Earlier Vegetation Activity Onset Enhances Springtime Water-use Efficiency in Temperate and Boreal Ecosystems

NASA Astrophysics Data System (ADS)

Jin, J.; Wang, Y.

2017-12-01

Ecosystem-scale water-use efficiency (EWUE), defined as the ratio of gross primary productivity (GPP) to evapotranspiration (ET), is an important indicator for understanding how water couples with the carbon cycle under global change. Relationships between EWUE and abiotic environmental factors (e.g. climatic factors, atmospheric CO2concentration and nitrogen deposition) have been widely investigated, but the variations in EWUE in response to biotic controls remain little understood. Here, we argue that phenology plays an important role in the regulation of EWUE by analyzing springtime EWUE responses to variability of the GPP-based vegetation activity onset (VAO) in temperate and boreal ecosystems using both satellite and flux-tower observations. Based on MODIS productions during 2000-2014, we found that spring EWUE widely significantly increased with the earlier VAO mainly in the mid- and high latitudes (over 50°N), southwestern China and mid-western North America. When AVO advanced a 10-day, the spring EWUE would increase on average by 0.17±0.09 g C kg-1 H2O in temperate and continental climates after removing the effect of environmental factors. The main response patterns of EWUE to phenology suggest that an increase in spring EWUE with an earlier VAO are mainly because the increase in GPP is relatively larger in magnitude compared to that of ET, or due to an increase in GPP accompanied by a decrease in ET, resulting from an advanced VAO. The credibility of the results is also supported by the local-scale observations. By analyzing 66 site-years of flux and meteorological data obtained from 8 temperate deciduous broadleaf forest sites across North America and Europe, spring EWUE increased 0.42±0.08 g C kg-1 H2O with a 10-day advance of VAO across all sites after controlling for environmental factors, mainly because an earlier VAO could lead to a steeper increase in GPP than in ET. Our results and conclusions highlight that phenological factors cannot be

[Process indicators and result indicators in the control of arterial hypertension].

PubMed

Dalfó Baqué, A; Sisó Almirall, A; Vila Coll, M A; Núñez Vázquez, S; Botinas Martí, M; Gibert Llorach, E

2000-12-01

To find whether better compliance with the indicators of procedure of a hypertension monitoring programme guarantees better control in the final blood pressure figures. Descriptive cross-sectional study. Gòtic Area Health Centre, Barcelona. Annual audit through random sampling of the computerised records of all the hypertense patients attended at the centre in each of 5 years (1992, n = 337; 1993, n = 318; 1994, n = 322; 1995, n = 325; 1996, n = 325). 1. Procedure indicators: complete physical examination took place in 1996 in only 12% of cases, proportion similar to at the start of the development of the programme (12.2%). Completion of at least two of the three records of protocols (complete physical examination, ECG and analysis) dropped during the period and did not cover half the patients. Screening of the various cardiovascular risk factors (CRF) increased markedly in the 1992-1995 period. 2. RESULTS INDICATORS: The proportion of patients under 66 with SP and DP < 140 and 99 mmHg went up from 23.2% in 1992 to 45.2% in 1996. In the over-65 age-group, it went from 58.9% in 1992 to 81.2% in 1996. The procedure indicators are still useful, in that they are necessary for designing a new hypertension programme. However, we must not forget that any health programme is designed in order to achieve good control and population impact (survival) results. The procedure is only an aid to reach these aims.

Adverse childhood experiences predict earlier age of drinking onset: results from a representative US sample of current or former drinkers.

PubMed

Rothman, Emily F; Edwards, Erika M; Heeren, Timothy; Hingson, Ralph W

2008-08-01

Our goal was to determine whether adverse childhood experiences predicted the age at which drinking was initiated and drinking motives in a representative sample of current or former drinkers in the United States. In 2006, a probability sample of 3592 US current or former drinkers aged 18 to 39 were surveyed. Multinomial logistic regression examined whether each of 10 adverse childhood experiences was associated with earlier ages of drinking onset, controlling for demographics, parental alcohol use, parental attitudes toward drinking, and peers' drinking in adolescence. We also examined whether there was a graded relationship between the number of adverse childhood experiences and age of drinking onset and whether adverse childhood experiences were related to self-reported motives for drinking during the first year that respondents drank. Sixty-six percent of respondents reported >or=1 adverse childhood experiences, and 19% reported experiencing >or=4. The most commonly reported adverse childhood experiences were parental separation/divorce (41.3%), living with a household member who was a problem drinker (28.7%), mental illness of a household member (24.8%), and sexual abuse (19.1%). Of the 10 specific adverse childhood experiences assessed, 5 were significantly associated with initiating drinking at or=21 years of age) after adjustment for confounders, including physical abuse, sexual abuse, having a mentally ill household member, substance abuse in the home, and parental discord or divorce. Compared with those without adverse childhood experiences, respondents with adverse childhood experiences were substantially more likely to report that they drank to cope during the first year that they used alcohol. Results suggest that children with particular adverse childhood experiences may initiate drinking earlier than their peers and that they may be more likely to drink to cope with problems (rather than for pleasure or to be

A Guide to Selecting Results and Indicators: Implementing Results-Based Budgeting.

ERIC Educational Resources Information Center

Melaville, Atelia I.

Many efforts to implement a results-based framework for public programs have been marred by confusion about terms and basic definitions, and difficulty in identifying appropriate results and performance measures. This guide is intended to help planners identifying program results and indicators and tie them to an established planning, budgeting,…

Perceptual sensitivity to spectral properties of earlier sounds during speech categorization.

PubMed

Stilp, Christian E; Assgari, Ashley A

2018-02-28

Speech perception is heavily influenced by surrounding sounds. When spectral properties differ between earlier (context) and later (target) sounds, this can produce spectral contrast effects (SCEs) that bias perception of later sounds. For example, when context sounds have more energy in low-F 1 frequency regions, listeners report more high-F 1 responses to a target vowel, and vice versa. SCEs have been reported using various approaches for a wide range of stimuli, but most often, large spectral peaks were added to the context to bias speech categorization. This obscures the lower limit of perceptual sensitivity to spectral properties of earlier sounds, i.e., when SCEs begin to bias speech categorization. Listeners categorized vowels (/ɪ/-/ɛ/, Experiment 1) or consonants (/d/-/g/, Experiment 2) following a context sentence with little spectral amplification (+1 to +4 dB) in frequency regions known to produce SCEs. In both experiments, +3 and +4 dB amplification in key frequency regions of the context produced SCEs, but lesser amplification was insufficient to bias performance. This establishes a lower limit of perceptual sensitivity where spectral differences across sounds can bias subsequent speech categorization. These results are consistent with proposed adaptation-based mechanisms that potentially underlie SCEs in auditory perception. Recent sounds can change what speech sounds we hear later. This can occur when the average frequency composition of earlier sounds differs from that of later sounds, biasing how they are perceived. These "spectral contrast effects" are widely observed when sounds' frequency compositions differ substantially. We reveal the lower limit of these effects, as +3 dB amplification of key frequency regions in earlier sounds was enough to bias categorization of the following vowel or consonant sound. Speech categorization being biased by very small spectral differences across sounds suggests that spectral contrast effects occur

Laparoscopic intersphincteric resection: indications and results.

PubMed

Scala, Dario; Niglio, Antonello; Pace, Ugo; Ruffolo, Fulvio; Rega, Daniela; Delrio, Paolo

2016-03-01

Surgical treatment of distal rectal cancer has long been based only on abdominoperineal excision, resulting in a permanent stoma and not always offering a definitive local control. Sphincter saving surgery has emerged in the last 20 years and can be offered also to patients with low lying tumours, provided that the external sphincter is not involved by the disease. An intersphincteric resection (ISR) is based on the resection of the rectum with a distal dissection proceeding into the space between the internal and the external anal sphincter. Originally described as an open procedure, it has also been developed with the laparoscopic approach, and also this technically demanding procedure is inscribed among those offered to the patient by a minimally invasive surgery. Indications have to be strict and patient selection is crucial to obtain both oncological and functional optimal results. The level of distal dissection and the extent of internal sphincter resected are chosen according to the distal margin of the tumour and is based on MRI findings: accurate imaging is therefore mandatory to better define the surgical approach. We here present our actual indications for ISR, results in terms of operative time, median hospital stay for ISR in our experience and review the updated literature.

Arctic Indicators of Change

NASA Astrophysics Data System (ADS)

Stanitski, D.; Druckenmiller, M.; Fetterer, F. M.; Gerst, M.; Intrieri, J. M.; Kenney, M. A.; Meier, W.; Overland, J. E.; Stroeve, J. C.; Trainor, S.

2016-12-01

The Arctic is undergoing unprecedented change. Indicators of change enable better decision-making at the community to policy levels. The results presented here focus on a subset of physical, biological, societal, and economic indicators of Arctic change recommended in one of a group of papers emanating from the earlier National Climate Indicators System (NCIS) work led by Kenney et al. (2016). The intent of the NCIS was to establish a "system of physical, natural, and societal indicators that communicate and inform decisions about key aspects of the physical climate, climate impacts, vulnerabilities, and preparedness" in support of the sustained U.S. National Climate Assessment. Our analysis, guided by a tailored selection and recommendation criteria, resulted in a list of "existing" indicators, as well as those "in development", "recommended", and "aspirational". A goal of this effort is to identify a set of both lagging and leading indicators that is based on reliable and sustained data sources with known user communities. We intend for these indicators to guide decision-makers in their responses to climate change, and ideally help inform decisions of groups like the Arctic Council and U.S. Global Change Research Program (USGCRP) as they develop plans and priorities.

Traumatic Brain Injury History is Associated with Earlier Age of Onset of Alzheimer Disease

PubMed Central

LoBue, Christian; Wadsworth, Hannah; Wilmoth, Kristin; Clem, Matthew; Hart, John; Womack, Kyle B.; Didehbani, Nyaz; Lacritz, Laura H.; Rossetti, Heidi C.; Cullum, C. Munro

2016-01-01

Objective This study examined whether a history of traumatic brain injury (TBI) is associated with earlier onset of Alzheimer disease (AD), independent of apolipoprotein ε4 status (Apoe4) and gender. Method Participants with a clinical diagnosis of AD (n=7625) were obtained from the National Alzheimer’s Coordinating Center Uniform Data Set, and categorized based on self-reported lifetime TBI with loss of consciousness (LOC) (TBI+ vs TBI-) and presence of Apoe4. ANCOVAs, controlling for gender, race, and education were used to examine the association between history of TBI, presence of Apoe4, and an interaction of both risk factors on estimated age of AD onset. Results Estimated AD onset differed by TBI history and Apoe4 independently (p’s <.001). The TBI+ group had a mean age of onset 2.5 years earlier than the TBI- group. Likewise, Apoe4 carriers had a mean age of onset 2.3 years earlier than non-carriers. While the interaction was non-significant (p = .34), participants having both a history of TBI and Apoe4 had the earliest mean age of onset compared to those with a TBI history or Apoe4 alone (MDifference = 2.8 & 2.7 years, respectively). These results remained unchanged when stratified by gender. Conclusions History of self-reported TBI can be associated with an earlier onset of AD-related cognitive decline, regardless of Apoe4 status and gender. TBI may be related to an underlying neurodegenerative process in AD, but the implications of age at time of injury, severity, and repetitive injuries remain unclear. PMID:27855547

[Pancreaticojejunal anastomosis. Indication, technique and results].

PubMed

Gebhardt, C

2001-01-01

Pancreaticojejunal anastomosis. Indication, technique and results. Pancreaticojejunal anastomoses are performed for the treatment of chronic pancreatitis and after resection of pancreatic carcinomas. In chronic pancreatitis by drainage procedures (Partington-Rochelle and Puestow-Gillesby) one can expect good long term results, if the diameter of the pancreatic duct is at least 1 cm and the length of the anastomosis 6 cm. The duodenumpreserving head resection (Beger or Frey) is a combination of resection and drainage and is significant in the therapy of inflammatory head processes. In the surgical treatment of pancreatic carcinomas pancreaticojejunostomies are applied after head resection (Whipple-, pyloruspreserving modification). The end-to-side mucosa-mucosa anastomosis offers the best results concerning postoperativ complications and mortality rates.

Research promises earlier warning for grapevine canker diseases

USDA-ARS?s Scientific Manuscript database

When it comes to detecting and treating vineyards for grapevine canker diseases (also called trunk diseases), like Botryosphaeria dieback (Bot canker), Esca, Eutypa dieback and Phomopsis dieback, the earlier the better, says plant pathologist Kendra Baumgartner, with the USDA’s Agricultural Research...

Earlier Snowmelt Changes the Ratio Between Early and Late Season Forest Productivity

NASA Astrophysics Data System (ADS)

Knowles, J. F.; Molotch, N. P.; Trujillo, E.; Litvak, M. E.

2017-12-01

Future projections of declining snowpack and increasing potential evaporation associated with climate warming are predicted to advance the timing of snowmelt in mountain ecosystems globally. This scenario has direct implications for snowmelt-driven forest productivity, but the net effect of temporally shifting moisture dynamics is unknown with respect to the annual carbon balance. Accordingly, this study uses both satellite- and tower-based observations to document the forest productivity response to snowpack and potential evaporation variability between 1989 and 2012 throughout the southern Rocky Mountain ecoregion, USA. These results show that a combination of low snow accumulation and record high potential evaporation in 2012 resulted in the 34-year minimum ecosystem productivity that could be indicative of future conditions. Moreover, early and late season productivity were significantly and inversely related, suggesting that future shifts toward earlier or reduced snowmelt could increase late-season moisture stress to vegetation and thus restrict productivity despite a longer growing season. This relationship was further subject to modification by summer precipitation, and the controls on the early/late season productivity ratio are explored within the context of ecosystem carbon storage in the future. Any perturbation to the carbon cycle at this scale represents a potential feedback to climate change since snow-covered forests represent an important global carbon sink.

An earlier de motu cordis.

PubMed Central

Daly, Walter J.

2004-01-01

Thirteenth century medical science, like medieval scholarship in general, was directed at reconciliation of Greek philosophy/science with prevailing medieval theology and philosophy. Peter of Spain [later Pope John XXI] was the leading medical scholar of his time. Peter wrote a long book on the soul. Imbedded in it was a chapter on the motion of the heart. Peter's De Motu was based on his own medical experience and Galen's De Usu Partium and De Usu Respirationis and De Usu Pulsuum. This earlier De Motu defines a point on the continuum of intellectual development leading to us and into the future. Thirteenth century scholarship relied on past authority to a degree that continues to puzzle and beg explanation. Images Fig. 1 PMID:17060956

Cardiac Complications, Earlier Treatment, and Initial Disease Severity in Kawasaki Disease.

PubMed

Abrams, Joseph Y; Belay, Ermias D; Uehara, Ritei; Maddox, Ryan A; Schonberger, Lawrence B; Nakamura, Yosikazu

2017-09-01

To assess if observed higher observed risks of cardiac complications for patients with Kawasaki disease (KD) treated earlier may reflect bias due to confounding from initial disease severity, as opposed to any negative effect of earlier treatment. We used data from Japanese nationwide KD surveys from 1997 to 2004. Receipt of additional intravenous immunoglobulin (IVIG) (data available all years) or any additional treatment (available for 2003-2004) were assessed as proxies for initial disease severity. We determined associations between earlier or later IVIG treatment (defined as receipt of IVIG on days 1-4 vs days 5-10 of illness) and cardiac complications by stratifying by receipt of additional treatment or by using logistic modeling to control for the effect of receiving additional treatment. A total of 48 310 patients with KD were included in the analysis. In unadjusted analysis, earlier IVIG treatment was associated with a higher risk for 4 categories of cardiac complications, including all major cardiac complications (risk ratio, 1.10; 95% CI, 1.06-1.15). Stratifying by receipt of additional treatment removed this association, and earlier IVIG treatment became protective against all major cardiac complications when controlling for any additional treatment in logistic regressions (OR, 0.90; 95% CI, 0.80-1.00). Observed higher risks of cardiac complications among patients with KD receiving IVIG treatment on days 1-4 of the illness are most likely due to underlying higher initial disease severity, and patients with KD should continue to be treated with IVIG as early as possible. Published by Elsevier Inc.

Travelling for earlier surgical treatment: the patient's view.

PubMed Central

Stewart, M; Donaldson, L J

1991-01-01

As part of the northern region's programme within the national waiting list initiative, schemes have been funded to test the feasibility and acceptability of offering patients the opportunity to travel further afield in order to receive earlier treatment. A total of 484 patients experiencing a long wait for routine surgical operations in the northern region were offered the opportunity to receive earlier treatment outside their local health district; 74% of the patients accepted the offer. The initiative was well received by the participating patients and the majority stated that if the need arose on a future occasion they would prefer to travel for treatment rather than have to wait for lengthy periods for treatment at their local hospital. These findings, interpreted in the light of the National Health Service reforms introduced in April 1991, suggest that for some types of care, patients would welcome greater flexibility in the placing of contracts, not merely reinforcement of historical patterns of referral. PMID:1823553

Earlier surgical intervention in congenital heart disease results in better outcome and resource utilization.

PubMed

Panni, Roheena Z; Ashfaq, Awais; Amanullah, Muhammad M

2011-12-29

Congenital heart disease (CHD) accounts for a major proportion of disease in the pediatric age group. The objective of the study was to estimate the cost of illness associated with CHD pre, intra and postoperatively; among patients referred to a tertiary care hospital in Karachi, Pakistan. This is the first study conducted to estimate the cost of managing CHD in Pakistan. A prevalence based cost of illness study design was used to estimate the cost of cardiac surgery (corrective & palliative) for congenital heart defects in children ≤ 5 years of age from June 2006 to June 2009. A total of 120 patients were enrolled after obtaining an informed consent and the data was collected using a pre-tested questionnaire. The mean age at the time of surgery in group A (1-12 mo age) was 6.08 ± 2.80 months and in group B (1-5 yrs) was 37.10 ± 19.94 months. The cost of surgical admission was found to be significantly higher in the older group, p = 0.001. The total number and cost of post-operative outpatient visits was also higher in group B, p = 0.003. Pre and post operative hospital admissions were not found to be significantly different among the two groups, p = 0.166 and 0.627, respectively. The number of complications were found to be different between the two groups (p = 0.019). Majority of these were contributed by hemorrhage and post-operative seizures. This study concluded that significant expenditure is incurred by people with CHD; with the implication that resources could be saved by earlier detection and awareness campaigns.

Prescription stimulant use is associated with earlier onset of psychosis.

PubMed

Moran, Lauren V; Masters, Grace A; Pingali, Samira; Cohen, Bruce M; Liebson, Elizabeth; Rajarethinam, R P; Ongur, Dost

2015-12-01

A childhood history of attention deficit hyperactivity disorder (ADHD) is common in psychotic disorders, yet prescription stimulants may interact adversely with the physiology of these disorders. Specifically, exposure to stimulants leads to long-term increases in dopamine release. We therefore hypothesized that individuals with psychotic disorders previously exposed to prescription stimulants will have an earlier onset of psychosis. Age of onset of psychosis (AOP) was compared in individuals with and without prior exposure to prescription stimulants while controlling for potential confounding factors. In a sample of 205 patients recruited from an inpatient psychiatric unit, 40% (n = 82) reported use of stimulants prior to the onset of psychosis. Most participants were prescribed stimulants during childhood or adolescence for a diagnosis of ADHD. AOP was significantly earlier in those exposed to stimulants (20.5 vs. 24.6 years stimulants vs. no stimulants, p < 0.001). After controlling for gender, IQ, educational attainment, lifetime history of a cannabis use disorder or other drugs of abuse, and family history of a first-degree relative with psychosis, the association between stimulant exposure and earlier AOP remained significant. There was a significant gender × stimulant interaction with a greater reduction in AOP for females, whereas the smaller effect of stimulant use on AOP in males did not reach statistical significance. In conclusion, individuals with psychotic disorders exposed to prescription stimulants had an earlier onset of psychosis, and this relationship did not appear to be mediated by IQ or cannabis. Copyright © 2015 Elsevier Ltd. All rights reserved.

Discharging patients earlier in the day: a concept worth evaluating.

PubMed

Kravet, Steven J; Levine, Rachel B; Rubin, Haya R; Wright, Scott M

2007-01-01

Patient discharges from the hospital often occur late in the day and are frequently clustered after 4 PM. When inpatients leave earlier in the day, quality is improved because new admissions awaiting beds are able to leave the emergency department sooner and emergency department waiting room backlog is reduced. Nursing staff, whose work patterns traditionally result in high activity of discharge and admission between 5 PM and 8 PM, benefit by spreading out their work across a longer part of the day. Discharging patients earlier in the day also has the potential to increase patient satisfaction. Despite multiple stakeholders in the discharge planning process, physicians play the most important role. Getting physician buy-in requires an ability to teach physicians about the concept of early-in-the-day discharges and their impact on the process. We defined a new physician-centered discharge planning process and introduced it to an internal medicine team with an identical control team as a comparison. Discharge time of day was analyzed for 1 month. Mean time of day of discharge was 13:39 for the intervention group versus 15:45 for the control group (P<.001). If reproduced successfully, this process could improve quality at an important transition point in patient care.

Do emotional support and classroom organization earlier in the year set the stage for higher quality instruction?

PubMed

Curby, Timothy W; Rimm-Kaufman, Sara E; Abry, Tashia

2013-10-01

Many teachers believe that providing greater emotional and organizational supports in the beginning of the year strengthens their ability to teach effectively as the year progresses. Some interventions, such as the Responsive Classroom (RC) approach, explicitly embed this sequence into professional development efforts. We tested the hypothesis that earlier emotional and organizational supports set the stage for improved instruction later in the year in a sample of third- and fourth-grade teachers enrolled in a randomized controlled trial of the RC approach. Further, we examined the extent to which the model generalized for teachers using varying levels of RC practices as well as whether or not teachers were in the intervention or control groups. Teachers' emotional, organizational, and instructional interactions were observed using the Classroom Assessment Scoring System (Pianta, La Paro, & Hamre, 2008) on five occasions throughout the year. Results indicated a reciprocal relation between emotional and instructional supports. Specifically, higher levels of emotional support earlier in the year predicted higher instructional support later in the year. Also, higher levels of instructional support earlier in the year predicted higher emotional support later in the year. Classroom organization was not found to have longitudinal associations with the other domains across a year. This pattern was robust when controlling for the use of RC practices as well as across intervention and control groups. Further, teachers' use of RC practices predicted higher emotional support and classroom organization throughout the year, suggesting the malleability of this teacher characteristic. Discussion highlights the connection between teachers' emotional and instructional supports and how the use of RC practices improves teachers' emotionally supportive interactions with students. Copyright © 2013 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights

Earlier Detection of Tumor Treatment Response Using Magnetic Resonance Diffusion Imaging with Oscillating Gradients

PubMed Central

Colvin, Daniel C.; Loveless, Mary E.; Does, Mark D.; Yue, Zou; Yankeelov, Thomas E.; Gore, John C.

2011-01-01

An improved method for detecting early changes in tumors in response to treatment, based on a modification of diffusion-weighted magnetic resonance imaging, has been demonstrated in an animal model. Early detection of therapeutic response in tumors is important both clinically and in pre-clinical assessments of novel treatments. Non-invasive imaging methods that can detect and assess tumor response early in the course of treatment, and before frank changes in tumor morphology are evident, are of considerable interest as potential biomarkers of treatment efficacy. Diffusion-weighted magnetic resonance imaging is sensitive to changes in water diffusion rates in tissues that result from structural variations in the local cellular environment, but conventional methods mainly reflect changes in tissue cellularity and do not convey information specific to micro-structural variations at sub-cellular scales. We implemented a modified imaging technique using oscillating gradients of the magnetic field for evaluating water diffusion rates over very short spatial scales that are more specific for detecting changes in intracellular structure that may precede changes in cellularity. Results from a study of orthotopic 9L gliomas in rat brains indicate that this method can detect changes as early as 24 hours following treatment with 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU), when conventional approaches do not find significant effects. These studies suggest that diffusion imaging using oscillating gradients may be used to obtain an earlier indication of treatment efficacy than previous magnetic resonance imaging methods. PMID:21190804

Compulsive Buying: Earlier Illicit Drug Use, Impulse Buying, Depression, and Adult ADHD Symptoms

PubMed Central

Brook, Judith S.; Zhang, Chenshu; Brook, David W.; Leukefeld, Carl G.

2015-01-01

This longitudinal study examined the association between psychosocial antecedents, including illicit drug use, and adult compulsive buying (CB) across a 29-year time period from mean age 14 to mean age 43. Participants originally came from a community-based random sample of residents in two upstate New York counties. Multivariate linear regression analysis was used to study the relationship between the participant’s earlier psychosocial antecedents and adult CB in the fifth decade of life. The results of the multivariate linear regression analyses showed that gender (female), earlier adult impulse buying (IB), depressive mood, illicit drug use, and concurrent ADHD symptoms were all significantly associated with adult CB at mean age 43. It is important that clinicians treating CB in adults should consider the role of drug use, symptoms of ADHD, IB, depression, and family factors in CB. PMID:26165963

Endochondral fracture healing with external fixation in the Sost knockout mouse results in earlier fibrocartilage callus removal and increased bone volume fraction and strength.

PubMed

Morse, A; Yu, N Y C; Peacock, L; Mikulec, K; Kramer, I; Kneissel, M; McDonald, M M; Little, D G

2015-02-01

Sclerostin deficiency, via genetic knockout or anti-Sclerostin antibody treatment, has been shown to cause increased bone volume, density and strength of calluses following endochondral bone healing. However, there is limited data on the effect of Sclerostin deficiency on the formative early stage of fibrocartilage (non-bony tissue) formation and removal. In this study we extensively investigate the early fibrocartilage callus. Closed tibial fractures were performed on Sost(-/-) mice and age-matched wild type (C57Bl/6J) controls and assessed at multiple early time points (7, 10 and 14days), as well as at 28days post-fracture after bony union. External fixation was utilized, avoiding internal pinning and minimizing differences in stability stiffness, a variable that has confounded previous research in this area. Normal endochondral ossification progressed in wild type and Sost(-/-) mice with equivalent volumes of fibrocartilage formed at early day 7 and day 10 time points, and bony union in both genotypes by day 28. There were no significant differences in rate of bony union; however there were significant increases in fibrocartilage removal from the Sost(-/-) fracture calluses at day 14 suggesting earlier progression of endochondral healing. Earlier bone formation was seen in Sost(-/-) calluses over wild type with greater bone volume at day 10 (221%, p<0.01). The resultant Sost(-/-) united bony calluses at day 28 had increased bone volume fraction compared to wild type calluses (24%, p<0.05), and the strength of the fractured Sost(-/-) tibiae was greater than that that of wild type fractured tibiae. In summary, bony union was not altered by Sclerostin deficiency in externally-fixed closed tibial fractures, but fibrocartilage removal was enhanced and the resultant united bony calluses had increased bone fraction and increased strength. Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.

Compulsive buying: Earlier illicit drug use, impulse buying, depression, and adult ADHD symptoms.

PubMed

Brook, Judith S; Zhang, Chenshu; Brook, David W; Leukefeld, Carl G

2015-08-30

This longitudinal study examined the association between psychosocial antecedents, including illicit drug use, and adult compulsive buying (CB) across a 29-year time period from mean age 14 to mean age 43. Participants originally came from a community-based random sample of residents in two upstate New York counties. Multivariate linear regression analysis was used to study the relationship between the participant's earlier psychosocial antecedents and adult CB in the fifth decade of life. The results of the multivariate linear regression analyses showed that gender (female), earlier adult impulse buying (IB), depressive mood, illicit drug use, and concurrent ADHD symptoms were all significantly associated with adult CB at mean age 43. It is important that clinicians treating CB in adults should consider the role of drug use, symptoms of ADHD, IB, depression, and family factors in CB. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Childhood hair product use and earlier age at menarche in a racially diverse study population: a pilot study.

PubMed

James-Todd, Tamarra; Terry, Mary Beth; Rich-Edwards, Janet; Deierlein, Andrea; Senie, Ruby

2011-06-01

Previous studies suggest that hair products containing endocrine disrupting chemicals could alter puberty. We evaluated the association between childhood hair product use and age at menarche in a racially diverse study population. We recruited 300 African-American, African-Caribbean, Hispanic, and white women from the New York City metropolitan area who were between 18-77 years of age. Data were collected retrospectively on hair oil, lotion, leave-in conditioner, perm, and other types of hair products used before age 13. Recalled age at menarche ranged from 8 to 19 years. We used multivariable binomial regression to evaluate the association between hair product use and age at menarche (<12 vs. ≥12), adjusting for potential confounders. African-Americans were more likely to use hair products and reached menarche earlier than other racial/ethnic groups. Women reporting childhood hair oil use had a risk ratio of 1.4 (95% confidence interval [CI]: 1.1-1.9) for earlier menarche, adjusting for race/ethnicity and year of birth. Hair perm users had an increased risk for earlier menarche (adjusted risk ratio = 1.4, 95% CI: 1.1-1.8). Other types of hair products assessed in this study were not associated with earlier menarche. Childhood hair oil and perm use were associated with earlier menarche. If replicated, these results suggest that hair product use may be important to measure in evaluating earlier age at menarche. Copyright © 2011 Elsevier Inc. All rights reserved.

Return of hunger following a relatively high carbohydrate breakfast is associated with earlier recorded glucose peak and nadir

PubMed Central

Chandler-Laney, Paula C.; Morrison, Shannon A.; Goree, Laura Lee T.; Ellis, Amy C.; Casazza, Krista; Desmond, Renee; Gower, Barbara A

2014-01-01

Objective To test the hypothesis that a breakfast meal with high carbohydrate/ low fat results in an earlier increase in postprandial glucose and insulin, a greater decrease below baseline in postprandial glucose, and an earlier return of appetite, compared to a low carbohydrate/high fat meal. Design Overweight but otherwise healthy adults (n=64) were maintained on one of two eucaloric diets: high carbohydrate/low fat (HC/LF; 55:27:18% kcals from carbohydrate: fat: protein) versus low carbohydrate/high fat (LC/HF; 43:39:18% kcals from carbohydrate: fat: protein). After 4 weeks of acclimation to the diets, participants underwent a meal test during which circulating glucose and insulin and self-reported hunger and fullness, were measured before and after consumption of breakfast from their assigned diets. Results The LC/HF meal resulted in a later time at the highest and lowest recorded glucose, higher glucose concentrations at 3 and 4 hours post-meal, and lower insulin incremental area under the curve. Participants consuming the LC/HF meal reported lower appetite 3 and 4 hours following the meal, a response that was associated with the timing of the highest and lowest recorded glucose. Conclusions Modest increases in meal carbohydrate content at the expense of fat content may facilitate weight gain over the long-term by contributing to an earlier rise and fall of postprandial glucose concentrations and an earlier return of appetite. PMID:24819342

Missed opportunities for earlier diagnosis of HIV in patients who presented with advanced HIV disease: a retrospective cohort study

PubMed Central

Levy, Itzchak; Maor, Yasmin; Mahroum, Naim; Olmer, Liraz; Wieder, Anat; Litchevski, Vladislav; Mor, Orna; Rahav, Galia

2016-01-01

Objective To quantify and characterise missed opportunities for earlier HIV diagnosis in patients diagnosed with advanced HIV. Design A retrospective observational cohort study. Setting A central tertiary medical centre in Israel. Measures The proportion of patients with advanced HIV, the proportion of missed opportunities to diagnose them earlier, and the rate of clinical indicator diseases (CIDs) in those patients. Results Between 2010 and 2015, 356 patients were diagnosed with HIV, 118 (33.4%) were diagnosed late, 57 (16%) with advanced HIV disease. Old age (OR=1.45 (95% CI 1.16 to 1.74)) and being heterosexual (OR=2.65 (95% CI 1.21 to 5.78)) were significant risk factors for being diagnosed late. All patients with advanced disease had at least one CID that did not lead to an HIV test in the 5 years prior to AIDS diagnosis. The median time between CID and AIDS diagnosis was 24 months (IQR 10–30). 60% of CIDs were missed by a general practitioner and 40% by a specialist. Conclusions Missed opportunities to early diagnosis of HIV occur in primary and secondary care. Lack of national guidelines, lack of knowledge regarding CIDs and communication barriers with patients may contribute to a late diagnosis of HIV. PMID:28186940

Earlier Parental Set Bedtimes as a Protective Factor Against Depression and Suicidal Ideation

PubMed Central

Gangwisch, James E.; Babiss, Lindsay A.; Malaspina, Dolores; Turner, J. Blake; Zammit, Gary K.; Posner, Kelly

2010-01-01

Study Objectives: To examine the relationships between parental set bedtimes, sleep duration, and depression as a quasi-experiment to explore the potentially bidirectional relationship between short sleep duration and depression. Short sleep duration has been shown to precede depression, but this could be explained as a prodromal symptom of depression. Depression in an adolescent can affect his/her chosen bedtime, but it is less likely to affect a parent's chosen set bedtime which can establish a relatively stable upper limit that can directly affect sleep duration. Design: Multivariate cross-sectional analyses of the ADD Health using logistic regression. Setting: United States nationally representative, school-based, probability-based sample in 1994-96. Participants: Adolescents (n = 15,659) in grades 7 to 12. Measurements and Results: Adolescents with parental set bedtimes of midnight or later were 24% more likely to suffer from depression (OR = 1.24, 95% CI 1.04-1.49) and 20% more likely to have suicidal ideation (1.20, 1.01-1.41) than adolescents with parental set bedtimes of 10:00 PM or earlier, after controlling for covariates. Consistent with sleep duration and perception of getting enough sleep acting as mediators, the inclusion of these variables in the multivariate models appreciably attenuated the associations for depression (1.07, 0.88-1.30) and suicidal ideation (1.09, 0.92-1.29). Conclusions: The results from this study provide new evidence to strengthen the argument that short sleep duration could play a role in the etiology of depression. Earlier parental set bedtimes could therefore be protective against adolescent depression and suicidal ideation by lengthening sleep duration. Citation: Gangwisch JE; Babiss LA; Malaspina D; Turner JB; Zammit GK; Posner K. Earlier parental set bedtimes as a protective factor against depression and suicidal ideation. SLEEP 2010;33(1):97-106. PMID:20120626

New formulae for Zagreb indices

NASA Astrophysics Data System (ADS)

Cangul, Ismail Naci; Yurttas, Aysun; Togan, Muge; Cevik, Ahmet Sinan

2017-07-01

In this paper, we study with some graph descriptors also called topological indices. These descriptors are useful in determination of some properties of chemical structures and preferred to some earlier descriptors as they are more practical. Especially the first and second Zagreb indices together with the first and second multiplicative Zagreb indices are considered and they are calculated in terms of the smallest and largest vertex degrees and vertex number for some well-known classes of graphs.

The associations of earlier trauma exposures and history of mental disorders with PTSD after subsequent traumas

PubMed Central

Kessler, Ronald C.; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Bromet, Evelyn J.; Gureje, Oye; Karam, Elie G.; Koenen, Karestan C.; Lee, Sing; Liu, Howard; Pennell, Beth-Ellen; Petukhova, Maria V.; Sampson, Nancy A.; Shahly, Victoria L.; Stein, Dan J.; Atwoli, Lukoye; Borges, Guilherme; Bunting, Brendan; de Girolamo, Giovanni; Gluzman, Semyon; Haro, Josep Maria; Hinkov, Hristo; Kawakami, Norito; Kovess-Masfety, Viviane; Navarro-Mateu, Fernando; Posada-Villa, Jose; Scott, Kate M.; Shalev, Arieh Y.; Have, Margreet ten; Torres, Yolanda; Viana, Maria Carmen; Zaslavsky, Alan M.

2017-01-01

Although earlier trauma exposure is known to predict post-traumatic stress disorder (PTSD) after subsequent traumas, it is unclear if this association is limited to cases where the earlier trauma led to PTSD. Resolution of this uncertainty has important implications for research on pre-trauma vulnerability to PTSD. We examined this issue in the WHO World Mental Health (WMH) Surveys with 34,676 respondents who reported lifetime trauma exposure. One lifetime trauma was selected randomly for each respondent. DSM-IV PTSD due to that trauma was assessed. We reported in a previous paper that four earlier traumas involving interpersonal violence significantly predicted PTSD after subsequent random traumas (OR=1.3–2.5). We also assessed 14 lifetime DSM-IV mood, anxiety, disruptive behavior, and substance disorders prior to random traumas. We show in the current report that only prior anxiety disorders significantly predicted PTSD in a multivariate model (OR=1.5–4.3) and that these disorders interacted significantly with three of the earlier traumas (witnessing atrocities, physical violence victimization, rape). History of witnessing atrocities significantly predicted PTSD after subsequent random traumas only among respondents with prior PTSD (OR=5.6). Histories of physical violence victimization (OR=1.5) and rape after age 17 (OR=17.6) significantly predicted only among respondents with no history of prior anxiety disorders. Although only preliminary due to reliance on retrospective reports, these results suggest that history of anxiety disorders and history of a limited number of earlier traumas might usefully be targeted in future prospective studies as distinct foci of research on individual differences in vulnerability to PTSD after subsequent traumas. PMID:28924183

Insight Into Illness and Cognition in Schizophrenia in Earlier and Later Life.

PubMed

Gerretsen, Philip; Voineskos, Aristotle N; Graff-Guerrero, Ariel; Menon, Mahesh; Pollock, Bruce G; Mamo, David C; Mulsant, Benoit H; Rajji, Tarek K

2017-04-01

Impaired insight into illness in schizophrenia is associated with illness severity and deficits in premorbid intellectual function, executive function, and memory. A previous study of patients aged 60 years and older found that illness severity and premorbid intellectual function accounted for variance in insight impairment. As such, we aimed to test whether similar relationships would be observed in earlier life. A retrospective analysis was performed on 1 large sample of participants (n = 171) with a DSM-IV-TR diagnosis of schizophrenia aged 19 to 79 years acquired from 2 studies: (1) a psychosocial intervention trial for older persons with schizophrenia (June 2008 to May 2014) and (2) a diffusion tensor imaging and genetics study of psychosis across the life span (February 2007 to December 2013). We assessed insight into illness using the Positive and Negative Syndrome Scale (PANSS) item G12 and explored its relationship to illness severity (PANSS total modified), premorbid intellectual function (Wechsler Test of Adult Reading [WTAR]), and cognition. Insight impairment was more severe in later life (≥ 60 years) than in earlier years (t = -3.75, P < .001). Across the whole sample, the variance of impaired insight was explained by PANSS total modified (Exp[B] = 1.070, P < .001) and WTAR scores (Exp[B] = 0.970, P = .028). Although age and cognition were correlated with impaired insight, they did not independently contribute to its variance. However, the relationships between impaired insight and illness severity and between impaired insight and cognition, particularly working memory, were stronger in later life than in earlier life. These results suggest an opportunity for intervention may exist with cognitive-enhancing neurostimulation or medications to improve insight into illness in schizophrenia across the life span. Original study registered on ClinicalTrials.gov (identifier: NCT00832845). © Copyright 2017 Physicians Postgraduate Press, Inc.

Reading-Related Skills in Earlier- and Later-Schooled Children

ERIC Educational Resources Information Center

Cunningham, Anna J.; Carroll, Julia M.

2011-01-01

We investigate the effects of age-related factors and formal instruction on the development of reading-related skills in children aged 4 and 7 years. Age effects were determined by comparing two groups of children at the onset of formal schooling; one aged 7 (later-schooled) and one aged 4 (earlier-schooled). Schooling effects were measured by…

The associations of earlier trauma exposures and history of mental disorders with PTSD after subsequent traumas.

PubMed

Kessler, R C; Aguilar-Gaxiola, S; Alonso, J; Bromet, E J; Gureje, O; Karam, E G; Koenen, K C; Lee, S; Liu, H; Pennell, B-E; Petukhova, M V; Sampson, N A; Shahly, V; Stein, D J; Atwoli, L; Borges, G; Bunting, B; de Girolamo, G; Gluzman, S F; Haro, J M; Hinkov, H; Kawakami, N; Kovess-Masfety, V; Navarro-Mateu, F; Posada-Villa, J; Scott, K M; Shalev, A Y; Ten Have, M; Torres, Y; Viana, M C; Zaslavsky, A M

2017-09-19

Although earlier trauma exposure is known to predict posttraumatic stress disorder (PTSD) after subsequent traumas, it is unclear whether this association is limited to cases where the earlier trauma led to PTSD. Resolution of this uncertainty has important implications for research on pretrauma vulnerability to PTSD. We examined this issue in the World Health Organization (WHO) World Mental Health (WMH) Surveys with 34 676 respondents who reported lifetime trauma exposure. One lifetime trauma was selected randomly for each respondent. DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition) PTSD due to that trauma was assessed. We reported in a previous paper that four earlier traumas involving interpersonal violence significantly predicted PTSD after subsequent random traumas (odds ratio (OR)=1.3-2.5). We also assessed 14 lifetime DSM-IV mood, anxiety, disruptive behavior and substance disorders before random traumas. We show in the current report that only prior anxiety disorders significantly predicted PTSD in a multivariate model (OR=1.5-4.3) and that these disorders interacted significantly with three of the earlier traumas (witnessing atrocities, physical violence victimization and rape). History of witnessing atrocities significantly predicted PTSD after subsequent random traumas only among respondents with prior PTSD (OR=5.6). Histories of physical violence victimization (OR=1.5) and rape after age 17 years (OR=17.6) significantly predicted only among respondents with no history of prior anxiety disorders. Although only preliminary due to reliance on retrospective reports, these results suggest that history of anxiety disorders and history of a limited number of earlier traumas might usefully be targeted in future prospective studies as distinct foci of research on individual differences in vulnerability to PTSD after subsequent traumas.Molecular Psychiatry advance online publication, 19 September 2017; doi:10.1038/mp.2017.194.

