Science.gov

Sample records for 5-year actuarial survival

  1. Prediction of 5-Year Survival with Data Mining Algorithms.

    PubMed

    Sailer, Fabian; Pobiruchin, Monika; Bochum, Sylvia; Martens, Uwe M; Schramm, Wendelin

    2015-01-01

    Survival time prediction at the time of diagnosis is of great importance to make decisions about treatment and long-term follow-up care. However, predicting the outcome of cancer on the basis of clinical information is a challenging task. We now examined the ability of ten different data mining algorithms (Perceptron, Rule Induction, Support Vector Machine, Linear Regression, Naïve Bayes, Decision Tree, k-nearest Neighbor, Logistic Regression, Neural Network, Random Forest) to predict the dichotomous attribute "5-year-survival" based on seven attributes (sex, UICC-stage, etc.) which are available at the time of diagnosis. For this study we made use of the nationwide German research data set on colon cancer provided by the Robert Koch Institute. To assess the results a comparison between data mining algorithms and physicians' opinions was performed. Therefore, physicians guessed the survival time by leveraging the same seven attributes. The average accuracy of the physicians' opinion was 59%, the average accuracy of the machine learning algorithms was 67.7%. PMID:26152957

  2. SVI implantation for carcinoma of the prostate: 5-year survival free of disease and incidence of local failure

    SciTech Connect

    Schellhammer, P.F.; el-Mahdi, A.E.; Ladaga, L.E.; Schultheiss, T.

    1985-12-01

    Interstitial implantation with the iodine isotope, SVI has been used as definitive treatment in 115 patients with localized carcinoma of the prostate. The disease was staged surgically by bilateral pelvic lymphadenectomy in all of the patients. Followup has been for a minimum of 1 year and 64 patients have been followed for a minimum of 5 years. There has been no operative mortality in this series. Mean patient age at implantation was 63 years. Potency has been maintained in 31 of 46 patients (78 per cent) followed for a minimum of 5 years and 15 of 26 (58 per cent) followed for a minimum of 7 years. At 5 years the actuarial survival free of disease by surgical stage was 100, 81, 49 and 41 per cent for patients with stages A2, B, C and D1 disease, respectively. Local failure was defined as palpable evidence of prostatic enlargement or irregularity with biopsy confirmation of neoplasm. The actuarial probability of local failure at 5 years was 0, 13, 27 and 44 per cent for patients with surgical stages A2, B, C and D1 disease, respectively, and 5, 23 and 43 per cent for those with well, moderately and poorly differentiated tumors, respectively. Based on our experience, interstitial implantation with SVI is reserved for patients with well or moderately differentiated stage B lesions. The ultimate success of this treatment modality awaits 10 and 15 years of followup.

  3. Survival Rate of Short, Locking Taper Implants with a Plateau Design: A 5-Year Retrospective Study

    PubMed Central

    Demiralp, Kemal Özgür; Akbulut, Nihat; Kursun, Sebnem; Argun, Didem; Bagis, Nilsun; Orhan, Kaan

    2015-01-01

    Background. Short implants have become popular in the reconstruction of jaws, especially in cases with limited bone height. Shorter implants, those with locking tapers and plateau root shapes, tend to have longer survival times. We retrospectively investigated the cumulative survival rates of Bicon short implants (<8 mm) according to patient variables over a 5-year period. Materials and Methods. This study included 111 consecutively treated patients with 371 implants supporting fixed or removable prosthetics. Data were evaluated to acquire cumulative survival rates according to gender, age, tobacco use, surgical procedure, bone quality, and restoration type. Statistics were performed using chi-square, Mann-Whitney, and Kruskal Wallis H tests. Results. The survival rate was 97.3% with, on average, 22.8 months of follow-up. Patients older than 60 years had higher failure rate than the other age groups (P < 0.05). Placed region, age, and bone quality had adverse effects on survival rate in the <8 mm implant group with statistically significant difference (P < 0.05). Conclusions. Approximately 23-month follow-up data indicate that short implants with locking tapers and plateau-type roots have comparable survival rates as other types of dental implants. However, due to limitations of study, these issues remain to be further investigated in future randomized controlled clinical trials. PMID:25961004

  4. The Clinicopathologic Characteristics and 5-year Survival Rate of Epithelial Ovarian Cancer in Yazd, Iran

    PubMed Central

    Karimi-Zarchi, Mojgan; Mortazavizadeh, Seyed Mohammad Reza; Bashardust, Nasrollah; Zakerian, Neda; Zaidabadi, Mahbube; Yazdian-Anari, Pouria; Teimoori, Soraya

    2015-01-01

    Introduction Ovarian cancer is the second most common malignancy in women, the most common cause of gynecologic cancer deaths, and most patients have advanced stage disease at the time of diagnosis. The purpose of this study was to estimate the 5-year survival of patients with epithelial ovarian cancer based on age, tumor histology, stage of disease, and type of treatment. Methods This study was conducted on 120 patients with epithelial ovarian cancer referred to Shahid Sadoughi hospital and Shah Vali oncology clinic of Yazd from 2006 to 2012. Demographic data and patient records were studied to evaluate the treatment outcome, pathology of the tumor, and stage of disease. Finally, the overall survival rate and tumor-free survival of patients was assessed. Results The mean patient age was 53.87± 14.11 years. Most participants had stage I (36.7%) or stage II (35%) disease. Serous adenocarcinoma (57.6%) was the most common pathology found in patients with epithelial ovarian cancer. The overall survival of patients in this study was significantly associated with the histological tumor type (p = 0.000) and disease stage (p = 0.0377). Stage I (84.18%) and serous adenocarcinoma (72.81%) demonstrated the best survival. The tumor-free survival rates were not associated with histology types (p = 0.079), surgical procedure (p = 0.18), or chemotherapy (p = 0.18). Conclusion The survival of patients with epithelial ovarian cancer was significantly associated with disease stage. Serous adenocarcinoma also had the best prognosis among the pathologies studied. Therefore, early detection of ovarian cancer can substantially increase the survival rate. PMID:26516450

  5. Disease Management Project Breast Cancer in Hesse – 5-Year Survival Data

    PubMed Central

    Jackisch, C.; Funk, A.; König, K.; Lubbe, D.; Misselwitz, B.; Wagner, U.

    2014-01-01

    Introduction: The Disease Management Project Breast Cancer (DMP Breast Cancer) was first launched in Hesse in 2004. The project is supported by the health insurance companies in Hesse and the Professional Association of Gynaecologists in Hesse. The aim is to offer structured treatment programmes to all women diagnosed with breast cancer in Hesse by creating intersectoral cooperations between coordinating clinics, associated hospitals and gynaecologists in private practice who registered in the DMP programme. Method: Between 1 January 2005 and 30 June 2011, 13 973 women were enrolled in the DMP programme. Results: After data cleansing, survival rates were calculated for a total of 11 214 women. The 5-year overall survival (OS) rate was 86.3 %; survival rates according to tumour stage on presentation were 92.2 % (pT1) and 82.3 % (pT2), respectively. The impact of steroid hormone receptor status on survival (87.8 % for receptor-positive cancers vs. 78.9 % for receptor-negative cancers) and of age at first diagnosis on survival (≤ 35 years = 91 %) were calculated. Conclusion: The project showed that intersectoral cooperation led to significant improvements in the quality of treatment over time, as measured by quality indicators and outcomes after treatment. PMID:24882878

  6. Predictors of long term survival after hepatic resection for hilar cholangiocarcinoma: A retrospective study of 5-year survivors

    PubMed Central

    Abd ElWahab, Mohamed; El Nakeeb, Ayman; El Hanafy, Ehab; Sultan, Ahmad M; Elghawalby, Ahmed; Askr, Waleed; Ali, Mahmoud; Abd El Gawad, Mohamed; Salah, Tarek

    2016-01-01

    AIM: To determine predictors of long term survival after resection of hilar cholangiocarcinoma (HC) by comparing patients surviving > 5 years with those who survived < 5 years. METHODS: This is a retrospective study of patients with pathologically proven HC who underwent surgical resection at the Gastroenterology Surgical Center, Mansoura University, Egypt between January 2002 and April 2013. All data of the patients were collected from the medical records. Patients were divided into two groups according to their survival: Patients surviving less than 5 years and those who survived > 5 years. RESULTS: There were 34 (14%) long term survivors (5 year survivors) among the 243 patients. Five-year survivors were younger at diagnosis than those surviving less than 5 years (mean age, 50.47 ± 4.45 vs 54.59 ± 4.98, P = 0.001). Gender, clinical presentation, preoperative drainage, preoperative serum bilirubin, albumin and serum glutamic-pyruvic transaminase were similar between the two groups. The level of CA 19-9 was significantly higher in patients surviving < 5 years (395.71 ± 31.43 vs 254.06 ± 42.19, P = 0.0001). Univariate analysis demonstrated nine variables to be significantly associated with survival > 5 year, including young age (P = 0.001), serum CA19-9 (P = 0.0001), non-cirrhotic liver (P = 0.02), major hepatic resection (P = 0.001), caudate lobe resection (P = 0.006), well differentiated tumour (P = 0.03), lymph node status (0.008), R0 resection margin (P = 0.0001) and early postoperative liver cell failure (P = 0.02). CONCLUSION: Liver status, resection of caudate lobe, lymph node status, R0 resection and CA19-9 were demonstrated to be independent risk factors for long term survival. PMID:27358676

  7. Periampullary adenocarcinoma: analysis of 5-year survivors.

    PubMed Central

    Yeo, C J; Sohn, T A; Cameron, J L; Hruban, R H; Lillemoe, K D; Pitt, H A

    1998-01-01

    OBJECTIVE: This single-institution experience retrospectively reviews the outcomes in a group of patients treated 5 or more years ago by pancreaticoduodenectomy for periampullary adenocarcinoma. SUMMARY BACKGROUND DATA: Controversy exists regarding the benefit of resection for periampullary adenocarcinoma, particularly for pancreatic tumors. Many series report only Kaplan-Meier actuarial 5-year survival rates. There are believed to be discrepancies between the actuarial 5-year survival data and the actual 5-year survival rates. METHODS: From April 1970 through May 1992, 242 patients underwent pancreaticoduodenal resection for periampullary adenocarcinoma at The Johns Hopkins Hospital. Follow-up was complete through May 1997. All pathology specimens were reviewed and categorized. Actual 5-year survival rates were calculated. The demographic, intraoperative, pathologic, and postoperative features of patients surviving > or =5 years were compared with those of patients who survived <5 years. RESULTS: Of the 242 patients with resected periampullary adenocarcinoma, 149 (62%) were pancreatic primaries, 46 (19%) arose in the ampulla, 30 (12%) were distal bile duct cancers, and 17 (7%) were duodenal cancers. There was a 5.3% operative mortality rate during the 22 years of the review, with a 2% operative mortality rate in the last 100 patients. There were 58 5-year survivors, 28 7-year survivors, and 7 10-year survivors. The tumor-specific 5-year actual survival rates were pancreatic 15%, ampullary 39%, distal bile duct 27%, and duodenal 59%. When compared with patients who did not survive 5 years, the 5-year survivors had a significantly higher percentage of well-differentiated tumors (14% vs. 4%; p = 0.02) and higher incidences of negative resection margins (98% vs. 73%, p < 0.0001) and negative nodal status (62% vs. 31%, p < 0.0001). The tumor-specific 10-year actuarial survival rates were pancreatic 5%, ampullary 25%, distal bile duct 21%, and duodenal 59%. CONCLUSIONS

  8. Long‐Term Post‐CABG Survival: Performance of Clinical Risk Models Versus Actuarial Predictions

    PubMed Central

    Carr, Brendan M.; Romeiser, Jamie; Ruan, Joyce; Gupta, Sandeep; Seifert, Frank C.; Zhu, Wei

    2015-01-01

    Abstract Background/aim Clinical risk models are commonly used to predict short‐term coronary artery bypass grafting (CABG) mortality but are less commonly used to predict long‐term mortality. The added value of long‐term mortality clinical risk models over traditional actuarial models has not been evaluated. To address this, the predictive performance of a long‐term clinical risk model was compared with that of an actuarial model to identify the clinical variable(s) most responsible for any differences observed. Methods Long‐term mortality for 1028 CABG patients was estimated using the Hannan New York State clinical risk model and an actuarial model (based on age, gender, and race/ethnicity). Vital status was assessed using the Social Security Death Index. Observed/expected (O/E) ratios were calculated, and the models' predictive performances were compared using a nested c‐index approach. Linear regression analyses identified the subgroup of risk factors driving the differences observed. Results Mortality rates were 3%, 9%, and 17% at one‐, three‐, and five years, respectively (median follow‐up: five years). The clinical risk model provided more accurate predictions. Greater divergence between model estimates occurred with increasing long‐term mortality risk, with baseline renal dysfunction identified as a particularly important driver of these differences. Conclusions Long‐term mortality clinical risk models provide enhanced predictive power compared to actuarial models. Using the Hannan risk model, a patient's long‐term mortality risk can be accurately assessed and subgroups of higher‐risk patients can be identified for enhanced follow‐up care. More research appears warranted to refine long‐term CABG clinical risk models. doi: 10.1111/jocs.12665 (J Card Surg 2016;31:23–30) PMID:26543019

  9. Actuarial Valuation.

    ERIC Educational Resources Information Center

    Teachers Retirement System of Louisiana, Baton Rouge.

    This report presents the results of the actuarial valuation of assets and liabilities as well as funding requirements for the Teachers Retirement System of Louisiana as of June 30, 1996. Data reported include current funding, actuarial assets and valuation assets. These include the Louisiana State University Agriculture and Extension Service Fund,…

  10. Missing data imputation on the 5-year survival prediction of breast cancer patients with unknown discrete values.

    PubMed

    García-Laencina, Pedro J; Abreu, Pedro Henriques; Abreu, Miguel Henriques; Afonoso, Noémia

    2015-04-01

    Breast cancer is the most frequently diagnosed cancer in women. Using historical patient information stored in clinical datasets, data mining and machine learning approaches can be applied to predict the survival of breast cancer patients. A common drawback is the absence of information, i.e., missing data, in certain clinical trials. However, most standard prediction methods are not able to handle incomplete samples and, then, missing data imputation is a widely applied approach for solving this inconvenience. Therefore, and taking into account the characteristics of each breast cancer dataset, it is required to perform a detailed analysis to determine the most appropriate imputation and prediction methods in each clinical environment. This research work analyzes a real breast cancer dataset from Institute Portuguese of Oncology of Porto with a high percentage of unknown categorical information (most clinical data of the patients are incomplete), which is a challenge in terms of complexity. Four scenarios are evaluated: (I) 5-year survival prediction without imputation and 5-year survival prediction from cleaned dataset with (II) Mode imputation, (III) Expectation-Maximization imputation and (IV) K-Nearest Neighbors imputation. Prediction models for breast cancer survivability are constructed using four different methods: K-Nearest Neighbors, Classification Trees, Logistic Regression and Support Vector Machines. Experiments are performed in a nested ten-fold cross-validation procedure and, according to the obtained results, the best results are provided by the K-Nearest Neighbors algorithm: more than 81% of accuracy and more than 0.78 of area under the Receiver Operator Characteristic curve, which constitutes very good results in this complex scenario. PMID:25725446

  11. Long term survival of radiotherapy for esophageal cancer: analysis of 1136 patients surviving for more than 5 years

    SciTech Connect

    Yang, Z.Y.; Gu, X.; Zhao, S.

    1983-12-01

    One thousand one hundred and thirty-six patients surviving for more than five years after radiotherapy were studied. The important prognostic factors are: lesion less than 5 cm in length, lesion located in the upper-third segment and lesion that is radiosensitive. The radiation dose given to long term survivors varies greatly, i.e., 2700 to 9300 rad. Yet, for the sensitive type of lesion, doses lower than 5000 rad could also effect a cure. The delivery of an optimum dose determined by serial examinations during radiotherapy could improve the result of treatment. For local recurrent lesions, the value of a second course of radiation is extremely limited and surgery is the only means to offer a cure. For metastasis in the lymph nodes, radiation offers some hope of cure, although the long term outcome may not be satisfactory. For second primary cancer of the esophagus, aggressive radiation still gives encouraging results.

  12. Survival and other clinical outcomes of maintenance hemodialysis patients in Taiwan: a 5-year multicenter follow-up study.

    PubMed

    Chen, Huan-Sheng; Cheng, Chun-Ting; Hou, Chun-Cheng; Liou, Hung-Hsiang; Lim, Paik-Seong

    2014-10-01

    The increasing aging and diabetes mellitus (DM) patients in dialysis population make the quality maintenance of dialysis an imperative issue. Recently, an increasing number of dialysis centers were run by private dialysis providers, many of which apply quality assurance programs and performance management systems to dialysis care. We studied patients in dialysis facilities in Taiwan run by a private chain to see clinical outcomes of centers operating under these systemic strategies. Hemodialysis patients from January 1, 2008 to December 31, 2012 in 25 dialysis facilities in Taiwan, which received the management and consultation from a dialysis service provider, NephroCare (NC), were included. Data pivotal to quality of dialysis were analyzed. During a 5-year interval, 5161 hemodialysis patients were included. For volume control, the proportion of patients with weight gain ≥4.5% decreases from 41.7% to 30.2%. Mean Kt/V is 1.74 ± 0.28. Mean albumin level is 3.92 ± 0.38 g/dL. Patients with phosphate <5.5 mg/dL is up to 71.8%. The mean hemoglobin level is 10.70 ± 1.40 g/dL. More than 80% of patients have adequate iron status. Further, 73% of patients use native arteriovenous fistula. Hospitalization-free survival rate was 56% at the fifth year. Patient survival rate at the fifth year was 66.4%. Overall clinical performances were maintained very stable in NC facilities from this temporal data analysis. The hospitalization and survival rate also compare favorably with those reported internationally. These results warrant further studies to justify the application of this kind of quality assurance programs and performance management systems in dialysis care. PMID:24766262

  13. Underlying theory of actuarial analyses.

    PubMed

    Benjamin, B

    1985-05-01

    The developments in theory governing the calculation of mortality rates for use in survival measurements working through the initial basic concept of exposure to risk to the later introduction of stochastic elements are reviewed. I have indicated the way in which actuaries and statisticians who work closely with those in the fields of medicine and biology have, by the exchange of methodologic ideas, come to an identity of approach. Recent new actuarial work and likely future developments in actuarial interests are reviewed. PMID:4047154

  14. An examination of racial differences in 5-year survival of cervical cancer among African American and white American women in the southeastern US from 1985 to 2010.

    PubMed

    Weragoda, Janaka; Azuero, Andres; Badiga, Suguna; Bell, Walter C; Matthews, Roland; Piyathilake, Chandrika

    2016-08-01

    Disparities in Cervical Cancer (CC) mortality outcomes between African American (AA) and White women have been studied for decades. However, conclusions about the effect of race on CC survival differ across studies. This study assessed differences in CC survival between AA and White women diagnosed between 1985 and 2010 and treated at two major hospitals in the southeastern US. The study sample included 925 AA and 1192 White women diagnosed with cervical adenocarcinoma, adenosquamous cell carcinoma, or squamous cell carcinoma. Propensity score adjustment and matching were employed to compare 5-year survival between the two racial groups. Crude comparisons suggested relevant racial differences in survival. However, the racial differences became of small magnitude after propensity-score adjustment and in matched analyses. Nonlinear models identified age at diagnosis, cancer stage, mode of treatment, and histological subtype as the most salient characteristics predicting 5-year survival of CC, yet these characteristics were also associated with race. Crude racial differences in survival might be partly explained by underlying differences in the characteristics of racial groups, such as age at diagnosis, histological subtype, cancer stage, and the mode of treatment. The study results highlight the need to improve access to early screening and treatment opportunities for AA women to improve posttreatment survival from CC. PMID:27185053

  15. A practice-based clinical evaluation of the survival and success of metal-ceramic and zirconia molar crowns: 5-year results.

    PubMed

    Rinke, S; Kramer, K; Bürgers, R; Roediger, M

    2016-02-01

    This practice-based study evaluates the survival and success of conventionally luted metal-ceramic and zirconia molar crowns fabricated by using a prolonged cooling period for the veneering porcelain. Fifty-three patients were treated from 07/2008 to 07/2009 with either metal-ceramic crowns (MCC) or zirconia crowns (ZC). Forty-five patients (26 female) with 91 restorations (obser-vational period: 64.0 ± 4.8 months) participated in a clinical follow-up examination and were included in the study. Estimated cumulative survival (ECSv), success (ECSc) and veneering ceramic success (ECVCSc) were calculated (Kaplan-Meier) and analysed by the crown fabrication technique and the position of the restoration (Cox regression model) (P < 0.05). Five complete failures (MCC: 2, ZC: 3) were recorded (5-year ECSv: MCC: 97.6%, (95% confidence interval (95%-CI): [93%; 100%]/ZC: 94.0%, (95%-CI): [87%; 100%]). Of the MCCs (n = 41), 85.0%, [95%-CI: (77%; 96%)] remained event-free, whereas the ECSc for the ZCs (n = 50) was 74.3% (95%-CI): [61%; 87%]. No significant differences in ECSv (P = 0.51), ECSc (P = 0.43) and ECVCSc (P = 0.36) were detected between the two fabrication techniques. Restorations placed on terminal abutments (n = 44) demonstrated a significantly lower ECVCSc (P = 0.035), (5-year VCF-rate: 14.8%) than crowns placed on tooth-neighboured abutments (n = 47), (5-year VCF-rate: 4.3%). In the present study, zirconia molar crowns demonstrated a 5-year ECSv, ECSc and ECVCSc comparable to MCCs. Irrespective of the fabrication technique, crowns on terminal abutments bear a significantly increased risk for VCFs. Clinical investigations with an increased number of restorations are needed. PMID:26393865

  16. Polymorphism of 9p21.3 Locus Is Associated with 5-Year Survival in High-Risk Patients with Myocardial Infarction

    PubMed Central

    Szpakowicz, Anna; Kiliszek, Marek; Pepinski, Witold; Waszkiewicz, Ewa; Franaszczyk, Maria; Skawronska, Małgorzata; Ploski, Rafal; Niemcunowicz-Janica, Anna; Dobrzycki, Sławomir; Opolski, Grzegorz; Musial, Włodzimierz Jerzy; Kaminski, Karol Adam

    2014-01-01

    Objective The rs10757278, rs1333049 and rs4977574 are single nucleotide polymorphisms (SNPs) of chromosome 9p21 locus associated with a prevalence of acute coronary syndromes (ACS). Reports concerning their association with long-term outcome after an ACS are equivocal. The aim of our study was to investigate the association of the 9p21.3 locus with 5-year overall mortality in patients with ST-elevation myocardial infarction (STEMI). Materials and methods We performed a retrospective analysis of data collected prospectively in 2 independent registries of consecutive patients with STEMI (derivation and validation group). Genotyping was performed with the TaqMan method. The analyzed end-point was total mortality. Results The derivation group comprised 589 patients: 25.3% female (n = 149), mean age 62.4±12.0 years, total 5-year mortality 16.6% (n = 98). When all the study group was analyzed, no significant differences in mortality were found between the genotypes. However, in high-risk patients (GRACE risk score ≥155 points, n = 238), homozygotes associated with higher risk for ACS had significantly better 5-year survival compared to other genotypes. The hazard ratio associated with the high-risk genotype (a homozygote of high risk for ACS or a heterozygote) was: HR = 2.2 (1.15–4.2) for the rs10757278 polymorphism, HR = 2.7 (95% CI 1.3–5.4) for the rs4977574 one and HR = 2.3 (1.2–4.5) for the rs1333049 one (Cox proportional hazards model). Survival analysis in the validation group (n = 365) showed a clear trend towards better prognosis in GG homozygotes of the rs10757278 SNP, which confirms our initial results (p = 0.09, log-rank test). Conclusions The 9p21.3 locus is associated with 5-year mortality in high-risk patients with STEMI. The genotypes associated with higher risk for ACS show a protective effect in terms of further survival (instead of a deteriorating prognosis, as reported previously). This finding, due to the very

  17. Squamous cell carcinoma of the lips in a northern Greek population. Evaluation of prognostic factors on 5-year survival rate--I.

    PubMed

    Antoniades, D Z; Styanidis, K; Papanayotou, P; Trigonidis, G

    1995-09-01

    The purpose of this study was to determine the clinical features of squamous cell carcinoma (SCC) of the lips, along with its prognostic factors, in order to extend and update the information related to lip cancer in northern Greece and to provide a basis for international comparison. Records of 1510 patients with SCC of the oral cavity presented at the Theagenion Anticancer Institute of Thessaloniki, Greece from 1979 and 1989 were reviewed. The most common site for oral squamous cell carcinoma (OSCC) was found to be the lips (59.4%) as compared to 40.5% of intra-oral SCC. Males were affected more frequently, presenting a ratio of 9.2:1. The peak age of incidence was found to be the 6th decade for men and the 8th for women. Rural residents and outdoor workers were affected more than urban residents (79.9% versus 28.1%). Most of the patients were diagnosed in early categories and early clinical stages of the disease. Almost all (98.5%) were classified into T1 and T2 categories, and 92.9% into stages I and II. A total of 7.59% of patients presented with clinically-positive lymph-node involvement. Most of them were classified as an advanced stage of the disease. Primary surgical excision was performed on 60.14%, radiotherapy on 35.14%, a combination of these on 2.47%, and chemotherapy alone or in combination with the above regimens in 2.22% of the cases. The outcome was adequate for surgery, radiotherapy, and the combination of the two, since 91.3, 74, and 90%, respectively, survived for more than 5 years. An overall 5-year survival rate of 83.3% was found. Our findings showed that the survival rate was significantly influenced by the main prognostic factors, such as the size of the tumour, the lymph-node involvement, the clinical stage of the disease and the histologic differentiation. SCC of the lips continues to be the most common site of oral cancer development amongst the Greek population. The aetiologic significance of actinic radiation for SCC of the lips is

  18. Polymorphism of 9p21.3 Locus Is Associated with 5-Year Survival in High-Risk Patients with Myocardial Infarction

    PubMed Central

    Szpakowicz, Anna; Pepinski, Witold; Waszkiewicz, Ewa; Maciorkowska, Dominika; Skawronska, Małgorzata; Niemcunowicz-Janica, Anna; Milewski, Robert; Dobrzycki, Sławomir; Musial, Włodzimierz Jerzy; Kaminski, Karol Adam

    2013-01-01

    Objective The rs1333049, rs10757278 and rs4977574 are single nucleotide polymorphisms (SNPs) of chromosome 9p21 locus that are associated with prevalence of acute coronary syndromes (ACS). The rs1333049 SNP was also associated with cardiac outcome 6 months post ACS. No data concerning their association with long term prognosis after myocardial infarction is available. The aim of our study was to investigate the association of the 9p21.3 locus with 5-year overall mortality in patients with ST-elevation myocardial infarction (STEMI) treated invasively. Materials and Methods We performed a retrospective analysis of data collected prospectively in a registry of consecutive patients with STEMI treated with primary PCI. Genotyping was performed with a TaqMan method. The analyzed end-point was total 5-year mortality. Results The study group comprised 589 patients: 25.3% of females (n = 149), mean age 62.4±11.9 years, total 5-year mortality 16.6% (n = 98). When all the study group was analyzed, no significant differences in mortality were found between the genotypes. However, in high-risk patients (Grace risk score ≥155 points, n = 238), low-risk homozygotes had significantly better 5-year survival compared to other genotypes. The hazard ratio associated with high-risk genotype (high-risk homozygote or heterozygote) was: HR = 2.9 (95%CI 1.4–6.1) for the rs4977574 polymorphism, HR = 2.6 (1.25–5.3) for the rs1333049 one and HR = 2.35 (1.2–4.6) for the rs10757278 one (Cox proportional hazards model). Conclusions The 9p21.3 locus is associated with 5-year mortality in high-risk patients with STEMI. This finding, due to very high effect size, could potentially be applied into clinical practice, if appropriate methods are elaborated. PMID:24069144

  19. The Casualty Actuarial Society: Helping Universities Train Future Actuaries

    ERIC Educational Resources Information Center

    Boa, J. Michael; Gorvett, Rick

    2014-01-01

    The Casualty Actuarial Society (CAS) believes that the most effective way to advance the actuarial profession is to work in partnership with universities. The CAS stands ready to assist universities in creating or enhancing courses and curricula associated with property/casualty actuarial science. CAS resources for university actuarial science…

  20. Stereotactic body radiation therapy for nonmetastatic lung cancer: An analysis of 75 patients treated over 5 years

    SciTech Connect

    Beitler, Jonathan J. . E-mail: jbeitler92@alumni.gsb.columbia.edu; Badine, Edgard A.; El-Sayah, Danny; Makara, Denise; Friscia, Phillip; Silverman, Phillip; Terjanian, Terenig

    2006-05-01

    Purpose: Non-small-cell lung cancer (NSCLC) may not be medically operable even in patients with surgically resectable disease. For patients who either refuse surgery or are medically inoperable, radiation therapy may be the best therapeutic choice. Stereotactic body radiation therapy (SBRT) employs external fixation and hypofractionation to deliver a high dose per fraction of radiation to a small target volume. Methods and Materials: Retrospective review of 75 patients treated over 5 years at Staten Island University Hospital as definitive treatment for NSCLC or presumed NSCLC. Patients received a median of 5 fractions of 8 Gy per fraction over 27 days. Results: Overall 1-, 2-, and 5-year actuarial survivals were 63%, 45%, and 17%. Patients with a gross tumor volume (GTV) less than 65 cm{sup 3} enjoyed a longer median survival (25.7 vs. 9.9 months, p < 0.003), and at 5 years, the actuarial survival for the patients with GTVs less than 65 cm{sup 3} was 24% vs. 0% for those with GTVs larger than 65 cm{sup 3}. Conclusions: Stereotactic body radiation therapy as delivered was ineffective for curing the patients whose GTVs were larger than 65 cm{sup 3}. SBRT was promising for those with GTVs less than 65 cm{sup 3}.

  1. 5-Year Budget Forecasting.

    ERIC Educational Resources Information Center

    Conyers, John G.; Lingel, George; Piekarski, Robert

    2000-01-01

    Financial planning is the key to providing a high-quality instructional plan. A 5-year financial plan is typically updated by looking at district financial history, future instructional plans, staffing requirements, and revenue projections. Planning assumptions must be clearly understood by the financial team and the community. (MLH)

  2. 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.

  3. 75 FR 63505 - Renewal of Advisory Committee on Actuarial Examinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-15

    ... ENROLLMENT OF ACTUARIES Renewal of Advisory Committee on Actuarial Examinations AGENCY: Joint Board for the... of Actuaries announces the renewal of the Advisory Committee on Actuarial Examinations. FOR FURTHER... Committee is to advise the Joint Board on examinations in actuarial mathematics and methodology. The...

  4. Developing an Actuarial Track Utilizing Existing Resources

    ERIC Educational Resources Information Center

    Rodgers, Kathy V.; Sarol, Yalçin

    2014-01-01

    Students earning a degree in mathematics often seek information on how to apply their mathematical knowledge. One option is to follow a curriculum with an actuarial emphasis designed to prepare students as an applied mathematician in the actuarial field. By developing only two new courses and utilizing existing courses for Validation by…

  5. Developmental milestones record - 5 years

    MedlinePlus

    ... milestones for children - 5 years References Feigelman S. The preschool years. In: Kliegman RM, Behrman RE, Jenson HB, ... Duplication for commercial use must be authorized in writing by ADAM Health Solutions. About MedlinePlus Site Map ...

  6. 42 CFR 403.258 - Statement of actuarial opinion.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Statement of actuarial opinion. 403.258 Section 403... Program: Loss Ratio Provisions § 403.258 Statement of actuarial opinion. (a) For purposes of certification... actuarial opinion means a signed declaration in which a qualified actuary states that the assumptions...

  7. 20 CFR 901.2 - Eligibility to perform actuarial services.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Eligibility to perform actuarial services... GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Definitions and Eligibility To Perform Actuarial Services § 901.2 Eligibility to perform actuarial...

  8. 20 CFR 901.2 - Eligibility to perform actuarial services.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Eligibility to perform actuarial services... GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Definitions and Eligibility To Perform Actuarial Services § 901.2 Eligibility to perform actuarial...

  9. 42 CFR 403.258 - Statement of actuarial opinion.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Statement of actuarial opinion. 403.258 Section 403... Program: Loss Ratio Provisions § 403.258 Statement of actuarial opinion. (a) For purposes of certification... actuarial opinion means a signed declaration in which a qualified actuary states that the assumptions...

  10. 20 CFR 901.2 - Eligibility to perform actuarial services.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Eligibility to perform actuarial services... GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Definitions and Eligibility To Perform Actuarial Services § 901.2 Eligibility to perform actuarial...

  11. 20 CFR 901.2 - Eligibility to perform actuarial services.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Eligibility to perform actuarial services... GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Definitions and Eligibility To Perform Actuarial Services § 901.2 Eligibility to perform actuarial...

  12. 42 CFR 403.258 - Statement of actuarial opinion.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Statement of actuarial opinion. 403.258 Section 403... Program: Loss Ratio Provisions § 403.258 Statement of actuarial opinion. (a) For purposes of certification... actuarial opinion means a signed declaration in which a qualified actuary states that the assumptions...

  13. 20 CFR 901.2 - Eligibility to perform actuarial services.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Eligibility to perform actuarial services... GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Definitions and Eligibility To Perform Actuarial Services § 901.2 Eligibility to perform actuarial...

  14. 42 CFR 403.258 - Statement of actuarial opinion.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Statement of actuarial opinion. 403.258 Section 403... Program: Loss Ratio Provisions § 403.258 Statement of actuarial opinion. (a) For purposes of certification... actuarial opinion means a signed declaration in which a qualified actuary states that the assumptions...

  15. 42 CFR 403.258 - Statement of actuarial opinion.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Statement of actuarial opinion. 403.258 Section 403... Program: Loss Ratio Provisions § 403.258 Statement of actuarial opinion. (a) For purposes of certification... actuarial opinion means a signed declaration in which a qualified actuary states that the assumptions...

  16. Extended (5-year) Outcomes of Accelerated Partial Breast Irradiation Using MammoSite Balloon Brachytherapy: Patterns of Failure, Patient Selection, and Dosimetric Correlates for Late Toxicity

    SciTech Connect

    Vargo, John A.; Verma, Vivek; Kim, Hayeon; Kalash, Ronny; Heron, Dwight E.; Johnson, Ronald; Beriwal, Sushil

    2014-02-01

    Purpose: Accelerated partial breast irradiation (APBI) with balloon and catheter-based brachytherapy has gained increasing popularity in recent years and is the subject of ongoing phase III trials. Initial data suggest promising local control and cosmetic results in appropriately selected patients. Long-term data continue to evolve but are limited outside of the context of the American Society of Breast Surgeons Registry Trial. Methods and Materials: A retrospective review of 157 patients completing APBI after breast-conserving surgery and axillary staging via high-dose-rate {sup 192}Ir brachytherapy from June 2002 to December 2007 was made. APBI was delivered with a single-lumen MammoSite balloon-based applicator to a median dose of 34 Gy in 10 fractions over a 5-day period. Tumor coverage and critical organ dosimetry were retrospectively collected on the basis of computed tomography completed for conformance and symmetry. Results: At a median follow-up time of 5.5 years (range, 0-10.0 years), the 5-year and 7-year actuarial incidences of ipsilateral breast control were 98%/98%, of nodal control 99%/98%, and of distant control 99%/99%, respectively. The crude rate of ipsilateral breast recurrence was 2.5% (n=4); of nodal failure, 1.9% (n=3); and of distant failure, 0.6% (n=1). The 5-year and 7-year actuarial overall survival rates were 89%/86%, with breast cancer–specific survival of 100%/99%, respectively. Good to excellent cosmetic outcomes were achieved in 93.4% of patients. Telangiectasia developed in 27% of patients, with 1-year, 3-year, and 5-year actuarial incidence of 7%/24%/33%; skin dose >100% significantly predicted for the development of telangiectasia (50% vs 14%, P<.0001). Conclusions: Long-term single-institution outcomes suggest excellent tumor control, breast cosmesis, and minimal late toxicity. Skin toxicity is a function of skin dose, which may be ameliorated with dosimetric optimization afforded by newer multicatheter brachytherapy

  17. Starting an Actuarial Program with Existing Resources

    ERIC Educational Resources Information Center

    Taylor, Paul T.

    2014-01-01

    Many institutions wish to offer a path for students pursuing actuarial careers but lack the student demand to offer new courses or hire additional faculty. Fortunately, a program training students to enter the profession can often be constructed using existing courses and well-informed advising.

  18. Recruiting and Advising Challenges in Actuarial Science

    ERIC Educational Resources Information Center

    Case, Bettye Anne; Guan, Yuanying Michelle; Paris, Stephen

    2014-01-01

    Some challenges to increasing actuarial science program size through recruiting broadly among potential students are identified. Possible solutions depend on the structures and culture of the school. Up to three student cohorts may result from partition of potential students by the levels of academic progress before program entry: students…

  19. A Brief Actuarial Assessment for the Prediction of Wife Assault Recidivism: The Ontario Domestic Assault Risk Assessment

    ERIC Educational Resources Information Center

    Hilton, N. Zoe; Harris, Grant T.; Rice, Marnie E.; Lang, Carol; Cormier, Catherine A.; Lines, Kathryn J.

    2004-01-01

    An actuarial assessment to predict male-to-female marital violence was constructed from a pool of potential predictors in a sample of 589 offenders identified in police records and followed up for an average of almost 5 years. Archival information in several domains (offender characteristics, domestic violence history, nondomestic criminal…

  20. Actuarial considerations of medical malpractice evaluations in M&As.

    PubMed

    Frese, Richard C

    2014-11-01

    To best project an actuarial estimate for medical malpractice exposure for a merger and acquisition, a organization's leaders should consider the following factors, among others: How to support an unbiased actuarial estimation. Experience of the actuary. The full picture of the organization's malpractice coverage. The potential for future loss development. Frequency and severity trends. PMID:25647911

  1. 5 CFR 839.1115 - What is an actuarial reduction?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false What is an actuarial reduction? 839.1115... COVERAGE CORRECTIONS ACT Effect of Election General Provisions § 839.1115 What is an actuarial reduction? An actuarial reduction allows you to receive benefits without having to pay an amount due in a...

  2. 5 CFR 839.1115 - What is an actuarial reduction?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false What is an actuarial reduction? 839.1115... COVERAGE CORRECTIONS ACT Effect of Election General Provisions § 839.1115 What is an actuarial reduction? An actuarial reduction allows you to receive benefits without having to pay an amount due in a...

  3. 5 CFR 839.1115 - What is an actuarial reduction?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false What is an actuarial reduction? 839.1115... COVERAGE CORRECTIONS ACT Effect of Election General Provisions § 839.1115 What is an actuarial reduction? An actuarial reduction allows you to receive benefits without having to pay an amount due in a...

  4. 5 CFR 839.1115 - What is an actuarial reduction?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false What is an actuarial reduction? 839.1115... COVERAGE CORRECTIONS ACT Effect of Election General Provisions § 839.1115 What is an actuarial reduction? An actuarial reduction allows you to receive benefits without having to pay an amount due in a...

  5. 29 CFR 4231.10 - Actuarial calculations and assumptions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false Actuarial calculations and assumptions. 4231.10 Section... MULTIEMPLOYER PLANS § 4231.10 Actuarial calculations and assumptions. (a) Most recent valuation. All calculations required by this part must be based on the most recent actuarial valuation as of the date...

  6. 29 CFR 4231.10 - Actuarial calculations and assumptions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 9 2014-07-01 2014-07-01 false Actuarial calculations and assumptions. 4231.10 Section... MULTIEMPLOYER PLANS § 4231.10 Actuarial calculations and assumptions. (a) Most recent valuation. All calculations required by this part must be based on the most recent actuarial valuation as of the date...

  7. 5 CFR 839.1115 - What is an actuarial reduction?

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false What is an actuarial reduction? 839.1115... COVERAGE CORRECTIONS ACT Effect of Election General Provisions § 839.1115 What is an actuarial reduction? An actuarial reduction allows you to receive benefits without having to pay an amount due in a...

  8. 29 CFR 4231.10 - Actuarial calculations and assumptions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 9 2011-07-01 2011-07-01 false Actuarial calculations and assumptions. 4231.10 Section... MULTIEMPLOYER PLANS § 4231.10 Actuarial calculations and assumptions. (a) Most recent valuation. All calculations required by this part must be based on the most recent actuarial valuation as of the date...

  9. 29 CFR 4231.10 - Actuarial calculations and assumptions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 9 2012-07-01 2012-07-01 false Actuarial calculations and assumptions. 4231.10 Section... MULTIEMPLOYER PLANS § 4231.10 Actuarial calculations and assumptions. (a) Most recent valuation. All calculations required by this part must be based on the most recent actuarial valuation as of the date...

  10. 29 CFR 4231.10 - Actuarial calculations and assumptions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Actuarial calculations and assumptions. 4231.10 Section... MULTIEMPLOYER PLANS § 4231.10 Actuarial calculations and assumptions. (a) Most recent valuation. All calculations required by this part must be based on the most recent actuarial valuation as of the date...

  11. Malignant lymphoma of the oral cavity and the maxillofacial region: Overall survival prognostic factors

    PubMed Central

    Morales-Vadillo, Rafael; Sacsaquispe-Contreras, Sonia J.; Barrionuevo-Cornejo, Carlos; Montes-Gil, Jaime; Cava-Vergiú, Carlos E.; Soares, Fernando A.; Chaves-Netto, Henrique D M.; Chaves, Maria G A M.

    2013-01-01

    Objective: To identify the overall survival and prognostic factors of malignant lymphoma of the oral cavity and the maxillofacial region. Study Design: Clinical records data were obtained in order to determine overall survival at 2 and 5 years, the individual survival percentage of each possible prognostic factor with the actuarial technique, and the survival regarding the possible prognostic factors with the actuarial technique and the Log-rank and Cox’s regression tests. Results: Of 151 subjects, an overall survival was 60% at 2 years, and 45% at 5 years. The multivariate analysis demonstrated statistically significant differences for clinical stage (p=0.002), extranodal involvement (p=0.030), presence of human immunodeficiency virus (p=0.032), and presence of Epstein-Barr virus (p=0.010). Conclusion: The advanced clinical stage and the larger number of involved extranodular sites are related to a lower overall survival, as well as, the presence of previous infections such as the human immunodeficiency and the Epstein-Barr virus. Key words:Lymphoma, oral cavity, survival. PMID:23722134

  12. Survival of breast cancer patients. Our experience.

    PubMed

    Marrazzoa, Antonio; Taormina, Pietra; David, Massimo; Riili, Ignazio; Casà, Luigi; Catalano, Filippo; Lo Gerfo, Domenico; Noto, Antonio

    2007-01-01

    Life expectancy for patients with breast carcinoma has changed in Europe over the last two decades. In Italy, the overall survival rate is about 77% at 5 years. When considering the situation in Sicily, the EUROCARE 2 study examined survival data from the Ragusa Cancer Registry, showing that the curves are worse than in other regions of Italy. Starting from these considerations we decide to evaluate whether these data from the Ragusa Cancer Registry corresponded to Palermo data. So we analysed data from 575 consecutive patients with breast cancer, treated in our Breast Unit from 1990 to 2003 according to the St. Gallen Recommendations and followed for a median period of 5 years. The prognostic role of age, tumour size, nodal status, TNM, stage, grading and hormonal receptors (OR, PR) were analysed and survival curves at 5 and 10 years were produced using the actuarial survival methods. All causes of death were considered. The median follow-up was 33 months. The Log rank test and univariate cox proportional model were used to demonstrate the association between prognostic factors and outcome. When considering T and N status, the curves showed an inverse correlation between survival and increases in these parameters. Overall survival was 92.9% at 5 years and 81.4% at 10 years for T1, 78.4% at 5 years and 61.4% at 10 years for T2 and 40.8% for T3-T4 at 5 and 10 years. Overall survival for NO was 92.1% and 78.2%, respectively, at 5 and 10 years, but decreased to 72.0% and 59.9% at 5 and 10 years for N1. In N2 patients we found that only about 50% of patients were still alive at 5 and 10 years, while for N3 patients the figures were 57.2% and 40%, respectively. PMID:17663369

  13. Partial Breast Radiation Therapy With Proton Beam: 5-Year Results With Cosmetic Outcomes

    SciTech Connect

    Bush, David A.; Do, Sharon; Lum, Sharon; Garberoglio, Carlos; Mirshahidi, Hamid; Patyal, Baldev; Grove, Roger; Slater, Jerry D.

    2014-11-01

    Purpose: We updated our previous report of a phase 2 trial using proton beam radiation therapy to deliver partial breast irradiation (PBI) in patients with early stage breast cancer. Methods and Materials: Eligible subjects had invasive nonlobular carcinoma with a maximal dimension of 3 cm. Patients underwent partial mastectomy with negative margins; axillary lymph nodes were negative on sampling. Subjects received postoperative proton beam radiation therapy to the surgical bed. The dose delivered was 40 Gy in 10 fractions, once daily over 2 weeks. Multiple fields were treated daily, and skin-sparing techniques were used. Following treatment, patients were evaluated with clinical assessments and annual mammograms to monitor toxicity, tumor recurrence, and cosmesis. Results: One hundred subjects were enrolled and treated. All patients completed the assigned treatment and were available for post-treatment analysis. The median follow-up was 60 months. Patients had a mean age of 63 years; 90% had ductal histology; the average tumor size was 1.3 cm. Actuarial data at 5 years included ipsilateral breast tumor recurrence-free survival of 97% (95% confidence interval: 100%-93%); disease-free survival of 94%; and overall survival of 95%. There were no cases of grade 3 or higher acute skin reactions, and late skin reactions included 7 cases of grade 1 telangiectasia. Patient- and physician-reported cosmesis was good to excellent in 90% of responses, was not changed from baseline measurements, and was well maintained throughout the entire 5-year follow-up period. Conclusions: Proton beam radiation therapy for PBI produced excellent ipsilateral breast recurrence-free survival with minimal toxicity. The treatment proved to be adaptable to all breast sizes and lumpectomy cavity configurations. Cosmetic results appear to be excellent and unchanged from baseline out to 5 years following treatment. Cosmetic results may be improved over those reported with photon

  14. 20 CFR 200.9 - Selection of members of Actuarial Advisory Committee.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false Selection of members of Actuarial Advisory... ADMINISTRATION § 200.9 Selection of members of Actuarial Advisory Committee. (a) Introduction. Under section 15(f... actuaries to serve on an Actuarial Advisory Committee. This section describes how the two actuaries...

  15. 20 CFR 200.9 - Selection of members of Actuarial Advisory Committee.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Selection of members of Actuarial Advisory... ADMINISTRATION § 200.9 Selection of members of Actuarial Advisory Committee. (a) Introduction. Under section 15(f... actuaries to serve on an Actuarial Advisory Committee. This section describes how the two actuaries...

  16. 20 CFR 200.9 - Selection of members of Actuarial Advisory Committee.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false Selection of members of Actuarial Advisory... ADMINISTRATION § 200.9 Selection of members of Actuarial Advisory Committee. (a) Introduction. Under section 15(f... actuaries to serve on an Actuarial Advisory Committee. This section describes how the two actuaries...

  17. 20 CFR 200.9 - Selection of members of Actuarial Advisory Committee.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true Selection of members of Actuarial Advisory... ADMINISTRATION § 200.9 Selection of members of Actuarial Advisory Committee. (a) Introduction. Under section 15(f... actuaries to serve on an Actuarial Advisory Committee. This section describes how the two actuaries...

  18. 20 CFR 200.9 - Selection of members of Actuarial Advisory Committee.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 1 2014-04-01 2012-04-01 true Selection of members of Actuarial Advisory... ADMINISTRATION § 200.9 Selection of members of Actuarial Advisory Committee. (a) Introduction. Under section 15(f... actuaries to serve on an Actuarial Advisory Committee. This section describes how the two actuaries...

  19. 29 CFR 4010.8 - Plan actuarial information.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... the extent the qualification(s) are permitted under 26 CFR 301.6059-1(d). (b) Alternative compliance... 29 Labor 9 2012-07-01 2012-07-01 false Plan actuarial information. 4010.8 Section 4010.8 Labor... DISCLOSURE REQUIREMENTS ANNUAL FINANCIAL AND ACTUARIAL INFORMATION REPORTING § 4010.8 Plan...

  20. An Application of Actuarial Methods in Psychiatric Diagnosis

    ERIC Educational Resources Information Center

    Overall, John E.; Higgins, C. Wayne

    1977-01-01

    This research provides an initial evaluation of an actuarial diagnostic testing program that is being conducted by the Psychometric Laboratory at the University of Texas Medical Branch, Galveston, Texas. It was hoped that an actuarial program for psychiatric diagnosis would create greater efficiency, lower cost, and superior validity with respect…

  1. 29 CFR 4010.8 - Plan actuarial information.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... the extent the qualification(s) are permitted under 26 CFR 301.6059-1(d). (b) Alternative compliance... 29 Labor 9 2011-07-01 2011-07-01 false Plan actuarial information. 4010.8 Section 4010.8 Labor... DISCLOSURE REQUIREMENTS ANNUAL FINANCIAL AND ACTUARIAL INFORMATION REPORTING § 4010.8 Plan...

  2. Actuarial models of life insurance with stochastic interest rate

    NASA Astrophysics Data System (ADS)

    Wei, Xiang; Hu, Ping

    2009-07-01

    On the basis of general actuarial model of life insurance, this article has carried on research to continuous life insurance actuarial models under the stochastic interest rate separately. And it provide net single premium for life insurance and life annuity due over a period based on that de Moivre law of mortality and Makeham's law of mortality separately.

  3. 29 CFR 4010.8 - Plan actuarial information.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... the extent the qualification(s) are permitted under 26 CFR 301.6059-1(d). (b) Alternative compliance... 29 Labor 9 2013-07-01 2013-07-01 false Plan actuarial information. 4010.8 Section 4010.8 Labor... DISCLOSURE REQUIREMENTS ANNUAL FINANCIAL AND ACTUARIAL INFORMATION REPORTING § 4010.8 Plan...

  4. 29 CFR 4010.8 - Plan actuarial information.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... the extent the qualification(s) are permitted under 26 CFR 301.6059-1(d). (b) Alternative compliance... 29 Labor 9 2014-07-01 2014-07-01 false Plan actuarial information. 4010.8 Section 4010.8 Labor... DISCLOSURE REQUIREMENTS ANNUAL FINANCIAL AND ACTUARIAL INFORMATION REPORTING § 4010.8 Plan...

  5. Potential Utility of Actuarial Methods for Identifying Specific Learning Disabilities

    ERIC Educational Resources Information Center

    Benson, Nicholas; Newman, Isadore

    2010-01-01

    This article describes how actuarial methods can supplant discrepancy models and augment problem solving and Response to Intervention (RTI) efforts by guiding the process of identifying specific learning disabilities (SLD). Actuarial methods use routinized selection and execution of formulas derived from empirically established relationships to…

  6. Development of an Actuarial Science Program at Salisbury University

    ERIC Educational Resources Information Center

    Wainwright, Barbara A.

    2014-01-01

    This paper focuses on the development of an actuarial science track for the mathematics major at Salisbury University (SU). A timeline from the initial investigation into such a program through the proposal and approval processes is shared for those who might be interested in developing a new actuarial program. It is wise to start small and take…

  7. The first 5 years after the dissertation.

    PubMed

    Hodges, L C; Poteet, G W

    1992-01-01

    To succeed in academia, nursing faculty members must devote the first 5 years following the dissertation to achieving a standard to tenure characteristic of the profession. Most institutions in the country adhere to the American Association of University Professors' guidelines for tenure. These guidelines mandate excellence in teaching, scholarship, and service. A fourth characteristic, leadership, is increasingly considered in tenure decisions. The expectations of an academic career in nursing serve as the foundation for a framework to evaluate the likelihood of success in a particular setting. A detailed 5-year plan for achieving tenure is proposed. PMID:1634654

  8. [Survival after gastrectomy for cancer. 209 cases].

    PubMed

    Le Treut, Y P; Capobianco, C; Botti, G; Christophe, M; Lebreuil, G; Bricot, R

    1992-09-26

    The long-term results of 209 gastrectomies performed for adenocarcinoma, including 117 which were prospectively collected, are presented. Resection was curative in 154 cases (73.6 percent). The TNM distribution of the tumours was: stage I (TxNOMO) 75 cases, stage II (TxN1MO) 46 cases, stage III (TxN2MO) 33 cases and stage IV (TxNxM1) 55 cases. Lymph node involvement was more frequent in the prospective than in the retrospective study. With a more than 5 years' follow-up of 80 percent of the patients operated upon, the actuarial survival rate at 5 years (operative mortality included) was 38 percent for all lesions, 52 percent for curative resection and 2 percent for palliative resection. Following curative resection, the survival rates for tumours of the upper, middle and lower thirds of the stomach were 40, 60 and 55 percent respectively. These rates were 60 percent for stage I tumours, 54 percent for stage II tumours and 25 percent for stage III tumours. The results obtained in this series, where most of the curative gastrectomies included excision of N1 and N2 lymph nodes, show that lymph node involvement has no significant importance for the prognosis when it is proximal (N1) and is not incompatible with prolonged survival when it is pedicular (N2). PMID:1465364

  9. Human actuarial aging increases faster when background death rates are lower: a consequence of differential heterogeneity?

    PubMed

    Hawkes, Kristen; Smith, Ken R; Blevins, James K

    2012-01-01

    Many analyses of human populations have found that age-specific mortality rates increase faster across most of adulthood when overall mortality levels decline. This contradicts the relationship often expected from Williams' classic hypothesis about the effects of natural selection on the evolution of senescence. More likely, much of the within-species difference in actuarial aging is not due to variation in senescence, but to the strength of filters on the heterogeneity of frailty in older survivors. A challenge to this differential frailty hypothesis was recently posed by an analysis of life tables from historical European populations and traditional societies that reported variation in actuarial aging consistent with Williams' hypothesis after all. To investigate the challenge, we reconsidered those cases and aging measures. Here we show that the discrepancy depends on Ricklefs' aging rate measure, ω, which decreases as mortality levels drop because it is an index of mortality level itself, not the rate of increase in mortality with age. We also show unappreciated correspondence among the parameters of Gompertz-Makeham and Weibull survival models. Finally, we compare the relationships among mortality parameters of the traditional societies and the historical series, providing further suggestive evidence that differential heterogeneity has strong effects on actuarial aging. PMID:22220868

  10. Accelerated Partial Breast Irradiation: 5-Year Results of the German-Austrian Multicenter Phase II Trial Using Interstitial Multicatheter Brachytherapy Alone After Breast-Conserving Surgery

    SciTech Connect

    Strnad, Vratislav; Hildebrandt, Guido; Poetter, Richard; Hammer, Josef; Hindemith, Marion; Resch, Alexandra; Spiegl, Kurt; Lotter, Michael; Uter, Wolfgang; Bani, Mayada; Kortmann, Rolf-Dieter; Beckmann, Matthias W.; Fietkau, Rainer; Ott, Oliver J.

    2011-05-01

    Purpose: To evaluate the impact of accelerated partial breast irradiation on local control, side effects, and cosmesis using multicatheter interstitial brachytherapy as the sole method for the adjuvant local treatment of patients with low-risk breast cancer. Methods and Materials: 274 patients with low-risk breast cancer were treated on protocol. Patients were eligible for the study if the tumor size was < 3 cm, resection margins were clear by at least 2 mm, no lymph node metastases existed, age was >35 years, hormone receptors were positive, and histologic grades were 1 or 2. Of the 274 patients, 175 (64%) received pulse-dose-rate brachytherapy (D{sub ref} = 50 Gy). and 99 (36%) received high-dose-rate brachytherapy (D{sub ref} = 32.0 Gy). Results: Median follow-up was 63 months (range, 9-103). Only 8 of 274 (2.9%) patients developed an ipsilateral in-breast tumor recurrence at the time of analysis. The 5-year actuarial local recurrence-free survival probability was 98%. The 5- year overall and disease-free survival probabilities of all patients were 97% and 96%, respectively. Contralateral in-breast malignancies were detected in 2 of 274 (0.7%) patients, and distant metastases occurred in 6 of 274 (2.2%). Late side effects {>=}Grade 3 (i.e., breast tissue fibrosis and telangiectasia) occurred in 1 patient (0.4%, 95%CI:0.0-2.0%) and 6 patients (2.2%, 95%CI:0.8-4.7%), respectively. Cosmetic results were good to excellent in 245 of 274 patients (90%). Conclusions: The long-term results of this prospective Phase II trial confirm that the efficacy of accelerated partial breast irradiation using multicatheter brachytherapy is comparable with that of whole breast irradiation and that late side effects are negligible.

  11. 20 CFR 901.20 - Standards of performance of actuarial services.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Standards of performance of actuarial... GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Standards of Performance for Enrolled Actuaries § 901.20 Standards of performance of actuarial services....

  12. 42 CFR 440.340 - Actuarial report for benchmark-equivalent coverage.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Actuarial report for benchmark-equivalent coverage... Benefit and Benchmark-Equivalent Coverage § 440.340 Actuarial report for benchmark-equivalent coverage. (a... described in § 440.335, must include an actuarial report. The actuarial report must contain an...

  13. 77 FR 63337 - Renewal of Charter of Advisory Committee on Actuarial Examinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-16

    ... ENROLLMENT OF ACTUARIES Renewal of Charter of Advisory Committee on Actuarial Examinations AGENCY: Joint... Committee on Actuarial Examinations. FOR FURTHER INFORMATION CONTACT: Patrick McDonough, 202-622-8225... advise the Joint Board for the Enrollment of Actuaries (Joint Board) on examinations in...

  14. 42 CFR 457.431 - Actuarial report for benchmark-equivalent coverage.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Actuarial report for benchmark-equivalent coverage... GRANTS TO STATES State Plan Requirements: Coverage and Benefits § 457.431 Actuarial report for benchmark... § 457.430, the State must submit to CMS an actuarial report that contains an actuarial opinion that...

  15. 42 CFR 457.431 - Actuarial report for benchmark-equivalent coverage.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Actuarial report for benchmark-equivalent coverage... GRANTS TO STATES State Plan Requirements: Coverage and Benefits § 457.431 Actuarial report for benchmark... § 457.430, the State must submit to CMS an actuarial report that contains an actuarial opinion that...

  16. 42 CFR 457.431 - Actuarial report for benchmark-equivalent coverage.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Actuarial report for benchmark-equivalent coverage... GRANTS TO STATES State Plan Requirements: Coverage and Benefits § 457.431 Actuarial report for benchmark... § 457.430, the State must submit to CMS an actuarial report that contains an actuarial opinion that...

  17. 20 CFR 901.20 - Standards of performance of actuarial services.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Standards of performance of actuarial... GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Standards of Performance for Enrolled Actuaries § 901.20 Standards of performance of actuarial services....

  18. 42 CFR 457.431 - Actuarial report for benchmark-equivalent coverage.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Actuarial report for benchmark-equivalent coverage... GRANTS TO STATES State Plan Requirements: Coverage and Benefits § 457.431 Actuarial report for benchmark... § 457.430, the State must submit to CMS an actuarial report that contains an actuarial opinion that...

  19. 20 CFR 901.20 - Standards of performance of actuarial services.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Standards of performance of actuarial... GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Standards of Performance for Enrolled Actuaries § 901.20 Standards of performance of actuarial services....

  20. 20 CFR 901.20 - Standards of performance of actuarial services.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Standards of performance of actuarial... GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Standards of Performance for Enrolled Actuaries § 901.20 Standards of performance of actuarial services....

  1. 20 CFR 901.20 - Standards of performance of actuarial services.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Standards of performance of actuarial... GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 Standards of Performance for Enrolled Actuaries § 901.20 Standards of performance of actuarial services....

  2. 42 CFR 440.340 - Actuarial report for benchmark-equivalent coverage.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Actuarial report for benchmark-equivalent coverage... Benefit and Benchmark-Equivalent Coverage § 440.340 Actuarial report for benchmark-equivalent coverage. (a... described in § 440.335, must include an actuarial report. The actuarial report must contain an...

  3. 42 CFR 457.431 - Actuarial report for benchmark-equivalent coverage.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Actuarial report for benchmark-equivalent coverage... GRANTS TO STATES State Plan Requirements: Coverage and Benefits § 457.431 Actuarial report for benchmark... § 457.430, the State must submit to CMS an actuarial report that contains an actuarial opinion that...

  4. 42 CFR 440.340 - Actuarial report for benchmark-equivalent coverage.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Actuarial report for benchmark-equivalent coverage... Benefit and Benchmark-Equivalent Coverage § 440.340 Actuarial report for benchmark-equivalent coverage. (a... described in § 440.335, must include an actuarial report. The actuarial report must contain an...

  5. 42 CFR 440.340 - Actuarial report for benchmark-equivalent coverage.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Actuarial report for benchmark-equivalent coverage... Benefit and Benchmark-Equivalent Coverage § 440.340 Actuarial report for benchmark-equivalent coverage. (a... described in § 440.335, must include an actuarial report. The actuarial report must contain an...

