Drift tube suspension for high intensity linear accelerators

DOEpatents

Liska, D.J.; Schamaun, R.G.; Clark, D.C.; Potter, R.C.; Frank, J.A.

1980-03-11

The disclosure relates to a drift tube suspension for high intensity linear accelerators. The system comprises a series of box-sections girders independently adjustably mounted on a linear accelerator. A plurality of drift tube holding stems are individually adjustably mounted on each girder.

Modelling female fertility traits in beef cattle using linear and non-linear models.

PubMed

Naya, H; Peñagaricano, F; Urioste, J I

2017-06-01

Female fertility traits are key components of the profitability of beef cattle production. However, these traits are difficult and expensive to measure, particularly under extensive pastoral conditions, and consequently, fertility records are in general scarce and somehow incomplete. Moreover, fertility traits are usually dominated by the effects of herd-year environment, and it is generally assumed that relatively small margins are kept for genetic improvement. New ways of modelling genetic variation in these traits are needed. Inspired in the methodological developments made by Prof. Daniel Gianola and co-workers, we assayed linear (Gaussian), Poisson, probit (threshold), censored Poisson and censored Gaussian models to three different kinds of endpoints, namely calving success (CS), number of days from first calving (CD) and number of failed oestrus (FE). For models involving FE and CS, non-linear models overperformed their linear counterparts. For models derived from CD, linear versions displayed better adjustment than the non-linear counterparts. Non-linear models showed consistently higher estimates of heritability and repeatability in all cases (h 2  < 0.08 and r < 0.13, for linear models; h 2  > 0.23 and r > 0.24, for non-linear models). While additive and permanent environment effects showed highly favourable correlations between all models (>0.789), consistency in selecting the 10% best sires showed important differences, mainly amongst the considered endpoints (FE, CS and CD). In consequence, endpoints should be considered as modelling different underlying genetic effects, with linear models more appropriate to describe CD and non-linear models better for FE and CS. © 2017 Blackwell Verlag GmbH.

Serum osteoprotegerin and renal function in the general population: the Tromsø Study.

PubMed

Vik, Anders; Brodin, Ellen E; Mathiesen, Ellisiv B; Brox, Jan; Jørgensen, Lone; Njølstad, Inger; Brækkan, Sigrid K; Hansen, John-Bjarne

2017-02-01

Serum osteoprotegerin (OPG) is elevated in patients with chronic kidney disease (CKD) and increases with decreasing renal function. However, there are limited data regarding the association between OPG and renal function in the general population. The aim of the present study was to explore the relation between serum OPG and renal function in subjects recruited from the general population. We conducted a cross-sectional study with 6689 participants recruited from the general population in Tromsø, Norway. Estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration equations. OPG was modelled both as a continuous and categorical variable. General linear models and linear regression with adjustment for possible confounders were used to study the association between OPG and eGFR. Analyses were stratified by the median age, as serum OPG and age displayed a significant interaction on eGFR. In participants ≤62.2 years with normal renal function (eGFR ≥90 mL/min/1.73 m 2 ) eGFR increased by 0.35 mL/min/1.73 m 2 (95% CI 0.13-0.56) per 1 standard deviation (SD) increase in serum OPG after multiple adjustment. In participants older than the median age with impaired renal function (eGFR <90 mL/min/1.73 m 2 ), eGFR decreased by 1.54 (95% CI -2.06 to -1.01) per 1 SD increase in serum OPG. OPG was associated with an increased eGFR in younger subjects with normal renal function and with a decreased eGFR in older subjects with reduced renal function. Our findings imply that the association between OPG and eGFR varies with age and renal function.

Using structural equation modeling for network meta-analysis.

PubMed

Tu, Yu-Kang; Wu, Yun-Chun

2017-07-14

Network meta-analysis overcomes the limitations of traditional pair-wise meta-analysis by incorporating all available evidence into a general statistical framework for simultaneous comparisons of several treatments. Currently, network meta-analyses are undertaken either within the Bayesian hierarchical linear models or frequentist generalized linear mixed models. Structural equation modeling (SEM) is a statistical method originally developed for modeling causal relations among observed and latent variables. As random effect is explicitly modeled as a latent variable in SEM, it is very flexible for analysts to specify complex random effect structure and to make linear and nonlinear constraints on parameters. The aim of this article is to show how to undertake a network meta-analysis within the statistical framework of SEM. We used an example dataset to demonstrate the standard fixed and random effect network meta-analysis models can be easily implemented in SEM. It contains results of 26 studies that directly compared three treatment groups A, B and C for prevention of first bleeding in patients with liver cirrhosis. We also showed that a new approach to network meta-analysis based on the technique of unrestricted weighted least squares (UWLS) method can also be undertaken using SEM. For both the fixed and random effect network meta-analysis, SEM yielded similar coefficients and confidence intervals to those reported in the previous literature. The point estimates of two UWLS models were identical to those in the fixed effect model but the confidence intervals were greater. This is consistent with results from the traditional pairwise meta-analyses. Comparing to UWLS model with common variance adjusted factor, UWLS model with unique variance adjusted factor has greater confidence intervals when the heterogeneity was larger in the pairwise comparison. The UWLS model with unique variance adjusted factor reflects the difference in heterogeneity within each comparison. SEM provides a very flexible framework for univariate and multivariate meta-analysis, and its potential as a powerful tool for advanced meta-analysis is still to be explored.

Economic evaluation of an implementation strategy for the management of low back pain in general practice.

PubMed

Jensen, Cathrine Elgaard; Riis, Allan; Petersen, Karin Dam; Jensen, Martin Bach; Pedersen, Kjeld Møller

2017-05-01

In connection with the publication of a clinical practice guideline on the management of low back pain (LBP) in general practice in Denmark, a cluster randomised controlled trial was conducted. In this trial, a multifaceted guideline implementation strategy to improve general practitioners' treatment of patients with LBP was compared with a usual implementation strategy. The aim was to determine whether the multifaceted strategy was cost effective, as compared with the usual implementation strategy. The economic evaluation was conducted as a cost-utility analysis where cost collected from a societal perspective and quality-adjusted life years were used as outcome measures. The analysis was conducted as a within-trial analysis with a 12-month time horizon consistent with the follow-up period of the clinical trial. To adjust for a priori selected covariates, generalised linear models with a gamma family were used to estimate incremental costs and quality-adjusted life years. Furthermore, both deterministic and probabilistic sensitivity analyses were conducted. Results showed that costs associated with primary health care were higher, whereas secondary health care costs were lower for the intervention group when compared with the control group. When adjusting for covariates, the intervention was less costly, and there was no significant difference in effect between the 2 groups. Sensitivity analyses showed that results were sensitive to uncertainty. In conclusion, the multifaceted implementation strategy was cost saving when compared with the usual strategy for implementing LBP clinical practice guidelines in general practice. Furthermore, there was no significant difference in effect, and the estimate was sensitive to uncertainty.

Bayes linear covariance matrix adjustment

NASA Astrophysics Data System (ADS)

Wilkinson, Darren J.

1995-12-01

In this thesis, a Bayes linear methodology for the adjustment of covariance matrices is presented and discussed. A geometric framework for quantifying uncertainties about covariance matrices is set up, and an inner-product for spaces of random matrices is motivated and constructed. The inner-product on this space captures aspects of our beliefs about the relationship between covariance matrices of interest to us, providing a structure rich enough for us to adjust beliefs about unknown matrices in the light of data such as sample covariance matrices, exploiting second-order exchangeability and related specifications to obtain representations allowing analysis. Adjustment is associated with orthogonal projection, and illustrated with examples of adjustments for some common problems. The problem of adjusting the covariance matrices underlying exchangeable random vectors is tackled and discussed. Learning about the covariance matrices associated with multivariate time series dynamic linear models is shown to be amenable to a similar approach. Diagnostics for matrix adjustments are also discussed.

Adjustment of Adaptive Gain with Bounded Linear Stability Analysis to Improve Time-Delay Margin for Metrics-Driven Adaptive Control

NASA Technical Reports Server (NTRS)

Bakhtiari-Nejad, Maryam; Nguyen, Nhan T.; Krishnakumar, Kalmanje Srinvas

2009-01-01

This paper presents the application of Bounded Linear Stability Analysis (BLSA) method for metrics driven adaptive control. The bounded linear stability analysis method is used for analyzing stability of adaptive control models, without linearizing the adaptive laws. Metrics-driven adaptive control introduces a notion that adaptation should be driven by some stability metrics to achieve robustness. By the application of bounded linear stability analysis method the adaptive gain is adjusted during the adaptation in order to meet certain phase margin requirements. Analysis of metrics-driven adaptive control is evaluated for a linear damaged twin-engine generic transport model of aircraft. The analysis shows that the system with the adjusted adaptive gain becomes more robust to unmodeled dynamics or time delay.

Failed reciprocity in close social relationships and health: findings from the Whitehall II study.

PubMed

Chandola, Tarani; Marmot, Michael; Siegrist, Johannes

2007-10-01

To extend the model of effort-reward imbalance at work to close and more general social relationships and test the associations with different measures of health. Lack of reciprocity at work is associated with poorer health in a number of studies. However, few studies have analysed the effect of nonreciprocity in other kinds of social relationships on health. The Whitehall II Study is an ongoing prospective study of British civil servants (n=10308 at baseline in 1985-88). Cross-sectional data from the latest phase (7, n=6944 in 2002-04) were used in the analyses. The main exposure was a questionnaire measuring nonreciprocal social relations in partnership, parent-children, and general trusting relationships. Health measures included the SF-36 mental and physical component scores, General Health Questionnaire-30 depression subscale, Jenkins' Sleep disturbance questionnaire, and the Rose Angina questionnaire. Logistic and linear regression models were analysed, adjusted for potential confounders, and mediators of the association. Lack of reciprocity is associated with all measures of poorer health. This association attenuates after adjustment for previous health and additional confounders and mediators but remains significant in a majority of models. Negative social support from a close person is independently associated with reduced health, but adjusting for this effect does not eliminate the association of nonreciprocity with poor health. The effort-reward imbalance at work model has been extended to close and more general social relationships. Lack of reciprocity in partnership, parent-children and general trusting relationships is associated with poorer health.

Predicting declines in perceived relationship continuity using practice deprivation scores: a longitudinal study in primary care.

PubMed

Levene, Louis S; Baker, Richard; Walker, Nicola; Williams, Christopher; Wilson, Andrew; Bankart, John

2018-06-01

Increased relationship continuity in primary care is associated with better health outcomes, greater patient satisfaction, and fewer hospital admissions. Greater socioeconomic deprivation is associated with lower levels of continuity, as well as poorer health outcomes. To investigate whether deprivation scores predicted variations in the decline over time of patient-perceived relationship continuity of care, after adjustment for practice organisational and population factors. An observational study in 6243 primary care practices with more than one GP, in England, using a longitudinal multilevel linear model, 2012-2017 inclusive. Patient-perceived relationship continuity was calculated using two questions from the GP Patient Survey. The effect of deprivation on the linear slope of continuity over time was modelled, adjusting for nine confounding variables (practice population and organisational factors). Clustering of measurements within general practices was adjusted for by using a random intercepts and random slopes model. Descriptive statistics and univariable analyses were also undertaken. Relationship continuity declined by 27.5% between 2012 and 2017, and at all deprivation levels. Deprivation scores from 2012 did not predict variations in the decline of relationship continuity at practice level, after accounting for the effects of organisational and population confounding variables, which themselves did not predict, or weakly predicted with very small effect sizes, the decline of continuity. Cross-sectionally, continuity and deprivation were negatively correlated within each year. The decline in relationship continuity of care has been marked and widespread. Measures to maximise continuity will need to be feasible for individual practices with diverse population and organisational characteristics. © British Journal of General Practice 2018.

Crime Prevention Through Environmental Design (CPTED) Characteristics Associated With Violence and Safety in Middle Schools.

PubMed

Vagi, Kevin J; Stevens, Mark R; Simon, Thomas R; Basile, Kathleen C; Carter, Sherry P; Carter, Stanley L

2018-04-01

This study used a new Crime Prevention Through Environmental Design (CPTED) assessment tool to test the associations between physical attributes of schools and violence-related behaviors and perceptions of students. Data were collected from 4717 students from 50 middle schools. Student perceptions of risk and safety, and violence were assessed. Evaluators used the CPTED School Assessment (CSA) to quantify how well the physical elements of each school correspond to ideal CPTED principles. Generalized linear mixed models were used to adjust for school- and student-level characteristics. Higher CSA scores were generally associated with higher perceptions of safety and lower levels of violence perpetration and perceived risk in unadjusted models. Higher CSA scores were also associated with lower odds of missing school because of safety concerns in most adjusted models, with significant adjusted odds ratios (AORs) ranging from 0.32 to 0.63. CSA scores for parking and bus loading areas also remained associated with higher perceived safety (AORs = 1.28 and 1.32, respectively) and lower perceived risk (AORs = 0.73 and 0.66, respectively) in adjusted models. The CSA is useful for assessing school environments that are associated with violence-related behaviors and perceptions. The CSA might help guide school environmental modifications to reduce violence. © 2018, American School Health Association.

Linear and nonlinear dynamics of isospectral granular chains

NASA Astrophysics Data System (ADS)

Chaunsali, R.; Xu, H.; Yang, J.; Kevrekidis, P. G.

2017-04-01

We study the dynamics of isospectral granular chains that are highly tunable due to the nonlinear Hertz contact law interaction between the granular particles. The system dynamics can thus be tuned easily from being linear to strongly nonlinear by adjusting the initial compression applied to the chain. In particular, we introduce both discrete and continuous spectral transformation schemes to generate a family of granular chains that are isospectral in their linear limit. Inspired by the principle of supersymmetry in quantum systems, we also introduce a methodology to add or remove certain eigenfrequencies, and we demonstrate numerically that the corresponding physical system can be constructed in the setting of one-dimensional granular crystals. In the linear regime, we highlight the similarities in the elastic wave transmission characteristics of such isospectral systems, and emphasize that the presented mathematical framework allows one to suitably tailor the wave transmission through a general class of granular chains, both ordered and disordered. Moreover, we show how the dynamic response of these structures deviates from its linear limit as we introduce Hertzian nonlinearity in the chain and how nonlinearity breaks the notion of linear isospectrality.

Propagation of uncertainty by Monte Carlo simulations in case of basic geodetic computations

NASA Astrophysics Data System (ADS)

Wyszkowska, Patrycja

2017-12-01

The determination of the accuracy of functions of measured or adjusted values may be a problem in geodetic computations. The general law of covariance propagation or in case of the uncorrelated observations the propagation of variance (or the Gaussian formula) are commonly used for that purpose. That approach is theoretically justified for the linear functions. In case of the non-linear functions, the first-order Taylor series expansion is usually used but that solution is affected by the expansion error. The aim of the study is to determine the applicability of the general variance propagation law in case of the non-linear functions used in basic geodetic computations. The paper presents errors which are a result of negligence of the higher-order expressions and it determines the range of such simplification. The basis of that analysis is the comparison of the results obtained by the law of propagation of variance and the probabilistic approach, namely Monte Carlo simulations. Both methods are used to determine the accuracy of the following geodetic computations: the Cartesian coordinates of unknown point in the three-point resection problem, azimuths and distances of the Cartesian coordinates, height differences in the trigonometric and the geometric levelling. These simulations and the analysis of the results confirm the possibility of applying the general law of variance propagation in basic geodetic computations even if the functions are non-linear. The only condition is the accuracy of observations, which cannot be too low. Generally, this is not a problem with using present geodetic instruments.

Should measures of patient experience in primary care be adjusted for case mix? Evidence from the English General Practice Patient Survey

PubMed Central

Paddison, Charlotte; Elliott, Marc; Parker, Richard; Staetsky, Laura; Lyratzopoulos, Georgios; Campbell, John L

2012-01-01

Objectives Uncertainties exist about when and how best to adjust performance measures for case mix. Our aims are to quantify the impact of case-mix adjustment on practice-level scores in a national survey of patient experience, to identify why and when it may be useful to adjust for case mix, and to discuss unresolved policy issues regarding the use of case-mix adjustment in performance measurement in health care. Design/setting Secondary analysis of the 2009 English General Practice Patient Survey. Responses from 2 163 456 patients registered with 8267 primary care practices. Linear mixed effects models were used with practice included as a random effect and five case-mix variables (gender, age, race/ethnicity, deprivation, and self-reported health) as fixed effects. Main outcome measures Primary outcome was the impact of case-mix adjustment on practice-level means (adjusted minus unadjusted) and changes in practice percentile ranks for questions measuring patient experience in three domains of primary care: access; interpersonal care; anticipatory care planning, and overall satisfaction with primary care services. Results Depending on the survey measure selected, case-mix adjustment changed the rank of between 0.4% and 29.8% of practices by more than 10 percentile points. Adjusting for case-mix resulted in large increases in score for a small number of practices and small decreases in score for a larger number of practices. Practices with younger patients, more ethnic minority patients and patients living in more socio-economically deprived areas were more likely to gain from case-mix adjustment. Age and race/ethnicity were the most influential adjustors. Conclusions While its effect is modest for most practices, case-mix adjustment corrects significant underestimation of scores for a small proportion of practices serving vulnerable patients and may reduce the risk that providers would ‘cream-skim’ by not enrolling patients from vulnerable socio-demographic groups. PMID:22626735

Should measures of patient experience in primary care be adjusted for case mix? Evidence from the English General Practice Patient Survey.

PubMed

Paddison, Charlotte; Elliott, Marc; Parker, Richard; Staetsky, Laura; Lyratzopoulos, Georgios; Campbell, John L; Roland, Martin

2012-08-01

Uncertainties exist about when and how best to adjust performance measures for case mix. Our aims are to quantify the impact of case-mix adjustment on practice-level scores in a national survey of patient experience, to identify why and when it may be useful to adjust for case mix, and to discuss unresolved policy issues regarding the use of case-mix adjustment in performance measurement in health care. Secondary analysis of the 2009 English General Practice Patient Survey. Responses from 2 163 456 patients registered with 8267 primary care practices. Linear mixed effects models were used with practice included as a random effect and five case-mix variables (gender, age, race/ethnicity, deprivation, and self-reported health) as fixed effects. Primary outcome was the impact of case-mix adjustment on practice-level means (adjusted minus unadjusted) and changes in practice percentile ranks for questions measuring patient experience in three domains of primary care: access; interpersonal care; anticipatory care planning, and overall satisfaction with primary care services. Depending on the survey measure selected, case-mix adjustment changed the rank of between 0.4% and 29.8% of practices by more than 10 percentile points. Adjusting for case-mix resulted in large increases in score for a small number of practices and small decreases in score for a larger number of practices. Practices with younger patients, more ethnic minority patients and patients living in more socio-economically deprived areas were more likely to gain from case-mix adjustment. Age and race/ethnicity were the most influential adjustors. While its effect is modest for most practices, case-mix adjustment corrects significant underestimation of scores for a small proportion of practices serving vulnerable patients and may reduce the risk that providers would 'cream-skim' by not enrolling patients from vulnerable socio-demographic groups.

Positive Aspects of Caregiving and Caregiver Burden: A Study of Caregivers of Patients With Dementia.

PubMed

Abdollahpour, Ibrahim; Nedjat, Saharnaz; Salimi, Yahya

2018-01-01

Now positive aspect of caregiving (PAC) is well-defined as caregiver gains, satisfaction, meaningful life, and enhanced family relationship. The adjusted association of PAC and caregiver burden is not well acknowledged. This study investigated the association of caregiver burden and PAC adjusting for potential confounders. This was a cross-sectional study that recruited 132 caregivers. A linear regression model with PAC was used to estimate the adjusted associations. The caregiver burden was negatively associated with PAC (mean difference in PAC per a 1-unit increase in caregiver burden = -0.12, 95% confidence interval: -0.18 to -0.056; P < .001). This association remained after adjustment for caregivers' age and marital status as well as patients' dependency level. The negative significant association of caregiver burden with PAC reinforces the need for interventional and/or educational programs aiming at decreasing the overall imposed burden. This can play an important role in improving caregivers' general health and quality of life.

Internal predictors of burnout in psychiatric nurses: An Indian study

PubMed Central

Chakraborty, Rudraprosad; Chatterjee, Arunima; Chaudhury, Suprakash

2012-01-01

Background: Research has not adequately focused on the issue of burnout in Psychiatric nurses, despite the fact that they suffer considerable stress in their work. Till date no study has been conducted on burnout among psychiatric nurses in India. Further, there is a particular lack of research in internal variables predicting burnout in them. Aims: To determine whether there are any internal psychological factors relevant to burnout in psychiatric nurses in India. Materials and Methods: We recruited 101 psychiatric nurses scoring less than two in General Health Questionnaire, version 12 (GHQ-12) from two psychiatric hospitals after obtaining informed consent. All subjects filled up a sociodemographic data sheet along with global adjustment scale, emotional maturity scale, PGI general well-being scale, locus of control scale, and Copenhagen burnout inventory (CBI). Correlations between burnout and sociodemographic/clinical variables were done by Pearson's r or Spearman's rho. Signi ficant variables were entered in a stepwise multiple linear regression analysis with total burnout score as dependent variable. Results: Age, duration of total period of nursing, prior military training, locus of control, sense of general well-being, adjustment capabilities, and emotional maturity had significant relation with burnout. Of them, emotional maturity was the most significant protective factors against burnout along with adjustment capabilities, sense of physical well-being, and military training in decreasing significance. Together they explained 41% variation in total burnout score which is significant at <0.001 level. An internal locus of control was inversely correlated with burnout, but failed to predict it in regression analysis. Conclusion: Emotional maturity, adjustability, sense of general physical well-being as well as prior military training significantly predicted lower burnout. Of them, emotional maturity was the most important predictor. Internal locus of control was also correlated with lower burnout. PMID:24250044

Internal predictors of burnout in psychiatric nurses: An Indian study.

PubMed

Chakraborty, Rudraprosad; Chatterjee, Arunima; Chaudhury, Suprakash

2012-07-01

Research has not adequately focused on the issue of burnout in Psychiatric nurses, despite the fact that they suffer considerable stress in their work. Till date no study has been conducted on burnout among psychiatric nurses in India. Further, there is a particular lack of research in internal variables predicting burnout in them. To determine whether there are any internal psychological factors relevant to burnout in psychiatric nurses in India. We recruited 101 psychiatric nurses scoring less than two in General Health Questionnaire, version 12 (GHQ-12) from two psychiatric hospitals after obtaining informed consent. All subjects filled up a sociodemographic data sheet along with global adjustment scale, emotional maturity scale, PGI general well-being scale, locus of control scale, and Copenhagen burnout inventory (CBI). Correlations between burnout and sociodemographic/clinical variables were done by Pearson's r or Spearman's rho. Signi ficant variables were entered in a stepwise multiple linear regression analysis with total burnout score as dependent variable. Age, duration of total period of nursing, prior military training, locus of control, sense of general well-being, adjustment capabilities, and emotional maturity had significant relation with burnout. Of them, emotional maturity was the most significant protective factors against burnout along with adjustment capabilities, sense of physical well-being, and military training in decreasing significance. Together they explained 41% variation in total burnout score which is significant at <0.001 level. An internal locus of control was inversely correlated with burnout, but failed to predict it in regression analysis. Emotional maturity, adjustability, sense of general physical well-being as well as prior military training significantly predicted lower burnout. Of them, emotional maturity was the most important predictor. Internal locus of control was also correlated with lower burnout.

An evaluation of bias in propensity score-adjusted non-linear regression models.

PubMed

Wan, Fei; Mitra, Nandita

2018-03-01

Propensity score methods are commonly used to adjust for observed confounding when estimating the conditional treatment effect in observational studies. One popular method, covariate adjustment of the propensity score in a regression model, has been empirically shown to be biased in non-linear models. However, no compelling underlying theoretical reason has been presented. We propose a new framework to investigate bias and consistency of propensity score-adjusted treatment effects in non-linear models that uses a simple geometric approach to forge a link between the consistency of the propensity score estimator and the collapsibility of non-linear models. Under this framework, we demonstrate that adjustment of the propensity score in an outcome model results in the decomposition of observed covariates into the propensity score and a remainder term. Omission of this remainder term from a non-collapsible regression model leads to biased estimates of the conditional odds ratio and conditional hazard ratio, but not for the conditional rate ratio. We further show, via simulation studies, that the bias in these propensity score-adjusted estimators increases with larger treatment effect size, larger covariate effects, and increasing dissimilarity between the coefficients of the covariates in the treatment model versus the outcome model.

Instrumental variables as bias amplifiers with general outcome and confounding.

PubMed

Ding, P; VanderWeele, T J; Robins, J M

2017-06-01

Drawing causal inference with observational studies is the central pillar of many disciplines. One sufficient condition for identifying the causal effect is that the treatment-outcome relationship is unconfounded conditional on the observed covariates. It is often believed that the more covariates we condition on, the more plausible this unconfoundedness assumption is. This belief has had a huge impact on practical causal inference, suggesting that we should adjust for all pretreatment covariates. However, when there is unmeasured confounding between the treatment and outcome, estimators adjusting for some pretreatment covariate might have greater bias than estimators without adjusting for this covariate. This kind of covariate is called a bias amplifier, and includes instrumental variables that are independent of the confounder, and affect the outcome only through the treatment. Previously, theoretical results for this phenomenon have been established only for linear models. We fill in this gap in the literature by providing a general theory, showing that this phenomenon happens under a wide class of models satisfying certain monotonicity assumptions. We further show that when the treatment follows an additive or multiplicative model conditional on the instrumental variable and the confounder, these monotonicity assumptions can be interpreted as the signs of the arrows of the causal diagrams.

Ordinal probability effect measures for group comparisons in multinomial cumulative link models.

PubMed

Agresti, Alan; Kateri, Maria

2017-03-01

We consider simple ordinal model-based probability effect measures for comparing distributions of two groups, adjusted for explanatory variables. An "ordinal superiority" measure summarizes the probability that an observation from one distribution falls above an independent observation from the other distribution, adjusted for explanatory variables in a model. The measure applies directly to normal linear models and to a normal latent variable model for ordinal response variables. It equals Φ(β/2) for the corresponding ordinal model that applies a probit link function to cumulative multinomial probabilities, for standard normal cdf Φ and effect β that is the coefficient of the group indicator variable. For the more general latent variable model for ordinal responses that corresponds to a linear model with other possible error distributions and corresponding link functions for cumulative multinomial probabilities, the ordinal superiority measure equals exp(β)/[1+exp(β)] with the log-log link and equals approximately exp(β/2)/[1+exp(β/2)] with the logit link, where β is the group effect. Another ordinal superiority measure generalizes the difference of proportions from binary to ordinal responses. We also present related measures directly for ordinal models for the observed response that need not assume corresponding latent response models. We present confidence intervals for the measures and illustrate with an example. © 2016, The International Biometric Society.

Tooth loss and general quality of life in dentate adults from Southern Brazil.

PubMed

Haag, Dandara Gabriela; Peres, Karen Glazer; Brennan, David Simon

2017-10-01

This study aimed to estimate the association between the number of teeth and general quality of life in adults. A population-based study was conducted with 1720 individuals aged 20-59 years residing in Florianópolis, Brazil, in 2009. Data were collected at participants' households using a structured questionnaire. In 2012, a second wave was undertaken with 1222 individuals. Oral examinations were performed for number of teeth, prevalence of functional dentition (≥21 natural teeth), and shortened dental arch (SDA), which were considered the main exposures. General quality of life was the outcome and was assessed with the WHO Abbreviated Instrument for Quality of Life (WHOQOL-BREF). Covariates included sociodemographic factors, health-related behaviors, and chronic diseases. Multivariable linear regression models were performed to test the associations between the main exposures and the outcome adjusted for covariates. In 2012, 1222 individuals participated in the study (response rate = 71.1%). Having more teeth was associated with greater scores on physical domain of the WHOQOL-BREF [β = 0.24 (95% CI 0.01; 0.46)] after adjustment for covariates. Absence of functional dentition was associated with lower scores on the physical domain [β = -3.94 (95% CI -7.40; -0.48)] in the adjusted analysis. There was no association between both SDA definitions and the domains of general quality of life. Oral health as measured by tooth loss was associated with negative impacts on general quality of life assessed by the WHOQOL-BREF. There was a lack of evidence that SDA is a condition that negatively affects general quality of life.

A novel heuristic for optimization aggregate production problem: Evidence from flat panel display in Malaysia

NASA Astrophysics Data System (ADS)

Al-Kuhali, K.; Hussain M., I.; Zain Z., M.; Mullenix, P.

2015-05-01

Aim: This paper contribute to the flat panel display industry it terms of aggregate production planning. Methodology: For the minimization cost of total production of LCD manufacturing, a linear programming was applied. The decision variables are general production costs, additional cost incurred for overtime production, additional cost incurred for subcontracting, inventory carrying cost, backorder costs and adjustments for changes incurred within labour levels. Model has been developed considering a manufacturer having several product types, which the maximum types are N, along a total time period of T. Results: Industrial case study based on Malaysia is presented to test and to validate the developed linear programming model for aggregate production planning. Conclusion: The model development is fit under stable environment conditions. Overall it can be recommended to adapt the proven linear programming model to production planning of Malaysian flat panel display industry.

Salivary cortisol differs with age and sex and shows inverse associations with WHR in Swedish women: a cross-sectional study.

PubMed

Larsson, Charlotte A; Gullberg, Bo; Råstam, Lennart; Lindblad, Ulf

2009-06-21

Most studies on cortisol have focused on smaller, selected samples. We therefore aimed to sex-specifically study the diurnal cortisol pattern and explore its association with abdominal obesity in a large unselected population. In 2001-2004, 1811 men and women (30-75 years) were randomly selected from the Vara population, south-western Sweden (81% participation rate). Of these, 1671 subjects with full information on basal morning and evening salivary cortisol and anthropometric measurements were included in this cross-sectional study. Differences between groups were examined by general linear model and by logistic and linear regression analyses. Morning and Delta-cortisol (morning - evening cortisol) were significantly higher in women than men. In both genders older age was significantly associated with higher levels of all cortisol measures, however, most consistently with evening cortisol. In women only, age-adjusted means of WHR were significantly lower in the highest compared to the lowest quartile of morning cortisol (p = 0.036) and Delta-cortisol (p < 0.001), respectively. Furthermore, when comparing WHR above and below the mean, the age-adjusted OR in women for the lowest quartile of cortisol compared to the highest was 1.5 (1.0-2.2, p = 0.058) for morning cortisol and 1.9 (1.3-2.8) for Delta-cortisol. All findings for Delta-cortisol remained after adjustments for multiple covariates and were also seen in a linear regression analysis (p = 0.003). In summary, our findings of generally higher cortisol levels in women than men of all ages are novel and the stronger results seen for Delta-cortisol as opposed to morning cortisol in the association with WHR emphasise the need of studying cortisol variation intra-individually. To our knowledge, the associations in this study have never before been investigated in such a large population sample of both men and women. Our results therefore offer important knowledge on the descriptive characteristics of cortisol in relation to age and gender, and on the impact that associations previously seen between cortisol and abdominal obesity in smaller, selected samples have on a population level.

Multiple imputation of rainfall missing data in the Iberian Mediterranean context

NASA Astrophysics Data System (ADS)

Miró, Juan Javier; Caselles, Vicente; Estrela, María José

2017-11-01

Given the increasing need for complete rainfall data networks, in recent years have been proposed diverse methods for filling gaps in observed precipitation series, progressively more advanced that traditional approaches to overcome the problem. The present study has consisted in validate 10 methods (6 linear, 2 non-linear and 2 hybrid) that allow multiple imputation, i.e., fill at the same time missing data of multiple incomplete series in a dense network of neighboring stations. These were applied for daily and monthly rainfall in two sectors in the Júcar River Basin Authority (east Iberian Peninsula), which is characterized by a high spatial irregularity and difficulty of rainfall estimation. A classification of precipitation according to their genetic origin was applied as pre-processing, and a quantile-mapping adjusting as post-processing technique. The results showed in general a better performance for the non-linear and hybrid methods, highlighting that the non-linear PCA (NLPCA) method outperforms considerably the Self Organizing Maps (SOM) method within non-linear approaches. On linear methods, the Regularized Expectation Maximization method (RegEM) was the best, but far from NLPCA. Applying EOF filtering as post-processing of NLPCA (hybrid approach) yielded the best results.

On the repeated measures designs and sample sizes for randomized controlled trials.

PubMed

Tango, Toshiro

2016-04-01

For the analysis of longitudinal or repeated measures data, generalized linear mixed-effects models provide a flexible and powerful tool to deal with heterogeneity among subject response profiles. However, the typical statistical design adopted in usual randomized controlled trials is an analysis of covariance type analysis using a pre-defined pair of "pre-post" data, in which pre-(baseline) data are used as a covariate for adjustment together with other covariates. Then, the major design issue is to calculate the sample size or the number of subjects allocated to each treatment group. In this paper, we propose a new repeated measures design and sample size calculations combined with generalized linear mixed-effects models that depend not only on the number of subjects but on the number of repeated measures before and after randomization per subject used for the analysis. The main advantages of the proposed design combined with the generalized linear mixed-effects models are (1) it can easily handle missing data by applying the likelihood-based ignorable analyses under the missing at random assumption and (2) it may lead to a reduction in sample size, compared with the simple pre-post design. The proposed designs and the sample size calculations are illustrated with real data arising from randomized controlled trials. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Estradiol and inflammatory markers in older men.

PubMed

Maggio, Marcello; Ceda, Gian Paolo; Lauretani, Fulvio; Bandinelli, Stefania; Metter, E Jeffrey; Artoni, Andrea; Gatti, Elisa; Ruggiero, Carmelinda; Guralnik, Jack M; Valenti, Giorgio; Ling, Shari M; Basaria, Shehzad; Ferrucci, Luigi

2009-02-01

Aging is characterized by a mild proinflammatory state. In older men, low testosterone levels have been associated with increasing levels of proinflammatory cytokines. It is still unclear whether estradiol (E2), which generally has biological activities complementary to testosterone, affects inflammation. We analyzed data obtained from 399 men aged 65-95 yr enrolled in the Invecchiare in Chianti study with complete data on body mass index (BMI), serum E2, testosterone, IL-6, soluble IL-6 receptor, TNF-alpha, IL-1 receptor antagonist, and C-reactive protein. The relationship between E2 and inflammatory markers was examined using multivariate linear models adjusted for age, BMI, smoking, physical activity, chronic disease, and total testosterone. In age-adjusted analysis, log (E2) was positively associated with log (IL-6) (r = 0.19; P = 0.047), and the relationship was statistically significant (P = 0.032) after adjustments for age, BMI, smoking, physical activity, chronic disease, and serum testosterone levels. Log (E2) was not significantly associated with log (C-reactive protein), log (soluble IL-6 receptor), or log (TNF-alpha) in both age-adjusted and fully adjusted analyses. In older men, E2 is weakly positively associated with IL-6, independent of testosterone and other confounders including BMI.

A Comparison of Inpatient Cost Per Day in General Surgery Patients with Type 2 Diabetes Treated with Basal-Bolus versus Sliding Scale Insulin Regimens.

PubMed

Phillips, Victoria L; Byrd, Anwar L; Adeel, Saira; Peng, Limin; Smiley, Dawn D; Umpierrez, Guillermo E

2017-01-01

The identification of cost-effective glycaemic management strategies is critical to hospitals. Treatment with a basal-bolus insulin (BBI) regimen has been shown to result in better glycaemic control and fewer complications than sliding scale regular insulin (SSI) in general surgery patients with type 2 diabetes mellitus (T2DM), but the effect on costs is unknown. We conducted a post hoc analysis of the RABBIT Surgery trial to examine whether total inpatient costs per day for general surgery patients with T2DM treated with BBI ( n  = 103) differed from those for patients with T2DM treated with SSI ( n  = 99) regimens. Data were collected from patient clinical and hospital billing records. Charges were adjusted to reflect hospital costs. General linearized models were used to estimate the risk-adjusted effects of BBI versus SSI treatment on average total inpatient costs per day. Risk-adjusted average total inpatient costs per day were $US5404. Treatment with BBI compared with SSI reduced average total inpatient costs per day by $US751 (14%; 95% confidence interval [CI] 20-4). Being treated in a university medical centre, being African American or having a bowel procedure or higher-volume pharmacy use significantly reduced costs per day. In general surgery patients with T2DM, a BBI regimen significantly reduced average total hospital costs per day compared with an SSI regimen. BBI has been shown to improve outcomes in a randomized controlled trial. Those results, combined with our findings regarding savings, suggest that hospitals should consider adopting BBI regimens in patients with T2DM undergoing surgery.

The Ostomy Adjustment Scale: translation into Norwegian language with validation and reliability testing.

PubMed

Indrebø, Kirsten Lerum; Andersen, John Roger; Natvig, Gerd Karin

2014-01-01

The purpose of this study was to adapt the Ostomy Adjustment Scale to a Norwegian version and to assess its construct validity and 2 components of its reliability (internal consistency and test-retest reliability). One hundred fifty-eight of 217 patients (73%) with a colostomy, ileostomy, or urostomy participated in the study. Slightly more than half (56%) were men. Their mean age was 64 years (range, 26-91 years). All respondents had undergone ostomy surgery at least 3 months before participation in the study. The Ostomy Adjustment Scale was translated into Norwegian according to standard procedures for forward and backward translation. The questionnaire was sent to the participants via regular post. The Cronbach alpha and test-retest were computed to assess reliability. Construct validity was evaluated via correlations between each item and score sums; correlations were used to analyze relationships between the Ostomy Adjustment Scale and the 36-item Short Form Health Survey, the Quality of Life Scale, the Hospital Anxiety & Depression Scale, and the General Self-Efficacy Scale. The Cronbach alpha was 0.93, and test-retest reliability r was 0.69. The average correlation quotient item to sum score was 0.49 (range, 0.31-0.73). Results showed moderate negative correlations between the Ostomy Adjustment Scale and the Hospital Anxiety and Depression Scale (-0.37 and -0.40), and moderate positive correlations between the Ostomy Adjustment Scale and the 36-item Short Form Health Survey, the Quality of Life Scale, and the General Self-Efficacy Scale (0.30-0.45) with the exception of the pain domain in the Short Form 36 (0.28). Regression analysis showed linear associations between the Ostomy Adjustment Scale and sociodemographic and clinical variables with the exception of education. The Norwegian language version of the Ostomy Adjustment Scale was found to possess construct validity, along with internal consistency and test-retest reliability. The instrument is sensitive for sociodemographic and clinical variables pertinent to persons with urostomies, colostomies, and ileostomies.

Examining the Error of Mis-Specifying Nonlinear Confounding Effect With Application on Accelerometer-Measured Physical Activity.

PubMed

Lee, Paul H

2017-06-01

Some confounders are nonlinearly associated with dependent variables, but they are often adjusted using a linear term. The purpose of this study was to examine the error of mis-specifying the nonlinear confounding effect. We carried out a simulation study to investigate the effect of adjusting for a nonlinear confounder in the estimation of a causal relationship between the exposure and outcome in 3 ways: using a linear term, binning into 5 equal-size categories, or using a restricted cubic spline of the confounder. Continuous, binary, and survival outcomes were simulated. We examined the confounder across varying measurement error. In addition, we performed a real data analysis examining the 3 strategies to handle the nonlinear effects of accelerometer-measured physical activity in the National Health and Nutrition Examination Survey 2003-2006 data. The mis-specification of a nonlinear confounder had little impact on causal effect estimation for continuous outcomes. For binary and survival outcomes, this mis-specification introduced bias, which could be eliminated using spline adjustment only when there is small measurement error of the confounder. Real data analysis showed that the associations between high blood pressure, high cholesterol, and diabetes and mortality adjusted for physical activity with restricted cubic spline were about 3% to 11% larger than their counterparts adjusted with a linear term. For continuous outcomes, confounders with nonlinear effects can be adjusting with a linear term. Spline adjustment should be used for binary and survival outcomes on confounders with small measurement error.

Methods, systems and apparatus for adjusting modulation index to improve linearity of phase voltage commands

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gallegos-Lopez, Gabriel; Perisic, Milun; Kinoshita, Michael H.

2017-03-14

Embodiments of the present invention relate to methods, systems and apparatus for controlling operation of a multi-phase machine in a motor drive system. The disclosed embodiments provide a mechanism for adjusting modulation index of voltage commands to improve linearity of the voltage commands.

Article mounting and position adjustment stage

DOEpatents

Cutburth, R.W.; Silva, L.L.

1988-05-10

An improved adjustment and mounting stage of the type used for the detection of laser beams is disclosed. A ring sensor holder has locating pins on a first side thereof which are positioned within a linear keyway in a surrounding housing for permitting reciprocal movement of the ring along the keyway. A rotatable ring gear is positioned within the housing on the other side of the ring from the linear keyway and includes an oval keyway which drives the ring along the linear keyway upon rotation of the gear. Motor-driven single-stage and dual (x, y) stage adjustment systems are disclosed which are of compact construction and include a large laser transmission hole. 6 figs.

Article mounting and position adjustment stage

DOEpatents

Cutburth, Ronald W.; Silva, Leonard L.

1988-01-01

An improved adjustment and mounting stage of the type used for the detection of laser beams is disclosed. A ring sensor holder has locating pins on a first side thereof which are positioned within a linear keyway in a surrounding housing for permitting reciprocal movement of the ring along the keyway. A rotatable ring gear is positioned within the housing on the other side of the ring from the linear keyway and includes an oval keyway which drives the ring along the linear keyway upon rotation of the gear. Motor-driven single-stage and dual (x, y) stage adjustment systems are disclosed which are of compact construction and include a large laser transmission hole.

Associations between overweight, obesity, health measures and need for recovery in office employees: a cross-sectional analysis.

PubMed

van der Starre, Robine E; Coffeng, Jennifer K; Hendriksen, Ingrid J M; van Mechelen, Willem; Boot, Cécile R L

2013-12-20

With both a high need for recovery (NFR) and overweight and obesity being a potential burden for organizations (e.g. productivity loss and sickness absence), the aim of this paper was to examine the associations between overweight and obesity and several other health measures and NFR in office workers. Baseline data of 412 office employees participating in a randomised controlled trial aimed at improving NFR in office workers were used. Associations between self-reported BMI categories (normal body weight, overweight, obesity) and several other health measures (general health, mental health, sleep quality, stress and vitality) with NFR were examined. Unadjusted and adjusted linear regression analyses were performed and adjusted for age, education and job demands. In addition, we adjusted for general health in the association between overweight and obesity and NFR. A significant positive association was observed between stress and NFR (B= 18.04, 95%CI:14.53-21.56). General health, mental health, sleep quality and vitality were negatively associated with NFR (p<0.001). Analyses also showed a significant positive association between obesity and NFR (B=8.77, 95%CI:0.01-17.56), but not between overweight and NFR. The findings suggest that self-reported stress is, and obesity may be, associated with a higher NFR. Additionally, the results imply that health measures that indicate a better health are associated with a lower NFR. The trial is registered at the Dutch Trial Register (NTR) under trial registration number: NTR2553.

A mathematical theory of learning control for linear discrete multivariable systems

NASA Technical Reports Server (NTRS)

Phan, Minh; Longman, Richard W.

1988-01-01

When tracking control systems are used in repetitive operations such as robots in various manufacturing processes, the controller will make the same errors repeatedly. Here consideration is given to learning controllers that look at the tracking errors in each repetition of the process and adjust the control to decrease these errors in the next repetition. A general formalism is developed for learning control of discrete-time (time-varying or time-invariant) linear multivariable systems. Methods of specifying a desired trajectory (such that the trajectory can actually be performed by the discrete system) are discussed, and learning controllers are developed. Stability criteria are obtained which are relatively easy to use to insure convergence of the learning process, and proper gain settings are discussed in light of measurement noise and system uncertainties.

A simple approach to optimal control of invasive species.

PubMed

Hastings, Alan; Hall, Richard J; Taylor, Caz M

2006-12-01

The problem of invasive species and their control is one of the most pressing applied issues in ecology today. We developed simple approaches based on linear programming for determining the optimal removal strategies of different stage or age classes for control of invasive species that are still in a density-independent phase of growth. We illustrate the application of this method to the specific example of invasive Spartina alterniflora in Willapa Bay, WA. For all such systems, linear programming shows in general that the optimal strategy in any time step is to prioritize removal of a single age or stage class. The optimal strategy adjusts which class is the focus of control through time and can be much more cost effective than prioritizing removal of the same stage class each year.

Smooth function approximation using neural networks.

PubMed

Ferrari, Silvia; Stengel, Robert F

2005-01-01

An algebraic approach for representing multidimensional nonlinear functions by feedforward neural networks is presented. In this paper, the approach is implemented for the approximation of smooth batch data containing the function's input, output, and possibly, gradient information. The training set is associated to the network adjustable parameters by nonlinear weight equations. The cascade structure of these equations reveals that they can be treated as sets of linear systems. Hence, the training process and the network approximation properties can be investigated via linear algebra. Four algorithms are developed to achieve exact or approximate matching of input-output and/or gradient-based training sets. Their application to the design of forward and feedback neurocontrollers shows that algebraic training is characterized by faster execution speeds and better generalization properties than contemporary optimization techniques.

Serum vitamin E concentrations among highly functioning hip fracture patients are higher than in nonfracture controls

PubMed Central

D’Adamo, Christopher R.; Shardell, Michelle D.; Hicks, Gregory E.; Orwig, Denise L.; Hochberg, Marc C.; Semba, Richard D.; Yu-Yahiro, Janet A.; Ferrucci, Luigi; Magaziner, Jay S.; Miller, Ram R.

2014-01-01

Malnutrition after hip fracture is common and associated with poor outcomes and protracted recovery. Low concentrations of vitamin E have been associated with incident decline in physical function among older adults and may, therefore, be particularly important to functionally compromised patients hip fracture patients. Serum concentrations of α-tocopherol and γ-tocopherol, the 2 major forms of vitamin E, were assessed in 148 female hip fracture patients 65 years or older from the Baltimore Hip Studies cohort 4 around the time of fracture (baseline) and at 2, 6, and 12 month postfracture follow-up visits (recovery). It was hypothesized that mean concentrations of both forms of vitamin E among these hip fracture patients would be lowest at the baseline visit and increase at each study visit during the year after fracture. Linear regression and generalized estimating equations were used to assess changes in vitamin E concentrations after adjustment for covariates and to determine predictors of vitamin E concentrations at baseline and throughout recovery. It was also hypothesized that vitamin E concentrations shortly after hip fracture would be lower than those in nonfracture controls after adjustment for covariates. To evaluate this hypothesis, linear regression was used to perform adjusted comparisons of baseline vitamin E concentrations among Baltimore Hip Studies cohort 4 participants to 1076 older women without history of hip fracture from the Women’s Health and Aging Study I, Invecchiare in Chianti Study, and the National Health and Nutrition Examination Surveys. Mean α-tocopherol was lowest at baseline, and time from fracture to blood draw was positively associated with baseline α-tocopherol (P = .005). Mean γ-tocopherol did not change appreciably throughout the year after fracture, although it fluctuated widely within individuals. Serum concentrations of α-tocopherol and γ-tocopherol were highest among the hip fracture population after adjustment (P < .0001). In general, highly cognitively and physically functioning hip fracture patients demonstrated higher vitamin E concentrations. Thus, the relatively high degree of function among this cohort of hip fracture patients may explain their higher-than-expected vitamin E concentrations. PMID:21481714

Serum vitamin E concentrations among highly functioning hip fracture patients are higher than in nonfracture controls.

PubMed

D'Adamo, Christopher R; Shardell, Michelle D; Hicks, Gregory E; Orwig, Denise L; Hochberg, Marc C; Semba, Richard D; Yu-Yahiro, Janet A; Ferrucci, Luigi; Magaziner, Jay S; Miller, Ram R

2011-03-01

Malnutrition after hip fracture is common and associated with poor outcomes and protracted recovery. Low concentrations of vitamin E have been associated with incident decline in physical function among older adults and may, therefore, be particularly important to functionally compromised patients hip fracture patients. Serum concentrations of α-tocopherol and γ-tocopherol, the 2 major forms of vitamin E, were assessed in 148 female hip fracture patients 65 years or older from the Baltimore Hip Studies cohort 4 around the time of fracture (baseline) and at 2, 6, and 12 month postfracture follow-up visits (recovery). It was hypothesized that mean concentrations of both forms of vitamin E among these hip fracture patients would be lowest at the baseline visit and increase at each study visit during the year after fracture. Linear regression and generalized estimating equations were used to assess changes in vitamin E concentrations after adjustment for covariates and to determine predictors of vitamin E concentrations at baseline and throughout recovery. It was also hypothesized that vitamin E concentrations shortly after hip fracture would be lower than those in nonfracture controls after adjustment for covariates. To evaluate this hypothesis, linear regression was used to perform adjusted comparisons of baseline vitamin E concentrations among Baltimore Hip Studies cohort 4 participants to 1076 older women without history of hip fracture from the Women's Health and Aging Study I, Invecchiare in Chianti Study, and the National Health and Nutrition Examination Surveys. Mean α-tocopherol was lowest at baseline, and time from fracture to blood draw was positively associated with baseline α-tocopherol (P = .005). Mean γ-tocopherol did not change appreciably throughout the year after fracture, although it fluctuated widely within individuals. Serum concentrations of α-tocopherol and γ-tocopherol were highest among the hip fracture population after adjustment (P < .0001). In general, highly cognitively and physically functioning hip fracture patients demonstrated higher vitamin E concentrations. Thus, the relatively high degree of function among this cohort of hip fracture patients may explain their higher-than-expected vitamin E concentrations. Copyright © 2011 Elsevier Inc. All rights reserved.

Least-Squares Data Adjustment with Rank-Deficient Data Covariance Matrices

DOE Office of Scientific and Technical Information (OSTI.GOV)

Williams, J.G.

2011-07-01

A derivation of the linear least-squares adjustment formulae is required that avoids the assumption that the covariance matrix of prior parameters can be inverted. Possible proofs are of several kinds, including: (i) extension of standard results for the linear regression formulae, and (ii) minimization by differentiation of a quadratic form of the deviations in parameters and responses. In this paper, the least-squares adjustment equations are derived in both these ways, while explicitly assuming that the covariance matrix of prior parameters is singular. It will be proved that the solutions are unique and that, contrary to statements that have appeared inmore » the literature, the least-squares adjustment problem is not ill-posed. No modification is required to the adjustment formulae that have been used in the past in the case of a singular covariance matrix for the priors. In conclusion: The linear least-squares adjustment formula that has been used in the past is valid in the case of a singular covariance matrix for the covariance matrix of prior parameters. Furthermore, it provides a unique solution. Statements in the literature, to the effect that the problem is ill-posed are wrong. No regularization of the problem is required. This has been proved in the present paper by two methods, while explicitly assuming that the covariance matrix of prior parameters is singular: i) extension of standard results for the linear regression formulae, and (ii) minimization by differentiation of a quadratic form of the deviations in parameters and responses. No modification is needed to the adjustment formulae that have been used in the past. (author)« less

Associations of blood lead, cadmium, and mercury with estimated glomerular filtration rate in the Korean general population: Analysis of 2008-2010 Korean National Health and Nutrition Examination Survey data

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kim, Yangho; Lee, Byung-Kook, E-mail: bklee@sch.ac.kr

Introduction: The objective of this study was to evaluate associations between blood lead, cadmium, and mercury levels with estimated glomerular filtration rate in a general population of South Korean adults. Methods: This was a cross-sectional study based on data obtained in the Korean National Health and Nutrition Examination Survey (KNHANES) (2008-2010). The final analytical sample consisted of 5924 participants. Estimated glomerular filtration rate (eGFR) was calculated using the MDRD Study equation as an indicator of glomerular function. Results: In multiple linear regression analysis of log2-transformed blood lead as a continuous variable on eGFR, after adjusting for covariates including cadmium andmore » mercury, the difference in eGFR levels associated with doubling of blood lead were -2.624 mL/min per 1.73 m Superscript-Two (95% CI: -3.803 to -1.445). In multiple linear regression analysis using quartiles of blood lead as the independent variable, the difference in eGFR levels comparing participants in the highest versus the lowest quartiles of blood lead was -3.835 mL/min per 1.73 m Superscript-Two (95% CI: -5.730 to -1.939). In a multiple linear regression analysis using blood cadmium and mercury, as continuous or categorical variables, as independent variables, neither metal was a significant predictor of eGFR. Odds ratios (ORs) and 95% CI values for reduced eGFR calculated for log2-transformed blood metals and quartiles of the three metals showed similar trends after adjustment for covariates. Discussion: In this large, representative sample of South Korean adults, elevated blood lead level was consistently associated with lower eGFR levels and with the prevalence of reduced eGFR even in blood lead levels below 10 {mu}g/dL. In conclusion, elevated blood lead level was associated with lower eGFR in a Korean general population, supporting the role of lead as a risk factor for chronic kidney disease.« less

Analysis of separation test for automatic brake adjuster based on linear radon transformation

NASA Astrophysics Data System (ADS)

Luo, Zai; Jiang, Wensong; Guo, Bin; Fan, Weijun; Lu, Yi

2015-01-01

The linear Radon transformation is applied to extract inflection points for online test system under the noise conditions. The linear Radon transformation has a strong ability of anti-noise and anti-interference by fitting the online test curve in several parts, which makes it easy to handle consecutive inflection points. We applied the linear Radon transformation to the separation test system to solve the separating clearance of automatic brake adjuster. The experimental results show that the feature point extraction error of the gradient maximum optimal method is approximately equal to ±0.100, while the feature point extraction error of linear Radon transformation method can reach to ±0.010, which has a lower error than the former one. In addition, the linear Radon transformation is robust.

Contract and ownership type of general practices and patient experience in England: multilevel analysis of a national cross-sectional survey

PubMed Central

Laverty, Anthony A; Harris, Matthew J; Watt, Hilary C; Greaves, Felix; Majeed, Azeem

2017-01-01

Objective To examine associations between the contract and ownership type of general practices and patient experience in England. Design Multilevel linear regression analysis of a national cross-sectional patient survey (General Practice Patient Survey). Setting All general practices in England in 2013–2014 (n = 8017). Participants 903,357 survey respondents aged 18 years or over and registered with a general practice for six months or more (34.3% of 2,631,209 questionnaires sent). Main outcome measures Patient reports of experience across five measures: frequency of consulting a preferred doctor; ability to get a convenient appointment; rating of doctor communication skills; ease of contacting the practice by telephone; and overall experience (measured on four- or five-level interval scales from 0 to 100). Models adjusted for demographic and socioeconomic characteristics of respondents and general practice populations and a random intercept for each general practice. Results Most practices had a centrally negotiated contract with the UK government (‘General Medical Services’ 54.6%; 4337/7949). Few practices were limited companies with locally negotiated ‘Alternative Provider Medical Services’ contracts (1.2%; 98/7949); these practices provided worse overall experiences than General Medical Services practices (adjusted mean difference −3.04, 95% CI −4.15 to −1.94). Associations were consistent in direction across outcomes and largest in magnitude for frequency of consulting a preferred doctor (−12.78, 95% CI −15.17 to −10.39). Results were similar for practices owned by large organisations (defined as having ≥20 practices) which were uncommon (2.2%; 176/7949). Conclusions Patients registered to general practices owned by limited companies, including large organisations, reported worse experiences of their care than other patients in 2013–2014. PMID:29096580

Contract and ownership type of general practices and patient experience in England: multilevel analysis of a national cross-sectional survey.

PubMed

Cowling, Thomas E; Laverty, Anthony A; Harris, Matthew J; Watt, Hilary C; Greaves, Felix; Majeed, Azeem

2017-11-01

Objective To examine associations between the contract and ownership type of general practices and patient experience in England. Design Multilevel linear regression analysis of a national cross-sectional patient survey (General Practice Patient Survey). Setting All general practices in England in 2013-2014 ( n = 8017). Participants 903,357 survey respondents aged 18 years or over and registered with a general practice for six months or more (34.3% of 2,631,209 questionnaires sent). Main outcome measures Patient reports of experience across five measures: frequency of consulting a preferred doctor; ability to get a convenient appointment; rating of doctor communication skills; ease of contacting the practice by telephone; and overall experience (measured on four- or five-level interval scales from 0 to 100). Models adjusted for demographic and socioeconomic characteristics of respondents and general practice populations and a random intercept for each general practice. Results Most practices had a centrally negotiated contract with the UK government ('General Medical Services' 54.6%; 4337/7949). Few practices were limited companies with locally negotiated 'Alternative Provider Medical Services' contracts (1.2%; 98/7949); these practices provided worse overall experiences than General Medical Services practices (adjusted mean difference -3.04, 95% CI -4.15 to -1.94). Associations were consistent in direction across outcomes and largest in magnitude for frequency of consulting a preferred doctor (-12.78, 95% CI -15.17 to -10.39). Results were similar for practices owned by large organisations (defined as having ≥20 practices) which were uncommon (2.2%; 176/7949). Conclusions Patients registered to general practices owned by limited companies, including large organisations, reported worse experiences of their care than other patients in 2013-2014.

Analysis of Binary Adherence Data in the Setting of Polypharmacy: A Comparison of Different Approaches

PubMed Central

Esserman, Denise A.; Moore, Charity G.; Roth, Mary T.

2009-01-01

Older community dwelling adults often take multiple medications for numerous chronic diseases. Non-adherence to these medications can have a large public health impact. Therefore, the measurement and modeling of medication adherence in the setting of polypharmacy is an important area of research. We apply a variety of different modeling techniques (standard linear regression; weighted linear regression; adjusted linear regression; naïve logistic regression; beta-binomial (BB) regression; generalized estimating equations (GEE)) to binary medication adherence data from a study in a North Carolina based population of older adults, where each medication an individual was taking was classified as adherent or non-adherent. In addition, through simulation we compare these different methods based on Type I error rates, bias, power, empirical 95% coverage, and goodness of fit. We find that estimation and inference using GEE is robust to a wide variety of scenarios and we recommend using this in the setting of polypharmacy when adherence is dichotomously measured for multiple medications per person. PMID:20414358

Influence of Patients’ Requests for Directly Advertised Antidepressants: A Randomized Controlled Trial

PubMed Central

Kravitz, Richard L.; Epstein, Ronald; Feldman, Mitchell D.; Franz, Carol E.; Azari, Rahman; Wilkes, Michael S.; Hinton, Ladson; Franks, Peter

2011-01-01

Context Direct-to-consumer (DTC) advertising of prescription drugs in the United States is both ubiquitous and controversial. Critics charge that DTC advertising leads to over-prescribing, while proponents counter that it helps avert under-use of effective treatments, especially for conditions such as depression that are poorly recognized or stigmatized. Objective To ascertain the effects of patients’ DTC-related requests on physicians’ initial treatment decisions (prescribing, referral, and follow-up) in patients with depressive symptoms. Design Randomized trial using Standardized Patients (SPs). Six SP roles (experimental cells) were created by crossing two conditions (major depression or adjustment disorder) with three request types (brand-specific, general, or none). Setting Offices of primary care physicians in Sacramento, CA; San Francisco, CA; and Rochester, NY. Participants 152 family physicians and general internists recruited from solo and group practices and health maintenance organizations; cooperation rates ranged from 53% to 61%. Interventions SPs were randomly assigned to make 298 unannounced visits, with assignments constrained so physicians saw 1 SP with major depression and 1 with adjustment disorder (approximately 50 visits per experimental cell). Main Outcome Measures Data on prescribing, mental health referral, and primary care follow-up were obtained from SP written reports, visit audio-recordings, chart review, and analysis of written prescriptions and drug samples. The effects of request type on prescribing were evaluated using contingency tables and confirmed in generalized linear mixed models that accounted for clustering and adjusted for site, physician, and visit characteristics. Results SP role fidelity was excellent, and the detection rate was 12%. In major depression, rates of antidepressant prescribing were 53%, 76%, and 31% for SPs making brand-specific requests, general requests, and no requests, respectively (p<.0001). In adjustment disorder, antidepressant prescribing was 55%, 39%, and 10%, respectively (p<.0001). The results were confirmed in multivariate models. “Minimally acceptable initial care” (any combination of an antidepressant, mental health referral, or follow-up within two weeks) in the major depression role was offered to 98% of SPs making a general request, 90% of those making a brand-specific request, and 56% of those making no request (p<0.001). Conclusions Patients’ requests have a profound effect on physician prescribing in major depression and adjustment disorder. DTC advertising may have competing effects on quality, potentially both averting under-use and promoting over-use. PMID:15855433

Native American ancestry, lung function, and COPD in Costa Ricans.

PubMed

Chen, Wei; Brehm, John M; Boutaoui, Nadia; Soto-Quiros, Manuel; Avila, Lydiana; Celli, Bartolome R; Bruse, Shannon; Tesfaigzi, Yohannes; Celedón, Juan C

2014-04-01

Whether Native American ancestry (NAA) is associated with COPD or lung function in a racially admixed Hispanic population is unknown. We recruited 578 Costa Ricans with and without COPD into a hybrid case-control/family-based cohort, including 316 members of families of index case subjects. All participants completed questionnaires and spirometry and gave a blood sample for DNA extraction. Genome-wide genotyping was conducted with the Illumina Human610-Quad and HumanOmniExpress BeadChip kits (Illumina Inc), and individual ancestral proportions were estimated from these genotypic data and reference panels. For unrelated individuals, linear or logistic regression was used for the analysis of NAA and COPD (GOLD [Global Initiative for Chronic Obstructive Lung Disease] stage II or greater) or lung function. For extended families, linear mixed models and generalized estimating equations were used for the analysis. All models were adjusted for age, sex, educational level, and smoking behavior; models for FEV1 were also adjusted for height. The average proportion of European, Native American, and African ancestry among participants was 62%, 35%, and 3%, respectively. After adjustment for current smoking and other covariates, NAA was inversely associated with COPD (OR per 10% increment, 0.55; 95% CI, 0.41-0.75) but positively associated with FEV1, FVC, and FEV1/FVC. After additional adjustment for pack-years of smoking, the association between NAA and COPD or lung function measures was slightly attenuated. We found that about 31% of the estimated effect of NAA on COPD is mediated by pack-years of smoking. NAA is inversely associated with COPD but positively associated with FEV1 or FVC in Costa Ricans. Ancestral effects on smoking behavior partly explain the findings for COPD but not for FEV1 or FVC.

Native American Ancestry, Lung Function, and COPD in Costa Ricans

PubMed Central

Chen, Wei; Brehm, John M.; Boutaoui, Nadia; Soto-Quiros, Manuel; Avila, Lydiana; Celli, Bartolome R.; Bruse, Shannon; Tesfaigzi, Yohannes

2014-01-01

Background: Whether Native American ancestry (NAA) is associated with COPD or lung function in a racially admixed Hispanic population is unknown. Methods: We recruited 578 Costa Ricans with and without COPD into a hybrid case-control/family-based cohort, including 316 members of families of index case subjects. All participants completed questionnaires and spirometry and gave a blood sample for DNA extraction. Genome-wide genotyping was conducted with the Illumina Human610-Quad and HumanOmniExpress BeadChip kits (Illumina Inc), and individual ancestral proportions were estimated from these genotypic data and reference panels. For unrelated individuals, linear or logistic regression was used for the analysis of NAA and COPD (GOLD [Global Initiative for Chronic Obstructive Lung Disease] stage II or greater) or lung function. For extended families, linear mixed models and generalized estimating equations were used for the analysis. All models were adjusted for age, sex, educational level, and smoking behavior; models for FEV1 were also adjusted for height. Results: The average proportion of European, Native American, and African ancestry among participants was 62%, 35%, and 3%, respectively. After adjustment for current smoking and other covariates, NAA was inversely associated with COPD (OR per 10% increment, 0.55; 95% CI, 0.41-0.75) but positively associated with FEV1, FVC, and FEV1/FVC. After additional adjustment for pack-years of smoking, the association between NAA and COPD or lung function measures was slightly attenuated. We found that about 31% of the estimated effect of NAA on COPD is mediated by pack-years of smoking. Conclusions: NAA is inversely associated with COPD but positively associated with FEV1 or FVC in Costa Ricans. Ancestral effects on smoking behavior partly explain the findings for COPD but not for FEV1 or FVC. PMID:24306962

Use of iDXA spine scans to evaluate total and visceral abdominal fat.

PubMed

Bea, J W; Hsu, C-H; Blew, R M; Irving, A P; Caan, B J; Kwan, M L; Abraham, I; Going, S B

2018-01-01

Abdominal fat may be a better predictor than body mass index (BMI) for risk of metabolically-related diseases, such as diabetes, cardiovascular disease, and some cancers. We sought to validate the percent fat reported on dual energy X-ray absorptiometry (DXA) regional spine scans (spine fat fraction, SFF) against abdominal fat obtained from total body scans using the iDXA machine (General Electric, Madison, WI), as previously done on the Prodigy model. Total body scans and regional spine scans were completed on the same day (N = 50). In alignment with the Prodigy-based study, the following regions of interest (ROI) were assessed from total body scans and compared to the SFF from regional spine scans: total abdominal fat at (1) lumbar vertebrae L2-L4 and (2) L2-Iliac Crest (L2-IC); (3) total trunk fat; and (4) visceral fat in the android region. Separate linear regression models were used to predict each total body scan ROI from SFF; models were validated by bootstrapping. The sample was 84% female, a mean age of 38.5 ± 17.4 years, and mean BMI of 23.0 ± 3.8 kg/m 2 . The SFF, adjusted for BMI, predicted L2-L4 and L2-IC total abdominal fat (%; Adj. R 2 : 0.90) and total trunk fat (%; Adj. R 2 : 0.88) well; visceral fat (%) adjusted R 2 was 0.83. Linear regression models adjusted for additional participant characteristics resulted in similar adjusted R 2 values. This replication of the strong correlation between SFF and abdominal fat measures on the iDXA in a new population confirms the previous Prodigy model findings and improves generalizability. © 2017 Wiley Periodicals, Inc.

Population health needs as predictors of variations in NHS practice payments: a cross-sectional study of English general practices in 2013-2014 and 2014-2015.

PubMed

Levene, Louis S; Baker, Richard; Wilson, Andrew; Walker, Nicola; Boomla, Kambiz; Bankart, M John G

2017-01-01

NHS general practice payments in England include pay for performance elements and a weighted component designed to compensate for workload, but without measures of specific deprivation or ethnic groups. To determine whether population factors related to health needs predicted variations in NHS payments to individual general practices in England. Cross-sectional study of all practices in England, in financial years 2013-2014 and 2014-2015. Descriptive statistics, univariable analyses (examining correlations between payment and predictors), and multivariable analyses (undertaking multivariable linear regressions for each year, with logarithms of payments as the dependent variables, and with population, practice, and performance factors as independent variables) were undertaken. Several population variables predicted variations in adjusted total payments, but inconsistently. Higher payments were associated with increases in deprivation, patients of older age, African Caribbean ethnic group, and asthma prevalence. Lower payments were associated with an increase in smoking prevalence. Long-term health conditions, South Asian ethnic group, and diabetes prevalence were not predictive. The adjusted R 2 values were 0.359 (2013-2014) and 0.374 (2014-2015). A slightly different set of variables predicted variations in the payment component designed to compensate for workload. Lower payments were associated with increases in deprivation, patients of older age, and diabetes prevalence. Smoking prevalence was not predictive. There was a geographical differential. Population factors related to health needs were, overall, poor predictors of variations in adjusted total practice payments and in the payment component designed to compensate for workload. Revising the weighting formula and extending weighting to other payment components might better support practices to address these needs. © British Journal of General Practice 2017.

Relative effects of educational level and occupational social class on body concentrations of persistent organic pollutants in a representative sample of the general population of Catalonia, Spain.

PubMed

Gasull, Magda; Pumarega, José; Rovira, Gemma; López, Tomàs; Alguacil, Juan; Porta, Miquel

2013-10-01

Scant evidence is available worldwide on the relative influence of occupational social class and educational level on body concentrations of persistent organic pollutants (POPs) in the general population. The objective was to analyse such influence in a representative sample of the general population of Catalonia, Spain. Participants in the Catalan Health Interview Survey aged 18-74 were interviewed face-to-face, gave blood, and underwent a physical exam. The role of age, body mass index (BMI), and parity was analysed with General Linear Models, and adjusted geometric means (GMs) were obtained. Crude (unadjusted) concentrations were higher in women and men with lower education, and in women, but not men, in the less affluent social class. After adjusting for age, in women there were no associations between POP levels and social class or education. After adjusting for age and BMI, men in the less affluent class had higher p,p'-DDE concentrations than men in class I (p-value=0.016), while men in class IV had lower HCB than men in the upper class (p-value<0.03). Also in contrast with some expectations, positive associations between education and POP levels were observed after adjusting for age and BMI in men; e.g., men with university studies had higher HCB concentrations than men with first stage of primary schooling (adjusted GM 153.9 and 80.5ng/g, respectively) (p-value<0.001). When education and social class were co-adjusted for, some positive associations with education in men remained statistically significant, whereas class remained associated only with p,p'-DDE. Educational level influenced blood concentrations of POPs more than occupational social class, especially in men. In women, POP concentrations were mainly explained by age/birth cohort, parity and BMI. In men, while concentrations were also mainly explained by age/birth cohort and BMI, both social class and education showed positive associations. Important characteristics of socioeconomic groups as age and BMI may largely explain crude differences among such groups in internal contamination by POPs. The absence of clear patterns of relationships between blood concentrations of POPs and indicators of socioeconomic position may fundamentally be due to the widespread, lifelong, and generally invisible contamination of human food webs. Decreasing historical trends would also partly explain crude socioeconomic differences apparently due to birth cohort effects. © 2013 Elsevier Ltd. All rights reserved.

Estradiol and Inflammatory Markers in Older Men

PubMed Central

Maggio, Marcello; Ceda, Gian Paolo; Lauretani, Fulvio; Bandinelli, Stefania; Metter, E. Jeffrey; Artoni, Andrea; Gatti, Elisa; Ruggiero, Carmelinda; Guralnik, Jack M.; Valenti, Giorgio; Ling, Shari M.; Basaria, Shehzad; Ferrucci, Luigi

2009-01-01

Background: Aging is characterized by a mild proinflammatory state. In older men, low testosterone levels have been associated with increasing levels of proinflammatory cytokines. It is still unclear whether estradiol (E2), which generally has biological activities complementary to testosterone, affects inflammation. Methods: We analyzed data obtained from 399 men aged 65–95 yr enrolled in the Invecchiare in Chianti study with complete data on body mass index (BMI), serum E2, testosterone, IL-6, soluble IL-6 receptor, TNF-α, IL-1 receptor antagonist, and C-reactive protein. The relationship between E2 and inflammatory markers was examined using multivariate linear models adjusted for age, BMI, smoking, physical activity, chronic disease, and total testosterone. Results: In age-adjusted analysis, log (E2) was positively associated with log (IL-6) (r = 0.19; P = 0.047), and the relationship was statistically significant (P = 0.032) after adjustments for age, BMI, smoking, physical activity, chronic disease, and serum testosterone levels. Log (E2) was not significantly associated with log (C-reactive protein), log (soluble IL-6 receptor), or log (TNF-α) in both age-adjusted and fully adjusted analyses. Conclusions: In older men, E2 is weakly positively associated with IL-6, independent of testosterone and other confounders including BMI. PMID:19050054

Clinical and genetic factors affecting tacrolimus trough levels and drug-related outcomes in Korean kidney transplant recipients.

PubMed

Kim, In-Wha; Moon, Yoo Jin; Ji, Eunhee; Kim, Kyung Im; Han, Nayoung; Kim, Sung Ju; Shin, Wan Gyoon; Ha, Jongwon; Yoon, Jeong-Hyun; Lee, Hye Suk; Oh, Jung Mi

2012-05-01

The purpose of this study was to characterize the effects of clinical and genetic variables on the pharmacokinetics and complications of tacrolimus during the first year after kidney transplantation. One hundred and thirty-two Korean kidney recipients who received tacrolimus were genotyped for ABCB1 (exons 12, 21, and 26) and CYP3A5 (intron 3). Tacrolimus trough levels, dose, or dose-adjusted trough levels and complications were compared among patients during the early stage (3, 7, 14, 30, and 90 days) and up to 1 year according to the genotypes. A donor source-adjusted linear mixed model with multilevel analysis adjusting for age, body weight, hematocrit, and serum creatinine showed that CYP3A5 genotype is associated with dose-adjusted level of tacrolimus (p < 0.001). The influence of ABCB1 polymorphisms on the pharmacokinetics or complications of tacrolimus was less certain in our study. The incidence of acute rejections was significantly higher in recipients of cadaveric donor kidney (p < 0.05). A generalized estimating equation model analysis showed that alopecia and hyperlipidemia were associated with dose-adjusted level of tacrolimus (p < 0.001). Genotype of CYP3A5 variants along with significant clinical covariates may be useful in individualizing tacrolimus therapy in kidney transplantation patients.

Hospital costs associated with surgical site infections in general and vascular surgery patients.

PubMed

Boltz, Melissa M; Hollenbeak, Christopher S; Julian, Kathleen G; Ortenzi, Gail; Dillon, Peter W

2011-11-01

Although much has been written about excess cost and duration of stay (DOS) associated with surgical site infections (SSIs) after cardiothoracic surgery, less has been reported after vascular and general surgery. We used data from the National Surgical Quality Improvement Program (NSQIP) to estimate the total cost and DOS associated with SSIs in patients undergoing general and vascular surgery. Using standard NSQIP practices, data were collected on patients undergoing general and vascular surgery at a single academic center between 2007 and 2009 and were merged with fully loaded operating costs obtained from the hospital accounting database. Logistic regression was used to determine which patient and preoperative variables influenced the occurrence of SSIs. After adjusting for patient characteristics, costs and DOS were fit to linear regression models to determine the effect of SSIs. Of the 2,250 general and vascular surgery patients sampled, SSIs were observed in 186 inpatients. Predisposing factors of SSIs were male sex, insulin-dependent diabetes, steroid use, wound classification, and operative time (P < .05). After adjusting for those characteristics, the total excess cost and DOS attributable to SSIs were $10,497 (P < .0001) and 4.3 days (P < .0001), respectively. SSIs complicating general and vascular surgical procedures share many risk factors with SSIs after cardiothoracic surgery. Although the excess costs and DOS associated with SSIs after general and vascular surgery are somewhat less, they still represent substantial financial and opportunity costs to hospitals and suggest, along with the implications for patient care, a continuing need for cost-effective quality improvement and programs of infection prevention. Copyright © 2011 Mosby, Inc. All rights reserved.

Chronic use of low-dose aspirin is not associated with lower bone mineral density in the general population.

PubMed

Bonten, T N; de Mutsert, R; Rosendaal, F R; Jukema, J W; van der Bom, J G; de Jongh, R T; den Heijer, M

2017-10-01

Low-dose aspirin is the cornerstone of secondary prevention of cardiovascular disease. Previous studies suggested that the use of aspirin is associated with an increased fracture risk. However, there is uncertainty whether this is due to an effect of aspirin on bone mineral density (BMD). Between 2008 and 2012, information on medication use and dual X-ray absorptiometry measured vertebral and femoral BMD of 916 participants was collected in the Netherland Epidemiology of Obesity study. The cross-sectional association between chronic low-dose aspirin use and BMD was estimated using linear regression, controlling for demography, body composition, comorbidity and other medication use which could affect BMD. A subgroup analysis in postmenopausal women (n=329) was conducted. After full adjustment, there was no difference between aspirin users and non-users for vertebral BMD (adjusted mean difference: 0.036 (95% CI -0.027 to 0.100) g/cm 2 ) and femoral BMD (adjusted mean difference: 0.001 (-0.067 to 0.069) g/cm 2 ). Also in the subgroup of postmenopausal women, aspirin use was not associated with lower vertebral (adjusted mean difference: 0.069 (-0.046 to 0.184) g/cm 2 ) or femoral BMD (adjusted mean difference: -0.055 (-0.139;0.029) g/cm 2 ). Chronic use of low-dose aspirin is not associated with lower BMD in the general population. The increased risk of fractures observed in aspirin users in previous studies is therefore more likely to be the result of common causes of aspirin use and fractures, but not of direct effects of aspirin on BMD. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Rank-based estimation in the {ell}1-regularized partly linear model for censored outcomes with application to integrated analyses of clinical predictors and gene expression data.

PubMed

Johnson, Brent A

2009-10-01

We consider estimation and variable selection in the partial linear model for censored data. The partial linear model for censored data is a direct extension of the accelerated failure time model, the latter of which is a very important alternative model to the proportional hazards model. We extend rank-based lasso-type estimators to a model that may contain nonlinear effects. Variable selection in such partial linear model has direct application to high-dimensional survival analyses that attempt to adjust for clinical predictors. In the microarray setting, previous methods can adjust for other clinical predictors by assuming that clinical and gene expression data enter the model linearly in the same fashion. Here, we select important variables after adjusting for prognostic clinical variables but the clinical effects are assumed nonlinear. Our estimator is based on stratification and can be extended naturally to account for multiple nonlinear effects. We illustrate the utility of our method through simulation studies and application to the Wisconsin prognostic breast cancer data set.

