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Sample records for 4-year disease-free survival

  1. Conditional disease-free survival after liver transplantation for hepatocellular carcinoma

    PubMed Central

    Dong, Jian; Zhu, Ying; Ma, Feng; Ren, Yifang; Lu, Jianwen; Wang, Zhengxin; Qin, Lunxiu; Wu, Rongqian; Lv, Yi

    2016-01-01

    Abstract Traditionally, survival estimates following liver transplantation (LT) of hepatocellular carcinoma (HCC) patients were calculated as survival from the surgery date, but future survival probabilities can change over time and conditional disease-free survival (CDFS) may provide patients and clinicians with more accurate prognostic information. This study aimed to assess CDFS in HCC patients after LT. Three hundred eighty-four HCC patients who underwent LT were included. Disease-free survival (DFS) was calculated using the Kaplan–Meier analysis. The 3-year CDFS, which represents the probability of remaining disease free for an additional 3 years, was calculated. 1-, 3-, and 5-year DFS rates after LT were 69.9%, 45.8%, and 39.0 %, respectively. Based on the concept of CDFS, the probability of surviving an additional 3 years given that the patient was disease free at 1 year, 3 years, and 5 years were 58.4%, 76.9%, and 83.1%, respectively. Multivariate analysis indicated that larger tumor size (hazard ratio [HR], 1.509; 95% CI, 1.146–1.985; P = 0.003) was associated with poorer DFS. Patients with worse prognostic features at baseline demonstrated the greater increase in CDFS over time. Survival estimates following liver transplantation of HCC patients change according to survival time accrued since surgery. CDFS estimates improved dramatically over time especially among patients with worse prognostic features at the time of surgery. CDFS may be a useful tool in counseling patients with HCC, as it is a more accurate assessment of future survival for those patients who have already survived a certain amount of time. PMID:27495049

  2. Liver transplantation for hepatocellular carcinoma - factors influencing outcome and disease-free survival

    PubMed Central

    Fahrner, René; Dondorf, Felix; Ardelt, Michael; Dittmar, Yves; Settmacher, Utz; Rauchfuß, Falk

    2015-01-01

    Hepatocellular carcinoma is one of the leading causes of cancer-related death worldwide. Liver transplantation can be a curative treatment in selected patients. However, there are several factors that influence disease-free survival after transplantation. This review addresses the pre-, intra- and postoperative factors that influence the risk of tumor recurrence after liver transplantation. PMID:26576092

  3. Complete DIEP flap survival following pedicle resection, 4 years after its transfer. Clinical evidence of autonomization

    PubMed Central

    Longo, Benedetto; Laporta, Rosaria; Sorotos, Michail; Atzeni, Matteo; Santanelli di Pompeo, Fabio

    2016-01-01

    Abstract We report a case of complete DIEP flap survival, following venous congestion due to the excision of a local recurrence with main pedicle, 4 years after its transfer for breast reconstruction. PMID:27713917

  4. Genetic variants in the vitamin D pathway and breast cancer disease-free survival

    PubMed Central

    Brewster, Abenaa M.

    2013-01-01

    Epidemiological studies have investigated the association between vitamin D pathway genes and breast cancer risk; however, little is known about the association between vitamin D pathway genes and breast cancer prognosis. In a retrospective cohort of 1029 patients with early-stage breast cancer, we analyzed the association between 106 tagging single nucleotide polymorphisms (SNPs) in eight vitamin D pathway genes and breast cancer disease-free survival (DFS) using Cox regression analysis adjusted for known prognostic variables. Using a false discovery rate of 10%, six intronic SNPs were significantly associated with poorer DFS: retinoid-X receptor alpha (RXRA) SNPs (rs881658, rs11185659, rs10881583, rs881657 and rs7864987) and plasminogen activator and urokinase receptor (PLAUR) SNP (rs4251864). Treatment received (no systemic therapy, hormone therapy alone or chemotherapy) was an effect modifier of the RXRA SNPs association with DFS (P < 0.05); therefore, we stratified further analysis by treatment group. Among patients who did not receive systemic therapy, RXRA SNP [rs10881583 (P = 0.02)] was associated with poorer DFS, and among patients who received chemotherapy, RXRA SNPs (rs881658, rs11185659, rs10881583, rs881657 and rs7864987) were associated with poorer DFS (P < 0.001 for all SNPs). However, RXRA SNPs: rs10881583 (P < 0.001) and rs881657 (P = 0.02) were associated with improved DFS in patients treated with hormone therapy alone. Our results suggest that SNPs in the RXRA and PLAUR genes in the vitamin D pathway may contribute to breast cancer DFS. In particular, SNPs in RXRA may predict for poorer or improved DFS in patients, according to type of systemic treatment received. If validated, these markers could be used for risk stratification of breast cancer patients. PMID:23180655

  5. Long-term disease-free survival after surgical resection for multiple bone metastases from rectal cancer

    PubMed Central

    Choi, Seok Jin; Kim, Jong Hun; Lee, Min Ro; Lee, Chang Ho; Kuh, Ja Hong; Kim, Jung Ryul

    2011-01-01

    Bone metastasis of primary colorectal cancer is uncommon. When it occurs, it is usually a late manifestation of disease and is indicative of poor prognosis. We describe a patient with multiple metachronous bone metastases from lower rectal cancer who was successfully treated with multimodal treatment including surgical resections and has shown 32 mo disease-free survival. Surgical resection of metastatic bone lesion(s) from colorectal cancer may be a good treatment option in selected patients. PMID:21876853

  6. Disease-Free Survival as a Surrogate for Overall Survival in Adjuvant Trials of Gastric Cancer: A Meta-Analysis

    PubMed Central

    Paoletti, Xavier; Alberts, Steven; Bang, Yung-Jue; Benedetti, Jacqueline; Bleiberg, Harry; Catalano, Paul; Lordick, Florian; Michiels, Stefan; Morita, Satoshi; Ohashi, Yasuo; Pignon, Jean-pierre; Rougier, Philippe; Sasako, Mitsuru; Sakamoto, Junichi; Sargent, Daniel; Shitara, Kohei; Cutsem, Eric Van; Buyse, Marc; Burzykowski, Tomasz

    2013-01-01

    Background In investigations of the effectiveness of surgery and adjuvant chemotherapy for gastric cancers, overall survival (OS) is considered the gold standard endpoint. However, the disadvantage of using OS as the endpoint is that it requires an extended follow-up period. We sought to investigate whether disease-free survival (DFS) is a valid surrogate for OS in trials of adjuvant chemotherapy for gastric cancer. Methods The GASTRIC group initiated a meta-analysis of individual patient data collected in randomized clinical trials comparing adjuvant chemotherapy vs surgery alone for patients with curatively resected gastric cancer. Surrogacy of DFS was assessed through the correlation between the endpoints as well as through the correlation between the treatment effects on the endpoints. External validation of the prediction based on DFS was also evaluated. Results Individual patient data from 14 randomized clinical trials that included a total of 3288 patients were analyzed. The rank correlation coefficient between DFS and OS was 0.974 (95% confidence interval [CI] = 0.971 to 0.976). The coefficient of determination between the treatment effects on DFS and on OS was as high as 0.964 (95% CI = 0.926 to 1.000), and the surrogate threshold effect based on adjusted regression analysis was 0.92. In external validation, the six hazard ratios for OS predicted according to DFS were in very good agreement with those actually observed for OS. Conclusions DFS is an acceptable surrogate for OS in trials of cytotoxic agents for gastric cancer in the adjuvant setting. PMID:24108812

  7. Time-varying effects of prognostic factors associated with disease-free survival in breast cancer.

    PubMed

    Natarajan, Loki; Pu, Minya; Parker, Barbara A; Thomson, Cynthia A; Caan, Bette J; Flatt, Shirley W; Madlensky, Lisa; Hajek, Richard A; Al-Delaimy, Wael K; Saquib, Nazmus; Gold, Ellen B; Pierce, John P

    2009-06-15

    Early detection and effective treatments have dramatically improved breast cancer survivorship, yet the risk of relapse persists even 15 years after the initial diagnosis. It is important to identify prognostic factors for late breast cancer events. The authors investigated time-varying effects of tumor characteristics on breast-cancer-free survival using data on 3,088 breast cancer survivors from 4 US states who participated in a randomized dietary intervention trial in 1995-2006, with maximum follow-up through 15 years (median, 9 years). A piecewise constant penalized spline approach incorporating time-varying coefficients was adopted, allowing for deviations from the proportional hazards assumption. This method is more flexible than standard approaches, provides direct estimates of hazard ratios across time intervals, and is computationally tractable. Having a stage II or III tumor was associated with a 3-fold higher hazard of breast cancer than having a stage I tumor during the first 2.5 years after diagnosis; this hazard ratio decreased to 2.1 after 7.7 years, but higher tumor stage remained a significant risk factor. Similar diminishing effects were found for poorly differentiated tumors. Interestingly, having a positive estrogen receptor status was protective up to 4 years after diagnosis but detrimental after 7.7 years (hazard ratio = 1.5). These results emphasize the importance of careful statistical modeling allowing for possibly time-dependent effects in long-term survivorship studies. PMID:19403844

  8. Time-Varying Effects of Prognostic Factors Associated With Disease-Free Survival in Breast Cancer

    PubMed Central

    Natarajan, Loki; Pu, Minya; Parker, Barbara A.; Thomson, Cynthia A.; Caan, Bette J.; Flatt, Shirley W.; Madlensky, Lisa; Hajek, Richard A.; Al-Delaimy, Wael K.; Saquib, Nazmus; Gold, Ellen B.

    2009-01-01

    Early detection and effective treatments have dramatically improved breast cancer survivorship, yet the risk of relapse persists even 15 years after the initial diagnosis. It is important to identify prognostic factors for late breast cancer events. The authors investigated time-varying effects of tumor characteristics on breast-cancer-free survival using data on 3,088 breast cancer survivors from 4 US states who participated in a randomized dietary intervention trial in 1995–2006, with maximum follow-up through 15 years (median, 9 years). A piecewise constant penalized spline approach incorporating time-varying coefficients was adopted, allowing for deviations from the proportional hazards assumption. This method is more flexible than standard approaches, provides direct estimates of hazard ratios across time intervals, and is computationally tractable. Having a stage II or III tumor was associated with a 3-fold higher hazard of breast cancer than having a stage I tumor during the first 2.5 years after diagnosis; this hazard ratio decreased to 2.1 after 7.7 years, but higher tumor stage remained a significant risk factor. Similar diminishing effects were found for poorly differentiated tumors. Interestingly, having a positive estrogen receptor status was protective up to 4 years after diagnosis but detrimental after 7.7 years (hazard ratio = 1.5). These results emphasize the importance of careful statistical modeling allowing for possibly time-dependent effects in long-term survivorship studies. PMID:19403844

  9. Improved graft-versus-host disease-free, relapse-free survival associated with bone marrow as the stem cell source in adults

    PubMed Central

    Mehta, Rohtesh S.; de Latour, Regis Peffault; DeFor, Todd E; Robin, Marie; Lazaryan, Aleksandr; Xhaard, Aliénor; Bejanyan, Nelli; de Fontbrune, Flore Sicre; Arora, Mukta; Brunstein, Claudio G.; Blazar, Bruce R.; Weisdorf, Daniel J.; MacMillan, Margaret L.; Socie, Gerard; Holtan, Shernan G.

    2016-01-01

    We previously reported that bone marrow grafts from matched sibling donors resulted in best graft-versus-host disease-free, relapse-free survival at 1-year post allogeneic hematopoietic cell transplantation. However, pediatric patients comprised the majority of bone marrow graft recipients in that study. To better define this outcome in adults and pediatric patients at 1- and 2-years post- allogeneic hematopoietic cell transplantation, we pooled data from the University of Minnesota and the Hôpital Saint-Louis in Paris, France (n=1901). Graft-versus-host disease-free, relapse-free survival was defined as the absence of grade III–IV acute graft-versus-host disease, chronic graft-versus-host disease (requiring systemic therapy or extensive stage), relapse and death. In adults, bone marrow from matched sibling donors (n=123) had best graft-versus-host disease-free, relapse-free survival at 1- and 2-years, compared with peripheral blood stem cell from matched sibling donors (n=540) or other graft/donor types. In multivariate analysis, peripheral blood stem cells from matched sibling donors resulted in a 50% increased risk of events contributing to graft-versus-host disease-free, relapse-free survival at 1- and 2-years than bone marrow from matched sibling donors. With limited numbers of peripheral blood stem cell grafts in pediatric patients (n=12), graft-versus-host disease-free, relapse-free survival did not differ between bone marrow and peripheral blood stem cell graft from any donor. While not all patients have a matched sibling donor, graft-versus-host disease-free, relapse-free survival may be improved by the preferential use of bone marrow for adults with malignant diseases. Alternatively, novel graft-versus-host disease prophylaxis regimens are needed to substantially impact graft-versus-host disease-free, relapse-free survival with the use of peripheral blood stem cell. PMID:27036159

  10. Survival rate of sealed, refurbished and repaired defective restorations: 4-year follow-up.

    PubMed

    Fernández, Eduardo M; Martin, Javier A; Angel, Pablo A; Mjör, Ivar A; Gordan, Valeria V; Moncada, Gustavo A

    2011-01-01

    The most common treatment in general dental practice is the replacement of restorations affected by secondary caries or marginal deficiencies. Alternative treatments to replacement of defective restorations, such as marginal sealing, refurbishment and repair, have demonstrated improvement of their clinical properties with minimal intervention. The aim of this clinical study was to estimate the median survival time (MST) of marginal sealing, repair and refurbishment of amalgam and resin-based composite restorations with localized defects as a treatment to increase the restoration longevity. A cohort of 66 patients, with 271 class I and II restorations clinically diagnosed with localized defects was longitudinally assessed. Each restoration was assigned to one of the following 5 groups: Marginal Sealing (n=48), Refurbishment (n=73), Repair (n=27), Replacement (n=42), and Untreated (n=81). Two calibrated examiners assessed the restorations at baseline and annually during 4 years, using the modified Ryge criteria: marginal adaptation, anatomic form, roughness, secondary caries and luster. Fifty-two patients with 208 restorations were assessed after 4 years; the distribution of restorations in the groups was as follows: Marginal Sealing (n=36), Refurbishment (n=63), Repair (n=21), Replacement (n=28) and Untreated (n=60). Kaplan Meier test indicated that the Sealed margins group showed the lowest MST while the Repair group showed the highest MST for restorations examined after 4 years of follow up. Defective amalgam and resin-based composite restorations treated by sealing of marginal gaps, refurbishment of anatomic form, luster or roughness, and repair of secondary caries lesions, had their longevity increased.

  11. Survival and disease-free benefits with mastectomy versus breast conservation therapy for early breast cancer: a meta-analysis.

    PubMed

    Chen, Yan; Jiang, Lei; Gao, Bo; Cheng, Zhi-Yuan; Jin, Jiaxin; Yang, Ke-Hu

    2016-06-01

    The objective of the present meta-analysis was to estimate the magnitude of survival and disease-free benefits from mastectomy compared with breast conservation therapy (BCT) in patients with early breast cancer. We searched PubMed, Embase, the Cochrane Library, Web of Science, and Chinese biomedical literature database from their inception to May 2015. All the data were independently extracted from the publications by two reviewers. Results regarding the overall survival (OS) and disease-free survival (DFS) in the meta-analysis were expressed as hazard ratios (HRs) with 95 % confidence intervals (CIs). Nine randomized control trials were eligible for final meta-analysis. Meta-analysis showed that mastectomy provided significant benefit in OS compared with BCT (HR 1.09, 95 % CI 1.01-1.19; P = 0.03). Sensitivity analysis gives similar OS estimates (HR 1.12, 95 % CI 1.01-1.25). In the subgroup analysis of patients according to tumor size, the pooled HRs for OS indicated that there is a borderline statistical difference between two arms in the subgroup with tumor size ranging between ≥2 cm and <5 cm (HR 1.09, 95 % CI 1.00-1.19), but subgroup analysis of tumor size <2 cm showed no statistically significant difference in OS (HR 1.08, 95 % CI 0.88-1.33) when comparing the BCT arm with the mastectomy arm. There was no significant difference in DFS between BCT and mastectomy groups (HR 1.08, 95 % CI 0.99-1.18; P = 0.08). Sensitivity analysis also gives similar DFS estimates (HR 1.11, 95 % CI 0.96-1.27). Subgroup analysis indicated that the pooled HRs for DFS did not favor mastectomy arm or BCT arm either in the subgroup with tumor size <2 cm (HR 1.09, 95 % CI 0.78-1.52) or in the subgroup with tumor size ranging between ≥2 cm and <5 cm (HR 1.08, 95 % CI 0.99-1.18) according to tumor size. Five-year OS decreased from 70 to 68 % with BCT. The present meta-analysis indicated that mastectomy might provide slight OS benefit compared with BCT in early

  12. A Randomized Study on Postrelapse Disease-Free Survival with Adjuvant Mistletoe versus Oral Etoposide in Osteosarcoma Patients

    PubMed Central

    Longhi, Alessandra; Reif, Marcus; Mariani, Erminia; Ferrari, Stefano

    2014-01-01

    Background. Osteosarcoma is a highly malignant bone tumour. After the second relapse, the 12-month postrelapse disease-free survival (PRDFS) rate decreases below 20%. Oral Etoposide is often used in clinical practice after surgery as an “adjuvant” outside any protocol and with only limited evidence of improved survival. Viscum album fermentatum Pini (Viscum) is an extract of mistletoe plants grown on pine trees for subcutaneous (sc) injection with immunomodulatory activity. Methods. Encouraged by preliminary findings, we conducted a study where osteosarcoma patients free from disease after second metastatic relapse were randomly assigned to Viscum sc or Oral Etoposide. Our goal was to compare 12-month PRDFS rates with an equivalent historical control group. Results. Twenty patients have been enrolled, with a median age of 34 years (range 11–65) and a median follow-up time of 38.5 months (3–73). The median PRDSF is currently 4 months (1–47) in the Etoposide and 39 months (2–73) in the Viscum group. Patients getting Viscum reported a higher quality of life due to lower toxicity. Conclusion. Viscum shows promise as adjuvant treatment in prolonging PRDFS after second relapse in osteosarcoma patients. A larger study is required to conclusively determine efficacy and immunomodulatory mechanisms of Viscum therapy in osteosarcoma patients. PMID:24803944

  13. Prognostic factors for disease-free survival in patients with T-4 or N+ rectal cancer treated with preoperative chemoradiation therapy, surgery, and intraoperative irradiation

    SciTech Connect

    Diaz-Gonzalez, Juan A.; Calvo, Felipe A.; Cortes, Javier; Garcia-Sabrido, Jose L.; Gomez-Espi, Marina; Valle, Emilio del; Munoz-Jimenez, Fernando; Alvarez, Emilio

    2006-03-15

    Purpose: Fluoropyrimidine-radiosensitizing agents in conjunction with preoperative radiotherapy have proven to induce tumor and nodal downstaging effects, sphincter preservation promotion, and mid-term favorable survival rates. Intraoperative electron beam radiation therapy may improve pelvic control in patients with locally advanced rectal cancer stages. Potential predictive factors for response and disease-free survival, with intense local multidisciplinary approach, are analyzed. Methods and Materials: One hundred fifteen patients with rectal cancer were treated with oral 5-fluorouracil or Tegafur with preoperative radiotherapy, surgery, and intraoperative electron beam radiation therapy to identify potential pre- and on-treatment characteristics that might be of prognostic value for disease outcome. Univariate and multivariate analyses were performed. Results: Older patients and those treated with Tegafur were more likely to achieve a major histologic response, categorized as persistence of minimal residual microscopic disease foci in the surgical specimen ('mic' response). Factors unfavorably associated with disease-free survival in the multivariate model were male gender and persistence of macroscopic disease in the rectal wall ('mac' response). Accordingly, 3-year disease-free survival rates in the groups of patients with 0, 1, or 2 of these risk factors were 100%, 81%, and 53%, respectively (p < 0.001). Conclusions: Females with an intense pathologic response (pT{sub mic} residue) to preoperative chemoradiotherapy have an excellent 3-year disease-free survival. This information might be of interest for stratification of patients in the development of adjuvant treatment trials.

  14. Neoadjuvant Chemotherapy Induces Expression Levels of Breast Cancer Resistance Protein That Predict Disease-Free Survival in Breast Cancer

    PubMed Central

    Kim, Baek; Fatayer, Hiba; Hanby, Andrew M.; Horgan, Kieran; Perry, Sarah L.; Valleley, Elizabeth M.A.; Verghese, Eldo T.; Williams, Bethany J.; Thorne, James L.; Hughes, Thomas A.

    2013-01-01

    Three main xenobiotic efflux pumps have been implicated in modulating breast cancer chemotherapy responses. These are P-glycoprotein (Pgp), Multidrug Resistance-associated Protein 1 (MRP1), and Breast Cancer Resistance Protein (BCRP). We investigated expression of these proteins in breast cancers before and after neoadjuvant chemotherapy (NAC) to determine whether their levels define response to NAC or subsequent survival. Formalin-fixed paraffin-embedded tissues were collected representing matched pairs of core biopsy (pre-NAC) and surgical specimen (post-NAC) from 45 patients with invasive ductal carcinomas. NAC regimes were anthracyclines +/− taxanes. Immunohistochemistry was performed for Pgp, MRP1 and BCRP and expression was quantified objectively using computer-aided scoring. Pgp and MRP1 were significantly up-regulated after exposure to NAC (Wilcoxon signed-rank p = 0.0024 and p<0.0001), while BCRP showed more variation in response to NAC, with frequent up- (59% of cases) and down-regulation (41%) contributing to a lack of significant difference overall. Pre-NAC expression of all markers, and post-NAC expression of Pgp and MRP1 did not correlate with NAC response or with disease-free survival (DFS). Post-NAC expression of BCRP did not correlate with NAC response, but correlated significantly with DFS (Log rank p = 0.007), with longer DFS in patients with low post-NAC BCRP expression. In multivariate Cox regression analyses, post-NAC BCRP expression levels proved to predict DFS independently of standard prognostic factors, with high expression associated with a hazard ratio of 4.04 (95% confidence interval 1.3–12.2; p = 0.013). We conclude that NAC-induced expression levels of BCRP predict survival after NAC for breast cancer, while Pgp and MRP1 expression have little predictive value. PMID:23658771

  15. Autologous peripheral blood stem cell transplantation in tumor-stage mycosis fungoides: predictors of disease-free survival.

    PubMed

    Russell-Jones, R; Child, F; Olavarria, E; Whittaker, S; Spittle, M; Apperley, J

    2001-09-01

    Nine patients with mycosis fungoides (age range 27-67) underwent autologous peripheral blood stem cell transplantation (PBSCT). All patients had tumor-stage disease, and four had lymph node involvement. Eight patients exhibited a peripheral blood T cell clone using PCR/SSCP analysis of the TCR gamma gene, six prior to harvest and two at the time of harvest. Mobilization of CD34+ stem cells was achieved with etoposide and G-CSF. Harvested cells were positively selected for CD34. After negative selection for CD4 and CD8, only two samples became PCR negative. Conditioning prior to reinfusion of stem cells was achieved with various combinations of total skin electron beam (TSEB), total body irradiation (TBI), and chemotherapy, depending upon the patient's prior exposure to radiotherapy. One patient failed to engraft and died of candidal septicemia 15 days posttransplant. The other eight patients achieved complete remission, but this was short-lived in four (median disease-free survival [DFS] = 2 months) and prolonged in three (median DFS 11 months). Those with a short DFS were distinguished by rapid tumor onset prior to transplant but not by stage at transplant. Loss of a detectable T cell clone after manipulation of the harvest did not discriminate between the two groups, but rapid relapsers had been subjected to a greater degree of T cell depletion, possibly indicating a compromised cytotoxic response post-PBSCT. The median survival of the cohort is four years from tumor onset, 15 months from PBSCT, and 27 months from the date a peripheral blood clone was first detected in the presence of tumor-stage disease. Rapid relapse was associated with poor overall survival. Our data demonstrate the value of PBSCT for inducing remission in tumor-stage mycosis fungoides. Reinfusion of neoplastic cells could be avoided by harvesting stem cells at an earlier stage in the disease process, preferably before a T cell clone is detectable in the peripheral blood. Alternatively T cell

  16. Evaluation of postradiotherapy PSA patterns and correlation with 10-year disease free survival outcomes for prostate cancer

    SciTech Connect

    Zelefsky, Michael J. . E-mail: zelefskm@mskcc.org; Ben-Porat, Leah; Chan, Heather M.; Fearn, Paul A.; Venkatraman, Ennapadam S.

    2006-10-01

    Purpose: To describe the prostate-specific antigen (PSA) pattern profiles observed after external beam radiotherapy with and without short-term neoadjuvant androgen deprivation therapy (ST-ADT) and to report the association of established posttreatment PSA patterns with long-term disease-free survival outcomes. Methods and Materials: A total of 1,665 patients were treated with conformal external beam radiotherapy for clinically localized prostate cancer. Of 570 patients who had the requisite >10 consecutive PSA measurements for statistical analysis, 194 patients received a median of 3 months of ADT before radiotherapy and 376 were treated with radiotherapy alone. The median follow up was 103 months. Results: In the group treated with ST-ADT, three distinct postradiotherapy PSA patterns were identified: a stable trend (44%), an increasing trend followed by stabilization of the PSA (25%), and an increasing trend (31%). Among the subgroup that demonstrated a rising and subsequent stabilizing patterns, PSA levels had gradually risen to a median value of 0.9 ng/mL after therapy, stabilized, and remained durably suppressed. The only identified trends among patients treated with external beam radiotherapy without ST-ADT were declining PSA levels followed by stable PSA trends or declining patterns followed by rising levels. Patients whose PSA levels stabilized after an initial rise or those with slowly rising PSA profiles had a lower incidence of distant metastasis compared to those with accelerated rises after therapy. Conclusions: For those treated with external beam radiotherapy in conjunction with ST-ADT, a significant percentage who develop a rising PSA after treatment are expected to manifest subsequent stabilization at plateaued levels of approximately 1.0 ng/mL, which can remain durably suppressed. The likelihood of distant metastasis in these patients is low despite the PSA stabilization at levels 1.0 ng/mL or higher and comparable to outcomes observed for those

  17. Relationship between cathepsin-D content and disease-free survival in node-negative breast cancer patients: a meta-analysis.

    PubMed Central

    Ferrandina, G.; Scambia, G.; Bardelli, F.; Benedetti Panici, P.; Mancuso, S.; Messori, A.

    1997-01-01

    Several reports have evaluated the correlation between cathepsin-D and overall survival or disease-free survival in node-negative breast cancer patients. Because conflicting data have so far been reported, a meta-analysis was conducted to clarify this problem. Eleven studies were included in our meta-analysis (total of 2690 patients). A specific meta-analytical methodology for censored data was used, and disease-free survival was the primary end point. Patients with low cathepsin-D levels had a significantly better disease-free survival than patients with high cathepsin-D values (meta-analytical odds ratio from 0.59 to 0.60 over the interval from 1 to 7 years). A secondary meta-analysis conducted exclusively on the data from eight studies based on cytosol assay gave substantially similar results. One limitation of our study is that the cut-off values to define high and low cathepsin-D concentrations were not identical in the various studies included in our meta-analysis (range from 20 to 78 pmol mg(-1) protein), thus introducing a possible bias in the statistical analysis of the data. However, a simulation based on the well-accepted method of the so-called publication bias showed that more than 100 null studies would be required to lead our results to a statistical level of non-significance. Considering the results of our meta-analysis, we conclude that the data presently available confirm a statistically significant association between high cathepsin-D values and poor disease-free survival in node-negative breast cancer patients. PMID:9303368

  18. High angiogenic potential in an in vivo rat corneal model is associated with shorter disease-free survival in low-grade oligodendrogliomas.

    PubMed

    Ozkan, Abdulkadir; Guduk, Mustafa; Atabay, Kutay Deniz; Uyar, Süheyla Bozkurt; Seker, Askin; Konya, Deniz; Pamir, M Necmettin; Kilic, Turker

    2011-01-01

    This study aimed to examine the association between time to tumor recurrence, angiogenic potential and tumor contrast-enhancement. Tumor samples were taken from 20 patients with low-grade oligodendroglioma and examined for their angiogenic potential using an in vivo rat corneal model of angiogenesis. Patients were evaluated for tumor contrast enhancement prior to surgical excision using MRI and they were followed for tumor recurrence. Patients who had tumors without contrast enhancement had longer disease-free survival (median time to tumor recurrence, 72 months) compared to those who had tumors with contrast enhancement (median, 42 months; p=0.0068). Based on corneal angiogenesis assay results, a high angiogenic potential was associated with a significantly shorter disease-free survival. Our findings suggest that radiological contrast enhancement and a high angiogenic potential based on an in vivo corneal angiogenesis assay were related to a shorter disease-free survival. This might have important prognostic implications in patients with low-grade oligodendrogliomas.

  19. c-erbB-2 oncoprotein detected by automated quantitative immunocytochemistry in breast carcinomas correlates with patients' overall and disease-free survival.

    PubMed Central

    Charpin, C.; Garcia, S.; Bouvier, C.; Martini, F.; Lavaut, M. N.; Allasia, C.; Bonnier, P.; Andrac, L.

    1997-01-01

    The prognostic significance of c-erbB-2 oncoprotein overexpression detected in tumours by immunocytochemical assays (ICAs) was investigated in 148 breast carcinomas. ICAs were performed under optimal technical conditions with frozen tissue sections and included automated immunoperoxidase technique and computer-assisted analysis (densitometry) of digitized coloured microscopic images. Results of quantitative ICAs (expressed in percentages of c-erbB-2-positive surfaces and mean optical densities) were correlated with the patients' follow-up in axillary lymph node-positive (N+) and node-negative (N-) subgroups of patients. Patients' follow-up ranged from 9 months (for the first death) to 101 months (for the 121 alive patients) with a 62.5 months mean overall follow-up. It was shown that marked c-erbB-2 immunocytochemical expression in tumours (cut-off point 35%) significantly correlated with the patients' poor overall survival in N+ and in N- patients (Kaplan-Meier, log-rank test, P = 0.045 and P = 0.015). Also, marked c-erbB-2 immunohistochemical expression correlates with short disease-free (P = 0.005), recurrence-free (P = 0.048) and metastasis-free survival (P = 0.05) (Kaplan-Meier, log-rank test) in N+, but not in N- subgroups. It is concluded that in optimal conditions (automated and quantitative ICAs on frozen sections) c-erbB immunohistochemical expression is a significant prognostic indicator in terms of overall and disease-free survival. The c-erbB-2 protein prognostic significance is independent of node status in terms of overall survival, but not of disease-free survival. Images Figure 1 PMID:9184184

  20. Medication compliance and comorbid substance abuse in schizophrenia: impact on community survival 4 years after a relapse.

    PubMed

    Hunt, Glenn E; Bergen, Jenny; Bashir, Marie

    2002-04-01

    This prospective study examined the effect of medication compliance and substance abuse on 4 year outcome in 99 patients following a relapse of schizophrenia. Univariate survival analysis revealed longer community tenure in patients if they were over the age of 35 years, not admitted 2 years prior to the index episode, remained medication compliant and did not abuse substances during the follow-up interval. Comparisons between patients grouped according to medication compliance and current substance abuse indicated that those patients who regularly took their medication but also abused substances were readmitted to hospital sooner (median survival, 10 months) compared to compliant patients who did not use substances (37 months). For noncompliant patients, time to first readmission was shorter for patients with a dual diagnosis (5 months) compared to patients with a singular diagnosis of schizophrenia (10 months). Over the 4 year period, noncompliant patients with a dual diagnosis (n=28) accounted for 57% of all hospital readmissions for the cohort and averaged 1.5 admissions per patient year. These data indicate that much of the benefit that antipsychotic medication has on increasing community survival is reduced by substance abuse. This interval is further reduced in patients who are both substance abusers and noncompliant with medication resulting in a revolving door situation of frequent hospital admissions. Integrated treatment programs which address these issues are likely to reduce the need for hospital readmission in patients with a dual diagnosis. PMID:11950550

  1. A novel truncated form of S100P predicts disease-free survival in patients with lymph node positive breast cancer.

    PubMed

    Chung, Liping; Phillips, Leo; Lin, Mike Z; Moore, Katrina; Marsh, Deborah J; Boyle, Frances M; Baxter, Robert C

    2015-11-01

    The calcium-binding protein S100P is overexpressed in various cancers and may contribute to the oncogenic phenotype. This study used mass spectrometry to characterize a novel 9.2-kDa C-terminally truncated form of S100P (t-S100P), and to investigate its potential prognostic value in breast cancer. Univariate analysis demonstrated the association between breast tissue t-S100P levels (n = 148) and conventional pathological markers. Across all tumor samples, high t-S100P was strongly prognostic for poor disease-free survival (P = 0.005), its efficacy confined to lymph node-positive tumors (n = 74, P = 0.007). Matrix-assisted laser desorption/ionization imaging mass spectrometry confirmed differential t-S100P abundance between breast cancer and unaffected adjacent tissue. t-S100P was exclusively located in the cell nucleus of breast cancer tissue, and full-length S100P was essentially undetectable by mass spectrometry. We conclude that t-S100P is the predominant form of S100P in breast cancer tissue and is strongly prognostic for disease-free survival in women with lymph node-positive disease.

  2. A novel truncated form of S100P predicts disease-free survival in patients with lymph node positive breast cancer.

    PubMed

    Chung, Liping; Phillips, Leo; Lin, Mike Z; Moore, Katrina; Marsh, Deborah J; Boyle, Frances M; Baxter, Robert C

    2015-11-01

    The calcium-binding protein S100P is overexpressed in various cancers and may contribute to the oncogenic phenotype. This study used mass spectrometry to characterize a novel 9.2-kDa C-terminally truncated form of S100P (t-S100P), and to investigate its potential prognostic value in breast cancer. Univariate analysis demonstrated the association between breast tissue t-S100P levels (n = 148) and conventional pathological markers. Across all tumor samples, high t-S100P was strongly prognostic for poor disease-free survival (P = 0.005), its efficacy confined to lymph node-positive tumors (n = 74, P = 0.007). Matrix-assisted laser desorption/ionization imaging mass spectrometry confirmed differential t-S100P abundance between breast cancer and unaffected adjacent tissue. t-S100P was exclusively located in the cell nucleus of breast cancer tissue, and full-length S100P was essentially undetectable by mass spectrometry. We conclude that t-S100P is the predominant form of S100P in breast cancer tissue and is strongly prognostic for disease-free survival in women with lymph node-positive disease. PMID:26276712

  3. Combined heavy smoking and drinking predicts overall but not disease-free survival after curative resection of locoregional esophageal squamous cell carcinoma

    PubMed Central

    Sun, Peng; Chen, Cui; Zhang, Fei; Yang, Hang; Bi, Xi-Wen; An, Xin; Wang, Feng-Hua; Jiang, Wen-Qi

    2016-01-01

    Introduction The prognostic impact of smoking and drinking on esophageal squamous cell carcinoma (ESCC) was scarcely discussed. We investigated the prognostic value of smoking and drinking and their relationships with clinicopathological characteristics in a large cohort of patients with locoregional ESCC. Patients and methods We retrospectively analyzed 488 patients who underwent curative treatment at a single institution between January 2007 and December 2008. A chi-square test was used to evaluate the relationships between smoking and drinking and clinicopathological variables, the Kaplan–Meier method was used for 5-year overall survival (OS) and disease-free survival, and Cox proportional hazards models were applied for univariate and multivariate analyses of variables with respect to OS and disease-free survival. Results Heavy smokers were more likely to have advanced Tumor-Node-Metastases (TNM) stage and higher neutrophil/lymphocyte ratio at diagnosis (P<0.05). Drinkers were more likely to have advanced TNM stage, to present with a larger tumor, and to undergo multidisciplinary treatment (P<0.05). For patients who used neither heavy tobacco nor alcohol, used either tobacco or alcohol, and used both, the 5-year OS rates and OS times were 57.4%, 46.4%, and 39.1% (P<0.05) and not reached, 55.2 months, and 41.2 months (P<0.05), respectively. On multivariate analysis, patients who both heavily smoked and drank had 1.392 times the risk of dying during follow-up compared with neither-users (95% CI =1.020–1.901, P=0.037). Conclusion We identified that combined heavy smoking and drinking might predict poor prognosis in ESCC patients. PMID:27471400

  4. Chemosensitivity of nonleukemic clonogenic precursors in AML patients in complete remission: association with CD34(+) mobilization and with disease-free survival.

    PubMed

    Milone, Giuseppe; Avola, Giuseppe; Leotta, Salvatore; Strano, Aurora; Camuglia, Maria Grazia; Pinto, Valeria; Mercurio, Salvatore; Poidomani, Massimo; Coppoletta, Stefania; Di Marco, Anna Lia; Consoli, Carla; Triolo, Anna; Spadaro, Andrea; Privitera, Antonella; Ragusa, Angela; Tibullo, Daniele; Di Mercurio, Sandra

    2012-01-01

    A high number of CD34(+) cells in the peripheral blood during mobilization in patients with acute myeloid leukemia (AML) in complete remission (CR) is associated with a high relapse rate. The variability in chemoresistance of normal bone marrow precursors has been hypothesized as explanation for the variable CD34 mobilization in AML. In 37 patients with AML in CR, we determined the chemosensitivity of bone marrow clonogenic precursors to maphosphamide and etoposide, which was then correlated with the degree of CD34(+) mobilization. In an enlarged set of 49 patients, we also studied the importance of chemosensitivity of marrow precursors for disease-free survival and relapse incidence. Significant correlations were demonstrated between the peak number of CD34(+) cells and residual growth of colony-forming unit granulocyte-macrophage (CFU-GM) after maphosphamide (R = 0.550; p = 0.0003) and after etoposide (R = 0.793; p = 0.0003). It was possible to identify three groups of AML patients based on chemosensitivity. The mean CD34(+) peak was 33 × 10(6)/L in the hyperchemosensitive group, 141 × 10(6)/L in the normochemosensitive (p = 0.03), and 379 × 10(6)/L in the chemoresistant group (p = 0.002). Failed CD34(+) mobilization was observed in 72% of the hyperchemosensitive group, 23% of the normochemosensitive group, and 0% of the chemoresistant group (p = 0.001). Hyperchemosensitivity of CFU-GM, together with a low platelet count, were independent factors important in the failure of CD34(+) cell mobilization. A disease-free survival significantly inferior to that of all other patients was associated with chemoresistance of CFU-GM (log rank, p = 0.030) and with chemoresistance of burst-forming unit erythroid (BFU-E) (log rank, p = 0.033). Chemoresistance of CFU-GM (p = 0.048) and BFU-E (p = 0.017) was also associated with increase relapse incidence. Nonleukemic nature of these precursors was demonstrated studying minimal residual disease from single colony cells

  5. Brain metastasis of ALK positive anaplastic large cell lymphoma after a long-term disease free survival in an old adult

    PubMed Central

    Wang, Cai-Xia; Wang, Hai; Li, Jie; Ma, Heng-Hui; Yu, Bo; Shi, Shan-Shan; Zhou, Xiao-Jun; Shi, Qun-Li

    2014-01-01

    Anaplastic large cell lymphoma (ALCL) is a subtype of non-Hodgkin lymphoma composed of CD30-positive cells and now recognized as three different entities: primary cutaneous ALCL, primary systemic anaplastic lymphoma kinase (ALK)-positive (ALK+) ALCL and primary ALK-negative (ALK-) ALCL. ALK+ ALCL is supposed to have a better prognosis than ALK- ALCL. It is rarely metastasized to other sites, especially to the central nervous system (CNS). Herein, we present a rare case of systemic ALK+ ALCL which metastasized to the brain after a long-term disease free survival in an adult. Neuroimaging revealed a well-enhanced mass in the left frontal lobe. And it was completely resected. The results of the pathological and immunohistochemical studies were consistent with the metastasized ALK+ ALCL. The clinical findings, pathologic characteristics and treatment are described. PMID:24696735

  6. [Disease-free survival in a patient with squamous cell lung carcinoma following complete response with the combination chemotherapy of cisplatin and etoposide].

    PubMed

    Taniwaki, M; Kakusui, M; Imoto, M; Takashima, T; Misawa, S; Kashima, K

    1993-05-01

    Disease-free survival is reported in a patient with non-small cell lung carcinoma successfully treated with the combination chemotherapy of cisplatin and etoposide (CDDP-ETOP). An 80-year-old woman was diagnosed as having squamous cell carcinoma of the lung with bone metastasis. Chest X-ray showed a tumor (64 x 68 mm in size) in the S1/4 segment of the right lobe, and CT scan revealed no apparent metastasis of hilar lymphnode. In March 1989, the patient achieved a complete response (CR) after two courses of CDDP-ETOP therapy, followed by ETOP(100mg) every two weeks and daily UFT (400 mg) for 10 months. Subsequently, a single course of CDDP-ETOP was administered as a consolidation therapy. The patient is alive with no evidence of recurrent disease for 3 years and half after achieving CR.

  7. Disease-free and overall survival of patients diagnosed with HPV-associated or HPV-negative cervical cancer

    NASA Astrophysics Data System (ADS)

    Ibragimova, M. K.; Tsyganov, M. M.; Karabut, I. V.; Kolomiets, L. A.; Choynzonov, E. L.; Litviakov, N. V.

    2015-11-01

    The real-time PCR method is used to study scrapings of cervical epithelium and outer portion of the cervix in 116 patients aged 24-79 years with stage I-IV primary cervical cancer. The comprehensive survey included colposcopy, cytological and histological analysis, detection and genotyping of high-risk human papillomavirus. In 84 patients (72.4%) the presence of human papillomavirus (HPV) of high carcinogenic risk (HCR) is found, in 32 patients (27.6%) the presence of the virus has not been inspected in the tumor. A significant decrease in the survival rate as well as the prevalence of the worst prognosis for patients with HPV-negative cervical cancer are shown.

  8. Reduced intensity haplo plus single cord transplant compared to double cord transplant: improved engraftment and graft-versus-host disease-free, relapse-free survival

    PubMed Central

    van Besien, Koen; Hari, Parameswaran; Zhang, Mei-Jie; Liu, Hong-Tao; Stock, Wendy; Godley, Lucy; Odenike, Olatoyosi; Larson, Richard; Bishop, Michael; Wickrema, Amittha; Gergis, Usama; Mayer, Sebastian; Shore, Tsiporah; Tsai, Stephanie; Rhodes, Joanna; Cushing, Melissa M.; Korman, Sandra; Artz, Andrew

    2016-01-01

    Umbilical cord blood stem cell transplants are commonly used in adults lacking HLA-identical donors. Delays in hematopoietic recovery contribute to mortality and morbidity. To hasten recovery, we used co-infusion of progenitor cells from a partially matched related donor and from an umbilical cord blood graft (haplo-cord transplant). Here we compared the outcomes of haplo-cord and double-cord transplants. A total of 97 adults underwent reduced intensity conditioning followed by haplo-cord transplant and 193 patients received reduced intensity conditioning followed by double umbilical cord blood transplantation. Patients in the haplo-cord group were more often from minority groups and had more advanced malignancy. Haplo-cord recipients received fludarabine-melphalan-anti-thymocyte globulin. Double umbilical cord blood recipients received fludarabine-cyclophosphamide and low-dose total body irradiation. In a multivariate analysis, haplo-cord had faster neutrophil (HR=1.42, P=0.007) and platelet (HR=2.54, P<0.0001) recovery, lower risk of grade II–IV acute graft-versus-host disease (HR=0.26, P<0.0001) and chronic graft-versus-host disease (HR=0.06, P<0.0001). Haplo-cord was associated with decreased risk of relapse (HR 0.48, P=0.001). Graft-versus-host disease-free, relapse-free survival was superior with haplo-cord (HR 0.63, P=0.002) but not overall survival (HR=0.97, P=0.85). Haplo-cord transplantation using fludarabine-melphalan-thymoglobulin conditioning hastens hematopoietic recovery with a lower risk of relapse relative to double umbilical cord blood transplantation using the commonly used fludarabine-cyclophosphamide-low-dose total body irradiation conditioning. Graft-versus-host disease-free and relapse-free survival is significantly improved. Haplo-cord is a readily available graft source that improves outcomes and access to transplant for those lacking HLA-matched donors. Trials registered at clinicaltrials.gov identifiers 00943800 and 01810588. PMID

  9. A modified duodenal neuroendocrine tumor staging schema better defines the risk of lymph node metastasis and disease-free survival.

    PubMed

    Kachare, Swapnil D; Liner, Kendall R; Vohra, Nasreen A; Zervos, Emmanuel E; Fitzgerald, Timothy L

    2014-08-01

    Duodenal neuroendocrine tumors are rare but increasing in incidence and optimal management is hindered by lack of duodenum-specific staging. Duodenal carcinoids were identified in the Surveillance, Epidemiology and End Results tumor registry. Depth of invasion was defined as limited to lamina propria (LP), invading muscularis propria (MP), through muscularis propria (TMP), and through serosa (S). Nine hundred forty-nine patients were identified with majorities being male (57%), white (70%), and node-negative (87%). Tumor size (cm) was less than 1, 47 per cent; 1 to 2, 35 per cent; and greater than 2, 8 per cent with 76 per cent LP. Lymph node (LN) involvement was associated with age, depth of invasion (LP 4%, MP 28%, TMP 54%, and S 57%) and size (less than 1 cm, 3%; 1 to 2 cm, 13%; and greater than 2 cm, 40%). Using the current T staging, LN involvement was: T1 (LP) 2 per cent, T2 (MP or greater than 1 cm) 13 per cent, T3 (TMP) 54 per cent, and T4 (S) 57 per cent. We reclassified current T1 to T1a and current T2 stage to T1b (1 to 2 cm and LP) and T2 (MP or greater than 2 cm). LN metastasis for T1b tumors was 4.7 per cent compared with 20.8 per cent for T2. The resulting TNM classification better defines 5-year disease-specific survival. Our modified staging schema identifies a low-risk group (T1a and T1b) that may be considered for local therapy.

  10. Adjuvant Cytokine-Induced Killer Cell Therapy Improves Disease-Free and Overall Survival in Solitary and Nonmicrovascular Invasive Hepatocellular Carcinoma After Curative Resection

    PubMed Central

    Chen, Jian-Lin; Lao, Xiang-Ming; Lin, Xiao-Jun; Xu, Li; Cui, Bo-Kang; Wang, Jun; Lin, Guo-He; Shuang, Ze-Yu; Mao, Yi-Ze; Huang, Xin; Yun, Jing-Ping; Jin, Jie-Tian; Li, Sheng-Ping

    2016-01-01

    Abstract Cytokine-induced killer (CIK) cell therapy has recently been used as an adjuvant setting following resection of hepatocellular carcinoma (HCC), while its benefit remains unclear. This study aimed to evaluate the efficacy of adjuvant CIK application in solitary HCC patients undergoing curative resection with stratification of microvascular invasion (MVI). In total, specimens and data from 307 solitary HCC patients undergoing curative resection between January 2007 and December 2010 were included. Of these, 102 patients received CIK treatment after surgery (CIK group), whereas 205 patients did not (control group). Pathological evaluation was used to retrospectively determine MVI status. The CIK group had 60 MVI-negative and 42 MVI-positive patients, while the numbers in control group were 124 and 81. Kaplan-Meier and Cox regression analyses were used to validate possible effects of CIK treatment on disease free survival (DFS) and overall survival (OS) as appropriate. For all patients, the CIK group exhibited significantly higher OS than the control group (log-rank test; PDFS = 0.055, POS = 0.020). Further analysis based on MVI stratification showed that for patients with MVI, DFS and OS did not differ between the 2 groups (PDFS = 0.439, POS = 0.374). For patients without MVI, the CIK group exhibited better DFS and OS than the control group (PDFS = 0.042, POS = 0.007), and multivariate analyses demonstrated that CIK treatment was an independent prognostic factor both for DFS and OS. For solitary HCC, CIK cell therapy after curative resection improves DFS and OS for patients without MVI, but has no statistically significant survival benefit for patients with MVI. PMID:26844496

  11. BRAF V600E mutation correlates with suppressive tumor immune microenvironment and reduced disease-free survival in Langerhans cell histiocytosis.

    PubMed

    Zeng, Kaixuan; Wang, Zhe; Ohshima, Koichi; Liu, Yixiong; Zhang, Weichen; Wang, Lu; Fan, Linni; Li, Mingyang; Li, Xia; Wang, Yingmei; Yu, Zhou; Yan, Qingguo; Guo, Shuangping; Wei, Jie; Guo, Ying

    2016-07-01

    Langerhans cell histiocytosis (LCH) is a neoplasm of myeloid origin characterized by a clonal proliferation of CD1a(+)/CD207(+) dendritic cells. Recurrent BRAF V600E mutation has been reported in LCH. In the present report, we confirm the feasibility of the high-specificity monoclonal antibody VE1 for detecting BRAF V600E mutation in 36/97 (37.1%) retrospectively enrolled patients with LCH; concordant immunohistochemistry and Sanger sequencing results were seen in 94.8% of cases. We then assessed the tumor immune microenvironment status in LCH, and found that the GATA binding protein 3 (GATA3)(+)/T-bet(+) ratio could distinguish between clinical multi-system/single-system (SS) multifocal and SS unifocal LCH. Notably, we found that BRAF V600E mutation is significantly correlated with increased programmed cell death 1 ligand 1 (PDL1) expression and forkhead box protein 3 (FOXP3)(+) regulatory T cells (p < 0.001, 0.009, respectively). Moreover, Cox multivariate survival analysis showed that BRAF V600E mutation and PDL1 were independent prognostic factors of poor disease-free survival (DFS) in LCH (hazard ratio [HR] = 2.38, 95% confidence interval [CI] 1.02-5.56, p = 0.044; HR = 3.06, 95%CI 1.14-7.14, p = 0.025, respectively), and the superiority of PDL1 in sensitivity and specificity as biomarker for DFS in LCH was demonstrated by receiver operator characteristic (ROC) curves when compared with BRAF V600E and risk category. Collectively, this study identifies for the first time relationship between BRAF V600E mutation and a suppressive tumor immune microenvironment in LCH, resulting in disruption of host-tumor immune surveillance, which is DFS. Our findings may provide a rationale for combining immunotherapy and BRAF-targeted therapy for treating patients with BRAF V600E mutant LCH. PMID:27622040

  12. BRAF V600E mutation correlates with suppressive tumor immune microenvironment and reduced disease-free survival in Langerhans cell histiocytosis

    PubMed Central

    Zeng, Kaixuan; Wang, Zhe; Ohshima, Koichi; Liu, Yixiong; Zhang, Weichen; Wang, Lu; Fan, Linni; Li, Mingyang; Li, Xia; Wang, Yingmei; Yu, Zhou; Yan, Qingguo; Guo, Shuangping; Wei, Jie; Guo, Ying

    2016-01-01

    ABSTRACT Langerhans cell histiocytosis (LCH) is a neoplasm of myeloid origin characterized by a clonal proliferation of CD1a+/CD207+ dendritic cells. Recurrent BRAF V600E mutation has been reported in LCH. In the present report, we confirm the feasibility of the high-specificity monoclonal antibody VE1 for detecting BRAF V600E mutation in 36/97 (37.1%) retrospectively enrolled patients with LCH; concordant immunohistochemistry and Sanger sequencing results were seen in 94.8% of cases. We then assessed the tumor immune microenvironment status in LCH, and found that the GATA binding protein 3 (GATA3)+/T-bet+ ratio could distinguish between clinical multi-system/single-system (SS) multifocal and SS unifocal LCH. Notably, we found that BRAF V600E mutation is significantly correlated with increased programmed cell death 1 ligand 1 (PDL1) expression and forkhead box protein 3 (FOXP3)+ regulatory T cells (p < 0.001, 0.009, respectively). Moreover, Cox multivariate survival analysis showed that BRAF V600E mutation and PDL1 were independent prognostic factors of poor disease-free survival (DFS) in LCH (hazard ratio [HR] = 2.38, 95% confidence interval [CI] 1.02–5.56, p = 0.044; HR = 3.06, 95%CI 1.14–7.14, p = 0.025, respectively), and the superiority of PDL1 in sensitivity and specificity as biomarker for DFS in LCH was demonstrated by receiver operator characteristic (ROC) curves when compared with BRAF V600E and risk category. Collectively, this study identifies for the first time relationship between BRAF V600E mutation and a suppressive tumor immune microenvironment in LCH, resulting in disruption of host–tumor immune surveillance, which is DFS. Our findings may provide a rationale for combining immunotherapy and BRAF-targeted therapy for treating patients with BRAF V600E mutant LCH.

  13. Association of Estrogen Receptor Alpha and Interleukin 6 Polymorphisms with Lymphovascular Invasion, Extranodal Extension, and Lower Disease-Free Survival in Thai Breast Cancer Patients.

    PubMed

    Sa-Nguanraksa, Doonyapat; Suntiparpluacha, Monthira; Kulprom, Anchalee; Kummalue, Tanawan; Chuangsuwanich, Tuenjai; Avirutnan, Panissadee; O-Charoenrat, Pornchai

    2016-01-01

    Breast cancer is the most frequent type of cancer diagnosed among women worldwide and also in Thailand. Estrogen and estrogen receptors exert important roles in its genesis and progression. Several cytokines have been reported to be involved in the microenvironment that promotes distant metastasis via modulation of immune and inflammatory responses to tumor cells. Estrogen receptor genetic polymorphisms and several cytokines have been reported to be associated with breast cancer susceptibility and aggressiveness. To investigate roles of genetic polymorphisms in estrogen receptor alpha (ESR1) and interleukin 6 (IL6), breast cancer patients and control subjects were recruited from the Division of Head, Neck and Breast Surgery (Siriraj Hospital, Bangkok, Thailand). Polymorphisms in ESR1 (rs3798577) and IL6 (rs1800795 and rs1800797) were evaluated by real-time PCR in 391 breast cancer patients and 79 healthy controls. Associations between genetic polymorphisms and clinicopathological data were determined. There was no association between genetic polymorphisms and breast cancer susceptibility. However the ESR1 rs3798577 CT genotype was associated with presence of lymphovascular invasion (OR=2.07, 95%CI 1.20-3.56, p=0.009) when compared to the TT genotype. IL6 rs1800795 CC genotype was associated with presence of extranodal extension (OR= 2.30, 95%CI 1.23-4.31, p=0.009) when compared to the GG genotype. Survival analysis showed that IL6 rs1800797 AG or AA genotypes were associated with lower disease-free survival. These findings indicate that polymorphisms in ESR1 and IL6 contribute to aggressiveness of breast cancer and may be used to identify high risk patients. PMID:27356714

  14. Gene polymorphisms in cyclophosphamide metabolism pathway, treatment-related toxicity and disease-free survival in SWOG 8897 clinical trial for breast cancer

    PubMed Central

    Yao, Song; Barlow, William E.; Albain, Kathy S.; Choi, Ji-Yeob; Zhao, Hua; Livingston, Robert B.; Davis, Warren; Rae, James M.; Yeh, I-Tien; Hutchins, Laura F.; Ravdin, Peter M.; Martino, Silvana; Lyss, Alan P.; Osborne, C. Kent; Abeloff, Martin; Hortobagyi, Gabriel N.; Hayes, Daniel F.; Ambrosone, Christine B.

    2010-01-01

    Purpose There are no established genetic markers for prediction of outcomes after cyclophosphamide (CP)-containing adjuvant therapy for breast cancer. In an ancillary study to a Southwest Oncology Group trial (S8897), we investigated functional polymorphisms in 4 genes in CP pharmacokinetic pathways in relation to hematological toxicity and disease-free survival (DFS). Experimental Design Germline DNA was available from 458 women who were at high risk of relapse and randomized to CAF vs CMF ± tamoxifen and from 874 women who had a presumed favorable prognosis and did not receive adjuvant therapy. Odds ratios for grade 3 and 4 hematological toxicity in the treated group and hazard ratios for DFS associated with selected functional polymorphisms in CYP2B6, CYP3A4, GSTA1, and GSTP1 were estimated by logistic regression and Cox proportional hazard regression. Results Compared to women with AA genotypes, those with at least one GSTP1 variant G allele had reduced risk of grade 3 and 4 neutropenia (OR=0.63, 95% CI=0.41–0.97) and leucopenia (OR=0.59, 95% CI=0.39–0.89). No other associations between SNPs and toxicity or survival were found in the treated or untreated group. Conclusion Known genetic variants in genes involved in CP pharmacokinetics may not have major effects on DFS in breast cancer patients. The lower risk of developing high grade hematological toxicity among women with variant GSTP1 alleles suggests that genetic markers in combination with clinical factors may be useful in defining a subgroup of women who are less susceptible to adverse hematological toxicities with CP-containing therapies. PMID:21169260

  15. BRAF V600E mutation correlates with suppressive tumor immune microenvironment and reduced disease-free survival in Langerhans cell histiocytosis

    PubMed Central

    Zeng, Kaixuan; Wang, Zhe; Ohshima, Koichi; Liu, Yixiong; Zhang, Weichen; Wang, Lu; Fan, Linni; Li, Mingyang; Li, Xia; Wang, Yingmei; Yu, Zhou; Yan, Qingguo; Guo, Shuangping; Wei, Jie; Guo, Ying

    2016-01-01

    ABSTRACT Langerhans cell histiocytosis (LCH) is a neoplasm of myeloid origin characterized by a clonal proliferation of CD1a+/CD207+ dendritic cells. Recurrent BRAF V600E mutation has been reported in LCH. In the present report, we confirm the feasibility of the high-specificity monoclonal antibody VE1 for detecting BRAF V600E mutation in 36/97 (37.1%) retrospectively enrolled patients with LCH; concordant immunohistochemistry and Sanger sequencing results were seen in 94.8% of cases. We then assessed the tumor immune microenvironment status in LCH, and found that the GATA binding protein 3 (GATA3)+/T-bet+ ratio could distinguish between clinical multi-system/single-system (SS) multifocal and SS unifocal LCH. Notably, we found that BRAF V600E mutation is significantly correlated with increased programmed cell death 1 ligand 1 (PDL1) expression and forkhead box protein 3 (FOXP3)+ regulatory T cells (p < 0.001, 0.009, respectively). Moreover, Cox multivariate survival analysis showed that BRAF V600E mutation and PDL1 were independent prognostic factors of poor disease-free survival (DFS) in LCH (hazard ratio [HR] = 2.38, 95% confidence interval [CI] 1.02–5.56, p = 0.044; HR = 3.06, 95%CI 1.14–7.14, p = 0.025, respectively), and the superiority of PDL1 in sensitivity and specificity as biomarker for DFS in LCH was demonstrated by receiver operator characteristic (ROC) curves when compared with BRAF V600E and risk category. Collectively, this study identifies for the first time relationship between BRAF V600E mutation and a suppressive tumor immune microenvironment in LCH, resulting in disruption of host–tumor immune surveillance, which is DFS. Our findings may provide a rationale for combining immunotherapy and BRAF-targeted therapy for treating patients with BRAF V600E mutant LCH. PMID:27622040

  16. Factors affecting disease-free survival in patients with human epidermal growth factor receptor 2-positive breast cancer who receive adjuvant trastuzumab

    PubMed Central

    GÜNDÜZ, SEYDA; GÖKSU, SEMA SEZGIN; ARSLAN, DENIZ; TATLI, ALI MURAT; UYSAL, MÜKREMIN; GÜNDÜZ, UMUT RIZA; SEVINÇ, MERT MAHSUNI; COŞKUN, HASAN SENOL; BOZCUK, HAKAN; MUTLU, HASAN; SAVAS, BURHAN

    2015-01-01

    Breast cancer is the most frequently diagnosed cancer in women worldwide and the second cause of cancer-related mortality. A total of 20–30% of patients with early-stage breast cancer develop recurrence within the first 5 years following diagnosis. Trastuzumab significantly improves overall survival and disease-free survival (DFS) in women with human epidermal growth factor receptor 2 (HER2)-positive early and locally advanced breast cancer. This study aimed to determine the factors that affect DFS following adjuvant transtuzumab therapy. A total of 62 patients treated with trastuzumab for early and locally advanced breast cancer were included in our study. Data, including pathology, treatment and treatment outcome, rate of recurrence and laboratory tests, were retrospectively collected. There was no significant association between DFS and age, menopausal status, disease stage and hormone receptor status. The median follow-up was 48.4 months. The median DFS of patients treated with adjuvant trastuzumab was 64.1 months. In addition, the median DFS was 44.3 vs. 66.8 months in patients with platelet-lymphocyte ratio (PLR) ≤200 vs. >200, respectively (log-rank test; P=0.001), and 70 vs. 45 months in patients with eosinophil count ≤70 vs. >70×103/mm3 (log-rank test; P=0.001). Our data revealed the prognostic relevance of a decrease in the peripheral blood eosinophil count and PLR value following trastuzumab therapy in breast cancer. PLR and eosinophil count measurements are cost-effective, readily available worldwide, non-invasive and safe. Combined with other markers, such as patient age, tumor stage and tumor histology, may be effectively used for patients with breast cancer. PMID:26623060

  17. Pulmonary function changes after radiotherapy in non-small-cell lung cancer patients with long-term disease-free survival

    SciTech Connect

    Borst, Gerben R.; Jaeger, Katrien de; Belderbos, Jose; Burgers, Sjaak A.; Lebesque, Joos V. . E-mail: j.lebesque@nki.nl

    2005-07-01

    Purpose: To evaluate the changes in pulmonary function after high-dose radiotherapy (RT) for non-small-cell lung cancer in patients with a long-term disease-free survival. Methods and Materials: Pulmonary function was measured in 34 patients with inoperable non-small-cell lung cancer before RT and at 3 and 18 months of follow-up. Thirteen of these patients had a pulmonary function test (PFT) 36 months after RT. The pulmonary function parameters (forced expiratory volume in 1 s [FEV{sub 1}], diffusion capacity [T{sub lcoc}], forced vital capacity, and alveolar volume) were expressed as a percentage of normal values. Changes were expressed as relative to the pre-RT value. We evaluated the impact of chronic obstructive pulmonary disease, radiation pneumonitis, mean lung dose, and PFT results before RT on the changes in pulmonary function. Results: At 3, 18, and 36 months, a significant decrease was observed for the T{sub lcoc} (9.5%, 14.6%, and 22.0%, respectively) and the alveolar volume (5.8%, 6.6%, and 15.8%, respectively). The decrease in FEV{sub 1} was significant at 18 and 36 months (8.8% and 13.4%, respectively). No recovery of any of the parameters was observed. Chronic obstructive pulmonary disease was an important risk factor for larger PFT decreases. FEV{sub 1} and T{sub lcoc} decreases were dependent on the mean lung dose. Conclusion: A significant decrease in pulmonary function was observed 3 months after RT. No recovery in pulmonary function was seen at 18 and 36 months after RT. The decrease in pulmonary function was dependent on the mean lung dose, and patients with chronic obstructive pulmonary disease had larger reductions in the PFTs.

  18. Ten-year Biochemical Disease-free Survival After High-intensity Focused Ultrasound (HIFU) for Localized Prostate Cancer: Comparison with Four Different Generation Devices

    SciTech Connect

    Uchida, T.; Nakano, M.; Shoji, S.; Omata, T.; Harano, Y.; Nagata, Y.; Usui, Y.; Terachi, T.

    2010-03-09

    HIFU has been recognized as a minimally invasive treatment option for localized prostate cancer. The purpose of the study was to assess with a long-term outcome of HIFU for prostate cancer. From January 1999, a total of 657 patients who had HIFU with at least 2 year follow-up were treated with four different types of Sonablate registered (Focus Surgery, Indianapolis, USA) devices. Thirty-three patients were treated with Sonablate registered 200 (S200) from 1999 to 2001, 406 patients with Sonablate registered 500 (S500) from 2001 to 2005, 200 patients with Sonablate registered 500 version 4 (V4) from 2005-2008 and 19 patients with Sonablate registered 500 TCM (TCM) from 2007. Biochemical disease-free survival rate (bDFS) in all patients was 59% in 8 years. bDFS in 8 years in patients with S200 and S500 groups were 55% and 56%, and bDFS in 4 and 2 years in patients with V4 and TCM group were 72% and 84%, respectively. bDFS in low, intermediate, and high risk groups were 75%, 54%, and 43% in S200/S500 and 93%, 72%, and 58% in V4/TCM group. Negative prostate biopsy rate after HIFU was 97% in S200, 79% in S500, 94% in V4 and 100% in TCM group. HIFU as primary therapy for prostate cancer is indicated in patients with low- and intermediate-risk (T1-T2b N0M0 disease, a Gleason score of <=7, a PSA level of <20 ng/mL) and a prostate volume of less than 40 mL. The rate of clinical outcome has significantly improved over the years due to technical improvements in the device.

  19. Nitric oxide synthase (NOS3) variants and disease-free survival among treated and untreated breast cancer patients in a SWOG Clinical Trial (S8897)

    PubMed Central

    Choi, Ji-Yeob; Barlow, William E.; Albain, Kathy S.; Hong, Chi-Chen; Blanco, Javier G.; Livingston, Robert B.; Davis, Warren; Rae, James M.; Yeh, I-Tien; Hutchins, Laura F.; Ravdin, Peter M.; Martino, Silvana; Lyss, Alan P.; Osborne, C. Kent; Abeloff, Martin D.; Hayes, Daniel F.; Ambrosone, Christine B.

    2009-01-01

    Purpose Numerous chemotherapeutic agents are cytotoxic through generation of reactive species, and variability in genes related to oxidative stress may influence disease free survival (DFS). We examined relationships between DFS and variants in NOS3, as well as NQO1, NQO2 and CBR3 among treated and untreated breast cancer patients in a Southwest Oncology Group clinical trial (S8897). Experimental Design In the parent trial, women were assigned according to prognostic features; the high risk group was randomized to CMF or CAF ± tamoxifen, and the low risk group did not receive adjuvant therapy. We extracted DNA from normal lymph node tissue and examined functional polymorphisms in NOS3, NQO1, NQO2 and CBR3, in relation to DFS, using Cox proportional hazard model. Results There were significant interactions between DFS, adjuvant therapy, and NOS3 Glu298Asp and -786 polymorphisms, alone and in combination (p for interaction=0.008). When NOS3 genotypes were combined, women with genotypes encoding for lower NO who received chemotherapy had more than a two fold increase in hazard of progression (HR=2.32, 95% CI=1.26-4.25), while there was reduced risk for those who did not receive adjuvant therapy (HR=0.42, 95% CI=0.19-0.95). There were no associations between the other genotypes and DFS in either group. Conclusion Variants encoding lower activity of NOS3 may affect outcomes in breast cancer patients, with the direction of risk differing depending upon chemotherapy status. These results may mirror the known dual functions of NO and NOS, depending upon oxidative environment. PMID:19671875

  20. Pathologic Nodal Classification Is the Most Discriminating Prognostic Factor for Disease-Free Survival in Rectal Cancer Patients Treated With Preoperative Chemoradiotherapy and Curative Resection

    SciTech Connect

    Kim, Tae Hyun; Chang, Hee Jin; Kim, Dae Yong

    2010-07-15

    Purpose: We retrospectively evaluated the effects of clinical and pathologic factors on disease-free survival (DFS) with the aim of identifying the most discriminating factor predicting DFS in rectal cancer patients treated with preoperative chemoradiotherapy (CRT) and curative resection. Methods and Materials: The study involved 420 patients who underwent preoperative CRT and curative resection between August 2001 and October 2006. Gender, age, distance from the anal verge, histologic type, histologic grade, pretreatment carcinoembryonic antigen (CEA) level, cT, cN, cStage, circumferential resection margin, type of surgery, preoperative chemotherapy, adjuvant chemotherapy, ypT, ypN, ypStage, and tumor regression grade (TRG) were analyzed to identify prognostic factors associated with DFS. To compare the discriminatory prognostic ability of four tumor response-related pathologic factors (ypT, ypN, ypStage, and TRG), the Akaike information criteria were calculated. Results: The 5-year DFS rate was 75.4%. On univariate analysis, distance from the anal verge, histologic type, histologic grade, pretreatment CEA level, cT, circumferential resection margin, type of surgery, preoperative chemotherapeutic regimen, ypT, ypN, ypStage, and TRG were significantly associated with DFS. Multivariate analysis showed that the four parameters ypT, ypN, ypStage, and TRG were, consistently, significant prognostic factors for DFS. The ypN showed the lowest Akaike information criteria value for DFS, followed by ypStage, ypT, and TRG, in that order. Conclusion: In our study, ypT, ypN, ypStage, and TRG were important prognostic factors for DFS, and ypN was the most discriminating factor.

  1. Absence of Gamma-Interferon-Inducible Lysosomal Thiol Reductase (GILT) Is Associated with Poor Disease-Free Survival in Breast Cancer Patients

    PubMed Central

    Zhou, Cheng-Jun; Liu, Lu; Han, Bo; Kong, Ling-Yu; Gao, Zhong-Cheng; Ma, Zhong-Bing; Wang, Lu; Feng, Man; Chen, Hai-Ying; Jia, Guo-Tao; Gao, De-Zong; Zhang, Qiang; Li, Liang; Li, Yu-Yang; Yu, Zhi-Gang

    2014-01-01

    Tumor immunosurveillance is known to be of critical importance in controlling tumorigenesis and progression in various cancers. The role of gamma-interferon-inducible lysosomal thiol reductase (GILT) in tumor immunosurveillance has recently been studied in several malignant diseases, but its role in breast cancer remains to be elucidated. In the present study, we found GILT as a significant different expressed gene by cDNA microarray analysis. To further determine the role of GILT in breast cancer, we examined GILT expression in breast cancers as well as noncancerous breast tissues by immunohistochemistry and real-time PCR, and assessed its association with clinicopathologic characteristics and patient outcome. The absence of GILT expression increased significantly from 2.02% (2/99) in noncancerous breast tissues to 15.6% (34/218) in breast cancer tissues (P<0.001). In accordance with its proliferation inhibiting function, GILT expression was inversely correlated with Ki67 index (P<0.05). In addition, absence of GILT was positively correlated with adverse characteristics of breast cancers, such as histological type, tumor size, lymph nodes status, and pTNM stage (P<0.05). Consistently, breast cancers with reduced GILT expression had poorer disease-free survival (P<0.005). Moreover, significantly decreased expression of GILT was found in both primary and metastatic breast cancer cells, in contrast to normal epithelial cells. These findings indicate that GILT may act as a tumor suppressor in breast cancer, in line with its previously suggested role in anti-tumor immunity. Thus, GILT has the potential to be a novel independent prognostic factor in breast cancer and further studies are needed to illustrate the underlying mechanism of this relationship. PMID:25333930

  2. Timing of Adjuvant Surgical Oophorectomy in the Menstrual Cycle and Disease-Free and Overall Survival in Premenopausal Women With Operable Breast Cancer

    PubMed Central

    Laudico, Adriano V.; Van Dinh, Nguyen; Allred, D. Craig; Uy, Gemma B.; Quang, Le Hong; Salvador, Jonathan Disraeli S.; Siguan, Stephen Sixto S.; Mirasol-Lumague, Maria Rica; Tung, Nguyen Dinh; Benjaafar, Noureddine; Navarro, Narciso S.; Quy, Tran Tu; De La Peña, Arturo S.; Dofitas, Rodney B.; Bisquera, Orlino C.; Linh, Nguyen Dieu; To, Ta Van; Young, Gregory S.; Hade, Erinn M.; Jarjoura, David

    2015-01-01

    Background: For women with hormone receptor–positive, operable breast cancer, surgical oophorectomy plus tamoxifen is an effective adjuvant therapy. We conducted a phase III randomized clinical trial to test the hypothesis that oophorectomy surgery performed during the luteal phase of the menstrual cycle was associated with better outcomes. Methods: Seven hundred forty premenopausal women entered a clinical trial in which those women estimated not to be in the luteal phase of their menstrual cycle for the next one to six days (n = 509) were randomly assigned to receive treatment with surgical oophorectomy either delayed to be during a five-day window in the history-estimated midluteal phase of the menstrual cycles, or in the next one to six days. Women who were estimated to be in the luteal phase of the menstrual cycle for the next one to six days (n = 231) were excluded from random assignment and received immediate surgical treatments. All patients began tamoxifen within 6 days of surgery and continued this for 5 years. Kaplan-Meier methods, the log-rank test, and multivariable Cox regression models were used to assess differences in five-year disease-free survival (DFS) between the groups. All statistical tests were two-sided. Results: The randomized midluteal phase surgery group had a five-year DFS of 64%, compared with 71% for the immediate surgery random assignment group (hazard ratio [HR] = 1.24, 95% confidence interval [CI] = 0.91 to 1.68, P = .18). Multivariable Cox regression models, which included important prognostic variables, gave similar results (aHR = 1.28, 95% CI = 0.94 to 1.76, P = .12). For overall survival, the univariate hazard ratio was 1.33 (95% CI = 0.94 to 1.89, P = .11) and the multivariable aHR was 1.43 (95% CI = 1.00 to 2.06, P = .05). Better DFS for follicular phase surgery, which was unanticipated, proved consistent across multiple exploratory analyses. Conclusions: The hypothesized benefit of adjuvant luteal phase oophorectomy was

  3. Prostate-Specific Antigen at 4 to 5 Years After Low-Dose-Rate Prostate Brachytherapy Is a Strong Predictor of Disease-Free Survival

    SciTech Connect

    Lo, Andrea C.; Morris, W. James; Lapointe, Vincent; Hamm, Jeremy; Keyes, Mira; Pickles, Tom; McKenzie, Michael; Spadinger, Ingrid

    2014-01-01

    Purpose: To determine (1) the prognostic utility of prostate-specific antigen (PSA) concentration at 45 to 60 months (48mPSA) after low-dose-rate prostate brachytherapy (LDR-PB); (2) the predictors of 48mPSA; and (3) the prognostic utility of directional trends between PSA levels at 24, 36, and 48 months after LDR-PB. Methods and Materials: Between 1998 and 2008, 2223 patients with low- and intermediate-risk prostate cancer received LDR-PB monotherapy. A cohort of 1434 of these patients was identified with a documented 48mPSA and no evidence of disease relapse prior to the 48mPSA. In addition, a subset of this cohort (n=585) was identified with ≥72 months of follow-up and documented PSA values at both 24 and 36 months after implantation. Results: Median follow-up time was 76 months. Eight-year Kaplan-Meier disease-free survival (DFS) rates were 100% vs 73.4% for patients with 48mPSA ≤0.2 vs those with >0.2 ng/mL; 99.1% versus 53.8% for a 48mPSA threshold of ≤0.4 versus >0.4 ng/mL, respectively; and 97.3% versus 0% for a threshold of ≤1.0 versus >1.0 ng/mL, respectively. On multivariate analysis, the only factor predictive of DFS was 48mPSA (P<.0001). On subset analysis (n=585), 29 patients had a PSA rise (defined as >0.2 ng/mL) between 24 and 36 months, 24 patients had a rise between 36 and 48 months, and 11 patients had rises over both intervals. Failure rates in these patients were 52%, 79%, and 100%, respectively. On multivariate analysis, initial PSA, androgen deprivation therapy, and dose to 90% of the prostate significantly correlated with 48mPSA but together accounted for only ∼5% of its total variance. Conclusions: The 48mPSA after LDR-PB is highly predictive of long-term DFS. Patients with 48mPSA ≤0.4 ng/mL had a <1% risk of disease relapse at 8 years, whereas all patients with 48mPSA >1.0 ng/mL relapsed. Consecutive PSA rises of >0.2 ng/mL from 24 to 36 months and from 36 to 48 months were also highly predictive of subsequent failure.