  6. A 5-year retrospective clinical study of the Dentium implants

    PubMed Central

    Lee, Jeong-Yol; Park, Hyo-Jin; Kim, Jong-Eun; Choi, Yong-Geun; Kim, Young-Soo; Huh, Jung-Bo

    2011-01-01

    PURPOSE The aim of this retrospective study was to evaluate cumulative survival rate (CSR) of Implantium implants followed for 5 years and association between risk factors and the CSR. MATERIALS AND METHODS A total of two hundred forty-nine Implantium Implants System (Dentium, Seoul, Korea) placed in ninety-five patients from 2004 to 2009 were investigated with several identified risk factors (sex, systemic disease, smoking, alchohol, reason of tooth loss, length, arch (maxilla or mandible), replace tooth type (incisor, canine, premolar or molar) Kennedy classification, prosthodontic type, prosthodontic design, opposite dentition, abutment type, occlusal material, occlusal unit, splint to tooth, cantilever, other surgery). Clinical examination (mobility, percussion, screw loosening, discomfort, etc.) and radiographic examination data were collected from patient records including all problems during follow-up period according to protocols described earlier. Life table analysis was undertaken to examine the CSR. Cox regression method was conducted to assess the association between potential risk factors and overall CSR. RESULTS Five of 249 implants were failed. Four of these were lost before loading. The 5-year implant cumulative survival rate was 97.37%. Cox regression analysis demonstrated a significant predictive association between overall CSR and systemic disease, smoking, reason of tooth loss, arch, Kennedy classification and prosthodontic design (P<.05). The screw related complication was rare. Two abutment screw fractures were found. Another complications of prosthetic components were porcelain fracture, resin facing fracture and denture fracture (n=19). CONCLUSION The 5-year CSR of Implantium implants was 97.37%. Implant survival may be dependent upon systemic disease, smoking reason of tooth loss, arch, Kennedy classification and prosthodontic design (P<.05). The presence of systemic diseases and combination of other surgical procedures may be associated

  7. Spontaneous Pneumothorax: A 5-Year Experience

    PubMed Central

    Sousa, Cristiana; Neves, Joao; Sa, Nuno; Goncalves, Fabienne; Oliveira, Julio; Reis, Ernestina

    2011-01-01

    Background Spontaneous pneumothorax (SP) is defined by the presence of air in the pleural space without history of trauma. It is classified as secondary if coexisting with underlying pulmonary disease. Its an entity with considerable incidence and treatment particularities which give reason for a reflection on the subject. We present a 5-year casuistry, characterizing the SP epidemiology, clinical presentation, investigation and therapeutic choices. Methods Sixty-six patients were included in the study, corresponding to 93 episodes of SP. Results We have found male predominance and the mean age was 34.5 years old. In 60.6% of cases there was history of tobacco use; 36.4% of cases were classified as secondary; 30.1% of patients with secondary SP and 21.7% with primary SP recurred; 89.2% had an acute presentation. The most frequent initial symptom was chest pain (90.3%) and 81.7% had diminished breath sounds. In 17.3% it was documented a physical strain associated. We did not identify statistically significant association between the SP occurrence and the variation of the atmospheric pressure, on the first day of symptoms. In 12.9% of episodes the initial treatment option was observation. In most of the episodes the lung totally expanded. However, in 29.1% of the episodes surgical treatment was needed. Conclusions Our results are similar to the literature. Some clinical records are incomplete, demanding the implementation of rules to improve knowledge about this matter. Keywords Spontaneous pneumothorax; Primary spontaneous pneumothorax; Secondary spontaneous pneumothorax; Epidemiology PMID:21811541

  8. Microbiological monitoring of endoscopes: 5-year review.

    PubMed

    Gillespie, Elizabeth E; Kotsanas, Despina; Stuart, Rhonda L

    2008-07-01

    Periodic microbiological monitoring of endoscopes is a recommendation of the Gastroenterological Society of Australia (GENSA). The aim of monitoring has been to provide quality assurance of the cleaning and disinfection of endoscopes; however, there is controversy regarding its frequency. This lack of consensus stimulated a review of the experience within our health service. At Southern Health, routine microbiological sampling has involved 4-weekly monitoring of bronchoscopes, duodenoscopes and automated flexible endoscope reprocessors (AFER), and 3-monthly monitoring of all other gastrointestinal endoscopes. Records of testing were reviewed from 1 January 2002 until 31 December 2006. A literature review was conducted, cost analysis performed and positive cultures investigated. There were 2374 screening tests performed during the 5-year period, including 287 AFER, 631 bronchoscopes for mycobacteria and 1456 endoscope bacterial screens. There were no positive results of the AFER or bronchoscopes for mycobacteria. Of the 1456 endoscopic bacterial samples, six were positive; however, retesting resulted in no growth. The overall cost of tests performed and cost in time for nursing staff to collect the samples was estimated at $AUD 100,400. Periodic monitoring of endoscopes is both time-consuming and costly. Our review demonstrates that AFER (Soluscope) perform well in cleaning endoscopes. Based on our 5-year experience, assurance of quality for endoscopic use could be achieved through process control as opposed to product control. Maintenance of endoscopes and AFER should be in accordance with the manufacturer's instructions and microbiological testing performed on commissioning, annually and following repair. Initial prompt manual leak testing and manual cleaning followed by mechanical leak testing, cleaning and disinfection should be the minimum standard in reprocessing of endoscopes. PMID:18086113

  9. Impact of actuarial assumptions on pension costs: A simulation analysis

    NASA Astrophysics Data System (ADS)

    Yusof, Shaira; Ibrahim, Rose Irnawaty

    2013-04-01

    This study investigates the sensitivity of pension costs to changes in the underlying assumptions of a hypothetical pension plan in order to gain a perspective on the relative importance of the various actuarial assumptions via a simulation analysis. Simulation analyses are used to examine the impact of actuarial assumptions on pension costs. There are two actuarial assumptions will be considered in this study which are mortality rates and interest rates. To calculate pension costs, Accrued Benefit Cost Method, constant amount (CA) modification, constant percentage of salary (CS) modification are used in the study. The mortality assumptions and the implied mortality experience of the plan can potentially have a significant impact on pension costs. While for interest rate assumptions, it is inversely related to the pension costs. Results of the study have important implications for analyst of pension costs.

  10. Single vs dual (en bloc) kidney transplants from donors ≤ 5 years of age: A single center experience

    PubMed Central

    Al-Shraideh, Yousef; Farooq, Umar; El-Hennawy, Hany; Farney, Alan C; Palanisamy, Amudha; Rogers, Jeffrey; Orlando, Giuseppe; Khan, Muhammad; Reeves-Daniel, Amber; Doares, William; Kaczmorski, Scott; Gautreaux, Michael D; Iskandar, Samy S; Hairston, Gloria; Brim, Elizabeth; Mangus, Margaret; Stratta, Robert J

    2016-01-01

    AIM: To compare outcomes between single and dual en bloc (EB) kidney transplants (KT) from small pediatric donors. METHODS: Monocentric nonprospective review of KTs from pediatric donors ≤ 5 years of age. Dual EB KT was defined as keeping both donor kidneys attached to the inferior vena cava and aorta, which were then used as venous and arterial conduits for the subsequent transplant into a single recipient. Donor age was less useful than either donor weight or kidney size in decision-making for kidney utilization as kidneys from donors < 8 kg or kidneys < 6 cm in length were not transplanted. Post-transplant management strategies were standardized in all patients. RESULTS: From 2002-2015, 59 KTs were performed including 34 dual EB and 25 single KTs. Mean age of donors (17 mo vs 38 mo, P < 0.001), mean weight (11.0 kg vs 17.4 kg, P = 0.046) and male donors (50% vs 84%, P = 0.01) were lower in the dual EB compared to the single KT group, respectively. Mean cold ischemia time (21 h), kidney donor profile index (KDPI; 73% vs 62%) and levels of serum creatinine (SCr, 0.37 mg/dL vs 0.49 mg/dL, all P = NS) were comparable in the dual EB and single KT groups, respectively. Actuarial graft and patient survival rates at 5-years follow-up were comparable. There was one case of thrombosis resulting in graft loss in each group. Delayed graft function incidence (12% dual EB vs 20% single KT, P = NS) was slightly lower in dual EB KT recipients. Initial duration of hospital stay (mean 5.4 d vs 5.6 d) and the one-year incidences of acute rejection (6% vs 16%), operative complications (3% vs 4%), and major infection were comparable in the dual EB and single KT groups, respectively (all P = NS). Mean 12 mo SCr and abbreviated MDRD levels were 1.17 mg/dL vs 1.35 mg/dL and 72.5 mL/min per 1.73 m2 vs 60.5 mL/min per 1.73 m2 (both P = NS) in the dual EB and single KT groups, respectively. CONCLUSION: By transplanting kidneys from young pediatric donors into adult recipients, one can

  11. Actuarial Science at One Four-Year Comprehensive University

    ERIC Educational Resources Information Center

    Charlwood, Kevin E.

    2014-01-01

    Building an Actuarial Science program designated as advanced requires dedicated faculty, support from the administration, and a core group of strong students. Washburn University may serve as a model for those wishing to start or enhance such a program at their institution. We face three main ongoing challenges: first, the hiring and retention of…

  12. Starting an Actuarial Science Major at a Liberal Arts College

    ERIC Educational Resources Information Center

    Mills, Mark A.

    2014-01-01

    The article provides details of the process of starting an actuarial science major at a small, liberal arts college. Some critique of the major is included, as well as some challenges that may be faced by others wanting to start such a major at their institution.

  13. Predicting Success for Actuarial Students in Undergraduate Mathematics Courses

    ERIC Educational Resources Information Center

    Smith, Richard Manning; Schumacher, Phyllis A.

    2005-01-01

    A study of undergraduate actuarial graduates found that math SAT scores, verbal SAT scores, percentile rank in high school graduating class, and percentage score on a college mathematics placement exam had some relevance to forecasting the students' grade point averages in their major. For both males and females, percentile rank in high school…

  14. 29 CFR 4010.8 - Plan actuarial information.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... the extent the qualification(s) are permitted under 26 CFR 301.6059-1(d). (b) Alternative compliance... retirement age assumptions used by the plan for the plan year ending within the information year for purposes... 29 Labor 9 2010-07-01 2010-07-01 false Plan actuarial information. 4010.8 Section 4010.8...

  15. Strategic Curricular Decisions in Butler University's Actuarial Science Major

    ERIC Educational Resources Information Center

    Wilson, Christopher James

    2014-01-01

    We describe specific curricular decisions employed at Butler University that have resulted in student achievement in the actuarial science major. The paper includes a discussion of how these decisions might be applied in the context of a new actuarial program.

  16. An Overview of the Society of Actuaries and Its Education Programs

    ERIC Educational Resources Information Center

    Klugman, Stuart; Long, Gena

    2014-01-01

    The Society of Actuaries (SOA) is the world's largest actuarial organization. This article describes the SOA with particular attention paid to its education and qualification processes and resources available for university and college programs.

  17. 76 FR 81362 - Regulations Governing the Performance of Actuarial Services Under the Employee Retirement Income...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-28

    ... published in the Federal Register on Thursday, March 31, 2011 (76 FR 17762). DATES: This correction is... ENROLLMENT OF ACTUARIES 20 CFR Part 901 RIN 1545-BC82 Regulations Governing the Performance of Actuarial...--REGULATIONS GOVERNING THE PERFORMANCE OF ACTUARIAL SERVICES UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY...

  18. The Role of an Actuarial Director in the Development of an Introductory Program

    ERIC Educational Resources Information Center

    Staples, Susan G.

    2014-01-01

    We describe the roles and duties of a director in developing an introductory actuarial program. Degree plan design, specialized exam courses, internship classes, coordination of efforts with Economics and Finance Departments, opportunities for creating a minor in actuarial mathematics, actuarial clubs, career advice, and interaction with actuarial…

  19. 29 CFR 2520.104-42 - Waiver of certain actuarial information in the annual report.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Waiver of certain actuarial information in the annual... Reporting and Disclosure Requirements § 2520.104-42 Waiver of certain actuarial information in the annual... ERISA that the annual report include as part of the actuarial statement (Schedule B) 1 the present...

  20. 26 CFR 301.6692-1 - Failure to file actuarial report.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 18 2012-04-01 2012-04-01 false Failure to file actuarial report. 301.6692-1... Assessable Penalties Additions to the Tax and Additional Amounts § 301.6692-1 Failure to file actuarial... the actuarial report described in section 6059 and § 301.6059-1 within the time prescribed, the...

  1. 26 CFR 301.6692-1 - Failure to file actuarial report.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 18 2014-04-01 2014-04-01 false Failure to file actuarial report. 301.6692-1... Assessable Penalties Additions to the Tax and Additional Amounts § 301.6692-1 Failure to file actuarial... the actuarial report described in section 6059 and § 301.6059-1 within the time prescribed, the...

  2. 77 FR 24233 - Actuarial Advisory Committee With Respect to the Railroad Retirement Account; Notice of Public...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-23

    ... Actuarial Advisory Committee With Respect to the Railroad Retirement Account; Notice of Public Meeting Notice is hereby given in accordance with Public Law 92-463 that the Actuarial Advisory Committee will... Retirement Board, 844 North Rush Street, Chicago, Illinois, on the conduct of the 25th Actuarial Valuation...

  3. 26 CFR 301.6692-1 - Failure to file actuarial report.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 18 2011-04-01 2011-04-01 false Failure to file actuarial report. 301.6692-1... Assessable Penalties Additions to the Tax and Additional Amounts § 301.6692-1 Failure to file actuarial... the actuarial report described in section 6059 and § 301.6059-1 within the time prescribed, the...

  4. 29 CFR 2520.104-42 - Waiver of certain actuarial information in the annual report.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 9 2014-07-01 2014-07-01 false Waiver of certain actuarial information in the annual... Reporting and Disclosure Requirements § 2520.104-42 Waiver of certain actuarial information in the annual... ERISA that the annual report include as part of the actuarial statement (Schedule B) 1 the present...

  5. 26 CFR 301.6692-1 - Failure to file actuarial report.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Failure to file actuarial report. 301.6692-1... Assessable Penalties Additions to the Tax and Additional Amounts § 301.6692-1 Failure to file actuarial... the actuarial report described in section 6059 and § 301.6059-1 within the time prescribed, the...

  6. 29 CFR 2520.104-42 - Waiver of certain actuarial information in the annual report.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 9 2011-07-01 2011-07-01 false Waiver of certain actuarial information in the annual... Reporting and Disclosure Requirements § 2520.104-42 Waiver of certain actuarial information in the annual... ERISA that the annual report include as part of the actuarial statement (Schedule B) 1 the present...

  7. The Undergraduate Statistics Major--A Prelude to Actuarial Science Training.

    ERIC Educational Resources Information Center

    Ratliff, Michael I.; Williams, Raymond E.

    Recently there has been increased interest related to the Actuarial Science field. An actuary is a business professional who uses mathematical skills to define, analyze, and solve financial and social problems. This paper examines: (1) the interface between Statistical and Actuarial Science training; (2) statistical courses corresponding to…

  8. 75 FR 68790 - Medicare Program; Medicare Part B Monthly Actuarial Rates, Premium Rate, and Annual Deductible...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-09

    ... Monthly Actuarial Rates, Premium Rate, and Annual Deductible Beginning January 1, 2011 AGENCY: Centers for... actuarial rates for aged (age 65 and over) and disabled (under age 65) beneficiaries enrolled in Part B of... certain threshold amounts. The monthly actuarial rates for 2011 are $230.70 for aged enrollees and...

  9. 26 CFR 301.6692-1 - Failure to file actuarial report.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 18 2013-04-01 2013-04-01 false Failure to file actuarial report. 301.6692-1... Assessable Penalties Additions to the Tax and Additional Amounts § 301.6692-1 Failure to file actuarial... the actuarial report described in section 6059 and § 301.6059-1 within the time prescribed, the...

  10. 29 CFR 2520.104-42 - Waiver of certain actuarial information in the annual report.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false Waiver of certain actuarial information in the annual... Reporting and Disclosure Requirements § 2520.104-42 Waiver of certain actuarial information in the annual... ERISA that the annual report include as part of the actuarial statement (Schedule B) 1 the present...

  11. 29 CFR 2520.104-42 - Waiver of certain actuarial information in the annual report.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 9 2012-07-01 2012-07-01 false Waiver of certain actuarial information in the annual... Reporting and Disclosure Requirements § 2520.104-42 Waiver of certain actuarial information in the annual... ERISA that the annual report include as part of the actuarial statement (Schedule B) 1 the present...

  12. Including an Exam P/1 Prep Course in a Growing Actuarial Science Program

    ERIC Educational Resources Information Center

    Wakefield, Thomas P.

    2014-01-01

    The purpose of this article is to describe the actuarial science program at our university and the development of a course to enhance students' problem solving skills while preparing them for Exam P/1 of the Society of Actuaries (SOA) and the Casualty Actuary Society (CAS). The Exam P/1 prep course, formally titled Mathematical Foundations of…

  13. Insights into managed care--operational, legal and actuarial.

    PubMed

    Melek, S P; Johnson, B A; Schryver, D

    1997-01-01

    Understanding the operational, legal and actuarial dimensions of managed care is essential to developing managed care contracts between managed care organizations and individual health care providers or groups such as provider-sponsored organizations or independent practice associations. Operationally, it is important to understand managed care and its trends, emphasizing business issues, knowing your practice and defining acceptable levels of reimbursement and risk. Legally, there are a number of common themes or issues relevant to all managed care contracts, including primary care vs. specialist contracts, services offered, program policies and procedures, utilization review, physician reimbursement and compensation, payment schedule, terms and conditions, term and termination, continuation of care requirements, indemnification, amendment of contract and program policies, and stop-loss insurance. Actuarial issues include membership, geography, age-gender distribution, degree of health care management, local managed care utilization levels, historical utilization levels, health plan benefit design, among others. PMID:10165777

  14. Human actuarial aging increases faster when back ground death rates are lower: a consequence of differential heterogeneity?

    PubMed Central

    Hawkes, Kristen; Smith, Ken R.; Blevins, James K.

    2014-01-01

    Many analyses of human populations have found that age-specific mortality rates increase faster across most of adulthood when overall mortality levels decline. This contradicts the relationship often expected from Williams′ classic hypothesis about the effects of natural selection on the evolution of senescence. More likely, much of the within-species difference in actuarial aging is not due to variation in senescence, but to the strength of filters on the heterogeneity of frailty in older survivors. A challenge to this differential frailty hypothesis was recently posed by an analysis of life tables from historical European populations and traditional societies that reported variation in actuarial aging consistent with Williams′ hypothesis after all. To investigate the challenge, we reconsidered those cases and aging measures. Here we show that the discrepancy depends on Ricklefs′ aging rate measure,ω, which decreases as mortality levels drop because it is an index of mortality level itself, not the rate of increase in mortality with age. We also show unappreciated correspondence among the parameters of Gompertz–Makeham and Weibull survival models. Finally, we compare the relationships among mortality parameters of the traditional societies and the historical series, providing further suggestive evidence that differential heterogeneity has strong effects on actuarial aging. PMID:22220868

  15. Long-term survival after resection of pancreatic cancer: A single-center retrospective analysis

    PubMed Central

    Yamamoto, Takehito; Yagi, Shintaro; Kinoshita, Hiromitsu; Sakamoto, Yusuke; Okada, Kazuyuki; Uryuhara, Kenji; Morimoto, Takeshi; Kaihara, Satoshi; Hosotani, Ryo

    2015-01-01

    AIM: To retrospectively analyze factors affecting the long-term survival of patients with pancreatic cancer who underwent pancreatic resection. METHODS: From January 2000 to December 2011, 195 patients underwent pancreatic resection in our hospital. The prognostic factors after pancreatic resection were analyzed in all 195 patients. After excluding the censored cases within an observational period, the clinicopathological characteristics of 20 patients who survived ≥ 5 (n = 20) and < 5 (n = 76) years were compared. For this comparison, we analyzed the patients who underwent surgery before June 2008 and were observed for more than 5 years. For statistical analyses, the log-rank test was used to compare the cumulative survival rates, and the χ2 and Mann-Whitney tests were used to compare the two groups. The Cox-Hazard model was used for a multivariate analysis, and P values less than 0.05 were considered significant. A multivariate analysis was conducted on the factors that were significant in the univariate analysis. RESULTS: The median survival for all patients was 27.1 months, and the 5-year actuarial survival rate was 34.5%. The median observational period was 595 d. With the univariate analysis, the UICC stage was significantly associated with survival time, and the CA19-9 ≤ 200 U/mL, DUPAN-2 ≤ 180 U/mL, tumor size ≤ 20 mm, R0 resection, absence of lymph node metastasis, absence of extrapancreatic neural invasion, and absence of portal invasion were favorable prognostic factors. The multivariate analysis showed that tumor size ≤ 20 mm (HR = 0.40; 95%CI: 0.17-0.83, P = 0.012) and negative surgical margins (R0 resection) (HR = 0.48; 95%CI: 0.30-0.77, P = 0.003) were independent favorable prognostic factors. Among the 96 patients, 20 patients survived for 5 years or more, and 76 patients died within 5 years after operation. Comparison of the 20 5-year survivors with the 76 non-survivors showed that lower concentrations of DUPAN-2 (79.5 vs 312.5 U/mL, P

  16. The Alcohol Warning and Adolescents: 5-Year Effects.

    ERIC Educational Resources Information Center

    MacKinnon, David P.; Nohre, Liva; Pentz, Mary Ann; Stacy, Alan W.

    2000-01-01

    Examined the effect of alcohol warning labels on adolescents during the first 5 years that the warning was required. Surveys of 10th and 12th grade students over 5 years indicated that the initial positive effects of the labels on adolescents leveled off after 3.5 years. The labels have not affected adolescents' beliefs about alcohol or…

  17. Survival Rates for Thymus Cancer

    MedlinePlus

    ... staged? Next Topic How is thymus cancer treated? Survival rates for thymus cancer Survival rates are often ... into account. Stage of thymoma 5-year observed survival rate I 74% II 73% III 64% IV ...

  18. 26 CFR 1.412(c)(2)-1 - Valuation of plan assets; reasonable actuarial valuation methods.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 5 2014-04-01 2014-04-01 false Valuation of plan assets; reasonable actuarial..., Stock Bonus Plans, Etc. § 1.412(c)(2)-1 Valuation of plan assets; reasonable actuarial valuation methods... actuarial valuation method which satisfies the requirements of section 412(c)(2)(A). An actuarial...

  19. 26 CFR 1.412(c)(2)-1 - Valuation of plan assets; reasonable actuarial valuation methods.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 5 2012-04-01 2011-04-01 true Valuation of plan assets; reasonable actuarial..., Stock Bonus Plans, Etc. § 1.412(c)(2)-1 Valuation of plan assets; reasonable actuarial valuation methods... actuarial valuation method which satisfies the requirements of section 412(c)(2)(A). An actuarial...

  20. 26 CFR 1.412(c)(2)-1 - Valuation of plan assets; reasonable actuarial valuation methods.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 5 2013-04-01 2013-04-01 false Valuation of plan assets; reasonable actuarial..., Stock Bonus Plans, Etc. § 1.412(c)(2)-1 Valuation of plan assets; reasonable actuarial valuation methods... actuarial valuation method which satisfies the requirements of section 412(c)(2)(A). An actuarial...

  1. Of pacemakers and statistics: the actuarial method extended.

    PubMed

    Dussel, J; Wolbarst, A B; Scott-Millar, R N; Obel, I W

    1980-01-01

    Pacemakers cease functioning because of either natural battery exhaustion (nbe) or component failure (cf). A study of four series of pacemakers shows that a simple extension of the actuarial method, so as to incorporate Normal statistics, makes possible a quantitative differentiation between the two modes of failure. This involves the separation of the overall failure probability density function PDF(t) into constituent parts pdfnbe(t) and pdfcf(t). The approach should allow a meaningful comparison of the characteristics of different pacemaker types. PMID:6160497

  2. Survival by Stage of Soft Tissue Sarcoma

    MedlinePlus

    ... Next Topic How are soft tissue sarcomas treated? Survival by stage of soft tissue sarcoma Survival rates ... observed, not relative survival): Stage 5-year observed survival rate I 90% II 81% III 56% IV ...

  3. An actuarial approach to retrofit savings in buildings

    SciTech Connect

    Subbarao, Krishnappa; Etingov, Pavel V.; Reddy, T. A.

    2014-01-01

    An actuarial method has been developed for determining energy savings from retrofits from energy use data for a number of buildings. This method should be contrasted with the traditional method of using pre- and post-retrofit data on the same building. This method supports the U.S. Department of Energy Building Performance Database of real building performance data and related tools that enable engineering and financial practitioners to evaluate retrofits. The actuarial approach derives, from the database, probability density functions (PDFs) for energy savings from retrofits by creating peer groups for the user’s pre post buildings. From the energy use distribution of the two groups, the savings PDF is derived. This provides the basis for engineering analysis as well as financial risk analysis leading to investment decisions. Several technical issues are addressed: The savings PDF is obtained from the pre- and post-PDF through a convolution. Smoothing using kernel density estimation is applied to make the PDF more realistic. The low data density problem can be mitigated through a neighborhood methodology. Correlations between pre and post buildings are addressed to improve the savings PDF. Sample size effects are addressed through the Kolmogorov--Smirnov tests and quantile-quantile plots.

  4. Blunt traumatic cardiac rupture. A 5-year experience.

    PubMed

    Brathwaite, C E; Rodriguez, A; Turney, S Z; Dunham, C M; Cowley, R

    1990-12-01

    Blunt traumatic cardiac rupture is associated with a high rate of mortality. A review of the computerized trauma registry (1983 to 1988) identified 32 patients with this injury (ages 19 to 65 years; mean age, 39.5 years; 21 men and 11 women). Twenty-one patients (65.6%) were injured in vehicular crashes, 3 (9.4%) in pedestrian accidents, 3 (9.4%) in motorcycle accidents; 3 (9.4%) sustained crush injury; 1 (3.1%) was injured by a fall; and 1 (3.1%) was kicked in the chest by a horse. Anatomic injuries included right atrial rupture (13[40.6%]), left atrial rupture (8 [25%]), right ventricular rupture (10[31.3%]), left ventricular rupture (4[12.5%]), and rupture of two cardiac chambers (3 [9.4%]). Diagnosis was made by thoracotomy in all 20 patients presenting in cardiac arrest. In the remaining 12 patients, the diagnosis was established in seven by emergency left anterolateral thoracotomy and in five by subxyphoid pericardial window. Seven of these 12 patients (58.3%) had clinical cardiac tamponade and significant upper torso cyanosis. The mean Injury Severity Score (ISS), Trauma Score (TS), and Glasgow Coma Scale (GCS) score were 33.8, 13.2, and 14.3, respectively, among survivors and 51.5, 8.3, and 7.0 for nonsurvivors. The overall mortality rate was 81.3% (26 of 32 patients), the only survivors being those presenting with vital signs (6 of 12 patients [50%]). All patients with rupture of two cardiac chambers or with ventricular rupture died. The mortality rate from myocardial rupture is very high. Rapid prehospital transportation, a high index of suspicion, and prompt surgical intervention contribute to survival in these patients. PMID:2256761

  5. Actuarial senescence can increase the risk of extinction of mammal populations.

    PubMed

    Robert, Alexandre; Chantepie, Stéphane; Pavard, Samuel; Sarrazin, François; Teplitsky, Céline

    2015-01-01

    Despite recent acknowledgement that senescence can have negative impact on survival and fertility in natural environments across a wide range of animal species, we still do not know if it can reduce the viability of wild endangered populations. Focusing on actuarial senescence (i.e., the decline of survival probabilities at old ages), we use species-specific demographic information to project the extinction risk of wild populations of 58 species of mammals, accounting (or not) for senescence. Our projections reveal potential negative effects of aging on population viability, with an average decrease of 27% of the time to extinction and a potential deterioration of the population-level projected conservation status in 10% of the species. Senescence is associated with particularly strong increases of the extinction risk in species with low mortality rates and long intervals between litters, independently of their place in the phylogeny, indicating that the pace of life history can be used to forecast the detrimental effects of aging on the viability of species. The aim of the various existing systems of classification of threatened species is to set conservation priorities based on assessments of extinction risk. Our results indicate that the quantitative effects of senescence on extinction are highly heterogeneous, which can affect the ranking of species and populations when setting conservation, priorities. In mammals, based on life history traits of a few species, generic patterns of senescence can be incorporated into projection population models to minimize these biases in viability assessments. PMID:26255361

  6. 76 FR 17762 - Regulations Governing the Performance of Actuarial Services Under the Employee Retirement Income...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-31

    ...This document contains final regulations under section 3042 of the Employee Retirement Income Security Act of 1974 (ERISA) relating to the enrollment of actuaries. These regulations update the eligibility requirements for performing actuarial services for ERISA-covered employee pension benefit plans, including the continuing professional education requirements, and the standards for performing......

  7. A Comparison of Logistic Regression, Neural Networks, and Classification Trees Predicting Success of Actuarial Students

    ERIC Educational Resources Information Center

    Schumacher, Phyllis; Olinsky, Alan; Quinn, John; Smith, Richard

    2010-01-01

    The authors extended previous research by 2 of the authors who conducted a study designed to predict the successful completion of students enrolled in an actuarial program. They used logistic regression to determine the probability of an actuarial student graduating in the major or dropping out. They compared the results of this study with those…

  8. Actuarial Prediction of Performance in a Six-Year A.B.-M.D. Program

    ERIC Educational Resources Information Center

    Hess, Thomas G.; Brown, Donald R.

    1977-01-01

    Four actuarial equations for predicting an academic performance criterion were developed and assessed at the University of Michigan. It was concluded that appropriately done actuarial prediction of an individual criterion is more efficient than the efforts of an admissions committee. (LBH)

  9. Clinical versus Actuarial Predictions of Violence in Patients with Mental Illness.

    ERIC Educational Resources Information Center

    Gardner, William; And Others

    1996-01-01

    Compared accuracy of an actuarial procedure for the prediction of community violence by patients with mental illnesses to accuracy of clinicians' concern ratings of patient violence. Data came from a study of 357 pairs of patients seen in a psychiatric emergency room. Actuarial predictions based only on patients' histories of violence were more…

  10. 75 FR 47650 - Actuarial Advisory Committee With Respect to the Railroad Retirement Account; Notice of Public...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-06

    ... Actuarial Advisory Committee With Respect to the Railroad Retirement Account; Notice of Public Meeting Notice is hereby given in accordance with Public Law 92-463 that the Actuarial Advisory Committee will.... Railroad Retirement Board, 844 North Rush Street, Chicago, Illinois, on the conduct of the 25th...

  11. Risk Assessment in Child Protective Services: Consensus and Actuarial Model Reliability.

    ERIC Educational Resources Information Center

    Baird, Christopher; Wagner, Dennis; Healy, Theresa; Johnson, Kristen

    1999-01-01

    Compared reliability of three widely used child protective service risk-assessment models (one actuarial, two consensus based). Found that, although no system approached 100% interrater reliability, raters employing the actuarial model made consistent estimates of risk for a high percentage of cases they assessed. Interrater reliability for the…

  12. 76 FR 81362 - Regulations Governing the Performance of Actuarial Services Under the Employee Retirement Income...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-28

    ..., 2011 (76 FR 17762) relating to the enrollment of actuaries. DATES: This correction is effective on..., the publication of the final regulations (TD 9517) which were the subject of FR Doc. 2011-7573 is... ENROLLMENT OF ACTUARIES 20 CFR Part 901 RIN 1545-BC82 Regulations Governing the Performance of...

  13. An analysis of possible applications of fuzzy set theory to the actuarial credibility theory

    NASA Technical Reports Server (NTRS)

    Ostaszewski, Krzysztof; Karwowski, Waldemar

    1992-01-01

    In this work, we review the basic concepts of actuarial credibility theory from the point of view of introducing applications of the fuzzy set-theoretic method. We show how the concept of actuarial credibility can be modeled through the fuzzy set membership functions and how fuzzy set methods, especially fuzzy pattern recognition, can provide an alternative tool for estimating credibility.

  14. Criminal Behavior as a Function of Clinical and Actuarial Variables in a Sexual Offender Population.

    ERIC Educational Resources Information Center

    Hall, Gordon C. Nagayama

    1988-01-01

    Investigated ability of clinical and actuarial variables to predict criminal behavior of 342 sexual offenders previously studied in 1987. Results suggested linear combination of actuarial variables was significantly predictive of sexual reoffenses against adults and of nonsexual reoffending. Clinical judgment was not significantly predictive of…

  15. 76 FR 67774 - Actuarial Advisory Committee With Respect to the Railroad Retirement Account; Notice of Public...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-02

    ... Actuarial Advisory Committee With Respect to the Railroad Retirement Account; Notice of Public Meeting Notice is hereby given in accordance with Public Law 92-463 that the Actuarial Advisory Committee will.... Railroad Retirement ] Board, 844 North Rush Street, Chicago, Illinois, on the conduct of the 25th...

  16. Is More Better? Combining Actuarial Risk Scales to Predict Recidivism among Adult Sex Offenders

    ERIC Educational Resources Information Center

    Seto, Michael C.

    2005-01-01

    The present study was conducted to determine whether combining the results of multiple actuarial risk scales increases accuracy in predicting sex offender recidivism. Multiple methods of combining 4 validated actuarial risk scales--the Violence Risk Appraisal Guide, the Sex Offender Risk Appraisal Guide, the Rapid Risk Assessment for Sexual…

  17. 5 CFR 839.1119 - How is the actuarial reduction for TSP computed?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false How is the actuarial reduction for TSP computed? 839.1119 Section 839.1119 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED... actuarial reduction for TSP computed? (a) The part of your TSP account on the date you retired that...

  18. 5 CFR 839.1119 - How is the actuarial reduction for TSP computed?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false How is the actuarial reduction for TSP computed? 839.1119 Section 839.1119 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED... actuarial reduction for TSP computed? (a) The part of your TSP account on the date you retired that...

  19. 5 CFR 839.1119 - How is the actuarial reduction for TSP computed?

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false How is the actuarial reduction for TSP computed? 839.1119 Section 839.1119 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED... actuarial reduction for TSP computed? (a) The part of your TSP account on the date you retired that...

  20. 5 CFR 839.1119 - How is the actuarial reduction for TSP computed?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false How is the actuarial reduction for TSP computed? 839.1119 Section 839.1119 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED... actuarial reduction for TSP computed? (a) The part of your TSP account on the date you retired that...

  1. 5 CFR 839.1119 - How is the actuarial reduction for TSP computed?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false How is the actuarial reduction for TSP computed? 839.1119 Section 839.1119 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED... actuarial reduction for TSP computed? (a) The part of your TSP account on the date you retired that...

  2. Superselective radioembolization of hepatocellular carcinoma: 5-year results of a prospective study.

    PubMed

    Rösler, H; Triller, J; Baer, H U; Geiger, L; Beer, H F; Becker, C; Blumgart, L H

    1994-10-01

    Twenty patients with unresectable hepatocellular carcinoma (HCC) were followed up to 5 years after transarterial radiotherapy with 90Y-resin particles. Diagnostic radioembolizations of 99mTc-macroaggregates facilitated scintigraphic assessment of activity distribution, dose evaluation and final procedural verification. The overall survival rates were 56, 38 and 14% (after 1, 2 and 3 years, resp.). Patients with unifocal HCC and a single feeding artery (n = 7) even presented 83, 67 and 40% (2 alive after 2.75 and 4 years). With multiple arteries (n = 7), the longest survival was 26 months. Patients with multifocal HCC survived up to 33 months after selective radioembolization. Quality of life was improved in all. Survival was positively correlated with absorbed dose but residual/recurrent tumour occurred even after > or = 300 Gy. Post-treatment symptoms were minimal (35 applications), pulmonary shunt rates were correctly predicted and pulmonary complications avoided. PMID:7997379

  3. Long-Term Survival in Patients With Synchronous, Solitary Brain Metastasis From Non-Small-Cell Lung Cancer Treated With Radiosurgery

    SciTech Connect

    Flannery, Todd W.; Suntharalingam, Mohan; Regine, William F.; Chin, Lawrence S.; Krasna, Mark J.; Shehata, Michael K.; Edelman, Martin J.; Kremer, Marnie; Patchell, Roy A.; Kwok, Young

    2008-09-01

    Purpose: To report the outcome of patients with synchronous, solitary brain metastasis from non-small-cell lung cancer (NSCLC) treated with gamma knife stereotactic radiosurgery (GKSRS). Patients and Methods: Forty-two patients diagnosed with synchronous, solitary brain metastasis from NSCLC were treated with GKSRS between 1993 and 2006. The median Karnofsky performance status (KPS) was 90. Patients had thoracic Stage I-III disease (American Joint Committee on Cancer 2002 guidelines). Definitive thoracic therapy was delivered to 26/42 (62%) patients; 9 patients underwent chemotherapy and radiation, 12 patients had surgical resection, and 5 patients underwent preoperative chemoradiation and surgical resection. Results: The median overall survival (OS) was 18 months. The 1-, 2-, and 5-year actuarial OS rates were 71.3%, 34.1%, and 21%, respectively. For patients who underwent definitive thoracic therapy, the median OS was 26.4 months compared with 13.1 months for those who had nondefinitive therapy, and the 5-year actuarial OS was 34.6% vs. 0% (p < 0.0001). Median OS was significantly longer for patients with a KPS {>=}90 vs. KPS < 90 (27.8 months vs. 13.1 months, p < 0.0001). The prognostic factors significant on multivariate analysis were definitive thoracic therapy (p = 0.020) and KPS (p = 0.001). Conclusions: This is one of the largest series of patients diagnosed with synchronous, solitary brain metastasis from NSCLC treated with GKSRS. Definitive thoracic therapy and KPS significantly impacted OS. The 5-year OS of 21% demonstrates the potential for long-term survival in patients treated with GKSRS; therefore, patients with good KPS should be considered for definitive thoracic therapy.

  4. Mating Reverses Actuarial Aging in Female Queensland Fruit Flies

    PubMed Central

    Yap, Sarsha; Fanson, Benjamin G.; Taylor, Phillip W.

    2015-01-01

    Animals that have a long pre-reproductive adult stage often employ mechanisms that minimize aging over this period in order to preserve reproductive lifespan. In a remarkable exception, one tephritid fruit fly exhibits substantial pre-reproductive aging but then mitigates this aging during a diet-dependent transition to the reproductive stage, after which life expectancy matches that of newly emerged flies. Here, we ascertain the role of nutrients, sexual maturation and mating in mitigation of previous aging in female Queensland fruit flies. Flies were provided one of three diets: ‘sugar’, ‘essential’, or ‘yeast-sugar’. Essential diet contained sugar and micronutrients found in yeast but lacked maturation-enabling protein. At days 20 and 30, a subset of flies on the sugar diet were switched to essential or yeast-sugar diet, and some yeast-sugar fed flies were mated 10 days later. Complete mitigation of actuarial aging was only observed in flies that were switched to a yeast-sugar diet and mated, indicating that mating is key. Identifying the physiological processes associated with mating promise novel insights into repair mechanisms for aging. PMID:26147734

  5. 2001 IFT Education Standards: A 5-Year Perspective

    ERIC Educational Resources Information Center

    Hartel, Richard W.

    2006-01-01

    The current IFT Education Standards used to evaluate Food Science programs for IFT approval have been in place now for 5 years. Most Food Science programs in the United States (as well as some in Mexico and Canada) have been reviewed according to these standards. The transition to instruction based on assessment of student learning outcomes, in…

  6. True or False: Do 5-Year-Olds Understand Belief?

    ERIC Educational Resources Information Center

    Fabricius, William V.; Boyer, Ty W.; Weimer, Amy A.; Carroll, Kathleen

    2010-01-01

    In 3 studies (N = 188) we tested the hypothesis that children use a perceptual access approach to reason about mental states before they understand beliefs. The perceptual access hypothesis predicts a U-shaped developmental pattern of performance in true belief tasks, in which 3-year-olds who reason about reality should succeed, 4- to 5-year-olds…

  7. Upper Body Muscular Endurance Among Children 2-5 Years.

    ERIC Educational Resources Information Center

    Gabbard, Carl P.; And Others

    The upper body muscular endurance of males and females 2-5 years of age was assessed, and relationships relative to sex, age, endurance and selected anthropometric measures were investigated. None of the relationships were found to be of practical predicative value; while upper body muscular strength increased with age, no significant differences…

  8. Stimulant Treatment over 5 Years: Effects on Growth

    ERIC Educational Resources Information Center

    Charach, Alice; Figueroa, Max; Chen, Shirley; Ickowicz, Abel; Schachar, Russell

    2006-01-01

    Objective: Long-term effects of psychostimulants on growth in height and in weight are investigated in children with attention-deficit/hyperactivity disorder. Method: Participants were 79 children, 6 to 12 years of age, with attention-deficit/hyperactivity disorder, who were followed annually for up to 5 years, between the years 1993 and 1994 and…

  9. 78 FR 773 - Hartford Financial Services Group, Inc., Commercial/Actuarial/Information Delivery Services (IDS...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-04

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF LABOR Employment and Training Administration Hartford Financial Services Group, Inc., Commercial/Actuarial/ Information Delivery Services (IDS)/Corporate & Financial Reporting Group, Hartford, CT; Notice of...

  10. Failure to immunize children under 5 years: a literature review.

    PubMed

    Lochhead, Y J

    1991-02-01

    This paper aims to provide a critical review of the current literature related to immunization default in children under 5 years of age. The author has used a health belief model as the framework for analysis, examining each area in detail. The principle recommendations for practice are addressed and critically evaluated with a concluding summary of the main points raised and the author's recommendation for practice. PMID:2013653

  11. Modified Mandibulotomy Technique to Reduce Postoperative Complications: 5-Year Results

    PubMed Central

    Na, Hye-Young; Choi, Eun-Joo; Kim, Hyung Jun; Cha, In-Ho

    2013-01-01

    Purpose To review the 5-year outcomes of our modified mandibulotomy technique. Retrospective review of a tertiary level oral cancer center. Materials and Methods During a 5-year period, 30 patients who had a uniform surgical technique consisting of a lower lip-splitting, modified stair-step osteotomy with thin saw blade and osteotome after plate-precontouring and combination fixation with monocortical osteosynthesis (miniplate) and bicortical osteosynthesis (maxiplate and bicortical screws), with at least 14 months postoperative follow-up, were selected and reviewed retrospectively. Results There were 8 women and 22 men with an average age of 56.5 years. All the patients involved malignancies were squamous cell carcinoma. The main primary sites of the those who underwent a mandibulotomy were the tonsil, the base of tongue, the oral tongue, the retromolar pad area, and others. Others included buccal cheek, floor of mouth, and soft palate. 23 patients received postoperative radiation therapy, and among whom 8 patients also received chemotherapy. Total four (13%) mandibulotomy-related complications occurred, only two (6.7%) requiring additional operation under general anesthesia. Conclusion Our modified mandibulotomy meets the criteria for an ideal mandibulotomy technique relatively well because it requires no intermaxillary fixation, can precise preserve the occlusion in a precise way, allows early function, requires no secondary procedures, and has few complications. PMID:23918577

  12. Prone Breast Intensity Modulated Radiation Therapy: 5-Year Results

    SciTech Connect

    Osa, Etin-Osa O.; DeWyngaert, Keith; Roses, Daniel; Speyer, James; Guth, Amber; Axelrod, Deborah; Fenton Kerimian, Maria; Goldberg, Judith D.; Formenti, Silvia C.

    2014-07-15

    Purpose: To report the 5-year results of a technique of prone breast radiation therapy delivered by a regimen of accelerated intensity modulated radiation therapy with a concurrent boost to the tumor bed. Methods and Materials: Between 2003 and 2006, 404 patients with stage I-II breast cancer were prospectively enrolled into 2 consecutive protocols, institutional trials 03-30 and 05-181, that used the same regimen of 40.5 Gy/15 fractions delivered to the index breast over 3 weeks, with a concomitant daily boost to the tumor bed of 0.5 Gy (total dose 48 Gy). All patients were treated after segmental mastectomy and had negative margins and nodal assessment. Patients were set up prone: only if lung or heart volumes were in the field was a supine setup attempted and chosen if found to better spare these organs. Results: Ninety-two percent of patients were treated prone, 8% supine. Seventy-two percent had stage I, 28% stage II invasive breast cancer. In-field lung volume ranged from 0 to 228.27 cm{sup 3}, mean 19.65 cm{sup 3}. In-field heart volume for left breast cancer patients ranged from 0 to 21.24 cm{sup 3}, mean 1.59 cm{sup 3}. There was no heart in the field for right breast cancer patients. At a median follow-up of 5 years, the 5-year cumulative incidence of isolated ipsilateral breast tumor recurrence was 0.82% (95% confidence interval [CI] 0.65%-1.04%). The 5-year cumulative incidence of regional recurrence was 0.53% (95% CI 0.41%-0.69%), and the 5-year overall cumulative death rate was 1.28% (95% CI 0.48%-3.38%). Eighty-two percent (95% CI 77%-85%) of patients judged their final cosmetic result as excellent/good. Conclusions: Prone accelerated intensity modulated radiation therapy with a concomitant boost results in excellent local control and optimal sparing of heart and lung, with good cosmesis. Radiation Therapy Oncology Group protocol 1005, a phase 3, multi-institutional, randomized trial is ongoing and is evaluating the equivalence of a similar dose and

  13. External Beam Accelerated Partial-Breast Irradiation Using 32 Gy in 8 Twice-Daily Fractions: 5-Year Results of a Prospective Study

    SciTech Connect

    Pashtan, Itai M.; Recht, Abram; Ancukiewicz, Marek; Brachtel, Elena; Abi-Raad, Rita F.; D'Alessandro, Helen A.; Levy, Antonin; Wo, Jennifer Y.; Hirsch, Ariel E.; Kachnic, Lisa A.; Goldberg, Saveli; Specht, Michelle; Gadd, Michelle; Smith, Barbara L.; Powell, Simon N.; Taghian, Alphonse G.

    2012-11-01

    Purpose: External beam accelerated partial breast irradiation (APBI) is an increasingly popular technique for treatment of patients with early stage breast cancer following breast-conserving surgery. Here we present 5-year results of a prospective trial. Methods and Materials: From October 2003 through November 2005, 98 evaluable patients with stage I breast cancer were enrolled in the first dose step (32 Gy delivered in 8 twice-daily fractions) of a prospective, multi-institutional, dose escalation clinical trial of 3-dimensional conformal external beam APBI (3D-APBI). Median age was 61 years; median tumor size was 0.8 cm; 89% of tumors were estrogen receptor positive; 10% had a triple-negative phenotype; and 1% had a HER-2-positive subtype. Median follow-up was 71 months (range, 2-88 months; interquartile range, 64-75 months). Results: Five patients developed ipsilateral breast tumor recurrence (IBTR), for a 5-year actuarial IBTR rate of 5% (95% confidence interval [CI], 1%-10%). Three of these cases occurred in patients with triple-negative disease and 2 in non-triple-negative patients, for 5-year actuarial IBTR rates of 33% (95% CI, 0%-57%) and 2% (95% CI, 0%-6%; P<.0001), respectively. On multivariable analysis, triple-negative phenotype was the only predictor of IBTR, with borderline statistical significance after adjusting for tumor grade (P=.0537). Conclusions: Overall outcomes were excellent, particularly for patients with estrogen receptor-positive disease. Patients in this study with triple-negative breast cancer had a significantly higher IBTR rate than patients with other receptor phenotypes when treated with 3D-APBI. Larger, prospective 3D-APBI clinical trials should continue to evaluate the effect of hormone receptor phenotype on IBTR rates.

  14. Circumcision: a refined technique and 5 year review.

    PubMed Central

    Tucker, S. C.; Cerqueiro, J.; Sterne, G. D.; Bracka, A.

    2001-01-01

    The vast majority of circumcisions currently performed in the UK are for phimosis or balanitis and the patients are not looking for the denuded glans appearance of a ritual circumcision. We present a refinement of the sleeve technique of circumcision, which involves Horton's test to define the proximal incision margin, and bipolar electro-dissection. A review of all patients undergoing circumcision at the Wordsley Plastic Surgery Unit, in a 5-year period, has shown this technique to be safe with a haematoma rate of only 1.4%, and an overall complication rate of 3%. Images Figure 1 Figure 1 (G,H) Figure 2 PMID:11320921

  15. Total wrist arthroplasty: a systematic review of the evidence from the last 5 years.

    PubMed

    Yeoh, D; Tourret, L

    2015-06-01

    We reviewed evidence on total wrist replacement from the last 5 years. Eight articles met a minimum set standard. The results of 405 prostheses were available, including seven different manufacturers. The mean follow up was 2.3-7.3 years with an average age of 52-63. Rheumatoid arthritis was the indication in 42% of patients. Motec demonstrated the best post-operative DASH scores. Only Maestro achieved a defined functional range of motion post-operatively. Universal 2 displayed the highest survival rates (100% at 3-5 years), while Elos had the lowest (57% at 5 years). Biaxial had the highest complication rates (68.7%), while Remotion had the lowest (11%). Wrist arthroplasty preserves some range of motion. Functional scores improved and were maintained over the mid- to long-term. Complication rates were higher than wrist fusion, with reports of radiological loosening and osteolysis. The evidence does not support the widespread use of arthroplasty over arthrodesis, and careful patient selection is essential. PMID:24963082

  16. Migration of the Duraloc cup after 5 years.

    PubMed

    Stihsen, Christoph; Pabinger, Christof; Radl, Roman; Rehak, Peter; Windhager, Reinhard

    2008-12-01

    The Duraloc cup is a frequently used metal-backed, porous-coated, hemispherical, press-fit acetabular component. Published data on loosening rates are contradictory. In this study we investigated migration patterns with computer-assisted Einzel-Bild-Roentgen-Analyse (EBRA) of 67 Duraloc 100 cups. Cup migration and clinical scores were analysed over a 5-year follow-up period. Median total migration of the Duraloc 100 cup was 1.21 mm at 5 years. Seventy-five percent of implants were radiologically stable at 2 years and 90% at 4 years. One cup loosened aseptically at 60 months, requiring revision. Cup diameters > or = 54 mm migrated significantly more than cups < 54 mm in diameter (p = 0.029 at 4 years). There was a significant correlation between high polyethylene wear and further migrating cups within the first post-operative year (p = 0.035 at 12 months). Our analysis revealed significantly higher wear in males (p = 0.029 at 4 years). Radiological loosening at two years could be calculated using receiver-operating characteristic curve analysis, and 1.2 mm as an adequate threshold value (sensitivity = 100%, specificity = 89%). PMID:17609953

  17. Predictive 5-Year Survivorship Model of Cystic Fibrosis

    PubMed Central

    Liou, Theodore G.; Adler, Frederick R.; FitzSimmons, Stacey C.; Cahill, Barbara C.; Hibbs, Jonathan R.; Marshall, Bruce C.

    2007-01-01

    The objective of this study was to create a 5-year survivorship model to identify key clinical features of cystic fibrosis. Such a model could help researchers and clinicians to evaluate therapies, improve the design of prospective studies, monitor practice patterns, counsel individual patients, and determine the best candidates for lung transplantation. The authors used information from the Cystic Fibrosis Foundation Patient Registry (CFFPR), which has collected longitudinal data on approximately 90% of cystic fibrosis patients diagnosed in the United States since 1986. They developed multivariate logistic regression models by using data on 5,820 patients randomly selected from 11,630 in the CFFPR in 1993. Models were tested for goodness of fit and were validated for the remaining 5,810 patients for 1993. The validated 5-year survivorship model included age, forced expiratory volume in 1 second as a percentage of predicted normal, gender, weight-for-age z score, pancreatic sufficiency, diabetes mellitus, Staphylococcus aureus infection, Burkerholderia cepacia infection, and annual number of acute pulmonary exacerbations. The model provides insights into the complex nature of cystic fibrosis and supplies a rigorous tool for clinical practice and research. PMID:11207152

  18. Do prostatic biopsies 12 months or more after external irradiation for adenocarcinoma, stage III, predict long-term survival

    SciTech Connect

    Cox, J.D.; Kline, R.W.

    1983-03-01

    Serial biopsies of the prostate after high dose external irradiation for adenocarcinoma show a gradual disappearance of the neoplastic cells. With such treatment, results of the biopsies do not have any short term prognostic significance. However, positive biopsies 12 months or more after treatment are reputed to be an unfavorable sign for long-term survival. From August, 1970 through February, 1974, 45 consecutive patients with locally advanced adenocarcinoma of the prostate underwent external irradiation with 2 MV X rays or cobalt-60 teletherapy. The center of the prostate received a total dose of 70 Gy in 30-37 fractions in 43 to 56 days. With a median follow-up of 8 years, the actuarial survival rates, uncorrected for death from intercurrent disease, are 69% at 5 years and 49% at 10 years. Biopsies of the prostate 12 months or more after treatment were available from 31 patients; 19 had one or more positive biopsies. Prostatic biopsies obtained 24 months or more after treatment were available from 21 patients: 10 had positive and 11 had negative biopsies; the survival curves are identical for those with and without residual cancer cells. Following adequate irradiation of patients with locally advanced adenocarcinoma of the prostate, the results of biopsies obtained one or two years after treatment do not predict long-term survival.

  19. Understanding persistence in bulimia nervosa: a 5-year naturalistic study.

    PubMed

    Fairburn, Christopher G; Stice, Eric; Cooper, Zafra; Doll, Helen A; Norman, Patricia A; O'Connor, Marianne E

    2003-02-01

    Bulimia nervosa shows a marked tendency to persist, suggesting that powerful maintaining mechanisms operate. Using data from a prospective, 5-year, study of the natural course of 102 people with bulimia nervosa, the authors sought to identify predictors of persistence and to test specific hypotheses derived from the cognitive-behavioral theory of the persistence of bulimia nervosa. The results of both sets of analyses were consistent with the theory, with the degree of overevaluation of shape and weight and a history of childhood obesity predicting a persistent course. There was also support for the central prediction of the cognitive-behavioral theory. These findings suggest that the mechanisms specified by the theory influence its longer term natural course. PMID:12602430

  20. Pyomyositis in a 5-year-old child.

    PubMed

    Romeo, S; Sunshine, S

    2000-07-01

    We present a case of pyomyositis in an otherwise healthy 5-year-old child that underscores the potential for serious, life-threatening complications. Pyomyositis of the gluteal, psoas, and iliacus muscles was associated with osteomyelitis, septic arthritis, a large inferior vena cava thrombus, septic pulmonary emboli, and eventual pneumonia. Primary pyomyositis is a purulent infection of striated muscle thought to be caused by seeding from a transient bacteremia. The focal infection typically forms an abscess that generally responds to intravenous antibiotics and occasionally requires adjunctive computed tomography-guided aspiration and drainage. This localized infectious process rarely produces further sequelae unless treatment is delayed. Pyomyositis is rare in healthy individuals and requires a high clinical suspicion in patients who present with fever, leukocytosis, and localized pain. PMID:10910315

  1. Modifiable diarrhoea risk factors in Egyptian children aged <5 years.

    PubMed

    Mansour, A M; Mohammady, H El; Shabrawi, M El; Shabaan, S Y; Zekri, M Abou; Nassar, M; Salem, M E; Mostafa, M; Riddle, M S; Klena, J D; Messih, I A Abdel; Levin, S; Young, S Y N

    2013-12-01

    By conducting a case-control study in two university hospitals, we explored the association between modifiable risk behaviours and diarrhoea. Children aged <5 years attending outpatient clinics for diarrhoea were matched by age and sex with controls. Data were collected on family demographics, socioeconomic indicators, and risk behaviour practices. Two rectal swabs and a stool specimen were collected from cases and controls. Samples were cultured for bacterial pathogens using standard techniques and tested by ELISA to detect rotavirus and Cryptosporidium spp. Four hundred cases and controls were enrolled between 2007 and 2009. The strongest independent risk factors for diarrhoea were: presence of another household member with diarrhoea [matched odds ratio (mOR) 4.9, 95% CI 2.8-8.4] in the week preceding the survey, introduction to a new kind of food (mOR 3, 95% CI 1.7-5.4), and the child being cared for outside home (mOR 2.6, 95% CI 1.3-5.2). While these risk factors are not identifiable, in some age groups more easily modifiable risk factors were identified including: having no soap for handwashing (mOR 6.3, 95% CI 1.2-33.9) for children aged 7-12 months, and pacifier use (mOR 1.9, 95% CI 1.0-3.5) in children aged 0-6 months. In total, the findings of this study suggest that community-based interventions to improve practices related to sanitation and hygiene, handwashing and food could be utilized to reduce the burden of diarrhoea in Egyptian children aged <5 years. PMID:23433452

  2. Evaluation of survival in patients after pancreatic head resection for ductal adenocarcinoma

    PubMed Central

    2013-01-01

    Background Surgery remains the only curative option for the treatment of pancreatic adenocarcinoma (PDAC). The goal of this study was to investigate the clinical outcome and prognostic factors in patients after resection for ductal adenocarcinoma of the pancreatic head. Methods The data from 195 patients who underwent pancreatic head resection for PDAC between 1993 and 2011 in our center were retrospectively analyzed. The prognostic factors for survival after operation were evaluated using multivariate analysis. Results The head resection surgeries included 69.7% pylorus-preserving pancreatoduodenectomies (PPPD) and 30.3% standard Kausch-Whipple pancreatoduodenectomies (Whipple). The overall mortality after pancreatoduodenectomy (PD) was 4.1%, and the overall morbidity was 42%. The actuarial 3- and 5-year survival rates were 31.5% (95% CI, 25.04%-39.6%) and 11.86% (95% CI, 7.38%-19.0%), respectively. Univariate analyses demonstrated that elevated CEA (p = 0.002) and elevated CA 19–9 (p = 0.026) levels, tumor grade (p = 0.001) and hard texture of the pancreatic gland (p = 0.017) were significant predictors of a poor survival. However, only CEA >3 ng/ml (p < 0.005) and tumor grade 3 (p = 0.027) were validated as significant predictors of survival in multivariate analysis. Conclusions Our results suggest that tumor marker levels and tumor grade are significant predictors of poor survival for patients with pancreatic head cancer. Furthermore, hard texture of the pancreatic gland appears to be associated with poor survival. PMID:23607915

  3. Donor Age and Corneal Endothelial Cell Loss 5 Years after Successful Corneal Transplantation: Specular Microscopy Ancillary Study Results

    PubMed Central

    2010-01-01

    Objective To determine whether endothelial cell loss 5 years after successful corneal transplantation is related to the age of the donor. Design Multicenter, prospective, double-masked clinical trial. Participants Three hundred forty-seven subjects participating in the Cornea Donor Study who had not experienced graft failure 5 years after corneal transplantation for a moderate-risk condition (principally Fuchs’ dystrophy or pseudophakic corneal edema). Testing Specular microscopic images of donor corneas obtained before surgery and postoperatively at 6 months, 12 months, and then annually through 5 years were submitted to a central reading center to measure endothelial cell density (ECD). Main Outcome Measure Endothelial cell density at 5 years. Results At 5 years, there was a substantial decrease in ECD from baseline for all donor ages. Subjects who received a cornea from a donor 12 to 65 years old experienced a median cell loss of 69% in the study eye, resulting in a 5-year median ECD of 824 cells/mm2 (interquartile range, 613–1342), whereas subjects who received a cornea from a donor 66 to 75 years old experienced a cell loss of 75%, resulting in a median 5-year ECD of 654 cells/mm2 (interquartile range, 538–986) (P [adjusted for baseline ECD] = 0.04). Statistically, there was a weak negative association between ECD and donor age analyzed as a continuous variable (r [adjusted for baseline ECD] = −0.19; 95% confidence interval, −0.29 to −0.08). Conclusions Endothelial cell loss is substantial in the 5 years after corneal transplantation. There is a slight association between cell loss and donor age. This finding emphasizes the importance of longer-term follow-up of this cohort to determine if this relationship affects graft survival. PMID:18387408

  4. Monitoring Actuarial Present Values of Term Life Insurance By a Statistical Process Control Chart

    NASA Astrophysics Data System (ADS)

    Hafidz Omar, M.

    2015-06-01

    Tracking performance of life insurance or similar insurance policy using standard statistical process control chart is complex because of many factors. In this work, we present the difficulty in doing so. However, with some modifications of the SPC charting framework, the difficulty can be manageable to the actuaries. So, we propose monitoring a simpler but natural actuarial quantity that is typically found in recursion formulas of reserves, profit testing, as well as present values. We shared some simulation results for the monitoring process. Additionally, some advantages of doing so is discussed.

  5. Equine-associated maxillofacial injuries: retrospective 5-year analysis.

    PubMed

    Islam, Shofiq; Gupta, Benjamin; Taylor, Christopher J; Chow, Jeffrey; Hoffman, Gary R

    2014-02-01

    We explored the relation between the causes of facial injuries in equestrians and the presence or absence of associated injuries. Over a 5-year period we retrospectively reviewed all patients who presented to the John Hunter Hospital, New South Wales, with facial injuries that had resulted from activity with horses. We analysed the rates of hard and soft tissue injuries, and of associated injuries by sex and mechanism. A total of 85 patients were included (50 female and 35 male) with an age range of 2-88 years. There was a significant difference in the rate of maxillofacial and associated injuries when groups were analysed for sex and mechanism of injury. Facial injuries caused by falling from a horse were more often associated with other injuries in men than in women (p<0.05), and men were 4 times more likely to present with associated injuries than women (OR 3.9; 95% CI 1.1 to 14) We also found significant differences in the rates of facial fracture. Women who had been kicked by a horse were more likely to sustain bony injuries than men (p<0.05). Our data confirm the association between kicks and facial fracture, and this may provide an impetus for the development of appropriate protective equipment. Patients who sustain facial injuries when falling from a horse often present with associated injuries and this has practical implications for clinicians involved in their management. PMID:24168759

  6. NASA Infrared Telescope Facility- The Next 5 Years

    NASA Astrophysics Data System (ADS)

    Tokunaga, A. T.; Bus, S. J.; Tollestrup, E. V.; Rayner, J. T.