Anthropometric factors and Breslow thickness: Prospective data on 2570 cutaneous melanoma cases in the population-based Janus Cohort.

PubMed

Stenehjem, J S; Veierød, M B; Nilsen, L T; Ghiasvand, R; Johnsen, B; Grimsrud, T K; Babigumira, R; Støer, N C; Rees, J R; Robsahm, T E

2018-06-01

Breslow thickness is the most important prognostic factor of localized cutaneous melanoma (CM), but associations with anthropometric factors have been sparsely and incompletely investigated. To examine pre-diagnostic body mass index (BMI), body surface area (BSA), height, weight and weight change in relation to Breslow thickness, overall and by anatomical site and histological subtype. Further, to assess possible non-linear associations between these anthropometric factors and Breslow thickness. CMs in the Janus Cohort were identified 1972-2014. Linear regression was used to estimate geometric mean ratios (GMRs) of Breslow thickness with 95% confidence intervals (CIs) according to anthropometric factors. Restricted cubic splines in generalized linear models predicted adjusted mean Breslow thickness, and were used to assess possible non-linear relationships. Among 2570 CM cases, obese had a GMR of 1.16 (95% CI: 1.04, 1.30) of Breslow thickness versus normal weight cases. For BSA and weight, quintile 5 showed GMRs of 1.13 (95% CI: 1.00, 1.27) and 1.17 (95% CI: 1.03, 1.33) of Breslow thickness versus quintile 1, respectively. Associations seemed restricted to superficial spreading melanomas and CMs on the trunk and lower limbs. The associations plateaued at an adjusted mean Breslow thickness of about 2.5 mm (BMI 29 kg/m 2 , BSA 2.05 m 2 and weight 90 kg), before declining for the highest values. No associations were found for height and weight change. This large case-series of incident CM demonstrated positive associations between BMI, BSA, weight and Breslow thickness, and suggested that behavioral or other mechanisms apply at high values. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Road Traffic and Railway Noise Exposures and Adiposity in Adults: A Cross-Sectional Analysis of the Danish Diet, Cancer, and Health Cohort.

PubMed

Christensen, Jeppe Schultz; Raaschou-Nielsen, Ole; Tjønneland, Anne; Overvad, Kim; Nordsborg, Rikke B; Ketzel, Matthias; Sørensen, Thorkild Ia; Sørensen, Mette

2016-03-01

Traffic noise has been associated with cardiovascular and metabolic disorders. Potential modes of action are through stress and sleep disturbance, which may lead to endocrine dysregulation and overweight. We aimed to investigate the relationship between residential traffic and railway noise and adiposity. In this cross-sectional study of 57,053 middle-aged people, height, weight, waist circumference, and bioelectrical impedance were measured at enrollment (1993-1997). Body mass index (BMI), body fat mass index (BFMI), and lean body mass index (LBMI) were calculated. Residential exposure to road and railway traffic noise exposure was calculated using the Nordic prediction method. Associations between traffic noise and anthropometric measures at enrollment were analyzed using general linear models and logistic regression adjusted for demographic and lifestyle factors. Linear regression models adjusted for age, sex, and socioeconomic factors showed that 5-year mean road traffic noise exposure preceding enrollment was associated with a 0.35-cm wider waist circumference (95% CI: 0.21, 0.50) and a 0.18-point higher BMI (95% CI: 0.12, 0.23) per 10 dB. Small, significant increases were also found for BFMI and LBMI. All associations followed linear exposure-response relationships. Exposure to railway noise was not linearly associated with adiposity measures. However, exposure > 60 dB was associated with a 0.71-cm wider waist circumference (95% CI: 0.23, 1.19) and a 0.19-point higher BMI (95% CI: 0.0072, 0.37) compared with unexposed participants (0-20 dB). The present study finds positive associations between residential exposure to road traffic and railway noise and adiposity.

Return to work from long-term sick leave: a six-year prospective study of the importance of adjustment latitudes at work and home.

PubMed

Dellve, Lotta; Fallman, Sara L; Ahlstrom, Linda

2016-01-01

The aim was to investigate the long-term importance of adjustment latitude for increased work ability and return to work among female human service workers on long-term sick leave. A cohort of female human service workers on long-term sick leave (>60 days) was given a questionnaire four times (0, 6, 12, 60 months). Linear mixed models were used for longitudinal analysis of the repeated measurements of work ability and return to work. Having a higher level of adjustment latitude was associated with both increased work ability and return to work. Adjustments related to work pace were strongly associated with increased work ability, as were adjustments to the work place. Having individual opportunities for taking short breaks and a general acceptance of taking short breaks were associated with increased work ability. At home, a higher level of responsibility for household work was related to increased work ability and return to work. Individuals with possibilities for adjustment latitude, especially pace and place at work, and an acceptance of taking breaks had greater increased work ability over time and a greater work ability compared with individuals who did not have such opportunities. This study highlights the importance of opportunities for adjustment latitude at work to increase work ability and return to work among female human service workers who have been on long-term sick leave. The results support push and pull theories for individual decision-making on return to work.

Effectiveness of Tai Chi on Physical and Psychological Health of College Students: Results of a Randomized Controlled Trial

PubMed Central

Li, Moyi; Ling, Kun; Lin, Hui; Chen, Lidian; Tao, Jing; Li, Junzhe; Zheng, Xin; Chen, Bai; Fang, Qianying

2015-01-01

Objective To investigate the effectiveness and safety of Tai Chi Chuan (TCC) on physical and psychological health of college students. Methods Two hundred six college students were recruited and randomly allocated to a control group or a TCC exercise group in an equal ratio. Participants in the control group were instructed to maintain their original activity level and those in the TCC exercise group received 12 weeks of TCC exercise training based on their original activity level. Physical and psychological outcomes were evaluated at baseline, 13 weeks and 25 weeks. Intention-to-treat analysis was performed for the above outcomes. Results Compared with the control group, the TCC exercise group showed significant improvements at the end of the 12-week intervention period for flexibility (length of Sit and Reach (cm): TCC group 14.09±7.40 versus control 12.88±6.57, P = 0.039 adjusted for its baseline measures using a general linear model) and balance ability (open eyes perimeter: TCC group 235.6(191~314) versus control 261(216~300); closed eyes perimeter: TCC group 370.5 (284~454) versus control 367 (293~483); P = 0.0414, 0.008, respectively, adjusted for corresponding baseline measures using a general linear model). No significant changes in other physical and mental outcomes were found between the two groups. No adverse events were reported during the study period. Conclusion TCC exercise was beneficial in college students for improving flexibility and balance capability to some extent, compared with usual exercise. Trial Registration Chinese Clinical Trial Registry ChiCTR-TRC-13003328 PMID:26147842

Associations between overweight, obesity, health measures and need for recovery in office employees: a cross-sectional analysis

PubMed Central

2013-01-01

Background With both a high need for recovery (NFR) and overweight and obesity being a potential burden for organizations (e.g. productivity loss and sickness absence), the aim of this paper was to examine the associations between overweight and obesity and several other health measures and NFR in office workers. Methods Baseline data of 412 office employees participating in a randomised controlled trial aimed at improving NFR in office workers were used. Associations between self-reported BMI categories (normal body weight, overweight, obesity) and several other health measures (general health, mental health, sleep quality, stress and vitality) with NFR were examined. Unadjusted and adjusted linear regression analyses were performed and adjusted for age, education and job demands. In addition, we adjusted for general health in the association between overweight and obesity and NFR. Results A significant positive association was observed between stress and NFR (B = 18.04, 95%CI:14.53-21.56). General health, mental health, sleep quality and vitality were negatively associated with NFR (p < 0.001). Analyses also showed a significant positive association between obesity and NFR (B = 8.77, 95%CI:0.01-17.56), but not between overweight and NFR. Conclusions The findings suggest that self-reported stress is, and obesity may be, associated with a higher NFR. Additionally, the results imply that health measures that indicate a better health are associated with a lower NFR. Trial registration The trial is registered at the Dutch Trial Register (NTR) under trial registration number: NTR2553. PMID:24359267

Hospital costs estimation and prediction as a function of patient and admission characteristics.

PubMed

Ramiarina, Robert; Almeida, Renan Mvr; Pereira, Wagner Ca

2008-01-01

The present work analyzed the association between hospital costs and patient admission characteristics in a general public hospital in the city of Rio de Janeiro, Brazil. The unit costs method was used to estimate inpatient day costs associated to specific hospital clinics. With this aim, three "cost centers" were defined in order to group direct and indirect expenses pertaining to the clinics. After the costs were estimated, a standard linear regression model was developed for correlating cost units and their putative predictors (the patients gender and age, the admission type (urgency/elective), ICU admission (yes/no), blood transfusion (yes/no), the admission outcome (death/no death), the complexity of the medical procedures performed, and a risk-adjustment index). Data were collected for 3100 patients, January 2001-January 2003. Average inpatient costs across clinics ranged from (US$) 1135 [Orthopedics] to 3101 [Cardiology]. Costs increased according to increases in the risk-adjustment index in all clinics, and the index was statistically significant in all clinics except Urology, General surgery, and Clinical medicine. The occupation rate was inversely correlated to costs, and age had no association with costs. The (adjusted) per cent of explained variance varied between 36.3% [Clinical medicine] and 55.1% [Thoracic surgery clinic]. The estimates are an important step towards the standardization of hospital costs calculation, especially for countries that lack formal hospital accounting systems.

Efficient techniques for forced response involving linear modal components interconnected by discrete nonlinear connection elements

NASA Astrophysics Data System (ADS)

Avitabile, Peter; O'Callahan, John

2009-01-01

Generally, response analysis of systems containing discrete nonlinear connection elements such as typical mounting connections require the physical finite element system matrices to be used in a direct integration algorithm to compute the nonlinear response analysis solution. Due to the large size of these physical matrices, forced nonlinear response analysis requires significant computational resources. Usually, the individual components of the system are analyzed and tested as separate components and their individual behavior may essentially be linear when compared to the total assembled system. However, the joining of these linear subsystems using highly nonlinear connection elements causes the entire system to become nonlinear. It would be advantageous if these linear modal subsystems could be utilized in the forced nonlinear response analysis since much effort has usually been expended in fine tuning and adjusting the analytical models to reflect the tested subsystem configuration. Several more efficient techniques have been developed to address this class of problem. Three of these techniques given as: equivalent reduced model technique (ERMT);modal modification response technique (MMRT); andcomponent element method (CEM); are presented in this paper and are compared to traditional methods.

Time and frequency domain characteristics of detrending-operation-based scaling analysis: Exact DFA and DMA frequency responses

NASA Astrophysics Data System (ADS)

Kiyono, Ken; Tsujimoto, Yutaka

2016-07-01

We develop a general framework to study the time and frequency domain characteristics of detrending-operation-based scaling analysis methods, such as detrended fluctuation analysis (DFA) and detrending moving average (DMA) analysis. In this framework, using either the time or frequency domain approach, the frequency responses of detrending operations are calculated analytically. Although the frequency domain approach based on conventional linear analysis techniques is only applicable to linear detrending operations, the time domain approach presented here is applicable to both linear and nonlinear detrending operations. Furthermore, using the relationship between the time and frequency domain representations of the frequency responses, the frequency domain characteristics of nonlinear detrending operations can be obtained. Based on the calculated frequency responses, it is possible to establish a direct connection between the root-mean-square deviation of the detrending-operation-based scaling analysis and the power spectrum for linear stochastic processes. Here, by applying our methods to DFA and DMA, including higher-order cases, exact frequency responses are calculated. In addition, we analytically investigate the cutoff frequencies of DFA and DMA detrending operations and show that these frequencies are not optimally adjusted to coincide with the corresponding time scale.

Time and frequency domain characteristics of detrending-operation-based scaling analysis: Exact DFA and DMA frequency responses.

PubMed

Kiyono, Ken; Tsujimoto, Yutaka

2016-07-01

We develop a general framework to study the time and frequency domain characteristics of detrending-operation-based scaling analysis methods, such as detrended fluctuation analysis (DFA) and detrending moving average (DMA) analysis. In this framework, using either the time or frequency domain approach, the frequency responses of detrending operations are calculated analytically. Although the frequency domain approach based on conventional linear analysis techniques is only applicable to linear detrending operations, the time domain approach presented here is applicable to both linear and nonlinear detrending operations. Furthermore, using the relationship between the time and frequency domain representations of the frequency responses, the frequency domain characteristics of nonlinear detrending operations can be obtained. Based on the calculated frequency responses, it is possible to establish a direct connection between the root-mean-square deviation of the detrending-operation-based scaling analysis and the power spectrum for linear stochastic processes. Here, by applying our methods to DFA and DMA, including higher-order cases, exact frequency responses are calculated. In addition, we analytically investigate the cutoff frequencies of DFA and DMA detrending operations and show that these frequencies are not optimally adjusted to coincide with the corresponding time scale.

Multigenerational effects of parental prenatal exposure to famine on adult offspring cognitive function

PubMed Central

Li, Jie; Na, Lixin; Ma, Hao; Zhang, Zhe; Li, Tianjiao; Lin, Liqun; Li, Qiang; Sun, Changhao; Li, Ying

2015-01-01

The effects of prenatal nutrition on adult cognitive function have been reported for one generation. However, human evidence for multigenerational effects is lacking. We examined whether prenatal exposure to the Chinese famine of 1959–61 affects adult cognitive function in two consecutive generations. In this retrospective family cohort study, we investigated 1062 families consisting of 2124 parents and 1215 offspring. We assessed parental and offspring cognitive performance by means of a comprehensive test battery. Generalized linear regression model analysis in the parental generation showed that prenatal exposure to famine was associated with a 8.1 (95% CI 5.8 to 10.4) second increase in trail making test part A, a 7.0 (1.5 to 12.5) second increase in trail making test part B, and a 5.5 (−7.3 to −3.7) score decrease in the Stroop color-word test in adulthood, after adjustment for potential confounders. In the offspring generation, linear mixed model analysis found no significant association between parental prenatal exposure to famine and offspring cognitive function in adulthood after adjustment for potential confounders. In conclusion, prenatal exposure to severe malnutrition is negatively associated with visual- motor skill, mental flexibility, and selective attention in adulthood. However, these associations are limited to only one generation. PMID:26333696

Adjusted variable plots for Cox's proportional hazards regression model.

PubMed

Hall, C B; Zeger, S L; Bandeen-Roche, K J

1996-01-01

Adjusted variable plots are useful in linear regression for outlier detection and for qualitative evaluation of the fit of a model. In this paper, we extend adjusted variable plots to Cox's proportional hazards model for possibly censored survival data. We propose three different plots: a risk level adjusted variable (RLAV) plot in which each observation in each risk set appears, a subject level adjusted variable (SLAV) plot in which each subject is represented by one point, and an event level adjusted variable (ELAV) plot in which the entire risk set at each failure event is represented by a single point. The latter two plots are derived from the RLAV by combining multiple points. In each point, the regression coefficient and standard error from a Cox proportional hazards regression is obtained by a simple linear regression through the origin fit to the coordinates of the pictured points. The plots are illustrated with a reanalysis of a dataset of 65 patients with multiple myeloma.

Impaired Fertility Associated with Subclinical Hypothyroidism and Thyroid Autoimmunity: The Danish General Suburban Population Study

PubMed Central

Pedersen, Palle L.; Larsen, Jacob

2015-01-01

Introduction. The aim of this study was to estimate the significance of TSH, thyroid peroxidase antibody (TPOAb), and mild (subclinical) hypothyroidism in women from The Danish General Suburban Population Study (GESUS) on the number of children born, the number of pregnancies, and the number of spontaneous abortions. Methods. Retrospective cross sectional study of 11254 women participating in GESUS. Data included biochemical measurements and a self-administrated questionnaire. Results. 6.7% had mild (subclinical) hypothyroidism and 9.4% prevalent hypothyroidism. In women with mild hypothyroidism TPOAb was significantly elevated and age at first child was older compared to controls. TSH and TPOAb were negatively linearly associated with the number of children born and the number of pregnancies in the full cohort in age-adjusted and multiadjusted models. TSH or TPOAb was not associated with spontaneous abortions. Mild (subclinical) hypothyroidism was associated with a risk of not having children and a risk of not getting pregnant in age-adjusted and multiadjusted models. Prevalent hypothyroidism was not associated with the number of children born, the number of pregnancies, or spontaneous abortions. Conclusion. Impaired fertility is associated with TSH, TPOAb, and mild (subclinical) hypothyroidism in a Danish population of women. PMID:26351582

Impaired Fertility Associated with Subclinical Hypothyroidism and Thyroid Autoimmunity: The Danish General Suburban Population Study.

PubMed

Feldthusen, Anne-Dorthe; Pedersen, Palle L; Larsen, Jacob; Toft Kristensen, Tina; Ellervik, Christina; Kvetny, Jan

2015-01-01

The aim of this study was to estimate the significance of TSH, thyroid peroxidase antibody (TPOAb), and mild (subclinical) hypothyroidism in women from The Danish General Suburban Population Study (GESUS) on the number of children born, the number of pregnancies, and the number of spontaneous abortions. Retrospective cross sectional study of 11254 women participating in GESUS. Data included biochemical measurements and a self-administrated questionnaire. 6.7% had mild (subclinical) hypothyroidism and 9.4% prevalent hypothyroidism. In women with mild hypothyroidism TPOAb was significantly elevated and age at first child was older compared to controls. TSH and TPOAb were negatively linearly associated with the number of children born and the number of pregnancies in the full cohort in age-adjusted and multiadjusted models. TSH or TPOAb was not associated with spontaneous abortions. Mild (subclinical) hypothyroidism was associated with a risk of not having children and a risk of not getting pregnant in age-adjusted and multiadjusted models. Prevalent hypothyroidism was not associated with the number of children born, the number of pregnancies, or spontaneous abortions. Impaired fertility is associated with TSH, TPOAb, and mild (subclinical) hypothyroidism in a Danish population of women.

Circulating levels of perfluoroalkyl substances and prevalent diabetes in the elderly.

PubMed

Lind, Lars; Zethelius, Björn; Salihovic, Samira; van Bavel, Bert; Lind, P Monica

2014-03-01

Several environmental contaminants, such as polychlorinated biphenyls, dioxins, bisphenol A and phthalates, have been linked to diabetes. We therefore investigated whether other kinds of contaminants, perfluoroalkyl substances (PFAS), also called perfluorinated compounds (PFCs), are also associated with diabetes. The Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study investigated 1,016 men and women aged 70 years. Seven PFAS were detected in almost all participant sera by ultra-high performance liquid chromatograph/tandem mass spectrometry. Diabetes was defined as use of hypoglycaemic agents or fasting glucose >7.0 mmol/l. 114 people had diabetes. In the linear analysis, no significant relationships were seen between the seven PFAS and prevalent diabetes. However, inclusion of the quadratic terms of the PFAS revealed a significant non-linear relationship between perfluorononanoic acid (PFNA) and diabetes, even after adjusting for multiple confounders (OR 1.96, 95% CI 1.19, 3.22, p = 0.008 for the linear term and OR 1.25, 95% CI 1.08, 1.44, p = 0.002 for the quadratic term). Perfluorooctanoic acid (PFOA) also showed such a relationship (p = 0.01). PFOA was related to the proinsulin/insulin ratio (a marker of insulin secretion), but none of the PFAS was related to the HOMA-IR (a marker of insulin resistance) following adjustment for multiple confounders. PFNA was related to prevalent diabetes in a non-monotonic fashion in this cross-sectional study, supporting the view that this perfluoroalkyl substance might influence glucose metabolism in humans at the level of exposure seen in the general elderly population.

Are skills learned in nursing transferable to other careers?

PubMed

Duffield, Christine; O'Brien-Pallas, Linda; Aitken, Leanne M

2005-01-01

To determine the influence of skills gained in nursing on the transition to a non-nursing career. Little is known about the impact that nursing skills have on the transition to new careers or about the transferability of nursing skills to professions outside nursing. A postal questionnaire was mailed to respondents who had left nursing. The questionnaire included demographic, nursing education and practice information, reasons for entering and leaving nursing, perceptions of the skills gained in nursing and the ease of adjustment to a new career. Data analysis included exploratory and confirmatory factor analysis, Pearson product moment correlations and linear and multiple regression analysis. Skills learned as a nurse that were valuable in acquiring a career outside nursing formed two factors, including "management of self and others" and "knowledge and skills learned," explaining 32% of the variation. The highest educational achievement while working as a nurse, choosing nursing as a "default choice," leaving nursing because of "worklife/homelife balance" and the skills of "management of self and others" and "knowledge and skills" had a significant relationship with difficulty adjusting to a non-nursing work role and, overall, explained 28% of the variation in this difficulty adjusting. General knowledge and skills learned in nursing prove beneficial in adjusting to roles outside nursing.

Solar radiation increases suicide rate after adjusting for other climate factors in South Korea.

PubMed

Jee, Hee-Jung; Cho, Chul-Hyun; Lee, Yu Jin; Choi, Nari; An, Hyonggin; Lee, Heon-Jeong

2017-03-01

Previous studies have indicated that suicide rates have significant seasonal variations. There is seasonal discordance between temperature and solar radiation due to the monsoon season in South Korea. We investigated the seasonality of suicide and assessed its association with climate variables in South Korea. Suicide rates were obtained from the National Statistical Office of South Korea, and climatic data were obtained from the Korea Meteorological Administration for the period of 1992-2010. We conducted analyses using a generalized additive model (GAM). First, we explored the seasonality of suicide and climate variables such as mean temperature, daily temperature range, solar radiation, and relative humidity. Next, we identified confounding climate variables associated with suicide rate. To estimate the adjusted effect of solar radiation on the suicide rate, we investigated the confounding variables using a multivariable GAM. Suicide rate showed seasonality with a pattern similar to that of solar radiation. We found that the suicide rate increased 1.008 times when solar radiation increased by 1 MJ/m 2 after adjusting for other confounding climate factors (P < 0.001). Solar radiation has a significant linear relationship with suicide after adjusting for region, other climate variables, and time trends. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Adjusting Expected Mortality Rates Using Information From a Control Population: An Example Using Socioeconomic Status.

PubMed

Bower, Hannah; Andersson, Therese M-L; Crowther, Michael J; Dickman, Paul W; Lambe, Mats; Lambert, Paul C

2018-04-01

Expected or reference mortality rates are commonly used in the calculation of measures such as relative survival in population-based cancer survival studies and standardized mortality ratios. These expected rates are usually presented according to age, sex, and calendar year. In certain situations, stratification of expected rates by other factors is required to avoid potential bias if interest lies in quantifying measures according to such factors as, for example, socioeconomic status. If data are not available on a population level, information from a control population could be used to adjust expected rates. We have presented two approaches for adjusting expected mortality rates using information from a control population: a Poisson generalized linear model and a flexible parametric survival model. We used a control group from BCBaSe-a register-based, matched breast cancer cohort in Sweden with diagnoses between 1992 and 2012-to illustrate the two methods using socioeconomic status as a risk factor of interest. Results showed that Poisson and flexible parametric survival approaches estimate similar adjusted mortality rates according to socioeconomic status. Additional uncertainty involved in the methods to estimate stratified, expected mortality rates described in this study can be accounted for using a parametric bootstrap, but this might make little difference if using a large control population.

School-related adjustment in children and adolescents with CHD.

PubMed

Im, Yu-Mi; Lee, Sunhee; Yun, Tae-Jin; Choi, Jae Young

2017-09-01

Advancements in medical and surgical treatment have increased the life expectancy of patients with CHD. Many patients with CHD, however, struggle with the medical, psychosocial, and behavioural challenges as they transition from childhood to adulthood. Specifically, the environmental and lifestyle challenges in school are very important factors that affect children and adolescents with CHD. This study aimed to evaluate school-related adjustments depending on school level and disclosure of disease in children and adolescents with CHD. This was a descriptive and exploratory study with 205 children and adolescents, aged 7-18 years, who were recruited from two congenital heart clinics from 5 January to 27 February, 2015. Data were analysed using the Student's t-test, analysis of variance, and a univariate general linear model. School-related adjustment scores were significantly different according to school level and disclosure of disease (p<0.001) when age, religion, experience being bullied, and parents' educational levels were assigned as covariates. The school-related adjustment score of patients who did not disclose their disease dropped significantly in high school. This indicated that it is important for healthcare providers to plan developmentally appropriate educational transition programmes for middle-school students with CHD in order for students to prepare themselves before entering high school.

Superstrong Adjustable Permanent Magnet for a Linear Collider Final Focus

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mihara, T.

A superstrong permanent magnet quadrupole (PMQ) is one of the candidates for the final focus lens for the linear collider because of its compactness and low power consumption. The first fabricated prototype of our PMQ achieved a 300T/m superstrong field gradient with a 100mm overall magnet radius and a 7mm bore radius, but a drawback is its fixed strength. Therefore, a second prototype of PMQ, whose strength is adjustable, was fabricated. Its strength adjustability is based on the ''double ring structure'', rotating subdivided magnet slices separately. This second prototype is being tested. Some of the early results are presented.

Surgery and Neurodevelopmental Outcome of Very Low Birth Weight Infants

PubMed Central

Morriss, Frank H.; Saha, Shampa; Bell, Edward F.; Colaizy, Tarah T.; Stoll, Barbara J.; Hintz, Susan R.; Shankaran, Seetha; Vohr, Betty R.; Hamrick, Shannon E. G.; Pappas, Athina; Jones, Patrick M.; Carlo, Waldemar A.; Laptook, Abbot R.; Van Meurs, Krisa P.; Sánchez, Pablo J.; Hale, Ellen C.; Newman, Nancy S.; Das, Abhik; Higgins, Rosemary D.

2014-01-01

IMPORTANCE Reduced death and neurodevelopmental impairment among infants is a goal of perinatal medicine. OBJECTIVE To assess the association between surgery during the initial hospitalization and death or neurodevelopmental impairment of very low birth weight infants. DESIGN Retrospective cohort analysis of patients enrolled in the National Institute of Child Health and Human Development Neonatal Research Network Generic Database from 1998–2009 and evaluated at 18–22 months’ corrected age. SETTING 22 academic neonatal intensive care units. PARTICIPANTS Inclusion criteria were: birth weight 401–1500 g; survival to 12 hours; available for follow-up. Some conditions were excluded. 12 111 infants were included in analyses, 87% of those eligible. EXPOSURES Surgical procedures; surgery also classified by expected anesthesia type as major (general anesthesia) or minor surgery (non-general anesthesia). MAIN OUTCOME MEASURES Multivariable logistic regression analyses planned a priori were performed for the primary outcome of death or neurodevelopmental impairment and for the secondary outcome of neurodevelopmental impairment among survivors. Multivariable linear regression analyses were performed as planned for the adjusted means of Bayley Scales of Infant Development, Second Edition, Mental Developmental Index and Psychomotor Developmental Index for patients born before 2006. RESULTS There were 2186 major, 784 minor and 9141 no surgery patients. The risk-adjusted odds ratio of death or neurodevelopmental impairment for all surgery patients compared with those who had no surgery was 1.29 (95% confidence interval 1.08–1.55). For patients who had major surgery compared with those who had no surgery the risk-adjusted odds ratio of death or neurodevelopmental impairment was 1.52 (95% confidence interval 1.24–1.87). Patients classified as having minor surgery had no increased adjusted risk. Among survivors who had major surgery compared with those who had no surgery the adjusted odds ratio for neurodevelopmental impairment was 1.56 (95% confidence interval 1.26–1.93) and the adjusted mean Mental Developmental Index and mean Psychomotor Developmental Index values were lower. CONCLUSIONS AND RELEVANCE Major surgery in very low birth weight infants is independently associated with a greater than 50% increased risk of death or neurodevelopmental impairment and of neurodevelopmental impairment at 18–22 months’ corrected age. The role of general anesthesia is implicated but remains unproven. PMID:24934607

Substantial shifts in ranking of California hospitals by hospital-associated methicillin-resistant Staphylococcus aureus infection following adjustment for hospital characteristics and case mix.

PubMed

Tehrani, David M; Phelan, Michael J; Cao, Chenghua; Billimek, John; Datta, Rupak; Nguyen, Hoanglong; Kwark, Homin; Huang, Susan S

2014-10-01

States have established public reporting of hospital-associated (HA) infections-including those of methicillin-resistant Staphylococcus aureus (MRSA)-but do not account for hospital case mix or postdischarge events. Identify facility-level characteristics associated with HA-MRSA infection admissions and create adjusted hospital rankings. A retrospective cohort study of 2009-2010 California acute care hospitals. We defined HA-MRSA admissions as involving MRSA pneumonia or septicemia events arising during hospitalization or within 30 days after discharge. We used mandatory hospitalization and US Census data sets to generate hospital population characteristics by summarizing across admissions. Facility-level factors associated with hospitals' proportions of HA-MRSA infection admissions were identified using generalized linear models. Using state methodology, hospitals were categorized into 3 tiers of HA-MRSA infection prevention performance, using raw and adjusted values. Among 323 hospitals, a median of 16 HA-MRSA infections (range, 0-102) per 10,000 admissions was found. Hospitals serving a greater proportion of patients who had serious comorbidities, were from low-education zip codes, and were discharged to locations other than home were associated with higher HA-MRSA infection risk. Total concordance between all raw and adjusted hospital rankings was 0.45 (95% confidence interval, 0.40-0.51). Among 53 community hospitals in the poor-performance category, more than 20% moved into the average-performance category after adjustment. Similarly, among 71 hospitals in the superior-performance category, half moved into the average-performance category after adjustment. When adjusting for nonmodifiable facility characteristics and case mix, hospital rankings based on HA-MRSA infections substantially changed. Quality indicators for hospitals require adequate adjustment for patient population characteristics for valid interhospital performance comparisons.

Population health needs as predictors of variations in NHS practice payments: a cross-sectional study of English general practices in 2013–2014 and 2014–2015

PubMed Central

Levene, Louis S; Baker, Richard; Wilson, Andrew; Walker, Nicola; Boomla, Kambiz; Bankart, M John G

2017-01-01

Background NHS general practice payments in England include pay for performance elements and a weighted component designed to compensate for workload, but without measures of specific deprivation or ethnic groups. Aim To determine whether population factors related to health needs predicted variations in NHS payments to individual general practices in England. Design and setting Cross-sectional study of all practices in England, in financial years 2013–2014 and 2014–2015. Method Descriptive statistics, univariable analyses (examining correlations between payment and predictors), and multivariable analyses (undertaking multivariable linear regressions for each year, with logarithms of payments as the dependent variables, and with population, practice, and performance factors as independent variables) were undertaken. Results Several population variables predicted variations in adjusted total payments, but inconsistently. Higher payments were associated with increases in deprivation, patients of older age, African Caribbean ethnic group, and asthma prevalence. Lower payments were associated with an increase in smoking prevalence. Long-term health conditions, South Asian ethnic group, and diabetes prevalence were not predictive. The adjusted R2 values were 0.359 (2013–2014) and 0.374 (2014–2015). A slightly different set of variables predicted variations in the payment component designed to compensate for workload. Lower payments were associated with increases in deprivation, patients of older age, and diabetes prevalence. Smoking prevalence was not predictive. There was a geographical differential. Conclusion Population factors related to health needs were, overall, poor predictors of variations in adjusted total practice payments and in the payment component designed to compensate for workload. Revising the weighting formula and extending weighting to other payment components might better support practices to address these needs. PMID:27872085

The association between long working hours and the metabolic syndrome: evidences from the 5th Korean National Health and Nutrition Examination Survey of 2010 and 2012.

PubMed

Jeong, Jae Uk; Jeon, Man Joong; Sakong, Joon

2014-01-01

This study was conducted in order to evaluate the association between the working hours of Korean employees and the metabolic syndrome and the effects of long working hours on metabolic syndrome based on the 5th Korean National Health and Nutrition Examination Survey (2010-2012). Based on the 5th Korean National Health and Nutrition Examination Survey (2010-2012), 4,456 Korean employees without shift work, aged over 15, who work 30 hours or more per week were targeted in this study. The association between the general characteristics, including age, smoking, alcohol drinking, exercise, and the metabolic syndrome criteria defined by International Diabetes Federation (IDF) and weekly working hours were analyzed. In addition, the association between weekly working hours and the metabolic syndrome of the subjects stratified by gender was analyzed through multiple logistic regression analyses and generalized linear mixed model after adjusting the general characteristics. In the results of stratified analysis by gender, in male subjects, in comparison with the 30-39 weekly working hours group, there were no significant adjusted odds ratios to the other working hours groups. In female subjects, in comparison with the 30-39 weekly working hours group, there were no significant adjusted odds ratios to the other working hours groups. In addition, no trend associations were observed among weekly working hour groups in both stratified genders. No significant differences in prevalence of metabolic syndrome of the subjects stratified by gender were found according to weekly increasing working hours. However, due to some limitations of this study, further prospective studies may be necessary for verification.

Outcomes associated with preoperative weight loss after laparoscopic Roux-en-Y gastric bypass

PubMed Central

Blackledge, Camille; Graham, Laura A.; Gullick, Allison A.; Richman, Joshua; Stahl, Richard; Grams, Jayleen

2016-01-01

Background Laparoscopic Roux-en-Y gastric bypass (LRYGB) is an effective treatment for achieving and maintaining weight loss and for improving obesity-related comorbidities. As part of the approval process for bariatric surgery, many insurance companies require patients to have documented recent participation in a supervised weight loss program. The goal of this study was to evaluate the relationship of preoperative weight changes with outcomes following LRYGB. Methods A retrospective review was conducted of adult patients undergoing LRYGB between 2008 and 2012 at a single institution. Patients were stratified into quartiles based on % excess weight gain (0–4.99 % and ≥5 % EWG) and % excess weight loss (0–4.99 % and ≥5 % EWL). Generalized linear models were used to examine differences in postoperative weight outcomes at 6, 12, and 24 months. Covariates included in the final adjusted models were determined using backwards stepwise selection. Results Of the 300 patients included in the study, there were no significant demographic differences among the quartiles. However, there was an increased time to operation for patients who gained or lost ≥5 % excess body weight (p < 0.001). Although there was no statistical significance in postoperative complications, there was a higher rate of complications in patients with ≥5 % EWG compared to those with ≥5 % EWL (12.5 vs. 4.8 %, respectively; p = 0.29). Unadjusted and adjusted generalized linear models showed no statistically significant association between preoperative % excess weight change and weight loss outcomes at 24 months. Conclusion Patients with the greatest % preoperative excess weight change had the longest intervals from initial visit to operation. No significant differences were seen in perioperative and postoperative outcomes. This study suggests preoperative weight loss requirements may delay the time to operation without improving postoperative outcomes or weight loss. PMID:26969666

Quality measurement in the shunt treatment of hydrocephalus: analysis and risk adjustment of the Revision Quotient.

PubMed

Piatt, Joseph H; Freibott, Christina E

2014-07-01

OBJECT.: The Revision Quotient (RQ) has been defined as the ratio of the number of CSF shunt revisions to the number of new shunt insertions for a particular neurosurgical practice in a unit of time. The RQ has been proposed as a quality measure in the treatment of childhood hydrocephalus. The authors examined the construct validity of the RQ and explored the feasibility of risk stratification under this metric. The Kids' Inpatient Database for 1997, 2000, 2003, 2006, and 2009 was queried for admissions with diagnostic codes for hydrocephalus and procedural codes for CSF shunt insertion or revision. Revision quotients were calculated for hospitals that performed 12 or more shunt insertions annually. The univariate associations of hospital RQs with a variety of institutional descriptors were analyzed, and a generalized linear model of the RQ was constructed. There were 12,244 admissions (34%) during which new shunts were inserted, and there were 23,349 admissions (66%) for shunt revision. Three hundred thirty-four annual RQs were calculated for 152 different hospitals. Analysis of variance in hospital RQs over the 5 years of study data supports the construct validity of the metric. The following factors were incorporated into a generalized linear model that accounted for 41% of the variance of the measured RQs: degree of pediatric specialization, proportion of initial case mix in the infant age group, and proportion with neoplastic hydrocephalus. The RQ has construct validity. Risk adjustment is feasible, but the risk factors that were identified relate predominantly to patterns of patient flow through the health care system. Possible advantages of an alternative metric, the Surgical Activity Ratio, are discussed.

Relation of Parental Transitions to Boys' Adjustment Problems: I.A. Linear Hypothesis II. Mothers at Risk for Transitions and Unskilled Parenting.

ERIC Educational Resources Information Center

Capaldi, D. M.; Patterson, G. R.

1991-01-01

Examined the adjustment of boys from intact, single-mother, stepfather, and multiple-transition families. Boys who had experienced multiple transitions showed the poorest adjustment. The antisocial mother was most at risk for transitions and unskilled parenting practices, which in turn placed her son at risk for poor adjustment. (BC)

Profile local linear estimation of generalized semiparametric regression model for longitudinal data.

PubMed

Sun, Yanqing; Sun, Liuquan; Zhou, Jie

2013-07-01

This paper studies the generalized semiparametric regression model for longitudinal data where the covariate effects are constant for some and time-varying for others. Different link functions can be used to allow more flexible modelling of longitudinal data. The nonparametric components of the model are estimated using a local linear estimating equation and the parametric components are estimated through a profile estimating function. The method automatically adjusts for heterogeneity of sampling times, allowing the sampling strategy to depend on the past sampling history as well as possibly time-dependent covariates without specifically model such dependence. A [Formula: see text]-fold cross-validation bandwidth selection is proposed as a working tool for locating an appropriate bandwidth. A criteria for selecting the link function is proposed to provide better fit of the data. Large sample properties of the proposed estimators are investigated. Large sample pointwise and simultaneous confidence intervals for the regression coefficients are constructed. Formal hypothesis testing procedures are proposed to check for the covariate effects and whether the effects are time-varying. A simulation study is conducted to examine the finite sample performances of the proposed estimation and hypothesis testing procedures. The methods are illustrated with a data example.

Non-Linear Concentration-Response Relationships between Ambient Ozone and Daily Mortality.

PubMed

Bae, Sanghyuk; Lim, Youn-Hee; Kashima, Saori; Yorifuji, Takashi; Honda, Yasushi; Kim, Ho; Hong, Yun-Chul

2015-01-01

Ambient ozone (O3) concentration has been reported to be significantly associated with mortality. However, linearity of the relationships and the presence of a threshold has been controversial. The aim of the present study was to examine the concentration-response relationship and threshold of the association between ambient O3 concentration and non-accidental mortality in 13 Japanese and Korean cities from 2000 to 2009. We selected Japanese and Korean cities which have population of over 1 million. We constructed Poisson regression models adjusting daily mean temperature, daily mean PM10, humidity, time trend, season, year, day of the week, holidays and yearly population. The association between O3 concentration and mortality was examined using linear, spline and linear-threshold models. The thresholds were estimated for each city, by constructing linear-threshold models. We also examined the city-combined association using a generalized additive mixed model. The mean O3 concentration did not differ greatly between Korea and Japan, which were 26.2 ppb and 24.2 ppb, respectively. Seven out of 13 cities showed better fits for the spline model compared with the linear model, supporting a non-linear relationships between O3 concentration and mortality. All of the 7 cities showed J or U shaped associations suggesting the existence of thresholds. The range of city-specific thresholds was from 11 to 34 ppb. The city-combined analysis also showed a non-linear association with a threshold around 30-40 ppb. We have observed non-linear concentration-response relationship with thresholds between daily mean ambient O3 concentration and daily number of non-accidental death in Japanese and Korean cities.

Bone and cartilage characteristics in postmenopausal women with mild knee radiographic osteoarthritis and those without radiographic osteoarthritis

PubMed Central

Multanen, J.; Heinonen, A.; Häkkinen, A.; Kautiainen, H.; Kujala, U.M.; Lammentausta, E.; Jämsä, T.; Kiviranta, I.; Nieminen, M.T.

2015-01-01

Objectives: To evaluate the association between radiographically-assessed knee osteoarthritis and femoral neck bone characteristics in women with mild knee radiographic osteoarthritis and those without radiographic osteoarthritis. Methods: Ninety postmenopausal women (mean age [SD], 58 [4] years; height, 163 [6] cm; weight, 71 [11] kg) participated in this cross-sectional study. The severity of radiographic knee osteoarthritis was defined using Kellgren-Lawrence grades 0=normal (n=12), 1=doubtful (n=25) or 2=minimal (n=53). Femoral neck bone mineral content (BMC), section modulus (Z), and cross-sectional area (CSA) were measured with DXA. The biochemical composition of ipsilateral knee cartilage was estimated using quantitative MRI measures, T2 mapping and dGEMRIC. The associations between radiographic knee osteoarthritis grades and bone and cartilage characteristics were analyzed using generalized linear models. Results: Age-, height-, and weight-adjusted femoral neck BMC (p for linearity=0.019), Z (p for linearity=0.033), and CSA (p for linearity=0.019) increased significantly with higher knee osteoarthritis grades. There was no linear relationship between osteoarthritis grades and knee cartilage indices. Conclusions: Increased DXA assessed hip bone strength is related to knee osteoarthritis severity. These results are hypothesis driven that there is an inverse relationship between osteoarthritis and osteoporosis. However, MRI assessed measures of cartilage do not discriminate mild radiographic osteoarthritis severity. PMID:25730654

Association of emphysema-like lung on cardiac computed tomography and mortality in persons without airflow obstruction: the Multi-Ethnic Study of Atherosclerosis (MESA) Lung Study

PubMed Central

Oelsner, Elizabeth C.; Hoffman, Eric A.; Folsom, Aaron R.; Carr, J. Jeffrey; Enright, Paul L.; Kawut, Steven M.; Kronmal, Richard; Lederer, David; Lima, Joao A. C.; Lovasi, Gina S.; Shea, Steven; Barr, R. Graham

2015-01-01

Background Whereas low lung function is known to predict mortality in the general population, the prognostic significance of emphysema on computed tomography (CT) in persons without chronic obstructive pulmonary disease (COPD) remains uncertain. Objective To determine whether greater emphysema-like lung on CT is associated with all-cause mortality among persons without airflow obstruction or COPD in the general population. Design Prospective cohort study. Setting Population-based, multiethnic sample from 6 US communities. Participants 2965 participants ages 45-84 years without airflow obstruction on spirometry. Measurements Emphysema-like lung was defined on cardiac CT as the number of lung voxels less than -950 Hounsfield Units, and was adjusted for the number of total imaged lung voxels. Results Among 2965 participants, 50.9% of whom never smoked, there were 186 deaths over a median of 6.2 years. Greater emphysema-like lung was independently associated with increased mortality (adjusted hazard ratio [HR]1.14 per one-half of the interquartile range, 95% CI 1.04-1.24, P=0.004), adjusting for potential confounders including cardiovascular risk factors and the forced expiratory volume in one second. Generalized additive models supported a linear association between emphysema-like lung and mortality without evidence for a threshold. The association was of greatest magnitude among smokers, although multiplicative interaction terms did not support effect modification by smoking status. Limitations Cardiac CT scans did not include lung apices. The number of deaths was limited among subgroup analyses. Conclusions Emphysema-like lung on CT was associated with all-cause mortality among persons without airflow obstruction or COPD in a general population sample, particularly among smokers. Recognition of the independent prognostic significance of emphysema on CT among patients without COPD on spirometry is warranted. Primary Funding Source NIH/NHLBI. PMID:25506855

Differential Association of Psychosocial Comorbidities With Subclinical Atherosclerosis in Rheumatoid Arthritis.

PubMed

Liu, Ying L; Szklo, Moyses; Davidson, Karina W; Bathon, Joan M; Giles, Jon T

2015-10-01

Rheumatoid arthritis (RA) is associated with an elevated risk of cardiovascular disease (CVD) events and subclinical atherosclerosis, but the reasons for the excess risk are unclear. We explored whether psychosocial comorbidities, which may be associated with CVD in the general population, are differentially associated with subclinical atherosclerosis in RA compared to controls. Data were from a longitudinal cohort study of 195 RA patients and 1,073 non-RA controls. Using validated scales, heterogeneity in the associations of psychosocial measures (depression, stress, anxiety/anger, support, discrimination/hassles) with measures of subclinical atherosclerosis (coronary artery calcium [CAC] and carotid intima-media thickness [IMT]/plaque) were compared in RA and non-RA groups using multivariable generalized linear models. Computed tomography and ultrasound were used to identify CAC and IMT/plaque, respectively. CAC >100 units was used to define moderate/severe CAC. In RA, per-unit higher anxiety scores (odds ratio [OR] 1.10, P = 0.029), anger scores (OR 1.14, P = 0.037), depressive symptoms (OR 3.41, P = 0.032), and caregiver stress (OR 2.86, P = 0.014) were associated with increased odds of CAC >100 units after adjustment for relevant covariates. These findings persisted despite adjustment for markers of inflammation (C-reactive protein and interleukin-6 levels) and were seen only in RA, not in controls (adjusted multiplicative interaction P = 0.001-0.077). In RA, job stress was associated with an increased risk of carotid plaque (adjusted OR = 3.21, P = 0.019), and increasing social support was associated with lower internal carotid IMT (adjusted P = 0.024). Depressive symptoms, stress, anger/anxiety, and social support may preferentially affect CVD risk in RA, and screening/treatment for psychosocial morbidities in RA may help ameliorate the additional CVD burden. © 2015, American College of Rheumatology.

Optimal control theory (OWEM) applied to a helicopter in the hover and approach phase

NASA Technical Reports Server (NTRS)

Born, G. J.; Kai, T.

1975-01-01

A major difficulty in the practical application of linear-quadratic regulator theory is how to choose the weighting matrices in quadratic cost functions. The control system design with optimal weighting matrices was applied to a helicopter in the hover and approach phase. The weighting matrices were calculated to extremize the closed loop total system damping subject to constraints on the determinants. The extremization is really a minimization of the effects of disturbances, and interpreted as a compromise between the generalized system accuracy and the generalized system response speed. The trade-off between the accuracy and the response speed is adjusted by a single parameter, the ratio of determinants. By this approach an objective measure can be obtained for the design of a control system. The measure is to be determined by the system requirements.

Design of a wearable hand exoskeleton for exercising flexion/extension of the fingers.

PubMed

Jo, Inseong; Lee, Jeongsoo; Park, Yeongyu; Bae, Joonbum

2017-07-01

In this paper, design of a wearable hand exoskeleton system for exercising flexion/extension of the fingers, is proposed. The exoskeleton was designed with a simple and wearable structure to aid finger motions in 1 degree of freedom (DOF). A hand grasping experiment by fully-abled people was performed to investigate general hand flexion/extension motions and the polynomial curve of general hand motions was obtained. To customize the hand exoskeleton for the user, the polynomial curve was adjusted to the joint range of motion (ROM) of the user and the optimal design of the exoskeleton structure was obtained using the optimization algorithm. A prototype divided into two parts (one part for the thumb, the other for rest fingers) was actuated by only two linear motors for compact size and light weight.

Relationship of early-life stress and resilience to military adjustment in a young adulthood population.

PubMed

Choi, Kang; Im, Hyoungjune; Kim, Joohan; Choi, Kwang H; Jon, Duk-In; Hong, Hyunju; Hong, Narei; Lee, Eunjung; Seok, Jeong-Ho

2013-11-01

Early-life stress (ELS) may mediate adjustment problems while resilience may protect individuals against adjustment problems during military service. We investigated the relationship of ELS and resilience with adjustment problem factor scores in the Korea Military Personality Test (KMPT) in candidates for the military service. Four hundred and sixty-one candidates participated in this study. Vulnerability traits for military adjustment, ELS, and resilience were assessed using the KMPT, the Korean Early-Life Abuse Experience Questionnaire, and the Resilience Quotient Test, respectively. Data were analyzed using multiple linear regression analyses. The final model of the multiple linear regression analyses explained 30.2 % of the total variances of the sum of the adjustment problem factor scores of the KMPT. Neglect and exposure to domestic violence had a positive association with the total adjustment problem factor scores of the KMPT, but emotion control, impulse control, and optimism factor scores as well as education and occupational status were inversely associated with the total military adjustment problem score. ELS and resilience are important modulating factors in adjusting to military service. We suggest that neglect and exposure to domestic violence during early life may increase problem with adjustment, but capacity to control emotion and impulse as well as optimistic attitude may play protective roles in adjustment to military life. The screening procedures for ELS and the development of psychological interventions may be helpful for young adults to adjust to military service.

Serum Fatty Acids, Desaturase Activities and Abdominal Obesity – A Population-Based Study of 60-Year Old Men and Women

PubMed Central

Alsharari, Zayed D.; Risérus, Ulf; Leander, Karin; Sjögren, Per; Carlsson, Axel C.; Vikström, Max; Laguzzi, Federica; Gigante, Bruna; Cederholm, Tommy; De Faire, Ulf; Hellénius, Mai-Lis

2017-01-01

Abdominal obesity is a key contributor of metabolic disease. Recent trials suggest that dietary fat quality affects abdominal fat content, where palmitic acid and linoleic acid influence abdominal obesity differently, while effects of n-3 polyunsaturated fatty acids are less studied. Also, fatty acid desaturation may be altered in abdominal obesity. We aimed to investigate cross-sectional associations of serum fatty acids and desaturases with abdominal obesity prevalence in a population-based cohort study. Serum cholesteryl ester fatty acids composition was measured by gas chromatography in 60-year old men (n = 1883) and women (n = 2015). Cross-sectional associations of fatty acids with abdominal obesity prevalence and anthropometric measures (e.g., sagittal abdominal diameter) were evaluated in multivariable-adjusted logistic and linear regression models, respectively. Similar models were employed to investigate relations between desaturase activities (estimated by fatty acid ratios) and abdominal obesity. In logistic regression analyses, palmitic acid, stearoyl-CoA-desaturase and Δ6-desaturase indices were associated with abdominal obesity; multivariable-adjusted odds ratios (95% confidence intervals) for highest versus lowest quartiles were 1.45 (1.19–1.76), 4.06 (3.27–5.05), and 3.07 (2.51–3.75), respectively. Linoleic acid, α-linolenic acid, docohexaenoic acid, and Δ5-desaturase were inversely associated with abdominal obesity; multivariable-adjusted odds ratios (95% confidence intervals): 0.39 (0.32–0.48), 0.74 (0.61–0.89), 0.76 (0.62–0.93), and 0.40 (0.33–0.49), respectively. Eicosapentaenoic acid was not associated with abdominal obesity. Similar results were obtained from linear regression models evaluating associations with different anthropometric measures. Sex-specific and linear associations were mainly observed for n3-polyunsaturated fatty acids, while associations of the other exposures were generally non-linear and similar across sexes. In accordance with findings from short-term trials, abdominal obesity was more common among individuals with relatively high proportions of palmitic acid, whilst the contrary was true for linoleic acid. Further trials should examine the potential role of linoleic acid and its main dietary source, vegetable oils, in abdominal obesity prevention. PMID:28125662

Some comparisons of complexity in dictionary-based and linear computational models.

PubMed

Gnecco, Giorgio; Kůrková, Věra; Sanguineti, Marcello

2011-03-01

Neural networks provide a more flexible approximation of functions than traditional linear regression. In the latter, one can only adjust the coefficients in linear combinations of fixed sets of functions, such as orthogonal polynomials or Hermite functions, while for neural networks, one may also adjust the parameters of the functions which are being combined. However, some useful properties of linear approximators (such as uniqueness, homogeneity, and continuity of best approximation operators) are not satisfied by neural networks. Moreover, optimization of parameters in neural networks becomes more difficult than in linear regression. Experimental results suggest that these drawbacks of neural networks are offset by substantially lower model complexity, allowing accuracy of approximation even in high-dimensional cases. We give some theoretical results comparing requirements on model complexity for two types of approximators, the traditional linear ones and so called variable-basis types, which include neural networks, radial, and kernel models. We compare upper bounds on worst-case errors in variable-basis approximation with lower bounds on such errors for any linear approximator. Using methods from nonlinear approximation and integral representations tailored to computational units, we describe some cases where neural networks outperform any linear approximator. Copyright © 2010 Elsevier Ltd. All rights reserved.

Proposal of digital interface for the system of the air conditioner's remote control: analysis of the system of feedback.

PubMed

da Silva de Queiroz Pierre, Raisa; Kawada, Tarô Arthur Tavares; Fontes, André Guimarães

2012-01-01

Develop a proposal of digital interface for the system of the remote control, that functions as support system during the manipulation of air conditioner adjusted for the users in general, from ergonomic parameters, objectifying the reduction of the problems faced for the user and improving the process. 20 people with questionnaire with both qualitative and quantitative level. Linear Method consists of a sequence of steps in which the input of one of them depends on the output from the previous one, although they are independent. The process of feedback, when necessary, must occur within each step separately.

Research on On-Line Modeling of Fed-Batch Fermentation Process Based on v-SVR

NASA Astrophysics Data System (ADS)

Ma, Yongjun

The fermentation process is very complex and non-linear, many parameters are not easy to measure directly on line, soft sensor modeling is a good solution. This paper introduces v-support vector regression (v-SVR) for soft sensor modeling of fed-batch fermentation process. v-SVR is a novel type of learning machine. It can control the accuracy of fitness and prediction error by adjusting the parameter v. An on-line training algorithm is discussed in detail to reduce the training complexity of v-SVR. The experimental results show that v-SVR has low error rate and better generalization with appropriate v.

Injunctive and Descriptive Peer Group Norms and the Academic Adjustment of Rural Early Adolescents

ERIC Educational Resources Information Center

Hamm, Jill V.; Schmid, Lorrie; Farmer, Thomas W.; Locke, Belinda

2011-01-01

This study integrates diverse literatures on peer group influence by conceptualizing and examining the relationship of peer group injunctive norms to the academic adjustment of a large and ethnically diverse sample of rural early adolescents' academic adjustment. Results of three-level hierarchical linear modeling indicated that peer groups were…

Cardiovascular diseases and air pollution in Novi Sad, Serbia.

PubMed

Jevtić, Marija; Dragić, Nataša; Bijelović, Sanja; Popović, Milka

2014-04-01

A large body of evidence has documented that air pollutants have adverse effect on human health as well as on the environment. The aim of this study was to determine whether there was an association between outdoor concentrations of sulfur dioxide (SO2) and nitrogen dioxide (NO2) and a daily number of hospital admissions due to cardiovascular diseases (CVD) in Novi Sad, Serbia among patients aged above 18. The investigation was carried out during over a 3-year period (from January 1, 2007 to December 31, 2009) in the area of Novi Sad. The number (N = 10 469) of daily CVD (ICD-10: I00-I99) hospital admissions was collected according to patients' addresses. Daily mean levels of NO2 and SO2, measured in the ambient air of Novi Sad via a network of fixed samplers, have been used to put forward outdoor air pollution. Associations between air pollutants and hospital admissions were firstly analyzed by the use of the linear regression in a single polluted model, and then trough a single and multi-polluted adjusted generalized linear Poisson model. The single polluted model (without confounding factors) indicated that there was a linear increase in the number of hospital admissions due to CVD in relation to the linear increase in concentrations of SO2 (p = 0.015; 95% confidence interval (95% CI): 0.144-1.329, R(2) = 0.005) and NO2 (p = 0.007; 95% CI: 0.214-1.361, R(2) = 0.007). However, the single and multi-polluted adjusted models revealed that only NO2 was associated with the CVD (p = 0.016, relative risk (RR) = 1.049, 95% CI: 1.009-1.091 and p = 0.022, RR = 1.047, 95% CI: 1.007-1.089, respectively). This study shows a significant positive association between hospital admissions due to CVD and outdoor NO2 concentrations in the area of Novi Sad, Serbia.

An approximation of herd effect due to vaccinating children against seasonal influenza - a potential solution to the incorporation of indirect effects into static models.

PubMed

Van Vlaenderen, Ilse; Van Bellinghen, Laure-Anne; Meier, Genevieve; Nautrup, Barbara Poulsen

2013-01-22

Indirect herd effect from vaccination of children offers potential for improving the effectiveness of influenza prevention in the remaining unvaccinated population. Static models used in cost-effectiveness analyses cannot dynamically capture herd effects. The objective of this study was to develop a methodology to allow herd effect associated with vaccinating children against seasonal influenza to be incorporated into static models evaluating the cost-effectiveness of influenza vaccination. Two previously published linear equations for approximation of herd effects in general were compared with the results of a structured literature review undertaken using PubMed searches to identify data on herd effects specific to influenza vaccination. A linear function was fitted to point estimates from the literature using the sum of squared residuals. The literature review identified 21 publications on 20 studies for inclusion. Six studies provided data on a mathematical relationship between effective vaccine coverage in subgroups and reduction of influenza infection in a larger unvaccinated population. These supported a linear relationship when effective vaccine coverage in a subgroup population was between 20% and 80%. Three studies evaluating herd effect at a community level, specifically induced by vaccinating children, provided point estimates for fitting linear equations. The fitted linear equation for herd protection in the target population for vaccination (children) was slightly less conservative than a previously published equation for herd effects in general. The fitted linear equation for herd protection in the non-target population was considerably less conservative than the previously published equation. This method of approximating herd effect requires simple adjustments to the annual baseline risk of influenza in static models: (1) for the age group targeted by the childhood vaccination strategy (i.e. children); and (2) for other age groups not targeted (e.g. adults and/or elderly). Two approximations provide a linear relationship between effective coverage and reduction in the risk of infection. The first is a conservative approximation, recommended as a base-case for cost-effectiveness evaluations. The second, fitted to data extracted from a structured literature review, provides a less conservative estimate of herd effect, recommended for sensitivity analyses.

Youth and young adult physical activity and body composition of young adult women: findings from the dietary intervention study in children.

PubMed

Hodge, Melissa G; Hovinga, Mary; Shepherd, John A; Egleston, Brian; Gabriel, Kelley; Van Horn, Linda; Robson, Alan; Snetselaar, Linda; Stevens, Victor K; Jung, Seungyoun; Dorgan, Joanne

2015-02-01

This study prospectively investigates associations between youth moderate-to-vigorous-intensity physical activity (MVPA) and body composition in young adult women using data from the Dietary Intervention Study in Children (DISC) and the DISC06 Follow-Up Study. MVPA was assessed by questionnaire on 5 occasions between the ages 8 and 18 years and at age 25-29 years in 215 DISC female participants. Using whole body dual-energy x-ray absorptiometry (DXA), overall adiposity and body fat distribution were assessed at age 25-29 years by percent body fat (%fat) and android-to-gynoid (A:G) fat ratio, respectively. Linear mixed effects models and generalized linear latent and mixed models were used to assess associations of youth MVPA with both outcomes. Young adult MVPA, adjusted for other young adult characteristics, was significantly inversely associated with young adult %fat (%fat decreased from 37.4% in the lowest MVPA quartile to 32.8% in the highest (p-trend = 0.02)). Adjusted for youth and young adult characteristics including young adult MVPA, youth MVPA also was significantly inversely associated with young adult %fat (β=-0.40 per 10 MET-hrs/wk, p = .02) . No significant associations between MVPA and A:G fat ratio were observed. Results suggest that youth and young adult MVPA are important independent predictors of adiposity in young women.

Robust Linear Models for Cis-eQTL Analysis.

PubMed

Rantalainen, Mattias; Lindgren, Cecilia M; Holmes, Christopher C

2015-01-01

Expression Quantitative Trait Loci (eQTL) analysis enables characterisation of functional genetic variation influencing expression levels of individual genes. In outbread populations, including humans, eQTLs are commonly analysed using the conventional linear model, adjusting for relevant covariates, assuming an allelic dosage model and a Gaussian error term. However, gene expression data generally have noise that induces heavy-tailed errors relative to the Gaussian distribution and often include atypical observations, or outliers. Such departures from modelling assumptions can lead to an increased rate of type II errors (false negatives), and to some extent also type I errors (false positives). Careful model checking can reduce the risk of type-I errors but often not type II errors, since it is generally too time-consuming to carefully check all models with a non-significant effect in large-scale and genome-wide studies. Here we propose the application of a robust linear model for eQTL analysis to reduce adverse effects of deviations from the assumption of Gaussian residuals. We present results from a simulation study as well as results from the analysis of real eQTL data sets. Our findings suggest that in many situations robust models have the potential to provide more reliable eQTL results compared to conventional linear models, particularly in respect to reducing type II errors due to non-Gaussian noise. Post-genomic data, such as that generated in genome-wide eQTL studies, are often noisy and frequently contain atypical observations. Robust statistical models have the potential to provide more reliable results and increased statistical power under non-Gaussian conditions. The results presented here suggest that robust models should be considered routinely alongside other commonly used methodologies for eQTL analysis.

Improvements to surrogate data methods for nonstationary time series.

PubMed

Lucio, J H; Valdés, R; Rodríguez, L R

2012-05-01

The method of surrogate data has been extensively applied to hypothesis testing of system linearity, when only one realization of the system, a time series, is known. Normally, surrogate data should preserve the linear stochastic structure and the amplitude distribution of the original series. Classical surrogate data methods (such as random permutation, amplitude adjusted Fourier transform, or iterative amplitude adjusted Fourier transform) are successful at preserving one or both of these features in stationary cases. However, they always produce stationary surrogates, hence existing nonstationarity could be interpreted as dynamic nonlinearity. Certain modifications have been proposed that additionally preserve some nonstationarity, at the expense of reproducing a great deal of nonlinearity. However, even those methods generally fail to preserve the trend (i.e., global nonstationarity in the mean) of the original series. This is the case of time series with unit roots in their autoregressive structure. Additionally, those methods, based on Fourier transform, either need first and last values in the original series to match, or they need to select a piece of the original series with matching ends. These conditions are often inapplicable and the resulting surrogates are adversely affected by the well-known artefact problem. In this study, we propose a simple technique that, applied within existing Fourier-transform-based methods, generates surrogate data that jointly preserve the aforementioned characteristics of the original series, including (even strong) trends. Moreover, our technique avoids the negative effects of end mismatch. Several artificial and real, stationary and nonstationary, linear and nonlinear time series are examined, in order to demonstrate the advantages of the methods. Corresponding surrogate data are produced with the classical and with the proposed methods, and the results are compared.

City-Level Adult Stroke Prevalence in Relation to Remote Sensing Derived PM2.5 Adjusting for Unhealthy Behaviors and Medical Risk Factors

NASA Astrophysics Data System (ADS)

Hu, Z.

2018-04-01

This research explores the use of PM2.5 gird derived from remote sensing for assessing the effect of long-term exposure to PM2.5 (ambient air pollution of particulate matter with an aerodynamic diameter of 2.5 μm or less) on stroke, adjusting for unhealthy behaviors and medical risk factors. Health data was obtained from the newly published CDC "500 Cities Project" which provides city- and census tract-level small area estimates for chronic disease risk factors, and clinical preventive service use for the largest 500 cities in the United States. PM2.5 data was acquired from the "The Global Annual PM2.5 Grids from MODIS, MISR and SeaWiFS Aerosol Optical Depth (AOD), V1 (1998-2012)" datasets. Average PM2.5 were calculated for each city using a GIS zonal statistics function. Map data visualization and pattern comparison, univariate linear regression, and a multivariate linear regression model fitted using a generalized linear model via penalized maximum likelihood found that long-term exposure to ambient PM2.5 may increase the risk of stroke. Increasing physical activity, reducing smoking and body weight, enough sleeping, controlling diseases such as blood pressure, coronary heart disease, diabetes, and cholesterol, may mitigate the effect. PM2.5 grids derived from moderate resolution satellite remote sensing imagery may offer a unique opportunity to fill the data gap due to limited ground monitoring at broader scales. The evidence of raised stroke prevalence risk in high PM2.5 areas would support targeting of policy interventions on such areas to reduce pollution levels and protect human health.

Wideband Communications Equipment, Ground Radio Communication, Space Comm Systems Equipment. 304X0/X4/X6. Appendix A - Task Analysis

DTIC Science & Technology

1990-05-01

ALARM LAMPS A CHECK TWT POWER SUPPLY VOLTAGE AND CURRENT A ADJUST POWER ALARM THRESHOLD AND TRANSMITTER OUTPUT A CHECK HELIX MONITOR K INTERPRET AN/FRC...POWER SUPPLY A CHECK TRAVELING WAVE TUBE ( TWT ) POWER SUPPLY HELIX CURRENT AND BEAM CURRENT A CHECK TWT RF POWER OUTPUT A CHECK TRANSMITTER POWER...A ADJUST TRANSMITTER LINEARITY A CALIBRATE TRANSMIT DEVIATION AND ADJUST MODULATION AMPLIFIER A ADJUST TWT PERFORMANCE MONITOR A ADJUST TWT OUTPUT

Esthetic Assessment of the Effect of Gingival Exposure in the Smile of Patients with Unilateral and Bilateral Maxillary Incisor Agenesis.

PubMed

Pinho, Teresa; Bellot-Arcís, Carlos; Montiel-Company, José María; Neves, Manuel

2015-07-01

The aim of this study was to determine the dental esthetic perception of the smile of patients with maxillary lateral incisor agenesis (MLIA); the perceptions were examined pre- and post-treatment. Esthetic determinations were made with regard to the gingival exposure in the patients' smile by orthodontists, general dentists, and laypersons. Three hundred eighty one people (80 orthodontists, 181 general dentists, 120 laypersons) rated the attractiveness of the smile in four cases before and after treatment, comprising two cases with unilateral MLIA and contralateral microdontia and two with bilateral MLIA. For each case, the buccal photograph was adjusted using a computer to apply standard lips to create high, medium, and low smiles. A numeric scale was used to measure the esthetic rating perceived by the judges. The resulting arithmetic means were compared using an ANOVA test, a linear trend, and a Student's t-test, applying a significance level of p < 0.05. The predictive capability of the variables, unilateral, or bilateral MLIA, symmetry of the treatment, gingival exposure of the smile, group, and gender were assessed using a multivariable linear regression model. In the pre- and post-treatment cases, medium smile photographs received higher scores than the same cases with high or low smiles, with significant differences between them. In all cases, orthodontists were the least-tolerant evaluation group (assigning lowest scores), followed by general dentists. In a predictive linear regression model, bilateral MLIA was the more predictive variable in pretreatment cases. The gingival exposure of the smile was a predictive variable in post-treatment cases only. The medium-height smile was considered to be more attractive. In all cases, orthodontists gave the lowest scores, followed by general dentists. Laypersons and male evaluators gave the highest scores. Symmetrical treatments scored higher than asymmetrical treatments. The gingival exposure had a significant influence on the esthetic perception of smiles in post-treatment cases. © 2014 by the American College of Prosthodontists.

Impacts of persistent general and site-specific pain on activities of daily living and physical performance: A prospective analysis of the English Longitudinal Study of Ageing.

PubMed

Yiengprugsawan, Vasoontara; Steptoe, Andrew

2018-03-23

Pain is an increasingly common phenomenon as people age; pain over a long period can result in limited functioning. The present study investigated the impacts of general and multisite-specific pain on activities of daily living and physical performance among older adults. Data were analyzed from the English Longitudinal Study of Ageing, a representative sample of the population aged ≥50 years. Face-to-face interview and nurse records were used from waves 2-6 (2004-2012) for analyses. General and site-specific pain (back, hip and knee) were measured biennially between 2004 and 2008 (n = 5010). Impaired activity of daily living and physical performance measures (chair rise and grip strength) between 2008 and 2012 were aggregated across assessments as outcomes. Multinomial logistic regressions were used for the former and linear regression for the latter, adjusting for potential covariates. General pain (moderate-to-severe) was prevalent, with close to one-quarter of participants reporting pain at least twice during the follow-up period. Multisite pain reports were strong predictors of subsequent limited activities of daily living (adjusted odds ratio range 1.86-3.97 for back and hip, 2.04-4.19 for back and knee, and 2.08-5.16 for hip and knee). Persistent pain was also strongly associated with worse physical performance outcomes. Our data confirm the longitudinal impacts of persistent pain among older adults. The findings highlight the value of monitoring and management of both general and site-specific pain in order to promote sustained independence at older ages. Geriatr Gerontol Int 2018; ••: ••-••. © 2018 Japan Geriatrics Society.

40 CFR Appendix B to Part 75 - Quality Assurance and Quality Control Procedures

Code of Federal Regulations, 2012 CFR

2012-07-01

... Systems 1.2.1Calibration Error Test and Linearity Check Procedures Keep a written record of the procedures used for daily calibration error tests and linearity checks (e.g., how gases are to be injected..., and when calibration adjustments should be made). Identify any calibration error test and linearity...

40 CFR Appendix B to Part 75 - Quality Assurance and Quality Control Procedures

Code of Federal Regulations, 2013 CFR

2013-07-01

... Systems 1.2.1Calibration Error Test and Linearity Check Procedures Keep a written record of the procedures used for daily calibration error tests and linearity checks (e.g., how gases are to be injected..., and when calibration adjustments should be made). Identify any calibration error test and linearity...

Breadth of Extracurricular Participation and Adolescent Adjustment Among African-American and European-American Youth

PubMed Central

Fredricks, Jennifer A.; Eccles, Jacquelynne S.

2012-01-01

We examined the linear and nonlinear relations between breadth of extracurricular participation in 11th grade and developmental outcomes at 11th grade and 1 year after high school in an economically diverse sample of African-American and European-American youth. In general, controlling for demographic factors, children's motivation, and the dependent variable measured 3 years earlier, breadth was positively associated with indicators of academic adjustment at 11th grade and at 1 year after high school. In addition, for the three academic outcomes (i.e., grades, educational expectations, and educational status) the nonlinear function was significant; at high levels of involvement the well-being of youth leveled off or declined slightly. In addition, breadth of participation at 11th grade predicted lower internalizing behavior, externalizing behavior, alcohol use, and marijuana use at 11th grade. Finally, the total number of extracurricular activities at 11th grade was associated with civic engagement 2 years later. PMID:22837637

Cardiorespiratory Fitness is Associated with Reduced Risk of Respiratory Diseases in Middle-Aged Caucasian Men: A Long-Term Prospective Cohort Study.

PubMed

Kunutsor, Setor K; Laukkanen, Tanjaniina; Laukkanen, Jari A

2017-10-01

Cardiorespiratory fitness (CRF), an index of cardiac and respiratory functioning, is strongly associated with a reduced risk of adverse health outcomes. We aimed to assess the prospective association of CRF with the risk of respiratory diseases (defined as chronic obstructive pulmonary disease, pneumonia, or asthma). Cardiorespiratory fitness, as measured by maximal oxygen uptake, was assessed in 1974 middle-aged men. During a median follow-up of 25.7 years, 382 hospital diagnosed respiratory diseases were recorded. Cardiorespiratory fitness was linearly associated with risk of respiratory diseases. In analysis adjusted for several established and potential risk factors, the hazard ratio (HR) (95% CI) for respiratory diseases was 0.63 (0.45-0.88), when comparing extreme quartiles of CRF levels. The corresponding multivariate adjusted HR (95% CI) for pneumonia was 0.67 (0.48-0.95). Our findings indicate a graded inverse and independent association between CRF and the future risk of respiratory diseases in a general male Caucasian population.

Breadth of Extracurricular Participation and Adolescent Adjustment Among African-American and European-American Youth.

PubMed

Fredricks, Jennifer A; Eccles, Jacquelynne S

2010-06-01

We examined the linear and nonlinear relations between breadth of extracurricular participation in 11th grade and developmental outcomes at 11th grade and 1 year after high school in an economically diverse sample of African-American and European-American youth. In general, controlling for demographic factors, children's motivation, and the dependent variable measured 3 years earlier, breadth was positively associated with indicators of academic adjustment at 11th grade and at 1 year after high school. In addition, for the three academic outcomes (i.e., grades, educational expectations, and educational status) the nonlinear function was significant; at high levels of involvement the well-being of youth leveled off or declined slightly. In addition, breadth of participation at 11th grade predicted lower internalizing behavior, externalizing behavior, alcohol use, and marijuana use at 11th grade. Finally, the total number of extracurricular activities at 11th grade was associated with civic engagement 2 years later.

Linearity optimizations of analog ring resonator modulators through bias voltage adjustments

NASA Astrophysics Data System (ADS)

Hosseinzadeh, Arash; Middlebrook, Christopher T.

2018-03-01

The linearity of ring resonator modulator (RRM) in microwave photonic links is studied in terms of instantaneous bandwidth, fabrication tolerances, and operational bandwidth. A proposed bias voltage adjustment method is shown to maximize spur-free dynamic range (SFDR) at instantaneous bandwidths required by microwave photonic link (MPL) applications while also mitigating RRM fabrication tolerances effects. The proposed bias voltage adjustment method shows RRM SFDR improvement of ∼5.8 dB versus common Mach-Zehnder modulators at 500 MHz instantaneous bandwidth. Analyzing operational bandwidth effects on SFDR shows RRMs can be promising electro-optic modulators for MPL applications which require high operational frequencies while in a limited bandwidth such as radio-over-fiber 60 GHz wireless network access.

Cardiorespiratory fitness and future risk of pneumonia: a long-term prospective cohort study.

PubMed

Kunutsor, Setor K; Laukkanen, Tanjaniina; Laukkanen, Jari A

2017-09-01

We aimed to assess the prospective association of cardiorespiratory fitness (CRF) with the risk of pneumonia. Cardiorespiratory fitness, as measured by maximal oxygen uptake, was assessed using a respiratory gas exchange analyzer in 2244 middle-aged men in the Kuopio Ischemic Heart Disease cohort. We corrected for within-person variability in CRF levels using data from repeat measurements taken several years apart. During a median follow-up of 25.8 years, 369 men received a hospital diagnosis of pneumonia. The age-adjusted regression dilution ratio of CRF was 0.58 (95% confidence interval: 0.53-0.63). Cardiorespiratory fitness was linearly associated with pneumonia risk. The hazard ratio (95% confidence interval) for pneumonia per 1 standard deviation increase in CRF in analysis adjusted for several risk factors for pneumonia was 0.77 (0.68-0.87). The association remained consistent on additional adjustment for total energy intake, socioeconomic status, physical activity, and C-reactive protein 0.82 (0.72-0.94). The corresponding adjusted hazard ratios (95% confidence intervals) were 0.58 (0.41-0.80) and 0.67 (0.48-0.95) respectively, when comparing the extreme quartiles of CRF levels. Our findings indicate a graded inverse and independent association between CRF and the future risk of pneumonia in a general male population. Copyright © 2017 Elsevier Inc. All rights reserved.

[Factors associated with the regular use of sources of information by medical students from four cities of Peru].

PubMed

Mejía, Christian R; Valladares-Garrido, Mario J; Luyo-Rivas, Aldo; Valladares-Garrido, Danai; Talledo-Ulfe, Lincolth; Vilela-Estrada, Martín A; Araujo Chumacero, Mary M

2015-01-01

Objetives. To determine the factors associated with regular use of sources of information by medical students in four cities in Peru. In this cross-sectional study, medical students were surveyed in four cities of Peru, gathering information on the use of 14 sources of information and other educational and computer variables. Frequent use of the information source was defined if the respondent reported that they access an information source at least once a week. P values were obtained by generalized linear models adjusted for each respondent site. 2,300 students were surveyed. The median age was 21 years and 53% were women. Having received training in the use of sources increased the use in twelve of the consulted bases, not in SciELO (p=0.053) or in the university library (p=0.509).When adjusting for owning a laptop/netbook, these associations remained. After also adjusting for owning a smartphone the association was lost with the BVS Peru database (p=0.067). The association was also lost after making the final adjustment, if the respondent had carried out any research activities. The frequent use of sources of information is associated with having received training, conducting research and use of information technologies and communication. This should be taken into account in training programs and continuous improvement in undergraduate education.

Healthcare cost differences with participation in a community-based group physical activity benefit for medicare managed care health plan members.

PubMed

Ackermann, Ronald T; Williams, Barbara; Nguyen, Huong Q; Berke, Ethan M; Maciejewski, Matthew L; LoGerfo, James P

2008-08-01

To determine whether participation in a physical activity benefit by Medicare managed care enrollees is associated with lower healthcare utilization and costs. Retrospective cohort study. Medicare managed care. A cohort of 1,188 older adult health maintenance organization enrollees who participated at least once in the EnhanceFitness (EF) physical activity benefit and a matched group of enrollees who never used the program. Healthcare costs and utilization were estimated. Ordinary least squares regression was used, adjusting for demographics, comorbidity, indicators of preventive service use, and baseline utilization or cost. Robustness of findings was tested in sensitivity analyses involving continuous propensity score adjustment and generalized linear models with nonconstant variance assumptions. EF participants had similar total healthcare costs during Year 1 of the program, but during Year 2, adjusted total costs were $1,186 lower (P=.005) than for non-EF users. Differences were partially attributable to lower inpatient costs (-$3,384; P=.02), which did not result from high-cost outliers. Enrollees who attended EF an average of one visit or more per week had lower adjusted total healthcare costs in Year 1 (-$1,929; P<.001) and Year 2 (-$1,784; P<.001) than nonusers. Health plan coverage of a preventive physical activity benefit for seniors is a promising strategy to avoid significant healthcare costs in the short term.

On the use and misuse of scalar scores of confounders in design and analysis of observational studies.