Floodplains within reservoirs promote earlier spawning of white crappies Pomoxis annularis

USGS Publications Warehouse

Miranda, Leandro E.; Dagel, Jonah D.; Kaczka, Levi J.; Mower, Ethan; Wigen, S. L.

2015-01-01

Reservoirs impounded over floodplain rivers are unique because they may include within their upper reaches extensive shallow water stored over preexistent floodplains. Because of their relatively flat topography and riverine origin, floodplains in the upper reaches of reservoirs provide broad expanses of vegetation within a narrow range of reservoir water levels. Elsewhere in the reservoir, topography creates a band of shallow water along the contour of the reservoir where vegetation often does not grow. Thus, as water levels rise, floodplains may be the first vegetated habitats inundated within the reservoir. We hypothesized that shallow water in reservoir floodplains would attract spawning white crappies Pomoxis annularis earlier than reservoir embayments. Crappie relative abundance over five years in floodplains and embayments of four reservoirs increased as spawning season approached, peaked, and decreased as fish exited shallow water. Relative abundance peaked earlier in floodplains than embayments, and the difference was magnified with higher water levels. Early access to suitable spawning habitat promotes earlier spawning and may increase population fitness. Recognition of the importance of reservoir floodplains, an understanding of how reservoir water levels can be managed to provide timely connectivity to floodplains, and conservation of reservoir floodplains may be focal points of environmental management in reservoirs.

View northeast, wharf A, portion AA, details showing earlier piers ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

View northeast, wharf A, portion AA, details showing earlier piers and braces sloping toward water, reused charred plates for existing decking - U.S. Coast Guard Sandy Hook Station, Western Docking Structure, West of intersection of Canfield Road & Hartshorne Drive, Highlands, Monmouth County, NJ

Results 1993. Oklahoma Educational Indicators Program. District Report.

ERIC Educational Resources Information Center

Oklahoma State Dept. of Education, Oklahoma City. Office of Accountability.

This report is a graphic presentation of teacher and student information, revenue and expenditure data, test results, and other student outcomes for each public school district. The indicators in the district report reflect the increased student enrollment (594,326) and staff (38,290) in 1993, as well as the new cost accounting system used by the…

The association between cannabis use and earlier age at onset of schizophrenia and other psychoses: meta-analysis of possible confounding factors.

PubMed

Myles, Nicholas; Newall, Hannah; Nielssen, Olav; Large, Matthew

2012-01-01

A recent meta-analysis showed that the mean age of onset of psychosis among cannabis users was almost three years earlier than that of non-cannabis users. However, because cannabis users usually smoke tobacco, the use of tobacco might independently contribute to the earlier onset of psychosis. We aimed to use meta-analysis to compare the extent to which cannabis and tobacco use are each associated with an earlier age at onset of schizophrenia and other psychoses. We also examined other factors that might have contributed to the finding of an earlier age of onset among cannabis users, including the proportion of males in the samples, the diagnostic inclusion criteria and aspects of study quality. The electronic databases MEDLINE, EMBASE, PsycINFO and ISI Web of Science, were searched for English-language peer-reviewed publications that reported age at onset of schizophrenia and other psychoses separately for cannabis users and non-users, or for tobaccosmokers and non-smokers. Meta-analysis showed that the age at onset of psychosis for cannabis users was 32 months earlier than for cannabis non-users (SMD=- 0.399, 95%CI -0.493 - -0.306, z=-8.34, p < 0.001), and was two weeks later in tobacco smokers compared with non-smokers (SMD=0.002, 95%CI -0.094 - 0.097, z=0.03, p=0.974). The main results were not affected by subgroup analyses examining studies of a single sex, the methods for making psychiatric diagnoses and measures of study quality. The results suggest that the association between cannabis use and earlier onset of psychosis is robust and is not the result either of tobacco smoking by cannabis using patients or the other potentially confounding factors we examined. This supports the hypothesis that, in some patients, cannabis use plays a causal role in the development of schizophrenia and raises the possibility of treating schizophrenia with new pharmacological treatments that have an affinity for endo-cannabinoid receptors.

Comprehensive methods for earlier detection and monitoring of forest decline

Treesearch

Jennifer Pontius; Richard Hallett

2014-01-01

Forested ecosystems are threatened by invasive pests, pathogens, and unusual climatic events brought about by climate change. Earlier detection of incipient forest health problems and a quantitatively rigorous assessment method is increasingly important. Here, we describe a method that is adaptable across tree species and stress agents and practical for use in the...

Reducing Older Driver Motor Vehicle Collisions via Earlier Cataract Surgery

PubMed Central

Mennemeyer, Stephen T.; Owsley, Cynthia; McGwin, Gerald

2013-01-01

Older adults who undergo cataract extraction have roughly half the rate of motor vehicle collision (MVC) involvement per mile driven compared to cataract patients who do not elect cataract surgery. Currently in the U.S., most insurers do not allow payment for cataract surgery based upon the findings of a vision exam unless accompanied by an individual’s complaint of visual difficulties that seriously interfere with driving or other daily activities and individuals themselves may be slow or reluctant to complain and seek relief. As a consequence, surgery tends to occur after significant vision problems have emerged. We hypothesize that a proactive policy encouraging cataract surgery earlier for a lesser level of complaint would significantly reduce MVCs among older drivers. We used a Monte Carlo model to simulate the MVC experience of the U.S. population from age 60 to 89 under alternative protocols for the timing of cataract surgery which we call “Current Practice” (CP) and “Earlier Surgery” (ES). Our base model finds, from a societal perspective with undiscounted 2010 dollars, that switching to ES from CP reduces by about 21% the average number of MVCs, fatalities, and MVC cost per person. The net effect on total cost – all MVC costs plus cataract surgery expenditures -- is a reduction of about 16%. Quality Adjusted Life Years would increase by about 5%. From the perspective of payers for healthcare, the switch would increase cataract surgery expenditure for ages 65+ by about 8% and for ages 60 to 64 by about 47% but these expenditures are substantially offset after age 65 by reductions in the medical and emergency services component of MVC cost. Similar results occur with discounting at 3% and with various sensitivity analyses. We conclude that a policy of ES would significantly reduce MVCs and their associated consequences. PMID:23369786

Daily Use, Especially of High-Potency Cannabis, Drives the Earlier Onset of Psychosis in Cannabis Users

PubMed Central

Di Forti, Marta; Sallis, Hannah; Allegri, Fabio; Trotta, Antonella; Ferraro, Laura; Stilo, Simona A.; Marconi, Arianna; La Cascia, Caterina; Reis Marques, Tiago; Pariante, Carmine; Dazzan, Paola; Mondelli, Valeria; Paparelli, Alessandra; Kolliakou, Anna; Prata, Diana; Gaughran, Fiona; David, Anthony S.; Morgan, Craig; Stahl, Daniel; Khondoker, Mizanur; MacCabe, James H.; Murray, Robin M.

2014-01-01

Cannabis use is associated with an earlier age of onset of psychosis (AOP). However, the reasons for this remain debated. Methods: We applied a Cox proportional hazards model to 410 first-episode psychosis patients to investigate the association between gender, patterns of cannabis use, and AOP. Results: Patients with a history of cannabis use presented with their first episode of psychosis at a younger age (mean years = 28.2, SD = 8.0; median years = 27.1) than those who never used cannabis (mean years = 31.4, SD = 9.9; median years = 30.0; hazard ratio [HR] = 1.42; 95% CI: 1.16–1.74; P < .001). This association remained significant after controlling for gender (HR = 1.39; 95% CI: 1.11–1.68; P < .001). Those who had started cannabis at age 15 or younger had an earlier onset of psychosis (mean years = 27.0, SD = 6.2; median years = 26.9) than those who had started after 15 years (mean years = 29.1, SD = 8.5; median years = 27.8; HR = 1.40; 95% CI: 1.06–1.84; P = .050). Importantly, subjects who had been using high-potency cannabis (skunk-type) every day had the earliest onset (mean years = 25.2, SD = 6.3; median years = 24.6) compared to never users among all the groups tested (HR = 1.99; 95% CI: 1.50- 2.65; P < .0001); these daily users of high-potency cannabis had an onset an average of 6 years earlier than that of non-cannabis users. Conclusions: Daily use, especially of high-potency cannabis, drives the earlier onset of psychosis in cannabis users. PMID:24345517

Earlier Violent Television Exposure and Later Drug Dependence

PubMed Central

Brook, David W.; Katten, Naomi S.; Ning, Yuming; Brook, Judith S.

2013-01-01

This research examined the longitudinal pathways from earlier violent television exposure to later drug dependence. African American and Puerto Rican adolescents were interviewed during three points in time (N = 463). Violent television exposure in late adolescence predicted violent television exposure in young adulthood, which in turn was related to tobacco/marijuana use, nicotine dependence, and later drug dependence. Some policy and clinical implications suggest: a) regulating the times when violent television is broadcast; b) creating developmentally targeted prevention/treatment programs; and c) recognizing that watching violent television may serve as a cue regarding increased susceptibility to nicotine and drug dependence. PMID:18612881

Integrated Tree-Ring-Radiocarbon High-Resolution Timeframe to Resolve Earlier Second Millennium BCE Mesopotamian Chronology.

PubMed

Manning, Sturt W; Griggs, Carol B; Lorentzen, Brita; Barjamovic, Gojko; Ramsey, Christopher Bronk; Kromer, Bernd; Wild, Eva Maria

2016-01-01

years earlier than previous assessments, indicating that it likely has no association with the subsequent Santorini volcanic eruption.

Integrated Tree-Ring-Radiocarbon High-Resolution Timeframe to Resolve Earlier Second Millennium BCE Mesopotamian Chronology

PubMed Central

Griggs, Carol B.; Lorentzen, Brita; Barjamovic, Gojko; Ramsey, Christopher Bronk; Kromer, Bernd; Wild, Eva Maria

2016-01-01

years earlier than previous assessments, indicating that it likely has no association with the subsequent Santorini volcanic eruption. PMID:27409585

Earlier flowering did not alter pollen limitation in an early flowering shrub under short-term experimental warming.

PubMed

Pan, Cheng-Chen; Feng, Qi; Zhao, Ha-Lin; Liu, Lin-De; Li, Yu-Lin; Li, Yu-Qiang; Zhang, Tong-Hui; Yu, Xiao-Ya

2017-06-05

In animal pollinated plants, phenological shifts caused by climate change may have important ecological consequences. However, no empirical evidence exists at present on the consequences that flowering phenology shifts have on the strength of pollen limitation under experimental warming. Here, we investigated the effects of experimental warming on flowering phenology, flower density, reproductive success, and pollen limitation intensity in Caragana microphylla and evaluated whether earlier flowering phenology affected plant reproduction and the level of pollen limitation using warmed and unwarmed open top chambers in the Horqin Sandy Land of Inner Mongolia, northern China. The results of this study indicated that artificial warming markedly advanced flower phenology rather than extending the duration of the flowering. Additionally, warming was found to significantly reduce flower density which led to seed production reduction, since there were insignificant effects observed on fruit set and seed number per fruit. Experimental floral manipulations showed that warming did not affect pollen limitation. These results revealed the negative effects of advanced phenology induced by warming on flower density and reproductive output, as well as the neutral effects on reproductive success and pollen limitation intensity of long surviving plants.

Mineralization of mandibular third molars can estimate chronological age--Brazilian indices.

PubMed

de Oliveira, Fernando Toledo; Capelozza, Ana Lúcia Álvares; Lauris, José Roberto Pereira; de Bullen, Izabel Regina Fischer Rubira

2012-06-10

Forensic age estimation is an important element of anthropological research, as it produces one of the primary sources of data that researchers use to establish the identity of a person living or the identity of unknown bodily remains. The aim of this study was to determine if the chronology of third molar mineralization could be an accurate indicator of estimated age in a sample Brazilian population. If so, mineralization could determine the probability of an individual being 18 years or older. The study evaluated 407 panoramic radiographs of males and females from the past 5 years in order to assess the mineralization status of the mandibular third molars. The evaluation was carried out using an adaptation of Demirjian's system. The results indicated a strong correlation between chronological age and the mineralization of the mandibular third molars. The results indicated that modern Brazilian generation tends to demonstrate an earlier mandibular third molar mineralization than older Brazilian generation and people of other nationalities. Males reached developmental stages slightly earlier than females, but statistically significant differences between the sex were not found. The probability that an individual with third molar mineralization stage H had reached an age of 18 years or older was 96.8-98.6% for males and females, respectively. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Identifying pneumonia outbreaks of public health importance: can emergency department data assist in earlier identification?

PubMed

Hope, Kirsty; Durrheim, David N; Muscatello, David; Merritt, Tony; Zheng, Wei; Massey, Peter; Cashman, Patrick; Eastwood, Keith

2008-08-01

To retrospectively review the performance of a near real-time Emergency Department (ED) Syndromic Surveillance System operating in New South Wales for identifying pneumonia outbreaks of public health importance. Retrospective data was obtained from the NSW Emergency Department data collection for a rural hospital that has experienced a cluster of pneumonia diagnoses among teenage males in August 2006. ED standard reports were examined for signals in the overall count for each respiratory syndrome, and for elevated counts in individual subgroups including; age, sex and admission to hospital status. Using the current thresholds, the ED syndromic surveillance system would have trigged a signal for pneumonia syndrome in children aged 5-16 years four days earlier than the notification by a paediatrician and this signal was maintained for 14 days. If the ED syndromic surveillance system had been operating it could have identified the outbreak earlier than the paediatrician's notification. This may have permitted an earlier public health response. By understanding the behaviour of syndromes during outbreaks of public health importance, response protocols could be developed to facilitate earlier implementation of control measures.

To achieve an earlier IFN-γ response is not sufficient to control Mycobacterium tuberculosis infection in mice.

PubMed

Vilaplana, Cristina; Prats, Clara; Marzo, Elena; Barril, Carles; Vegué, Marina; Diaz, Jorge; Valls, Joaquim; López, Daniel; Cardona, Pere-Joan

2014-01-01

The temporo-spatial relationship between the three organs (lung, spleen and lymph node) involved during the initial stages of Mycobacterium tuberculosis infection has been poorly studied. As such, we performed an experimental study to evaluate the bacillary load in each organ after aerosol or intravenous infection and developed a mathematical approach using the data obtained in order to extract conclusions. The results showed that higher bacillary doses result in an earlier IFN-γ response, that a certain bacillary load (BL) needs to be reached to trigger the IFN-γ response, and that control of the BL is not immediate after onset of the IFN-γ response, which might be a consequence of the spatial dimension. This study may have an important impact when it comes to designing new vaccine candidates as it suggests that triggering an earlier IFN-γ response might not guarantee good infection control, and therefore that additional properties should be considered for these candidates.

To Achieve an Earlier IFN-γ Response Is Not Sufficient to Control Mycobacterium tuberculosis Infection in Mice

PubMed Central

Marzo, Elena; Barril, Carles; Vegué, Marina; Diaz, Jorge; Valls, Joaquim; López, Daniel; Cardona, Pere-Joan

2014-01-01

The temporo-spatial relationship between the three organs (lung, spleen and lymph node) involved during the initial stages of Mycobacterium tuberculosis infection has been poorly studied. As such, we performed an experimental study to evaluate the bacillary load in each organ after aerosol or intravenous infection and developed a mathematical approach using the data obtained in order to extract conclusions. The results showed that higher bacillary doses result in an earlier IFN-γ response, that a certain bacillary load (BL) needs to be reached to trigger the IFN-γ response, and that control of the BL is not immediate after onset of the IFN-γ response, which might be a consequence of the spatial dimension. This study may have an important impact when it comes to designing new vaccine candidates as it suggests that triggering an earlier IFN-γ response might not guarantee good infection control, and therefore that additional properties should be considered for these candidates. PMID:24959669

Minimally invasive thyroidectomy (MIT): indications and results.

PubMed

Docimo, Giovanni; Salvatore Tolone, Salvatore; Gili, Simona; d'Alessandro, A; Casalino, G; Brusciano, L; Ruggiero, Roberto; Docimo, Ludovico

2013-01-01

To establish if the indication for different approaches for thyroidectomy and the incision length provided by means of pre-operative assessment of gland volume and size of nodules resulted in safe and effective outcomes and in any notable aesthetic or quality-of-life impact on patients. Ninehundred eightytwo consecutive patients, undergoing total thyroidectomy, were enrolled. The thyroid volume and maximal nodule diameter were measured by means of ultrasounds. Based on ultrasounds findings, patients were divided into three groups: minimally invasive video assisted thyroidectomy (MIVAT), minimally invasive thyroidectomy (MIT) and conventional thyroidectomy (CT) groups. The data concerning the following parameters were collected: operative time, postoperative complications, postoperative pain and cosmetic results. The MIVAT group included 179 patients, MIT group included 592 patients and CT group included 211 patients. Incidence of complications did not differ significantly in each group. In MIVAT and MIT group, the perception of postoperative pain was less intense than CT group. The patients in the MIVAT (7±1.5) and MIT (8±2) groups were more satisfied with the cosmetic results than those in CT group (5±1.3) (p= <0.05). The MIT is a technique totally reproducible, and easily convertible to perform surgical procedures in respect of the patient, without additional complications, increased costs, and with better aesthetic results.

Earlier tachycardia onset in right than left mesial temporal lobe seizures.

PubMed

Kato, Kazuhiro; Jin, Kazutaka; Itabashi, Hisashi; Iwasaki, Masaki; Kakisaka, Yosuke; Aoki, Masashi; Nakasato, Nobukazu

2014-10-07

To clarify whether the presence and timing of peri-ictal heart rate (HR) change is a seizure lateralizing sign in patients with mesial temporal lobe epilepsy (mTLE). Long-term video EEGs were retrospectively reviewed in 21 patients, 7 men and 14 women aged 13 to 67 years, diagnosed as mTLE with MRI lesions in the mesial temporal structures (hippocampal sclerosis in 20 cases, amygdala hypertrophy in 1 case). Seventy-seven partial seizures without secondary generalization were extracted. Peri-ictal HR change was compared between 29 right seizures (9 patients) and 48 left seizures (12 patients). HR abruptly increased in all 29 right seizures and 42 of 48 left seizures. Onset time of HR increase in relation to ictal EEG onset was significantly earlier in right seizures than in left seizures (mean ± SD, -11.5 ± 14.8 vs 9.2 ± 21.7 seconds; p < 0.0001). Time of maximum HR was also significantly earlier in right seizures than in left seizures (36.0 ± 18.1 vs 58.0 ± 28.7 seconds; p < 0.0001). Maximum HR changes from baseline showed no significant difference between right and left seizures (47.5 ± 19.1 vs 40.8 ± 20.0/min). Significantly earlier tachycardia in right than left mTLE seizures supports previous hypotheses that the right cerebral hemisphere is dominant in the sympathetic network. No HR change, or delayed tachycardia possibly due to seizure propagation to the right hemisphere, may be a useful lateralizing sign of left mTLE seizures. © 2014 American Academy of Neurology.

PDT in clinics: indications, results, and markets.

PubMed

Patrice, Thierry; Olivier, David; Bourre, Ludovic

2006-01-01

Photodynamic therapy (PDT) is based on the selective light activation of an exogenously given drug to patients. PDT acts mainly on cell membranes either of neovascular endothelial cells or of cancer cells leading to cancer cell death. Six drugs are now marketed based on clinical assays in various indications, which showed a clear cost efficiency as compared to other classical procedures. PDT is easy to handle and can be performed in medical installations fitting the conditions of health care in developing countries. Its cost effectiveness could represent an appropriate solution to the increasing number of cancers of various origin. However despite all the clinical results now available, PDT development remains slow. The reasons for this situation include cost of development, intellectual property, and competition between pharmaceutical companies.

Earlier Mother's Age at Menarche Predicts Rapid Infancy Growth and Childhood Obesity

PubMed Central

Ong, Ken K; Northstone, Kate; Wells, Jonathan CK; Rubin, Carol; Ness, Andy R; Golding, Jean; Dunger, David B

2007-01-01

Background Early menarche tends to be preceded by rapid infancy weight gain and is associated with increased childhood and adult obesity risk. As age at menarche is a heritable trait, we hypothesised that age at menarche in the mother may in turn predict her children's early growth and obesity risk. Methods and Findings We tested associations between mother's age at menarche, mother's adult body size and obesity risk, and her children's growth and obesity risk in 6,009 children from the UK population-based Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort who had growth and fat mass at age 9 y measured by dual-energy X-ray absorptiometry. A subgroup of 914 children also had detailed infancy and childhood growth data. In the mothers, earlier menarche was associated with shorter adult height (by 0.64 cm/y), increased weight (0.92 kg/y), and body mass index (BMI, 0.51 kg/m2/y; all p < 0.001). In contrast, in her children, earlier mother's menarche predicted taller height at 9 y (by 0.41 cm/y) and greater weight (0.80 kg/y), BMI (0.29 kg/m2/y), and fat mass index (0.22 kg/m2/year; all p < 0.001). Children in the earliest mother's menarche quintile (≤11 y) were more obese than the oldest quintile (≥15 y) (OR, 2.15, 95% CI 1.46 to 3.17; p < 0.001, adjusted for mother's education and BMI). In the subgroup, children in the earliest quintile showed faster gains in weight (p < 0.001) and height (p < 0.001) only from birth to 2 y, but not from 2 to 9 y (p = 0.3–0.8). Conclusions Earlier age at menarche may be a transgenerational marker of a faster growth tempo, characterised by rapid weight gain and growth, particularly during infancy, and leading to taller childhood stature, but likely earlier maturation and therefore shorter adult stature. This growth pattern confers increased childhood and adult obesity risks. PMID:17455989

Earlier time to aerobic exercise is associated with faster recovery following acute sport concussion

PubMed Central

Richards, Doug; Comper, Paul; Hutchison, Michael G.

2018-01-01

Objective To determine whether earlier time to initiation of aerobic exercise following acute concussion is associated with time to full return to (1) sport and (2) school or work. Methods A retrospective stratified propensity score survival analysis of acute (≤14 days) concussion was used to determine whether time (days) to initiation of aerobic exercise post-concussion was associated with, both, time (days) to full return to (1) sport and (2) school or work. Results A total of 253 acute concussions [median (IQR) age, 17.0 (15.0–20.0) years; 148 (58.5%) males] were included in this study. Multivariate Cox regression models identified that earlier time to aerobic exercise was associated with faster return to sport and school/work adjusting for other covariates, including quintile propensity strata. For each successive day in delay to initiation of aerobic exercise, individuals had a less favourable recovery trajectory. Initiating aerobic exercise at 3 and 7 days following injury was associated with a respective 36.5% (HR, 0.63; 95% CI, 0.53–0.76) and 73.2% (HR, 0.27; 95% CI, 0.16–0.45) reduced probability of faster full return to sport compared to within 1 day; and a respective 45.9% (HR, 0.54; 95% CI, 0.44–0.66) and 83.1% (HR, 0.17; 95% CI, 0.10–0.30) reduced probability of faster full return to school/work. Additionally, concussion history, symptom severity, LOC deleteriously influenced concussion recovery. Conclusion Earlier initiation of aerobic exercise was associated with faster full return to sport and school or work. This study provides greater insight into the benefits and safety of aerobic exercise within the first week of the injury. PMID:29668716

[Physiokinesitherapeutic management of traumatic lesions of the brachial plexus. Indications and results].

PubMed

Gusso, M I; Innocenti, M; Mauceri, M C

1985-03-31

An account is given of the indications and results of physical and rehabilitative management of brachial plexus lesions when used electively or as a complement to surgery. Material from the Florence Traumatological and Orthopaedics Centre and the V. Putti Mutilated Patients Centre, Bologna (formerly directed by Prof. O. Scaglietti) dating from 1940 to 1980 is used to explain the indications for conservative and surgical management, in the conviction that sound results depend on exact indication. A selected sample of 51 patients treated conservatively and 194 surgically is presented. The results were satisfactory in about 50% of each group, with a slight advantage in favour of physiotherapy, this being obviously employed when lesions were less severe.

Delusions and underlying needs in older adults with Alzheimer's disease: influence of earlier life experiences and the current environment.

PubMed

Wang, Jing-Jy; Cheng, Wen-Yun; Lai, Pei-Ru; Pai, Ming-Chyi

2014-12-01

Delusions are one of the most severe psychiatric symptoms of individuals with Alzheimer's disease (AD), which often increase the stress experienced by caregivers. The purpose of this study was to understand the influences of earlier life experiences and the current environment on delusions, as well as the underlying needs of older adults with AD who experience delusions. Using an exploratory research design with a qualitative approach and purposive sampling, 20 family caregivers were interviewed. Two psychosocial types of attributes of delusion were categorized: Type A, the influence of earlier life experiences; and Type B, current environmental influences. The underlying needs of those with delusions include physical comfort, a desire to be secure, and a sense of belonging. The contents of delusions are easily influenced by patients' earlier negative experiences and responsibilities, whereas the current environment exerts a crucial influence on the occurrence, frequency, and severity of specific delusions. These results can facilitate planning for patient-centered care by enhancing health care providers' understanding of the psychosocial and environmental attributes and needs behind delusions. Copyright 2014, SLACK Incorporated.

Identified research directions for using manufacturing knowledge earlier in the product lifecycle

PubMed Central

Hedberg, Thomas D.; Hartman, Nathan W.; Rosche, Phil; Fischer, Kevin

2016-01-01

Design for Manufacturing (DFM), especially the use of manufacturing knowledge to support design decisions, has received attention in the academic domain. However, industry practice has not been studied enough to provide solutions that are mature for industry. The current state of the art for DFM is often rule-based functionality within Computer-Aided Design (CAD) systems that enforce specific design requirements. That rule-based functionality may or may not dynamically affect geometry definition. And, if rule-based functionality exists in the CAD system, it is typically a customization on a case-by-case basis. Manufacturing knowledge is a phrase with vast meanings, which may include knowledge on the effects of material properties decisions, machine and process capabilities, or understanding the unintended consequences of design decisions on manufacturing. One of the DFM questions to answer is how can manufacturing knowledge, depending on its definition, be used earlier in the product lifecycle to enable a more collaborative development environment? This paper will discuss the results of a workshop on manufacturing knowledge that highlights several research questions needing more study. This paper proposes recommendations for investigating the relationship of manufacturing knowledge with shape, behavior, and context characteristics of product to produce a better understanding of what knowledge is most important. In addition, the proposal includes recommendations for investigating the system-level barriers to reusing manufacturing knowledge and how model-based manufacturing may ease the burden of knowledge sharing. Lastly, the proposal addresses the direction of future research for holistic solutions of using manufacturing knowledge earlier in the product lifecycle. PMID:27990027

Identified research directions for using manufacturing knowledge earlier in the product lifecycle.

PubMed

Hedberg, Thomas D; Hartman, Nathan W; Rosche, Phil; Fischer, Kevin

2017-01-01

Design for Manufacturing (DFM), especially the use of manufacturing knowledge to support design decisions, has received attention in the academic domain. However, industry practice has not been studied enough to provide solutions that are mature for industry. The current state of the art for DFM is often rule-based functionality within Computer-Aided Design (CAD) systems that enforce specific design requirements. That rule-based functionality may or may not dynamically affect geometry definition. And, if rule-based functionality exists in the CAD system, it is typically a customization on a case-by-case basis. Manufacturing knowledge is a phrase with vast meanings, which may include knowledge on the effects of material properties decisions, machine and process capabilities, or understanding the unintended consequences of design decisions on manufacturing. One of the DFM questions to answer is how can manufacturing knowledge, depending on its definition, be used earlier in the product lifecycle to enable a more collaborative development environment? This paper will discuss the results of a workshop on manufacturing knowledge that highlights several research questions needing more study. This paper proposes recommendations for investigating the relationship of manufacturing knowledge with shape, behavior, and context characteristics of product to produce a better understanding of what knowledge is most important. In addition, the proposal includes recommendations for investigating the system-level barriers to reusing manufacturing knowledge and how model-based manufacturing may ease the burden of knowledge sharing. Lastly, the proposal addresses the direction of future research for holistic solutions of using manufacturing knowledge earlier in the product lifecycle.

Advanced seasonal reproductive development in a male urban bird is reflected in earlier plasma luteinizing hormone rise but not energetic status.

PubMed

Davies, Scott; Behbahaninia, Hirbod; Giraudeau, Mathieu; Meddle, Simone L; Waites, Kyle; Deviche, Pierre

2015-12-01

Urban animals inhabit an environment considerably different than do their non-urban conspecifics, and to persist urban animals must adjust to these novel environments. The timing of seasonal reproductive development (i.e., growth of gonads and secondary sex organs) is a fundamental determinant of the breeding period and is frequently advanced in urban bird populations. However, the underlying mechanism(s) by which birds adjust the timing of reproductive development to urban areas remain(s) largely unknown. Here, we compared the timing of vernal reproductive development in free-ranging urban and non-urban male Abert's Towhees, Melozone aberti, in Phoenix, Arizona, USA, and tested the non-mutually exclusive hypotheses that earlier reproductive development is due to improved energetic status and/or earlier increase in endocrine activity of the reproductive system. We found that urban birds initiated testicular development earlier than non-urban birds, but this disparity was not associated with differences in body condition, fat stores, or innate immune performance. These results provide no support for the hypothesis that energetic constraints are responsible for delayed reproductive development of non-urban relative to urban male Abert's Towhees. Urban birds did, however, increase their plasma luteinizing hormone, but not plasma testosterone, earlier than non-urban birds. These findings suggest that adjustment to urban areas by Abert's Towhees involves increases in the endocrine activity of the anterior pituitary gland and/or hypothalamus earlier than non-urban towhees. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

[An earlier diagnosis of depression].

PubMed

Campagne, D M

Data of the last decade indicate that, in the Western world and also in Spain, an important part of general practicioners' consultations are related to mental health, but depression is consistently underdiagnosed. Causes are lack of time and back-up, as well as lack of specific training. In Spain, there is no national health service primary care database with actualized clinical information as to mental health. There is evident clinical interest in a more agile diagnostic, resulting from a recollection of data from voluntary selective screening and continuing evaluation of adult depression along the model used by other National Health Systems. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

Can social media data lead to earlier detection of drug‐related adverse events?

PubMed Central

Cremieux, Pierre; Audenrode, Marc Van; Vekeman, Francis; Karner, Paul; Zhang, Haimin; Greenberg, Paul

2016-01-01

Abstract Purpose To compare the patient characteristics and the inter‐temporal reporting patterns of adverse events (AEs) for atorvastatin (Lipitor®) and sibutramine (Meridia®) in social media (AskaPatient.com) versus the FDA Adverse Event Reporting System (FAERS). Methods We identified clinically important AEs associated with atorvastatin (muscle pain) and sibutramine (cardiovascular AEs), compared their patterns in social media postings versus FAERS and used Granger causality tests to assess whether social media postings were useful in forecasting FAERS reports. Results We analyzed 998 and 270 social media postings between 2001 and 2014, 69 003 and 7383 FAERS reports between 1997 and 2014 for atorvastatin and sibutramine, respectively. Social media reporters were younger (atorvastatin: 53.9 vs. 64.0 years, p < 0.001; sibutramine: 36.8 vs. 43.8 years, p < 0.001). Social media reviews contained fewer serious AEs (atorvastatin, pain: 2.5% vs. 38.2%; sibutramine, cardiovascular issues: 7.9% vs. 63.0%; p < 0.001 for both) and concentrated on fewer types of AEs (proportion comprising the top 20 AEs: atorvastatin, 88.7% vs. 55.4%; sibutramine, 86.3% vs. 65.4%) compared with FAERS. While social media sibutramine reviews mentioning cardiac issues helped predict those in FAERS 11 months later (p < 0.001), social media atorvastatin reviews did not help predict FAERS reports. Conclusions Social media AE reporters were younger and focused on less‐serious and fewer types of AEs than FAERS reporters. The potential for social media to provide earlier indications of AEs compared with FAERS is uncertain. Our findings highlight some of the promises and limitations of online social media versus conventional pharmacovigilance sources and the need for careful interpretation of the results. © 2016 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons Ltd. PMID:27601271

Transcriptional analysis of micronutrient zinc-associated response for enhanced carbohydrate utilization and earlier solventogenesis in Clostridium acetobutylicum.

PubMed

Wu, You-Duo; Xue, Chuang; Chen, Li-Jie; Wan, Hui-Hui; Bai, Feng-Wu

2015-11-20

The micronutrient zinc plays vital roles in ABE fermentation by Clostridium acetobutylicum. In order to elucidate the zinc-associated response for enhanced glucose utilization and earlier solventogenesis, transcriptional analysis was performed on cells grown in glucose medium at the exponential growth phase of 16 h without/with supplementary zinc. Correspondingly, the gene glcG (CAC0570) encoding a glucose-specific PTS was significantly upregulated accompanied with the other two genes CAC1353 and CAC1354 for glucose transport in the presence of zinc. Additionally, genes involved in the metabolisms of six other carbohydrates (maltose, cellobiose, fructose, mannose, xylose and arabinose) were differentially expressed, indicating that the regulatory effect of micronutrient zinc is carbohydrate-specific with respects to the improved/inhibited carbohydrate utilization. More importantly, multiple genes responsible for glycolysis (glcK and pykA), acidogenesis (thlA, crt, etfA, etfB and bcd) and solventogenesis (ctfB and bdhA) of C. acetobutylicum prominently responded to the supplementary zinc at differential expression levels. Comparative analysis of intracellular metabolites revealed that the branch node intermediates such as acetyl-CoA, acetoacetyl-CoA, butyl-CoA, and reducing power NADH remained relatively lower whereas more ATP was generated due to enhanced glycolysis pathway and earlier initiation of solventogenesis, suggesting that the micronutrient zinc-associated response for the selected intracellular metabolisms is significantly pleiotropic.

Can Biannual Ultrasound Surveillance Detect Smaller Second Cancers or Detect Cancers Earlier in Patients with Breast Cancer History?

PubMed

You, Jai Kyung; Song, Mi Kyung; Kim, Min Jung; Kim, Eun-Kyung; Moon, Hee Jung; Youk, Ji Hyun; Yoon, Jung Hyun; Park, Vivian Youngjean; Park, Seho; Kim, Seung Il; Park, Byeong-Woo

2018-07-01

The aim of the work described here was to evaluate whether surveillance with biannual ultrasound (US) plus annual mammography (biannual group) for women with a history of breast cancer surgery results in earlier detection or in the detection of smaller second cancers than annual US plus mammography (annual group). Additionally, we compared the prevalence of distant metastases or palpable second cancers between the biannual and annual groups. The institutional review board of our institution approved this retrospective study, and patient consent was waived. Between January 2011 and December 2012, we retrospectively reviewed the clinical and imaging follow-up of 3023 patients with mammographic and US surveillance after breast cancer surgery to assess second cancers detected by local surveillance (locoregional recurrence, contralateral breast cancer or distant metastasis). The biannual and annual groups were divided with respect to the mean surveillance interval and compared with respect to clinicopathologic findings. Multivariable logistic regression with propensity score methods was used to examine the effect of the type of surveillance on outcomes. As for the size of the second cancer, no difference was seen between the biannual and annual groups (12.8 ± 6.6 mm vs. 14.1 ± 7.1 mm, p = 0.461); neither was there a significant difference between the groups in the presence of symptoms at the time of diagnosis of the second cancer (17.0% [8/47] vs. 10% [2/20], p = 0.711). Regardless of detection by local surveillance, the prevalence of distant metastases did not differ between the two groups (1.1% [27/2370] vs. 1.0% [7/653], p = 0.88) on univariate or multivariate analysis. The results of our retrospective study indicate that second cancers detected by biannual US surveillance in patients with a history of breast cancer surgery are not smaller and do not occur earlier than those detected by annual US surveillance. However, a randomized

24 CFR 902.68 - Technical review of results of PHAS physical condition indicator.

Code of Federal Regulations, 2012 CFR

2012-04-01

... physical condition indicator. 902.68 Section 902.68 Housing and Urban Development REGULATIONS RELATING TO... review of results of PHAS physical condition indicator. (a) Request for technical reviews. This section describes the process for requesting and granting technical reviews of physical inspection results. (1) For...

24 CFR 902.68 - Technical review of results of PHAS physical condition indicator.

Code of Federal Regulations, 2014 CFR

2014-04-01

... physical condition indicator. 902.68 Section 902.68 Housing and Urban Development REGULATIONS RELATING TO... review of results of PHAS physical condition indicator. (a) Request for technical reviews. This section describes the process for requesting and granting technical reviews of physical inspection results. (1) For...

24 CFR 902.68 - Technical review of results of PHAS physical condition indicator.

Code of Federal Regulations, 2013 CFR

2013-04-01

... physical condition indicator. 902.68 Section 902.68 Housing and Urban Development REGULATIONS RELATING TO... review of results of PHAS physical condition indicator. (a) Request for technical reviews. This section describes the process for requesting and granting technical reviews of physical inspection results. (1) For...

Economic Costs Avoided by Diagnosing Melanoma Six Months Earlier Justify >100 Benign Biopsies.

PubMed

Aires, Daniel J; Wick, Jo; Shaath, Tarek S; Rajpara, Anand N; Patel, Vikas; Badawi, Ahmed H; Li, Cicy; Fraga, Garth R; Doolittle, Gary; Liu, Deede Y

2016-05-01

New melanoma drugs bring enormous benefits but do so at significant costs. Because melanoma grows deeper and deadlier over time, deeper lesions are costlier due to increased sentinel lymph node biopsy, chemotherapy, and disease-associated income loss. Prior studies have justified pigmented lesion biopsies on a "value per life" basis; by contrast we sought to assess how many biopsies are justified per melanoma found on a purely economic basis. We modeled how melanomas in the United States would behave if diagnosis were delayed by 6 months, eg, not biopsied, only observed until the next surveillance visit. Economic loss from delayed biopsy is the obverse of economic benefit of performing biopsy earlier. Growth rates were based on Liu et al. The results of this study can be applied to all patients presenting to dermatologists with pigmented skin lesions suspicious for melanoma. In-situ melanomas were excluded because no studies to date have modeled growth rates analogous to those for invasive melanoma. We assume conservatively that all melanomas not biopsied initially will be biopsied and treated 6 months later. Major modeled costs are (1) increased sentinel lymph node biopsy, (2) increased chemotherapy for metastatic lesions using increased 5-yr death as metastasis marker, and (3) income loss per melanoma death at $413,370 as previously published. Costs avoided by diagnosing melanoma earlier justify 170 biopsies per melanoma found. Efforts to penalize "unnecessary" biopsies may be economically counterproductive.

J Drugs Dermatol. 2016;15(5):527-532.

New forecasting methodology indicates more disease and earlier mortality ahead for today's younger Americans.

PubMed

Reither, Eric N; Olshansky, S Jay; Yang, Yang

2011-08-01

Traditional methods of projecting population health statistics, such as estimating future death rates, can give inaccurate results and lead to inferior or even poor policy decisions. A new "three-dimensional" method of forecasting vital health statistics is more accurate because it takes into account the delayed effects of the health risks being accumulated by today's younger generations. Applying this forecasting technique to the US obesity epidemic suggests that future death rates and health care expenditures could be far worse than currently anticipated. We suggest that public policy makers adopt this more robust forecasting tool and redouble efforts to develop and implement effective obesity-related prevention programs and interventions.

Thoracic sympathectomy for hyperhidrosis: from surgical indications to clinical results

PubMed Central

Araújo, José Augusto

2017-01-01

Sympathectomy and its variations have been performed in thoracic surgery for more than 100 years. However, its indications have undergone profound modifications in this period. Likewise, since then the surgical technique has also evolved dramatically up to the minimally invasive techniques worldwide accessible in present days. Currently, primary hyperhidrosis is, by far, the main indication for thoracic sympathectomy and this procedure is usually carried out thoracoscopically with excellent results. However, until today, hyperhidrosis is a part of thoracic surgery still surrounded by controversy, persisting as an open field over which some confusion still resides regarding its pathophysiology, terms definitions and operative approaches. The aim of this article is to provide a wide but easily comprehensible review of the theme, discussing and clarifying the major concepts with respect to its clinical presentation, all the presently available treatment options and strategies with their potential benefits and risks, the adequate patient selection for sympathectomy, as well as the postoperative clinical results. PMID:28446983

Thoracic sympathectomy for hyperhidrosis: from surgical indications to clinical results.

