Sample records for cumulative effects analysis

  1. Chapter 19. Cumulative watershed effects and watershed analysis

    Treesearch

    Leslie M. Reid

    1998-01-01

    Cumulative watershed effects are environmental changes that are affected by more than.one land-use activity and that are influenced by.processes involving the generation or transport.of water. Almost all environmental changes are.cumulative effects, and almost all land-use.activities contribute to cumulative effects

  2. Cumulative effects analysis of the water quality risk of herbicides used for site preparation in the Central North Island, New Zealand

    Treesearch

    Dan Neary; Brenda R. Baillie

    2016-01-01

    Herbicide use varies both spatially and temporally within managed forests. While information exists on the effects of herbicide use on water quality at the site and small catchment scale, little is known about the cumulative effects of herbicide use at the landscape scale. A cumulative effects analysis was conducted in the upper Rangitaiki catchment (118,345...

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

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

    Johnson, Gary E.; Diefenderfer, Heida L.; Borde, Amy B.

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

  4. Software for calculating vegetation disturbance and recovery by using the equivalent clearcut area model.

    Treesearch

    Alan A. Ager; Caty Clifton

    2005-01-01

    The use of cumulative watershed effects models is mandated as part of interagency consultation over projects that might affect habitat for salmonids federally listed as threatened or endangered. Cumulative effects analysis is also required by a number of national forest plans in the Pacific Northwest Region (Region 6). Cumulative watershed effects in many cases are...

  5. Prolonged Repeated Acupuncture Stimulation Induces Habituation Effects in Pain-Related Brain Areas: An fMRI Study

    PubMed Central

    Li, Chuanfu; Yang, Jun; Park, Kyungmo; Wu, Hongli; Hu, Sheng; Zhang, Wei; Bu, Junjie; Xu, Chunsheng; Qiu, Bensheng; Zhang, Xiaochu

    2014-01-01

    Most previous studies of brain responses to acupuncture were designed to investigate the acupuncture instant effect while the cumulative effect that should be more important in clinical practice has seldom been discussed. In this study, the neural basis of the acupuncture cumulative effect was analyzed. For this experiment, forty healthy volunteers were recruited, in which more than 40 minutes of repeated acupuncture stimulation was implemented at acupoint Zhusanli (ST36). Three runs of acupuncture fMRI datasets were acquired, with each run consisting of two blocks of acupuncture stimulation. Besides general linear model (GLM) analysis, the cumulative effects of acupuncture were analyzed with analysis of covariance (ANCOVA) to find the association between the brain response and the cumulative duration of acupuncture stimulation in each stimulation block. The experimental results showed that the brain response in the initial stage was the strongest although the brain response to acupuncture was time-variant. In particular, the brain areas that were activated in the first block and the brain areas that demonstrated cumulative effects in the course of repeated acupuncture stimulation overlapped in the pain-related areas, including the bilateral middle cingulate cortex, the bilateral paracentral lobule, the SII, and the right thalamus. Furthermore, the cumulative effects demonstrated bimodal characteristics, i.e. the brain response was positive at the beginning, and became negative at the end. It was suggested that the cumulative effect of repeated acupuncture stimulation was consistent with the characteristic of habituation effects. This finding may explain the neurophysiologic mechanism underlying acupuncture analgesia. PMID:24821143

  6. Cumulative Risk Assessment: An Overview of Methodological Approaches for Evaluating Combined Health Effects from Exposure to Multiple Environmental Stressors

    PubMed Central

    Sexton, Ken

    2012-01-01

    Systematic evaluation of cumulative health risks from the combined effects of multiple environmental stressors is becoming a vital component of risk-based decisions aimed at protecting human populations and communities. This article briefly examines the historical development of cumulative risk assessment as an analytical tool, and discusses current approaches for evaluating cumulative health effects from exposure to both chemical mixtures and combinations of chemical and nonchemical stressors. A comparison of stressor-based and effects-based assessment methods is presented, and the potential value of focusing on viable risk management options to limit the scope of cumulative evaluations is discussed. The ultimate goal of cumulative risk assessment is to provide answers to decision-relevant questions based on organized scientific analysis; even if the answers, at least for the time being, are inexact and uncertain. PMID:22470298

  7. CUMULATIVE RISK ANALYSIS FOR ORGANOPHOSPHORUS PESTICIDES

    EPA Science Inventory

    Cumulative Risk Analysis for Organophosphorus Pesticides
    R. Woodrow Setzer, Jr. NHEERL MD-74, USEPA, RTP, NC 27711

    The US EPA has recently completed a risk assessment of the effects of exposure to 33 organophosphorous pesticides (OPs) through the diet, water, and resi...

  8. Analysis of modeling cumulative noise from simultaneous flights volume 2 : supplemental analysis

    DOT National Transportation Integrated Search

    2012-12-31

    This is the second of two volumes of the report on modeling cumulative noise from simultaneous flights. This volume examines the effect of several modeling input cases on Percent Time Audible results calculated by the Integrated Noise Model. The case...

  9. Adaptive strategies for cumulative cultural learning.

    PubMed

    Ehn, Micael; Laland, Kevin

    2012-05-21

    The demographic and ecological success of our species is frequently attributed to our capacity for cumulative culture. However, it is not yet known how humans combine social and asocial learning to generate effective strategies for learning in a cumulative cultural context. Here we explore how cumulative culture influences the relative merits of various pure and conditional learning strategies, including pure asocial and social learning, critical social learning, conditional social learning and individual refiner strategies. We replicate the Rogers' paradox in the cumulative setting. However, our analysis suggests that strategies that resolved Rogers' paradox in a non-cumulative setting may not necessarily evolve in a cumulative setting, thus different strategies will optimize cumulative and non-cumulative cultural learning. Copyright © 2012 Elsevier Ltd. All rights reserved.

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

    EPA Science Inventory

    INTRODUCTION: GETTING FROM TOXICOLOGY TO QUANTITATIVE ANALYSIS FOR CUMULATIVE RISK

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

  11. Watershed Planning within a Quantitative Scenario Analysis Framework.

    PubMed

    Merriam, Eric R; Petty, J Todd; Strager, Michael P

    2016-07-24

    There is a critical need for tools and methodologies capable of managing aquatic systems within heavily impacted watersheds. Current efforts often fall short as a result of an inability to quantify and predict complex cumulative effects of current and future land use scenarios at relevant spatial scales. The goal of this manuscript is to provide methods for conducting a targeted watershed assessment that enables resource managers to produce landscape-based cumulative effects models for use within a scenario analysis management framework. Sites are first selected for inclusion within the watershed assessment by identifying sites that fall along independent gradients and combinations of known stressors. Field and laboratory techniques are then used to obtain data on the physical, chemical, and biological effects of multiple land use activities. Multiple linear regression analysis is then used to produce landscape-based cumulative effects models for predicting aquatic conditions. Lastly, methods for incorporating cumulative effects models within a scenario analysis framework for guiding management and regulatory decisions (e.g., permitting and mitigation) within actively developing watersheds are discussed and demonstrated for 2 sub-watersheds within the mountaintop mining region of central Appalachia. The watershed assessment and management approach provided herein enables resource managers to facilitate economic and development activity while protecting aquatic resources and producing opportunity for net ecological benefits through targeted remediation.

  12. Acute Stress Symptoms in Seriously Injured Patients: Precipitating Versus Cumulative Trauma and the Contribution of Peritraumatic Distress.

    PubMed

    Briere, John; Dias, Colin P; Semple, Randye J; Scott, Catherine; Bigras, Noémie; Godbout, Natacha

    2017-08-01

    The relationship between type of trauma exposure, cumulative trauma, peritraumatic distress, and subsequent acute stress disorder (ASD) symptoms was examined prospectively in 96 individuals presenting with acute medical injuries to a Level 1 emergency/trauma department. Common precipitating traumas included motor vehicle-related events, stabbings, shootings, and physical assaults. At 2 to 3 weeks follow-up, 22.9% of participants had developed ASD. Univariate analysis revealed no relationship between type of precipitating trauma and ASD symptoms, whereas robust path analysis indicated direct effects of gender, lifetime cumulative trauma exposure, and peritraumatic distress. Peritraumatic distress did not mediate the association between cumulative trauma and symptoms, but did mediate the association between gender and symptomatology. These results, which account for 23.1% of the variance in ASD symptoms, suggest that ASD may be more due to cumulative trauma exposure than the nature of the precipitating trauma, but that cumulative trauma does not exert its primary effect by increasing peritraumatic distress to the most recent trauma. Copyright © 2017 International Society for Traumatic Stress Studies.

  13. Cumulative (Dis)Advantage and the Matthew Effect in Life-Course Analysis

    PubMed Central

    Bask, Miia; Bask, Mikael

    2015-01-01

    To foster a deeper understanding of the mechanisms behind inequality in society, it is crucial to work with well-defined concepts associated with such mechanisms. The aim of this paper is to define cumulative (dis)advantage and the Matthew effect. We argue that cumulative (dis)advantage is an intra-individual micro-level phenomenon, that the Matthew effect is an inter-individual macro-level phenomenon and that an appropriate measure of the Matthew effect focuses on the mechanism or dynamic process that generates inequality. The Matthew mechanism is, therefore, a better name for the phenomenon, where we provide a novel measure of the mechanism, including a proof-of-principle analysis using disposable personal income data. Finally, because socio-economic theory should be able to explain cumulative (dis)advantage and the Matthew mechanism when they are detected in data, we discuss the types of models that may explain the phenomena. We argue that interactions-based models in the literature traditions of analytical sociology and statistical mechanics serve this purpose. PMID:26606386

  14. Cumulative meta-analysis: a new tool for detection of temporal trends and publication bias in ecology.

    PubMed Central

    Leimu, Roosa; Koricheva, Julia

    2004-01-01

    Temporal changes in the magnitude of research findings have recently been recognized as a general phenomenon in ecology, and have been attributed to the delayed publication of non-significant results and disconfirming evidence. Here we introduce a method of cumulative meta-analysis which allows detection of both temporal trends and publication bias in the ecological literature. To illustrate the application of the method, we used two datasets from recently conducted meta-analyses of studies testing two plant defence theories. Our results revealed three phases in the evolution of the treatment effects. Early studies strongly supported the hypothesis tested, but the magnitude of the effect decreased considerably in later studies. In the latest studies, a trend towards an increase in effect size was observed. In one of the datasets, a cumulative meta-analysis revealed publication bias against studies reporting disconfirming evidence; such studies were published in journals with a lower impact factor compared to studies with results supporting the hypothesis tested. Correlation analysis revealed neither temporal trends nor evidence of publication bias in the datasets analysed. We thus suggest that cumulative meta-analysis should be used as a visual aid to detect temporal trends and publication bias in research findings in ecology in addition to the correlative approach. PMID:15347521

  15. Benchmark Dose Analysis from Multiple Datasets: The Cumulative Risk Assessment for the N-Methyl Carbamate Pesticides

    EPA Science Inventory

    The US EPA’s N-Methyl Carbamate (NMC) Cumulative Risk assessment was based on the effect on acetylcholine esterase (AChE) activity of exposure to 10 NMC pesticides through dietary, drinking water, and residential exposures, assuming the effects of joint exposure to NMCs is dose-...

  16. An evaluation paradigm for cumulative impact analysis

    NASA Astrophysics Data System (ADS)

    Stakhiv, Eugene Z.

    1988-09-01

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

  17. Study of the Cumulative Number Distribution of Charged Particles Produced in d12C-Interactions at 4.2 A GeV/c

    NASA Astrophysics Data System (ADS)

    Aslam, S. M.; Suleymanov, M. K.; Wazir, Z.; Gilani, A. R.

    2018-06-01

    In this paper the behavior of the cumulative number and also with maximum values of cumulative number distribution of protons, π + and π --mesons, have been studied, produced in d12C-interctions at 4.2 A GeV/c. The experimental data has been compared with ones coming from the Dubna version of the cascade model. In the analysis we have observed; four different regions in the cumulative number distributions for all charged particle and protons and the last region is corresponding to values of cumulative number greater than 1; for pions number of regions decreased to 2 for π ±-mesons but cumulative area is absent for both mesons. Cascade cannot describe satisfactorily the distributions of the cumulative protons and cumulative π -+-mesons, it gives less number for the all produced particles. In case of particles with maximum values of cumulative number cascade can describe the behavior of cumulative number distribution well. There exist some events with two cumulative particles which could not describe by the cascade dynamics. May be collective nucleon effect could be reasons of the observation two cumulative particles events.

  18. Review of: Methods to complete watershed analysis on Pacific Lumber lands in Northern California

    Treesearch

    L. M. Reid

    1999-01-01

    The three questions of primary concern for this review are: 1) are the WDNR modules adequately and validly modified to suit local conditions, as required by the HCP/SYP? 2) is there an adequate "distinct cumulative effects assessment" method, as required by the HCP/SYP? 3) will the cumulative effects assessment method and the modified WDNR modules be...

  19. Journalism Abstracts; Cumulative Index, Volumes 1 to 15; 1963-1977.

    ERIC Educational Resources Information Center

    Popovich, Mark N., Ed.

    Arranged by subject categories and authors, the more than 4,400 abstracts in this cumulative index provide information on doctoral dissertations and master's theses in the field of journalism. The 28 subject areas are as follows: advertising; audience analysis; communication and national development; communication theory, process, and effects;…

  20. The Effects of Cumulative Violence Clusters on Young Mothers' School Participation: Examining Attention and Behavior Problems as Mediators.

    PubMed

    Kennedy, Angie C; Adams, Adrienne E

    2016-04-01

    Using a cluster analysis approach with a sample of 205 young mothers recruited from community sites in an urban Midwestern setting, we examined the effects of cumulative violence exposure (community violence exposure, witnessing intimate partner violence, physical abuse by a caregiver, and sexual victimization, all with onset prior to age 13) on school participation, as mediated by attention and behavior problems in school. We identified five clusters of cumulative exposure, and found that the HiAll cluster (high levels of exposure to all four types) consistently fared the worst, with significantly higher attention and behavior problems, and lower school participation, in comparison with the LoAll cluster (low levels of exposure to all types). Behavior problems were a significant mediator of the effects of cumulative violence exposure on school participation, but attention problems were not. © The Author(s) 2014.

  1. Air Pollution and Deaths among Elderly Residents of São Paulo, Brazil: An Analysis of Mortality Displacement.

    PubMed

    Costa, Amine Farias; Hoek, Gerard; Brunekreef, Bert; Ponce de Leon, Antônio C M

    2017-03-01

    Evaluation of short-term mortality displacement is essential to accurately estimate the impact of short-term air pollution exposure on public health. We quantified mortality displacement by estimating single-day lag effects and cumulative effects of air pollutants on mortality using distributed lag models. We performed a daily time series of nonaccidental and cause-specific mortality among elderly residents of São Paulo, Brazil, between 2000 and 2011. Effects of particulate matter smaller than 10 μm (PM 10 ), nitrogen dioxide (NO 2 ) and carbon monoxide (CO) were estimated in Poisson generalized additive models. Single-day lag effects of air pollutant exposure were estimated for 0-, 1- and 2-day lags. Distributed lag models with lags of 0-10, 0-20 and 0-30 days were used to assess mortality displacement and potential cumulative exposure effects. PM 10 , NO 2 and CO were significantly associated with nonaccidental and cause-specific deaths in both single-day lag and cumulative lag models. Cumulative effect estimates for 0-10 days were larger than estimates for single-day lags. Cumulative effect estimates for 0-30 days were essentially zero for nonaccidental and circulatory deaths but remained elevated for respiratory and cancer deaths. We found evidence of mortality displacement within 30 days for nonaccidental and circulatory deaths in elderly residents of São Paulo. We did not find evidence of mortality displacement within 30 days for respiratory or cancer deaths. Citation: Costa AF, Hoek G, Brunekreef B, Ponce de Leon AC. 2017. Air pollution and deaths among elderly residents of São Paulo, Brazil: an analysis of mortality displacement. Environ Health Perspect 125:349-354; http://dx.doi.org/10.1289/EHP98.

  2. Cumulative doses analysis in young trauma patients: a single-centre experience.

    PubMed

    Salerno, Sergio; Marrale, Maurizio; Geraci, Claudia; Caruso, Giuseppe; Lo Re, Giuseppe; Lo Casto, Antonio; Midiri, Massimo

    2016-02-01

    Multidetector computed tomography (MDCT) represents the main source of radiation exposure in trauma patients. The radiation exposure of young patients is a matter of considerable medical concern due to possible long-term effects. Multiple MDCT studies have been observed in the young trauma population with an increase in radiation exposure. We have identified 249 young adult patients (178 men and 71 women; age range 14-40 years) who had received more than one MDCT study between June 2010 and June 2014. According to the International Commission on Radiological Protection publication, we have calculated the cumulative organ dose tissue-weighting factors by using CT-EXPO software(®). We have observed a mean cumulative dose of about 27 mSv (range from 3 to 297 mSv). The distribution analysis is characterised by low effective dose, below 20 mSv, in the majority of the patients. However, in 29 patients, the effective dose was found to be higher than 20 mSv. Dose distribution for the various organs analysed (breasts, ovaries, testicles, heart and eye lenses) shows an intense peak for lower doses, but in some cases high doses were recorded. Even though cumulative doses may have long-term effects, which are still under debate, high doses are observed in this specific group of young patients.

  3. Epigenome-wide association analysis revealed that SOCS3 methylation influences the effect of cumulative stress on obesity.

    PubMed

    Xu, Ke; Zhang, Xinyu; Wang, Zuoheng; Hu, Ying; Sinha, Rajita

    2018-01-01

    Chronic stress has a significant impact on obesity. However, how stress influences obesity remains unclear. We conducted an epigenome-wide DNA methylation association analysis of obesity (N=510) and examined whether cumulative stress influenced the DNA methylation on body weight. We identified 20 CpG sites associated with body mass index at the false discovery rate q<0.05, including a novel site, cg18181703, in suppressor of cytokine signaling 3 (SOCS3) gene (coefficient β=-0.0022, FDR q=4.94×10 -5 ). The interaction between cg18181703 and cumulative adverse life stress contributed to variations in body weight (p=0.002). Individuals with at least five major life events and lower methylation of cg1818703 showed a 1.38-fold higher risk of being obese (95%CI: 1.17-1.76). Our findings suggest that aberrant in DNA methylation is associated with body weight and that methylation of SOCS3 moderates the effect of cumulative stress on obesity. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. Longitudinal Pathways from Cumulative Contextual Risk at Birth to School Functioning in Adolescence: Analysis of Mediation Effects and Gender Moderation.

    PubMed

    January, Stacy-Ann A; Mason, W Alex; Savolainen, Jukka; Solomon, Starr; Chmelka, Mary B; Miettunen, Jouko; Veijola, Juha; Moilanen, Irma; Taanila, Anja; Järvelin, Marjo-Riitta

    2017-01-01

    Children and adolescents exposed to multiple contextual risks are more likely to have academic difficulties and externalizing behavior problems than those who experience fewer risks. This study used data from the Northern Finland Birth Cohort 1986 (a population-based study; N = 6961; 51 % female) to investigate (a) the impact of cumulative contextual risk at birth on adolescents' academic performance and misbehavior in school, (b) learning difficulties and/or externalizing behavior problems in childhood as intervening mechanisms in the association of cumulative contextual risk with functioning in adolescence, and (c) potential gender differences in the predictive associations of cumulative contextual risk at birth with functioning in childhood or adolescence. The results of the structural equation modeling analysis suggested that exposure to cumulative contextual risk at birth had negative associations with functioning 16 years later, and academic difficulties and externalizing behavior problems in childhood mediated some of the predictive relations. Gender, however, did not moderate any of the associations. Therefore, the findings of this study have implications for the prevention of learning and conduct problems in youth and future research on the impact of cumulative risk exposure.

  5. Longitudinal Pathways from Cumulative Contextual Risk at Birth to School Functioning in Adolescence: Analysis of Mediation Effects and Gender Moderation

    PubMed Central

    January, Stacy-Ann A.; Mason, W. Alex; Savolainen, Jukka; Solomon, Starr; Chmelka, Mary B.; Miettunen, Jouko; Veijola, Juha; Moilanen, Irma; Taanila, Anja; Järvelin, Marjo-Riitta

    2016-01-01

    Children and adolescents exposed to multiple contextual risks are more likely to have academic difficulties and externalizing behavior problems than those who experience fewer risks. This study used data from the Northern Finland Birth Cohort 1986 (a population-based study; N = 6,961; 51% female) to investigate (a) the impact of cumulative contextual risk at birth on adolescents’ academic performance and misbehavior in school, (b) learning difficulties and/or externalizing behavior problems in childhood as intervening mechanisms in the association of cumulative contextual risk with functioning in adolescence, and (c) potential gender differences in the predictive associations of cumulative contextual risk at birth with functioning in childhood or adolescence. The results of the structural equation modeling analysis suggested that exposure to cumulative contextual risk at birth had negative associations with functioning 16 years later, and academic difficulties and externalizing behavior problems in childhood mediated some of the predictive relations. Gender, however, did not moderate any of the associations. Therefore, the findings of this study have implications for the prevention of learning and conduct problems in youth and future research on the impact of cumulative risk exposure. PMID:27665276

  6. Variants of the MTHFR gene and susceptibility to acute lymphoblastic leukemia in children: a synthesis of genetic association studies.

    PubMed

    Zintzaras, Elias; Doxani, Chrysoula; Rodopoulou, Paraskevi; Bakalos, Georgios; Ziogas, Dimitris C; Ziakas, Panayiotis; Voulgarelis, Michael

    2012-04-01

    Acute lymphoblastic leukemia (ALL) is a complex disease with genetic background. The genetic association studies (GAS) that investigated the association between ALL and the MTHFR C677T and A1298C gene variants have produced contradictory or inconclusive results. In order to decrease the uncertainty of estimated genetic risk effects, a meticulous meta-analysis of published GAS related the variants in the MTFHR gene with susceptibility to ALL was conducted. The risk effects were estimated based on the odds ratio (OR) of the allele contrast and the generalized odds ratio (OR(G)). Cumulative and recursive cumulative meta-analyses were also performed. The analysis showed marginal significant association for the C677T variant, overall [OR=0.91 (0.82-1.00) and OR(G)=0.89 (0.79-1.01)], and in Whites [OR=0.88 (0.77-0.99) and OR(G)=0.85 (0.73-0.99)]. The A1298C variant produced non-significant results. For both variants, the cumulative meta-analysis did not show a trend of association as evidence accumulates and the recursive cumulative meta-analysis indicated lack of sufficient evidence for denying or claiming an association. The current evidence is not sufficient to draw definite conclusions regarding the association of MTHFR variants and development of ALL. Copyright © 2011 Elsevier Ltd. All rights reserved.

  7. Evidence-based evaluation of the cumulative effects of ecosystem restoration

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

    Diefenderfer, Heida L.; Johnson, Gary E.; Thom, Ronald M.

    Evaluating the cumulative effects of large-scale ecological restoration programs is necessary to inform adaptive ecosystem management and provide society with resilient and sustainable services. However, complex linkages between restorative actions and ecosystem responses make evaluations problematic. Despite long-term federal investments in restoring aquatic ecosystems, no standard evaluation method has been adopted and most programs focus on monitoring and analysis, not synthesis and evaluation. In this paper, we demonstrate a new transdisciplinary approach integrating techniques from evidence-based medicine, critical thinking, and cumulative effects assessment. Tiered hypotheses are identified using an ecosystem conceptual model. The systematic literature review at the core ofmore » evidence-based assessment becomes one of many lines of evidence assessed collectively, using critical thinking strategies and causal criteria from a cumulative effects perspective. As a demonstration, we analyzed data from 166 locations on the Columbia River and estuary representing 12 indicators of habitat and fish response to floodplain restoration actions intended to benefit threatened and endangered salmon. Synthesis of seven lines of evidence showed that hydrologic reconnection promoted macrodetritis export, prey availability, and fish access and feeding. The evidence was sufficient to infer cross-boundary, indirect, compounding and delayed cumulative effects, and suggestive of nonlinear, landscape-scale, and spatial density effects. On the basis of causal inferences regarding food web functions, we concluded that the restoration program has a cumulative beneficial effect on juvenile salmon. As a result, this evidence-based approach will enable the evaluation of restoration in complex coastal and riverine ecosystems where data have accumulated without sufficient synthesis.« less

  8. Evidence-based evaluation of the cumulative effects of ecosystem restoration

    DOE PAGES

    Diefenderfer, Heida L.; Johnson, Gary E.; Thom, Ronald M.; ...

    2016-03-18

    Evaluating the cumulative effects of large-scale ecological restoration programs is necessary to inform adaptive ecosystem management and provide society with resilient and sustainable services. However, complex linkages between restorative actions and ecosystem responses make evaluations problematic. Despite long-term federal investments in restoring aquatic ecosystems, no standard evaluation method has been adopted and most programs focus on monitoring and analysis, not synthesis and evaluation. In this paper, we demonstrate a new transdisciplinary approach integrating techniques from evidence-based medicine, critical thinking, and cumulative effects assessment. Tiered hypotheses are identified using an ecosystem conceptual model. The systematic literature review at the core ofmore » evidence-based assessment becomes one of many lines of evidence assessed collectively, using critical thinking strategies and causal criteria from a cumulative effects perspective. As a demonstration, we analyzed data from 166 locations on the Columbia River and estuary representing 12 indicators of habitat and fish response to floodplain restoration actions intended to benefit threatened and endangered salmon. Synthesis of seven lines of evidence showed that hydrologic reconnection promoted macrodetritis export, prey availability, and fish access and feeding. The evidence was sufficient to infer cross-boundary, indirect, compounding and delayed cumulative effects, and suggestive of nonlinear, landscape-scale, and spatial density effects. On the basis of causal inferences regarding food web functions, we concluded that the restoration program has a cumulative beneficial effect on juvenile salmon. As a result, this evidence-based approach will enable the evaluation of restoration in complex coastal and riverine ecosystems where data have accumulated without sufficient synthesis.« less

  9. Unraveling the Link between Trauma and Male Delinquency: The Cumulative Versus Differential Risk Perspectives

    ERIC Educational Resources Information Center

    Maschi, Tina

    2006-01-01

    This study examined how the cumulative (additive) versus differential (individual) effects of trauma influenced male delinquency. Using a comprehensive measure of trauma, a secondary data analysis was conducted on a nationally representative sample of male youths between the ages of 12 and 17. Logistic regression analyses revealed that all three…

  10. The Interacting Axes of Environmental, Health, and Social Justice Cumulative Impacts: A Case Study of the Blueberry River First Nations

    PubMed Central

    Gislason, Maya K; Andersen, Holly K

    2016-01-01

    We consider the case of intensive resource extractive projects in the Blueberry River First Nations in Northern British Columbia, Canada, as a case study. Drawing on the parallels between concepts of cumulative environmental and cumulative health impacts, we highlight three axes along which to gauge the effects of intensive extraction projects. These are environmental, health, and social justice axes. Using an intersectional analysis highlights the way in which using individual indicators to measure impact, rather than considering cumulative effects, hides the full extent by which the affected First Nations communities are impacted by intensive extraction projects. We use the case study to contemplate several mechanisms at the intersection of these axes whereby the negative effects of each not only add but also amplify through their interactions. For example, direct impact along the environmental axis indirectly amplifies other health and social justice impacts separately from the direct impacts on those axes. We conclude there is significant work still to be done to use cumulative indicators to study the impacts of extractive industry projects—like liquefied natural gas—on peoples, environments, and health. PMID:27763548

  11. Reconceptualizing synergism and antagonism among multiple stressors.

    PubMed

    Piggott, Jeremy J; Townsend, Colin R; Matthaei, Christoph D

    2015-04-01

    The potential for complex synergistic or antagonistic interactions between multiple stressors presents one of the largest uncertainties when predicting ecological change but, despite common use of the terms in the scientific literature, a consensus on their operational definition is still lacking. The identification of synergism or antagonism is generally straightforward when stressors operate in the same direction, but if individual stressor effects oppose each other, the definition of synergism is paradoxical because what is synergistic to one stressor's effect direction is antagonistic to the others. In their highly cited meta-analysis, Crain et al. (Ecology Letters, 11, 2008: 1304) assumed in situations with opposing individual effects that synergy only occurs when the cumulative effect is more negative than the additive sum of the opposing individual effects. We argue against this and propose a new systematic classification based on an additive effects model that combines the magnitude and response direction of the cumulative effect and the interaction effect. A new class of "mitigating synergism" is identified, where cumulative effects are reversed and enhanced. We applied our directional classification to the dataset compiled by Crain et al. (Ecology Letters, 11, 2008: 1304) to determine the prevalence of synergistic, antagonistic, and additive interactions. Compared to their original analysis, we report differences in the representation of interaction classes by interaction type and we document examples of mitigating synergism, highlighting the importance of incorporating individual stressor effect directions in the determination of synergisms and antagonisms. This is particularly pertinent given a general bias in ecology toward investigating and reporting adverse multiple stressor effects (double negative). We emphasize the need for reconsideration by the ecological community of the interpretation of synergism and antagonism in situations where individual stressor effects oppose each other or where cumulative effects are reversed and enhanced.

  12. [Relationships between horqin meadow NDVI and meteorological factors].

    PubMed

    Qu, Cui-ping; Guan, De-xin; Wang, An-zhi; Jin, Chang-jie; Wu, Jia-bing; Wang, Ji-jun; Ni, Pan; Yuan, Feng-hui

    2009-01-01

    Based on the 2000-2006 MODIS 8-day composite NDVI and day-by-day meteorological data, the seasonal and inter-annual variations of Horqin meadow NDVI as well as the relationships between the NDVI and relevant meteorological factors were studied. The results showed that as for the seasonal variation, Horqin meadow NDVI was more related to water vapor pressure than to precipitation. Cumulated temperature and cumulated precipitation together affected the inter-annual turning-green period significantly, and the precipitation in growth season (June and July), compared with that in whole year, had more obvious effects on the annual maximal NDVI. The analysis of time lag effect indicated that water vapor pressure had a persistent (about 12 days) prominent effect on the NDVI. The time lag effect of mean air temperature was 11-15 days, and the cumulated dual effect of the temperature and precipitation was 36-52 days.

  13. Assessing the overall benefit of a medication: cumulative benefit of secukinumab over time in patients with moderate-to-severe plaque psoriasis.

    PubMed

    Armstrong, April W; Feldman, Steven R; Korman, Neil J; Meng, Xiangyi; Guana, Adriana; Nyirady, Judit; Herrera, Vivian; Zhao, Yang

    2017-05-01

    Conventional measurements for assessing psoriasis treatment effects capture improvements at fixed, pre-specified timepoints, failing to account for cumulative clinical benefit over time. Explore the innovative concept of "cumulative clinical benefit" by examining the effect of secukinumab over 52 weeks in moderate-to-severe psoriasis patients. Cumulative clinical benefit was determined as the area-under-the-curve of the percentage of responders over 52 weeks (AUC 0-52 wks ), using pooled data from two phase III trials for patients receiving secukinumab (300 or 150 mg) or etanercept. Normalized cumulative benefit with secukinumab 300 mg, secukinumab 150 mg, and etanercept was 74.2%, 63.2%, and 50.5%, respectively, for PASI 75; 58.0%, 42.5%, and 29.5%, respectively, for PASI 90; 32.3%, 18.8%, and 8.7%, respectively, for PASI 100; and 58.3%, 47.9%, and 38.3%, respectively, for DLQI 0/1. 52-week PASI 75 clinical benefit ratios for secukinumab 300 and 150 mg versus etanercept were 1.47 and 1.25, respectively; the ratio of the two secukinumab doses was 1.17, favoring 300 mg. Post hoc analysis. Cumulative clinical benefit estimated by AUC 0-52 wks is a novel measure for comparing psoriasis treatments. Secukinumab 300 mg provides greater cumulative clinical benefit than secukinumab 150 mg; both provide greater cumulative benefit than etanercept.

  14. A Screening Method for Assessing Cumulative Impacts

    PubMed Central

    Alexeeff, George V.; Faust, John B.; August, Laura Meehan; Milanes, Carmen; Randles, Karen; Zeise, Lauren; Denton, Joan

    2012-01-01

    The California Environmental Protection Agency (Cal/EPA) Environmental Justice Action Plan calls for guidelines for evaluating “cumulative impacts.” As a first step toward such guidelines, a screening methodology for assessing cumulative impacts in communities was developed. The method, presented here, is based on the working definition of cumulative impacts adopted by Cal/EPA [1]: “Cumulative impacts means exposures, public health or environmental effects from the combined emissions and discharges in a geographic area, including environmental pollution from all sources, whether single or multi-media, routinely, accidentally, or otherwise released. Impacts will take into account sensitive populations and socio-economic factors, where applicable and to the extent data are available.” The screening methodology is built on this definition as well as current scientific understanding of environmental pollution and its adverse impacts on health, including the influence of both intrinsic, biological factors and non-intrinsic socioeconomic factors in mediating the effects of pollutant exposures. It addresses disparities in the distribution of pollution and health outcomes. The methodology provides a science-based tool to screen places for relative cumulative impacts, incorporating both the pollution burden on a community- including exposures to pollutants, their public health and environmental effects- and community characteristics, specifically sensitivity and socioeconomic factors. The screening methodology provides relative rankings to distinguish more highly impacted communities from less impacted ones. It may also help identify which factors are the greatest contributors to a community’s cumulative impact. It is not designed to provide quantitative estimates of community-level health impacts. A pilot screening analysis is presented here to illustrate the application of this methodology. Once guidelines are adopted, the methodology can serve as a screening tool to help Cal/EPA programs prioritize their activities and target those communities with the greatest cumulative impacts. PMID:22470315

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

    PubMed

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

    2016-09-01

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

  16. Potential utilization of the absolute point cumulative semivariogram technique for the evaluation of distribution coefficient.

    PubMed

    Külahci, Fatih; Sen, Zekâi

    2009-09-15

    The classical solid/liquid distribution coefficient, K(d), for radionuclides in water-sediment systems is dependent on many parameters such as flow, geology, pH, acidity, alkalinity, total hardness, radioactivity concentration, etc. in a region. Considerations of all these effects require a regional analysis with an effective methodology, which has been based on the concept of the cumulative semivariogram concept in this paper. Although classical K(d) calculations are punctual and cannot represent regional pattern, in this paper a regional calculation methodology is suggested through the use of Absolute Point Cumulative SemiVariogram (APCSV) technique. The application of the methodology is presented for (137)Cs and (90)Sr measurements at a set of points in Keban Dam reservoir, Turkey.

  17. Cumulative Effects of Short-Term Polymetal Contamination on Soil Bacterial Community Structure

    PubMed Central

    Ranjard, L.; Lignier, L.; Chaussod, R.

    2006-01-01

    In this study we evaluated the short-term effects of copper, cadmium, and mercury, added singly or in combination at different doses, on soil bacterial community structure using the bacterial automated ribosomal intergenic spacer analysis (B-ARISA) fingerprinting technique. Principal-component analysis of B-ARISA profiles allowed us to deduce the following order of impact: (Cu + Cd + Hg) >> Hg ≥ Cd > Cu. These results demonstrated that there was a cumulative effect of metal toxicity. Furthermore, the trend of modifications was consistent with the “hump-backed” relationships between biological diversity and disturbance described by Giller et al. (K. E. Giller, E. Witler, and S. P. McGrath, Soil Biol. Biochem. 30:1389-1414, 1998). PMID:16461728

  18. Kaplan-Meier survival analysis overestimates cumulative incidence of health-related events in competing risk settings: a meta-analysis.

    PubMed

    Lacny, Sarah; Wilson, Todd; Clement, Fiona; Roberts, Derek J; Faris, Peter; Ghali, William A; Marshall, Deborah A

    2018-01-01

    Kaplan-Meier survival analysis overestimates cumulative incidence in competing risks (CRs) settings. The extent of overestimation (or its clinical significance) has been questioned, and CRs methods are infrequently used. This meta-analysis compares the Kaplan-Meier method to the cumulative incidence function (CIF), a CRs method. We searched MEDLINE, EMBASE, BIOSIS Previews, Web of Science (1992-2016), and article bibliographies for studies estimating cumulative incidence using the Kaplan-Meier method and CIF. For studies with sufficient data, we calculated pooled risk ratios (RRs) comparing Kaplan-Meier and CIF estimates using DerSimonian and Laird random effects models. We performed stratified meta-analyses by clinical area, rate of CRs (CRs/events of interest), and follow-up time. Of 2,192 identified abstracts, we included 77 studies in the systematic review and meta-analyzed 55. The pooled RR demonstrated the Kaplan-Meier estimate was 1.41 [95% confidence interval (CI): 1.36, 1.47] times higher than the CIF. Overestimation was highest among studies with high rates of CRs [RR = 2.36 (95% CI: 1.79, 3.12)], studies related to hepatology [RR = 2.60 (95% CI: 2.12, 3.19)], and obstetrics and gynecology [RR = 1.84 (95% CI: 1.52, 2.23)]. The Kaplan-Meier method overestimated the cumulative incidence across 10 clinical areas. Using CRs methods will ensure accurate results inform clinical and policy decisions. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Cumulative Small Effect Genetic Markers and the Risk of Colorectal Cancer in Poland, Estonia, Lithuania, and Latvia

    PubMed Central

    Serrano-Fernandez, Pablo; Dymerska, Dagmara; Kurzawski, Grzegorz; Derkacz, Róża; Sobieszczańska, Tatiana; Banaszkiewicz, Zbigniew; Roomere, Hanno; Oitmaa, Eneli; Metspalu, Andres; Janavičius, Ramūnas; Elsakov, Pavel; Razumas, Mindaugas; Petrulis, Kestutis; Irmejs, Arvīds; Miklaševičs, Edvīns; Scott, Rodney J.; Lubiński, Jan

    2015-01-01

    The continued identification of new low-penetrance genetic variants for colorectal cancer (CRC) raises the question of their potential cumulative effect among compound carriers. We focused on 6 SNPs (rs380284, rs4464148, rs4779584, rs4939827, rs6983267, and rs10795668), already described as risk markers, and tested their possible independent and combined contribution to CRC predisposition. Material and Methods. DNA was collected and genotyped from 2330 unselected consecutive CRC cases and controls from Estonia (166 cases and controls), Latvia (81 cases and controls), Lithuania (123 cases and controls), and Poland (795 cases and controls). Results. Beyond individual effects, the analysis revealed statistically significant linear cumulative effects for these 6 markers for all samples except of the Latvian one (corrected P value = 0.018 for the Estonian, corrected P value = 0.0034 for the Lithuanian, and corrected P value = 0.0076 for the Polish sample). Conclusions. The significant linear cumulative effects demonstrated here support the idea of using sets of low-risk markers for delimiting new groups with high-risk of CRC in clinical practice that are not carriers of the usual CRC high-risk markers. PMID:26101521

  20. Cumulative Small Effect Genetic Markers and the Risk of Colorectal Cancer in Poland, Estonia, Lithuania, and Latvia.

    PubMed

    Serrano-Fernandez, Pablo; Dymerska, Dagmara; Kurzawski, Grzegorz; Derkacz, Róża; Sobieszczańska, Tatiana; Banaszkiewicz, Zbigniew; Roomere, Hanno; Oitmaa, Eneli; Metspalu, Andres; Janavičius, Ramūnas; Elsakov, Pavel; Razumas, Mindaugas; Petrulis, Kestutis; Irmejs, Arvīds; Miklaševičs, Edvīns; Scott, Rodney J; Lubiński, Jan

    2015-01-01

    The continued identification of new low-penetrance genetic variants for colorectal cancer (CRC) raises the question of their potential cumulative effect among compound carriers. We focused on 6 SNPs (rs380284, rs4464148, rs4779584, rs4939827, rs6983267, and rs10795668), already described as risk markers, and tested their possible independent and combined contribution to CRC predisposition. Material and Methods. DNA was collected and genotyped from 2330 unselected consecutive CRC cases and controls from Estonia (166 cases and controls), Latvia (81 cases and controls), Lithuania (123 cases and controls), and Poland (795 cases and controls). Results. Beyond individual effects, the analysis revealed statistically significant linear cumulative effects for these 6 markers for all samples except of the Latvian one (corrected P value = 0.018 for the Estonian, corrected P value = 0.0034 for the Lithuanian, and corrected P value = 0.0076 for the Polish sample). Conclusions. The significant linear cumulative effects demonstrated here support the idea of using sets of low-risk markers for delimiting new groups with high-risk of CRC in clinical practice that are not carriers of the usual CRC high-risk markers.

  1. Effect of vitamin B supplementation on cancer incidence, death due to cancer, and total mortality: A PRISMA-compliant cumulative meta-analysis of randomized controlled trials.

    PubMed

    Zhang, Sui-Liang; Chen, Ting-Song; Ma, Chen-Yun; Meng, Yong-Bin; Zhang, Yu-Fei; Chen, Yi-Wei; Zhou, Yu-Hao

    2016-08-01

    Observational studies have suggested that vitamin B supplementation is associated with cancer risk, but this association remains controversial. A pooled data-based meta-analysis was conducted to summarize the evidence from randomized controlled trials (RCTs) investigating the effects of vitamin B supplementation on cancer incidence, death due to cancer, and total mortality. PubMed, EmBase, and the Cochrane Library databases were searched to identify trials to fit our analysis through August 2015. Relative risk (RR) was used to measure the effect of vitamin B supplementation on the risk of cancer incidence, death due to cancer, and total mortality using a random-effect model. Cumulative meta-analysis, sensitivity analysis, subgroup analysis, heterogeneity tests, and tests for publication bias were also conducted. Eighteen RCTs reporting the data on 74,498 individuals were included in the meta-analysis. Sixteen of these trials included 4103 cases of cancer; in 6 trials, 731 cancer-related deaths occurred; and in 15 trials, 7046 deaths occurred. Vitamin B supplementation had little or no effect on the incidence of cancer (RR: 1.04; 95% confidence interval [CI]: 0.98-1.10; P = 0.216), death due to cancer (RR, 1.05; 95% CI: 0.90-1.22; P = 0.521), and total mortality (RR, 1.00; 95% CI: 0.94-1.06; P = 0.952). Upon performing a cumulative meta-analysis for cancer incidence, death due to cancer, and total mortality, the nonsignificance of the effect of vitamin B persisted. With respect to specific types of cancer, vitamin B supplementation significantly reduced the risk of skin melanoma (RR, 0.47; 95% CI: 0.23-0.94; P = 0.032). Vitamin B supplementation does not have an effect on cancer incidence, death due to cancer, or total mortality. It is associated with a lower risk of skin melanoma, but has no effect on other cancers.

  2. Cumulative environmental impacts and integrated coastal management: the case of Xiamen, China.

    PubMed

    Xue, Xiongzhi; Hong, Huasheng; Charles, Anthony T

    2004-07-01

    This paper examines the assessment of cumulative environmental impacts and the implementation of integrated coastal management within the harbour of Xiamen, China, an urban region in which the coastal zone is under increasing pressure as a result of very rapid economic growth. The first stage of analysis incorporates components of a cumulative effects assessment, including (a) identification of sources of environmental impacts, notably industrial expansion, port development, shipping, waste disposal, aquaculture and coastal construction, (b) selection of a set of valued ecosystem components, focusing on circulation and siltation, water quality, sediment, the benthic community, and mangrove forests, and (c) use of a set of key indicators to examine cumulative impacts arising from the aggregate of human activities. In the second stage of analysis, the paper describes and assesses the development of an institutional framework for integrated coastal management in Xiamen, one that combines policy and planning (including legislative and enforcement mechanisms) with scientific and monitoring mechanisms (including an innovative 'marine functional zoning' system). The paper concludes that the integrated coastal management framework in Xiamen has met all relevant requirements for 'integration' as laid out in the literature, and has explicitly incorporated consideration of cumulative impacts within its management and monitoring processes.

  3. Growing literature, stagnant science? Systematic review, meta-regression and cumulative analysis of audit and feedback interventions in health care.

    PubMed

    Ivers, Noah M; Grimshaw, Jeremy M; Jamtvedt, Gro; Flottorp, Signe; O'Brien, Mary Ann; French, Simon D; Young, Jane; Odgaard-Jensen, Jan

    2014-11-01

    This paper extends the findings of the Cochrane systematic review of audit and feedback on professional practice to explore the estimate of effect over time and examine whether new trials have added to knowledge regarding how optimize the effectiveness of audit and feedback. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE for randomized trials of audit and feedback compared to usual care, with objectively measured outcomes assessing compliance with intended professional practice. Two reviewers independently screened articles and abstracted variables related to the intervention, the context, and trial methodology. The median absolute risk difference in compliance with intended professional practice was determined for each study, and adjusted for baseline performance. The effect size across studies was recalculated as studies were added to the cumulative analysis. Meta-regressions were conducted for studies published up to 2002, 2006, and 2010 in which characteristics of the intervention, the recipients, and trial risk of bias were tested as predictors of effect size. Of the 140 randomized clinical trials (RCTs) included in the Cochrane review, 98 comparisons from 62 studies met the criteria for inclusion. The cumulative analysis indicated that the effect size became stable in 2003 after 51 comparisons from 30 trials. Cumulative meta-regressions suggested new trials are contributing little further information regarding the impact of common effect modifiers. Feedback appears most effective when: delivered by a supervisor or respected colleague; presented frequently; featuring both specific goals and action-plans; aiming to decrease the targeted behavior; baseline performance is lower; and recipients are non-physicians. There is substantial evidence that audit and feedback can effectively improve quality of care, but little evidence of progress in the field. There are opportunity costs for patients, providers, and health care systems when investigators test quality improvement interventions that do not build upon, or contribute toward, extant knowledge.

  4. The effects of cumulative risks and promotive factors on urban adolescent alcohol and other drug use: a longitudinal study of resiliency.

    PubMed

    Ostaszewski, Krzysztof; Zimmerman, Marc A

    2006-12-01

    Resiliency theory provides a conceptual framework for studying why some youth exposed to risk factors do not develop the negative behaviors they predict. The purpose of this study was to test compensatory and protective models of resiliency in a longitudinal sample of urban adolescents (80% African American). The data were from Years 1 (9th grade) and 4 (12th grade). The study examined effects of cumulative risk and promotive factors on adolescent polydrug use including alcohol, tobacco and marijuana. Cumulative measures of risk/promotive factors represented individual characteristics, peer influence, and parental/familial influences. After controlling for demographics, results of multiple regression of polydrug use support the compensatory model of resiliency both cross-sectionally and longitudinally. Promotive factors were also found to have compensatory effects on change in adolescent polydrug use. The protective model of resiliency evidenced cross-sectionally was not supported in longitudinal analysis. The findings support resiliency theory and the use of cumulative risk/promotive measures in resiliency research. Implications focused on utilizing multiple assets and resources in prevention programming are discussed.

  5. Cumulative adversity and smaller gray matter volume in medial prefrontal, anterior cingulate, and insula regions.

    PubMed

    Ansell, Emily B; Rando, Kenneth; Tuit, Keri; Guarnaccia, Joseph; Sinha, Rajita

    2012-07-01

    Cumulative adversity and stress are associated with risk of psychiatric disorders. While basic science studies show repeated and chronic stress effects on prefrontal and limbic neurons, human studies examining cumulative stress and effects on brain morphology are rare. Thus, we assessed whether cumulative adversity is associated with differences in gray matter volume, particularly in regions regulating emotion, self-control, and top-down processing in a community sample. One hundred three healthy community participants, aged 18 to 48 and 68% male, completed interview assessment of cumulative adversity and a structural magnetic resonance imaging protocol. Whole-brain voxel-based-morphometry analysis was performed adjusting for age, gender, and total intracranial volume. Cumulative adversity was associated with smaller volume in medial prefrontal cortex (PFC), insular cortex, and subgenual anterior cingulate regions (familywise error corrected, p < .001). Recent stressful life events were associated with smaller volume in two clusters: the medial PFC and the right insula. Life trauma was associated with smaller volume in the medial PFC, anterior cingulate, and subgenual regions. The interaction of greater subjective chronic stress and greater cumulative life events was associated with smaller volume in the orbitofrontal cortex, insula, and anterior and subgenual cingulate regions. Current results demonstrate that increasing cumulative exposure to adverse life events is associated with smaller gray matter volume in key prefrontal and limbic regions involved in stress, emotion and reward regulation, and impulse control. These differences found in community participants may serve to mediate vulnerability to depression, addiction, and other stress-related psychopathology. Copyright © 2012 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  6. Cumulative Adversity and Smaller Gray Matter Volume in Medial Prefrontal, Anterior Cingulate, and Insula Regions

    PubMed Central

    Ansell, Emily B.; Rando, Kenneth; Tuit, Keri; Guarnaccia, Joseph; Sinha, Rajita

    2012-01-01

    Background Cumulative adversity and stress are associated with risk of psychiatric disorders. While basic science studies show repeated and chronic stress effects on prefrontal and limbic neurons, human studies examining cumulative stress and effects on brain morphology are rare. Thus, we assessed whether cumulative adversity is associated with differences in gray matter volume, particularly in regions regulating emotion, self-control, and top-down processing in a community sample. Methods One hundred three healthy community participants, aged 18 to 48 and 68% male, completed interview assessment of cumulative adversity and a structural magnetic resonance imaging protocol. Whole-brain voxel-based-morphometry analysis was performed adjusting for age, gender, and total intracranial volume. Results Cumulative adversity was associated with smaller volume in medial prefrontal cortex (PFC), insular cortex, and subgenual anterior cingulate regions (familywise error corrected, p <.001). Recent stressful life events were associated with smaller volume in two clusters: the medial PFC and the right insula. Life trauma was associated with smaller volume in the medial PFC, anterior cingulate, and subgenual regions. The interaction of greater subjective chronic stress and greater cumulative life events was associated with smaller volume in the orbitofrontal cortex, insula, and anterior and subgenual cingulate regions. Conclusions Current results demonstrate that increasing cumulative exposure to adverse life events is associated with smaller gray matter volume in key prefrontal and limbic regions involved in stress, emotion and reward regulation, and impulse control. These differences found in community participants may serve to mediate vulnerability to depression, addiction, and other stress-related psychopathology. PMID:22218286

  7. Reviewing the Research on Mail Survey Response Rates: Meta-Analysis.

    ERIC Educational Resources Information Center

    Green, Kathy E.; Hutchinson, Susan R.

    Meta-analysis, a way of cumulating the results of research studies, focuses on the magnitudes of effect sizes and seeks to explain effects through study characteristics. This meta-analysis used the methods developed by G. V. Glass to summarize the research on mail survey response rate manipulations. A narrative review using the same studies set…

  8. 10 CFR 51.45 - Environmental report.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... an analysis of the cumulative impacts of the activities to be authorized by the limited work... the proposed action should it be implemented. (c) Analysis. The environmental report must include an analysis that considers and balances the environmental effects of the proposed action, the environmental...

  9. Effects of cumulative illness severity on hippocampal gray matter volume in major depression: a voxel-based morphometry study.

    PubMed

    Zaremba, Dario; Enneking, Verena; Meinert, Susanne; Förster, Katharina; Bürger, Christian; Dohm, Katharina; Grotegerd, Dominik; Redlich, Ronny; Dietsche, Bruno; Krug, Axel; Kircher, Tilo; Kugel, Harald; Heindel, Walter; Baune, Bernhard T; Arolt, Volker; Dannlowski, Udo

    2018-02-08

    Patients with major depression show reduced hippocampal volume compared to healthy controls. However, the contribution of patients' cumulative illness severity to hippocampal volume has rarely been investigated. It was the aim of our study to find a composite score of cumulative illness severity that is associated with hippocampal volume in depression. We estimated hippocampal gray matter volume using 3-tesla brain magnetic resonance imaging in 213 inpatients with acute major depression according to DSM-IV criteria (employing the SCID interview) and 213 healthy controls. Patients' cumulative illness severity was ascertained by six clinical variables via structured clinical interviews. A principal component analysis was conducted to identify components reflecting cumulative illness severity. Regression analyses and a voxel-based morphometry approach were used to investigate the influence of patients' individual component scores on hippocampal volume. Principal component analysis yielded two main components of cumulative illness severity: Hospitalization and Duration of Illness. While the component Hospitalization incorporated information from the intensity of inpatient treatment, the component Duration of Illness was based on the duration and frequency of illness episodes. We could demonstrate a significant inverse association of patients' Hospitalization component scores with bilateral hippocampal gray matter volume. This relationship was not found for Duration of Illness component scores. Variables associated with patients' history of psychiatric hospitalization seem to be accurate predictors of hippocampal volume in major depression and reliable estimators of patients' cumulative illness severity. Future studies should pay attention to these measures when investigating hippocampal volume changes in major depression.

  10. Time course of ozone-induced changes in breathing pattern in healthy exercising humans.

    PubMed

    Schelegle, Edward S; Walby, William F; Adams, William C

    2007-02-01

    We examined the time course of O3-induced changes in breathing pattern in 97 healthy human subjects (70 men and 27 women). One- to five-minute averages of breathing frequency (f(B)) and minute ventilation (Ve) were used to generate plots of cumulative breaths and cumulative exposure volume vs. time and cumulative exposure volume vs. cumulative breaths. Analysis revealed a three-phase response; delay, no response detected; onset, f(B) began to increase; response, f(B) stabilized. Regression analysis was used to identify four parameters: time to onset, number of breaths at onset, cumulative inhaled dose of ozone at onset of O3-induced tachypnea, and the percent change in f(B). The effect of altering O3 concentration, Ve, atropine treatment, and indomethacin treatment were examined. We found that the lower the O3 concentration, the greater the number of breaths at onset of tachypnea at a fixed ventilation, whereas number of breaths at onset of tachypnea remains unchanged when Ve is altered and O3 concentration is fixed. The cumulative inhaled dose of O3 at onset of tachypnea remained constant and showed no relationship with the magnitude of percent change in f(B). Atropine did not affect any of the derived parameters, whereas indomethacin did not affect time to onset, number of breaths at onset, or cumulative inhaled dose of O3 at onset of tachypnea but did attenuate percent change in f(B). The results are discussed in the context of dose response and intrinsic mechanisms of action.

  11. Sequential change detection and monitoring of temporal trends in random-effects meta-analysis.

    PubMed

    Dogo, Samson Henry; Clark, Allan; Kulinskaya, Elena

    2017-06-01

    Temporal changes in magnitude of effect sizes reported in many areas of research are a threat to the credibility of the results and conclusions of meta-analysis. Numerous sequential methods for meta-analysis have been proposed to detect changes and monitor trends in effect sizes so that meta-analysis can be updated when necessary and interpreted based on the time it was conducted. The difficulties of sequential meta-analysis under the random-effects model are caused by dependencies in increments introduced by the estimation of the heterogeneity parameter τ 2 . In this paper, we propose the use of a retrospective cumulative sum (CUSUM)-type test with bootstrap critical values. This method allows retrospective analysis of the past trajectory of cumulative effects in random-effects meta-analysis and its visualization on a chart similar to CUSUM chart. Simulation results show that the new method demonstrates good control of Type I error regardless of the number or size of the studies and the amount of heterogeneity. Application of the new method is illustrated on two examples of medical meta-analyses. © 2016 The Authors. Research Synthesis Methods published by John Wiley & Sons Ltd. © 2016 The Authors. Research Synthesis Methods published by John Wiley & Sons Ltd.

  12. HISTORICAL ANALYSIS OF ECOLOGICAL EFFECTS: A USEFUL EDUCATIONAL TOOL

    EPA Science Inventory

    An historical analysis that presents the ecological consequences of development can be a valuable educational tool for citizens, students, and environmental managers. In highly impacted areas, the cumulative impacts of multiple stressors can result in complex environmental condit...

  13. An effective measure of childhood adversity that is valid with older adults.

    PubMed

    Danielson, Ramona; Sanders, Gregory F

    2018-06-12

    Childhood adversity (CA) has life-long effects that we are just beginning to understand. The Midlife in the United States (MIDUS) data is a rich resource that could contribute to the knowledge of the impact of CA in the later years but, while a number of CA items are included in MIDUS, a cumulative CA scale based on those items has not been created. Development of a CA scale would create numerous research opportunities within MIDUS and overcome some of the challenges of using a secondary dataset. The present study aimed to demonstrate that a cumulative measure of CA that is valid with older adults could be created using retrospective MIDUS Refresher study data (Ryff et al., 2016); analysis included data collected from 2011 to 2014 from 2542 adults ages 23-76 (1017 adults 55-76). The present study provided a rationale for which measures of CA to include in a cumulative scale. The distribution of eight types of CA and the cumulative CA scale were consistent with findings from past studies of CA. The factor structure of the cumulative CA scale was similar to the original ACE study and included two factors: household dynamics and child abuse/neglect. Consistent with past studies, the CA scale predicted a negative association with life satisfaction and a positive association with number of chronic conditions. This study demonstrated that an effective cumulative measure of CA could be created that would be of value to other studies using MIDUS data to explore outcomes with older adults. Copyright © 2018 Elsevier Ltd. All rights reserved.

  14. 43 CFR 46.115 - Consideration of past actions in the analysis of cumulative effects.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Interior IMPLEMENTATION OF THE NATIONAL ENVIRONMENTAL POLICY ACT OF 1969 Protection and Enhancement of... must analyze the effects in accordance with 40 CFR 1508.7 and in accordance with relevant guidance...

  15. 43 CFR 46.115 - Consideration of past actions in the analysis of cumulative effects.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Interior IMPLEMENTATION OF THE NATIONAL ENVIRONMENTAL POLICY ACT OF 1969 Protection and Enhancement of... must analyze the effects in accordance with 40 CFR 1508.7 and in accordance with relevant guidance...

  16. Additive scales in degenerative disease--calculation of effect sizes and clinical judgment.

    PubMed

    Riepe, Matthias W; Wilkinson, David; Förstl, Hans; Brieden, Andreas

    2011-12-16

    The therapeutic efficacy of an intervention is often assessed in clinical trials by scales measuring multiple diverse activities that are added to produce a cumulative global score. Medical communities and health care systems subsequently use these data to calculate pooled effect sizes to compare treatments. This is done because major doubt has been cast over the clinical relevance of statistically significant findings relying on p values with the potential to report chance findings. Hence in an aim to overcome this pooling the results of clinical studies into a meta-analyses with a statistical calculus has been assumed to be a more definitive way of deciding of efficacy. We simulate the therapeutic effects as measured with additive scales in patient cohorts with different disease severity and assess the limitations of an effect size calculation of additive scales which are proven mathematically. We demonstrate that the major problem, which cannot be overcome by current numerical methods, is the complex nature and neurobiological foundation of clinical psychiatric endpoints in particular and additive scales in general. This is particularly relevant for endpoints used in dementia research. 'Cognition' is composed of functions such as memory, attention, orientation and many more. These individual functions decline in varied and non-linear ways. Here we demonstrate that with progressive diseases cumulative values from multidimensional scales are subject to distortion by the limitations of the additive scale. The non-linearity of the decline of function impedes the calculation of effect sizes based on cumulative values from these multidimensional scales. Statistical analysis needs to be guided by boundaries of the biological condition. Alternatively, we suggest a different approach avoiding the error imposed by over-analysis of cumulative global scores from additive scales.

  17. General model for the pointing error analysis of Risley-prism system based on ray direction deviation in light refraction

    NASA Astrophysics Data System (ADS)

    Zhang, Hao; Yuan, Yan; Su, Lijuan; Huang, Fengzhen; Bai, Qing

    2016-09-01

    The Risley-prism-based light beam steering apparatus delivers superior pointing accuracy and it is used in imaging LIDAR and imaging microscopes. A general model for pointing error analysis of the Risley prisms is proposed in this paper, based on ray direction deviation in light refraction. This model captures incident beam deviation, assembly deflections, and prism rotational error. We derive the transmission matrixes of the model firstly. Then, the independent and cumulative effects of different errors are analyzed through this model. Accuracy study of the model shows that the prediction deviation of pointing error for different error is less than 4.1×10-5° when the error amplitude is 0.1°. Detailed analyses of errors indicate that different error sources affect the pointing accuracy to varying degree, and the major error source is the incident beam deviation. The prism tilting has a relative big effect on the pointing accuracy when prism tilts in the principal section. The cumulative effect analyses of multiple errors represent that the pointing error can be reduced by tuning the bearing tilting in the same direction. The cumulative effect of rotational error is relative big when the difference of these two prism rotational angles equals 0 or π, while it is relative small when the difference equals π/2. The novelty of these results suggests that our analysis can help to uncover the error distribution and aid in measurement calibration of Risley-prism systems.

  18. Evaluating effects of developmental education for college students using a regression discontinuity design.

    PubMed

    Moss, Brian G; Yeaton, William H

    2013-10-01

    Annually, American colleges and universities provide developmental education (DE) to millions of underprepared students; however, evaluation estimates of DE benefits have been mixed. Using a prototypic exemplar of DE, our primary objective was to investigate the utility of a replicative evaluative framework for assessing program effectiveness. Within the context of the regression discontinuity (RD) design, this research examined the effectiveness of a DE program for five, sequential cohorts of first-time college students. Discontinuity estimates were generated for individual terms and cumulatively, across terms. Participants were 3,589 first-time community college students. DE program effects were measured by contrasting both college-level English grades and a dichotomous measure of pass/fail, for DE and non-DE students. Parametric and nonparametric estimates of overall effect were positive for continuous and dichotomous measures of achievement (grade and pass/fail). The variability of program effects over time was determined by tracking results within individual terms and cumulatively, across terms. Applying this replication strategy, DE's overall impact was modest (an effect size of approximately .20) but quite consistent, based on parametric and nonparametric estimation approaches. A meta-analysis of five RD results yielded virtually the same estimate as the overall, parametric findings. Subset analysis, though tentative, suggested that males benefited more than females, while academic gains were comparable for different ethnicities. The cumulative, within-study comparison, replication approach offers considerable potential for the evaluation of new and existing policies, particularly when effects are relatively small, as is often the case in applied settings.

  19. Analysis of LDPE-ZnO-clay nanocomposites using novel cumulative rheological parameters

    NASA Astrophysics Data System (ADS)

    Kracalik, Milan

    2017-05-01

    Polymer nanocomposites exhibit complex rheological behaviour due to physical and also possibly chemical interactions between individual phases. Up to now, rheology of dispersive polymer systems has been usually described by evaluation of viscosity curve (shear thinning phenomenon), storage modulus curve (formation of secondary plateau) or plotting information about dumping behaviour (e.g. Van Gurp-Palmen-plot, comparison of loss factor tan δ). On the contrary to evaluation of damping behaviour, values of cot δ were calculated and called as "storage factor", analogically to loss factor. Then values of storage factor were integrated over specific frequency range and called as "cumulative storage factor". In this contribution, LDPE-ZnO-clay nanocomposites with different dispersion grades (physical networks) have been prepared and characterized by both conventional as well as novel analysis approach. Next to cumulative storage factor, further cumulative rheological parameters like cumulative complex viscosity, cumulative complex modulus or cumulative storage modulus have been introduced.

  20. The Effects of Violent Video Games on Aggression: A Meta-Analysis.

    ERIC Educational Resources Information Center

    Sherry, John L.

    2001-01-01

    Cumulates findings across existing empirical research on the effects of violent video games to estimate overall effect size and discern important trends and moderating variables. Suggests there is a smaller effect of violent video games on aggression than has been found with television violence on aggression. (SG)

  1. Effects of cumulative stress and impulsivity on smoking status.

    PubMed

    Ansell, Emily B; Gu, Peihua; Tuit, Keri; Sinha, Rajita

    2012-03-01

    The stress-vulnerability model of addiction predicts that environmental factors, such as cumulative stress, will result in individual adaptations that decrease self-control, increase impulsivity, and increase risk for addiction. Impulsivity and cumulative stress are risk factors for tobacco smoking that are rarely examined simultaneously in research. We examined the indirect and direct effects of cumulative adversity in a community sample consisting of 291 men and women who participated in an assessment of cumulative stress, self-reported impulsivity, and smoking history. Data were analyzed using bootstrapping techniques to estimate indirect effects of stress on smoking via impulsivity. Cumulative adversity is associated with smoking status via direct effects and indirect effects through impulsivity scores. Additional models examining specific types of stress indicate contributions of traumatic stress and recent life events as well as chronic relationship stressors. Overall, cumulative stress is associated with increased risk of smoking via increased impulsivity and via pathways independent of impulsivity. These findings support the stress-vulnerability model and highlight the utility of mediation models in assessing how, and for whom, cumulative stress increases risk of current cigarette smoking. Increasing self-control is a target for interventions with individuals who have experienced cumulative adversity. Copyright © 2012 John Wiley & Sons, Ltd.

  2. Effects of cumulative stress and impulsivity on smoking status

    PubMed Central

    Ansell, Emily B.; Gu, Peihua; Tuit, Keri; Sinha, Rajita

    2013-01-01

    Objective The stress-vulnerability model of addiction predicts that environmental factors, such as cumulative stress, will result in individual adaptations that decrease self-control, increase impulsivity, and increase risk for addiction. Impulsivity and cumulative stress are risk factors for tobacco smoking that are rarely examined simultaneously in research. Methods We examined the indirect and direct effects of cumulative adversity in a community sample consisting of 291 men and women who participated in an assessment of cumulative stress, self-reported impulsivity, and smoking history. Data were analyzed using bootstrapping techniques to estimate indirect effects of stress on smoking via impulsivity. Results Cumulative adversity is associated with smoking status via direct effects and indirect effects through impulsivity scores. Additional models examining specific types of stress indicate contributions of traumatic stress and recent life events as well as chronic relationship stressors. Conclusions Overall, cumulative stress is associated with increased risk of smoking via increased impulsivity and via pathways independent of impulsivity. These findings support the stress-vulnerability model and highlight the utility of mediation models in assessing how, and for whom, cumulative stress increases risk of current cigarette smoking. Increasing self-control is a target for interventions with individuals who have experienced cumulative adversity. PMID:22389084

  3. Cumulative effective dose associated with radiography and CT of adolescents with spinal injuries.

    PubMed

    Lemburg, Stefan P; Peters, Soeren A; Roggenland, Daniela; Nicolas, Volkmar; Heyer, Christoph M

    2010-12-01

    The purpose of this study was to analyze the quantity and distribution of cumulative effective doses in diagnostic imaging of adolescents with spinal injuries. At a level 1 trauma center from July 2003 through June 2009, imaging procedures during initial evaluation and hospitalization and after discharge of all patients 10-20 years old with spinal fractures were retrospectively analyzed. The cumulative effective doses for all imaging studies were calculated, and the doses to patients with spinal injuries who had multiple traumatic injuries were compared with the doses to patients with spinal injuries but without multiple injuries. The significance level was set at 5%. Imaging studies of 72 patients (32 with multiple injuries; average age, 17.5 years) entailed a median cumulative effective dose of 18.89 mSv. Patients with multiple injuries had a significantly higher total cumulative effective dose (29.70 versus 10.86 mSv, p < 0.001) mainly owing to the significantly higher CT-related cumulative effective dose to multiple injury patients during the initial evaluation (18.39 versus 2.83 mSv, p < 0.001). Overall, CT accounted for 86% of the total cumulative effective dose. Adolescents with spinal injuries receive a cumulative effective dose equal to that of adult trauma patients and nearly three times that of pediatric trauma patients. Areas of focus in lowering cumulative effective dose should be appropriate initial estimation of trauma severity and careful selection of CT scan parameters.

  4. Ionizing diagnostic radiation exposure in patients with Crohn's disease: A retrospective study in a medium hospital and its predictive factors.

    PubMed

    Merino Rodríguez, Esther; Carrera Alonso, Elisa; Torralba González de Suso, Miguel; Sánchez da Silva, Marta; Martínez López, María; Sánchez-Tembleque Zarandona, María Dolores

    2018-02-01

    It is estimated that diagnostic medical radiation exposure may be responsable for 0.5-2% of cancers worldwide. Because of the relapsing course of Crohn's disease (CD), these patients usually requiere multiple ionizing radiation test. Stimating the total cumulative effective dose received by our CD patients and identifying the risk factors associated with the exposure to a cumulative effective dose due to the disease (CEED) > 50mSv. Retrospective cohort study (2001-2014). patients with CD. Risk dose >50mSv. For calculating de cumulative effective dose and the CEED, all the ionizing test done were taken. For identifying predictive factors for receiving a CEDD >50mSv, an univariate and a multivariate logistic regression analyses were performed using a >50mSv dose as dependent variable. Of the 267 patients analyzed the 24.6% of them received a cumulative effective dose > 50mSv and the 15.2% a CEED>50mSv. In the multivariate analysis, the following variables were identified as independent predictors associated with a CEDD >50mSv: major surgery (OR= 2.1; IC 95% [1.1-3.8]; p=.019) and severity (OR= 20.6; IC 95% [4.5-94.8]; p<.01). Patients with CD are more at risk of receiving risk CEED, so it would be advisable to monitor the cumulative effective dose received to anticipate our intervention in order to avoid reaching that dose. The ultrasounds and abdominal resonance enterography are alternatives in these cases, although their accessibility is limited in some centers. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  5. Self-learning Monte Carlo method and cumulative update in fermion systems

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

    Liu, Junwei; Shen, Huitao; Qi, Yang

    2017-06-07

    In this study, we develop the self-learning Monte Carlo (SLMC) method, a general-purpose numerical method recently introduced to simulate many-body systems, for studying interacting fermion systems. Our method uses a highly efficient update algorithm, which we design and dub “cumulative update”, to generate new candidate configurations in the Markov chain based on a self-learned bosonic effective model. From a general analysis and a numerical study of the double exchange model as an example, we find that the SLMC with cumulative update drastically reduces the computational cost of the simulation, while remaining statistically exact. Remarkably, its computational complexity is far lessmore » than the conventional algorithm with local updates.« less

  6. Shale Gas Development and Brook Trout: Scaling Best Management Practices to Anticipate Cumulative Effects

    USGS Publications Warehouse

    Smith, David; Snyder, Craig D.; Hitt, Nathaniel P.; Young, John A.; Faulkner, Stephen P.

    2012-01-01

    Shale gas development may involve trade-offs between energy development and benefits provided by natural ecosystems. However, current best management practices (BMPs) focus on mitigating localized ecological degradation. We review evidence for cumulative effects of natural gas development on brook trout (Salvelinus fontinalis) and conclude that BMPs should account for potential watershed-scale effects in addition to localized influences. The challenge is to develop BMPs in the face of uncertainty in the predicted response of brook trout to landscape-scale disturbance caused by gas extraction. We propose a decision-analysis approach to formulating BMPs in the specific case of relatively undisturbed watersheds where there is consensus to maintain brook trout populations during gas development. The decision analysis was informed by existing empirical models that describe brook trout occupancy responses to landscape disturbance and set bounds on the uncertainty in the predicted responses to shale gas development. The decision analysis showed that a high efficiency of gas development (e.g., 1 well pad per square mile and 7 acres per pad) was critical to achieving a win-win solution characterized by maintaining brook trout and maximizing extraction of available gas. This finding was invariant to uncertainty in predicted response of brook trout to watershed-level disturbance. However, as the efficiency of gas development decreased, the optimal BMP depended on the predicted response, and there was considerable potential value in discriminating among predictive models through adaptive management or research. The proposed decision-analysis framework provides an opportunity to anticipate the cumulative effects of shale gas development, account for uncertainty, and inform management decisions at the appropriate spatial scales.

  7. An analysis of cumulative risks based on biomonitoring data for six phthalates using the Maximum Cumulative Ratio

    EPA Science Inventory

    The Maximum Cumulative Ratio (MCR) quantifies the degree to which a single chemical drives the cumulative risk of an individual exposed to multiple chemicals. Phthalates are a class of chemicals with ubiquitous exposures in the general population that have the potential to cause ...

  8. Effects of bisphosphonate treatment on DNA methylation in osteonecrosis of the jaw.

    PubMed

    Polidoro, Silvia; Broccoletti, Roberto; Campanella, Gianluca; Di Gaetano, Cornelia; Menegatti, Elisa; Scoletta, Matteo; Lerda, Ennio; Matullo, Giuseppe; Vineis, Paolo; Berardi, Daniela; Scully, Crispian; Arduino, Paolo G

    2013-10-09

    Bisphosphonates are used in the treatment of hypocalcaemia, mainly in cancer and osteoporosis. Some patients experience adverse events, such as BP-related osteonecrosis of the jaw (BRONJ). DNA methylation plays a key role in gene regulation in many tissues, but its involvement in bone homeostasis is not well characterized, and no information is available regarding altered methylation in BRONJ. Using the Illumina Infinium HumanMethylation27 BeadChip assay, we performed an epigenome-wide association study in peripheral blood samples from 68 patients treated with nitrogenous BP, including 35 with BRONJ. Analysis of the estimated cumulative BP exposure distribution indicated that the exposure of the case group to BP was slightly higher than that of the control group; more severely affected cases (i.e., with BRONJ in both mandible and maxilla) were significantly more exposed to BP than were those with BRONJ only in the mandible or maxilla (one-sided Wilcoxon rank sum test, p=0.002). Logistic regression analysis confirmed the positive association between cumulative bisphosphonates exposure and risk of BRONJ (OR 1.015 per mg of cumulative exposure, 95% CI 1.004-1.032, p=0.036). Although no statistically significant differences were observed between case and control groups, methylation levels of probes mapping on three genes, ERCC8, LEPREL1 and SDC2, were strongly associated with cumulative BP exposure levels (p<1.31E-007). Enrichment analysis, combining differentially methylated genes with genes involved in the mevalonate pathway, showed that BP treatment can affect the methylation pattern of genes involved in extracellular matrix organization and inflammatory responses, leading to more frequent adverse effects such as BRONJ. Differences in DNA methylation induced by BP treatment could be involved in the pathogenesis of the bone lesion. Copyright © 2013 Elsevier B.V. All rights reserved.