PubMed

Pfeiffer, R M; Riedl, R

2015-08-15

We assess the asymptotic bias of estimates of exposure effects conditional on covariates when summary scores of confounders, instead of the confounders themselves, are used to analyze observational data. First, we study regression models for cohort data that are adjusted for summary scores. Second, we derive the asymptotic bias for case-control studies when cases and controls are matched on a summary score, and then analyzed either using conditional logistic regression or by unconditional logistic regression adjusted for the summary score. Two scores, the propensity score (PS) and the disease risk score (DRS) are studied in detail. For cohort analysis, when regression models are adjusted for the PS, the estimated conditional treatment effect is unbiased only for linear models, or at the null for non-linear models. Adjustment of cohort data for DRS yields unbiased estimates only for linear regression; all other estimates of exposure effects are biased. Matching cases and controls on DRS and analyzing them using conditional logistic regression yields unbiased estimates of exposure effect, whereas adjusting for the DRS in unconditional logistic regression yields biased estimates, even under the null hypothesis of no association. Matching cases and controls on the PS yield unbiased estimates only under the null for both conditional and unconditional logistic regression, adjusted for the PS. We study the bias for various confounding scenarios and compare our asymptotic results with those from simulations with limited sample sizes. To create realistic correlations among multiple confounders, we also based simulations on a real dataset. Copyright © 2015 John Wiley & Sons, Ltd.

Analysing the Costs of Integrated Care: A Case on Model Selection for Chronic Care Purposes

PubMed Central

Sánchez-Pérez, Inma; Ibern, Pere; Coderch, Jordi; Inoriza, José María

2016-01-01

Background: The objective of this study is to investigate whether the algorithm proposed by Manning and Mullahy, a consolidated health economics procedure, can also be used to estimate individual costs for different groups of healthcare services in the context of integrated care. Methods: A cross-sectional study focused on the population of the Baix Empordà (Catalonia-Spain) for the year 2012 (N = 92,498 individuals). A set of individual cost models as a function of sex, age and morbidity burden were adjusted and individual healthcare costs were calculated using a retrospective full-costing system. The individual morbidity burden was inferred using the Clinical Risk Groups (CRG) patient classification system. Results: Depending on the characteristics of the data, and according to the algorithm criteria, the choice of model was a linear model on the log of costs or a generalized linear model with a log link. We checked for goodness of fit, accuracy, linear structure and heteroscedasticity for the models obtained. Conclusion: The proposed algorithm identified a set of suitable cost models for the distinct groups of services integrated care entails. The individual morbidity burden was found to be indispensable when allocating appropriate resources to targeted individuals. PMID:28316542

Physiological Aldosterone Concentrations Are Associated with Alterations of Lipid Metabolism: Observations from the General Population.

PubMed

Hannich, M; Wallaschofski, H; Nauck, M; Reincke, M; Adolf, C; Völzke, H; Rettig, R; Hannemann, A

2018-01-01

Aldosterone and high-density lipoprotein cholesterol (HDL-C) are involved in many pathophysiological processes that contribute to the development of cardiovascular diseases. Previously, associations between the concentrations of aldosterone and certain components of the lipid metabolism in the peripheral circulation were suggested, but data from the general population is sparse. We therefore aimed to assess the associations between aldosterone and HDL-C, low-density lipoprotein cholesterol (LDL-C), total cholesterol, triglycerides, or non-HDL-C in the general adult population. Data from 793 men and 938 women aged 25-85 years who participated in the first follow-up of the Study of Health in Pomerania were obtained. The associations of aldosterone with serum lipid concentrations were assessed in multivariable linear regression models adjusted for sex, age, body mass index (BMI), estimated glomerular filtration rate (eGFR), and HbA1c. The linear regression models showed statistically significant positive associations of aldosterone with LDL-C ( β -coefficient = 0.022, standard error = 0.010, p = 0.03) and non-HDL-C ( β -coefficient = 0.023, standard error = 0.009, p = 0.01) as well as an inverse association of aldosterone with HDL-C ( β -coefficient = -0.022, standard error = 0.011, p = 0.04). The present data show that plasma aldosterone is positively associated with LDL-C and non-HDL-C and inversely associated with HDL-C in the general population. Our data thus suggests that aldosterone concentrations within the physiological range may be related to alterations of lipid metabolism.

The Management Standards Indicator Tool and evaluation of burnout.

PubMed

Ravalier, J M; McVicar, A; Munn-Giddings, C

2013-03-01

Psychosocial hazards in the workplace can impact upon employee health. The UK Health and Safety Executive's (HSE) Management Standards Indicator Tool (MSIT) appears to have utility in relation to health impacts but we were unable to find studies relating it to burnout. To explore the utility of the MSIT in evaluating risk of burnout assessed by the Maslach Burnout Inventory-General Survey (MBI-GS). This was a cross-sectional survey of 128 borough council employees. MSIT data were analysed according to MSIT and MBI-GS threshold scores and by using multivariate linear regression with MBI-GS factors as dependent variables. MSIT factor scores were gradated according to categories of risk of burnout according to published MBI-GS thresholds, and identified priority workplace concerns as demands, relationships, role and change. These factors also featured as significant independent variables, with control, in outcomes of the regression analysis. Exhaustion was associated with demands and control (adjusted R (2) = 0.331); cynicism was associated with change, role and demands (adjusted R (2) =0.429); and professional efficacy was associated with managerial support, role, control and demands (adjusted R (2) = 0.413). MSIT analysis generally has congruence with MBI-GS assessment of burnout. The identification of control within regression models but not as a priority concern in the MSIT analysis could suggest an issue of the setting of the MSIT thresholds for this factor, but verification requires a much larger study. Incorporation of relationship, role and change into the MSIT, missing from other conventional tools, appeared to add to its validity.

The Storm and Stress (or Calm) of Early Adolescent Self-Concepts: Within- and Between-Person Variability

PubMed Central

Molloy, Lauren E.; Ram, Nilam; Gest, Scott D.

2014-01-01

This study uses intraindividual variability and change methods to test theoretical accounts of self-concept and its change across time and context, and the developmental implications of this variability. The five-year longitudinal study of 541 youth in a rural Pennsylvania community from 3rd through 7th grade included twice-yearly assessments of self-concept (academic and social), corresponding external evaluations of competence (e.g., teacher-rated academic skills, peer-nominated “likeability”), and multiple measures of youths' overall adjustment. Multiphase growth models replicate previous research, suggesting significant decline in academic self-concept during middle school, but modest growth in social self-concept from 3rd through 7th grade. Next, a new contribution is made to the literature by quantifying the amount of within-person variability (i.e., “lability”) around these linear self-concept trajectories as a between-person characteristic. Self-concept lability was found to associate with a general profile of poorer competence and adjustment, and to predict poorer academic and social competence at the end of 7th grade above and beyond level of self-concept. Finally, there was substantial evidence that wave-to-wave changes in youths' self-concepts correspond to teacher and peer evaluations of youths' competence, that attention to peer feedback may be particularly strong during middle school, and that these relations may be moderated by between-person indicators of youths' general adjustment. Overall, findings highlight the utility of methods sensitive to within-person variation for clarifying the dynamics of youths' self-system development. PMID:21928883

Observations and modeling of ocean-induced melt beneath Petermann Glacier Ice Shelf in northwestern Greenland

NASA Astrophysics Data System (ADS)

Cai, Cilan; Rignot, Eric; Menemenlis, Dimitris; Nakayama, Yoshihiro

2017-08-01

We update observationally based estimates of subaqueous melt, Qm, beneath Petermann Glacier Ice Shelf (PGIS), Greenland, and model its sensitivity to oceanic thermal forcing, TF, and subglacial runoff, Qsg, using the Massachusetts Institute of Technology general circulation model (MITgcm), in a two-dimensional domain, with 20 m vertical and 40 m horizontal resolution at the grounding line. We adjust the drag coefficient to match the observationally based Qm. With the inclusion of Qsg, the maximum melt rate (Qmmax) is 2 times larger in summer and 1/3 larger annually than in winter. Qmmax increases above linear with TF and below linear with Qsg. We estimate that Qmmax increased by 24% (+8.1 m/yr) beneath PGIS from the 1990s to the 2000s from a 0.21°C warming in ocean temperature and a doubling in Qsg, hence contributing to its thinning. If the PGIS is removed, we estimate that the modeled melt rate near the grounding line will increase 13-16 times.

Sci—Fri PM: Topics — 05: Experience with linac simulation software in a teaching environment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Carlone, Marco; Harnett, Nicole; Jaffray, David

Medical linear accelerator education is usually restricted to use of academic textbooks and supervised access to accelerators. To facilitate the learning process, simulation software was developed to reproduce the effect of medical linear accelerator beam adjustments on resulting clinical photon beams. The purpose of this report is to briefly describe the method of operation of the software as well as the initial experience with it in a teaching environment. To first and higher orders, all components of medical linear accelerators can be described by analytical solutions. When appropriate calibrations are applied, these analytical solutions can accurately simulate the performance ofmore » all linear accelerator sub-components. Grouped together, an overall medical linear accelerator model can be constructed. Fifteen expressions in total were coded using MATLAB v 7.14. The program was called SIMAC. The SIMAC program was used in an accelerator technology course offered at our institution; 14 delegates attended the course. The professional breakdown of the participants was: 5 physics residents, 3 accelerator technologists, 4 regulators and 1 physics associate. The course consisted of didactic lectures supported by labs using SIMAC. At the conclusion of the course, eight of thirteen delegates were able to successfully perform advanced beam adjustments after two days of theory and use of the linac simulator program. We suggest that this demonstrates good proficiency in understanding of the accelerator physics, which we hope will translate to a better ability to understand real world beam adjustments on a functioning medical linear accelerator.« less

Effect of Facet Displacement on Radiation Field and Its Application for Panel Adjustment of Large Reflector Antenna

NASA Astrophysics Data System (ADS)

Wang, Wei; Lian, Peiyuan; Zhang, Shuxin; Xiang, Binbin; Xu, Qian

2017-05-01

Large reflector antennas are widely used in radars, satellite communication, radio astronomy, and so on. The rapid developments in these fields have created demands for development of better performance and higher surface accuracy. However, low accuracy and low efficiency are the common disadvantages for traditional panel alignment and adjustment. In order to improve the surface accuracy of large reflector antenna, a new method is presented to determinate panel adjustment values from far field pattern. Based on the method of Physical Optics (PO), the effect of panel facet displacement on radiation field value is derived. Then the linear system is constructed between panel adjustment vector and far field pattern. Using the method of Singular Value Decomposition (SVD), the adjustment value for all panel adjustors are obtained by solving the linear equations. An experiment is conducted on a 3.7 m reflector antenna with 12 segmented panels. The results of simulation and test are similar, which shows that the presented method is feasible. Moreover, the discussion about validation shows that the method can be used for many cases of reflector shape. The proposed research provides the instruction to adjust surface panels efficiently and accurately.

The optimal hormonal replacement modality selection for multiple organ procurement from brain-dead organ donors

PubMed Central

Mi, Zhibao; Novitzky, Dimitri; Collins, Joseph F; Cooper, David KC

2015-01-01

The management of brain-dead organ donors is complex. The use of inotropic agents and replacement of depleted hormones (hormonal replacement therapy) is crucial for successful multiple organ procurement, yet the optimal hormonal replacement has not been identified, and the statistical adjustment to determine the best selection is not trivial. Traditional pair-wise comparisons between every pair of treatments, and multiple comparisons to all (MCA), are statistically conservative. Hsu’s multiple comparisons with the best (MCB) – adapted from the Dunnett’s multiple comparisons with control (MCC) – has been used for selecting the best treatment based on continuous variables. We selected the best hormonal replacement modality for successful multiple organ procurement using a two-step approach. First, we estimated the predicted margins by constructing generalized linear models (GLM) or generalized linear mixed models (GLMM), and then we applied the multiple comparison methods to identify the best hormonal replacement modality given that the testing of hormonal replacement modalities is independent. Based on 10-year data from the United Network for Organ Sharing (UNOS), among 16 hormonal replacement modalities, and using the 95% simultaneous confidence intervals, we found that the combination of thyroid hormone, a corticosteroid, antidiuretic hormone, and insulin was the best modality for multiple organ procurement for transplantation. PMID:25565890

A time series analysis of the relationship of ambient temperature and common bacterial enteric infections in two Canadian provinces

NASA Astrophysics Data System (ADS)

Fleury, Manon; Charron, Dominique F.; Holt, John D.; Allen, O. Brian; Maarouf, Abdel R.

2006-07-01

The incidence of enteric infections in the Canadian population varies seasonally, and may be expected to be change in response to global climate changes. To better understand any potential impact of warmer temperature on enteric infections in Canada, we investigated the relationship between ambient temperature and weekly reports of confirmed cases of three pathogens in Canada: Salmonella, pathogenic Escherichia coli and Campylobacter, between 1992 and 2000 in two Canadian provinces. We used generalized linear models (GLMs) and generalized additive models (GAMs) to estimate the effect of seasonal adjustments on the estimated models. We found a strong non-linear association between ambient temperature and the occurrence of all three enteric pathogens in Alberta, Canada, and of Campylobacter in Newfoundland-Labrador. Threshold models were used to quantify the relationship of disease and temperature with thresholds chosen from 0 to -10°C depending on the pathogen modeled. For Alberta, the log relative risk of Salmonella weekly case counts increased by 1.2%, Campylobacter weekly case counts increased by 2.2%, and E. coli weekly case counts increased by 6.0% for every degree increase in weekly mean temperature. For Newfoundland-Labrador the log relative risk increased by 4.5% for Campylobacter for every degree increase in weekly mean temperature.

39 CFR 3010.6 - Type 3 adjustment-in general.

Code of Federal Regulations, 2010 CFR

2010-07-01

... extraordinary circumstances. (b) An exigency-based rate adjustment is not subject to the inflation-based....6 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL REGULATION OF RATES FOR MARKET DOMINANT PRODUCTS General Provisions § 3010.6 Type 3 adjustment—in general. (a) A Type 3 rate adjustment is a...

The effect of marital status on the presentation and outcomes of elderly male veterans hospitalized for pneumonia.

PubMed

Metersky, Mark L; Fine, Michael J; Mortensen, Eric M

2012-10-01

Although marital status has been shown to affect the outcomes of many conditions, there are limited data on the relationships between marital status and the presentation and outcomes of pneumonia. We used Veterans Affairs administrative databases to identify a retrospective cohort of male veterans age ≥ 65 years hospitalized for pneumonia between 2002 and 2007. We assessed unadjusted and adjusted associations between marital status and mortality, hospital length of stay, and readmission to the hospital using generalized linear mixed-effect models with admitting hospital as a random effect and adjusted for baseline patient characteristics. There were 48,635 patients (26,558 married and 22,077 unmarried) in the study. Married men had a slightly higher Charlson comorbidity score (3.0 vs 2.8, P < .0001) but were less likely to require ICU admission, ventilator support, and vasopressor treatment during the first 48 h of hospitalization. Married patients had significantly lower crude and adjusted in-hospital mortality (9.4% vs 10.6%; adjusted OR, 0.87; 95% CI, 0.81-0.93) and mortality during the 90 days after hospital discharge (14.7% vs 16.0%; adjusted OR, 0.92; 95% CI, 0.88-0.98). Their adjusted incidence rate ratio length of stay was also lower (0.92; 95% CI, 0.91-0.92). Unmarried elderly men admitted to the hospital with pneumonia have a higher risk of in-hospital and postdischarge mortality, despite having a lower degree of comorbidity. Although marital status may be a surrogate marker for other predictors, it is an easily identifiable one. These results should be considered by those responsible for care-transition decisions for patients hospitalized with pneumonia.

The role of thyroid eye disease and other factors in the overcorrection of hypotropia following unilateral adjustable suture recession of the inferior rectus (an American Ophthalmological Society thesis).

PubMed

Kerr, Natalie C

2011-12-01

Overcorrection of hypotropia subsequent to adjustable suture surgery following inferior rectus recession is undesirable, often resulting in persistent diplopia and reoperation. I hypothesized that overcorrection shift after suture adjustment may be unique to thyroid eye disease, and the use of a nonabsorbable suture may reduce the occurrence of overcorrection. A retrospective chart review of adult patients who had undergone eye muscle surgery with an adjustable suture technique was performed. Overcorrection shifts that occurred between the time of suture adjustment and 2 months postoperatively were examined. Descriptive statistics, linear regression, Anderson-Darling tests, generalized Pareto distributions, odds ratios, and Fisher tests were performed for two overcorrection shift thresholds (>2 and >5 prism diopters [PD]). Seventy-seven patients were found: 34 had thyroid eye disease and inferior rectus recession, 30 had no thyroid eye disease and inferior rectus recession, and 13 patients had thyroid eye disease and medial rectus recession. Eighteen cases exceeded the 2 PD threshold, and 12 exceeded the 5 PD threshold. Statistical analyses indicated that overcorrection was associated with thyroid eye disease (P=6.7E-06), inferior rectus surgery (P=6.7E-06), and absorbable sutures (>2 PD: OR=3.7, 95% CI=0.4-35.0, P=0.19; and >5 PD: OR=6.0, 95% CI=1.1-33.5, P=0.041). After unilateral muscle recession for hypotropia, overcorrection shifts are associated with thyroid eye disease, surgery of the inferior rectus, and use of absorbable sutures. Surgeons performing unilateral inferior rectus recession on adjustable suture in the setting of thyroid eye disease should consider using a nonabsorbable suture to reduce the incidence of postoperative overcorrection.

The Role of Thyroid Eye Disease and Other Factors in the Overcorrection of Hypotropia Following Unilateral Adjustable Suture Recession of the Inferior Rectus (An American Ophthalmological Society Thesis)

PubMed Central

Kerr, Natalie C.

2011-01-01

Purpose Overcorrection of hypotropia subsequent to adjustable suture surgery following inferior rectus recession is undesirable, often resulting in persistent diplopia and reoperation. I hypothesized that overcorrection shift after suture adjustment may be unique to thyroid eye disease, and the use of a nonabsorbable suture may reduce the occurrence of overcorrection. Methods A retrospective chart review of adult patients who had undergone eye muscle surgery with an adjustable suture technique was performed. Overcorrection shifts that occurred between the time of suture adjustment and 2 months postoperatively were examined. Descriptive statistics, linear regression, Anderson-Darling tests, generalized Pareto distributions, odds ratios, and Fisher tests were performed for two overcorrection shift thresholds (>2 and >5 prism diopters [PD]). Results Seventy-seven patients were found: 34 had thyroid eye disease and inferior rectus recession, 30 had no thyroid eye disease and inferior rectus recession, and 13 patients had thyroid eye disease and medial rectus recession. Eighteen cases exceeded the 2 PD threshold, and 12 exceeded the 5 PD threshold. Statistical analyses indicated that overcorrection was associated with thyroid eye disease (P=6.7E-06), inferior rectus surgery (P=6.7E-06), and absorbable sutures (>2 PD: OR=3.7, 95% CI=0.4–35.0, P=0.19; and >5 PD: OR=6.0, 95% CI=1.1–33.5, P=0.041). Conclusions After unilateral muscle recession for hypotropia, overcorrection shifts are associated with thyroid eye disease, surgery of the inferior rectus, and use of absorbable sutures. Surgeons performing unilateral inferior rectus recession on adjustable suture in the setting of thyroid eye disease should consider using a nonabsorbable suture to reduce the incidence of postoperative overcorrection. PMID:22253487

Flow adjustment inside homogeneous canopies after a leading edge – An analytical approach backed by LES

DOE PAGES

Kroniger, Konstantin; Banerjee, Tirtha; De Roo, Frederik; ...

2017-10-06

A two-dimensional analytical model for describing the mean flow behavior inside a vegetation canopy after a leading edge in neutral conditions was developed and tested by means of large eddy simulations (LES) employing the LES code PALM. The analytical model is developed for the region directly after the canopy edge, the adjustment region, where one-dimensional canopy models fail due to the sharp change in roughness. The derivation of this adjustment region model is based on an analytic solution of the two-dimensional Reynolds averaged Navier–Stokes equation in neutral conditions for a canopy with constant plant area density (PAD). The main assumptionsmore » for solving the governing equations are separability of the velocity components concerning the spatial variables and the neglection of the Reynolds stress gradients. These two assumptions are verified by means of LES. To determine the emerging model parameters, a simultaneous fitting scheme was applied to the velocity and pressure data of a reference LES simulation. Furthermore a sensitivity analysis of the adjustment region model, equipped with the previously calculated parameters, was performed varying the three relevant length, the canopy height ( h), the canopy length and the adjustment length ( Lc), in additional LES. Even if the model parameters are, in general, functions of h/ Lc, it was found out that the model is capable of predicting the flow quantities in various cases, when using constant parameters. Subsequently the adjustment region model is combined with the one-dimensional model of Massman, which is applicable for the interior of the canopy, to attain an analytical model capable of describing the mean flow for the full canopy domain. As a result, the model is tested against an analytical model based on a linearization approach.« less

Flow adjustment inside homogeneous canopies after a leading edge – An analytical approach backed by LES

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kroniger, Konstantin; Banerjee, Tirtha; De Roo, Frederik

A two-dimensional analytical model for describing the mean flow behavior inside a vegetation canopy after a leading edge in neutral conditions was developed and tested by means of large eddy simulations (LES) employing the LES code PALM. The analytical model is developed for the region directly after the canopy edge, the adjustment region, where one-dimensional canopy models fail due to the sharp change in roughness. The derivation of this adjustment region model is based on an analytic solution of the two-dimensional Reynolds averaged Navier–Stokes equation in neutral conditions for a canopy with constant plant area density (PAD). The main assumptionsmore » for solving the governing equations are separability of the velocity components concerning the spatial variables and the neglection of the Reynolds stress gradients. These two assumptions are verified by means of LES. To determine the emerging model parameters, a simultaneous fitting scheme was applied to the velocity and pressure data of a reference LES simulation. Furthermore a sensitivity analysis of the adjustment region model, equipped with the previously calculated parameters, was performed varying the three relevant length, the canopy height ( h), the canopy length and the adjustment length ( Lc), in additional LES. Even if the model parameters are, in general, functions of h/ Lc, it was found out that the model is capable of predicting the flow quantities in various cases, when using constant parameters. Subsequently the adjustment region model is combined with the one-dimensional model of Massman, which is applicable for the interior of the canopy, to attain an analytical model capable of describing the mean flow for the full canopy domain. As a result, the model is tested against an analytical model based on a linearization approach.« less

Racial Differences in Home Dialysis Utilization and Outcomes in Canada.

PubMed

Trinh, Emilie; Na, Yingbo; Sood, Manish M; Chan, Christopher T; Perl, Jeffrey

2017-11-07

Data on racial disparities in home dialysis utilization and outcomes are lacking in Canada, where health care is universally available. We studied patients starting maintenance dialysis between 1996 and 2012 in the Canadian Organ Replacement Register, stratified by race: white, Asian, black, Aboriginal, Indian subcontinent, and other. The association between race and treatment with home dialysis was examined using generalized linear models. Secondary outcomes assessed racial differences in all-cause mortality and technique failure using a Fine and Gray competing risk model. 66,600 patients initiated chronic dialysis between 1996 and 2012. Compared with whites ( n =46,092), treatment with home dialysis was lower among Aboriginals ( n =3866; adjusted relative risk, RR, 0.71; 95% confidence interval, CI, 0.66 to 0.76) and higher in Asians ( n =4157; adjusted RR, 1.28; 95% CI, 1.22 to 1.35) and others ( n =2170; adjusted RR, 1.12; 95% CI, 1.04 to 1.20) but similar in blacks ( n =2143) and subcontinent Indians ( n =2809). Black (adjusted hazard ratio, HR, 1.31; 95% CI, 1.16 to 1.48) and Aboriginal (adjusted HR, 1.19; 95% CI, 1.06 to 1.33) patients treated with peritoneal dialysis had a significantly higher adjusted risk of technique failure compared with whites, whereas Asians had a lower risk (adjusted HR, 0.89; 95% CI, 0.82 to 0.99). In patients on peritoneal dialysis, the risk of death was significantly lower in Asians (adjusted HR, 0.83; 95% CI, 0.75 to 0.92), blacks (adjusted HR, 0.71; 95% CI, 0.59 to 0.85), and others (adjusted HR, 0.79; 95% CI, 0.68 to 0.92) but higher in Aboriginals (adjusted HR, 1.16; 95% CI, 1.02 to 1.32) compared with whites. Among patients on home hemodialysis, no significant racial differences in patient and technique survival were observed, which may be limited by the low number of events among each subgroups. With the exception of Aboriginals, all racial minority groups in Canada were as likely to be treated with home dialysis compared with whites. However, significant racial differences exist in outcomes. Copyright © 2017 by the American Society of Nephrology.

19 CFR 201.205 - Salary adjustments.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 3 2010-04-01 2010-04-01 false Salary adjustments. 201.205 Section 201.205 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF GENERAL APPLICATION Debt Collection § 201.205 Salary adjustments. Any negative adjustment to pay arising out of an employee's election...

19 CFR 201.205 - Salary adjustments.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 19 Customs Duties 3 2014-04-01 2014-04-01 false Salary adjustments. 201.205 Section 201.205 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF GENERAL APPLICATION Debt Collection § 201.205 Salary adjustments. Any negative adjustment to pay arising out of an employee's election...

19 CFR 201.205 - Salary adjustments.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 3 2011-04-01 2011-04-01 false Salary adjustments. 201.205 Section 201.205 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF GENERAL APPLICATION Debt Collection § 201.205 Salary adjustments. Any negative adjustment to pay arising out of an employee's election...

19 CFR 201.205 - Salary adjustments.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 19 Customs Duties 3 2013-04-01 2013-04-01 false Salary adjustments. 201.205 Section 201.205 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF GENERAL APPLICATION Debt Collection § 201.205 Salary adjustments. Any negative adjustment to pay arising out of an employee's election...

19 CFR 201.205 - Salary adjustments.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 19 Customs Duties 3 2012-04-01 2012-04-01 false Salary adjustments. 201.205 Section 201.205 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF GENERAL APPLICATION Debt Collection § 201.205 Salary adjustments. Any negative adjustment to pay arising out of an employee's election...

Articulated limiter blade for a tokamak fusion reactor

DOEpatents

Doll, D.W.

1982-10-21

A limiter blade for a large tokomak fusion reactor includes three articulated blade sections for enabling the limiter blade to be adjusted for plasmas of different sizes. Each blade section is formed of a rigid backing plate carrying graphite tiles coated with titanium carbide, and the limiter blade forms a generally elliptic contour in both the poloidal and toroidal directions to uniformly distribute the heat flow to the blade. The limiter blade includes a central blade section movable along the major radius of the vacuum vessel, and upper and lower pivotal blade sections which may be pivoted by linear actuators having rollers held to the back surface of the pivotal blade sections.

Articulated limiter blade for a tokamak fusion reactor

DOEpatents

Doll, David W.

1985-01-01

A limiter blade for a large tokomak fusion reactor includes three articulated blade sections for enabling the limiter blade to be adjusted for plasmas of different sizes. Each blade section is formed of a rigid backing plate carrying graphite tiles coated with titanium carbide, and the limiter blade forms a generally elliptic contour in both the poloidal and toroidal directions to uniformly distribute the heat flow to the blade. The limiter blade includes a central blade section movable along the major radius of the vacuum vessel, and upper and lower pivotal blade sections which may be pivoted by linear actuators having rollers held to the back surface of the pivotal blade sections.

Comparative economic evaluation of home-based and hospital-based palliative care for terminal cancer patients.

PubMed

Kato, Koki; Fukuda, Haruhisa

2017-11-01

To quantify the difference between adjusted costs for home-based palliative care and hospital-based palliative care in terminally ill cancer patients. We carried out a case-control study of home-care patients (cases) who had died at home between January 2009 and December 2013, and hospital-care patients (controls) who had died at a hospital between April 2008 and December 2013. Data on patient characteristics were obtained from insurance claims data and medical records. We identified the determinants of home care using a multivariate logistic regression analysis. Cox proportional hazards analysis was used to examine treatment duration in both types of care, and a generalized linear model was used to estimate the reduction in treatment costs associated with home care. The case and control groups comprised 48 and 99 patients, respectively. Home care was associated with one or more person(s) living with the patient (adjusted OR 6.54, 95% CI 1.18-36.05), required assistance for activities of daily living (adjusted OR 3.61, 95% CI 1.12-10.51), non-use of oxygen inhalation therapy (adjusted OR 12.75, 95% CI 3.53-46.02), oral or suppository opioid use (adjusted OR 5.74, 95% CI 1.11-29.54) and transdermal patch opioid use (adjusted OR 8.30, 95% CI 1.97-34.93). The adjusted hazard ratio of home care for treatment duration was not significant (adjusted OR 0.95, 95% CI 0.59-1.53). However, home care was significantly associated with a reduction of $7523 (95% CI $7093-7991, P = 0.015) in treatment costs. Despite similar treatment durations between the groups, treatment costs were substantially lower in the home-care group. These findings might inform the policymaking process for improving the home-care support system. Geriatr Gerontol Int 2017; 17: 2247-2254. © 2017 Japan Geriatrics Society.

A linear cavity multiwavelength fiber laser with adjustable lasing line number for fixed spectral regions

NASA Astrophysics Data System (ADS)

Tian, J. J.; Yao, Y.

2011-03-01

We report an experimental demonstration of muliwavelength erbium-doped fiber laser with adjustable wavelength number based on a power-symmetric nonlinear optical loop mirror (NOLM) in a linear cavity. The intensity-dependent loss (IDL) induced by the NOLM is used to suppress the mode competition and realize the stable multiwavelength oscillation. The controlling of the wavelength number is achieved by adjusting the strength of IDL, which is dependent on the pump power. As the pump power increases from 40 to 408 mW, 1-7 lasing line(s) at fixed wavelength around 1601 nm are obtained. The output power stability is also investigated. The most power fluctuation of single wavelength is less than 0.9 dB, when the wavelength number is increased from 1-7.

Serum trans-fatty acids level are positively associated with lower food security among american adults.

PubMed

Mazidi, Mohsen; Vatanparast, Hassan

2018-03-07

In the current study we aimed to assess whether the food security is associated with serum trans-fatty acids (TFAs) and dietary fat. Analyses were restricted to participants (from the US National Health and Nutrition Examination Survey) with data available on serum and diet TFAs and food security status from 2009 to 2010. All statistical analyses (analysis of covariance and linear regression) accounted for the survey design and sample weights. We included 3876 participants, overall (48.6%) participants were men, and (51.4%) were women, generally (69.0%) had high food security. Subjects with higher food security had a higher level of education as well (p < 0.001). Age-adjusted, sex-adjusted, race-adjusted, education-adjusted mean of trans 9-octadecenoic acid and trans-9, trans-12-octadecadienoic acid were higher in plasma of participants with lower food security (all p < 0.001), moreover in same model there was a significant positive association between plasma level of trans-11-octadecenoic acid, trans-9-octadecenoic acid and trans-9, trans-12-octadecadienoic acid and score of food security. Further, age, sex, race, education, and energy intake adjusted mean of dietary fatty acids show that total polyunsaturated fatty acids are higher in subjects with higher food security (p = 0.026) while, cholesterol consumption is higher in subjects with lower food security (p = 0.039). Our findings provide more evidence on the association between food insecurity and the higher level of TFAs in serum and different type of fat in the diet.

Feeling Good, Feeling Bad: Influences of Maternal Perceptions of the Child and Marital Adjustment on Well-Being in Mothers of Children with an Autism Spectrum Disorder

ERIC Educational Resources Information Center

Lickenbrock, Diane M.; Ekas, Naomi V.; Whitman, Thomas L.

2011-01-01

Mothers of children with an autism spectrum disorder (n = 49) participated in a 30-day diary study which examined associations between mothers' positive and negative perceptions of their children, marital adjustment, and maternal well-being. Hierarchical linear modeling results revealed that marital adjustment mediated associations between…

Generalized adjustment by least squares ( GALS).

USGS Publications Warehouse

Elassal, A.A.

1983-01-01

The least-squares principle is universally accepted as the basis for adjustment procedures in the allied fields of geodesy, photogrammetry and surveying. A prototype software package for Generalized Adjustment by Least Squares (GALS) is described. The package is designed to perform all least-squares-related functions in a typical adjustment program. GALS is capable of supporting development of adjustment programs of any size or degree of complexity. -Author

Structure of weakly 2-dependent siphons

NASA Astrophysics Data System (ADS)

Chao, Daniel Yuh; Chen, Jiun-Ting

2013-09-01

Deadlocks arising from insufficiently marked siphons in flexible manufacturing systems can be controlled by adding monitors to each siphon - too many for large systems. Li and Zhou add monitors to elementary siphons only while controlling the rest of (called dependent) siphons by adjusting control depth variables of elementary siphons. Only a linear number of monitors are required. The control of weakly dependent siphons (WDSs) is rather conservative since only positive terms were considered. The structure for strongly dependent siphons (SDSs) has been studied earlier. Based on this structure, the optimal sequence of adding monitors has been discovered earlier. Better controllability has been discovered to achieve faster and more permissive control. The results have been extended earlier to S3PGR2 (systems of simple sequential processes with general resource requirements). This paper explores the structures for WDSs, which, as found in this paper, involve elementary resource circuits interconnecting at more than (for SDSs, exactly) one resource place. This saves the time to compute compound siphons, their complementary sets and T-characteristic vectors. Also it allows us (1) to improve the controllability of WDSs and control siphons and (2) to avoid the time to find independent vectors for elementary siphons. We propose a sufficient and necessary test for adjusting control depth variables in S3PR (systems of simple sequential processes with resources) to avoid the sufficient-only time-consuming linear integer programming test (LIP) (Nondeterministic Polynomial (NP) time complete problem) required previously for some cases.

Adherence to the Mediterranean diet and quality of life in the SUN Project.

PubMed

Henríquez Sánchez, P; Ruano, C; de Irala, J; Ruiz-Canela, M; Martínez-González, M A; Sánchez-Villegas, A

2012-03-01

Mediterranean diet has been related with reduced morbidity and better well-being. The aim of this study was to assess whether the adherence to the Mediterranean diet were associated with mental and physical health related to quality of life. This analysis included 11 015 participants with 4 years of follow-up in the SUN Project (a multipurpose cohort study based on university graduates from Spain). A validated 136-item food frequency questionnaire was used to assess the adherence to the Mediterranean diet at baseline, according to a nine-point score, presented in four categories (low, low-moderate, moderate-high and high). Health-related quality of life (HRQL) was measured after 4 years of follow-up with the Spanish version of the SF-36 Health Survey. Generalized Linear Models were fitted to assess adjusted mean scores, the regression coefficients (β) and their 95% confidence intervals (95% CIs) for the SF-36 domains according to categories of adherence to Mediterranean diet. Multivariate-adjusted models revealed a significant direct association between adherence to Mediterranean diet and all the physical and most mental health domains (vitality, social functioning and role emotional). Vitality (β=0.50, 95% CI=0.32-0.68) and general health (β=0.45, 95% CI=0.26-0.62) showed the highest coefficients. Mean values for physical functioning, role physical, bodily pain, general health and vitality domains were significantly better with increasing adherence to the Mediterranean diet. Those having improved their initial high diet scores have better scores in physical functioning, general health and vitality. Adherence to the Mediterranean diet seems to be a factor importantly associated with a better HRQL.

Association between hepatic steatosis and serum liver enzyme levels with atrial fibrillation in the general population: The Study of Health in Pomerania (SHIP).

PubMed

Markus, Marcello Ricardo Paulista; Meffert, Peter J; Baumeister, Sebastian Edgar; Lieb, Wolfgang; Siewert, Ulrike; Schipf, Sabine; Koch, Manja; Kors, Jan A; Felix, Stephan Burkhard; Dörr, Marcus; Targher, Giovanni; Völzke, Henry

2016-02-01

Hepatic steatosis (HS) affects up to 35% of adults in the general population. Atrial fibrillation (AF) is the most prevalent sustained arrhythmia and has a substantial impact on healthcare costs. We analyzed cross-sectional associations of HS and serum liver enzyme levels with prevalent AF in a general population sample. We analyzed data from 3090 women and men, aged 20-81 years, from the population-based Study of Health in Pomerania. HS was determined by ultrasonography. Serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyltranspeptidase (GGT) were measured photometrically. AF was determined by automatic electrocardiographic analysis software. The prevalences of HS and AF were 30.3% and 1.49%, respectively. ALT, AST and GGT showed a positive linear association with the risk of prevalent AF, after multivariable adjustment. The adjusted odds ratios for AF per 1-standard deviation increment in log-transformed serum liver enzyme levels were 1.65 (95% confidence interval [CI]: 1.16 to 2.35; p = 0.006) for ALT, 1.47 (95%CI: 1.07 to 2.02; p = 0.017) for AST and 2.17 (95%CI: 1.64 to 2.87; p < 0.001) for GGT. In contrast, ultrasonographic HS was not associated with AF. Our findings indicate that moderately elevated serum liver enzymes, but not sonographic liver hyperechogenicity, were associated with increased AF prevalence in the general adult population. The hepatic release of increased levels of serum liver enzymes might be accompanied by higher levels of pro-inflammatory, pro-coagulant and pro-fibronogenic mediators that might lead to structural and electrical remodeling of the atrium resulting in the development and persistence of AF. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Long-term outcomes of childhood cancer survivors in Sweden: a population-based study of education, employment, and income.

PubMed

Boman, Krister K; Lindblad, Frank; Hjern, Anders

2010-03-01

Studies of different national populations were indispensable for estimating the impact of illness-related disability on social outcomes in adult childhood cancer survivors. The effects of childhood cancer on educational attainment, employment, and income in adulthood in a Swedish setting were studied. The study population was a national cohort of 1.46 million Swedish residents, including 1716 survivors of childhood cancer diagnosed before their 16th birthday, followed up in 2002 in registries at >25 years of age. Main outcomes were educational attainment, employment, and net income. Markers of persistent disability were considered, and outcomes were analyzed with multivariate linear and logistic regression models adjusted for age, sex, and socioeconomic indicators of the childhood households. Non-central nervous system (CNS) cancer survivors had similar education, employment, and income as the general population in adjusted models, whereas survivors of CNS tumors more often had no more than basic (< or =9 years) education (relative risk [RR], 1.80 [95% confidence interval (95% CI), 1.45-2.23]), less often attained education beyond secondary school (RR, 0.69 [95% CI, 0.58-0.81]), and less often were employed (RR, 0.85 [95% CI, 0.77-0.94]). Predicted net income from work was lower in CNS tumor survivors (P <.001) than in the general population, even after the exclusion of individuals who received economic disability compensation. CNS tumor survivors had poorer social outcomes compared with the general population, whereas outcomes for survivors of other childhood cancers were similar to the general population. Established late effects highlighted the importance of improved, safer pediatric CNS tumor treatment protocols and surveillance that identified individual needs for preventive and remedial measures.

Absence of race- or gender-specific income disparities among full-time white and Asian general internists working for the Veterans Administration.

PubMed

Weeks, William B; Wallace, Amy E

2010-02-01

Gender-based, but not race-based, income disparities exist among general internists who practice medicine in the private sector. The aim of this study was to assess whether race- or gender-based income disparities existed among full-time white and Asian general internists who worked for the Veterans Health Administration of the US Department of Veterans Affairs (VA) between fiscal years 2004 and 2007, and whether any disparities changed after the VA enacted physician pay reform in early 2006. A retrospective study was conducted of all nonsupervisory, board-certified, full-time white or Asian VA general internists who did not change their location of practice between fiscal years 2004 and 2007. A longitudinal cohort design and linear regression modeling, adjusted for physician characteristics, were used to compare race- and gender-specific incomes in fiscal years 2004-2007. A total of 176 physicians were included in the study: 82 white males, 33 Asian males, 30 white females, and 31 Asian females. In all fiscal years examined, white males had the highest mean annual incomes, though not statistically significantly so. Regression analyses for fiscal years 2004 through 2006 revealed that physician age and years of service were predictive of total income. After physician pay reform was enacted, Asian male VA primary care physicians had higher annual incomes than did physicians in all other race or gender categories, after adjustment for age and years of VA service, though these differences were not statistically significant. No significant gender-based income disparities were noted among these white and Asian VA physicians. Our findings for white and Asian general internists suggest that the VA' s goal of maintaining a racially diverse workforce may have been effected, in part, through use of market pay among primary care general internists. Copyright 2010. Published by Elsevier Inc.

Outcomes associated with preoperative weight loss after laparoscopic Roux-en-Y gastric bypass.

PubMed

Blackledge, Camille; Graham, Laura A; Gullick, Allison A; Richman, Joshua; Stahl, Richard; Grams, Jayleen

2016-11-01

Laparoscopic Roux-en-Y gastric bypass (LRYGB) is an effective treatment for achieving and maintaining weight loss and for improving obesity-related comorbidities. As part of the approval process for bariatric surgery, many insurance companies require patients to have documented recent participation in a supervised weight loss program. The goal of this study was to evaluate the relationship of preoperative weight changes with outcomes following LRYGB. A retrospective review was conducted of adult patients undergoing LRYGB between 2008 and 2012 at a single institution. Patients were stratified into quartiles based on % excess weight gain (0-4.99 % and ≥5 % EWG) and % excess weight loss (0-4.99 % and ≥5 % EWL). Generalized linear models were used to examine differences in postoperative weight outcomes at 6, 12, and 24 months. Covariates included in the final adjusted models were determined using backwards stepwise selection. Of the 300 patients included in the study, there were no significant demographic differences among the quartiles. However, there was an increased time to operation for patients who gained or lost ≥5 % excess body weight (p < 0.001). Although there was no statistical significance in postoperative complications, there was a higher rate of complications in patients with ≥5 % EWG compared to those with ≥5 % EWL (12.5 vs. 4.8 %, respectively; p = 0.29). Unadjusted and adjusted generalized linear models showed no statistically significant association between preoperative % excess weight change and weight loss outcomes at 24 months. Patients with the greatest % preoperative excess weight change had the longest intervals from initial visit to operation. No significant differences were seen in perioperative and postoperative outcomes. This study suggests preoperative weight loss requirements may delay the time to operation without improving postoperative outcomes or weight loss.

Association between serum vitamin D concentrations and inflammatory markers in the general adult population.

PubMed

Mellenthin, Liesa; Wallaschofski, Henri; Grotevendt, Anne; Völzke, Henry; Nauck, Matthias; Hannemann, Anke

2014-08-01

In recent years links among vitamin D deficiency, inflammation and cardio-metabolic disease were proposed. As information regarding the associations between vitamin D and inflammatory markers in the general population is sparse, we investigated the associations of 25-hydroxy vitamin D [25(OH)D] with high-sensitivity C-reactive protein (hs-CRP), fibrinogen and white blood cell count (WBC). The study population comprised 2723 men and women aged 25-88 years from the first follow-up of the Study of Health in Pomerania. Analyses of variance, linear and logistic regressions were performed to assess the associations between 25(OH)D and the three inflammatory markers. The models were adjusted for age, sex, waist circumference, diabetes mellitus, dyslipidemia, anti-inflammatory medication and month of blood sampling. The association between 25(OH)D and WBC was assessed separately in smokers (n = 718) and non-smokers (n = 2005) as effect modification was observed. We detected a U-shaped association between 25(OH)D and hs-CRP with a nadir of 21-25 ng/ml in fully-adjusted linear regression models with restricted cubic splines (p < 0.01; p' < 0.01). We further detected an inverse association between 25(OH)D and fibrinogen (p < 0.01). In addition, there was an inverse association between 25(OH)D and WBC in smokers (p = 0.02) but no association in non-smokers (p = 0.73). Our study confirms a potential role of 25(OH)D in chronic inflammation. Yet, different inflammatory biomarkers are differently associated with 25(OH)D. Beneficial effects of increasing 25(OH)D were observed for fibrinogen and WBC (in smokers only). In contrast, the U-shaped association between 25(OH)D and hs-CRP indicates that ever-increasing 25(OH)D concentrations may also be related to proinflammatory states. Copyright © 2014 Elsevier Inc. All rights reserved.

Impact of investigations in general practice on timeliness of referral for patients subsequently diagnosed with cancer: analysis of national primary care audit data.

PubMed

Rubin, G P; Saunders, C L; Abel, G A; McPhail, S; Lyratzopoulos, G; Neal, R D

2015-02-17

For patients with symptoms of possible cancer who do not fulfil the criteria for urgent referral, initial investigation in primary care has been advocated in the United Kingdom and supported by additional resources. The consequence of this strategy for the timeliness of diagnosis is unknown. We analysed data from the English National Audit of Cancer Diagnosis in Primary Care on patients with lung (1494), colorectal (2111), stomach (246), oesophagus (513), pancreas (327), and ovarian (345) cancer relating to the ordering of investigations by the General Practitioner and their nature. Presenting symptoms were categorised according to National Institute for Health and Care Excellence (NICE) guidance on referral for suspected cancer. We used linear regression to estimate the mean difference in primary-care interval by cancer, after adjustment for age, gender, and the symptomatic presentation category. Primary-care investigations were undertaken in 3198/5036 (64%) of cases. The median primary-care interval was 16 days (IQR 5-45) for patients undergoing investigation and 0 days (IQR 0-10) for those not investigated. Among patients whose symptoms mandated urgent referral to secondary care according to NICE guidelines, between 37% (oesophagus) and 75% (pancreas) were first investigated in primary care. In multivariable linear regression analyses stratified by cancer site, adjustment for age, sex, and NICE referral category explained little of the observed prolongation associated with investigation. For six specified cancers, investigation in primary care was associated with later referral for specialist assessment. This effect was independent of the nature of symptoms. Some patients for whom urgent referral is mandated by NICE guidance are nevertheless investigated before referral. Reducing the intervals between test order, test performance, and reporting can help reduce the prolongation of primary-care intervals associated with investigation use. Alternative models of assessment should be considered.

Impact of investigations in general practice on timeliness of referral for patients subsequently diagnosed with cancer: analysis of national primary care audit data

PubMed Central

Rubin, G P; Saunders, C L; Abel, G A; McPhail, S; Lyratzopoulos, G; Neal, R D

2015-01-01

Background: For patients with symptoms of possible cancer who do not fulfil the criteria for urgent referral, initial investigation in primary care has been advocated in the United Kingdom and supported by additional resources. The consequence of this strategy for the timeliness of diagnosis is unknown. Methods: We analysed data from the English National Audit of Cancer Diagnosis in Primary Care on patients with lung (1494), colorectal (2111), stomach (246), oesophagus (513), pancreas (327), and ovarian (345) cancer relating to the ordering of investigations by the General Practitioner and their nature. Presenting symptoms were categorised according to National Institute for Health and Care Excellence (NICE) guidance on referral for suspected cancer. We used linear regression to estimate the mean difference in primary-care interval by cancer, after adjustment for age, gender, and the symptomatic presentation category. Results: Primary-care investigations were undertaken in 3198/5036 (64%) of cases. The median primary-care interval was 16 days (IQR 5–45) for patients undergoing investigation and 0 days (IQR 0–10) for those not investigated. Among patients whose symptoms mandated urgent referral to secondary care according to NICE guidelines, between 37% (oesophagus) and 75% (pancreas) were first investigated in primary care. In multivariable linear regression analyses stratified by cancer site, adjustment for age, sex, and NICE referral category explained little of the observed prolongation associated with investigation. Interpretation: For six specified cancers, investigation in primary care was associated with later referral for specialist assessment. This effect was independent of the nature of symptoms. Some patients for whom urgent referral is mandated by NICE guidance are nevertheless investigated before referral. Reducing the intervals between test order, test performance, and reporting can help reduce the prolongation of primary-care intervals associated with investigation use. Alternative models of assessment should be considered. PMID:25602963

Surgery for left ventricular aneurysm: early and late survival after simple linear repair and endoventricular patch plasty.

PubMed

Lundblad, Runar; Abdelnoor, Michel; Svennevig, Jan Ludvig

2004-09-01

Simple linear resection and endoventricular patch plasty are alternative techniques to repair postinfarction left ventricular aneurysm. The aim of the study was to compare these 2 methods with regard to early mortality and long-term survival. We retrospectively reviewed 159 patients undergoing operations between 1989 and 2003. The epidemiologic design was of an exposed (simple linear repair, n = 74) versus nonexposed (endoventricular patch plasty, n = 85) cohort with 2 endpoints: early mortality and long-term survival. The crude effect of aneurysm repair technique versus endpoint was estimated by odds ratio, rate ratio, or relative risk and their 95% confidence intervals. Stratification analysis by using the Mantel-Haenszel method was done to quantify confounders and pinpoint effect modifiers. Adjustment for multiconfounders was performed by using logistic regression and Cox regression analysis. Survival curves were analyzed with the Breslow test and the log-rank test. Early mortality was 8.2% for all patients, 13.5% after linear repair and 3.5% after endoventricular patch plasty. When adjusted for multiconfounders, the risk of early mortality was significantly higher after simple linear repair than after endoventricular patch plasty (odds ratio, 4.4; 95% confidence interval, 1.1-17.8). Mean follow-up was 5.8 +/- 3.8 years (range, 0-14.0 years). Overall 5-year cumulative survival was 78%, 70.1% after linear repair and 91.4% after endoventricular patch plasty. The risk of total mortality was significantly higher after linear repair than after endoventricular patch plasty when controlled for multiconfounders (relative risk, 4.5; 95% confidence interval, 2.0-9.7). Linear repair dominated early in the series and patch plasty dominated later, giving a possible learning-curve bias in favor of patch plasty that could not be adjusted for in the regression analysis. Postinfarction left ventricular aneurysm can be repaired with satisfactory early and late results. Surgical risk was lower and long-term survival was higher after endoventricular patch plasty than simple linear repair. Differences in outcome should be interpreted with care because of the retrospective study design and the chronology of the 2 repair methods.

The relationship between body mass index and uric acid: a study on Japanese adult twins.

PubMed

Tanaka, Kentaro; Ogata, Soshiro; Tanaka, Haruka; Omura, Kayoko; Honda, Chika; Hayakawa, Kazuo

2015-09-01

The present study aimed to investigate the association between body mass index (BMI) and uric acid (UA) using the twin study methodology to adjust for genetic factors. The association between BMI and UA was investigated in a cross-sectional study using data from both monozygotic and dizygotic twins registered at the Osaka University Center for Twin Research and the Osaka University Graduate School of Medicine. From January 2011 to March 2014, 422 individuals participated in the health examination. We measured height, weight, age, BMI, lifestyle habits (Breslow's Health Practice Index), serum UA, and serum creatinine. To investigate the association between UA and BMI with adjustment for the clustering of a twin within a pair, individual-level analyses were performed using generalized linear mixed models (GLMMs). To investigate an association with adjustment for genetic and family environmental factors, twin-pair difference values analyses were performed. In all analysis, BMI was associated with UA in men and women. Using the GLMMs, standardized regression coefficients were 0.194 (95 % confidence interval: 0.016-0.373) in men and 0.186 (95 % confidence interval: 0.071-0.302) in women. Considering twin-pair difference value analyses, standardized regression coefficients were 0.333 (95 % confidence interval: 0.072-0.594) in men and 0.314 (95 % confidence interval: 0.151-0.477) in women. The present study shows that BMI was significantly associated with UA, after adjusting for both genetic and familial environment factors in both men and women.

Probiotic milk consumption in pregnancy and infancy and subsequent childhood allergic diseases.

PubMed

Bertelsen, Randi J; Brantsæter, Anne Lise; Magnus, Maria C; Haugen, Margaretha; Myhre, Ronny; Jacobsson, Bo; Longnecker, Matthew P; Meltzer, Helle M; London, Stephanie J

2014-01-01

Whether probiotics, which can influence the microbiome, prevent infant eczema or allergic disease remains an open question. Most studies have focused on high-risk infants. We sought to assess whether consumption of probiotic milk products protects against atopic eczema, rhinoconjunctivitis, and asthma in early childhood in a large population-based pregnancy cohort (the Norwegian Mother and Child Cohort study). We examined associations between consumption of probiotic milk products in pregnancy and infancy with questionnaire-reported atopic eczema, rhinoconjunctivitis, and asthma in 40,614 children. Relative risks (RRs) were calculated by using general linear models adjusted for potential confounders. Consumption of probiotic milk in pregnancy was associated with a slightly reduced relative risk (RR) of atopic eczema at 6 months (adjusted RR, 0.94; 95% CI, 0.89-0.99) and of rhinoconjunctivitis between 18 and 36 months (adjusted RR, 0.87; 95% CI, 0.78-0.98) compared with no consumption during pregnancy. Maternal history of allergic disease did not notably influence the associations. When both the mother (during pregnancy) and infant (after 6 months of age) had consumed probiotic milk, the adjusted RR of rhinoconjunctivitis was 0.80 (95% CI, 0.68-0.93) relative to no consumption by either. Probiotic milk consumption was not associated with asthma at 36 months. In this population-based cohort consumption of probiotic milk products was related to a reduced incidence of atopic eczema and rhinoconjunctivitis, but no association was seen for incidence of asthma by 36 months of age. Published by Mosby, Inc.

An approximation of herd effect due to vaccinating children against seasonal influenza – a potential solution to the incorporation of indirect effects into static models

PubMed Central

2013-01-01

Background Indirect herd effect from vaccination of children offers potential for improving the effectiveness of influenza prevention in the remaining unvaccinated population. Static models used in cost-effectiveness analyses cannot dynamically capture herd effects. The objective of this study was to develop a methodology to allow herd effect associated with vaccinating children against seasonal influenza to be incorporated into static models evaluating the cost-effectiveness of influenza vaccination. Methods Two previously published linear equations for approximation of herd effects in general were compared with the results of a structured literature review undertaken using PubMed searches to identify data on herd effects specific to influenza vaccination. A linear function was fitted to point estimates from the literature using the sum of squared residuals. Results The literature review identified 21 publications on 20 studies for inclusion. Six studies provided data on a mathematical relationship between effective vaccine coverage in subgroups and reduction of influenza infection in a larger unvaccinated population. These supported a linear relationship when effective vaccine coverage in a subgroup population was between 20% and 80%. Three studies evaluating herd effect at a community level, specifically induced by vaccinating children, provided point estimates for fitting linear equations. The fitted linear equation for herd protection in the target population for vaccination (children) was slightly less conservative than a previously published equation for herd effects in general. The fitted linear equation for herd protection in the non-target population was considerably less conservative than the previously published equation. Conclusions This method of approximating herd effect requires simple adjustments to the annual baseline risk of influenza in static models: (1) for the age group targeted by the childhood vaccination strategy (i.e. children); and (2) for other age groups not targeted (e.g. adults and/or elderly). Two approximations provide a linear relationship between effective coverage and reduction in the risk of infection. The first is a conservative approximation, recommended as a base-case for cost-effectiveness evaluations. The second, fitted to data extracted from a structured literature review, provides a less conservative estimate of herd effect, recommended for sensitivity analyses. PMID:23339290

Caffeine intake and abstract reasoning among 1374 unselected men and women from general population. Role of the -163C>A polymorphism of CYP1A2 gene.

PubMed

Casiglia, Edoardo; Tikhonoff, Valérie; Albertini, Federica; Favaro, Jacopo; Montagnana, Martina; Danese, Elisa; Finatti, Francesco; Benati, Marco; Mazza, Alberto; Dal Maso, Lucia; Spinella, Paolo; Palatini, Paolo

2017-08-01

The possible effect of caffeine as an enhancer of cognitive performance, particularly that on abstract reasoning, has never been studied in an epidemiological setting, especially in relation to -163C>A polymorphism of CYP1A2 gene, largely controlling caffeine metabolism. Aim of this study was to ascertain whether in general population free chronic caffeine intake modifies abstract reasoning, and if this effect is influenced by the above mentioned genotype, by age, schooling, ethanol intake and smoking habits. We studied 1374 unselected men and women aged 51 ± 15 years (range 18-89) from a general population. Daily caffeine intake deriving from coffee, tea, chocolate or cola was calculated from an anamnestic questionnaire and from a 7-day dietary diary. Abstract reasoning was measured in the frame of a neuropsychological assessment as the ability to find a concept linking two words indicating objects or actions and explaining how they were connected. In age-schooling-adjusted linear regression, the higher the caffeine intake, the better the abstraction score. Abstract reasoning depended on caffeine in the -163C>A CC homozygous only (so-called slow metabolizers), where it was higher in the 3rd tertile of caffeine intake. Age and ethanol reduced while smoking and schooling enhanced this association. The interaction term between caffeine and the -163C>A polymorphism was accepted in linear regressions. Caffeine consumption resulted innocuous for the A-carriers (so-called fast metabolizers). In general population, a positive association between caffeine intake and abstract reasoning exists in the CC homozygous of the -163C>A polymorphism of CYP1A2 gene. Copyright © 2017 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

A novel task-oriented optimal design for P300-based brain-computer interfaces.

PubMed

Zhou, Zongtan; Yin, Erwei; Liu, Yang; Jiang, Jun; Hu, Dewen

2014-10-01

Objective. The number of items of a P300-based brain-computer interface (BCI) should be adjustable in accordance with the requirements of the specific tasks. To address this issue, we propose a novel task-oriented optimal approach aimed at increasing the performance of general P300 BCIs with different numbers of items. Approach. First, we proposed a stimulus presentation with variable dimensions (VD) paradigm as a generalization of the conventional single-character (SC) and row-column (RC) stimulus paradigms. Furthermore, an embedding design approach was employed for any given number of items. Finally, based on the score-P model of each subject, the VD flash pattern was selected by a linear interpolation approach for a certain task. Main results. The results indicate that the optimal BCI design consistently outperforms the conventional approaches, i.e., the SC and RC paradigms. Specifically, there is significant improvement in the practical information transfer rate for a large number of items. Significance. The results suggest that the proposed optimal approach would provide useful guidance in the practical design of general P300-based BCIs.

A novel task-oriented optimal design for P300-based brain-computer interfaces

NASA Astrophysics Data System (ADS)

Zhou, Zongtan; Yin, Erwei; Liu, Yang; Jiang, Jun; Hu, Dewen

2014-10-01

Objective. The number of items of a P300-based brain-computer interface (BCI) should be adjustable in accordance with the requirements of the specific tasks. To address this issue, we propose a novel task-oriented optimal approach aimed at increasing the performance of general P300 BCIs with different numbers of items. Approach. First, we proposed a stimulus presentation with variable dimensions (VD) paradigm as a generalization of the conventional single-character (SC) and row-column (RC) stimulus paradigms. Furthermore, an embedding design approach was employed for any given number of items. Finally, based on the score-P model of each subject, the VD flash pattern was selected by a linear interpolation approach for a certain task. Main results. The results indicate that the optimal BCI design consistently outperforms the conventional approaches, i.e., the SC and RC paradigms. Specifically, there is significant improvement in the practical information transfer rate for a large number of items. Significance. The results suggest that the proposed optimal approach would provide useful guidance in the practical design of general P300-based BCIs.

40 CFR 86.1603 - General requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... certified to meet the appropriate high-altitude emission standards. (2) High-altitude adjustment... the general public. EPA encourages manufacturers to notify vehicle owners in high-altitude areas of the availability of high-altitude adjustments. (g) If altitude adjustments are performed according to...

40 CFR 86.1603 - General requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... certified to meet the appropriate high-altitude emission standards. (2) High-altitude adjustment... the general public. EPA encourages manufacturers to notify vehicle owners in high-altitude areas of the availability of high-altitude adjustments. (g) If altitude adjustments are performed according to...

Variation in mortality of ischemic and hemorrhagic strokes in relation to high temperature.

PubMed

Lim, Youn-Hee; Kim, Ho; Hong, Yun-Chul

2013-01-01

Outdoor temperature has been reported to have a significant influence on the seasonal variations of stroke mortality, but few studies have investigated the effect of high temperature on the mortality of ischemic and hemorrhagic strokes. The main study goal was to examine the effect of temperature, particularly high temperature, on ischemic and hemorrhagic strokes. We investigated the association between outdoor temperature and stroke mortality in four metropolitan cities in Korea during 1992-2007. We used time series analysis of the age-adjusted mortality rate for ischemic and hemorrhagic stroke deaths by using generalized additive and generalized linear models, and estimated the percentage change of mortality rate associated with a 1°C increase of mean temperature. The temperature-responses for the hemorrhagic and ischemic stroke mortality differed, particularly in the range of high temperature. The estimated percentage change of ischemic stroke mortality above a threshold temperature was 5.4 % (95 % CI, 3.9-6.9 %) in Seoul, 4.1 % (95 % CI, 1.6-6.6 %) in Incheon, 2.3 % (-0.2 to 5.0 %) in Daegu and 3.6 % (0.7-6.6 %) in Busan, after controlling for daily mean humidity, mean air pressure, day of the week, season, and year. Additional adjustment of air pollution concentrations in the model did not change the effects. Hemorrhagic stroke mortality risk significantly decreased with increasing temperature without a threshold in the four cities after adjusting for confounders. These findings suggest that the mortality of hemorrhagic and ischemic strokes show different patterns in relation to outdoor temperature. High temperature was harmful for ischemic stroke but not for hemorrhagic stroke. The risk of high temperature to ischemic stroke did not differ by age or gender.

Variation in mortality of ischemic and hemorrhagic strokes in relation to high temperature

NASA Astrophysics Data System (ADS)

Lim, Youn-Hee; Kim, Ho; Hong, Yun-Chul

2013-01-01

Outdoor temperature has been reported to have a significant influence on the seasonal variations of stroke mortality, but few studies have investigated the effect of high temperature on the mortality of ischemic and hemorrhagic strokes. The main study goal was to examine the effect of temperature, particularly high temperature, on ischemic and hemorrhagic strokes. We investigated the association between outdoor temperature and stroke mortality in four metropolitan cities in Korea during 1992-2007. We used time series analysis of the age-adjusted mortality rate for ischemic and hemorrhagic stroke deaths by using generalized additive and generalized linear models, and estimated the percentage change of mortality rate associated with a 1°C increase of mean temperature. The temperature-responses for the hemorrhagic and ischemic stroke mortality differed, particularly in the range of high temperature. The estimated percentage change of ischemic stroke mortality above a threshold temperature was 5.4 % (95 % CI, 3.9-6.9 %) in Seoul, 4.1 % (95 % CI, 1.6-6.6 %) in Incheon, 2.3 % (-0.2 to 5.0 %) in Daegu and 3.6 % (0.7-6.6 %) in Busan, after controlling for daily mean humidity, mean air pressure, day of the week, season, and year. Additional adjustment of air pollution concentrations in the model did not change the effects. Hemorrhagic stroke mortality risk significantly decreased with increasing temperature without a threshold in the four cities after adjusting for confounders. These findings suggest that the mortality of hemorrhagic and ischemic strokes show different patterns in relation to outdoor temperature. High temperature was harmful for ischemic stroke but not for hemorrhagic stroke. The risk of high temperature to ischemic stroke did not differ by age or gender.

The Association of Albuminuria With Tubular Reabsorption of Uric Acid: Results From a General Population Cohort

PubMed Central

Scheven, Lieneke; Joosten, Michel M.; de Jong, Paul E.; Bakker, Stephan J. L.; Gansevoort, Ron T.

2014-01-01

Background Elevated albuminuria as well as an increased serum uric acid concentration is associated with poor cardiovascular outcome. We questioned whether these 2 variables (albuminuria and serum uric concentration) may be interrelated via tubular uric acid reabsorption. Methods and Results Included were 7688 participants of the PREVEND Study, an observational, general population‐based cohort study. Linear regression analyses were used to test associations of baseline albuminuria with baseline serum uric acid concentration and tubular uric acid reabsorption (calculated as [100−fractional uric acid excretion]%). Cox regression analyses were used to study the association of baseline serum uric acid and albuminuria with incident cardiovascular morbidity and mortality. In cross‐sectional analyses, albuminuria was associated positively with serum uric acid concentration, both crude and after adjustment for potential confounders (both P<0.001). Albuminuria was found to be associated positively with tubular uric acid reabsorption, again both crude and after adjustment for potential confounders (both P<0.001). In longitudinal analyses during a median follow‐up of 10.5 years, 702 cardiovascular events occurred. After adjusting for cardiovascular risk factors, both albuminuria and serum uric acid were associated with incident cardiovascular events (Hazard Ratios 1.09 [1.03 to 1.17], P=0.01 and 1.19 [1.09 to 1.30], P<0.001, respectively). A significant interaction between these variables was present (P<0.001), consistent with high serum uric acid being less predictive for cardiovascular morbidity and mortality in the presence of high albuminuria and vice versa. Conclusions Albuminuria is strongly associated with tubular uric acid reabsorption, and consequently with serum uric acid concentration. This phenomenon may explain in part why albuminuria is associated with cardiovascular outcome. PMID:24772520

Association between left ventricular mechanics and diffuse myocardial fibrosis in patients with repaired Tetralogy of Fallot: a cross-sectional study.

PubMed

Haggerty, Christopher M; Suever, Jonathan D; Pulenthiran, Arichanah; Mejia-Spiegeler, Abba; Wehner, Gregory J; Jing, Linyuan; Charnigo, Richard J; Fornwalt, Brandon K; Fogel, Mark A

2017-12-11

Patients with repaired tetralogy of Fallot (TOF) have progressive, adverse biventricular remodeling, leading to abnormal contractile mechanics. Defining the mechanisms underlying this dysfunction, such as diffuse myocardial fibrosis, may provide insights into poor long-term outcomes. We hypothesized that left ventricular (LV) diffuse fibrosis is related to impaired LV mechanics. Patients with TOF were evaluated with cardiac magnetic resonance in which modified Look-Locker (MOLLI) T1-mapping and spiral cine Displacement encoding (DENSE) sequences were acquired at three LV short-axis positions. Linear mixed modeling was used to define the association between regional LV mechanics from DENSE based on regional T1-derived diffuse fibrosis measures, such as extracellular volume fraction (ECV). Forty patients (26 ± 11 years) were included. LV ECV was generally within normal range (0.24 ± 0.05). For LV mechanics, peak circumferential strains (-15 ± 3%) and dyssynchrony indices (16 ± 8 ms) were moderately impaired, while peak radial strains (29 ± 8%) were generally normal. After adjusting for patient age, sex, and regional LV differences, ECV was associated with log-adjusted LV dyssynchrony index (β = 0.67) and peak LV radial strain (β = -0.36), but not LV circumferential strain. Moreover, post-contrast T1 was associated with log-adjusted LV diastolic circumferential strain rate (β = 0.37). We observed several moderate associations between measures of fibrosis and impaired mechanics, particularly the LV dyssynchrony index and peak radial strain. Diffuse fibrosis may therefore be a causal factor in some ventricular dysfunction in TOF.

Preterm birth and dyscalculia.

PubMed

Jaekel, Julia; Wolke, Dieter

2014-06-01

To evaluate whether the risk for dyscalculia in preterm children increases the lower the gestational age (GA) and whether small-for-gestational age birth is associated with dyscalculia. A total of 922 children ranging from 23 to 41 weeks' GA were studied as part of a prospective geographically defined longitudinal investigation of neonatal at-risk children in South Germany. At 8 years of age, children's cognitive and mathematic abilities were measured with the Kaufman Assessment Battery for Children and with a standardized mathematics test. Dyscalculia diagnoses were evaluated with discrepancy-based residuals of a linear regression predicting children's math scores by IQ and with fixed cut-off scores. We investigated each GA group's ORs for general cognitive impairment, general mathematic impairment, and dyscalculia by using binary logistic regressions. The risk for general cognitive and mathematic impairment increased with lower GA. In contrast, preterm children were not at increased risk of dyscalculia after statistically adjusting for child sex, family socioeconomic status, and small-for-gestational age birth. The risk of general cognitive and mathematic impairments increases with lower GA but preterm children are not at increased risk of dyscalculia. Copyright © 2014 Elsevier Inc. All rights reserved.

Stroke and the "stroke belt" in dialysis: contribution of patient characteristics to ischemic stroke rate and its geographic variation.

PubMed

Wetmore, James B; Ellerbeck, Edward F; Mahnken, Jonathan D; Phadnis, Milind A; Rigler, Sally K; Spertus, John A; Zhou, Xinhua; Mukhopadhyay, Purna; Shireman, Theresa I

2013-12-01

Geographic variation in stroke rates is well established in the general population, with higher rates in the South than in other areas of the United States. ESRD is a potent risk factor for stroke, but whether regional variations in stroke risk exist among dialysis patients is unknown. Medicare claims from 2000 to 2005 were used to ascertain ischemic stroke events in a large cohort of 265,685 incident dialysis patients. A Poisson generalized linear mixed model was generated to determine factors associated with stroke and to ascertain state-by-state geographic variability in stroke rates by generating observed-to-expected (O/E) adjusted rate ratios for stroke. Older age, female sex, African American race and Hispanic ethnicity, unemployed status, diabetes, hypertension, history of stroke, and permanent atrial fibrillation were positively associated with ischemic stroke, whereas body mass index >30 kg/m(2) was inversely associated with stroke (P<0.001 for each). After full multivariable adjustment, the three states with O/E rate ratios >1.0 were all in the South: North Carolina, Mississippi, and Oklahoma. Regional efforts to increase primary prevention in the "stroke belt" or to better educate dialysis patients on the signs of stroke so that they may promptly seek care may improve stroke care and outcomes in dialysis patients.

Understanding the Low Level of Cervical Cancer Screening in Masaka Uganda Using the ASE Model: A Community-Based Survey.

PubMed

Twinomujuni, Cyprian; Nuwaha, Fred; Babirye, Juliet Ndimwibo

2015-01-01

Cervical cancer is one of the leading causes of cancer deaths among women globally and its impact is mostly felt in developing countries like Uganda where its prevalence is higher and utilization of cancer screening services is low. This study aimed to identify factors associated with intention to screen for cervical cancer among women of reproductive age in Masaka Uganda using the attitude, social influence and self efficacy (ASE) model. A descriptive community based survey was conducted among 416 women. A semi-structured interviewer administered questionnaire was used to collect data. Unadjusted and adjusted prevalence ratios (PR) were computed using a generalized linear model with Poisson family and a log link using STATA 12. Only 7% (29/416) of our study respondents had ever screened for cervical cancer although a higher proportion (63%, 262/416) reported intention to screen for cervical cancer. The intention to screen for cervical cancer was higher among those who said they were at risk of developing cervical cancer (Adjusted prevalence ratio [PR] 2.0, 95% CI 1.60-2.58), those who said they would refer other women for screening (Adjusted PR 1.4, 95% CI 1.06-1.88) and higher among those who were unafraid of being diagnosed with cervical cancer (Adjusted PR 1.6, 95% CI 1.36-1.93). Those who reported discussions on cervical cancer with health care providers (Adjusted PR 1.2, 95% CI 1.05-1.44), those living with a sexual partner (Adjusted PR 1.4, 95% CI 1.11-1.68), and those who were formally employed (Adjusted PR 1.2, 95% CI 1.03-1.35) more frequently reported intention to screen for cervical cancer. In conclusion, health education to increase risk perception, improve women's attitudes towards screening for cervical cancer and address the fears held by the women would increase intention to screen for cervical cancer. Interventions should also target increased discussions with health workers.

Are classic predictors of voltage valid in cardiac amyloidosis? A contemporary analysis of electrocardiographic findings.

PubMed

Sperry, Brett W; Vranian, Michael N; Hachamovitch, Rory; Joshi, Hariom; McCarthy, Meghann; Ikram, Asad; Hanna, Mazen

2016-07-01

Low voltage electrocardiography (ECG) coupled with increased ventricular wall thickness is the hallmark of cardiac amyloidosis. However, patient characteristics influencing voltage in the general population, including bundle branch block, have not been evaluated in amyloid heart disease. A retrospective analysis was performed of patients with newly diagnosed cardiac amyloidosis from 2002 to 2014. ECG voltage was calculated using limb (sum of QRS complex in leads I, II and III) and precordial (Sokolow: S in V1 plus R in V5-V6) criteria. The associations between voltage and clinical variables were tested using multivariable linear regression. A Cox model assessed the association of voltage with mortality. In 389 subjects (transthyretin ATTR 186, light chain AL 203), 30% had conduction delay (QRS >120ms). In those with narrow QRS, 68% met low limb, 72% low Sokolow and 57% both criteria, with lower voltages found in AL vs ATTR. LV mass index as well as other typical factors that impact voltage (age, sex, race, hypertension, BSA, and smoking) in the general population were not associated with voltage in this cardiac amyloidosis cohort. Patients with LBBB and IVCD had similar voltages when compared to those with narrow QRS. Voltage was significantly associated with mortality (p<0.001 for both criteria) after multivariable adjustment. Classic predictors of ECG voltage in the general population are not valid in cardiac amyloidosis. In this cohort, the prevalence estimates of ventricular conduction delay and low voltage are higher than previously reported. Voltage predicts mortality after multivariable adjustment. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Road Traffic and Railway Noise Exposures and Adiposity in Adults: A Cross-Sectional Analysis of the Danish Diet, Cancer, and Health Cohort

PubMed Central

Christensen, Jeppe Schultz; Raaschou-Nielsen, Ole; Tjønneland, Anne; Overvad, Kim; Nordsborg, Rikke B.; Ketzel, Matthias; Sørensen, Thorkild IA; Sørensen, Mette

2015-01-01

Background Traffic noise has been associated with cardiovascular and metabolic disorders. Potential modes of action are through stress and sleep disturbance, which may lead to endocrine dysregulation and overweight. Objectives We aimed to investigate the relationship between residential traffic and railway noise and adiposity. Methods In this cross-sectional study of 57,053 middle-aged people, height, weight, waist circumference, and bioelectrical impedance were measured at enrollment (1993–1997). Body mass index (BMI), body fat mass index (BFMI), and lean body mass index (LBMI) were calculated. Residential exposure to road and railway traffic noise exposure was calculated using the Nordic prediction method. Associations between traffic noise and anthropometric measures at enrollment were analyzed using general linear models and logistic regression adjusted for demographic and lifestyle factors. Results Linear regression models adjusted for age, sex, and socioeconomic factors showed that 5-year mean road traffic noise exposure preceding enrollment was associated with a 0.35-cm wider waist circumference (95% CI: 0.21, 0.50) and a 0.18-point higher BMI (95% CI: 0.12, 0.23) per 10 dB. Small, significant increases were also found for BFMI and LBMI. All associations followed linear exposure–response relationships. Exposure to railway noise was not linearly associated with adiposity measures. However, exposure > 60 dB was associated with a 0.71-cm wider waist circumference (95% CI: 0.23, 1.19) and a 0.19-point higher BMI (95% CI: 0.0072, 0.37) compared with unexposed participants (0–20 dB). Conclusions The present study finds positive associations between residential exposure to road traffic and railway noise and adiposity. Citation Christensen JS, Raaschou-Nielsen O, Tjønneland A, Overvad K, Nordsborg RB, Ketzel M, Sørensen TI, Sørensen M. 2016. Road traffic and railway noise exposures and adiposity in adults: a cross-sectional analysis of the Danish Diet, Cancer, and Health cohort. Environ Health Perspect 124:329–335; http://dx.doi.org/10.1289/ehp.1409052 PMID:26241990

Academic well-being and smoking among 14- to 17-year-old schoolchildren in six European cities.

PubMed

Kinnunen, Jaana M; Lindfors, Pirjo; Rimpelä, Arja; Salmela-Aro, Katariina; Rathmann, Katharina; Perelman, Julian; Federico, Bruno; Richter, Matthias; Kunst, Anton E; Lorant, Vincent

2016-07-01

It is well established that poor academic performance is related to smoking, but the association between academic well-being and smoking is less known. We measured academic well-being by school burnout and schoolwork engagement and studied their associations with smoking among 14- to 17-year-old schoolchildren in Belgium, Germany, Finland, Italy, the Netherlands, and Portugal. A classroom survey (2013 SILNE survey, N = 11,015) was conducted using the Short School Burnout Inventory and the Schoolwork Engagement Inventory. Logistic regression, generalized linear mixed models, and ANOVA were used. Low schoolwork engagement and high school burnout increased the odds for daily smoking in all countries. Academic performance was correlated with school burnout and schoolwork engagement, and adjusting for it slightly decreased the odds for smoking. Adjusting for socioeconomic factors and school level had little effect. Although high school burnout and low schoolwork engagement correlate with low academic performance, they are mutually independent risk factors for smoking. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Serum Lipid Levels in Relation to Consumption of Yogurt: The 2012 Korea National Health and Nutrition Examination Survey

PubMed Central

Seo, Bong-Kyung; Kim, Nam-Eun; Park, Kyong-Min; Park, Kye-Yeung; Park, Hoon-Ki

2017-01-01

Background The purpose of this study was to evaluate serum lipid levels in Korean adults after consumption of different types of yogurt. Methods Study subjects were 3,038 individuals (≥19 years of age) who participated in the 2012 Korean National Health and Nutrition Examination Survey. Yogurt intake was assessed with a food frequency questionnaire by using the 24-hour recall method. We conducted complex samples general linear analysis with adjustment for covariates. Results The serum triglyceride levels in the group consuming viscous yogurt were lower than those in the group consuming non-viscous yogurt. Conclusion Consumption of viscous yogurt is associated with low serum triglyceride levels in Korean adults. PMID:29026484

Stratification for the propensity score compared with linear regression techniques to assess the effect of treatment or exposure.