    2005-08-01

    The NASA Infrared Telescope Facility (IRTF) is a 3-meter optical/IR telescope dedicated to NASA-related programs of mission support and basic solar system research. All of the funding for IRTF operations comes from the Planetary Astronomy Program. We are preparing the Cooperative Agreement with NASA for the next 5 years (Feb. 2006 -- Jan. 2011). We will strive to refurbish the telescope in order to provide mission support and to allow the IRTF to provide fundamental data for future missions to Mars, comets, satellites, Near-Earth Objects, and asteroids. A major component of our activities will be to improve the image quality of the telescope and to provide high dynamic imaging on the IRTF. Details of our plans can be obtained at: http://irtfweb.ifa.hawaii.edu/Documents/pdf/1_plan_mar04C.pdf We acknowledge the support of NASA Cooperative Agreement no. NCC 5-538 with the National Aeronautics and Space Administration, Planetary Astronomy Program.

  7. 5 CFR 839.1121 - What is the Actuarial Reduction for the Basic Employee Death Benefit (BEDB)?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false What is the Actuarial Reduction for the... Benefits § 839.1121 What is the Actuarial Reduction for the Basic Employee Death Benefit (BEDB)? If you... employee's death. The result is rounded to the next highest dollar amount and is the monthly...

  8. 5 CFR 839.1121 - What is the Actuarial Reduction for the Basic Employee Death Benefit (BEDB)?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false What is the Actuarial Reduction for the... Benefits § 839.1121 What is the Actuarial Reduction for the Basic Employee Death Benefit (BEDB)? If you... employee's death. The result is rounded to the next highest dollar amount and is the monthly...

  9. 5 CFR 831.663 - Actuarial reduction in annuity of retirees who make post-retirement elections to provide a...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Actuarial reduction in annuity of retirees who make post-retirement elections to provide a current spouse annuity or a former spouse annuity... Actuarial reduction in annuity of retirees who make post-retirement elections to provide a current...

  10. 5 CFR 839.1121 - What is the Actuarial Reduction for the Basic Employee Death Benefit (BEDB)?

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false What is the Actuarial Reduction for the... Benefits § 839.1121 What is the Actuarial Reduction for the Basic Employee Death Benefit (BEDB)? If you... employee's death. The result is rounded to the next highest dollar amount and is the monthly...

  11. 5 CFR 831.663 - Actuarial reduction in annuity of retirees who make post-retirement elections to provide a...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Actuarial reduction in annuity of retirees who make post-retirement elections to provide a current spouse annuity or a former spouse annuity... Actuarial reduction in annuity of retirees who make post-retirement elections to provide a current...

  12. 5 CFR 839.1121 - What is the Actuarial Reduction for the Basic Employee Death Benefit (BEDB)?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false What is the Actuarial Reduction for the... Benefits § 839.1121 What is the Actuarial Reduction for the Basic Employee Death Benefit (BEDB)? If you... employee's death. The result is rounded to the next highest dollar amount and is the monthly...

  13. 5 CFR 831.663 - Actuarial reduction in annuity of retirees who make post-retirement elections to provide a...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Actuarial reduction in annuity of retirees who make post-retirement elections to provide a current spouse annuity or a former spouse annuity... Actuarial reduction in annuity of retirees who make post-retirement elections to provide a current...

  14. 5 CFR 831.663 - Actuarial reduction in annuity of retirees who make post-retirement elections to provide a...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Actuarial reduction in annuity of retirees who make post-retirement elections to provide a current spouse annuity or a former spouse annuity... Actuarial reduction in annuity of retirees who make post-retirement elections to provide a current...

  15. 5 CFR 831.663 - Actuarial reduction in annuity of retirees who make post-retirement elections to provide a...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Actuarial reduction in annuity of retirees who make post-retirement elections to provide a current spouse annuity or a former spouse annuity... Actuarial reduction in annuity of retirees who make post-retirement elections to provide a current...

  16. 5 CFR 839.1121 - What is the Actuarial Reduction for the Basic Employee Death Benefit (BEDB)?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false What is the Actuarial Reduction for the... Benefits § 839.1121 What is the Actuarial Reduction for the Basic Employee Death Benefit (BEDB)? If you... employee's death. The result is rounded to the next highest dollar amount and is the monthly...

  17. Choosing the 'best' plan in a health insurance exchange: actuarial value tells only part of the story.

    PubMed

    Lore, Ryan; Gabel, Jon R; McDevitt, Roland; Slover, Michael

    2012-08-01

    In the health insurance exchanges that will come online in 2014, consumers will be able to compare health plans with respect to actuarial value, or the percentage of health care costs that a plan would pay for a standard population. This analysis illustrates the out-of-pocket costs that might result from plans with various plan designs and actuarial values. We find that average out-of-pocket expense declines as actuarial values rise, but two plans with similar actuarial values can produce very different outcomes for a given person. The overall affordability of a plan also will be influenced by age rating, income-related premium subsidies, and out-of-pocket subsidies. Actuarial value is a useful starting point for selecting a plan, but it does not pinpoint which plan will produce the best overall value for a particular person. PMID:22946140

  18. Working with Workflows: Highlights from 5 years Building Scientific Workflows

    SciTech Connect

    Critchlow, Terence J.; Altintas, Ilkay; Chin, George; Crawl, Daniel; Iyer, H.; Khan, Ayla; Klasky, S.; Koehler, Sven; Ludaescher, Bertram T.; Mouallem, Pierre; Nagappan, Mie; Podhorszki, Norbert; Shoshani, Arie; Silva, C.; Tchoua, Roselynne; Vouk, M.

    2011-07-30

    In 2006, the SciDAC Scientific Data Management (SDM) Center proposed to continue its work deploying leading edge data management and analysis capabilities to scientific applications. One of three thrust areas within the proposed center was focused on Scientific Process Automation (SPA) using workflow technology. As a founding member of the Kepler consortium [LAB+09], the SDM Center team was well positioned to begin deploying workflows immediately. We were also keenly aware of some of the deficiencies in Kepler when applied to high performance computing workflows, which allowed us to focus our research and development efforts on critical new capabilities which were ultimately integrated into the Kepler open source distribution, benefiting the entire community. Significant work was required to ensure Kepler was capable of supporting large-scale production runs for SciDAC applications. Our work on generic actors and templates have improved the portability of workflows across machines and provided a higher level of abstraction for workflow developers. Fault tolerance and provenance tracking were obvious areas for improvement within Kepler given the longevity and complexity of our target workflows. To monitor workflow execution, we developed and deployed a web-based dashboard. We then generalized this interface and released it so it could be deployed at other locations. Outreach has always been a primary focus of our work and we had many successful deployments across a number of scientific domains while continually publishing and presenting our work. This short paper describes our most significant accomplishments over the past 5 years. Additional information about the SDM Center can be found in the companion paper: The Scientific Data Management Center: Available Technologies and Highlights.

  19. Applying a Forensic Actuarial Assessment (the Violence Risk Appraisal Guide) to Nonforensic Patients

    ERIC Educational Resources Information Center

    Harris, Grant T.; Rice, Marnie E.; Camilleri, Joseph A..

    2004-01-01

    The actuarial Violence Risk Appraisal Guide (VRAG) was developed for male offenders where it has shown excellent replicability in many new forensic samples using officially recorded outcomes. Clinicians also make decisions, however, about the risk of interpersonal violence posed by nonforensic psychiatric patients of both sexes. Could an actuarial…

  20. Academic Attributes of College Freshmen that Lead to Success in Actuarial Studies in a Business College

    ERIC Educational Resources Information Center

    Smith, Richard Manning; Schumacher, Phyllis

    2006-01-01

    The authors studied beginning undergraduate actuarial concentrators in a business college. They identified four variables (math Scholastic Aptitude Test [SAT] score, verbal SAT score, percentile rank in high school graduating class, and percentage score on a college mathematics placement exam) that were available for entering college students that…

  1. Should Actuarial Risk Assessments Be Used with Sex Offenders Who Are Intellectually Disabled?

    ERIC Educational Resources Information Center

    Harris, Andrew J. R.; Tough, Susan

    2004-01-01

    Background: Objective actuarial assessments are critical for making risk decisions, determining the necessary level of supervision and intensity of treatment ( Andrews & Bonta 2003). This paper reviews the history of organized risk assessment and discusses some issues in current attitudes towards sexual offenders with intellectual disabilities.…

  2. Sexual Reconviction Rates in the United Kingdom and Actuarial Risk Estimates

    ERIC Educational Resources Information Center

    Craig, Leam A.; Browne, Kevin D.; Stringer, Ian; Hogue, Todd E.

    2008-01-01

    Objective: Assessing the risk of further offending behavior by adult sexual perpetrators of children is highly relevant and important to professionals involved in child protection. Recent progress in assessing risk in sexual offenders has established the validity of actuarial measures, although there continues to be some debate about the…

  3. Total Knee Arthroplasty Using a Posterior Cruciate Ligament Sacrificing Medial Pivot Knee: Minimum 5-year Follow-up Results

    PubMed Central

    Youm, Yoon-Seok; Lee, Seon-Ho; Cho, Hye-Yong

    2014-01-01

    Purpose To evaluate minimum 5-year follow-up clinical and radiological results of total knee arthroplasty (TKA) using a posterior cruciate ligament sacrificing (PS), non-substituting Advance Medial Pivot Knee. Materials and Methods One hundred and twenty knees in 80 patients who could be followed up for more than 5 years after TKA using the PS Advance Medial Pivot Knee were evaluated retrospectively. The evaluations included the preoperative and postoperative range of motion (ROM), tibiofemoral angle, Knee Society (KS) knee and function scores, and Western Ontario and McMaster Universities Arthritis Index (WOMAC) score. The Kaplan-Meier method was used for survival analysis. Results The ROM increased from a preoperative mean flexion contracture of 7.6° and further flexion of 115.1° to a postoperative mean flexion contracture of 1.5° and further flexion of 120.5°. The tibiofemoral angle was changed from 4.6° varus preoperatively to 5.8° valgus postoperatively. The KS knee and function scores as well as WOMAC score significantly improved after surgery (p<0.05). Complications developed in 4 cases (3.3%): 2 cases of periprosthetic patellar fracture (1.7%) and 2 cases of aseptic loosening (1.7%). The seven-year survival rate was 98.1% in the Kaplan-Meier survival analysis. Conclusions The minimum 5-year follow-up results of TKA using the PS Medial Pivot Knee were satisfactory. PMID:25229042

  4. Clinical spectrum and outcome of pulmonary nocardiosis: 5-year experience

    PubMed Central

    Singh, Akashdeep; Chhina, Deepinder; Soni, RK; Kakkar, Chandan; Sidhu, US

    2016-01-01

    Background: Pulmonary nocardiosis is a rare but a life-threatening infection caused by Nocardia spp. The diagnosis is often missed and delayed resulting in delay in appropriate treatment and thus higher mortality. Aim: In this study, we aim to evaluate the clinical spectrum and outcome of patients with pulmonary nocardiosis. Methods: A retrospective, 5-year (2009–2014) review of demographic profile, risk factors, clinical manifestations, imaging findings, treatment, and outcome of patients with pulmonary nocardiosis admitted to a tertiary care hospital. Results: The median age of the study subjects was 54 years (range, 16–76) and majority of them (75%) were males. The risk factors for pulmonary nocardiosis identified in our study were long-term steroid use (55.6%), chronic lung disease (52.8%), diabetes (27.8%), and solid-organ transplantation (22.2%). All the patients were symptomatic, and the most common symptoms were cough (91.7%), fever (78%), and expectoration (72%). Almost two-third of the patients were initially misdiagnosed and the alternative diagnosis included pulmonary tuberculosis (n = 7), community-acquired pneumonia (n = 5), lung abscess (n = 4), invasive fungal infection (n = 3), lung cancer (n = 2), and Wegener's granulomatosis (n = 2). The most common radiographic features were consolidation (77.8%) and nodules (56%). The mortality rate for indoor patients was 33% despite treatment. Higher mortality rate was observed among those who had brain abscess (100.0%), HIV positivity (100%), need for mechanical ventilation (87.5%), solid-organ transplantation (50%), and elderly (age > 60 years) patients (43%). Conclusion: The diagnosis of pulmonary nocardiosis is often missed and delayed resulting in delay in appropriate treatment and thus high mortality. A lower threshold for diagnosing pulmonary nocardiosis needs to be exercised, in chest symptomatic patients with underlying chronic lung diseases or systemic immunosuppression, for the early diagnosis

  5. A 5-year experience with an elective scholarly concentrations program

    PubMed Central

    George, Paul; Green, Emily P.; Park, Yoon S.; Gruppuso, Philip A.

    2015-01-01

    Problem Programs that encourage scholarly activities beyond the core curriculum and traditional biomedical research are now commonplace among US medical schools. Few studies have generated outcome data for these programs. The goal of the present study was to address this gap. Intervention The Scholarly Concentration (SC) Program, established in 2006 at the Warren Alpert Medical School of Brown University, is a 4-year elective program that not only encourages students to pursue scholarly work that may include traditional biomedical research but also seeks to broaden students’ focus to include less traditional areas. We compared characteristics and academic performance of SC students and non-SC students for the graduating classes of 2010–2014. Context Approximately one-third of our students opt to complete an SC during their 4-year undergraduate medical education. Because this program is additional to the regular MD curriculum, we sought to investigate whether SC students sustained the academic achievement of non-SC students while at the same time producing scholarly work as part of the program. Outcome Over 5 years, 35% of students elected to enter the program and approximately 81% of these students completed the program. The parameters that were similar for both SC and non-SC students were age at matriculation, admission route, proportion of undergraduate science majors, and number of undergraduate science courses. Most academic indicators, including United States Medical Licensing Examinations scores, were similar for the two groups; however, SC students achieved more honors in the six core clerkships and were more likely to be inducted into the medical school's two honor societies. Residency specialties selected by graduates in the two groups were similar. SC students published an average of 1.3 peer-reviewed manuscripts per student, higher than the 0.8 manuscripts per non-SC student (p=0.013). Conclusions An elective, interdisciplinary scholarly program with

  6. Meningitis in infancy in England and Wales: follow up at age 5 years

    PubMed Central

    Bedford, Helen; de Louvois, John; Halket, Susan; Peckham, Catherine; Hurley, Rosalinde; Harvey, David

    2001-01-01

    Objective To describe important sequelae occurring among a cohort of children aged 5 years who had had meningitis during the first year of life and who had been identified by a prospective national study of meningitis in infancy in England and Wales between 1985 and 1987. Design Follow up questionnaires asking about the children's health and development were sent to general practitioners and parents of the children and to parents of matched controls. The organism that caused the infection and age at infection were also recorded. Setting England and Wales. Participants General practitioners and parents of children who had had meningitis before the age of 1 year and of matched controls. Main outcome measures The prevalence of health and developmental problems and overall disability among children who had had meningitis compared with controls. Results Altogether, 1584 of 1717 (92.2%) children who had had meningitis and 1391 of 1485 (93.6%) controls were successfully followed up. Among children who survived to age 5 years 247 of 1584 (15.6%) had a disability; there was a 10-fold increase in the risk of severe or moderate disability at 5 years of age among children who had had meningitis (relative risk 10.3, 95% confidence interval 6.7 to 16.0, P<0.001). There was considerable variation in the rates of severe or moderate disability in children infected with different organisms. Conclusion The long term consequences of having meningitis during the first year of life are significant: 32 of 1717 (1.8%) children died within five years. Not only did almost a fifth of children with meningitis have a permanent, severe or moderately severe disability, but subtle deficits were also more prevalent. What is already known on this topicMeningitis in infancy is associated with important long term consequencesThere is considerable variation in outcome depending on which organism caused the infectionWhat this study addsThis follow up study of 1717 children who had meningitis in infancy

  7. 24 CFR 903.6 - What information must a PHA provide in the 5-Year Plan?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... in the 5-Year Plan? 903.6 Section 903.6 Housing and Urban Development REGULATIONS RELATING TO HOUSING... must a PHA provide in the 5-Year Plan? (a) A PHA must include in its 5-Year Plan a statement of: (1... domestic violence, dating violence, sexual assault, or stalking. (b) After submitting its first 5-Year...

  8. 24 CFR 903.6 - What information must a PHA provide in the 5-Year Plan?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... in the 5-Year Plan? 903.6 Section 903.6 Housing and Urban Development REGULATIONS RELATING TO HOUSING... must a PHA provide in the 5-Year Plan? (a) A PHA must include in its 5-Year Plan a statement of: (1... domestic violence, dating violence, sexual assault, or stalking. (b) After submitting its first 5-Year...

  9. 24 CFR 903.6 - What information must a PHA provide in the 5-Year Plan?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... in the 5-Year Plan? 903.6 Section 903.6 Housing and Urban Development REGULATIONS RELATING TO HOUSING... must a PHA provide in the 5-Year Plan? (a) A PHA must include in its 5-Year Plan a statement of: (1... domestic violence, dating violence, sexual assault, or stalking. (b) After submitting its first 5-Year...

  10. Fasting Plasma Insulin at 5 Years of Age Predicted Subsequent Weight Increase in Early Childhood over a 5-Year Period—The Da Qing Children Cohort Study

    PubMed Central

    Chen, Yan Yan; Wang, Jin Ping; Jiang, Ya Yun; Li, Hui; Hu, Ying Hua; Lee, Kok Onn; Li, Guang Wei

    2015-01-01

    Background The association between hyperinsulinemia and obesity is well known. However, it is uncertain especially in childhood obesity, if initial fasting hyperinsulinemia predicts obesity, or obesity leads to hyperinsulinemia through insulin resistance. Objective To investigate the predictive effect of fasting plasma insulin on subsequent weight change after a 5-year interval in childhood. Methods 424 Children from Da Qing city, China, were recruited at 5 years of age and followed up for 5 years. Blood pressure, anthropometric measurements, fasting plasma insulin, glucose and triglycerides were measured at baseline and 5 years later. Results Fasting plasma insulin at 5 years of age was significantly correlated with change of weight from 5 to 10 years (ΔWeight). Children in the lowest insulin quartile had ΔWeight of 13.08±0.73 kg compare to 18.39±0.86 in the highest insulin quartile (P<0.0001) in boys, and similarly 12.03±0.71 vs 15.80±0.60 kg (P<0.0001) in girls. Multivariate analysis showed that the predictive effect of insulin at 5 years of age on subsequent weight gain over 5 years remained statistically significant even after the adjustment for age, sex, birth weight, TV-viewing time and weight (or body mass index) at baseline. By contrast, the initial weight at 5 years of age did not predict subsequent changes in insulin level 5 years later. Children who had both higher fasting insulin and weight at 5 years of age showed much higher levels of systolic blood pressures, fasting plasma glucose, the homeostasis model assessment for insulin resistance (HOMA-IR) and triglycerides at 10 years of age. Conclusions Fasting plasma insulin at 5 years of age predicts weight gain and cardiovascular risk factors 5 year later in Chinese children of early childhood, but the absolute weight at 5 years of age did not predict subsequent change in fasting insulin. PMID:26047327

  11. Prognostic Significance of 5-Year PSA Value for Predicting Prostate Cancer Recurrence After Brachytherapy Alone and Combined With Hormonal Therapy and/or External Beam Radiotherapy

    SciTech Connect

    Stock, Richard G. Klein, Thomas J.; Cesaretti, Jamie A.; Stone, Nelson N.

    2009-07-01

    Purpose: To analyze the prognosis and outcomes of patients who remain free of biochemical failure during the first 5 years after treatment. Methods and Materials: Between 1991 and 2002, 742 patients with prostate cancer were treated with brachytherapy alone (n = 306), brachytherapy and hormonal therapy (n = 212), or combined implantation and external beam radiotherapy (with or without hormonal therapy; n = 224). These patients were free of biochemical failure (American Society for Therapeutic Radiology and Oncology [ASTRO] definition) during the first 5 post-treatment years and had a documented 5-year prostate-specific antigen (PSA) value. The median follow-up was 6.93 years. Results: The actuarial 10-year freedom from PSA failure rate was 97% using the ASTRO definition and 95% using the Phoenix definition. The median 5-year PSA level was 0.03 ng/mL (range, 0-3.6). The 5-year PSA value was {<=}0.01 in 47.7%, >0.01-0.10 in 31.1%, >0.10-0.2 in 10.2%, >0.2-0.5 in 7.82%, and >0.5 in 3.10%. The 5-year PSA value had prognostic significance, with a PSA value of {<=}0.2 ng/mL (n = 661) corresponding to a 10-year freedom from PSA failure rate of 99% with the ASTRO definition and 98% with the Phoenix definition vs. 86% (ASTRO definition) and 81% (Phoenix definition) for a PSA value {>=}0.2 ng/mL (n = 81; p < .0001). The treatment regimen had no effect on biochemical failure. None of the 742 patients in this study developed metastatic disease or died of prostate cancer. Conclusion: The results of this study have shown that the prognosis for patients treated with brachytherapy and who remain biochemically free of disease for {>=}5 years is excellent and none developed metastatic disease during the first 10 years after treatment. The 5-year PSA value is prognostic, and patients with a PSA value <0.2 ng/mL are unlikely to develop subsequent biochemical relapse.

  12. Do age-specific survival patterns of wild boar fit current evolutionary theories of senescence?

    PubMed

    Gamelon, Marlène; Focardi, Stefano; Gaillard, Jean-Michel; Gimenez, Olivier; Bonenfant, Christophe; Franzetti, Barbara; Choquet, Rémi; Ronchi, Francesca; Baubet, Eric; Lemaître, Jean-François

    2014-12-01

    Actuarial senescence is widespread in age-structured populations. In growing populations, the progressive decline of Hamiltonian forces of selection with age leads to decreasing survival. As actuarial senescence is overcompensated by a high fertility, actuarial senescence should be more intense in species with high reproductive effort, a theoretical prediction that has not been yet explicitly tested across species. Wild boar (Sus scrofa) females have an unusual life-history strategy among large mammals by associating both early and high reproductive effort with potentially long lifespan. Therefore, wild boar females should show stronger actuarial senescence than similar-sized related mammals. Moreover, being polygynous and much larger than females, males should display higher senescence rates than females. Using a long-term monitoring (18 years) of a wild boar population, we tested these predictions. We provided clear evidence of actuarial senescence in both sexes. Wild boar females had earlier but not stronger actuarial senescence than similar-sized ungulates. Both sexes displayed similar senescence rates. Our study indicates that the timing of senescence, not the rate, is associated with the magnitude of fertility in ungulates. This demonstrates the importance of including the timing of senescence in addition to its rate to understand variation in senescence patterns in wild populations. PMID:25180915

  13. Adjuvant Radiation Therapy Treatment Time Impacts Overall Survival in Gastric Cancer

    SciTech Connect

    McMillan, Matthew T.; Ojerholm, Eric; Roses, Robert E.; Plastaras, John P.; Metz, James M.; Mamtani, Ronac; Stripp, Diana; Ben-Josef, Edgar; Datta, Jashodeep

    2015-10-01

    Purpose: Prolonged radiation therapy treatment time (RTT) is associated with worse survival in several tumor types. This study investigated whether delays during adjuvant radiation therapy impact overall survival (OS) in gastric cancer. Methods and Materials: The National Cancer Data Base was queried for patients with resected gastric cancer who received adjuvant radiation therapy with National Comprehensive Cancer Network–recommended doses (45 or 50.4 Gy) between 1998 and 2006. RTT was classified as standard (45 Gy: 33-36 days, 50.4 Gy: 38-41 days) or prolonged (45 Gy: >36 days, 50.4 Gy: >41 days). Cox proportional hazards models evaluated the association between the following factors and OS: RTT, interval from surgery to radiation therapy initiation, interval from surgery to radiation therapy completion, radiation therapy dose, demographic/pathologic and operative factors, and other elements of adjuvant multimodality therapy. Results: Of 1591 patients, RTT was delayed in 732 (46%). Factors associated with prolonged RTT were non-private health insurance (OR 1.3, P=.005) and treatment at non-academic facilities (OR 1.2, P=.045). Median OS and 5-year actuarial survival were significantly worse in patients with prolonged RTT compared with standard RTT (36 vs 51 months, P=.001; 39 vs 47%, P=.005); OS worsened with each cumulative week of delay (P<.0004). On multivariable analysis, prolonged RTT was associated with inferior OS (hazard ratio 1.2, P=.002); the intervals from surgery to radiation therapy initiation or completion were not. Prolonged RTT was particularly detrimental in patients with node positivity, inadequate nodal staging (<15 nodes examined), and those undergoing a cycle of chemotherapy before chemoradiation therapy. Conclusions: Delays during adjuvant radiation therapy appear to negatively impact survival in gastric cancer. Efforts to minimize cumulative interruptions to <7 days should be considered.

  14. Alice in actuarial-land: through the looking glass of changing Static-99 norms.

    PubMed

    Sreenivasan, Shoba; Weinberger, Linda E; Frances, Allen; Cusworth-Walker, Sarah

    2010-01-01

    The Static-99, an actuarial rating method, is employed to conduct sexual violence risk assessment in legal contexts. The proponents of the Static-99 dismiss clinical judgment as not empirical. Two elements must be present to apply an actuarial risk model to a specific individual: sample representativeness and uniform measurement of outcome. This review demonstrates that both of these elements are lacking in the normative studies of the Static-99 and its revised version, the Static-99R. Studies conducted since the publication of the Static-99 have not replicated the original norms. Sexual recidivism rates for the same Static-99 score vary widely, from low to high, depending on the sample used. A hypothetical case example is presented to illustrate how the solitary application of the Static-99 or Static-99R recidivism rates to the exclusion of salient clinical factors for identifying sexual dangerousness can have serious consequences for public safety. PMID:20852227

  15. Actuarial calculation for PSAK-24 purposes post-employment benefit using market-consistent approach

    NASA Astrophysics Data System (ADS)

    Effendie, Adhitya Ronnie

    2015-12-01

    In this paper we use a market-consistent approach to calculate present value of obligation of a companies' post-employment benefit in accordance with PSAK-24 (the Indonesian accounting standard). We set some actuarial assumption such as Indonesian TMI 2011 mortality tables for mortality assumptions, accumulated salary function for wages assumption, a scaled (to mortality) disability assumption and a pre-defined turnover rate for termination assumption. For economic assumption, we use binomial tree method with estimated discount rate as its average movement. In accordance with PSAK-24, the Projected Unit Credit method has been adapted to determine the present value of obligation (actuarial liability), so we use this method with a modification in its discount function.

  16. A 5-year activity report from the Oral Cancer Center, Tokyo Dental College.

    PubMed

    Yamamoto, Nobuharu; Sato, Kazumichi; Yamauchi, Tomohiro; Suzuki, Taiki; Osaka, Ryuta; Kin, Mira; Yoshida, Yoshifumi; Noguchi, Sunaki; Ishizaki, Ken; Takano, Masayuki; Katakura, Akira; Tanaka, Yoichi; Shibahara, Takahiko; Takano, Nobuo

    2013-01-01

    The Tokyo Dental College Oral Cancer Center was established on April 1st, 2006 at our Ichikawa General Hospital for the purpose of providing multimodal treatment for oral cancer. This report summarizes the Center's activities over the last 5 years. The total number of oral cancer patients treated was 360 (April 2006 to March 2011), with 205 primary cases. We investigated the following treatment-related items: 1) site, 2) age, 3) sex, 4) pathological examination, 5) staging, 6) systemic disorder, 7) double cancer, 8) treatment, and 9) prognosis. Out of 205 patients, 60% were men and 40% were women. Men in their 60s and women in their 80s were seen the most. The most common site was the tongue, at 42%, followed by the mandibular gingiva, maxillary gingiva, oral floor, and buccal mucosa. Squamous cell carcinomas were seen most frequently, at 94% (15% were stage I, 33% stage II, 15% stage III, and 34% stage IV). The most common treatment method was surgical treatment, at 83%. The 5-year survival rate at all stages was 85.4%. At the Oral Cancer Center, oral surgeons take the initiative in establishing treatment in cooperation with other departments and branches. Since the establishment of the Ambulatory Center for Maxillary Prosthetics in October 2011, 26 patients have undergone treatment. Related departments and branches work in teams, enabling comprehensive treatment, from the preoperative state to postoperative functional recovery. We wish to use these strengths to improve oral cancer treatment in Japan and will continue to work toward providing the best possible care for our patients. PMID:24521553

  17. Impact of Screening and Risk Factors for Local Recurrence and Survival After Conservative Surgery and Radiotherapy for Early Breast Cancer: Results From a Large Series With Long-Term Follow-Up

    SciTech Connect

    Kunkler, Ian H.; Kerr, Gillian R.; Thomas, Jeremy S.; Jack, Wilma J.L.; Bartlett, John M.S.; Pedersen, Hans C.; Cameron, David A.; Dixon, J. Michael; Chetty, Udi

    2012-07-01

    Purpose: To investigate conventional prognostic factors for ipsilateral breast tumor recurrence (IBTR), distant metastasis (DM), and survival after breast-conserving therapy (BCT) in screen-detected and symptomatic cases on surveillance up to 25 years. Patients and Methods: A total of 1812 consecutive patients in three cohorts (1981-1989, 1990-1992, and 1993-1998) with T12N01M0 invasive breast cancer were treated with BCT (median follow-up, 14 years). Tumor type and grade were reviewed by a single pathologist. Hormone receptor status was measured by immunohistochemistry on tissue microarrays. A Cox proportional hazards model was used to assess independent prognostic variables for relapse and survival. Results: A total of 205 IBTR occurred, with 5-, 10-, 15-, and 20-year actuarial relapse rates of 4.5% (95% confidence interval [CI] 3.35-5.5%), 8.4% (95% CI 7.1-9.8%), 14.1% (95% CI 12.0-16%), and 17.4% (95% CI 14.5-20.2%). Number of nodes, young age, pathologic tumor size, and multifocality were significant factors for IBTR. Three hundred seventy-eight patients developed DM. The actuarial metastatic rate was 12% at 5 years and 17.9% at 10 years. Young age, number of positive nodes, pathologic tumor size, and tumor grade were significant factors for DM relapse. When conventional prognostic indices were taken into account screen-detected cancers showed no improvement in overall relapse or survival rate compared with symptomatic cases but did show a reduced risk of DM after IBTR. After 10 years IBTR relapse continued at a constant rate of 0.87% per annum. Conclusions: The Edinburgh BCT series has shown that screen-detected invasive breast cancers do not have significantly different clinical outcomes compared with symptomatic cases when pathologic risk factors are taken into account. This suggests that these patients be managed in a similar way.

  18. Surgical treatment of cardiac tumors: a 5-year experience from a single cardiac center

    PubMed Central

    Yin, Liang; He, Dengke; Shen, Hua; Ling, Xinyu; Li, Wei; Xue, Qian

    2016-01-01

    Background Cardiac tumors are rare but manifested with various clinical presentations and often cause unexpected symptoms or sudden death. The objective is to review the clinical presentation, histopathological spectrum, mortality and follow-up data of patients with cardiac tumors following surgery treatment over a period of 5 years. Methods We retrospectively collected the medical records of all patients diagnosed of cardiac tumors in the period between January 2008 and December 2013 at the cardiac center of our university. Clinical histories, perioperative data, surgical findings, efficacy and follow-up data were reviewed in our study. Patients were divided into two groups according to site distribution of the tumors in the heart. Results A total of 131 patients underwent surgical treatment of cardiac tumors were enrolled in this study, with a mean age of 51.39±16.37. The result of analysis showed that 79.47% (n=104) of the primary intracardiac tumors were benign, while primary malignant neoplasms accounted for 16.03% (n=21) of all patients, with the remainder (n=6, 4.6%) metastatic tumors transferred from other organs. Among all patients there were 2 in-hospital deaths and the survival rate in all patients at 1-year, 3-year and 5-year follow up was 83.20%, 78.62% and 66.41% respectively. Both patients with tumors in the left and right heart had similar basic characteristics except sex gender (P=0.002), BSA (P=0.045) and weight (P=0.033). Compared with patients with tumors in the right heart, patients with tumors in the left heart had significant higher CPB time (P<0.001), cross clamp time (P<0.001) and time of mechanical ventilation (P<0.001), and they also had longer ICU stay (P<0.001) but not total hospital stay (P=0.434). Conclusions Surgical resection represents an effective protocol in treating cardiac tumors. Data in our study of cardiac tumors on frequency and allocation were consistent with previous reports which may provide useful clinical evidence on

  19. 24 CFR 257.303 - Prohibition on subordinate liens during first 5 years.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... CFR 226.2). ... during first 5 years. 257.303 Section 257.303 Housing and Urban Development Regulations Relating to... Prohibition on subordinate liens during first 5 years. (a) Prohibition on subordinate liens during first...

  20. Salvage HDR Brachytherapy for Recurrent Prostate Cancer After Previous Definitive Radiation Therapy: 5-Year Outcomes

    SciTech Connect

    Chen, Chien Peter; Weinberg, Vivian; Shinohara, Katsuto; Roach, Mack; Nash, Marc; Gottschalk, Alexander; Chang, Albert J.; Hsu, I-Chow

    2013-06-01

    Purpose: Evaluate efficacy and toxicity of salvage high-dose-rate brachytherapy (HDRB) for locally recurrent prostate cancer after definitive radiation therapy (RT). Methods and Materials: We retrospectively analyzed 52 consecutively accrued patients undergoing salvage HDRB between 1998 and 2009 for locally recurrent prostate cancer after previous definitive RT. After pathologic confirmation of locally recurrent disease, patients received 36 Gy in 6 fractions. Twenty-four patients received neoadjuvant hormonal therapy before salvage, and no patients received adjuvant hormonal therapy. Determination of biochemical failure after salvage HDRB was based on the Phoenix definition. Overall survival (OS) and bF distributions were calculated using the Kaplan-Meier method. Univariate analyses were performed to identify predictors of biochemical control. Acute and late genitourinary (GU) and gastrointestinal (GI) toxicities, based on Common Terminology Criteria for Adverse Events (version 4), were documented. Results: Median follow-up after salvage HDRB was 59.6 months. The 5-year OS estimate was 92% (95% confidence interval [CI]: 80%-97%) with median survival not yet reached. Five-year biochemical control after salvage was 51% (95% CI: 34%-66%). Median PSA nadir postsalvage was 0.1 (range: 0-7.2) reached at a median of 10.2 months after completing HDRB. As for complications, acute and late grade 3 GU toxicities were observed in only 2% and 2%, respectively. No grade 2 or higher acute GI events and 4% grade 2 GI late events were observed. On univariate analysis, disease-free interval after initial definitive RT (P=.07), percent of positive cores at the time of diagnosis (P=.08), interval from first recurrence to salvage HDRB (P=.09), and pre-HDRB prostate-specific antigen (P=.07) were each of borderline significance in predicting biochemical control after salvage HDRB. Conclusions: Prostate HDRB is an effective salvage modality with relatively few long-term toxicities. We

  1. Results of treatment in patients with IIa - IIIast. breast cancer treated by combination of low-level laser therapy (LLLT) and surgery (5-year experience)

    NASA Astrophysics Data System (ADS)

    Mikhailov, V. A.; Skobelkin, Oleg K.; Denisov, I. N.; Frank, George A.; Voltchenko, N. N.

    1996-01-01

    Laser therapy with semiconductor laser (wavelength 890 nm) was performed in 41 patients with IIa - IIIast. breast cancer. LLLT was used before surgery and in postoperative period during 2 years. LLLT decreased postoperative complications by 15.3% and decreased duration of lymphorrhea. 5 years survival in patients with IIast. breast cancer treated by LLLT was 100%, in control group--85.71%. In patients with IIIast. breast cancer treated by LLLT survival was 94.44%, in control group--78.94%. 91.3% of patients with IIast. treated by LLLT had not recurrences in 5 year period, in the controls they were in about 77.7%. 82.35% of patients with IIIast. treated by laser therapy had no recurrences in 5 year period, in control group--60%.

  2. Results and survival after photodynamic therapy in early-stage esophageal carcinoma

    NASA Astrophysics Data System (ADS)

    Spinelli, Pasquale; Mancini, Andrea; Dal Fante, Marco; Meroni, Emmanuele; Jasinskas, Algirdas

    1996-01-01

    From January 1985 to December 1994, 23 early stage carcinomas of the esophagus were treated by photodynamic therapy in 21 patients. The stage of the tumors was assessed by esophagoscopy with multiple biopsies, CT scan and, from June 1991, also by endoscopic ultrasonography: 7 lesions were classified as carcinoma in situ (Tis) and 16 as invasive (T1). The photosensitizers used for PDT were hematoporphyrin derivative 3 mg/kg in 4 patients and dihematoporphyrin ether 2 mg/kg in 17. Light irradiation was performed using an Argon-dye laser system at a wavelength of 630 nm with an average energy of 50 J/cm2 and 70 J/cm2 for the treatment of Tis and T1, respectively. A complete response was achieved in 17/23 (74%) tumors, 15/21 (71%) patients. In the follow-up period from 6 to 78 months (median 36 months) 3 recurrences occurred 6, 12, and 14 months after PDT, respectively. Seven patients died due to concomitant diseases, not related to tumor progression. The actuarial survival rate was 95%, 75% and 37% at 1, 3, and 5 years, respectively. Complications included 1 case of sunburn and 2 cases of esophageal stenosis at the treatment site, that gradually responded to endoscopic bougienage.

  3. A case of primary spinal atypical teratoid/rhabdoid tumor in a 5-year-old child

    PubMed Central

    Mankotia, Dipanker Singh; Tandon, Vivek; Sharma, Bhawani Shankar; Rajeshwari, Madhu; Sharma, Mehar Chand

    2016-01-01

    Atypical teratoid/rhabdoid tumor (AT/RT) is a rare central nervous system neoplasm affecting children, and isolated primary spinal involvement is extremely rare. Authors describe a case of spinal AT/RT in a 5-year-old male child presenting with rapidly progressing quadriparesis diagnosed and managed surgically and medically. Biopsy revealed large, rhabdoid cells with prominent nucleoli in nest and immunohistochemistry further showed loss of integrase integrator 1 expression considered to be gold standard for diagnosis. AT/RT has extremely poor prognosis with median survival being 6 months. PMID:27606020

  4. A case of primary spinal atypical teratoid/rhabdoid tumor in a 5-year-old child.

    PubMed

    Mankotia, Dipanker Singh; Tandon, Vivek; Sharma, Bhawani Shankar; Rajeshwari, Madhu; Sharma, Mehar Chand

    2016-01-01

    Atypical teratoid/rhabdoid tumor (AT/RT) is a rare central nervous system neoplasm affecting children, and isolated primary spinal involvement is extremely rare. Authors describe a case of spinal AT/RT in a 5-year-old male child presenting with rapidly progressing quadriparesis diagnosed and managed surgically and medically. Biopsy revealed large, rhabdoid cells with prominent nucleoli in nest and immunohistochemistry further showed loss of integrase integrator 1 expression considered to be gold standard for diagnosis. AT/RT has extremely poor prognosis with median survival being 6 months. PMID:27606020

  5. Who Stays and Who Leaves? Father Accessibility Across Children's First 5 Years.

    PubMed

    Shannon, Jacqueline D; Cabrera, Natasha J; Tamis-Lemonda, Catherine; Lamb, Michael E

    2009-01-01

    OBJECTIVE: This longitudinal investigation examines whether fathers' prenatal involvement (e.g., attending doctor appointments and discussing pregnancy with mother) and residence status at infant's birth predict the first time a father becomes inaccessible to his child (defined as seeing child fewer than a few times per month) at six developmental time points in children's first 5 years. DESIGN: Data were gathered from 2,160 ethnically diverse mothers (i.e., European American, African American, and Latin American) who participated in the National Early Head Start Research and Evaluation Project. Survival analysis was used to predict the timing of father inaccessibility based on interviews. RESULTS: By prekindergarten, fathers' residence at birth and prenatal involvement decreased their risk of being inaccessible to their children for the first time by 71% and 47%, respectively, after adjusting for all other variables in the model. Residence at birth was a stronger predictor of the timing of father inaccessibility than was prenatal involvement for European American and Latin American fathers; for African American fathers, prenatal involvement was a stronger predictor of the timing of father inaccessibility than nonresidential status at birth. Nearly 65% of fathers who were engaged in both prenatal activities remained consistently accessible to their child through child age of 63 months, whereas nearly 50% of fathers who were not prenatally involved were already inaccessible by the time infants were 3 months. CONCLUSION: These findings have implications for early intervention programs aimed at strengthening the role of fathers in their families from the prenatal period. PMID:20333276

  6. Coronary artery bypass grafting associated to aortic valve replacement in the elderly: survival and quality of life

    PubMed Central

    2012-01-01

    Myocardial ischemia is often associated to aortic valve stenosis in the elderly. Aim of this study was to evaluate the impact on survival and quality of life of CABG associated to aortic valve replacement in the septuagenarians and octogenarians. Between January 1991 and January 2010, 520 patients ageing > 70 years underwent aortic valve replacement with a mechanical prosthesis in two Institutions. They were divided into 2 groups: Group A included 406 patients undergoing isolated aortic valve replacement; Group B 114 patients receiving aortic valve replacement and CABG. A comparative analysis of long-term survival and quality of life (SF-36 test) was performed. Mean age was 74.2 ± 3.6 years (74.3 ± 3.6 in Group A, 74 ± 3.3 in Group B; p = 0.33). Hospital mortality was 9.5% (46 patients). Twenty-nine (7.8%) in Group A and 17 in Group B (15.2%)(p = 0.019). Actuarial survival was 88.5% ± 0.015 at 1 year, 81.9% ± 0.02 at 5 years, 76.6% ± 0.032 at 10 and 57.3 ± 0.1 at 15 years. Ten-year survival was 77% ± 0.034 in Group A and 77.8% ± 0.045 in Group B (p = 0.2). Multivariate analysis did not reveal associated CABG as a predictor of long term mortality. The scores obtained in the SF-36 test were similar in the two groups and significantly higher than those of the general population matched for country, age and sex (p < 0.001 in all domains). Associated CABG determines a significant increase of hospital mortality in the elderly undergoing aortic valve replacement. Survivors did not show differences in long-term outcome and quality of life according to the presence of associated CABG. PMID:22309837

  7. Prognosis of HIV-1-infected patients up to 5 years after initiation of HAART: collaborative analysis of prospective studies

    PubMed Central

    2012-01-01

    Objective To estimate the prognosis over 5 years of HIV-1-infected, treatment-naive patients starting HAART, taking into account the immunological and virological response to therapy. Design A collaborative analysis of data from 12 cohorts in Europe and north America on 20 379 adults who started HAART between 1995 and 2003. Methods Parametric survival models were used to predict the cumulative incidence at 5 years of a new AIDS-defining event or death, and death alone, first from the start of HAART and second from 6 months after the start of HAART. Data were analysed by intention-to-continue-treatment, ignoring treatment changes and interruptions. Results During 61 798 person-years of follow-up, 1005 patients died and an additional 1303 developed AIDS. A total of 10 046 (49%) patients started HAART either with a CD4 cell count of less than 200 cells/μl or with a diagnosis of AIDS. The 5-year risk of AIDS or death (death alone) from the start of HAART ranged from 5.6 to 77% (1.8–65%), depending on age, CD4 cell count, HIV-1-RNA level, clinical stage, and history of injection drug use. From 6 months the corresponding figures were 4.1–99% for AIDS or death and 1.3–96% for death alone. Conclusion On the basis of data collected routinely in HIV care, prognostic models with high discriminatory power over 5 years were developed for patients starting HAART in industrialized countries. A risk calculator that produces estimates for progression rates at years 1 to 5 after starting HAART is available from www.art-cohort-collaboration.org. PMID:17502729

  8. Alveolar Ridge Contouring with Free Connective Tissue Graft at Implant Placement: A 5-Year Consecutive Clinical Study.

    PubMed

    Hanser, Thomas; Khoury, Fouad

    2016-01-01

    This study evaluated volume stability after alveolar ridge contouring with free connective tissue grafts at implant placement in single-tooth gaps. A total of 52 single-tooth gaps with labial volume deficiencies in the maxilla (incisors, canines, and premolars) were consecutively treated with implants and concomitant free palatal connective tissue grafts in 46 patients between 2006 and 2009. Implants had to be covered with at least 2 mm peri-implant local bone after insertion. At implant placement, a free connective tissue graft from the palate was fixed inside a labial split-thickness flap to form an existing concave buccal alveolar ridge contour due to tissue volume deficiency into a convex shape. Standardized volumetric measurements of the labial alveolar contour using a template were evaluated before connective tissue grafting and at 2 weeks, 1 year, and 5 years after implantprosthetic incorporation. Tissue volume had increased significantly (P < .05) in all six reference points representing the outer alveolar soft tissue contour of the implant before connective tissue grafting to baseline (2 weeks after implant-prosthetic incorporation). Statistically, 50% of the reference points (P > .05) kept their volume from baseline to 1 year after prosthetic incorporation and from baseline to 5 years after prosthetic incorporation, respectively, whereas reference points located within the area of the implant sulcus showed a significant (P < .05) decrease in volume. Clinically, 5 years after prosthetic incorporation the originally concave buccal alveolar contour was still convex in all implants, leading to a continuous favorable anatomical shape and improved esthetic situation. Intraoral radiographs confirmed osseointegration and stable peri-implant parameters with a survival rate of 100% after a follow-up of approximately 5 years. Implant placement with concomitant free connective tissue grafting appears to be an appropriate long-term means to contour preexisting buccal

  9. Ethical practice in sex offender assessment: consideration of actuarial and polygraph methods.

    PubMed

    Vess, James

    2011-09-01

    The current generation of community protection laws represents a shift in priorities that may see the individual rights of sex offenders compromised for the goal of public safety. At the center of many judicial decisions under these laws are the risk assessment reports provided by mental health practitioners. The widespread enactment of laws allowing for additional sanctions for sex offenders, and a burgeoning research literature regarding the methods used to assess risk have served to heighten rather than resolve the ethical concerns associated with professional practice in this area. This article examines ethical issues inherent in the use of two assessment methods commonly used with sex offenders in the correctional context, focusing on actuarial measures and polygraph tests. Properly conducted and adequately reported actuarial findings are considered to provide useful information of sufficient accuracy to inform rather than mislead judicial decision makers, although careful consideration must be given to the limitations of current measures in each individual case. Despite its increasing use, polygraph testing is considered controversial, with little consensus regarding its accuracy or appropriate applications. On the basis of the current state of the professional literature regarding the polygraph, its use with sex offenders raises unresolved ethical concerns. PMID:20944058

  10. Stereotactic body radiation therapy for prostate cancer patients with old age or medical comorbidity: a 5-year follow-up of an investigational study.

    PubMed

    Lee, Sea-Won; Jang, Hong Seok; Lee, Jong Hoon; Kim, Sung Hwan; Yoon, Sei Chul

    2014-12-01

    We evaluated 5-year follow-up of stereotactic body radiation therapy (SBRT) with Cyberknife for prostate cancer patients. Forty-five men with prostate adenocarcinoma who received SBRT using Cyberknife from May 2006 to November 2012 were enrolled in this study. They were prostate cancer patients with old age and medical comorbidities who received a total of 36 Gy to the prostate in 5 fractions with either everyday or every other day schedule. Prostate-specific antigen (PSA) levels at initial diagnosis and after radiation were traced. Primary endpoints were biochemical relapse-free survival (bRFS), progression-free survival (PFS), and overall survival (OS). The definition of biochemical relapse was a PSA level of nadir+2 ng/mL. Progression was defined as biochemically or clinically detected disease and the start of salvage therapy. After median follow-up of 63 months, the 5-year bRFS for all patients was estimated at 89.7%. The 5-year PFS was estimated at 71%. Four cases of biochemical relapse were observed, including two patients who experienced locoregional failure and one patient who had distant metastasis with biochemical relapse. The 5-year OS was estimated at 94.3%. There were five deaths, all of which were unrelated to prostate cancer. There was no grade 3 or higher acute complication. Grade 3 or higher late urinary toxicity was reported in 2 (4.4%) of 45 patients. The 5-year survival and toxicity outcome of SBRT using Cyberknife on prostate cancer patients with old age or comorbidities were favorable and safe in an investigational study. PMID:25526468

  11. Who Stays and Who Leaves? Father Accessibility Across Children’s First 5 Years

    PubMed Central

    Shannon, Jacqueline D.; Cabrera, Natasha J.; Tamis-LeMonda, Catherine; Lamb, Michael E.

    2010-01-01

    SYNOPSIS Objective This longitudinal investigation examines whether fathers’ prenatal involvement (e.g., attending doctor appointments and discussing pregnancy with mother) and residence status at infant’s birth predict the first time a father becomes inaccessible to his child (defined as seeing child fewer than a few times per month) at six developmental time points in children’s first 5 years. Design Data were gathered from 2,160 ethnically diverse mothers (i.e., European American, African American, and Latin American) who participated in the National Early Head Start Research and Evaluation Project. Survival analysis was used to predict the timing of father inaccessibility based on interviews. Results By prekindergarten, fathers’ residence at birth and prenatal involvement decreased their risk of being inaccessible to their children for the first time by 71% and 47%, respectively, after adjusting for all other variables in the model. Residence at birth was a stronger predictor of the timing of father inaccessibility than was prenatal involvement for European American and Latin American fathers; for African American fathers, prenatal involvement was a stronger predictor of the timing of father inaccessibility than nonresidential status at birth. Nearly 65% of fathers who were engaged in both prenatal activities remained consistently accessible to their child through child age of 63 months, whereas nearly 50% of fathers who were not prenatally involved were already inaccessible by the time infants were 3 months. Conclusion These findings have implications for early intervention programs aimed at strengthening the role of fathers in their families from the prenatal period. PMID:20333276

  12. 77 FR 64959 - Endangered and Threatened Species; Initiation of 5-Year Review for the Southern Distinct...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-24

    ... update, if necessary, the Northern DPS' status in five years time (70 FR 17386; April 6, 2005). Therefore...; Initiation of 5-Year Review for the Southern Distinct Population Segment of North American Green Sturgeon... 5-year review of the Southern Distinct Population Segment (DPS) of North American green...

  13. 77 FR 5491 - Endangered and Threatened Species; Initiation of 5-Year Review for Sei Whales

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-03

    ...; Initiation of 5-Year Review for Sei Whales AGENCY: National Marine Fisheries Service (NMFS), National Oceanic...; request for information. SUMMARY: NMFS announces a 5-year review of sei whales (Balaenoptera borealis... of any such information on sei whales that has become available since that has become available...

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

    SciTech Connect

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

    2012-05-01

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

  15. Does early establishment of favorable oral health behavior influence caries experience at age 5 years?

    PubMed Central

    Wigen, Tove I.; Wang, Nina J.

    2015-01-01

    Objective The purpose was to study associations between tooth brushing frequency, use of fluoride lozenges and consumption of sugary drinks at 1.5 year of age and having caries experience at 5 years of age. Methods This study was based on data from the Norwegian Mother and Child Cohort Study conducted by the Norwegian Institute of Public Health and by the Public Dental Services. A total of 1095 children were followed from pregnancy to the age of 5 years. Questionnaires regarding oral health behavior were completed by the parents at 1.5 and 5 years of age. Clinical and radiographic examination of the children was performed at the age of 5 years. Results In multiple logistic regression, having caries experience at 5 years of age was associated with; at 1.5 year of age having the teeth brushed less than twice daily (OR 2.1, CI 1.3–3.6) and being offered sugary drinks at least once a week (OR 1.8, CI 1.1–2.9) when controlled for family characteristics and oral health behavior at 5 years of age. Conclusions Tooth brushing frequency and consumption of sugary drinks in early childhood were related to caries development during preschool age independent of family characteristics and oral health behavior at 5 years of age. The results indicate that early established habits regarding tooth brushing and consumption of sugary drinks have long term effects on caries development. Parents encountering difficulties in establishing favorable oral health behavior in children’s first years of life should receive special attention from health personnel. PMID:25385683

  16. Actuarial aging rate is not constant within the human life span.

    PubMed

    Ekonomov, A L; Rudd, C L; Lomakin, A J

    1989-01-01

    It is often believed that the mortality intensity in the modern human population undergoes an exponential growth after 40 years, i.e. the actuarial aging rate is regarded to be constant after 40 years. To check this assumption we have calculated local aging rate values for 13 age ranges (within the interval of 30-92 years) for the male and female population of 48 states of the US (1969-1971). It was found that generally the male aging rate is not constant but lowers monotonically with time, while for females the aging rate has a pronounced approximately-shaped character with a minimum in the range of 45-60 years and a maximum within the range of 70-80 years. The results obtained are a warning to those who boldly use Gompertz or Gompertz-Makeham formulas when describing human aging on the population level. PMID:2792778

  17. Projections of health care expenditures as a share of the GDP: actuarial and macroeconomic approaches.

    PubMed Central

    Warshawsky, M J

    1994-01-01

    STUDY QUESTION. Can the steady increases in health care expenditures as a share of GDP projected by widely cited actuarial models be rationalized by a macroeconomic model with sensible parameters and specification? DATA SOURCES. National Income and Product Accounts, and Social Security and Health Care Financing Administration are the data sources used in parameters estimates. STUDY DESIGN. Health care expenditures as a share of gross domestic product (GDP) are projected using two methodological approaches--actuarial and macroeconomic--and under various assumptions. The general equilibrium macroeconomic approach has the advantage of allowing an investigation of the causes of growth in the health care sector and its consequences for the overall economy. DATA COLLECTION METHODS. Simulations are used. PRINCIPAL FINDINGS. Both models unanimously project a continued increase in the ratio of health care expenditures to GDP. Under the most conservative assumptions, that is, robust economic growth, improved demographic trends, or a significant moderation in the rate of health care price inflation, the health care sector will consume more than a quarter of national output by 2065. Under other (perhaps more realistic) assumptions, including a continuation of current trends, both approaches predict that health care expenditures will comprise between a third and a half of national output. In the macroeconomic model, the increasing use of capital goods in the health care sector explains the observed rise in relative prices. Moreover, this "capital deepening" implies that a relatively modest fraction of the labor force is employed in health care and that the rest of the economy is increasingly starved for capital, resulting in a declining standard of living. PMID:8063567

  18. Projections of health care expenditures as a share of the GDP: actuarial and macroeconomic approaches.

    PubMed

    Warshawsky, M J

    1994-08-01

    STUDY QUESTION. Can the steady increases in health care expenditures as a share of GDP projected by widely cited actuarial models be rationalized by a macroeconomic model with sensible parameters and specification? DATA SOURCES. National Income and Product Accounts, and Social Security and Health Care Financing Administration are the data sources used in parameters estimates. STUDY DESIGN. Health care expenditures as a share of gross domestic product (GDP) are projected using two methodological approaches--actuarial and macroeconomic--and under various assumptions. The general equilibrium macroeconomic approach has the advantage of allowing an investigation of the causes of growth in the health care sector and its consequences for the overall economy. DATA COLLECTION METHODS. Simulations are used. PRINCIPAL FINDINGS. Both models unanimously project a continued increase in the ratio of health care expenditures to GDP. Under the most conservative assumptions, that is, robust economic growth, improved demographic trends, or a significant moderation in the rate of health care price inflation, the health care sector will consume more than a quarter of national output by 2065. Under other (perhaps more realistic) assumptions, including a continuation of current trends, both approaches predict that health care expenditures will comprise between a third and a half of national output. In the macroeconomic model, the increasing use of capital goods in the health care sector explains the observed rise in relative prices. Moreover, this "capital deepening" implies that a relatively modest fraction of the labor force is employed in health care and that the rest of the economy is increasingly starved for capital, resulting in a declining standard of living. PMID:8063567

  19. If You Build It, Will They Come? Tales of Developing a New Degree Program in Actuarial Science

    ERIC Educational Resources Information Center

    Marano, Lisa E.

    2014-01-01

    In 2007, the B.S. in Applied Mathematics program consisting of five concentrations, including Actuarial Science, began at West Chester University of Pennsylvania, and we graduated our first class (of one) that December. We describe our program, some ideas to consider when planning your own program, and share some of the successes of our program…

  20. Actuarial Models for Assessing Prison Violence Risk: Revisions and Extensions of the Risk Assessment Scale for Prison (RASP)

    ERIC Educational Resources Information Center

    Cunningham, Mark D.; Sorensen, Jon R.

    2006-01-01

    An investigation and extension of the Risk Assessment Scale for Prison (RASP-Potosi), an actuarially derived scale for the assessment of prison violence, was undertaken through a retrospective review of the disciplinary records of the first 12 months of confinement of a cohort of inmates entering the Florida Department of Corrections in 2002 and…

  1. Competence in Mathematics and Academic Achievement: An Analysis of Enrollees in the Bachelor of Science in Actuarial Science Program

    ERIC Educational Resources Information Center

    Wamala, Robert; Maswere, Dyson W.; Mwanga, Yeko

    2013-01-01

    This study investigates the role of prior grounding attained in mathematics in predicting the academic achievement of enrollees in Bachelor of Science in Actuarial Science (BSAS). The investigation is based on administrative records of 240 BSAS enrollees at Makerere University, School of Statistics and Planning in the 2007-2009 cohorts. Students'…

  2. 26 CFR 1.412(c)(2)-1 - Valuation of plan assets; reasonable actuarial valuation methods.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... of 120 percent of the current fair market value of plan assets as of the applicable asset valuation... assets in the period in which it occurs. (iii) The asset valuation rules contained in paragraph (b...) Asset valuation method requirements—(1) Consistent basis. (i) The actuarial asset valuation method...

  3. 78 FR 9890 - DoD Medicare-Eligible Retiree Health Care Board of Actuaries; Notice of Federal Advisory...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-12

    ... of the Secretary DoD Medicare-Eligible Retiree Health Care Board of Actuaries; Notice of Federal... that the following Federal Advisory Committee meeting of the DoD Medicare-Eligible Retiree Health Care... in the valuation of benefits under DoD retiree health care programs for...

  4. 75 FR 6360 - Federal Advisory Committee; DoD Medicare-Eligible Retiree Health Care Board of Actuaries

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-09

    ... of the Secretary Federal Advisory Committee; DoD Medicare-Eligible Retiree Health Care Board of... that the DoD Medicare-Eligible Retiree Health Care Board of Actuaries will meet on August 18, 2010... used in the valuation of benefits under DoD retiree health care programs for...

  5. Has actuarial aging "slowed" over the past 250 years? A comparison of small-scale subsistence populations and European cohorts.

    PubMed

    Gurven, Michael; Fenelon, Andrew

    2009-04-01

    G.C. Williams's 1957 hypothesis famously argues that higher age-independent, or "extrinsic," mortality should select for faster rates of senescence. Long-lived species should therefore show relatively few deaths from extrinsic causes such as predation and starvation. Theoretical explorations and empirical tests of Williams's hypothesis have flourished in the past decade but it has not yet been tested empirically among humans. We test Williams's hypothesis using mortality data from subsistence populations and from historical cohorts from Sweden and England/Wales, and examine whether rates of actuarial aging declined over the past two centuries. We employ three aging measures: mortality rate doubling time (MRDT), Ricklefs's omega, and the slope of mortality hazard from ages 60-70, m'(60-70), and model mortality using both Weibull and Gompertz-Makeham hazard models. We find that (1) actuarial aging in subsistence societies is similar to that of early Europe, (2) actuarial senescence has slowed in later European cohorts, (3) reductions in extrinsic mortality associate with slower actuarial aging in longitudinal samples, and (4) men senesce more rapidly than women, especially in later cohorts. To interpret these results, we attempt to bridge population-based evolutionary analysis with individual-level proximate mechanisms. PMID:19220451

  6. Intraoperative Radiotherapy as a Boost During Breast-Conserving Surgery Using Low-Kilovoltage X-Rays: The First 5 Years of Experience With a Novel Approach

    SciTech Connect

    Wenz, Frederik; Welzel, Grit; Blank, Elena; Hermann, Brigitte; Steil, Volker; Suetterlin, Marc; Kraus-Tiefenbacher, Uta

    2010-08-01

    Purpose: Intraoperative radiotherapy (IORT) during breast-conserving surgery (BCS) has been recently introduced using different devices. We report the first 5 years of a single-center experience after introduction of a novel approach to deliver IORT as a tumor bed boost during BCS for breast cancer. Methods and Materials: A total of 155 breast cancers in 154 women (median age, 63 years; range, 30-83 years; T1/T2 = 100/55; N0/N+ = 108/47) were treated between February 2002 and December 2007 at the University Medical Center Mannheim, in whom IORT as tumor bed boost was applied using 50-kV X-rays (20 Gy) followed by 46-50 Gy whole-breast external-beam radiotherapy (EBRT). Chemotherapy, if indicated, was given before EBRT. The median interval between BCS plus IORT and EBRT was 40 days. Median follow-up was 34 months (maximum 80 months, 1 patient lost to follow-up). Overall survival and local relapse-free survival were calculated at 5 years using the Kaplan-Meier method. Seventy-nine patients were evaluated at 3-year follow-up for late toxicity according to the Late Effects in Normal Tissues-Subjective, Objective, Management, and Analytic system. Results: Ten patients died, 2 had in-breast relapse, and 8 developed distant metastases (5-year overall survival = 87.0%; 5-year local relapse-free survival = 98.5%). Grade 3 fibroses of the tumor bed were detected in 5% of the patients after 3 years. Skin toxicity was mild (telangiectases and hyperpigmentations in approximately 6% each). Conclusions: Intraoperative radiotherapy as a tumor bed boost during BCS for breast cancer using low-kilovoltage X-rays followed by EBRT yields low recurrence and toxicity rates.