PubMed

Vannucci, Fernando; Araújo, José Augusto

2017-04-01

Sympathectomy and its variations have been performed in thoracic surgery for more than 100 years. However, its indications have undergone profound modifications in this period. Likewise, since then the surgical technique has also evolved dramatically up to the minimally invasive techniques worldwide accessible in present days. Currently, primary hyperhidrosis is, by far, the main indication for thoracic sympathectomy and this procedure is usually carried out thoracoscopically with excellent results. However, until today, hyperhidrosis is a part of thoracic surgery still surrounded by controversy, persisting as an open field over which some confusion still resides regarding its pathophysiology, terms definitions and operative approaches. The aim of this article is to provide a wide but easily comprehensible review of the theme, discussing and clarifying the major concepts with respect to its clinical presentation, all the presently available treatment options and strategies with their potential benefits and risks, the adequate patient selection for sympathectomy, as well as the postoperative clinical results.

24 CFR 902.68 - Technical review of results of PHAS physical condition indicator.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Technical review of results of PHAS physical condition indicator. 902.68 Section 902.68 Housing and Urban Development REGULATIONS RELATING TO... review of results of PHAS physical condition indicator. (a) Request for technical reviews. This section...

49 CFR 219.611 - Test result indicating prohibited alcohol concentration; procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Random Alcohol and Drug Testing Programs § 219.611 Test result indicating prohibited alcohol...

49 CFR 219.611 - Test result indicating prohibited alcohol concentration; procedures.

Code of Federal Regulations, 2012 CFR

2012-10-01

... (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Random Alcohol and Drug Testing Programs § 219.611 Test result indicating prohibited alcohol...

49 CFR 219.611 - Test result indicating prohibited alcohol concentration; procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Random Alcohol and Drug Testing Programs § 219.611 Test result indicating prohibited alcohol...

49 CFR 219.611 - Test result indicating prohibited alcohol concentration; procedures.

Code of Federal Regulations, 2014 CFR

2014-10-01

... (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Random Alcohol and Drug Testing Programs § 219.611 Test result indicating prohibited alcohol...

49 CFR 219.611 - Test result indicating prohibited alcohol concentration; procedures.

Code of Federal Regulations, 2013 CFR

2013-10-01

... (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Random Alcohol and Drug Testing Programs § 219.611 Test result indicating prohibited alcohol...

An earlier age of breast cancer diagnosis related to more frequent use of antiperspirants/deodorants and underarm shaving.

PubMed

McGrath, K G

2003-12-01

Breast cancer incidence suggests a lifestyle cause. A lifestyle factor used near the breast is the application of antiperspirants/deodorants accompanied by axillary shaving. A previous study did not support a link with breast cancer. If these habits have a role in breast cancer development, women using antiperspirants/deodorants and shaving their underarms frequently would be expected to have an earlier age of diagnosis than those doing so less often. An earlier age of diagnosis would also be expected in those starting to use deodorants and shaving at an earlier age. This is the first study to investigate the intensity of underarm exposure in a cohort of breast cancer survivors. Four hundred and thirty-seven females diagnosed with breast cancer were surveyed. Once grouped by their frequency of underarm hygiene habits, the mean age of diagnosis was the primary end point. Secondary end points included the overall frequency of these habits, and potential usage group confounding variables were evaluated. All statistical tests were two-sided. Frequency and earlier onset of antiperspirant/deodorant usage with underarm shaving were associated with an earlier age of breast cancer diagnosis. Combined habits are likely for this earlier age of diagnosis. In conclusion, underarm shaving with antiperspirant/deodorant use may play a role in breast cancer. It is not clear which of these components are involved. Reviewed literature insinuates absorption of aluminium salts facilitated by dermal barrier disruption. Case-controlled investigations are needed before alternative underarm hygiene habits are suggested.

Antiretroviral treatment-based cost saving interventions may offset expenses for new patients and earlier treatment start.

PubMed

Angeletti, C; Pezzotti, P; Antinori, A; Mammone, A; Navarra, A; Orchi, N; Lorenzini, P; Mecozzi, A; Ammassari, A; Murachelli, S; Ippolito, G; Girardi, E

2014-03-01

Combination antiretroviral therapy (cART) has become the main driver of total costs of caring for persons living with HIV (PLHIV). The present study estimated the short/medium-term cost trends in response to the recent evolution of national guidelines and regional therapeutic protocols for cART in Italy. We developed a deterministic mathematical model that was calibrated using epidemic data for Lazio, a region located in central Italy with about six million inhabitants. In the Base Case Scenario, the estimated number of PLHIV in the Lazio region increased over the period 2012-2016 from 14 414 to 17 179. Over the same period, the average projected annual cost for treating the HIV-infected population was €147.0 million. An earlier cART initiation resulted in a rise of 2.3% in the average estimated annual cost, whereas an increase from 27% to 50% in the proportion of naïve subjects starting cART with a nonnucleoside reverse transcriptase inhibitor (NNRTI)-based regimen resulted in a reduction of 0.3%. Simplification strategies based on NNRTIs co-formulated in a single tablet regimen and protease inhibitor/ritonavir-boosted monotherapy produced an overall reduction in average annual costs of 1.5%. A further average saving of 3.3% resulted from the introduction of generic antiretroviral drugs. In the medium term, cost saving interventions could finance the increase in costs resulting from the inertial growth in the number of patients requiring treatment and from the earlier treatment initiation recommended in recent guidelines. © 2013 British HIV Association.

Spring Indices (SI): National (and Global) Indicators of Climate Impacts on Ecosystems and Society

NASA Astrophysics Data System (ADS)

Betancourt, J. L.; Schwartz, M. D.; Ault, T. R.; McCabe, G. J.; Macalady, A. K.; Pederson, G. T.; Cook, B. P.; Henebry, G. M.; Moore, D. J.; Enquist, C.

2011-12-01

Indicators are vital in everyday life, such as tracking blood pressure to assess your health or monitoring the nation's economy using unemployment rates. Tracking the state of the environment in a uniform and integrated manner requires simple and broadly-applicable indicators of year-to-year variability and change. For example, indices such as the Start of Season (SOS) in remotely-sensed land surface phenology, Center of Mass (CM) in the hydrology of snowfed inland waters, and other biogeophysical metrics are being widely used as metrics of global change in seasonal timing. Here, we present a new, standardized spring index (SSI) that uses only daily minimum and maximum temperatures as input. This builds on an earlier version of the spring indices (SI) for lilac and honeysuckle phenology (first leaf and first flower) that required plant chilling to be satisfied over winter. The SSI tracks the transition from winter to spring by tallying phenologically relevant variables, (such as the number and intensity of warm days and total hours of sunlight) from January 1st onward, while ignoring the chilling requirement. This adjustment allows determination of first leaf and first bloom dates across the entire USA, including southernmost latitudes. Outputs from the new SSI is highly correlated with the earlier version, and both models process weather data into indices directly related to growth and development of many plants. Spatially averaged anomalies of SSI are well correlated with remotely sensed data and phenological observations from a wide variety of trees and shrubs in Europe, China, and North America. An advantage of SSI is that it only "sees" the atmosphere, meaning that it is free of local biological effects. Therefore, it can enhance the ability to identify important relationships between the large-scale climate modes of variability and the index itself, an advantage over other plant-based indices (such as SOS). If the state of these atmospheric modes can be

Diagnosis of varicoceles in men undergoing vasectomy may lead to earlier detection of hypogonadism.

PubMed

Liu, Joceline S; Jones, Madeline; Casey, Jessica T; Fuchs, Amanda B; Cashy, John; Lin, William W

2014-06-01

To determine the temporal relationship between vasectomy, varicocele, and hypogonadism diagnosis. Many young men undergo their first thorough genitourinary examination in their adult lives at the time of vasectomy consultation, providing a unique opportunity for diagnosis of asymptomatic varicoceles. Varicoceles have recently been implicated as a possible reversible contributor to hypogonadism. Hypogonadism may be associated with significant adverse effect, including decreased libido, impaired cognitive function, and increased cardiovascular events. Early diagnosis and treatment of hypogonadism may prevent these adverse sequelae. Data were collected from the Truven Health Analytics MarketScan database, a large outpatient claims database. We reviewed records between 2003 and 2010 for male patients between the ages of 25 and 50 years with International Classification of Diseases, Ninth Revision codes for hypogonadism, vasectomy, and varicocele, and queried dates of first claim. A total of 15,679 men undergoing vasectomies were matched with 156,790 men with nonvasectomy claims in the same year. Vasectomy patients were diagnosed with varicocele at an earlier age (40.9 vs 42.5 years; P=.009). We identified 224,817 men between the ages of 25 and 50 years with a claim of hypogonadism, of which 5883 (2.6%) also had a claim of varicocele. Men with hypogonadism alone were older at presentation compared with men with an accompanying varicocele (41.3 [standard deviation±6.5] vs 34.9 [standard deviation±6.1]; P<.001). Men undergoing vasectomies are diagnosed with varicoceles at a younger age than age-matched controls. Men with varicoceles present with hypogonadism earlier than men without varicoceles. Earlier diagnosis of varicocele at the time of vasectomy allows for earlier detection of hypogonadism. Copyright © 2014 Elsevier Inc. All rights reserved.

Earlier and greater hand pre-shaping in the elderly: a study based on kinematic analysis of reaching movements to grasp objects.

PubMed

Tamaru, Yoshiki; Naito, Yasuo; Nishikawa, Takashi

2017-11-01

Elderly people are less able to manipulate objects skilfully than young adults. Although previous studies have examined age-related deterioration of hand movements with a focus on the phase after grasping objects, the changes in the reaching phase have not been studied thus far. We aimed to examine whether changes in hand shape patterns during the reaching phase of grasping movements differ between young adults and the elderly. Ten healthy elderly adults and 10 healthy young adults were examined using the Simple Test for Evaluating Hand Functions and kinetic analysis of hand pre-shaping reach-to-grasp tasks. The results were then compared between the two groups. For kinetic analysis, we measured the time of peak tangential velocity of the wrist and the inter-fingertip distance (the distance between the tips of the thumb and index finger) at different time points. The results showed that the elderly group's performance on the Simple Test for Evaluating Hand Functions was significantly lower than that of the young adult group, irrespective of whether the dominant or non-dominant hand was used, indicating deterioration of hand movement in the elderly. The peak tangential velocity of the wrist in either hand appeared significantly earlier in the elderly group than in the young adult group. The elderly group also showed larger inter-fingertip distances with arch-like fingertip trajectories compared to the young adult group for all object sizes. To perform accurate prehension, elderly people have an earlier peak tangential velocity point than young adults. This allows for a longer adjustment time for reaching and grasping movements and for reducing errors in object prehension by opening the hand and fingers wider. Elderly individuals gradually modify their strategy based on previous successes and failures during daily living to compensate for their decline in dexterity and operational capabilities. © 2017 Japanese Psychogeriatric Society.

A reversal of the shift towards earlier spring phenology in several Mediterranean reptiles and amphibians during the 1998-2013 warming slowdown.

PubMed

Prodon, Roger; Geniez, Philippe; Cheylan, Marc; Devers, Florence; Chuine, Isabelle; Besnard, Aurelien

2017-12-01

Herps, especially amphibians, are particularly susceptible to climate change, as temperature tightly controls many parameters of their biological cycle-above all, their phenology. The timing of herps' activity or migration period-in particular the dates of their first appearance in spring and first breeding-and the shift to earlier dates in response to warming since the last quarter of the 20 th century has often been described up to now as a nearly monotonic trend towards earlier phenological events. In this study, we used citizen science data opportunistically collected on reptiles and amphibians in the northern Mediterranean basin over a period of 32 years to explore temporal variations in herp phenology. For 17 common species, we measured shifts in the date of the species' first spring appearance-which may be the result of current changes in climate-and regressed the first appearance date against temperatures and precipitations. Our results confirmed the expected overall trend towards earlier first spring appearances from 1983 to 1997, and show that the first appearance date of both reptiles and amphibians fits well with the temperature in late winter. However, the trend towards earlier dates was stopped or even reversed in most species between 1998 and 2013. We interpret this reversal as a response to cooling related to the North Atlantic Oscillation (NAO) in the late winter and early spring. During the positive NAO episodes, for certain species only (mainly amphibians), the effect of a warm weather, which tends to advance the phenology, seems to be counterbalanced by the adverse effects of the relative dryness. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

Earlier parental set bedtimes as a protective factor against depression and suicidal ideation.

PubMed

Gangwisch, James E; Babiss, Lindsay A; Malaspina, Dolores; Turner, J Blake; Zammit, Gary K; Posner, Kelly

2010-01-01

To examine the relationships between parental set bedtimes, sleep duration, and depression as a quasi-experiment to explore the potentially bidirectional relationship between short sleep duration and depression. Short sleep duration has been shown to precede depression, but this could be explained as a prodromal symptom of depression. Depression in an adolescent can affect his/her chosen bedtime, but it is less likely to affect a parent's chosen set bedtime which can establish a relatively stable upper limit that can directly affect sleep duration. Multivariate cross-sectional analyses of the ADD Health using logistic regression. United States nationally representative, school-based, probability-based sample in 1994-96. Adolescents (n = 15,659) in grades 7 to 12. Adolescents with parental set bedtimes of midnight or later were 24% more likely to suffer from depression (OR = 1.24, 95% CI 1.04-1.49) and 20% more likely to have suicidal ideation (1.20, 1.01-1.41) than adolescents with parental set bedtimes of 10:00 PM or earlier, after controlling for covariates. Consistent with sleep duration and perception of getting enough sleep acting as mediators, the inclusion of these variables in the multivariate models appreciably attenuated the associations for depression (1.07, 0.88-1.30) and suicidal ideation (1.09, 0.92-1.29). The results from this study provide new evidence to strengthen the argument that short sleep duration could play a role in the etiology of depression. Earlier parental set bedtimes could therefore be protective against adolescent depression and suicidal ideation by lengthening sleep duration.

Earlier Right Ventricular Pacing in Cardiac Resynchronization Therapy for a Patient with Right Axis Deviation.

PubMed

Hattori, Yusuke; Ishibashi, Kohei; Noda, Takashi; Okamura, Hideo; Kanzaki, Hideaki; Anzai, Toshihisa; Yasuda, Satoshi; Kusano, Kengo

2017-09-01

We describe the case of a 37-year-old woman who presented with complete right bundle branch block and right axis deviation. She was admitted to our hospital due to severe heart failure and was dependent on inotropic agents. Cardiac resynchronization therapy was initiated but did not improve her condition. After the optimization of the pacing timing, we performed earlier right ventricular pacing, which led to an improvement of her heart failure. Earlier right ventricular pacing should be considered in patients with complete right bundle branch block and right axis deviation when cardiac resynchronization therapy is not effective.

Earlier versus later continuous Kangaroo Mother Care (KMC) for stable low-birth-weight infants: a randomized controlled trial.

PubMed

Nagai, S; Andrianarimanana, D; Rabesandratana, N; Yonemoto, N; Nakayama, T; Mori, R

2010-06-01

The aim of this study was to examine the effectiveness of earlier continuous Kangaroo Mother Care (KMC) for relatively stable low-birth-weight (LBW) infants in a resource-limited country. A randomized controlled trial was performed in LBW infants at a referral hospital in Madagascar. Earlier continuous KMC (intervention) was begun as soon as possible, within 24 h postbirth, and later continuous KMC (control: conventional care) was begun after complete stabilization (generally after 24 h postbirth). Main outcome measure was mortality during the first 28 days postbirth. This trial was registered with ClinicalTrials.gov, NCT00531492. A total of 73 infants (intervention 37, control 36) were included. Earlier continuous KMC had higher but no statistically different mortality in the first 28 days postbirth (1 vs. 2; risk ratio, 1.95; 95% CIs, 0.18-20.53; p = 1.00). There were no differences in incidence of morbidities. Body weight loss from birth to 24 h postbirth was significantly less in earlier KMC infants compared with later KMC infants. (-34.81 g vs. -73.97 g; mean difference, 39.16 g; 95% CIs, 10.30-68.03; p = 0.01; adjusted p = 0.02). Adverse events and duration of hospitalization were not different between the two groups. Further evaluations of earlier continuous KMC including measurement of KMC dose, are needed in resource-limited countries.

[Confirming Indicators of Qualitative Results by Chromatography-mass Spectrometry in Biological Samples].

PubMed

Liu, S D; Zhang, D M; Zhang, W; Zhang, W F

2017-04-01

Because of the exist of complex matrix, the confirming indicators of qualitative results for toxic substances in biological samples by chromatography-mass spectrometry are different from that in non-biological samples. Even in biological samples, the confirming indicators are different in various application areas. This paper reviews the similarities and differences of confirming indicators for the analyte in biological samples by chromatography-mass spectrometry in the field of forensic toxicological analysis and other application areas. These confirming indicators include retention time （RT）, relative retention time （RRT）, signal to noise （S/N）, characteristic ions, relative abundance of characteristic ions, parent ion-daughter ion pair and abundance ratio of ion pair, etc. Copyright© by the Editorial Department of Journal of Forensic Medicine.

Southern P indices, water quality data, and modeling results: a comparison

USDA-ARS?s Scientific Manuscript database

Phosphorus (P) indices in the south frequently produce different results for similar conditions. After collecting data from benchmark sites throughout the south (6 Arkansas, 1 Georgia, 2 Mississippi, 4 North Carolina, 4 Oklahoma, and 4 Texas site/treatment water quality and land treatment data sets...

Can social media data lead to earlier detection of drug-related adverse events?

PubMed

Duh, Mei Sheng; Cremieux, Pierre; Audenrode, Marc Van; Vekeman, Francis; Karner, Paul; Zhang, Haimin; Greenberg, Paul

2016-12-01

To compare the patient characteristics and the inter-temporal reporting patterns of adverse events (AEs) for atorvastatin (Lipitor ® ) and sibutramine (Meridia ® ) in social media (AskaPatient.com) versus the FDA Adverse Event Reporting System (FAERS). We identified clinically important AEs associated with atorvastatin (muscle pain) and sibutramine (cardiovascular AEs), compared their patterns in social media postings versus FAERS and used Granger causality tests to assess whether social media postings were useful in forecasting FAERS reports. We analyzed 998 and 270 social media postings between 2001 and 2014, 69 003 and 7383 FAERS reports between 1997 and 2014 for atorvastatin and sibutramine, respectively. Social media reporters were younger (atorvastatin: 53.9 vs. 64.0 years, p < 0.001; sibutramine: 36.8 vs. 43.8 years, p < 0.001). Social media reviews contained fewer serious AEs (atorvastatin, pain: 2.5% vs. 38.2%; sibutramine, cardiovascular issues: 7.9% vs. 63.0%; p < 0.001 for both) and concentrated on fewer types of AEs (proportion comprising the top 20 AEs: atorvastatin, 88.7% vs. 55.4%; sibutramine, 86.3% vs. 65.4%) compared with FAERS. While social media sibutramine reviews mentioning cardiac issues helped predict those in FAERS 11 months later (p < 0.001), social media atorvastatin reviews did not help predict FAERS reports. Social media AE reporters were younger and focused on less-serious and fewer types of AEs than FAERS reporters. The potential for social media to provide earlier indications of AEs compared with FAERS is uncertain. Our findings highlight some of the promises and limitations of online social media versus conventional pharmacovigilance sources and the need for careful interpretation of the results. © 2016 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons Ltd. © 2016 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons Ltd.

Complete theory of symmetry-based indicators of band topology.

PubMed

Po, Hoi Chun; Vishwanath, Ashvin; Watanabe, Haruki

2017-06-30

The interplay between symmetry and topology leads to a rich variety of electronic topological phases, protecting states such as the topological insulators and Dirac semimetals. Previous results, like the Fu-Kane parity criterion for inversion-symmetric topological insulators, demonstrate that symmetry labels can sometimes unambiguously indicate underlying band topology. Here we develop a systematic approach to expose all such symmetry-based indicators of band topology in all the 230 space groups. This is achieved by first developing an efficient way to represent band structures in terms of elementary basis states, and then isolating the topological ones by removing the subset of atomic insulators, defined by the existence of localized symmetric Wannier functions. Aside from encompassing all earlier results on such indicators, including in particular the notion of filling-enforced quantum band insulators, our theory identifies symmetry settings with previously hidden forms of band topology, and can be applied to the search for topological materials.Understanding the role of topology in determining electronic structure can lead to the discovery, or appreciation, of materials with exotic properties such as protected surface states. Here, the authors present a framework for identifying topologically distinct band-structures for all 3D space groups.

A Review of Quality of Life after Predictive Testing for and Earlier Identification of Neurodegenerative Diseases

PubMed Central

Paulsen, Jane S.; Nance, Martha; Kim, Ji-In; Carlozzi, Noelle E.; Panegyres, Peter K.; Erwin, Cheryl; Goh, Anita; McCusker, Elizabeth; Williams, Janet K.

2013-01-01

The past decade has witnessed an explosion of evidence suggesting that many neurodegenerative diseases can be detected years, if not decades, earlier than previously thought. To date, these scientific advances have not provoked any parallel translational or clinical improvements. There is an urgency to capitalize on this momentum so earlier detection of disease can be more readily translated into improved health-related quality of life for families at risk for, or suffering with, neurodegenerative diseases. In this review, we discuss health-related quality of life (HRQOL) measurement in neurodegenerative diseases and the importance of these “patient reported outcomes” for all clinical research. Next, we address HRQOL following early identification or predictive genetic testing in some neurodegenerative diseases: Huntington disease, Alzheimer's disease, Parkinson's disease, Dementia with Lewy bodies, frontotemporal dementia, amyotrophic lateral sclerosis, prion diseases, hereditary ataxias, Dentatorubral-pallidoluysian atrophy and Wilson's disease. After a brief report of available direct-to-consumer genetic tests, we address the juxtaposition of earlier disease identification with assumed reluctance towards predictive genetic testing. Forty-one studies examining health related outcomes following predictive genetic testing for neurodegenerative disease suggested that (a) extreme or catastrophic outcomes are rare; (b) consequences commonly include transiently increased anxiety and/or depression; (c) most participants report no regret; (d) many persons report extensive benefits to receiving genetic information; and (e) stigmatization and discrimination for genetic diseases are poorly understood and policy and laws are needed. Caution is appropriate for earlier identification of neurodegenerative diseases but findings suggest further progress is safe, feasible and likely to advance clinical care. PMID:24036231

Empirical corroboration of an earlier theoretical resolution to the UV paradox of insect polarized skylight orientation.

PubMed

Wang, Xin; Gao, Jun; Fan, Zhiguo

2014-02-01

It is surprising that many insect species use only the ultraviolet (UV) component of the polarized skylight for orientation and navigation purposes, while both the intensity and the degree of polarization of light from the clear sky are lower in the UV than at longer (blue, green, red) wavelengths. Why have these insects chosen the UV part of the polarized skylight? This strange phenomenon is called the "UV-sky-pol paradox". Although earlier several speculations tried to resolve this paradox, they did this without any quantitative data. A theoretical and computational model has convincingly explained why it is advantageous for certain animals to detect celestial polarization in the UV. We performed a sky-polarimetric approach and built a polarized skylight sensor that models the processing of polarization signals by insect photoreceptors. Using this model sensor, we carried out measurements under clear and cloudy sky conditions. Our results showed that light from the cloudy sky has maximal degree of polarization in the UV. Furthermore, under both clear and cloudy skies the angle of polarization of skylight can be detected with a higher accuracy. By this, we corroborated empirically the soundness of the earlier computational resolution of the UV-sky-pol paradox.

Empirical corroboration of an earlier theoretical resolution to the UV paradox of insect polarized skylight orientation

NASA Astrophysics Data System (ADS)

Wang, Xin; Gao, Jun; Fan, Zhiguo

2014-02-01

It is surprising that many insect species use only the ultraviolet (UV) component of the polarized skylight for orientation and navigation purposes, while both the intensity and the degree of polarization of light from the clear sky are lower in the UV than at longer (blue, green, red) wavelengths. Why have these insects chosen the UV part of the polarized skylight? This strange phenomenon is called the "UV-sky-pol paradox". Although earlier several speculations tried to resolve this paradox, they did this without any quantitative data. A theoretical and computational model has convincingly explained why it is advantageous for certain animals to detect celestial polarization in the UV. We performed a sky-polarimetric approach and built a polarized skylight sensor that models the processing of polarization signals by insect photoreceptors. Using this model sensor, we carried out measurements under clear and cloudy sky conditions. Our results showed that light from the cloudy sky has maximal degree of polarization in the UV. Furthermore, under both clear and cloudy skies the angle of polarization of skylight can be detected with a higher accuracy. By this, we corroborated empirically the soundness of the earlier computational resolution of the UV-sky-pol paradox.

Traumatic brain injury history is associated with an earlier age of dementia onset in autopsy-confirmed Alzheimer's disease.

PubMed

Schaffert, Jeff; LoBue, Christian; White, Charles L; Chiang, Hsueh-Sheng; Didehbani, Nyaz; Lacritz, Laura; Rossetti, Heidi; Dieppa, Marisara; Hart, John; Cullum, C Munro

2018-05-01

To evaluate whether a history of traumatic brain injury (TBI) with reported loss of consciousness (LOC) is a risk factor for earlier onset of Alzheimer's disease (AD) in an autopsy-confirmed sample. Data from 2,133 participants with autopsy-confirmed AD (i.e., at least Braak neurofibrillary tangle stages III to VI and CERAD neuritic plaque score moderate to frequent) were obtained from the National Alzheimer's Coordinating Center (NACC). Participants were categorized by presence/absence of self-reported remote (i.e., >1 year prior to their first Alzheimer's Disease Center visit) history of TBI with LOC (TBI+ vs. TBI-). Analyses of Covariance (ANCOVA) controlling for sex, education, and race compared groups on clinician-estimated age of symptom onset and age of diagnosis. Average age of onset was 2.34 years earlier (p = .01) for the TBI+ group (n = 194) versus the TBI- group (n = 1900). Dementia was diagnosed on average 2.83 years earlier (p = .002) in the TBI+ group (n = 197) versus the TBI- group (n = 1936). Using more stringent neuropathological criteria (i.e., Braak stages V-VI and CERAD frequent), both age of AD onset and diagnosis were 3.6 years earlier in the TBI+ group (both p's < .001). History of TBI with reported LOC appears to be a risk factor for earlier AD onset. This is the first study to use autopsy-confirmed cases, supporting previous investigations that used clinical criteria for the diagnosis of AD. Further investigation as to possible underlying mechanisms of association is needed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Earlier Pulmonary Valve Replacement in Down Syndrome Patients Following Tetralogy of Fallot Repair.

PubMed

Sullivan, Rachel T; Frommelt, Peter C; Hill, Garick D

2017-08-01

The association between Down syndrome and pulmonary hypertension could contribute to more severe pulmonary regurgitation after tetralogy of Fallot repair and possibly earlier pulmonary valve replacement. We compared cardiac magnetic resonance measures of pulmonary regurgitation and right ventricular dilation as well as timing of pulmonary valve replacement between those with and without Down syndrome after tetralogy of Fallot repair. Review of our surgical database from 2000 to 2015 identified patients with tetralogy of Fallot with pulmonary stenosis. Those with Down syndrome were compared to those without. The primary outcome of interest was time from repair to pulmonary valve replacement. Secondary outcomes included pulmonary regurgitation and indexed right ventricular volume on cardiac magnetic resonance imaging. The cohort of 284 patients included 35 (12%) with Down syndrome. Transannular patch repair was performed in 210 (74%). Down syndrome showed greater degree of pulmonary regurgitation (55 ± 14 vs. 37 ± 16%, p = 0.01) without a significantly greater rate of right ventricular dilation (p = 0.09). In multivariable analysis, Down syndrome (HR 2.3, 95% CI 1.2-4.5, p = 0.02) and transannular patch repair (HR 5.5, 95% CI 1.7-17.6, p = 0.004) were significant risk factors for valve replacement. Those with Down syndrome had significantly lower freedom from valve replacement (p = 0.03). Down syndrome is associated with an increased degree of pulmonary regurgitation and earlier pulmonary valve replacement after tetralogy of Fallot repair. These patients require earlier assessment by cardiac magnetic resonance imaging to determine timing of pulmonary valve replacement and evaluation for and treatment of preventable causes of pulmonary hypertension.

40 CFR 87.21 - Exhaust emission standards for Tier 4 and earlier engines.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Emissions (New Aircraft Gas Turbine Engines) § 87.21 Exhaust emission standards for Tier 4 and earlier... standards. (a) Exhaust emissions of smoke from each new aircraft gas turbine engine of class T8 manufactured... from each new aircraft gas turbine engine of class TF and of rated output of 129 kilonewtons thrust or...

40 CFR 87.21 - Exhaust emission standards for Tier 4 and earlier engines.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Emissions (New Aircraft Gas Turbine Engines) § 87.21 Exhaust emission standards for Tier 4 and earlier... standards. (a) Exhaust emissions of smoke from each new aircraft gas turbine engine of class T8 manufactured... from each new aircraft gas turbine engine of class TF and of rated output of 129 kilonewtons thrust or...

Climate-induced alteration of hydrologic indicators in the Athabasca River Basin, Alberta, Canada

NASA Astrophysics Data System (ADS)

Eum, Hyung-Il; Dibike, Yonas; Prowse, Terry

2017-01-01

The hydrologic response of the Athabasca River Basin (ARB) in Alberta to projected changes in the future climate is investigated using the Variable Infiltration Capacity (VIC) process-based and distributed hydrologic model. The model forcings are derived from a selected set of GCMs from the latest Coupled Model Intercomparison Project (CMIP5) statistically downscaled to a higher resolution (10 km) over Canada. Twelve hydrologic indicators that represent the magnitude and timing of the hydrologic regimes are evaluated for three 30-year time periods centered at the 1990s, 2050s and 2080s to identify significant alterations of hydrologic regimes between the reference and the two future periods using a t-test at 5% significance level. Hydrologic alteration factors (HAF) are also evaluated for each hydrologic indicator using the range of variability approach (RVA) to investigate projected changes in the distribution of these indicators. The results show increases in spring and winter flows for the two future periods at all hydrometric stations within the basin, resulting in an extended period of spring freshet. A higher rate of increase is projected for the stations located at the upper reach of the river because of the combined effects of increased precipitation and earlier snowmelt resulting from a warming climate. By contrast, summer flows are projected to decrease by up to 21% on average in the 2080s over most of the mainstem stations because of earlier snowmelt, increased evapotranspiration and no significant increase in summer precipitation. A water-management rule that optimizes impacts of water withdrawal from the lower reach of the Athabasca River under the current condition is also applied to the future scenarios to assess its relative performance under the projected climate conditions. The results indicate possible improvement in the water resources system performance in terms of increased reliability and resilience and reduced vulnerability during the two

Number of Diverticulitis Episodes Before Resection and Factors Associated With Earlier Interventions

PubMed Central

Simianu, Vlad V.; Fichera, Alessandro; Bastawrous, Amir L.; Davidson, Giana H.; Florence, Michael G.; Thirlby, Richard C.; Flum, David R.

2016-01-01

IMPORTANCE Despite professional recommendations to delay elective colon resection for patients with uncomplicated diverticulitis, early surgery (after <3 preceding episodes) appears to be common. Several factors have been suggested to contribute to early surgery, including increasing numbers of younger patients, a lower threshold to operate laparoscopically, and growing recognition of “smoldering” (or nonrecovering) diverticulitis episodes. However, the relevance of these factors in early surgery has not been well tested, and most prior studies have focused on hospitalizations, missing outpatient events and making it difficult to assess guideline adherence in earlier interventions. OBJECTIVE To describe patterns of episodes of diverticulitis before surgery and factors associated with earlier interventions using inpatient, outpatient, and antibiotic prescription claims. DESIGN, SETTING, AND PARTICIPANTS This investigation was a nationwide retrospective cohort study from January 1, 2009, to December 31, 2012. The dates of the analysis were July 2014 to May 2015. Participants were immunocompetent adult patients (age range, 18-64 years) with incident, uncomplicated diverticulitis. EXPOSURE Elective colectomy for diverticulitis. MAIN OUTCOMES AND MEASURES Inpatient, outpatient, and antibiotic prescription claims for diverticulitis captured in the MarketScan (Truven Health Analytics) databases. RESULTS Of 87 461 immunocompetent patients having at least 1 claim for diverticulitis, 6.4% (n = 5604) underwent a resection. The final study cohort comprised 3054 nonimmunocompromised patients who underwent elective resection for uncomplicated diverticulitis, of whom 55.6% (n = 1699) were male. Before elective surgery, they had a mean (SD) of 1.0 (0.9) inpatient claims, 1.5 (1.5) outpatient claims, and 0.5 (1.2) antibiotic prescription claims related to diverticulitis. Resection occurred after fewer than 3 episodes in 94.9% (2897 of 3054) of patients if counting inpatient

[Practice report: the process-based indicator dashboard. Visualising quality assurance results in standardised processes].

PubMed

Petzold, Thomas; Hertzschuch, Diana; Elchlep, Frank; Eberlein-Gonska, Maria

2014-01-01

Process management (PM) is a valuable method for the systematic analysis and structural optimisation of the quality and safety of clinical treatment. PM requires a high motivation and willingness to implement changes of both employees and management. Definition of quality indicators is required to systematically measure the quality of the specified processes. One way to represent comparable quality results is the use of quality indicators of the external quality assurance in accordance with Sect. 137 SGB V—a method which the Federal Joint Committee (GBA) and the institutions commissioned by the GBA have employed and consistently enhanced for more than ten years. Information on the quality of inpatient treatment is available for 30 defined subjects throughout Germany. The combination of specified processes with quality indicators is beneficial for the information of employees. A process-based indicator dashboard provides essential information about the treatment process. These can be used for process analysis. In a continuous consideration of these indicator results values can be determined and errors will be remedied quickly. If due consideration is given to these indicators, they can be used for benchmarking to identify potential process improvements. Copyright © 2014. Published by Elsevier GmbH.

Facilitating earlier transfer of care from acute stroke services into the community.

PubMed

Robinson, Jennifer

This article outlines an initiative to reduce length of stay for stroke patients within an acute hospital and to facilitate earlier transfer of care. Existing care provision was remodelled and expanded to deliver stroke care to patients within a community bed-based intermediate care facility or intermediate care at home. This new model of care has improved the delivery of rehabilitation through alternative and innovative ways of addressing service delivery that meet the needs of the patients.

Principal component-based weighted indices and a framework to evaluate indices: Results from the Medical Expenditure Panel Survey 1996 to 2011

PubMed Central

Wu, Chao-Jung

2017-01-01

Producing indices composed of multiple input variables has been embedded in some data processing and analytical methods. We aim to test the feasibility of creating data-driven indices by aggregating input variables according to principal component analysis (PCA) loadings. To validate the significance of both the theory-based and data-driven indices, we propose principles to review innovative indices. We generated weighted indices with the variables obtained in the first years of the two-year panels in the Medical Expenditure Panel Survey initiated between 1996 and 2011. Variables were weighted according to PCA loadings and summed. The statistical significance and residual deviance of each index to predict mortality in the second years was extracted from the results of discrete-time survival analyses. There were 237,832 surviving the first years of panels, represented 4.5 billion civilians in the United States, of which 0.62% (95% CI = 0.58% to 0.66%) died in the second years of the panels. Of all 134,689 weighted indices, there were 40,803 significantly predicting mortality in the second years with or without the adjustment of age, sex and races. The significant indices in the both models could at most lead to 10,200 years of academic tenure for individual researchers publishing four indices per year or 618.2 years of publishing for journals with annual volume of 66 articles. In conclusion, if aggregating information based on PCA loadings, there can be a large number of significant innovative indices composing input variables of various predictive powers. To justify the large quantities of innovative indices, we propose a reporting and review framework for novel indices based on the objectives to create indices, variable weighting, related outcomes and database characteristics. The indices selected by this framework could lead to a new genre of publications focusing on meaningful aggregation of information. PMID:28886057

Daily use, especially of high-potency cannabis, drives the earlier onset of psychosis in cannabis users.

PubMed

Di Forti, Marta; Sallis, Hannah; Allegri, Fabio; Trotta, Antonella; Ferraro, Laura; Stilo, Simona A; Marconi, Arianna; La Cascia, Caterina; Reis Marques, Tiago; Pariante, Carmine; Dazzan, Paola; Mondelli, Valeria; Paparelli, Alessandra; Kolliakou, Anna; Prata, Diana; Gaughran, Fiona; David, Anthony S; Morgan, Craig; Stahl, Daniel; Khondoker, Mizanur; MacCabe, James H; Murray, Robin M

2014-11-01

Cannabis use is associated with an earlier age of onset of psychosis (AOP). However, the reasons for this remain debated. We applied a Cox proportional hazards model to 410 first-episode psychosis patients to investigate the association between gender, patterns of cannabis use, and AOP. Patients with a history of cannabis use presented with their first episode of psychosis at a younger age (mean years = 28.2, SD = 8.0; median years = 27.1) than those who never used cannabis (mean years = 31.4, SD = 9.9; median years = 30.0; hazard ratio [HR] = 1.42; 95% CI: 1.16-1.74; P < .001). This association remained significant after controlling for gender (HR = 1.39; 95% CI: 1.11-1.68; P < .001). Those who had started cannabis at age 15 or younger had an earlier onset of psychosis (mean years = 27.0, SD = 6.2; median years = 26.9) than those who had started after 15 years (mean years = 29.1, SD = 8.5; median years = 27.8; HR = 1.40; 95% CI: 1.06-1.84; P = .050). Importantly, subjects who had been using high-potency cannabis (skunk-type) every day had the earliest onset (mean years = 25.2, SD = 6.3; median years = 24.6) compared to never users among all the groups tested (HR = 1.99; 95% CI: 1.50- 2.65; P < .0001); these daily users of high-potency cannabis had an onset an average of 6 years earlier than that of non-cannabis users. Daily use, especially of high-potency cannabis, drives the earlier onset of psychosis in cannabis users. © The Author 2013. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Light pollution is associated with earlier tree budburst across the United Kingdom.

PubMed

Ffrench-Constant, Richard H; Somers-Yeates, Robin; Bennie, Jonathan; Economou, Theodoros; Hodgson, David; Spalding, Adrian; McGregor, Peter K

2016-06-29

The ecological impact of night-time lighting is of concern because of its well-demonstrated effects on animal behaviour. However, the potential of light pollution to change plant phenology and its corresponding knock-on effects on associated herbivores are less clear. Here, we test if artificial lighting can advance the timing of budburst in trees. We took a UK-wide 13 year dataset of spatially referenced budburst data from four deciduous tree species and matched it with both satellite imagery of night-time lighting and average spring temperature. We find that budburst occurs up to 7.5 days earlier in brighter areas, with the relationship being more pronounced for later-budding species. Excluding large urban areas from the analysis showed an even more pronounced advance of budburst, confirming that the urban 'heat-island' effect is not the sole cause of earlier urban budburst. Similarly, the advance in budburst across all sites is too large to be explained by increases in temperature alone. This dramatic advance of budburst illustrates the need for further experimental investigation into the impact of artificial night-time lighting on plant phenology and subsequent species interactions. As light pollution is a growing global phenomenon, the findings of this study are likely to be applicable to a wide range of species interactions across the world. © 2016 The Authors.

Sensory, physical and chemical characteristics of cooked ham manufactured from rapidly chilled and earlier deboned M. semimembranosus.

PubMed

Tomović, Vladimir M; Jokanović, Marija R; Petrović, Ljiljana S; Tomović, Mila S; Tasić, Tatjana A; Ikonić, Predrag M; Sumić, Zdravko M; Sojić, Branislav V; Skaljac, Snežana B; Sošo, Milena M

2013-01-01

Effects of rapid chilling of carcasses (at -31°C in the first 3h of chilling, and then at 2-4°C) and earlier deboning (8h post-mortem), compared to rapid (till 24h post-mortem) and conventional chilling (at 2-4°C, till 24h post-mortem), on quality characteristics of pork M. semimebranosus and cooked ham were investigated. Quality measurements included pH value, colour (CIEL a b values) and total aerobic count of M. semimebranosus, as well as sensory (colour, juiciness, texture, and flavour), physical (pH value, colour - CIEL a b values and texture - Warner-Bratzler shear and penetration forces) and chemical (protein, total fat, and moisture content) characteristics of cooked ham. The cooked ham was manufactured from pieces of M. semimebranosus with ultimate lightness (CIEL value) lower than 50. Rapid chilling and earlier deboning significantly increased quantity of M. semimebranosus desirable for cooked ham manufacturing. Earlier start of pork fabrication did not affect important quality characteristics of cooked ham. Copyright © 2012 Elsevier Ltd. All rights reserved.

Trends of earlier palliative care consultation in advanced cancer patients receiving palliative radiation therapy.

PubMed

Chang, Sanders; Sigel, Keith; Goldstein, Nathan E; Wisnivesky, Juan; Dharmarajan, Kavita V

2018-06-06

The American Society of Clinical Oncology recommends that all patients with metastatic disease receive dedicated palliative care (PC) services early in their illness, ideally via interdisciplinary care teams. We investigated the time trends of specialty palliative care consultations from the date of metastatic cancer diagnosis among patients receiving palliative radiation therapy (PRT). A shorter time interval between metastatic diagnosis and first PC consultation suggests earlier involvement of palliative care in a patient's life with metastatic cancer. In this IRB-approved retrospective analysis, patients treated with PRT for solid tumors (bone and brain) at a single tertiary care hospital between 2010 and 2016 were included. Cohorts were arbitrarily established by metastatic diagnosis within approximately two-year intervals: (1) 1/1/2010-3/27/2012; (2) 3/28/2012-5/21/2014; and (3) 5/22/2014-12/31/2016. Cox-proportional hazards regression modelling was used to compare trends of PC consultation among cohorts. Of 284 patients identified, 184 patients received PC consultation, whereas 15 patients died before receiving a PC consult. Median follow-up time until an event or censor was 257 days (range: 1,900). Patients in the most recent cohort had a shorter median time to first PC consult (57 days) compared to those in the first (374 days) and second (186 days) cohorts. On multivariable analysis, patients in the third cohort were more likely to undergo a PC consultation earlier in their metastatic illness (HR: 1.8, 95% CI: 1.2,2.8). Over a six-year period, palliative care consultation occurred earlier for metastatic patients treated with PRT at our institution. Copyright © 2018. Published by Elsevier Inc.

