual cases. PMID:27369709

  18. Effect of ablation rings and soil temperature on 3-year spring CO2 efflux along the Dalton Highway, Alaska

    NASA Astrophysics Data System (ADS)

    Kim, Y.

    2014-12-01

    Winter and spring soil CO2 efflux measurements represent a significant component in the assessment of annual carbon budgets of tundra and boreal forest ecosystems, reflecting responses to climate change in the Arctic. This study was conducted in order to quantify CO2 efflux, using a portable chamber system at representative sites along the Dalton Highway. Study sites included three tundra, two white spruce, and three black spruce forest locations during the winter and spring seasons of 2010-2012; the study of these sites promised better understanding of winter and spring carbon contributions to the annual carbon budget, as well as the respective ablation-ring effects during spring. Three-year spring CO2 efflux depends on soil temperature at 5 cm depth on a regional scale. At their highest, Q10 values were 4.2 × 106, within the exposed tussock tundra of the upland tundra site, which tundra soils warmed from -0.9 to 0.5 °C, involving soil microbial activity. From the forest census (400 m2) of the two white spruce forest sites, CO2 emissions were estimated as 0.09-0.36 gC m-2 day-1 in winter and 0.14-4.95 gC m-2 day-1 in spring, corresponding to 1-3% and 1-27% of annual carbon, respectively. Contributions from spring CO2 emissions are likely to increase as exposed soils widen in average length (major axis) from the east-, west-, south-, and north-side lengths (minor axis). Considering the periods of winter and spring seasons across tundra and boreal forests, average winter- and spring-seasonal CO2 contributions to annual carbon budgets correspond roughly to 14-22% for tundra and 9-24% for boreal forest sites during 2011 and 2012. Spring carbon contributions, such as growing season CO2 emissions, are sensitive to subtle changes at the onset of spring and during the snow-covered period in northern high latitudes, in response to recent Arctic climate change.

  19. COMPLETE STEROID AVOIDANCE IS EFFECTIVE AND SAFE IN CHILDREN WITH RENAL TRANSPLANTS: A MULTICENTER RANDOMIZED TRIAL WITH 3 YEAR FOLLOW UP

    PubMed Central

    Sarwal, Minnie M.; Ettenger, Robert; Dharnidharka, Vikas; Benfield, Mark; Mathias, Robert; Portale, Anthony; McDonald, Ruth; Harmon, William; Kershaw, David; Vehaskari, V. Matti; Kamil, Elaine; Baluarte, H. Jorge; Warady, Bradley; Tang, Lily; Liu, Jun; Li, Li; Naesens, Maarten; Sigdel, Tara; Waskerwitz, Janie; Salvatierra, Oscar

    2012-01-01

    To determine whether steroid avoidance in pediatric kidney transplantation is safe and efficacious, a randomized, multicenter trial was performed in 12 pediatric kidney transplant centers. One hundred thirty children receiving primary kidney transplants were randomized to steroid-free (SF) or steroid-based (SB) immunosuppression, with concomitant tacrolimus, mycophenolate, and standard dose daclizumab (SB group) or extended dose daclizumab (SF group). Follow-up was 3 years post-transplant. Standardized height Z score change after 3 years follow-up was −0.99±2.20 in SF vs. −0.93±1.11 in SB; p=0.825. In subgroup analysis, recipients under 5 years of age showed improved linear growth with SF compared to SB treatment (change in standardized height Z score at 3 years −0.43±1.15 vs. −1.07±1.14; p=0.019). There were no differences in the rates of biopsy-proven acute rejection at 3 years after transplantation (16.7% in SF vs. 17.1% in SB; p=0.94). Patient survival was 100% in both arms; graft survival was 95% in the SF and 90% in the SB arms (p=0.30) at 3 years follow-up. Over the three year follow-up period, the SF group showed lower systolic BP (p=0.017) and lower cholesterol levels (p=0.034). In conclusion, complete steroid avoidance is safe and effective in unsensitized children receiving primary kidney transplants. PMID:22694755

  20. Contribution of long-range transported aerosols to aerosol optical and physical properties: 3-year measurements at Gosan, Korea

    NASA Astrophysics Data System (ADS)

    Heo, J.; Kim, S. W.; Kim, J. H.; Ogren, J. A.; Yoon, S. C.

    2015-12-01

    Recently, more attentions have been paid to air quality in East Asia due to the enhanced loading of atmospheric pollutants related to rapid industrialization. Gosan Climate Observatory (GCO), Korea is regarded as an ideal site to study the transport of atmospheric pollutants because it is frequently influenced by various airmasses from China, Korea, Japan and Pacific Ocean. In order to understand aerosol optical and physical properties according to airmass transport routes, three-year (2012-2014) continuous measurements of aerosol scattering/absorption coefficient and number size distribution were analyzed, together with 48-hour backward trajectory calculations. The averaged aerosol absorption (σa) and scattering coefficient (σs) for airmasses transported from North China (NC; 36% of all trajectories) were 6.65 Mm-1 and 94.72 Mm-1 at 550 nm wavelength, respectively, which were similar to those for stagnant airmasses (ST; 22% of all trajectories; σa: 6.26 Mm-1, σs: 93.99 Mm-1). The highest values of σa (7.03 Mm-1) and σs (108.34 Mm-1) were observed when airmasses were traveled from South China (SC; 11% of all trajectories). σa and σs for airmasses from Korean Peninsula (KP; 7% of all trajectories) and Pacific Ocean (PO; 14% of all trajectories; in parenthesis) were 5.63 (2.76) Mm-1 and 73.63 (50.93) Mm-1, respectively. Compared to other airmasses, the higher values of Scattering Angstrom Exponent (SAE) for ST (1.65) is thought to be the build-up of anthropogenic fine particulate pollutants. The Absorption Angstrom Exponent (AAE) was estimated to be 1.32 for NC airmass and 1.02 for SC airmass. Over the study period, 130 days of total 557 days were identified as new particle formation and growth event (NPF) from Scanning Mobility Particle Sizer (SMPS) measurements by Cyclostationary Empirical Orthogonal Function (CSEOF) approach. Especially, 55.4% (72 days) of total 130 NPF days were found when a cold and dry airmass comes from NC after passing the frontal

  1. Computational Estimation

    ERIC Educational Resources Information Center

    Fung, Maria G.; Latulippe, Christine L.

    2010-01-01

    Elementary school teachers are responsible for constructing the foundation of number sense in youngsters, and so it is recommended that teacher-training programs include an emphasis on number sense to ensure the development of dynamic, productive computation and estimation skills in students. To better prepare preservice elementary school teachers…

  2. RTOG 0417: Efficacy of Bevacizumab in Combination With Definitive Radiation Therapy and Cisplatin Chemotherapy in Untreated Patients With Locally Advanced Cervical Carcinoma

    SciTech Connect

    Schefter, Tracey; Winter, Kathryn; Kwon, Janice S.; Stuhr, Kelly; Balaraj, Khalid; Yaremko, Brian Patrick; Small, William; Sause, William; Gaffney, David

    2014-01-01

    Purpose: Radiation Therapy Oncology Group 0417 was a phase II study that explored the safety and efficacy of the addition of bevacizumab to chemoradiation therapy. The safety results have been previously reported. Herein we report the secondary efficacy endpoints of overall survival (OS), locoregional failure (LRF), para-aortic nodal failure (PAF), distant failure (DF), and disease-free survival (DFS). Methods and Materials: Eligible patients with bulky Stage IB-IIIB disease were treated with once-weekly cisplatin (40 mg/m{sup 2}) chemotherapy and standard pelvic radiation therapy and brachytherapy. Bevacizumab was administered at 10 mg/kg intravenously every 2 weeks for 3 cycles during chemoradiation. For OS, failure was defined as death of any cause and was measured from study entry to date of death. LRF was defined as any failure in the pelvis. PAF was defined as any para-aortic nodal failure. DF was analyzed both including and excluding PAF. DFS was measured from study entry to date of first LRF. DF was measured with or without PAF or death. OS and DFS were estimated by the Kaplan-Meier method, and LRF and DF rates were estimated by the cumulative incidence method. Results: 49 eligible patients from 28 institutions were enrolled between 2006 and 2009. The median follow-up time was 3.8 years (range, 0.8-6.0 years). The surviving patients had a median follow-up time of 3.9 years (range, 2.1-6.0 years). Most patients had tumors of International Federation of Gynecology and Obstetrics Stage IIB (63%), and 80% were squamous. The 3-year OS, DFS, and LRF were 81.3% (95% confidence interval [CI], 67.2%-89.8%), 68.7% (95% CI, 53.5%-79.8%), and 23.2% (95% CI, 11%-35.4%), respectively. The PAF, DF without PAF, and DF with PAF at 3 years were 8.4% (95% CI, 0.4%-16.3%), 14.7% (95% CI, 4.5%-24.9%), and 23.1% (95% CI 11.0%-35.2%), respectively. Conclusion: In this study, bevacizumab in combination with standard pelvic chemoradiation therapy for locally advanced cervical

  3. Hypopharynx and larynx defect repair after resection for pyriform fossa cancer with a platysma skin flap.

    PubMed

    Cai, Qian; Liang, Faya; Huang, Xiaoming; Han, Ping; Pan, Yong; Zheng, Yiqing

    2015-02-01

    We used a platysma skin flap to repair larynx and hypopharynx defects to improve postoperative laryngeal function in patients with pyriform fossa cancer. Larynx-sparing surgery and postoperative radiotherapy were used in 10 patients with pyriform fossa cancer. The surgical approaches of lymph node dissection of the neck, vertical partial laryngectomy, and pyriform fossa resection were adopted, and a platysma skin flap was used to repair the resulting defects. In this group, the overall 3-year survival rate was 75% according to the Kaplan-Meier analysis, and the local control rate was 90%. Additionally, all patients were able to speak fluently with mild-to-moderate hoarseness. The tracheal tube was removed in all cases. Laryngeal fistulas were observed in 1 patient during radiotherapy. In conclusion, a platysma skin flap can be used to rebuild the larynx and hypopharynx in larynx-sparing resection for pyriform fossa cancer. These patients can obtain good postoperative function in swallowing, breathing, and pronunciation.

  4. The results of acetabular impaction grafting in 129 primary cemented total hip arthroplasties.

    PubMed

    Wilson, Matthew J; Whitehouse, Sarah L; Howell, Jonathan R; Hubble, Matthew J W; Timperley, A John; Gie, Graham A

    2013-09-01

    Between 1995 and 2003, 129 cemented primary THAs were performed using full acetabular impaction grafting to reconstruct acetabular deficiencies. These were classified as cavitary in 74 and segmental in 55 hips. Eighty-one patients were reviewed at mean 9.1 (6.2-14.3) years post-operatively. There were seven acetabular component revisions due to aseptic loosening, and a further 11 cases that had migrated >5mm or tilted >5° on radiological review - ten of which reported no symptoms. Kaplan-Meier analysis of revisions for aseptic loosening demonstrates 100% survival at nine years for cavitary defects compared to 82.6% for segmental defects. Our results suggest that the medium-term survival of this technique is excellent when used for purely cavitary defects but less predictable when used with large rim meshes in segmental defects. PMID:23523217

  5. Usefulness of the European standard series for patch testing in children. A 3-year single-centre study of 337 patients.

    PubMed

    Roul, S; Ducombs, G; Taieb, A

    1999-05-01

    Results of patch tests in 337 children aged 1 to 15 performed in our paediatric unit during the past 3 years have been analysed retrospectively in order to optimize the patch test series and to assess their relevance. This study represents the most important single-centre study reported so far over a short period. We found a positive patch test rate of 66%, with a peak incidence among children less than 3 years of age (88% versus 58.9%). The most common allergens were metals, especially nickel, fragrances and, less frequently, rubber chemicals. Concerning nickel, positive reactions rarely correlated with a relevant exposure and were difficult to interpret, especially in patients with atopic dermatitis, who are probably more likely to have irritant or false-positive reactions to metals. Based on the results and their relevance, we propose a shortened standard series of patch tests for paediatric patients.