  9. Kaplan-Meier Survival Analysis Overestimates the Risk of Revision Arthroplasty: A Meta-analysis.

    PubMed

    Lacny, Sarah; Wilson, Todd; Clement, Fiona; Roberts, Derek J; Faris, Peter D; Ghali, William A; Marshall, Deborah A

    2015-11-01

    Although Kaplan-Meier survival analysis is commonly used to estimate the cumulative incidence of revision after joint arthroplasty, it theoretically overestimates the risk of revision in the presence of competing risks (such as death). Because the magnitude of overestimation is not well documented, the potential associated impact on clinical and policy decision-making remains unknown. We performed a meta-analysis to answer the following questions: (1) To what extent does the Kaplan-Meier method overestimate the cumulative incidence of revision after joint replacement compared with alternative competing-risks methods? (2) Is the extent of overestimation influenced by followup time or rate of competing risks? We searched Ovid MEDLINE, EMBASE, BIOSIS Previews, and Web of Science (1946, 1980, 1980, and 1899, respectively, to October 26, 2013) and included article bibliographies for studies comparing estimated cumulative incidence of revision after hip or knee arthroplasty obtained using both Kaplan-Meier and competing-risks methods. We excluded conference abstracts, unpublished studies, or studies using simulated data sets. Two reviewers independently extracted data and evaluated the quality of reporting of the included studies. Among 1160 abstracts identified, six studies were included in our meta-analysis. The principal reason for the steep attrition (1160 to six) was that the initial search was for studies in any clinical area that compared the cumulative incidence estimated using the Kaplan-Meier versus competing-risks methods for any event (not just the cumulative incidence of hip or knee revision); we did this to minimize the likelihood of missing any relevant studies. We calculated risk ratios (RRs) comparing the cumulative incidence estimated using the Kaplan-Meier method with the competing-risks method for each study and used DerSimonian and Laird random effects models to pool these RRs. Heterogeneity was explored using stratified meta-analyses and metaregression. The pooled cumulative incidence of revision after hip or knee arthroplasty obtained using the Kaplan-Meier method was 1.55 times higher (95% confidence interval, 1.43-1.68; p < 0.001) than that obtained using the competing-risks method. Longer followup times and higher proportions of competing risks were not associated with increases in the amount of overestimation of revision risk by the Kaplan-Meier method (all p > 0.10). This may be due to the small number of studies that met the inclusion criteria and conservative variance approximation. The Kaplan-Meier method overestimates risk of revision after hip or knee arthroplasty in populations where competing risks (such as death) might preclude the occurrence of the event of interest (revision). Competing-risks methods should be used to more accurately estimate the cumulative incidence of revision when the goal is to plan healthcare services and resource allocation for revisions.

  10. An Analysis of Cumulative Risks Indicated by Biomonitoring Data of Six Phthalates Using the Maximum Cumulative Ratio

    EPA Science Inventory

    The Maximum Cumulative Ratio (MCR) quantifies the degree to which a single component of a chemical mixture drives the cumulative risk of a receptor.1 This study used the MCR, the Hazard Index (HI) and Hazard Quotient (HQ) to evaluate co-exposures to six phthalates using biomonito...

  11. Patients with Staged Bilateral Total Joint Arthroplasty in Registries: Immortal Time Bias and Methodological Options.

    PubMed

    van der Pas, Stéphanie L; Nelissen, Rob G H H; Fiocco, Marta

    2017-08-02

    In arthroplasty data, patients with staged bilateral total joint arthroplasty (TJA) pose a problem in statistical analysis. Subgroup analysis, in which patients with unilateral and bilateral TJA are studied separately, is sometimes considered an appropriate solution to the problem; we aim to show that this is not true because of immortal time bias. We reviewed patients who underwent staged (at any time) bilateral TJA. The logical fallacy leading to immortal time bias is explained through a simple artificial data example. The cumulative incidences of revision and death are computed by subgroup analysis and by landmark analysis based on hip replacement data from the Dutch Arthroplasty Register and on simulated data sets. For patients who underwent unilateral TJA, subgroup analysis can lead to an overestimate of the cumulative incidence of death and an underestimate of the cumulative incidence of revision. The reverse conclusion holds for patients who underwent staged bilateral TJA. Analysis of these patients can lead to an underestimate of the cumulative incidence of death and an overestimate of the cumulative incidence of revision. Immortal time bias can be prevented by using landmark analysis. When examining arthroplasty registry data, patients who underwent staged bilateral TJA should be analyzed with caution. An appropriate statistical method to address the research question should be selected.

  12. Cumulative watershed effects: Then and now

    Treesearch

    Leslie M. Reid

    2001-01-01

    Abstract - Cumulative effects are the combined effects of multiple activities, and watershed effects are those which involve processes of water transport. Almost all impacts are influenced by multiple activities, so almost all impacts must be evaluated as cumulative impacts rather than as individual impacts. Existing definitions suggest that to be significant, an...

  13. Cumulative meta-analysis of the relationship between useful field of view and driving performance in older adults: current and future implications.

    PubMed

    Clay, Olivio J; Wadley, Virginia G; Edwards, Jerri D; Roth, David L; Roenker, Daniel L; Ball, Karlene K

    2005-08-01

    Driving is a complex behavior that requires the utilization of a wide range of individual abilities. Identifying assessments that not only capture individual differences, but also are related to older adults' driving performance would be beneficial. This investigation examines the relationship between the Useful Field of View (UFOV) assessment and objective measures of retrospective or concurrent driving performance, including state-recorded accidents, on-road driving, and driving simulator performance. The PubMed and PsycINFO databases were searched to retrieve eight studies that reported bivariate relationships between UFOV and these objective driving measures. Cumulative meta-analysis techniques were used to combine the effect sizes in an attempt to determine whether the strength of the relationship was stable across studies and to assess whether a sufficient number of studies have been conducted to validate the relationship between UFOV and driving performance. A within-group homogeneity of effect sizes test revealed that the samples could be thought of as being drawn from the same population, Q [7] = 11.29, p (one-tailed) = 0.13. Therefore, the effect sizes of eight studies were combined for the present cumulative meta-analysis. The weighted mean effect size across the studies revealed a large effect (Cohen's d = 0.945), with poorer UFOV performance associated with negative driving outcomes. This relationship was robust across multiple indices of driving performance and several research laboratories. This convergence of evidence across numerous studies using different methodologies confirms the importance of the UFOV assessment as a valid and reliable index of driving performance and safety. Recent prospective studies have confirmed a relationship between UFOV performance and future crashes, further supporting the use of this instrument as a potential screening measure for at-risk older drivers.

  14. Pulmonary function of U.S. coal miners related to dust exposure estimates.

    PubMed

    Attfield, M D; Hodous, T K

    1992-03-01

    This study of 7,139 U.S. coal miners used linear regression analysis to relate estimates of cumulative dust exposure to several pulmonary function variables measured during medical examinations undertaken between 1969 and 1971. The exposure data included newly derived cumulative dust exposure estimates for the period up to time of examination based on large data bases of underground airborne dust sampling measurements. Negative associations were found between measures of cumulative exposure and FEV1, FVC, and the FEV1/FVC ratio (p less than 0.001). In general, the relationships were similar to those reported for British coal miners. Overall, the results demonstrate an adverse effect of coal mine dust exposure on pulmonary function that occurs even in the absence of radiographically detected pneumoconiosis.

  15. Cumulative Effective Hölder Exponent Based Indicator for Real-Time Fetal Heartbeat Analysis during Labour

    NASA Astrophysics Data System (ADS)

    Struzik, Zbigniew R.; van Wijngaarden, Willem J.

    We introduce a special purpose cumulative indicator, capturing in real time the cumulative deviation from the reference level of the exponent h (local roughness, Hölder exponent) of the fetal heartbeat during labour. We verify that the indicator applied to the variability component of the heartbeat coincides with the fetal outcome as determined by blood samples. The variability component is obtained from running real time decomposition of fetal heartbeat into independent components using an adaptation of an oversampled Haar wavelet transform. The particular filters used and resolutions applied are motivated by obstetricial insight/practice. The methodology described has the potential for real-time monitoring of the fetus during labour and for the prediction of the fetal outcome, allerting the attending staff in the case of (threatening) hypoxia.

  16. Cumulative impacts of oil fields on northern Alaskan landscapes

    USGS Publications Warehouse

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

    1987-01-01

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

  17. An Analysis of the Effects Housing Improvements Have on the Retention of Air Force Personnel

    DTIC Science & Technology

    1990-09-01

    facilities for preteens 3. Avaiablrity of recreational facilities for preteens 03. ionvenience of residence to playyards/playgrounds 4> Convenience of...t, but insulazion wou%, definitely save 3n c.ergy costs. No oiaygroundE c- preteen activity center is avai’a"’ -. se to base housing. ’..uui_ ’ r m...recreational facilities for preteens Cumulative Cumulative HSAT25 Frequency Percent Frequency Percent 17 5.1 17 5 a9 14.7 66 19. 3 40 12.0 106 31.3 69 20.7

  18. ANALYSIS OF FUNCTIONAL EFFECTS OF A MIXTURE OF FIVE PESTICIDES USING A RAY DESIGN

    EPA Science Inventory


    Abstract
    The protection of human health from the adverse effects of cumulative environmental exposure to chemical mixtures is an important issue. Of particular interest is the potential detection and characterization of interaction among chemicals in complex mixtures. R...

  19. Nonadiabatic rate constants for proton transfer and proton-coupled electron transfer reactions in solution: Effects of quadratic term in the vibronic coupling expansion

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

    Soudackov, Alexander V.; Hammes-Schiffer, Sharon

    2015-11-21

    Rate constant expressions for vibronically nonadiabatic proton transfer and proton-coupled electron transfer reactions are presented and analyzed. The regimes covered include electronically adiabatic and nonadiabatic reactions, as well as high-frequency and low-frequency proton donor-acceptor vibrational modes. These rate constants differ from previous rate constants derived with the cumulant expansion approach in that the logarithmic expansion of the vibronic coupling in terms of the proton donor-acceptor distance includes a quadratic as well as a linear term. The analysis illustrates that inclusion of this quadratic term in the framework of the cumulant expansion framework may significantly impact the rate constants at highmore » temperatures for proton transfer interfaces with soft proton donor-acceptor modes that are associated with small force constants and weak hydrogen bonds. The effects of the quadratic term may also become significant in these regimes when using the vibronic coupling expansion in conjunction with a thermal averaging procedure for calculating the rate constant. In this case, however, the expansion of the coupling can be avoided entirely by calculating the couplings explicitly for the range of proton donor-acceptor distances sampled. The effects of the quadratic term for weak hydrogen-bonding systems are less significant for more physically realistic models that prevent the sampling of unphysical short proton donor-acceptor distances. Additionally, the rigorous relation between the cumulant expansion and thermal averaging approaches is clarified. In particular, the cumulant expansion rate constant includes effects from dynamical interference between the proton donor-acceptor and solvent motions and becomes equivalent to the thermally averaged rate constant when these dynamical effects are neglected. This analysis identifies the regimes in which each rate constant expression is valid and thus will be important for future applications to proton transfer and proton-coupled electron transfer in chemical and biological processes.« less

  20. The impact of nonsteroidal anti-inflammatory drugs on inflammatory response after aneurysmal subarachnoid hemorrhage.

    PubMed

    Muroi, Carl; Hugelshofer, Michael; Seule, Martin; Keller, Emanuela

    2014-04-01

    The degree of inflammatory response with cytokine release is associated with poor outcomes after aneurysmal subarachnoid hemorrhage (SAH). Previously, we reported on an association between systemic IL-6 levels and clinical outcome in patients with aneurysmal SAH. The intention was to assess the impact of nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen on the inflammatory response after SAH. Our method involved exploratory analysis of data and samples collected within a previous study. In 138 patients with SAH, systemic interleukin (IL-6) and c-reactive protein (CRP) were measured daily up to day 14 after SAH. The correlations among the cumulatively applied amount of NSAIDs, inflammatory parameters, and clinical outcome were calculated. An inverse correlation between cumulatively applied NSAIDs and both IL-6 and CRP levels was found (r = -0.437, p < 0.001 and r = -0.369, p < 0.001 respectively). Multivariable linear regression analysis showed a cumulative amount of NSAIDs to be independently predictive for systemic IL-6 and CRP levels. The cumulative amount of NSAIDs reduced the odds for unfavorable outcome, defined as Glasgow outcome scale 1-3. The results indicate a potential beneficial effect of NSAIDs in patients with SAH in terms of ameliorating inflammatory response, which might have an impact on outcome.

  1. GREAT I Study of the Upper Mississippi River. Technical Appendixes. Volume 2. Floodplain Management, Dredged Material Uses, Dredging Requirements.

    DTIC Science & Technology

    1980-09-01

    placement of dredged material is proposed, a quantitative analysis of the effects on the 1-percent chance flood be made. The analysis must include a...FPMWG will accept the site. b. Until a quantitative analysis is conducted, place- ment sites be selected following these guidelines. (1) Dredge4 material... Analysis of site-specific encroachments would continue to be made without considering the opposite bank impacts or the long-term cumulative effects. 5

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

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... of Changes in Accounting Principles Section 18 Section 18 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS UNIFORM SYSTEM OF... Objective Classification—Cumulative Effect of Changes in Accounting Principles 98Cumulative Effect of...

  3. Cumulative watershed effects: Caspar Creek and beyond

    Treesearch

    Leslie M. Reid

    1998-01-01

    Cumulative effects are the combined effects of multiple activities, and watershed effects are those which involve processes of water transport. Almost all impacts are influenced by multiple activities, so almost all impacts must be evaluated as cumulative impacts rather than as individual impacts. Existing definitions suggest that to be significant, an impact must be...

  4. Cumulative effects of forest management activities: how might they occur?

    Treesearch

    R. M. Rice; R. B. Thomas

    1985-01-01

    Concerns are often voiced about possible environmental damage as the result of the cumulative sedimentation effects of logging and forest road construction. In response to these concerns, National Forests are developing procedures to reduce the possibility that their activities may lead to unacceptable cumulative effects

  5. Cumulative effects of land use on fish metrics in different types of running waters in Austria.

    PubMed

    Trautwein, Clemens; Schinegger, Rafaela; Schmutz, Stefan

    The catchment land-use composition of 249 fish sampling sites in Austrian running waters revealed effects on the biological integrity. Beyond correlative analysis, we investigated (1) which land-use category had the strongest effect on fish, (2) whether metrics of functional fish guilds reacted differently, (3) whether there were cumulative effects of land-use categories, and (4) whether effects varied in strength across river types. We fed 5 land-use categories into regression trees to predict the European Fish Index or fish metric of intolerant species (mainly Salmo trutta fario ) . Agriculture and urbanisation were the best predictors and indicated significant effects at levels of >23.3 and >2%, respectively. Model performance was R 2  = 0.15 with the Fish Index and R 2  = 0.46 with intolerant species. The tree structure showed a cumulative effect from agriculture and urbanisation. For the intolerant species metric, a combination of high percentages for agriculture and urbanisation was related to moderate status, whereas <7.3% agriculture were related to good status, although urbanisation was higher than 1.8%. Headwater river types showed stronger responses to land use than river types of lower gradient and turned out to be more sensitive to urbanisation than agriculture.

  6. Competing approaches to analysis of failure times with competing risks.

    PubMed

    Farley, T M; Ali, M M; Slaymaker, E

    2001-12-15

    For the analysis of time to event data in contraceptive studies when individuals are subject to competing causes for discontinuation, some authors have recently advocated the use of the cumulative incidence rate as a more appropriate measure to summarize data than the complement of the Kaplan-Meier estimate of discontinuation. The former method estimates the rate of discontinuation in the presence of competing causes, while the latter is a hypothetical rate that would be observed if discontinuations for the other reasons could not occur. The difference between the two methods of analysis is the continuous time equivalent of a debate that took place in the contraceptive literature in the 1960s, when several authors advocated the use of net (adjusted or single decrement life table rates) rates in preference to crude rates (multiple decrement life table rates). A small simulation study illustrates the interpretation of the two types of estimate - the complement of the Kaplan-Meier estimate corresponds to a hypothetical rate where discontinuations for other reasons did not occur, while the cumulative incidence gives systematically lower estimates. The Kaplan-Meier estimates are more appropriate when estimating the effectiveness of a contraceptive method, but the cumulative incidence estimates are more appropriate when making programmatic decisions regarding contraceptive methods. Other areas of application, such as cancer studies, may prefer to use the cumulative incidence estimates, but their use should be determined according to the application. Copyright 2001 John Wiley & Sons, Ltd.

  7. Longitudinal analysis of respiratory outcomes among bauxite exposed workers in Western Australia.

    PubMed

    Dennekamp, Martine; de Klerk, Nicholas Hubert; Reid, Alison; Abramson, Michael John; Cui, Jisheng; Del Monaco, Anthony; Fritschi, Lin; Benke, Geza Paul; Sim, Malcolm Ross; Musk, Arthur William

    2015-08-01

    Occupational exposure to bauxite is common in the aluminium industry but little is known about the associated health effects. This study investigates respiratory health in relation to respirable bauxite dust exposure longitudinally over a 13 year period. An inception cohort study recruited 91 male bauxite miners and 363 male alumina refinery workers. Annual measurements of respiratory symptoms and lung function were made. Cumulative exposure to bauxite was derived from job histories and air monitoring data. Mixed-effects modeling was used. No associations were found between cumulative bauxite exposure and respiratory symptoms or lung function. However, when analysis was restricted to the first three rounds, FEV1 was significantly lower in all exposure groups than in those unexposed but with no significant trend. Increasing exposure to bauxite dust in the aluminum industry was not associated with respiratory symptoms or consistent decrements in lung function. © 2015 Wiley Periodicals, Inc.

  8. Lack of evidence for a harmful effect of sodium-glucose co-transporter 2 (SGLT2) inhibitors on fracture risk among type 2 diabetes patients: a network and cumulative meta-analysis of randomized controlled trials.

    PubMed

    Tang, H L; Li, D D; Zhang, J J; Hsu, Y H; Wang, T S; Zhai, S D; Song, Y Q

    2016-12-01

    To evaluate the comparative effects of sodium-glucose co-transporter 2 (SGLT2) inhibitors on risk of bone fracture in patients with type 2 diabetes mellitus (T2DM). PubMed, EMBASE, CENTRAL and ClinicalTrials.gov were systematically searched from inception to 27 January 2016 to identify randomized controlled trials (RCTs) reporting the outcome of fracture in patients with T2DM treated with SGLT2 inhibitors. Pairwise and network meta-analyses, as well as a cumulative meta-analysis, were performed to calculate odds ratios (ORs) and 95% confidence intervals (CIs). A total of 38 eligible RCTs (10 canagliflozin, 15 dapagliflozin and 13 empagliflozin) involving 30 384 patients, with follow-ups ranging from 24 to 160 weeks, were included. The fracture event rates were 1.59% in the SGLT2 inhibitor groups and 1.56% in the control groups. The incidence of fracture events was similar among these three SGLT2 inhibitor groups. Compared with placebo, canagliflozin (OR 1.15; 95% CI 0.71-1.88), dapagliflozin (OR 0.68; 95% CI 0.37-1.25) and empagliflozin (OR 0.93; 95% CI 0.74-1.18) were not significantly associated with an increased risk of fracture. Our cumulative meta-analysis indicated the robustness of the null findings with regard to SGLT2 inhibitors. Our meta-analysis based on available RCT data does not support the harmful effect of SGLT2 inhibitors on fractures, although future safety monitoring from RCTs and real-world data with detailed information on bone health is warranted. © 2016 John Wiley & Sons Ltd.

  9. Collaborative Chronic Care Models for Mental Health Conditions: Cumulative Meta-Analysis and Meta-Regression to Guide Future Research and Implementation

    PubMed Central

    Grogan-Kaylor, Andrew; Perron, Brian E.; Kilbourne, Amy M.; Woltmann, Emily; Bauer, Mark S.

    2013-01-01

    Objective Prior meta-analysis indicates that collaborative chronic care models (CCMs) improve mental and physical health outcomes for individuals with mental disorders. This study aimed to investigate the stability of evidence over time and identify patient and intervention factors associated with CCM effects in order to facilitate implementation and sustainability of CCMs in clinical practice. Method We reviewed 53 CCM trials that analyzed depression, mental quality of life (QOL), or physical QOL outcomes. Cumulative meta-analysis and meta-regression were supplemented by descriptive investigations across and within trials. Results Most trials targeted depression in the primary care setting, and cumulative meta-analysis indicated that effect sizes favoring CCM quickly achieved significance for depression outcomes, and more recently achieved significance for mental and physical QOL. Four of six CCM elements (patient self-management support, clinical information systems, system redesign, and provider decision support) were common among reviewed trials, while two elements (healthcare organization support and linkages to community resources) were rare. No single CCM element was statistically associated with the success of the model. Similarly, meta-regression did not identify specific factors associated with CCM effectiveness. Nonetheless, results within individual trials suggest that increased illness severity predicts CCM outcomes. Conclusions Significant CCM trials have been derived primarily from four original CCM elements. Nonetheless, implementing and sustaining this established model will require healthcare organization support. While CCMs have typically been tested as population-based interventions, evidence supports stepped care application to more severely ill individuals. Future priorities include developing implementation strategies to support adoption and sustainability of the model in clinical settings while maximizing fit of this multi-component framework to local contextual factors. PMID:23938600

  10. Steroid therapy and the risk of osteonecrosis in SARS patients: a dose-response meta-analysis.

    PubMed

    Zhao, R; Wang, H; Wang, X; Feng, F

    2017-03-01

    This meta-analysis synthesized current evidence from 10 trials to evaluate the association between steroid therapy and osteonecrosis incidence in patients with severe acute respiratory syndrome (SARS). Our results suggest that higher cumulative doses and longer treatment durations of steroids are more likely to lead to the development of osteonecrosis in SARS patients. The link between steroid treatment and the risk of osteonecrosis in SARS patients remains unknown. The present meta-analysis aimed to examine the dose-response association between steroid therapy and osteonecrosis incidence in SARS patients. The sex differences in the development of steroid-induced osteonecrosis were also examined. We searched PubMed, Web of Science, CNKI, and WANFANG for studies that involved steroid therapy and reported osteonecrosis data in SARS patients. Two authors independently extracted the data from the individual studies, and the rate ratio (RR) of osteonecrosis was calculated using random-effect models. Ten studies with 1137 recovered SARS patients met the inclusion criteria. Close relationships between osteonecrosis incidence and both the cumulative dose and treatment duration of steroids were observed. The summary RR of osteonecrosis was 1.57 (95% confidence interval (CI) 1.30-1.89, p < 0.001) per 5.0 g increase in the cumulative dose of steroids and was 1.29 (95% CI 1.09-1.53, p = 0.003) for each 10-day increment of increase in treatment duration. The relationship was non-linear (p non-linear  < 0.001 and p non-linear  = 0.022). There were no significant differences in the risk of developing osteonecrosis between the male and female patients (RR 0.01, 95% CI -0.03 to 0.06, p = 0.582). SARS patients who received higher cumulative doses and longer treatment durations of steroids were more likely to develop osteonecrosis, and there were no sex differences in this dose-dependent side effect. Our findings suggest that it is important to reduce osteonecrosis risk by modifying the cumulative dose and the treatment duration of steroids in SARS patients.

  11. Watershed analysis

    Treesearch

    Alan Gallegos

    2002-01-01

    Watershed analyses and assessments for the Kings River Sustainable Forest Ecosystems Project were done on about 33,000 acres of the 45,500-acre Big Creek watershed and 32,000 acres of the 85,100-acre Dinkey Creek watershed. Following procedures developed for analysis of cumulative watershed effects (CWE) in the Pacific Northwest Region of the USDA Forest Service, the...

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

    Bluhm, Marcus; Nahrgang, Marlene; Bass, Steffen A.

    The non-monotonic beam energy dependence of the higher cumulants of net-proton fluctuations is a widely studied signature of the conjectured presence of a critical point in the QCD phase diagram. In this work we study the effect of resonance decays on critical fluctuations. We show that resonance effects reduce the signatures of critical fluctuations, but that for reasonable parameter choices critical effects in the net-proton cumulants survive. The relative role of resonance decays has a weak dependence on the order of the cumulants studied with a slightly stronger suppression of critical effects for higher-order cumulants.

  13. A simple scoring system for predicting early major complications in spine surgery: the cumulative effect of age and size of surgery.

    PubMed

    Brasil, Albert Vincent Berthier; Teles, Alisson R; Roxo, Marcelo Ricardo; Schuster, Marcelo Neutzling; Zauk, Eduardo Ballverdu; Barcellos, Gabriel da Costa; Costa, Pablo Ramon Fruett da; Ferreira, Nelson Pires; Kraemer, Jorge Luiz; Ferreira, Marcelo Paglioli; Gobbato, Pedro Luis; Worm, Paulo Valdeci

    2016-10-01

    To analyze the cumulative effect of risk factors associated with early major complications in postoperative spine surgery. Retrospective analysis of 583 surgically-treated patients. Early "major" complications were defined as those that may lead to permanent detrimental effects or require further significant intervention. A balanced risk score was built using multiple logistic regression. Ninety-two early major complications occurred in 76 patients (13%). Age > 60 years and surgery of three or more levels proved to be significant independent risk factors in the multivariate analysis. The balanced scoring system was defined as: 0 points (no risk factor), 2 points (1 factor) or 4 points (2 factors). The incidence of early major complications in each category was 7% (0 points), 15% (2 points) and 29% (4 points) respectively. This balanced scoring system, based on two risk factors, represents an important tool for both surgical indication and for patient counseling before surgery.

  14. Automated reconstruction of rainfall events responsible for shallow landslides

    NASA Astrophysics Data System (ADS)

    Vessia, G.; Parise, M.; Brunetti, M. T.; Peruccacci, S.; Rossi, M.; Vennari, C.; Guzzetti, F.

    2014-04-01

    Over the last 40 years, many contributions have been devoted to identifying the empirical rainfall thresholds (e.g. intensity vs. duration ID, cumulated rainfall vs. duration ED, cumulated rainfall vs. intensity EI) for the initiation of shallow landslides, based on local as well as worldwide inventories. Although different methods to trace the threshold curves have been proposed and discussed in literature, a systematic study to develop an automated procedure to select the rainfall event responsible for the landslide occurrence has rarely been addressed. Nonetheless, objective criteria for estimating the rainfall responsible for the landslide occurrence (effective rainfall) play a prominent role on the threshold values. In this paper, two criteria for the identification of the effective rainfall events are presented: (1) the first is based on the analysis of the time series of rainfall mean intensity values over one month preceding the landslide occurrence, and (2) the second on the analysis of the trend in the time function of the cumulated mean intensity series calculated from the rainfall records measured through rain gauges. The two criteria have been implemented in an automated procedure written in R language. A sample of 100 shallow landslides collected in Italy by the CNR-IRPI research group from 2002 to 2012 has been used to calibrate the proposed procedure. The cumulated rainfall E and duration D of rainfall events that triggered the documented landslides are calculated through the new procedure and are fitted with power law in the (D,E) diagram. The results are discussed by comparing the (D,E) pairs calculated by the automated procedure and the ones by the expert method.

  15. Cumulative psychosocial risk, parental socialization, and child cognitive functioning: A longitudinal cascade model.

    PubMed

    Wade, Mark; Madigan, Sheri; Plamondon, Andre; Rodrigues, Michelle; Browne, Dillon; Jenkins, Jennifer M

    2018-06-01

    Previous studies have demonstrated that various psychosocial risks are associated with poor cognitive functioning in children, and these risks frequently cluster together. In the current longitudinal study, we tested a model in which it was hypothesized that cumulative psychosocial adversity of mothers would have deleterious effects on children's cognitive functioning by compromising socialization processes within families (i.e., parental competence). A prospective community birth cohort of 501 families was recruited when children were newborns. At this time, mothers reported on their current psychosocial circumstances (socioeconomic status, teen parenthood, depression, etc.), which were summed into a cumulative risk score. Families were followed up at 18 months and 3 years, at which point maternal reflective capacity and cognitive sensitivity were measured, respectively. Child cognition (executive functioning, theory of mind, and language ability) was assessed at age 4.5 using age-appropriate observational and standardized tasks. Analyses controlled for child age, gender, number of children in the home, number of years married, and mothers' history of adversity. The results revealed significant declines in child cognition as well as maternal reflective capacity and cognitive sensitivity as the number of psychosocial risks increased. Moreover, longitudinal path analysis showed significant indirect effects from cumulative risk to all three cognitive outcomes via reflective capacity and cognitive sensitivity. Findings suggest that cumulative risk of mothers may partially account for child cognitive difficulties in various domains by disrupting key parental socialization competencies. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  16. Randomised controlled trials define shape of dose-response for Pollinex Quattro Birch allergoid immunotherapy.

    PubMed

    Worm, Margitta; Higenbottam, Tim; Pfaar, Oliver; Mösges, Ralph; Aberer, Werner; Gunawardena, Kulasiri; Wessiepe, Dorothea; Lee, Denise; Kramer, Matthias F; Skinner, Murray; Lees, Bev; Zielen, Stefan

    2018-05-19

    The Birch Allergoid, Tyrosine Adsorbate, Monophosphoryl Lipid A (POLLINEX ® Quattro Plus 1.0 ml Birch 100%) is an effective, well-tolerated short course subcutaneous immunotherapy. We performed two phase II studies to determine its optimal cumulative dose. The studies were conducted in Germany, Austria and Poland (EudraCT numbers: 2012-004336-28 PQBirch203 and 2015-000984-15 PQBirch204) using a wide range of cumulative doses. In both studies, subjects were administered 6 therapy injections weekly outside the pollen season. Conjunctival Provocation Tests were performed at screening, baseline and 3-4 weeks after completing treatment, to quantify the reduction of Total Symptom Scores (as the primary endpoint) with each cumulative dose. Multiple Comparison Procedure and Modelling analysis was used to test for the dose-response, shape of the curve, and estimation of the median effective dose (ED 50 ), a measure of potency. Statistically significant dose-responses (p<0.01 & 0.001) were seen respectively. The highest cumulative dose in PQBirch204 (27300 standardised units [SU]) approached a plateau. Potency of the PQ Birch was demonstrated by an ED 50 2723 SU, just over half the current dose. Prevalence of treatment-emergent adverse events was similar for active doses, most being short-lived and mild. Compliance was over 85% in all groups. Increasing the cumulative dose of PQ Birch 5.5-fold from 5100 to 27300 SU achieved an absolute point difference from placebo of 1.91, a relative difference 32.3% and an increase of efficacy of 50%, without compromising safety. The cumulative dose-response was confirmed to be curvilinear in shape. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  17. Late effect of multiple daily fraction palliation schedule for advanced pelvic malignancies (RTOG 8502)

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

    Spanos, W.J. Jr.; Clery, M.; Perez, C.A.

    1994-07-30

    The purpose was to determine late complication incidence for pelvic palliation using accelerated multiple daily fraction radiation [Radiation Therapy Oncology Group (RTOG) 8502]. None of the patients with < 30 Gy (less than three courses) developed late toxicity. A total of 11/193 (6%) developed Grade 3+ late toxicity (nine Grade 3, on Grade 4, one Grade 5). Actuarial analysis of complication rate by survival time for Grades 3, 4, and 5 shows a cumulative incidence for complications after 6 months that plateaus at 6.9% by 18 months. The cumulative incidence for Grades 4 and 5 is 2.0% by 12 months.more » The difference in late effect for the 2-week rest vs. 4-week rest was not statistically different (p = .47). Patient factors evaluated for increased risk of late complications included prior surgeries, age, sex, KPS and primary. None were found to have significant statistical correlations with late effects. The crude late complications rate is 6%. Actuarial analysis using cumulative incidence shows 6.9% by 18 months. This represents a significant decrease in late complications from 49% seen with higher dose per fraction (10 Gy {times} 3) piloted by Radiation Therapy Oncology Group (7905) for a similar group of patients. Long-term analysis of late complication indicates this schedule can be used in the pelvis with relatively low incidence of complication. This schedule has significant logistic benefits and has been shown to produce good tumor regression and excellent palliation of symptoms. 14 refs., 4 figs., 4 tabs.« less

  18. A meta-analysis of shared leadership and team effectiveness.

    PubMed

    Wang, Danni; Waldman, David A; Zhang, Zhen

    2014-03-01

    A growing number of studies have examined the "sharedness" of leadership processes in teams (i.e., shared leadership, collective leadership, and distributed leadership). We meta-analytically cumulated 42 independent samples of shared leadership and examined its relationship to team effectiveness. Our findings reveal an overall positive relationship (ρ = .34). But perhaps more important, what is actually shared among members appears to matter with regard to team effectiveness. That is, shared traditional forms of leadership (e.g., initiating structure and consideration) show a lower relationship (ρ = .18) than either shared new-genre leadership (e.g., charismatic and transformational leadership; ρ = .34) or cumulative, overall shared leadership (ρ = .35). In addition, shared leadership tends to be more strongly related to team attitudinal outcomes and behavioral processes and emergent team states, compared with team performance. Moreover, the effects of shared leadership are stronger when the work of team members is more complex. Our findings further suggest that the referent used in measuring shared leadership does not influence its relationship with team effectiveness and that compared with vertical leadership, shared leadership shows unique effects in relation to team performance. In total, our study not only cumulates extant research on shared leadership but also provides directions for future research to move forward in the study of plural forms of leadership.

  19. The conflicting effects of delayed marriage and declining divorce rates on cumulative fertility in Indonesia.

    PubMed

    Palmore, J A; Singarimbun, M

    1992-01-01

    The impact of nuptiality patterns on fertility in Indonesia is examined with multivariate analysis controlling for 8 socioeconomic variables. Data were obtained from the 1987 Indonesian Contraceptive Prevalence Survey. Marriage is usually universal by age 35, and in this study all women 30 years had been married at least once. 20% were married at 15 years and 45% married at 18 years. For those married more than once, prevalence of 1st marriage was 7% for women 15-24 years, 15% for 25-34 years, and 29% for 35-49 years. In 1976 and 1987, the age at 1st marriage and number of times married were both strongly and negatively correlated. The % never marrying between 15-49 years rose from 21.5% to 26.4% between 1980-87. Cumulative fertility w as related to both age at 1st marriage and number of times married. Muslim women, women in Java and Bali, and rural women all marry at younger ages. 27% of the variance in age at 1st marriage is explained by women aged 25-34, current residence, region, religion, language, education, and work or not before marriage. The number of times married is also associated with socioeconomic characteristics without control, i.e., Muslim women 25-34 years were 3 times more likely to have been married more than once than in other faiths. With controls for socioeconomic factors, only 13% of the variance is explained and being Muslim has no statistically significant effect. The important net effects were being interviewed in Balinese, age, and age at 1st marriage. In the analysis of cumulative fertility, age at 1st marriage consistently is related to cumulative fertility in almost every socioeconomic group when age and number of times married is controlled for. Women married more than once have lower fertility. 36% of the variance is explained by all the variables. Being married more than once leads to having 2.1 fewer children. A 5-year delay in marriage leads to .75-1.1 fewer children. When other variables are controlled for, neither educational level nor prior work experience has a statistically significant effect on cumulative fertility. In the contraception analysis, women married more than once used contraception less. Among women 35-49, those marrying later had higher contraceptive use, but in general contraceptive use declined with age. More information is needed on why marriage patterns are changing.

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

    EPA Pesticide Factsheets

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

  1. Optimal pricing and lot-sizing for perishable inventory with price and time dependent ramp-type demand

    NASA Astrophysics Data System (ADS)

    Panda, S.; Saha, S.; Basu, M.

    2013-01-01

    Product perishability is an important aspect of inventory control. To minimise the effect of deterioration, retailers in supermarkets, departmental store managers, etc. always want higher inventory depletion rate. In this article, we propose a dynamic pre- and post-deterioration cumulative discount policy to enhance inventory depletion rate resulting low volume of deterioration cost, holding cost and hence higher profit. It is assumed that demand is a price and time dependent ramp-type function and the product starts to deteriorate after certain amount of time. Unlike the conventional inventory models with pricing strategies, which are restricted to a fixed number of price changes and to a fixed cycle length, we allow the number of price changes before as well as after the start of deterioration and the replenishment cycle length to be the decision variables. Before start of deterioration, discounts on unit selling price are provided cumulatively in successive pricing cycles. After the start of deterioration, discounts on reduced unit selling price are also provided in a cumulative way. A mathematical model is developed and the existence of the optimal solution is verified. A numerical example is presented, which indicates that under the cumulative effect of price discounting, dynamic pricing policy outperforms static pricing strategy. Sensitivity analysis of the model is carried out.

  2. Cumulative reproductive effects of in utero administration of mixtures of antiandrogens in male SD rats: synergy or additivity?

    EPA Science Inventory

    In 1996 the USEPA was charged under the FQPA to consider the cumulative effects of chemicals in their risk assessments. Our studies were conducted to provide a framework for assessing the cumulative effects of antiandrogens. Toxicants were administered individually or as mixtures...

  3. A mixture of Iprodione and Vinclozolin delays the onset of puberty in the male rat in a cumulative manner.

    EPA Science Inventory

    Vinclozolin and iprodione are dicarboximide fungicides that display anti-androgenic effects in the male rat, which suggests co-exposure to these fungicides would lead to cumulative effects on androgen-sensitive endpoints. In order to test for cumulative effects by iprodione and v...

  4. Estimating multi-factor cumulative watershed effects on fish populations with an individual-based model

    Treesearch

    Bret C. Harvey; Steven F. Railsback

    2007-01-01

    While the concept of cumulative effects is prominent in legislation governing environmental management, the ability to estimate cumulative effects remains limited. One reason for this limitation is that important natural resources such as fish populations may exhibit complex responses to changes in environmental conditions, particularly to alteration of multiple...

  5. Cumulative Retrospective Exposure Assessment (REA) as a predictor of amphibole asbestos lung burden: validation procedures and results for industrial hygiene and pathology estimates.

    PubMed

    Rasmuson, James O; Roggli, Victor L; Boelter, Fred W; Rasmuson, Eric J; Redinger, Charles F

    2014-01-01

    A detailed evaluation of the correlation and linearity of industrial hygiene retrospective exposure assessment (REA) for cumulative asbestos exposure with asbestos lung burden analysis (LBA) has not been previously performed, but both methods are utilized for case-control and cohort studies and other applications such as setting occupational exposure limits. (a) To correlate REA with asbestos LBA for a large number of cases from varied industries and exposure scenarios; (b) to evaluate the linearity, precision, and applicability of both industrial hygiene exposure reconstruction and LBA; and (c) to demonstrate validation methods for REA. A panel of four experienced industrial hygiene raters independently estimated the cumulative asbestos exposure for 363 cases with limited exposure details in which asbestos LBA had been independently determined. LBA for asbestos bodies was performed by a pathologist by both light microscopy and scanning electron microscopy (SEM) and free asbestos fibers by SEM. Precision, reliability, correlation and linearity were evaluated via intraclass correlation, regression analysis and analysis of covariance. Plaintiff's answers to interrogatories, work history sheets, work summaries or plaintiff's discovery depositions that were obtained in court cases involving asbestos were utilized by the pathologist to provide a summarized brief asbestos exposure and work history for each of the 363 cases. Linear relationships between REA and LBA were found when adjustment was made for asbestos fiber-type exposure differences. Significant correlation between REA and LBA was found with amphibole asbestos lung burden and mixed fiber-types, but not with chrysotile. The intraclass correlation coefficients (ICC) for the precision of the industrial hygiene rater cumulative asbestos exposure estimates and the precision of repeated laboratory analysis were found to be in the excellent range. The ICC estimates were performed independent of specific asbestos fiber-type. Both REA and pathology assessment are reliable and complementary predictive methods to characterize asbestos exposures. Correlation analysis between the two methods effectively validates both REA methodology and LBA procedures within the determined precision, particularly for cumulative amphibole asbestos exposures since chrysotile fibers, for the most part, are not retained in the lung for an extended period of time.

  6. Predicting Late Effects of Pelvic Radiotherapy: Is There a Better Approach?

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

    Wedlake, Linda J.; Thomas, Karen B.Sc.; Lalji, Amyn

    2010-11-15

    Purpose: Significant chronic symptoms following pelvic radiotherapy occur more frequently than commonly realized. Predictive factors for the development of late symptoms are poorly defined. Moderate sustained acute (cumulative) toxicity might predict severe late effects better than peak reaction. Methods and Materials: To determine prospectively whether peak or cumulative gastrointestinal (GI) acute symptoms better predict late symptoms in patients receiving pelvic radiotherapy. Symptom scores were measured weekly from the start of radiotherapy, and at 1 year using the Modified Inflammatory Bowel Disease Questionnaire-Bowel subset. The possible prognostic impact of patient-related factors was explored. Results: Three hundred and eight patients were recruited.more » 100 were excluded due to lack of follow-up data at one year resulting from death, too ill, stoma, relapsed, non-response or withdrawal. A further 15 were excluded for incomplete data, leaving 193 patients with evaluable data. Of these, 28 had GI, 101 urological, and 64 gynecological cancers. Patients' median age was 65 years (range, 23-82), and they were treated with median 60 Gy dose for a median of 6 weeks. Univariate analysis revealed a significant association between cumulative acute symptom scores and scores at 1 year (p < 0.001), which was dose-independent (p < 0.001). Acute peak and 1-year scores were not associated (p = 0.431). The correlation coefficient between cumulative acute symptoms and symptoms at 1 year was 0.367 and for peak acute symptoms was weaker at 0.057. Patients with an abnormal body mass index and current smokers were more likely to experience worse symptoms at 1 year. Conclusion: Cumulative acute symptoms are more predictive of late symptoms than peak acute changes in score. This association is independent of the radiotherapy dose delivered and is suggestive of a consequential late effect.« less

  7. The use of the multi-cumulant tensor analysis for the algorithmic optimisation of investment portfolios

    NASA Astrophysics Data System (ADS)

    Domino, Krzysztof

    2017-02-01

    The cumulant analysis plays an important role in non Gaussian distributed data analysis. The shares' prices returns are good example of such data. The purpose of this research is to develop the cumulant based algorithm and use it to determine eigenvectors that represent investment portfolios with low variability. Such algorithm is based on the Alternating Least Square method and involves the simultaneous minimisation 2'nd- 6'th cumulants of the multidimensional random variable (percentage shares' returns of many companies). Then the algorithm was tested during the recent crash on the Warsaw Stock Exchange. To determine incoming crash and provide enter and exit signal for the investment strategy the Hurst exponent was calculated using the local DFA. It was shown that introduced algorithm is on average better that benchmark and other portfolio determination methods, but only within examination window determined by low values of the Hurst exponent. Remark that the algorithm is based on cumulant tensors up to the 6'th order calculated for a multidimensional random variable, what is the novel idea. It can be expected that the algorithm would be useful in the financial data analysis on the world wide scale as well as in the analysis of other types of non Gaussian distributed data.

  8. Forest Practice Rules and cumulative watershed impacts in California

    Treesearch

    L. M. Reid

    1999-01-01

    Response to the following questions, "As currently implemented, are existing California forest practice rules effective in preventing cumulative watershed impacts, including flooding?" and "What kind of measures might improve the effectiveness of forest practices rules for avoiding forestry-related cumulative watershed impacts

  9. Impact of resonance decays on critical point signals in net-proton fluctuations

    DOE PAGES

    Bluhm, Marcus; Nahrgang, Marlene; Bass, Steffen A.; ...

    2017-04-03

    The non-monotonic beam energy dependence of the higher cumulants of net-proton fluctuations is a widely studied signature of the conjectured presence of a critical point in the QCD phase diagram. In this work we study the effect of resonance decays on critical fluctuations. We show that resonance effects reduce the signatures of critical fluctuations, but that for reasonable parameter choices critical effects in the net-proton cumulants survive. The relative role of resonance decays has a weak dependence on the order of the cumulants studied with a slightly stronger suppression of critical effects for higher-order cumulants.

  10. The cumulative effects assessment of a coastal ecological restoration project in China: An integrated perspective.

    PubMed

    Ma, Deqiang; Zhang, Liyu; Fang, Qinhua; Jiang, Yuwu; Elliott, Michael

    2017-05-15

    Large scale coastal land-claim and sea-enclosing (CLASE) activities have caused habitat destruction, biodiversity losses and water deterioration, thus the local governments in China have recently undertaken seabed dredging and dyke opening (SDADO) as typical ecological restoration projects. However, some projects focus on a single impact on hydrodynamic conditions, water quality or marine organisms. In a case study in Xiamen, China, an integrated effects assessment framework centres on ecohydrology, using modeling of hydrodynamic conditions and statistical analysis of water quality, was developed to assess the effects of ecological restoration projects. The benefits of SDADO projects include improving hydrodynamic conditions and water quality, as a precursor to further marine biological improvements. This study highlights the need to comprehensively consider ecological effects of SDADO projects in the planning stage, and an integrative assessment method combining cumulative effects of hydrodynamic conditions, water quality and biological factors. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. A Multimethodological Analysis of Cumulative Risk and Allostatic Load among Rural Children.

    ERIC Educational Resources Information Center

    Evans, Gary W.

    2003-01-01

    This study modeled physical and psychosocial aspects of home environment and personal characteristics in a cumulative risk heuristic. Found that elevated cumulative risk was associated with heightened cardiovascular and neuroendocrine parameters, increased deposition of body fat, and higher summary index of total allostatic load. Replicated…

  12. Characterizing the Connectivity and Cumulative Effects of Wetlands on Downstream Hydrology: A Modeling Analysis

    EPA Science Inventory

    Geographically isolated wetlands (GIWs) are depressional landscape features entirely surrounded by uplands. While “GIW” may imply functional isolation from other surface waters, these systems exhibit a gradient of hydrologic, biological, and/or chemical connectivity. ...

  13. 32 CFR 989.13 - Categorical exclusion.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... significant cumulative environmental impact. (4) Socioeconomic effects only. (5) Similarity to actions previously assessed and found to have no significant environmental impacts. (c) CATEXs apply to actions in... ENVIRONMENTAL IMPACT ANALYSIS PROCESS (EIAP) § 989.13 Categorical exclusion. (a) CATEXs define those categories...

  14. CUMULATIVE REPRODUCTIVE EFFECTS OF IN UTERO ADMINISTRATION OF A MIXTURE OF TEN “ANTIANDROGENS” IN MALE SD RATS: SYNERGY OR ADDITIVITY?

    EPA Science Inventory

    In 1996, the USEPA was charged under FQPA to consider the cumulative effects of chemicals in their risk assessments. We are conducting studies to provide a framework for assessing the cumulative effects of antiandrogens. In the current study, ten “antiandrogenic” chemicals were a...

  15. Simulating the cumulative effects of multiple forest management strategies on landscape measures of forest sustainability

    Treesearch

    Eric J. Gustafson; David E. Lytle; Randy Swaty; Craig Loehle

    2007-01-01

    While the cumulative effects of the actions of multiple owners have long been recognized as critically relevant to efforts to maintain sustainable forests at the landscape scale, few studies have addressed these effects. We used the HARVEST timber harvest simulator to predict the cumulative effects of four owner groups (two paper companies, a state forest and non-...

  16. Cost-effectiveness analysis of liver resection versus transplantation for early hepatocellular carcinoma within the Milan criteria.

    PubMed

    Lim, Kheng Choon; Wang, Vivian W; Siddiqui, Fahad J; Shi, Luming; Chan, Edwin S Y; Oh, Hong Choon; Tan, Say Beng; Chow, Pierce K H

    2015-01-01

    Both liver resection (LR) and cadaveric liver transplantation (CLT) are potentially curative treatments for patients with hepatocellular carcinoma (HCC) within the Milan criteria and with adequate liver function. Adopting either as a first-line therapy carries major cost and resource implications. The objective of this study was to estimate the relative cost-effectiveness of LR against CLT for patients with HCC within the Milan criteria using a decision analytic model. A Markov cohort model was developed to simulate a cohort of patients aged 55 years with HCC within the Milan criteria and Child-Pugh A/B cirrhosis, undergoing LR or CLT, and followed up over their remaining life expectancy. Analysis was performed in different geographical cost settings: the USA, Switzerland and Singapore. Transition probabilities were obtained from systematic literature reviews, supplemented by databases from Singapore and the Organ Procurement and Transplantation Network (USA). Utility and cost data were obtained from open sources. LR produced 3.9 quality-adjusted life years (QALYs) while CLT had an additional 1.4 QALYs. The incremental cost-effectiveness ratio (ICER) of CLT versus LR ranged from $111,821/QALY in Singapore to $156,300/QALY in Switzerland, and was above thresholds for cost-effectiveness in all three countries. Sensitivity analysis revealed that CLT-related 5-year cumulative survival, one-time cost of CLT, and post-LR 5-year cumulative recurrence rates were the most sensitive parameters in all cost scenarios. ICERs were reduced below threshold when CLT-related 5-year cumulative survival exceeded 84.9% and 87.6% in Singapore and the USA, respectively. For Switzerland, the ICER remained above the cost-effectiveness threshold regardless of the variations. In patients with HCC within the Milan criteria and Child-Pugh A/B cirrhosis, LR is more cost-effective than CLT across three different costing scenarios: the USA, Switzerland, Singapore. © 2014 by the American Association for the Study of Liver Diseases.

  17. Factors affecting the outcome of excimer laser photorefractive keratectomy: a preliminary multivariable regression analysis

    NASA Astrophysics Data System (ADS)

    Maguen, Ezra I.; Papaioannou, Thanassis; Nesburn, Anthony B.; Salz, James J.; Warren, Cathy; Grundfest, Warren S.

    1996-05-01

    Multivariable regression analysis was used to evaluate the combined effects of some preoperative and operative variables on the change of refraction following excimer laser photorefractive keratectomy for myopia (PRK). This analysis was performed on 152 eyes (at 6 months postoperatively) and 156 eyes (at 12 months postoperatively). The following variables were considered: intended refractive correction, patient age, treatment zone, central corneal thickness, average corneal curvature, and intraocular pressure. At 6 months after surgery, the cumulative R2 was 0.43 with 0.38 attributed to the intended correction and 0.06 attributed to the preoperative corneal curvature. At 12 months, the cumulative R2 was 0.37 where 0.33 was attributed to the intended correction, 0.02 to the preoperative corneal curvature, and 0.01 to both preoperative corneal thickness and to the patient age. Further model augmentation is necessary to account for the remaining variability and the behavior of the residuals.

  18. Steps and Pips in the History of the Cumulative Recorder

    ERIC Educational Resources Information Center

    Lattal, Kennon A.

    2004-01-01

    From its inception in the 1930s until very recent times, the cumulative recorder was the most widely used measurement instrument in the experimental analysis of behavior. It was an essential instrument in the discovery and analysis of schedules of reinforcement, providing the first real-time analysis of operant response rates and patterns. This…

  19. Assessing cumulative watershed effects in the central Sierra Nevada: hillslope measurements and catchment-scale modeling

    Treesearch

    Lee H. MacDonald; Drew Coe; Sandra Litschert

    2004-01-01

    Cumulative effects result from the combined impact of multiple activities over space and time. Land and aquatic resource managers are particularly concerned with cumulative watershed effects (CWEs). CWEs can encompass a broad range of concerns, but primary issues are changes in runoff, water quality, channel morphology, and aquatic ecosystems at the watershed scale (...

  20. Early cumulative risk predicts externalizing behavior at age 10: The mediating role of adverse parenting.

    PubMed

    Gach, Emily J; Ip, Ka I; Sameroff, Arnold J; Olson, Sheryl L

    2018-02-01

    Multiple environmental risk factors in early childhood predict a broad range of adverse developmental outcomes. However, most prior longitudinal research has not illuminated explanatory mechanisms. Our main goals were to examine predictive associations between cumulative ecological risk factors in early childhood and children's later externalizing problems and to determine whether these associations were explained by variations in parenting quality. Participants were 241 children (118 girls) at risk for school-age conduct problems and their parents and teachers. Children were approximately 3 years old at Time 1 (T1) and 10 years old at Time 2 (T2). Reports of contextual risk at T1 were used to develop a cumulative risk index consisting of 6 singular risk variables from 3 ecological levels: social resources (low income; social isolation), family resources (marital aggression; poor total family functioning), and maternal resources (single parent status; poor maternal mental health). At T1, parenting variables were measured (corporal punishment, warm responsiveness, maternal efficacy, and negative perceptions of child behavior). At T2, mothers, fathers, and teachers reported child externalizing problems. Johnson's relative weight analysis revealed that the cumulative risk index was a more powerful predictor of age 10 years externalizing behavior than any of the singular contextual risk variables. Adverse parenting mediated the effects of cumulative risk on later child externalizing problems. Our findings have significant implications for understanding long-term effects of multiple contextual risk factors present in early childhood and for the implementation of positive parenting interventions early on. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  1. Case Report: Linezolid Optic Neuropathy and Proposed Evidenced-based Screening Recommendation.

    PubMed

    Dempsey, Sean P; Sickman, Amy; Slagle, William Scott

    2018-05-01

    This case illustrates a novel screening protocol for linezolid-induced toxic optic neuropathy. To present a case report and analysis of linezolid-induced optic neuropathies in adult patients to develop screening recommendations. A case report of optic neuropathy from extended use of linezolid illustrates its potential effects on vision. We conduct a retrospective analysis of 39 reported cases to derive a recommended screening protocol for linezolid-induced toxic optic neuropathy in adult patients. Of 39 reported adult cases, 32 presented with optic neuropathy within 90 to 365 days of treatment. Within this subset, the duration of linezolid dosage to first symptoms is 235 ± 71 days. Seven outliers either experienced optic neuropathy within the first 28 days or between 600 and 1125 days. Of the 33 cases that quantified visual recovery, 30 reported final binocular visual acuity equivalent to 20/40 or better when the medication was discontinued from 0 to 268 days after symptom onset. Recovery potential was reported over a period of 2 weeks to approximately 6 months after cessation. To evaluate the effect of cumulative dose, the data were separated into patients taking 600 mg twice daily and those at 600 mg once daily. At the higher dosage, a mean of 180 ± 96 days with a mean cumulative dosage of 216 ± 115 g was noted at first symptom, whereas at lower dosage, a mean of 201 ± 102 days was noted with a mean cumulative dose of 138 ± 69 g. We recommend screening adult patients within 1 month after initiating linezolid, followed by a subsequent evaluation every 30 to 60 days beginning 3 months from initiation. Substantial visual recovery is reported when linezolid is discontinued. Toxicity appears to be correlated to duration of treatment, rather than cumulative dose.

  2. Analysis of modeling cumulative noise from simultaneous flights volume 1 : analysis at four national parks

    DOT National Transportation Integrated Search

    2012-12-31

    This is the first of two volumes of the report on modeling cumulative noise from simultaneous flights. This volume includes: an overview of the time compression algorithms used to model simultaneous aircraft; revised summary of a preliminary study (w...

  3. Potential for cumulative effects of human stressors on fish, sea birds and marine mammals in Arctic waters

    NASA Astrophysics Data System (ADS)

    Andersen, Jesper H.; Berzaghi, Fabio; Christensen, Tom; Geertz-Hansen, Ole; Mosbech, Anders; Stock, Andy; Zinglersen, Karl B.; Wisz, Mary S.

    2017-01-01

    We estimate the potential for cumulative impacts from multiple anthropogenic stressors on fish, sea birds, and marine mammals in the western, southern and south-eastern parts of marine waters around Greenland. The analysis is based on a comprehensive data set representing five human activities including two proxies for climate change, as well as 25 key animal species including commercially important fish and top predators such as sea birds and marine mammals. Anthropogenic stressors are concentrated in two areas: the offshore waters south of Greenland, and especially the western coast from the Qeqertarsuaq (Disko Island) area to the southern tip of Greenland. The latter is also an area of high importance for many key species, thus the potential for cumulative impacts is high along Greenland's west coast. We conclude that this area should be under high scientific scrutiny and conservation attention. Our study is a first attempt and a stepping-stone towards more detailed and accurate estimates of the effects of multiple human stressors on Arctic marine ecosystems.

  4. Decision analysis with cumulative prospect theory.

    PubMed

    Bayoumi, A M; Redelmeier, D A

    2000-01-01

    Individuals sometimes express preferences that do not follow expected utility theory. Cumulative prospect theory adjusts for some phenomena by using decision weights rather than probabilities when analyzing a decision tree. The authors examined how probability transformations from cumulative prospect theory might alter a decision analysis of a prophylactic therapy in AIDS, eliciting utilities from patients with HIV infection (n = 75) and calculating expected outcomes using an established Markov model. They next focused on transformations of three sets of probabilities: 1) the probabilities used in calculating standard-gamble utility scores; 2) the probabilities of being in discrete Markov states; 3) the probabilities of transitioning between Markov states. The same prophylaxis strategy yielded the highest quality-adjusted survival under all transformations. For the average patient, prophylaxis appeared relatively less advantageous when standard-gamble utilities were transformed. Prophylaxis appeared relatively more advantageous when state probabilities were transformed and relatively less advantageous when transition probabilities were transformed. Transforming standard-gamble and transition probabilities simultaneously decreased the gain from prophylaxis by almost half. Sensitivity analysis indicated that even near-linear probability weighting transformations could substantially alter quality-adjusted survival estimates. The magnitude of benefit estimated in a decision-analytic model can change significantly after using cumulative prospect theory. Incorporating cumulative prospect theory into decision analysis can provide a form of sensitivity analysis and may help describe when people deviate from expected utility theory.

  5. 32 CFR 651.16 - Cumulative impacts.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... § 651.16 Cumulative impacts. (a) NEPA analyses must assess cumulative effects, which are the impact on the environment resulting from the incremental impact of the action when added to other past, present... 32 National Defense 4 2011-07-01 2011-07-01 false Cumulative impacts. 651.16 Section 651.16...

  6. 32 CFR 651.16 - Cumulative impacts.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... § 651.16 Cumulative impacts. (a) NEPA analyses must assess cumulative effects, which are the impact on the environment resulting from the incremental impact of the action when added to other past, present... 32 National Defense 4 2010-07-01 2010-07-01 true Cumulative impacts. 651.16 Section 651.16...

  7. Impaired ambulation and steroid therapy impact negatively on bone health in multiple sclerosis.

    PubMed

    Tyblova, M; Kalincik, T; Zikan, V; Havrdova, E

    2015-04-01

    The prevalence of osteopenia and osteoporosis is higher amongst patients with multiple sclerosis in comparison with the general population. In addition to the general determinants of bone health, two factors may contribute to reduced bone mineral density in multiple sclerosis: physical disability and corticosteroid therapy. The aim of this study was to examine the effect of physical disability and steroid exposure on bone health in weight-bearing bones and spine and on the incidence of low-trauma fractures in multiple sclerosis. In this retrospective analysis of prospectively collected data, associations between bone mineral density (at the femoral neck, total femur and the lumbar spine) and its change with disability or cumulative steroid dose were evaluated with random-effect models adjusted for demographic and clinical determinants of bone health. The incidence of low-trauma fractures during the study follow-up was evaluated with Andersen-Gill models. Overall, 474 and 438 patients were included in cross-sectional and longitudinal analyses (follow-up 2347 patient-years), respectively. The effect of severely impaired gait was more apparent in weight-bearing bones (P ≤ 10(-15) ) than in spine (P = 0.007). The effect of cumulative steroid dose was relatively less pronounced but diffuse (P ≤ 10(-4) ). Risk of low-trauma fractures was associated with disability (P = 0.02) but not with cumulative steroid exposure and was greater amongst patients with severely impaired gait (annual risk 3.5% vs. 3.0%). Synergistic effects were found only between cumulative steroid dose in patients ambulatory without support (P = 0.02). Bone health and the incidence of low-trauma fractures in multiple sclerosis are more related to impaired gait than to extended corticosteroid therapy. © 2014 The Author(s) European Journal of Neurology © 2014 EAN.

  8. Non-equilibrium time evolution of higher order cumulants of conserved charges and event-by-event analysis

    NASA Astrophysics Data System (ADS)

    Kitazawa, Masakiyo; Asakawa, Masayuki; Ono, Hirosato

    2014-01-01

    We investigate the time evolution of higher order cumulants of conserved charges in a volume with the diffusion master equation. Applying the result to the diffusion of non-Gaussian fluctuations in the hadronic stage of relativistic heavy ion collisions, we show that the fourth-order cumulant of net-electric charge at LHC energy is suppressed compared with the recently observed second-order cumulant at ALICE, if the higher order cumulants at hadronization are suppressed compared with their values in the hadron phase in equilibrium. The significance of the experimental information on the rapidity window dependence of various cumulants in investigating the history of the dynamical evolution of the hot medium created in relativistic heavy ion collisions is emphasized.

  9. Temperature-related mortality estimates after accounting for the cumulative effects of air pollution in an urban area.

    PubMed

    Stanišić Stojić, Svetlana; Stanišić, Nemanja; Stojić, Andreja

    2016-07-11

    To propose a new method for including the cumulative mid-term effects of air pollution in the traditional Poisson regression model and compare the temperature-related mortality risk estimates, before and after including air pollution data. The analysis comprised a total of 56,920 residents aged 65 years or older who died from circulatory and respiratory diseases in Belgrade, Serbia, and daily mean PM10, NO2, SO2 and soot concentrations obtained for the period 2009-2014. After accounting for the cumulative effects of air pollutants, the risk associated with cold temperatures was significantly lower and the overall temperature-attributable risk decreased from 8.80 to 3.00 %. Furthermore, the optimum range of temperature, within which no excess temperature-related mortality is expected to occur, was very broad, between -5 and 21 °C, which differs from the previous findings that most of the attributable deaths were associated with mild temperatures. These results suggest that, in polluted areas of developing countries, most of the mortality risk, previously attributed to cold temperatures, can be explained by the mid-term effects of air pollution. The results also showed that the estimated relative importance of PM10 was the smallest of four examined pollutant species, and thus, including PM10 data only is clearly not the most effective way to control for the effects of air pollution.

  10. Methods used for analyzing the cumulative watershed effects of fuel management on sediment in the Eastern United States

    Treesearch

    Daniel A. Marion; J. Alan Clingenpeel

    2012-01-01

    Previous chapters have described how various resource systems within a watershed can experience cumulative effects from fuel management activities like prescribed burning. As noted before, a cumulative effect is “the impact on the environment which results from the incremental impact of the action when added to other past, present, and reasonably foreseeable future...

  11. Modeling of cumulative ash curve in hard red spring wheat

    USDA-ARS?s Scientific Manuscript database

    Analysis of cumulative ash curves (CAC) is very important for evaluation of milling quality of wheat and blending different millstreams for specific applications. The aim of this research was to improve analysis of CAC. Five hard red spring wheat genotype composites from two regions were milled on...

  12. A pebble count procedure for assessing watershed cumulative effects

    Treesearch

    Gregory S. Bevenger; Rudy M. King

    1995-01-01

    Land mangement activities can result in the delivery of fine sediment to streams. Over time, such delivery can lead to cumulative impacts to the aquactic ecosystem. Because numerous laws require Federal land managers to analyze watershed cumulative effects, field personnel need simple monitoring procedures that can be used directly and consistently. One approach to...

  13. Estimation and comparison of cumulative incidences of biliary self-expandable metallic stent dysfunction accounting for competing risks.

    PubMed

    Hamada, Tsuyoshi; Nakai, Yousuke; Isayama, Hiroyuki; Togawa, Osamu; Kogure, Hirofumi; Kawakubo, Kazumichi; Tsujino, Takeshi; Sasahira, Naoki; Hirano, Kenji; Yamamoto, Natsuyo; Ito, Yukiko; Sasaki, Takashi; Mizuno, Suguru; Toda, Nobuo; Tada, Minoru; Koike, Kazuhiko

    2014-03-01

    Self-expandable metallic stent (SEMS) placement is widely carried out for distal malignant biliary obstruction, and survival analysis is used to evaluate the cumulative incidences of SEMS dysfunction (e.g. the Kaplan-Meier [KM] method and the log-rank test). However, these statistical methods might be inappropriate in the presence of 'competing risks' (here, death without SEMS dysfunction), which affects the probability of experiencing the event of interest (SEMS dysfunction); that is, SEMS dysfunction can no longer be observed after death. A competing risk analysis has rarely been done in studies on SEMS. We introduced the concept of a competing risk analysis and illustrated its impact on the evaluation of SEMS outcomes using hypothetical and actual data. Our illustrative study included 476 consecutive patients who underwent SEMS placement for unresectable distal malignant biliary obstruction. A significant difference between cumulative incidences of SEMS dysfunction in male and female patients via theKM method (P = 0.044 by the log-rank test) disappeared after applying a competing risk analysis (P = 0.115 by Gray's test). In contrast, although cumulative incidences of SEMS dysfunction via the KM method were similar with and without chemotherapy (P = 0.647 by the log-rank test), cumulative incidence of SEMS dysfunction in the non-chemotherapy group was shown to be significantly lower (P = 0.031 by Gray's test) in a competing risk analysis. Death as a competing risk event needs to be appropriately considered in estimating a cumulative incidence of SEMS dysfunction, otherwise analytical results may be biased. © 2013 The Authors. Digestive Endoscopy © 2013 Japan Gastroenterological Endoscopy Society.

  14. Turning stumbling blocks into stepping stones in the analysis of cumulative impacts

    Treesearch

    Leslie M. Reid

    2004-01-01

    Federal and state legislation, such as the National Environmental Policy Act and the California Environmental Quality Act, require that responsible agency staff consider the cumulative impacts of proposed activities before permits are issued for certain kinds of public or private projects. The Council on Environmental Quality (CEQ 1997) defined a cumulative impact as...

  15. Evaluating Neurotoxicity of a Mixture of Five OP Pesticides Using a Composite Score

    EPA Science Inventory

    The evaluation of the cumulative effects of neurotoxic pesticides often involves the analysis of both neurochemical and behavioral endpoints. Multiple statistical tests on many endpoints can greatly inflate Type I error rates. Multiple comparison adjustments are often overly con...

  16. SAMPLE EXTRACTION AND GC-MS ANALYSIS FOR POLAR VOLATILE ORGANIC COMPOUNDS (PVOCS) IN LIQUID BIOLOGICAL MEDIA

    EPA Science Inventory

    Current approaches for assessing the cumulative exposures and effects from broad classes of environmental stressors incorporate the measurement of specific groups of endogenous compounds in human biological fluids. Recent focus has been on interpreting patterns of differentially...

  17. Olfactory function in chemical workers exposed to acrylate and methacrylate vapors.

    PubMed Central

    Schwartz, B S; Doty, R L; Monroe, C; Frye, R; Barker, S

    1989-01-01

    An investigation of the olfactory function of 731 workers at a chemical facility which manufacturers acrylates and methacrylates was undertaken using a standardized quantitative test. In a cross-sectional analysis of the data, no associations of chemical exposure with olfactory test scores were observed. A nested case-control study designed to evaluate the cumulative effects of exposure on olfactory function, however, revealed elevated crude exposure odds ratios (95% confidence interval) of 2.0 (1.1, 3.8) for all workers and 6.0 (1.7, 21.5) for workers who never smoked cigarettes. Logistic regression analysis, adjusting for multiple confounders, revealed exposure odds ratios of 2.8 (1.1, 7.0) and 13.5 (2.1, 87.6) in these same groups, respectively, and a dose-response relationship between olfactory dysfunction and cumulative exposure scores--semi-quantitative indices of lifetime exposure to the acrylates. The data also revealed decreasing exposure odds ratios with increasing duration since last exposure to these chemicals, suggesting that the effects may be reversible. PMID:2784947

  18. Improving the Design of a Conservation Reserve for a Critically Endangered Species

    PubMed Central

    2017-01-01

    Setting aside protected areas is a key strategy for tackling biodiversity loss. Reserve effectiveness depends on the extent to which protected areas capture both known occurrences and areas likely to support the species. We assessed the effectiveness of the existing reserve network for Leadbeater’s Possum (Gymnobelideus leadbeateri) and other forest-dependent species, and compared the existing reserve system to a set of plausible reserve expansion options based on area targets implied in a recent Population Viability Analysis (PVA). The existing Leadbeater’s Reserve and surrounding reserve system captured 7.6% and 29.6% of cumulative habitat suitability, respectively, across the landscape. Expanded reserve scenarios captured 34% to 62% of cumulative habitat suitability. We found acute trade-offs between conserving Leadbeater’s Possum habitat and conserving habitat of other forest-dependent species. Our analysis provides a template for systematically expanding and evaluating reserve expansion options in terms of trade-offs between priority species’ needs. PMID:28121984

  19. Meta-analysis of expression and function of neprilysin in Alzheimer's disease.

    PubMed

    Zhang, Huifeng; Liu, Dan; Wang, Yixing; Huang, Huanhuan; Zhao, Yujia; Zhou, Hui

    2017-09-14

    Neprilysin (NEP) is one of the most important Aβ-degrading enzymes, and its expression and activity in Alzheimer's brain have been widely reported, but the results remain debatable. Thus, the meta-analysis was performed to elucidate the role of NEP in Alzheimer's disease (AD). The relevant case-control or cohort studies were retrieved according to our inclusion/exclusion criteria. Six studies with 123 controls and 141 AD cases, seven studies with 102 controls and 90 AD cases, and four studies with 93 controls and 132 AD cases were included in meta-analysis of NEP's protein, mRNA, and enzyme activity respectively. We conducted Meta regression to detect the sources of heterogeneity and further performed cumulative meta-analysis or subgroup analysis. Our meta-analysis revealed a significantly lower level of NEP mRNA (SMD=-0.44, 95%CI: -0.87, -0.00, p=0.049) in AD cases than in non-AD cases, and such pattern was not altered over time in the cumulative meta-analysis. However, the decrease of NEP protein (SMD=-0.18, 95%CI: -0.62, 0.25) and enzyme activity (SMD=-0.35, 95%CI: -1.03, 0.32) in AD cases did not pass the significance check, while the cumulative meta-analysis by average age showed the pooled effect became insignificant as adding the studies with younger subjects, which indicates that the protein expression and enzyme activity of NEP in the cortex are affected by age. Therefore, the present meta-analysis suggests the need of further investigation of roles of NEP in AD pathogenesis and treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Emotion dysregulation mediates the relationship between lifetime cumulative adversity and depressive symptomatology.

    PubMed

    Abravanel, Benjamin T; Sinha, Rajita

    2015-02-01

    Repeated exposure to stressful events across the lifespan, referred to as cumulative adversity, is a potent risk factor for depression. Research indicates that cumulative adversity detrimentally affects emotion regulation processes, which may represent a pathway linking cumulative adversity to vulnerability to depression. However, empirical evidence that emotion dysregulation mediates the relationship between cumulative adversity and depression is limited, particularly in adult populations. We examined the direct and indirect effects of cumulative adversity on depressive symptomatology in a large community sample of adults (n = 745) who were further characterized by risk status: never-depressed (n = 638) and "at-risk" remitted mood-disordered (n = 107). All participants completed the Cumulative Adversity Inventory (CAI), the Difficulties in Emotion Regulation Scale (DERS), and the Center for Epidemiologic Studies Depression Scale (CES-D). Bootstrapped confidence intervals were computed to estimate the indirect effect of emotion dysregulation on the relationship between cumulative adversity and depressive symptomatology and to test whether this indirect effect was moderated by risk status. Emotion dysregulation partially and significantly mediated the relationship between cumulative adversity and depressive symptomatology independent of risk status. Overall, cumulative adversity and emotion dysregulation accounted for 50% of the variance in depressive symptomatology. These findings support the hypothesis that disruption of adaptive emotion regulation processes associated with repeated exposure to stressful life events represents an intrapersonal mechanism linking the experience of adverse events to depression. Our results support the utility of interventions that simultaneously emphasize stress reduction and emotion regulation to treat and prevent depressive vulnerability and pathology. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Emotion Dysregulation Mediates the Relationship between Lifetime Cumulative Adversity and Depressive Symptomatology

    PubMed Central

    Abravanel, Benjamin T.; Sinha, Rajita

    2014-01-01

    Repeated exposure to stressful events across the lifespan, referred to as cumulative adversity, is a potent risk factor for depression. Research indicates that cumulative adversity detrimentally affects emotion regulation processes, which may represent a pathway linking cumulative adversity to vulnerability to depression. However, empirical evidence that emotion dysregulation mediates the relationship between cumulative adversity and depression is limited, particularly in adult populations. We examined the direct and indirect effects of cumulative adversity on depressive symptomatology in a large community sample of adults (n = 745) who were further characterized by risk status: never-depressed (n = 638) and “at-risk” remitted mood-disordered (n = 107). All participants completed the Cumulative Adversity Inventory (CAI), the Difficulties in Emotion Regulation Scale (DERS), and the Center for Epidemiologic Studies Depression Scale (CES-D). Bootstrapped confidence intervals were computed to estimate the indirect effect of emotion dysregulation on the relationship between cumulative adversity and depressive symptomatology and to test whether this indirect effect was moderated by risk status. Emotion dysregulation partially and significantly mediated the relationship between cumulative adversity and depressive symptomatology independent of risk status. Overall, cumulative adversity and emotion dysregulation accounted for 50% of the variance in depressive symptomatology. These findings support the hypothesis that disruption of adaptive emotion regulation processes associated with repeated exposure to stressful life events represents an intrapersonal mechanism linking the experience of adverse events to depression. Our results support the utility of interventions that simultaneously emphasize stress reduction and emotion regulation to treat and prevent depressive vulnerability and pathology. PMID:25528603

  2. Cumulative radiation exposure and associated cancer risk estimates for scoliosis patients: Impact of repetitive full spine radiography.

    PubMed

    Law, Martin; Ma, Wang-Kei; Lau, Damian; Chan, Eva; Yip, Lawrance; Lam, Wendy

    2016-03-01

    To quantitatively evaluate the cumulative effective dose and associated cancer risk for scoliotic patients undergoing repetitive full spine radiography during their diagnosis and follow up periods. Organ absorbed doses of full spine exposed scoliotic patients at different age were computer simulated with the use of PCXMC software. Gender specific effective dose was then calculated with the ICRP-103 approach. Values of lifetime attributable cancer risk for patients exposed at different age were calculated for both patient genders and for Asian and Western population. Mathematical fitting for effective dose and for lifetime attributable cancer risk, as function of exposed age, was analytically obtained to quantitatively estimate patient cumulated effective dose and cancer risk. The cumulative effective dose of full spine radiography with posteroanterior and lateral projection for patients exposed annually at age between 5 and 30 years using digital radiography system was calculated as 15mSv. The corresponding cumulative lifetime attributable cancer risk for Asian and Western population was calculated as 0.08-0.17%. Female scoliotic patients would be at a statistically significant higher cumulated cancer risk than male patients under the same full spine radiography protocol. We demonstrate the use of computer simulation and analytic formula to quantitatively obtain the cumulated effective dose and cancer risk at any age of exposure, both of which are valuable information to medical personnel and patients' parents concern about radiation safety in repetitive full spine radiography. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  3. Fluctuations and QCD phase structure

    NASA Astrophysics Data System (ADS)

    Kitazawa, Masakiyo

    2014-11-01

    Fluctuation observables are invaluable tools in relativistic heavy ion collisions to investigate primordial thermodynamics of fireballs. Active experimental measurements have been performed at RHIC and LHC. In particular, interesting experimental results were recently reported on the electric charge fluctuation at ALICE and on the higher order cumulants at STAR, which show nontrivial behaviors reflecting non-hadronic and/or non-thermal physics. We argue that more detailed understanding on these observables are needed to use them effectively in the analysis of QCD phase structure. We suggest that the measurement of various cumulants of conserved charges including baryon number and their rapidity window dependence will provide important information needed for making progress in this subject.