  7. Marginal bone preservation in single-tooth replacement: a 5-year prospective clinical multicenter study.

    PubMed

    2016-06-10

    Although this study heralded that over half the implants gained bone, this was between 1 and 5 years after placement, the amounts were trivial, and this has to be balanced with loss of bone during the first year. PMID:27283560

  8. Perceived Control and Intellectual Functioning in the Elderly: A 5-Year Longitudinal Study.

    ERIC Educational Resources Information Center

    Lachman, Margie E.; Leff, Rona

    1989-01-01

    Examined the relation of control beliefs to individual differences in 63 elderly adults in 1981 and 1986. Over the 5 years, generalized control and intellectual performance did not change, but intellectual control beliefs did. (RJC)

  9. Effect of water content and temperature on seed longevity of seven Brassicaceae species after 5 years of storage.

    PubMed

    Mira, S; Estrelles, E; González-Benito, M E

    2015-01-01

    Maximising seed longevity is crucial for genetic resource preservation and longevity of orthodox seeds is determined by environmental conditions (water content and temperature). The effect of water content (down to 0.01 g·H₂O·g(-1) ) on seed viability was studied at different temperatures for a 5-year storage period in taxonomically related species. Seeds of seven Brassicaceae species (Brassica repanda, Eruca vesicaria, Malcolmia littorea, Moricandia arvensis, Rorippa nasturtium-aquaticum, Sinapis alba, Sisymbrium runcinatum) were stored at 48 environments comprising a combination of eight water contents, from 0.21 to 0.01 g·H₂O·g(-1) DW and six temperatures (45, 35, 20, 5, -25, -170 °C). Survival curves were modelled and P50 calculated for those conditions where germination was reduced over the 5-year assay period. Critical water content for storage of seeds of six species at 45 °C ranged from 0.02 to 0.03 g·H₂O·g(-1) . The effect of extreme desiccation at 45 °C showed variability among species: three species showed damaging effects of drying below the critical water content, while for three species it was neither detrimental nor beneficial to seed longevity. Lipid content could be related to longevity, depending on the storage conditions. A variable seed longevity response to water content among taxonomically related species was found. The relative position of some of the species as long- or short-lived at 45 °C varied depending on the humidity at which storage behaviour was evaluated. Therefore, predictions of survival under desiccated conditions based on results obtained at high humidity might be problematic for some species. PMID:24804799

  10. The temporal outcomes of open versus arthroscopic knotted and knotless rotator cuff repair over 5 years

    PubMed Central

    Lucena, Thomas R; Lam, Patrick H; Millar, Neal L

    2015-01-01

    Background The present study aimed to determine how repair technique influenced structural and clinical outcomes at 5 years post-surgery. Methods Three cohorts of patients had repair of a symptomatic rotator cuff tear using (i) an open double-row mattress repair technique (n = 25); (ii) arthroscopic single-row simple suture knotted technique (n = 25); or (iii) arthroscopic single-row inverted mattress knotless technique (n = 36) by one surgeon. Standardized patient- and examiner-determined outcomes were obtained pre-operatively and postoperatively with a validated protocol, ultrasound were also performed at the same time. Results Retear occurred more often after open repair (48%) at 5 years than after arthroscopic knotted (33%) and arthroscopic knotless (26%) repair. Retear was associated with increasing age, pre-operative tear size and weaker pre-operative and 5 years postoperative cuff strength. Between 2 years and 5 years, the open repair group experienced an increase in the frequency of pain during activity, as well as in the difficulty experienced and the severity of pain during overhead activities (p < 0.05) and, at 5 years, also experienced more difficulty with overhead activities, compared to the arthroscopic knotless repair group. Conclusions At 5-year follow-up, arthroscopic rotator cuff repair techniques resulted in fewer retears and better outcomes compared to an open double-row technique.

  11. Tutorial: survival analysis--a statistic for clinical, efficacy, and theoretical applications.

    PubMed

    Gruber, F A

    1999-04-01

    Current demands for increased research attention to therapeutic efficacy, efficiency, and also for improved developmental models call for analysis of longitudinal outcome data. Statistical treatment of longitudinal speech and language data is difficult, but there is a family of statistical techniques in common use in medicine, actuarial science, manufacturing, and sociology that has not been used in speech or language research. Survival analysis is introduced as a method that avoids many of the statistical problems of other techniques because it treats time as the outcome. In survival analysis, probabilities are calculated not just for groups but also for individuals in a group. This is a major advantage for clinical work. This paper provides a basic introduction to nonparametric and semiparametric survival analysis using speech outcomes as examples. A brief discussion of potential conflicts between actuarial analysis and clinical intuition is also provided. PMID:10229458

  12. Innovative estimation of survival using log-normal survival modelling on ACCENT database

    PubMed Central

    Chapman, J W; O'Callaghan, C J; Hu, N; Ding, K; Yothers, G A; Catalano, P J; Shi, Q; Gray, R G; O'Connell, M J; Sargent, D J

    2013-01-01

    Background: The ACCENT database, with individual patient data for 20 898 patients from 18 colon cancer clinical trials, was used to support Food and Drug Administration (FDA) approval of 3-year disease-free survival as a surrogate for 5-year overall survival. We hypothesised substantive differences in survival estimation with log-normal modelling rather than standard Kaplan–Meier or Cox approaches. Methods: Time to relapse, disease-free survival, and overall survival were estimated using Kaplan–Meier, Cox, and log-normal approaches for male subjects aged 60–65 years, with stage III colon cancer, treated with 5-fluorouracil-based chemotherapy regimens (with 5FU), or with surgery alone (without 5FU). Results: Absolute differences between Cox and log-normal estimates with (without) 5FU varied by end point. The log-normal model had 5.8 (6.3)% higher estimated 3-year time to relapse than the Cox model; 4.8 (5.1)% higher 3-year disease-free survival; and 3.2 (2.2)% higher 5-year overall survival. Model checking indicated greater data support for the log-normal than the Cox model, with Cox and Kaplan–Meier estimates being more similar. All three model types indicate consistent evidence of treatment benefit on both 3-year disease-free survival and 5-year overall survival; patients allocated to 5FU had 5.0–6.7% higher 3-year disease-free survival and 5.3–6.8% higher 5-year overall survival. Conclusion: Substantive absolute differences between estimates of 3-year disease-free survival and 5-year overall survival with log-normal and Cox models were large enough to be clinically relevant, and warrant further consideration. PMID:23385733

  13. No superiority of cemented metal-on-metal vs metal-on-polyethylene THA at 5-year follow-up.

    PubMed

    Zijlstra, Wierd P; Cheung, John; Sietsma, Maurits S; van Raay, Jos Jam; Deutman, Robert

    2009-07-01

    A randomized controlled trial was performed to compare the cemented Stanmore metal-on-metal (Biomet, Warsaw, Indiana) total hip arthroplasty (THA; 102 hips) to the cemented Stanmore metal-on-polyethylene (Biomet) THA (98 hips). The primary outcome was clinical performance. Radiological performance, serum cobalt analysis, and prosthetic survival were secondary outcome measures. At a mean follow-up of 5.6 years, 5 patients were lost to follow-up, 18 died, and 4 were revised (3 metal-on- metal, 1 metal-on-polyethylene). Harris Hip Scores improved from 48 to 90 in the metal-on-metal patients (P<.001) and from 46 to 87 in the metal-on-polyethylene patients (P<.001). Oxford Hip Scores changed from 40 to 19 in the metal-on-metal group (P<.001) and from 40 to 18 in the metal-on-polyethylene group (P<.001). For both Harris and Oxford Hip Scores, there was no significant difference between the 2 groups. Five-year survival with revision for any reason was 97% (95% CI 93%-100%) in the metal-on-metal group and 99% (95% CI 97%-100%) in the metal-on-polyethylene group. All revisions were indicated for aseptic loosening (metal-on-metal: 3 cup revisions; metal-on-polyethylene: 1 total revision). At 5-year follow-up, cemented metal-on-metal THA showed no clinical superiority over metal-on-polyethylene THA. PMID:19634856

  14. Long Term Results (>5 Years) in Patients With Peritoneovenous Shunting for Intractable Ascites: Liver Function and Cancer Mortality

    PubMed Central

    Meakins, Jonathan L.; Wu, Andrew; Smadja, Claude; Bonnet, Patrick; Gouffier, Etienne; Campillo, Bernard

    1989-01-01

    This report is based on twenty-eight (26%) of 107 patients included in a protocol for prospective evaluation of elective peritoneo-venous shunting for intractable ascites in cirrhosis. These patients had no other procedures and survived more than 5 years after the operation. All patients were free of ascites except one in whom it was mild. One patient refused follow-up. Shunt patency was assessed in 23 patients. In 14 patients (60.9%), the shunt was obstructed and the superior vena cava was occluded in 5 of them. In 9 patients (39.1%), the shunt was still functioning. No clinical or biological parameters differentiated these two groups of patients. Of the 24 patients who were alcoholics, 2 abstained completely and 20 significantly reduced their drinking habits. In 25 patients, the Pugh's score improved and was A at the time of the study. Seven patients (25.9%) developed a malignant tumor of the oro-pharynx or digestive tract, all other patients were alive and in good health. This study suggests that patients with intractable ascites treated by a peritoneo-venous shunt may survive for a long period. In patients abstaining from heavy drinking, it may function as a therapeutic bridge permitting spontaneous improvement of liver function. The risk of supervening neoplasms suggests that a continuous follow-up of these patients is warranted. PMID:2487384

  15. Sex offender treatment outcome, actuarial risk, and the aging sex offender in Canadian corrections: a long-term follow-up.

    PubMed

    Olver, Mark E; Nicholaichuk, Terry P; Gu, Deqiang; Wong, Stephen C P

    2013-08-01

    The present study is an examination of sex offender treatment outcome in a large national cohort of Canadian Federally incarcerated sex offenders followed up an average of 11.7 years postrelease. A brief actuarial risk scale (BARS), which predicted sexual and violent recidivism, was created for the purposes of the present study to control for risk-related differences between treated and untreated offenders. In total, 732 offenders were identified as having completed (n = 625) or not attended (n = 107) a sex offender treatment program and for whom sufficient information was available to complete the scale. Controlling for risk and individual differences in follow-up time using Cox regression survival analyses and an 8-year fixed follow-up period, treated sex offenders demonstrated significantly lower rates of violent, but not sexual, recidivism. When the treated and untreated groups were stratified by risk level, significant differences were observed only among moderate or high risk offenders. Some significant group differences also emerged on indicators of recidivism severity, with treated offenders demonstrating slower times to sexual reoffense and lower scores on a quantified metric of sexual and violent recidivism severity after controlling for risk. Differences in recidivism base rates between treated and untreated offenders were also larger in magnitude for younger offenders (i.e., under age 50 at release), than for older offenders; however, interactions between age and treatment were not found. The findings are consistent with the risk principle and have possible implications regarding the dynamic nature of sexual violence risk. PMID:23136142

  16. The effects of oil pollution on Antarctic benthic diatom communities over 5 years.

    PubMed

    Polmear, R; Stark, J S; Roberts, D; McMinn, A

    2015-01-15

    Although considered pristine, Antarctica has not been impervious to hydrocarbon pollution. Antarctica's history is peppered with oil spills and numerous abandoned waste disposal sites. Both spill events and constant leakages contribute to previous and current sources of pollution into marine sediments. Here we compare the response of the benthic diatom communities over 5 years to exposure to a commonly used standard synthetic lubricant oil, an alternative lubricant marketed as more biodegradable, in comparison to a control treatment. Community composition varied significantly over time and between treatments with some high variability within contaminated treatments suggesting community stress. Both lubricants showed evidence of significant effects on community composition after 5 years even though total petroleum hydrocarbon reduction reached approximately 80% over this time period. It appears that even after 5 years toxicity remains high for both the standard and biodegradable lubricants revealing the temporal scale at which pollutants persist in Antarctica. PMID:25499184

  17. Ranibizumab in neovascular age-related macular degeneration: a 5-year follow-up

    PubMed Central

    Cvetkova, Nadezhda P; Hölldobler, Kristina; Prahs, Philipp; Radeck, Viola; Helbig, Horst; Märker, David

    2016-01-01

    Purpose Our aim was to evaluate an optical coherence tomography (OCT) and visual acuity (VA)-guided, variable-dosing regimen with intravitreal ranibizumab injection for treating patients with neovascular age-related macular degeneration (AMD) from 2007 to 2012. Design This was a retrospective clinical study of 5 years follow-up in a tertiary eye center. Patients and methods In this study, 66 patients with neovascular AMD (mean age of 74 years, SD 8.7 years) were included. We investigated the development of best-corrected visual acuity (BCVA), the number of intravitreal injections, and the central retinal thickness measured with OCT (OCT Spectralis) over 5 years of intravitreal treatment. Results The mean number of intravitreal ranibizumab injections over 5 years was 8.8. The mean BCVA before therapy was 0.4 logarithm of the minimum angle of resolution (logMAR). After 5 years of therapy, the mean BCVA was 0.6 logMAR. In all, 16% of treated patients had stable VA over 5 years and 10% of study eyes approved their VA. The mean OCT-measured central retinal thickness at the beginning of this study was 295 µm; after 5 years of treatment, the mean central retinal thickness was 315 µm. There was an increase in central retinal thickness in 47.5% of examined eyes. Conclusion Other studies showed VA improvement in OCT-guided variable-dosing regimens. Our study revealed a moderate decrease in VA after a total mean injection number as low as 8.8 injections over 5 years. In OCT, an increase in central retinal thickness over 5 years could be observed. Probably, this is due to deficient treatment when comparing the total injection number to other treatment regimens. Anti-VEGF therapy helps to keep the VA stable for a period of time, but cannot totally stop the progression of the disease completely. Patients with late stages of neovascular AMD can maintain VA even if they are relatively undertreated. PMID:27354758

  18. A theoretical model of the evolution of actuarial senescence under environmental stress.

    PubMed

    Watson, H; Cohen, A A; Isaksson, C

    2015-11-01

    Free-living organisms are exposed to a wide range of stressors, all of which can disrupt components of stress-related and detoxification physiology. The subsequent accumulation of somatic damage is widely believed to play a major role in the evolution of senescence. Organisms have evolved sophisticated physiological regulatory mechanisms to maintain homeostasis in response to environmental perturbations, but these systems are likely to be constrained in their ability to optimise robustness to multiple stressors due to functional correlations among related traits. While evolutionary change can accelerate due to human ecological impacts, it remains to be understood how exposure to multiple environmental stressors could affect senescence rates and subsequently population dynamics and fitness. We used a theoretical evolutionary framework to quantify the potential consequences for the evolution of actuarial senescence in response to exposure to simultaneous physiological stressors--one versus multiple and additive versus synergistic--in a hypothetical population of avian "urban adapters". In a model in which multiple stressors have additive effects on physiology, species may retain greater capacity to recover, or respond adaptively, to environmental challenges. However, in the presence of high synergy, physiological dysregulation suddenly occurs, leading to a rapid increase in age-dependent mortality and subsequent population collapse. Our results suggest that, if the synergistic model is correct, population crashes in environmentally-stressed species could happen quickly and with little warning, as physiological thresholds of stress resistance are overcome. PMID:26335620

  19. Accuracy of actuarial procedures for assessment of sexual offender recidivism risk may vary across ethnicity.

    PubMed

    Långström, Niklas

    2004-04-01

    Little is known about whether the accuracy of tools for assessment of sexual offender recidivism risk holds across ethnic minority offenders. I investigated the predictive validity across ethnicity for the RRASOR and the Static-99 actuarial risk assessment procedures in a national cohort of all adult male sex offenders released from prison in Sweden 1993-1997. Subjects ordered out of Sweden upon release from prison were excluded and remaining subjects (N = 1303) divided into three subgroups based on citizenship. Eighty-three percent of the subjects were of Nordic ethnicity, and non-Nordic citizens were either of non-Nordic European (n = 49, hereafter called European) or African Asian descent (n = 128). The two tools were equally accurate among Nordic and European sexual offenders for the prediction of any sexual and any violent nonsexual recidivism. In contrast, neither measure could differentiate African Asian sexual or violent recidivists from nonrecidivists. Compared to European offenders, AfricanAsian offenders had more often sexually victimized a nonrelative or stranger, had higher Static-99 scores, were younger, more often single, and more often homeless. The results require replication, but suggest that the promising predictive validity seen with some risk assessment tools may not generalize across offender ethnicity or migration status. More speculatively, different risk factors or causal chains might be involved in the development or persistence of offending among minority or immigrant sexual abusers. PMID:15208896

  20. Age, actuarial risk, and long-term recidivism in a national sample of sex offenders.

    PubMed

    Nicholaichuk, Terry P; Olver, Mark E; Gu, Deqiang; Wong, Stephen C P

    2014-10-01

    Age at release has become an increasing focus of study with regard to evaluating risk in the sex offender population and has been repeatedly shown to be an important component of the risk assessment equation. This study constitutes an extension of a study of sex offender outcomes prepared for the Evaluation Branch, Correctional Service of Canada. The entire cohort of 2,401 male federally incarcerated sexual offenders who reached their warrant expiry date (WED) within 1997/1998, 1998/1999, and 1999/2000 fiscal years were reviewed for the study. Sexual and violent reconviction information was obtained from CPIC criminal records over an average of 12.0 years (SD = 1.7) follow-up. This study focused upon the cohort of sex offenders who were 50 years or older at time of release (N = 542). They were stratified according to risk using a brief actuarial scale (BARS) comprising six binary variables. For the most part, older offenders showed low base rates of sexual recidivism regardless of the risk band into which they fell. The exception was a small group of elderly offenders (n = 20) who fell into the highest risk band, and who showed high levels of sexual recidivism. The results of this combination of cross-sectional and longitudinal analyses of elderly sexual offenders may have important implications for offender management, particularly in light of the increasing numbers of offenders in Canada who fall into the over 50 age cohort. PMID:23818657

  1. A theoretical model of the evolution of actuarial senescence under environmental stress

    PubMed Central

    Watson, H.; Cohen, A.A.; Isaksson, C.

    2015-01-01

    Free-living organisms are exposed to a wide range of stressors, all of which can disrupt components of stress-related and detoxification physiology. The subsequent accumulation of somatic damage is widely believed to play a major role in the evolution of senescence. Organisms have evolved sophisticated physiological regulatory mechanisms to maintain homeostasis in response to environmental perturbations, but these systems are likely to be constrained in their ability to optimise robustness to multiple stressors due to functional correlations among related traits. While evolutionary change can accelerate due to human ecological impacts, it remains to be understood how exposure to multiple environmental stressors could affect senescence rates and subsequently population dynamics and fitness. We used a theoretical evolutionary framework to quantify the potential consequences for the evolution of actuarial senescence in response to exposure to simultaneous physiological stressors – one versus multiple and additive versus synergistic – in a hypothetical population of avian “urban adapters”. In a model in which multiple stressors have additive effects on physiology, species may retain greater capacity to recover, or respond adaptively, to environmental challenges. However, in the presence of high synergy, physiological dysregulation suddenly occurs, leading to a rapid increase in age-dependent mortality and subsequent population collapse. Our results suggest that, if the synergistic model is correct, population crashes in environmentally-stressed species could happen quickly and with little warning, as physiological thresholds of stress resistance are overcome. PMID:26335620

  2. IMRT for Sinonasal Tumors Minimizes Severe Late Ocular Toxicity and Preserves Disease Control and Survival

    SciTech Connect

    Duprez, Frederic; Madani, Indira; Morbee, Lieve; Bonte, Katrien; Deron, Philippe; Domjan, Vilmos; Boterberg, Tom; De Gersem, Werner; De Neve, Wilfried

    2012-05-01

    Purpose: To report late ocular (primary endpoint) and other toxicity, disease control, and survival (secondary endpoints) after intensity-modulated radiotherapy (IMRT) for sinonasal tumors. Methods and Materials: Between 1998 and 2009, 130 patients with nonmetastatic sinonasal tumors were treated with IMRT at Ghent University Hospital. Prescription doses were 70 Gy (n = 117) and 60-66 Gy (n = 13) at 2 Gy per fraction over 6-7 weeks. Most patients had adenocarcinoma (n = 82) and squamous cell carcinoma (n = 23). One hundred and one (101) patients were treated postoperatively. Of 17 patients with recurrent tumors, 9 were reirradiated. T-stages were T1-2 (n = 39), T3 (n = 21), T4a (n = 38), and T4b (n = 22). Esthesioneuroblastoma was staged as Kadish A, B, and C in 1, 3, and 6 cases, respectively. Results: Median follow-up was 52, range 15-121 months. There was no radiation-induced blindness in 86 patients available for late toxicity assessment ({>=}6 month follow-up). We observed late Grade 3 tearing in 10 patients, which reduced to Grade 1-2 in 5 patients and Grade 3 visual impairment because of radiation-induced ipsilateral retinopathy and neovascular glaucoma in 1 patient. There was no severe dry eye syndrome. The worst grade of late ocular toxicity was Grade 3 (n = 11), Grade 2 (n = 31), Grade 1 (n = 33), and Grade 0 (n = 11). Brain necrosis and osteoradionecrosis occurred in 6 and 1 patients, respectively. Actuarial 5-year local control and overall survival were 59% and 52%, respectively. On multivariate analysis local control was negatively affected by cribriform plate and brain invasion (p = 0.044 and 0.029, respectively) and absence of surgery (p = 0.009); overall survival was negatively affected by cribriform plate and orbit invasion (p = 0.04 and <0.001, respectively) and absence of surgery (p = 0.001). Conclusions: IMRT for sinonasal tumors allowed delivering high doses to targets at minimized ocular toxicity, while maintaining disease control and survival

  3. A mathematical proof and example that Bayes's Theorem is fundamental to actuarial estimates of sexual recidivism risk.

    PubMed

    Donaldson, Theodore; Wollert, Richard

    2008-06-01

    Expert witnesses in sexually violent predator (SVP) cases often rely on actuarial instruments to make risk determinations. Many questions surround their use, however. Bayes's Theorem holds much promise for addressing these questions. Some experts nonetheless claim that Bayesian analyses are inadmissible in SVP cases because they are not accepted by the relevant scientific community. This position is illogical because Bayes's Theorem is simply a probabilistic restatement of the way that frequency data are combined to arrive at whatever recidivism rates are paired with each test score in an actuarial table. This article presents a mathematical proof and example validating this assertion. The advantages and implications of a logic model that combines Bayes's Theorem and the null hypothesis are also discussed. PMID:18490482

  4. Local control and survival after external irradiation for adenocarcinoma of the prostate

    SciTech Connect

    Rangala, N.; Cox, J.D.; Byhardt, R.W.; Wilson, J.F.; Greenberg, M.; Da Conceicao, A.L.

    1982-11-01

    From 1966 through 1978, 128 patients with biopsy-proven adenocarcinoma of the prostate underwent external irradiation to the entire pelvis followed by additional irradiation with a field that encompassed the entire prostate with generous margins. Local recurrence was diagnosed when palpable regrowth occurred and was confirmed by biopsy. Eighteen patients (14%) had local recurrence. Actuarial (life table) local recurrence rates, however, were 24% for both for Stage B and C patients. Actuarial five year survival was 100% for the 10 Stage A patients, 91% for the 25 Stage B, and 78% for the 93 Stage C patients. Actuarial five year disease-free survival was 59% for Stage B and 69% for Stage C patients. Local recurrence was affected by the total dose to the whole pelvis and the dose at the center of the prostate. Disease-free survival was influenced by differentiation. High dose external irradiation to the prostate and regional lymph nodes offers the greatest probability of long-term disease-free survival for patients with localized disease. Late bowel complications were seen in 14 patients (11%), two of whom required colostomies. Late urinary tract complications were observed in five patients (4%).

  5. Deferiprone versus deferoxamine in sickle cell disease: results from a 5-year long-term Italian multi-center randomized clinical trial.

    PubMed

    Calvaruso, Giusi; Vitrano, Angela; Di Maggio, Rosario; Ballas, Samir; Steinberg, Martin H; Rigano, Paolo; Sacco, Massimiliano; Telfer, Paul; Renda, Disma; Barone, Rita; Maggio, Aurelio

    2014-12-01

    Blood transfusion and iron chelation currently represent a supportive therapy to manage anemia, vasculopathy and vaso-occlusion crises in Sickle-Cell-Disease. Here we describe the first 5-year long-term randomized clinical trial comparing Deferiprone versus Deferoxamine in patients with Sickle-Cell-Disease. The results of this study show that Deferiprone has the same effectiveness as Deferoxamine in decreasing body iron burden, measured as repeated measurements of serum ferritin concentrations on the same patient over 5-years and analyzed according to the linear mixed-effects model (LMM) (p=0.822). Both chelators are able to decrease, significantly, serum ferritin concentrations, during 5-years, without any effect on safety (p=0.005). Moreover, although the basal serum ferritin levels were higher in transfused compared with non-transfused group (p=0.031), the changes over time in serum ferritin levels were not statistically significantly different between transfused and non-transfused cohort of patients (p=0.389). Kaplan-Meier curve, during 5-years of study, suggests that Deferiprone does not alter survival in comparison with Deferoxamine (p=0.38). In conclusion, long-term iron chelation therapy with Deferiprone was associated with efficacy and safety similar to that of Deferoxamine. Therefore, in patients with Sickle-Cell-Disease, Deferiprone may represent an effective long-term treatment option. PMID:24814618

  6. Episodic Memory and Episodic Foresight in 3- and 5-Year-Old Children

    ERIC Educational Resources Information Center

    Hayne, Harlene; Gross, Julien; McNamee, Stephanie; Fitzgibbon, Olivia; Tustin, Karen

    2011-01-01

    In the present study, we examined the development of episodic memory and episodic foresight. Three- and 5-year-olds were interviewed individually using a personalised timeline that included photographs of them at different points in their life. After constructing the timeline with the experimenter, each child was asked to discuss a number of…

  7. Changes in Exercise Capacity of Cardiac Asymptomatic Hereditary Hemochromatosis Subjects over 5-Year Follow up

    PubMed Central

    Shizukuda, Yukitaka; Smith, Kevin P.; Tripodi, Dorothy J.; Arena, Ross; Yau, Yu-Ying; Bolan, Charles D.; Waclawiw, Myron A.; Leitman, Susan F.; Rosing, Douglas R.

    2012-01-01

    Objective A long-term effect of hereditary hemochromatosis (HH) on aerobic exercise capacity (AEC) has not been well described. Design Forty-three HH and 21 volunteer control (VC) subjects who were asymptomatic underwent cardiopulmonary exercise testing using the Bruce protocol. AEC was assessed with minute ventilation (VE), oxygen uptake (VO2), and carbon dioxide production (VCO2) at baseline (BL) at a 5-year follow up (5Y) assessment. A paired t-test was used for analyses of normality data; otherwise, a Wilcoxon singed rank sum test was used. Results Thirty-three HH subjects and 18 VC subjects returned for a repeat CPX at 5Y (80% overall return rate). At 5Y, AEC was not different between the two groups. As compared with BL measurements, exercise time, peak VO2, and the VE/VCO2 slope did not differ statistically at 5Y between both groups. Iron depletion by phlebotomy for 5 years did not significantly affect AEC in newly diagnosed HH subjects at baseline (n=14) and cardiac arrhythmias during exercise tended to decrease after 5 years of therapy in this group. Conclusions The AEC of asymptomatic HH subjects treated with conventional therapy is not statistically affected by the disease over a 5-year period. PMID:22311055

  8. How Do 5-Year-Olds Understand Questions? Differences in Languages across Europe

    ERIC Educational Resources Information Center

    Sauerland, Uli; Grohmann, Kleanthes K.; Guasti, Maria Teresa; Andelkovic, Darinka; Argus, Reili; Armon-Lotem, Sharon; Arosio, Fabrizio; Avram, Larisa; Costa, João; Dabašinskiene, Ineta; de López, Kristine; Gatt, Daniela; Grech, Helen; Haman, Ewa; van Hout, Angeliek; Hrzica, Gordana; Kainhofer, Judith; Kamandulyte-Merfeldiene, Laura; Kunnari, Sari; Kovacevic, Melita; Kuvac Kraljevic, Jelena; Lipowska, Katarzyna; Mejias, Sandrine; Popovic, Maša; Ruzaite, Jurate; Savic, Maja; Sevcenco, Anca; Varlokosta, Spyridoula; Varnava, Marina; Yatsushiro, Kazuko

    2016-01-01

    The comprehension of constituent questions is an important topic for language acquisition research and for applications in the diagnosis of language impairment. This article presents the results of a study investigating the comprehension of different types of questions by 5-year-old, typically developing children across 19 European countries, 18…

  9. Ready, Set, Grow! Health Education for 3-5 Year Olds.

    ERIC Educational Resources Information Center

    Peterson, Paula J.

    Intended for use in family day care, preschool centers, professional preparation institutions, and in homes, this comprehensive health education curriculum for 3- through 5-year-old children contains units designed to sequentially teach concepts about physical health, mental health, family living, and safety. Contents include the following…

  10. Secondary Science Teachers' Use of Technology in the Classroom during Their First 5 Years

    ERIC Educational Resources Information Center

    Bang, EunJin; Luft, Julie A.

    2013-01-01

    This study examined the technology use of beginning secondary science teachers and explored factors facilitating or inhibiting their use of technology. The researchers collected and analyzed interviews and observational data from 95 teachers over a 5-year period. The results show that teachers used PowerPoint the most and other software the least…

  11. A Multidimensional Scaling Study of Visual Memory of 5-Year Olds and Adults

    ERIC Educational Resources Information Center

    Arabie, Phipps; And Others

    1975-01-01

    An investigation of memory development using nonmetric multidimensional scaling. Judgments of similarities between complex objects were obtained from 5-year-olds and adults under two conditions: (1) when objects were simultaneously present at the time of comparison, and (2) when the objects were not simultaneously present and had to be compared on…

  12. Predictors of ADHD Persistence in Girls at 5-Year Follow-Up

    ERIC Educational Resources Information Center

    Mick, Eric; Byrne, Deirdre; Fried, Ronna; Monuteaux, Michael; Faraone, Stephen V.; Biederman, Joseph

    2011-01-01

    Objective: The main aim of this study was to examine the age-dependent remission from ADHD in girls transitioning through childhood into adolescence and early adulthood. Method: We conducted a 5-year prospective follow-up study of 123 girls with ADHD and 106 non-ADHD control girls aged between 6 and 17 years at ascertainment. ADHD was considered…

  13. Effectiveness of Multipurpose Unit Early Classroom Intervention Program for 4-5-Year-Old Children

    ERIC Educational Resources Information Center

    Celebioglu Morkoc, Ozlem; Aktan Acar, Ebru

    2014-01-01

    This research examined the effectiveness of Multipurpose Unit Early Classroom Intervention Program (MUECIP) prepared for 4-5-year-old (48-60 months) children whose development is at risk because of their families' socioeconomic conditions. The research adopted a preliminary test-final test control group trial model. The research participants…

  14. A Case Series of Marijuana Exposures in Pediatric Patients Less than 5 Years of Age

    ERIC Educational Resources Information Center

    Wang, George Sam; Narang, Sandeep K.; Wells, Kathryn; Chuang, Ryan

    2011-01-01

    Objective: In Colorado, there has been a large increase in medical marijuana dispensaries and licenses for the use of medical marijuana over the past year. This is a retrospective case series of marijuana exposures that have presented to the emergency department (ED) in children less than 5 years of age. Methods: We performed a retrospective chart…

  15. The Use of Psychological State Words by Late Talkers at Ages 3, 4, and 5 Years

    ERIC Educational Resources Information Center

    Lee, Eliza Carlson; Rescorla, Leslie

    2008-01-01

    The use of four types of psychological state words (physiological, emotional, desire, and cognitive) during mother-child play sessions at ages 3, 4, and 5 years was examined in 30 children diagnosed with delayed expressive language at 24-31 months and 15 age-matched comparison children with typical development. The children's mean length of…

  16. Cognitive and Temperament Clusters in 3- to 5-Year-Old Children with Aggressive Behavior

    ERIC Educational Resources Information Center

    Sakimura, Jean N.; Dang, Michelle T.; Ballard, Kelley B.; Hansen, Robin L.

    2008-01-01

    Background: This study assessed the co-occurrence of cognitive problems and difficult temperament characteristics in children aged 3 to 5 years exhibiting aggressive behavior. Methods: Thirty-one children with high ratings on the Aggressive Behavior subscale of the Achenbach Child Behavior Checklist or Teacher Report Form were recruited from a…

  17. 24 CFR 903.6 - What information must a PHA provide in the 5-Year Plan?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false What information must a PHA provide in the 5-Year Plan? 903.6 Section 903.6 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN...

  18. Early Book Stages, 0-5 Years [and] Creciendo con Libros (Growing [up] with Books). [Videotape.

    ERIC Educational Resources Information Center

    Holguin, Roxanna

    Using a lighthearted and simple approach, this 23-minute videotape in English and Spanish versions presents interactions between parents and children while reading books. The children in the videotape range in age from 0 to 5 years. The video is introduced by scenes of children enjoying books while narration discussing the impact of reading to…

  19. Renal adenoma in a 5-year-old Labrador retriever: Big is not always bad

    PubMed Central

    Lillakas, Kristina

    2013-01-01

    A 5-year-old Labrador retriever was presented with anorexia, hematuria, and a 3-week history of mild lethargy, periodic inappetance, and weight loss. A firm mass in the cranial abdomen was discovered on physical examination. Following clinical work-up the owners elected euthanasia. On postmortem examination, histopathology determined that the mass was a benign renal adenoma. PMID:23904644

  20. Therapeutic Community in a California Prison: Treatment Outcomes after 5 Years

    ERIC Educational Resources Information Center

    Zhang, Sheldon X.; Roberts, Robert E. L.; McCollister, Kathryn E.

    2011-01-01

    Therapeutic communities have become increasingly popular among correctional agencies with drug-involved offenders. This quasi-experimental study followed a group of inmates who participated in a prison-based therapeutic community in a California state prison, with a comparison group of matched offenders, for more than 5 years after their initial…

  1. Ensemble Perception of Size in 4-5-Year-Old Children

    ERIC Educational Resources Information Center

    Sweeny, Timothy D.; Wurnitsch, Nicole; Gopnik, Alison; Whitney, David

    2015-01-01

    Groups of objects are nearly everywhere we look. Adults can perceive and understand the "gist" of multiple objects at once, engaging ensemble-coding mechanisms that summarize a group's overall appearance. Are these group-perception mechanisms in place early in childhood? Here, we provide the first evidence that 4-5-year-old children use…

  2. Structural Priming as Learning: Evidence from Mandarin-Learning 5-Year-Olds

    ERIC Educational Resources Information Center

    Hsu, Dong-Bo

    2014-01-01

    Three experiments on structural priming in Mandarin-speaking 5-year-olds were conducted to test the priming as implicit learning hypothesis. It describes a learning mechanism that acts on a shared abstract syntactic representation in response to linguistic input using an equi-biased Mandarin SVO-"ba" alternation. The first two…

  3. Introducing Engineering in Elementary Education: A 5-Year Study of Teachers and Students

    ERIC Educational Resources Information Center

    Diefes-Dux, Heidi A.

    2015-01-01

    Engineering, when integrated into K-12 education, may offer a number of potential student learning and future success benefits. In a 5-year study, four cohorts of elementary teachers of grades 2 to 4 in a single US school district were provided with teacher professional development with engineering education. Teachers were prepared to teach…

  4. 5-year mortality in hemodialysis patients: a single center study in Tripoli.

    PubMed

    Buargub, Mahdia A

    2008-03-01

    To investigate the 5-year mortality of patients undergoing maintenance hemo-dialysis (HD) at Al-Shat center Tripoli, we reviewed during June 2007 the records of all the HD patients initiated on HD from Jun 2000 and Jan 2002. There were 124 patients in the study, 77 males (63.6%) and 47 (36.4%) females, with a mean age of 49 +/- 14 years. Diabetic nephropathy (DN) was the underlying kidney disease in 34 (27.4%) patients. After 5 years; 3 patients were transferred to other centers, 18 (14.9%) patients underwent kidney transplan-tation. Out of the 103 patients who continued on hemodialysis, 53 (51.4%) expired during the 5-year follow-up. Mortality was associated with older age (p 50 years) and DN (p< 0.002 and OR of 3.9). Mortality rate in diabetics was 74.1% and significantly associated with male sex (p< 0.0067 and OR of 2.4), older age (p< 0.004), presence of hypertension (p< 0.003 and OR of 3.9), type 1 diabetes (OR 1.6), and elevated mean body weight (p< 0.046). Mortality was also relatively higher in black patients (OR of 2.0) and smokers (OR of 1.39). In conclusion, the overall 5- year mortality for dialysis patients was elevated and higher in the diabetics. PMID:18310882

  5. 24 CFR 903.6 - What information must a PHA provide in the 5-Year Plan?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false What information must a PHA provide in the 5-Year Plan? 903.6 Section 903.6 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT...

  6. Verbal Competence in Narrative Retelling in 5-Year-Olds with Unilateral Cleft Lip and Palate

    ERIC Educational Resources Information Center

    Klintö, Kristina; Salameh, Eva-Kristina; Lohmander, Anette

    2015-01-01

    Background: Research regarding expressive language performance in children born with cleft palate is sparse. The relationship between articulation/phonology and expressive language skills also needs to be further explored. Aims: To investigate verbal competence in narrative retelling in 5-year-old children born with unilateral cleft lip and palate…

  7. Hands as Companions of the Mind: Essential Practical Life for the 5-Year-Old

    ERIC Educational Resources Information Center

    Gilder, Sharon Allen

    2012-01-01

    Numerous observations in Montessori classrooms led veteran Montessorians Pamela W. Trumble and Eleni Bokas to the conclusion that a universal need exists to bring integrity back to Practical Life, especially for 5-year-olds. Maria Montessori's observations over a century ago revealed the importance of Practical Life and its relationship to the…

  8. 76 FR 70156 - Draft Programmatic Environmental Impact Study (PEIS) for Proposed 5-Year Outer Continental Shelf...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-10

    ... Bureau of Ocean Energy Management Draft Programmatic Environmental Impact Study (PEIS) for Proposed 5-Year Outer Continental Shelf (OCS) Oil and Gas Leasing Program for 2012-2017 AGENCY: Bureau of Ocean... FURTHER INFORMATION CONTACT: Bureau of Ocean Energy Management, Headquarters, 381 Elden Street,...

  9. Treatment of Sleep Problems in a 5-Year-Old Boy with Autism Using Behavioural Principles.

    ERIC Educational Resources Information Center

    Weiskop, Sophie; Matthews, Jan; Richdale, Amanda

    2001-01-01

    This article describes the successful treatment of sleep problems in a 5-year-old boy with autism. The intervention was based on behavioral principles and involved the parents attending an individually run parent training program. The parents learned how to use a bedtime routine, reinforcement, effective instructions, partner support strategies,…

  10. Wakefulness (Not Sleep) Promotes Generalization of Word Learning in 2.5-Year-Old Children

    ERIC Educational Resources Information Center

    Werchan, Denise M.; Gómez, Rebecca L.

    2014-01-01

    Sleep enhances generalization in adults, but this has not been examined in toddlers. This study examined the impact of napping versus wakefulness on the generalization of word learning in toddlers when the contextual background changes during learning. Thirty 2.5-year-old children (M = 32.94, SE = 0.46) learned labels for novel categories of…

  11. Guidelines for Health Assessment and Intervention Techniques for 3, 4, and 5 Year Old Children.

    ERIC Educational Resources Information Center

    Bentley, Judy K.

    These guidelines were developed to help registered nurses identify preschoolers with potential handicaps in the course of health assessments. Contents include guidelines on 3-, 4-, and 5-year-olds. Contents are organized within age levels in terms of functioning levels and anticipatory guidance. Functional areas covered include physical,…

  12. The Development of Regulatory Functions from Birth to 5 Years: Insights from Premature Infants

    ERIC Educational Resources Information Center

    Feldman, Ruth

    2009-01-01

    This study examined physiological, emotional, and attentional regulatory functions as predictors of self-regulation in 125 infants followed 7 times from birth to 5 years. Physiological regulation was assessed by neonatal vagal tone and sleep-wake cyclicity; emotion regulation by response to stress at 3, 6, and 12 months; and attention regulation…

  13. Effects of A 2.5-Year Campus-Wide Intervention to Reduce College Drinking

    ERIC Educational Resources Information Center

    Seo, Dong-Chul; Owens, Dee; Gassman, Ruth; Kingori, Caroline

    2013-01-01

    Objective: The present study reports on the results of a 2.5-year college-wide, coordinated intervention that was implemented from June 2007 to December 2009 to reduce the amount and frequency of students' alcohol consumption. Design: Quasi-experimental study using a one-group (freshmen living on campus) pretest/posttest design ("N"…

  14. Influence of Emotional Facial Expressions on 3-5-Year-Olds' Face Recognition

    ERIC Educational Resources Information Center

    Freitag, Claudia; Schwarzer, Gudrun

    2011-01-01

    Three experiments examined 3- and 5-year-olds' recognition of faces in constant and varied emotional expressions. Children were asked to identify repeatedly presented target faces, distinguishing them from distractor faces, during an immediate recognition test and during delayed assessments after 10 min and one week. Emotional facial expression…

  15. 76 FR 50447 - Endangered and Threatened Species; 5-Year Reviews for 5 Evolutionarily Significant Units of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-15

    ..., Oregon, Washington, and Idaho (75 FR 13082). Both ESUs and DPSs are treated as ``species'' under the ESA... FR 37204). The 5-year review reports prepared by the Southwest Region, the Southwest Science Center's... since they were previously reviewed in 2005 (70 FR 37160) and 2006 (71 FR 834), respectively....

  16. 76 FR 50448 - Endangered and Threatened Species; 5-Year Reviews for 17 Evolutionarily Significant Units and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-15

    ... Regional Offices announced initiation of 5-year reviews of Pacific salmon ESUs and steelhead DPSs (75 FR... Salmon and Steelhead in Listing Determinations under the ESA (70 FR 37204) to complete this evaluation...-promulgating the threatened listing for Oregon Coast coho salmon (76 FR 35755). This notice also addresses...

  17. 77 FR 12577 - Department of Defense (DoD) Medicare-Eligible Retiree Health Care Board of Actuaries; Federal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-01

    ...Under the provisions of the Federal Advisory Committee Act of 1972 (5 U.S.C., Appendix, as amended), the Government in the Sunshine Act of 1976 (5 U.S.C. 552b, as amended), and 41 CFR 102-3.150, the Department of Defense announces that the following Federal advisory committee meeting of the DoD Medicare-Eligible Retiree Health Care Board of Actuaries will take...

  18. Respiratory Viruses Associated Hospitalization among Children Aged <5 Years in Bangladesh: 2010-2014

    PubMed Central

    Homaira, Nusrat; Luby, Stephen P.; Hossain, Kamal; Islam, Kariul; Ahmed, Makhdum; Rahman, Mustafizur; Rahman, Ziaur; Paul, Repon C.; Bhuiyan, Mejbah Uddin; Brooks, W. Abdullah; Sohel, Badrul Munir; Banik, Kajal Chandra; Widdowson, Marc-Alain; Willby, Melisa; Rahman, Mahmudur; Bresee, Joseph; Ramirez, Katharine-Sturm; Azziz-Baumgartner, Eduardo

    2016-01-01

    Background We combined hospital-based surveillance and health utilization survey data to estimate the incidence of respiratory viral infections associated hospitalization among children aged < 5 years in Bangladesh. Methods Surveillance physicians collected respiratory specimens from children aged <5 years hospitalized with respiratory illness and residing in the primary hospital catchment areas. We tested respiratory specimens for respiratory syncytial virus, parainfluenza viruses, human metapneumovirus, influenza, adenovirus and rhinoviruses using rRT-PCR. During 2013, we conducted a health utilization survey in the primary catchment areas of the hospitals to determine the proportion of all hospitalizations for respiratory illness among children aged <5 years at the surveillance hospitals during the preceding 12 months. We estimated the respiratory virus-specific incidence of hospitalization by dividing the estimated number of hospitalized children with a laboratory confirmed infection with a respiratory virus by the population aged <5 years of the catchment areas and adjusted for the proportion of children who were hospitalized at the surveillance hospitals. Results We estimated that the annual incidence per 1000 children (95% CI) of all cause associated respiratory hospitalization was 11.5 (10–12). The incidences per 1000 children (95% CI) per year for respiratory syncytial virus, parainfluenza, adenovirus, human metapneumovirus and influenza infections were 3(2–3), 0.5(0.4–0.8), 0.4 (0.3–0.6), 0.4 (0.3–0.6), and 0.4 (0.3–0.6) respectively. The incidences per 1000 children (95%CI) of rhinovirus-associated infections among hospitalized children were 5 (3–7), 2 (1–3), 1 (0.6–2), and 3 (2–4) in 2010, 2011, 2012 and 2013, respectively. Conclusion Our data suggest that respiratory viruses are associated with a substantial burden of hospitalization in children aged <5 years in Bangladesh. PMID:26840782

  19. Extended Long-Term (5 Years) Outcomes of Triangle Tilt Surgery in Obstetric Brachial Plexus Injury

    PubMed Central

    Nath, Rahul K; Somasundaram, Chandra

    2013-01-01

    Objective: We evaluated the "extended" long-term (5 years) functional outcomes in obstetric brachial plexus injury (OBPI) patients, who underwent triangle tilt surgery between February 2005 and January 2008. Methods: Twenty two children (9 girls and 13 boys, mean age at surgery was 5.8 years; ranging 2.1-11.8 years old), who initially presented with medial rotation contracture and scapula deformity secondary to obstetric brachial plexus injury were included in this study. Functional movements were evaluated pre-operatively, and 5 years following triangle tilt surgery by modified Mallet scale. Results: Here, we report long-term (5 years) follow-up of triangle tilt surgery for 22 OBPI patients. Upper extremity functional movements such as, external rotation (2.5±0.6 to 4.1±0.8, p<0.0001), hand-to-spine (2.6±0.6 to 3.4±1.1, p<0.005), hand-to-neck (2.7±0.7 to 4.3±0.7, p<0.0001), hand-to-mouth (2.3±0.9 (92º±33) to 4.2±0.5 (21º±16), p<0.0001), and supination (2.6±1.1 (-8.2º ±51) to 4.1±0.7 (61±32)) were significantly improved (p<0.0001), and maintained over the extended long-term (5 years). Total modified Mallet functional score was also shown to improve from 14.1±2.7 to 20.3±2.5. Conclusions: The triangle tilt surgery improved all shoulder functions significantly, and maintained over the extended long-term (5 years) in these patients. PMID:23730369

  20. Situational analysis and future directions of AYUSH: An assessment through 5-year plans of India

    PubMed Central

    Samal, Janmejaya

    2015-01-01

    AYUSH is an acronym for Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy. These are the six indigenous systems of medicine practiced in India. A department called Department of Indian System of medicine was created in March 1995 and renamed to AYUSH in November 2003 with a focus to provide increased attention for the development of these systems. Very recently, in 2014, a separate ministry was created under the union Government of India, which is headed by a minister of state. Planning regarding these systems of medicine was a part of 5-year planning process since 1951. Since then many developments have happened in this sector albeit the system was struggling with a great degree of uncertainty at the time of 1st5-year plan. A progressive path of development could be observed since the first to the 12th5-year plan. It was up to the 7thplan the growth was little sluggish and from 8thplan onward the growth took its pace and several innovative development processes could be observed thereafter. The system is gradually progressing ahead with a vision to be a globally accepted system, as envisaged in 11th5-year plan. Currently, AYUSH system is a part of mainstream health system implemented under National Rural Health Mission (NRHM). NRHM came into play in 2005 but implemented at ground level in 2006 and introduced the scheme of “Mainstreaming of AYUSH and revitalization of local health traditions” to strengthen public health services. This scheme is currently in operation in its second phase, since 1stApril 2012, with the 12th5-year plan. The scheme was primarily brought in to operation with three important objectives; choice of treatment system to the patients, strengthen facility functionally and strengthen the implementation of national health programmes, however, in some places it seems to be a forced medical pluralism owing to a top-down approach by the union government without considerable involvement of the concerned community. In this study, the

  1. Fracture Prediction After Discontinuation of 4 to 5 Years of Alendronate Therapy

    PubMed Central

    Bauer, Douglas C.; Schwartz, Ann; Palermo, Lisa; Cauley, Jane; Hochberg, Marc; Santora, Art; Cummings, Steven R.; Black, Dennis M.

    2015-01-01

    IMPORTANCE Discontinuation of bisphosphonate therapy after 3 to 5 years is increasingly considered, but methods to monitor fracture risk after discontinuation have not been established. OBJECTIVE To test methods of predicting fracture risk among women who have discontinued alendronate therapy after 4 to 5 years. DESIGN, SETTING, AND PARTICIPANTS The prospective Fracture Intervention Trial Long-term Extension (FLEX) study randomized postmenopausal women aged 61 to 86 years previously treated with 4 to 5 years of alendronate therapy to 5 more years of alendronate or placebo from 1998 through 2003; the present analysis includes only the placebo group. Hip and spine dual-energy x-ray absorptiometry (DXA) were measured when placebo was begun (FLEX baseline) and after 1 to 3 years of follow-up. Two biochemical markers of bone turnover, urinary type 1 collagen cross-linked N-telopeptide (NTX) and serum bone-specific alkaline phosphatase (BAP), were measured at FLEX baseline and after 1 and 3 years. MAIN OUTCOMES AND MEASURES Symptomatic spine and nonspine fractures occurring after the follow-up measurement of DXA or bone turnover. RESULTS During 5 years of placebo, 94 of 437 women (22%) experienced 1 or more symptomatic fractures; 82 had fractures after 1 year. One-year changes in hip DXA, NTX, and BAP were not related to subsequent fracture risk, but older age and lower hip DXA at time of discontinuation were significantly related to increased fracture risk (lowest tertile of baseline femoral neck DXA vs other 2 tertiles relative hazard ratio, 2.17 [95%CI, 1.38–3.41]; total hip DXA relative hazard ratio, 1.87 [95%CI, 1.20–2.92]). CONCLUSIONS AND RELEVANCE Among postmenopausal women who discontinue alendronate therapy after 4 to 5 years, age and hip BMD at discontinuation predict clinical fractures during the subsequent 5 years. Follow-up measurements of DXA 1 year after discontinuation and of BAP or NTX 1 to 2 years after discontinuation are not associated with

  2. Situational analysis and future directions of AYUSH: An assessment through 5-year plans of India.

    PubMed

    Samal, Janmejaya

    2015-01-01

    AYUSH is an acronym for Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy. These are the six indigenous systems of medicine practiced in India. A department called Department of Indian System of medicine was created in March 1995 and renamed to AYUSH in November 2003 with a focus to provide increased attention for the development of these systems. Very recently, in 2014, a separate ministry was created under the union Government of India, which is headed by a minister of state. Planning regarding these systems of medicine was a part of 5-year planning process since 1951. Since then many developments have happened in this sector albeit the system was struggling with a great degree of uncertainty at the time of 1(st)5-year plan. A progressive path of development could be observed since the first to the 12(th)5-year plan. It was up to the 7(th)plan the growth was little sluggish and from 8(th)plan onward the growth took its pace and several innovative development processes could be observed thereafter. The system is gradually progressing ahead with a vision to be a globally accepted system, as envisaged in 11(th)5-year plan. Currently, AYUSH system is a part of mainstream health system implemented under National Rural Health Mission (NRHM). NRHM came into play in 2005 but implemented at ground level in 2006 and introduced the scheme of "Mainstreaming of AYUSH and revitalization of local health traditions" to strengthen public health services. This scheme is currently in operation in its second phase, since 1(st)April 2012, with the 12(th)5-year plan. The scheme was primarily brought in to operation with three important objectives; choice of treatment system to the patients, strengthen facility functionally and strengthen the implementation of national health programmes, however, in some places it seems to be a forced medical pluralism owing to a top-down approach by the union government without considerable involvement of the concerned community. In this

  3. 24 CFR 903.19 - When is the 5-Year Plan or Annual Plan ready for submission to HUD?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 4 2014-04-01 2014-04-01 false When is the 5-Year Plan or Annual Plan ready for submission to HUD? 903.19 Section 903.19 Housing and Urban Development REGULATIONS... is the 5-Year Plan or Annual Plan ready for submission to HUD? A PHA may adopt its 5-Year Plan or...

  4. 24 CFR 903.19 - When is the 5-Year Plan or Annual Plan ready for submission to HUD?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false When is the 5-Year Plan or Annual Plan ready for submission to HUD? 903.19 Section 903.19 Housing and Urban Development Regulations... is the 5-Year Plan or Annual Plan ready for submission to HUD? A PHA may adopt its 5-Year Plan or...

  5. 24 CFR 903.19 - When is the 5-Year Plan or Annual Plan ready for submission to HUD?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 4 2012-04-01 2012-04-01 false When is the 5-Year Plan or Annual Plan ready for submission to HUD? 903.19 Section 903.19 Housing and Urban Development REGULATIONS... is the 5-Year Plan or Annual Plan ready for submission to HUD? A PHA may adopt its 5-Year Plan or...

  6. 24 CFR 903.19 - When is the 5-Year Plan or Annual Plan ready for submission to HUD?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false When is the 5-Year Plan or Annual Plan ready for submission to HUD? 903.19 Section 903.19 Housing and Urban Development REGULATIONS... is the 5-Year Plan or Annual Plan ready for submission to HUD? A PHA may adopt its 5-Year Plan or...

  7. 24 CFR 903.19 - When is the 5-Year Plan or Annual Plan ready for submission to HUD?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 4 2013-04-01 2013-04-01 false When is the 5-Year Plan or Annual Plan ready for submission to HUD? 903.19 Section 903.19 Housing and Urban Development REGULATIONS... is the 5-Year Plan or Annual Plan ready for submission to HUD? A PHA may adopt its 5-Year Plan or...

  8. Developmental potential in the first 5 years for children in developing countries.

    PubMed

    Grantham-McGregor, Sally; Cheung, Yin Bun; Cueto, Santiago; Glewwe, Paul; Richter, Linda; Strupp, Barbara

    2007-01-01

    Many children younger than 5 years in developing countries are exposed to multiple risks, including poverty, malnutrition, poor health, and unstimulating home environments, which detrimentally affect their cognitive, motor, and social-emotional development. There are few national statistics on the development of young children in developing countries. We therefore identified two factors with available worldwide data--the prevalence of early childhood stunting and the number of people living in absolute poverty--to use as indicators of poor development. We show that both indicators are closely associated with poor cognitive and educational performance in children and use them to estimate that over 200 million children under 5 years are not fulfilling their developmental potential. Most of these children live in south Asia and sub-Saharan Africa. These disadvantaged children are likely to do poorly in school and subsequently have low incomes, high fertility, and provide poor care for their children, thus contributing to the intergenerational transmission of poverty. PMID:17208643

  9. Clinical Case Report on Treatment of Generalized Aggressive Periodontitis: 5-Year Follow-up.

    PubMed

    Hu, Kai-Fang; Ho, Ya-Ping; Ho, Kun-Yen; Wu, Yi-Min; Wang, Wen-Chen; Chou, Yu-Hsiang

    2015-01-01

    Generalized aggressive periodontitis (GAgP) is a distinct type of periodontal disease associated with considerably more rapid periodontal tissue destruction than chronic periodontitis. This study presents the 5-year follow-up of a patient with GAgP. A 29-year-old man reported experiencing increasing gingival recession. He was treated using cause-related therapy, provisional splints, and flap surgery combined with allograft grafting and was followed up for 5 years. This case study shows that elimination of infectious microorganisms and meticulous long-term maintenance provide an effective treatment modality for aggressive periodontitis cases. This treatment modality can restore the masticatory function and provide the GAgP patient with improved quality of life. PMID:25909527

  10. GEOPHYSICS, ASTRONOMY, AND ASTROPHYSICS: Reconstructing Quintom from WMAP 5-year Observations: Generalized Ghost Condensate

    NASA Astrophysics Data System (ADS)

    Zhang, Jing-Fei; Gui, Yuan-Xing

    2010-08-01

    In the 5-year WMAP data analysis, a new parametrization form for dark energy equation-of-state was used, and it has been shown that the equation-of-state, w(z), crosses the cosmological-constant boundary w = -1. Based on this observation, in this paper, we investigate the reconstruction of quintom dark energy model. As a single-real-scalarfield model of dark energy, the generalized ghost condensate model provides us with a successful mechanism for realizing the quintom-like behavior. Therefore, we reconstruct this scalar-field quintom dark energy model from the WMAP 5-year observational results. As a comparison, we also discuss the quintom reconstruction based on other specific dark energy ansatzs, such as the CPL parametrization and the holographic dark energy scenarios.

  11. Synovial Sarcoma in the Foot of a 5-Year-Old ChildA Case Report.

    PubMed

    Lepow, Gary M; Grimmer, Daniel L; Lemar, Onya V; Bridges, Evan A

    2016-07-01

    The purpose of this case report is to present a rare finding of synovial sarcoma in a 5-year-old child. Most soft-tissue masses of the foot are too often presumed to be small and benign; therefore, compared with soft-tissue sarcomas, they are difficult to clinically differentiate and treat. A 5-year-old girl presented with a painful lesion that was diagnosed as synovial sarcoma after an excisional biopsy was performed. This was an unexpected finding of synovial sarcoma involving the tibialis posterior tendon of her right foot. The patient presented with an 8-month history of tenderness and an antalgic gait. We would like to encourage that all soft-tissue tumors of the foot be preoperatively evaluated with the aid of diagnostic imaging so that a well-planned biopsy assessment can be performed, with adequate margins excised. PMID:27489968

  12. Surveillance of lymphatic filariasis 5 years after stopping mass drug administration in Menoufiya Governorate, Egypt.

    PubMed

    Moustafa, M A; Thabet, H S; Saad, G A; El-Setouhy, M; Mehrez, M; Hamdy, D M

    2014-05-01

    The World Health Organization recommends that before lymphatic filariasis elimination in an area can be confirmed, an additional survey should be performed at least 5 years after stopping mass drug administration. The current study aimed to determine the status of lymphatic filariasis 5 years after cessation ofthe mass drug administration in 3 sentinel Egyptian villages in Menoufiya Governorate. The rapid immunochromatographic card test (ICT) and a new commercial antibody detection kit (CELISA®) were used. All 1321 primary-school children aged 6-7 years old were ICT negative but 27 children were antibody positive. All households surveyed in one village with the highest antibody prevalence were ICT negative, indicating an absence of lymphatic filariasis. The CELISA antibody kit needs more standardization and development to be useful under field conditions. We conclude that lymphatic filariasis is no longer a public health problem in these villages and other villages with similar epidemiological conditions. PMID:24952286

  13. Regulation of emotion and behavior among 3- and 5-year-olds.

    PubMed

    Kalpidou, Maria D; Power, Thomas G; Cherry, Katie E; Gottfried, Nathan W

    2004-04-01

    In this cross-sectional study, the authors examined the relationship between emotion and behavior regulation in 3- and 5-year olds. Eighty-seven children performed a compliance sorting task. The authors manipulated the demand for emotion regulation by presenting and then hiding toys (low) or making toys visible (high). Mothers and teachers rated children's coping responses. Five-year-olds sorted less in the high condition than in the low condition, and 3-year-olds spent equal time sorting in both conditions. Compliance was positively correlated with problem-focused coping and negatively correlated with emotion-focused coping. Correlations between emotion and behavior regulation were stronger for the 5-year-olds. Age groups were differently affected by the higher demands of emotion regulation, indicating that the child's resources for regulation interact with the task demands to determine behavioral outcome. PMID:15088868

  14. OLFACTION AND THE 5-YEAR INCIDENCE OF COGNITIVE IMPAIRMENT IN AN EPIDEMIOLOGIC STUDY OF OLDER ADULTS

    PubMed Central

    Schubert, Carla R.; Carmichael, Lakeesha L.; Murphy, Claire; Klein, Barbara E.K.; Klein, Ronald; Cruickshanks, Karen J.

    2008-01-01

    Objectives To determine if odor identification ability is associated with the 5-year incidence of cognitive impairment in a large population of older adults with normal cognition at baseline and if olfactory impairment contributes to the prediction of cognitive decline in a population. Design Population-based longitudinal study. Setting Beaver Dam, WI. Participants 1920 participants in the Epidemiology of Hearing Loss Study (mean age = 66.9 years). Measurements Olfaction was measured by the San Diego Odor Identification Test (SDOIT). Incident cognitive impairment was defined as a Mini-Mental State Exam Score (MMSE) < 24 or reported diagnosis of dementia or Alzheimer’s disease (AD) at the follow-up among people with MMSE ≥ 24 and no diagnosis of dementia or AD at baseline. Results There was a significant association between olfactory impairment at baseline and the 5-year incidence of cognitive impairment (Odds Ratio (O.R.) = 6.62, 95% Confidence Interval (C.I.) = 4.36, 10.05). The association remained significant after adjusting for possible confounders (O.R. = 3.72, 95% C.I. = 2.31, 5.99). The Positive Predictive Value of the SDOIT was 15.9%, the Negative Predictive Value was 97.2% and the sensitivity and specificity were 55.1% and 84.4%, respectively, for the 5-year incidence of cognitive impairment. Conclusion Olfactory impairment at baseline was strongly associated with the 5-year incidence of cognitive impairment as measured by the MMSE. Odor identification testing may be useful in high risk settings, but not in the general population, to identify patients at risk for cognitive decline. PMID:18662205

  15. Mercury toxicity presenting as acrodynia and a papulovesicular eruption in a 5-year-old girl.

    PubMed

    Lai, Olivia; Parsi, Kory K; Wu, Davina; Konia, Thomas H; Younts, Alexandra; Sinha, Natasha; McNelis, Amy; Sharon, Victoria R

    2016-01-01

    Acrodynia is a reaction that occurs in children who have been exposed to mercury. Mercury toxicity has systemic manifestations as well as cutaneous manifestations, which can appear similar to those found in a number of other diseases. We present a case of acrodynia caused by mercury exposure in a previously healthy 5-year-old girl who developed hypertension, palmoplantar pruritus, and a papulovesicular eruption. PMID:27136627

  16. Equatorial Annual Oscillation with QBO-driven 5-year Modulation in NCEP Data

    NASA Technical Reports Server (NTRS)

    Mayr, H. G.; Mengel, J. G.; Huang, F. T.; Nash, E. R.