  6. Occurrence and molecular characterization of Klebsiella pneumoniae ST37 clinical isolates producing plasmid-mediated AmpC recovered over a 3-year period.

    PubMed

    Illiaquer, Marina; Caroff, Nathalie; Bémer, Pascale; Aubin, Guillaume G; Juvin, Marie-Emmanuelle; Lepelletier, Didier; Reynaud, Alain; Corvec, Stéphane

    2012-09-01

    We investigated the clinical and microbiological epidemiology of AmpC plasmidic cephalosporinases (pAmpC) in Klebsiella pneumoniae strains resistant to ceftazidime, during a 3-year period (2007-2009). Among 1505 K. pneumoniae, 7 were pAmpC producers. Molecular characterization revealed the spread of a ST37 strain producing DHA-1 within intensive care units and the diffusion of the same plasmid among unrelated strains.

  7. Prescription pain reliever misuse and levels of pain impairment: 3-year course in a nationally representative outpatient sample of US adults

    PubMed Central

    Novak, Scott P; Glasheen, Cristie; Roland, Carl L

    2016-01-01

    Background The primary aim of this work was to present the prevalence data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a representative 3-year longitudinal survey (ages 18+ years) that captured information on patterns of self-reported pain interference and prescription pain reliever misuse. A second aim was to assess the degree to which the risk of various types of opioid misuse (onset, desistance, and incidence of dependence) was related to the longitudinal course of self-reported pain interference over the 3-year period. Methods We used a two-wave, nationally representative sample of adults (aged 18+ years) in which the baseline data were collected during 2001–2002 and a single follow-up was obtained ~3 years later (2004–2005 with 34,332 respondents with complete data on study variables for both waves). Results Our findings indicated that ~10% reported high pain interference in the past month at each wave. There was tremendous stability in levels of pain, with ~5% reporting consistent levels of high impairment over the 3-year study, a proxy for chronic pain. Levels of pain were more strongly associated with prescription pain reliever misuse concurrently rather than prospectively, and the association was largely linear, with the likelihood of misuse increasing with levels of pain. Finally, health service factors were also prominent predictors of onset, but not the outcomes, of desistance or transitions to problem use. Conclusion This study is the first to use a nationally representative sample with measures of pain and drug use history collected over an extended period. These results may help provide clinicians with an understanding that the risk of misuse is greatest when pain is active and may help guide the selection of appropriate intervention materials and monitor strategies for those at greatest risk. PMID:27418863

  8. Risk Factors for Soil-Transmitted Helminth Infections during the First 3 Years of Life in the Tropics; Findings from a Birth Cohort

    PubMed Central

    Menzies, Stefanie K.; Rodriguez, Alejandro; Chico, Martha; Sandoval, Carlos; Broncano, Nely; Guadalupe, Irene; Cooper, Philip J.

    2014-01-01

    Background Soil-transmitted helminths (STH) infect more than 2 billion humans worldwide, causing significant morbidity in children. There are few data on the epidemiology and risk factors for infection in pre-school children. To investigate risk factors for infection in early childhood, we analysed data prospectively collected in the ECUAVIDA birth cohort in Ecuador. Methods and Findings Children were recruited at birth and followed up to 3 years of age with periodic collection of stool samples that were examined microscopically for STH parasites. Data on social, demographic, and environmental risk factors were collected from the mother at time of enrolment. Associations between exposures and detection of STH infections were analysed by multivariable logistic regression. Data were analysed from 1,697 children for whom a stool sample was obtained at 3 years. 42.3% had at least one STH infection in the first 3 years of life and the most common infections were caused by A. lumbricoides (33.2% of children) and T. trichiura (21.2%). Hookworm infection was detected in 0.9% of children. Risk of STH infection was associated with factors indicative of poverty in our study population such as Afro-Ecuadorian ethnicity and low maternal educational level. Maternal STH infections during pregnancy were strong risk factors for any childhood STH infection, infections with either A. lumbricoides or T. trichiura, and early age of first STH infection. Children of mothers with moderate to high infections intensities with A. lumbricoides were most at risk. Conclusions Our data show high rates of infection with STH parasites during the first 3 years of life in an Ecuadorian birth cohort, an observation that was strongly associated with maternal STH infections during pregnancy. The targeted treatment of women of childbearing age, in particular before pregnancy, with anthelmintic drugs could offer a novel approach to the prevention of STH infections in pre-school children. PMID:24587469

  9. Occurrence and molecular characterization of Klebsiella pneumoniae ST37 clinical isolates producing plasmid-mediated AmpC recovered over a 3-year period.

    PubMed

    Illiaquer, Marina; Caroff, Nathalie; Bémer, Pascale; Aubin, Guillaume G; Juvin, Marie-Emmanuelle; Lepelletier, Didier; Reynaud, Alain; Corvec, Stéphane

    2012-09-01

    We investigated the clinical and microbiological epidemiology of AmpC plasmidic cephalosporinases (pAmpC) in Klebsiella pneumoniae strains resistant to ceftazidime, during a 3-year period (2007-2009). Among 1505 K. pneumoniae, 7 were pAmpC producers. Molecular characterization revealed the spread of a ST37 strain producing DHA-1 within intensive care units and the diffusion of the same plasmid among unrelated strains. PMID:22749243

  10. A telescopic crown concept for the restoration of partially edentulous patients with aggressive generalized periodontitis: a 3-year prospective longitudinal study.

    PubMed

    Mengel, Reiner; Kreuzer, Gerd; Lehmann, Klaus M; Flores-de-Jacoby, Lavin

    2007-06-01

    This prospective longitudinal 3-year study compared clinical parameters and implant success rates of removable superstructures supported by both teeth and implants in patients with treated generalized aggressive periodontitis (GAP) and of cemented, implant-retained fixed superstructures in periodontally healthy patients. A total of 17 partially edentulous patients with 54 implants took part in the study. Nine patients with treated GAP received removable superstructures according to the Marburg double crown system, and eight periodontally healthy patients received fixed superstructures. Teeth were examined 2 to 4 weeks before extraction of the nonretainable teeth (baseline) and 3 weeks after insertion of the definitive abutments. Every 3 months over a 3-year period, clinical parameters were recorded and the composition of the subgingival microflora was determined. Intraoral radiographs were obtained at baseline, just after insertion of the superstructure, and 1 and 3 years later. Both groups showed mean plaque and gingival indices below 0.43 at implants and teeth. Mean probing depths around implants increased by approximately 0.7 mm and remained virtually constant for the teeth. Mean attachment loss at implants was 0.9 mm in GAP patients and 0.5 mm in healthy patients. The morphologic distribution of microorganisms in both groups showed healthy conditions. Moderate bone loss at teeth and implants was registered. Implant success rates were 100% in the healthy patients and 97.6% in the GAP patients. No significant differences were seen in the results between the groups.

  11. Sample Length Affects the Reliability of Language Sample Measures in 3-Year-Olds: Evidence From Parent-Elicited Conversational Samples

    PubMed Central

    Eisenberg, Sarita

    2015-01-01

    Purpose The goal of this study was to investigate the extent to which sample length affected the reliability of total number of words (TNW), number of different words (NDW), and mean length of C-units in morphemes (MLCUm) in parent-elicited conversational samples for 3-year-olds. Method Participants were sixty 3-year-olds. A 22-min language sample was collected from each child during free play with the parent in the laboratory. Samples of 1, 3, 7, and 10 min were extracted from the 22-min samples. TNW, NDW, and MLCUm were computed from each shorter sample and the 22-min sample. TNW and NDW were adjusted by number of minutes for comparisons. The differences and correlations between each shorter sample cut and the 22-min sample on MLCUm and adjusted TNW and NDW were computed. Results The shorter samples and the 22-min samples significantly differed in adjusted TNW and NDW, but not in MLCUm. TNW reached an acceptable reliability level (i.e., r = .90) in 7-min samples. NDW and MLCUm approached the acceptable reliability level (rs = .88) in 7-min samples and reached it in 10-min samples. Conclusion For conversational language samples with similar collection procedures, samples of 7 to 10 min are desirable for calculating TNW, NDW, and MLCUm in 3-year-olds. PMID:25615272

  12. Independent and Combined Effects of Maternal Prepregnancy Body Mass Index and Gestational Weight Gain on Offspring Growth at 0–3 Years of Age

    PubMed Central

    2016-01-01

    Background. The objective of this study was to investigate the independent and combined effects of maternal prepregnancy body mass index (BMI) and gestational weight gain (GWG) on offspring growth at 0–3 years old. Methods. A total of 826 pairs of nondiabetic mothers and their offspring were recruited in this study. Maternal information was abstracted from medical records and questionnaires. Offspring growth trajectories of weights and BMIs were depicted based on anthropometric measurements. Results. Offspring of mothers who were prepregnancy overweight/obese or obtained excessive GWGs continuously had greater weight and BMI Z-scores throughout the first 3 years of life. Children of prepregnancy overweight/obese mothers with excessive GWGs had a phenotype of higher weight and BMI Z-scores than those prepregnancy overweight/obese ones with nonexcessive GWGs from birth to 18 months. Maternal excessive GWGs increased offspring's risk of overweight/obesity at 12 months (AOR = 1.43, 95% CI: 1.03–2.00) and 24 months (AOR = 1.51, 95% CI: 1.02–2.25). Combination of excessive prepregnancy BMIs and GWGs was significantly associated with offspring's overweight/obesity at 30 months (AOR = 2.98, 95% CI: 1.36–6.53). Conclusions. Maternal prepregnancy overweight/obesity and excessive GWG are both significantly associated with rapid offspring growth from birth to 3 years old. Excessive GWGs strengthen the effects of high maternal prepregnancy BMIs on excessive offspring growth during their early life.

  13. Association of mid-pregnancy antioxidative vitamin and oxidative stress levels with infant growth during the first 3 years of life

    PubMed Central

    Hong, Juhee; Lee, Hye Ah; Park, Eun Ae; Kim, Young-Ju; Lee, Hwayoung; Park, Bo-Hyun; Ha, Eun-Hee; Kong, Kyoung Ae; Chang, Namsoo; Park, Hyesook

    2014-01-01

    Objective Numerous studies have revealed the impacts of maternal nutritional status on subsequent birth outcome, but much less is known about the long-term impacts on infant growth after birth. We investigated the association between maternal micronutrient levels/oxidative stress status in pregnancy and infant growth during the first 3 years of life. Design Prospective cohort study. Setting The Ewha Birth & Growth Cohort study was constructed for women who had been recruited between 24 and 28 weeks’ gestation and their offspring at Ewha Womans University Hospital. Subjects Maternal serum vitamin and urinary oxidative stress levels were measured, and infant weight, height, and head circumference were measured repeatedly at birth and at 6, 12, 18, 24, and 36 months of age. Results Maternal vitamins A and C were positively associated with infant head circumference and infant weight, respectively, during the first 3 years of life, even after controlling for potential confounding factors. But, maternal oxidative stress was not related to infant growth. Conclusions The effects of maternal vitamin levels on subsequent infant growth during the first 3 years of life necessitate interventions to supplement antioxidative vitamins during pregnancy. PMID:25278823

  14. Effectiveness Trial of a Selective Dissonance-based Eating Disorder Prevention Program with Female College Students: Effects at 2- and 3-Year Follow-up

    PubMed Central

    Stice, Eric; Rohde, Paul; Butryn, Meghan L.; Shaw, Heather; Marti, C. Nathan

    2015-01-01

    Objective An efficacy trial found that a dissonance-based prevention program reduced risk factors, eating disorder symptoms, and future eating disorder onset, but smaller effects emerged when high school clinicians recruited students and delivered the program under real-world conditions in an effectiveness trial. The current report describes results at 2- and 3-year follow-up from an effectiveness trial that tested whether a new enhanced dissonance version of this program produced larger effects when college clinicians recruit students and deliver the intervention using improved train and supervision procedures. Method Young women from eight universities (N = 408, M age = 21.6, SD = 5.64) were randomized to the prevention program or an educational brochure control condition. Results Dissonance participants showed greater decreases in risk factors, eating disorder symptoms, and psychosocial impairment by 3-year follow-up than controls, but not healthcare utilization, BMI, or eating disorder onset. Conclusions This novel multisite effectiveness trial found that the enhanced dissonance intervention and improved training and supervision procedures produced an average effect size at 3-year follow-up that was 290% and 160% larger than effects observed in the high school effectiveness trial and efficacy trial respectively. Yet, the lack of eating disorder onset effects may imply that factors beyond pursuit of the thin ideal now contribute to eating disorder onset. PMID:26056749

  15. Independent and Combined Effects of Maternal Prepregnancy Body Mass Index and Gestational Weight Gain on Offspring Growth at 0-3 Years of Age.