  4. When More Is Not Better: The Role of Cumulative Risk in Child Behavior Outcomes

    ERIC Educational Resources Information Center

    Appleyard, Karen; Egeland, Byron; van Dulmen, Manfred H. M.; Sroufe, L. Alan

    2005-01-01

    Background: Cumulative risk research has established the deleterious effects of co-occurring risk factors on child behavior outcomes. However, extant literature has not addressed potential differential effects of cumulative risk at different points in development and has left open questions about whether a threshold model or a linear risk model…

  5. Disaster incubation, cumulative impacts and the urban/ex-urban/rural dynamic

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

    Mulvihill, Peter R.; Ali, S. Harris

    2007-05-15

    This article explores environmental impacts and risks that can accumulate in rural and ex-urban areas and regions and their relation to urban and global development forces. Two Southern Ontario cases are examined: an area level water disaster and cumulative change at the regional level. The role of disaster incubation analysis and advanced environmental assessment tools are discussed in terms of their potential to contribute to more enlightened and effective assessment and planning processes. It is concluded that conventional approaches to EA and planning are characteristically deficient in addressing the full range of impacts and risks, and particularly those originating frommore » pathogens, dispersed and insidious sources. Rigorous application of disaster incubation analysis and more advanced forms of EA has considerable potential to influence a different pattern of planning and decision making.« less

  6. Enteral Docosahexaenoic Acid Reduces Analgesic Administration in Neonates Undergoing Cardiovascular Surgery.

    PubMed

    Bernabe-Garcia, Mariela; López-Alarcon, Mardia; Salgado-Sosa, Alfredo; Villegas-Silva, Raul; Maldonado-Hernandez, Jorge; Rodríguez-Cruz, Maricela; Rivas-Ruiz, Rodolfo; Chavez-Sanchez, Luis; Blanco-Favela, Francisco A; Mancilla-Ramirez, Javier; Gordillo-Alvarez, Virginia; Madrigal-Muñiz, Olivia

    2016-01-01

    Neonates undergoing surgery require analgesic medication to ameliorate acute pain. These medications produce negative side effects. Docosahexaenoic acid (DHA) has an antinociceptive effect in animals, but this has not been evaluated in human neonates. We evaluated the DHA effect on cumulative dose and duration of analgesics administered to neonates undergoing cardiovascular surgery. A secondary analysis was performed with data from a clinical trial, in which enteral DHA was administered perioperatively compared with sunflower oil (SO). Present study assessed the antinociceptive effect of DHA by measuring the cumulative dose and duration of analgesics administered during postoperative stay in a neonatal intensive care unit. Multivariate linear regression models were performed. Seventeen neonates received DHA and 18 received SO in the control group. Compared with the control group, the DHA group received lower cumulative dose (14.6 ± 2.2 vs. 25.2 ± 4.8 μg/kg, p = 0.029) and shorter duration of buprenorphine (2 days (1-8) vs. 4.5 days (1-12); p = 0.053). After adjusting for confounders, the DHA group received significantly lesser buprenorphine (β = -27 μg/kg, p = 0.028; R2 model = 0.90) for shorter duration (β = -9 days, p = 0.003; R2 model = 0.94). No differences in fentanyl or ketorolac were detected. Buprenorphine administration was reduced in neonates who received DHA, suggesting that DHA likely has analgesic effects. © 2016 S. Karger AG, Basel.

  7. Analysis of Memory Codes and Cumulative Rehearsal in Observational Learning

    ERIC Educational Resources Information Center

    Bandura, Albert; And Others

    1974-01-01

    The present study examined the influence of memory codes varying in meaningfulness and retrievability and cumulative rehearsal on retention of observationally learned responses over increasing temporal intervals. (Editor)

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

    Yee, J.P.

    The following studies were conducted using the resistive pulse spectroscopy (RPS) technique: cumulative spectra and individual pulse forms for rigid latex polymer spheres; acquisition and analysis of RPS spectral data by means of special computer program; interaction of red blood cells with glutaraldehyde; membrane properties of erythrocytes undergoing abrupt osmotic hemolysis; reversible effects of the binding of chlorpromazine HCl at the red cell membrane surface; effects of high cholesterol diet on erythrocytes of guinea pigs; and multi-population analysis for a mixture of fetal and maternal red cells. (HLW)

  9. Length of unemployment and health-related outcomes: a life-course analysis.

    PubMed

    Janlert, Urban; Winefield, Anthony H; Hammarström, Anne

    2015-08-01

    Most previous studies on the effects of length of unemployment on health have focused on the duration of continuous spells of unemployment rather than on the cumulative length of intermittent spells. This study analysed the relationship between the cumulative length of intermittent spells of unemployment and different health-related outcomes using data from a longitudinal study of school leavers. All pupils who completed compulsory schooling in 1981 in a medium-sized town in northern Sweden (N = 1083) were followed for 14 years with repeated questionnaires including questions about unemployment, health and health behaviour. Men tended to react with a steady state or a levelling off of health symptoms with increased unemployment, whereas women showed deteriorating health symptoms. For health behaviour the reverse occurred. Women's health behaviour was less connected with increased unemployment while men's health behaviour tended to deteriorate. Cumulative length of unemployment is correlated with deteriorated health and health behaviour. Long-term unemployment, even as a result of cumulated shorter employment spells over a number of years should be an urgent target for policy makers. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  10. Modeling of second-harmonic generation of circumferential guided wave propagation in a composite circular tube

    NASA Astrophysics Data System (ADS)

    Li, Mingliang; Deng, Mingxi; Gao, Guangjian; Xiang, Yanxun

    2018-05-01

    This paper investigated modeling of second-harmonic generation (SHG) of circumferential guided wave (CGW) propagation in a composite circular tube, and then analyzed the influences of interfacial properties on the SHG effect of primary CGW. Here the effect of SHG of primary CGW propagation is treated as a second-order perturbation to its linear wave response. Due to the convective nonlinearity and the inherent elastic nonlinearity of material, there are second-order bulk driving forces and surface/interface driving stresses in the interior and at the surface/interface of a composite circular tube, when a primary CGW mode propagates along its circumference. Based on the approach of modal expansion analysis for waveguide excitation, the said second-order driving forces/stresses are regarded as the excitation sources to generate a series of double-frequency CGW modes that constitute the second-harmonic field of the primary CGW propagation. It is found that the modal expansion coefficient of each double-frequency CGW mode is closely related to the interfacial stiffness constants that are used to describe the interfacial properties between the inner and outer circular parts of the composite tube. Furthermore, changes in the interfacial stiffness constants essentially influence the dispersion relation of CGW propagation. This will remarkably affect the efficiency of cumulative SHG of primary CGW propagation. Some finite element simulations have been implemented of response characteristics of cumulative SHG to the interfacial properties. Both the theoretical analyses and numerical simulations indicate that the effect of cumulative SHG is found to be much more sensitive to changes in the interfacial properties than primary CGW propagation. The potential of using the effect of cumulative SHG by primary CGW propagation to characterize a minor change in the interfacial properties is considered.

  11. Male chromosomal polymorphisms reduce cumulative live birth rate for IVF couples.

    PubMed

    Ni, Tianxiang; Li, Jing; Chen, Hong; Gao, Yuan; Gao, Xuan; Yan, Junhao; Chen, Zi-Jiang

    2017-08-01

    Chromosomal polymorphisms are associated with infertility, but their effects on assisted reproductive outcomes are still quite conflicting, especially after IVF treatment. This study evaluated the role of chromosomal polymorphisms of different genders in IVF pregnancy outcomes. Four hundred and twenty-five infertile couples undergoing IVF treatment were divided into three groups: 214 couples with normal chromosomes (group A, control group), 86 couples with female polymorphisms (group B), and 125 couples with male polymorphisms (group C). The pregnancy outcomes after the first and cumulative transfer cycles were analyzed, and the main outcome measures were live birth rate (LBR) after the first transfer cycle and cumulative LBR after a complete IVF cycle. Comparison of pregnancy outcomes after the first transfer cycle within group A, group B, and group C demonstrated a similar LBR as well as other rates of implantation, clinical pregnancy, early miscarriage, and ongoing pregnancy (P > 0.05). However, the analysis of cumulative pregnancy outcomes indicated that compared with group A, group C had a significantly lower LBR per cycle (80.4 vs 68.00%), for a rate ratio of 1.182 (95% CI 1.030 to 1.356, P = 0.01) and a significantly higher cumulative early miscarriage rate (EMR) among clinical pregnancies (7.2 vs 14.7%), for a rate ratio of 0.489 (95% CI 0.248 to 0.963, P = 0.035). Couples with chromosomal polymorphisms in only male partners have poor pregnancy outcomes after IVF treatment manifesting as high cumulative EMR and low LBR after a complete cycle.

  12. Assessing cumulative impacts within state environmental review frameworks in the United States

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

    Ma Zhao, E-mail: zma@nrc.umass.ed; Becker, Dennis R., E-mail: drbecker@umn.ed; Kilgore, Michael A., E-mail: mkilgore@umn.ed

    Cumulative impact assessment (CIA) is the process of systematically assessing a proposed action's cumulative environmental effects in the context of past, present, and future actions, regardless of who undertakes such actions. Previous studies have examined CIA efforts at the federal level but little is known about how states assess the cumulative impacts of nonfederal projects. By examining state environmental review statutes, administrative rules, agency-prepared materials, and a national survey of the administrators of state environmental review programs, this study identifies the legal and administrative frameworks for CIA. It examines current CIA practice, discusses the relationship between CIA policy and itsmore » implementation, and explores the opportunities for improvement. The results of the study show that twenty-nine state environmental review programs across twenty-six states required the assessment of cumulative environmental impacts. More than half of these programs have adopted specific procedures for implementing their policies. Some programs assessed cumulative impacts using a standard review document, and others have created their own documentations incorporated into applications for state permits or funding. The majority of programs have adopted various scales, baselines, significance criteria, and coordination practices in their CIA processes. Mixed methods were generally used for data collection and analysis; qualitative methods were more prevalent than quantitative methods. The results also suggest that a program with comprehensive and consistent environmental review policies and procedures does not always imply extensive CIA requirements and practices. Finally, this study discusses the potential for improving existing CIA processes and promoting CIA efforts in states without established environmental review programs.« less

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

    Lea, C.S.; Selvin, S.; Buffler, P.A.

    This pilot study uses a unique method to calculate cumulative lifetime exposure to, ultraviolet radiation-b to determine if this refined method would indicate differences in lifetime cumulative UVB exposure between age and sex matched controls. Forty-four age and sex matched cases and controls demonstrated no significant difference in mean cumulative lifetime UVB exposure based on the duration and location of residence. This pilot study suggests that further analysis of the dataset should be conducted to determine if the cumulative lifetime exposure hypothesis is of primary importance regarding the association between UVB exposure and development of cutaneous malignant melanoma.

  14. Lifetime Stress Cumulatively Programs Brain Transcriptome and Impedes Stroke Recovery: Benefit of Sensory Stimulation

    PubMed Central

    Zucchi, Fabíola C. R.; Yao, Youli; Ilnytskyy, Yaroslav; Robbins, Jerrah C.; Soltanpour, Nasrin; Kovalchuk, Igor; Kovalchuk, Olga; Metz, Gerlinde A. S.

    2014-01-01

    Prenatal stress (PS) represents a critical variable affecting lifetime health trajectories, metabolic and vascular functions. Beneficial experiences may attenuate the effects of PS and its programming of health outcomes in later life. Here we investigated in a rat model (1) if PS modulates recovery following cortical ischemia in adulthood; (2) if a second hit by adult stress (AS) exaggerates stress responses and ischemic damage; and (3) if tactile stimulation (TS) attenuates the cumulative effects of PS and AS. Prenatally stressed and non-stressed adult male rats underwent focal ischemic motor cortex lesion and were tested in skilled reaching and skilled walking tasks. Two groups of rats experienced recurrent restraint stress in adulthood and one of these groups also underwent daily TS therapy. Animals that experienced both PS and AS displayed the most severe motor disabilities after lesion. By contrast, TS promoted recovery from ischemic lesion and reduced hypothalamic-pituitary-adrenal axis activity. The data also showed that cumulative effects of adverse and beneficial lifespan experiences interact with disease outcomes and brain plasticity through the modulation of gene expression. Microarray analysis of the lesion motor cortex revealed that cumulative PS and AS interact with genes related to growth factors and transcription factors, which were not affected by PS or lesion alone. TS in PS+AS animals reverted these changes, suggesting a critical role for these factors in activity-dependent motor cortical reorganization after ischemic lesion. These findings suggest that beneficial experience later in life can moderate adverse consequences of early programming to improve cerebrovascular health. PMID:24651125

  15. Summary of studies supporting cumulative effects analysis of upper Yellowstone River channel modifications

    USGS Publications Warehouse

    Auble, Gregor T.; Bowen, Zachary H.; Bovee, Ken D.; Farmer, Adrian H.; Sexton, Natalie R.; Waddle, Terry J.

    2004-01-01

    The largest portion of the document is an Appendix that summarizes each of the individual scientific studies in terms of scope and methods, findings, principal variables, and metrics used in the study or suggested by the study results, and important needs for further study.

  16. Surgery versus endoscopic cauterization in patients with third or fourth branchial pouch sinuses: A systematic review.

    PubMed

    Derks, Laura S M; Veenstra, Hidde J; Oomen, Karin P Q; Speleman, Lucienne; Stegeman, Inge

    2016-01-01

    To systematically review the current literature on treatment of third and fourth branchial pouch sinuses with endoscopic cauterization, including chemocauterization and electrocauterization, in comparison to surgical treatment. PubMed, Embase, and the Cochrane Library. We conducted a systematic search. Studies reporting original study data were included. After assessing the directness of evidence and risk of bias, studies with a low directness of evidence or a high risk of bias were excluded from analysis. Cumulative success rates after initial and recurrent treatments were calculated for both methods. A meta-analysis was conducted comparing the success rate of electrocauterization and surgery. A total of 2,263 articles were retrieved, of which seven retrospective and one prospective article were eligible for analysis. The cumulative success rate after primary treatment with cauterization ranged from 66.7% to 100%, and ranged from 77.8% to 100% after a second cauterization. The cumulative success rate after the first surgical treatment ranged from 50% to 100% and was 100% after the second surgical attempt. Meta-analysis on electrocauterization showed a nonsignificant risk ratio of 1.35 (95% confidence interval: 0.78-2.33). The effectiveness of cauterization in preventing recurrence seems to be comparable to surgical treatment. However, we suggest endoscopic cauterization as the treatment of choice for third and fourth branchial pouch sinuses because of the lower morbidity rate. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  17. Stable and unstable chromosomal aberrations among Finnish nuclear power plant workers.

    PubMed

    Lindholm, C

    2001-01-01

    Twenty nuclear power plant workers with relatively high recorded cumulative doses were studied using FISH chromosome painting and dicentric analysis after solid Giemsa staining. The results indicated that chronic exposure to ionising radiation can be detected on the group level using translocation analysis after chromosome painting, although the mean cumulative dose was approximately 100 mSv. A significant association between translocation frequency and cumulative dose was observed. Variability in the translocation yields among workers with similar recorded doses was large, resulting in a poor correlation between translocation frequencies and documented doses on the individual level. The yields of dicentric and acentric chromosomes were not correlated with the cumulative dose, indicating the inability of unstable aberrations to monitor long-term exposures. It was also shown that the unstable aberrations were not correlated with the most recent annual dose.

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

    Johnson, Gary E.; Diefenderfer, Heida L.; Borde, Amy B.

    This is the sixth annual report of a seven-year project (2004 through 2010) to evaluate the cumulative effects of habitat restoration actions in the lower Columbia River and estuary (LCRE). The project, called the Cumulative Effects Study, is being conducted for the U.S. Army Corps of Engineers Portland District (USACE) by the Marine Sciences Laboratory of the Pacific Northwest National Laboratory (PNNL), the Pt. Adams Biological Field Station of the National Marine Fisheries Service (NMFS), the Columbia River Estuary Study Taskforce (CREST), and the University of Washington. The goal of the Cumulative Effects Study is to develop a methodology tomore » evaluate the cumulative effects of multiple habitat restoration projects intended to benefit ecosystems supporting juvenile salmonids in the 235-km-long LCRE. Literature review in 2004 revealed no existing methods for such an evaluation and suggested that cumulative effects could be additive or synergistic. From 2005 through 2009, annual field research involved intensive, comparative studies paired by habitat type (tidal swamp versus marsh), trajectory (restoration versus reference site), and restoration action (tidegate replacement vs. culvert replacement vs. dike breach).« less

  19. Development of a new approach to cumulative effects assessment: a northern river ecosystem example.

    PubMed

    Dubé, Monique; Johnson, Brian; Dunn, Gary; Culp, Joseph; Cash, Kevin; Munkittrick, Kelly; Wong, Isaac; Hedley, Kathlene; Booty, William; Lam, David; Resler, Oskar; Storey, Alex

    2006-02-01

    If sustainable development of Canadian waters is to be achieved, a realistic and manageable framework is required for assessing cumulative effects. The objective of this paper is to describe an approach for aquatic cumulative effects assessment that was developed under the Northern Rivers Ecosystem Initiative. The approach is based on a review of existing monitoring practices in Canada and the presence of existing thresholds for aquatic ecosystem health assessments. It suggests that a sustainable framework is possible for cumulative effects assessment of Canadian waters that would result in integration of national indicators of aquatic health, integration of national initiatives (e.g., water quality index, environmental effects monitoring), and provide an avenue where long-term monitoring programs could be integrated with baseline and follow-up monitoring conducted under the environmental assessment process.

  20. Cumulative impact assessment: A case study

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

    Irving, J.S.; Bain, M.B.

    The National Environmental Policy Act of 1969 (NEPA) indirectly addressed cumulative impacts. Attempts to include cumulative impacts in environmental impact assessments, however, did not began until the early 1980's. One such effort began when The Federal Energy and Regulatory Commission (FERC) received over 1200 applications for hydroelectric projects in the Pacific Northwest. Federal and State Agencies, Indian tribes and environmental groups realized the potential cumulative effect such development could have on fish and wildfire resources. In response, the FERC developed the Cluster Impact Assessment Procedure (CIAP). The CIAP consisted of public scoping meetings; interactive workshops designed to identify projects withmore » potential for cumulative effects, important resources, available data; and preparation of a NEPA document (EA or EIS). The procedure was modifies to assess the cumulative impacts of fifteen hydroelectric projects in the Salmon River Basin, Idaho. The methodology achieved its basic objective of evaluating the impact of hydroelectric development on fish and wildfire resources. In addition, the use of evaluative techniques to determine project interactions and degrees of impact hindered acceptance of the conclusions. Notwithstanding these problems, the studies provided a basis for decision-makers to incorporate the potential effects of cumulative impacts into the decision-making process. 22 refs., 2 figs., 4 tabs.« less

  1. Effects of cumulative trauma load on perceptions of health, blood pressure, and resting heart rate in urban African American youth.

    PubMed

    Conner-Warren, Rhonda

    2014-04-01

    This study examined relationships between cumulative trauma (CT) and urban African American (AA) adolescents' blood pressure (BP), heart rate (HR), and perceptions of health. A correlational design using secondary data analysis studied effects of CT, health outcomes, and perceptions of health. Participants were 175 urban AA youth (11-16 years) who completed structured surveys and physiological measures of HR and BP before and after exercise. AA youth were experiencing high levels of CT. Negative correlations were obtained between AA females' perceptions of their health and systolic BP with levels of trauma. No gender differences were found in HR or BP. AA females with high CT may perceive themselves as less healthy and can be at risk for health problems. © 2014, Wiley Periodicals, Inc.

  2. Assessing the cumulative environmental effects of marine renewable energy developments: Establishing common ground.

    PubMed

    Willsteed, Edward; Gill, Andrew B; Birchenough, Silvana N R; Jude, Simon

    2017-01-15

    Assessing and managing the cumulative impacts of human activities on the environment remains a major challenge to sustainable development. This challenge is highlighted by the worldwide expansion of marine renewable energy developments (MREDs) in areas already subject to multiple activities and climate change. Cumulative effects assessments in theory provide decision makers with adequate information about how the environment will respond to the incremental effects of licensed activities and are a legal requirement in many nations. In practise, however, such assessments are beset by uncertainties resulting in substantial delays during the licensing process that reduce MRED investor confidence and limit progress towards meeting climate change targets. In light of these targets and ambitions to manage the marine environment sustainably, reducing the uncertainty surrounding MRED effects and cumulative effects assessment are timely and vital. This review investigates the origins and evolution of cumulative effects assessment to identify why the multitude of approaches and pertinent research have emerged, and discusses key considerations and challenges relevant to assessing the cumulative effects of MREDs and other activities on ecosystems. The review recommends a shift away from the current reliance on disparate environmental impact assessments and limited strategic environmental assessments, and a move towards establishing a common system of coordinated data and research relative to ecologically meaningful areas, focussed on the needs of decision makers tasked with protecting and conserving marine ecosystems and services. Copyright © 2016. Published by Elsevier B.V.

  3. Combined impacts of global changes on biodiversity across the USA

    PubMed Central

    Bellard, C.; Leclerc, C.; Courchamp, F.

    2015-01-01

    Most studies of the effects of global changes on biodiversity focus on a single threat, but multiple threats lead to species extinction. We lack spatially explicit assessments of the intensity of multiple threats and their impacts on biodiversity. Here, we used a novel metric of cumulative threats and impacts to assess the consequences of multiple threats on 196 endemic species across the USA. We predict that large areas with high cumulative impact scores for amphibians, birds, mammals, and reptiles will be concentrated in the eastern part of the USA by the 2050 s and 2080 s. These high cumulative impact values are due mainly to the presence of invasive species, climate change, cropland and pasture areas; additionally, a significant proportion of endemic species are vulnerable to some of these threats where they occur. This analysis provides a useful means of identifying where conservation measures and monitoring programs that should consider multiple threats should be implemented in the future. PMID:26149694

  4. Capturing the Cumulative Effects of School Reform: An 11-Year Study of the Impacts of America's Choice on Student Achievement

    ERIC Educational Resources Information Center

    May, Henry; Supovitz, Jonathan A.

    2006-01-01

    This article presents the results of an 11-year longitudinal study of the impact of America's Choice comprehensive school reform (CSR) design on student learning gains in Rochester, New York. A quasi-experimental interrupted time-series approach using Bayesian hierarchical growth curve analysis with crossed random effects is used to compare the…

  5. Introduction to stream network habitat analysis

    USGS Publications Warehouse

    Bartholow, John M.; Waddle, Terry J.

    1986-01-01

    Increasing demands on stream resources by a variety of users have resulted in an increased emphasis on studies that evaluate the cumulative effects of basinwide water management programs. Network habitat analysis refers to the evaluation of an entire river basin (or network) by predicting its habitat response to alternative management regimes. The analysis principally focuses on the biological and hydrological components of the riv er basin, which include both micro- and macrohabitat. (The terms micro- and macrohabitat are further defined and discussed later in this document.) Both conceptual and analytic models are frequently used for simplifying and integrating the various components of the basin. The model predictions can be used in developing management recommendations to preserve, restore, or enhance instream fish habitat. A network habitat analysis should begin with a clear and concise statement of the study objectives and a thorough understanding of the institutional setting in which the study results will be applied. This includes the legal, social, and political considerations inherent in any water management setting. The institutional environment may dictate the focus and level of detail required of the study to a far greater extent than the technical considerations. After the study objectives, including species on interest, and institutional setting are collectively defined, the technical aspects should be scoped to determine the spatial and temporal requirements of the analysis. A macro level approach should be taken first to identify critical biological elements and requirements. Next, habitat availability is quantified much as in a "standard" river segment analysis, with the likely incorporation of some macrohabitat components, such as stream temperature. Individual river segments may be aggregated to represent the networkwide habitat response of alternative water management schemes. Things learned about problems caused or opportunities generated may be fed back to the design of new alternatives, which themselves may be similarly tested. One may get as sophisticated an analysis as the decisionmaking process demands. Figure 1 shows a decision point that asks whether the results from the micro- or macrohabitat models display cumulative or synergistic effects. If they do, then network habitat analysis is the appropriate tool. We are left, however, in a difficult bind. We may not know a priori whether the effects are cumulative or synergistic unless some network-type questions are investigated as part of the scoping process. The next several sections raise issues designed to alert the modeler to relevant questions necessary to address this paradox.

  6. About the cumulants of periodic signals

    NASA Astrophysics Data System (ADS)

    Barrau, Axel; El Badaoui, Mohammed

    2018-01-01

    This note studies cumulants of time series. These functions originating from the probability theory being commonly used as features of deterministic signals, their classical properties are examined in this modified framework. We show additivity of cumulants, ensured in the case of independent random variables, requires here a different hypothesis. Practical applications are proposed, in particular an analysis of the failure of the JADE algorithm to separate some specific periodic signals.

  7. Head Impact Exposure in Youth Football: High School Ages 14 to 18 Years and Cumulative Impact Analysis

    PubMed Central

    Urban, Jillian E.; Davenport, Elizabeth M.; Golman, Adam J.; Maldjian, Joseph A.; Whitlow, Christopher T.; Powers, Alexander K.; Stitzel, Joel D.

    2015-01-01

    Sports-related concussion is the most common athletic head injury with football having the highest rate among high school athletes. Traditionally, research on the biomechanics of football-related head impact has been focused at the collegiate level. Less research has been performed at the high school level, despite the incidence of concussion among high school football players. The objective of this study is to twofold: to quantify the head impact exposure in high school football, and to develop a cumulative impact analysis method. Head impact exposure was measured by instrumenting the helmets of 40 high school football players with helmet mounted accelerometer arrays to measure linear and rotational acceleration. A total of 16,502 head impacts were collected over the course of the season. Biomechanical data were analyzed by team and by player. The median impact for each player ranged from 15.2 to 27.0 g with an average value of 21.7 (±2.4) g. The 95th percentile impact for each player ranged from 38.8 to 72.9 g with an average value of 56.4 (±10.5) g. Next, an impact exposure metric utilizing concussion injury risk curves was created to quantify cumulative exposure for each participating player over the course of the season. Impacts were weighted according to the associated risk due to linear acceleration and rotational acceleration alone, as well as the combined probability (CP) of injury associated with both. These risks were summed over the course of a season to generate risk weighted cumulative exposure. The impact frequency was found to be greater during games compared to practices with an average number of impacts per session of 15.5 and 9.4, respectively. However, the median cumulative risk weighted exposure based on combined probability was found to be greater for practices vs. games. These data will provide a metric that may be used to better understand the cumulative effects of repetitive head impacts, injury mechanisms, and head impact exposure of athletes in football. PMID:23864337

  8. Do Holocaust survivors show increased vulnerability or resilience to post-Holocaust cumulative adversity?

    PubMed

    Shrira, Amit; Palgi, Yuval; Ben-Ezra, Menachem; Shmotkin, Dov

    2010-06-01

    Prior trauma can hinder coping with additional adversity or inoculate against the effect of recurrent adversity. The present study further addressed this issue by examining whether a subsample of Holocaust survivors and comparison groups, drawn from the Israeli component of the Survey of Health, Ageing, and Retirement in Europe, were differentially affected by post-Holocaust cumulative adversity. Post-Holocaust cumulative adversity had a stronger effect on the lifetime depression of Holocaust survivors than on that of comparisons. However, comparisons were more negatively affected by post-Holocaust cumulative adversity when examining markers of physical and cognitive functioning. Our findings suggest that previous trauma can both sensitize and immunize, as Holocaust survivors show general resilience intertwined with specific vulnerability when confronted with additional cumulative adversity.

  9. Pesticide Cumulative Risk Assessment: Framework for Screening Analysis

    EPA Pesticide Factsheets

    This document provides guidance on how to screen groups of pesticides for cumulative evaluation using a two-step approach: begin with evaluation of available toxicological information and, if necessary, follow up with a risk-based screening approach.

  10. Depressive Symptoms in College Women: Examining the Cumulative Effect of Childhood and Adulthood Domestic Violence.

    PubMed

    Al-Modallal, Hanan

    2016-10-01

    The purpose of this study was to examine the cumulative effect of childhood and adulthood violence on depressive symptoms in a sample of Jordanian college women. Snowball sampling technique was used to recruit the participants. The participants were heterosexual college-aged women between the ages of 18 and 25. The participants were asked about their experiences of childhood violence (including physical violence, sexual violence, psychological violence, and witnessing parental violence), partner violence (including physical partner violence and sexual partner violence), experiences of depressive symptoms, and about other demographic and familial factors as possible predictors for their complaints of depressive symptoms. Multiple linear regression analysis was implemented to identify demographic- and violence-related predictors of their complainants of depressive symptoms. Logistic regression analysis was further performed to identify possible type(s) of violence associated with the increased risk of depressive symptoms. The prevalence of depressive symptoms in this sample was 47.4%. For the violence experience, witnessing parental violence was the most common during childhood, experienced by 40 (41.2%) women, and physical partner violence was the most common in adulthood, experienced by 35 (36.1%) women. Results of logistic regression analysis indicated that experiencing two types of violence (regardless of the time of occurrence) was significant in predicting depressive symptoms (odds ratio [OR] = 3.45, p < .05). Among college women's demographic characteristics, marital status (single vs. engaged), mothers' level of education, income, and smoking were significant in predicting depressive symptoms. Assessment of physical violence and depressive symptoms including the cumulative impact of longer periods of violence on depressive symptoms is recommended to be explored in future studies. © The Author(s) 2015.

  11. Inclusive fitness analysis of cumulative cultural evolution in an island-structured population.

    PubMed

    Ohtsuki, Hisashi; Wakano, Joe Yuichiro; Kobayashi, Yutaka

    2017-06-01

    The success of humans on the globe is largely supported by our cultural excellence. Our culture is cumulative, meaning that it is improved from generation to generation. Previous works have revealed that two modes of learning, individual learning and social learning, play pivotal roles in the accumulation of culture. However, under the trade-off between learning and reproduction, one's investment into learning is easily exploited by those who copy the knowledge of skillful individuals and selfishly invest more efforts in reproduction. It has been shown that in order to prevent such a breakdown, the rate of vertical transmission (i.e. transmission from parents to their offspring) of culture must be unrealistically close to one. Here we investigate what if the population is spatially structured. In particular, we hypothesize that spatial structure should favor highly cumulative culture through endogenously arising high kinship. We employ Wright's island model and assume that cultural transmission occurs within a local island. Our inclusive fitness analysis reveals combined effects of direct fitness of the actor, indirect fitness through relatives in the current generation, and indirect fitness through relatives in future generations. The magnitude of those indirect benefits is measured by intergenerational coefficients of genetic relatedness. Our result suggests that the introduction of spatial structure raises the stationary level of culture in the population, but that the extent of its improvement compared with a well-mixed population is marginal unless spatial localization is extreme. Overall, our model implies that we need an alternative mechanism to explain highly cumulative culture of modern humans. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Relationship between airborne pollen count and treatment outcome in Japanese cedar pollinosis patients.

    PubMed

    Takasaki, Kenji; Enatsu, Kaori; Kumagami, Hidetaka; Takahashi, Haruo

    2009-05-01

    In Japan, information on daily Japanese cedar pollen counts is made public during pollen season. If symptom severity and treatment outcome are predictable according to these pollen counts, management of seasonal allergic rhinitis may become more precise. The aims of the study were to evaluate the relationship between airborne pollen counts, symptom severity and treatment outcome in Japanese cedar pollinosis patients. In the randomized study, patients with moderate to most severe Japanese pollinosis were treated with fexofenadine (60 mg BD) or fexofenadine and nasal corticosteroids for 2 weeks. During the same period daily airborne pollen counts were measured. A total of 105 adult patients were enrolled. No difference of treatment efficacy was seen among groups. Detailed results of efficacy and safety were previously described elsewhere. In univariate analysis, the mean cumulative amount of airborne pollen exposure for 4 days prior to the study tended to affect symptom severity (P = 0.053) and the mean cumulative amount of airborne pollen during the treatment period tended to show difference among five treatment outcome categories (P = 0.066). In multivariate analysis, the mean cumulative amount of airborne pollen exposure for 4 days prior to the study was identified as the only significant factor of symptom severity (P = 0.0327) and cumulative amount of airborne pollen during the treatment period (P = 0.027) and allergic history (P = 0.027) were significant factors of treatment outcomes. No serious adverse effect was reported during the study. The amount of airborne pollen may be predictive of both symptom severity and treatment outcome.

  13. Efficacy and Cost-effectiveness of the Children’s Oncology Group Long-Term Follow-Up Screening Guidelines for Childhood Cancer Survivors at Risk of Treatment-related Heart Failure

    PubMed Central

    Wong, F. Lennie; Bhatia, Smita; Landier, Wendy; Francisco, Liton; Leisenring, Wendy; Hudson, Melissa M.; Armstrong, Gregory T.; Mertens, Ann; Stovall, Marilyn; Robison, Leslie L.; Lyman, Gary H.; Lipshultz, Steven E.; Armenian, Saro H.

    2014-01-01

    Background Childhood cancer survivors treated with anthracyclines are at high risk for asymptomatic left ventricular dysfunction (ALVD), subsequent heart failure (HF), and death. The consensus-based Children’s Oncology Group (COG) Long-Term Follow-Up Guidelines recommend lifetime echocardiographic screening for ALVD. Objective To evaluate the efficacy and cost-effectiveness of the COG Guidelines and to identify more cost-effective screening strategies. Design Simulation of life-histories using Markov health states. Data Sources Childhood Cancer Survivor Study; published literature. Target Population Childhood cancer survivors. Time Horizon Lifetime. Perspective Societal. Intervention Echocardiographic screening, followed by angiotensin-converting enzyme (ACE) inhibitor and beta-blocker therapies after ALVD diagnosis. Measurements Quality-adjusted life years (QALYs), costs, incremental cost-effectiveness ratios (ICERs) in dollars per QALY, and the cumulative incidence of HF. Results of Base-Case Analysis The COG Guidelines versus no screening have an ICER of $61,500, extend life expectancy by 6 months and QALYs by 1.6 months, and reduce the cumulative incidence of HF by 18% at 30 years after cancer diagnosis. However, less-frequent screenings are more cost-effective than the Guidelines, and maintain 80% of the health benefits. Results of Sensitivity Analysis The ICER was most sensitive to the magnitude of ALVD treatment efficacy; higher treatment efficacy resulted in lower ICER. Limitation Lifetime non-HF mortality and the cumulative incidence of HF more than 20 years after diagnosis were extrapolated; the efficacy of ACE inhibitor and beta-blocker therapy in childhood cancer survivors with ALVD is undetermined (or unknown). Conclusion The COG Guidelines could reduce the risk of HF in survivors at less than $100,000/QALY. Less-frequent screening achieves most of the benefits and would be more cost-effective than the COG Guidelines. Primary Funding Source Lance Armstrong Foundation, National Cancer Institute. PMID:24842414

  14. One versus two venous anastomoses in microsurgical head and neck reconstruction: a cumulative meta-analysis.

    PubMed

    Christianto, S; Lau, A; Li, K Y; Yang, W F; Su, Y X

    2018-05-01

    Venous compromise is still the most common cause of free flap failure. The use of two venous anastomoses has been advocated to reduce venous compromise. However, the effectiveness of this approach remains controversial. A systematic review and cumulative meta-analysis was performed to assess the effect of one versus two venous anastomoses on venous compromise and free flap failure in head and neck microsurgical reconstruction. A total of 27 articles reporting 7389 flaps were included in this study. On comparison of one versus two venous anastomoses, the odds ratio (OR) for flap failure was 1.66 (95% confidence interval 1.11-2.50; P=0.014) and for venous compromise was 1.50 (95% confidence interval 1.10-2.05; P=0.011), suggesting a significant increase in the flap failure rate and venous compromise rate in the single venous anastomosis group. These results show that the execution of two venous anastomoses has significant effects on reducing the vascular compromise and free flap failure rate in head and neck reconstruction. Copyright © 2018 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  15. Probabilistic analysis of bladed turbine disks and the effect of mistuning

    NASA Technical Reports Server (NTRS)

    Shah, A. R.; Nagpal, V. K.; Chamis, Christos C.

    1990-01-01

    Probabilistic assessment of the maximum blade response on a mistuned rotor disk is performed using the computer code NESSUS. The uncertainties in natural frequency, excitation frequency, amplitude of excitation and damping are included to obtain the cumulative distribution function (CDF) of blade responses. Advanced mean value first order analysis is used to compute CDF. The sensitivities of different random variables are identified. Effect of the number of blades on a rotor on mistuning is evaluated. It is shown that the uncertainties associated with the forcing function parameters have significant effect on the response distribution of the bladed rotor.

  16. Probabilistic analysis of bladed turbine disks and the effect of mistuning

    NASA Technical Reports Server (NTRS)

    Shah, Ashwin; Nagpal, V. K.; Chamis, C. C.

    1990-01-01

    Probabilistic assessment of the maximum blade response on a mistuned rotor disk is performed using the computer code NESSUS. The uncertainties in natural frequency, excitation frequency, amplitude of excitation and damping have been included to obtain the cumulative distribution function (CDF) of blade responses. Advanced mean value first order analysis is used to compute CDF. The sensitivities of different random variables are identified. Effect of the number of blades on a rotor on mistuning is evaluated. It is shown that the uncertainties associated with the forcing function parameters have significant effect on the response distribution of the bladed rotor.

  17. [Identification of the cumulative eco-environment effect of coal-electricity integration based on interpretative structural model].

    PubMed

    Han, Lin Wei; Fu, Xiao; Yan, Yan; Wang, Chen Xing; Wu, Gang

    2017-05-18

    In order to determine the cumulative eco-environmental effect of coal-electricity integration, we selected 29 eco-environmental factors including different development and construction activities of coal-electricity integration, soil, water, atmospheric conditions, biology, landscape, and ecology. Literature survey, expert questionnaire and interview were conducted to analyze the interactive relationships between different factors. The structure and correlations between the eco-environmental factors influenced by coal-electricity integration activities were analyzed using interpretive structural modeling (ISM) and the cumulative eco-environment effect of development and construction activities was determined. A research and evaluation framework for the cumulative eco-environmental effect was introduced in addition to specific evaluation and management needs. The results of this study would provide a theoretical and technical basis for planning and management of coal-electricity integration development activities.

  18. Beyond Cumulative Risk: Distinguishing Harshness and Unpredictability as Determinants of Parenting and Early Life History Strategy

    ERIC Educational Resources Information Center

    Belsky, Jay; Schlomer, Gabriel L.; Ellis, Bruce J.

    2012-01-01

    Drawing on life history theory, Ellis and associates' (2009) recent across- and within-species analysis of ecological effects on reproductive development highlighted two fundamental dimensions of environmental variation and influence: harshness and unpredictability. To evaluate the unique contributions of these factors, the authors of present…

  19. Chapter 13: Tools for analysis

    Treesearch

    William Elliot; Kevin Hyde; Lee MacDonald; James McKean

    2007-01-01

    This chapter presents a synthesis of current computer modeling tools that are, or could be, adopted for use in evaluating the cumulative watershed effects of fuel management. The chapter focuses on runoff, soil erosion and slope stability predictive tools. Readers should refer to chapters on soil erosion and stability for more detailed information on the physical...

  20. Partial T-cell depletion improves the composite endpoint graft-versus-host disease-free, relapse-free survival after allogeneic hematopoietic stem cell transplantation.

    PubMed

    Simonetta, Federico; Masouridi-Levrat, Stavroula; Beauverd, Yan; Tsopra, Olga; Tirefort, Yordanka; Koutsi, Aikaterini; Stephan, Caroline; Polchlopek-Blasiak, Karolina; Pradier, Amandine; Dantin, Carole; Ansari, Marc; Roosnek, Eddy; Chalandon, Yves

    2018-03-01

    Graft-versus-host disease (GvHD)-free, relapse-free survival (GRFS) is a recently reported composite endpoint that allows to simultaneously estimate risk of death, relapse and GvHD after allogeneic hematopoietic stem cell transplantation (HSCT). In this retrospective study comprising 333 patients transplanted for hematologic malignancies, we compared GRFS in patients receiving partial T-cell-depleted (pTCD) grafts with patients receiving T-cell-replete grafts (No-TCD). pTCD was associated with a significantly improved GRFS. The beneficial effect of pTCD on GRFS remained highly significant in multivariable analysis taking into account clinical factors differing between patient groups. We observed no effect of pTCD on overall survival, progression-free survival, and relapse cumulative incidence, while non-relapse mortality cumulative incidence was significantly lower in patients receiving pTCD. The results of our retrospective analysis suggest that pTCD could improve GRFS in allogeneic HSCT recipients without significantly affecting OS and PFS, thus improving patients' quality of life without impairing the curative potential of allogeneic HSCT.

  1. [Comparison of antibacterial effects of different antiseptics after hand washing].

    PubMed

    Buluş, Nesrin; Kaleli, Ilknur

    2004-01-01

    The aim of this study was to compare 4% chlorhexidine gluconate, 7.5% povidone iodine and liquid soap, which are used as hand washing solutions for the immediate, cumulative and residual effects in bacterial growth. For this purpose, 18 volunteers washed their hands with 7.5% povidone iodine, 4% chlorhexidine gluconate and liquid soap by applying standard hygienic hand washing technique. In order to find out the bacterial amount in the hands of study group, glove liquid test was used. For the evaluation of immediate effects, samples were collected just after the washing procedure, for the residual effects samples were collected from gloved hands after 3 hours, and for the cumulative effects, samples were collected after 5 days with daily hand washings. It is found that the immediate effects of 4% chlorhexidine gluconate was superior than others, and 7.5% povidone iodine was superior to liquid soap. There was no difference between 4% chlorhexidine gluconate and 7.5% povidone iodine for residual effects. The cumulative effects were observed for 4% chlorhexidine gluconate and 7.5% povidone iodine, while there was no cumulative effect for liquid soap. According to these results, it can be suggested that 4% chlorhexidine gluconate can be used as a reliable antiseptic agent in the hospitals, especially for laboratories, intensive care units and operating rooms, owing to its favourable immediate, residual and cumulative effects.

  2. Cumulative childhood trauma and psychological maladjustment of sexually abused children in Korea: mediating effects of emotion regulation.

    PubMed

    Choi, Ji Young; Oh, Kyung Ja

    2014-02-01

    The purpose of the present study was to identify the mediating effects of emotion regulation on the association between cumulative childhood trauma and behavior problems in sexually abused children in Korea, using structural equation modeling (SEM). Data were collected on 171 children (ages 6-13 years) referred to a public counseling center for sexual abuse in Seoul, Korea. Cumulative childhood traumas were defined on the basis of number of traumas (physical abuse, witnessing domestic violence, neglect, traumatic separation from parent, and sexual abuse) and the severity and duration of traumas. Children were evaluated by their parents on emotion regulation using the Emotion Regulation Checklist and internalizing and externalizing behavior problems using the Korean-Child Behavior Checklist. SEM analyses confirmed the complete mediation model, in which emotion dysregulation fully mediates the relationship between cumulative childhood traumas and internalizing/externalizing behavior problems. These findings indicate that emotion regulation is an important mechanism that can explain the negative effects of cumulative childhood traumas and that there is a need to focus on emotion regulation in sexually abused children exposed to cumulative trauma. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Subcutaneous ofatumumab in patients with relapsing-remitting multiple sclerosis: The MIRROR study.

    PubMed

    Bar-Or, Amit; Grove, Richard A; Austin, Daren J; Tolson, Jerry M; VanMeter, Susan A; Lewis, Eric W; Derosier, Frederick J; Lopez, Monica C; Kavanagh, Sarah T; Miller, Aaron E; Sorensen, Per S

    2018-05-15

    To assess dose-response effects of the anti-CD20 monoclonal antibody ofatumumab on efficacy and safety outcomes in a phase 2b double-blind study of relapsing forms of multiple sclerosis (RMS). Patients (n = 232) were randomized to ofatumumab 3, 30, or 60 mg every 12 weeks, ofatumumab 60 mg every 4 weeks, or placebo for a 24-week treatment period, with a primary endpoint of cumulative number of new gadolinium-enhancing lesions (per brain MRI) at week 12. Relapses and safety/tolerability were assessed, and CD19+ peripheral blood B-lymphocyte counts measured. Safety monitoring continued weeks 24 to 48 with subsequent individualized follow-up evaluating B-cell repletion. The cumulative number of new lesions was reduced by 65% for all ofatumumab dose groups vs placebo ( p < 0.001). Post hoc analysis (excluding weeks 1-4) estimated a ≥90% lesion reduction vs placebo (week 12) for all cumulative ofatumumab doses ≥30 mg/12 wk. Dose-dependent CD19 B-cell depletion was observed. Notably, complete depletion was not necessary for a robust treatment effect. The most common adverse event was injection-related reactions (52% ofatumumab, 15% placebo), mild to moderate severity in 97%, most commonly associated with the first dose and diminishing on subsequent dosing. Imaging showed that all subcutaneous ofatumumab doses demonstrated efficacy (most robust: cumulative doses ≥30 mg/12 wk), with a safety profile consistent with existing ofatumumab data. This treatment effect also occurred with dosage regimens that only partially depleted circulating B cells. This study provides Class I evidence that for patients with RMS, ofatumumab decreases the number of new MRI gadolinium-enhancing lesions 12 weeks after treatment initiation. © 2018 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

  4. Subcutaneous ofatumumab in patients with relapsing-remitting multiple sclerosis

    PubMed Central

    Grove, Richard A.; Austin, Daren J.; Tolson, Jerry M.; VanMeter, Susan A.; Lewis, Eric W.; Derosier, Frederick J.; Lopez, Monica C.; Kavanagh, Sarah T.; Miller, Aaron E.; Sorensen, Per S.

    2018-01-01

    Objective To assess dose-response effects of the anti-CD20 monoclonal antibody ofatumumab on efficacy and safety outcomes in a phase 2b double-blind study of relapsing forms of multiple sclerosis (RMS). Methods Patients (n = 232) were randomized to ofatumumab 3, 30, or 60 mg every 12 weeks, ofatumumab 60 mg every 4 weeks, or placebo for a 24-week treatment period, with a primary endpoint of cumulative number of new gadolinium-enhancing lesions (per brain MRI) at week 12. Relapses and safety/tolerability were assessed, and CD19+ peripheral blood B-lymphocyte counts measured. Safety monitoring continued weeks 24 to 48 with subsequent individualized follow-up evaluating B-cell repletion. Results The cumulative number of new lesions was reduced by 65% for all ofatumumab dose groups vs placebo (p < 0.001). Post hoc analysis (excluding weeks 1–4) estimated a ≥90% lesion reduction vs placebo (week 12) for all cumulative ofatumumab doses ≥30 mg/12 wk. Dose-dependent CD19 B-cell depletion was observed. Notably, complete depletion was not necessary for a robust treatment effect. The most common adverse event was injection-related reactions (52% ofatumumab, 15% placebo), mild to moderate severity in 97%, most commonly associated with the first dose and diminishing on subsequent dosing. Conclusion Imaging showed that all subcutaneous ofatumumab doses demonstrated efficacy (most robust: cumulative doses ≥30 mg/12 wk), with a safety profile consistent with existing ofatumumab data. This treatment effect also occurred with dosage regimens that only partially depleted circulating B cells. Classification of evidence This study provides Class I evidence that for patients with RMS, ofatumumab decreases the number of new MRI gadolinium-enhancing lesions 12 weeks after treatment initiation. PMID:29695594

  5. An Assessment of Cumulative Axial and Torsional Fatigue in a Cobalt-Base Superalloy

    NASA Technical Reports Server (NTRS)

    Kalluri, Sreeramesh; Bonacuse, Peter J.

    2010-01-01

    Cumulative fatigue under axial and torsional loading conditions can include both load-order (higMow and low/high) as well as load-type sequence (axial/torsional and torsional/axial) effects. Previously reported experimental studies on a cobalt-base superalloy, Haynes 188 at 538 C, addressed these effects. These studies characterized the cumulative axial and torsional fatigue behavior under high amplitude followed by low amplitude (Kalluri, S. and Bonacuse, P. J., "Cumulative Axial and Torsional Fatigue: An Investigation of Load-Type Sequance Effects," in Multiaxial Fatigue and Deformation: Testing and Prediction, ASTM STP 1387, S. Kalluri, and P. J. Bonacuse, Eds., American Society for Testing and Materials, West Conshohocken, PA, 2000, pp. 281-301) and low amplitude followed by high amplitude (Bonacuse, P. and Kalluri, S. "Sequenced Axial and Torsional Cumulative Fatigue: Low Amplitude Followed by High Amplitude Loading," Biaxial/Multiaxial Fatigue and Fracture, ESIS Publication 31, A. Carpinteri, M. De Freitas, and A. Spagnoli, Eds., Elsevier, New York, 2003, pp. 165-182) conditions. In both studies, experiments with the following four load-type sequences were performed: (a) axial/axial, (b) torsional/torsional, (c) axial/torsional, and (d) torsional/axial. In this paper, the cumulative axial and torsional fatigue data generated in the two previous studies are combined to generate a comprehensive cumulative fatigue database on both the load-order and load-type sequence effects. This comprehensive database is used to examine applicability of the Palmgren-langer-Miner linear damage rule and a nonlinear damage curve approach for Haynes 188 subjected to the load-order and load-type sequencing described above. Summations of life fractions from the experiments are compared to the predictions from both the linear and nonlinear cumulative fatigue damage approaches. The significance of load-order versus load-type sequence effects for axial and torsional loading conditions is discussed. Possible reasons for the observed differences between the computed and observed summations of cycle fractions are rationalized in terms of the observed ever lutions of cyclic axial and shear stress ranges in the cumulative fatigue tests.

  6. Estimating the burden of recurrent events in the presence of competing risks: the method of mean cumulative count.

    PubMed

    Dong, Huiru; Robison, Leslie L; Leisenring, Wendy M; Martin, Leah J; Armstrong, Gregory T; Yasui, Yutaka

    2015-04-01

    Cumulative incidence has been widely used to estimate the cumulative probability of developing an event of interest by a given time, in the presence of competing risks. When it is of interest to measure the total burden of recurrent events in a population, however, the cumulative incidence method is not appropriate because it considers only the first occurrence of the event of interest for each individual in the analysis: Subsequent occurrences are not included. Here, we discuss a straightforward and intuitive method termed "mean cumulative count," which reflects a summarization of all events that occur in the population by a given time, not just the first event for each subject. We explore the mathematical relationship between mean cumulative count and cumulative incidence. Detailed calculation of mean cumulative count is described by using a simple hypothetical example, and the computation code with an illustrative example is provided. Using follow-up data from January 1975 to August 2009 collected in the Childhood Cancer Survivor Study, we show applications of mean cumulative count and cumulative incidence for the outcome of subsequent neoplasms to demonstrate different but complementary information obtained from the 2 approaches and the specific utility of the former. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Cumulative versus end-of-course assessment: effects on self-study time and test performance.

    PubMed

    Kerdijk, Wouter; Cohen-Schotanus, Janke; Mulder, B Florentine; Muntinghe, Friso L H; Tio, René A

    2015-07-01

    Students tend to postpone preparation for a test until the test is imminent, which raises various risks associated with 'cramming' behaviours, including that for suboptimal learning. Cumulative assessment utilises spaced testing to stimulate students to study more frequently and to prevent procrastination. This randomised controlled study investigated how cumulative assessment affects time spent on self-study and test performance compared with end-of-course assessment. A total of 78 undergraduate medical students in a Year 2 pre-clinical course were randomly assigned to either of two conditions. Students in the cumulative assessment condition were assessed in weeks 4, 8 and 10. Students in the end-of-course assessment condition were assessed in week 10 only. Each week, students reported the number of hours they spent on self-study. Students in the cumulative assessment condition (n = 25) spent significantly more time on self-study than students in the end-of-course assessment condition (n = 37) in all weeks of the course except weeks 5, 9 and 10. Overall, the cumulative assessment group spent 69 hours more on self-study during the course than did the control group, although the control group spent 7 hours more in studying during the final week of the course than did the cumulative assessment group. Students in the cumulative assessment condition scored slightly higher on questions concerning the content of the last part of the course. Cumulative assessment encourages students to distribute their learning activities over a course, which leaves them more opportunity to study the content of the last part of the course prior to the final examination. There was no evidence for a short-term effect of cumulative assessment on overall knowledge gain. We hypothesise that larger positive effects might be found if retention were to be measured in the long term. © 2015 John Wiley & Sons Ltd.

  8. The Contribution of Project Environmental Assessment to Assessing and Managing Cumulative Effects: Individually and Collectively Insignificant?

    PubMed

    Noble, Bram; Liu, Jialang; Hackett, Paul

    2017-04-01

    This paper explores the opportunities and constraints to project-based environmental assessment as a means to support the assessment and management of cumulative environmental effects. A case study of the hydroelectric sector is used to determine whether sufficient information is available over time through project-by-project assessments to support an adequate understanding of cumulative change. Results show inconsistency from one project to the next in terms of the components and indicators assessed, limited transfer of baseline information between project assessments over time, and the same issues and concerns being raised by review panels-even though the projects reviewed are operating in the same watershed and operated by the same proponent. Project environmental assessments must be managed, and coordinated, as part of a larger system of impact assessment, if project-by-project assessments are to provide a meaningful forum for learning and understanding cumulative change. The paper concludes with recommendations for improved project-based assessment practice in support of cumulative effects assessment and management.

  9. Cumulative Stress and Cortisol Disruption among Black and Hispanic Pregnant Women in an Urban Cohort.

    PubMed

    Suglia, Shakira Franco; Staudenmayer, John; Cohen, Sheldon; Enlow, Michelle Bosquet; Rich-Edwards, Janet W; Wright, Rosalind J

    2010-12-01

    While adult hypothalamic-pituitary-adrenocortical (HPA) axis functioning is thought to be altered by traumatic experiences, little data exist on the effects of cumulative stress on HPA functioning among pregnant women or among specific racial and ethnic groups. Individuals may be increasingly vulnerable to physiological alterations when experiencing cumulative effects of multiple stressors. These effects may be particularly relevant in urban poor communities where exposure to multiple stressors is more prevalent. The goal of this study was to explore the effects of multiple social stressors on HPA axis functioning in a sample of urban Black (n = 68) and Hispanic (n = 132) pregnant women enrolled in the Asthma Coalition on Community, Environment, and Social Stress (ACCESS). Pregnant women were administered the Revised Conflict Tactics Scale (R-CTS) survey to assess interpersonal violence, the Experiences of Discrimination (EOD) survey, the Crisis in Family Systems-Revised (CRISYS-R) negative life events survey, and the My Exposure to Violence (ETV) survey, which ascertains exposure to community violence. A cumulative stress measure was derived from these instruments. Salivary cortisol samples were collected five times per day over three days to assess area under the curve (AUC), morning change, and basal awakening response in order to characterize diurnal salivary cortisol patterns. Repeated measures mixed models, stratified by race/ethnicity, were performed adjusting for education level, age, smoking status, body mass index and weeks pregnant at time of cortisol sampling. The majority of Hispanic participants (57%) had low cumulative stress exposure, while the majority of Black participants had intermediate (35%) or high (41%) cumulative stress exposure. Results showed that among Black but not Hispanic women, cumulative stress was associated with lower morning cortisol levels, including a flatter waking to bedtime rhythm. These analyses suggest that the combined effects of cumulative stressful experiences are associated with disrupted HPA functioning among pregnant women. While the etiology of racial/ethnic differences in stress-induced HPA alterations is not clear, this warrants further research.

  10. Acute and Cumulative Effects of Unmodified 50-nm Nano-ZnO on Mice.

    PubMed

    Kong, Tao; Zhang, Shu-Hui; Zhang, Ji-Liang; Hao, Xue-Qin; Yang, Fan; Zhang, Cai; Yang, Zi-Jun; Zhang, Meng-Yu; Wang, Jie

    2018-01-02

    Nanometer zinc oxide (nano-ZnO) is widely used in diverse industrial and agricultural fields. Due to the extensive contact humans have with these particles, it is crucial to understand the potential effects that nano-ZnO have on human health. Currently, information related to the toxicity and mechanisms of nano-ZnO is limited. The aim of the present study was to investigate acute and cumulative toxic effects of 50-nm unmodified ZnO in mice. This investigation will seek to establish median lethal dose (LD50), a cumulative coefficient, and target organs. The acute and cumulative toxicity was investigated by Karber's method and via a dose-increasing method, respectively. During the experiment, clinical signs, mortality, body weights, hematology, serum biochemistry, gross pathology, organ weight, and histopathology were examined. The LD50 was 5177-mg/kg·bw; the 95% confidence limits for the LD50 were 5116-5238-mg/kg·bw. It could be concluded that the liver, kidney, lung, and gastrointestinal tract were target organs for the 50-nm nano-ZnO acute oral treatment. The cumulative coefficient (K) was 1.9 which indicated that the cumulative toxicity was apparent. The results also indicated that the liver, kidney, lung, and pancrea were target organs for 50-nm nano-ZnO cumulative oral exposure and might be target organs for subchronic and chronic toxicity of oral administered 50-nm ZnO.

  11. Democratization and life expectancy in Europe, 1960-2008.

    PubMed

    Mackenbach, Johan P; Hu, Yannan; Looman, Caspar W N

    2013-09-01

    Over the past five decades, two successive waves of political reform have brought democracy to, first, Spain, Portugal and Greece, and, more recently, Central and Eastern European countries. We assessed whether democratization was associated with improvements in population health, as indicated by life expectancy and cause-specific mortality rates. Data on life expectancy at birth, age-standardized total and cause-specific mortality rates, levels of democracy and potential time-variant confounding variables were collected from harmonized international databanks. In two pooled cross-sectional time-series analyses with country-fixed effects, life expectancy and cause-specific mortality were regressed on measures of current and cumulative democracy, controlling for confounders. A first analysis covered the 1960-1990 period, a second covered the 1987-2008 period. In the 1960-1990 period, current democracy was more strongly associated with higher life expectancy than cumulative democracy. The positive effects of current democracy on total mortality were mediated mainly by lower mortality from heart disease, pneumonia, liver cirrhosis, and suicide. In the 1987-2008 period, however, current democracy was associated with lower, and cumulative democracy with higher life expectancy, particularly among men. The positive effects of cumulative democracy on total mortality were mediated mainly by lower mortality from circulatory diseases, cancer of the breast, and external causes. Current democracy was associated with higher mortality from motor vehicle accidents in both periods, and also with higher mortality from cancer and all external causes in the second. Our results suggest that in Europe during these two periods democratization has had mixed effects. That short-term changes in levels of democracy had positive effects in the first but not in the second period is probably due to the fact that democratization in Central and Eastern Europe was part of a complete system change which caused major societal disruptions. Copyright © 2013 Elsevier Ltd. All rights reserved.

  12. The challenges and opportunities in cumulative effects assessment

    USGS Publications Warehouse

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

    2016-01-01

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

  13. The challenges and opportunities in cumulative effects assessment

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

    Foley, Melissa M., E-mail: mfoley@usgs.gov; Center for Ocean Solutions, Stanford University, 99 Pacific St., Monterey, CA 93940; Mease, Lindley A., E-mail: lamease@stanford.edu

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

  14. Expansive Soil Crack Depth under Cumulative Damage

    PubMed Central

    Shi, Bei-xiao; Chen, Sheng-shui; Han, Hua-qiang; Zheng, Cheng-feng

    2014-01-01

    The crack developing depth is a key problem to slope stability of the expansive soil and its project governance and the crack appears under the roles of dry-wet cycle and gradually develops. It is believed from the analysis that, because of its own cohesion, the expansive soil will have a certain amount of deformation under pulling stress but without cracks. The soil body will crack only when the deformation exceeds the ultimate tensile strain that causes cracks. And it is also believed that, due to the combined effect of various environmental factors, particularly changes of the internal water content, the inherent basic physical properties of expansive soil are weakened, and irreversible cumulative damages are eventually formed, resulting in the development of expansive soil cracks in depth. Starting from the perspective of volumetric strain that is caused by water loss, considering the influences of water loss rate and dry-wet cycle on crack developing depth, the crack developing depth calculation model which considers the water loss rate and the cumulative damages is established. Both the proposal of water loss rate and the application of cumulative damage theory to the expansive soil crack development problems try to avoid difficulties in matrix suction measurement, which will surely play a good role in promoting and improving the research of unsaturated expansive soil. PMID:24737974

  15. Decomposition of fluctuating initial conditions and flow harmonics

    NASA Astrophysics Data System (ADS)

    Qian, Wei-Liang; Mota, Philipe; Andrade, Rone; Gardim, Fernando; Grassi, Frédérique; Hama, Yogiro; Kodama, Takeshi

    2014-01-01

    Collective flow observed in heavy-ion collisions is largely attributed to initial geometrical fluctuations, and it is the hydrodynamic evolution of the system that transforms those initial spatial irregularities into final state momentum anisotropies. Cumulant analysis provides a mathematical tool to decompose those initial fluctuations in terms of radial and azimuthal components. It is usually thought that a specified order of azimuthal cumulant, for the most part, linearly produces flow harmonics of the same order. In this work, by considering the most central collisions (0%-5%), we carry out a systematic study on the connection between cumulants and flow harmonics using a hydrodynamic code called NeXSPheRIO. We conduct three types of calculation, by explicitly decomposing the initial conditions into components corresponding to a given eccentricity and studying the out-coming flow through hydrodynamic evolution. It is found that for initial conditions deviating significantly from Gaussian, such as those from NeXuS, the linearity between eccentricities and flow harmonics partially breaks down. Combined with the effect of coupling between cumulants of different orders, it causes the production of extra flow harmonics of higher orders. We argue that these results can be seen as a natural consequence of the non-linear nature of hydrodynamics, and they can be understood intuitively in terms of the peripheral-tube model.

  16. Cumulative sum control charts for assessing performance in arterial surgery.

    PubMed

    Beiles, C Barry; Morton, Anthony P

    2004-03-01

    The Melbourne Vascular Surgical Association (Melbourne, Australia) undertakes surveillance of mortality following aortic aneurysm surgery, patency at discharge following infrainguinal bypass and stroke and death following carotid endarterectomy. Quality improvement protocol employing the Deming cycle requires that the system for performing surgery first be analysed and optimized. Then process and outcome data are collected and these data require careful analysis. There must be a mechanism so that the causes of unsatisfactory outcomes can be determined and a good feedback mechanism must exist so that good performance is acknowledged and unsatisfactory performance corrected. A simple method for analysing these data that detects changes in average outcome rates is available using cumulative sum statistical control charts. Data have been analysed both retrospectively from 1999 to 2001, and prospectively during 2002 using cumulative sum control methods. A pathway to deal with control chart signals has been developed. The standard of arterial surgery in Victoria, Australia, is high. In one case a safe and satisfactory outcome was achieved by following the pathway developed by the audit committee. Cumulative sum control charts are a simple and effective tool for the identification of variations in performance standards in arterial surgery. The establishment of a pathway to manage problem performance is a vital part of audit activity.

  17. Cumulative environmental risk and youth maladjustment: the role of youth attributes.

    PubMed

    Gerard, Jean M; Buehler, Cheryl

    2004-01-01

    Using data from 5,070 youth ages 11 to 18 years old who participated in the National Longitudinal Study of Adolescent Health, concurrent and longitudinal associations among cumulative risk, protective factors, and youth maladjustment were examined. Cumulative risk was associated with concurrent conduct problems and depressed mood. For conduct problems, a compensatory effect was found for scholastic achievement and problem-solving ability. For depressed mood, a compensatory effect was found for scholastic achievement. A protective-reactive effect of self-esteem was found for both forms of maladjustment. Youth gender, grade, and ethnicity moderated these associations. Cumulative risk predicted change over time in depressed mood. Scholastic achievement and self-esteem compensated for this risk. Findings indicate that youth attributes offer limited protection when adolescents experience risk factors across life domains.

  18. Application of Maxent Multivariate Analysis to Define Climate-Change Effects on Species Distributions and Changes

    DTIC Science & Technology

    2014-09-01

    approaches. Ecological Modelling Volume 200, Issues 1–2, 10, pp 1–19. Buhlmann, Kurt A ., Thomas S.B. Akre , John B. Iverson, Deno Karapatakis, Russell A ...statistical multivariate analysis to define the current and projected future range probability for species of interest to Army land managers. A software...15 Figure 4. RCW omission rate and predicted area as a function of the cumulative threshold

  19. A critical review and analysis of the use of exposure- and flux-based ozone indices for predicting vegetation effects

    Treesearch

    Robert C. Musselman; Allen S. Lefohn; William J. Massman; Robert L. Heath

    2006-01-01

    Early studies of plant response to ozone (O3) utilized concentration-based metrics, primarily by summarizing the commonly monitored hourly average data sets. Research with the O3 concentration parameter led to the recognition that both peak concentrations and cumulative effects are important when relating plant response to O3. The US and Canada currently use O3...

  20. Probability and Statistics in Sensor Performance Modeling

    DTIC Science & Technology

    2010-12-01

    language software program is called Environmental Awareness for Sensor and Emitter Employment. Some important numerical issues in the implementation...3 Statistical analysis for measuring sensor performance...complementary cumulative distribution function cdf cumulative distribution function DST decision-support tool EASEE Environmental Awareness of

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

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

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

    1988-01-01

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

  2. Cumulative Incidence of Cancer among HIV-infected Individuals in North America

    PubMed Central

    Silverberg, Michael J.; Lau, Bryan; Achenbach, Chad J.; Jing, Yuezhou; Althoff, Keri N.; D’Souza, Gypsyamber; Engels, Eric A.; Hessol, Nancy; Brooks, John T.; Burchell, Ann N.; Gill, M. John; Goedert, James J.; Hogg, Robert; Horberg, Michael A.; Kirk, Gregory D.; Kitahata, Mari M.; Korthuis, Phillip T.; Mathews, William C.; Mayor, Angel; Modur, Sharada P.; Napravnik, Sonia; Novak, Richard M.; Patel, Pragna; Rachlis, Anita R.; Sterling, Timothy R.; Willig, James H.; Justice, Amy C.; Moore, Richard D.; Dubrow, Robert

    2016-01-01

    Background Cancer is increasingly common among HIV patients given improved survival. Objective To examine calendar trends in cumulative cancer incidence and hazard rate by HIV status. Design Cohort study Setting North American AIDS Cohort Collaboration on Research and Design during 1996–2009 Patients 86,620 HIV-infected and 196,987 uninfected adults Measurements We estimated cancer-type-specific cumulative incidence by age 75 years by HIV status and calendar era, and examined calendar trends in cumulative incidence and hazard rates. Results Cumulative incidences (%) of cancer by age 75 (HIV+/HIV−) were: Kaposi sarcoma (KS), 4.4/0.01; non-Hodgkin’s lymphoma (NHL), 4.5/0.7; lung, 3.4/2.8; anal, 1.5/0.1; colorectal, 1.0/1.5; liver, 1.1/0.4; Hodgkin lymphoma (HL), 0.9/0.1; melanoma, 0.5/0.6; and oral cavity/pharyngeal, 0.8/0.8. Among HIV-infected subjects, we observed decreasing calendar trends in cumulative incidence and hazard rate for KS and NHL. For anal, colorectal and liver cancers, increasing cumulative incidence, but not hazard rate trends, were due to the decreasing mortality rate trend (−9% per year), allowing greater opportunity to be diagnosed with these cancer types. Despite decreasing hazard rate trends for lung, HL, and melanoma, we did not observe cumulative incidence trends due to the compensating effect of the declining mortality rate on cumulative incidence. Limitations Secular trends in screening, smoking, and viral co-infections were not evaluated. Conclusions Our analytic approach helped disentangle the effects of improved survival and changing cancer-specific hazard rates on cumulative incidence trends among HIV patients. Cumulative cancer incidence by age 75, approximating lifetime risk in HIV patients, may have clinical utility in this population. The high cumulative incidences by age 75 for KS, NHL, and lung cancer supports early and sustained ART and smoking cessation. Primary Funding Source National Institutes of Health PMID:26436616

  3. 14 CFR Section 8 - General

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS... and infrequent occurrence. (7) Cumulative effect of changes in accounting principles. This primary classification (9800) shall include the cumulative effect of material changes in accounting principles. [ER-755...

  4. A framework for assessing cumulative effects in watersheds: an introduction to Canadian case studies.

    PubMed

    Dubé, Monique G; Duinker, Peter; Greig, Lorne; Carver, Martin; Servos, Mark; McMaster, Mark; Noble, Bram; Schreier, Hans; Jackson, Lee; Munkittrick, Kelly R

    2013-07-01

    From 2008 to 2013, a series of studies supported by the Canadian Water Network were conducted in Canadian watersheds in an effort to improve methods to assess cumulative effects. These studies fit under a common framework for watershed cumulative effects assessment (CEA). This article presents an introduction to the Special Series on Watershed CEA in IEAM including the framework and its impetus, a brief introduction to each of the articles in the series, challenges, and a path forward. The framework includes a regional water monitoring program that produces 3 core outputs: an accumulated state assessment, stressor-response relationships, and development of predictive cumulative effects scenario models. The framework considers core values, indicators, thresholds, and use of consistent terminology. It emphasizes that CEA requires 2 components, accumulated state quantification and predictive scenario forecasting. It recognizes both of these components must be supported by a regional, multiscale monitoring program. Copyright © 2013 SETAC.

  5. Looking up, down, and sideways: Reconceiving cumulative effects assessment as a mindset

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

    Sinclair, A. John, E-mail: jsincla@umanitoba.ca; Doelle, Meinhard, E-mail: mdoelle@dal.ca; Duinker, Peter N., E-mail: peter.duinker@dal.ca

    Despite all the effort that has gone into defining, researching and establishing best practices for cumulative effects assessment (CEA), understanding remains weak and practice wanting. At one extreme of implementation, CEA can be described as merely an irritant to the completion of a project-specific environmental assessment (EA). At the other extreme, the conceptual view is that all effects in EA should be deemed cumulative unless demonstrated otherwise. Our purpose here is to consider how we might reconceive CEA as a mindset that is at the heart of absolutely every assessment of valued ecosystem component (VEC) to ensure that we understandmore » the relative contributions of various stressors and can decide when cumulative effects may foreclose future activities due to impacts on VECs. Conceptually, we ground the CEA mindset in the context of three lenses that must all be functioning and working together for the mindset to be operative: a technical lens; a law and policy lens; and a participatory lens. Our arguments are based on a review of the CEA, strategic effects assessment (SEA) and regional effects assessment literatures, an examination and consideration of Canadian EA and SEA case practice, and our combined professional experiences. Through using the Bay of Fundy in Canada as a case example, we establish the concept of the CEA mindset and an approach for moving forward with implementation. - Highlights: • Conceptualization of cumulative effects assessment as a mindset. • Elaboration of technical, law and policy and participation lenses critical to CEA • Coordination and integration of cumulative effects for valued ecosystem components • Application in Bay of Fundy ecosystem and terrestrial watershed.« less

  6. A Topical Overview of Cumulative Risk Assessment Concepts ...

    EPA Pesticide Factsheets

    Cumulative risk assessments (CRAs) address combined risks from exposures to multiple chemical and nonchemical stressors and may focus on vulnerable communities or populations. Significant contributions have been made to the development of concepts, methods, and applications for CRA over the past decade. Work in both human health and ecological cumulative risk has advanced in two different contexts. First, in assessing the effects of chemical mixtures that share common modes of action, or that cause common adverse outcomes. In this context two primary models are used for predicting mixture effects, dose addition or response addition. The second context is evaluating the combined effects of chemical and nonchemical (e.g., radiation, biological, nutritional, economic, psychological, habitat alteration, land-use change, global climate change, and natural disasters) stressors. CRA can be adapted to address risk in many contexts, and this adaptability is reflected in the range in disciplinary perspectives in the published literature. This article presents the results of a literature search by presenting a range of selected work with the intention to give a broad overview of relevant topics and provide a starting point for researchers interested in CRA applications. This is a select literature review of topics in CRA. As a published article it will allow the citation of an analysis conducted on a rich and diverse set of CRA publications relevant to assessment methods

  7. Empirical, dimensionless, cumulative-rainfall hyetographs developed from 1959-86 storm data for selected small watersheds in Texas

    USGS Publications Warehouse

    Williams-Sether, Tara; Asquith, William H.; Thompson, David B.; Cleveland, Theodore G.; Fang, Xing

    2004-01-01

    A database of incremental cumulative-rainfall values for storms that occurred in small urban and rural watersheds in north and south central Texas during the period from 1959 to 1986 was used to develop empirical, dimensionless, cumulative-rainfall hyetographs. Storm-quartile classifications were determined from the cumulative-rainfall values, which were divided into data groups on the basis of storm-quartile classification (first, second, third, fourth, and first through fourth combined), storm duration (0 to 6, 6 to 12, 12 to 24, 24 to 72, and 0 to 72 hours), and rainfall amount (1 inch or more). Removal of long leading tails, in effect, shortened the storm duration and, in some cases, affected the storm-quartile classification. Therefore, two storm groups, untrimmed and trimmed, were used for analysis. The trimmed storms generally are preferred for interpretation. For a 12-hour or less trimmed storm duration, approximately 49 percent of the storms are first quartile. For trimmed storm durations of 12 to 24 and 24 to 72 hours, 47 and 38 percent, respectively, of the storms are first quartile. For a trimmed storm duration of 0 to 72 hours, the first-, second-, third-, and fourth-quartile storms accounted for 46, 21, 20, and 13 percent of all storms, respectively. The 90th-percentile curve for first-quartile storms indicated about 90 percent of the cumulative rainfall occurs during the first 20 percent of the storm duration. The 10th-percentile curve for first-quartile storms indicated about 30 percent of the cumulative rainfall occurs during the first 20 percent of the storm duration. The 90th-percentile curve for fourth-quartile storms indicated about 33 percent of the cumulative rainfall occurs during the first 20 percent of the storm duration. The 10th-percentile curve for fourth-quartile storms indicated less than 5 percent of the cumulative rainfall occurs during the first 20 percent of the storm duration. Statistics for the empirical, dimensionless, cumulative-rainfall hyetographs are presented in the report along with hyetograph curves and tables. The curves and tables presented do not present exact mathematical relations but can be used to estimate distributions of rainfall with time for small drainage areas of less than about 160 square miles in urban and small rural watersheds in north and south central Texas.