PubMed

Senn, Stephen; Graf, Erika; Caputo, Angelika

2007-12-30

Stratifying and matching by the propensity score are increasingly popular approaches to deal with confounding in medical studies investigating effects of a treatment or exposure. A more traditional alternative technique is the direct adjustment for confounding in regression models. This paper discusses fundamental differences between the two approaches, with a focus on linear regression and propensity score stratification, and identifies points to be considered for an adequate comparison. The treatment estimators are examined for unbiasedness and efficiency. This is illustrated in an application to real data and supplemented by an investigation on properties of the estimators for a range of underlying linear models. We demonstrate that in specific circumstances the propensity score estimator is identical to the effect estimated from a full linear model, even if it is built on coarser covariate strata than the linear model. As a consequence the coarsening property of the propensity score-adjustment for a one-dimensional confounder instead of a high-dimensional covariate-may be viewed as a way to implement a pre-specified, richly parametrized linear model. We conclude that the propensity score estimator inherits the potential for overfitting and that care should be taken to restrict covariates to those relevant for outcome. Copyright (c) 2007 John Wiley & Sons, Ltd.

A Statistical Approach to Passive Target Tracking.

DTIC Science & Technology

1981-04-01

a fixed heading of 90 degrees. For 7F. A. Graybill , An Introduction to Linear Statistical Models , Vol. 1, New York: John Wiley&-Sons -Inc. (1961). 13...likelihood estimators. 12 NCSC TM 311-81 The adjustment for a changing error variance is easy using the linear model approach; i.e., use weighted

Assessment of bias correction under transient climate change

NASA Astrophysics Data System (ADS)

Van Schaeybroeck, Bert; Vannitsem, Stéphane

2015-04-01

Calibration of climate simulations is necessary since large systematic discrepancies are generally found between the model climate and the observed climate. Recent studies have cast doubt upon the common assumption of the bias being stationary when the climate changes. This led to the development of new methods, mostly based on linear sensitivity of the biases as a function of time or forcing (Kharin et al. 2012). However, recent studies uncovered more fundamental problems using both low-order systems (Vannitsem 2011) and climate models, showing that the biases may display complicated non-linear variations under climate change. This last analysis focused on biases derived from the equilibrium climate sensitivity, thereby ignoring the effect of the transient climate sensitivity. Based on the linear response theory, a general method of bias correction is therefore proposed that can be applied on any climate forcing scenario. The validity of the method is addressed using twin experiments with a climate model of intermediate complexity LOVECLIM (Goosse et al., 2010). We evaluate to what extent the bias change is sensitive to the structure (frequency) of the applied forcing (here greenhouse gases) and whether the linear response theory is valid for global and/or local variables. To answer these question we perform large-ensemble simulations using different 300-year scenarios of forced carbon-dioxide concentrations. Reality and simulations are assumed to differ by a model error emulated as a parametric error in the wind drag or in the radiative scheme. References [1] H. Goosse et al., 2010: Description of the Earth system model of intermediate complexity LOVECLIM version 1.2, Geosci. Model Dev., 3, 603-633. [2] S. Vannitsem, 2011: Bias correction and post-processing under climate change, Nonlin. Processes Geophys., 18, 911-924. [3] V.V. Kharin, G. J. Boer, W. J. Merryfield, J. F. Scinocca, and W.-S. Lee, 2012: Statistical adjustment of decadal predictions in a changing climate, Geophys. Res. Lett., 39, L19705.

Modelling leaf photosynthetic and transpiration temperature-dependent responses in Vitis vinifera cv. Semillon grapevines growing in hot, irrigated vineyard conditions

PubMed Central

Greer, Dennis H.

2012-01-01

Background and aims Grapevines growing in Australia are often exposed to very high temperatures and the question of how the gas exchange processes adjust to these conditions is not well understood. The aim was to develop a model of photosynthesis and transpiration in relation to temperature to quantify the impact of the growing conditions on vine performance. Methodology Leaf gas exchange was measured along the grapevine shoots in accordance with their growth and development over several growing seasons. Using a general linear statistical modelling approach, photosynthesis and transpiration were modelled against leaf temperature separated into bands and the model parameters and coefficients applied to independent datasets to validate the model. Principal results Photosynthesis, transpiration and stomatal conductance varied along the shoot, with early emerging leaves having the highest rates, but these declined as later emerging leaves increased their gas exchange capacities in accordance with development. The general linear modelling approach applied to these data revealed that photosynthesis at each temperature was additively dependent on stomatal conductance, internal CO2 concentration and photon flux density. The temperature-dependent coefficients for these parameters applied to other datasets gave a predicted rate of photosynthesis that was linearly related to the measured rates, with a 1 : 1 slope. Temperature-dependent transpiration was multiplicatively related to stomatal conductance and the leaf to air vapour pressure deficit and applying the coefficients also showed a highly linear relationship, with a 1 : 1 slope between measured and modelled rates, when applied to independent datasets. Conclusions The models developed for the grapevines were relatively simple but accounted for much of the seasonal variation in photosynthesis and transpiration. The goodness of fit in each case demonstrated that explicitly selecting leaf temperature as a model parameter, rather than including temperature intrinsically as is usually done in more complex models, was warranted. PMID:22567220

Sleep and body mass index in adolescence: results from a large population-based study of Norwegian adolescents aged 16 to 19 years

PubMed Central

2014-01-01

Background The aim of this study was to examine the association between body mass index (BMI) and sleep duration, insomnia and symptoms of obstructive sleep apnea (OSA) in adolescents. Methods Data were taken from a large population based study of 9,875 Norwegian adolescents aged 16–19. BMI was calculated from the self-reported body weight and categorized according to recommended age and gender specific cut offs for underweight, overweight and obesity. Detailed sleep parameters (sleep duration, insomnia, and OSA symptoms) were reported separately for weekdays and weekends. Data were analyzed using Pearson’s chi-squared test and ANOVAs for simple categorical and continuous comparisons, and multinomial logistic regressions for analyses adjusting for known confounders. Results There was evidence for a curvilinear relationship between BMI and both sleep duration and insomnia for girls, whereas the relationship was linear for boys. Compared to the average weekday sleep duration among adolescents in the normal weight range (6 hrs 29 min), both underweight (5 hrs 48 min), overweight (6 hrs 13 min) and obese (5 hrs 57 min) adolescents had shorter sleep duration. OSA symptoms were linearly associated with BMI. Controlling for demographical factors as well as physical activity did not attenuate the associations. Additional adjustment for depression reduced the association between insomnia and obesity to a non-significant level. The evidence for a link between both underweight and overweight/obesity, and short sleep duration and OSA symptoms remained in the fully adjusted analyses. The associations were generally stronger for girls. Conclusions This is one of the first population-based studies to investigate the relationship between sleep and BMI in adolescents while simultaneously controlling for important confounding factors. These findings require further research to investigate the temporal association between weights and sleep problems. PMID:25128481

Academic status does not affect outcome following complex hepato-pancreato-biliary procedures.

PubMed

Altieri, Maria S; Yang, Jie; Groves, Donald; Yin, Donglei; Cagino, Kristen; Talamini, Mark; Pryor, Aurora

2018-05-01

There is a growing debate regarding outcomes following complex hepato-pancreato-biliary (HPB) procedures. The purpose of our study is to examine if facility type has any impact on complications, readmission rates, emergency department (ED) visit rates, and length of stay (LOS) for patients undergoing HPB surgery. The SPARCS administrative database was used to identify patients undergoing complex HPB procedures between 2012 and 2014 in New York. Univariate generalized linear mixed models were fit to estimate the marginal association between outcomes such as overall/severe complication rates, 30-day and 1-year readmission rates, 30-day and 1-year ED-visit rates, and potential risk factors. Univariate linear mixed models were used to estimate the marginal association between possible risk factors and LOS. Facility type, as well as any variables found to be significant in our univariate analysis (p = 0.05), was further included in the multivariable regression models. There were 4122 complex HPB procedures performed. Academic facilities were more likely to have a higher hospital volume (p < 0001). Surgery at academic facilities were less likely to have coexisting comorbidities; however, they were more likely to have metastatic cancer and/or liver disease (p = 0.0114, < 0. 0001, and = 0.0299, respectively). Postoperatively, patients at non-academic facilities experienced higher overall complication rates, and higher severe complication rates, when compared to those at academic facilities (p < 0.0001 and = 0.0018, respectively). Further analysis via adjustment for possible confounding factors, however, revealed no significant difference in the risk of severe complications between the two facility types. Such adjustment also demonstrated higher 30-day readmission risk in patients who underwent their surgery at an academic facility. No significant difference was found when comparing the outcomes of academic and non-academic facilities, after adjusting for age, gender, race, region, insurance, and hospital volume. Patients from academic facilities were more likely to be readmitted within the first 30-days after surgery.

Egg consumption and risk of type 2 diabetes among African Americans: The Jackson Heart Study

PubMed Central

Djoussé, Luc; Petrone, Andrew B; Hickson, DeMarc A; Talegawkar, Sameera A.; Dubbert, Patricia M; Taylor, Herman; Tucker, Katherine L

2015-01-01

Background and Aims Type 2 diabetes (DM) disproportionally affects African Americans. Data on the association between egg consumption and risk of DM are sparse. We sought to examine whether egg consumption is associated with the prevalence and incidence of DM among African Americans. Methods We analyzed baseline data from 4,568 participants of the Jackson Heart Study. Egg consumption was obtained using a food frequency questionnaire designed for this population. We used generalized estimating equations to calculate adjusted prevalence ratios of DM and Cox regression to estimate hazard ratios of DM with corresponding 95% confidence intervals (CI). Results The average age was 55±13 years and 64% of subjects were women. The median frequency of egg consumption was 2/week for men and 1/week for women. The prevalence of DM was 22% overall (21% of men and 23% of women). Multivariable adjusted prevalence ratio [PR(95% CI)] for DM were: 1.00 (ref), 1.14 (0.90–1.44), 1.33 (1.04–1.70), 1.33 (1.06–1.68), 1.26 (0.99–1.61), and 1.52 (1.17–1.97) for egg consumption of <1/month, 1–3/month, 1/week, 2/week, 3–4/week, and 5+/week, respectively, p for linear trend 0.0024. Corresponding multivariable adjusted hazard ratios were 1.00 (ref), 0.88 (0.65–1.19), 0.94 (0.68–1.30), 0.91 (0.66–1.25), 1.11 (0.81–1.52), and 1.17 (0.81–1.70), respectively, during a mean follow up of 7.3 years (p for linear trend 0.22). Conclusions While egg consumption was positively associated with prevalent DM, prospective analysis did not show an association of egg intake with incidence of DM among African Americans. PMID:25971658

Optimizing the general linear model for functional near-infrared spectroscopy: an adaptive hemodynamic response function approach

PubMed Central

Uga, Minako; Dan, Ippeita; Sano, Toshifumi; Dan, Haruka; Watanabe, Eiju

2014-01-01

Abstract. An increasing number of functional near-infrared spectroscopy (fNIRS) studies utilize a general linear model (GLM) approach, which serves as a standard statistical method for functional magnetic resonance imaging (fMRI) data analysis. While fMRI solely measures the blood oxygen level dependent (BOLD) signal, fNIRS measures the changes of oxy-hemoglobin (oxy-Hb) and deoxy-hemoglobin (deoxy-Hb) signals at a temporal resolution severalfold higher. This suggests the necessity of adjusting the temporal parameters of a GLM for fNIRS signals. Thus, we devised a GLM-based method utilizing an adaptive hemodynamic response function (HRF). We sought the optimum temporal parameters to best explain the observed time series data during verbal fluency and naming tasks. The peak delay of the HRF was systematically changed to achieve the best-fit model for the observed oxy- and deoxy-Hb time series data. The optimized peak delay showed different values for each Hb signal and task. When the optimized peak delays were adopted, the deoxy-Hb data yielded comparable activations with similar statistical power and spatial patterns to oxy-Hb data. The adaptive HRF method could suitably explain the behaviors of both Hb parameters during tasks with the different cognitive loads during a time course, and thus would serve as an objective method to fully utilize the temporal structures of all fNIRS data. PMID:26157973

Sedentary Screen Time and Left Ventricular Structure and Function: the CARDIA Study

PubMed Central

Gibbs, Bethany Barone; Reis, Jared P.; Schelbert, Erik B.; Craft, Lynette L.; Sidney, Steve; Lima, Joao; Lewis, Cora E.

2013-01-01

Sedentary screen time (watching TV or using a computer) predicts cardiovascular outcomes independently from moderate and vigorous physical activity and could impact left ventricular structure and function through the adverse consequences of sedentary behavior. Purpose To determine whether sedentary screen time is associated with measures of left ventricular structure and function. Methods The Coronary Artery Risk Development in Young Adults (CARDIA) Study measured screen time by questionnaire and left ventricular structure and function by echocardiography in 2,854 black and white participants, aged 43–55 years, in 2010–2011. Generalized linear models evaluated cross-sectional trends for echocardiography measures across higher categories of screen time and adjusting for demographics, smoking, alcohol, and physical activity. Further models adjusted for potential intermediate factors (blood pressure, antihypertensive medication use, diabetes, and body mass index (BMI). Results The relationship between screen time and left ventricular mass(LVM) differed in blacks vs. whites. Among whites, higher screen time was associated with larger LVM (P<0.001), after adjustment for height, demographics, and lifestyle variables. Associations between screen time and LVM persisted when adjusting for blood pressure, antihypertensive medication use, and diabetes (P=0.008) but not with additional adjustment for BMI (P=0.503). Similar relationships were observed for screen time with LVM indexed to height2.7, relative wall thickness, and mass-to-volume ratio. Screen time was not associated with left ventricular structure among blacks or left ventricular function in either race group. Conclusions Sedentary screen time is associated with greater LVM in white adults and this relationship was largely explained by higher overall adiposity. The lack of association in blacks supports a potential qualitative difference in the cardiovascular consequences of sedentary screen-based behavior. PMID:23863618

Options For General Education To Limit Revenue Disparities. Report To Legislature: As Required By Minnesota Statutes 2003, Section 127A.51.

ERIC Educational Resources Information Center

Minnesota State Department of Education, 2004

2004-01-01

Minnesota Statutes 2003, Section 127A.51, reads as follows: Section 127A.51 Statewide average revenue. By October 1 of each year the commissioner must estimate the statewide average adjusted general revenue per adjusted marginal cost pupil unit and the disparity in adjusted general revenue among pupils and districts by computing the ratio of the…

Performance of new alternative providers of primary care services in England: an observational study

PubMed Central

Greaves, Felix; Laverty, Anthony A; Pape, Utz; Ratneswaren, Anenta; Majeed, Azeem

2015-01-01

Summary Objectives Health system reforms in England are opening broad areas of clinical practice to new providers of care. As part of these reforms, new entrants – including private companies – have been allowed into the primary care market under ‘alternative provider of medical services’ contracting mechanisms since 2004. The characteristics and performance of general practices working under new alternative provider contracts are not well described. We sought to compare the quality of care provided by new entrant providers to that provided by the traditional model of general practice. Design Open cohort study of English general practices. We used linear regression in cross-sectional and time series analyses, adjusting for practice and population characteristics, to compare quality in practices using alternative provider contracts to traditional practices. We created regression models using practice fixed effects to estimate the impact of practices changing to the new contract type. Setting The English National Health Service. Participants All general practices open from 2008/2009 to 2012/2013. Main outcome measures Seventeen established quality indicators – covering clinical effectiveness, efficiency, access and patient experience. Results In total, 4.1% (347 of 8300) of general practices in England were run by alternative contract providers. These practices tended to be smaller, and serve younger, more diverse and more deprived populations than traditional providers. Practices run by alternative providers performed worse than traditional providers on 15 of 17 indicators after adjusting for practice and population characteristics (p < 0.01 for all). Switching to a new alternative provider contract did not result in improved performance. Conclusions The introduction of new alternative providers to deliver primary care services in England has not led to improvements in quality and may have resulted in worse care. Regulators should ensure that new entrants to clinical provider markets are performing to adequate standards and at least as well as traditional providers. PMID:25908312

Performance of new alternative providers of primary care services in England: an observational study.

PubMed

Greaves, Felix; Laverty, Anthony A; Pape, Utz; Ratneswaren, Anenta; Majeed, Azeem; Millett, Christopher

2015-05-01

Health system reforms in England are opening broad areas of clinical practice to new providers of care. As part of these reforms, new entrants--including private companies--have been allowed into the primary care market under 'alternative provider of medical services' contracting mechanisms since 2004. The characteristics and performance of general practices working under new alternative provider contracts are not well described. We sought to compare the quality of care provided by new entrant providers to that provided by the traditional model of general practice. Open cohort study of English general practices. We used linear regression in cross-sectional and time series analyses, adjusting for practice and population characteristics, to compare quality in practices using alternative provider contracts to traditional practices. We created regression models using practice fixed effects to estimate the impact of practices changing to the new contract type. The English National Health Service. All general practices open from 2008/2009 to 2012/2013. Seventeen established quality indicators--covering clinical effectiveness, efficiency, access and patient experience. In total, 4.1% (347 of 8300) of general practices in England were run by alternative contract providers. These practices tended to be smaller, and serve younger, more diverse and more deprived populations than traditional providers. Practices run by alternative providers performed worse than traditional providers on 15 of 17 indicators after adjusting for practice and population characteristics (p < 0.01 for all). Switching to a new alternative provider contract did not result in improved performance. The introduction of new alternative providers to deliver primary care services in England has not led to improvements in quality and may have resulted in worse care. Regulators should ensure that new entrants to clinical provider markets are performing to adequate standards and at least as well as traditional providers. © The Royal Society of Medicine.

Labor Market Integration of People with Disabilities: Results from the Swiss Spinal Cord Injury Cohort Study

PubMed Central

Post, Marcel W. M.; Fekete, Christine; Trezzini, Bruno; Brinkhof, Martin W. G.

2016-01-01

Objectives We aimed to describe labor market participation (LMP) of persons with spinal cord injury (SCI) in Switzerland, to examine potential determinants of LMP, and to compare LMP between SCI and the general population. Methods We analyzed data from 1458 participants of employable age from the cross-sectional community survey of the Swiss Spinal Cord Injury Cohort Study. Data on LMP of the Swiss general population were obtained from the Swiss Federal Statistical Office. Factors associated with employment status as well as the amount of work performed in terms of full-time equivalent (FTE) were examined with regression techniques. Results 53.4% of the participants were employed at the time of the study. Adjusted odds of being employed were increased for males (OR = 1.73, 95% CI 1.33–2.25) and participants with paraplegia (OR = 1.78, 95% CI 1.40–2.27). The likelihood of being employed showed a significant concave relationship with age, peaking at age 40. The relation of LMP with education was s-shaped, while LMP was linearly related to time since injury. On average, employment rates were 30% lower than in the general population. Males with tetraplegia aged between 40 and 54 showed the greatest difference. From the 771 employed persons, the majority (81.7%) worked part-time with a median of 50% FTE (IRQ: 40%-80%). Men, those with younger age, higher education, incomplete lesions, and non-traumatic etiology showed significantly increased odds of working more hours per week. Significantly more people worked part-time than in the general population with the greatest difference found for males with tetraplegia aged between 40 and 54. Conclusions LMP of persons with SCI is comparatively high in Switzerland. LMP after SCI is, however, considerably lower than in the general population. Future research needs to show whether the reduced LMP in SCI reflects individual capacity adjustment, contextual constraints on higher LMP or both. PMID:27875566

Labor Market Integration of People with Disabilities: Results from the Swiss Spinal Cord Injury Cohort Study.

PubMed

Reinhardt, Jan D; Post, Marcel W M; Fekete, Christine; Trezzini, Bruno; Brinkhof, Martin W G

2016-01-01

We aimed to describe labor market participation (LMP) of persons with spinal cord injury (SCI) in Switzerland, to examine potential determinants of LMP, and to compare LMP between SCI and the general population. We analyzed data from 1458 participants of employable age from the cross-sectional community survey of the Swiss Spinal Cord Injury Cohort Study. Data on LMP of the Swiss general population were obtained from the Swiss Federal Statistical Office. Factors associated with employment status as well as the amount of work performed in terms of full-time equivalent (FTE) were examined with regression techniques. 53.4% of the participants were employed at the time of the study. Adjusted odds of being employed were increased for males (OR = 1.73, 95% CI 1.33-2.25) and participants with paraplegia (OR = 1.78, 95% CI 1.40-2.27). The likelihood of being employed showed a significant concave relationship with age, peaking at age 40. The relation of LMP with education was s-shaped, while LMP was linearly related to time since injury. On average, employment rates were 30% lower than in the general population. Males with tetraplegia aged between 40 and 54 showed the greatest difference. From the 771 employed persons, the majority (81.7%) worked part-time with a median of 50% FTE (IRQ: 40%-80%). Men, those with younger age, higher education, incomplete lesions, and non-traumatic etiology showed significantly increased odds of working more hours per week. Significantly more people worked part-time than in the general population with the greatest difference found for males with tetraplegia aged between 40 and 54. LMP of persons with SCI is comparatively high in Switzerland. LMP after SCI is, however, considerably lower than in the general population. Future research needs to show whether the reduced LMP in SCI reflects individual capacity adjustment, contextual constraints on higher LMP or both.

Use of bias correction techniques to improve seasonal forecasts for reservoirs - A case-study in northwestern Mediterranean.

PubMed

Marcos, Raül; Llasat, Ma Carmen; Quintana-Seguí, Pere; Turco, Marco

2018-01-01

In this paper, we have compared different bias correction methodologies to assess whether they could be advantageous for improving the performance of a seasonal prediction model for volume anomalies in the Boadella reservoir (northwestern Mediterranean). The bias correction adjustments have been applied on precipitation and temperature from the European Centre for Middle-range Weather Forecasting System 4 (S4). We have used three bias correction strategies: two linear (mean bias correction, BC, and linear regression, LR) and one non-linear (Model Output Statistics analogs, MOS-analog). The results have been compared with climatology and persistence. The volume-anomaly model is a previously computed Multiple Linear Regression that ingests precipitation, temperature and in-flow anomaly data to simulate monthly volume anomalies. The potential utility for end-users has been assessed using economic value curve areas. We have studied the S4 hindcast period 1981-2010 for each month of the year and up to seven months ahead considering an ensemble of 15 members. We have shown that the MOS-analog and LR bias corrections can improve the original S4. The application to volume anomalies points towards the possibility to introduce bias correction methods as a tool to improve water resource seasonal forecasts in an end-user context of climate services. Particularly, the MOS-analog approach gives generally better results than the other approaches in late autumn and early winter. Copyright © 2017 Elsevier B.V. All rights reserved.

Additivity of nonsimultaneous masking for short Gaussian-shaped sinusoids.

PubMed

Laback, Bernhard; Balazs, Peter; Necciari, Thibaud; Savel, Sophie; Ystad, Solvi; Meunier, Sabine; Kronland-Martinet, Richard

2011-02-01

The additivity of nonsimultaneous masking was studied using Gaussian-shaped tone pulses (referred to as Gaussians) as masker and target stimuli. Combinations of up to four temporally separated Gaussian maskers with an equivalent rectangular bandwidth of 600 Hz and an equivalent rectangular duration of 1.7 ms were tested. Each masker was level-adjusted to produce approximately 8 dB of masking. Excess masking (exceeding linear additivity) was generally stronger than reported in the literature for longer maskers and comparable target levels. A model incorporating a compressive input/output function, followed by a linear summation stage, underestimated excess masking when using an input/output function derived from literature data for longer maskers and comparable target levels. The data could be predicted with a more compressive input/output function. Stronger compression may be explained by assuming that the Gaussian stimuli were too short to evoke the medial olivocochlear reflex (MOCR), whereas for longer maskers tested previously the MOCR caused reduced compression. Overall, the interpretation of the data suggests strong basilar membrane compression for very short stimuli.

Observer-based distributed adaptive fault-tolerant containment control of multi-agent systems with general linear dynamics.

PubMed

Ye, Dan; Chen, Mengmeng; Li, Kui

2017-11-01

In this paper, we consider the distributed containment control problem of multi-agent systems with actuator bias faults based on observer method. The objective is to drive the followers into the convex hull spanned by the dynamic leaders, where the input is unknown but bounded. By constructing an observer to estimate the states and bias faults, an effective distributed adaptive fault-tolerant controller is developed. Different from the traditional method, an auxiliary controller gain is designed to deal with the unknown inputs and bias faults together. Moreover, the coupling gain can be adjusted online through the adaptive mechanism without using the global information. Furthermore, the proposed control protocol can guarantee that all the signals of the closed-loop systems are bounded and all the followers converge to the convex hull with bounded residual errors formed by the dynamic leaders. Finally, a decoupled linearized longitudinal motion model of the F-18 aircraft is used to demonstrate the effectiveness. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

Neuromotor outcomes in infants with bronchopulmonary dysplasia.

PubMed

Karagianni, Paraskevi; Tsakalidis, Christos; Kyriakidou, Maria; Mitsiakos, Georgios; Chatziioanidis, Helias; Porpodi, Maria; Evangeliou, Athanasios; Nikolaides, Nikolaos

2011-01-01

We examine the neuromotor outcomes of preterm infants with bronchopulmonary dysplasia. Two hundred and nineteen infants (gestational age, ≤ 32 weeks; birth weight, ≤ 1500 g) were studied. Neuromotor development was assessed using the Hammersmith Infant Neurological Examination. All potential risk factors associated with neuromotor scores (P < 0.015) were included in the generalized linear model (multiple linear regression) to determine if bronchopulmonary dysplasia had an independent relationship with neuromotor scores. Infants with severe bronchopulmonary dysplasia had lower global scores at ages 6 and 12 months. After adjustment for confounding factors, scores of infants with severe bronchopulmonary dysplasia were reduced by 13.2 units, whereas scores for those with periventricular leukomalacia were reduced by 11.1 units, at age 6 months. At age 12 months, scores for those with periventricular leukomalacia were reduced by 11.9 units. Duration of hospital stay reduced scores by 0.1 for each additional day increase in hospital. Bronchopulmonary dysplasia constitutes a major cause of poor neuromotor outcomes at age 6 months, but improvements in motor outcomes occur over time. Copyright © 2011 Elsevier Inc. All rights reserved.

[Influence of humidex on incidence of bacillary dysentery in Hefei: a time-series study].

PubMed

Zhang, H; Zhao, K F; He, R X; Zhao, D S; Xie, M Y; Wang, S S; Bai, L J; Cheng, Q; Zhang, Y W; Su, H

2017-11-10

Objective: To investigate the effect of humidex combined with mean temperature and relative humidity on the incidence of bacillary dysentery in Hefei. Methods: Daily counts of bacillary dysentery cases and weather data in Hefei were collected from January 1, 2006 to December 31, 2013. Then, the humidex was calculated from temperature and relative humidity. A Poisson generalized linear regression combined with distributed lag non-linear model was applied to analyze the relationship between humidex and the incidence of bacillary dysentery, after adjusting for long-term and seasonal trends, day of week and other weather confounders. Stratified analyses by gender, age and address were also conducted. Results: The risk of bacillary dysentery increased with the rise of humidex. The adverse effect of high humidex (90 percentile of humidex) appeared in 2-days lag and it was the largest at 4-days lag ( RR =1.063, 95 %CI : 1.037-1.090). Subgroup analyses indicated that all groups were affected by high humidex at lag 2-5 days. Conclusion: High humidex could significantly increase the risk of bacillary dysentery, and the lagged effects were observed.

Iterative usage of fixed and random effect models for powerful and efficient genome-wide association studies

USDA-ARS?s Scientific Manuscript database

False positives in a Genome-Wide Association Study (GWAS) can be effectively controlled by a fixed effect and random effect Mixed Linear Model (MLM) that incorporates population structure and kinship among individuals to adjust association tests on markers; however, the adjustment also compromises t...

Just Another Club? The Distinctiveness of the Relation between Religious Service Attendance and Adolescent Psychosocial Adjustment

ERIC Educational Resources Information Center

Good, Marie; Willoughby, Teena; Fritjers, Jan

2009-01-01

This study used hierarchical linear modeling to compare longitudinal patterns of adolescent religious service attendance and club attendance, and to contrast the longitudinal relations between adolescent adjustment and religious service versus club attendance. Participants included 1050 students (47% girls) encompassing a school district in…

The linear relationship between the Vulnerable Elders Survey-13 score and mortality in an Asian population of community-dwelling older persons.

PubMed

Wang, Jye; Lin, Wender; Chang, Ling-Hui

2018-01-01

The Vulnerable Elders Survey-13 (VES-13) has been used as a screening tool to identify vulnerable community-dwelling older persons for more in-depth assessment and targeted interventions. Although many studies supported its use in different populations, few have addressed Asian populations. The optimal scaling system for the VES-13 in predicting health outcomes also has not been adequately tested. This study (1) assesses the applicability of the VES-13 to predict the mortality of community-dwelling older persons in Taiwan, (2) identifies the best scaling system for the VES-13 in predicting mortality using generalized additive models (GAMs), and (3) determines whether including covariates, such as socio-demographic factors and common geriatric syndromes, improves model fitting. This retrospective longitudinal cohort study analyzed the data of 2184 community-dwelling persons 65 years old or older from the 2003 wave of the national-wide Taiwan Longitudinal Study on Aging. Cox proportional hazards models and Generalized Additive Models (GAMs) were used. The VES-13 significantly predicted the mortality of Taiwan's community-dwelling elders. A one-point increase in the VES-13 score raised the risk of death by 26% (hazard ratio, 1.26; 95% confidence interval, 1.21-1.32). The hazard ratio of death increased linearly with each additional VES-13 score point, suggesting that using a continuous scale is appropriate. Inclusion of socio-demographic factors and geriatric syndromes improved the model-fitting. The VES-13 is appropriate for an Asian population. VES-13 scores linearly predict the mortality of this population. Adjusting the weighting of the physical activity items may improve the performance of the VES-13. Copyright © 2017 Elsevier B.V. All rights reserved.

Photocathode device that replenishes photoemissive coating

DOE Office of Scientific and Technical Information (OSTI.GOV)

Moody, Nathan A.; Lizon, David C.

2016-06-14

A photocathode device may replenish its photoemissive coating to replace coating material that desorbs/evaporates during photoemission. A linear actuator system may regulate the release of a replenishment material vapor, such as an alkali metal, from a chamber inside the photocathode device to a porous cathode substrate. The replenishment material deposits on the inner surface of a porous membrane and effuses through the membrane to the outer surface, where it replenishes the photoemissive coating. The rate of replenishment of the photoemissive coating may be adjusted using the linear actuator system to regulate performance of the photocathode device during photoemission. Alternatively, themore » linear actuator system may adjust a plasma discharge gap between a cartridge containing replenishment material and a metal grid. A potential is applied between the cartridge and the grid, resulting in ejection of metal ions from the cartridge that similarly replenish the photoemissive coating.« less

Marital adjustment, marital discord over childrearing, and child behavior problems: moderating effects of child age.

PubMed

Mahoney, A; Jouriles, E N; Scavone, J

1997-12-01

Examined whether marital discord over childrearing contributes to child behavior problems after taking into account general marital adjustment, and if child age moderates associations between child behavior problems and either general marital adjustment or marital discord over childrearing. Participants were 146 two-parent families seeking services for their child's (4 to 9 years of age) conduct problems. Data on marital functioning and child behavior problems were collected from both parents. Mothers' and fathers' reports of marital discord over childrearing related positively to child externalizing problems after accounting for general marital adjustment. Child age moderated associations between fathers' reports of general marital adjustment and both internalizing and externalizing child problems, with associations being stronger in families with younger children. The discussion highlights the role that developmental factors may play in understanding the link between marital and child behavior problems in clinic-referred families.

Predicting oropharyngeal tumor volume throughout the course of radiation therapy from pretreatment computed tomography data using general linear models.

PubMed

Yock, Adam D; Rao, Arvind; Dong, Lei; Beadle, Beth M; Garden, Adam S; Kudchadker, Rajat J; Court, Laurence E

2014-05-01

The purpose of this work was to develop and evaluate the accuracy of several predictive models of variation in tumor volume throughout the course of radiation therapy. Nineteen patients with oropharyngeal cancers were imaged daily with CT-on-rails for image-guided alignment per an institutional protocol. The daily volumes of 35 tumors in these 19 patients were determined and used to generate (1) a linear model in which tumor volume changed at a constant rate, (2) a general linear model that utilized the power fit relationship between the daily and initial tumor volumes, and (3) a functional general linear model that identified and exploited the primary modes of variation between time series describing the changing tumor volumes. Primary and nodal tumor volumes were examined separately. The accuracy of these models in predicting daily tumor volumes were compared with those of static and linear reference models using leave-one-out cross-validation. In predicting the daily volume of primary tumors, the general linear model and the functional general linear model were more accurate than the static reference model by 9.9% (range: -11.6%-23.8%) and 14.6% (range: -7.3%-27.5%), respectively, and were more accurate than the linear reference model by 14.2% (range: -6.8%-40.3%) and 13.1% (range: -1.5%-52.5%), respectively. In predicting the daily volume of nodal tumors, only the 14.4% (range: -11.1%-20.5%) improvement in accuracy of the functional general linear model compared to the static reference model was statistically significant. A general linear model and a functional general linear model trained on data from a small population of patients can predict the primary tumor volume throughout the course of radiation therapy with greater accuracy than standard reference models. These more accurate models may increase the prognostic value of information about the tumor garnered from pretreatment computed tomography images and facilitate improved treatment management.

Alterations in theory of mind in patients with schizophrenia and non-psychotic relatives.

PubMed

Janssen, I; Krabbendam, L; Jolles, J; van Os, Jim

2003-08-01

It has been proposed that alterations in theory of mind underlie specific symptoms of psychosis. The present study examined whether alterations in theory of mind reflect a trait that can be detected in non-psychotic relatives of patients with schizophrenia. Participants were 43 patients with schizophrenia or schizoaffective disorder, 41 first-degree non-psychotic relatives and 43 controls from the general population. Theory of mind was assessed using a hinting task and a false-belief task. There was a significant association between schizophrenia risk and failure on the hinting task (OR linear trend = 2.01, 95% CI: 1.22-3.31), with relatives having intermediate values between patients and controls. Adjustment for IQ and neuropsychological factors reduced the association by small amounts. The association between schizophrenia risk and failure on the false-belief tasks was not significant. Changes in theory of mind are associated with schizophrenia liability. General cognitive ability and neuropsychological measures seem to mediate only part of this association.

The financial performance of rural hospitals and implications for elimination of the Critical Access Hospital program.

PubMed

Holmes, George M; Pink, George H; Friedman, Sarah A

2013-01-01

To compare the financial performance of rural hospitals with Medicare payment provisions to those paid under prospective payment and to estimate the financial consequences of elimination of the Critical Access Hospital (CAH) program. Financial data for 2004-2010 were collected from the Healthcare Cost Reporting Information System (HCRIS) for rural hospitals. HCRIS data were used to calculate measures of the profitability, liquidity, capital structure, and financial strength of rural hospitals. Linear mixed models accounted for the method of Medicare reimbursement, time trends, hospital, and market characteristics. Simulations were used to estimate profitability of CAHs if they reverted to prospective payment. CAHs generally had lower unadjusted financial performance than other types of rural hospitals, but after adjustment for hospital characteristics, CAHs had generally higher financial performance. Special payment provisions by Medicare to rural hospitals are important determinants of financial performance. In particular, the financial condition of CAHs would be worse if they were paid under prospective payment. © 2012 National Rural Health Association.

Attitudes Toward Nursing Students With Disabilities: Promoting Social Inclusion.

PubMed

Shpigelman, Carmit-Noa; Zlotnick, Cheryl; Brand, Rachel

2016-08-01

Nursing education programs rarely refer to individuals with disabilities as potential nursing students; more often, the assumption is that they are patients. Thus, this study aimed to capture nursing students' perspectives of social inclusion through examination of their attitudes toward nursing student colleagues with disabilities. Paper-and-pencil structured surveys containing two validated scales were collected from Israeli nursing students (N = 270). Analyses included measuring associations using Pearson's correlation coefficient and general linear regression models. Nursing students held relatively negative attitudes toward colleagues with disabilities, and these negative attitudes were correlated to attitudes toward people with disabilities in general, even after adjusting for noted confounders. Nurse educators and nursing students should be aware of prejudicial attitudes with their respective communities toward nursing student colleagues with disabilities, and they should work toward a better understanding that cultural competence and awareness extends not only to patients but also to one's colleagues. [J Nurs Educ. 2016;55(8):441-449.]. Copyright 2016, SLACK Incorporated.

Food Security Status is Related to Mental Health Quality of Life Among Persons Living with HIV.

PubMed

Hatsu, Irene; Hade, Erinn; Campa, Adriana

2017-03-01

This study evaluated the association between health related quality of life and food security among persons living with HIV (PLHIV). We studied 167 PLHIV who completed questionnaires assessing food security, disease symptomatology, and several domains of the SF-36 health related quality of life survey. HIV disease state was assessed from medical records. Associations between independent and outcome variables were determined through linear regression models. Compared to food security, very low food security was significantly associated with lower mental component summary scores, [average difference -4.98 (95 % CI -9.85, -0.10)]; mental health, [average difference -5.44 (95 % CI -10.08, -0.81)]; and general health, [average difference -5.13 (95 % CI -9.65, -0.65)] after adjusting for covariates. About a fourth of participants experienced severe food insecurity, which negatively influenced their mental health and general wellbeing. The inclusion of resources for food assistance in HIV treatment programs may help ameliorate mental health challenges faced by PLHIV.

21 CFR 880.5100 - AC-powered adjustable hospital bed.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false AC-powered adjustable hospital bed. 880.5100... (CONTINUED) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use Therapeutic Devices § 880.5100 AC-powered adjustable hospital bed. (a) Identification. An AC-powered...

21 CFR 880.5100 - AC-powered adjustable hospital bed.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false AC-powered adjustable hospital bed. 880.5100... (CONTINUED) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use Therapeutic Devices § 880.5100 AC-powered adjustable hospital bed. (a) Identification. An AC-powered...

21 CFR 880.5100 - AC-powered adjustable hospital bed.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false AC-powered adjustable hospital bed. 880.5100... (CONTINUED) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use Therapeutic Devices § 880.5100 AC-powered adjustable hospital bed. (a) Identification. An AC-powered...

21 CFR 880.5100 - AC-powered adjustable hospital bed.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false AC-powered adjustable hospital bed. 880.5100... (CONTINUED) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use Therapeutic Devices § 880.5100 AC-powered adjustable hospital bed. (a) Identification. An AC-powered...

Bounded Linear Stability Margin Analysis of Nonlinear Hybrid Adaptive Control

NASA Technical Reports Server (NTRS)

Nguyen, Nhan T.; Boskovic, Jovan D.

2008-01-01

This paper presents a bounded linear stability analysis for a hybrid adaptive control that blends both direct and indirect adaptive control. Stability and convergence of nonlinear adaptive control are analyzed using an approximate linear equivalent system. A stability margin analysis shows that a large adaptive gain can lead to a reduced phase margin. This method can enable metrics-driven adaptive control whereby the adaptive gain is adjusted to meet stability margin requirements.

Slapping and spanking in childhood and its association with lifetime prevalence of psychiatric disorders in a general population sample.

PubMed

MacMillan, H L; Boyle, M H; Wong, M Y; Duku, E K; Fleming, J E; Walsh, C A

1999-10-05

Little information is available in Canada about the prevalence of and outcomes associated with a history of slapping and spanking in childhood. The objectives of this study were to estimate the prevalence of a history of slapping or spanking in a general population sample and to assess the relation between such a history and the lifetime prevalence of psychiatric disorders. In this general population survey, a probability sample of 9953 residents of Ontario aged 15 years and older who participated in the Ontario Health Supplement was used to examine the prevalence of a history of slapping and spanking. A subgroup of this sample (n = 4888), which comprised people aged 15 to 64 years who did not report a history of physical or sexual abuse during childhood, was used to assess the relation between a history of slapping or spanking and the lifetime prevalence of 4 categories of psychiatric disorder. The measures included a self-administered questionnaire with a question about frequency of slapping and spanking during childhood, as well as an interviewer-administered questionnaire to measure psychiatric disorder. The majority of respondents indicated that they had been slapped or spanked, or both, by an adult during childhood "sometimes" (33.4%) or "rarely" (40.9%); 5.5% reported that this occurred "often." The remainder (20.2%) reported "never" experiencing these behaviours. Among the respondents without a history of physical or sexual abuse during childhood, those who reported being slapped or spanked "often" or "sometimes" had significantly higher lifetime rates of anxiety disorders (adjusted odds ratio [OR] 1.43, 95% confidence interval [CI] 1.04-1.96), alcohol abuse or dependence (adjusted OR 2.02, 95% CI 1.27-3.21) and one or more externalizing problems (adjusted OR 2.08, 95% CI 1.36-3.16), compared with those who reported "never" being slapped or spanked. There was also an association between a history of slapping or spanking and major depression, but it was not statistically significant (adjusted OR 1.64, 95% CI 0.96-2.80). There appears to be a linear association between the frequency of slapping and spanking during childhood and a lifetime prevalence of anxiety disorder, alcohol abuse or dependence and externalizing problems.

Slapping and spanking in childhood and its association with lifetime prevalence of psychiatric disorders in a general population sample

PubMed Central

MacMillan, H L; Boyle, M H; Wong, M Y; Duku, E K; Fleming, J E; Walsh, C A

1999-01-01

BACKGROUND: Little information is available in Canada about the prevalence of and outcomes associated with a history of slapping and spanking in childhood. The objectives of this study were to estimate the prevalence of a history of slapping or spanking in a general population sample and to assess the relation between such a history and the lifetime prevalence of psychiatric disorders. METHODS: In this general population survey, a probability sample of 9953 residents of Ontario aged 15 years and older who participated in the Ontario Health Supplement was used to examine the prevalence of a history of slapping and spanking. A subgroup of this sample (n = 4888), which comprised people aged 15 to 64 years who did not report a history of physical or sexual abuse during childhood, was used to assess the relation between a history of slapping or spanking and the lifetime prevalence of 4 categories of psychiatric disorder. The measures included a self-administered questionnaire with a question about frequency of slapping and spanking during childhood, as well as an interviewer-administered questionnaire to measure psychiatric disorder. RESULTS: The majority of respondents indicated that they had been slapped or spanked, or both, by an adult during childhood "sometimes" (33.4%) or "rarely" (40.9%); 5.5% reported that this occurred "often." The remainder (20.2%) reported "never" experiencing these behaviours. Among the respondents without a history of physical or sexual abuse during childhood, those who reported being slapped or spanked "often" or "sometimes" had significantly higher lifetime rates of anxiety disorders (adjusted odds ratio [OR] 1.43, 95% confidence interval [CI] 1.04-1.96), alcohol abuse or dependence (adjusted OR 2.02, 95% CI 1.27-3.21) and one or more externalizing problems (adjusted OR 2.08, 95% CI 1.36-3.16), compared with those who reported "never" being slapped or spanked. There was also an association between a history of slapping or spanking and major depression, but it was not statistically significant (adjusted OR 1.64, 95% CI 0.96-2.80). INTERPRETATION: There appears to be a linear association between the frequency of slapping and spanking during childhood and a lifetime prevalence of anxiety disorder, alcohol abuse or dependence and externalizing problems. PMID:10530296

Property-process relations in simulated clinical abrasive adjusting of dental ceramics.

PubMed

Yin, Ling

2012-12-01

This paper reports on property-process correlations in simulated clinical abrasive adjusting of a wide range of dental restorative ceramics using a dental handpiece and diamond burs. The seven materials studied included four mica-containing glass ceramics, a feldspathic porcelain, a glass-infiltrated alumina, and a yttria-stabilized tetragonal zirconia. The abrasive adjusting process was conducted under simulated clinical conditions using diamond burs and a clinical dental handpiece. An attempt was made to establish correlations between process characteristics in terms of removal rate, chipping damage, and surface finish and material mechanical properties of hardness, fracture toughness and Young's modulus. The results show that the removal rate is mainly a function of hardness, which decreases nonlinearly with hardness. No correlations were noted between the removal rates and the complex relations of hardness, Young's modulus and fracture toughness. Surface roughness was primarily a linear function of diamond grit size and was relatively independent of materials. Chipping damage in terms of the average chipping width decreased with fracture toughness except for glass-infiltrated alumina. It also had higher linear correlations with critical strain energy release rates (R²=0.66) and brittleness (R²=0.62) and a lower linear correlation with indices of brittleness (R²=0.32). Implications of these results can provide guidance for the microstructural design of dental ceramics, optimize performance, and guide the proper selection of technical parameters in clinical abrasive adjusting conducted by dental practitioners. Copyright © 2012 Elsevier Ltd. All rights reserved.

Quantum Chemically Estimated Abraham Solute Parameters Using Multiple Solvent-Water Partition Coefficients and Molecular Polarizability.

PubMed

Liang, Yuzhen; Xiong, Ruichang; Sandler, Stanley I; Di Toro, Dominic M

2017-09-05

Polyparameter Linear Free Energy Relationships (pp-LFERs), also called Linear Solvation Energy Relationships (LSERs), are used to predict many environmentally significant properties of chemicals. A method is presented for computing the necessary chemical parameters, the Abraham parameters (AP), used by many pp-LFERs. It employs quantum chemical calculations and uses only the chemical's molecular structure. The method computes the Abraham E parameter using density functional theory computed molecular polarizability and the Clausius-Mossotti equation relating the index refraction to the molecular polarizability, estimates the Abraham V as the COSMO calculated molecular volume, and computes the remaining AP S, A, and B jointly with a multiple linear regression using sixty-five solvent-water partition coefficients computed using the quantum mechanical COSMO-SAC solvation model. These solute parameters, referred to as Quantum Chemically estimated Abraham Parameters (QCAP), are further adjusted by fitting to experimentally based APs using QCAP parameters as the independent variables so that they are compatible with existing Abraham pp-LFERs. QCAP and adjusted QCAP for 1827 neutral chemicals are included. For 24 solvent-water systems including octanol-water, predicted log solvent-water partition coefficients using adjusted QCAP have the smallest root-mean-square errors (RMSEs, 0.314-0.602) compared to predictions made using APs estimated using the molecular fragment based method ABSOLV (0.45-0.716). For munition and munition-like compounds, adjusted QCAP has much lower RMSE (0.860) than does ABSOLV (4.45) which essentially fails for these compounds.

Item Purification in Differential Item Functioning Using Generalized Linear Mixed Models

ERIC Educational Resources Information Center

Liu, Qian

2011-01-01

For this dissertation, four item purification procedures were implemented onto the generalized linear mixed model for differential item functioning (DIF) analysis, and the performance of these item purification procedures was investigated through a series of simulations. Among the four procedures, forward and generalized linear mixed model (GLMM)…

Bone mineral density across a range of physical activity volumes: NHANES 2007-2010.

PubMed

Whitfield, Geoffrey P; Kohrt, Wendy M; Pettee Gabriel, Kelley K; Rahbar, Mohammad H; Kohl, Harold W

2015-02-01

The association between aerobic physical activity volume and bone mineral density (BMD) is not completely understood. The purpose of this study was to clarify the association between BMD and aerobic activity across a broad range of activity volumes, particularly volumes between those recommended in the 2008 Physical Activity Guidelines for Americans and those of trained endurance athletes. Data from the 2007-2010 National Health and Nutrition Examination Survey were used to quantify the association between reported physical activity and BMD at the lumbar spine and proximal femur across the entire range of activity volumes reported by US adults. Participants were categorized into multiples of the minimum guideline-recommended volume based on reported moderate- and vigorous-intensity leisure activity. Lumbar and proximal femur BMD were assessed with dual-energy x-ray absorptiometry. Among women, multivariable-adjusted linear regression analyses revealed no significant differences in lumbar BMD across activity categories, whereas proximal femur BMD was significantly higher among those who exceeded the guidelines by 2-4 times than those who reported no activity. Among men, multivariable-adjusted BMD at both sites neared its highest values among those who exceeded the guidelines by at least 4 times and was not progressively higher with additional activity. Logistic regression estimating the odds of low BMD generally echoed the linear regression results. The association between physical activity volume and BMD is complex. Among women, exceeding guidelines by 2-4 times may be important for maximizing BMD at the proximal femur, whereas among men, exceeding guidelines by ≥4 times may be beneficial for lumbar and proximal femur BMD.

7 CFR 1580.101 - General statement.

Code of Federal Regulations, 2010 CFR

2010-01-01

... OF AGRICULTURE TRADE ADJUSTMENT ASSISTANCE FOR FARMERS § 1580.101 General statement. This part provides regulations for the Trade Adjustment Assistance for Farmers program. Under these provisions...

An Analysis of COLA (Cost of Living Adjustment) Allocation within the United States Coast Guard.

DTIC Science & Technology

1983-09-01

books Applied Linear Regression [Ref. 39], and Statistical Methods in Research and Production [Ref. 40], or any other book on regression. In the event...Indexes, Master’s Thesis, Air Force Institute of Technology, Wright-Patterson AFB, 1976. 39. Weisberg, Stanford, Applied Linear Regression , Wiley, 1980. 40

Using Linear and Non-Linear Temporal Adjustments to Align Multiple Phenology Curves, Making Vegetation Status and Health Directly Comparable

NASA Astrophysics Data System (ADS)

Hargrove, W. W.; Norman, S. P.; Kumar, J.; Hoffman, F. M.

2017-12-01

National-scale polar analysis of MODIS NDVI allows quantification of degree of seasonality expressed by local vegetation, and also selects the most optimum start/end of a local "phenological year" that is empirically customized for the vegetation that is growing at each location. Interannual differences in timing of phenology make direct comparisons of vegetation health and performance between years difficult, whether at the same or different locations. By "sliding" the two phenologies in time using a Procrustean linear time shift, any particular phenological event or "completion milestone" can be synchronized, allowing direct comparison of differences in timing of other remaining milestones. Going beyond a simple linear translation, time can be "rubber-sheeted," compressed or dilated. Considering one phenology curve to be a reference, the second phenology can be "rubber-sheeted" to fit that baseline as well as possible by stretching or shrinking time to match multiple control points, which can be any recognizable phenological events. Similar to "rubber sheeting" to georectify a map inside a GIS, rubber sheeting a phenology curve also yields a warping signature that shows at every time and every location how many days the adjusted phenology is ahead or behind the phenological development of the reference vegetation. Using such temporal methods to "adjust" phenologies may help to quantify vegetation impacts from frost, drought, wildfire, insects and diseases by permitting the most commensurate quantitative comparisons with unaffected vegetation.

Humidity and Gravimetric Equivalency Adjustments for Nephelometer-Based Particulate Matter Measurements of Emissions from Solid Biomass Fuel Use in Cookstoves

PubMed Central

Soneja, Sutyajeet; Chen, Chen; Tielsch, James M.; Katz, Joanne; Zeger, Scott L.; Checkley, William; Curriero, Frank C.; Breysse, Patrick N.

2014-01-01

Great uncertainty exists around indoor biomass burning exposure-disease relationships due to lack of detailed exposure data in large health outcome studies. Passive nephelometers can be used to estimate high particulate matter (PM) concentrations during cooking in low resource environments. Since passive nephelometers do not have a collection filter they are not subject to sampler overload. Nephelometric concentration readings can be biased due to particle growth in high humid environments and differences in compositional and size dependent aerosol characteristics. This paper explores relative humidity (RH) and gravimetric equivalency adjustment approaches to be used for the pDR-1000 used to assess indoor PM concentrations for a cookstove intervention trial in Nepal. Three approaches to humidity adjustment performed equivalently (similar root mean squared error). For gravimetric conversion, the new linear regression equation with log-transformed variables performed better than the traditional linear equation. In addition, gravimetric conversion equations utilizing a spline or quadratic term were examined. We propose a humidity adjustment equation encompassing the entire RH range instead of adjusting for RH above an arbitrary 60% threshold. Furthermore, we propose new integrated RH and gravimetric conversion methods because they have one response variable (gravimetric PM2.5 concentration), do not contain an RH threshold, and is straightforward. PMID:24950062

Humidity and gravimetric equivalency adjustments for nephelometer-based particulate matter measurements of emissions from solid biomass fuel use in cookstoves.

PubMed

Soneja, Sutyajeet; Chen, Chen; Tielsch, James M; Katz, Joanne; Zeger, Scott L; Checkley, William; Curriero, Frank C; Breysse, Patrick N

2014-06-19

Great uncertainty exists around indoor biomass burning exposure-disease relationships due to lack of detailed exposure data in large health outcome studies. Passive nephelometers can be used to estimate high particulate matter (PM) concentrations during cooking in low resource environments. Since passive nephelometers do not have a collection filter they are not subject to sampler overload. Nephelometric concentration readings can be biased due to particle growth in high humid environments and differences in compositional and size dependent aerosol characteristics. This paper explores relative humidity (RH) and gravimetric equivalency adjustment approaches to be used for the pDR-1000 used to assess indoor PM concentrations for a cookstove intervention trial in Nepal. Three approaches to humidity adjustment performed equivalently (similar root mean squared error). For gravimetric conversion, the new linear regression equation with log-transformed variables performed better than the traditional linear equation. In addition, gravimetric conversion equations utilizing a spline or quadratic term were examined. We propose a humidity adjustment equation encompassing the entire RH range instead of adjusting for RH above an arbitrary 60% threshold. Furthermore, we propose new integrated RH and gravimetric conversion methods because they have one response variable (gravimetric PM2.5 concentration), do not contain an RH threshold, and is straightforward.

Dietary linolenic acid and fasting glucose and insulin: the National Heart, Lung, and Blood Institute Family Heart Study.

PubMed

Djoussé, Luc; Hunt, Steven C; Tang, Weihong; Eckfeldt, John H; Province, Michael A; Ellison, R Curtis

2006-02-01

To assess whether dietary linolenic acid is associated with fasting insulin and glucose. In a cross-sectional design, we studied 3993 non-diabetic participants of the National Heart, Lung, and Blood Institute Family Heart Study 25 to 93 years of age. Linolenic acid was assessed through a food frequency questionnaire, and laboratory data were obtained after at least a 12-hour fast. We used generalized linear models to calculate adjusted means of insulin and glucose across quartiles of dietary linolenic acid. From the lowest to the highest sex-specific quartile of dietary linolenic acid, means +/- standard error for logarithmic transformed fasting insulin were 4.06 +/- 0.02 (reference), 4.09 +/- 0.02, 4.13 +/- 0.02, and 4.17 +/- 0.02 pM, respectively (trend, p < 0.0001), after adjustment for age, sex, energy intake, waist-to-hip ratio, smoking, and high-density lipoprotein-cholesterol. When dietary linolenic acid was used as a continuous variable, the multivariable adjusted regression coefficient was 0.42 +/- 0.08. There was no association between dietary linolenic acid and fasting glucose (trend p = 0.82). Our data suggest that higher consumption of dietary linolenic acid is associated with higher plasma insulin, but not glucose levels, in non-diabetic subjects. Additional studies are needed to assess whether higher intake of linolenic acid results in an increased insulin secretion and improved glucose use in vivo.

Pregnancy in polymyositis or dermatomyositis: retrospective results from a tertiary centre in China.

PubMed

Zhong, Zhiqiang; Lin, Fuan; Yang, Jing; Zhang, Fengchun; Zeng, Xiaofeng; You, Xin

2017-08-01

To examine if patients with PM/DM are at higher risk of complicated pregnancies. In a retrospective cohort in a large tertiary centre in North China, the outcomes of 144 pregnancies were evaluated in 62 women with PM/DM. Generalized linear mixed effect models were fitted to assess the effect of pregnancy occurring after disease on pregnancy outcomes including preterm birth (PTB), abortion (spontaneous or induced) and normal delivery. Adjustment for confounding factors including parity, maternal age and pregnancy-disease interval were achieved with a multivariable model. For women who became pregnant after disease onset, there was significantly higher risk of either PTB or spontaneous abortion (adjusted odds ratio, OR = 9.36, 95% CI: 1.10, 79.88; P = 0.041). The odds increase was more prominent if PM/DM was also active during pregnancy (adjusted OR = 435.35, 95% CI: 5.32, 35628.18; P = 0.007). Disease flare upon conception was observed in 4 of 22 post-PM/DM pregnancies (P = 0.125), and responded well to steroids and IVIG but resulted in PTB or spontaneous abortion. PM/DM, especially those less well controlled, might contribute to an increased risk of complicated pregnancy. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Grandparental education, parental education and child height: evidence from Hong Kong's "Children of 1997" birth cohort.

PubMed

Kwok, Man Ki; Leung, Gabriel M; Lam, Tai Hing; Leung, Shirley S L; Schooling, C Mary

2013-08-01

Adult height is the sum of growth during fetal, infancy, childhood, and puberty, controlled by different biological factors. In long-term developed Western populations, height is positively associated with socioeconomic position, but less clearly so in recently developing populations. We aimed to elucidate socioeconomic influences on height at different growth phases. We examined the associations of parents' education and grandparents' education with birth weight and height gain z-scores during infancy (birth to <2 years), childhood (2 to <8 years), and puberty (8 to <14 years) adjusted for parents' height using generalized estimating equations in Hong Kong's "Children of 1997" birth cohort (n = 8264). Parents' education, but not grandparents', was positively associated with birth weight (z-score, 0.07; 95% confidence interval [CI] 0.01-0.12 for grade ≥12 compared with grade ≤9) and height gain during infancy (0.11; 95% CI, 0.05-0.18), adjusted for gender, gestational age, initial size, parity, parents' age, parents' birthplace, and parents' height. Conversely, similarly adjusted, grandparents' education, but not parents', was associated with height gain during childhood (0.11; 95% CI, 0.04-0.18). Parental education was associated with fetal and infant, but not childhood, linear growth, suggesting the mechanism underlying socioeconomic influences on height at different growth phases may be contextually specific. Copyright © 2013 Elsevier Inc. All rights reserved.

Bias-correction of PERSIANN-CDR Extreme Precipitation Estimates Over the United States

NASA Astrophysics Data System (ADS)

Faridzad, M.; Yang, T.; Hsu, K. L.; Sorooshian, S.

2017-12-01

Ground-based precipitation measurements can be sparse or even nonexistent over remote regions which make it difficult for extreme event analysis. PERSIANN-CDR (CDR), with 30+ years of daily rainfall information, provides an opportunity to study precipitation for regions where ground measurements are limited. In this study, the use of CDR annual extreme precipitation for frequency analysis of extreme events over limited/ungauged basins is explored. The adjustment of CDR is implemented in two steps: (1) Calculated CDR bias correction factor at limited gauge locations based on the linear regression analysis of gauge and CDR annual maxima precipitation; and (2) Extend the bias correction factor to the locations where gauges are not available. The correction factors are estimated at gauge sites over various catchments, elevation zones, and climate regions and the results were generalized to ungauged sites based on regional and climatic similarity. Case studies were conducted on 20 basins with diverse climate and altitudes in the Eastern and Western US. Cross-validation reveals that the bias correction factors estimated on limited calibration data can be extended to regions with similar characteristics. The adjusted CDR estimates also outperform gauge interpolation on validation sites consistently. It is suggested that the CDR with bias adjustment has a potential for study frequency analysis of extreme events, especially for regions with limited gauge observations.

Adjustment Issues Affecting Employment for Immigrants from the Former Soviet Union.

ERIC Educational Resources Information Center

Yost, Anastasia Dimun; Lucas, Margaretha S.

2002-01-01

Describes major issues, including culture shock and loss of status, that affect general adjustment of immigrants and refugees from the former Soviet Union who are resettling in the United States. Issues that affect career and employment adjustment are described and the interrelatedness of general and career issues is explored. (Contains 39…

5 CFR 530.307 - OPM review and adjustment of special rate schedules.

Code of Federal Regulations, 2010 CFR

2010-01-01

.... 5305(d), special rate schedule adjustments made by OPM have the force and effect of statute. (d)(1) For... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false OPM review and adjustment of special rate... REGULATIONS PAY RATES AND SYSTEMS (GENERAL) Special Rate Schedules for Recruitment and Retention General...

Physician wages across specialties: informing the physician reimbursement debate.

PubMed

Leigh, J Paul; Tancredi, Daniel; Jerant, Anthony; Kravitz, Richard L

2010-10-25

Disparities in remuneration between primary care and other physician specialties may impede health care reform by undermining the sustainability of a primary care workforce. Previous studies have compared annual incomes across specialties unadjusted for work hours. Wage (earnings-per-hour) comparisons could better inform the physician payment debate. In a cross-sectional analysis of data from 6381 physicians providing patient care in the 2004-2005 Community Tracking Study (adjusted response rate, 53%), we compared wages across broad and narrow categories of physician specialties. Tobit and linear regressions were run. Four broad specialty categories (primary care, surgery, internal medicine and pediatric subspecialties, and other) and 41 specific specialties were analyzed together with demographic, geographic, and market variables. In adjusted analyses on broad categories, wages for surgery, internal medicine and pediatric subspecialties, and other specialties were 48%, 36%, and 45% higher, respectively, than for primary care specialties. In adjusted analyses for 41 specific specialties, wages were significantly lower for the following than for the reference group of general surgery (wage near median, $85.98): internal medicine and pediatrics combined (-$24.36), internal medicine (-$24.27), family medicine (-$23.70), and other pediatric subspecialties (-$23.44). Wage rankings were largely impervious to adjustment for control variables, including age, race, sex, and region. Wages varied substantially across physician specialties and were lowest for primary care specialties. The primary care wage gap was likely conservative owing to exclusion of radiologists, anesthesiologists, and pathologists. In light of low and declining medical student interest in primary care, these findings suggest the need for payment reform aimed at increasing incomes or reducing work hours for primary care physicians.

Associations between frequency of bullying involvement and adjustment in adolescence.

PubMed

Gower, Amy L; Borowsky, Iris W

2013-01-01

To examine whether infrequent bullying perpetration and victimization (once or twice a month) are associated with elevated levels of internalizing and externalizing problems and to assess evidence for a minimum frequency threshold for bullying involvement. The analytic sample included 128,681 6th, 9th, and 12th graders who completed the 2010 Minnesota Student Survey. Logistic regression and general linear models examined the association between bullying frequency and adjustment correlates including emotional distress, self-harm, physical fighting, and substance use while controlling for demographic characteristics. Gender and grade were included as moderators. Infrequent bullying perpetration and victimization were associated with increased levels of all adjustment problems relative to those who did not engage in bullying in the past 30 days. Grade moderated many of these findings, with perpetration frequency being more strongly related to substance use, self-harm, and suicidal ideation for 6th graders than 12th graders, whereas victimization frequency was associated with self-harm more strongly for 12th graders than 6th graders. Evidence for minimum thresholds for bullying involvement across all outcomes, grades, and bullying roles was inconsistent. Infrequent bullying involvement may pose risks to adolescent adjustment; thus, clinicians and school personnel should address even isolated instances of bullying behavior. Researchers should reexamine the use of cut points in bullying research in order to more fully understand the nature of bullying in adolescence. These data indicate the need for prevention and intervention programs that target diverse internalizing and externalizing problems for bullies and victims, regardless of bullying frequency. Copyright © 2013 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

42 CFR § 484.325 - Payments for home health services under Home Health Value-Based Purchasing (HHVBP) Model.

Code of Federal Regulations, 2010 CFR

2017-10-01

... Purchasing (HHVBP) Model. CMS will determine a payment adjustment up to the maximum applicable percentage... Total Performance Score using a linear exchange function. Payment adjustments made under the HHVBP Model... 42 Public Health 5 2017-10-01 2017-10-01 false Payments for home health services under Home Health...

42 CFR § 484.325 - Payments for home health services under Home Health Value-Based Purchasing (HHVBP) Model.

Code of Federal Regulations, 2010 CFR

2016-10-01

... Purchasing (HHVBP) Model. CMS will determine a payment adjustment up to the maximum applicable percentage... Total Performance Score using a linear exchange function. Payment adjustments made under the HHVBP Model... 42 Public Health 5 2016-10-01 2016-10-01 false Payments for home health services under Home Health...

Smoothed Residual Plots for Generalized Linear Models. Technical Report #450.

ERIC Educational Resources Information Center

Brant, Rollin

Methods for examining the viability of assumptions underlying generalized linear models are considered. By appealing to the likelihood, a natural generalization of the raw residual plot for normal theory models is derived and is applied to investigating potential misspecification of the linear predictor. A smooth version of the plot is also…

A Comparison of Variable Selection Criteria for Multiple Linear Regression: A Second Simulation Study

DTIC Science & Technology

1993-03-01

statistical mathe- matics, began in the late 1800’s when Sir Francis Galton first attempted to use practical mathematical techniques to investigate the...randomly collected (sampled) many pairs of parent/child height mea- surements (data), Galton observed that for a given parent- height average, the...ty only Maximum Adjusted R2 will be discussed. However, Maximum Adjusted R’ and Minimum MSE test exactly the same 2.thing. Adjusted R is related to R

Adjustment Disorders as a Stress-Related Disorder: A Longitudinal Study of the Associations among Stress, Resources, and Mental Health

PubMed Central

Kocalevent, Rüya-Daniela; Mierke, Annett; Danzer, Gerhard; Klapp, Burghard F.

2014-01-01

Objective Adjustment disorders are re-conceptualized in the DSM-5 as a stress-related disorder; however, besides the impact of an identifiable stressor, the specification of a stress concept, remains unclear. This study is the first to examine an existing stress-model from the general population, in patients diagnosed with adjustment disorders, using a longitudinal design. Methods The study sample consisted of 108 patients consecutively admitted for adjustment disorders. Associations of stress perception, emotional distress, resources, and mental health were measured at three time points: the outpatients’ presentation, admission for inpatient treatment, and discharge from the hospital. To evaluate a longitudinal stress model of ADs, we examined whether stress at admission predicted mental health at each of the three time points using multiple linear regressions and structural equation modeling. A series of repeated-measures one-way analyses of variance (rANOVAs) was performed to assess change over time. Results Significant within-participant changes from baseline were observed between hospital admission and discharge with regard to mental health, stress perception, and emotional distress (p<0.001). Stress perception explained nearly half of the total variance (44%) of mental health at baseline; the adjusted R2 increased (0.48), taking emotional distress (i.e., depressive symptoms) into account. The best predictor of mental health at discharge was the level of emotional distress (i.e., anxiety level) at baseline (β = −0.23, R2 corr = 0.56, p<0.001). With a CFI of 0.86 and an NFI of 0.86, the fit indices did not allow for acceptance of the stress-model (Cmin/df = 15.26; RMSEA = 0.21). Conclusions Stress perception is an important predictor in adjustment disorders, and mental health-related treatment goals are dependent on and significantly impacted by stress perception and emotional distress. PMID:24825165

Forest litter crickets prefer higher substrate moisture for oviposition: Evidence from field and lab experiments

PubMed Central

Sperber, Carlos Frankl; Albeny-Simões, Daniel; Breaux, Jennifer Ann; Fianco, Marcos; Szinwelski, Neucir

2017-01-01

For insects, choosing a favorable oviposition site is a type of parental care, as far as it increases the fitness of its offspring. Niche theory predicts that crickets should show a bell-shaped oviposition response to substrate moisture. However, lab experiments with mole crickets showed a linear oviposition response to substrate moisture. Studies with the house cricket Acheta domesticus also showed a linear juvenile body growth response to water availability, thus adult ovipositing females should respond positively to substrate moisture. We used a field experiment to evaluate the relationship between oviposition preference and substrate moisture in forest litter-dwelling cricket species. We also evaluated oviposition responses to substrate moisture level in Ubiquepuella telytokous, the most abundant litter cricket species in our study area, using a laboratory study. We offered cotton substrate for oviposition which varied in substrate moisture level from zero (i.e., dry) to maximum water absorption capacity. We used two complementary metrics to evaluate oviposition preference: (i) presence or absence of eggs in each sampling unit as binary response variable, and (ii) number of eggs oviposited per sampling unit as count response variable. To test for non-linear responses, we adjusted generalized additive models (GAMM) with mixed effects. We found that both cricket oviposition probability and effort (i.e., number of eggs laid) increased linearly with substrate moisture in the field experiment, and for U. telytokous in the lab experiment. We discarded any non-linear responses. Our results demonstrate the importance of substrate moisture as an ecological niche dimension for litter crickets. This work bolsters knowledge of litter cricket life history association with moisture, and suggests that litter crickets may be particularly threatened by changes in climate that favor habitat drying. PMID:28977023

Forest litter crickets prefer higher substrate moisture for oviposition: Evidence from field and lab experiments.

PubMed

de Farias-Martins, Fernando; Sperber, Carlos Frankl; Albeny-Simões, Daniel; Breaux, Jennifer Ann; Fianco, Marcos; Szinwelski, Neucir

2017-01-01

For insects, choosing a favorable oviposition site is a type of parental care, as far as it increases the fitness of its offspring. Niche theory predicts that crickets should show a bell-shaped oviposition response to substrate moisture. However, lab experiments with mole crickets showed a linear oviposition response to substrate moisture. Studies with the house cricket Acheta domesticus also showed a linear juvenile body growth response to water availability, thus adult ovipositing females should respond positively to substrate moisture. We used a field experiment to evaluate the relationship between oviposition preference and substrate moisture in forest litter-dwelling cricket species. We also evaluated oviposition responses to substrate moisture level in Ubiquepuella telytokous, the most abundant litter cricket species in our study area, using a laboratory study. We offered cotton substrate for oviposition which varied in substrate moisture level from zero (i.e., dry) to maximum water absorption capacity. We used two complementary metrics to evaluate oviposition preference: (i) presence or absence of eggs in each sampling unit as binary response variable, and (ii) number of eggs oviposited per sampling unit as count response variable. To test for non-linear responses, we adjusted generalized additive models (GAMM) with mixed effects. We found that both cricket oviposition probability and effort (i.e., number of eggs laid) increased linearly with substrate moisture in the field experiment, and for U. telytokous in the lab experiment. We discarded any non-linear responses. Our results demonstrate the importance of substrate moisture as an ecological niche dimension for litter crickets. This work bolsters knowledge of litter cricket life history association with moisture, and suggests that litter crickets may be particularly threatened by changes in climate that favor habitat drying.

Absolute and relative educational inequalities in obesity among adults in Tehran: Findings from the Urban HEART study-2.

PubMed

Kiadaliri, Aliasghar A; Asadi-Lari, Mohsen; Kalantari, Naser; Jafari, Mehdi; Vaez Mahdavi, Mohammad Reza; Faghihzadeh, Soghrat

2016-09-01

The prevalence of obesity is increasing in Iran. Previous studies showed mixed results in relation to association between socioeconomic status and obesity in the country. The current study aimed to examine educational inequalities among adults in Tehran in 2011. Data on 90,435 persons 18 years and older from Urban Health Equity Assessment and Response Tool (Urban HEART-2) were analyzed. The Slope Index of Inequality (SII) and the Relative Index of Inequality (RII) were used for assessing educational inequalities in obesity. These measures were quantified using generalized linear models for the binomial family adjusted for sex and age. Subgroup analysis was conducted across sex, age groups and the 22 districts of Tehran. Both SII and RII showed substantial educational inequalities in obesity in favour of more educated adults [RII and SII (95% CI were equal to 2.91 (2.71-3.11) and 0.12 (0.12-0.13)), respectively]. These educational inequalities were persistent even after adjusting for employment, marital status and smoking. Subgroup analysis revealed that educational inequalities were more profound among women. While among men educational inequalities were generally increasing with age, an inverse trend was observed among women. Educational inequalities were observed within all 22 districts of Tehran and generally there were no statistically significant differences between districts. An inverse association between education and obesity was observed in the current study. To decrease educational inequalities in Tehran, priority should be given to younger women and older men. Further analyses are needed to explain these inequalities. Copyright © 2015 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

Assessing and adjusting for differences between HIV prevalence estimates derived from national population-based surveys and antenatal care surveillance, with applications for Spectrum 2013

PubMed Central

Marsh, Kimberly; Mahy, Mary; Salomon, Joshua A.; Hogan, Daniel R.

2014-01-01

Objective(s): To assess differences between HIV prevalence estimates derived from national population surveys and antenatal care (ANC) surveillance sites and to improve the calibration of ANC-derived estimates in Spectrum 2013 to more appropriately account for differences between these data. Design: Retrospective analysis of national population survey and ANC surveillance data from 25 countries with generalized epidemics in sub-Saharan Africa and 8 countries with concentrated epidemics. Methods: Adult national population survey and ANC surveillance HIV prevalence estimates were compared for all available national population survey data points for the years 1999–2012. For sub-Saharan Africa, a mixed-effects linear regression model determined whether the relationship between national population and ANC estimates was constant across surveys. A new calibration method was developed to incorporate national population survey data directly into the likelihood for HIV prevalence in countries with generalized epidemics. Results were used to develop default rules for adjusting ANC data for countries with no national population surveys. Results: ANC surveillance data typically overestimate population prevalence, although a wide variation, particularly in rural areas, is observed across countries and survey years. The new calibration method yields similar point estimates to previous approaches, but leads to an average 44% increase in the width of 95% uncertainty intervals. Conclusion: Important biases remain in ANC surveillance data for HIV prevalence. The new approach to model-fitting in Spectrum 2013 more appropriately accounts for this bias when producing national estimates in countries with generalized epidemics. In countries with concentrated epidemics, local sex ratios should be used to calibrate ANC surveillance estimates. PMID:25203158

28 CFR 85.1 - In general.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false In general. 85.1 Section 85.1 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) CIVIL MONETARY PENALTIES INFLATION ADJUSTMENT § 85.1 In general. (a) In accordance with the requirements of the Federal Civil Penalties Inflation Adjustment Act of...

A method for the selection of a functional form for a thermodynamic equation of state using weighted linear least squares stepwise regression

NASA Technical Reports Server (NTRS)

Jacobsen, R. T.; Stewart, R. B.; Crain, R. W., Jr.; Rose, G. L.; Myers, A. F.

1976-01-01

A method was developed for establishing a rational choice of the terms to be included in an equation of state with a large number of adjustable coefficients. The methods presented were developed for use in the determination of an equation of state for oxygen and nitrogen. However, a general application of the methods is possible in studies involving the determination of an optimum polynomial equation for fitting a large number of data points. The data considered in the least squares problem are experimental thermodynamic pressure-density-temperature data. Attention is given to a description of stepwise multiple regression and the use of stepwise regression in the determination of an equation of state for oxygen and nitrogen.

Analysis of observed surface ozone in the dry season over Eastern Thailand during 1997-2012

NASA Astrophysics Data System (ADS)

Assareh, Nosha; Prabamroong, Thayukorn; Manomaiphiboon, Kasemsan; Theramongkol, Phunsak; Leungsakul, Sirakarn; Mitrjit, Nawarat; Rachiwong, Jintarat

2016-09-01

This study analyzed observed surface ozone (O3) in the dry season over a long-term period of 1997-2012 for the eastern region of Thailand and incorporated several technical tools or methods in investigating different aspects of O3. The focus was the urbanized and industrialized coastal areas recently recognized as most O3-polluted areas. It was found that O3 is intensified most in the dry-season months when meteorological conditions are favorable to O3 development. The diurnal variations of O3 and its precursors show the general patterns of urban background. From observational O3 isopleth diagrams and morning ratios of non-methane volatile organic compounds (NMVOC) and nitrogen oxides (NOx), the chemical regime of O3 formation was identified as VOC-sensitive, and the degree of VOC sensitivity tends to increase over the years, suggesting emission control on VOC to be suitable for O3 management. Both total oxidant analysis and back-trajectory modeling (together with K-means clustering) indicate the potential role of regional transport or influence in enhancing surface O3 level over the study areas. A meteorological adjustment with generalized linear modeling was performed to statistically exclude meteorological effects on the variability of O3. Local air-mass recirculation factor was included in the modeling to support the coastal application. The derived trends in O3 based on the meteorological adjustment were found to be significantly positive using a Mann-Kendall test with block bootstrapping.

HbA1c is significantly associated with arterial stiffness but not with carotid atherosclerosis in a community-based population without type 2 diabetes: The Dong-gu study.

PubMed

Lee, Young-Hoon; Shin, Min-Ho; Choi, Jin-Su; Rhee, Jung-Ae; Nam, Hae-Sung; Jeong, Seul-Ki; Park, Kyeong-Soo; Ryu, So-Yeon; Choi, Seong-Woo; Kim, Bok-Hee; Oh, Gyung-Jae; Kweon, Sun-Seog

2016-04-01

We examined the associations between HbA1c levels and various atherosclerotic vascular parameters among adults without diabetes from the general population. A total of 6500 community-dwelling adults, who were free of type 2 diabetes and ≥50 years of age, were included. High-resolution B-mode ultrasound was used to evaluate carotid artery structure, including intima-media thickness (IMT), plaque, and luminal diameter. Brachial-ankle pulse wave velocity (baPWV), which is a useful indicator of systemic arterial stiffness, was determined using an automatic waveform analysis device. No significant associations were observed between HbA1c, carotid IMT, plaque, or luminal diameter in a fully adjusted model. However, the odds ratio (95% confidence interval) for high baPWV (defined as the highest quartile) increased by 1.43 (1.19-1.71) per 1% HbA1c increase after adjusting for conventional risk factors in a multivariate logistic regression analysis. In addition, HbA1c was independently associated with baPWV in a multivariate linear regression analysis. High-normal HbA1c level was independently associated with arterial stiffness, but not with carotid atherosclerotic parameters, in the general population without diabetes. Our results suggest that the functional atherosclerotic process may already be accelerated according to HbA1c level, even at a level below the diagnostic threshold for diabetes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Walking for Transportation or Leisure Among U.S. Women and Men - National Health Interview Survey, 2005-2015.