    PubMed

    Jin, Wen-Yuan; Lv, Yao; Bao, Yu; Tang, Li; Zhu, Zhi-Wei; Shao, Jie; Zhao, Zheng-Yan

    2016-01-01

    Background. The objective of this study was to investigate the independent and combined effects of maternal prepregnancy body mass index (BMI) and gestational weight gain (GWG) on offspring growth at 0-3 years old. Methods. A total of 826 pairs of nondiabetic mothers and their offspring were recruited in this study. Maternal information was abstracted from medical records and questionnaires. Offspring growth trajectories of weights and BMIs were depicted based on anthropometric measurements. Results. Offspring of mothers who were prepregnancy overweight/obese or obtained excessive GWGs continuously had greater weight and BMI Z-scores throughout the first 3 years of life. Children of prepregnancy overweight/obese mothers with excessive GWGs had a phenotype of higher weight and BMI Z-scores than those prepregnancy overweight/obese ones with nonexcessive GWGs from birth to 18 months. Maternal excessive GWGs increased offspring's risk of overweight/obesity at 12 months (AOR = 1.43, 95% CI: 1.03-2.00) and 24 months (AOR = 1.51, 95% CI: 1.02-2.25). Combination of excessive prepregnancy BMIs and GWGs was significantly associated with offspring's overweight/obesity at 30 months (AOR = 2.98, 95% CI: 1.36-6.53). Conclusions. Maternal prepregnancy overweight/obesity and excessive GWG are both significantly associated with rapid offspring growth from birth to 3 years old. Excessive GWGs strengthen the effects of high maternal prepregnancy BMIs on excessive offspring growth during their early life. PMID:27652262

  16. Independent and Combined Effects of Maternal Prepregnancy Body Mass Index and Gestational Weight Gain on Offspring Growth at 0–3 Years of Age

    PubMed Central

    2016-01-01

    Background. The objective of this study was to investigate the independent and combined effects of maternal prepregnancy body mass index (BMI) and gestational weight gain (GWG) on offspring growth at 0–3 years old. Methods. A total of 826 pairs of nondiabetic mothers and their offspring were recruited in this study. Maternal information was abstracted from medical records and questionnaires. Offspring growth trajectories of weights and BMIs were depicted based on anthropometric measurements. Results. Offspring of mothers who were prepregnancy overweight/obese or obtained excessive GWGs continuously had greater weight and BMI Z-scores throughout the first 3 years of life. Children of prepregnancy overweight/obese mothers with excessive GWGs had a phenotype of higher weight and BMI Z-scores than those prepregnancy overweight/obese ones with nonexcessive GWGs from birth to 18 months. Maternal excessive GWGs increased offspring's risk of overweight/obesity at 12 months (AOR = 1.43, 95% CI: 1.03–2.00) and 24 months (AOR = 1.51, 95% CI: 1.02–2.25). Combination of excessive prepregnancy BMIs and GWGs was significantly associated with offspring's overweight/obesity at 30 months (AOR = 2.98, 95% CI: 1.36–6.53). Conclusions. Maternal prepregnancy overweight/obesity and excessive GWG are both significantly associated with rapid offspring growth from birth to 3 years old. Excessive GWGs strengthen the effects of high maternal prepregnancy BMIs on excessive offspring growth during their early life. PMID:27652262

  17. Clinical characteristics and abandonment and outcome of treatment in 67 Chinese children with medulloblastoma.

    PubMed

    Wang, Chen; Yuan, Xiao-Jun; Jiang, Ma-Wei; Wang, Li-Feng

    2016-01-01

    OBJECT The purpose of this study was to explore the clinical features and outcome of medulloblastoma in Chinese children. The authors analyze the reasons that treatment is abandoned and attempt to provide evidence-based recommendations for improving the prognosis of medulloblastoma in this population. METHODS A total of 67 pediatric cases of newly diagnosed medulloblastoma were included in this study. All of the children were treated at Xinhua Hospital between January 2007 and June 2013. The authors retrospectively analyzed the clinical data, treatment modalities, and outcome. The male-to-female ratio was 2:1, and the patients' median age at diagnosis was 51.96 months (range 3.96-168.24 months). The median duration of follow-up was 32 months (range 3-70 months). RESULTS At the most recent follow-up date, 31 patients (46%) were alive, 30 (45%) had died, and 6 (9%) had been lost to follow-up. The estimated 3-year overall survival and progression-free survival, based on Kaplan-Meier analysis, were 55.1% ± 6.4% and 45.6% ± 6.7%, respectively. Univariate analysis showed that standard-risk group (p = 0.009), postoperative radiotherapy (RT) combined with chemotherapy (p < 0.001), older age (≥ 3 years) at diagnosis (p = 0.010), gross-total resection (p = 0.012), annual family income higher than $3000 (p = 0.033), and living in urban areas (p = 0.008) were favorable prognostic factors. Multivariate analysis revealed that postoperative RT combined with chemotherapy was an independent prognostic factor (p < 0.001). The treatment abandonment rate in this cohort was 31% (21 of 67 cases). CONCLUSIONS There was a large gap between the outcome of medulloblastoma in Chinese children and the outcome in Western children. Based on our data, treatment abandonment was the major cause of therapeutic failure. Parents' misunderstanding of medulloblastoma played a major role in abandonment, followed by financial and transportation difficulties. Establishment of multidisciplinary

  18. Motion patterns in activities of daily living: 3- year longitudinal follow-up after total shoulder arthroplasty using an optical 3D motion analysis system

    PubMed Central

    2014-01-01

    Background Total shoulder arthroplasty (TSA) can improve function in osteoarthritic shoulders, but the ability to perform activities of daily living (ADLs) can still remain impaired. Routinely, shoulder surgeons measure range of motion (ROM) using a goniometer. Objective data are limited, however, concerning functional three-dimensional changes in ROM in ADLs after TSA in patients with degenerative glenohumeral osteoarthritis. Methods This study included ten consecutive patients, who received TSA for primary glenohumeral osteoarthritis. The patients were examined the day before, 6 months, and 3 years after shoulder replacement as well. We compared them with a control group (n = 10) without any shoulder pathology and measured shoulder movement by 3D motion analysis using a novel 3 D model. The measurement included static maximum values, the ability to perform and the ROM of the ADLs “combing the hair”, “washing the opposite armpit”, “tying an apron”, and “taking a book from a shelf”. Results Six months after surgery, almost all TSA patients were able to perform the four ADLs (3 out of 40 tasks could not be performed by the 10 patients); 3 years postoperatively all patients were able to carry out all ADLs (40 out of 40 tasks possible). In performing the ADLs, comparison of the pre- with the 6-month and 3-year postoperative status of the TSA group showed that the subjects did not fully use the available maximum flexion/extension ROM in performing the four ADLs. The ROM used for flexion/extension did not change significantly (preoperatively 135°-0° -34° vs. 3 years postoperatively 131° -0° -53°). For abduction/adduction, ROM improved significantly from 33°-0° -27° preoperatively to 76° -0° -35° postoperatively. Compared to the controls (118°) the TSA group used less ROM for abduction to perform the four ADLs 3 years postoperatively. Conclusion TSA improves the ability to perform ADL and the individual ROM in ADLs in patients with

  19. Outcome analysis of high-dose chemotherapy and autologous stem cell transplantation in adolescent and young adults with relapsed or refractory Hodgkin lymphoma.

    PubMed

    Akhtar, Saad; Rauf, Shahzad M; Elhassan, Tusneem A M; Maghfoor, Irfan

    2016-09-01

    High-dose chemotherapy (HDC) and autologous stem cell transplantation (auto-SCT) can salvage many patients with relapsed or refractory Hodgkin's lymphoma (HL). We are reporting the outcome of HDC auto-SCT and the impact of 21 prognostic factors in relapsed and refractory adolescent (14-21 years) and young adult (>21-30 years) (AYA) HL patients. We used Fine and Gray's competing risk analysis method and regression model for outcome analysis. From 1996 to 2013, 290 consecutive patients with biopsy-proven HL underwent HDC auto-SCT for relapsed/refractory HL; 216 patients (74.5 %) were AYA at the time of auto-SCT. Male/female were equal, median age at auto-SCT was 22.4 years, and there were 94 adolescent (43.5 %) and 122 young adults (56.5 %). There was refractory disease in 121 (56 %) patients, relapsed in 95 (44 %). Median follow-up was 72.6 months. The Kaplan-Meier method estimated that 5-year overall survival is 62.7 % (adolescents (63.5 %), young adults (62 %)) and event-free survival was 51.3 %. Five-year cumulative incidence of disease-specific death (DS-death) is 33 % and that of DS-event is 45 %. For DS-death, the multivariate analysis identified complete remission (CR) duration of <12 months (hazard ratio (HR) 3.61, P = 0.0009), no CR after salvage (HR: 3.93, P = 0.0002), and nodular sclerosis pathology (HR 3.3, P = 0.016) and positive B symptoms (HR 2, P = 0.028) as negative factors. For DS-event, CR duration of <12 months (HR 1.88, P = 0.02), no CR after salvage (HR 3.47, P = 0.000005) and nodular sclerosis pathology (HR 1.88, P = 0.02) were found significant. The Kaplan-Meier method estimated overall survival (OS) at 36 months with 0-2:3:4 factors being 93.6:54:21 %, respectively (P value <0.001). Kaplan-Meier estimated event-free survival (EFS) at 36 months with 0-1:2:3 factors being 84.6:65:31 %, respectively (P value <0.001). Clinically, adolescents have similar outcomes as young adults. PMID:27376363

  20. Clinical performance of chairside CAD/CAM feldspathic ceramic posterior shoulder crowns and endocrowns up to 12 years.

    PubMed

    Otto, T; Mörmann, W H

    2015-01-01

    In 55 patients, 25 endocrowns (test) and 40 shoulder crowns (control) were produced chairside in a private practice using the Cerec 3 (CAD/CAM) method and Vita Mark II feldspathic ceramic. The crowns were examined at baseline and after up to 12 years using modified USPHS criteria. The survival estimate was assessed by Kaplan-Meier analysis. The 12 years survival estimate of the shoulder crowns was 95% on molars and 94.7% on premolars. Endocrowns showed 90.5% survival on molars and 75% on premolars. Statistically, the differences between the survival estimates were not significant (P > 0.05). The longevity of Vita Mark II Cerec 3 shoulder crowns on molars and premolars, as well as of endocrowns on molars, proved to be--for private practice--a very acceptable result, while the premolar endocrowns tended to show a higher risk for failure. PMID:26110927

  1. Smooth conditional distribution function and quantiles under random censorship.

    PubMed

    Leconte, Eve; Poiraud-Casanova, Sandrine; Thomas-Agnan, Christine

    2002-09-01

    We consider a nonparametric random design regression model in which the response variable is possibly right censored. The aim of this paper is to estimate the conditional distribution function and the conditional alpha-quantile of the response variable. We restrict attention to the case where the response variable as well as the explanatory variable are unidimensional and continuous. We propose and discuss two classes of estimators which are smooth with respect to the response variable as well as to the covariate. Some simulations demonstrate that the new methods have better mean square error performances than the generalized Kaplan-Meier estimator introduced by Beran (1981) and considered in the literature by Dabrowska (1989, 1992) and Gonzalez-Manteiga and Cadarso-Suarez (1994).