    2007-01-01

    An analysis is presented of the zonal wind and temperature variations supplied by the National Center for Environmental Prediction (NCEP), which have been assimilated in the Reanalysis and the Climate Prediction Center (CCP) data sets. The derived zonal-mean variations are employed. Stimulated by modeling studies, the data are separated into the hemispherically symmetric and anti-symmetric components, and spectral analysis is applied to study the annual 12-month oscillation and Quasi-biennial Oscillation (QBO). For data samples that cover as much as 40 years, the results reveal a pronounced 5-year modulation of the symmetric AO in the lower stratosphere, which is confined to equatorial latitudes. This modulation is also inferred for the temperature variations but extends to high latitudes, qualitatively consistent with published model results. A comparison between different data samples indicates that the signature of the 5-year oscillation is larger when the QBO of 30 months is more pronounced. Thus there is circumstantial evidence that this periodicity of the QBO is involved in generating the oscillation. The spectral analysis shows that there is a weak anti-symmetric 5-year oscillation in the zonal winds, which could interact with the large antisymmetric A0 to produce the modulation of the symmetric AO as was shown in earlier modeling studies. According to these studies, the 30-month QBO tends to be synchronized by the equatorial Semi-annual Oscillation (SAO), and this would explain why the inferred 5-year modulation is observed to persist and is phase locked over several cycles.

  17. Intraindividual variation in plasma 25-hydroxyvitamin D measures 5 years apart among postmenopausal women

    PubMed Central

    Meng, Jennifer E.; Hovey, Kathleen M.; Wactawski-Wende, Jean; Andrews, Christopher A; LaMonte, Michael J.; Horst, Ronald L.; Genco, Robert J.; Millen, Amy E.

    2012-01-01

    Background Current literature examining associations between vitamin D and chronic disease generally use a single assessment of 25-hydroxyvitamin D (25(OH)D), assuming an individual’s 25(OH)D concentration is consistent over time. Methods We investigated the intraindividual variability between two measures of plasma 25(OH)D concentrations collected ~5 years apart (1997-2000 to 2002-2005) in 672 postmenopausal women participating in the Women’s Health Initiative. Plasma 25(OH)D was assessed using the DiaSorin LIAISON® chemiluminescence immunoassay. The within-pair coefficient of variation (CV) was 4.9% using blinded quality control samples. Mean and standard deviations (SD) of 25(OH)D at the two time points were compared using a paired t-test. An intraindividual CV and intra-class correlation coefficient (ICC) were used to assess intraindividual variability. A Spearman correlation coefficient (r) assessed the strength of the association between the two measures and concordance in vitamin D status at two time points Results Mean 25(OH)D concentrations (nmol/L) significantly increased over time from 60.0 (SD=22.2) to 67.8 (SD=22.2) (p<0.05). The CV was 24.6%, the ICC (95% Confidence Interval (CI)) was 0.59 (0.54-0.64), and the Spearman r was 0.61 (95% CI=0.56-0.66). Greater concordance over 5 years was observed in participants with sufficient compared to deficient or inadequate baseline 25(OH)D concentrations (weighted kappa=0.39). Reliability measures were moderately influenced by season of blood draw and vitamin D supplement use. Conclusion There is moderate intraindividual variation in 25(OH)D concentrations over approximately 5 years. Impact These data support the use of a one-time measure of blood 25(OH)D in prospective studies with ≤ 5 years of follow-up. PMID:22523182

  18. A 5-year Journey with Cutis Laxa in an Indian Child: The De Barsy Syndrome Revisited

    PubMed Central

    Dutta, Abhijit; Ghosh, Sudip Kumar; Ghosh, Arghyaprasun; Roy, Sutirtha

    2016-01-01

    De Barsy syndrome (DBS), synonymously known as autosomal recessive cutis laxa type III, is an extremely rare condition clinically characterized by cutis laxa, a progeroid appearance, and ophthalmologic abnormalities. We present here an account of 5-year follow-up since the birth of an Indian boy with DBS, who had a few rare and unusual manifestations. In addition, our case probably represents the first reported case of DBS from India. PMID:26955101

  19. The prevalence of dental erosion in 5-year-old preschoolers in Sharjah, United Arab Emirates

    PubMed Central

    Gopinath, Vellore Kannan

    2016-01-01

    Objective: The aim of this study was to determine the percentage of 5-year-old preschoolers in Sharjah, affected by dental erosion and to assess the predictors. Materials and Methods: A total of 403 5-year-old children were examined of which 48.14% (n = 194) were boys and 51.86% (n = 209) were girls; 31.27% (n = 126) were Emirati and 68.73% (n = 277) were non-Emirati Arabs. Examination of dental erosion was confined to palatal surfaces of maxillary incisors using the erosion index described in the UK National Survey of Children's Dental Health, 1993. Dental caries was charted using the World Health Organization 1997 criteria. Results: In the sample of 403 5-year-old preschoolers examined, dental erosion was apparent in 237 (58.80%) children, with 55.09% showing the dissolution of enamel and 3.72% exhibiting exposed dentin. Predictors of dental erosion as determined by logistic regression concluded that compared to Emirati citizens other Arab nationalities have 0.27 times the odds (95% confidence interval [CI] =0.18–0.42) of having tooth erosion (P < 0.05). Children with caries experience have 0.28 times the odds (95% CI = 0.16–0.51) of having tooth erosion compared to children with no caries experience (P < 0.05). Children who drink sugary or carbonated beverages have 0.30 times the odds (95% CI = 0.19–0.41) of having dental erosion compared to children who drink water (P < 0.05). Conclusions: The findings of this study indicate that 58.80% of 5-year-old preschoolers in Sharjah, United Arab Emirates, were affected by dental erosion. Caries experience and consumption of acidic drinks were associated with dental erosion. PMID:27095899

  20. Bifocal Spinal Cord Injury without Radiographic Abnormalities in a 5-Year Old Boy: A Case Report.

    PubMed

    Snoek, K G; Jacobsohn, M; van As, A B

    2012-01-01

    We present the extremely unusual case of a 5-year-old boy with a bifocal (cervical as well as lumbar) spinal cord injury without radiographic abnormalities (SCIWORAs). The MRI showed cord oedema at the level of C2 and T10. We propose that during the motor vehicle crash severe propulsion of the head with a flexed lumbar region resulted in a traction injury to the lower thoracic and lumbar spine and maximum flexion caused SCIWORA in C2. PMID:22649746

  1. Development and verification of child observation sheet for 5-year-old children.

    PubMed

    Fujimoto, Keiko; Nagai, Toshisaburo; Okazaki, Shin; Kawajiri, Mie; Tomiwa, Kiyotaka

    2014-02-01

    The aim of the study was to develop a newly devised child observation sheet (COS-5) as a scoring sheet, based on the Childhood Autism Rating Scale (CARS), for use in the developmental evaluation of 5-year-old children, especially focusing on children with autistic features, and to verify its validity. Seventy-six children were studied. The children were recruited among participants of the Japan Children's Cohort Study, a research program implemented by the Research Institute of Science and Technology for Society (RISTEX) from 2004 to 2009. The developmental evaluation procedure was performed by doctors, clinical psychologists, and public health nurses. The COS-5 was also partly based on the Kyoto Scale of Psychological Development 2001 (Kyoto Scale 2001). Further, the Developmental Disorders Screening Questionnaire for 5-Years-Olds, PDD-Autism Society Japan Rating Scale (PARS), doctor interview questions and neurological examination for 5-year-old children, and the Draw-a-Man Test (DAM) were used as evaluation scales. Eighteen (25.4%) children were rated as Suspected, including Suspected PDD, Suspected ADHD and Suspected MR. The COS-5 was suggested to be valid with favorable reliability (α=0.89) and correlation with other evaluation scales. The COS-5 may be useful, with the following advantages: it can be performed within a shorter time frame; it facilitates the maintenance of observation quality; it facilitates sharing information with other professions; and it is reliable to identify the autistic features of 5-year-old children. In order to verify its wider applications including the screening of infants (18months to 3years old) by adjusting the items of younger age, additional study is needed. PMID:23415454

  2. SIRT6 Minor Allele Genotype Is Associated with >5-Year Decrease in Lifespan in an Aged Cohort

    PubMed Central

    TenNapel, Mindi J.; Lynch, Charles F.; Burns, Trudy L.; Wallace, Robert; Smith, Brian J.; Button, Anna; Domann, Frederick E.

    2014-01-01

    Aging is a natural process involving complex interplay between environment, metabolism, and genes. Sirtuin genes and their downstream targets have been associated with lifespan in numerous organisms from nematodes to humans. Several target proteins of the sirtuin genes are key sensors and/or effectors of oxidative stress pathways including FOXO3, SOD3, and AKT1. To examine the relationship between single nucleotide polymorphisms (SNP) at candidate genes in these pathways and human lifespan, we performed a molecular epidemiologic study of an elderly cohort (≥65 years old.). Using age at death as a continuous outcome variable and assuming a co-dominant genetic model within the framework of multi-variable linear regression analysis, the genotype-specific adjusted mean age at death was estimated for individual SNP genotypes while controlling for age-related risk factors including smoking, body mass index, alcohol consumption and co-morbidity. Significant associations were detected between human lifespan and SNPs in genes SIRT3, SIRT5, SIRT6, FOXO3 and SOD3. Individuals with either the CC or CT genotype at rs107251 within SIRT6 displayed >5-year mean survival advantages compared to the TT genotype (5.5 and 5.9 years, respectively; q-value  = 0.012). Other SNPs revealed genotype-specific mean survival advantages ranging from 0.5 to 1.6 years. Gender also modified the effect of SNPs in SIRT3, SIRT5 and AKT1 on lifespan. Our novel findings highlight the impact of sirtuins and sirtuin-related genotypes on lifespan, the importance of evaluating gender and the advantage of using age as a continuous variable in analyses to report mean age at death. PMID:25541994

  3. Study on Rotavirus Infection and Its Genotyping in Children Below 5 Years in South West Iran

    PubMed Central

    Azaran, Azarakhsh; Makvandi, Manoochehr; Samarbafzadeh, Alireza; Neisi, Niloofar; Hoseinzadeh, Mohsen; Rasti, Mojtaba; Teymurirad, Majid; Teimoori, Ali; Varnaseri, Mehran; Makvandi, Kamyar

    2016-01-01

    Background Human rotaviruses are the most important agents for severe dehydrating diarrhea in children below 5 years old. Rotaviruses (RV) is a serious public health problem in developing and developed countries. Objectives The aim of this study was to determine the prevalence of rotavirus infection and their genotypes in children younger than 5 years of age with acute diarrhea in Ahvaz, Iran. Materials and Methods For this study, 200 stool samples from children below 5 years of age with acute diarrhea were collected between October 2011 and March 2012. Initially all stool samples were tested for rotavirus antigen by ELISA, and positive samples were confirmed by RT-PCR targeting the VP6 rotavirus gene. Determination of rotavirus genotypes was carried out by performing RT-PCR for G and P types. Altogether, 15 samples were sequenced. Results Out of 200 stool samples, 100 (50%) had rotavirus antigen detected by ELISA and 73 (36.5%) were found positive by RT-PCR. Of the rotavirus strains identified, only 63 (86.3%) were positive for both VP7 and VP4 while 10 (13.7%) strains were found nontypeable. Rotavirus infection accounts for 36.5% of gastroenteritis cases in samples from symptomatic children. The most prevalent rotavirus genotypes were G1P [8] (80%) followed by G2P [4] (20%). Conclusions Our results suggest that group A rotavirus is a major pathogene of acute diarrhea in Ahvaz city. The genotypes circulating are similar with those of other countries. PMID:27307959

  4. Cryobanking of human ovarian tissue: Do women still want their tissue stored beyond 5 years?

    PubMed

    Macklon, Kirsten Tryde; Ernst, Erik; Andersen, Anders Nyboe; Andersen, Claus Yding

    2014-10-01

    Cryopreservation of ovarian tissue is one way of preserving fertility in young women with a malignant disease or other disorders that require gonadotoxic treatment. The purpose of the study was to explore how many women remained interested in continued cryostorage of their ovarian tissue beyond an initial 5-year period. Between 1999 and 2006, a total of 201 girls and young women had one ovary cryopreserved for fertility preservation in Denmark. One hundred of these met our inclusion criteria, which included a follow-up period of at least 5 years, and were mailed a questionnaire. The response rate was 95%. Sixteen of the patients (17%) stated that they wanted disposal of their tissue; the main reason was completion of family (63%). The mean age of those requesting disposal was 36.6 years, whereas those still wanting their tissue stored were significantly younger, with a mean age of 33.0 years (P < 0.008). In conclusion, most women with ovarian tissue cryobanked requested continued cryostorage after an initial period of at least 5 years. The main reason for requesting disposal was successful completion of a family. PMID:25129692

  5. The Treatment of Parasomnias with Hypnosis: a 5-Year Follow-Up Study

    PubMed Central

    Hauri, Peter J.; Silber, Michael H.; Boeve, Bradley F.

    2007-01-01

    Study Objectives: This study involves a replication and extension of a previous one reported by Hurwitz et al (1991) on the treatment of certain parasomnias with hypnosis. Methods: Thirty-six patients (17 females), mean age 32.7 years (range 6–71). Four were children aged 6 to 16. All had chronic, “functionally autonomous” (self-sustaining) parasomnias. All underwent 1 or 2 hypnotherapy sessions and were then followed by questionnaire for 5 years. Results: Of the 36 patients, 45.4% were symptom-free or at least much improved at the 1-month follow-up, 42.2% at the 18-month follow-up, and 40.5% at the 5-year follow-up. Conclusions: One or 2 sessions of hypnotherapy might be an efficient first-line therapy for patients with certain types of parasomnias. Citation: Hauri PJ; Silber MH; Boeve BF. The treatment of parasomnias with hypnosis: a 5-year follow-up study. J Clin Sleep Med 2007;3(4):369-373. PMID:17694725

  6. Endocrine dysfunction following traumatic brain injury: a 5-year follow-up nationwide-based study

    PubMed Central

    Yang, Wei-Hsun; Chen, Pau-Chung; Wang, Ting-Chung; Kuo, Ting-Yu; Cheng, Chun-Yu; Yang, Yao-Hsu

    2016-01-01

    Post-traumatic endocrine dysfunction is a complication of traumatic brain injury (TBI). However, there is lack of long-term follow-up and large sample size studies. This study included patients suffering from TBI registered in the Health Insurance Database. Endocrine disorders were identified using the ICD codes: 244 (acquired hypothyroidism), 253 (pituitary dysfunction), 255 (disorders of the adrenal glands), 258 (polyglandular dysfunction), and 259 (other endocrine disorders) with at least three outpatient visits within 1 year or one admission diagnosis. Overall, 156,945 insured subjects were included in the final analysis. The 1- and 5-year incidence rates of post-traumatic endocrinopathies were 0.4% and 2%, respectively. The risks of developing a common endocrinopathy (p < 0.001) or pituitary dysfunction (P < 0.001) were significantly higher in patients with a TBI history. Patients with a skull bone fracture had a higher risk of developing pituitary dysfunction at the 1-year follow up (p value < 0.001). At the 5-year follow up, the association between intracranial hemorrhage and pituitary dysfunction (p value: 0.002) was significant. The risk of developing endocrine dysfunction after TBI increased during the entire 5-year follow-up period. Skull bone fracture and intracranial hemorrhage may be associated with short and long-term post-traumatic pituitary dysfunction, respectively. PMID:27608606

  7. Prevalence and Factors Associated with Anemia Among Children Under 5 Years of Age--Uganda, 2009.

    PubMed

    Menon, Manoj P; Yoon, Steven S

    2015-09-01

    Anemia in children under 5 years of age, defined by the World Health Organization as a hemoglobin concentration < 11 g/dL, is a global public health problem. According to the 2006 Demographic Health Survey, the prevalence of anemia among children under five in Uganda was 72% in 2006. The 2009 Uganda Malaria Indicator Survey was conducted in late 2009 and revealed that over 60% of children less than 5 years of age were anemic and that over half of children tested positive for malaria via a rapid diagnostic test. Children with concomitant malaria infection, and in households without any type of mosquito net were more likely to be anemic, confirming that children under 5 years, are vulnerable to both the threat of malaria and anemia and the beneficial effect of malaria prevention tools. However, prevention and treatment of other factors associated with the etiology of anemia (e.g., iron deficiency) are likely necessary to combat the toll of anemia in Uganda. PMID:26055748

  8. Outcomes 5 years after response to rituximab therapy in children and adults with immune thrombocytopenia

    PubMed Central

    Mahévas, Matthieu; Lee, Soo Y.; Stasi, Roberto; Cunningham-Rundles, Susanna; Godeau, Bertrand; Kanter, Julie; Neufeld, Ellis; Taube, Tillmann; Ramenghi, Ugo; Shenoy, Shalini; Ward, Mary J.; Mihatov, Nino; Patel, Vinay L.; Bierling, Philippe; Lesser, Martin; Cooper, Nichola; Bussel, James B.

    2012-01-01

    Treatments for immune thrombocytopenic purpura (ITP) providing durable platelet responses without continued dosing are limited. Whereas complete responses (CRs) to B-cell depletion in ITP usually last for 1 year in adults, partial responses (PRs) are less durable. Comparable data do not exist for children and 5-year outcomes are unavailable. Patients with ITP treated with rituximab who achieved CRs and PRs (platelets > 150 × 109/L or 50-150 × 109/L, respectively) were selected to be assessed for duration of their response; 72 adults whose response lasted at least 1 year and 66 children with response of any duration were included. Patients had baseline platelet counts < 30 × 109/L; 95% had ITP of > 6 months in duration. Adults and children each had initial overall response rates of 57% and similar 5-year estimates of persisting response (21% and 26%, respectively). Children did not relapse after 2 years from initial treatment whereas adults did. Initial CR and prolonged B-cell depletion predicted sustained responses whereas prior splenectomy, age, sex, and duration of ITP did not. No novel or substantial long-term clinical toxicity was observed. In summary, 21% to 26% of adults and children with chronic ITP treated with standard-dose rituximab maintained a treatment-free response for at least 5 years without major toxicity. These results can inform clinical decision-making. PMID:22566601

  9. Endocrine dysfunction following traumatic brain injury: a 5-year follow-up nationwide-based study.

    PubMed

    Yang, Wei-Hsun; Chen, Pau-Chung; Wang, Ting-Chung; Kuo, Ting-Yu; Cheng, Chun-Yu; Yang, Yao-Hsu

    2016-01-01

    Post-traumatic endocrine dysfunction is a complication of traumatic brain injury (TBI). However, there is lack of long-term follow-up and large sample size studies. This study included patients suffering from TBI registered in the Health Insurance Database. Endocrine disorders were identified using the ICD codes: 244 (acquired hypothyroidism), 253 (pituitary dysfunction), 255 (disorders of the adrenal glands), 258 (polyglandular dysfunction), and 259 (other endocrine disorders) with at least three outpatient visits within 1 year or one admission diagnosis. Overall, 156,945 insured subjects were included in the final analysis. The 1- and 5-year incidence rates of post-traumatic endocrinopathies were 0.4% and 2%, respectively. The risks of developing a common endocrinopathy (p < 0.001) or pituitary dysfunction (P < 0.001) were significantly higher in patients with a TBI history. Patients with a skull bone fracture had a higher risk of developing pituitary dysfunction at the 1-year follow up (p value < 0.001). At the 5-year follow up, the association between intracranial hemorrhage and pituitary dysfunction (p value: 0.002) was significant. The risk of developing endocrine dysfunction after TBI increased during the entire 5-year follow-up period. Skull bone fracture and intracranial hemorrhage may be associated with short and long-term post-traumatic pituitary dysfunction, respectively. PMID:27608606

  10. Prediction of glucuronidated drug clearance in pediatrics (≤5 years): An allometric approach.

    PubMed

    Mahmood, Iftekhar

    2015-03-01

    Children are not small adults. The differences between children of different age groups and adults are not merely due to body weight, but also due to physiological and biochemical differences resulting in different rates of drug metabolism or renal clearance. Glucuronidation is an important pathway of drug metabolism. Therefore, the objective of this study is to evaluate the predictive performance of several allometric exponents in children of ≤5 years for the total clearance of drugs which are mainly metabolized by glucuronidation. Four exponents (0.75, 1.0, 1.2, or 1.4) on the body weights and an allometric model developed from adults were evaluated. The four exponents and the allometric model were examined to determine the suitability of the method(s) to predict the clearances of drugs which are glucuronidated in children ≤5 years of age. Based on the analysis of ten drugs, it was noted that the combination of two allometric exponents 1.2 (for children ≤3 months) and 1.0 (for children ≥3 months ≤5 years) can be used to predict mean clearances of drugs which are mainly metabolized by glucuronidation. The suggested approach may be used to estimate a first-in-pediatric dose to initiate a pediatric clinical trial. PMID:24519316

  11. Declining Use of Radiotherapy in Stage I and II Hodgkin's Disease and Its Effect on Survival and Secondary Malignancies

    SciTech Connect

    Koshy, Matthew; Rich, Shayna E.; Mahmood, Usama; Kwok, Young

    2012-02-01

    Purpose: Concerns regarding long-term toxicities have led some to withhold radiotherapy (RT) for the treatment of Stage I and II Hodgkin's disease (HD). The present study was undertaken to assess the use of RT for HD and its effect on overall survival and the development of secondary malignancies. Methods and Materials: The present study included data from the Surveillance, Epidemiology, and End Results database from patients aged {>=}20 years who had been diagnosed with Stage I or II HD between 1988 and 2006. Overall survival was estimated using the Kaplan-Meier method, and the Cox multivariate regression model was used to analyze trends. Results: A total of 12,247 patients were selected, and 51.5% had received RT. The median follow-up for the present cohort was 4.9 years, with 21% of the cohort having >10 years of follow-up. Between 1988 and 1991, 62.9% had undergone RT, but between 2004 and 2006, only 43.7% had undergone RT (p < .001). The 5-year overall survival rate was 76% for patients who had not received RT and 87% for those who had (p < .001). The hazard ratio adjusted for other variables in the regression model showed that patients who had not undergone RT (hazard ratio, 1.72; 95% confidence interval, 1.72-2.02) was associated with significantly worse survival compared with patients who had received RT. The actuarial rate of developing a second malignancy was 14.6% vs. 15.0% at 15 years for those who had and had not undergone RT, respectively (p = .089). Conclusions: The present study is one of the largest studies to examine the role of RT for Stage I and II HD. Our results revealed a survival benefit with the addition of RT with no increase in the development of secondary malignancies compared with patients who had not received RT. Furthermore, the present nationwide study revealed a >20% absolute decrease in the use of RT from 1988 to 2006.

  12. Ten Years of Tamoxifen Reduces Breast Cancer Recurrences, Improves Survival

    MedlinePlus

    ... Cancer Screening Research Ten Years of Tamoxifen Reduces Breast Cancer Recurrences, Improves Survival For some women with breast ... took it for 5 years. (See the table.) Breast Cancer Recurrence and Death 5 to 14 Years after ...

  13. Human cadaver multipotent stromal/stem cells isolated from arteries stored in liquid nitrogen for 5 years

    PubMed Central

    2014-01-01

    Introduction Regenerative medicine challenges researchers to find noncontroversial, safe and abundant stem cell sources. In this context, harvesting from asystolic donors could represent an innovative and unlimited reservoir of different stem cells. In this study, cadaveric vascular tissues were established as an alternative source of human cadaver mesenchymal stromal/stem cells (hC-MSCs). We reported the successful cell isolation from postmortem arterial segments stored in a tissue-banking facility for at least 5 years. Methods After thawing, hC-MSCs were isolated with a high efficiency (12 × 106) and characterized with flow cytometry, immunofluorescence, molecular and ultrastructural approaches. Results In early passages, hC-MSCs were clonogenic, highly proliferative and expressed mesenchymal (CD44, CD73, CD90, CD105, HLA-G), stemness (Stro-1, Oct-4, Notch-1), pericyte (CD146, PDGFR-β, NG2) and neuronal (Nestin) markers; hematopoietic and vascular markers were negative. These cells had colony and spheroid-forming abilities, multipotency for their potential to differentiate in multiple mesengenic lineages and immunosuppressive activity to counteract proliferation of phytohemagglutinin-stimulated blood mononuclear cells. Conclusions The efficient procurement of stem cells from cadaveric sources, as postmortem vascular tissues, demonstrates that such cells can survive to prolonged ischemic insult, anoxia, freezing and dehydration injuries, thus paving the way for a scientific revolution where cadaver stromal/stem cells could effectively treat patients demanding cell therapies. PMID:24429026

  14. Health transitions in sub-Saharan Africa: overview of mortality trends in children under 5 years old (1950-2000).

    PubMed Central

    Garenne, Michel; Gakusi, Enéas

    2006-01-01

    OBJECTIVE: To reconstruct and analyse mortality trends in children younger than 5 years in sub-Saharan Africa between 1950 and 2000. METHODS: We selected 66 Demographic and Health Surveys and World Fertility Surveys from 32 African countries for analysis. Death rates were calculated by yearly periods for each survey. When several surveys were available for the same country, overlapping years were combined. Country-specific time series were analysed to identify periods of monotonic trends, whether declining, steady or increasing. We tested changes in trends using a linear logistic model. FINDINGS: A quarter of the countries studied had monotonic declining mortality trends: i.e. a smooth health transition. Another quarter had long-term declines with some minor rises over short periods of time. Eight countries had periods of major increases in mortality due to political or economic crises, and in seven countries mortality stopped declining for several years. In eight other countries mortality has risen in recent years as a result of paediatric AIDS. Reconstructed levels and trends were compared with other estimates made by international organizations, usually based on indirect methods. CONCLUSION: Overall, major progress in child survival was achieved in sub-Saharan Africa during the second half of the twentieth century. However, transition has occurred more slowly than expected, with an average decline of 1.8% per year. Additionally, transition was chaotic in many countries. The main causes of mortality increase were political instability, serious economic downturns, and emerging diseases. PMID:16799731

  15. Exemestane Following Tamoxifen Reduces Breast Cancer Recurrences and Prolongs Survival

    Cancer.gov

    Postmenopausal women with early-stage hormone receptor-positive breast cancer had delayed disease recurrence and longer survival after taking 2-3 years of tamoxifen followed by exemestane for a total of 5 years compared to taking tamoxifen for 5 years.

  16. Survivorship after Arthroscopic Management of Glenohumeral Osteoarthritis with a Minimum 5 year Follow-up

    PubMed Central

    Mitchell, Justin; Horan, Marilee P.; Greenspoon, Joshua A.; Menge, Travis; Tahal, Dimitri S.; Millett, Peter J.

    2016-01-01

    Objectives: We previously reported clinical improvement and pain relief following arthroscopic management of glenohumeral osteoarthritis (GHOA) at 2 years. The purpose of this study was to determine 5 year survivorship for the comprehensive arthroscopic management (CAM) procedure for the treatment of GHOA. Methods: This study had prior IRB approval. The CAM procedure was performed on a consecutive series of 42 young patients (44 shoulders) with GHOA who otherwise met criteria for shoulder arthroplasty but instead opted for joint preservation. The procedure included glenohumeral chondroplasty, capsular release, and synovectomy, humeral osteoplasty, axillary nerve neurolysis, subacromial decompression, loose body removal, microfracture and biceps tenodesis. Only patients who were a minimum of 5 years out from surgery were included in the study. Patients completed a subjective questionnaire, and further surgical intervention of the index shoulder was noted for survivorship analysis. Failure was defined as progression to TSA. Kaplan Meier survivorship analysis was performed. Results: Forty-two patients (with 44 shoulders) underwent a CAM procedure between 1/2006-12/2009 and were included. All patients were self-described recreational athletes. Seven patients were former collegiate or professional athletes. Mean follow-up was 5.9 years (range, 5 years to 8.1 years). Mean age at surgery was 52 (range 27- 68) years old in 13 women and 29 men. Eleven shoulders (26%) failed and progressed to TSA at a mean of 2.9 years (1.0-5.4 years). Shoulder status (progression to TSA or not) at minimum 5 years (range 5.3 - 9.4 years) was known for 95% (42/44). One patient progressed to another surgery for stiffness at a mean of 5.6 months and another patient underwent a revision CAM procedure at 7.9 years. From this cohort, Kaplan Meier survivorship was 92% at 1 year, 85.7% at 3 years, and 75.3% survivorship at 5 years. Conclusion: The long term durability of arthroscopic management for

  17. Clinical Study of Nasopharyngeal Carcinoma Treated by Helical Tomotherapy in China: 5-Year Outcomes

    PubMed Central

    Du, Lei; Zhang, Xin-Xin; Ma, Lin; Feng, Lin-Chun; Li, Fang; Zhou, Gui-Xia; Qu, Bao-Lin; Xu, Shou-Ping; Xie, Chuan-Bin; Yang, Jack

    2014-01-01

    Background. To evaluate the outcomes of nasopharyngeal carcinoma (NPC) patients treated with helical tomotherapy (HT). Methods. Between September 2007 and August 2012, 190 newly diagnosed NPC patients were treated with HT. Thirty-one patients were treated with radiation therapy as single modality, 129 with additional cisplatin-based chemotherapy with or without anti-EGFR monoclonal antibody therapy, and 30 with concurrent anti-EGFR monoclonal antibody therapy. Results. Acute radiation related side effects were mainly grade 1 or 2. Grade 3 and greater toxicities were rarely noted. The median followup was 32 (3–38) months. The local relapse-free survival (LRFS), nodal relapse-free survival (NRFS), distant metastasis-free survival (DMFS), and overall survival (OS) were 96.1%, 98.2%, 92.0%, and 86.3%, respectively, at 3 years. Cox multivariate regression analysis showed that age and T stage were independent predictors for 3-year OS. Conclusions. Helical tomotherapy for NPC patients achieved excellent 3-year locoregional control, distant metastasis-free survival, and overall survival, with relatively minor acute and late toxicities. Age and T stage were the main prognosis factors. PMID:25114932

  18. 5-Year Longitudinal Follow-up after Retropubic and Transobturator Midurethral Slings

    PubMed Central

    Kenton, Kimberly; Stoddard, Anne M.; Zyczynski, Halina; Albo, Michael; Rickey, Leslie; Norton, Peggy; Wai, Clifford; Kraus, Stephen R.; Sirls, Larry T.; Kusek, John W.; Litman, Heather J.; Chang, Robert P.; Richter, Holly E.

    2014-01-01

    Background Few studies have characterized longer-term outcomes after retropubic and transobturator midurethral slings. Methods Women completing 2-year participation in a randomized equivalence trial who had not received surgical retreatment for stress urinary incontinence were invited to participate in a 5-year observational cohort. The primary outcome, treatment success, was defined as no retreatment or self-reported stress incontinence symptoms. Secondary outcomes included urinary symptoms and quality of life, satisfaction, sexual function and adverse events. Results 404 of 597 (68%) women from the original trial enrolled. Five-years after surgical treatment, success was 7.9% greater in women assigned to retropubic-sling compared to transobturator-sling (51.3% vs 43.4%, 95% CI −1.4%, 17.2%) not meeting pre-specified criteria for equivalence. Satisfaction decreased over 5-years, but remained high and similar between arms (79%, retropubic-sling vs 85%, transobturator-sling groups, p=0.15). Urinary symptoms and quality of life worsened over time (p<0.001), and women with retropubic-sling reported greater urinary urgency (P=0.001), more negative quality of life impact (p=0.02), and worse sexual function (P=0.001). There was no difference in proportion of women experiencing at least 1 adverse event (p=0.17). Seven new mesh erosions were noted (retropubic-sling-3, transobturator-sling-4). Conclusion Treatment success declined over 5-years for retropubic and transobturator-slings and did not meet pre-specified criteria for equivalence with retropubic demonstrating a slight benefit. However, satisfaction remained high in both arms. Women undergoing transobturator-sling reported more sustained improvement in urinary symptoms and sexual function. New mesh erosions occurred in both arms over time, although at a similarly low rate. PMID:25158274

  19. Traditional endodontic surgery versus modern technique: a 5-year controlled clinical trial.

    PubMed

    Tortorici, Silvia; Difalco, Paolo; Caradonna, Luigi; Tetè, Stefano

    2014-05-01

    In this study, we compared outcomes of traditional apicoectomy versus modern apicoectomy, by means of a controlled clinical trial with a 5-year follow-up. The study investigated 938 teeth in 843 patients. On the basis of the procedure performed, the teeth were grouped in 3 groups. Differences between the groups were the method of osteotomy (type of instruments used), type of preparation of retrograde cavity (different apicoectomy angles and instruments used for root-end preparation), and root-end filling material used (gray mineral trioxide aggregate or silver amalgam). Outcome (tooth healing) was estimated after 1 and 5 years, postoperatively. Clinical success rates after 1 year were 67% (306 teeth), 90% (186 teeth), and 94% (256 teeth) according to traditional apicoectomy (group 1), modern microsurgical apicoectomy using burns for osteotomy (group 2) or using piezo-osteotomy (group 3), respectively. After 1 year, group comparison results were statistically significant (P < 0.0001). Linear trend test was also statistically significant (P < 0.0001), pointing out larger healing from group 1 to group 3. After 5 years, teeth were classified into 2 groups on the basis of root-end filling material used. Clinical success was 90.8% (197 teeth) in the silver amalgam group versus 96% (309 teeth) in the mineral trioxide aggregate group (P < 0.00214). Multiple logistic regression analysis found that surgical technique was independently associated to tooth healing. In conclusion, modern apicoectomy resulted in a probability of success more than 5 times higher (odds ratio, 5.20 [95% confidence interval, 3.94-6.92]; P < 0.001) compared with the traditional technique. PMID:24469371

  20. Calcineurin activity in tacrolimus-treated renal transplant patients early after and 5 years after transplantation.

    PubMed

    Mortensen, D M; Koefoed-Nielsen, P B; Jørgensen, K A

    2006-10-01

    The pharmacodynamic (PD) action of tacrolimus (FK) within the T-cell is inhibition of calcineurin phosphatase (CaN). Determination of CaN activity provides us with an important PD marker. Eleven renal transplant patients treated with FK were investigated on day 14 following transplantation and 5 years later. Blood samples drawn before as well as 1, 2, 3, and 4 hours after oral intake of FK were analyzed for CaN activity and blood FK concentrations. Twenty healthy subjects had one blood sample drawn for CaN activity, which was measured as the release of (32)P from a phosphorylated peptide. Radioactivity of (32)P was quantitated by liquid scintillation counting with the results converted to units of CaN utilizing a calibration curve. On day 14, we observed significant inhibition of CaN activity at T:1, 2, and 3 compared with the predose level (P = .002; P = .015; P = .015). Furthermore, all measured CaN activities were significantly different from those observed in healthy nonmedicated subjects. In contrast, at 5 years posttransplant only the CaN activity at T:2 was significantly inhibited compared with the predose level (P = .02). Additionally, all CaN activities at this time were not significantly different from CaN activities in the healthy subjects. We were not able to demonstrate individual CaN activity profiles in the patients. The lack of CaN inhibition at 5 years after transplantation despite relevant drug concentrations, probably reflected the lower drug dose used long after transplantation. This result raises the question of whether CaN inhibition is necessary to hold graft function and whether FK possess CaN-independent mechanisms of action. PMID:17098028

  1. Clinical treatment of a ruptured temporomandibular joint disc: morphological changes at 5-year follow-up.

    PubMed

    Cardinal, Lucas; Porto, Felipe; Agarwal, Sachin; Grossman, Eduardo

    2014-01-01

    Osteoarthrosis is a disease that affects the temporomandibular joint (TMJ). This case report chronicles the diagnosis and treatment of a patient for whom this pathological condition was accompanied by a rupture of the articular disc. The patient presented with loud sounds in the left TMJ and an irregular mandibular occlusal plane due to condylar intrusion in the glenoid fossa on the ipsilateral side. A noninvasive treatment was selected. A 4-month follow-up revealed remission of the articular sounds, and tissue regeneration was noted. These improvements remained visible at 5-year follow-up. PMID:24598507

  2. Small bowel obstruction 5 years following the ingestion of serrated scissors

    PubMed Central

    Limb, Richard; Karam, Edward; Lingam, Krishna M.

    2016-01-01

    Ingested foreign bodies are common in the cohort of psychiatric patients, however clinical quiescence in this group is rare. We present a case of a 45-year-old female with emotionally unstable personality disorder (borderline type) presenting with partial intestinal obstruction 5 years after the known ingestion of serrated metallic scissors. In the asymptomatic interim a conservative approach of tracking the blades radiologically was taken. Following discussion, we conclude the following: early surgical intervention is encouraged if natural passage does not occur within 3 days following ingestion, and that any concurrent surgical needs should be addressed at this time. PMID:27190200

  3. Drifter-based estimate of the 5 year dispersal of Fukushima-derived radionuclides

    NASA Astrophysics Data System (ADS)

    Rypina, I. I.; Jayne, S. R.; Yoshida, S.; Macdonald, A. M.; Buesseler, K.

    2014-11-01

    Employing some 40 years of North Pacific drifter-track observations from the Global Drifter Program database, statistics defining the horizontal spread of radionuclides from Fukushima nuclear power plant into the Pacific Ocean are investigated over a time scale of 5 years. A novel two-iteration method is employed to make the best use of the available drifter data. Drifter-based predictions of the temporal progression of the leading edge of the radionuclide distribution are compared to observed radionuclide concentrations from research surveys occupied in 2012 and 2013. Good agreement between the drifter-based predictions and the observations is found.

  4. Maintenance pharmacotherapy for recurrent major depressive disorder: 5-year follow-up study.

    PubMed

    Holma, Irina A K; Holma, K Mikael; Melartin, Tarja K; Isometsä, Erkki T

    2008-08-01

    Practice guidelines endorse maintenance antidepressant treatment for recurrent major depressive disorder. In the Vantaa Depression Study, we followed 218 psychiatric patients with major depressive disorder for up to 5 years with a life-chart. Of these patients, 86 (39.4%) had more than three lifetime episodes and an indication for maintenance pharmacotherapy. However, of these, only 57% received treatment and only for 16% of the time indicated. Good adherence to pharmacotherapy in the acute phase independently predicted maintenance treatment. The tertiary preventive impact of maintenance treatment may remain limited, as many patients with major depressive disorder either do not receive it, or receive it for too short a period. PMID:18670005

  5. Malnutrition Among Children Younger Than 5 Years-Old in Conflict Zones of Chiapas, Mexico

    PubMed Central

    Sánchez-Pérez, Héctor Javier; Hernán, Miguel A.; Ríos-González, Adriana; Arana-Cedeño, Marcos; Navarro, Albert; Ford, Douglas; Micek, Mark A.; Brentlinger, Paula

    2007-01-01

    We performed a cross-sectional, community-based survey, supplemented by interviews with community leaders in Chiapas, Mexico, to examine the prevalence and predictors of child malnutrition in regions affected by the Zapatista conflict. The prevalence rates of stunting, wasting, and underweight were 54.1%, 2.9%, and 20.3%, respectively, in 2666 children aged younger than 5 years. Stunting was associated with indigenous ethnicity, poverty, region of residence, and intracommunity division. The results indicate that malnutrition is a serious public health problem in the studied regions. PMID:17194868

  6. Infantile fibrosarcoma of ethmoid sinus, misdiagnosed as an adenoid in a 5-year-old child

    PubMed Central

    Geramizadeh, Bita; Khademi, Bijan; Karimi, Mehran; Shekarkhar, Golsa

    2015-01-01

    Infantile fibrosarcoma of head and neck is rare and the presence of this tumor in ethmoid sinus is even more uncommon. To the best of our knowledge, <5 cases have been reported in the last 20 years in the English literature, so far, only one of which has been infantile type in a 15 months old girl. In this case report, we will explain our experience with a rare case of infantile fibrosarcoma originating from ethmoid sinus in a 5-year-old boy who presented with dyspnea and epistaxis. After biopsy, it was diagnosed as fibrosarcoma of sinus origin. PMID:26604519

  7. Symptoms of Central Anticholinergic Syndrome After Glycopyrrolate Administration in a 5-Year-Old Child.

    PubMed

    Toksvang, Linea Natalie; Plovsing, Ronni R

    2016-01-15

    Anesthesia-related central anticholinergic syndrome (CAS) is most commonly associated with administration of atropine or scopolamine, whereas glycopyrrolate is an extremely rare cause of CAS. Here, we report a case of CAS in a 5-year-old boy admitted to the intensive care unit. Immediately after the administration of glycopyrrolate, he became agitated and developed apnea, hypertension, tachycardia, and anuria. Although the present case describes a rare cause of CAS, it is an important reminder of an iatrogenic condition that is presumably underdiagnosed in the operating theater as well as the intensive care unit. PMID:26513676

  8. Bilateral renal leiomyoma with 5 year follow-up: Case report.

    PubMed

    Goren, Mehmet Resit; Erbay, Gurcan; Ozer, Cevahir; Goren, Vinil; Bal, Nebil

    2015-01-01

    Renal leiomyomas are exceptionally rare benign tumours of the kidney. Although the renal leiomyomas usually do not metastasize, the differential diagnosis between renal leiomyomas and malign lesions (leiomyosarcoma or renal cell carcinoma) cannot be done by radiological examinations, but is possible by histological examination. Surgery is the preferred treatment. After surgery, the prognosis is excellent without recurrence. Although uterine leiomyomas can be multicentric, renal leiomyomas have been single lesions. We report an incidentally detected case of bilateral renal leiomyoma in a 50-year-old woman with a 5-year follow-up. We also review the literature and discuss clinical, radiological and histological features of renal leiomyomas. PMID:26664510

  9. Meckel's diverticulum with intussusception in a 5-year-old patient with Down's syndrome.

    PubMed

    Anwar, Mohammed Omer; Ahmed, Hamza Ibn; Al Hindi, Saeed; Al Omran, Yasser

    2014-01-01

    Meckel's diverticulum is understood to be the commonest congenital malformation within the gastrointestinal tract with a prevalence of 2%, as found on autopsy studies. Although many cases are asymptomatic, complications can occur including haemorrhage, diverticulitis, chronic ulceration and intestinal obstruction. Intussusception is also a complication, but extremely rare. We present a rare case of Meckel's diverticulum causing intussusception, which was surgically resolved, in a 5-year-old girl. Our aim through this case report is to generate greater awareness of this complication and to provide some potential guidance towards its treatment. PMID:25540213

  10. Stage I carcinoma of the endometrium: a 5-year experience utilizing preoperative cesium

    SciTech Connect

    Belinson, J.L.; Spirou, B.; McClure, M.; Badger, G.; Pretorius, R.G.; Roland, T.A.

    1985-03-01

    A treatment protocol for the management of stage I endometrial carcinoma utilizing preoperative cesium is evaluated. One hundred and twelve consecutive patients were treated according to this protocol over a 5-year period. Based on this experience and a literature review a new protocol is recommended. The significant changes include primary surgery without preoperative cesium, primary treatment based on grade without regard to uterine size, modified radical hysterectomy for G3 tumors, pelvic radiotherapy for clear cell carcinoma confined to the pelvis regardless of depth of invasion, cytoxan, adriamycin, and cis-platinum for papillary serous tumors, and postoperative vaginal cuff cesium for G2 and G3 tumors not requiring pelvic radiotherapy.

  11. Small bowel obstruction 5 years following the ingestion of serrated scissors.

    PubMed

    Limb, Richard; Karam, Edward; Lingam, Krishna M

    2016-01-01

    Ingested foreign bodies are common in the cohort of psychiatric patients, however clinical quiescence in this group is rare. We present a case of a 45-year-old female with emotionally unstable personality disorder (borderline type) presenting with partial intestinal obstruction 5 years after the known ingestion of serrated metallic scissors. In the asymptomatic interim a conservative approach of tracking the blades radiologically was taken. Following discussion, we conclude the following: early surgical intervention is encouraged if natural passage does not occur within 3 days following ingestion, and that any concurrent surgical needs should be addressed at this time. PMID:27190200

  12. Early Onset Bipolar Disorder in a 5.5 Years- Old Child

    PubMed Central

    Zarei, Mina; Bidaki, Reza; Hakim-Shooshtari, Mitra

    2011-01-01

    Bipolar disorder is a mental disease that can be presented as irritable mood with affective storms, mixed symptoms of depression and mania, rapid cycles, emotional labiality and irritability during all episodes. A confirmed positive familial history of the disease is the single most robust risk factor for developing the illness. This report presents 5.5 years-old girl with the symptoms of bipolar disorder and with the purpose to draw attention to the diversity of possible symptoms of mood disorders in childhood. PMID:24644461

  13. Drifter-based estimate of the 5-year dispersal of Fukushima-derived radionuclides

    NASA Astrophysics Data System (ADS)

    Rypina, I.; Jayne, S. R.; Yoshida, S.; Macdonald, A. M.; Buesseler, K. O.

    2014-12-01

    Employing some 40 years of North Pacific drifter-track observations from the Global Drifter Program database, statistics defining the horizontal spread of radionuclides from Fukushima nuclear power plant into the Pacific Ocean are investigated over a time-scale of 5 years. A novel two-iteration method is employed to make the best use of the available drifter data. Drifter-based predictions of the temporal progression of the leading edge of the radionuclide distribution are compared to observed radionuclide concentrations from research surveys occupied in 2012 and 2013. Excellent agreement between the drifter-based predictions and the observations is found.

  14. Angiomyolipoma of donor kidney: Successful transplantation and 5-year follow-up

    PubMed Central

    Gopalakrishnan, N.; Dhanapriya, J.; Sakthirajan, R.; Dineshkumar, T.; Balasubramaniyan, T.; Haris, Md.

    2016-01-01

    Angiomyolipomas (AML) of the kidney are non-encapsulated benign neoplasms with the incidence of 45-80% in patients with tuberous sclerosis and 1-3% in sporadic cases. There are very few case reports in the literature in which kidneys with AML have been used for transplantation. We report here a 27-year-old female patient who received a live related renal transplant from her mother with isolated angiomyolipoma in donor kidney and on follow-up after 5 years, has stable graft function and tumor size. PMID:27051138

  15. Epidemiology of invasive pneumococcal disease in Saudi Arabian children younger than 5years of age.

    PubMed

    Almazrou, Yagob; Shibl, Atef M; Alkhlaif, Riyadh; Pirçon, Jean-Yves; Anis, Sameh; Kandeil, Walid; Hausdorff, William P

    2016-06-01

    This study evaluated the incidence, serotype distribution, and antimicrobial susceptibility of invasive pneumococcal disease (IPD) in Saudi Arabian children. This multicenter, prospective, clinical surveillance study included children under 5years of age, residents of one of the seven study health areas, who were brought to a study hospital with suspicion of IPD. Bacterial isolates from sterile site samples, collected less than 24h after hospital visit/admission, were identified, serotyped, and tested for antibiotic susceptibility. Between June 2007 and January 2009, 631 episodes of suspected IPD were recorded, and 623 were included in the analysis. One child (0.2%) had previously received one dose of a pneumococcal vaccine. Forty-seven episodes were positive for Streptococcus pneumoniae and three for Haemophilus influenzae. The incidence of confirmed IPD cases was estimated to be 2.5-21.6 per 100,000 children (<5years). Among the 46 S. pneumoniae isolates serotyped and tested for antibiotic susceptibility, the most common serotypes were 5 and 23F (20% each), 6B (17%), and 1 and 14 (11% each). Sixty-three percent of isolates were multidrug-resistant. Vaccination of Saudi Arabian children with expanded-coverage conjugate pneumococcal vaccines containing serotypes 1 and 5 could have a substantial impact to prevent IPD in this population. PMID:26368823

  16. The relationship between clinical periodontal status and insulin-dependent diabetes mellitus. Results after 5 years.

    PubMed

    Firatli, E

    1997-02-01

    The clinical periodontal status of 44 insulin-dependent diabetic children and adolescents and 20 healthy control subjects was compared for a period of approximately 5 years. Fasting blood glucose, fructosamine, and glycosylated hemoglobin (HbA1) values were determined at baseline and 5 years later. The differences in the clinical and laboratory parameters were compared during the study period. The differences between the two groups were also evaluated. The only statistically significant difference observed in the diabetic group was clinical attachment loss (CAL). The CAL was statistically significantly higher in the diabetic group compared to the controls, and a statistically significantly higher in the diabetic group compared to the controls, and a statistically significant positive correlation was observed between the duration of diabetes and CAL. Fructosamine was also correlated with the gingival index in the diabetic group while there was no correlation in the controls. It may be concluded that diabetes modifies the clinical status of the periodontal tissues and increases clinical attachment loss. PMID:9058330

  17. The 5-Year Onset and Regression of Diabetic Retinopathy in Chinese Type 2 Diabetes Patients

    PubMed Central

    Jin, Peiyao; Peng, Jinjuan; Zou, Haidong; Wang, Weiwei; Fu, Jiong; Shen, Binjie; Bai, Xuelin; Xu, Xun; Zhang, Xi

    2014-01-01

    Purpose To determine the rate and risk factors of diabetic retinopathy (DR) onset and regression in Chinese type 2 diabetes mellitus patients. Methods This is a 5-year community-based prospective study. The demographic information, systemic examination results and ophthalmological test results of each participant were collected. The study outcomes were DR incidence, defined as the onset of DR in at least one eye, and DR regression, defined as full regression from existing DR to no retinopathy without invasive treatments. The associations between each potential risk factor and the outcomes were studied. Results In total, 778 participants were enrolled. There were 322 patients without DR at baseline, of which 151 participants developed DR during follow-up (DR incidence rate = 46.89%). Baseline hyperglycemia and high blood pressure were two independent risk factors associated with DR incidence. Among the 456 participants with existing DR at entry, 110 fully recovered after 5 years (DR regression rate = 24.12%). Low baseline glucose and low serum triglyceride were two independent factors associated with DR regression. Conclusions DR incidence occurred more frequently in patients with hyperglycemia and high blood pressure. DR regression occurred mostly in patients with lower glucose and lower serum triglyceride levels among Chinese type 2 diabetes patients. PMID:25402474

  18. Body composition during fetal development and infancy through the age of 5 years.

    PubMed

    Toro-Ramos, T; Paley, C; Pi-Sunyer, F X; Gallagher, D

    2015-12-01

    Fetal body composition is an important determinant of body composition at birth, and it is likely to be an important determinant at later stages in life. The purpose of this work is to provide a comprehensive overview by presenting data from previously published studies that report on body composition during fetal development in newborns and the infant/child through 5 years of age. Understanding the changes in body composition that occur both in utero and during infancy and childhood, and how they may be related, may help inform evidence-based practice during pregnancy and childhood. We describe body composition measurement techniques from the in utero period to 5 years of age, and identify gaps in knowledge to direct future research efforts. Available literature on chemical and cadaver analyses of fetal studies during gestation is presented to show the timing and accretion rates of adipose and lean tissues. Quantitative and qualitative aspects of fetal lean and fat mass accretion could be especially useful in the clinical setting for diagnostic purposes. The practicality of different pediatric body composition measurement methods in the clinical setting is discussed by presenting the assumptions and limitations associated with each method that may assist the clinician in characterizing the health and nutritional status of the fetus, infant and child. It is our hope that this review will help guide future research efforts directed at increasing the understanding of how body composition in early development may be associated with chronic diseases in later life. PMID:26242725

  19. A 5-Year Analysis of Peer-Reviewed Journal Article Publications of Pharmacy Practice Faculty Members

    PubMed Central

    Spivey, Christina; Martin, Jennifer R.; Wyles, Christina; Ehrman, Clara; Schlesselman, Lauren S.

    2012-01-01

    Objectives. To evaluate scholarship, as represented by peer-reviewed journal articles, among US pharmacy practice faculty members; contribute evidence that may better inform benchmarking by academic pharmacy practice departments; and examine factors that may be related to publication rates. Methods. Journal articles published by all pharmacy practice faculty members between January 1, 2006, and December 31, 2010, were identified. College and school publication rates were compared based on public vs. private status, being part of a health science campus, having a graduate program, and having doctor of pharmacy (PharmD) faculty members funded by the National Institutes of Health (NIH). Results. Pharmacy practice faculty members published 6,101 articles during the 5-year study period, and a pharmacy practice faculty member was the primary author on 2,698 of the articles. Pharmacy practice faculty members published an average of 0.51 articles per year. Pharmacy colleges and schools affiliated with health science campuses, at public institutions, with NIH-funded PharmD faculty members, and with graduate programs had significantly higher total publication rates compared with those that did not have these characteristics (p<0.006). Conclusion. Pharmacy practice faculty members contributed nearly 6,000 unique publications over the 5-year period studied. However, this reflects a rate of less than 1 publication per faculty member per year, suggesting that a limited number of faculty members produced the majority of publications. PMID:23049099

  20. Factors associated with vaccination coverage in children < 5 years in Angola

    PubMed Central

    de Oliveira, Manuel Falcão Saturnino; Martinez, Edson Zangiacomi; Rocha, Juan Stuardo Yazlle

    2014-01-01

    OBJECTIVE To analyze vaccination coverage and factors associated with a complete immunization scheme in children < 5 years old. METHODS This cross-sectional household census survey evaluated 1,209 children < 5 years old living in Bom Jesus, Angola, in 2010. Data were obtained from interviews, questionnaires, child immunization histories, and maternal health histories. The statistical analysis used generalized linear models, in which the dependent variable followed a binary distribution (vaccinated, unvaccinated) and the association function was logarithmic and had the children’s individual, familial, and socioeconomic factors as independent variables. RESULTS Vaccination coverage was 37.0%, higher in children < 1 year (55.0%) and heterogeneous across neighborhoods; 52.0% of children of both sexes had no immunization records. The prevalence rate of vaccination significantly varied according to child age, mother’s level of education, family size, ownership of household appliances, and destination of domestic waste. CONCLUSIONS Vulnerable groups with vaccination coverage below recommended levels continue to be present. Some factors indicate inequalities that represent barriers to full immunization, indicating the need to implement more equitable policies. The knowledge of these factors contributes to planning immunization promotion measures that focus on the most vulnerable groups. PMID:26039393

  1. Stability of Pediatric Migraine Subtype After a 5-year Follow-Up.

    PubMed

    Cuvellier, Jean-Christophe; Tourte, Mathilde; Lucas, Christian; Vallée, Louis

    2016-08-01

    The study assessed the 5-year follow-up outcome and possible prognostic factors of migraine subtypes with onset in childhood or adolescence. A total of 343 patients meeting the International Classification of Headache Disorders (ICHD)-II criteria for migraine without aura (MO), migraine with aura (MA), or both MO+MA (ie, 1.1, 1.2) were contacted by phone and underwent structured follow-up headache interviews. Of the original sample patients, 22.7% were headache-free at follow-up, 14.1% had a transformed headache diagnosis (tension-type headache: 8.2%, chronic daily headache: 5.8%), and 63.3% still had migraine fulfilling the criteria for ICHD-II 1.1. or 1.2, but those who were still migraineurs at follow-up were older at baseline (respectively 12.93, 9.99, and 11.02 years for MO, MA and MO+MA, P = .0005). The probability of having the same migraine subtype diagnosis at baseline and at 5-year follow-up was 55.2%, 95.1%, and 31.1% for ICHD-II 1.1, 1.2, and both 1.1 and 1.2, respectively. PMID:27071466

  2. Factors associated with vaccination coverage in children < 5 years in Angola.

    PubMed

    Oliveira, Manuel Falcão Saturnino de; Martinez, Edson Zangiacomi; Rocha, Juan Stuardo Yazlle

    2014-12-01

    OBJECTIVE To analyze vaccination coverage and factors associated with a complete immunization scheme in children < 5 years old. METHODS This cross-sectional household census survey evaluated 1,209 children < 5 years old living in Bom Jesus, Angola, in 2010. Data were obtained from interviews, questionnaires, child immunization histories, and maternal health histories. The statistical analysis used generalized linear models, in which the dependent variable followed a binary distribution (vaccinated, unvaccinated) and the association function was logarithmic and had the children's individual, familial, and socioeconomic factors as independent variables. RESULTS Vaccination coverage was 37.0%, higher in children < 1 year (55.0%) and heterogeneous across neighborhoods; 52.0% of children of both sexes had no immunization records. The prevalence rate of vaccination significantly varied according to child age, mother's level of education, family size, ownership of household appliances, and destination of domestic waste. CONCLUSIONS Vulnerable groups with vaccination coverage below recommended levels continue to be present. Some factors indicate inequalities that represent barriers to full immunization, indicating the need to implement more equitable policies. The knowledge of these factors contributes to planning immunization promotion measures that focus on the most vulnerable groups. PMID:26039393

  3. Developmental potential in the first 5 years for children in developing countries

    PubMed Central

    Grantham-McGregor, Sally; Cheung, Yin Bun; Cueto, Santiago; Glewwe, Paul; Richter, Linda; Strupp, Barbara

    2007-01-01

    Summary Many children younger than 5 years in developing countries are exposed to multiple risks, including poverty, malnutrition, poor health, and unstimulating home environments, which detrimentally affect their cognitive, motor, and social-emotional development. There are few national statistics on the development of young children in developing countries. We therefore identified two factors with available worldwide data—the prevalence of early childhood stunting and the number of people living in absolute poverty—to use as indicators of poor development. We show that both indicators are closely associated with poor cognitive and educational performance in children and use them to estimate that over 200 million children under 5 years are not fulfilling their developmental potential. Most of these children live in south Asia and sub-Saharan Africa. These disadvantaged children are likely to do poorly in school and subsequently have low incomes, high fertility, and provide poor care for their children, thus contributing to the intergenerational transmission of poverty. PMID:17208643

  4. HIV rapid testing in a Veterans Affairs hospital ED setting: a 5-year sustainability evaluation.

    PubMed

    Knapp, Herschel; Hagedorn, Hildi; Anaya, Henry D

    2014-08-01

    Routine HIV testing in primary care settings is now recommended in the United States. The US Department of Veterans Affairs (VA) has increased the number of patients tested for HIV, but overall HIV testing rates in VA remain low. A proven strategy for increasing such testing involves nurse-initiated HIV rapid testing (HIV RT). The purpose of this work was to use a mixed methodology approach to evaluate the 5-year sustainability of an intervention that implemented HIV RT in a VA emergency department setting in a large, urban VA medical center to reduce missed diagnostic and treatment opportunities in this vulnerable patient population. In-person semistructured interviews were conducted with providers and stakeholders. Interview notes were qualitatively coded for emerging themes. Quarterly testing rates were evaluated for a 5-year time span starting from the launch in July 2008. Findings indicate that HIV RT was sustained by the enthusiasm of 2 clinical champions who oversaw the registered nurses responsible for conducting the testing. The departure of the clinical champions was correlated with a substantial drop-off in testing. Findings also indicate potential strategies for improving sustainability including engaging senior leadership in the project, engaging line staff in the implementation planning from the start to increase ownership over the innovation, incorporating information into initial training explaining the importance of the innovation to quality patient care, providing ongoing training to maintain skills, and providing routine progress reports to staff to demonstrate the ongoing impact of their efforts. PMID:24908442

  5. The understanding and experience of mixed emotions in 3-5-year-old children.

    PubMed

    Smith, Joshua P; Glass, Daniel J; Fireman, Gary

    2015-01-01

    The term mixed emotions refers to the presence of two opposite-valence emotions toward a single target. Identifying when children begin to report experiencing and understanding mixed emotions is critical in identifying how skills such as adaptive functioning, coping strategies, environmental understanding, and socioemotional competence emerge. Prior research has shown that children as young as 5 years old can understand and experience mixed emotion, but perhaps appropriately sensitive methodologies can reveal these abilities in younger children. The present study evaluated 57 children between 3 and 5 years old for mixed emotion experience and understanding using an animated video clip in which a character experiences a mixed emotional episode. Ordinal logistic regression was utilized to examine the relation of gender, attention, and understanding of content to experience and understanding of mixed emotion. While only 12% of children reported experiencing mixed emotion while watching the clip, 49% of children-some as young as 3 years old-were able to recognize the mixed emotional experience of the character. Thus, mixed emotion understanding emerges earlier than previously identified and the expression of understanding may develop independently of the ability to report mixed emotion experience. These findings are discussed in relation to cognitive and developmental considerations. PMID:25695201

  6. Radiometric calibration stability of the EO-1 advanced land imager: 5 years on-orbit

    USGS Publications Warehouse

    Markham, B.L.; Ong, L.; Barsi, J.A.; Mendenhall, J.A.; Lencioni, D.E.; Helder, D.L.; Hollaren, D.M.; Morfitt, R.

    2006-01-01

    The Advanced Land Imager (ALI) was developed as a prototype sensor for follow on missions to Landsat-7. It was launched in November 2000 on the Earth Observing One (EO-1) satellite as a nominal one-year technology demonstration mission. As of this writing, the sensor has continued to operate in excess of 5 years. Six of the ALl's nine multi-spectral (MS) bands and the panchromatic band have similar spectral coverage as those on the Landsat-7 ETM+. In addition to on-board lamps, which have been significantly more stable than the lamps on ETM+, the ALI has a solar diffuser and has imaged the moon monthly since launch. This combined calibration dataset allows understanding of the radiometric stability of the ALI system, its calibrators and some differentiation of the sources of the changes with time. The solar dataset is limited as the mechanism controlling the aperture to the solar diffuser failed approximately 18 months after launch. Results over 5 years indicate that: the shortest wavelength band (443 nm) has degraded in response about 2%; the 482 nm and 565 nm bands decreased in response about 1%; the 660 nm, 790 nm and 868 nm bands each degraded about 5%; the 1250 nm and 1650 nm bands did not change significantly and the 2215 nm band increased in response about 2%.