  8. Cumulative culture in the laboratory: methodological and theoretical challenges.

    PubMed

    Miton, Helena; Charbonneau, Mathieu

    2018-05-30

    In the last decade, cultural transmission experiments (transmission chains, replacement, closed groups and seeded groups) have become important experimental tools in investigating cultural evolution. However, these methods face important challenges, especially regarding the operationalization of theoretical claims. In this review, we focus on the study of cumulative cultural evolution, the process by which traditions are gradually modified and, for technological traditions in particular, improved upon over time. We identify several mismatches between theoretical definitions of cumulative culture and their implementation in cultural transmission experiments. We argue that observed performance increase can be the result of participants learning faster in a group context rather than effectively leading to a cumulative effect. We also show that in laboratory experiments, participants are asked to complete quite simple tasks, which can undermine the evidential value of the diagnostic criterion traditionally used for cumulative culture (i.e. that cumulative culture is a process that produces solutions that no single individual could have invented on their own). We show that the use of unidimensional metrics of cumulativeness drastically curtail the variation that may be observed, which raises specific issues in the interpretation of the experimental evidence. We suggest several solutions to these mismatches (learning times, task complexity and variation) and develop the use of design spaces in experimentally investigating old and new questions about cumulative culture. © 2018 The Author(s).

  9. The neurocognitive consequences of sleep restriction: A meta-analytic review.

    PubMed

    Lowe, Cassandra J; Safati, Adrian; Hall, Peter A

    2017-09-01

    The current meta-analytic review evaluated the effects of experimentally manipulated sleep restriction on neurocognitive functioning. Random-effects models were employed to estimate the overall effect size and the differential effect size across cognitive domains. Age, time of day, age-adjusted sleep deficit, cumulative days of restricted sleep, sleep latency, subjective sleepiness, and biological sex were examined as potential moderators of the effect. Based on a sample of 61 studies, from 71 different populations, findings revealed a significant negative effect of sleep restriction on cognitive processing across cognitive domains (g=-0.383, p<0.001). This effect held for executive functioning (g=-0.324, p<0.001), sustained attention (g=-0.409, p<0.001), and long-term memory (g=-0.192, p=0.002). There was insufficient evidence to detect an effect within the domains of attention, multitask, impulsive decision-making or intelligence. Age group, time of day, cumulative days of restricted sleep, sleep latency, subjective sleepiness, and biological sex were all significant moderators of the overall effect. In conclusion, the current meta-analysis is the first comprehensive review to provide evidence that short-term sleep restriction significantly impairs waking neurocognitive functioning. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Computer-aided system of evaluation for population-based all-in-one service screening (CASE-PASS): from study design to outcome analysis with bias adjustment.

    PubMed

    Chen, Li-Sheng; Yen, Amy Ming-Fang; Duffy, Stephen W; Tabar, Laszlo; Lin, Wen-Chou; Chen, Hsiu-Hsi

    2010-10-01

    Population-based routine service screening has gained popularity following an era of randomized controlled trials. The evaluation of these service screening programs is subject to study design, data availability, and the precise data analysis for adjusting bias. We developed a computer-aided system that allows the evaluation of population-based service screening to unify these aspects and facilitate and guide the program assessor to efficiently perform an evaluation. This system underpins two experimental designs: the posttest-only non-equivalent design and the one-group pretest-posttest design and demonstrates the type of data required at both the population and individual levels. Three major analyses were developed that included a cumulative mortality analysis, survival analysis with lead-time adjustment, and self-selection bias adjustment. We used SAS AF software to develop a graphic interface system with a pull-down menu style. We demonstrate the application of this system with data obtained from a Swedish population-based service screen and a population-based randomized controlled trial for the screening of breast, colorectal, and prostate cancer, and one service screening program for cervical cancer with Pap smears. The system provided automated descriptive results based on the various sources of available data and cumulative mortality curves corresponding to the study designs. The comparison of cumulative survival between clinically and screen-detected cases without a lead-time adjustment are also demonstrated. The intention-to-treat and noncompliance analysis with self-selection bias adjustments are also shown to assess the effectiveness of the population-based service screening program. Model validation was composed of a comparison between our adjusted self-selection bias estimates and the empirical results on effectiveness reported in the literature. We demonstrate a computer-aided system allowing the evaluation of population-based service screening programs with an adjustment for self-selection and lead-time bias. This is achieved by providing a tutorial guide from the study design to the data analysis, with bias adjustment. Copyright © 2010 Elsevier Inc. All rights reserved.

  11. An Analysis of Learning Rate and Curricular Scope: Caution When Choosing Academic Interventions Based on Aggregated Outcomes

    ERIC Educational Resources Information Center

    Poncy, Brian C.; Solomon, Benjamin; Duhon, Gary; Skinner, Christopher; Moore, Kathryn; Simons, Sean

    2015-01-01

    We aggregated and analyzed single-case research targeting math-fact fluency to investigate whether learning (behavior change) data were sufficient to summarize and compare intervention outcomes or if learning rate (learning/cumulative instructional time) data would provide divergent effect size (ES) results. We also extracted the curricular scope…

  12. Continuing Injuries of Racism: Counseling in a Racist Context

    ERIC Educational Resources Information Center

    Thompson-Miller, Ruth; Feagin, Joe R.

    2007-01-01

    In this reaction article, the authors support and extend Robert T. Carter's excellent analysis of the impact of racism today on Americans of color. Drawing on their own data, they suggest important extensions of his arguments in regard to the cumulative and long-term effects of racial discrimination and other racial oppression--as well as in…

  13. Novel Method of Weighting Cumulative Helmet Impacts Improves Correlation with Brain White Matter Changes After One Football Season of Sub-concussive Head Blows.

    PubMed

    Merchant-Borna, Kian; Asselin, Patrick; Narayan, Darren; Abar, Beau; Jones, Courtney M C; Bazarian, Jeffrey J

    2016-12-01

    One football season of sub-concussive head blows has been shown to be associated with subclinical white matter (WM) changes on diffusion tensor imaging (DTI). Prior research analyses of helmet-based impact metrics using mean and peak linear and rotational acceleration showed relatively weak correlations to these WM changes; however, these analyses failed to account for the emerging concept that neuronal vulnerability to successive hits is inversely related to the time between hits (TBH). To develop a novel method for quantifying the cumulative effects of sub-concussive head blows during a single season of collegiate football by weighting helmet-based impact measures for time between helmet impacts. We further aim to compare correlations to changes in DTI after one season of collegiate football using weighted cumulative helmet-based impact measures to correlations using non-weighted cumulative helmet-based impact measures and non-cumulative measures. We performed a secondary analysis of DTI and helmet impact data collected on ten Division III collegiate football players during the 2011 season. All subjects underwent diffusion MR imaging before the start of the football season and within 1 week of the end of the football season. Helmet impacts were recorded at each practice and game using helmet-mounted accelerometers, which computed five helmet-based impact measures for each hit: linear acceleration (LA), rotational acceleration (RA), Gadd Severity Index (GSI), Head Injury Criterion (HIC 15 ), and Head Impact Technology severity profile (HITsp). All helmet-based impact measures were analyzed using five methods of summary: peak and mean (non-cumulative measures), season sum-totals (cumulative unweighted measures), and season sum-totals weighted for time between hits (TBH), the interval of time from hit to post-season DTI assessment (TUA), and both TBH and TUA combined. Summarized helmet-based impact measures were correlated to statistically significant changes in fractional anisotropy (FA) using bivariate and multivariable correlation analyses. The resulting R 2 values were averaged in each of the five summary method groups and compared using one-way ANOVA followed by Tukey post hoc tests for multiple comparisons. Total head hits for the season ranged from 431 to 1850. None of the athletes suffered a clinically evident concussion during the study period. The mean R 2 value for the correlations using cumulative helmet-based impact measures weighted for both TUA and TBH combined (0.51 ± 0.03) was significantly greater than the mean R 2 value for correlations using non-cumulative HIMs (vs. 0.19 ± 0.04, p < 0.0001), unweighted cumulative helmet-based impact measures (vs. 0.27 + 0.03, p < 0.0001), and cumulative helmet-based impact measures weighted for TBH alone (vs. 0.34 ± 0.02, p < 0.001). R 2 values for weighted cumulative helmet-based impact measures ranged from 0.32 to 0.77, with 60% of correlations being statistically significant. Cumulative GSI weighted for TBH and TUA explained 77% of the variance in the percent of white matter voxels with statistically significant (PWMVSS) increase in FA from pre-season to post-season, while both cumulative GSI and cumulative HIC 15 weighted for TUA accounted for 75% of the variance in PWMVSS decrease in FA. A novel method for weighting cumulative helmet-based impact measures summed over the course of a football season resulted in a marked improvement in the correlation to brain WM changes observed after a single football season of sub-concussive head blows. Our results lend support to the emerging concept that sub-concussive head blows can result in sub-clinical brain injury, and this may be influenced by the time between hits. If confirmed in an independent data set, our novel method for quantifying the cumulative effects of sub-concussive head blows could be used to develop threshold-based countermeasures to prevent the accumulation of WM changes with multiple seasons of play.

  14. Studies of two cumulative effects riddles

    Treesearch

    R. M. Rice; R. R. Ziemer; J. Lewis; T. E. Lisle

    1989-01-01

    Although it is unquestionably prudent to consider the cumulative watershed effects (CWEs) of timber harvesting, the presumed CWE phenomena offer limited opportunity for scientific inquiry. We are addressing two questions: are there synergistic sedimentation effects of sufficient magnitude to warrant consideration beyond efforts to reduce on-site erosion; and what are...

  15. Cumulative advantages and the emergence of social and ethnic inequality: Matthew effects in reading and mathematics development within elementary schools?

    PubMed

    Baumert, Jürgen; Nagy, Gabriel; Lehmann, Rainer

    2012-01-01

    This article examines the development of social and ethnic disparities in academic achievement in elementary schooling. It investigated whether reading and mathematics development in 136 mixed-ability classes shows path-dependent processes of cumulative advantage (Matthew effects) from Grades 4 to 6 (Grade 4 mean age = 10.62, SD = 0.57) resulting in growing inequality. Status-dependent processes of cumulative advantage, their interaction with path-dependent processes, and consequences for the degree of social and ethnic inequality are examined. Two complementary methods for analyzing multilevel data are used: growth curve and quasi-simplex models. No evidence for a Matthew effect was found in either domain. A compensation effect emerged for reading, to the benefit of ethnic minorities. A fan-spread effect was found for mathematics, partly attributable to status-dependent processes of cumulative advantage. © 2012 The Authors. Child Development © 2012 Society for Research in Child Development, Inc.

  16. College Students' Memory for Unannounced Cumulative Items on the Final Exam

    ERIC Educational Resources Information Center

    Aagaard, Lola; Templeton, Jenny; Conner, Timothy W., II; Skidmore, Ronald L.

    2014-01-01

    Although there has been much published research on the benefits of distributed practice (Cepeda, Pashler, Vul, Wixted, & Rohrer, 2006) and the testing effect (Eisenkraemer, Jaeger, & Stein, 2013), very few studies are available regarding cumulative testing in college courses. Those available show a benefit to cumulative testing (Lawrence,…

  17. Short- and Long-Term Effects of Cumulative Finals on Student Learning

    ERIC Educational Resources Information Center

    Khanna, Maya M.; Brack, Amy S. Badura; Finken, Laura L.

    2013-01-01

    In two experiments, we examined the benefits of cumulative and noncumulative finals on students' short- and long-term course material retention. In Experiment 1, we examined results from course content exams administered immediately after course finals. Course sections including cumulative finals had higher content exam scores than sections…

  18. The Scarring Effects of Bankruptcy: Cumulative Disadvantage across Credit and Labor Markets

    ERIC Educational Resources Information Center

    Maroto, Michelle

    2012-01-01

    As the recent economic crisis has demonstrated, inequality often spans credit and labor markets, supporting a system of cumulative disadvantage. Using data from the National Longitudinal Survey of Youth, this research draws on stigma, cumulative disadvantage and status characteristics theories to examine whether credit and labor markets intersect…

  19. 25. Cumulative effects assessment impact thresholds: myths and realities

    Treesearch

    Robert R. Ziemer

    1994-01-01

    A cumulative impact has been commonly defined as: ""...the impact on the environment which results from the incremental impact of the action when added to other past, present, and reasonably foreseeable future actions regardless of what agency or person undertakes such other actions. Cumulative impacts can result from individually minor but collectively...

  20. Appraisal and coping as mediators of the effects of cumulative risk on preadolescent adjustment

    PubMed Central

    Thompson, Stephanie F.; Lengua, Liliana J.; Garcia, Connie Meza

    2016-01-01

    This study examined the concurrent and longitudinal relations among cumulative risk, appraisal, coping, and adjustment. Longitudinal path models were tested in a community sample of 316 children in preadolescence to examine hypotheses that threat appraisal and avoidant coping mediate the effects of cumulative risk on child adjustment, whereas positive appraisal and active coping were hypothesized to predict better adjustment independently. Children and their mothers were assessed during in-home interviews at three time points at one-year intervals. Children reported on appraisal and coping strategies. Mothers and children reported on child adjustment problems and positive adjustment. Rank-order changes in appraisal and coping predicted rank-order changes in adjustment. Cumulative risk was concurrently related to higher threat appraisal and avoidant coping at each time point. Threat appraisal and avoidant coping mediated the relations of cumulative risk to rank-order changes in adjustment. There is specificity in the relations of cumulative risk to threat appraisal and avoidant coping, whereas positive appraisal and active coping are independent of risk and operate as individual resource factors. PMID:27110087

  1. The cumulative effect of air pollutants on the acute exacerbation of COPD in Shanghai, China.

    PubMed

    Sun, Xian Wen; Chen, Pei Li; Ren, Lei; Lin, Ying Ni; Zhou, Jian Ping; Ni, Lei; Li, Qing Yun

    2018-05-01

    Epidemiologic studies have shown the effect of air pollutants on acute exacerbation of chronic obstructive pulmonary disease (AECOPD). However, little is known regarding the dose-response relationship. This study aimed to investigate the cumulative effect of air pollutants on AECOPD. We collected 101 patients with AECOPD from November 2010 through August 2011 in Shanghai. Multiple logistic regression was used to estimate associations between air pollutants and AECOPD. Poisson regression was then applied to determine the cumulative effect of air pollutants including particulate matter 10 (PM10), PM2.5, nitrogen dioxide (NO 2 ), sulphur dioxide (SO 2 ) and ozone (O 3 ) on AECOPD, of which the seasonal variation was further explored. The monthly episodes of AECOPD were associated with the concentrations of PM2.5 (r=0.884, p<0.05) and NO 2 (r=0.763, p<0.05). The cutoff value of PM2.5 and NO 2 for predicting AECOPD was 83.0μg/m 3 and 53.5μg/m 3 , respectively. It showed that per 10μg/m 3 increment in PM2.5 increased the relative risks (RR) for AECOPD was 1.09 with 3days cumulative effect in cold season, whereas 7days in warm season. The RR for AECOPD for per 10μg/m 3 increment in NO 2 was 1.07, with a 5-day cumulative effect without seasonal variation. High consecutive levels of PM2.5 and NO 2 increase the risk of developing AECOPD. Cumulative effect of PM2.5 and NO 2 appears before the exacerbation onset. These gradations were more evident in the PM2.5 during different seasons. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Evaluation of Cumulative Ecosystem Response to Restoration Projects in the Lower Columbia River and Estuary, 2010

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

    Johnson, Gary E.; Diefenderfer, Heida L.; Thom, Ronald M.

    This is the seventh and final annual report of a project (2004–2010) addressing evaluation of the cumulative effects of habitat restoration actions in the 235-km-long lower Columbia River and estuary. The project, called the Cumulative Effects (CE) study, was conducted for the U.S. Army Corps of Engineers Portland District by a collaboration of research agencies led by the Pacific Northwest National Laboratory. We achieved the primary goal of the CE study to develop a methodology to evaluate the cumulative effects of habitat actions in the Columbia Estuary Ecosystem Restoration Program. We delivered 1) standard monitoring protocols and methods to prioritizemore » monitoring activities; 2) the theoretical and empirical basis for a CE methodology using levels-of-evidence; 3) evaluations of cumulative effects using ecological relationships, geo-referenced data, hydrodynamic modeling, and meta-analyses; and 4) an adaptive management process to coordinate and coalesce restoration efforts in the LCRE. A solid foundation has been laid for future comprehensive evaluations of progress made by the Columbia Estuary Ecosystem Restoration Program to understand, conserve, and restore ecosystems in the lower Columbia River and estuary.« less

  3. Cumulative biological impacts framework for solar energy projects in the California Desert

    USGS Publications Warehouse

    Davis, Frank W.; Kreitler, Jason R.; Soong, Oliver; Stoms, David M.; Dashiell, Stephanie; Hannah, Lee; Wilkinson, Whitney; Dingman, John

    2013-01-01

    This project developed analytical approaches, tools and geospatial data to support conservation planning for renewable energy development in the California deserts. Research focused on geographical analysis to avoid, minimize and mitigate the cumulative biological effects of utility-scale solar energy development. A hierarchical logic model was created to map the compatibility of new solar energy projects with current biological conservation values. The research indicated that the extent of compatible areas is much greater than the estimated land area required to achieve 2040 greenhouse gas reduction goals. Species distribution models were produced for 65 animal and plant species that were of potential conservation significance to the Desert Renewable Energy Conservation Plan process. These models mapped historical and projected future habitat suitability using 270 meter resolution climate grids. The results were integrated into analytical frameworks to locate potential sites for offsetting project impacts and evaluating the cumulative effects of multiple solar energy projects. Examples applying these frameworks in the Western Mojave Desert ecoregion show the potential of these publicly-available tools to assist regional planning efforts. Results also highlight the necessity to explicitly consider projected land use change and climate change when prioritizing areas for conservation and mitigation offsets. Project data, software and model results are all available online.

  4. Incidence Proportion of Acute Cor Pulmonale in Patients with Acute Respiratory Distress Syndrome Subjected to Lung Protective Ventilation: A Systematic Review and Meta-analysis.

    PubMed

    Das, Saurabh Kumar; Choupoo, Nang Sujali; Saikia, Priyam; Lahkar, Amitabh

    2017-06-01

    Reported incidence of acute cor pulmonale (ACP) in patients with acute respiratory distress syndrome (ARDS) varies from 10% to 84%, despite being subjected to lung protective ventilation according to the current guidelines. The objective of this review is to find pooled cumulative incidence of ACP in patients with ARDS undergoing lung protective ventilation. We searched MEDLINE, EMBASE, Cochrane Library, KoreaMed, LILACS, and WHO Clinical Trial Registry. Cross-sectional or cohort studies were included if they reported or provided data that could be used to calculate the incidence proportion of ACP. Inverse variance heterogeneity (IVhet) and random effect model were used for the main outcome and measures. We included 16 studies encompassing 1661 patients. The cumulative incidence of ACP using IVhet analysis was 23% (95% confidence interval [CI] = 18%-28%) over 3 days of lung protective ventilation. Random effect analysis of 7 studies (1250 patients) revealed pooled odd ratio of mortality of 1.16 (95% CI = 0.80-1.67, P = 0.44) due to ACP. Patients with ARDS have a 23% risk of developing ACP with lung protective ventilation. Findings of this review indicate the need of updating existing guidelines for ventilating ARDS patients to incorporate right ventricle protective strategy.

  5. Quantitative methods for analysing cumulative effects on fish migration success: a review.

    PubMed

    Johnson, J E; Patterson, D A; Martins, E G; Cooke, S J; Hinch, S G

    2012-07-01

    It is often recognized, but seldom addressed, that a quantitative assessment of the cumulative effects, both additive and non-additive, of multiple stressors on fish survival would provide a more realistic representation of the factors that influence fish migration. This review presents a compilation of analytical methods applied to a well-studied fish migration, a more general review of quantitative multivariable methods, and a synthesis on how to apply new analytical techniques in fish migration studies. A compilation of adult migration papers from Fraser River sockeye salmon Oncorhynchus nerka revealed a limited number of multivariable methods being applied and the sub-optimal reliance on univariable methods for multivariable problems. The literature review of fisheries science, general biology and medicine identified a large number of alternative methods for dealing with cumulative effects, with a limited number of techniques being used in fish migration studies. An evaluation of the different methods revealed that certain classes of multivariable analyses will probably prove useful in future assessments of cumulative effects on fish migration. This overview and evaluation of quantitative methods gathered from the disparate fields should serve as a primer for anyone seeking to quantify cumulative effects on fish migration survival. © 2012 The Authors. Journal of Fish Biology © 2012 The Fisheries Society of the British Isles.

  6. Modeling cumulative dose and exposure duration provided insights regarding the associations between benzodiazepines and injuries.

    PubMed

    Abrahamowicz, Michal; Bartlett, Gillian; Tamblyn, Robyn; du Berger, Roxane

    2006-04-01

    Accurate assessment of medication impact requires modeling cumulative effects of exposure duration and dose; however, postmarketing studies usually represent medication exposure by baseline or current use only. We propose new methods for modeling various aspects of medication use history and employment of them to assess the adverse effects of selected benzodiazepines. Time-dependent measures of cumulative dose or duration of use, with weighting of past exposures by recency, were proposed. These measures were then included in alternative versions of the multivariable Cox model to analyze the risk of fall related injuries among the elderly new users of three benzodiazepines (nitrazepam, temazepam, and flurazepam) in Quebec. Akaike's information criterion (AIC) was used to select the most predictive model for a given benzodiazepine. The best-fitting model included a combination of cumulative duration and current dose for temazepam, and cumulative dose for flurazepam and nitrazepam, with different weighting functions. The window of clinically relevant exposure was shorter for flurazepam than for the two other products. Careful modeling of the medication exposure history may enhance our understanding of the mechanisms underlying their adverse effects.

  7. Exposure to Violence Predicting Cortisol Response During Adolescence and Early Adulthood: Understanding Moderating Factors

    PubMed Central

    Heinze, Justin E.; Miller, Alison L.; Stoddard, Sarah A.; Zimmerman, Marc A.

    2014-01-01

    Previous research on the association between violence and biological stress regulation has been largely cross-sectional, and has also focused on childhood. Using longitudinal data from a low-income, high-risk, predominantly African-American sample (n = 266; 57 % female), we tested hypotheses about the influence of cumulative exposure to violence during adolescence and early adulthood on cortisol responses in early adulthood. We found that cumulative exposure to violence predicted an attenuated cortisol response. Further, we tested whether sex, mothers’ support, or fathers’ support moderated the effect of exposure to violence on cortisol responses. We found that the effect of cumulative exposure to violence on cortisol was modified by sex; specifically, males exposed to violence exhibited a more attenuated response pattern. In addition, the effect of cumulative exposure to violence on cortisol was moderated by the presence of fathers’ support during adolescence. The findings contribute to a better understanding of how cumulative exposure to violence influences biological outcomes, emphasizing the need to understand sex and parental support as moderators of risk. PMID:24458765

  8. U.S. EPA Authority to Use Cumulative Risk Assessments in Environmental Decision-Making

    PubMed Central

    Alves, Sarah; Tilghman, Joan; Rosenbaum, Arlene; Payne-Sturges, Devon C.

    2012-01-01

    Conventionally, in its decision-making, the U.S. EPA has evaluated the effects and risks associated with a single pollutant in a single exposure medium. In reality, people are exposed to mixtures of pollutants or to the same pollutant through a variety of media, including the air, water, and food. It is now more recognized than before that environmental exposure to pollutants occurs via multiple exposure routes and pathways, including inhalation, ingestion, and dermal absorption. Moreover, chemical, biologic, radiologic, physical, and psychologic stressors are all acknowledged as affecting human health. Although many EPA offices attempt to consider cumulative risk assessment and cumulative effects in various ways, there is no Agency-wide policy for considering these risks and the effects of exposure to these risks when making environmental decisions. This article examines how U.S. courts might assess EPA’s general authority and discretion to use cumulative risk assessment as the basis for developing data in support of environmental decision-making, and how courts might assess the validity of a cumulative risk assessment methodology itself. PMID:22829786

  9. Impact of post-colposcopy management on women's long-term worries: results from the UK population-based TOMBOLA trial.

    PubMed

    Sharp, Linda; Cotton, Seonaidh; Cruickshank, Margaret; Gray, Nicola; Smart, Louise; Whynes, David; Little, Julian

    2016-01-01

    Effective cervical screening reduces cancer incidence and mortality. However, these benefits may be accompanied by some harms, potentially including, adverse psychological impacts. Studies suggest women may have concerns about various specific issues, such as cervical cancer. To compare worries about cervical cancer, future fertility, having sex, and general health between women managed by alternative policies at colposcopy. Multicentre individually-randomised controlled trial, nested within the National Health Service Cervical Screening Programmes. UK. 1515 women, aged 20-59 years, with low-grade cytology who attended colposcopy during February 2001-October 2002, were randomised to immediate loop excision or punch biopsies with recall for treatment if cervical intraepithelial neoplasia (CIN)2/3 was confirmed. Women completed questionnaires at recruitment and after 12, 18, 24 and 30 months. Outcomes were prevalence of worries at each time-point (point prevalence) and at any time-point during follow-up (12-30 months; cumulative prevalence). Primary analysis was by intention-to-treat (ITT); secondary per-protocol analysis compared groups according to management received among women with an abnormal transformation zone. Cumulative prevalence of worries was: cervical cancer 40%; having sex 26%, future fertility 24%, and general health 60%. In ITT analyses, there were no statistically significant differences between management arms in cumulative or point prevalence of any of the worries. In per-protocol analyses, between-group differences were significant only for future fertility; cumulative prevalence was highest in women who underwent punch biopsies and treatment. There is no difference in the prevalence of specific worries in women randomised to alternative post-colposcopy management policies. 34841617. 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/

  10. Cumulative exposure to biologics and risk of cancer in psoriasis patients: A meta-analysis of Psonet studies from Israel, Italy, Spain, United Kingdom and Republic of Ireland.

    PubMed

    Garcia-Doval, I; Descalzo, M A; Mason, K J; Cohen, A D; Ormerod, A D; Gómez-García, F J; Cazzaniga, S; Feldhamer, I; Ali, H; Herrera-Acosta, E; Griffiths, C E M; Stern, R; Naldi, L

    2018-05-03

    Cancer risk following long-term exposure to systemic immunomodulatory therapies in psoriasis patients is possible. To assess a dose-response relationship between cumulative length of exposure to biologic therapy and risk of cancer. Four national studies (a healthcare database from Israel, and prospective cohorts form Italy, Spain and UK/ROI) collaborating through Psonet (European Registry of Psoriasis) participated in these nested case-control studies, including nearly 60.000 person-years of observation. Cases were patients who developed an incident cancer. Patients with previous cancers and benign or in-situ tumours were excluded. Four cancer-free controls were matched to each case on year of birth, gender, geographic area, and registration year. Follow-up for controls was censored at the date of cancer diagnosis for the matched case. Conditional logistic regression was performed by each registry. Results were pooled using random effects meta-analysis. 728 cases and 2671 controls were identified. After matching, differences between cases and controls were present for the Charlson comorbidity index in all three registries, and in the prevalence of previous exposure to psoralen-ultraviolet-A (PUVA) and smoking (BADBIR only). The risk of first cancers was not significantly associated with cumulative exposure to biologics (adjusted odds ratio per year of exposure 1.02; 95%CI 0.92, 1.13). Results were similar if squamous and basal cell carcinomas were included in the outcome. Cumulative length of exposure to biologic therapies of psoriasis patients in real-world clinical practice does not appear to be linked to a higher risk of cancer after several years of use. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  11. Ecological footprint analysis of environmental impacts by cascaded exploitation of diversion-type small hydropower: a case study in southwest china

    NASA Astrophysics Data System (ADS)

    Wang, Zhenhua; Li, Qingyun; Huang, Zhuo; Tang, Xianqiang; Zhao, Weihua

    2017-05-01

    Cascaded exploitation of diversion-type small hydropower (SHP) offers a source of new energy as well as socioeconomic benefits; however, it inevitably causes environmental disturbance and damage. Previous studies on the cumulative effect of cascaded diversion SHP rarely discussed using quantitative analysis method. In this paper, the ecological footprint analysis approach is proposed to assess the positive and negative impacts of cascaded diversion SHP on environment of a small-scale river in Southwest China. Positive impact is defined as ecological supply footprint (ESF), which refers to vegetation protection by replacing firewood with SHP. Negative impact is defined as ecological loss footprint (ELF), which includes fish and net primary productivity loss, vegetation destruction and soil erosion. With the raising in the number (n>4) of diversion SHP stations, the difference between ELF and ESF increases remarkably, suggesting that the adverse impacts of cascaded diversion SHP accumulate in the study area. Compared with vegetation destruction and soil erosion, the cumulative loss of fish and net productivity is the most important aspect of the adverse impacts which needs more attentions.

  12. A Framework to Assess the Cumulative Hydrological Impacts of Dams on flow Regime

    NASA Astrophysics Data System (ADS)

    Wang, Y.; Wang, D.

    2016-12-01

    In this study we proposed a framework to assess the cumulative impact of dams on hydrological regime, and the impacts of the Three Gorges Dam on flow regime in Yangtze River were investigated with the framework. We reconstructed the unregulated flow series to compare with the regulated flow series in the same period. Eco-surplus and eco-deficit and the Indicators of Hydrologic Alteration parameters were used to examine the hydrological regime change. Among IHA parameters, Wilcoxon signed-rank test and Principal Components Analysis identified the representative indicators of hydrological alterations. Eco-surplus and eco-deficit showed that the reservoir also changed the seasonal regime of the flows in autumn and winter. Annual extreme flows and October flows changes lead to negative ecological implications downstream from the Three Gorges Dam. Ecological operation for the Three Gorges Dam is necessary to mitigate the negative effects on the river ecosystem in the middle reach of Yangtze River. The framework proposed here could be a robust method to assess the cumulative impacts of reservoir operation.

  13. Cumulative Exposure Assessment for Trace-Level Polycyclic Aromatic Hydrocarbons (PAHs) using Human Blood and Plasma Analysis

    EPA Science Inventory

    Humans experience chronic cumulative trace-level exposure to mixtures of volatile, semi-volatile, and non-volatile polycyclic aromatic hydrocarbons (PAHs) present in the environment as by-products of combustion processes. Certain PAHs are known or suspected human carcinogens and ...

  14. Estimating the effect of immortal-time bias in urological research: a case example of testosterone-replacement therapy.

    PubMed

    Wallis, Christopher J D; Saskin, Refik; Narod, Steven A; Law, Calvin; Kulkarni, Girish S; Seth, Arun; Nam, Robert K

    2017-10-01

    To quantify the effect of immortal-time bias in an observational study examining the effect of cumulative testosterone exposure on mortality. We used a population-based matched cohort study of men aged ≥66 years, newly treated with testosterone-replacement therapy (TRT), and matched-controls from 2007 to 2012 in Ontario, Canada to quantify the effects of immortal-time bias. We used generalised estimating equations to determine the association between cumulative TRT exposure and mortality. Results produced by models using time-fixed and time-varying exposures were compared. Further, we undertook a systematic review of PubMed to identify studies addressing immortal-time bias or time-varying exposures in the urological literature and qualitatively summated these. Among 10 311 TRT-exposed men and 28 029 controls, the use of a time-varying exposure resulted in the attenuation of treatment effects compared with an analysis that did not account for immortal-time bias. While both analyses showed a decreased risk of death for patients in the highest tertile of TRT exposure, the effect was overestimated when using a time-fixed analysis (adjusted hazard ratio [aHR] 0.56, 95% confidence interval [CI]: 0.52-0.61) when compared to a time-varying analysis (aHR 0.67, 95% CI: 0.62-0.73). Of the 1 241 studies employing survival analysis identified in the literature, nine manuscripts met criteria for inclusion. Of these, five used a time-varying analytical method. Each of these was a large, population-based retrospective cohort study assessing potential harms of pharmacological agents. Where exposures vary over time, a time-varying exposure is necessary to draw meaningful conclusions. Failure to use a time-varying analysis will result in overestimation of a beneficial effect. However, time-varying exposures are uncommonly utilised among manuscripts published in prominent urological journals. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.

  15. Effect modification of the association of cumulative exposure and cancer risk by intensity of exposure and time since exposure cessation: a flexible method applied to cigarette smoking and lung cancer in the SYNERGY Study.

    PubMed

    Vlaanderen, Jelle; Portengen, Lützen; Schüz, Joachim; Olsson, Ann; Pesch, Beate; Kendzia, Benjamin; Stücker, Isabelle; Guida, Florence; Brüske, Irene; Wichmann, Heinz-Erich; Consonni, Dario; Landi, Maria Teresa; Caporaso, Neil; Siemiatycki, Jack; Merletti, Franco; Mirabelli, Dario; Richiardi, Lorenzo; Gustavsson, Per; Plato, Nils; Jöckel, Karl-Heinz; Ahrens, Wolfgang; Pohlabeln, Hermann; Tardón, Adonina; Zaridze, David; Field, John K; 't Mannetje, Andrea; Pearce, Neil; McLaughlin, John; Demers, Paul; Szeszenia-Dabrowska, Neonila; Lissowska, Jolanta; Rudnai, Peter; Fabianova, Eleonora; Stanescu Dumitru, Rodica; Bencko, Vladimir; Foretova, Lenka; Janout, Vladimir; Boffetta, Paolo; Forastiere, Francesco; Bueno-de-Mesquita, Bas; Peters, Susan; Brüning, Thomas; Kromhout, Hans; Straif, Kurt; Vermeulen, Roel

    2014-02-01

    The indiscriminate use of the cumulative exposure metric (the product of intensity and duration of exposure) might bias reported associations between exposure to hazardous agents and cancer risk. To assess the independent effects of duration and intensity of exposure on cancer risk, we explored effect modification of the association of cumulative exposure and cancer risk by intensity of exposure. We applied a flexible excess odds ratio model that is linear in cumulative exposure but potentially nonlinear in intensity of exposure to 15 case-control studies of cigarette smoking and lung cancer (1985-2009). Our model accommodated modification of the excess odds ratio per pack-year of cigarette smoking by time since smoking cessation among former smokers. We observed negative effect modification of the association of pack-years of cigarette smoking and lung cancer by intensity of cigarette smoke for persons who smoked more than 20-30 cigarettes per day. Patterns of effect modification were similar across individual studies and across major lung cancer subtypes. We observed strong negative effect modification by time since smoking cessation. Application of our method in this example of cigarette smoking and lung cancer demonstrated that reducing a complex exposure history to a metric such as cumulative exposure is too restrictive.

  16. Effect Modification of the Association of Cumulative Exposure and Cancer Risk by Intensity of Exposure and Time Since Exposure Cessation: A Flexible Method Applied to Cigarette Smoking and Lung Cancer in the SYNERGY Study

    PubMed Central

    Vlaanderen, Jelle; Portengen, Lützen; Schüz, Joachim; Olsson, Ann; Pesch, Beate; Kendzia, Benjamin; Stücker, Isabelle; Guida, Florence; Brüske, Irene; Wichmann, Heinz-Erich; Consonni, Dario; Landi, Maria Teresa; Caporaso, Neil; Siemiatycki, Jack; Merletti, Franco; Mirabelli, Dario; Richiardi, Lorenzo; Gustavsson, Per; Plato, Nils; Jöckel, Karl-Heinz; Ahrens, Wolfgang; Pohlabeln, Hermann; Tardón, Adonina; Zaridze, David; Field, John K.; 't Mannetje, Andrea; Pearce, Neil; McLaughlin, John; Demers, Paul; Szeszenia-Dabrowska, Neonila; Lissowska, Jolanta; Rudnai, Peter; Fabianova, Eleonora; Stanescu Dumitru, Rodica; Bencko, Vladimir; Foretova, Lenka; Janout, Vladimir; Boffetta, Paolo; Forastiere, Francesco; Bueno-de-Mesquita, Bas; Peters, Susan; Brüning, Thomas; Kromhout, Hans; Straif, Kurt; Vermeulen, Roel

    2014-01-01

    The indiscriminate use of the cumulative exposure metric (the product of intensity and duration of exposure) might bias reported associations between exposure to hazardous agents and cancer risk. To assess the independent effects of duration and intensity of exposure on cancer risk, we explored effect modification of the association of cumulative exposure and cancer risk by intensity of exposure. We applied a flexible excess odds ratio model that is linear in cumulative exposure but potentially nonlinear in intensity of exposure to 15 case-control studies of cigarette smoking and lung cancer (1985–2009). Our model accommodated modification of the excess odds ratio per pack-year of cigarette smoking by time since smoking cessation among former smokers. We observed negative effect modification of the association of pack-years of cigarette smoking and lung cancer by intensity of cigarette smoke for persons who smoked more than 20–30 cigarettes per day. Patterns of effect modification were similar across individual studies and across major lung cancer subtypes. We observed strong negative effect modification by time since smoking cessation. Application of our method in this example of cigarette smoking and lung cancer demonstrated that reducing a complex exposure history to a metric such as cumulative exposure is too restrictive. PMID:24355332

  17. Modeling the effect of comprehensive interventions on Ebola virus transmission

    NASA Astrophysics Data System (ADS)

    Shen, Mingwang; Xiao, Yanni; Rong, Libin

    2015-10-01

    Since the re-emergence of Ebola in West Africa in 2014, comprehensive and stringent interventions have been implemented to decelerate the spread of the disease. The effectiveness of interventions still remains unclear. In this paper, we develop an epidemiological model that includes various controlling measures to systematically evaluate their effects on the disease transmission dynamics. By fitting the model to reported cumulative cases and deaths in Guinea, Sierra Leone and Liberia until March 22, 2015, we estimate the basic reproduction number in these countries as 1.2552, 1.6093 and 1.7994, respectively. Model analysis shows that there exists a threshold of the effectiveness of isolation, below which increasing the fraction of latent individuals diagnosed prior to symptoms onset or shortening the duration between symptoms onset and isolation may lead to more Ebola infection. This challenges an existing view. Media coverage plays a substantial role in reducing the final epidemic size. The response to reported cumulative infected cases and deaths may have a different effect on the epidemic spread in different countries. Among all the interventions, we find that shortening the duration between death and burial and improving the effectiveness of isolation are two effective interventions for controlling the outbreak of Ebola virus infection.

  18. Modeling the effect of comprehensive interventions on Ebola virus transmission.

    PubMed

    Shen, Mingwang; Xiao, Yanni; Rong, Libin

    2015-10-30

    Since the re-emergence of Ebola in West Africa in 2014, comprehensive and stringent interventions have been implemented to decelerate the spread of the disease. The effectiveness of interventions still remains unclear. In this paper, we develop an epidemiological model that includes various controlling measures to systematically evaluate their effects on the disease transmission dynamics. By fitting the model to reported cumulative cases and deaths in Guinea, Sierra Leone and Liberia until March 22, 2015, we estimate the basic reproduction number in these countries as 1.2552, 1.6093 and 1.7994, respectively. Model analysis shows that there exists a threshold of the effectiveness of isolation, below which increasing the fraction of latent individuals diagnosed prior to symptoms onset or shortening the duration between symptoms onset and isolation may lead to more Ebola infection. This challenges an existing view. Media coverage plays a substantial role in reducing the final epidemic size. The response to reported cumulative infected cases and deaths may have a different effect on the epidemic spread in different countries. Among all the interventions, we find that shortening the duration between death and burial and improving the effectiveness of isolation are two effective interventions for controlling the outbreak of Ebola virus infection.

  19. Analysis and Presentation of Cumulative Antimicrobial Susceptibility Test Data--The Influence of Different Parameters in a Routine Clinical Microbiology Laboratory.

    PubMed

    Kohlmann, Rebekka; Gatermann, Sören G

    2016-01-01

    Many clinical microbiology laboratories report on cumulative antimicrobial susceptibility testing (cAST) data on a regular basis. Criteria for generation of cAST reports, however, are often obscure and inconsistent. Whereas the CLSI has published a guideline for analysis and presentation of cAST data, national guidelines directed at clinical microbiology laboratories are not available in Europe. Thus, we sought to describe the influence of different parameters in the process of cAST data analysis in the setting of a German routine clinical microbiology laboratory during 2 consecutive years. We developed various program scripts to assess the consequences ensuing from different algorithms for calculation of cumulative antibiograms from the data collected in our clinical microbiology laboratory in 2013 and 2014. One of the most pronounced effects was caused by exclusion of screening cultures for multi-drug resistant organisms which decreased the MRSA rate in some cases to one third. Dependent on the handling of duplicate isolates, i.e. isolates of the same species recovered from successive cultures on the same patient during the time period analyzed, we recorded differences in resistance rates of up to 5 percentage points for S. aureus, E. coli and K. pneumoniae and up to 10 percentage points for P. aeruginosa. Stratification by site of care and specimen type, testing of antimicrobials selectively on resistant isolates, change of interpretation rules and analysis at genus level instead of species level resulted in further changes of calculated antimicrobial resistance rates. The choice of parameters for cAST data analysis may have a substantial influence on calculated antimicrobial resistance rates. Consequently, comparability of cAST reports from different clinical microbiology laboratories may be limited. We suggest that laboratories communicate the strategy used for cAST data analysis as long as national guidelines for standardized cAST data analysis and reporting do not exist in Europe.

  20. Cumulative ecological and socioeconomic effects of forest policies in coastal Oregon.

    Treesearch

    T.A. Spies; K.N. Johnson; K.M. Burnett; J.L. Ohmann; B.C. McComb; G.H. Reeves; P. Bettinger; J.D. Kline; B. Garber-Yonts

    2007-01-01

    Forest biodiversity policies in multiownership landscapes are typically developed in an uncoordinated fashion with little consideration of their interactions or possible unintended cumulative effects. We conducted an assessment of some of the ecological and socioeconomic effects of recently enacted forest management policies in the 2.3-million-ha Coast Range...

  1. Validation of a two-generational reproduction test in Daphnia magna: An interlaboratory exercise.

    PubMed

    Barata, Carlos; Campos, Bruno; Rivetti, Claudia; LeBlanc, Gerald A; Eytcheson, Stephanie; McKnight, Stephanie; Tobor-Kaplon, Marysia; de Vries Buitenweg, Selinda; Choi, Suhyon; Choi, Jinhee; Sarapultseva, Elena I; Coutellec, Marie-Agnès; Coke, Maïra; Pandard, Pascal; Chaumot, Arnaud; Quéau, Hervé; Delorme, Nicolas; Geffard, Olivier; Martínez-Jerónimo, Fernando; Watanabe, Haruna; Tatarazako, Norihisa; Lopes, Isabel; Pestana, João L T; Soares, Amadeu M V M; Pereira, Cecilia Manuela; De Schamphelaere, Karel

    2017-02-01

    Effects observed within one generation disregard potential detrimental effects that may appear across generations. Previously we have developed a two generation Daphnia magna reproduction test using the OECD TG 211 protocol with a few amendments, including initiating the second generation with third brood neonates produced from first generation individuals. Here we showed the results of an inter-laboratory calibration exercise among 12 partners that aimed to test the robustness and consistency of a two generation Daphnia magna reproduction test. Pyperonyl butoxide (PBO) was used as a test compound. Following experiments, PBO residues were determined by TQD-LC/MS/MS. Chemical analysis denoted minor deviations of measured PBO concentrations in freshly prepared and old test solutions and between real and nominal concentrations in all labs. Other test conditions (water, food, D. magna clone, type of test vessel) varied across partners as allowed in the OECD test guidelines. Cumulative fecundity and intrinsic population growth rates (r) were used to estimate "No observed effect concentrations "NOEC using the solvent control as the control treatment. EC 10 and EC- 50 values were obtained regression analyses. Eleven of the twelve labs succeeded in meeting the OECD criteria of producing >60 offspring per female in control treatments during 21days in each of the two consecutive generations. Analysis of variance partitioning of cumulative fecundity indicated a relatively good performance of most labs with most of the variance accounted for by PBO (56.4%) and PBO by interlaboratory interactions (20.2%), with multigenerational effects within and across PBO concentrations explaining about 6% of the variance. EC 50 values for reproduction and population growth rates were on average 16.6 and 20.8% lower among second generation individuals, respectively. In summary these results suggest that the proposed assay is reproducible but cumulative toxicity in the second generation cannot reliably be detected with this assay. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. Cumulative and booster effects of tdcs sessions on drug cravings, lapse, and cognitive impairment in methamphetamine use disorder: A case study report.

    PubMed

    Shariatirad, Schwann; Vaziri, Alaleh; Hassani-Abharian, Peyman; Sharifi Fardshad, Mona; Molavi, Nader; Fitzgerald, Paul B

    2016-06-01

    Transcranial Direct Current Stimulation (tDCS) is a non-invasive brain stimulation method, which shows promising therapeutic effects in controlling drug cravings. In this study, we present cumulative and booster effects of tDCS sessions on methamphetamine cravings, lapse, and cognitive impairment in a methamphetamine dependent subject. Our study shows cumulative effects of continuous anodal tDCS sessions on right dorsolateral prefrontal cortex (DLPFC) could reduce drug cravings and their consequences. Moreover, booster tDCS treatments might be helpful in controlling psychological stress and drug cravings. (Am J Addict 2016;25:264-266). © 2016 American Academy of Addiction Psychiatry.

  3. Cumulative Risk of Guillain–Barré Syndrome Among Vaccinated and Unvaccinated Populations During the 2009 H1N1 Influenza Pandemic

    PubMed Central

    Iqbal, Shahed; Stewart, Brock; Tokars, Jerome; DeStefano, Frank

    2014-01-01

    Objectives. We sought to assess risk of Guillain–Barré syndrome (GBS) among influenza A (H1N1) 2009 monovalent (pH1N1) vaccinated and unvaccinated populations at the end of the 2009 pandemic. Methods. We applied GBS surveillance data from a US population catchment area of 45 million from October 15, 2009, through May 31, 2010. GBS cases meeting Brighton Collaboration criteria were included. We calculated the incidence density ratio (IDR) among pH1N1 vaccinated and unvaccinated populations. We also estimated cumulative GBS risk using life table analysis. Additionally, we used vaccine coverage data and census population estimates to calculate denominators. Results. There were 392 GBS cases; 64 (16%) occurred after pH1N1vaccination. The vaccinated population had lower average risk (IDR = 0.83, 95% confidence interval = 0.63, 1.08) and lower cumulative risk (6.6 vs 9.2 cases per million persons, P = .012) of GBS. Conclusions. Our findings suggest that at the end of the influenza season cumulative GBS risk was less among the pH1N1vaccinated than the unvaccinated population, suggesting the benefit of vaccination as it relates to GBS. The observed potential protective effect on GBS attributed to vaccination warrants further study. PMID:24524517

  4. Repeated exposure to high-frequency spanking and child externalizing behavior across the first decade: a moderating role for cumulative risk.

    PubMed

    MacKenzie, Michael J; Nicklas, Eric; Brooks-Gunn, Jeanne; Waldfogel, Jane

    2014-12-01

    This study used the Fragile Families and Child Well-Being Study to examine the effects of repeated exposure to harsh parenting on child externalizing behavior across the first decade of life, and a moderating role for cumulative ecological risk. Maternal report of harsh parenting, defined as high frequency spanking, was assessed at age 1, 3, 5, and 9, along with child externalizing at age 9 (N=2,768). Controlling for gender, race, maternal nativity, and city of residence, we found a cumulative risk index to significantly moderate the effects of repeated harsh parenting on child behavior, with the effects of repeated high-frequency spanking being amplified for those experiencing greater levels of cumulative risk. Harsh parenting, in the form of high frequency spanking, remains a too common experience for children, and results demonstrate that the effects of repeated exposure to harsh parenting across the first decade are amplified for those children already facing the most burden. Copyright © 2014. Published by Elsevier Ltd.

  5. Repeated exposure to high-frequency spanking and child externalizing behavior across the first decade: A moderating role for cumulative risk

    PubMed Central

    MacKenzie, Michael J.; Nicklas, Eric; Brooks-Gunn, Jeanne; Waldfogel, Jane

    2016-01-01

    This study used the Fragile Families and Child Well-being study to examine the effects of repeated exposure to harsh parenting on child externalizing behavior across the first decade of life, and a moderating role for cumulative ecological risk. Maternal report of harsh parenting, defined as high frequency spanking, was assessed at age 1, 3, 5, and 9, along with child externalizing at age 9 (N=2768). Controlling for gender, race, maternal nativity, and city of residence, we found a cumulative risk index to significantly moderate the effects of repeated harsh parenting on child behavior, with the effects of repeated high-frequency spanking being amplified for those experiencing greater levels of cumulative risk. Harsh parenting, in the form of high frequency spanking, remains a too common experience for children, and results demonstrate that the effects of repeated exposure to harsh parenting across the first decade are amplified for those children already facing the most burden. PMID:25465318

  6. 78 FR 25440 - Request for Information and Citations on Methods for Cumulative Risk Assessment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-01

    ... Citations on Methods for Cumulative Risk Assessment AGENCY: Office of the Science Advisor, Environmental... requesting information and citations on approaches and methods for the planning, analysis, assessment, and... approaches to understanding risks to human health and the environment. For example, in Science & Decisions...

  7. HESI EXPOSURE FACTORS DATABASE FOR AGGREGATE AND CUMULATIVE RISK ASSESSMENT

    EPA Science Inventory

    In recent years, the risk analysis community has broadened its use of complex aggregate and cumulative residential exposure models (e.g., to meet the requirements of the 1996 Food Quality Protection Act). The value of these models is their ability to incorporate a range of inp...

  8. Multiple Testing, Cumulative Radiation Dose, and Clinical Indications in Patients Undergoing Myocardial Perfusion Imaging

    PubMed Central

    Einstein, Andrew J.; Weiner, Shepard D.; Bernheim, Adam; Kulon, Michal; Bokhari, Sabahat; Johnson, Lynne L.; Moses, Jeffrey W.; Balter, Stephen

    2013-01-01

    Context Myocardial perfusion imaging (MPI) is the single medical test with the highest radiation burden to the US population. While many patients undergoing MPI receive repeat MPI testing, or additional procedures involving ionizing radiation, no data are available characterizing their total longitudinal radiation burden and relating radiation burden with reasons for testing. Objective To characterize procedure counts, cumulative estimated effective doses of radiation, and clinical indications, for patients undergoing MPI. Design, Setting, Patients Retrospective cohort study evaluating, for 1097 consecutive patients undergoing index MPI during the first 100 days of 2006 at Columbia University Medical Center, all preceding medical imaging procedures involving ionizing radiation undergone beginning October 1988, and all subsequent procedures through June 2008, at that center. Main Outcome Measures Cumulative estimated effective dose of radiation, number of procedures involving radiation, and indications for testing. Results Patients underwent a median (interquartile range, mean) of 15 (6–32, 23.9) procedures involving radiation exposure; 4 (2–8, 6.5) were high-dose (≥3 mSv, i.e. one year's background radiation), including 1 (1–2, 1.8) MPI studies per patient. 31% of patients received cumulative estimated effective dose from all medical sources >100mSv. Multiple MPIs were performed in 39% of patients, for whom cumulative estimated effective dose was 121 (81–189, 149) mSv. Men and whites had higher cumulative estimated effective doses, and there was a trend towards men being more likely to undergo multiple MPIs than women (40.8% vs. 36.6%, Odds ratio 1.29, 95% confidence interval 0.98–1.69). Over 80% of initial and 90% of repeat MPI exams were performed in patients with known cardiac disease or symptoms consistent with it. Conclusion In this institution, multiple testing with MPI was very common, and in many patients associated with very high cumulative estimated doses of radiation. PMID:21078807

  9. Analysis and design of randomised clinical trials involving competing risks endpoints.

    PubMed

    Tai, Bee-Choo; Wee, Joseph; Machin, David

    2011-05-19

    In randomised clinical trials involving time-to-event outcomes, the failures concerned may be events of an entirely different nature and as such define a classical competing risks framework. In designing and analysing clinical trials involving such endpoints, it is important to account for the competing events, and evaluate how each contributes to the overall failure. An appropriate choice of statistical model is important for adequate determination of sample size. We describe how competing events may be summarised in such trials using cumulative incidence functions and Gray's test. The statistical modelling of competing events using proportional cause-specific and subdistribution hazard functions, and the corresponding procedures for sample size estimation are outlined. These are illustrated using data from a randomised clinical trial (SQNP01) of patients with advanced (non-metastatic) nasopharyngeal cancer. In this trial, treatment has no effect on the competing event of loco-regional recurrence. Thus the effects of treatment on the hazard of distant metastasis were similar via both the cause-specific (unadjusted csHR = 0.43, 95% CI 0.25 - 0.72) and subdistribution (unadjusted subHR 0.43; 95% CI 0.25 - 0.76) hazard analyses, in favour of concurrent chemo-radiotherapy followed by adjuvant chemotherapy. Adjusting for nodal status and tumour size did not alter the results. The results of the logrank test (p = 0.002) comparing the cause-specific hazards and the Gray's test (p = 0.003) comparing the cumulative incidences also led to the same conclusion. However, the subdistribution hazard analysis requires many more subjects than the cause-specific hazard analysis to detect the same magnitude of effect. The cause-specific hazard analysis is appropriate for analysing competing risks outcomes when treatment has no effect on the cause-specific hazard of the competing event. It requires fewer subjects than the subdistribution hazard analysis for a similar effect size. However, if the main and competing events are influenced in opposing directions by an intervention, a subdistribution hazard analysis may be warranted.

  10. Activation of Antibiotic Production in Bacillus spp. by Cumulative Drug Resistance Mutations

    PubMed Central

    Tojo, Shigeo; Tanaka, Yukinori

    2015-01-01

    Bacillus subtilis strains produce a wide range of antibiotics, including ribosomal and nonribosomal peptide antibiotics, as well as bacilysocin and neotrehalosadiamine. Mutations in B. subtilis strain 168 that conferred resistance to drugs such as streptomycin and rifampin resulted in overproduction of the dipeptide antibiotic bacilysin. Cumulative drug resistance mutations, such as mutations in the mthA and rpsL genes, which confer low- and high-level resistance, respectively, to streptomycin, and mutations in rpoB, which confer resistance to rifampin, resulted in cells that overproduced bacilysin. Transcriptional analysis demonstrated that the enhanced transcription of biosynthesis genes was responsible for the overproduction of bacilysin. This approach was effective also in activating the cryptic genes of Bacillus amyloliquefaciens, leading to actual production of antibiotic(s). PMID:26369962

  11. High cumulants of conserved charges and their statistical uncertainties

    NASA Astrophysics Data System (ADS)

    Li-Zhu, Chen; Ye-Yin, Zhao; Xue, Pan; Zhi-Ming, Li; Yuan-Fang, Wu

    2017-10-01

    We study the influence of measured high cumulants of conserved charges on their associated statistical uncertainties in relativistic heavy-ion collisions. With a given number of events, the measured cumulants randomly fluctuate with an approximately normal distribution, while the estimated statistical uncertainties are found to be correlated with corresponding values of the obtained cumulants. Generally, with a given number of events, the larger the cumulants we measure, the larger the statistical uncertainties that are estimated. The error-weighted averaged cumulants are dependent on statistics. Despite this effect, however, it is found that the three sigma rule of thumb is still applicable when the statistics are above one million. Supported by NSFC (11405088, 11521064, 11647093), Major State Basic Research Development Program of China (2014CB845402) and Ministry of Science and Technology (MoST) (2016YFE0104800)

  12. Effects of B Vitamins Overload on Plasma Insulin Level and Hydrogen Peroxide Generation in Rats.

    PubMed

    Sun, Wuping; Zhai, Mingzhu; Zhou, Qian; Qian, Chengrui; Jiang, Changyu

    2017-08-31

    It has been reported that nicotinamide-overload induces oxidative stress associated with insulin resistance, the key feature of type 2 diabetes mellitus (T2DM). This study aimed to investigate the effects of B vitamins in T2DM. Glucose tolerance tests were carried out in adult Sprague-Dawley rats treated with or without cumulative doses of B vitamins. More specifically, insulin tolerance tests were also carried out in adult Sprague-Dawley rats treated with or without cumulative doses of Vitamin B3. We found that cumulative Vitamin B1 and Vitamin B3 administration significantly increased the plasma H₂O₂ levels associated with high insulin levels. Only Vitamin B3 reduced muscular and hepatic glycogen contents. Cumulative administration of nicotinic acid, another form of Vitamin B3, also significantly increased plasma insulin level and H₂O₂ generation. Moreover, cumulative administration of nicotinic acid or nicotinamide impaired glucose metabolism. This study suggested that excess Vitamin B1 and Vitamin B3 caused oxidative stress and insulin resistance.

  13. Atomic Oxygen Erosion of EVA-Stranded Soft-Goods on the ISS

    NASA Technical Reports Server (NTRS)

    Alred, John W.

    2017-01-01

    This paper presents the results of an analysis to calculate the cumulative, effective atomic oxygen (AO) flux impinging on short-duration EVA tethers used to secure panel NOD1/C2-02 and panel LAB/C2-03. Shadowing from the ram reduces the AO flux on much of the Node 1 panel. On the Lab panel, the tethers are essentially in the ram flux. Table 1 summarizes the results of the analysis for Node 1 and the US Lab panels.

  14. Modeling the cumulative watershed effects of forest management strategies

    Treesearch

    R. R. Ziemer; J. Lewis; R. M. Rice; T. E. Lisle

    1991-01-01

    Abstract - There is increasing concern over the possibility of adverse cumulative watershed effects from intensive forest management. It is impractical to address many aspects of the problem experimentally because to do so would require studying large watersheds for 100 yr or more. One such aspect is the long-term effect of forest management strategies on erosion and...

  15. Probabilistic structural analysis methods of hot engine structures

    NASA Technical Reports Server (NTRS)

    Chamis, C. C.; Hopkins, D. A.

    1989-01-01

    Development of probabilistic structural analysis methods for hot engine structures at Lewis Research Center is presented. Three elements of the research program are: (1) composite load spectra methodology; (2) probabilistic structural analysis methodology; and (3) probabilistic structural analysis application. Recent progress includes: (1) quantification of the effects of uncertainties for several variables on high pressure fuel turbopump (HPFT) turbine blade temperature, pressure, and torque of the space shuttle main engine (SSME); (2) the evaluation of the cumulative distribution function for various structural response variables based on assumed uncertainties in primitive structural variables; and (3) evaluation of the failure probability. Collectively, the results demonstrate that the structural durability of hot engine structural components can be effectively evaluated in a formal probabilistic/reliability framework.

  16. Conceptual and methodological challenges to integrating SEA and cumulative effects assessment

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

    Gunn, Jill, E-mail: jill.gunn@usask.c; Noble, Bram F.

    The constraints to assessing and managing cumulative environmental effects in the context of project-based environmental assessment are well documented, and the potential benefits of a more strategic approach to cumulative effects assessment (CEA) are well argued; however, such benefits have yet to be clearly demonstrated in practice. While it is widely assumed that cumulative effects are best addressed in a strategic context, there has been little investigation as to whether CEA and strategic environmental assessment (SEA) are a 'good fit' - conceptually or methodologically. This paper identifies a number of conceptual and methodological challenges to the integration of CEA andmore » SEA. Based on results of interviews with international experts and practitioners, this paper demonstrates that: definitions and conceptualizations of CEA are typically weak in practice; approaches to effects aggregation vary widely; a systems perspective lacks in both SEA and CEA; the multifarious nature of SEA complicates CEA; tiering arrangements between SEA and project-based assessment are limited to non-existing; and the relationship of SEA to regional planning remains unclear.« less

  17. Radiation exposure of ventilated trauma patients in intensive care: a retrospective study comparing two time periods.

    PubMed

    Yee, Micaela V; Barron, Rochelle A; Knobloch, Tom A; Pandey, Umesh; Twyford, Catherine; Freebairn, Ross C

    2012-08-01

    To describe the cumulative effective dose of radiation that was received during the initial Emergency Department assessment and ICU stay of patients admitted with trauma, who required mechanical ventilation, during two time periods. A retrospective analysis of radiological and clinical data, set in a regional nonurban ICU. Two cohorts (starting 1 January 2004 and 1 January 2009), each comprising 45 adult patients admitted with trauma who were mechanically ventilated in intensive care, were studied. Frequency and type of radiological examinations, demographic information, and clinical data were collated from the radiological database, hospital admission record and Australian Outcomes Research Tool for Intensive Care database. Cumulative effective doses were calculated and expressed as a total dose and average daily dose for each cohort. The median cumulative effective dose per patient (in milliSieverts) increased from 34.59 [interquartile range (IQR) 9.08-43.91] in 2004 to 40.51 (IQR 22.01-48.87) in 2009, P=0.045. An increased number of computed tomography examinations per patient was also observed over the same interval from an average of 2.11 (median 2, IQR 1-3) in 2004 to an average of 2.62 (2, 2-4) in 2009, P=0.046. The radiation exposure of mechanically ventilated trauma patients in intensive care has increased over time. Radiation exposure should be prospectively monitored and staff should be aware of the increased risk resulting from this change in practice.

  18. Lifetime endogenous estrogen exposure and electrocardiographic frontal T axis changes in postmenopausal women.

    PubMed

    Atsma, Femke; van der Schouw, Yvonne T; Grobbee, Diederick E; Kors, Jan A; Bartelink, Marie-Louise E L

    2009-08-20

    The protective effect of endogenous estrogens in cardiovascular disease may in part originate from effects of circulating estrogens on the electrophysiological properties of the myocardium. The aim of this study was to investigate the relation between reproductive factors and the electrocardiographic frontal T axis in postmenopausal women. Cohort study. The study was conducted at the University Medical Center Utrecht. In total, 998 postmenopausal women were included. Information of women's reproductive life was obtained by a questionnaire. Electrocardiographic frontal T axes were categorized as normal (25-65 degrees) or abnormal (-180 degrees to 24 degrees and 66-180 degrees). Logistic regression analysis was used to assess the relationship between reproductive factors and the frontal T axis. Moreover, the effect of the lifetime cumulative number of menstrual cycles, a composite measure of all reproductive factors, on the frontal T axis was investigated. The mean age was 66.0 (+/-5.6) years and 15.3% had T-axes abnormalities. Later menopausal age decreased the risk on frontal T-axis abnormalities; the multivariable adjusted odds ratio was 0.97 (95% CI: 0.94-0.99) per year increasing menopause. For the lifetime cumulative number of menstrual cycles the age-adjusted odds ratio was 0.84 (95% CI: 0.75-0.99) per 100 menstrual cycles increase. Later age at menopause and increasing lifetime cumulative number of menstrual cycles decreased the risk on frontal T-axis changes. This supports the view that estrogens may protect against ventricular repolarization disturbances.

  19. Cumulative effects of exposure to violence on posttraumatic stress in Palestinian and Israeli youth.

    PubMed

    Dubow, Eric F; Boxer, Paul; Huesmann, L Rowell; Landau, Simha; Dvir, Shira; Shikaki, Khalil; Ginges, Jeremy

    2012-01-01

    We examine cumulative and prospective effects of exposure to conflict and violence across four contexts (ethnic-political, community, family, school) on posttraumatic stress (PTS) symptoms in Palestinian and Israeli youth. Interviews were conducted with 600 Palestinian and 901 Israeli (Jewish and Arab) children (ages 8, 11, and 14) and their parents once a year for 3 consecutive years. Palestinian children, males, and older youth were generally at greatest risk for exposure to conflict/violence across contexts. Regression analysis found unique effects of exposure to ethnic-political (Palestinian sample), school (Palestinian and Israeli Jewish samples), and family conflict/violence (Israeli Arab sample) during the first 2 years on PTS symptoms in Year 3, controlling for prior PTS symptoms. Cumulative exposure to violence in more contexts during the first 2 years predicted higher subsequent PTS symptoms than did exposure to violence in fewer contexts, and this was true regardless of the youth's level of prior PTS symptoms. These results highlight the risk that ongoing exposure to violence across multiple contexts in the social ecology poses for the mental health of children in contexts of ethnic-political violence. Researchers and mental health professionals working with war-exposed youth in a given cultural context must assess both war- and non-war-related stressors affecting youth. Based on this assessment, interventions may not be limited to individual-based, war-trauma-focused approaches but also may include school-based, community-based, and family-level interventions.

  20. Effect of brucellosis vaccination and dehorning on transmission of bovine leukemia virus in heifers on a California dairy.

    PubMed Central

    Lassauzet, M L; Thurmond, M C; Johnson, W O; Stevens, F; Picanso, J P

    1990-01-01

    Brucellosis vaccination and dehorning were examined for an association with bovine leukemia virus (BLV) infection in heifers on a California dairy between April 1984 and June 1987. Between December 1985 and June 1986, weaned heifers were dehorned using the gouge method at the time of brucellosis vaccination. Using logistic regression, the estimated probability for a nondehorned heifer to seroconvert within three months after brucellosis vaccination (0.08) was significantly less than that for heifers dehorned after a noninfected heifer (0.46) or than that for heifers dehorned after an infected heifer (0.85) (p = 0.039 and p less than 0.001, respectively). To evaluate risk of transmission by brucellosis vaccination, which was usually done within one month postweaning, cumulative proportions of heifers remaining uninfected were computed among heifers that did not seroconvert three months after dehorning. Because results of a Cox model analysis indicated that groups of heifers were 6.6 times more at risk of becoming infected if placed in pens holding gouge-dehorned heifers (where prevalence varied between 50 and 70%) (p less than 0.001) than other groups placed in pens without gouge-dehorned heifers (where prevalence varied between 10 and 30%), cumulative proportions of heifers remaining uninfected were computed for each type of group. The cumulative proportion of heifers remaining uninfected from weaning to first calving was 0.60 for the high prevalence group and 0.96 for the low prevalence group. No change in slope of cumulative proportions was observed before and after one month postweaning, suggesting that brucellosis vaccination was not an effective means of transmission.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2155048

  1. A map of human impacts to a ``pristine'' coral reef ecosystem, the Papahānaumokuākea Marine National Monument

    NASA Astrophysics Data System (ADS)

    Selkoe, K. A.; Halpern, B. S.; Ebert, C. M.; Franklin, E. C.; Selig, E. R.; Casey, K. S.; Bruno, J.; Toonen, R. J.

    2009-09-01

    Effective and comprehensive regional-scale marine conservation requires fine-grained data on the spatial patterns of threats and their overlap. To address this need for the Papahānaumokuākea Marine National Monument (Monument) in Hawaii, USA, spatial data on 14 recent anthropogenic threats specific to this region were gathered or created, including alien species, bottom fishing, lobster trap fishing, ship-based pollution, ship strike risks, marine debris, research diving, research equipment installation, research wildlife sacrifice, and several anthropogenic climate change threats i.e., increase in ultraviolet (UV) radiation, seawater acidification, the number of warm ocean temperature anomalies relevant to disease outbreaks and coral bleaching, and sea level rise. These data were combined with habitat maps and expert judgment on the vulnerability of different habitat types in the Monument to estimate spatial patterns of current cumulative impact at 1 ha (0.01 km2) resolution. Cumulative impact was greatest for shallow reef areas and peaked at Maro Reef, where 13 of the 14 threats overlapped in places. Ocean temperature variation associated with disease outbreaks was found to have the highest predicted impact overall, followed closely by other climate-related threats, none of which have easily tractable management solutions at the regional scale. High impact threats most tractable to regional management relate to ship traffic. Sensitivity analyses show that the results are robust to both data availability and quality. Managers can use these maps to (1) inform management and surveillance priorities based on the ranking of threats and their distributions, (2) guide permitting decisions based on cumulative impacts, and (3) choose areas to monitor for climate change effects. Furthermore, this regional analysis can serve as a case study for managers elsewhere interested in assessing and mapping region-specific cumulative human impacts.

  2. Evaluation of mortality among marines and navy personnel exposed to contaminated drinking water at USMC base Camp Lejeune: a retrospective cohort study.

    PubMed

    Bove, Frank J; Ruckart, Perri Zeitz; Maslia, Morris; Larson, Theodore C

    2014-02-19

    Two drinking water systems at U.S. Marine Corps Base Camp Lejeune, North Carolina were contaminated with solvents during 1950s-1985. We conducted a retrospective cohort mortality study of Marine and Naval personnel who began service during 1975-1985 and were stationed at Camp Lejeune or Camp Pendleton, California during this period. Camp Pendleton's drinking water was uncontaminated. Mortality follow-up was 1979-2008. Standardized Mortality Ratios were calculated using U.S. mortality rates as reference. We used survival analysis to compare mortality rates between Camp Lejeune (N = 154,932) and Camp Pendleton (N = 154,969) cohorts and assess effects of cumulative exposures to contaminants within the Camp Lejeune cohort. Models estimated monthly contaminant levels at residences. Confidence intervals (CIs) indicated precision of effect estimates. There were 8,964 and 9,365 deaths respectively, in the Camp Lejeune and Camp Pendleton cohorts. Compared to Camp Pendleton, Camp Lejeune had elevated mortality hazard ratios (HRs) for all cancers (HR = 1.10, 95% CI: 1.00, 1.20), kidney cancer (HR = 1.35, 95% CI: 0.84, 2.16), liver cancer (HR = 1.42, 95% CI: 0.92, 2.20), esophageal cancer (HR = 1.43 95% CI: 0.85, 2.38), cervical cancer (HR = 1.33, 95% CI: 0.24, 7.32), Hodgkin lymphoma (HR = 1.47, 95% CI: 0.71, 3.06), and multiple myeloma (HR = 1.68, 95% CI: 0.76, 3.72). Within the Camp Lejeune cohort, monotonic categorical cumulative exposure trends were observed for kidney cancer and total contaminants (HR, high cumulative exposure = 1.54, 95% CI: 0.63, 3.75; log10 β = 0.06, 95% CI: -0.05, 0.17), Hodgkin lymphoma and trichloroethylene (HR, high cumulative exposure = 1.97, 95% CI: 0.55, 7.03; β = 0.00005, 95% CI: -0.00003, 0.00013) and benzene (HR, high cumulative exposure = 1.94, 95% CI: 0.54, 6.95; β = 0.00203, 95% CI: -0.00339, 0.00745). Amyotrophic Lateral Sclerosis (ALS) had HR = 2.21 (95% CI: 0.71, 6.86) at high cumulative vinyl chloride exposure but a non-monotonic exposure-response relationship (β = 0.0011, 95% CI: 0.0002, 0.0020). The study found elevated HRs at Camp Lejeune for several causes of death including cancers of the kidney, liver, esophagus, cervix, multiple myeloma, Hodgkin lymphoma and ALS. CIs were wide for most HRs. Because <6% of the cohort had died, long-term follow-up would be necessary to comprehensively assess effects of drinking water exposures at the base.

  3. Cumulative radiation exposure and cancer risk estimation in children with heart disease.

    PubMed

    Johnson, Jason N; Hornik, Christoph P; Li, Jennifer S; Benjamin, Daniel K; Yoshizumi, Terry T; Reiman, Robert E; Frush, Donald P; Hill, Kevin D

    2014-07-08

    Children with heart disease are frequently exposed to imaging examinations that use ionizing radiation. Although radiation exposure is potentially carcinogenic, there are limited data on cumulative exposure and the associated cancer risk. We evaluated the cumulative effective dose of radiation from all radiation examinations to estimate the lifetime attributable risk of cancer in children with heart disease. Children ≤6 years of age who had previously undergone 1 of 7 primary surgical procedures for heart disease at a single institution between 2005 and 2010 were eligible for the study. Exposure to radiation-producing examinations was tabulated, and cumulative effective dose was calculated in millisieverts. These data were used to estimate lifetime attributable risk of cancer above baseline using the approach of the Committee on Biological Effects of Ionizing Radiation VII. The cohort included 337 children exposed to 13 932 radiation examinations. Conventional radiographs represented 92% of examinations, whereas cardiac catheterization and computed tomography accounted for 81% of cumulative exposure. Overall median cumulative effective dose was 2.7 mSv (range, 0.1-76.9 mSv), and the associated lifetime attributable risk of cancer was 0.07% (range, 0.001%-6.5%). Median lifetime attributable risk of cancer ranged widely depending on surgical complexity (0.006%-1.6% for the 7 surgical cohorts) and was twice as high in females per unit exposure (0.04% versus 0.02% per 1-mSv effective dose for females versus males, respectively; P<0.001). Overall radiation exposures in children with heart disease are relatively low; however, select cohorts receive significant exposure. Cancer risk estimation highlights the need to limit radiation dose, particularly for high-exposure modalities. © 2014 American Heart Association, Inc.

  4. Occupational radon exposure and lung cancer mortality: estimating intervention effects using the parametric g-formula.

    PubMed

    Edwards, Jessie K; McGrath, Leah J; Buckley, Jessie P; Schubauer-Berigan, Mary K; Cole, Stephen R; Richardson, David B

    2014-11-01

    Traditional regression analysis techniques used to estimate associations between occupational radon exposure and lung cancer focus on estimating the effect of cumulative radon exposure on lung cancer. In contrast, public health interventions are typically based on regulating radon concentration rather than workers' cumulative exposure. Estimating the effect of cumulative occupational exposure on lung cancer may be difficult in situations vulnerable to the healthy worker survivor bias. Workers in the Colorado Plateau Uranium Miners cohort (n = 4,134) entered the study between 1950 and 1964 and were followed for lung cancer mortality through 2005. We use the parametric g-formula to compare the observed lung cancer mortality to the potential lung cancer mortality had each of 3 policies to limit monthly radon exposure been in place throughout follow-up. There were 617 lung cancer deaths over 135,275 person-years of follow-up. With no intervention on radon exposure, estimated lung cancer mortality by age 90 was 16%. Lung cancer mortality was reduced for all interventions considered, and larger reductions in lung cancer mortality were seen for interventions with lower monthly radon exposure limits. The most stringent guideline, the Mine Safety and Health Administration standard of 0.33 working-level months, reduced lung cancer mortality from 16% to 10% (risk ratio = 0.67 [95% confidence interval = 0.61 to 0.73]). This work illustrates the utility of the parametric g-formula for estimating the effects of policies regarding occupational exposures, particularly in situations vulnerable to the healthy worker survivor bias.

  5. CUMULATIVE EFFECTS OF THIRAM AND AMITRAZ ON PREGNANCY MAINTENANCE AND DEVELOPMENT IN THE RAT

    EPA Science Inventory

    Cumulative Effects of Thiram and Amitraz on Pregnancy Maintenance and Development in the Rat.

    Deborah S. Best, Michael G. Narotsky, and Ralph L. Cooper

    Reproductive Toxicology Division, NHEERL, ORD, US Environmental Protection Agency, Research Triangle Park, NC
    <...

  6. The Cumulative Effect of Stress on Preschool Children of Divorced and Intact Families.

    ERIC Educational Resources Information Center

    Hodges, William F.; And Others

    1984-01-01

    Investigated the response of 90 preschool children to their parents' divorce by looking at the cumulative effects of stressful life events, as reported by mothers and preschool teachers. Results indicated being from a divorced family predicted aggression, concentration problems, and acting out toward parents. (JAC)

  7. 7 CFR 1767.24 - Extraordinary items.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ....1Cumulative Effect on Prior Years of a Change in Accounting Principle Extraordinary Items 434Extraordinary... on Prior Years of a Change in Accounting Principle This account shall include the cumulative effect on margins of prior periods as a result of a change in accounting principle from one that is no...