  2. Combined immunodeficiency in a 3-year-old boy with 16p11.2 and 20p12.2-11.2 chromosomal duplications.

    PubMed

    Batanian, Jacqueline R; Braddock, Stephen R; Christensen, Katherine; Knutsen, Alan P

    2014-02-01

    We report for the first time on a 3-year-old boy with paternally inherited 212.85 kb-16p11.2 and 7.8 Mb-20p12.2-11.23 interstitial microduplications associated with having congenital cardiac defect, dysmorphic facial features, and combined T-, B-, and NK cell immunodeficiency. In addition the 7.8 Mb-20p12.2-11.23 microduplication is unique showing novel breakpoints among all partial trisomy/duplication 20p reported to date, narrowing down the critical region for trisomy 20p syndrome. PMID:24311374

  3. Ethnic differences in infant feeding practices and their relationship with BMI at 3 years of age - results from the Born in Bradford birth cohort study.

    PubMed

    Santorelli, Gillian; Fairley, Lesley; Petherick, Emily S; Cabieses, Baltica; Sahota, Pinki

    2014-05-28

    The present study aimed to explore previously unreported ethnic differences in infant feeding practices during the introduction of solid foods, accounting for maternal and birth factors, and to determine whether these feeding patterns are associated with BMI at 3 years of age. An observational study using Poisson regression was carried out to investigate the relationship between ethnicity and infant feeding practices and linear regression was used to investigate the relationship between feeding practices and BMI at 3 years of age in a subsample of 1327 infants in Bradford. It was found that compared with White British mothers, mothers of Other ethnicities were less likely to replace breast milk with formula milk before introducing solid foods (adjusted relative risk (RR) - Pakistani: 0·76 (95 % CI 0·64, 0·91), Other South Asian: 0·58 (95 % CI 0·39, 0·86), and Other ethnicities: 0·50 (95 % CI 0·34, 0·73)). Pakistani and Other South Asian mothers were less likely to introduce solid foods early ( < 17 weeks) (adjusted RR - Pakistani: 0·92 (95 % CI 0·87, 0·96) and Other South Asian: 0·87 (95 % CI 0·81, 0·93)). Other South Asian mothers and mothers of Other ethnicities were more likely to continue breast-feeding after introducing solid foods (adjusted RR - 1·72 (95 % CI 1·29, 2·29) and 2·12 (95 % CI 1·60, 2·81), respectively). Pakistani and Other South Asian infants were more likely to be fed sweetened foods (adjusted RR - 1·18 (95 % CI 1·13, 1·23) and 1·19 (95 % CI 1·10, 1·28), respectively) and Pakistani infants were more likely to consume sweetened drinks (adjusted RR 1·72 (95 % CI 1·15, 2·57)). No association between infant feeding practices and BMI at 3 years was observed. Although ethnic differences in infant feeding practices were found, there was no association with BMI at 3 years of age. Interventions targeting infant feeding practices need to consider ethnicity to identify which populations are failing to follow

  4. A Multidisciplinary Breast Cancer Brain Metastases Clinic: The University of North Carolina Experience

    PubMed Central

    McKee, Megan J.; Keith, Kevin; Deal, Allison M.; Garrett, Amy L.; Wheless, Amy A.; Green, Rebecca L.; Benbow, Julie M.; Dees, E. Claire; Carey, Lisa A.; Ewend, Matthew G.; Zagar, Timothy M.

    2016-01-01

    Background. Breast cancer brain metastasis (BCBM) confers a poor prognosis and is unusual in requiring multidisciplinary care in the metastatic setting. The University of North Carolina at Chapel Hill (UNC-CH) has created a BCBM clinic to provide medical and radiation oncology, neurosurgical, and supportive services to this complex patient population. We describe organization and design of the clinic as well as characteristics, treatments, and outcomes of the patients seen in its first 3 years. Methods. Clinical and demographic data were collected from patients in a prospectively maintained database. Descriptive statistics are reported as percentages and means. The Kaplan-Meier method was used to estimate time-to-event outcomes. Results. Sixty-five patients were seen between January 2012 and January 2015. At the time of presentation to the BCBM clinic, most patients (74%) had multiple (≥2) brain metastases and had received prior systemic (77%) and whole-brain radiation therapy and/or central nervous system stereotactic radiosurgery (65%) in the metastatic setting. Seventy-eight percent returned for a follow-up visit; 32% were enrolled in a clinical trial. Median time from diagnosis of brain metastasis to death was 2.11 years (95% confidence interval [CI] 1.31–2.47) for all patients, 1.15 years (95% CI 0.4–2.43) for triple-negative breast cancer, 1.31 years (95% CI 0.51–2.52) for hormone receptor-positive/HER2− breast cancer, and 3.03 years (95% CI lower limit 1.94, upper limit not estimable) for HER2+ breast cancer (p = .0037). Conclusion. Patients with BCBM have unique and complex needs that require input from several oncologic disciplines. The development of the UNC-CH multidisciplinary BCBM clinic is a model that can be adapted at other centers to provide coordinated care for patients with a challenging and complex disease. Implications for Practice: Patients with breast cancer brain metastases often require unique multidisciplinary care to meet the

  5. The Impact of Normal Range of Serum Phosphorus on the Incidence of End-Stage Renal Disease by A Propensity Score Analysis

    PubMed Central

    Chang, Wen Xiu; Xu, Ning; Kumagai, Takanori; Shiraishi, Takeshi; Kikuyama, Takahiro; Omizo, Hiroki; Sakai, Kazuhiro; Arai, Shigeyuki; Tamura, Yoshifuru; Ota, Tatsuru; Shibata, Shigeru; Fujigaki, Yoshihide; Shen, Zhong Yang; Uchida, Shunya

    2016-01-01

    Background Although hyperphosphatemia is deemed a risk factor of the progression of chronic kidney disease (CKD), it remains unclear whether the normal range of serum phosphorus likewise deteriorates CKD. A propensity score analysis was applied to examine the causal effect of the normal range of serum phosphorus on the incidence of end-stage renal disease (ESRD). Methods A retrospective CKD cohort of 803 participants in a single institution was analyzed. Propensity score was estimated using 22 baseline covariates by multivariate binary logistic regression for the different thresholds of time-averaged phosphorus (TA-P) in the normal range of serum phosphorus incremented by 0.1 mg/dL from 3.3 to 4.5 mg/dL. Results The incidence rate of ESRD was 33.9 per 1,000 person-years over median follow-up of 4.3 years. Total patients showed the mean baseline phosphorus of 3.37 mg/dL and were divided to quartile. The higher quartile was associated with the parameters consistent with the advancement of CKD. A stratified Cox regression showed the highest hazard ratio (HR) at TA-P 3.4 mg/dL (HR 17.60, 95% CI 3.92–78.98) adjusted for baseline covariates such as sex, age, diabetic nephropathy, estimated GFR, serum albumin, Na-Cl, phosphorus, LDL-C and proteinuria. Adjusted HRs remained high up to TA-P 4.2 mg/dL (HR 2.22, 95% CI 1.33–3.71). After propensity score matching conducted at the thresholds of TA-P 3.4, 3.6, 3.8 and 4.0 mg/dL, the higher levels of TA-P showed the higher HRs by Kaplan-Meier analysis (p < 0.05 by stratified log-rank test). The numbers needed to treat were calculated as 3.9 to 5.3 over 5 years. Conclusions The propensity score analysis shows that even the normal range of serum phosphorus clearly accelerates CKD progression to ESRD. Our results encourage clinicians to target serum phosphorus to inhibit CKD progression in the manner of ‘the lower the better.’ PMID:27123981

  6. Long-term drug treatment of benign prostatic hyperplasia - results of a prospective 3-year multicenter study using Sabal extract IDS 89.

    PubMed

    Bach, D; Ebeling, L

    1996-09-01

    A 3-year prospective multicenter study on Sabal extract IDS 89 was carried out to evaluate its potential and limitations as phytotherapy in the treatment of benign prostatic hyperplasia (BPH). The results obtained from 435 patients confirm its sustained therapeutic efficacy. A marked symptomatic improvement, that included a 50% reduction in residual urine and a 6.1 ml/sec increase in peak urinary flow rate due to therapy was observed. Both physicians and patients voted its efficacy as good or very good in over 80% of the cases, and the drug was well tolerated by 98% of the patients. The clinical status of BPH and thus the quality of life of 4 out of 5 patients was markedly improved by long-term IDS 89 therapy. Furthermore, the deterioration rate at the end of the 3-year treatment period was significantly lower than in untreated BPH subjects. It is therefore concluded that long-term IDS 89 therapy can also reduce the incidence of surgery.

  7. Flapless CAD/CAM-guided surgery for staged transition from failing dentition to complete arch implant rehabilitation: a 3-year clinical report.

    PubMed

    Papaspyridakos, Panos; White, George Shelby; Lal, Kunal

    2012-03-01

    The transition of patients from failing dentition to complete arch implant rehabilitation often requires that the patient be rendered edentulous and has to wear a complete removable dental prosthesis for varying periods of time. This is objectionable to many patients. A staged treatment approach allows a fixed interim restoration, patient comfort, and prosthodontic control throughout the rehabilitation process. CAD/CAM-guided flapless implant surgery has the advantage of prosthetically driven implant placement and minimal postoperative sequelae. A patient with a failing dentition was treated with this combined protocol and was followed up for 3 years after loading. Implant and prosthesis survival rates were 100%, with no technical complications encountered up to the last recall. The purpose of this clinical report is to describe a combination of CAD/CAM-guided flapless surgery and a staged treatment approach, thereby giving the patient a tooth-supported or implant-supported fixed interim prosthesis during the entire rehabilitation process. The various surgical, laboratory, and prosthetic stages are illustrated for the complete arch prosthetic rehabilitation, and the 3-year follow-up outcome is reported.

  8. Effects of sarin on the nervous system in rescue team staff members and police officers 3 years after the Tokyo subway sarin attack.

    PubMed

    Nishiwaki, Y; Maekawa, K; Ogawa, Y; Asukai, N; Minami, M; Omae, K

    2001-11-01

    Although the clinical manifestations of acute sarin poisoning have been reported in detail, no comprehensive study of the chronic physical and psychiatric effects of acute sarin poisoning has been carried out. To clarify the chronic effects of sarin on the nervous system, a cross-sectional epidemiologic study was conducted 3 years after the Tokyo subway sarin attack. Subjects consisted of the rescue team staff members and police officers who had worked at the disaster site. Subjects consisted of 56 male exposed subjects and 52 referent subjects matched for age and occupation. A neurobehavioral test, stabilometry, and measurement of vibration perception thresholds were performed, as well as psychometric tests to assess traumatic stress symptoms. The exposed group performed less well in the backward digit span test than the referent group in a dose-effect manner. This result was the same after controlling for possible confounding factors and was independent of traumatic stress symptoms. In other tests of memory function, except for the Benton visual retention test (mean correct answers), effects related to exposure were also suggested, although they were not statistically significant. In contrast, the dose-effect relationships observed in the neurobehavioral tests (psychomotor function) were unclear. None of the stabilometry and vibration perception threshold parameters had any relation to exposure. Our findings suggest the chronic decline of memory function 2 years and 10 months to 3 years and 9 months after exposure to sarin in the Tokyo subway attack, and further study is needed.