PubMed

Ussery, Emily N; Carlson, Susan A; Whitfield, Geoffrey P; Watson, Kathleen B; Berrigan, David; Fulton, Janet E

2017-06-30

Physical activity confers considerable health benefits, but only half of U.S. adults report participating in levels of aerobic physical activity consistent with guidelines (1,2). Step It Up! The Surgeon General's Call to Action to Promote Walking and Walkable Communities identified walking as an important public health strategy to increase physical activity levels (3). A previous report showed that the self-reported prevalence of walking for transportation or leisure increased by 6 percentage points from 2005 to 2010 (4), but it is unknown whether this increase has been sustained. CDC analyzed National Health Interview Survey (NHIS) data from 2005 (26,551 respondents), 2010 (23,313), and 2015 (28,877) to evaluate trends in the age-adjusted prevalence of self-reported walking among adults aged ≥18 years. The prevalence of walking increased steadily among women, from 57.3% in 2005, to 62.5% in 2010, and to 65.1% in 2015 (significant linear trend). Among men, a significant linear increase in reported walking was observed, from 54.3% in 2005, to 61.8% in 2010, and to 62.8% in 2015, although the increase stalled between 2010 and 2015 (significant linear and quadratic trends). Community design policies and practices that encourage pedestrian activity and programs tailored to the needs of specific population subgroups remain important strategies for promoting walking (3).

Elastic metamaterial beam with remotely tunable stiffness

NASA Astrophysics Data System (ADS)

Qian, Wei; Yu, Zhengyue; Wang, Xiaole; Lai, Yun; Yellen, Benjamin B.

2016-02-01

We demonstrate a dynamically tunable elastic metamaterial, which employs remote magnetic force to adjust its vibration absorption properties. The 1D metamaterial is constructed from a flat aluminum beam milled with a linear array of cylindrical holes. The beam is backed by a thin elastic membrane, on which thin disk-shaped permanent magnets are mounted. When excited by a shaker, the beam motion is tracked by a Laser Doppler Vibrometer, which conducts point by point scanning of the vibrating element. Elastic waves are unable to propagate through the beam when the driving frequency excites the first elastic bending mode in the unit cell. At these frequencies, the effective mass density of the unit cell becomes negative, which induces an exponentially decaying evanescent wave. Due to the non-linear elastic properties of the membrane, the effective stiffness of the unit cell can be tuned with an external magnetic force from nearby solenoids. Measurements of the linear and cubic static stiffness terms of the membrane are in excellent agreement with experimental measurements of the bandgap shift as a function of the applied force. In this implementation, bandgap shifts by as much as 40% can be achieved with ˜30 mN of applied magnetic force. This structure has potential for extension in 2D and 3D, providing a general approach for building dynamically tunable elastic metamaterials for applications in lensing and guiding elastic waves.

A robust fingerprint matching algorithm based on compatibility of star structures

NASA Astrophysics Data System (ADS)

Cao, Jia; Feng, Jufu

2009-10-01

In fingerprint verification or identification systems, most minutiae-based matching algorithms suffered from the problems of non-linear distortion and missing or faking minutiae. Local structures such as triangle or k-nearest structure are widely used to reduce the impact of non-linear distortion, but are suffered from missing and faking minutiae. In our proposed method, star structure is used to present local structure. A star structure contains various number of minutiae, thus, it is more robust with missing and faking minutiae. Our method consists of four steps: 1) Constructing star structures at minutia level; 2) Computing similarity score for each structure pair, and eliminating impostor matched pairs which have the low scores. As it is generally assumed that there is only linear distortion in local area, the similarity is defined by rotation and shifting. 3) Voting for remained matched pairs according to the compatibility between them, and eliminating impostor matched pairs which gain few votes. The concept of compatibility is first introduced by Yansong Feng [4], the original definition is only based on triangles. We define the compatibility for star structures to adjust to our proposed algorithm. 4) Computing the matching score, based on the number of matched structures and their voting scores. The score also reflects the fact that, it should get higher score if minutiae match in more intensive areas. Experiments evaluated on FVC 2004 show both effectiveness and efficiency of our methods.

Linearly Adjustable International Portfolios

NASA Astrophysics Data System (ADS)

Fonseca, R. J.; Kuhn, D.; Rustem, B.

2010-09-01

We present an approach to multi-stage international portfolio optimization based on the imposition of a linear structure on the recourse decisions. Multiperiod decision problems are traditionally formulated as stochastic programs. Scenario tree based solutions however can become intractable as the number of stages increases. By restricting the space of decision policies to linear rules, we obtain a conservative tractable approximation to the original problem. Local asset prices and foreign exchange rates are modelled separately, which allows for a direct measure of their impact on the final portfolio value.

Examining the Error of Mis-Specifying Nonlinear Confounding Effect with Application on Accelerometer-Measured Physical Activity

ERIC Educational Resources Information Center

Lee, Paul H.

2017-01-01

Purpose: Some confounders are nonlinearly associated with dependent variables, but they are often adjusted using a linear term. The purpose of this study was to examine the error of mis-specifying the nonlinear confounding effect. Methods: We carried out a simulation study to investigate the effect of adjusting for a nonlinear confounder in the…

The brain adjusts grip forces differently according to gravity and inertia: a parabolic flight experiment

PubMed Central

White, Olivier

2015-01-01

In everyday life, one of the most frequent activities involves accelerating and decelerating an object held in precision grip. In many contexts, humans scale and synchronize their grip force (GF), normal to the finger/object contact, in anticipation of the expected tangential load force (LF), resulting from the combination of the gravitational and the inertial forces. In many contexts, GF and LF are linearly coupled. A few studies have examined how we adjust the parameters–gain and offset–of this linear relationship. However, the question remains open as to how the brain adjusts GF regardless of whether LF is generated by different combinations of weight and inertia. Here, we designed conditions to generate equivalent magnitudes of LF by independently varying mass and movement frequency. In a control experiment, we directly manipulated gravity in parabolic flights, while other factors remained constant. We show with a simple computational approach that, to adjust GF, the brain is sensitive to how LFs are produced at the fingertips. This provides clear evidence that the analysis of the origin of LF is performed centrally, and not only at the periphery. PMID:25717293

Assessing oral health-related quality of life in general dental practice in Scotland: validation of the OHIP-14.

PubMed

Fernandes, Marcelo José; Ruta, Danny Adolph; Ogden, Graham Richard; Pitts, Nigel Berry; Ogston, Simon Alexander

2006-02-01

To validate the Oral Health Impact Profile (OHIP)-14 in a sample of patients attending general dental practice. Patients with pathology-free impacted wisdom teeth were recruited from six general dental practices in Tayside, Scotland, and followed for a year to assess the development of problems related to impaction. The OHIP-14 was completed at baseline and at 1-year follow-up, and analysed using three different scoring methods: a summary score, a weighted and standardized score and the total number of problems reported. Instrument reliability was measured by assessing internal consistency and test-retest reliability. Construct validity was assessed using a number of variables. Linear regression was then used to model the relationship between OHIP-14 and all significantly correlated variables. Responsiveness was measured using the standardized response mean (SRM). Adjusted R(2)s and SRMs were calculated for each of the three scoring methods. Estimates for the differences between adjusted R(2)s and the differences between SRMs were obtained with 95% confidence intervals. A total of 278 and 169 patients completed the questionnaire at baseline and follow-up, respectively. Reliability - Cronbach's alpha coefficients ranged from 0.30 to 0.75. Alpha coefficients for all 14 items were 0.88 and 0.87 for baseline and follow-up, respectively. Test-retest coefficients ranged from 0.72 to 0.78. Validity - OHIP-14 scores were significantly correlated with number of teeth, education, main activity, the use of mouthwash, frequency of seeing a dentist, the reason for the last dental appointment, smoking, alcohol intake, pain and symptoms. Adjusted R(2)s ranged from 0.123 to 0.202 and there were no statistically significant differences between those for the three different scoring methods. Responsiveness - The SRMs ranged from 0.37 to 0.56 and there was a statistically significant difference between the summary scores method and the total number of problems method for symptomatic patients. The OHIP-14 is a valid and reliable measure of oral health-related quality of life in general dental practice and is responsive to third molar clinical change. The summary score method demonstrated performance as good as, or better than, the other methods studied.

Regular exercisers have stronger pelvic floor muscles than nonregular exercisers at midpregnancy.

PubMed

Bø, Kari; Ellstrøm Engh, Marie; Hilde, Gunvor

2018-04-01

Today all healthy pregnant women are encouraged to be physically active throughout pregnancy, with recommendations to participate in at least 30 minutes of aerobic activity on most days of the week in addition to performing strength training of the major muscle groups 2-3 days per week and also pelvic floor muscle training. There is, however, an ongoing debate whether general physical activity enhances or declines pelvic floor muscle function. The objectives of the study were to compare vaginal resting pressure, pelvic floor muscle strength, and endurance in regular exercisers (exercise ≥30 minutes 3 or more times per week) and nonexercisers at midpregnancy. Furthermore, another objective was to assess whether regular general exercise or pelvic floor muscle strength was associated with urinary incontinence. This was a cross-sectional study at mean gestational week 20.9 (±1.4) including 218 nulliparous pregnant women, with a mean age of 28.6 years (range, 19-40 years) and prepregnancy body mass index of 23.9 kg/m 2 (SD, 4.0). Vaginal resting pressure, pelvic floor muscle strength, and pelvic floor muscle endurance were measured by a high-precision pressure transducer connected to a vaginal balloon. The International Consultation on Incontinence Questionnaire Urinary Incontinence Short Form was used to assess urinary incontinence. Differences between groups were analyzed using an independent-sample Student t test. Linear regression analysis was conducted to adjust for prepregnancy body mass index, age, smoking during pregnancy, and regular pelvic floor muscle training during pregnancy. The significance value was set to P ≤ .05. Regular exercisers had statistically significant stronger (mean 6.4 cm H 2 O [95% confidence interval, 1.7-11.2]) and more enduring (mean 39.9 cm H 2 Osec [95% confidence interval, 42.2-75.7]) pelvic floor muscles. Only pelvic floor muscle strength remained statistically significant, when adjusting for possible confounders. Pelvic floor muscle strength and not regular general exercise was associated with urinary continence (adjusted B, -6.4 [95% confidence interval, -11.5 to -1.4]). Regular exercisers at midpregnancy have stronger pelvic floor muscles than their sedentary counterparts. However, pelvic floor muscle strength and not regular general exercise was associated with urinary incontinence. There is a need for additional studies in elite athletes and women performing more strenuous exercise regimens. Copyright © 2017 Elsevier Inc. All rights reserved.

38 CFR 10.0 - Adjusted service pay entitlements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Adjusted service pay... COMPENSATION Adjusted Compensation; General § 10.0 Adjusted service pay entitlements. A veteran entitled to adjusted service pay is one whose adjusted service credit does not amount to more than $50 as distinguished...

Factors associated with pharmacy students' attitudes towards learning communication skills - A study among Nordic pharmacy students.

PubMed

Svensberg, Karin; Brandlistuen, Ragnhild Eek; Björnsdottir, Ingunn; Sporrong, Sofia Kälvemark

2018-03-01

Good communication skills are essential for pharmacy students to help patients with their medicines. Students' attitudes towards communication skills learning will influence their willingness to engage in communication training, and their skills when dealing with patients later on in their professional life. The aim of this study was to explore Nordic pharmacy students' attitudes to communication skills learning, and the associations between those attitudes and various student characteristics. A cross-sectional questionnaire-based study was conducted in 11 Nordic pharmacy schools between April 2015 and January 2016. The overall response rate for the final study population was 77% (367 out of 479 students). Pharmacy students who had fulfilled all mandatory communication training and most of their pharmacy practical experience periods were included. The communication skills attitudes scale was the main outcome. Linear regression models were fitted with the outcome variable and various student characteristics as the predictors, using generalized estimating equations to account for clustering within pharmacy schools. Nordic pharmacy students in general have moderately positive attitudes towards learning communication skills. Positive attitudes towards learning communication skills among pharmacy students were associated with being female (β adjusted 0.42, 95% CI 0.20 to 0.63, p < 0.001), following a newer pharmacy training program (β adjusted 0.81, 95% CI 0.63 to 0.98, p < 0.001), having higher self-rated need for communication skills improvement (β adjusted 0.50, 95% CI 0.30 to 0.71, p<0.001) and believing one's communication skills are not the result of personality (β adjusted  -0.24, 95% CI -0.44 to -0.04, p=0.017). The study provides important information for faculty members responsible for curriculum improvements and teachers to refine their teaching of communication skills. From this, the teaching can be better tailored to suit different students. The students' chances of being able to effectively help patients in the future will be increased by that. Copyright © 2017 Elsevier Inc. All rights reserved.

Quality of Life of Adults With Congenital Heart Disease in 15 Countries: Evaluating Country-Specific Characteristics.

PubMed

Apers, Silke; Kovacs, Adrienne H; Luyckx, Koen; Thomet, Corina; Budts, Werner; Enomoto, Junko; Sluman, Maayke A; Wang, Jou-Kou; Jackson, Jamie L; Khairy, Paul; Cook, Stephen C; Chidambarathanu, Shanthi; Alday, Luis; Eriksen, Katrine; Dellborg, Mikael; Berghammer, Malin; Mattsson, Eva; Mackie, Andrew S; Menahem, Samuel; Caruana, Maryanne; Veldtman, Gruschen; Soufi, Alexandra; Romfh, Anitra W; White, Kamila; Callus, Edward; Kutty, Shelby; Fieuws, Steffen; Moons, Philip

2016-05-17

Measuring quality of life (QOL) is fundamental to understanding the impact of disease and treatment on patients' lives. This study aimed to explore QOL in an international sample of adults with congenital heart disease (CHD), the association between patient characteristics and QOL, and international variation in QOL and its relationship to country-specific characteristics. We enrolled 4,028 adults with CHD from 15 countries. QOL was assessed using a linear analog scale (LAS) (0 to 100) and the Satisfaction with Life Scale (SWLS) (5 to 35). Patient characteristics included sex, age, marital status, educational level, employment status, CHD complexity, and patient-reported New York Heart Association (NYHA) functional class. Country-specific characteristics included general happiness and 6 cultural dimensions. Linear mixed models were applied. Median QOL was 80 on the LAS and 27 on the SWLS. Older age, lack of employment, no marriage history, and worse NYHA functional class were associated with lower QOL (p < 0.001). Patients from Australia had the highest QOL (LAS: 82) and patients from Japan the lowest (LAS: 72). Happiness scores and cultural dimensions were not associated with variation in QOL after adjustment for patient characteristics and explained only an additional 0.1% of the variance above and beyond patient characteristics (p = 0.56). This large-scale, international study found that overall QOL in adults with CHD was generally good. Variation in QOL was related to patient characteristics but not country-specific characteristics. Hence, patients at risk for poorer QOL can be identified using uniform criteria. General principles for designing interventions to improve QOL can be developed. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

A GLM Post-processor to Adjust Ensemble Forecast Traces

NASA Astrophysics Data System (ADS)

Thiemann, M.; Day, G. N.; Schaake, J. C.; Draijer, S.; Wang, L.

2011-12-01

The skill of hydrologic ensemble forecasts has improved in the last years through a better understanding of climate variability, better climate forecasts and new data assimilation techniques. Having been extensively utilized for probabilistic water supply forecasting, interest is developing to utilize these forecasts in operational decision making. Hydrologic ensemble forecast members typically have inherent biases in flow timing and volume caused by (1) structural errors in the models used, (2) systematic errors in the data used to calibrate those models, (3) uncertain initial hydrologic conditions, and (4) uncertainties in the forcing datasets. Furthermore, hydrologic models have often not been developed for operational decision points and ensemble forecasts are thus not always available where needed. A statistical post-processor can be used to address these issues. The post-processor should (1) correct for systematic biases in flow timing and volume, (2) preserve the skill of the available raw forecasts, (3) preserve spatial and temporal correlation as well as the uncertainty in the forecasted flow data, (4) produce adjusted forecast ensembles that represent the variability of the observed hydrograph to be predicted, and (5) preserve individual forecast traces as equally likely. The post-processor should also allow for the translation of available ensemble forecasts to hydrologically similar locations where forecasts are not available. This paper introduces an ensemble post-processor (EPP) developed in support of New York City water supply operations. The EPP employs a general linear model (GLM) to (1) adjust available ensemble forecast traces and (2) create new ensembles for (nearby) locations where only historic flow observations are available. The EPP is calibrated by developing daily and aggregated statistical relationships form historical flow observations and model simulations. These are then used in operation to obtain the conditional probability density function (PDF) of the observations to be predicted, thus jointly adjusting individual ensemble members. These steps are executed in a normalized transformed space ('z'-space) to account for the strong non-linearity in the flow observations involved. A data window centered on each calibration date is used to minimize impacts from sampling errors and data noise. Testing on datasets from California and New York suggests that the EPP can successfully minimize biases in ensemble forecasts, while preserving the raw forecast skill in a 'days to weeks' forecast horizon and reproducing the variability of climatology for 'weeks to years' forecast horizons.

13 CFR 315.16 - Adjustment proposal requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... OF COMMERCE TRADE ADJUSTMENT ASSISTANCE FOR FIRMS Adjustment Proposals § 315.16 Adjustment proposal... reasonably calculated to contribute materially to the economic adjustment of the Firm (i.e., that such... generally consists of knowledge-based services such as market penetration studies, customized business...

Generation of optical vortices with controllable topological charges and polarization patterns

NASA Astrophysics Data System (ADS)

Yang, Ching-Han; Fuh, Andy Ying-Guey

2017-02-01

We present a simple and flexible method of generating various vectorial vortex beams (VVBs) based on the scheme of double modulations from a single liquid crystal spatial light modulator (SLM). In this configuration, a half-wave plate (HWP) placed in front of the SLM is first used to control the weights of linear polarization components of incident light. Then, we respectively encode two orbital angular momentum (OAM) eigenstates displayed on each half of the SLM onto each of the linear components of light. This yields the generation of VVB fields spanned by a pair of linearly polarized OAM eigenstates. In order to convert polarization bases from the linear pair into another orthogonal pair, a quarter-wave plate (QWP) placed behind the SLM is used. This enables us to generate VVBs spanned by any pair of orthogonally polarized OAM eigenstates. Generally, the light states of polarization (SOP) can be presented as a geodesic path located on the plane perpendicular to the axis connecting the pair of bases used on the Poincaré sphere. The light property is adjustable depending on both slow axes of HWP and QWP, as well as via computer generated holograms. To validate generated beams, two measurement procedures are subsequently applied. First, Stokes polarimetry is used to measure the light SOP over the transverse plane. Next, a Shack-Hartmann wavefront sensor is used to measure the OAM charge. Both the simulated and experimental results are shown to be in a good qualitative agreement. In addition, both polarization patterns and OAM charges can be controlled independently using the proposed method.

New Parents’ Psychological Adjustment and Trajectories of Early Parental Involvement

PubMed Central

Jia, Rongfang; Kotila, Letitia E.; Schoppe-Sullivan, Sarah J.; Kamp Dush, Claire M.

2016-01-01

Trajectories of parental involvement time (engagement and child care) across 3, 6, and 9 months postpartum and associations with parents’ own and their partners’ psychological adjustment (dysphoria, anxiety, and empathic personal distress) were examined using a sample of dual-earner couples experiencing first-time parenthood (N = 182 couples). Using time diary measures that captured intensive parenting moments, hierarchical linear modeling analyses revealed that patterns of associations between psychological adjustment and parental involvement time depended on the parenting domain, aspect of psychological adjustment, and parent gender. Psychological adjustment difficulties tended to bias the 2-parent system toward a gendered pattern of “mother step in” and “father step out,” as father involvement tended to decrease, and mother involvement either remained unchanged or increased, in response to their own and their partners’ psychological adjustment difficulties. In contrast, few significant effects were found in models using parental involvement to predict psychological adjustment. PMID:27397935

Feeling good, feeling bad: influences of maternal perceptions of the child and marital adjustment on well-being in mothers of children with an autism spectrum disorder.

PubMed

Lickenbrock, Diane M; Ekas, Naomi V; Whitman, Thomas L

2011-07-01

Mothers of children with an autism spectrum disorder (n = 49) participated in a 30-day diary study which examined associations between mothers' positive and negative perceptions of their children, marital adjustment, and maternal well-being. Hierarchical linear modeling results revealed that marital adjustment mediated associations between positive perceptions and maternal well-being. Mothers who reported higher levels of positive perceptions of the child were higher in marital adjustment and well-being. Results also revealed that marital adjustment moderated the relation between negative perceptions and negative maternal affect. Mothers low in marital adjustment had a positive association between negative maternal perceptions of the child and negative maternal affect. These findings highlight the dynamic roles that mothers' perceptions and marital adjustment play in determining maternal psychological outcomes.

Association of perceived ethnic discrimination with general and abdominal obesity in ethnic minority groups: the HELIUS study.

PubMed

Schmengler, Heiko; Ikram, Umar Z; Snijder, Marieke B; Kunst, Anton E; Agyemang, Charles

2017-05-01

Discrimination is associated with obesity, but this may differ according to the type of obesity and ethnic group. This study examines the association of perceived ethnic discrimination (PED) with general and abdominal obesity in 5 ethnic minority groups. We used cross-sectional data from the HELIUS study, collected from 2011 to 2015. The study sample included 2297 Ghanaians, 4110 African Surinamese, 3021 South-Asian Surinamese, 3562 Turks and 3868 Moroccans aged 18-70 years residing in Amsterdam, the Netherlands. Body mass index (BMI) was used as a measure for general obesity, and waist circumference (WC) for abdominal obesity. PED was measured using the Everyday Discrimination Scale. We used linear regression models adjusted for sociodemographics, psychosocial stressors and health behaviours. In additional analysis, we used standardised variables to compare the strength of the associations. In adjusted models, PED was significantly, positively associated with BMI in the South-Asian Surinamese (β coefficient 0.338; 95% CI 0.106 to 0.570), African Surinamese (0.394; 0.171 to 0.618) and Turks (0.269; 0.027 to 0.510). For WC, a similar pattern was seen: positive associations in the South-Asian Surinamese (0.759; 0.166 to 1.353), African Surinamese (0.833; 0.278 to 1.388) and Turks (0.870; 0.299 to 1.440). When stratified by sex, we found positive associations in Surinamese women, Turkish men and Moroccan men. The strength of the associations with BMI and WC was comparable in the groups. Among the Ghanaians, no significant associations were observed. Ethnic and sex variations are observed in the association of PED with both general and abdominal obesity. Further research on psychosocial buffers and underlying biological mechanisms might help in understanding these variations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Leveraging prognostic baseline variables to gain precision in randomized trials

PubMed Central

Colantuoni, Elizabeth; Rosenblum, Michael

2015-01-01

We focus on estimating the average treatment effect in a randomized trial. If baseline variables are correlated with the outcome, then appropriately adjusting for these variables can improve precision. An example is the analysis of covariance (ANCOVA) estimator, which applies when the outcome is continuous, the quantity of interest is the difference in mean outcomes comparing treatment versus control, and a linear model with only main effects is used. ANCOVA is guaranteed to be at least as precise as the standard unadjusted estimator, asymptotically, under no parametric model assumptions and also is locally semiparametric efficient. Recently, several estimators have been developed that extend these desirable properties to more general settings that allow any real-valued outcome (e.g., binary or count), contrasts other than the difference in mean outcomes (such as the relative risk), and estimators based on a large class of generalized linear models (including logistic regression). To the best of our knowledge, we give the first simulation study in the context of randomized trials that compares these estimators. Furthermore, our simulations are not based on parametric models; instead, our simulations are based on resampling data from completed randomized trials in stroke and HIV in order to assess estimator performance in realistic scenarios. We provide practical guidance on when these estimators are likely to provide substantial precision gains and describe a quick assessment method that allows clinical investigators to determine whether these estimators could be useful in their specific trial contexts. PMID:25872751

Changes in beverage consumption among adolescents from public schools in the first decade of the century XXI.

PubMed

Monteiro, Luana Silva; Vasconcelos, Thaís Meirelles de; Veiga, Gloria Valéria da; Pereira, Rosângela Alves

2016-01-01

To evaluate the changes in beverage consumption among adolescents between 2003 and 2008. Two school-based cross-sectional studies were carried out with public school students (12 to 19 years-old) from Niterói, Rio de Janeiro, Brazil. Data from three food records were used to estimate daily, weekdays and weekend average consumption (volume and percent contribution for total daily energy intake) of milk and milk-based beverages, sugar sweetened beverages, fresh squeezed fruit juices, caffeinated and alcoholic beverages. Beverage consumption age-adjusted means for weekdays and weekends were compared using linear regression (Generalized Linear Models - GLM). A total of 433 adolescents were examined in 2003, and 510 in 2008. The prevalence of overweight was 17% in 2003 and 22% in 2008 (p > 0.05). Milk was the most consumed beverage, being reported by 89% of adolescents, followed by sodas (75%). In general, in the five-year period, there was an increase in the prevalence of consumption of alcoholic drinks, guarana syrup refreshment, and processed fruit drinks, especially on weekdays. The soft drink was the largest contributor to the total energy consumption, corresponding on average to 4% of daily energy intake. The main changes in the beverage consumption among adolescents from Niterói, in the first decade of the XXI century, were the tendency to reduce the consumption of milk and the increase in the consumption of processed and alcoholic beverages.

Goal management tendencies predict trajectories of adjustment to lower limb amputation up to 15 months post rehabilitation discharge.

PubMed

Coffey, Laura; Gallagher, Pamela; Desmond, Deirdre; Ryall, Nicola; Wegener, Stephen T

2014-10-01

To explore patterns of change in positive affect, general adjustment to lower-limb amputation, and self-reported disability from rehabilitation admission to 15 months postdischarge, and to examine whether goal pursuit and goal adjustment tendencies predict either initial status or rates of change in these outcomes, controlling for sociodemographic and clinical covariates. Prospective cohort study with 4 time points (t1: on admission; t2: 6wk postdischarge; t3: 6mo postdischarge; t4: 15mo postdischarge). Inpatient rehabilitation. Consecutive sample (N=98) of persons aged ≥18 years with major lower-limb amputation. Not applicable. Positive affect subscale of the Positive and Negative Affect Schedule; general adjustment subscale of the Trinity Amputation and Prosthesis Experience Scales-Revised; and World Health Organization Disability Assessment Schedule 2.0. Positive affect decreased from t1 to t4 for the overall sample, whereas general adjustment increased. Self-reported disability scores remained stable over this period. Stronger goal pursuit tendencies were associated with greater positive affect at t1, and stronger goal adjustment tendencies were associated with more favorable initial scores on each outcome examined. With regard to rates of change, stronger goal pursuit tendencies buffered against decreases in positive affect and promoted decreases in self-reported disability over time, whereas stronger goal adjustment tendencies enhanced increases in general adjustment to lower-limb amputation. Greater use of goal pursuit and goal adjustment strategies appears to promote more favorable adjustment to lower-limb amputation over time across a range of important rehabilitation outcomes. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Association between Allergic Rhinitis and Asthma Control in Peruvian School Children: A Cross-Sectional Study

PubMed Central

Uceda, Mónica; Ziegler, Otto; Lindo, Felipe; Herrera-Pérez, Eder

2013-01-01

Background. Asthma and allergic rhinitis are highly prevalent conditions that cause major illness worldwide. This study aimed to assess the association between allergic rhinitis and asthma control in Peruvian school children. Methods. A cross-sectional study was conducted among 256 children with asthma recruited in 5 schools from Lima and Callao cities. The outcome was asthma control assessed by the asthma control test. A score test for trend of odds was used to evaluate the association between allergic rhinitis severity and the prevalence of inadequate asthma control. A generalized linear regression model was used to estimate the adjusted prevalence ratios of inadequate asthma control. Results. Allergic rhinitis was present in 66.4% of the population with asthma. The trend analysis showed a positive association between allergic rhinitis and the probability of inadequate asthma control (P < 0.001). It was associated with an increased prevalence of inadequate asthma control, with adjusted prevalence ratios of 1.53 (95% confidence interval: 1.19−1.98). Conclusion. This study indicates that allergic rhinitis is associated with an inadequate level of asthma control, giving support to the recommendation of evaluating rhinitis to improve asthma control in children. PMID:23984414

A smart-phone intervention to address mental health stigma in the construction industry: A two-arm randomised controlled trial.

PubMed

Milner, A; Law, P C F; Mann, C; Cooper, T; Witt, K; LaMontagne, A D

2018-04-01

High levels of self-stigma are associated with a range of adverse mental health, treatment, and functional outcomes. This prospective study examined the effects of an electronic mental health stigma reduction intervention on self-stigma (self-blame, shame, and help-seeking inhibition) among male construction workers in Australia. Male construction workers (N = 682) were randomly assigned to receive either the intervention condition or the wait list control over a six-week period. Self-stigma was assessed using the Self-Stigma of Depression Scale at post-intervention. We conducted linear regression to assess the effectiveness of the intervention on self-stigma, adjusting for relevant covariates. Self-stigma was relatively low in the sample. The intervention had no significant effect on self-stigma, after adjusting for confounders. There were reductions in stigma in both the intervention and control groups at 6-week follow-up. Process evaluation indicated that participants generally enjoyed the program and felt that it was beneficial to their mental health. These observations underscore the need for further research to elucidate understanding of the experience of self-stigma among employed males.

Short leukocyte telomere length is associated with obesity in American Indians: the Strong Heart Family study.

PubMed

Chen, Shufeng; Yeh, Fawn; Lin, Jue; Matsuguchi, Tet; Blackburn, Elizabeth; Lee, Elisa T; Howard, Barbara V; Zhao, Jinying

2014-05-01

Shorter leukocyte telomere length (LTL) has been associated with a wide range of age-related disorders including cardiovascular disease (CVD) and diabetes. Obesity is an important risk factor for CVD and diabetes. The association of LTL with obesity is not well understood. This study for the first time examines the association of LTL with obesity indices including body mass index, waist circumference, percent body fat, waist-to-hip ratio, and waist-to-height ratio in 3,256 American Indians (14-93 years old, 60% women) participating in the Strong Heart Family Study. Association of LTL with each adiposity index was examined using multivariate generalized linear mixed model, adjusting for chronological age, sex, study center, education, lifestyle (smoking, alcohol consumption, and total energy intake), high-sensitivity C-reactive protein, hypertension and diabetes. Results show that obese participants had significantly shorter LTL than non-obese individuals (age-adjusted P=0.0002). Multivariate analyses demonstrate that LTL was significantly and inversely associated with all of the studied obesity parameters. Our results may shed light on the potential role of biological aging in pathogenesis of obesity and its comorbidities.

The modifying influence of country development on the effect of individual educational attainment on self-rated health.

PubMed

van der Kooi, Anne L F; Stronks, Karien; Thompson, Caroline A; DerSarkissian, Maral; Arah, Onyebuchi A

2013-11-01

We investigated how much the Human Development Index (HDI), a global measure of development, modifies the effect of education on self-reported health. We analyzed cross-sectional World Health Survey data on 217,642 individuals from 49 countries, collected in 2002 to 2005, with random-intercept multilevel linear regression models. We observed greater positive associations between educational levels and self-reported good health with increasing HDI. The magnitude of this effect modification of the education-health relation tended to increase with educational attainment. For example, before adjustment for effect modification, at comparable HDI, on average, finishing primary school was associated with better general health (b = 1.49; 95% confidence interval [CI] = 1.18, 1.80). With adjustment for effect modification by HDI, the impact became 4.63 (95% CI = 3.63, 5.62) for every 0.1 increase in HDI. Among those who completed high school, these associations were, respectively, 5.59 (95% CI = 5.20, 5.98) and 9.95 (95% CI = 8.89, 11.00). The health benefits of educational attainment are greater in countries with greater human development. Health inequalities attributable to education are, therefore, larger in more developed countries.

Patterns of Change in Depression Post Stroke

PubMed Central

Ostir, Glenn V.; Berges, Ivonne-M.; Ottenbacher, Allison; Ottenbacher, Kenneth J.

2011-01-01

Background Little information is available on depressive symptom change in persons with stroke. Objectives Provide estimates of change in depressive symptoms and determine how depressive symptom change influences recovery of functional status. Design Prospective cohort study. Setting Eleven in-patient medical rehabilitation facilities located across the U.S. Participants 544 persons with a first-time stroke. Measurements General linear regression model estimates assessed associations between depressive symptom change and functional status 3 and 12 months post discharge. Results The majority of persons with stroke were aged 75 and older, white, female and married. The most prevalent stroke type was ischemic. Non-depressed patients at discharge who reported fewer symptoms 12-months later had an adjusted functional status score of 108.2. This compared to adjusted functional status scores of 104.6 for those non-depressed at discharge with increasing symptoms over the 12-month follow-up, 100.3 for those depressed at discharge with fewer symptoms over the 12-month follow-up, and 88.0 for those depressed at discharge with more symptoms over the 12-month follow-up. Conclusion Tracking depressive symptom change in hospital and post discharge is clinically relevant and an important component of patient care and recovery of functional status. PMID:21275930

Firearm and nonfirearm homicide in 5 South African cities: a retrospective population-based study.

PubMed

Matzopoulos, Richard G; Thompson, Mary Lou; Myers, Jonathan E

2014-03-01

We assessed the effectiveness of South Africa's Firearm Control Act (FCA), passed in 2000, on firearm homicide rates compared with rates of nonfirearm homicide across 5 South African cities from 2001 to 2005. We conducted a retrospective population-based study of 37 067 firearm and nonfirearm homicide cases. Generalized linear models helped estimate and compare time trends of firearm and nonfirearm homicides, adjusting for age, sex, race, day of week, city, year of death, and population size. There was a statistically significant decreasing trend regarding firearm homicides from 2001, with an adjusted year-on-year homicide rate ratio of 0.864 (95% confidence interval [CI] = 0.848, 0.880), representing a decrease of 13.6% per annum. The year-on-year decrease in nonfirearm homicide rates was also significant, but considerably lower at 0.976 (95% CI = 0.954, 0.997). Results suggest that 4585 (95% CI = 4427, 4723) lives were saved across 5 cities from 2001 to 2005 because of the FCA. Strength, timing and consistent decline suggest stricter gun control mediated by the FCA accounted for a significant decrease in homicide overall, and firearm homicide in particular, during the study period.

Analytical solution to compensate for thermal expansion change in photopolymer volume holograms using a tunable laser.

PubMed

Tanaka, Tomiji; Watanabe, Kenjiro

2008-02-20

For holographic data storage, it is necessary to adjust the wavelength and direction of the reading beam if the reading and recording temperature do not match. An analytical solution for this adjustment is derived using first-order approximations in a two-dimensional model. The optimum wavelength is a linear function of the temperature difference between recording and reading, and is independent of the direction of the reference beam. However, the optimum direction of incidence is not only a linear function of the temperature difference, but also depends on the direction of the reference beam. The retrieved image, which is produced by a diffracted beam, shrinks or expands slightly according to the temperature difference.

Regression equations for estimation of annual peak-streamflow frequency for undeveloped watersheds in Texas using an L-moment-based, PRESS-minimized, residual-adjusted approach

USGS Publications Warehouse

Asquith, William H.; Roussel, Meghan C.

2009-01-01

Annual peak-streamflow frequency estimates are needed for flood-plain management; for objective assessment of flood risk; for cost-effective design of dams, levees, and other flood-control structures; and for design of roads, bridges, and culverts. Annual peak-streamflow frequency represents the peak streamflow for nine recurrence intervals of 2, 5, 10, 25, 50, 100, 200, 250, and 500 years. Common methods for estimation of peak-streamflow frequency for ungaged or unmonitored watersheds are regression equations for each recurrence interval developed for one or more regions; such regional equations are the subject of this report. The method is based on analysis of annual peak-streamflow data from U.S. Geological Survey streamflow-gaging stations (stations). Beginning in 2007, the U.S. Geological Survey, in cooperation with the Texas Department of Transportation and in partnership with Texas Tech University, began a 3-year investigation concerning the development of regional equations to estimate annual peak-streamflow frequency for undeveloped watersheds in Texas. The investigation focuses primarily on 638 stations with 8 or more years of data from undeveloped watersheds and other criteria. The general approach is explicitly limited to the use of L-moment statistics, which are used in conjunction with a technique of multi-linear regression referred to as PRESS minimization. The approach used to develop the regional equations, which was refined during the investigation, is referred to as the 'L-moment-based, PRESS-minimized, residual-adjusted approach'. For the approach, seven unique distributions are fit to the sample L-moments of the data for each of 638 stations and trimmed means of the seven results of the distributions for each recurrence interval are used to define the station specific, peak-streamflow frequency. As a first iteration of regression, nine weighted-least-squares, PRESS-minimized, multi-linear regression equations are computed using the watershed characteristics of drainage area, dimensionless main-channel slope, and mean annual precipitation. The residuals of the nine equations are spatially mapped, and residuals for the 10-year recurrence interval are selected for generalization to 1-degree latitude and longitude quadrangles. The generalized residual is referred to as the OmegaEM parameter and represents a generalized terrain and climate index that expresses peak-streamflow potential not otherwise represented in the three watershed characteristics. The OmegaEM parameter was assigned to each station, and using OmegaEM, nine additional regression equations are computed. Because of favorable diagnostics, the OmegaEM equations are expected to be generally reliable estimators of peak-streamflow frequency for undeveloped and ungaged stream locations in Texas. The mean residual standard error, adjusted R-squared, and percentage reduction of PRESS by use of OmegaEM are 0.30log10, 0.86, and -21 percent, respectively. Inclusion of the OmegaEM parameter provides a substantial reduction in the PRESS statistic of the regression equations and removes considerable spatial dependency in regression residuals. Although the OmegaEM parameter requires interpretation on the part of analysts and the potential exists that different analysts could estimate different values for a given watershed, the authors suggest that typical uncertainty in the OmegaEM estimate might be about +or-0.1010. Finally, given the two ensembles of equations reported herein and those in previous reports, hydrologic design engineers and other analysts have several different methods, which represent different analytical tracks, to make comparisons of peak-streamflow frequency estimates for ungaged watersheds in the study area.

MHD Simulations of Plasma Dynamics with Non-Axisymmetric Boundaries

NASA Astrophysics Data System (ADS)

Hansen, Chris; Levesque, Jeffrey; Morgan, Kyle; Jarboe, Thomas

2015-11-01

The arbitrary geometry, 3D extended MHD code PSI-TET is applied to linear and non-linear simulations of MCF plasmas with non-axisymmetric boundaries. Progress and results from simulations on two experiments will be presented: 1) Detailed validation studies of the HIT-SI experiment with self-consistent modeling of plasma dynamics in the helicity injectors. Results will be compared to experimental data and NIMROD simulations that model the effect of the helicity injectors through boundary conditions on an axisymmetric domain. 2) Linear studies of HBT-EP with different wall configurations focusing on toroidal asymmetries in the adjustable conducting wall. HBT-EP studies the effect of active/passive stabilization with an adjustable ferritic wall. Results from linear verification and benchmark studies of ideal mode growth with and without toroidal asymmetries will be presented and compared to DCON predictions. Simulations of detailed experimental geometries are enabled by use of the PSI-TET code, which employs a high order finite element method on unstructured tetrahedral grids that are generated directly from CAD models. Further development of PSI-TET will also be presented including work to support resistive wall regions within extended MHD simulations. Work supported by DoE.

Linear positioning laser calibration setup of CNC machine tools

NASA Astrophysics Data System (ADS)

Sui, Xiulin; Yang, Congjing

2002-10-01

The linear positioning laser calibration setup of CNC machine tools is capable of executing machine tool laser calibraiotn and backlash compensation. Using this setup, hole locations on CNC machien tools will be correct and machien tool geometry will be evaluated and adjusted. Machien tool laser calibration and backlash compensation is a simple and straightforward process. First the setup is to 'find' the stroke limits of the axis. Then the laser head is then brought into correct alignment. Second is to move the machine axis to the other extreme, the laser head is now aligned, using rotation and elevation adjustments. Finally the machine is moved to the start position and final alignment is verified. The stroke of the machine, and the machine compensation interval dictate the amount of data required for each axis. These factors determine the amount of time required for a through compensation of the linear positioning accuracy. The Laser Calibrator System monitors the material temperature and the air density; this takes into consideration machine thermal growth and laser beam frequency. This linear positioning laser calibration setup can be used on CNC machine tools, CNC lathes, horizontal centers and vertical machining centers.

Linear mixed-effects models to describe individual tree crown width for China-fir in Fujian Province, southeast China.

PubMed

Hao, Xu; Yujun, Sun; Xinjie, Wang; Jin, Wang; Yao, Fu

2015-01-01

A multiple linear model was developed for individual tree crown width of Cunninghamia lanceolata (Lamb.) Hook in Fujian province, southeast China. Data were obtained from 55 sample plots of pure China-fir plantation stands. An Ordinary Linear Least Squares (OLS) regression was used to establish the crown width model. To adjust for correlations between observations from the same sample plots, we developed one level linear mixed-effects (LME) models based on the multiple linear model, which take into account the random effects of plots. The best random effects combinations for the LME models were determined by the Akaike's information criterion, the Bayesian information criterion and the -2logarithm likelihood. Heteroscedasticity was reduced by three residual variance functions: the power function, the exponential function and the constant plus power function. The spatial correlation was modeled by three correlation structures: the first-order autoregressive structure [AR(1)], a combination of first-order autoregressive and moving average structures [ARMA(1,1)], and the compound symmetry structure (CS). Then, the LME model was compared to the multiple linear model using the absolute mean residual (AMR), the root mean square error (RMSE), and the adjusted coefficient of determination (adj-R2). For individual tree crown width models, the one level LME model showed the best performance. An independent dataset was used to test the performance of the models and to demonstrate the advantage of calibrating LME models.

Exposure to preeclampsia in utero affects growth from birth to late childhood dependent on child’s sex and severity of exposure: Follow-up of a nested case-control study

PubMed Central

Øymar, Knut; Eide, Geir Egil; Forman, Michele R.; Júlíusson, Pétur Benedikt

2017-01-01

Background and objective An adverse intrauterine environment may affect offspring growth and development. Our aim was to explore whether preeclampsia (PE) exposure in utero influences growth from birth to 13 years. Methods In a nested case-control study, 229 children were exposed to PE (mild/moderate: n = 164, severe: n = 54) and 385 were unexposed. Length/height and weight were abstracted from records at birth, 3 and 6 months, 1 and 4 years, and measured along with waist circumference and skinfolds at follow-up at 11/12 (girls/boys) and 13 years (both sexes). Associations between PE and z-scores for growth were analyzed by multiple linear and fractional polynomial regression with adjustment for potential confounders. Results In boys, exposure to mild/moderate PE was positively associated with linear growth after 0.5 years, but severe PE was negatively associated with linear growth in all ages. In girls, both exposure to mild/moderate and severe PE were negatively associated with linear growth. Exposure to PE was negatively associated with weight and body mass index (BMI) during infancy, but positively associated with weight and BMI thereafter, except that boys exposed to severe PE consistently had a lower weight and BMI compared to the unexposed. Exposure to severe PE only was positively associated with waist-to-height ratio at 11/12 (girls/boys) and 13 years (both sexes). Conclusions From birth to adolescence, linear growth, weight and BMI trajectories differed between the sexes by severity of exposure to PE. In general, PE exposure was negatively associated with linear growth, while in girls; positive associations with weight and BMI were observed. This underlines fetal life as a particularly sensitive period affecting subsequent growth and this may have implications for targeted approaches for healthy growth and development. PMID:28486480

Generalized Multilevel Structural Equation Modeling

ERIC Educational Resources Information Center

Rabe-Hesketh, Sophia; Skrondal, Anders; Pickles, Andrew

2004-01-01

A unifying framework for generalized multilevel structural equation modeling is introduced. The models in the framework, called generalized linear latent and mixed models (GLLAMM), combine features of generalized linear mixed models (GLMM) and structural equation models (SEM) and consist of a response model and a structural model for the latent…

A hybrid approach to modeling and control of vehicle height for electronically controlled air suspension

NASA Astrophysics Data System (ADS)

Sun, Xiaoqiang; Cai, Yingfeng; Wang, Shaohua; Liu, Yanling; Chen, Long

2016-01-01

The control problems associated with vehicle height adjustment of electronically controlled air suspension (ECAS) still pose theoretical challenges for researchers, which manifest themselves in the publications on this subject over the last years. This paper deals with modeling and control of a vehicle height adjustment system for ECAS, which is an example of a hybrid dynamical system due to the coexistence and coupling of continuous variables and discrete events. A mixed logical dynamical (MLD) modeling approach is chosen for capturing enough details of the vehicle height adjustment process. The hybrid dynamic model is constructed on the basis of some assumptions and piecewise linear approximation for components nonlinearities. Then, the on-off statuses of solenoid valves and the piecewise approximation process are described by propositional logic, and the hybrid system is transformed into the set of linear mixed-integer equalities and inequalities, denoted as MLD model, automatically by HYSDEL. Using this model, a hybrid model predictive controller (HMPC) is tuned based on online mixed-integer quadratic optimization (MIQP). Two different scenarios are considered in the simulation, whose results verify the height adjustment effectiveness of the proposed approach. Explicit solutions of the controller are computed to control the vehicle height adjustment system in realtime using an offline multi-parametric programming technology (MPT), thus convert the controller into an equivalent explicit piecewise affine form. Finally, bench experiments for vehicle height lifting, holding and lowering procedures are conducted, which demonstrate that the HMPC can adjust the vehicle height by controlling the on-off statuses of solenoid valves directly. This research proposes a new modeling and control method for vehicle height adjustment of ECAS, which leads to a closed-loop system with favorable dynamical properties.

Association between air pollution and acute childhood wheezy episodes: prospective observational study.

PubMed Central

Buchdahl, R.; Parker, A.; Stebbings, T.; Babiker, A.

1996-01-01

OBJECTIVE--To examine the association between the air pollutants ozone, sulphur dioxide, and nitrogen dioxide and the incidence of acute childhood wheezy episodes. DESIGN--Prospective observational study over one year. SETTING--District general hospital. SUBJECTS--1025 children attending the accident and emergency department with acute wheezy episodes; 4285 children with other conditions as the control group. MAIN OUTCOME MEASURES--Daily incidence of acute wheezy episodes. RESULTS--After seasonal adjustment, day to day variations in daily average concentrations of ozone and sulphur dioxide were found to have significant associations with the incidence of acute wheezy episodes. The strongest association was with ozone, for which a non-linear U shaped relation was seen. In terms of the incidence rate ratio (1 at a mean 24 hour ozone concentration of 40 microg/m3 (SD=19.1)), children were more likely to attend when the concentration was two standard deviations below the mean (incidence rate ratio=3.01; 95% confidence interval 2.17 to 4.18) or two standard deviations above the mean (1.34; 1.09 to 1.66). Sulphur dioxide had a weaker log-linear relation with incidence (1.12; 1.05 to 1.19 for each standard deviation (14.1) increase in sulphur dioxide concentration). Further adjustment for temperature and wind speed did not significantly alter these associations. CONCLUSIONS--Independent of season, temperature, and wind speed, fluctuations in concentrations of atmospheric ozone and sulphur dioxide are strongly associated with patterns of attendance at accident and emergency departments for acute childhood wheezy episodes. A critical ozone concentration seems to exist in the atmosphere above or below which children are more likely to develop symptoms. PMID:8597731

Dietary flavonoid intake, total antioxidant capacity and lipid oxidative damage: A cross-sectional study of Iranian women.

PubMed

Alipour, Beitolah; Rashidkhani, Bahram; Edalati, Sareh

2016-05-01

Although strong evidence supports the antioxidant potential of flavonoids in vitro, the effect of flavonoids at physiological concentrations on the overall antioxidant status in humans is inconsistent. The aim of this study was to examine cross-sectional associations between total flavonoid consumption, serum total antioxidant capacity (TAC), and malondialdehyde (MDA) levels in apparently healthy women. Through a multistage cluster sampling, 170 women ages 20 to 48 y were recruited. The usual dietary flavonoid intake was estimated using a semiquantitive food frequency questionnaire (FFQ) by matching food items with the US Department of Agriculture flavonoid databases. General linear models were used to compare the biochemical parameters across tertiles of flavonoid intakes. As dietary anthocyanin intake rose from the lowest to the highest tertile, the multivariate-adjusted mean TAC concentrations significantly increased from 1.08 to 1.28 (Ptrend = 0.01). This association was still significant after adjustment for fruit and vegetable intake and antioxidant vitamins (Ptrend = 0.03). The highest tertile of total flavonoid intake and theaflavins had higher mean concentrations of TAC than did the lowest tertile, but there was no linear trend (P < 0.05). There were statistically significant positive relationships between dietary intake of grapes and eggplant as main food sources of anthocyanins and serum TAC (P = 0.02 and 0.04, respectively). No significant associations were found between MDA and flavonoids intakes (P > 0.05). The findings of the present study support the attribution of anthocyanins to overall antioxidant status. However, further research is needed to confirm these observed associations. Copyright © 2016 Elsevier Inc. All rights reserved.

Pregnancy urinary phthalate metabolite concentrations and gestational diabetes risk factors.

PubMed

James-Todd, Tamarra M; Meeker, John D; Huang, Tianyi; Hauser, Russ; Ferguson, Kelly K; Rich-Edwards, Janet W; McElrath, Thomas F; Seely, Ellen W

2016-11-01

Epidemiologic studies suggest phthalate metabolite concentrations are associated with type 2 diabetes. GDM is a strong risk factor for type 2 diabetes. Little is known about phthalates and GDM risk factors (i.e. 1st trimester body mass index (BMI), gestational weight gain (GWG), and 2nd trimester glucose levels). A total of 350 women participating in Lifecodes pregnancy cohort (Boston, MA), delivered at term and had pregnancy urinary phthalate metabolite concentrations. Nine specific gravity-adjusted urinary phthalate metabolites were evaluated. General linear regression was used to assess associations between quartiles of phthalate metabolites and continuous 1st trimester BMI and late 2nd trimester blood glucose. Linear mixed models were used for total GWG. Multivariable logistic regression was used for phthalate concentrations and categorized GWG and impaired glucose tolerance defined as glucose≥140mg/dL based on a 50-gram glucose load test. Models were adjusted for potential confounders. There were no associations between 1st trimester urinary phthalate metabolite concentrations and 1st trimester BMI. Mono-ethyl phthalate concentrations averaged across pregnancy were associated with a 2.17 increased odds of excessive GWG (95% CI: 0.98, 4.79). Second trimester mono-ethyl phthalate was associated with increased odds of impaired glucose tolerance (adj. OR: 7.18; 95% CI: 1.97, 26.15). A summary measure of di-2-ethylhexyl phthalate metabolite concentrations were inversely associated with impaired glucose tolerance (adj. OR: 0.25; adj. 95% CI: 0.08, 0.85). Higher exposure to mono-ethyl phthalate, a metabolite of the parent compound of di-ethyl phthalate, may be associated with excessive GWG and impaired glucose tolerance; higher di-2-ethylhexyl phthalate was associated with reduced odds of impaired glucose tolerance. Copyright © 2016 Elsevier Ltd. All rights reserved.

Pregnancy urinary phthalate metabolite concentrations and gestational diabetes risk factors

PubMed Central

James-Todd, TM; Meeker, JD; Huang, T; Hauser, R; Ferguson, KK; Rich-Edwards, JW; McElrath, TF; Seely, EW

2016-01-01

Background Epidemiologic studies suggest phthalate metabolite concentrations are associated with type 2 diabetes. GDM is a strong risk factor for type 2 diabetes. Little is known about phthalates and GDM risk factors (i.e. 1st trimester body mass index (BMI), gestational weight gain (GWG), and 2nd trimester glucose levels). Methods A total of 350 women participating in Lifecodes pregnancy cohort (Boston, MA), delivered at term and had pregnancy urinary phthalate metabolite concentrations. Nine specific gravity-adjusted urinary phthalate metabolites were evaluated. General linear regression was used to assess associations between quartiles of phthalate metabolites and continuous 1st trimester BMI and late 2nd trimester blood glucose. Linear mixed models were used for total GWG. Multivariable logistic regression was used for phthalate concentrations and categorized GWG and impaired glucose tolerance defined as glucose ≥ 140mg/dL based on a 50-gram glucose load test. Models were adjusted for potential confounders. Results There were no associations between 1st trimester urinary phthalate metabolite concentrations and 1st trimester BMI. Mono-ethyl phthalate (MEP) concentrations averaged across pregnancy were associated with a 2.17 increased odds of excessive GWG (95% CI: 0.98, 4.79). Second trimester MEP was associated with an increased odds of impaired glucose tolerance (adj. OR: 7.18; 95% CI: 1.97, 26.15). Di-2-ethylhexyl phthalate metabolite concentrations were inversely associated with impaired glucose tolerance (adj. OR: 0.25; adj. 95% CI: 0.08, 0.85). Conclusions Higher exposure to di-ethyl phthalate, the parent compound of MEP, may be associated with excessive GWG and impaired glucose tolerance; higher di-2-ethylhexyl phthalate was associated with reduced odds of impaired glucose tolerance. PMID:27649471

Bone Mineral Density across a Range of Physical Activity Volumes: NHANES 2007–2010

PubMed Central

Whitfield, Geoffrey P.; Kohrt, Wendy M.; Pettee Gabriel, Kelley K.; Rahbar, Mohammad H.; Kohl, Harold W.

2014-01-01

Introduction The association between aerobic physical activity volume and bone mineral density (BMD) is not completely understood. The purpose of this study was to clarify the association between BMD and aerobic activity across a broad range of activity volumes, in particular volumes between those recommended in the 2008 Physical Activity Guidelines for Americans and those of trained endurance athletes. Methods Data from the 2007–2010 National Health and Nutrition Examination Survey were used to quantify the association between reported physical activity and BMD at the lumbar spine and proximal femur across the entire range of activity volumes reported by US adults. Participants were categorized into multiples of the minimum guideline-recommended volume based on reported moderate and vigorous intensity leisure activity. Lumbar and proximal femur BMD was assessed with dual-energy x-ray absorptiometry. Results Among women, multivariable-adjusted linear regression analyses revealed no significant differences in lumbar BMD across activity categories, while proximal femur BMD was significantly higher among those who exceeded guidelines by 2–4 times than those who reported no activity. Among men, multivariable-adjusted BMD at both sites neared its highest values among those who exceeded guidelines by at least 4 times and was not progressively higher with additional activity. Logistic regression estimating the odds of low BMD generally echoed the linear regression results. Conclusion The association between physical activity volume and BMD is complex. Among women, exceeding guidelines by 2–4 times may be important for maximizing BMD at the proximal femur, while among men, exceeding guidelines by 4+ times may be beneficial for lumbar and proximal femur BMD. PMID:24870584

42 CFR 416.172 - Adjustments to national payment rates.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 3 2014-10-01 2014-10-01 false Adjustments to national payment rates. 416.172... Adjustments to national payment rates. (a) General rule. Contractors adjust the payment rates established for...; or (2) The geographically adjusted payment rate determined under this subpart. (c) Geographic...

42 CFR 416.172 - Adjustments to national payment rates.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 3 2012-10-01 2012-10-01 false Adjustments to national payment rates. 416.172... Adjustments to national payment rates. (a) General rule. Contractors adjust the payment rates established for...; or (2) The geographically adjusted payment rate determined under this subpart. (c) Geographic...

Attention-Deficit/Hyperactivity Disorder Medication Treatment Impact on Response to Growth Hormone Therapy: Results from the ANSWER Program, a Non-Interventional Study.

PubMed

Rose, Susan R; Reeves, Grafton; Gut, Robert; Germak, John

2015-12-01

To examine whether attention-deficit/hyperactivity disorder (ADHD) stimulant medication modified the linear growth response to growth hormone (GH) treatment in children enrolled in the American Norditropin Studies: Web-Enabled Research Program. Short, GH treatment-naive children with or without GH deficiency (GHD) received GH therapy. A subset also received ADHD stimulant medication (n = 1190), and others did not (n = 7230). Linear mixed models (adjusted means) examined height SDS (HSDS) and body mass index (BMI) SDS from baseline through year 4. Analyses were repeated with ADHD groups matched for baseline age, height, weight, BMI, and sex. Groups with and without GHD were compared between ADHD groups. Adjusted change in HSDS for the group receiving ADHD stimulant medication was slightly lower than that for patients not receiving stimulant medication at years 1 to 4 (P < .05). However, adjusted change in HSDS was similar between children receiving and not receiving ADHD stimulant medication when matched for baseline measurements. At year 4, 86.7% of patients receiving ADHD stimulant medication, 86.8% of total patients not receiving ADHD stimulant medication, and 84.6% of matched group patients not receiving ADHD stimulant medication achieved HSDS >-2. Year 4 adjusted change in BMI SDS was greater in the patients receiving ADHD stimulant medication compared with both groups not receiving ADHD stimulant medication (P < .05). Patients with GHD showed comparable differences in adjusted change in BMI SDS among the ADHD groups at year 4, whereas patients without GHD showed no significant differences. ADHD medication did not affect the linear growth response of children treated with GH when those receiving or not receiving ADHD stimulant medication were matched for baseline measurements. Underlying reasons for the observed greater increase in BMI in patients with GHD concomitantly treated with ADHD medication remain to be elucidated. ClinicalTrials.gov: NCT01009905. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Comparison of dynamical approximation schemes for non-linear gravitational clustering

NASA Technical Reports Server (NTRS)

Melott, Adrian L.

1994-01-01

We have recently conducted a controlled comparison of a number of approximations for gravitational clustering against the same n-body simulations. These include ordinary linear perturbation theory (Eulerian), the adhesion approximation, the frozen-flow approximation, the Zel'dovich approximation (describable as first-order Lagrangian perturbation theory), and its second-order generalization. In the last two cases we also created new versions of approximation by truncation, i.e., smoothing the initial conditions by various smoothing window shapes and varying their sizes. The primary tool for comparing simulations to approximation schemes was crosscorrelation of the evolved mass density fields, testing the extent to which mass was moved to the right place. The Zel'dovich approximation, with initial convolution with a Gaussian e(exp -k(exp 2)/k(exp 2, sub G)) where k(sub G) is adjusted to be just into the nonlinear regime of the evolved model (details in text) worked extremely well. Its second-order generalization worked slightly better. All other schemes, including those proposed as generalizations of the Zel'dovich approximation created by adding forces, were in fact generally worse by this measure. By explicitly checking, we verified that the success of our best-choice was a result of the best treatment of the phases of nonlinear Fourier components. Of all schemes tested, the adhesion approximation produced the most accurate nonlinear power spectrum and density distribution, but its phase errors suggest mass condensations were moved to slightly the wrong location. Due to its better reproduction of the mass density distribution function and power spectrum, it might be preferred for some uses. We recommend either n-body simulations or our modified versions of the Zel'dovich approximation, depending upon the purpose. The theoretical implication is that pancaking is implicit in all cosmological gravitational clustering, at least from Gaussian initial conditions, even when subcondensations are present.

Cerebral microbleeds are associated with cognitive decline and dementia: the Rotterdam Study

PubMed Central

Akoudad, Saloua; Wolters, Frank J.; Viswanathan, Anand; de Bruijn, Renée F.; van der Lugt, Aad; Hofman, Albert; Koudstaal, Peter J.; Ikram, M. Arfan; Vernooij, Meike W.

2018-01-01

Importance Cerebral microbleeds are hypothesized downstream markers of brain damage caused by both vascular and amyloid pathological mechanisms. To date, it remains unclear whether their presence if associated with cognitive deterioration in the general population. Objective To determine whether microbleeds, and more specifically microbleed count and location, associate with an increased risk of cognitive impairment and dementia in the general population. Design Prospective population-based Rotterdam Study. Setting General community. Participants In the Rotterdam Study, we assessed presence, number, and location of microbleeds at baseline (2005–2011) on brain MRI of 4,841 participants aged ≥45 years. Participants underwent neuropsychological testing at two time points on average 5.9 years (SD 0.6) apart, and were followed for incident dementia throughout the study period until 2013. The association of microbleeds with cognitive decline and dementia was studied using multiple linear regression, linear mixed effects modeling, and Cox proportional hazards. Exposure cerebral microbleed presence, location, and number. Main outcomes cognitive decline and dementia. Results Microbleed prevalence was 15.3% (median count 1 [1–88]). Presence of >4 microbleeds associated with cognitive decline. Lobar (with or without cerebellar) microbleeds were associated with decline in executive functions, information processing, and memory function, whereas microbleeds in other brain regions were associated with decline in information processing and motor speed. After mean follow-up of 4.8 years (SD 1.4), 72 people developed dementia, of whom 53 had Alzheimer’s disease. Presence of microbleeds was associated with an increased risk of dementia (age, sex, education adjusted HR 2.02, 95%CI 1.25;3.24), including Alzheimer’s dementia (HR 2.10, 95%CI 1.21;3.64). Conclusions and relevance In the general population, a high microbleed count associated with an increased risk of cognitive deterioration and dementia. Microbleeds thus mark the presence of diffuse vascular and neurodegenerative brain damage. PMID:27271785

Doubly robust estimation of generalized partial linear models for longitudinal data with dropouts.

PubMed

Lin, Huiming; Fu, Bo; Qin, Guoyou; Zhu, Zhongyi

2017-12-01

We develop a doubly robust estimation of generalized partial linear models for longitudinal data with dropouts. Our method extends the highly efficient aggregate unbiased estimating function approach proposed in Qu et al. (2010) to a doubly robust one in the sense that under missing at random (MAR), our estimator is consistent when either the linear conditional mean condition is satisfied or a model for the dropout process is correctly specified. We begin with a generalized linear model for the marginal mean, and then move forward to a generalized partial linear model, allowing for nonparametric covariate effect by using the regression spline smoothing approximation. We establish the asymptotic theory for the proposed method and use simulation studies to compare its finite sample performance with that of Qu's method, the complete-case generalized estimating equation (GEE) and the inverse-probability weighted GEE. The proposed method is finally illustrated using data from a longitudinal cohort study. © 2017, The International Biometric Society.

Ab initio calculations of the elastic and thermodynamic properties of gold under pressure

NASA Astrophysics Data System (ADS)

Smirnov, N. A.

2017-03-01

The paper presents first-principles FP-LMTO calculations on the relative stability of fcc, bcc, hcp and dhcp gold under pressure. They were done in local density approximation (LDA), as well as in generalized gradient approximation (GGA) with and without spin-orbit interaction. Phonon spectra for the considered gold structures were obtained from LDA calculations within linear response theory and the contribution of lattice vibrations to the free energy of the system was determined in quasiharmonic approximation. Our thorough adjustment of FP-LMTO internal parameters (linearization and tail energies, the MT-sphere radius) helped us to obtain results that agree well with the available experimental phase relation Dubrovinsky et al (2007 Phys. Rev. Lett. 98 045503) between fcc and hcp structures of gold under pressure. The calculations suggest that gold compressed at room temperature successively undergoes the following structural changes: fcc\\to hcp\\to bcc . The paper also presents the calculated elastic constants of fcc, bcc and hcp Au, the principal Hugoniot and the melting curve. Calculated results were used to construct the PT-diagram which describes the relative stability of the gold structures under study up to 500 GPa.

Evaluation of the site effect with Heuristic Methods

NASA Astrophysics Data System (ADS)

Torres, N. N.; Ortiz-Aleman, C.

2017-12-01

The seismic site response in an area depends mainly on the local geological and topographical conditions. Estimation of variations in ground motion can lead to significant contributions on seismic hazard assessment, in order to reduce human and economic losses. Site response estimation can be posed as a parameterized inversion approach which allows separating source and path effects. The generalized inversion (Field and Jacob, 1995) represents one of the alternative methods to estimate the local seismic response, which involves solving a strongly non-linear multiparametric problem. In this work, local seismic response was estimated using global optimization methods (Genetic Algorithms and Simulated Annealing) which allowed us to increase the range of explored solutions in a nonlinear search, as compared to other conventional linear methods. By using the VEOX Network velocity records, collected from August 2007 to March 2009, source, path and site parameters corresponding to the amplitude spectra of the S wave of the velocity seismic records are estimated. We can establish that inverted parameters resulting from this simultaneous inversion approach, show excellent agreement, not only in terms of adjustment between observed and calculated spectra, but also when compared to previous work from several authors.

Estimating the variance for heterogeneity in arm-based network meta-analysis.

PubMed

Piepho, Hans-Peter; Madden, Laurence V; Roger, James; Payne, Roger; Williams, Emlyn R

2018-04-19

Network meta-analysis can be implemented by using arm-based or contrast-based models. Here we focus on arm-based models and fit them using generalized linear mixed model procedures. Full maximum likelihood (ML) estimation leads to biased trial-by-treatment interaction variance estimates for heterogeneity. Thus, our objective is to investigate alternative approaches to variance estimation that reduce bias compared with full ML. Specifically, we use penalized quasi-likelihood/pseudo-likelihood and hierarchical (h) likelihood approaches. In addition, we consider a novel model modification that yields estimators akin to the residual maximum likelihood estimator for linear mixed models. The proposed methods are compared by simulation, and 2 real datasets are used for illustration. Simulations show that penalized quasi-likelihood/pseudo-likelihood and h-likelihood reduce bias and yield satisfactory coverage rates. Sum-to-zero restriction and baseline contrasts for random trial-by-treatment interaction effects, as well as a residual ML-like adjustment, also reduce bias compared with an unconstrained model when ML is used, but coverage rates are not quite as good. Penalized quasi-likelihood/pseudo-likelihood and h-likelihood are therefore recommended. Copyright © 2018 John Wiley & Sons, Ltd.

Ab initio calculations of the elastic and thermodynamic properties of gold under pressure.

PubMed

Smirnov, N A

2017-03-15

The paper presents first-principles FP-LMTO calculations on the relative stability of fcc, bcc, hcp and dhcp gold under pressure. They were done in local density approximation (LDA), as well as in generalized gradient approximation (GGA) with and without spin-orbit interaction. Phonon spectra for the considered gold structures were obtained from LDA calculations within linear response theory and the contribution of lattice vibrations to the free energy of the system was determined in quasiharmonic approximation. Our thorough adjustment of FP-LMTO internal parameters (linearization and tail energies, the MT-sphere radius) helped us to obtain results that agree well with the available experimental phase relation Dubrovinsky et al (2007 Phys. Rev. Lett. 98 045503) between fcc and hcp structures of gold under pressure. The calculations suggest that gold compressed at room temperature successively undergoes the following structural changes: [Formula: see text]. The paper also presents the calculated elastic constants of fcc, bcc and hcp Au, the principal Hugoniot and the melting curve. Calculated results were used to construct the PT-diagram which describes the relative stability of the gold structures under study up to 500 GPa.

Causal Inference for fMRI Time Series Data with Systematic Errors of Measurement in a Balanced On/Off Study of Social Evaluative Threat.

PubMed

Sobel, Michael E; Lindquist, Martin A

2014-07-01

Functional magnetic resonance imaging (fMRI) has facilitated major advances in understanding human brain function. Neuroscientists are interested in using fMRI to study the effects of external stimuli on brain activity and causal relationships among brain regions, but have not stated what is meant by causation or defined the effects they purport to estimate. Building on Rubin's causal model, we construct a framework for causal inference using blood oxygenation level dependent (BOLD) fMRI time series data. In the usual statistical literature on causal inference, potential outcomes, assumed to be measured without systematic error, are used to define unit and average causal effects. However, in general the potential BOLD responses are measured with stimulus dependent systematic error. Thus we define unit and average causal effects that are free of systematic error. In contrast to the usual case of a randomized experiment where adjustment for intermediate outcomes leads to biased estimates of treatment effects (Rosenbaum, 1984), here the failure to adjust for task dependent systematic error leads to biased estimates. We therefore adjust for systematic error using measured "noise covariates" , using a linear mixed model to estimate the effects and the systematic error. Our results are important for neuroscientists, who typically do not adjust for systematic error. They should also prove useful to researchers in other areas where responses are measured with error and in fields where large amounts of data are collected on relatively few subjects. To illustrate our approach, we re-analyze data from a social evaluative threat task, comparing the findings with results that ignore systematic error.

Growing Up With the Right to Marry: Sexual Attraction, Substance Use, and Well-Being of Dutch Adolescents.

PubMed

Kuyper, Lisette; de Roos, Simone; Iedema, Jurjen; Stevens, Gonneke

2016-09-01

To assess the well-being and substance use of sexual minority adolescents growing up in a tolerant society, we examined differences among same-sex attracted (SSA), those who do not know their attraction yet (not yet attracted [NYA]), and heterosexual Dutch adolescents. Unadjusted and adjusted logistic and linear multilevel analyses were performed using representative data of the 2013 Health Behaviour in School-Aged Children study (N = 5,995; 11-16 years old). The adjusted analyses controlled for sociodemographics (gender, age, education type, ethnicity, urbanicity, and religion). Adjusted results showed that SSA adolescents substantially more often reported alcohol use (adjusted odds ratio [AOR] = 2.01), tobacco smoking (AOR = 2.37), and cannabis smoking (AOR = 3.52) than their heterosexual peers, while NYA participants less often reported alcohol use (AOR = .57) and equal levels of tobacco (AOR = .71) and cannabis smoking (AOR = .87) compared with heterosexual adolescents. SSA adolescents reported lower levels of life satisfaction (b = -1.25) and higher levels of psychosomatic complaints (b = .61) and emotional problems (b = 1.57) than heterosexual adolescents. NYA adolescents reported equal levels of life satisfaction (b = -.18) and psychosomatic complaints (b = .06) as heterosexual adolescents, but higher levels of emotional problems (b = .51). In Dutch society, with over 20 years of inclusive policies for sexual minorities and generally tolerant population attitudes toward sexual minorities, SSA adolescents are still at increased risk of substance use and have lower levels of well-being compared with peers. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Estimating regression to the mean and true effects of an intervention in a four-wave panel study.

PubMed

Gmel, Gerhard; Wicki, Matthias; Rehm, Jürgen; Heeb, Jean-Luc

2008-01-01

First, to analyse whether a taxation-related decrease in spirit prices had a similar effect on spirit consumption for low-, medium- and high-level drinkers. Secondly, as the relationship between baseline values and post-intervention changes is confounded with regression to the mean (RTM) effects, to apply different approaches for estimating the RTM effect and true change. Consumption of spirits and total alcohol consumption were analysed in a four-wave panel study (one pre-intervention and three post-intervention measurements) of 889 alcohol consumers sampled from the general population of Switzerland. Two correlational methods, one method quantitatively estimating the RTM effect and one growth curve approach based on hierarchical linear models (HLM), were used to estimate RTM effects among low-, medium- and high-level drinkers. Adjusted for RTM effects, high-level drinkers increased consumption more than lighter drinkers in the short term, but this was not a persisting effect. Changes in taxation affected mainly light and moderate drinkers in the long term. All methods concurred that RTM effects were present to a considerable degree, and methods quantifying the RTM effect or adjusting for it yielded similar estimates. Intervention studies have to consider RTM effects both in the study design and in the evaluation methods. Observed changes can be adjusted for RTM effects and true change can be estimated. The recommended method, particularly if the aim is to estimate change not only for the sample as a whole, but for groups of drinkers with different baseline consumption levels, is growth curve modelling. If reliability of measurement instruments cannot be increased, the incorporation of more than one pre-intervention measurement point may be a valuable adjustment of the study design.

Cost comparison between uterine-sparing fibroid treatments one year following treatment

PubMed Central

2014-01-01

Background To compare one-year all-cause and uterine fibroid (UF)-related direct costs in patients treated with one of the following three uterine-sparing procedures: magnetic resonance-guided focused ultrasound (MRgFUS), uterine artery embolization (UAE) and myomectomy. Methods This retrospective observational cohort study used healthcare claims for several million individuals with healthcare coverage from employers in the MarketScan Database for the period 2003–2010. UF patients aged 25–54 on their first UF procedure (index) date with 366-day baseline experience, 366-day follow-up period, continuous health plan enrollment during baseline and follow-up, and absence of any baseline UF procedures were included in the final sample. Cost outcomes were measured by allowed charges (sum of insurer-paid and patient-paid amounts). UF-related cost was defined as difference in mean cost between study cohorts and propensity-score-matched control cohorts without UF. Multivariate adjustment of cost outcomes was conducted using generalized linear models. Results The study sample comprised 14,426 patients (MRgFUS = 14; UAE = 4,092; myomectomy = 10,320) with a higher percent of older patients in MRgFUS cohort (71% vs. 50% vs. 12% in age-group 45–54, P < 0.001). Adjusted all-cause mean cost was lowest for MRgFUS ($19,763; 95% CI: $10,425-$38,694) followed by myomectomy ($20,407; 95% CI: $19,483-$21,381) and UAE ($25,019; 95% CI: $23,738-$26,376) but without statistical significance. Adjusted UF-related costs were also not significantly different between the three procedures. Conclusions Adjusted all-cause and UF-related costs at one year were not significantly different between patients undergoing MRgFUS, myomectomy and UAE. PMID:25512868

Acute health impacts of airborne particles estimated from satellite remote sensing.

PubMed

Wang, Zhaoxi; Liu, Yang; Hu, Mu; Pan, Xiaochuan; Shi, Jing; Chen, Feng; He, Kebin; Koutrakis, Petros; Christiani, David C

2013-01-01

Satellite-based remote sensing provides a unique opportunity to monitor air quality from space at global, continental, national and regional scales. Most current research focused on developing empirical models using ground measurements of the ambient particulate. However, the application of satellite-based exposure assessment in environmental health is still limited, especially for acute effects, because the development of satellite PM(2.5) model depends on the availability of ground measurements. We tested the hypothesis that MODIS AOD (aerosol optical depth) exposure estimates, obtained from NASA satellites, are directly associated with daily health outcomes. Three independent healthcare databases were used: unscheduled outpatient visits, hospital admissions, and mortality collected in Beijing metropolitan area, China during 2006. We use generalized linear models to compare the short-term effects of air pollution assessed by ground monitoring (PM(10)) with adjustment of absolute humidity (AH) and AH-calibrated AOD. Across all databases we found that both AH-calibrated AOD and PM(10) (adjusted by AH) were consistently associated with elevated daily events on the current day and/or lag days for cardiovascular diseases, ischemic heart diseases, and COPD. The relative risks estimated by AH-calibrated AOD and PM(10) (adjusted by AH) were similar. Additionally, compared to ground PM(10), we found that AH-calibrated AOD had narrower confidence intervals for all models and was more robust in estimating the current day and lag day effects. Our preliminary findings suggested that, with proper adjustment of meteorological factors, satellite AOD can be used directly to estimate the acute health impacts of ambient particles without prior calibrating to the sparse ground monitoring networks. Copyright © 2012 Elsevier Ltd. All rights reserved.

Surgeon length of service and risk-adjusted outcomes: linked observational analysis of the UK National Adult Cardiac Surgery Audit Registry and General Medical Council Register.

PubMed

Hickey, Graeme L; Grant, Stuart W; Freemantle, Nick; Cunningham, David; Munsch, Christopher M; Livesey, Steven A; Roxburgh, James; Buchan, Iain; Bridgewater, Ben

2014-09-01

To explore the relationship between in-hospital mortality following adult cardiac surgery and the time since primary clinical qualification for the responsible consultant cardiac surgeon (a proxy for experience). Retrospective analysis of prospectively collected national registry data over a 10-year period using mixed-effects multiple logistic regression modelling. Surgeon experience was defined as the time between the date of surgery and award of primary clinical qualification. UK National Health Service hospitals performing cardiac surgery between January 2003 and December 2012. All patients undergoing coronary artery bypass grafts and/or valve surgery under the care of a consultant cardiac surgeon. All-cause in-hospital mortality. A total of 292,973 operations performed by 273 consultant surgeons (with lengths of service from 11.2 to 42.0 years) were included. Crude mortality increased approximately linearly until 33 years service, before decreasing. After adjusting for case-mix and year of surgery, there remained a statistically significant (p=0.002) association between length of service and in-hospital mortality (odds ratio 1.013; 95% CI 1.005-1.021 for each year of 'experience'). Consultant cardiac surgeons take on increasingly complex surgery as they gain experience. With this progression, the incidence of adverse outcomes is expected to increase, as is demonstrated in this study. After adjusting for case-mix using the EuroSCORE, we observed an increased risk of mortality in patients operated on by longer serving surgeons. This finding may reflect under-adjustment for risk, unmeasured confounding or a real association. Further research into outcomes over the time course of surgeon's careers is required. © The Royal Society of Medicine.

Workplace bullying and mental distress - a prospective study of Norwegian employees.