  8. 75 FR 52360 - Upper Truckee River Restoration and Golf Course Reconfiguration Project, El Dorado County, CA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-25

    ...: Short-term risk of surface water or groundwater degradation during construction and short-term risk of surface water or groundwater degradation following construction. In addition, the cumulative effects of... cumulative beneficial effects: Long-term modified groundwater levels and flow patterns, long- term stream...

  9. Direct and indirect effects of child abuse and environmental stress: A lifecourse perspective on adversity and depressive symptoms.

    PubMed

    Sousa, Cindy; Mason, W Alex; Herrenkohl, Todd I; Prince, Dana; Herrenkohl, Roy C; Russo, M Jean

    2018-01-01

    There is a great deal of evidence about the mental health implications of physical child abuse and environmental stressors, or hardships that people experience at the household and neighborhood level (e.g., neighborhood violence; economic hardship, substance abuse, or conflict among family members). Yet, studies often focus on either abuse or environmental stress, not both, or examine abuse and environmental stressors as a combined set of experiences. Less is known, therefore, about how child abuse and environmental stress might work as either distinct or interrelated risks to diminish mental health over time. In this longitudinal study, we used path analyses to examine the cumulative effects of physical child abuse and environmental stressors on adult depressive symptoms among a sample of children followed into adulthood (N = 356). The goal was to assess whether chronic physical child abuse remains an independent predictor of adult outcomes once we accounted for the cumulative effects of household and neighborhood stressors across the lifecourse. Cumulative measures of physical child abuse and environmental stress each independently predicted a higher likelihood of adult depressive symptoms (ß = .122, p < .01 and ß = .283, p < .001, respectively). After accounting for adolescent depressive symptoms, only cumulative environmental stressors independently predicted depressive symptoms (ß = .202, p < .001). Tests of the indirect effect of cumulative environmental stress on the relationship between cumulative physical abuse and adult depressive symptoms were marginally statistically significant. Results add to literature that examines child abuse, adversity, and lifecourse perspectives on health. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  10. Bayesian Statistics in Educational Research: A Look at the Current State of Affairs

    ERIC Educational Resources Information Center

    König, Christoph; van de Schoot, Rens

    2018-01-01

    The ability of a scientific discipline to build cumulative knowledge depends on its predominant method of data analysis. A steady accumulation of knowledge requires approaches which allow researchers to consider results from comparable prior research. Bayesian statistics is especially relevant for establishing a cumulative scientific discipline,…

  11. Cumulating the Intellectual Gold of Case Study Research.

    ERIC Educational Resources Information Center

    Rodgers, Robert; Jensen, Jason L.

    2001-01-01

    Looks at criticisms of public administration research: (1) knowledge in the field is not being accumulated, and (2) the research has low quality. Proposes meta-analysis as a solution to the first problem. Suggests that quality judgments should be based on knowledge cumulation, which acknowledges the value of all research methods. (Contains 48…

  12. HEALTH AND ENVIRONMENTAL SCIENCES INSTITUTE'S EXPOSURE FACTORS DATABASE FOR AGGREGATE AND CUMULATIVE RISK ASSESSMENT

    EPA Science Inventory

    In recent years, the risk analysis community has broadened its use of complex aggregate and cumulative residential exposure models (e.g., to meet the requirements of the 1996 Food Quality Protection Act). The value of these models is their ability to incorporate a range of input...

  13. Inter-rater reliability of output measures for a posture matching assessment approach: a pilot study with food service workers.

    PubMed

    Cann, A P; Connolly, M; Ruuska, R; MacNeil, M; Birmingham, T B; Vandervoort, A A; Callaghan, J P

    2008-04-01

    Despite the ongoing health problem of repetitive strain injuries, there are few tools currently available for ergonomic applications evaluating cumulative loading that have well-documented evidence of reliability and validity. The purpose of this study was to determine the inter-rater reliability of a posture matching based analysis tool (3DMatch, University of Waterloo) for predicting cumulative and peak spinal loads. A total of 30 food service workers were each videotaped for a 1-h period while performing typical work activities and a single work task was randomly selected from each for analysis by two raters. Inter-rater reliability was determined using intraclass correlation coefficients (ICC) model 2,1 and standard errors of measurement for cumulative and peak spinal and shoulder loading variables across all subjects. Overall, 85.5% of variables had moderate to excellent inter-rater reliability, with ICCs ranging from 0.30-0.99 for all cumulative and peak loading variables. 3DMatch was found to be a reliable ergonomic tool when more than one rater is involved.

  14. Animal manure application and soil organic carbon stocks: a meta-analysis.

    PubMed

    Maillard, Émilie; Angers, Denis A

    2014-02-01

    The impact of animal manure application on soil organic carbon (SOC) stock changes is of interest for both agronomic and environmental purposes. There is a specific need to quantify SOC change for use in national greenhouse gas (GHG) emission inventories. We quantified the response of SOC stocks to manure application from a large worldwide pool of individual studies and determined the impact of explanatory factors such as climate, soil properties, land use and manure characteristics. Our study is based on a meta-analysis of 42 research articles totaling 49 sites and 130 observations in the world. A dominant effect of cumulative manure-C input on SOC response was observed as this factor explained at least 53% of the variability in SOC stock differences compared to mineral fertilized or unfertilized reference treatments. However, the effects of other determining factors were not evident from our data set. From the linear regression relating cumulative C inputs and SOC stock difference, a global manure-C retention coefficient of 12% ± 4 (95% Confidence Interval, CI) could be estimated for an average study duration of 18 years. Following an approach comparable to the Intergovernmental Panel on Climate Change, we estimated a relative SOC change factor of 1.26 ± 0.14 (95% CI) which was also related to cumulative manure-C input. Our results offer some scope for the refinement of manure retention coefficients used in crop management guidelines and for the improvement of SOC change factors for national GHG inventories by taking into account manure-C input. Finally, this study emphasizes the need to further document the long-term impact of manure characteristics such as animal species, especially pig and poultry, and manure management systems, in particular liquid vs. solid storage.

  15. Rate of Dehydration and Cumulative Desiccation Stress Interacted to Modulate Desiccation Tolerance of Recalcitrant Cocoa and Ginkgo Embryonic Tissues1

    PubMed Central

    Liang, Yongheng; Sun, Wendell Q.

    2002-01-01

    Rate of dehydration greatly affects desiccation tolerance of recalcitrant seeds. This effect is presumably related to two different stress vectors: direct mechanical or physical stress because of the loss of water and physicochemical damage of tissues as a result of metabolic alterations during drying. The present study proposed a new theoretic approach to represent these two types of stresses and investigated how seed tissues responded differently to two stress vectors, using the models of isolated cocoa (Theobroma cacao) and ginkgo (Ginkgo biloba) embryonic tissues dehydrated under various drying conditions. This approach used the differential change in axis water potential (ΔΨ/Δt) to quantify rate of dehydration and the intensity of direct physical stress experienced by embryonic tissues during desiccation. Physicochemical effect of drying was expressed by cumulative desiccation stress [∫\\documentclass[10pt]{article} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\pagestyle{empty} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} \\begin{equation*}{\\mathrm{_{o}^{t}}}\\end{equation*}\\end{document}f(ψ,t)], a function of both the rate and time of dehydration. Rapid dehydration increased the sensitivity of embryonic tissues to desiccation as indicated by high critical water contents, below which desiccation damage occurred. Cumulative desiccation stress increased sharply under slow drying conditions, which was also detrimental to embryonic tissues. This quantitative analysis of the stress-time-response relationship helps to understand the physiological basis for the existence of an optimal dehydration rate, with which maximum desiccation tolerance could be achieved. The established numerical analysis model will prove valuable for the design of experiments that aim to elucidate biochemical and physiological mechanisms of desiccation tolerance. PMID:11950981

  16. Cumulative Risk of Type 2 Diabetes in a Working Population: The Japan Epidemiology Collaboration on Occupational Health Study.

    PubMed

    Hu, Huanhuan; Nakagawa, Tohru; Okazaki, Hiroko; Nishiura, Chihiro; Imai, Teppei; Miyamoto, Toshiaki; Sasaki, Naoko; Yamamoto, Makoto; Murakami, Taizo; Kochi, Takeshi; Eguchi, Masafumi; Tomita, Kentaro; Nagahama, Satsue; Kuwahara, Keisuke; Kabe, Isamu; Mizoue, Tetsuya; Dohi, Seitaro

    2018-05-04

    We estimated the cumulative risk of type 2 diabetes from age 30 to 65 years in a large working population in Japan. We used data from the Japan Epidemiology Collaboration on Occupational Health Study. Participants (46,065 men and 7,763 women) were aged 30-59 years, free of diabetes at baseline, and followed up for a maximum of 7 years. Incident type 2 diabetes was defined based on fasting and casual glucose, glycated hemoglobin, and current medical treatment for type 2 diabetes. We calculated the sex-specific cumulative risk of type 2 diabetes using the Practical Incidence Estimator macro, which was created to produce several estimates of disease incidence for prospective cohort studies based on a modified Kaplan-Meier method. During 274,349 person-years of follow-up, 3,587 individuals (3,339 men and 248 women) developed type 2 diabetes. The cumulative risk was 34.7% (95% confidence interval, 33.1-36.3%) for men and 18.6% (95% confidence interval, 15.5-21.7%) for women. In BMI-stratified analysis, obese (BMI ≥30 kg/m 2 ) and overweight (BMI 25-29.9 kg/m 2 ) men and women had a much higher cumulative risk of type 2 diabetes (obese: 77.3% for men and 64.8% for women; overweight: 49.1% and 35.7%, respectively) than those with BMI <25 kg/m 2 (26.2% and 13.4% for men and women, respectively). The present data highlight the public health burden of type 2 diabetes in the working population. There is a need for effective programs for weight management and type 2 diabetes screening, especially for young obese employees, to prevent or delay the development of type 2 diabetes.

  17. Cumulative positive fluid balance is a risk factor for acute kidney injury and requirement for renal replacement therapy after liver transplantation.

    PubMed

    Codes, Liana; de Souza, Ygor Gomes; D'Oliveira, Ricardo Azevedo Cruz; Bastos, Jorge Luiz Andrade; Bittencourt, Paulo Lisboa

    2018-04-24

    To analyze whether fluid overload is an independent risk factor of adverse outcomes after liver transplantation (LT). One hundred and twenty-one patients submitted to LT were retrospectively evaluated. Data regarding perioperative and postoperative variables previously associated with adverse outcomes after LT were reviewed. Cumulative fluid balance (FB) in the first 12 h and 4 d after surgery were compared with major adverse outcomes after LT. Most of the patients were submitted to a liberal approach of fluid administration with a mean cumulative FB over 5 L and 10 L, respectively, in the first 12 h and 4 d after LT. Cumulative FB in 4 d was independently associated with occurrence of both AKI and requirement for renal replacement therapy (RRT) (OR = 2.3; 95%CI: 1.37-3.86, P = 0.02 and OR = 2.89; 95%CI: 1.52-5.49, P = 0.001 respectively). Other variables on multivariate analysis associated with AKI and RRT were, respectively, male sex and Acute Physiology and Chronic Health Disease Classification System (APACHE II) levels and sepsis or septic shock. Mortality was shown to be independently related to AST and APACHE II levels (OR = 2.35; 95%CI: 1.1-5.05, P = 0.02 and 2.63; 95%CI: 1.0-6.87, P = 0.04 respectively), probably reflecting the degree of graft dysfunction and severity of early postoperative course of LT. No effect of FB on mortality after LT was disclosed. Cumulative positive FB over 4 d after LT is independently associated with the development of AKI and the requirement of RRT. Survival was not independently related to FB, but to surrogate markers of graft dysfunction and severity of postoperative course of LT.

  18. The Role of Child Temperament on Head Start Preschoolers' Social Competence in the Context of Cumulative Risk

    ERIC Educational Resources Information Center

    Corapci, Feyza

    2008-01-01

    This study examined the main and interactive effects of cumulative risk and child temperament on teacher ratings of social competence and observer ratings of peer play in a sample of Head Start preschoolers. A cumulative risk index (CRI) was computed by summing the total number of risk factors for each family. There was a difference in the…

  19. Cumulative abuse: do things add up? An evaluation of the conceptualization, operationalization, and methodological approaches in the study of the phenomenon of cumulative abuse.

    PubMed

    Scott-Storey, Kelly

    2011-07-01

    For women, any one type of abuse rarely occurs in isolation of other types, and a single abusive experience is often the exception rather than the norm. The importance of this concept of the cumulative nature of abuse and its negative impact on health has been well recognized within the empirical literature, however there has been little consensus on what to call this phenomenon or how to study it. For the most part researchers have operated on the premise that it is the sheer number of different types of cumulating abuse experiences that is primarily responsible for worse health outcomes among women. And although this simplistic 'more is worse' approach to conceptualizing and operationalizing cumulative abuse has proven to be a powerful predictor of poorer health, it contradicts growing empirical evidence that suggests not all victimizations are created equal and that some victimizations may have a more deleterious effect on health than others. Embedded in abuse histories are individual and abuse characteristics as well as other life adversities that need to be considered in order to fully understand the spectrum and magnitude of cumulative abuse and its impact on women's health. Furthermore, given the long-term and persistent effects of abuse on health it becomes imperative to not only evaluate recent abusive experiences, but rather all abuse experiences occurring across the lifespan. This review highlights and evaluates the conceptual, operational, and methodological challenges posed by our current methods of studying and understanding the phenomenon of cumulative abuse and suggests that this phenomenon and its relationship to health is much more complex than research is currently portraying. This paper calls for the urgent need for interdisciplinary collaboration in order to more effectively and innovatively study the phenomenon of cumulative abuse.

  20. Learning by Doing, Scale Effects, or Neither? Cardiac Surgeons after Residency

    PubMed Central

    Huesch, Marco D

    2009-01-01

    Objective To examine impacts of operating surgeon scale and cumulative experience on postoperative outcomes for patients treated with coronary artery bypass grafts (CABG) by “new” surgeons. Pooled linear, fixed effects panel, and instrumented regressions were estimated. Data Sources The administrative data included comorbidities, procedures, and outcomes for 19,978 adult CABG patients in Florida in 1998–2006, and public data on 57 cardiac surgeons who completed residencies after 1997. Study Design Analysis was at the patient level. Controls for risk, hospital scale and scope, and operating surgeon characteristics were made. Patient choice model instruments were constructed. Experience was estimated allowing for “forgetting” effects. Principal Findings Panel regressions with surgeon fixed effects showed neither surgeon scale nor cumulative volumes significantly impacted mortality nor consistently impacted morbidity. Estimation of “forgetting” suggests that almost all prior experience is depreciated from one quarter to the next. Instruments were strong, but exogeneity of volume was not rejected. Conclusions In postresidency surgeons, no persuasive evidence is found for learning by doing, scale, or selection effects. More research is needed to support the cautious view that, for these “new” cardiac surgeons, patient volume could be redistributed based on realized outcomes without disruption. PMID:19732169

  1. Assessing the cumulative effects of linear recreation routes on wildlife habitats on the Okanogan and Wenatchee National Forests.

    Treesearch

    William L. Gaines; Peter H. Singleton; Roger C. Ross

    2003-01-01

    We conducted a literature review to document the effects of linear recreation routes on focal wildlife species. We identified a variety of interactions between focal species and roads, motorized trails, and nonmotorized trails. We used the available science to develop simple geographic information system-based models to evaluate the cumulative effects of recreational...

  2. Individual behavior, culture, and social change

    PubMed Central

    Glenn, Sigrid S.

    2004-01-01

    The principle of operant selection is examined as a prototype of cultural selection, and the role of the social environment is suggested as the critical element in the emergence of cultural phenomena. Operant contingencies are compared to cultural selection contingencies, designated as metacontingencies. Both of these types of contingency relations result in evolving lineages of recurrences that can become increasingly complex in the number and organization of their elements. In addition to its role in the recurring interlocking behavioral contingencies that constitute cultural organization, operant behavior plays another role in cultures. Although the operants of individuals are functionally independent of one another, the behavior of each person may contribute to a cumulative effect that is relevant to the well-being of many people. Similarly, the outcomes of metacontingencies may also contribute to a cumulative effect. The relation between independently evolving operant lineages, or between independently evolving cultural lineages, and their cumulative effect is identified as a macrocontingency. Macrocontingencies do not involve cultural-level selection per se. Effective cultural engineering requires identifying the macrocontingencies that produce less than desirable effects and altering the relevant operant contingencies or metacontingencies to produce change in the cumulative effects. PMID:22478424

  3. Life course pathways of adverse childhood experiences toward adult psychological well-being: A stress process analysis.

    PubMed

    Nurius, Paula S; Green, Sara; Logan-Greene, Patricia; Borja, Sharon

    2015-07-01

    Growing evidence suggests that toxic stressors early in life not only convey developmental impacts but also augment risk of proliferating chains of additional stressors that can overwhelm individual coping and undermine recovery and health. Examining trauma within a life course stress process perspective, we posit that early childhood adversity carries a unique capacity to impair adult psychological well-being both independent of and cumulative with other contributors, including social disadvantage and stressful adult experiences. This study uses data from a representative population-based health survey (N=13,593) to provide one of the first multivariate assessments of unique, cumulative, and moderated effects of adverse childhood experiences (ACEs) toward explaining 3 related yet distinct measures of adult mental health: perceived well-being, psychological distress, and impaired daily activities. Results demonstrate support for each set of hypothesized associations, including exacerbation and amelioration of ACEs effects by adult stress and resilience resources, respectively. Implications for services and future research are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Life Course Pathways of Adverse Childhood Experiences Toward Adult Psychological Well-Being: A Stress Process Analysis

    PubMed Central

    Nurius, Paula S.; Green, Sara; Logan-Greene, Patricia; Borja, Sharon

    2015-01-01

    Growing evidence suggests that toxic stressors early in life not only convey developmental impacts but also augment risk of proliferating chains of additional stressors that can overwhelm individual coping and undermine recovery and health. Examining trauma within a life course stress process perspective, we posit that early childhood adversity carries a unique capacity to impair adult psychological well-being both independent of and cumulative with other contributors, including social disadvantage and stressful adult experiences. This study uses data from a representative population-based health survey (N = 13,593) to provide one of the first multivariate assessments of unique, cumulative, and moderated effects of adverse childhood experiences (ACEs) toward explaining 3 related yet distinct measures of adult mental health: perceived well-being, psychological distress, and impaired daily activities. Results demonstrate support for each set of hypothesized associations, including exacerbation and amelioration of ACEs effects by adult stress and resilience resources, respectively. Implications for services and future research are discussed. PMID:25846195

  5. Employability and personal initiative as antecedents of job satisfaction.

    PubMed

    Gamboa, Juan Pablo; Gracia, Francisco; Ripoll, Pilar; Peiró, José María

    2009-11-01

    In a changing and flexible labour market it is important to clarify the role of environmental and personal variables that contribute to obtaining adequate levels of job satisfaction. The aim of the present study is to analyze the direct effects of employability and personal initiative on intrinsic, extrinsic and social job satisfaction, clarifying their cumulative and interactive effects. The study has been carried out in a sample of 1319 young Spanish workers. Hypotheses were tested by means of the moderated hierarchical regression analysis. Results show that employability and personal initiative predict in a cumulative way the intrinsic, extrinsic and social job satisfaction. Moreover, the interaction between employability and personal initiative increases the prediction of these two variables on intrinsic and extrinsic job satisfaction. Results also indicate that higher values of employability when initiative is also high are associated to higher levels of intrinsic and extrinsic satisfaction. These results have implications for theory and practice in a context of new employment relations.

  6. Effect of Different Sugar Beet Pulp Pretreatments on Biogas Production Efficiency.

    PubMed

    Ziemiński, Krzysztof; Kowalska-Wentel, Monika

    2017-03-01

    The objective of this study was to determine the effect of different sugar beet pulp (SBP) pretreatments on biogas yield from anaerobic digestion. SBP was subjected to grinding, thermal-pressure processing, enzymatic hydrolysis, or combination of these pretreatments. It was observed that grinding of SBP to 2.5-mm particles resulted in the cumulative biogas productivity of 617.2 mL/g volatile solids (VS), which was 20.2 % higher compared to the biogas yield from the not pretreated SBP, and comparable to that from not ground, enzymatically hydrolyzed SBP. The highest cumulative biogas productivity, 898.7 mL/g VS, was obtained from the ground, thermal-pressure pretreated and enzymatically hydrolyzed SBP. The latter pretreatment variant enabled to achieve the highest glucose concentration (24.765 mg/mL) in the enzymatic hydrolysates. The analysis of energy balance showed that the increase in the number of SBP pretreatment operations significantly reduced the gain of electric energy.

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

    PubMed Central

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

    2015-01-01

    The purpose of this study was to identify differences in the incidence characteristics of coal workers’ pneumoconiosis (CWP) based on data from four large state-owned colliery groups of China, by comparing the cumulative incidence rates of CWP. We investigated 87,904 coal workers from the Datong, Kailuan, Fuxin, and Tiefa Colliery Groups, who were exposed to dust for at least 1 year. The cumulative incidence rate of CWP was calculated with the life-table method and stratified analysis among coal workers with different occupational categories during different years of first dust exposure. Our results showed the cumulative incidence rate of Datong was higher than that of any other colliery group among workers with different occupational categories during different years of first dust exposure. For Datong workers who started their dust exposure in the 1970s, the cumulative incidence rates of CWP among tunneling, mining, combining, and helping workers were 34.77%, 10.20%, 34.59%, and 4.91% during the observed time of 34 years, respectively. For those in the 1980s, the cumulative incidence rates were 32.29%, 13.51%, 2.98%, and 0.47%, respectively. The cumulative incidence rates of Fuxin and Tiefa were the lowest. In conclusion, the Datong colliery has the highest cumulative incidence rate of CWP among the four studied collieries, followed by Kailuan. The cumulative incidence rates of Fuxin and Tiefa were the lowest. Additional dust-proofing measures for decreasing dust concentrations are still necessary. PMID:26133134

  8. Cumulative iron dose and resistance to erythropoietin.

    PubMed

    Rosati, A; Tetta, C; Merello, J I; Palomares, I; Perez-Garcia, R; Maduell, F; Canaud, B; Aljama Garcia, P

    2015-10-01

    Optimizing anemia treatment in hemodialysis (HD) patients remains a priority worldwide as it has significant health and financial implications. Our aim was to evaluate in a large cohort of chronic HD patients in Fresenius Medical Care centers in Spain the value of cumulative iron (Fe) dose monitoring for the management of iron therapy in erythropoiesis-stimulating agent (ESA)-treated patients, and the relationship between cumulative iron dose and risk of hospitalization. Demographic, clinical and laboratory parameters from EuCliD(®) (European Clinical Dialysis Database) on 3,591 patients were recorded including ESA dose (UI/kg/week), erythropoietin resistance index (ERI) [U.I weekly/kg/gr hemoglobin (Hb)] and hospitalizations. Moreover the cumulative Fe dose (mg/kg of bodyweight) administered over the last 2 years was calculated. Univariate and multivariate analyses were performed to identify the main predictors of ESA resistance and risk of hospitalization. Patients belonging to the 4th quartile of ERI were defined as hypo-responders. The 2-year iron cumulative dose was significantly higher in the 4th quartile of ERI. In hypo-responders, 2-year cumulative iron dose was the only iron marker associated with ESA resistance. At case-mix adjusted multivariate analysis, 2-year iron cumulative dose was an independent predictor of hospitalization risk. In ESA-treated patients cumulative Fe dose could be a useful tool to monitor the appropriateness of Fe therapy and to prevent iron overload. To establish whether the associations between cumulative iron dose, ERI and hospitalization risk are causal or attributable to selection bias by indication, clinical trials are necessary.

  9. Effect of co-medication on the pharmacokinetic parameters of phenobarbital in asphyxiated newborns.

    PubMed

    Šíma, M; Pokorná, P; Hronová, K; Slanař, O

    2015-01-01

    Phenobarbital is an anticonvulsive drug widely used in newborns with hypoxic-ischemic encephalopathy. The objective of our study was to describe possible effect of frequently co-administered medications (dopamine, dobutamine, norepinephrine, furosemide, phenytoin, and analgesics) on the phenobarbital pharmacokinetics in full term newborns with hypoxic-ischemic encephalopathy. Phenobarbital pharmacokinetic parameters (standardized intravenous loading dose was 10-20 mg/kg, maintenance dose 2-6 mg/kg/day) were computed using non-compartmental analysis. Co-medication was evaluated throughout the whole treatment period up to 5 days. Volume of distribution, clearance, and half-life median values (95 % CI) for phenobarbital in the whole study population (n=37) were 0.48 (0.41-0.56) l/kg, 0.0034 (0.0028-0.0040) l/h/kg, and 93.7 (88.1-99.2) h, respectively. Phenobarbital pharmacokinetic parameters were not significantly affected by vasoactive drugs (dopamine, dobutamine, and norepinephrine), furosemide, phenytoin, or analgesics. Furthermore, no dose-dependent alteration of phenobarbital pharmacokinetic parameters was noted for vasoactive medication at doses equivalent to cumulative vasoactive-inotropic score (area under the curve in a plot of vasoactive-inotropic score against time) 143.2-8473.6, furosemide at cumulative doses of 0.2-42.9 mg/kg, or phenytoin at cumulative doses of 10.3-46.2 mg/kg. Phenobarbital pharmacokinetics was not affected by investigated co-administered drugs used in newborns with hypoxic-ischemic encephalopathy in real clinical settings.

  10. Independent and combined effects of resting heart rate and pulse pressure with metabolic syndrome in Chinese rural population: The Henan Rural Cohort study.

    PubMed

    Zhang, Xia; Li, Yuqian; Wang, Fang; Zang, Jianguo; Liu, Xiaotian; Zhang, Honglei; Yang, Kaili; Zhang, Gongyuan; Wang, Chongjian

    2018-06-07

    We examined the independent and cumulative associations of resting heart rate and pulse pressure with metabolic syndrome in Chinese rural population based on epidemiological research. A total of 38,708 participants were derived from the Henan Rural Cohort study. Restricted cubic splines and logistic regression model were used to estimate the odds ratios and 95% confidence intervals of metabolic syndrome risk in relation to resting heart rate and pulse pressure. After adjusting for potential confounders, the odds ratio (95% confidence intervals) of resting heart rate and pulse pressure in the highest quartile with the risk of metabolic syndrome were 1.59 (1.48-1.70) and1.81 (1.67-1.95), respectively. Simultaneously, the cumulative effect analysis indicated that the adjusted the odd ratio of resting heart rate and pulse pressure in the highest quartile was 2.89 (2.40-3.47). Furthermore, there was a significantly additive interaction between resting heart rate and pulse pressure on the risk of metabolic syndrome. Increased resting heart rate and pulse pressure are associated with the higher risk of metabolic syndrome as well as the influences of resting heart rate with pulse pressure might cumulatively increase the risk of metabolic syndrome. However, the potential clinical application remains to be determined. Copyright © 2018. Published by Elsevier B.V.

  11. Can superior natural amenities create high-quality employment opportunities? The case of nonconsumptive river recreation in central Idaho

    USGS Publications Warehouse

    McKean, J.R.; Johnson, D.M.; Johnson, Richard L.; Taylor, R.G.

    2005-01-01

    Central Idaho has superior environmental amenities, as evidenced by exceptionally high-value tourism, such as guided whitewater rafting. The focus of our study concerns the attainment of high-quality jobs in a high-quality natural environment. We estimate cumulative wage rate effects unique to nonconsumptive river recreation in central Idaho for comparison with other sectors. The cumulative effects are based on a detailed survey of recreation spending and a modified synthesized input–output model. Cumulative wage rate effects support using the abundance of environmental amenities to expand and attract high-wage, environmentally sensitive firms, as opposed to expanded tourism to improve employment quality.

  12. Developing statistical wildlife habitat relationships for assessing cumulative effects of fuels treatments: Final Report for Joint Fire Science Program Project

    Treesearch

    Samuel A. Cushman; Kevin S. McKelvey

    2006-01-01

    The primary weakness in our current ability to evaluate future landscapes in terms of wildlife lies in the lack of quantitative models linking wildlife to forest stand conditions, including fuels treatments. This project focuses on 1) developing statistical wildlife habitat relationships models (WHR) utilizing Forest Inventory and Analysis (FIA) and National Vegetation...

  13. The Impact of Female Schooling on Fertility and Contraceptive Use: A Study of Fourteen Sub-Saharan Countries. Living Standards Measurement Study Working Paper No. 110.

    ERIC Educational Resources Information Center

    Ainsworth, Martha; And Others

    This paper examines the relationship between female schooling and two behaviors--cumulative fertility and contraceptive use--in 14 Sub-Saharan African countries where Demographic and Health Surveys (DHS) have been conducted since the mid-1980s. Using multivariate regression analysis, the paper compares the effect of schooling across countries, in…

  14. Is Tomorrow Another Day? The Labor Supply of New York City Cabdrivers.

    ERIC Educational Resources Information Center

    Farber, Henry S.

    2005-01-01

    The labor supply of taxi drivers is consistent with the existence of intertemporal substitution. My analysis of the stopping behavior of New York City cabdrivers shows that daily income effects are small and that the decision to stop work at a particular point on a given day is primarily related to cumulative daily hours to that point. This is in…

  15. The EPA's human exposure research program for assessing cumulative risk in communities.

    PubMed

    Zartarian, Valerie G; Schultz, Bradley D

    2010-06-01

    Communities are faced with challenges in identifying and prioritizing environmental issues, taking actions to reduce their exposures, and determining their effectiveness for reducing human health risks. Additional challenges include determining what scientific tools are available and most relevant, and understanding how to use those tools; given these barriers, community groups tend to rely more on risk perception than science. The U.S. Environmental Protection Agency's Office of Research and Development, National Exposure Research Laboratory (NERL) and collaborators are developing and applying tools (models, data, methods) for enhancing cumulative risk assessments. The NERL's "Cumulative Communities Research Program" focuses on key science questions: (1) How to systematically identify and prioritize key chemical stressors within a given community?; (2) How to develop estimates of exposure to multiple stressors for individuals in epidemiologic studies?; and (3) What tools can be used to assess community-level distributions of exposures for the development and evaluation of the effectiveness of risk reduction strategies? This paper provides community partners and scientific researchers with an understanding of the NERL research program and other efforts to address cumulative community risks; and key research needs and opportunities. Some initial findings include the following: (1) Many useful tools exist for components of risk assessment, but need to be developed collaboratively with end users and made more comprehensive and user-friendly for practical application; (2) Tools for quantifying cumulative risks and impact of community risk reduction activities are also needed; (3) More data are needed to assess community- and individual-level exposures, and to link exposure-related information with health effects; and (4) Additional research is needed to incorporate risk-modifying factors ("non-chemical stressors") into cumulative risk assessments. The products of this research program will advance the science for cumulative risk assessments and empower communities with information so that they can make informed, cost-effective decisions to improve public health.

  16. Unified framework for triaxial accelerometer-based fall event detection and classification using cumulants and hierarchical decision tree classifier.

    PubMed

    Kambhampati, Satya Samyukta; Singh, Vishal; Manikandan, M Sabarimalai; Ramkumar, Barathram

    2015-08-01

    In this Letter, the authors present a unified framework for fall event detection and classification using the cumulants extracted from the acceleration (ACC) signals acquired using a single waist-mounted triaxial accelerometer. The main objective of this Letter is to find suitable representative cumulants and classifiers in effectively detecting and classifying different types of fall and non-fall events. It was discovered that the first level of the proposed hierarchical decision tree algorithm implements fall detection using fifth-order cumulants and support vector machine (SVM) classifier. In the second level, the fall event classification algorithm uses the fifth-order cumulants and SVM. Finally, human activity classification is performed using the second-order cumulants and SVM. The detection and classification results are compared with those of the decision tree, naive Bayes, multilayer perceptron and SVM classifiers with different types of time-domain features including the second-, third-, fourth- and fifth-order cumulants and the signal magnitude vector and signal magnitude area. The experimental results demonstrate that the second- and fifth-order cumulant features and SVM classifier can achieve optimal detection and classification rates of above 95%, as well as the lowest false alarm rate of 1.03%.

  17. The U.S. Forest Service's analysis of cumulative effects to wildlife: A study of legal standards, current practice, and ongoing challenges on a National Forest

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

    Schultz, Courtney A., E-mail: courtney.schultz@colostate.edu

    Cumulative effects analysis (CEA) allows natural resource managers to understand the status of resources in historical context, learn from past management actions, and adapt future activities accordingly. U.S. federal agencies are required to complete CEA as part of environmental impact assessment under the National Environmental Policy Act (NEPA). Past research on CEA as part of NEPA has identified significant deficiencies in CEA practice, suggested methodologies for handling difficult aspects of CEA, and analyzed the rise in litigation over CEA in U.S. courts. This article provides a review of the literature and legal standards related to CEA as it is donemore » under NEPA and then examines current practice on a U.S. National Forest, utilizing qualitative methods in order to provide a detailed understanding of current approaches to CEA. Research objectives were to understand current practice, investigate ongoing challenges, and identify impediments to improvement. Methods included a systematic review of a set of NEPA documents and semi-structured interviews with practitioners, scientists, and members of the public. Findings indicate that the primary challenges associated with CEA include: issues of both geographic and temporal scale of analysis, confusion over the purpose of the requirement, the lack of monitoring data, and problems coordinating and disseminating data. Improved monitoring strategies and programmatic analyses could support improved CEA practice.« less

  18. Multiple thrombophilic single nucleotide polymorphisms lack a significant effect on outcomes in fresh IVF cycles: an analysis of 1717 patients.

    PubMed

    Patounakis, George; Bergh, Eric; Forman, Eric J; Tao, Xin; Lonczak, Agnieszka; Franasiak, Jason M; Treff, Nathan; Scott, Richard T

    2016-01-01

    The aim of the study is to determine if thrombophilic single nucleotide polymorphisms (SNPs) affect outcomes in fresh in vitro fertilization (IVF) cycles in a large general infertility population. A prospective cohort analysis was performed at a university-affiliated private IVF center of female patients undergoing fresh non-donor IVF cycles. The effect of the following thrombophilic SNPs on IVF outcomes were explored: factor V (Leiden and H1299R), prothrombin (G20210A), factor XIII (V34L), β-fibrinogen (-455G → A), plasminogen activator inhibitor-1 (4G/5G), human platelet antigen-1 (a/b9L33P), and methylenetetrahydrofolate reductase (C677T and A1298C). The main outcome measures included positive pregnancy test, clinical pregnancy, embryo implantation, live birth, and pregnancy loss. Patients (1717) were enrolled in the study, and a total of 4169 embryos were transferred. There were no statistically significant differences in positive pregnancy test, clinical pregnancy, embryo implantation, live birth, or pregnancy loss in the analysis of 1717 patients attempting their first cycle of IVF. Receiver operator characteristics and logistic regression analyses showed that outcomes cannot be predicted by the cumulative number of thrombophilic mutations present in the patient. Individual and cumulative thrombophilic SNPs do not affect IVF outcomes. Therefore, initial screening for these SNPs is not indicated.

  19. Effects of whole body vibration on bone mineral density in postmenopausal women: a systematic review and meta-analysis.

    PubMed

    Oliveira, L C; Oliveira, R G; Pires-Oliveira, D A A

    2016-10-01

    This systematic review and meta-analysis of randomized controlled trials (RCTs) identified significant effects of whole body vibration (WBV) on bone mineral density (BMD) of the lumbar spine (in the sensitivity analysis and seven subgroup analyses), femoral neck (in one subgroup analysis), and trochanter (four subgroup analyses) in postmenopausal women, but not other measurements of BMD. Interventions using WBV training have been conducted in postmenopausal women, aimed at increasing BMD; however, the results are contradictory. Our objective is to conduct a systematic review and meta-analysis of RCTs examining WBV effect on BMD. RCTs were considered eligible, with follow-up ≥6 months, which verified the effects of WBV on the BMD of postmenopausal women. The calculations of the meta-analysis were performed through the weighted mean difference between the WBV and control groups, or the WBV and combined training, through the absolute change between pre- and post-intervention in the areal bone mineral density (aBMD) or trabecular volumetric bone mineral density (vBMDt). Fifteen RCTs were included in the meta-analysis. No differences were observed in the primary analysis. WBV was found to improve aBMD compared with the control group, after exclusion of studies with low quality methodological (lumbar spine), when excluding the studies which combined WBV with medication or combined training (lumbar spine), with the use of low frequency and high magnitude (lumbar spine and trochanter), high frequency and low magnitude (lumbar spine), high cumulative dose and low magnitude (lumbar spine), low cumulative dose and high magnitude (lumbar spine and trochanter), with semi-flexed knee (lumbar spine, femoral neck, and trochanter), and side-alternating type of vibration (lumbar spine and trochanter). Despite WBV presenting potential to act as a coadjuvant in the prevention or treatment of osteoporosis, especially for aBMD of the lumbar spine, the ideal intervention is not yet clear. Our subgroup analyses helped to demonstrate the various factors which appear to influence the effects of WBV on BMD, contributing to clinical practice and the definition of protocols for future interventions.

  20. Progression of Unresected Intraductal Papillary Mucinous Neoplasms of the Pancreas to Cancer: A Systematic Review and Meta-analysis.

    PubMed

    Choi, Sang Hyun; Park, Seong Ho; Kim, Kyung Won; Lee, Ja Youn; Lee, Sang Soo

    2017-10-01

    It is not clear how best to manage patients with low-risk intraductal papillary mucinous neoplasms (IPMNs) of the pancreas because little is known about IPMN progression to cancer. We sought to determine the cumulative incidence of development of pancreatic cancer in persons with unresected IPMNs (particularly low-risk IPMNs). We performed a systematic search of the MEDLINE and Embase databases through November 30, 2016 for studies reporting the cumulative incidence of pancreatic cancer in patients with unresected IPMNs or studies that provided data in sufficient detail for us to calculate cumulative incidence values. We categorized patient series as studies on low-risk IPMNs (lesions without main pancreatic duct involvement or mural nodules) or non-low-risk IPMNs. We calculated meta-analytic cumulative incidence values for pancreatic cancer at 1, 3, 5, and 10 years of follow-up by using the inverse variance method and random-effects model. Among 1514 articles screened, we identified 10 studies of low-risk IPMNs (n = 2411) and 9 studies of non-low-risk IPMNs (n = 825). In studies of low-risk IPMNs, the meta-analytic cumulative incidence values for pancreatic cancer were 0.02% at 1 year (95% confidence interval [CI], 0.0%-0.23%; I 2 = 0.0%), 1.40% at 3 years (95% CI, 0.58%-2.48%; I 2  = 58.5%), 3.12% at 5 years (95% CI, 1.12%-5.90%; I 2  = 88.0%), and 7.77% at 10 years (95% CI, 4.09%-12.39%; I 2  = 79.8%). These values were much higher in studies of non-low-risk IPMNs; cumulative incidence values for pancreatic cancer were 1.95% at 1 year (95% CI, 0.0%-5.99%; I 2  = 84.2%), 5.69% at 3 years (95% CI, 1.10%-12.77%; I 2  = 89.9%), 9.77% at 5 years (95% CI, 3.04%-19.27%; I 2  = 92.0%), and 24.68% at 10 years (95% CI, 14.87%-35.90%; I 2  = 74.3%). The pooled cumulative incidence steadily increased linearly as the follow-up duration increased. In a systematic review and meta-analysis, we found that low-risk IPMNs have almost 8% chance of progressing to pancreatic cancer within 10 years, and higher-risk IPMNs have almost 25% chance of progressing to cancer in 10 years; incidence values increase linearly with time. Continued long-term surveillance is therefore vital for patients with low-risk IPMNs. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

  1. Research and cumulative watershed effects

    Treesearch

    L. M. Reid

    1993-01-01

    The mandate for land managers to address cumulative watershed effects (CWEs) requires that planners evaluate the potential impacts of their activities on multiple beneficial uses within the context of other coexisting activities in a watershed. Types of CWEs vary with the types of land-use activities and their modes of interaction, but published studies illustrate...

  2. Activation of Antibiotic Production in Bacillus spp. by Cumulative Drug Resistance Mutations.

    PubMed

    Tojo, Shigeo; Tanaka, Yukinori; Ochi, Kozo

    2015-12-01

    Bacillus subtilis strains produce a wide range of antibiotics, including ribosomal and nonribosomal peptide antibiotics, as well as bacilysocin and neotrehalosadiamine. Mutations in B. subtilis strain 168 that conferred resistance to drugs such as streptomycin and rifampin resulted in overproduction of the dipeptide antibiotic bacilysin. Cumulative drug resistance mutations, such as mutations in the mthA and rpsL genes, which confer low- and high-level resistance, respectively, to streptomycin, and mutations in rpoB, which confer resistance to rifampin, resulted in cells that overproduced bacilysin. Transcriptional analysis demonstrated that the enhanced transcription of biosynthesis genes was responsible for the overproduction of bacilysin. This approach was effective also in activating the cryptic genes of Bacillus amyloliquefaciens, leading to actual production of antibiotic(s). Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  3. Repeat Gamma-Knife Radiosurgery for Refractory or Recurrent Trigeminal Neuralgia with Consideration About the Optimal Second Dose.

    PubMed

    Park, Seong-Cheol; Kwon, Do Hoon; Lee, Do Hee; Lee, Jung Kyo

    2016-02-01

    To investigate adequate radiation doses for repeat Gamma Knife radiosurgery (GKS) for trigeminal neuralgia in our series and meta-analysis. Fourteen patients treated by ipsilateral repeat GKS for trigeminal neuralgia were included. Median age of patients was 65 years (range, 28-78), the median target dose, 140-180). Patients were followed a median of 10.8 months (range, 1-151) after the second gamma-knife surgery. Brainstem dose analysis and vote-counting meta-analysis of 19 studies were performed. After the second gamma-knife radiosurgeries, pain was relieved effectively in 12 patients (86%; Barrow Neurological Institute Pain Intensity Score I-III). Post-gamma-knife radiosurgery trigeminal nerve deficits were mild in 5 patients. No serious anesthesia dolorosa was occurred. The second GKS radiation dose ≤ 60 Gy was significantly associated with worse pain control outcome (P = 0.018 in our series, permutation analysis of variance, and P = 0.009 in the meta-analysis, 2-tailed Fisher's exact test). Cumulative dose ≤ 140-150 Gy was significantly associated with poor pain control outcome (P = 0.033 in our series and P = 0.013 in the meta-analysis, 2-tailed Fisher's exact test). A cumulative brainstem edge dose >12 Gy tended to be associated with trigeminal nerve deficit (P = 0.077). Our study suggests that the second GKS dose is a potentially important factor. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. The Role of Cumulative Trauma, Betrayal, and Appraisals in Understanding Trauma Symptomatology.

    PubMed

    Martin, Christina Gamache; Cromer, Lisa Demarni; Deprince, Anne P; Freyd, Jennifer J

    2013-03-01

    Poor psychological outcomes are common among trauma survivors, yet not all survivors experience adverse sequelae. The current study examined links between cumulative trauma exposure as a function of the level of betrayal (measured by the relational closeness of the survivor and the perpetrator), trauma appraisals, gender, and trauma symptoms. Participants were 273 college students who reported experiencing at least one traumatic event on a trauma checklist. Three cumulative indices were constructed to assess the number of different types of traumas experienced that were low (LBTs), moderate (MBTs), or high in betrayal (HBTs). Greater trauma exposure was related to more symptoms of depression, dissociation, and PTSD, with exposure to HBTs contributing the most. Women were more likely to experience HBTs than men, but there were no gender differences in trauma-related symptoms. Appraisals of trauma were predictive of trauma-related symptoms over and above the effects explained by cumulative trauma at each level of betrayal. The survivor's relationship with the perpetrator, the effect of cumulative trauma, and their combined impact on trauma symptomatology are discussed.

  5. The Role of Cumulative Trauma, Betrayal, and Appraisals in Understanding Trauma Symptomatology

    PubMed Central

    Martin, Christina Gamache; Cromer, Lisa DeMarni; DePrince, Anne P.; Freyd, Jennifer J.

    2012-01-01

    Poor psychological outcomes are common among trauma survivors, yet not all survivors experience adverse sequelae. The current study examined links between cumulative trauma exposure as a function of the level of betrayal (measured by the relational closeness of the survivor and the perpetrator), trauma appraisals, gender, and trauma symptoms. Participants were 273 college students who reported experiencing at least one traumatic event on a trauma checklist. Three cumulative indices were constructed to assess the number of different types of traumas experienced that were low (LBTs), moderate (MBTs), or high in betrayal (HBTs). Greater trauma exposure was related to more symptoms of depression, dissociation, and PTSD, with exposure to HBTs contributing the most. Women were more likely to experience HBTs than men, but there were no gender differences in trauma-related symptoms. Appraisals of trauma were predictive of trauma-related symptoms over and above the effects explained by cumulative trauma at each level of betrayal. The survivor’s relationship with the perpetrator, the effect of cumulative trauma, and their combined impact on trauma symptomatology are discussed. PMID:23542882

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

    PubMed

    Mayfield, Kristin H; Chase, Philip N

    2002-01-01

    This study compared three different methods of teaching five basic algebra rules to college students. All methods used the same procedures to teach the rules and included four 50-question review sessions interspersed among the training of the individual rules. The differences among methods involved the kinds of practice provided during the four review sessions. Participants who received cumulative practice answered 50 questions covering a mix of the rules learned prior to each review session. Participants who received a simple review answered 50 questions on one previously trained rule. Participants who received extra practice answered 50 extra questions on the rule they had just learned. Tests administered after each review included new questions for applying each rule (application items) and problems that required novel combinations of the rules (problem-solving items). On the final test, the cumulative group outscored the other groups on application and problem-solving items. In addition, the cumulative group solved the problem-solving items significantly faster than the other groups. These results suggest that cumulative practice of component skills is an effective method of training problem solving.

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

    PubMed Central

    Mayfield, Kristin H; Chase, Philip N

    2002-01-01

    This study compared three different methods of teaching five basic algebra rules to college students. All methods used the same procedures to teach the rules and included four 50-question review sessions interspersed among the training of the individual rules. The differences among methods involved the kinds of practice provided during the four review sessions. Participants who received cumulative practice answered 50 questions covering a mix of the rules learned prior to each review session. Participants who received a simple review answered 50 questions on one previously trained rule. Participants who received extra practice answered 50 extra questions on the rule they had just learned. Tests administered after each review included new questions for applying each rule (application items) and problems that required novel combinations of the rules (problem-solving items). On the final test, the cumulative group outscored the other groups on application and problem-solving items. In addition, the cumulative group solved the problem-solving items significantly faster than the other groups. These results suggest that cumulative practice of component skills is an effective method of training problem solving. PMID:12102132

  8. Cumulative watershed effects: Can they be measured? What have we learned from the Caspar Creek studies in northern California?

    Treesearch

    R. M. Rice

    1991-01-01

    Cumulative Watershed Effects (CWEs) may be additive or synergistic. Additive CWEs are the accumulation downstream of the effects of various activities. Their existence is inevitable. However, their magnitude is often difficult to measure. The amount of sediment, for example, has considerable natural variation which may mask the CWEs caused by road construction or...

  9. Brain Vulnerability to Repeated Blast Overpressure and Polytrauma

    DTIC Science & Technology

    2015-10-01

    characterization of the mouse model of repeated blast also found no cumula- tive effect of repeated blast on cortical levels of reactive oxygen species [39]. C...overpressure in rats to investigate the cumulative effects of multiple blast exposures on neurologic status, neurobehavioral function, and brain...preclinical model of blast overpressure in rats to investigate the cumulative effects of multiple blast exposures using neurological, neurochemical

  10. Forecasting landscape-scale, cumulative effects of forest management on vegetation and wildlife habitat: a case study of issues, limitations, and opportunities

    Treesearch

    Stephen R. Shifley; Frank R. Thompson; William D. Dijak; Zhaofei F. Fan

    2008-01-01

    Forest landscape disturbance and succession models have become practical tools for large-scale, long-term analyses of the cumulative effects of forest management on real landscapes. They can provide essential information in a spatial context to address management and policy issues related to forest planning, wildlife habitat quality, timber harvesting, fire effects,...

  11. Functional polymorphisms of circadian negative feedback regulation genes are associated with clinical outcome in hepatocellular carcinoma patients receiving radical resection.

    PubMed

    Zhang, Zhaohui; Ma, Fei; Zhou, Feng; Chen, Yibing; Wang, Xiaoyan; Zhang, Hongxin; Zhu, Yong; Bi, Jianwei; Zhang, Yiguan

    2014-12-01

    Previous studies have demonstrated that circadian negative feedback loop genes play an important role in the development and progression of many cancers. However, the associations between single-nucleotide polymorphisms (SNPs) in these genes and the clinical outcomes of hepatocellular carcinoma (HCC) after surgical resection have not been studied so far. Thirteen functional SNPs in circadian genes were genotyped using the Sequenom iPLEX genotyping system in a cohort of 489 Chinese HCC patients who received radical resection. Multivariate Cox proportional hazards model and Kaplan-Meier curve were used for the prognosis analysis. Cumulative effect analysis and survival tree analysis were used for the multiple SNPs analysis. Four individual SNPs, including rs3027178 in PER1, rs228669 and rs2640908 in PER3 and rs3809236 in CRY1, were significantly associated with overall survival (OS) of HCC patients, and three SNPs, including rs3027178 in PER1, rs228729 in PER3 and rs3809236 in CRY1, were significantly associated with recurrence-free survival (RFS). Moreover, we observed a cumulative effect of significant SNPs on OS and RFS (P for trend < 0.001 for both). Survival tree analysis indicated that wild genotype of rs228729 in PER3 was the primary risk factor contributing to HCC patients' RFS. Our study suggests that the polymorphisms in circadian negative feedback loop genes may serve as independent prognostic biomarkers in predicting clinical outcomes for HCC patients who received radical resection. Further studies with different ethnicities are needed to validate our findings and generalize its clinical utility.

  12. Associations between ambient air pollution and daily mortality in a cohort of congestive heart failure: Case-crossover and nested case-control analyses using a distributed lag nonlinear model.

    PubMed

    Buteau, Stephane; Goldberg, Mark S; Burnett, Richard T; Gasparrini, Antonio; Valois, Marie-France; Brophy, James M; Crouse, Dan L; Hatzopoulou, Marianne

    2018-04-01

    Persons with congestive heart failure may be at higher risk of the acute effects related to daily fluctuations in ambient air pollution. To meet some of the limitations of previous studies using grouped-analysis, we developed a cohort study of persons with congestive heart failure to estimate whether daily non-accidental mortality were associated with spatially-resolved, daily exposures to ambient nitrogen dioxide (NO 2 ) and ozone (O 3 ), and whether these associations were modified according to a series of indicators potentially reflecting complications or worsening of health. We constructed the cohort from the linkage of administrative health databases. Daily exposure was assigned from different methods we developed previously to predict spatially-resolved, time-dependent concentrations of ambient NO 2 (all year) and O 3 (warm season) at participants' residences. We performed two distinct types of analyses: a case-crossover that contrasts the same person at different times, and a nested case-control that contrasts different persons at similar times. We modelled the effects of air pollution and weather (case-crossover only) on mortality using distributed lag nonlinear models over lags 0 to 3 days. We developed from administrative health data a series of indicators that may reflect the underlying construct of "declining health", and used interactions between these indicators and the cross-basis function for air pollutant to assess potential effect modification. The magnitude of the cumulative as well as the lag-specific estimates of association differed in many instances according to the metric of exposure. Using the back-extrapolation method, which is our preferred exposure model, we found for the case-crossover design a cumulative mean percentage changes (MPC) in daily mortality per interquartile increment in NO 2 (8.8 ppb) of 3.0% (95% CI: -0.9, 6.9%) and for O 3 (16.5 ppb) 3.5% (95% CI: -4.5, 12.1). For O 3 there was strong confounding by weather (unadjusted MPC = 7.1%; 95% CI: 1.7, 12.7%). For the nested case-control approach the cumulative MPC for NO 2 in daily mortality was 2.9% (95% CI: -0.9, 6.9%) and for O 3 7.3% (95% CI: 3.0, 11.9%). We found evidence of effect modification between daily mortality and cumulative NO 2 and O 3 according to the prescribed dose of furosemide in the nested case-control analysis, but not in the case-crossover analysis. Mortality in congestive heart failure was associated with exposure to daily ambient NO 2 and O 3 predicted from a back-extrapolation method using a land use regression model from dense sampling surveys. The methods used to assess exposure can have considerable influence on the estimated acute health effects of the two air pollutants. Copyright © 2018 Elsevier Ltd. All rights reserved.

  13. Exploring factors that influence work analysis data: A meta-analysis of design choices, purposes, and organizational context.

    PubMed

    DuVernet, Amy M; Dierdorff, Erich C; Wilson, Mark A

    2015-09-01

    Work analysis is fundamental to designing effective human resource systems. The current investigation extends previous research by identifying the differential effects of common design decisions, purposes, and organizational contexts on the data generated by work analyses. The effects of 19 distinct factors that span choices of descriptor, collection method, rating scale, and data source, as well as project purpose and organizational features, are explored. Meta-analytic results cumulated from 205 articles indicate that many of these variables hold significant consequences for work analysis data. Factors pertaining to descriptor choice, collection method, rating scale, and the purpose for conducting the work analysis each showed strong associations with work analysis data. The source of the work analysis information and organizational context in which it was conducted displayed fewer relationships. Findings can be used to inform choices work analysts make about methodology and postcollection evaluations of work analysis information. (c) 2015 APA, all rights reserved).

  14. Clinical Outcomes of Vertical Distraction Osteogenesis for Dental Implantation: A Systematic Review and Meta-Analysis.

    PubMed

    Zhao, Kai; Wang, Feng; Huang, Wei; Wu, Yiqun

    The aim of this study was to evaluate the clinical outcomes of vertical distraction osteogenesis (VDO) for patients with vertically deficient alveolar ridges in terms of (1) the cumulative implant survival rate, (2) bone gain, (3) bone resorption before and after implant insertion, and (4) complications. An electronic search was conducted via MEDLINE (PubMed), EMBASE, and the Cochrane Library, complemented by manual searches, to identify eligible clinical studies of VDO before dental implantation. Two reviewers independently performed the study selection and data extraction. The implant survival rate, mean bone gain, and bone resorption amount, with 95% confidence intervals (CIs), were pooled separately. A random-effects model or fixed-effects model was chosen based on the heterogeneity. A funnel plot and Egger's test were performed to identify publication bias. Of the 4,391 records after removal of duplicates, 113 full-text articles were obtained for further analysis, and 12 articles were ultimately included in the analysis. Two studies were defined as low quality. The estimated cumulative implant survival rate was 98.00% (95% CI: 96.02% to 99.40%), with a mean follow-up of 3.52 years. The bone gain was 7.92 mm (95% CI: 6.27 to 9.57 mm), with a range from 4 to 20 mm, and the level of bone relapse between the end of the distraction and the implant insertion was 0.97 mm (95% CI: 0.68 to 1.26 mm). The complication rate was high, with rates of 0.728 per site and 0.821 per patient. The most common major complication was basal bone fracture, with a rate of 2.27%, and the most common minor complication was displacement of the transport segments, with a rate of 16.71%. Vertical alveolar defects could be rehabilitated successfully with distraction osteogenesis, and the implant placed in the distraction sites showed a high cumulative survival rate. However, the high complication rate necessitates caution. Due to the observed heterogeneity, the results of this meta-analysis should be interpreted with caution.

  15. [Effects of biochar addition into soils in semiarid land on water infiltration under the condition of the same bulk density].

    PubMed

    Qi, Rui-Peng; Zhang, Lei; Yan, Yong-Hao; Wen, Man; Zheng, Ji-Yong

    2014-08-01

    Making clear the effects of biochar addition on soil water infiltration process can provide the scientific basis for the evaluation of the influence of biochar application on soil hydrology in semi-arid region. In this paper, through the soil column simulation method in laboratory, the effects of biochar of three sizes (1-2 mm, 0.25-1 mm and ≤ 0.25 mm) at 4 doses (10, 50, 100 and 150 g x kg(-1)) on the cumulative infiltration, the permeability and the stable infiltration rate of two different soils (anthrosol and aeolian sandy soil) were studied. The results showed that the infiltration capacity of the anthrosol was obviously increased compared to the control, however, the one in the aeolian sandy soil was decreased due to the biochar addition. At 100 minutes after infiltration starting, the averaged cumulative infiltration was increased by 25.1% in the anthrosol with comparison to the control. Contrarily, the averaged cumulative infiltration was decreased by 11.1% in the aeolian sandy soil at 15 minutes after infiltration starting. When the dose was the same, biochar with different particle sizes improved the infiltration for the anthrosol, but for the different dose treatments, the particle size of biochar which showed the greatest improvement was different. As for the aeolian sandy soil, the infiltration increased at the dose of 10 g x kg(-1) after the addition of biochar with different particle sizes, while decreased at the higher dose of 50, 100 and 150 g x kg(-1). The cumulative infiltration of the aeolian sandy soil was decreased with the increase in addition amount of biochar with the same particle size, while it was not so for the anthrosol. The determination coefficient fitted by the Philip infiltration model ranged from 0.965 to 0.999, suggesting this model was suitable for the simulation of soil water infiltration process after biochar application. Statistical analysis of main effects showed that the biochar particle size, the biochar addition amount, and the interactive effect had statistically significant effect on the soil permeability and stable infiltration rate in the two soils. In conclusion, the biochar had different effects on the soils with different textures, moreover, there was a positive correlation relationship between the impact and the addition amount.

  16. Cumulative Risk and Impact Modeling on Environmental Chemical and Social Stressors.

    PubMed

    Huang, Hongtai; Wang, Aolin; Morello-Frosch, Rachel; Lam, Juleen; Sirota, Marina; Padula, Amy; Woodruff, Tracey J

    2018-03-01

    The goal of this review is to identify cumulative modeling methods used to evaluate combined effects of exposures to environmental chemicals and social stressors. The specific review question is: What are the existing quantitative methods used to examine the cumulative impacts of exposures to environmental chemical and social stressors on health? There has been an increase in literature that evaluates combined effects of exposures to environmental chemicals and social stressors on health using regression models; very few studies applied other data mining and machine learning techniques to this problem. The majority of studies we identified used regression models to evaluate combined effects of multiple environmental and social stressors. With proper study design and appropriate modeling assumptions, additional data mining methods may be useful to examine combined effects of environmental and social stressors.

  17. Engaging Communities in Research on Cumulative Risk and Social Stress-Environment Interactions: Lessons Learned from EPA's STAR Program.

    PubMed

    Payne-Sturges, Devon C; Korfmacher, Katrina Smith; Cory-Slechta, Deborah A; Jimenez, Maria; Symanski, Elaine; Carr Shmool, Jessie L; Dotson-Newman, Ogonnaya; Clougherty, Jane E; French, Robert; Levy, Jonathan I; Laumbach, Robert; Rodgers, Kathryn; Bongiovanni, Roseann; Scammell, Madeleine K

    2015-12-01

    Studies have documented cumulative health effects of chemical and nonchemical exposures, particularly chronic environmental and social stressors. Environmental justice groups have advocated for community participation in research that assesses how these interactions contribute to health disparities experienced by low-income and communities of color. In 2009, the U.S. Environmental Protection Agency issued a request for research applications (RFA), "Understanding the Role of Nonchemical Stressors and Developing Analytic Methods for Cumulative Risk Assessments." Seven research projects were funded to help address this knowledge gap. Each engaged with communities in different ways. We describe the community engagement approaches of the seven research projects, which ranged from outreach through shared leadership/participatory. We then assess the experiences of these programs with respect to the community engagement goals of the RFA. We present insights from these community engagement efforts, including how the grants helped to build or enhance the capacity of community organizations in addition to contributing to the research projects. Our analysis of project proposals, annual grantee reports, and participant observation of these seven projects suggests guidelines for the development of future funding mechanisms and for conducting community-engaged research on cumulative risk involving environmental and social stressors including: 1) providing for flexibility in the mode of community engagement; 2) addressing conflict between research timing and engagement needs, 3) developing approaches for communicating about the uniquely sensitive issues of nonchemical stressors and social risks; and 4) encouraging the evaluation of community engagement efforts.

  18. Dropout rates in medical students at one school before and after the installation of admission tests in Austria.

    PubMed

    Reibnegger, Gilbert; Caluba, Hans-Christian; Ithaler, Daniel; Manhal, Simone; Neges, Heide Maria; Smolle, Josef

    2011-08-01

    Admission to medical studies in Austria since academic year 2005-2006 has been regulated by admission tests. At the Medical University of Graz, an admission test focusing on secondary-school-level knowledge in natural sciences has been used for this purpose. The impact of this important change on dropout rates of female versus male students and older versus younger students is reported. All 2,860 students admitted to the human medicine diploma program at the Medical University of Graz from academic years 2002-2003 to 2008-2009 were included. Nonparametric and semiparametric survival analysis techniques were employed to compare cumulative probability of dropout between demographic groups. Cumulative probability of dropout was significantly reduced in students selected by active admission procedure versus those admitted openly (P < .0001). Relative hazard ratio of selected versus openly admitted students was only 0.145 (95% CI, 0.106-0.198). Among openly admitted students, but not for selected ones, the cumulative probabilities for dropout were higher for females (P < .0001) and for older students (P < .0001). Generally, dropout hazard is highest during the second year of study. The introduction of admission testing significantly decreased the cumulative probability for dropout. In openly admitted students a significantly higher risk for dropout was found in female students and in older students, whereas no such effects can be detected after admission testing. Future research should focus on the sex dependence, with the aim of improving success rates among female applicants on the admission tests.

  19. Association between somatic cell count after first parturition and cumulative milk yield in dairy cows.

    PubMed

    Archer, S C; Mc Coy, F; Wapenaar, W; Green, M J

    2013-10-05

    The aim was to assess the association between the somatic cell count of parity 1 cows between 5 and 30 days in milk (SCC1), and subsequent cumulative milk yield over approximately two years for cows in English and Welsh dairy herds. The dataset included records from 43,461 cows in 2111 herds, from 2004 to 2006. Cumulative milk yield was the model outcome, and a random effect was included to account for variation between herds. The model fitted the data well and was used to make predictions of cumulative milk yield, based on SCC1. A unit increase in the natural logarithm of SCC1/1000 was associated with a median decrease in cumulative milk yield of 482 kg, over a median study period of 868 days.

  20. Cumulative human impacts on marine predators.

    PubMed

    Maxwell, Sara M; Hazen, Elliott L; Bograd, Steven J; Halpern, Benjamin S; Breed, Greg A; Nickel, Barry; Teutschel, Nicole M; Crowder, Larry B; Benson, Scott; Dutton, Peter H; Bailey, Helen; Kappes, Michelle A; Kuhn, Carey E; Weise, Michael J; Mate, Bruce; Shaffer, Scott A; Hassrick, Jason L; Henry, Robert W; Irvine, Ladd; McDonald, Birgitte I; Robinson, Patrick W; Block, Barbara A; Costa, Daniel P

    2013-01-01

    Stressors associated with human activities interact in complex ways to affect marine ecosystems, yet we lack spatially explicit assessments of cumulative impacts on ecologically and economically key components such as marine predators. Here we develop a metric of cumulative utilization and impact (CUI) on marine predators by combining electronic tracking data of eight protected predator species (n=685 individuals) in the California Current Ecosystem with data on 24 anthropogenic stressors. We show significant variation in CUI with some of the highest impacts within US National Marine Sanctuaries. High variation in underlying species and cumulative impact distributions means that neither alone is sufficient for effective spatial management. Instead, comprehensive management approaches accounting for both cumulative human impacts and trade-offs among multiple stressors must be applied in planning the use of marine resources.

  1. Joint analysis of stressors and ecosystem services to enhance restoration effectiveness.

    PubMed

    Allan, J David; McIntyre, Peter B; Smith, Sigrid D P; Halpern, Benjamin S; Boyer, Gregory L; Buchsbaum, Andy; Burton, G A; Campbell, Linda M; Chadderton, W Lindsay; Ciborowski, Jan J H; Doran, Patrick J; Eder, Tim; Infante, Dana M; Johnson, Lucinda B; Joseph, Christine A; Marino, Adrienne L; Prusevich, Alexander; Read, Jennifer G; Rose, Joan B; Rutherford, Edward S; Sowa, Scott P; Steinman, Alan D

    2013-01-02

    With increasing pressure placed on natural systems by growing human populations, both scientists and resource managers need a better understanding of the relationships between cumulative stress from human activities and valued ecosystem services. Societies often seek to mitigate threats to these services through large-scale, costly restoration projects, such as the over one billion dollar Great Lakes Restoration Initiative currently underway. To help inform these efforts, we merged high-resolution spatial analyses of environmental stressors with mapping of ecosystem services for all five Great Lakes. Cumulative ecosystem stress is highest in near-shore habitats, but also extends offshore in Lakes Erie, Ontario, and Michigan. Variation in cumulative stress is driven largely by spatial concordance among multiple stressors, indicating the importance of considering all stressors when planning restoration activities. In addition, highly stressed areas reflect numerous different combinations of stressors rather than a single suite of problems, suggesting that a detailed understanding of the stressors needing alleviation could improve restoration planning. We also find that many important areas for fisheries and recreation are subject to high stress, indicating that ecosystem degradation could be threatening key services. Current restoration efforts have targeted high-stress sites almost exclusively, but generally without knowledge of the full range of stressors affecting these locations or differences among sites in service provisioning. Our results demonstrate that joint spatial analysis of stressors and ecosystem services can provide a critical foundation for maximizing social and ecological benefits from restoration investments.

  2. Maternal Distress Influences Young Children's Family Representations Through Maternal View of Child Behavior and Parent-Child Interactions

    PubMed Central

    Yoo, Yeon Soo; Popp, Jill; Robinson, JoAnn

    2014-01-01

    Objective Distress of a parent is a key influence on the quality of the child's experience in the family. We hypothesized that maternal distress would spill over into more negative views of their children's behaviors and less emotional availability in their relationships. Further, we investigated whether these cumulative experiences contributed to children's emerging narratives about mothers and family life. Method In this longitudinal study, mothers of young twin children reported their distress on three occasions in relation to: self, the marital relationship, and the family climate. Mothers also reported on their children's externalizing behavior problems. Mother-child interaction was observed focusing on maternal sensitivity and child responsivity. Children responded to story stem beginnings about challenging situations in the family and their narratives were scored for family conflict and cohesion themes. APIM methods of dyadic data analysis accounted for the inclusion of both twins in the analysis. Results Results from structural equation models supported the hypothesized cumulative experience of maternal distress on children's family life representations for both family conflict and family cohesion. Conclusion A family environment in which children are exposed to persistent maternal distress early in life may have cumulative effects, influencing how mothers interact with and view their children's behavior at later developmental stages. Moreover, exposure to repeated distress for longer periods of time may contribute to an intergenerational continuity of distress for the child that may become rooted in negative affective bias in their own view of family relationships. PMID:23568672

  3. Joint analysis of stressors and ecosystem services to enhance restoration effectiveness

    PubMed Central

    Allan, J. David; McIntyre, Peter B.; Smith, Sigrid D. P.; Halpern, Benjamin S.; Boyer, Gregory L.; Buchsbaum, Andy; Burton, G. A.; Campbell, Linda M.; Chadderton, W. Lindsay; Ciborowski, Jan J. H.; Doran, Patrick J.; Eder, Tim; Infante, Dana M.; Johnson, Lucinda B.; Joseph, Christine A.; Marino, Adrienne L.; Prusevich, Alexander; Read, Jennifer G.; Rose, Joan B.; Rutherford, Edward S.; Sowa, Scott P.; Steinman, Alan D.

    2013-01-01

    With increasing pressure placed on natural systems by growing human populations, both scientists and resource managers need a better understanding of the relationships between cumulative stress from human activities and valued ecosystem services. Societies often seek to mitigate threats to these services through large-scale, costly restoration projects, such as the over one billion dollar Great Lakes Restoration Initiative currently underway. To help inform these efforts, we merged high-resolution spatial analyses of environmental stressors with mapping of ecosystem services for all five Great Lakes. Cumulative ecosystem stress is highest in near-shore habitats, but also extends offshore in Lakes Erie, Ontario, and Michigan. Variation in cumulative stress is driven largely by spatial concordance among multiple stressors, indicating the importance of considering all stressors when planning restoration activities. In addition, highly stressed areas reflect numerous different combinations of stressors rather than a single suite of problems, suggesting that a detailed understanding of the stressors needing alleviation could improve restoration planning. We also find that many important areas for fisheries and recreation are subject to high stress, indicating that ecosystem degradation could be threatening key services. Current restoration efforts have targeted high-stress sites almost exclusively, but generally without knowledge of the full range of stressors affecting these locations or differences among sites in service provisioning. Our results demonstrate that joint spatial analysis of stressors and ecosystem services can provide a critical foundation for maximizing social and ecological benefits from restoration investments. PMID:23248308

  4. Modelling the changing cumulative vulnerability to climate-related hazards for river basin management using a GIS-based multicriteria decision approach

    NASA Astrophysics Data System (ADS)

    Hung, Hung-Chih; Wu, Ju-Yu; Hung, Chih-Hsuan

    2017-04-01

    1. Background Asia-Pacific region is one of the most vulnerable areas of the world to climate-related hazards and extremes due to rapid urbanization and over-development in hazard-prone areas. It is thus increasingly recognized that the management of land use and reduction of hazard risk are inextricably linked. This is especially critical from the perspective of integrated river basin management. A range of studies has targeted existing vulnerability assessments. However, limited attention has been paid to the cumulative effects of multiple vulnerable factors and their dynamics faced by local communities. This study proposes a novel methodology to access the changing cumulative vulnerability to climate-related hazards, and to examine the relationship between the attraction factors relevant to the general process of urbanization and vulnerability variability with a focus on a river basin management unit. 2. Methods and data The methods applied in this study include three steps. First, using Intergovernmental Panel on Climate Change's (IPCC) approach, a Cumulative Vulnerability Assessment Framework (CVAF) is built with a goal to characterize and compare the vulnerability to climate-related hazards within river basin regions based on a composition of multiple indicators. We organize these indicator metrics into three categories: (1) hazard exposure; (2) socioeconomic sensitivity, and (3) adaptive capacity. Second, the CVAF is applied by combining a geographical information system (GIS)-based spatial statistics technique with a multicriteria decision analysis (MCDA) to assess and map the changing cumulative vulnerability, comparing conditions in 1996 and 2006 in Danshui River Basin, Taiwan. Third, to examine the affecting factors of vulnerability changing, we develop a Vulnerability Changing Model (VCM) using four attraction factors to reflect how the process of urban developments leads to vulnerability changing. The factors are transport networks, land uses, production values of industries, and infrastructures. We then conduct a regression analysis to test the VCM. To illustrate the proposed methodology, the data are collected from the National Science and Technology Center for Disaster Reduction, Taiwan as well as the National Land Use Investigation and official census statistics. 3. Results and policy implications Results of CVAF analysis demonstrate heterogeneous patterns of vulnerability in the region, and highlight trends of long-term changes. The vulnerable areas unfold as clustered patterns and spatial analogues across regions, rather than randomly distributed. Highest cumulative vulnerability is concentrated in densely populated and downstream reaches (such as Taipei City) of the Danshui River in both time periods. When examining the VCM, it indicates that upper stream and more remote areas generally show low vulnerability, increases are observed in some areas between 1996 and 2006 due to land use intensification, industrial and infrastructure expansion. These findings suggest that land use planning should consider the socioeconomic progression and infrastructure investment factors that contribute to urban sprawl and address current as well as future urban developments vulnerable to hazard risk transmission. The cumulative vulnerability assessment, mapping methods and modelling presented here can be applied to other climate change and hazard risks to highlight priority areas for further investigation and contribute towards improving river basin management.

  5. Long-term exposure to high air pollution induces cumulative DNA damages in traffic policemen.

    PubMed

    Tan, Chaochao; Lu, Shijie; Wang, Yupeng; Zhu, Yan; Shi, Ting; Lin, Mingyue; Deng, Zhonghua; Wang, Zhu; Song, Nana; Li, Shuna; Yang, Pingting; Yang, Liyan; Liu, Yuanyuan; Chen, Zhiheng; Xu, Keqian

    2017-09-01

    The specific effects of long-term exposure to high air pollution on human health and biological remain unclear. To explore the adverse health effects as well as biological mechanisms and biomarkers for durative exposure to air pollution, 183 traffic policemen and 88 office policemen were enrolled in this study. The concentration of PM2.5 in both the traffic and office policemen's working environments were obtained. Detailed personal questionnaires were completed and levels of inflammation, oxidative stress and DNA damage markers of all participants were analyzed in this study. The average PM2.5 concentration of the intersections of main roads and the offices of control group were 132.4±48.9μg/m 3 and 50.80±38.6μg/m 3 , respectively. The traffic policemen, who stably exposed to at least 2 times higher PM2.5 in their work area as compared with the control group, have a median average duration of 7.00years, and average cumulative intersection duty time reached 8030h. No statistically significant differences in the levels of inflammation markers were observed between the traffic and office policemen. However, the DNA damage markers in traffic policemen shared significant positive correlation with cumulative intersection duty time and higher than those in the office policemen. Multiple linear regression analysis demonstrated that the increase of cumulative intersection duty time by 1h per day for one year was associated with the increase in 8-hydroxy-20-deoxyguanosine of 0.329% (95% CI: 0.249% to 0.409%), tail DNA of 0.051% (95% CI: 0.041% to 0.061%), micronucleus frequency of 0.036‰ (95% CI: 0.03‰ to 0.043‰), and a decrease in glutathione of 0.482% (95% CI: -0.652% to -0.313%). These findings suggest that long-term exposure to high air pollution could induce cumulative DNA damages, supporting the hypothesis that durative exposure to air pollution is associated with an increased risk of cancer. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Language delay in severely neglected children: a cumulative or specific effect of risk factors?