  4. Hyperthermic intraperitoneal chemotherapy (HIPEC) and neoadjuvant chemotherapy as prophylaxis of peritoneal carcinosis from advanced gastric cancer—effects on overall and disease free survival

    PubMed Central

    Celotti, Andrea; Ceresoli, Marco; Montori, Giulia; Marini, Michele; Catena, Fausto; Ansaloni, Luca

    2016-01-01

    Background The possibility to enlarge criteria for intra-peritoneal chemotherapy (IPC) to all patients at high-risk to develop peritoneal carcinosis (i.e., with serosal invasion) is still discussed. Methods Retrospective case-control study. Three-groups: advanced-gastric-cancer (AGC) (pT4) without proven carcinosis: prophylactic group (PG), those with PC: treatment group (TG), AGC (pT3–pT4) operated without hyperthermic intraperitoneal chemotherapy (HIPEC), surgery alone group (SG T3, SG T4). Results Forty four patients. 26 (59.1%) were male. Sixteen (36%) patients underwent 16 HIPEC: 6 (38%) had AGC (pT4) without PC (PG), 10 (62%) had carcinosis (TG), 28 were operated without HIPEC (SG T3, SG T4). The mean disease free survival (DFS): TG: 7.7 months, SG T4: 21.6 months, SG T3: 27.7 months, PG: 34.5 months. DFS was significantly different for TG (P=0.03, P=0.021, P=0.013 respectively). The mean OS TG: 10 months, SG T4: 27.1 months, SG T3: 28.2 months, PG: 34.6 months. OS was significantly different for TG (P=0.04, P=0.04, P=0.045 respectively). Severe complication rate: TG: 60%, PG: 16.7%, SG T3: 7.7% and SG T4: 25% (P=0.035). Length-of-stay differs significantly (P=0.003); overall length-of-stay: 19.41 days [standard deviation (SD) ±15.03]; TG: 33.01 (SD ±23.08), PG: 20.17 (SD ±6.21), SG T3: 11.33 (SD ±3.22), SG T4: 15.36 (SD ±5.48). Conclusions Prophylactic intraperitoneal chemotherapy associated to neoadjuvant chemotherapy increases the DFS and OS in patients with AGC without carcinosis. More data are needed in order to confirm these results. PMID:27563441

  5. Complete response and prolonged disease-free survival in a patient with recurrent duodenal adenocarcinoma treated with bevacizumab plus FOLFOX6

    PubMed Central

    Nagaraj, Gayathri; Zarbalian, Yousef; Flora, Karin

    2014-01-01

    Small bowel adenocarcinoma is an uncommon gastrointestinal malignancy with limited data on effective chemotherapy in the adjuvant setting, as well as for advanced disease. We present a case report of a patient with recurrent duodenal adenocarcinoma after resection and adjuvant chemotherapy who experienced a complete response to bevacizumab with oxaliplatin and 5FU (FOLFOX) followed by bevacizumab/capecitabine maintenance therapy for 2 years. The patient continues to be disease-free 8 years after his recurrence. This case highlights the potential of vascular endothelial growth factor (VEGF) inhibitors to enhance chemotherapeutic regimens for advanced small bowel adenocarcinoma. PMID:24490045

  6. Determination of CYP2D6 *3, *4, and *10 frequency in women with breast cancer in São Luís, Brazil, and its association with prognostic factors and disease-free survival

    PubMed Central

    Martins, D.M.F.; Vidal, F.C.B.; Souza, R.D.M.; Brusaca, S.A.; Brito, L.M.O.

    2014-01-01

    The CYP2D6 enzyme is crucial for the metabolism of tamoxifen. The CYP2D6 gene is highly polymorphic, and individuals can be extensive, intermediate, or poor tamoxifen metabolizers. The aim of this study was to determine the frequencies of the CYP2D6 *3, *4, and *10 alleles in women with breast cancer who were treated with tamoxifen and analyze the association of enzyme activity with prognostic factors and disease-free survival. We observed a high frequency of CYP2D6 *10, with an allelic frequency of 0.14 (14.4%). The *3 allele was not present in the studied population, and *4 had an allelic frequency of 0.13 (13.8%). We conclude that patients with reduced CYP2D6 activity did not present worse tumor characteristics or decreased disease-free survival than women with normal enzyme activity, as the difference was not statistically significant. We also observed a high frequency of CYP2D6 *10, which had not been previously described in this specific population. This study is the first in north-northeastern Brazil that aimed to contribute to the knowledge of the Brazilian regional profile for CYP2D6 polymorphisms and their phenotypes. These findings add to the knowledge of the distribution of different polymorphic CYP2D6 alleles and the potential role of CYP2D6 genotyping in clinical practice prior to choosing therapeutic protocols. PMID:25296365

  7. Extremity preservation by combined modality therapy in sarcomas of the hand and foot: an analysis of local control, disease free survival and functional result

    SciTech Connect

    Kinsella, T.J.; Loeffler, J.S.; Fraass, B.A.; Tepper, J.

    1983-08-01

    A primary tumor arising in the hand or foot represents an uncommon presentation for patients with Ewing's sarcoma (ES) or soft tissue sarcoma (STS). While there exists considerable literature on the treatment of extremity sarcomas, very little deals specifically with lesions of the hand or foot. It remains controversial whether these lesions can be successfully treated with combined modality therapy which preserves the extremity and maintains function. From 1972 to 1979, 10 patients with sarcomas arising in the hand or foot were treated with combined modality therapy at the National Cancer Institute. Seven patients with ES of bone received local irradiation to 5000 rad and combination chemotherapy following an incisional biopsy. Three patients with STS received a gross tumor excision and local irradiation to 6000 rad. Local control was achieved in nine patients (90%) with a follow-up of 30 to 119 months (median 56 months). These patients have complete or almost complete function of the treated extremity. Nine patients are alive with five patients remaining disease-free following the initial combined modality treatment. We conclude that for selected patients with sarcomas arising in the hand or foot, combined modality therapy which leaves the extremity intact results in excellent local tumor control and preserves function. Careful treatment planning is an essential aspect of successful radiation therapy of a hand or foot primary. Our treatment recommendations are outlined. This approach is a viable alternative to amputation in these patients.

  8. Correlation of tumor markers p53, bcl-2 and cathepsin-D with clinicopathologic features and disease-free survival in laryngeal squamous cell carcinoma.

    PubMed

    Lazaris, A C; Lendari, I; Kavantzas, N; Kandiloros, D; Adamopoulos, G; Davaris, P

    2000-09-01

    Various recognized prognostic factors in squamous cell carcinoma (SCC) of the larynx influence the therapeutic options offered to an individual patient in order to extend the survival expectancy. Additional prognostic indicators are required in specific patient subgroups. The present study used a standard immunohistochemical technique in order to retrospectively evaluate the accumulation of p53 gene product and the immunoreactivity of bcl-2 protein and cathepsin-D as possible prognostic markers of laryngeal SCC. Formalin-fixed, paraffin-embedded tumor materials were obtained from a series of 64 patients with cancer of the larynx. Immunostaining was evaluated by computerized image analysis. The accumulation of p53 protein was found in 57.8% (37/64) of the patients and was associated with large tumor size. The percentage of p53-positive neoplastic cells increased in high-grade carcinomas, particularly when they simultaneously demonstrated cathepsin-D immunoreaction in stromal cells (P = 0.049); bcl-2 immunoexpression was found to be generally limited. Cathepsin-D immunostaining was observed in tumor parenchymal and stromal cells (31.25% and 37.5% of all cases, respectively); it was found to be useful in defining patient subgroups with differences in relapse-free survival. Among patients with posi-tive lymph nodes, those with cathepsin-D immunopositive tumor cells were at higher risk for relapsing (P = 0.0395). Although the classical prognostic factors of laryngeal carcinoma retain their predominance, cathepsin-D immunoreactivity may serve as an additional prognosticator in specific patient subgroups.

  9. Granulocyte Colony Stimulating Factor (GCSF) Alters the Phenotype of Neuroblastoma Cells: Implications for disease free survival of high-risk patients

    PubMed Central

    Gay, Andre N.; Chang, Shirong; Rutland, Lindsey; Yu, Ling; Byeseda, Sarah; Naik-Mathuria, Bindi; Cass, Darrell L.; Russell, Heidi; Olutoye, Oluyinka O.

    2008-01-01

    Introduction GCSF is commonly employed for the treatment of chemotherapy-induced neutropenia. Despite high-dose intensive chemotherapy for advanced stage neuroblastoma, the survival rate remains poor. GCSF therapy is quite common in these children, thus we questioned its effect on neuroblastoma cells. We hypothesized that exogenous GCSF stimulates the proliferation and invasive character of neuroblastoma cells. Methods Expression of a GCSF receptor in five different neuroblastoma cell lines was determined by PCR. In addition, we determined the effect of increasing doses of GCSF (0, 1 ng/ml, 10 ng/ml, 1 µg/ml, 10 µg/ml) on DNA synthesis (BrdU assay), invasiveness (Matrigel invasion chambers) and cell proliferation. Results We tested five neuroblastoma cell lines; all expressed the GCSF receptor. GCSF treatment resulted in significantly increased proliferation of SK-N-SH, SK-N-AS and SHSY-5Y cells. Likewise, increased invasiveness of SK-N-SH cells was observed with GCSF treatment. Conclusions Our results indicate that neuroblastoma cell lines express the GCSF receptor and respond to exogenous GCSF by increased proliferation and invasiveness. These findings suggest that GCSF may stimulate the growth of neuroblastoma cells in patients undergoing high-dose chemotherapy with GCSF rescue and could have a significant impact on the ability to eradicate these tumors. PMID:18485949

  10. Use of Cox's Cure Model to Establish Clinical Determinants of Long-Term Disease-Free Survival in Neoadjuvant-Chemotherapy-Treated Breast Cancer Patients without Pathologic Complete Response.

    PubMed

    Asano, Junichi; Hirakawa, Akihiro; Hamada, Chikuma; Yonemori, Kan; Hirata, Taizo; Shimizu, Chikako; Tamura, Kenji; Fujiwara, Yasuhiro

    2013-01-01

    In prognostic studies for breast cancer patients treated with neoadjuvant chemotherapy (NAC), the ordinary Cox proportional-hazards (PH) model has been often used to identify prognostic factors for disease-free survival (DFS). This model assumes that all patients eventually experience relapse or death. However, a subset of NAC-treated breast cancer patients never experience these events during long-term follow-up (>10 years) and may be considered clinically "cured." Clinical factors associated with cure have not been studied adequately. Because the ordinary Cox PH model cannot be used to identify such clinical factors, we used the Cox PH cure model, a recently developed statistical method. This model includes both a logistic regression component for the cure rate and a Cox regression component for the hazard for uncured patients. The purpose of this study was to identify the clinical factors associated with cure and the variables associated with the time to recurrence or death in NAC-treated breast cancer patients without a pathologic complete response, by using the Cox PH cure model. We found that hormone receptor status, clinical response, human epidermal growth factor receptor 2 status, histological grade, and the number of lymph node metastases were associated with cure.

  11. High Disease-Free Survival with Enhanced Protection against Relapse after Double-Unit Cord Blood Transplantation When Compared with T Cell-Depleted Unrelated Donor Transplantation in Patients with Acute Leukemia and Chronic Myelogenous Leukemia.

    PubMed

    Ponce, Doris M; Hilden, Patrick; Devlin, Sean M; Maloy, Molly; Lubin, Marissa; Castro-Malaspina, Hugo; Dahi, Parastoo; Hsu, Katharine; Jakubowski, Ann A; Kernan, Nancy A; Koehne, Guenther; O'Reilly, Richard J; Papadopoulos, Esperanza B; Perales, Miguel-Angel; Sauter, Craig; Scaradavou, Andromachi; Tamari, Roni; van den Brink, Marcel R M; Young, James W; Giralt, Sergio; Barker, Juliet N

    2015-11-01

    Double-unit cord blood (DCB) grafts are a rapidly available stem cell source for adults with high-risk leukemias. However, how disease-free survival (DFS) after DCB transplantation (DCBT) compares to that of unrelated donor transplantation (URDT) is not fully established. We analyzed 166 allograft recipients (66 8/8 HLA-matched URDT, 45 7/8 HLA-matched URDT, and 55 DCBT) ages 16 to 60 years with high-risk acute leukemia or chronic myelogenous leukemia (CML). URDT and DCBT recipients were similar except DCBT recipients were more likely to have lower weight and non-European ancestry and to receive intermediate-intensity conditioning. All URDT recipients received a CD34(+) cell-selected (T cell-depleted) graft. Overall, differences between the 3-year transplantation-related mortality were not significant (8/8 URDT, 18%; 7/8 URDT, 39%; and DCBT, 24%; P = .108), whereas the 3-year relapse risk was decreased after DCBT (8/8 URDT, 23%; 7/8 URDT, 20%; and DCBT 9%, P = .037). Three-year DFS was 57% in 8/8 URDT, 41% in 7/8 URDT, and 68% in DCBT recipients (P = .068), and the 3-year DFS in DCBT recipients was higher than that of 7/8 URDT recipients (P = .021). In multivariate analysis in acute leukemia patients, factors adversely associated with DFS were female gender (hazard ratio [HR], 1.68; P = .031), diagnosis of acute lymphoblastic leukemia (HR, 2.09; P = .004), and 7/8 T cell-depleted URDT (HR, 1.91; P = .037). High DFS can be achieved in adults with acute leukemia and CML with low relapse rates after DCBT. Our findings support performing DCBT in adults in preference to HLA-mismatched T cell-depleted URDT and suggest DCBT is a readily available alternative to T cell-depleted 8/8 URDT, especially in patients requiring urgent transplantation.

  12. NADH-Cytochrome b5 Reductase 3 Promotes Colonization and Metastasis Formation and Is a Prognostic Marker of Disease-Free and Overall Survival in Estrogen Receptor-Negative Breast Cancer.

    PubMed

    Lund, Rikke R; Leth-Larsen, Rikke; Caterino, Tina Di; Terp, Mikkel G; Nissen, Jeanette; Lænkholm, Anne-Vibeke; Jensen, Ole N; Ditzel, Henrik J

    2015-11-01

    Metastasis is the main cause of cancer-related deaths and remains the most significant challenge to management of the disease. Metastases are established through a complex multistep process involving intracellular signaling pathways. To gain insight to proteins central to specific steps in metastasis formation, we used a metastasis cell line model that allows investigation of extravasation and colonization of circulating cancer cells to lungs in mice. Using stable isotopic labeling by amino acids in cell culture and subcellular fractionation, the nuclear, cytosol, and mitochondria proteomes were analyzed by LC-MS/MS, identifying a number of proteins that exhibited altered expression in isogenic metastatic versus nonmetastatic cancer cell lines, including NADH-cytochrome b5 reductase 3 (CYB5R3), l-lactate dehydrogenase A (LDHA), Niemann-pick c1 protein (NPC1), and nucleolar RNA helicase 2 (NRH2). The altered expression levels were validated at the protein and transcriptional levels, and analysis of breast cancer biopsies from two cohorts of patients demonstrated a significant correlation between high CYB5R3 expression and poor disease-free and overall survival in patients with estrogen receptor-negative tumors (DFS: p = .02, OS: p = .04). CYB5R3 gene knock-down using siRNA in metastasizing cells led to significantly decreased tumor burden in lungs when injected intravenously in immunodeficient mice. The cellular effects of CYB5R3 knock-down showed signaling alterations associated with extravasation, TGFβ and HIFα pathways, and apoptosis. The decreased apoptosis of CYB5R3 knock-down metastatic cancer cell lines was confirmed in functional assays. Our study reveals a central role of CYB5R3 in extravasation/colonization of cancer cells and demonstrates the ability of our quantitative, comparative proteomic approach to identify key proteins of specific important biological processes that may also prove useful as potential biomarkers of clinical relevance. MS data are

  13. Developmental milestones record - 4 years

    MedlinePlus

    Normal childhood growth milestones - 4 years; Growth milestones for children - 4 years; Childhood growth milestones - 4 years ... care provider. PHYSICAL AND MOTOR During the fourth year, a child typically: Gains weight at the rate ...

  14. Overall and disease-free survival greater than 12 years in metastatic non-small cell lung cancer after linear accelerator-based stereotactic radiosurgery for solitary brain metastasis.

    PubMed

    Scorsetti, Marta; Alongi, Filippo; Navarria, Piera; Cortinovis, Diego; Bidoli, Paolo

    2012-01-01

    The best treatment approach for solitary brain metastasis is not well defined and there is no consensus on this issue. It is still being debated whether patients with isolated brain metastasis should undergo surgical resection or stereotactic radiosurgery, and which patients should receive adjuvant whole brain radiotherapy. The median survival in patients with single or multiple metastatic lesions who underwent only stereotactic radiosurgery improved from two-three months to nine months. To the best of our knowledge this is the first report on patients treated with linear accelerator-based stereotactic radiosurgery alone where an overall survival of more than 12 years was obtained, maintaining good quality of life in three cases of solitary brain metastasis from non-small cell lung cancer. In addition to the case reports, we present a brief literature review on this topic. PMID:22677999

  15. Two or Three Year Disease Free Survival (DFS) as a Primary Endpoint in Stage III Adjuvant Colon Cancer Trials with fluoropyrimidines with or without Oxaliplatin or Irinotecan: Data from 12,676 patients from MOSAIC, X-ACT, PETACC-3, C-06, C-07, and C89803

    PubMed Central

    Sargent, D; Shi, Q; Yothers, G; Van Cutsem, E; Cassidy, J; Saltz, L; Wolmark, N; Bot, B; Grothey, A; Buyse, M; de Gramont, A

    2011-01-01

    Summary Background The ACCENT group previously established disease-free survival (DFS) with 2 or 3 years median follow-up to predict 5 year overall survival (5yr OS) in stage II and III colon cancer. ACCENT further proposed (1) a stronger association between DFS and OS in stage III than II, and (2) 6 or 7 years necessary to demonstrate DFS/OS surrogacy in recent trials. The relationship between endpoints in trials with oral fluoropyrimidines, oxaliplatin, and irinotecan is unknown. Methods Associations between the treatment effect hazard ratios (HRs) on 2 and 3yr DFS, and 5 and 6yr OS were examined in 6 phase III trials not included in prior analyses from 1997-2002. Individual data for 12,676 patients were analyzed; two trials each tested oxaliplatin, irinotecan, and oral treatment vs 5-FU/LV. Findings Overall association between 2/3 yr DFS and 5/6 yr OS HRs was modest to poor (simple R2 measures: 0.58 to 0.76, model-based R2: 0.17 to 0.49). In stage III patients, the association increased (model-based R2≥0.79). Observed treatment effects on 2 yr DFS accurately 5/6 yr OS effects overall and in stage III patients. Interpretation In recent trials of cytotoxic chemotherapy, 2 or 3yr DFS HRs are highly predictive of 5 and 6yr OS HRs in stage III but not stage II patients. In all patients the DFS/OS association is stronger for 6yr OS, thus at least 6 year follow-up is recommended to assess OS benefit. These data support DFS as the primary endpoint for stage III colon cancer trials testing cytotoxic agents. Funding Funded by NCI Grant CA-25224 to the Mayo Clinic to support the North Central Cancer Treatment Group. PMID:21257306

  16. Inverse Planned High-Dose-Rate Brachytherapy for Locoregionally Advanced Cervical Cancer: 4-Year Outcomes

    SciTech Connect

    Tinkle, Christopher L.; Weinberg, Vivian; Chen, Lee-May; Littell, Ramey; Cunha, J. Adam M.; Sethi, Rajni A.; Chan, John K.; Hsu, I-Chow

    2015-08-01

    Purpose: Evaluate the efficacy and toxicity of image guided brachytherapy using inverse planning simulated annealing (IPSA) high-dose-rate brachytherapy (HDRB) boost for locoregionally advanced cervical cancer. Methods and Materials: From December 2003 through September 2009, 111 patients with primary cervical cancer were treated definitively with IPSA-planned HDRB boost (28 Gy in 4 fractions) after external radiation at our institution. We performed a retrospective review of our experience using image guided brachytherapy. Of the patients, 70% had a tumor size >4 cm, 38% had regional nodal disease, and 15% had clinically evident distant metastasis, including nonregional nodal disease, at the time of diagnosis. Surgical staging involving pelvic lymph node dissection was performed in 15% of patients, and 93% received concurrent cisplatin-based chemotherapy. Toxicities are reported according to the Common Terminology Criteria for Adverse Events version 4.0 guidelines. Results: With a median follow-up time of 42 months (range, 3-84 months), no acute or late toxicities of grade 4 or higher were observed, and grade 3 toxicities (both acute and late) developed in 8 patients (1 constitutional, 1 hematologic, 2 genitourinary, 4 gastrointestinal). The 4-year Kaplan-Meier estimate of late grade 3 toxicity was 8%. Local recurrence developed in 5 patients (4 to 9 months after HDRB), regional recurrence in 3 (6, 16, and 72 months after HDRB), and locoregional recurrence in 1 (4 months after HDR boost). The 4-year estimates of local, locoregional, and distant control of disease were 94.0%, 91.9%, and 69.1%, respectively. The overall and disease-free survival rates at 4 years were 64.3% (95% confidence interval [CI] of 54%-73%) and 61.0% (95% CI, 51%-70%), respectively. Conclusions: Definitive radiation by use of inverse planned HDRB boost for locoregionally advanced cervical cancer is well tolerated and achieves excellent local control of disease. However, overall

  17. 4-Year Cohort Graduation Rate: Overview

    ERIC Educational Resources Information Center

    Pennsylvania Department of Education, 2010

    2010-01-01

    Federal law requires Pennsylvania, and all other states, to transition to a new calculation method for determining high school graduation rates. Beginning in 2012, using graduation data from the Classes of 2010 and 2011, the "4-Year Cohort Graduation Rate" calculation will replace the "4-Year Leaver Graduation Rate" calculation. The new…

  18. ASA grade and disease-free mortality in head and neck cancer patients: a prospective study.

    PubMed

    Kanatas, Anastasios; Gorton, Heather; Smith, Adam B; Mannion, Christopher; Ong, Thian K; Mitchell, David

    2010-12-01

    Complex surgery with curative intent as part of the care of patients with head and neck cancer, who also have serious coexisting conditions is sometimes viewed critically as being unduly, optimistic. We have used American Society of Anesthesiologists' (ASA) grading by a single anaesthetist prospectively as a baseline to investigate a possible link between coexisiting conditions and disease-free survival in 114 patients with head and neck cancer patients treated by the same anaesthetist and surgical team, and found that the ASA grade is not a reliable predictor of disease-free survival. There was no significant association between ASA grade and overall mortality, but there was a significant association between ASA grade and mortality associated with metastatic disease. However, the test for trend was not significant, which suggested that deaths from metastatic disease did not increase in line with ASA grading. All patients in ASA grades II and III were alive 2 years after their initial operation and the risk of mortality after 2 years may increase by up to 10%.

  19. ALEXIS, the little satellite that could -- 4 years later

    SciTech Connect

    Roussel-Dupre, D.; Bloch, J.; Little, C.

    1997-10-01

    The 113-kg Array of Low Energy X-ray Imaging Sensors (ALEXIS) satellite was launched from the fourth flight of Pegasus on 25 April, 1993 into a 750 x 850 km, 70 degree inclination orbit. Due to damage sustained at the time of launch, ground controllers did not make contact with the satellite until late June. By late July, full satellite operations had been restored through the implementation of new procedures for attitude control. Science operations with the two onboard experiments began at that time. Now 4 years later is still collecting more than 100 MB of mission data per day. ALEXIS was originally designed to be a high risk, single string. {open_quotes}Smarter-Faster-Cheaper{close_quotes} satellite, with a 1 year nominal and a 3 year design limit. This paper will discuss how well the various satellite and experiment subsystems are surviving a variety of low and high radiation environments and what improvements have been made to make operations more autonomous. 11 refs., 2 figs., 2 tabs.

  20. High-risk thyroid cancer. Prolonged survival with early multimodality therapy.

    PubMed

    Durie, B G; Hellman, D; Woolfenden, J M; O'Mara, R; Kartchner, M; Salmon, S E

    1981-01-01

    Eleven patients with high-risk thyroid carcinoma of anaplastic or mixed anaplastic-differentiated histology were treated using an early multimodality approach. Patients were classified using the prognostic index for thyroid carcinoma developed by the EORTC. Therapy consisted of a four-drug chemotherapy combination, radioiodine (131I), and Bacille-Calmette-Guerin (BCG) immunotherapy. Treatment was designed to maximize effects against both anaplastic and differentiated tumor components. There has been prolonged disease-free survival (14+ to 73+ months) in patients with clear cell, small cell, and mixed anaplastic histologies. Currently five patients have been in complete remission for over 4 years. Treatment has been well tolerated. The long-term participation in care by a multispecialty team has produced promising results which we hope can be valuable as a basis for multicenter trials.

  1. The Effectiveness of Alcohol Policies in 4-Year Public Universities

    ERIC Educational Resources Information Center

    Walter, Gayle T.

    2010-01-01

    A problem facing American universities is heavy drinking by the student body which results in unintentional injuries and deaths, illegal offenses, sexual assault, altercations, and academic demise. The relationship between the type of alcohol policy enacted on campus and alcohol consumption among undergraduate students attending 4-year public…

  2. 20 CFR 210.4 - Year of service.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 1 2014-04-01 2012-04-01 true Year of service. 210.4 Section 210.4 Employees... SERVICE § 210.4 Year of service. (a) A year of service is twelve months of reported or deemed service, consecutive or not consecutive. A fraction of a year of service is taken at its actual value. (b) The...

  3. 20 CFR 210.4 - Year of service.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Year of service. 210.4 Section 210.4... RAILROAD SERVICE § 210.4 Year of service. (a) A year of service is twelve months of reported or deemed service, consecutive or not consecutive. A fraction of a year of service is taken at its actual value....

  4. 20 CFR 210.4 - Year of service.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false Year of service. 210.4 Section 210.4... RAILROAD SERVICE § 210.4 Year of service. (a) A year of service is twelve months of reported or deemed service, consecutive or not consecutive. A fraction of a year of service is taken at its actual value....

  5. 20 CFR 210.4 - Year of service.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true Year of service. 210.4 Section 210.4 Employees... SERVICE § 210.4 Year of service. (a) A year of service is twelve months of reported or deemed service, consecutive or not consecutive. A fraction of a year of service is taken at its actual value. (b) The...

  6. 20 CFR 210.4 - Year of service.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false Year of service. 210.4 Section 210.4... RAILROAD SERVICE § 210.4 Year of service. (a) A year of service is twelve months of reported or deemed service, consecutive or not consecutive. A fraction of a year of service is taken at its actual value....

  7. Head Start, 4 years After Completing the Program

    ERIC Educational Resources Information Center

    Kim, Young-Joo

    2013-01-01

    This paper studies the effect of the Head Start program on children's achievements in reading and math tests during their first 4 years of schooling after completing the program. Using nationally representative data from the Early Childhood Longitudinal Study, I found large measurement error in the parental reports of Head Start attendance,…

  8. Faculty Employment at 4-Year Colleges and Universities

    ERIC Educational Resources Information Center

    Zhang, Liang; Liu, Xiangmin

    2010-01-01

    We examine the variation in employment levels of part-time faculty, full-time teaching faculty, and full-time professorial faculty across 4-year colleges and universities in the United States. Employment structures and practices in higher education institutions are determined by a variety of economic and institutional factors. For example, a 1%…

  9. Emerging Understanding of Patterning in 4-Year-Olds

    ERIC Educational Resources Information Center

    Rittle-Johnson, Bethany; Fyfe, Emily R.; McLean, Laura E.; McEldoon, Katherine L.

    2013-01-01

    Young children have an impressive amount of mathematics knowledge, but past psychological research has focused primarily on their number knowledge. Preschoolers also spontaneously engage in a form of early algebraic thinking-patterning. In the current study, we assessed 4-year-old children's knowledge of repeating patterns on two occasions…

  10. Case report: Successful treatment of recurrent chordoma and bilateral pulmonary metastases following an 11-year disease-free period

    PubMed Central

    Erkmen, Cherie P.; Barth, Richard J.; Raman, Vignesh

    2014-01-01

    INTRODUCTION Chordomas are rare but aggressive tumors due to local recurrence and distant metastases. They originate commonly in the sphenooccipital and sacrococcygeal regions, and metastasize to the lungs, bone, skin, liver, and lymph nodes. They occur more frequently in men and people over the age of 40. PRESENTATION OF CASE A 28 year-old female presented with sacrococcygeal chordoma for which she received wide local excision and adjuvant radiation therapy. She enjoyed an unusual disease-free survival for 11 years until a routine surveillance scan of the pelvis identified local recurrence. Further work up revealed bilateral pulmonary metastases. She underwent local excision of the recurrent tumor and video-assisted thoracoscopic (VATS) wedge resection of pulmonary metastases. She also received adjuvant radiation therapy to the recurrent resection bed. Two years later, she remains free of disease and symptoms. DISCUSSION Chordomas are commonly insensitive to chemotherapy and radiation, making surgery the most successful therapeutic modality. However, there are few guidelines on the surveillance and treatment of recurrent chordoma. We report success with aggressive surgical resection of recurrence and metastasis as well as adjuvant radiation therapy. CONCLUSION The prolonged survival of our patient underscores the importance of (1) aggressive surgical resection of chordoma, whether primary, recurrent, or metastatic, with adjuvant radiation therapy, (2) minimization of surgical seeding of tumor, and (3) diligent cancer surveillance. PMID:24907541

  11. Acute opercular syndrome in 4-year-old boy.

    PubMed

    Pniewska, Anna; Pawłowska, Małgorzata

    2016-01-01

    Acute opercular syndrome is a rare described syndrome caused by a sudden damage of the cerebral cortex and subcortical white matter, located around the insula. A rare cause of this syndrome can be an infectious agent, particularly herpes simplex virus. Quick diagnosis and immediate initiation of treatment significantly reduce the risk of neurological consequences and mortality. We present a case of encephalitis of unknown etiology and severe course, with the symptoms of acute opercular syndrome in 4-year-old boy. PMID:27154445

  12. 9 CFR 92.4 - Reestablishment of a region's disease-free status.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Reestablishment of a region's disease... Reestablishment of a region's disease-free status. This section applies to regions that are designated in this subchapter D as free of a specific animal disease and then experience an outbreak of that disease....

  13. 9 CFR 92.4 - Reestablishment of a region's disease-free status.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Reestablishment of a region's disease... Reestablishment of a region's disease-free status. This section applies to regions that are designated in this subchapter D as free of a specific animal disease and then experience an outbreak of that disease....

  14. 9 CFR 92.4 - Reestablishment of a region's disease-free status.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Reestablishment of a region's disease... Reestablishment of a region's disease-free status. This section applies to regions that are designated under this subchapter as free of a specific animal disease and then experience an outbreak of that disease. (a)...

  15. 9 CFR 92.4 - Reestablishment of a region's disease-free status.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Reestablishment of a region's disease... Reestablishment of a region's disease-free status. This section applies to regions that are designated in this subchapter D as free of a specific animal disease and then experience an outbreak of that disease....

  16. 9 CFR 92.4 - Reestablishment of a region's disease-free status.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Reestablishment of a region's disease... Requesting Recognition of Regions Other Than for BSE § 92.4 Reestablishment of a region's disease-free status... disease and then experience an outbreak of that disease. (a) Interim designation. If a region...

  17. Perlite exposure and 4-year change in lung function.

    PubMed

    Polatli, M; Erdinç, M; Erdinç, E; Okyay, E

    2001-07-01

    Perlite is a volcanic glass or amorphous aluminium silicate composed of 71-75% SiO(2). When heated to 800-1100 degrees C, it expands to form processed perlite, which has a low density, high surface area, and a low thermal conductivity. The objective was to determine the effect of perlite exposure on pulmonary function tests. Pulmonary function tests in conjunction with chest radiogram were carried out in 36 perlite-exposed workers and 22 unexposed office workers in 1992 and 1996. Respirable dust level exceeded permissible dust levels in work places in the 4 years under study. Transfer coefficient (K(CO)) decline was significant in nonsmoker perlite-exposed workers (n=9), and found to be 5.28+/-0.71 (predicted 4.32+/-0.11) and 3.84+/-0.96 (predicted 4.18+/-0.18) 1/min/mmHg, in 1992 and 1996, respectively (P<0.001). Both smoker perlite workers and office workers showed significant obstruction to airflow in small airways with respect to predicted values and 4-year change in transfer factor (T(L), CO) was significant. Although predicted, 12-year perlite exposure did not lead to a decrease in mean pulmonary function test parameters, there was a tendency to a decline in T(L), CO in the 4-year study period, which may be due to high perlite dust levels. As early effects of perlite dust exposure may not be detected by spirometric measurements alone, the transfer coefficient should be added to spirometry.

  18. Fermi Large Area Telescope Operations: Progress Over 4 Years

    SciTech Connect

    Cameron, Robert A.; /SLAC

    2012-06-28

    The Fermi Gamma-ray Space Telescope was launched into orbit in June 2008, and is conducting a multi-year gamma-ray all-sky survey, using the main instrument on Fermi, the Large Area Telescope (LAT). Fermi began its science mission in August 2008, and has now been operating for almost 4 years. The SLAC National Accelerator Laboratory hosts the LAT Instrument Science Operations Center (ISOC), which supports the operation of the LAT in conjunction with the Mission Operations Center (MOC) and the Fermi Science Support Center (FSSC), both at NASA's Goddard Space Flight Center. The LAT has a continuous output data rate of about 1.5 Mbits per second, and data from the LAT are stored on Fermi and transmitted to the ground through TDRS and the MOC to the ISOC about 10 times per day. Several hundred computers at SLAC are used to process LAT data to perform event reconstruction, and gamma-ray photon data are subsequently delivered to the FSSC for public release with a few hours of being detected by the LAT. We summarize the current status of the LAT, and the evolution of the data processing and monitoring performed by the ISOC during the first 4 years of the Fermi mission, together with future plans for further changes to detected event data processing and instrument operations and monitoring.

  19. Multifocal tumoral calcinosis in a 4-year-old girl

    PubMed Central

    Sayar, Ilyas; Peker, Kemal; Kapısız, Alparslan; Bostancı, Isıl Esen; Gürbüzel, Mehmet; Isik, Arda; Peker, Necla Aydın

    2014-01-01

    Patient: Female, 4 Final Diagnosis: Tumoral calcinosis Symptoms: Hard immobile mass Medication: — Clinical Procedure: — Specialty: Surgery Objective: Congenital defects Background: Tumoral calcinosis is an uncommon condition associated with the deposition of painless calcific masses. It is more common in childhood or early adolescence of African-American females. Case Report: We present a case of a 4-year-old girl with tumoral calcinosis treated surgically. The case is rather rare in terms of the age of the patient and the localization of the masses (gluteal site). In our patient, the biochemical findings were normal, except for hyperphosphatemia and elevated alkaline phosphatase. Conclusions: Total excision appears to lead to a good clinical outcome and a low incidence of local relapse. PMID:24644527

  20. The effectiveness of alcohol policies in 4-year public universities.

    PubMed

    Walter, Gayle; Kowalczyk, John

    2012-04-01

    The objective of this study was to evaluate the type of alcohol policy in place in 4-year public universities against the odds of heavy drinking. Data was collected during the months of April-June 2010 using the Core Alcohol and Drug Survey. The participants included a random sample of undergraduate students from 4 public universities in the Midwest. Two of the universities had policies in place allowing the sale and use of alcohol on campus, and 2 universities had policies in place prohibiting the sale and use of alcohol. There were a total of 186 participants which included 63 males and 123 females. There was statistical significance in gender, age, and participation in sports against the odds of heavy drinking (P < .05). The type of policy in place was not significantly associated with the odds of heavy drinking. Even though there was an association between gender, age, and participation in sports with the odds of heavy drinking among college students in this sample, the type of alcohol policy (wet or dry) had no association. The results demonstrate the need for the implementation of alcohol prevention strategies, in addition to policy, to reduce the number of college students who drink heavily. It may be beneficial to target those alcohol intervention programs to the high risk groups such as males, over the age of 21, and those students who participate in sports.

  1. Fra-1 is a key driver of colon cancer metastasis and a Fra-1 classifier predicts disease-free survival

    PubMed Central

    Iskit, Sedef; Schlicker, Andreas; Wessels, Lodewyk; Peeper, Daniel S.

    2015-01-01

    Fra-1 (Fos-related antigen-1) is a member of the AP-1 (activator protein-1) family of transcription factors. We previously showed that Fra-1 is necessary for breast cancer cells to metastasize in vivo, and that a classifier comprising genes that are expressed in a Fra-1-dependent fashion can predict breast cancer outcome. Here, we show that Fra-1 plays an important role also in colon cancer progression. Whereas Fra-1 depletion does not affect 2D proliferation of human colon cancer cells, it impairs growth in soft agar and in suspension. Consistently, subcutaneous tumors formed by Fra-1-depleted colon cancer cells are three times smaller than those produced by control cells. Most remarkably, when injected intravenously, Fra-1 depletion causes a 200-fold reduction in tumor burden. Moreover, a Fra-1 classifier generated by comparing RNA profiles of parental and Fra-1-depleted colon cancer cells can predict the prognosis of colon cancer patients. Functional pathway analysis revealed Wnt as one of the central pathways in the classifier, suggesting a possible mechanism of Fra-1 function in colon cancer metastasis. Our results demonstrate that Fra-1 is an important determinant of the metastatic potential of human colon cancer cells, and that the Fra-1 classifier can be used as a prognostic predictor in colon cancer patients. PMID:26646695

  2. [Relapsed acute myeloid leukemia with Down syndrome showing long disease-free survival after bone marrow transplantation].

    PubMed

    Daifu, Tomoo; Kato, Itaru; Matubara, Hiroshi; Abe, Daisuke; Uryu, Kumiko; Tokumasu, Mayu; Umeda, Katsutsugu; Watanabe, Kenichiro; Izawa, Kazusi; Asai, Kouichi; Nakahata, Tatsutoshi; Adachi, Souichi

    2009-02-01

    We report a sixteen-year-old boy with Down syndrome and relapse of AML (M7), who has been in complete remission (CR) more than 12 months after bone marrow transplantation (BMT) from an HLA-matched sibling donor. Because monosomy 7 was detected at onset of AML and he experienced relapse after the treatment of AML 99 Down protocol, his prognosis was considered very poor. However, he achieved CR following chemotherapy that included high-dose AraC and BMT from an HLA-matched sibling donor without severe complication. He has remained in CR for more than 12 months after BMT. In this case, GATA1 mutation was not detected at either onset or relapse of AML and it is suggested that this case is in a different risk group than the usual Down syndrome patient with AML showing GATA1 mutation.

  3. The National Practitioner Data Bank: the first 4 years.

    PubMed

    Oshel, R E; Croft, T; Rodak, J

    1995-01-01

    The National Practitioner Data Bank became operational September 1, 1990, as a flagging system to identify health care practitioners who may have been involved in incidents of medical incompetence. Query volumes have grown substantially over the Data Bank's first 4 years of operation. The greatest increase has come in the number of voluntary queries. By the end of 1994, the Data Bank had processed more than 4.5 million requests for information on practitioners, more than 1.5 million of which were received in 1994 alone. The proportion of queries for which the Data Bank contains information on the practitioner in question has grown as the Data Bank has come to contain more reports. During 1994, 7.9 percent of queries were matched. The Data Bank contained more than 97,500 reports at the end of 1994. More than 82 percent of the reports concerned malpractice payments. Licensure reports made up the bulk of the rest. Physicians predominate in reports, accounting for slightly more than 76 percent of the total. The remainder are related to dentists (16 percent) and all other types of practitioners (8 percent). Since reporting of adverse actions is mandatory only for physicians and dentists, the proportion of reports attributable to these types of practitioners is higher than it would be if adverse action reporting requirements were uniform for all practitioners. State malpractice payment rates and adverse action rates vary widely, but a State's rate in any given year is highly correlated with its rate in any other year. State malpractice rates are not strongly correlated with adverse action rates, neither are the rates for physicians strongly correlated with those for dentists. There is a weak tendency for States with smaller physician populations to have higher levels of licensure and privileging actions.

  4. The National Practitioner Data Bank: the first 4 years.

    PubMed Central

    Oshel, R E; Croft, T; Rodak, J

    1995-01-01

    The National Practitioner Data Bank became operational September 1, 1990, as a flagging system to identify health care practitioners who may have been involved in incidents of medical incompetence. Query volumes have grown substantially over the Data Bank's first 4 years of operation. The greatest increase has come in the number of voluntary queries. By the end of 1994, the Data Bank had processed more than 4.5 million requests for information on practitioners, more than 1.5 million of which were received in 1994 alone. The proportion of queries for which the Data Bank contains information on the practitioner in question has grown as the Data Bank has come to contain more reports. During 1994, 7.9 percent of queries were matched. The Data Bank contained more than 97,500 reports at the end of 1994. More than 82 percent of the reports concerned malpractice payments. Licensure reports made up the bulk of the rest. Physicians predominate in reports, accounting for slightly more than 76 percent of the total. The remainder are related to dentists (16 percent) and all other types of practitioners (8 percent). Since reporting of adverse actions is mandatory only for physicians and dentists, the proportion of reports attributable to these types of practitioners is higher than it would be if adverse action reporting requirements were uniform for all practitioners. State malpractice payment rates and adverse action rates vary widely, but a State's rate in any given year is highly correlated with its rate in any other year. State malpractice rates are not strongly correlated with adverse action rates, neither are the rates for physicians strongly correlated with those for dentists. There is a weak tendency for States with smaller physician populations to have higher levels of licensure and privileging actions. PMID:7638325

  5. Dynamics of hand preference in 4 year-old children.

    PubMed

    Rostoft, M S; Sigmundsson, H; Whiting, H T A; Ingvaldsen, R P

    2002-04-15

    Hand preference in groups of 4 year-old children towards either end of the skill continuum (as determined by the Movement ABC test) was explored by means of a catching task in which the 'direction of approach of the ball' was used as a control parameter within a dynamical systems framework. In Condition 1, the ball direction was systematically scaled in degrees from the right side of the subject to the left and vice versa. In Condition 2, the spatial location of the ball direction was varied randomly, rather than systematically, over the same range as for Condition 1. In both conditions, the two groups of children were shown to switch between hands (from left to right and vice versa) at well-defined positions on the scale. The different scale values obtained when ball direction was scaled from left to right compared with right to left were used to define hysteresis areas. These areas were more extensive and located more to the left of the midline for the group towards the less skilled end of the continuum than for those towards the more skilled end. Additionally, the less-skilled children were shown to use the right hand more to catch the balls delivered to the left side than did the more skilled children. In Condition 3, objects were placed on the table of the ball-delivery apparatus in order to make the catching action more complicated. The less skilled group were shown to use the right hand more than the left hand in all catching positions whereas the more skilled group showed an equal usage of both catching regimes.

  6. Predicting remembering and forgetting of autobiographical memories in children and adults: a 4-year prospective study.

    PubMed

    Bauer, Patricia J; Larkina, Marina

    2016-11-01

    Preservation and loss to forgetting of autobiographical memories is a focus in both the adult and developmental literatures. In both, there are comparative arguments regarding rates of forgetting. Children are assumed to forget autobiographical memories more rapidly than adults, and younger children are assumed to forget more rapidly than older children. Yet few studies can directly inform these comparisons: few feature children and adults, and few prospectively track the survival of specific autobiographical memories over time. In a 4-year prospective study, we obtained autobiographical memories from children 4, 6, and 8 years, and adults. We tested recall of different subsets of the events after 1, 2, and 3 years. Accelerated rates of forgetting were apparent among all child groups relative to adults; within the child groups, 4- and 6-year-olds had accelerated forgetting relative to 8-year-olds. The differences were especially pronounced in open-ended recall. The thematic coherence of initial memory reports also was a significant predictor of the survival of specific memories. The pattern of findings is consistent with suggestions that the adult distribution of autobiographical memories is achieved as the quality of memory traces increases (here measured by thematic coherence) and the rate of forgetting decreases.

  7. African horse sickness: The potential for an outbreak in disease-free regions and current disease control and elimination techniques.

    PubMed

    Robin, M; Page, P; Archer, D; Baylis, M

    2016-09-01

    African horse sickness (AHS) is an arboviral disease of equids transmitted by Culicoides biting midges. The virus is endemic in parts of sub-Saharan Africa and official AHS disease-free status can be obtained from the World Organization for Animal Health on fulfilment of a number of criteria. AHS is associated with case fatality rates of up to 95%, making an outbreak among naïve horses both a welfare and economic disaster. The worldwide distributions of similar vector-borne diseases (particularly bluetongue disease of ruminants) are changing rapidly, probably due to a combination of globalisation and climate change. There is extensive evidence that the requisite conditions for an AHS epizootic currently exist in disease-free countries. In particular, although the stringent regulations enforced upon competition horses make them extremely unlikely to redistribute the virus, there are great concerns over the effects of illegal equid movement. An outbreak of AHS in a disease free region would have catastrophic effects on equine welfare and industry, particularly for international events such as the Olympic Games. While many regions have contingency plans in place to manage an outbreak of AHS, further research is urgently required if the equine industry is to avoid or effectively contain an AHS epizootic in disease-free regions. This review describes the key aspects of AHS as a global issue and discusses the evidence supporting concerns that an epizootic may occur in AHS free countries, the planned government responses, and the roles and responsibilities of equine veterinarians. PMID:27292229

  8. African horse sickness: The potential for an outbreak in disease-free regions and current disease control and elimination techniques.

    PubMed

    Robin, M; Page, P; Archer, D; Baylis, M

    2016-09-01

    African horse sickness (AHS) is an arboviral disease of equids transmitted by Culicoides biting midges. The virus is endemic in parts of sub-Saharan Africa and official AHS disease-free status can be obtained from the World Organization for Animal Health on fulfilment of a number of criteria. AHS is associated with case fatality rates of up to 95%, making an outbreak among naïve horses both a welfare and economic disaster. The worldwide distributions of similar vector-borne diseases (particularly bluetongue disease of ruminants) are changing rapidly, probably due to a combination of globalisation and climate change. There is extensive evidence that the requisite conditions for an AHS epizootic currently exist in disease-free countries. In particular, although the stringent regulations enforced upon competition horses make them extremely unlikely to redistribute the virus, there are great concerns over the effects of illegal equid movement. An outbreak of AHS in a disease free region would have catastrophic effects on equine welfare and industry, particularly for international events such as the Olympic Games. While many regions have contingency plans in place to manage an outbreak of AHS, further research is urgently required if the equine industry is to avoid or effectively contain an AHS epizootic in disease-free regions. This review describes the key aspects of AHS as a global issue and discusses the evidence supporting concerns that an epizootic may occur in AHS free countries, the planned government responses, and the roles and responsibilities of equine veterinarians.

  9. Reverse evolution: selection against costly resistance in disease-free microcosm populations of Paramecium caudatum.

    PubMed

    Duncan, Alison B; Fellous, Simon; Kaltz, Oliver

    2011-12-01

    Evolutionary costs of parasite resistance arise if genes conferring resistance reduce fitness in the absence of parasites. Thus, parasite-mediated selection may lead to increased resistance and a correlated decrease in fitness, whereas relaxed parasite-mediated selection may lead to reverse evolution of increased fitness and a correlated decrease in resistance. We tested this idea in experimental populations of the protozoan Paramecium caudatum and the parasitic bacterium Holospora undulata. After eight years, resistance to infection and asexual reproduction were compared among paramecia from (1) "infected" populations, (2) uninfected "naive" populations, and (3) previously infected, parasite-free "recovered" populations. Paramecia from "infected" populations were more resistant (+12%), but had lower reproduction (-15%) than "naive" paramecia, indicating an evolutionary trade-off between resistance and fitness. Recovered populations showed similar reproduction to naive populations; however, resistance of recently (<3 years) recovered populations was similar to paramecia from infected populations, whereas longer (>3 years) recovered populations were as susceptible as naive populations. This suggests a weak, convex trade-off between resistance and fitness, allowing recovery of fitness, without complete loss of resistance, favoring the maintenance of a generalist strategy of intermediate fitness and resistance. Our results indicate that (co)evolution with parasites can leave a genetic signature in disease-free populations. PMID:22133218

  10. Survival analysis of patients with advanced-stage nasopharyngeal carcinoma according to the Epstein-Barr virus status

    PubMed Central

    Peng, Hao; Chen, Lei; Zhang, Yuan; Guo, Rui; Li, Wen-Fei; Mao, Yan-Ping; Tan, Ling-Long; Sun, Ying; Zhang, Fan; Liu, Li-Zhi; Tian, Li; Lin, Ai-Hua; Ma, Jun

    2016-01-01

    Purpose The main aim of this study is to analyze the prognostic differences in nasopharyngeal carcinoma (NPC) patients who are positive and negative for Epstein-Barr virus (EBV). Results Of the 1106 patients, 248 (22.4%) had undetectable pre-treatment plasma EBV DNA levels. The total distant metastasis rate for EBV-negative group vs. EBV-positive group were 3.6% (9/248) vs. 15.0% (128/858) (P < 0.001). The estimated 4-year disease-free survival (DFS), overall survival (OS), distant metastasis-free survival (DMFS) and locoregional relapse-free survival (LRRFS) for EBV-negative group vs. EBV-positive group were 88.9% vs. 76.9% (P < 0.001), 93.6% vs. 85.9% (P = 0.001), 96.7% vs. 84.8% (P < 0.001) and 94.1% vs. 90.0% (P = 0.1), respectively. Multivariate analysis revealed that the EBV status was an independent prognostic factor for DFS (HR, 1.813; 95% CI, 1.219-2.695; P = 0.003), OS (HR, 1.828; 95% CI, 1.075-3.107; P = 0.026) and DMFS (HR, 3.678; 95% CI, 1.859-7.277; P <0.001), and overall stage still remained the most important prognostic factor in patients with stage III-IVB NPC. Methods and Materials Data on 1106 patients with non-metastatic, histologically proven advanced-stage (III-IVB) NPC who underwent intensity-modulated radiotherapy (IMRT) were retrospectively reviewed. Patient survival between different EBV status groups were compared. Conclusions EBV status was an independent prognostic factor for patients with stage III–IVB NPC. Neoadjuvant chemotherapy (NCT) plus concurrent chemoradiotherapy (CCRT) should be better treatment regimen for EBV-positive patients since distant metastasis was the main failure pattern, and CCRT may be enough for EBV-negative patients. PMID:27008701

  11. The Cumulative Cisplatin Dose Affects the Long-Term Survival Outcomes of Patients with Nasopharyngeal Carcinoma Receiving Concurrent Chemoradiotherapy

    PubMed Central

    Peng, Hao; Chen, Lei; Li, Wen-Fei; Guo, Rui; Mao, Yan-Ping; Zhang, Yuan; Zhang, Fan; Liu, Li-Zhi; Tian, Li; Lin, Ai-Hua; Sun, Ying; Ma, Jun

    2016-01-01

    The prognostic value of the cumulative cisplatin dose (CCD) remains controversial for patients with nasopharyngeal carcinoma (NPC) receiving only concurrent chemoradiotherapy (CCRT). We retrospectively reviewed 549 consecutive patients with non-metastatic, histologically-proven NPC treated using intensity-modulated radiotherapy (IMRT) at Sun Yat-sen university cancer center. Patient survival between different CCD groups were compared. The cut-off value of pre-treatment plasma EBV DNA (pre-DNA) and CCD based on disease-free survival (DFS) were 1460 copies/ml (AUC, 0.691; sensitivity, 0.717; specificity, 0.635) and 240 mg/m2 (AUC, 0.506; sensitivity, 0.526; specificity, 0.538), respectively. Of the entire cohort, 92/549 (16.8%) patients received a CCD ≥ 240 mg/m2 and 457 (83.2%) patients, <240 mg/m2. For CCD ≥ 240 mg/m2 vs. < 240 mg/m2, the estimated 4-year DFS, overall survival (OS), locoregional-free survival (LRFFS) and distant metastasis-free survival (DMFS) rates were 89.1% vs. 81.3% (P = 0.097), 92.4% vs. 90.0% (P = 0.369), 95.6% vs. 91.2% (P = 0.156), and 91.3% vs. 88.4% (P = 0.375), respectively. For the whole cohort, multivariate analysis identified the CCD was an independent prognostic factor for DFS (HR, 0.515; 95% CI, 0.267–0.995; P = 0.048). However, CCD (≥240 mg/m2) had no prognostic value in subgroup analysis with stratification by the cut-off value of pre-DNA (P > 0.05 for all rates). PMID:27071833

  12. Smoking Patterns, Attitudes and Motives: Unique Characteristics among 2-Year versus 4-Year College Students

    ERIC Educational Resources Information Center

    Berg, C. J.; An, L. C.; Thomas, J. L.; Lust, K. A.; Sanem, J. R.; Swan, D. W.; Ahluwalia, J. S.

    2011-01-01

    Given the previously documented higher rates of smoking among 2-year college students in comparison with 4-year university students, this study compares smoking patterns, attitudes and motives among 2-year and 4-year college students. Two thousand two hundred and sixty-five undergraduate students aged 18-25 years at a 2-year college and a 4-year…

  13. 26 CFR 1.702-3T - 4-Year spread (temporary).

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 8 2014-04-01 2014-04-01 false 4-Year spread (temporary). 1.702-3T Section 1... (CONTINUED) INCOME TAXES (CONTINUED) Partners and Partnerships § 1.702-3T 4-Year spread (temporary). (a... taxable year for the first taxable year beginning after December 31, 1986 (partnership's year of...

  14. 26 CFR 1.702-3T - 4-Year spread (temporary).

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 8 2011-04-01 2011-04-01 false 4-Year spread (temporary). 1.702-3T Section 1... (CONTINUED) INCOME TAXES (CONTINUED) Partners and Partnerships § 1.702-3T 4-Year spread (temporary). (a... taxable year for the first taxable year beginning after December 31, 1986 (partnership's year of...

  15. 26 CFR 1.702-3T - 4-Year spread (temporary).

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 8 2010-04-01 2010-04-01 false 4-Year spread (temporary). 1.702-3T Section 1... (CONTINUED) INCOME TAXES Partners and Partnerships § 1.702-3T 4-Year spread (temporary). (a) Applicability... year for the first taxable year beginning after December 31, 1986 (partnership's year of change);...

  16. 26 CFR 1.702-3T - 4-Year spread (temporary).

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 8 2012-04-01 2012-04-01 false 4-Year spread (temporary). 1.702-3T Section 1... (CONTINUED) INCOME TAXES (CONTINUED) Partners and Partnerships § 1.702-3T 4-Year spread (temporary). (a... taxable year for the first taxable year beginning after December 31, 1986 (partnership's year of...

  17. Changes in Early Childhood: Public School Programs for 4-Year-Olds.

    ERIC Educational Resources Information Center

    Lawler, S. Dianne; Boals, Beverly M.

    Education programs for 4-year-olds may offer unique opportunities for the growth of services for young children. Currently, the role of state departments of education in preschool instruction is evolving; no single approach to public school programming for 4-year-olds exists. Approximately two-thirds of the 28 state and District of Columbia early…

  18. Should Community College Students Earn an Associate Degree before Transferring to a 4-Year Institution?

    ERIC Educational Resources Information Center

    Kopko, Elizabeth M.; Crosta, Peter M.

    2016-01-01

    Using data on over 41,000 students in one state who entered community college before transferring to a 4-year institution, this study examines the following question: Are community college students who earn an associate degree before transferring to a 4-year college more likely to earn a bachelor's degree? Due to the causal nature surrounding this…

  19. 42 CFR 414.42 - Adjustment for first 4 years of practice.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Adjustment for first 4 years of practice. 414.42 Section 414.42 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Other Practitioners § 414.42 Adjustment for first 4 years of practice. (a) General rule. For...

  20. 42 CFR 414.42 - Adjustment for first 4 years of practice.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Adjustment for first 4 years of practice. 414.42 Section 414.42 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Other Practitioners § 414.42 Adjustment for first 4 years of practice. (a) General rule. For...

  1. Institutional Characteristics Contributing to the Effectiveness of 4-Year Business Degrees

    ERIC Educational Resources Information Center

    Book-Ellard, Tracy Lynn

    2012-01-01

    Over $8 billion is spent yearly, on college education in one Southern U.S. state, yet the employment effectiveness of public and private 4-year undergraduate business degrees (effectiveness defined as obtaining employment or entering into a degree program requiring a 4-year business degree by the end of Year 1 and remaining employed or in a degree…

  2. The Maine Question: How Is 4-Year College Enrollment Affected by Mandatory College Entrance Exams?

    ERIC Educational Resources Information Center

    Hurwitz, Michael; Smith, Jonathan; Niu, Sunny; Howell, Jessica

    2015-01-01

    We use a difference-in-differences analytic approach to estimate postsecondary consequences from Maine's mandate that all public school juniors take the SAT®. We find that, overall, the policy increased 4-year college-going rates by 2- to 3-percentage points and that 4-year college-going rates among induced students increased by 10-percentage…

  3. Smoking patterns, attitudes and motives: unique characteristics among 2-year versus 4-year college students.

    PubMed

    Berg, C J; An, L C; Thomas, J L; Lust, K A; Sanem, J R; Swan, D W; Ahluwalia, J S

    2011-08-01

    Given the previously documented higher rates of smoking among 2-year college students in comparison with 4-year university students, this study compares smoking patterns, attitudes and motives among 2-year and 4-year college students. Two thousand two hundred and sixty-five undergraduate students aged 18-25 years at a 2-year college and a 4-year university completed an online survey in 2008. Current (past 30-day) smoking was reported by 43.5% of 2-year and 31.9% of 4-year college students, and daily smoking was reported by 19.9% of 2-year and 8.3% of 4-year college students. Attending a 2-year college was associated with higher rates of current smoking [odds ratio (OR) = 1.72] and daily smoking (OR = 2.84), and with less negative attitudes regarding smoking, controlling for age, gender, ethnicity and parental education. Also, compared with 4-year college student smokers, 2-year college smokers had lower motivation to smoke for social reasons, but more motivation to smoke for affect regulation, after controlling for age, gender, ethnicity and parental education. Two- and 4-year college students report different smoking patterns, attitudes and motives. These distinctions might inform tobacco control messages and interventions targeting these groups of young adults.

  4. Universal SAT® Policy Boosts 4-Year College Enrollment. Info to Go™ 2015-1

    ERIC Educational Resources Information Center

    Hurwitz, Michael; Smith, Jonathan; Niu, Sunny; Howell, Jessica

    2015-01-01

    Maine replaced its existing high school statewide assessment with the SAT® and administered the exam to almost all public high school juniors. A primary goal of this policy change was to increase 4-year college enrollment by public school students in Maine. This brief report provides an overview of the data, research methodology employed, as well…

  5. My Body. Developing an Early Interest in Science: A Preschool Science Curriculum. (4-Year-Olds).

    ERIC Educational Resources Information Center

    Summer, Gail L.; Giovannini, Kathleen

    This teaching guide on the body for 4-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 childhood environments.…

  6. Social Context Effects in 2- and 4-Year-Olds' Selective versus Faithful Imitation

    ERIC Educational Resources Information Center

    Yu, Yue; Kushnir, Tamar

    2014-01-01

    This study asked whether children's tendency to imitate selectively (ignore causally unnecessary actions) versus faithfully ("overimitate" causally unnecessary actions) varies across ages and social contexts. In the first experiment, 2-year-olds and 4-year-olds were randomly assigned to play 1 of 3 prior games with a demonstrator: a…

  7. Relations of Television Viewing and Reading: Findings from a 4-Year Longitudinal Study

    ERIC Educational Resources Information Center

    Ennemoser, Marco; Schneider, Wolfgang

    2007-01-01

    This longitudinal study explored the long-term effects of television viewing on the development of children's reading competencies. Among 2 cohorts of German children (N[subscript 1] = 165, N[subscript 2] = 167), measures of television viewing were collected over 4 years, and tests of reading speed and reading comprehension were administered…

  8. Institutional Characteristics and Student Retention in Public 4-Year Colleges and Universities

    ERIC Educational Resources Information Center

    Marsh, Gregory

    2014-01-01

    The purpose of this study was to determine the relative importance of specific student and institutional factors and characteristics on the retention of students at public, 4-year colleges and universities in the United States based on aggregate student cohort and institutional data. The overriding goal of this research was to identify any…

  9. Transfer between Community Colleges and 4-Year Colleges: The All-American Game

    ERIC Educational Resources Information Center

    Hagedorn, Linda Serra; Moon, Hye Sun; Cypers, Scott; Maxwell, William E.; Lester, Jaime

    2006-01-01

    In this article, the authors introduce a novel way, using the metaphor of a baseball game, to evaluate and measure community college student progress for those whose stated goal is to transfer to a 4-year institution and, ultimately, earn a bachelor's degree. The proposed framework of "the Transfer Game" is an outgrowth of the Transfer and…

  10. Through Another's Eyes: Elements in the Eyes of a 4-Year-Old

    ERIC Educational Resources Information Center

    Hu, Xuan

    2004-01-01

    My husband, who is a scientist, often brings home different scientific journals and magazines to read, and my 4-year-old son, Nicholas J. Hu, likes to flip through them. A recent issue of Chemical and Engineering News (September, 2003) caught his interest more than usual because there were stories of different elements. Nicholas has been able to…

  11. Creppy Crawlies. Developing an Early Interest in Science: A Preschool Science Curriculum. (4-Year-Olds).

    ERIC Educational Resources Information Center

    Summer, Gail L.; Giovannini, Kathleen

    This science teaching guide on insects and animals for 4-year-old children 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…

  12. Vowel Confusion Patterns in Adults during Initial 4 Years of Implant Use

    ERIC Educational Resources Information Center

    Vaalimaa, Taina T.; Sorri, Martti J.; Laitakari, Jaakko; Sivonen, Ville; Muhli, Arto

    2011-01-01

    This study investigated adult cochlear implant users' (n == 39) vowel recognition and confusions by an open-set syllable test during 4 years of implant use, in a prospective repeated-measures design. Subjects' responses were coded for phoneme errors and estimated by the generalized mixed model. Improvement in overall vowel recognition was highest…

  13. Predictors of Funded Scholarly Activity at 4-Year, Non-Doctoral Colleges and Universities

    ERIC Educational Resources Information Center

    Edwards, Maria Montoro

    2010-01-01

    This study seeks to develop a model of institutional supports necessary for faculty to succeed as funded scholars at 4-year non-doctoral colleges and universities. Research was conducted using secondary data analysis on a pre-existing, cross-sectional database from the 2004 National Study of Postsecondary Faculty. Expectancy theory was used as the…

  14. A Gender Comparison of the Cooperation of 4-Year-Old Children in Classroom Activity Centers

    ERIC Educational Resources Information Center

    Anderson, Genan T.; Hilton, Sterling C.; Wouden-Miller, Melissa

    2003-01-01

    This study examined the proportion of cooperative play in 4-year-old children across centers (housekeeping, block, manipulative, and computer) and gender in a natural classroom setting. Eighty-four white, middle-income children (41 boys and 43 girls, mean age = 55 months) were videotaped during free-play for 30 minutes per day for four weeks in…

  15. Measuring Implicit Attitudes of 4-Year-Olds: The Preschool Implicit Association Test

    ERIC Educational Resources Information Center

    Cvencek, Dario; Greenwald, Anthony G.; Meltzoff, Andrew N.

    2011-01-01

    The Preschool Implicit Association Test (PSIAT) is an adaptation of an established social cognition measure (IAT) for use with preschool children. Two studies with 4-year-olds found that the PSIAT was effective in evaluating (a) attitudes toward commonly liked objects ("flowers"="good") and (b) gender attitudes ("girl"="good" or "boy"="good"). The…

  16. Preventing and Responding to Bullying: An Elementary School's 4-Year Journey

    ERIC Educational Resources Information Center

    McCormac, Mary E.

    2015-01-01

    Bullying continues to be a pervasive problem in schools and requires a schoolwide approach. This article describes the action research process used to examine the impact of a 4-year, K-5 school bullying prevention and intervention. The school counselors collaborated with students, staff, and parents to implement the program, and collected and…

  17. Collaboration between 3- and 4-Year-Olds in Self-Initiated Play on Instruments

    ERIC Educational Resources Information Center

    Young, Susan

    2008-01-01

    This article reports on a study of collaborative music-making on instruments among 3- and 4-year-old children. An area equipped with musical instruments was provided as a free-choice play option in an early childhood setting and a fixed camera recorded the children's play continuously during a number of visits. From the total 17 h of data five…

  18. Examining the Role of Advanced Placement[R] Exam Participation in 4-Year College Enrollment

    ERIC Educational Resources Information Center

    Chajewski, Michael; Mattern, Krista D.; Shaw, Emily J.

    2011-01-01

    The purpose of the current study was to examine the relationship between Advanced Placement (AP) exam participation and enrollment in a 4-year postsecondary institution. A positive relationship was expected given that the primary purpose of offering AP courses is to allow students to engage in college-level academic work while in high school, and…

  19. Transfer Rates of Texas Hispanic Community College Students to 4-Year Institutions: Selected Institutional Factors

    ERIC Educational Resources Information Center

    Klement, Emily Conrady

    2012-01-01

    The purpose of this non-experimental, quantitative study was to determine how well selected institutional characteristics explain the variance in Hispanic community college students' transfer rates to 4-year institutions. Due to the rapidly growing Texas Hispanic population, understanding challenges to their educational attainment has become…

  20. Leading Indicators: Increasing Statewide Bachelor's Degree Completion Rates at 4-Year Public Institutions

    ERIC Educational Resources Information Center

    Davidson, Jeffrey Cody

    2014-01-01

    For the United States to maintain national and global economic stability, colleges must graduate more students. Four-year completion rates have declined and less than one-third of full-time, degree-seeking students graduate in 4 years. Some researchers and policymakers have suggested "leading indicators" to track postsecondary…

  1. [Multiloculated mesenteric and retroperitoneal tumour - lymphatic malformation - in a 4-year-old girl].

    PubMed

    Obuchowicz, Anna; Łoboda, Magdalena; Madziara, Wojciech; Jarecka, Beata

    2015-01-01

    Mesenteric cysts are rare and mostly benign abdominal tumours in children. Majority of them are lymphangiomas (lymphatic malformations). We diagnosed a broad, multiloculated mesenteric and retroperitoneal cyst, associated with intensive inflammation, in a 4-year-old girl. Surgical therapy was fully successful.

  2. Overweight among Low-Income Texas Preschoolers Aged 2 to 4 Years

    ERIC Educational Resources Information Center

    Lewis, Kayan L.; Castrucci, Brian C.; Gossman, Ginger; Mirchandani, Gita; Sayegh, M. Aaron; Moehlman, Clint; Van Eck, Mary; Petrilli, Kimberly

    2010-01-01

    Objective: Determine child/maternal factors associated with overweight among 2- to 4-year-olds enrolled in the Texas Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Design: Matched child and maternal data collected by self-report of the mother during WIC certification. These data were extracted from existing…

  3. Preparing the Workforce: Early Childhood Teacher Preparation at 2- and 4-year Institutions of Higher Education.

    ERIC Educational Resources Information Center

    Early, Diane M.; Winton, Pamela J.

    2001-01-01

    Details investigation of characteristics of early childhood teacher preparation programs at 2- and 4-year institutions through a survey of program chairs or directors. Presents findings on faculty characteristics, including racial makeup; course and practica requirements; comparisons between early childhood programs and the institutions as whole…

  4. Markers for Persistent Specific Expressive Language Delay in 3-4-Year-Olds

    ERIC Educational Resources Information Center

    Everitt, Andrea; Hannaford, Philip; Conti-Ramsden, Gina

    2013-01-01

    Background: Identifying 3-4-year-olds who are most at risk of persisting language difficulties, and possibly specific language impairment (SLI), is difficult due to the natural variation of language in young children. In older children, markers for SLI have been identified that differentiate between children with and without SLI. It is not known…

  5. Prosthetic rehabilitation of a patient with gastroesophageal reflux disease: 4-year followup.

    PubMed

    Okida, Ricardo Coelho; Dos Santos, Daniela Micheline; Vechiato Filho, Aljomar José; Andreotti, Agda Marobo; de Medeiros, Rodrigo Antonio; Goiato, Marcelo Coelho

    2014-01-01

    The gastroesophageal reflux disease (GERD) is one of the main causes of dental erosion. The aim of this case presented is to describe the prosthetic rehabilitation of a patient with GERD after 4 years of followup. A 33-year-old male patient complained about tooth sensitivity. The lingual surface of the maxillary anterior teeth and the cusps of the upper and lower posterior teeth presented wear. It was suspected that the feeling of heartburn reported by the patient associated with the intake of sports supplements (isotonics) was causing gastroesophageal changes. The patient was referred to a gastroenterologist and was diagnosed with GERD. Dental treatment was performed with metal-free crowns and porcelain veneers after medical treatment of the disease. With the change in eating habits, the treatment of GERD and lithium disilicate ceramics provided excellent cosmetic results after 4 years and the patient reported satisfaction with the treatment.

  6. Conjunctival lymphangioma in a 4-year-old girl revealed tuberous sclerosis complex

    PubMed Central

    Freiberg, Florentina Joyce; Kunstmann, Erdmute; König, Thomas; Matlach, Juliane; Kampik, Daniel

    2016-01-01

    Background: To present a case of conjunctival lymphangioma in a 4-year-old girl with tuberous sclerosis complex. Methods/results: A 4-year-old girl presented with a relapsing cystic lesion of the bulbar conjunctiva in the right eye with string-of-pearl-like dilation of lymphatic vessels and right-sided facial swelling with mild pain. Best-corrected vision was not impaired. Examination of the skin revealed three hypomelanotic macules and a lumbal Shagreen patch. Magnetic resonance imaging (MRI) findings displayed minimal enhancement of buccal fat on the right side. Cranial and orbital MRI showed signal enhancement in the right cortical and subcortical areas. Genetic analysis revealed a heterozygous deletion encompassing exon 1 and 2 of the TSC1 gene (tuberous sclerosis complex 1 gene), confirming the diagnosis of tuberous sclerosis complex. Conclusion: In conjunctival lymphangioma, tuberous sclerosis complex should be considered as the primary disease. PMID:27703871

  7. Intentional replantation of a maxillary molar. A 4-year follow-up.

    PubMed

    Kaufman, A Y

    1982-12-01

    A 4-year follow-up of a case treated by intentional replantation has been presented. A maxillary molar with a metal core was diagnosed as having acute apical periodontitis, endodontic treatment was determined to be impractical, and the tooth was extracted. Three roots canals which could not be detected roentgenologically were discovered and, after apicoectomy and reversed amalgam filling, the tooth was replanted in its socket. The follow-up reveals periapical repair with no signs of root resorption or ankylosis.

  8. Canadian Sedentary Behaviour Guidelines for the Early Years (aged 0-4 years).

    PubMed

    Tremblay, Mark S; Leblanc, Allana G; Carson, Valerie; Choquette, Louise; Connor Gorber, Sarah; Dillman, Carrie; Duggan, Mary; Gordon, Mary Jane; Hicks, Audrey; Janssen, Ian; Kho, Michelle E; Latimer-Cheung, Amy E; Leblanc, Claire; Murumets, Kelly; Okely, Anthony D; Reilly, John J; Stearns, Jodie A; Timmons, Brian W; Spence, John C

    2012-04-01

    The Canadian Society for Exercise Physiology (CSEP), with assistance from multiple partners, stakeholders, and researchers, developed the first Canadian Sedentary Behaviour Guidelines for the Early Years (aged 0-4 years). These national guidelines are in response to a call from health and health care professionals, child care providers, and fitness practitioners for guidance on sedentary behaviour in the early years. The guideline development process followed the Appraisal of Guidelines for Research Evaluation (AGREE) II framework. The recommendations are informed by evidence from a systematic review that examined the relationships between sedentary behaviour (predominantly screen time) and health indicators (healthy body weight, bone and skeletal health, motor skill development, psychosocial health, cognitive development, and cardio-metabolic disease risk factors) for three age groups (infants aged <1 year; toddlers aged 1-2 years; preschoolers aged 3-4 years). Evidence from the review was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. The new guidelines include a preamble to provide context, followed by the specific recommendations. The final guidelines benefitted from extensive on-line consultations with input from >900 domestic and international stakeholders, end-users, and key informants. The final guidelines state: for healthy growth and development, caregivers should minimize the time infants (aged <1 year), toddlers (aged 1-2 years), and preschoolers (aged 3-4 years) spend being sedentary during waking hours. This includes prolonged sitting or being restrained (e.g., stroller, high chair) for more than 1 h at a time. For those under 2 years, screen time (e.g., TV, computer, electronic games) is not recommended. For children 2-4 years, screen time should be limited to under 1 h per day; less is better.

  9. Effects of a Full-Day Preschool Program on 4-Year-Old Children

    ERIC Educational Resources Information Center

    Herry, Yves; Maltais, Claire; Thompson, Katherine

    2007-01-01

    This study explored the effects of a full-day preschool program on 4-year-old children. The study compared the development of a group of children (N = 403) who attended the preschool program on a half-day basis during the 1999-2000 school year (the last year the half-day program was in place) with the development of a group of children (N = 418)…

  10. Efficacy and safety of continuous 4-year telbivudine treatment in patients with chronic hepatitis B

    PubMed Central

    Wang, Y; Thongsawat, S; Gane, E J; Liaw, Y-F; Jia, J; Hou, J; Chan, H L Y; Papatheodoridis, G; Wan, M; Niu, J; Bao, W; Trylesinski, A; Naoumov, N V

    2013-01-01

    In the phase-III GLOBE/015 studies, telbivudine demonstrated superior efficacy vs lamivudine during 2-year treatment in HBeAg-positive and HBeAg-negative chronic hepatitis B (CHB). After completion, 847 patients had an option to continue telbivudine treatment for further 2 years. A total of 596 (70%) of telbivudine-treated patients, who were serum HBV DNA positive or negative and without genotypic resistance to telbivudine at the end of the GLOBE/015 trials, were enrolled into a further 2-year extension study. A group of 502 patients completed 4 years of continuous telbivudine treatment and were included in the telbivudine per-protocol population. Amongst 293 HBeAg-positive patients, 76.2% had undetectable serum HBV DNA and 86.0% had normal serum ALT at the end of 4 years. Notably, the cumulative rate of HBeAg seroconversion was 53.2%. Amongst 209 HBeAg-negative patients, 86.4% had undetectable HBV DNA and 89.6% had normal serum ALT. In patients who had discontinued telbivudine treatment due to HBeAg seroconversion, the HBeAg response was durable in 82% of patients (median 111 weeks of off-treatment follow-up). The cumulative 4-year resistance rate was 10.6% for HBeAg-positive and 10.0% for HBeAg-negative patients. Most adverse events were mild or moderate in severity and transient. Renal function measured by estimated glomerular filtration rate (eGFR) increased by 14.9 mL/min/1.73 m2 (16.6%) from baseline to 4 years (P < 0.0001). In conclusion, in HBeAg-positive and HBeAg-negative CHB patients without resistance after 2 years, two additional years of telbivudine treatment continued to provide effective viral suppression with a favourable safety profile. Moreover, telbivudine achieved 53% of HBeAg seroconversion in HBeAg-positive patients. PMID:23490388

  11. Impact of cervical disease and its definitive radiotherapeutic management on survival: Experience in 2013 patients with squamous cell carcinomas of the oropharynx and pharyngolarynx

    SciTech Connect

    Bataini, J.P.; Bernier, J.; Jaulerry, C.; Brunin, F.; Pontvert, D. )

    1990-07-01

    Two thousand thirteen patients with squamous cell carcinoma of oropharynx and pharyngolarynx were reviewed with regard to neck disease presentation and disease-free survival after radical radiotherapy. All patients were staged according to both the AJCC 1976 and the UICC 1978 classifications. Causes of failure, disease-free survival, and complication rates were assessed. Sixty percent had a clinically positive neck. The 3-year disease-free survival rates were 58%, 44%, 38%, and 25% for AJCC N0, N1, N2, and N3 cases, respectively. Corresponding UICC figures were 58%, 46%, 26%, and 29%. Analyzed parameters were nodal stage, size, site and fixity, and location of primary. Complications attributed to neck disease did not exceed 3%. A critical appraisal of the nodal staging systems is derived from these sets of data.

  12. Beyond Survival

    ERIC Educational Resources Information Center

    Steffenson, Dave

    1975-01-01

    The author argues that environmentalists need to realize that the present ecological crisis is essentially a value crisis, not merely a fight for survival alone. He envisions a complete value change for the human population and advocates the incorporation of value strategies into all environmental education programs immediately. (MA)

  13. Survival after local treatment for early breast cancer.

    PubMed

    Hacking, E A; Dent, D M; Gudgeon, C A; Prescott, R

    1985-05-25

    A 10-year survival rate of 82% was found in 517 women with early localized breast cancer (pathological stage T1-2N0M0) who had been treated with local therapy alone (total mastectomy and axillary clearance). Factors influencing survival were tumour size (T1 versus T2) and age; patients older than 50 years fared better than younger patients at 5 years but this advantage had disappeared at 10 years. Receptor status influenced disease-free survival, but not survival. Recurrence developed in 93 patients--systemic in 46 and local in 47. Support for the contention that all breast cancer is systemic was thus not found at 10 years, and the value of local therapy alone in node-negative women was endorsed.