  7. Longitudinal study of dental caries increment in Malaysian school children: a 5-year cohort study.

    PubMed

    Masood, Mohd; Yusof, Norashikin; Hassan, Mohamed I A; Jaafar, Nasaruddin

    2014-05-01

    The aim of this 5-year longitudinal cohort study was to assess the prevalence, severity, and trends in caries increment and impact of the School Dental Incremental Care Programme (SDICP). Data were gathered from school dental records as part of the SDICP. A sample of 1830 children were included and checked for caries experience annually using World Health Organization criteria. In total, 95.4% of the children were caries free in 2004, and caries experience declined to 70.5% in 2009 with an average of 4.9% annually. At baseline, the mean DMFT (confidence interval [CI]) was 0.06 (0.05-0.08) and increased to 0.58 (0.53-0.63) in 2009. Children with active caries were 4.4% in 2004, and figures rose to 9.6% in 2009. The FT component increased most rapidly during these 5 years from 0.2% to 25.1%. Overall caries prevalence and increment was low in this study. Proportions of FT component were higher as compared with DT component with low rate of extractions during the latter years of the study. PMID:22218936

  8. Fatal head injuries in children under the age of 5 years in Pretoria.

    PubMed

    du Toit-Prinsloo, Lorraine; Saayman, Gert

    2014-09-01

    The incidence of fatal injuries in children has been reported to be highest among children aged 1 to 4 years. Major causes of head injury include road traffic accidents, falls, and intentional or inflicted injury (such as nonaccidental injury syndrome). This study reviewed the profile of children (under 5 years of age) who had been admitted to a large urban medicolegal mortuary (in Pretoria, the capital city of South Africa), after having suffered fatal head injuries. This study was conducted over a 5-year period (from January 2004 through December 2008), and a total of 107 cases were identified for inclusion. These cases constituted nearly a fifth of admissions in this age group. The male-to-female ratio was 56%:44%, and the peak age of injury was less than 1 year. Most head injuries were sustained in road traffic accidents (70%) followed by falls (10%) and other types of blunt force injuries (9%). Only 1 case of nonaccidental injury syndrome (child abuse) was found. The great majority of deaths were deemed to have been accidental in nature (91%) with 6 (6%) homicides. Urgent review pertaining to the use of child restraint devices and the safety of pedestrians is required, and the institution of childhood injury registers could aid in reducing childhood fatalities in South Africa. PMID:25072811

  9. Separable Sustained and Selective Attention Factors Are Apparent in 5-Year-Old Children

    PubMed Central

    Underbjerg, Mette; George, Melanie S.; Thorsen, Poul; Kesmodel, Ulrik S.; Mortensen, Erik L.; Manly, Tom

    2013-01-01

    In adults and older children, evidence consistent with relative separation between selective and sustained attention, superimposed upon generally positive inter-test correlations, has been reported. Here we examine whether this pattern is detectable in 5-year-old children from the healthy population. A new test battery (TEA-ChJ) was adapted from measures previously used with adults and older children and administered to 172 5-year-olds. Test-retest reliability was assessed in 60 children. Ninety-eight percent of the children managed to complete all measures. Discrimination of visual and auditory stimuli were good. In a factor analysis, the two TEA-ChJ selective attention tasks (one visual, one auditory) loaded onto a common factor and diverged from the two sustained attention tasks (one auditory, one motor), which shared a common loading on the second factor. This pattern, which suggests that the tests are indeed sensitive to underlying attentional capacities, was supported by the relationships between the TEA-ChJ factors and Test of Everyday Attention for Children subtests in the older children in the sample. It is possible to gain convincing performance-based estimates of attention at the age of 5 with the results reflecting a similar factor structure to that obtained in older children and adults. The results are discussed in light of contemporary models of attention function. Given the potential advantages of early intervention for attention difficulties, the findings are of clinical as well as theoretical interest. PMID:24376591

  10. A 5-Year Investigation of Children's Adaptive Functioning Following Conformal Radiation Therapy for Localized Ependymoma

    SciTech Connect

    Netson, Kelli L.; Conklin, Heather M.; Wu Shengjie; Xiong Xiaoping; Merchant, Thomas E.

    2012-09-01

    Purpose: Conformal and intensity modulated radiation therapies have the potential to preserve cognitive outcomes in children with ependymoma; however, functional behavior remains uninvestigated. This longitudinal investigation prospectively examined intelligence quotient (IQ) and adaptive functioning during the first 5 years after irradiation in children diagnosed with ependymoma. Methods and Materials: The study cohort consisted of 123 children with intracranial ependymoma. Mean age at irradiation was 4.60 years (95% confidence interval [CI], 3.85-5.35). Serial neurocognitive evaluations, including an age-appropriate IQ measure and the Vineland Adaptive Behavior Scales (VABS), were completed before irradiation, 6 months after treatment, and annually for 5 years. A total of 579 neurocognitive evaluations were included in these analyses. Results: Baseline IQ and VABS were below normative means (P<.05), although within the average range. Linear mixed models revealed stable IQ and VABS across the follow-up period, except for the VABS Communication Index, which declined significantly (P=.015). Annual change in IQ (-.04 points) did not correlate with annual change in VABS (-.90 to +.44 points). Clinical factors associated with poorer baseline performance (P<.05) included preirradiation chemotherapy, cerebrospinal fluid shunt placement, number and extent of surgical resections, and younger age at treatment. No clinical factors significantly affected the rate of change in scores. Conclusions: Conformal and intensity modulated radiation therapies provided relative sparing of functional outcomes including IQ and adaptive behaviors, even in very young children. Communication skills remained vulnerable and should be the target of preventive and rehabilitative interventions.

  11. An implantable neuroprosthesis for standing and walking in paraplegia: 5-year patient follow-up

    NASA Astrophysics Data System (ADS)

    Guiraud, David; Stieglitz, Thomas; Koch, Klaus Peter; Divoux, Jean-Louis; Rabischong, Pierre

    2006-12-01

    We present the results of a 5-year patient follow-up after implantation of an original neuroprosthesis. The system is able to stimulate both epimysial and neural electrodes in such a way that the complete flexor-extensor chain of the lower limb can be activated without using the withdrawal reflex. We demonstrate that standing and assisted walking are possible, and the results have remained stable for 5 years. Nevertheless, some problems were noted, particularly regarding the muscle response on the epimysial channels. Analysis of the electrical behaviour and thresholds indicated that the surgical phase is crucial because of the sensitivity of the functional responses to electrode placement. Neural stimulation proved to be more efficient and more stable over time. This mode requires less energy and provides more selective stimulation. This FES system can be improved to enable balanced standing and less fatiguing gait, but this will require feedback on event detection to trigger transitions between stimulation sequences, as well as feedback to the patient about the state of his lower limbs.

  12. Pancreatic Cancer Survival Increases with Chemo Combo.

    PubMed

    2016-08-01

    For patients able to have surgery for pancreatic cancer, the adjuvant use of gemcitabine plus capecitabine, instead of gemcitabine alone, leads to a significant improvement in 5-year survival, according to results of the ESPAC-4 trial. The finding will likely change the standard of care for these patients. PMID:27363975

  13. Melanoma survival in the United States, 1992 to 2005

    PubMed Central

    Pollack, Lori A.; Li, Jun; Berkowitz, Zahava; Weir, Hannah K.; Wu, Xiao-Cheng; Ajani, Umed A.; Ekwueme, Donatus U.; Li, Chunyu; Pollack, Brian P.

    2016-01-01

    Background Population-based data on melanoma survival are important for understanding the impact of demographic and clinical factors on prognosis. Objective We describe melanoma survival by age, sex, race/ethnicity, stage, depth, histology, and site. Methods Using Surveillance, Epidemiology, and End Results data, we calculated unadjusted cause-specific survival up to 10 years from diagnosis for 68,495 first primary cases of melanoma diagnosed from 1992 to 2005. Cox multivariate analysis was performed for 5-year survival. Data from 1992 to 2001 were divided into 3 time periods to compare stage distribution and differences in stage-specific 5-year survival over time. Results Melanomas that had metastasized (distant stage) or were thicker than 4.00 mm had a poor prognosis (5-year survival: 15.7% and 56.6%). The 5-year survival for men was 86.8% and for persons given the diagnosis at age 65 years or older was 83.2%, varying by stage at diagnosis. Scalp/neck melanoma had lower 5-year survival (82.6%) than other anatomic sites; unspecified/overlapping lesions had the least favorable prognosis (41.5%). Nodular and acral lentiginous melanomas had the poorest 5-year survival among histologic subtypes (69.4% and 81.2%, respectively). Survival differences by race/ethnicity were observed in the unadjusted survival, but nonsignificant in the multivariate analysis. Overall 5-year melanoma survival increased from 87.7% to 90.1% for melanomas diagnosed in 1992 through 1995 compared with 1999 through 2001, and this change was not clearly associated with a shift toward localized diagnosis. Limitations Prognostic factors included in revised melanoma staging guidelines were not available for all study years and were not examined. Conclusions Poorer survival from melanoma was observed among those given the diagnosis at late stage and older age. Improvements in survival over time have been minimal. Although newly available therapies may impact survival, prevention and early detection

  14. Surviving Cancer

    MedlinePlus

    ... Watch the video to learn more about these breast cancer survivors. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.) Age and Health May Affect Survival A person's age, and more importantly his or ...

  15. 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)

  16. Evaluation of 5-Year Trends in Knee Society Scores Stratified by Comorbidities: A Prospective, Longitudinal Study.

    PubMed

    Jauregui, Julio J; Issa, Kimona; Cherian, Jeffrey J; Harwin, Steven F; Given, Kristin; Mont, Michael A

    2016-01-01

    Total knee arthroplasties (TKAs) are reliable procedures for treating end-stage knee osteoarthritis with excellent long-term outcomes. The purpose of this study was to longitudinally evaluate temporal trends of Knee Society Scores (KSS) after TKA and to identify potential demographic and comorbid factors that affect these outcomes. This prospective study evaluated 281 patients (108 men and 173 women) with a mean age of 66 years (range, 39-80 years) who underwent primary TKA (minimum follow-up 5 years). During each follow-up visit, KS objective, function, and total scores were evaluated. The effects of different demographics and comorbidities on outcomes were further analyzed using multivariate regression analysis. Following TKA, peak mean KSS were observed at 1-year follow-up (mean, 92 points), after which there was no significant difference in scores at 5 years compared with 1-year follow-up (mean, 92 points). KS function scores were observed to be unchanged from preoperative levels (mean, 53 points) and at 6 weeks (mean, 56 points). These were significantly higher at 3 months (mean, 78 points) and reached a maximum mean peak at 1 year (mean, 85 points). KS objective scores increased earlier than function scores. The demographic variables and comorbidities that demonstrated a significantly negative impact in KS function scores were increased age, female gender, higher body mass index, and several medical comorbidities including immunological and neurological disease, and neoplasm. Race was the only variable that significantly decreased the KS objective scores. KSS after TKA follow temporal trends with scores initially unchanged from preoperative levels for the objective component, but the scores increased for the functional component. All components demonstrated higher levels compared with preoperative scores by 3 months and peaked at 1-year follow-up. At 5-year follow-up, all mean KSS were unchanged relative to peak scores seen at 1 year. Various patient

  17. Risk assessments by female victims of intimate partner violence: predictors of risk perceptions and comparison to an actuarial measure.

    PubMed

    Connor-Smith, Jennifer K; Henning, Kris; Moore, Stephanie; Holdford, Robert

    2011-08-01

    Recent studies support the validity of both structured risk assessment tools and victim perceptions as predictors of risk for repeat intimate partner violence (IPV). Combining structured risk assessments and victim risk assessments leads to better predictions of repeat violence than either alone, suggesting that the two forms of assessment provide unique and complementary information. However, very little is known about elements involved in women's risk assessments. The present study explores predictors of women's risk assessment and differences in factors linked to victim and actuarial risk assessments in a large sample of women (N = 728) shortly after the arrest of their male partner for IPV. In multivariate analyses, women's risk assessments were strongly related to past relationship violence and their partner's substance abuse but weakly related to demographic factors, family constellation, and the partner's criminal history. Women who perceived high risk but had a low risk score on an actuarial measure were more likely to report the presence of dynamic risk factors, such as escalating violence and violence during separations, along with a history of emotional and psychological abuse. Qualitative findings paralleled quantitative findings, with women's stated reasons for expecting high or low risk indicating that women were attending to IPV history and dynamic factors. Implications for risk assessment and safety planning are discussed. PMID:20841332

  18. Comparative 5-year results of short hip total hip arthroplasty with Ti- or CoCr-neck adapters.

    PubMed

    Wittenberg, Ralf H; Steffen, Reinhard

    2015-03-01

    This prospective study investigated revision after modular short stem implantation. Results are presented for 2 different types of neck adapters (titanium and cobalt-chromium [CoCr]). Eighty-five patients with titanium adapters and 87 patients with CoCr adapters underwent follow-up examination after an average of 5.7 and 5.2 years, respectively. Mean patient age was 57 years in both groups. Indications were primary osteoarthritis (80%), cup dysplasia (14%), and other (6%). Mean Harris Hip Scores were 98 and 99 points (titanium and CoCr groups, respectively). Ninety percent and 96% of patients were very satisfied or satisfied (titanium and CoCr groups, respectively); 3% of patients in both groups were dissatisfied. Pain decreased from visual analog scale score 7 and 6 preoperatively to 0.37 and 0.15 postoperatively for the titanium and CoCr groups, respectively. No joint dislocation occurred. Six patients needed revision within the first year (2 for infection, 1 for via falsa position, and 2 for aseptic loosening in the titanium group, and 1 for aseptic loosening in the CoCr group). Nine revisions occurred due to neck adapter failure (titanium group). Primary standard stems were used in all revisions. Excluding material-related adapter failures in the titanium group, the 5-year survival rate was 94.8% (95% confidence interval [CI], 88.9-97.6 for titanium) and 99% (95% CI, 93.7-99.8 for CoCr). No radiographic signs of loosening were seen at last follow-up. Fine sclerotic lines were detected in Gruen zones 1 (17.2%) and 2 (14%), hypertrophies in zone 3 (4.3%), and periprosthetic cancellous bone compressions in zone 6 (75.8%). No adapter fractures occurred for CoCr components. The treatment and anchoring system of the short stem studied yielded good results and allowed revision using standard stems in all patients. PMID:25826630

  19. Renal Stone Associated with the Ketogenic Diet in a 5-Year Old Girl with Intractable Epilepsy

    PubMed Central

    Choi, Ji Na; Song, Ji Eun; Shin, Jae Il; Kim, Heung Dong; Kim, Myung Joon

    2010-01-01

    In this paper, we report on a 5-year-old girl who developed a renal stone while following the ketogenic diet to treat refractory seizure disorder. Three months after initiating the ketogenic diet, she developed severe abdominal pain and vomiting. The spot urine calcium-to-creatinine (Ca/Cr) ratio and 24-hour urine evaluation showed hypercalciuria. Computed tomography (CT) imaging revealed a stone in the right ureteropelvic junction, resulting in hydronephrosis of the right kidney. The renal stone disappeared 5 days after conservative treatment; the patien's microscopic hematuria resolved concurrently. In light of this case report, we recommend regularly monitoring the urine Ca/Cr ratio with ultrasonography for further development of renal stones in patients following the ketogenic diet. If these patients exhibit evidence of symptomatic hypercalciuria or cyristalluria, liberalization of fluid restriction and urine alkalization using oral potassium citrate should be considered. PMID:20376903

  20. Constraints on the Time Variation of the Fine Structure Constant by the 5-Year WMAP Data

    NASA Astrophysics Data System (ADS)

    Nakashima, M.; Nagata, R.; Yokoyama, J.

    2008-12-01

    The constraints on the time variation of the fine structure constant at recombination epoch relative to its present value, Δα/α ≡ (α_{rec} - α_{now})/α_{now}, are obtained from the analysis of the 5-year WMAP cosmic microwave background data. As a result of Markov-Chain Monte-Carlo analysis, it is found that, contrary to the analysis based on the previous WMAP data, the mean value of Δα/α = -0.0009 does not change significantly whether we use the Hubble Space Telescope (HST) measurement of the Hubble parameter as a prior or not. The resultant 95% confidence ranges of Δα/α are -0.028 < Δα/α < 0.026 with HST prior and -0.050 < Δα/α < 0.042 without HST prior.

  1. The thermoregulatory theory of yawning: what we know from over 5 years of research

    PubMed Central

    Gallup, Andrew C.; Eldakar, Omar T.

    2012-01-01

    Over the past 5 years numerous reports have confirmed and replicated the specific brain cooling and thermal window predictions derived from the thermoregulatory theory of yawning, and no study has found evidence contrary to these findings. Here we review the comparative research supporting this model of yawning among homeotherms, while highlighting a recent report showing how the expression of contagious yawning in humans is altered by seasonal climate variation. The fact that yawning is constrained to a thermal window of ambient temperature provides unique and compelling support in favor of this theory. Heretofore, no existing alternative hypothesis of yawning can explain these results, which have important implications for understanding the potential functional role of this behavior, both physiologically and socially, in humans and other animals. In discussion we stress the broader applications of this work in clinical settings, and counter the various criticisms of this theory. PMID:23293583

  2. Performance of the MIR Cooperative Solar Array After 2.5 Years in Orbit

    NASA Technical Reports Server (NTRS)

    Kerslake, Thomas W.; Hoffman, David J.

    1999-01-01

    The Mir Cooperative Solar Array (MCSA) was developed jointly by the United States and Russia to produce 6 kW of power for the Russian space station Mir. Four, multi-orbit test sequences were executed between June 1996 and December 1998 to measure MCSA electrical performance. A dedicated Fortran computer code was developed to analyze the detailed thermal-electrical performance of the MCSA. The computational performance results compared very favorably with the measured flight data in most cases. Minor performance degradation was detected in one current generating section of the MCSA. Yet overall, the flight data indicated the MCSA was meeting and exceeding performance expectations. There was no precipitous performance loss due to contamination or other causes after 2.5 years of operation. In this paper, we review the MCSA flight electrical performance tests, data and computational modeling and discuss findings from data comparisons with the computational results.

  3. 5 years of experience with a large-scale mentoring program for medical students

    PubMed Central

    Pinilla, Severin; Pander, Tanja; von der Borch, Philip; Fischer, Martin R.; Dimitriadis, Konstantinos

    2015-01-01

    In this paper we present our 5-year-experience with a large-scale mentoring program for undergraduate medical students at the Ludwig Maximilians-Universität Munich (LMU). We implemented a two-tiered program with a peer-mentoring concept for preclinical students and a 1:1-mentoring concept for clinical students aided by a fully automated online-based matching algorithm. Approximately 20-30% of each student cohort participates in our voluntary mentoring program. Defining ideal program evaluation strategies, recruiting mentors from beyond the academic environment and accounting for the mentoring network reality remain challenging. We conclude that a two-tiered program is well accepted by students and faculty. In addition the online-based matching seems to be effective for large-scale mentoring programs. PMID:25699108

  4. Neurological Recovery of Upper Extremity in Stroke Woman after 5 Years: A Case Report.

    PubMed

    Vejabhuti, Chayanin

    2016-02-01

    Strokes are common neurological disorders in Thailand. Rehabilitation programs significantly improve arm function outcomes if performed during the sub-acute period of stroke rehabilitation, within 6 months of the attack. This report describes the case of a stroke patient who gained upper extremity motor recovery after 5 years, which is beyond the normal recovery period. Although the patient does not have functionality, she has partial motor recovery, and she is enthusiastic about learning to gain better use of her hand. However there is still limited evidence to use in designing effective intervention and proper timing of rehabilitation administered by personnel in training chronic stroke patients. Therefore, evidence based on neuroplasticity and neurological recovery in chronic stroke patients, including rehabilitation intervention, is presented in this report. PMID:27266238

  5. A 5-year-old male child with late infantile metachromatic leukodystrophy: a case report.

    PubMed

    Mahmood, Afreen; Chacham, Swathi; Reddy, Uppin Narayan; Rao, Jillalla Narsing; Rao, S Pratap

    2015-03-01

    Metachromatic leukodystrophy is a rare disorder of myelin metabolism. This degenerative disorder results from the accumulation of cerebroside sulfatide within the myelin sheath of central and peripheral nervous system, due to deficiency of aryl sulfatase A enzyme. We report a 5-year-old male child, who presented with regression of milestones, recurrent seizures and spasticity from second year of life. Initially neurodegenerative disorder was considered and the case was investigated with neuroimaging and enzyme levels. Computed tomography (CT) of the brain showed hypodensities in the corpus callosum and bilateral periventricular and deep cerebral white matter suggestive of neurodegenerative disorder. Subsequently, magnetic resonance imaging (MRI) of the brain was done, which showed symmetrical hyperintensities in the periventricular white matter with classical sparing of subcortical "U" fibers. The β-galactosidase enzyme activity was normal; however, the activity of aryl sulfatase A enzyme was undetectable, confirming the diagnosis of late infantile variant of metachromatic leukodystrophy. PMID:25117420

  6. A student-centred, problem-based curriculum: 5 years' experience.

    PubMed Central

    Des Marchais, J E

    1993-01-01

    In 1987, the University of Sherbrooke's school of medicine implemented a student-centred, problem-based learning (PBL) curriculum. The experience of the first 5 years is reviewed; program goals, the schedule of learning activities, the instructional format and assessment of student learning are described. The new program is more demanding of teachers and requires better faculty training in pedagogy. No new financial resources have been available. The preclinical reform has led to revision of the clerkship, where sessions on clinical reasoning are now based on the PBL philosophy. Student reactions to the program are reported. The Sherbrooke experience has demonstrated that it is both possible and feasible to shift from a traditional to a problem-based curriculum. PMID:8477383

  7. The 5-Year Scientific Achievement of NASA's Chandra X-Ray Observatory

    NASA Technical Reports Server (NTRS)

    2004-01-01

    NASA's Chandra X-Ray Observatory (CXO) was launched July 22, 1999 aboard the Space Shuttle Columbia, STS-93 mission. This image was produced by combining a dozen CXO observations made of a 130 light-year region in the center of the Milky Way over the last 5 years. The colors represent low (red), medium (green) and high (blue) energy x-rays. Thanks to Chandra's unique resolving power, astronomers have now been able to identify thousands of point-like x-ray sources due to neutron stars, black holes, white dwarfs, foreground stars, and background galaxies. What remains is a diffuse x-ray glow extending from the upper left to the lower right, along the direction of the disk of the galaxy. NASA's Marshall Space Flight Center in Huntsville, Alabama manages the Chandra program. (NASA/CXC/UCLA/M. Muno et al.)

  8. [The geriatric psychiatric day hospital: an analysis of 5 years of activities].

    PubMed

    Trifonov, E G; Ognev, A E

    1997-01-01

    233 patients (53 men and 180 women) at the age of 60 years and older were treated in day gerontopsychiatric out-patient clinic for 5 years. 60-69 year old patients prevailed (146 individuals). Nearly all mental diseases characteristic for the old age were found in such patients; majority of patients suffered from schizophrenia (31.3%) and affective pathology (25.8%). Vascular form of dementia prevailed among the patients with dementia while atrophic degenerative dementia was rarely observed (2 patients). Syndromological distribution revealed that the main groups were formed by patients with depressions (41.6%) as well as individuals with neurosis- and psychopathic-like conditions (37.3%). Mental disorders with paranoid syndromes were observed in 8.6% of the patients. It is shown that day gerontopsychiatric out-patient clinic had some preferences in comparison with usual mental hospitals and psychoneurological out-patient clinic. PMID:9157762

  9. Full-mouth rehabilitation of Class II deep-bite patient: A 5-year clinical report

    PubMed Central

    Ergun, Gulfem; Bozkaya, Erdal

    2016-01-01

    This case report demonstrates the full-mouth rehabilitation of a 45-year-old male patient with severe deep-bite by increasing vertical dimension. The technique of anterior maxillary osteotomy performed in the present situation has been found to be effective, requiring anterior and inferior repositioning of the anterior maxilla to provide an esthetic and functional implant supported fixed prosthesis. Four months after surgery, the fixation system was removed, and 6 dental implants were placed. The anterior and inferior movements of the segment allowed for natural tooth anatomy and size in the definitive implant supported partial fixed prosthesis. A satisfactory functional and esthetic result was obtained after 5 years of follow-up. PMID:27403066

  10. Central venous catheters for chemotherapy of solid tumors--our results in the last 5 years.

    PubMed

    Zganjer, Mirko; Cizmić, Ante; Butković, Diana; Matolić, Martina; Karaman-Ilić, Maja; Stepan, Jasminka

    2008-09-01

    Central venous catheters provide an easy access for intravenous medications. Having a central line in place will relieve a child from the discomfort and danger of multiple regular intravenous lines for chemotherapy. The use of indwelling central venous catheters has become commonplace in the management of children undergoing oncological treatment. There are two types of central lines commonly used. There are Broviac catheters and Port-A-Cath (PAC) catheters. In the last 5 years we inserted 194 catheters in 175 children. We inserted 121 Broviac catheters and 73 PAC catheters. During the follow up of 39382 catheter days 44 complications were observed. In Broviac group the median follow up was 155 days and in PAC group was 230 days. We observed differences in the incidence between two devices. In Broviac group infections were more frequent and in PAC group other complications were more frequent than infections. PMID:18982750

  11. Atlantoaxial rotatory subluxation as a cause of torticollis in a 5-year-old girl.

    PubMed

    Bagouri, Elmunzar; Deshmukh, Sandeep; Lakshmanan, Palaniappan

    2014-01-01

    Many patients present to the emergency department complaining of a sore or stiff neck and lateral flexion of the neck with contralateral rotation. Under the pressure of the breaching time and busy shifts some of the patients are discharged to the care of their general practitioners without adequate investigations. While most of the cases are due to benign causes, torticollis can be due to many congenital and acquired pathologies, some of which may need further investigation and urgent management. Atlantoaxial subluxation (AAS), tumours of the base of the skull and infections are among these causes. Delayed diagnosis may lead to worsening neurology and complicate the management. We report a case of a 5-year-old girl who presented to our fracture clinic with a fractured clavicle and torticollis; her subsequent investigations confirmed the diagnosis of AAS. Our patient responded to non-operative treatment and improved with no neurological complications. PMID:24832710

  12. [Research review on apoplectic urinary incontinence treated with acupuncture-moxibustion in recent 5 years].

    PubMed

    Song, Feng-Jun; Zhang, Hong; Zheng, Shi-Li; Fang, Jun-Hui; Liu, Hai-Fei

    2011-10-01

    The relevant documents of apoplectic urinary incontinence treated with acupuncture-moxibustion in recent 5 years have been collated and analyzed in aspect of current situation of acupuncture-moxibustion treatment, acupoint selection, manipulation and problems. The result indicates that the main therapy for this disease is acupuncture-moxibustion combined with electroacupuncture or other methods, and the acupuncture-moxibustion therapy is superior to the medicine. The clinical research has made considerable progress and the great importance has been attached to the research method. The main problems are low credibility of total quality, inconsistent curative course, incomplete case of illness, missing of quality control, disordered standards of clinical diagnosis and curative effect evaluation, varied observation index and phatic discussion of mechanism. It is suggested to carry on scientific research, enhance research lever, expand mind, innovate ideas, and establish uniformed standards of diagnosis and curative effect evaluation and observation index. PMID:22043698

  13. A 5-year experience of the changing management of ectopic pregnancy.

    PubMed

    Berry, Janet; Davey, Mark; Hon, Mei-See; Behrens, Renée

    2016-07-01

    This retrospective audit reviewed all ectopic pregnancies over a 5-year period in a district general hospital setting. Of 215 ectopic pregnancies identified, notes were available for 208 (97%). 202 cases were determined to have been diagnosed and managed as ectopic pregnancies. Six cases were excluded as they were pregnancies of unknown location managed as such. The proportion of patients managed non-surgically has increased following the introduction of our consultant-led early pregnancy assessment unit from 25% prior to 31% currently. The success rates have improved in both those managed expectantly (50%-73%) and those with methotrexate (75%-90%). There has been a corresponding drop in those managed surgically from 75% to 69%, and a reduction in negative laparoscopies from 13% to 6%. Provided recommended criteria and follow-up are adhered to, non-surgical management has been shown to have comparative safety to traditional surgical management with acceptable efficacy and patient acceptability. PMID:27012598

  14. The impact patient-specific instrumentation has had on my practice in the last 5 years.

    PubMed

    Collins, Michael J

    2014-03-01

    I have performed total knee arthroplasty (TKA) using patient- specific instrumentation (PSI) (TRUMATCH® Personalized Solutions, DePuy Synthes Joint Reconstruction, Warsaw, Indiana) since July 2009. Since that time, I have performed over 600 of these procedures, all at the same hospital and all using the same personnel I worked with before I began using PSI. I do not have a physician assistant, but I do have a surgical assistant who scrubs with and assists me on all TKAs. There are a number of reasons why a surgeon may decide to use PSI. This paper discusses the effect PSI has had on my practice in the last 5 years, including my experiences and conclusions. PMID:24911641

  15. Delayed tumor resection in a 5-year-old child with bilateral Wilms tumor.

    PubMed

    Carmichael, Samuel P; Pulliam, Joseph F; D'Orazio, John A

    2013-01-01

    We describe the case of a 5-year-old girl whose abdominal pain and distension were caused by Wilms tumor of the kidney. Because of the bilateral nature of her disease, she was spared biopsy or initial nephrectomy as part of her treatment course. Rather, she was treated presumptively for Wilms tumor based primarily on radiologic findings. Neoadjuvant chemotherapy consisting of vincristine, dactinomycin and doxorubicin was given to facilitate nephron-sparing surgery for tumor resection. Her initial chemotherapeutic course was complicated by tumor lysis syndrome manifested by elevated serum uric acid and was treated effectively with hyperhydration and alkalization of intravenous fluids. The patient's disease responded well to chemotherapy, and she underwent successful tumor excision after 12 weeks of chemotherapy. The resected tumor was identified as anaplastic Wilms tumor, illustrating that pathologic identification of Wilms tumor is possible even after multiple cycles of neoadjuvant chemotherapy and marked tumor shrinkage. PMID:24964423

  16. 5 years of experience with a large-scale mentoring program for medical students.

    PubMed

    Pinilla, Severin; Pander, Tanja; von der Borch, Philip; Fischer, Martin R; Dimitriadis, Konstantinos

    2015-01-01

    In this paper we present our 5-year-experience with a large-scale mentoring program for undergraduate medical students at the Ludwig Maximilians-Universität Munich (LMU). We implemented a two-tiered program with a peer-mentoring concept for preclinical students and a 1:1-mentoring concept for clinical students aided by a fully automated online-based matching algorithm. Approximately 20-30% of each student cohort participates in our voluntary mentoring program. Defining ideal program evaluation strategies, recruiting mentors from beyond the academic environment and accounting for the mentoring network reality remain challenging. We conclude that a two-tiered program is well accepted by students and faculty. In addition the online-based matching seems to be effective for large-scale mentoring programs. PMID:25699108

  17. The magnetosphere, ionosphere, and atmosphere as a system - Dynamics Explorer 5 years later

    NASA Technical Reports Server (NTRS)

    Hoffman, R. A.

    1988-01-01

    The Dynamics Explorer (DE) program summarizes its accomplishments during the first 5 years since the launch of the two DE satellites. This introduction to six review articles provides background information and a brief history of the program, especially citing the contributions of many people to its development. The principal investigators who had primary responsibility to implement the program are listed, together with the instruments they provided. Orbital information and approaches and constraints to data acquisition are explained. The brief description of the ground data processing and analysis system provides information on access to data catalogs and data sets. Each review article is then placed in the context of the categories of scientific objectives of the program.

  18. Department of Energy Resource Assessment Program 5-year plan, FY 1991--FY 1995

    SciTech Connect

    Not Available

    1990-10-01

    The US Department of Energy's (DOE) Resource Assessment Program produces scientific descriptions and assessments of the nation's renewable energy resources, such as solar energy. Information about the resources --- for example, how solar energy varies with location and climate --- is required to develop energy conversion technologies, design and site systems, and forecast the systems' performance. With information about resource availability and renewable energy system performance, DOE can assess the potential for renewable energy to contribute to the nation's energy supply as part of the long-term national energy strategy. This 5-year plan for fiscal years (FY) 1991 through 1995 gives the strategy to produce solar radiation resource characterizations and assessments under the DOE project at SERI. It is consistent with the mini-multiyear plan for resource assessment prepared by DOE in 1989 and incorporates the comments received at a project overview held in April 1990 at DOE Headquarters. 7 figs.

  19. Predictors and consequences of childhood depressive symptoms: a 5-year longitudinal study.

    PubMed

    Nolen-Hoeksema, S; Girgus, J S; Seligman, M E

    1992-08-01

    A 5-year longitudinal study investigated the interrelationships among children's experiences of depressive symptoms, negative life events, explanatory style, and helplessness behaviors in social and achievement situations. The results revealed that early in childhood, negative events, but not explanatory style, predicted depressive symptoms; later in childhood, a pessimistic explanatory style emerged as a significant predictor of depressive symptoms, alone and in conjunction with negative events. When children suffered periods of depression, their explanatory styles not only deteriorated but remained pessimistic even after their depression subsided, presumably putting them at risk for future episodes of depression. Some children seem repeatedly prone to depressive symptoms over periods of at least 2 years. Depressed children consistently showed helpless behaviors in social and achievement settings. PMID:1500598

  20. 5 Years review of periocular basal cell carcinoma and proposed follow-up protocol

    PubMed Central

    Ho, S F; Brown, L; Bamford, M; Sampath, R; Burns, J

    2013-01-01

    Aim (1) To investigate the recurrence of periocular basal cell carcinoma (BCC) reported as completely excised on histology. (2) To identify risks associated with recurrence. (3) To recommend a rational follow-up protocol. Methods This is a cohort study by case note review of consecutive patients undergoing excision of periocular BCC between 2000 and 2006 at University Hospitals of Leicester. All lesions were excised with 3 mm clinical margin and the defect reconstructed only after the excision margin was declared clear. Results A total of 413 episodes of surgical excision were recorded for 270 patients over the 7-year period of 2000–2006. All of them have 5 years follow-up. Mean age 73.7 (±12.5). In all, 67% were nodular BCC and 45.4% located in the lower eyelid. The main outcome measure was the recurrence rate. None of the patients with primary nodular BCC suffered recurrence. The recurrence rate for primary morphoeaform BCC following complete excision is 3.8%. In total, 8.1% of patients had several lesions simultaneously whereas 7.8% patients had BCC in multiple locations subsequently (metachronous). Three patients who had previously recurrent BCC (rBCC) treated elsewhere or not using this method had orbital/lacrimal drainage system involvement requiring exenteration. Conclusion We recommend that patients with a single, completely excised primary solid or nodular BCC can be discharged after one 6-monthly review, although they should be instructed to monitor for the development of further lesions. The incidence of recurrence for primary morphoeaform BCC is 3.8% and for rBCC is 3.6% over 5 years and these patients should stay under review for this period. PMID:23154501

  1. POSTTRAUMATIC STRESS DISORDER AMONG INDONESIAN CHILDREN 5 YEARS AFTER THE TSUNAMI.

    PubMed

    Irwantol; Faisal; Zulfa, Hendra

    2015-09-01

    Children are at risk for developing posttraumatic stress disorder (PTSD) due to experiencing or living in a disaster area. The factors that increase the likelihood of a child developing PTSD need further clarification. We studied the factors associated with PTSD among children who experienced the tsunami in Sumatra, Indonesia. We conducted a cross sectional study in 2 subdistricts of Sumatra 5 years after experiencing a tsunami. Children aged 7-13 years were enrolled using stratified cluster sampling. A tsunami-modified version of The PsySTART Rapid Triage System was used to question children about their tsunami-specific traumatic experiences. Trauma symptoms were evaluated using the Trauma Symptom Checklist For Children (TSCC). The diagnosis of PTSD was made using the Child PTSD Symptom Scale (CPSS) and DSM-IV criteria. The data were analyzed with chi-square tests and multivariate logistic regression analysis with 95% confidence intervals (CI). A total of 262 children were enrolled in this study. The prevalence of PTSD in these children was 20.6%. On multivariate analysis, having experienced a delay in evacuation (PR = 4.5; 95% CI: 2.794-13.80; p < 0.001) and being unable to escape (PR = 13.07; 95% CI: 5.884-64; p < 0.001) were significantly associated with PTSD 5 years after the tsunami. Children who experienced a traumatic event in which they were unable to escape or when there is a delay in evacuation are at risk of developing PTSD and need appropriate treatment. PMID:26863863

  2. Smoking in pregnancy and children's mental and motor development at age 1 and 5 years.

    PubMed

    Trasti, N; Vik, T; Jacobsen, G; Bakketeig, L S

    1999-06-01

    We used data from a Scandinavian prospective multicenter study to investigate if smoking in pregnancy may have an adverse effect on the child's mental and motor abilities. Eligible for enrolment were para I and 2 women with a singleton pregnancy, who resided in one of the study areas and could be registered before the 20th gestational week. Women were classified as 'smokers' or 'non-smokers' at study start. At 13 months, 376 children (124 children of smokers) were evaluated with the Bayley Scales of Infant Development. At this age, children of smokers and non-smokers performed equally well. At 5 years, 369 children (132 children of smokers) were tested with the Wechsler Preschool and Primary Scales of Intelligence Revised (WPPSI-R), and 362 children with the Peabody Developmental Motor Scales (PDMS). Children of smokers had an increased risk of getting a WPPSI-R score below the median value of the population (OR = 2.1, 95% CI: 1.2-3.3), but the risk was reduced when we adjusted for maternal education (OR = 1.6, 95% CI: 0.9-3.7). Children of smokers had an increased risk of getting a test score below the median population value on the subscale 'balance' from PDMS (OR = 1.8, 95% CI: 1.2-2.8). Thus, we found that smoking in pregnancy was associated with a small, but demonstrable adverse effect on the child's balance at 5 years, whereas the negative effect on cognitive function did not reach statistical significance, when we adjusted for the mother's level of education. PMID:10390089

  3. Endoscopic removal of foreign bodies from the upper gastrointestinal tract: 5-year experience

    PubMed Central

    Emara, Mohamed H; Darwiesh, Ehab M; Refaey, Mohamed M; Galal, Sherif M

    2014-01-01

    Background Foreign bodies (FBs) in the upper gastrointestinal tract are produced chiefly by accidental swallowing but rarely produce symptoms. Removal of FBs is not an infrequent challenge for upper gastrointestinal endoscopy. The aim of this study is to elicit our experience in a 5-year period in dealing with FBs in the upper gastrointestinal tract using upper endoscopy. Methods This retrospective study was conducted at Zagazig University Hospitals, Egypt, over a 5-year period. We reviewed all patients’ files with full notations on age, sex, type of FB and its anatomical location, treatments, and outcomes (complications, success rates, and mortalities). Patients with incomplete files and those with FBs not identified at the endoscopic examination were excluded. Results A total of 45 patients were identified. Their ages ranged from 6 months to 102 years. Slight male predominance was noticed (53.3%). The most frequent presentation was a history of FB ingestion without any associated manifestations (44.4%). Coins were the most commonly encountered FBs (14/45). Esophagus was the most common site of trapping (27/45). The overall success rate was 95.6% (43/45). Upper endoscopy successfully resolved the problem by either FB removal (41/43) or dislodgment of the impacted fleshy meat to the stomach (2/43). Two cases were referred for surgical removal. The rate of complications was 6.7%. Furthermore, no mortalities due to FB ingestion or removal had been reported throughout the study. Conclusion Our experience with FB removal emphasizes its importance and ease when performed by experienced hands, at well-equipped endoscopy units, and under conscious sedation in most cases, with high success rates and minor complications. PMID:25053889

  4. Radiologically Isolated Syndrome: 5-Year Risk for an Initial Clinical Event

    PubMed Central

    Okuda, Darin T.; Siva, Aksel; Kantarci, Orhun; Inglese, Matilde; Katz, Ilana; Tutuncu, Melih; Keegan, B. Mark; Donlon, Stacy; Hua, Le H.; Vidal-Jordana, Angela; Montalban, Xavier; Rovira, Alex; Tintoré, Mar; Amato, Maria Pia; Brochet, Bruno; de Seze, Jérôme; Brassat, David; Vermersch, Patrick; De Stefano, Nicola

    2014-01-01

    Objective To report the 5-year risk and to identify risk factors for the development of a seminal acute or progressive clinical event in a multi-national cohort of asymptomatic subjects meeting 2009 RIS Criteria. Methods Retrospectively identified RIS subjects from 22 databases within 5 countries were evaluated. Time to the first clinical event related to demyelination (acute or 12-month progression of neurological deficits) was compared across different groups by univariate and multivariate analyses utilizing a Cox regression model. Results Data were available in 451 RIS subjects (F: 354 (78.5%)). The mean age at from the time of the first brain MRI revealing anomalies suggestive of MS was 37.2 years (y) (median: 37.1 y, range: 11–74 y) with mean clinical follow-up time of 4.4 y (median: 2.8 y, range: 0.01–21.1 y). Clinical events were identified in 34% (standard error = 3%) of individuals within a 5-year period from the first brain MRI study. Of those who developed symptoms, 9.6% fulfilled criteria for primary progressive MS. In the multivariate model, age [hazard ratio (HR): 0.98 (95% CI: 0.96–0.99); p = 0.03], sex (male) [HR: 1.93 (1.24–2.99); p = 0.004], and lesions within the cervical or thoracic spinal cord [HR: 3.08 (2.06–4.62); p = <0.001] were identified as significant predictors for the development of a first clinical event. Interpretation These data provide supportive evidence that a meaningful number of RIS subjects evolve to a first clinical symptom. An age <37 y, male sex, and spinal cord involvement appear to be the most important independent predictors of symptom onset. PMID:24598783

  5. Configuring Balanced Scorecards for Measuring Health System Performance: Evidence from 5 Years' Evaluation in Afghanistan

    PubMed Central

    Edward, Anbrasi; Kumar, Binay; Kakar, Faizullah; Salehi, Ahmad Shah; Burnham, Gilbert; Peters, David H.

    2011-01-01

    Background In 2004, Afghanistan pioneered a balanced scorecard (BSC) performance system to manage the delivery of primary health care services. This study examines the trends of 29 key performance indicators over a 5-year period between 2004 and 2008. Methods and Findings Independent evaluations of performance in six domains were conducted annually through 5,500 patient observations and exit interviews and 1,500 provider interviews in >600 facilities selected by stratified random sampling in each province. Generalized estimating equation (GEE) models were used to assess trends in BSC parameters. There was a progressive improvement in the national median scores scaled from 0–100 between 2004 and 2008 in all six domains: patient and community satisfaction of services (65.3–84.5, p<0.0001); provider satisfaction (65.4–79.2, p<0.01); capacity for service provision (47.4–76.4, p<0.0001); quality of services (40.5–67.4, p<0.0001); and overall vision for pro-poor and pro-female health services (52.0–52.6). The financial domain also showed improvement until 2007 (84.4–95.7, p<0.01), after which user fees were eliminated. By 2008, all provinces achieved the upper benchmark of national median set in 2004. Conclusions The BSC has been successfully employed to assess and improve health service capacity and service delivery using performance benchmarking during the 5-year period. However, scorecard reconfigurations are needed to integrate effectiveness and efficiency measures and accommodate changes in health systems policy and strategy architecture to ensure its continued relevance and effectiveness as a comprehensive health system performance measure. The process of BSC design and implementation can serve as a valuable prototype for health policy planners managing performance in similar health care contexts. Please see later in the article for the Editors' Summary PMID:21814499

  6. Food assistance programmes are indirectly associated with anaemia status in children <5 years old in Mexico.

    PubMed

    Shamah-Levy, Teresa; Méndez-Gómez-Humarán, Ignacio; Gaona-Pineda, Elsa B; Cuevas-Nasu, Lucia; Villalpando, Salvador

    2016-09-01

    Anaemia in children is a public health concern in Mexico; Federal food assistance programmes are being implemented to prevent it. We undertook this research to investigate the indirect association between food assistance programmes (FAP) and anaemia through dietary and socio-economic conditions of beneficiary children. A structural equation model (SEM) was constructed to assess associations among FAP, dietary and socio-economic conditions, as well as anaemia. A cross-sectional comparative study was conducted based on a sample of 1214 households with children <5 years old, beneficiaries of two FAP: Prospera and rescue from malnutrition with amaranth (RMA) and a comparison group in San Luis Potosí, Mexico. The SEM and a decomposition effect analysis revealed the existence of a significant indirect association of FAP on the prevalence of anaemia via dietary and socio-economic conditions in children under 5 years old. The Prospera assistance programme showed a significant indirect positive association with the prevalence of anaemia (standard coefficient=0·027, P<0·031), and the RMA programme showed a significant indirect negative association with the prevalence of anaemia (standard coefficient=-0·029, P=0·047). There was a direct association between FAP and dietary and socio-economic conditions. FAP could indirectly modify the prevalence of anaemia in young children with a direct improvement on dietary and socio-economic conditions. The unexpected finding of the association between RMA, dietary and socio-economic conditions and the prevalence of anaemia reflects differences in the focus of the programmes. PMID:27545977

  7. Status of medical education reform at Saga Medical School 5 years after introducing PBL.

    PubMed

    Oda, Yasutomo; Koizumi, Shunzo

    2008-03-01

    In Japan, problem-based learning (PBL) is a relatively new method of educating medical students that is reforming the face of medical education throughout the world, including Asia. It shifts from teacher-centered learning strategies (for example, lectures in large auditoriums) to student-centered, self-directed learning methods (for example, active discussions and problem-solving by students in small groups under the guidance of faculty tutors). Upon a recommendation by the Japan Model Core Curriculum, Saga Medical School introduced a PBL curriculum 5 years ago. A full PBL curriculum was adopted from the McMaster model through Hawaii. A description of how PBL was implemented into the 3rd and 4th year (Phase III curriculum) is given. The overall result has been good. Students who experienced PBL had increased scores on the National Medical License Exam, and Saga increased its ranking from 56th to 19th of the 80 medical schools in Japan. A key step was introduction of the educational scaffolding in PBL Step 0. Students were allowed to see page one of the PBL case, containing the chief complaint, on the weekend before meeting in small groups. Despite a perceived overall benefit to student learning, symptoms of superficial discussions by students have been observed recently. How this may be caused by poor case design is discussed. Other problems, including "silent tutors" and increased faculty workload, are discussed. It is concluded that after 5 years, Saga's implementation of a PBL curriculum has been successful. However, many additional issues, including motivation of students and preparation for PBL in the first 2 years, must still be resolved in the future. This is the first description of the positive and negative outcomes associated with the reform of medical education and the introduction of PBL to a traditional medical school curriculum in Japan. PMID:18364287

  8. Stereopsis Results at 4.5 Years of Age in the Infant Aphakia Treatment Study

    PubMed Central

    Hartmann, E. Eugenie; Stout, Ann U.; Lynn, Michael J.; Yen, Kimberly G.; Kruger, Stacey J.; Lambert, Scott R.

    2014-01-01

    Purpose To determine whether stereopsis of infants treated for monocular cataracts varies with the type of optical correction used. Design Randomized prospective clinical trial Methods The Infant Aphakia Treatment Study randomized 114 patients with unilateral cataracts at age 1 to 7 months to either primary intraocular lens (IOL) or contact lens correction. At 4.5 years of age a masked examiner assessed stereopsis on these patients using three different tests: 1) Frisby; 2) Randot Preschool; and 3) Titmus fly. Results Twenty-eight patients (25%) had a positive response to at least one of the stereopsis tests. There was no statistically significant difference in stereopsis between the two treatment groups. Frisby (contact lens, 6 (11%); IOL, 7 (13%); p=0.99), Randot (contact lens, 3 (6%); IOL, 1 (2%); p=0.62) or Titmus: (contact lens, 8 (15%); IOL, 13 (23%); p=0.34). The median age at surgery for patients with stereopsis was younger than for those without stereopsis (1.2 versus 2.4 months; p=0.002). The median visual acuity for patients with stereopsis was better than for those without stereopsis (20/40 vs. 20/252; p=0.0003). Conclusion The type of optical correction did not influence stereopsis outcomes. However, two other factors did: age at surgery and visual acuity in the treated eye at age 4.5 years. Early surgery for unilateral congenital cataract and the presence of visual acuity better than or equal to 20/40 appear to be more important than the type of initial optical correction used for the development of stereopsis. PMID:25261241

  9. Specialist Pediatric Palliative Care Referral Practices in Pediatric Oncology: A Large 5-year Retrospective Audit

    PubMed Central

    Ghoshal, Arunangshu; Salins, Naveen; Damani, Anuja; Deodhar, Jayita; Muckaden, MaryAnn

    2016-01-01

    Purpose: To audit referral practices of pediatric oncologists referred to specialist pediatric palliative care services. Patients and Methods: Retrospective review of medical case records of pediatric palliative care patients over a period of 5 years from January 1, 2010 to December 31, 2014. Descriptive summaries of demographic, clinical variables, and patient circumstances at the time of referral and during end-of-life care were examined. Results: A total of 1135 patients were referred from pediatric oncology with a gradual increasing trend over 5 years. About 84.6% consultations took place in the outpatient setting. In 97.9% of the cases, parents were the primary caregivers. Availability of specialist pediatric health-care services at local places was available in 21.2% cases and 48% families earned <5000 INR (approximately 73 USD) in a month. Around 28.3% of the referrals were from leukemia clinic and maximum references were late with 72.4% patients having advanced disease at presentation. 30.3% of the referrals were made for counseling and communication and 54.2% had high symptom burden during referral. After referral, 21.2% patients continued with oral metronomic chemotherapy and 10.5% were referred back to oncology services for palliative radiotherapy. Only 4.9% patients had more than 2 follow-ups. 90.8% of the patients were cared for at home in the last days of illness by local general practitioners. 70.6% of the deaths were anticipated. Conclusions: Oncologists referred patients late in the course of disease trajectory. Most of the referrals were made for counseling and communication, but many patients had high symptom burden during referral. PMID:27559254

  10. A 5-year scientometric analysis of research centers affiliated to Tehran University of Medical Sciences

    PubMed Central

    Yazdani, Kamran; Rahimi-Movaghar, Afarin; Nedjat, Saharnaz; Ghalichi, Leila; Khalili, Malahat

    2015-01-01

    Background: Since Tehran University of Medical Sciences (TUMS) has the oldest and highest number of research centers among all Iranian medical universities, this study was conducted to evaluate scientific output of research centers affiliated to Tehran University of Medical Sciences (TUMS) using scientometric indices and the affecting factors. Moreover, a number of scientometric indicators were introduced. Methods: This cross-sectional study was performed to evaluate a 5-year scientific performance of research centers of TUMS. Data were collected through questionnaires, annual evaluation reports of the Ministry of Health, and also from Scopus database. We used appropriate measures of central tendency and variation for descriptive analyses. Moreover, uni-and multi-variable linear regression were used to evaluate the effect of independent factors on the scientific output of the centers. Results: The medians of the numbers of papers and books during a 5-year period were 150.5 and 2.5 respectively. The median of the "articles per researcher" was 19.1. Based on multiple linear regression, younger age centers (p=0.001), having a separate budget line (p=0.016), and number of research personnel (p<0.001) had a direct significant correlation with the number of articles while real properties had a reverse significant correlation with it (p=0.004). Conclusion: The results can help policy makers and research managers to allocate sufficient resources to improve current situation of the centers. Newly adopted and effective scientometric indices are is suggested to be used to evaluate scientific outputs and functions of these centers. PMID:26157724

  11. Midterm survivorship and clinical outcome of INDUS knee prosthesis: 5 year followup study

    PubMed Central

    Sancheti, Kantilal H; Sancheti, Parag K; Joshi, Rajeev S; Patil, Kailash R; Shyam, Ashok K; Bhaskar, Raja R

    2016-01-01

    Background: INDUS knee implant has been designed as per the anatomical morphology of the Indian population and has shown good clinical outcome in short term studies. The purpose of the present study was to report the midterm survivorship and clinical outcome of this implant. Materials and Methods: Two hundred and twenty three primary total knee arthroplasties in 209 consecutive patients using the INDUS knee prosthesis were prospectively enrolled. There were 145 females (155 knees) and 64 males (68 knees) with a mean age of 69.95 years (range 42–86 years). Annual followup with clinical and radiological examination was conducted, and a survivorship analysis was done using the Kaplan–Meier analysis. Results: Mean followup was 5.8 years (range 5–6.5 years). Eleven patients died while eight were lost to followup and a total of 204 knees were available for followup. The mean knee flexion improved from preoperative 110.4° ± 11.24° (range 60°–130°) to 128.17° ± 8.32° (range 100°–140°) at the final followup. The mean knee score improved from 40.1 ± 10.7 to 90.3 ± 5.34 while the function score improved from 44.35 ± 12.9 to 89.58 ± 7.43. Two patient developed infection and required revision. The Kaplan–Meier analysis reported a survivorship of 98.6% (confidence interval 95.7–99.6%) at the end for 5 years for INDUS knee prosthesis. Conclusion: INDUS knee prosthesis has excellent survivorship with a good clinical outcome and low failure rate. PMID:27053801

  12. Long-term survival following emergency abdominal aortic aneurysm repair.

    PubMed

    Milner, Q J; Burchett, K R

    2000-05-01

    Survival following emergency surgery for ruptured abdominal aortic aneurysm remains poor and is in stark contrast to that for elective repair. We have carried out a 5-year retrospective observational study to determine the long-term (5-year) survival of patients following emergency surgery for ruptured abdominal aortic aneurysm at a district general hospital in East Anglia. A total of 99 patients presented to the operating theatre for emergency repair of ruptured abdominal aortic aneurysm in this 5-year study period. In-hospital mortality was 70% and was unchanged over the 5 years. Overall long-term survival in those patients discharged from hospital was good. The ICU cost per long-term survivor was calculated to be pound sterling 36750. PMID:10792133

  13. Recent research (N = 9,305) underscores the importance of using age-stratified actuarial tables in sex offender risk assessments.

    PubMed

    Wollert, Richard; Cramer, Elliot; Waggoner, Jacqueline; Skelton, Alex; Vess, James

    2010-12-01

    A useful understanding of the relationship between age, actuarial scores, and sexual recidivism can be obtained by comparing the entries in equivalent cells from "age-stratified" actuarial tables. This article reports the compilation of the first multisample age-stratified table of sexual recidivism rates, referred to as the "multisample age-stratified table of sexual recidivism rates (MATS-1)," from recent research on Static-99 and another actuarial known as the Automated Sexual Recidivism Scale. The MATS-1 validates the "age invariance effect" that the risk of sexual recidivism declines with advancing age and shows that age-restricted tables underestimate risk for younger offenders and overestimate risk for older offenders. Based on data from more than 9,000 sex offenders, our conclusion is that evaluators should report recidivism estimates from age-stratified tables when they are assessing sexual recidivism risk, particularly when evaluating the aging sex offender. PMID:21098823

  14. Relapse and Late Mortality in 5-Year Survivors of Myeloablative Allogeneic Hematopoietic Cell Transplantation for Chronic Myeloid Leukemia in First Chronic Phase

    PubMed Central

    Goldman, John M.; Majhail, Navneet S.; Klein, John P.; Wang, Zhiwei; Sobocinski, Kathleen A.; Arora, Mukta; Horowitz, Mary M.; Rizzo, J. Douglas

    2010-01-01

    Purpose Allogeneic hematopoietic cell transplantation (HCT) is curative therapy for chronic myeloid leukemia (CML), but its long-term outcomes are not well described. We studied the long-term outcomes of CML patients in first chronic phase who receive an allogeneic HCT. Patients and Methods Our study included 2,444 patients who received myeloablative HCT for CML in first chronic phase between 1978 and 1998 and survived in continuous complete remission for at least 5 years (median follow-up, 11 years; range, 5 to 25 years). Donor sources were human leukocyte antigen–matched siblings in 1,692 patients, unrelated donors in 639 patients, and other related donors in 113 patients. Results Overall survival rates at 15 years were 88% (95% CI, 86% to 90%) for sibling HCT and 87% (95% CI, 83% to 90%) for unrelated donor HCT. Corresponding cumulative incidences of relapse were 8% (95% CI, 7% to 10%) and 2% (95% CI, 1% to 4%), respectively. The latest relapse was reported 18 years post-HCT. In multivariable analyses, history of chronic graft-versus-host disease increased risks of late overall mortality and nonrelapse mortality but reduced risks of relapse. In comparison with age-, race-, and sex-adjusted normal populations, the mortality of HCT recipients was significantly higher until 14 years post-HCT; thereafter, mortality rates were similar to those of the general population (relative mortality ratio at 15 years, 2.3; 95% CI, 0 to 4.9). Conclusion Recipients of allogeneic HCT for CML in first chronic phase who remain in remission for at least 5 years have favorable subsequent long-term survival, and their mortality rates eventually approach those of the general population. PMID:20212247

  15. 75 FR 57492 - Notice of Submission of Proposed Information Collection to OMB Public Housing 5 Year Annual PHA Plan

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-21

    ... URBAN DEVELOPMENT Notice of Submission of Proposed Information Collection to OMB Public Housing 5 Year... public comments on the subject proposal. PHAs are required to submit annual and 5-Year Plans to HUD as required by section 5A of the United States Housing Act of 1937 (42 U.S.C. 1437c-1) The purpose of the...

  16. 75 FR 38979 - Endangered and Threatened Species; Initiation of a 5-Year Review of the Eastern Distinct...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-07

    ... for the eastern Distinct Population Segment of the Steller sea lion (75 FR 37385). NMFS inadvertently... of a 5-Year Review of the Eastern Distinct Population Segment of the Steller Sea Lion AGENCY... of a 5-year review of the eastern Distinct Population Segment (DPS) of the Steller Sea...

  17. A 5 Year Study of Carbon Fluxes from a Restored English Blanket Bog

    NASA Astrophysics Data System (ADS)

    Worrall, F.; Dixon, S.; Evans, M.

    2014-12-01

    This study aimed to measure the effects of ecological restoration on blanket peat water table depths, DOC concentrations and CO2 fluxes. In April 2003 the Bleaklow Plateau, an extensive area of deep blanket peat in the Peak District National Park, northern England, was devegetated by a wildfire. As a result the area was selected for large scale restoration. In this study we considered a 5-year study of four restored sites in comparison to both an unrestored, bare peat control and to vegetated control that did not require restoration. Results suggested that sites with revegetation alongside slope stabilisation had the highest rates of photosynthesis and were the largest net (daylight hours) sinks of CO2. Bare sites were the largest net sources of CO2 and had the deepest water table depths. Sites with gully wall stabilisation were between 5-8 times more likely to be net CO2 sinks than the bare sites. Revegetation without gully flow blocking using plastic dams did not have a large effect on water table depths in and around the gullies investigated whereas a blocked gully had water table depths comparable to a naturally revegetating gully. A ten centimetre lowering in water table depth decreased the probability of observing a net CO2 sink, on a given site, by up to 30%. With respect to DOC the study showed that the average soil porewater DOC concentration on the restored sites rose significantly over the 5 year study representing a 34% increase relative to the vegetated control and an 11% increase relative to the unrestored, bare control. Soil pore water concentrations were not significantly different from surface runoff DOC concentrations and therefore restoration as conducted by this study would have contributed to water quality deterioration in the catchment. The most important conclusion of this research was that restoration interventions were apparently effective at increasing the likelihood of net CO2 sink behaviour and raising water tables on degraded

  18. Hyperpigmented Torpedo Maculopathy with Pseudo-Lacuna: A 5-Year Follow-Up

    PubMed Central

    Rohl, Austin; Vance, Sushma

    2016-01-01

    Purpose The aim of the study was to describe a case of globally hyperpigmented torpedo maculopathy that also contained a novel central lesion resembling a ‘pseudo-lacuna’. We compare the morphology of the lesion after 5 years of follow-up. Case Presentation An asymptomatic 10-year-old Caucasian male was referred by his optometrist after having found a hyperpigmented lesion on routine dilated examination in 2010. Color fundus photography OS from October 2015 showed a 1.74 × 0.67 mm hyperpigmented oval-shaped lesion temporal to the macula. Since June 2010, the hyperpigmented torpedo lesion appeared to have assumed a more ovoid shape and increased in size in the vertical axis. Centrally, there was a small pearlescent-colored pseudo-lacuna lesion that seemed to also have significantly increased in size since June 2010. Enhanced depth imaging optical coherence tomography of this pseudo-lacuna showed retinal pigment epithelium clumping and migration. Fundus autofluorescence revealed reduced autofluorescence of the torpedo lesion and marked hyperautofluorescence of the pseudo-lacuna. Fluorescein angiography shows no neovascular disease or leakage. Conclusion Torpedo maculopathy has been described previously as a hypopigmented, nonprogressive lesion of unknown etiology. The findings of global hyperpigmentation, pseudo-lacuna formation, and morphologic changes over time in this lesion challenge these classically held descriptions, and necessitate long-term follow-up with multimodal imaging. PMID:27462244

  19. Oral glucose retention, saliva viscosity and flow rate in 5-year-old children.

    PubMed

    Negoro, M; Nakagaki, H; Tsuboi, S; Adachi, K; Hanaki, M; Tanaka, D; Takami, Y; Nakano, T; Kuwahara, M; Thuy, T T

    2000-11-01

    There are significant differences of glucose retention in site-specificity and individuals. Sixty-two 5-year-old nursery schoolchildren participated in this study on the relation between the viscosity of saliva and flow rate and glucose retention. Each child was instructed to rinse his/her mouth with a glucose solution (0.5 M, 5 ml) and then to spit out. Three minutes after rinsing, glucose retention was determined. Resting saliva was collected by a natural outflow method, then the flow rate was determined. A rotational viscometer was used to determine the viscosity. Glucose retention and flow rate were correlated at the left maxillary primary molars, and glucose retention and viscosity were correlated at the maxillary central primary incisors. It was concluded that glucose retention after glucose mouth rinsing was site-specific, and that glucose retention and the index of decayed, missing and filled primary teeth (dmft) were slightly correlated with the salivary viscosity and flow rate. PMID:11000387

  20. Vitamin A deficiency and attributable mortality among under-5-year-olds.

    PubMed Central

    Humphrey, J. H.; West, K. P.; Sommer, A.