  9. Development of understory vegetation in pine and pine-hardwood shelterwood stands in the Ouachita mountains: The first 3 years. Forest Service research paper

    SciTech Connect

    Shelton, M.G.

    1997-09-01

    The shelterwood reproduction cutting method using two overstory compositions (a pine basal area of 30 square feet per acre with and without 15 square feet per acre of hardwoods) and two methods of submerchantable hardwood control (chain-saw felling with and without stump-applied herbicide) was tested in a 2x2 factorial, split-plot design with four randomized complete blocks. Total coverage of understory vegetation after 3 years was greater in the pine overstory treatment (68 percent) than in the pine-hardwood overstory treatment (46 percent) and was slightly greater for manual than chemical hardwood control (60 versus 55 percent). Results indicate that 15 square feet per acre of scattered hardwoods can be retained through at least 3 years after harvest, but additional monitoring will be needed to determine the long-term success of reproduction. Early results suggest that the herbicide treatment was not justified in the stand and site conditions tested in this study; contributing factors were the abundant pine seed production and low levels of competing vegetation.

  10. Effects of Health Guidance on Outpatient and Pharmacy Expenditures: A Disease- and Drug-Specific 3-Year Observational Study Using Propensity-Score Matching

    PubMed Central

    Okamoto, Etsuji

    2013-01-01

    Background Evidence is lacking on whether health guidance for metabolic syndrome reduces health care expenditures. The author used propensity-score matching to evaluate the effects of health guidance on health care expenditure. Methods Men who did and did not receive health guidance from a health insurance society (approximately 60 000 covered lives) were matched (n = 397 respectively) using propensity scores. Health insurance claims were compared using cumulative health care expenditures for metabolic syndrome-related outpatient medical care and drug costs for the period from the initial consultation to 3 years later. Results No difference was observed between intervention and control groups in cumulative outpatient charges or drug costs related to metabolic syndrome. However, regression analysis using the Tobit model showed that health guidance resulted in a small, nonsignificant reduction in health care expenditure. Conclusions Health guidance for metabolic syndrome did not reduce outpatient charges or drug costs related to metabolic syndrome during the 3-year period after the intervention. Findings from Tobit regression suggest that health guidance might eventually result in savings, but this hypothesis remains untested. PMID:23728485

  11. Community vs. Clinic-based modular treatment of children with early-onset ODD or CD: A clinical trial with 3-year follow-up

    PubMed Central

    Kolko, David J.; Bukstein, Oscar G.; Padini, Dustin; Holden, Elizabeth A.; Hart, Jonathan; Dorn, Lorah D.

    2016-01-01

    This study examines the treatment outcomes of 144, 6–11 year-old, clinically referred boys and girls diagnosed with Oppositional Defiant Disorder (ODD) or Conduct Disorder (CD) who were randomly assigned to a modular-based treatment protocol that was applied by research study clinicians either in the community (COMM) or a clinic office (CLINIC). To examine normative comparisons, a matched sample of 69 healthy control children was included. Multiple informants completed diagnostic interviews and self-reports at six assessment timepoints (pretreatment to 3-year follow-up) to evaluate changes in the child’s behavioral and emotional problems, psychopathic features, functional impairment, diagnostic status, and service involvement. Using HLM and logistic regression models, COMM and CLINIC showed significant and comparable improvements on all outcomes. By 3-year follow-up, 36% of COMM and 47% of CLINIC patients no longer met criteria for either ODD or CD, and 48% and 57% of the children in these two respective conditions had levels of parent-rated externalizing behavior problems in the normal range. We discuss the nature and implications of these novel findings regarding the role of treatment context or setting for the treatment and long-term outcome of behavior disorders. PMID:19221871

  12. Early response with dasatinib or imatinib in chronic myeloid leukemia: 3-year follow-up from a randomized phase 3 trial (DASISION)

    PubMed Central

    Jabbour, Elias; Saglio, Giuseppe; Steegmann, Juan Luis; Shah, Neil P.; Boqué, Concepción; Chuah, Charles; Pavlovsky, Carolina; Mayer, Jiří; Cortes, Jorge; Baccarani, Michele; Kim, Dong-Wook; Bradley-Garelik, M. Brigid; Mohamed, Hesham; Wildgust, Mark; Hochhaus, Andreas

    2014-01-01

    This analysis explores the impact of early cytogenetic and molecular responses on the outcomes of patients with chronic myeloid leukemia in chronic phase (CML-CP) in the phase 3 DASatinib versus Imatinib Study In treatment-Naive CML patients trial with a minimum follow-up of 3 years. Patients with newly diagnosed CML-CP were randomized to receive 100 mg dasatinib (n = 259) or 400 mg imatinib (n = 260) once daily. The retrospective landmark analysis included patients evaluable at the relevant time point (3, 6, or 12 months). Median time to complete cytogenetic response was 3 vs 6 months with dasatinib vs imatinib. At 3 and 6 months, the proportion of patients with BCR-ABL transcript levels ≤10% was higher in the dasatinib arm. Deeper responses at 3, 6, and 12 months were observed in a higher proportion of patients on dasatinib therapy and were associated with better 3-year progression-free survival and overall survival in both arms. First-line dasatinib resulted in faster and deeper responses compared with imatinib. The achievement of an early molecular response was predictive of improved progression-free survival and overall survival, supporting new milestones for optimal response in patients with early CML-CP treated with tyrosine kinase inhibitors. This study was registered at www.clinicaltrials.gov as NCT00481247. PMID:24311723

  13. Lasting Effects of Workplace Strength Training for Neck/Shoulder/Arm Pain among Laboratory Technicians: Natural Experiment with 3-Year Follow-Up

    PubMed Central

    Larsen, Anders I.; Zebis, Mette K.; Pedersen, Mogens T.; Sjøgaard, Gisela; Andersen, Lars L.

    2014-01-01

    Objectives. This study investigated long-term effects and implementation processes of workplace strength training for musculoskeletal disorders. Methods. 333 and 140 laboratory technicians from private and public sector companies, respectively, replied to a 3-year follow-up questionnaire subsequent to a 1-year randomized controlled trial (RCT) with high-intensity strength training for prevention and treatment of neck, shoulder, and arm pain. Being a natural experiment, the two participating companies implemented and modified the initial training program in different ways during the subsequent 2 years after the RCT. Results. At 3-year follow-up the pain reduction in neck, shoulder, elbow, and wrist achieved during the first year was largely maintained at both companies. However, the private sector company was rated significantly better than the public sector company in (1) training adherence, (2) training culture, that is, relatively more employees trained at the workplace and with colleagues, (3) self-reported health changes, and (4) prevention of neck and wrist pain development among initially pain-free employees. Conclusions. This natural experiment shows that strength training can be implemented successfully at different companies during working hours on a long-term basis with lasting effects on pain in neck, shoulder, and arm. PMID:24734247

  14. The effectiveness of solution-focused therapy and short- and long-term psychodynamic psychotherapy on self-concept during a 3-year follow-up.

    PubMed

    Lindfors, Olavi; Knekt, Paul; Virtala, Esa; Laaksonen, Maarit A

    2012-11-01

    This study compares the effectiveness of solution-focused therapy (SFT) and short- and long-term psychodynamic psychotherapy (SPP and LPP) on self-concept during a 3-year follow-up. Altogether, 326 patients with mood or anxiety disorder were randomized to SFT, SPP, and LPP in the Helsinki Psychotherapy Study. Outcome was assessed using the Structural Analysis of Social Behavior questionnaire at baseline and 7, 12, 24, and 36 months after. Overall, during the first year of follow-up, self-concept improved more in both SFT and SPP than in LPP, indicated by the primary outcome indicators self-directed affiliation (AF) and self-directed autonomy, as well as by most of the eight secondary cluster scores. After the 3-year follow-up, LPP was more effective than SFT in AF and in the cluster scores self-affirm, self-blame, and self-neglect, whereas no difference was noted between LPP and SPP. Long duration and psychodynamic orientation of therapy may be beneficial for self-concept improvement.

  15. Influence of Gender on the Tolerability, Safety, and Efficacy of Quinidine Used for Treatment of Supraventricular and Ventricular Arrhythmias.

    PubMed

    Higgins, Angela Y; Waks, Jonathan W; Josephson, Mark E

    2015-12-15

    Quinidine, a class IA antiarrhythmic drug (AAD), has been used for the treatment of arrhythmias since the early 1900s. Use has decreased recently because of the availability of newer AADs and concerns about side effects and safety. Quinidine can cause QT prolongation, and women have longer QT intervals and are more susceptible to torsades de pointes (TdP) than are men. We sought to evaluate the influence of gender on quinidine tolerability, safety, and efficacy. We performed retrospective analyses of patients at our institution prescribed quinidine as an AAD between 2000 and 2012. Time to quinidine discontinuation and arrhythmia recurrence were evaluated using Cox proportional hazards models. In 179 patients, 23.5% were women and median age was 65.8 years. Quinidine indication was supraventricular arrhythmias in 68.7% and ventricular arrhythmias in 27.9% of patients. At 3 years after quinidine initiation, Kaplan-Meier probability of quinidine discontinuation was 65.7% for men and 82.4% for women (p = 0.015). Women were more likely than men to discontinue quinidine for QT prolongation (14.3 vs 4.4%, p = 0.036) and TdP (4.8 vs 0%, p = 0.054). After multivariate adjustment, female gender remained independently associated with quinidine discontinuation (adjusted hazard ratio 1.97, p = 0.014). Gender had no influence on arrhythmia recurrence: 1 year after quinidine initiation, Kaplan-Meier probability of freedom from recurrent arrhythmia was 62.4% in men and 57.9% in women (p = 0.33). Quinidine is highly effective in both genders. However, women are more likely than men to experience QT prolongation and TdP on quinidine and are more likely to discontinue quinidine independent of these side effects.

  16. Risk of cardiovascular thrombotic events after surgical castration versus gonadotropin-releasing hormone agonists in Chinese men with prostate cancer.

    PubMed

    Teoh, Jeremy Yc; Chan, Samson Ys; Chiu, Peter Kf; Poon, Darren Mc; Cheung, Ho-Yuen; Hou, Simon Sm; Ng, Chi-Fai

    2015-01-01

    We investigated the cardiovascular thrombotic risk after surgical castration (SC) versus gonadotropin-releasing hormone agonists (GnRHa) in Chinese men with prostate cancer. All Chinese prostate cancer patients who were treated with SC or GnRHa from year 2000 to 2009 were reviewed and compared. The primary outcome was any new-onset of cardiovascular thrombotic events after SC or GnRHa, which was defined as any event of acute myocardial infarction or ischemic stroke. The risk of new-onset cardiovascular thrombotic event was compared between the SC group and the GnRHa group using Kaplan-Meier method. Multivariate Cox regression analysis was performed to adjust for other potential confounding factors. A total of 684 Chinese patients was included in our study, including 387 patients in the SC group and 297 patients in the GnRHa group. The mean age in the SC group (75.3 ± 7.5 years) was significantly higher than the GnRHa group (71.8 ± 8.3 years) (P < 0.001). There was increased risk of new cardiovascular thrombotic events in the SC group when compared to the GnRHa group upon Kaplan-Meier analysis (P = 0.014). Upon multivariate Cox regression analysis, age (hazard ratio [HR] 1.072, 95% confidence interval [CI] 1.04-1.11, P< 0.001), hyperlipidemia (HR 2.455, 95% CI 1.53-3.93, P< 0.001), and SC (HR 1.648, 95% CI 1.05-2.59, P= 0.031) were significant risk factors of cardiovascular thrombotic events. In conclusion, SC was associated with increased risk of cardiovascular thrombotic events when compared to GnRHa. This is an important aspect to consider while deciding on the method of androgen deprivation therapy, especially in elderly men with known history of hyperlipidemia.