Earlier time to aerobic exercise is associated with faster recovery following acute sport concussion.

PubMed

Lawrence, David Wyndham; Richards, Doug; Comper, Paul; Hutchison, Michael G

2018-01-01

To determine whether earlier time to initiation of aerobic exercise following acute concussion is associated with time to full return to (1) sport and (2) school or work. A retrospective stratified propensity score survival analysis of acute (≤14 days) concussion was used to determine whether time (days) to initiation of aerobic exercise post-concussion was associated with, both, time (days) to full return to (1) sport and (2) school or work. A total of 253 acute concussions [median (IQR) age, 17.0 (15.0-20.0) years; 148 (58.5%) males] were included in this study. Multivariate Cox regression models identified that earlier time to aerobic exercise was associated with faster return to sport and school/work adjusting for other covariates, including quintile propensity strata. For each successive day in delay to initiation of aerobic exercise, individuals had a less favourable recovery trajectory. Initiating aerobic exercise at 3 and 7 days following injury was associated with a respective 36.5% (HR, 0.63; 95% CI, 0.53-0.76) and 73.2% (HR, 0.27; 95% CI, 0.16-0.45) reduced probability of faster full return to sport compared to within 1 day; and a respective 45.9% (HR, 0.54; 95% CI, 0.44-0.66) and 83.1% (HR, 0.17; 95% CI, 0.10-0.30) reduced probability of faster full return to school/work. Additionally, concussion history, symptom severity, LOC deleteriously influenced concussion recovery. Earlier initiation of aerobic exercise was associated with faster full return to sport and school or work. This study provides greater insight into the benefits and safety of aerobic exercise within the first week of the injury.

Earlier nesting by generalist predatory bird is associated with human responses to climate change.

PubMed

Smith, Shawn H; Steenhof, Karen; McClure, Christopher J W; Heath, Julie A

2017-01-01

Warming temperatures cause temporal changes in growing seasons and prey abundance that drive earlier breeding by birds, especially dietary specialists within homogeneous habitat. Less is known about how generalists respond to climate-associated shifts in growing seasons or prey phenology, which may occur at different rates across land cover types. We studied whether breeding phenology of a generalist predator, the American kestrel (Falco sparverius), was associated with shifts in growing seasons and, presumably, prey abundance, in a mosaic of non-irrigated shrub/grasslands and irrigated crops/pastures. We examined the relationship between remotely-sensed normalized difference vegetation index (NDVI) and abundance of small mammals that, with insects, constitute approximately 93% of kestrel diet biomass. We used NDVI to estimate the start of the growing season (SoGS) in irrigated and non-irrigated lands from 1992 to 2015 and tested whether either estimate of annual SoGS predicted the timing of kestrel nesting. Finally, we examined relationships among irrigated SoGS, weather and crop planting. NDVI was a useful proxy for kestrel prey because it predicted small mammal abundance and past studies showed that NDVI predicts insect abundance. NDVI-estimated SoGS advanced significantly in irrigated lands (β = -1·09 ± 0·30 SE) but not in non-irrigated lands (β = -0·57 ± 0·53). Average date of kestrel nesting advanced 15 days in the past 24 years and was positively associated with the SoGS in irrigated lands, but not the SoGS in non-irrigated lands. Advanced SoGS in irrigated lands was related to earlier planting of crops after relatively warm winters, which were more common in recent years. Despite different patterns of SoGS change between land cover types, kestrel nesting phenology shifted with earlier prey availability in irrigated lands. Kestrels may preferentially track prey in irrigated lands over non-irrigated lands because of higher quality prey on

Recent gestational diabetes was associated with mothers stopping predominant breastfeeding earlier in a multi-ethnic population.

PubMed

Baerug, Anne; Sletner, Line; Laake, Petter; Fretheim, Atle; Løland, Beate Fossum; Waage, Christin W; Birkeland, Kåre I; Jenum, Anne Karen

2018-06-01

It has previously been shown that breastfeeding may reduce the risk of type 2 diabetes in mothers with recent gestational diabetes mellitus (GDM). This study compared the cessation of predominant breastfeeding in mothers with and without recent GDM in a multi-ethnic population. From May 2008 to May 2010, healthy pregnant women attending antenatal care provided by community health services in Eastern Oslo, Norway were recruited. We included 616 women-58% non-Western-and interviewed and examined them at a mean of 15 and 28 weeks of gestation and 14 weeks' postpartum. Cox regression models examined the association between GDM, as assessed by the 2013 World Health Organization criteria, and breastfeeding cessation. Overall, 190 of the 616 (31%) mothers had GDM and they ended predominant breastfeeding earlier than mothers without GDM, with an adjusted hazard ratio (aHR) of 1.33 and 95% confidence interval (95% CI) of 1.01-1.77. Mothers of South Asian origin ended predominant breastfeeding earlier than Western European mothers in the adjusted analysis (aHR 1.53, 95% CI: 1.04-2.25), but Middle Eastern mothers did not. Recent gestational diabetes was associated with earlier cessation of predominant breastfeeding in Western European and non-Western women. ©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Tidal Wave II Revisited: A Review of Earlier Enrollment Projections for California Higher Education.

ERIC Educational Resources Information Center

Hayward, Gerald C.; Breneman, David W.; Estrada, Leobardo F.

This report examined enrollment projections for higher education institutions in California in relation to earlier projections conducted in the mid-1990s that forecasted steep declines in enrollment. It notes that California's remarkable economic recovery over the last several years has allowed it to fund higher education enrollment growth at a…

Variations in a university subject pool as a function of earlier or later participation and self-report: a replication and extension.

PubMed

Bernard, Larry C; Walsh, R Patricia

2002-10-01

The present study replicated and extended earlier research on temporal sampling effects in university subject pools. Data were obtained from 236 participants, 79 men and 157 women, in a university subject pool during a 15-wk. semester. Without knowing the purpose of the study, participants self-selected to participate earlier (Weeks 4 and 5; n = 105) or later (Weeks 14 and 15; n = 131). Three hypotheses were investigated: (1) that the personality patterns of earlier and later participants on the NEO Personality Inventory-Revised and the Personality Research Form differ significantly, with earlier participants scoring higher on the latter scales reflecting social responsibility and higher on former Conscientiousness and Neuroticism scales; (2) that there are similar significant differences between participants in the earlier and later groups compared to the male and female college normative samples for the two tests: and (3) that earlier participants will have higher actual Scholastic Assessment Test scores and Grade Point Averages. Also investigated was whether participants' foreknowledge that their actual Scholastic Assessment Test scores and Grade Point Averages would be obtained would affect their accuracy of self-report. In contrast to prior research, neither the first nor second hypothesis was supported by the current study; there do not appear to be consistent differences on personality variables. However, the third hypothesis was supported. Earlier participants had higher actual high school Grade Point Average, college Grade Point Average, and Scholastic Assessment Test Verbal scores. Foreknowledge that actual Scholastic Assessment Test scores and Grade Point Averages would be obtained did not affect the accuracy of self-report. In addition, later participants significantly over-reported their scores, and significantly more women than men and more first-year than senior-year subjects participated in the early group.

Relationship Between Marital Transitions, Health Behaviors, and Health Indicators of Postmenopausal Women: Results from the Women's Health Initiative

PubMed Central

Kutob, Randa M.; Yuan, Nicole P.; Wertheim, Betsy C.; Sbarra, David A.; Loucks, Eric B.; Nassir, Rami; Bareh, Gihan; Kim, Mimi M.; Snetselaar, Linda G.

2017-01-01

Abstract Background: Historically, marital status has been associated with lower mortality and transitions into marriage were generally accompanied by improved health status. Conversely, divorce has been associated with increased mortality, possibly mediated by changes in health behaviors. Methods: This study uses data from a prospective cohort of 79,094 postmenopausal women participating in the Women's Health Initiative Observational Study (WHI-OS) to examine the relationship between marital transition and health indicators (blood pressure, waist circumference, body mass index [BMI]) as well as health behaviors (diet pattern, alcohol use, physical activity, and smoking) in a sample of relatively healthy and employed women. Linear and logistic regression modeling were used to test associations, controlling for confounding factors. Results: Women's transitions into marriage/marriage-like relationship after menopause were associated with greater increase in BMI (β = 0.22; confidence interval (95% CI), 0.11–0.33) and alcohol intake (β = 0.08; 95% CI, 0.04–0.11) relative to remaining unmarried. Divorce/separation was associated with a reduction in BMI and waist circumference, changes that were accompanied by improvements in diet quality (β = 0.78, 95% CI, 0.10–1.47) and physical activity (β = 0.98, 95% CI, 0.12–1.85), relative to women who remained married. Conclusion: Contrary to earlier literature, these findings among well-educated, predominantly non-Hispanic white women suggest that marital transitions after menopause are accompanied by modifiable health outcomes/behaviors that are more favorable for women experiencing divorce/separation than those entering a new marriage. PMID:28072926

Higher Childhood Red Meat Intake Frequency Is Associated with Earlier Age at Menarche.

PubMed

Jansen, Erica C; Marín, Constanza; Mora-Plazas, Mercedes; Villamor, Eduardo

2016-03-09

Early age at menarche is associated with increased breast cancer risk. Red meat consumption in adolescence predicts breast cancer risk, but it is unknown whether it is also related to earlier menarche. We studied the association between intake of red meat at ages 5-12 y and age at menarche in a prospective study. We assessed usual diets with a food-frequency questionnaire in a group of 456 girls aged 8.4 ± 1.7 y and followed them for a median 5.6 y in Bogotá, Colombia. Girls were asked periodically about the occurrence and date of menarche. Median age at menarche was estimated with use of Kaplan-Meier survival probabilities by categories of red meat intake frequency. Cox proportional hazards models were used to compare the incidence of menarche by red meat intake frequency, adjusting for potential sociodemographic and dietary confounders including total energy intake and intake frequency of other animal food groups (dairy, poultry, freshwater fish, tuna/sardines, eggs, and innards). Median age at menarche was 12.4 y. After adjustment for total energy intake, maternal parity, and socioeconomic status, red meat intake frequency was inversely associated with age at menarche. When compared with girls with red meat intake <4 times/wk, those consuming it ≥2 times/d had a significantly earlier age at menarche (HR: 1.64; 95% CI: 1.11, 2.41; P-trend = 0.0009). Incidentally, we found that girls with tuna/sardine intake >1 time/wk had a significantly later age at menarche (HR: 0.62; 95% CI: 0.42, 0.90; P = 0.01) than those with intake <1 time/mo. Intake frequency of other animal food groups was not significantly associated with age at menarche. Higher red meat intake frequency during childhood is associated with an earlier age at menarche, whereas greater fatty fish intake frequency is associated with a later menarcheal age. © 2016 American Society for Nutrition.

The evaluation of clinical and cost outcomes associated with earlier initiation of insulin in patients with type 2 diabetes mellitus.

PubMed

Smolen, Harry J; Murphy, Daniel R; Gahn, James C; Yu, Xueting; Curtis, Bradley H

2014-09-01

The treatment for patients with type 2 diabetes mellitus (T2DM) follows a stepwise progression. As a treatment loses its effectiveness, it is typically replaced with a more complex and frequently more costly treatment. Eventually this progression leads to the use of basal insulin typically with concomitant treatments (e.g., metformin, a GLP-1 RA [glucagon-like peptide-1 receptor agonist], a TZD [thiazolidinedione] or a DPP-4i [dipeptidyl peptidase 4 inhibitor]) and, ultimately, to basal-bolus insulin in some forms. As the cost of oral antidiabetics (OADs) and noninsulin injectables have approached, and in some cases exceeded, the cost of insulin, we reexamined the placement of insulin in T2DM treatment progression. Our hypothesis was that earlier use of insulin produces clinical and cost benefits due to its superior efficacy and treatment scalability at an acceptable cost when considered over a 5-year period. To (a) estimate clinical and payer cost outcomes of initiating insulin treatment for patients with T2DM earlier in their treatment progression and (b) estimate clinical and payer cost outcomes resulting from delays in escalating treatment for T2DM when indicated by patient hemoglobin A1c levels. We developed a Monte Carlo microsimulation model to estimate patients reaching target A1c, diabetes-related complications, mortality, and associated costs under various treatment strategies for newly diagnosed patients with T2DM. Treatment efficacies were modeled from results of randomized clinical trials, including the time and rate of A1c drift. A typical treatment progression was selected based on the American Diabetes Association and the European Association for the Study of Diabetes guidelines as the standard of care (SOC). Two treatment approaches were evaluated: two-stage insulin (basal plus antidiabetics followed by biphasic plus metformin) and single-stage insulin (biphasic plus metformin). For each approach, we analyzed multiple strategies. For each analysis

Clinical presentation of retinoblastoma in Alexandria: A step toward earlier diagnosis.

PubMed

Soliman, Sameh E; Eldomiaty, Wesam; Goweida, Mohamed B; Dowidar, Amgad

2017-01-01

To evaluate the clinical presentation of retinoblastoma in Alexandria, Egypt, correlate the timing of accurate diagnosis with the presence of advanced disease and identify causes of delayed presentation. Retrospective noncomparative single institution study reviews demographic and clinical data of all new children with retinoblastoma presenting to Alexandria Main University ocular oncology clinic (OOC) from January 2012 to June 2014. Diagnosis time was from initial parental complaint to retinoblastoma diagnosis and referral time was from retinoblastoma diagnosis to presentation to the Alexandria OCC. Delayed Diagnosis and referral were counted if >2 weeks. Advanced presentation is defined as clinical TNMH (8th edition) staging of cT2 or cT3 (international intraocular retinoblastoma classification group D or E) in at least one eye or the presence of extra-ocular disease (cT4). Seventy eyes of 47 children were eligible: 52% unilateral, 7% with family history and 96% presented with leukocorea. Sixty-four percent of children had advanced intraocular disease and none had extra-ocular disease. Delayed presentation occurred in 58% of children and was significantly associated with advanced disease in both unilaterally and bilaterally affected children (p = 0.003, 0.002 respectively). The delay in diagnosis was more in unilateral cases while the delay in referral was more in bilateral cases. The main cause of delayed presentation in unilateral retinoblastoma was misdiagnosis (30%) while parental shopping for second medical opinion (30%) was the main cause in bilateral children. Delayed diagnosis is a problem affecting retinoblastoma management. Better medical education and training, health education and earlier screening are recommended to achieve earlier diagnosis.

Cholesterol testing and results

MedlinePlus

... profile results; Hyperlipidemia-results; Lipid disorder test results; Heart disease - cholesterol results ... at an earlier age if you have: Diabetes Heart disease Stroke High blood pressure A strong family history ...

Design a Fuzzy Rule-based Expert System to Aid Earlier Diagnosis of Gastric Cancer.

PubMed

Safdari, Reza; Arpanahi, Hadi Kazemi; Langarizadeh, Mostafa; Ghazisaiedi, Marjan; Dargahi, Hossein; Zendehdel, Kazem

2018-01-01

Screening and health check-up programs are most important sanitary priorities, that should be undertaken to control dangerous diseases such as gastric cancer that affected by different factors. More than 50% of gastric cancer diagnoses are made during the advanced stage. Currently, there is no systematic approach for early diagnosis of gastric cancer. to develop a fuzzy expert system that can identify gastric cancer risk levels in individuals. This system was implemented in MATLAB software, Mamdani inference technique applied to simulate reasoning of experts in the field, a total of 67 fuzzy rules extracted as a rule-base based on medical expert's opinion. 50 case scenarios were used to evaluate the system, the information of case reports is given to the system to find risk level of each case report then obtained results were compared with expert's diagnosis. Results revealed that sensitivity was 92.1% and the specificity was 83.1%. The results show that is possible to develop a system that can identify High risk individuals for gastric cancer. The system can lead to earlier diagnosis, this may facilitate early treatment and reduce gastric cancer mortality rate.

Quantifying the Economic Value and Quality of Life Impact of Earlier Influenza Vaccination

PubMed Central

Lee, Bruce Y.; Bartsch, Sarah M.; Brown, Shawn T.; Cooley, Philip; Wheaton, William D.; Zimmerman, Richard K.

2015-01-01

Background Influenza vaccination is administered throughout the influenza disease season, even as late as March. Given such timing, what is the value of vaccinating the population earlier than currently being practiced? Methods We used real data on when individuals were vaccinated in Allegheny County, Pennsylvania, and the following 2 models to determine the value of vaccinating individuals earlier (by the end of September, October, and November): Framework for Reconstructing Epidemiological Dynamics (FRED), an agent-based model (ABM), and FluEcon, our influenza economic model that translates cases from the ABM to outcomes and costs [health care and lost productivity costs and quality-adjusted life-years (QALYs)]. We varied the reproductive number (R0) from 1.2 to 1.6. Results Applying the current timing of vaccinations averted 223,761 influenza cases, $16.3 million in direct health care costs, $50.0 million in productivity losses, and 804 in QALYs, compared with no vaccination (February peak, R0 1.2). When the population does not have preexisting immunity and the influenza season peaks in February (R0 1.2–1.6), moving individuals who currently received the vaccine after September to the end of September could avert an additional 9634–17,794 influenza cases, $0.6–$1.4 million in direct costs, $2.1–$4.0 million in productivity losses, and 35–64 QALYs. Moving the vaccination of just children to September (R0 1.2–1.6) averted 11,366–1660 influenza cases, $0.6–$0.03 million in direct costs, $2.3–$0.2 million in productivity losses, and 42–8 QALYs. Moving the season peak to December increased these benefits, whereas increasing preexisting immunity reduced these benefits. Conclusion Even though many people are vaccinated well after September/October, they likely are still vaccinated early enough to provide substantial cost-savings. PMID:25590676

Brief Report: Applying an Indicator Set to Survey the Health of People with Intellectual Disabilities in Europe

ERIC Educational Resources Information Center

Walsh, Patricia Noonan

2008-01-01

This report gives an account of applying a health survey tool by the "Pomona" Group that earlier documented the process of developing a set of health indicators for people with intellectual disabilities in Europe. The "Pomona" health indicator set mirrors the much larger set of health indicators prepared by the European…

Accreting Binary Populations in the Earlier Universe

NASA Technical Reports Server (NTRS)

Hornschemeier, Ann

2010-01-01

It is now understood that X-ray binaries dominate the hard X-ray emission from normal star-forming galaxies. Thanks to the deepest (2-4 Ms) Chandra surveys, such galaxies are now being studied in X-rays out to z approximates 4. Interesting X-ray stacking results (based on 30+ galaxies per redshift bin) suggest that the mean rest-frame 2-10 keV luminosity from z=3-4 Lyman break galaxies (LBGs), is comparable to the most powerful starburst galaxies in the local Universe. This result possibly indicates a similar production mechanism for accreting binaries over large cosmological timescales. To understand and constrain better the production of X-ray binaries in high-redshift LBGs, we have utilized XMM-Newton observations of a small sample of z approximates 0.1 GALEX-selected Ultraviolet-Luminous Galaxies (UVLGs); local analogs to high-redshift LBGs. Our observations enable us to study the X-ray emission from LBG-like galaxies on an individual basis, thus allowing us to constrain object-to-object variances in this population. We supplement these results with X-ray stacking constraints using the new 3.2 Ms Chandra Deep Field-South (completed spring 2010) and LBG candidates selected from HST, Swift UVOT, and ground-based data. These measurements provide new X-ray constraints that sample well the entire z=0-4 baseline

Changing facial phenotype in Cohen syndrome: towards clues for an earlier diagnosis.

PubMed

El Chehadeh-Djebbar, Salima; Blair, Edward; Holder-Espinasse, Muriel; Moncla, Anne; Frances, Anne-Marie; Rio, Marlène; Debray, François-Guillaume; Rump, Patrick; Masurel-Paulet, Alice; Gigot, Nadège; Callier, Patrick; Duplomb, Laurence; Aral, Bernard; Huet, Frédéric; Thauvin-Robinet, Christel; Faivre, Laurence

2013-07-01

Cohen syndrome (CS) is a rare autosomal recessive condition caused by mutations and/or large rearrangements in the VPS13B gene. CS clinical features, including developmental delay, the typical facial gestalt, chorioretinal dystrophy (CRD) and neutropenia, are well described. CS diagnosis is generally raised after school age, when visual disturbances lead to CRD diagnosis and to VPS13B gene testing. This relatively late diagnosis precludes accurate genetic counselling. The aim of this study was to analyse the evolution of CS facial features in the early period of life, particularly before school age (6 years), to find clues for an earlier diagnosis. Photographs of 17 patients with molecularly confirmed CS were analysed, from birth to preschool age. By comparing their facial phenotype when growing, we show that there are no special facial characteristics before 1 year. However, between 2 and 6 years, CS children already share common facial features such as a short neck, a square face with micrognathia and full cheeks, a hypotonic facial appearance, epicanthic folds, long ears with an everted upper part of the auricle and/or a prominent lobe, a relatively short philtrum, a small and open mouth with downturned corners, a thick lower lip and abnormal eye shapes. These early transient facial features evolve to typical CS facial features with aging. These observations emphasize the importance of ophthalmological tests and neutrophil count in children in preschool age presenting with developmental delay, hypotonia and the facial features we described here, for an earlier CS diagnosis.

Inevitable end-of-21st-century trends toward earlier surface runoff timing in California's Sierra Nevada Mountains

NASA Astrophysics Data System (ADS)

Schwartz, M. A.; Hall, A. D.; Sun, F.; Walton, D.; Berg, N.

2015-12-01

Hybrid dynamical-statistical downscaling is used to produce surface runoff timing projections for California's Sierra Nevada, a high-elevation mountain range with significant seasonal snow cover. First, future climate change projections (RCP8.5 forcing scenario, 2081-2100 period) from five CMIP5 global climate models (GCMs) are dynamically downscaled. These projections reveal that future warming leads to a shift toward earlier snowmelt and surface runoff timing throughout the Sierra Nevada region. Relationships between warming and surface runoff timing from the dynamical simulations are used to build a simple statistical model that mimics the dynamical model's projected surface runoff timing changes given GCM input or other statistically-downscaled input. This statistical model can be used to produce surface runoff timing projections for other GCMs, periods, and forcing scenarios to quantify ensemble-mean changes, uncertainty due to intermodel variability and consequences stemming from choice of forcing scenario. For all CMIP5 GCMs and forcing scenarios, significant trends toward earlier surface runoff timing occur at elevations below 2500m. Thus, we conclude that trends toward earlier surface runoff timing by the end-of-the-21st century are inevitable. The changes to surface runoff timing diagnosed in this study have implications for many dimensions of climate change, including impacts on surface hydrology, water resources, and ecosystems.

[Contact lenses for children. Indications and results].

PubMed

Steinbach, P D; Nover, A

1976-03-18

If it is necessary to prescribe contact lenses for children, this correction should be made as soon as possible. As a consequence of the development of soft (hydrophile) lenses, the above mentioned group of patients has increased considerably. In any case, a monolateral aphakia as well as a manifest anisometropia should be corrected by a contact lense to avoid amblyopia, heterotropia and loss of stereoscopic vision. Usually soft lenses are well tolerated, so that patients suffering from aphakia as well as hyperopia should always use this type of lense. Nevertheless, the hard lense still has its indication in treating myopia and high astigmatism.

[Psychophysiological indicators for children using mobile phones. Communication 2. Results of four-year monitoring].

PubMed

Khorseva, N I; Grigor'ev, Iu G; Gorbunova, N V

2011-01-01

This study submits the results of a four-year monitoring of a complex diagnostics of the psychophysiological indicators for 196 children aged 7 to 12 years old: 147 of them are child users of mobile communication (test group) and 49 are in the control group. We have identified the following major trends of the psychophysiological indicators for child users of mobile communication: an increased number of phonemic perception disorders, abatement of efficiency, reduced indicators for the arbitrary and semantic memory, an increased fatigue. A steady decline of the parameters from high values to bottom standards has been found.

Assessing agro-environmental performance of dairy farms in northwest Italy based on aggregated results from indicators.

PubMed

Gaudino, Stefano; Goia, Irene; Grignani, Carlo; Monaco, Stefano; Sacco, Dario

2014-07-01

Dairy farms control an important share of the agricultural area of Northern Italy. Zero grazing, large maize-cropped areas, high stocking densities, and high milk production make them intensive and prone to impact the environment. Currently, few published studies have proposed indicator sets able to describe the entire dairy farm system and their internal components. This work had four aims: i) to propose a list of agro-environmental indicators to assess dairy farms; ii) to understand which indicators classify farms best; iii) to evaluate the dairy farms based on the proposed indicator list; iv) to link farmer decisions to the consequent environmental pressures. Forty agro-environmental indicators selected for this study are described. Northern Italy dairy systems were analysed considering both farmer decision indicators (farm management) and the resulting pressure indicators that demonstrate environmental stress on the entire farming system, and its components: cropping system, livestock system, and milk production. The correlations among single indicators identified redundant indicators. Principal Components Analysis distinguished which indicators provided meaningful information about each pressure indicator group. Analysis of the communalities and the correlations among indicators identified those that best represented farm variability: Farm Gate N Balance, Greenhouse Gas Emission, and Net Energy of the farm system; Net Energy and Gross P Balance of the cropping system component; Energy Use Efficiency and Purchased Feed N Input of the livestock system component; N Eco-Efficiency of the milk production component. Farm evaluation, based on the complete list of selected indicators demonstrated organic farming resulted in uniformly high values, while farms with low milk-producing herds resulted in uniformly low values. Yet on other farms, the environmental quality varied greatly when different groups of pressure indicators were considered, which highlighted the

The two faces of selective memory retrieval: Earlier decline of the beneficial than the detrimental effect with older age.

PubMed

Aslan, Alp; Schlichting, Andreas; John, Thomas; Bäuml, Karl-Heinz T

2015-12-01

Recent work with young adults has shown that, depending on study context access, selective memory retrieval can both impair and improve recall of other memories (Bäuml & Samenieh, 2010). Here, we investigated the 2 opposing effects of selective retrieval in older age. In Experiment 1, we examined 64 younger (20-35 years) and 64 older participants (above 60 years), and manipulated study context access using list-method directed forgetting. Whereas both age groups showed a detrimental effect of selective retrieval on to-be-remembered items, only younger but not older adults showed a beneficial effect on to-be-forgotten items. In Experiment 2, we examined 112 participants from a relatively wide age range (40-85 years), and manipulated study context access by varying the retention interval between study and test. Overall, a detrimental effect of selective retrieval arose when the retention interval was relatively short, but a beneficial effect when the retention interval was prolonged. Critically, the size of the beneficial but not the detrimental effect of retrieval decreased with age and this age-related decline was mediated by individuals' working memory capacity, as measured by the complex operation span task. Together, the results suggest an age-related dissociation in retrieval dynamics, indicating an earlier decline of the beneficial than the detrimental effect of selective retrieval with older age. (c) 2015 APA, all rights reserved).

Effects of earlier sea ice breakup on survival and population size of polar bears in western Hudson Bay

USGS Publications Warehouse

Regehr, E.V.; Lunn, N.J.; Amstrup, Steven C.; Stirling, I.

2007-01-01

Some of the most pronounced ecological responses to climatic warming are expected to occur in polar marine regions, where temperature increases have been the greatest and sea ice provides a sensitive mechanism by which climatic conditions affect sympagic (i.e., with ice) species. Population-level effects of climatic change, however, remain difficult to quantify. We used a flexible extension of Cormack-Jolly-Seber capture-recapture models to estimate population size and survival for polar bears (Ursus maritimus), one of the most ice-dependent of Arctic marine mammals. We analyzed data for polar bears captured from 1984 to 2004 along the western coast of Hudson Bay and in the community of Churchill, Manitoba, Canada. The Western Hudson Bay polar bear population declined from 1,194 (95% CI = 1,020-1,368) in 1987 to 935 (95% CI = 794-1,076) in 2004. Total apparent survival of prime-adult polar bears (5-19 yr) was stable for females (0.93; 95% CI = 0.91-0.94) and males (0.90; 95% CI = 0.88-0.91). Survival of juvenile, subadult, and senescent-adult polar bears was correlated with spring sea ice breakup date, which was variable among years and occurred approximately 3 weeks earlier in 2004 than in 1984. We propose that this correlation provides evidence for a causal association between earlier sea ice breakup (due to climatic warming) and decreased polar bear survival. It may also explain why Churchill, like other communities along the western coast of Hudson Bay, has experienced an increase in human-polar bear interactions in recent years. Earlier sea ice breakup may have resulted in a larger number of nutritionally stressed polar bears, which are encroaching on human habitations in search of supplemental food. Because western Hudson Bay is near the southern limit of the species' range, our findings may foreshadow the demographic responses and management challenges that more northerly polar bear populations will experience if climatic warming in the Arctic continues as

5 CFR Appendix A to Subpart C of... - Present Value Conversion Factors for Earlier Commencing Date of Annuities of Current and Former...

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Present Value Conversion Factors for Earlier Commencing Date of Annuities of Current and Former Spouses of Deceased Separated Employees A...—Present Value Conversion Factors for Earlier Commencing Date of Annuities of Current and Former Spouses of...

Organized screening detects breast cancer at earlier stage regardless of molecular phenotype.

PubMed

Holloway, Claire M B; Jiang, Li; Whitehead, Marlo; Racz, Jennifer M; Groome, Patti A

2018-06-16

Mortality reduction attributable to organized breast screening is modest. Screening may be less effective at detecting more aggressive cancers at an earlier stage. This study was conducted to determine the relative efficacy of screening mammography to detect cancers at an earlier stage by molecular phenotype. We identified 2882 women with primary invasive breast cancer diagnosed between January 1, 2008 and December 31, 2012 and who had a mammogram through the Ontario Breast Screening Program in the 28 months before diagnosis. Five tumor phenotypes were defined by expression of estrogen (ER) and progesterone (PR) receptors and HER2/neu oncogene. We conducted univariable and multivariable analyses to describe the predictors of detection as an interval cancer. Additional analyses identified predictors of detection at stages II, III, or IV compared with stage I, by phenotype. Analyses were adjusted for the effects of age, grade, and breast density. ER negative and HER2 positive tumors were over-represented among interval cancers, and triple negative cancers were more likely than ER +/HER2 - cancers to be detected as interval cancers OR 2.5 (95% CI 2.0-3.2, p < 0.0001). Method of detection (interval vs. screen) and molecular phenotype were independently associated with stage at diagnosis (p < 0.0001), but there was no interaction between method of detection and phenotype (p = 0.44). In a screened population, triple negative and HER2 + breast cancers are diagnosed at a higher stage but this appears to be due to higher growth rates of these tumors rather than a relative inability of screening to detect them.

Testing the Association Between Traditional and Novel Indicators of County-Level Structural Racism and Birth Outcomes among Black and White Women.

PubMed

Chambers, Brittany D; Erausquin, Jennifer Toller; Tanner, Amanda E; Nichols, Tracy R; Brown-Jeffy, Shelly

2017-12-07

Despite decreases in infants born premature and at low birth weight in the United States (U.S.), racial disparities between Black and White women continue. In response, the purpose of this analysis was to examine associations between both traditional and novel indicators of county-level structural racism and birth outcomes among Black and White women. We merged individual-level data from the California Birth Statistical Master Files 2009-2013 with county-level data from the United States (U.S.) Census American Community Survey. We used hierarchical linear modeling to examine Black-White differences among 531,170 primiparous women across 33 California counties. Traditional (e.g., dissimilarity index) and novel indicators (e.g., Black to White ratio in elected office) were associated with earlier gestational age and lower birth weight among Black and White women. A traditional indicator was more strongly associated with earlier gestational age for Black women than for White women. This was the first study to empirically demonstrate that structural racism, measured by both traditional and novel indicators, is associated with poor health and wellbeing of infants born to Black and White women. However, findings indicate traditional indicators of structural racism, rather than novel indicators, better explain racial disparities in birth outcomes. Results also suggest the need to develop more innovative approaches to: (1) measure structural racism at the county-level and (2) reform public policies to increase integration and access to resources.

A primary care Web-based Intervention Modeling Experiment replicated behavior changes seen in earlier paper-based experiment.

PubMed

Treweek, Shaun; Francis, Jill J; Bonetti, Debbie; Barnett, Karen; Eccles, Martin P; Hudson, Jemma; Jones, Claire; Pitts, Nigel B; Ricketts, Ian W; Sullivan, Frank; Weal, Mark; MacLennan, Graeme

2016-12-01

Intervention Modeling Experiments (IMEs) are a way of developing and testing behavior change interventions before a trial. We aimed to test this methodology in a Web-based IME that replicated the trial component of an earlier, paper-based IME. Three-arm, Web-based randomized evaluation of two interventions (persuasive communication and action plan) and a "no intervention" comparator. The interventions were designed to reduce the number of antibiotic prescriptions in the management of uncomplicated upper respiratory tract infection. General practitioners (GPs) were invited to complete an online questionnaire and eight clinical scenarios where an antibiotic might be considered. One hundred twenty-nine GPs completed the questionnaire. GPs receiving the persuasive communication did not prescribe an antibiotic in 0.70 more scenarios (95% confidence interval [CI] = 0.17-1.24) than those in the control arm. For the action plan, GPs did not prescribe an antibiotic in 0.63 (95% CI = 0.11-1.15) more scenarios than those in the control arm. Unlike the earlier IME, behavioral intention was unaffected by the interventions; this may be due to a smaller sample size than intended. A Web-based IME largely replicated the findings of an earlier paper-based study, providing some grounds for confidence in the IME methodology. Copyright © 2016 Elsevier Inc. All rights reserved.

Retrospective study of reasons for improved survival in patients with breast cancer in east Anglia: earlier diagnosis or better treatment.

PubMed Central

Stockton, D.; Davies, T.; Day, N.; McCann, J.

1997-01-01

OBJECTIVES: To investigate the recent fall in mortality from breast cancer in England and Wales, and to determine the relative contributions of improvements in treatment and earlier detection of tumours. DESIGN: Retrospective study of all women with breast cancer registered by the East Anglian cancer registry and diagnosed between 1982 and 1989. SUBJECTS: 3965 patients diagnosed 1982-5 compared with 4665 patients diagnosed 1986-9, in three age groups 0-49, 50-64, > or = 65 years, with information on stage at diagnosis and survival. MAIN OUTCOME MEASURES: Three year relative survival rates by time period, age group, and stage; relative hazard ratios for each time period and age group derived from Cox's proportional hazards model, adjusted for single year of age and stage. RESULTS: Survival improved in the later time period, although there was little stage specific improvement. The proportion of early stage tumours increased especially in the 50-64 year age group, and adjustment for stage accounted for over half of the improvement in survival in women aged under 65 years. CONCLUSION: Over half of the drop in mortality in women aged under 65 years seems to be attributable to earlier detection of tumours, which has been observed since the mid-1980s. This could have resulted from an increase in breast awareness predating the start of the breast screening programme. PMID:9056796

Rectifying an Honest Error in World University Rankings: A Solution to the Problem of Indicator Weight Discrepancies

ERIC Educational Resources Information Center

Soh, Kaycheng

2013-01-01

Discrepancies between the nominal and attained indicator weights misinform rank consumers as to the relative importance of the indicators. This may lead to unwarranted institutional judgements and misdirected actions, causing resources being wasted unnecessarily. As a follow-up to two earlier studies, data from the Academic Ranking of World…

Hemodynamic parameters change earlier than tissue oxygen tension in hemorrhage.

PubMed

Pestel, Gunther J; Fukui, Kimiko; Kimberger, Oliver; Hager, Helmut; Kurz, Andrea; Hiltebrand, Luzius B

2010-05-15

Untreated hypovolemia results in impaired outcome. This study tests our hypothesis whether general hemodynamic parameters detect acute blood loss earlier than monitoring parameters of regional tissue beds. Eight pigs (23-25 kg) were anesthetized and mechanically ventilated. A pulmonary artery catheter and an arterial catheter were inserted. Tissue oxygen tension was measured with Clark-type electrodes in the jejunal and colonic wall, in the liver, and subcutaneously. Jejunal microcirculation was assessed by laser Doppler flowmetry (LDF). Intravascular volume was optimized using difference in pulse pressure (dPP) to keep dPP below 13%. Sixty minutes after preparation, baseline measurements were taken. At first, 5% of total blood volume was withdrawn, followed by another 5% increment, and then in 10% increments until death. After withdrawal of 5% of estimated blood volume, dPP increased from 6.1% +/- 3.0% to 20.8% +/- 2.7% (P < 0.01). Mean arterial pressure (MAP), mean pulmonary artery pressure (PAP) and pulmonary artery occlusion pressure (PAOP) decreased with a blood loss of 10% (P < 0.01). Cardiac output (CO) changed after a blood loss of 20% (P < 0.05). Tissue oxygen tension in central organs, and blood flow in the jejunal muscularis decreased (P < 0.05) after a blood loss of 20%. Tissue oxygen tension in the skin, and jejunal mucosa blood flow decreased (P < 0.05) after a blood loss of 40% and 50%, respectively. In this hemorrhagic pig model systemic hemodynamic parameters were more sensitive to detect acute hypovolemia than tissue oxygen tension measurements or jejunal LDF measurements. Acute blood loss was detected first by dPP. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Earlier reperfusion in patients with ST-elevation Myocardial infarction by use of helicopter

PubMed Central

2012-01-01

Background In patients with ST-elevation myocardial infarction (STEMI) reperfusion therapy should be initiated as soon as possible. This study evaluated whether use of a helicopter for transportation of patients is associated with earlier initiation of reperfusion therapy. Material and methods A prospective study was conducted, including patients with STEMI and symptom duration less than 12 hours, who had primary percutaneous coronary intervention (PPCI) performed at Aarhus University Hospital in Skejby. Patients with a health care system delay (time from emergency call to first coronary intervention) of more than 360 minutes were excluded. The study period ran from 1.1.2011 until 31.12.2011. A Western Denmark Helicopter Emergency Medical Service (HEMS) project was initiated 1.6.2011 for transportation of patients with time-critical illnesses, including STEMI. Results The study population comprised 398 patients, of whom 376 were transported by ambulance Emergency Medical Service (EMS) and 22 by HEMS. Field-triage directly to the PCI-center was used in 338 of patients. The median system delay was 94 minutes among those field-triaged, and 168 minutes among those initially admitted to a local hospital. Patients transported by EMS and field-triaged were stratified into four groups according to transport distance from the scene of event to the PCI-center: ≤25 km., 26–50 km., 51–75 km. and > 75 km. For these groups, the median system delay was 78, 89, 99, and 141 minutes. Among patients transported by HEMS and field-triaged the estimated median transport distance by ground transportation was 115 km, and the observed system delay was 107 minutes. Based on second order polynomial regression, it was estimated that patients with a transport distance of >60 km to the PCI-center may benefit from helicopter transportation, and that transportation by helicopter is associated with a system delay of less than 120 minutes even at a transport distance up to 150 km

Recent Perplexing Behavior in Solar Activity Indices

NASA Astrophysics Data System (ADS)

Lopresto, James C.

1997-05-01

Calcium K and Hα and SOHO He II UV plage and sunspot ara have been monitored using images on the INTERNET since November of 1992. The purpose of the project is to determine the degree of correlation between changing plage area and solar irradiance changes (also obtained via the INTERNET). Also the project provides a low cost process to involve undergraduates in astronomy research. When using weighted weekly averages for both spot Hα plage pixel counts, we see the expected decline from the last maximum. The activity continues to decline, or at best, has flattened out over the past several months. In contrast, the K-line plage pixel count from both Big Bear and Sacramento Peak show an upswing since mid-1995 or earlier. The k2 measurments from both Kitt Peak and Sacramento Peak are in general agreement with the spot and Hα behavior, indicating wer are in, or barely passed minimum. Images high in the chromosphere, detailing the magnetic network, may be more senstive to smaller field changes. This might be a partial explanation for the earlier upswing in K line and He 304 activity, which are receiving radiation near or at the top of the chromosphere.

37 CFR 1.78 - Claiming benefit of earlier filing date and cross-references to other applications.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 37 Patents, Trademarks, and Copyrights 1 2014-07-01 2014-07-01 false Claiming benefit of earlier filing date and cross-references to other applications. 1.78 Section 1.78 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE GENERAL RULES OF PRACTICE IN...

37 CFR 1.78 - Claiming benefit of earlier filing date and cross-references to other applications.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 37 Patents, Trademarks, and Copyrights 1 2011-07-01 2011-07-01 false Claiming benefit of earlier filing date and cross-references to other applications. 1.78 Section 1.78 Patents, Trademarks, and Copyrights UNITED STATES PATENT AND TRADEMARK OFFICE, DEPARTMENT OF COMMERCE GENERAL RULES OF PRACTICE IN...