  14. Nutritional status of the opiate dependent persons after 4 years of methadone maintenance treatment.

    PubMed

    Kolarzyk, Emilia; Pach, Dorota; Wojtowicz, Barbara; Szpanowska-Wohn, Agnieszka; Szurkowska, Magdalena

    2005-01-01

    The aim of the study was to evaluate the nutritional status of opiate dependent patients before and after 4 years of participation in the methadone maintenance treatment. The examinations were performed in 30 opiates addicted persons (7 women and 23 men). The initial examination (exam 1) was done during the patients qualification for the methadone program, preceding methadone administration and final examination (exam 2) after 4 years of the treatment. In order to estimate the nutritional status body mass, the height, the arm circumference and the thickness of the triceps and subscapular fat-skin folds were measured. On the basis of them the BMI and mid arm muscle circumference (MAMC) were counted. The measurements of the body composition (using the bioimpedance method) were performed. The changes between the results of subsequent examination were tested using the t-Student test. In the examination that took place after 4 years of follow-up, body weight loss in the group of women was observed (mean--1.7 kg). It was followed by the decrease of BMI value (from 20.3 to 19.8 kg/m2). In both examinations the percentage of fatty tissue in general body mass was significantly below recommended values (10.7% in both examinations--the recommended values are 20%-22%). In the group of men an increase in body weight (mean--8.8 kg) and BMI value (from 23.3 to 25.9 kg/m2) was noticed. Arm circumference, muscle arm circumference and fat-skin folds values were increased. The analysis of particular body components showed increased fatty body mass (11.9% in the first and 18.5% in the second examination--the recommended values 16-19%) together with the decrease of lean body mass and body water.

  15. Undergraduate public health at 4-year institutions: it's here to stay.

    PubMed

    Riegelman, Richard K; Albertine, Susan

    2011-02-01

    Undergraduate public health education at 4-year institutions, those with and without graduate public health education, has grown rapidly during the first decade of the 21st century since the IOM recommended that "all undergraduates have access to education in public health." Much of this growth has been guided by the Educated Citizen and Public Health initiative, a collaboration of arts and sciences and public health educators that encourages introductory course work in public health, epidemiology, and global health plus undergraduate minors and majors in public health. The Educated Citizen and Public Health model, as opposed to existing professional models, envisions core public health education based on the Association of American Colleges and Universities' Liberal Education and America's Promise essential learning outcomes that encourage experiential learning, evidence-based thinking, a global and community focus, plus integration and synthesis. Public health education in this model provides solid generalist grounding for graduate education in public health as well as a range of graduate disciplines from the health professions to international affairs and from law to business. In addition, it helps ensure a broad range of college graduates who understand and support public health approaches. The Healthy People 2020 objective to increase the proportion of 4-year colleges and universities that offer minor or major in public health should help propel additional growth, especially in 4-year colleges without graduate public health education. Integrative curricula designed as part of the reform of undergraduate education provide opportunities to make evidence-based public health approaches available to a large number of undergraduates.

  16. Changes in Health Care Spending and Quality 4 Years into Global Payment

    PubMed Central

    Song, Zirui; Rose, Sherri; Safran, Dana G.; Landon, Bruce E.; Day, Matthew P.; Chernew, Michael E.

    2014-01-01

    BACKGROUND Spending and quality under global budgets remain unknown beyond 2 years. We evaluated spending and quality measures during the first 4 years of the Blue Cross Blue Shield of Massachusetts Alternative Quality Contract (AQC). METHODS We compared spending and quality among enrollees whose physician organizations entered the AQC from 2009 through 2012 with those among persons in control states. We studied spending changes according to year, category of service, site of care, experience managing risk contracts, and price versus utilization. We evaluated process and outcome quality. RESULTS In the 2009 AQC cohort, medical spending on claims grew an average of $62.21 per enrollee per quarter less than it did in the control cohort over the 4-year period (P<0.001). This amount is equivalent to a 6.8% savings when calculated as a proportion of the average post-AQC spending level in the 2009 AQC cohort. Analogously, the 2010, 2011, and 2012 cohorts had average savings of 8.8% (P<0.001), 9.1% (P<0.001), and 5.8% (P = 0.04), respectively, by the end of 2012. Claims savings were concentrated in the outpatient-facility setting and in procedures, imaging, and tests, explained by both reduced prices and reduced utilization. Claims savings were exceeded by incentive payments to providers during the period from 2009 through 2011 but exceeded incentive payments in 2012, generating net savings. Improvements in quality among AQC cohorts generally exceeded those seen elsewhere in New England and nationally. CONCLUSIONS As compared with similar populations in other states, Massachusetts AQC enrollees had lower spending growth and generally greater quality improvements after 4 years. Although other factors in Massachusetts may have contributed, particularly in the later part of the study period, global budget contracts with quality incentives may encourage changes in practice patterns that help reduce spending and improve quality. (Funded by the Commonwealth Fund and others

  17. Screening for developmental delay among children aged 1-4 years: a systematic review

    PubMed Central

    Warren, Rachel; Kenny, Meghan; Bennett, Teresa; Fitzpatrick-Lewis, Donna; Ali, Muhammad Usman; Sherifali, Diana; Raina, Parminder

    2016-01-01

    Background: Existing guidelines on screening children less than 5 years of age for developmental delay vary. In this systematic review, we synthesized the literature on the effectiveness and harms of screening for developmental delay in asymptomatic children aged 1-4 years. Methods: We searched MEDLINE, Embase and PsychINFO for relevant articles published to June 16, 2015. We identified studies that included children aged 1-4 years who were not at high risk of developmental delay, screened in a primary care setting. Randomized trials and controlled cohort studies were considered for benefits (cognitive, academic and functional outcomes); no restrictions on study design were imposed for the review of harms. Results: Two studies were included. One used the Ages and Stages Questionnaire II for screening and reported significantly more referrals to early intervention in the intervention groups than in the control group (relative risk [RR] 1.95, 95% confidence interval [CI] 1.49-2.54, in the intervention group with office support and RR 1.71, 95% CI 1.30-2.25, in the intervention group without office support). The time to referral was 70% shorter in the intervention group with office support (rate ratio 0.30, 95% CI 0.19-0.48) and 64% shorter in the intervention group without office support (rate ratio 0.36, 95% CI 0.23-0.59), compared with the control group. The other study used the VroegTijdige Onderkenning Ontwikkelingsstoornissen Language Screening instrument to screen children aged 15 months at enrolment for language delay. It reported no differences between groups in academic performance outcomes at age 8 years. Interpretation: The evidence on screening for developmental delay in asymptomatic children aged 1-4 years is inconclusive. Further research with longer-term outcomes is needed to inform decisions about screening and screening intervals. PMID:27226967

  18. Giant ductal aneurysm in an asymptomatic 4-year-old girl.

    PubMed

    Sachdeva, Ritu; Smith, Clinton; Greenberg, Bruce S; Jaquiss, Robert D B

    2009-03-01

    Ductal aneurysm is a rare but potentially fatal condition. We report the case of an asymptomatic 4-year-old girl who was noted to have a murmur and with further evaluation by echocardiography and computed tomographic angiography was diagnosed with a giant ductal aneurysm. The aneurysm occupied a large space in the mediastinum, compressed the pulmonary arteries, and was in close proximity to the sternum. At surgery, the aneurysm was successfully resected after careful separation from adjacent structures. Because the anterolateral wall of the ascending aorta was noted to be extraordinarily thinned-out, it was replaced with a patch.

  19. [Awake Nasotracheal Intubation for a 4-Year-old Boy with an Oral Penetrating Toothbrush Injury].

    PubMed

    Kobayashi, Naoya; Ando, Kokichi; Saito, Kazutomo; Toyama, Hiroaki; Fudeta, Hiroto; Yamauchi, Masanori

    2015-09-01

    We report a case of an oral penetrating injury caused by a toothbrush in a 4-year-old 17-kg boy. The toothbrush was lodged in the right cervical region through the oral cavity, and emergency surgery for removal was planned under general anesthesia. Although mask ventilation was not possible because of the protruding toothbrush handle, awake nasotracheal intubation was successfully performed with a fiber-scope and intravenous fentanyl 25 μg. We conclude that appropriate analgesics could facilitate awake intubation in pediatric patients.

  20. Defining and measuring stabilization of patients during 4 years of intensive community support.

    PubMed

    Wright, R G; Heiman, J R; Shupe, J; Olvera, G

    1989-10-01

    The first 4 years of an intensive community support program were evaluated in terms of key variables of patient stabilization. Patients (N = 196) had previously demonstrated an inability to manage themselves without repeated and/or lengthy hospitalizations. During program participation, there were significant reductions in hospital days and events (80%), jail incarcerations and charges, billings per patient, and stressful events. Patients reported increased satisfaction both with their lives and the program. The results support the value of continued multidimensional and multimethod examinations of patient stabilization.

  1. Where there's smoke there's fire--ear candling in a 4-year-old girl.

    PubMed

    Hornibrook, Jeremy

    2012-12-14

    It is estimated that one-third of the United States population subscribes to alternative medical therapies (Eisenberg et al, NEJM 1993;328:246-252). Ear candles are popular products promoted by alternative health practitioners, and sold by health shops and even over the Internet. They have been promoted for ear and sinus discomfort, rhinitis, sinusitis, glue ear, colds, flu, migraine, tinnitus, but particularly for removal of ear wax (cerumen). In this case report, a 4-year-old girl in New Zealand presents with otitis media and during the course of the ear examination white deposits were noticed on her eardrum; this was confirmed as being caused by ear candling.

  2. Adoptive and Nonadoptive Mother–Child Behavioral Interaction: A Comparative Study at 4 Years of Age

    PubMed Central

    Suwalsky, Joan T. D.; Padilla, Christina M.; Yuen, Cynthia X.; Horn, E. Parham; Bradley, Alexandra L.; Putnick, Diane L.; Bornstein, Marc H.

    2016-01-01

    Comparable samples of low-risk adopted and nonadopted children and mothers were observed during 3 tasks at age 4 years. Quality of mother-child interactions, child level of functioning in 4 domains, and maternal parenting satisfaction and social support were assessed. Adopted children were as competent as nonadopted children on measures of developmental functioning. Both groups of mothers expressed high satisfaction and support as parents. However, ratings of child, maternal, and dyadic behavior when interacting were all lower for adoptive dyads than for nonadoptive dyads, and adoptive dyads with boys accounted for the maternal and dyadic group differences. PMID:27134518

  3. Case Report: Traumatic anterior cerebral artery aneurysm in a 4-year old child

    PubMed Central

    Munakomi, Sunil; Tamrakar, Karuna; Chaudhary, Pramod; Bhattarai, Binod; Cherian, Iype

    2015-01-01

    Traumatic intracranial aneurysm in the proximal part of the anterior cerebral artery in the pediatric population has not been documented so far. Here we report the case of a 4 year-old child who developed a pseudo-aneurysm after minor head trauma and was managed successfully with trapping of the aneurysm. A ventriculo-peritoneal shunt was placed as the child became dependent on extraventricular drain during the post-operative period. The patient made excellent recovery in neurological status within 1 month of post-operative clinical follow up.

  4. Idiopathic myelofibrosis with generalized periostitis in a 4-year-old girl.

    PubMed

    Walia, Mandeep; Mehta, Rajesh; Paul, Premila; Saluja, Sumita; Kapoor, Sujala; Sharma, Monika

    2005-05-01

    Idiopathic myelofibrosis, a chronic myeloproliferative disorder of unknown origin, is characterized by splenomegaly, extramedullary hematopoiesis, leukoerythroblastosis, teardrop erythrocytes, and myelofibrosis. It is a rare disorder in childhood. The authors describe a 4-year-old girl with features consistent with idiopathic myelofibrosis, who also had generalized solid laminated periosteal reaction involving all long bones. The presence of thrombocytopenia at the onset and lack of leukocytosis were in contrast to the reported features seen in children. Recent case reports describe a relatively indolent course in children. Spontaneous remissions have also been described in pediatric cases. The fulminant course of this patient without any features of malignant transformation was noteworthy in this regard.

  5. Case Report: Traumatic anterior cerebral artery aneurysm in a 4-year old child

    PubMed Central

    Munakomi, Sunil; Tamrakar, Karuna; Chaudhary, Pramod; Bhattarai, Binod; Cherian, Iype

    2015-01-01

    Traumatic intracranial aneurysm in the proximal part of the anterior cerebral artery in the pediatric population has not been documented so far. Here we report the case of a 4 year-old child who developed a pseudo-aneurysm after minor head trauma and was managed successfully with trapping of the aneurysm. A ventriculo-peritoneal shunt was placed as the child became dependent on extraventricular drain during the post-operative period. The patient made excellent recovery in neurological status within 1 month of post-operative clinical follow up. PMID:27635218

  6. Crown fracture of the mandibular second primary molars in a 4-year-old child

    PubMed Central

    Deshpande, Anshula; Patel, Jalark; Sujan, Sunanda Gul; Mallikarjuna, Rachappa

    2013-01-01

    Dental traumas are highly prevalent lesions in primary teeth, but crown root fractures are rare. Mostly anterior tooth segment is more commonly involved. Posterior crown root fractures are very rare. A 4-year-old girl reported to our paediatric dentistry department with a 10-day history of severe pain and discomfort in both right and left posterior teeth region. The child was suffering from severe and continuous pain and was unable to chew food. After an examination a fracture was noticed in intraoral periapical radiograph and treatment plan was decided to preserve the affected teeth. PMID:23780765

  7. Predictive indicators for adjustment in 4-year-old children whose mothers used amphetamine during pregnancy.

    PubMed

    Billing, L; Eriksson, M; Steneroth, G; Zetterström, R

    1988-01-01

    Psychosocial factors that could be used as predictive indicators for adjustment of 4-year-old children whose mothers had used amphetamine during pregnancy were studied by means of simple and multivariate correlation analyses. The following statistically significant correlations were found: Length of maternal alcohol and drug abuse during pregnancy was correlated negatively with the child's adjustment as were numbers of paternal criminal convictions, number of stress factors of the mother, and number of earlier children born to the mother. Paternal criminality was associated with the outcome, regardless of amount of contact between father and child.

  8. Quality of life and sexuality in disease-free survivors of cervical cancer after radical hysterectomy alone

    PubMed Central

    Xiao, Meizhu; Gao, Huiqiao; Bai, Huimin; Zhang, Zhenyu

    2016-01-01

    Abstract The aim of the present study was to evaluate the possible differences between total laparoscopy and laparotomy regarding their impact on postoperative quality of life and sexuality in disease-free cervical cancer survivors who received radical hysterectomy (RH) and/or lymphadenectomy alone and were followed for >1 year. We reviewed all patients with cervical cancer who had received surgical treatment in our hospital between January 2001 and March 2014. Consecutive sexually active survivors who received RH and/or lymphadenectomy for early stage cervical cancer were enrolled and divided into 2 groups based on surgical approach. Survivors were interviewed and completed validated questionnaires, including the European Organization for Research Treatment of Cancer Quality-of-Life Core Questionnaire including 30 items, the Cervical Cancer-Specific Module of European Organization for Research Treatment of Cancer Quality-of-Life Questionnaire including 24 items (EORTC QLQ-CX24), and the Female Sexual Function Index (FSFI). In total, 273 patients with histologically confirmed cervical cancer were retrospectively reviewed. However, only 64 patients had received RH and/or lymphadenectomy alone; 58 survivors meeting the inclusion criteria were enrolled, including 42 total laparoscopy cases and 16 laparotomy cases, with an average follow-up of 46.1 and 51.2 months, respectively. The survivors in the 2 groups obtained good and similar scores on all items of the European Organization for Research Treatment of Cancer Quality-of-Life Core Questionnaire including 30 items and Cervical Cancer-Specific Module of European Organization for Research Treatment of Cancer Quality-of-Life Questionnaire including 24 items, without significant differences after controlling for covariate background characteristics. To the date of submission, 21.4% (9/42) of cases in the total laparoscopy group and 31.2% (5/16) of cases in the laparotomy group had not resumed sexual behavior after RH

  9. Social context effects in 2- and 4-year-olds' selective versus faithful imitation.

    PubMed

    Yu, Yue; Kushnir, Tamar

    2014-03-01

    This study asked whether children's tendency to imitate selectively (ignore causally unnecessary actions) versus faithfully (overimitate causally unnecessary actions) varies across ages and social contexts. In the first experiment, 2-year-olds and 4-year-olds were randomly assigned to play 1 of 3 prior games with a demonstrator: a mimicry game, an instrumental game, or a noninteractive control game. They then participated in a puzzle-box imitation task in which the demonstrator performed 1 causally necessary and 1 unnecessary action to retrieve an object. Whereas 4-year-olds imitated faithfully across all conditions, 2-year-olds were more likely to imitate faithfully after a mimicry game and to imitate selectively after an instrumental game. Experiment 2 showed no effect of playing a mimicry game with a different experimenter prior to the imitation trials, thus ruling out 2-year-olds' faithful imitation being the result of motor priming or training effects. The results are discussed in terms of children's social affiliation and social-cognitive inferences.

  10. Traffic-related air pollution is related to interrupter resistance in 4-year-old children.

    PubMed

    Eenhuizen, Esther; Gehring, Ulrike; Wijga, Alet H; Smit, Henriette A; Fischer, Paul H; Brauer, Michael; Koppelman, Gerard H; Kerkhof, Marjan; de Jongste, Johan C; Brunekreef, Bert; Hoek, Gerard

    2013-06-01

    Outdoor air pollution has been associated with decrements in lung function and growth of lung function in school-age children. Lung function effects have not been examined in preschoolers, with the exception of one study on minute ventilation in newborns. Our goal was to assess the relationship between long- and short-term exposure to traffic-related air pollution and interrupter resistance in 4-year-old children. Lung function was measured using the interrupter resistance method in children participating in a Dutch birth cohort study. Long-term average air pollution concentrations of fine particulate matter, nitrogen dioxide and soot at the residential address at birth were assessed using land-use regression models. Daily average air pollution concentrations on the day of clinical examination were obtained from the Dutch National Air Quality Monitoring Network. Significant associations were found between long-term average air pollution concentrations and interrupter resistance. Interrupter resistance increased by 0.04 kPa·s·L(-1) (95% CI 0.01-0.07) per interquartile range increase (3.3 μg·m(-3)) in fine particle concentration. Short-term exposure was not associated with interrupter resistance. Long-term exposure to traffic-related air pollution was associated with increased interrupter resistance in 4-year-old children, supporting previous birth cohort studies reporting effects of air pollution on subjectively reported respiratory symptoms in preschool children.

  11. Nocardia brasiliensis infection mimicking juvenile idiopathic arthritis in a 4-year-old girl.

    PubMed

    Kapur, Nitin; Adib, Navid; Grimwood, Keith

    2013-11-01

    Nocardia are ubiquitous environmental saprophytes that cause pneumonia and disseminated disease in immunocompromised patients. They can also cause localized cutaneous and soft tissue infections in healthy people after direct percutaneous inoculation. Nocardia arthritis is rare in both forms of the disease. Here we present the first published case of a child with septic arthritis caused by N brasiliensis. Importantly, this otherwise well 4-year-old girl had no known history of trauma but presented with transient cutaneous lesions and a 6-week history of arthritis involving the right fourth digit proximal interphalangeal joint without accompanying fever or raised systemic inflammatory markers. She received a diagnosis of juvenile idiopathic arthritis and underwent antiinflammatory and immunosuppressant therapy. After 2 months she developed frank septic arthritis, which necessitated a surgical joint washout, from which an intraoperative swab grew N brasiliensis. The patient received 6 months of high-dose trimethoprim-sulfamethoxazole and remains well more than 4 years after treatment. This unusual case highlights the importance of considering an indolent infection from slow-growing organisms, including Nocardia, when diagnosing the oligoarthritis subtype of juvenile idiopathic arthritis. This is especially relevant when a single joint is involved and response to antiinflammatory therapy is suboptimal because antiinflammatory agents may mask evolving signs of infection.

  12. Total Body Fat Content versus BMI in 4-Year-Old Healthy Swedish Children

    PubMed Central

    Forsum, Elisabet; Flinke Carlsson, Eva; Henriksson, Hanna; Henriksson, Pontus; Löf, Marie

    2013-01-01

    Childhood overweight and obesity, a worldwide problem, is generally identified using BMI (body mass index). However, this application of BMI has been little investigated in children below 5 years of age due to a lack of appropriate methods to assess body composition. Therefore, we used air displacement plethysmography (ADP) to study 4.4-year old boys and girls since this method is accurate in young children if they accept the requirements of the measurement. The purpose was to analyze the relationship between BMI and body fat in these children. Body composition was assessed in 76 (43 boys, 33 girls) of the 84 children brought to the measurement session. Boys and girls contained 25.2 ± 4.7 and 26.8 ± 4.0% body fat, respectively. BMI-based cut-offs for overweight could not effectively identify children with a high body fat content. There was a significant (P < 0.001) but weak (r = 0.39) correlation between BMI and body fat (%). In conclusion, requirements associated with a successful assessment of body composition by means of ADP were accepted by most 4-year-olds. Furthermore, BMI-based cut-offs for overweight did not effectively identify children with a high body fatness and BMI explained only a small proportion of the variation in body fat (%) in this age group. PMID:23606949

  13. A 4-year investigation into phonetic inventory development in young cochlear implant users.

    PubMed

    Serry, T A; Blamey, P J

    1999-02-01

    Phonetic inventories of 9 children with profoundly impaired hearing who used the 22-electrode cochlear implant (Cochlear Limited) were monitored before implantation and during the first 4 years of implant use. All children were 5 years old or younger at the time of implant. Spontaneous speech samples were collected at regular intervals for each child and analyzed to investigate phone acquisition over the post-implant period. Acquisition was measured using two different criteria. The "targetless" criterion required the child to produce a phonetically recognizable sound spontaneously, and the "target" criterion required the child to produce the phone correctly at least 50% of the time in meaningful words. At 4 years post-implant, 40 out of 44 phones (91 %) had reached the targetless criterion, and 29 phones (66%) had reached the target criterion for 5 or more of the children. Over the time of the study 100% of monophthongs, 63% of diphthongs, and 54% of consonants reached the target criterion. The average time taken for a phone to progress from the targetless to target criterion was 15 months. Overall, the data suggest trends in the order of phone acquisition similar to those of normally hearing children, although the process of acquisition occurred at a slower rate.

  14. A longitudinal study of the emerging self from 9 months to the age of 4 years

    PubMed Central

    Kristen-Antonow, Susanne; Sodian, Beate; Perst, Hannah; Licata, Maria

    2015-01-01

    The aim of this study was to investigate if children’s early responsiveness toward social partners is developmentally related to their growing concept of self, as reflected in their mirror self-recognition (MSR) and delayed self-recognition (DSR). Thus, a longitudinal study assessed infants’ responsiveness (e.g., smiling, gaze) toward social partners during the still-face (SF) task and a social imitation game and related it to their emerging MSR and DSR. Thereby, children were tested at regular time points from 9 months to 4 years of age. Results revealed significant predictive relations between children’s responsiveness toward a social partner in the SF task at 9 months and their MSR at 24 months. Further, interindividual differences in children’s awareness of and responsiveness toward being imitated in a social imitation game at 12 months proved to be the strongest predictor of children’s DSR at 4 years, while some additional variance was explained by MSR at 24 months and verbal intelligence. Overall, findings suggest a developmental link between children’s early awareness of and responsiveness toward the social world and their later ability to form a concept of self. PMID:26113834

  15. Reporting outcome measures of functional constipation in children from 0 to 4 years of age.

    PubMed

    Kuizenga-Wessel, Sophie; Benninga, Marc A; Tabbers, Merit M

    2015-04-01

    Functional constipation (FC) often begins in the first year of life. Although standard definitions and criteria have been formulated to describe FC, these are rarely used in research and clinical practice. The aim of the study is to systematically assess how definitions and outcome measures are defined in therapeutic randomized controlled trials (RCTs) of infants with FC. PubMed, EMBASE, and Cochrane databases were searched. Studies were included if it was a (systematic review of) therapeutic RCT, children ≤4 years old, they had FC, a clear definition of constipation was provided, and were written in English. Quality was assessed using the Delphi list. A total of 1115 articles were found; only 5 studies fulfilled the inclusion criteria. Four different definitions were used, of which only 2 used the internationally accepted Rome III criteria. Defecation frequency was used as primary outcome in all included trials and stool consistency in 3 trials. Two trials involving infants investigated new infant formulas, whereas the third RCT evaluated the efficacy of a probiotic strain. The 2 trials including infants up to 4 years of age compared polyethylene glycol without electrolytes (PEG4000) with lactulose and milk of magnesia. All of the trials used nonvalidated parental diaries. Different definitions and outcome measures for FC in infants are used in RCTs. Disappointingly, there is a lack of well-designed therapeutic trials in infants with constipation. To make comparison between future trials possible, standard definitions, core outcomes, and validated instruments are needed.

  16. Intellectual Disability in a Birth Cohort: Prevalence, Etiology, and Determinants at the Age of 4 Years

    PubMed Central

    Karam, Simone M.; Barros, Aluísio J.D.; Matijasevich, Alícia; dos Santos, Iná S.; Anselmi, Luciana; Barros, Fernando; Leistner-Segal, Sandra; Félix, Têmis M.; Riegel, Mariluce; Maluf, Sharbel W.; Giugliani, Roberto; Black, Maureen M.

    2016-01-01

    Background Intellectual disability (ID), characterized by impairments in intellectual function and adaptive behavior, affects 1-3% of the population. Many studies investigated its etiology, but few are cohort studies in middle-income countries. Aims To estimate prevalence, etiology, and factors related to ID among children prospectively followed since birth in a Southern Brazilian city (Pelotas). Methods In 2004, maternity hospitals were visited daily and births were identified. Live-born infants (n = 4,231) whose family lived in the urban area have been followed for several years. At the age of 2 and 4 years, performances in development and intelligence tests were evaluated using the Battelle Developmental Inventory and Wechsler Intelligence Scale, respectively. Children considered as having developmental delay were invited to attend a genetic evaluation. Results At 4 years of age, the prevalence of ID was 4.5%, and the etiology was classified into 5 groups: environmental (44.4%), genetic (20.5%), idiopathic (12.6%), neonatal sequelae (13.2%), other diseases (9.3%). Most children presented impairment in two or more areas of adaptive behavior. There was no difference in prenatal care attendance or maternal schooling among the groups. Conclusion For about 40% of children, ID was attributed to nonbiological factors, suggesting that the rate may be reduced with appropriate interventions early in life. PMID:27595410

  17. Social context effects in 2- and 4-year-olds' selective versus faithful imitation.

    PubMed

    Yu, Yue; Kushnir, Tamar

    2014-03-01

    This study asked whether children's tendency to imitate selectively (ignore causally unnecessary actions) versus faithfully (overimitate causally unnecessary actions) varies across ages and social contexts. In the first experiment, 2-year-olds and 4-year-olds were randomly assigned to play 1 of 3 prior games with a demonstrator: a mimicry game, an instrumental game, or a noninteractive control game. They then participated in a puzzle-box imitation task in which the demonstrator performed 1 causally necessary and 1 unnecessary action to retrieve an object. Whereas 4-year-olds imitated faithfully across all conditions, 2-year-olds were more likely to imitate faithfully after a mimicry game and to imitate selectively after an instrumental game. Experiment 2 showed no effect of playing a mimicry game with a different experimenter prior to the imitation trials, thus ruling out 2-year-olds' faithful imitation being the result of motor priming or training effects. The results are discussed in terms of children's social affiliation and social-cognitive inferences. PMID:23978298

  18. Factors correlated with fatigue in disease-free breast cancer patients: application of the Cancer Fatigue Scale.

    PubMed

    Okuyama, T; Akechi, T; Kugaya, A; Okamura, H; Imoto, S; Nakano, T; Mikami, I; Hosaka, T; Uchitomi, Y

    2000-05-01

    Fatigue is one of the most frequent symptoms in cancer patients. However, the precise causes of this fatigue are still unknown, and this situation makes it difficult to combat the problem. The present study was conducted to investigate factors correlated with fatigue in disease-free breast cancer patients. A group of 134 randomly selected ambulatory breast cancer patients who had undergone successful surgical treatment participated. They completed the Cancer Fatigue Scale, the Hospital Anxiety and Depression Scale, the Mental Adjustment to Cancer Scale, and an ad hoc questionnaire detailing physical symptoms, social support, and demographic variables at home and returned them by mail the following day. Multiple regression analysis revealed that fatigue was significantly correlated with dyspnea, insufficient sleep, and depression, and that these three variables accounted for a total of 46% of variance in fatigue. Factors concerned with the cancer and treatment, such as disease stage, lymph node metastasis, number of days since operation, past intravenous chemotherapy, radiotherapy, current use of fluoropyrimidine compounds, and current use of tamoxifen citrate were not correlated with fatigue. The results suggest that fatigue in this population is determined by current physical and psychological distress rather than by the cancer itself and prior cancer treatments, and that the management of dyspnea, insomnia, and depression might be important in reducing fatigue in this population.

  19. Pretreatment Evaluation of Microcirculation by Dynamic Contrast-Enhanced Magnetic Resonance Imaging Predicts Survival in Primary Rectal Cancer Patients

    SciTech Connect

    DeVries, Alexander Friedrich; Piringer, Gudrun; Kremser, Christian; Judmaier, Werner; Saely, Christoph Hubert; Lukas, Peter; Öfner, Dietmar

    2014-12-01

    Purpose: To investigate the prognostic value of the perfusion index (PI), a microcirculatory parameter estimated from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), which integrates information on both flow and permeability, to predict overall survival and disease-free survival in patients with primary rectal cancer. Methods and Materials: A total of 83 patients with stage cT3 rectal cancer requiring neoadjuvant chemoradiation were investigated with DCE-MRI before start of therapy. Contrast-enhanced dynamic T{sub 1} mapping was obtained, and a simple data analysis strategy based on the calculation of the maximum slope of the tissue concentration–time curve divided by the maximum of the arterial input function was used as a measure of tumor microcirculation (PI), which integrates information on both flow and permeability. Results: In 39 patients (47.0%), T downstaging (ypT0-2) was observed. During a mean (±SD) follow-up period of 71 ± 29 months, 58 patients (69.9%) survived, and disease-free survival was achieved in 45 patients (54.2%). The mean PI (PImean) averaged over the group of nonresponders was significantly higher than for responders. Additionally, higher PImean in age- and gender-adjusted analyses was strongly predictive of therapy nonresponse. Most importantly, PImean strongly and significantly predicted disease-free survival (unadjusted hazard ratio [HR], 1.85 [ 95% confidence interval, 1.35-2.54; P<.001)]; HR adjusted for age and sex, 1.81 [1.30-2.51]; P<.001) as well as overall survival (unadjusted HR 1.42 [1.02-1.99], P=.040; HR adjusted for age and sex, 1.43 [1.03-1.98]; P=.034). Conclusions: This analysis identifies PImean as a novel biomarker that is predictive for therapy response, disease-free survival, and overall survival in patients with primary locally advanced rectal cancer.

  20. [Lineage switch - conversion of acute lymphoblastic leukaemia to acute myeloid leukaemia in 4 years old girl].

    PubMed

    Szpecht, Dawid; Derwich, Katarzyna; Wachowiak, Jacek; Konatkowska, Benigna; Dworacki, Grzegorz

    2008-01-01

    We report a case of a 4-year-old girl with diagnosed proB acute lymphoblastic leukaemia with co-expression CD33 antigen, treated according to Acute Lymphoblastic Leukaemia Intercontinental - Berlin Frankfurt Münster 2002 (ALL-IC BFM 2002) protocol for standard risk group. Haematological remission was obtained on day 33 of induction treatment (on time). During induction and consolidation therapy there were no early serious adverse effects. The late isolated bone marrow relapse of acute myeloid leukaemia, type 7 was noted in our patient. We recognized this case as a lineage switch acute lymphoblastic leukaemia to acute myeloid leukaemia. In spite of Ida Flag regimen and following Acute Myeloid Leukaemia - Berlin Frankfurt Münster 2004 (AML-BFM 2004) protocol were administered, the clinical and haematological remission was not achieved and the patient died because of disease progression (circulatory and respiratory insufficiency).

  1. From community college to 4-year institutions: Latinas' successful completion of STEM baccalaureate degrees

    NASA Astrophysics Data System (ADS)

    Zamudio, Rocio

    The purpose of this qualitative study was to explore the narrative of Latina graduates who successfully navigated through community college and 4-year institutions in the STEM fields. Rather than focus on what these students lack as much of the current research does, the study explored what assets these students bring that supports their success in STEM fields. Utilizing an ethnographic interview approach, participants who attained STEM baccalaureates in California were interviewed. Qualitative findings revealed various experiences, attitudes, and cultural influences that led to successful completion of a STEM degree. First, the study found that successful community college Latina STEM graduates exhibit grit, are resilient, determined, and have positive attitudes about their underrepresentation in STEM. Second, participants sought after peer, faculty, and staff relationships that helped them be successful. Lastly, participants had the support of their families and reported a high level of connectedness to their culture. Implications, recommendations for practice, and directions for future research are discussed.

  2. [Noma in a 4 year-old girl: a case report from Chad].

    PubMed

    Cocquempot, K; Javaudin, O; Lerasle, P; Aigle, L

    2014-01-01

    This case report describes a 4-year-old girl in Chad with noma, also called cancrum oris. This acute gangrenous stomatitis has a combined morbidity-mortality rate that can reach 70%. It occurs worldwide but is most common in sub-Saharan Africa in children aged 2 to 16 years. Its pathogenesis is uncertain, but several bacteria including Fusobacterium necrophorum, Prevotella intermedia and Pseudomonas aeruginosa may be responsible for the development of noma, which develops over the oral lesions these bacteria cause. Poverty is its most important risk factor. Due to its rapid course and high lethality, it requires emergency treatment with antibiotics, daily dressing of the lesion, and nutritional rehabilitation. Surgical removal of the remaining necrotic tissue can be followed by reconstructive procedures. Physical and speech therapy should be initiated to prevent functional complications. PMID:24736219

  3. [A 4-year-old girl with diarrhoea, paresis and mutism].

    PubMed

    Engan, Mette; Bjørlykke, John Asle; Moen, Gunnar; Lund, Kjetil Børve; Njølstad, Gro

    2016-09-01

    BACKGROUND Rotavirus is a common cause of gastroenteritis in children. Neurological manifestations associated with rotavirus infections are well described and range from benign afebrile convulsions to lethal encephalopathy or encephalitis.CASE PRESENTATION We present an uncommon neurological manifestation in a Caucasian child in the course of a rotavirus infection. A 4-year old girl presented with mutism, hypotonia and reduced consciousness. Magnetic resonance imaging revealed diffusion abnormalities in the splenium corpus callosum and bilaterally in the nuclei dentate in the cerebellum. She was diagnosed with rotavirus cerebellitis.INTERPRETATION Her clinical symptoms and the magnetic resonance imaging abnormalities were uncommon and previously described in only a few Caucasian children. The outcome has varied, and some children have shown long term neurological sequela. Treatment with immunoglobulins and corticosteroids has been used in similar cases, but there is no established treatment for this condition.

  4. Investigation of 4-year-old stabilised/solidified and accelerated carbonated contaminated soil.

    PubMed

    Antemir, A; Hills, C D; Carey, P J; Magnié, M-C; Polettini, A

    2010-09-15

    The investigation of the pilot-scale application of two different stabilisation/solidification (S/S) techniques was carried out at a former fireworks and low explosives manufacturing site in SE England. Cores and granular samples were recovered from uncovered accelerated carbonated (ACT) and cement-treated soils (S/S) after 4 years to evaluate field-performance with time. Samples were prepared for microstructural examination and leaching testing. The results indicated that the cement-treated soil was progressively carbonated over time, whereas the mineralogy of the carbonated soil remained essentially unchanged. Distinct microstructures were developed in the two soils. Although Pb, Zn and Cu leached less from the carbonated soil, these metals were adequately immobilised by both treatments. Geochemical modeling of pH-dependent leaching data suggested that the retention of trace metals resulted from different immobilisation mechanisms operating in the two soils examined. PMID:20579807

  5. [Preclinical management of accidental methadone intoxication of a 4-year-old girl. Antagonist or intubation?].

    PubMed

    Hainer, C; Bernhard, M; Gries, A

    2004-10-01

    We report on the preclinical management of a 4-year-old child who was found in a comatose condition with respiratory failure after accidental ingestion of methadone. Emergency airway management was carried out with endotracheal intubation instead of administering the antagonist naloxone. The child could be extubated 12 h later and was released from hospital after 3 days with no neurological symptoms. The authors attempt to formulate an algorithm for the preclinical management of opioid intoxication with reference to the literature and own experience. Endotracheal intubation seems to be superior to the use of the antagonist naloxone, especially in a critical situation. This is the only way to ensure a rapid oxygenation with adequate airway protection and with the simultaneous avoidance of the side-effects of naloxone. A restrictive and critical administration of the opioid antagonist naloxone is recommended when there is suspicion of opioid ingestion but no signs of intoxication. PMID:15278196

  6. [A 4-year-old girl with diarrhoea, paresis and mutism].

    PubMed

    Engan, Mette; Bjørlykke, John Asle; Moen, Gunnar; Lund, Kjetil Børve; Njølstad, Gro

    2016-09-01

    BACKGROUND Rotavirus is a common cause of gastroenteritis in children. Neurological manifestations associated with rotavirus infections are well described and range from benign afebrile convulsions to lethal encephalopathy or encephalitis.CASE PRESENTATION We present an uncommon neurological manifestation in a Caucasian child in the course of a rotavirus infection. A 4-year old girl presented with mutism, hypotonia and reduced consciousness. Magnetic resonance imaging revealed diffusion abnormalities in the splenium corpus callosum and bilaterally in the nuclei dentate in the cerebellum. She was diagnosed with rotavirus cerebellitis.INTERPRETATION Her clinical symptoms and the magnetic resonance imaging abnormalities were uncommon and previously described in only a few Caucasian children. The outcome has varied, and some children have shown long term neurological sequela. Treatment with immunoglobulins and corticosteroids has been used in similar cases, but there is no established treatment for this condition. PMID:27686206

  7. Investigation of 4-year-old stabilised/solidified and accelerated carbonated contaminated soil.

    PubMed

    Antemir, A; Hills, C D; Carey, P J; Magnié, M-C; Polettini, A

    2010-09-15

    The investigation of the pilot-scale application of two different stabilisation/solidification (S/S) techniques was carried out at a former fireworks and low explosives manufacturing site in SE England. Cores and granular samples were recovered from uncovered accelerated carbonated (ACT) and cement-treated soils (S/S) after 4 years to evaluate field-performance with time. Samples were prepared for microstructural examination and leaching testing. The results indicated that the cement-treated soil was progressively carbonated over time, whereas the mineralogy of the carbonated soil remained essentially unchanged. Distinct microstructures were developed in the two soils. Although Pb, Zn and Cu leached less from the carbonated soil, these metals were adequately immobilised by both treatments. Geochemical modeling of pH-dependent leaching data suggested that the retention of trace metals resulted from different immobilisation mechanisms operating in the two soils examined.

  8. The outcome status of chronic pain patients 4 years after multidisciplinary care.

    PubMed

    Tyre, T E; Walworth, D E; Tyre, E M

    1994-01-01

    Thirty-three patients previously treated for a variety of chronic pain syndromes (largely non-surgical back problems) were selected for study on the basis of 2 years or greater post-discharge status. A patient profile was developed revealing an 86% successful return-to-work rate and minimal use of narcotics 4 years after discharge. In addition, there was relatively low use of either inpatient or outpatient medical services after treatment. These patient behaviors were specific goals of the pain management program in which these patients had participated. Interesting data were also collected on medication use after treatment and methods of pain control used most successfully. Selected outcome variables were also studied across specific diagnostic categories (surgical v non-surgical back problems, amputee pain, reflex sympathetic dystrophy, and others) for this group. In general, rather compelling positive outcomes are shown for the long-term effects of multi-disciplinary pain management.

  9. Cerebral candidiasis in a 4-year-old boy after intestinal surgery.

    PubMed

    Zhang, Shu-Cheng

    2015-03-01

    Cerebral candidiasis is a devastating disease which contributes to a high mortality. Most of the cerebral candidiasis are never microbiologically or radiologically confirmed. In this case, a 4-year-old boy who developed cerebral candidiasis was successfully rescued and presented. The diagnosis of cerebral candidiasis was established based on both microbiologic and radiologic examinations. The pathogen was revealed to be Candida albicans by cerebrospinal fluid and central venous catheter cultures, and the cerebral involvement was recorded by series head magnetic resonance imaging (MRI) with an appearance of special encephalitis demonstrated. The imaging studies played a critical role throughout the diagnosis and treatment. Familiarity with the imaging findings in the appropriate clinical setting may result in a heightened level of awareness of this infection and, consequently, in earlier diagnosis and treatment.

  10. The dipole observed in the {ital COBE} DMR 4 year data

    SciTech Connect

    Lineweaver, C.H.; Tenorio, L.; Smoot, G.F.; Keegstra, P.

    1996-10-01

    The largest anisotropy in the cosmic microwave background (CMB) is the {approx_equal}3 mK dipole assumed to be due to our velocity with respect to the CMB. Using the 4 year data set from all six channels of the {ital COBE} Differential Microwave Radiometers (DMR), we obtain a best-fit dipole amplitude 3.358{plus_minus}0.001{plus_minus}0.023 mK in the direction ({ital l},{ital b})=(264.31{degrees}{plus_minus}0.04{degree}{plus_minus}0.16{degree} +48.05{degrees}{plus_minus}0.02{degree}{plus_minus}0.09{degree}), where the first uncertainties are statistical and the second include calibration and combined systematic uncertainties. This measurement is consistent with previous DMR and FIRAS results. {copyright} {ital 1996 The American Astronomical Society.}

  11. Measuring implicit attitudes of 4-year-olds: the preschool implicit association test.

    PubMed

    Cvencek, Dario; Greenwald, Anthony G; Meltzoff, Andrew N

    2011-06-01

    The Preschool Implicit Association Test (PSIAT) is an adaptation of an established social cognition measure (IAT) for use with preschool children. Two studies with 4-year-olds found that the PSIAT was effective in evaluating (a) attitudes toward commonly liked objects (flowers=good) and (b) gender attitudes (girl=good or boy=good). The gender attitude PSIAT was positively correlated with corresponding explicit attitude measures and also children's actual sex. The new implicit and explicit measures of gender attitudes demonstrated discriminant validity; each predicted variance in children's gendered play activities beyond that predicted by the other. Discussion describes potential uses of the PSIAT to investigate development of societally significant attitudes and stereotypes at younger ages than are achievable with currently available methods.

  12. [Noma in a 4 year-old girl: a case report from Chad].

    PubMed

    Cocquempot, K; Javaudin, O; Lerasle, P; Aigle, L

    2014-01-01

    This case report describes a 4-year-old girl in Chad with noma, also called cancrum oris. This acute gangrenous stomatitis has a combined morbidity-mortality rate that can reach 70%. It occurs worldwide but is most common in sub-Saharan Africa in children aged 2 to 16 years. Its pathogenesis is uncertain, but several bacteria including Fusobacterium necrophorum, Prevotella intermedia and Pseudomonas aeruginosa may be responsible for the development of noma, which develops over the oral lesions these bacteria cause. Poverty is its most important risk factor. Due to its rapid course and high lethality, it requires emergency treatment with antibiotics, daily dressing of the lesion, and nutritional rehabilitation. Surgical removal of the remaining necrotic tissue can be followed by reconstructive procedures. Physical and speech therapy should be initiated to prevent functional complications.

  13. Predicting Reading and Spelling Disorders: A 4-Year Prospective Cohort Study

    PubMed Central

    Bigozzi, Lucia; Tarchi, Christian; Caudek, Corrado; Pinto, Giuliana

    2016-01-01

    In this 4-year prospective cohort study, children with a reading and spelling disorder, children with a spelling impairment, and children without a reading and/or spelling disorder (control group) in a transparent orthography were identified in third grade, and their emergent literacy performances in kindergarten compared retrospectively. Six hundred and forty-two Italian children participated. This cohort was followed from the last year of kindergarten to third grade. In kindergarten, the children were assessed in phonological awareness, conceptual knowledge of writing systems and textual competence. In third grade, 18 children with a reading and spelling impairment and 13 children with a spelling impairment were identified. Overall, conceptual knowledge of the writing system was the only statistically significant predictor of the clinical samples. No differences were found between the two clinical samples. PMID:27014145

  14. Predicting Reading and Spelling Disorders: A 4-Year Prospective Cohort Study.

    PubMed

    Bigozzi, Lucia; Tarchi, Christian; Caudek, Corrado; Pinto, Giuliana

    2016-01-01

    In this 4-year prospective cohort study, children with a reading and spelling disorder, children with a spelling impairment, and children without a reading and/or spelling disorder (control group) in a transparent orthography were identified in third grade, and their emergent literacy performances in kindergarten compared retrospectively. Six hundred and forty-two Italian children participated. This cohort was followed from the last year of kindergarten to third grade. In kindergarten, the children were assessed in phonological awareness, conceptual knowledge of writing systems and textual competence. In third grade, 18 children with a reading and spelling impairment and 13 children with a spelling impairment were identified. Overall, conceptual knowledge of the writing system was the only statistically significant predictor of the clinical samples. No differences were found between the two clinical samples. PMID:27014145

  15. Laparoscopic Removal of a Large Gastric Trichobezoar in a 4-Year-Old Girl

    PubMed Central

    Cintolo, Jessica; Telem, Dana A.; Divino, Celia M.; Chin, Edward H.

    2009-01-01

    Background: Standard treatment of large gastric bezoars not amenable to medical or endoscopic management is surgical removal. The optimal operative approach, laparotomy versus laparoscopy, is a contested subject. Though laparoscopic removal has been described, it remains a relatively new technique for surgical management with outcome literature limited to case reports. In addition, currently described laparoscopic techniques often involve limited midline laparotomy incisions or >3 cm extensions of port sites. Methods: The following describes the case of a 4-year-old girl with a large gastric trichobezoar. Results: The gastric trichobezoar was successfully removed through a 12-mm left lower quadrant trocar incision cosmetically hidden within a skin crease. Conclusion: This case, along with accumulating literature, supports the use of laparoscopy to treat large gastric bezoars. PMID:20202404

  16. Phonological awareness and phonemic perception in 4-year-old children with delayed expressive phonology skills.

    PubMed

    Rvachew, Susan; Ohberg, Alyssa; Grawburg, Meghann; Heyding, Joan

    2003-11-01

    The purpose of this study was to compare the phonological awareness abilities of 2 groups of 4-year-old children: one with normally developing speech and language skills and the other with moderately or severely delayed expressive phonological skills but age-appropriate receptive vocabulary skills. Each group received tests of articulation, receptive vocabulary, phonemic perception, early literacy, and phonological awareness skills. The groups were matched for receptive language skills, age, socioeconomic status, and emergent literacy knowledge. The children with expressive phonological delays demonstrated significantly poorer phonemic perception and phonological awareness skills than their normally developing peers. The results suggest that preschool children with delayed expressive phonological abilities should be screened for their phonological awareness skills even when their language skills are otherwise normally developing. PMID:14658998

  17. Long-Term Exercise in Older Adults: 4-Year Outcomes of Music-Based Multitask Training

    PubMed Central

    Herrmann, François R.; Fielding, Roger A.; Reid, Kieran F.; Rizzoli, René; Trombetti, Andrea

    2016-01-01

    Prospective controlled evidence supporting the efficacy of long-term exercise to prevent physical decline and reduce falls in old age is lacking. The present study aimed to assess the effects of long-term music-based multitask exercise (i.e., Jaques-Dalcroze eurhythmics) on physical function and fall risk in older adults. A 3-year follow-up extension of a 1-year randomized controlled trial (NCT01107288) was conducted in Geneva (Switzerland), in which 134 community-dwellers aged ≥65 years at increased risk of falls received a 6-month music-based multitask exercise program. Four years following original trial enrolment, 52 subjects (baseline mean ± SD age, 75 ± 8 years) who (i) have maintained exercise program participation through the 4-year follow-up visit (“long-term intervention group”, n = 23) or (ii) have discontinued participation following original trial completion (“control group”, n = 29) were studied. They were reassessed in a blind fashion, using the same procedures as at baseline. At 4 years, linear mixed-effects models showed significant gait (gait speed, P = 0.006) and balance (one-legged stance time, P = 0.015) improvements in the long-term intervention group, compared with the control group. Also, long-term intervention subjects did better on Timed Up & Go, Five-Times-Sit-to-Stand and handgrip strength tests, than controls (P < 0.05, for all comparisons). Furthermore, the exercise program reduced the risk of falling (relative risk, 0.69; 95 % confidence interval, 0.5–0.9; P = 0.008). These findings suggest that long-term maintenance of a music-based multitask exercise program is a promising strategy to prevent age-related physical decline in older adults. They also highlight the efficacy of sustained long-term adherence to exercise for falls prevention. PMID:25148876

  18. Changes in soil chemical and microbiological properties during 4 years of application of various organic residues.

    PubMed

    Odlare, M; Pell, M; Svensson, K

    2008-01-01

    A 4-year field trial was established in eastern Sweden to evaluate the effects of organic waste on soil chemical and microbiological variables. A simple crop rotation with barley and oats was treated with either compost from household waste, biogas residue from household waste, anaerobically treated sewage sludge, pig manure, cow manure or mineral fertilizer. All fertilizers were amended in rates corresponding to 100kgNha(-1)year(-1). The effects of the different types of organic waste were evaluated by subjecting soil samples, taken each autumn 4 weeks after harvest, to an extensive set of soil chemical (pH, Org-C, Tot-N, Tot-P, Tot-S, P-AL, P-Olsen, K-AL, and some metals) and microbiological (B-resp, SIR, microSIR active and dormant microorganisms, PDA, microPDA, PAO, Alk-P and N-min) analyses. Results show that compost increased pH, and that compost as well as sewage sludge increased plant available phosphorus; however, the chemical analysis showed few clear trends over the 4 years and few clear relations to plant yield or soil quality. Biogas residues increased substrate induced respiration (SIR) and, compared to the untreated control amendment of biogas residues as well as compost, led to a higher proportion of active microorganisms. In addition, biogas residues increased potential ammonia oxidation rate (PAO), nitrogen mineralization capacity (N-min) as well as the specific growth rate constant of denitrifiers (microPDA). Despite rather large concentrations of heavy metals in some of the waste products, no negative effects could be seen on either chemical or microbiological soil properties. Changes in soil microbial properties appeared to occur more rapidly than most chemical properties. This suggests that soil microbial processes can function as more sensitive indicators of short-term changes in soil properties due to amendment of organic wastes. PMID:17697770

  19. College for All? Is There Too Much Emphasis on Getting a 4-Year College Degree? Research Synthesis.

    ERIC Educational Resources Information Center

    Boesel, David; Fredland, Eric

    Over the years, larger and larger portions of high school graduates have enrolled in 4-year colleges. Although many people view college as essential to success in the labor market, the movement toward 4-year colleges also has its critics. These critics contend that the public has come to believe that almost all high school graduates should go to…

  20. Dietary Glycemic Load and Cancer Recurrence and Survival in Patients with Stage III Colon Cancer: Findings From CALGB 89803

    PubMed Central

    2012-01-01

    Background The influence of glycemic load and related measures on survival among colon cancer patients remains largely unknown. Methods We conducted a prospective, observational study of 1011 stage III colon cancer patients reporting dietary intake during and 6 months after participation in an adjuvant chemotherapy trial. We examined the influence of glycemic load, glycemic index, fructose, and carbohydrate intakes on cancer recurrence and mortality using Cox proportional hazards regression; all tests of statistical significance were two-sided. Results Stage III colon cancer patients in the highest quintile of dietary glycemic load experienced an adjusted hazard ratio (HR) for disease-free survival of 1.79 (95% confidence interval [CI] = 1.29 to 2.48), compared with those in the lowest quintile (P trend across quintiles <.001). Increased glycemic load was associated with similar detriments in recurrence-free (P trend across quintiles <.001) and overall survival (P trend across quintiles <.001). These associations differed statistically significant by body mass index (BMI) (P interaction =.01). Whereas glycemic load was not associated with disease-free survival in patients with BMI < 25kg/m2, higher glycemic load was statistically significant associated with worse disease-free survival among overweight or obese participants (BMI ≥ 25kg/m2; HR = 2.26; 95% CI = 1.53 to 3.32; P trend across quintiles <.001). Increasing total carbohydrate intake was similarly associated with inferior disease-free, recurrence-free, and overall survival (P trend across quintiles <.001). Conclusion Higher dietary glycemic load and total carbohydrate intake were statistically significant associated with an increased risk of recurrence and mortality in stage III colon cancer patients. These findings support the role of energy balance factors in colon cancer progression and may offer potential opportunities to improve patient survival. PMID:23136358

  1. A 4-year follow-up study of a rural community with endemic Chagas' disease*

    PubMed Central

    Puigbó, J. J.; Rhode, J. R. Nava; Barrios, H. García; Yépez, C. Gil

    1968-01-01

    The paper reports on a 4-year follow-up study that represents the continuation of a previous cross-sectional study on Chagas' disease carried out in a rural community (Belén) in Venezuela. The earlier study included 1210 persons all over 5 years of age out of a total of 1656 inhabitants and demonstrated a high prevalence of Chagas' infection (47.3%) and a high rate of Chagas' disease seropositivity among those with chronic myocardial heart disease (84.8%); heart disease was found in 17.3% of persons studied. The follow-up study was based on 812 persons and established that in the sample the frequency of Chagas' infection was 16.3% and that of heart disease 2.2%. Clinical, electrocardiographic and radiological analyses were made on patients with previous heart disease as well as on new patients. Different evolutive electrocardiographic patterns have been found, including variations ranging from normal to definitively abnormal. ImagesFIG. 1FIG. 2 PMID:4974002

  2. Sexual development in prepubertal obese boys: a 4-year longitudinal study.

    PubMed

    Zhai, Lingling; Zhao, Jian; Bai, Yinglong; Liu, Li; Zheng, Linlin; Jia, Lihong; Yao, Xingjia

    2013-01-01

    The objective of the study was to evaluate whether or not sexual development differs between boys with prepubertal obesity and boys of normal weight. We enrolled healthy obese and normoweight schoolboys from Shenyang City, Liaoning, China. Eligible boys were at Tanner stage 1 and 8 years of age at baseline. We measured testosterone and estradiol concentrations in the saliva and assessed auxology annually for 4 years. In all 56 obese and 56 normoweight boys, the height, weight, body composition, and sex organ volume increased with age. The percentages of body fat, fat mass, and lean mass were all higher in obese than in normoweight boys. The mean testicular volume was smaller in obese boys than in normoweight boys. The sex hormone concentrations increased with age, except for testosterone in obese boys in year 3 of follow-up. In year 4, estradiol concentrations were significantly higher in obese boys than in normoweight boys. Excessive adiposity in prepubertal boys might affect testicular volume, possibly because of high estradiol and low testosterone concentrations.

  3. Visual access trumps gender in 3- and 4-year-old children's endorsement of testimony.

    PubMed

    Terrier, Nathalie; Bernard, Stéphane; Mercier, Hugo; Clément, Fabrice

    2016-06-01

    Several studies have investigated how preschoolers weigh social cues against epistemic cues when taking testimony into account. For instance, one study showed that 4- and 5-year-olds preferred to endorse the testimony of an informant who had the same gender as the children; by contrast, when the gender cue conflicted with an epistemic cue--past reliability--the latter trumped the former. None of the previous studies, however, has shown that 3-year-olds can prioritize an epistemic cue over a social cue. In Experiment 1, we offer the first demonstration that 3-year-olds favor testimony from a same-gender informant in the absence of other cues. In Experiments 2 and 3, an epistemic cue-visual access--was introduced. In those experiments, 3- and 4-year-olds endorsed the testimony of the informant with visual access regardless of whether it was a same-gender informant (Experiment 3) or a different-gender informant (Experiment 2). These results demonstrate that 3-year-olds are able to give more weight to an epistemic cue than to a social cue when evaluating testimony.

  4. Sprain of the neck: quality of life and psychological functioning. A 4-year retrospective study.

    PubMed

    Versteegen, G J; Dijkstra, P U; Jaspers, J P C; Meijler, W J; ten Duis, H J; Klip, E C

    2003-05-01

    Aim of the study was to analyse quality of life and psychological functioning in patients with sprain of the neck, to analyse the relationship between complaints, quality of life, psychological functioning and personality factors, and to analyse the profile of patients with whiplash associated disorders (WAD), 4 years after trauma. From the University Hospital Groningen 193 patients with the diagnose sprain of the neck filled out a questionnaire. Of this group 100 subjects did not have complaints before the accident and were therefore at risk for the development of complaints as a result of sprain of the neck. Quality of life and psychological functioning were assessed using the RAND-36 and the SCL-90, respectively. Personality was assessed by means of the Dutch Personality Questionnaire. Of the group at risk (56% women and 44% men, mean age: 33.9, SD: 14.6) quality of life was significantly worse in subjects with complaints (mean: 78.4, SD: 15.5) compared to subjects without complaints (mean: 87.5, SD: 8.7). Psychological functioning did not differ significantly between the group with complaints compared to group without complaints. Personality did not differ between the groups. Personality and complaints together were significantly related to quality of life (r: 0.77) and psychological functioning (r: 0.85). No specific profile of WAD patients was found. In conclusion, personality and complaints influence quality of life and psychological functioning to a considerable extent.

  5. Microbiologically influenced corrosion of stainless steel weld and base metal -- 4 year field test results

    SciTech Connect

    Felder, C.M.; Stein, A.A.

    1994-12-31

    This paper presents the results obtained from a 4-year test program to determine the effects of microbiologically influenced corrosion (MIC) on piping materials under service conditions representative of a fresh water cooling water system. The test was performed in a field installed test loop and was constructed to operate under four typical flow conditions: continuous flow at 4--6 fps (1.2--1.8 m/s), continuous flow at 0.5--1 fps (0.15--0.3 m/s), intermittent flow, and stagnant. Test materials consisted of pipe spools as well as coupons fabricated from Type 304, Type 316, Type 316L, and 6-percent molybdenum stainless steel, and titanium pipe. The pipe spools and coupons contained girth welds; the stainless steel girth welds were made with high and low heat inputs. Two types of bacterial colonization, bulbous nodules and shiny flat deposits, were observed in both weld metal and base metal of the Type 300 series materials, including Type 316L. Three different MIC morphologies were observed: pits with small openings and extensive tunneling, open pits, and shallow surface attack. A correlation was found to exist between the type of bacteria colonization, the MIC morphology, and the metallurgical characteristics of the materials. The MIC was not preferential to sensitized regions but was found to be related to residual cold work in the material.

  6. Outdoor transmission measurement at 26 GHz: Results of a 4 year trial in Prague

    NASA Astrophysics Data System (ADS)

    Thorvaldsen, Per; Henne, Ingvar

    2016-05-01

    This paper presents the results from a field trial that was performed during a 4 year period on a 5.5 km long radio link path operating at 26 GHz in Prague. The purpose was to investigate the amount of attenuation due to precipitation and its yearly variations. The attenuation of the radio link signal and the rain rate were measured. The measured attenuation results are compared to the models given by the International Telecommunication Union (ITU). The propagation measurements show large yearly variations due to variability in rain rate from one year to another. The measured results are in agreement with the ITU long-term statistical rain attenuation model if the measured rain rate for the individual year is used. For the worst year the number of fades, the fade duration, the fade speed, the worst month statistics, and the polarization correlation are presented. The measurements presented will add to the current knowledge of fading due to precipitation, and some of the results, such as the fade duration distributions, are new knowledge.

  7. Performance of the SCUBA-2 dry dilution refrigerator: 4 years of operation at the JCMT

    NASA Astrophysics Data System (ADS)

    Bintley, Dan; Kuroda, John T.; Starman, Erik G.; Craig, Simon; Holland, Wayne S.

    2012-09-01

    Cryogen free or ‘dry’ dilution refrigerators that integrate a cryocooler such as a two stage pulse tube to replace the conventional liquid helium bath and 1K pot, have become a practical alternative for cooling astronomical detectors to mK temperatures and offer many advantages. SCUBA-2, the new submillimetre camera in operation at the JCMT, on the summit of Mauna Kea, Hawaii, was one of the first instruments to use such a fridge design. The dry dilution fridge for SCUBA-2 has now been in service for almost 4 years during commissioning at JCMT. In the most recent astronomical commissioning phase, the dilution fridge was in continuous operation for 10 months with no loss of base temperature or cooling power, cooling the SCUBA-2 detector arrays to below 100mK while maintaining a further 100Kg of enclosure, shields and SQUID amplifiers at 1K. In this paper we review some of the lessons from operating a dry dilution fridge at the JCMT and the necessary changes that have been incorporated. We present the performance of the fridge and discus its role in ensuring the success of SCUBA-2.

  8. Occasional detection of thymic epithelial tumor 4 years after diagnosis of adult onset Still disease

    PubMed Central

    Lococo, Filippo; Bajocchi, Gianluigi; Caruso, Andrea; Valli, Riccardo; Ricchetti, Tommaso; Sgarbi, Giorgio; Salvarani, Carlo

    2016-01-01

    Abstract Background: Thymoma is a T cell neoplasm arising from the thymic epithelium that due to its immunological role, frequently undercover derangements of immunity such a tumors and autoimmune diseases. Methods: Herein, we report, to the best of our knowledge, the first description of an association between thymoma and adult onset Still disease (AOSD) in a 47-year-old man. The first one was occasionally detected 4 years later the diagnosis of AOSD, and surgically removed via right lateral thoracotomy. Histology confirmed an encapsulated thymic tumor (type AB sec. WHO-classification). Results: The AOSD was particularly resistant to the therapy, requiring a combination of immunosuppressant followed by anti-IL1R, that was the only steroids-sparing treatment capable to induce and maintain the remission. The differential diagnosis was particularly challenging because of the severe myasthenic-like symptoms that, with normal laboratory tests, were initially misinterpreted as fibromyalgia. The pathogenic link of this association could be a thymus escape of autoreactive T lymphocytes causing autoimmunity. Conclusion: Clinicians should be always include the possibility of a thymoma in the differential diagnosis of an unusual new onset of weakness and normal laboratories data, in particular once autoimmune disease is present in the medical history. PMID:27603335

  9. Ameloblastic Fibro-Odontoma in a 4-Year-Old Boy

    PubMed Central

    Ghandehari-Motlagh, Mehdi; Khosravi, Zahra; Meighani, Ghasem; Baradaran-Nakhjavani, Yahya

    2016-01-01

    Introduction Ameloblastic fibro-odontoma (AFO) is defined as a benign odontogenic tumor with slow growing behavior. Its prevalence is rare. AFO is characterized by histologic features of ameloblastic fibroma (AF) with the formation of enamel and dentine. Case Presentation This is a case report of AFO accompanied with a number of impacted deciduous teeth and its management in a 4-year old boy. Examination of oral cavity revealed an extensive swelling from midline to left deciduous maxillary first molar, covered with normal mucosa. Radiographic examination showed a well-defined mixed radiolucent-radiopaque lesion that extended horizontally from midline to mesial border of the left maxillary primary first molar and vertically from alveolar crest to the floor of nose. The differential diagnosis was odontoma (ameloblastic fibro-odontoma, complex odontoma). Surgical enucleation and curettage was performed under general anesthesia. Histopathologic sections show bone trabeculae in marrow spaces. There was myxoid matrix in some spaces which contained odontogenic epithelial cells. These findings led to diagnosis of AFO. No sign of recurrence has been observed during the 12-month follow-up period. Conclusion Although AFO is a rare tumor, it is more prevalent in childrenʼs jaw. Conservative surgical treatment allowed the normal development of teeth. PMID:27307963

  10. Children's Spatial Representations: 3- and 4-Year-Olds are Affected by Irrelevant Peripheral References.

    PubMed

    Krüger, Markus; Jahn, Georg

    2015-01-01

    Children as young as 3 years can remember an object's location within an arrangement and can retrieve it from a novel viewpoint (Nardini et al., 2006). However, this ability is impaired if the arrangement is rotated to compensate for the novel viewpoint, or, if the arrangement is rotated and children stand still. There are two dominant explanations for this phenomenon: self-motion induces an automatic spatial updating process which is beneficial if children move around the arrangement, but misleading if the children's movement is matched by the arrangement and not activated if children stand still and only the arrangement is moved (see spatial updating; Simons and Wang, 1998). Another explanation concerns reference frames: spatial representations might depend on peripheral spatial relations concerning the surrounding room instead on proximal relations within the arrangement, even if these proximal relations are sufficient or more informative. To evaluate these possibilities, we rotated children (N = 120) aged between 3 and 6 years with an occluded arrangement. When the arrangement was in misalignment to the surrounding room, 3- and 4-year-olds' spatial memory was impaired and 5-year-olds' was lightly impaired suggesting that they relied on peripheral references of the surrounding room for retrieval. In contrast, 6-years-olds' spatial representation seemed robust against misalignment indicating a successful integration of spatial representations. PMID:26617537

  11. [Evolution of nutritional status in hemodialysis patients during 4 years of follow].

    PubMed

    Fernández Castillo, Rafael; Fernández Gallegos, Ruth

    2011-12-01

    Protein-calorie malnutrition as well as systemic inflammation and metabolic disorders are common among patients with chronic renal failure undergoing renal replacement therapy (hemodialysis), which contributes to their morbidity and mortality. This work has followed 90 patients of both sexes with chronic kidney disease who were treated with hemodialysis periodically in our unit for four years. All patients were performed quarterly measurements of plasma albúmina (A1b), total cholesterol (TC), total protein (TP) and monthly transferrin (Tr), Anthropometric measurements of height and weight were taken on all patients by using a balance/stadiometer (Perperson 113481); weight was measured in kilograms and height in centimetres. BMI was calculated with this formula: weight/height2 and classified according to the WHO criteria: BMI < 18.50: Underweight; from 18.50 to 24.99: Normal range; from 25.00 to 29.99: Overweight; and BMI > or =30.00: Obese. The aim of this work was evaluate the nutritional status of these patients through the assessment of biochemical parameters and anthropometric parameters and determine if these patients suffer alterations suggesting nutritional deterioration directly related to the time on dialysis. During the 4 years all patients showed a significant decline of biochemical parameters, on the other hand the BMI did not significant changes in relation to malnutrition. Malnutrition in patients on dialysis is therefore evident, the BMI does not correspond with the biochemical parameters observed, so nutritional deterioration of these patients is mainly manifested by biochemical parameters studied. PMID:23094520

  12. A 4-year study of invasive and native spider populations in Maine

    USGS Publications Warehouse

    Jakob, Elizabeth M.; Porter, Adam H.; Ginsberg, Howard; Bednarski, Julie V.; Houser, Jeremy

    2011-01-01

    Invasive spiders pose potential threats to native spiders. In 2002, the European spider Linyphia triangularis (Clerck, 1757) (Araneae: Linyphiidae) was discovered in all but one county in Maine. At Acadia National Park, we conducted a 4-year study of L. triangularis and three native linyphiid species of a similar size (Frontinella communis (Hentz, 1850), Pityohyphantes subarcticus Chamberlin and Ivie, 1943, and Neriene radiata (Walckenaer, 1842)). Using line-transect surveys, we measured population densities in coastal and forest habitat. The density of L. triangularis varied across years but was always significantly higher on the coast than in the forest. In contrast, only one native species was present on the coast and at very low numbers. Coastal L. triangularis were larger and in better condition than those in the forest, and numbers and biomass of insect prey were also higher on the coast. In 2 years, we also conducted transects at a second coastal location in Maine where the invader was at low density. At that site, native densities were substantially higher than at either Acadia site. Our data are consistent with the hypothesis that L. triangularis is reducing populations of native spiders. Companion studies suggest that L. triangularis negatively impacts natives by usurping both web sites and webs.

  13. The MACHO Project: Preliminary Results from 4 years of LMC observations.

    NASA Astrophysics Data System (ADS)

    Cook, K.; Alcock, C.; Alves, D.; Minniti, D.; Marshall, S.; Vandehei, T.; Griest, K.; Allsman, R.; Axelrod, T.; Freeman, K.; Peterson, B.; Rodgers, A.; Pratt, M.; Becker, A.; Stubbs, C.; Tomaney, A.; Lehner, M.; Bennett, D.; Nelson, C.; Quinn, P.; Sutherland, W.; Welch, D.

    1997-12-01

    The MACHO Project is a search for dark matter in the form of massive compact halo objects (MACHOs). Photometric monitoring of tens of millions of stars in the Large Magellanic Cloud (LMC), Small Magellanic Cloud (SMC), and Galactic bulge is used to search for gravitational microlensing events caused by these otherwise invisible objects. An analysis of 4 years of LMC data on 12.5 million stars is currently underway. We present preliminary results of this analysis which reveal about 15 candidate microlensing events. We also present our microlensing detection efficiency calculation pipeline. The accurate determination of our detection efficiency is key in estimating the MACHO contribution to the dark matter halo. The efficiency pipeline uses data from the MACHO Project's ground based survey and from HST observations of MACHO fields to determine the true color and luminosity distribution of LMC source stars. Artificial microlensing events are then inserted into the underlying source distribution, image sequences are created from a wide sample of real image conditions and detection efficiencies are determined using our standard reduction pipeline. The full calculation of our efficiencies requires the creation, reduction and analysis of 322 Gbytes of artificial image data and is currently underway. The MACHO Project dedicates this work to one of its key founders, Alex Rodgers.

  14. The effects of a 4-year program promoting bicycle helmet use among children in Quebec.

    PubMed Central

    Farley, C; Haddad, S; Brown, B

    1996-01-01

    OBJECTIVES. This study assessed the effectiveness of a 4-year program of bicycle helmet promotion that targeted elementary school children in one region of Quebec. The program revolved primarily around persuasive communication and community organization, combining standard educational activities and activities to facilitate helmet acquisition and use. METHODS. Helmet use was compared between more than 8000 young cyclists in municipalities exposed or not exposed to the program. Factors influencing helmet use were controlled through the use of multivariate analyses. RESULTS. Helmet use increased from 1.3% before program implementation to 33% in 1993. The program was clearly effective in most cycling circumstances and for various groups of children. However, the benefits of the program were unequally distributed; the program was one third as effective in poorer municipalities as in "average-rich" ones. CONCLUSIONS. This community-based program that combined various types of activities appeared to be effective. New intervention models are needed to ensure an equitable distribution of benefits. PMID:8561241

  15. Step to college. Moving from the high school career academy through the 4-year university.

    PubMed

    Maxwell, N L

    2001-12-01

    This study addresses the question "Do school-to-work programs, as embodied by career academies, facilitate postsecondary education?" The author conceptualizes postsecondary education as a series of steps through the university and examines the high school career academy's influence on entrance into, route through, and outcomes from a 4-year university. Data are drawn from applicant and student records at a comprehensive, urban university for all individuals originating from a single district's high schools. The findings suggest that students from career academies have higher academic achievement upon leaving high school, less need for remediation in English at the university, and a 4-percentage-point increase in graduation from the university than students who are not from academies. These findings suggest that school-to-work programs could facilitate positive outcomes in postsecondary education. However, the continued high rates of remediation and the low rates of graduation, even for students from career academics, suggest that their influence might not be enough to ensure success in postsecondary education. This analysis therefore suggests that further research should identify program components that increase postsecondary education and determine how these components can be institutionalized and built on in subsequent reforms.

  16. Atresia of the Aortic Arch in 4-Year-Old Child: A Clinical Case Study

    PubMed Central

    Nigro Stimato, Vittoria; Didier, Dominique; Beghetti, Maurice; Tissot, Cécile

    2015-01-01

    Atresia of the aortic arch is a rare congenital heart defect with a high mortality when associated with other intracardiac defects. Cardiac magnetic resonance (CMR) provides the exact anatomy of the aortic arch and collateral circulation and is useful to diagnose-associated aortic arch anomalies. This report describes the case of a 4-year-old child with atresia of the aortic arch, referred to our institution with the diagnosis of aortic coarctation and bicuspid aortic valve. On clinical exam, the femoral pulses were not palpable and there was a significant differential blood pressure between the upper and lower limbs. The echocardiography showed a severely stenotic bicuspid aortic valve but was limited for the exact description of the aortic arch. CMR showed absence of lumen continuity between the ascending and descending aorta distal to the left subclavian artery, extending over 5 mm, with the presence of a bend in the arch and diverticulum on either side of the zone of discontinuity, suggesting the diagnosis atresia of the aortic arch rather than coarctation or interruption. The patient benefited from a successful surgical commissurotomy of the aortic valve and reconstruction of the aortic arch with a homograft. The post-operative CMR confirmed the good surgical result. This case emphasizes the utility of CMR to provide good anatomical information to establish the exact diagnosis and the operative strategy. PMID:25853109

  17. Stability of alexithymia in late adolescence: results of a 4-year follow-up study.

    PubMed

    Karukivi, Max; Pölönen, Tuukka; Vahlberg, Tero; Saikkonen, Suvi; Saarijärvi, Simo

    2014-10-30

    The aim of the present study was to assess the stability of alexithymia in adolescents and the effects of parental factors and social support thereon. The sample comprised 315 late adolescents, of whom 259 were female and 56 male. At baseline, the mean age of the subjects was 19 years (range 17-21 years). The follow-up period was 4 years (2008-2012). The 20-item Toronto Alexithymia Scale (TAS-20) was used for the assessment of alexithymia both at baseline and follow-up. The Multidimensional Scale of Perceived Social Support (MSPSS) and the Parental Bonding Instrument (PBI) were used as measures at baseline. Regarding absolute stability, the changes in the TAS-20 total scores and two subscales (DIF and EOT) were statistically significant but the effect sizes for the changes were small (Cohen׳s d 0.21-0.24). The test-retest correlations for the TAS-20 total and subscale scores were high (ρ=0.50-0.64, P<0.001), indicating relative stability. While several parental and social support variables were associated with alexithymia at baseline, low social support from friends was the only to predict higher alexithymia at follow-up. Alexithymia is a stable personality trait also in late adolescence. Low social support from friends is related to alexithymia in young adulthood.

  18. [Evolution of nutritional status in hemodialysis patients during 4 years of follow].

    PubMed

    Fernández Castillo, Rafael; Fernández Gallegos, Ruth

    2011-12-01

    Protein-calorie malnutrition as well as systemic inflammation and metabolic disorders are common among patients with chronic renal failure undergoing renal replacement therapy (hemodialysis), which contributes to their morbidity and mortality. This work has followed 90 patients of both sexes with chronic kidney disease who were treated with hemodialysis periodically in our unit for four years. All patients were performed quarterly measurements of plasma albúmina (A1b), total cholesterol (TC), total protein (TP) and monthly transferrin (Tr), Anthropometric measurements of height and weight were taken on all patients by using a balance/stadiometer (Perperson 113481); weight was measured in kilograms and height in centimetres. BMI was calculated with this formula: weight/height2 and classified according to the WHO criteria: BMI < 18.50: Underweight; from 18.50 to 24.99: Normal range; from 25.00 to 29.99: Overweight; and BMI > or =30.00: Obese. The aim of this work was evaluate the nutritional status of these patients through the assessment of biochemical parameters and anthropometric parameters and determine if these patients suffer alterations suggesting nutritional deterioration directly related to the time on dialysis. During the 4 years all patients showed a significant decline of biochemical parameters, on the other hand the BMI did not significant changes in relation to malnutrition. Malnutrition in patients on dialysis is therefore evident, the BMI does not correspond with the biochemical parameters observed, so nutritional deterioration of these patients is mainly manifested by biochemical parameters studied.