  17. Knee extension and flexion muscle power after anterior cruciate ligament reconstruction with patellar tendon graft or hamstring tendons graft: a cross-sectional comparison 3 years post surgery.

    PubMed

    Ageberg, Eva; Roos, Harald P; Silbernagel, Karin Grävare; Thomeé, Roland; Roos, Ewa M

    2009-02-01

    Hamstring muscles play a major role in knee-joint stabilization after anterior cruciate ligament (ACL) injury. Weakness of the knee extensors after ACL reconstruction with patellar tendon (PT) graft, and in the knee flexors after reconstruction with hamstring tendons (HT) graft has been observed up to 2 years post surgery, but not later. In these studies, isokinetic muscle torque was used. However, muscle power has been suggested to be a more sensitive and sport-specific measures of strength. The aim was to study quadriceps and hamstring muscle power in patients with ACL injury treated with surgical reconstruction with PT or HT grafts at a mean of 3 years after surgery. Twenty subjects with PT and 16 subjects with HT grafts (mean age at follow up 30 years, range 20-39, 25% women), who were all included in a prospective study and followed the same goal-based rehabilitation protocol for at least 4 months, were assessed with reliable, valid, and responsive tests of quadriceps and hamstring muscle power at 3 years (SD 0.9, range 2-5) after surgery. The mean difference between legs (injured minus uninjured), the hamstring to quadriceps (H:Q, hamstring divided by quadriceps) ratio, and the limb symmetry index (LSI, injured leg divided by uninjured and multiplied by 100) value, were used for comparisons between the groups (analysis of variance). The mean difference between the injured and uninjured legs was greater in the HT than in the PT group for knee flexion power (-21.3 vs. 7.7 W, p = 0.001). Patients with HT graft had lower H:Q ratio in the injured leg than the patients with PT graft (0.63 vs. 0.77, p = 0.012). They also had lower LSI for knee flexion power than those in the PT group (88 vs. 106%, p < 0.001). No differences were found between the groups for knee extension power. The lower hamstring muscle power, and the lower hamstring to quadriceps ratio in the HT graft group than in the PT graft group 3 years (range 2-5) after ACL reconstruction, reflect imbalance

  18. Mini-percutaneous Nephrolithotomy Under Total Ultrasonography in Patients Aged Less Than 3 Years: A Single-center Initial Experience from China

    PubMed Central

    Xiao, Bo; Zhang, Xin; Hu, Wei-Guo; Chen, Song; Li, Yu-Hong; Tang, Yu-Zhe; Liu, Yu-Bao; Li, Jian-Xing

    2015-01-01

    Background: Urolithiasis in pediatric population is a serious problem with the incidence increased these years. In the management of larger stones (diameters >2 cm), percutaneous nephrolithotomy (PCNL) is considered to be the gold standard. This study aimed to investigate the efficacy and safety of mini-PCNL under total ultrasonography in patients aged <3 years. Methods: We reviewed 68 patients (80 renal units) aged <3 years between August 2006 and December 2014 in Peking University People's Hospital and Beijing Tsinghua Changung Hospital, including 36 renal units with a single stone, 6 with staghorn stones, 14 with upper ureteral stones, and 24 with multiple stones. The mean age of the patients was 24.2 months (range 6–36 months), and the mean maximum stone diameter was 19.2 mm (range 10–35 mm). The puncture site selection and tract dilation were guided by Doppler ultrasonography solely. All procedures were performed using 12–16 Fr tracts. Stones were fragmented using pneumatic lithotripsy and a holmium laser with an 8/9.8 Fr rigid ureteroscope. Results: Fifty-six patients with unilateral stones underwent a single session procedure, and 12 patients with bilateral stones underwent two procedures. The mean time to establish access was 2.8 min (range 1.8–5.0 min), the mean operative time was 36.5 min (range 20–88 min), the mean decrease in hemoglobin concentration was 8.9 g/L (2–15 g/L), and the stone-free rate (SFR) at hospital discharge was 94.0%. The mean postoperative hospital stay was 7.1 days (range 3–13 days). Postprocedure complications included fever (>38.5°C) in five patients and reactive pleural effusion in one patient. Blood loss requiring transfusion, sepsis, adjacent organ injury, and kidney loss were not observed. Conclusions: This study indicated that ultrasound-guided mini-PCNL is feasible and safe in patients aged <3 years, without major complications or radiation exposure. PMID:26063360

  19. Oral health of 3-year-old children and their parents after 29 months of child-focused antiatherosclerotic dietary intervention in a prospective randomized trial.

    PubMed

    Karjalainen, S; Sewón, L; Söderling, E; Lapinleimu, H; Seppänen, R; Simell, O

    1997-01-01

    A long-term prospective, randomized dietary intervention to prevent exposure of children to the known atherosclerosis risk factors (the STRIP baby project) was started when the age of the children was 7 months. The aim of this substudy was to analyze the oral effects of the dietary intervention in the children and their parents when the children had reached the age of 3 years. Every fifth family of the main study was invited to this substudy (n = 179). Those studied (n = 148) represented well the intervention and the control groups and both genders in terms of intake of saturated fatty acids, the dietary polyunsaturated fatty acid to saturated fatty acid (PUFA/SAFA) ration and serum cholesterol and HDL cholesterol concentrations. Though no difference was found in sucrose consumption between the intervention and the control groups, the intervention children received relatively (in E%) more energy from carbohydrates than the control children (p < 0.005), used absolutely (in g) and relatively (in E%) less fat (p < 0.05) and had a higher PUFA/SAFA ratio in their diet (p < 0.001). Of the 3-year-old children 93% were caries free, and dental decay was a prevalent in the intervention as in the control children. Control children brushed their teeth unassisted more often than the intervention children (p < 0.05). The intervention fathers also received more energy (in E%) from carbohydrates (p < 0.01), the intervention mothers used less fat (p < 0.05) and had a higher PUFA/SAFA ratio in the diet (p < 0.05) than the control fathers and mothers, respectively. Dental and periodontal health of the intervention and control parents (n = 250, 84% attending, mean +/- SD age: 34.2 +/- 54.5 years also showed no differences even though the control parents had more commonly last visited a dentist over 3 years before this examination (p < 0.05). We conclude that a 29-month period of a low-saturated-fat, low-cholesterol but high-carbohydrate diet as advocated in the STRIP baby trial does

  20. Sociodemographic and psychiatric diagnostic predictors of 3-year incidence of DSM-IV substance use disorders among men and women in the National Epidemiologic Survey on Alcohol and Related Conditions.

    PubMed

    Goldstein, Risë B; Smith, Sharon M; Dawson, Deborah A; Grant, Bridget F

    2015-12-01

    Incidence rates of alcohol and drug use disorders (AUDs and DUDs) are consistently higher in men than women, but information on whether sociodemographic and psychiatric diagnostic predictors of AUD and DUD incidence differ by sex is limited. Using data from Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions, sex-specific 3-year incidence rates of AUDs and DUDs among United States adults were compared by sociodemographic variables and baseline psychiatric disorders. Sex-specific logistic regression models estimated odds ratios for prediction of incident AUDs and DUDs, adjusting for potentially confounding baseline sociodemographic and diagnostic variables. Few statistically significant sex differences in predictive relationships were identified and those observed were generally modest. Prospective research is needed to identify predictors of incident DSM-5 AUDs and DUDs and their underlying mechanisms, including whether there is sex specificity by developmental phase, in the role of additional comorbidity in etiology and course, and in outcomes of prevention and treatment. PMID:26727008

  1. Extensive ameloblastic fibroma of the mandibula in a female adult patient: A case report with a follow-up of 3 years.

    PubMed

    Tozoglu, Sinan; Hatipoglu, Mukerrem; Aytekin, Zeliha; Gurer, Elif Inanc

    2016-01-01

    Ameloblastic fibroma (AF) is rare benign odontogenic tumour which usually occurs in the first two decades of life. It can occur either the mandible or maxilla but it is most frequently found in the posterior region of the mandible. Treatment of AF in usual is a conservative approach, such as enucleation and curettage but the aggressive lesions require a radical approach. A more radical approach should be considered in older patients who have likely high recurrence tendency. This report describes a case of AF in a 38-year-old female patient identified during a routine radiographic exam. Tomographic examination through three-dimensional reconstruction indicated vestibular fenestration of the cortical bone, with involvement of lingual cortical bone as the lession extended to the posterior region. We removed the tumor under local anesthesia. In this case patient has continued to be followed frequently and has been disease-free for 3 years.

  2. Clinical evaluation of the marginal gingiva as a donor tissue to augment the width of keratinized gingiva: Series of 2 cases with 3-year follow-up

    PubMed Central

    Khanuja, Palka Kaur; Sharma, R. K.; Tewari, Shikha; Narula, S. C.

    2015-01-01

    The indications to increase the width of keratinized gingiva have not been proven beyond doubt; however it becomes indispensable in certain clinical situations. Inspite of frequently encountered complications, palate is considered most preferred area to harvest the free gingival graft (FGG). This procedure aimed at investigating the potential of buccal marginal gingiva as a donor to augment keratinized gingiva. To the best of our knowledge, no such cases have been documented in the literature. FGG harvested from maxillary buccal marginal gingiva was used to augment gingiva in the mandibular anterior region for two patients. This not only improved plaque control but also resulted in acceptable esthetic results over 3 years. Furthermore, gingiva at donor sites gained its normal form and was in harmony with the neighboring teeth. It may be concluded that buccal marginal gingiva may provide a predictable substitute to other donor tissues to augment gingiva. PMID:25821366

  3. Post-Traumatic Stress Disorder and It's Predictors Among Tibetan Adolescents 3Years After the High-Altitude Earthquake in China.

    PubMed

    Liu, Dongling; Fu, Liyan; Jing, Zhang; Chen, Changying

    2016-10-01

    This study examined post-traumatic stress disorder(PTSD) and it's predictors among 4072 Tibetan adolescents 3years after the highaltitude earthquake. The instruments included The PTSD Checklist-Civilian version, The Internality, Powerful others, and Chance Scale and The Coping Style Scale. The results indicated the prevalence rate of probable PTSD was 17.8%.The predicting factors for PTSD were found to being aged 14 or older, being senior student, being monitor, being buried/injured, have family member died/amputated, have severer property loss, have witnessed death, have negative coping skills, and have power others locus of control. Effective mental health services should be developed to facilitate post-disaster recovery. PMID:27654243

  4. Post-Traumatic Stress Disorder and It's Predictors Among Tibetan Adolescents 3Years After the High-Altitude Earthquake in China.

    PubMed

    Liu, Dongling; Fu, Liyan; Jing, Zhang; Chen, Changying

    2016-10-01

    This study examined post-traumatic stress disorder(PTSD) and it's predictors among 4072 Tibetan adolescents 3years after the highaltitude earthquake. The instruments included The PTSD Checklist-Civilian version, The Internality, Powerful others, and Chance Scale and The Coping Style Scale. The results indicated the prevalence rate of probable PTSD was 17.8%.The predicting factors for PTSD were found to being aged 14 or older, being senior student, being monitor, being buried/injured, have family member died/amputated, have severer property loss, have witnessed death, have negative coping skills, and have power others locus of control. Effective mental health services should be developed to facilitate post-disaster recovery.

  5. Values Stability and Change in Adulthood: A 3-Year Longitudinal Study of Rank-Order Stability and Mean-Level Differences.