Endoscopic papillectomy: indications, techniques, and results.

PubMed

De Palma, Giovanni D

2014-02-14

Endoscopic papillectomy (EP) is currently accepted as a viable alternative therapy to surgery in sporadic ampullary adenoma and has been reported to have high success and low recurrence rates. At present, the indications for EP are not yet fully established. The accepted criteria for EP include size (up to 5 cm), no evidence of intraductal growth, and no evidence of malignancy on endoscopic findings (ulceration, friability, and spontaneous bleeding). Endoscopic ultrasound (EUS) is the imaging modality of choice for local T staging in ampullary neoplasms. Data reported in the literature have revealed that linear EUS is superior to helical computed tomography in the preoperative assessment of tumor size, detection of regional nodal metastases and detection of major vascular invasion. Endoscopic ampullectomy is performed using a standard duodenoscope in a similar manner to snare polypectomy of a mucosal lesion. There is no standardization of the equipment or technique and broad EP methods are described. Endoscopic ampullectomy is considered a ''high-risk'' procedure due to complications. Complications of endoscopic papillectomy can be classified as early (pancreatitis, bleeding, perforation, and cholangitis) and late (papillary stenosis) complications. The appropriate use of stenting after ampullectomy may prevent post-procedural pancreatitis and papillary stenosis. Tumor recurrence of benign lesions occurs in up to 20% of patients and depends on tumor size, final histology, presence of intraductal tumor, coexisting familial adenomatous polyposis (FAP), and the expertise of the endoscopist. Recurrent lesions are usually benign and most can be retreated endoscopically.

[Plan for improving pharmacy indicators in a primary health area of Madrid. Description and results].

PubMed

Izquierdo-Palomares, José Manuel; Carretón, María José Almodóvar; Fernández, Luís Carlos Saiz; Gómez, Raquel Siguín; Gómez, Carlos López; Elustondo, Sofía Garrido

2011-03-01

To evaluate the results of a plan for improving pharmacy indicators in a Primary Care (PC) Health Area. Quasi-experimental study with a control group. The differences between the pre-intervention (Jan-Dec 2007) and post-intervention (Jan-Dec 2008) periods were evaluated. Intervention group: Primary Care doctors from PC Area 7 of the Community of Madrid (n=397). the rest of PC doctors of the Community of Madrid (n=4428). A multi-focus plan in which the main activities were: sessions in the health centres with the worst results, involvement of those responsible for the Rational Use of Drugs, interviews with the doctors with the most improvable indicators, recognition of those with good indicators, and preparing short notes on drugs. Prescription and notification indicators associated with the safety of drugs. In relation to Madrid, the absolute improvements of Area 7 in the accumulated indicators, %Generic drugs, %Statins, %ARAII y %Omeprazole were 0.29; 1.17; 0.61 and 0.37 percentage points, respectively. DHD Osteoporosis equalled the improvement of Madrid. In Area 7, the increase in notifications of suspected serious ADRs was 180% and number of ADR notifications of ADRs was 233%, better than the Madrid data (48% and 21%). The notification of medication errors showed similar increases in both groups (PC Area 7 1567% vs. Madrid PC 1633%). Implementing a multi-focus improvement plan with feasible and specific actions can be a useful tool for improving pharmacy indicators. Copyright © 2009 Elsevier España, S.L. All rights reserved.

Do BRCA1/2 mutation carriers have an earlier onset of natural menopause?

PubMed

van Tilborg, Theodora C; Broekmans, Frank J; Pijpe, Anouk; Schrijver, Lieske H; Mooij, Thea M; Oosterwijk, Jan C; Verhoef, Senno; Gómez Garcia, Encarna B; van Zelst-Stams, Wendy A; Adank, Muriel A; van Asperen, Christi J; van Doorn, Helena C; van Os, Theo A; Bos, Anna M; Rookus, Matti A; Ausems, Margreet G

2016-08-01

It has been hypothesized that BRCA1/2 mutation carriers have an earlier age at natural menopause (ANM), although to date findings are inconclusive. This study assessed the influence of BRCA mutation status on ANM, and aimed to explore the reasons of inconsistency in the literature. Cross-sectional assessment from an ongoing nationwide cohort study among members of BRCA1/2 mutated families. Information was obtained by a standardized questionnaire. Kaplan-Meier curves were constructed, and Cox regression was used to assess the association between BRCA1/2 mutation status and ANM. Adjustments were made for birth cohort, family, smoking, use of hormonal contraceptives, and parity. A total of 1,208 BRCA1/2 mutation carriers and 2,211 proven noncarriers were included. Overall, no association was found between BRCA1/2 mutation status and ANM (adjusted hazard ratio [HR] = 1.06 [95% CI, 0.87-1.30]). We examined if the null finding was due to informative censoring by uptake of risk-reducing salpingo-oophorectomy. Indeed, within the oldest birth cohort, in which the percentage of surgical menopause events was lowest and comparable between carriers and noncarriers, the HR for earlier natural menopause in carriers was 1.45 (95% CI, 1.09-1.94). The second oldest birth cohort, however, demonstrated a decreased HR (0.67 [95% CI, 0.46-0.98]), and thus no trend over birth cohorts was found. Various types of selection bias hamper the comparison of ANM between BRCA1/2 mutation carriers and noncarriers, genetically tested in the clinic.

Operative rigid bronchoscopy: indications, basic techniques and results.

PubMed

Petrella, Francesco; Borri, Alessandro; Casiraghi, Monica; Cavaliere, Sergio; Donghi, Stefano; Galetta, Domenico; Gasparri, Roberto; Guarize, Juliana; Pardolesi, Alessandro; Solli, Piergiorgio; Tessitore, Adele; Venturino, Marco; Veronesi, Giulia; Spaggiari, Lorenzo

2014-05-27

Palliative airway treatments are essential to improve quality and length of life in lung cancer patients with central airway obstruction. Rigid bronchoscopy has proved to be an excellent tool to provide airway access and control in this cohort of patients. The main indication for rigid bronchoscopy in adult bronchology remains central airway obstruction due to neoplastic or non-neoplastic disease. We routinely use negative pressure ventilation (NPV) under general anaesthesia to prevent intraoperative apnoea and respiratory acidosis. This procedure allows opioid sparing, a shorter recovery time and avoids manually assisted ventilation, thereby reducing the amount of oxygen needed, while maintaining optimal surgical conditions. The major indication for NPV rigid bronchoscopy at our institution has been airway obstruction by neoplastic tracheobronchial tissue, mainly treated by laser-assisted mechanical dissection. When strictly necessary, we use silicone stents for neoplastic or cicatricial strictures, reserving metal stents to cover tracheo-oesophageal fistulae. NPV rigid bronchoscopy is an excellent tool for the endoscopic treatment of locally advanced tumours of the lung, especially when patients have exhausted the conventional therapeutic resources. Laser-assisted mechanical resection and stent placement are the most effective procedures for preserving quality of life in patients with advanced stage cancer. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-thoracic Surgery. All rights reserved.

The case for earlier cochlear implantation in postlingually deaf adults.

PubMed

Dowell, Richard C

2016-01-01

This paper aimed to estimate the difference in speech perception outcomes that may occur due to timing of cochlear implantation in relation to the progression of hearing loss. Data from a large population-based sample of adults with acquired hearing loss using cochlear implants (CIs) was used to estimate the effects of duration of hearing loss, age, and pre-implant auditory skills on outcomes for a hypothetical standard patient. A total of 310 adults with acquired severe/profound bilateral hearing loss who received a CI in Melbourne, Australia between 1994 and 2006 provided the speech perception data and demographic information to derive regression equations for estimating CI outcomes. For a hypothetical CI candidate with progressive sensorineural hearing loss, the estimates of speech perception scores following cochlear implantation are significantly better if implantation occurs relatively soon after onset of severe hearing loss and before the loss of all functional auditory skills. Improved CI outcomes and quality of life benefit may be achieved for adults with progressive severe hearing loss if they are implanted earlier in the progression of the pathology.

[Infection prevention in Dutch hospitals; results say more than process indicators].

PubMed

Bonten, Marc J M; Friedrich, Alexander; Kluytmans, Jan A J W; Vandenbroucke-Grauls, Christina M J E; Voss, Andreas; Vos, Margreet C

2014-01-01

The Dutch Health Care Inspectorate investigated the preparedness of Dutch hospitals for the emergence of antibiotic resistance, and concluded that hospitals are not well prepared and are insufficiently aware that infection prevention is a prerequisite for patient safety. These conclusions are based on observations of process indicators of current practice guidelines, without including the available outcome indicators that demonstrate the persistently low incidence of infections with antibiotic resistant bacteria in Dutch hospitals. The conclusions may have negative effects on the quality of infection prevention in Dutch hospitals. Therefore, it is advisable to use outcome indicators rather than process indicators to evaluate the quality of infection prevention.

Changes in Selected Biochemical Indices Resulting from Various Pre-sampling Handling Techniques in Broilers

PubMed Central

2011-01-01

Background Since it is not yet clear whether it is possible to satisfactorily avoid sampling-induced stress interference in poultry, more studies on the pattern of physiological response and detailed quantification of stress connected with the first few minutes of capture and pre-sampling handling in poultry are required. This study focused on detection of changes in the corticosterone level and concentrations of other selected biochemical parameters in broilers handled in two different manners during blood sampling (involving catching, carrying, restraint, and blood collection itself) that lasted for various time periods within the interval 30-180 seconds. Methods Stress effects of pre-sampling handling were studied in a group (n = 144) of unsexed ROSS 308 broiler chickens aged 42 d. Handling (catching, carrying, restraint, and blood sampling itself) was carried out in a gentle (caught, held and carried carefully in an upright position) or rough (caught by the leg, held and carried with lack of care in inverted position) manner and lasted for 30 s, 60 s, 90 s, 120 s, 150 s, and 180 s. Plasma corticosterone, albumin, glucose, cholesterol, lactate, triglycerides and total protein were measured in order to assess the stress-induced changes to these biochemical indices following handling in the first few minutes of capture. Results Pre-sampling handling in a rough manner resulted in considerably higher plasma concentrations of all biochemical indices monitored when compared with gentle handling. Concentrations of plasma corticosterone after 150 and 180 s of handling were considerably higher (P < 0.01) than concentrations after 30-120 s of handling regardless of handling technique. Concentrations of plasma lactate were also increased by prolonged handling duration. Handling for 90-180 seconds resulted in a highly significant elevation of lactate concentration in comparison with 30 s handling regardless of handling technique. Similarly to corticosterone concentrations

Selection of children to provide care: the effect of earlier parental transfers.

PubMed

Henretta, J C; Hill, M S; Li, W; Soldo, B J; Wolf, D A

1997-05-01

We use the first wave of data from the Asset and Health Dynamics Among the Oldest Old (AHEAD) study to examine the effects of past parent-to-child financial transfers on selection of a child to provide assistance with basic personal care for unmarried parents. We estimate a fixed-effects conditional logit model and find a positive and significant association between past financial transfers and a child's current helping behavior. The coefficient of past financial transfers is in the direction hypothesized, and its magnitude is 80% as large as that of gender, a well-documented powerful predictor of parental caregiving. There appears to be substantial evidence that earlier parent-to-child financial gifts play a role in determining which child in the family will provide assistance.

Moderately premature infants at Kaiser Permanente Medical Care Program in California are discharged home earlier than their peers in Massachusetts and the United Kingdom

PubMed Central

Profit, J; Zupancic, J A F; McCormick, M C; Richardson, D K; Escobar, G J; Tucker, J; Tarnow‐Mordi, W; Parry, G

2006-01-01

Objective To compare gestational age at discharge between infants born at 30–34+6 weeks gestational age who were admitted to neonatal intensive care units (NICUs) in California, Massachusetts, and the United Kingdom. Design Prospective observational cohort study. Setting Fifty four United Kingdom, five California, and five Massachusetts NICUs. Subjects A total of 4359 infants who survived to discharge home after admission to an NICU. Main outcome measures Gestational age at discharge home. Results The mean (SD) postmenstrual age at discharge of the infants in California, Massachusetts, and the United Kingdom were 35.9 (1.3), 36.3 (1.3), and 36.3 (1.9) weeks respectively (p  =  0.001). Compared with the United Kingdom, adjusted discharge of infants occurred 3.9 (95% confidence interval (CI) 1.4 to 6.5) days earlier in California, and 0.9 (95% CI −1.2 to 3.0) days earlier in Massachusetts. Conclusions Infants of 30–34+6 weeks gestation at birth admitted and cared for in hospitals in California have a shorter length of stay than those in the United Kingdom. Certain characteristics of the integrated healthcare approach pursued by the health maintenance organisation of the NICUs in California may foster earlier discharge. The California system may provide opportunities for identifying practices for reducing the length of stay of moderately premature infants. PMID:16449257

Earlier adolescent substance use onset predicts stronger connectivity between reward and cognitive control brain networks.

PubMed

Weissman, David G; Schriber, Roberta A; Fassbender, Catherine; Atherton, Olivia; Krafft, Cynthia; Robins, Richard W; Hastings, Paul D; Guyer, Amanda E

2015-12-01

Early adolescent onset of substance use is a robust predictor of future substance use disorders. We examined the relation between age of substance use initiation and resting state functional connectivity (RSFC) of the core reward processing (nucleus accumbens; NAcc) to cognitive control (prefrontal cortex; PFC) brain networks. Adolescents in a longitudinal study of Mexican-origin youth reported their substance use annually from ages 10 to 16 years. At age 16, 69 adolescents participated in a resting state functional magnetic resonance imaging scan. Seed-based correlational analyses were conducted using regions of interest in bilateral NAcc. The earlier that adolescents initiated substance use, the stronger the connectivity between bilateral NAcc and right dorsolateral PFC, right dorsomedial PFC, right pre-supplementary motor area, right inferior parietal lobule, and left medial temporal gyrus. The regions that demonstrated significant positive linear relationships between the number of adolescent years using substances and connectivity with NAcc are nodes in the right frontoparietal network, which is central to cognitive control. The coupling of reward and cognitive control networks may be a mechanism through which earlier onset of substance use is related to brain function over time, a trajectory that may be implicated in subsequent substance use disorders. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

The Sooner, the Worse? Association between Earlier Age of Sexual Initiation and Worse Adolescent Health and Well-being Outcomes

PubMed Central

Osorio, Alfonso; Lopez-del Burgo, Cristina; Carlos, Silvia; de Irala, Jokin

2017-01-01

This cross-sectional study assesses the association between age of sexual initiation during adolescence and a selection of well-being outcomes regarding that first relationship. High-school adolescents from El Salvador (2,686) and from Peru (3,399) replied to a paper-pencil questionnaire. Those who were sexually initiated replied to several questions regarding their age at sexual initiation, condom use, satisfaction and reasons/circumstances for that sexual relationship. Approximately 19% of participants were sexually initiated (n = 1,179). After retaining participants with valid responses and with sexual initiation ages between 13 and 17, the final sample for this paper consisted of 996 sexually initiated participants (526 Salvadorians and 470 Peruvians). Multiple logistic regression analyses showed that those who initiated sex at earlier ages had worse outcomes compared to those who initiated at older ages. Specifically, they had lower odds of having used a condom, of having good memories of that experience and of having had that first relationship because they were in love. Conversely, they had higher odds of having had that first sexual relationship as a result of peer pressure (“Most of my friends already had sex”), because of partner pressure (“I was afraid to lose him/her,” “My partner told me he/she would leave me” or “I did not know how to say no to a person who insisted”), or as a consequence of different forms of impaired autonomy (“I was under the influence of alcohol or drugs” or “As a consequence of seeing sexual images”). Results show that sex at earlier ages is associated with worse adolescent health and well-being outcomes. PMID:28798715

Combined circulating tumor DNA and protein biomarker-based liquid biopsy for the earlier detection of pancreatic cancers.

PubMed

Cohen, Joshua D; Javed, Ammar A; Thoburn, Christopher; Wong, Fay; Tie, Jeanne; Gibbs, Peter; Schmidt, C Max; Yip-Schneider, Michele T; Allen, Peter J; Schattner, Mark; Brand, Randall E; Singhi, Aatur D; Petersen, Gloria M; Hong, Seung-Mo; Kim, Song Cheol; Falconi, Massimo; Doglioni, Claudio; Weiss, Matthew J; Ahuja, Nita; He, Jin; Makary, Martin A; Maitra, Anirban; Hanash, Samir M; Dal Molin, Marco; Wang, Yuxuan; Li, Lu; Ptak, Janine; Dobbyn, Lisa; Schaefer, Joy; Silliman, Natalie; Popoli, Maria; Goggins, Michael G; Hruban, Ralph H; Wolfgang, Christopher L; Klein, Alison P; Tomasetti, Cristian; Papadopoulos, Nickolas; Kinzler, Kenneth W; Vogelstein, Bert; Lennon, Anne Marie

2017-09-19

The earlier diagnosis of cancer is one of the keys to reducing cancer deaths in the future. Here we describe our efforts to develop a noninvasive blood test for the detection of pancreatic ductal adenocarcinoma. We combined blood tests for KRAS gene mutations with carefully thresholded protein biomarkers to determine whether the combination of these markers was superior to any single marker. The cohort tested included 221 patients with resectable pancreatic ductal adenocarcinomas and 182 control patients without known cancer. KRAS mutations were detected in the plasma of 66 patients (30%), and every mutation found in the plasma was identical to that subsequently found in the patient's primary tumor (100% concordance). The use of KRAS in conjunction with four thresholded protein biomarkers increased the sensitivity to 64%. Only one of the 182 plasma samples from the control cohort was positive for any of the DNA or protein biomarkers (99.5% specificity). This combinatorial approach may prove useful for the earlier detection of many cancer types.

Cost-Effectiveness of Earlier Initiation of Antiretroviral Therapy for Uninsured HIV-Infected Adults

PubMed Central

Schackman, Bruce R.; Goldie, Sue J.; Weinstein, Milton C.; Losina, Elena; Zhang, Hong; Freedberg, Kenneth A.

2001-01-01

Objectives. This study was designed to examine the societal cost-effectiveness and the impact on government payers of earlier initiation of antiretroviral therapy for uninsured HIV-infected adults. Methods. A state-transition simulation model of HIV disease was used. Data were derived from the Multicenter AIDS Cohort Study, published randomized trials, and medical care cost estimates for all government payers and for Massachusetts, New York, and Florida. Results. Quality-adjusted life expectancy increased from 7.64 years with therapy initiated at 200 CD4 cells/μL to 8.21 years with therapy initiated at 500 CD4 cells/μL. Initiating therapy at 500 CD4/μL was a more efficient use of resources than initiating therapy at 200 CD4/μL and had an incremental cost-effectiveness ratio of $17 300 per quality-adjusted life-year gained, compared with no therapy. Costs to state payers in the first 5 years ranged from $5500 to $24 900 because of differences among the states in the availability of federal funds for AIDS drug assistance programs. Conclusions. Antiretroviral therapy initiated at 500 CD4 cells/μL is cost-effective from a societal perspective compared with therapy initiated later. States should consider Medicaid waivers to expand access to early therapy. PMID:11527782

Health care strategies to promote earlier presentation of symptomatic breast cancer: perspectives of women and family physicians

PubMed Central

Heisey, R.; Clemons, M.; Granek, L.; Fergus, K.; Hum, S.; Lord, B.; McCready, D.R.; Fitzgerald, B.

2011-01-01

Background Many women with symptoms suggestive of a breast cancer diagnosis delay presentation to their family physician. Although factors associated with delay have been well described, there is a paucity of data on strategies to mitigate delay. Objectives We conducted a qualitative research project to examine factors related to delay and to identify health care system changes that might encourage earlier presentation. Methods Individual semi-structured interviews were conducted with women who sought care 12 weeks or more after self-detection of breast cancer symptoms and with family physicians whose practices included patients meeting that criterion. Results The women and physicians both suggested a need for clearer screening mammography guidelines for women 40–49 years of age and for better messaging concerning breast awareness. The use of additional hopeful testimonials from breast cancer survivors were suggested to help dispel the notion of cancer as a “death sentence.” Educational initiatives were proposed, aimed at both increasing awareness of “non-lump” breast cancer symptoms and advising women that a previous benign diagnosis does not ensure that future symptoms are not cancer. Women wanted empathic nonjudgmental access to care. Improved methods to track compliance with screening mammography and with periodic health exams and access to a rapid diagnostic process were suggested. Conclusions A list of “at-risk situations for delay” in diagnosis of breast cancer was developed for physicians to assist in identifying women who might delay. Health care system changes actionable both at the health policy level and in the family physician’s office were identified to encourage earlier presentation of women with symptomatic breast cancer. PMID:21980254

The HepHIV 2017 Conference in Malta: joining forces for the earlier diagnosis of HIV and viral hepatitis.

PubMed

Raben, D; Hoekstra, M; Sperle, I; Amato Gauci, A J; Gauci, C; West, B; Sullivan, A; Lazarus, J V; Platteau, T; Rockstroh, J K

2018-02-01

The objective of the article is to provide an overview of the results of the HepHIV 2017 Conference organized by the HIV in Europe initiative under the Maltese EU Presidency in January 2017. A thourough review of all conference presentations (oral and poster presentations) was performed to retrieve the key outcomes of the conference. The key result from the conference was a call to action summarising key priorities in HIV and viral hepatitis testing and linkage to care. This included improving monitoring of viral hepatitis and HIV, mixing testing strategies and ensuring policy support. The important contribution and outcomes of EU funded projects OptTEST and EuroHIVEdat was highlighted. An integrated approach to earlier testing and linkage to care across diseases is needed in Europe and the HepHIV conferences create an important forum to reach this aim. © 2018 British HIV Association.

An earlier origin for the Acheulian.

PubMed

Lepre, Christopher J; Roche, Hélène; Kent, Dennis V; Harmand, Sonia; Quinn, Rhonda L; Brugal, Jean-Philippe; Texier, Pierre-Jean; Lenoble, Arnaud; Feibel, Craig S

2011-08-31

The Acheulian is one of the first defined prehistoric techno-complexes and is characterized by shaped bifacial stone tools. It probably originated in Africa, spreading to Europe and Asia perhaps as early as ∼1 million years (Myr) ago. The origin of the Acheulian is thought to have closely coincided with major changes in human brain evolution, allowing for further technological developments. Nonetheless, the emergence of the Acheulian remains unclear because well-dated sites older than 1.4 Myr ago are scarce. Here we report on the lithic assemblage and geological context for the Kokiselei 4 archaeological site from the Nachukui formation (West Turkana, Kenya) that bears characteristic early Acheulian tools and pushes the first appearance datum for this stone-age technology back to 1.76 Myr ago. Moreover, co-occurrence of Oldowan and Acheulian artefacts at the Kokiselei site complex indicates that the two technologies are not mutually exclusive time-successive components of an evolving cultural lineage, and suggests that the Acheulian was either imported from another location yet to be identified or originated from Oldowan hominins at this vicinity. In either case, the Acheulian did not accompany the first human dispersal from Africa despite being available at the time. This may indicate that multiple groups of hominins distinguished by separate stone-tool-making behaviours and dispersal strategies coexisted in Africa at 1.76 Myr ago.

Percentile-Based ETCCDI Temperature Extremes Indices for CMIP5 Model Output: New Results through Semiparametric Quantile Regression Approach

NASA Astrophysics Data System (ADS)

Li, L.; Yang, C.

2017-12-01

Climate extremes often manifest as rare events in terms of surface air temperature and precipitation with an annual reoccurrence period. In order to represent the manifold characteristics of climate extremes for monitoring and analysis, the Expert Team on Climate Change Detection and Indices (ETCCDI) had worked out a set of 27 core indices based on daily temperature and precipitation data, describing extreme weather and climate events on an annual basis. The CLIMDEX project (http://www.climdex.org) had produced public domain datasets of such indices for data from a variety of sources, including output from global climate models (GCM) participating in the Coupled Model Intercomparison Project Phase 5 (CMIP5). Among the 27 ETCCDI indices, there are six percentile-based temperature extremes indices that may fall into two groups: exceedance rates (ER) (TN10p, TN90p, TX10p and TX90p) and durations (CSDI and WSDI). Percentiles must be estimated prior to the calculation of the indices, and could more or less be biased by the adopted algorithm. Such biases will in turn be propagated to the final results of indices. The CLIMDEX used an empirical quantile estimator combined with a bootstrap resampling procedure to reduce the inhomogeneity in the annual series of the ER indices. However, there are still some problems remained in the CLIMDEX datasets, namely the overestimated climate variability due to unaccounted autocorrelation in the daily temperature data, seasonally varying biases and inconsistency between algorithms applied to the ER indices and to the duration indices. We now present new results of the six indices through a semiparametric quantile regression approach for the CMIP5 model output. By using the base-period data as a whole and taking seasonality and autocorrelation into account, this approach successfully addressed the aforementioned issues and came out with consistent results. The new datasets cover the historical and three projected (RCP2.6, RCP4.5 and RCP

A Hepatocellular Carcinoma Case in a Patient Who had Immunity to Hepatitis B Virus Earlier.

PubMed

Ates, Ihsan; Kaplan, Mustafa; Demirci, Selim; Altiparmak, Emin

2016-01-01

Hepatocellular carcinoma (HCC) is the most common malignant tumor of the liver. Hepatitis B virus infection is one of the most important etilogical factors of HCC. In this case report, a patient with HCC previously infected and having ongoing immunity against hepatitis B virus will be discussed. Ates I, Kaplan M, Demirci S, Altiparmak E. A Hepatocellular Carcinoma Case in a Patient Who had Immunity to Hepatitis B Virus Earlier. Euroasian J Hepato-Gastroenterol 2016;6(1):82-83.

Deformation strain is the main physical driver for skeletal precursors to undergo osteogenesis in earlier stages of osteogenic cell maturation.

PubMed

Ramani-Mohan, Ram-Kumar; Schwedhelm, Ivo; Finne-Wistrand, Anna; Krug, Melanie; Schwarz, Thomas; Jakob, Franz; Walles, Heike; Hansmann, Jan

2018-03-01

Mesenchymal stem cells play a major role during bone remodelling and are thus of high interest for tissue engineering and regenerative medicine applications. Mechanical stimuli, that is, deformation strain and interstitial fluid-flow-induced shear stress, promote osteogenic lineage commitment. However, the predominant physical stimulus that drives early osteogenic cell maturation is not clearly identified. The evaluation of each stimulus is challenging, as deformation and fluid-flow-induced shear stress interdepend. In this study, we developed a bioreactor that was used to culture mesenchymal stem cells harbouring a strain-responsive AP-1 luciferase reporter construct, on porous scaffolds. In addition to the reporter, mineralization and vitality of the cells was investigated by alizarin red staining and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide. Quantification of the expression of genes associated to bone regeneration and bone remodelling was used to confirm alizarin red measurements. Controlled perfusion and deformation of the 3-dimensional scaffold facilitated the alteration of the expression of osteogenic markers, luciferase activity, and calcification. To isolate the specific impact of scaffold deformation, a computational model was developed to derive a perfusion flow profile that results in dynamic shear stress conditions present in periodically loaded scaffolds. In comparison to actually deformed scaffolds, a lower expression of all measured readout parameters indicated that deformation strain is the predominant stimulus for skeletal precursors to undergo osteogenesis in earlier stages of osteogenic cell maturation. Copyright © 2017 John Wiley & Sons, Ltd.

Quantifying the economic value and quality of life impact of earlier influenza vaccination.

PubMed

Lee, Bruce Y; Bartsch, Sarah M; Brown, Shawn T; Cooley, Philip; Wheaton, William D; Zimmerman, Richard K

2015-03-01

Influenza vaccination is administered throughout the influenza disease season, even as late as March. Given such timing, what is the value of vaccinating the population earlier than currently being practiced? We used real data on when individuals were vaccinated in Allegheny County, Pennsylvania, and the following 2 models to determine the value of vaccinating individuals earlier (by the end of September, October, and November): Framework for Reconstructing Epidemiological Dynamics (FRED), an agent-based model (ABM), and FluEcon, our influenza economic model that translates cases from the ABM to outcomes and costs [health care and lost productivity costs and quality-adjusted life-years (QALYs)]. We varied the reproductive number (R0) from 1.2 to 1.6. Applying the current timing of vaccinations averted 223,761 influenza cases, $16.3 million in direct health care costs, $50.0 million in productivity losses, and 804 in QALYs, compared with no vaccination (February peak, R0 1.2). When the population does not have preexisting immunity and the influenza season peaks in February (R0 1.2-1.6), moving individuals who currently received the vaccine after September to the end of September could avert an additional 9634-17,794 influenza cases, $0.6-$1.4 million in direct costs, $2.1-$4.0 million in productivity losses, and 35-64 QALYs. Moving the vaccination of just children to September (R0 1.2-1.6) averted 11,366-1660 influenza cases, $0.6-$0.03 million in direct costs, $2.3-$0.2 million in productivity losses, and 42-8 QALYs. Moving the season peak to December increased these benefits, whereas increasing preexisting immunity reduced these benefits. Even though many people are vaccinated well after September/October, they likely are still vaccinated early enough to provide substantial cost-savings.

Changes in selected biochemical indices resulting from various pre-sampling handling techniques in broilers.

PubMed

Chloupek, Petr; Bedanova, Iveta; Chloupek, Jan; Vecerek, Vladimir

2011-05-13

Since it is not yet clear whether it is possible to satisfactorily avoid sampling-induced stress interference in poultry, more studies on the pattern of physiological response and detailed quantification of stress connected with the first few minutes of capture and pre-sampling handling in poultry are required. This study focused on detection of changes in the corticosterone level and concentrations of other selected biochemical parameters in broilers handled in two different manners during blood sampling (involving catching, carrying, restraint, and blood collection itself) that lasted for various time periods within the interval 30-180 seconds. Stress effects of pre-sampling handling were studied in a group (n = 144) of unsexed ROSS 308 broiler chickens aged 42 d. Handling (catching, carrying, restraint, and blood sampling itself) was carried out in a gentle (caught, held and carried carefully in an upright position) or rough (caught by the leg, held and carried with lack of care in inverted position) manner and lasted for 30 s, 60 s, 90 s, 120 s, 150 s, and 180 s. Plasma corticosterone, albumin, glucose, cholesterol, lactate, triglycerides and total protein were measured in order to assess the stress-induced changes to these biochemical indices following handling in the first few minutes of capture. Pre-sampling handling in a rough manner resulted in considerably higher plasma concentrations of all biochemical indices monitored when compared with gentle handling. Concentrations of plasma corticosterone after 150 and 180 s of handling were considerably higher (P < 0.01) than concentrations after 30-120 s of handling regardless of handling technique. Concentrations of plasma lactate were also increased by prolonged handling duration. Handling for 90-180 seconds resulted in a highly significant elevation of lactate concentration in comparison with 30 s handling regardless of handling technique. Similarly to corticosterone concentrations, a strong positive

The Earlier the Better? Taking the AP® in 10th Grade. Research Report No. 2012-10

ERIC Educational Resources Information Center

Rodriguez, Awilda; McKillip, Mary E. M.; Niu, Sunny X.

2013-01-01

In this report, the authors examine the impact of scoring a 1 or 2 on an AP® Exam in 10th grade on later AP Exam participation and performance. As access to AP courses increases within and across schools, a growing number of students are taking AP courses and exams in the earlier grades of high school. Using a matched sample of AP and no-AP…

Key Performance Indicators: From Promise to Payoff. The Productivity for Results Series No. 2

ERIC Educational Resources Information Center

Casserly, Michael; Eugene, Michael

2014-01-01

This paper draws upon the expertise of two leading educators, Michael Casserly, director of the Council of the Great City Schools, and Michael Eugene, chief operating officer of the Orange County Public Schools in Florida. They outline a set of key performance indicators that some urban districts use to benchmark the results of their operating…

Association between severe dorsolateral prefrontal dysfunction during random number generation and earlier onset in schizophrenia.

PubMed

Koike, Shinsuke; Takizawa, Ryu; Nishimura, Yukika; Marumo, Kohei; Kinou, Masaru; Kawakubo, Yuki; Rogers, Mark A; Kasai, Kiyoto

2011-08-01

Schizophrenia involves impairment in attention, working memory and executive processes associated with prefrontal cortical function, an essential contributor of social functioning. Age at onset is a major factor for predicting social outcome in schizophrenia. In clinical settings, we need an objective assessment tool for evaluating prefrontal function and social outcome. Participants included 22 right-handed patients with schizophrenia and 40 gender- and age-matched healthy controls. We used a 52-channel near-infrared spectroscopy (NIRS) instrument to measure oxygenated haemoglobin ([oxy-Hb]) changes over the prefrontal cortex during a random number generation (RNG) task. In healthy controls, we found significant [oxy-Hb] increase in the bilateral dorsolateral (DLPFC; BA9 and BA46) and ventrolateral prefrontal cortex (VLPFC; BA44, 45 and 47). The patients with schizophrenia showed significantly smaller activation than the healthy controls in the same approximate regions. In the patient group, a smaller [oxy-Hb] increase in the right DLPFC region (BA9) was significantly correlated with earlier age at onset. NIRS can detect prefrontal cortical dysfunction associated with an executive task, which was coupled with earlier age at onset in schizophrenia. Multichannel NIRS, a non-invasive and user-friendly instrument, may be useful in evaluating cognitive function and social outcome in clinical settings in psychiatry. Copyright © 2011 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Do clinical safety charts improve paramedic key performance indicator results? (A clinical improvement programme evaluation).

PubMed

Ebbs, Phillip; Middleton, Paul M; Bonner, Ann; Loudfoot, Allan; Elliott, Peter

2012-07-01

Is the Clinical Safety Chart clinical improvement programme (CIP) effective at improving paramedic key performance indicator (KPI) results within the Ambulance Service of New South Wales? The CIP intervention area was compared with the non-intervention area in order to determine whether there was a statistically significant improvement in KPI results. The CIP was associated with a statistically significant improvement in paramedic KPI results within the intervention area. The strategies used within this CIP are recommended for further consideration.

Combined circulating tumor DNA and protein biomarker-based liquid biopsy for the earlier detection of pancreatic cancers

PubMed Central

Cohen, Joshua D.; Javed, Ammar A.; Thoburn, Christopher; Wong, Fay; Tie, Jeanne; Gibbs, Peter; Schmidt, C. Max; Yip-Schneider, Michele T.; Allen, Peter J.; Schattner, Mark; Brand, Randall E.; Singhi, Aatur D.; Petersen, Gloria M.; Hong, Seung-Mo; Kim, Song Cheol; Falconi, Massimo; Doglioni, Claudio; Weiss, Matthew J.; Ahuja, Nita; He, Jin; Makary, Martin A.; Maitra, Anirban; Hanash, Samir M.; Dal Molin, Marco; Wang, Yuxuan; Li, Lu; Ptak, Janine; Dobbyn, Lisa; Schaefer, Joy; Silliman, Natalie; Popoli, Maria; Goggins, Michael G.; Hruban, Ralph H.; Wolfgang, Christopher L.; Klein, Alison P.; Tomasetti, Cristian; Papadopoulos, Nickolas; Kinzler, Kenneth W.; Vogelstein, Bert; Lennon, Anne Marie

2017-01-01

The earlier diagnosis of cancer is one of the keys to reducing cancer deaths in the future. Here we describe our efforts to develop a noninvasive blood test for the detection of pancreatic ductal adenocarcinoma. We combined blood tests for KRAS gene mutations with carefully thresholded protein biomarkers to determine whether the combination of these markers was superior to any single marker. The cohort tested included 221 patients with resectable pancreatic ductal adenocarcinomas and 182 control patients without known cancer. KRAS mutations were detected in the plasma of 66 patients (30%), and every mutation found in the plasma was identical to that subsequently found in the patient’s primary tumor (100% concordance). The use of KRAS in conjunction with four thresholded protein biomarkers increased the sensitivity to 64%. Only one of the 182 plasma samples from the control cohort was positive for any of the DNA or protein biomarkers (99.5% specificity). This combinatorial approach may prove useful for the earlier detection of many cancer types. PMID:28874546

An environmental generalised Luenberger-Hicks-Moorsteen productivity indicator and an environmental generalised Hicks-Moorsteen productivity index.

PubMed

Abad, A

2015-09-15

The purpose of this paper is to introduce an environmental generalised productivity indicator and its ratio-based counterpart. The innovative environmental generalised total factor productivity measures inherit the basic structure of both Hicks-Moorsteen productivity index and Luenberger-Hicks-Moorsteen productivity indicator. This methodological contribution shows that these new environmental generalised total factor productivity measures yield the earlier standard Hicks-Moorsteen index and Luenberger-Hicks-Moorsteen indicator, as well as environmental performance index, as special cases. Copyright © 2015 Elsevier Ltd. All rights reserved.

Lung transplantation for cystic fibrosis: results, indications, complications, and controversies.

PubMed

Lynch, Joseph P; Sayah, David M; Belperio, John A; Weigt, S Sam

2015-04-01

Survival in patients with cystic fibrosis (CF) has improved dramatically over the past 30 to 40 years, with mean survival now approximately 40 years. Nonetheless, progressive respiratory insufficiency remains the major cause of mortality in CF patients, and lung transplantation (LT) is eventually required. Timing of listing for LT is critical, because up to 25 to 41% of CF patients have died while awaiting LT. Globally, approximately 16.4% of lung transplants are performed in adults with CF. Survival rates for LT recipients with CF are superior to other indications, yet LT is associated with substantial morbidity and mortality (∼50% at 5-year survival rates). Myriad complications of LT include allograft failure (acute or chronic), opportunistic infections, and complications of chronic immunosuppressive medications (including malignancy). Determining which patients are candidates for LT is difficult, and survival benefit remains uncertain. In this review, we discuss when LT should be considered, criteria for identifying candidates, contraindications to LT, results post-LT, and specific complications that may be associated with LT. Infectious complications that may complicate CF (particularly Burkholderia cepacia spp., opportunistic fungi, and nontuberculous mycobacteria) are discussed. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Lung Transplantation for Cystic Fibrosis: Results, Indications, Complications, and Controversies

PubMed Central

Lynch, Joseph P.; Sayah, David M.; Belperio, John A.; Weigt, S. Sam

2016-01-01

Survival in patients with cystic fibrosis (CF) has improved dramatically over the past 30 to 40 years, with mean survival now approximately 40 years. Nonetheless, progressive respiratory insufficiency remains the major cause of mortality in CF patients, and lung transplantation (LT) is eventually required. Timing of listing for LT is critical, because up to 25 to 41% of CF patients have died while awaiting LT. Globally, approximately 16.4% of lung transplants are performed in adults with CF. Survival rates for LT recipients with CF are superior to other indications, yet LT is associated with substantial morbidity and mortality (~50% at 5-year survival rates). Myriad complications of LT include allograft failure (acute or chronic), opportunistic infections, and complications of chronic immunosuppressive medications (including malignancy). Determining which patients are candidates for LT is difficult, and survival benefit remains uncertain. In this review, we discuss when LT should be considered, criteria for identifying candidates, contraindications to LT, results post-LT, and specific complications that may be associated with LT. Infectious complications that may complicate CF (particularly Burkholderia cepacia spp., opportunistic fungi, and nontuberculous mycobacteria) are discussed. PMID:25826595

Colorectal cancer occurs earlier in those exposed to tobacco smoke: implications for screening

PubMed Central

Mahoney, Martin C.; Cummings, K. Michael; Michalek, Arthur M.; Reid, Mary E.; Moysich, Kirsten B.; Hyland, Andrew

2011-01-01

Background Colorectal cancer (CRC) is the third most common cancer in the USA. While various lifestyle factors have been shown to alter the risk for colorectal cancer, recommendations for the early detection of CRC are based only on age and family history. Methods This case-only study examined the age at diagnosis of colorectal cancer in subjects exposed to tobacco smoke. Subjects included all patients who attended RPCI between 1957 and 1997, diagnosed with colorectal cancer, and completed an epidemiologic questionnaire. Adjusted linear regression models were calculated for the various smoking exposures. Results Of the 3,540 cases of colorectal cancer, current smokers demonstrated the youngest age of CRC onset (never: 64.2 vs. current: 57.4, P < 0.001) compared to never smokers, followed by recent former smokers. Among never smokers, individuals with past second-hand smoke exposure were diagnosed at a significantly younger age compared to the unexposed. Conclusion This study found that individuals with heavy, long-term tobacco smoke exposure were significantly younger at the time of CRC diagnosis compared to lifelong never smokers. The implication of this finding is that screening for colorectal cancer, which is recommended to begin at age 50 years for persons at average risk should be initiated 5–10 years earlier for persons with a significant lifetime history of exposure to tobacco smoke. PMID:18264728

Refractive indices at visible wavelengths of soot emitted from buoyant turbulent diffusion flames

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

Wu, J.S.; Krishnan, S.K.; Faeth, G.M.