  19. Antibiotic Consumption During a 4-year Period in a Community Hospital with an Antimicrobial Stewardship Program

    PubMed Central

    Garcell, Humberto Guanche; Arias, Ariadna Villanueva; Fernandez, Eliezer Alemán; Guerrero, Yaquelín Batista; Serrano, Ramon N. Alfonso

    2016-01-01

    Objectives We sought to evaluate the trend of antibiotic consumption in patients admitted to a community hospital in Qatar with an antimicrobial stewardship program. Methods This observational study was carried out in a 75-bed facility in Western Qatar over a 4-year period (2012–2015). The monitoring of antimicrobial consumption from inpatient wards was performed from the pharmacy records and presented as defined daily dose (DDD) divided by the patient days and expressed as 100 bed-days (DBD). Results The consumption of antimicrobials in 2012 was 171.3 DBD, and increased to 252.7 DBD in 2013, 229.1 DBD in 2014, and 184.7 DBD in 2015. Cephalosporins use reduced from 98.2 DBD in 2013 to 51.5 DBD in 2015 while the consumption of penicillins increased during the beginning of 2014 with a slight decrease in 2015. Carbapenems consumption during 2014–2015 was lower than previous years, and vice-versa for aminoglycosides. Fluoroquinolones had a sustained increase with 37.1% increased consumption in 2015 compared to the two previous years. There was an increase in the use of intravenous (IV) (108.5%) and oral azithromycin (55.1%) and the use of oral (152.8%) and IV moxifloxacin (22.9%). Conclusions We observed a decrease in antibiotic use in patients admitted to a community hospital with an antimicrobial stewardship program, but the increase in fluoroquinolones consumption is a concern that requires focused strategies. PMID:27602189

  20. Zirconia Implants in Esthetic Areas: 4-Year Follow-Up Evaluation Study

    PubMed Central

    Borgonovo, Andrea Enrico; Censi, Rachele; Vavassori, Virna; Arnaboldi, Oscar; Maiorana, Carlo

    2015-01-01

    Objectives. The aim is to evaluate the survival and success rates, as well as the marginal bone loss (MBL) and periodontal indexes of zirconia implants positioned in the esthetic jaw areas. Materials and Method. 13 patients were selected and 20 one-piece zirconia implants were used for the rehabilitation of single tooth or partially edentulous ridge in the esthetic jaw areas. Six months after surgery and then once a year, a clinical-radiographic evaluation was performed in order to estimate peri-implant tissue health and marginal bone loss. Results. The survival and success rates were 100%. The average marginal bone loss from baseline to 48 months after surgery was +2.1 mm. Four years after surgery, the median and the mode for visible Plaque Index and Bleeding On Probing resulted 1 whereas Probing Pocket Depth amounted to 3 mm (SD = ±0.49 mm). Conclusion. One-piece zirconia dental implants are characterized by high biocompatibility, low plaque adhesion, and absence of microgap that can be related to the clinical success of these implants even in the esthetic areas. PMID:26124836

  1. Risk of recurrence and conditional survival in complete responders treated with TKIs plus or less locoregional therapies for metastatic renal cell carcinoma

    PubMed Central

    Santini, Daniele; Santoni, Matteo; Conti, Alessandro; Procopio, Giuseppe; Verzoni, Elena; Galli, Luca; di Lorenzo, Giuseppe; De Giorgi, Ugo; De Lisi, Delia; Nicodemo, Maurizio; Maruzzo, Marco; Massari, Francesco; Buti, Sebastiano; Altobelli, Emanuela; Biasco, Elisa; Ricotta, Riccardo; Porta, Camillo; Vincenzi, Bruno; Papalia, Rocco; Marchetti, Paolo; Burattini, Luciano; Berardi, Rossana; Muto, Giovanni; Montironi, Rodolfo; Cascinu, Stefano; Tonini, Giuseppe

    2016-01-01

    PURPOSE We retrospectively analyzed the risk of recurrence and conditional Disease-Free Survival (cDFS) in 63 patients with complete remission during treatment with tirosin kinase inhibitor (TKI), alone or with local treatment in metastatic renal cell carcinoma. RESULTS 37% patients achieve CR with TKI alone, while 63% with additional loco-regional treatments. 49% patients recurred after CR, with a median Disease free survival of 28.2 months. Patients treated with multimodal approaches present lower rate of recurrence (40% vs 61%) and longer Disease free survival compared to patient treated with TKI alone (16.5 vs 41.9 months, p=0.039).Furthermore the rate of recurrence was higher in patients with brain (88%), pancreatic (71%) and bone metastasis (50%). Patients who continued TKI therapy after complete response had a longer disease free survival than patients who stopped therapy, although the difference was not significant (42.1 vs 25.1 months, p=0.254). 2y-cDFS was better in patients treated with multimodal treatment and who continued TKIs than the other patient arms. CONCLUSIONS The prognostic value of CR depends on the site where was obtained and how was obtained (with or without locoregional treatment). Cessation of TKI should be carefully considered in complete responder patients. PMID:27027342

  2. Serological and clinical surveillance studies to validate reported foot-and-mouth disease free status in Tsirang district of Bhutan.

    PubMed

    Dukpa, Kinzang; Robertson, Ian D; Ellis, Trevor M

    2012-04-01

    Serological and clinical studies were conducted between March 2009 and August 2010 to validate the foot-and-mouth disease free status of Tsirang district of Bhutan as determined by the country's passive surveillance system. Randomised (first survey) and targeted (third survey) samplings, with subsequent follow-up samplings (second and fourth), were conducted on FMD-susceptible animals to detect the disease at a design prevalence of 25% and 20% at the individual animal-level and village-level, respectively. Sera from cattle, goats, pigs, and sheep were tested for the presence of non-structural protein (NSP) antibodies using two commercial (PrioCHECK(®) FMDV NS and CHEKIT(®)-FMD-3ABC-bo-ov) and one in-house NSP kit (c-ELISA, AAHL, Australia). The overall seropositivity (all species) at the animal-level was 3% (95% CI: 1.7, 4.8) and 3.5% (95% CI: 2.1, 5.4), for the randomised and targeted surveys, respectively. Except for one goat from the first survey, none of the small ruminants and pigs had NSP antibodies. The seropositives from the first and targeted surveys were distributed among 13 and 16 of 20 villages sampled, respectively. All repeat testing from the initial seropositive animals and their herd mates, for both the first and third surveys, were negative in the NSP tests 6-8 months later. Using the hypergeometric exact probability formula for two-stage analyses, the results enabled rejection of the null hypothesis and supported conclusion that the population was free from disease at the minimum expected prevalence of 20% at the 95.53% and 99.46% confidence levels, for the randomised and targeted surveys, respectively. Clinical surveillance also showed absence of disease or clinical signs suggestive of FMD. The few seropositives were likely to be false positives due to factors such as imperfect specificities of the tests and possible NSP-residues in the vaccines. The study has paved the way for initiation of zoning approaches for the progressive control of FMD

  3. Association of vascular endothelial factors with cardiovascular outcome and mortality in chronic kidney disease patients: A 4-year cohort study

    PubMed Central

    Rambod, Mehdi; Heine, Gunnar H.; Seiler, Sarah; Dominic, Elizabeth A; Rogacev, Kyrill S.; Dwivedi, Rama; Ramezani, Ali; Wing, Maria R.; Amdur, Richard L.; Fliser, Danilo; Raj, Dominic S

    2014-01-01

    Background Angiogenic cytokines fms-like tyrosine kinase-1(sFlt-1) and placental growth factor (PlGF) are associated with increased risk for cardiovascular disease (CVD) in the general population. In this study we examine the association between these vascular endothelial factors and atherosclerosis, cardiovascular outcome, and mortality in chronic kidney disease (CKD) patients. Methods Serum level of PlGF and sFlt-1 were measured in 301 patients with CKD, who were followed for up to 4 years. Primary outcomes were CV events and all-cause mortality. Carotid-intima media thickness (CIMT) was used as marker of atherosclerosis. Kaplan-Meier survival curves and the Cox proportional hazard model were used to assess the association of biomarkers and clinical outcomes. Results Mean (SD) PlGF and sFlt-1 were 5.45 ng/ml (3.76) and 68.6 (28.0) pg/ml, respectively. During the follow up time, 60 patients (19.9%) experienced CV events and 22 patients (7.3%) died. Compared with low PlGF, patients with PlGF above median level had higher CV events (12.7% vs. 27.2%, p=0.002) and mortality (2.0% vs. 12.6%, p < 0.001). The associations of PlGF and sFlt-1 with CV events were not statistically significant in the fully adjusted model. Higher PlGF was associated with greater death risk (HR=5.22, 95%CI: 1.49–18.33, p=0.01), which was robust to adjustment for sFlt-1 and other risk factors. Elevated sFlt-1 level was also an independent predictor of mortality (HR 3.41, 95%CI: 1.49-9.51, p=0.019). Conclusion In CKD patients not yet on dialysis, higher serum level of PlGF and sFlt-1 are associated with increased mortality, but not CV events. PMID:25128974

  4. Sparing Sphincters and Laparoscopic Resection Improve Survival by Optimizing the Circumferential Resection Margin in Rectal Cancer Patients

    PubMed Central

    Keskin, Metin; Bayraktar, Adem; Sivirikoz, Emre; Yegen, Gülcin; Karip, Bora; Saglam, Esra; Bulut, Mehmet Türker; Balik, Emre

    2016-01-01

    Abstract The goal of rectal cancer treatment is to minimize the local recurrence rate and extend the disease-free survival period and survival. For this aim, obtainment of negative circumferential radial margin (CRM) plays an important role. This study evaluated predictive factors for positive CRM status and its effect on patient survival in mid- and distal rectal tumors. Patients who underwent curative resection for rectal cancer were included. The main factors were demographic data, tumor location, surgical technique, neoadjuvant therapy, tumor diameter, tumor depth, lymph node metastasis, mesorectal integrity, CRM, the rate of local recurrence, distant metastasis, and overall and disease-free survival. Statistical analyses were performed by using the Chi-squared test, Fisher exact test, Student t test, Mann–Whitney U test and the Mantel–Cox log-rank sum test. A total of 420 patients were included, 232 (55%) of whom were male. We observed no significant differences in patient characteristics or surgical treatment between the patients who had positive CRM and who had negative CRM, but a higher positive CRM rate was observed in patients undergone abdominoperineal resection (APR) (P < 0.001). Advanced T-stage (P < 0.001), lymph node invasion (P = 0.001) and incomplete mesorectum (P = 0.007) were encountered significantly more often in patients with positive CRM status. Logistic regression analysis revealed that APR (P < 0.001) and open resection (P = 0.046) were independent predictors of positive CRM status. Moreover, positive CRM was associated with decreased 5-year overall and disease-free survival (P = 0.002 and P = 0.004, respectively). This large single-institution series demonstrated that APR and open resection were independent predictive factors for positive CRM status in rectal cancer. Positive CRM independently decreased the 5-year overall and disease-free survival rates. PMID:26844498

  5. Sparing Sphincters and Laparoscopic Resection Improve Survival by Optimizing the Circumferential Resection Margin in Rectal Cancer Patients.

    PubMed

    Keskin, Metin; Bayraktar, Adem; Sivirikoz, Emre; Yegen, Gülcin; Karip, Bora; Saglam, Esra; Bulut, Mehmet Türker; Balik, Emre

    2016-02-01

    The goal of rectal cancer treatment is to minimize the local recurrence rate and extend the disease-free survival period and survival. For this aim, obtainment of negative circumferential radial margin (CRM) plays an important role. This study evaluated predictive factors for positive CRM status and its effect on patient survival in mid- and distal rectal tumors.Patients who underwent curative resection for rectal cancer were included. The main factors were demographic data, tumor location, surgical technique, neoadjuvant therapy, tumor diameter, tumor depth, lymph node metastasis, mesorectal integrity, CRM, the rate of local recurrence, distant metastasis, and overall and disease-free survival. Statistical analyses were performed by using the Chi-squared test, Fisher exact test, Student t test, Mann-Whitney U test and the Mantel-Cox log-rank sum test.A total of 420 patients were included, 232 (55%) of whom were male. We observed no significant differences in patient characteristics or surgical treatment between the patients who had positive CRM and who had negative CRM, but a higher positive CRM rate was observed in patients undergone abdominoperineal resection (APR) (P < 0.001). Advanced T-stage (P < 0.001), lymph node invasion (P = 0.001) and incomplete mesorectum (P = 0.007) were encountered significantly more often in patients with positive CRM status. Logistic regression analysis revealed that APR (P < 0.001) and open resection (P = 0.046) were independent predictors of positive CRM status. Moreover, positive CRM was associated with decreased 5-year overall and disease-free survival (P = 0.002 and P = 0.004, respectively).This large single-institution series demonstrated that APR and open resection were independent predictive factors for positive CRM status in rectal cancer. Positive CRM independently decreased the 5-year overall and disease-free survival rates.

  6. Effects of explicit teacher-implemented phoneme awareness instruction in 4-year-olds.

    PubMed

    Tyler, Ann A; Osterhouse, Heather; Wickham, Katherine; Mcnutt, Robert; Shao, Yuanyuan

    2014-01-01

    The purpose of this study was to determine whether gains would be observed in an integrated group of 4-year-olds when phoneme awareness skills were explicitly taught by trained early childhood educators. In a quasi-experimental design with a delayed treatment approach, one classroom (N = 14) was randomly assigned to receive the instructional program in fall, while a second classroom (N = 10) served as a control and subsequently received the program in spring. Baseline assessment of speech and language skills indicated there were four participants with speech and/or language impairments. The teacher training involved an initial workshop and weekly hour-long mentoring meetings; the program was provided for 20 min a day, 4 d a week, for 10 weeks. Outcome measures of phoneme awareness and letter knowledge skills were obtained from non-standardized tasks administered pre-instruction and post-instruction, at mid-year and end-year points. When each classroom received the phoneme instruction, participants made gains in letter knowledge and phoneme level skills in comparison with group performance under regular instruction. These gains were statistically significant for phoneme blending and letter knowledge. Using an aggregate of all outcome measures, the gain for each classroom when under instruction was statistically significant as compared with when that same classroom was receiving the regular curriculum. Children with speech and/or language impairment responded more variably. Gains in the more difficult phoneme awareness skill of blending suggest the potential for marked change with an intensive, explicit classroom instruction and hold promise for SLPs collaborating with preschool teachers to provide time-efficient PA instruction.

  7. Allergen avoidance in infancy and allergy at 4 years of age.

    PubMed

    Hide, D W; Matthews, S; Tariq, S; Arshad, S H

    1996-02-01

    In an attempt to prevent or reduce the manifestations of atopic disease, a group of infants considered to be genetically at high risk of atopy was entered in a prenatally randomized, controlled study. A prophylactic group (n = 58) was either breast-fed with their mothers excluding foods regarded as highly antigenic from their diets, or given an extensively hydrolysed formula. In addition, strenuous efforts were made to reduce exposure to the house-dust mite by application of acaricide to the bedroom and living room carpets and upholstered furniture. A control group (n = 62) was fed conventionally by breast or on formula, and no specific environmental measures were taken. The results (previously reported) after 1 year showed significantly less total allergy, asthma, and eczema in the prophylactic group. Similar results were obtained at 2 years although the reduction in asthma no longer achieved statistical significance. However, there was significantly less sensitization, as shown by a battery of skin prick tests (SPTs), to both dietary allergens and aeroallergens in the prophylactic group. All the children have now been reviewed at the age of 4 years, and SPTs to a wide range of dietary allergens and aeroallergens have been performed. The control group continues to show more total allergy (odds ratio [OR] 2.73, 95% confidence interval [CI] 1.21-6.13, P < 0.02), definite allergy (allergic symptoms plus positive SPT) (OR 5.6, CI 1.8-17.9, P < 0.005), and eczema (OR 3.4, CI 1.2-10.1, P < 0.05). More control children have positive SPTs (OR 3.7, CI 1.3-10.0, P < 0.02). A dual approach to the prevention of allergic disease, avoiding as far as possible sensitization to food and aeroallergens, significantly reduces the risk of atopic disease. This should be reserved for infants considered at very high risk of atopy, and close medical and dietetic supervision must be available.

  8. Drinking consequences and subsequent drinking in college students over 4 years.

    PubMed

    Martinez, Julia A; Sher, Kenneth J; Wood, Phillip K

    2014-12-01

    There is some evidence that college student drinkers may continue drinking in the face of adverse consequences. We examined 2 hypotheses: (a) that this seemingly pathological behavior is a phenomenon of university life, occurring with consistency throughout the entirety of college, and (b) that individuals accumulate these consequences over multiple semesters in college. A sample of 3,720 students from a large Midwestern university was asked to complete surveys the summer before college and every semester thereafter for 4 years. Results showed that certain drinking-related consequences (e.g., blackouts, regretted sexual experiences) consistently predicted continued frequent heavy drinking in the following semester, even after controlling for sex, race, age, and previous-semester frequent heavy drinking (range of odds ratio = 1.17 to 1.45 across semesters, p < .01). Such potent consequences may predict subsequent drinking for a number of possible reasons that may be examined and addressed as they would pertain to specific protective behavioral strategy-related and cognitive interventions. Furthermore, consequences were accumulated over multiple semesters by notable proportions of students. For example, 13.8% of students reported blacking out 5 time-points or more--describing a full half or more of their college careers. Experimental studies which aim to modify students' perceptions of norms associated with these consequences may aid in developing interventions to reduce the burden of harm to students. In the broader context, and given the prevalence of students' accumulation of consequences, future study might aim to determine how and in what ways these findings describe either pathological or normative processes.

  9. Cognitive development in low risk preterm infants at 3–4 years of life

    PubMed Central

    Caravale, B; Tozzi, C; Albino, G; Vicari, S

    2005-01-01

    Background: Major neurological handicaps and neuropsychological disturbances are more common in ex-preterm children than their counterparts born at term. Objective: To establish in a prospective study whether a characteristic neuropsychological profile exists in ex-preterm children who do not exhibit neurodevelopmental deficits on routine clinical examination. Methods: Thirty intellectually normal children born preterm (30–34 weeks gestation) without major neurological disabilities and a control group of term children matched for age, sex, and parental educational and occupational status were assessed at 3–4 years of age to obtain a complete neuropsychological profile. Intellectual ability, language comprehension and expression, perceptual and visual motor function, working memory, and attention and behavioural problems were investigated. Results: Even in the absence of major neurological signs, children born preterm achieved lower mean scores than controls on the Stanford-Binet intelligence scale (110.8 v 121, p<0.001), visual perception test (33.8 v 42.7, p<0.001), visual motor integration test (42.6 v 47.4, p = 0.049), memory for location test (8.4 v 9.5, p = 0.007), sustained attention test (41.6 v 51.5, p = 0.009), and the picture vocabulary test (33.3 v 44.7, p = 0.021). Conclusions: Neuropsychological abnormalities can be detected early in childhood in apparently normal ex-preterm children and are consistent with a growing body of evidence that prematurity may be associated with long term neuropsychological morbidity in childhood and adolescence. PMID:15956096

  10. Stereotactic Body Radiotherapy for Clinically Localized Prostate Cancer: Toxicity and Biochemical Disease-Free Outcomes from a Multi-Institutional Patient Registry

    PubMed Central

    Sharma, Sanjeev; Shumway, Richard; Perry, David; Bydder, Sean; Simpson, C. Kelley; D'Ambrosio, David

    2015-01-01

    Objectives: To report on initial patient characteristics, treatment practices, toxicity, and early biochemical disease-free survival (bDFS) of localized prostate cancer treated with stereotactic body radiotherapy (SBRT) and enrolled in the RSSearch® Patient Registry. Methods: A retrospective analysis was conducted on patients with clinically localized prostate cancer enrolled in RSSearch® from June 2006 - January 2015. Patients were classified as low-risk (PSA ≤ 10 ng/ml, T1c-T2a, Gleason score ≤ 6), intermediate-risk (PSA 10.1 - 20 ng/ml, T2b-T2c, or Gleason 7), or high-risk (PSA > 20 ng/ml, T3 or Gleason ≥ 8). Toxicity was reported using Common Toxicity Criteria for Adverse Events, version 3. Biochemical failure was assessed using the Phoenix definition (nadir + 2 ng/ml). The Kaplan-Meier analysis was used to calculate bDFS and association of patient and tumor characteristics with the use of SBRT. Results: Four hundred thirty-seven patients (189 low, 215 intermediate, and 33 high-risk) at a median of 69 years (range: 48-88) received SBRT at 17 centers. Seventy-eight percent of patients received 36.25 Gy/5 fractions, 13% received 37 Gy/5 fractions, 6% received 35 Gy/5 fractions, 3% received 38 Gy/4 fractions, and 5% received a boost dose of 19.5-29 Gy following external beam radiation therapy. Median follow-up was 20 months (range: 1–64 months). Genitourinary (GU) and gastrointestinal (GI) toxicities were minimal, with no acute or late Grade 3+ GU or GI toxicity. Late Grade 1 and 2 urinary frequency was 25% and 8%. Late Grade 1 and 2 proctitis was 3% and 2%. Median PSA decreased from 5.8 ng/ml (range: 0.3-43) to 0.88, 0.4, and 0.3 ng/ml at one, two, and three years. Two-year bDFS for all patients was 96.1%. Two-year bDFS was 99.0%, 94.5%, and 89.8% for low, intermediate, and high-risk patients (p < 0.0001). Two-year bDFS was 99.2%, 93.2%, and 90.4% for Gleason ≤ 6, Gleason 7, and Gleason ≥ 8 (p < 0.0001). Two-year bDFS was 96.4%, 97

  11. Prognostic factors influencing survival in gastrointestinal leiomyosarcomas. Implications for surgical management and staging.

    PubMed Central

    Ng, E H; Pollock, R E; Munsell, M F; Atkinson, E N; Romsdahl, M M

    1992-01-01

    The appropriate surgical therapeutic options for either localized or more advanced disease in patients with gastrointestinal leiomyosarcomas remain unclear. A staging classification for this disease has not been adopted nor risk factors identifying patients at risk for recurrence defined. To address these issues, this study evaluated the influence of various clinicopathologic variables on overall and disease-free survival. In an univariate analysis of overall survival involving 191 patients, the Cox proportional hazards model identified four factors that were associated with a significantly better outcome: complete resection without tumor rupture (p less than 0.001), localized lesions (p less than 0.001), low grade of tumor (p = 0.02), and tumors smaller than 5 cm (p = 0.03). When interactive effects of these factors were taken into account, however, type of resection of the tumor was selected as the only significant prognostic factor in a multivariate analysis. Complete resection without tumor rupture improved overall survival of patients with localized disease (median, 46 months) as well as those with contiguous organ invasion (median, 36 months) or peritoneal implants (median, 36 months). In contrast, patients with incomplete resections survived for a median of 21 months. Patients with tumor rupture, despite removal of all gross disease, behaved similarly to those with incomplete resections; median survival was only 17 months. For disease-free survival, important determinants selected from a multivariate analysis were tumor rupture (p = 0.002), contiguous organ invasion (p = 0.02) and high tumor grade (p = 0.02). A staging classification incorporating these prognostic factors of significance was evaluated using a TGM system: T1 (less than 5 cm), T2 (greater than or equal to 5 cm), T3 (contiguous organ invasion or peritoneal implants), T4 (tumor rupture); G: G1 (low grade), G2 (high grade); M: M0 (no metastases), M1 (metastases present). The corresponding 5-year

  12. Maternal child-feeding practices and dietary inadequacy of 4-year-old children.

    PubMed

    Durão, Catarina; Andreozzi, Valeska; Oliveira, Andreia; Moreira, Pedro; Guerra, António; Barros, Henrique; Lopes, Carla

    2015-09-01

    This study aimed to evaluate the association between maternal perceived responsibility and child-feeding practices and dietary inadequacy of 4-year-old children. We studied 4122 mothers and children enrolled in the population-based birth cohort - Generation XXI (Porto, Portugal). Mothers self-completed the Child Feeding Questionnaire and a scale on covert and overt control, and answered to a food frequency questionnaire in face-to-face interviews. Using dietary guidelines for preschool children, adequacy intervals were defined: fruit and vegetables (F&V) 4-7 times/day; dairy 3-5 times/day; meat and eggs 5-10 times/week; fish 2-4 times/week. Inadequacy was considered as below or above these cut-points. For energy-dense micronutrient-poor foods and beverages (EDF), a tolerable limit was defined (<6 times/week). Associations between maternal perceived responsibility and child-feeding practices (restriction, monitoring, pressure to eat, overt and covert control) and children's diet were examined by logistic regression models. After adjustment for maternal BMI, education, and diet, and children's characteristics (sex, BMI z-scores), restriction, monitoring, overt and covert control were associated with 11-18% lower odds of F&V consumption below the interval defined as adequate. Overt control was also associated with 24% higher odds of their consumption above it. Higher perceived responsibility was associated with higher odds of children consuming F&V and dairy above recommendations. Pressure to eat was positively associated with consumption of dairy above the adequate interval. Except for pressure to eat, maternal practices were associated with 14-27% lower odds of inadequate consumption of EDF. In conclusion, children whose mothers had higher levels of covert control, monitoring, and restriction were less likely to consume F&V below recommendations and EDF above tolerable limits. Higher overt control and pressure to eat were associated, respectively, with higher

  13. CO2 fluxes exchanged by a 4-year crop rotation cycle.

    NASA Astrophysics Data System (ADS)

    Aubinet, M.; Moureaux, C.; Bodson, B.; Dufranne, D.; Heinesch, B.; Suleau, M.; Vancutsem, F.; Vilret, A.

    2009-04-01

    This study analyses carbon fluxes exchanged by a production crop during a four year cycle. Between 2004 and 2008, the successive crops were sugar beet, winter wheat, potato and again winter wheat. Eddy covariance, automatic and manual soil chamber, leaf diffusion and biomass measurements were performed continuously in order to obtain the daily and seasonal Net Ecosystem Exchange (NEE), Gross Primary Productivity (GPP), Total Ecosystem Respiration (TER), Net Primary Productivity (NPP), Autotrophic Respiration, Heterotrophic Respiration and Net Biome Production (NBP). The whole cycle budget showed that NEE was negative and the rotation behaved as a sink of 1.59 kgC m-2 over the 4-year rotation. However, if exports were deducted from the budget, the crop would become a small source of 0.22 (+/- 0.14) kgC m-2, which also suggests that the crop soil carbon content decreased. This could partly be explained by the crop management, as neither farmyard manure nor slurry had been applied to the crop for more than 10 years and as cereal straw had been systematically exported for livestock. This result is also strongly dependent on climate: the fluxes were subjected to a large inter-annual variability due to differences between crops but also to climate variability. In particular, the mild winter and the dry spring underwent in 2007 induced an increase of the biomass fraction that returned to the soil, at the expense of harvested biomass. If 2007 had been a ‘normal' year, the carbon emission by the crop rotation would have been twice as great. This is analysed more in detail in a companion presentation (Dufranne et al., this session). The impacts of some farmer interventions were quantified. In particular, the impact of ploughing was found to be limited both in intensity (1 to 2 micromol m-2 s-1) and duration (not more than 1 day). Seasonal budgets showed that, during cropping periods, the TER/GPP ratio varied between 40 and 60% and that TER was dominated mainly by the

  14. Evaluation of a glass-fiber-reinforced, bonded, inlay-supported fixed partial denture--4-year results.

    PubMed

    Jain, Poonam; Cobb, Deborah

    2002-09-01

    Glass-fiber-reinforced composite resin systems may be used as conservative alternatives to conventional fixed partial dentures (FPDs) for the replacement of a single missing tooth. This article describes a clinical technique and 4-year evaluation of an inlay bonded FPD. The patient presented with a missing maxillary right second premolar. A high-caries risk and moderate-to-advanced attachment loss around the abutment teeth, which were clinically stable, were noted. The patient had a strong desire to maintain his remaining dentition. Advantages of supragingival margins and minimal tooth structure removal made the bonded inlay bridge a viable alternative to a conventional FPD for this compromised restorative situation. The clinical performance of this glass-fiber-reinforced resin inlay FPD at the 4-year follow-up is provided. The restoration has served satisfactorily for more than 4 years and holds promise as a conservative, esthetic alternative to the conventional FPD in certain clinical cases.

  15. Loss of expression of MHC class I-related chain A (MICA) is a frequent event and predicts poor survival in patients with hepatocellular carcinoma.

    PubMed

    Zhang, Jie; Xu, Zhuding; Zhou, Xingchun; Zhang, Haibin; Yang, Ning; Wu, Yousheng; Chen, Yibing; Yang, Guangshun; Ren, Tingting

    2014-01-01

    Natural killer (NK) cells are important effector cells for the first line of defense against tumor. Distant MHC class I homolog MICA has been identified as human ligand for NK cell activating receptor NKG2D. Engagement of MICA triggers NK cells and augments antigen-specific CTL anti-tumor immunity. However, the expression level of MICA and its clinical significance in hepatocellular carcinoma remains to be elucidated. In the present study, a hospital-based study cohort of 143 HCC patients was involved. MICA expression levels were determined by immunohistochemical staining. The association of MICA expression with tumor clinicopathologic features, disease-free survival, and overall survival of HCC patients were analyzed. Significantly decreased expression of MICA was detected in tumor specimens. MICA expression was significantly associated with AFP level (P < 0.001) and tumor node metastasis stage (P = 0.003). Patients with reduced level of MICA had a statistically significantly shorter disease-free survival and overall survival duration than patients with preserved expression of MICA. However, in multivariate analysis, MICA expression level was found not to be an independent prognostic factor for both disease-free survival and overall survival of HCC patients. Our findings suggest that decreased MICA expression may play an important role in HCC tumor evasion of host immunity, which warrants further investigation in future studies.

  16. Multiple-factor analysis of the first radioactive iodine therapy in post-operative patients with differentiated thyroid cancer for achieving a disease-free status

    PubMed Central

    Liu, Na; Meng, Zhaowei; Jia, Qiang; Tan, Jian; Zhang, Guizhi; Zheng, Wei; Wang, Renfei; Li, Xue; Hu, Tianpeng; Upadhyaya, Arun; Zhou, Pingping; Wang, Sen

    2016-01-01

    131I treatment is an important management method for patients with differentiated thyroid cancer (DTC). Unsuccessful 131I ablation drastically affects the prognosis of the patients. This study aimed to analyze potential predictive factors influencing the achievement of a disease-free status following the first 131I therapy. This retrospective review included 315 DTC patients, and multiple factors were analyzed. Tumor size, pathological tumor stage, lymph node (LN) metastasis, distant metastasis, American Thyroid Association recommended risks, pre-ablation thyroglobulin (Tg), and thyroid stimulating hormone (TSH) displayed significant differences between unsuccessful and successful group. Cutoff values of Tg and TSH to predict a successful outcome were 3.525 ng/mL and 99.700 uIU/ml by receiver operating characteristic curves analysis. Binary logistic regression analysis showed that tumor stage T3 or T4, LN metastasis to N1b station, intermediate and high risks, pre-ablation Tg ≥ 3.525 ng/ml and TSH <99.700 μIU/mL were significantly associated with unsuccessful outcomes. Logistic regression equation for achieving a disease-free status could be rendered as: y (successful treatment) = −0.270–0.503 X1 (LN metastasis) −0.236 X2 (Tg) + 0.015 X3 (TSH). This study demonstrated LN metastasis, pre-ablation Tg and TSH were the most powerful predictors for achieving a disease-free status by the first 131I therapy. PMID:27721492

  17. Survival and Neurocognitive Outcomes After Cranial or Craniospinal Irradiation Plus Total-Body Irradiation Before Stem Cell Transplantation in Pediatric Leukemia Patients With Central Nervous System Involvement

    SciTech Connect

    Hiniker, Susan M.; Agarwal, Rajni; Modlin, Leslie A.; Gray, Christine C.; Harris, Jeremy P.; Million, Lynn; Kiamanesh, Eileen F.; Donaldson, Sarah S.

    2014-05-01

    Purpose: To evaluate survival and neurocognitive outcomes in pediatric acute lymphoblastic leukemia (ALL) patients with central nervous system (CNS) involvement treated according to an institutional protocol with stem cell transplantation (SCT) and a component of craniospinal irradiation (CSI) in addition to total-body irradiation (TBI) as preparative regimen. Methods and Materials: Forty-one pediatric ALL patients underwent SCT with TBI and received additional cranial irradiation or CSI because of CNS leukemic involvement. Prospective neurocognitive testing was performed before and after SCT in a subset of patients. Cox regression models were used to determine associations of patient and disease characteristics and treatment methods with outcomes. Results: All patients received a cranial radiation boost; median total cranial dose was 24 Gy. Eighteen patients (44%) received a spinal boost; median total spinal dose for these patients was 18 Gy. Five-year disease-free survival (DFS) for all patients was 67%. Those receiving CSI had a trend toward superior DFS compared with those receiving a cranial boost alone (hazard ratio 3.23, P=.14). Patients with isolated CNS disease before SCT had a trend toward superior DFS (hazard ratio 3.64, P=.11, 5-year DFS 74%) compared with those with combined CNS and bone marrow disease (5-year DFS 59%). Neurocognitive testing revealed a mean post-SCT overall intelligence quotient of 103.7 at 4.4 years. Relative deficiencies in processing speed and/or working memory were noted in 6 of 16 tested patients (38%). Pre- and post-SCT neurocognitive testing revealed no significant change in intelligence quotient (mean increase +4.7 points). At a mean of 12.5 years after transplant, 11 of 13 long-term survivors (85%) had completed at least some coursework at a 2- or 4-year college. Conclusion: The addition of CSI to TBI before SCT in pediatric ALL with CNS involvement is effective and well-tolerated. Craniospinal irradiation plus TBI is worthy

  18. Changes in Smoking Prevalence, Attitudes, and Beliefs over 4 Years Following a Campus-Wide Anti-Tobacco Intervention

    ERIC Educational Resources Information Center

    Lechner, William V.; Meier, Ellen; Miller, Mary Beth; Wiener, Josh L.; Fils-Aime, Yvon

    2012-01-01

    Objective: The current study examined the effectiveness of an institutional intervention aimed at decreasing prevalence of tobacco use and exposure to smoke on campus over a 4-year period. Participants: Participants were undergraduate students (N = 4,947) enrolled at a large Midwestern university between 2007 and 2010. Methods: In 2008, tobacco…

  19. Cigarette Use among Young Adults: Comparisons between 2-Year College Students, 4-Year College Students, and Those Not in College

    ERIC Educational Resources Information Center

    Lenk, Kathleen; Rode, Peter; Fabian, Lindsey; Bernat, Debra; Klein, Elizabeth; Forster, Jean

    2012-01-01

    Objective: To examine cigarette smoking among young adults based on education status. Participants: Community-based sample of 2,694 young adults in the United States Methods: The authors compared 3 groups--those not in college with no college degree, 2-year college students/graduates, 4-year college students/graduates--on various smoking measures:…

  20. Sensitivity of 4-Year-Olds to Featural and Second-Order Relational Changes in Face Distinctiveness

    ERIC Educational Resources Information Center

    McKone, Elinor; Boyer, Barbara L.

    2006-01-01

    Sensitivity to adult ratings of facial distinctiveness (how much an individual stands out in a crowd) has been demonstrated previously in children age 5 years or older. Experiment 1 extended this result to 4-year-olds using a "choose the more distinctive face" task. Children's patterns of choice across item pairs also correlated well with those of…

  1. Factors Influencing Childcare Workers' Promotion of Physical Activity in Children Aged 0-4 Years: A Qualitative Study

    ERIC Educational Resources Information Center

    Wilke, Sarah; Opdenakker, Claudia; Kremers, Stef P. J; Gubbels, Jessica S

    2013-01-01

    The present study examined the factors influencing childcare workers' promotion of physical activity (PA) among children aged 0-4?years, a particularly interesting context because of the increasing number of children attending childcare. Twenty Dutch childcare workers were interviewed. The interviews revealed some important barriers to the…

  2. A Case of a 4-Year-Old Boy with a Mesenteric Chylous Cyst Infected with Histoplasma capsulatum

    PubMed Central

    Apiyo, Mirraim; Olika, Biratu

    2016-01-01

    Mesenteric cysts are uncommon entities and chyle- (lymph-) containing cysts are the rarest of this group. This is a case report of a 4-year-old boy with a mesenteric chylous cyst who was later found to have Histoplasma capsulatum infection. PMID:26881169

  3. Different Executive Functions Support Different Kinds of Cognitive Flexibility: Evidence from 2-, 3-, and 4-Year-Olds

    ERIC Educational Resources Information Center

    Blakey, Emma; Visser, Ingmar; Carroll, Daniel J.

    2016-01-01

    Improvements in cognitive flexibility during the preschool years have been linked to developments in both working memory and inhibitory control, though the precise contribution of each remains unclear. In the current study, one hundred and twenty 2-, 3-, and 4-year-olds completed two rule-switching tasks. In one version, children switched rules in…

  4. Barriers and Opportunities for 2-Year and 4-Year STEM Degrees: Systemic Change to Support Students' Diverse Pathways

    ERIC Educational Resources Information Center

    Malcom, Shirley, Ed.; Feder, Michael, Ed.

    2016-01-01

    Nearly 40 percent of the students entering 2- and 4-year postsecondary institutions indicated their intention to major in science, technology, engineering, and mathematics (STEM) in 2012. But the barriers to students realizing their ambitions are reflected in the fact that about half of those with the intention to earn a STEM bachelor's degree and…

  5. Obesity and Developmental Functioning among Children Aged 2-4 Years. National Poverty Center Working Paper Series #08-07

    ERIC Educational Resources Information Center

    Cawley, John; Spiess, C. Katharina

    2008-01-01

    In developed countries, obesity tends to be associated with worse labor market outcomes. One possible reason is that obesity leads to less human capital formation early in life. This paper investigates the association between obesity and the developmental functioning of children at younger ages (2-4 years) than ever previously examined. Data from…

  6. How Do Symbols Affect 3- to 4-Year-Olds' Executive Function? Evidence from a Reverse-Contingency Task

    ERIC Educational Resources Information Center

    Apperly, Ian A.; Carroll, Daniel J.

    2009-01-01

    In two experiments, 330 3- to 4-year-olds competed for stickers in a game in which the optimal response strategy was to point to an empty box that their opponent would receive in order to obtain a baited box for themselves. When the baited box contained stickers, children showed a strong tendency to point at the baited box and therefore lose the…

  7. The Prevalence of ADHD, ODD, Depression, and Anxiety in a Community Sample of 4-Year-Olds

    ERIC Educational Resources Information Center

    Lavigne, John V.; LeBailly, Susan A.; Hopkins, Joyce; Gouze, Karen R.; Binns, Helen J.

    2009-01-01

    Few studies have examined the epidemiology of preschoolers' psychopathology. This study included 796 4-year-old children recruited from schools and pediatric practices in a diverse, urban area. Psychiatric disorder was assessed by a structured interview adapted for preschool children and by questionnaire. The most common disorders were…

  8. CO2 AND N-FERTILIZATION EFFECTS ON FINE ROOT LENGTH, PRODUCTION, AND MORTALITY: A 4-YEAR PONDEROSA PINE STUDY

    EPA Science Inventory

    We conducted a 4-year study of Pinus ponderosa fine root (<2 mm) responses to atmospheric CO2 and N-fertilization. Seedlings were grown in open-top chambers at 3 CO2 levels (ambient, ambient+175 mol/mol, ambient+350 mol/mol) and 3 N-fertilization levels (0, 10, 20 g?m-2?yr-1). ...

  9. Integrating Research-Informed Teaching within an Undergraduate Level 4 (Year 1) Diagnostic Radiography Curriculum: A Pilot Study

    ERIC Educational Resources Information Center

    Higgins, Robert; Hogg, Peter; Robinson, Leslie

    2013-01-01

    This article discusses the piloting and evaluation of the Research-informed Teaching experience (RiTe) project. The aim of RiTe was to link teaching and learning with research within an undergraduate diagnostic radiography curriculum. A preliminary pilot study of RiTe was undertaken with a group of level 4 (year 1) volunteer BSc (Hons) diagnostic…

  10. Effectiveness of a Fundamental Motor Skill Intervention for 4-Year-Old Children with Autism Spectrum Disorder: A Pilot Study

    ERIC Educational Resources Information Center

    Bremer, Emily; Balogh, Robert; Lloyd, Meghann

    2015-01-01

    A wait-list control experimental design was employed to investigate the effectiveness of a fundamental motor skill intervention at improving the motor skills, adaptive behavior, and social skills of 4-year-old children with autism spectrum disorder (experimental n?=?5, control n?=?4); the impact of intervention intensity was also explored. The…

  11. FACTORS AFFECTING PERFORMANCE OF TRANSFER STUDENTS FROM 2- TO 4-YEAR COLLEGES--WITH IMPLICATIONS FOR COORDINATION AND ARTICULATION.

    ERIC Educational Resources Information Center

    KNOELL, DOROTHY M.; MEDSKER, LELAND L.

    AN INTENSIVE STUDY WAS MADE OF THE FACTORS AFFECTING PERSISTENCE AND ACADEMIC ACCOMPLISHMENT OF STUDENTS TRANSFERRING FROM 2-YEAR (JUNIOR COLLEGE) TO 4-YEAR COLLEGES. THE OBJECTIVE WAS TO OBTAIN NORMATIVE INFORMATION ABOUT THE CHARACTERISTICS OF THESE STUDENTS. THE MAJOR STUDY GROUP WAS COMPOSED OF APPROXIMATELY 9,000 JUNIOR COLLEGE STUDENTS WHO…

  12. Long-Term Effectiveness of Behavioral versus Insight-Oriented Marital Therapy: A 4-Year Follow-Up Study.

    ERIC Educational Resources Information Center

    Snyder, Douglas K.; And Others

    1991-01-01

    Obtained 4-year follow-up data regarding marital status and marital accord for 59 couples receiving either behavioral (BMT) or insight-oriented (IOMT) marital therapy in a controlled outcome study. Found no significant group differences between the two treatment conditions at termination or six-month followup; but by four-year followup, a…

  13. Fathers' challenging parenting behavior prevents social anxiety development in their 4-year-old children: a longitudinal observational study.

    PubMed

    Majdandžić, Mirjana; Möller, Eline L; de Vente, Wieke; Bögels, Susan M; van den Boom, Dymphna C

    2014-02-01

    Recent models on parenting propose different roles for fathers and mothers in the development of child anxiety. Specifically, it is suggested that fathers' challenging parenting behavior, in which the child is playfully encouraged to push her limits, buffers against child anxiety. In this longitudinal study, we explored whether the effect of challenging parenting on children's social anxiety differed between fathers and mothers. Fathers and mothers from 94 families were separately observed with their two children (44 % girls), aged 2 and 4 years at Time 1, in three structured situations involving one puzzle task and two games. Overinvolved and challenging parenting behavior were coded. Child social anxiety was measured by observing the child's response to a stranger at Time 1, and half a year later at Time 2, and by parental ratings. In line with predictions, father's challenging parenting behavior predicted less subsequent observed social anxiety of the 4-year-old child. Mothers' challenging behavior, however, predicted more observed social anxiety of the 4-year-old. Parents' overinvolvement at Time 1 did not predict change in observed social anxiety of the 4-year-old child. For the 2-year-old child, maternal and paternal parenting behavior did not predict subsequent social anxiety, but early social anxiety marginally did. Parent-rated social anxiety was predicted by previous parental ratings of social anxiety, and not by parenting behavior. Challenging parenting behavior appears to have favorable effects on observed 4-year-old's social anxiety when displayed by the father. Challenging parenting behavior emerges as an important focus for future research and interventions.

  14. Association between energy-dense food consumption at 2 years of age and diet quality at 4 years of age.

    PubMed

    Vilela, Sofia; Oliveira, Andreia; Ramos, Elisabete; Moreira, Pedro; Barros, Henrique; Lopes, Carla

    2014-04-14

    The present study aimed to evaluate the association between the consumption of energy-dense foods at 2 years of age and the consumption of foods and diet quality at 4 years of age. The sample included 705 children evaluated at 2 and 4 years of age, as part of the population-based birth cohort Generation XXI (Porto, Portugal). Data on sociodemographic and lifestyle factors of both children and mothers were collected by face-to-face interviews. The weight and height of children were measured by trained professionals. Based on FFQ, four energy-dense food groups were defined: soft drinks; sweets; cakes; salty snacks. A healthy eating index was developed using the WHO dietary recommendations for children (2006) aged 4 years. The associations were evaluated through Poisson regression models. After adjustment for maternal age and education, child's carer, child's siblings and child's BMI, higher consumption of energy-dense foods at 2 years of age was found to be associated with higher consumption of the same foods 2 years later. An inverse association was found between the intake (≥ median) of soft drinks (incidence rate ratio (IRR) = 0.74, 95% CI 0.58, 0.95), salty snacks (IRR = 0.80, 95% CI 0.65, 1.00) and sweets (IRR = 0.73, 95% CI 0.58, 0.91) at 2 years of age and the consumption of fruit and vegetables at 4 years of age (≥ 5 times/d). Weekly and daily consumption of energy-dense foods at 2 years of age was associated with a lower healthy eating score at 4 years of age (IRR = 0.75, 95% CI 0.58, 0.96; IRR = 0.56, 95% CI 0.41, 0.77, respectively). The consumption of energy-dense foods at young ages is negatively associated with the diet quality of children a few years later.

  15. Fathers' challenging parenting behavior prevents social anxiety development in their 4-year-old children: a longitudinal observational study.

    PubMed

    Majdandžić, Mirjana; Möller, Eline L; de Vente, Wieke; Bögels, Susan M; van den Boom, Dymphna C

    2014-02-01

    Recent models on parenting propose different roles for fathers and mothers in the development of child anxiety. Specifically, it is suggested that fathers' challenging parenting behavior, in which the child is playfully encouraged to push her limits, buffers against child anxiety. In this longitudinal study, we explored whether the effect of challenging parenting on children's social anxiety differed between fathers and mothers. Fathers and mothers from 94 families were separately observed with their two children (44 % girls), aged 2 and 4 years at Time 1, in three structured situations involving one puzzle task and two games. Overinvolved and challenging parenting behavior were coded. Child social anxiety was measured by observing the child's response to a stranger at Time 1, and half a year later at Time 2, and by parental ratings. In line with predictions, father's challenging parenting behavior predicted less subsequent observed social anxiety of the 4-year-old child. Mothers' challenging behavior, however, predicted more observed social anxiety of the 4-year-old. Parents' overinvolvement at Time 1 did not predict change in observed social anxiety of the 4-year-old child. For the 2-year-old child, maternal and paternal parenting behavior did not predict subsequent social anxiety, but early social anxiety marginally did. Parent-rated social anxiety was predicted by previous parental ratings of social anxiety, and not by parenting behavior. Challenging parenting behavior appears to have favorable effects on observed 4-year-old's social anxiety when displayed by the father. Challenging parenting behavior emerges as an important focus for future research and interventions. PMID:23812638

  16. On the Survival Stage.

    ERIC Educational Resources Information Center

    Callahan, Steven

    1997-01-01

    Presents a survival expert's model of survival. Characterizes survival in terms of being prepared for a crisis, escaping the immediate threat, avoiding disorientation and fear, and the survival routine, which includes hope, flexibility, and humor. Notes the impact of posttrauma situations and the need for continued vigilance. (RJM)

  17. Asthma and asthma medication use among 4-year-old offspring of subfertile couples--association with IVF?

    PubMed

    Kuiper, Derk B; Seggers, Jorien; Schendelaar, Pamela; Haadsma, Maaike L; Roseboom, Tessa J; Heineman, Maas J; Hadders-Algra, Mijna

    2015-11-01

    This study evaluated the prevalence of asthma and asthma medication use in 213 4-year-old singletons followed from birth onwards, including three groups of children born following: (i) controlled ovarian hyperstimulation IVF/intracytoplasmic sperm injection (ICSI); (ii) modified natural cycle IVF/ICSI; and (iii) natural conception in subfertile couples. The rate of asthma medication was higher in the ovarian hyperstimulation-IVF/ICSI than in the subfertile group (adjusted odds ratios [aOR]: 1.96 [1.00-3.84]). Time to pregnancy, a proxy for the severity of subfertility, was not associated with asthma and asthma medication. In conclusion, controlled ovarian hyperstimulation-IVF/ICSI is associated with the use of asthma medication in 4-year-old offspring of subfertile couples.

  18. Risk of Developmental Delay Increases Exponentially as Gestational Age of Preterm Infants Decreases: A Cohort Study at Age 4 Years

    ERIC Educational Resources Information Center

    Kerstjens, Jorien M.; de Winter, Andrea F.; Bocca-TJeertes, Inger F.; Bos, Arend F.; Reijneveld, Sijmen A.

    2012-01-01

    Aim: The aim of the study was to assess the influence of decreasing gestational age on the risk of developmental delay in various domains at age 4 years among children born at a wide range of gestational ages. Method: In a community-based cohort, the parents of 1439 preterm-born children (24 0/7 to 35 6/7wks) and 544 term-born children (38 0/7 to…

  19. Self-critical perfectionism and depressive and anxious symptoms over 4 years: The mediating role of daily stress reactivity.

    PubMed

    Mandel, Tobey; Dunkley, David M; Moroz, Molly

    2015-10-01

    This study of 150 community adults examined heightened emotional reactivity to daily stress as a mediator in the relationships between self-critical (SC) perfectionism and depressive and anxious symptoms over a period of 4 years. Participants completed questionnaires assessing: perfectionism dimensions, general depressive symptoms (i.e., shared with anxiety), specific depressive symptoms (i.e., anhedonia), general anxious symptoms (i.e., shared with depression), and specific anxious symptoms (i.e., somatic anxious arousal) at Time 1; daily stress and affect (e.g., sadness, negative affect) for 14 consecutive days at Month 6 and Year 3; and depressive and anxious symptoms at Year 4. Path analyses indicated that SC perfectionism predicted daily stress-sadness reactivity (i.e., greater increases in sadness in response to increases in stress) across Month 6 and Year 3, which in turn explained why individuals with higher SC perfectionism had more general depressive symptoms, anhedonic depressive symptoms, and general anxious symptoms, respectively, 4 years later. In contrast, daily reactivity to stress with negative affect did not mediate the prospective relation between SC perfectionism and anhedonic depressive symptoms. Findings also demonstrated that higher mean levels of daily stress did not mediate the relationship between SC perfectionism and depressive and anxious symptoms 4 years later. These findings highlight the importance of targeting enduring heightened stress reactivity in order to reduce SC perfectionists' vulnerability to depressive and anxious symptoms over the long term. PMID:26191980

  20. Self-critical perfectionism and depressive and anxious symptoms over 4 years: The mediating role of daily stress reactivity.

    PubMed

    Mandel, Tobey; Dunkley, David M; Moroz, Molly

    2015-10-01

    This study of 150 community adults examined heightened emotional reactivity to daily stress as a mediator in the relationships between self-critical (SC) perfectionism and depressive and anxious symptoms over a period of 4 years. Participants completed questionnaires assessing: perfectionism dimensions, general depressive symptoms (i.e., shared with anxiety), specific depressive symptoms (i.e., anhedonia), general anxious symptoms (i.e., shared with depression), and specific anxious symptoms (i.e., somatic anxious arousal) at Time 1; daily stress and affect (e.g., sadness, negative affect) for 14 consecutive days at Month 6 and Year 3; and depressive and anxious symptoms at Year 4. Path analyses indicated that SC perfectionism predicted daily stress-sadness reactivity (i.e., greater increases in sadness in response to increases in stress) across Month 6 and Year 3, which in turn explained why individuals with higher SC perfectionism had more general depressive symptoms, anhedonic depressive symptoms, and general anxious symptoms, respectively, 4 years later. In contrast, daily reactivity to stress with negative affect did not mediate the prospective relation between SC perfectionism and anhedonic depressive symptoms. Findings also demonstrated that higher mean levels of daily stress did not mediate the relationship between SC perfectionism and depressive and anxious symptoms 4 years later. These findings highlight the importance of targeting enduring heightened stress reactivity in order to reduce SC perfectionists' vulnerability to depressive and anxious symptoms over the long term.

  1. The effect of verbal reminders on memory reactivation in 2-, 3-, and 4-year-old children.

    PubMed

    Imuta, Kana; Scarf, Damian; Hayne, Harlene

    2013-06-01

    For adults, verbal reminders provide a powerful key to unlock our memories. For example, a simple question, such as "Do you remember your wedding day?" can reactivate rich memories of the past, allowing us to recall experiences that may have occurred days, weeks, and even decades earlier. The ability to use another person's language to access our memory of a prior experience is considered to be one of the hallmarks in human memory development, but surprisingly, little is known about the ontogeny of this fundamental ability. Prior research has shown that by 4 years of age, children can use a simple verbal reminder (e.g., "Do you remember coming here before?") to reactivate an otherwise inaccessible memory of a unique visual stimulus. Given that language comprehension precedes production, it has been hypothesized that the ability to use verbal reminders may emerge well before 4 years of age. In the present experiment, we tested this hypothesis by examining whether a verbal reminder reactivated memory in 2-, 3-, and 4-year-old children who were tested using the visual-paired comparison (VPC) paradigm. Our findings showed that the ability to exploit a simple verbal reminder emerges by at least 2 years of age. PMID:22822936

  2. The prosurvival activity of ascites against TRAIL is associated with a shorter disease-free interval in patients with ovarian cancer

    PubMed Central

    2010-01-01

    Background The production of ascites is a common complication of ovarian cancer. Ascites constitute a unique tumor microenvironment that may affect disease progression. In this context, we recently showed that ovarian cancer ascites may protect tumor cells from TRAIL-induced apoptosis. In this study, we sought to determine whether the prosurvival effect of ascites affects disease-free intervals. Methods Peritoneal fluids were obtained from 54 women undergoing intra-abdominal surgery for suspected ovarian cancer (44 cancers and 10 benign diseases). The ability of peritoneal fluids to protect from TRAIL was assessed in the ovarian cancer cell line CaOV3, and IC50 were determined. The anti-apoptotic activity of 6 ascites against cisplatin, paclitaxel, doxorubicin, etoposide and vinorelbine was also assessed in CaOV3 cells, and the prosurvival activity of two ascites was assessed in 9 primary ovarian cancer cultures. Results Among the 54 peritoneal fluids tested, inhibition of TRAIL cytotoxicity was variable. Fluids originating from ovarian cancer were generally more protective than fluids from non-malignant diseases. Most of the 44 ovarian cancer ascites increased TRAIL IC50 and this inhibitory effect did not correlate strongly with the protein concentration in these ascites or the levels of serum CA125, a tumor antigen which is used in the clinic as a marker of tumor burden. The effect of ascites on cisplatin- and paclitaxel-induced cell death was assessed with 4 ascites having inhibitory effect on TRAIL-induced cell death and 2 that do not. The four ascites with prosurvival activity against TRAIL had some inhibitory on cisplatin and/or paclitaxel. Two ovarian cancer ascites, OVC346 and OVC509, also inhibited TRAIL cytotoxicity in 9 primary cultures of ovarian tumor and induced Akt activation in three of these primary cultures. Among a cohort of 35 patients with ascites, a threshold of TRAIL IC50 with ascites/IC50 without ascites > 2 was associated with shorter

  3. Association of Family History with Cancer Recurrence and Survival Among Patients with Stage III Colon Cancer

    PubMed Central

    Chan, Jennifer A.; Meyerhardt, Jeffrey A.; Niedzwiecki, Donna; Hollis, Donna; Saltz, Leonard B.; Mayer, Robert J.; Thomas, James; Schaefer, Paul; Whittom, Renaud; Hantel, Alexander; Goldberg, Richard M.; Warren, Robert S.; Bertagnolli, Monica; Fuchs, Charles S.

    2011-01-01

    Context A family history of colorectal cancer in a first-degree relative increases the risk of developing colorectal cancer. However, the influence of family history on cancer recurrence and survival among patients with established disease remains uncertain. Objective To examine the association of family history of colorectal cancer with cancer recurrence and survival of patients with colon cancer. Design, Setting, and Participants Prospective observational study of 1,087 patients with stage III colon cancer enrolled in a randomized adjuvant chemotherapy trial (CALGB 89803) between April 1999 and May 2001. Patients provided data on family history at baseline and were followed up until March 2007 for disease recurrence and death (median follow-up 5.6 years). In a subset of patients, we assessed microsatellite instability (MSI) and expression of the mismatch repair (MMR) proteins, MLH1 and MSH2, in tumor specimens. Main Outcome Measure Disease-free survival, recurrence-free survival, and overall survival according to the presence or absence of a family history of colorectal cancer. Results Among 1,087 eligible patients, 195 (17.9%) reported a family history of colorectal cancer in a first-degree relative. Cancer recurrence or death occurred in 57/195 patients (29%; 95% confidence interval [CI], 23%-36%) with a family history of colorectal cancer and 343/892 patients (38%; 95% CI, 35%-42%) without a family history. Compared to patients without a family history, the adjusted hazard ratios (HR) among those with ≥1 affected first-degree relatives were 0.72 (95% CI, 0.54-0.96) for disease-free survival (DFS), 0.74 (95% CI, 0.55-0.99) for recurrence-free survival (RFS), and 0.75 (95% CI, 0.54-1.05) for overall survival (OS). This reduction in risk of cancer recurrence or death associated with a family history became stronger with an increasing number of affected first-degree relatives. Compared to participants without a family history of colorectal cancer, those with 1

  4. A Winter Survival Unit.

    ERIC Educational Resources Information Center

    Phillips, Ronald E.

    1979-01-01

    The article is a condensation of materials from the winter survival unit of a Canadian snow ecology course. The unit covers: cold physiology, frostbite, snowblindness, hypothermia, winter campout, and survival strategies. (SB)

  5. Survivability Versus Time

    NASA Technical Reports Server (NTRS)

    Joyner, James J., Sr.

    2014-01-01

    Develop Survivability vs Time Model as a decision-evaluation tool to assess various emergency egress methods used at Launch Complex 39B (LC 39B) and in the Vehicle Assembly Building (VAB) on NASAs Kennedy Space Center. For each hazard scenario, develop probability distributions to address statistical uncertainty resulting in survivability plots over time and composite survivability plots encompassing multiple hazard scenarios.

  6. Decreased MALL expression negatively impacts colorectal cancer patient survival

    PubMed Central

    Cui, Feifei; Sun, Xing; Zhong, Lin; Yan, Dongwang; Zhou, Chongzhi; Deng, Guilong; Wang, Bin; Qi, Xiaosheng; Wang, Shuyun; Qu, Lei; Deng, Biao; Pan, Ming; Chen, Jian; Wang, Yupeng; Song, Guohe; Tang, Huamei; Zhou, Zongguang; Peng, Zhihai

    2016-01-01

    The aim of the present study was to determine whether MALL expression is associated with colon cancer progression and patient survival. MALL mRNA expression was reduced in the tumor tissues of 70% of the colon cancer patients and 75% of the rectal cancer patients as compared to their normal tissues. MALL protein was also significantly reduced in the tumor tissues of colon cancer patients (P < 0.001). Increased LOH and methylation of MALL was observed in tumor tissues as compared to normal tissues. Reduced MALL expression was associated with vessin invasion, disease recurrence and metastasis or death (P ≤ 0.027). Furthermore, patients with MALL-negative tumors had significantly decreased overall survival (OS) and disease-free survival (DFS) (P < 0.008 and P < 0.011, respectively). Univariate analysis indicated that MALL expression was significantly associated with OS and DFS. Finally, overexpression of MALL suppressed HCT116 and SW480 cell proliferation and inhibited HCT116 migration. MALL may play a role in colorectal cancer progression as suppression of its expression in tumor tissues negatively impacts colorectal cancer patient survival. Further analyses are required to determine if reduced MALL expression is due to LOH and/or methylation. PMID:26992238

  7. Perforation of Meckel’s diverticulum by a wood splinter in a 4-year-old child: a case report

    PubMed Central

    Anyfantakis, D; Kastanakis, M; Papadomichelakis, A; Kokinos, I; Katsougris, N; Petrakis, G; Karona, P; Bobolakis, E

    2013-01-01

    Perforation of Meckel's diverticulum by a foreign body represents an unusual and serious clinical occurrence. We present a case of a 4-year-old male who was admitted with symptoms of abdominal pain in the right iliac fossa, raising the suspicion of acute appendicitis. Exploratory laparotomy disclosed normal appendix and perforation of Meckel's diverticulum caused by a wood splinter. Meckel's diverticulectomy was performed and the child had an uneventful postoperative course. Preoperative diagnosis of perforated Meckel’s diverticulum remains a challenging issue. Diagnosis should be considered in the presence of a right lower quadrant abdominal pain or a positive history of ingestion of a sharp foreign body PMID:23976900

  8. Anticoagulant and vasodilator therapy for Nicolau syndrome following intramuscular benzathine penicillin injection in a 4 year old boy.

    PubMed

    Alkan Bozkaya, Tijen; Demirel, Gamze; Ormeci, Tugrul; Al, Serdar; Çakar, Engin; Tastekin, Ayhan; Turkoglu, Halil

    2016-06-01

    Nicolau syndrome (NS) is a rare complication of intramuscular, intraarticular or subcutaneous injection of particular drugs leading to ischemic necrosis of the surrounding skin, soft tissue and muscular tissue. Benzathine penicilin one of the most widely used antibiotic for upper respiratory tract infections and has been rarely reported to cause NS. Here we describe a 4 year old boy with diagnosis of NS after the injection of benzathine penicillin who was successfuly treated with unfractionized heparin (enoxaparine) and pentoxifylline. The practitioners should pay attention for unnecessary use of benzathine penicillin to avoid from probable complications.

  9. Large Renal Artery Aneurysm Treated with Guglielmi Detachable Coils: Procedural and 4-Year Follow-up Results

    SciTech Connect

    Damascelli, Bruno; Bartorelli, Antonio L.; Ticha, Vladimira; Trabattoni, Daniela; Lanocita, Rodolfo

    2008-07-15

    A large aneurysm of the left renal artery was found incidentally during abdominal ultrasound in a 39-year-old woman with no medical or family history of cardiovascular disease. Vascular pathology with a dysplastic appearance was confirmed by magnetic resonance angiography and the patient was offered transcatheter embolization. Since the position and size of the neck of the aneurysm could not be determined at angiography, detachable platinum coils were used for occlusion. The procedure was performed without complications. During a 4-year follow-up no alterations of renal function, recanalization of the aneurysm, or perfusion defects in the rest of the left renal circulation were noted.

  10. Traumatic hip dislocation with incomplete reduction due to soft-tissue interposition in a 4-year-old boy.

    PubMed

    Burgos, J; Gonzalez-Herranz, P; Ocete, G

    1995-01-01

    The case of a traumatic dislocation of the left hip in a 4-year-old boy is presented. After an initial attempt at reduction under general anesthesia, a permanent deformity in the flexion of the hip remained, and there was radiographic evidence of a nonconcentric reduction. Computed tomography (CT) showed interposition in the posterior part of the joint. Under general anesthesia, the mobilization of the hip reduced the dislocation correctly, removing the necessity of open treatment. This case stresses the need for early diagnosis of this serious complication and closed reduction of the joint, avoiding the poor results of open and deferred treatments.

  11. Epithelioid hemangioendothelioma of the mandibular gingiva: A rare case of metastasis 4 years after radical excision and literature review

    PubMed Central

    Salgarelli, Attilio Carlo; Bellini, Pierantonio; Maccio, Livia; Setti, Giacomo

    2016-01-01

    Malignant epithelioid hemangioendothelioma (MEH), or high-risk epithelioid hemangioendothelioma, is a low- to intermediate-grade vascular malignancy. A few cases of MEH have been documented in the head and neck region, including the neck, thyroid gland, larynx and scalp. MEHs are extremely rare in the oral cavity. Only 31 cases of MEH in the oral cavity were described in English literature between 1975 and 2014. Further, only eleven cases were referred to MEH of the maxillary or mandibular gingiva. No gingival MEH metastases have been described in literature. We report a literature review and a case of MEH with a metastatic occurrence 4 years after surgical excision. PMID:27194877

  12. Severe digital necrosis in a 4-year-old boy: primary Raynaud’s or jellyfish sting

    PubMed Central

    Binnetoglu, Fatih Koksal; Kizildag, Betul; Topaloglu, Naci; Kasapcopur, Ozgur

    2013-01-01

    Raynaud's phenomena is a common disorder which may be primary or secondary to some connective tissue disorders such as systemic sclerosis and systemic lupus erythematosus. Jellyfish sting is a rare but life-threatening cause of Raynaud's phenomena. Digital gangrene is reported in 3% of children with secondary Raynaud's phenomena but does not occur in children with primary Raynaud's phenomena. We report a case of a 4-year-old boy who initially presented with episodes of pain and bluish to blackish discolouration and necrosis affecting the fingers on both hands after a jellyfish sting without any sign of connective tissue disorder. PMID:24248320

  13. Does obesity compromise survival in women with breast cancer?

    PubMed

    Carmichael, A R; Bendall, S; Lockerbie, L; Prescott, R J; Bates, T

    2004-04-01

    Obesity, measured by high body mass index (BMI >30 kg/m2) is associated with an increased risk of postmenopausal breast cancer but the effect of obesity on prognosis is not clear. A prospectively accrued and regularly validated database of 1579 patients with breast cancer treated in a district general hospital between 1963 and 1999 was analysed for clinical and pathological tumour characteristics including the family history, grade, tumour type, treatment and outcome. The risk factors and outcome of obese and non-obese patients were compared. Breast cancer in obese women was associated with significantly larger tumour size and worse Nottingham prognostic index. There was no statistically significant difference in overall and disease-free survival between obese and non-obese group. Hazard ratios (95% Cl) were 0.81 (0.62-1.06) and 0.80 (0.63-1.01), respectively. In the present study, obesity is not an indicator of worst prognosis of breast cancer.

  14. Surviving Atmospheric Spacecraft Breakup

    NASA Technical Reports Server (NTRS)

    Szewczyk, Nathaniel J.; Conley, Catharine A.

    2003-01-01

    In essence, to survival a spacecraft breakup an animal must not experience a lethal event. Much as with surviving aircraft breakup, dissipation of lethal forces via breakup of the craft around the organism is likely to greatly increase the odds of survival. As spacecraft can travel higher and faster than aircraft, it is often assumed that spacecraft breakup is not a survivable event. Similarly, the belief that aircraft breakup or crashes are not survivable events is still prevalent in the general population. As those of us involved in search and rescue know, it is possible to survive both aircraft breakup and crashes. Here we make the first report of an animal, C. elegans, surviving atmospheric breakup of the spacecraft supporting it and discuss both the lethal events these animals had to escape and the implications implied for search and rescue following spacecraft breakup.

  15. Long-term Survival of Patients With Invasive Ultra-thin Cutaneous Melanoma

    PubMed Central

    Vecchiato, Antonella; Zonta, Elisa; Campana, Luca; Dal Bello, Giacomo; Rastrelli, Marco; Rossi, Carlo Riccardo; Alaibac, Mauro

    2016-01-01

    Abstract The incidence of cutaneous melanoma is increasing worldwide, especially for thin melanoma (Breslow ≤1 mm). Thin cutaneous melanoma has a favorable prognosis but there are few data about the prognosis of patients with ultra-thin cutaneous melanoma (Breslow ≤ 0.5 mm). Our aim was to investigate the disease-free survival among patients with invasive cutaneous melanoma with Breslow ≤ 0.5 mm after 10 years from the initial diagnosis. A retrospective review of 240 cutaneous melanoma patients with Breslow ≤ 0.5 mm was performed. Recurrence, death from cutaneous melanoma, and disease-free survival were all identified. In the whole group of patients, we observed only 2 deaths from cutaneous melanoma. Median follow-up was 13, 11 years. Among all 240 patients, 221 were alive and disease free, 2 died of cutaneous melanoma, 11 died of other non-neoplastic diseases, 5 died of other neoplastic diseases different from melanoma, and 1 patient had a local recurrence; therefore the 10-year melanoma survival rate was 99.6%. Our data indicate that death from cutaneous melanoma in the group of patients with Breslow ≤0.5 mm was a very rare event and that diagnosis at this stage dramatically decreases the risk of developing metastatic tumors to a <0.5% also after a 10-year period of follow-up. Limitation of the study includes the fact that other risk factors for melanoma, notably ulceration, and mitotic rate, were not evaluated. PMID:26765437

  16. Undetectable ultrasensitive PSA after radical prostatectomy for prostate cancer predicts relapse-free survival.

    PubMed

    Doherty, A P; Bower, M; Smith, G L; Miano, R; Mannion, E M; Mitchell, H; Christmas, T J

    2000-12-01

    Radical retropubic prostatectomy is considered by many centres to be the treatment of choice for men aged less than 70 years with localized prostate cancer. A rise in serum prostate-specific antigen after radical prostatectomy occurs in 10-40% of cases. This study evaluates the usefulness of novel ultrasensitive PSA assays in the early detection of biochemical relapse. 200 patients of mean age 61. 2 years underwent radical retropubic prostatectomy. Levels < or = 0.01 ng ml-1 were considered undetectable. Mean pre-operative prostate-specific antigen was 13.3 ng ml-1. Biochemical relapse was defined as 3 consecutive rises. The 2-year biochemical disease-free survival for the 134 patients with evaluable prostate-specific antigen nadir data was 61.1% (95% CI: 51.6-70.6%). Only 2 patients with an undetectable prostate-specific antigen after radical retropubic prostatectomy biochemically relapsed (3%), compared to 47 relapses out of 61 patients (75%) who did not reach this level. Cox multivariate analysis confirms prostate-specific antigen nadir < or = 0.01 ng ml-1 to be a superb independent variable predicting a favourable biochemical disease-free survival (P < 0.0001). Early diagnosis of biochemical relapse is feasible with sensitive prostate-specific antigen assays. These assays more accurately measure the prostate-specific antigen nadir, which is an excellent predictor of biochemical disease-free survival. Thus, sensitive prostate-specific antigen assays offer accurate prognostic information and expedite decision-making regarding the use of salvage prostate-bed radiotherapy or hormone therapy.

  17. [A continuous 4-year evaluation of medical informatics education in a graduate school of health sciences using a questionnaire survey].

    PubMed

    Monzen, Satoru; Matsutani, Hideya; Kashiwakura, Ikuo

    2013-01-01

    The purpose of this study was to identify the level of awareness among undergraduate students regarding medical informatics and to ascertain whether educational training has progressed with time in the Department of Health Sciences at Hirosaki University, Japan, which is a co-medical staff training institution that conducts a 4-year university course in medical informatics. The university accepts students who have completed the 3rd grade of medical licensing tests and who have attended the medical informatics lectures for 4 years (2007-2010). The ratio of first sight terminology percentage in any given fiscal year in all the 30 terminology categories varied widely from 0% to 80%, but the trend in various categories did not vary between fiscal years. The terminology of informatics under medical technology students obtained high scores of 52.5-77.3% after attending courses, which was higher compared with students from other classes. On the other hand, student nurses and occupational therapy students obtained 0-44.2%. Each class scored a high percentage of correct answers in the medical information-related terminology. Among the radiology students who attended the classes, the percentage of correct answers in categories of "digital imaging and communication in medicine" and "picture archiving and communication system" were lower than other medical terminology categories. These results reflect the gaps in educational curriculum of 1st and 2nd grades of medical licensing tests. PMID:23358336

  18. [A continuous 4-year evaluation of medical informatics education in a graduate school of health sciences using a questionnaire survey].

    PubMed

    Monzen, Satoru; Matsutani, Hideya; Kashiwakura, Ikuo

    2013-01-01

    The purpose of this study was to identify the level of awareness among undergraduate students regarding medical informatics and to ascertain whether educational training has progressed with time in the Department of Health Sciences at Hirosaki University, Japan, which is a co-medical staff training institution that conducts a 4-year university course in medical informatics. The university accepts students who have completed the 3rd grade of medical licensing tests and who have attended the medical informatics lectures for 4 years (2007-2010). The ratio of first sight terminology percentage in any given fiscal year in all the 30 terminology categories varied widely from 0% to 80%, but the trend in various categories did not vary between fiscal years. The terminology of informatics under medical technology students obtained high scores of 52.5-77.3% after attending courses, which was higher compared with students from other classes. On the other hand, student nurses and occupational therapy students obtained 0-44.2%. Each class scored a high percentage of correct answers in the medical information-related terminology. Among the radiology students who attended the classes, the percentage of correct answers in categories of "digital imaging and communication in medicine" and "picture archiving and communication system" were lower than other medical terminology categories. These results reflect the gaps in educational curriculum of 1st and 2nd grades of medical licensing tests.

  19. Measles, polio and tetanus toxoid antibody levels in Gambian children aged 3 to 4 years following routine vaccination.

    PubMed

    Fortuin, M; Maine, N; Mendy, M; Hall, A; George, M; Whittle, H

    1995-01-01

    A nation-wide cross-sectional survey of 816 children 3-4 years old was carried out in The Gambia between September 1990 and July 1991 to assess the seroprevalence of antibodies against 3 diseases included in the expanded programme on immunization: measles, poliomyelitis and tetanus. Among 689 children whose records were available, 94.5% were fully immunized. Measles vaccine was administered to 97% of the children and 91% of these had detectable antibodies at the time of the survey. Antibodies against type 1 and type 3 polioviruses, after up to 6 doses of oral polio vaccine, were present in 88.1% and 89.3% of the children respectively. Ninety-seven percent of the children who had received 4 doses of diphtheria-pertussis-tetanus vaccine (DPT) and 91% of those who received 3 doses had detectable tetanus toxoid antibodies at the age of 3-4 years. This study shows that serological responses to EPI vaccines given in infancy persist at very satisfactory levels throughout early childhood.

  20. Improvement of survival and prospect of cure in patients with metastatic breast cancer.

    PubMed

    Cheng, Yee Chung; Ueno, Naoto T

    2012-07-01

    Patients with metastatic breast cancer have traditionally been considered incurable with conventional treatment. However, 5-10% of those patients survive more than 5 years, and 2-5% survive more than 10 years. Recent studies suggest that the survival of patients with metastatic breast cancer has been slowly improving. In this review, we examine the possible curative approach for a certain group of patients with metastatic breast cancer. We identify that patients most likely to benefit from such an aggressive approach are young and have good performance status, adequate body functional reserve, long disease-free interval before recurrence, oligometastatic disease, and low systemic tumor load. An aggressive multidisciplinary approach including both local treatment of macroscopic disease and systemic treatment of microscopic disease can result in prolonged disease control in certain patients with metastatic breast cancer. Whether patients with prolonged disease control are "cured" remains controversial.