    PubMed

    Milfont, Taciano L; Milojev, Petar; Sibley, Chris G

    2016-05-01

    Recent studies have examined whether values change across time. The present study investigates both rank-order stability and mean-level differences in core values--and whether age and sex moderate stability and change--over 3 years using a national probability sample (from 25 to 75 years;N= 3,962). Value priorities were highly stable, except for Conservation values among women, which peaked in stability at age 50 and decreased afterward. Older adults and women placed greater emphasis on values relating to the welfare of others and preservation of traditional practices and stability (Self-Transcendence and Conservation values). Younger individuals and men tended to more highly value the pursuit of status and power, and independent thought and behavior (Self-Enhancement and Openness to Change). The results are consistent with a life span perspective on values development and indicate values may change slowly throughout life as a reflection of biological and psychological maturation. PMID:27029575

  6. A Cross-sectional Study on Posttraumatic Stress Disorder and General Psychiatric Morbidity Among Adult Survivors 3 Years After the Wenchuan Earthquake, China.

    PubMed

    Zhang, Wei; Duan, Guangfeng; Xu, Qin; Jia, Zhaobao; Bai, Zhengyang; Liu, Weizhi; Pan, Xiao; Tian, Wenhua

    2015-11-01

    After the Wenchuan earthquake, a large number of studies have focused on postearthquake psychological disorders among survivors; however, most of these studies were conducted within a relatively short period. This study was conducted to examine the symptoms of posttraumatic stress disorder (PTSD) and general psychiatric morbidity among adult survivors 3 years after the Wenchuan earthquake, China. Through a multistage systematic sampling approach, a cross-sectional survey of 360 participants, 18 years or older, was conducted. The prevalence of PTSD and general psychiatric morbidity was 10.3% and 20.6%, respectively. Multivariate analysis revealed significant predictors for PTSD, including female gender and having felt guilt concerning someone's death or injury. Significant predictors for general psychiatric morbidity included unmarried status and having been in serious danger. These results suggest that mental health services should be continuously available to earthquake survivors.

  7. Acting and planning on the basis of a false belief: its effects on 3-year-old children's reasoning about their own false beliefs.

    PubMed

    Atance, Cristina M; O'Neill, Daniela K

    2004-11-01

    This study examined 3-year-olds' explanations for actions of theirs that were premised on a false belief. In Experiment 1, children stated what they thought was inside a crayon box. After stating "crayons," they went to retrieve some paper to draw on. Children were then shown that the box contained candles and were asked to (a) state their initial belief and (b) explain their action of getting paper. Children who were unable to retrieve their false belief were unable to correctly explain their action. Experiments 2 and 3 ruled out several alternative interpretations for these findings. In Experiment 4, children planned and acted on their false belief. Again, children who were unable to retrieve their false belief were unable to correctly explain their action. PMID:15535750

  8. Extensive ameloblastic fibroma of the mandibula in a female adult patient: A case report with a follow-up of 3 years

    PubMed Central

    Tozoglu, Sinan; Hatipoglu, Mukerrem; Aytekin, Zeliha; Gurer, Elif Inanc

    2016-01-01

    Ameloblastic fibroma (AF) is rare benign odontogenic tumour which usually occurs in the first two decades of life. It can occur either the mandible or maxilla but it is most frequently found in the posterior region of the mandible. Treatment of AF in usual is a conservative approach, such as enucleation and curettage but the aggressive lesions require a radical approach. A more radical approach should be considered in older patients who have likely high recurrence tendency. This report describes a case of AF in a 38-year-old female patient identified during a routine radiographic exam. Tomographic examination through three-dimensional reconstruction indicated vestibular fenestration of the cortical bone, with involvement of lingual cortical bone as the lession extended to the posterior region. We removed the tumor under local anesthesia. In this case patient has continued to be followed frequently and has been disease-free for 3 years. PMID:27011753

  9. Evolution of a filmless digital imaging and communications in medicine-conformant picture archiving and communications system: design issues and lessons learned over the last 3 years.

    PubMed

    Henri, C J; Cox, R D; Rubin, R; Bret, P M; Couch, G G

    1999-05-01

    This presentation describes our experience and lessons learned over the first 3 years of developing and operating a filmless picture archiving and communications system (PACS) for all computed tomography (CT), magnetic resonance (MR), ultrasound, and nuclear medicine studies in our hospital. The PACS conforms to the Digital Imaging and Communications in Medicine (DICOM) standard and includes a sophisticated Worldwide Web (WWW)-based interface to complement the regular DICOM services. The PACS has undergone many design modifications from its inception, which have addressed performance, functionality, support, and maintenance issues. The lessons we have learned through making these modifications are described here and may prove to be helpful to anyone planning to deploy a PACS of their own.

  10. Atopic allergy and chronic inflammation of the oral mucosa in a 3-year-old boy after heart transplantation – diagnostic and therapeutic difficulties

    PubMed Central

    Machura, Edyta; Chodór, Beata; Pindycka-Piaszczyńska, Małgorzata; Chrobak, Ewelina; Białkowski, Jacek

    2015-01-01

    In recent years, we have been observing an increased proportion of atopic diseases in children after solid organ transplantation. The pathogenesis of post-transplantation allergy is not completely understood and probably involves several factors, including immunosuppressive therapy. In this paper we present a case of 3-year old boy, after orthotopic heart transplantation at 6 months of age, with symptoms of food allergy associated with atopic dermatitis and changes in the orofacial area. The mentioned symptoms and elevated levels of total and specific IgE occurred with a year of transplant. Because of failure to achieve remission after typical allergy therapy we suspected that the reason of allergy in this case can be immunosuppressive therapy. PMID:26336506

  11. A Case for Regular Aflatoxin Monitoring in Peanut Butter in Sub-Saharan Africa: Lessons from a 3-Year Survey in Zambia.

    PubMed

    Njoroge, Samuel M C; Matumba, Limbikani; Kanenga, Kennedy; Siambi, Moses; Waliyar, Farid; Maruwo, Joseph; Monyo, Emmanuel S

    2016-05-01

    A 3-year comprehensive analysis of aflatoxin contamination in peanut butter was conducted in Zambia, sub-Saharan Africa. The study analyzed 954 containers of 24 local and imported peanut butter brands collected from shops in Chipata, Mambwe, Petauke, Katete, and Nyimba districts and also in Lusaka from 2012 to 2014. For analysis, a sample included six containers of a single brand, from the same processing batch number and the same shop. Each container was quantitatively analyzed for aflatoxin B1 (AFB1) in six replicates by using competitive enzyme-linked immunosorbent assay; thus, aflatoxin contamination level of a given sample was derived from an average of 36 test values. Results showed that 73% of the brands tested in 2012 were contaminated with AFB1 levels >20 μg/kg and ranged up to 130 μg/kg. In 2013, 80% of the brands were contaminated with AFB1 levels >20 μg/kg and ranged up to 10,740 μg/kg. Compared with brand data from 2012 and 2013, fewer brands in 2014, i.e., 53%, had aflatoxin B1 levels >20 μg/kg and ranged up to 1,000 μg/kg. Of the eight brands tested repeatedly across the 3-year period, none consistently averaged ≤20 μg/kg. Our survey clearly demonstrates the regular occurrence of high levels of AF B1 in peanut butter in Zambia. Considering that some of the brands tested originated from neighboring countries such as Malawi, Zimbabwe, and South Africa, the current findings provide a sub-Saharan regional perspective regarding the safety of peanut butter.

  12. Abnormality in glutamine-glutamate cycle in the cerebrospinal fluid of cognitively intact elderly individuals with major depressive disorder: a 3-year follow-up study.

    PubMed

    Hashimoto, K; Bruno, D; Nierenberg, J; Marmar, C R; Zetterberg, H; Blennow, K; Pomara, N

    2016-03-01

    Major depressive disorder (MDD), common in the elderly, is a risk factor for dementia. Abnormalities in glutamatergic neurotransmission via the N-methyl-D-aspartate receptor (NMDA-R) have a key role in the pathophysiology of depression. This study examined whether depression was associated with cerebrospinal fluid (CSF) levels of NMDA-R neurotransmission-associated amino acids in cognitively intact elderly individuals with MDD and age- and gender-matched healthy controls. CSF was obtained from 47 volunteers (MDD group, N=28; age- and gender-matched comparison group, N=19) at baseline and 3-year follow-up (MDD group, N=19; comparison group, N=17). CSF levels of glutamine, glutamate, glycine, L-serine and D-serine were measured by high-performance liquid chromatography. CSF levels of amino acids did not differ across MDD and comparison groups. However, the ratio of glutamine to glutamate was significantly higher at baseline in subjects with MDD than in controls. The ratio decreased in individuals with MDD over the 3-year follow-up, and this decrease correlated with a decrease in the severity of depression. No correlations between absolute amino-acid levels and clinical variables were observed, nor were correlations between amino acids and other biomarkers (for example, amyloid-β42, amyloid-β40, and total and phosphorylated tau protein) detected. These results suggest that abnormalities in the glutamine-glutamate cycle in the communication between glia and neurons may have a role in the pathophysiology of depression in the elderly. Furthermore, the glutamine/glutamate ratio in CSF may be a state biomarker for depression.

  13. Functional and Radiological Outcome of Schatzker type V and VI Tibial Plateau Fracture Treatment with Dual Plates with Minimum 3 years follow-up: A Prospective Study

    PubMed Central

    Suri, Harpreet Singh; Gangrade, Kewal

    2016-01-01

    Introduction High energy intra-articular fractures involving the tibial plateau causes various problems related to management like wound dehiscence, severe comminution leading to malalignment and delayed complications like varus collapse, implant failure and arthritis of knee joint. Aim This study was done to determine functional, radiological outcome and the complications of Schatzker V and VI tibial plateau fractures treated with bipillar plating with dual plates with a regular follow-up of atleast 3 years. Materials and Methods Total 34 cases of tibial plateau fracture type V and VI treated with dual plating were studied from January 2011 to December 2013 in KIMS Hospital were followed for minimum of 3 years. The patients were operated through an anterolateral approach for lateral plate and a medial column plate was put through a minimally invasive medial approach or an open posteromedial approach. Results Total 34 patients were evaluated postoperatively thoroughly for functional outcome using The Knee Society Score and radiological outcomes by Modified Rasmussen Assessment criteria which showed 29 patients (85.29%) had excellent and 5 patients (14.71%) had good objective knee society score. 24 patients (70.59%) had excellent, 8 patients (23.53%) had good and 1patient (2.94%) were each of poor and fair functional knee society score. Eleven patients (32.35%) had excellent, 21patients (61.76%) had good and 2 patients (5.88%) had fair radiological outcome. Conclusion We conclude that open reduction and internal fixation of high-energy tibial plateau fractures with dual plates via 2 incisions gives excellent to good functional outcome with minimal soft tissue complications. Thus, a minimally invasive approach should be used which helps in preventing soft tissue problems and helps in early wound healing. Fixation done by bipillar plating is important for early mobilization of knee joint. Early mobilization leads to better range of movements and thereby better

  14. A 3-year follow-up study of β-cell function in patients with early-onset type 2 diabetes

    PubMed Central

    Zhou, Shaoling; Meng, Xiaomei; Wang, Shuyan; Ren, Ruizhen; Hou, Weikai; Huang, Kuixiang; Shi, Hongli

    2016-01-01

    Insulin resistance and reduced β-cell glucose sensitivity are present in patients with type 2 diabetes. In the present study, we investigated the changes in β-cell function in patients with type 2 diabetes during a 3-year follow-up study. A total of 48 patients with early-onset type 2 diabetes (EOD) and 55 patients with late-onset type 2 diabetes (LOD) were enrolled. Weight, height, waist circumference, hip circumference, blood pressure and plasma levels of lipids, glucose, fasting serum C-peptide (CPR0) and serum C-peptide 6 min after glucagon stimulation (CPR6) were measured. In addition, islet β-cell secretory activity was detected. Subjects with EOD had lower Systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), fasting CPR0, CPR6 and greater glycated hemoglobin A1c (HbA1c), triglyceride (TG) compared with subjects with LOD. CPR0, CPR6 and TG were decreased in both EOD and LOD groups 3 years later. The ratio of β-cell function failure was 29.17 and 10.91% in the EOD and LOD groups, respectively, and there was significant difference between the two groups. A positive correlation was identified between the CPR0 and waist-hip ratio, HbA1c in the EOD group. A similar positive correlation was observed between CPR0 and BMI in the LOD group. Collectively, islet β-cell function has declined in patients with EOD, and this change may be more evident when compared with those with LOD. PMID:27446326

  15. Treatment of Patients with Obese Type 2 Diabetes with Tantalus-DIAMOND® Gastric Electrical Stimulation: Normal Triglycerides Predict Durable Effects for at Least 3 Years.