    PubMed

    Sylvestre, Audette; Mérette, Chantal

    2010-06-01

    This research sought to determine if the language delay (LD) of severely neglected children under 3 years old was better explained by a cumulative risk model or by the specificity of risk factors. The objective was also to identify the risk factors with the strongest impact on LD among various biological, psychological, and environmental factors. Sixty-eight severely neglected children and their mothers participated in this cross-sectional study. Children were between 2 and 36 months of age. Data included information about the child's language development and biological, psychological, and environmental risk factors. Prevalence of LD is significantly higher in this subgroup of children than in the population as a whole. Although we observed that the risk of LD significantly increased with an increase in the cumulative count of the presence of the child's biological-psychological risk factors, the one-by-one analysis of the individual factors revealed that the cumulative effect mainly reflected the specific impact of the child's cognitive development. When we considered also the environmental risk factors, multivariate logistic regression established that cognitive development, the mother's own physical and emotional abuse experience as a child, and the mother's low acceptability level towards her child are linked to LD in severely neglected children. Language development is the result of a complex interaction between risk factors. LD in severely neglected children is better explained by the specificity of risk factors than by the cumulative risk model. Most prevention and early intervention programs promote and target an increase in the quantity and quality of language stimulation offered to the child. Our results suggest that particular attention should be given to other environmental factors, specifically the mother's psychological availability and her sensitivity towards the child. It is essential to suggest interventions targeting various ecological dimensions of neglectful mothers to help break the intergenerational neglect transmission cycle. It is also important to develop government policies and ensure that efforts among the various response networks are concerted since in-depth changes to neglect situations can only come about when all interested parties become involved. Copyright 2010 Elsevier Ltd. All rights reserved.

  7. Effects of antipsychotic drugs on cardiovascular variability in participants with bipolar disorder

    PubMed Central

    Linder, Jonathan R.; Sodhi, Simrit K.; Haynes, William G.; Fiedorowicz, Jess G.

    2014-01-01

    Objective The risk for cardiovascular diseases is elevated in persons with bipolar disorder. However, it remains unknown how much of this excess risk is secondary to pharmacologic treatment. We tested the hypothesis that current and cumulative antipsychotic drug exposure is associated with increased cardiovascular risk as indicated by lower heart rate variability (HRV) and increased blood pressure variability (BPV). Methods 55 individuals with bipolar disorder (33±7 years; 67% female) underwent non-invasive electrocardiogram assessment of time- and frequency-domain HRV, as well as BPV analysis. Medication histories were obtained through systematic review of pharmacy records for the past five years. Results Current antipsychotic exposure was associated with lower SDNN. Second generation antipsychotics were associated with lower SDNN and RMSSD. There was no significant relationship between five-year antipsychotic exposure and HRV in subjects with bipolar disorder. Exploratory analysis revealed a possible link between SSRI exposure and increased low frequency spectral HRV. Conclusions Current antipsychotic use (particularly second generation antipsychotics with high affinities for the D2S receptor) is associated with reduced autonomic-mediated variability of heart rate. The absence of an association with cumulative exposure suggests that the effects are acute in onset, and may therefore relate more to altered autonomic function than structural cardiovascular abnormalities. Future studies should prospectively examine effects of these antipsychotics on autonomic function. PMID:24590543

  8. Do self-reported concussions have cumulative or enduring effects on drivers' anticipation of traffic hazards?

    PubMed

    Preece, Megan H W; Horswill, Mark S; Ownsworth, Tamara

    2016-01-01

    To investigate the cumulative effect of multiple self-reported concussions and the enduring effect of concussion on drivers' hazard perception ability. It was hypothesized: (1) that individuals reporting multiple previous concussions would be slower to anticipate traffic hazards than individuals reporting either one previous concussion or none; and (2) that individuals reporting a concussion within the past 3 months would be slower to anticipate traffic hazards than individuals reporting either an earlier concussion or no prior concussion. Two hundred and eighty-two predominantly young drivers (nconcussed = 68, Mage = 21.57 years, SDage = 6.99 years, 66% female) completed a validated hazard perception test (HPT) and measures of emotional, cognitive, health and driving status. A one-way analysis of variance showed that there was no significant effect of concussion number on HPT response times. Similarly, pairwise comparisons showed no significant differences between the HPT response times of individuals reporting a concussion within the previous 3 months, individuals reporting an earlier concussion and the never concussed group. The findings suggest that previous concussions do not adversely affect young drivers' ability to anticipate traffic hazards; however, due to reliance on self-reports of concussion history, further prospective longitudinal research is needed.

  9. Impact of an effective multidrug-resistant tuberculosis control programme in the setting of an immature HIV epidemic: system dynamics simulation model.

    PubMed

    Atun, Rifat A; Lebcir, Reda; Drobniewski, Francis; Coker, Richard J

    2005-08-01

    This study sought to determine the impact of an effective programme of multidrug resistant tuberculosis control (MDRTB) on a population that is witnessing an explosive HIV epidemic among injecting drug users (IDUs), where the prevalence of MDRTB is already high. A transmission model was constructed that represents the dynamics of the drug-susceptible tuberculosis (DSTB), MDRTB and HIV spread among the adult population of Samara Oblast, Russia: from official notifications of tuberculosis and of HIV infection, estimates of MDRTB derived from surveillance studies, population data from official regional statistics, data on transmission probabilities from peer-reviewed publications and informed estimates, and policy-makers' estimates of IDU populations. Two scenarios of programme effectiveness for MDRTB were modelled and run over a period of 10 years to predict cumulative deaths. In a population of 3.3 million with a high prevalence of MDRTB, an emerging epidemic of HIV among IDUs, and a functioning directly observed therapy-short course (DOTS) programme, the model predicts that under low cure rates for MDRTB the expected cumulative deaths from tuberculosis will reach 6303 deaths including 1900 deaths from MDRTB at 10 years. Under high cure rate for MDRTB 4465 deaths will occur including 134 deaths from MDRTB. At 10 years there is little impact on HIV-infected populations from the MDRTB epidemic, but as the HIV epidemic matures the impact becomes substantial. When the model is extended to 20 years cumulative deaths from MDRTB become very high if cure rates for MDRTB are low and cumulative deaths in the HIV-infected population, likewise, are profoundly affected. In the presence of an immature HIV epidemic failure to actively control MDRTB may result in approximately a third more deaths than if effective treatment is given. As the HIV epidemic matures then the impact of MDRTB grows substantially if MDRTB control strategies are ineffective. The epidemiological starting point for these scenarios is present in many regions within the former Soviet Union and this analysis suggests control of MDRTB should be an urgent priority.

  10. An application of the Aggregate Exposure Pathway (AEP) and Adverse Outcome Pathway (AOP) frameworks to mechanistically integrate data sources across multiple species into cumulative risk assessment (CRA)

    EPA Science Inventory

    Toxicologists use dose-response data from both in vivo and in vitro experiments to evaluate the effects of chemical contaminants on organisms. Cumulative risk assessments (CRAs) consider the effects of multiple stressors on multiple endpoints, and utilize environmental exposure ...

  11. Effects of Multiple Context and Cumulative Stress on Urban Children's Adjustment in Elementary School

    ERIC Educational Resources Information Center

    Morales, Julie R.; Guerra, Nancy G.

    2006-01-01

    Using longitudinal data collected over 2 years on a sample of 2,745 urban elementary school children (1st-6th graders, ages 6-11 years) from economically disadvantaged communities, effects of stressful experiences within 3 contexts (school, family, neighborhood), cumulative stress, and multiple context stress on 3 indices of children's adjustment…

  12. Cumulative watershed effects: a research perspective

    Treesearch

    Leslie M. Reid; Robert R. Ziemer

    1989-01-01

    A cumulative watershed effect (CWE) is any response to multiple land-use activities that is caused by, or results in, altered watershed function. The CWE issue is politically defined, as is the significance of particular impacts. But the processes generating CWEs are the traditional focus of geomorphology and ecology, and have thus been studied for decades. The CWE...

  13. The Effect of Cumulative Risk on Paternal Engagement: Examining Differences among Adolescent and Older Couples

    ERIC Educational Resources Information Center

    Farrie, Danielle; Lee, Yookyong; Fagan, Jay

    2011-01-01

    This study examined the association between fathers' and mothers' risk factors and paternal engagement 1 and 3 years postbirth. Distinguishing between new and persistent risk factors, we tested whether cumulative risk has unique effects on couples where one or both parents are adolescents at birth. Results indicated that although fathers' and…

  14. Concepts, Methods, and Data Sources for Cumulative Health Risk Assessment of Multiple Chemicals, Exposures and Effects: A Resource Document (Final Report, 2008)

    EPA Science Inventory

    EPA announced the availability of the final report, Concepts, Methods, and Data Sources for Cumulative Health Risk Assessment of Multiple Chemicals, Exposures and Effects: A Resource Document. This report provides the concepts, methods and data sources needed to assist in...

  15. Separate and Cumulative Effects of Adverse Childhood Experiences in Predicting Adult Health and Health Care Utilization

    ERIC Educational Resources Information Center

    Chartier, Mariette J.; Walker, John R.; Naimark, Barbara

    2010-01-01

    Objectives: Objectives of this population-based study were: (1) to examine the relative contribution of childhood abuse and other adverse childhood experiences to poor adult health and increased health care utilization and (2) to examine the cumulative effects of adverse childhood experiences on adult health and health care utilization. Methods:…

  16. Cumulative Effects of Exposure to Violence on Posttraumatic Stress in Palestinian and Israeli Youth

    ERIC Educational Resources Information Center

    Dubow, Eric F.; Boxer, Paul; Huesmann, L. Rowell; Landau, Simha; Dvir, Shira; Shikaki, Khalil; Ginges, Jeremy

    2012-01-01

    We examine cumulative and prospective effects of exposure to conflict and violence across four contexts (ethnic-political, community, family, school) on posttraumatic stress (PTS) symptoms in Palestinian and Israeli youth. Interviews were conducted with 600 Palestinian and 901 Israeli (Jewish and Arab) children (ages 8, 11, and 14) and their…

  17. Integrating LANDIS model and a multi-criteria decision-making approach to evaluate cumulative effects of forest management in the Missouri Ozarks, USA

    Treesearch

    Zong Bo Shang; Hong S. He; Weimin Xi; Stephen R. Shifley; Brian J. Palik

    2012-01-01

    Public forest management requires consideration of numerous objectives including protecting ecosystem health, sustaining habitats for native communities, providing sustainable forest products, and providing noncommodity ecosystem services. It is difficult to evaluate the long-term, cumulative effects and tradeoffs these and other associated management objectives. To...

  18. Evaluating long-term cumulative hydrologic effects of forest management: a conceptual approach

    Treesearch

    Robert R. Ziemer

    1992-01-01

    It is impractical to address experimentally many aspects of cumulative hydrologic effects, since to do so would require studying large watersheds for a century or more. Monte Carlo simulations were conducted using three hypothetical 10,000-ha fifth-order forested watersheds. Most of the physical processes expressed by the model are transferable from temperate to...

  19. Single-Fraction Versus Multifraction (3 × 9 Gy) Stereotactic Radiosurgery for Large (>2 cm) Brain Metastases: A Comparative Analysis of Local Control and Risk of Radiation-Induced Brain Necrosis

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

    Minniti, Giuseppe, E-mail: gminniti@ospedalesantandrea.it; IRCCS Neuromed, Pozzilli; Scaringi, Claudia

    Purpose: To investigate the local control and radiation-induced brain necrosis in patients with brain metastases >2 cm in size who received single-fraction or multifraction stereotactic radiosurgery (SRS); factors associated with clinical outcomes and the development of brain radionecrosis were assessed. Methods and Materials: Two hundred eighty-nine consecutive patients with brain metastases >2.0 cm who received SRS as primary treatment at Sant'Andrea Hospital, University of Rome Sapienza, Rome, Italy, were analyzed. Cumulative incidence analysis was used to compare local control and radiation-induced brain necrosis between groups from the time of SRS. To achieve a balanced distribution of baseline covariates between treatment groups, amore » propensity score analysis was used. Results: The 1-year cumulative local control rates were 77% in the single-fraction SRS (SF-SRS) group and 91% in the multifraction SRS (MF-SRS) group (P=.01). Recurrences occurred in 25 and 11 patients who received SF-SRS or MF-SRS (P=.03), respectively. Thirty-one patients (20%) undergoing SF-SRS and 11 (8%) subjected to MF-SRS experienced brain radionecrosis (P=.004); the 1-year cumulative incidence rate of radionecrosis was 18% and 9% (P=.01), respectively. Significant differences between the 2 groups in terms of local control and risk of radionecrosis were maintained after propensity score adjustment. Conclusions: Multifraction SRS at a dose of 27 Gy in 3 daily fractions seems to be an effective treatment modality for large brain metastases, associated with better local control and a reduced risk of radiation-induced radionecrosis as compared with SF-SRS.« less

  20. An Integrated Modeling Framework Forecasting Ecosystem Exposure-- A Systems Approach to the Cumulative Impacts of Multiple Stressors

    NASA Astrophysics Data System (ADS)

    Johnston, J. M.

    2013-12-01

    Freshwater habitats provide fishable, swimmable and drinkable resources and are a nexus of geophysical and biological processes. These processes in turn influence the persistence and sustainability of populations, communities and ecosystems. Climate change and landuse change encompass numerous stressors of potential exposure, including the introduction of toxic contaminants, invasive species, and disease in addition to physical drivers such as temperature and hydrologic regime. A systems approach that includes the scientific and technologic basis of assessing the health of ecosystems is needed to effectively protect human health and the environment. The Integrated Environmental Modeling Framework 'iemWatersheds' has been developed as a consistent and coherent means of forecasting the cumulative impact of co-occurring stressors. The Framework consists of three facilitating technologies: Data for Environmental Modeling (D4EM) that automates the collection and standardization of input data; the Framework for Risk Assessment of Multimedia Environmental Systems (FRAMES) that manages the flow of information between linked models; and the Supercomputer for Model Uncertainty and Sensitivity Evaluation (SuperMUSE) that provides post-processing and analysis of model outputs, including uncertainty and sensitivity analysis. Five models are linked within the Framework to provide multimedia simulation capabilities for hydrology and water quality processes: the Soil Water Assessment Tool (SWAT) predicts surface water and sediment runoff and associated contaminants; the Watershed Mercury Model (WMM) predicts mercury runoff and loading to streams; the Water quality Analysis and Simulation Program (WASP) predicts water quality within the stream channel; the Habitat Suitability Index (HSI) model scores physicochemical habitat quality for individual fish species; and the Bioaccumulation and Aquatic System Simulator (BASS) predicts fish growth, population dynamics and bioaccumulation of toxic substances. The capability of the Framework to address cumulative impacts will be demonstrated for freshwater ecosystem services and mountaintop mining.

  1. Genetic characterization of multiple hepatitis C virus infections following acute infection in HIV-infected men who have sex with men.

    PubMed

    Thomas, Xiomara V; Grady, Bart P X; Van Der Meer, Jan T M; Ho, Cynthia K; Vanhommerig, Joost W; Rebers, Sjoerd P; De Jong, Menno D; Van Der Valk, Marc; Prins, Maria; Molenkamp, Richard; Schinkel, Janke

    2015-11-01

    High rates of hepatitis C virus (HCV) reinfections among HIV-infected men who have sex with men (MSM) following clearance of a primary infection suggest absence of protective immunity. Here, we investigated the incidence of HCV super and reinfections in 85 HIV-infected MSM with incident HCV infection. Serial sequencing of a fragment of NS5B and the HCV envelope was used to longitudinally characterize the virus. If the primary genotype was still present at the most recent viremic time point, as indicated by the NS5B sequence analysis, serial envelope 2/hypervariable region 1 (E2/HRV1) sequence analysis was performed to distinguish a new infection with the same genotype (clade switch) from intrahost evolution. Incidence rate and cumulative incidence of secondary infections were estimated, and the effect of the primary genotype (1a versus non1) on the risk of acquiring a second infection with the same genotype was determined using Cox proportional-hazards analysis. Among 85 patients with a median follow-up of 4.8 years, incidence rate of secondary infections was 5.39 cases/100 person-years (95% confidence interval 3.34-8.26). Cumulative incidence of genotype switches was markedly higher than the cumulative incidence of clade switches (26.7 versus 4.8% at 5 years, respectively). In patients with HCV-1a as primary infection, the risk for acquiring another HCV-1a infection was reduced compared to those with a primary non-HCV-1a subsequently acquiring HCV-1a (hazard ratio 0.25, 95% confidence interval 0.07-0.93). Risk of acquiring a secondary infection with the primary genotype was strikingly reduced compared with the risk of acquiring a secondary infection with a different genotype.

  2. Thromboprophylaxis With Apixaban in Patients Undergoing Major Orthopedic Surgery: Meta-Analysis and Trial-Sequential Analysis.

    PubMed

    Caldeira, Daniel; Rodrigues, Filipe B; Pinto, Fausto J; Ferreira, Joaquim J; Costa, João

    2017-01-01

    Venous thromboembolism (VTE) is a potentially fatal complication of orthopedic surgery, and until recently, few antithrombotic compounds were available for postoperative thromboprophylaxis. The introduction of the non-vitamin K antagonists oral anticoagulants (NOAC), including apixaban, has extended the therapeutic armamentarium in this field. Therefore, estimation of NOAC net clinical benefit in comparison with the established treatment is needed to inform clinical decision making. Systematic review to assess the efficacy and safety of apixaban 2.5 mg twice a day versus low-molecular-weight heparins (LMWH) for thromboprophylaxis in patients undergoing knee or hip replacement. MEDLINE, Embase, and CENTRAL were searched from inception to September 2016, other systematic reviews, reference lists, and experts were consulted. All major orthopedic surgery randomized controlled trials comparing apixaban 2.5 mg twice daily with LMWH, reporting thrombotic and bleeding events. Two independent reviewers, using a predetermined form. The Cochrane tool to assess risk bias was used by two independent authors. RevMan software was used to estimate pooled risk ratio (RR) and 95% confidence intervals (95% CI) using random-effects meta-analysis. Trial sequential analysis (TSA) was performed in statistical significant results to evaluate whether cumulative sample size was powered for the obtained effect. Overall confidence in cumulative evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group methodology. Four studies comparing apixaban 2.5 mg twice daily with LMWH were included, with a total of 11.828 patients (55% undergoing knee and 45% hip replacement). The overall risk of bias across studies was low. In comparison with LMWH (all regimens), apixaban showed a significantly lower risk of VTE events and overall mortality combined (RR: 0.63, 95% CI: 0.42-0.95, I 2 = 84%, n = 8346), but not of major VTE events (RR: 0.62, 95% CI: 0.32-1.19, I 2 = 63%, n = 9493), or of symptomatic VTE events and VTE-related mortality combined (RR: 1.14, 95% CI: 0.68-1.90, I 2 = 0%, n = 11 879). Trial sequential analysis showed that the risk reduction obtained for VTE and mortality was based on underpowered cumulative sample size and effect dimension. Subgroup analysis according to LMWH regimens showed that apixaban reduced the risk of VTE events and overall mortality, and major VTE events, when compared with LMWH once daily, without differences between apixaban and LMWH twice daily. There is low to moderate evidence that in patients undergoing knee or hip replacement, apixaban seems equally effective and safe to LMWH twice a day. When compared with LMWH once a day, apixaban seems a superior thromboprophylaxis option. However, the results are underpowered which precludes definite answers regarding the true net clinical benefit of apixaban versus LMWH in this clinical context.

  3. Projected lifetime risks and hospital care expenditure for traumatic injury.

    PubMed

    Chang, David C; Anderson, Jamie E; Kobayashi, Leslie; Coimbra, Raul; Bickler, Stephen W

    2012-08-01

    The lifetime risk and expected cost of trauma care would be valuable for health policy planners, but this information is currently unavailable. The cumulative incidence rates methodology, based on a cross-sectional population analysis, offers an alternative approach to prohibitively costly prospective cohort studies. Retrospective analysis of the California Office of Statewide Health Planning and Development (OSHPD) database was performed for 2008. Trauma admissions were identified by ICD-9 primary diagnosis codes 800-959, with certain exclusions. Cumulative incidence rates were calculated as the cumulative summation of incidence risks sequentially across age groups. A total of 2.2 million admissions were identified, with mean age of 63.8 y, 49.6% men, 82.8% Whites, 5.7% Blacks, 11.3% Hispanics, and 3.1% Asians. The cumulative incidence rate for patients older than age 85 y was 1119 per 10,000 people, with the majority of risk in the elderly, compared with 24,325 per 10,000 people for all-cause hospitalizations. The rates were 946 for men, 1079 for women, 999 for non-Hispanic Whites, 568 for Blacks, 577 for Hispanics, and 395 for Asians, per 10,000 population. The cumulative expected hospital charge was $6538, compared with $81,257 for all-cause hospitalizations. The cumulative lifetime risk of trauma/injury requiring hospitalization for a person living to age 85 y in California is 11.2%, accounting for 4.6% of expected lifetime hospitalizations, but accounting for 8.0% of expected lifetime hospital expenditures. Risk of trauma is significant in the elderly. The total expenditure for all trauma hospitalizations in California was $7.62 billion in 2008. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. Higher Fluid Balance Increases the Risk of Death From Sepsis: Results From a Large International Audit.

    PubMed

    Sakr, Yasser; Rubatto Birri, Paolo Nahuel; Kotfis, Katarzyna; Nanchal, Rahul; Shah, Bhagyesh; Kluge, Stefan; Schroeder, Mary E; Marshall, John C; Vincent, Jean-Louis

    2017-03-01

    Excessive fluid therapy in patients with sepsis may be associated with risks that outweigh any benefit. We investigated the possible influence of early fluid balance on outcome in a large international database of ICU patients with sepsis. Observational cohort study. Seven hundred and thirty ICUs in 84 countries. All adult patients admitted between May 8 and May 18, 2012, except admissions for routine postoperative surveillance. For this analysis, we included only the 1,808 patients with an admission diagnosis of sepsis. Patients were stratified according to quartiles of cumulative fluid balance 24 hours and 3 days after ICU admission. ICU and hospital mortality rates were 27.6% and 37.3%, respectively. The cumulative fluid balance increased from 1,217 mL (-90 to 2,783 mL) in the first 24 hours after ICU admission to 1,794 mL (-951 to 5,108 mL) on day 3 and decreased thereafter. The cumulative fluid intake was similar in survivors and nonsurvivors, but fluid balance was less positive in survivors because of higher fluid output in these patients. Fluid balances became negative after the third ICU day in survivors but remained positive in nonsurvivors. After adjustment for possible confounders in multivariable analysis, the 24-hour cumulative fluid balance was not associated with an increased hazard of 28-day in-hospital death. However, there was a stepwise increase in the hazard of death with higher quartiles of 3-day cumulative fluid balance in the whole population and after stratification according to the presence of septic shock. In this large cohort of patients with sepsis, higher cumulative fluid balance at day 3 but not in the first 24 hours after ICU admission was independently associated with an increase in the hazard of death.

  5. Occidental Geothermal, Inc. , Oxy geothermal power plant No. 1. Final environmental impact report

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

    Not Available

    1981-12-01

    The project-specific environmental analysis covers the following: geology, soils, water resources, biology, air quality, noise, waste management, health, safety, transportation, energy and material resources, cultural resources, socioeconomics, public services, land use, and aesthetics. Other topics covered are: the cumulative envionmental analysis; unavoidable significant adverse environmental effects; irreversible environmental changes and irretrievable commitments of energy and materials; the relationship between local short-term uses of man's environment and the maintenance and enhancement of long-term productivity; growth-inducing impacts; and alternatives to the proposed action. (MHR)

  6. Cost utility, budget impact, and scenario analysis of racecadotril in addition to oral rehydration for acute diarrhea in children in Malaysia

    PubMed Central

    Rautenberg, Tamlyn Anne; Zerwes, Ute; Lee, Way Seah

    2018-01-01

    Objective To perform cost utility (CU) and budget impact (BI) analyses augmented by scenario analyses of critical model structure components to evaluate racecadotril as adjuvant to oral rehydration solution (ORS) for children under 5 years with acute diarrhea in Malaysia. Methods A CU model was adapted to evaluate racecadotril plus ORS vs ORS alone for acute diarrhea in children younger than 5 years from a Malaysian public payer’s perspective. A bespoke BI analysis was undertaken in addition to detailed scenario analyses with respect to critical model structure components. Results According to the CU model, the intervention is less costly and more effective than comparator for the base case with a dominant incremental cost-effectiveness ratio of −RM 1,272,833/quality-adjusted life year (USD −312,726/quality-adjusted life year) in favor of the intervention. According to the BI analysis (assuming an increase of 5% market share per year for racecadotril+ORS for 5 years), the total cumulative incremental percentage reduction in health care expenditure for diarrhea in children is 0.136578%, resulting in a total potential cumulative cost savings of −RM 73,193,603 (USD −17,983,595) over a 5-year period. Results hold true across a range of plausible scenarios focused on critical model components. Conclusion Adjuvant racecadotril vs ORS alone is potentially cost-effective from a Malaysian public payer perspective subject to the assumptions and limitations of the model. BI analysis shows that this translates into potential cost savings for the Malaysian public health care system. Results hold true at evidence-based base case values and over a range of alternate scenarios. PMID:29588606

  7. Forecasting the Relative and Cumulative Effects of Multiple Stressors on At-risk Populations

    DTIC Science & Technology

    2011-08-01

    Vitals (observed vital rates), Movement, Ranges, Barriers (barrier interactions), Stochasticity (a time series of stochasticity indices...Simulation Viewer are themselves stochastic . They can change each time it is run. B. 196 Analysis If multiple Census events are present in the life...30-year period. A monthly time series was generated for the 20th-century using monthly anomalies for temperature, precipitation, and percent

  8. Double inverse-weighted estimation of cumulative treatment effects under nonproportional hazards and dependent censoring.

    PubMed

    Schaubel, Douglas E; Wei, Guanghui

    2011-03-01

    In medical studies of time-to-event data, nonproportional hazards and dependent censoring are very common issues when estimating the treatment effect. A traditional method for dealing with time-dependent treatment effects is to model the time-dependence parametrically. Limitations of this approach include the difficulty to verify the correctness of the specified functional form and the fact that, in the presence of a treatment effect that varies over time, investigators are usually interested in the cumulative as opposed to instantaneous treatment effect. In many applications, censoring time is not independent of event time. Therefore, we propose methods for estimating the cumulative treatment effect in the presence of nonproportional hazards and dependent censoring. Three measures are proposed, including the ratio of cumulative hazards, relative risk, and difference in restricted mean lifetime. For each measure, we propose a double inverse-weighted estimator, constructed by first using inverse probability of treatment weighting (IPTW) to balance the treatment-specific covariate distributions, then using inverse probability of censoring weighting (IPCW) to overcome the dependent censoring. The proposed estimators are shown to be consistent and asymptotically normal. We study their finite-sample properties through simulation. The proposed methods are used to compare kidney wait-list mortality by race. © 2010, The International Biometric Society.

  9. Assessment of Energy Efficiency Improvement and CO2 Emission Reduction Potentials in India's Cement Industry

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

    Morrow, III, William R.; Hasanbeigi, Ali; Xu, Tengfang

    2012-12-03

    India’s cement industry is the second largest in the world behind China with annual cement production of 168 Mt in 2010 which accounted for slightly greater than six percent of the world’s annual cement production in the same year. To produce that amount of cement, the industry consumed roughly 700 PJ of fuel and 14.7 TWh of electricity. We identified and analyzed 22 energy efficiency technologies and measures applicable to the processes in the Indian cement industry. The Conservation Supply Curve (CSC) used in this study is an analytical tool that captures both the engineering and the economic perspectives ofmore » energy conservation. Using a bottom-up electricity CSC model and compared to an electricity price forecast the cumulative cost-effective plant-level electricity savings potential for the Indian cement industry for 2010- 2030 is estimated to be 83 TWh, and the cumulative plant-level technical electricity saving potential is 89 TWh during the same period. The grid-level CO2 emissions reduction associated with cost-effective electricity savings is 82 Mt CO2 and the electric grid-level CO2 emission reduction associated with technical electricity saving potential is 88 Mt CO2. Compared to a fuel price forecast, an estimated cumulative cost-effective fuel savings potential of 1,029 PJ with associated CO2 emission reduction of 97 Mt CO2 during 2010-2030 is possible. In addition, a sensitivity analysis with respect to the discount rate used is conducted to assess the effect of changes in this parameter on the results. The result of this study gives a comprehensive and easy to understand perspective to the Indian cement industry and policy makers about the energy efficiency potential and its associated cost over the next twenty years.« less

  10. The histomorphological findings of kidneys after application of high dose and high-energy shock wave lithotripsy.

    PubMed

    Demir, Aslan; Türker, Polat; Bozkurt, Suheyla Uyar; İlker, Yalcin Nazmi

    2015-01-01

    In this animal study, we reviewed the histomorphological findings in rabbit kidneys after a high number of high-energy shock wave applications and observed if there were any cumulative effects after repeated sessions. We formed 2 groups, each consisting of 8 rabbits. Group 1 received 1 session and group 2 received 3 sessions of ESWL with a 7 day interval between sessions, consisting of 3500 beats to the left kidney and 5500 beats to the right kidney per session. The specimens of kidneys were examined histomorphologically after bilateral nephrectomy was performed. For statistical analysis, 4 groups of specimens were formed. The first and second groups received 1 session, 3500 and 5500 beats, respectively. The third and fourth groups received 3 sessions, at 3500 and 5500 beats per each session, respectively. The sections were evaluated under a light microscope to determine subcapsular thickening; subcapsular, intratubular and parenchymal hemorrhage; subcapsular, intersitital, perivascular and proximal ureteral fibrosis; paranchymal necrosis; tubular epithelial vacuolization; tubular atrophy; glomerular destruction and calcification. In histopathological examinations capsular thickening, subcapsular hematoma, tubuloepithelial vacuolisation, glomerular destruction, parenchymal hemorrhage, interstitial fibrosis, and perivascular fibrosis were observed in all groups. In statistical analysis, on the basis of perivascular fibrosis and tubular atrophy, there was a beats per session dependent increase of both. The detrimental effects from ESWL are dose dependent but not cumulative for up to 3 sessions. Histopathological experimental animal studies will aid in understanding local and maybe, by means of these local effects, systemic effects.

  11. Retooling CalEnviroScreen: Cumulative Pollution Burden and Race-Based Environmental Health Vulnerabilities in California.

    PubMed

    Liévanos, Raoul S

    2018-04-16

    The California Community Environmental Health Screening Tool (CalEnviroScreen) advances research and policy pertaining to environmental health vulnerability. However, CalEnviroScreen departs from its historical foundations and comparable screening tools by no longer considering racial status as an indicator of environmental health vulnerability and predictor of cumulative pollution burden. This study used conceptual frameworks and analytical techniques from environmental health and inequality literature to address the limitations of CalEnviroScreen, especially its inattention to race-based environmental health vulnerabilities. It developed an adjusted measure of cumulative pollution burden from the CalEnviroScreen 2.0 data that facilitates multivariate analyses of the effect of neighborhood racial composition on cumulative pollution burden, net of other indicators of population vulnerability, traffic density, industrial zoning, and local and regional clustering of pollution burden. Principal component analyses produced three new measures of population vulnerability, including Latina/o cumulative disadvantage that represents the spatial concentration of Latinas/os, economic disadvantage, limited English-speaking ability, and health vulnerability. Spatial error regression analyses demonstrated that concentrations of Latinas/os, followed by Latina/o cumulative disadvantage, are the strongest demographic determinants of adjusted cumulative pollution burden. Findings have implications for research and policy pertaining to cumulative impacts and race-based environmental health vulnerabilities within and beyond California.

  12. Retooling CalEnviroScreen: Cumulative Pollution Burden and Race-Based Environmental Health Vulnerabilities in California

    PubMed Central

    2018-01-01

    The California Community Environmental Health Screening Tool (CalEnviroScreen) advances research and policy pertaining to environmental health vulnerability. However, CalEnviroScreen departs from its historical foundations and comparable screening tools by no longer considering racial status as an indicator of environmental health vulnerability and predictor of cumulative pollution burden. This study used conceptual frameworks and analytical techniques from environmental health and inequality literature to address the limitations of CalEnviroScreen, especially its inattention to race-based environmental health vulnerabilities. It developed an adjusted measure of cumulative pollution burden from the CalEnviroScreen 2.0 data that facilitates multivariate analyses of the effect of neighborhood racial composition on cumulative pollution burden, net of other indicators of population vulnerability, traffic density, industrial zoning, and local and regional clustering of pollution burden. Principal component analyses produced three new measures of population vulnerability, including Latina/o cumulative disadvantage that represents the spatial concentration of Latinas/os, economic disadvantage, limited English-speaking ability, and health vulnerability. Spatial error regression analyses demonstrated that concentrations of Latinas/os, followed by Latina/o cumulative disadvantage, are the strongest demographic determinants of adjusted cumulative pollution burden. Findings have implications for research and policy pertaining to cumulative impacts and race-based environmental health vulnerabilities within and beyond California. PMID:29659481

  13. Cumulative Socioeconomic Status Risk, Allostatic Load, and Adjustment: A Prospective Latent Profile Analysis with Contextual and Genetic Protective Factors

    ERIC Educational Resources Information Center

    Brody, Gene H.; Yu, Tianyi; Chen, Yi-Fu; Kogan, Steven M.; Evans, Gary W.; Beach, Steven R. H.; Windle, Michael; Simons, Ronald L.; Gerrard, Meg; Gibbons, Frederick X.; Philibert, Robert A.

    2013-01-01

    The health disparities literature has identified a common pattern among middle-aged African Americans that includes high rates of chronic disease along with low rates of psychiatric disorders despite exposure to high levels of cumulative socioeconomic status (SES) risk. The current study was designed to test hypotheses about the developmental…

  14. Analysis of difference between direct and geodetic mass balance measurements at South Cascade Glacier, Washington

    USGS Publications Warehouse

    Krimmel, R.M.

    1999-01-01

    Net mass balance has been measured since 1958 at South Cascade Glacier using the 'direct method,' e.g. area averages of snow gain and firn and ice loss at stakes. Analysis of cartographic vertical photography has allowed measurement of mass balance using the 'geodetic method' in 1970, 1975, 1977, 1979-80, and 1985-97. Water equivalent change as measured by these nearly independent methods should give similar results. During 1970-97, the direct method shows a cumulative balance of about -15 m, and the geodetic method shows a cumulative balance of about -22 m. The deviation between the two methods is fairly consistent, suggesting no gross errors in either, but rather a cumulative systematic error. It is suspected that the cumulative error is in the direct method because the geodetic method is based on a non-changing reference, the bedrock control, whereas the direct method is measured with reference to only the previous year's summer surface. Possible sources of mass loss that are missing from the direct method are basal melt, internal melt, and ablation on crevasse walls. Possible systematic measurement errors include under-estimation of the density of lost material, sinking stakes, or poorly represented areas.

  15. Cumulative meta-analysis of interleukins 6 and 1β, tumour necrosis factor α and C-reactive protein in patients with major depressive disorder.

    PubMed

    Haapakoski, Rita; Mathieu, Julia; Ebmeier, Klaus P; Alenius, Harri; Kivimäki, Mika

    2015-10-01

    Cumulative meta-analyses are used to evaluate the extent to which further studies are needed to confirm or refute a hypothesis. We used this approach to assess observational evidence on systemic inflammation in individuals with major depressive disorder. We identified 58 studies of four common inflammatory markers in a literature search of PubMed, Embase and PsychInfo databases in May 2014. Pooled data from the earliest eight studies already showed an association between interleukin-6 concentrations and major depression; 23 more recent studies confirmed this finding (d=0.54, p<0.0001). A significant association between C-reactive protein levels and major depression was noted after 14 studies and this did not change after addition of six more studies (d=0.47, p<0.0001). For these two inflammatory markers, there was moderate heterogeneity in study-specific estimates, subgroup differences were small, and publication bias appeared to be an unlikely explanation for the findings. Sensitivity analyses including only high-quality studies and subjects free of antidepressant medication further verified the associations. While there was a link between tumour necrosis factor-α levels and major depression (d=0.40, p=0.002), the cumulative effect remained uncertain due to the extensive heterogeneity in study-specific estimates and inconsistencies between subgroups. No evidence was found for the association between interleukin-1β levels and major depression (d=-0.05, p=0.86). In conclusion, this cumulative meta-analysis confirmed higher mean levels of interleukin-6 and C-reactive protein in patients with major depression compared to non-depressed controls. No consistent association between tumour necrosis factor-α, interleukin-1β and major depression was observed. Future studies should clarify the specific immune mechanisms involved as well as continue testing anti-inflammatory therapies in patients suffering from major depression. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  16. Cumulative meta-analysis of interleukins 6 and 1β, tumour necrosis factor α and C-reactive protein in patients with major depressive disorder

    PubMed Central

    Haapakoski, Rita; Mathieu, Julia; Ebmeier, Klaus P.; Alenius, Harri; Kivimäki, Mika

    2015-01-01

    Cumulative meta-analyses are used to evaluate the extent to which further studies are needed to confirm or refute a hypothesis. We used this approach to assess observational evidence on systemic inflammation in individuals with major depressive disorder. We identified 58 studies of four common inflammatory markers in a literature search of PubMed, Embase and PsychInfo databases in May 2014. Pooled data from the earliest eight studies already showed an association between interleukin-6 concentrations and major depression; 23 more recent studies confirmed this finding (d = 0.54, p < 0.0001). A significant association between C-reactive protein levels and major depression was noted after 14 studies and this did not change after addition of six more studies (d = 0.47, p < 0.0001). For these two inflammatory markers, there was moderate heterogeneity in study-specific estimates, subgroup differences were small, and publication bias appeared to be an unlikely explanation for the findings. Sensitivity analyses including only high-quality studies and subjects free of antidepressant medication further verified the associations. While there was a link between tumour necrosis factor-α levels and major depression (d = 0.40, p = 0.002), the cumulative effect remained uncertain due to the extensive heterogeneity in study-specific estimates and inconsistencies between subgroups. No evidence was found for the association between interleukin-1β levels and major depression (d = −0.05, p = 0.86). In conclusion, this cumulative meta-analysis confirmed higher mean levels of interleukin-6 and C-reactive protein in patients with major depression compared to non-depressed controls. No consistent association between tumour necrosis factor-α, interleukin-1β and major depression was observed. Future studies should clarify the specific immune mechanisms involved as well as continue testing anti-inflammatory therapies in patients suffering from major depression. PMID:26065825

  17. Tools to Assess Community-Based Cumulative Risk and Exposures

    EPA Science Inventory

    Multiple agents and stressors can interact in a given community to adversely affect human and ecological conditions. A cumulative risk assessment (CRA) analyzes, characterizes, and potentially quantifies the effects from multiple stressors, which include chemical agents (for exam...

  18. ORD PYRETHROIDS PROJECT

    EPA Science Inventory

    The Food Quality Protection Act (FQPA) of 1996 requires the Agency to consider the cumulative effects of pesticides and other substances that act by a common mechanism. Under the mandates of FQPA, the Agency conducted a cumulative risk assessment for the organophosphate pesticid...

  19. Sequential Neighborhood Effects: The Effect of Long-Term Exposure to Concentrated Disadvantage on Children's Reading and Math Test Scores.

    PubMed

    Hicks, Andrew L; Handcock, Mark S; Sastry, Narayan; Pebley, Anne R

    2018-02-01

    Prior research has suggested that children living in a disadvantaged neighborhood have lower achievement test scores, but these studies typically have not estimated causal effects that account for neighborhood choice. Recent studies used propensity score methods to account for the endogeneity of neighborhood exposures, comparing disadvantaged and nondisadvantaged neighborhoods. We develop an alternative propensity function approach in which cumulative neighborhood effects are modeled as a continuous treatment variable. This approach offers several advantages. We use our approach to examine the cumulative effects of neighborhood disadvantage on reading and math test scores in Los Angeles. Our substantive results indicate that recency of exposure to disadvantaged neighborhoods may be more important than average exposure for children's test scores. We conclude that studies of child development should consider both average cumulative neighborhood exposure and the timing of this exposure.

  20. Sequential Neighborhood Effects: The Effect of Long-Term Exposure to Concentrated Disadvantage on Children's Reading and Math Test Scores

    PubMed Central

    Hicks, Andrew L.; Handcock, Mark S.; Sastry, Narayan

    2018-01-01

    Prior research has suggested that children living in a disadvantaged neighborhood have lower achievement test scores, but these studies typically have not estimated causal effects that account for neighborhood choice. Recent studies used propensity score methods to account for the endogeneity of neighborhood exposures, comparing disadvantaged and nondisadvantaged neighborhoods. We develop an alternative propensity function approach in which cumulative neighborhood effects are modeled as a continuous treatment variable. This approach offers several advantages. We use our approach to examine the cumulative effects of neighborhood disadvantage on reading and math test scores in Los Angeles. Our substantive results indicate that recency of exposure to disadvantaged neighborhoods may be more important than average exposure for children's test scores. We conclude that studies of child development should consider both average cumulative neighborhood exposure and the timing of this exposure. PMID:29192386

  1. Cost-benefit analysis of electronic medical record system at a tertiary care hospital.

    PubMed

    Choi, Jong Soo; Lee, Woo Baik; Rhee, Poong-Lyul

    2013-09-01

    Although Electronic Medical Record (EMR) systems provide various benefits, there are both advantages and disadvantages regarding its cost-effectiveness. This study analyzed the economic effects of EMR systems using a cost-benefit analysis based on the differential costs of managerial accounting. Samsung Medical Center (SMC) is a general hospital in Korea that developed an EMR system for outpatients from 2006 to 2008. This study measured the total costs and benefits during an 8-year period after EMR adoption. The costs include the system costs of building the EMR and the costs incurred in smoothing its adoption. The benefits included cost reductions after its adoption and additional revenues from both remodeling of paper-chart storage areas and medical transcriptionists' contribution. The measured amounts were discounted by SMC's expected interest rate to calculate the net present value (NPV), benefit-cost ratio (BCR), and discounted payback period (DPP). During the analysis period, the cumulative NPV and the BCR were US$3,617 thousand and 1.23, respectively. The DPP was about 6.18 years. Although the adoption of an EMR resulted in overall growth in administrative costs, it is cost-effective since the cumulative NPV was positive. The positive NPV was attributed to both cost reductions and additional revenues. EMR adoption is not so attractive to management in that the DPP is longer than 5 years at 6.18 and the BCR is near 1 at 1.23. However, an EMR is a worthwhile investment, seeing that this study did not include any qualitative benefits and that the paper-chart system was cost-centric.

  2. Carbon dioxide and methane fluxes from legumes based rotations under conventional and organic practices

    NASA Astrophysics Data System (ADS)

    Sánchez-Navarro, Virginia; Zornoza, Raúl; Faz, Ángel; Fernández, Juan A.

    2017-04-01

    In this study we assessed the effect of two different rotations based on winter (faba bean) or summer (cowpea) legumes on the direct emissions of CO2 and CH4. Faba bean was rotated with the summer melon crop (Cucumis melo) while cowpea was rotated with the winter broccoli crop (Brassica oleracea). We also assessed if different legume cultivars and management practices (conventional and organic) significantly influenced gas emissions. The study was randomly designed in blocks with four replications, in plots of 10 m2, during two complete cycles. Gas samples were taken in different times (0, 30 and 60 minutes) once a week using the static gas chamber technique for each crop. Results showed that cumulative CO2 emissions in broccoli decreased after the rotation with both cowpea cultivars under conventional management practices. Faba bean cultivars and management practices had no influence on cumulative CO2 emissions in melon crop. Cumulative CH4 emissions in broccoli crop were lowest after the rotation with Grey-eyed pea than Black-eyed pea cultivar, under both management practices. However, faba bean cultivars and management practices had no influence on cumulative CH4 emissions in melon crop. Cumulative CH4 emissions in melon crop were highest than in the rest of crops. Cowpea cultivar and management practice influenced cumulative CH4 and CO2 emissions of broccoli crop, respectively. Faba bean cultivar and management practice had no effect on cumulative CH4 and CO2 emissions of melon crop. Acknowledgements: This research was financed by the FP7 European Project Eurolegume (FP7-KBBE-613781).

  3. Is frozen embryo transfer better for mothers and babies? Can cumulative meta-analysis provide a definitive answer?

    PubMed

    Maheshwari, Abha; Pandey, Shilpi; Amalraj Raja, Edwin; Shetty, Ashalatha; Hamilton, Mark; Bhattacharya, Siladitya

    2018-01-01

    Initial observational studies and a systematic review published 5 years ago have suggested that obstetric and perinatal outcomes are better in offspring conceived following frozen rather than fresh embryo transfers, with reduced risks of preterm birth, small for gestational age, low birth weight and pre-eclampsia. More recent primary studies are beginning to challenge some of these findings. We therefore conducted an updated systematic review and cumulative meta-analysis to examine if these results have remained consistent over time. The aim of this study was to perform a systematic review and cumulative meta-analysis (trend with time) of obstetric and perinatal complications in singleton pregnancies following the transfer of frozen thawed and fresh embryos generated through in-vitro fertilisation. Data Sources from Medline, EMBASE, Cochrane Central Register of Clinical Trials DARE and CINAHL (1984-2016) were searched using appropriate key words. Observational and randomised studies comparing obstetric and perinatal outcomes in singleton pregnancies conceived through IVF using either fresh or frozen thawed embryos. Two independent reviewers extracted data in 2 × 2 tables and assessed the methodological quality of the relevant studies using CASP scoring. Both aggregated as well as cumulative meta-analysis was done using STATA. Twenty-six studies met the inclusion criteria. Singleton babies conceived from frozen thawed embryos were at lower relative risk (RR) of preterm delivery (0.90; 95% CI 0.84-0.97) low birth weight (0.72; 95% CI 0.67-0.77) and small for gestational age (0.61; 95% CI 0.56-0.67) compared to those conceived from fresh embryo transfers, but faced an increased risk (RR) of hypertensive disorders of pregnancy (1.29; 95% CI 1.07-1.56) large for gestational age (1.54; 95% CI 1.48-1.61) and high birth weight (1.85; 95% CI 1.46-2.33). There was no difference in the risk of congenital anomalies and perinatal mortality between the two groups. The direction and magnitude of effect for these outcomes have remained virtually unchanged over time while the degree of precision has improved with the addition of data from newer studies. The results of this cumulative meta-analysis confirm that the decreased risks of small for gestational age, low birth weight and preterm delivery and increased risks of large for gestational age and high birth weight associated with pregnancies conceived from frozen embryos have been consistent in terms of direction and magnitude of effect over several years, with increasing precision around the point estimates. Replication in a number of different populations has provided external validity for the results, for outcomes of birth weight and preterm delivery. Meanwhile, caution should be exercised about embarking on a policy of electively freezing all embryos in IVF as there are increased risks for large for gestational age babies and hypertensive disorders of pregnancy. Therefore, elective freezing should ideally be undertaken in specific cases such as ovarian hyperstimulation syndrome, fertility preservation or in the context of randomised trials. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  4. Haze is an important medium for the spread of rotavirus.

    PubMed

    Ye, Qing; Fu, Jun-Feng; Mao, Jian-Hua; Shen, Hong-Qiang; Chen, Xue-Jun; Shao, Wen-Xia; Shang, Shi-Qiang; Wu, Yi-Feng

    2016-09-01

    This study investigated whether the rotavirus infection rate in children is associated with temperature and air pollutants in Hangzhou, China. This study applied a distributed lag non-linear model (DLNM) to assess the effects of daily meteorological data and air pollutants on the rotavirus positive rate among outpatient children. There was a negative correlation between temperature and the rotavirus infection rate. The impact of temperature on the detection rate of rotavirus presented an evident lag effect, the temperature change shows the greatest impact on the detection rate of rotavirus approximate at lag one day, and the maximum relative risk (RR) was approximately 1.3. In 2015, the maximum cumulative RR due to the cumulative effect caused by the temperature drop was 2.5. Particulate matter (PM) 2.5 and PM10 were the primary air pollutants in Hangzhou. The highest RR of rotavirus infection occurred at lag 1-1.5 days after the increase in the concentration of these pollutants, and the RR increased gradually with the increase in concentration. Based on the average concentrations of PM2.5 of 53.9 μg/m(3) and PM10 of 80.6 μg/m(3) in Hangzhou in 2015, the cumulative RR caused by the cumulative effect was 2.5 and 2.2, respectively. The current study suggests that temperature is an important factor impacting the rotavirus infection rate of children in Hangzhou. Air pollutants significantly increased the risk of rotavirus infection, and dosage, lag and cumulative effects were observed. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. An exploratory study on differences in cumulative plantar tissue stress between healing and non-healing plantar neuropathic diabetic foot ulcers.

    PubMed

    van Netten, Jaap J; van Baal, Jeff G; Bril, Adriaan; Wissink, Marieke; Bus, Sicco A

    2018-03-01

    Mechanical stress is important in causing and healing plantar diabetic foot ulcers, but almost always studied as peak pressure only. Measuring cumulative plantar tissue stress combines plantar pressure and ambulatory activity, and better defines the load on ulcers. Our aim was to explore differences in cumulative plantar tissue stress between people with healing and non-healing plantar diabetic foot ulcers. We analyzed a subgroup of 31 patients from a randomized clinical trial, treated with a removable offloading device for their plantar diabetic forefoot ulcer. We measured in-device dynamic plantar pressure and daily stride count to calculate cumulative plantar tissue stress at the ulcer location and associated this with ulcer healing and ulcer surface area reduction at four weeks (Student's t and chi-square test for significance, Cohen's d for effect size). In 12 weeks, 68% (n = 21) of the ulcers healed and 32% (n = 10) did not. No statistically significant differences were found for cumulative plantar tissue stress, plantar pressure or ambulatory activity between people with healed and not-healed ulcers. Cumulative plantar tissue stress was 25% lower for people with healed ulcers (155 vs. 207 MPa·s/day; P = 0.71; Effect size: d = 0.29). Post-hoc analyses in the 27 patients who self-reported to be adherent to wearing the device showed that cumulative plantar tissue stress was 49% lower for those who reached ≥75% ulcer surface area reduction at four weeks (140 vs. 275 MPa·s/day; P = 0.09; d = 0.76); smaller differences and effect sizes were found for peak pressure (24%), peak pressure-time integral (30%) and ambulatory activity (26%); (P-value range: 0.14-0.97; Cohen's d range: 0.14-0.70). Measuring cumulative plantar tissue stress may provide insight beyond that obtained from plantar pressure or ambulatory activity alone, with regard to diabetic foot ulcer healing using removable offloading devices. These explorative findings provide baseline data for further studies on this relevant topic. Copyright © 2018 Elsevier Ltd. All rights reserved.

  6. Safety and tolerability profile of daclizumab in patients with relapsing-remitting multiple sclerosis: An integrated analysis of clinical studies.

    PubMed

    Giovannoni, Gavin; Kappos, Ludwig; Gold, Ralf; Khatri, Bhupendra O; Selmaj, Krzysztof; Umans, Kimberly; Greenberg, Steven J; Sweetser, Marianne; Elkins, Jacob; McCroskery, Peter

    2016-09-01

    Daclizumab has been evaluated in multicentre, randomised, double-blind studies for the treatment of patients with relapsing-remitting multiple sclerosis (RRMS). Safety and tolerability are key considerations in MS treatment selection, as they influence adherence to medication. Evaluate the safety of daclizumab in patients with RRMS from an integrated analysis of six clinical studies. Patients treated with at least one dose of subcutaneous daclizumab 150mg or 300mg monthly in three completed and three ongoing clinical studies were included in this integrated analysis. Cumulative incidence of treatment-emergent adverse events (AEs) was the primary endpoint. This analysis included 2236 patients with 5214 patient-years of exposure to daclizumab. The cumulative incidence of any AE was 84% and of any serious AE excluding MS relapse was 16%. The incidences of AEs when evaluated by 6-month intervals remained stable over the 6.5 years of maximum follow-up. Most AEs were mild or moderate in severity. An important safety concern associated with daclizumab therapy involved hepatic AEs (16%) and serum transaminase elevations at least three times the upper limit of normal (10%), most of which were asymptomatic, self-limiting, and non-recurring. Cumulative incidences of cutaneous, infectious, and gastrointestinal AEs were 33%, 59%, and 25%, respectively; most events either resolved spontaneously or were treated successfully with standard medical interventions and did not result in discontinuation of treatment. This integrated analysis demonstrates that treatment of RRMS with daclizumab for periods of up to 6.5 years is associated with an acceptable safety profile with no evidence of cumulative toxicity over time. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  7. Extreme weather-year sequences have nonadditive effects on environmental nitrogen losses.

    PubMed

    Iqbal, Javed; Necpalova, Magdalena; Archontoulis, Sotirios V; Anex, Robert P; Bourguignon, Marie; Herzmann, Daryl; Mitchell, David C; Sawyer, John E; Zhu, Qing; Castellano, Michael J

    2018-01-01

    The frequency and intensity of extreme weather years, characterized by abnormal precipitation and temperature, are increasing. In isolation, these years have disproportionately large effects on environmental N losses. However, the sequence of extreme weather years (e.g., wet-dry vs. dry-wet) may affect cumulative N losses. We calibrated and validated the DAYCENT ecosystem process model with a comprehensive set of biogeophysical measurements from a corn-soybean rotation managed at three N fertilizer inputs with and without a winter cover crop in Iowa, USA. Our objectives were to determine: (i) how 2-year sequences of extreme weather affect 2-year cumulative N losses across the crop rotation, and (ii) if N fertilizer management and the inclusion of a winter cover crop between corn and soybean mitigate the effect of extreme weather on N losses. Using historical weather (1951-2013), we created nine 2-year scenarios with all possible combinations of the driest ("dry"), wettest ("wet"), and average ("normal") weather years. We analyzed the effects of these scenarios following several consecutive years of relatively normal weather. Compared with the normal-normal 2-year weather scenario, 2-year extreme weather scenarios affected 2-year cumulative NO 3 - leaching (range: -93 to +290%) more than N 2 O emissions (range: -49 to +18%). The 2-year weather scenarios had nonadditive effects on N losses: compared with the normal-normal scenario, the dry-wet sequence decreased 2-year cumulative N 2 O emissions while the wet-dry sequence increased 2-year cumulative N 2 O emissions. Although dry weather decreased NO 3 - leaching and N 2 O emissions in isolation, 2-year cumulative N losses from the wet-dry scenario were greater than the dry-wet scenario. Cover crops reduced the effects of extreme weather on NO 3 - leaching but had a lesser effect on N 2 O emissions. As the frequency of extreme weather is expected to increase, these data suggest that the sequence of interannual weather patterns can be used to develop short-term mitigation strategies that manipulate N fertilizer and crop rotation to maximize crop N uptake while reducing environmental N losses. © 2017 John Wiley & Sons Ltd.

  8. Evaluation of mortality among marines and navy personnel exposed to contaminated drinking water at USMC base Camp Lejeune: a retrospective cohort study

    PubMed Central

    2014-01-01

    Background Two drinking water systems at U.S. Marine Corps Base Camp Lejeune, North Carolina were contaminated with solvents during 1950s-1985. Methods We conducted a retrospective cohort mortality study of Marine and Naval personnel who began service during 1975-1985 and were stationed at Camp Lejeune or Camp Pendleton, California during this period. Camp Pendleton’s drinking water was uncontaminated. Mortality follow-up was 1979-2008. Standardized Mortality Ratios were calculated using U.S. mortality rates as reference. We used survival analysis to compare mortality rates between Camp Lejeune (N = 154,932) and Camp Pendleton (N = 154,969) cohorts and assess effects of cumulative exposures to contaminants within the Camp Lejeune cohort. Models estimated monthly contaminant levels at residences. Confidence intervals (CIs) indicated precision of effect estimates. Results There were 8,964 and 9,365 deaths respectively, in the Camp Lejeune and Camp Pendleton cohorts. Compared to Camp Pendleton, Camp Lejeune had elevated mortality hazard ratios (HRs) for all cancers (HR = 1.10, 95% CI: 1.00, 1.20), kidney cancer (HR = 1.35, 95% CI: 0.84, 2.16), liver cancer (HR = 1.42, 95% CI: 0.92, 2.20), esophageal cancer (HR = 1.43 95% CI: 0.85, 2.38), cervical cancer (HR = 1.33, 95% CI: 0.24, 7.32), Hodgkin lymphoma (HR = 1.47, 95% CI: 0.71, 3.06), and multiple myeloma (HR = 1.68, 95% CI: 0.76, 3.72). Within the Camp Lejeune cohort, monotonic categorical cumulative exposure trends were observed for kidney cancer and total contaminants (HR, high cumulative exposure = 1.54, 95% CI: 0.63, 3.75; log10 β = 0.06, 95% CI: -0.05, 0.17), Hodgkin lymphoma and trichloroethylene (HR, high cumulative exposure = 1.97, 95% CI: 0.55, 7.03; β = 0.00005, 95% CI: -0.00003, 0.00013) and benzene (HR, high cumulative exposure = 1.94, 95% CI: 0.54, 6.95; β = 0.00203, 95% CI: -0.00339, 0.00745). Amyotrophic Lateral Sclerosis (ALS) had HR = 2.21 (95% CI: 0.71, 6.86) at high cumulative vinyl chloride exposure but a non-monotonic exposure-response relationship (β = 0.0011, 95% CI: 0.0002, 0.0020). Conclusion The study found elevated HRs at Camp Lejeune for several causes of death including cancers of the kidney, liver, esophagus, cervix, multiple myeloma, Hodgkin lymphoma and ALS. CIs were wide for most HRs. Because <6% of the cohort had died, long-term follow-up would be necessary to comprehensively assess effects of drinking water exposures at the base. PMID:24552493

  9. A probabilistic analysis of cumulative carbon emissions and long-term planetary warming

    DOE PAGES

    Fyke, Jeremy Garmeson; Matthews, H. Damon

    2015-11-16

    Efforts to mitigate and adapt to long-term climate change could benefit greatly from probabilistic estimates of cumulative carbon emissions due to fossil fuel burning and resulting CO 2-induced planetary warming. Here we demonstrate the use of a reduced-form model to project these variables. We performed simulations using a large-ensemble framework with parametric uncertainty sampled to produce distributions of future cumulative emissions and consequent planetary warming. A hind-cast ensemble of simulations captured 1980–2012 historical CO 2 emissions trends and an ensemble of future projection simulations generated a distribution of emission scenarios that qualitatively resembled the suite of Representative and Extended Concentrationmore » Pathways. The resulting cumulative carbon emission and temperature change distributions are characterized by 5–95th percentile ranges of 0.96–4.9 teratonnes C (Tt C) and 1.4 °C–8.5 °C, respectively, with 50th percentiles at 3.1 Tt C and 4.7 °C. Within the wide range of policy-related parameter combinations that produced these distributions, we found that low-emission simulations were characterized by both high carbon prices and low costs of non-fossil fuel energy sources, suggesting the importance of these two policy levers in particular for avoiding dangerous levels of climate warming. With this analysis we demonstrate a probabilistic approach to the challenge of identifying strategies for limiting cumulative carbon emissions and assessing likelihoods of surpassing dangerous temperature thresholds.« less

  10. Type 2 Diabetes Mellitus in Youth Exposed to Antipsychotics: A Systematic Review and Meta-analysis.

    PubMed

    Galling, Britta; Roldán, Alexandra; Nielsen, René E; Nielsen, Jimmi; Gerhard, Tobias; Carbon, Maren; Stubbs, Brendon; Vancampfort, Davy; De Hert, Marc; Olfson, Mark; Kahl, Kai G; Martin, Andres; Guo, Jeff J; Lane, Hsien-Yuan; Sung, Fung-Chang; Liao, Chun-Hui; Arango, Celso; Correll, Christoph U

    2016-03-01

    Antipsychotics are used increasingly in youth for nonpsychotic and off-label indications, but cardiometabolic adverse effects and (especially) type 2 diabetes mellitus (T2DM) risk have raised additional concern. To assess T2DM risk associated with antipsychotic treatment in youth. Systematic literature search of PubMed and PsycINFO without language restrictions from database inception until May 4, 2015. Data analyses were performed in July 2015, and additional analyses were added in November 2015. Longitudinal studies reporting on T2DM incidence in youth 2 to 24 years old exposed to antipsychotics for at least 3 months. Two independent investigators extracted study-level data for a random-effects meta-analysis and meta-regression of T2DM risk. The coprimary outcomes were study-defined T2DM, expressed as cumulative T2DM risk or as T2DM incidence rate per patient-years. Secondary outcomes included the comparison of the coprimary outcomes in antipsychotic-treated youth with psychiatric controls not receiving antipsychotics or with healthy controls. Thirteen studies were included in the meta-analysis, including 185,105 youth exposed to antipsychotics and 310,438 patient-years. The mean (SD) age of patients was 14.1 (2.1) years, and 59.5% were male. The mean (SD) follow-up was 1.7 (2.3) years. Among them, 7 studies included psychiatric controls (1,342,121 patients and 2,071,135 patient-years), and 8 studies included healthy controls (298,803 patients and 463,084 patient-years). Antipsychotic-exposed youth had a cumulative T2DM risk of 5.72 (95% CI, 3.45-9.48; P < .001) per 1000 patients. The incidence rate was 3.09 (95% CI, 2.35-3.82; P < .001) cases per 1000 patient-years. Compared with healthy controls, cumulative T2DM risk (odds ratio [OR], 2.58; 95% CI, 1.56-4.24; P < .0001) and incidence rate ratio (IRR) (IRR, 3.02; 95% CI, 1.71-5.35; P < .0001) were significantly greater in antipsychotic-exposed youth. Similarly, compared with psychiatric controls, antipsychotic-exposed youth had significantly higher cumulative T2DM risk (OR, 2.09; 95% CI, 1.50-52.90; P < .0001) and IRR (IRR, 1.79; 95% CI, 1.31-2.44; P < .0001). In multivariable meta-regression analyses of 10 studies, greater cumulative T2DM risk was associated with longer follow-up (P < .001), olanzapine prescription (P < .001), and male sex (P = .002) (r(2) = 1.00, P < .001). Greater T2DM incidence was associated with second-generation antipsychotic prescription (P ≤ .050) and less autism spectrum disorder diagnosis (P = .048) (r(2) = 0.21, P = .044). Although T2DM seems rare in antipsychotic-exposed youth, cumulative risk and exposure-adjusted incidences and IRRs were significantly higher than in healthy controls and psychiatric controls. Olanzapine treatment and antipsychotic exposure time were the main modifiable risk factors for T2DM development in antipsychotic-exposed youth. Antipsychotics should be used judiciously and for the shortest necessary duration, and their efficacy and safety should be monitored proactively.

  11. Complement factor H Y402H variant and risk of age-related macular degeneration in Asians: a systematic review and meta-analysis.

    PubMed

    Kondo, Naoshi; Bessho, Hiroaki; Honda, Shigeru; Negi, Akira

    2011-02-01

    To investigate whether the Y402H variant in the complement factor H gene is associated with age-related macular degeneration (AMD) in Asian populations. Meta-analysis of previous publications. Case-control groups of subjects with AMD and controls from 13 association studies. We performed a meta-analysis of the association between Y402H and AMD in Asian populations using data available from 13 case-control studies involving 3973 subjects. Summary odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using fixed- and random-effects models. The Q-statistic test was used to assess heterogeneity, and Egger's test was used to evaluate publication bias. Sensitivity analysis, cumulative meta-analysis, and meta-regression analysis were also performed. Allele and genotype frequencies of the Y402H variant. The Y402H variant showed a significant summary OR of 1.97 (95% CI, 1.54-2.52; P<0.001; allelic contrast model) per allele. Possession of at least 1 copy of the C allele increased the disease risk by 1.97-fold (95% CI, 1.63-2.39; P<0.001; dominant model) and accounted for 8.8% of the attributable risk of AMD in Asian populations. Sensitivity analysis indicated the robustness of our findings, and evidence of publication bias was not observed in our meta-analysis. Meta-regression analysis indicated no significant effect of baseline study characteristics on the summary effect size. Cumulative meta-analysis revealed that the summary ORs were stable and the 95% CIs narrowed with the accumulation of data over time. Our analysis provides substantial evidence that the Y402H variant is significantly associated with AMD in Asian populations. Our results expand the number of confirmed AMD susceptibility loci for Asians populations, which provide a better understanding of the genetic architecture underlying disease susceptibility and may advance the potential for preclinical prediction in future genetic tests by a combined evaluation of inherited susceptibility with previously established loci. Copyright © 2011 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  12. The value of atorvastatin over the product life cycle in the United States.

    PubMed

    Grabner, Michael; Johnson, Wallace; Abdulhalim, Abdulla M; Kuznik, Andreas; Mullins, C Daniel

    2011-10-01

    US health care reform mandates the reduction of wasteful health care spending while maintaining quality of care. Introducing new drugs into crowded therapeutic classes may be viewed as offering "me-too" (new drugs with a similar mechanism of action compared to existing drugs) drugs without incremental benefit. This article presents an analysis of the incremental costs and benefits of atorvastatin, a lipid-lowering agent. This analysis models the cost-effectiveness of atorvastatin over the product life cycle. The yearly cost-effectiveness of atorvastatin compared to simvastatin was modeled from 1997 to 2030 from the point of view of a US third-party payer. Estimates for incremental costs (in US $) and effects (in quality-adjusted life-years [QALYs]) for the primary and secondary prevention of cardiovascular events were taken from previously published literature and adjusted for changes in drug prices over time. Estimates of total statin use were derived using the National Health and Nutrition Examination Survey. Sensitivity analyses were conducted to examine variations in study parameters, including drug prices, indications, and discount rates. Assuming increasing statin use over time (with a mean of 1.07 million new users per year) and a 3% discount rate, the cumulative incremental cost-effectiveness ratio (ICER) of atorvastatin versus simvastatin ranged from cost-savings at release to a maximum of $45,066/QALY after 6 years of generic simvastatin use in 2012. Over the full modeled life cycle (1997-2030), the cumulative ICER of atorvastatin was $20,331/QALY. The incremental value of atorvastatin to US payers (after subtracting costs) was estimated at $44.57 to $194.78 billion, depending on willingness to pay. Findings from the sensitivity analyses were similar. A hypothetical situation in which atorvastatin did not exist was associated with a reduction in total expenditures but also a loss of QALYs gained. The cumulative ICER of atorvastatin varied across the product life cycle, increasing during the period between generic simvastatin entry and generic atorvastatin entry, and decreasing thereafter. Copyright © 2011 Elsevier HS Journals, Inc. All rights reserved.

  13. Accumulated state assessment of the Peace-Athabasca-Slave River system.

    PubMed

    Dubé, Monique G; Wilson, Julie E

    2013-07-01

    Effects-based analysis is a fundamental component of watershed cumulative effects assessment. This study conducted an effects-based analysis for the Peace-Athabasca-Slave River System, part of the massive Mackenzie River Basin, encompassing 20% of Canada's total land mass and influenced by cumulative contributions of the W.A.C. Bennett Dam (Peace River) and industrial activities including oil sands mining (Athabasca River). This study assessed seasonal changes in 1) Peace River water quality and quantity before and after dam development, 2) Athabasca River water quality and quantity before and after oil sands developments, 3) tributary inputs from the Peace and Athabasca Rivers to the Slave River, and 4) upstream to downstream differences in water quality in the Slave River. In addition, seasonal benchmarks were calculated for each river based on pre-perturbation post-perturbation data for future cumulative effects assessments. Winter discharge (January-March) from the Peace and Slave Rivers was significantly higher than before dam construction (pre-1967) (p < 0.05), whereas summer peak flows (May-July) were significantly lower than before the dam showing that regulation has significantly altered seasonal flow regimes. During spring freshet and summer high flows, the Peace River strongly influenced the quality of the Slave River, as there were no significant differences in loadings of dissolved N, total P (TP), total organic C (TOC), total As, total Mn, total V, and turbidity and specific conductance between these rivers. In the Athabasca River, TP and specific conductance concentrations increased significantly since before oil sands developments (1967-2010), whereas dissolved N and sulfate have increased after the oil sands developments (1977-2010). Recently, the Athabasca River had significantly higher concentrations of dissolved N, TP, TOC, dissolved sulfate, specific conductance, and total Mn than either the Slave or the Peace Rivers during the winter months. The transboundary nature of the Peace, Athabasca, and Slave River basins has resulted in fragmented monitoring and reporting of the state of these rivers, and a more consistent monitoring framework is recommended. Copyright © 2012 SETAC.

  14. Impact of gender on efficacy and acute toxicity of alkylating agent -based chemotherapy in Ewing sarcoma: secondary analysis of the Euro-Ewing99-R1 trial.

    PubMed

    van den Berg, Henk; Paulussen, Michael; Le Teuff, Gwénaël; Judson, Ian; Gelderblom, Hans; Dirksen, Uta; Brennan, Bernadette; Whelan, Jeremy; Ladenstein, Ruth Lydia; Marec-Berard, Perrine; Kruseova, Jarmila; Hjorth, Lars; Kühne, Thomas; Brichard, Benedicte; Wheatley, Keith; Craft, Alan; Juergens, Heribert; Gaspar, Nathalie; Le Deley, Marie-Cécile

    2015-11-01

    Based on the randomised Euro-EWING99-R1 trial, vincristine, adriamycin, cyclophosphamide (VAC) may be able to replace vincristine, adriamycin, ifosfamide (VAI) in the treatment of standard-risk Ewing sarcoma. However some heterogeneity of treatment effect by gender was observed. The current exploratory study aimed at investigating the influence of gender on treatment efficacy and acute toxicity. Impact of gender on event-free survival (EFS), acute toxicity by course, switches between treatment arms and cumulative dose of alkylating agents was evaluated in multivariable models adjusted for age including terms to test for heterogeneity of treatment effect by gender. The analysis of the EFS was performed on the intention-to-treat population. EFS did not significantly differ between the 509 males and 347 females (p=0.33), but an interaction in terms of efficacy was suspected between treatment and gender (p=0.058): VAC was associated with poorer EFS than VAI in males, hazard ratio (HR) (VAC/VAI)=1.37 [95% confidence interval (CI), 0.98-1.90], contrasting with HR=0.81 [95%CI, 0.53-1.24] in females. Severe toxicity was more frequent in females, whatever the toxicity type. Thirty patients switched from VAI to VAC (9/251 males, 4%, and 21/174 females, 12%) mostly due to renal toxicity, and three from VAC to VAI (2/258 males, 0.8%, and 1/173 females, 0.6%). A reduction of alkylating agent cumulative dose >20% was more frequent in females (15% versus 9%, p=0.005), with no major difference between VAC and VAI (10% versus 13%, p=0.15). Differences of acute toxicity rate and cumulative doses of alkylating agents could not explain the marginal interaction observed in the Euro-EWING99-R1 trial data. Effects of gender-dependent polymorphism/activity of metabolic enzymes (e.g. known for CYP2B6) of ifosfamide versus cyclophosphamide should be explored. External data are required to further evaluate whether there is heterogeneity of alkylating agent effect by gender. NCT00987636 and EudraCT 2008-003658-13. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Associations between environmental quality and mortality in the contiguous United States 2000-2005

    EPA Science Inventory

    BACKGROUND: Assessing cumulative effects of the multiple environmental factors influencing mortality remains a challenging task. OBJECTIVES: This study aimed to examine the associations between cumulative environmental quality and all-cause and leading cause-specific (heart dise...

  16. PERMETHRIN BUT NOT DELTAMETHRIN INCREASES SPONTANEOUS GLUTAMATE RELEASE FROM HIPPOCAMPAL NEURONS IN CULTURE.

    EPA Science Inventory

    This manuscript provides important information relevant to the cumulative risk assessment of pyrethroid insecticides. Others have proposed that pyrethroid effects on voltage-gated calcium channels contribute the neurotoxicity and must be considered in cumulative risk assessments ...

  17. Mentor Tutoring: An Efficient Method for Teaching Laparoscopic Colorectal Surgical Skills in a General Hospital.

    PubMed

    Ichikawa, Nobuki; Homma, Shigenori; Yoshida, Tadashi; Ohno, Yosuke; Kawamura, Hideki; Wakizaka, Kazuki; Nakanishi, Kazuaki; Kazui, Keizo; Iijima, Hiroaki; Shomura, Hiroki; Funakoshi, Tohru; Nakano, Shiro; Taketomi, Akinobu

    2017-12-01

    We retrospectively assessed the efficacy of our mentor tutoring system for teaching laparoscopic colorectal surgical skills in a general hospital. A series of 55 laparoscopic colectomies performed by 1 trainee were evaluated. Next, the learning curves for high anterior resection performed by the trainee (n=20) were compared with those of a self-trained surgeon (n=19). Cumulative sum analysis and multivariate regression analyses showed that 38 completed cases were needed to reduce the operative time. In high anterior resection, the mean operative times were significantly shorter after the seventh average for the tutored surgeon compared with that for the self-trained surgeon. In cumulative sum charting, the curve reached a plateau by the seventh case for the tutored surgeon, but continued to increase for the self-trained surgeon. Mentor tutoring effectively teaches laparoscopic colorectal surgical skills in a general hospital setting.

  18. Accelerated test system strength models based on Birnbaum-Saunders distribution: a complete Bayesian analysis and comparison.

    PubMed

    Upadhyay, S K; Mukherjee, Bhaswati; Gupta, Ashutosh

    2009-09-01

    Several models for studies related to tensile strength of materials are proposed in the literature where the size or length component has been taken to be an important factor for studying the specimens' failure behaviour. An important model, developed on the basis of cumulative damage approach, is the three-parameter extension of the Birnbaum-Saunders fatigue model that incorporates size of the specimen as an additional variable. This model is a strong competitor of the commonly used Weibull model and stands better than the traditional models, which do not incorporate the size effect. The paper considers two such cumulative damage models, checks their compatibility with a real dataset, compares them with some of the recent toolkits, and finally recommends a model, which appears an appropriate one. Throughout the study is Bayesian based on Markov chain Monte Carlo simulation.

  19. Discussion of the paper ``the use of conditional simulation in nuclear waste site performance assessment,`` by Carol A. Gotway

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

    Gilbert, R.O.; Doctor, P.G.

    1993-08-01

    First, we applaud Dr. Gotway for seeking via her paper to expose a wider audience of statisticians to the many interesting and challenging modeling and statistical problems in the environmental area. This well-written paper effective explains the WIPP and the context of the analysis. Dr. Gotway`s paper describes a geostatistical conditional simulation approach combined with deterministic modeling to estimate the cumulative distribution function (cdf) of groundwater travel time (GWTT), information that is needed for estimating the cumulative release of nuclear waste from the repository. We begin our discussion with comments and questions on modeling aspects of Dr. Gotway`s paper. Thenmore » we discuss uncertainty and sensitivity analyses and some of the problems inherent with implementing those techniques including correlations, elicitation of expert opinion, and planning to achieve specified Data Quality Objectives (DQOs).« less

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

    PubMed

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

    2010-01-01

    Nursing staff burnout is a significant challenge in the delivery of nursing home care. Using a representative sample of nursing staff working within the nursing home setting, our analysis addressed the influence of conflict with residents' families on the burnout experience of staff. Through the use of computer simulation modeling we were able to assess the cumulative effects of conflict between staff and families. Findings indicated that conflict with the residents' families increased both burnout and dissatisfaction among nursing staff. The burnout experience of nursing staff peaked with initial episodes of conflict, then leveled off as simulated conflict with family members continued. Because previous research has indicated that burnout tends to peak early in nurses' career cycle, the finding that initial episodes of conflict have a strong influence on nursing staff burnout highlights the importance of interpersonal conflict within nursing homes in both individual and institutional outcomes. Copyright 2010, SLACK Incorporated.