  1. Continuous up to 4 Years Entecavir Treatment of HBV-Infected Adolescents – A Longitudinal Study in Real Life

    PubMed Central

    Pawłowska, Małgorzata; Smok, Beata; Rajewski, Paweł; Wietlicka-Piszcz, Magdalena; Halota, Waldemar; Tretyn, Andrzej

    2016-01-01

    This study evaluated the long-term (up to 4 years) efficacy and safety of entecavir ETV treatment and analysed the significance of baseline and on-treatment factors in long-term ETV outcomes in adolescents with chronic hepatitis B (CHB). We determined the cumulative virological and serological outcomes of 44 adolescents with CHB receiving ETV for up to 4 years. To investigate the dynamics of HBV DNA, ALT activity and hepatitis B e antigen (HBeAg) seroconversion over time and their associations with the considered factors, generalized estimating equation (GEE) models were used. The cumulative rates of undetectable HBV DNA (<20 IU/ml) and HBeAg seroconversion after 4 years were 89.7% and 55.4%, respectively. In the study group, we showed that having undetectable HBV DNA at the 6th or 12th month of therapy predicted the achievement of a sustained response rate (SRR, defined as the loss of HBV DNA, loss of HBeAg and ALT normalization) at year 3 of ETV therapy (P = 0.048, OR = 5.83; P = 0.012; OR = 14.57, respectively). The GEE analysis indicated that of the different factors, the duration of ETV therapy had a strong impact on the achievement of virological suppression, HBeAg seroconversion and SRR in adolescents. Each month after the initiation of therapy, the odds of loss of HBV DNA increased by approximately 5% (OR = 1.05, P<0.0001), on average. Additionally, the GEE analysis revealed that adolescents with an age at infection of ≥10 years had 3 times higher odds of achieving undetectable HBV DNA than patients with a younger infection age (OR = 3.67, P = 0.028). None of the ETV-treated patients reported significant adverse effects. ETV is an effective and safe treatment option for adolescents with CHB. Undetectable HBV DNA in the 6th and/or 12th month of ETV treatment and older age at infection could predict maintained virological suppression. PMID:27685782

  2. Recent (<4 year old) Leaf Litter is Not a Major Source of Microbial Carbon in a Temperate Forest Mineral Soil

    SciTech Connect

    Kramer, Christiane; Trumbore, Susan E.; Froberg, Mats J.; Cisneros dozal, Luz Maria; Zhang, Dachun; Xu, Xiamei; Santos, Guaciara; Hanson, Paul J

    2010-01-01

    Microbial communities in soil A horizons derive their carbon from several potential sources: organic carbon (C) transported down from overlying litter and organic horizons, root-derived C, or soil organic matter. We took advantage of a multi-year experiment that manipulated the {sup 14}C isotope signature of surface leaf litter inputs in a temperate forest at the Oak Ridge Reservation, Tennessee, USA, to quantify the contribution of recent leaf litter C to microbial respiration and biomarkers in the underlying mineral soil. We observed no measurable difference (< {approx}40{per_thousand} given our current analytical methods) in the radiocarbon signatures of microbial phospholipid fatty acids (PLFA) isolated from the top 10 cm of mineral soil in plots that experienced 3 years of litterfall that differed in each year by {approx}750{per_thousand} between high-{sup 14}C and low-{sup 14}C treatments. Assuming any difference in {sup 14}C between the high- and low-{sup 14}C plots would reflect C derived from these manipulated litter additions, we estimate that <6% of the microbial C after 4 years was derived from the added 1-4-year-old surface litter. Large contributions of C from litter < 1 year (or >4 years) old (which fell after (or prior to) the manipulation and therefore did not differ between plots) are not supported because the {sup 14}C signatures of the PLFA compounds (averaging 200-220{per_thousand}) is much higher that of the 2004-5 leaf litter (115{per_thousand}) or pre-2000 litter. A mesocosm experiment further demonstrated that C leached from {sup 14}C-enriched surface litter or the O horizon was not a detectable C source in underlying mineral soil microbes during the first eight months after litter addition. Instead a decline in the {sup 14}C of PLFA over the mesocosm experiment likely reflected the loss of a pre-existing substrate not associated with added leaf litter. Measured PLFA {Delta}{sup 14}C signatures were higher than those measured in bulk

  3. Quality of life and sexuality in disease-free survivors of cervical cancer after radical hysterectomy alone: A comparison between total laparoscopy and laparotomy.

    PubMed

    Xiao, Meizhu; Gao, Huiqiao; Bai, Huimin; Zhang, Zhenyu

    2016-09-01

    The aim of the present study was to evaluate the possible differences between total laparoscopy and laparotomy regarding their impact on postoperative quality of life and sexuality in disease-free cervical cancer survivors who received radical hysterectomy (RH) and/or lymphadenectomy alone and were followed for >1 year.We reviewed all patients with cervical cancer who had received surgical treatment in our hospital between January 2001 and March 2014. Consecutive sexually active survivors who received RH and/or lymphadenectomy for early stage cervical cancer were enrolled and divided into 2 groups based on surgical approach. Survivors were interviewed and completed validated questionnaires, including the European Organization for Research Treatment of Cancer Quality-of-Life Core Questionnaire including 30 items, the Cervical Cancer-Specific Module of European Organization for Research Treatment of Cancer Quality-of-Life Questionnaire including 24 items (EORTC QLQ-CX24), and the Female Sexual Function Index (FSFI).In total, 273 patients with histologically confirmed cervical cancer were retrospectively reviewed. However, only 64 patients had received RH and/or lymphadenectomy alone; 58 survivors meeting the inclusion criteria were enrolled, including 42 total laparoscopy cases and 16 laparotomy cases, with an average follow-up of 46.1 and 51.2 months, respectively. The survivors in the 2 groups obtained good and similar scores on all items of the European Organization for Research Treatment of Cancer Quality-of-Life Core Questionnaire including 30 items and Cervical Cancer-Specific Module of European Organization for Research Treatment of Cancer Quality-of-Life Questionnaire including 24 items, without significant differences after controlling for covariate background characteristics. To the date of submission, 21.4% (9/42) of cases in the total laparoscopy group and 31.2% (5/16) of cases in the laparotomy group had not resumed sexual behavior after RH. Additionally

  4. Effect of Interval to Definitive Breast Surgery on Clinical Presentation and Survival in Early-Stage Invasive Breast Cancer

    SciTech Connect

    Vujovic, Olga; Yu, Edward; Cherian, Anil; Perera, Francisco; Dar, A. Rashid; Stitt, Larry; Hammond, A.

    2009-11-01

    Purpose: To examine the effect of clinical presentation and interval to breast surgery on local recurrence and survival in early-stage breast cancer. Methods and Materials: The data from 397 patients with Stage T1-T2N0 breast carcinoma treated with conservative surgery and breast radiotherapy between 1985 and 1992 were reviewed at the London Regional Cancer Program. The clinical presentation consisted of a mammogram finding or a palpable lump. The intervals from clinical presentation to definitive breast surgery used for analysis were 0-4, >4-12, and >12 weeks. The Kaplan-Meier estimates of the time to local recurrence, disease-free survival, and cause-specific survival were determined for the three groups. Cox regression analysis was used to evaluate the effect of clinical presentation and interval to definitive surgery on survival. Results: The median follow-up was 11.2 years. No statistically significant difference was found in local recurrence as a function of the interval to definitive surgery (p = .424). A significant difference was noted in disease-free survival (p = .040) and cause-specific survival (p = .006) with an interval of >12 weeks to definitive breast surgery. However, the interval to definitive surgery was dependent on the presentation for cause-specific survival, with a substantial effect for patients with a mammographic presentation and a negligible effect for patients with a lump presentation (interaction p = .041). Conclusion: The results of this study suggest that an interval of >12 weeks to breast surgery might be associated with decreased survival for patients with a mammographic presentation, but it appeared to have no effect on survival for patients presenting with a palpable breast lump.

  5. First Pregnancy, Somatic and Psychological Status of a 4-Year-Old Child Born following Annexin V TESA Sperm Separation

    PubMed Central

    Lukaszuk, Krzysztof; Wcislo, Monika; Liss, Joanna; Stachowicz, Anna; Jakiel, Grzegorz; Lukaszuk, Mariusz; Pastuszek, Ewa; Woclawek-Potocka, Izabela; Galvao, Antonio; Bialobrzeska, Dorota

    2015-01-01

    Introduction Sperm DNA integrity is a crucial paternal factor affecting fertilization and pregnancy rates, as well as embryo development. Case The present case report describes the successful pregnancy after testicular sperm aspiration (TESA) combined with intracytoplasmic sperm injection (ICSI) (TESA-ICSI) in a couple where the male presented high sperm DNA fragmentation. In order to sort damaged sperm presenting DNA fragmentation, magnetic activated cell sorting (MACS) with annexin V microbeads (MACS Miltenyi Biotec, Teterow, Germany) was used. Conclusion The authors present the first description of a successful medical case using TESA-ICSI annexin V sperm sorting. Additionally, a follow-up of the child at the age of 4 years old was done. PMID:26495164

  6. No aggression in a 4-year-old boy with an androgen-producing tumour: Case Report

    PubMed Central

    De la Marche, Wouter; Prinsen, Karin; Boot, Annemieke M; Ferdinand, Robert F

    2005-01-01

    Background The androgen testosterone plays a critical role in many aspects of sexual differentiation. Also, it is thought to induce aggressive behaviours or to play a role in social dominance. Case presentation In this case report a 4-year-old boy is described whose testosterone and dehydroepiandrosterone sulphate (DHEA-S) levels were raised to pubertal levels due to a testosterone producing testis tumour. This provided the unique opportunity to examine the effects of elevated levels of androgens on levels of aggression or on social dominance before the onset of puberty. Conclusion The present case report does not support the hypothesis of a causal relationship between testosterone and aggression or between testosterone and social dominance in young children. PMID:16202122

  7. A young male adolescent with feminine appearance: diagnosis of 46, XX syndrome neglected for 4 years with gynaecomastia presentation.

    PubMed

    Fu, C-P; Sheu, W H-H; Tseng, J-J; Lin, S-Y

    2014-04-01

    Gynaecomastia is common in infancy and adolescent boys, but other inciting causes should be kept in mind and necessitate further evaluation should be conducted to determine any underlying conditions. A 22-year-old unmarried male adolescent visited our endocrinology clinic for feminine appearance despite operations for bilateral gynaecomastia 4 years ago. Physical examination showed inverted triangular distribution of pubic hair, sparse beard, small-sized testes, flaccid short penis and surgical scar of the chest wall. Serum hormones study revealed primary hypergonadotropic hypogonadism, and cytogenetic study disclosed female complement (46, XX). The authors recommend that sexual chromosome abnormality should be considered in patients with hypogonadism to avert androgen deficiency-related complications early and that long-term team care should be provided to improve the patient's health-related quality of life.

  8. Bilateral Thalamic and Right Fronto-temporo-parietal Gliomas in a 4 Years Old Child Diagnosed by Magnetic Resonance Imaging

    PubMed Central

    Sharaf, Ahmed Fathy; Hamouda, Ehab Shaban Mahmoud; Teo, Jennifer Gek Choo

    2016-01-01

    We report the neuroimaging findings of a 4-year-old girl with biopsy-proven bilateral thalamic and right fronto-temporo-parietal cortical gliomas, which are uncommon tumours involving the central nervous system. Despite their benignity, the prognosis is usually poor because of involvement of the thalamic nuclei and difficulty in surgical excision. These lesions have limited differential diagnoses that include metabolic, toxic, infective, vascular and neoplastic. Imaging characteristics on conventional Magnetic Resonance (MR), Magnetic Resonance Spectroscopy (MRS) and Diffusion tensor imaging (DTI) can further narrow the differential diagnosis and also provide additional information regarding the degree of involvement of adjacent brain tissue and white matter tracts around the lesions. PMID:27200150

  9. The use of medicinal leeches in fingertip replantation without venous anastomosis - case report of a 4-year-old patient.

    PubMed

    Streit, L; Dvořák, Z; Novák, O; Stiborová, S; Veselý, J

    2014-01-01

    Replantation of amputated fingertip is a technical challenge to the microsurgeons. The success rate depends directly on the availability and the size of preserved vessels and on the degree of their damage. In distal digital amputations, veins are usually not easily recovered or even absent, and thus high number of replantation procedures fails because of the venous congestion. The use of medicinal leeches is a treatment option for venous congestion of replanted fingers. A case report of a 4-year-old patient after fingertip replantation without venous anastomosis when temporary venous drainage was provided by an application of medicinal leeches is reported together with literature review. We observed an unusually short duration of venous congestion (48 hours) and there was no need of blood transfusion.

  10. Occlusal relationships and spacing or crowding of teeth in the dentitions of 3-4-year-old Nigerian children.

    PubMed

    Otuyemi, O D; Sote, E O; Isiekwe, M C; Jones, S P

    1997-09-01

    A study of 525 3-4-year-old children in nursery schools and day-care centres was carried out to assess occlusal relationships and the presence of spacing or crowding of teeth. No significant differences in occlusal relationships were found between boys and girls (P > 0.05). Bilateral straight terminal planes of molars and class 1 canine relationship were the most prevalent features (74.5% and 73.3% respectively). Most of the children had 'normal' vertical and transverse occlusal relationships. The most common sites of spacing were mesial to maxillary canines and distal to mandibular canines. 32% of the children were found to have generalized anterior segment spacing, 4% showed exclusively anthropoid spaces, and 18% had either contact between all the teeth or crowding in the anterior region.

  11. Effectiveness of a fundamental motor skill intervention for 4-year-old children with autism spectrum disorder: A pilot study.

    PubMed

    Bremer, Emily; Balogh, Robert; Lloyd, Meghann

    2015-11-01

    A wait-list control experimental design was employed to investigate the effectiveness of a fundamental motor skill intervention at improving the motor skills, adaptive behavior, and social skills of 4-year-old children with autism spectrum disorder (experimental n = 5, control n = 4); the impact of intervention intensity was also explored. The experimental group significantly improved their object manipulation and overall motor scores from pre- to post-intervention. The wait-list control design revealed no group-by-time interactions; however, with the groups combined time was a significant factor for all motor variables. There were no significant changes in adaptive behavior and social skills. These preliminary findings suggest that a fundamental motor skill intervention may benefit young children with autism spectrum disorder. Future research with larger samples is warranted.

  12. A Successfully Treated Metastatic Choriocarcinoma Coexistent With Pregnancy: A Case Report of a 4-Year Follow-Up.

    PubMed

    Yu, Panxi; Diao, Wenqi; Jiang, Xuefeng

    2016-05-01

    Gestational choriocarcinoma ended with a successful parturition is extremely rare, especially in cases where multiple metastases occurred.A 29-year-old Chinese primigravida was admitted with vaginal bleeding at 32 gestational week, and diagnosed with gestational choriocarcinoma with vaginal, pulmonary, and cerebral metastasis after pathological, and imaging examination. At 33 gestational week, a healthy infant was delivered by cesarean section. Although no evidence of choriocarcinoma or any other forms of gestational trophoblastic diseases was found in the placenta and uterine curettages, the patient was given 7 cycles of postpartum chemotherapy. Her serum beta-human chorionic gonadotropin level fell to the normal range, and the metastatic lesions reduced. The baby is still free from diseases, and the patient reports no clinical manifestation 4 years after the hospital discharge.Despite its rapid metastases and complications, gestational choriocarcinoma still can be successfully treated by postpartum chemotherapy with the least delay. PMID:27227917

  13. Mineral trioxide aggregate pulpotomy in autotransplanted immature mandibular third molar with a 4-year follow-up

    PubMed Central

    Dharmani, Umesh; Jadhav, Ganesh Ranganath; Kaur Dharmani, Charan Kamal; Devi, Takhellambam Premlata

    2016-01-01

    Autotransplantation is the surgical transposition of a tooth from its original site to another, replacing a lost or a compromised tooth by another tooth, usually the third molar in the same individual. This technique is considered a viable method due to its high success rate, well-grounded treatment option, provided the case selection and the procedure followed is within the acceptable limits. Autotransplantation is considered as an alternative approach of oral rehabilitations in a conservative manner mainly in young patients with compromised financial conditions to perform a high cost treatment. It is a fast way to recover function and aesthetic properties without interfering with the orofacial growth. This report describes a successful 4-year follow-up of a case of immediately performed mineral trioxide aggregate (MTA) pulpotomy in autotransplantated mandibular left immature third molar to replace the mandibular left first molar that was extracted due to extensive carious lesion. PMID:27217648

  14. Mineral trioxide aggregate pulpotomy in autotransplanted immature mandibular third molar with a 4-year follow-up.

    PubMed

    Dharmani, Umesh; Jadhav, Ganesh Ranganath; Kaur Dharmani, Charan Kamal; Devi, Takhellambam Premlata

    2016-01-01

    Autotransplantation is the surgical transposition of a tooth from its original site to another, replacing a lost or a compromised tooth by another tooth, usually the third molar in the same individual. This technique is considered a viable method due to its high success rate, well-grounded treatment option, provided the case selection and the procedure followed is within the acceptable limits. Autotransplantation is considered as an alternative approach of oral rehabilitations in a conservative manner mainly in young patients with compromised financial conditions to perform a high cost treatment. It is a fast way to recover function and aesthetic properties without interfering with the orofacial growth. This report describes a successful 4-year follow-up of a case of immediately performed mineral trioxide aggregate (MTA) pulpotomy in autotransplantated mandibular left immature third molar to replace the mandibular left first molar that was extracted due to extensive carious lesion.

  15. Changes in bread consumption and 4-year changes in adiposity in Spanish subjects at high cardiovascular risk.

    PubMed

    Bautista-Castaño, I; Sánchez-Villegas, A; Estruch, R; Martínez-González, M A; Corella, D; Salas-Salvadó, J; Covas, M I; Schroder, H; Alvarez-Pérez, J; Quilez, J; Lamuela-Raventós, R M; Ros, E; Arós, F; Fiol, M; Lapetra, J; Muñoz, M A; Gómez-Gracia, E; Tur, J; Pintó, X; Ruiz-Gutierrez, V; Portillo-Baquedano, M P; Serra-Majem, L

    2013-07-28

    The effects of bread consumption change over time on anthropometric measures have been scarcely studied. We analysed 2213 participants at high risk for CVD from the PREvención con DIeta MEDiterránea (PREDIMED) trial to assess the association between changes in the consumption of bread and weight and waist circumference gain over time. Dietary habits were assessed with validated FFQ at baseline and repeatedly every year during 4 years of follow-up. Using multivariate models to adjust for covariates, long-term weight and waist circumference changes according to quartiles of change in energy-adjusted white and whole-grain bread consumption were calculated. The present results showed that over 4 years, participants in the highest quartile of change in white bread intake gained 0·76 kg more than those in the lowest quartile (P for trend = 0·003) and 1·28 cm more than those in the lowest quartile (P for trend < 0·001). No significant dose-response relationships were observed for change in whole-bread consumption and anthropometric measures. Gaining weight (>2 kg) and gaining waist circumference (>2 cm) during follow-up was not associated with increase in bread consumption, but participants in the highest quartile of changes in white bread intake had a reduction of 33 % in the odds of losing weight (>2 kg) and a reduction of 36 % in the odds of losing waist circumference (>2 cm). The present results suggest that reducing white bread, but not whole-grain bread consumption, within a Mediterranean-style food pattern setting is associated with lower gains in weight and abdominal fat. PMID:23199451

  16. Increase in child behavior problems among urban Brazilian 4-year olds: 1993 and 2004 Pelotas birth cohorts

    PubMed Central

    Matijasevich, Alicia; Murray, Elizabeth; Stein, Alan; Anselmi, Luciana; Menezes, Ana M; Santos, Iná S; Barros, Aluísio JD; Gigante, Denise P; Barros, Fernando C; Victora, Cesar G

    2014-01-01

    Background There are an increasing number of reports on time trends in child and adolescent psychological problems but none from low- and middle-income countries, and very few covering the preschool period. The aim was to investigate changes in preschool behavioral/emotional problems in two birth cohorts from a middle-income country born 11 years apart. Methods We analyzed data from the 1993 and 2004 Pelotas birth cohort studies from Brazil. A subsample of 4-year olds from the 1993 cohort (634) and all 4-year olds from the 2004 cohort (3750) were assessed for behavioral/emotional problems through maternal report using the Child Behavior Checklist (CBCL). Response rates in these two population-based cohorts were above 90%. Results We found a significant increase in CBCL total problems, internalizing and externalizing mean scores over the 11-year period. For 1993 and 2004 Pelotas cohorts, respectively, CBCL mean values (SE) total problems scores were 27.9 (0.8) and 34.7 (0.3); for internalizing scores, 5.7 (0.2) and 6.3 (0.1) and for externalizing scores, 12.4 (0.4) and 15.5 (0.1). After adjusting for confounding variables, the largest increase from 1993 to 2004 was identified in the aggressive behavior syndrome score (Cohen's d = .50), followed by the externalizing problem score (Cohen's d = .40) and CBCL total problem score (Cohen's d = .36), respectively. The rise in child psychological problems was more marked in children from families with fewer assets and with less educated mothers. Conclusions Our findings provide evidence for a substantial increase in preschool behavioral problems among children in Brazil over an 11-year period. PMID:24735354

  17. Metabolic Health Is More Important than Obesity in the Development of Nonalcoholic Fatty Liver Disease: A 4-Year Retrospective Study

    PubMed Central

    Lee, Min-Kyung; Rhee, Eun-Jung; Kim, Min Chul; Moon, Byung Sub; Lee, Jeong In; Song, Young Seok; Han, Eun Na; Lee, Hyo Sun; Son, Yoonjeong; Park, Se Eun; Park, Cheol-Young; Oh, Ki-Won; Park, Sung-Woo

    2015-01-01

    Background The aim of this study is to compare the risk for future development of nonalcoholic fatty liver disease (NAFLD) according to different status of metabolic health and obesity. Methods A total of 3,045 subjects without NAFLD and diabetes at baseline were followed for 4 years. Subjects were categorized into four groups according to the following baseline metabolic health and obesity statuses: metabolically healthy, non-obese (MHNO); metabolically healthy, obese (MHO); metabolically unhealthy, non-obese (MUHNO); and metabolically unhealthy, obese (MUHO). Being metabolically healthy was defined as having fewer than two of the following five components: high blood pressure, high fasting blood glucose, high triglyceride, low high density lipoprotein cholesterol, and being in the highest decile of the homeostasis model assessment-insulin resistance index. Obesity was defined as a body mass index >25 kg/m2. The presence of NAFLD was assessed by ultrasonography. Results The proportions of subjects included in the MHNO, MHO, MUHNO, and MUHO groups were 71.4%, 9.8%, 13.0%, and 5.8%, respectively. The proportions of subjects who developed NAFLD were 10.5%, 31.4%, 23.2%, and 42% in the MHNO, MHO, MUHNO, and MUHO groups, respectively. The risk for developing NAFLD was highest in subjects who were metabolically unhealthy both at baseline and after 4 years compared with subjects who were consistently metabolically healthy during the follow-up period (odds ratio, 2.862). Using the MHNO group as reference, the odds ratios for the MHO, MUHNO, and MUHO groups were 1.731, 1.877, and 2.501, respectively. Conclusion The risk for NAFLD was lower in MHO subjects than in MUNO subjects. PMID:26394730

  18. What physical performance measures predict incident cognitive decline among intact older adults? A 4.4year follow up study.

    PubMed

    Veronese, Nicola; Stubbs, Brendon; Trevisan, Caterina; Bolzetta, Francesco; De Rui, Marina; Solmi, Marco; Sartori, Leonardo; Musacchio, Estella; Zambon, Sabina; Perissinotto, Egle; Crepaldi, Gaetano; Manzato, Enzo; Sergi, Giuseppe

    2016-08-01

    Reductions in physical performance, cognitive impairment (CI) and decline (CD), are common in older age, but few prospective cohort studies have considered the relationship between these domains. In this study we investigated whether reduced physical performance and low handgrip/lower limbs strength, could predict a higher incidence of CI/CD during a 4-year follow-up among a cohort of elderly individuals. From 3099 older community-dwelling individuals initially enrolled in the Progetto Veneto Anziani (PRO.V.A.) study, 1249 participants without CI at the baseline were included (mean age 72.2years, 59.5% females). Physical performance measures included the Short Physical Performance Battery (SPPB), 4m gait speed, chair stands time, leg extension and flexion, handgrip strength, and 6-Minute Walking Test (6MWT), categorized in gender-specific tertiles. CI was defined as a Mini-Mental State Examination (MMSE) score below 24; CD a decline of 3 or more points in the MMSE without CI. At baseline, participants developing CI during follow-up scored significantly worse across all physical performance measures compared to those that retained normal cognitive status. After adjusting for potential confounders, a significant trend for MMSE changes was noted for all physical performance tests, except for the SPPB and chair stands time. Multinomial logistic regression revealed that slow gait speed at baseline significantly predicted CD at follow up. Poor SPPB performance and slower gait speed predicted the onset of CI at the follow-up. In conclusion, slow walking speed appears to be the best independent predictor of poor cognitive status over a 4.4-year follow-up, while other items of SPPB were also significantly associated with CI.

  19. Retrospective Study of Adjuvant Chemotherapy Effects on Survival Rate after Three-Field Lymph Node Dissection for Stage IIA Esophageal Cancer.

    PubMed

    Chen, Hua-Xia; Wang, Zhou

    2015-01-01

    To determine the efficacy of postoperative adjuvant chemotherapy with paclitaxel plus cisplatin (Taxol+DDP, TP therapy) for stage IIA esophageal squamous cell carcinoma (ESCC) and to investigate the expression of RUNX3 in lymph node metastasis-negative esophageal cancer and its relationship with medical prognosis, a retrospective summary of clinical treatment of 143 cases of stage IIA esophageal squamous cell carcinoma patients was made. The patients were divided into two groups, a surgery alone control group (52 patients) and a chemotherapy group that received postoperative TP therapy (91 patients). The disease-free and 5 year survival rates were compared between the groups and a multivariate analysis of prognostic factors was performed. The same analysis was performed for cases classified as RUNX3 positive and negative, with post-operative specimens assessed by immunohistochemistry. Although the disease-free and 5 year survival rates in control and chemotherapy groups did not significantly differ and there was no significance in RUNX3 negative cases, postoperative adjuvant chemotherapy in the chemotherapy group was shown to improve disease-free and 5 year survival rate compared to the control group in RUNX3 positive cases. On Cox regression multivariate analysis, postoperative adjuvant chemotherapy (P<0.01) was an independent prognostic factor for RUNX3 positive cases, suggesting that postoperative TP may be effective as adjuvant chemotherapy for stage IIA esophageal cancer patients with RUNX3 positive lesions. PMID:26225648

  20. 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.

  1. Vehicle child restraint usage for Pacific children aged 6 weeks to 4 years: findings from the Pacific Islands Families study.

    PubMed

    Schluter, Philip J; Paterson, Janis

    2010-11-01

    Child restraint systems (CRSs) for vehicles are designed to provide protection and prevent or reduce child mortality and morbidity in road traffic accidents. Overall, 90% of children under 5 years of age in New Zealand currently use CRSs. There is considerable regional variability in CRS usage, but little information exists on its ethnic variations or determinants. "Increasing the level of restraint use" is explicitly stated as one of the 13 priorities within the New Zealand Ministry of Transport's new road safety strategy. As such, understanding CRS prevalence, patterns and associates within different communities is essential in realising this priority. Utilising a large birth cohort of Pacific children (n=1376 mothers), this study aimed to report the prevalence of maternal self-reported car seat usage at the 6 weeks, 1-year, and 2 years postpartum measurement waves; car/booster seat usage at the 4 years postpartum measurement wave; and to identify important associates using generalised estimating equation (GEE) models. Car seats were not used by 161 (11.8%) Pacific children at the 6 weeks measurement wave, 71 (5.8%) at 1-year, and 44 (3.8%) at 2 years, while car/booster seats were not used by 139 (13.3%) at the 4 years wave. Multivariable GEE model results revealed that mothers with no formal education, high parity, who smoked tobacco, lower household income, who lacked English language proficiency, and had multiple births were all at higher odds of failing to use car seat/booster seats. Despite differential attrition being noted in mothers over time, a sensitivity analysis using multiple imputation methods yielded similar findings. Targeted initiatives and education programs focusing on these higher risk groups, in particular, is needed to increase uptake and use of CRS thereby decreasing Pacific children's exposure to injury risk. As New Zealand has a large and increasing proportion of Pacific, Maori and Asian people, there is a continuing need to understand

  2. Efficacy of 4 Years of Octreotide Long-Acting Release Therapy in Patients With Severe Polycystic Liver Disease

    PubMed Central

    Hogan, Marie C.; Masyuk, Tetyana; Bergstralh, Eric; Li, Bill; Kremers, Walter K.; Vaughan, Lisa E.; Ihrke, Angela; Severson, Amanda L.; Irazabal, Maria V.; Glockner, James; LaRusso, Nicholas F.; Torres, Vicente E.

    2016-01-01

    Objective To observe the effect on total liver volume (TLV) on and off therapy in selected symptomatic patients with autosomal dominant polycystic kidney disease (ADPKD) or autosomal dominant polycystic liver disease (PLD) who received octreotide long-acting release (OctLAR) for up to 4 years. Patients and Methods Twenty-eight of 42 participants in a prospective 2-year clinical trial of OctLAR (40 mg monthly) consisting of double-blind, randomized (year 1) and open-label treatment (year 2) phases reenrolled in a 2-year open-label extension (OLE) study after being off OctLAR a mean of 8.3 months (original study: July 1, 2007, through June 30, 2013). Participants underwent magnetic resonance imaging at baseline, years 1 and 2, reenrollment, and study completion. Primary end point: change in TLV; secondary end points: changes in total kidney volume, glomerular filtration rate, quality of life (QoL), safety, vital signs, and laboratory parameters. Results Twenty-five participants (59.5%) completed the OLE. Off therapy, TLVs increased a mean ± SD of 3.4%±8.2% per year; after resuming therapy, TLVs decreased a mean ± SD of −4.7%±6.1% per year. Despite regrowth off treatment, overall reductions were observed, with a median (interquartile range) TLV of 4047 mL (3107–7402 mL) at baseline and 3477 (2653–7131 mL) at study completion (−13.2%; P<.001) and with improved health-related QoL. Total kidney volumes increased, and glomerular filtration rates declined from 58.2 mL/min to 54.5 mL/min (n=16) in patients with ADPKD on therapy from baseline to study completion. Conclusion Therapy with OctLAR over 4 years in selected patients with symptomatic PLD arrested PLD progression, alleviating symptoms and improving health-related QoL. Discontinuation led to organ regrowth. Trial Registration: clinicaltrials.gov Identifier: NCT00426153. PMID:26166166

  3. Reentry survivability modeling

    NASA Astrophysics Data System (ADS)

    Fudge, Michael L.; Maher, Robert L.

    1997-10-01

    Statistical methods for expressing the impact risk posed to space systems in general [and the International Space Station (ISS) in particular] by other resident space objects have been examined. One of the findings of this investigation is that there are legitimate physical modeling reasons for the common statistical expression of the collision risk. A combination of statistical methods and physical modeling is also used to express the impact risk posed by re-entering space systems to objects of interest (e.g., people and property) on Earth. One of the largest uncertainties in the expressing of this risk is the estimation of survivable material which survives reentry to impact Earth's surface. This point was recently demonstrated in dramatic fashion by the impact of an intact expendable launch vehicle (ELV) upper stage near a private residence in the continental United States. Since approximately half of the missions supporting ISS will utilize ELVs, it is appropriate to examine the methods used to estimate the amount and physical characteristics of ELV debris surviving reentry to impact Earth's surface. This paper examines reentry survivability estimation methodology, including the specific methodology used by Caiman Sciences' 'Survive' model. Comparison between empirical results (observations of objects which have been recovered on Earth after surviving reentry) and Survive estimates are presented for selected upper stage or spacecraft components and a Delta launch vehicle second stage.

  4. Changes in White college students' color-blind racial ideology over 4 years: do diversity experiences make a difference?

    PubMed

    Neville, Helen A; Poteat, V Paul; Lewis, Jioni A; Spanierman, Lisa B

    2014-04-01

    In this longitudinal study, we explored how White students' (N = 857) color-blind racial ideology (CBRI; i.e., beliefs that serve to deny, minimize, and/or distort the existence of racism) changed over time and the factors associated with these patterns of change. Specifically, we investigated whether gender, diversity attitudes (i.e., openness to diversity and interest in social issues), and college diversity experiences (i.e., diversity-related courses/activities and close interracial friendships) predicted patterns of CBRI change. Findings indicated that gender and diversity attitudes were related to initial levels of CBRI, such that women and students who were more open to diversity issues at the beginning of college were more likely to report lower levels of CBRI; gender was also related to a greater decrease in CBRI changes over the college experience. Furthermore, college diversity experiences predicted changes in CBRI over time, such that students who completed a greater number of diversity courses and activities and those who had a greater number of close Black friends showed a significantly greater decrease in CBRI over their 4 years in college; interestingly, students who reported having no Latino friends compared with having some close Latino friends showed a significantly greater decrease in CBRI over time.

  5. [YEL-AND meningoencephalitis in a 4-year-old boy consecutive to a yellow-fever vaccine].

    PubMed

    Gerin, M; Wroblewski, I; Bost-Bru, C; N'guyen, M-A; Debillon, T

    2014-04-01

    Yellow fever is a vector-borne disease transmitted by an endemic mosquito in sub-Saharan Africa and tropical South America. It causes fever and possibly liver and renal failure with hemorrhagic signs, which may be fatal. The yellow-fever vaccine is an attenuated vaccine that is recommended for all travelers over the age of 9 months in high-risk areas. Adverse effects have been reported: minor symptoms (such as viral syndrome), hypersensitivity reactions, and major symptoms such as viscerotropic disease (YEL-AVD) and neurotropic disease (YEL-AND). The yellow-fever vaccine-associated autoimmune disease with central nervous system involvement (such as acute disseminated encephalomyelitis) associates fever and headaches, neurologic dysfunction, seizures, cerebrospinal fluid (CSF) pleocytosis, and elevated protein, with neuroimaging consistent with multifocal areas of demyelization. The presence of antibodies or virus in CSF, within 1-30 days following vaccination, and the exclusion of other causes is necessary for diagnosis. We describe herein the case of a 4-year-old child who presented with severe encephalitis consecutive to a yellow-fever vaccine, with favorable progression. Diagnosis is based on the chronology of clinical and paraclinical signs and the presence of yellow-fever-specific antibodies in CSF. The treatment consists of symptomatic treatment and immunoglobulin injection.

  6. [Primary adrenal insufficiency as the form of onset of adrenoleukodystrophy in a 4-year-old boy].

    PubMed

    Tornero Patricio, Sebastián; de la Vega, José Antonio Bermúdez; Nehme Alvarez, Daniel; Gentil González, Francisco Javier; Lluch Fernández, María Dolores; González Hachero, José

    2009-01-01

    X-linked adrenoleukodystrophy is an inherited metabolic disease caused by the accumulation of saturated very long chain fatty acids (VLCFA). Given that the form of presentation can be primary adrenal insufficiency, diagnosis in affected males is important. Patient was a 4-year-old boy with attention deficit hyperactivity disorder, cutaneous-mucosal hyperpigmentation, and dehydration with hyponatremia and hyperpotassemia was diagnosed with adrenoleukodystrophy presenting as primary adrenal insufficiency. Antiadrenal antibodies: negative. Plasma VLCFA: C(26:0)=1.25mg/ml (0.18-0.48), C(24:0)/C(22:0) =1.53 (< 1), and C(26:0)/ C(22:0)=0.04 (< 0.02). Abdominal computed tomography: small adrenal glands. Cranial magnetic resonance imaging and evoked potentials: normal at diagnosis and with signs of white matter demyelination after 2 years of follow-up. Testing for an autoimmune etiology and adrenoleukodystrophy is important in boys with primary adrenal insufficiency before Addison's disease is diagnosed.

  7. [Risk of death 4 years after a 1st cerebral infarction: prospective study in Barquisimeto, Estado Lara, Venezuela].

    PubMed

    Poni, E; Granero, R; Escobar, B

    1995-12-01

    Stroke, the 5th. cause of death in Venezuela, has been associated to cerebral infarction. However, there is little information concerning lethality factors. 33 atherothrombotic subtype stroke patients, 31 (96%) Latino and 2(4%) white, were admitted into a prospective study to analyze the role of 11 mortality risk factors for those patients. A mortality relative risk (RR) > 1.5 or < 1 (protective) was considered clinically important if 1 was excluded from the 95% confidence interval (95%CI). The Mantel-Haenszel Chi-square procedure was use to test statistical significance (p < 0.05). Mortality RR for patients age 65 and over (RR = 2.95) and 4 year mortality RR for male patients (RR = 2.04) were clinically and statistically significant. History of high blood pressure was protective (RR = 0.62) probably due to good medical control. Cumulative mortality was higher than that of comparable studies, even from the first week of follow-up, reaching 67% at the 4th year.

  8. A vesicular variant of pseudoverrucous papules and nodules in the genital area of an incontinent 4-year-old.

    PubMed

    Dixit, Shreya; Scurry, James P; Fischer, Gayle

    2013-11-01

    Irritant contact dermatitis is a common cause of chronic vulvitis in patients wearing diapers and incontinence garments. In most cases the diagnosis is obvious; however, atypical presentations may mimic more serious dermatoses. We present a 4-year-old girl who presented at birth with cloacal atresia corrected surgically and resulting in chronic incontinence requiring full-time diapers. She presented with crops of herpetiform vesicles and bullae on a base that ranged from normal skin to severe erythema and oedema. A histological examination revealed a well-demarcated lesion showing a thickened epidermis with hyperkeratosis and parakeratosis, acanthosis and an abrupt transition to pallor of the upper half. Focal full thickness epidermis necrosis and small areas of spongiosis, acantholysis and apoptotic keratinocytes were seen. Immunofluorescence was negative. The lesions improved with the treatment of secondary infection and minimal topical therapy with an emollient only. This case represents an unusual vesicular variant of pseudoverrucous papules and nodules, which has been reported only once previously. PMID:23043543

  9. Supination and Pronation Strength Deficits Persist at 2-4 Years after Treatment of Distal Radius Fractures.

    PubMed

    Ploegmakers, Joris; The, Bertram; Wang, Allan; Brutty, Mike; Ackland, Tim

    2015-10-01

    Forearm rotation is a key function in the upper extremity. Following distal radius fracture, residual disability may occur in tasks requiring forearm rotation. The objectives of this study are to define pronation and supination strength profiles tested through the range of forearm rotation in normal individuals, and to evaluate the rotational strength profiles and rotational strength deficits across the testing range in a cohort of patients treated for distal radius fracture associated with an ulnar styloid base fracture. In a normative cohort of 29 subjects the supination strength profile showed an increasing linear relationship from supination to pronation. Twelve subjects were evaluated 2-4 years after anatomical open reduction and volar plate fixation of a distal radius fracture. The injured wrist was consistently weaker (corrected for hand dominance) in both supination and pronation strength in all testing positions, with the greatest loss in 60 degrees supination. Mean supination strength loss across all testing positions was significantly correlated with worse PRWE scores, highlighting the importance of supination in wrist function.

  10. Hematogones With Lambda Light Chain Restriction in a 4-Year-Old Boy With Burkitt Lymphoma: A Potential Diagnostic Pitfall

    PubMed Central

    Guillory, Tesha; Li, Shiyong; Bergsagel, Daniel J.; Weinzierl, Elizabeth; Bunting, Silvia T.

    2016-01-01

    Hematogones are immature normal B cell precursors with a characteristic immunophenotype profile on flow cytometry that typically do not express surface immunoglobulin light chains. In this report, we describe a case in which the hematogones exhibit light chain restriction. Our patient was a 4-year-old boy with a complicated medical history involving treatment for a presumed bilateral Wilms tumor of the kidney that on later resection was diagnosed as Burkitt lymphoma. Flow cytometry analysis of his bone marrow revealed a small distinct population of cells expressing dim cluster of differentiation (CD)10, CD19, CD22, CD38, dim CD58, human leukocyte antigen–D related (HLA-DR), and dim CD45, which are characteristic of hematogones. These cells, however, demonstrated dim surface immunoglobulin lambda light-chain restriction. Molecular study results for immunoglobulin heavy and kappa light-chain gene rearrangements were negative. We present this case to raise awareness of the potential pitfalls of working up bone marrow for involvement by B cell lymphoproliferative disorder. PMID:27069035

  11. Imitation as a mechanism in cognitive development: a cross-cultural investigation of 4-year-old children's rule learning.

    PubMed

    Wang, Zhidan; Williamson, Rebecca A; Meltzoff, Andrew N

    2015-01-01

    Children learn about the social and physical world by observing other people's acts. This experiment tests both Chinese and American children's learning of a rule. For theoretical reasons we chose the rule of categorizing objects by the weight. Children, age 4 years, saw an adult heft four visually-identical objects and sort them into two bins based on an invisible property-the object's weight. Children who saw this categorization behavior were more likely to sort those objects by weight than were children who saw control actions using the same objects and the same bins. Crucially, children also generalized to a novel set of objects with no further demonstration, suggesting rule learning. We also report that high-fidelity imitation of the adult's "hefting" acts may give children crucial experience with the objects' weights, which could then be used to infer the more abstract rule. The connection of perception, action, and cognition was found in children from both cultures, which leads to broad implications for how the imitation of adults' acts functions as a lever in cognitive development.

  12. Surviving at extremes

    NASA Astrophysics Data System (ADS)

    Dougan, Lorna

    2015-11-01

    Wherever we look on Earth - even in the most inhospitable places - we find life. But how do organisms manage to survive such difficult conditions? Lorna Dougan explains how physicists are helping to unravel the properties of “extremophile” life.

  13. Survival of falling robots

    NASA Astrophysics Data System (ADS)

    Cameron, Jonathan M.; Arkin, Ronald C.

    1992-02-01

    As mobile robots are used in more uncertain and dangerous environments, it will become important to design them so that they can survive falls. In this paper, we examine a number of mechanisms and strategies that animals use to withstand these potentially catastrophic events and extend them to the design of robots. A brief survey of several aspects of how common cats survive falls provides an understanding of the issues involved in preventing traumatic injury during a falling event. After outlining situations in which robots might fall, a number of factors affecting their survival are described. From this background, several robot design guidelines are derived. These include recommendations for the physical structure of the robot as well as requirements for the robot control architecture. A control architecture is proposed based on reactive control techniques and action-oriented perception that is geared to support this form of survival behavior.

  14. Survival of falling robots

    NASA Technical Reports Server (NTRS)

    Cameron, Jonathan M.; Arkin, Ronald C.

    1992-01-01

    As mobile robots are used in more uncertain and dangerous environments, it will become important to design them so that they can survive falls. In this paper, we examine a number of mechanisms and strategies that animals use to withstand these potentially catastrophic events and extend them to the design of robots. A brief survey of several aspects of how common cats survive falls provides an understanding of the issues involved in preventing traumatic injury during a falling event. After outlining situations in which robots might fall, a number of factors affecting their survival are described. From this background, several robot design guidelines are derived. These include recommendations for the physical structure of the robot as well as requirements for the robot control architecture. A control architecture is proposed based on reactive control techniques and action-oriented perception that is geared to support this form of survival behavior.

  15. Identification of an obese eating style in 4-year-old children born at high and low risk for obesity.

    PubMed

    Berkowitz, Robert I; Moore, Renee' H; Faith, Myles S; Stallings, Virginia A; Kral, Tanja V E; Stunkard, Albert J

    2010-03-01

    This study tested whether children's eating behavior and parental feeding prompts during a laboratory test meal differ among children born at high risk (HR) or low risk (LR) for obesity and are associated with excess child weight gain. At 4 years of age, 32 HR children (mean maternal prepregnancy BMI = 30.4 kg/m(2)) and 29 LR children (maternal BMI = 19.6 kg/m(2)) consumed a test meal in which their eating behavior was assessed, including rate of caloric consumption, mouthfuls/min, and requests for food. Parental prompts for the child to eat also were measured at year 4, and child body composition was measured at ages 4 and 6 years. T-tests, and logistic and multiple regression analyses tested study aims. Results indicated that HR and LR children did not differ in eating rate or parental feeding prompts. Greater maternal BMI, child mouthfuls of food/min, and total caloric intake/min during the test meal predicted an increased risk of being overweight or obese at age 6, whereas greater active mealtime was associated with a reduced risk of being overweight or obese. Regression analyses indicated that only mouthfuls of food/min predicted changes in BMI from 4 to 6 years, and mouthfuls of food/min and gender predicted 2-year changes in sum of skinfolds and total body fat. Thus, a rapid eating style, characterized by increased mouthfuls of food/min, may be a behavioral marker for the development of childhood obesity. PMID:19779474

  16. The burden of hearing loss in Kaduna, Nigeria: a 4-year study at the National Ear Care Centre.

    PubMed

    Kodiya, Aliyu M; Afolabi, Olushola A; Ahmad, Babagana M

    2012-04-01

    Hearing loss among people in developing countries has been recognized as a major source of disability. Many of its causes are preventable, and others are curable. We reviewed the records of 5,485 patients who had presented during a 4-year period to the National Ear Care Centre in Kaduna, Nigeria. Of these, we identified 1,435 patients-812 males and 623 females, aged 9 months to 90 years (mean: 29.2 yr)-who had been diagnosed with hearing loss (26.2%). In addition to demographic data, we compiled information on each patient's type and degree of hearing loss, the affected side, and the predisposing factors. Sex and age cross-tabulations revealed that the greatest proportion of hearing loss according to sex occurred between the ages of 11 and 20 years for males and 21 and 30 years for females. The most common type of hearing loss was sensorineural, which was seen in 78.9% of patients; conductive hearing loss was seen in 17.7% and mixed in 3.4%. More than three-quarters of hearing losses were either moderate, moderately severe, or severe. Bilateral losses were far more common than unilateral losses; among the latter, the left side was affected slightly more often than the right. Predisposing factors were not documented in the vast majority of cases (87.6%), but when they were, the most common were chronic suppurative otitis media, meningitis, febrile convulsion, measles, and trauma. We present these findings to highlight the burden of hearing loss in our part of the world.

  17. A 4-year study of avian influenza virus prevalence and subtype diversity in ducks of Newfoundland, Canada.

    PubMed

    Huang, Yanyan; Wille, Michelle; Dobbin, Ashley; Robertson, Gregory J; Ryan, Pierre; Ojkic, Davor; Whitney, Hugh; Lang, Andrew S

    2013-10-01

    The island of Newfoundland, Canada, is at the eastern edge of North America and has migratory bird connections with the continental mainland as well as across the North Atlantic Ocean. Here, we report a 4-year avian influenza virus (AIV) epidemiological study in ducks in the St. John's region of Newfoundland. The overall prevalence of AIV detection in ducks during this study was 7.2%, with American Black Ducks contributing the vast majority of the collected samples and the AIV positives. The juvenile ducks showed a significantly higher AIV detection rate (10.6%) compared with adults (3.4%). Seasonally, AIV prevalence rates were higher in the autumn (8.4%), but positives were still detected in the winter (4.6%). Preliminary serology tests showed a high incidence of previous AIV infection (20/38, 52.6%). A total of 43 viruses were characterized for their HA-NA or HA subtypes, which revealed a large diversity of AIV subtypes and little recurrence of subtypes from year to year. Investigation of the movement patterns of ducks in this region showed that it is a largely non-migratory duck population, which may contribute to the observed pattern of high AIV subtype turnover. Phylogenetic analysis of 4 H1N1 and one H5N4 AIVs showed these viruses were highly similar to other low pathogenic AIV sequences from waterfowl in North America and assigned all gene segments into American-avian clades. Notably, the H1N1 viruses, which were identified in consecutive years, possessed homologous genomes. Such detection of homologous AIV genomes across years is rare, but indicates the role of the environmental reservoir in viral perpetuation.

  18. Injury risk is low among world-class volleyball players: 4-year data from the FIVB Injury Surveillance System

    PubMed Central

    Bere, Tone; Kruczynski, Jacek; Veintimilla, Nadège; Hamu, Yuichiro; Bahr, Roald

    2015-01-01

    Background Little is known about the rate and pattern of injuries in international volleyball competition. Objective To describe the risk and pattern of injuries among world-class players based on data from the The International Volleyball Federation (FIVB) Injury Surveillance System (ISS) (junior and senior, male and female). Methods The FIVB ISS is based on prospective registration of injuries by team medical staff during all major FIVB tournaments (World Championships, World Cup, World Grand Prix, World League, Olympic Games). This paper is based on 4-year data (September 2010 to November 2014) obtained through the FIVB ISS during 32 major FIVB events (23 senior and 9 junior). Results The incidence of time-loss injuries during match play was 3.8/1000 player hours (95% CI 3.0 to 4.5); this was greater for senior players than for junior players (relative risk: 2.04, 1.29 to 3.21), while there was no difference between males and females (1.04, 0.70 to 1.55). Across all age and sex groups, the ankle was the most commonly injured body part (25.9%), followed by the knee (15.2%), fingers/thumb (10.7%) and lower back (8.9%). Injury incidence was greater for centre players and lower for liberos than for other player functions; injury patterns also differed between player functions. Conclusions Volleyball is a very safe sport, even at the highest levels of play. Preventive measures should focus on acute ankle and finger sprains, and overuse injuries in the knee, lower back and shoulder. PMID:26194501

  19. Calibration and Validation of a Wrist- and Hip-Worn Actigraph Accelerometer in 4-Year-Old Children

    PubMed Central

    Johansson, Elin; Larisch, Lisa-Marie; Marcus, Claude; Hagströmer, Maria

    2016-01-01

    Introduction To determine time spent at different physical activity intensities, accelerometers need calibration. The aim of this study was to develop and cross-validate intensity thresholds for the Actigraph GT3X+ accelerometer for wrist and hip placement in four-year-old children. Methods In total 30 children (49 months, SD 3.7) were recruited from five preschools in Stockholm. Equipped with an accelerometer on the wrist and another on the hip, children performed three indoor activities and one free-play session while being video recorded. Subsequently, physical activity intensity levels were coded every 5th second according to the Children’s Activity Rating Scale. Receiver Operating Characteristic (ROC) curves was used to develop wrist and hip intensity thresholds, the upper threshold for sedentary, and lower threshold for moderate-to-vigorous physical activity (MVPA), for the vertical axis (VA) and for the vector magnitude (VM). A leave-one-out method was used to cross-validate the thresholds. Results Intensity thresholds for wrist placement were ≤ 178 (VA) and ≤ 328 (VM) for sedentary and ≥ 871 (VA) and ≥ 1393 (VM) counts/5 seconds for MVPA. The corresponding thresholds for hip placement were ≤ 43 (VA) and ≤ 105 (VM) for sedentary and ≥ 290 (VA) and ≥ 512 (VM) for MVPA. The quadratic weighted Kappa was 0.92 (95% CI 0.91–0.93) (VA) and 0.95 (95% CI 0.94–0.96) (VM) for the wrist-worn accelerometer and 0.76 (98% CI 0.74–0.77) and 0.86 (95% CI 0.85–0.87) for the hip-worn. Conclusion Using wrist placement and the VM when measuring physical activity with accelerometry in 4-year-old children is recommended. PMID:27617962

  20. Fat Imaging via Magnetic Resonance Imaging (MRI) in Young Children (Ages 1-4 Years) without Sedation

    PubMed Central

    Shearrer, Grace E.; House, Benjamin T.; Gallas, Michelle C.; Luci, Jeffrey J.; Davis, Jaimie N.

    2016-01-01

    Introduction This pilot study developed techniques to perform Magnetic Resonance Imaging (MRI) of specific fat deposition in 18 children (age 18 months to 4 years). Methods The children engaged in a series of practice tests to become acclimated to the scanner noises, reduce claustrophobia, and rehearse holding still for a set time. The practice tests assessed if the child could remain still for two minutes while watching a video, first while lying on a blanket, second, on the blanket with headphones, and third, in the mock scanner. The children who passed the three practice tests were then scanned with a 3T Siemens Skyra magnet. Abdominal fat distribution (region of interest (ROI) from the top of the ileac crest to the bottom of the ribcage) volume was measured using 2-point DIXON technique. This region was chosen to give an indication of the body composition around the liver. Results Twelve out of eighteen participants successfully completed the actual MRI scan. Chi-squared test showed no significant difference between male and female pass-fail rates. The median age of completed scans was 36 months, whereas the median age for children unable to complete a scan was 28 months. The average total trunk fat was 240.9±85.2mL and the average total VAT was 37.7±25.9mLand liver fat was not quantifiable due to physiological motion. Several strategies (modeling, videos, and incentives) were identified to improve pediatric imaging in different age ranges. Conclusion Using an age-specific and tailored protocol, we were able to successfully use MRI for fat imaging in a majority of young children. Development of such protocols enables researchers to better understand the etiology of fat deposition in young children, which can be used to aid in the prevention and treatment of adiposity. PMID:26901881

  1. Laparoscopic sleeve gastrectomy in obese Korean patients: up to 4-year follow-up in a single center

    PubMed Central

    Park, Ji Yeon

    2015-01-01

    Purpose Laparoscopic sleeve gastrectomy (LSG) has been gaining marked popularity as a stand-alone treatment for morbid obesity. This study aimed to evaluate the midterm outcomes and efficacy of LSG performed at a single center in Korea. Methods The records of 192 consecutive patients who underwent LSG between April 2009 and December 2012 were retrospectively reviewed. The patients' demographics and surgical outcomes including anthropometric data were analyzed. Results The mean preoperative body mass index was 40.0 ± 7.2 kg/m2, and 120 patients (62.5%) had at least one obesity-related comorbidity. Three patients (1.6%) required endoscopic or surgical intervention to manage postoperative bleeding or leakage. At the postoperative 1-, 2-, 3-, and 4-year follow-ups, the mean percent of excess weight loss (%EWL) values were 72.6%, 80.6%, 71.1%, and 57.8%, respectively, with follow-up rates of 81%, 56%, 58%, and 30% respectively. The overall mean %EWL reached 68.3% ± 27.2% at a mean follow-up of 25 months. Obesity-related comorbidities were resolved in >70% of the patients after surgery. Twelve months after LSG, 25 patients (13.0%) showed a %EWL of <50%; 9 (4.7%) required conversion to gastric bypass due to inadequate weight loss, intolerable reflux symptoms, or intractable diabetes. Conclusion These midterm results show that LSG is a safe and effective surgical procedure for morbidly obese patients. However, a longer follow-up period is necessary to elucidate whether LSG can achieve durable weight loss and long-term outcomes, comparable to those of more aggressive procedures. PMID:25960987

  2. Learning to perceive English /d/ versus /edh/: A comparison of French, English, and English-French bilingual 4-year-olds

    NASA Astrophysics Data System (ADS)

    Sundara, Megha; Polka, Linda; Campisi, Lisa; Genesee, Fred; Marcoux, Caroline

    2002-05-01

    Recent findings show that discrimination of the English /d-edh/ does not differ for English and French infants (6-8-month-olds and 10-12-month-olds), although English adults clearly outperform French adults on this contrast, which is not phonemic in French. With respect to age effects, English listeners' perception of /d-edh/ improves between infancy and adulthood, whereas French listeners' perception remains unchanged [Polka et al., J. Acoust. Soc. Am. 109, 2190-2200 (2001)]. In the present study, we tested monolingual English, monolingual French, and early English-French bilingual 4-year-olds on the same contrast using the same stimuli and procedures to clarify when facilitative effects of language experience emerge and whether they are affected by bilingualism. Four findings are reported. First, a language effect (English>French) is evident by 4 years of age. Second, among native (English) listeners facilitative effects are evident by 4-years of age (infants<4-year-olds4-year-olds=adults). Fourth, bilingual 4-year-olds' performance is virtually identical to that of their French-speaking peers, revealing a strong effect of bilingualism on the perception of this contrast. Several factors contributing to these findings will be discussed.

  3. Conditional Probability of Survival in Patients With Newly Diagnosed Glioblastoma

    PubMed Central

    Polley, Mei-Yin C.; Lamborn, Kathleen R.; Chang, Susan M.; Butowski, Nicholas; Clarke, Jennifer L.; Prados, Michael

    2011-01-01

    Purpose The disease outcome for patients with cancer is typically described in terms of estimated survival from diagnosis. Conditional probability offers more relevant information regarding survival for patients once they have survived for some time. We report conditional survival probabilities on the basis of 498 patients with glioblastoma multiforme receiving radiation and chemotherapy. For 1-year survivors, we evaluated variables that may inform subsequent survival. Motivated by the trend in data, we also evaluated the assumption of constant hazard. Patients and Methods Patients enrolled onto seven phase II protocols between 1975 and 2007 were included. Conditional survival probabilities and 95% CIs were calculated. The Cox proportional hazards model was used to evaluate prognostic values of age, Karnofsky performance score (KPS), and prior progression 1-year post diagnosis. To assess the constant hazard assumption, we used a likelihood-ratio test to compare the Weibull and exponential distributions. Results The probabilities of surviving an additional year given survival to 1, 2, 3, and 4 years were 35%, 49%, 69%, and 93%, respectively. For patients who survived for 1 year, lower KPS and progression were significantly predictive of shorter survival (both P < .001), but age was not (hazard ratio, 1.22 for a 10-year increase; P = .25). The Weibull distribution fits the data significantly better than exponential (P = .02), suggesting nonconstant hazard. Conclusion Conditional probabilities provide encouraging information regarding life expectancy to survivors of glioblastoma multiforme. Our data also showed that the constant hazard assumption may be violated in modern brain tumor trials. For single-arm trials, we advise using individual patient data from historical data sets for efficacy comparisons. PMID:21969507

  4. Dynamics of CO2-exchange and C-budgets due to soil erosion: Insights from a 4 years observation period

    NASA Astrophysics Data System (ADS)

    Hoffmann, Mathias; Albiac Borraz, Elisa; Garcia Alba, Juana; Augustin, Jürgen; Sommer, Michael

    2015-04-01

    Agriculture in the hummocky ground moraine landscape of NE-Germany is characterized by an increase in energy crop cultivation, like maize or sorghum. Both enhance lateral C fluxes by erosion and induce feedbacks on C dynamics of agroecosystems as a result of reduced wintertime plant cover and vigorous crop growth during summer. However, the actual impact of these phenomena on the CO2-sink/-source function of agricultural landscapes, is still not clear. Therefore, the interdisciplinary project "CarboZALF" was established in Dedelow/Prenzlau (NE-Germany) in 2009. Within the field experiment CarboZALF-D, CO2 fluxes for the soil-plant systems were monitored, covering typical landscape relevant soil states in respect to erosion and deposition, like Calcic Cutanic Luvisol and Endogleyic Colluvic Regosol. Automated chamber systems, each consisting of four transparent chambers (2.5 m height, basal area 2.25 m2), were placed along gradients at both measurement sites. Monitored CO2 fluxes were gap-filled on a high-temporal resolution by modelling ecosystem respiration (Reco), gross primary productivity (GPP) and net ecosystem exchange (NEE) based on parallel and continuous measurements of the CO2 exchange, soil and air temperatures as well as photosynthetic active radiation (PAR). Gap-filling was e.g. needed in case of chamber malfunctions and abrupt disturbances by farming practice. The monitored crop rotation was corn-winter wheat (2 a), sorghum-winter triticale and alfalfa (1.5 a). In our presentation we would like to show insights from a 4 years observation period, with prounounced differences between the eroded and the colluvial soil: The Endogleyic Colluvic Regosol showed higher flux rates for Reco, GPP and NEE compared to the Calcic Cutanic Luvisol. Site-specific NEE and C-balances were positively related to soil C-stocks as well as biomass production, and generated a minor C-sink in case of the Calcic Cutanic Luvisol and a highly variable C-source in case of the

  5. Evaluation of 4 years of continuous δ13C(CO2) data using a moving Keeling plot method

    NASA Astrophysics Data System (ADS)

    Vardag, Sanam Noreen; Hammer, Samuel; Levin, Ingeborg

    2016-07-01

    Different carbon dioxide (CO2) emitters can be distinguished by their carbon isotope ratios. Therefore measurements of atmospheric δ13C(CO2) and CO2 concentration contain information on the CO2 source mix in the catchment area of an atmospheric measurement site. This information may be illustratively presented as the mean isotopic source signature. Recently an increasing number of continuous measurements of δ13C(CO2) and CO2 have become available, opening the door to the quantification of CO2 shares from different sources at high temporal resolution. Here, we present a method to compute the CO2 source signature (δS) continuously and evaluate our result using model data from the Stochastic Time-Inverted Lagrangian Transport model. Only when we restrict the analysis to situations which fulfill the basic assumptions of the Keeling plot method does our approach provide correct results with minimal biases in δS. On average, this bias is 0.2 ‰ with an interquartile range of about 1.2 ‰ for hourly model data. As a consequence of applying the required strict filter criteria, 85 % of the data points - mainly daytime values - need to be discarded. Applying the method to a 4-year dataset of CO2 and δ13C(CO2) measured in Heidelberg, Germany, yields a distinct seasonal cycle of δS. Disentangling this seasonal source signature into shares of source components is, however, only possible if the isotopic end members of these sources - i.e., the biosphere, δbio, and the fuel mix, δF - are known. From the mean source signature record in 2012, δbio could be reliably estimated only for summer to (-25.0 ± 1.0) ‰ and δF only for winter to (-32.5 ± 2.5) ‰. As the isotopic end members δbio and δF were shown to change over the season, no year-round estimation of the fossil fuel or biosphere share is possible from the measured mean source signature record without additional information from emission inventories or other tracer measurements.

  6. False belief understanding and “cool” inhibitory control in 3-and 4-years-old Italian children

    PubMed Central

    Bellagamba, Francesca; Addessi, Elsa; Focaroli, Valentina; Pecora, Giulia; Maggiorelli, Valentina; Pace, Beatrice; Paglieri, Fabio

    2015-01-01

    During preschool years, major developments occur in both executive function and theory of mind (ToM), and several studies have demonstrated a correlation between these processes. Research on the development of inhibitory control (IC) has distinguished between more cognitive, “cool” aspects of self-control, measured by conflict tasks, that require inhibiting an habitual response to generate an arbitrary one, and “hot,” affective aspects, such as affective decision making, measured by delay tasks, that require inhibition of a prepotent response. The aim of this study was to investigate the relations between 3- and 4-year-olds’ performance on a task measuring false belief understanding, the most widely used index of ToM in preschoolers, and three tasks measuring cognitive versus affective aspects of IC. To this end, we tested 101 Italian preschool children in four tasks: (a) the Unexpected Content False Belief task, (b) the Conflict task (a simplified version of the Day–Night Stroop task), (c) the Delay task, and (d) the Delay Choice task. Children’s receptive vocabulary was assessed by the Peabody Picture Vocabulary test. Children’s performance in the False Belief task was significantly related only to performance in the Conflict task, controlling for vocabulary and age. Importantly, children’s performance in the Conflict task did not significantly correlate with their performance in the Delay task or in the Delay Choice task, suggesting that these tasks measure different components of IC. The dissociation between the Conflict and the Delay tasks may indicate that monitoring and regulating a cool process (as flexible categorization) may involve different abilities than monitoring and regulating a hot process (not touching an available and highly attractive stimulus or choosing between a smaller immediate option and a larger delayed one). Moreover, our findings support the view that “cool” aspects of IC and ToM are interrelated, extending to an

  7. A Description and Qualitative Assessment of a 4-Year Intervention to Improve Patient Counseling by Improving Medical Student Health

    PubMed Central

    Frank, Erica; Smith, Donna; Fitzmaurice, Dorothy

    2005-01-01

    Background To test whether promoting medical student health could efficiently improve patient counseling, we developed and implemented a 4-year-long curricular and extracurricular intervention to promote healthy behaviors among students in the Class of 2003 at Emory University School of Medicine, Atlanta, Georgia. Methods We asked students: (1) “What did you think about these [listed intervention components]”; (2) “did any of these interventions influence your personal health habits/attitudes toward your personal health”; and (3) “did any of these interventions influence your behavior or attitudes regarding current or future clinical practices, including history taking or counseling? If so, how? If not, why not?” Students evaluated the effectiveness of these formats and proposed changes in our intervention. The focus groups were transcribed and analyzed with QSR N5. Results Several major themes emerged from the focus groups: Listen to the students early, often, substantively, and noticeably;Incorporate many faculty and student leaders;Quietly integrate the curricular activities into the regular curriculum;Provide a strong, science-based, pragmatic prevention curriculum to complement the personal health promotion;Don't just use lectures to teach;Offer plentiful, nonrequired, fun extracurriculars;Don't nag;Have achievable interventions and recommendations;Provide collective data, but don't overexpose the students to it, and don't assume that collective data apply to every student, especially if it's unpleasant news;Provide personalized data where possible; andUncouple evaluations from the intervention, and keep evaluations brief. Conclusions Some students seemed pleased to have their medical school be attentive to their health, and believed that the project positively influenced their personal health practices and clinical practices (which was our goal). The students enjoyed many components of the intervention, especially the extracurricular activities

  8. An analysis of survival and treatment failure following abdominoperineal and sphincter-saving resection in Dukes' B and C rectal carcinoma. A report of the NSABP clinical trials. National Surgical Adjuvant Breast and Bowel Project.

    PubMed Central

    Wolmark, N; Fisher, B

    1986-01-01

    Abdominoperineal resections for rectal carcinoma are being performed with decreasing frequency in favor of sphincter-saving resections. It remains, however, to be unequivocally demonstrated that sphincter preservation has not resulted in compromised local disease control, disease-free survival, and survival. Accordingly, it is the specific aim of this endeavor to compare local recurrence, disease-free survival, and survival in patients with Dukes' B and C rectal cancer undergoing curative abdominoperineal resection or sphincter-saving resection. For the purpose of this study, 232 patients undergoing abdominoperineal resection and 181 subjected to sphincter-saving resections were available for analysis from an NSABP randomized prospective clinical trial designed to ascertain the efficacy of adjuvant therapy in rectal carcinoma (protocol R-01). The mean time on study was 48 months. Analyses were carried out comparing the two operations according to Dukes' class, the number of positive nodes, and tumor size. The only significant differences in disease-free survival and survival were observed for the cohort characterized by greater than 4 positive nodes and were in favor of patients treated with sphincter-saving resections. A patient undergoing sphincter-saving resection was 0.62 times as likely to sustain a treatment failure as a similar patient undergoing abdominoperineal resection (p = 0.07) and 0.49 times as likely to die (p = 0.02). The inability to demonstrate an attenuated disease-free survival and survival for patients treated with sphincter-saving resection was in spite of an increased incidence of local recurrence (anastomotic and pelvic) observed for the latter operation when compared to abdominoperineal resection (13% vs. 5%). A similar analysis evaluating the length of margins of resection in patients undergoing sphincter-preserving operations indicated that treatment failure and survival were not significantly different in patients whose distal resection

  9. Surviving atmospheric spacecraft breakup.

    PubMed

    Szewczyk, Nathaniel J; McLamb, William

    2005-01-01

    Spacecraft travel higher and faster than aircraft, making breakup potentially less survivable. As with aircraft breakup, the dissipation of lethal forces via spacecraft breakup around an organism is likely to greatly increase the odds of survival. By employing a knowledge of space and aviation physiology, comparative physiology, and search-and-rescue techniques, we were able to correctly predict and execute the recovery of live animals following the breakup of the space shuttle Columbia. In this study, we make what is, to our knowledge, the first report of an animal, Caenorhabditis elegans, surviving the atmospheric breakup of the spacecraft that was supporting it and discuss both the lethal events these animals had to escape and the implications for search and rescue following spacecraft breakup.

  10. Surviving atmospheric spacecraft breakup

    NASA Technical Reports Server (NTRS)

    Szewczyk, Nathaniel J.; McLamb, William

    2005-01-01

    Spacecraft travel higher and faster than aircraft, making breakup potentially less survivable. As with aircraft breakup, the dissipation of lethal forces via spacecraft breakup around an organism is likely to greatly increase the odds of survival. By employing a knowledge of space and aviation physiology, comparative physiology, and search-and-rescue techniques, we were able to correctly predict and execute the recovery of live animals following the breakup of the space shuttle Columbia. In this study, we make what is, to our knowledge, the first report of an animal, Caenorhabditis elegans, surviving the atmospheric breakup of the spacecraft that was supporting it and discuss both the lethal events these animals had to escape and the implications for search and rescue following spacecraft breakup.

  11. A new immunohistochemistry prognostic score (IPS) for recurrence and survival in resected pancreatic neuroendocrine tumors (PanNET)

    PubMed Central

    Viúdez, Antonio; Carvalho, Filipe L.F.; Maleki, Zahra; Zahurak, Marianna; Laheru, Daniel; Stark, Alejandro; Azad, Nilofer Z.; Wolfgang, Christopher L.; Baylin, Stephen; Herman, James G.; De Jesus-Acosta, Ana

    2016-01-01

    Pancreatic neuroendocrine tumor (PanNET) is a neoplastic entity in which few prognostic factors are well-known. Here, we aimed to evaluate the prognostic significance of N-myc downstream-regulated gen-1 (NDRG-1), O6-methylguanine DNA methyltransferase (MGMT) and Pleckstrin homology-like domain family A member 3 (PHLDA-3) by immunohistochemistry (IHC) and methylation analysis in 92 patients with resected PanNET and follow-up longer than 24 months. In multivariate analyses, ki-67 and our immunohistochemistry prognostic score (IPS-based on MGMT, NDRG-1 and PHLDA-3 IHC expression) were independent prognostic factors for disease-free-survival (DFS), while age and IPS were independent prognostic factors for overall survival (OS). Our IPS could be a useful prognostic biomarker for recurrence and survival in patients following resection for PanNET. PMID:26894863

  12. Treatment and survival among 1594 patients with ATL.

    PubMed

    Katsuya, Hiroo; Ishitsuka, Kenji; Utsunomiya, Atae; Hanada, Shuichi; Eto, Tetsuya; Moriuchi, Yukiyoshi; Saburi, Yoshio; Miyahara, Masaharu; Sueoka, Eisaburo; Uike, Naokuni; Yoshida, Shinichiro; Yamashita, Kiyoshi; Tsukasaki, Kunihiro; Suzushima, Hitoshi; Ohno, Yuju; Matsuoka, Hitoshi; Jo, Tatsuro; Amano, Masahiro; Hino, Ryosuke; Shimokawa, Mototsugu; Kawai, Kazuhiro; Suzumiya, Junji; Tamura, Kazuo

    2015-12-10

    Adult T-cell leukemia/lymphoma (ATL) is a malignancy of mature T lymphocytes caused by human T-lymphotropic virus type I. Intensive combination chemotherapy and allogeneic hematopoietic stem cell transplantation have been introduced since the previous Japanese nationwide survey was performed in the late 1980s. In this study, we delineated the current features and management of ATL in Japan. The clinical data were collected retrospectively from the medical records of patients diagnosed with ATL between 2000 and 2009, and a total of 1665 patients' records were submitted to the central office from 84 institutions in Japan. Seventy-one patients were excluded; 895, 355, 187, and 157 patients with acute, lymphoma, chronic, and smoldering types, respectively, remained. The median survival times were 8.3, 10.6, 31.5, and 55.0 months, and 4-year overall survival (OS) rates were 11%, 16%, 36%, and 52%, respectively, for acute, lymphoma, chronic, and smoldering types. The number of patients with allogeneic hematopoietic stem cell transplantation was 227, and their median survival time and OS at 4 years after allogeneic hematopoietic stem cell transplantation was 5.9 months and 26%, respectively. This study revealed that the prognoses of the patients with acute and lymphoma types were still unsatisfactory, despite the recent progress in treatment modalities, but an improvement of 4-year OS was observed in comparison with the previous survey. Of note, one-quarter of patients who could undergo transplantation experienced long survival. It is also noted that the prognosis of the smoldering type was worse than expected. PMID:26361794

  13. Survival after judicial hanging.

    PubMed

    Sabermoghaddam, Mohsen; Abad, Mohsen; Golmakani, Ebrahim; Mozaffari, Nasrollah

    2015-06-01

    Hanging is known not only as a common method of suicide but also as a capital punishment method in some countries. Although several cases have been reported to survive after the attempted suicidal/accidental hanging, to the extent of our knowledge, no modern case of survival after judicial hanging exists. We reported a case of an individual who revived after modern judicial hanging despite being declared dead. The case was admitted with poor clinical presentations and the Glasgow Coma Scale of 6/15. The victim received all the standard supportive intensive care and gained complete clinical recovery.

  14. Survival after judicial hanging.

    PubMed

    Sabermoghaddam, Mohsen; Abad, Mohsen; Golmakani, Ebrahim; Mozaffari, Nasrollah

    2015-06-01

    Hanging is known not only as a common method of suicide but also as a capital punishment method in some countries. Although several cases have been reported to survive after the attempted suicidal/accidental hanging, to the extent of our knowledge, no modern case of survival after judicial hanging exists. We reported a case of an individual who revived after modern judicial hanging despite being declared dead. The case was admitted with poor clinical presentations and the Glasgow Coma Scale of 6/15. The victim received all the standard supportive intensive care and gained complete clinical recovery. PMID:25747958

  15. Prolonged survival of a cat diagnosed with feline infectious peritonitis by immunohistochemistry.

    PubMed

    Hugo, Timothy B; Heading, Kathryn L

    2015-01-01

    A 4-year-old, neutered male, British shorthair cat was presented with inappetence, vomiting, hyperproteinemia, and hyperglobulinemia. An exploratory celiotomy identified enlarged mesenteric lymph nodes. Immunohistochemistry of lymph node biopsies confirmed feline infectious peritonitis. This patient had a prolonged survival of 787 d after initial presentation.

  16. Prolonged survival of a cat diagnosed with feline infectious peritonitis by immunohistochemistry

    PubMed Central

    Hugo, Timothy B.; Heading, Kathryn L.

    2015-01-01

    A 4-year-old, neutered male, British shorthair cat was presented with inappetence, vomiting, hyperproteinemia, and hyperglobulinemia. An exploratory celiotomy identified enlarged mesenteric lymph nodes. Immunohistochemistry of lymph node biopsies confirmed feline infectious peritonitis. This patient had a prolonged survival of 787 d after initial presentation. PMID:25565715

  17. Sarcopenia is an Independent Predictor of Severe Postoperative Complications and Long-Term Survival After Radical Gastrectomy for Gastric Cancer

    PubMed Central

    Zhuang, Cheng-Le; Huang, Dong-Dong; Pang, Wen-Yang; Zhou, Chong-Jun; Wang, Su-Lin; Lou, Neng; Ma, Liang-Liang; Yu, Zhen; Shen, Xian

    2016-01-01

    Abstract Currently, the association between sarcopenia and long-term prognosis after gastric cancer surgery has not been investigated. Moreover, the association between sarcopenia and postoperative complications remains controversial. This large-scale retrospective study aims to ascertain the prevalence of sarcopenia and assess its impact on postoperative complications and long-term survival in patients undergoing radical gastrectomy for gastric cancer. From December 2008 to April 2013, the clinical data of all patients who underwent elective radical gastrectomy for gastric cancer were collected prospectively. Only patients with available preoperative abdominal CT scan within 30 days of surgery were considered for analysis. Skeletal muscle mass was determined by abdominal (computed tomography) CT scan, and sarcopenia was diagnosed by the cut-off values obtained by means of optimum stratification. Univariate and multivariate analyses evaluating risk factors of postoperative complications and long-term survival were performed. A total of 937 patients were included in this study, and 389 (41.5%) patients were sarcopenic based on the diagnostic cut-off values (34.9 cm2/m2 for women and 40.8 cm2/m2 for men). Sarcopenia was an independent risk factor for severe postoperative complications (OR = 3.010, P < 0.001), but not for total complications. However, sarcopenia did not show significant association with operative mortality. Moreover, sarcopenia was an independent predictor for poorer overall survival (HR = 1.653, P < 0.001) and disease-free survival (HR = 1.620, P < 0.001). Under the adjusted tumor-node-metastasis (TNM) stage, sarcopenia remained an independent risk factor for overall survival and disease-free survival in patients with TNM stage II and III, but not in patients with TNM stage I. Sarcopenia is an independent predictive factor of severe postoperative complications after radical gastrectomy for gastric cancer. Moreover

  18. Education for Survival.

    ERIC Educational Resources Information Center

    Allen, James E., Jr.

    In this address, James E. Allen, Jr., Assistant Secretary for Education and U.S. Commissioner of Education, discusses the relationship of education to the problem of ecological destruction. He states that the solutions to the problems of air, water, and soil pollution may be found in redirected education. This "education for survival" can serve to…

  19. Communications Survival Kit.

    ERIC Educational Resources Information Center

    Williamson, Shirley Porter; Braden, Bill

    The purpose of the Communications Survival Kit is to serve as a guide for counselors to assist in planning, developing and implementing a public relations program for the guidance department at the local school level. The kit contains practical information in three categories. First is a rationale for a public relations (PR) program, what PR is…

  20. Unix survival guide.

    PubMed

    Stein, Lincoln D

    2007-01-01

    For a mixture of historical and practical reasons, much of the bioinformatics software discussed in this series runs on Linux, Mac OSX, Solaris, or one of the many other Unix variants. This appendix provides the novice with easy-to-understand information needed to survive in the Unix environment.

  1. Independence and Survival.

    ERIC Educational Resources Information Center

    James, H. Thomas

    Independent schools that are of viable size, well managed, and strategically located to meet competition will survive and prosper past the current financial crisis. We live in a complex technological society with insatiable demands for knowledgeable people to keep it running. The future will be marked by the orderly selection of qualified people,…

  2. Survivability via Control Objectives

    SciTech Connect

    CAMPBELL,PHILIP L.

    2000-08-11

    Control objectives open an additional front in the survivability battle. A given set of control objectives is valuable if it represents good practices, it is complete (it covers all the necessary areas), and it is auditable. CobiT and BS 7799 are two examples of control objective sets.

  3. The Option for Survival

    ERIC Educational Resources Information Center

    Berry, R. Stephen

    1971-01-01

    Suggests formula for survival that takes a thermodynamic view which holds that we must recycle waste while the thermodynamic potential still is moderately high. Otherwise they are lost, as helium is lost when it leaves Earth's atmosphere and goes into space. The idea that the Earth is a closed system is a myth; it collapses each time we put our…

  4. Education for Survival

    ERIC Educational Resources Information Center

    Aldrich, Richard

    2010-01-01

    This article provides a brief overview of current approaches to education and concludes that none of these is sufficient to meet the challenges that now face the human race. It argues instead for a new concept of education for survival. (Contains 1 note.)