PubMed

Finne, Live Bakke; Knardahl, Stein; Lau, Bjørn

2011-07-01

Using a prospective design, the objective of this study was to determine the relationship between workplace bullying and mental distress. Altogether, 1971 Norwegian employees, recruited from 20 organizations, answered questions regarding workplace bullying and mental distress at both baseline and follow-up. Baseline data were gathered between 2004-2006, and follow-up data were gathered between 2006-2009. The time-lag between baseline and follow-up was approximately two years for all the respondents in all the organizations. The factors measured in the study were individual characteristics, mental distress measured with the Hopkins Symptom Checklist (HSCL-10), self-reported workplace bullying measured with a single item from the General Nordic Questionnaire for Psychological and Social Factors at Work (QPSNordic) and job demands and job control assessed by QPSNordic. A multiple linear regression analysis adjusted for mental distress, sex, age, job demands and job control at baseline [β=0.05, 95% confidence interval (95% CI) 0.03-0.17] and a repeated measures ANOVA adjusted for sex and age [F(3,1965)=38.37; partial η (2)=0.06] showed that workplace bullying predicted mental distress. Furthermore, a multiple binary logistic regression analysis adjusted for bullying, sex, age, job demands and job control at baseline [odds ratio (OR) 2.30, 95% CI 1.43-3.69] showed that mental distress was a predictor of bullying. We found support for the notion that self-reported workplace bullying is a predictor of mental distress two years later. Bullying had an independent effect on mental distress after adjusting for job demands and job control. Mental distress was also found to be a predictor of bullying, indicating that the reverse relationship is also important.

Quality of life at diagnosis predicts overall survival in patients with aggressive lymphoma.

PubMed

Thompson, Carrie A; Yost, Kathleen J; Maurer, Matthew J; Allmer, Cristine; Farooq, Umar; Habermann, Thomas M; Inwards, David J; Macon, William R; Link, Brian K; Rosenthal, Allison C; Cerhan, James R

2018-06-03

Our aim was to evaluate whether quality of life (QOL) scores at diagnosis predict survival among patients with aggressive lymphoma. Newly diagnosed lymphoma patients were prospectively enrolled within 9 months of diagnosis in the University of Iowa/Mayo Clinic SPORE and systematically followed for event-free and overall survival (OS). QOL was measured with the Functional Assessment of Cancer Treatment-General (FACT-G), which measures 4 domains: physical, social/family, emotional, and functional well-being (WB); a single item Linear Analogue Self-Assessment (LASA) measuring overall QOL; and a spiritual WB LASA. From 9/2002 to 12/2009, 701 patients with aggressive lymphoma who completed baseline QOL questionnaires were enrolled. At a median follow-up of 71 months (range 6-128), 316 patients (45%) had an event and 228 patients (33%) died. All baseline QOL measures but emotional WB were significantly associated with OS (all P < 0.04); of which all but LASA spiritual remained significant after adjusting for IPI and NHL subtype. The strongest associations were with total FACT-G (adjusted HR = 0.86, 95% CI: 0.79-0.94, P = 0.00062) and functional WB (adjusted HR = 0.88, 95% CI: 0.83-0.93, P < .0001). QOL LASA was associated with OS (adjusted HR = 0.92, 95% CI: 0.87-0.97, P = 0.0041). Patients with clinically deficient QOL (overall QOL ≤50) had a median OS of 92 months compared with 121 months for patients with QOL >50 (P = 0.0004). In this large sample of patients with aggressive lymphoma, we found that baseline QOL is independently predictive of OS. QOL should be assessed as a prognostic factor in patients with aggressive lymphoma. Copyright © 2018 John Wiley & Sons, Ltd.

The association of endothelial function and tone by digital arterial tonometry with MRI left ventricular mass in African Americans: the Jackson Heart Study.

PubMed

Tripathi, Avnish; Benjamin, Emelia J; Musani, Solomon K; Hamburg, Naomi M; Tsao, Connie W; Saraswat, Arti; Vasan, Ramachandran S; Mitchell, Gary F; Fox, Ervin R

2017-05-01

Peripheral vascular endothelial dysfunction assessed by digital peripheral arterial tonometry (PAT) has been associated with risk for adverse cardiovascular events. We examined the relations of peripheral microvascular dysfunction and left ventricular mass in a community-based cohort of African Americans. We examined participants of the Jackson Heart Study who had PAT and cardiac magnetic resonance imaging evaluations between 2007 and 2013. Consistent with pertinent literature, left ventricular mass index (LVMI) was adjusted for body size by indexing to height 2.7 . Pearson's correlation and general linear regression analyses were used to relate reactive hyperemia index, baseline pulse amplitude (BPA), and augmentation index (markers of microvascular vasodilator function, baseline vascular pulsatility, and relative wave reflection, respectively) to LVMI after adjusting for traditional cardiovascular risk factors. A total of 440 participants (mean age 59 ± 10 years, 60% women) were included. Age- and sex-adjusted Pearson's correlation analysis suggested that natural log transformed LVMI was negatively correlated with reactive hyperemia index (coefficient: -0.114; P = .02) and positively correlated with BPA (coefficient: 0.272; P < .001). In multivariable analyses, higher log e LVMI was associated with higher BPA (β: 0.210; P = .03) after accounting for age, sex, body mass index, diabetes, hypertension, ratio of total cholesterol and high-density lipoprotein cholesterol, smoking, and history of cardiovascular disease. In a community-based sample of African Americans, higher baseline pulsatility measured by PAT was associated with higher LVMI by cardiac magnetic resonance imaging after adjusting for traditional risk factors. Copyright © 2017 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

Maternal biomass smoke exposure and birth weight in Malawi: Analysis of data from the 2010 Malawi Demographic and Health Survey.

PubMed

Milanzi, Edith B; Namacha, Ndifanji M

2017-06-01

Use of biomass fuels has been shown to contribute to ill health and complications in pregnancy outcomes such as low birthweight, neonatal deaths and mortality in developing countries. However, there is insufficient evidence of this association in the Sub-Saharan Africa and the Malawian population. We, therefore, investigated effects of exposure to biomass fuels on reduced birth weight in the Malawian population. We conducted a cross-sectional analysis using secondary data from the 2010 Malawi Demographic Health Survey with a total of 9124 respondents. Information on exposure to biomass fuels, birthweight, and size of child at birth as well as other relevant information on risk factors was obtained through a questionnaire. We used linear regression models for continuous birth weight outcome and logistic regression for the binary outcome. Models were systematically adjusted for relevant confounding factors. Use of high pollution fuels resulted in a 92 g (95% CI: -320.4; 136.4) reduction in mean birth weight compared to low pollution fuel use after adjustment for child, maternal as well as household characteristics. Full adjusted OR (95% CI) for risk of having size below average at birth was 1.29 (0.34; 4.48). Gender and birth order of child were the significant confounders factors in our adjusted models. We observed reduced birth weight in children whose mothers used high pollution fuels suggesting a negative effect of maternal exposure to biomass fuels on birth weight of the child. However, this reduction was not statistically significant. More carefully designed studies need to be carried out to explore effects of biomass fuels on pregnancy outcomes and health outcomes in general.

Preventive benefit of access to fluoridated water for young adults.

PubMed

Spencer, A John; Liu, Pingzhou; Armfield, Jason Mathew; Do, Loc Giang

2017-06-01

Water fluoridation has been repeatedly associated with lower caries experience in children but uncertainty still exists on strength and extent of the association into adulthood. To analyze the preventive effect of access to fluoridated water on dental caries among young adults. In 1991/92 a cross-section of South Australian children aged 5-17 were recruited. Parents provided information on residential history, socioeconomic status, and behaviors. Children were dentally examined. Across 2006/2011, these participants were traced and recruited to follow-up examination. Similar data were updated. Residential history was used to compute percent lifetime access to fluoridated water (%LAFW). The participants underwent examinations scoring tooth surfaces decayed, missing and filled due to caries (DMFS). Unadjusted and adjusted models were generated using generalized linear modeling to estimate rate ratios (RR). Half of the 1991/92 participants traced could be recruited (n = 1,221) aged 20-35 years. Mean DMFS was 5.57 (95 percent CI: 5.0-6.1). Adjusted RR of DMFS for %LAFW (Birth-2006) 0-75 percent against 100 percent was 1.26 (1.01-1.57). RRs for 0-75 percent against 100 percent of %LAFW (1991-2006) and %LAFW (Birth-2006) were higher than that for %LAFW (Birth-1991). However, these differences were small once the comparisons were adjusted for all covariates. Early life access to fluoridated water was not as strongly associated with caries outcomes than either full lifetime access or access across the more proximal years with the caries outcome of young adults, especially after adjustment for covariates which may become increasingly important across longer spans of the life course. © 2017 American Association of Public Health Dentistry.

Accounting for time- and space-varying changes in the gravity field to improve the network adjustment of relative-gravity data

USGS Publications Warehouse

Kennedy, Jeffrey R.; Ferre, Ty P.A.

2015-01-01

The relative gravimeter is the primary terrestrial instrument for measuring spatially and temporally varying gravitational fields. The background noise of the instrument—that is, non-linear drift and random tares—typically requires some form of least-squares network adjustment to integrate data collected during a campaign that may take several days to weeks. Here, we present an approach to remove the change in the observed relative-gravity differences caused by hydrologic or other transient processes during a single campaign, so that the adjusted gravity values can be referenced to a single epoch. The conceptual approach is an example of coupled hydrogeophysical inversion, by which a hydrologic model is used to inform and constrain the geophysical forward model. The hydrologic model simulates the spatial variation of the rate of change of gravity as either a linear function of distance from an infiltration source, or using a 3-D numerical groundwater model. The linear function can be included in and solved for as part of the network adjustment. Alternatively, the groundwater model is used to predict the change of gravity at each station through time, from which the accumulated gravity change is calculated and removed from the data prior to the network adjustment. Data from a field experiment conducted at an artificial-recharge facility are used to verify our approach. Maximum gravity change due to hydrology (observed using a superconducting gravimeter) during the relative-gravity field campaigns was up to 2.6 μGal d−1, each campaign was between 4 and 6 d and one month elapsed between campaigns. The maximum absolute difference in the estimated gravity change between two campaigns, two months apart, using the standard network adjustment method and the new approach, was 5.5 μGal. The maximum gravity change between the same two campaigns was 148 μGal, and spatial variation in gravity change revealed zones of preferential infiltration and areas of relatively high groundwater storage. The accommodation for spatially varying gravity change would be most important for long-duration campaigns, campaigns with very rapid changes in gravity and (or) campaigns where especially precise observed relative-gravity differences are used in the network adjustment.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schmidt, T.; Zimoch, D.

The operation of an APPLE II based undulator beamline with all its polarization states (linear horizontal and vertical, circular and elliptical, and continous variation of the linear vector) requires an effective description allowing an automated calculation of gap and shift parameter as function of energy and operation mode. The extension of the linear polarization range from 0 to 180 deg. requires 4 shiftable magnet arrrays, permitting use of the APU (adjustable phase undulator) concept. Studies for a pure fixed gap APPLE II for the SLS revealed surprising symmetries between circular and linear polarization modes allowing for simplified operation. A semi-analyticalmore » model covering all types of APPLE II and its implementation will be presented.« less

About APPLE II Operation

NASA Astrophysics Data System (ADS)

Schmidt, T.; Zimoch, D.

2007-01-01

The operation of an APPLE II based undulator beamline with all its polarization states (linear horizontal and vertical, circular and elliptical, and continous variation of the linear vector) requires an effective description allowing an automated calculation of gap and shift parameter as function of energy and operation mode. The extension of the linear polarization range from 0 to 180° requires 4 shiftable magnet arrrays, permitting use of the APU (adjustable phase undulator) concept. Studies for a pure fixed gap APPLE II for the SLS revealed surprising symmetries between circular and linear polarization modes allowing for simplified operation. A semi-analytical model covering all types of APPLE II and its implementation will be presented.

Caloric sweetener consumption and dyslipidemia among US adults.

PubMed

Welsh, Jean A; Sharma, Andrea; Abramson, Jerome L; Vaccarino, Viola; Gillespie, Cathleen; Vos, Miriam B

2010-04-21

Dietary carbohydrates have been associated with dyslipidemia, a lipid profile known to increase cardiovascular disease risk. Added sugars (caloric sweeteners used as ingredients in processed or prepared foods) are an increasing and potentially modifiable component in the US diet. No known studies have examined the association between the consumption of added sugars and lipid measures. To assess the association between consumption of added sugars and blood lipid levels in US adults. Cross-sectional study among US adults (n = 6113) from the National Health and Nutrition Examination Survey (NHANES) 1999-2006. Respondents were grouped by intake of added sugars using limits specified in dietary recommendations (< 5% [reference group], 5%-<10%, 10%-<17.5%, 17.5%-<25%, and > or = 25% of total calories). Linear regression was used to estimate adjusted mean lipid levels. Logistic regression was used to determine adjusted odds ratios of dyslipidemia. Interactions between added sugars and sex were evaluated. Adjusted mean high-density lipoprotein cholesterol (HDL-C), geometric mean triglycerides, and mean low-density lipoprotein cholesterol (LDL-C) levels and adjusted odds ratios of dyslipidemia, including low HDL-C levels (< 40 mg/dL for men; < 50 mg/dL for women), high triglyceride levels (> or = 150 mg/dL), high LDL-C levels (> or = 130 mg/dL), or high ratio of triglycerides to HDL-C (> 3.8). Results were weighted to be representative of the US population. A mean of 15.8% of consumed calories was from added sugars. Among participants consuming less than 5%, 5% to less than 17.5%, 17.5% to less than 25%, and 25% or greater of total energy as added sugars, adjusted mean HDL-C levels were, respectively, 58.7, 57.5, 53.7, 51.0, and 47.7 mg/dL (P < .001 for linear trend), geometric mean triglyceride levels were 105, 102, 111, 113, and 114 mg/dL (P < .001 for linear trend), and LDL-C levels modified by sex were 116, 115, 118, 121, and 123 mg/dL among women (P = .047 for linear trend). There were no significant trends in LDL-C levels among men. Among higher consumers (> or = 10% added sugars) the odds of low HDL-C levels were 50% to more than 300% greater compared with the reference group (< 5% added sugars). In this study, there was a statistically significant correlation between dietary added sugars and blood lipid levels among US adults.

School Performance: A Matter of Health or Socio-Economic Background? Findings from the PIAMA Birth Cohort Study

PubMed Central

Ruijsbroek, Annemarie; Wijga, Alet H.; Gehring, Ulrike; Kerkhof, Marjan; Droomers, Mariël

2015-01-01

Background Performance in primary school is a determinant of children’s educational attainment and their socio-economic position and health inequalities in adulthood. We examined the relationship between five common childhood health conditions (asthma symptoms, eczema, general health, frequent respiratory infections, and overweight), health related school absence and family socio-economic status on children’s school performance. Methods We used data from 1,865 children in the Dutch PIAMA birth cohort study. School performance was measured as the teacher’s assessment of a suitable secondary school level for the child, and the child’s score on a standardized achievement test (Cito Test). Both school performance indicators were standardised using Z-scores. Childhood health was indicated by eczema, asthma symptoms, general health, frequent respiratory infections, overweight, and health related school absence. Children’s health conditions were reported repeatedly between the age of one to eleven. School absenteeism was reported at age eleven. Highest attained educational level of the mother and father indicated family socio-economic status. We used linear regression models with heteroskedasticity-robust standard errors for our analyses with adjustment for sex of the child. Results The health indicators used in our study were not associated with children’s school performance, independently from parental educational level, with the exception of asthma symptoms (-0.03 z-score / -0.04 z-score with Cito Test score after adjusting for respectively maternal and paternal education) and missing more than 5 schooldays due to illness (-0.18 z-score with Cito Test score and -0.17 z-score with school level assessment after adjustment for paternal education). The effect estimates for these health indicators were much smaller though than the effect estimates for parental education, which was strongly associated with children’s school performance. Conclusion Children’s school performance was affected only slightly by a number of common childhood health problems, but was strongly associated with parental education. PMID:26247468

Physical activity level at work and risk of chronic low back pain: A follow-up in the Nord-Trøndelag Health Study.

PubMed

Heuch, Ingrid; Heuch, Ivar; Hagen, Knut; Zwart, John-Anker

2017-01-01

Physical activity in leisure time seems to reduce the risk of low back pain, but it is not known whether occupational activity, as recorded in a representative working population, produces a higher or lower risk. To study associations between physical activity level at work and risk of chronic low back pain. Associations were examined in a Norwegian prospective study using data from the HUNT2 and HUNT3 surveys carried out in the whole county of Nord-Trøndelag. Participants were 7580 women and 7335 men who supplied information about physical activity level at work. Levels considered were sedentary work, work involving walking but no heavy lifting, work involving walking and heavy lifting, and particularly strenuous physical work. Nobody in the cohort was affected by chronic low back pain at baseline. After 11 years, participants reported whether they suffered from chronic low back pain. Generalized linear modelling with adjustment for potential confounders was applied to assess associations with risk factors. In age-adjusted analyses both women and men showed statistically significant associations between physical activity at work and risk of chronic low back pain, suggesting positive relationships. For particularly strenuous physical work the relative risk of chronic low back pain was 1.30 (95% CI: 1.00-1.71) in women and 1.36 (95% CI 1.17-1.59) in men, compared to sedentary work. Women still showed a general association with activity level after adjustment for education, leisure time physical activity, BMI, smoking and occupational category. In men, the higher risk was only maintained for particularly strenuous work. In this cohort, women had a higher risk of chronic low back pain with work involving walking and heavy lifting or particularly strenuous work, compared to sedentary work. Men participating in particularly strenuous work also experienced a higher risk of chronic low back pain.

Estimating relative risks in multicenter studies with a small number of centers - which methods to use? A simulation study.

PubMed

Pedroza, Claudia; Truong, Van Thi Thanh

2017-11-02

Analyses of multicenter studies often need to account for center clustering to ensure valid inference. For binary outcomes, it is particularly challenging to properly adjust for center when the number of centers or total sample size is small, or when there are few events per center. Our objective was to evaluate the performance of generalized estimating equation (GEE) log-binomial and Poisson models, generalized linear mixed models (GLMMs) assuming binomial and Poisson distributions, and a Bayesian binomial GLMM to account for center effect in these scenarios. We conducted a simulation study with few centers (≤30) and 50 or fewer subjects per center, using both a randomized controlled trial and an observational study design to estimate relative risk. We compared the GEE and GLMM models with a log-binomial model without adjustment for clustering in terms of bias, root mean square error (RMSE), and coverage. For the Bayesian GLMM, we used informative neutral priors that are skeptical of large treatment effects that are almost never observed in studies of medical interventions. All frequentist methods exhibited little bias, and the RMSE was very similar across the models. The binomial GLMM had poor convergence rates, ranging from 27% to 85%, but performed well otherwise. The results show that both GEE models need to use small sample corrections for robust SEs to achieve proper coverage of 95% CIs. The Bayesian GLMM had similar convergence rates but resulted in slightly more biased estimates for the smallest sample sizes. However, it had the smallest RMSE and good coverage across all scenarios. These results were very similar for both study designs. For the analyses of multicenter studies with a binary outcome and few centers, we recommend adjustment for center with either a GEE log-binomial or Poisson model with appropriate small sample corrections or a Bayesian binomial GLMM with informative priors.

Ethnic differences in serum adipokine and C-reactive protein levels: the multiethnic cohort.

PubMed

Morimoto, Y; Conroy, S M; Ollberding, N J; Kim, Y; Lim, U; Cooney, R V; Franke, A A; Wilkens, L R; Hernandez, B Y; Goodman, M T; Henderson, B E; Kolonel, L N; Le Marchand, L; Maskarinec, G

2014-11-01

Ethnic disparities in metabolic disease risk may be the result of differences in circulating adipokines and inflammatory markers related to ethnic variations in obesity and body fat distribution. In a cross-sectional design, we compared serum levels of leptin, adiponectin, C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in control subjects (321 men and 930 women) from two nested case-control studies conducted within the Multiethnic Cohort Study consisting of whites, Japanese Americans (JA), Latinos, African Americans (AA) and Native Hawaiians (NH). General linear models were applied to evaluate ethnic differences in log-transformed serum biomarker levels before and after adjusting for body mass index (BMI) at cohort entry. In comparison to whites, significant ethnic differences were observed for all biomarkers except TNF-α. JA men and women had significantly lower leptin and CRP levels than whites, and JA women also had lower adiponectin levels. Leptin was significantly higher in AA women (P < 0.01), adiponectin was significantly lower in AA men and women (P = 0.02 and P < 0.001), and CRP and IL-6 were significantly higher in AA men and women. Lower adiponectin (P < 0.0001) and CRP (P = 0.03) levels were the only biomarkers in NH women that differed from whites; no statistically significant differences were seen for NH men and for Latino men and women. When adjusted for BMI at cohort entry, the differences between the lowest and the highest values across ethnic groups decreased for all biomarkers except adiponectin in men indicating that ethnic differences were partially due to weight status. These findings demonstrate the ethnic variations in circulating adipokine and CRP levels before and after adjustment for BMI. Given the limitation of BMI as a general measure of obesity, further investigation with visceral and subcutaneous adiposity measures are warranted to elucidate ethnicity-related differences in adiposity in relation to disparities in obesity-related disease risk.

School Performance: A Matter of Health or Socio-Economic Background? Findings from the PIAMA Birth Cohort Study.

PubMed

Ruijsbroek, Annemarie; Wijga, Alet H; Gehring, Ulrike; Kerkhof, Marjan; Droomers, Mariël

2015-01-01

Performance in primary school is a determinant of children's educational attainment and their socio-economic position and health inequalities in adulthood. We examined the relationship between five common childhood health conditions (asthma symptoms, eczema, general health, frequent respiratory infections, and overweight), health related school absence and family socio-economic status on children's school performance. We used data from 1,865 children in the Dutch PIAMA birth cohort study. School performance was measured as the teacher's assessment of a suitable secondary school level for the child, and the child's score on a standardized achievement test (Cito Test). Both school performance indicators were standardised using Z-scores. Childhood health was indicated by eczema, asthma symptoms, general health, frequent respiratory infections, overweight, and health related school absence. Children's health conditions were reported repeatedly between the age of one to eleven. School absenteeism was reported at age eleven. Highest attained educational level of the mother and father indicated family socio-economic status. We used linear regression models with heteroskedasticity-robust standard errors for our analyses with adjustment for sex of the child. The health indicators used in our study were not associated with children's school performance, independently from parental educational level, with the exception of asthma symptoms (-0.03 z-score / -0.04 z-score with Cito Test score after adjusting for respectively maternal and paternal education) and missing more than 5 schooldays due to illness (-0.18 z-score with Cito Test score and -0.17 z-score with school level assessment after adjustment for paternal education). The effect estimates for these health indicators were much smaller though than the effect estimates for parental education, which was strongly associated with children's school performance. Children's school performance was affected only slightly by a number of common childhood health problems, but was strongly associated with parental education.

Comparison of clinical burden between patients with erosive hand osteoarthritis and inflammatory arthritis in symptomatic community-dwelling adults: the Keele clinical assessment studies

PubMed Central

Kloppenburg, Margreet; Marshall, Michelle; Nicholls, Elaine; Rosendaal, Frits R.; van der Windt, Danielle A.; Peat, George

2013-01-01

Objective. To investigate in the general population the clinical impact of erosive OA in interphalangeal joints (IPJs) compared with symptomatic radiographic hand OA and inflammatory arthritis. Methods. Standardized assessments with hand radiographs were performed in participants of two population-based cohorts in North Staffordshire with hand symptoms lasting ≥1 day in the past month. Erosive OA was defined as the presence of an eroded or remodelled phase in ≥1 IPJ using the Verbruggen–Veys method. Radiographic hand OA was defined as the presence of ≥1 IPJ/first carpometacarpal joint with a Kellgren–Lawrence score of ≥2. Diagnoses of inflammatory arthritis were based on medical records. Hand pain and disability were assessed with the Australian/Canadian Hand Osteoarthritis Index (AUSCAN). Linear regression analyses were used to compare clinical determinants between groups and calculate mean differences with 95% CIs, adjusted for age and sex. Results. Of 1076 participants with hand symptoms [60% women, mean age 64.8 years (s.d. 8.3 years)]; 80 persons (7.4%) had erosive OA. The population prevalence of erosive OA in ≥1 IPJ was 2.4% (95% CI 1.8, 3.0). Persons with erosive OA reported more pain and disability than persons with symptomatic radiographic hand OA [adjusted mean difference 1.3 (95% CI 0.3, 2.3) and 2.3 (95% CI 0.4, 4.2), respectively]. Individuals with inflammatory arthritis (n = 44) reported more pain and disability than those with erosive OA [adjusted mean difference 1.7 (95% CI 0.05, 3.4) and 6.3 (95% CI 2.8, 9.9), respectively]. Conclusion. While erosive OA has a greater impact than symptomatic radiographic hand OA in the general population, it is not as severe in terms of hand pain and disability as inflammatory RA. PMID:24046470

Does size matter? Kidney transplant donor size determines kidney function among living donors

PubMed Central

Narasimhamurthy, Meenakshi; Smith, Lachlan M.; Machan, Jason T.; Reinert, Steven E.; Gohh, Reginald Y.; Dworkin, Lance D.; Merhi, Basma; Patel, Nikunjkumar; Beland, Michael D.

2017-01-01

Background Kidney donor outcomes are gaining attention, particularly as donor eligibility criteria continue to expand. Kidney size, a useful predictor of recipient kidney function, also likely correlates with donor outcomes. Although donor evaluation includes donor kidney size measurements, the association between kidney size and outcomes are poorly defined. Methods We examined the relationship between kidney size (body surface area-adjusted total volume, cortical volume and length) and renal outcomes (post-operative recovery and longer-term kidney function) among 85 kidney donors using general linear models and time-to-chronic kidney disease data. Results Donors with the largest adjusted cortical volume were more likely to achieve an estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m2 over a median 24-month follow-up than those with smaller cortical volumes (P <0.001), had a shorter duration of renal recovery (1.3–2.2 versus 32.5 days) and started with a higher eGFR at pre-donation (107–110 versus 91 mL/min/1.73 m2) and immediately post-nephrectomy (∼63 versus 50–51 mL/min/1.73 m2). Similar findings were seen with adjusted total volume and length. Conclusions Larger kidney donors were more likely to achieve an eGFR ≥60 mL/min/1.73 m2 with renal recovery over a shorter duration due to higher pre-donation and initial post-nephrectomy eGFRs. PMID:28638611

Physical activity and cognition in the northern Manhattan study.

PubMed

Willey, Joshua Z; Park Moon, Yeseon; Ruder, Rachel; Cheung, Yuen K; Sacco, Ralph L; Elkind, Mitchell S V; Wright, Clinton B

2014-01-01

To test the hypothesis that leisure time physical activity (PA) is associated with cognitive status. We assessed cognition using the Mini-Mental Status Examination (MMSE) at enrollment and using the modified Telephone Interview for Cognitive Status (TICS-m) administered annually since 2001 in the Northern Manhattan Study. Baseline measures of leisure time PA were collected via in-person questionnaires. Total PA was categorized into 3 groups based on the metabolic equivalent (MET) score, a composite of total reported intensity and time. We used linear regression models to examine the association of PA with MMSE, and generalized estimating equations for change in TICS-m over time. There were 3,298 stroke-free participants with MMSE data (mean MMSE 26.0 ± 3.8) and 2,279 with TICS-m scores available. Compared to no PA, those with the upper quartile of MET scores had greater baseline MMSE scores (adjusted β = 0.4, p = 0.01) but no association with change in TICS-m over time. There were interactions (p < 0.05) between PA and both insurance and education; compared to no PA, those in the upper quartile of MET scores had a greater MMSE score only among those with Medicaid/no insurance (adjusted β = 0.83, p = 0.0005) and those who did not complete high school (adjusted β = 0.68, p = 0.001). Increased levels of PA were associated with better baseline MMSE, particularly among those with socioeconomic disadvantages, but not with cognitive decline. © 2013 S. Karger AG, Basel.

Parental palliative cancer: psychosocial adjustment and health-related quality of life in adolescents participating in a German family counselling service

PubMed Central

2012-01-01

Background Parental palliative disease is a family affair, however adolescent's well-being and coping are still rarely considered. The objectives of this paper were a) to identify differences in psychosocial adjustment and health-related quality of life (HRQoL) among adolescents and young adults with parents suffering from palliative cancer or cancers in other disease stages, b) to relate psychosocial adjustment and health-related quality of life to adolescent coping, and c) to explore significant mediator and predictor variables. Methods Cross-sectional data were derived from a multi-site research study of families before child-centered counselling. N=86 adolescents and young adults were included, their mean age 13.78 years (sd 2.45), 56% being female. Performed analyses included ANCOVA, multiple linear regression, and mediation analysis. Results Adolescents with parents suffering from palliative cancers reported significantly less total psychosocial problems, and better overall HRQoL. There were no significant group differences regarding coping frequency and efficacy. Our set of coping items significantly mediated the effect of parental disease stage on psychosocial problems and HRQoL. Further, parental disease status and general family functioning predicted psychosocial problems (R2adj =.390) and HRQoL (R2adj =.239) best. Conclusion The study indicates distress among adolescents throughout the entire parental disease process. Our analysis suggests that counselling services could offer supportive interventions which focus particularly on adolescent coping as well as family functioning. PMID:23110440

Hospital-Level Factors Associated with Pediatric Emergency Department Return Visits.

PubMed

Pittsenbarger, Zachary; Thurm, Cary; Neuman, Mark; Spencer, Sandra; Simon, Harold; Gosdin, Craig; Shah, Samir; McClead, Richard; Stack, Anne; Alpern, Elizabeth

2017-07-01

Return visits (RVs) and RVs with admission (RVAs) are commonly used emergency department quality measures. Visit- and patient-level factors, including several social determinants of health, have been associated with RV rates, but hospital-specific factors have not been studied. To identify what hospital-level factors correspond with high RV and RVA rates. Multicenter mixed-methods study of hospital characteristics associated with RV and RVA rates. Pediatric Health Information System with survey of emergency department directors. Adjusted return rates were calculated with generalized linear mixed-effects models. Hospitals were categorized by adjusted RV and RVA rates for analysis. Twenty-four hospitals accounted for 1,456,377 patient visits with an overall adjusted RV rate of 3.7% and RVA rate of 0.7%. Hospitals with the highest RV rates served populations that were more likely to have government insurance and lower median household incomes and less likely to carry commercial insurance. Hospitals in the highest RV rate outlier group had lower pediatric emergency medicine specialist staffing, calculated as full-time equivalents per 10,000 patient visits: median (interquartile range) of 1.9 (1.5-2.1) versus 2.9 (2.2-3.6). There were no differences in hospital population characteristics or staffing by RVA groups. RV rates were associated with population social determinants of health and inversely related to staffing. Hospital-level variation may indicate population-level economic factors outside the control of the hospital and unrelated to quality of care. © 2017 Society of Hospital Medicine

Redesigning inpatient care: Testing the effectiveness of an accountable care team model.

PubMed

Kara, Areeba; Johnson, Cynthia S; Nicley, Amy; Niemeier, Michael R; Hui, Siu L

2015-12-01

US healthcare underperforms on quality and safety metrics. Inpatient care constitutes an immense opportunity to intervene to improve care. Describe a model of inpatient care and measure its impact. A quantitative assessment of the implementation of a new model of care. The graded implementation of the model allowed us to follow outcomes and measure their association with the dose of the implementation. Inpatient medical and surgical units in a large academic health center. Eight interventions rooted in improving interprofessional collaboration (IPC), enabling data-driven decisions, and providing leadership were implemented. Outcome data from August 2012 to December 2013 were analyzed using generalized linear mixed models for associations with the implementation of the model. Length of stay (LOS) index, case-mix index-adjusted variable direct costs (CMI-adjusted VDC), 30-day readmission rates, overall patient satisfaction scores, and provider satisfaction with the model were measured. The implementation of the model was associated with decreases in LOS index (P < 0.0001) and CMI-adjusted VDC (P = 0.0006). We did not detect improvements in readmission rates or patient satisfaction scores. Most providers (95.8%, n = 92) agreed that the model had improved the quality and safety of the care delivered. Creating an environment and framework in which IPC is fostered, performance data are transparently available, and leadership is provided may improve value on both medical and surgical units. These interventions appear to be well accepted by front-line staff. Readmission rates and patient satisfaction remain challenging. © 2015 Society of Hospital Medicine.

College student engaging in cyberbullying victimization: cognitive appraisals, coping strategies, and psychological adjustments.

PubMed

Na, Hyunjoo; Dancy, Barbara L; Park, Chang

2015-06-01

The study's purpose was to explore whether frequency of cyberbullying victimization, cognitive appraisals, and coping strategies were associated with psychological adjustments among college student cyberbullying victims. A convenience sample of 121 students completed questionnaires. Linear regression analyses found frequency of cyberbullying victimization, cognitive appraisals, and coping strategies respectively explained 30%, 30%, and 27% of the variance in depression, anxiety, and self-esteem. Frequency of cyberbullying victimization and approach and avoidance coping strategies were associated with psychological adjustments, with avoidance coping strategies being associated with all three psychological adjustments. Interventions should focus on teaching cyberbullying victims to not use avoidance coping strategies. Copyright © 2015 Elsevier Inc. All rights reserved.

How large are the consequences of covariate imbalance in cluster randomized trials: a simulation study with a continuous outcome and a binary covariate at the cluster level.

PubMed

Moerbeek, Mirjam; van Schie, Sander

2016-07-11

The number of clusters in a cluster randomized trial is often low. It is therefore likely random assignment of clusters to treatment conditions results in covariate imbalance. There are no studies that quantify the consequences of covariate imbalance in cluster randomized trials on parameter and standard error bias and on power to detect treatment effects. The consequences of covariance imbalance in unadjusted and adjusted linear mixed models are investigated by means of a simulation study. The factors in this study are the degree of imbalance, the covariate effect size, the cluster size and the intraclass correlation coefficient. The covariate is binary and measured at the cluster level; the outcome is continuous and measured at the individual level. The results show covariate imbalance results in negligible parameter bias and small standard error bias in adjusted linear mixed models. Ignoring the possibility of covariate imbalance while calculating the sample size at the cluster level may result in a loss in power of at most 25 % in the adjusted linear mixed model. The results are more severe for the unadjusted linear mixed model: parameter biases up to 100 % and standard error biases up to 200 % may be observed. Power levels based on the unadjusted linear mixed model are often too low. The consequences are most severe for large clusters and/or small intraclass correlation coefficients since then the required number of clusters to achieve a desired power level is smallest. The possibility of covariate imbalance should be taken into account while calculating the sample size of a cluster randomized trial. Otherwise more sophisticated methods to randomize clusters to treatments should be used, such as stratification or balance algorithms. All relevant covariates should be carefully identified, be actually measured and included in the statistical model to avoid severe levels of parameter and standard error bias and insufficient power levels.

Linear regression techniques for use in the EC tracer method of secondary organic aerosol estimation

NASA Astrophysics Data System (ADS)

Saylor, Rick D.; Edgerton, Eric S.; Hartsell, Benjamin E.

A variety of linear regression techniques and simple slope estimators are evaluated for use in the elemental carbon (EC) tracer method of secondary organic carbon (OC) estimation. Linear regression techniques based on ordinary least squares are not suitable for situations where measurement uncertainties exist in both regressed variables. In the past, regression based on the method of Deming [1943. Statistical Adjustment of Data. Wiley, London] has been the preferred choice for EC tracer method parameter estimation. In agreement with Chu [2005. Stable estimate of primary OC/EC ratios in the EC tracer method. Atmospheric Environment 39, 1383-1392], we find that in the limited case where primary non-combustion OC (OC non-comb) is assumed to be zero, the ratio of averages (ROA) approach provides a stable and reliable estimate of the primary OC-EC ratio, (OC/EC) pri. In contrast with Chu [2005. Stable estimate of primary OC/EC ratios in the EC tracer method. Atmospheric Environment 39, 1383-1392], however, we find that the optimal use of Deming regression (and the more general York et al. [2004. Unified equations for the slope, intercept, and standard errors of the best straight line. American Journal of Physics 72, 367-375] regression) provides excellent results as well. For the more typical case where OC non-comb is allowed to obtain a non-zero value, we find that regression based on the method of York is the preferred choice for EC tracer method parameter estimation. In the York regression technique, detailed information on uncertainties in the measurement of OC and EC is used to improve the linear best fit to the given data. If only limited information is available on the relative uncertainties of OC and EC, then Deming regression should be used. On the other hand, use of ROA in the estimation of secondary OC, and thus the assumption of a zero OC non-comb value, generally leads to an overestimation of the contribution of secondary OC to total measured OC.

Body mass index and waist circumference predict health-related quality of life, but not satisfaction with life, in the elderly.

PubMed

Wang, Lucy; Crawford, John D; Reppermund, Simone; Trollor, Julian; Campbell, Lesley; Baune, Bernhard T; Sachdev, Perminder; Brodaty, Henry; Samaras, Katherine; Smith, Evelyn

2018-06-07

While obesity has been linked with lower quality of life in the general adult population, the prospective effects of present obesity on future quality of life amongst the elderly is unclear. This article investigates the cross-sectional and longitudinal relationships between obesity and aspects of quality of life in community-dwelling older Australians. A 2-year longitudinal sample of community dwellers aged 70-90 years at baseline, derived from the Sydney Memory and Ageing Study (MAS), was chosen for the study. Of the 1037 participants in the original MAS sample, a baseline (Wave 1) sample of 926 and a 2-year follow-up (Wave 2) sample of 751 subjects were retained for these analyses. Adiposity was measured using body mass index (BMI) and waist circumference (WC). Quality of life was measured using the Assessment of Quality of Life (6 dimensions) questionnaire (AQoL-6D) as well as the Satisfaction with Life Scale (SWLS). Linear regression and analysis of covariance (ANCOVA) were used to examine linear and non-linear relationships between BMI and WC and measures of health-related quality of life (HRQoL) and satisfaction with life, adjusting for age, sex, education, asthma, osteoporosis, depression, hearing and visual impairment, mild cognitive impairment, physical activity, and general health. Where a non-linear relationship was found, established BMI or WC categories were used in ANCOVA. Greater adiposity was associated with lower HRQoL but not life satisfaction. Regression modelling in cross-sectional analyses showed that higher BMI and greater WC were associated with lower scores for independent living, relationships, and pain (i.e. worse pain) on the AQoL-6D. In planned contrasts within a series of univariate analyses, obese participants scored lower in independent living and relationships, compared to normal weight and overweight participants. Longitudinal analyses found that higher baseline BMI and WC were associated with lower independent living scores at Wave 2. Obesity is associated with and predicts lower quality of life in elderly adults aged 70-90 years, and the areas most affected are independent living, social relationships, and the experience of pain.

Design and Implement of Low Ripple and Quasi-digital Power Supply

NASA Astrophysics Data System (ADS)

Xiangli, Li; Yanjun, Wei; Hanhong, Qi; Yan, Ma

A switch linearity hybrid power supply based on single chip microcomputer is designed which merged the merits of the switching and linear power supply. Main circuit includes pre-regulator which works in switching mode and series regulator which works in linear mode. Two-stage regulation mode was adopted in the main circuit of the power. A single chip computer (SCM) and high resolution of series D/A and A/D converters are applied to control and measurement which achieved continuous adjustable and low ripple constant current or voltage power supply

Communications circuit including a linear quadratic estimator

DOEpatents

Ferguson, Dennis D.

2015-07-07

A circuit includes a linear quadratic estimator (LQE) configured to receive a plurality of measurements a signal. The LQE is configured to weight the measurements based on their respective uncertainties to produce weighted averages. The circuit further includes a controller coupled to the LQE and configured to selectively adjust at least one data link parameter associated with a communication channel in response to receiving the weighted averages.

37 CFR 258.1 - General.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Patents, Trademarks, and Copyrights COPYRIGHT OFFICE, LIBRARY OF CONGRESS COPYRIGHT ARBITRATION ROYALTY PANEL RULES AND PROCEDURES ADJUSTMENT OF ROYALTY FEE FOR SECONDARY TRANSMISSIONS BY SATELLITE CARRIERS § 258.1 General. This part 258 adjusts the rates of royalties payable under the compulsory license for...

ASSOCIATION OF KNEE PAIN WITH A REDUCTION IN THIGH MUSCLE STRENGTH – A CROSS-SECTIONAL ANALYSIS INCLUDING 4553 OSTEOARTHRITIS INITIATIVE PARTICIPANTS

PubMed Central

Ruhdorfer, Anja; Wirth, Wolfgang; Eckstein, Felix

2016-01-01

Objective To cross-sectionally determine the quantitative relationship of age-adjusted, sex-specific isometric knee extensor and flexor strength to patient-reported knee pain. Methods Difference of thigh muscle strength by age, and that of age-adjusted strength per unit increase on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) knee pain scale, was estimated from linear regression analysis of 4553 Osteoarthritis Initiative participants (58% women). Strata encompassing the minimal clinically important difference (MCID) in knee pain were compared to evaluate a potentially non-linear relationship between WOMAC pain levels and muscle strength. Results In Osteoarthritis Initiative participants without pain, the age-related difference in isometric knee extensor strength was −9.0%/−8.2% (women/men) per decade, and that of flexor strength was −11%/−6.9%. Differences in age-adjusted strength values for each unit of WOMAC pain (1/20) amounted to −1.9%/−1.6% for extensor and −2.5%/−1.7% for flexor strength. Differences in torque/weight for each unit of WOMAC pain ranged from −3.3 to − 2.1%. There was no indication of a non-linear relationship between pain and strength across the range of observed WOMAC values, and similar results were observed in women and men. Conclusion Each increase by 1/20 units in WOMAC pain was associated with a ~2% lower age-adjusted isometric extensor and flexor strength in either sex. As a reduction in muscle strength is known to prospectively increase symptoms in knee osteoarthritis and as pain appears to reduce thigh muscle strength, adequate therapy of pain and muscle strength is required in knee osteoarthritis patients to avoid a vicious circle of self-sustaining clinical deterioration. PMID:27836675

Traveling waves in an optimal velocity model of freeway traffic.

PubMed

Berg, P; Woods, A

2001-03-01

Car-following models provide both a tool to describe traffic flow and algorithms for autonomous cruise control systems. Recently developed optimal velocity models contain a relaxation term that assigns a desirable speed to each headway and a response time over which drivers adjust to optimal velocity conditions. These models predict traffic breakdown phenomena analogous to real traffic instabilities. In order to deepen our understanding of these models, in this paper, we examine the transition from a linear stable stream of cars of one headway into a linear stable stream of a second headway. Numerical results of the governing equations identify a range of transition phenomena, including monotonic and oscillating travelling waves and a time- dependent dispersive adjustment wave. However, for certain conditions, we find that the adjustment takes the form of a nonlinear traveling wave from the upstream headway to a third, intermediate headway, followed by either another traveling wave or a dispersive wave further downstream matching the downstream headway. This intermediate value of the headway is selected such that the nonlinear traveling wave is the fastest stable traveling wave which is observed to develop in the numerical calculations. The development of these nonlinear waves, connecting linear stable flows of two different headways, is somewhat reminiscent of stop-start waves in congested flow on freeways. The different types of adjustments are classified in a phase diagram depending on the upstream and downstream headway and the response time of the model. The results have profound consequences for autonomous cruise control systems. For an autocade of both identical and different vehicles, the control system itself may trigger formations of nonlinear, steep wave transitions. Further information is available [Y. Sugiyama, Traffic and Granular Flow (World Scientific, Singapore, 1995), p. 137].

Traveling waves in an optimal velocity model of freeway traffic

NASA Astrophysics Data System (ADS)

Berg, Peter; Woods, Andrew

2001-03-01

Car-following models provide both a tool to describe traffic flow and algorithms for autonomous cruise control systems. Recently developed optimal velocity models contain a relaxation term that assigns a desirable speed to each headway and a response time over which drivers adjust to optimal velocity conditions. These models predict traffic breakdown phenomena analogous to real traffic instabilities. In order to deepen our understanding of these models, in this paper, we examine the transition from a linear stable stream of cars of one headway into a linear stable stream of a second headway. Numerical results of the governing equations identify a range of transition phenomena, including monotonic and oscillating travelling waves and a time- dependent dispersive adjustment wave. However, for certain conditions, we find that the adjustment takes the form of a nonlinear traveling wave from the upstream headway to a third, intermediate headway, followed by either another traveling wave or a dispersive wave further downstream matching the downstream headway. This intermediate value of the headway is selected such that the nonlinear traveling wave is the fastest stable traveling wave which is observed to develop in the numerical calculations. The development of these nonlinear waves, connecting linear stable flows of two different headways, is somewhat reminiscent of stop-start waves in congested flow on freeways. The different types of adjustments are classified in a phase diagram depending on the upstream and downstream headway and the response time of the model. The results have profound consequences for autonomous cruise control systems. For an autocade of both identical and different vehicles, the control system itself may trigger formations of nonlinear, steep wave transitions. Further information is available [Y. Sugiyama, Traffic and Granular Flow (World Scientific, Singapore, 1995), p. 137].

Job strain and resting heart rate: a cross-sectional study in a Swedish random working sample.

PubMed

Eriksson, Peter; Schiöler, Linus; Söderberg, Mia; Rosengren, Annika; Torén, Kjell

2016-03-05

Numerous studies have reported an association between stressing work conditions and cardiovascular disease. However, more evidence is needed, and the etiological mechanisms are unknown. Elevated resting heart rate has emerged as a possible risk factor for cardiovascular disease, but little is known about the relation to work-related stress. This study therefore investigated the association between job strain, job control, and job demands and resting heart rate. We conducted a cross-sectional survey of randomly selected men and women in Västra Götalandsregionen, Sweden (West county of Sweden) (n = 1552). Information about job strain, job demands, job control, heart rate and covariates was collected during the period 2001-2004 as part of the INTERGENE/ADONIX research project. Six different linear regression models were used with adjustments for gender, age, BMI, smoking, education, and physical activity in the fully adjusted model. Job strain was operationalized as the log-transformed ratio of job demands over job control in the statistical analyses. No associations were seen between resting heart rate and job demands. Job strain was associated with elevated resting heart rate in the unadjusted model (linear regression coefficient 1.26, 95 % CI 0.14 to 2.38), but not in any of the extended models. Low job control was associated with elevated resting heart rate after adjustments for gender, age, BMI, and smoking (linear regression coefficient -0.18, 95 % CI -0.30 to -0.02). However, there were no significant associations in the fully adjusted model. Low job control and job strain, but not job demands, were associated with elevated resting heart rate. However, the observed associations were modest and may be explained by confounding effects.

A general solution for the registration of optical multispectral scanners

NASA Technical Reports Server (NTRS)

Rader, M. L.

1974-01-01

The paper documents a general theory for registration (mapping) of data sets gathered by optical scanners such as the ERTS satellite MSS and the Skylab S-192 MSS. This solution is generally applicable to scanners which have rotating optics. Navigation data and ground control points are used in a statistically weighted adjustment based on a mathematical model of the dynamics of the spacecraft and the scanner system. This adjustment is very similar to the well known photogrammetric adjustments used in aerial mapping. Actual tests have been completed on NASA aircraft 24 channel MSS data, and the results are very encouraging.

A computer package for the design and eigenproblem solution of damped linear multidegree of freedom systems

NASA Technical Reports Server (NTRS)

Ahmadian, M.; Inman, D. J.

1982-01-01

Systems described by the matrix differental equation are considered. An interactive design routine is presented for positive definite mass, damping, and stiffness matrices. Designing is accomplished by adjusting the mass, damping, and stiffness matrices to obtain a desired oscillation behavior. The algorithm also features interactively modifying the physical structure of the system, obtaining the matrix structure and a number of other system properties. In case of a general system, where the M, C, and K matrices lack any special properties, a routine for the eigenproblem solution of the system is developed. The latent roots are obtained by computing the characteristic polynomial of the system and solving for its roots. The above routines are prepared in FORTRAN IV and prove to be usable for the machines with low core memory.

Hair mercury concentrations and in vitro fertilization (IVF) outcomes among women from a fertility clinic

PubMed Central

Ehrlich, Shelley; Smith, Kristen; Williams, Paige L.; Chavarro, Jorge E.; Batsis, Maria; Toth, Thomas L.; Hauser, Russ

2015-01-01

Total hair mercury (Hg) was measured among 205 women undergoing in vitro fertilization (IVF) treatment and the association with prospectively collected IVF outcomes (229 IVF cycles) was evaluated. Hair Hg levels (median=0.62 ppm, range: 0.03-5.66 ppm) correlated with fish intake (r=0.59), and exceeded the recommended EPA reference of 1ppm in 33% of women. Generalized linear mixed models with random intercepts accounting for within-woman correlations across treatment cycles were used to evaluate the association of hair Hg with IVF outcomes adjusted for age, body mass index, race, smoking status, infertility diagnosis, and protocol type. Hair Hg levels were not related to ovarian stimulation outcomes (peak estradiol levels, total and mature oocyte yields) or to fertilization rate, embryo quality, clinical pregnancy rate or live birth rate. PMID:25601638

Maternal and Paternal Age are Jointly Associated with Childhood Autism in Jamaica

PubMed Central

Samms-Vaughan, Maureen; Loveland, Katherine A.; Pearson, Deborah A.; Bressler, Jan; Chen, Zhongxue; Ardjomand-Hessabi, Manouchehr; Shakespeare-Pellington, Sydonnie; Grove, Megan L.; Beecher, Compton; Bloom, Kari; Boerwinkle, Eric

2013-01-01

Several studies have reported maternal and paternal age as risk factors for having a child with Autism Spectrum Disorder (ASD), yet the results remain inconsistent. We used data for 68 age- and sex-matched case–control pairs collected from Jamaica. Using Multivariate General Linear Models (MGLM) and controlling for parity, gestational age, and parental education, we found a significant (p < 0.0001) joint effect of parental ages on having children with ASD indicating an adjusted mean paternal age difference between cases and controls of [5.9 years; 95% CI (2.6, 9.1)] and a difference for maternal age of [6.5 years; 95% CI (4.0, 8.9)]. To avoid multicollinearity in logistic regression, we recommend joint modeling of parental ages as a vector of outcome variables using MGLM. PMID:22230961

Aging expectations are associated with physical activity and health among older adults of low socioeconomic status.

PubMed

Dogra, Shilpa; Al-Sahab, Ban; Manson, James; Tamim, Hala

2015-04-01

The purpose of the current study was to determine whether aging expectations (AE) are associated with physical activity participation and health among older adults of low socioeconomic status (SES). A cross-sectional analysis of a sample of 170 older adults (mean age 70.9 years) was conducted. Data on AE, physical activity, and health were collected using the 12 item Expectations Regarding Aging instrument, the Healthy Physical Activity Participation Questionnaire, and the Short Form-36, respectively. Adjusted linear regression models showed significant associations between AE and social functioning, energy/vitality, mental health, and self-rated general health, as well as physical activity. These results suggest that AE may help to better explain the established association between low SES, low physical activity uptake, and poor health outcomes among older adults.

An Experimental Evaluation of Generalized Predictive Control for Tiltrotor Aeroelastic Stability Augmentation in Airplane Mode of Flight

NASA Technical Reports Server (NTRS)

Kvaternik, Raymond G.; Piatak, David J.; Nixon, Mark W.; Langston, Chester W.; Singleton, Jeffrey D.; Bennett, Richard L.; Brown, Ross K.

2001-01-01

The results of a joint NASA/Army/Bell Helicopter Textron wind-tunnel test to assess the potential of Generalized Predictive Control (GPC) for actively controlling the swashplate of tiltrotor aircraft to enhance aeroelastic stability in the airplane mode of flight are presented. GPC is an adaptive time-domain predictive control method that uses a linear difference equation to describe the input-output relationship of the system and to design the controller. The test was conducted in the Langley Transonic Dynamics Tunnel using an unpowered 1/5-scale semispan aeroelastic model of the V-22 that was modified to incorporate a GPC-based multi-input multi-output control algorithm to individually control each of the three swashplate actuators. Wing responses were used for feedback. The GPC-based control system was highly effective in increasing the stability of the critical wing mode for all of the conditions tested, without measurable degradation of the damping in the other modes. The algorithm was also robust with respect to its performance in adjusting to rapid changes in both the rotor speed and the tunnel airspeed.

Phase Response Design of Recursive All-Pass Digital Filters Using a Modified PSO Algorithm

PubMed Central

2015-01-01

This paper develops a new design scheme for the phase response of an all-pass recursive digital filter. A variant of particle swarm optimization (PSO) algorithm will be utilized for solving this kind of filter design problem. It is here called the modified PSO (MPSO) algorithm in which another adjusting factor is more introduced in the velocity updating formula of the algorithm in order to improve the searching ability. In the proposed method, all of the designed filter coefficients are firstly collected to be a parameter vector and this vector is regarded as a particle of the algorithm. The MPSO with a modified velocity formula will force all particles into moving toward the optimal or near optimal solution by minimizing some defined objective function of the optimization problem. To show the effectiveness of the proposed method, two different kinds of linear phase response design examples are illustrated and the general PSO algorithm is compared as well. The obtained results show that the MPSO is superior to the general PSO for the phase response design of digital recursive all-pass filter. PMID:26366168

Intensity-hue-saturation-based image fusion using iterative linear regression

NASA Astrophysics Data System (ADS)

Cetin, Mufit; Tepecik, Abdulkadir

2016-10-01

The image fusion process basically produces a high-resolution image by combining the superior features of a low-resolution spatial image and a high-resolution panchromatic image. Despite its common usage due to its fast computing capability and high sharpening ability, the intensity-hue-saturation (IHS) fusion method may cause some color distortions, especially when a large number of gray value differences exist among the images to be combined. This paper proposes a spatially adaptive IHS (SA-IHS) technique to avoid these distortions by automatically adjusting the exact spatial information to be injected into the multispectral image during the fusion process. The SA-IHS method essentially suppresses the effects of those pixels that cause the spectral distortions by assigning weaker weights to them and avoiding a large number of redundancies on the fused image. The experimental database consists of IKONOS images, and the experimental results both visually and statistically prove the enhancement of the proposed algorithm when compared with the several other IHS-like methods such as IHS, generalized IHS, fast IHS, and generalized adaptive IHS.

Method and apparatus for assembling solid oxide fuel cells

DOEpatents

Szreders, B.E.; Campanella, N.

1988-05-11

This invention relates generally to solid oxide fuel power generators and is particularly directed to improvements in the assembly and coupling of solid oxide fuel cell modules. A plurality of jet air tubes are supported and maintained in a spaced matrix array by a positioning/insertion assembly for insertion in respective tubes of a solid oxide fuel cell (SOFC) in the assembly of an SOFC module. The positioning/insertion assembly includes a plurality of generally planar, elongated, linear vanes which are pivotally mounted at each end thereof to a support frame. A rectangular compression assembly of adjustable size is adapted to receive and squeeze a matrix of SOFC tubes so as to compress the inter-tube nickel felt conductive pads which provide series/parallel electrical connection between adjacent SOFCs, with a series of increasingly larger retainer frames used to maintain larger matrices of SOFC tubes in position. Expansion of the SOFC module housing at the high operating temperatures of the SOFC is accommodated by conductive, flexible, resilient expansion, connector bars which provide support and electrical coupling at the top and bottom of the SOFC module housing. 17 figs.

Food Security Status is related to Mental Health Quality of Life among Persons Living with HIV

PubMed Central

Hatsu, Irene; Hade, Erinn; Campa, Adriana

2016-01-01

This study evaluated the association between health related quality of life and food security among persons living with HIV (PLHIV). We studied 167 PLHIV who completed questionnaires assessing food security, disease symptomatology, and several domains of the SF-36 health related quality of life survey. HIV disease state was assessed from medical records. Associations between independent and outcome variables were determined through linear regression models. Compared to food security, very low food security was significantly associated with lower mental component summary scores, [average difference: −4.98 (95% CI: −9.85, −0.10; mental health, [average difference: −5.44 (95% CI: −10.08, −0.81); and general health, [average difference: −5.13 (95% CI: −9.65, −0.65)] after adjusting for covariates. About a fourth of participants experienced severe food insecurity, which negatively influenced their mental health and general wellbeing. The inclusion of resources for food assistance in HIV treatment programs may help ameliorate mental health challenges faced by PLHIV. PMID:27699597

An epidemiologic overview of 13 years of firearm hospitalizations in Pennsylvania.

PubMed

Gross, Brian W; Cook, Alan D; Rinehart, Cole D; Lynch, Caitlin A; Bradburn, Eric H; Bupp, Katherine A; Morrison, Chet A; Rogers, Frederick B

2017-04-01

Gun violence is a controversial public health issue plagued by a lack of recent research. We sought to provide a 13-y overview of firearm hospitalizations in Pennsylvania, analyzing trends in mode, intent, and outcome. We hypothesized that no adjusted change in mortality or functional status at discharge (FSD) would be observed for gunshot wound (GSW) victims over the study period. All admissions to the Pennsylvania Trauma Outcome Study database from 2003 to 2015 were queried. GSWs were identified by external cause-of-injury codes. Collected variables included patient demographics, firearm type, intent (assault and attempted suicide), FSD, and mortality. Multilevel mixed-effects logistic regression models and ordinal regression analyses using generalized linear mixed models assessed the impact of admission year (continuous) on adjusted mortality and FSD score, respectively. Significance was set at P < 0.05. Of the 462,081 patients presenting to Pennsylvania trauma centers from 2003 to 2015, 19,342 were GSWs (4.2%). Handguns were the most common weapon of injury (n = 7007; 86.7%) among cases with specified firearm type. Most GSWs were coded as assaults (n = 15,415; 79.7%), with suicide attempts accounting 1866 hospitalizations (9.2%). Suicide attempts were most prevalent among young and middle-aged white males, whereas assaults were more common in young black males. Rates of firearm hospitalizations decreased over time (test of trend P = 0.001); however, admission year was not associated with improved adjusted survival (adjusted odds ratio: 0.99, 95% confidence interval: 0.97-1.01; P = 0.353) or FSD (adjusted odds ratio: 0.99, 95% confidence interval: 0.98-1.00; P = 0.089) while controlling for demographic and injury severity covariates. Temporal trends in outcomes suggest rates of firearm hospitalizations are declining in Pennsylvania; however, outcomes remain unchanged. To combat this epidemic, a multidisciplinary, demographic-specific approach to prevention should be the focus of future scientific pursuits. Copyright © 2016 Elsevier Inc. All rights reserved.

Smoking is associated with increased resting energy expenditure in the general population: The NEO study.

PubMed

Blauw, Lisanne L; Boon, Mariëtte R; Rosendaal, Frits R; de Mutsert, Renée; Gast, Karin B; van Dijk, Ko Willems; Rensen, Patrick C N; Dekkers, Olaf M

2015-11-01

Animal studies and human studies in small selected populations have shown a positive association between nicotine smoking and resting energy expenditure (REE), but data in large cohorts are lacking. We aimed to investigate the association between smoking behavior and REE in a large, population-based study. Population-based cross-sectional study. In this cross-sectional analysis of baseline measurements from the Netherlands Epidemiology of Obesity (NEO) study (n=6673), we included participants with REE measurement by indirect calorimetry who were not using lipid or glucose lowering drugs (n=1189). We used linear regression analysis to examine the association of smoking status (never, former, occasional, current smoker) and smoking quantity (pack years) with REE per kilogram (kg) fat free mass (FFM) and with REE adjusted for FFM. Models were adjusted for age, sex, ethnicity, educational level, physical activity, energy intake and body mass index (BMI). Mean (standard deviation, SD) age was 55.2 (5.9) years and BMI was 26.3 (4.4) kg/m(2). 60% of the participants were women. Mean (SD) REE/FFM (kcal/day/kg FFM) was for male never smokers 25.1 (2.0), male current smokers 26.4 (2.8), female never smokers 28.9 (2.5) and female current smokers 30.1 (3.7). After adjustment, only current smokers had a higher REE/FFM (mean difference 1.28, 95% CI 0.64, 1.92), and a higher REE adjusted for FFM (mean difference 60.3 kcal/day, 95% CI 29.1, 91.5), compared with never smokers. There was no association between pack years and REE/FFM (mean difference -0.01, 95% CI -0.06, 0.04) or REE adjusted for FFM (mean difference 0.2, 95% CI -2.4, 2.8) in current smokers. Current smoking is associated with a higher resting energy expenditure compared with never smoking in a large population-based cohort. Copyright © 2015 Elsevier Inc. All rights reserved.

A Comparison of Anthropometric Measures for Assessing the Association between Body Size and Risk of Chronic Low Back Pain: The HUNT Study.

PubMed

Heuch, Ingrid; Heuch, Ivar; Hagen, Knut; Zwart, John-Anker

2015-01-01

Previous work indicates that overweight and obese individuals carry an increased risk of experiencing chronic low back pain (LBP). It is not known, however, how the association with body size depends on the choice of anthropometric measure used. This work compares relationships with LBP for several measures of body size. Different results may indicate underlying mechanisms for the association between body size and risk of LBP. In a cohort study, baseline information was collected in the community-based HUNT2 (1995-1997) and HUNT3 (2006-2008) surveys in Norway. Participants were 10,059 women and 8725 men aged 30-69 years without LBP, and 3883 women and 2662 men with LBP at baseline. Associations with LBP at end of follow-up were assessed by generalized linear modeling, with adjustment for potential confounders. Relationships between waist-hip-ratio and occurrence of LBP at end of follow-up were weak and non-significant after adjustment for age, education, work status, physical activity, smoking, lipid levels and blood pressure. Positive associations with LBP at end of follow-up were all significant for body weight, BMI, waist circumference and hip circumference after similar adjustment, both in women without and with LBP at baseline, and in men without LBP at baseline. After additional mutual adjustment for anthropometric measures, the magnitude of the association with body weight increased in women without LBP at baseline (RR: 1.130 per standard deviation, 95% CI: 0.995-1.284) and in men (RR: 1.124, 95% CI 0.976-1.294), with other measures showing weak associations only. Central adiposity is unlikely to play a major role in the etiology of LBP. Total fat mass may be one common factor underlying the associations observed. The association with body weight remaining after mutual adjustment may reflect mechanical or structural components behind the relationship between overweight or obesity and LBP.

Staphylococcus aureus bloodstream infections in Latin America: results of a multinational prospective cohort study.

PubMed

Seas, Carlos; Garcia, Coralith; Salles, Mauro J; Labarca, Jaime; Luna, Carlos; Alvarez-Moreno, Carlos; Mejía-Villatoro, Carlos; Zurita, Jeannete; Guzmán-Blanco, Manuel; Rodríguez-Noriega, Eduardo; Reyes, Jinnethe; Arias, Cesar A; Carcamo, Cesar; Gotuzzo, Eduardo

2018-01-01

Substantial heterogeneity in the epidemiology and management of Staphylococcus aureus bacteraemia (SAB) occurs in Latin America. We conducted a prospective cohort study in 24 hospitals from nine Latin American countries. To assess the clinical impact of SAB in Latin America. We evaluated differences in the 30 day attributable mortality among patients with SAB due to MRSA compared with MSSA involving 84 days of follow-up. Adjusted relative risks were calculated using a generalized linear model. A total of 1030 patients were included. MRSA accounted for 44.7% of cases with a heterogeneous geographical distribution. MRSA infection was associated with higher 30 day attributable mortality [25% (78 of 312) versus 13.2% (48 of 363), adjusted RR: 1.94, 95% CI: 1.38-2.73, P < 0.001] compared with MSSA in the multivariable analysis based on investigators' assessment, but not in a per-protocol analysis [13% (35 of 270) versus 8.1% (28 of 347), adjusted RR: 1.10, 95% CI: 0.75-1.60, P = 0.616] or in a sensitivity analysis using 30 day all-cause mortality [36% (132 of 367) versus 27.8% (123 of 442), adjusted RR: 1.09, 95% CI: 0.96-1.23, P = 0.179]. MRSA infection was not associated with increased length of hospital stay. Only 49% of MSSA bloodstream infections (BSI) received treatment with β-lactams, but appropriate definitive treatment was not associated with lower mortality (adjusted RR: 0.93, 95% CI: 0.70-1.23, P = 0.602). MRSA-BSIs in Latin America are not associated with higher 30 day mortality or longer length of stay compared with MSSA. Management of MSSA-BSIs was not optimal, but appropriate definitive therapy did not appear to influence mortality. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Calibration Adjustment of the Mid-infrared Analyzer for an Accurate Determination of the Macronutrient Composition of Human Milk.

PubMed

Billard, Hélène; Simon, Laure; Desnots, Emmanuelle; Sochard, Agnès; Boscher, Cécile; Riaublanc, Alain; Alexandre-Gouabau, Marie-Cécile; Boquien, Clair-Yves

2016-08-01

Human milk composition analysis seems essential to adapt human milk fortification for preterm neonates. The Miris human milk analyzer (HMA), based on mid-infrared methodology, is convenient for a unique determination of macronutrients. However, HMA measurements are not totally comparable with reference methods (RMs). The primary aim of this study was to compare HMA results with results from biochemical RMs for a large range of protein, fat, and carbohydrate contents and to establish a calibration adjustment. Human milk was fractionated in protein, fat, and skim milk by covering large ranges of protein (0-3 g/100 mL), fat (0-8 g/100 mL), and carbohydrate (5-8 g/100 mL). For each macronutrient, a calibration curve was plotted by linear regression using measurements obtained using HMA and RMs. For fat, 53 measurements were performed, and the linear regression equation was HMA = 0.79RM + 0.28 (R(2) = 0.92). For true protein (29 measurements), the linear regression equation was HMA = 0.9RM + 0.23 (R(2) = 0.98). For carbohydrate (15 measurements), the linear regression equation was HMA = 0.59RM + 1.86 (R(2) = 0.95). A homogenization step with a disruptor coupled to a sonication step was necessary to obtain better accuracy of the measurements. Good repeatability (coefficient of variation < 7%) and reproducibility (coefficient of variation < 17%) were obtained after calibration adjustment. New calibration curves were developed for the Miris HMA, allowing accurate measurements in large ranges of macronutrient content. This is necessary for reliable use of this device in individualizing nutrition for preterm newborns. © The Author(s) 2015.

Nondestructive Evaluation of Metallized Tape Bonds Formed by Tape Automated Bonding (TAB)

DTIC Science & Technology

1989-04-01

powered by micro-positioning linear actuators. 3) Interchangeable sample-holding fixtures mounted upon top of slide assembly. 4) Coverslip gantry mounted...Controller Unit 1) Motor power supplies 2) Motor output servo driver amplifiers 3) "Macro-language" command Interpreter 4) Two-way cormunications with...adjustments are manual knobs giving approximately one degree of tilt adjustment per turn. The servo controller has self-contained power supplies for

37 CFR 1.705 - Patent term adjustment determination.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., DEPARTMENT OF COMMERCE GENERAL RULES OF PRACTICE IN PATENT CASES Adjustment and Extension of Patent Term....18(e); and (2) A statement of the facts involved, specifying: (i) The correct patent term adjustment....703(a) through (e) for which an adjustment is sought and the adjustment as specified in § 1.703(f) to...

49 CFR 393.47 - Brake actuators, slack adjusters, linings/pads and drums/rotors.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 5 2010-10-01 2010-10-01 false Brake actuators, slack adjusters, linings/pads and..., slack adjusters, linings/pads and drums/rotors. (a) General requirements. Brake components must be... same size. (c) Slack adjusters. The effective length of the slack adjuster on each end of an axle must...

26 CFR 1.25A-0 - Table of contents.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Credit and Lifetime Learning Credit. (1) In general. (2) Hope Scholarship Credit. (3) Lifetime Learning...) Modified adjusted gross income defined. (3) Inflation adjustment. (d) Election. (e) Identification... conviction. (2) Examples. (e) Academic period for prepayments. (1) In general. (2) Example. (f) Effective...

37 CFR 256.1 - General.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Patents, Trademarks, and Copyrights COPYRIGHT OFFICE, LIBRARY OF CONGRESS COPYRIGHT ARBITRATION ROYALTY PANEL RULES AND PROCEDURES ADJUSTMENT OF ROYALTY FEE FOR CABLE COMPULSORY LICENSE § 256.1 General. This part establishes adjusted terms and rates for royalty payments in accordance with the provisions of 17...

77 FR 69442 - Federal Acquisition Regulation; Information Collection; Economic Price Adjustment

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-19

...; Information Collection; Economic Price Adjustment AGENCIES: Department of Defense (DOD), General Services... economic price adjustment. Public comments are particularly invited on: Whether this collection of..., Economic Price Adjustment by any of the following methods: Regulations.gov : http://www.regulations.gov...

MO-F-16A-02: Simulation of a Medical Linear Accelerator for Teaching Purposes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Carlone, M; Lamey, M; Anderson, R

Purpose: Detailed functioning of linear accelerator physics is well known. Less well developed is the basic understanding of how the adjustment of the linear accelerator's electrical components affects the resulting radiation beam. Other than the text by Karzmark, there is very little literature devoted to the practical understanding of linear accelerator functionality targeted at the radiotherapy clinic level. The purpose of this work is to describe a simulation environment for medical linear accelerators with the purpose of teaching linear accelerator physics. Methods: Varian type lineacs were simulated. Klystron saturation and peak output were modelled analytically. The energy gain of anmore » electron beam was modelled using load line expressions. The bending magnet was assumed to be a perfect solenoid whose pass through energy varied linearly with solenoid current. The dose rate calculated at depth in water was assumed to be a simple function of the target's beam current. The flattening filter was modelled as an attenuator with conical shape, and the time-averaged dose rate at a depth in water was determined by calculating kerma. Results: Fifteen analytical models were combined into a single model called SIMAC. Performance was verified systematically by adjusting typical linac control parameters. Increasing klystron pulse voltage increased dose rate to a peak, which then decreased as the beam energy was further increased due to the fixed pass through energy of the bending magnet. Increasing accelerator beam current leads to a higher dose per pulse. However, the energy of the electron beam decreases due to beam loading and so the dose rate eventually maximizes and the decreases as beam current was further increased. Conclusion: SIMAC can realistically simulate the functionality of a linear accelerator. It is expected to have value as a teaching tool for both medical physicists and linear accelerator service personnel.« less

A study of the linear free energy model for DNA structures using the generalized Hamiltonian formalism

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yavari, M., E-mail: yavari@iaukashan.ac.ir

2016-06-15

We generalize the results of Nesterenko [13, 14] and Gogilidze and Surovtsev [15] for DNA structures. Using the generalized Hamiltonian formalism, we investigate solutions of the equilibrium shape equations for the linear free energy model.

40 CFR 1066.220 - Linearity verification.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., you must demonstrate to us that the deficiency does not adversely affect your ability to demonstrate... system at the specified temperatures and pressures. This may include any specified adjustment or periodic...

40 CFR 1066.220 - Linearity verification.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., you must demonstrate to us that the deficiency does not adversely affect your ability to demonstrate... system at the specified temperatures and pressures. This may include any specified adjustment or periodic...

Trajectories of the Framingham general cardiovascular risk profile in midlife and poor motor function later in life: the Whitehall II study.

PubMed

Elbaz, Alexis; Shipley, Martin J; Nabi, Hermann; Brunner, Eric J; Kivimaki, Mika; Singh-Manoux, Archana

2014-03-01

Vascular risk factors are associated with increased risk of cognitive impairment and dementia, but their association with motor function, another key feature of aging, has received little research attention. We examined the association between trajectories of the Framingham general cardiovascular disease risk score (FRS) over midlife and motor function later in life. A total of 5376 participants of the Whitehall II cohort study (29% women) who had up to four repeat measures of FRS between 1991-1993 (mean age=48.6 years) and 2007-2009 (mean age=65.4 years) and without history of stroke or coronary heart disease in 2007-2009 were included. Motor function was assessed in 2007-2009 through objective tests (walking speed, chair rises, balance, finger tapping, grip strength). We used age- and sex-adjusted linear mixed models. Participants with poorer performances for walking speed, chair rises, and balance in 2007-2009 had higher FRS concurrently and also in 1991-1993, on average 16 years earlier. These associations were robust to adjustment for cognition, socio-economic status, height, and BMI, and not explained by incident mobility limitation prior to motor assessment. No association was found with finger tapping and grip strength. Cardiovascular risk early in midlife is associated with poor motor performances later in life. Vascular risk factors play an important and under-recognized role in motor function, independently of their impact on cognition, and suggest that better control of vascular risk factors in midlife may prevent physical impairment and disability in the elderly. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Associations between mass media exposure and birth preparedness among women in southwestern Uganda: a community-based survey.

PubMed

Asp, Gustav; Odberg Pettersson, Karen; Sandberg, Jacob; Kabakyenga, Jerome; Agardh, Anette

2014-01-01

Exposure to mass media provides increased awareness and knowledge, as well as changes in attitudes, social norms and behaviors that may lead to positive public health outcomes. Birth preparedness (i.e. the preparations for childbirth made by pregnant women, their families, and communities) increases the use of skilled birth attendants (SBAs) and hence reduces maternal morbidity and mortality. The aim of this study was to explore the association between media exposure and birth preparedness in rural Uganda. A total of 765 recently delivered women from 120 villages in the Mbarara District of southwest Uganda were selected for a community-based survey using two-stage cluster sampling. Univariate and multivariate logistic regression was performed with generalized linear mixed models using SPSS 21. We found that 88.6% of the women surveyed listened to the radio and 33.9% read newspapers. Birth preparedness actions included were money saved (87.8%), identified SBA (64.3%), identified transport (60.1%), and purchased childbirth materials (20.7%). Women who had taken three or more actions were coded as well birth prepared (53.9%). Women who read newspapers were more likely to be birth prepared (adjusted OR 2.2, 95% CI 1.5-3.2). High media exposure, i.e. regular exposure to radio, newspaper, or television, showed no significant association with birth preparedness (adjusted OR 1.3, 95% CI 0.9-2.0). Our results indicate that increased reading of newspapers can enhance birth preparedness and skilled birth attendance. Apart from general literacy skills, this requires newspapers to be accessible in terms of language, dissemination, and cost.

Context-dependent urgency influences speed-accuracy trade-offs in decision-making and movement execution.

PubMed

Thura, David; Cos, Ignasi; Trung, Jessica; Cisek, Paul

2014-12-03

Speed-accuracy tradeoffs (SATs) exist in both decision-making and movement control, and are generally studied separately. However, in natural behavior animals are free to adjust the time invested in deciding and moving so as to maximize their reward rate. Here, we investigate whether shared mechanisms exist for SAT adjustment in both decisions and actions. Two monkeys performed a reach decision task in which they watched 15 tokens jump, one every 200 ms, from a central circle to one of two peripheral targets, and had to guess which target would ultimately receive the majority of tokens. The monkeys could decide at any time, and once a target was reached, the remaining token movements accelerated to either 50 ms ("fast" block) or 150 ms ("slow" block). Decisions were generally earlier and less accurate in fast than slow blocks, and in both blocks, the criterion of accuracy decreased over time within each trial. This could be explained by a simple model in which sensory information is combined with a linearly growing urgency signal. Remarkably, the duration of the reaching movements produced after the decision decreased over time in a similar block-dependent manner as the criterion of accuracy estimated by the model. This suggests that SATs for deciding and acting are influenced by a shared urgency/vigor signal. Consistent with this, we observed that the vigor of saccades performed during the decision process was higher in fast than in slow blocks, suggesting the influence of a context-dependent global arousal. Copyright © 2014 the authors 0270-6474/14/3416442-13$15.00/0.

Equivalence between a generalized dendritic network and a set of one-dimensional networks as a ground of linear dynamics.

PubMed

Koda, Shin-ichi

2015-05-28

It has been shown by some existing studies that some linear dynamical systems defined on a dendritic network are equivalent to those defined on a set of one-dimensional networks in special cases and this transformation to the simple picture, which we call linear chain (LC) decomposition, has a significant advantage in understanding properties of dendrimers. In this paper, we expand the class of LC decomposable system with some generalizations. In addition, we propose two general sufficient conditions for LC decomposability with a procedure to systematically realize the LC decomposition. Some examples of LC decomposable linear dynamical systems are also presented with their graphs. The generalization of the LC decomposition is implemented in the following three aspects: (i) the type of linear operators; (ii) the shape of dendritic networks on which linear operators are defined; and (iii) the type of symmetry operations representing the symmetry of the systems. In the generalization (iii), symmetry groups that represent the symmetry of dendritic systems are defined. The LC decomposition is realized by changing the basis of a linear operator defined on a dendritic network into bases of irreducible representations of the symmetry group. The achievement of this paper makes it easier to utilize the LC decomposition in various cases. This may lead to a further understanding of the relation between structure and functions of dendrimers in future studies.

16 CFR 1.98 - Adjustment of civil monetary penalty amounts.

Code of Federal Regulations, 2010 CFR

2010-01-01

... OF PRACTICE GENERAL PROCEDURES Civil Penalty Adjustments Under the Federal Civil Penalties Inflation... monetary penalty amounts. This section makes inflation adjustments in the dollar amounts of civil monetary...

A Study on the Relationships among Surface Variables to Adjust the Height of Surface Temperature for Data Assimilation.

NASA Astrophysics Data System (ADS)

Kang, J. H.; Song, H. J.; Han, H. J.; Ha, J. H.