  1. Cumulative effects from repeated exposures to ultraviolet radiation

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

    Kaidbey, K.H.; Kligman, A.M.

    Repeated exposures to subliminal doses of UVR, given at 24-hr intervals, resulted in a lowering of the erythema threshold dose. At erythemogenically equivalent doses, UV-A was the most effective and UV-C the least. A similar and more pronounced effect was observed following repeated exposures to subthreshold doses of UV-A and topically applied 8-methoxypsoralen. These findings provide quantitative evidence for the cumulative nature of acute UVR damage in human skin.

  2. Long-Term Cumulative Effects of Childcare on Children's Mental Development and Socioemotional Adjustment in a Non-Risk Sample: The Moderating Effects of Gender

    ERIC Educational Resources Information Center

    Bornstein, Marc H.; Hahn, Chun-Shin; Gist, Nancy F.; Haynes, O. Maurice

    2006-01-01

    We studied the long-term cumulative effects of two common indices of childcare--the total number of hours of non-maternal care and the mean hour-weighted child-to-caregiver ratio per caregiving situation--on mental development and socioemotional adjustment from birth to 4.5 years old in a non-risk middle-class sample of girls and boys after taking…

  3. Effects of gravel on infiltration, runoff, and sediment yield in landslide deposit slope in Wenchuan earthquake area, China.

    PubMed

    Li, Tianyang; He, Binghui; Chen, Zhanpeng; Zhang, Yi; Liang, Chuan; Wang, Renxin

    2016-06-01

    Amounts of landslide deposits were triggered by the Wenchuan earthquake with magnitude 8.0 on May 12, 2008. The landslide deposits were composed of soil and rock fragments, which play important roles in hydrological and erosion processes in the steep slope of landslide deposits. The mixtures of soil and gravels are common in the top layers of landslide deposits, and its processes are obviously different with the soil without gravels. Based on the data of field investigation, a series of simulated scouring flow experiments with four proportion of gravel (0, 25, 33.3, and 50 %) and three scouring flow rates (4, 8, 12 L/min) under two steep slopes (67.5, 72.7 %) were conducted sequentially to know the effects of proportion of gravel on infiltration capacity, runoff generation, and sediment production in the steep slope of landslide deposit. Results indicated that gravel had promoted or reduced effects on infiltration capacity which could affect further the cumulative runoff volume and cumulative sediment mass increase or decrease. The cumulative infiltration volume in 25 % proportion of gravel was less than those in 0, 33.3, and 50 % proportion of gravel. The cumulative runoff volume was in an order of 25 > 0 > 33.3 > 50 % while cumulative sediment mass ranked as 25 > 33.3 > 0 > 50 % with different proportions of gravel. A significant power relationship was found between scouring time and cumulative runoff volume as well as cumulative sediment mass. The relationship between average soil and water loss rate and proportion of gravel was able to express by quadratic function, with a high degree of reliability. The results have important implications for soil and water conservation and modeling in landslide deposit but also provide useful information for the similar conditions.

  4. Approaches for grouping of pesticides into cumulative assessment groups for risk assessment of pesticide residues in food.

    PubMed

    Colnot, Thomas; Dekant, Wolfgang

    2017-02-01

    The European Food Safety Authority (EFSA) is developing approaches to cumulative risk assessment of pesticides by assigning individual pesticides to cumulative assessment groups (CAGs). For assignment to CAGs, EFSA recommended to rely on adverse effects on the specific target system. Contractors to EFSA have proposed to allocate individual pesticides into CAGs relying on NOAELs for effects on target organs. This manuscript evaluates the assignments by applying EFSAs criteria to the CAGs "Toxicity to the nervous system" and "Toxicity to the thyroid hormone system (gland or hormones)". Assignment to the CAG "Toxicity to the nervous system" based, for example, on neurochemical effects like choline esterase inhibition is well supported, whereas assignment to the CAG "Toxicity to the thyroid hormone system (gland or hormones)" has been based in the examined case studies on non-reproducible effects seen in single studies or on observations that are not adverse. Therefore, a more detailed effects evaluation is required to assign a pesticide to a CAG for a target organ where many confounders regarding effects are present. Relative potency factors in cumulative risk assessment should be based on benchmark doses from studies in one species with identical study design and human relevance of effects on specific target organs should be analyzed to define minimal margins of exposure. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  5. Cumulative Impact Assessment: Approaching Environmental Capacity in Development Area Using Environmental Impact Assessment Information

    NASA Astrophysics Data System (ADS)

    Cho, N.; Lee, M. J.; Maeng, J. H.

    2017-12-01

    Environmental impact assessment estimates the impact of development as a business unit and establishes mitigation plan. If the development is done, its economic effects can spread to the nearby areas. So that various developments can be distributed at different time intervals. The impact of the new developments can be combined with existing environmental impacts and can have a larger impact. That is, Cumulative impact assessment is needed to consider the environmental capacity of the Nearby area. Cumulative impact assessments require policy tools such as environmental impact assessment information and cumulative impact estimation models. In Korea, environmental information (water quality, air quality, etc.) of the development site is measured for environmental impact assessment and monitored for a certain period (generally 5 years) after the project. In addition, by constructing the environmental information as a spatial database, it is possible to express the environmental impact on a regional basis spatially and to intuitively use it for development site selection. Utilizing a composite model of environmental impact assessment information and Remote Sensing data for cumulative impact estimation, That can be used as a policy decision support tool that provides quantitative information for development area management, such as time series effect and sprawl phenomenon.

  6. Evaluation of environmental impact produced by different economic activities with the global pollution index.

    PubMed

    Zaharia, Carmen

    2012-07-01

    The paper analyses the environment pollution state in different case studies of economic activities (i.e. co-generation electric and thermal power production, iron profile manufacturing, cement processing, waste landfilling, and wood furniture manufacturing), evaluating mainly the environmental cumulative impacts (e.g. cumulative impact against the health of the environment and different life forms). The status of the environment (air, water resources, soil, and noise) is analysed with respect to discharges such as gaseous discharges in the air, final effluents discharged in natural receiving basins or sewerage system, and discharges onto the soil together with the principal pollutants expressed by different environmental indicators corresponding to each specific productive activity. The alternative methodology of global pollution index (I (GP)*) for quantification of environmental impacts is applied. Environmental data analysis permits the identification of potential impact, prediction of significant impact, and evaluation of cumulative impact on a commensurate scale by evaluation scores (ES(i)) for discharge quality, and global effect to the environment pollution state by calculation of the global pollution index (I (GP)*). The I (GP)* values for each productive unit (i.e. 1.664-2.414) correspond to an 'environment modified by industrial/economic activity within admissible limits, having potential of generating discomfort effects'. The evaluation results are significant in view of future development of each productive unit and sustain the economic production in terms of environment protection with respect to a preventive environment protection scheme and continuous measures of pollution control.

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

    PubMed

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

    2005-01-01

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

  8. Cumulative childhood risk and adult functioning in abused and neglected children grown up

    PubMed Central

    HORAN, JACQUELINE M.; WIDOM, CATHY SPATZ

    2017-01-01

    This paper examines the relationship between childhood exposure to cumulative risk and three indicators of psychosocial adjustment in adulthood (educational attainment, mental health, and criminal behavior) and tests three different models (linear, quadratic, and interaction). Data were collected over several time points from individuals who were part of a prospective cohort design study that matched children with documented cases of abuse and/or neglect with children without such histories and followed them into adulthood. Hierarchical multiple regressions compared linear and quadratic models and then examined potential moderating effects of child abuse/neglect and gender. Exposure to a greater number of childhood risk factors was significantly related to fewer years of education, more anxiety and depression symptomatology, and more criminal arrests in adulthood. The relationship between cumulative risk and years of education demonstrated a curvilinear pattern, whereas the relationship between cumulative risk and both mental health and criminal arrests was linear. Child abuse/neglect did not moderate these relationships, although there were direct effects for both child abuse/neglect and gender on criminal arrests, with more arrests for abused/neglected individuals than controls and more for males than females. Gender interacted with cumulative risk to impact educational attainment and criminal behavior, suggesting that interventions may be more effective if tailored differently for males and females. Interventions may need to be multifaceted and designed to address these different domains of functioning. PMID:25196178

  9. Cumulative childhood risk and adult functioning in abused and neglected children grown up.

    PubMed

    Horan, Jacqueline M; Widom, Cathy Spatz

    2015-08-01

    This paper examines the relationship between childhood exposure to cumulative risk and three indicators of psychosocial adjustment in adulthood (educational attainment, mental health, and criminal behavior) and tests three different models (linear, quadratic, and interaction). Data were collected over several time points from individuals who were part of a prospective cohort design study that matched children with documented cases of abuse and/or neglect with children without such histories and followed them into adulthood. Hierarchical multiple regressions compared linear and quadratic models and then examined potential moderating effects of child abuse/neglect and gender. Exposure to a greater number of childhood risk factors was significantly related to fewer years of education, more anxiety and depression symptomatology, and more criminal arrests in adulthood. The relationship between cumulative risk and years of education demonstrated a curvilinear pattern, whereas the relationship between cumulative risk and both mental health and criminal arrests was linear. Child abuse/neglect did not moderate these relationships, although there were direct effects for both child abuse/neglect and gender on criminal arrests, with more arrests for abused/neglected individuals than controls and more for males than females. Gender interacted with cumulative risk to impact educational attainment and criminal behavior, suggesting that interventions may be more effective if tailored differently for males and females. Interventions may need to be multifaceted and designed to address these different domains of functioning.

  10. Generation of electromagnetic energy in a magnetic cumulation generator with the use of inductively coupled circuits with a variable coupling coefficient

    NASA Astrophysics Data System (ADS)

    Gilev, S. D.; Prokopiev, V. S.

    2017-07-01

    A method of generation of electromagnetic energy and magnetic flux in a magnetic cumulation generator is proposed. The method is based on dynamic variation of the circuit coupling coefficient. This circuit is compared with other available circuits of magnetic energy generation with the help of magnetic cumulation (classical magnetic cumulation generator, generator with transformer coupling, and generator with a dynamic transformer). It is demonstrated that the proposed method allows obtaining high values of magnetic energy. The proposed circuit is found to be more effective than the known transformer circuit. Experiments on electromagnetic energy generation are performed, which demonstrate the efficiency of the proposed method.

  11. Analysis of the heavy oil production technology effectiveness using natural thermal convection with heat agent recirculation method in reservoirs with varying initial water saturation

    NASA Astrophysics Data System (ADS)

    Osnos, V. B.; Kuneevsky, V. V.; Larionov, V. M.; Saifullin, E. R.; Gainetdinov, A. V.; Vankov, Yu V.; Larionova, I. V.

    2017-01-01

    The method of natural thermal convection with heat agent recirculation (NTC HAR) in oil reservoirs is described. The analysis of the effectiveness of this method for oil reservoir heating with the values of water saturation from 0 to 0.5 units is conducted. As the test element Ashalchinskoye oil field is taken. CMG STARS software was used for calculations. Dynamics of cumulative production, recovery factor and specific energy consumption per 1 m3 of crude oil produced in the application of the heat exchanger with heat agent in cases of different initial water saturation are defined and presented as graphs.

  12. Evaluation of marginal failures of dental composite restorations by acoustic emission analysis.

    PubMed

    Gu, Ja-Uk; Choi, Nak-Sam

    2013-01-01

    In this study, a nondestructive method based on acoustic emission (AE) analysis was developed to evaluate the marginal failure states of dental composite restorations. Three types of ring-shaped substrates, which were modeled after a Class I cavity, were prepared from polymethyl methacrylate, stainless steel, and human molar teeth. A bonding agent and a composite resin were applied to the ring-shaped substrates and cured by light exposure. At each time-interval measurement, the tooth substrate presented a higher number of AE hits than polymethyl methacrylate and steel substrates. Marginal disintegration estimations derived from cumulative AE hits and cumulative AE energy parameters showed that a signification portion of marginal gap formation was already realized within 1 min at the initial light-curing stage. Estimation based on cumulative AE energy gave a higher level of marginal failure than that based on AE hits. It was concluded that the AE analysis method developed in this study was a viable approach in predicting the clinical survival of dental composite restorations efficiently within a short test period.

  13. The limits to cumulative causation: international migration from Mexican urban areas.

    PubMed

    Fussell, Elizabeth; Massey, Douglas S

    2004-02-01

    We present theoretical arguments and empirical research to suggest that the principal mechanisms of cumulative causation do not function in large urban settings. Using data from the Mexican Migration Project, we found evidence of cumulative causation in small cities, rural towns and villages, but not in large urban areas. With event-history models, we found little positive effect of community-level social capital and a strong deterrent effect of urban labor markets on the likelihood of first and later U.S. trips for residents of urban areas in Mexico, suggesting that the social process of migration from urban areas is distinct from that in the more widely studied rural migrant-sending communities of Mexico.

  14. Model for Cumulative Solar Heavy Ion Energy and LET Spectra

    NASA Technical Reports Server (NTRS)

    Xapsos, Mike; Barth, Janet; Stauffer, Craig; Jordan, Tom; Mewaldt, Richard

    2007-01-01

    A probabilistic model of cumulative solar heavy ion energy and lineary energy transfer (LET) spectra is developed for spacecraft design applications. Spectra are given as a function of confidence level, mission time period during solar maximum and shielding thickness. It is shown that long-term solar heavy ion fluxes exceed galactic cosmic ray fluxes during solar maximum for shielding levels of interest. Cumulative solar heavy ion fluences should therefore be accounted for in single event effects rate calculations and in the planning of space missions.

  15. 76 FR 69726 - Pyrethrins/Pyrethroid Cumulative Risk Assessment; Notice of Availability

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-09

    ... to consider available information concerning the cumulative effects on human health resulting from... stakeholders including environmental, human health, farm worker, and agricultural advocates; the chemical... factors, may have atypical or disproportionately high and adverse human health impacts or environmental...

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

    PubMed

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

    2016-01-01

    Many communities are located near multiple sources of pollution, including current and former industrial sites, major roadways, and agricultural operations. Populations in such locations are predominantly low-income, with a large percentage of minorities and non-English speakers. These communities face challenges that can affect the health of their residents, including limited access to health care, a shortage of grocery stores, poor housing quality, and a lack of parks and open spaces. Environmental exposures may interact with social stressors, thereby worsening health outcomes. Age, genetic characteristics, and preexisting health conditions increase the risk of adverse health effects from exposure to pollutants. There are existing approaches for characterizing cumulative exposures, cumulative risks, and cumulative health impacts. Although such approaches have merit, they also have significant constraints. New developments in exposure monitoring, mapping, toxicology, and epidemiology, especially when informed by community participation, have the potential to advance the science on cumulative impacts and to improve decision making.

  17. Measurement of flow harmonics with multi-particle cumulants in Pb+Pb collisions at √s NN = 2.76  TeV with the ATLAS detector

    DOE PAGES

    Aad, G.

    2014-11-26

    ATLAS measurements of the azimuthal anisotropy in lead–lead collisions at √s NN = 2.76 TeV are shown using a dataset of approximately 7 μb –1 collected at the LHC in 2010. The measurements are performed for charged particles with transverse momenta 0.5 < p T < 20 GeV and in the pseudorapidity range |η| < 2.5. The anisotropy is characterized by the Fourier coefficients, v n, of the charged-particle azimuthal angle distribution for n = 2–4. The Fourier coefficients are evaluated using multi-particle cumulants calculated with the generating function method. Results on the transverse momentum, pseudorapidity and centrality dependence ofmore » the v n coefficients are presented. The elliptic flow, v 2, is obtained from the two-, four-, six- and eight-particle cumulants while higher-order coefficients, v 3 and v 4, are determined with two- and four-particle cumulants. Flow harmonics v n measured with four-particle cumulants are significantly reduced compared to the measurement involving two-particle cumulants. A comparison to vn measurements obtained using different analysis methods and previously reported by the LHC experiments is also shown. Results of measurements of flow fluctuations evaluated with multi-particle cumulants are shown as a function of transverse momentum and the collision centrality. As a result, models of the initial spatial geometry and its fluctuations fail to describe the flow fluctuations measurements.« less

  18. Incidence, prevalence and clinical correlates of antidepressant-emergent mania in bipolar depression: a systematic review and meta-analysis.

    PubMed

    Fornaro, Michele; Anastasia, Annalisa; Novello, Stefano; Fusco, Andrea; Solmi, Marco; Monaco, Francesco; Veronese, Nicola; De Berardis, Domenico; de Bartolomeis, Andrea

    2018-05-01

    Treatment-emergent mania (TEM) represents a common phenomenon inconsistently reported across primary studies, warranting further assessment. A systematic review and meta-analysis following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) and Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guidelines were conducted. Major electronic databases were searched from inception to May 2017 to assess the incidence and prevalence rates and clinical features associated with manic switch among bipolar depressed patients receiving antidepressants, using meta-regression and subgroup analysis. Overall, 10 098 depressed patients with bipolar disorder (BD) across 51 studies/arms were included in the quantitative analysis. The cumulative incidence of cases (TEM + ) among 4767 patients with BD over 15 retrospective studies was 30.9% (95% confidence interval [CI] 19.6-45.0%, I 2  = 97.9%). The cumulative incidence of TEM + among 1929 patients with BD over 12 prospective open studies was 14.4% (95% CI 7.4-26.1%, I 2  = 93.7%). The cumulative incidence of TEM + among 1316 patients with BD over 20 randomized controlled trials (RCTs) was 11.8% (95% CI 8.4-16.34%, I 2  = 73.46%). The pooled prevalence of TEM + among 2086 patients with BD over four cross-sectional studies was 30.9% (95% CI 18.1-47.4%, I 2  = 95.6%). Overall, concurrent lithium therapy predicted the lowest TEM rates. Inconsistent operational definitions of TEM were recorded, and the lack of information about age, sex, co-occurring anxiety, and other clinically relevant moderators precluded further stratification of the results. Rates of TEM vary primarily depending on study setting, which is concordant with the high degree of heterogeneity of the included records. Forthcoming RCT studies should adopt consistent operational definitions of TEM and broaden the number of moderators, in order to contribute most effectively to the identification of clear-cut sub-phenotypes of BD and patient-tailored pharmacotherapy. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Valued ecosystem components for watershed cumulative effects: an analysis of environmental impact assessments in the South Saskatchewan River watershed, Canada.

    PubMed

    Ball, Murray A; Noble, Bram F; Dubé, Monique G

    2013-07-01

    The accumulating effects of human development are threatening water quality and availability. In recognition of the constraints to cumulative effects assessment (CEA) under traditional environmental impact assessment (EIA), there is an emerging body of research dedicated to watershed-based cumulative effects assessment (WCEA). To advance the science of WCEA, however, a standard set of ecosystem components and indicators is required that can be used at the watershed scale, to inform effects-based understanding of cumulative change, and at the project scale, to inform regulatory-based project based impact assessment and mitigation. A major challenge, however, is that it is not clear how such ecosystem components and indicators for WCEA can or should be developed. This study examined the use of aquatic ecosystem components and indicators in EIA practice in the South Saskatchewan River watershed, Canada, to determine whether current practice at the project scale could be "scaled up" to support ecosystem component and indicator development for WCEA. The hierarchy of assessment components and indicators used in a sample of 35 environmental impact assessments was examined and the factors affecting aquatic ecosystem component selection and indicator use were identified. Results showed that public environmental impact statements are not necessarily publically accessible, thus limiting opportunities for data and information sharing from the project to the watershed scale. We also found no consistent terminology across the sample of impact statements, thus making comparison of assessment processes and results difficult. Regulatory compliance was found to be the dominant factor influencing the selection of ecosystem components and indicators for use in project assessment, rather than scientific reasoning, followed by the mandate of the responsible government agency for the assessment, public input to the assessment process, and preexisting water licensing arrangements external to the assessment process. The current approach to project-based assessment offered little support for WCEA initiatives. It did not provide a standard set of aquatic ecosystem components and indicators or allow the sharing of information across projects and from the project to the watershed scale. We suggest that determining priority assessment parameters for WCEA requires adoption of a standardized framework of component and indicator terminology, which can then be populated for the watershed of concern based on both watershed-based priorities and project-specific regulatory requirements. Copyright © 2012 SETAC.

  20. Higher order net-proton number cumulants dependence on the centrality definition and other spurious effects

    NASA Astrophysics Data System (ADS)

    Sombun, S.; Steinheimer, J.; Herold, C.; Limphirat, A.; Yan, Y.; Bleicher, M.

    2018-02-01

    We study the dependence of the normalized moments of the net-proton multiplicity distributions on the definition of centrality in relativistic nuclear collisions at a beam energy of \\sqrt{{s}{NN}}=7.7 {GeV}. Using the ultra relativistic quantum molecular dynamics model as event generator we find that the centrality definition has a large effect on the extracted cumulant ratios. Furthermore we find that the finite efficiency for the determination of the centrality introduces an additional systematic uncertainty. Finally, we quantitatively investigate the effects of event-pile up and other possible spurious effects which may change the measured proton number. We find that pile-up alone is not sufficient to describe the data and show that a random double counting of events, adding significantly to the measured proton number, affects mainly the higher order cumulants in most central collisions.

  1. Cumulative psychosocial stress, coping resources, and preterm birth.

    PubMed

    McDonald, Sheila W; Kingston, Dawn; Bayrampour, Hamideh; Dolan, Siobhan M; Tough, Suzanne C

    2014-12-01

    Preterm birth constitutes a significant international public health issue, with implications for child and family well-being. High levels of psychosocial stress and negative affect before and during pregnancy are contributing factors to shortened gestation and preterm birth. We developed a cumulative psychosocial stress variable and examined its association with early delivery controlling for known preterm birth risk factors and confounding environmental variables. We further examined this association among subgroups of women with different levels of coping resources. Utilizing the All Our Babies (AOB) study, an ongoing prospective pregnancy cohort study in Alberta, Canada (n = 3,021), multinomial logistic regression was adopted to examine the independent effect of cumulative psychosocial stress and preterm birth subgroups compared to term births. Stratified analyses according to categories of perceived social support and optimism were undertaken to examine differential effects among subgroups of women. Cumulative psychosocial stress was a statistically significant risk factor for late preterm birth (OR = 1.73; 95 % CI = 1.07, 2.81), but not for early preterm birth (OR = 2.44; 95 % CI = 0.95, 6.32), controlling for income, history of preterm birth, pregnancy complications, reproductive history, and smoking in pregnancy. Stratified analyses showed that cumulative psychosocial stress was a significant risk factor for preterm birth at <37 weeks gestation for women with low levels of social support (OR = 2.09; 95 % CI = 1.07, 4.07) or optimism (OR = 1.87; 95 % CI = 1.04, 3.37). Our analyses suggest that early vulnerability combined with current anxiety symptoms in pregnancy confers risk for preterm birth. Coping resources may mitigate the effect of cumulative psychosocial stress on the risk for early delivery.

  2. Temporal Variability of Cumulative Risk Assessment on Phthalates in Chinese Pregnant Women: Repeated Measurement Analysis.

    PubMed

    Gao, Hui; Zhu, Bei-Bei; Tao, Xing-Yong; Zhu, Yuan-Duo; Tao, Xu-Guang; Tao, Fang-Biao

    2018-06-05

    The assessment of the combined effects of multiple phthalate exposures at low levels is a newly developed concept to avoid underestimating their actual cumulative health risk. A previous study included 3455 Chinese pregnant women. Each woman provided up to three urine samples (in total 9529). This previous study characterized the concentrations of phthalate metabolites. In the present study, the data from 9529 samples was reanalyzed to examine the cumulative risk assessment (CRA) with two models: (1) the creatinine-based and (2) the volume-based. Hazard index (HI) values for three phthalates, dibutyl phthalate, butyl benzyl phthalate, and di(2-ethylhexyl) phthalate, in the first, second, and third trimesters of pregnancy, were calculated, respectively. In creatinine-based model, 3.43%, 14.63%, and 17.28% of women showed HI based on the European Food Safety Authority tolerable daily intake exceeding 1 in the first, second, and third trimester of pregnancy, respectively. The intraclass correlation coefficient of HI was 0.49 (95% confidence interval: 0.46-0.53). Spearman correlations between HI of the creatinine model and ∑androgen disruptor (a developed potency weighted approach) ranged from 0.824 to 0.984. In summary, this study suggested a considerable risk of cumulative exposure to phthalates during the whole gestation in Chinese pregnant women. In addition, moderate temporal reproducibility indicated that single HI, estimated by the phthalate concentration in single spot of urine, seemed representative to describe the throughout pregnancy CRA. Finally, strong correlation between HI of the creatinine model and ∑androgen disruptor revealed that the creatinine-based model was more appropriate to evaluate the CRA.

  3. Engaging Communities in Research on Cumulative Risk and Social Stress-Environment Interactions: Lessons Learned from EPA's STAR Program

    PubMed Central

    Korfmacher, Katrina Smith; Cory-Slechta, Deborah A.; Jimenez, Maria; Symanski, Elaine; Carr Shmool, Jessie L.; Dotson-Newman, Ogonnaya; Clougherty, Jane E.; French, Robert; Levy, Jonathan I.; Laumbach, Robert; Rodgers, Kathryn; Bongiovanni, Roseann; Scammell, Madeleine K.

    2015-01-01

    Abstract Studies have documented cumulative health effects of chemical and nonchemical exposures, particularly chronic environmental and social stressors. Environmental justice groups have advocated for community participation in research that assesses how these interactions contribute to health disparities experienced by low-income and communities of color. In 2009, the U.S. Environmental Protection Agency issued a request for research applications (RFA), “Understanding the Role of Nonchemical Stressors and Developing Analytic Methods for Cumulative Risk Assessments.” Seven research projects were funded to help address this knowledge gap. Each engaged with communities in different ways. We describe the community engagement approaches of the seven research projects, which ranged from outreach through shared leadership/participatory. We then assess the experiences of these programs with respect to the community engagement goals of the RFA. We present insights from these community engagement efforts, including how the grants helped to build or enhance the capacity of community organizations in addition to contributing to the research projects. Our analysis of project proposals, annual grantee reports, and participant observation of these seven projects suggests guidelines for the development of future funding mechanisms and for conducting community-engaged research on cumulative risk involving environmental and social stressors including: 1) providing for flexibility in the mode of community engagement; 2) addressing conflict between research timing and engagement needs, 3) developing approaches for communicating about the uniquely sensitive issues of nonchemical stressors and social risks; and 4) encouraging the evaluation of community engagement efforts. PMID:27688822

  4. Effects of Cumulative Frequency, but Not of Frequency Trajectory, in Lexical Decision Times of Older Adults and Patients with Alzheimer's Disease

    ERIC Educational Resources Information Center

    Caza, Nicole; Moscovitch, Morris

    2005-01-01

    The purpose of this study was to investigate the issue of age-limited learning effects on visual lexical decision in normal and pathological aging, by using words with different frequency trajectories and cumulative frequencies. We selected words that objectively changed in frequency trajectory from an early word count (Thorndike, 1921, 1932;…

  5. Effect of Individual Component Life Distribution on Engine Life Prediction

    NASA Technical Reports Server (NTRS)

    Zaretsky, Erwin V.; Hendricks, Robert C.; Soditus, Sherry M.

    2003-01-01

    The effect of individual engine component life distributions on engine life prediction was determined. A Weibull-based life and reliability analysis of the NASA Energy Efficient Engine was conducted. The engine s life at a 95 and 99.9 percent probability of survival was determined based upon the engine manufacturer s original life calculations and assumed values of each of the component s cumulative life distributions as represented by a Weibull slope. The lives of the high-pressure turbine (HPT) disks and blades were also evaluated individually and as a system in a similar manner. Knowing the statistical cumulative distribution of each engine component with reasonable engineering certainty is a condition precedent to predicting the life and reliability of an entire engine. The life of a system at a given reliability will be less than the lowest-lived component in the system at the same reliability (probability of survival). Where Weibull slopes of all the engine components are equal, the Weibull slope had a minimal effect on engine L(sub 0.1) life prediction. However, at a probability of survival of 95 percent (L(sub 5) life), life decreased with increasing Weibull slope.

  6. Cumulative Incidence of Cancer Among Persons With HIV in North America: A Cohort Study.

    PubMed

    Silverberg, Michael J; Lau, Bryan; Achenbach, Chad J; Jing, Yuezhou; Althoff, Keri N; D'Souza, Gypsyamber; Engels, Eric A; Hessol, Nancy A; Brooks, John T; Burchell, Ann N; Gill, M John; Goedert, James J; Hogg, Robert; Horberg, Michael A; Kirk, Gregory D; Kitahata, Mari M; Korthuis, Philip T; Mathews, William C; Mayor, Angel; Modur, Sharada P; Napravnik, Sonia; Novak, Richard M; Patel, Pragna; Rachlis, Anita R; Sterling, Timothy R; Willig, James H; Justice, Amy C; Moore, Richard D; Dubrow, Robert

    2015-10-06

    Cancer is increasingly common among persons with HIV. To examine calendar trends in cumulative cancer incidence and hazard rate by HIV status. Cohort study. North American AIDS Cohort Collaboration on Research and Design during 1996 to 2009. 86 620 persons with HIV and 196 987 uninfected adults. Cancer type-specific cumulative incidence by age 75 years and calendar trends in cumulative incidence and hazard rates, each by HIV status. Cumulative incidences of cancer by age 75 years for persons with and without HIV, respectively, were as follows: Kaposi sarcoma, 4.4% and 0.01%; non-Hodgkin lymphoma, 4.5% and 0.7%; lung cancer, 3.4% and 2.8%; anal cancer, 1.5% and 0.05%; colorectal cancer, 1.0% and 1.5%; liver cancer, 1.1% and 0.4%; Hodgkin lymphoma, 0.9% and 0.09%; melanoma, 0.5% and 0.6%; and oral cavity/pharyngeal cancer, 0.8% and 0.8%. Among persons with HIV, calendar trends in cumulative incidence and hazard rate decreased for Kaposi sarcoma and non-Hodgkin lymphoma. For anal, colorectal, and liver cancer, increasing cumulative incidence, but not hazard rate trends, were due to the decreasing mortality rate trend (-9% per year), allowing greater opportunity to be diagnosed. Despite decreasing hazard rate trends for lung cancer, Hodgkin lymphoma, and melanoma, cumulative incidence trends were not seen because of the compensating effect of the declining mortality rate. Secular trends in screening, smoking, and viral co-infections were not evaluated. Cumulative cancer incidence by age 75 years, approximating lifetime risk in persons with HIV, may have clinical utility in this population. The high cumulative incidences by age 75 years for Kaposi sarcoma, non-Hodgkin lymphoma, and lung cancer support early and sustained antiretroviral therapy and smoking cessation.

  7. Effects of Soldiers’ Deployment on Children’s Academic Performance and Behavioral Health

    DTIC Science & Technology

    2011-01-01

    tests. We found a negative relationship between the cumulative months a parent had deployed and achievement test scores across states (North Carolina...strongest negative relationship with cumulative parental deployment of 1 to 18 months and 19 months or more, and this effect size is larger than...that the negative effect of parental deployment on academic scores is more pronounced on elementary-age children (grades 3–6) than on secondary-age

  8. Effects of consumption of a fermented dairy product containing the probiotic Lactobacillus casei DN-114 001 on common respiratory and gastrointestinal infections in shift workers in a randomized controlled trial.

    PubMed

    Guillemard, Eric; Tanguy, Jérôme; Flavigny, Ann'Laure; de la Motte, Stephan; Schrezenmeir, Juergen

    2010-10-01

    The risk of infection may be increased in people under stress such as shift workers. This study examined the effect of a fermented dairy product containing the probiotic Lactobacillus casei DN-114 001 (verum) on the incidence of respiratory and gastrointestinal common infectious diseases (CIDs) and on immune functions in healthy shift workers. The study was single-center, randomized, double-blind, and controlled. Volunteers received 200 g/day of verum (n = 500) or control product (n = 500) for 3 months; 1-month follow-up was carried out. The cumulated number of CIDs (primary outcome) was not significantly different between groups. Because the Poisson distribution of the primary parameter did not fully fit the observed data, a post hoc categorical analysis was applied and showed a significantly lower cumulated number of CIDs in the verum group during the product consumption phase (odds ratio [OR] = 0.75, 95% confidence interval [CI] 0.59-0.95, p = 0.017). Verum also reduced the proportion of volunteers experiencing at least 1 CID (43% vs. 51%, p = 0.005), increased the time to the first occurrence of CID (p = 0.017) in the whole population, and reduced the cumulated number of CIDs in the subgroup of smokers (p = 0.033). In the course of CID, cumulated duration of fever was lower in the verum group (in the whole study phase) (p = 0.022), and an increase in leukocyte, neutrophil, and natural killer (NK) cell counts and activity (p = 0.047 to p < 0.001) was observed compared with control group. Verum was safe and well tolerated. The results indicate that daily consumption of a fermented dairy product containing Lactobacillus casei DN-114 001 could reduce the risk of common infections in stressed individuals such as shift workers.

  9. Adolescent Substance Use in the Multimodal Treatment Study of Attention-Deficit/Hyperactivity Disorder (ADHD) (MTA) as a Function of Childhood ADHD, Random Assignment to Childhood Treatments, and Subsequent Medication

    PubMed Central

    Molina, Brooke S.G.; Hinshaw, Stephen P.; Arnold, L. Eugene; Swanson, James M.; Pelham, William E.; Hechtman, Lily; Hoza, Betsy; Epstein, Jeffery N.; Wigal, Timothy; Abikoff, Howard B.; Greenhill, Laurence L.; Jensen, Peter S.; Wells, Karen C.; Vitiello, Benedetto; Gibbons, Robert D.; Howard, Andrea; Houck, Patricia R.; Hur, Kwan; Lu, Bo; Marcus, Sue

    2013-01-01

    Objectives To determine long-term effects on substance use and substance use disorder (SUD), up to 8 years after childhood enrollment, of the randomly assigned 14-month treatments in the multisite Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder (MTA; n=436); to test whether (a) medication at follow-up, (b) cumulative psychostimulant treatment over time, or (c) both relate to substance use/SUD; to compare substance use/SUD in the ADHD sample to the non-ADHD childhood classmate comparison group (n=261). Method Mixed-effects regression models with planned contrasts were used for all tests except the important cumulative stimulant treatment question, for which propensity score matching analysis was used. Results The originally randomized treatment groups did not differ significantly on substance use/SUD by the 8 year follow-up or earlier (M age = 17 years). Neither medication at follow-up (mostly stimulants) nor cumulative stimulant treatment was associated with adolescent substance use/SUD. Substance use at all time points, including use of two or more substances and SUD, were each greater in the ADHD than non-ADHD samples, regardless of sex. Conclusions Medication for ADHD did not protect from, nor contribute to, visible risk of substance use or SUD by adolescence, whether analyzed as randomized treatment assignment in childhood, as medication at follow-up, or as cumulative stimulant treatment over an 8 year follow-up from childhood. These results suggest the need to identify alternative or adjunctive adolescent-focused approaches to substance abuse prevention and treatment for boys and girls with ADHD, especially given their increased risk for use and abuse of multiple substances that is not improved with stimulant medication. Clinical trial registration information—Multimodal Treatment Study of Children with Attention Deficit and Hyperactivity Disorder (MTA); http://clinical trials.gov/; NCT00000388. PMID:23452682

  10. Survey on low-dose medical radiation exposure in occupational workers: the effect on hematological change

    NASA Astrophysics Data System (ADS)

    Ryu, J. K.; Cho, S. M.; Cho, J. H.; Dong, K. R.; Chung, W. K.; Lee, J. W.

    2013-03-01

    This study examined the changes in the hematological index caused by low-dose medical radiation exposure in workers in a medical radiation-exposed environment. The cumulative dose was obtained using thermoluminescent dosimeters over a 9-year period, and the changes in hematological index count (red blood cells (RBCs), hemoglobin, platelets, white blood cells (WBCs), monocytes, lymphocytes, neutrophils, basophils, and eosinophils) were examined in both the occupational workers and controls. In total, 370 occupational workers and 335 controls were compared. The analysis led to the following observations: (1) The average cumulative dose in males and females was 9.65±15.2 and 4.82±5.55 mSv, respectively. (2) In both males and females, there was a very low correlation between the occupation period and the cumulative dose (r<±0.25). (3) When the occupation period was longer, the WBC counts both decreased and increased in the male workers and the RBC counts were lower in the workers than in the control group (p<0.05). In females, the WBC counts both decreased and increased in the workers and the eosinophil counts were lower in the workers than in the control group (p<0.01). (4) When the cumulative dose was large, the lymphocyte counts decreased in male workers and the platelet count was lower in the workers than in the control group (p<0.05). In females, the lymphocyte count and RBC count were lower in the workers than in the control group (p<0.05). Abnormal distributions of some blood indices were observed in the occupational radiation workers compared with the controls. Attempts were made to limit radiation exposure to personnel, but the employees did not always follow the preset rules. Actually, the adverse effects of low-level radiation were attributed to probability. Overall, workers should obey the radiation protection regulations provided by the government and a national system of radiation protection is needed.

  11. Adolescent substance use in the multimodal treatment study of attention-deficit/hyperactivity disorder (ADHD) (MTA) as a function of childhood ADHD, random assignment to childhood treatments, and subsequent medication.

    PubMed

    Molina, Brooke S G; Hinshaw, Stephen P; Eugene Arnold, L; Swanson, James M; Pelham, William E; Hechtman, Lily; Hoza, Betsy; Epstein, Jeffery N; Wigal, Timothy; Abikoff, Howard B; Greenhill, Laurence L; Jensen, Peter S; Wells, Karen C; Vitiello, Benedetto; Gibbons, Robert D; Howard, Andrea; Houck, Patricia R; Hur, Kwan; Lu, Bo; Marcus, Sue

    2013-03-01

    To determine long-term effects on substance use and substance use disorder (SUD), up to 8 years after childhood enrollment, of the randomly assigned 14-month treatments in the multisite Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder (MTA; n = 436); to test whether medication at follow-up, cumulative psychostimulant treatment over time, or both relate to substance use/SUD; and to compare substance use/SUD in the ADHD sample to the non-ADHD childhood classmate comparison group (n = 261). Mixed-effects regression models with planned contrasts were used for all tests except the important cumulative stimulant treatment question, for which propensity score matching analysis was used. The originally randomized treatment groups did not differ significantly on substance use/SUD by the 8-year follow-up or earlier (mean age = 17 years). Neither medication at follow-up (mostly stimulants) nor cumulative stimulant treatment was associated with adolescent substance use/SUD. Substance use at all time points, including use of two or more substances and SUD, were each greater in the ADHD than in the non-ADHD samples, regardless of sex. Medication for ADHD did not protect from, or contribute to, visible risk of substance use or SUD by adolescence, whether analyzed as randomized treatment assignment in childhood, as medication at follow-up, or as cumulative stimulant treatment over an 8-year follow-up from childhood. These results suggest the need to identify alternative or adjunctive adolescent-focused approaches to substance abuse prevention and treatment for boys and girls with ADHD, especially given their increased risk for use and abuse of multiple substances that is not improved with stimulant medication. Clinical trial registration information-Multimodal Treatment Study of Children With Attention Deficit and Hyperactivity Disorder (MTA); http://clinical trials.gov/; NCT00000388. Copyright © 2013 American Academy of Child and Adolescent Psychiatry. All rights reserved.

  12. Early life socioeconomic position and immune response to persistent infections among elderly Latinos.

    PubMed

    Meier, Helen C S; Haan, Mary N; Mendes de Leon, Carlos F; Simanek, Amanda M; Dowd, Jennifer B; Aiello, Allison E

    2016-10-01

    Persistent infections, such as cytomegalovirus (CMV), herpes simplex virus-1 (HSV-1), Helicobacter pylori (H. pylori), and Toxoplasma gondii (T. gondii), are common in the U.S. but their prevalence varies by socioeconomic status. It is unclear if early or later life socioeconomic position (SEP) is a more salient driver of disparities in immune control of these infections. Using data from the Sacramento Area Latino Study on Aging, we examined whether early or later life SEP was the strongest predictor of immune control later in life by contrasting two life course models, the critical period model and the chain of risk model. Early life SEP was measured as a latent variable, derived from parental education and occupation, and food availability. Indicators for SEP in later life included education level and occupation. Individuals were categorized by immune response to each pathogen (seronegative, low, medium and high) with increasing immune response representing poorer immune control. Cumulative immune response was estimated using a latent profile analysis with higher total immune response representing poorer immune control. Structural equation models were used to examine direct, indirect and total effects of early life SEP on each infection and cumulative immune response, controlling for age and gender. The direct effect of early life SEP on immune response was not statistically significant for the infections or cumulative immune response. Higher early life SEP was associated with lower immune response for T. gondii, H. pylori and cumulative immune response through pathways mediated by later life SEP. For CMV, higher early life SEP was both directly associated and partially mediated by later life SEP. No association was found between SEP and HSV-1. Findings from this study support a chain of risk model, whereby early life SEP acts through later life SEP to affect immune response to persistent infections in older age. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Cumulative Social Risk and Obesity in Early Childhood

    PubMed Central

    Duarte, Cristiane S.; Chambers, Earle C.; Boynton-Jarrett, Renée

    2012-01-01

    OBJECTIVES: The goal of this study was to examine the relationship between cumulative social adversity and childhood obesity among preschool-aged children (N = 1605) in the Fragile Families and Child Wellbeing Study. METHODS: Maternal reports of intimate partner violence, food insecurity, housing insecurity, maternal depressive symptoms, maternal substance use, and father’s incarceration were obtained when the child was 1 and 3 years of age. Two cumulative social risk scores were created by summing the 6 factors assessed at ages 1 and 3 years. Child height and weight were measured at 5 years of age. Logistic regression models stratified according to gender were used to estimate the association between cumulative social risk and obesity, adjusting for sociodemographic factors. RESULTS: Seventeen percent of children were obese at age 5 years, and 57% had at least 1 social risk factor. Adjusting for sociodemographic factors, girls experiencing high cumulative social risk (≥2 factors) at age 1 year only (odds ratio [OR]: 2.1 [95% confidence interval [CI]: 1.1–4.1]) or at 3 years only (OR: 2.2 [95% CI: 1.2–4.2]) were at increased odds of being obese compared with girls with no risk factors at either time point. Those experiencing high cumulative risk at age 1 and 3 years were not at statistically significant odds of being obese (OR: 1.9 [95% CI: 0.9–4.0]). No significant associations were noted among boys. CONCLUSIONS: There seems to be gender differences in the effects of cumulative social risk factors on the prevalence of obesity at 5 years of age. Understanding the social context of families could make for more effective preventive efforts to combat childhood obesity. PMID:22508921

  14. Association Between Physical Therapy and Risk of Coronary Artery Disease and Dyslipidemia Among Osteoarthritis Patients: A Nationwide Database Study.

    PubMed

    Yeh, Huan-Jui; Chou, Yiing-Jenq; Yang, Nan-Ping; Cheng, Chi-Chia; Huang, Nicole

    2016-01-01

    To provide empirical evidence on the effect of early physical therapy (PT) within the first year of osteoarthritis (OA) diagnosis on reduction in OA-related comorbidities in patients with OA. Retrospective cohort study. The study was conducted using a nationally representative sample of 1 million National Health Insurance enrollees. Newly diagnosed patients with OA (N=13,545). One-to-one propensity score matching was used to match patients who received PT within the first year of OA diagnosis (PT group; n=3403) with an equal number of patients with OA who did not receive PT (non-PT group). Not applicable. The 4-year cumulative risk of comorbidities including coronary artery disease (CAD), diabetes mellitus, dyslipidemia, osteoporosis, gastrointestinal tract ulcer, and renal failure was estimated. A Cox proportional hazards regression analysis was performed to identify the dose-response relation between the PT dosage and the risk of OA-related comorbidities. A total of 3403 patients (25.1%) received PT within the first year of OA diagnosis. The PT group had a significantly lower 4-year cumulative risk of dyslipidemia (P=.05) and a potentially lower 4-year cumulative risk of CAD (P=.09). After adjusting for other potential confounders, the Cox proportional hazards regression analysis showed that patients with OA who received a high PT dosage had a low risk of CAD and dyslipidemia. Patients with OA who received PT had a lower risk of OA-related comorbidities such as dyslipidemia or CAD. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  15. Relationships between iron dose, hospitalizations and mortality in incident haemodialysis patients: a propensity-score matched approach.

    PubMed

    Varas, Javier; Ramos, Rosa; Aljama, Pedro; Pérez-García, Rafael; Moreso, Francesc; Pinedo, Miguel; Ignacio Merello, José; Stuard, Stefano; Canaud, Bernard; Martín-Malo, Alejandro

    2018-01-01

    Intravenous iron management is common in the haemodialysis population. However, the safest dosing strategy remains uncertain, in terms of the risk of hospitalization and mortality. We aimed to determine the effects of cumulative monthly iron doses on mortality and hospitalization. This multicentre observational retrospective propensity-matched score study included 1679 incident haemodialysis patients. We measured baseline demographic variables, haemodialysis clinical parameters and laboratory analytical values. We compared outcomes among quartiles of cumulative iron dose (mg/kg/month). We implemented propensity-score matching (PSM) to reduce confounding due to indication. In the PSM cohort (330 patients), we compared outcomes between groups that received cumulative iron doses above and below 5.66 mg/kg/month. Kaplan-Meier analyses showed that the high iron dose group had significantly worse survival than the low iron dose group. A univariate analysis indicated that the monthly iron dose could significantly predict mortality. However, a multivariate regression did not confirm that finding. The multivariate regression analysis revealed that iron doses  >5.58 mg/kg/month were not associated with elevated mortality risk, but they were associated with elevated risks of all-cause and cardiovascular-related hospitalizations. These results were ratified in the PSM population. Intravenous iron administration is advisable for maintaining haemoglobin levels in patients that receive haemodialysis. Our data suggested that large monthly iron doses, adjusted for body weight, were associated with more hospitalizations, but not with mortality or infection-related hospitalizations. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  16. Cumulative Socioeconomic Status Risk, Allostatic Load, and Adjustment: A Prospective Latent Profile Analysis With Contextual and Genetic Protective Factors

    PubMed Central

    Brody, Gene H.; Yu, Tianyi; Chen, Yi-fu; Kogan, Steven M.; Evans, Gary W.; Beach, Steven R. H.; Windle, Michael; Simons, Ronald L.; Gerrard, Meg; Gibbons, Frederick X.; Philibert, Robert A.

    2012-01-01

    The health disparities literature identified a common pattern among middle-aged African Americans that includes high rates of chronic disease along with low rates of psychiatric disorders despite exposure to high levels of cumulative SES risk. The current study was designed to test hypotheses about the developmental precursors to this pattern. Hypotheses were tested with a representative sample of 443 African American youths living in the rural South. Cumulative SES risk and protective processes were assessed at 11-13 years; psychological adjustment was assessed at ages 14-18 years; genotyping at the 5-HTTLPR was conducted at age 16 years; and allostatic load (AL) was assessed at age 19 years. A Latent Profile Analysis identified 5 profiles that evinced distinct patterns of SES risk, AL, and psychological adjustment, with 2 relatively large profiles designated as focal profiles: a physical health vulnerability profile characterized by high SES risk/high AL/low adjustment problems, and a resilient profile characterized by high SES risk/low AL/low adjustment problems. The physical health vulnerability profile mirrored the pattern found in the adult health disparities literature. Multinomial logistic regression analyses indicated that carrying an s allele at the 5-HTTLPR and receiving less peer support distinguished the physical health vulnerability profile from the resilient profile. Protective parenting and planful self-regulation distinguished both focal profiles from the other 3 profiles. The results suggest the public health importance of preventive interventions that enhance coping and reduce the effects of stress across childhood and adolescence. PMID:22709130

  17. Cumulative socioeconomic status risk, allostatic load, and adjustment: a prospective latent profile analysis with contextual and genetic protective factors.

    PubMed

    Brody, Gene H; Yu, Tianyi; Chen, Yi-fu; Kogan, Steven M; Evans, Gary W; Beach, Steven R H; Windle, Michael; Simons, Ronald L; Gerrard, Meg; Gibbons, Frederick X; Philibert, Robert A

    2013-05-01

    The health disparities literature has identified a common pattern among middle-aged African Americans that includes high rates of chronic disease along with low rates of psychiatric disorders despite exposure to high levels of cumulative socioeconomic status (SES) risk. The current study was designed to test hypotheses about the developmental precursors to this pattern. Hypotheses were tested with a representative sample of 443 African American youths living in the rural South. Cumulative SES risk and protective processes were assessed at ages 11-13 years; psychological adjustment was assessed at ages 14-18 years; genotyping at the 5-HTTLPR was conducted at age 16 years; and allostatic load (AL) was assessed at age 19 years. A latent profile analysis identified 5 profiles that evinced distinct patterns of SES risk, AL, and psychological adjustment, with 2 relatively large profiles designated as focal profiles: a physical health vulnerability profile characterized by high SES risk/high AL/low adjustment problems, and a resilient profile characterized by high SES risk/low AL/low adjustment problems. The physical health vulnerability profile mirrored the pattern found in the adult health disparities literature. Multinomial logistic regression analyses indicated that carrying an s allele at the 5-HTTLPR and receiving less peer support distinguished the physical health vulnerability profile from the resilient profile. Protective parenting and planful self-regulation distinguished both focal profiles from the other 3 profiles. The results suggest the public health importance of preventive interventions that enhance coping and reduce the effects of stress across childhood and adolescence.

  18. DEVELOPING A LANDSCAPE APPROACH TO EVALUATION OF WETLAND CONDITION IN THE SOUTHERN ROCKY MOUNTAINS: PHASE I

    EPA Science Inventory

    Cumulative impacts and their resultant cumulative effects have become an important focus of both environemntal regulation and scientific investigation because of their potentially severe consequences. For example, the federal National Environmental Policy Act and the Clean Water...

  19. AOP description: Androgen receptor agonism leading to reproductive dysfunction (in fish)

    EPA Science Inventory

    This adverse outcome pathway details the linkage between binding and activation of androgen receptor as a nuclear transcription factor in females and the adverse effect of reduced cumulative fecundity in repeat-spawning fish species. Cumulative fecundity is the most apical endpoi...

  20. AOP description: ER antagonism leading to reproductive dysfunction (in fish)

    EPA Science Inventory

    This adverse outcome pathway details the linkage between antagonism of estrogen receptor in females and the adverse effect of reduced cumulative fecundity in repeat-spawning fish species. Cumulative fecundity is the most apical endpoint considered in the OECD 229 Fish Short Term ...

  1. AOP description: Aromatase inhibition leading to reproductive dysfunction (in fish)

    EPA Science Inventory

    This adverse outcome pathway details the linkage between inhibition of gonadal aromatase activity in females and the adverse effect of reduced cumulative fecundity in repeat-spawning fish species. Cumulative fecundity is the most apical endpoint considered in the OECD 229 Fish Sh...

  2. DOSE-RESPONSE MODELING FOR THE ASSESSMENT OF CUMULATIVE RISK DUE TO EXPOSURE TO N-METHYL CARBAMATE PESTICIDES

    EPA Science Inventory

    The US EPAs N-Methyl Carbamate Cumulative Risk Assessment (NMCRA) assesses the effect on acetylcholine esterase (AChE) activity of exposure to 10 N-methyl carbamate (NMC) pesticides through dietary, drinking water, and residential exposures.

  3. NATURE OF CUMULATIVE IMPACTS ON BIOTIC DIVERSITY OF WETLAND VERTEBRATES

    EPA Science Inventory

    There is no longer any doubt that cumulative impacts have important effects on wetland vertebrates. he interactions of species diversity and community structure produce a complex pattern in which environmental impacts can play a highly significant role. ariety of examples shows h...

  4. Pulmonary deposition modeling with airborne fiber exposure data: a study of workers manufacturing refractory ceramic fibers.

    PubMed

    Lentz, Thomas J; Rice, Carol H; Succop, Paul A; Lockey, James E; Dement, John M; LeMasters, Grace K

    2003-04-01

    Increasing production of refractory ceramic fiber (RCF), a synthetic vitreous material with industrial applications (e.g., kiln insulation), has created interest in potential respiratory effects of exposure to airborne fibers during manufacturing. An ongoing study of RCF manufacturing workers in the United States has indicated an association between cumulative fiber exposure and pleural plaques. Fiber sizing data, obtained from electron microscopy analyses of 118 air samples collected in three independent studies over a 20-year period (1976-1995), were used with a computer deposition model to estimate pulmonary dose of fibers of specified dimensions for 652 former and current RCF production workers. Separate dose correction factors reflecting differences in fiber dimensions in six uniform job title groups were used with data on airborne fiber concentration and employment duration to calculate cumulative dose estimates for each worker. From review of the literature, critical dimensions (diameter <0.4 microm, length <10 microm) were defined for fibers that may translocate to the parietal pleura. Each of three continuous exposure/dose metrics analyzed in separate logistic regression models was significantly related to plaques, even after adjusting for possible past asbestos exposure: cumulative fiber exposure, chi(2) = 15.2 (p < 0.01); cumulative pulmonary dose (all fibers), chi(2) = 14.6 (p < 0.01); cumulative pulmonary dose (critical dimension fibers), chi(2) = 12.4 (p < 0.01). Odds ratios (ORs) were calculated for levels of each metric. Increasing ORs were statistically significant for the two highest dose levels of critical dimension fibers (level three, OR = 11, 95%CI = [1.4, 98]; level four, OR = 25, 95%CI = [3.2, 190]). Similar associations existed for all metrics after adjustment for possible asbestos exposure. It was concluded that development of pleural plaques follows exposure- and dose-response patterns, and that airborne fibers in RCF manufacturing facilities include those with critical dimensions associated with pleural plaque formation. Analysis of additional air samples may improve estimates of the dose-response relationship.

  5. Impact of treatment characteristics on response of different breast cancer phenotypes: pooled analysis of the German neo-adjuvant chemotherapy trials.

    PubMed

    von Minckwitz, Gunter; Untch, Michael; Nüesch, Eveline; Loibl, Sibylle; Kaufmann, Manfred; Kümmel, Sherko; Fasching, Peter A; Eiermann, Wolfgang; Blohmer, Jens-Uwe; Costa, Serban Dan; Mehta, Keyur; Hilfrich, Jörn; Jackisch, Christian; Gerber, Bernd; du Bois, Andreas; Huober, Jens; Hanusch, Claus; Konecny, Gottfried; Fett, Werner; Stickeler, Elmar; Harbeck, Nadia; Müller, Volkmar; Jüni, Peter

    2011-01-01

    Pathological complete response (pCR) to neoadjuvant treatment correlates with outcome in breast cancer. We determined whether characteristics of neoadjuvant therapy are associated with pCR. We used multi-level models, which accounted for heterogeneity in pCR across trials and trial arms, to analyze individual patient data from 3332 women included in 7 German neoadjuvant trials with uniform protocols. PCR was associated with an increase in number of chemotherapy cycles (odds ratio [OR] 1.2 for every two additional cycles; P = 0.009), with higher cumulative anthracycline doses (OR 1.6; P = 0.002), higher cumulative taxane doses (OR 1.6; P = 0.009), and with capecitabine containing regimens (OR 1.62; P = 0.022). Association of pCR with increase in number of cycles appeared more pronounced in hormone receptor (HR)-positive tumors (OR 1.35) than in HR-negative tumors (OR 1.04; P for interaction = 0.046). Effect of anthracycline dose was particularly pronounced in HER2-negative tumors (OR 1.61), compared to HER2-positive tumors (OR 0.83; P for interaction = 0.14). Simultaneous trastuzumab treatment in HER2-positive tumors increased odds of pCR 3.2-fold (P < 0.001). No association of pCR and number of trastuzumab cycles was found (OR 1.20, P = 0.39). Dosing characteristics appear important for successful treatment of breast cancer. Longer treatment, higher cumulative doses of anthracyclines and taxanes, and the addition of capecitabine and trastuzumab are associated with better response. Tailoring according to breast cancer phenotype might be possible: longer treatment in HR-positive tumors, higher cumulative anthracycline doses for HER2-negative tumors, shorter treatment at higher cumulative doses for triple-negative tumors, and limited number of preoperative trastuzumab cycles in HER2-positive tumors.

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

    Bidstrup, Morten, E-mail: bidstrup@plan.aau.dk; Kørnøv, Lone, E-mail: lonek@plan.aau.dk; Partidário, Maria Rosário, E-mail: mariapartidario@tecnico.ulisboa.pt

    Cumulative effects (CE) assessment is lacking quality in impact assessment (IA) worldwide. It has been argued that the strategic environmental assessment (SEA) provides a suitable IA framework for addressing CE because it is applied to developments with broad boundaries, but few have tested this claim. Through a case study on the Danish mining sector, this article explores how plan boundaries influence the analytical boundaries applied for assessing CE in SEA. The case was studied through document analysis in combination with semi-structured group interviews of the responsible planners, who also serve as SEA practitioners. It was found that CE are tomore » some extent assessed and managed implicitly throughout the planning process. However, this is through a focus on lowering the cumulative stress of mining rather than the cumulative stress on and capacity of the receiving environment. Plan boundaries do influence CE assessment, though all boundaries are not equally influential. The geographical and time boundaries of the Danish mining plans are broad or flexible enough to accommodate a meaningful assessment of CE, but the topical boundary is restrictive. The study indicates that collaboration among planning authorities and legally appointed CE leadership may facilitate better practice on CE assessment in sector-specific SEA contexts. However, most pressing is the need for relating assessment to the receiving environment as opposed to solely the stress of a proposed plan.« less

  7. Efficacy of icotinib versus traditional chemotherapy as first-line treatment for preventing brain metastasis from advanced lung adenocarcinoma in patients with epidermal growth factor receptor-sensitive mutation.

    PubMed

    Zhao, Xiao; Zhu, Guangqin; Chen, Huoming; Yang, Ping; Li, Fang; Du, Nan

    2016-01-01

    This study aimed to investigate the potential use of icotinib as first-line treatment to prevent brain metastasis from advanced lung adenocarcinoma. This investigation was designed as a retrospective nonrandomized controlled study. Enrolled patients received either icotinib or traditional chemotherapy as their first-line treatment. The therapeutic efficacy was compared among patients with advanced. (stages IIIB and IV) lung adenocarcinoma with epidermal growth factor receptor (EGFR)-sensitive mutation. The primary endpoint was the cumulative incidence of brain metastasis, whereas, the secondary endpoint was overall survival(OS). Death without brain metastasis was considered a competitive risk to calculate the cumulative risk of brain metastasis. Survival analysis was conducted using the Kaplan-Meier method and statistical significance was determined using the log-rank test. The present study included 396 patients with 131 in the icotinib group and 265 in the chemotherapy group. Among those with EGFR-sensitive mutation, the cumulative risk of brain metastasis was lower in the icotinib group than in the chemotherapy group. However, no significant difference in OS was observed between the two groups. Icotinib can effectively reduce the incidence of brain metastasis and therefore improve prognosis in advanced lung adenocarcinoma patients with EGFR.sensitive mutation.

  8. Efficacy of icotinib versus traditional chemotherapy as first-line treatment for preventing brain metastasis from advanced lung adenocarcinoma in patients with epidermal growth factor receptor-sensitive mutation.

    PubMed

    Zhao, Xiao; Zhu, Guangqin; Chen, Huoming; Yang, Ping; Li, Fang; Du, Nan

    2014-11-01

    This study aimed to investigate the potential use of icotinib as first-line treatment to prevent brain metastasis from advanced lung adenocarcinoma. This investigation was designed as a retrospective nonrandomized controlled study. Enrolled patients received either icotinib or traditional chemotherapy as their first-line treatment. The therapeutic efficacy was compared among patients with advanced (stages IIIB and IV) lung adenocarcinoma with epidermal growth factor receptor (EGFR)-sensitive mutation. The primary endpoint was the cumulative incidence of brain metastasis, whereas the secondary endpoint was overall survival (OS). Death without brain metastasis was considered a competitive risk to calculate the cumulative risk of brain metastasis. Survival analysis was conducted using the Kaplan-Meier method and statistical significance were determined using the log-rank test. The present study included 396 patients with 131 in the icotinib group and 265 in the chemotherapy group. Among those with EGFR-sensitive mutation, the cumulative risk of brain metastasis was lower in the icotinib group than in the chemotherapy group. However, no significant difference in OS was observed between the two groups. Icotinib can effectively reduce the incidence of brain metastasis and therefore improve prognosis in advanced lung adenocarcinoma patients with EGFR-sensitive mutation.

  9. Quantifying Process-Based Mitigation Strategies in Historical Context: Separating Multiple Cumulative Effects on River Meander Migration

    PubMed Central

    Fremier, Alexander K.; Girvetz, Evan H.; Greco, Steven E.; Larsen, Eric W.

    2014-01-01

    Environmental legislation in the US (i.e. NEPA) requires defining baseline conditions on current rather than historical ecosystem conditions. For ecosystems with long histories of multiple environmental impacts, this baseline method can subsequently lead to a significantly altered environment; this has been termed a ‘sliding baseline’. In river systems, cumulative effects caused by flow regulation, channel revetment and riparian vegetation removal significantly impact floodplain ecosystems by altering channel dynamics and precluding subsequent ecosystem processes, such as primary succession. To quantify these impacts on floodplain development processes, we used a model of river channel meander migration to illustrate the degree to which flow regulation and riprap impact migration rates, independently and synergistically, on the Sacramento River in California, USA. From pre-dam conditions, the cumulative effect of flow regulation alone on channel migration is a reduction by 38%, and 42–44% with four proposed water diversion project scenarios. In terms of depositional area, the proposed water project would reduce channel migration 51–71 ha in 130 years without current riprap in place, and 17–25 ha with riprap. Our results illustrate the utility of a modeling approach for quantifying cumulative impacts. Model-based quantification of environmental impacts allow scientists to separate cumulative and synergistic effects to analytically define mitigation measures. Additionally, by selecting an ecosystem process that is affected by multiple impacts, it is possible to consider process-based mitigation scenarios, such as the removal of riprap, to allow meander migration and create new floodplains and allow for riparian vegetation recruitment. PMID:24964145

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

    PubMed

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

    2016-05-01

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

  11. Cumulative stress and autonomic dysregulation in a community sample

    PubMed Central

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

    2016-01-01

    Whether cumulative stress, including both chronic stress and adverse life events, is associated with decreased heart rate variability (HRV), a non-invasive measure of autonomic status which predicts poor cardiovascular outcomes, is unknown. Healthy community dwelling volunteers, (N= 157, mean age 29 years) participated in the Cumulative Stress/Adversity Interview, (CAI) a 140-item event interview measuring cumulative adversity including major life events, life trauma, recent life events and chronic stressors, and underwent 24 hour ambulatory ECG monitoring. HRV was analyzed in the frequency domain and standard deviation of NN intervals (SDNN) calculated. Initial simple regression analyses revealed that total cumulative stress score, chronic stressors, and cumulative adverse life events (CALE) were all inversely associated with ultra low frequency (ULF), very low frequency (VLF), and low frequency (LF) power and SDNN (all p<0.05). In hierarchical regression analyses, total cumulative stress and chronic stress each was significantly associated with SDNN and ULF even after the high significant contribution of age and sex, with no other covariates accounting for additional appreciable variance. For VLF and LF, both total cumulative stress and chronic stress significantly contributed to the variance were no longer significant after adjusting for race and health behaviors. (p’s<.05). In summary, total cumulative stress, and its components of adverse life events and chronic stress were associated with decreased cardiac autonomic function as measured by HRV. Findings suggest one potential mechanism by which stress may exert adverse effects on mortality in healthy individuals. Primary preventive strategies including stress management may prove beneficial. PMID:27112063

  12. Cumulative trauma and partner conflict predict post-traumatic stress disorder in postpartum African-American women.

    PubMed

    Hauff, Nancy J; Fry-McComish, Judith; Chiodo, Lisa M

    2017-08-01

    To describe relationships between cumulative trauma, partner conflict and post-traumatic stress in African-American postpartum women. Cumulative trauma exposure estimates for women in the USA range from 51-69%. During pregnancy, most trauma research has focused on physical injury to the mother. Post-traumatic stress disorder (PTSD) is associated with trauma and more prevalent in African-American women than women of other groups. Knowledge about both the rate and impact of cumulative trauma on pregnancy may contribute to our understanding of women seeking prenatal care, and disparities in infant morbidity and mortality. This retrospective, correlational, cross-sectional study took place on postpartum units of two Detroit hospitals. Participants were 150 African-American women aged between 18-45 who had given birth. Mothers completed the Cumulative Trauma Scale, Conflict Tactics Scale, Clinician Administered Post-traumatic Stress Scale, Edinburgh Postnatal Depression Scale and a Demographic Data form. Descriptive statistics, correlations and multiple regressions were used for data analysis. All participants reported at least one traumatic event in their lifetime. Cumulative trauma and partner conflict predicted PTSD, with the trauma of a life-threatening event for a loved one reported by 60% of the sample. Nearly, one-fourth of the women screened were at risk for PTSD. Increased cumulative trauma, increased partner conflict and lower level of education were related to higher rates of PTSD symptoms. Both cumulative trauma and partner conflict in the past year predict PTSD. Reasoning was used most often for partner conflict resolution. The results of this study offer additional knowledge regarding relationships between cumulative trauma, partner conflict and PTSD in African-American women. Healthcare providers need to be sensitive to patient life-threatening events, personal failures, abuse and other types of trauma. Current evidence supports the need to assess for post-traumatic stress symptoms during pregnancy. © 2016 John Wiley & Sons Ltd.

  13. Evaluation of the efficacy of once-daily use of tadalafil vs. on-demand use. Is there a cumulative effect?

    PubMed

    Jamshidian, Hasan; Borhan, Armin; Kooraki, Soheil; Borhan, Arash

    2012-11-01

    To assess and compare the efficacy of on-demand versus daily dosages of tadalafil in the treatment of erectile dysfunction. The case-control double-blind study was conducted at the Department of Urology, Tehran University of Medical Science, Imam Khomeini Hospital, from March 2008 to January 2010. It comprised 100 males suffering from erectile dysfunction who were randomised into two groups; one receiving on-demand tadalafil (10mg), and the other receiving once-daily dose of tadalafil (10mg). The erectile function domain of the International Index of Erectile Function was evaluated initially at the baseline and then at 24 weeks after treatment. To evaluate the possible cumulative effect of tadalafil, the index was measured in the group taking daily tadalafil at 12 weeks after the initiation of the treatment. SPSS 13 was used for statistical analysis. The study showed significant improvement in the mean erectile function domain measured after 24 weeks in both daily (17.08+/-3.896 vs baseline 12.64+/-2.92; p<0.001) and on-demand (15.46+/-3.64 vs baseline 13.48+/-2.86; p<0.001) groups. Data showed significant difference in mean scores between on-demand and daily groups (p = 0.03). In daily group, the mean domain measured at the 24th week showed significant improvement compared to the mean score of the 12th week (p <0.001). Treatment with daily tadalafil was associated with a significantly higher erectile function domain score compared to the on-demand use. The significant difference between mean scores of 12th week and 24th week in the daily group points towards the possible cumulative effect of tadalafil.

  14. Cumulative contextual risk at birth in relation to adolescent substance use, conduct problems, and risky sex: General and specific predictive associations in a Finnish birth cohort.

    PubMed

    Mason, W Alex; January, Stacy-Ann A; Chmelka, Mary B; Parra, Gilbert R; Savolainen, Jukka; Miettunen, Jouko; Järvelin, Marjo-Riitta; Taanila, Anja; Moilanen, Irma

    2016-07-01

    Research indicates that risk factors cluster in the most vulnerable youth, increasing their susceptibility for adverse developmental outcomes. However, most studies of cumulative risk are cross-sectional or short-term longitudinal, and have been based on data from the United States or the United Kingdom. Using data from the Northern Finland Birth Cohort 1986 Study (NFBC1986), we examined cumulative contextual risk (CCR) at birth as a predictor of adolescent substance use and co-occurring conduct problems and risky sex to determine the degree to which CCR predicts specific outcomes over-and-above its effect on general problem behavior, while testing for moderation of associations by gender. Analyses of survey data from 6963 participants of the NFBC1986 followed from the prenatal/birth period into adolescence were conducted using structural equation modeling. CCR had long-term positive associations with first-order substance use, conduct problems, and risky sex factors, and, in a separate analysis, with a second-order general problem behavior factor. Further analyses showed that there was a positive specific effect of CCR on risky sex, over-and-above general problem behavior, for girls only. This study, conducted within the Finnish context, showed that CCR at birth had long-term general and specific predictive associations with substance use and co-occurring problem behaviors in adolescence; effects on risky sex were stronger for girls. Results are consistent with the hypothesis that early exposure to CCR can have lasting adverse consequences, suggesting the need for early identification and intervention efforts for vulnerable children. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Cumulative risk assessment for combined health effects from chemical and nonchemical stressors.

    PubMed

    Sexton, Ken; Linder, Stephen H

    2011-12-01

    Cumulative risk assessment is a science policy tool for organizing and analyzing information to examine, characterize, and possibly quantify combined threats from multiple environmental stressors. We briefly survey the state of the art regarding cumulative risk assessment, emphasizing challenges and complexities of moving beyond the current focus on chemical mixtures to incorporate nonchemical stressors, such as poverty and discrimination, into the assessment paradigm. Theoretical frameworks for integrating nonchemical stressors into cumulative risk assessments are discussed, the impact of geospatial issues on interpreting results of statistical analyses is described, and four assessment methods are used to illustrate the diversity of current approaches. Prospects for future progress depend on adequate research support as well as development and verification of appropriate analytic frameworks.

  16. Cumulative Risk Assessment for Combined Health Effects From Chemical and Nonchemical Stressors

    PubMed Central

    Linder, Stephen H.

    2011-01-01

    Cumulative risk assessment is a science policy tool for organizing and analyzing information to examine, characterize, and possibly quantify combined threats from multiple environmental stressors. We briefly survey the state of the art regarding cumulative risk assessment, emphasizing challenges and complexities of moving beyond the current focus on chemical mixtures to incorporate nonchemical stressors, such as poverty and discrimination, into the assessment paradigm. Theoretical frameworks for integrating nonchemical stressors into cumulative risk assessments are discussed, the impact of geospatial issues on interpreting results of statistical analyses is described, and four assessment methods are used to illustrate the diversity of current approaches. Prospects for future progress depend on adequate research support as well as development and verification of appropriate analytic frameworks. PMID:21551386

  17. EFFECTS-BASED CUMULATIVE RISK ASSESSMENT IN A LOW-INCOME URBAN COMMUNITY NEAR A SUPERFUND SITE

    EPA Science Inventory

    We will introduce into the cumulative risk assessment framework novel methods for non-cancer risk assessment, techniques for dose-response modeling that extend insights from chemical mixtures frameworks to non-chemical stressors, multilevel statistical methods used to address ...

  18. Identification and Quantification of Cumulative Factors that Increase Environmental Exposures and Impacts

    EPA Science Inventory

    Evaluating the combined adverse effects of multiple stressors upon human health is an imperative component of cumulative risk assessment (CRA)1. In addition to chemical stressors, other non-chemical factors are also considered. For examples, smoking will elevate the risks of havi...

  19. Testing for carryover effects after cessation of treatments: a design approach.

    PubMed

    Sturdevant, S Gwynn; Lumley, Thomas

    2016-08-02

    Recently, trials addressing noisy measurements with diagnosis occurring by exceeding thresholds (such as diabetes and hypertension) have been published which attempt to measure carryover - the impact that treatment has on an outcome after cessation. The design of these trials has been criticised and simulations have been conducted which suggest that the parallel-designs used are not adequate to test this hypothesis; two solutions are that either a differing parallel-design or a cross-over design could allow for diagnosis of carryover. We undertook a systematic simulation study to determine the ability of a cross-over or a parallel-group trial design to detect carryover effects on incident hypertension in a population with prehypertension. We simulated blood pressure and focused on varying criteria to diagnose systolic hypertension. Using the difference in cumulative incidence hypertension to analyse parallel-group or cross-over trials resulted in none of the designs having acceptable Type I error rate. Under the null hypothesis of no carryover the difference is well above the nominal 5 % error rate. When a treatment is effective during the intervention period, reliable testing for a carryover effect is difficult. Neither parallel-group nor cross-over designs using the difference in cumulative incidence appear to be a feasible approach. Future trials should ensure their design and analysis is validated by simulation.

  20. The Caspar Creek watersheds: a case study of cumulative effects in a small coastal basin in northern California

    Treesearch

    R. R. Ziemer; P. H. Cafferata

    1991-01-01

    Abstract - Since 1962, the 483-ha North Fork and 424-ha South Fork of Caspar Creek in northwestern California have been used to evaluate the hydrologic impacts of road building and harvesting second-growth redwood/Douglas-fir forests. Three tributaries are serving as untreated controls. In 1985, the study was modified to evaluate the cumulative watershed effects of...

  1. In Situ Estimation of Applied Biaxial Loads with Lamb Waves (Preprint)

    DTIC Science & Technology

    2012-07-01

    be correct. IV. EXPERIMENTS AND RESULTS Fatigue tests were conducted for an array of six surface-bonded PZT transducers permanently attached to...because of their cumulative effects on the fatigue life of the structures. Waves propagating between array elements are directly affected by applied loads...their cumulative effects on the fatigue life of the structures. Waves propagating between array elements are directly affected by applied loads

  2. Cumulative risk effects for the development of behaviour difficulties in children and adolescents with special educational needs and disabilities.