  5. Surviving Tight Times.

    ERIC Educational Resources Information Center

    Neugebauer, Roger

    2002-01-01

    Discusses several strategies recommended by small business experts to help for-profit and non-profit child care centers survive a financial crisis. Strategies include: identifying the source of the problem, monitoring cash flow, reducing or deferring expenditures, expediting regular income and exploring new sources of income, patiently working…

  6. Survival of female American Woodcock breeding in Maine

    USGS Publications Warehouse

    Longcore, J.R.; McAuley, D.G.; Sepik, G.F.; Pendleton, G.W.; McAuley, Daniel G.; Bruggink, John G.; Sepik, Greg F.

    2000-01-01

    During 1986-1989, 89 female American woodcock (Scolopax minor) included in this study were radio-marked and survival estimated for the period 1 Aprii-15 June. Eleven woodcock died: five (45%) were killed by mammals, two (18%) by unknown predators, and one (9%) by a raptor; two (18%) died from entanglement in the transmitter harness; and 1 (9%) collided with a vehicle. Survival varied among years from 0.700 (1986) to 0.900 (1989) with a 4-year mean (95% CI) of 0.826. Survival did not differ between age classes (P = 0.900), or among years (P > 0.14), except for higher (P = 0.025) survival (0.875) in 1987 than in 1988 (0.735). A composite survival estimate--based on telemetry studies for the breeding, post-breeding, and winter periods-- was 0.363 for immatures and 0.474 for adults. Mean weights were not different between second year and after second year age classes (P = 0.167), but weight was related to woodcock capture date (P = 0.001). Survival for female woodcock was not related to mean snow depth or to mean, minimum temperature in winter or spring. Habitat use was different between females that died and those that lived, but sample size was small.

  7. Prediction of Breast Cancer Survival Through Knowledge Discovery in Databases

    PubMed Central

    Afshar, Hadi Lotfnezhad; Ahmadi, Maryam; Roudbari, Masoud; Sadoughi, Farahnaz

    2015-01-01

    The collection of large volumes of medical data has offered an opportunity to develop prediction models for survival by the medical research community. Medical researchers who seek to discover and extract hidden patterns and relationships among large number of variables use knowledge discovery in databases (KDD) to predict the outcome of a disease. The study was conducted to develop predictive models and discover relationships between certain predictor variables and survival in the context of breast cancer. This study is Cross sectional. After data preparation, data of 22,763 female patients, mean age 59.4 years, stored in the Surveillance Epidemiology and End Results (SEER) breast cancer dataset were analyzed anonymously. IBM SPSS Statistics 16, Access 2003 and Excel 2003 were used in the data preparation and IBM SPSS Modeler 14.2 was used in the model design. Support Vector Machine (SVM) model outperformed other models in the prediction of breast cancer survival. Analysis showed SVM model detected ten important predictor variables contributing mostly to prediction of breast cancer survival. Among important variables, behavior of tumor as the most important variable and stage of malignancy as the least important variable were identified. In current study, applying of the knowledge discovery method in the breast cancer dataset predicted the survival condition of breast cancer patients with high confidence and identified the most important variables participating in breast cancer survival. PMID:25946945

  8. Prediction of breast cancer survival through knowledge discovery in databases.

    PubMed

    Lotfnezhad Afshar, Hadi; Ahmadi, Maryam; Roudbari, Masoud; Sadoughi, Farahnaz

    2015-01-26

    The collection of large volumes of medical data has offered an opportunity to develop prediction models for survival by the medical research community. Medical researchers who seek to discover and extract hidden patterns and relationships among large number of variables use knowledge discovery in databases (KDD) to predict the outcome of a disease. The study was conducted to develop predictive models and discover relationships between certain predictor variables and survival in the context of breast cancer. This study is Cross sectional. After data preparation, data of 22,763 female patients, mean age 59.4 years, stored in the Surveillance Epidemiology and End Results (SEER) breast cancer dataset were analyzed anonymously. IBM SPSS Statistics 16, Access 2003 and Excel 2003 were used in the data preparation and IBM SPSS Modeler 14.2 was used in the model design. Support Vector Machine (SVM) model outperformed other models in the prediction of breast cancer survival. Analysis showed SVM model detected ten important predictor variables contributing mostly to prediction of breast cancer survival. Among important variables, behavior of tumor as the most important variable and stage of malignancy as the least important variable were identified. In current study, applying of the knowledge discovery method in the breast cancer dataset predicted the survival condition of breast cancer patients with high confidence and identified the most important variables participating in breast cancer survival.

  9. Prognostic Factors for Survival after Resection of Pulmonary Metastases from Colorectal Carcinoma

    PubMed Central

    Osoegawa, Atsushi; Kometani, Takuro; Fukuyama, Seiichi; Hirai, Fumihiko; Seto, Takashi; Ichinose, Yukito

    2015-01-01

    Purpose: As chemotherapy has improved, the survival of patients with metastatic colorectal carcinoma has reached up to 2.5 years. Many of these patients experience pulmonary metastases; however, the prognosis after pulmonary metastasectomy is not satisfying. In this study, we analyzed the prognostic factors for survival in patients who underwent pulmonary metastasectomy. Methods: Eighty-seven patients with colorectal carcinoma received pulmonary metastasectomy. The pathological status of the primary tumor, outcome of the pulmonary metastasectomy, disease-free interval, perioperative carcinoembryonic antigen (CEA) level and history of liver metastases were assessed. Results: The five-year survival was 42.5% after pulmonary metastasectomy. A univariate analyses revealed that the CEA level (p = 0.043) and the number of pulmonary metastases (p = 0.047) were prognostic factors for survival. The CEA level was an independent prognostic factor in a multivariate analysis (relative risk = 2.01, p = 0.037). Among cases with elevated preoperative CEA levels, those whose CEA level normalized after metastasectomy had a better prognosis compared with those whose CEA level decreased but was still high, or whose level increased after metastasectomy (median survival time of 41.8 months compared with 28.1 or 15.7 months, respectively p = 0.021). Conclusion: The CEA level can be a predictive marker for the prognosis in patients with pulmonary metastases from colorectal carcinoma. PMID:26289631

  10. SURVIVAL OF AMORPHOUS WATER ICE ON CENTAURS

    SciTech Connect

    Guilbert-Lepoutre, Aurelie

    2012-10-01

    Centaurs are believed to be Kuiper Belt objects in transition between Jupiter and Neptune before possibly becoming Jupiter family comets. Some indirect observational evidence is consistent with the presence of amorphous water ice in Centaurs. Some of them also display a cometary activity, probably triggered by the crystallization of the amorphous water ice, as suggested by Jewitt and this work. Indeed, we investigate the survival of amorphous water ice against crystallization, using a fully three-dimensional thermal evolution model. Simulations are performed for varying heliocentric distances and obliquities. They suggest that crystallization can be triggered as far as 16 AU, though amorphous ice can survive beyond 10 AU. The phase transition is an efficient source of outgassing up to 10-12 AU, which is broadly consistent with the observations of the active Centaurs. The most extreme case is 167P/CINEOS, which barely crystallizes in our simulations. However, amorphous ice can be preserved inside Centaurs in many heliocentric distance-obliquity combinations, below a {approx}5-10 m crystallized crust. We also find that outgassing due to crystallization cannot be sustained for a time longer than 10{sup 4}-10{sup 4} years, leading to the hypothesis that active Centaurs might have recently suffered from orbital changes. This could be supported by both observations (although limited) and dynamical studies.

  11. Hypertabastic survival model.

    PubMed

    Tabatabai, Mohammad A; Bursac, Zoran; Williams, David K; Singh, Karan P

    2007-10-26

    A new two-parameter probability distribution called hypertabastic is introduced to model the survival or time-to-event data. A simulation study was carried out to evaluate the performance of the hypertabastic distribution in comparison with popular distributions. We then demonstrate the application of the hypertabastic survival model by applying it to data from two motivating studies. The first one demonstrates the proportional hazards version of the model by applying it to a data set from multiple myeloma study. The second one demonstrates an accelerated failure time version of the model by applying it to data from a randomized study of glioma patients who underwent radiotherapy treatment with and without radiosensitizer misonidazole. Based on the results from the simulation study and two applications, the proposed model shows to be a flexible and promising alternative to practitioners in this field.

  12. Survival of extreme opinions

    NASA Astrophysics Data System (ADS)

    Hsu, Jiann-wien; Huang, Ding-wei

    2009-12-01

    We study the survival of extreme opinions in various processes of consensus formation. All the opinions are treated equally and subjected to the same rules of changing. We investigate three typical models to reach a consensus in each case: (A) personal influence, (B) influence from surroundings, and (C) influence to surroundings. Starting with uniformly distributed random opinions, our calculated results show that the extreme opinions can survive in both models (A) and (B), but not in model (C). We obtain a conclusion that both personal influence and passive adaptation to the environment are not sufficient enough to eradicate all the extreme opinions. Only the active persuasion to change the surroundings eliminates the extreme opinions completely.

  13. Doubly robust survival trees.

    PubMed

    Steingrimsson, Jon Arni; Diao, Liqun; Molinaro, Annette M; Strawderman, Robert L

    2016-09-10

    Estimating a patient's mortality risk is important in making treatment decisions. Survival trees are a useful tool and employ recursive partitioning to separate patients into different risk groups. Existing 'loss based' recursive partitioning procedures that would be used in the absence of censoring have previously been extended to the setting of right censored outcomes using inverse probability censoring weighted estimators of loss functions. In this paper, we propose new 'doubly robust' extensions of these loss estimators motivated by semiparametric efficiency theory for missing data that better utilize available data. Simulations and a data analysis demonstrate strong performance of the doubly robust survival trees compared with previously used methods. Copyright © 2016 John Wiley & Sons, Ltd. PMID:27037609

  14. Survival outcome of radioiodine therapy in post thyroidectomy thyroid carcinoma patients: Outcome of long term follow up

    NASA Astrophysics Data System (ADS)

    Haque, F.; Nahar, N.; Sultana, S.; Nasreen, F.; Jabin, Z.; Alam, A. S. M. M.

    2016-03-01

    The overall prognosis of patients with thyroid carcinoma is excellent whenever managed following best practice guidelines. Objective: To calculate sex and age group affected by thyroid cancer; to compare between single or multiple dose of radio ablation needed after thyroidectomy and to determine the percentage of patients become disease free during their follow up. Methods: This was a retrospective study done in NINMAS, Bangladesh on 687 patients from 1984 to 2004. In all cases total or near total thyroidectomy was done before commencing radioiodine therapy. Patients TG level, neck ultrasonography, thyroid scan, whole body I131 scans, neck examination were done every six monthly/yearly. Results: Among 687 patients, female were more sufferers (68.1%) and female to male ratio was 2:1. Age group 19-40 years was mostly affected (57.8%). Most common type seen was papillary carcinoma (81.8%). After ablation 100 patients did not follow-up. Total 237 patients discontinued within 4 years. Remaining 450 patients undergone regular follow-up for 5 years and more, 394 were disease free (87.6%). Total recurrence of metastasis was 23 and 12 patients expired at different times. Conclusions: Long-term regular follow-up is necessary after radioiodine ablation to become free of disease.

  15. How worms survive desiccation

    PubMed Central

    Erkut, Cihan; Penkov, Sider; Fahmy, Karim; Kurzchalia, Teymuras V.

    2012-01-01

    While life requires water, many organisms, known as anhydrobiotes, can survive in the absence of water for extended periods of time. Although discovered 300 years ago, we know very little about the fascinating phenomenon of anhydrobiosis. In this paper, we summarize our previous findings on the desiccation tolerance of the Caenorhabditis elegans dauer larva. A special emphasis is given to the role of trehalose in protecting membranes against desiccation. We also propose a simple mechanism for this process. PMID:24058825

  16. Survival after Radiofrequency Ablation in 122 Patients with Inoperable Colorectal Lung Metastases

    SciTech Connect

    Gillams, Alice; Khan, Zahid; Osborn, Peter; Lees, William

    2013-06-15

    Purpose. To analyze the factors associated with favorable survival in patients with inoperable colorectal lung metastases treated with percutaneous image-guided radiofrequency ablation. Methods. Between 2002 and 2011, a total of 398 metastases were ablated in 122 patients (87 male, median age 68 years, range 29-90 years) at 256 procedures. Percutaneous CT-guided cool-tip radiofrequency ablation was performed under sedation/general anesthesia. Maximum tumor size, number of tumors ablated, number of procedures, concurrent/prior liver ablation, previous liver or lung resection, systemic chemotherapy, disease-free interval from primary resection to lung metastasis, and survival from first ablation were recorded prospectively. Kaplan-Meier analysis was performed, and factors were compared by log rank test. Results. The initial number of metastases ablated was 2.3 (range 1-8); the total number was 3.3 (range 1-15). The maximum tumor diameter was 1.7 (range 0.5-4) cm, and the number of procedures was 2 (range 1-10). The major complication rate was 3.9 %. Overall median and 3-year survival rate were 41 months and 57 %. Survival was better in patients with smaller tumors-a median of 51 months, with 3-year survival of 64 % for tumors 2 cm or smaller versus 31 months and 44 % for tumors 2.1-4 cm (p = 0.08). The number of metastases ablated and whether the tumors were unilateral or bilateral did not affect survival. The presence of treated liver metastases, systemic chemotherapy, or prior lung resection did not affect survival. Conclusion. Three-year survival of 57 % in patients with inoperable colorectal lung metastases is better than would be expected with chemotherapy alone. Patients with inoperable but small-volume colorectal lung metastases should be referred for ablation.

  17. Carbonaceous Survivability on Impact

    NASA Technical Reports Server (NTRS)

    Bunch, T. E.; Becker, Luann; Morrison, David (Technical Monitor)

    1994-01-01

    In order to gain knowledge about the potential contributions of comets and cosmic dust to the origin of life on Earth, we need to explore the survivability of their potential organic compounds on impact and the formation of secondary products that may have arisen from the chaotic events sustained by the carriers as they fell to Earth. We have performed a series of hypervelocity impact experiments using carbon-bearing impactors (diamond, graphite, kerogens, PAH crystals, and Murchison and Nogoya meteorites) into Al plate targets at velocities - 6 km/s. Estimated peak shock pressures probably did not exceed 120 GPa and peak shock temperatures were probably less than 4000 K for times of nano- to microsecs. Nominal crater dia. are less than one mm. The most significant results of these experiments are the preservation of the higher mass PAHs (e. g., pyrene relative to napthalene) and the formation of additional alkylated PAHs. We have also examined the residues of polystyrene projectiles impacted by a microparticle accelerator into targets at velocities up to 15 km/s. This talk will discuss the results of these experiments and their implications with respect to the survival of carbonaceous deliverables to early Earth. The prospects of survivability of organic molecules on "intact" capture of cosmic dust in space via soft: and hard cosmic dust collectors will also be discussed.

  18. Seasonal 4-year investigation into the role of the alpine marmot (Marmota marmota) as a carrier of zoophilic dermatophytes.

    PubMed

    Gallo, M G; Lanfranchi, P; Poglayen, G; Calderola, S; Menzano, A; Ferroglio, E; Peano, A

    2005-06-01

    stable character of the M. canis/M. marmota relationship (no seasonally or annually related difference in the prevalence of this dermatophyte has been found) suggests the inclusion of the alpine marmot in the reservoir of this zoophilic pathogenic agent. In this situation, hibernation in labyrinthine burrow systems, where temperature and moisture ranges are quite uniform the whole year round, may favour the viability of M. canis arthroconidia, whose survival in mountain habitat might otherwise be compromised. This seems to be confirmed by the fact that the fungus has never been found in the control samples collected at a distance of 300 m from the outer edge of the sampled burrow systems. PMID:16110784

  19. Seasonal 4-year investigation into the role of the alpine marmot (Marmota marmota) as a carrier of zoophilic dermatophytes.

    PubMed

    Gallo, M G; Lanfranchi, P; Poglayen, G; Calderola, S; Menzano, A; Ferroglio, E; Peano, A

    2005-06-01

    stable character of the M. canis/M. marmota relationship (no seasonally or annually related difference in the prevalence of this dermatophyte has been found) suggests the inclusion of the alpine marmot in the reservoir of this zoophilic pathogenic agent. In this situation, hibernation in labyrinthine burrow systems, where temperature and moisture ranges are quite uniform the whole year round, may favour the viability of M. canis arthroconidia, whose survival in mountain habitat might otherwise be compromised. This seems to be confirmed by the fact that the fungus has never been found in the control samples collected at a distance of 300 m from the outer edge of the sampled burrow systems.

  20. A Latent Class Analysis of Weight-Related Health Behaviors among 2- and 4-year College Students, and Associated Risk of Obesity

    PubMed Central

    Mathur, C; Stigler, M; Lust, K; Laska, M

    2016-01-01

    Little is known about the complex patterning of weight-related health behaviors in 2- and 4-year college students. The objective of this study was to identify and describe unique classes of weight-related health behaviors among college youth. Latent class analysis was used to identify homogenous, mutually exclusive classes of nine health behaviors which represent multiple theoretically/clinically relevant dimensions of obesity risk among 2- versus 4-year college students using cross-sectional statewide surveillance data (n= 17,584). Additionally, differences in class membership on selected sociodemographic characteristics were examined using a model-based approach. Analysis was conducted separately for both college groups, and 5 and 4 classes were identified for 2-and 4-year college students, respectively. Four classes were similar across 2-and 4-year college groups and were characterized as “mostly healthy dietary habits, active”, “moderately high screen time, active”, “moderately healthy dietary habits, inactive”, and “moderately high screen time, inactive”. “Moderately healthy dietary habits, high screen time” was the additional class unique to 2-year college students. These classes differed on a number of sociodemographic characteristics, including the proportion in each class who were classified as obese. Implications for prevention scientists and future intervention programs are considered. PMID:24990599

  1. Maternal depression from pregnancy to 4 years postpartum and emotional/behavioural difficulties in children: results from a prospective pregnancy cohort study.

    PubMed

    Woolhouse, Hannah; Gartland, Deirdre; Mensah, Fiona; Giallo, Rebecca; Brown, Stephanie

    2016-02-01

    Considerable attention has been focused on women's mental health in the perinatal period and the subsequent impacts on children. Comparatively, we know much less about maternal depression at later time points and the potential implications for child mental health. The objective of this paper was to explore the association between maternal depression and child emotional/behavioural difficulties at 4 years postpartum, taking into account earlier episodes of perinatal depression. The Maternal Health Study is a prospective cohort study of 1,507 nulliparous women. Maternal depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS) in early pregnancy and at 3, 6 and 12 months postpartum and again at 4 years postpartum. Maternal depressive symptoms at 4 years postpartum were associated with significantly increased odds of child emotional/behavioural difficulties (odds ratio (OR) = 3.46, 95 % confidence interval (CI) = 2.21-5.43). This remained significant after adjusting for earlier episodes of perinatal depression and socio-demographic characteristics (OR = 2.07, 95 % CI = 1.18-3.63). We also observed a robust association between child difficulties at age 4 and measures of socio-economic disadvantage. Our findings suggest a pressing need to rethink current paradigms of maternal health surveillance and extend mental health surveillance and support to at least 4 years postpartum. PMID:26271281

  2. Looking but Not Seeing: Atypical Visual Scanning and Recognition of Faces in 2 and 4-Year-Old Children with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Chawarska, Katarzyna; Shic, Frederick

    2009-01-01

    This study used eye-tracking to examine visual scanning and recognition of faces by 2- and 4-year-old children with autism spectrum disorder (ASD) (N = 44) and typically developing (TD) controls (N = 30). TD toddlers at both age levels scanned and recognized faces similarly. Toddlers with ASD looked increasingly away from faces with age,…

  3. A latent class analysis of weight-related health behaviors among 2- and 4-year college students and associated risk of obesity.

    PubMed

    Mathur, Charu; Stigler, Melissa; Lust, Katherine; Laska, Melissa

    2014-12-01

    Little is known about the complex patterning of weight-related health behaviors in 2- and 4-year college students. The objective of this study was to identify and describe unique classes of weight-related health behaviors among college students. Latent class analysis was used to identify homogenous, mutually exclusive classes of nine health behaviors that represent multiple theoretically/clinically relevant dimensions of obesity risk among 2- versus 4-year college students using cross-sectional statewide surveillance data (N = 17,584). Additionally, differences in class membership on selected sociodemographic characteristics were examined using a model-based approach. Analysis was conducted separately for both college groups, and five and four classes were identified for 2- and 4-year college students, respectively. Four classes were similar across 2- and 4-year college groups and were characterized as "mostly healthy dietary habits, active"; "moderately high screen time, active"; "moderately healthy dietary habits, inactive"; and "moderately high screen time, inactive." "Moderately healthy dietary habits, high screen time" was the additional class unique to 2-year college students. These classes differed on a number of sociodemographic characteristics, including the proportion in each class who were classified as obese. Implications for prevention scientists and future intervention programs are considered.

  4. Is the Community College a Less Expensive Path toward a Bachelor's Degree? Public 2- and 4-Year Colleges' Impact on Loan Debt

    ERIC Educational Resources Information Center

    Canché, Manuel S. González

    2014-01-01

    Policy makers and state representatives have claimed that, compared to the traditional path to a four-year degree, a course of study that begins in the 2-year sector provides a more affordable option. If this is true, then all else equal, 2-year students who obtained a 4-year degree would be expected to have acquired less student loan debt. To…

  5. Academic Transfer Shock and Social Integration: A Comparison of Outcomes for Traditional and Nontraditional Students Transferring from 2-Year to 4-Year Institutions

    ERIC Educational Resources Information Center

    Strahn-Koller, Brooke Lindsey

    2012-01-01

    The purpose of this study was to explore whether traditional and nontraditional students who transferred from 2-year to 4-year institutions experienced differences in transfer shock, academic integration, and social integration. A substantial body of knowledge comparing transfer students to native students on transfer shock exists, while only a…

  6. Knowing Minds, Controlling Actions: The Developmental Relations between Theory of Mind and Executive Function from 2 to 4 Years of Age

    ERIC Educational Resources Information Center

    Muller, Ulrich; Liebermann-Finestone, Dana P.; Carpendale, Jeremy I. M.; Hammond, Stuart I.; Bibok, Maximilian B.

    2012-01-01

    This longitudinal study examined the concurrent and predictive relations between executive function (EF) and theory of mind (ToM) in 82 preschoolers who were assessed when they were 2, 3, and 4 years old. The results showed that the concurrent relation between EF and ToM, after controlling for age, verbal ability, and sex, was significant at 3 and…

  7. Developing a General Outcome Measure of Growth in the Cognitive Abilities of Children 1 to 4 Years Old: The Early Problem-Solving Indicator

    ERIC Educational Resources Information Center

    Greenwood, Charles R.; Walker, Dale; Carta, Judith J.; Higgins, Susan K.

    2006-01-01

    Proficiency in problem solving is an important outcome in early childhood necessary for cognitive and emotional development. The development of an individual growth and development indicator of problem solving for children 1 to 4 years of age is described. Based on the general outcome measurement approach (Deno, 1997), the measure is intended for…

  8. A STABLE ISOTOPE ANALYSIS OF SOIL CARBON DENSITY FRACTIONS FOLLOWING 4 YEARS OF CONTINUOUS CLIMATE CHANGE EXPOSURE IN A DOUGLAS FIR MESOCOSM STUDY

    EPA Science Inventory

    We conducted a 4-year full-factorial study of the effects of elevated atmospheric CO2 and temperature on Douglas fir seedlings growing in reconstructed native forest soils in mesocosms. The elevated CO2 treatment was ambient CO2 plus 200 ppm CO2. The elevated temperature treatm...

  9. Compositionality and Statistics in Adjective Acquisition: 4-Year-Olds Interpret "Tall" and "Short" Based on the Size Distributions of Novel Noun Referents

    ERIC Educational Resources Information Center

    Barner, David; Snedeker, Jesse

    2008-01-01

    Four experiments investigated 4-year-olds' understanding of adjective-noun compositionality and their sensitivity to statistics when interpreting scalar adjectives. In Experiments 1 and 2, children selected "tall" and "short" items from 9 novel objects called "pimwits" (1-9 in. in height) or from this array plus 4 taller or shorter distractor…

  10. A Latent Class Analysis of Weight-Related Health Behaviors among 2-and 4-Year College Students and Associated Risk of Obesity

    ERIC Educational Resources Information Center

    Mathur, Charu; Stigler, Melissa; Lust, Katherine; Laska, Melissa

    2014-01-01

    Little is known about the complex patterning of weight-related health behaviors in 2-and 4-year college students. The objective of this study was to identify and describe unique classes of weight-related health behaviors among college students. Latent class analysis was used to identify homogenous, mutually exclusive classes of nine health…

  11. Two-Year Community: Cultivating the STEM Transfer Pathway and Capacity for Research: A Partnership between a Community College and a 4-Year College

    ERIC Educational Resources Information Center

    Hirst, Rachel A.; Bolduc, Gilles; Liotta, Louis; Packard, Becky Wai-Ling

    2014-01-01

    Summer research experiences have been identified as important vehicles for fostering the learning, skill development, and retention of undergraduates in the sciences. In this initiative, community college faculty and students partnered with private 4-year college colleagues on summer research in order to expand the capacity for research for…

  12. Children's Intellectual and Emotional-Behavioral Adjustment at 4 Years as a Function of Cocaine Exposure, Maternal Characteristics, and Environmental Risk.

    ERIC Educational Resources Information Center

    Bennett, David S.; Bendersky, Margaret; Lewis, Michael

    2002-01-01

    Examined 4-year-olds for effects on IQ of prenatal cocaine exposure, exposure to other substances, risk factors, and neonatal medical problems. Found that maternal verbal IQ and low environmental risk predicted child IQ. Cocaine exposure negatively predicted children's overall IQ and verbal reasoning scores for boys only. Maternal harsh…

  13. Focus Particles in Children's Language: Production and Comprehension of "Auch" "Also" in German Learners from 1 Year to 4 Years of Age

    ERIC Educational Resources Information Center

    Hohle, Barbara; Berger, Frauke; Muller, Anja; Schmitz, Michaela; Weissenborn, Jurgen

    2009-01-01

    This article investigates the acquisition of the focus particle "auch" "also" by German-learning children. We report data from spontaneous and elicited production of utterances with the focus particle "auch" by 1- to 4-year-olds complementing earlier findings of a delayed production of the unaccented "auch" compared to the accented one. But in…

  14. Baccalaureate and Beyond: A First Look at the Employment Experiences and Lives of College Graduates, 4 Years On (B&B:08/12). NCES 2014-141

    ERIC Educational Resources Information Center

    Cataldi, Emily Forrest; Siegel, Peter; Shepherd, Bryan; Cooney, Jennifer

    2014-01-01

    This report presents initial findings about the employment outcomes of bachelor's degree recipients approximately 4 years after they completed their 2007-08 degrees. These findings are based on data from the second follow-up of the Baccalaureate and Beyond Longitudinal Study (B&B:08/12), a nationally representative longitudinal sample…

  15. Nuclear War Survival Skills

    SciTech Connect

    Kearny, C.H.

    2002-06-24

    The purpose of this book is to provide Americans with information and instructions that will significantly increase their chances of surviving a possible nuclear attack. It brings together field-tested instructions that, if followed by a large fraction of Americans during a crisis that preceded an attack, could save millions of lives. The author is convinced that the vulnerability of our country to nuclear threat or attack must be reduced and that the wide dissemination of the information contained in this book would help achieve that objective of our overall defense strategy.

  16. Survival of the strategist

    SciTech Connect

    Burr, M.T.

    1994-10-01

    Competition and privatization are two significant trends in the global power market. Surviving in this competitive environment will require developers to maximize their strategic advantages. The logjam in project development is caused by a variety of market factors. Political, regulatory and financing barriers combine to impede the development flow in many countries. Also, a lack of expertise in dealing with the unfamiliar business and cultural environments of developing markets is frustrating developers efforts to break through barriers. In response, many companies are reexamining markets and formulating new approaches to international development.

  17. Smoking and survival of colorectal cancer patients: systematic review and meta-analysis.

    PubMed

    Walter, V; Jansen, L; Hoffmeister, M; Brenner, H

    2014-08-01

    Smoking is a risk factor for colorectal cancer (CRC) incidence and mortality. However, little is known on smoking and its association with survival after CRC diagnosis. We conducted a systematic review and meta-analysis to summarize current evidence. A systematic literature search was carried out in MEDLINE and ISI Web of Science. We included studies that analyzed recurrence-free survival, disease-free survival, all-cause, and CRC-specific mortality according to smoking status. Data were extracted in duplicate. Standard methods of meta-analysis were applied. Sixteen studies from 11 countries were identified, comprising a total sample size of 62 278 CRC patients. Overall, in the 16 included studies, current smoking and, to a lesser extent, former smoking were rather consistently associated with a poorer prognosis compared with never smokers. Meta-analyses yielded random-effects hazard ratio estimates (95% confidence intervals) for all-cause mortality of 1.26 (1.15-1.37) and 1.11 (0.93-1.33) for current and former smokers, compared with never smokers, respectively. In particular, 30-day mortality was found to be increased by between 49% and 100% among current compared with never smokers. Our results support the existence of detrimental effects of smoking on survival also after CRC diagnosis. Perspectives for enhancing prognosis of CRC patients by smoking abstinence deserve increased attention in further research and clinical practice.

  18. Defining the Survival Benchmark for Breast Cancer Patients with Systemic Relapse

    PubMed Central

    Zeichner, Simon B; Ambros, Tadeu; Zaravinos, John; Montero, Alberto J; Mahtani, Reshma L; Ahn, Eugene R; Mani, Aruna; Markward, Nathan J; Vogel, Charles L

    2015-01-01

    BACKGROUND Our original paper, published in 1992, reported a median overall survival after first relapse in breast cancer of 26 months. The current retrospective review concentrates more specifically on patients with first systemic relapse, recognizing that subsets of patients with local recurrence are potentially curable. METHODS Records of 5,168 patients from a largely breast-cancer-specific oncology practice were reviewed to identify breast cancer patients with their first relapse between 1996 and 2006 after primary treatment. There were 189 patients diagnosed with metastatic disease within 2 months of being seen by our therapeutic team and 101 patients diagnosed with metastatic disease greater than 2 months. The patients were divided in order to account for lead-time bias than could potentially confound the analysis of the latter 101 patients. RESULTS Median survival for our primary study population of 189 patients was 33 months. As expected, the median survival from first systemic relapse (MSFSR) for the 101 patients excluded because of the potential for lead-time bias was better at 46 months. Factors influencing prognosis included estrogen receptor (ER) status, disease-free interval (DFI), and dominant site of metastasis. Compared with our original series, even with elimination of local-regional recurrences in our present series, the median survival from first relapse has improved by 7 months over the past two decades. CONCLUSION The new benchmark for MSFSR approaches 3 years. PMID:25922577

  19. HIF1-Alpha Expression Predicts Survival of Patients with Squamous Cell Carcinoma of the Oral Cavity

    PubMed Central

    dos Santos, Marcelo; Mercante, Ana Maria da Cunha; Louro, Iúri Drumond; Gonçalves, Antônio José; de Carvalho, Marcos Brasilino; da Silva, Eloiza Helena Tajara; da Silva, Adriana Madeira Álvares

    2012-01-01

    Background Oral squamous cell carcinoma is an important cause of death and morbidity wordwide and effective prognostic markers are still to be discovered. HIF1α protein is associated with hypoxia response and neovascularization, essential conditions for solid tumors survival. The relationship between HIF1α expression, tumor progression and treatment response in head and neck cancer is still poorly understood. Patients and Methods In this study, we investigated HIF1α expression by immunohistochemistry in tissue microarrays and its relationship with clinical findings, histopathological results and survival of 66 patients with squamous cell carcinoma of the lower mouth. Results Our results demonstrated that high HIF1α expression is associated with local disease-free survival, independently from the choice of treatment. Furthermore, high expression of HIF1α in patients treated with postoperative radiotherapy was associated with survival, therefore being a novel prognostic marker in squamous cell carcinoma of the mouth. Additionally, our results showed that MVD was associated with HIF1α expression and local disease relapse. Conclusion These findings suggest that HIF1α expression can be used as a prognostic marker and predictor of postoperative radiotherapy response, helping the oncologist choose the best treatment for each patient. PMID:23028863

  20. Increasing chimerism after allogeneic stem cell transplantation is associated with longer survival time.

    PubMed

    Tang, Xiaowen; Alatrash, Gheath; Ning, Jing; Jakher, Haroon; Stafford, Patricia; Zope, Madhushree; Shpall, Elizabeth J; Jones, Roy B; Champlin, Richard E; Thall, Peter F; Andersson, Borje S

    2014-08-01

    Donor chimerism after allogeneic stem cell transplantation (allo-SCT) is commonly used to predict overall survival (OS) and disease-free survival (DFS). Because chimerism is observed at 1 or more times after allo-SCT and not at baseline, if chimerism is in fact associated with OS or DFS, then the occurrence of either disease progression or death informatively censors (terminates) the observed chimerism process. This violates the assumptions underlying standard statistical regression methods for survival analysis, which may lead to biased conclusions. To assess the association between the longitudinal post-allo-SCT donor chimerism process and OS or DFS, we analyzed data from 195 patients with acute myelogenous leukemia (n = 157) or myelodysplastic syndrome (n = 38) who achieved complete remission after allo-SCT following a reduced-toxicity conditioning regimen of fludarabine/intravenous busulfan. Median follow-up was 31 months (range, 1.1 to 105 months). Fitted joint longitudinal-survival time models showed that a binary indicator of complete (100%) donor chimerism and increasing percent of donor T cells were significantly associated with longer OS, whereas decreasing percent of donor T cells was highly significantly associated with shorter OS. Our analyses illustrate the usefulness of modeling repeated post-allo-SCT chimerism measurements as individual longitudinal processes jointly with OS and DFS to estimate their relationships.

  1. SURVIV for survival analysis of mRNA isoform variation

    PubMed Central

    Shen, Shihao; Wang, Yuanyuan; Wang, Chengyang; Wu, Ying Nian; Xing, Yi

    2016-01-01

    The rapid accumulation of clinical RNA-seq data sets has provided the opportunity to associate mRNA isoform variations to clinical outcomes. Here we report a statistical method SURVIV (Survival analysis of mRNA Isoform Variation), designed for identifying mRNA isoform variation associated with patient survival time. A unique feature and major strength of SURVIV is that it models the measurement uncertainty of mRNA isoform ratio in RNA-seq data. Simulation studies suggest that SURVIV outperforms the conventional Cox regression survival analysis, especially for data sets with modest sequencing depth. We applied SURVIV to TCGA RNA-seq data of invasive ductal carcinoma as well as five additional cancer types. Alternative splicing-based survival predictors consistently outperform gene expression-based survival predictors, and the integration of clinical, gene expression and alternative splicing profiles leads to the best survival prediction. We anticipate that SURVIV will have broad utilities for analysing diverse types of mRNA isoform variation in large-scale clinical RNA-seq projects. PMID:27279334

  2. The Effect of Early Detection of Occult Brain Metastases in HER2-Positive Breast Cancer Patients on Survival and Cause of Death

    SciTech Connect

    Niwinska, Anna; Tacikowska, Malgorzata; Murawska, Magdalena

    2010-07-15

    Purpose: The aim of the study is to evaluate disease-free survival, survival from the detection of brain metastases, overall survival, and cause of death in patients with occult brain metastases (Group I) vs. patients with symptomatic brain metastases (Group II). Methods and Materials: In 80 HER2-positive breast cancer patients, treated with trastuzumab and cytostatic agents for metastatic disease, magnetic resonance imaging screening of the brain was performed, and in 29 patients (36%) occult brain metastasis was detected (Group I). Whole-brain radiotherapy was delivered to Group I. This first group was compared with 52 patients who had symptomatic brain metastases (Group II) and was treated the same way, at the same clinic, during the same time period. Results: Median disease-free survival was 17 months in Group I and 19.9 months in Group II (p = 0.58). The median time interval between the dissemination of the disease and the detection of occult or symptomatic brain metastases was 9 and 15 months, respectively (p = 0.11). When the brain metastases were detected, the median survival was 9 and 8.78 months, respectively (p = 0.80). The median overall survival was 53 and 51 months, respectively (p = 0.94). In the group with occult brain metastases (Group I) 16% of patients died because of progression within the brain. In the group with symptomatic brain metastases (Group II) the rate of cerebral death was 48% (p = 0.009). Conclusions: Whole-brain radiotherapy of occult brain metastases in HER2-positive breast cancer patients with visceral dissemination produces a three-fold decrease in cerebral deaths but does not prolong survival.

  3. Cemented and screw-retained implant-supported single-tooth restorations in the molar mandibular region: A retrospective comparison study after an observation period of 1 to 4 years

    PubMed Central

    Peñarrocha-Diago, Miguel; Pradíes, Guillermo; Sola-Ruiz, María-Fernanda; Agustín-Panadero, Rubén

    2015-01-01

    Objectives: The aim of this study was to evaluate the survival and compare the appearance of different mechanical and biological complications, in screw-retained and cemented-retained single-tooth implant-supported restorations localized in the molar mandibular region, over a period of 1 to 4 years. Material and Methods: A retrospective study was carried out with a total of eighty implant-supported restorations, which were placed in eighty patients for prosthetic rehabilitation of a mandibular molar. Forty patients were rehabilitated with a cemented-retained restoration and the other forty with a screw-retained restoration. The presence of the following complications was recorded for both types of prostheses: Fractures of the ceramic veneering, loosening screws, mucositis and peri-implantitis. Debonding of the restoration was analyzed in the cemented-retained restoration group. The clinical survival of crowns was analyzed with a Kaplan-Meier test and the clinical complications were compared, using a Student t test and Log-rank test. Results: 27 patients registered some complication. The average rate of complications was 37,5% for cemented-retained restorations and 30% for screw-retained restorations. The complications more common in the cemented-retained restoration were the presence of mucositis (14,87%), while in the screw-retained restorations was the loosening screw (20%). Student t test and Log-Rank test found significant differences (p=0,001) between the screw loosening and presence of mucositis. Conclusions: The cemented-retained restorations seem to prevent screw loosening, but the presence of cement seem to increase the complications around the soft tissues, however in the screw-retained restorations the presence of mucositis and peri-implantitis are lower than cemented-retained restorations. The incidence of fracture of ceramic veneering was similar in both groups. Key words:Screw-retained restorations, cemented-retained restorations, screw loosening

  4. Mechanisms of Fat Graft Survival.

    PubMed

    Pu, Lee L Q

    2016-02-01

    Although more fat grafting procedures have been performed by plastic surgeons with the primary goal to restore soft tissue loss, the actual mechanism on how fat graft survives remains less completely understood. An established old theory on fat graft survival is still based on the cell survival theory proposed by Peer in the early 1950s. On the basis of his preliminary experimental study, he proposed that the mechanism of fat graft survival is based on established early blood circulation through anastomosis of the fat graft and host blood vessels. Recently, several investigators have demonstrated new concepts of the fat graft survival: One further advanced the old Peer cell survival theory and another based on new discovery and understanding of adipose-derived stem cells. This article serves as a scientific review on how fat graft survives after in vivo transplantation based on a number of well-conducted experimental studies. Both the graft survival and graft replacement theories on how fat graft survives are true based on the previously mentioned well-conducted experimental studies. Each theory may play a role in fat graft survival. It is possible that graft survival may be more dominant in some patients but the graft replacement may be more dominant in other patients.

  5. Postfledging survival of European starlings

    USGS Publications Warehouse

    Krementz, D.G.; Nichols, J.D.; Hines, J.E.

    1989-01-01

    We tested the hypotheses that mass at fledging and fledge date within the breeding season affect postfledging survival in European Starlings (Sturnus vulgaris). Nestlings were weighed on day 18 after hatch and tagged with individually identifiable patagial tags. Fledge date was recorded. Marked fledglings were resighted during weekly two-day intensive observation periods for 9 weeks postfledging. Post-fledging survival and sighting probabilities were estimated for each of four groups (early or late fledging by heavy or light fledging mass). Body mass was related to post-fledging survival for birds that fledged early. Results were not clear-cut for relative fledge date, although there was weak evidence that this also influenced survival. Highest survival probability estimates occurred in the EARLY-HEAVY group, while the lowest survival estimate occurred in the LATE-LIGHT group. Sighting probabilities differed significantly among groups, emphasizing the need to estimate and compare survival using models which explicitly incorporate sighting probabilities.

  6. Sun Exposure and Melanoma Survival: A GEM Study

    PubMed Central

    Berwick, Marianne; Reiner, Anne S.; Paine, Susan; Armstrong, Bruce K.; Kricker, Anne; Goumas, Chris; Cust, Anne E.; Thomas, Nancy E.; Groben, Pamela A.; From, Lynn; Busam, Klaus; Orlow, Irene; Marrett, Loraine D.; Gallagher, Richard P.; Gruber, Stephen B.; Anton-Culver, Hoda; Rosso, Stefano; Zanetti, Roberto; Kanetsky, Peter A.; Dwyer, Terry; Venn, Alison; Lee-Taylor, Julia; Begg, Colin B.

    2014-01-01

    Background We previously reported a significant association between higher ultraviolet radiation exposure before diagnosis and greater survival with melanoma in a population-based study in Connecticut. We sought to evaluate the hypothesis that sun exposure prior to diagnosis was associated with greater survival in a larger, international population-based study with more detailed exposure information. Methods We conducted a multi-center, international population-based study in four countries – Australia, Italy, Canada and the United States – with 3,578 cases of melanoma with an average of 7.4 years of follow-up. Measures of sun exposure included sunburn, intermittent exposure, hours of holiday sun exposure, hours of water-related outdoor activities, ambient UVB dose, histological solar elastosis and season of diagnosis. Results Results were not strongly supportive of the earlier hypothesis. Having had any sunburn in one year within 10 years of diagnosis was inversely associated with survival; solar elastosis – a measure of lifetime cumulative exposure – was not. Additionally, none of the intermittent exposure measures – water related activities and sunny holidays - were associated with melanoma-specific survival. Estimated ambient UVB dose was not associated with survival. Conclusion Although there was an apparent protective effect of sunburns within 10 years of diagnosis, there was only weak evidence in this large, international, population-based study of melanoma that sun exposure prior to diagnosis is associated with greater melanoma-specific survival. Impact This study adds to the evidence that sun exposure prior to melanoma diagnosis has little effect on survival with melanoma. PMID:25069694

  7. Vertebral Osteomyelitis and Acinetobacter Spp. Paravertebral Soft Tissue Infection in a 4-Year-Old Boy With X-Linked Chronic Granulomatous Disease.

    PubMed

    Vignesh, Pandiarajan; Bhattad, Sagar; Shandilya, Jitendra-Kumar; Vyas, Sameer; Garg, Rashi; Rawat, Amit

    2016-09-01

    Vertebral osteomyelitis is known to occur in chronic granulomatous disease, a phagocytic disorder and the etiology is usually a fungus. Indolent spread of fungal infection from lungs to adjacent ribs and vertebra often results in persistent pneumonia and vertebral deformities. We report a 4-year-old boy with chronic cough and kyphosis, who had a fungal vertebral osteomyelitis and Acinetobacter spp. paravertebral soft tissue infection related to X-linked chronic granulomatous disease.

  8. Women’s Satisfaction with Body Image before Pregnancy and Body Mass Index 4 Years after Delivery in the Mothers of Generation XXI

    PubMed Central

    Henriques, Ana; Alves, Elisabete; Barros, Henrique; Azevedo, Ana

    2013-01-01

    Background Body image satisfaction (BIS) influences body weight regulation and may contribute to long-term healthier lifestyle after pregnancy. Thus, we aimed to assess the association between BIS before pregnancy and body mass index (BMI) 4 years after the index pregnancy. Methods As part of the follow-up of a birth cohort, 3612 women with prepregnancy BMI >18.5 kg/m2 were reevaluated 4 years after the birth of a child. BIS was defined as the difference between perceived and ideal body size before pregnancy, assessed by Stunkard Silhouettes after birth. The associations of BIS with BMI change (continuous) and BMI classes at 4 years, based on measured weight and height, were estimated using linear and multinomial regression, respectively. Results Among women with normal prepregnancy BMI, those who felt too small, regarding their ideal, had a 0.25 kg/m2 smaller increase in BMI within 4 years and a lower likelihood of becoming overweight or obese [multivariate-adjusted odds ratio (OR) = 0.63; 95% confidence interval (95%CI): 0.44–0.91 and OR = 0.21; 95%CI: 0.05–0.91, respectively) than those satisfied with body image. Feeling too large was associated with a 0.41 kg/m2 larger increase in BMI and a higher risk of becoming overweight or obese (OR = 2.12; 95%CI:1.73–2.59 and OR = 3.42; 95%CI:2.02–5.79, respectively). A similar, non-significant, trend was observed for overweight women. Obese women who felt too large had a non-significant decrease in BMI. Conclusions BIS plays a role in maternal body weight after delivery. Realistic body size goals may promote the motivation to lose weight and contribute to higher success in attaining them. PMID:23936169

  9. Endomyocardial fibrosis and mural thrombus in a 4-year-old girl due to idiopathic hypereosinophilia syndrome described with serial cardiac magnetic resonance imaging.

    PubMed

    Tai, Christiana P; Chung, Taylor; Avasarala, Kishor

    2016-01-01

    We present the case of a 4-year-old girl with idiopathic hypereosinophilia syndrome, endomyocardial fibrosis, and mural thrombus. This condition is rarely seen in children outside the tropics. Myocardial biopsy is historically the standard for diagnosis. Reports in adult literature, however, have shown the utility of cardiac MRI as a non-invasive tool for diagnosis, prognosis, and monitoring. To our knowledge, this is the first reported case with serial cardiac MRI in a child.

  10. Argus II retinal prosthesis implantation with scleral flap and autogenous temporalis fascia as alternative patch graft material: a 4-year follow-up

    PubMed Central

    Matet, Alexandre; Amar, Nawel; Mohand-Said, Saddek; Sahel, José-Alain; Barale, Pierre-Olivier

    2016-01-01

    Introduction The Argus II retinal prosthesis is composed of an epiretinal electrode array positioned over the macula and connected to an extrascleral electronics case via a silicone cable, running through a sclerotomy. During implantation, the manufacturer recommends to cover the sclerotomy site with a patch of processed human pericardium to prevent postoperative hypotony and conjunctival erosion by the underlying electronics case. Due to biomedical regulations prohibiting the use of this material in France, we developed an alternative technique combining a scleral flap protecting the sclerotomy and an autogenous graft of superior temporalis fascia overlying the electronics case. Methods The purpose of this study is to describe the 4-year outcomes of this modified procedure in three subjects who underwent Argus II Retinal Prosthesis System implantation. Clinical data consisting of intraocular pressure measurements and tolerance in terms of conjunctival erosion or inflammation were retrospectively assessed over a 4-year postoperative follow-up. Results None of the three patients implanted with the modified technique developed ocular hypotony over 4 years. A normal, transient conjunctival inflammation occurred during the first postoperative month but conjunctival erosion was not observed in any of the three patients over 4 years. Four years after implantation, the autogenous temporalis fascia graft remained well tolerated and the retinal prosthesis was functional in all three patients. Conclusion The combination of an autograft of superficial temporalis fascia and a scleral flap efficiently prevented leakage through the sclerotomy site, ocular hypotony, and conjunctival erosion by the extrascleral electronics case. This modified technique is suitable for the implantation of existing and forthcoming retinal prostheses. Superficial temporalis fascia may also be used as alternative to commercial tectonic tissues for scleral wound repair in clinical settings where they

  11. Exploring the Academic and Social Experiences of Latino Engineering Community College Transfer Students at a 4-Year Institution: A Qualitative Research Study

    NASA Astrophysics Data System (ADS)

    Hagler, LaTesha R.

    As the number of historically underrepresented populations transfer from community college to university to pursue baccalaureate degrees in science, technology, engineering, and mathematics (STEM), little research exists about the challenges and successes Latino students experience as they transition from 2-year colleges to 4-year universities. Thus, institutions of higher education have limited insight to inform their policies, practices, and strategic planning in developing effective sources of support, services, and programs for underrepresented students in STEM disciplines. This qualitative research study explored the academic and social experiences of 14 Latino engineering community college transfer students at one university. Specifically, this study examined the lived experiences of minority community college transfer students' transition into and persistence at a 4-year institution. The conceptual framework applied to this study was Schlossberg's Transition Theory, which analyzed the participant's social and academic experiences that led to their successful transition from community college to university. Three themes emerged from the narrative data analysis: (a) Academic Experiences, (b) Social Experiences, and (c) Sources of Support. The findings indicate that engineering community college transfer students experience many challenges in their transition into and persistence at 4-year institutions. Some of the challenges include lack of academic preparedness, environmental challenges, lack of time management skills and faculty serving the role as institutional agents.

  12. Quantifying the effect of resin type and sterilization method on the degradation of ultrahigh molecular weight polyethylene after 4 years of real-time shelf aging.

    PubMed

    Willie, Bettina M; Ashrafi, Shadi; Alajbegovic, Sanjin; Burnett, Trever; Bloebaum, Roy D

    2004-06-01

    Alternative sterilization methods including ethylene oxide, gas plasma, and gamma-radiation in an inert environment were implemented in the late 1990s, to limit oxidative degradation of ultrahigh molecular weight polyethylene (PE). There was also a simultaneous transition to PE resins that did not contain calcium stearate. Shelf storage duration of PE inserts following gamma-irradiation in air has been correlated to poor clinical performance and increased wear. This study aimed to determine how sterilization method and resin type influenced degradation of PE after 4 years of real-time shelf aging. It was hypothesized that gamma-irradiation and stearate containing resins would incur significantly more degradation than nonradiated, stearate-free resins. Gamma-irradiated PE samples in air and nitrogen had a significantly increased density and oxidation index, compared to nonirradiated PE after 4 years of shelf aging. Alternative sterilization methods such as ethylene oxide and gas plasma appeared to have significantly less oxidation regardless of PE resin type. A partial correlation demonstrated that density and oxidation index were not correlated (r(2) = 0.079) when examining the influence of sterilization method. The data supported that after 4 years of real-time shelf aging, the type of sterilization method had a larger influence on PE degradation than resin type.

  13. Modified internal mandibular distraction osteogenesis in the treatment of micrognathia secondary to temporomandibular joint ankylosis: 4-year follow-up of a case.

    PubMed

    Shang, Hongtao; Xue, Yang; Liu, Yanpu; Zhao, Jinlong; He, Lisheng

    2012-06-01

    Micrognathia and obstructive sleep apnoea syndrome (OSAS) are problems subsequent to temporomandibular joint ankylosis (TMJa) in growing patients. For patients with micrognathia and OSAS secondary to TMJa, it is important to restore proper mandibular form and dimension, achieve occlusal stability and recover satisfactory joint movement. We report a 4-year follow-up of a patient with micrognathia and OSAS secondary to bilateral TMJa. The treatment of this patient involved (1) a modified internal mandibular distraction osteogenesis without altering the pre-existing occlusion; (2) TMJ arthroplasty in which the dislocated disc was found and repositioned and the shape of the glenoid fossa and articular head was formed without removing bone in vertical dimension; (3) passive mouth-opening exercise with an individualized occlusal pad postoperatively for one month; and (4) orthodontic treatment for the occlusal disturbance and active mouth-opening exercise for one year. After the treatment the micrognathia was corrected; the oropharyngeal airway was increased significantly; mouth-opening increased to 40mm intraoperatively was maintained at 36.66mm 4 years after surgery. Satisfactory occlusion was achieved after orthodontic treatment. Through the 4-year follow-up, no signs of reankylosis were found. In conclusion, this new clinical protocol is a safe, effective and quick way to treat micrognathia and OSAS secondary to TMJa.

  14. Cold sea survival.

    NASA Technical Reports Server (NTRS)

    Veghte, J. H.

    1972-01-01

    Two prototype three-man life rafts were evaluated during the winter months in Arctic waters off Kodiak Island, Alaska, to assess potential survival problems and determine tolerance limits. Each raft incorporated thermal characteristics specifically designed for cold water. Water and air temperatures varied from 0 to +2 C and -5 to +4 C respectively. All subjects were removed upon reaching subjective tolerance. The results showed that none of the clothing assemblies was adequate to maintain a person in comfort even with dry boarding. No significant biochemical shifts in the blood or urine were found. The TUL raft was found to be superior in its thermal characteristics and afforded better subject protection. General tolerance for cold water immersion, wet and dry, and cold water raft exposures are depicted graphically, based on previously reported data.

  15. Process control for survival

    SciTech Connect

    Yocom, J.A.

    1991-06-01

    Increasing competition for a decreasing market mandates that the success of a company be determined by the manner in which it embraces quality. Statistical Process Control (SPC) is the most efficient means of dramatically improving quality and is essential to survival in the emerging electronic marketplace. During the three years that industry practitioners assembled to write IPC-PC-90, General Requirements for the Implementation of statistical Process Control, many heated discussions ensued about the actual definition of SPC. Some people view SPC as the application of Control Chart methods, others view it as the use of Statistical Experimental Design. Both are in some ways wrong and are limiting the scope of application. Those companies that have successfully applied SPC view it as a philosophy of statistical principles that will reduce variation in every phase of their business. 2 figs.

  16. Metabolic Response of Lymph Nodes Immediately After RT Is Related With Survival Outcome of Patients With Pelvic Node-Positive Cervical Cancer Using Consecutive [{sup 18}F]fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography

    SciTech Connect

    Yoon, Mee Sun; Ahn, Sung-Ja; Nah, Byung-Sik; Chung, Woong-Ki; Song, Ho-Chun; Yoo, Su Woong; Song, Ju-Young; Jeong, Jae-Uk; Nam, Taek-Keun

    2012-11-15

    Purpose: To evaluate the metabolic response of uterine cervix and pelvic lymph nodes (LNs) using consecutive {sup 18}F-fluorodeoxyglucose-positron emission tomography/computed tomography (PET/CT) immediately after RT and to correlate survival outcome with the metabolic response. Methods and Materials: We retrospectively reviewed 48 patients with cervical cancer who had positive pelvic LNs by preradiation therapy (pre-RT) PET/CT. All patients underwent PET/CT scans immediately after RT (inter-RT PET/CT) after median 63 Gy to the gross LNs. The metabolic response of the LNs was assessed quantitatively and semiquantitatively by measurement of the maximal standardized uptake value (SUV{sub max}). Results: Classifying the metabolic response of all nodal lesions, 37 patients (77%) had LNs with complete metabolic response on the inter-RT PET/CT (LNCMRi), and 11 patients had a non-LNCMRi, including 4 patients with progressive metabolic disease. The overall 3-year survival rates were 83% for the patients with LNCMRi and 73% for the non-LNCMRi group (P=.038). The disease-free survival for patients with LNCMRi were significantly better than that for the non-LNCMRi group (71% vs 18%, respectively, P<.001). The 3-year distant metastasis-free survival rates were 79% for the patients with LNCMRi and 27% for the non-LNCMRi group (P<.001). There were no statistically significant differences in overall survival (76% vs 86%, respectively, P=.954) and disease-free survival rates (58% vs 61%, respectively, P=.818) between the CMR of primary cervical tumor and the non-CMR groups. Conclusions: The results showed a significant correlation between survival outcome and the interim metabolic response of pelvic LNs. CMR of nodal lesion on inter-RT PET/CT had excellent overall survival, disease-free survival and distant metastasis-free survival rates. This suggested that PET/CT immediately after RT can be a useful tool for the evaluation of the interim response of the LNs and identify a subset

  17. Genetic polymorphisms in the MMP-7 gene and breast cancer survival

    PubMed Central

    Beeghly-Fadiel, Alicia; Shu, Xiao-ou; Long, Jirong; Li, Chun; Cai, Qiuyin; Cai, Hui; Gao, Yu-Tang; Zheng, Wei

    2008-01-01

    Matrix metalloproteinase-7 (MMP-7) is a small secreted proteolytic enzyme with broad substrate specificity. Its expression has been shown to be associated with tumor invasion, metastasis, and survival for a variety of cancers. We systematically evaluated single nucleotide polymorphisms (SNPs) in this gene in relation to breast cancer survival in a large follow-up study. This study included 1,079 breast cancer patients, recruited from 1996 to 1998, that were followed for a median of 7.1 years as part of the Shanghai Breast Cancer Study (SBCS). Eleven SNPs, including two known functional promoter SNPs, were analyzed using the Affymetrix Targeted Genotyping System. Associations with survival were evaluated by Cox proportional hazards regression and Kaplan-Meier functions. Statistically significant associations with disease-free (DFS) and/or overall survival (OS) were found for 5 polymorphisms; these associations were explained primarily by two SNPs (rs11568818 and rs11225297) that were in high linkage disequilibrium (LD) with the others. Patients homozygous for the rs11568818 rare allele (G) had a significantly worse prognosis (OS HR: 6.7, 95% CI: 2.4–18.6) than patients homozygous for the common allele (A). Significantly improved survival was seen for patients with the rs11225297 T allele, and this association occurred in a dose-response manner; patients with AT (OS HR: 0.7, 95% CI: 0.5–0.9) and TT (OS HR: 0.3, 95% CI: 0.1–0.8) fared better than patients with AA (p-value for trend: 0.001). Thus, common MMP-7 genetic polymorphisms were found to be significant determinants of survival among Chinese women with breast cancer. PMID:18798254

  18. Relationship Between Statin Use and Colon Cancer Recurrence and Survival: Results From CALGB 89803

    PubMed Central

    Ogino, Shuji; Meyerhardt, Jeffrey A.; Chan, Jennifer A.; Chan, Andrew T.; Niedzwiecki, Donna; Hollis, Donna; Saltz, Leonard B.; Mayer, Robert J.; Benson, Al B.; Schaefer, Paul L.; Whittom, Renaud; Hantel, Alexander; Goldberg, Richard M.; Bertagnolli, Monica M.; Venook, Alan P.; Fuchs, Charles S.

    2011-01-01

    Background Although preclinical and epidemiological data suggest that statins may have antineoplastic properties, the impact of statin use on patient survival after a curative resection of stage III colon cancer is unknown. Methods We conducted a prospective observational study of 842 patients with stage III colon cancer enrolled in a randomized adjuvant chemotherapy trial from April 1999 to May 2001 to investigate the relationship between statin use and survival. Disease-free survival (DFS), recurrence-free survival (RFS), and overall survival (OS) were investigated by Kaplan–Meier curves and log-rank tests in the overall study population and in a subset of patients stratified by KRAS mutation status (n = 394), and Cox proportional hazards regression was used to assess the simultaneous impact of confounding variables. All statistical tests were two-sided. Results Among 842 patients, 134 (15.9%) reported statin use after completing adjuvant chemotherapy. DFS among statin users and nonusers was similar (hazard ratio [HR] of cancer recurrence or death = 1.04, 95% confidence interval [CI] = 0.73 to 1.49). RFS and OS were also similar between statin users and nonusers (adjusted HR of cancer recurrence = 1.14, 95% CI = 0.77 to 1.69; adjusted HR of death = 1.15, 95% CI = 0.77 to 1.71). Survival outcomes were similar regardless of increasing duration of statin use before cancer diagnosis (Ptrend = .63, .63, and .59 for DFS, RFS, and OS, respectively). The impact of statin use did not differ by tumor KRAS mutation status, with similar DFS, RFS, and OS for statin use among mutant and wild-type subgroups (Pinteraction = .84, .67, and .98 for DFS, RFS, and OS, respectively). Conclusion Statin use during and after adjuvant chemotherapy was not associated with improved DFS, RFS, or OS in patients with stage III colon cancer, regardless of KRAS mutation status. PMID:21849660

  19. What is the survival after surgery for localized malignant pleural mesothelioma?†

    PubMed Central

    Gelvez-Zapata, Sandra M.; Gaffney, Daniel; Scarci, Marco; Coonar, Aman S.

    2013-01-01

    A best evidence topic in thoracic surgery was written according to a structured protocol. This was with the purpose of assisting our management of patients with localized malignant mesothelioma of the pleura (LMM). Although the terminology is used inconsistently, this variant has been formally defined by the WHO as a distinct entity defined as localized disease histologically identical to the diffuse form but without any evidence of pleural spread. Treatments for LMM include different combinations of surgery, chemotherapy and radiotherapy. There is an impression that LMM may have a better outcome than the commoner diffuse form of malignant mesothelioma that has been reported to have a survival between 8 and 14 months. In order to advise our patients on prognosis, we studied the duration of survival after surgical resection of LMM. A total of 150 papers were found, of which 16 represented the best evidence to answer the question. The authors, journal, date, country of publication, study type, relevant outcomes and results of these papers are tabulated. It is difficult to combine the results of these 16 papers because both treatments and results are reported differently. Some report median survival (range: 11.6–36 months) and others disease-free survival (range: 0 months to 11 years). Median survival to the longest follow-up was 29 months when calculated by pooling data from informative papers using the Kaplan–Meier method. Our review suggests that survival in LMM is longer than that generally quoted for the more common diffuse form of malignant mesothelioma. Hence, aggressive treatment of LMM may be reasonable in appropriate patients. PMID:23328002

  20. Sarcopenia is an Independent Predictor of Severe Postoperative Complications and Long-Term Survival After Radical Gastrectomy for Gastric Cancer: Analysis from a Large-Scale Cohort.

    PubMed

    Zhuang, Cheng-Le; Huang, Dong-Dong; Pang, Wen-Yang; Zhou, Chong-Jun; Wang, Su-Lin; Lou, Neng; Ma, Liang-Liang; Yu, Zhen; Shen, Xian

    2016-03-01

    Currently, the association between sarcopenia and long-term prognosis after gastric cancer surgery has not been investigated. Moreover, the association between sarcopenia and postoperative complications remains controversial. This large-scale retrospective study aims to ascertain the prevalence of sarcopenia and assess its impact on postoperative complications and long-term survival in patients undergoing radical gastrectomy for gastric cancer. From December 2008 to April 2013, the clinical data of all patients who underwent elective radical gastrectomy for gastric cancer were collected prospectively. Only patients with available preoperative abdominal CT scan within 30 days of surgery were considered for analysis. Skeletal muscle mass was determined by abdominal (computed tomography) CT scan, and sarcopenia was diagnosed by the cut-off values obtained by means of optimum stratification. Univariate and multivariate analyses evaluating risk factors of postoperative complications and long-term survival were performed. A total of 937 patients were included in this study, and 389 (41.5%) patients were sarcopenic based on the diagnostic cut-off values (34.9 cm²/m² for women and 40.8 cm²/m² for men). Sarcopenia was an independent risk factor for severe postoperative complications (OR = 3.010, P < 0.001), but not for total complications. However, sarcopenia did not show significant association with operative mortality. Moreover, sarcopenia was an independent predictor for poorer overall survival (HR = 1.653, P < 0.001) and disease-free survival (HR = 1.620, P < 0.001). Under the adjusted tumor-node-metastasis (TNM) stage, sarcopenia remained an independent risk factor for overall survival and disease-free survival in patients with TNM stage II and III, but not in patients with TNM stage I. Sarcopenia is an independent predictive factor of severe postoperative complications after radical gastrectomy for gastric cancer. Moreover, sarcopenia

  1. Sarcopenia is an Independent Predictor of Severe Postoperative Complications and Long-Term Survival After Radical Gastrectomy for Gastric Cancer: Analysis from a Large-Scale Cohort.

    PubMed

    Zhuang, Cheng-Le; Huang, Dong-Dong; Pang, Wen-Yang; Zhou, Chong-Jun; Wang, Su-Lin; Lou, Neng; Ma, Liang-Liang; Yu, Zhen; Shen, Xian

    2016-03-01

    Currently, the association between sarcopenia and long-term prognosis after gastric cancer surgery has not been investigated. Moreover, the association between sarcopenia and postoperative complications remains controversial. This large-scale retrospective study aims to ascertain the prevalence of sarcopenia and assess its impact on postoperative complications and long-term survival in patients undergoing radical gastrectomy for gastric cancer. From December 2008 to April 2013, the clinical data of all patients who underwent elective radical gastrectomy for gastric cancer were collected prospectively. Only patients with available preoperative abdominal CT scan within 30 days of surgery were considered for analysis. Skeletal muscle mass was determined by abdominal (computed tomography) CT scan, and sarcopenia was diagnosed by the cut-off values obtained by means of optimum stratification. Univariate and multivariate analyses evaluating risk factors of postoperative complications and long-term survival were performed. A total of 937 patients were included in this study, and 389 (41.5%) patients were sarcopenic based on the diagnostic cut-off values (34.9 cm²/m² for women and 40.8 cm²/m² for men). Sarcopenia was an independent risk factor for severe postoperative complications (OR = 3.010, P < 0.001), but not for total complications. However, sarcopenia did not show significant association with operative mortality. Moreover, sarcopenia was an independent predictor for poorer overall survival (HR = 1.653, P < 0.001) and disease-free survival (HR = 1.620, P < 0.001). Under the adjusted tumor-node-metastasis (TNM) stage, sarcopenia remained an independent risk factor for overall survival and disease-free survival in patients with TNM stage II and III, but not in patients with TNM stage I. Sarcopenia is an independent predictive factor of severe postoperative complications after radical gastrectomy for gastric cancer. Moreover, sarcopenia

  2. Survival of radiomarked canvasback ducklings in northwestern Minnesota

    USGS Publications Warehouse

    Korschgen, Carl E.; Kenow, Kevin P.; Green, William L.; Johnson, Douglas H.

    1996-01-01

    Duckling survival, an important factor affecting annual recruitment, has not been determined adequately for canvasbacks (Aythya valisineria). We investigated the magnitude, timing, and causes of mortality of canvasback ducklings from hatch to fledging at the Agassiz National Wildlife Refuge (NWR) in northwestern Minnesota during 1987-90. During the 4 years, 217 day-old ducklings were radiomarked and released in 52 broods. Another 141 ducklings were radiomarked at 4 weeks of age. Survival was estimated with the Kaplan-Meier nonparametric estimator and the Weibull parametric model. Most mortalities occurred within 10 days after hatch. Total brood loss occurred in 18 (35%) of 52 broods released. The primary sources of mortality were predation, principally by mink (Mustela vison), and exposure to precipitation and cold temperature. For combined years, females had lower survival than males (P = 0.03). If the disparate survival between sexes of canvasbacks observed in this study is representative of canvasbacks in their breeding range, this phenomenon contributes to reduced reproductive potential and the male-biased sex ratio of the species.

  3. Survival of radiomarked canvasback ducklings in northwestern Minnesota

    USGS Publications Warehouse

    Korschgen, Carl E.; Kenow, Kevin P.; Green, William L.; Johnson, Douglas H.; Samuel, Michael D.; Sileo, Louis

    1996-01-01

    Duckling survival, an important factor affecting annual recruitment, has not been determined adequately for canvasbacks (Aythya valisineria). We investigated the magnitude, timing, and causes of mortality of canvasback ducklings from hatch to fledging at the Agassiz National Wildlife Refuge (NWR) in northwestern Minnesota during 1987-90. During the 4 years, 217 day-old ducklings were radiomarked and released in 52 broods. Another 141 ducklings were radiomarked at greater than or equal to 4weeks of age. Survival was estimated with the Kaplan-Meier nonparametric estimator and the Weibull parametric model. Most mortalities occurred within 10 days after hatch. Total brood loss occurred in 18 (85%) of 52 broods released. The primary sources of mortality were predation principally by mink (Mustela vison), and exposure to precipitation and cold temperature. For combined years, females had lower survival than males (P=0.03). If the disparate survival between sexes of canvasbacks observed in this study is representative of canvasbacks in their breeding range, this phenomenon contributes to reduced reproductive potential and the male-biased sex ratio of the species.

  4. Prognostic Factors and Survival in Pediatric and Adolescent Liposarcoma

    PubMed Central

    Stanelle, Eric J.; Christison-Lagay, Emily R.; Sidebotham, Emma L.; Singer, Samuel; Antonescu, Cristina R.; Meyers, Paul A.; La Quaglia, Michael P.

    2012-01-01

    Purpose. Liposarcoma is extremely rare in the pediatric population. To identify prognostic factors and determine treatment outcomes, we reviewed our institutional experience with pediatric liposarcoma. Methods. We retrospectively reviewed all pediatric patients (age <22 years) with confirmed liposarcoma treated at Memorial Sloan-Kettering Cancer Center. Histologic subtype, tumor location, margin status, recurrence, and adjuvant therapy were analyzed and correlated with overall survival. Results. Thirty-four patients (56% male) with a median age of 18.1 years were identified. Twenty-two (65%) had peripheral tumors and 12 (35%) had centrally located tumors. Histologically, 29 (85%) tumors were low grade, and 5 (15%) were high grade pleomorphic. Eleven (32%) had recurrent disease, 9 patients with central tumors and 2 patients with peripheral lesions. Eight deaths occurred, all in patients with central disease. Five-year overall survival was 78%, with a median follow-up time of 5.4 years (range, 0.3–30.3 years). Tumor grade (P = .003), histologic subtype (P = .01), and primary location (P < .001) all correlated with survival, as did stage (P < .001) and margin status (P = .001). Conclusions. Central location of the primary tumor, high tumor grade, and positive surgical margins are strongly correlated with poor survival in pediatric patients with liposarcoma. PMID:22991488

  5. Will the olympics survive?.

    PubMed Central

    Khosla, T.

    1977-01-01

    The United States of America dominated 58 events in athletics, field and swimming, which between them accounted for 35 per cent of all events in the Munich Olympiad. 1972; these events favour taller individuals. But, in 25 per cent of other events (1) cycling, (2) fencing, (3) gymnastics, (4) judo, (5) weightlifting and (6) Graeco Roman wrestling the U.S.A. did not win a single medal. The failure of the U.S.A. to maintain her lead in Munich was largely due to weaknesses in these other events in many of which the potential medallists can be derived from the lower half of the height distribution (events 3 to 6). These weaknesses are Russia's strength and they continued to remain unstrengthened at Montreal. Also, the domination held by the U.S.A. in swimming was seriously challenged by East Germany. The present trends indicate that the U.S.A.'s ranking is likely to slip further to the third position in Moscow 1980. Factors inhibiting the survival of the Olympics are pointed. PMID:861436

  6. Surviving a Suicide Attempt

    PubMed Central

    Al-Harrasi, Ahmed; Al Maqbali, Mandhar; Al-Sinawi, Hamed

    2016-01-01

    Suicide is a global phenomenon in all regions of the world affecting people of all age groups. It has detrimental consequences on patients, their families, and the community as a whole. There have been numerous risk factors described for suicide including mental illness, stressful life situations, loss of social support, and general despair. The association of suicide with Islam has not been extensively studied. The common impression from clinical practice is that being a practicing Muslim reduces the risk of suicide. Another factor associated with suicide is starting a patient on antidepressants. However, this has been questioned recently. This report describes a middle-aged man with depression and multiple social stressors who survived a serious suicide attempt. The discussion will focus on the factors that lead him to want to end his life and the impact of the assumed protective factors such as religious belief and family support on this act of self-harm. Such patients can be on the edge when there is an imbalance between risk factors (such as depression, insomnia, and psychosocial stressors) and protective factors (like religious affiliation and family support). All physicians are advised to assess the suicide risk thoroughly in patients with depression regardless of any presumed protective factor. PMID:27602193

  7. Surviving a Suicide Attempt

    PubMed Central

    Al-Harrasi, Ahmed; Al Maqbali, Mandhar; Al-Sinawi, Hamed

    2016-01-01

    Suicide is a global phenomenon in all regions of the world affecting people of all age groups. It has detrimental consequences on patients, their families, and the community as a whole. There have been numerous risk factors described for suicide including mental illness, stressful life situations, loss of social support, and general despair. The association of suicide with Islam has not been extensively studied. The common impression from clinical practice is that being a practicing Muslim reduces the risk of suicide. Another factor associated with suicide is starting a patient on antidepressants. However, this has been questioned recently. This report describes a middle-aged man with depression and multiple social stressors who survived a serious suicide attempt. The discussion will focus on the factors that lead him to want to end his life and the impact of the assumed protective factors such as religious belief and family support on this act of self-harm. Such patients can be on the edge when there is an imbalance between risk factors (such as depression, insomnia, and psychosocial stressors) and protective factors (like religious affiliation and family support). All physicians are advised to assess the suicide risk thoroughly in patients with depression regardless of any presumed protective factor.

  8. Surviving a Suicide Attempt.

    PubMed

    Al-Harrasi, Ahmed; Al Maqbali, Mandhar; Al-Sinawi, Hamed

    2016-09-01

    Suicide is a global phenomenon in all regions of the world affecting people of all age groups. It has detrimental consequences on patients, their families, and the community as a whole. There have been numerous risk factors described for suicide including mental illness, stressful life situations, loss of social support, and general despair. The association of suicide with Islam has not been extensively studied. The common impression from clinical practice is that being a practicing Muslim reduces the risk of suicide. Another factor associated with suicide is starting a patient on antidepressants. However, this has been questioned recently. This report describes a middle-aged man with depression and multiple social stressors who survived a serious suicide attempt. The discussion will focus on the factors that lead him to want to end his life and the impact of the assumed protective factors such as religious belief and family support on this act of self-harm. Such patients can be on the edge when there is an imbalance between risk factors (such as depression, insomnia, and psychosocial stressors) and protective factors (like religious affiliation and family support). All physicians are advised to assess the suicide risk thoroughly in patients with depression regardless of any presumed protective factor. PMID:27602193

  9. Determination of Survivable Fires

    NASA Technical Reports Server (NTRS)

    Dietrich, D. L.; Niehaus, J. E.; Ruff, G. A.; Urban, D. L.; Takahashi, F.; Easton, J. W.; Abbott, A. A.; Graf, J. C.

    2012-01-01

    At NASA, there exists no standardized design or testing protocol for spacecraft fire suppression systems (either handheld or total flooding designs). An extinguisher's efficacy in safely suppressing any reasonable or conceivable fire is the primary benchmark. That concept, however, leads to the question of what a reasonable or conceivable fire is. While there exists the temptation to over-size' the fire extinguisher, weight and volume considerations on spacecraft will always (justifiably) push for the minimum size extinguisher required. This paper attempts to address the question of extinguisher size by examining how large a fire a crew member could successfully survive and extinguish in the confines of a spacecraft. The hazards to the crew and equipment during an accidental fire include excessive pressure rise resulting in a catastrophic rupture of the vehicle skin, excessive temperatures that burn or incapacitate the crew (due to hyperthermia), carbon dioxide build-up or other accumulation of other combustion products (e.g. carbon monoxide). Estimates of these quantities are determined as a function of fire size and mass of material burned. This then becomes the basis for determining the maximum size of a target fire for future fire extinguisher testing.