1996-11-01

Measurements of the optical properties of soot, emphasizing refractive indices, are reported for visible wavelengths. The experiments considered soot in the fuel-lean (overfire) region of buoyant turbulent diffusion flames in the long residence time regime where soot properties are independent of position in the overfire region and residence time. Flames fueled with acetylene, propylene, ethylene and propane burning in still air provided a range of soot physical and structure properties. Measurements included soot composition, density, structure, gravimetric volume fraction, scattering properties and absorption properties. These data were analyzed to find soot fractal dimensions, refractive indices and dimensionless extinction coefficients, assumingmore » Rayleigh-Debye-Gans scattering for polydisperse mass fractal aggregates (RDG-PFA theory). RDG-PFA theory was successfully evaluated, based on measured scattering patterns. Soot fractal dimensions were independent of both fuel type and wavelength, yielding a mean value of 1.77 with a standard deviation of 0.04. Refractive indices were independent of fuel type within experimental uncertainties and were in reasonably good agreement with earlier measurements for soot in the fuel-lean region of diffusion flames due to Dalzell and Sarofim (1969). Dimensionless extinction coefficients were independent of both fuel type and wavelength, yielding a mean value of 5.1 with a standard deviation of 0.5, which is lower than earlier measurements for reasons that still must be explained.« less

[Tracheobronchial stents: a retrospective analysis of indications, results and in particular complications].

PubMed

Tonn, H; Mall, W; Schneider, K-D; Schönhofer, B

2008-10-01

Tracheobronchial stents are inserted mainly in cases of malignant and benign airway stenosis. Further indications are esophago-tracheal fistulas, mediastinal fistulas and tracheomalacia. A retrospective analysis was conducted on patients' records, information provided by the general practitioners and relatives of the patients from July 1993 to December 2006 in the Department of Pneumology of the Heidehaus Hospital Hannover (since 6/05 Department of Pneumology and Internal Intensive Care Medicine, Oststadt-Heidehaus Hospital). During the observation period of 13 years a total of 269 stents (177 permanent, 92 temporary) were implanted in 207 patients (1.3 stents per patient). The vast majority of patients (173/207) suffered from an underlying malignancy. About half of the stents were deployed in the trachea. The median length of placement was 116 days in patients with malignancies and 313 days in patients with benign diseases. In about 40 % of the patients notable complications were observed which were directly or indirectly associated with the stents. These findings show the importance of a critical indication for stent implantation. In benign diseases a stent can remain for years inside the tracheobronchial system, if it is well tolerated in the beginning. In malignant diseases the result depends decisively on the stage of the tumour: has the stent been implanted before any other tumour therapy is started or is it an end-stage tumor with no other therapeutic option? In general, complications of stents occur quite frequently. The analysis of stent data leads to some aspects for the prevention of stent-related complications. There should be a strict indication and appropriate choice of stent material. Nevertheless, there remains an ethical dilemma in patients with end-stage disease as to whether to implant a stent or to do nothing against the tumor, because the benefit immediately after stent insertion vanishes with progression of the tumour, so causing extra

[Breast cancer screening program. Results of the process and impact indicators (1990-2002)].

PubMed

Ascunce, N; Barcos, A; Ederra, M; Erdozain, N; Murillo, A; Osa, A; Mellado, M

2004-01-01

There is a general consensus on the recommendation of applying breast cancer screening programs to the population. In March 1990, the Health Department set in motion a Program for the Early Detection of Breast Cancer, with the aim of reducing mortality due to this tumour. At present, the program is reaching the end of its seventh round. The present study aims to analyze the results obtained, describing the principal indicators of the process and the impact predictions according to the most determinant factors. Data was collected for the screening explorations carried out from the start of the program up until December 31st 2002; the data was classified according to age at the time of exploration, type of exploration and round. During the period, 354,575 explorations were carried out. Process indicators: an additional exploration was recommended for 11.22% of the women. Naught point sixty seven percent (0.67%) of the women were sent to hospital units for a diagnostic evaluation. A malignant tumour was confirmed in 0.34% of the women subjected to exploration. It was recommended that 8.37% of the women should carry out an intermediate exploration before the next call from the screening program. Predictive impact indicators: global recruitment was 88.68%; global participation 87.91%; and adherence to the program was 96.32%. The rate of detection reached the figure of 3.95 per 1,000 women explored. Of the tumours detected: 19.17% were intraductal and 37.23% of the invasive tumours had a size equal to or below 10mm. Seventy-four point eighty nine percent (74.89%) of total tumours did not show ganglionary invasion. Considering the references established by the European Union for screening programs, all of the calculated predictive indicators exceed the required standards.

A Hepatocellular Carcinoma Case in a Patient Who had Immunity to Hepatitis B Virus Earlier

PubMed Central

Kaplan, Mustafa; Demirci, Selim; Altiparmak, Emin

2016-01-01

ABSTRACT Hepatocellular carcinoma (HCC) is the most common malignant tumor of the liver. Hepatitis B virus infection is one of the most important etilogical factors of HCC. In this case report, a patient with HCC previously infected and having ongoing immunity against hepatitis B virus will be discussed. How to cite this article Ates I, Kaplan M, Demirci S, Altiparmak E. A Hepatocellular Carcinoma Case in a Patient Who had Immunity to Hepatitis B Virus Earlier. Euroasian J Hepato-Gastroenterol 2016;6(1):82-83. PMID:29201732

NMR-based fecal metabolomics fingerprinting as predictors of earlier diagnosis in patients with colorectal cancer.

PubMed

Lin, Yan; Ma, Changchun; Liu, Chengkang; Wang, Zhening; Yang, Jurong; Liu, Xinmu; Shen, Zhiwei; Wu, Renhua

2016-05-17

Colorectal cancer (CRC) is a growing cause of mortality in developing countries, warranting investigation into its earlier detection for optimal disease management. A metabolomics based approach provides potential for noninvasive identification of biomarkers of colorectal carcinogenesis, as well as dissection of molecular pathways of pathophysiological conditions. Here, proton nuclear magnetic resonance spectroscopy (1HNMR) -based metabolomic approach was used to profile fecal metabolites of 68 CRC patients (stage I/II=20; stage III=25 and stage IV=23) and 32 healthy controls (HC). Pattern recognition through principal component analysis (PCA) and orthogonal partial least squares-discriminant analysis (OPLS-DA) was applied on 1H-NMR processed data for dimension reduction. OPLS-DA revealed that each stage of CRC could be clearly distinguished from HC based on their metabolomic profiles. Successive analyses identified distinct disturbances to fecal metabolites of CRC patients at various stages, compared with those in cancer free controls, including reduced levels of acetate, butyrate, propionate, glucose, glutamine, and elevated quantities of succinate, proline, alanine, dimethylglycine, valine, glutamate, leucine, isoleucine and lactate. These altered fecal metabolites potentially involved in the disruption of normal bacterial ecology, malabsorption of nutrients, increased glycolysis and glutaminolysis. Our findings revealed that the fecal metabolic profiles of healthy controls can be distinguished from CRC patients, even in the early stage (stage I/II), highlighting the potential utility of NMR-based fecal metabolomics fingerprinting as predictors of earlier diagnosis in CRC patients.

NMR-based fecal metabolomics fingerprinting as predictors of earlier diagnosis in patients with colorectal cancer

PubMed Central

Lin, Yan; Ma, Changchun; Liu, Chengkang; Wang, Zhening; Yang, Jurong; Liu, Xinmu; Shen, Zhiwei; Wu, Renhua

2016-01-01

Colorectal cancer (CRC) is a growing cause of mortality in developing countries, warranting investigation into its earlier detection for optimal disease management. A metabolomics based approach provides potential for noninvasive identification of biomarkers of colorectal carcinogenesis, as well as dissection of molecular pathways of pathophysiological conditions. Here, proton nuclear magnetic resonance spectroscopy (1HNMR) -based metabolomic approach was used to profile fecal metabolites of 68 CRC patients (stage I/II=20; stage III=25 and stage IV=23) and 32 healthy controls (HC). Pattern recognition through principal component analysis (PCA) and orthogonal partial least squares-discriminant analysis (OPLS-DA) was applied on 1H-NMR processed data for dimension reduction. OPLS-DA revealed that each stage of CRC could be clearly distinguished from HC based on their metabolomic profiles. Successive analyses identified distinct disturbances to fecal metabolites of CRC patients at various stages, compared with those in cancer free controls, including reduced levels of acetate, butyrate, propionate, glucose, glutamine, and elevated quantities of succinate, proline, alanine, dimethylglycine, valine, glutamate, leucine, isoleucine and lactate. These altered fecal metabolites potentially involved in the disruption of normal bacterial ecology, malabsorption of nutrients, increased glycolysis and glutaminolysis. Our findings revealed that the fecal metabolic profiles of healthy controls can be distinguished from CRC patients, even in the early stage (stage I/II), highlighting the potential utility of NMR-based fecal metabolomics fingerprinting as predictors of earlier diagnosis in CRC patients. PMID:27107423

Earlier surgery improves outcomes from painful chronic pancreatitis

PubMed Central

Ke, Nengwen; Jia, Dan; Huang, Wei; Nunes, Quentin M.; Windsor, John A.; Liu, Xubao; Sutton, Robert

2018-01-01

Abstract The timing of surgery for painful chronic pancreatitis (CP) may affect outcomes. Clinical course, Izbicki pain scores, and pancreatic function were retrospectively compared and analyzed between patients undergoing either early or late surgery (< 3 or ≥ 3 years from diagnosis) for painful CP in a single center from 2007 to 2012. The early surgery group (n = 98) more frequently than the late group (n = 199) had abdominal pain with jaundice (22.4% vs 9.5%, P = .002) and pancreatic mass +/− ductal dilatation (47% vs 27%, P < .001), but less frequently abdominal pain alone (73.5% vs 85.9%, P = .009), ductal dilatation alone (31% vs 71%, P < .001), parenchymal calcification (91.8% vs 100%, P < .001) or exocrine insufficiency (60% vs 72%, P = .034); there were no other significant differences. The early group had longer hospital stay (14.4 vs 12.2 days, P = .009), but no difference in complications. Significantly greater pain relief followed early surgery (complete 69% vs 47%, partial 22% vs 37%, none 8% vs 16%, P = .01) with lower rates of exocrine (60% vs 80%, P = .005) and endocrine insufficiency (36% vs 53%, P = .033). Our data indicate that early surgery results in higher rates of pain relief and pancreatic sufficiency than late surgery for chronic pancreatitis patients. Frey and Berne procedures showed better results than other surgical procedures. PMID:29742705

Earlier surgery improves outcomes from painful chronic pancreatitis.

PubMed

Ke, Nengwen; Jia, Dan; Huang, Wei; Nunes, Quentin M; Windsor, John A; Liu, Xubao; Sutton, Robert

2018-05-01

The timing of surgery for painful chronic pancreatitis (CP) may affect outcomes.Clinical course, Izbicki pain scores, and pancreatic function were retrospectively compared and analyzed between patients undergoing either early or late surgery (< 3 or ≥ 3 years from diagnosis) for painful CP in a single center from 2007 to 2012.The early surgery group (n = 98) more frequently than the late group (n = 199) had abdominal pain with jaundice (22.4% vs 9.5%, P = .002) and pancreatic mass +/- ductal dilatation (47% vs 27%, P < .001), but less frequently abdominal pain alone (73.5% vs 85.9%, P = .009), ductal dilatation alone (31% vs 71%, P < .001), parenchymal calcification (91.8% vs 100%, P < .001) or exocrine insufficiency (60% vs 72%, P = .034); there were no other significant differences. The early group had longer hospital stay (14.4 vs 12.2 days, P = .009), but no difference in complications. Significantly greater pain relief followed early surgery (complete 69% vs 47%, partial 22% vs 37%, none 8% vs 16%, P = .01) with lower rates of exocrine (60% vs 80%, P = .005) and endocrine insufficiency (36% vs 53%, P = .033).Our data indicate that early surgery results in higher rates of pain relief and pancreatic sufficiency than late surgery for chronic pancreatitis patients. Frey and Berne procedures showed better results than other surgical procedures.

Elementary Physics Considerations Indicate an Elegant Construction Technique For the Pyramids At Giza. Our Information Indicates They and the Sphinx Were Engineered and Built Around BCE 2500, Not Earlier!

NASA Astrophysics Data System (ADS)

Mc Leod, Roger D.; Mc Leod, David M.

2002-10-01

Archimedes articulated an applied physics experience of many children who observe the upward movement of floating objects when they get into their "tubs." This same principle can effectively allow massive Egyptian construction blocks and obelisks to be elevated and erected. Platform bases at Giza were leveled by means of water channels that were cut into the rock. There is a canal behind the pyramids. The bathtub technique can elevate or transport the water-borne block (or obelisk) to sites involved, including the Sphinx temple. Water outflow from the barge locks (tubs) can erode Sphinx surrounds, without invoking 7000+ year-ago rainy weather. Our previously detailed account of how constellations, Canis Major, Phoenix, Leo can be detected at sites like America's Stonehenge, while they are below the local horizon, also indicates ancient Egyptians may have done likewise. Orion, or Leo the Sphinx could have been detected while they were in the "underground," around BCE 2500, in alignments otherwise requiring a date of BCE 1050.

Onset of rigor mortis is earlier in red muscle than in white muscle.

PubMed

Kobayashi, M; Takatori, T; Nakajima, M; Sakurada, K; Hatanaka, K; Ikegaya, H; Matsuda, Y; Iwase, H

2000-01-01

Rigor mortis is thought to be related to falling ATP levels in muscles postmortem. We measured rigor mortis as tension determined isometrically in three rat leg muscles in liquid paraffin kept at 37 degrees C or 25 degrees C--two red muscles, red gastrocnemius (RG) and soleus (SO) and one white muscle, white gastrocnemius (WG). Onset, half and full rigor mortis occurred earlier in RG and SO than in WG both at 37 degrees C and at 25 degrees C even though RG and WG were portions of the same muscle. This suggests that rigor mortis directly reflects the postmortem intramuscular ATP level, which decreases more rapidly in red muscle than in white muscle after death. Rigor mortis was more retarded at 25 degrees C than at 37 degrees C in each type of muscle.

The Chinese Visible Human (CVH) datasets incorporate technical and imaging advances on earlier digital humans

PubMed Central

Zhang, Shao-Xiang; Heng, Pheng-Ann; Liu, Zheng-Jin; Tan, Li-Wen; Qiu, Ming-Guo; Li, Qi-Yu; Liao, Rong-Xia; Li, Kai; Cui, Gao-Yu; Guo, Yan-Li; Yang, Xiao-Ping; Liu, Guang-Jiu; Shan, Jing-Lu; Liu, Ji-Jun; Zhang, Wei-Guo; Chen, Xian-Hong; Chen, Jin-Hua; Wang, Jian; Chen, Wei; Lu, Ming; You, Jian; Pang, Xue-Li; Xiao, Hong; Xie, Yong-Ming; Cheng, Jack Chun-Yiu

2004-01-01

We report the availability of a digitized Chinese male and a digitzed Chinese female typical of the population and with no obvious abnormalities. The embalming and milling procedures incorporate three technical improvements over earlier digitized cadavers. Vascular perfusion with coloured gelatin was performed to facilitate blood vessel identification. Embalmed cadavers were embedded in gelatin and cryosectioned whole so as to avoid section loss resulting from cutting the body into smaller pieces. Milling performed at −25 °C prevented small structures (e.g. teeth, concha nasalis and articular cartilage) from falling off from the milling surface. The male image set (.tiff images each of 36 Mb) has a section resolution of 3072 × 2048 pixels (∼170 μm, the accompanying magnetic resonance imaging and computer tomography data have a resolution of 512 × 512, i.e. ∼440 μm). The Chinese Visible Human male and female datasets are available at http://www.chinesevisiblehuman.com. (The male is 90.65 Gb and female 131.04 Gb). MPEG videos of direct records of real-time volume rendering are at: http://www.cse.cuhk.edu.hk/~crc PMID:15032906

Improving Program Results through the Use of Predictive Operational Performance Indicators: A Canadian Case Study

ERIC Educational Resources Information Center

Barrados, Maria; Blain, J. S.

2013-01-01

In Canada, in-depth evaluations of federal programs are intended to occur every 5 years. As such, evaluation is a periodic retrospective (lag) indicator examining results achieved versus program objectives. In a Canadian context, stand-alone evaluations have proved challenging to implement, time consuming, and not well adapted to annual management…

Earlier anal sexarche and co-occurring sexual risk are associated with current HIV-related risk behaviors among an online sample of men who have sex with men in Asia

PubMed Central

Cheung, Doug H.; Suharlim, Christian; Guadamuz, Thomas E.; Lim, Sin How; Koe, Stuart; Wei, Chongyi

2014-01-01

Studies of heterosexual populations across the globe and men who have sex with men (MSM) in a few developed countries showed that earlier sexual debut (sexarche) was associated with higher levels of co-occurring and subsequent HIV risk behaviors. We examined the relationships between earlier anal sexarche, unprotected earlier anal sexarche and current HIV risks among MSM from Asia. A cross-sectional online survey was conducted among MSM (N = 10,826) in Asia in 2010. Bivariate and multivariable logistic regressions were used to identify co-occurring (i.e., sexual experiences during sexarche) and current HIV-related risk factors (i.e., past six months) associated with earlier anal sexarche (before the age of 18) and unprotected earlier anal sexarche, respectively. Earlier anal sexarche was significantly associated with lack of condom use, being anal receptive or both receptive and insertive, and having a partner who were older during sexarche. It was also associated with current HIV-related risk behaviors including having multiple male sexual partners, having been paid for sex, and increased frequencies of recreational drug use. Unprotected earlier anal sexarche was significantly associated with inconsistent condom use in the past the six months. Improved and culturally sensitive sex education at schools should be included in national and regional HIV/AIDS prevention programming and policies in Asia. Such sex education programs should incorporate curriculum that address sexuality, sexual orientation, and sexual behaviors beyond those related to reproductive health. PMID:24920344

Earlier anal sexarche and co-occurring sexual risk are associated with current HIV-related risk behaviors among an online sample of men who have sex with men in Asia.

PubMed

Cheung, Doug H; Suharlim, Christian; Guadamuz, Thomas E; Lim, Sin How; Koe, Stuart; Wei, Chongyi

2014-12-01

Studies of heterosexual populations across the globe and men who have sex with men (MSM) in a few developed countries showed that earlier sexual debut (sexarche) was associated with higher levels of co-occurring and subsequent HIV risk behaviors. We examined the relationships between earlier anal sexarche, unprotected earlier anal sexarche and current HIV risks among MSM from Asia. A cross-sectional online survey was conducted among MSM (N = 10,826) in Asia in 2010. Bivariate and multivariable logistic regressions were used to identify co-occurring (i.e., sexual experiences during sexarche) and current HIV-related risk factors (i.e., past 6 months) associated with earlier anal sexarche (before the age of 18) and unprotected earlier anal sexarche, respectively. Earlier anal sexarche was significantly associated with lack of condom use, being anal receptive or both receptive and insertive, and having a partner who were older during sexarche. It was also associated with current HIV-related risk behaviors including having multiple male sexual partners, having been paid for sex, and increased frequencies of recreational drug use. Unprotected earlier anal sexarche was significantly associated with inconsistent condom use in the past the 6 months. Improved and culturally sensitive sex education at schools should be included in national and regional HIV/AIDS prevention programming and policies in Asia. Such sex education programs should incorporate curriculum that address sexuality, sexual orientation, and sexual behaviors beyond those related to reproductive health.

Infliximab for uveitis of Behçet's syndrome: a trend for earlier initiation.

PubMed

Guzelant, Gul; Ucar, Didar; Esatoglu, Sinem Nihal; Hatemi, Gulen; Ozyazgan, Yilmaz; Yurdakul, Sebahattin; Seyahi, Emire; Yazici, Hasan; Hamuryudan, Vedat

2017-01-01

The prognosis of uveitis in Behçet's syndrome (BS) has improved over decades. Whether this is related to the use of more aggressive management strategies is not known. This is a retrospective study of BS patients who received infliximab (IFX) for refractory eye disease between 2003-2015. The patients were divided into two groups according to the date of onset of in IFX treatment as before and after 2013. We compared the two groups in terms of disease characteristics at the onset of IFX treatment and response to treatment. There were 43 patients in the old and 14 patients in the new group. The duration of uveitis and previous immunosuppressive treatment before the initiation of IFX were significantly shorter in the new group compared to the old group (p=0.043 and p=0.028, respectively). The baseline visual acuity (VA) at the initiation of IFX was better in the new group, but this was only significant for the left eye. Treatment with IFX was effective in both groups in preserving VA and this was more pronounced in the new group. Attack frequency under IFX was significantly lower in the new group (p<0.001). IFX seems to be initiated earlier and also in less severe cases during the course of BS uveitis than before. Despite the few numbers of patients and relatively short duration of follow-up, our results give a hint that this change has improved the outcome.

Endovascular aortic aneurysm repair with chimney and snorkel grafts: indications, techniques and results.

PubMed

Patel, Rakesh P; Katsargyris, Athanasios; Verhoeven, Eric L G; Adam, Donald J; Hardman, John A

2013-12-01

The chimney technique in endovascular aortic aneurysm repair (Ch-EVAR) involves placement of a stent or stent-graft parallel to the main aortic stent-graft to extend the proximal or distal sealing zone while maintaining side branch patency. Ch-EVAR can facilitate endovascular repair of juxtarenal and aortic arch pathology using available standard aortic stent-grafts, therefore, eliminating the manufacturing delays required for customised fenestrated and branched stent-grafts. Several case series have demonstrated the feasibility of Ch-EVAR both in acute and elective cases with good early results. This review discusses indications, technique, and the current available clinical data on Ch-EVAR.

Age of diagnosis of breast cancer in china: almost 10 years earlier than in the United States and the European union.

PubMed

Song, Qing-Kun; Li, Jing; Huang, Rong; Fan, Jin-Hu; Zheng, Rong-Shou; Zhang, Bao-Ning; Zhang, Bin; Tang, Zhong-Hua; Xie, Xiao-Ming; Yang, Hong-Jian; He, Jian-Jun; Li, Hui; Li, Jia-Yuan; Qiao, You-Lin; Chen, Wan-Qing

2014-01-01

The study aimed to describe the age distribution of breast cancer diagnosis among Chinese females for comparison with the United States and the European Union, and provide evidence for the screening target population in China. Median age was estimated from hospital databases from 7 tertiary hospitals in China. Population-based data in China, United States and European Union was extracted from the National Central Cancer Registry, SEER program and GLOBOCAN 2008, respectively. Age-standardized distribution of breast cancer at diagnosis in the 3 areas was estimated based on the World Standard Population 2000. The median age of breast cancer at diagnosis was around 50 in China, nearly 10 years earlier than United States and European Union. The diagnosis age in China did not vary between subgroups of calendar year, region and pathological characteristics. With adjustment for population structure, median age of breast cancer at diagnosis was 50~54 in China, but 55~59 in United States and European Union. The median diagnosis age of female breast cancer is much earlier in China than in the United States and the European Union pointing to racial differences in genetics and lifestyle. Screening programs should start at an earlier age for Chinese women and age disparities between Chinese and Western women warrant further studies.

Decreased length of stay and earlier oral feeding associated with standardized postoperative clinical care for total gastrectomies at a cancer center.

PubMed

Selby, Luke V; Rifkin, Marissa B; Yoon, Sam S; Ariyan, Charlotte E; Strong, Vivian E

2016-09-01

Standardization of postoperative care has been shown to decrease postoperative length of stay. In June 2009, we standardized postoperative care for all gastrectomies at our institution. Four years' worth of total gastrectomies (2 years prior to standardization and 2 years after standardization) were reviewed to determine the effect of standardization on postoperative care, length of stay, complications, and readmissions. Between June 2007 and July 2011, 99 patients underwent curative intent open total gastrectomy: 51 patients prior to standardization, and 48 patients poststandardization. Patients were predominantly male (70%); median age was 63; and median body mass index was 26. Standardization of postoperative care was associated with a decrease in median time to beginning both clear liquids and a postgastrectomy diet, earlier removal of epidural catheters, earlier use of oral pain medication, less time receiving intravenous fluids, and decreased length of stay (all P < .01). Groups showed no differences in complication rates, complication severity, diet intolerance, return to our Urgent Care Center, or readmission. Institution of standardized postoperative orders for total gastrectomy was associated with a significantly decreased length of stay and earlier oral feeding without increasing postoperative complications, early postoperative outpatient visits, or readmissions. Copyright © 2016 Elsevier Inc. All rights reserved.

Algal layer ratios as indicators of air pollutant effects in Permelia sulcata

USGS Publications Warehouse

Bennett, J.P.

2002-01-01

Parmelia sulcata Taylor is generally believed to be fairly pollution tolerant, and consequently it is sometimes collected in urban and/or polluted localities. The condition of these specimens, however, is not always luxuriant and healthy. This study tested the hypothesis that total thallus and algal layer thickness, and the algal layer ratio would be thinner in polluted areas, thus allowing these characters to be used a indicators of air pollutant effects. Herbarium specimens were studied from 16 different localities varying in pollution level. The thallus and algal layers and ratio were not affected by year or locality of sampling, but decreased 11, 31 and 21% respectively between low and high pollution level localities. These results agreed with earlier studies using other species, but further work is needed to clarify the effects of geography and substrate on these phenomena.

Differences in the timing of reproduction between urban and forest European blackbirds (Turdus merula): result of phenotypic flexibility or genetic differences?

PubMed Central

Partecke, Jesko; Van't Hof, Thomas; Gwinner, Eberhard

2004-01-01

Species which have settled in urban environments are exposed to different conditions from their wild conspecifics. A previous comparative study of an urban and a forest-living European blackbird population had revealed a three weeks earlier onset of gonadal growth in urban individuals. These physiological adjustments are either the result of genetic differences that have evolved during the urbanization process, or of phenotypic flexibility resulting from the bird's exposure to the different environmental conditions of town or forest. To identify which of these two mechanisms causes the differences in reproductive timing, hand-reared birds originating from the urban and the forest populations were kept in identical conditions. The substantial differences in the timing of reproduction between urban and forest birds known from the field did not persist under laboratory conditions, indicating that temporal differences in reproductive timing between these two populations are mainly a result of phenotypic flexibility. Nevertheless, urban males initiated plasma luteinizing hormone (LH) secretion and testicular development earlier than forest males in their first reproductive season. Moreover, plasma LH concentration and follicle size declined earlier in urban females than in forest females, suggesting that genetic differences are also involved and might contribute to the variations in the timing of reproduction in the wild. PMID:15451688

Earlier occurrence and increased explanatory power of climate for the first incidence of potato late blight caused by Phytophthora infestans in Fennoscandia

PubMed Central

Wiik, Lars; Hannukkala, Asko; Andreasson, Erik; Chen, Deliang; Ou, Tinghai; Liljeroth, Erland; Lankinen, Åsa

2017-01-01

Background Late blight (caused by Phytophthora infestans) is a devastating potato disease that has been found to occur earlier in the season over the last decades in Fennoscandia. Up until now the reasons for this change have not been investigated. Possible explanations for this change are climate alterations, changes in potato production or changes in pathogen biology, such as increased fitness or changes in gene flow within P. infestans populations. The first incidence of late blight is of high economic importance since fungicidal applications should be typically applied two weeks before the first signs of late blight and are repeated on average once a week. Methods We use field observations of first incidence of late blight in experimental potato fields from five sites in Sweden and Finland covering a total of 30 years and investigate whether the earlier incidence of late blight can be related to the climate. Results We linked the field data to meteorological data and found that the previous assumption, used in common late blight models, that the disease only develops at relative humidity levels above 90% had to be rejected. Rather than the typically assumed threshold relationship between late blight disease development and relative humidity we found a linear relationship. Our model furthermore showed two distinct responses of late blight to climate. At the beginning of the observation time (in Sweden until the early 90s and in Finland until the 2000s) the link between climate and first incidence was very weak. However, for the remainder of the time period the link was highly significant, indicating a change in the biological properties of the pathogen which could for example be a change in the dominating reproduction mode or a physiological change in the response of the pathogen to climate. Conclusions The study shows that models used in decision support systems need to be checked and re-parametrized regularly to be able to capture changes in pathogen biology

The Fischa-Dagnitz spring, Southern Vienna Basin: a multi tracer time series study re-assessing earlier conceptual assumptions.

NASA Astrophysics Data System (ADS)

Suckow, Axel; Gerber, Christoph; Kralik, Martin; Sültenfuss, Jürgen; Purtschert, Roland

2013-04-01

The gravel aquifer of the Southern Vienna Basin is a very important backup drinking water resource for the city of Vienna. A discharge location, the Fischa-Dagnitz spring in the Southern Vienna Basin, Austria, was re-investigated in 2011, five years after the gas exchange tracer test published in (Stolp et al., 2010), and sampled for stable isotopes 18O/2H, tritium, 3He, SF6 and 85Kr (Gerber et al., 2012). Additionally, new tritium time series data (Davis et al., 1967), previously not considered in Stolp et al. (2010), were included. These show a higher and earlier tritium peak of >300 TU in 1965 in the discharge of the Fischa-Dagnitz spring as compared to 221 TU in 1972 considered in Stolp et al. (2010). The new 3He, SF6 and 85Kr gas tracer data from 2011 confirm the earlier finding for 3He of Stolp et al. (2010) and indicate a more recent equilibration with the atmosphere than the water bound tracers 18O, 2H and tritium. A new modelling attempt using the Lumpy code (Suckow, 2012) confirmed the discrepancy between the tritium data and the gaseous tracers 3He, SF6 and 85Kr. No steady-state combination of local recharge (represented by an exponential model) and Schwarza river infiltration flowing through the gravel aquifer (represented by a parallel dispersion model) can equally well explain both the tritium time series and the gas tracer results. A revised conceptual model proposes that a pinching of the aquifer at unconformities in the gravel body or a fault zone known in the gravel body forces groundwater along the flow path closer to the surface and exposes it to the atmosphere. This would tend to reset the "dating" clock for the gaseous tracers 3He, SF6 and 85Kr, which can equilibrate quickly with the atmosphere, but not for tritium, which marks the transport behaviour of the water itself. These findings are of importance also for other multi-tracer assessments of groundwater movement in phreatic aquifer systems. References: Davis, G.H., Payne, B.R., Dincer, T

Fetal fibronectin, cervical length, and the risk of preterm birth in patients with an ultrasound or physical exam indicated cervical cerclage.

PubMed

Kim, Renita S; Gupta, Simi; Lam-Rachlin, Jennifer; Saltzman, Daniel H; Rebarber, Andrei; Fox, Nathan S

2016-11-01

The objective of this study is to estimate the risk of preterm birth in patients with an ultrasound or physical exam indicated cervical cerclage based on the results of fetal fibronectin (fFN) and cervical length (CL) screening. Retrospective cohort of patients with a singleton pregnancy and an ultrasound or physical exam indicated Shirodkar cerclage placed by one maternal-fetal medicine practice from November 2005 to January 2015. Patients routinely underwent serial CL and fFN testing from 22 to 32 weeks. Based on ROC curve analysis, a short CL was defined as ≤15 mm. All fFN and CL results included are from after the cerclage placement. One hundred and four patients were included. Seventy eight (75%) patients had an ultrasound-indicated cerclage and 26 (25%) patients had a physical exam-indicated cerclage. A positive fFN was associate with preterm birth <32 weeks (15.6% versus 4.2%, p = 0.043),  <35 weeks (37.5% versus 11.1%, p = 0.002),  <37 weeks (65.6% versus 20.8%, p < 0.001), and earlier gestational ages at delivery (35.2 ± 3.9 versus 37.4 ± 2.9, p = 0.001). A short CL was also associated with preterm birth <35 weeks (50.0% versus 11.9%, p < 0.01), preterm birth <37 weeks (55.0% versus 29.8%, p = 0.033), and earlier gestational ages at delivery (34.8 ± 4.1 versus 37.2 ± 3.0, p = 0.004). The risk of preterm birth <32,  <35, and <37 weeks increased significantly with the number of abnormal markers. In patients with an ultrasound or physical exam indicated cerclage, a positive fFN and a short CL are both associated with preterm birth. The risk of preterm birth increases with the number of abnormal biomarkers.

The ECHI project: health indicators for the European Community.

PubMed

Kramers, Pieter G N

2003-09-01

Within the EU Health Monitoring Programme (HMP), the ECHI project has proposed a comprehensive list of 'European Community Health Indicators'. In the design of the indicator set, a set of explicit criteria was applied. These included: i) be comprehensive and coherent, i.e. cover all domains of the public health field; ii) take account of earlier work, especially that by WHO-Europe, OECD and Eurostat; and iii) cover the priority areas that Member States and Community health policies currently pursue. Flexibility is an important characteristic of the present proposal. In ECHI, this has been emphasized by the definition of 'user-windows'. These are subsets from the overall indicator list, each of which should reflect a specific user's requirement or interest. The proposed indicators are, in most cases, defined as generic indicators, i.e. their actual operational definitions have not yet been attempted. This work has been, and is being carried out to a large part by other projects financed under the HMP, which cover specific areas of public health or areas of data collection. Apart from indicators covered by regularly available data, indicators (or issues) have been proposed for which data are currently difficult to collect but which from a policy point of view would be needed. All this points to the fact that establishing an indicator list which is actually used by Member States is a continuously developing process. This process is now continued by the first strand of the new EU Public Health Action Programme.

Earlier detection of breast cancer by surveillance of women at familial risk.

PubMed

Tilanus-Linthorst, M M; Bartels, C C; Obdeijn, A I; Oudkerk, M

2000-03-01

A positive family history increases the risk for breast cancer which oft en occurs at a much younger age than in the general population. We stud ied whether surveillance of these women resulted in the detection of bre ast cancer in an earlier stage than in symptomatic patients with a famil y history. Between January 1994 and April 1998, 294 women with 15-25% r isk (moderate), mean age:43.3 (22-75) years, were screened with a yearly physical examination and mammography from 5 years before the youngest ag e of onset in the family and 384 women with >25% risk (high) for breast cancer, mean age: 42.9 (20-74) years were screened with a physical examination every 6 months and yearly mammography. From September 1995 breast magnetic resonance imaging (MRI) was also carried out for 109 high risk women where mammography showed over 50% density. 26 breast cancers detected under surveillance were significantly more often found in an early T1N0 stage than the 24 breast cancers in patients with a family history referred in that period because of symptoms: 81 versus 46% (P=0.018). Patients under surveillance were also less frequently node-positive than the symptomatic group: 19 versus 42% (P=0.12). 20 patients with a family history referred by our national screening programme in that period had 21 breast cancers detected, 81% in stage T1N0 and 5% node-positive, which was comparable to the results in our national screening programme T1N0 66%, N+ 24% resulting in a 30% reduction in mortality. The incidence in women under surveillance was 10.1 per 1000 in the 'high' risk group and 13.3 per 1000 in the 'moderate' risk group. Expected incidence in an average risk population aged 40-50 years is 1.5, expected if the group consisted of only gene carriers 15 per 1000. 23% of the breast cancers in the surveillance group were detected at physical examination, but occult at mammography. 38% were detected at mammography and clinically occult. Breast MRI (in the subgroup) detected 3 occult

Accessing Real-Life Episodic Information from Minutes versus Hours Earlier Modulates Hippocampal and High-Order Cortical Dynamics

PubMed Central

Chen, J.; Honey, C. J.; Simony, E.; Arcaro, M. J.; Norman, K. A.; Hasson, U.

2016-01-01

It is well known that formation of new episodic memories depends on hippocampus, but in real-life settings (e.g., conversation), hippocampal amnesics can utilize information from several minutes earlier. What neural systems outside hippocampus might support this minutes-long retention? In this study, subjects viewed an audiovisual movie continuously for 25 min; another group viewed the movie in 2 parts separated by a 1-day delay. Understanding Part 2 depended on retrieving information from Part 1, and thus hippocampus was required in the day-delay condition. But is hippocampus equally recruited to access the same information from minutes earlier? We show that accessing memories from a few minutes prior elicited less interaction between hippocampus and default mode network (DMN) cortical regions than accessing day-old memories of identical events, suggesting that recent information was available with less reliance on hippocampal retrieval. Moreover, the 2 groups evinced reliable but distinct DMN activity timecourses, reflecting differences in information carried in these regions when Part 1 was recent versus distant. The timecourses converged after 4 min, suggesting a time frame over which the continuous-viewing group may have relied less on hippocampal retrieval. We propose that cortical default mode regions can intrinsically retain real-life episodic information for several minutes. PMID:26240179

Past and future changes in climate and hydrological indicators in the US Northeast

USGS Publications Warehouse

Hayhoe, K.; Wake, C.P.; Huntington, T.G.; Luo, L.; Schwartz, M.D.; Sheffield, J.; Wood, E.; Anderson, B.; Bradbury, J.; DeGaetano, A.; Troy, T.J.; Wolfe, D.

2007-01-01

To assess the influence of global climate change at the regional scale, we examine past and future changes in key climate, hydrological, and biophysical indicators across the US Northeast (NE). We first consider the extent to which simulations of twentieth century climate from nine atmosphere-ocean general circulation models (AOGCMs) are able to reproduce observed changes in these indicators. We then evaluate projected future trends in primary climate characteristics and indicators of change, including seasonal temperatures, rainfall and drought, snow cover, soil moisture, streamflow, and changes in biometeorological indicators that depend on threshold or accumulated temperatures such as growing season, frost days, and Spring Indices (SI). Changes in indicators for which temperature-related signals have already been observed (seasonal warming patterns, advances in high-spring streamflow, decreases in snow depth, extended growing seasons, earlier bloom dates) are generally reproduced by past model simulations and are projected to continue in the future. Other indicators for which trends have not yet been observed also show projected future changes consistent with a warmer climate (shrinking snow cover, more frequent droughts, and extended low-flow periods in summer). The magnitude of temperature-driven trends in the future are generally projected to be higher under the Special Report on Emission Scenarios (SRES) mid-high (A2) and higher (A1FI) emissions scenarios than under the lower (B1) scenario. These results provide confidence regarding the direction of many regional climate trends, and highlight the fundamental role of future emissions in determining the potential magnitude of changes we can expect over the coming century. ?? Springer-Verlag 2006.

Early full weight-bearing versus 6-week partial weight-bearing after open wedge high tibial osteotomy leads to earlier improvement of the clinical results: a prospective, randomised evaluation.

PubMed

Schröter, S; Ateschrang, A; Löwe, W; Nakayama, H; Stöckle, U; Ihle, C

2017-01-01

Open wedge high tibial osteotomy is a widespread treatment option in patients with varus malalignment and medial compartment osteoarthritis. There is no standardised protocol for post-operative rehabilitation available. The purpose of this study was to compare two post-operative rehabilitation protocols and to evaluate the clinical outcome of early full weight-bearing after open wedge HTO. One hundred and twenty consecutive patients with varus malalignment and medial compartment osteoarthritis received an open wedge HTO using an angular locking plate fixation between December 2008 and December 2011. All patients were assigned randomly into one of two groups with different post-operative rehabilitation protocols (11-day vs. 6-week 20-kg partial weight-bearing). Clinical outcome was evaluated using established instruments (Lequesne, Lysholm, HSS and IKDC scores) preoperatively, 6, 12 and 18 months post-operatively. Deformity analysis was performed preoperatively and during follow-up. All clinical scores showed a significant pre- to post-operative improvement. After 6 months, there was a higher improvement in the group of early full weight-bearing. The difference between preoperative and 6-month follow-up for the group with early full weight-bearing and for the group with 20-kg PWB for 6 weeks was 28 ± 26 and 18 ± 22, respectively, for the Lysholm score and -5.0 ± 5.1 and -3.0 ± 3.6, respectively, for the Lequesne score. Early full weight-bearing (11-day 20-kg partial weight-bearing) after open wedge HTO without bone graft leads to earlier improvement of the clinical results and can be recommended for post-operative rehabilitation after open wedge HTO and fixation with an angular locking plate. Therapeutic study, Level I.