    PubMed

    Oldfield, Jeremy; Humphrey, Neil; Hebron, Judith

    2015-01-01

    Research has identified multiple risk factors for the development of behaviour difficulties. What have been less explored are the cumulative effects of exposure to multiple risks on behavioural outcomes, with no study specifically investigating these effects within a population of young people with special educational needs and disabilities (SEND). Furthermore, it is unclear whether a threshold or linear risk model better fits the data for this population. The sample included 2660 children and 1628 adolescents with SEND. Risk factors associated with increases in behaviour difficulties over an 18-month period were summed to create a cumulative risk score, with this explanatory variable being added into a multi-level model. A quadratic term was then added to test the threshold model. There was evidence of a cumulative risk effect, suggesting that exposure to higher numbers of risk factors, regardless of their exact nature, resulted in increased behaviour difficulties. The relationship between risk and behaviour difficulties was non-linear, with exposure to increasing risk having a disproportionate and detrimental impact on behaviour difficulties in child and adolescent models. Interventions aimed at reducing behaviour difficulties need to consider the impact of multiple risk variables. Tailoring interventions towards those exposed to large numbers of risks would be advantageous. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Derivation of occupational exposure levels (OELs) of low-toxicity isometric biopersistent particles: How can the kinetic lung overload paradigm be used for improved inhalation toxicity study design and OEL-derivation?

    PubMed

    Pauluhn, Jürgen

    2014-12-20

    Convincing evidence suggests that poorly soluble low-toxicity particles (PSP) exert two unifying major modes of action (MoA), in which one appears to be deposition-related acute, whilst the other is retention-related and occurs with particle accumulation in the lung and associated persistent inflammation. Either MoA has its study- and cumulative dose-specific adverse outcome and metric. Modeling procedures were applied to better understand as to which extent protocol variables may predetermine any specific outcome of study. The results from modeled and empirical studies served as basis to derive OELs from modeled and empirically confirmed directions. This analysis demonstrates that the accumulated retained particle displacement volume was the most prominent unifying denominator linking the pulmonary retained volumetric particle dose to inflammogenicity and toxicity. However, conventional study design may not always be appropriate to unequivocally discriminate the surface thermodynamics-related acute adversity from the cumulative retention volume-related chronic adversity. Thus, in the absence of kinetically designed studies, it may become increasingly challenging to differentiate substance-specific deposition-related acute effects from the more chronic retained cumulative dose-related effects. It is concluded that the degree of dissolution of particles in the pulmonary environment seems to be generally underestimated with the possibility to attribute to toxicity due to decreased particle size and associated changes in thermodynamics and kinetics of dissolution. Accordingly, acute deposition-related outcomes become an important secondary variable within the pulmonary microenvironment. In turn, lung-overload related chronic adversities seem to be better described by the particle volume metric. This analysis supports the concept that 'self-validating', hypothesis-based computational study design delivers the highest level of unifying information required for the risk characterization of PSP. In demonstrating that the PSP under consideration is truly following the generic PSP-paradigm, this higher level of mechanistic information reduces the potential uncertainty involved with OEL derivation.

  4. Cost analysis of a growth guidance system compared with traditional and magnetically controlled growing rods for early-onset scoliosis: a US-based integrated health care delivery system perspective.

    PubMed

    Luhmann, Scott J; McAughey, Eoin M; Ackerman, Stacey J; Bumpass, David B; McCarthy, Richard E

    2018-01-01

    Treating early-onset scoliosis (EOS) with traditional growing rods (TGR) is effective but requires periodic surgical lengthening, risking complications. Alternatives include magnetically controlled growing rods (MCGR) that lengthen noninvasively and the growth guidance system (GGS), which obviate the need for active, distractive lengthenings. Previous studies have reported promising clinical effectiveness for GGS; however the direct medical costs of GGS compared to TGR and MCGR have not yet been explored. To estimate the cost of GGS compared with MCGR and TGR for EOS an economic model was developed from the perspective of a US integrated health care delivery system. Using dual-rod constructs, the model estimated the cumulative costs associated with initial implantation, rod lengthenings (TGR, MCGR), revisions due to device failure, surgical-site infections, device exchange, and final spinal fusion over a 6-year episode of care. Model parameters were from peer-reviewed, published literature. Medicare payments were used as a proxy for provider costs. Costs (2016 US$) were discounted 3% annually. Over a 6-year episode of care, GGS was associated with fewer invasive surgeries per patient than TGR (GGS: 3.4; TGR: 14.4) and lower cumulative costs than MCGR and TGR, saving $25,226 vs TGR. Sensitivity analyses showed that results were sensitive to changes in construct costs, rod breakage rates, months between lengthenings, and TGR lengthening setting of care. Within the model, GGS resulted in fewer invasive surgeries and deep surgical site infections than TGR, and lower cumulative costs per patient than both MCGR and TGR, over a 6-year episode of care. The analysis did not account for family disruption, pain, psychological distress, or compromised health-related quality of life associated with invasive TGR lengthenings, nor for potential patient anxiety surrounding the frequent MCGR lengthenings. Further analyses focusing strictly on current generation technologies should be considered for future research.

  5. Cost analysis of a growth guidance system compared with traditional and magnetically controlled growing rods for early-onset scoliosis: a US-based integrated health care delivery system perspective

    PubMed Central

    Luhmann, Scott J; McAughey, Eoin M; Ackerman, Stacey J; Bumpass, David B; McCarthy, Richard E

    2018-01-01

    Purpose Treating early-onset scoliosis (EOS) with traditional growing rods (TGR) is effective but requires periodic surgical lengthening, risking complications. Alternatives include magnetically controlled growing rods (MCGR) that lengthen noninvasively and the growth guidance system (GGS), which obviate the need for active, distractive lengthenings. Previous studies have reported promising clinical effectiveness for GGS; however the direct medical costs of GGS compared to TGR and MCGR have not yet been explored. Methods To estimate the cost of GGS compared with MCGR and TGR for EOS an economic model was developed from the perspective of a US integrated health care delivery system. Using dual-rod constructs, the model estimated the cumulative costs associated with initial implantation, rod lengthenings (TGR, MCGR), revisions due to device failure, surgical-site infections, device exchange, and final spinal fusion over a 6-year episode of care. Model parameters were from peer-reviewed, published literature. Medicare payments were used as a proxy for provider costs. Costs (2016 US$) were discounted 3% annually. Results Over a 6-year episode of care, GGS was associated with fewer invasive surgeries per patient than TGR (GGS: 3.4; TGR: 14.4) and lower cumulative costs than MCGR and TGR, saving $25,226 vs TGR. Sensitivity analyses showed that results were sensitive to changes in construct costs, rod breakage rates, months between lengthenings, and TGR lengthening setting of care. Conclusion Within the model, GGS resulted in fewer invasive surgeries and deep surgical site infections than TGR, and lower cumulative costs per patient than both MCGR and TGR, over a 6-year episode of care. The analysis did not account for family disruption, pain, psychological distress, or compromised health-related quality of life associated with invasive TGR lengthenings, nor for potential patient anxiety surrounding the frequent MCGR lengthenings. Further analyses focusing strictly on current generation technologies should be considered for future research. PMID:29588607

  6. Comparison of dust related respiratory effects in Dutch and Canadian grain handling industries: a pooled analysis.

    PubMed Central

    Peelen, S J; Heederik, D; Dimich-Ward, H D; Chan-Yeung, M; Kennedy, S M

    1996-01-01

    OBJECTIVES: Four previously conducted epidemiological studies in more than 1200 grain workers were used to compare exposure-response relations between exposure to grain dust and respiratory health. METHODS: The studies included Dutch workers from an animal feed mill and a transfer grain elevator and Canadian workers from a terminal grain elevator and the docks. Relations between forced expiratory volume in one second (FEV1) and exposure were analysed with multiple regression analysis corrected for smoking, age, and height. Exposure variables examined included cumulative and current dust exposure and the numbers of years a subject was employed in the industry. Sampling efficiencies of the Dutch and Canadian measurement techniques were compared in a pilot study. Results of this study were used to correct slopes of exposure-response relations for differences in dust fractions sampled by Dutch and Canadian personal dust samplers. RESULTS: Negative exposure-response relations were shown for regressions of FEV1 on cumulative and current exposure and years employed. Slopes of the exposure-response relations differed by a factor of three to five between industries, apart from results for cumulative exposure. Here the variation in slopes differed by a factor of 100, from -1 to -0.009 ml/mg.y/m3. The variation in slopes between industries reduced to between twofold to fivefold when the Dutch transfer elevator workers were not considered. There was evidence that the small exposure-response slope found for this group is caused by misclassification of exposure and a strong healthy worker effect. Alternative, but less likely explanations for the variation in slopes were differences in exposure concentrations, composition of grain dust, exposure characteristics, and measurement techniques. CONCLUSION: In conclusion, this study showed moderately similar negative exposure-response relations for four different populations from different countries, despite differences in methods of exposure assessment and exposure estimation. PMID:8983468

  7. Comparison of dust related respiratory effects in Dutch and Canadian grain handling industries: a pooled analysis.

    PubMed

    Peelen, S J; Heederik, D; Dimich-Ward, H D; Chan-Yeung, M; Kennedy, S M

    1996-08-01

    Four previously conducted epidemiological studies in more than 1200 grain workers were used to compare exposure-response relations between exposure to grain dust and respiratory health. The studies included Dutch workers from an animal feed mill and a transfer grain elevator and Canadian workers from a terminal grain elevator and the docks. Relations between forced expiratory volume in one second (FEV1) and exposure were analysed with multiple regression analysis corrected for smoking, age, and height. Exposure variables examined included cumulative and current dust exposure and the numbers of years a subject was employed in the industry. Sampling efficiencies of the Dutch and Canadian measurement techniques were compared in a pilot study. Results of this study were used to correct slopes of exposure-response relations for differences in dust fractions sampled by Dutch and Canadian personal dust samplers. Negative exposure-response relations were shown for regressions of FEV1 on cumulative and current exposure and years employed. Slopes of the exposure-response relations differed by a factor of three to five between industries, apart from results for cumulative exposure. Here the variation in slopes differed by a factor of 100, from -1 to -0.009 ml/mg.y/m3. The variation in slopes between industries reduced to between twofold to fivefold when the Dutch transfer elevator workers were not considered. There was evidence that the small exposure-response slope found for this group is caused by misclassification of exposure and a strong healthy worker effect. Alternative, but less likely explanations for the variation in slopes were differences in exposure concentrations, composition of grain dust, exposure characteristics, and measurement techniques. In conclusion, this study showed moderately similar negative exposure-response relations for four different populations from different countries, despite differences in methods of exposure assessment and exposure estimation.

  8. [SYMPTOMS OF NEGATIVE EFFECTS CUMULATION IN HUMANS AND ANIMALS UNDER THE ACTION OF G-LOADS OF VARYING DIRECTION IN CONTEXT OF AVIATION AND SPACE FLIGHTS].

    PubMed

    Kotovskaya, A R

    2015-01-01

    Author's and literary data are analyzed to evince symptoms of cumulation in humans and animals of the negative effects caused by g-forces of different directions experienced in aviation and space flights. The author cites evidence for the decisive importance of g-duration for the development of negative effects. Functional indices of g-tolerance do not rule out possible latent changes in visceral organs and body tissues.

  9. Assessment of cumulative evidence for the association between glutathione S-transferase polymorphisms and lung cancer: application of the Venice interim guidelines.

    PubMed

    Langevin, Scott M; Ioannidis, John P A; Vineis, Paolo; Taioli, Emanuela

    2010-10-01

    There is an overwhelming abundance of genetic association studies available in the literature, which can often be collectively difficult to interpret. To address this issue, the Venice interim guidelines were established for determining the credibility of the cumulative evidence. The objective of this report is to evaluate the literature on the association of common glutathione S-transferase (GST) variants (GSTM1 null, GSTT1 null and GSTP1 Ile105Val polymorphism) and lung cancer, and to assess the credibility of the associations using the newly proposed cumulative evidence guidelines. Information from the literature was enriched with an updated meta-analysis and a pooled analysis using data from the Genetic Susceptibility to Environmental Carcinogens database. There was a significant association between GSTM1 null and lung cancer for the meta-analysis (meta odds ratio=1.17, 95% confidence interval: 1.10-1.25) and pooled analysis (adjusted odds ratio=1.10, 95% confidence interval: 1.04-1.16), although substantial heterogeneity was present. No overall association between lung cancer and GSTT1 null or GSTP1 Ile105Val was found. When the Venice criteria was applied, cumulative evidence for all associations were considered 'weak', with the exception of East Asian carriers of the G allele of GSTP1 Ile105Val, which was graded as 'moderate' evidence. Despite the large amounts of studies, and several statistically significant summary estimates produced by meta-analyses, the application of the Venice criteria suggests extensive heterogeneity and susceptibility to bias for the studies on association of common genetic polymorphisms, such as with GST variants and lung cancer.

  10. Cumulative proportion of responders analysis (CPRA) as a tool to assess treatment outcome in alcohol clinical trials.

    PubMed

    Falk, Daniel E; Litten, Raye Z; Anton, Raymond F; Kranzler, Henry R; Johnson, Bankole A

    2014-03-01

    Several definitions of treatment response have been proposed for alcohol clinical trials (e.g., abstinence and no heavy drinking). However, each of these outcomes allows only one definition of successful response. In contrast, the cumulative proportion of responders analysis (CPRA) includes all of the possible drinking response cutoff points, providing a more complete picture of the therapeutic effects of a treatment. CPRA has been used to examine the efficacy of analgesics but not alcohol pharmacotherapy. To demonstrate its potential utility, we conducted CPRA in two large alcohol treatment trials: the COMBINE (Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence) trial (naltrexone) and a multisite topiramate trial. CPRA was used to demonstrate the efficacy of naltrexone and topiramate on continuous measures of in-treatment drinking-heavy drinking days and drinks per day-and their reductions from pretreatment. All possible cutoff points were portrayed for each measure. We provide graphs to illustrate the effects of the active medications compared with placebo and examined them statistically over a number of salient drinking outcomes to evaluate their efficacy. Treatment group responder curves were not parallel across the entire range of cutoff points; rather, they separated only at lower levels of drinking. In general, effect sizes increased by 0.10-0.15 when going from the lowest drinking level cutoff (i.e., abstinence and no heavy drinking) to the cutoff associated with the maximal treatment effect. CPRA may be useful in designing subsequent trials and helping to illustrate for treatment providers the likelihood of treatment success given various definitions of a positive response.

  11. [Efficacy and safety profile of cranberry in infants and children with recurrent urinary tract infection].

    PubMed

    Fernández-Puentes, V; Uberos, J; Rodríguez-Belmonte, R; Nogueras-Ocaña, M; Blanca-Jover, E; Narbona-López, E

    2015-06-01

    Cranberry prophylaxis of recurrent urinary tract infection in infants has proven effective in the experimental model of the adult. There are few data on its efficacy, safety and recommended dose in the pediatric population. A controlled, double-blind Phase III clinical trial was conducted on children older than 1 month of age to evaluate the efficacy and safety of cranberry in recurrent urinary tract infection. The assumption was of the non-inferiority of cranberry versus trimethoprim. Statistical analysis was performed using Kaplan Meier analysis. A total of 85 patients under 1 year of age and 107 over 1 year were recruited. Trimethoprim was prescribed to 75 patients and 117 received cranberry. The cumulative rate of urinary infection associated with cranberry prophylaxis in children under 1 year was 46% (95% CI; 23-70) in children and 17% (95% CI; 0-38) in girls, effectively at doses inferior to trimethoprim. In children over 1 year-old cranberry was not inferior to trimethoprim, with a cumulative rate of urine infection of 26% (95% CI; 12-41). The cranberry was well tolerated and with no new adverse effects. Our study confirms that cranberry is safe and effective in the prophylaxis of recurrent urinary tract infection in infants and children. With the doses used, their efficiency is not less than that observed for trimethoprim among those over 1 year-old. (Clinical Trials Registry ISRCTN16968287). Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  12. Assessment of some cultural experimental methods to study the effects of antibiotics on microbial activities in a soil: An incubation study

    PubMed Central

    Molaei, Ali; Haghnia, Gholamhosain; Astaraei, Alireza; Rasouli-Sadaghiani, MirHassan; Teresa Ceccherini, Maria; Datta, Rahul

    2017-01-01

    Oxytetracycline (OTC) and sulfamethoxazole (SMX) are two of most widely used antibiotics in livestock and poultry industry. After consumption of antibiotics, a major portion of these compounds is excreted through the feces and urine of animals. Land application of antibiotic-treated animal wastes has caused increasing concern about their adverse effects on ecosystem health. In this regard, inconsistent results have been reported regarding the effects of antibiotics on soil microbial activities. This study was conducted based on the completely randomized design to the measure microbial biomass carbon, cumulative respiration and iron (III) reduction bioassays. Concentrations of OTC and SMX including 0, 1, 10, 25, 50, and 100 mg/kg were spiked in triplicate to a sandy loam soil and incubated for 21 days at 25°C. Results showed that the effects of OTC and SMX antibiotics on cumulative respiration and microbial biomass carbon were different. SMX antibiotic significantly affected soil microbial biomass carbon and cumulative respiration at different treatments compared to control with increasing incubation time. OTC antibiotic, on the other hand, negatively affected cumulative respiration compared to control treatment throughout the incubation period. Although OTC antibiotic positively affected microbial biomass carbon at day one of incubation, there was no clear trend in microbial biomass carbon between different treatments of this antibiotic after that time period. Nevertheless, sulfamethoxazole and oxytetracycline antibiotics had similar effects on iron (III) reduction such that they considerably affected iron (III) reduction at 1 and 10 mg/kg, and iron (III) reduction was completely inhibited at concentrations above 10 mg/kg. Hence, according to our results, microbial biomass carbon and cumulative respiration experiments are not able alone to exhibit the effect of antibiotics on soil microbial activity, but combination of these two experiments with iron (III) reduction test could well display the effects of sulfamethoxazole (SMX) and oxytetracycline (OTC) antibiotics on soil biochemical activities. PMID:28683144

  13. Impact on Medical Cost, Cumulative Survival, and Cost-Effectiveness of Adding Rituximab to First-Line Chemotherapy for Follicular Lymphoma in Elderly Patients: An Observational Cohort Study Based on SEER-Medicare

    PubMed Central

    Griffiths, Robert I.; Gleeson, Michelle L.; Mikhael, Joseph; Danese, Mark D.

    2012-01-01

    Rituximab improves survival in follicular lymphoma (FL), but is considerably more expensive than conventional chemotherapy. We estimated the total direct medical costs, cumulative survival, and cost-effectiveness of adding rituximab to first-line chemotherapy for FL, based on a single source of data representing routine practice in the elderly. Using surveillance, epidemiology, and end results (SEER) registry data plus Medicare claims, we identified 1,117 FL patients who received first-line CHOP (cyclophosphamide (C), doxorubicin, vincristine (V), and prednisone (P)) or CVP +/− rituximab. Multivariate regression was used to estimate adjusted cumulative cost and survival differences between the two groups over four years after beginning treatment. The median age was 73 years (minimum 66 years), 56% had stage III-IV disease, and 67% received rituximab. Adding rituximab to first-line chemotherapy was associated with higher adjusted incremental total cost ($18,695; 95% Confidence Interval (CI) $9,302–$28,643) and longer adjusted cumulative survival (0.18 years; 95% CI 0.10–0.27) over four years of followup. The expected cost-effectiveness was $102,142 (95% CI $34,531–296,337) per life-year gained. In routine clinical practice, adding rituximab to first-line chemotherapy for elderly patients with FL results in higher direct medical costs to Medicare and longer cumulative survival after four years. PMID:22969803

  14. Mismatch or cumulative stress: toward an integrated hypothesis of programming effects.

    PubMed

    Nederhof, Esther; Schmidt, Mathias V

    2012-07-16

    This paper integrates the cumulative stress hypothesis with the mismatch hypothesis, taking into account individual differences in sensitivity to programming. According to the cumulative stress hypothesis, individuals are more likely to suffer from disease as adversity accumulates. According to the mismatch hypothesis, individuals are more likely to suffer from disease if a mismatch occurs between the early programming environment and the later adult environment. These seemingly contradicting hypotheses are integrated into a new model proposing that the cumulative stress hypothesis applies to individuals who were not or only to a small extent programmed by their early environment, while the mismatch hypothesis applies to individuals who experienced strong programming effects. Evidence for the main effects of adversity as well as evidence for the interaction between adversity in early and later life is presented from human observational studies and animal models. Next, convincing evidence for individual differences in sensitivity to programming is presented. We extensively discuss how our integrated model can be tested empirically in animal models and human studies, inviting researchers to test this model. Furthermore, this integrated model should tempt clinicians and other intervenors to interpret symptoms as possible adaptations from an evolutionary biology perspective. Copyright © 2011 Elsevier Inc. All rights reserved.

  15. Structural bias in the sentencing of felony defendants.

    PubMed

    Sutton, John R

    2013-09-01

    As incarceration rates have risen in the US, so has the overrepresentation of African Americans and Latinos among prison inmates. Whether and to what degree these disparities are due to bias in the criminal courts remains a contentious issue. This article pursues two lines of argument toward a structural account of bias in the criminal law, focusing on (1) cumulative disadvantages that may accrue over successive stages of the criminal justice process, and (2) the contexts of racial disadvantage in which courts are embedded. These arguments are tested using case-level data on male defendants charged with felony crimes in urban US counties in 2000. Multilevel binary and ordinal logit models are used to estimate contextual effects on pretrial detention, guilty pleas, and sentence severity, and cumulative effects are estimated as conditional probabilities that are allowed to vary by race across all three outcomes. Results yield strong, but qualified, evidence of cumulative disadvantage accruing to black and Latino defendants, but do not support the contextual hypotheses. When the cumulative effects of bias are taken into account, the estimated probability of the average African American or Latino felon going to prison is 26% higher than that of the average Anglo. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Is Serotonin Transporter Genotype Associated with Epigenetic Susceptibility or Vulnerability? Examination of the Impact of SES Risk on African American Youth

    PubMed Central

    Beach, S. R. H.; Brody, G. H.; Lei, M.K.; Kim, S.; Cui, J.

    2014-01-01

    We hypothesized that presence of the s allele in the promoter region of the serotonin transporter (5-HTTLR) would moderate the effect of early cumulative SES risk on epigenetic change among African American youth. Contrasting hypotheses regarding the shape of the interaction effect were generated using vulnerability and susceptibility frameworks and applied to data from a sample of 388 African American youth. Early, cumulative SES risk assessed at 11–13 years based on parent report interacted with presence of the s allele to predict differential methylation assessed at age 19. Across multiple tests, a differential susceptibility perspective rather than a diathesis stress framework best fit the data for genes associated with depression, consistently demonstrating greater epigenetic response to early cumulative SES risk among s allele carriers. A pattern consistent with greater impact among s allele carriers also was observed using all CpG sites across the genome that were differentially affected by early cumulative SES risk. We conclude that the s allele is associated with increased responsiveness to early cumulative SES risk among African American youth, leading to epigenetic divergence for depression-related genes in response to exposure to heightened SES risk among s allele carriers in a “for better” or “for worse” pattern. PMID:24438855

  17. Cumulative effects of cascade hydropower stations on total dissolved gas supersaturation.

    PubMed

    Ma, Qian; Li, Ran; Feng, Jingjie; Lu, Jingying; Zhou, Qin

    2018-05-01

    Elevated levels of total dissolved gas (TDG) may occur downstream of dams during the spill process. These high levels would increase the incidence of gas bubble disease in fish and cause severe environmental impacts. With increasing numbers of cascade hydropower stations being built or planned, the cumulative effects of TDG supersaturation are becoming increasingly prominent. The TDG saturation distribution in the downstream reaches of the Jinsha River was studied to investigate the cumulative effects of TDG supersaturation resulting from the cascade hydropower stations. A comparison of the effects of the joint operation and the single operation of two hydropower stations (XLD and XJB) was performed to analyze the risk degree to fish posed by TDG supersaturation. The results showed that water with supersaturated TDG generated at the upstream cascade can be transported to the downstream power station, leading to cumulative TDG supersaturation effects. Compared with the single operation of XJB, the joint operation of both stations produced a much higher TDG saturation downstream of XJB, especially during the non-flood discharge period. Moreover, the duration of high TDG saturation and the lengths of the lethal and sub-lethal areas were much higher in the joint operation scenario, posing a greater threat to fish and severely damaging the environment. This work provides a scientific basis for strategies to reduce TDG supersaturation to the permissible level and minimize the potential risk of supersaturated TDG.

  18. An inferential and descriptive statistical examination of the relationship between cumulative work metrics and injury in Major League Baseball pitchers.

    PubMed

    Karakolis, Thomas; Bhan, Shivam; Crotin, Ryan L

    2013-08-01

    In Major League Baseball (MLB), games pitched, total innings pitched, total pitches thrown, innings pitched per game, and pitches thrown per game are used to measure cumulative work. Often, pitchers are allocated limits, based on pitches thrown per game and total innings pitched in a season, in an attempt to prevent future injuries. To date, the efficacy in predicting injuries from these cumulative work metrics remains in question. It was hypothesized that the cumulative work metrics would be a significant predictor for future injury in MLB pitchers. Correlations between cumulative work for pitchers during 2002-07 and injury days in the following seasons were examined using regression analyses to test this hypothesis. Each metric was then "binned" into smaller cohorts to examine trends in the associated risk of injury for each cohort. During the study time period, 27% of pitchers were injured after a season in which they pitched. Although some interesting trends were noticed during the binning process, based on the regression analyses, it was found that no cumulative work metric was a significant predictor for future injury. It was concluded that management of a pitcher's playing schedule based on these cumulative work metrics alone could not be an effective means of preventing injury. These findings indicate that an integrated approach to injury prevention is required. This approach will likely involve advanced cumulative work metrics and biomechanical assessment.

  19. Exercise and BMI z-score in overweight and obese children and adolescents: protocol for a systematic review and network meta-analysis of randomised trials.

    PubMed

    Kelley, George A; Kelley, Kristi S

    2016-04-15

    While overweight and obesity in children and adolescents is a major global health problem, the effects of exercise on overweight and obesity in children and adolescents are not well established despite numerous studies on this topic. The purpose of this study is to use the network meta-analytic approach to determine the effects of exercise (aerobic, strength training or both) on body mass index (BMI) z-score in overweight and obese children and adolescents. Randomised exercise intervention trials >4 weeks, published in any language between 1 January 1990 and 31 September 2015, and which include direct and/or indirect evidence, will be included. Studies will be retrieved by searching 6 electronic databases, cross-referencing and expert review. Dual abstraction of data will occur. The primary outcome will be changes in BMI z-score while the secondary outcome will be changes in body weight in kilograms (kg). Risk of bias will be assessed using the Cochrane risk of bias assessment instrument while confidence in the cumulative evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) instrument for network meta-analysis. Network meta-analysis will be performed using multivariate random-effects meta-regression models. The surface under the cumulative ranking curve will be used to provide a hierarchy of exercise treatments (aerobic, strength training or both). The results of this study will be presented at a professional conference and published in a peer-reviewed journal. CRD42015026377. 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/

  20. Concreteness Effects and Syntactic Modification in Written Composition.

    ERIC Educational Resources Information Center

    Sadoski, Mark; Goetz, Ernest T.

    1998-01-01

    Investigates whether concreteness was related to a key characteristic of written composition--the cumulative sentence with a final modifier--which has been consistently associated with higher quality writing. Supports the conceptual-peg hypothesis of dual coding theory, with concrete verbs providing the pegs on which cumulative sentences are…

  1. Direct and Indirect Effects of Childhood Adversity on Depressive Symptoms in Young Adults.

    ERIC Educational Resources Information Center

    Turner, Heather A.; Butler, Melissa J.

    2003-01-01

    Examined whether cumulative trauma in childhood and adolescence is related to depressive symptoms in young adults and explored mediating factors. Results for 649 college students indicate clear differences in cumulative trauma by sociodemographic characteristics, with high trauma associated with early onset of depression and later depressive…

  2. Environmental quality impact on human mortality and its spatial variations in the contiguous United States 2000-2005

    EPA Science Inventory

    Assessing the cumulative effects of multiple environmental factors that influence mortality remains a challenging task. This study used the Environmental Quality Index (EQI), and its five domain indices (air, water, land, built and sociodemographic) as a measure of cumulative env...

  3. EVALUATING CUMULATIVE EFFECTS OF DISTURBANCE ON THE HYDROLOGIC FUNCTION OF BOGS, FENS, AND MIRES

    EPA Science Inventory

    Few quantitative studies have been done on the hydrology of fens, bogs and mires, and consequently any predictions of the cumulative impacts of disturbances on their hydrologic functions is extremely difficult. or example, few data are available on the role of bogs and fens with ...

  4. Mothering and Peer Associations Mediate Cumulative Risk Effects for Latino Youth

    ERIC Educational Resources Information Center

    Loukas, Alexandra; Prelow, Hazel M.; Suizzo, Marie-Anne; Allua, Shane

    2008-01-01

    The present study examined whether positive parenting and deviant peer associations mediated the relations between a cumulative risk composite comprising financial strain, neighborhood problems, and maternal psychological distress and subsequent youth adjustment problems. Drawn from the Welfare, Children, and Families: A Three City Study, the…

  5. Cumulative trauma, hyperarousal, and suicidality in the general population: a path analysis.

    PubMed

    Briere, John; Godbout, Natacha; Dias, Colin

    2015-01-01

    Although trauma exposure and posttraumatic stress disorder (PTSD) both have been linked to suicidal thoughts and behavior, the underlying basis for this relationship is not clear. In a sample of 357 trauma-exposed individuals from the general population, younger participant age, cumulative trauma exposure, and all three Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, PTSD clusters (reexperiencing, avoidance, and hyperarousal) were correlated with clinical levels of suicidality. However, logistic regression analysis indicated that when all PTSD clusters were considered simultaneously, only hyperarousal continued to be predictive. A path analysis confirmed that posttraumatic hyperarousal (but not other components of PTSD) fully mediated the relationship between extent of trauma exposure and degree of suicidal thoughts and behaviors.

  6. Uncertainty in the analysis of the overall equipment effectiveness on the shop floor

    NASA Astrophysics Data System (ADS)

    Rößler, M. P.; Abele, E.

    2013-06-01

    In this article an approach will be presented which supports transparency regarding the effectiveness of manufacturing equipment by combining the fuzzy set theory with the method of the overall equipment effectiveness analysis. One of the key principles of lean production and also a fundamental task in production optimization projects is the prior analysis of the current state of a production system by the use of key performance indicators to derive possible future states. The current state of the art in overall equipment effectiveness analysis is usually performed by cumulating different machine states by means of decentralized data collection without the consideration of uncertainty. In manual data collection or semi-automated plant data collection systems the quality of derived data often diverges and leads optimization teams to distorted conclusions about the real optimization potential of manufacturing equipment. The method discussed in this paper is to help practitioners to get more reliable results in the analysis phase and so better results of optimization projects. Under consideration of a case study obtained results are discussed.

  7. Contraceptive confidence and timing of first birth in Moldova: an event history analysis of retrospective data.

    PubMed

    Lyons-Amos, Mark; Padmadas, Sabu S; Durrant, Gabriele B

    2014-08-11

    To test the contraceptive confidence hypothesis in a modern context. The hypothesis is that women using effective or modern contraceptive methods have increased contraceptive confidence and hence a shorter interval between marriage and first birth than users of ineffective or traditional methods. We extend the hypothesis to incorporate the role of abortion, arguing that it acts as a substitute for contraception in the study context. Moldova, a country in South-East Europe. Moldova exhibits high use of traditional contraceptive methods and abortion compared with other European countries. Data are from a secondary analysis of the 2005 Moldovan Demographic and Health Survey, a nationally representative sample survey. 5377 unmarried women were selected. The outcome measure was the interval between marriage and first birth. This was modelled using a piecewise-constant hazard regression, with abortion and contraceptive method types as primary variables along with relevant sociodemographic controls. Women with high contraceptive confidence (modern method users) have a higher cumulative hazard of first birth 36 months following marriage (0.88 (0.87 to 0.89)) compared with women with low contraceptive confidence (traditional method users, cumulative hazard: 0.85 (0.84 to 0.85)). This is consistent with the contraceptive confidence hypothesis. There is a higher cumulative hazard of first birth among women with low (0.80 (0.79 to 0.80)) and moderate abortion propensities (0.76 (0.75 to 0.77)) than women with no abortion propensity (0.73 (0.72 to 0.74)) 24 months after marriage. Effective contraceptive use tends to increase contraceptive confidence and is associated with a shorter interval between marriage and first birth. Increased use of abortion also tends to increase contraceptive confidence and shorten birth duration, although this effect is non-linear-women with a very high use of abortion tend to have lengthy intervals between marriage and first birth. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  8. Impact of Therapy on Metabolic Syndrome in Young Adult Premenopausal Female Lupus Patients: Beneficial Effect of Antimalarials.

    PubMed

    Muniz, Luciana F; Pereira, Rosa M R; Silva, Thiago F; Bonfá, Eloisa; Borba, Eduardo F

    2015-09-01

    There are no data about the main factors associated with metabolic syndrome in young premenopausal systemic lupus erythematosus (SLE) patients. The aim of the study was to evaluate the frequency of metabolic syndrome and disease- or therapy-related factors in premenopausal young SLE patients. A total of 103 premenopausal SLE patients ages <40 years were selected and compared to 35 healthy premenopausal age-matched women. Metabolic syndrome was defined according to the 2009 Joint Interim Statement. A higher frequency of metabolic syndrome (22.3% versus 5.7%; P = 0.03) was observed in the SLE group. Metabolic syndrome-SLE patients had higher SLE Disease Activity Index scores (mean ± SD 5.9 ± 7.6 versus 1.9 ± 2.7; P = 0.006), more frequently had previous renal disease (73.9% versus 51.2%; P = 0.05) and current renal disease (34.8% versus 10.0%; P = 0.008), and had higher current prednisone dose (median [range] 20 [0-60] versus 5 [0-60] mg/dl; P = 0.018) and cumulative prednisone dose (mean ± SD 41.48 ± 27.81 versus 24.7 ± 18.66 gm; P = 0.023) than those without metabolic syndrome. Chloroquine was less frequently used in metabolic syndrome-SLE patients (65.2% versus 90.0%; P = 0.008). In multivariate analysis, only current chloroquine use (prevalence ratio [PR] 0.29, 95% confidence interval [95% CI] 0.13-0.64) and cumulative prednisone were associated with metabolic syndrome (PR 1.02, 95% CI 1.01-1.04). Further estimated prevalence analysis identified the fact that antimalarial use promoted continuous decrease in the progressive metabolic syndrome prevalence associated with glucocorticoid cumulative dose. The prevalence of metabolic syndrome is high in premenopausal young adult SLE patients. Chloroquine has a protective effect on the prevalence of metabolic syndrome in these patients, and this benefit counteracts the deleterious effect of glucocorticoids in a dose-dependent manner. © 2015, American College of Rheumatology.

  9. Effects of urban land-use change on streamflow and water quality in Oakland County, Michigan, 1970-2003, as inferred from urban gradient and temporal analysis

    USGS Publications Warehouse

    Aichele, Stephen S.

    2005-01-01

    This apparent contradiction may be caused by the differences in the changes measured in each analysis. The change-through-time approach describes change from a fixed starting point of approximately 1970; the gradient approach describes the cumulative effect of all change up to approximately 2000. These findings indicate that although urbanization in Oakland County results in most of the effects observed in the literature, as evidenced in the gradient approach, relatively few of the anticipated effects have been observed during the past three decades. This relative stability despite rapid land-cover change may be related to efforts to mitigate the effects of development and a general decrease in the density of new residential development. It may also be related to external factors such as climate variability and reduced atmospheric deposition of specific chemicals. 

  10. Body mass index and cholesterol level predict surgical outcome in patients with hepatocellular carcinoma in Taiwan - a cohort study.

    PubMed

    Lee, Ya-Ling; Li, Wan-Chun; Tsai, Tung-Hu; Chiang, Hsin-Yu; Ting, Chin-Tsung

    2016-04-19

    Curative surgical resection (CSR) remains the most effective therapeutic intervention for patients with hepatocellular carcinoma (HCC); however, frequent post-surgical recurrence leads to high cancer related mortality. This study aimed to clarify the role of body mass index (BMI) and serum cholesterol level in predicting post-surgical outcomes in HCC patients after CSR. A total of 484 HCC patients including 213 BMIhigh and 271 BMIlow patients were included. Overall survival (OS) and recurrence-free survival (RFS) rates were examined in patients with differential BMI and serum cholesterol level. The analysis showed that significant different 1-, 3- and 5-year cumulative OS rates (P-value=0.015) and RFS rate (P-value=0.010) between BMIlow and BMIhigh patients. Further analysis in groups with differential serum cholesterol levels among BMIlow and BMIhigh patients indicated that the BMIlow/Chollow patients exhibited the significant lower cumulative OS and RFS rates in comparison with the remaining subjects (P-value=0.007 and 0.039 for OS and RFS rates, respectively). In conclusion, the coexistence of low BMI and low serum cholesterol level could serve as prognostic factors to predict post-operative outcomes in HCC patients undergoing surgical hepatectomy.

  11. Environmental Assessment for Selected Capital Improvement Plan (CIP) Projects

    DTIC Science & Technology

    2009-01-01

    the USACE Wetlands Delineation Manual as ”those areas that are inundated or saturated by surface or ground water at a frequency and duration... potential for a conventional water supply (Air Force 2000a). Due to its proximity to the Back River and the Chesapeake Bay, and its low ground elevation...coincide, even partially, in time would tend to offer a higher potential for cumulative effects . To identify cumulative effects , this EA addresses three

  12. Random forests as cumulative effects models: A case study of lakes and rivers in Muskoka, Canada.

    PubMed

    Jones, F Chris; Plewes, Rachel; Murison, Lorna; MacDougall, Mark J; Sinclair, Sarah; Davies, Christie; Bailey, John L; Richardson, Murray; Gunn, John

    2017-10-01

    Cumulative effects assessment (CEA) - a type of environmental appraisal - lacks effective methods for modeling cumulative effects, evaluating indicators of ecosystem condition, and exploring the likely outcomes of development scenarios. Random forests are an extension of classification and regression trees, which model response variables by recursive partitioning. Random forests were used to model a series of candidate ecological indicators that described lakes and rivers from a case study watershed (The Muskoka River Watershed, Canada). Suitability of the candidate indicators for use in cumulative effects assessment and watershed monitoring was assessed according to how well they could be predicted from natural habitat features and how sensitive they were to human land-use. The best models explained 75% of the variation in a multivariate descriptor of lake benthic-macroinvertebrate community structure, and 76% of the variation in the conductivity of river water. Similar results were obtained by cross-validation. Several candidate indicators detected a simulated doubling of urban land-use in their catchments, and a few were able to detect a simulated doubling of agricultural land-use. The paper demonstrates that random forests can be used to describe the combined and singular effects of multiple stressors and natural environmental factors, and furthermore, that random forests can be used to evaluate the performance of monitoring indicators. The numerical methods presented are applicable to any ecosystem and indicator type, and therefore represent a step forward for CEA. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  13. Subjective effect of September 11, 2001 among pregnant women: is cumulative history of interpersonal violence important?

    PubMed

    Lewis, Marilyn W; Cavanagh, Paul K; Ahn, Grace; Yoshioka, Marianne R

    2008-06-01

    Prior history of trauma may sensitize individuals to subsequent trauma, including terrorist attacks. Using a convenience sample of secondary, cross-sectional data, pregnant women were grouped based on lifetime interpersonal violence history. Cumulative risk theory was used to evaluate the association of lifetime interpersonal violence history and subjective impact of the September 11, 2001 (9/11) terrorists attacks. Using hierarchical linear regression, cumulative risk theory was partially supported. Women with a history of only one type of interpfersonal violence reported greater effect of 9/11 than did women without a history, but women with both types of violence did not report a greater effect of 9/11 compared to women endorsing history of one type. These data corroborate the literature in that level of exposure to terrorist-related trauma predicts subjective reaction to the attacks. Future research with a larger sample and standardized instruments is warranted.

  14. A Poisson process approximation for generalized K-5 confidence regions

    NASA Technical Reports Server (NTRS)

    Arsham, H.; Miller, D. R.

    1982-01-01

    One-sided confidence regions for continuous cumulative distribution functions are constructed using empirical cumulative distribution functions and the generalized Kolmogorov-Smirnov distance. The band width of such regions becomes narrower in the right or left tail of the distribution. To avoid tedious computation of confidence levels and critical values, an approximation based on the Poisson process is introduced. This aproximation provides a conservative confidence region; moreover, the approximation error decreases monotonically to 0 as sample size increases. Critical values necessary for implementation are given. Applications are made to the areas of risk analysis, investment modeling, reliability assessment, and analysis of fault tolerant systems.

  15. Automated nystagmus analysis. [on-line computer technique for eye data processing

    NASA Technical Reports Server (NTRS)

    Oman, C. M.; Allum, J. H. J.; Tole, J. R.; Young, L. R.

    1973-01-01

    Several methods have recently been used for on-line analysis of nystagmus: A digital computer program has been developed to accept sampled records of eye position, detect fast phase components, and output cumulative slow phase position, continuous slow phase velocity, instantaneous fast phase frequency, and other parameters. The slow phase velocity is obtained by differentiation of the calculated cumulative position rather than the original eye movement record. Also, a prototype analog device has been devised which calculates the velocity of the slow phase component during caloric testing. Examples of clinical and research eye movement records analyzed with these devices are shown.

  16. Probabilistic Analysis of Solid Oxide Fuel Cell Based Hybrid Gas Turbine System

    NASA Technical Reports Server (NTRS)

    Gorla, Rama S. R.; Pai, Shantaram S.; Rusick, Jeffrey J.

    2003-01-01

    The emergence of fuel cell systems and hybrid fuel cell systems requires the evolution of analysis strategies for evaluating thermodynamic performance. A gas turbine thermodynamic cycle integrated with a fuel cell was computationally simulated and probabilistically evaluated in view of the several uncertainties in the thermodynamic performance parameters. Cumulative distribution functions and sensitivity factors were computed for the overall thermal efficiency and net specific power output due to the uncertainties in the thermodynamic random variables. These results can be used to quickly identify the most critical design variables in order to optimize the design and make it cost effective. The analysis leads to the selection of criteria for gas turbine performance.

  17. Analysis of autosomal genes reveals gene-sex interactions and higher total genetic risk in men with systemic lupus erythematosus.

    PubMed

    Hughes, Travis; Adler, Adam; Merrill, Joan T; Kelly, Jennifer A; Kaufman, Kenneth M; Williams, Adrienne; Langefeld, Carl D; Gilkeson, Gary S; Sanchez, Elena; Martin, Javier; Boackle, Susan A; Stevens, Anne M; Alarcón, Graciela S; Niewold, Timothy B; Brown, Elizabeth E; Kimberly, Robert P; Edberg, Jeffrey C; Ramsey-Goldman, Rosalind; Petri, Michelle; Reveille, John D; Criswell, Lindsey A; Vilá, Luis M; Jacob, Chaim O; Gaffney, Patrick M; Moser, Kathy L; Vyse, Timothy J; Alarcón-Riquelme, Marta E; James, Judith A; Tsao, Betty P; Scofield, R Hal; Harley, John B; Richardson, Bruce C; Sawalha, Amr H

    2012-05-01

    Systemic lupus erythematosus (SLE) is a sexually dimorphic autoimmune disease which is more common in women, but affected men often experience a more severe disease. The genetic basis of sexual dimorphism in SLE is not clearly defined. A study was undertaken to examine sex-specific genetic effects among SLE susceptibility loci. A total of 18 autosomal genetic susceptibility loci for SLE were genotyped in a large set of patients with SLE and controls of European descent, consisting of 5932 female and 1495 male samples. Sex-specific genetic association analyses were performed. The sex-gene interaction was further validated using parametric and non-parametric methods. Aggregate differences in sex-specific genetic risk were examined by calculating a cumulative genetic risk score for SLE in each individual and comparing the average genetic risk between male and female patients. A significantly higher cumulative genetic risk for SLE was observed in men than in women. (P=4.52x10-8) A significant sex-gene interaction was seen primarily in the human leucocyte antigen (HLA) region but also in IRF5, whereby men with SLE possess a significantly higher frequency of risk alleles than women. The genetic effect observed in KIAA1542 is specific to women with SLE and does not seem to have a role in men. The data indicate that men require a higher cumulative genetic load than women to develop SLE. These observations suggest that sex bias in autoimmunity could be influenced by autosomal genetic susceptibility loci.

  18. Lifetime use of psychiatric medications and cognition at 43years of age in schizophrenia in the Northern Finland Birth Cohort 1966.

    PubMed

    Hulkko, A P; Murray, G K; Moilanen, J; Haapea, M; Rannikko, I; Jones, P B; Barnett, J H; Huhtaniska, S; Isohanni, M K; Koponen, H; Jääskeläinen, E; Miettunen, J

    2017-09-01

    Higher lifetime antipsychotic exposure has been associated with poorer cognition in schizophrenia. The cognitive effects of adjunctive psychiatric medications and lifetime trends of antipsychotic use remain largely unclear. We aimed to study how lifetime and current benzodiazepine and antidepressant medications, lifetime trends of antipsychotic use and antipsychotic polypharmacy are associated with cognitive performance in midlife schizophrenia. Sixty participants with DSM-IV schizophrenia from the Northern Finland Birth Cohort 1966 were examined at 43years of age with an extensive cognitive test battery. Cumulative lifetime and current use of psychiatric medications were collected from medical records and interviews. The associations between medication and principal component analysis-based cognitive composite score were analysed using linear regression. Lifetime cumulative DDD years of benzodiazepine and antidepressant medications were not significantly associated with global cognition. Being without antipsychotic medication (for minimum 11months) before the cognitive examination was associated with better cognitive performance (P=0.007) and higher lifetime cumulative DDD years of antipsychotics with poorer cognition (P=0.020), when adjusted for gender, onset age and lifetime hospital treatment days. Other lifetime trends of antipsychotic use, such as a long antipsychotic-free period earlier in the treatment history, and antipsychotic polypharmacy, were not significantly associated with cognition. Based on these naturalistic data, low exposure to adjunctive benzodiazepine and antidepressant medications does not seem to affect cognition nor explain the possible negative effects of high dose long-term antipsychotic medication on cognition in schizophrenia. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

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

    PubMed Central

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

    2005-01-01

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

  20. Specific Trauma Subtypes Improve the Predictive Validity of the Harvard Trauma Questionnaire in Iraqi Refugees

    PubMed Central

    Arnetz, Bengt B.; Broadbridge, Carissa L.; Jamil, Hikmet; Lumley, Mark A.; Pole, Nnamdi; Barkho, Evone; Fakhouri, Monty; Talia, Yousif Rofa; Arnetz, Judith E.

    2014-01-01

    Background Trauma exposure contributes to poor mental health among refugees, and exposure often is measured using a cumulative index of items from the Harvard Trauma Questionnaire (HTQ). Few studies, however, have asked whether trauma subtypes derived from the HTQ could be superior to this cumulative index in predicting mental health outcomes. Methods A community sample of recently arrived Iraqi refugees (N = 298) completed the HTQ and measures of posttraumatic stress disorder (PTSD) and depression symptoms. Results Principal components analysis of HTQ items revealed a 5-component subtype model of trauma that accounted for more item variance than a 1-component solution. These trauma subtypes also accounted for more variance in PTSD and depression symptoms (12% and 10%, respectively) than did the cumulative trauma index (7% and 3%, respectively). Discussion Trauma subtypes provided more information than cumulative trauma in the prediction of negative mental health outcomes. Therefore, use of these subtypes may enhance the utility of the HTQ when assessing at-risk populations. PMID:24549491

  1. Structural variations in prefrontal cortex mediate the relationship between early childhood stress and spatial working memory

    PubMed Central

    Hanson, Jamie L.; Chung, Moo K.; Avants, Brian B.; Rudolph, Karen D.; Shirtcliff, Elizabeth A.; Gee, James C.; Davidson, Richard J.; Pollak, Seth D.

    2012-01-01

    A large corpus of research indicates exposure to stress impairs cognitive abilities, specifically executive functioning dependent on the prefrontal cortex (PFC). We collected structural MRI scans (n=61), well-validated assessments of executive functioning, and detailed interviews assessing stress exposure in humans, to examine whether cumulative life stress affected brain morphometry and one type of executive functioning, spatial working memory, during adolescence—a critical time of brain development and reorganization. Analysis of variations in brain structure revealed that cumulative life stress and spatial working memory were related to smaller volumes in the PFC, specifically prefrontal gray and white matter between the anterior cingulate and the frontal poles. Mediation analyses revealed that individual differences in prefrontal volumes accounted for the association between cumulative life stress and spatial working memory. These results suggest that structural changes in the PFC may serve as a mediating mechanism through which greater cumulative life stress engenders decrements in cognitive functioning. PMID:22674267

  2. Radiation exposure assessment for portsmouth naval shipyard health studies.

    PubMed

    Daniels, R D; Taulbee, T D; Chen, P

    2004-01-01

    Occupational radiation exposures of 13,475 civilian nuclear shipyard workers were investigated as part of a retrospective mortality study. Estimates of annual, cumulative and collective doses were tabulated for future dose-response analysis. Record sets were assembled and amended through range checks, examination of distributions and inspection. Methods were developed to adjust for administrative overestimates and dose from previous employment. Uncertainties from doses below the recording threshold were estimated. Low-dose protracted radiation exposures from submarine overhaul and repair predominated. Cumulative doses are best approximated by a hybrid log-normal distribution with arithmetic mean and median values of 20.59 and 3.24 mSv, respectively. The distribution is highly skewed with more than half the workers having cumulative doses <10 mSv and >95% having doses <100 mSv. The maximum cumulative dose is estimated at 649.39 mSv from 15 person-years of exposure. The collective dose was 277.42 person-Sv with 96.8% attributed to employment at Portsmouth Naval Shipyard.

  3. Comparing multistate expected damages, option price and cumulative prospect measures for valuing flood protection

    NASA Astrophysics Data System (ADS)

    Farrow, Scott; Scott, Michael

    2013-05-01

    Floods are risky events ranging from small to catastrophic. Although expected flood damages are frequently used for economic policy analysis, alternative measures such as option price (OP) and cumulative prospect value exist. The empirical magnitude of these measures whose theoretical preference is ambiguous is investigated using case study data from Baltimore City. The outcome for the base case OP measure increases mean willingness to pay over the expected damage value by about 3%, a value which is increased with greater risk aversion, reduced by increased wealth, and only slightly altered by higher limits of integration. The base measure based on cumulative prospect theory is about 46% less than expected damages with estimates declining when alternative parameters are used. The method of aggregation is shown to be important in the cumulative prospect case which can lead to an estimate up to 41% larger than expected damages. Expected damages remain a plausible and the most easily computed measure for analysts.

  4. Specific trauma subtypes improve the predictive validity of the Harvard Trauma Questionnaire in Iraqi refugees.

    PubMed

    Arnetz, Bengt B; Broadbridge, Carissa L; Jamil, Hikmet; Lumley, Mark A; Pole, Nnamdi; Barkho, Evone; Fakhouri, Monty; Talia, Yousif Rofa; Arnetz, Judith E

    2014-12-01

    Trauma exposure contributes to poor mental health among refugees, and exposure often is measured using a cumulative index of items from the Harvard Trauma Questionnaire (HTQ). Few studies, however, have asked whether trauma subtypes derived from the HTQ could be superior to this cumulative index in predicting mental health outcomes. A community sample of recently arrived Iraqi refugees (N = 298) completed the HTQ and measures of posttraumatic stress disorder (PTSD) and depression symptoms. Principal components analysis of HTQ items revealed a 5-component subtype model of trauma that accounted for more item variance than a 1-component solution. These trauma subtypes also accounted for more variance in PTSD and depression symptoms (12 and 10%, respectively) than did the cumulative trauma index (7 and 3%, respectively). Trauma subtypes provided more information than cumulative trauma in the prediction of negative mental health outcomes. Therefore, use of these subtypes may enhance the utility of the HTQ when assessing at-risk populations.

  5. Axial and Torsional Load-Type Sequencing in Cumulative Fatigue: Low Amplitude Followed by High Amplitude Loading

    NASA Technical Reports Server (NTRS)

    Bonacuse, Peter J.; Kalluri, Sreeramesh

    2001-01-01

    The experiments described herein were performed to determine whether damage imposed by axial loading interacts with damage imposed by torsional loading. This paper is a follow on to a study that investigated effects of load-type sequencing on the cumulative fatigue behavior of a cobalt base superalloy, Haynes 188 at 538 C Both the current and the previous study were used to test the applicability of cumulative fatigue damage models to conditions where damage is imposed by different loading modes. In the previous study, axial and torsional two load level cumulative fatigue experiments were conducted, in varied combinations, with the low-cycle fatigue (high amplitude loading) applied first. In present study, the high-cycle fatigue (low amplitude loading) is applied initially. As in the previous study, four sequences (axial/axial, torsion/torsion, axial/torsion, and torsion/axial) of two load level cumulative fatigue experiments were performed. The amount of fatigue damage contributed by each of the imposed loads was estimated by both the Palmgren-Miner linear damage rule (LDR) and the non-linear damage curve approach (DCA). Life predictions for the various cumulative loading combinations are compared with experimental results.

  6. Latino Mothers' Cumulative Food Insecurity Exposure and Child Body Composition.

    PubMed

    Hernandez, Daphne C

    2016-01-01

    To document whether an intergenerational transmission of food insecurity is occurring by assessing low-income foreign-born Latino mothers' experiences with food insecurity as none, once (either childhood or adulthood) or twice (during both childhood and adulthood). Also the association between maternal cumulative food insecurity and children's body composition was examined. Maternal self-reported surveys on retrospective measures of food insecurity during childhood, current measures of food insecurity, and demographics were collected from Houston-area community centers (N = 96). Children's body mass index (BMI) and waist circumference (WC) were directly assessed. Covariate-adjusted logistic regression models analyzed the association between cumulative food insecurity experiences and children's body composition. Fifty-eight percent of mothers experienced food insecurity both as a child and as an adult and 31% of the mothers experienced food insecurity either as a child or adult. Maternal cumulative exposure to food insecurity was unrelated to BMI but was negatively related to elevated WC. Although an intergenerational transmission of food insecurity does exist, maternal cumulative exposure to food insecurity does not impact children's body composition negatively in the short term. Studying the long-term effects of cumulative food insecurity exposure can provide information for the development and timing of obesity interventions.

  7. Numerical modeling of nanodrug distribution in tumors with heterogeneous vasculature.

    PubMed

    Chou, Cheng-Ying; Chang, Wan-I; Horng, Tzyy-Leng; Lin, Win-Li

    2017-01-01

    The distribution and accumulation of nanoparticle dosage in a tumor are important in evaluating the effectiveness of cancer treatment. The cell survival rate can quantify the therapeutic effect, and the survival rates after multiple treatments are helpful to evaluate the efficacy of a chemotherapy plan. We developed a mathematical tumor model based on the governing equations describing the fluid flow and particle transport to investigate the drug transportation in a tumor and computed the resulting cumulative concentrations. The cell survival rate was calculated based on the cumulative concentration. The model was applied to a subcutaneous tumor with heterogeneous vascular distributions. Various sized dextrans and doxorubicin were respectively chosen as the nanodrug carrier and the traditional chemotherapeutic agent for comparison. The results showed that: 1) the largest nanoparticle drug in the current simulations yielded the highest cumulative concentration in the well vascular region, but second lowest in the surrounding normal tissues, which implies it has the best therapeutic effect to tumor and at the same time little harmful to normal tissue; 2) on the contrary, molecular chemotherapeutic agent produced the second lowest cumulative concentration in the well vascular tumor region, but highest in the surrounding normal tissue; 3) all drugs have very small cumulative concentrations in the tumor necrotic region, where drug transport is solely through diffusion. This might mean that it is hard to kill tumor stem cells hiding in it. The current model indicated that the effectiveness of the anti-tumor drug delivery was determined by the interplay of the vascular density and nanoparticle size, which governs the drug transport properties. The use of nanoparticles as anti-tumor drug carriers is generally a better choice than molecular chemotherapeutic agent because of its high treatment efficiency on tumor cells and less damage to normal tissues.

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

    Johnson, Gary E.; Borde, Amy B.; Dawley, Earl

    This report is the third annual report of a six-year project to evaluate the cumulative effects of habitat restoration action in the Columbia River Estuary (CRE). The project is being conducted for the U.S. Army Corps of Engineers (Corps) by the Marine Sciences Laboratory of the Pacific Northwest National Laboratory, the Pt. Adams Biological Field Station of the National Marine Fisheries Service, and the Columbia River Estuary Study Taskforce. Measurement of the cumulative effects of ecological restoration projects in the Columbia River estuary is a formidable task because of the size and complexity of the estuarine landscape and the meta-populationsmore » of salmonids in the Columbia River basin. Despite the challenges presented by this system, developing and implementing appropriate indicators and methods to measure cumulative effects is the best way to enable estuary managers to track the overall effectiveness of investments in estuarine restoration projects. This project is developing methods to quantify the cumulative effects of multiple restoration activities in the CRE. The overall objectives of the 2006 study were to continue to develop techniques to assess cumulative effects, refine the standard monitoring protocols, and initiate development of an adaptive management system for Corps of Engineers’ habitat restoration monitoring efforts in the CRE. (The adaptive management effort will be reported at a later date.) Field studies during 2006 were conducted in tidal freshwater at Kandoll Farm on the lower Grays River and tidal brackish water at Vera Slough on Youngs Bay. Within each of area, we sampled one natural reference site and one restoration site. We addressed the overall objectives with field work in 2006 that, coupled with previous field data, had specific objectives and resulted in some important findings that are summarized here by chapter in this report. Each chapter of the report contains data on particular monitored variables for pre- and post-restoration conditions at both the Kandoll and Vera study areas.« less

  9. Significant variation from a 1/R-squared potential in the cumulative flux determined from the Giotto Comet Halley Dust Impact Experiment

    NASA Technical Reports Server (NTRS)

    Alexander, W. M.; Goad, S.; Mcdonald, R. A.; Tanner, W. G., Jr.; Pollock, J. J.

    1989-01-01

    The Dust Impact Detection System (DIDSY) aboard the Giotto spacecraft provided the information on the dust flux, mass spectrum, and cumulative mass distribution flux in the coma of Comet Halley. Analysis of discrete pulse height data of cometary particles for the mass range of particles between 4.0 x 10 to the -10th g and 6.0 x 10 to the -6th g registered by the Giotto DIDSY detectors 2, 3, and 4 has been completed, and a cumulative flux has been determined for this size range of particles. Inside the cometopause, anomalous peaks have been identified as deviation from a 1/R-squared curve in both pre- and postencounter measurements.

  10. Analysis of dynamic accumulative damage about the lining structure of high speed railway’s tunnel based on ultrasonic testing technology

    NASA Astrophysics Data System (ADS)

    Wang, Xiang-qiu; Zhang, Huojun; Xie, Wen-xi

    2017-08-01

    Based on the similar material model test of full tunnel, the theory of elastic wave propagation and the testing technology of intelligent ultrasonic wave had been used to research the dynamic accumulative damage characteristics of tunnel’s lining structure under the dynamic loads of high speed train. For the more, the dynamic damage variable of lining structure of high speed railway’s tunnel was obtained. The results shown that the dynamic cumulative damage of lining structure increases nonlinearly with the times of cumulative vibration, the weakest part of dynamic cumulative damage is the arch foot of tunnel. Much more attention should be paid to the design and operation management of high speed railway’s tunnel.

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

    PubMed Central

    Yuan, Juxiang; Han, Bing; Cui, Kai; Ding, Yu; Fan, Xueyun; Cao, Hong; Yao, Sanqiao; Suo, Xia; Sun, Zhiqian; Yun, Xiang; Hua, Zhengbing; Chen, Jie

    2015-01-01

    We aimed to estimate the economic losses currently caused by coal workers’ pneumoconiosis (CWP) and, on the basis of these measurements, confirm the economic benefit of preventive measures. Our cohort study included 1,847 patients with CWP and 43,742 coal workers without CWP who were registered in the employment records of the Datong Coal Mine Group. We calculated the cumulative incidence rate of pneumoconiosis using the life-table method. We used the dose-response relationship between cumulative incidence density and cumulative dust exposure to predict the future trend in the incidence of CWP. We calculate the economic loss caused by CWP and economic effectiveness of CWP prevention by a step-wise model. The cumulative incidence rates of CWP in the tunneling, mining, combining, and helping cohorts were 58.7%, 28.1%, 21.7%, and 4.0%, respectively. The cumulative incidence rates increased gradually with increasing cumulative dust exposure (CDE). We predicted 4,300 new CWP cases, assuming the dust concentrations remained at the levels of 2011. If advanced dustproof equipment was adopted, 537 fewer people would be diagnosed with CWP. In all, losses of 1.207 billion Renminbi (RMB, official currency of China) would be prevented and 4,698.8 healthy life years would be gained. Investments in advanced dustproof equipment would be total 843 million RMB, according to our study; the ratio of investment to restored economic losses was 1:1.43. Controlling workplace dust concentrations is critical to reduce the onset of pneumoconiosis and to achieve economic benefits. PMID:26098706

  12. Study of cumulative fatigue damage detection for used parts with nonlinear output frequency response functions based on NARMAX modelling

    NASA Astrophysics Data System (ADS)

    Huang, Honglan; Mao, Hanying; Mao, Hanling; Zheng, Weixue; Huang, Zhenfeng; Li, Xinxin; Wang, Xianghong

    2017-12-01

    Cumulative fatigue damage detection for used parts plays a key role in the process of remanufacturing engineering and is related to the service safety of the remanufactured parts. In light of the nonlinear properties of used parts caused by cumulative fatigue damage, the based nonlinear output frequency response functions detection approach offers a breakthrough to solve this key problem. First, a modified PSO-adaptive lasso algorithm is introduced to improve the accuracy of the NARMAX model under impulse hammer excitation, and then, an effective new algorithm is derived to estimate the nonlinear output frequency response functions under rectangular pulse excitation, and a based nonlinear output frequency response functions index is introduced to detect the cumulative fatigue damage in used parts. Then, a novel damage detection approach that integrates the NARMAX model and the rectangular pulse is proposed for nonlinear output frequency response functions identification and cumulative fatigue damage detection of used parts. Finally, experimental studies of fatigued plate specimens and used connecting rod parts are conducted to verify the validity of the novel approach. The obtained results reveal that the new approach can detect cumulative fatigue damages of used parts effectively and efficiently and that the various values of the based nonlinear output frequency response functions index can be used to detect the different fatigue damages or working time. Since the proposed new approach can extract nonlinear properties of systems by only a single excitation of the inspected system, it shows great promise for use in remanufacturing engineering applications.

  13. Comparison of the immediate, residual, and cumulative antibacterial effects of Novaderm R,* Novascrub R,* Betadine Surgical Scrub, Hibiclens, and liquid soap.

    PubMed

    Faoagali, J; Fong, J; George, N; Mahoney, P; O'Rourke, V

    1995-12-01

    Triclosan (Irgasan), an antibacterial active against staphylococci and coliform bacteria, has been formulated for use as a handwash. There has been only one previous report of the use of the glove juice test to determine the immediate, residual, and cumulative effects of a 1% triclosan-based handwash product. There have been no previous studies on the use of 1% triclosan combined with povidone-iodine (PI) in a handwash product. The glove juice technique was used to document and compare the immediate, 3-hour residual, and 5-day cumulative effects on the mean log10 bacterial counts of 1% triclosan-based handwash product and 1% triclosan with 5% PI. A standardized surgical handwashing technique was used before sample collection. These results and the identity and type of the aerobic bacteria cultured from the samples were compared with the results of standardized washing and glove juice sampling with 4% weight/volume chlorhexidine gluconate (CHG), 7.5% PI, and a nonantimicrobial liquid soap. All five tested products showed significant log10 reduction from baseline on day 1, hour 0 (p < 0.05). There was no significant difference between the mean log10 bacterial count when 7.5% PI, 4% CHG, and 1% triclosan with 5% PI were compared with each other immediately after washing (p > 0.05). There was a significant difference between 1% triclosan and the liquid soap when they were each compared with 4% CHG, 7.5% PI, and 1% triclosan with 5% PI. There was no statistically significant difference between the 1% triclosan product and the liquid soap (p > 0.20). All products were effective at reducing the immediate bacterial count from the baseline level. All formulations except the liquid soap showed significant cumulative effect (p < 0.05) after multiple washes, with no significant difference between the cumulative effects of the liquid soap and 1% triclosan (p > 0.05). Both products differed significantly (p < 0.05) from the CHG, PI, and triclosan with PI. CHG, PI, and triclosan with PI showed effects significantly different from each other (p < 0.05). Triclosan combined with PI resulted in the prevention of bacterial regrowth at 3 hours such as occurred when PI alone was used. Triclosan-containing products have a small cumulative effect, although not as great as that produced by CHG. The triclosan-based products did not appear to select for gram-negative bacterial overgrowth, although the study period may have been too short to detect such an effect.

  14. Risk of locoregional recurrence by receptor status in breast cancer patients receiving modern systemic therapy and post-mastectomy radiation.

    PubMed

    Panoff, J E; Hurley, J; Takita, C; Reis, I M; Zhao, W; Sujoy, V; Gomez, C R; Jorda, M; Koniaris, L; Wright, J L

    2011-08-01

    We assessed differences in locoregional outcome based on receptor status combinations in a cohort of stage II-III breast cancer patients treated with modern trimodality therapy. Medical records of 582 consecutively treated patients receiving post-mastectomy radiation (PMRT) between 1/1999 and 12/2009 were reviewed. Rate of local regional recurrence (LRR) was estimated by the method of cumulative incidence allowing for competing risks. The effect of prognostic factors was examined by Gray's test and by Fine and Gray's modeling approach. Median follow-up was 44.7 months. Five-year progression-free survival (PFS) was 73.9% and overall survival (OS) was 84%. The cumulative 5-year incidence of LRR as first site of failure was 6.2% (95% CI 4.2-8.7). Five-year cumulative incidence of LRR was 8.6 versus 4.4% for estrogen receptor (ER) negative versus ER positive (P = 0.017), 8.5 versus 3.4% for progesterone receptor (PR) negative versus PR positive (P = 0.011), and 1.7 versus 7.5% for HER2 positive (86% received trastuzamab) versus HER2 negative (P = 0.032). Five-year cumulative incidence of LRR was 11.8% for the triple negative subtype and 3.9% for other receptor combinations (P < 0.001). Among patients whose disease is ER positive, 5-year LRR rate was 7.8 versus 3.4% for PR negative versus PR positive (P = 0.130). The prognostic value of the triple negative and HER2 negative subtypes was maintained on multivariate analysis. In the era of HER-2 targeted therapy, tumors that are HER-2 over expressing and are treated with trastuzumab have a very low rate of LRR. ER negative, PR negative, and triple negative status are associated with increased risk of LRR.

  15. Cumulative poor psychosocial and behavioral health among low-income women at 6 weeks postpartum.

    PubMed

    Walker, Lorraine O; Sterling, Bobbie Sue; Guy, Sarah; Mahometa, Michael J

    2013-01-01

    During the postpartum period, women may experience unfavorable psychosocial and behavioral health in multiple domains with adverse effects on parenting and maternal and infant health. Yet, little is known about the accumulation of poor health across the domains of depressive symptoms; body image; diet and physical activity; substance use including smoking and alcohol; and general self-care at 6 weeks postpartum, the usual end of maternity care. The aims of this study were to evaluate relationships among the domains comprising psychosocial and behavioral health and to examine the distribution and risk factors associated with cumulative poor psychosocial and behavioral health at 6 weeks postpartum. This study was a secondary analysis of cumulative poor health assessed by self-report scales for depressive symptoms, body image dissatisfaction, diet and exercise, substance use, and general self-care among 419 low-income White, African American, and Hispanic women at 6 weeks postpartum. Multivariable Poisson and logistic regression were used in key analyses. The correlation among psychosocial and behavioral domains had a range of r = .50-.00. In this sample of women, 45% had two or more domains in which they had poor health. The model testing risk factors for cumulative poor health was significant (likelihood ratio chi-square = 39.26, df = 11, p < 0.05), with two significant factors: not exclusively breastfeeding (odds ratio [OR] = 1.459, 95% confidence interval [CI] [1.119, 1.901]) and Hispanic ethnicity (OR = 0.707, 95% CI [0.582, 0.858], psuedo-R = .029). Within individual domains, significant risk factors (body mass index, not exclusively breastfeeding, ethnicity, education level, and parity) varied by domain. Many low-income women postpartum have poor psychosocial and behavioral health in multiple domains, which constitute areas for health promotion and early disease prevention.

  16. Cumulative incidence of suicidal ideation and associated factors among adults living in temporary housing during the three years after the Great East Japan Earthquake.

    PubMed

    Xu, Qingyi; Fukasawa, Maiko; Kawakami, Norito; Baba, Toshiaki; Sakata, Kiyomi; Suzuki, Ruriko; Tomita, Hiroaki; Nemoto, Harumi; Yasumura, Seiji; Yabe, Hirooki; Horikoshi, Naoko; Umeda, Maki; Suzuki, Yuriko; Shimoda, Haruki; Tachimori, Hisateru; Takeshima, Tadashi; Bromet, Evelyn J

    2018-05-01

    The effect of disasters on suicidality is not known. We aimed to retrospectively determine the cumulative incidence of suicidal ideation during the 3 years after the Great East Japan Earthquake among residents in temporary housing without prior suicidal ideation, as compared to the general population. Moreover, we aimed to identify the risk factors for the onset of suicidal ideation. A cross-sectional survey involving face-to-face interviews was conducted 3 years after the earthquake with adult community residents in disaster-affected areas and a control area using the World Health Organization Composite International Diagnostic Interview version 3.0. We compared the cumulative incidence of suicidal ideation between the two areas using the Cox proportional hazard model and examined risk factors for the onset of suicidal ideation using a multiple logistic regression analysis. Among 1019 respondents in the disaster-affected areas, the cumulative incidence of suicidal ideation over 1, 2, and 3 years after the earthquake was 1.4%, 2.4%, and 2.8%, respectively, which was significantly higher than that in the control area. Not being married, being injured in the disaster, and poor subjective physical health were associated with the onset of suicidal ideation. We estimated the time of onset of suicidal ideation based on the respondents' current age and self-reported onset age, which limits the accuracy of the onset timing. We revealed a higher incidence of suicidal ideation in temporary housing residents and identified several risk factors, which suggests the importance of developing countermeasures to prevent suicide after a disaster. Copyright © 2018 Elsevier B.V. All rights reserved.

  17. The Response of African Land Surface Phenology to Large Scale Climate Oscillations

    NASA Technical Reports Server (NTRS)

    Brown, Molly E.; de Beurs, Kirsten; Vrieling, Anton

    2010-01-01

    Variations in agricultural production due to rainfall and temperature fluctuations are a primary cause of food insecurity on the African continent. Analysis of changes in phenology can provide quantitative information on the effect of climate variability on growing seasons in agricultural regions. Using a robust statistical methodology, we describe the relationship between phenology metrics derived from the 26 year AVHRR NDVI record and the North Atlantic Oscillation index (NAO), the Indian Ocean Dipole (IOD), the Pacific Decadal Oscillation (PDO), and the Multivariate ENSO Index (MEI). We map the most significant positive and negative correlation for the four climate indices in Eastern, Western and Southern Africa between two phenological metrics and the climate indices. Our objective is to provide evidence of whether climate variability captured in the four indices has had a significant impact on the vegetative productivity of Africa during the past quarter century. We found that the start of season and cumulative NDVI were significantly affected by large scale variations in climate. The particular climate index and the timing showing highest correlation depended heavily on the region examined. In Western Africa the cumulative NDVI correlates with PDO in September-November. In Eastern Africa the start of the June-October season strongly correlates with PDO in March-May, while the PDO in December-February correlates with the start of the February-June season. The cumulative NDVI over this last season relates to the MEI of March-May. For Southern Africa, high correlations exist between SOS and NAO of September-November, and cumulative NDVI and MEI of March-May. The research shows that climate indices can be used to anticipate late start and variable vigor in the growing season of sensitive agricultural regions in Africa.

  18. Effect of finite particle number sampling on baryon number fluctuations

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

    Steinheimer, Jan; Koch, Volker

    The effects of finite particle number sampling on the net baryon number cumulants, extracted from fluid dynamical simulations, are studied. The commonly used finite particle number sampling procedure introduces an additional Poissonian (or multinomial if global baryon number conservation is enforced) contribution which increases the extracted moments of the baryon number distribution. If this procedure is applied to a fluctuating fluid dynamics framework, one severely overestimates the actual cumulants. We show that the sampling of so-called test particles suppresses the additional contribution to the moments by at least one power of the number of test particles. We demonstrate this methodmore » in a numerical fluid dynamics simulation that includes the effects of spinodal decomposition due to a first-order phase transition. Furthermore, in the limit where antibaryons can be ignored, we derive analytic formulas which capture exactly the effect of particle sampling on the baryon number cumulants. These formulas may be used to test the various numerical particle sampling algorithms.« less

  19. Effect of finite particle number sampling on baryon number fluctuations

    DOE PAGES

    Steinheimer, Jan; Koch, Volker

    2017-09-28

    The effects of finite particle number sampling on the net baryon number cumulants, extracted from fluid dynamical simulations, are studied. The commonly used finite particle number sampling procedure introduces an additional Poissonian (or multinomial if global baryon number conservation is enforced) contribution which increases the extracted moments of the baryon number distribution. If this procedure is applied to a fluctuating fluid dynamics framework, one severely overestimates the actual cumulants. We show that the sampling of so-called test particles suppresses the additional contribution to the moments by at least one power of the number of test particles. We demonstrate this methodmore » in a numerical fluid dynamics simulation that includes the effects of spinodal decomposition due to a first-order phase transition. Furthermore, in the limit where antibaryons can be ignored, we derive analytic formulas which capture exactly the effect of particle sampling on the baryon number cumulants. These formulas may be used to test the various numerical particle sampling algorithms.« less

  20. Estimating cumulative effects of clearcutting on stream temperatures

    USGS Publications Warehouse

    Bartholow, J.M.

    2000-01-01

    The Stream Segment Temperature Model was used to estimate cumulative effects of large-scale timber harvest on stream temperature. Literature values were used to create parameters for the model for two hypothetical situations, one forested and the other extensively clearcut. Results compared favorably with field studies of extensive forest canopy removal. The model provided insight into the cumulative effects of clearcutting. Change in stream shading was, as expected, the most influential factor governing increases in maximum daily water temperature, accounting for 40% of the total increase. Altered stream width was found to be more influential than changes to air temperature. Although the net effect from clearcutting was a 4oC warming, increased wind and reduced humidity tended to cool the stream. Temperature increases due to clearcutting persisted 10 km downstream into an unimpacted forest segment of the hypothetical stream, but those increases were moderated by cooler equilibrium conditions downstream. The model revealed that it is a complex set of factors, not single factors such as shade or air temperature, that governs stream temperature dynamics.

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