  10. Coyote removal, understory cover, and survival of white-tailed deer neonates: Coyote Control and Fawn Survival

    SciTech Connect

    Kilgo, John C.; Vukovich, Mark; Ray, H. Scott; Shaw, Christopher E.; Ruth, Charles

    2014-09-01

    Predation by coyotes (Canis latrans) on white-tailed deer (Odocoileus virginianus) neonates has led to reduced recruitment in many deer populations in southeastern North America. This low recruitment combined with liberal antlerless deer harvest has resulted in declines in some deer populations, and consequently, increased interest in coyote population control. We investigated whether neonate survival increased after coyote removal, whether coyote predation on neonates was additive to other mortality sources, and whether understory vegetation density affected neonate survival. We monitored neonate survival for 4 years prior to (2006–2009) and 3 years during (2010–2012) intensive coyote removal on 3 32-km2 units on the United States Department of Energy’s Savannah River Site, South Carolina. We removed 474 coyotes (1.63 coyotes/km2 per unit per year), reducing coyote abundance by 78% from pre-removal levels. The best model (wi = 0.927) describing survival probability among 216 radio-collared neonates included a within-year quadratic time trend variable, date of birth, removal treatment, and a varying removal year effect. Under this model, survival differed between pre-treatment and removal periods and it differed among years during the removal period, being >100% greater than pre-treatment survival (0.228) during the first removal year (0.513), similar to pre-treatment survival during the second removal year (0.202), and intermediate during the third removal year (0.431). Despite an initial increase, the overall effect of coyote removal on neonate survival was modest. Mortality rate attributable to coyote predation was lowest during the first removal year (0.357) when survival was greatest, but the mortality rate from all other causes did not differ between the pretreatment period and any year during removals, indicating that coyote predation acted as an additive source of mortality. Survival probability was not related to

  11. Health risk factors and the incidence of hypertension: 4-year prospective findings from a national cohort of 60 569 Thai Open University students

    PubMed Central

    Thawornchaisit, Prasutr; de Looze, Ferdinandus; Reid, Christopher M; Seubsman, Sam-ang; Sleigh, Adrian C

    2013-01-01

    Objective This study evaluates the impact of a number of demographic, biological, behavioural and lifestyle health risk factors on the incidence of hypertension in Thailand over a 4-year period. Design A 4-year prospective study of health risk factors and their effects on the incidence of hypertension in a national Thai Cohort Study from 2005 to 2009. Setting As Thailand is transitioning from a developing to a middle-income developed country, chronic diseases (particularly cardiovascular disease) have emerged as major health issues. Hypertension is a major risk factor for heart attack and stroke and cross-sectional studies have indicated that the prevalence is increasing. Study participants A total of 57 558 Sukhothai Thammathirat Open University students who participated in both the 2005 and 2009 questionnaire surveys and who were normotensive in 2005 were included in the analysis. Measures Adjusted relative risks associating each risk factor and incidence of hypertension by sex, after controlling for confounders such as age, socioeconomic status, body mass index (BMI) and underlying diseases. Results The overall 4-year incidence of hypertension was 3.5%, with the rate in men being remarkably higher than that in women (5.2% vs 2.1%). In both sexes, hypertension was associated with age, higher BMI and comorbidities but not with income and education. In men, hypertension was associated with physical inactivity, smoking, alcohol and fast food intake. In women, hypertension was related to having a partner. Conclusions In both men and women, hypertension was strongly associated with age, obesity and comorbidities while it had no association with socioeconomic factors. The cohort patterns of socioeconomy and hypertension reflect that the health risk transition in Thais is likely to be at the middle stage. Diet and lifestyle factors associate with incidence of hypertension in Thais and may be amenable targets for hypertension control programmes. PMID:23801711

  12. A 4-Year Study of the Association between Short Sleep Duration and Change in Body Mass Index in Japanese Male Workers

    PubMed Central

    Nishiura, Chihiro; Hashimoto, Hideki

    2010-01-01

    Background Studies of Western populations have shown an inconsistent longitudinal association between short sleep duration and change in body mass index (BMI); a recent Japanese cohort study reported a significant association in men, but over a 1-year period. The aim of this longitudinal study was to examine whether this association was robust over a 4-year interval in Japanese men. Methods A total of 3803 middle-aged Japanese male white-collar workers (mean age 47.8 years, mean BMI 23.9 kg/m2) in Tokyo, Japan, were included in this study from 1994–1995 (baseline) to 1998–1999 (follow-up). Height and weight were objectively measured at annual health checkups, and other data, including sleep duration, were collected using a structured interview. We used linear regression models to estimate change in BMI, after adjustment for covariates. The reference category for sleep duration was set to 7 hours, to conform with previous studies. Results As compared with participants sleeping 7 hours, those sleeping 5 hours or less had a significantly higher BMI at baseline (beta coefficient: 0.34 kg/m2, 95% confidence interval (CI): 0.03, 0.65) and gained 0.15 kg/m2 in BMI over 4 years (95% CI: 0.03, 0.27), after adjustment for age, baseline BMI, lifestyle behavior, and medication. Conclusions The longitudinal association between short sleep duration at baseline and relative increase in BMI was significant in Japanese male workers over a 4-year interval. PMID:20699599

  13. Five-year-olds are willing, but 4-year-olds refuse, to trust informants who offer new and unfamiliar labels for parts of the body.

    PubMed

    Luu, Betty; Rosnay, Marc de; Harris, Paul L

    2013-10-01

    This study employed the selective trust paradigm to examine how children interpret novel labels when compared with labels they already know to be accurate or inaccurate within the biological domain. The participants--3-, 4-, and 5-year-olds (N=144)--were allocated to one of three conditions. In the accurate versus inaccurate condition, one informant labeled body parts correctly, whereas the other labeled them incorrectly (e.g., calling an eye an "arm"). In the accurate versus novel condition, one informant labeled body parts accurately, whereas the other provided novel labels (e.g., calling an eye a "roke"). Finally, in the inaccurate versus novel condition, one informant labeled body parts incorrectly, whereas the other offered novel labels. In subsequent test trials, the two informants provided conflicting labels for unfamiliar internal organs. In the accurate versus inaccurate condition, children sought and endorsed labels from the accurate informant. In the accurate versus novel condition, only 4- and 5-year-olds preferred the accurate informant, whereas 3-year-olds did not selectively prefer either informant. In the inaccurate versus novel condition, only 5-year-olds preferred the novel informant, whereas 3- and 4-year-olds did not demonstrate a selective preference. Results are supportive of previous studies suggesting that 3-year-olds are sensitive to inaccuracy and that 4-year-olds privilege accuracy. However, 3- and 4-year-olds appear to be unsure as to how the novel informant should be construed. In contrast, 5-year-olds appreciate that speakers offering new information are more trustworthy than those offering inaccurate information, but they are cautious in judging such informants as being "better" at providing that information.

  14. Annual rates of change in pre- vs. post-bronchodilator FEV1 and FVC over 4 years in moderate to very severe COPD.

    PubMed

    Tashkin, Donald P; Li, Ning; Halpin, David; Kleerup, Eric; Decramer, Marc; Celli, Bartolome; Elashoff, Robert

    2013-12-01

    While the slope of decline in FEV1 has traditionally been calculated from the post- rather than the pre-bronchodilator measurement in COPD interventional trials, it is not clear whether and to what extent these two slopes differ in symptomatic patients with COPD. Therefore, we used data from the 4-year UPLIFT trial of tiotropium 18 mcg QD vs. placebo to compare annual rates of change in pre- vs. post-bronchodilator FEV1 in 5041 patients with moderate to very severe COPD (mean FEV1 48% pred) in whom the post-bronchodilator FEV1 was measured after 4 inhalations of two different classes of short-acting inhaled bronchodilators at baseline and 1 month and every 6 months post-randomization over 4 years. Linear mixed effects models were used to estimate annual rates of decline in FEV1 and FVC pre- and post-bronchodilator in each treatment group separately, after adjusting for height, gender, smoking status, baseline % predicted FEV1 or FVC, and baseline acute % improvement in lung function. The slopes of the post-bronchodilator FEV1 and FVC were significantly steeper than the pre-bronchodilator slopes regardless of treatment arm (p < 0.001), while the estimated variances of the slopes were similar. Post-bronchodilator increases in FEV1 and FVC diminished progressively and significantly (p < 0.0001) over the 4-year trial, suggesting a possible explanation for the significant differences between the pre- and post-bronchodilator slopes. While the reasons for these differences are not completely clear, they are important to consider when assessing treatment effects on rates of decline in FEV1 and FVC.

  15. The Impact of Admission Diagnosis on Recurrent or Frequent Hospitalizations in 3 Dementia Subtypes: A Hospital-Based Cohort in Taiwan with 4 Years Longitudinal Follow-Ups.

    PubMed

    Chang, Chiung-Chih; Lin, Pin-Hsuan; Chang, Ya-Ting; Chen, Nai-Ching; Huang, Chi-Wei; Lui, Chun-Chung; Huang, Shu-Hua; Chang, Yen-Hsiang; Lee, Chen-Chang; Lai, Wei-An

    2015-11-01

    Increasing numbers of patients with different types of dementia have resulted in the increasing medical care loads. It is not known whether explanatory factors for recurrent or prolong hospitalization were driven by the subtypes of dementia. We analyzed 203 dementia patients aged >65-year-old with a clinical diagnosis of Alzheimer disease (AD), vascular dementia (VaD), or Parkinsonism-related dementia (PRD). With a 4-year follow-up period, logistic regression analyses were used to identify predictors of dementia diagnosis, cerebrovascular risk factors, chronic systemic diseases, and the etiology for admission for recurrent (>4 times/4 years) or prolonged hospitalization stay (>14 days per hospitalization). There were 48 AD, 96 VaD, and 59 PRD patients that completed the 4-year study. The average length of hospital stay was significant, the shortest in AD and the longest in PRD (P = 0.01), whereas the frequency of hospitalization was not different among 3 dementia subtypes. Although delirium is the most common etiology for admission in the patients, diabetes mellitus (Odds ratio, OR = 2.79, P = 0.02), pneumonia (OR = 11.21, P < 0.001), and fall-related hip fracture (OR = 4.762, P = 0.029) were significantly associated with prolong hospitalization. Patients with coronary artery disease (OR = 9.87, P = 0.02), pneumonia (OR = 84.48, P < 0.001), urinary tract infection (OR = 55.09, P < 0.001), and fall-related fracture (OR = 141.7, P < 0.001) predict recurrent hospitalization. Dementia subtypes did not influence directly on the hospitalization courses. The etiologies for admission carried higher clinical significance, compared with the coexisted systemic diseases. PMID:26579820

  16. Study of the Clinical Outcome between Traumatic and Degenerative (non-traumatic) Meniscal Tears after Arthroscopic Surgery: A 4-Years Follow-up Study

    PubMed Central

    Ghislain, Nietiayurk Aminake; Wei, Ji-Nan

    2016-01-01

    Introduction The meniscus is a biconcave fibrocartilage in the knee joint interpose between the femoral condyles and tibial plateau; the meniscus has functions in load bearing, load transmission, shock absorption joint stability, joint lubrication, and joint congruity. Aim The aim of this study is to provide orthopeadic surgeon a base of reference in the choice of the optimal course of management for meniscal tears. Materials and Methods One hundred and seventeen patients met the criteria of inclusion for the present study. Patients were divided in two groups T and NT according to the presence of distinct previous traumatic events to the knees. Two subgroups were formed in each groups T and NT respectively at a mean follow up of 1 and 4 years. Postoperative clinical outcome were assessed using Lysholm scores and Rand SF-36 survey. Results One hundred and seventeen patients were included in the present study with 60(51.28%) patients in the traumatic group and 57(48.71%) in the degenerative group. 95(81.19%) patients in total were satisfied with their health status at end of follow up. The mean value of Lysholm scores at 1 year were respectively 85.25±8.78 for traumatic group and 86.38±12.14 for non-traumatic group and at 4 years were respectively 92.63±7.31 for traumatic group and 72.90±20.77 for non-traumatic group. According to Rand SF-36 health, traumatic group showed better improvements compare to non-traumatic group between 1 and 4 years after arthroscopic meniscus surgery. Conclusion A total of 95(81.19%) patients in total were satisfied with their health status at follow up, however, we found that arthroscopy as a treatment for meniscal tear have a relatively better mid-term clinical outcome for traumatic meniscal tears compare to non-traumatic/degenerative meniscal tears. PMID:27190905

  17. Long-term Survival, Organ Function, and Malignancy after Hematopoietic Stem Cell Transplantation for Fanconi Anemia.

    PubMed

    Bonfim, Carmem; Ribeiro, Lisandro; Nichele, Samantha; Bitencourt, Marco; Loth, Gisele; Koliski, Adriana; Funke, Vaneuza A M; Pilonetto, Daniela V; Pereira, Noemi F; Flowers, Mary E D; Velleuer, Eunike; Dietrich, Ralf; Fasth, Anders; Torres-Pereira, Cassius C; Pedruzzi, Paola; Eapen, Mary; Pasquini, Ricardo

    2016-07-01

    We report on long-term survival in 157 patients with Fanconi anemia (FA) who survived 2 years or longer after their first transplantation with a median follow-up of 9 years. Marrow failure (80%) was the most common indication for transplantation. There were 20 deaths beyond 2 years after transplantation, with 12 of the deaths occurring beyond 5 years after transplantation. Donor chimerism was available for 149 patients: 112 (76%) reported > 95% chimerism, 27 (18%) reported 90% to 95% chimerism, and 8 (5%) reported 20% to 89% donor chimerism. Two patients have < 20% donor chimerism. The 10- and 15-year probabilities of survival were 90% and 79%, respectively. Results of multivariate analysis showed higher mortality risks for transplantations before 2003 (hazard ratio [HR], 7.87; P = .001), chronic graft-versus-host disease (GVHD) (HR, 3.80; P = .004) and squamous cell carcinoma after transplantation (HR, 38.17; P < .0001). The predominant cause of late mortality was squamous cell carcinoma, with an incidence of 8% and 14% at 10 and 15 years after transplantation, respectively, and was more likely to occur in those with chronic GVHD. Other causes of late mortality included chronic GVHD, infection, graft failure, other cancers, and hemorrhage. Although most patients are disease free and functional long term, our data support aggressive surveillance for long periods to identify those at risk for late mortality.

  18. Metformin use improves the survival of diabetic combined small-cell lung cancer patients.

    PubMed

    Kong, Fanming; Gao, Fangfang; Liu, Honggen; Chen, Liwei; Zheng, Rongxiu; Yu, Jianchun; Li, Xiaojiang; Liu, Geli; Jia, Yingjie

    2015-09-01

    Metformin has been reported having potential anticancer effect on kinds of solid tumors, but its role in combined small-cell lung cancer (C-SCLC) remains indistinct. This study aimed to explore whether metformin use has a prognosis benefit in diabetic C-SCLC patients. A total of 259 C-SCLC patients with diabetes were enrolled in our study. The clinicopathological parameters and survival data were collected and analyzed. The correlation between metformin use and clinicopathological characters was analyzed. Univariate and multivariate analyses were performed to investigate the prognostic significance of metformin use for C-SCLC. The metformin was used in 120 (46.3 %) patients. Our data showed that the metformin use decreased C-SCLC recurrence rate (p = 0.001). The median overall survival (OS) and disease-free survival (DFS) were significantly better in the metformin use group compared to non-metformin group (OS 19.0 vs 11.5 months, p < 0.001; DFS 10.5 vs 7.0 months, p < 0.001). Multivariate analyses indicated that metformin use was an independent prognostic factor for OS and DFS (p = 0.001 vs p = 0.018). The metformin use improved the long-term outcome of C-SCLC patients with diabetes, which might be considered a potential useful prognostic indicator and anticancer drug.

  19. Antibody persistence and immune memory 4 years post-vaccination with combined hepatitis A and B vaccine in adults aged over 40 years.

    PubMed

    Chlibek, Roman; von Sonnenburg, Frank; Van Damme, Pierre; Smetana, Jan; Tichy, Petr; Gunapalaiah, Bhavyashree; Leyssen, Maarten; Jacquet, Jeanne-Marie

    2011-01-01

    Persistence of immune response was assessed in adults aged >40 years (N = 596) following primary vaccination with combined hepatitis A/B vaccine or concomitant monovalent hepatitis A and B vaccines. Anti-hepatitis A virus antibody responses persisted for at least 4 years regardless of the vaccine used, with anti-hepatitis B surface antibody responses higher and more sustained in subjects who received the combined hepatitis A/B vaccine. Response rates to an additional dose of the same vaccine(s) used for priming were high.

  20. Surviving your new CEO.

    PubMed

    Coyne, Kevin P; Coyne, Edward J

    2007-05-01

    Almost 50% of the largest American firms will have a new CEO within the next four years; your company could very well be next. Senior executives know that a CEO transition means they're in for a round of firings, organizational reshuffles, and other unwelcome career changes. When your career suddenly depends on the views of a person you may not know, how worried should you be? According to the authors--very. They investigated the 2002-2004 CEO turnover rates of the top 1,000 U.S. companies and interviewed more than a dozen CEOs, each of whom had taken over at least one very large organization. Their study reveals that when a new CEO takes charge, remaining top managers are more likely than not to be shown the door. Those who leave often land in a lower position at a new company, work in a much smaller firm, or retire altogether. The news is not all grim, however. The interviewees offer some pointers on how to create a good impression and maximize your chances of survival and success under the new regime. Some of that advice may surprise you. One CEO pointed out, for instance, that "managers do not realize how much the CEO is looking for teammates on day one. I am amazed at how few people come through the door and say, 'I want to help. I may not be perfect, but I buy into your vision:" Other recommendations are more intuitive, such as learning the new CEO's working style, understanding her agenda, and helping her look good in her new position by achieving positive operating results--and soon. Along with the inevitable stresses, the authors point out, CEO transitions can provide opportunities. Whether you reinvigorate your career within your company or find fulfillment elsewhere, the key lies in deciding what you want to do--and then doing it right.

  1. Predicting Survival in ARDS.

    PubMed

    Karnik, Niteen D; Gupta, Anish V

    2015-11-01

    Acute respiratory distress syndrome (ARDS) is a fulminant clinical disorder of varied etiology, characterized by diffuse lung injury and severe hypoxemia. It is a leading cause of ICU admission and the associated high mortality has sparked a lot of research on etiology, outcome, scoring systems, mortality predictors, biomarkers including inflammatory cytokines and even genomics in ARDS. The previously used AECC (American European Consensus Conference) definition (1994) of ARDS was replaced by the recent Berlin definition (2012) so as to improve its validity and reliability.1,2 This would not only standardize patient enrollment into clinical trials but also help implement the results of these trials into clinical practice. Although various studies have shown a reduction in mortality due to ARDS, it has been largely attributed to the general improvement in critical care and the use of lung protection ventilation strategies.3-6 Hence focus on the etiology, co-morbidities, risk factors, complications and mortality predictors, is the need of the hour so as to improve survival. ARDS can occur secondary to multiple causes i.e. either due to direct lung involvement (pneumonia, lung contusion etc) or indirect alveolar damage by inflammatory cytokines (sepsis, trauma, burns, pancreatitis etc.). The causes of ARDS in tropical countries are varied with seasonal variation. Acute febrile illnesses (AFI) like malaria, leptospirosis and dengue usually predominate in the monsoons while H1N1 infection and pneumonias typically peak in the colder winter months. However, malaria, dengue and H1N1 have a potential to be perennial. PMID:27608777

  2. Infant survival in prematurity.

    PubMed

    CARTWRIGHT, E W

    1954-05-01

    Reduction of neonatal mortality and the rate of stillbirth may be expected from improved management of spontaneous labor and delivery.Neither roentgenographic measurement nor the inception of fetal movement or heartbeat nor any other single test is an index of fetal maturity; all must be considered together. Prenatal care, particularly supplemented diet, will help to avoid premature delivery, or at least to prolong pregnancy; since the fetus undergoes accelerated growth during the last weeks of pregnancy, even slight extension of gestation increases the chances for survival. Analgesia in the first stage of premature labor is contraindicated. Only low spinal anesthesia and other types of conduction anesthesia should be employed for later stages. The fetal membranes should be preserved as long as possible, but premature rupture does not call for immediate termination of pregnancy. Deep episiotomy and prophylactic outlet forceps are routinely employed to hasten the second stage of premature delivery and to protect the immature fetus. Breech presentation is managed by unassisted expulsion or by forceps extraction of the head. The umbilical cord is not immediately severed on delivery; administration of oxytocic drugs after the second stage of labor, combined with gentle stripping of the cord, results in rapid transfer of increased amount of placental blood. The airways of the infant should be immediately cleared. Artificial respiration may be necessary and it must be gentle.All premature infants should receive supplementary oxygen to render breathing regular and more efficient. They should be insulated immediately in controlled temperature and humidity, and they should be handled little.

  3. Presidential Survival in Tough Times.

    ERIC Educational Resources Information Center

    Bowen, Raymond C.

    Surviving the position of college president requires the development of a presidential survival kit filled with idiosyncratic items not normally associated with formal educational training. Strength, agility, control, and the ability to improvise are some of the talents required of a college president. In addition, the longevity and success of a…

  4. Association of cyclin D1 genotype with breast cancer risk and survival.

    PubMed

    Shu, Xiao Ou; Moore, Derek B; Cai, Qiuyin; Cheng, Jiarong; Wen, Wanqing; Pierce, Larry; Cai, Hui; Gao, Yu-Tang; Zheng, Wei

    2005-01-01

    Cyclin D1 (CCND1) is a key cell cycle regulatory protein that governs cell cycle progression from the G(1) to S phase. A common polymorphism (A870G) in exon 4 of the CCND1 gene produces an alternate transcript (transcript-b) that preferentially encodes a protein with enhanced cell transformation activity and possible prolonged half-life. We evaluated the association of CCND1 A870G polymorphism with breast cancer risk and survival in 1,130 breast cancer cases and 1,196 controls who participated in the Shanghai Breast Cancer Study. Approximately 81% of cases and 79% of controls carried the A allele at A870G of the CCND1 gene [odds ratio, 1.1; 95% confidence interval (95% CI), 0.9-1.4]. As lightly stronger but nonsignificant association was found for the A allele among younger women (odds ratio, 1.3; 95% CI, 0.9-1.8). However, this polymorphism seems to modify the effect of hormonal exposures on postmenopausal breast cancer, as the positive associations of postmenopausal breast cancer with body mass index (Pfor interaction = 0.02) and waist-to-hip ratios (P for interaction < 0.03; all Ps are two sided) were only observed among women who carry the A allele at A870G of the CCND1 gene. Following up with this cohort of patients for an average of 4.84 years, we found that the CCND1 A870G polymorphism was inversely associated with overall and disease-free survival, particularly among women with late stage or estrogen/progesterone receptor-negative breast cancer. The adjusted hazard ratios for disease-free survival associated with GA and AA genotypes were 0.94 (95% CI, 0.49-1.82) and 0.41 (95% CI, 0.19-0.91) for tumor-node-metastasis stage III to IV breast cancer, and 0.35 (95% CI, 0.15-0.80) and 0.32 (95% CI, 0.13-0.79) for estrogen/progesterone receptor-negative breast cancer. This study suggests that CCND1 A870G polymorphism may modify the postmenopausal breast cancer risk associated with hormonal exposure and predict survival after breast cancer diagnosis. PMID:15668481

  5. Lymphatic microsurgical preventing healing approach (LYMPHA) for primary surgical prevention of breast cancer-related lymphedema: over 4 years follow-up.

    PubMed

    Boccardo, Francesco; Casabona, Federico; De Cian, Franco; DeCian, Franco; Friedman, Daniele; Murelli, Federica; Puglisi, Maria; Campisi, Corrado C; Molinari, Lidia; Spinaci, Stefano; Dessalvi, Sara; Campisi, Corradino

    2014-09-01

    Breast cancer-related lymphedema (LE) represents an important morbidity that jeopardizes breast cancer patients' quality of life. Different attempts to prevent LE brought about improvements in the incidence of the pathology but LE still represents a frequent occurrence in breast cancer survivors. Over 4 years ago, Lymphatic Microsurgical Preventing Healing Approach (LYMPHA) was proposed and long-term results are reported in this study. From July 2008 to December 2012, 74 patients underwent axillary nodal dissection for breast cancer treatment together with LYMPHA procedure. Volumetry was performed preoperatively in all patients and after 1, 3, 6, 12 months, and once a year. Lymphoscintigraphy was performed in 45 patients preoperatively and in 30 also postoperatively after at least over 1 year. Seventy one patients had no sign of LE, and volumetry was coincident to preoperative condition. In three patients, LE occurred after 8-12 months postoperatively. Lymphoscintigraphy showed the patency of lymphatic-venous anastomoses at 1-4 years after operation. LYMPHA technique represents a successful surgical procedure for primary prevention of arm LE in breast cancer patients.

  6. The Columbus Knee System: 4-Year Results of a New Deep Flexion Design Compared to the NexGen Full Flex Implant.

    PubMed

    Goebel, D; Schultz, W

    2012-01-01

    The Columbus knee system is designed as a standard knee implant to allow high flexion without additional bone resection. Between August, 2004 and March, 2010 we performed 109 total knee arthroplasties of the Columbus knee system in 101 consecutive patients suffering from primary arthrosis of the knee. Mean age was 72.4 years in women and 70.3 years in men. Mean followup was 47.3 months. The 4-year results of a group of patients who received the NexGen Full Flex implant operated by the same surgeon were used for comparison. Mean total knee score was Columbus: 175.6 and NexGen Flex: 183.4; P = 0.037. Mean operation time was 53 min for Columbus and 66 min for NexGen Flex; P < 0.001. With new streamlined instruments operative time became 60 min for the Columbus; P > 0.05. Radiological assessment showed no signs of loosening for both groups. Therefore, the Columbus knee system can be recommended for flexion angles up to 140°.

  7. An Assessment of the Consumption of Energy and Selected Minerals and Their Content in the Hair of Children Aged 1-4 Years.

    PubMed

    Marcinek, Katarzyna; Wójciak, Rafał Wojciech; Krejpcio, Zbigniew; Stanisławska-Kubiak, Maia

    2016-04-01

    The aim of this study was to assess the consumption of energy and selected minerals (Ca, Mg, Fe, Zn, Cu) and their content in the hair of children aged 1-4 years. Seventy-five children were divided into three age subgroups: 12-24-month-olds, 25-36-month-olds and 37-48-month-olds. The data on energy intake and consumption of nutrients were obtained by means of a nutritional interview. The content of elements in the hair was measured by means of flame atomic absorption spectrometry (AAS) with an AAS-3 spectrophotometer (Zeiss). The daily food rations of children aged 12-36 months were characterised by adequate energy value, but the values of Ca and K were too low, whereas the content of Mg, Zn and Cu was high. On the other hand, the daily food rations of children aged 37-48 months provided sufficient amounts of Mg and Zn, but the value of Cu was too high, whereas energy, Ca, K and Fe were too low. About 42.7% of the children under study were characterised by an abnormal state of nutrition. An inadequately balanced diet needs to be corrected by educating parents or guardians in appropriate nutrition. There are significant correlations (r > 0.9) between the supply of Ca in the diet of children aged 1-4 years and the content of this element in their hair.

  8. Knowing minds, controlling actions: the developmental relations between theory of mind and executive function from 2 to 4 years of age.

    PubMed

    Müller, Ulrich; Liebermann-Finestone, Dana P; Carpendale, Jeremy I M; Hammond, Stuart I; Bibok, Maximilian B

    2012-02-01

    This longitudinal study examined the concurrent and predictive relations between executive function (EF) and theory of mind (ToM) in 82 preschoolers who were assessed when they were 2, 3, and 4 years old. The results showed that the concurrent relation between EF and ToM, after controlling for age, verbal ability, and sex, was significant at 3 and 4 years of age but not at 2 years of age. Hierarchical regression analyses showed that EF at age 2 significantly predicted ToM at age 3 and that EF at age 3 significantly predicted ToM at age 4, over and above the effects of age, verbal ability, and prior performance on ToM tasks. However, ToM at ages 2 and 3 did not explain a significant amount of variance in EF at age 4. Bootstrap procedures revealed that verbal ability at age 3 fully mediated the relation between ToM at age 2 and EF at age 4.

  9. Children's Comprehension of Sentences with Focus Particles and the Role of Cognitive Control: An Eye Tracking Study with German-Learning 4-Year-Olds.

    PubMed

    Höhle, Barbara; Fritzsche, Tom; Müller, Anja

    2016-01-01

    Children's interpretations of sentences containing focus particles do not seem adult-like until school age. This study investigates how German 4-year-old children comprehend sentences with the focus particle 'nur' (only) by using different tasks and controlling for the impact of general cognitive abilities on performance measures. Two sentence types with 'only' in either pre-subject or pre-object position were presented. Eye gaze data and verbal responses were collected via the visual world paradigm combined with a sentence-picture verification task. While the eye tracking data revealed an adult-like pattern of focus particle processing, the sentence-picture verification replicated previous findings of poor comprehension, especially for 'only' in pre-subject position. A second study focused on the impact of general cognitive abilities on the outcomes of the verification task. Working memory was related to children's performance in both sentence types whereas inhibitory control was selectively related to the number of errors for sentences with 'only' in pre-subject position. These results suggest that children at the age of 4 years have the linguistic competence to correctly interpret sentences with focus particles, which--depending on specific task demands--may be masked by immature general cognitive abilities. PMID:26930286

  10. Increased plasma DPP4 activity predicts new-onset hypertension in Chinese over a 4-year period: possible associations with inflammation and oxidative stress.

    PubMed

    Zheng, T; Chen, T; Liu, Y; Gao, Y; Tian, H

    2015-07-01

    To investigate whether increased dipeptidyl peptidase 4 (DPP4) activity predicts new-onset hypertension in Chinese patients. A prospective study was conducted for 1884 adults (804 men/1080 women) aged 18-70 years without hypertension. Participants were examined in 2007 (baseline) and 2011 (follow-up) and circulating DPP4 activity, mannose 6-phosphate receptor (M6P-R) concentration, inflammatory markers and oxidative stress parameters were measured. After a 4-year follow-up, 296 individuals developed hypertension with an incidence of 39 per 1000 patient years. In multiple linear regression analyses, baseline DPP4 activity was an independent predictor of an increase in M6P-R, inflammatory markers and oxidative stress parameters over a 4-year period (all P < 0.01). Cox proportional hazards models revealed that DPP4 activity independently predicted the risk of developing hypertension (relative risk 2.68 (95% confidence interval 1.71-4.21) P < 0.01). Our results indicate that DPP4 activity is an important predictor of hypertension onset in apparently healthy Chinese individuals. This finding may have important implications for understanding the effects of DPP4 in promoting inflammation and oxidative stress in the pathogenesis of hypertension.

  11. Children’s Comprehension of Sentences with Focus Particles and the Role of Cognitive Control: An Eye Tracking Study with German-Learning 4-Year-Olds

    PubMed Central

    Höhle, Barbara; Fritzsche, Tom; Müller, Anja

    2016-01-01

    Children’s interpretations of sentences containing focus particles do not seem adult-like until school age. This study investigates how German 4-year-old children comprehend sentences with the focus particle ‘nur’ (only) by using different tasks and controlling for the impact of general cognitive abilities on performance measures. Two sentence types with ‘only’ in either pre-subject or pre-object position were presented. Eye gaze data and verbal responses were collected via the visual world paradigm combined with a sentence-picture verification task. While the eye tracking data revealed an adult-like pattern of focus particle processing, the sentence-picture verification replicated previous findings of poor comprehension, especially for ‘only’ in pre-subject position. A second study focused on the impact of general cognitive abilities on the outcomes of the verification task. Working memory was related to children’s performance in both sentence types whereas inhibitory control was selectively related to the number of errors for sentences with ‘only’ in pre-subject position. These results suggest that children at the age of 4 years have the linguistic competence to correctly interpret sentences with focus particles, which–depending on specific task demands–may be masked by immature general cognitive abilities. PMID:26930286

  12. Temperament and character as predictors of recurrence in remitted patients with major depression: a 4-year prospective follow-up study.

    PubMed

    Asano, Tadashi; Baba, Hajime; Kawano, Rumiko; Takei, Hiroto; Maeshima, Hitoshi; Takahashi, Yukina; Suzuki, Toshihito; Arai, Heii

    2015-02-28

    The aim of the present study was to examine whether the specific personality traits, Harm-Avoidance (HA) and Self-Directedness (SD) as measured by the Temperament and Character Inventory (TCI), were predictive for subsequent depressive episodes in remitted patients with major depressive disorders (MDDs) over a 4-year follow-up. A total of 109 inpatients with MDD participated in this study. The subjects completed the TCI when they were assessed to be in remission. They were divided into high or low HA groups and high or low SD groups, as discriminated by the quartile value. A total of 69 patients were followed-up over a 4-year period or until recurrence. Both Kaplan-Meier analysis and Cox׳s proportional hazards regression analysis indicated that patients with a low SD score had a significantly shorter time to recurrence from remission than patients with a high SD score even when some prognostic predictors were controlled for. In contrast, HA was not found to be a predictor of recurrence for future depressive episodes. A part of MDD patients with low scores in Self-Directedness are likely to develop depression over a subsequent period of time. Interventions that improve SD may help to delay recurrence of depression in MDD patients.

  13. Children's Comprehension of Sentences with Focus Particles and the Role of Cognitive Control: An Eye Tracking Study with German-Learning 4-Year-Olds.

    PubMed

    Höhle, Barbara; Fritzsche, Tom; Müller, Anja

    2016-01-01

    Children's interpretations of sentences containing focus particles do not seem adult-like until school age. This study investigates how German 4-year-old children comprehend sentences with the focus particle 'nur' (only) by using different tasks and controlling for the impact of general cognitive abilities on performance measures. Two sentence types with 'only' in either pre-subject or pre-object position were presented. Eye gaze data and verbal responses were collected via the visual world paradigm combined with a sentence-picture verification task. While the eye tracking data revealed an adult-like pattern of focus particle processing, the sentence-picture verification replicated previous findings of poor comprehension, especially for 'only' in pre-subject position. A second study focused on the impact of general cognitive abilities on the outcomes of the verification task. Working memory was related to children's performance in both sentence types whereas inhibitory control was selectively related to the number of errors for sentences with 'only' in pre-subject position. These results suggest that children at the age of 4 years have the linguistic competence to correctly interpret sentences with focus particles, which--depending on specific task demands--may be masked by immature general cognitive abilities.

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

    PubMed Central

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

    2014-01-01

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

  15. Impact of immunohistochemistry-based molecular subtype on chemosensitivity and survival in Hispanic breast cancer patients following neoadjuvant chemotherapy

    PubMed Central

    Gómez, Rodolfo; Ossa, Carlos Andrés; Montoya, María Elvira; Echeverri, Carolina; Ángel, Gonzalo; Ascuntar, Johana; Borrero, Mauricio; Gil, Mónica; Herrera, Sabrina; Gutiérrez, Eduardo; Herazo, Fernando; Jiménez, Alejo; Madrid, Jorge; Reyes, Pedro Alejandro; Zuluaga, Lina; García, Héctor

    2015-01-01

    Background Neoadjuvant chemotherapy (NAC) is the standard treatment for patients with locally advanced breast cancer, showing improvement in disease-free survival (DFS) and overall survival (OS) rates in patients achieving pathological complete response (pCR). The relationship between immunohistochemistry-based molecular subtyping (IMS), chemo sensitivity and survival is currently a matter of interest. We explore this relationship in a Hispanic cohort of breast cancer patients treated with NAC. Methods A retrospective survival analysis was performed on Colombian females with breast cancer treated at Instituto de Cancerología-Clinica Las Américas between January 2009 and December 2011. Patients were classified according to immunohistochemistry-based subtyping into the following five groups: Luminal A, Luminal B, Luminal B/HER 2+, HER2-enriched, and triple-negative breast cancer. Demographic characteristics, recurrence pattern, and survival rate were reviewed by bivariate and multivariate analysis. Results A total of 328 patients fulfilled the study’s inclusion parameters and the distribution of subtypes were as follows: Luminal A: 73 (22.3%), Luminal B/HER2−: 110 (33.5%), Luminal B/HER2+: 75 (22.9%), HER2-enriched: 30 (9.1%), and triple-negative: 40 (12.2%). The median follow-up was 41 months (interquartile range: 31–52). Pathological response to NAC was as follows: complete pathological response (pCR) in 28 (8.5%) patients, partial 247 (75.3%); stable disease 47 (14.3%), and progression 6 (1.8%) patients. The presence of pCR had a significant DFS and OS in the entire group (p = 0.01) but subtypes had different DFS in Luminal B (p = 0.01) and triple negative (p = 0.02) and also OS in Luminal B (p = 0.01) and triple negative (p = 0.01). Conclusions pCR is associated with an improved overall survival and disease-free survival rates in this group of Hispanics patients. Advanced stages, Luminal B subtypes, triple-negative tumours and non-pCR showed lower DFS

  16. Marketing child survival.

    PubMed

    Grant, J P

    1984-01-01

    Growth monitoring charts, packets of oral rehydration salts (ORS), and vaccines, are inexpensive, life-saving, growth-protecting technologies which can enable parents to protect their children against the worst effects of poverty. Similarly, a matrix of current and easily understandable information about pregnancy, breast feeding, weaning, feeding during and immediately after illness, child spacing, and preparing and using home-made oral rehydration solutions, also could empower parents to protect the lives and the health of their children. The question arises as to how can these technologies and this information be put at the disposal of millions of families in the low-income world. The initial task of the Child Survival and Development Revolution is the communication of what is now possible, yet little is known about how to communicate information whose principal value is to the poor. There are 2 large-scale precedents: the Green Revolution, which in many instances succeeded in putting into the hands of thousands of small and large farmers the techniques and the knowledge which enabled them to double and treble the yields from their lands; and the campaign to put the knowledge and the means of family planning at the disposal of many millions of people. There are 2 lessons to be learned from these precedents: they have shown that the way to promote a people's technology and to put information at the disposal of the majority is by mobilizing all possible resources and working through all possible channels both to create the demand and to meet it; and neither the Green Revolution nor the family planning movement rally took off until they were viewed as political and economic priorities and given the full support of the nation's political leadership. Nowhere are these 2 lessons more clearly illustrated than in present-day Indonesia. Because the campaign for family planning was given high personal and political priority by the President, and because 85% of all family

  17. Surgery Is Associated with Improved Survival for Adrenocortical Cancer, Even in Metastatic Disease

    PubMed Central

    Livhits, Masha; Li, Ning; Yeh, Michael W.; Harari, Avital

    2016-01-01

    Background Adrenocortical carcinoma (ACC) is a rare but lethal tumor. Predictors of survival include earlier stage at presentation and complete surgical resection. We assessed effect of treatment and demographic variables on survival. Methods ACC cases were abstracted from the California Cancer Registry and Office of Statewide Health Planning and Development (1999-2008). Predictors included patient demographics, comorbidities, tumor size, stage, and treatment (none, surgery, chemotherapy and/or radiation (CRT), and surgery plus CRT (S+CRT)). Results We studied 367 patients with median tumor size of 10cm. At presentation, 37% had localized, 17% had regional, and 46% had metastatic disease. Median survival was 1.7 years (7.4 years local, 2.6 years regional, and 0.3 years metastatic, P<0.0001). One-year and five-year survival was: 92%/62% (local); 73%/39% (regional); 24%/7% (metastatic). Increased age (HR 1.16) and Cushing's syndrome (HR 1.66) worsened survival (P<0.05). Low socioeconomic status worsened survival in local and regional disease (P<0.05). In multivariable regression, both surgery (regional HR 0.13; metastatic HR 0.52) and S+CRT (regional HR 0.15; metastatic HR 0.31) improved survival compared to no treatment (P<0.02). Conclusion In ACC, surgery is associated with improved survival, even in metastatic disease. Surgery should be considered for select patients as part of multi-modality treatment. PMID:25456949

  18. Protein kinase C beta II suppresses colorectal cancer by regulating IGF-1 mediated cell survival

    PubMed Central

    Dowling, Catríona M.; Phelan, James; Callender, Julia A.; Cathcart, Mary Clare; Mehigan, Brian; McCormick, Paul; Dalton, Tara; Coffey, John C.; Newton, Alexandra C.; O'sullivan, Jacintha; Kiely, Patrick A.

    2016-01-01

    Despite extensive efforts, cancer therapies directed at the Protein Kinase C (PKC) family of serine/threonine kinases have failed in clinical trials. These therapies have been directed at inhibiting PKC and have, in some cases, worsened disease outcome. Here we examine colon cancer patients and show not only that PKC Beta II is a tumour suppressor, but patients with low levels of this isozyme have significantly decreased disease free survival. Specifically, analysis of gene expression levels of all PKC genes in matched normal and cancer tissue samples from colon cancer patients revealed a striking down-regulation of the gene coding PKC Beta in the cancer tissue (n = 21). Tissue microarray analysis revealed a dramatic down-regulation of PKC Beta II protein levels in both the epithelial and stromal diseased tissue (n = 166). Of clinical significance, low levels of the protein in the normal tissue of patients is associated with a low (10%) 10 year survival compared with a much higher (60%) survival in patients with relatively high levels of the protein. Consistent with PKC Beta II levels protecting against colon cancer, overexpression of PKC Beta II in colon cancer cell lines reveals that PKC Beta II reverses transformation in cell based assays. Further to this, activation of PKC Beta II results in a dramatic downregulation of IGF-I-induced AKT, indicating a role for PKCs in regulating IGF-1 mediated cell survival. Thus, PKC Beta II is a tumour suppressor in colon cancer and low levels serve as a predictor for poor survival outcome. PMID:26989024

  19. Metformin therapy associated with survival benefit in lung cancer patients with diabetes

    PubMed Central

    Wan, Guoxing; Yu, Xiongjie; Chen, Ping; Wang, Xianhe; Pan, Dongfeng; Wang, Xuanbin; Li, Linjun; Cai, Xiaojun; Cao, Fengjun

    2016-01-01

    The purpose of this study is to summarize the currently available evidence regarding the concerned issue by performing a comprehensive meta-analysis. Relevant publications reporting the association of metformin use with survival of lung cancer patients with diabetes were electronically searched to identify eligible studies. The meta-analysis was performed with hazard ratios (HRs) and 95% confidence intervals (95% CIs) as effect measures for disease-free survival(DFS) and overall survival(OS) estimates. A total of 17 individual studies from 10 publications were included in the meta-analysis. Overall, the results revealed a significant association of metformin use with a better survival of lung cancer patients with diabetes(for DFS: HR = 0.65, 95%CI = 0.52-0.83; for OS: HR = 0.78, 95%CI = 0.64-0.93). The subgroup analyses showed similar association in Asian region(for DFS:HR = 0.69, 95%CI = 0.59-0.80; for OS: HR = 0.55, 95%CI = 0.46-0.67) but not in Western region. Such association was also presented in small cell lung cancer (for DFS: HR = 0.54, 95%CI = 0.38-0.77; for OS: HR = 0.52, 95%CI = 0.39-0.69) and in non-small cell lung cancer(for DFS: HR = 0.70, 95%CI = 0.51-0.96; for OS: HR = 0.75, 95%CI = 0.58-0.97). Analyses stratified by treatment strategy showed a reduction in the risk of cancer-related mortality in patients receiving chemotherapy(for DFS: HR = 0.71, 95%CI = 0.64-0.83; for OS: HR = 0.58, 95%CI = 0.47-0.71) but not in patients receiving chemoradiotherapy. The meta-analysis demonstrated that metformin use was significantly associated with a favorable survival outcome of lung cancer patients with diabetes. PMID:27105507

  20. Survival in patients with human papillomavirus positive tonsillar cancer in relation to treatment.

    PubMed

    Attner, Per; Näsman, Anders; Du, Juan; Hammarstedt, Lalle; Ramqvist, Torbjörn; Lindholm, Johan; Munck-Wikland, Eva; Dalianis, Tina; Marklund, Linda

    2012-09-01

    The incidence of tonsillar cancer and the proportion of human papillomavirus (HPV) positive tonsillar cancer cases have increased in the last decades. In parallel, treatment for tonsillar cancer has been intensified e.g., by accelerated radiotherapy, and chemotherapy, resulting in more side effects. Patients with HPV-positive tonsillar cancer have better prognosis than those with HPV-negative tumors, and the former group could hypothetically benefit from reduced, less-toxic treatment without compromising survival. Here, we therefore evaluated possible differences in overall and disease-specific survival after different oncological treatments in 153 patients with HPV DNA- and P16-positive tonsillar cancer who were diagnosed and treated with intent to cure between 2000 and 2007, in Stockholm, Sweden. Of these patients, 86 were treated with conventional radiotherapy, 40 were treated with accelerated radiotherapy and 27 were treated with chemoradiotherapy. There were no significant differences in overall or disease-free survival between the groups. However, there was a trend, implying a beneficial effect of the intensified treatment, with chemoradiotherapy being better than radiotherapy despite that more patients had stage IV disease in the former group; and accelerated radiotherapy being better than conventional radiotherapy. This needs to be followed further in larger more homogenous groups of patients. In conclusion, patients with HPV-positive tonsillar cancer treated with conventional- or accelerated radiotherapy or chemoradiotherapy disclosed similar survival rates. The trend for better survival and less metastasis after intensified treatment underlines the need for large prospective studies comparing less intense to more intense treatment (chemoradiotherapy). PMID:22038860

  1. Human papillomavirus and survival in patients with base of tongue cancer.

    PubMed

    Attner, Per; Du, Juan; Näsman, Anders; Hammarstedt, Lalle; Ramqvist, Torbjörn; Lindholm, Johan; Marklund, Linda; Dalianis, Tina; Munck-Wikland, Eva

    2011-06-15

    The incidence of base of tongue cancer is increasing in Sweden and the proportion of human papillomavirus (HPV) positive cancer has increased in Stockholm, Sweden. Between 2006 and 2007, 84% of base of tongue cancer cases in Stockholm were HPV-positive. The objective of this study was to assess the impact of HPV status on prognosis for base of tongue cancer patients. One-hundred and nine patients were diagnosed with base of tongue cancer between 1998 and 2007 in Stockholm County and 95 paraffin-embedded diagnostic tumor biopsies were obtained and tested for HPV by PCR. Eighty-seven patients had available biopsies, were treated with intention to cure and could be included in the survival analysis. Age, sex, TNM-stage, stage, treatment and survival were recorded from patient charts. Kaplan-Meier curves were used to present survival data. In multivariable analyses, a Cox proportional hazards model was used to adjust for covariates. In total 68 (78%) tumor biopsies from the 87 included patients were HPV DNA positive. Kaplan-Meier estimates showed that the overall survival for patients with HPV-positive cancer was significantly better (p = 0.0004), (log-rank test) than that of patients with HPV-negative cancer. Patients with HPV-positive tumors also had significantly better disease-free survival (p = 0.0008), (log-rank test) than those with HPV-negative tumors. These results further strengthen the option to consider HPV-status when planning prospective studies on treatment for base of tongue cancer. PMID:20725995

  2. Mathematical learning instruction and teacher motivation factors affecting science technology engineering and math (STEM) major choices in 4-year colleges and universities: Multilevel structural equation modeling

    NASA Astrophysics Data System (ADS)

    Lee, Ahlam

    2011-12-01

    Using the Educational Longitudinal Study of 2002/06, this study examined the effects of the selected mathematical learning and teacher motivation factors on graduates' science, technology, engineering, and math (STEM) related major choices in 4-year colleges and universities, as mediated by math performance and math self-efficacy. Using multilevel structural equation modeling, I analyzed: (1) the association between mathematical learning instruction factors (i.e., computer, individual, and lecture-based learning activities in mathematics) and students' STEM major choices in 4-year colleges and universities as mediated by math performance and math self-efficacy and (2) the association between school factor, teacher motivation and students' STEM major choices in 4-year colleges and universities via mediators of math performance and math self-efficacy. The results revealed that among the selected learning experience factors, computer-based learning activities in math classrooms yielded the most positive effects on math self-efficacy, which significantly predicted the increase in the proportion of students' STEM major choice as mediated by math self-efficacy. Further, when controlling for base-year math Item Response Theory (IRT) scores, a positive relationship between individual-based learning activities in math classrooms and the first follow-up math IRT scores emerged, which related to the high proportion of students' STEM major choices. The results also indicated that individual and lecture-based learning activities in math yielded positive effects on math self-efficacy, which related to STEM major choice. Concerning between-school levels, teacher motivation yielded positive effects on the first follow up math IRT score, when controlling for base year IRT score. The results from this study inform educators, parents, and policy makers on how mathematics instruction can improve student math performance and encourage more students to prepare for STEM careers. Students

  3. [Some features of immunological status in young peoples irradiated in utero or in age up to 4 years as result of Chernobyl accident].

    PubMed

    Pal'okha, E A; Saenko, A S; Lekakh, I V; Leonova, O

    2010-01-01

    Some characteristics of immune system, namely quantities of serum immunoglobulins A, G, M and activity of free and hidden autoantibodies to DNA, cardiolipin and microsomal thyroid antigen were studied in young people irradiated in utero or in age up to 4 years through Chernobyl accident. The hallmarker of observed immunological changes is low content of immunoglobulin A. Degree of reduction was in back proportion with level 137Cs contamination inhabit territory. A lowering of the content of IgA in persons irradiated in utero depends on period of pregnancy at a moment of the accident: the most reduction was observed in young people irradiated in the first trimester of gestation. It was shown elevation of activity autoantibodies to cardiolipin. Both deficit of IgA and elevation activity the autoantibodies were observed only in proportion of young people irradiated in utero or in early period of life.

  4. Child anxiety treatment: outcomes in adolescence and impact on substance use and depression at 7.4-year follow-up.

    PubMed

    Kendall, Philip C; Safford, Scott; Flannery-Schroeder, Ellen; Webb, Alicia

    2004-04-01

    Research suggests that the sequelae of childhood anxiety disorders, if left untreated, can include chronic anxiety, depression, and substance abuse. The current study evaluated the maintenance of outcomes of children who received a 16-week cognitive-behavioral treatment for primary anxiety disorders (generalized, separation, and social anxiety disorders) an average of 7.4 years earlier. The 86 participants (ages 15 to 22 years; 91% of the original sample) and their parents completed diagnostic interviews and self- and parent-report measures. According to the diagnostic interviews, a meaningful percentage of participants maintained significant improvements in anxiety at long-term follow-up. With regard to sequelae, positive responders to anxiety treatment, as compared with less positive responders, had a reduced amount of substance use involvement and related problems at long-term follow-up. The findings are discussed with regard to child anxiety and some of its sequelae. PMID:15065961

  5. Emergency coronary artery bypass grafting for cardiogenic shock due to left main coronary artery obstruction caused by Kawasaki disease in a 4-year-old boy.

    PubMed

    Tamaki, Wataru; Tsuda, Etsuko; Nakajima, Hiroyuki; Kobayashi, Junjiro; Shiono, Junko

    2014-04-01

    We describe the case of a 4-year-old boy whose clinical course after Kawasaki disease resulted in coronary artery bypass grafting (CABG) due to acute myocardial infarction (AMI) causing cardiogenic shock. He had developed an ischemic cardiomyopathy due to severe localized stenosis of the left main coronary artery (LCA) and went into cardiogenic shock due to AMI on the day before a scheduled operation. He underwent successful emergency CABG within 4 h of MI. Postoperatively his neurological status was intact. This is the first report of a successful emergency CABG in a small child with cardiogenic shock due to LCA occlusion. CABG should be undertaken in small patients when appropriate indications exist, if bodyweight is >10 kg.

  6. Surviving Hypopharynx-Larynx Carcinoma in the Era of IMRT

    SciTech Connect

    Studer, Gabriela; Peponi, Evangelia; Kloeck, Stephan; Dossenbach, Thomas; Huber, Gerhard; Glanzmann, Christoph

    2010-08-01

    Purpose: Outcome in locoregionally advanced laryngeal carcinoma and hypopharyngeal carcinoma after conventional radiation techniques is known for modest disease control and considerable late toxicity. Considering the lack of standardization in prescription dose for intensity-modulated radiotherapy (IMRT), we aimed to compare the results after our methods of simultaneously integrated boost IMRT with published results. Methods and Materials: Between March 2002 and December 2008, 65 hypopharyngeal, 31 supraglottic, and 27 locoregionally advanced glottic tumor patients underwent definitive IMRT (with simultaneous chemotherapy in 86%). Of these, 64% presented with locoregionally advanced disease. Mean follow-up was 26 months (range, 3-83 months), with a median of 21 months. Treatment (2.0-2.2Gy per fraction, 66-72.6Gy) followed a prospectively defined protocol. If the boost volume included more than half of the larynx or a substantial part of the pharynx, dose was limited to 2.0Gy per fraction. Results: The 2-year local, nodal, and locoregional control (LRC) rates for the entire cohort were 82%, 90%, and 77%, respectively; the disease-free and overall survival rates were 75% and 83%, respectively. The ultimate 2-year LRC rate, including salvage surgery, was 86%. Laryngectomy was required in 2 LRC patients needing tracheostoma already before; 2 further LRC patients needed tracheostomy before IMRT and remained tracheostoma dependent, and 3 patients remained feeding tube dependent after IMRT. Salvage laryngectomy was successful in 8 of 11. Of all 123 patients, 91 patients (74%) are locoregionally controlled and live with a functional laryngopharynx. Conclusions: Simultaneously integrated boost IMRT with limited acceptance of dose inhomogeneity resulted in very satisfactory disease control despite a slight left shift of planning target volume curves on the dose-volume histogram. Considering the treatment tolerance, a careful increase in dose in our patients seems possible

  7. Mother's Perception of General Family Functioning and Sugar Consumption of 3- and 4-Year-Old Children: The East London Family Study.

    PubMed

    Nanjappa, Sucharita; Hector, Mark; Marcenes, Wagner

    2015-01-01

    Frequent consumption of sugary foods is a common risk factor for chronic diseases such as dental caries and obesity. Dietary patterns are acquired at home during early life and form a blueprint for dietary behaviours in later life. A favourable family environment can provide a supportive context that enhances the adoption of healthy dietary habits. The aim of this study was to identify the contribution of general family functioning towards the frequent consumption of sugary foods by 3- and 4-year-old children in Outer North East London. The research question was explored with data from the East London Family study, which collected data through home visits from a representative sample of adults and children living in Outer North East London in 2008-2010. This study analysed data from 3- and 4-year-old children (n = 698) and their mothers and included logistic regression, conceptual hierarchical modelling and mediation analysis. The results showed that 17% of the sample consumed sugary foods more than 4 times per day, and that effective general family functioning may help reducing frequent consumption of sugary foods. There was a 67% reduction in children's frequent consumption of sugary foods with every unit increase in the general family functioning score. Mother's higher education may also help reduce the frequent consumption of sugary foods by children. The negative impact of mother's lower education was buffered by the effect of effective general family functioning. The study findings underscore the prospect of identifying factors that contribute to the acquisition of good dietary behaviours. PMID:26304625

  8. Air Pollution and Acute Respiratory Infections Among Children 0–4 Years of Age: An 18-Year Time-Series Study

    PubMed Central

    Darrow, Lyndsey A.; Klein, Mitchel; Flanders, W. Dana; Mulholland, James A.; Tolbert, Paige E.; Strickland, Matthew J.

    2014-01-01

    Upper and lower respiratory infections are common in early childhood and may be exacerbated by air pollution. We investigated short-term changes in ambient air pollutant concentrations, including speciated particulate matter less than 2.5 μm in diameter (PM2.5), in relation to emergency department (ED) visits for respiratory infections in young children. Daily counts of ED visits for bronchitis and bronchiolitis (n = 80,399), pneumonia (n = 63,359), and upper respiratory infection (URI) (n = 359,246) among children 0–4 years of age were collected from hospitals in the Atlanta, Georgia, area for the period 1993–2010. Daily pollutant measurements were combined across monitoring stations using population weighting. In Poisson generalized linear models, 3-day moving average concentrations of ozone, nitrogen dioxide, and the organic carbon fraction of particulate matter less than 2.5 μm in diameter (PM2.5) were associated with ED visits for pneumonia and URI. Ozone associations were strongest and were observed at low (cold-season) concentrations; a 1–interquartile range increase predicted a 4% increase (95% confidence interval: 2%, 6%) in visits for URI and an 8% increase (95% confidence interval: 4%, 13%) in visits for pneumonia. Rate ratios tended to be higher in the 1- to 4-year age group compared with infants. Results suggest that primary traffic pollutants, ozone, and the organic carbon fraction of PM2.5 exacerbate upper and lower respiratory infections in early life, and that the carbon fraction of PM2.5 is a particularly harmful component of the ambient particulate matter mixture. PMID:25324558

  9. Minimum 4-year outcomes of cervical total disc arthroplasty versus fusion: a meta-analysis based on prospective randomized controlled trials.

    PubMed

    Wu, Ai-Min; Xu, Hui; Mullinix, Kenneth Paul; Jin, Hai-Ming; Huang, Zhe-Yu; Lv, Qing-Bo; Wang, Sheng; Xu, Hua-Zi; Chi, Yong-Long

    2015-04-01

    The prevalence of cervical disc disease is high, and the traditional surgical method of anterior cervical discectomy and fusion (ACDF) carries with it the disadvantages of motion loss at the operated level, and accelerated adjacent level disc degeneration. Preliminary results of the efficacy and reoperative rate comparing TDA versus ACDF have been reported; however, the long-term outcomes of TDA versus ACDF still remain a topic of debate. This review was prepared following the standard procedures set forth by the Cochrane Collaboration organization, and preferred reporting items for systematic reviews and meta-analyses (PRISMA). The only studies included were randomized controlled trials with a minimum of 4 years of follow-up data. The meta-analysis included the neck disability index (NDI), visual analog scale (VAS) of neck and arm pain, SF-36 physical component scores (SF-36 PCS), over success, neurological success, work status, implant-related complications, and secondary surgery events. Four randomized controlled trials meet the inclusion criteria. The long-term improvement of NDI, VAS of neck and arm pain, SF-36 PCS, over success, and neurological success favored the TDA group. The TDA group also had a lower incidence of secondary surgery for both the index level (RR: 0.45 [0.28, 0.72]) and adjacent level (RR: 0.53 [0.33, 0.88]). In this meta-analysis of 4 included RCTs with a minimum 4 years of follow-ups, total disc arthroplasty showed improvements over ACDF as measured by the NDI, VAS of neck and arm pain, and SF-36 PCS. PMID:25881841

  10. Reduced Prevalence of Oral Human Papillomavirus (HPV) 4 Years after Bivalent HPV Vaccination in a Randomized Clinical Trial in Costa Rica

    PubMed Central

    Herrero, Rolando; Quint, Wim; Hildesheim, Allan; Gonzalez, Paula; Struijk, Linda; Katki, Hormuzd A.; Porras, Carolina; Schiffman, Mark; Rodriguez, Ana Cecilia; Solomon, Diane; Jimenez, Silvia; Schiller, John T.; Lowy, Douglas R.; van Doorn, Leen-Jan; Wacholder, Sholom; Kreimer, Aimée R.

    2013-01-01

    Background Human papillomavirus (HPV) infection, particularly with type 16, causes a growing fraction of oropharyngeal cancers, whose incidence is increasing, mainly in developed countries. In a double-blind controlled trial conducted to investigate vaccine efficacy (VE) of the bivalent HPV 16/18 vaccine against cervical infections and lesions, we estimated VE against prevalent oral HPV infections 4 years after vaccination. Methods and Findings A total of 7,466 women 18–25 years old were randomized (1∶1) to receive the HPV16/18 vaccine or hepatitis A vaccine as control. At the final blinded 4-year study visit, 5,840 participants provided oral specimens (91·9% of eligible women) to evaluate VE against oral infections. Our primary analysis evaluated prevalent oral HPV infection among all vaccinated women with oral and cervical HPV results. Corresponding VE against prevalent cervical HPV16/18 infection was calculated for comparison. Oral prevalence of identifiable mucosal HPV was relatively low (1·7%). Approximately four years after vaccination, there were 15 prevalent HPV16/18 infections in the control group and one in the vaccine group, for an estimated VE of 93·3% (95% CI = 63% to 100%). Corresponding efficacy against prevalent cervical HPV16/18 infection for the same cohort at the same visit was 72·0% (95% CI = 63% to 79%) (p versus oral VE = 0·04). There was no statistically significant protection against other oral HPV infections, though power was limited for these analyses. Conclusions HPV prevalence four years after vaccination with the ASO4-adjuvanted HPV16/18 vaccine was much lower among women in the vaccine arm compared to the control arm, suggesting that the vaccine affords strong protection against oral HPV16/18 infection, with potentially important implications for prevention of increasingly common HPV-associated oropharyngeal cancer. ClinicalTrials.gov, Registry number NCT00128661 PMID:23873171

  11. Weight gain and reduced energy expenditure in low-income Brazilian women living in slums: a 4-year follow-up study.

    PubMed

    Florêncio, Telma M M T; Bueno, Nassib B; Clemente, Ana P G; Albuquerque, Fabiana C A; Britto, Revilane P A; Ferriolli, Eduardo; Sawaya, Ana L

    2015-08-14

    The present study aimed to investigate the possible changes in anthropometric and biochemical parameters in low-income women living in the outskirts of Maceió (northeast Brazil), and to explore the possible role of dietary intake and physical activity in these changes. A prospective longitudinal study was conducted in a cohort of mothers of malnourished children who attended the Center for Nutritional Recovery and Education, an outreach programme of the Federal University of Alagoas. Socio-economic, anthropometric, biochemical and dietary intake data were assessed at baseline and after a follow-up period of 4 years. Energy expenditure (using doubly labelled water) and physical activity (using triaxial accelerometers) were assessed only in a subgroup of women after 4 years. A total of eighty-five women were assessed. Participants showed an altered biochemical profile, increased systolic blood pressure, decreased thyroid hormone levels, and body-weight gain. However, dietary intakes of the participants did not include large quantities of highly processed and high-glycaemic index foods. The energy intake of the participants did not differ from their total energy expenditure (7990.3 (7173.7-8806.8) v. 8798.1 (8169.0-9432.4) kJ, respectively; P= 0.084). Multivariate analyses showed a significant effect of time spent watching television (β = 0.639 (0.003 to 1.275); P= 0.048) and dietary diversity score (β = -1.039 ( -2.010 to -0.067); P = 0.036) on weight gain. The present study indicates that poor women, who are mothers of malnourished children and have a reasonably balanced dietary intake, exhibit weight gain and are at risk of developing chronic diseases.

  12. Perceptions of veterinary admissions committee members of undergraduate credits earned from community colleges or online compared to traditional 4-year institutions

    PubMed Central

    Kogan, L.R.; Stewart, S.M.; Schoenfeld-Tacher, R.; Hellyer, P.W.

    2015-01-01

    Veterinary admission committees are asked to create and implement a fair, reliable, and valid system to select the candidates most likely to succeed in veterinary school from a large pool of applicants. Although numerous studies have explored grade point average (GPA) as a predictive value of later academic success, there has been little attention paid to how and where an applicant acquires his/her undergraduate coursework. Quality of academic program is an important component of applicant files, and it is suggested that the source of a candidate’s coursework might influence admissions committee decisions, perhaps even outside of the committee’s immediate awareness. Options for undergraduate education include taking classes at a traditional four-year institution, a community college, or online. This study provides an overview of the current state of online courses and community colleges in the US as a foundation to explore the views of veterinary admissions committee members pertaining to coursework completed at traditional residential 4-year schools or at community colleges and whether they are delivered on campus or online (at either type of institution). Survey participants reported a pattern of preference for traditional four-year residential coursework compared to online or community college courses. These results are interesting given the exponential growth of students taking online courses and data showing community colleges are providing a successful gateway to obtaining a four-year degree. This also points to the need for admission committees to discuss potential biases since the information about type of school and/or course may not be consistently available for all applicants. Finally, at a time when admitting a diverse class of students is a goal of many programs, it is of special concern that there are potential biases against courses taken online or from community colleges - venues that tend to draw a more diverse population than traditional 4

  13. Perceptions of veterinary admissions committee members of undergraduate credits earned from community colleges or online compared to traditional 4-year institutions.

    PubMed

    Kogan, L R; Stewart, S M; Schoenfeld-Tacher, R; Hellyer, P W

    2015-01-01

    Veterinary admission committees are asked to create and implement a fair, reliable, and valid system to select the candidates most likely to succeed in veterinary school from a large pool of applicants. Although numerous studies have explored grade point average (GPA) as a predictive value of later academic success, there has been little attention paid to how and where an applicant acquires his/her undergraduate coursework. Quality of academic program is an important component of applicant files, and it is suggested that the source of a candidate's coursework might influence admissions committee decisions, perhaps even outside of the committee's immediate awareness. Options for undergraduate education include taking classes at a traditional four-year institution, a community college, or online. This study provides an overview of the current state of online courses and community colleges in the US as a foundation to explore the views of veterinary admissions committee members pertaining to coursework completed at traditional residential 4-year schools or at community colleges and whether they are delivered on campus or online (at either type of institution). Survey participants reported a pattern of preference for traditional four-year residential coursework compared to online or community college courses. These results are interesting given the exponential growth of students taking online courses and data showing community colleges are providing a successful gateway to obtaining a four-year degree. This also points to the need for admission committees to discuss potential biases since the information about type of school and/or course may not be consistently available for all applicants. Finally, at a time when admitting a diverse class of students is a goal of many programs, it is of special concern that there are potential biases against courses taken online or from community colleges - venues that tend to draw a more diverse population than traditional 4-year

  14. Perceptions of veterinary admissions committee members of undergraduate credits earned from community colleges or online compared to traditional 4-year institutions.

    PubMed

    Kogan, L R; Stewart, S M; Schoenfeld-Tacher, R; Hellyer, P W

    2015-01-01

    Veterinary admission committees are asked to create and implement a fair, reliable, and valid system to select the candidates most likely to succeed in veterinary school from a large pool of applicants. Although numerous studies have explored grade point average (GPA) as a predictive value of later academic success, there has been little attention paid to how and where an applicant acquires his/her undergraduate coursework. Quality of academic program is an important component of applicant files, and it is suggested that the source of a candidate's coursework might influence admissions committee decisions, perhaps even outside of the committee's immediate awareness. Options for undergraduate education include taking classes at a traditional four-year institution, a community college, or online. This study provides an overview of the current state of online courses and community colleges in the US as a foundation to explore the views of veterinary admissions committee members pertaining to coursework completed at traditional residential 4-year schools or at community colleges and whether they are delivered on campus or online (at either type of institution). Survey participants reported a pattern of preference for traditional four-year residential coursework compared to online or community college courses. These results are interesting given the exponential growth of students taking online courses and data showing community colleges are providing a successful gateway to obtaining a four-year degree. This also points to the need for admission committees to discuss potential biases since the information about type of school and/or course may not be consistently available for all applicants. Finally, at a time when admitting a diverse class of students is a goal of many programs, it is of special concern that there are potential biases against courses taken online or from community colleges - venues that tend to draw a more diverse population than traditional 4-year

  15. Air pollution and acute respiratory infections among children 0-4 years of age: an 18-year time-series study.

    PubMed

    Darrow, Lyndsey A; Klein, Mitchel; Flanders, W Dana; Mulholland, James A; Tolbert, Paige E; Strickland, Matthew J

    2014-11-15

    Upper and lower respiratory infections are common in early childhood and may be exacerbated by air pollution. We investigated short-term changes in ambient air pollutant concentrations, including speciated particulate matter less than 2.5 μm in diameter (PM2.5), in relation to emergency department (ED) visits for respiratory infections in young children. Daily counts of ED visits for bronchitis and bronchiolitis (n = 80,399), pneumonia (n = 63,359), and upper respiratory infection (URI) (n = 359,246) among children 0-4 years of age were collected from hospitals in the Atlanta, Georgia, area for the period 1993-2010. Daily pollutant measurements were combined across monitoring stations using population weighting. In Poisson generalized linear models, 3-day moving average concentrations of ozone, nitrogen dioxide, and the organic carbon fraction of particulate matter less than 2.5 μm in diameter (PM2.5) were associated with ED visits for pneumonia and URI. Ozone associations were strongest and were observed at low (cold-season) concentrations; a 1-interquartile range increase predicted a 4% increase (95% confidence interval: 2%, 6%) in visits for URI and an 8% increase (95% confidence interval: 4%, 13%) in visits for pneumonia. Rate ratios tended to be higher in the 1- to 4-year age group compared with infants. Results suggest that primary traffic pollutants, ozone, and the organic carbon fraction of PM2.5 exacerbate upper and lower respiratory infections in early life, and that the carbon fraction of PM2.5 is a particularly harmful component of the ambient particulate matter mixture.

  16. Sources of dietary fluoride intake in 4-year-old children residing in low, medium and high fluoride areas in Iran.

    PubMed

    Zohouri, F V; Rugg-Gunn, A J

    2000-09-01

    Accurate estimation of fluoride dietary intake is desirable for optimising caries prevention. Little is known about the dietary fluoride intake of children aged 4 years, an age when many permanent teeth are forming. This study was undertaken in Fars Province, Iran, in 1995-1996, where there are big differences in temperature between winter and summer. The aims were to determine: (a) the relative contributions of different components of the diet to fluoride intake, (b) the effect of variation in fluoride concentration in drinking water, and (c) the effect of climate temperature. Temperature varied between +40 degrees C in summer to -5 degrees C in winter. The mean fluoride concentrations in drinking water in the three areas were 0.3, 0.6 and 4.0 mgF/L. Dietary information was obtained by two 3-day diet diaries with interview, validated with reference to international standards. The fluoride content of foods was measured using the silicon-facilitated diffusion method. One hundred and three 4-year-old children completed the study. The mean (and 95% confidence interval) dietary fluoride intakes in each of the three areas, respectively, were 413 (+/- 21), 698 (+/- 89) and 3472 (+/- 557) micrograms/day. Drinks provided 72 to 87% of dietary fluoride--this proportion increased with increasing water fluoride concentration and increasing climate temperature. Tea (infusion) was an important source of dietary fluoride, providing 31 to 38% of total dietary intake. Tap water was a more important source of fluoride than soft drinks. Cooked rice and bread were the most important food source of fluoride and the amount of fluoride they contributed increased as water fluoride concentration increased. The results of this first such survey in the Middle East showed (a) that water (as a drink) and tea were by far the most important contributors to dietary fluoride intake, (b) substantial increases in fluoride intake with increasing water fluoride concentrations, and (c) substantially

  17. Survivability of Deterministic Dynamical Systems

    NASA Astrophysics Data System (ADS)

    Hellmann, Frank; Schultz, Paul; Grabow, Carsten; Heitzig, Jobst; Kurths, Jürgen

    2016-07-01

    The notion of a part of phase space containing desired (or allowed) states of a dynamical system is important in a wide range of complex systems research. It has been called the safe operating space, the viability kernel or the sunny region. In this paper we define the notion of survivability: Given a random initial condition, what is the likelihood that the transient behaviour of a deterministic system does not leave a region of desirable states. We demonstrate the utility of this novel stability measure by considering models from climate science, neuronal networks and power grids. We also show that a semi-analytic lower bound for the survivability of linear systems allows a numerically very efficient survivability analysis in realistic models of power grids. Our numerical and semi-analytic work underlines that the type of stability measured by survivability is not captured by common asymptotic stability measures.

  18. [Physical activity and cancer survival].

    PubMed

    Romieu, Isabelle; Touillaud, Marina; Ferrari, Pietro; Bignon, Yves-Jean; Antoun, Sami; Berthouze-Aranda, Sophie; Bachmann, Patrick; Duclos, Martine; Ninot, Grégory; Romieu, Gilles; Sénesse, Pierre; Behrendt, Jan; Balosso, Jacques; Pavic, Michel; Kerbrat, Pierre; Serin, Daniel; Trédan, Olivier; Fervers, Béatrice

    2012-10-01

    Physical activity has been shown in large cohort studies to positively impact survival in cancer survivors. Existing randomized controlled trials showed a beneficial effect of physical activity on physical fitness, quality of life, anxiety and self-esteem; however, the small sample size, the short follow-up and the lack of standardization of physical activity intervention across studies impaired definite conclusion in terms of survival. Physical activity reduces adiposity and circulating estrogen levels and increases insulin sensitivity among other effects. A workshop was conducted at the International Agency for Research on Cancer in April 2011 to discuss the role of physical activity on cancer survival and the methodology to develop multicentre randomized intervention trials, including the type of physical activity to implement and its association with nutritional recommendations. The authors discuss the beneficial effect of physical activity on cancer survival with a main focus on breast cancer and report the conclusions from this workshop. PMID:24007856

  19. Survivability of Deterministic Dynamical Systems.

    PubMed

    Hellmann, Frank; Schultz, Paul; Grabow, Carsten; Heitzig, Jobst; Kurths, Jürgen

    2016-01-01

    The notion of a part of phase space containing desired (or allowed) states of a dynamical system is important in a wide range of complex systems research. It has been called the safe operating space, the viability kernel or the sunny region. In this paper we define the notion of survivability: Given a random initial condition, what is the likelihood that the transient behaviour of a deterministic system does not leave a region of desirable states. We demonstrate the utility of this novel stability measure by considering models from climate science, neuronal networks and power grids. We also show that a semi-analytic lower bound for the survivability of linear systems allows a numerically very efficient survivability analysis in realistic models of power grids. Our numerical and semi-analytic work underlines that the type of stability measured by survivability is not captured by common asymptotic stability measures. PMID:27405955

  20. The Survival of the Wisest

    ERIC Educational Resources Information Center

    Salk, Jonas

    1975-01-01

    Suggests that humans differ from other living organisms in the ability to exercise learned behavior and the individual will, which may allow people to make the changes in values necessary to survive on this planet. (DW)

  1. Natural Freedom and Wilderness Survival

    ERIC Educational Resources Information Center

    Welton, George E.

    1978-01-01

    The "naturalism" of Jean Jacques Rousseau offers a philosophical base for wilderness survival: the renewal of participants in nature so that they can reenter civilization with a proper balance of natural and civil liberty. (MJB)

  2. Staying Alive: Problems of Survival.

    ERIC Educational Resources Information Center

    Stalheim, Bill

    1990-01-01

    Presented is an approach to the teaching of biological diversity using the theme of survival. Teaching methods for this approach and the advantages of its use are discussed. A suggested course outline is included. (CW)

  3. Survivability of Deterministic Dynamical Systems

    PubMed Central

    Hellmann, Frank; Schultz, Paul; Grabow, Carsten; Heitzig, Jobst; Kurths, Jürgen

    2016-01-01

    The notion of a part of phase space containing desired (or allowed) states of a dynamical system is important in a wide range of complex systems research. It has been called the safe operating space, the viability kernel or the sunny region. In this paper we define the notion of survivability: Given a random initial condition, what is the likelihood that the transient behaviour of a deterministic system does not leave a region of desirable states. We demonstrate the utility of this novel stability measure by considering models from climate science, neuronal networks and power grids. We also show that a semi-analytic lower bound for the survivability of linear systems allows a numerically very efficient survivability analysis in realistic models of power grids. Our numerical and semi-analytic work underlines that the type of stability measured by survivability is not captured by common asymptotic stability measures. PMID:27405955

  4. [Physical activity and cancer survival].

    PubMed

    Romieu, Isabelle; Touillaud, Marina; Ferrari, Pietro; Bignon, Yves-Jean; Antoun, Sami; Berthouze-Aranda, Sophie; Bachmann, Patrick; Duclos, Martine; Ninot, Grégory; Romieu, Gilles; Sénesse, Pierre; Behrendt, Jan; Balosso, Jacques; Pavic, Michel; Kerbrat, Pierre; Serin, Daniel; Trédan, Olivier; Fervers, Béatrice

    2012-10-01

    Physical activity has been shown in large cohort studies to positively impact survival in cancer survivors. Existing randomized controlled trials showed a beneficial effect of physical activity on physical fitness, quality of life, anxiety and self-esteem; however, the small sample size, the short follow-up and the lack of standardization of physical activity intervention across studies impaired definite conclusion in terms of survival. Physical activity reduces adiposity and circulating estrogen levels and increases insulin sensitivity among other effects. A workshop was conducted at the International Agency for Research on Cancer in April 2011 to discuss the role of physical activity on cancer survival and the methodology to develop multicentre randomized intervention trials, including the type of physical activity to implement and its association with nutritional recommendations. The authors discuss the beneficial effect of physical activity on cancer survival with a main focus on breast cancer and report the conclusions from this workshop.

  5. Customer service skills for survival.

    PubMed

    McAtee, L F

    1999-11-01

    As APICS practitioners, we all must share a common goal. How can we contribute to our company's success? Success can be measured in positive terms of market share, growth, profitability, return on investment, or some combination thereof. Each company must establish its own definition of success. For the purposes of this article, success will be equated to one word that we can all readily identify with: survival. What skills do we need to survive in the marketplace of the next millennium?