2016-12-01

The observation processing system, KPOP (KIAPS - Korea Institute of Atmospheric Prediction Systems - Package for Observation Processing) have developed to provide optimal observations to the data assimilation system for the KIAPS Integrated Model (KIM). Currently, the KPOP has capable of processing almost all of observations for the KMA (Korea Meteorological Administration) operational global data assimilation system. The height adjustment of SURFACE observations are essential for the quality control due to the difference in height between observation station and model topography. For the SURFACE observation, it is usual to adjust the height using lapse rate or hypsometric equation, which decides values mainly depending on the difference of height. We have a question of whether the height can be properly adjusted following to the linear or exponential relationship solely with regard to the difference of height, with disregard the atmospheric conditions. In this study, firstly we analyse the change of surface variables such as temperature (T2m), pressure (Psfc), humidity (RH2m and Q2m), and wind components (U and V) according to the height difference. Additionally, we look further into the relationships among surface variables . The difference of pressure shows a strong linear relationship with difference of height. But the difference of temperature according to the height shows a significant correlation with difference of relative humidity than with the height difference. A development of reliable model for the height-adjustment of surface temperature is being undertaken based on the preliminary results.

Oligopolies with contingent workforce and unemployment insurance systems

NASA Astrophysics Data System (ADS)

Matsumoto, Akio; Merlone, Ugo; Szidarovszky, Ferenc

2015-10-01

In the recent literature the introduction of modified cost functions has added reality into the classical oligopoly analysis. Furthermore, the market evolution requires much more flexibility to firms, and in several countries contingent workforce plays an important role in the production choices by the firms. Therefore, an analysis of dynamic adjustment costs is in order to understand oligopoly dynamics. In this paper, dynamic single-product oligopolies without product differentiation are first examined with the additional consideration of production adjustment costs. Linear inverse demand and cost functions are considered and it is assumed that the firms adjust their outputs partially toward best response. The set of the steady states is characterized by a system of linear inequalities and there are usually infinitely many steady states. The asymptotic behavior of the output trajectories is examined by using computer simulation. The numerical results indicate that the resulting dynamics is richer than in the case of the classical Cournot model. This model and results are then compared to oligopolies with unemployment insurance systems when the additional cost is considered if firms do not use their maximum capacities.

75 FR 30730 - Atlantic Highly Migratory Species; Atlantic Bluefin Tuna Fisheries

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-02

...-XW54 Atlantic Highly Migratory Species; Atlantic Bluefin Tuna Fisheries AGENCY: National Marine... Atlantic tunas General category daily Atlantic bluefin tuna (BFT) retention limit should be adjusted for... criteria regarding inseason adjustments. This action applies to Atlantic tunas General category permitted...

26 CFR 1.9001-2 - Basis adjustments for taxable years beginning on or after 1956 adjustment date.

Code of Federal Regulations, 2010 CFR

2010-04-01

... on or after 1956 adjustment date. 1.9001-2 Section 1.9001-2 Internal Revenue INTERNAL REVENUE SERVICE....9001-2 Basis adjustments for taxable years beginning on or after 1956 adjustment date. (a) In general. Subsection (d) of the Act provides the basis adjustments required to be made by the taxpayer as of the 1956...

Integrating tracer-based metabolomics data and metabolic fluxes in a linear fashion via Elementary Carbon Modes.

PubMed

Pey, Jon; Rubio, Angel; Theodoropoulos, Constantinos; Cascante, Marta; Planes, Francisco J

2012-07-01

Constraints-based modeling is an emergent area in Systems Biology that includes an increasing set of methods for the analysis of metabolic networks. In order to refine its predictions, the development of novel methods integrating high-throughput experimental data is currently a key challenge in the field. In this paper, we present a novel set of constraints that integrate tracer-based metabolomics data from Isotope Labeling Experiments and metabolic fluxes in a linear fashion. These constraints are based on Elementary Carbon Modes (ECMs), a recently developed concept that generalizes Elementary Flux Modes at the carbon level. To illustrate the effect of our ECMs-based constraints, a Flux Variability Analysis approach was applied to a previously published metabolic network involving the main pathways in the metabolism of glucose. The addition of our ECMs-based constraints substantially reduced the under-determination resulting from a standard application of Flux Variability Analysis, which shows a clear progress over the state of the art. In addition, our approach is adjusted to deal with combinatorial explosion of ECMs in genome-scale metabolic networks. This extension was applied to infer the maximum biosynthetic capacity of non-essential amino acids in human metabolism. Finally, as linearity is the hallmark of our approach, its importance is discussed at a methodological, computational and theoretical level and illustrated with a practical application in the field of Isotope Labeling Experiments. Copyright © 2012 Elsevier Inc. All rights reserved.

Three estimates of the association between linear growth failure and cognitive ability.

PubMed

Cheung, Y B; Lam, K F

2009-09-01

To compare three estimators of association between growth stunting as measured by height-for-age Z-score and cognitive ability in children, and to examine the extent statistical adjustment for covariates is useful for removing confounding due to socio-economic status. Three estimators, namely random-effects, within- and between-cluster estimators, for panel data were used to estimate the association in a survey of 1105 pairs of siblings who were assessed for anthropometry and cognition. Furthermore, a 'combined' model was formulated to simultaneously provide the within- and between-cluster estimates. Random-effects and between-cluster estimators showed strong association between linear growth and cognitive ability, even after adjustment for a range of socio-economic variables. In contrast, the within-cluster estimator showed a much more modest association: For every increase of one Z-score in linear growth, cognitive ability increased by about 0.08 standard deviation (P < 0.001). The combined model verified that the between-cluster estimate was significantly larger than the within-cluster estimate (P = 0.004). Residual confounding by socio-economic situations may explain a substantial proportion of the observed association between linear growth and cognition in studies that attempt to control the confounding by means of multivariable regression analysis. The within-cluster estimator provides more convincing and modest results about the strength of association.

Serum bilirubin levels are inversely associated with PAI-1 and fibrinogen in Korean subjects.

PubMed

Cho, Hyun Sun; Lee, Sung Won; Kim, Eun Sook; Shin, Juyoung; Moon, Sung Dae; Han, Je Ho; Cha, Bong Yun

2016-01-01

Oxidative stress may contribute to atherosclerosis and increased activation of the coagulation pathway. Bilirubin may reduce activation of the hemostatic system to inhibit oxidative stress, which would explain its cardioprotective properties shown in many epidemiological studies. This study investigated the association of serum bilirubin with fibrinogen and plasminogen activator inhibitor-1 (PAI-1), respectively. A cross-sectional analysis was performed on 968 subjects (mean age, 56.0 ± 11.2 years; 61.1% men) undergoing a general health checkup. Serum biochemistry was analyzed including bilirubin subtypes, insulin resistance (using homeostasis model of assessment [HOMA]), C-reactive protein (CRP), fibrinogen, and PAI-1. Compared with subjects with a total bilirubin (TB) concentration of <10.0 μmol/L, those with a TB concentration of >17.1 μmol/L had a smaller waist circumference, a lower triglyceride level, a lower prevalence of metabolic syndrome, and decreased HOMA-IR and CRP levels. Correlation analysis revealed linear relationships of fibrinogen with TB and direct bilirubin (DB), whereas PAI-1 was correlated with DB. After adjustment for confounding factors, bilirubin levels were inversely associated with fibrinogen and PAI-1 levels, respectively. Multivariate regression models showed a negative linear relationship between all types of bilirubin and fibrinogen, whereas there was a significant linear relationship between PAI-1 and DB. High bilirubin concentrations were independently associated with low levels of fibrinogen and PAI-1, respectively. The association between TB and PAI-1 was confined to the highest TB concentration category whereas DB showed a linear association with PAI-1. Bilirubin may protect against the development of atherothrombosis by reducing the hemostatic response. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Characterizing the effect of summer temperature on heatstroke-related emergency ambulance dispatches in the Kanto area of Japan

NASA Astrophysics Data System (ADS)

Ng, Chris Fook Sheng; Ueda, Kayo; Ono, Masaji; Nitta, Hiroshi; Takami, Akinori

2014-07-01

Despite rising concern on the impact of heat on human health, the risk of high summer temperature on heatstroke-related emergency dispatches is not well understood in Japan. A time-series study was conducted to examine the association between apparent temperature and daily heatstroke-related ambulance dispatches (HSAD) within the Kanto area of Japan. A total of 12,907 HSAD occurring from 2000 to 2009 in five major cities—Saitama, Chiba, Tokyo, Kawasaki, and Yokohama—were analyzed. Generalized additive models and zero-inflated Poisson regressions were used to estimate the effects of daily maximum three-hour apparent temperature (AT) on dispatch frequency from May to September, with adjustment for seasonality, long-term trend, weekends, and public holidays. Linear and non-linear exposure effects were considered. Effects on days when AT first exceeded its summer median were also investigated. City-specific estimates were combined using random effects meta-analyses. Exposure-response relationship was found to be fairly linear. Significant risk increase began from 21 °C with a combined relative risk (RR) of 1.22 (95 % confidence interval, 1.03-1.44), increasing to 1.49 (1.42-1.57) at peak AT. When linear exposure was assumed, combined RR was 1.43 (1.37-1.50) per degree Celsius increment. Overall association was significant the first few times when median AT was initially exceeded in a particular warm season. More than two-thirds of these initial hot days were in June, implying the harmful effect of initial warming as the season changed. Risk increase that began early at the fairly mild perceived temperature implies the need for early precaution.

Characterizing the effect of summer temperature on heatstroke-related emergency ambulance dispatches in the Kanto area of Japan.

PubMed

Ng, Chris Fook Sheng; Ueda, Kayo; Ono, Masaji; Nitta, Hiroshi; Takami, Akinori

2014-07-01

Despite rising concern on the impact of heat on human health, the risk of high summer temperature on heatstroke-related emergency dispatches is not well understood in Japan. A time-series study was conducted to examine the association between apparent temperature and daily heatstroke-related ambulance dispatches (HSAD) within the Kanto area of Japan. A total of 12,907 HSAD occurring from 2000 to 2009 in five major cities-Saitama, Chiba, Tokyo, Kawasaki, and Yokohama-were analyzed. Generalized additive models and zero-inflated Poisson regressions were used to estimate the effects of daily maximum three-hour apparent temperature (AT) on dispatch frequency from May to September, with adjustment for seasonality, long-term trend, weekends, and public holidays. Linear and non-linear exposure effects were considered. Effects on days when AT first exceeded its summer median were also investigated. City-specific estimates were combined using random effects meta-analyses. Exposure-response relationship was found to be fairly linear. Significant risk increase began from 21 °C with a combined relative risk (RR) of 1.22 (95% confidence interval, 1.03-1.44), increasing to 1.49 (1.42-1.57) at peak AT. When linear exposure was assumed, combined RR was 1.43 (1.37-1.50) per degree Celsius increment. Overall association was significant the first few times when median AT was initially exceeded in a particular warm season. More than two-thirds of these initial hot days were in June, implying the harmful effect of initial warming as the season changed. Risk increase that began early at the fairly mild perceived temperature implies the need for early precaution.

26 CFR 1.56-0 - Table of contents to § 1.56-1, adjustment for book income of corporations.

Code of Federal Regulations, 2014 CFR

2014-04-01

... book income of corporations. 1.56-0 Section 1.56-0 Internal Revenue INTERNAL REVENUE SERVICE..., adjustment for book income of corporations. (a) Computation of the book income adjustment. (1) In general. (2) Taxpayers subject to the book income adjustment. (3) Consolidated returns. (4) Examples. (b) Adjusted net...

Association Between Hospitals Caring for a Disproportionately High Percentage of Minority Trauma Patients and Increased Mortality

PubMed Central

Haider, Adil H.; Ong’uti, Sharon; Efron, David T.; Oyetunji, Tolulope A.; Crandall, Marie L.; Scott, Valerie K.; Haut, Elliott R.; Schneider, Eric B.; Powe, Neil R.; Cooper, Lisa A.; Cornwell, Edward E.

2012-01-01

Objective To determine whether there is an increased odds of mortality among trauma patients treated at hospitals with higher proportions of minority patients (ie, black and Hispanic patients combined). Design Hospitals were categorized on the basis of the percentage of minority patients admitted with trauma. The adjusted odds of in-hospital mortality were compared between hospitals with less than 25% of patients who were minorities (the reference group) and hospitals with 25% to 50% of patients who were minorities and hospitals with more than 50% of patients who were minorities. Multivariate logistic regression (with generalized linear modeling and a cluster-correlated robust estimate of variance) was used to control for multiple patient and injury severity characteristics. Setting A total of 434 hospitals in the National Trauma Data Bank. Participants Patients aged 18 to 64 years whose medical records were included in the National Trauma Data Bank for the years 2007 and 2008 with an Injury Severity Score of 9 or greater and who were white, black, or Hispanic. Main Outcome Measures Crude mortality and adjusted odds of in-hospital mortality. Results A total of 311 568 patients were examined. Hospitals in which the percentage of minority patients was more than 50% also had younger patients, fewer female patients, more patients with penetrating trauma, and the highest crude mortality. After adjustment for potential confounders, patients treated at hospitals in which the percentage of minority patients was 25% to 50% and at hospitals in which the percentage of minority patients was more than 50% demonstrated increased odds of death (adjusted odds ratio, 1.16 [95% confidence interval, 1.01–1.34] and adjusted odds ratio, 1.37 [95% confidence interval, 1.16–1.61], respectively), compared with the reference group. This disparity increased further on subset analysis of patients with a blunt injury. Uninsured patients had significantly increased odds of mortality within all 3 hospital groups. Conclusions Patients treated at hospitals with higher proportions of minority trauma patients have increased odds of dying, even after adjusting for potential confounders. Differences in outcomes between trauma hospitals may partly explain racial disparities. PMID:21930976

General anesthesia in orthognathic surgeries: does it affect horizontal jaw relations?

PubMed

Yaghmaei, Masoud; Ejlali, Masoud; Nikzad, Sekieneh; Sayyedi, Ashraf; Shafaeifard, Shahrouz; Pourdanesh, Fereydoun

2013-10-01

The aim of this study was to evaluate the influence of general anesthesia on centric jaw relation (CR) records of orthognathic surgical patients in different postural positions. Fifty patients undergoing orthognathic surgery at Taleghani Hospital (Tehran, Iran) in 2008 were prospectively studied. CR records were obtained in conscious patients in 2 different positions (upright and supine) 1 day before surgery and in the supine position under general anesthesia. The impressions were made and the corresponding casts were mounted on a semiadjustable articulator. Differences were measured to the nearest 0.10 mm using a caliper. Paired t test and a general linear regression model were used for statistical analysis. Fifty patients (27 women and 23 men; mean age, 22.5 ± 3.5 yr) were enrolled. Angle Class I (group I), Class II (group II), and Class III (group III) malocclusions were detected in 16% (n = 8), 54% (n = 27), and 30% (n = 15) of patients, respectively. Although mean changes were smaller than 2 mm, statistically significant differences were found by paired t test in all Angle classification groups. No significant differences were found between the supine and conscious and the supine and unconscious patient positions in groups I and III (P > .05). However, in group II, this difference was statistically significant (P = .001). Regarding the impact of anesthesia on CR records of patients with different Angle classes, this study showed a significant effect, particularly in group II. Assessment of the outcome of interest (difference between the supine and conscious and the upright and conscious positions) versus position after adjustment for Angle class using a general linear regression model showed that the difference was significant only for Angle class (β = +0.29; t = 3.05; P = .003). General anesthesia may not adversely affect the mandibular condylar position in orthognathic patients in a supine position compared with a supine and conscious position. However, among all study groups, group II showed more significant changes in CR records under general anesthesia. Oral and maxillofacial surgeons should be well aware of such changes in these particular positions and avoid possible mismanagement and potential complications. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Impact of Residency Training Level on the Surgical Quality Following General Surgery Procedures.

PubMed

Loiero, Dominik; Slankamenac, Maja; Clavien, Pierre-Alain; Slankamenac, Ksenija

2017-11-01

To investigate the safety of surgical performance by residents of different training level performing common general surgical procedures. Data were consecutively collected from all patients undergoing general surgical procedures such as laparoscopic cholecystectomy, laparoscopic appendectomy, inguinal, femoral and umbilical hernia repair from 2005 to 2011 at the Department of Surgery of the University Hospital of Zurich, Switzerland. The operating surgeons were grouped into junior residents, senior residents and consultants. The comprehensive complication index (CCI) representing the overall number and severity of all postoperative complications served as primary safety endpoint. A multivariable linear regression analysis was used to analyze differences between groups. Additionally, we focused on the impact of senior residents assisting junior residents on postoperative outcome comparing to consultants. During the observed time, 2715 patients underwent a general surgical procedure. In 1114 times, a senior resident operated and in 669 procedures junior residents performed the surgery. The overall postoperative morbidity quantified by the CCI was for consultants 5.0 (SD 10.7), for senior residents 3.5 (8.2) and for junior residents 3.6 (8.3). After adjusting for possible confounders, no difference between groups concerning the postoperative complications was detected. There is also no difference in postoperative complications detectable if junior residents were assisted by consultants then if assisted by senior residents. Patient safety is ensured in general surgery when performed by surgical junior residents. Senior residents are able to adopt the role of the teaching surgeon in charge without compromising patients' safety.

5 CFR 531.207 - Applying annual pay adjustments.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Applying annual pay adjustments. 531.207 Section 531.207 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY UNDER THE GENERAL SCHEDULE Determining Rate of Basic Pay General Provisions § 531.207 Applying annual...

Psychiatric diagnoses and psychoactive medication use among nonsurgical critically ill patients receiving mechanical ventilation.

PubMed

Wunsch, Hannah; Christiansen, Christian F; Johansen, Martin B; Olsen, Morten; Ali, Naeem; Angus, Derek C; Sørensen, Henrik Toft

2014-03-19

The relationship between critical illness and psychiatric illness is unclear. To assess psychiatric diagnoses and medication prescriptions before and after critical illness. Population-based cohort study in Denmark of critically ill patients in 2006-2008 with follow-up through 2009, and 2 matched comparison cohorts from hospitalized patients and from the general population. Critical illness defined as intensive care unit admission with mechanical ventilation. Adjusted prevalence ratios (PRs) of psychiatrist-diagnosed psychiatric illnesses and prescriptions for psychoactive medications in the 5 years before critical illness. For patients with no psychiatric history, quarterly cumulative incidence (risk) and adjusted hazard ratios (HRs) for diagnoses and medications in the following year, using Cox regression. Among 24,179 critically ill patients, 6.2% had 1 or more psychiatric diagnoses in the prior 5 years vs 5.4% for hospitalized patients (adjusted PR, 1.31; 95% CI, 1.22-1.42; P<.001) and 2.4% for the general population (adjusted PR, 2.57; 95% CI, 2.41-2.73; P<.001). Five-year preadmission psychoactive prescription rates were similar to hospitalized patients: 48.7% vs 48.8% (adjusted PR, 0.97; 95% CI, 0.95-0.99; P<.001) but were higher than the general population (33.2%; adjusted PR, 1.40; 95% CI, 1.38-1.42; P<.001). Among the 9912 critical illness survivors with no psychiatric history, the absolute risk of new psychiatric diagnoses was low but higher than hospitalized patients: 0.5% vs 0.2% over the first 3 months (adjusted HR, 3.42; 95% CI, 1.96-5.99; P <.001), and the general population cohort (0.02%; adjusted HR, 21.77; 95% CI, 9.23-51.36; P<.001). Risk of new psychoactive medication prescriptions was also increased in the first 3 months: 12.7% vs 5.0% for the hospital cohort (adjusted HR, 2.45; 95% CI, 2.19-2.74; P<.001) and 0.7% for the general population (adjusted HR, 21.09; 95% CI, 17.92-24.82; P<.001). These differences had largely resolved by 9 to 12 months after discharge. Prior psychiatric diagnoses are more common in critically ill patients than in hospital and general population cohorts. Among survivors of critical illness, new psychiatric diagnoses and psychoactive medication use is increased in the months after discharge. Our data suggest both a possible role of psychiatric disease in predisposing patients to critical illness and an increased but transient risk of new psychiatric diagnoses and treatment after critical illness.

Adjusting Health Expenditures for Inflation: A Review of Measures for Health Services Research in the United States.

PubMed

Dunn, Abe; Grosse, Scott D; Zuvekas, Samuel H

2018-02-01

To provide guidance on selecting the most appropriate price index for adjusting health expenditures or costs for inflation. Major price index series produced by federal statistical agencies. We compare the key characteristics of each index and develop suggestions on specific indexes to use in many common situations and general guidance in others. Price series and methodological documentation were downloaded from federal websites and supplemented with literature scans. The gross domestic product implicit price deflator or the overall Personal Consumption Expenditures (PCE) index is preferable to the Consumer Price Index (CPI-U) to adjust for general inflation, in most cases. The Personal Health Care (PHC) index or the PCE health-by-function index is generally preferred to adjust total medical expenditures for inflation. The CPI medical care index is preferred for the adjustment of consumer out-of-pocket expenditures for inflation. A new, experimental disease-specific Medical Care Expenditure Index is now available to adjust payments for disease treatment episodes. There is no single gold standard for adjusting health expenditures for inflation. Our discussion of best practices can help researchers select the index best suited to their study. © Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

Cohort Differences in Cognitive Aging in the Longitudinal Aging Study Amsterdam.

PubMed

Brailean, Anamaria; Huisman, Martijn; Prince, Martin; Prina, A Matthew; Deeg, Dorly J H; Comijs, Hannie

2016-09-30

This study aims to examine cohort differences in cognitive performance and rates of change in episodic memory, processing speed, inductive reasoning, and general cognitive performance and to investigate whether these cohort effects may be accounted for by education attainment. The first cohort (N = 705) was born between 1920 and 1930, whereas the second cohort (N = 646) was born between 1931 and 1941. Both birth cohorts were aged 65 to 75 years at baseline and were followed up 3 and 6 years later. Data were analyzed using linear mixed models. The later born cohort had better general cognitive performance, inductive reasoning, and processing speed at baseline, but cohort differences in inductive reasoning and general cognitive performance disappeared after adjusting for education. The later born cohort showed steeper decline in processing speed. Memory decline was steeper in the earlier born cohort but only from Time 1 to Time 3 when the same memory test was administered. Education did not account for cohort differences in cognitive decline. The later born cohort showed better initial performance in certain cognitive abilities, but no better preservation of cognitive abilities overtime compared with the earlier born cohort. These findings carry implications for healthy cognitive aging. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America.

Associations of perceived work strain with nicotine dependence in a community sample.

PubMed

John, U; Riedel, J; Rumpf, H-J; Hapke, U; Meyer, C

2006-03-01

Little is known about work strain and smoking, and even less about work strain and nicotine dependence. To investigate the relations of perceived work strain with nicotine dependence among an adult general population sample. Cross sectional survey with a probability sample of residents of a northern German area with 4075 participants, aged 18-64 years (participation rate 70.2%). The current study is based on 2549 participants who were working 15 or more hours per week. Face to face at-home computer aided interviews (World Health Organization Composite International Diagnostic Interview) were carried out. Work strain, defined as high work demand and low work control, was assessed with a questionnaire. Nicotine dependence was diagnosed according to the Diagnostic and Statistical Manual (DSM-IV) of the American Psychiatric Association. In addition, the Fagerström Test for Nicotine Dependence (FTND) was used. Subjects with work strain had an odds ratio of 1.6 (95% CI 1.2 to 2.3) for nicotine dependence compared to those who had no work strain. In a general linear model, higher work strain was associated with a stronger relation between work demand and work control and the FTND. The findings were adjusted for alcohol use disorders, occupational status, age, and sex. Perceived work strain is related to nicotine dependence in this general adult population.

Phenotypic plasticity in the scaling of avian basal metabolic rate

PubMed Central

McKechnie, Andrew E; Freckleton, Robert P; Jetz, Walter

2006-01-01

Many birds exhibit short-term, reversible adjustments in basal metabolic rate (BMR), but the overall contribution of phenotypic plasticity to avian metabolic diversity remains unclear. The available BMR data include estimates from birds living in natural environments and captive-raised birds in more homogenous, artificial environments. All previous analyses of interspecific variation in BMR have pooled these data. We hypothesized that phenotypic plasticity is an important contributor to interspecific variation in avian BMR, and that captive-raised populations exhibit general differences in BMR compared to wild-caught populations. We tested this hypothesis by fitting general linear models to BMR data for 231 bird species, using the generalized least-squares approach to correct for phylogenetic relatedness when necessary. The scaling exponent relating BMR to body mass in captive-raised birds (0.670) was significantly shallower than in wild-caught birds (0.744). The differences in metabolic scaling between captive-raised and wild-caught birds persisted when migratory tendency and habitat aridity were controlled for. Our results reveal that phenotypic plasticity is a major contributor to avian interspecific metabolic variation. The finding that metabolic scaling in birds is partly determined by environmental factors provides further support for models that predict variation in scaling exponents, such as the allometric cascade model. PMID:16627278

Intrauterine growth and intelligence within sibling pairs: findings from the Mater-University study of pregnancy and its outcomes.

PubMed

Lawlor, Debbie A; Bor, William; O'Callaghan, Michael J; Williams, Gail M; Najman, Jake M

2005-04-01

To examine the association between intrauterine growth and intelligence. Population based birth cohort study of sibling pairs born within a maximum of three years of each other. Mater-University women and children's hospital, Brisbane, Australia. 235 (470 children) sibling pairs. Among one randomly selected sibling from each pair verbal comprehension at age 5, general intelligence at age 14, and reading ability at age 14 increased linearly with increasing gestational age and sex standardised birth weight z scores. With adjustment for maternal age, race, and smoking during pregnancy, birth order, family income, and parental education the associations with verbal comprehension at age 5 and general intelligence at age 14 remained, whereas the association with reading ability at age 14 was attenuated to the null. Within sibling pairs, differences in intrauterine growth were positively associated with differences in verbal comprehension at age 5 (test score difference per one unit difference in birth weight z score = 1.52 (0.11 to 3.26)) and general intelligence at age 14 (1.09 (0.01 to 2.18)), but not with reading ability at age 14. Socioeconomic position or other fixed maternal characteristics do not seem to explain the positive association between intrauterine growth and childhood intelligence.

Relationship between FEV1 and Cardiovascular Risk Factors in General Population without Airflow Limitation.

PubMed

Lee, Jeong Hyeon; Kang, Yun-Seong; Jeong, Yun-Jeong; Yoon, Young-Soon; Kwack, Won Gun; Oh, Jin Young

2016-01-01

Purpose. We aimed to determine the value of lung function measurement for predicting cardiovascular (CV) disease by evaluating the association between FEV1 (%) and CV risk factors in general population. Materials and Methods. This was a cross-sectional, retrospective study of subjects above 18 years of age who underwent health examinations. The relationship between FEV1 (%) and presence of carotid plaque and thickened carotid IMT (≥0.8 mm) was analyzed by multiple logistic regression, and the relationship between FEV1 (%) and PWV (%), and serum uric acid was analyzed by multiple linear regression. Various factors were adjusted by using Model 1 and Model 2. Results. 1,003 subjects were enrolled in this study and 96.7% ( n = 970) of the subjects were men. In both models, the odds ratio of the presence of carotid plaque and thickened carotid IMT had no consistent trend and statistical significance. In the analysis of the PWV (%) and uric acid, there was no significant relationship with FEV1 (%) in both models. Conclusion. FEV1 had no significant relationship with CV risk factors. The result suggests that FEV1 may have no association with CV risk factors or may be insensitive to detecting the association in general population without airflow limitation.

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

Evaluation of goal kicking performance in international rugby union matches.

PubMed

Quarrie, Kenneth L; Hopkins, Will G

2015-03-01

Goal kicking is an important element in rugby but has been the subject of minimal research. To develop and apply a method to describe the on-field pattern of goal-kicking and rank the goal kicking performance of players in international rugby union matches. Longitudinal observational study. A generalized linear mixed model was used to analyze goal-kicking performance in a sample of 582 international rugby matches played from 2002 to 2011. The model adjusted for kick distance, kick angle, a rating of the importance of each kick, and venue-related conditions. Overall, 72% of the 6769 kick attempts were successful. Forty-five percent of points scored during the matches resulted from goal kicks, and in 5.7% of the matches the result of the match hinged on the outcome of a kick attempt. There was an extremely large decrease in success with increasing distance (odds ratio for two SD distance 0.06, 90% confidence interval 0.05-0.07) and a small decrease with increasingly acute angle away from the mid-line of the goal posts (odds ratio for 2 SD angle, 0.44, 0.39-0.49). Differences between players were typically small (odds ratio for 2 between-player SD 0.53, 0.45-0.65). The generalized linear mixed model with its random-effect solutions provides a tool for ranking the performance of goal kickers in rugby. This modelling approach could be applied to other performance indicators in rugby and in other sports in which discrete outcomes are measured repeatedly on players or teams. Copyright © 2015. Published by Elsevier Ltd.

A Two-Step Approach for Analysis of Nonignorable Missing Outcomes in Longitudinal Regression: an Application to Upstate KIDS Study.

PubMed

Liu, Danping; Yeung, Edwina H; McLain, Alexander C; Xie, Yunlong; Buck Louis, Germaine M; Sundaram, Rajeshwari

2017-09-01

Imperfect follow-up in longitudinal studies commonly leads to missing outcome data that can potentially bias the inference when the missingness is nonignorable; that is, the propensity of missingness depends on missing values in the data. In the Upstate KIDS Study, we seek to determine if the missingness of child development outcomes is nonignorable, and how a simple model assuming ignorable missingness would compare with more complicated models for a nonignorable mechanism. To correct for nonignorable missingness, the shared random effects model (SREM) jointly models the outcome and the missing mechanism. However, the computational complexity and lack of software packages has limited its practical applications. This paper proposes a novel two-step approach to handle nonignorable missing outcomes in generalized linear mixed models. We first analyse the missing mechanism with a generalized linear mixed model and predict values of the random effects; then, the outcome model is fitted adjusting for the predicted random effects to account for heterogeneity in the missingness propensity. Extensive simulation studies suggest that the proposed method is a reliable approximation to SREM, with a much faster computation. The nonignorability of missing data in the Upstate KIDS Study is estimated to be mild to moderate, and the analyses using the two-step approach or SREM are similar to the model assuming ignorable missingness. The two-step approach is a computationally straightforward method that can be conducted as sensitivity analyses in longitudinal studies to examine violations to the ignorable missingness assumption and the implications relative to health outcomes. © 2017 John Wiley & Sons Ltd.

A Bivariate Generalized Linear Item Response Theory Modeling Framework to the Analysis of Responses and Response Times.

PubMed

Molenaar, Dylan; Tuerlinckx, Francis; van der Maas, Han L J

2015-01-01

A generalized linear modeling framework to the analysis of responses and response times is outlined. In this framework, referred to as bivariate generalized linear item response theory (B-GLIRT), separate generalized linear measurement models are specified for the responses and the response times that are subsequently linked by cross-relations. The cross-relations can take various forms. Here, we focus on cross-relations with a linear or interaction term for ability tests, and cross-relations with a curvilinear term for personality tests. In addition, we discuss how popular existing models from the psychometric literature are special cases in the B-GLIRT framework depending on restrictions in the cross-relation. This allows us to compare existing models conceptually and empirically. We discuss various extensions of the traditional models motivated by practical problems. We also illustrate the applicability of our approach using various real data examples, including data on personality and cognitive ability.

Evaluation of a Nonlinear Finite Element Program - ABAQUS.

DTIC Science & Technology

1983-03-15

anisotropic properties. * MATEXP - Linearly elastic thermal expansions with isotropic, orthotropic and anisotropic properties. * MATELG - Linearly...elastic materials for general sections (options available for beam and shell elements). • MATEXG - Linearly elastic thermal expansions for general...decomposition of a matrix. * Q-R algorithm • Vector normalization, etc. Obviously, by consolidating all the utility subroutines in a library, ABAQUS has

17 CFR 143.8 - Inflation-adjusted civil monetary penalties.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Inflation-adjusted civil... JURISDICTION General Provisions § 143.8 Inflation-adjusted civil monetary penalties. (a) Unless otherwise amended by an act of Congress, the inflation-adjusted maximum civil monetary penalty for each violation of...

45 CFR 153.365 - General oversight requirements for State-operated risk adjustment programs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... risk adjustment programs. 153.365 Section 153.365 Public Welfare Department of Health and Human Services REQUIREMENTS RELATING TO HEALTH CARE ACCESS STANDARDS RELATED TO REINSURANCE, RISK CORRIDORS, AND RISK ADJUSTMENT UNDER THE AFFORDABLE CARE ACT State Standards Related to the Risk Adjustment Program...

26 CFR 301.6231(a)(6)-1 - Computational adjustments.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 18 2013-04-01 2013-04-01 false Computational adjustments. 301.6231(a)(6)-1... Computational adjustments. (a) Changes in a partner's tax liability—(1) In general. A change in the tax... 63 of the Internal Revenue Code is made through a computational adjustment. A computational...

26 CFR 301.6231(a)(6)-1 - Computational adjustments.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 18 2012-04-01 2012-04-01 false Computational adjustments. 301.6231(a)(6)-1... Computational adjustments. (a) Changes in a partner's tax liability—(1) In general. A change in the tax... 63 of the Internal Revenue Code is made through a computational adjustment. A computational...

26 CFR 301.6231(a)(6)-1 - Computational adjustments.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 18 2011-04-01 2011-04-01 false Computational adjustments. 301.6231(a)(6)-1... Computational adjustments. (a) Changes in a partner's tax liability—(1) In general. A change in the tax... 63 of the Internal Revenue Code is made through a computational adjustment. A computational...

26 CFR 301.6231(a)(6)-1 - Computational adjustments.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Computational adjustments. 301.6231(a)(6)-1... Computational adjustments. (a) Changes in a partner's tax liability—(1) In general. A change in the tax... 63 of the Internal Revenue Code is made through a computational adjustment. A computational...

26 CFR 301.6231(a)(6)-1 - Computational adjustments.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 26 Internal Revenue 18 2014-04-01 2014-04-01 false Computational adjustments. 301.6231(a)(6)-1... Computational adjustments. (a) Changes in a partner's tax liability—(1) In general. A change in the tax... 63 of the Internal Revenue Code is made through a computational adjustment. A computational...

Linear discrete systems with memory: a generalization of the Langmuir model

NASA Astrophysics Data System (ADS)

Băleanu, Dumitru; Nigmatullin, Raoul R.

2013-10-01

In this manuscript we analyzed a general solution of the linear nonlocal Langmuir model within time scale calculus. Several generalizations of the Langmuir model are presented together with their exact corresponding solutions. The physical meaning of the proposed models are investigated and their corresponding geometries are reported.

YADCLAN: yet another digitally-controlled linear artificial neuron.

PubMed

Frenger, Paul

2003-01-01

This paper updates the author's 1999 RMBS presentation on digitally controlled linear artificial neuron design. Each neuron is based on a standard operational amplifier having excitatory and inhibitory inputs, variable gain, an amplified linear analog output and an adjustable threshold comparator for digital output. This design employs a 1-wire serial network of digitally controlled potentiometers and resistors whose resistance values are set and read back under microprocessor supervision. This system embodies several unique and useful features, including: enhanced neuronal stability, dynamic reconfigurability and network extensibility. This artificial neuronal is being employed for feature extraction and pattern recognition in an advanced robotic application.

Making reasonable and achievable adjustments: the contributions of learning disability liaison nurses in 'Getting it right' for people with learning disabilities receiving general hospitals care.

PubMed

MacArthur, Juliet; Brown, Michael; McKechanie, Andrew; Mack, Siobhan; Hayes, Matthew; Fletcher, Joan

2015-07-01

To examine the role of learning disability liaison nurses in facilitating reasonable and achievable adjustments to support access to general hospital services for people with learning disabilities. Mixed methods study involving four health boards in Scotland with established Learning Disability Liaison Nurses (LDLN) Services. Quantitative data of all liaison nursing referrals over 18 months and qualitative data collected from stakeholders with experience of using the liaison services within the previous 3-6 months. Six liaison nurses collected quantitative data of 323 referrals and activity between September 2008-March 2010. Interviews and focus groups were held with 85 participants included adults with learning disabilities (n = 5), carers (n = 16), primary care (n = 39), general hospital (n = 19) and liaison nurses (n = 6). Facilitating reasonable and achievable adjustments was an important element of the LDLNs' role and focussed on access to information; adjustments to care; appropriate environment of care; ensuring equitable care; identifying patient need; meeting patient needs; and specialist tools/resources. Ensuring that reasonable adjustments are made in the general hospital setting promotes person-centred care and equal health outcomes for people with a learning disability. This view accords with 'Getting it right' charter produced by the UK Charity Mencap which argues that healthcare professionals need support, encouragement and guidance to make reasonable adjustments for this group. LDLNs have an important and increasing role to play in advising on and establishing adjustments that are both reasonable and achievable. © 2015 John Wiley & Sons Ltd.

Automated control of linear constricted plasma source array

DOEpatents

Anders, Andre; Maschwitz, Peter A.

2000-01-01

An apparatus and method for controlling an array of constricted glow discharge chambers are disclosed. More particularly a linear array of constricted glow plasma sources whose polarity and geometry are set so that the contamination and energy of the ions discharged from the sources are minimized. The several sources can be mounted in parallel and in series to provide a sustained ultra low source of ions in a plasma with contamination below practical detection limits. The quality of film along deposition "tracks" opposite the plasma sources can be measured and compared to desired absolute or relative values by optical and/or electrical sensors. Plasma quality can then be adjusted by adjusting the power current values, gas feed pressure/flow, gas mixtures or a combination of some or all of these to improve the match between the measured values and the desired values.

Hospital costs associated with smoking in veterans undergoing general surgery.

PubMed

Kamath, Aparna S; Vaughan Sarrazin, Mary; Vander Weg, Mark W; Cai, Xueya; Cullen, Joseph; Katz, David A

2012-06-01

Approximately 30% of patients undergoing elective general surgery smoke cigarettes. The association between smoking status and hospital costs in general surgery patients is unknown. The objectives of this study were to compare total inpatient costs in current smokers, former smokers, and never smokers undergoing general surgical procedures in Veterans Affairs (VA) hospitals; and to determine whether the relationship between smoking and cost is mediated by postoperative complications. Patients undergoing general surgery during the period of October 1, 2005 to September 30, 2006 were identified in the VA Surgical Quality Improvement Program (VASQIP) data set. Inpatient costs were extracted from the VA Decision Support System (DSS). Relative surgical costs (incurred during index hospitalization and within 30 days of operation) for current and former smokers relative to never smokers, and possible mediators of the association between smoking status and cost were estimated using generalized linear regression models. Models were adjusted for preoperative and operative variables, accounting for clustering of costs at the hospital level. Of the 14,853 general surgical patients, 34% were current smokers, 39% were former smokers, and 27% were never smokers. After controlling for patient covariates, current smokers had significantly higher costs compared with never smokers: relative cost was 1.04 (95% Cl 1.00 to 1.07; p = 0.04); relative costs for former smokers did not differ significantly from those of never smokers: 1.02 (95% Cl 0.99 to 1.06; p = 0.14). The relationship between smoking and hospital costs for current smokers was partially mediated by postoperative respiratory complications. These findings complement emerging evidence recommending effective smoking cessation programs in general surgical patients and provide an estimate of the potential savings that could be accrued during the preoperative period. Published by Elsevier Inc.

An approximate generalized linear model with random effects for informative missing data.

PubMed

Follmann, D; Wu, M

1995-03-01

This paper develops a class of models to deal with missing data from longitudinal studies. We assume that separate models for the primary response and missingness (e.g., number of missed visits) are linked by a common random parameter. Such models have been developed in the econometrics (Heckman, 1979, Econometrica 47, 153-161) and biostatistics (Wu and Carroll, 1988, Biometrics 44, 175-188) literature for a Gaussian primary response. We allow the primary response, conditional on the random parameter, to follow a generalized linear model and approximate the generalized linear model by conditioning on the data that describes missingness. The resultant approximation is a mixed generalized linear model with possibly heterogeneous random effects. An example is given to illustrate the approximate approach, and simulations are performed to critique the adequacy of the approximation for repeated binary data.

Friendship conflict and the development of generalized physical aggression in the early school years: a genetically informed study of potential moderators.

PubMed

Salvas, Marie-Claude; Vitaro, Frank; Brendgen, Mara; Dionne, Ginette; Tremblay, Richard E; Boivin, Michel

2014-06-01

Several authors consider high and frequent conflicts between friends during childhood as a serious risk for subsequent conduct problems such as generalized physical aggression toward others (e.g., Kupersmidt, Burchinal, & Patterson, 1995; Sebanc, 2003). Although it seems logical to assume that friendship conflict could have some negative consequences on children's behaviors, some scholars have suggested that a certain amount of conflict between friends may actually promote social adjustment (e.g., Laursen & Pursell, 2009). The aim of this study was to investigate the role of friendship conflict in regard to the development of generalized physical aggression toward others in the early school years (i.e., from kindergarten to Grade 1), as well as the moderating role of relational (i.e., shared positive affect and dyadic conflict resolution skills) and personal (i.e., children's sex and genetic liability for aggression) characteristics in this context. The sample included 745 twins assessed through teacher, peer, child, and friend ratings in kindergarten and Grade 1. Friendship conflict in kindergarten was linearly related to an increase in boys' but not girls' generalized physical aggression. However, shared positive affect and conflict resolution skills mitigated the prospective associations between friendship conflict and generalized physical aggression. These results were independent of children's sex, genetic risk for physical aggression, and initial levels of generalized physical aggression in kindergarten. Fostering a positive relationship between friends at school entry may buffer against the risk associated with experiencing friendship conflict. PsycINFO Database Record (c) 2014 APA, all rights reserved.

The impact of monetary incentives on general fertility rates in Western Australia.

PubMed

Langridge, Amanda T; Nassar, Natasha; Li, Jianghong; Jacoby, Peter; Stanley, Fiona J

2012-04-01

There has been widespread international concern about declining fertility rates and the long-term negative consequences particularly for industrialised countries with ageing populations. In an attempt to boost fertility rates, the Australian Government introduced a maternity payment known as the Baby Bonus. However, major concerns have been raised that such monetary incentives would attract teenagers and socially disadvantaged groups. Population-level data and generalised linear models were used to examine general fertility rates between 1995 and 2006 by socioeconomic group, maternal age group, Aboriginality and location in Western Australia prior to and following the introduction of the Baby Bonus in July 2004. After a steady decline in general fertility rates between 1995 and 2004, rates increased significantly from 52.2 births per 1000 women, aged between 15 and 49 years, in 2004 to 58.6 births per 1000 women in 2006. While there was an overall increase in general fertility rates after adjusting for maternal socio-demographic characteristics, there were no significant differences among maternal age groups (p=0.98), between Aboriginal and non-Aboriginal women(p=0.80), maternal residential locations (p=0.98) or socioeconomic groups (p=0.68). The greatest increase in births were among women residing in the highest socioeconomic areas who had the lowest general fertility rate in 2004 (21.5 births per 1000 women) but the highest in 2006 (38.1 births per 1000 women). Findings suggest that for countries with similar social, economic and political climates to Australia, a monetary incentive may provide a satisfactory solution to declining general fertility rates.

Resonance Parameter Adjustment Based on Integral Experiments

DOE PAGES

Sobes, Vladimir; Leal, Luiz; Arbanas, Goran; ...

2016-06-02

Our project seeks to allow coupling of differential and integral data evaluation in a continuous-energy framework and to use the generalized linear least-squares (GLLS) methodology in the TSURFER module of the SCALE code package to update the parameters of a resolved resonance region evaluation. We recognize that the GLLS methodology in TSURFER is identical to the mathematical description of a Bayesian update in SAMMY, the SAMINT code was created to use the mathematical machinery of SAMMY to update resolved resonance parameters based on integral data. Traditionally, SAMMY used differential experimental data to adjust nuclear data parameters. Integral experimental data, suchmore » as in the International Criticality Safety Benchmark Experiments Project, remain a tool for validation of completed nuclear data evaluations. SAMINT extracts information from integral benchmarks to aid the nuclear data evaluation process. Later, integral data can be used to resolve any remaining ambiguity between differential data sets, highlight troublesome energy regions, determine key nuclear data parameters for integral benchmark calculations, and improve the nuclear data covariance matrix evaluation. Moreover, SAMINT is not intended to bias nuclear data toward specific integral experiments but should be used to supplement the evaluation of differential experimental data. Using GLLS ensures proper weight is given to the differential data.« less

Impaired renal function is associated with worse self-reported outcomes after kidney transplantation.

PubMed

Neri, Luca; Dukes, Jonathan; Brennan, Daniel C; Salvalaggio, Paulo R; Seelam, Susmitha; Desiraju, Srividya; Schnitzler, Mark

2011-12-01

We sought to determine the association between health-related quality of life (HRQOL) and graft function in renal transplant recipients. We enrolled 577 kidney transplant recipients aged 18-74 years (response rate 87%). Recipients with multiple or multi-organ transplantation, creatine kinase >200 U/L, acute renal failure or cellular rejection (n = 64), and without creatinine assessments in 3 months pre-enrollment (n = 127) were excluded. The questionnaire included Euro QOL 5 Dimensions (EQ-5D), Health Utility Index III (HUI-III), Kidney Disease Quality of Life-36 (KDQOL36) which include a generic section (RAND SF-12). Data on medical conditions, therapy regimens, and biochemistry results were extracted from clinical charts. We used general linear models adjusted for demographic, socioeconomic, and clinical characteristics to assess the association between HRQOL and severity of chronic kidney disease (CKD). Patients with more advanced CKD were more likely to be African-American, covered by public insurance, more likely to have shorter time after transplantation, higher phosphorus and lower hemoglobin, serum albumin, and calcium levels. All HRQOL scales were inversely associated with CKD severity. All associations were robust to adjustment for possible confounders. Several health-related quality of life dimensions may be affected by poor renal function after transplantation.

Exenatide's effect in reducing weight and glycosylated hemoglobin level in an Arab population with type 2 diabetes.

PubMed

Bashier, Alaaeldin M; Abdelgadir, Elamin I; Khalifa, Azza A; Rashid, Fouzia; Abuelkeir, Sona M; Bachet, Fawzi E

2014-11-01

To determine whether exenatide is effective in reducing weight and glycosylated hemoglobin level (HbA1c), and to investigate its efficacy in improving lipid profile, blood pressure, and creatinine levels in the Arab population. This study was conducted at the Endocrine Unit, Dubai Hospital, Dubai, United Arab Emirates. We retrospectively collected data from patients with type 2 diabetes started on exenatide between November 2011 and February 2012. Data included demographics, clinical, laboratory results, and medications used. A general linear model adjusted by baseline characteristics (weight, HbA1C, age, use of statins, and duration of diabetes) was used to assess changes between baseline and end of trial in HbA1C, weight, low density lipoprotein cholesterol, total cholesterol, triglycerides, creatinine, and blood pressure. After 6 months of treatment with exenatide, the HbA1c decreased by 0.47% (95% confidence level [CI]: -0.01 - 0.95) (p=0.055). Weight reduction was highly significant; 5.6 kg (95% CI: 3.34 - 7.85) (p<0.001). Those reductions remained significant after adjustment for confounding factors. This study showed that weight reduction was highly significant with exenatide. The borderline significance in HbA1c reduction can be attributed to the small sample size. 

The impact of an online disease management program on medical costs among health plan members.

PubMed

Schwartz, Steven M; Day, Brian; Wildenhaus, Kevin; Silberman, Anna; Wang, Chun; Silberman, Jordan

2010-01-01

This study evaluated the economic impact of an online disease management program within a broader population health management strategy. A retrospective, quasi-experimental, cohort design evaluated program participants and a matched cohort of nonparticipants on 2003-2007 claims data in a mixed model. The study was conducted through Highmark Inc, Blue Cross Blue Shield, covering 4.8 million members in five regions of Pennsylvania. Overall, 413 online self-management program participants were compared with a matched cohort of 360 nonparticipants. The costs and claims data were measured per person per calendar year. Total payments were aggregated from inpatient, outpatient, professional services, and pharmacy payments. The costs of the online program were estimated on a per-participant basis. All dollars were adjusted to 2008 values. The online intervention, implemented in 2006, was a commercially available, tailored program for chronic condition self management, nested within the Blues on Call(SM) condition management strategy. General linear modeling (with covariate adjustment) was used. Data trends were also explored using second-order polynomial regressions. Health care costs per person per year were $757 less than predicted for participants relative to matched nonparticipants, yielding a return on investment of $9.89 for every dollar spent on the program. This online intervention showed a favorable and cost-effective impact on health care cost.

Persistent organic pollutants (POPs) and metals in primiparous women: a comparison from Canada and Mexico☆

PubMed Central

Adlard, Bryan; Davis, Karelyn; Liang, Chun Lei; Curren, Meredith S.; Rodríguez-Dozal, Sandra; Riojas-Rodríguez, Horacio; Hernández-Ávila, Mauricio; Foster, Warren; Needham, Larry; Wong, Lee-Yang; Weber, Jean-Philippe; Marro, Leonora; Leech, Tara; Van Oostdam, Jay

2016-01-01

Under the North American Commission for Environmental Cooperation (CEC) and its Sound Management of Chemicals (SMOC) program, a tri-national human contaminant monitoring initiative was completed to provide baseline exposure information for several environmental contaminants in Canada, Mexico and the United States (U.S). Blood samples were collected from primiparous women in Canada and Mexico, and were analysed for a suite of environmental contaminants including polychlorinated biphenyls (PCBs), dichlorodiphenyldichloroethylene(p,p′-DDE),beta-hexachlorocyclohexane (β-HCH), mercury and lead. A multiple stepwise linear regression analysis was conducted using data from Canadian and Mexican primiparous mothers, adjusting for ethnicity group, age, pre-pregnancy BMI, years at current city and ever-smoking status. Concentrations of p,p′-DDE, β-HCH, and lead were found to be higher among Mexican participants; however, concentrations of most PCBs among Mexican participants were similar to Canadian primiparous women after adjusting for covariates. Concentrations of total mercury were generally higher among Mexican primiparous women although this difference was smaller as age increased. This initial dataset can be used to determine priorities for future activities and to track progress in the management of the selected chemicals, both domestically and on a broader cooperative basis within North America. PMID:25233368

[Association between cerumen impaction, cognitive function and hearing in Japanese elderly].

PubMed

Sugiura, Saiko; Uchida, Yasue; Nakashima, Tsutomu; Nishita, Yukiko; Tange, Chikako; Ando, Fujiko; Shimokata, Hiroshi

2012-01-01

In this study we aimed to evaluate the frequency of cerumen impaction in Japanese elderly and clarify the associations between cerumen, cognitive function, and hearing impairment. The subjects enrolleded in this study were participants in the National Institute for Longevity Sciences, Longitudinal Study of Aging (NILS-LSA). The data of 792 community-dwelling participants aged 60 to 88 years old were collected. All had taken the Mini-Mental State Examination (MMSE) and had undergone pure tone audiometry (PTA) assessment and video recording of an otoscopic examination. We then analyzed associations between the incidence of the cerumen impaction of better-hearing ear, hearing level and MMSE scores using a general linear model. Cerumen impaction of the better-hearing ear was observed in 10.7% of all participants. In participants with an MMSE score of less than 24, the frequency of cerumen impaction was 23.3%. Cerumen was significant associated with poorer hearing after adjustment for sex and age (p=0.0001). Cerumen impaction also showed a significant association with a low MMSE score after adjustment for sex, age, hearing level and education (p=0.02). The frequency of cerumen impaction in Japanese elderly was estimated to be approximately 10%. The existence of cerumen impaction was associated with poorer hearing level and lower MMSE score.

[Impact of level of physical activity on healthcare utilization among Korean adults].

PubMed

Kim, Jiyun; Park, Seungmi

2012-04-01

This study was done to identify the impact of physical activity on healthcare utilization among Korean adults. Drawing from the 2008 Korean National Health and Nutrition Examination Survey (NHANES IV-2), data from 6,521 adults who completed the Health Interview and Health Behavior Surveys were analyzed. Association between physical activity and healthcare utilization was tested using the χ²-test. Multiple logistic regression analysis was used to calculate the odds ratios of using outpatient and inpatient healthcare for different levels of physical activity after adjusting for predisposing, enabling, and need factors. A generalized linear model applying a negative binomial distribution was used to determine how the level of physical activity was related to use of outpatient and inpatient healthcare. Physically active participants were 16% less likely to use outpatient healthcare (OR, 0.84; 95% CI, 0.74-0.97) and 23% less likely to use inpatient healthcare (OR, 0.77; 95% CI, 0.63-0.93) than physically inactive participants. Levels of outpatient and inpatient healthcare use decreased as levels of physical activity increased, after adjusting for relevant factors. An independent association between being physically active and lower healthcare utilization was ascertained among Korean adults indicating a need to develop nursing intervention programs that encourage regular physical activity.

Joint nonparametric correction estimator for excess relative risk regression in survival analysis with exposure measurement error

PubMed Central

Wang, Ching-Yun; Cullings, Harry; Song, Xiao; Kopecky, Kenneth J.

2017-01-01

SUMMARY Observational epidemiological studies often confront the problem of estimating exposure-disease relationships when the exposure is not measured exactly. In the paper, we investigate exposure measurement error in excess relative risk regression, which is a widely used model in radiation exposure effect research. In the study cohort, a surrogate variable is available for the true unobserved exposure variable. The surrogate variable satisfies a generalized version of the classical additive measurement error model, but it may or may not have repeated measurements. In addition, an instrumental variable is available for individuals in a subset of the whole cohort. We develop a nonparametric correction (NPC) estimator using data from the subcohort, and further propose a joint nonparametric correction (JNPC) estimator using all observed data to adjust for exposure measurement error. An optimal linear combination estimator of JNPC and NPC is further developed. The proposed estimators are nonparametric, which are consistent without imposing a covariate or error distribution, and are robust to heteroscedastic errors. Finite sample performance is examined via a simulation study. We apply the developed methods to data from the Radiation Effects Research Foundation, in which chromosome aberration is used to adjust for the effects of radiation dose measurement error on the estimation of radiation dose responses. PMID:29354018

The role of parental alcohol use, parental discipline and antisocial behaviour on adolescent drinking trajectories.

PubMed

Alati, R; Baker, P; Betts, K S; Connor, J P; Little, K; Sanson, A; Olsson, C A

2014-01-01

Parental drinking, harsh parental discipline and adolescent antisocial behaviour have been independently implicated in adolescent alcohol use. Robust prospective studies are required to examine developmental relationships between these factors and their effect on trajectories of alcohol use across adolescence. Data were ascertained at three consecutive adolescent waves (13.5, 15.5 and 17.5 years) from the Australian Temperament Project, a 15-wave (30 year) general population birth cohort in Victoria, Australia. Adolescent alcohol trajectories, adjusted for time-varying measures of parenting and antisocial behaviour, were regressed on time-stable measures of parental alcohol use. The full case analysis comprised 751 individuals with complete data. Two distinct alcohol trajectories were identified across the three adolescent waves after adjusting for time-varying factors: a higher and lower drinking group. Both trajectories increased linearly over the study period. Antisocial behaviour was positively associated with both trajectories while harsh parental discipline was positively associated with alcohol use in the lower-use group only. Increased maternal and paternal drinking at 13.5 years placed teenagers at a greater risk of being included in the high-risk trajectory. Parental drinking was the strongest predictor of different drinking trajectories in adolescence. This finding underscores the importance of comprehensive public heath approaches that target both parental and adolescent drinking attitudes and behaviour.

Environmental Exposure to Dioxins, Dibenzofurans, Bisphenol A, and Phthalates in Children with and without Autism Spectrum Disorder Living near the Gulf of Mexico.

PubMed

Rahbar, Mohammad H; Swingle, Hanes M; Christian, MacKinsey A; Hessabi, Manouchehr; Lee, MinJae; Pitcher, Meagan R; Campbell, Sean; Mitchell, Amy; Krone, Ryan; Loveland, Katherine A; Patterson, Donald G

2017-11-21

Environmental exposure to organic endocrine disrupting chemicals, including dioxins, dibenzofurans, bisphenol A (BPA), and phthalates has been associated with neurodevelopmental disorders, including autism spectrum disorder (ASD). We conducted a pilot monitoring study of 30 ASD cases and 10 typically developing (TD) controls ages 2-8 years from communities along the Gulf of Mexico near Alabama, which houses 14 Superfund sites, to assess the concentrations of dioxins and dibenzofurans in serum, and BPA and phthalate ester metabolites in urine. Based on General Linear Models, the lipid- or creatinine-adjusted geometric mean concentrations of the aforementioned chemicals did not differ between the ASD case and TD control groups (all p ≥ 0.27). We compared our findings to the adjusted means as reported by the National Health and Nutrition Examination Survey, survey years 2011-2012, and found that TD controls in our study had lower BPA (59%) and MEHHP (26%) concentrations, higher MBP (50%) concentration, and comparable (<20% difference) MEP, MBZP, MEOHP, and MCPP concentrations. We also conducted a preliminary investigation of dietary exposures and found that the consumption of certain types of fish may be associated with higher OCDD concentrations, and the consumption of soft drinks and juices may be associated with lower BPA and MEOHP concentrations, respectively.

Modifications to the Conduit Flow Process Mode 2 for MODFLOW-2005

USGS Publications Warehouse

Reimann, T.; Birk, S.; Rehrl, C.; Shoemaker, W.B.

2012-01-01

As a result of rock dissolution processes, karst aquifers exhibit highly conductive features such as caves and conduits. Within these structures, groundwater flow can become turbulent and therefore be described by nonlinear gradient functions. Some numerical groundwater flow models explicitly account for pipe hydraulics by coupling the continuum model with a pipe network that represents the conduit system. In contrast, the Conduit Flow Process Mode 2 (CFPM2) for MODFLOW-2005 approximates turbulent flow by reducing the hydraulic conductivity within the existing linear head gradient of the MODFLOW continuum model. This approach reduces the practical as well as numerical efforts for simulating turbulence. The original formulation was for large pore aquifers where the onset of turbulence is at low Reynolds numbers (1 to 100) and not for conduits or pipes. In addition, the existing code requires multiple time steps for convergence due to iterative adjustment of the hydraulic conductivity. Modifications to the existing CFPM2 were made by implementing a generalized power function with a user-defined exponent. This allows for matching turbulence in porous media or pipes and eliminates the time steps required for iterative adjustment of hydraulic conductivity. The modified CFPM2 successfully replicated simple benchmark test problems. ?? 2011 The Author(s). Ground Water ?? 2011, National Ground Water Association.

Firearm and Nonfirearm Homicide in 5 South African Cities: A Retrospective Population-Based Study

PubMed Central

Thompson, Mary Lou; Myers, Jonathan E.

2014-01-01

Objective. We assessed the effectiveness of South Africa’s Firearm Control Act (FCA), passed in 2000, on firearm homicide rates compared with rates of nonfirearm homicide across 5 South African cities from 2001 to 2005. Methods. We conducted a retrospective population-based study of 37 067 firearm and nonfirearm homicide cases. Generalized linear models helped estimate and compare time trends of firearm and nonfirearm homicides, adjusting for age, sex, race, day of week, city, year of death, and population size. Results. There was a statistically significant decreasing trend regarding firearm homicides from 2001, with an adjusted year-on-year homicide rate ratio of 0.864 (95% confidence interval [CI] = 0.848, 0.880), representing a decrease of 13.6% per annum. The year-on-year decrease in nonfirearm homicide rates was also significant, but considerably lower at 0.976 (95% CI = 0.954, 0.997). Results suggest that 4585 (95% CI = 4427, 4723) lives were saved across 5 cities from 2001 to 2005 because of the FCA. Conclusions. Strength, timing and consistent decline suggest stricter gun control mediated by the FCA accounted for a significant decrease in homicide overall, and firearm homicide in particular, during the study period. PMID:24432917

Racial Disparities in the Association between Alcohol Use Disorders and Health in Black and White Women.

PubMed

Ransome, Yusuf; Carty, Denise C; Cogburn, Courtney D; Williams, David R

2017-01-01

Adverse health attributed to alcohol use disorders (AUD) is more pronounced among black than white women. We investigated whether socioeconomic status (education and income), health care factors (insurance, alcoholism treatment), or psychosocial stressors (stressful life events, racial discrimination, alcoholism stigma) could account for black-white differences in the association between AUD and physical and functional health among current women drinkers 25 years and older (N = 8,877) in the National Epidemiological Survey on Alcohol and Related Conditions. Generalized linear regression tested how race interacted with the association between 12-month DSM-IV AUD in Wave 1 (2001-2002) and health in Wave 2 (2004-2005), adjusted for covariates (age group, alcohol consumption, smoking, body mass index, physical activity, diabetes, cardiovascular disease, and arthritis). Black women with AUD had poorer health than white women with AUD (β = -3.18, SE = 1.28, p < .05). This association was partially attenuated after adjusting for socioeconomic status, health care, and psychosocial factors (β = -2.64, SE = 1.27, p < .05). In race-specific analyses, AUD was associated with poorer health for black but not white women. Accounting for black-white differences in AUD and physical and functional health among women requires investigation beyond traditional explanatory mechanisms.

Are Optimism and Cynical Hostility Associated with Smoking Cessation in Older Women?

PubMed

Progovac, Ana M; Chang, Yue-Fang; Chang, Chung-Chou H; Matthews, Karen A; Donohue, Julie M; Scheier, Michael F; Habermann, Elizabeth B; Kuller, Lewis H; Goveas, Joseph S; Chapman, Benjamin P; Duberstein, Paul R; Messina, Catherine R; Weaver, Kathryn E; Saquib, Nazmus; Wallace, Robert B; Kaplan, Robert C; Calhoun, Darren; Smith, J Carson; Tindle, Hilary A

2017-08-01

Optimism and cynical hostility independently predict morbidity and mortality in Women's Health Initiative (WHI) participants and are associated with current smoking. However, their association with smoking cessation in older women is unknown. The purpose of this study is to test whether optimism (positive future expectations) or cynical hostility (mistrust of others) predicts smoking cessation in older women. Self-reported smoking status was assessed at years 1, 3, and 6 after study entry for WHI baseline smokers who were not missing optimism or cynical hostility scores (n = 10,242). Questionnaires at study entry assessed optimism (Life Orientation Test-Revised) and cynical hostility (Cook-Medley, cynical hostility subscale). Generalized linear mixed models adjusted for sociodemographics, lifestyle factors, and medical and psychosocial characteristics including depressive symptoms. After full covariate adjustment, optimism was not related to smoking cessation. Each 1-point increase in baseline cynical hostility score was associated with 5% lower odds of cessation over 6 years (OR = 0.95, CI = 0.92-0.98, p = 0.0017). In aging postmenopausal women, greater cynical hostility predicts lower smoking cessation over time. Future studies should examine whether individuals with this trait may benefit from more intensive cessation resources or whether attempting to mitigate cynical hostility itself may aid smoking cessation.

Adjusting for overdispersion in piecewise exponential regression models to estimate excess mortality rate in population-based research.

PubMed

Luque-Fernandez, Miguel Angel; Belot, Aurélien; Quaresma, Manuela; Maringe, Camille; Coleman, Michel P; Rachet, Bernard

2016-10-01

In population-based cancer research, piecewise exponential regression models are used to derive adjusted estimates of excess mortality due to cancer using the Poisson generalized linear modelling framework. However, the assumption that the conditional mean and variance of the rate parameter given the set of covariates x i are equal is strong and may fail to account for overdispersion given the variability of the rate parameter (the variance exceeds the mean). Using an empirical example, we aimed to describe simple methods to test and correct for overdispersion. We used a regression-based score test for overdispersion under the relative survival framework and proposed different approaches to correct for overdispersion including a quasi-likelihood, robust standard errors estimation, negative binomial regression and flexible piecewise modelling. All piecewise exponential regression models showed the presence of significant inherent overdispersion (p-value <0.001). However, the flexible piecewise exponential model showed the smallest overdispersion parameter (3.2 versus 21.3) for non-flexible piecewise exponential models. We showed that there were no major differences between methods. However, using a flexible piecewise regression modelling, with either a quasi-likelihood or robust standard errors, was the best approach as it deals with both, overdispersion due to model misspecification and true or inherent overdispersion.

Radiation phantom with humanoid shape and adjustable thickness

DOEpatents

Lehmann, Joerg [Pleasanton, CA; Levy, Joshua [Salem, NY; Stern, Robin L [Lodi, CA; Siantar, Christine Hartmann [Livermore, CA; Goldberg, Zelanna [Carmichael, CA

2006-12-19

A radiation phantom comprising a body with a general humanoid shape and at least a portion having an adjustable thickness. In one embodiment, the portion with an adjustable thickness comprises at least one tissue-equivalent slice.

Development of a Multileaf Collimator for Proton Radiotherapy

DTIC Science & Technology

2006-06-01

voxel size and slice thickness can be adjusted and determine the resolution. Each voxel is assigned a CT Number, in Hounsfield units , which is a...measure of the linear attenuation of the material in that voxel. The Hounsfield unit is a comparison of the linear attenuation coefficient of some...a header, which contains relevant patient and scan information, and the data, which is a sequential listing of the Hounsfield units of each voxel

Linearly Polarized Single-Frequency Oscillations of Laser-Diode-Pumped Microchip Ceramic Nd:YAG Lasers with Forced Ince-Gaussian Mode Operations

NASA Astrophysics Data System (ADS)

Otsuka, Kenju; Nemoto, Kana; Kamikariya, Koji; Miyasaka, Yoshihiko; Chu, Shu-Chun

2007-09-01

Detailed oscillation spectra and polarization properties have been examined in laser-diode-pumped (LD-pumped) microchip ceramic (i.e., polycrystalline) Nd:YAG lasers and the inherent segregation of lasing patterns into local modes possessing different polarization states was observed. Single-frequency linearly-polarized stable oscillations were realized by forcing the laser to Ince-Gaussian mode operations by adjusting azimuthal cavity symmetry.

Resultant as the determinant of a Koszul complex

NASA Astrophysics Data System (ADS)

Anokhina, A. S.; Morozov, A. Yu.; Shakirov, Sh. R.

2009-09-01

The determinant is a very important characteristic of a linear map between vector spaces. Two generalizations of linear maps are intensively used in modern theory: linear complexes (nilpotent chains of linear maps) and nonlinear maps. The determinant of a complex and the resultant are then the corresponding generalizations of the determinant of a linear map. It turns out that these two quantities are related: the resultant of a nonlinear map is the determinant of the corresponding Koszul complex. We give an elementary introduction into these notions and relations, which will definitely play a role in the future development of theoretical physics.

Dose and dose rate extrapolation factors for malignant and non-malignant health endpoints after exposure to gamma and neutron radiation.

PubMed

Tran, Van; Little, Mark P

2017-11-01

Murine experiments were conducted at the JANUS reactor in Argonne National Laboratory from 1970 to 1992 to study the effect of acute and protracted radiation dose from gamma rays and fission neutron whole body exposure. The present study reports the reanalysis of the JANUS data on 36,718 mice, of which 16,973 mice were irradiated with neutrons, 13,638 were irradiated with gamma rays, and 6107 were controls. Mice were mostly Mus musculus, but one experiment used Peromyscus leucopus. For both types of radiation exposure, a Cox proportional hazards model was used, using age as timescale, and stratifying on sex and experiment. The optimal model was one with linear and quadratic terms in cumulative lagged dose, with adjustments to both linear and quadratic dose terms for low-dose rate irradiation (<5 mGy/h) and with adjustments to the dose for age at exposure and sex. After gamma ray exposure there is significant non-linearity (generally with upward curvature) for all tumours, lymphoreticular, respiratory, connective tissue and gastrointestinal tumours, also for all non-tumour, other non-tumour, non-malignant pulmonary and non-malignant renal diseases (p < 0.001). Associated with this the low-dose extrapolation factor, measuring the overestimation in low-dose risk resulting from linear extrapolation is significantly elevated for lymphoreticular tumours 1.16 (95% CI 1.06, 1.31), elevated also for a number of non-malignant endpoints, specifically all non-tumour diseases, 1.63 (95% CI 1.43, 2.00), non-malignant pulmonary disease, 1.70 (95% CI 1.17, 2.76) and other non-tumour diseases, 1.47 (95% CI 1.29, 1.82). However, for a rather larger group of malignant endpoints the low-dose extrapolation factor is significantly less than 1 (implying downward curvature), with central estimates generally ranging from 0.2 to 0.8, in particular for tumours of the respiratory system, vasculature, ovary, kidney/urinary bladder and testis. For neutron exposure most endpoints, malignant and non-malignant, show downward curvature in the dose response, and for most endpoints this is statistically significant (p < 0.05). Associated with this, the low-dose extrapolation factor associated with neutron exposure is generally statistically significantly less than 1 for most malignant and non-malignant endpoints, with central estimates mostly in the range 0.1-0.9. In contrast to the situation at higher dose rates, there are statistically non-significant decreases of risk per unit dose at gamma dose rates of less than or equal to 5 mGy/h for most malignant endpoints, and generally non-significant increases in risk per unit dose at gamma dose rates ≤5 mGy/h for most non-malignant endpoints. Associated with this, the dose-rate extrapolation factor, the ratio of high dose-rate to low dose-rate (≤5 mGy/h) gamma dose response slopes, for many tumour sites is in the range 1.2-2.3, albeit not statistically significantly elevated from 1, while for most non-malignant endpoints the gamma dose-rate extrapolation factor is less than 1, with most estimates in the range 0.2-0.8. After neutron exposure there are non-significant indications of lower risk per unit dose at dose rates ≤5 mGy/h compared to higher dose rates for most malignant endpoints, and for all tumours (p = 0.001), and respiratory tumours (p = 0.007) this reduction is conventionally statistically significant; for most non-malignant outcomes risks per unit dose non-significantly increase at lower dose rates. Associated with this, the neutron dose-rate extrapolation factor is less than 1 for most malignant and non-malignant endpoints, in many cases statistically significantly so, with central estimates mostly in the range 0.0-0.2.

Bisimulation equivalence of differential-algebraic systems

NASA Astrophysics Data System (ADS)

Megawati, Noorma Yulia; Schaft, Arjan van der

2018-01-01

In this paper, the notion of bisimulation relation for linear input-state-output systems is extended to general linear differential-algebraic (DAE) systems. Geometric control theory is used to derive a linear-algebraic characterisation of bisimulation relations, and an algorithm for computing the maximal bisimulation relation between two linear DAE systems. The general definition is specialised to the case where the matrix pencil sE - A is regular. Furthermore, by developing a one-sided version of bisimulation, characterisations of simulation and abstraction are obtained.

Hair mercury concentrations and in vitro fertilization (IVF) outcomes among women from a fertility clinic.

PubMed

Wright, Diane L; Afeiche, Myriam C; Ehrlich, Shelley; Smith, Kristen; Williams, Paige L; Chavarro, Jorge E; Batsis, Maria; Toth, Thomas L; Hauser, Russ

2015-01-01

Total hair mercury (Hg) was measured among 205 women undergoing in vitro fertilization (IVF) treatment and the association with prospectively collected IVF outcomes (229 IVF cycles) was evaluated. Hair Hg levels (median=0.62ppm, range: 0.03-5.66ppm) correlated with fish intake (r=0.59), and exceeded the recommended EPA reference of 1ppm in 33% of women. Generalized linear mixed models with random intercepts accounting for within-woman correlations across treatment cycles were used to evaluate the association of hair Hg with IVF outcomes adjusted for age, body mass index, race, smoking status, infertility diagnosis, and protocol type. Hair Hg levels were not related to ovarian stimulation outcomes (peak estradiol levels, total and mature oocyte yields) or to fertilization rate, embryo quality, clinical pregnancy rate or live birth rate. Copyright © 2015 Elsevier Inc. All rights reserved.

Interaction of Neuritic Plaques and Education Predicts Dementia

PubMed Central

Roe, Catherine M.; Xiong, Chengjie; Miller, J. Phillip; Cairns, Nigel J.; Morris, John C.

2009-01-01

In exploring the cognitive reserve hypothesis in persons with substantial Alzheimer disease neuropathology, we aimed to determine the extent to which educational attainment and densities of diffuse plaques, neuritic plaques, and neurofibrillary tangles predict dementia. Participants were 1563 individuals aged 65 years or above who were assessed for dementia within 1 year of death. Generalized linear mixed models were used to examine whether education and density ratings of diffuse plaques and neuritic plaques, and neurofibrillary tangle stage were associated with a dementia diagnosis. Education interacted with densities of neuritic plaques to predict dementia. Tangle density independently predicted dementia, but did not interact with education. Diffuse plaque density was unrelated to dementia when adjusted for densities of neuritic plaques and tangles. Among individuals with Alzheimer disease neuropathology, educational attainment, as a surrogate of cognitive reserve, modifies the influence of neuritic, but not diffuse, plaque neuropathology on the expression of dementia. PMID:18525294

Sheep Feed and Scrapie, France

PubMed Central

Philippe, Sandrine; Ducrot, Christian; Roy, Pascal; Remontet, Laurent; Jarrige, Nathalie

2005-01-01

Scrapie is a small ruminant, transmissible spongiform encephalopathy (TSE). Although in the past scrapie has not been considered a zoonosis, the emergence of bovine spongiform encephalopathy, transmissible to humans and experimentally to sheep, indicates that risk exists for small ruminant TSEs in humans. To identify the risk factors for introducing scrapie into sheep flocks, a case-control study was conducted in France from 1999 to 2000. Ninety-four case and 350 control flocks were matched by location and main breed. Three main hypotheses were tested: direct contact between flocks, indirect environmental contact, and foodborne risk. Statistical analysis was performed by using adjusted generalized linear models with the complementary log-log link function, considering flock size as an offset. A notable effect of using proprietary concentrates and milk replacers was observed. The risk was heterogeneous among feed factories. Contacts between flocks were not shown to be a risk factor. PMID:16102318

Realization of quantum gates with multiple control qubits or multiple target qubits in a cavity

NASA Astrophysics Data System (ADS)

Waseem, Muhammad; Irfan, Muhammad; Qamar, Shahid

2015-06-01

We propose a scheme to realize a three-qubit controlled phase gate and a multi-qubit controlled NOT gate of one qubit simultaneously controlling n-target qubits with a four-level quantum system in a cavity. The implementation time for multi-qubit controlled NOT gate is independent of the number of qubit. Three-qubit phase gate is generalized to n-qubit phase gate with multiple control qubits. The number of steps reduces linearly as compared to conventional gate decomposition method. Our scheme can be applied to various types of physical systems such as superconducting qubits coupled to a resonator and trapped atoms in a cavity. Our scheme does not require adjustment of level spacing during the gate implementation. We also show the implementation of Deutsch-Joza algorithm. Finally, we discuss the imperfections due to cavity decay and the possibility of physical implementation of our scheme.

Outcomes of a pilot hand hygiene randomized cluster trial to reduce communicable infections among US office-based employees.

PubMed

Stedman-Smith, Maggie; DuBois, Cathy L Z; Grey, Scott F; Kingsbury, Diana M; Shakya, Sunita; Scofield, Jennifer; Slenkovich, Ken

2015-04-01

To determine the effectiveness of an office-based multimodal hand hygiene improvement intervention in reducing self-reported communicable infections and work-related absence. A randomized cluster trial including an electronic training video, hand sanitizer, and educational posters (n = 131, intervention; n = 193, control). Primary outcomes include (1) self-reported acute respiratory infections (ARIs)/influenza-like illness (ILI) and/or gastrointestinal (GI) infections during the prior 30 days; and (2) related lost work days. Incidence rate ratios calculated using generalized linear mixed models with a Poisson distribution, adjusted for confounders and random cluster effects. A 31% relative reduction in self-reported combined ARI-ILI/GI infections (incidence rate ratio: 0.69; 95% confidence interval, 0.49 to 0.98). A 21% nonsignificant relative reduction in lost work days. An office-based multimodal hand hygiene improvement intervention demonstrated a substantive reduction in self-reported combined ARI-ILI/GI infections.

Modified Levenberg-Marquardt Method for RÖSSLER Chaotic System Fuzzy Modeling Training

NASA Astrophysics Data System (ADS)

Wang, Yu-Hui; Wu, Qing-Xian; Jiang, Chang-Sheng; Xue, Ya-Li; Fang, Wei

Generally, fuzzy approximation models require some human knowledge and experience. Operator's experience is involved in the mathematics of fuzzy theory as a collection of heuristic rules. The main goal of this paper is to present a new method for identifying unknown nonlinear dynamics such as Rössler system without any human knowledge. Instead of heuristic rules, the presented method uses the input-output data pairs to identify the Rössler chaotic system. The training algorithm is a modified Levenberg-Marquardt (L-M) method, which can adjust the parameters of each linear polynomial and fuzzy membership functions on line, and do not rely on experts' experience excessively. Finally, it is applied to training Rössler chaotic system fuzzy identification. Comparing this method with the standard L-M method, the convergence speed is accelerated. The simulation results demonstrate the effectiveness of the proposed method.