    1992-01-01

    Reported are estimates of the prevalence in developing countries of physiologically significant vitamin A deficiency and the number of attributable deaths. The WHO classification of countries by the severity and extent of xerophthalmia was used to categorize developing countries by likely risk of subclinical vitamin A deficiency. Using vital statistics compiled by UNICEF, we derived population figures and mortality rates for under-5-year-olds. The findings of vitamin A supplementation trials were applied to populations at-risk of endemic vitamin A deficiency to estimate the potential impact of improved vitamin A nutriture in reducing mortality during preschool years. Worldwide, over 124 million children are estimated to be vitamin A deficient. Improved vitamin A nutriture would be expected to prevent approximately 1-2 million deaths annually among children aged 1-4 years. An additional 0.25-0.5 million deaths may be averted if improved vitamin A nutriture can be achieved during the latter half of infancy. Improved vitamin A nutriture alone could prevent 1.3-2.5 million of the nearly 8 million late infancy and preschool-age child deaths that occur each year in the highest-risk developing countries. PMID:1600583

  1. Continuous improvement of arterial compliance beyond blood pressure decrease after 5 years of antihypertensive treatment.

    PubMed

    Bellido, Claudio A; Iavicoli, Oscar R; Rusak, Eduardo J; Vazquez, Sonia T; Piñeiro, Daniel J; Lerman, Jorge

    2006-08-01

    Pulse wave velocity is a reliable marker of arterial compliance. Stiffness of large and elastic arteries leads to a faster propagation of pulse wave. The aim of this study was to evaluate changes in arterial distensibility using antihypertensive drugs. This treatment focused on the inhibition of the renin-angiotensin-aldosterone system and the changes produced in blood pressure. Measurements were taken at baseline and throughout 60 months in 66 previously untreated hypertensive patients (22 men and 44 women, aged 54 +/- 9.5 years, range 38-73 years at baseline). All patients received either angiotensin-converting enzyme inhibitors or, in case of adverse effects, angiotensin receptor blockers. To control blood pressure, diuretics, calcium channel blocking agents, or beta blockers were added when appropriate. Statistical analysis was performed by means of ANOVA with alpha = 0.05. Systolic and diastolic blood pressure decreased during the first year without significant changes thereafter. There were no significant changes in pulse pressure. Pulse wave velocity showed a continuous and significant decrease throughout the follow-up period, but its reduction since the third year was more evident than the decrease in systolic and diastolic blood pressure (p < 0.0001 for both). This observation could be related to changes in arterial remodeling probably due to angiotensin-converting enzyme inhibition or renin angiotensin system blockade. Further investigations are needed to establish this relationship. PMID:16896271

  2. DRAWING SKILLS IN CHILDREN WITH NEURODEVELOPMENTAL DELAY AGED 2-5 YEARS.

    PubMed

    Morović, Maja Lang; Matijević, Valentina; Divljaković, Kristina; Kraljević, Marija; Dimić, Zdenka

    2015-06-01

    In typically developing children, drawing development occurs in stages from uncontrolled strokes to complex drawing. In this study, we examined drawing development in children with neurodevelopmental delay (NDD). In order to do so, we observed the influence of age, intraventricular hemorrhage (IVH) and gender on the development of drawing skills. The sample consisted of 52 children with NDD, aged 2 years and 6 months to 5 years. All children were hospitalized for multidisciplinary team monitoring and developmental support. The evaluation of drawing development was administered by giving each child a blank A4 paper and the instruction to draw anything they wanted. All of the drawings were scored satisfactory or unsatisfactory. Descriptive statistics was employed on all relevant data to show results in frequencies and percentages. In order to determine differences between groups, the χ2-test was administered. The results showed greatest difference in drawing in children aged from 3 years to 3 years and 11 months. Children with lower IVH had better drawing scores than children with higher IVH levels. According to gender dissimilarities, a difference was found showing girls to have better drawing skills than boys. All study results pointed to the importance of early rehabilitation and continuous structured work with children with NDD. PMID:26415307

  3. A 2-year longitudinal nutritional survey of 405 Northumberland children initially aged 11.5 years.

    PubMed

    Hackett, A F; Rugg-Gunn, A J; Appleton, D R; Eastoe, J E; Jenkins, G N

    1984-01-01

    Children (405), initially of average age 11.5 years, recorded all food and drinks consumed for three consecutive days (with an interview on the fourth day) on five separate occasions over a 2-year period. Food tables (Paul & Southgate, 1978) enabled nutrient intakes to be calculated. The data collected were found to be of high reliability (Hackett et al. 1983). The mean energy intakes showed broad agreement with other recent British dietary surveys but were well below those recorded in the prewar study by Widdowson (1947) and the FAO/WHO (1973) recommended levels. They were slightly below the current Department of Health and Social Security (DHSS; 1979) recommended intakes. Over the 2-year period, the energy intake of the boys increased by 13% compared with an increase of only 7% in the girls. The iron and vitamin A intakes of all groups of children were low compared with current recommendations (DHSS, 1979). This seems to be a result of falling energy intake. Mean calcium intakes were also only marginally in excess of the recommended intake, and those of most of the girls would fall below the recommendation if the proposal to end the fortification of flour (DHSS, 1981) is implemented. PMID:6317011

  4. Procedural Metacognition and False Belief Understanding in 3- to 5-Year-Old Children

    PubMed Central

    Bernard, Stéphane; Proust, Joëlle; Clément, Fabrice

    2015-01-01

    Some studies, so far limited in number, suggest the existence of procedural metacognition in young children, that is, the practical capacity to monitor and control one’s own cognitive activity in a given task. The link between procedural metacognition and false belief understanding is currently under theoretical discussion. If data with primates seem to indicate that procedural metacognition and false belief understanding are not related, no study in developmental psychology has investigated this relation in young children. The present paper aims, first, to supplement the findings concerning young children’s abilities to monitor and control their uncertainty (procedural metacognition) and, second, to explore the relation between procedural metacognition and false belief understanding. To examine this, 82 3- to 5-year-old children were presented with an opt-out task and with 3 false belief tasks. Results show that children can rely on procedural metacognition to evaluate their perceptual access to information, and that success in false belief tasks does not seem related to success in the task we used to evaluate procedural metacognition. These results are coherent with a procedural view of metacognition, and are discussed in the light of recent data from primatology and developmental psychology. PMID:26517260

  5. Measurement of primordial non-Gaussianity using the WMAP 5-year temperature skewness power spectrum

    SciTech Connect

    Smidt, Joseph; Amblard, Alexandre; Serra, Paolo; Cooray, Asantha

    2009-12-15

    We constrain the primordial non-Gaussianity parameter of the local model f{sub NL} using the skewness power spectrum associated with the two-to-one cumulant correlator of cosmic microwave background temperature anisotropies. This bispectrum-related power spectrum was constructed after weighting the temperature map with the appropriate window functions to form an estimator that probes the multipolar dependence of the underlying bispectrum associated with the primordial non-Gaussianity. We also estimate a separate skewness power spectrum sensitive more strongly to unresolved point sources. When compared to previous attempts at measuring the primordial non-Gaussianity with WMAP data, our estimators have the main advantage that we do not collapse information to a single number. When model fitting the two-to-one skewness power spectrum, we make use of bispectra generated by the primordial non-Gaussianity, radio point sources, and lensing-secondary correlation. We analyze Q, V, and W-band WMAP 5-year data using the KQ75 mask out to l{sub max}=600. Using V and W-band data and marginalizing over model parameters related to point sources and lensing-secondary bispectrum, our overall and preferred constraint on f{sub NL} is 11.0{+-}23.7 at the 68% confidence level (-36.4

  6. EFFECTS OF PRENATAL METHAMPHETAMINE EXPOSURE ON BEHAVIORAL AND COGNITIVE FINDINGS AT 7.5 YEARS

    PubMed Central

    Diaz, Sabrina D.; Smith, Lynne M.; LaGasse, Linda L.; Derauf, Chris; Newman, Elana; Shah, Rizwan; Arria, Amelia; Huestis, Marilyn A.; Grotta, Sheri Della; Dansereau, Lynne M.; Neal, Charles; Lester, Barry M.

    2014-01-01

    Objective To examine child behavioral and cognitive outcomes after prenatal exposure to methamphetamine. Study design 412 mother-infant pairs (204 methamphetamine-exposed and 208 unexposed matched comparisons) were enrolled in the Infant Development, Environment and Lifestyle (IDEAL) study. The 151 children exposed to methamphetamine and 147 comparisons who attended the 7.5 year visit were included. Exposure was determined by maternal self-report and/or positive meconium toxicology. Maternal interviews assessed behavioral and cognitive outcomes using the Conner’s Parent Rating Scale – Revised: Short Form (CPRS-R:S). Results After adjusting for covariates, children exposed to methamphetamine had significantly higher cognitive problems subscale scores than comparisons and were 2.8 times more likely to have cognitive problems scores that were above average on the CPRS-R:S No association between prenatal methamphetamine exposure and behavioral problems, measured by the oppositional, hyperactivity and ADHD Index subscales, were found. Conclusion Prenatal methamphetamine exposure was associated with increased cognitive problems which may impact academic achievement and lead to increased negative behavioral outcomes. PMID:24630350

  7. Characterization of corrosion products from atmospheric exposures for up to 5 years

    SciTech Connect

    Hernandez, L.S.; Miranda, J.M.; Narvaez, L.; Garcia, G.

    1998-12-31

    Four metallic materials of economic significance were exposed to an urban atmosphere up to five years. These materials were low carbon steel, zinc (as galvanized steel), copper and aluminum all of commercial quality. The corrosion rate was measured after 1, 2, 3 and 5 years using a weight loss method. Sulfur dioxide deposition rate and climatological parameters were determined monthly. At the same time, different techniques were used to characterize the corrosion products developed on the above materials. Results obtained by polarization resistance technique (Rp) in a 0.1 M Na{sub 2}SO{sub 4} solution revealed that, the longer the exposure time, the greater the corrosion products protection, as result of broadening and compactness of such products, this was verified by scanning electron microscopy (SEM). Through x-rays diffraction (XRD), the expected crystalline compounds on steel and copper were identified and also, the transformation of middling protective initial products into other more protective was followed. For aluminum and zinc it was not possible to identify the crystalline compounds perhaps due to the very thin corrosion products layers. So, these materials were analyzed by means of Raman spectroscopy. a-Al{sub 2}O, was identified on an aluminum sample whereas on zinc any corrosion product could not be identified due to excessive fluorescence.

  8. Growth of tumor-infiltrating lymphocytes from human solid cancers: summary of a 5-year experience.

    PubMed

    Yannelli, J R; Hyatt, C; McConnell, S; Hines, K; Jacknin, L; Parker, L; Sanders, M; Rosenberg, S A

    1996-02-01

    Between 1989 and 1993, 255 tumor biopsies representing 4 tumor histologies (melanoma, breast cancer, colon cancer and renal cell cancer) were received by the Surgery Branch of the National Cancer Institute. Tumor-infiltrating lymphocytes (TIL) were grown from single-cell suspensions of tumor biopsies over the course of 30-45 days. The TIL were grown in medium containing IL-2. To obtain numbers suitable for therapy (>10(11)), TIL were expanded using a large-scale system of cell culture and harvesting. While the largest number of biopsies was obtained from melanoma patients, TIL were successfully grown from 160 of 255 tumor biopsies representing all 4 histologies. Under the culture conditions employed, several characteristics of TIL expansion were observed. The cell surface phenotype of TIL which grew out from the tumor biopsies was generally a mix of CD3+/CD4+ or CD3+/CD8+ lymphocytes. Only TIL from melanoma biopsies were found to be consistently cytolytic and, in many cases, lysed autologous tumor cells preferentially. Interestingly, TIL derived from extra-nodal sites of metastatic melanoma biopsies (subcutaneous, lung, bowel; 36 of 67, 54%) were more likely to have these cytolytic characteristics than TIL derived from tumor-involved lymph node biopsies (7 of 39, 18%). The present study summarizes 5 years of laboratory effort and validates the technologies developed for the large-scale growth and harvesting of TIL. In addition, it summarizes the laboratory effort supporting previously published clinical reports on TIL from our group. PMID:8621219

  9. Municipal solid waste management in Tehran: Changes during the last 5 years.

    PubMed

    Malmir, Tahereh; Tojo, Yasumasa

    2016-05-01

    The situation of waste management in Tehran was a typical example of it in developing countries. The amount of municipal solid waste has been increasing and the city has depended on landfill for municipal solid waste management. However, in recent years, various measures have been taken by the city, such as collecting recyclables at the source and increasing the capacity of waste-processing facilities. As a result, significant changes in the waste stream are starting to occur. This study investigated the nature of, and reasons for, the marked changes in the waste stream from 2008 to 2012 by analysing the municipal solid waste statistics published by the Tehran Waste Management Organization in 2013 and survey data on the physical composition of the municipal solid waste. The following trends were identified: Although the generation of municipal solid waste increased by 10% during the 5-year period, the amount of waste directly disposed of to landfill halved and resource recovery almost doubled. An increase in the capacity of a waste-processing facility contributed significantly to these changes. The biodegradable fraction going to landfill was estimated by using the quantity and the composition of each input to the landfill. The estimated result in 2012 decreased to 49% of its value in 2008. PMID:26922086

  10. Results of proximal gastric vagotomy over 1-5 years in a district general hospital.

    PubMed

    Makey, D A; Tovey, F I; Heald, R J

    1979-01-01

    One hundred and seventy-three underwent proximal gastric vagotomy for duodenal ulceration over a 6-year period. One hundred and fifteen of these have been followed up for 1-5 years. The operative mortality was nil and the result was satisfactory in 91 per cent. The incidence of side effects was small, notably that of dumping being 2.4 per cent and of diarrhoea, 3.6 per cent. Incidence of postoperative heartburn was reduced from 13 per cent to 4 per cent by the introduction of hepatic interposition. The incidence of recurrent ulceration was 5.1 per cent after an average interval of 2 years and that of new gastric ulceration 2.6 per cent after an average of 4 years. There were no recurrent ulcers in those who had peroperative Burge tests, although secretory studies showed no difference between those tested and those not tested. Most recurrences occurred in the earliest cases operated on before Burge testing was introduced and when only 2 cm of the lower oesophagus were exposed. PMID:420970

  11. Dimensionality and Reliability of Letter Writing in 3- to 5-Year-Old Preschool Children

    PubMed Central

    Puranik, Cynthia S.; Petscher, Yaacov; Lonigan, Christopher J.

    2015-01-01

    The primary purpose of this study was to examine the dimensionality and reliability of letter writing skills in preschool children with the aim of determining whether a sequence existed in how children learn to write the letters of the alphabet. Additionally, we examined gender differences in the development of letter writing skills. 471 children aged 3 to 5 years old completed a letter writing task. Results from factor analyses indicated that letter writing represented a unidimensional skill. Similar to research findings that the development of letter-names and letter-sound knowledge varies in acquisition, our findings indicate that the ability to write some letters is acquired earlier than the ability to write other letters. Although there appears to be an approximate sequence for the easiest and most difficult letters, there appears to be a less clear sequence for letters in the middle stages of development. Overall, girls had higher letter writing scores compared to boys. Gender differences regarding difficulty writing specific letters was less conclusive; however, results indicated that when controlling for ability level, girls had a higher probability of writing a letter correctly than boys. Implications of these findings for the assessment and instruction of letter writing are discussed. PMID:26346443

  12. The South American Land Data Assimilation System (SALDAS) 5-Year Retrospective Atmospheric Forcing Datasets

    NASA Technical Reports Server (NTRS)

    deGoncalves, Luis Gustavo G.; Shuttleworth, William J.; Vila, Daniel; Larroza, Elaine; Bottino, Marcus J.; Herdies, Dirceu L.; Aravequia, Jose A.; De Mattos, Joao G. Z.; Toll, David L.; Rodell, Matthew; Houser, Paul

    2008-01-01

    The definition and derivation of a 5-year, 0.125deg, 3-hourly atmospheric forcing dataset for the South America continent is described which is appropriate for use in a Land Data Assimilation System and which, because of the limited surface observational networks available in this region, uses remotely sensed data merged with surface observations as the basis for the precipitation and downward shortwave radiation fields. The quality of this data set is evaluated against available surface observations. There are regional difference in the biases for all variables in the dataset, with biases in precipitation of the order 0-1 mm/day and RMSE of 5-15 mm/day, biases in surface solar radiation of the order 10 W/sq m and RMSE of 20 W/sq m, positive biases in temperature typically between 0 and 4 K, depending on region, and positive biases in specific humidity around 2-3 g/Kg in tropical regions and negative biases around 1-2 g/Kg further south.

  13. The results of photorefractive keratectomy with Mitomycin-C in myopia correction after 5 years

    PubMed Central

    Hashemi, Masih; Amiri, Mohammad Aghazadeh; Tabatabaee, Mehdi; Ayatollahi, Ali

    2016-01-01

    Objective: To evaluate the results of photorefractive keratectomy (PRK) with mitomycin C in myopia correction after five years. Methods: This is a cross sectional study which included 145 eyes of 74 patients in 18 to 51 years age group that were undergoing Photorefractive keratectomy with mitomycin C using Allegretto Wave Eye-Q 400-Hz excimer laser platform in Markazi Eye Center, Tehran, Iran. All the surgical procedures were performed by the same surgeon. After five years follow-up evaluation including BCVA, UCVA, Refractive error measurement and external eye examination was performed. Results: The mean diopter of spherical equivalent before surgery was -3.40±1.73. The following findings were obtained after 5 years follow up visit: The mean spherical equivalent value: -0.08±0.40, the mean: Log MARUCVA: 0.02±0.07, the mean Log MAR BCVA: 0.00±0.04. Conclusion: PRK is an effective, safe and predictable method used to correct myopia. The wave front-optimized algorithm of the Allegretto Wave Eye-Q 400-Hz excimer laser platform demonstrated good refractive and visual results. Presence of variables such as gender, age and astigmatism before operation have no significant impact on the result of this operation. PMID:27022380

  14. LC-MS/MS in endocrinology: what is the profit of the last 5 years?

    PubMed

    Ackermans, Mariëtte Theodora; Endert, Erik

    2014-01-01

    Currently, chromatography (GC but more commonly HPLC) is the analytical method of choice for several hormones, either because the immunoassays suffer from extensive crossreactivity or because chromatography permits simultaneous measurements of hormones. However, sometimes the conventional detection systems with HPLC methods do not meet desired specificity. With the increase of robust and affordable LC-MS/MS systems, the next step forward in specificity was taken. LC-MS/MS is rapidly being incorporated in the endocrine laboratories. To be useful in the clinical diagnostic practice, it is of utmost importance that methods are both analytically and clinically vaidated, as until now, the majority of applications of LC-MS/MS in the clinical laboratories are 'home-made' methods, therefore special case must be taken. This review aims to focus on Clinical and Laboratory Standards Institute or comparable validated LC-MS/MS methods for targeted hormone analysis used for diagnostic purposes in human samples, published in the last 5 years. PMID:24341494

  15. Facebook as a medium for promoting statement of intent for organ donation: 5-years of experience.

    PubMed

    Brzeziński, Michał; Klikowicz, Paweł

    2015-01-01

    The number of potential registered organ donors does not cover the actual demand in most developed countries. Therefore, methods increasing awareness and interest in organ donation, including modern tools of social marketing, are being researched worldwide. The aim of this paper is to present our 5-year experiences with a Facebook networking campaign - the Dawca.pl Club. The mission of the campaign is to raise awareness and educate Polish society on tissue, cell, and organ transplants, to increase public acceptance for transplants as a treatment method, and to increase the number of voluntary donors signing consents for organ donation. The project is based on the idea of creating a community promoting transplantation, focused around the Dawca.pl Club. At present the club has over 48,000 registered members - people who declared willingness to donate their organs after death. We present a description of members of this social networking service, the possibilities of using it to promote transplants and organ donation, and the efficacy of selected schemes for creating and publishing content on Facebook. The example of Dawca.pl shows that 2-way relations, spread over time, are required for social media to effectively engage and exert influence in a chosen sphere of public health and medicine. Unfortunately, at this time it is difficult to assess how such campaigns, apart from raising social awareness and acceptance, will affect the number of transplantations of organs from living and deceased donors. PMID:25761524

  16. Bachelor of Midwifery: reflections on the first 5 years from two Victorian universities.

    PubMed

    McKenna, Lisa; Rolls, Colleen

    2007-06-01

    Bachelor of Midwifery programs in the state of Victoria, Australia commenced in 2002 through an affiliation of three universities in Melbourne named the 'Werna Naloo Bachelor of Midwifery consortium'. The approach allowed for collaborative synergies in program delivery through offering online 'consortium' units each semester in addition to on-campus content at each university. It is now 5 years since the first cohort of students commenced the course. During those years, members of the consortium have experienced a range of challenges and tensions. This paper provides a reflection by the course coordinators from two remaining members of the consortium, Australian Catholic University and Monash University. It explores issues confronted, regulation and registration, educational and clinical practice issues. In addition, the authors discuss course outcomes in terms of employment of graduates and their integration into the workforce, career development pathways and demand for the course. The authors conclude that the consortium has been successful and course outcomes positive with graduates successful in securing employment. Overall, the future for the Bachelor of Midwifery at both universities appears positive. PMID:17499037

  17. The use of modern quality improvement approaches to strengthen African health systems: a 5-year agenda.

    PubMed

    Heiby, James

    2014-04-01

    There is a growing international consensus that African health systems need to improve, but no agreement on how to accomplish this. From the perspective of modern quality improvement (QI), a central issue for low performance in these health systems is the relative neglect of health-care processes. Both health system leaders and international donors have focused their efforts elsewhere, producing noteworthy health gains. But these gains are at risk if health systems do not develop the capacity to study and improve care processes. Substantial experience with QI in Africa shows impressive potential for broad-based process improvement. But this experience also highlights the need for modifying these growing programs to incorporate a more rigorous learning component to address challenges that have emerged recently. The addition of a region-wide knowledge management program could increase the efficiency of each country's QI program by learning from the experiences of other programs. With a coordinated donor initiative, it is reasonable to project that within 5 years, evidence-based improvement will become a norm in health services, and African health systems will approach the model of a learning organization. PMID:24481053

  18. Residual strength of repaired graphite/epoxy laminates after 5 years of outdoor exposure

    NASA Technical Reports Server (NTRS)

    Deaton, Jerry W.

    1990-01-01

    The NASA Langley Research Center has sponsored research to develop generic repair techniques and processes for advanced graphite/epoxy (Gr/Ep) composites applicable to secondary structures for commercial transport aircraft. The long-term durability of such repairs is being addressed in a 10-year outdoor exposure program at the Langley Research Center. Details of the program and results of residual strength tests after 5 years of outdoor exposure are presented. Four repair methods are being evaluated. These include: (1) externally bolted aluminum-plus adhesive; (2) precured, bonded external Gr/Ep; (3) cure-in-place external Gr/Ep; and (4) cure-in-place flush Gr/Ep. Repaired specimens as well as undamaged and damaged unrepaired controls are being exposed outdoors for 1, 3, 5, 7, and 10 years. The residual tensile strength of stressed, unstressed, and fatigue specimens from each group is reported and compared with the tensile strength of baseline specimens which received no outdoor exposure. Identification of the commercial products and companies is used to describe adequately the test materials. The identification of these commercial products does not constitute endorsement, expressed or implied, of such products by the National Aeronautics and Space Administration.

  19. Improving executive function in childhood: evaluation of a training intervention for 5-year-old children.

    PubMed

    Traverso, Laura; Viterbori, Paola; Usai, Maria Carmen

    2015-01-01

    Executive function (EF) refers to a set of higher order cognitive processes that control and modulate cognition under continuously changing and multiple task demands. EF plays a central role in early childhood, is associated and predictive of important cognitive achievements and has been recognized as a significant aspect of school readiness. This study examines the efficacy of a group based intervention for 5-year-old children that focuses on basic components of EF (working memory, inhibitory control, cognitive flexibility). The intervention included 12 sessions, lasted 1 month and used low-cost materials. Seventy-five children took part in the study. The results indicate that the children who attended the intervention outperformed controls in simple and more complex EF tasks. Specifically, these children exhibited increased abilities to delay gratification, to control on-going responses, to process and update information, and to manage high cognitive conflict. These results suggest the possibility that this intervention, which may be easily implemented in educational services, can promote EF during preschool period before the entrance in primary school. PMID:25983706

  20. Diarrhea Prevalence, Care, and Risk Factors Among Poor Children Under 5 Years of Age in Mesoamerica.

    PubMed

    Colombara, Danny V; Hernández, Bernardo; McNellan, Claire R; Desai, Sima S; Gagnier, Marielle C; Haakenstad, Annie; Johanns, Casey; Palmisano, Erin B; Ríos-Zertuche, Diego; Schaefer, Alexandra; Zúñiga-Brenes, Paola; Zyznieuski, Nicholas; Iriarte, Emma; Mokdad, Ali H

    2016-03-01

    Care practices and risk factors for diarrhea among impoverished communities across Mesoamerica are unknown. Using Salud Mesoamérica Initiative baseline data, collected 2011-2013, we assessed the prevalence of diarrhea, adherence to evidence-based treatment guidelines, and potential diarrhea correlates in poor and indigenous communities across Mesoamerica. This study surveyed 14,500 children under 5 years of age in poor areas of El Salvador, Guatemala, Mexico (Chiapas State), Nicaragua, and Panama. We compared diarrhea prevalence and treatment modalities using χ(2) tests and used multivariable Poisson regression models to calculate adjusted risk ratios (aRRs) and 95% confidence intervals (CIs) for potential correlates of diarrhea. The 2-week point prevalence of diarrhea was 13% overall, with significant differences between countries (P < 0.05). Approximately one-third of diarrheal children were given oral rehydration solution and less than 3% were given zinc. Approximately 18% were given much less to drink than usual or nothing to drink at all. Antimotility medication was given to 17% of diarrheal children, while antibiotics were inappropriately given to 36%. In a multivariable regression model, compared with children 0-5 months, those 6-23 months had a 49% increased risk for diarrhea (aRR = 1.49, 95% CI = 1.15, 1.95). Our results call for programs to examine and remedy low adherence to evidence-based treatment guidelines. PMID:26787152

  1. ‘Workshops in healing’ for senior medical students: a 5-year overview and appraisal

    PubMed Central

    Kearsley, John H; Lobb, Elizabeth A

    2014-01-01

    We report upon the design, content and feedback from an interactive, experiential series of Workshops in Healing for senior medical students. Fifty-six final year medical students enrolled in 2×3 h workshops designed around the core themes of ‘physician know thyself’ (Workshop 1) and ‘confronting suffering’ (Workshop 2). Of the 56 students who initially enrolled, 48 students completed both workshops and provided a written open-ended reflection of their learning experience. The study, undertaken over a consecutive 5-year period (2008–2012), employed an emergent, qualitative design using thematic analysis of the reflective comments. We found that the design and content of both workshops promoted transformative learning for these final year medical students. Students identified the following benefits: (1) the opportunity to reaffirm their commitment to their chosen career path; (2) the value of listening to other students share their stories; (3) the importance of the timing of the workshops to occur after exams; (4) the use of various mediums such as art, poetry, music and contemporary/classic literature to present concepts of suffering and healing; and (5) the creation of a safe and confidential space. Students reported that these innovative workshops gave them a renewed sense of drive and enthusiasm for their chosen career. They highlighted the importance of addressing an aspect of medicine (healing) not covered in the traditional medical curriculum. Workshops in Healing helped them to rediscover a deeper meaning to medicine and their roles as future healthcare professionals. PMID:24473159

  2. Caustic Agent Ingestion by a 1.5-Year-Old Boy.

    PubMed

    Gharib, Behdad; Mohammadpour, Masoud; Yaghmaie, Bahareh; Sharifzadeh, Meisam; Mehdizadeh, Mehrzad; Zamani, Fatemeh; Edalatkhah, Rouhollah; Mohsenipour, Reihaneh

    2016-07-01

    We present a case of caustic ingestion by a 1.5-year-old boy. The caustic agent was drain opener which is a strong alkaline substance. Children in Iran and many other countries are still exposed to not "child proof" (child resistant packaging) toxic substance containers. Ingestion of caustic agents may lead to necrosis, perforation, and strictures. Substances that are ingested more frequently are liquid alkali material which causes severe, deep liquefaction necrosis. Common signs and symptoms of caustic agents are vomiting, drooling, refusal to drink, oral burns, stridor, hematemesis, dyspnea, dysphagia and abdominal pain. Even if no oropharyngeal lesion is seen, a significant esophageal injury which can lead to perforation and stricture cannot be ruled out. If abdominal pain or rigidity, substernal, chest or back pain exists, visceral perforation should be considered. The first thing to be checked is airway assessment. A lot of patients should be admitted to intensive care unit, and endoscopic evaluation, surgical intervention, long-term hospitalization, and worsening quality of life or among the complications. Preventive measures especially at the country level and approving proper legislation for obligating the related industries to produce child proof containers for house hold toxic products are the urgent measures to be followed by all of us. PMID:27424019

  3. Epidemiology and mortality of burns in the Lucknow Region, India--a 5 year study.

    PubMed

    Kumar, Sachil; Ali, Wahid; Verma, Anoop K; Pandey, Abhishek; Rathore, Shiuli

    2013-12-01

    Nearly 95% of global burn deaths and disabilities are estimated to occur in low and middle income countries of the world. Burns are extremely common and are a major public health problem in a developing country like India. The purpose of this study was to record and evaluate the causes and the magnitude of the fatal burns retrospectively. An analysis of autopsy records revealed 2225 (10.7%) cases of burns among the total autopsies done over 5 years period (1st January 2008-27th November 2012) in the mortuary of Forensic Medicine & Toxicology, K.G.M.U., Lucknow. The majority of deaths (88.8%) occurred between 10 and 49 years of age group with a preponderance of females (87.5%). The flame burns were seen in 60.1% of the victims. The majority of burn incidents were suicidal (38.6%) in nature followed by accidental (37.3%) and homicidal (24.1%) deaths. The percentages of burns with a total body surface area (TBSA) over 50% were observed in most of the cases (82.5%). In most of the cases deaths occurred within a week (82%) and most of the victims died from septicaemia and pneumonia (43.7%) followed by neurogenic shock (28.5%). The results of this study provide the necessary information to implement programmes for health education relating to prevention of burns focusing on the domestic setting. PMID:23663899

  4. A 5-year follow-up study of an atypical case of myotonic dystrophy.

    PubMed

    Macniven, J A B; Graham, N L; Davies, R R; Wilson, B A

    2005-12-20

    This study presents 5-year follow-up data on NG, a woman with adult onset myotonic dystrophy and progressive cognitive decline who was first described by Wilson et al. The extent of the cognitive impairment is atypical of symptom-onset in adulthood and of paternal inheritance, both of which apply to this case. Together, the present and earlier studies report the results of regular neuropsychological assessments over a 16-year period. Severe impairment in executive functioning, episodic and semantic memory were apparent early in the history, while visuospatial skills and working memory were only mildly impaired after 16 years of follow-up. There was also a progressive dyslexia, initially characterized by the regularization errors typical of surface dyslexia, but subsequently dominated by visual/phonological reading errors. This pattern of impairment is not typical of myotonic dystrophy but resembles semantic dementia. Whilst the deficits may be attributable wholly to myotonic dystrophy pathology, the co-existence of a form of semantic dementia is also possible. It is noted that the aggregation of tau protein is a neuropathological feature common to both diseases. PMID:16286337

  5. Friability and aggregate stability of loamy soil after 5 years of biochar application

    NASA Astrophysics Data System (ADS)

    Utomo, Wani; Ganika, Shaory; Wisnubroto, Erwin; Islami, Titiek

    2016-04-01

    The effect of biochar application on soil friability and aggregate stability of loamy soil was studied at Brawijaya University field experimental station, Jatikerto, Malang, Indonesia. The soil has been planted with cassava for 4 years continuously and 1 year planted with maiz. The biochar applied was made from cassava stem and farm yard manure. It was found that biochar application, either made from cassava stem or farm yard manure improved soil qualities. Soil applied with biochar was more friable compared to that of the no biochar soil, although biochar application did not influence Atterberg limits. It seems that the higher friability of biochar applied soil was associated with the higher soil organic matter. It was found that until 5 years application, the biochar treated soil had a higher soil organic matter content. Soil applied with biochar possessed a better soil aggregate stability, both dry and wet stability. This was shown by the higher aggregate mean weight diameter (MWD) of biochar applied soil. The cassava biochar applied soil had MWD of 2.22 mm (dry stability) and 1.56 mm (wet stability), whereas the control soil had MWD of 1.45 mm (dry stability) and 1.25 (wet stability). There was a significant positive correlation between soil friability and dry aggregate stability. The biochar applied soils also had higher soil permeability. Key words: soil qualities, soil physical properties, Atterberg limits, hydraulic conductivity

  6. Translating weight loss into agency: Men's experiences 5 years after bariatric surgery

    PubMed Central

    Natvik, Eli; Gjengedal, Eva; Moltu, Christian; Råheim, Målfrid

    2015-01-01

    Fewer men than women with severe obesity undergo bariatric surgery for weight loss, and knowledge about men's situation after surgery, beyond medical status, is lacking. Our aim was to explore men's experiences with life after bariatric surgery from a long-term perspective. We conducted in-depth interviews with 13 men, aged 28–60 years, between 5 and 7 years after surgery. The analysis was inspired by Giorgi's phenomenological method. We found that agency was pivotal for how the men understood themselves and their lives after surgery. Weight loss meant regaining opportunities for living and acting in unrestricted and independent daily lives, yet surgery remained a radical treatment with complex consequences. Turning to surgery had involved conceptualizing their own body size as illness, which the men had resisted doing for years. After surgery, the rapid and major weight loss and the feelings of being exhausted, weak, and helpless were intertwined. The profound intensity of the weight loss process took the men by surprise. Embodying weight loss and change involved an inevitable renegotiating of experiences connected to the large body. Having bariatric surgery was a long-term process that seemed unfinished 5 years after surgery. Restrictions and insecurity connected to health and illness persist, despite successful weight loss and embodied change. Bariatric surgery initiated a complex and long-lasting life-changing process, involving both increased capacity for agency and illness-like experiences. PMID:26066518

  7. METEO in the TALNET project after 5 years - meteorology for talented high schools students

    NASA Astrophysics Data System (ADS)

    Pisoft, P.; Miksovsky, J.

    2010-09-01

    TALNET is a project aiming to systematically identify and work with gifted youth (13-19 years). Specifically, it applies online educational activities combined with face to face activities. It has been organised by the Faculty of Maths and Physics (MFF) of Charles University in Prague (UK) and National Institute for Youth (NIDM) since 2003, later in cooperation with other faculties, e.g. Natural Sciences (PrF UK), universities and science and research institutes in the Czech Republic and abroad, e.g. DLR, Germany. Topics of the educational activities come from natural sciences (such as physics, astronomy, biology, chemistry, meteorology etc.) and mathematics. The presented project's part METEO embraces lessons primarily focused on basics of meteorology and atmospheric physics in general and it has been part of the Talnet project for 5 years. The meteorological lectures consist of description of, e.g., climate system, meteorological quantities, weather forecasting, ozone and the stratosphere, climate change or atmospheric optics. On top of the lectures, the students are encouraged to work on enclosed homework such as meteorological time series analysis, clouds observation and classification, halo simulation and so on. The METEO course lasts one semester and the students make their seminar thesis at the end. The presented materials will consist of examples of the contemporary lectures and their organization, homeworks or seminar theses.

  8. Recurrent pretibial ganglion cyst formation over 5 years after anterior cruciate ligament reconstruction.

    PubMed

    Sekiya, Jon K; Elkousy, Hussein A; Fu, Freddie H

    2004-03-01

    Although ganglion cysts of the anterior cruciate ligament have been described in the literature, they are a relatively rare phenomenon. Cyst formation after anterior cruciate ligament reconstruction is even less frequent, with only a few reported cases. The proposed etiology of these cysts has been attributed to a number of causes, including the use of bioabsorbable screws, Gore-Tex (W. L. Gore and Associates, Flagstaff, AZ) grafts, extra-articular fluid extravasation secondary to direct tibial tunnel communication, allografts with or without ethylene oxide sterilization, and the use of nonabsorbable suture. We report an unusual case of a recurrent pretibial ganglion cyst that initially formed more than 5 years after an anterior cruciate ligament reconstruction and recurred 2 years after resection of the mass. We believe the initial surgical resection was unsuccessful probably because the foreign body irritant was not identified. Only after resection of the entire stalk of the cyst and removal of all of the inciting suture material that was found near the entrance of the tibial tunnel were we able to definitively eradicate the ganglion cyst. PMID:15007323

  9. Towson University's Professional Science Master's Program in Applied Physics: The first 5 years

    NASA Astrophysics Data System (ADS)

    Kolagani, Rajeswari

    It is a well-established fact that the scientific knowledge and skills acquired in the process of obtaining a degree in physics meet the needs of a variety of positions in multiple science and technology sectors. However, in addition to scientific competence, challenging careers often call for skills in advanced communication, leadership and team functions. The professional science master's degree, which has been nick-named as the `Science MBA', aims at providing science graduates an edge both in terms of employability and earning levels by imparting such skills. Our Professional Science Master's Program in Applied Physics is designed to develop these `plus' skills through multiple avenues. In addition to advanced courses in Applied Physics, the curriculum includes graduate courses in project management, business and technical writing, together with research and internship components. I will discuss our experience and lessons learned over the 5 years since the inception of the program in 2010. The author acknowledges support from the Elkins Professorship of the University System of Maryland.

  10. 'Workshops in healing' for senior medical students: a 5-year overview and appraisal.

    PubMed

    Kearsley, John H; Lobb, Elizabeth A

    2014-12-01

    We report upon the design, content and feedback from an interactive, experiential series of Workshops in Healing for senior medical students. Fifty-six final year medical students enrolled in 2×3 h workshops designed around the core themes of 'physician know thyself' (Workshop 1) and 'confronting suffering' (Workshop 2). Of the 56 students who initially enrolled, 48 students completed both workshops and provided a written open-ended reflection of their learning experience. The study, undertaken over a consecutive 5-year period (2008-2012), employed an emergent, qualitative design using thematic analysis of the reflective comments. We found that the design and content of both workshops promoted transformative learning for these final year medical students. Students identified the following benefits: (1) the opportunity to reaffirm their commitment to their chosen career path; (2) the value of listening to other students share their stories; (3) the importance of the timing of the workshops to occur after exams; (4) the use of various mediums such as art, poetry, music and contemporary/classic literature to present concepts of suffering and healing; and (5) the creation of a safe and confidential space. Students reported that these innovative workshops gave them a renewed sense of drive and enthusiasm for their chosen career. They highlighted the importance of addressing an aspect of medicine (healing) not covered in the traditional medical curriculum. Workshops in Healing helped them to rediscover a deeper meaning to medicine and their roles as future healthcare professionals. PMID:24473159

  11. French brain tumor database: 5-year histological results on 25 756 cases.

    PubMed

    Rigau, Valérie; Zouaoui, Sonia; Mathieu-Daudé, Hélène; Darlix, Amélie; Maran, Aurélie; Trétarre, Brigitte; Bessaoud, Faiza; Bauchet, Fabienne; Attaoua, Redha; Fabbro-Peray, Pascale; Fabbro, Michel; Kerr, Christine; Taillandier, Luc; Duffau, Hugues; Figarella-Branger, Dominique; Costes, Valérie; Bauchet, Luc

    2011-11-01

    This work aimed to prospectively record all primary central nervous system tumor (PCNST) cases in France, for which histological diagnosis is available. The objectives were to (i) create a national registry and a network to perform epidemiological studies; (ii) implement clinical and basic research protocols; and (iii) harmonize the health care of patients affected by PCNST. For 5 years, 25 756 cases of newly diagnosed and histologically confirmed PCNST have been recorded. Histological diagnoses included glioma (48.9%), all other neuroepithelial tumors (5%), meningioma (28.8%), nerve sheath tumors (8.4%), lymphoma (3.2%) and others (5.7%). Cryopreservation was reported for 6018 PCNST specimens. Tumor resections (R) were performed in 78% cases, while biopsies accounted for 22%. Median age (MA), sex, percentage R and number of cryopreserved tumors were detailed for each histology; for example, out of 6053 glioblastomas (MA 63 years, male 59.4%, R 62%, 1611 were cryopreserved), and out of 37 atypical teratoid/rhabdoid tumors (MA 2 years, male 56.8%, R 94%, 17 were cryopreserved). This database or databank dedicated to PCNST cases contains detailed data on clinical, histological and other characteristics, such as the inclusion of data on cryopreserved specimens that are not available in other European registries. Therefore, this is a valuable resource that can be used for planning future epidemiological and clinical research. PMID:21554472

  12. Research from the Model Spinal Cord Injury Systems: findings from the current 5-year grant cycle.

    PubMed

    Lammertse, Daniel P; Jackson, Amie B; Sipski, Marca L

    2004-11-01

    This issue of the Archives of Physical Medicine and Rehabilitation is dedicated to current research findings of the Model Spinal Cord Injury Systems (MSCIS) program. The MSCIS grants were established by the Rehabilitation Services Administration in the 1970s. Now administered by the National Institute on Disability and Rehabilitation Research within the Office of Special Education and Rehabilitation Services in the US Department of Education, the program has included 27 spinal cord injury centers in the United States over the years. In the current 5-year grant cycle (2000-2005), there are 16 designated regional MSCIS centers. In addition to establishing a comprehensive system of care, the grantees contribute patient data to the National Spinal Cord Injury Database (which now contains data on 30,532 subjects with follow-up of up to 30 y). In addition, the MSCIS grants enable the conduct of site-specific and collaborative research projects. To highlight the research findings of the program, the MSCIS have produced a special dissemination effort during each of the previous 5 grant cycles, with this issue of the Archives representing the latest of these endeavors. This article provides a brief history of the MSCIS program and highlights the important findings of the 17 original research articles contained in this issue. PMID:15520967

  13. Bilateral, tumorlike diabetic mastopathy-progression and regression of the disease during 5-year follow up.

    PubMed

    Bayer, U; Horn, L C; Schulz, H G

    1998-02-01

    Diabetic mastopathy is a recently described collection of radiographical and histological features found in dense fibrous masses of the breast in long standing Type I diabetes. We describe the first case of bilateral disease with the alternate progression and regression of the disease over a 5 year period. A 45-year-old woman has been affected of insulin dependent diabetes mellitus (IDDM) for 21 years. She developed palpable mass retromamillar of the right side, indistinguishable radiographically from cancer. The histology showed a diabetic mastopathy (DMP) with B-lymphocytic ductitis and lobulitis, a discrete monocellular vasculitis and a keloid-like fibrosis. After 22 months she developed a suspicious palpable mass contralateral on the left side. The FNAB presented an identical morphology on histology. Additionally 10 months later there were no palpable masses of both mammae. Mammographically no suspect alterations were observed. One year later the clinical and mammographical examination showed similar findings, mentioned before. The pathogenesis is still obscure and includes the hypothesis of extracellular accumulation, secondary to prolonged hyperglycemia in IDDM, production of alternated non-enzymatic glycosylated end products with neoantigen formation, B cell predominant inflammation with autoimmune response against neoantigens and cytokine release secondary to the autoimmune response. PMID:9587750

  14. Improving executive function in childhood: evaluation of a training intervention for 5-year-old children

    PubMed Central

    Traverso, Laura; Viterbori, Paola; Usai, Maria Carmen

    2015-01-01

    Executive function (EF) refers to a set of higher order cognitive processes that control and modulate cognition under continuously changing and multiple task demands. EF plays a central role in early childhood, is associated and predictive of important cognitive achievements and has been recognized as a significant aspect of school readiness. This study examines the efficacy of a group based intervention for 5-year-old children that focuses on basic components of EF (working memory, inhibitory control, cognitive flexibility). The intervention included 12 sessions, lasted 1 month and used low-cost materials. Seventy-five children took part in the study. The results indicate that the children who attended the intervention outperformed controls in simple and more complex EF tasks. Specifically, these children exhibited increased abilities to delay gratification, to control on-going responses, to process and update information, and to manage high cognitive conflict. These results suggest the possibility that this intervention, which may be easily implemented in educational services, can promote EF during preschool period before the entrance in primary school. PMID:25983706

  15. Prenatal Drug Exposure: Effects on Cognitive Functioning at 5 Years of Age

    PubMed Central

    Pulsifer, Margaret B.; Butz, Arlene M.; Foran, Megan O’Reilly; Belcher, Harolyn M. E.

    2008-01-01

    The goal of this cross-sectional study was to compare cognitive functioning at age 5 years in prenatal drug-exposed children with nondrug-exposed children from a comparable inner-city environment. Children with prenatal drug exposure scored significantly lower on measures of language, school readiness skills, impulse control, and visual attention span/sequencing than controls matched for age and socioeconomic status. Intelligence, visual-motor, manual dexterity, and sustained attention scores were not significantly different between groups. The total sample scored significantly below the normative mean on standardized measures of intelligence, language, school readiness, visual-motor skills, impulse control, and sustained attention, with 40% scoring at least 1 standard deviation below the mean (IQ <85) on a measure of intelligence. Findings suggest that children with prenatal drug exposure are at increased risk for learning and attention problems and are in need of close developmental surveillance and possible intervention to support school success and improve behavioral outcome. PMID:17766581

  16. Socio-demographic and environmental determinants of infectious disease morbidity in children under 5 years in Ghana

    PubMed Central

    Amugsi, Dickson A.; Aborigo, Raymond A.; Oduro, Abraham R.; Asoala, Victor; Awine, Timothy; Amenga-Etego, Lucas

    2015-01-01

    Background Globally, diarrhoea and acute respiratory infections (ARIs) have been identified as major threats to child survival. In Ghana, the two conditions are among the top three causes of morbidity and mortality among children under 5 years. An in-depth analysis of the factors associated with these two diseases is warranted, because of their high degree of fatality and also it provides a basis for intervention planning. Objectives To investigate socio-demographic and environmental factors associated with infectious disease morbidity in children under 5 years old in Ghana. Design Population-based cross-sectional survey. The study sample comprised 2,790 children aged 0–59 months, drawn from the Ghana Demographic and Health Surveys. The mothers reported whether their children under age 5 had been ill with a cough accompanied by short, rapid breathing (ARI), or diarrhoea with the presence of blood or mucus in the stool, in the 2 weeks preceding the survey. Results Children in the 6–11, 12–23, and 24–59 months age groups had, respectively, 3.48 (95% CI=2.23, 5.44), 4.57 (95% CI=3.03, 6.90), and 1.93 (95% CI=1.30, 2.87) increased odds of getting diarrhoea infection compared to those in the youngest age category (0–5). Similarly, children in the 6–11, 12–23, and 24–59 months age brackets were, respectively, 2.64 (95% CI=1.76, 3.97), 2.63 (95% CI=1.81, 3.83), and 1.83 (95% CI=1.29, 2.59) times more likely to have cough compared to children in 0–5 months age brackets. Children who were not breastfeeding had higher odds of childhood diarrhoea (OR=1.33, 95% CI=1.03, 1.73) compared to those who were breastfeeding. Compared to children who were living in households without co-wives, children who were living in households with co-wives had 1.74 increased odds of diarrhoea (95% CI=1.33, 2.27). A unit increase in maternal opinion regarding wife beating was associated with 14% reduced odds of diarrhoea (OR=0.86, 95% CI=0.80, 0.91), while a unit change in the

  17. Five-year survival-after first-ever stroke.

    PubMed

    Smajlović, Dzevdet; Kojić, Biljana; Sinanović, Osman

    2006-08-01

    The aim of the study was to analyze the 5-year survival after first-ever ischemic stroke and intracerebral hemorrhage. In this study 836 patients were analyzed with a first-ever stroke admitted at the Department of Neurology Tuzla, Bosnia and Herzegovina, from January 1(st) 1997 to December 31(st) 1998. Of these 613 (73,3%) were ischemic strokes and 223 intracerebral hemorrhages (26,7%) Subarachnoid hemorrhages were excluded. After hospitalization surviving patients examined periodically, and a final examination was performed 5 years after the stroke. Overall, case-fatility at the first month was 36% (301/836) and the mortality rate was significantly higher in the patients with intracerebral hemorrhage (58,3% vs. 27,9%, p<0,0001). The first year survived 60% patients with ischemic stroke, and 38% with intracerebral hemorrhage. After 5 years, 188 (31%) patients with ischemic stroke and 53 (24%) with intracerebral hemorrhage were alive (p=0,5), and the cumulative survival rate for the entire study was 29%. Among 30-day survivors (n=535) surviving rate after 5 years was significantly higher in patients with intracerebral hemorrhage (57% vs. 42,5%, p=0,01). The survival rate was the highest for those 50 years and younger (57%), and the lowest for those aged over 70 years (9%). Predictors of 5-year mortality were older age and hypertension for both types of stroke, heart diseases for ischemic stroke and diabetes for intracerebral hemorrhage. Long-term survival after first-ever ischemic stroke and intracerebral hemorrhage is similar. However, among 30-day survivors the 5-year survival is better in patients with intracerebral hemorrhage. PMID:16995842

  18. Use of endocrinological and neurological medication among 5-year survivors of young onset brain tumors.

    PubMed

    Gunn, Mirja Erika; Lähdesmäki, Tuire; Malila, Nea; Arola, Mikko; Grönroos, Marika; Matomäki, Jaakko; Lähteenmäki, Päivi Maria

    2016-07-01

    The burden of late-effects for young onset brain tumor (BT) survivors needs more careful evaluation. Our aim was to assess the need for endocrinological and neurological medication among this specific group. We identified 5-year survivors diagnosed at the age of 0-24 years between 1988 and 2004 from the Finnish Cancer Registry (N = 602). Data on endocrinological and neurological drug purchases were collected from the Social Insurance Institution of Finland. Five years after diagnosis the most commonly purchased drugs had been: antiepileptics (44.8 %), systemic hydrocortisone (18.3 %), female sex hormones (17.6 %), thyroid hormones (11.2 %), and growth hormone (10.0 %). The survivors showed an increased hazard ratio (HR) for a need for new types of drugs still 5 years after diagnosis. Thyroid hormones (HR 10.6, 95 % CI 5.1-21.4), estrogens (HR 8.0, 95 % CI 2.1-25.7), and antiepileptics (HR 6.3, 95 % CI 3.4-11.2) were bought with high frequencies. Irradiation increased the hazard for drug-purchases other than antiepileptics. Cumulative incidence of purchases of estrogens or androgens increased still 15 years after diagnosis. The cumulative incidence of purchasing thyroid hormones and antiepileptics showed continuous increase for the youngest group, whereas survivors diagnosed at 15-24 years of age reached stable level before 15 years from diagnosis. The need for new medication continued more than a decade after BT diagnosis. Especially the need for new thyroid or sex hormone medication among childhood BT survivors may emerge long after diagnosis. PMID:27115743

  19. Trends of CT utilisation in an emergency department in Taiwan: a 5-year retrospective study

    PubMed Central

    Hu, Sung-Yuan; Hsieh, Ming-Shun; Lin, Meng-Yu; Hsu, Chiann-Yi; Lin, Tzu-Chieh; How, Chorng-Kuang; Wang, Chen-Yu; Tsai, Jeffrey Che-Hung; Wu, Yu-Hui; Chang, Yan-Zin

    2016-01-01

    Objectives To investigate the association between the trends of CT utilisation in an emergency department (ED) and changes in clinical imaging practice and patients' disposition. Setting A hospital-based retrospective observational study of a public 1520-bed referral medical centre in Taiwan. Participants Adult ED visits (aged ≥18 years) during 2009–2013, with or without receiving CT, were enrolled as the study participants. Main outcome measures For all enrolled ED visits, we retrospectively analysed: (1) demographic characteristics, (2) triage categories, (3) whether CT was performed and the type of CT scan, (4) further ED disposition, (5) ED cost and (6) ED length of stay. Results In all, 269 239 adult ED visits (148 613 male patients and 120 626 female patients) were collected during the 5-year study period, comprising 38 609 CT scans. CT utilisation increased from 11.10% in 2009 to 17.70% in 2013 (trend test, p<0.001). Four in 5 types of CT scan (head, chest, abdomen and miscellaneous) were increasingly utilised during the study period. Also, CT was increasingly ordered annually in all age groups. Although ED CT utilisation rates increased markedly, the annual ED visits did not actually increase. Moreover, the subsequent admission rate, after receiving ED CT, declined (59.9% in 2009 to 48.2% in 2013). Conclusions ED CT utilisation rates increased significantly during 2009–2013. Emergency physicians may be using CT for non-emergent studies in the ED. Further investigation is needed to determine whether increasing CT utilisation is efficient and cost-effective. PMID:27279477

  20. QTC TENDENCY IN PACEMAKER DEPENDENT PATIENTS - PROGNOSTIC MEANING OF LONG QTC DURING 5 YEAR FOLLOW UP.

    PubMed

    Tsetskhladze, E; Khintibidze, I

    2016-04-01

    Prolongation of ventricular repolarization, which is represented by QTc prolongation on the standard ECG can be considered as increased risk for fatal arrhythmia. However, in pacemaker dependency (with ventricular pacing from the right apex) Ventricular Pacemaker causes abnormal steps of ventricular activation and therefore widens QRS complex and alters ventricular repolarization. It is still questionable whether QTc prolongation in right ventricular-paced patients is associated with increased risk of fatal arrhythmia or other cardiac complications. The other important question is whether the pacemaker dependent patient with long QTc interval may safely receive medications with known potential to prolong ventricular repolarization. The aim of the study was to determine whether QTc prolongation in VP (ventricular pacemaker) patients is associated with increased risk of fatal arrhythmia or other cardiac complications and whether these patients can safely receive medications with known potential to prolong ventricular repolarization. The study is based on retrospective analysis of the QTc interval prior and after pacemaker insertion; dynamic changes of QTc interval and possible influence of the medications, with known potential to prolong ventricular repolarization. Study population consisted 76 patients with narrow native QRS complexes and QTcF/QTcB <500 ms for both male and female patients. QTc prolongation in VP patients most likely does not represent true repolarization abnormalities and is not associated with risk of fatal arrhythmia. While analysis of group receiving medications with known potency of QTc increase we found no additional tendency of QTc increase. Based on our data receiving the medications with known potency of QTc prolongation in VP patients should be considered as safe approach. Long-term follow up data (5 years) assessed retrospectively shows that in patients with widened QRS after VP are at increased risk of development of HF and HF

  1. Fulminate Hepatic Failure in a 5 Year Old Female after Inappropriate Acetaminophen Treatment

    PubMed Central

    Kasmi, Irena; Sallabanda, Sashenka; Kasmi, Gentian

    2015-01-01

    BACKGROUND: Acetaminophen is a drug widely used in children because of its safety and efficacy. Although the risk of its toxicity is lower in children such reactions occur in pediatric patients from intentional overdoses and less frequently attributable to unintended inappropriate dosing. The aim of reporting this case is to attract the attention to the risk of the acetaminophen toxicity when administered in high doses. CASE PRESENTATION: We report here a 5 year old girl who developed fulminate liver failure with renal impairment and acute pancreatitis, as a result of acetaminophen toxicity caused from unintentional repeated supratherapeutic ingestion, with a total administered dose of 4800 mg in three consecutive days, 1600 mg/day, approximately 90 mg/kg/day. The blood level of acetaminophen after 10 hours of the last administered dose was 32 mg/l. The patient presented with high fever, jaundice, lethargic, agitating with abdominal pain accompanied by encephalopathy. The liver function test revealed with high level of alanine aminotransferase 5794 UI/l and aspartate aminotransferase 6000 UI/l. Early initiation of oral N-acetylcysteine (NAC) after biochemical evidence of liver toxicity was beneficial with rapid improvement of liver enzymes, hepatic function and encephalopathy. During the course of the illness the child developed acute pancreatitis with hyperamylasemia 255 UI/L and hyperlypasemia 514 UI/L. Patient totally recovered within 29 days. CONCLUSION: Healthcare providers should considered probable acetaminophen toxicity in any child who has received the drug and presented with liver failure. When there is a high index of suspicion of acetaminophen toxicity NAC should be initiated and continued until there are no signs of hepatic dysfunction.

  2. Insertion of Balloon Retained Gastrostomy Buttons: A 5-Year Retrospective Review of 260 Patients

    SciTech Connect

    Power, Sarah Kavanagh, Liam N.; Shields, Mary C.; Given, Mark F.; Keeling, Aoife N.; McGrath, Frank P.; Lee, Michael J.

    2013-04-15

    Radiologically inserted gastrostomy (RIG) is an established way of maintaining enteral nutrition in patients who cannot maintain nutrition orally. The purpose of this study was to evaluate the safety and efficacy of primary placement of a wide bore button gastrostomy in a large, varied patient population through retrospective review. All patients who underwent gastrostomy placement from January 1, 2004 to January 1, 2009 were identified. 18-Fr gastrostomy buttons (MIC-Key G) were inserted in the majority. Follow-up ranged from 6 months to 4.5 years. A total of 260 patients (M:F 140:120, average age 59.2 years) underwent gastrostomy during the study period. Overall success rate for RIG placement was 99.6 %, with success rate of 95.3 % for primary button insertion. Indications included neurological disorders (70 %), esophageal/head and neck malignancy (21 %), and other indications (9 %). Major and minor complication rates were 1.2 and 12.8 %, respectively. Thirty-day mortality rate was 6.8 %. One third of patients underwent gastrostomy reinsertion during the study period, the main indication for which was inadvertent catheter removal. Patency rate was high at 99.5 %. The maximum number of procedures in any patient was 8 (n = 2), and the average tube dwell time was 125 days. Primary radiological insertion of a wide bore button gastrostomy is a safe technique, with high success rate, high patency rate, and low major complication rate. We believe that it is feasible to attempt button gastrostomy placement in all patients, once tract length is within limits of tube length. If difficulty is encountered, then a standard tube may simply be placed instead.

  3. Hypospadias repair and outcome in Abuja, Nigeria: A 5-year single-centre experience

    PubMed Central

    Aisuodionoe-Shadrach, Oseremen Inokhoife; Atim, Terkaa; Eniola, Bolarinwa Sefiu; Ohemu, Alexander Akogwu

    2015-01-01

    Background: To determine the outcome of hypospadias repair in children. Patients and Methods: This was a retrospective study of all patients with hypospadias managed at the University of Abuja Teaching Hospital, Abuja, Nigeria from January 2009 to December 2013. Results: Twenty-four cases of hypospadias had corrective surgery during the 5-year period under review. Seventy-five percent of the patients (n = 18) were seen after the 1st year of life. There were two peaks of ages at corrective repair; 45.8% between age 1 and 3 years and 29.1% between age 5 and 10 years. The average age at time of surgery was 44.9 months. Distal hypospadias were more common (58.4%), followed by glanular (20.8%) and proximal (20.8%) hypospadias. Associated anomalies included chordee, maldescended testicles and inguinal hernia in 20.8%, 4.1% and 8.3% cases, respectively. Operative techniques were single-stage procedures in 79.1% of patients consisting of simple circumcision in two cases (10.5%), Mathieu's peri-meatal based flap in four cases (21%), meatal advancement and glanuloplasty incorporated in three cases (16%) and Snodgrass tubularised incised urethral plate tubularised incised plate in 10 cases (52.5%). The remaining 20.9% (n = 5) had multi-staged procedures. The most common post-operative complications were urethrocutenous fistula in nine patients (33.3%) and metal stenosis in 3 patients (12.5%). Conclusions: Our results show that hypospadia repair is froth with attendant high complications in our setting. PMID:25659549

  4. Differential changes in quality of life components over 5 years in chronic obstructive pulmonary disease patients

    PubMed Central

    Nagai, Katsura; Makita, Hironi; Suzuki, Masaru; Shimizu, Kaoruko; Konno, Satoshi; Ito, Yoichi M; Nishimura, Masaharu

    2015-01-01

    Background The aim of the study was to examine the longitudinal change in quality of life components of patients with chronic obstructive pulmonary disease (COPD). Methods In the Hokkaido COPD Cohort Study, 261 subjects were appropriately treated and followed over 5 years with a 74% follow-up rate at the end. The longitudinal changes in St George’s Respiratory Questionnaire (SGRQ) scores were annually evaluated with forced expiratory volume in 1 second (FEV1). The subjects were classified into the rapid decliners, slow decliners, and sustainers based on ΔFEV1/year. Results The activity component of SGRQ generally deteriorated over time, and its annual decline was the greatest in the rapid decliners (<25th percentile). In contrast, the symptom component improved significantly year by year in the sustainers (>75 percentile), and it did not deteriorate even in the rapid decliners. Of the baseline data, predictors for worsening of the activity component were older age and lower body mass index. Larger reversibility was related to symptom component improvement. Of the follow-up data, ΔFEV1/year was the best predictor for worsening of the components of SGRQ. Continuous smoking was another factor for worsening of the activity component. For the symptom component, a history of exacerbation by admission definition was the determinant of its deterioration, whereas use of beta agonists was related to improvement. Conclusion The longitudinal changes of quality of life and their determinants are markedly different and independent between its components. The activity component of SGRQ generally deteriorated over years, while the symptom component rather improved in some patients with COPD under appropriate treatment. PMID:25914531

  5. WHO global rotavirus surveillance network: a strategic review of the first 5 years, 2008-2012.

    PubMed

    Agócs, Mary M; Serhan, Fatima; Yen, Catherine; Mwenda, Jason M; de Oliveira, Lúcia H; Teleb, Nadia; Wasley, Annemarie; Wijesinghe, Pushpa R; Fox, Kimberley; Tate, Jacqueline E; Gentsch, Jon R; Parashar, Umesh D; Kang, Gagandeep

    2014-07-25

    Since 2008, the World Health Organization (WHO) has coordinated the Global Rotavirus Surveillance Network, a network of sentinel surveillance hospitals and laboratories that report to ministries of health (MoHs) and WHO clinical features and rotavirus testing data for children aged <5 years hospitalized with acute gastroenteritis. In 2013, WHO conducted a strategic review to assess surveillance network performance, provide recommendations for strengthening the network, and assess the network's utility as a platform for other vaccine-preventable disease surveillance. The strategic review team determined that during 2011 and 2012, a total of 79 sites in 37 countries met reporting and testing inclusion criteria for data analysis. Of the 37 countries with sites meeting inclusion criteria, 13 (35%) had introduced rotavirus vaccine nationwide. All 79 sites included in the analysis were meeting 2008 network objectives of documenting presence of disease and describing disease epidemiology, and all countries were using the rotavirus surveillance data for vaccine introduction decisions, disease burden estimates, and advocacy; countries were in the process of assessing the use of this surveillance platform for other vaccine-preventable diseases. However, the review also indicated that the network would benefit from enhanced management, standardized data formats, linkage of clinical data with laboratory data, and additional resources to support network functions. In November 2013, WHO's Strategic Advisory Group of Experts on Immunization (SAGE) endorsed the findings and recommendations made by the review team and noted potential opportunities for using the network as a platform for other vaccine-preventable disease surveillance. WHO will work to implement the recommendations to improve the network's functions and to provide higher quality surveillance data for use in decisions related to vaccine introduction and vaccination program sustainability. PMID:25055187

  6. Abdominal computed tomography during pregnancy for suspected appendicitis: a 5-year experience at a maternity hospital.