  6. Long-term haemodialysis survival

    PubMed Central

    Nielsen, Arne Høj; Hansen, Henrik Post

    2012-01-01

    Haemodialysis (HD) treatment for end-stage renal disease bears a poor prognosis. We present a case of a patient who, apart from two transplant periods lasting 8 months in all, was treated with conventional in-centre HD three times a week and who survived for 41 years. Patients should be aware that there is no theoretical upper limit for patient survival on HD. PMID:22833810

  7. Telomere length of tumor tissues and survival in patients with early stage non-small cell lung cancer.

    PubMed

    Jeon, Hyo-Sung; Choi, Yi Young; Choi, Jin Eun; Lee, Won Kee; Lee, Eungbae; Yoo, Seung Soo; Lee, Shin Yup; Lee, Jaehee; Cha, Seung Ick; Kim, Chang Ho; Park, Jae Yong

    2014-04-01

    Telomere shortening leads to genomic instability that drives oncogenesis through the activation of telomerase and the generation of other mutations necessary for tumor progression. This study was conducted to determine the impact of telomere shortening on the survival of patients with early stage non-small cell lung cancer (NSCLC). Relative telomere length in tumor tissues was measured by quantitative polymerase chain reaction in 164 patients with surgically resected NSCLC. The association between telomere length and overall survival (OS) and disease-free survival (DFS) was analyzed. When the patients were categorized into quartiles based on telomere length, those patients with the 1st quartile (shortest) of telomere length had a significantly worse OS and DFS compared to patients with the 2nd to the 4th quartiles of telomere length (adjusted hazard ratio for OS = 2.67, 95% confidence interval = 1.50-4.75, P = 0.001; and adjusted hazard ratio for DFS = 1.92, 95% confidence interval = 1.17-3.14, P = 0.01). An association between telomere length and survival outcome was more pronounced in squamous cell carcinomas than adenocarcinomas (P-value of test for homogeneity for OS and DFS = 0.05 and 0.02, respectively). Telomere length of tumor tissues is an independent prognostic factor in patients with surgically resected early stage NSCLC.

  8. Cyclooxygenase-2 expression is associated with initiation of hepatocellular carcinoma, while prostaglandin receptor-1 expression predicts survival

    PubMed Central

    Yang, Hao-Jie; Jiang, Jing-Hang; Yang, Yu-Ting; Yang, Xiang-Di; Guo, Zhe; Qi, Ya-Peng; Zeng, Feng-Hua; Zhang, Ke-Lan; Chen, Neng-Zhi; Xiang, Bang-De; Li, Le-Qun

    2016-01-01

    AIM To determine whether cyclooxygenase-2 (COX-2) and prostaglandin E1 receptor (EP1) contribute to disease and whether they help predict prognosis. METHODS We retrospectively reviewed the records of 116 patients with hepatocellular carcinoma (HCC) who underwent surgery between 2008 and 2011 at our hospital. Expression of COX-2 and EP1 receptor was examined by immunohistochemistry of formalin-fixed, paraffin-embedded tissues using polyclonal antibodies. Possible associations between immunohistochemical scores and survival were determined. RESULTS Factors associated with poor overall survival (OS) were alpha-fetoprotein > 400 ng/mL, tumor size ≥ 5 cm, and high EP1 receptor expression, but not high COX-2 expression. Disease-free survival was not significantly different between patients with low or high levels of COX-2 or EP1. COX-2 immunoreactivity was significantly higher in well-differentiated HCC tissues (Edmondson grade I-II) than in poorly differentiated tissues (Edmondson grade III-IV) (P = 0.003). EP1 receptor immunoreactivity was significantly higher in poorly differentiated tissue than in well-differentiated tissue (P = 0.001). CONCLUSION COX-2 expression appears to be linked to early HCC events (initiation), while EP1 receptor expression may participate in tumor progression and predict survival.

  9. Long-term survival and late effects among one-year survivors of second allogeneic hematopoietic cell transplantation for relapsed acute leukemia and myelodysplastic syndromes.

    PubMed

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

    2015-01-01

    We analyzed the outcomes of patients who survived disease-free for 1 year or more after a second allogeneic hematopoietic cell transplantation (HCT) for relapsed acute leukemia or myelodysplastic syndromes between 1980 and 2009. A total of 1285 patients received a second allogeneic transplant after disease relapse; among these, 325 were relapse free at 1 year after the second HCT. The median time from first to second HCT was 17 and 24 months for children and adults, respectively. A myeloablative preparative regimen was used in the second transplantation in 62% of children and 45% of adult patients. The overall 10-year conditional survival rates after second transplantation in this cohort of patients who had survived disease-free for at least 1 year was 55% in children and 39% in adults. Relapse was the leading cause of mortality (77% and 54% of deaths in children and adults, respectively). In multivariate analyses, only disease status before second HCT was significantly associated with higher risk for overall mortality (hazard ratio, 1.71 for patients with disease not in complete remission before second HCT, P < .01). Chronic graft-versus-host disease (GVHD) developed in 43% and 75% of children and adults after second transplantation. Chronic GVHD was the leading cause of nonrelapse mortality, followed by organ failure and infection. The cumulative incidence of developing at least 1 of the studied late effects within 10 years after second HCT was 63% in children and 55% in adults. The most frequent late effects in children were growth disturbance (10-year cumulative incidence, 22%) and cataracts (20%); in adults they were cataracts (20%) and avascular necrosis (13%). Among patients with acute leukemia and myelodysplastic syndromes who receive a second allogeneic HCT for relapse and survive disease free for at least 1 year, many can be expected to survive long term. However, they continue to be at risk for relapse and nonrelapse morbidity and mortality. Novel

  10. Metastasis-associated in colon cancer 1 is a novel survival-related biomarker for human patients with renal pelvis carcinoma.

    PubMed

    Hu, Hailong; Tian, Dawei; Chen, Tao; Han, Ruifa; Sun, Yan; Wu, Changli

    2014-01-01

    Metastasis-associated in colon cancer 1 (MACC1) has recently been identified as a novel independent prognostic indicator for metastasis occurrence, overall survival and cancer-free survival for patients with colon cancer and other solid tumors. In this study, we investigated the role of MACC1 in the development and progression of renal pelvis carcinoma, a form of upper tract urothelial carcinomas. MACC1 protein has been found in the cytoplasm as well as in the nucleus of the transitional epithelial cells of the normal renal pelvis in immunohistochemical (IHC) assays. Quantitative IHC examinations revealed that MACC1 abnormal abundance in cancerous tissues might represent a biological indicator clinically suggestive of tumor malignancy in the renal pelvis. Furthermore, investigation of the association of MACC1 protein levels with clinicopathological parameters in this study has suggested a correlation of MACC1 expression with tumor-node-metastasis stage and histopathological grade of patients with renal pelvis carcinoma, with elevated MACC1 protein levels frequently associated with higher aggressiveness of the disease. Moreover, both disease-free survival and overall survival for the patients in the high MACC1 expression group were significantly lower than those in the low expression group. Multivariate analysis with a Cox proportional-hazards model suggested that MACC1 is indeed an independent prognostic indicator of overall survival and cancer-free survival for patients with renal pelvis carcinoma. Thus, MACC1 may represent a promising prognostic biomarker candidate, as well as a potential therapeutic target for this disease. PMID:24949951

  11. Metastasis-Associated in Colon Cancer 1 Is a Novel Survival-Related Biomarker for Human Patients with Renal Pelvis Carcinoma

    PubMed Central

    Chen, Tao; Han, Ruifa; Sun, Yan; Wu, Changli

    2014-01-01

    Metastasis-associated in colon cancer 1 (MACC1) has recently been identified as a novel independent prognostic indicator for metastasis occurrence, overall survival and cancer-free survival for patients with colon cancer and other solid tumors. In this study, we investigated the role of MACC1 in the development and progression of renal pelvis carcinoma, a form of upper tract urothelial carcinomas. MACC1 protein has been found in the cytoplasm as well as in the nucleus of the transitional epithelial cells of the normal renal pelvis in immunohistochemical (IHC) assays. Quantitative IHC examinations revealed that MACC1 abnormal abundance in cancerous tissues might represent a biological indicator clinically suggestive of tumor malignancy in the renal pelvis. Furthermore, investigation of the association of MACC1 protein levels with clinicopathological parameters in this study has suggested a correlation of MACC1 expression with tumor-node-metastasis stage and histopathological grade of patients with renal pelvis carcinoma, with elevated MACC1 protein levels frequently associated with higher aggressiveness of the disease. Moreover, both disease-free survival and overall survival for the patients in the high MACC1 expression group were significantly lower than those in the low expression group. Multivariate analysis with a Cox proportional-hazards model suggested that MACC1 is indeed an independent prognostic indicator of overall survival and cancer-free survival for patients with renal pelvis carcinoma. Thus, MACC1 may represent a promising prognostic biomarker candidate, as well as a potential therapeutic target for this disease. PMID:24949951

  12. Adjuvant treatment with tumor-targeting Salmonella typhimurium A1-R reduces recurrence and increases survival after liver metastasis resection in an orthotopic nude mouse model

    PubMed Central

    Murakami, Takashi; Hiroshima, Yukihiko; Zhao, Ming; Zhang, Yong; Chishima, Takashi; Tanaka, Kuniya; Bouvet, Michael; Endo, Itaru; Hoffman, Robert M.

    2015-01-01

    Colon cancer liver metastasis is often the lethal aspect of this disease. Well-isolated metastases are candidates for surgical resection, but recurrence is common. Better adjuvant treatment is therefore needed to reduce or prevent recurrence. In the present study, HT-29 human colon cancer cells expressing red fluorescent protein (RFP) were used to establish liver metastases in nude mice. Mice with a single liver metastasis were randomized into bright-light surgery (BLS) or the combination of BLS and adjuvant treatment with tumor-targeting S. typhimurium A1-R. Residual tumor fluorescence after BLS was clearly visualized at high magnification by fluorescence imaging. Adjuvant treatment with S. typhimurium A1-R was highly effective to increase survival and disease-free survival after BLS of liver metastasis. The results suggest the future clinical potential of adjuvant S. typhimurium A1-R treatment after liver metastasis resection. PMID:26497690

  13. Adjuvant treatment with tumor-targeting Salmonella typhimurium A1-R reduces recurrence and increases survival after liver metastasis resection in an orthotopic nude mouse model.

    PubMed

    Murakami, Takashi; Hiroshima, Yukihiko; Zhao, Ming; Zhang, Yong; Chishima, Takashi; Tanaka, Kuniya; Bouvet, Michael; Endo, Itaru; Hoffman, Robert M

    2015-12-01

    Colon cancer liver metastasis is often the lethal aspect of this disease. Well-isolated metastases are candidates for surgical resection, but recurrence is common. Better adjuvant treatment is therefore needed to reduce or prevent recurrence. In the present study, HT-29 human colon cancer cells expressing red fluorescent protein (RFP) were used to establish liver metastases in nude mice. Mice with a single liver metastasis were randomized into bright-light surgery (BLS) or the combination of BLS and adjuvant treatment with tumor-targeting S. typhimurium A1-R. Residual tumor fluorescence after BLS was clearly visualized at high magnification by fluorescence imaging. Adjuvant treatment with S. typhimurium A1-R was highly effective to increase survival and disease-free survival after BLS of liver metastasis. The results suggest the future clinical potential of adjuvant S. typhimurium A1-R treatment after liver metastasis resection.

  14. Primary gliosarcoma with long-survival: report of two cases and review of literature

    PubMed Central

    Huo, Zhen; Yang, Di; Shen, Jie; Li, Yuan; Wu, Huanwen; Meng, Yunxiao; Zhang, Shuying; Luo, Yufeng; Cao, Jinling; Liang, Zhiyong

    2014-01-01

    Background: Gliosarcoma (GS) is a rare high-grade malignant tumor with poor prognosis. The survival period of GS ranges from 4 to 18.5 months. Rarely would it be over 40 months. Survival of intraventricular GS is less than 8 months. Methods: There were 2 cases of primary gliosarcoma in our hospital with long-term survival after resection, with one of pure intraventricular origin. We confirmed that our diagnosis was correct by light microscopy, GFAP immunohistochemistry and histochemistry of reticular fiber staining. Results: In the first case, a 47-year-old man with intraventricular gliosarcoma survived for 130 months after surgery. In another case, a 63-year-old woman survived for 4 years after resection. Both cases of GS exhibited biphasic glioblastoma and fibrosarcoma with necrosis. According to the review of surgical records, complete tumor resections, including extended resections were carried out in both cases. The two patients received postoperative radiation therapy and chemotherapy without any further recurrence and metastasis. Conclusions: We reported two cases of GS with long survival. The presented cases demonstrate that, in rare instances, gliosarcoma may show prolonged survival with after surgical excision combined with radiotherapy and chemotherapy. PMID:25337286

  15. Survival of captive-reared Puerto Rican Parrots released in the Caribbean National Forest

    USGS Publications Warehouse

    White, T.H.; Collazo, J.A.; Vilella, F.J.

    2005-01-01

    We report first-year survival for 34 captive-reared Puerto Rican Parrots (Amazona vittata) released in the Caribbean National Forest, Puerto Rico between 2000 and 2002. The purpose of the releases were to increase population size and the potential number of breeding individuals of the sole extant wild population, and to refine release protocols for eventual reintroduction of a second wild population elsewhere on the island. After extensive prerelease training, we released 10 parrots in 2000, 16 parrots in 2001, and eight parrots in 2002 ranging in age from 1-4 years old. All birds were equipped with radio-transmitters to monitor survival. The overall first-year survival estimate for the 34 parrots was 41% (CI = 22%-61%). Only one parrot died within the first week postrelease, with most (94%) surviving for at least eight weeks after release. Most (54%) documented mortalities were due to raptor predation, which claimed 21% of all released parrots. A captive-reared bird (male, age one), released in 2001, paired with a wild female and fledged two young in 2004. We also calculated survival based on 0% and 50% of observed predation losses and found hypothetical survival rates of 72% and 54%, respectively. Rigorous prerelease training and acclimation was believed to have improved initial postrelease parrot survival, and releasing mixed age-class groups suggests the potential for shortening the time to recruitment. ?? The Cooper Ornithological Society 2005.

  16. Coexpression of CD44-positive/CD133-positive cancer stem cells and CD204-positive tumor-associated macrophages is a predictor of survival in pancreatic ductal adenocarcinoma

    PubMed Central

    Hou, Ya-Chin; Chao, Ying-Jui; Tung, Hui-Ling; Wang, Hao-Chen; Shan, Yan-Shen

    2014-01-01

    BACKGROUND The interactions between cancer stem cells (CSCs) and tumor-associated macrophages (TAMs) can promote tumor progression, maintain the CSCs population, and reduce therapeutic effects. The objective of this study was to investigate the coexpression of CSCs and TAMs and its clinical significance in pancreatic ductal adenocarcinoma (PDAC). METHODS Ninety-six patients with PDAC were included in this study. Tissue microarrays were constructed for immunostaining of the CSCs markers CD44 and CD133 and the TAMs marker CD204. Correlations between the expression of CSCs and TAMs markers and clinicopathologic characteristics or disease progression were analyzed. RESULTS Expression levels of CD44/CD133 and CD204 were significantly higher in tumor tissues than in normal tissues (P < .0001). The variables associated with survival were high coexpression of CD44/CD133 (P = .000), high expression of CD204 (P = .011), and tumor grade (P = .014). There was a positive correlation between CD44/CD133 and CD204 expression (r = 0.294; P = .004). Survival analysis indicated that high coexpression of CD44/CD133 and CD204 was associated significantly with shorter overall survival (P = .000) and disease-free survival (P = .003). Multivariate analysis revealed that high CD44/CD133 expression was an independent prognostic factor for disease-free survival, whereas high CD204 expression was an independent predictor for both overall and disease-free survival. CONCLUSIONS Coexpression of CD44/CD133 and CD204 is a useful survival prediction marker for patients with PDAC. Cancer 2014;120:2766–2777. © The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. The clinical significance of pancreatic cancer stem cells and tumor-associated macrophages is explored in patients with pancreatic ductal adenocarcinoma. The results clearly demonstrate that coexpression of 2 cancer stem cell markers (CD44 and CD133) and a tumor

  17. Probabilistic Survivability Versus Time Modeling

    NASA Technical Reports Server (NTRS)

    Joyner, James J., Sr.

    2015-01-01

    This technical paper documents Kennedy Space Centers Independent Assessment team work completed on three assessments for the Ground Systems Development and Operations (GSDO) Program to assist the Chief Safety and Mission Assurance Officer (CSO) and GSDO management during key programmatic reviews. The assessments provided the GSDO Program with an analysis of how egress time affects the likelihood of astronaut and worker survival during an emergency. For each assessment, the team developed probability distributions for hazard scenarios to address statistical uncertainty, resulting in survivability plots over time. The first assessment developed a mathematical model of probabilistic survivability versus time to reach a safe location using an ideal Emergency Egress System at Launch Complex 39B (LC-39B); the second used the first model to evaluate and compare various egress systems under consideration at LC-39B. The third used a modified LC-39B model to determine if a specific hazard decreased survivability more rapidly than other events during flight hardware processing in Kennedys Vehicle Assembly Building (VAB).Based on the composite survivability versus time graphs from the first two assessments, there was a soft knee in the Figure of Merit graphs at eight minutes (ten minutes after egress ordered). Thus, the graphs illustrated to the decision makers that the final emergency egress design selected should have the capability of transporting the flight crew from the top of LC 39B to a safe location in eight minutes or less. Results for the third assessment were dominated by hazards that were classified as instantaneous in nature (e.g. stacking mishaps) and therefore had no effect on survivability vs time to egress the VAB. VAB emergency scenarios that degraded over time (e.g. fire) produced survivability vs time graphs that were line with aerospace industry norms.

  18. Multiple tumours in survival estimates.

    PubMed

    Rosso, Stefano; De Angelis, Roberta; Ciccolallo, Laura; Carrani, Eugenio; Soerjomataram, Isabelle; Grande, Enrico; Zigon, Giulia; Brenner, Hermann

    2009-04-01

    In international comparisons of cancer registry based survival it is common practice to restrict the analysis to first primary tumours and exclude multiple cancers. The probability of correctly detecting subsequent cancers depends on the registry's running time, which results in different proportions of excluded patients and may lead to biased comparisons. We evaluated the impact on the age-standardised relative survival estimates of also including multiple primary tumours. Data from 2,919,023 malignant cancers from 69 European cancer registries participating in the EUROCARE-4 collaborative study were used. A total of 183,683 multiple primary tumours were found, with an overall proportion of 6.3% over all the considered cancers, ranging from 0.4% (Naples, Italy) to 12.9% (Iceland). The proportion of multiple tumours varied greatly by type of tumour, being higher for those with high incidence and long survival (breast, prostate and colon-rectum). Five-year relative survival was lower when including patients with multiple cancers. For all cancers combined the average difference was -0.4 percentage points in women and -0.7 percentage points in men, and was greater for older registries. Inclusion of multiple tumours led to lower survival in 44 out of 45 cancer sites analysed, with the greatest differences found for larynx (-1.9%), oropharynx (-1.5%), and penis (-1.3%). Including multiple primary tumours in survival estimates for international comparison is advisable because it reduces the bias due to different observation periods, age, registration quality and completeness of registration. The general effect of inclusion is to reduce survival estimates by a variable amount depending on the proportion of multiple primaries and cancer site.

  19. The validity of recommendations from clinical guidelines: a survival analysis

    PubMed Central

    García, Laura Martínez; Sanabria, Andrea Juliana; Álvarez, Elvira García; Trujillo-Martín, Maria Mar; Etxeandia-Ikobaltzeta, Itziar; Kotzeva, Anna; Rigau, David; Louro-González, Arturo; Barajas-Nava, Leticia; del Campo, Petra Díaz; Estrada, Maria-Dolors; Solà, Ivan; Gracia, Javier; Salcedo-Fernandez, Flavia; Lawson, Jennifer; Haynes, R. Brian; Alonso-Coello, Pablo

    2014-01-01

    Background: Clinical guidelines should be updated to maintain their validity. Our aim was to estimate the length of time before recommendations become outdated. Methods: We used a retrospective cohort design and included recommendations from clinical guidelines developed in the Spanish National Health System clinical guideline program since 2008. We performed a descriptive analysis of references, recommendations and resources used, and a survival analysis of recommendations using the Kaplan–Meier method. Results: We included 113 recommendations from 4 clinical guidelines with a median of 4 years since the most recent search (range 3.9–4.4 yr). We retrieved 39 136 references (range 3343–14 787) using an exhaustive literature search, 668 of which were related to the recommendations in our sample. We identified 69 (10.3%) key references, corresponding to 25 (22.1%) recommendations that required updating. Ninety-two percent (95% confidence interval 86.9–97.0) of the recommendations were valid 1 year after their development. This probability decreased at 2 (85.7%), 3 (81.3%) and 4 years (77.8%). Interpretation: Recommendations quickly become outdated, with 1 out of 5 recommendations being out of date after 3 years. Waiting more than 3 years to review a guideline is potentially too long. PMID:25200758

  20. Adoptive TIL Transfer in the Adjuvant Setting for Melanoma: Long-Term Patient Survival

    PubMed Central

    Khammari, Amir; Knol, Anne-Chantal; Nguyen, Jean-Michel; Bossard, Céline; Denis, Marc-Guillaume; Pandolfino, Marie-Christine; Quéreux, Gaëlle; Bercegeay, Sylvain; Dréno, Brigitte

    2014-01-01

    Two first analyses of our clinical trial on TIL as adjuvant therapy for melanoma were published in 2002 and 2007. We present here an update of the clinical results after a 17-year median followup. In this trial, disease-free patients were randomly assigned to receive either TIL/IL-2 or IL-2. The relapse-free survival (RFS) was the primary objective. Eighty-eight patients were enrolled. A new analysis performed in May 2013 did not show significant changes in RFS or OS duration. However, our first finding on the association between the number of invaded lymph nodes and TIL effectiveness was strengthened. The Cox model adjusted on this interaction showed for the first time a significant treatment effect when considering the overall population, both on the RFS and OS. Patients treated with TIL had a longer RFS (P = 0.023) or OS (P = 0.020). This study being with a very long followup (17 years), confirmed the association between TIL effectiveness and the number of invaded lymph nodes, indicating that a low tumor burden could be a crucial factor enhancing the curative effect of TIL in possible microscopic residual disease. Moreover, we confirmed that a prolonged survival was associated with the presence of specific TIL and a decrease in Foxp3 expression. PMID:24741578

  1. Risk Factors of Anastomotic Leakage and Long-Term Survival After Colorectal Surgery

    PubMed Central

    Park, Jong Seob; Huh, Jung Wook; Park, Yoon Ah; Cho, Yong Beom; Yun, Seong Hyeon; Kim, Hee Cheol; Lee, Woo Yong

    2016-01-01

    Abstract Anastomotic leakage (AL) is one of the most serious complications of colorectal surgery. It can affect long-term oncologic outcomes, but the impact on long-term survival remains uncertain. The aim of this study is to evaluate the operative characteristics of leakage and no leakage groups and to analyze long-term oncologic outcomes. We prospectively enrolled 10,477 patients from 2000 to 2011 and retrospectively reviewed the data. Male sex (odds ratio [OR], 3.90; P < 0.001), intraoperative transfusion (OR, 2.31; P = 0.042), and operative time (OR, 1.73; P = 0.032) were independent risk factors of AL in the colon. In the rectum, male sex (OR, 2.37; P < 0.001), neoadjuvant chemoradiotherapy (OR, 2.26; P < 0.001), and regional lymph node metastasis (OR, 1.43; P = 0.012) were independent risk factors of AL, and diverting stoma (OR, 0.24; P < 0.001) was associated with a deceased risk of AL. AL in the rectum without a diverting stoma was associated with disease-free survival (DFS, OR, 1.47; P = 0.037). Colonic leakage was not associated with 5-year DFS (leakage group vs nonleakage group, 72.4% vs 80.9%, P = 0.084); however, in patients undergoing rectal resection, there was a significant difference in 5-year DFS (67.0% vs 76.6%, P = 0.005, respectively). AL in the rectum is associated with worse long-term DFS and overall survival. A diverting stoma was shown to protect against this effect and was associated with long-term survival in rectal surgery. Therefore, creating a diverting stoma should be considered in high-risk patients undergoing rectal surgery. PMID:26937928

  2. Circulating tumor cells, disease recurrence and survival in newly diagnosed breast cancer

    PubMed Central

    2012-01-01

    Introduction The presence of circulating tumor cells (CTC) is an independent prognostic factor for progression-free survival and breast cancer-related death (BRD) for patients with metastatic breast cancer beginning a new line of systemic therapy. The current study was undertaken to explore whether the presence of CTC at the time of diagnosis was associated with recurrence-free survival (RFS) and BRD. Methods In a prospective single center study, CTC were enumerated with the CellSearch system in 30 ml of peripheral blood of 602 patients before undergoing surgery for breast cancer. There were 97 patients with a benign tumor, 101 did not meet the inclusion criteria of which there were 48 patients with DCIS, leaving 404 stage I to III patients. Patients were stratified into unfavorable (CTC ≥1) and favorable (CTC = 0) prognostic groups. Results ≥1 CTC in 30 ml blood was detected in 15 (15%) benign tumors, in 9 DCIS (19%), in 28 (16%) stage I, 32 (18%) stage II and in 16 (31%) patients with stage III. In stage I to III patients 76 (19%) had ≥1 CTC of whom 16 (21.1%) developed a recurrence. In 328 patients with 0 CTC 38 (11.6%) developed a recurrence. Four-year RFS was 88.4% for favorable CTC and 78.9% for unfavorable CTC (P = 0.038). A total of 25 patients died of breast cancer-related causes and 11 (44%) had ≥1 CTC. BRD was 4.3% for favorable and 14.5% for unfavorable CTC (P = 0.001). In multivariate analysis ≥1 CTC was associated with distant disease-free survival, but not for overall recurrence-free survival. CTC, progesterone receptor and N-stage were independent predictors of BRD in multivariate analysis. Conclusions Presence of CTC in breast cancer patients before undergoing surgery with curative intent is associated with an increased risk for breast cancer-related death. PMID:23088337

  3. Risk Factors of Anastomotic Leakage and Long-Term Survival After Colorectal Surgery.

    PubMed

    Park, Jong Seob; Huh, Jung Wook; Park, Yoon Ah; Cho, Yong Beom; Yun, Seong Hyeon; Kim, Hee Cheol; Lee, Woo Yong

    2016-02-01

    Anastomotic leakage (AL) is one of the most serious complications of colorectal surgery. It can affect long-term oncologic outcomes, but the impact on long-term survival remains uncertain. The aim of this study is to evaluate the operative characteristics of leakage and no leakage groups and to analyze long-term oncologic outcomes.We prospectively enrolled 10,477 patients from 2000 to 2011 and retrospectively reviewed the data.Male sex (odds ratio [OR], 3.90; P < 0.001), intraoperative transfusion (OR, 2.31; P = 0.042), and operative time (OR, 1.73; P = 0.032) were independent risk factors of AL in the colon. In the rectum, male sex (OR, 2.37; P < 0.001), neoadjuvant chemoradiotherapy (OR, 2.26; P < 0.001), and regional lymph node metastasis (OR, 1.43; P = 0.012) were independent risk factors of AL, and diverting stoma (OR, 0.24; P < 0.001) was associated with a deceased risk of AL. AL in the rectum without a diverting stoma was associated with disease-free survival (DFS, OR, 1.47; P = 0.037). Colonic leakage was not associated with 5-year DFS (leakage group vs nonleakage group, 72.4% vs 80.9%, P = 0.084); however, in patients undergoing rectal resection, there was a significant difference in 5-year DFS (67.0% vs 76.6%, P = 0.005, respectively).AL in the rectum is associated with worse long-term DFS and overall survival. A diverting stoma was shown to protect against this effect and was associated with long-term survival in rectal surgery. Therefore, creating a diverting stoma should be considered in high-risk patients undergoing rectal surgery. PMID:26937928

  4. Safety and immunogenicity of Vi conjugate vaccines for typhoid fever in adults, teenagers, and 2- to 4-year-old children in Vietnam.

    PubMed

    Kossaczka, Z; Lin, F Y; Ho, V A; Thuy, N T; Van Bay, P; Thanh, T C; Khiem, H B; Trach, D D; Karpas, A; Hunt, S; Bryla, D A; Schneerson, R; Robbins, J B; Szu, S C

    1999-11-01

    The capsular polysaccharide of Salmonella typhi, Vi, is an essential virulence factor and a protective vaccine for people older than 5 years. The safety and immunogenicity of two investigational Vi conjugate vaccines were evaluated in adults, 5- to 14-year-old children, and 2- to 4-year-old children in Vietnam. The conjugates were prepared with Pseudomonas aeruginosa recombinant exoprotein A (rEPA) as the carrier, using either N-succinimidyl-3-(2-pyridyldithio)-propionate (SPDP; Vi-rEPA(1)) or adipic acid dihydrazide (ADH; Vi-rEPA(2)) as linkers. None of the recipients experienced a temperature of >38.5 degrees C or significant local reactions. One injection of Vi-rEPA(2) into adults elicited a geometric mean (GM) increase in anti-Vi immunoglobulin G (IgG) from 9.62 enzyme-linked immunosorbent assay units/ml (EU) to 465 EU at 6 weeks; this level fell to 119 EU after 26 weeks. In the 5- to 14-year-old children, anti-Vi IgG levels at 6 weeks elicited by Vi-rEPA(2), Vi-rEPA(1), and Vi were 169, 22.8, and 18.9 EU, respectively (P = 0.0001 for Vi-rEPA(1) and Vi with respect to Vi-rEPA(2)). At 26 weeks, the anti-Vi IgG levels for recipients of Vi-rEPA(2), Vi-rEPA(1), and Vi were 30.0, 10.8, and 13.4 EU, respectively (P < 0.001 for Vi-rEPA(1) and Vi with respect to Vi-rEPA(2)); all were higher than the preinjection levels (P = 0. 0001). Vi-rEPA(2) also elicited the highest anti-Vi IgM and IgA levels of the three vaccines. In the 2- to 4-year-old children at 6 weeks following the first injection, Vi-rEPA(2) elicited an anti-Vi IgG level of 69.9 EU compared to 28.9 EU for Vi-rEPA(1) (P = 0.0001). Reinjection increased Vi antibody levels from 69.9 to 95.4 EU for Vi-rEPA(2) and from 28.9 to 83.0 EU for Vi-rEPA(1). At 26 weeks, anti-Vi IgG levels remained higher than those at preinjection (30.6 versus 0.18 for Vi-rEPA(2) and 12.8 versus 0.33 for Vi-rEPA(1); P = 0.0001 for both). Vi vaccine is recommended for individuals of 5 years of age or older. In the present study, the GM

  5. Antipsychotic prescribing in care homes before and after launch of a national dementia strategy: an observational study in English institutions over a 4-year period

    PubMed Central

    Szczepura, Ala; Owen, David W; Palmer, Thomas; Muhammad, Tariq; Clark, Michael D

    2016-01-01

    Objectives To assess associations between the launch of the National Dementia Strategy (NDS) and antipsychotic prescribing in long-term residential care (LTC) in England. Setting and participants Retrospective analysis of prescribing patterns in 616 LTC institutions (31 619 residents) following launch of the NDS, using information from electronic medicines management system. Primary and secondary outcome measures Antipsychotic prescribing point prevalence (PP) for all residents in a cross section of LTC settings over a 4-year period following NDS launch. Secondary outcomes included dosages, length of treatment and use of recommended second-generation antipsychotics (SGAs) versus first-generation antipsychotics (FGAs). Associations between facility-level PP values and institutional characteristics, resident demographics were explored. Variations across geographical areas examined. Prescription net ingredient costs calculated. Results No statistically significant difference was observed in overall prescribing rates over the 4-year period (Kolmogorov-Smirnov (KS) test p=0.60), and there was no significant shift towards newer SGAs (KS test p=0.32). Dosages were above the maximum indicated in only 1.3% of cases, but duration of prescribing was excessive in 69.7% of cases. Care homes in the highest prescribing quintile were more likely to be located in a deprived area (rate ratio (Q5/Q1) RR=5.89, 95% CI 4.35 to 7.99), registered for dementia (RR=3.38, 95% CI 3.06 to 3.73) and those in the lowest quintile were more likely to be served by a single general practitioner (GP) practice (RR=0.48; 95% CI 0.37 to 0.63); p<0.001 all. A sixfold variation in PP levels was observed between geographical areas. The average annual expenditure on antipsychotics was £65.6 per person resident (2012 prices). Conclusions The NDS in England was not associated with reduced PP levels or the types of antipsychotic prescribing in care homes. Further research is needed to explore why. Clear

  6. Micronutrient Fortified Milk Improves Iron Status, Anemia and Growth among Children 1–4 Years: A Double Masked, Randomized, Controlled Trial

    PubMed Central

    Sazawal, Sunil; Dhingra, Usha; Dhingra, Pratibha; Hiremath, Girish; Sarkar, Archana; Dutta, Arup; Menon, Venugopal P.; Black, Robert E.

    2010-01-01

    Background Multiple micronutrient deficiencies are highly prevalent among preschool children and often lead to anemia and growth faltering. Given the limited success of supplementation and health education programs, fortification of foods could be a viable and sustainable option. We report results from a community based double-masked, randomized trial among children 1–4 years evaluating the effects of micronutrients (especially of zinc and iron) delivered through fortified milk on growth, anemia and iron status markers as part of a four group study design, running two studies simultaneously. Methods and Findings Enrolled children (n = 633) were randomly allocated to receive either micronutrients fortified milk (MN = 316) or control milk (Co = 317). Intervention of MN milk provided additional 7.8 mg zinc, 9.6 mg iron, 4.2 µg selenium, 0.27 mg copper, 156 µg vitamin A, 40.2 mg vitamin C, and 7.5 mg vitamin E per day (three serves) for one year. Anthropometry was recorded at baseline, mid- and end-study. Hematological parameters were estimated at baseline and end-study. Both groups were comparable at baseline. Compliance was over 85% and did not vary between groups. Compared to children consuming Co milk, children consuming MN milk showed significant improvement in weight gain (difference of mean: 0.21 kg/year; 95% confidence interval [CI] 0.12 to 0.31, p<0.001) and height gain (difference of mean: 0.51 cm/year; 95% CI 0.27 to 0.75, p<0.001). Mean hemoglobin (Hb) (difference of 13.6 g/L; 95% CI 11.1 to 16.0, p<0.001) and serum ferritin levels (difference of 7.9 µg/L; 95% CI 5.4 to 10.5, p<0.001) also improved. Children in MN group had 88% (odds ratio = 0.12, 95% CI 0.08 to 0.20, p<0.001) lower risk of iron deficiency anemia. Conclusions/Significance Milk provides an acceptable and effective vehicle for delivery of specific micronutrients, especially zinc and iron. Micronutrient bundle improved growth and iron status and reduced anemia in children

  7. Antibody Persistence at 1 and 4 Years Following a Single Dose of MenAfriVac or Quadrivalent Polysaccharide Vaccine in Healthy Subjects Aged 2–29 Years

    PubMed Central

    Diallo, Aldiouma; Sow, Samba O.; Idoko, Olubukola T.; Hirve, Siddhivinayak; Findlow, Helen; Preziosi, Marie-Pierre; Elie, Cheryl; Kulkarni, Prasad S.; Parulekar, Varsha; Diarra, Bou; Cheick Haidara, Fadima; Diallo, Fatoumata; Tapia, Milagritos; Akinsola, Adebayo K.; Adegbola, Richard A.; Bavdekar, Ashish; Juvekar, Sanjay; Chaumont, Julie; Martellet, Lionel; Marchetti, Elisa; LaForce, Marc F.; Plikaytis, Brian D.; Enwere, Godwin C.; Tang, Yuxiao; Borrow, Ray; Carlone, George; Viviani, Simonetta

    2015-01-01

    Background. Mass vaccination campaigns of the population aged 1–29 years with 1 dose of group A meningococcal (MenA) conjugate vaccine (PsA-TT, MenAfriVac) in African meningitis belt countries has resulted in the near-disappearance of MenA. The vaccine was tested in clinical trials in Africa and in India and found to be safe and highly immunogenic compared with the group A component of the licensed quadrivalent polysaccharide vaccine (PsACWY). Antibody persistence in Africa and in India was investigated. Methods. A total of 900 subjects aged 2–29 years were followed up for 4 years in Senegal, Mali, and The Gambia (study A). A total of 340 subjects aged 2–10 years were followed up for 1 year in India (study B). In study A, subjects were randomized in a 2:1 ratio, and in study B a 1:1 ratio to receive either PsA-TT or PsACWY. Immunogenicity was evaluated by measuring MenA serum bactericidal antibody (SBA) with rabbit complement and by a group A–specific immunoglobulin G (IgG) enzyme-linked immunosorbent assay. Results. In both studies, substantial SBA decay was observed at 6 months postvaccination in both vaccine groups, although more marked in the PsACWY group. At 1 year and 4 years (only for study A) postvaccination, SBA titers were relatively sustained in the PsA-TT group, whereas a slight increasing trend, more pronounced among the youngest, was observed in the participants aged <18 years in the PsACWY groups. The SBA titers were significantly higher in the PsA-TT group than in the PsACWY group at any time point, and the majority of subjects in the PsA-TT group had SBA titers ≥128 and group A–specific IgG concentrations ≥2 µg/mL at any point in time in both the African and Indian study populations. Conclusions. Four years after vaccination with a single dose of PsA-TT vaccine in Africa, most subjects are considered protected from MenA disease. Clinical Trials Registration. PsA-TT-003 (ISRCTN87739946); PsA-TT-003a (ISRCTN46335400). PMID

  8. Effects of a Specialist-Led, School Physical Education Program on Bone Mass, Structure, and Strength in Primary School Children: A 4-Year Cluster Randomized Controlled Trial.

    PubMed

    Daly, Robin M; Ducher, Gaele; Hill, Briony; Telford, Rohan M; Eser, Prisca; Naughton, Geraldine; Seibel, Markus J; Telford, Richard D

    2016-02-01

    This 4-year cluster randomized controlled trial of 365 boys and 362 girls (mean age 8.1 ± 0.3 years) from grade 2 in 29 primary schools investigated the effects of a specialist-taught physical education (PE) program on bone strength and body composition. All children received 150 min/week of common practice (CP) PE from general classroom teachers but in 13 schools 100 min/week of CP PE was replaced by specialized-led PE (SPE) by teachers who emphasized more vigorous exercise/games combined with static and dynamic postural activities involving muscle strength. Outcome measures assessed in grades 2, 4, and 6 included: total body bone mineral content (BMC), lean mass (LM), and fat mass (FM) by DXA, and radius and tibia (4% and 66% sites) bone structure, volumetric density and strength, and muscle cross-sectional area (CSA) by pQCT. After 4-years, gains in total body BMC, FM, and muscle CSA were similar between the groups in both sexes, but girls in the SPE group experienced a greater gain in total body LM (mean 1.0 kg; 95% CI, 0.2 to 1.9 kg). Compared to CP, girls in the SPE group also had greater gains in cortical area (CoA) and cortical thickness (CoTh) at the mid-tibia (CoA, 5.0% [95% CI, 0.2% to 1.9%]; CoTh, 7.5% [95% CI, 2.4% to 12.6%]) and mid-radius (CoA, 9.3% [95% CI, 3.5% to 15.1%]; CoTh, 14.4% [95% CI, 6.1% to 22.7%]), whereas SPE boys had a 5.2% (95% CI, 0.4% to 10.0%) greater gain in mid-tibia CoTh. These benefits were due to reduced endocortical expansion. There were no significant benefits of SPE on total bone area, cortical density or bone strength at the mid-shaft sites, nor any appreciable effects at the distal skeletal sites. This study indicates that a specialist-led school-based PE program improves cortical bone structure, due to reduced endocortical expansion. This finding challenges the notion that periosteal apposition is the predominant response of bone to loading during the prepubertal and early-pubertal period.

  9. Surviving cancer without compromising aspirations.

    PubMed

    McGregor, Sandra

    2011-07-01

    This short paper is a reflection of how one person coped, survived and grew following numerous metastatic incidences over a 20 year period. Surviving cancer is a complex process but coping with the threat of regular recurrence has required a coping strategy that embraced the disease, set it aside and refused to compromise hopes, dreams and future life. Central to this personal journey has been the need to redefine normality, live with and set aside the fear of future metastases and death and find an answer and meaning in a changing biology, increased morbidity and possible mortality. This paper contends that not compromising the direction of travel and being able to focus on a career has ensured that survival was valuable and valued. A working environment in which students' problems have been immediate has produced different stressors. These have ultimately forced personal worries to be set aside, while living with cancer has become normal and accepted. PMID:21514884

  10. Surviving cancer without compromising aspirations.

    PubMed

    McGregor, Sandra

    2011-07-01

    This short paper is a reflection of how one person coped, survived and grew following numerous metastatic incidences over a 20 year period. Surviving cancer is a complex process but coping with the threat of regular recurrence has required a coping strategy that embraced the disease, set it aside and refused to compromise hopes, dreams and future life. Central to this personal journey has been the need to redefine normality, live with and set aside the fear of future metastases and death and find an answer and meaning in a changing biology, increased morbidity and possible mortality. This paper contends that not compromising the direction of travel and being able to focus on a career has ensured that survival was valuable and valued. A working environment in which students' problems have been immediate has produced different stressors. These have ultimately forced personal worries to be set aside, while living with cancer has become normal and accepted.

  11. [Loeys-Dietz syndrome (TGFβR2 mutation) in a 4-year-old child with thoracic aortic aneurysm].

    PubMed

    De Potter, M-J; Edouard, T; Amadieu, R; Plaisancié, J; Julia, S; Hadeed, K; Hascoët, S; Acar, P; Dulac, Y

    2016-05-01

    Loeys-Dietz syndrome is a rare form of connective tissue disorder, whose clinical features can resemble those of Marfan syndrome, but with a more unpolished appearance. Recently brought out, this pathology remains little known; however, its consequences may be dramatic. We report on the case of a 4-year-old girl followed for a congenital hip dislocation, in which a systematic exam found increased cutaneous elasticity and a bifid uvula, suggesting a connective tissue disorder. Symptoms were unpolished, as the child's height was normal, without any positive cardiac, rheumatological, or ophthalmological family history. Cardiovascular tests found a thoracic aortic aneurysm at the Valsalva sinus (26mm, Z-score=+4.24). A genetic investigation found a TGFβR2 gene mutation, leading to the diagnosis of Loeys-Dietz syndrome type 2. Skeletal damage associated with bifid uvula and/or hypertelorism and an aneurysm of the ascending aorta should guide the genetic investigation to the search for TGF-β vasculopathy such as Loeys-Dietz syndrome.

  12. Lack of physiological responses to hydrocarbon accumulation by Mytilus trossulus after 3-4 years chronic exposure to spilled Exxon Valdez crude oil in Prince William Sound.

    PubMed

    Thomas, R E; Brodersen, C; Carls, M G; Babcock, M; Rice, S D

    1999-01-01

    Mussels, Mytilus trossulus, were sampled in 1992 and 1993 from beaches in Prince William Sound that had been oiled by the Exxon Valdez spill of March, 1989. At some of the oiled beaches, mussels were collected from beds overlying oiled sediments, and from bedrock adjacent to these beds. Mussels were also collected from beaches within the Sound that had not been impacted by the spill. Polynuclear aromatic hydrocarbon (PAH) concentrations in mussel tissue, physiological responses (byssal thread production, condition index, clearance rate, and glycogen content), were determined for each group of mussels. Total PAH concentrations in mussel tissue ranged from 0 to 6 micrograms g-1, and were significantly greater in mussels from oiled beds than those from reference beds. No significant differences were noted in byssal thread production, condition index, clearance rate, or glycogen content between oiled sample sites and reference sites. The lack of physiological response was surprising because mussels in this study were chronically exposed to PAH for 3-4 years, and none of the physiological responses measured appeared to be affected by that exposure. The lack of a physiological response suggests that chronically exposed mussels may develop a physiological tolerance to PAH, but we recognize that these measures may not have been sensitive enough to discriminate response from background noise.

  13. Ventriculo-bipleural shunt as last resort in a 4-year-old child in whom a VP and VA shunt failed.

    PubMed

    Ratliff, Miriam; Unterberg, Andreas; Bächli, Heidi

    2016-03-01

    The authors present the unusual case of a 4-year-old boy who had a complex history of posthemorrhagic hydrocephalus and who underwent more than 40 surgeries related to this condition. In the course of trying to treat his condition, ventriculoperitoneal, ventriculoatrial, and ventriculopleural shunts were inserted and failed. The child presented with a dysfunction of his shunt system. A ventriculopleural shunt was inserted, but within days the patient developed dyspnea as a clinical symptom of pleural effusion that required repeated thoracentesis. A bipleural drainage system was inserted, and no relevant pleural effusions developed during the follow-up period. Although the authors' experience is based on a single case, they do suggest bipleural drainage in patients with clinically relevant pleural effusions when the more common alternatives are not a good choice. Bipleural drainage might particularly be an option in children, who are prone to pleural effusion because of the smaller absorbing pleural surface. The authors reviewed the English-language literature on PubMed dating back to 1952. To their knowledge, this is the only published case in which a patient was treated with a ventriculo-bipleural shunt.

  14. Development of temperamental effortful control mediates the relationship between maturation of the prefrontal cortex and psychopathology during adolescence: a 4-year longitudinal study.

    PubMed

    Vijayakumar, Nandita; Whittle, Sarah; Dennison, Meg; Yücel, Murat; Simmons, Julian; Allen, Nicholas B

    2014-07-01

    This study investigated the relationship between the development of effortful control (EC), a temperamental measure of self-regulation, and concurrent development of three regions of the prefrontal cortex (anterior cingulate cortex, ACC; dorsolateral prefrontal cortex, dlPFC; ventrolateral prefrontal cortex, vlPFC) between early- and mid-adolescence. It also examined whether development of EC mediated the relationship between cortical maturation and emotional and behavioral symptoms. Ninety-two adolescents underwent baseline assessments when they were approximately 12 years old and follow-up assessments approximately 4 years later. At each assessment, participants had MRI scans and completed the Early Adolescent Temperament Questionnaire-Revised, as well as measures of depressive and anxious symptoms, and aggressive and risk taking behavior. Cortical thicknesses of the ACC, dlPFC and vlPFC, estimated using the FreeSurfer software, were found to decrease over time. EC also decreased over time in females. Greater thinning of the left ACC was associated with less reduction in EC. Furthermore, change in effortful control mediated the relationship between greater thinning of the left ACC and improvements in socioemotional functioning, including reductions in psychopathological symptoms. These findings highlight the dynamic association between EC and the maturation of the anterior cingulate cortex, and the importance of this relationship for socioemotional functioning during adolescence.

  15. Chronic Candida albicans Meningitis in a 4-Year-Old Girl with a Homozygous Mutation in the CARD9 Gene (Q295X).

    PubMed

    Herbst, Martin; Gazendam, Roel; Reimnitz, Denise; Sawalle-Belohradsky, Julie; Groll, Andreas; Schlegel, Paul-Gerhardt; Belohradsky, Bernd; Renner, Ellen; Klepper, Jörg; Grimbacher, Bodo; Kuijpers, Taco; Liese, Johannes

    2015-09-01

    A 4-year-old Turkish girl of consanguineous parents was hospitalized for the evaluation of headaches and recurrent febrile episodes of unknown origin. Her medical history was unremarkable except for a few episodes of uncomplicated oral thrush. Meningitis was diagnosed, and Candida albicans was the only pathogen identified by polymerase chain reaction and culture. Despite systemic antifungal multidrug therapy, a prolonged course of 16 months of therapy was necessary to clear C. albicans from the cerebrospinal fluid. Molecular genetic analysis revealed a homozygous caspase recruitment domain 9 (CARD9) mutation (Q295X), which was reported to predispose to chronic mucocutaneous candidiasis. Immunologic workup excluded predisposing B-cell and T-cell defects. In addition, T cells producing interleukin-17 were repeatedly measured within the normal range. Analyses of neutrophils demonstrated normal nicotinamide adenine dinucleotide phosphate oxidase activity in response to various stimuli including Staphylococcus aureus and C. albicans. Additional neutrophilic functional testing, however, showed a decreased cytotoxicity to nonopsonized C. albicans, indicating an impaired killing mechanism against Candida spp. independent from the production of reactive oxygen species by the nicotinamide adenine dinucleotide phosphate oxidase system. Because this defect was only demonstrated in the absence of opsonins, it might especially predispose to chronic C. albicans infections in the central nervous system where opsonin concentrations are usually low. We, therefore, suggest that due to an additional neutrophil dependent defect CARD9 deficiency predisposes not only to chronic mucocutaneous candidiasis, but also to invasive chronic Candida infections, especially of the central nervous system.

  16. The successful treatment of rapidly progressive idiopathic membranoproliferative glomerulo-nephritis Type 1 in a 4-year-old male pediatric patient.

    PubMed

    Fujinaga, S; Ohtomo, Y; Hirano, D; Nishizaki, N; Someya, T; Ohtsuka, Y; Kaneko, K; Shimizu, T

    2010-10-01

    A multivariate analysis [4] revealed that the presence of crescent formation on initial biopsy irrespective of type of membranoproliferative glomerulonephritis (MPGN) was independently associated not only with end-stage renal disease but also with post-transplantation recurrence. In this study, we reported on a 4-year-old male pediatric patient requiring hemodialysis due to rapidly progressive idiopathic MPGN Type 1 with severe nephrotic syndrome and extensive cellular crescent formation on initial biopsy. The patient had been treated intravenously (i.v.) with 9 pulses of methylprednisolone, followed by daily prednisolone, resulting in the withdrawal of dialysis within 1 month. However, since active lesions in the second renal biopsy such as cellular crescents still remained and nephrotic range proteinuria had persisted for more than 2 months, the patient received additional 3 i.v. pulses of methylprednisolone, followed by combinations of alternate-day prednisolone, mizoribine, dipyridamole and warfarin, which lead to complete remission in a short-period of time. The patient has been off the combination therapy for 10 months because the third biopsy prior to the termination of this regimen showed decreased inflammatory activity. There is currently no established protocol for children with crescentic MPGN due to a rarity of its clinicopathological presentation. This case report indicates that early treatment with multiple pulses of methylprednisolone followed by the short-term combination therapy may be of benefit for children with rapidly progressive idiopathic MPGN Type 1, even when both diffuse crescentic changes and nephrotic syndrome are present at onset.

  17. Reading faces: differential lateral gaze bias in processing canine and human facial expressions in dogs and 4-year-old children.

    PubMed

    Racca, Anaïs; Guo, Kun; Meints, Kerstin; Mills, Daniel S

    2012-01-01

    Sensitivity to the emotions of others provides clear biological advantages. However, in the case of heterospecific relationships, such as that existing between dogs and humans, there are additional challenges since some elements of the expression of emotions are species-specific. Given that faces provide important visual cues for communicating emotional state in both humans and dogs, and that processing of emotions is subject to brain lateralisation, we investigated lateral gaze bias in adult dogs when presented with pictures of expressive human and dog faces. Our analysis revealed clear differences in laterality of eye movements in dogs towards conspecific faces according to the emotional valence of the expressions. Differences were also found towards human faces, but to a lesser extent. For comparative purpose, a similar experiment was also run with 4-year-old children and it was observed that they showed differential processing of facial expressions compared to dogs, suggesting a species-dependent engagement of the right or left hemisphere in processing emotions.

  18. Lack of physiological responses to hydrocarbon accumulation by Mytilus trossulus after 3-4 years chronic exposure to spilled Exxon Valdez crude oil in Prince William Sound.

    PubMed

    Thomas, R E; Brodersen, C; Carls, M G; Babcock, M; Rice, S D

    1999-01-01

    Mussels, Mytilus trossulus, were sampled in 1992 and 1993 from beaches in Prince William Sound that had been oiled by the Exxon Valdez spill of March, 1989. At some of the oiled beaches, mussels were collected from beds overlying oiled sediments, and from bedrock adjacent to these beds. Mussels were also collected from beaches within the Sound that had not been impacted by the spill. Polynuclear aromatic hydrocarbon (PAH) concentrations in mussel tissue, physiological responses (byssal thread production, condition index, clearance rate, and glycogen content), were determined for each group of mussels. Total PAH concentrations in mussel tissue ranged from 0 to 6 micrograms g-1, and were significantly greater in mussels from oiled beds than those from reference beds. No significant differences were noted in byssal thread production, condition index, clearance rate, or glycogen content between oiled sample sites and reference sites. The lack of physiological response was surprising because mussels in this study were chronically exposed to PAH for 3-4 years, and none of the physiological responses measured appeared to be affected by that exposure. The lack of a physiological response suggests that chronically exposed mussels may develop a physiological tolerance to PAH, but we recognize that these measures may not have been sensitive enough to discriminate response from background noise. PMID:10190040

  19. Reading faces: differential lateral gaze bias in processing canine and human facial expressions in dogs and 4-year-old children.

    PubMed

    Racca, Anaïs; Guo, Kun; Meints, Kerstin; Mills, Daniel S

    2012-01-01

    Sensitivity to the emotions of others provides clear biological advantages. However, in the case of heterospecific relationships, such as that existing between dogs and humans, there are additional challenges since some elements of the expression of emotions are species-specific. Given that faces provide important visual cues for communicating emotional state in both humans and dogs, and that processing of emotions is subject to brain lateralisation, we investigated lateral gaze bias in adult dogs when presented with pictures of expressive human and dog faces. Our analysis revealed clear differences in laterality of eye movements in dogs towards conspecific faces according to the emotional valence of the expressions. Differences were also found towards human faces, but to a lesser extent. For comparative purpose, a similar experiment was also run with 4-year-old children and it was observed that they showed differential processing of facial expressions compared to dogs, suggesting a species-dependent engagement of the right or left hemisphere in processing emotions. PMID:22558335

  20. Health-related quality of life in posttraumatic stress disorder: 4 years follow-up study of individuals exposed to urban violence.

    PubMed

    Pupo, Mariana Cadrobbi; Serafim, Paula Maria; de Mello, Marcelo Feijó

    2015-08-30

    Evidence suggests that Posttraumatic Stress Disorder (PTSD) is associated with substantially reduced Health-related quality of life (HRQoL). This study aimed to explore the impact of PTSD symptoms in HRQoL and its predictors in individuals exposed to urban violence. We follow-up a cohort of 267 individuals exposed to urban violence, derived from an epidemiological survey and clinical cases from an outpatient program of victims of violence, with and without PTSD, by assessing symptoms and other measures at two intervals, approximately 4 years apart. PTSD symptom severity was associated with poorer quality of life at baseline and at follow-up. Higher levels of depression and anxiety, new trauma experiences, more traumas in childhood and more PTSD arousal symptoms were all predictors of lower HRQoL over time. Results strongly suggest the need to assess HRQoL in addition to symptoms in order to assess the true severity of PTSD. These results have implications for the functional recovery in the treatment of PTSD.

  1. Short Sleep Duration in the First Years of Life and Obesity/Overweight at Age 4 Years: A Birth Cohort Study

    PubMed Central

    Halal, Camila S.E.; Matijasevich, Alicia; Howe, Laura D.; Santos, Iná S.; Barros, Fernando C.; Nunes, Magda L.

    2016-01-01

    Objective To investigate whether short sleep duration from the first year of life influenced weight at an early age. Study design During 2004, children born in Pelotas, Brazil, were enrolled in a cohort study. Sleeping habits during the previous 2 weeks were assessed, and the children were weighed and measured at 1-, 2-, and 4-year follow-ups. Overweight and obesity at 4 years were defined according to World Health Organization z-scores for body mass index for age. Short sleep duration was defined as fewer than 10 hours of sleep per night at any follow-up. Results Out of the 4263 live births, 4231 were recruited. The prevalence of short sleep duration at any follow-up from 1-4 years of age was 10.1%. At 4 years of age, 201 children were obese (5.3%), and 302 (8%) were overweight. Among short sleepers, the prevalence ratio for overweight/obesity after adjusting for maternal and children's characteristics was 1.32 (1.03; 1.70). Conclusions Children who slept for fewer than 10 hours per night at any follow-up from 1-4 years of age were more likely to be overweight or obese at 4 years of age, despite their sociodemographic and sleep characteristics. PMID:26541426

  2. Imitation as a mechanism in cognitive development: a cross-cultural investigation of 4-year-old children’s rule learning

    PubMed Central

    Wang, Zhidan; Williamson, Rebecca A.; Meltzoff, Andrew N.

    2015-01-01

    Children learn about the social and physical world by observing other people’s acts. This experiment tests both Chinese and American children’s learning of a rule. For theoretical reasons we chose the rule of categorizing objects by the weight. Children, age 4 years, saw an adult heft four visually-identical objects and sort them into two bins based on an invisible property—the object’s weight. Children who saw this categorization behavior were more likely to sort those objects by weight than were children who saw control actions using the same objects and the same bins. Crucially, children also generalized to a novel set of objects with no further demonstration, suggesting rule learning. We also report that high-fidelity imitation of the adult’s “hefting” acts may give children crucial experience with the objects’ weights, which could then be used to infer the more abstract rule. The connection of perception, action, and cognition was found in children from both cultures, which leads to broad implications for how the imitation of adults’ acts functions as a lever in cognitive development. PMID:26029132

  3. Compensation for a lip-tube perturbation in 4-year-olds: Articulatory, acoustic, and perceptual data analyzed in comparison with adults.

    PubMed

    Ménard, Lucie; Perrier, Pascal; Aubin, Jérôme

    2016-05-01

    The nature of the speech goal in children was investigated in a study of compensation strategies for a lip-tube perturbation. Acoustic, articulatory, and perceptual analyses of the vowels /y/ and /u/ produced by ten 4-year-old French speakers and ten adult French speakers were conducted under two conditions: normal and with a large tube inserted between the lips. Ultrasound and acoustic recordings of isolated vowels were made in the normal condition before any perturbation, for each of the trials in the perturbed condition, and in the normal condition after the perturbed trials. Data revealed that adult participants moved their tongues in the perturbed condition more than children did. The perturbation was generally at least partly compensated for during the perturbed trials in adults, but children did not show a typical learning effect. In particular, unsystematic improvements were observed during the sequence of perturbed trials, and after-effects were not clear in the articulatory domain. This suggests that children may establish associative links between multisensory phonemic representations and articulatory maneuvers, but those links may mainly rely on trial-to-trial, error-based feedback correction mechanisms rather than on the internal model of the speech production apparatus, as they are in adults. PMID:27250147

  4. Acute VI nerve palsy in a 4 year-old girl with Chiari I malformation and pontomedullary extension of syringomyelia: case report and review of the literature.

    PubMed

    Massey, Shavonne L; Buland, Justin; Hauber, Stacey; Piatt, Joseph; Goraya, Jatinder; Faerber, Eric; Valencia, Ignacio

    2011-07-01

    We report the case of a previously healthy 4 year-old African American female who presented to the emergency department with acute onset of unilateral abducens nerve palsy and torticollis. Within 12 h of presentation, the patient's symptoms progressed to include ipsilateral facial nerve palsy and gait ataxia. On exam, the patient demonstrated right cranial nerve VI and VII palsies, ataxic gait with left lateropulsion, spasticity of bilateral lower extremities with clonus, and the presence of bilateral Babinski sign. MRI of the brain and spinal cord revealed severe Chiari I malformation with associated extensive holochord syringomyelia and syringobulbia. The patient underwent successful surgical decompression 72 h after initial presentation. We review the literature on Chiari malformations and syringomyelia, including epidemiology, presentation and neurological manifestations, and treatment recommendations. As our patient had a very acute presentation, we additionally review the previously reported cases of acute and atypical presentation of patients with Chiari I malformation and syringomyelia. The aim of this report is to make practitioners aware of the acuteness with which children with Chiari malformation type I with syringomyelia and syringobulbia can present.

  5. Does the Age and Familiarity of the Informant Group Influence the Tendency of 3- and 4-year-old Children to Conform?

    PubMed

    McGuigan, Nicola; Stevenson, Amy

    2016-01-01

    The authors' aim was to explore whether the age and the familiarity of the individuals comprising a group majority influenced the tendency of 3- and 4-year-old children to conform. Participants were presented with 2 variants of a novel task in which they were required to judge which of 3 line-drawn tigers had the greatest number of stripes. The participants made their judgments in 2 contexts, first after viewing 5 informants perform the task incorrectly, and second without viewing the responses of other individuals. The informants comprised a group of familiar children, a group of unfamiliar children, a group of familiar adults, or a group of unfamiliar adults. The results showed that the children displayed selective conformity with respect to informant age, readily adopting the incorrect response when it was indicated by an adult majority, but failing to do so when the same incorrect response was indicated by a majority of children. In contrast the familiarity of the individuals comprising the majority had little influence on the tendency of children to conform. These results suggest that children are not blanket conformists, rather they respond selectively depending on characteristics of the individuals comprising the group majority. PMID:27341477

  6. Compensation for a lip-tube perturbation in 4-year-olds: Articulatory, acoustic, and perceptual data analyzed in comparison with adults.

    PubMed

    Ménard, Lucie; Perrier, Pascal; Aubin, Jérôme

    2016-05-01

    The nature of the speech goal in children was investigated in a study of compensation strategies for a lip-tube perturbation. Acoustic, articulatory, and perceptual analyses of the vowels /y/ and /u/ produced by ten 4-year-old French speakers and ten adult French speakers were conducted under two conditions: normal and with a large tube inserted between the lips. Ultrasound and acoustic recordings of isolated vowels were made in the normal condition before any perturbation, for each of the trials in the perturbed condition, and in the normal condition after the perturbed trials. Data revealed that adult participants moved their tongues in the perturbed condition more than children did. The perturbation was generally at least partly compensated for during the perturbed trials in adults, but children did not show a typical learning effect. In particular, unsystematic improvements were observed during the sequence of perturbed trials, and after-effects were not clear in the articulatory domain. This suggests that children may establish associative links between multisensory phonemic representations and articulatory maneuvers, but those links may mainly rely on trial-to-trial, error-based feedback correction mechanisms rather than on the internal model of the speech production apparatus, as they are in adults.

  7. Survival of Sami cancer patients

    PubMed Central

    Soininen, Leena; Pokhrel, Arun; Dyba, Tadek; Pukkala, Eero; Hakulinen, Timo

    2012-01-01

    Objectives The incidence of cancer among the indigenous Sami people of Northern Finland is lower than among the Finnish general population. The survival of Sami cancer patients is not known, and therefore it is the object of this study. Study design The cohort consisted of 2,091 Sami and 4,161 non-Sami who lived on 31 December 1978 in the two Sami municipalities of Inari and Utsjoki, which are located in Northern Finland and are 300–500 km away from the nearest central hospital. The survival experience of Sami and non-Sami cancer patients diagnosed in this cohort during 1979–2009 was compared with that of the Finnish patients outside the cohort. Methods The Sami and non-Sami cancer patients were matched to other Finnish cancer patients for gender, age and year of diagnosis and for the site of cancer. An additional matching was done for the stage at diagnosis. Cancer-specific survival analyses were made using the Kaplan–Meier method and Cox regression modelling. Results There were 204 Sami and 391 non-Sami cancer cases in the cohort, 20,181 matched controls without matching with stage, and 7,874 stage-matched controls. In the cancer-specific analysis without stage variable, the hazard ratio for Sami was 1.05 (95% confidence interval 0.85–1.30) and for non-Sami 1.02 (0.86–1.20), indicating no difference between the survival of those groups and other patients in Finland. Likewise, when the same was done by also matching the stage, there was no difference in cancer survival. Conclusion Long distances to medical care or Sami ethnicity have no influence on the cancer patient survival in Northern Finland. PMID:22765936

  8. The Women's Guide to Surviving Graduate School. Graduate Survival Skills.

    ERIC Educational Resources Information Center

    Rittner, Barbara; Trudeau, Patricia

    This guidebook offers advice to women students on surviving and thriving in graduate school. It takes the reader from the graduate school selection process to completing the program successfully. Written in a informal style, the 11 chapters include: (1) "Should You Go to Graduate School?" (pros and cons of attending graduate school, deciding what…

  9. Survival analysis and neural nets.

    PubMed

    Liestøl, K; Andersen, P K; Andersen, U

    1994-06-30

    We consider feed-forward neural nets and their relation to regression models for survival data. We show how the back-propagation algorithm may be used to obtain maximum likelihood estimates in certain standard regression models for survival data, as well as in various generalizations of these. Examples concerning malignant melanoma and post-partum amenorrhoea during lactation are used as illustration. We conclude that although problems with the substantial number of parameters and their interpretation remain, the feed-forward neural network models are flexible extensions to the standard regression models and thereby candidates for use in prediction and exploratory analyses in larger data sets.

  10. Campylobacter virulence and survival factors.

    PubMed

    Bolton, Declan J

    2015-06-01

    Despite over 30 years of research, campylobacteriosis is the most prevalent foodborne bacterial infection in many countries including in the European Union and the United States of America. However, relatively little is known about the virulence factors in Campylobacter or how an apparently fragile organism can survive in the food chain, often with enhanced pathogenicity. This review collates information on the virulence and survival determinants including motility, chemotaxis, adhesion, invasion, multidrug resistance, bile resistance and stress response factors. It discusses their function in transition through the food processing environment and human infection. In doing so it provides a fundamental understanding of Campylobacter, critical for improved diagnosis, surveillance and control.

  11. A nomogram that predicts pathologic complete response to neoadjuvant chemoradiation also predicts survival outcomes after definitive chemoradiation for esophageal cancer

    PubMed Central

    Wang, Jingya; Allen, Pamela K.; Correa, Arlene M.; Maru, Dipen M.; Swisher, Stephen G.; Hofstetter, Wayne L.; Liao, Zhongxing; Ajani, Jaffer A.

    2015-01-01

    Background Pathologic complete response (pCR) to neoadjuvant chemoradiation for esophageal cancer is associated with improved outcomes. We evaluated whether a nomogram designed to predict who would have a pCR after trimodality therapy could also predict outcome after definitive chemoradiation. Methods Patients in this retrospective, single-institution analysis had received chemoradiation without surgery for esophageal cancer from 1998 through 2010; 333 such patients had complete information on all variables required for the pCR nomogram: sex; T status (by endoscopic sonography); tumor grade; tumor avidity on positron emission tomography (PET); and esophagogastroduodenoscopy (EGD)-directed biopsy results after chemoradiation. We used multivariate Cox regression to test potential associations between clinical outcomes [overall survival (OS), locoregional recurrence, and distant metastasis] and patient or treatment factors and the pCR nomogram score; the component variables of the nomogram were not reintroduced into the multivariate analysis. Results The median follow-up time for all patients (median age 66 years) was 18.2 months (30.7 months for those alive at the time of analysis). Patients with nomogram scores ≤125 (median for all patients) had significantly worse outcomes than patients with scores >125: median OS time 19.7 vs. 48.2 months; disease-free survival (DFS) time 6.1 vs. 31.1 months; locoregional failure-free survival time 17.7 months vs. not reached; and distant metastasis-free survival time 11.7 months vs. not reached (all P<0.001). Multivariate Cox regression analysis indicated that nomogram score independently predicted each survival outcome, along with other patient and disease factors. Conclusions The pCR nomogram score predicted survival outcomes in patients receiving definitive chemoradiation for esophageal cancer. Although this nomogram requires further validation, it may prove useful for stratifying patients for clinical trials designed to

  12. Temporal and spatial variation in age-specific survival rates of a long-lived mammal, the Hawaiian monk seal.

    PubMed

    Baker, Jason D; Thompson, Paul M

    2007-02-01

    Estimates of variability in pinniped survival rates are generally based on observations at single sites, so it is not certain whether observed rates represent the whole population. Here, we provide a comprehensive analysis of spatio-temporal variation in age-specific survival rates for endangered Hawaiian monk seals (Monachus schauinslandi) based on capture-recapture analyses of more than 85% of the pups weaned in this population over the last two decades. Uniquely, these data have been collected from six subpopulations, encompassing all major breeding sites across its 1800 km long core range. Analyses of individual subpopulations revealed similar patterns in age-specific survival, characterized by the relatively low survival rates from weaning to 2 years of age, intermediate rates to 4 years of age, and then by relatively high 'mature' survival rates until 17 years of age, after which a senescent decline was observed. Juvenile, subadult and adult survival rates all varied significantly over time. Trends in survival among subpopulations were coherent with their relative geographical positions, suggesting regional structuring and connectedness within the archipelago. Survival rates for different age classes tended to be positively correlated, suggesting that similar factors may influence the survival for seals of all ages. PMID:17164205

  13. Effects of forest management on density, survival, and population growth of wood thrushes

    USGS Publications Warehouse

    Powell, L.A.; Lang, J.D.; Conroy, M.J.; Krementz, D.G.

    2000-01-01

    Loss and alteration of breeding habitat have been proposed as causes of declines in several Neotropical migrant bird populations. We conducted a 4-year study to determine the effects of winter prescribed burning and forest thinning on breeding wood thrush (Hylocichla mustelina) populations at the Piedmont National Wildlife Refuge (PNWR) in Georgia. We estimated density, adult and juvenile survival rates, and apparent annual survival using transect surveys, radiotelemetry, and mist netting. Burning and thinning did not cause lower densities (P = 0.25); wood thrush density ranged from 0.15 to 1.30 pairs/10 ha. No radiomarked male wood thrushes (n = 68) died during the 4 years, but female (n = 63) weekly survival was 0.981 ? 0.014 (SE) for females (n = 63) and 0.976 ? 0.010 for juveniles (n = 38). Apparent annual adult survival was 0.579 (SE = 0.173). Thinning and prescribed burning did not reduce adult or juvenile survival during the breeding season or apparent annual adult survival. Annual population growth (lambda) at PNWR was 1.00 (95% confidence interval = 0.32--1.63), and the considerable uncertainty in this prediction underscores the need for long term monitoring to effectively manage Neotropical migrants. Population growth increased on experimental compartments after the burn and thin (95% CI before = 0.91--0.97, after = 0.98--1.05), while control compartment declined (before = 0.98--1.05, after = 0.87--0.92). We found no evidence that the current management regime at PNWR, designed to improve red-cockaded woodpecker (Picoides borealis) habitat, negatively affected wood thrushes.

  14. Ets-1 messenger RNA expression is a novel marker of poor survival in ovarian carcinoma.

    PubMed

    Davidson, B; Reich, R; Goldberg, I; Gotlieb, W H; Kopolovic, J; Berner, A; Ben-Baruch, G; Bryne, M; Nesland, J M

    2001-03-01

    Ets-1 proto-oncogene is a transcription factor involved in several cellular functions, including the activation of several proteases participating in tumor invasion and metastasis. The objective of this study was to analyze the possible correlation between Ets-1 mRNA expression and survival in advanced-stage ovarian carcinomas, studying two patient groups with extremely different disease outcome. Sections from 66 primary ovarian carcinomas and metastatic lesions from 41 patients diagnosed with advanced-stage ovarian carcinoma (International Federation of Gynecologists and Obstetricians stages III and IV) were evaluated for expression of Ets-1 using mRNA in situ hybridization. Patients were divided into long-term (n = 17) and short-term (n = 24) survivors. The mean values for disease-free survival and overall survival were 116 and 133 months for long-term survivors, as compared to 3 and 21 months for short-term survivors, respectively. Expression of Ets-1 mRNA was detected in carcinoma cells and stromal cells in 28 of 66 (42%) and 22 of 66 (33%) lesions, respectively. Ets-1 expression showed an association with mRNA expression of vascular endothelial growth factor (P = 0.001 for carcinoma cells; P = 0.004 for stromal cells), basic fibroblast growth factor (P = 0.049 for carcinoma cells), and membrane type-1 matrix metalloproteinase (P = 0.045), which were previously studied in this patient cohort. Ets-1 mRNA was detected more often in both carcinoma and stromal cells in tumors of short-term survivors (P = 0.038 for carcinoma cells). In univariate survival analysis for all cases, Ets-1 expression in both tumor (P = 0.018) and stroma (P = 0.026) correlated with poor survival. These findings were reproduced in an analysis of primary tumors alone (P = 0.039 for tumor cells; P < 0.001 for stromal cells). Ets-1 mRNA expression in stromal cells retained its predictive power in a multivariate survival analysis in which all molecules studied previously in this patient cohort

  15. Reading As a Survival Skill.

    ERIC Educational Resources Information Center

    Blosser, Patricia E.

    1980-01-01

    Described is a technique for the development of survival reading activity packets for the science classroom. The reading packets described include labels from different food and medicine products and from magazine and newspaper articles. Three types of questions were used with each packet: factual, interpretive, and application. (DS)

  16. Wilderness Emergency: Surviving the Unexpected.

    ERIC Educational Resources Information Center

    Fear, Gene

    In any unexpected survival experience, one must accept the situation with just what one has at the moment it happens, where it happens, and how it happens. Problem solving must be based on known body enemies that threaten life, their priority of influence, and their severity of threat to life. Solutions will depend on the body's energy supply,…

  17. Wilderness Survival and Outdoor Education.

    ERIC Educational Resources Information Center

    Ball, Matt

    Outdoor education is often delivered through games and activities such as nature hikes or observing an ecosystem within a 1-foot circle on the ground. Often, participants look closely at the earth only for that brief moment. Wilderness survival is another way to teach about the outdoors. It offers skills that encourage participants to become more…

  18. Cool echidnas survive the fire.

    PubMed

    Nowack, Julia; Cooper, Christine Elizabeth; Geiser, Fritz

    2016-04-13

    Fires have occurred throughout history, including those associated with the meteoroid impact at the Cretaceous-Palaeogene (K-Pg) boundary that eliminated many vertebrate species. To evaluate the recent hypothesis that the survival of the K-Pg fires by ancestral mammals was dependent on their ability to use energy-conserving torpor, we studied body temperature fluctuations and activity of an egg-laying mammal, the echidna (Tachyglossus aculeatus), often considered to be a 'living fossil', before, during and after a prescribed burn. All but one study animal survived the fire in the prescribed burn area and echidnas remained inactive during the day(s) following the fire and substantially reduced body temperature during bouts of torpor. For weeks after the fire, all individuals remained in their original territories and compensated for changes in their habitat with a decrease in mean body temperature and activity. Our data suggest that heterothermy enables mammals to outlast the conditions during and after a fire by reducing energy expenditure, permitting periods of extended inactivity. Therefore, torpor facilitates survival in a fire-scorched landscape and consequently may have been of functional significance for mammalian survival at the K-Pg boundary. PMID:27075255

  19. Top 10 Staff Survival Tips.

    ERIC Educational Resources Information Center

    O'Brien, Laurie

    1995-01-01

    Tips for camp staff on how to survive summer camp include not giving campers sugary drinks before bedtime, setting behavior limits with campers, setting an example by following camp rules, getting enough rest, being fair and consistent, controlling anger, being accountable for actions, asking questions, and being flexible. (LP)

  20. Corticosteroids compromise survival in glioblastoma.

    PubMed

    Pitter, Kenneth L; Tamagno, Ilaria; Alikhanyan, Kristina; Hosni-Ahmed, Amira; Pattwell, Siobhan S; Donnola, Shannon; Dai, Charles; Ozawa, Tatsuya; Chang, Maria; Chan, Timothy A; Beal, Kathryn; Bishop, Andrew J; Barker, Christopher A; Jones, Terreia S; Hentschel, Bettina; Gorlia, Thierry; Schlegel, Uwe; Stupp, Roger; Weller, Michael; Holland, Eric C; Hambardzumyan, Dolores

    2016-05-01

    Glioblastoma is the most common and most aggressive primary brain tumour. Standard of care consists of surgical resection followed by radiotherapy and concomitant and maintenance temozolomide (temozolomide/radiotherapy→temozolomide). Corticosteroids are commonly used perioperatively to control cerebral oedema and are frequently continued throughout subsequent treatment, notably radiotherapy, for amelioration of side effects. The effects of corticosteroids such as dexamethasone on cell growth in glioma models and on patient survival have remained controversial. We performed a retrospective analysis of glioblastoma patient cohorts to determine the prognostic role of steroid administration. A disease-relevant mouse model of glioblastoma was used to characterize the effects of dexamethasone on tumour cell proliferation and death, and to identify gene signatures associated with these effects. A murine anti-VEGFA antibody was used in parallel as an alternative for oedema control. We applied the dexamethasone-induced gene signature to The Cancer Genome Atlas glioblastoma dataset to explore the association of dexamethasone exposure with outcome. Mouse experiments were used to validate the effects of dexamethasone on survival in vivo Retrospective clinical analyses identified corticosteroid use during radiotherapy as an independent indicator of shorter survival in three independent patient cohorts. A dexamethasone-associated gene expression signature correlated with shorter survival in The Cancer Genome Atlas patient dataset. In glioma-bearing mice, dexamethasone pretreatment decreased tumour cell proliferation without affecting tumour cell viability, but reduced survival when combined with radiotherapy. Conversely, anti-VEGFA antibody decreased proliferation and increased tumour cell death, but did not affect survival when combined with radiotherapy. Clinical and mouse experimental data suggest that corticosteroids may decrease the effectiveness of treatment and shorten