Using Linear and Quadratic Functions to Teach Number Patterns in Secondary School

ERIC Educational Resources Information Center

Kenan, Kok Xiao-Feng

2017-01-01

This paper outlines an approach to definitively find the general term in a number pattern, of either a linear or quadratic form, by using the general equation of a linear or quadratic function. This approach is governed by four principles: (1) identifying the position of the term (input) and the term itself (output); (2) recognising that each…

Promoting mobility and reducing length of stay in hospitalized general medicine patients: A quality-improvement project.

PubMed

Hoyer, Erik H; Friedman, Michael; Lavezza, Annette; Wagner-Kosmakos, Kathleen; Lewis-Cherry, Robin; Skolnik, Judy L; Byers, Sherrie P; Atanelov, Levan; Colantuoni, Elizabeth; Brotman, Daniel J; Needham, Dale M

2016-05-01

To determine whether a multidisciplinary mobility promotion quality-improvement (QI) project would increase patient mobility and reduce hospital length of stay (LOS). Implemented using a structured QI model, the project took place between March 1, 2013 and March 1, 2014 on 2 general medicine units in a large academic medical center. There were 3352 patients admitted during the QI project period. The Johns Hopkins Highest Level of Mobility (JH-HLM) scale, an 8-point ordinal scale ranging from bed rest (score = 1) to ambulating ≥250 feet (score = 8), was used to quantify mobility. Changes in JH-HLM scores were compared for the first 4 months of the project (ramp-up phase) versus 4 months after project completion (post-QI phase) using generalized estimating equations. We compared the relative change in median LOS for the project months versus 12 months prior among the QI units, using multivariable linear regression analysis adjusting for 7 demographic and clinically relevant variables. Comparing the ramp-up versus post-QI phases, patients reaching JH-HLM's ambulation status increased from 43% to 70% (P < 0.001), and patients with improved JH-HLM mobility scores between admission and discharge increased from 32% to 45% (P < 0.001). For all patients, the QI project was associated with an adjusted median LOS reduction of 0.40 (95% confidence interval [CI]: -0.57 to -0.21, P < 0.001) days compared to 12 months prior. A subgroup of patients expected to have a longer LOS (expected LOS >7 days), were associated with a significantly greater adjusted median reduction in LOS of 1.11 (95% CI: -1.53 to -0.65, P < 0.001) days. Increased mobility was not associated with an increase in injurious falls compared to 12 months prior on the QI units (P = 0.73). Active prevention of a decline in physical function that commonly occurs during hospitalization may be achieved with a structured QI approach. In an adult medicine population, our QI project was associated with improved mobility, and this may have contributed to a reduction in LOS, particularly for more complex patients with longer expected hospital stay. Journal of Hospital Medicine 2016. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

Just another club? The distinctiveness of the relation between religious service attendance and adolescent psychosocial adjustment.

PubMed

Good, Marie; Willoughby, Teena; Fritjers, Jan

2009-10-01

This study used hierarchical linear modeling to compare longitudinal patterns of adolescent religious service attendance and club attendance, and to contrast the longitudinal relations between adolescent adjustment and religious service versus club attendance. Participants included 1050 students (47% girls) encompassing a school district in Canada, who completed the survey first in grade nine and again in grades 11 and 12. Results demonstrated that patterns of religious service attendance over time were quite different from other clubs. Religious attendance was uniquely associated with several indicators of positive as well as negative adjustment. Club involvement, conversely, was only associated with positive adjustment--particularly for individuals who reported sustained involvement over time. Findings suggest that religious services may provide some unique experiences--both positive and negative--over and above what may be provided in other clubs, and that sustained, rather than sporadic participation in clubs, may be especially important for adolescent adjustment.

Forecasting longitudinal changes in oropharyngeal tumor morphology throughout the course of head and neck radiation therapy

PubMed Central

Yock, Adam D.; Rao, Arvind; Dong, Lei; Beadle, Beth M.; Garden, Adam S.; Kudchadker, Rajat J.; Court, Laurence E.

2014-01-01

Purpose: To create models that forecast longitudinal trends in changing tumor morphology and to evaluate and compare their predictive potential throughout the course of radiation therapy. Methods: Two morphology feature vectors were used to describe 35 gross tumor volumes (GTVs) throughout the course of intensity-modulated radiation therapy for oropharyngeal tumors. The feature vectors comprised the coordinates of the GTV centroids and a description of GTV shape using either interlandmark distances or a spherical harmonic decomposition of these distances. The change in the morphology feature vector observed at 33 time points throughout the course of treatment was described using static, linear, and mean models. Models were adjusted at 0, 1, 2, 3, or 5 different time points (adjustment points) to improve prediction accuracy. The potential of these models to forecast GTV morphology was evaluated using leave-one-out cross-validation, and the accuracy of the models was compared using Wilcoxon signed-rank tests. Results: Adding a single adjustment point to the static model without any adjustment points decreased the median error in forecasting the position of GTV surface landmarks by the largest amount (1.2 mm). Additional adjustment points further decreased the forecast error by about 0.4 mm each. Selection of the linear model decreased the forecast error for both the distance-based and spherical harmonic morphology descriptors (0.2 mm), while the mean model decreased the forecast error for the distance-based descriptor only (0.2 mm). The magnitude and statistical significance of these improvements decreased with each additional adjustment point, and the effect from model selection was not as large as that from adding the initial points. Conclusions: The authors present models that anticipate longitudinal changes in tumor morphology using various models and model adjustment schemes. The accuracy of these models depended on their form, and the utility of these models includes the characterization of patient-specific response with implications for treatment management and research study design. PMID:25086518

Forecasting longitudinal changes in oropharyngeal tumor morphology throughout the course of head and neck radiation therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yock, Adam D.; Kudchadker, Rajat J.; Rao, Arvind

2014-08-15

Purpose: To create models that forecast longitudinal trends in changing tumor morphology and to evaluate and compare their predictive potential throughout the course of radiation therapy. Methods: Two morphology feature vectors were used to describe 35 gross tumor volumes (GTVs) throughout the course of intensity-modulated radiation therapy for oropharyngeal tumors. The feature vectors comprised the coordinates of the GTV centroids and a description of GTV shape using either interlandmark distances or a spherical harmonic decomposition of these distances. The change in the morphology feature vector observed at 33 time points throughout the course of treatment was described using static, linear,more » and mean models. Models were adjusted at 0, 1, 2, 3, or 5 different time points (adjustment points) to improve prediction accuracy. The potential of these models to forecast GTV morphology was evaluated using leave-one-out cross-validation, and the accuracy of the models was compared using Wilcoxon signed-rank tests. Results: Adding a single adjustment point to the static model without any adjustment points decreased the median error in forecasting the position of GTV surface landmarks by the largest amount (1.2 mm). Additional adjustment points further decreased the forecast error by about 0.4 mm each. Selection of the linear model decreased the forecast error for both the distance-based and spherical harmonic morphology descriptors (0.2 mm), while the mean model decreased the forecast error for the distance-based descriptor only (0.2 mm). The magnitude and statistical significance of these improvements decreased with each additional adjustment point, and the effect from model selection was not as large as that from adding the initial points. Conclusions: The authors present models that anticipate longitudinal changes in tumor morphology using various models and model adjustment schemes. The accuracy of these models depended on their form, and the utility of these models includes the characterization of patient-specific response with implications for treatment management and research study design.« less

Validation of questionnaire on the Spiritual Needs Assessment for Patients (SNAP) questionnaire in Brazilian Portuguese

PubMed Central

de Araujo Toloi, Diego; Uema, Deise; Matsushita, Felipe; da Silva Andrade, Paulo Antonio; Branco, Tiago Pugliese; de Carvalho Chino, Fabiana Tomie Becker; Guerra, Raquel Bezerra; Pfiffer, Túlio Eduardo Flesch; Chiba, Toshio; Guindalini, Rodrigo Santa Cruz; Sulmasy, Daniel P; Riechelmann, Rachel P

2016-01-01

Summary Objectives Spirituality is related to the care and the quality of life of cancer patients. Thus, it is very important to assess their needs. The objective of this study was the translation and cultural adjustment of the Spiritual Needs Assessment for Patients (SNAP) questionnaire to the Brazilian Portuguese language. Methodology The translation and cultural adjustment of the SNAP questionnaire involved six stages: backtranslation, revision of backtranslation, translation to the original language and adjustments, pre-test on ten patients, and test and retest with 30 patients after three weeks. Adult patients, with a solid tumour and literate with a minimum of four years schooling were included. For analysis and consistency we used the calculation of the Cronbach alpha coefficient and the Pearson linear correlation. Results The final questionnaire had some language and content adjustments compared to the original version in English. The correlation analysis of each item with the total score of the questionnaire showed coefficients above 0.99. The calculation of the Cronbach alpha coefficient was 0.9. The calculation of the Pearson linear correlation with the test and retest of the questionnaire was equal to 0.95. Conclusion The SNAP questionnaire translated into Brazilian Portuguese is adequately reliable and consistent. This instrument allows adequate access to spiritual needs and can help patient care. PMID:28101137

78 FR 12318 - Federal Acquisition Regulation; Submission for OMB Review; Economic Price Adjustment

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-22

...; Submission for OMB Review; Economic Price Adjustment AGENCY: Department of Defense (DOD), General Services... economic price adjustment. A notice was published in the Federal Register at 77 FR 69442, on November 19...: Submit comments identified by Information Collection 9000- 0068, Economic Price Adjustment by any of the...

26 CFR 1.9001-4 - Adjustments required in computing excess-profits credit.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 13 2010-04-01 2010-04-01 false Adjustments required in computing excess... Adjustments required in computing excess-profits credit. (a) In general. Subsection (f) of the Act provides adjustments required to be made in computing the excess-profits credit for any taxable year under the Excess...

42 CFR 419.43 - Adjustments to national program payment and beneficiary copayment amounts.

Code of Federal Regulations, 2012 CFR

2012-10-01

...) Drugs and biologicals that are paid under a separate APC; and (2) Items and services paid at charges... excluded from qualification for the payment adjustment in paragraph (g)(2) of this section: (i) Drugs and...) Payment adjustment for certain cancer hospitals—(1) General rule. CMS provides for a payment adjustment...

Significance of adjusting salt intake by body weight in the evaluation of dietary salt and blood pressure.

PubMed

Hashimoto, Tomomi; Takase, Hiroyuki; Okado, Tateo; Sugiura, Tomonori; Yamashita, Sumiyo; Kimura, Genjiro; Ohte, Nobuyuki; Dohi, Yasuaki

2016-08-01

The close association between dietary salt and hypertension is well established. However, previous studies generally assessed salt intake without adjustment for body weight. Herein, we investigated the significance of body weight-adjusted salt intake in the general population. The present cross-sectional study included 7629 participants from our yearly physical checkup program, and their salt intake was assessed using a spot urine test to estimate 24-hour urinary salt excretion. Total salt intake increased with increasing body weight. Body weight-adjusted salt intake was greater in participants with hypertension than in those without hypertension. Systolic blood pressure, estimated glomerular filtration rate, and urinary albumin were independently correlated with body weight-adjusted salt intake after adjustment for possible cardiovascular risk factors. Excessive body weight-adjusted salt intake could be related to an increase in blood pressure and hypertensive organ damage. Adjustment for body weight might therefore provide clinically important information when assessing individual salt intake. Copyright © 2016 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

Relationship of Pain and Ancestry in African American Women

PubMed Central

Robbins, John A.; Qi, Lihong; Garcia, Lorena; Younger, Jarred W.; Seldin, Michael F.

2015-01-01

Background African Americans are reported to be more sensitive to pain than European Americans. Pain sensitivity has been shown to be genetically linked in animal models and is likely to be in humans. Methods 11,239 self-identified African American post menopausal women enrolled in the Women’s Health Initiative had percentage African ancestry determined by ancestry informative markers, “Pain Construct” measurements and covariate information. They answered 5 questions about specific types and location of pain, such as joint, neck, low back, headache, and urinary. They also answered 2 questions which were used to derive a “Pain Construct”, a measure of general pain scored on a scale of 1 to 100. Associations were tested in linear regression models adjusting for age, self-reported medical conditions, neighborhood socio-economic status, education, and depression. Results In the unadjusted model of the 5 specific types of pain measures, greater pain perception was associated with a higher proportion of African ancestry. However, some of the specific types of pain measures were no longer associated with African ancestry after adjustment for other study covariates. The Pain Construct was statistically significantly associated with African ancestry in both the unadjusted [Beta = −0.132, 95% confidence interval (C I) = −099 – −0.164; r = −0.075, 95% CI −0.056 – −0.093] and the adjusted models (Beta = −0.069 95% CI = −0.04 – 0.10). Conclusions Greater African ancestry was associated with higher levels of self-reported pain although this accounted for only a minor fraction of the overall variation in the Pain Construct. PMID:25752262

Coffee Consumption and Heart Rate Variability: The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) Cohort Study.

PubMed

de Oliveira, Rackel Aguiar Mendes; Araújo, Larissa Fortunato; de Figueiredo, Roberta Carvalho; Goulart, Alessandra C; Schmidt, Maria Ines; Barreto, Sandhi Maria; Ribeiro, Antonio Luiz Pinho

2017-07-13

Studies have shown that acute coffee ingestion can affect cardiovascular autonomic activity, although the chronic effects on heart rate variability (HRV) remain controversial. A cross-sectional study with baseline data (2008-2010) from ELSA-Brasil cohort of 15,105 (aged 35-74), based in six Brazilian states. Coffee consumption in the previous 12 months was measured using the semi-quantitative food frequency questionnaire, and HRV was obtained through electrocardiographic tracings during 10 min at rest. Independent association between the frequency of coffee consumption "never or almost never", "≤1 cup/day", "2-3 cups/day", "≥3 cups/day", and HRV was estimated using generalized linear regression, adjusting for socio-demographic characteristics, health-related behavior, markers of abnormal metabolism, and the presence of coronary artery disease. Further, we applied Bonferroni correction in the full models. The mean age was 52 years (standard deviation (SD) = 9.1), and 52% was female; 9.5% never/almost never consumed coffee. In univariate analysis, coffee consumers had reduced values of HRV indexes, but after full adjustments and correction for multiple comparisons, these associations disappeared. A trend of reduction in HRV vagal indexes was observed in those that consumed ≥3 cups of coffee/day. Most of the effects attributed to the chronic use of coffee on the HRV indexes is related to the higher prevalence of unhealthy habits in coffee users, such as smoking and alcohol use. Adjustment for confounding factors weaken this association, making it non-significant. The effect of higher daily doses of coffee on the autonomic system should be evaluated in further studies.

Probiotic milk consumption in pregnancy and infancy and subsequent childhood allergic diseases

PubMed Central

Bertelsen, Randi J.; Brantsæter, Anne Lise; Magnus, Maria C.; Haugen, Margaretha; Myhre, Ronny; Jacobsson, Bo; Longnecker, Matthew P.; Meltzer, Helle M.; London, Stephanie J.

2013-01-01

Background Whether probiotics, which can influence the microbiome, prevent infant eczema or allergic diseases remains an open question. Most studies have focused on high-risk infants. Objectives To assess whether consumption of probiotic milk products protects against atopic eczema, rhinoconjuctivitis, and asthma in early childhood in a large population-based pregnancy cohort (The Norwegian Mother and Child Cohort Study). Methods We examined associations between consumption of probiotic milk products in pregnancy and infancy with questionnaire-reported atopic eczema, rhinoconjuctivitis, and asthma in 40,614 children. Relative risks (RR) were calculated using general linear models, adjusted for potential confounders. Results Consumption of probiotic milk in pregnancy was associated with a slightly reduced risk [(adjusted RR (aRR)] of atopic eczema at 6 months aRR=0.94 (95% CI: 0.89, 0.99) and of rhinoconjuctivitis between 18 and 36 months, aRR=0.87 (95% CI: 0.78, 0.98) compared with no consumption during pregnancy. Maternal history of allergic disease did not notably influence the associations. When both mother (during pregnancy) and infant (after 6 months of age) had consumed probiotic milk, the adjusted relative risk of rhinoconjunctivitis was aRR=0.80 (95% CI: 0.68, 0.93) relative to no consumption by either. Probiotic milk consumption was not associated with asthma at 36 months. Conclusions In this population-based cohort, consumption of probiotic milk products was related to a reduced incidence of atopic eczema and rhinoconjuctivitis, but no association was seen for incidence of asthma by 36 months of age. PMID:24034345

The relationship between target joints and direct resource use in severe haemophilia.

PubMed

O'Hara, Jamie; Walsh, Shaun; Camp, Charlotte; Mazza, Giuseppe; Carroll, Liz; Hoxer, Christina; Wilkinson, Lars

2018-01-16

Target joints are a common complication of severe haemophilia. While factor replacement therapy constitutes the majority of costs in haemophilia, the relationship between target joints and non drug-related direct costs (NDDCs) has not been studied. Data on haemophilia patients without inhibitors was drawn from the 'Cost of Haemophilia across Europe - a Socioeconomic Survey' (CHESS) study, a cost assessment in severe haemophilia A and B across five European countries (France, Germany, Italy, Spain, and the United Kingdom) in which 139 haemophilia specialists provided demographic and clinical information for 1285 adult patients. NDDCs were calculated using publicly available cost data, including 12-month ambulatory and secondary care activity: haematologist and other specialist consultant consultations, medical tests and examinations, bleed-related hospital admissions, and payments to professional care providers. A generalized linear model was developed to investigate the relationship between NDDCs and target joints (areas of chronic synovitis), adjusted for patient covariates. Five hundred and thirteen patients (42% of the sample) had no diagnosed target joints; a total of 1376 target joints (range 1-10) were recorded in the remaining 714 patients. Mean adjusted NDDCs for persons with no target joints were EUR 3134 (standard error (SE) EUR 158); for persons with one or more target joints, mean adjusted NDDCs were EUR 3913 (SE EUR 157; average mean effect EUR 779; p < 0.001). Our analysis suggests that the presence of one or more target joints has a significant impact on NDDCs for patients with severe haemophilia, ceteris paribus. Prevention and management of target joints should be an important consideration of managing haemophilia patients.

Pleiotropy of cardiometabolic syndrome with obesity-related anthropometric traits determined using empirically derived kinships from the Busselton Health Study.

PubMed

Cadby, Gemma; Melton, Phillip E; McCarthy, Nina S; Almeida, Marcio; Williams-Blangero, Sarah; Curran, Joanne E; VandeBerg, John L; Hui, Jennie; Beilby, John; Musk, A W; James, Alan L; Hung, Joseph; Blangero, John; Moses, Eric K

2018-01-01

Over two billion adults are overweight or obese and therefore at an increased risk of cardiometabolic syndrome (CMS). Obesity-related anthropometric traits genetically correlated with CMS may provide insight into CMS aetiology. The aim of this study was to utilise an empirically derived genetic relatedness matrix to calculate heritabilities and genetic correlations between CMS and anthropometric traits to determine whether they share genetic risk factors (pleiotropy). We used genome-wide single nucleotide polymorphism (SNP) data on 4671 Busselton Health Study participants. Exploiting both known and unknown relatedness, empirical kinship probabilities were estimated using these SNP data. General linear mixed models implemented in SOLAR were used to estimate narrow-sense heritabilities (h 2 ) and genetic correlations (r g ) between 15 anthropometric and 9 CMS traits. Anthropometric traits were adjusted by body mass index (BMI) to determine whether the observed genetic correlation was independent of obesity. After adjustment for multiple testing, all CMS and anthropometric traits were significantly heritable (h 2 range 0.18-0.57). We identified 50 significant genetic correlations (r g range: - 0.37 to 0.75) between CMS and anthropometric traits. Five genetic correlations remained significant after adjustment for BMI [high density lipoprotein cholesterol (HDL-C) and waist-hip ratio; triglycerides and waist-hip ratio; triglycerides and waist-height ratio; non-HDL-C and waist-height ratio; insulin and iliac skinfold thickness]. This study provides evidence for the presence of potentially pleiotropic genes that affect both anthropometric and CMS traits, independently of obesity.

Paranoid beliefs and realistic expectations of victimization: Data from the survey of police-public encounters.

PubMed

Jun, Hyun-Jin; Nam, Boyoung; Fedina, Lisa; Smith, Melissa Edmondson; Schiffman, Jason; Link, Bruce; DeVylder, Jordan E

2018-03-08

The anticipation of threat or victimization is a core feature of paranoia. Cognitive theories of paranoia suggest that paranoid thoughts may arise as a psychological response to trauma exposure, which likewise may lead to greater anticipation of subsequent victimization. Little is known, however, about the relation between paranoid beliefs and anticipated victimization when accounting for past victimization experience. The present study aimed to address whether the experiences of past victimization contribute to the link between paranoid beliefs and the anticipation of threat or victimization, with a particular focus on exposure to police violence. Data were collected through the Survey of Police-Public Encounters (N=1615), a cross-sectional, general population survey study conducted in four Eastern U.S. cities. Associations between paranoia and anticipated victimization were assessed using linear regression models, with and without adjustment for past victimization exposure. Paranoid beliefs were positively associated with police victimization expectations (β=0.19, p<0.001), but these associations were statistically better explained by past exposures to similar victimization such that paranoia was no longer associated with anticipated victimization in adjusted models (β=0.02, p=0.451). To assess for the specificity of past exposures to victimization, adjusting for past exposure to intimate partner violence (as a control condition) did not eliminate the association between paranoia and expected police victimization. The overall findings are consistent with cognitive theories of paranoia in which paranoid beliefs may be a severe but normative reaction to past victimization exposures in some cases. Copyright © 2018 Elsevier B.V. All rights reserved.

Do trauma type, stressful life events, and social support explain women veterans' high prevalence of PTSD?

PubMed

Lehavot, Keren; Goldberg, Simon B; Chen, Jessica A; Katon, Jodie G; Glass, Joseph E; Fortney, John C; Simpson, Tracy L; Schnurr, Paula P

2018-06-23

To examine factors that account for women veterans' higher prevalence of past-year DSM-5 posttraumatic stress disorder (PTSD) compared to women civilians and men veterans. Cross-sectional analyses of the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III). Face-to-face interviews with 379 women veterans, 20,007 women civilians, and 2740 men veterans were conducted. Trauma type (child abuse, interpersonal violence, combat or war zone, and other), number of trauma types, past-year stressful life events, current social support, and DSM-5 PTSD were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-5. Generalized linear models were used that accounted for the complex survey design. Women veterans had a higher unadjusted prevalence of past-year PTSD (11.40%) compared to their civilian (5.96%) and male (5.19%) counterparts. Individual predictor models indicated that the difference between women veterans' and civilians' prevalence of PTSD was attenuated when adjusting for number of trauma types, whereas the difference between men and women veterans was attenuated when adjusting for child abuse, interpersonal violence, and stressful life events. Nonetheless, while full adjustment in a multiple predictor model accounted for the difference in PTSD between women veterans and civilians, gender differences between men and women veterans remained. Number of trauma types, type of trauma, and social factors may together help explain women veterans' higher PTSD prevalence compared to women civilians, but do not fully account for differences between men and women veterans. Results highlight a need to explore additional explanatory factors and evaluate associations with longitudinal data.

Explaining prescription drug use and expenditures using the adjusted clinical groups case-mix system in the population of British Columbia, Canada.

PubMed

Hanley, Gillian E; Morgan, Steve; Reid, Robert J

2010-05-01

Given that prescription drugs have become a major financial component of health care, there is an increased need to explain variations in the use of and expenditure on medicines. Case-mix systems built from existing administrative datasets may prove very useful for such prediction. We estimated the concurrent and prospective predictive validity of the adjusted clinical groups (ACG) system in pharmaceutical research and compared the ACG system with the Charlson index of comorbidity. We ran a generalized linear models to examine the predictive validity of the ACG system and the Charlson index and report the correlation between the predicted and observed expenditures. We reported mean predictive ratios across medical condition and cost-defined groups. When predicting use of medicines, we used C-statistics to summarize the area under the receiver operating characteristic curve. The 3,908,533 British Columbia residents who were registered for the universal health care plan for 275+ days in the calendar years 2004 and 2005. Outcomes were total pharmaceutical expenditures, use of any medicines, and use of medicines from 4+ different therapeutic categories. The ACG case mix system predicted drug expenditures better than the Charlson index. The mean predictive ratios for the ACG system models were all within 4% of the actual costs when examining medical condition group and the C-stats for the 2 dichotomous outcomes were between 0.82 and 0.89. ACG case-mix adjusters are a valuable predictor of pharmaceutical use and expenditures with much higher predictive power than age, sex, and the Charlson index of comorbidity.

Increased popliteal circumferential wall tension induced by orthostatic body posture is associated with local atherosclerotic plaques.

PubMed

Gemignani, Tiago; Azevedo, Renata C; Higa, Celina M; Coelho, Otávio R; Matos-Souza, José R; Nadruz, Wilson

2012-09-01

Lower limb arteries are exposed to higher hemodynamic burden in erectile posture. This study evaluated the effects of body posture on popliteal, carotid and brachial circumferential wall tension (CWT) and investigated the relationship between local CWT and atherosclerotic plaques in subjects with cardiovascular risk factors. Two hundred and three subjects (118 women and 85 men) with cardiovascular risk factors (smoking, hypertension or diabetes mellitus) underwent clinical and laboratory analysis and had their blood pressure measured in the arm and calf in supine and orthostatic positions. Arteries were evaluated by ultrasound analysis, while CWT was calculated according to Laplace's law. Among the enrolled participants, 47%, 29% and none presented popliteal, carotid and brachial plaques, respectively. Carotid CWT measurements were not associated with local plaques after adjustment for potential confounders. Conversely, general linear model and logistic regression analyses adjusted for potential confounders demonstrated that peak orthostatic CWT was the only local hemodynamic parameter showing significant relationship with popliteal plaques in the whole sample. In gender-specific analyses, although positively correlated with popliteal plaques in both genders, local peak orthostatic CWT exhibited an independent association with popliteal plaques after adjustment for potential confounders only in women. Popliteal CWT measured in orthostatic posture, rather than in supine position, is associated with popliteal atherosclerotic plaques, particularly in women. These findings suggest that erectile posture might play a role in the atherogenesis of leg arteries by modifying local hemodynamic forces and that there may be gender differences in this regard. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Disturbances of automatic gait control mechanisms in higher level gait disorder.

PubMed

Danoudis, Mary; Ganesvaran, Ganga; Iansek, Robert

2016-07-01

The underlying mechanisms responsible for the gait changes in frontal gait disorder (FGD), a form of higher level gait disorders, are poorly understood. We investigated the relationship between stride length and cadence (SLCrel) in people with FGD (n=15) in comparison to healthy older adults (n=21) to improve our understanding of the changes to gait in FGD. Gait data was captured using an electronic walkway system as participants walked at five self-selected speed conditions: preferred, very slow, slow, fast and very fast. Linear regression was used to determine the strength of the relationship (R(2)), slope and intercept. In the FGD group 9 participants had a strong SLCrel (linear group) (R(2)>0.8) and 6 a weak relationship (R(2)<0.8) (nonlinear group). The linear FGD group did not differ to healthy control for slope (p>0.05) but did have a lower intercept (p<0.001). The linear FGD group modulated gait speed by adjusting stride length and cadence similar to controls whereas the nonlinear FGD participants adjusted stride length but not cadence similar to controls. The non-linear FGD group had greater disturbance to their gait, poorer postural control and greater fear of falling compared to the linear FGD group. Investigation of the SLCrel resulted in new insights into the underlying mechanisms responsible for the gait changes found in FGD. The findings suggest stride length regulation was disrupted in milder FGD but as the disorder worsened, cadence control also became disordered resulting in a break down in the relationship between stride length and cadence. Copyright © 2016 Elsevier B.V. All rights reserved.

Quantum corrections to the generalized Proca theory via a matter field

NASA Astrophysics Data System (ADS)

Amado, André; Haghani, Zahra; Mohammadi, Azadeh; Shahidi, Shahab

2017-09-01

We study the quantum corrections to the generalized Proca theory via matter loops. We consider two types of interactions, linear and nonlinear in the vector field. Calculating the one-loop correction to the vector field propagator, three- and four-point functions, we show that the non-linear interactions are harmless, although they renormalize the theory. The linear matter-vector field interactions introduce ghost degrees of freedom to the generalized Proca theory. Treating the theory as an effective theory, we calculate the energy scale up to which the theory remains healthy.

34 CFR 668.208 - General requirements for adjusting official cohort default rates and for appealing their...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 3 2010-07-01 2010-07-01 false General requirements for adjusting official cohort default rates and for appealing their consequences. 668.208 Section 668.208 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF...

34 CFR 668.189 - General requirements for adjusting official cohort default rates and for appealing their...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 3 2010-07-01 2010-07-01 false General requirements for adjusting official cohort default rates and for appealing their consequences. 668.189 Section 668.189 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF...

A General Accelerated Degradation Model Based on the Wiener Process.

PubMed

Liu, Le; Li, Xiaoyang; Sun, Fuqiang; Wang, Ning

2016-12-06

Accelerated degradation testing (ADT) is an efficient tool to conduct material service reliability and safety evaluations by analyzing performance degradation data. Traditional stochastic process models are mainly for linear or linearization degradation paths. However, those methods are not applicable for the situations where the degradation processes cannot be linearized. Hence, in this paper, a general ADT model based on the Wiener process is proposed to solve the problem for accelerated degradation data analysis. The general model can consider the unit-to-unit variation and temporal variation of the degradation process, and is suitable for both linear and nonlinear ADT analyses with single or multiple acceleration variables. The statistical inference is given to estimate the unknown parameters in both constant stress and step stress ADT. The simulation example and two real applications demonstrate that the proposed method can yield reliable lifetime evaluation results compared with the existing linear and time-scale transformation Wiener processes in both linear and nonlinear ADT analyses.

A General Accelerated Degradation Model Based on the Wiener Process

PubMed Central

Liu, Le; Li, Xiaoyang; Sun, Fuqiang; Wang, Ning

2016-01-01

Accelerated degradation testing (ADT) is an efficient tool to conduct material service reliability and safety evaluations by analyzing performance degradation data. Traditional stochastic process models are mainly for linear or linearization degradation paths. However, those methods are not applicable for the situations where the degradation processes cannot be linearized. Hence, in this paper, a general ADT model based on the Wiener process is proposed to solve the problem for accelerated degradation data analysis. The general model can consider the unit-to-unit variation and temporal variation of the degradation process, and is suitable for both linear and nonlinear ADT analyses with single or multiple acceleration variables. The statistical inference is given to estimate the unknown parameters in both constant stress and step stress ADT. The simulation example and two real applications demonstrate that the proposed method can yield reliable lifetime evaluation results compared with the existing linear and time-scale transformation Wiener processes in both linear and nonlinear ADT analyses. PMID:28774107

Embodied linearity of speed control in Drosophila melanogaster.

PubMed

Medici, V; Fry, S N

2012-12-07

Fruitflies regulate flight speed by adjusting their body angle. To understand how low-level posture control serves an overall linear visual speed control strategy, we visually induced free-flight acceleration responses in a wind tunnel and measured the body kinematics using high-speed videography. Subsequently, we reverse engineered the transfer function mapping body pitch angle onto flight speed. A linear model is able to reproduce the behavioural data with good accuracy. Our results show that linearity in speed control is realized already at the level of body posture-mediated speed control and is therefore embodied at the level of the complex aerodynamic mechanisms of body and wings. Together with previous results, this study reveals the existence of a linear hierarchical control strategy, which can provide relevant control principles for biomimetic implementations, such as autonomous flying micro air vehicles.

Embodied linearity of speed control in Drosophila melanogaster

PubMed Central

Medici, V.; Fry, S. N.

2012-01-01

Fruitflies regulate flight speed by adjusting their body angle. To understand how low-level posture control serves an overall linear visual speed control strategy, we visually induced free-flight acceleration responses in a wind tunnel and measured the body kinematics using high-speed videography. Subsequently, we reverse engineered the transfer function mapping body pitch angle onto flight speed. A linear model is able to reproduce the behavioural data with good accuracy. Our results show that linearity in speed control is realized already at the level of body posture-mediated speed control and is therefore embodied at the level of the complex aerodynamic mechanisms of body and wings. Together with previous results, this study reveals the existence of a linear hierarchical control strategy, which can provide relevant control principles for biomimetic implementations, such as autonomous flying micro air vehicles. PMID:22933185

A normative study of the Italian printed word version of the free and cued selective reminding test.

PubMed

Girtler, N; De Carli, F; Amore, M; Arnaldi, D; Bosia, L E; Bruzzaniti, C; Cappa, S F; Cocito, L; Colazzo, G; Ghio, L; Magi, E; Mancardi, G L; Nobili, F; Pardini, M; Picco, A; Rissotto, R; Serrati, C; Brugnolo, A

2015-07-01

According to the new research criteria for the diagnosis of Alzheimer's disease, episodic memory impairment, not significantly improved by cueing, is the core neuropsychological marker, even at a pre-dementia stage. The FCSRT assesses verbal learning and memory using semantic cues and is widely used in Europe. Standardization values for the Italian population are available for the colored picture version, but not for the 16-item printed word version. In this study, we present age- and education-adjusted normative data for FCSRT-16 obtained using linear regression techniques and generalized linear model, and critical values for classifying sub-test performance into equivalent scores. Six scores were derived from the performance of 194 normal subjects (MMSE score, range 27-30, mean 29.5 ± 0.5) divided per decade (from 20 to 90), per gender and per level of education (4 levels: 3-5, 6-8, 9-13, >13 years): immediate free recall (IFR), immediate total recall (ITR), recognition phase (RP), delayed free recall (DFR), delayed total recall (DTR), Index of Sensitivity of Cueing (ISC), number of intrusions. This study confirms the effect of age and education, but not of gender on immediate and delayed free and cued recall. The Italian version of the FCSRT-16 can be useful for both clinical and research purposes.

Uncovering Local Trends in Genetic Effects of Multiple Phenotypes via Functional Linear Models.

PubMed

Vsevolozhskaya, Olga A; Zaykin, Dmitri V; Barondess, David A; Tong, Xiaoren; Jadhav, Sneha; Lu, Qing

2016-04-01

Recent technological advances equipped researchers with capabilities that go beyond traditional genotyping of loci known to be polymorphic in a general population. Genetic sequences of study participants can now be assessed directly. This capability removed technology-driven bias toward scoring predominantly common polymorphisms and let researchers reveal a wealth of rare and sample-specific variants. Although the relative contributions of rare and common polymorphisms to trait variation are being debated, researchers are faced with the need for new statistical tools for simultaneous evaluation of all variants within a region. Several research groups demonstrated flexibility and good statistical power of the functional linear model approach. In this work we extend previous developments to allow inclusion of multiple traits and adjustment for additional covariates. Our functional approach is unique in that it provides a nuanced depiction of effects and interactions for the variables in the model by representing them as curves varying over a genetic region. We demonstrate flexibility and competitive power of our approach by contrasting its performance with commonly used statistical tools and illustrate its potential for discovery and characterization of genetic architecture of complex traits using sequencing data from the Dallas Heart Study. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

Error-related processing following severe traumatic brain injury: An event-related functional magnetic resonance imaging (fMRI) study

PubMed Central

Sozda, Christopher N.; Larson, Michael J.; Kaufman, David A.S.; Schmalfuss, Ilona M.; Perlstein, William M.

2011-01-01

Continuous monitoring of one’s performance is invaluable for guiding behavior towards successful goal attainment by identifying deficits and strategically adjusting responses when performance is inadequate. In the present study, we exploited the advantages of event-related functional magnetic resonance imaging (fMRI) to examine brain activity associated with error-related processing after severe traumatic brain injury (sTBI). fMRI and behavioral data were acquired while 10 sTBI participants and 12 neurologically-healthy controls performed a task-switching cued-Stroop task. fMRI data were analyzed using a random-effects whole-brain voxel-wise general linear model and planned linear contrasts. Behaviorally, sTBI patients showed greater error-rate interference than neurologically-normal controls. fMRI data revealed that, compared to controls, sTBI patients showed greater magnitude error-related activation in the anterior cingulate cortex (ACC) and an increase in the overall spatial extent of error-related activation across cortical and subcortical regions. Implications for future research and potential limitations in conducting fMRI research in neurologically-impaired populations are discussed, as well as some potential benefits of employing multimodal imaging (e.g., fMRI and event-related potentials) of cognitive control processes in TBI. PMID:21756946

Plasma amino acid profile associated with fatty liver disease and co-occurrence of metabolic risk factors.

PubMed

Yamakado, Minoru; Tanaka, Takayuki; Nagao, Kenji; Imaizumi, Akira; Komatsu, Michiharu; Daimon, Takashi; Miyano, Hiroshi; Tani, Mizuki; Toda, Akiko; Yamamoto, Hiroshi; Horimoto, Katsuhisa; Ishizaka, Yuko

2017-11-03

Fatty liver disease (FLD) increases the risk of diabetes, cardiovascular disease, and steatohepatitis, which leads to fibrosis, cirrhosis, and hepatocellular carcinoma. Thus, the early detection of FLD is necessary. We aimed to find a quantitative and feasible model for discriminating the FLD, based on plasma free amino acid (PFAA) profiles. We constructed models of the relationship between PFAA levels in 2,000 generally healthy Japanese subjects and the diagnosis of FLD by abdominal ultrasound scan by multiple logistic regression analysis with variable selection. The performance of these models for FLD discrimination was validated using an independent data set of 2,160 subjects. The generated PFAA-based model was able to identify FLD patients. The area under the receiver operating characteristic curve for the model was 0.83, which was higher than those of other existing liver function-associated markers ranging from 0.53 to 0.80. The value of the linear discriminant in the model yielded the adjusted odds ratio (with 95% confidence intervals) for a 1 standard deviation increase of 2.63 (2.14-3.25) in the multiple logistic regression analysis with known liver function-associated covariates. Interestingly, the linear discriminant values were significantly associated with the progression of FLD, and patients with nonalcoholic steatohepatitis also exhibited higher values.

Linear feasibility algorithms for treatment planning in interstitial photodynamic therapy

NASA Astrophysics Data System (ADS)

Rendon, A.; Beck, J. C.; Lilge, Lothar

2008-02-01

Interstitial Photodynamic therapy (IPDT) has been under intense investigation in recent years, with multiple clinical trials underway. This effort has demanded the development of optimization strategies that determine the best locations and output powers for light sources (cylindrical or point diffusers) to achieve an optimal light delivery. Furthermore, we have recently introduced cylindrical diffusers with customizable emission profiles, placing additional requirements on the optimization algorithms, particularly in terms of the stability of the inverse problem. Here, we present a general class of linear feasibility algorithms and their properties. Moreover, we compare two particular instances of these algorithms, which are been used in the context of IPDT: the Cimmino algorithm and a weighted gradient descent (WGD) algorithm. The algorithms were compared in terms of their convergence properties, the cost function they minimize in the infeasible case, their ability to regularize the inverse problem, and the resulting optimal light dose distributions. Our results show that the WGD algorithm overall performs slightly better than the Cimmino algorithm and that it converges to a minimizer of a clinically relevant cost function in the infeasible case. Interestingly however, treatment plans resulting from either algorithms were very similar in terms of the resulting fluence maps and dose volume histograms, once the diffuser powers adjusted to achieve equal prostate coverage.

Active imaging with the aids of polarization retrieve in turbid media system

NASA Astrophysics Data System (ADS)

Tao, Qiangqiang; Sun, Yongxuan; Shen, Fei; Xu, Qiang; Gao, Jun; Guo, Zhongyi

2016-01-01

We propose a novel active imaging based on the polarization retrieve (PR) method in turbid media system. In our simulations, the Monte Carlo (MC) algorithm has been used to investigate the scattering process between the incident photons and the scattering particles, and the visually concordant object but with different polarization characteristics in different regions, has been selected as the original target that is placed in the turbid media. Under linearly and circularly polarized illuminations, the simulation results demonstrate that the corresponding polarization properties can provide additional information for the imaging, and the contrast of the polarization image can also be enhanced greatly compared to the simplex intensity image in the turbid media. Besides, the polarization image adjusted by the PR method can further enhance the visibility and contrast. In addition, by PR imaging method, with the increasing particles' size in Mie's scale, the visibility can be enhanced, because of the increased forward scattering effect. In general, in the same circumstance, the circular polarization images can offer a better contrast and visibility than that of linear ones. The results indicate that the PR imaging method is more applicable to the scattering media system with relatively larger particles such as aerosols, heavy fog, cumulus, and seawater, as well as to biological tissues and blood media.

Error-related processing following severe traumatic brain injury: an event-related functional magnetic resonance imaging (fMRI) study.

PubMed

Sozda, Christopher N; Larson, Michael J; Kaufman, David A S; Schmalfuss, Ilona M; Perlstein, William M

2011-10-01

Continuous monitoring of one's performance is invaluable for guiding behavior towards successful goal attainment by identifying deficits and strategically adjusting responses when performance is inadequate. In the present study, we exploited the advantages of event-related functional magnetic resonance imaging (fMRI) to examine brain activity associated with error-related processing after severe traumatic brain injury (sTBI). fMRI and behavioral data were acquired while 10 sTBI participants and 12 neurologically-healthy controls performed a task-switching cued-Stroop task. fMRI data were analyzed using a random-effects whole-brain voxel-wise general linear model and planned linear contrasts. Behaviorally, sTBI patients showed greater error-rate interference than neurologically-normal controls. fMRI data revealed that, compared to controls, sTBI patients showed greater magnitude error-related activation in the anterior cingulate cortex (ACC) and an increase in the overall spatial extent of error-related activation across cortical and subcortical regions. Implications for future research and potential limitations in conducting fMRI research in neurologically-impaired populations are discussed, as well as some potential benefits of employing multimodal imaging (e.g., fMRI and event-related potentials) of cognitive control processes in TBI. Copyright © 2011 Elsevier B.V. All rights reserved.

Extraction of object skeletons in multispectral imagery by the orthogonal regression fitting

NASA Astrophysics Data System (ADS)

Palenichka, Roman M.; Zaremba, Marek B.

2003-03-01

Accurate and automatic extraction of skeletal shape of objects of interest from satellite images provides an efficient solution to such image analysis tasks as object detection, object identification, and shape description. The problem of skeletal shape extraction can be effectively solved in three basic steps: intensity clustering (i.e. segmentation) of objects, extraction of a structural graph of the object shape, and refinement of structural graph by the orthogonal regression fitting. The objects of interest are segmented from the background by a clustering transformation of primary features (spectral components) with respect to each pixel. The structural graph is composed of connected skeleton vertices and represents the topology of the skeleton. In the general case, it is a quite rough piecewise-linear representation of object skeletons. The positions of skeleton vertices on the image plane are adjusted by means of the orthogonal regression fitting. It consists of changing positions of existing vertices according to the minimum of the mean orthogonal distances and, eventually, adding new vertices in-between if a given accuracy if not yet satisfied. Vertices of initial piecewise-linear skeletons are extracted by using a multi-scale image relevance function. The relevance function is an image local operator that has local maximums at the centers of the objects of interest.

Proposing a new iterative learning control algorithm based on a non-linear least square formulation - Minimising draw-in errors

NASA Astrophysics Data System (ADS)

Endelt, B.

2017-09-01

Forming operation are subject to external disturbances and changing operating conditions e.g. new material batch, increasing tool temperature due to plastic work, material properties and lubrication is sensitive to tool temperature. It is generally accepted that forming operations are not stable over time and it is not uncommon to adjust the process parameters during the first half hour production, indicating that process instability is gradually developing over time. Thus, in-process feedback control scheme might not-be necessary to stabilize the process and an alternative approach is to apply an iterative learning algorithm, which can learn from previously produced parts i.e. a self learning system which gradually reduces error based on historical process information. What is proposed in the paper is a simple algorithm which can be applied to a wide range of sheet-metal forming processes. The input to the algorithm is the final flange edge geometry and the basic idea is to reduce the least-square error between the current flange geometry and a reference geometry using a non-linear least square algorithm. The ILC scheme is applied to a square deep-drawing and the Numisheet’08 S-rail benchmark problem, the numerical tests shows that the proposed control scheme is able control and stabilise both processes.

Associations between heavy episodic drinking and alcohol related injuries: a case control study

PubMed Central

2013-01-01

Background Alcohol is a significant risk factor for injuries. This study addresses 1) whether the risk of alcohol related injury increases with frequency of heavy episodic drinking (HED) in a linear fashion, and 2) whether a small group of high risk drinkers accounts for the majority of alcohol related injuries. Methods We applied a case – control design. Cases were BAC positive injured patients (n = 534) and controls were respondents to a general population survey in Norway (n = 1947). Age and gender adjusted association between self-reported past year HED frequency and alcohol related injury risk was estimated in logistic regression models for all alcohol related injuries and for violence injuries and accident injuries separately. Results An increase in HED was associated with an increase in risk of alcohol related injury, resembling a linear risk function. The small fraction of high risk drinkers (6.6%) accounted for 41.6% of all alcohol related injuries, thus lending support to the validity of the prevention paradox. Conclusion There is a strong relationship between frequency of heavy episodic drinking and risk of alcohol related injuries, yet the majority of alcohol related injuries are found among drinkers who are not in the high risk group. PMID:24228707

Generalized Parameter-Adjusted Stochastic Resonance of Duffing Oscillator and Its Application to Weak-Signal Detection.

PubMed

Lai, Zhi-Hui; Leng, Yong-Gang

2015-08-28

A two-dimensional Duffing oscillator which can produce stochastic resonance (SR) is studied in this paper. We introduce its SR mechanism and present a generalized parameter-adjusted SR (GPASR) model of this oscillator for the necessity of parameter adjustments. The Kramers rate is chosen as the theoretical basis to establish a judgmental function for judging the occurrence of SR in this model; and to analyze and summarize the parameter-adjusted rules under unmatched signal amplitude, frequency, and/or noise-intensity. Furthermore, we propose the weak-signal detection approach based on this GPASR model. Finally, we employ two practical examples to demonstrate the feasibility of the proposed approach in practical engineering application.

Levels and determinants of breast and cervical cancer screening uptake in HIV-infected women compared with the general population in France.

PubMed

Tron, L; Lert, F; Spire, B; Dray-Spira, R

2017-03-01

Cancer is a growing concern for HIV-infected people, and screening plays a major role in alleviating the burden it causes. We sought to investigate the levels and determinants of breast cancer screening (BCS) and cervical cancer screening (CCS) in HIV-infected women as compared with the general population. The Agence Nationale de Recherche sur le Sida et les Hépatites Virales (ANRS)-Vespa2 study was conducted in 2011 in a national representative sample of 3022 HIV-infected hospital out-patients in France. The rates and correlates of BCS and CCS among HIV-infected women were compared with those in the general population using multivariate Poisson regression models. The BCS rate during the 2 years preceding the survey interview was 80.7% among HIV-infected women vs. 89.1% in the general population (P = 0.146). The CCS rate during the preceding 3 years was 88.1% among HIV-infected women vs. 83.1% in the general population (P = 0.021). During the preceding year, the CCS rate among HIV-infected women was 76.5%. The barriers to BCS and CCS were a low educational level [BCS: adjusted prevalence rate ratio 0.88; 95% confidence interval (CI) 0.80-0.97; CCS: adjusted prevalence rate ratio 0.91; 95% CI 0.83-0.99], not having supplementary health insurance (CCS: adjusted prevalence rate ratio 0.92; 95% CI 0.86-0.98), an irregular gynaecological follow-up (BCS: adjusted prevalence rate ratio 0.77; 95% CI 0.64-0.92; CCS: adjusted prevalence rate ratio 0.72; 95% CI 0.64-0.81) and a low CD4 count (BCS: adjusted prevalence rate ratio 0.83; 95% CI 0.71-0.97; CCS: adjusted prevalence rate ratio 0.78; 95% CI 0.63-0.98). The disparities in CCS uptake in terms of age, employment and gynaecological follow-up were less pronounced among HIV-infected women than in the general population. BCS and CCS uptake was not lower among HIV-infected women than in the general population, but CCS was suboptimal. Specificities in the profile of barriers to screening emerged. © 2016 British HIV Association.

Psychosocial Working Conditions and Cognitive Complaints among Swedish Employees

PubMed Central

Stenfors, Cecilia U. D.; Magnusson Hanson, Linda; Oxenstierna, Gabriel; Theorell, Töres; Nilsson, Lars-Göran

2013-01-01

Background Cognitive complaints involving problems with concentration, memory, decision-making and thinking are relatively common in the work force. The sensitivity of both subjective and objective cognitive functioning to common psychiatric conditions, stress levels and to cognitive load makes it plausible that psychosocial working conditions play a role in cognitive complaints. Thus, this study aimed to test the associations between psychosocial work factors and cognitive complaints in nationally representative samples of the Swedish work force. Cross-sectional (n = 9751) and prospective (n = 3644; two time points two years apart) sequential multiple regression analyses were run, adjusting for general confounders, depressive- and sleeping problems. Additional prospective analyses were run adjusting for baseline cognitive complaints. Cross-sectional results High quantitative demands, information and communication technology (ICT) demands, underqualification and conflicts were positively associated with cognitive complaints, while social support, good resources at work and overqualification were negatively associated with cognitive complaints in all models. Skill discretion and decision authority were weakly associated with cognitive complaints. Conflicts were more strongly associated with cognitive complaints in women than in men, after adjustment for general confounders. Prospective results Quantitative job demands, ICT demands and underqualification were positively associated with future cognitive complaints in all models, including when adjusted for baseline cognitive complaints. Decision authority was weakly positively associated with future cognitive complaints, only after adjustment for depressive- and sleeping problems respectively. Social support was negatively associated with future cognitive complaints after adjustment for general confounders and baseline cognitive complaints. Skill discretion and resources were negatively associated with future cognitive complaints after adjustment for general confounders. The associations between quantitative demands and future cognitive complaints were stronger in women. Discussion/Conclusions The findings indicate that psychosocial working conditions should be taken into account when considering cognitive complaints among employees. PMID:23560101

Comparing Multiple-Group Multinomial Log-Linear Models for Multidimensional Skill Distributions in the General Diagnostic Model. Research Report. ETS RR-08-35

ERIC Educational Resources Information Center

Xu, Xueli; von Davier, Matthias

2008-01-01

The general diagnostic model (GDM) utilizes located latent classes for modeling a multidimensional proficiency variable. In this paper, the GDM is extended by employing a log-linear model for multiple populations that assumes constraints on parameters across multiple groups. This constrained model is compared to log-linear models that assume…

Dietary fat intake and quality of life: the SUN project.

PubMed

Ruano, Cristina; Henriquez, Patricia; Bes-Rastrollo, Maira; Ruiz-Canela, Miguel; del Burgo, Cristina López; Sánchez-Villegas, Almudena

2011-11-02

Few studies have related nutritional factors with quality of life in healthy populations. The purpose of the study was to assess whether dietary fat intake is associated to mental and physical quality of life. This analysis included 8,430 participants from the SUN (Seguimiento Universidad de Navarra) Project. The intake of saturated fatty acids (SFA), polyunsaturated fatty acids (PUFA), trans unsaturated fatty acids (TFA), and monounsaturated fatty acids (MUFA) was assessed through a 136-item food frequency questionnaire at baseline. Quality of life was measured with the SF-36 Health Survey after 4 years of follow-up. Generalized Linear Models were fitted to assess the regression coefficients (b) and their 95% confidence intervals (95% CI) for the 8 domains of the SF-36 according to successive quintiles of each kind of fatty acids intake. The multivariate-adjusted models revealed a significant inverse association for SFA intake (in quintiles) and two of the physical domains (physical functioning and general health). E.g. for general health domain: (highest quintile of intake (Q5) vs. lowest quintile (Q1), b = -1.6; 95% CI = -3.1, -0.1. General health also showed a dose-response relationship (p for trend < 0.05). For TFA intake (in quintiles), a significant inverse association was found for most of the mental domains (vitality, social functioning and role emotional). E.g. for vitality domain (Q5) vs. (Q1), b = -2.0, 95% CI = -3.4 to -0.6. We also found an inverse association between TFA intake and the bodily pain domain: (Q5 vs. Q1), b = -2.6; 95% CI = -4.4 to -0.8, with a statistically significant dose-response relationship (p for trend < 0.05). Except for TFA intake and the mental domains, the rest of the associations were attenuated when we repeated the analysis adjusting for adherence to the Mediterranean diet. A detrimental relationship between TFA intake at baseline and most of the SF-36 mental domains measured 4 years later were found, whereas weak inverse associations were found for SFA intake and some physical domains.

Adolescent RSA Responses during an Anger Discussion Task: Relations to Emotion Regulation and Adjustment

PubMed Central

Cui, Lixian; Morris, Amanda Sheffield; Harrist, Amanda W.; Larzelere, Robert E.; Criss, Michael M.; Houltberg, Benjamin J.

2015-01-01

The current study examined associations between adolescent respiratory sinus arrhythmia (RSA) during an angry event discussion task and adolescents’ emotion regulation and adjustment. Data were collected from 206 adolescents (10–18 years old, M age = 13.37). Electrocardiogram (ECG) and respiration data were collected from adolescents, and RSA values and respiration rates were computed. Adolescents reported on their own emotion regulation, prosocial behavior, and aggressive behavior. Multi-level latent growth modeling was employed to capture RSA responses across time (i.e., linear and quadratic changes; time course approach), and adolescent emotion regulation and adjustment variables were included in the model to test their links to RSA responses. Results indicated that high RSA baseline was associated with more adolescent prosocial behavior. A pattern of initial RSA decreases (RSA suppression) in response to angry event recall and subsequent RSA increases (RSA rebound) were related to better anger and sadness regulation and more prosocial behavior. However, RSA was not significantly linked to adolescent aggressive behavior. We also compared the time course approach with the conventional linear approach and found that the time course approach provided more meaningful and rich information. The implications of adaptive RSA change patterns are discussed. PMID:25642723

39 CFR 3010.14 - Contents of notice of rate adjustment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Contents of notice of rate adjustment. 3010.14... Adjustments) § 3010.14 Contents of notice of rate adjustment. (a) General. The Postal Service notice of rate... sources; (4) The amount of new unused rate authority, if any, that will be generated by the rate...

78 FR 24336 - Rules of Practice and Procedure; Adjusting Civil Money Penalties for Inflation

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-25

... courts. \\4\\ The CPI is published by the Department of Labor, Bureau of Statistics, and is available at.... Mathematical Calculation In general, the adjustment calculation required by the Inflation Adjustment Act is... adjusted in 2009. According to the Bureau of Labor Statistics, the CPI for June 1996 and June 2009 was 156...

42 CFR 419.43 - Adjustments to national program payment and beneficiary copayment amounts.

Code of Federal Regulations, 2014 CFR

2014-10-01

...) Drugs and biologicals that are paid under a separate APC; and (2) Items and services paid at charges... excluded from qualification for the payment adjustment in paragraph (g)(2) of this section: (i) Drugs and...) Payment adjustment for certain cancer hospitals.—(1) General rule. CMS provides for a payment adjustment...

Method for measuring the contour of a machined part

DOEpatents

Bieg, L.F.

1995-05-30

A method is disclosed for measuring the contour of a machined part with a contour gage apparatus, having a probe assembly including a probe tip for providing a measure of linear displacement of the tip on the surface of the part. The contour gage apparatus may be moved into and out of position for measuring the part while the part is still carried on the machining apparatus. Relative positions between the part and the probe tip may be changed, and a scanning operation is performed on the machined part by sweeping the part with the probe tip, whereby data points representing linear positions of the probe tip at prescribed rotation intervals in the position changes between the part and the probe tip are recorded. The method further allows real-time adjustment of the apparatus machining the part, including real-time adjustment of the machining apparatus in response to wear of the tool that occurs during machining. 5 figs.

Transducer-actuator systems and methods for performing on-machine measurements and automatic part alignment

DOEpatents

Barkman, William E.; Dow, Thomas A.; Garrard, Kenneth P.; Marston, Zachary

2016-07-12

Systems and methods for performing on-machine measurements and automatic part alignment, including: a measurement component operable for determining the position of a part on a machine; and an actuation component operable for adjusting the position of the part by contacting the part with a predetermined force responsive to the determined position of the part. The measurement component consists of a transducer. The actuation component consists of a linear actuator. Optionally, the measurement component and the actuation component consist of a single linear actuator operable for contacting the part with a first lighter force for determining the position of the part and with a second harder force for adjusting the position of the part. The actuation component is utilized in a substantially horizontal configuration and the effects of gravitational drop of the part are accounted for in the force applied and the timing of the contact.

Method for measuring the contour of a machined part

DOEpatents

Bieg, Lothar F.

1995-05-30

A method for measuring the contour of a machined part with a contour gage apparatus, having a probe assembly including a probe tip for providing a measure of linear displacement of the tip on the surface of the part. The contour gage apparatus may be moved into and out of position for measuring the part while the part is still carried on the machining apparatus. Relative positions between the part and the probe tip may be changed, and a scanning operation is performed on the machined part by sweeping the part with the probe tip, whereby data points representing linear positions of the probe tip at prescribed rotation intervals in the position changes between the part and the probe tip are recorded. The method further allows real-time adjustment of the apparatus machining the part, including real-time adjustment of the machining apparatus in response to wear of the tool that occurs during machining.

The effect of hyperactive bladder severity on healthcare utilization and labor productivity.

PubMed

Angulo, J C; Brenes, F J; Ochayta, D; Lizarraga, I; Arumí, D; Trillo, S; Rejas, J

2014-05-01

To explore the relationship between the severity of urinary urge incontinence (UUI) on healthcare resources utilization (HRU) and loss of labor productivity of subjects with overactive bladder (OAB) in the general population in Spain. Secondary analysis of a cross-sectional web-based study conducted in the general population >18 years, through a battery of HRU questions asked using an online method. Probable OAB subjects were identified using a previously validated algorithm and a score >8 in the OAB-V8 questionnaire. HRU questions included an assessment of concomitant medication used as a consequence of OAB/UUI, pad utilization, and medical office visits. Patients were grouped according to the number of UUI episodes into 0, 1, 2-3 or 4+ episodes. Of a total of 2,035 subjects participating from the general population, 396 patients [52.5% women, mean age: 55.3 (11.1) years, OAB-V8 mean score: 14.5 (7.9)] were analyzed; 203 (51.3%) with 0 episodes, 119 (30.1%) with 1, 52 (13.1%) with 2 or 3, and 22 (5.6%) with 4 or more episodes. A linear and significant adjusted association was observed between the number of UUI episodes and HRU; the higher the number of daily episodes the higher the HRU. Subjects with more episodes had medical visits more frequently at the primary care (P = .001) and specialist (P = .009) level as well. Consumption of day (P < .001) and night (P < .001) urinary absorbents, anxiolytic medicines (P = .021) and antibiotics (P = .05) was higher in patients with more UUI episodes. The severity of OAB in terms of frequency of daily urge incontinence episodes was significantly and linearly associated with higher healthcare resources utilization and a decrease in labor productivity in subjects with probable OAB in Spain. Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.

Psychosocial education improves low back pain beliefs: results from a cluster randomized clinical trial (NCT00373009) in a primary prevention setting.

PubMed

George, Steven Z; Teyhen, Deydre S; Wu, Samuel S; Wright, Alison C; Dugan, Jessica L; Yang, Guijun; Robinson, Michael E; Childs, John D

2009-07-01

The general population has a pessimistic view of low back pain (LBP), and evidence-based information has been used to positively influence LBP beliefs in previously reported mass media studies. However, there is a lack of randomized trials investigating whether LBP beliefs can be modified in primary prevention settings. This cluster randomized clinical trial investigated the effect of an evidence-based psychosocial educational program (PSEP) on LBP beliefs for soldiers completing military training. A military setting was selected for this clinical trial, because LBP is a common cause of soldier disability. Companies of soldiers (n = 3,792) were recruited, and cluster randomized to receive a PSEP or no education (control group, CG). The PSEP consisted of an interactive seminar, and soldiers were issued the Back Book for reference material. The primary outcome measure was the back beliefs questionnaire (BBQ), which assesses inevitable consequences of and ability to cope with LBP. The BBQ was administered before randomization and 12 weeks later. A linear mixed model was fitted for the BBQ at the 12-week follow-up, and a generalized linear mixed model was fitted for the dichotomous outcomes on BBQ change of greater than two points. Sensitivity analyses were performed to account for drop out. BBQ scores (potential range: 9-45) improved significantly from baseline of 25.6 +/- 5.7 (mean +/- SD) to 26.9 +/- 6.2 for those receiving the PSEP, while there was a significant decline from 26.1 +/- 5.7 to 25.6 +/- 6.0 for those in the CG. The adjusted mean BBQ score at follow-up for those receiving the PSEP was 1.49 points higher than those in the CG (P < 0.0001). The adjusted odds ratio of BBQ improvement of greater than two points for those receiving the PSEP was 1.51 (95% CI = 1.22-1.86) times that of those in the CG. BBQ improvement was also mildly associated with race and college education. Sensitivity analyses suggested minimal influence of drop out. In conclusion, soldiers that received the PSEP had an improvement in their beliefs related to the inevitable consequences of and ability to cope with LBP. This is the first randomized trial to show positive influence on LBP beliefs in a primary prevention setting, and these findings have potentially important public health implications for prevention of LBP.

Reduced brain/serum glucose ratios predict cerebral metabolic distress and mortality after severe brain injury.

PubMed

Kurtz, Pedro; Claassen, Jan; Schmidt, J Michael; Helbok, Raimund; Hanafy, Khalid A; Presciutti, Mary; Lantigua, Hector; Connolly, E Sander; Lee, Kiwon; Badjatia, Neeraj; Mayer, Stephan A

2013-12-01

The brain is dependent on glucose to meet its energy demands. We sought to evaluate the potential importance of impaired glucose transport by assessing the relationship between brain/serum glucose ratios, cerebral metabolic distress, and mortality after severe brain injury. We studied 46 consecutive comatose patients with subarachnoid or intracerebral hemorrhage, traumatic brain injury, or cardiac arrest who underwent cerebral microdialysis and intracranial pressure monitoring. Continuous insulin infusion was used to maintain target serum glucose levels of 80-120 mg/dL (4.4-6.7 mmol/L). General linear models of logistic function utilizing generalized estimating equations were used to relate predictors of cerebral metabolic distress (defined as a lactate/pyruvate ratio [LPR] ≥ 40) and mortality. A total of 5,187 neuromonitoring hours over 300 days were analyzed. Mean serum glucose was 133 mg/dL (7.4 mmol/L). The median brain/serum glucose ratio, calculated hourly, was substantially lower (0.12) than the expected normal ratio of 0.40 (brain 2.0 and serum 5.0 mmol/L). In addition to low cerebral perfusion pressure (P = 0.05) and baseline Glasgow Coma Scale score (P < 0.0001), brain/serum glucose ratios below the median of 0.12 were independently associated with an increased risk of metabolic distress (adjusted OR = 1.4 [1.2-1.7], P < 0.001). Low brain/serum glucose ratios were also independently associated with in-hospital mortality (adjusted OR = 6.7 [1.2-38.9], P < 0.03) in addition to Glasgow Coma Scale scores (P = 0.029). Reduced brain/serum glucose ratios, consistent with impaired glucose transport across the blood brain barrier, are associated with cerebral metabolic distress and increased mortality after severe brain injury.

Cognitive impairment as measured by the THINC-integrated tool (THINC-it): The association with self-reported anxiety in Major Depressive Disorder.

PubMed

Cha, Danielle S; Carmona, Nicole E; Rodrigues, Nelson B; Mansur, Rodrigo B; Lee, Yena; Subramaniapillai, Mehala; Phan, Lee; Cha, Rebekah H; Pan, Zihang; Lee, Jae Hon; Lee, JungGoo; Almatham, Fahad; Alageel, Asem; Rosenblat, Joshua D; Shekotikhina, Margarita; Rong, Carola; Harrison, John; McIntyre, Roger S

2018-06-01

This study evaluated the association between self-reported anxiety and objective/subjective measures of cognitive performance in adults with Major Depressive Disorder (MDD). Acutely depressed subjects with recurrent MDD (n = 100) and age-, sex-, and education-matched healthy controls (HC; n = 100) between the ages of 18 and 65 completed the cross-sectional validation study of the THINC-integrated tool (THINC-it; ClinicalTrials.gov: NCT02508493). Objective cognitive performance was assessed using the THINC-it, and subjective cognitive impairment with the Perceived Deficits Questionnaire for Depression-5-item. Subjects also completed the Generalized Anxiety Disorder-7-item (GAD-7) questionnaire. Subjects with MDD reported significantly more anxiety symptoms, as assessed by the GAD-7, compared to HC (p < 0.001). Linear regression analysis determined that anxiety symptoms significantly accounted for 70.4% of the variability in subjective cognitive impairment, adjusting for depression severity. Moreover, subjects' ratings of the difficulties caused by their anxiety were reported as significantly more severe among subjects with MDD when compared to HC (p < 0.001). Likewise, greater self-reported difficulties with anxiety significantly predicted 57.8% of the variability in subjective cognitive impairment, adjusting for depression severity. Neither anxiety symptoms nor impairment due to anxiety symptoms predicted objective cognitive performance. Subjects were not prospectively verified to have a clinical diagnosis of GAD. Rather, this study examined the relationships between symptoms of generalized anxiety, assessed using a brief screening tool, and subjective and objective cognitive function. Results from the current study indicate that adults with MDD and high levels of self-reported anxiety are significantly more likely to report experiencing subjective cognitive dysfunction. Copyright © 2018 Elsevier B.V. All rights reserved.

Self-reported sunscreen use and urinary benzophenone-3 concentrations in the United States: NHANES 2003-2006 and 2009-2012

PubMed Central

Zamoiski, Rachel D.; Cahoon, Elizabeth K.; Freedman, D. Michal; Linet, Martha S.

2015-01-01

Background Sunscreens protect against skin cancer and other harmful effects of solar ultraviolet radiation (UVR). Epidemiologic and public health surveys often rely on self-reported sunscreen use to estimate sun exposure and avoidance, but questions remain about the validity of self-reports. Benzophenone-3 (BP-3), a common sunscreen ingredient, can be detected in the urine. Prior studies suggest that BP-3 concentrations increase after application of sunscreen. Objectives The goal of this study was to assess the validity of self-reported frequency of sunscreen use in relation to urinary BP-3 concentrations in a representative sample of the general US population, including in sub-groups defined by age, sex and race/ethnicity. Methods To assess the relationship between categorical self-reported sunscreen use and creatinine-corrected urinary BP-3 concentrations, we conducted a linear regression adjusted for age, sex, race/ethnicity, six-month time period, body mass index, education, and sun avoidance behaviors. We tested for effect modification by age, sex, ethnicity and time period of measurement using multiplicative interaction terms and a F test. Results BP-3 was positively associated with self-reported frequency of sunscreen use across all ages, sexes, race/ethnicities, and time periods. Crude and multivariate adjusted models were all statistically significant. R-square was relatively low for all models, ranging from 0.15-0.43. Conclusions Urinary BP-3 is positively associated with self-reported frequency of sunscreen use in the general US population, even in groups with overall low sunscreen use. These results suggest that self-report is a valid, although weak, way of assessing relative frequencies of sunscreen usage in a population-based study. PMID:26298557

Use of atypical antipsychotics in pregnancy and maternal gestational diabetes.

PubMed

Panchaud, Alice; Hernandez-Diaz, Sonia; Freeman, Marlene P; Viguera, Adele C; MacDonald, Sarah C; Sosinsky, Alexandra Z; Cohen, Lee S

2017-12-01

Second generation antipsychotic medications (SGAs) are widely used by reproductive-age women to treat a number of psychiatric illnesses. Some SGAs have been associated with an increased risk of developing diabetes, although information regarding their diabetogenic effect in pregnant women is scarce. To evaluate the risk of gestational diabetes (GDM) among women treated with SGA. The Massachusetts General Hospital (MGH) National Pregnancy Registry for Atypical Antipsychotics (NPRAA) collects data on drug use, pregnancy outcomes, and other characteristics from pregnant women, ages 18-45 years, using 3 phone interviews conducted at (1) enrollment during pregnancy, (2) 7 months' gestation, and (3) 2-3 months postpartum. Information on GDM was abstracted from obstetric and delivery medical records. The study population was restricted to women without pre-gestational diabetes. Pregnancies exposed to SGAs during the first trimester were compared with a reference group of women with psychiatric conditions but not treated with SGAs during pregnancy. Generalized linear models were used to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI) for GDM. Of 303 women exposed to SGAs, 33 (10.9%) had GDM compared to 16 (10.7%) in the 149 non-exposed women. The crude OR of GDM for SGA was 1.02 (95% CI, 0.54-1.91). After adjustment for maternal age, race, marital status, employment status, level of education, smoking, and primary psychiatric diagnosis, the OR moved to 0.79 (0.40-1.56). Findings did not suggest an increased risk of GDM associated with exposure to SGAs during pregnancy in women who had used SGA before pregnancy without developing diabetes, compared to psychiatrically ill women who were not exposed to SGA. ClinicalTrials.gov identifier: NCT01246765. Copyright © 2017 Elsevier Ltd. All rights reserved.

Self-reported sunscreen use and urinary benzophenone-3 concentrations in the United States: NHANES 2003-2006 and 2009-2012.

PubMed

Zamoiski, Rachel D; Cahoon, Elizabeth K; Michal Freedman, D; Linet, Martha S

2015-10-01

Sunscreens protect against skin cancer and other harmful effects of solar ultraviolet radiation (UVR). Epidemiologic and public health surveys often rely on self-reported sunscreen use to estimate sun exposure and avoidance, but questions remain about the validity of self-reports. Benzophenone-3 (BP-3), a common sunscreen ingredient, can be detected in the urine. Prior studies suggest that BP-3 concentrations increase after application of sunscreen. The goal of this study was to assess the validity of self-reported frequency of sunscreen use in relation to urinary BP-3 concentrations in a representative sample of the general US population, including in sub-groups defined by age, sex and race/ethnicity. To assess the relationship between categorical self-reported sunscreen use and creatinine-corrected urinary BP-3 concentrations, we conducted a linear regression adjusted for age, sex, race/ethnicity, six-month time period, body mass index, education, and sun avoidance behaviors. We tested for effect modification by age, sex, ethnicity and time period of measurement using multiplicative interaction terms and a F test. BP-3 was positively associated with self-reported frequency of sunscreen use across all ages, sexes, race/ethnicities, and time periods. Crude and multivariate adjusted models were all statistically significant. R-square was relatively low for all models, ranging from 0.15 to 0.43. Urinary BP-3 is positively associated with self-reported frequency of sunscreen use in the general US population, even in groups with overall low sunscreen use. These results suggest that self-report is a valid, although weak, way of assessing relative frequencies of sunscreen usage in a population-based study. Published by Elsevier Inc.

The Relation of Education and Income to Cognitive Function among Professional Women

PubMed Central

Lee, Sunmin; Buring, Julie E.; Cook, Nancy R.; Grodstein, Francine

2005-01-01

We investigated the relation of educational attainment and annual household income to cognitive function and cognitive decline in community-dwelling women aged 66 years or older. Subjects were 6,314 health professionals participating in the Women’s Health Study, among whom information on education and income was self-reported. From 1998 to 2000, we administered five cognitive tests, measuring general cognition, episodic memory and verbal fluency, using a validated telephone interview. Second cognitive assessments were conducted approximately two years later; information was complete for 5,573 women at the time of analysis, with 94% follow-up. We used linear and logistic regression to calculate multivariate-adjusted mean differences, and odds of cognitive impairment (defined as worst 10% of test distribution) and of substantial decline in performance (worst 10% of distribution), across various levels of education and income. After adjusting for numerous potential confounding factors, we found strong trends of increasing mean cognitive performance with increasing level of education (p-trend<0.0005 on all cognitive measures). Odds of cognitive impairment also consistently decreased with increasing education (eg, on summary score combining all tests, OR=0.6, 95% CI 0.3–0.9 comparing those with a doctoral degree to those with a 3-year associate’s degree). For income, we found significant trends of increasing mean cognitive performance with increasing income on the summary score and on episodic memory (p-trends<0.0001). For example, the OR was 0.6 (95% CI 0.4–0.8) comparing those with the highest income to the lowest income on the summary score. Results were generally similar for cognitive decline over two years, although somewhat weaker. Thus, in these well-educated, professional women, educational attainment and income both predicted cognitive function and decline. PMID:16352912

Physicians' anxiety due to uncertainty and use of race in medical decision making.

PubMed

Cunningham, Brooke A; Bonham, Vence L; Sellers, Sherrill L; Yeh, Hsin-Chieh; Cooper, Lisa A

2014-08-01

The explicit use of race in medical decision making is contested. Researchers have hypothesized that physicians use race in care when they are uncertain. The aim of this study was to investigate whether physician anxiety due to uncertainty (ADU) is associated with a higher propensity to use race in medical decision making. This study included a national cross-sectional survey of general internists. A national sample of 1738 clinically active general internists drawn from the SK&A physician database were included in the study. ADU is a 5-item measure of emotional reactions to clinical uncertainty. Bonham and Sellers Racial Attributes in Clinical Evaluation (RACE) scale includes 7 items that measure self-reported use of race in medical decision making. We used bivariate regression to test for associations between physician characteristics, ADU, and RACE. Multivariate linear regression was performed to test for associations between ADU and RACE while adjusting for potential confounders. The mean score on ADU was 19.9 (SD=5.6). Mean score on RACE was 13.5 (SD=5.6). After adjusting for physician demographics, physicians with higher levels of ADU scored higher on RACE (+β=0.08 in RACE, P=0.04, for each 1-point increase in ADU), as did physicians who understood "race" to mean biological or genetic ancestral, rather than sociocultural, group. Physicians who graduated from a US medical school, completed fellowship, and had more white patients scored lower on RACE. This study demonstrates positive associations between physicians' ADU, meanings attributed to race, and self-reported use of race in medical decision making. Future research should examine the potential impact of these associations on patient outcomes and health care disparities.

Association between urinary biomarkers of total sugars intake and measures of obesity in a cross-sectional study

PubMed Central

Campbell, Rachel; Tasevska, Natasha; Jackson, Kim G.; Sagi-Kiss, Virag; di Paolo, Nick; Mindell, Jennifer S.; Lister, Susan J.; Khaw, Kay-Tee

2017-01-01

Obesity is an important modifiable risk factor for chronic diseases. While there is increasing focus on the role of dietary sugars, there remains a paucity of data establishing the association between sugar intake and obesity in the general public. The objective of this study was to investigate associations of estimated sugar intake with odds for obesity in a representative sample of English adults. We used data from 434 participants of the 2005 Health Survey of England. Biomarkers for total sugar intake were measured in 24 h urine samples and used to estimate intake. Linear and logistic regression analyses were used to investigate associations between biomarker-based estimated intake and measures of obesity (body mass intake (BMI), waist circumference and waist-to-hip ratio) and obesity risk, respectively. Estimated sugar intake was significantly associated with BMI, waist circumference and waist-to-hip ratio; these associations remained significant after adjustment for estimated protein intake as a marker of non-sugar energy intake. Estimated sugar intake was also associated with increased odds for obesity based on BMI (OR 1.02; 95%CI 1.00–1.04 per 10g), waist-circumference (1.03; 1.01–1.05) and waist-to-hip ratio (1.04; 1.02–1.06); all OR estimates remained significant after adjusting for estimated protein intake. Our results strongly support positive associations between total sugar intake, measures of obesity and likelihood of being obese. It is the first time that such an association has been shown in a nationally-representative sample of the general population using a validated biomarker. This biomarker could be used to monitor the efficacy of public health interventions to reduce sugar intake. PMID:28723954

Association between urinary biomarkers of total sugars intake and measures of obesity in a cross-sectional study.

PubMed

Campbell, Rachel; Tasevska, Natasha; Jackson, Kim G; Sagi-Kiss, Virag; di Paolo, Nick; Mindell, Jennifer S; Lister, Susan J; Khaw, Kay-Tee; Kuhnle, Gunter G C

2017-01-01

Obesity is an important modifiable risk factor for chronic diseases. While there is increasing focus on the role of dietary sugars, there remains a paucity of data establishing the association between sugar intake and obesity in the general public. The objective of this study was to investigate associations of estimated sugar intake with odds for obesity in a representative sample of English adults. We used data from 434 participants of the 2005 Health Survey of England. Biomarkers for total sugar intake were measured in 24 h urine samples and used to estimate intake. Linear and logistic regression analyses were used to investigate associations between biomarker-based estimated intake and measures of obesity (body mass intake (BMI), waist circumference and waist-to-hip ratio) and obesity risk, respectively. Estimated sugar intake was significantly associated with BMI, waist circumference and waist-to-hip ratio; these associations remained significant after adjustment for estimated protein intake as a marker of non-sugar energy intake. Estimated sugar intake was also associated with increased odds for obesity based on BMI (OR 1.02; 95%CI 1.00-1.04 per 10g), waist-circumference (1.03; 1.01-1.05) and waist-to-hip ratio (1.04; 1.02-1.06); all OR estimates remained significant after adjusting for estimated protein intake. Our results strongly support positive associations between total sugar intake, measures of obesity and likelihood of being obese. It is the first time that such an association has been shown in a nationally-representative sample of the general population using a validated biomarker. This biomarker could be used to monitor the efficacy of public health interventions to reduce sugar intake.