    PubMed

    Lebovitz, H E; Ludvik, B; Yaniv, I; Schwartz, T; Zelewski, M; Gutterman, D D

    2015-06-01

    The objectives of the present work are to evaluate long-term benefit of nonexcitatory gastric electrical stimulation (GES) by the DIAMOND(®) device on glycemic control and body weight in patients with type 2 diabetes inadequately controlled with oral agents and to determine the magnitude of the modulating effects of fasting plasma triglyceride (FTG) levels on these effects of GES. Sixty one patients with type 2 diabetes [HbA1c > 7.0% (53 mmol/mol) to < 10.5% (91 mmol/mol)] were implanted with the DIAMOND(®) GES device and treated with meal-mediated antral electrical stimulation for up to 36 months. The effects of baseline HbA1c and FTG on glycemic control, body weight, and systolic blood pressure were measured. GES reduced mean HbA1c by 0.9% and body weight by 5.7%. The effects were greater in patients with normal fasting plasma triglycerides (NTG) as compared to those with hypertriglyceridemia. The mean decrease in HbA1c in patients with NTG averaged 1.1% and was durable over 3 years of follow-up. ANCOVA indicated that improvement in HbA1c was a function of both baseline FTG group (p = 0.02) and HbA1c (p = 0.001) and their interaction (p = 0.01). Marked weight loss (≥ 10%) was observed in a significant proportion of NTG patients by 12 months of treatment and persisted through the 3 years. GES improves glycemic control and reduces body weight by a triglyceride-dependent mechanism in patients with type 2 diabetes inadequately controlled on oral agents. It is postulated that this is through a gut-brain interaction that modulates effects on the liver and pancreatic islets. PMID:25993254

  16. Meniscus treatment and age associated with narrower radiographic joint space width 2 – 3 years after ACL reconstruction: Data from the MOON onsite cohort

    PubMed Central

    Jones, Morgan H.; Spindler, Kurt P.; Fleming, Braden C.; Duryea, Jeffrey; Obuchowski, Nancy A.; Scaramuzza, Erica A.; Oksendahl, Heidi L.; Winalski, Carl S.; Duong, Carol L.; Huston, Laura J.; Parker, Richard D.; Kaeding, Christopher C.; Andrish, Jack T.; Flanigan, David C.; Dunn, Warren R.; Reinke, Emily K.

    2015-01-01

    Objective To identify risk factors for radiographic signs of post-traumatic OA 2–3 years after ACL reconstruction through multivariable analysis of minimum joint space width (mJSW) differences in a specially designed nested cohort. Methods A nested cohort within the Multicenter Orthopaedic Outcomes Network cohort included 262 patients (148 females, average age 20) injured in sport who underwent ACL reconstruction in a previously uninjured knee, were 35 or younger, and did not have ACL revision or contralateral knee surgery. mJSW on semi-flexed radiographs was measured in the medial compartment using a validated computerized method. A multivariable generalized linear model was constructed to assess mJSW difference between the ACL reconstructed and contralateral control knees while adjusting for potential confounding factors. Results Unexpectedly, we found the mean mJSW was 0.35 mm wider in ACL reconstructed than in control knees (5.06 mm (95% CI 4.96 – 5.15 mm) versus 4.71 mm (95% CI 4.62 – 4.80 mm), p<0.001). However, ACL reconstructed knees with meniscectomy had narrower mJSW compared to contralateral normal knees by 0.64 mm (95% C.I. 0.38 – 0.90 mm) (p<0.001). Age (p<0.001) and meniscus repair (p=0.001) were also significantly associated with mJSW difference. Conclusion Semi-flexed radiographs can detect differences in mJSW between ACL reconstructed and contralateral normal knees 2–3 years following ACL reconstruction, and the unexpected wider mJSW in ACL reconstructed knees may represent the earliest manifestation of post-traumatic osteoarthritis and warrants further study. PMID:25559582

  17. Treatment of Patients with Obese Type 2 Diabetes with Tantalus-DIAMOND® Gastric Electrical Stimulation: Normal Triglycerides Predict Durable Effects for at Least 3 Years.

    PubMed

    Lebovitz, H E; Ludvik, B; Yaniv, I; Schwartz, T; Zelewski, M; Gutterman, D D

    2015-06-01

    The objectives of the present work are to evaluate long-term benefit of nonexcitatory gastric electrical stimulation (GES) by the DIAMOND(®) device on glycemic control and body weight in patients with type 2 diabetes inadequately controlled with oral agents and to determine the magnitude of the modulating effects of fasting plasma triglyceride (FTG) levels on these effects of GES. Sixty one patients with type 2 diabetes [HbA1c > 7.0% (53 mmol/mol) to < 10.5% (91 mmol/mol)] were implanted with the DIAMOND(®) GES device and treated with meal-mediated antral electrical stimulation for up to 36 months. The effects of baseline HbA1c and FTG on glycemic control, body weight, and systolic blood pressure were measured. GES reduced mean HbA1c by 0.9% and body weight by 5.7%. The effects were greater in patients with normal fasting plasma triglycerides (NTG) as compared to those with hypertriglyceridemia. The mean decrease in HbA1c in patients with NTG averaged 1.1% and was durable over 3 years of follow-up. ANCOVA indicated that improvement in HbA1c was a function of both baseline FTG group (p = 0.02) and HbA1c (p = 0.001) and their interaction (p = 0.01). Marked weight loss (≥ 10%) was observed in a significant proportion of NTG patients by 12 months of treatment and persisted through the 3 years. GES improves glycemic control and reduces body weight by a triglyceride-dependent mechanism in patients with type 2 diabetes inadequately controlled on oral agents. It is postulated that this is through a gut-brain interaction that modulates effects on the liver and pancreatic islets.

  18. Abnormality in glutamine–glutamate cycle in the cerebrospinal fluid of cognitively intact elderly individuals with major depressive disorder: a 3-year follow-up study

    PubMed Central

    Hashimoto, K; Bruno, D; Nierenberg, J; Marmar, C R; Zetterberg, H; Blennow, K; Pomara, N

    2016-01-01

    Major depressive disorder (MDD), common in the elderly, is a risk factor for dementia. Abnormalities in glutamatergic neurotransmission via the N-methyl-d-aspartate receptor (NMDA-R) have a key role in the pathophysiology of depression. This study examined whether depression was associated with cerebrospinal fluid (CSF) levels of NMDA-R neurotransmission-associated amino acids in cognitively intact elderly individuals with MDD and age- and gender-matched healthy controls. CSF was obtained from 47 volunteers (MDD group, N=28; age- and gender-matched comparison group, N=19) at baseline and 3-year follow-up (MDD group, N=19; comparison group, N=17). CSF levels of glutamine, glutamate, glycine, l-serine and d-serine were measured by high-performance liquid chromatography. CSF levels of amino acids did not differ across MDD and comparison groups. However, the ratio of glutamine to glutamate was significantly higher at baseline in subjects with MDD than in controls. The ratio decreased in individuals with MDD over the 3-year follow-up, and this decrease correlated with a decrease in the severity of depression. No correlations between absolute amino-acid levels and clinical variables were observed, nor were correlations between amino acids and other biomarkers (for example, amyloid-β42, amyloid-β40, and total and phosphorylated tau protein) detected. These results suggest that abnormalities in the glutamine–glutamate cycle in the communication between glia and neurons may have a role in the pathophysiology of depression in the elderly. Furthermore, the glutamine/glutamate ratio in CSF may be a state biomarker for depression. PMID:26926880

  19. A Case for Regular Aflatoxin Monitoring in Peanut Butter in Sub-Saharan Africa: Lessons from a 3-Year Survey in Zambia.

    PubMed

    Njoroge, Samuel M C; Matumba, Limbikani; Kanenga, Kennedy; Siambi, Moses; Waliyar, Farid; Maruwo, Joseph; Monyo, Emmanuel S

    2016-05-01

    A 3-year comprehensive analysis of aflatoxin contamination in peanut butter was conducted in Zambia, sub-Saharan Africa. The study analyzed 954 containers of 24 local and imported peanut butter brands collected from shops in Chipata, Mambwe, Petauke, Katete, and Nyimba districts and also in Lusaka from 2012 to 2014. For analysis, a sample included six containers of a single brand, from the same processing batch number and the same shop. Each container was quantitatively analyzed for aflatoxin B1 (AFB1) in six replicates by using competitive enzyme-linked immunosorbent assay; thus, aflatoxin contamination level of a given sample was derived from an average of 36 test values. Results showed that 73% of the brands tested in 2012 were contaminated with AFB1 levels >20 μg/kg and ranged up to 130 μg/kg. In 2013, 80% of the brands were contaminated with AFB1 levels >20 μg/kg and ranged up to 10,740 μg/kg. Compared with brand data from 2012 and 2013, fewer brands in 2014, i.e., 53%, had aflatoxin B1 levels >20 μg/kg and ranged up to 1,000 μg/kg. Of the eight brands tested repeatedly across the 3-year period, none consistently averaged ≤20 μg/kg. Our survey clearly demonstrates the regular occurrence of high levels of AF B1 in peanut butter in Zambia. Considering that some of the brands tested originated from neighboring countries such as Malawi, Zimbabwe, and South Africa, the current findings provide a sub-Saharan regional perspective regarding the safety of peanut butter. PMID:27296427

  20. Plaque Brachytherapy for Uveal Melanoma: A Vision Prognostication Model

    SciTech Connect

    Khan, Niloufer; Khan, Mohammad K.; Bena, James; Macklis, Roger; Singh, Arun D.

    2012-11-01

    Purpose: To generate a vision prognostication model after plaque brachytherapy for uveal melanoma. Methods and Materials: All patients with primary single ciliary body or choroidal melanoma treated with iodine-125 or ruthenium-106 plaque brachytherapy between January 1, 2005, and June 30, 2010, were included. The primary endpoint was loss of visual acuity. Only patients with initial visual acuity better than or equal to 20/50 were used to evaluate visual acuity worse than 20/50 at the end of the study, and only patients with initial visual acuity better than or equal to 20/200 were used to evaluate visual acuity worse than 20/200 at the end of the study. Factors analyzed were sex, age, cataracts, diabetes, tumor size (basal dimension and apical height), tumor location, and radiation dose to the tumor apex, fovea, and optic disc. Univariate and multivariable Cox proportional hazards were used to determine the influence of baseline patient factors on vision loss. Kaplan-Meier curves (log rank analysis) were used to estimate freedom from vision loss. Results: Of 189 patients, 92% (174) were alive as of February 1, 2011. At presentation, visual acuity was better than or equal to 20/50 and better than or equal to 20/200 in 108 and 173 patients, respectively. Of these patients, 44.4% (48) had post-treatment visual acuity of worse than 20/50 and 25.4% (44) had post-treatment visual acuity worse than 20/200. By multivariable analysis, increased age (hazard ratio [HR] of 1.01 [1.00-1.03], P=.05), increase in tumor height (HR of 1.35 [1.22-1.48], P<.001), and a greater total dose to the fovea (HR of 1.01 [1.00-1.01], P<.001) were predictive of vision loss. This information was used to develop a nomogram predictive of vision loss. Conclusions: By providing a means to predict vision loss at 3 years after treatment, our vision prognostication model can be an important tool for patient selection and treatment counseling.