    PubMed

    Shetty, Mahesh K; Garrett, Nan M; Carpenter, Wendy S; Shah, Yogesh P; Roberts, Candace

    2010-02-01

    The objective of this article is to evaluate the role of computed tomography (CT) in a pregnant patient with right lower quadrant pain in whom there was a clinical suspicion of acute appendicitis. During a 5-year period the clinical records of all pregnant women who underwent imaging examination for clinically suspected appendicitis were reviewed. The imaging findings were correlated with patient management and final outcome. Thirty-nine pregnant patients were referred for imaging, of which 35 underwent initial evaluation with sonography, 23 of these women underwent a computed tomographic examination, and an additional 4 patients were directly imaged with CT without earlier sonographic assessment. Surgery confirmed appendicitis in all 5 patients who were operated on on the basis of findings of appendicitis on a CT scan. Two patients underwent surgery based on an alternate diagnosis suggested preoperatively (tubal torsion = 1, ovarian torsion = 1). All patients with negative findings at CT had an uneventful clinical course. In those patients who were evaluated only with ultrasound, a diagnosis of appendicitis was missed in 5 patients. The sensitivity of CT in the diagnosis of appendicitis in our study group was 100%, compared with a sensitivity of 46.1% for ultrasound. CT provides an accurate diagnosis in patients suspected to have acute appendicitis and is of value in avoiding false negative exploratory laparatomy with its consequent risk of maternal and fetal mortality and morbidity. Although sonography is the preferred initial imaging modality as its lack of ionizing radiation, CT is more accurate in providing a timely diagnosis and its use is justified to reduce maternal mortality and mortality in patients with appendicitis. PMID:20102691

  7. Molecular Typing of Treponema pallidum: a 5-Year Surveillance in Shanghai, China

    PubMed Central

    Dai, Ting; Li, Kang; Lu, Haikong; Gu, Xin

    2012-01-01

    Previously, a small study showed that 14f was the predominant subtype of Treponema pallidum in Shanghai, China. The result was quite different from the genotype distribution in other areas of China. This study aimed to identify the strain types of Treponema pallidum in samples collected over a 5-year period in Shanghai. From 2007 to 2011, genital swabs were collected from patients with syphilis from the Shanghai Skin Disease Hospital. Positive specimens were typed by the enhanced typing method by adding a tp0548 gene to the existing arp and tpr genotype system. In total, 304 of the 372 enrolled patients yielded fully typeable DNA. Ten arp types (4, 6, 8, 9, 11, 12, 13, 14, 15, and 19), 3 tpr types (a, d, and o), and 5 tp0548 types (a, c, f, g, and i) were identified. In total, 12 subtypes were identified with a combination of the arp and tpr genes. Subtype 14d was found in 270 samples (88.8%). When the combination included the tp0548 gene, the 12 CDC subtypes identified were divided into 14 strain types. The predominant type was 14d/f (88.8%), followed by 15d/f (3.6%), 13d/f (1.3%), and 19d/c (1.3%). Two of the 44 14d/f-infected patients and both of the 19d/c-infected patients who underwent a lumbar puncture were diagnosed with neurosyphilis. This study showed that the predominant type in Shanghai was 14d/f. While this is in keeping with data from other areas in China, it is different from an earlier report showing that 14f is the most common genotype in Shanghai. Further studies are needed to better understand the association between strain types and neurosyphilis. PMID:22972832

  8. Global surgery in a postconflict setting - 5-year results of implementation in the Russian North Caucasus

    PubMed Central

    Lunze, Fatima I.; Lunze, Karsten; Tsorieva, Zemfira M.; Esenov, Constantin T.; Reutov, Alexandr; Eichhorn, Thomas; Offergeld, Christian

    2015-01-01

    Background Collaborations for global surgery face many challenges to achieve fair and safe patient care and to build sustainable capacity. The 2004 terrorist attack on a school in Beslan in North Ossetia in the Russian North Caucasus left many victims with complex otologic barotrauma. In response, we implemented a global surgery partnership between the Vladikavkaz Children's Hospital, international surgical teams, the North Ossetian Health Ministry, and civil society organizations. This study's aim was to describe the implementation and 5-year results of capacity building for complex surgery in a postconflict, mid-income setting. Design We conducted an observational study at the Children's Hospital in Vladikavkaz in the autonomous Republic of North Ossetia-Alania, part of the Russian Federation. We assessed the outcomes of 15 initial patients who received otologic surgeries for complex barotrauma resulting from the Beslan terrorism attack and for other indications, and report the incidence of intra- and postoperative complications. Results Patients were treated for trauma related to terrorism (53%) and for indications not related to violence (47%). None of the patients developed peri- or postoperative complications. Three patients (two victims of terrorism) who underwent repair of tympanic perforations presented with re-perforations. Four junior and senior surgeons were trained on-site and in Germany to perform and teach similar procedures autonomously. Conclusions In mid-income, postconflict settings, complex surgery can be safely implemented and achieve patient outcomes comparable to global standards. Capacity building can build on existing resources, such as operation room management, nursing, and anesthesia services. In postconflict environments, substantial surgical burden is not directly attributable to conflict-related injury and disease, but to health systems weakened by conflicts. Extending training and safe surgical care to include specialized

  9. Omnifit-HA stem in total hip arthroplasty. A 2- to 5-year followup.

    PubMed

    D'Lima, D D; Walker, R H; Colwell, C W

    1999-06-01

    Outcomes of the first 60 noncemented Omnifit-HA total hip arthroplasties in 56 patients were studied prospectively for 2 to 5 years. The femoral prosthesis had a proximal third circumferential hydroxyapatite coated surface treatment. The acetabular component was a hemispheric modular, porous, nonhydroxyapatite press fit cup, supplemented with screw fixation. One cup was revised for recurrent dislocation, with no femoral revisions. The mean Harris hip score was 54 (range, 20-76) before surgery and 96 (range, 83-100) at final followup, with all patients having an excellent or good outcome. Mild thigh pain occurred in 6% of hips. Subsidence occurred in 9% of hips (range, 1-2.8 mm); in all cases, subsidence was nonprogressive after 1 year. Stable bone ingrowth fixation was evident at the hydroxyapatite coated portion in 100%. A sclerotic reactive line adjacent to the nonhydroxyapatite portion of the stem occurred in 81% but was not adjacent to the hydroxyapatite coated portion of any stem. Endosteal condensation occurred in 90% and correlated with a higher Harris hip score (mean score, 96 with, 91 without). Endosteal lysis adjacent to or distal to the hydroxyapatite coating did not occur. Lytic lesions at the calcar occurred in 19% and correlated with a greater linear acetabular polyethylene wear rate (mean, 0.30 mm/year with lytic lesions, 0.17 mm/year without). This noncemented stem with proximal third hydroxyapatite coating showed excellent short term clinical and radiographic outcome. Absence of distal endosteal lysis, along with correlation of calcar erosion to polyethylene wear, suggests that early circumferential bony ingrowth afforded by hydroxyapatite coating prevents distal endosteal access to polyethylene debris at short term followup. PMID:10379318

  10. 5 years of continuous seismic monitoring of snowmelt cycles in a Pyrenean valley

    NASA Astrophysics Data System (ADS)

    Diaz, Jordi; Sánchez-Pastor, Pilar; Gallart, Josep

    2016-04-01

    In recent years the analysis of background seismic noise variations in the proximity of river channels has revealed as a useful tool to monitor river flow, even for modest discharges. We will focus here in the application of this methodology to study the snowmelt cycle in an Pyrenean valley during the last 5 years, using data from the seismic geophysical station located inside the Canfranc Underground Laboratory (Central Pyrenees). Diaz et al. (2014) first identified in the seismic data the signature of river flow increases associated to snowmelt episodes in the catchment area of the Aragon River, based on the marked correlation between the seismic energy variations in the 2-8 Hz frequency band and the estimated variations in water resources from snowfall. The analysis of seismic data during the snowmelt periods allows to identify a clear 24h cycle, with energy increasing from about 14:00 GMT, remaining at a relatively high level for 12 hours and then smoothly vanishing. The spectrogram reveals richer information, as clear variations in the frequency content can be detected during the time intervals in which the amplitude of the seismic signal remains constant. The data available so far allow to compare the evolution of snowmelt in five seasons with very different hydrological behavior. The 2011 and 2012 seasons have been dry, with snow volumes 30-50 % beneath the average values, while the 2013, 2014 and in particular the 2015 seasons have been largely above the mean. Those variations are reflected in the seismic data, which allow to monitor the time occurrence of the main snowmelt stages for each season and to estimate the intensity of the different snowmelt episodes. Therefore, seismic data can be useful for long term monitoring of snowmelt in Alpine-style mountains.

  11. Insight, psychopathology, explanatory models and outcome of schizophrenia in India: a prospective 5-year cohort study

    PubMed Central

    2012-01-01

    Background The sole focus of models of insight on bio-medical perspectives to the complete exclusion of local, non-medical and cultural constructs mandates review. This study attempted to investigate the impact of insight, psychopathology, explanatory models of illness on outcome of first episode schizophrenia. Method Patients diagnosed to have DSM IV schizophrenia (n = 131) were assessed prospectively for insight, psychopathology, explanatory models of illness at baseline, 6, 12 and 60 months using standard instruments. Multiple linear and logistic regression and generalized estimating equations (GEE) were employed to assess predictors of outcome. Results We could follow up 95 (72.5%) patients. Sixty-five of these patients (68.4%) achieved remission. There was a negative relationship between psychosis rating and insight scores. Urban residence, fluctuating course of the initial illness, and improvement in global functioning at 6 months and lower psychosis rating at 12 months were significantly related to remission at 5 years. Insight scores, number of non-medical explanatory models and individual explanatory models held during the later course of the illness were significantly associated with outcome. Analysis of longitudinal data using GEE showed that women, rural residence, insight scores and number of non-medical explanatory models of illness held were significantly associated with BPRS scores during the study period. Conclusions Insight, the disease model and the number of non-medical model positively correlated with improvement in psychosis arguing for a complex interaction between the culture, context and illness variables. These finding argue that insight and explanatory models are secondary to psychopathology, course and outcome of the illness. The awareness of mental illness is a narrative act in which people make personal sense of the many challenges they face. The course and outcome of the illness, cultural context, acceptable cultural explanations

  12. Specialist Pediatric Palliative Care Prescribing Practices: A Large 5-year Retrospective Audit

    PubMed Central

    Damani, Anuja; Salins, Naveen; Ghoshal, Arunangshu; Muckaden, MaryAnn

    2016-01-01

    Introduction: There is a gradual increasing trend in childhood cancers in India and pediatric palliative care in India is an emerging specialty. Prescribing pain and symptom control drugs in children with cancer requires knowledge of palliative care formulary, dosing schedules, and prescription guidelines. This study is a retrospective audit of prescribing practices of a specialist palliative care service situated in a tertiary cancer center. Methods: A total of 1135 medication records of children receiving specialist pediatric palliative care services were audited for 5 years (2010–2014) to evaluate prescribing practices in children with advanced cancer. Results: A total of 51 types of drugs were prescribed with an average of 4.2 drugs per prescription. 66.9% of the prescriptions had paracetamol, and 33.9% of the prescriptions had morphine. Most common nonsteroidal anti-inflammatory drugs prescribed was ibuprofen (23.9%), and more than 50% of the prescriptions had aperients. The most commonly prescribed aperient was a combination of liquid paraffin and sodium-picosulfate. Dexamethasone was prescribed in 51.9% of patients and in most cases this was part of oral chemotherapy regimen. Generic names in prescription were used only in 33% of cases, and adverse effects of the drugs were documented in only 9% of cases. In 25% of cases, noncompliance to the WHO prescription guidelines was seen, and patient compliance to prescription was seen in 40% of cases. Conclusions: Audit of the prescribing practices in specialist pediatric palliative care service shows that knowledge of pediatric palliative care formulary, rational drug use, dosing, and prescribing guidelines is essential for symptom control in children with advanced life-limiting illness. Noncompliance to WHO prescribing guidelines in one fourth of cases and using nongeneric names in two-thirds of prescription indicates poor prescribing practices and warrants prescriber education. Prescription noncompliance by

  13. Supporting countries in establishing and strengthening NITAGs: lessons learned from 5 years of the SIVAC initiative.

    PubMed

    Adjagba, Alex; Senouci, Kamel; Biellik, Robin; Batmunkh, Nyambat; Faye, Pape Coumba; Durupt, Antoine; Gessner, Bradford D; da Silva, Alfred

    2015-01-29

    To empower governments to formulate rational policies without pressure from any group, and to increase the use of evidence-based decision-making to adapt global recommendations on immunization to their local context, the WHO has recommended on multiple occasions that countries should establish National Immunization Technical Advisory Groups (NITAGs). The World Health Assembly (WHA) reinforced those recommendations in 2012 when Member States endorsed the Decade of Vaccines Global Vaccine Action Plan (GVAP). NITAGs are multidisciplinary groups of national experts responsible for providing independent, evidence-informed advice to health authorities on all policy-related issues for all vaccines across all populations. In 2012, according to the WHO-UNICEF Joint Reporting Form, among 57 countries eligible for immunization program financial support from the GAVI Alliance, only 9 reported having a functional NITAG. Since 2008, the Supporting Independent Immunization and Vaccine Advisory Committees (SIVAC) Initiative (at the Agence de Médecine Préventive or AMP) in close collaboration with the WHO and other partners has been working to accelerate and systematize the establishment of NITAGs in low- and middle-income countries. In addition to providing direct support to countries to establish advisory groups, the initiative also supports existing NITAGs to strengthen their capacity in the use of evidence-based processes for decision-making aligned with international standards. After 5 years of implementation and based on lessons learned, we recommend that future efforts should target both expanding new NITAGs and strengthening existing NITAGs in individual countries, along three strategic lines: (i) reinforce NITAG institutional integration to promote sustainability and credibility, (ii) build technical capacity within NITAG secretariats and evaluate NITAG performance, and (iii) increase networking and regional collaborations. These should be done through the development

  14. Uremic Pruritus, Dialysis Adequacy, and Metabolic Profiles in Hemodialysis Patients: A Prospective 5-Year Cohort Study

    PubMed Central

    Chen, Hung-Yuan; Chiu, Yen-Ling; Hsu, Shih-Ping; Pai, Mei-Fen; Ju-YehYang; Lai, Chun-Fu; Lu, Hui-Min; Huang, Shu-Chen; Yang, Shao-Yu; Wen, Su-Yin; Chiu, Hsien-Ching; Hu, Fu-Chang; Peng, Yu-Sen; Jee, Shiou-Hwa

    2013-01-01

    Background Uremic pruritus is a common and intractable symptom in patients on chronic hemodialysis, but factors associated with the severity of pruritus remain unclear. This study aimed to explore the associations of metabolic factors and dialysis adequacy with the aggravation of pruritus. Methods We conducted a 5-year prospective cohort study on patients with maintenance hemodialysis. A visual analogue scale (VAS) was used to assess the intensity of pruritus. Patient demographic and clinical characteristics, laboratory parameters, dialysis adequacy (assessed by Kt/V), and pruritus intensity were recorded at baseline and follow-up. Change score analysis of the difference score of VAS between baseline and follow-up was performed using multiple linear regression models. The optimal threshold of Kt/V, which is associated with the aggravation of uremic pruritus, was determined by generalized additive models and receiver operating characteristic analysis. Results A total of 111 patients completed the study. Linear regression analysis showed that lower Kt/V and use of low-flux dialyzer were significantly associated with the aggravation of pruritus after adjusting for the baseline pruritus intensity and a variety of confounding factors. The optimal threshold value of Kt/V for pruritus was 1.5 suggested by both generalized additive models and receiver operating characteristic analysis. Conclusions Hemodialysis with the target of Kt/V ≥1.5 and use of high-flux dialyzer may reduce the intensity of pruritus in patients on chronic hemodialysis. Further clinical trials are required to determine the optimal dialysis dose and regimen for uremic pruritus. PMID:23940749

  15. Relationship between Angiographic Late Loss and 5-Year Clinical Outcome after Drug-Eluting Stent Implantation

    PubMed Central

    Yang, Young-June; Shin, Sanghoon; Kim, Byeong-Keuk; Kim, Jung-Sun; Shin, Dong-Ho; Ko, Young-Guk; Choi, Donghoon; Jang, Yangsoo

    2013-01-01

    Purpose Currently, insufficient data exist to evaluate the relationship between angiographic late loss (LL) and long-term clinical outcome after drug-eluting stent (DES) implantation. In this study, we hypothesized that angiographic LL between 0.3 and 0.6 mm correlate with favorable long-term clinical outcomes. Materials and Methods Patients were enrolled in the present study if they had undergone both DES implantation in single coronary vessel and a subsequent follow-up angiogram (n=634). These individuals were then subdivided into three groups based on their relative angiographic LL: group I (angiographic LL <0.3 mm, n=378), group II (angiographic LL between 0.3 and 0.6 mm, n=124), and group III (angiographic LL >0.6 mm, n=134). During a 5-year follow-up period, all subjects were tracked for critical events, defined as any cause of death or myocardial infarction, which were then compared among the three groups. Results Mean follow-up duration was 63.0±10.0 months. Critical events occurred in 25 subjects in group I (6.6%), 5 in group II (4.0%), and 17 in group III (12.7%), (p=0.020; group I vs. group II, p=0.293; group II vs. group III, p=0.013). In a subsequent multivariate logistic regression analysis, chronic renal failure [odds ratio (OR)=3.29, 95% confidence interval (CI): 1.48-7.31, p=0.003] and long lesion length, defined as lesion length >28 mm (OR=1.88, 95% CI: 1.02-3.46, p=0.042) were independent predictors of long-term critical events. Conclusion This retrospective analysis fails to demonstrate that post-DES implantation angiographic LL between 0.3 and 0.6 mm is protective against future critical events. PMID:23225797

  16. The Burden of Health Care Costs in the Last 5 Years of Life

    PubMed Central

    Kelley, Amy S.; McGarry, Kathleen; Gorges, Rebecca; Skinner, Jonathan S.

    2016-01-01

    Background Common diseases, particularly dementia, entail large social costs, previously well described for the U.S. population. Less is known about end-of-life costs of specific diseases and the associated financial risk for individual households. Objective To examine social costs and financial risks faced by Medicare beneficiaries five years before death. Design Retrospective cohort. Setting Health and Retirement Study. Participants Medicare fee-for-service beneficiaries, aged 70 years or older, who died 2005-2010 (N = 1702), stratified into four cohorts: individuals with high probability of dementia, or with either heart disease, cancer, or other causes of death. Measurements Total social costs and its components: Medicare, Medicaid, private insurance, out-of-pocket, and informal care, measured over the last 5 years of life; and out-of-pocket spending as a proportion of household wealth. Results Average total cost per decedent for dementia ($287,038) was significantly greater than for those who died of heart disease ($175,136), cancer ($173,383), or other causes ($197,286), p<0.001. While Medicare expenditures were similar across groups, average out-of-pocket spending for dementia patients ($61,522) was 81% higher than for non-dementia patients ($34,068); a similar pattern held for informal care. Out-of-pocket spending for the dementia group (median, $36,919) represented 32% of wealth measured five years before death, compared to 11% for non-dementia decedents (p<0.001). This proportion was greater for Blacks (84%), those with less than high school education (48%), and unmarried/widowed women (58%). Limitations Imputed Medicaid, private insurance and informal care costs Conclusions Healthcare expenditures among those with dementia were substantially larger than for other diseases, with much of those expenses uninsured, thus placing a large financial burden on families. These burdens are particularly pronounced among demographic groups least prepared for

  17. Substance Abuse among High-Risk Sexual Offenders: Do Measures of Lifetime History of Substance Abuse Add to the Prediction of Recidivism over Actuarial Risk Assessment Instruments?

    ERIC Educational Resources Information Center

    Looman, Jan; Abracen, Jeffrey

    2011-01-01

    There has been relatively little research on the degree to which measures of lifetime history of substance abuse add to the prediction of risk based on actuarial measures alone among sexual offenders. This issue is of relevance in that a history of substance abuse is related to relapse to substance using behavior. Furthermore, substance use has…

  18. Has actuarial aging “slowed” over the past 250 years? A comparison of small-scale subsistence populations and European cohorts

    PubMed Central

    Gurven, Michael; Fenelon, Andrew

    2012-01-01

    G.C. Williams’ 1957 hypothesis famously argues that higher age-independent, or “extrinsic”, mortality should select for faster rates of senescence. Long-lived species should therefore show relatively few deaths from extrinsic causes such as predation and starvation. Theoretical explorations and empirical tests of Williams’ hypothesis have flourished in the past decade but it has not yet been tested empirically among humans. We test Williams’ hypothesis using mortality data from subsistence populations and from historical cohorts from Sweden and England/Wales, and examine whether rates of actuarial aging declined over the past two centuries. We employ three aging measures: mortality rate doubling time (MRDT), Ricklef’s ω, and the slope of mortality hazard from ages sixty to seventy, m’60–70, and model mortality using both Weibull and Gompertz-Makeham hazard models. We find that (1) actuarial aging in subsistence societies is similar to that of early Europe, (2) actuarial senescence has slowed in later European cohorts, (3) reductions in extrinsic mortality associate with slower actuarial aging in longitudinal samples, and (4) men senesce more rapidly than women, especially in later cohorts. To interpret these results, we attempt to bridge population-based evolutionary analysis with individual-level proximate mechanisms. PMID:19220451

  19. Category-specific face prototypes are emerging, but not yet mature, in 5-year-old children.

    PubMed

    Short, Lindsey A; Lee, Kang; Fu, Genyue; Mondloch, Catherine J

    2014-10-01

    Adults' expertise in face recognition has been attributed to norm-based coding. Moreover, adults possess separable norms for a variety of face categories (e.g., race, sex, age) that appear to enhance recognition by reducing redundancy in the information shared by faces and ensuring that only relevant dimensions are used to encode faces from a given category. Although 5-year-old children process own-race faces using norm-based coding, little is known about the organization and refinement of their face space. The current study investigated whether 5-year-olds rely on category-specific norms and whether experience facilitates the development of dissociable face prototypes. In Experiment 1, we examined whether Chinese 5-year-olds show race-contingent opposing aftereffects and the extent to which aftereffects transfer across face race among Caucasian and Chinese 5-year-olds. Both participant races showed partial transfer of aftereffects across face race; however, there was no evidence for race-contingent opposing aftereffects. To examine whether experience facilitates the development of category-specific prototypes, we investigated whether race-contingent aftereffects are present among Caucasian 5-year-olds with abundant exposure to Chinese faces (Experiment 2) and then tested separate groups of 5-year-olds with two other categories with which they have considerable experience: sex (male/female faces) and age (adult/child faces) (Experiment 3). Across all three categories, 5-year-olds showed no category-contingent opposing aftereffects. These results demonstrate that 5 years of age is a stage characterized by minimal separation in the norms and associated coding dimensions used for faces from different categories and suggest that refinement of the mechanisms that underlie expert face processing occurs throughout childhood. PMID:24937629

  20. 78 FR 33113 - Publication of the 5-Year Research and Evaluation Strategic Plan Program Years 2012-2017

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-03

    ...Notice is hereby given of the publication of the U.S. Department of Labor, Employment and Training Administration's (USDOL/ ETA) 5-Year Research and Evaluation Strategic Plan for 2012-2017. Under Section 171 of the Workforce Investment Act, every 2 years the Secretary of Labor is required to transmit to Congress a strategic plan for pilots, demonstrations, and research over the next 5 years in......

  1. The 5-Year EFS of Multisystem LCH With Risk-Organ Involvement Is Suboptimal: A Single-center Experience From India.

    PubMed

    Totadri, Sidharth; Bansal, Deepak; Trehan, Amita; Srinivasan, Radhika; Varma, Neelam; Kakkar, Nandita; Saxena, Akshay K; Bhatia, Prateek

    2016-01-01

    The study describes an 8-year experience of a single center in managing patients with langerhans cell histiocytosis on the basis of the langerhans cell histiocytosis-III platform. A retrospective case-file review of children diagnosed during 2006 to 2013 was performed. Group 1 (multisystem with risk-organ involvement) patients received an initial treatment of 6 to 12 weeks, followed by continuation treatment to complete 12 months. Drugs included vinblastine, prednisolone, and 6-mercaptopurine. Group 2 (multisystem without risk-organ involvement) patients received a similar treatment, except for 6-mercaptopurine. Group 3 (single-system/multifocal bone disease) patients were treated for a duration of 6 months. Forty-nine patients were treated: 24 (49%), 14 (28.6%), and 11 (22.4%) in groups 1, 2, and 3, respectively. The mean age at diagnosis was 31.6 ± 28.4 months (range, 4 to 120 mo). Five patients abandoned treatment. There were 7 deaths, all in group 1. All patients who died had either a partial response or progressive disease after induction (P=0.000). Among patients with liver involvement, those with sclerosing cholangitis had a greater mortality (P=0.007). A relapse was observed in 12 (24.5%) patients. The frequency of relapse was not different in the 3 groups (P=0.833). The 5-year event-free survival in groups 1, 2, and 3 was 29.3 ± 10%, 58.9 ± 14.6%, and 69.3 ± 15%, respectively (P=0.019). The 5-year overall survival was 100% in groups 2/3 and 68.9 ± 9.8% in group 1 (P=0.011). PMID:26274033

  2. Lung function and respiratory symptoms among female hairdressers in Palestine: a 5-year prospective study

    PubMed Central

    Nemer, Maysaa; Kristensen, Petter; Nijem, Khaldoun; Bjertness, Espen; Skare, Øivind; Skogstad, Marit

    2015-01-01

    Objectives Hairdressers are exposed to chemicals at the workplace which are known to cause respiratory symptoms and asthma. This study aimed to examine changes in self-reported respiratory symptoms over 5 years, as well as to examine the lung function decline and determine whether it is within the expected range, to assess the dropout rate and reasons for leaving the profession, and to examine the associations between occupational factors and lung function changes at follow-up. Design Prospective study. Setting Female hairdressing salons in Hebron city, Palestine. Participants 170 female hairdressers who participated in a baseline survey in 2008 were followed up in 2013. A total of 161 participants participated in 2013. Outcome measures Change in reported respiratory symptoms and change in lung function over follow-up. Dropout from the profession and reasons for it. Differences between current and former hairdressers in respiratory symptoms and lung function at follow-up. Ambient air ammonia levels in 13 salons. Results Current hairdressers reported more respiratory symptoms in 2013 compared with baseline. Former hairdressers reported fewer symptoms at follow-up. At follow-up, current hairdressers showed a significant decrease in forced vital capacity of 35 mL/year (95% CI 26 to 44 mL/year) and of 31 mL/year (95% CI 25 to 36 mL/year) for forced expiratory volume in 1 s (FEV1). 28 (16%) of the hairdressers quit the job during the 5-year follow-up, 8 (28%) because of health problems. Hairdressers who had been working for 4 years or more at baseline showed a stronger decline in FEV1 compared with those who worked less than 4 years (difference 13, 95% CI 1 to 25). Conclusions Current hairdressers developed more respiratory symptoms and larger lung function decline than former hairdressers during follow-up. Few hairdressers left their profession because of respiratory health problems. Working for more years is associated with lung function decline among

  3. Participation in an Intensive Longitudinal Study with Weekly Web Surveys Over 2.5 Years

    PubMed Central

    Barber, Jennifer; Kusunoki, Yasamin; Schulz, Paul

    2016-01-01

    Background Technological advances have made it easier for researchers to collect more frequent longitudinal data from survey respondents via personal computers, smartphones, and other mobile devices. Although technology has led to an increase in data-intensive longitudinal studies, little is known about attrition from such studies or the differences between respondents who complete frequently administered surveys in a timely manner, and respondents who do not. Objective We examined respondent characteristics and behaviors associated with continued and on-time participation in a population-based intensive longitudinal study, using weekly web-based survey interviews over an extended period. Methods We analyzed data from the Relationship Dynamics and Social Life study, an intensive longitudinal study that collected weekly web-based survey interviews for 2.5 years from 1003 18- and 19-year-olds to investigate factors shaping the dynamics of their sexual behavior, contraceptive use, and pregnancies. Results Ordinary least squares and logistic regression analyses showed background respondent characteristics measured at baseline were associated with the number of days respondents remained enrolled in the study, the number of interviews they completed, and the odds that they were late completing interviews. In addition, we found that changes in pregnancy-related behaviors reported in the weekly interviews were associated with late completion of interviews. Specifically, after controlling for sociodemographic, personality, contact information, and prior experience variables, we found that weekly reports such as starting to have sex (odds ratio [OR] 1.17, 95% CI 1.03-1.32, P=.01), getting a new partner (OR 1.76, 95% CI 1.53-2.03, P<.001), stopping the use of contraception (OR 1.28, 95% CI 1.10-1.49, P=.001), and having a new pregnancy (OR 5.57, 95% CI 4.26-7.29, P<.001) were significantly associated with late survey completion. However, young women who reported changes in

  4. Vertical distribution of the Saharan Air Layer from 5 years of CALIPSO observations

    NASA Astrophysics Data System (ADS)

    Tsamalis, C.; Chédin, A.

    2012-04-01

    The Saharan Air Layer (SAL) forms as dry and hot air moves across the Sahara desert. SAL, containing substantial amounts of mineral dust, is a dominant feature that influences the large scale environment from West Africa to eastern tropical America, inhibiting tropical cyclogenesis and Atlantic hurricane formation. Furthermore, SAL dust aerosols have a strong impact on the energy budget through the so-called direct and indirect effects. The SAL has been studied with dedicated campaigns at the two sides of the Atlantic or using space observations due to lack of systematic in situ measurements away from the continents. However the campaigns are restricted in time, while satellite observations of thermodynamic variables are affected by the presence of dust. Moreover, satellite measurements of aerosols, particularly in the visible, mostly provide column integrated properties like the optical depth, without information about the vertical distribution. On the other hand, new generation infrared sounders now bring reliable information on the dust layer mean altitude, but their new established results need further validation. However, the two-wavelength lidar CALIOP, launched on board CALIPSO in April 2006, permits an accurate determination of the aerosol vertical distribution, on a global scale. Thanks to depolarisation at 532 nm, CALIOP is able to discriminate between dust and other types of aerosols, which generally do not depolarize light. Here, the L2 5 km aerosol layer product (version 3.01) is used to calculate the vertical distribution of the dust aerosols above the Atlantic during the last 5 years (June 2006 - May 2011) with a horizontal resolution of 1 degree for the four seasons. More specifically, two classes of aerosols are used from the L2 product: dust and polluted dust, in order to take into account the change of dust aerosols optical properties with transport. Results show the latitudinal displacement of the SAL between winter [-5, 15]°N and summer [10

  5. Behavior of 60Co and 134Cs in a Canadian Shield lake over 5 years.

    PubMed

    Bird, G A; Schwartz, W J; Motycka, M; Rosentreter, J

    1998-04-01

    Radionuclides were added to the anoxic hypolimnion of a Canadian Shield lake to simulate the nuclear fuel waste disposal scenario where radionuclides might enter the bottom waters of a lake. The radionuclides remained in the hypolimnion until lake mixing at autumn turnover after which 60Co was rapidly lost and 134Cs was slowly lost from the water. Only 0.4% of the 60Co and 0.6% of the 134Cs remained in the water at year 5. Highest concentrations occurred in periphyton and filter feeders, Holopedium gibberum and clams (Anodonata grandis grandis). From maximum annual concentrations in clam tissues, it was estimated that the availability of 60Co for uptake had a half-time (t1/2) of 835 days in the lake, whereas that for 134Cs was 780 days. Loss rate coefficients, k, for the radionuclides from taxa ranged from 0.0008 to 0.0043 day-1 (t1/2 = 161-866 days) for 60Co and from 0.0009 to 0.005 day-1 (t1/2 = 139-770 days) for 134Cs. Cobalt-60 concentrations in forage fish were low, whereas 134Cs concentrations increased over the first year or two, then slowly declined. On the basis of k values measured for forage fish, the biological half-time of 134Cs in forage fish ranged from 428 to 630 days. Maximum 134Cs concentrations in forage fish were higher following hypolimnetic addition than epilimnetic addition. Relatively high 134Cs concentrations in periphyton at year 5 point to the importance of benthic pathways in the recycling of contaminants to higher trophic levels. The presence of 134Cs in biota 5 years after the addition, long after concentrations were no longer detectable in surface waters, is evidence of the persistence of Cs in aquatic systems. The k values (or t1/2 values) for the loss of 60Co and 134Cs from water and their uptake and loss from biota can be used to establish parameter values for assessment models. The results demonstrate that assessment models should account for the release of radionuclides from sediment and their subsequent recycling in the food

  6. Survival rates of cervical cancer patients in Malaysia.

    PubMed

    Muhamad, Nor Asiah; Kamaluddin, Muhammad Amir; Adon, Mohd Yusoff; Noh, Mohamed Asyraf; Bakhtiar, Mohammed Faizal; Ibrahim Tamim, Nor Saleha; Mahmud, Siti Haniza; Aris, Tahir

    2015-01-01

    Cervical cancer is the most common malignant cancer of the female reproductive organs worldwide. Currently, cervical cancer can be prevented by vaccination and detected at an early stage via various screening methods. Malaysia, as a developing country faces a heavy disease burden of cervical cancer as it is the second most common cancer among Malaysian women. This population based study was carried out to fulfil the primary aim of determining the survival rates of Malaysian women with cervical cancer and associated factors. Data were obtained from two different sources namely, the Malaysian National Cancer Registry (MNCR) and National Health Informatics Centre (NHIC) from 1st January 2000 to 31st December 2005. Kaplan Meier analyses were conducted to identify the overall survival rates and median survival time. Differences in survival among different ethnic and age group were compared using the log-rank test. A total of 5,859 patients were included. The median survival time for cervical cancer in this study was 65.8 months and the 5-year survival rate was 71.1%. The overall observed survival rates at 1, 3 and 5 years were 94.1%, 79.3% and 71.1% respectively. The log-rank test finding also showed that there were significant differences in the 5-year survival rate among different ethnic groups. Malays had the lowest survival rate of 59.2% followed by Indians (69.5%) and Chinese (73.8%). The overall 5-year survival rate among patients with cervical cancer in Malaysia is relatively good. Age and ethnic groups remain as significant determining factors for cervical cancer survival rate. PMID:25854407

  7. Does really previous stenting affect graft patency following CABG? A 5-year follow-up: The effect of PCI on graft survival.

    PubMed

    Songur, Murat Çetin; Özyalçin, Sertan; Özen, Anıl; Şimşek, Erdal; Kervan, Ümit; Taşoğlu, İrfan; Kaplan, Sadi; Köse, Kenan; Ulus, Ahmet Tulga

    2016-04-01

    The aim of this study was to compare the graft patency rates among patients who had a previous history of percutaneous coronary intervention (PCI) followed by coronary artery bypass grafting surgery (CABG) with the patients who had experienced CABG surgery alone. The 69 patients who were included in the study had a history of bare metal stent implantation prior to CABG (group 1). The coronary angiography results were compared with 69 patients who had a previous history of CABG (group 2). Graft patency rates of the left anterior descending artery and circumflex anastomoses are statistically significant for both groups, whereas the right coronary artery anastomoses are not statistically significant (p = 0.008; 0.009; 0.2). Graft patency rate of LIMA-LAD anastomoses was 43.9 ± 10.8 % in group 1 and 86.2 ± 6 % in group 2 for means of 60 months (p = 0.0001) and circumflex coronary artery anastomosis is 28.9 ± 0.9 % in group 1, 65.7 ± 10.8 % in group 2 (p = 0.0001) and the right coronary artery anastomosis is 37.2 ± 13.6 % in group 1, 56.4 ± 8.9 % in group 2 (p = 0.0001). The graft patency rates of coronary arteries without previous stent implantation were higher than the patients with previous stent implantation and experienced CABG. The results suggest that prior PCI may induce atherosclerotic events in the vessel that can adversely affect graft patency after surgery. PMID:25637043

  8. Self-Control, Gender, and Age: A Survival Analysis of Recidivism among Boot Camp Graduates in a 5-Year Follow-Up

    ERIC Educational Resources Information Center

    Benda, Brent B.; Toombs, Nancy J.; Corwyn, Robert Flynn

    2005-01-01

    This study of 572 male and 120 female graduates of a boot camp investigates the potency of self-control as a predictor of recidivism in comparison to gender, age, and elements of life-course theory. It also examines whether the effects of self-control on recidivism are commensurate within the categories of gender. Recidivism is defined as a felony…

  9. Cerebellar medulloblastoma: the importance of posterior fossa dose to survival and patterns of failure

    SciTech Connect

    Silverman, C.L.; Simpson, J.R.

    1982-11-01

    Fifty patients with biopsy-proven cerebellar medulloblastoma were retrospectively analyzed for prognostic factors, survival and patterns of failure. Five- and ten-year actuarial survivals for the entire group were 51% and 42%. Survival and local control were significantly better for the 21 patients who received doses greater than 5000 rad to the posterior fossa (85% and 80% respectively) than for the remaining patients (38% and 38%, respectively). Significant prognostic factors included achievement of local control in the posterior fossa (p = .0001) and dose to the posterior fossa (p = .0005). Sex, age, duration of symptoms, extent of surgery and initial T-stage of disease were not significant. Posterior fossa was the predominant site of failure (71% of failures), but 10% of patients failed in the cerebrum and 12% outside the CNS. This experience confirms that survival rates of 70-80% are achievable with current treatment policies but accurate and consistent dose delivery to the posterior fossa is essential.

  10. Cerebellar medulloblastoma: the importance of posterior fossa dose to survival and patterns of failure

    SciTech Connect

    Silverman, C.L.; Simpson, J.R.

    1982-11-01

    Fifty patients with biopsy-proven cerebellar medulloblastoma were retrospectively analyzed for prognostic factors, survival and patterns of failure. Five- and ten-year actuarial survivals for the entire group were 51% and 42%. Survival and local control were significantly better for the 21 patients who received doses greater that 5000 rad to the posterior fossa (85% and 80% respectively) than for the remaining patients (38% and 38%, respectively). Significant prognostic factors included achievement of local control in the posterior fossa (p = .0001) and dose to the posterior fossa (p = .0005). Sex, age, duration of symptoms, extent of surgery and initial T-stage of disease were not significant. Posterior fossa was the predominant site of failure (71% of failures), but 10% of patients failed in the cerebrum and 12% outside the CNS. This experience confirms that survival rates of 70-80% are achievable with current treatment policies but accurate and consistent dose delivery to the posterior fossa is essential.

  11. Migration, urbanisation and mortality: 5-year longitudinal analysis of the PERU MIGRANT study

    PubMed Central

    Pena, Melissa S Burroughs; Bernabé-Ortiz, Antonio; Carrillo-Larco, Rodrigo M; Sánchez, Juan F; Quispe, Renato; Pillay, Timesh D; Málaga, Germán; Gilman, Robert H; Smeeth, Liam; Miranda, J Jaime

    2015-01-01

    Objective To compare all-cause and cause-specific mortality among 3 distinct groups: within-country, rural-to-urban migrants, and rural and urban dwellers in a longitudinal cohort in Peru. Methods The PERU MIGRANT Study, a longitudinal cohort study, used an age-stratified and sex-stratified random sample of urban dwellers in a shanty town community in the capital city of Peru, rural dwellers in the Andes, and migrants from the Andes to the shanty town community. Participants underwent a questionnaire and anthropomorphic measurements at a baseline evaluation in 2007–2008 and at a follow-up visit in 2012–2013. Mortality was determined by death certificate or family interview. Results Of the 989 participants evaluated at baseline, 928 (94%) were evaluated at follow-up (mean age 48 years; 53% female). The mean follow-up time was 5.1 years, totalling 4732.8 person-years. In a multivariable survival model, and relative to urban dwellers, rural participants had lower all-cause mortality (HR=0.27; 95% CI 0.07 to 0.98), and both the rural (HR=0.07; 95% CI 0.01 to 0.87) and migrant (HR=0.13; 95% CI 0.02 to 0.81) groups had lower cardiovascular mortality. Conclusions Cardiovascular mortality of migrants remains similar to that of the rural group, suggesting that rural-to-urban migrants do not appear to catch up with urban mortality in spite of having a more urban cardiovascular risk factor profile. PMID:25987723

  12. Cognitive decline in dementia with Lewy bodies: a 5-year prospective cohort study

    PubMed Central

    Rongve, A; Soennesyn, H; Skogseth, Ragnhild; Oesterhus, Ragnhild; Hortobágyi, T; Ballard, Clive; Auestad, B H; Aarsland, D

    2016-01-01

    Objectives We report the cognitive decline in persons diagnosed with mild dementia with Lewy bodies (DLB) and mild Alzheimer's disease (AD) during 5 years of annual follow-ups. Methods Patients were recruited into the study from geriatric, psychiatric and neurology clinics in Western Norway during 2005–2013. They were diagnosed according to clinical consensus criteria, based on standardised clinical rating scales. Autopsy-based diagnoses were available for 20 cases. Cognitive decline for up to 5 years was assessed using the Clinical Dementia Rating (CDR) scale and the Mini-Mental State Examination (MMSE). Survival analysis including Cox regression (time to reach severe dementia) and linear mixed-effects (lme) modelling were used to model the decline on MMSE. Results At least one follow-up assessment was available for 67 patients with DLB and 107 patients with AD, with a median follow-up time of 4.3 years. The time to reach severe dementia was significantly shorter in DLB (median 1793 days) compared with AD (1947 days; p=0.033), and the difference remained significant in the multiple Cox regression analysis (HR=2.0, p<0.02). In the adjusted lme model, MMSE decline was faster in DLB (annual decline 4.4 points) compared with AD (3.2 points; p<0.008). Conclusions Our findings show that from the mild dementia stage, patients with DLB have a more rapid cognitive decline than in AD. Such prognostic information is vital for patients and families and crucial for planning clinical trials and enabling health economic modelling. PMID:26928028

  13. A prospective randomised controlled trial of laparoscopic vs open radical cystectomy for bladder cancer: perioperative and oncologic outcomes with 5-year follow-upT Lin et al

    PubMed Central

    Lin, T; Fan, X; Zhang, C; Xu, K; Liu, H; Zhang, J; Jiang, C; Huang, H; Han, J; Yao, Y; Xie, W; Dong, W; Bi, L; Huang, J

    2014-01-01

    Background: Laparoscopic radical cystectomy (LRC) is increasingly being used for muscle-invasive bladder cancer. However, high levels of clinical evidence comparing laparoscopic vs open radical cystectomy (ORC) are lacking. Methods: A prospective randomised controlled clinical trial comparing LRC vs ORC in patients undergoing radical cystectomy for bladder cancer. Thirty-five patients were eligible for final analysis in each group. Results: The median follow-up was 26 months (range, 4–59 months) for laparoscopic vs 32 months (range, 6–60 months) for ORC. Significant differences were noted in operative time, estimated blood loss (EBL), blood transfusion rate, analgesic requirement, and time to resumption of oral intake. No significant differences were noted in the length of hospital stay, complication rate, lymph node yield (14.1±6.3 for LRC and 15.2±5.9 for ORC), positive surgical margin rate, postoperative pathology, or recurrence rate (7 for LRC and 8 for ORC). The 5-year recurrence-free survival with laparoscopic vs ORC was 78.5% vs 70.9%, respectively (P=0.773). The overall survival with laparoscopic vs ORC was 73.8% vs 67.4%, respectively (P=0.511). Conclusion: Our study demonstrated that LRC is superior to ORC in perioperative outcomes, including EBL, blood transfusion rate, and analgesic requirement. We found no major difference in oncologic outcomes. The number of patients is too small to allow for a final conclusion. PMID:24407192

  14. Spanish Network on Effects of Wildfires on Soils. The view after 5 years of networking

    NASA Astrophysics Data System (ADS)

    Jordán, Antonio; Mataix-Solera, Jorge; Cerdà, Artemi

    2013-04-01

    1. WHAT IS FUEGORED? The Spanish Thematic Network "Effects of Wildfires on Soils" (FUEGORED, http://grupo.us.es/fuegored) has been working for over 5 years at becoming a point of reference for the study of fire-affected soils and restoration strategies. FUEGORED started in 2007, originally scheduled to run three years, as a result of the interest of Spanish researchers for developing better strategies and scientific interchange of ideas, people and collaboration between research groups. The first steps towards the establishment of a working group were a series of fieldtrips through Spain (2003), USA (2004) and Portugal (2005), where discussions about problems and research strategies arised. In its early years the network was supported by the former Ministry of Science and Innovation. This is a project to review scientific knowledge developed to date and discuss and propose future developments in scientific research about the effects of wildfires on soils. The objectives of the network are to promote and disseminate scientific research findings, provide technical and management information, and facilitate transference of knowledge between scientists, forest managers, students and society. 2. WHO IS IN THE NETWORK? The research group consists of the leading names of Spanish science in the topic and young talents, which are currently developing the most innovative research lines. Currently, the network is formed by 245 members, researchers from over 30 Spanish universities and research centers to provide the experience of decades of scientific and technical work in areas affected by forest fires and outstanding foreign researchers from Europe, Australia and America, including countries such as Australia, Italy, Lithuania, Portugal, UK, USA and others. Forest managers and technicians from various institutions are also present. 3. MAIN ACHIEVEMENTS Four international congresses have been promoted by the network in Valencia, 2008, Seville, 2009, Santiago de Compostela

  15. The Development and Validation of an Actuarial Risk Assessment Tool for the Prediction of First-Time Offending.

    PubMed

    Assink, Mark; van der Put, Claudia E; Stams, Geert Jan J M

    2016-05-01

    For prevention purposes, it is important that police officers can estimate the risk for delinquency among juveniles who were involved in a criminal offense, but not in the role of a suspect. In the present study, the Youth Actuarial Risk Assessment Tool for First-Time Offending (Y-ARAT-FO) was developed based solely on police records with the aim to enable Dutch police officers to predict the risk for first-time offending. For the construction of this initial screening instrument, an Exhaustive Chi-squared Automatic Interaction Detector (Exhaustive CHAID) analysis was performed on a data set that was retrieved from the Dutch police system. The Y-ARAT-FO was developed on a sample of 1,368 juveniles and validated on a different sample of 886 juveniles showing moderate predictive accuracy in the validation sample (area under the receiver operating characteristic curve [AUC] = .728). The predictive accuracy of the Y-ARAT-FO was considered sufficient to justify its use as an initial screening instrument by the Dutch police. PMID:25395478

  16. Sentinel Lymph Node Occult Metastases Have Minimal Survival Effect in Some Breast Cancer Patients

    Cancer.gov

    Detailed examination of sentinel lymph node tissue from breast cancer patients revealed previously unidentified metastases in about 16% of the samples, but the difference in 5-year survival between patients with and without these metastases was very small

  17. 75 FR 42684 - Endangered and Threatened Species; Initiation of a 5-year Review of the Baiji/Chinese River...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-22

    ... of a 5-year Review of the Baiji/Chinese River Dolphin/Yangtze River Dolphin AGENCY: National Marine... the Baiji/Chinese River Dolphin/Yangtze River Dolphin (Lipotes vexillifer) under the Endangered... Baiji/Chinese River Dolphin/Yangtze River Dolphin that has become available. Based on the results...

  18. A 3.5 year diary study: Remembering and life story importance are predicted by different event characteristics.

    PubMed

    Thomsen, Dorthe Kirkegaard; Jensen, Thomas; Holm, Tine; Olesen, Martin Hammershøj; Schnieber, Anette; Tønnesvang, Jan

    2015-11-01

    Forty-five participants described and rated two events each week during their first term at university. After 3.5 years, we examined whether event characteristics rated in the diary predicted remembering, reliving, and life story importance at the follow-up. In addition, we examined whether ratings of life story importance were consistent across a three year interval. Approximately 60% of events were remembered, but only 20% of these were considered above medium importance to life stories. Higher unusualness, rehearsal, and planning predicted whether an event was remembered 3.5 years later. Higher goal-relevance, importance, emotional intensity, and planning predicted life story importance 3.5 years later. There was a moderate correlation between life story importance rated three months after the diary and rated at the 3.5 year follow-up. The results suggest that autobiographical memory and life stories are governed by different mechanisms and that life story memories are characterized by some degree of stability. PMID:26164104

  19. Early Developmental Assessment of Children with Major Non-Cardiac Congenital Anomalies Predicts Development at the Age of 5 Years

    ERIC Educational Resources Information Center

    Mazer, Petra; Gischler, Saskia J.; van der Cammen-van Zijp, Monique H. M.; Tibboel, Dick; Bax, Nicolaas M. A.; Ijsselstijn, Hanneke; van Dijk, Monique; Duivenvoorden, Hugo J.

    2010-01-01

    Aim: The aim of this study was to evaluate cognitive and motor development in children with major congenital anomalies and the predictability of development at age 5 years. Method: A prospective, longitudinal follow-up study was undertaken. The Dutch version of the Bayley Scales of Infant Development--Mental Developmental Index (MDI) and…

  20. Are Story Preferences Sex-Linked for 2 and 3 Year Olds and for 4 and 5 Year Olds?

    ERIC Educational Resources Information Center

    Ross, Martha

    This study attempted to determine: (1) whether 2-, 3-, 4-, and 5-year-old children have sex typed story preferences; and (2) whether an attempt on the part of parents to prevent sex stereotyping would affect sex typed preferences. A review of previous research discusses measures used to determine sex linked responses and the implications of…

  1. Cognitive Based Programming for the 3, 4, and 5 Year Old and Application to Later Reading Skills.

    ERIC Educational Resources Information Center

    Range, Dale G.; And Others

    Parents and teachers are encouraged in this paper to provide home and school cognitive science activities to help their preschool-age children develop prereading skills. Many of the activities mentioned could be introduced prior to the age of 3 years and all by the age of 5 years. In general, activities that develop cognitive skills should precede…

  2. Reduced levodopa-induced complications after 5 years of subthalamic stimulation in Parkinson's disease: a second honeymoon.

    PubMed

    Simonin, Clemence; Tir, M; Devos, D; Kreisler, A; Dujardin, K; Salleron, J; Delval, A; Blond, S; Defebvre, L; Destée, A; Krystkowiak, P

    2009-10-01

    The purpose of this paper is to describe the effect of 5 years of subthalamic nucleus deep brain stimulation (STN DBS) on levodopa-induced complications, both in everyday life and during an acute challenge with levodopa. Thirty three patients were evaluated during an acute levodopa challenge before surgery and then 1 and 5 years afterwards (both off stim and on stim), using the UPDRS III scale and the CAPSIT-PD scales for dystonia and peak-dose dyskinesia. The UPDRS IV scale was used to assess motor complications in everyday life. The levodopa daily dose and DBS parameters were also recorded. Levodopa-induced complications in everyday life (UPDRS IV) and during an acute levodopa challenge had improved markedly after 1 year (both on and off stim) and still further at 5 years. Peak-dose dyskinesia decreased between the 1- and 5-year measurements. STN DBS decreases levodopa-induced motor complications over the long term. This phenomenon may be explained by (a) overall stabilization of the basal ganglia network and (b) striatal synaptic changes. Our results suggest that DBS leads to both qualitative and quantitative modulations in the corticostriatal loops. PMID:19536584

  3. Traumatic fracture through the neurocentral synchondroses of L3 vertebra in a 5-year-old child.

    PubMed

    Shapira, Gali; Militianu, Daniela

    2015-09-01

    Neurocentral synchondroses (NCS) are growth plates that contribute to the transverse growth of the vertebra. Fractures through these NCS are very rare and none have been reported in the lumbar spine. We present a rare case of a traumatic fracture through the neurocentral synchondroses of L3 vertebra in a 5-year-old child. PMID:25975183

  4. 75 FR 37385 - Endangered and Threatened Species; Initiation of a 5-Year Review of the Eastern Distinct...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-29

    ... the Recognition of Distinct Vertebrate in Population Segments (61 FR 4722). For a population to be...) under the Endangered Species Act of 1973, as amended (ESA). A 5-year review is a periodic process... law. If you wish us to withhold your name or address, you must state this request clearly at...

  5. 75 FR 16833 - Preliminary Revised 5-Year Outer Continental Shelf (OCS) Oil and Gas Leasing Program for 2007-2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-02

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF THE INTERIOR Minerals Management Service Preliminary Revised 5-Year Outer Continental Shelf (OCS) Oil and Gas Leasing... original environmental sensitivity analysis relied on only two studies conducted by Continental...

  6. A Study of the Utilization Patterns of an Elementary School-Based Health Clinic over a 5-Year Period

    ERIC Educational Resources Information Center

    Johnson, Veda; Hutcherson, Valerie

    2006-01-01

    The purpose of this study was to determine the utilization pattern of an elementary school-based clinic over a 5-year period. It involved a retrospective analysis of computer-based data for all patient visits during this study period. Results revealed high clinic utilization with an average of over 5 encounters for all users each year. The most…

  7. Trajectories of Symptoms and Impairment for Pediatric Patients with Functional Abdominal Pain: A 5-Year Longitudinal Study

    ERIC Educational Resources Information Center

    Mulvaney, Shelagh; Lambert, E. Warren; Garber, Judy; Walker, Lynn S.

    2006-01-01

    Objective: This prospective study characterizes trajectories of symptoms and impairment in pediatric patients with abdominal pain not associated with identifiable organic disease. Method: The Children's Somatization Inventory and the Functional Disability Inventory were administered four times over 5 years to 132 patients (6-18 years old) seen in…

  8. 76 FR 70156 - Proposed 5-Year Outer Continental Shelf (OCS) Oil and Gas Leasing Program for 2012-2017

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-10

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF THE INTERIOR Bureau of Ocean Energy Management Proposed 5-Year Outer Continental Shelf (OCS) Oil and Gas Leasing... Continental Shelf Lands Act (OCSLA) specifies a multi-step process of consultation and analysis that must...

  9. 77 FR 61573 - Endangered and Threatened Species; Initiation of 5-Year Review for Kemp's Ridley, Olive Ridley...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-10

    ...; Initiation of 5-Year Review for Kemp's Ridley, Olive Ridley, Leatherback, and Hawksbill Sea Turtles AGENCY... (Dermochelys coriacea), and hawksbill (Eretmochelys imbricata) sea turtles under the Endangered Species Act of... sea turtles that has become available since that has become available since their last status...

  10. Asperger Syndrome and Autism: A Comparative Longitudinal Follow-Up Study More than 5 Years after Original Diagnosis

    ERIC Educational Resources Information Center

    Cederlund, Mats; Hagberg, Bibbi; Billstedt, Eva; Gillberg, I. Carina; Gillberg, Christopher

    2008-01-01

    Prospective follow-up study of 70 males with Asperger syndrome (AS), and 70 males with autism more than 5 years after original diagnosis. Instruments used at follow-up included overall clinical assessment, the Diagnostic Interview for Social and Communication Disorders, Wechsler Intelligence Scales, Vineland Adaptive Behavior Scales, and Global…

  11. Epidemiology of Speech and Language Impairment in a Nationally Representative Sample of 4- to 5-Year-Old Children

    ERIC Educational Resources Information Center

    McLeod, Sharynne; Harrison, Linda J.

    2009-01-01

    Purpose: To draw on multiple sources of information to determine prevalence of speech and language impairment in young Australian children. Method: Information about 4,983 children (ages 4-5 years) from Growing Up in Australia: The Longitudinal Study of Australian Children (Australian Institute of Family Studies, 2007) was obtained via parent…

  12. 75 FR 53272 - Endangered and Threatened Species; Initiation of 5-Year Review of the Eastern Distinct Population...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-31

    ... requesting information related to that review (75 FR 37385). A notice correcting the email address and fax number to which comments and information should be sent was published July 7, 2010 (75 FR 38979). Written... of 5-Year Review of the Eastern Distinct Population Segment of the Steller Sea Lion AGENCY:...

  13. The Effect of Inversion on 3- to 5-Year-Olds' Recognition of Face and Nonface Visual Objects

    ERIC Educational Resources Information Center

    Picozzi, Marta; Cassia, Viola Macchi; Turati, Chiara; Vescovo, Elena

    2009-01-01

    This study compared the effect of stimulus inversion on 3- to 5-year-olds' recognition of faces and two nonface object categories matched with faces for a number of attributes: shoes (Experiment 1) and frontal images of cars (Experiments 2 and 3). The inversion effect was present for faces but not shoes at 3 years of age (Experiment 1). Analogous…

  14. 77 FR 16538 - Endangered and Threatened Species; Initiation of 5-Year Review for the North Atlantic Right Whale...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-21

    ...; Initiation of 5-Year Review for the North Atlantic Right Whale and the North Pacific Right Whale AGENCY... review of North Atlantic right whale (Eubalaena glacialis) and North Pacific right whale (Eubalaena... of any such information on these whales that has become available since the last status review...

  15. Changes in Weight over the School Year and Summer Vacation: Results of a 5-Year Longitudinal Study

    ERIC Educational Resources Information Center

    Moreno, Jennette P.; Johnston, Craig A.; Woehler, Deborah

    2013-01-01

    Background: Evidence suggests that children gain more weight during the summer months compared with the school year. To examine the impact of the school and summer environment on children's weight further, we conducted a 5-year longitudinal study examining changes in standardized BMI (zBMI) of students entering kindergarten. Methods: Heights…

  16. 76 FR 20698 - Notice of Proposed Information Collection for Public Comment; Public Housing Agency (PHA) 5-Year...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-13

    ... URBAN DEVELOPMENT Notice of Proposed Information Collection for Public Comment; Public Housing Agency (PHA) 5-Year and Annual Plan AGENCY: Office of the Assistant Secretary for Public and Indian Housing.... This Notice also lists the following information: Title of Proposal: Public Housing Agency (PHA)...

  17. Changes in weight over the school year and summer vacation: Results of a 5-year longitudinal study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Evidence suggests that children gain more weight during the summer months compared with the school year. In order to further examine the impact of the school and summer environment on children's weight, we conducted a 5-year longitudinal study examining changes in standardized BMI (zBMI) of students...

  18. Interactive Reading Experiences of African American Fathers and Social Fathers and Their 4- and 5-Year-Old Children

    ERIC Educational Resources Information Center

    Jackson, Clarissa R.

    2012-01-01

    The purpose of this mixed-methods study was to investigate the patterns of book choice and interaction during book reading sessions of six African American fathers and social fathers and their 4- to 5-year-old children. The fathers/social fathers selected and read aloud expository text, narrative text, and poetry to their children while…

  19. Point Vowel Duration in Children with Hearing Aids and Cochlear Implants at 4 and 5 Years of Age

    ERIC Educational Resources Information Center

    Vandam, Mark; Ide-Helvie, Dana; Moeller, Mary Pat

    2011-01-01

    This work investigates the developmental aspects of the duration of point vowels in children with normal hearing compared with those with hearing aids and cochlear implants at 4 and 5 years of age. Younger children produced longer vowels than older children, and children with hearing loss (HL) produced longer and more variable vowels than their…

  20. False-Belief Understanding in 2.5-Year-Olds: Evidence from Two Novel Verbal Spontaneous-Response Tasks

    ERIC Educational Resources Information Center

    Scott, Rose M.; He, Zijing; Baillargeon, Renee; Cummins, Denise

    2012-01-01

    Recent research indicates that toddlers and infants succeed at various "non-verbal" spontaneous-response false-belief tasks; here we asked whether toddlers would also succeed at verbal spontaneous-response false-belief tasks that imposed significant linguistic demands. We tested 2.5-year-olds using two novel tasks: a "preferential-looking" task in…