Selection for Earlier Flowering Crop Associated with Climatic Variations in the Sahel

PubMed Central

Vigouroux, Yves; Mariac, Cédric; De Mita, Stéphane; Pham, Jean-Louis; Gérard, Bruno; Kapran, Issoufou; Sagnard, Fabrice; Deu, Monique; Chantereau, Jacques; Ali, Abdou; Ndjeunga, Jupiter; Luong, Viviane; Thuillet, Anne-Céline; Saïdou, Abdoul-Aziz; Bezançon, Gilles

2011-01-01

Climate changes will have an impact on food production and will require costly adaptive responses. Adapting to a changing environment will be particularly challenging in sub-Saharan Africa where climate change is expected to have a major impact. However, one important phenomenon that is often overlooked and is poorly documented is the ability of agro-systems to rapidly adapt to environmental variations. Such an adaptation could proceed by the adoption of new varieties or by the adaptation of varieties to a changing environment. In this study, we analyzed these two processes in one of the driest agro-ecosystems in Africa, the Sahel. We performed a detailed study in Niger where pearl millet is the main crop and covers 65% of the cultivated area. To assess how the agro-system is responding to recent recurrent drought, we analyzed samples of pearl millet landraces collected in the same villages in 1976 and 2003 throughout the entire cultivated area of Niger. We studied phenological and morphological differences in the 1976 and 2003 collections by comparing them over three cropping seasons in a common garden experiment. We found no major changes in the main cultivated varieties or in their genetic diversity. However, we observed a significant shift in adaptive traits. Compared to the 1976 samples, samples collected in 2003 displayed a shorter lifecycle, and a reduction in plant and spike size. We also found that an early flowering allele at the PHYC locus increased in frequency between 1976 and 2003. The increase exceeded the effect of drift and sampling, suggesting a direct effect of selection for earliness on this gene. We conclude that recurrent drought can lead to selection for earlier flowering in a major Sahelian crop. Surprisingly, these results suggest that diffusion of crop varieties is not the main driver of short term adaptation to climatic variation. PMID:21573243

Clinical indications for antibiotic use in Danish general practice: results from a nationwide electronic prescription database

PubMed Central

Aabenhus, Rune; Hansen, Malene Plejdrup; Siersma, Volkert; Bjerrum, Lars

2017-01-01

Objective To assess the availability and applicability of clinical indications from electronic prescriptions on antibiotic use in Danish general practice. Design Retrospective cohort register-based study including the Danish National Prescription Register. Setting Population-based study of routine electronic antibiotic prescriptions from Danish general practice. Subjects All 975,626 patients who redeemed an antibiotic prescription at outpatient pharmacies during the 1-year study period (July 2012 to June 2013). Main outcome measures Number of prescriptions per clinical indication. Number of antibiotic prescriptions per 1000 inhabitants by age and gender. Logistic regression analysis estimated the association between patient and provider factors and missing clinical indications on antibiotic prescriptions. Results A total of 2.381.083 systemic antibiotic prescriptions were issued by Danish general practitioners in the study period. We identified three main clinical entities: urinary tract infections (n = 506.634), respiratory tract infections (n = 456.354) and unspecified infections (n = 416.354). Women were more exposed to antibiotics than men. Antibiotic use was high in children under 5 years and even higher in elderly people. In 32% of the issued prescriptions, the clinical indication was missing. This was mainly associated with antibiotic types. We found that a prescription for a urinary tract agent without a specific clinical indication was uncommon. Conclusion Clinical indications from electronic prescriptions are accessible and available to provide an overview of drug use, in casu antibiotic prescriptions, in Danish general practice. These clinical indications may be further explored in detail to assess rational drug use and congruence with guidelines, but validation and optimisation of the system is preferable. PMID:28585886

Modelling drought-related yield losses in Iberia using remote sensing and multiscalar indices

NASA Astrophysics Data System (ADS)

Ribeiro, Andreia F. S.; Russo, Ana; Gouveia, Célia M.; Páscoa, Patrícia

2018-04-01

The response of two rainfed winter cereal yields (wheat and barley) to drought conditions in the Iberian Peninsula (IP) was investigated for a long period (1986-2012). Drought hazard was evaluated based on the multiscalar Standardized Precipitation Evapotranspiration Index (SPEI) and three remote sensing indices, namely the Vegetation Condition (VCI), the Temperature Condition (TCI), and the Vegetation Health (VHI) Indices. A correlation analysis between the yield and the drought indicators was conducted, and multiple linear regression (MLR) and artificial neural network (ANN) models were established to estimate yield at the regional level. The correlation values suggested that yield reduces with moisture depletion (low values of VCI) during early-spring and with too high temperatures (low values of TCI) close to the harvest time. Generally, all drought indicators displayed greatest influence during the plant stages in which the crop is photosynthetically more active (spring and summer), rather than the earlier moments of plants life cycle (autumn/winter). Our results suggested that SPEI is more relevant in the southern sector of the IP, while remote sensing indices are rather good in estimating cereal yield in the northern sector of the IP. The strength of the statistical relationships found by MLR and ANN methods is quite similar, with some improvements found by the ANN. A great number of true positives (hits) of occurrence of yield-losses exhibiting hit rate (HR) values higher than 69% was obtained.

Quadruple cancer including Bowen's disease after arsenic injections 40 years earlier: report of a case.

PubMed

Murata, K; Iwazawa, T; Takayama, T; Yamashita, K; Okagawa, K

1994-01-01

This report describes the successful treatment of quadruple cancer including Bowen's disease in a 71-year-old man who had been given injections of salvarsan, an arsenic compound, for syphilis more than 40 years earlier. Resection of a skin lesion on his chest subsequently confirmed a diagnosis of Bowen's disease, 3 years after which he was operated on for concurrent gastric cancer and sigmoid colon cancer. A fourth cancer was discovered on his left vocal cord 2 weeks after this operation; it was resected 2 years later. A discussion of multiple malignant neoplasms and the possible relationship between arsenic and cancer is presented following this case report.

Indications and results of omental pedicle grafts in oncology

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

Petit, J.Y.; Lacour, J.; Margulis, A.

1979-12-01

Sixty omental grafts were performed in our department. Sixty-two percent concerned breast cancer patients. Other grafts were undertaken for other cancers: head and neck, gynecologic urologic and intestinal, skin and soft tissue tumors. These grafts were indicated for radionecrosis or chemonecrosis in 33 cases and for cancer recurrence in 26 cases (among whom 24 were previously irradiated). Only one graft was performed for lymphoedema treatment. Overall, fifty four patients (83.5%) had successful grafts, and six (16.5%) had graft failures. According to the treated lesion we obtained 82% of successful treatment among patients treated for radio or chemonecrosis, and 92% formore » patients treated for recurrences.« less

Latittudinal and energy dependence of energetic neutral atom spectral indices measured by the Interstellar Boundary Explorer

DOE PAGES

Desai, M. I.; Allegrini, F.; Dayeh, M. A.; ...

2015-03-30

Here, we investigate the latitudinal and energy dependence of the globally distributed 0.5-6 keV energetic neutral atom (ENA) spectra measured by the Interstellar Boundary Explorer (IBEX) during the first 3 yrs of the mission. Our results are: (1) the ENA spectral indices at the two lowest energies (0.89 and 1.47 keV) exhibit no clear trend with ecliptic latitude θ, while those at ~2.29 and ~3.41 keV exhibit a clear latitudinal pattern; flatter spectra occur above 60° latitude and steeper spectra occur ±30° of the equator. (2) The latitudinal dependence of the spectral indices at different energies can be represented bymore » the cosine function γ =a 0 + a 1 cos (a 2θ) with unique offsets, amplitudes, and phase angles; the higher energy ENA indices transition to successively larger amplitudes within ±45° of the equator. The results confirm the previously reported latitudinal organization of the ENA spectra and their remarkable similarity to that of the solar wind (SW) speed observed by Ulysses in the inner heliosphere. And while earlier studies showed that the ~0.5-6 keV globally distributed ENA spectral indices could be represented as single power laws over much of the sky, our new results indicate that this is an over-simplification because the spectral indices have an energy and latitude dependence. Furthermore, this dependence is an important factor that must be taken into consideration by models and simulations that seek to map the IBEX ENA observations back to the latitudinal profile of the SW speed structure observed in the inner heliosphere.« less

Latitudinal and Energy Dependence of Energetic Neutral Atom Spectral Indices Measured by the Interstellar Boundary Explorer

NASA Astrophysics Data System (ADS)

Desai, M. I.; Allegrini, F.; Dayeh, M. A.; Funsten, H.; Heerikhuisen, J.; McComas, D. J.; Fuselier, S. A.; Pogorelov, N.; Schwadron, N. A.; Zank, G. P.; Zirnstein, E. J.

2015-04-01

We investigate the latitudinal and energy dependence of the globally distributed 0.5-6 keV energetic neutral atom (ENA) spectra measured by the Interstellar Boundary Explorer (IBEX) during the first 3 yrs of the mission. Our results are: (1) the ENA spectral indices at the two lowest energies (0.89 and 1.47 keV) exhibit no clear trend with ecliptic latitude θ, while those at ˜2.29 and ˜3.41 keV exhibit a clear latitudinal pattern; flatter spectra occur above 60° latitude and steeper spectra occur ±30° of the equator. (2) The latitudinal dependence of the spectral indices at different energies can be represented by the cosine function γ ={{a}0}+{{a}1}cos ({{a}2}θ ) with unique offsets, amplitudes, and phase angles; the higher energy ENA indices transition to successively larger amplitudes within ±45° of the equator. Our results confirm the previously reported latitudinal organization of the ENA spectra and their remarkable similarity to that of the solar wind (SW) speed observed by Ulysses in the inner heliosphere. While earlier studies showed that the ˜0.5-6 keV globally distributed ENA spectral indices could be represented as single power laws over much of the sky, our new results indicate that this is an over-simplification because the spectral indices have an energy and latitude dependence. This dependence is an important factor that must be taken into consideration by models and simulations that seek to map the IBEX ENA observations back to the latitudinal profile of the SW speed structure observed in the inner heliosphere.

Earlier Endpoints Are Required for Hemorrhagic Shock Trials among Severely Injured Patients

PubMed Central

Fox, Erin E.; Holcomb, John B.; Wade, Charles E.; Bulger, Eileen M.; Tilley, Barbara C.

2016-01-01

Background Choosing the appropriate endpoint for a trauma hemorrhage control trial can determine the likelihood of its success. Recent Phase 3 trials and observational studies have used 24-hour and/or 30-day all-cause mortality as the primary endpoint and some have not used exception from informed consent (EFIC), resulting in multiple failed trials. Five recent high-quality prospective studies among 4,064 hemorrhaging trauma patients provide new evidence to support earlier primary endpoints. Methods The goal of this project was to determine the optimal endpoint for hemorrhage control trials using existing literature and new analyses of previously published data. Results Recent studies among bleeding trauma patients show that hemorrhagic deaths occur rapidly, at a high rate, and in a consistent pattern. Early preventable deaths among trauma patients are largely due to hemorrhage and the median time to hemorrhagic death from admission is 2.0-2.6 hours. Approximately 85% of hemorrhagic deaths occur within 6 hours. The hourly mortality rate due to traumatic injury decreases rapidly after enrollment from 4.6% per hour at 1 hour post-enrollment to 1% per hour at 6 hours to <0.1% per hour by 9 hours and thereafter. Early primary endpoints (within 6 hours) have critically important benefits for hemorrhage control trials, including being congruent with the median time to hemorrhagic death, biologic plausibility, and enabling the use of all-cause mortality, which is definitive and objective. Conclusions Primary endpoints should be congruent with the timing of the disease process. Therefore, if a resuscitation/hemorrhage control intervention is under study, a primary endpoint of all-cause mortality evaluated within the first 6 hours is appropriate. Before choosing the timing of the primary endpoint for a large multicenter trial, we recommend performing a Phase 2 trial under EFIC to better understand the effects of the hemorrhage control intervention and distribution of time

M-Mode Ultrasound Reveals Earlier Gluteus Minimus Activity in Individuals With Chronic Hip Pain During a Step-down Task.

PubMed

Dieterich, Angela V; Deshon, Louise; Strauss, Geoffrey R; McKay, Jan; Pickard, Christine M

2016-04-01

Controlled laboratory study. The hip abductor muscles are important hip joint stabilizers. Hip joint pain may alter muscle recruitment. Motion-mode (M-mode) ultrasound enables noninvasive measurements of the onset of deep and superficial muscle motion, which is associated with activation onset. To compare (1) the onset of superficial and deep gluteus medius and gluteus minimus muscle motion relative to the instant of peak ground reaction force and (2) the level of swing-phase muscle motion during step-down between subjects with chronic hip pain and controls using M-mode ultrasound. Thirty-five subjects with anterior, nontraumatic hip pain for more than 6 months (mean ± SD age, 54 ± 9 years) and 35 controls (age, 57 ± 7 years) were scanned on the lateral hip of the leading leg during frontal step-down onto a force platform using M-mode ultrasound. Computerized motion detection with the Teager-Kaiser energy operator was applied on the gluteus minimus and the deep and superficial gluteus medius to determine the time lag between muscle motion onset and instant of peak ground reaction force and the level of gluteus minimus motion during the swing phase. Time lags and motion levels were averaged per subject, and t tests were used to determine between-group differences. In participants with hip pain, gluteus minimus motion onset was 103 milliseconds earlier (P = .002) and superficial gluteus medius motion was 70 milliseconds earlier (P = .047) than those in healthy control participants. The level of gluteus minimus swing-phase motion was higher with pain (P = .006). Increased gluteus minimus motion during the swing phase and earlier gluteus minimus and superficial gluteus medius motion in individuals with hip pain suggest an overall increase of muscle activity, possibly a protective behavior.

Earlier reperfusion in patients with ST-elevation myocardial infarction by use of helicopter.

PubMed

Knudsen, Lars; Stengaard, Carsten; Hansen, Troels Martin; Lassen, Jens Flensted; Terkelsen, Christian Juhl

2012-10-04

In patients with ST-elevation myocardial infarction (STEMI) reperfusion therapy should be initiated as soon as possible. This study evaluated whether use of a helicopter for transportation of patients is associated with earlier initiation of reperfusion therapy. A prospective study was conducted, including patients with STEMI and symptom duration less than 12 hours, who had primary percutaneous coronary intervention (PPCI) performed at Aarhus University Hospital in Skejby. Patients with a health care system delay (time from emergency call to first coronary intervention) of more than 360 minutes were excluded. The study period ran from 1.1.2011 until 31.12.2011. A Western Denmark Helicopter Emergency Medical Service (HEMS) project was initiated 1.6.2011 for transportation of patients with time-critical illnesses, including STEMI. The study population comprised 398 patients, of whom 376 were transported by ambulance Emergency Medical Service (EMS) and 22 by HEMS. Field-triage directly to the PCI-center was used in 338 of patients. The median system delay was 94 minutes among those field-triaged, and 168 minutes among those initially admitted to a local hospital. Patients transported by EMS and field-triaged were stratified into four groups according to transport distance from the scene of event to the PCI-center: ≤25 km., 26-50 km., 51-75 km. and > 75 km. For these groups, the median system delay was 78, 89, 99, and 141 minutes. Among patients transported by HEMS and field-triaged the estimated median transport distance by ground transportation was 115 km, and the observed system delay was 107 minutes. Based on second order polynomial regression, it was estimated that patients with a transport distance of >60 km to the PCI-center may benefit from helicopter transportation, and that transportation by helicopter is associated with a system delay of less than 120 minutes even at a transport distance up to 150 km. The present study indicates that use of a

LIVER TRANSPLANTATION AFTER SEVERE HEPATIC TRAUMA: CURRENT INDICATIONS AND RESULTS

PubMed Central

RIBEIRO-JR, Marcelo Augusto Fontenelle; MEDRADO, Melina Botelho; ROSA, Otto Mauro; SILVA, Ana Júlia de Deus; FONTANA, Mariana Prado; CRUVINEL-NETO, José; FONSECA, Alexandre Zanchenko

2015-01-01

Background : The liver is the most injured organ in abdominal trauma. Currently, the treatment in most cases is non-operative, but surgery may be necessary in severe abdominal trauma with blunt liver damage, especially those that cause uncontrollable bleeding. Despite the damage control approaches in order to achieve hemodynamic stability, many patients develop hypovolemic shock, acute liver failure, multiple organ failure and death. In this context, liver transplantation appears as the lifesaving last resource Aim : Analyze the use of liver transplantation as a treatment option for severe liver trauma. Methods : Were reviewed 14 articles in the PubMed, Medline and Lilacs databases, selected between 2008-2014 and 10 for this study. Results : Were identified 46 cases undergoing liver transplant after liver trauma; the main trauma mechanism was closed/blunt abdominal trauma in 83%, and severe trauma (>grade IV) in 81 %. The transplant can be done, in this context, performing one-stage procedure (damaged organ removed with immediate transplantation), used in 72% of cases. When the two-stage approach is performed, end-to-side temporary portacaval shunt is provided, until new organ becomes available to be transplanted. If two different periods are considered - from 1980 to 2000 and from 2000 to 2014 - the survival rate increased significantly, from 48% to 76%, while the mortality decreased from 52% to 24%. Conclusion : Despite with quite restricted indications, liver transplantation in hepatic injury is a therapeutic modality viable and feasible today, and can be used in cases when other therapeutic modalities in short and long term, do not provide the patient survival chances. PMID:26734803

A combination of body condition measurements is more informative than conventional condition indices: temporal variation in body condition and corticosterone in brown tree snakes (Boiga irregularis).

PubMed

Waye, Heather L; Mason, Robert T

2008-02-01

The body condition index is a common method for quantifying the energy reserves of individual animals. Because good body condition is necessary for reproduction in many species, body condition indices can indicate the potential reproductive output of a population. Body condition is related to glucocorticoid production, in that low body condition is correlated to high concentrations of corticosterone in reptiles. We compared the body condition index and plasma corticosterone levels of brown tree snakes on Guam in 2003 to those collected in 1992/1993 to determine whether that population still showed the chronic stress and poor condition apparent in the earlier study. We also examined the relationship between fat mass, body condition and plasma corticosterone concentrations as indicators of physiological condition of individuals in the population. Body condition was significantly higher in 2003 than in the earlier sample for mature male and female snakes, but not for juveniles. The significantly lower levels of corticosterone in all three groups in 2003 suggests that although juveniles did not have significantly improved energy stores they, along with the mature males and females, were no longer under chronic levels of stress. Although the wet season of 2002 was unusually rainy, low baseline levels of corticosterone measured in 2000 indicate that the improved body condition of snakes in 2003 is likely the result of long-term changes in prey populations rather than annual variation in response to environmental conditions.

Heteroskedasticity as a leading indicator of desertification in spatially explicit data.

PubMed

Seekell, David A; Dakos, Vasilis

2015-06-01

Regime shifts are abrupt transitions between alternate ecosystem states including desertification in arid regions due to drought or overgrazing. Regime shifts may be preceded by statistical anomalies such as increased autocorrelation, indicating declining resilience and warning of an impending shift. Tests for conditional heteroskedasticity, a type of clustered variance, have proven powerful leading indicators for regime shifts in time series data, but an analogous indicator for spatial data has not been evaluated. A spatial analog for conditional heteroskedasticity might be especially useful in arid environments where spatial interactions are critical in structuring ecosystem pattern and process. We tested the efficacy of a test for spatial heteroskedasticity as a leading indicator of regime shifts with simulated data from spatially extended vegetation models with regular and scale-free patterning. These models simulate shifts from extensive vegetative cover to bare, desert-like conditions. The magnitude of spatial heteroskedasticity increased consistently as the modeled systems approached a regime shift from vegetated to desert state. Relative spatial autocorrelation, spatial heteroskedasticity increased earlier and more consistently. We conclude that tests for spatial heteroskedasticity can contribute to the growing toolbox of early warning indicators for regime shifts analyzed with spatially explicit data.

Clinical Evidence for the Earlier Initiation of Insulin Therapy in Type 2 Diabetes

PubMed Central

2013-01-01

Abstract The natural history of type 2 diabetes mellitus (T2DM) is a relentless progression of β-cell failure and dysregulation of β-cell function with increasing metabolic derangement. Insulin remains the only glucose-lowering therapy that is efficacious throughout this continuum. However, the timing of introduction and the choice of insulin therapy remain contentious because of the heterogeneity of T2DM and the well-recognized behavioral and therapeutic challenges associated with this mode of therapy. Nevertheless, the early initiation of basal insulin has been shown to improve glycemic control and affect long-term outcomes in people with T2DM and is a treatment strategy supported by international guidelines as part of an individualized approach to chronic disease management. The rationale for early initiation of insulin is based on evidence demonstrating multifaceted benefits, including overcoming the glucotoxic effects of hyperglycemia, thereby facilitating “β-cell rest,” and preserving β-cell mass and function, while also improving insulin sensitivity. Independent of its effects on glycemic control, insulin possesses anti-inflammatory and antioxidant properties that may help protect against endothelial dysfunction and damage resulting in vascular disease. Insulin therapy and the achievement of good glycemic control earlier in T2DM provide long-term protection to end organs via “metabolic memory” regardless of subsequent treatments and degree of glycemic control. This is evidenced from long-term observations continuing from trials such as the United Kingdom Prospective Diabetes Study. As such, early initiation of insulin therapy may not only help to avoid the effects of prolonged glycemic burden, but may also positively alter the course of disease progression. PMID:23786228

Two-photon voltage imaging using a genetically encoded voltage indicator

PubMed Central

Akemann, Walther; Sasaki, Mari; Mutoh, Hiroki; Imamura, Takeshi; Honkura, Naoki; Knöpfel, Thomas

2013-01-01

Voltage-sensitive fluorescent proteins (VSFPs) are a family of genetically-encoded voltage indicators (GEVIs) reporting membrane voltage fluctuation from genetically-targeted cells in cell cultures to whole brains in awake mice as demonstrated earlier using 1-photon (1P) fluorescence excitation imaging. However, in-vivo 1P imaging captures optical signals only from superficial layers and does not optically resolve single neurons. Two-photon excitation (2P) imaging, on the other hand, has not yet been convincingly applied to GEVI experiments. Here we show that 2P imaging of VSFP Butterfly 1.2 expresssing pyramidal neurons in layer 2/3 reports optical membrane voltage in brain slices consistent with 1P imaging but with a 2–3 larger ΔR/R value. 2P imaging of mouse cortex in-vivo achieved cellular resolution throughout layer 2/3. In somatosensory cortex we recorded sensory responses to single whisker deflections in anesthetized mice at full frame video rate. Our results demonstrate the feasibility of GEVI-based functional 2P imaging in mouse cortex. PMID:23868559

Electroconvulsive therapy and its different indications

PubMed Central

Baghai, Thomas C.; Möller, Hans-Jürgen

2008-01-01

In spite of recent developments in the pharmacotherapy of depressive disorders, the delay until clinical improvement can be achieved, and the considerable rate of nonresponse and nonremission, are major problems which remain unresolved. Electroconvulsive therapy (ECT) is a nonpharmacoloqic bioloqical treatment which has been proven to be a highly effective treatment option, predominantly for depression, but also for schizophrenia and other indications. Though there is a lack of controlled investigations on long-term treatments, ECT can also be used for relapse prevention during maintenance therapies. The safety and tolerabitity of electroconvulsive treatment have been enhanced by the use of modified stimulation techniques and by progress in modern anesthesia. Thus, today a safe treatment can also be offered to patients with higher somatic risks, ECT still represents an important option, especially in the therapy of treatmentresistant psychiatric disorders after medication treatment failures. Earlier consideration of ECT may reduce the rate of chronic and difficult-to-treat psychiatric disorders. PMID:18472488

Restrained Proton Indicator in Combined Quantum-Mechanics/Molecular-Mechanics Dynamics Simulations of Proton Transfer through a Carbon Nanotube.

PubMed

Duster, Adam W; Lin, Hai

2017-09-14

Recently, a collective variable "proton indicator" was purposed for tracking an excess proton solvated in bulk water in molecular dynamics simulations. In this work, we demonstrate the feasibility of utilizing the position of this proton indicator as a reaction coordinate to model an excess proton migrating through a hydrophobic carbon nanotube in combined quantum-mechanics/molecular-mechanics simulations. Our results indicate that applying a harmonic restraint to the proton indicator in the bulk solvent near the nanotube pore entrance leads to the recruitment of water molecules into the pore. This is consistent with an earlier study that employed a multistate empirical valence bond potential and a different representation (center of excess charge) of the proton. We attribute this water recruitment to the delocalized nature of the solvated proton, which prefers to be in high-dielectric bulk solvent. While water recruitment into the pore is considered an artifact in the present simulations (because of the artificially imposed restraint on the proton), if the proton were naturally restrained, it could assist in building water wires prior to proton transfer through the pore. The potential of mean force for a proton translocation through the water-filled pore was computed by umbrella sampling, where the bias potentials were applied to the proton indicator. The free energy curve and barrier heights agree reasonably with those in the literature. The results suggest that the proton indicator can be used as a reaction coordinate in simulations of proton transport in confined environments.

Study of the biochemical indicators of chronic irradiation in rats.

PubMed

Szabo, L D; Benko, A B; Gyenge, L; Predmerszky, T

1976-01-01

Daily urinary excretion of pseudouridine, creatinine and creatine of chronically irradiated Wistar rats was estimated. The irradiation conditions were: 60Co gamma source, dose-rate 10 rad/day, total dose 200, 400 and 600 rad. Control groups were kept under similar conditions. Urine samples were taken three times after the end of the irradiation period. It was found that: (1) pseudouridine excretion seems more suitable for indicating radiation injury than the creatine/creatinine ratio in chronic irradiation in rats; (ii) there are significant changes in dose dependence of pseudouridine excretion in the post-irradiation period; (iii) a new method for pseudouridine estimation gives closely similar data to those of earlier investigations.

Attachment styles, earlier interpersonal relationships and schizotypy in a non-clinical sample.

PubMed

Berry, Katherine; Band, Rebecca; Corcoran, Rhiannon; Barrowclough, Christine; Wearden, Alison

2007-12-01

This paper investigates associations between adult attachment style, relationships with significant others during childhood, traumatic life-events and schizotypy. Relationships between attachment and hypothesized correlates were investigated in a cross-sectional design using an analogue sample. The reliability of the attachment and trauma measures was investigated using a test-retest design. Three hundred and four students completed the self-report version of the Psychosis Attachment Measure (PAM), maternal and paternal versions of the Parental Bonding Instrument, the Attachment History Questionnaire, a measure of trauma and the Oxford-Liverpool Inventory of Feelings and Experiences scale through an internet website. As predicted, there were statistically significant associations between insecure attachment in adult relationships and experiences of negative interpersonal events. Both earlier interpersonal experiences and adult attachment style predicted schizotypy, and adult attachment style emerged as an independent predictor of positive schizotypal characteristics. The findings support associations between adult attachment style and previous interpersonal experiences and between adult attachment and schizotypy. The PAM is a reliable and valid instrument that can be used to explore attachment styles in analogue samples and associations between attachment styles and psychotic symptoms in clinical samples.

Comparison of the Multiple-sample means with composite sample results for fecal indicator bacteria by quantitative PCR and culture

EPA Science Inventory

ABSTRACT: Few studies have addressed the efficacy of composite sampling for measurement of indicator bacteria by QPCR. In this study, composite results were compared to single sample results for culture- and QPCR-based water quality monitoring. Composite results for both methods ...

Earlier Age of Onset of Chronic Hypertension and Type 2 Diabetes Mellitus After a Hypertensive Disorder of Pregnancy or Gestational Diabetes Mellitus.

PubMed

Heida, Karst Y; Franx, Arie; van Rijn, Bas B; Eijkemans, Marinus J C; Boer, Jolanda M A; Verschuren, Monique W M; Oudijk, Martijn A; Bots, Michiel L; van der Schouw, Yvonne T

2015-12-01

A prospective cohort study was conducted to assess the impact of a history of hypertensive disorder of pregnancy (HDP) or gestational diabetes mellitus (GDM) on the risk and age of onset of hypertension, type 2 diabetes mellitus (T2D), and cardiovascular disease (CVD) later in life, independent of hypertension and T2D. Between 1993 and 1997, 22 265 ever-pregnant women were included from the European Prospective Investigation into Cancer and Nutrition-NL study, aged 20 to 70 years at baseline. Details on complications of pregnancy and known hypertension were obtained by questionnaire. Blood pressure was measured at enrollment. Participants were followed for the occurrence of CVD events. Data were analyzed using ANCOVA, multivariable logistic regression, and Cox proportional hazard (with HDP and GDM as time-dependent variables for T2D and CVD) models. At enrollment, women with a HDP reported diagnosis of hypertension 7.7 years earlier (95% confidence interval [CI] 6.9-8.5) and women with GDM reported diagnosis of T2D 7.7 years earlier (95% CI 5.8-9.6) than women without pregnancy complications. After adjustment for potential confounders, HDP was associated with presence of hypertension at enrollment (odds ratio 2.12, 95% CI 1.98-2.28) and onset of CVD later in life (hazard ratio 1.21, 95% CI 1.10-1.32). After including the intermediates hypertension and T2D in the model, the risk of CVD later in life decreased (hazard ratio 1.09, 95% CI 1.00-1.20). GDM was associated with an increased risk of developing T2D later in life (hazard ratio 3.68, 95% CI 2.77-4.90), but not with risk of CVD. HDP and GDM have a substantial impact on the risk of CVD and are potentially important indicators for preventive cardiovascular risk management. © 2015 American Heart Association, Inc.

Documentation for the machine-readable version of A Finding List of Stars of Spectral Type F2 and Earlier in a North Galactic Pole Region

NASA Technical Reports Server (NTRS)

Warren, W. H., Jr.

1982-01-01

The machine-readable data set is the result of an objective-prism survey made with an 80 cm/120 cm Schmidt telescope. The F2 and earlier stars were isolated from later type objects by using the MK classification criteria. The catalog contains 601 stars and includes cross identifications to the BD and HD catalogs, coordinates, photographic magnitudes and spectral types. A separate file contains the remarks from the original data tables merged with those following the data. The machine-readable files are described.

Modeling Drought Impact Occurrence Based on Climatological Drought Indices for Europe

NASA Astrophysics Data System (ADS)

Stagge, J. H.; Kohn, I.; Tallaksen, L. M.; Stahl, K.

2014-12-01

Meteorological drought indices are often assumed to accurately characterize the severity of a drought event; however, these indices do not necessarily reflect the likelihood or severity of a particular type of drought impact experienced on the ground. In previous research, this link between index and impact was often estimated based on thresholds found by experience, measured using composite indices with assumed weighting schemes, or defined based on very narrow impact measures, using either a narrow spatial extent or very specific impacts. This study expands on earlier work by demonstrating the feasibility of relating user-provided impact reports to the climatological drought indices SPI and SPEI by logistic regression. The user-provided drought impact reports are based on the European Drought Impact Inventory (EDII, www.geo.uio.no/edc/droughtdb/), a newly developed online database that allows both public report submission and querying the more than 4,000 reported impacts spanning 33 European countries. This new tool is used to quantify the link between meteorological drought indices and impacts focusing on four primary impact types, spanning agriculture, energy and industry, public water supply, and freshwater ecosystem across five European countries. Statistically significant climate indices are retained as predictors using step-wise regression and used to compare the most relevant drought indices and accumulation periods for different impact types and regions. Agricultural impacts are explained best by 2-12 month anomalies, with 2-3 month anomalies found in predominantly rain-fed agricultural regions, and anomalies greater than 3 months related to agricultural management practices. Energy and industry impacts, related to hydropower and energy cooling water in these countries, respond to longer accumulated precipitation anomalies (6-12 months). Public water supply and freshwater ecosystem impacts are explained by a more complex combination of short (1-3 month

[Impact of quality-indicator-based measures to improve the treatment of acute poisoning in pediatric emergency patients].

PubMed

Martínez Sánchez, Lidia; Trenchs Sainz de la Maza, Victoria; Azkunaga Santibáñez, Beatriz; Nogué-Xarau, Santiago; Ferrer Bosch, Nuria; García González, Elsa; Luaces I Cubells, Carles

2016-02-01

To analyze the impact of quality-indicator-based measures for improving quality of care for acute poisoning in pediatric emergency departments. Recent assessments of quality indicators were compared with benchmark targets and with results from previous studies. The first study evaluated 6 basic indicators in the pediatric emergency departments of members of to the working group on poisoning of the Spanish Society of Pediatric Emergency Medicine (GTI-SEUP). The second study evaluated 20 indicators in a single emergency department of GTI-SEUP members. Based on the results of those studies, the departments implemented the following corrective measures: creation of a team for gastric lavage follow-up, preparation of a new GTI-SEUP manual on poisoning, implementation of a protocol for poisoning incidents, and creation of specific poisoning-related fields for computerized patient records. The benchmark targets were reached on 4 quality indicators in the first study. Improvements were seen in the availability of protocols, as indicators exceeded the target in all the pediatric emergency departments (vs 29.2% of the departments in an earlier study, P < .001). No other significant improvements were observed. In the second study the benchmarks were reached on 13 indicators. Improvements were seen in compliance with incident reporting to the police (recently, 44.4% vs 19.2% previously, P = .036), case registration in the minimum basic data set (51.0% vs 1.9%, P < .001), and a trend toward increased administration of activated carbon within 2 hours (93.1% vs 83.5%, P = .099). No other significant improvements were seen. The corrective measures led to improvements in some quality indicators. There is still room for improvement in these emergency departamens' care of pediatric poisoning.

Indicators for Assessing Climate Change Resilience Resulting from Emplacement of Green Infrastructure Projects Across an Urban Landscape

NASA Astrophysics Data System (ADS)

Parish, E. S.; Omitaomu, O.; Sylvester, L.; Nugent, P.

2015-12-01

Many U.S. cities are exploring the potential of using green infrastructure (e.g., porous pavements, green roofs, street planters) to reduce urban storm water runoff, which can be both be a nuisance and costly to treat. While tools exist to measure local runoff changes resulting from individual green infrastructure (GI) projects, most municipalities currently have no method of analyzing the collective impact of GI projects on urban stormwater systems under future rainfall scenarios and impervious surface distribution patterns. Using the mid-sized city of Knoxville, Tennessee as a case study, we propose a set of indicators that can be used to monitor and analyze the collective effects of GI emplacement on urban storm water runoff volumes as well as to quantify potential co-benefits of GI projects (e.g., urban heat island reduction, reduced stream scouring) under different climate projection ensembles and population growth scenarios. These indicators are intended to help the city prioritize GI projects as opportunities arise, as well as to track the effectiveness of GI implementation over time. We explore the aggregation of these indicators across different spatial scales (e.g., plot, neighborhood, watershed, city) in order to assess potential changes in climate change resilience resulting from the collective implementation of GI projects across an urban landscape.

Implementation Challenges and Results

ERIC Educational Resources Information Center

Walters, Kirk; Sorensen, Nicholas

2013-01-01

This paper describes the implementation of the online and f2f summer algebra courses that were delivered in summers 2011 and 2012. These data will be used to frame the impact results presented in an earlier paper. In particular, the paper will provide a detailed picture of how the online course was structured and the types of supports provided to…

Screening for Colorectal Cancer in African Americans: Determinants and Rationale for an Earlier Age to Commence Screening

PubMed Central

Carethers, John M.

2014-01-01

Colorectal cancer (CRC) screening is a highly cost-effective approach to reduce morbidity and mortality of patients, as well as reduce the prevalence of CRC in populations. Current recommendations for CRC screening for the asymptomatic general population begin at age 50 years, an age after which ~95% of cancers occur. Determinants that modify the timing and frequency for screening include a personal or family history of adenomatous polyps or CRC, the age of onset of these colonic lesions, and the presence or potential for a patient to harbor a higher-risk syndrome such as inflammatory bowel disease (IBD), familial adenomatous polyposis (FAP), or Lynch syndrome.. Although race, like family history, is a heritable factor, it has not engendered inclusion in the same broad systematic screening recommendations despite multiple studies demonstrating a disparity in the incidence and mortality from CRC, and the potential for targeted screening to reduce the disparity. In particular, African Americans, when compared to Caucasians, (a) have lower CRC screening utilization rates, (b) have an earlier presentation of CRC (0-8 years younger than Caucasians) and, more often have aggressive biological features more prone to metastasis, (c) have a higher CRC prevalence at all ages and a higher proportion of CRCs before 50 years of age (~11% vs 5% in Caucasians), (d) are less likely to know or transmit personal or family history of adenomas or CRC that might change their screening to an earlier age, (e) present with 7-15% excess right-sided CRCs that are not microsatellite unstable, (f) show higher frequencies of high-risk adenomas at every decile of age, and an excess of high-risk proximal adenomas that mirror the excess of proximal CRCs, (g) have cancers that demonstrate lower proportions of good prognostic biomarkers such as MSI and higher proportions of bad prognosticators such as EMAST, (h) may possess gut microbiota more conducive to initiating and/or propagating colonic

Propeller Flaps: A Review of Indications, Technique, and Results

PubMed Central

D'Arpa, Salvatore; Toia, Francesca; Pirrello, Roberto; Moschella, Francesco; Cordova, Adriana

2014-01-01

In the last years, propeller flaps have become an appealing option for coverage of a large range of defects. Besides having a more reliable vascular pedicle than traditional flap, propeller flaps allow for great freedom in design and for wide mobilization that extend the possibility of reconstructing difficult wounds with local tissues and minimal donor-site morbidity. They also allow one-stage reconstruction of defects that usually require multiple procedures. Harvesting of a propeller flap requires accurate patient selection, preoperative planning, and dissection technique. Complication rate can be kept low, provided that potential problems are prevented, promptly recognized, and adequately treated. This paper reviews current knowledge on propeller flaps. Definition, classification, and indications in the different body regions are discussed based on a review of the literature and on the authors' experience. Details about surgical technique are provided, together with tips to avoid and manage complications. PMID:24971367

[Hypofractionated whole breast irradiation (WBRT): Results and indications].

PubMed

Cutuli, B

2016-10-01

Breast irradiation after breast-conserving surgery is essential for maximizing local control and overall survival. The increase of breast cancer (BC) incidence, constraints of classical five weeks (w) radiation regimens and scarcity of radiotherapy units have led to test short hypofractionated WBRT schemes. One pilot study and three prospective randomized trials have tested various hypofractionated regimens of WBRT. About 7000 patients were included and follow-up ranged from 5 to 12 years. The conclusion of these trials is similar, showing local control and toxicity equivalent to these of the standard regimens. Three schemes are now clearly validated: 42.5Gy/16fr/3w, 40Gy/15fr/3w, or 42Gy/13fr/5w. However, the majority of included patients had favorable prognostic factors, were treated to the breast only and the boost dose, when indicated, was delivered with a standard fractionation. Therefore, we recommend the regimens preferentially in patients treated to the breast only, and without nodal involvement. These studies did not evaluate the addition of a boost dose with a hypofractionated scheme. If a boost is to be given, a standard fractionation should be used. Particular care should be taken to avoid heterogeneities leading to high fraction doses to organs at risk (lung and heart). Copyright © 2016 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

From Rationale to Results: Implementing Performance Indicators in a Public Library.

ERIC Educational Resources Information Center

Alston, Ruth

This paper describes the theoretical design and practical implementation of a set of performance indicators in a public library system in London (England). Bromley Libraries has 15 branch libraries and serves 300,000 people. The need for improved management control by assessing performance and monitoring progress, library restructuring, and…

Advancement and results in hostile fire indication using potassium line missile warning sensors

NASA Astrophysics Data System (ADS)

Montgomery, Joel; Montgomery, Marjorie; Hardie, Russell

2014-06-01

M&M Aviation has been developing and conducting Hostile Fire Indication (HFI) tests using potassium line emission sensors for the Air Force Visible Missile Warning System (VMWS) to advance both algorithm and sensor technologies for UAV and other airborne systems for self protection and intelligence purposes. Work began in 2008 as an outgrowth of detecting and classifying false alarm sources for the VMWS using the same K-line spectral discrimination region but soon became a focus of research due to the high interest in both machine-gun fire and sniper geo-location via airborne systems. Several initial tests were accomplished in 2009 using small and medium caliber weapons including rifles. Based on these results, the Air Force Research Laboratory (AFRL) funded the Falcon Sentinel program in 2010 to provide for additional development of both the sensor concept, algorithm suite changes and verification of basic phenomenology including variance based on ammunition type for given weapons platform. Results from testing over the past 3 years have showed that the system would be able to detect and declare a sniper rifle at upwards of 3km, medium machine gun at 5km, and explosive events like hand-grenades at greater than 5km. This paper will outline the development of the sensor systems, algorithms used for detection and classification, and test results from VMWS prototypes as well as outline algorithms used for the VMWS. The Falcon Sentinel Program will be outlined and results shown. Finally, the paper will show the future work for ATD and transition efforts after the Falcon Sentinel program completed.

Does earlier arrival of the retrieval team improve short-term outcomes in outborn extremely premature infants?

PubMed

Sharpe, Janet B; Davies, Mark W

2018-05-31

The risk of mortality and morbidity is increased in outborn, extremely premature infants. We aim to determine whether earlier arrival of the retrieval team after the birth of infants less than 29 weeks gestation improves short-term mortality and morbidity. This is a retrospective analysis of a cohort of infants less than 29 weeks gestation who were retrieved to the Royal Brisbane and Women's Hospital (RBWH) over a 5-year period. Demographic information regarding the infant and mother, retrieval team arrival time and outcome data was collected. Primary outcomes investigated were mortality prior to discharge from hospital or a composite of mortality or severe intraventricular haemorrhage (IVH). Data on 105 infants were analysed; 88 infants (83.8%) survived to discharge home, and 79 (75.2%) survived to discharge without severe IVH. On univariate analysis, there was no significant association between age at arrival of the retrieval team and death prior to discharge (P = 0.94) or death prior to discharge or severe IVH (P = 0.83). On logistic regression analysis, age at arrival of retrieval team remained non-significant for a reduction in death prior to discharge and composite of death or severe IVH (P = 0.70 and P = 0.99, respectively). The earlier arrival of the retrieval team is not associated with improved short-term outcomes in outborn, extremely preterm infants who are retrieved and admitted to a tertiary neonatal intensive care unit - for infants where the retrieval team arrived within about 8 h of birth. © 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

Double Helical Gear Performance Results in High Speed Gear Trains

NASA Technical Reports Server (NTRS)

Handschuh, Robert F.; Ehinger, Ryan; Sinusas, Eric; Kilmain, Charles

2009-01-01

The operation of high speed gearing systems in the transmissions of tiltrotor aircraft has an effect on overall propulsion system efficiency. Recent work has focused on many aspects of high-speed helical gear trains as would be used in tiltrotor aircraft such as operational characteristics, comparison of analytical predictions to experimental data and the affect of superfinishing on transmission performance. Baseline tests of an aerospace quality system have been conducted in the NASA Glenn High-Speed Helical Gear Train Test Facility and have been described in earlier studies. These earlier tests had utilized single helical gears. The results that will be described in this study are those attained using double helical gears. This type of gear mesh can be configured in this facility to either pump the air-oil environment from the center gap between the meshing gears to the outside of tooth ends or in the reverse direction. Tests were conducted with both inward and outward air-oil pumping directions. Results are compared to the earlier baseline results of single helical gears.

Double Helical Gear Performance Results in High Speed Gear Trains

NASA Technical Reports Server (NTRS)

Handschuh, Robert F.; Ehinger, Ryan; Sinusas, Eric; Kilmain, Charles

2010-01-01

The operation of high speed gearing systems in the transmissions of tiltrotor aircraft has an effect on overall propulsion system efficiency. Recent work has focused on many aspects of high-speed helical gear trains as would be used in tiltrotor aircraft such as operational characteristics, comparison of analytical predictions to experimental data and the affect of superfinishing on transmission performance. Baseline tests of an aerospace quality system have been conducted in the NASA Glenn High-Speed Helical Gear Train Test Facility and have been described in earlier studies. These earlier tests had utilized single helical gears. The results that will be described in this study are those attained using double helical gears. This type of gear mesh can be configured in this facility to either pump the air-oil environment from the center gap between the meshing gears to the outside of tooth ends or in the reverse direction. Tests were conducted with both inward and outward air-oil pumping directions. Results are compared to the earlier baseline results of single helical gears.

An inhibitor of polyamine synthesis arrests cells at an earlier stage of G1 than does calcium deprivation.

PubMed Central

Cheetham, B F

1983-01-01

Methylglyoxal bis(guanylhydrazone) completely inhibits the induction of thymidine kinase after serum stimulation of quiescent fibroblasts only if added within 3 h after serum, whereas calcium deprivation blocks this induction up to 12 h after serum stimulation. Experiments in which one of these blocks was imposed as the other was released confirmed that cells blocked by methylglyoxal bis(guanylhydrazone) are arrested at an earlier stage in G1 than cells blocked by calcium deprivation. PMID:6843551

On the evolution of high-B radio pulsars with measured braking indices

NASA Astrophysics Data System (ADS)

Benli, O.; Ertan, Ü.

2017-11-01

We have investigated the long-term evolutions of the high-magnetic field radio pulsars (HBRPs) with measured braking indices in the same model that was applied earlier to individual anomalous X-ray pulsars (AXPs), soft gamma repeaters (SGRs) and dim isolated neutron stars (XDINs). We have shown that the rotational properties (period, period derivative and braking index) and the X-ray luminosity of individual HBRPs can be acquired simultaneously by the neutron stars evolving with fallback discs. The model sources reach the observed properties of HBRPs in the propeller phases, when pulsed radio emission is allowed, at ages consistent with the estimated ages of the supernova remnants of the sources. Our results indicate that the strength of magnetic dipole fields of HBRPs are comparable to and even greater than those of AXP/SGRs and XDINs, but still one or two orders of magnitude smaller than the values inferred from the magnetic dipole torque formula. The possible evolutionary paths of the sources imply that they will lose their seemingly HBRP property after about a few 104 yr, because either their rapidly decreasing period derivatives will lead them into the normal radio pulsar population or they will evolve into the accretion phase switching off the radio pulses.

The characteristics of national health initiatives promoting earlier cancer diagnosis among adult populations: a systematic review protocol

PubMed Central

Calanzani, Natalia; Weller, David; Campbell, Christine

2017-01-01

Introduction The increasing burden of cancer morbidity and mortality has led to the development of national health initiatives to promote earlier cancer diagnosis and improve cancer survival. This protocol describes a systematic review aiming to identify the evidence about such initiatives among the adult population. We will describe their components, stakeholders and target populations, and summarise their outcomes. Methods and analysis We will search databases and websites for peer-reviewed publications and grey literature on national health initiatives in high-income countries as defined by the World Bank. Quantitative, qualitative and mixed-methods studies will be included and assessed for their methodological quality. Study selection, quality assessment and data extraction will be carried out independently by two reviewers. Narrative synthesis will be used to analyse the findings. Ethics and dissemination This systematic review analyses secondary data and ethical approval is not required. Review findings will be helpful to researchers, policy makers, governments and other key stakeholders developing similar initiatives and assessing cancer outcomes. The results will be submitted to a peer-reviewed journal in order to reach a diverse group of healthcare professionals, researchers and policy makers. This systematic review protocol is registered at PROSPERO (CRD42016047233). PMID:28698336

Presetting ECG electrodes for earlier heart rate detection in the delivery room.

PubMed

Gulati, Rashmi; Zayek, Michael; Eyal, Fabien

2018-07-01

To determine whether heart rate (HR) could be detected earlier than by pulse oximeter (POX), using a novel method of application of electrocardiogram (ECG) electrodes during neonatal resuscitation in the delivery room. ECG electrodes were set before delivery to be applied to the back of infants' thorax. Time to detect HR was recorded as soon as a numerical HR along with a recognizable and persistent QRS complex was observed on ECG monitor (HRECG) and a plethysmographic waveform was seen on POX monitor (HRPOX). Out of 334 infants, 49 were <31 weeks of gestational age. Overall, the median (interquartile range, IQR) time to detect HRECG was significantly shorter [29 (5, 60) seconds] than time by POX [60 (45,120) seconds], (p < 0.001). Similarly, in <31-week infants, the median (IQR) time to detect HRECG was 10 (2, 40) seconds compared to 60 (30,120) seconds by POX, (p < 0.001). Failure to have HR detected by 1 minute occurred in 30%, 54% and 20% of infants by ECG, POX and either of the devices, respectively. In the delivery room, electrodes applied by the study method are more effective than pulse oximetry in providing the neonatal team with timely HR information that is necessary for proper resuscitative actions. Published by Elsevier B.V.

Indications and organisational methods for autologous blood transfusion procedures in Italy: results of a national survey

PubMed Central

Catalano, Liviana; Campolongo, Alessandra; Caponera, Maurizio; Berzuini, Alessandra; Bontadini, Andrea; Furlò, Giuseppe; Pasqualetti, Patrizio; Liumbruno, Giancarlo M.

2014-01-01

Introduction Pre-operative donation of autologous blood is a practice that is now being abandoned. Alternative methods of transfusing autologous blood, other than predeposited blood, do however play a role in limiting the need for transfusion of allogeneic blood. This survey of autologous blood transfusion practices, promoted by the Italian Society of Transfusion Medicine and Immunohaematology more than 2 years after the publication of national recommendations on the subject, was intended to acquire information on the indications for predeposit in Italy and on some organisational aspects of the alternative techniques of autotransfusion. Materials and methods A structured questionnaire consisting of 22 questions on the indications and organisational methods of autologous blood transfusion was made available on a web platform from 15 January to 15 March, 2013. The 232 Transfusion Services in Italy were invited by e-mail to complete the online survey. Results Of the 232 transfusion structures contacted, 160 (69%) responded to the survey, with the response rate decreasing from the North towards the South and the Islands. The use of predeposit has decreased considerably in Italy and about 50% of the units collected are discarded because of lack of use. Alternative techniques (acute isovolaemic haemodilution and peri-operative blood salvage) are used at different frequencies across the country. Discussion The data collected in this survey can be considered representative of national practice; they show that the already very limited indications for predeposit autologous blood transfusion must be adhered to even more scrupulously, also to avoid the notable waste of resources due to unused units. Users of alternative autotransfusion techniques must be involved in order to gain a full picture of the degree of use of such techniques; multidisciplinary agreement on the indications for their use is essential in order for these indications to have an effective role in �

Nearby Quasars Result From Galactic Encounters, VLA Studies Indicate

NASA Astrophysics Data System (ADS)

1998-12-01

by particular atoms, the pattern was at first indecipherable. In 1963, Maarten Schmidt of Caltech realized that the pattern made sense if the light's wavelength had been shifted through the Doppler effect by the object's motion away from Earth at greater velocities than had yet been seen. Because the universe is expanding, objects are moving away from Earth with greater speed at greater distances. The speeds seen in the quasars indicated that they were the most distant objects yet found, and, because they appear bright even at those great distances, must be extremely energetic. The idea that the tremendous amounts of energy released by quasars results from material being drawn into a black hole at the center of a galaxy quickly rose as the leading explanation. Galactic interactions were first proposed as an explanation for nearby quasar activity in 1972. Today, quasars are thought to be one of several types of active galactic nuclei, all of which are powered by central black holes. The VLA is an instrument of the National Radio Astronomy Observatory, a facility of the National Science Foundation, operated under cooperative agreement by Associated Universities, Inc. Radio-Optical Image of Quasar and Companion Galaxy CAPTION: A combined optical-radio image of the quasar IRAS 17596+4221 and a companion galaxy. The orange areas are the hydrogen gas imaged by the VLA. In the optical image, there is no direct evidence for an interaction between the galaxy hosting the quasar and the companion galaxy. The extensions in the hydrogen gas, however, are a clear indication of disruption resulting from an interaction between the two galaxies.

Analysis of arrhythmic events is useful to detect lead failure earlier in patients followed by remote monitoring.

PubMed

Nishii, Nobuhiro; Miyoshi, Akihito; Kubo, Motoki; Miyamoto, Masakazu; Morimoto, Yoshimasa; Kawada, Satoshi; Nakagawa, Koji; Watanabe, Atsuyuki; Nakamura, Kazufumi; Morita, Hiroshi; Ito, Hiroshi

2018-03-01

Remote monitoring (RM) has been advocated as the new standard of care for patients with cardiovascular implantable electronic devices (CIEDs). RM has allowed the early detection of adverse clinical events, such as arrhythmia, lead failure, and battery depletion. However, lead failure was often identified only by arrhythmic events, but not impedance abnormalities. To compare the usefulness of arrhythmic events with conventional impedance abnormalities for identifying lead failure in CIED patients followed by RM. CIED patients in 12 hospitals have been followed by the RM center in Okayama University Hospital. All transmitted data have been analyzed and summarized. From April 2009 to March 2016, 1,873 patients have been followed by the RM center. During the mean follow-up period of 775 days, 42 lead failure events (atrial lead 22, right ventricular pacemaker lead 5, implantable cardioverter defibrillator [ICD] lead 15) were detected. The proportion of lead failures detected only by arrhythmic events, which were not detected by conventional impedance abnormalities, was significantly higher than that detected by impedance abnormalities (arrhythmic event 76.2%, 95% CI: 60.5-87.9%; impedance abnormalities 23.8%, 95% CI: 12.1-39.5%). Twenty-seven events (64.7%) were detected without any alert. Of 15 patients with ICD lead failure, none has experienced inappropriate therapy. RM can detect lead failure earlier, before clinical adverse events. However, CIEDs often diagnose lead failure as just arrhythmic events without any warning. Thus, to detect lead failure earlier, careful human analysis of arrhythmic events is useful. © 2017 Wiley Periodicals, Inc.

Selective Episiotomy: Indications, Techinique, and Association with Severe Perineal Lacerations.

PubMed

Corrêa Junior, Mário Dias; Passini Júnior, Renato

2016-06-01

Introduction Episiotomy is a controversial procedure, especially because the discussion that surrounds it has gone beyond the field of scientific debate, being adopted as an indicator of the "humanization of childbirth". The scientific literature indicates that episiotomy should not be performed routinely, but selectively. Objectives To review the literature in order to assess whether the implementation of selective episiotomy protects against severe perineal lacerations, the indications for the procedure, and the best technique to perform it. Methods A literature search was performed in PubMed using the terms episiotomy or perineal lacerations, and the filter clinical trial. The articles concerning the risk of severe perineal lacerations with or without episiotomy, perineal protection, or episiotomy techniques were selected. Results A total of 141 articles were identified, and 24 of them were included in the review. Out of the 13 studies that evaluated the risk of severe lacerations with and without episiotomy, 5 demonstrated a protective role of selective episiotomy, and 4 showed no significant differences between the groups. Three small studies confirmed the finding that episiotomy should be performed selectively and not routinely, and one study showed that midline episiotomy increased the risk of severe lacerations. The most cited indications were primiparity, fetal weight greater than 4 kg, prolonged second stage, operative delivery, and shoulder dystocia. As for the surgical technique, episiotomies performed with wider angles (> 40°) and earlier in the second stage (before "crowning ") appeared to be more protective. Conclusions Selective episiotomy decreases the risk of severe lacerations when compared with the non-performance or the performance of routine episiotomy. The use of a proper surgical technique is fundamental to obtain better results, especially in relation to the angle of incision, the distance from the vaginal introitus, and the

[Diagnostic hysteroscopy indications and results in Complexo Hospitalario Universitario De Ourense].

PubMed

Pato-Mosquera, Mónica; Vázquez-Rodríguez, Marta; Pérez-Adán, Marta; García-García, María Jesús; Blanco-Pérez, Susana

2013-07-01

Diagnostic hysteroscopy is an endoscopic technique that allows the evaluation of the endocervical canal and uterine cavity. To evaluate indications, complications and referral to operative hysteroscopy. To analyze the correlation between sonographic display, hysteroscopy findings and histological diagnosis. Retrospective and descriptive study of 904 patients who underwent diagnostic hysteroscopy between January 1, 2008 and June 30, 2012. The most frequent indication was sonographic detection of endometrial polyps (75% were premenopausal and 71.2% postmenopausal). The complication rate associated with the test was 11.4%. The reduction experimented in operative hysteroscopies was from 31.2% in 2008 to 12.2% between January and June 2012. When a polyp or a myoma was detected by sonography, diagnostic hysteroscopy showed them in 64.4% y 62.5% of the cases, respectively. The correlation between hysteroscopic findings and histopathologic diagnosis was 77.7% for normal endometrium, 77.9% for polyps, 17.8% for hyperplasic appearance and 100% for carcinoma suspicion. Diagnostic hysteroscopy is a safe technique that allows small interventions avoiding operative hysteroscopies. There is a good relation between hysteroscopic visual inspection and anatomopathologic diagnosis, but biopsy should be taken except if normal endometrium is visualized.

Earlier predictors of eating disorder symptoms in 9-year-old children. A longitudinal study.

PubMed

Parkinson, Kathryn N; Drewett, Robert F; Le Couteur, Ann S; Adamson, Ashley J

2012-08-01

The aim of the study was to examine predictors of eating disorder symptoms in a population based sample at the earliest age at which they can be measured using the Children's Eating Attitudes Test. Data were collected from the longitudinal Gateshead Millennium Study cohort; 609 children participated in the 7 year data sweep (and their mothers and teachers), and 589 children participated in the 9 year data sweep. Eating disorder symptoms at 9 years were higher in boys, and in children from more deprived families. Higher eating disorder symptoms were associated with more body dissatisfaction at 9 years. Higher symptoms were predicted by higher levels of dietary restraint and of emotional symptoms, but not greater body dissatisfaction, 2 years earlier. The study showed that some correlates of high eating disorder symptoms found in adolescents and adults are also found in children, before the rise in diagnosable eating disorders over the pubertal period. Copyright © 2012 Elsevier Ltd. All rights reserved.

Reduced abundance and earlier collection of bumble bee workers under intensive cultivation of a mass-flowering prairie crop.

PubMed

Galpern, Paul; Johnson, Sarah A; Retzlaff, Jennifer L; Chang, Danielle; Swann, John

2017-04-01

One of the most commonly seeded crops in Canada is canola, a cultivar of oilseed rape ( Brassica napus ). As a mass-flowering crop grown intensively throughout the Canadian Prairies, canola has the potential to influence pollinator success across tens of thousands of square kilometers of cropland. Bumble bees ( Bombus sp.) are efficient pollinators of many types of native and crop plants. We measured the influence of this mass-flowering crop on the abundance and phenology of bumble bees, and on another species of social bee (a sweat bee; Halictus rubicundus ), by continuously deploying traps at different levels of canola cultivation intensity, spanning the start and end of canola bloom. Queen bumble bees were more abundant in areas with more canola cover, indicating that this crop is attractive to queens. However, bumble bee workers were significantly fewer in these locations later in the season, suggesting reduced colony success. The median collection dates of workers of three bumble bee species were earlier near canola fields, suggesting a dynamic response of colonies to the increased floral resources. Different species experienced this shift to different extents. The sweat bee was not affected by canola cultivation intensity. Our findings suggest that mass-flowering crops such as canola are attractive to bumble bee queens and therefore may lead to higher rates of colony establishment, but also that colonies established near this crop may be less successful. We propose that the effect on bumble bees can be mitigated by spacing the crop more evenly with respect to alternate floral resources.

Indications and outcome of pediatric tracheostomy: results from a Nigerian tertiary hospital.

PubMed

Adoga, Adeyi A; Ma'an, Nuhu D

2010-01-12

There is a change in the concept of pediatric tracheostomy. This study investigates the indications and outcomes of pediatric tracheostomy in a Nigerian teaching hospital finding out whether there is also a change in the trend in our environment as compared to other centers. A retrospective chart review of 46 patients aged between 2 months and 15 years who presented to our Otorhinolaryngological facility and had tracheostomy between January 2000 and December 2008. The age range was 2 months to 15 years. There were 29 males and 17 females. Thirty two (69.6%) patients were in the age range 6-10 years. Forty tracheostomies (87%) were performed as emergency while 6 (13%) as elective procedures. The commonest indication for tracheostomy was upper airway obstruction (n = 29, 63%). Transverse skin incision was employed in all the cases. No intra-operative complication was recorded. The post-operative complication rate was 15.2%. The duration of tracheostomy ranged from 5 days to 3 months. All the patients were successfully decannulated. The overall mortality was 8 (17.4%). There was no tracheostomy related mortality. There is no increase in the incidence of tracheostomy in patients under 1 year of age and the commonest indication for the procedure in Nigeria has remained relief of upper airway obstruction. Pediatric tracheostomy is safe when performed in the tertiary hospital setting.

Phylogenomic analysis of Copepoda (Arthropoda, Crustacea) reveals unexpected similarities with earlier proposed morphological phylogenies.

PubMed

Eyun, Seong-Il

2017-01-19

Copepods play a critical role in marine ecosystems but have been poorly investigated in phylogenetic studies. Morphological evidence supports the monophyly of copepods, whereas interordinal relationships continue to be debated. In particular, the phylogenetic position of the order Harpacticoida is still ambiguous and inconsistent among studies. Until now, a small number of molecular studies have been done using only a limited number or even partial genes and thus there is so far no consensus at the order-level. This study attempted to resolve phylogenetic relationships among and within four major copepod orders including Harpacticoida and the phylogenetic position of Copepoda among five other crustacean groups (Anostraca, Cladocera, Sessilia, Amphipoda, and Decapoda) using 24 nuclear protein-coding genes. Phylogenomics has confirmed the monophyly of Copepoda and Podoplea. However, this study reveals surprising differences with the majority of the copepod phylogenies and unexpected similarities with postembryonic characters and earlier proposed morphological phylogenies; More precisely, Cyclopoida is more closely related to Siphonostomatoida than to Harpacticoida which is likely the most basally-branching group of Podoplea. Divergence time estimation suggests that the origin of Harpacticoida can be traced back to the Devonian, corresponding well with recently discovered fossil evidence. Copepoda has a close affinity to the clade of Malacostraca and Thecostraca but not to Branchiopoda. This result supports the hypothesis of the newly proposed clades, Communostraca, Multicrustacea, and Allotriocarida but further challenges the validity of Hexanauplia and Vericrustacea. The first phylogenomic study of Copepoda provides new insights into taxonomic relationships and represents a valuable resource that improves our understanding of copepod evolution and their wide range of ecological adaptations.

Counselor-Level Predictors of Sustained Use of an Indicated Preventive Intervention for Aggressive Children.

PubMed

Lochman, John E; Powell, Nicole P; Boxmeyer, Caroline L; Qu, Lixin; Sallee, Meghann; Wells, Karen C; Windle, Michael

2015-11-01

Despite widespread concern about the frequent failure of trained prevention staff to continue to use evidence-based programs following periods of intensive training, little research has addressed the characteristics and experiences of counselors that might predict their sustained use of a program. The current study follows a sample of school counselors who were trained to use an indicated preventive intervention, the Coping Power program, in an earlier dissemination study, and determines their levels of continued use of the program's child and parent components in the 2 years following the counselors' intensive training in the program. Counselor characteristics and experiences were also examined as predictors of their sustained use of the program components. The Coping Power program addresses children's emotional regulation, social cognitive processes, and increases in positive interpersonal behaviors with at-risk children who have been screened to have moderate to high levels of aggressive behavior. The results indicated that counselors' perceptions of interpersonal support from teachers within their schools, their perceptions of the effectiveness of the program, and their expectations for using the program were all predictive of program use over the following 2 years. In addition, certain counselor personality characteristics (i.e., conscientiousness) and the level of actual teacher-rated behavior change experienced by the children they worked with during training were predictors of counselors' use of the program during the second year after training. These results indicate the central importance of teacher support and of child progress during training in the prediction of counselors' sustained use of a prevention program.

How to Develop Critical Thinking Skills Within the Armys Officer Education System (OES) Earlier in an Officer’s Career

DTIC Science & Technology

2016-02-13

thinking emerges.”31 Military leaders should minimize bureaucracy when possible in an attempt to facilitate creative thinking . Consequently, a...AIR WAR COLLEGE AIR UNIVERSITY HOW TO DEVELOP CRITICAL THINKING SKILLS WITHIN THE ARMY’S OFFICER EDUCTION SYSTEM (OES) EARLIER IN AN...Force Dragon’s Heart.” iv Abstract Critical thinking skills are required by strategic leaders to solve complex problems in an environment

Earlier occurrence and increased explanatory power of climate for the first incidence of potato late blight caused by Phytophthora infestans in Fennoscandia.

PubMed

Lehsten, Veiko; Wiik, Lars; Hannukkala, Asko; Andreasson, Erik; Chen, Deliang; Ou, Tinghai; Liljeroth, Erland; Lankinen, Åsa; Grenville-Briggs, Laura

2017-01-01

Late blight (caused by Phytophthora infestans) is a devastating potato disease that has been found to occur earlier in the season over the last decades in Fennoscandia. Up until now the reasons for this change have not been investigated. Possible explanations for this change are climate alterations, changes in potato production or changes in pathogen biology, such as increased fitness or changes in gene flow within P. infestans populations. The first incidence of late blight is of high economic importance since fungicidal applications should be typically applied two weeks before the first signs of late blight and are repeated on average once a week. We use field observations of first incidence of late blight in experimental potato fields from five sites in Sweden and Finland covering a total of 30 years and investigate whether the earlier incidence of late blight can be related to the climate. We linked the field data to meteorological data and found that the previous assumption, used in common late blight models, that the disease only develops at relative humidity levels above 90% had to be rejected. Rather than the typically assumed threshold relationship between late blight disease development and relative humidity we found a linear relationship. Our model furthermore showed two distinct responses of late blight to climate. At the beginning of the observation time (in Sweden until the early 90s and in Finland until the 2000s) the link between climate and first incidence was very weak. However, for the remainder of the time period the link was highly significant, indicating a change in the biological properties of the pathogen which could for example be a change in the dominating reproduction mode or a physiological change in the response of the pathogen to climate. The study shows that models used in decision support systems need to be checked and re-parametrized regularly to be able to capture changes in pathogen biology. While this study was performed with

Earlier initialization of highly active antiretroviral therapy is associated with long-term survival and is cost-effective: findings from a deterministic model of a 10-year Ugandan cohort.

PubMed

Mills, Fergal P; Ford, Nathan; Nachega, Jean B; Bansback, Nicholas; Nosyk, Bohdan; Yaya, Sanni; Mills, Edward J

2012-11-01

Raising the guidelines for the initiation of antiretroviral therapy in resource-limited settings at CD4 T-cell counts of 350 cells per microliter raises concerns about feasibility and cost. We examined costs of this shift using data from Uganda for almost 10 years. We projected total costs of earlier initiation with combined antiretroviral therapy, including inpatient and outpatient services, antiretroviral treatment and treatment for limited HIV-related opportunistic diseases, and benefits expressed in years-of-life-saved over 5- and 30-year time horizons using a deterministic economic model to examine the incremental cost-effectiveness ratio (ICER), expressed in cost per year-of-life-saved (YLS). The model generated ICERs for 5- and 30-year time horizons. Discounting both costs and benefits at 3% annually, for the 5-year analysis, the ICER was $695/YLS and $769 in the 30-year analysis. The results were most sensitive to program cost and the discount rate applied, but they were less sensitive to opportunistic infection treatment costs or the relative-risk reduction from earlier initiation. Program costs varied from 25% to 125%, and the ICER for the lower bound decreased to $491/YLS at 5-years and $574/YLS at 30 years. For the upper bound, the ICER increased to $899 for 5-years and $964 at 30-years. The budget impact of adoption, assuming the same level of program penetration in the community, is $261,651,942 for 5 years and $872,685,561 for 30 years. Our model showed that earlier initiation of combined antiretroviral therapy in Uganda is associated with improved long-term survival and is highly cost-effective, as defined by WHO-CHOICE.

Earlier Visual N1 Latencies in Expert Video-Game Players: A Temporal Basis of Enhanced Visuospatial Performance?

PubMed Central

Latham, Andrew J.; Patston, Lucy L. M.; Westermann, Christine; Kirk, Ian J.; Tippett, Lynette J.

2013-01-01

Increasing behavioural evidence suggests that expert video game players (VGPs) show enhanced visual attention and visuospatial abilities, but what underlies these enhancements remains unclear. We administered the Poffenberger paradigm with concurrent electroencephalogram (EEG) recording to assess occipital N1 latencies and interhemispheric transfer time (IHTT) in expert VGPs. Participants comprised 15 right-handed male expert VGPs and 16 non-VGP controls matched for age, handedness, IQ and years of education. Expert VGPs began playing before age 10, had a minimum 8 years experience, and maintained playtime of at least 20 hours per week over the last 6 months. Non-VGPs had little-to-no game play experience (maximum 1.5 years). Participants responded to checkerboard stimuli presented to the left and right visual fields while 128-channel EEG was recorded. Expert VGPs responded significantly more quickly than non-VGPs. Expert VGPs also had significantly earlier occipital N1s in direct visual pathways (the hemisphere contralateral to the visual field in which the stimulus was presented). IHTT was calculated by comparing the latencies of occipital N1 components between hemispheres. No significant between-group differences in electrophysiological estimates of IHTT were found. Shorter N1 latencies may enable expert VGPs to discriminate attended visual stimuli significantly earlier than non-VGPs and contribute to faster responding in visual tasks. As successful video-game play requires precise, time pressured, bimanual motor movements in response to complex visual stimuli, which in this sample began during early childhood, these differences may reflect the experience and training involved during the development of video-game expertise, but training studies are needed to test this prediction. PMID:24058667

Earlier visual N1 latencies in expert video-game players: a temporal basis of enhanced visuospatial performance?

PubMed

Latham, Andrew J; Patston, Lucy L M; Westermann, Christine; Kirk, Ian J; Tippett, Lynette J

2013-01-01

Increasing behavioural evidence suggests that expert video game players (VGPs) show enhanced visual attention and visuospatial abilities, but what underlies these enhancements remains unclear. We administered the Poffenberger paradigm with concurrent electroencephalogram (EEG) recording to assess occipital N1 latencies and interhemispheric transfer time (IHTT) in expert VGPs. Participants comprised 15 right-handed male expert VGPs and 16 non-VGP controls matched for age, handedness, IQ and years of education. Expert VGPs began playing before age 10, had a minimum 8 years experience, and maintained playtime of at least 20 hours per week over the last 6 months. Non-VGPs had little-to-no game play experience (maximum 1.5 years). Participants responded to checkerboard stimuli presented to the left and right visual fields while 128-channel EEG was recorded. Expert VGPs responded significantly more quickly than non-VGPs. Expert VGPs also had significantly earlier occipital N1s in direct visual pathways (the hemisphere contralateral to the visual field in which the stimulus was presented). IHTT was calculated by comparing the latencies of occipital N1 components between hemispheres. No significant between-group differences in electrophysiological estimates of IHTT were found. Shorter N1 latencies may enable expert VGPs to discriminate attended visual stimuli significantly earlier than non-VGPs and contribute to faster responding in visual tasks. As successful video-game play requires precise, time pressured, bimanual motor movements in response to complex visual stimuli, which in this sample began during early childhood, these differences may reflect the experience and training involved during the development of video-game expertise, but training studies are needed to test this prediction.

Lichen communities indicator results from Idaho: baseline sampling

Treesearch

Peter Neitlich; Paul Rogers; Roger Rosentreter

2003-01-01

Epiphytic lichen communities are included in the national Forest Health Monitoring (FHM) program because they help us assess resource contamination, biodiversity, and sustainability in the context of forest health. In 1996, field crews collected lichen samples on 141 field plots systematically located across all forest ownership groups in Idaho. Results presented here...

Bowel cancer screening is safe, detects earlier stage cancer and adenomas in 50% of cases: experience of the prevalent round of screening from two first wave centres in the North East of England

PubMed Central

Rajasekhar, P T; Clifford, G M; Lee, T J W; Rutter, M D; Waddup, G; Ritchie, M; Nylander, D; Painter, J; Singh, J; Ward, I; Dempsey, N; Bowes, J; Handley, G; Henry, J; Rees, C J

2012-01-01

Objective The NHS Bowel Cancer Screening Programme (BCSP) began roll-out in 2006 aiming to reduce cancer mortality through detection at an earlier stage. We report results from the prevalent round of screening at two first wave centres and compare with the UK pilot study. Design This is a service evaluation study. Data were collected prospectively for all individuals undergoing faecal occult blood testing (FOBt) and colonoscopy including: uptake and outcomes of FOBt, colonoscopic performance, findings, histological data and complications. Continuous data were compared using a two-tailed test of two proportions. Setting The South of Tyne and Tees Bowel Cancer Screening centres. Patients Participants of the BCSP. Main Outcome Measures 1) Colonoscopy Quality Assurance and 2) Cancer stage shift. Results 195,772 individuals were invited to participate. Uptake was 54% and FOBt positivity 1.7%. 1524 underwent colonoscopy with caecal intubation in 1485 (97%). 180 (12%) cancers were detected. Dukes stages were: 76 (42%) A; 47 (26%) B; 47 (26%) C; 8 (4%) D and 2 (1%) unknown. This demonstrates a significantly earlier stage at diagnosis compared with data from 2867 non-screening detected cancers (p<0.001). Adenomas were detected in 758 (50%). One perforation occurred (0.07%) and two intermediate bleeds requiring transfusion only (0.12%). Both caecal intubation and adenoma detection were significantly higher than in the UK pilot study (p<0.001). Conclusions The prevalent round of screening demonstrates a high adenoma and cancer detection rate and significantly earlier stage at diagnosis. Complications were few providing reassurance regarding safety. Efforts are required to improve uptake. PMID:28839624

Low protein content of drainage fluid is a good predictor for earlier chest tube removal after lobectomy.

PubMed

Olgac, Guven; Cosgun, Tugba; Vayvada, Mustafa; Ozdemir, Atilla; Kutlu, Cemal Asim

2014-10-01

Owing to the great absorption capability of the pleura for transudates, the protein content of draining pleural fluid may be considered as a more adequate determinant than its daily draining amount in the decision-making for earlier chest tube removal. In an a priori pilot study, we observed that the initially draining protein-rich exudate converts to a transudate quickly in most patients after lobectomies. Thus, chest tubes draining high-volume but low-protein fluids can safely be removed earlier in the absence of an air leak. This randomized study aims to investigate the validity and clinical applicability of this hypothesis as well as its influence on the timing for chest tube removal and earlier discharge after lobectomy. Seventy-two consecutive patients undergoing straightforward lobectomy were randomized into two groups. Patients with conditions affecting postoperative drainage and with persisting air leaks beyond the third postoperative day were excluded. Drains were removed if the pleural fluid to blood protein ratio (PrRPl/B) was ≤0.5, regardless of its daily draining amount in the study arm (Group S; n = 38), and patients in the control arm (Group C; n = 34) had their tubes removed if daily drainage was ≤250 ml regardless of its protein content. Patients were discharged home immediately or the following morning after removal of the last drain. All cases were followed up regarding the development of symptomatic pleural effusions and hospital readmissions for a redrainage procedure. Demographic and clinical characteristics as well as the pattern of decrease in PrRPl/B were the same between groups. The mean PrRPl/B was 0.65 and 0.67 (95% CI = 0.60-0.69 and 0.62-0.72) on the first postoperative day, and it remarkably dropped down to 0.39 and 0.33 (95% CI = 0.33-0.45 and 0.27-0.39) on the second day in Groups S and C, respectively, and remained below 0.5 on the third day (repeated-measures of ANOVA design, post hoc 'within-group' comparison of the first

[Endoscopic calcaneoplasty (ECP) in Haglund's syndrome. Indication, surgical technique, surgical findings and results].

PubMed

Jerosch, J; Sokkar, S; Dücker, M; Donner, A

2012-06-01

Posterior calcaneal exostosis treatment modalities have given rise to many controversial opinions. After failure of the conservative treatment, surgical bursectomy and resection of the calcaneal exostosis are indicated by many authors. But clinical studies also show a high rate of unsatisfactory results with a relative high incidence of complications. The minimally invasive surgical technique by an endoscopic calcaneoplasty (ECP) could be an option to overcome some of these problems. Between 1999 und 2010 we operated 164 patients with an age range between 16 and 67 years, 81 males and 83 females. The radiological examination prior to surgery documented in all cases a posterior superior calcaneal exostosis that showed friction to the Achilles tendon. All patients included in the study had no clinical varus of the hind foot, nor cavus deformities. All patients had undergone a trial of conservative treatment for at least 6 months and did not show a positive response. The average follow-up was 46.3 (range: 8-120) months. According to the Ogilvie-Harris score 71 patients presented good and 84 patients excellent results, while 5 patients showed fair results, and 4 patients only poor results. All the post-operative radiographs showed sufficient resection of the calcaneal spur. In 61 patients the preoperative MRI showed a partial rupture of the Achilles tendon close to the insertion side. In no case could we observe a complete tear at the time of follow-up. Only minor postoperative complications were observed. In many patients we could observe a chondral layer at the posterior aspect of the calcaneus. Close to the intersion the Achilles tendon showed also in many patients a chondroide metaplasia. ECP is an effective and minimally invasive procedure for the treatment of patients with calcaneal exostosis. After a short learning curve the endoscopic exposure is superior to the open technique, has less morbidity, less operating time, and nearly no complications. Moreover, the

Information and Communication Technologies (ICT) and Their Relation to Academic Results Indicators in State Public Universities in Mexico

ERIC Educational Resources Information Center

Arcos-Vega, José L.; Ramiro Marentes, Fabiola; Algravez Uranga, Juan J.

2017-01-01

We present an analysis regarding Information and Communication Technologies (ICT) and their relation with indicators of academic results in bachelor's degree programs offered in state public universities in Mexico. This work is non experimental, cross-sectional, and correlational. The goal is to determine significant relations between variables:…

Interpreting magnesium status to enhance clinical care: key indicators.

PubMed

Costello, Rebecca B; Nielsen, Forrest

2017-11-01

To update advances in identifying factors affecting magnesium (Mg) status that assist in providing improved evidence-based clinical decision-making for assessing Mg status. Findings from recent cohort studies, small randomized control trials, and multiple meta-analyses reinforce earlier work that serum Mg concentrations, urinary Mg excretion, and Mg dietary intakes are inversely associated with cardiovascular disease, chronic kidney disease, and diabetes. These studies indicate that the reference range for serum Mg needs updating, and that individuals with serum Mg in the range of 0.75-0.85 mmol/l and displaying changes in other factors associated with a low Mg status may be Mg deficient. Individuals with serum Mg concentrations below this range most likely are Mg deficient and, above this range, are most likely Mg sufficient. The combined determination of serum Mg concentration, 24-h urinary Mg excretion, and dietary Mg intake is currently the most practical method to obtain a sound assessment of Mg status. The strong correlations of Mg deficiency with increased risk of several chronic diseases, some of which exist as comorbidities, indicate that Mg status should be ascertained in patients presenting such disorder.

Second chronological supplement to the Carcinogenic Potency Database: standardized results of animal bioassays published through December 1984 and by the National Toxicology Program through May 1986.

PubMed Central

Gold, L S; Slone, T H; Backman, G M; Magaw, R; Da Costa, M; Lopipero, P; Blumenthal, M; Ames, B N

1987-01-01

This paper is the second chronological supplement to the Carcinogenic Potency Database, published earlier in this journal (1,2,4). We report here results of carcinogenesis bioassays published in the general literature between January 1983 and December 1984, and in Technical Reports of the National Cancer Institute/National Toxicology Program between January 1983 and May 1986. This supplement includes results of 525 long-term, chronic experiments of 199 test compounds, and reports the same information about each experiment in the same plot format as the earlier papers: e.g., the species and strain of test animal, the route and duration of compound administration, dose level and other aspects of experimental protocol, histopathology and tumor incidence, TD50 (carcinogenic potency) and its statistical significance, dose response, author's opinion about carcinogenicity, and literature citation. We refer the reader to the 1984 publications for a description of the numerical index of carcinogenic potency (TD50), a guide to the plot of the database, and a discussion of the sources of data, the rationale for the inclusion of particular experiments and particular target sites, and the conventions adopted in summarizing the literature. The three plots of the database are to be used together, since results of experiments published in earlier plots are not repeated. Taken together, the three plots include results for more than 3500 experiments on 975 chemicals. Appendix 14 is an index to all chemicals in the database and indicates which plot(s) each chemical appears in. PMID:3691431

Ecoclimatic indicators to study crop suitability in present and future climatic conditions

NASA Astrophysics Data System (ADS)

Caubel, Julie; Garcia de Cortazar Atauri, Inaki; Huard, Frédéric; Launay, Marie; Ripoche, Dominique; Gouache, David; Bancal, Marie-Odile; Graux, Anne-Isabelle; De Noblet, Nathalie

2013-04-01

simulated by the STICS, CERES and PANORAMIX crop models with the same input climatic data. Results showed that phenological stages tend to be reached earlier in the future. Significant differences were noted between indicators calculated for invariable calendar periods and indicators calculated during phenological phases. Therefore, ecoclimatic indicators are relevant to provide accurate information about crop suitability in the context of climate change. Whereas most of the indicators do not indicate any significant changes in the future, plant mortality due to frost risks from emergence to ear 1 cm tends to decrease and water supply tends to be more limiting in the future. These indicators do not replace models but represent additional tools for understanding and spatializing some results obtained by models. Their use can provide a spatial distribution of crops according to their suitability in present or future climatic conditions and enable us to minimize the risk of crop failure. It would be interesting to consider the response uncertainties according to the uncertainties we have in future climatic predictions by using different greenhouse emission scenarios and downscaling methods.

Process quality indicators in family medicine: results of an international comparison.

PubMed

Pavlič, Danica Rotar; Sever, Maja; Klemenc-Ketiš, Zalika; Švab, Igor

2015-12-02

The aim of our study was to describe variability in process quality in family medicine among 31 European countries plus Australia, New Zealand, and Canada. The quality of family medicine was measured in terms of continuity, coordination, community orientation, and comprehensiveness of care. The QUALICOPC study (Quality and Costs of Primary Care in Europe) was carried out among family physicians in 31 European countries (the EU 27 except for France, plus Macedonia, Iceland, Norway, Switzerland, and Turkey) and three non-European countries (Australia, Canada, and New Zealand). We used random sampling when national registers of practitioners were available. Regional registers or lists of facilities were used for some countries. A standardized questionnaire was distributed to the physicians, resulting in a sample of 6734 participants. Data collection took place between October 2011 and December 2013. Based on completed questionnaires, a three-dimensional framework was established to measure continuity, coordination, community orientation, and comprehensiveness of care. Multilevel linear regression analysis was performed to evaluate the variation of quality attributable to the family physician level and the country level. None of the 34 countries in this study consistently scored the best or worst in all categories. Continuity of care was perceived by family physicians as the most important dimension of quality. Some components of comprehensiveness of care, including medical technical procedures, preventive care and health care promotion, varied substantially between countries. Coordination of care was identified as the weakest part of quality. We found that physician-level characteristics contributed to the majority of variation. A comparison of process quality indicators in family medicine revealed similarities and differences within and between countries. The researchers found that the major proportion of variation can be explained by physicians' characteristics.

The response of aboveground plant productivity to earlier snowmelt and summer warming in an Arctic ecosystem

NASA Astrophysics Data System (ADS)

Livensperger, C.; Steltzer, H.; Darrouzet-Nardi, A.; Sullivan, P.; Wallenstein, M. D.; Weintraub, M. N.

2012-12-01

Plant communities in the Arctic are undergoing changes in structure and function due to shifts in seasonality from changing winters and summer warming. These changes will impact biogeochemical cycling, surface energy balance, and functioning of vertebrate and invertebrate communities. To examine seasonal controls on aboveground net primary production (ANPP) in a moist acidic tundra ecosystem in northern Alaska, we shifted the growing season by accelerating snowmelt (using radiation absorbing shadecloth) and warming air and soil temperature (using 1 m2 open-top chambers), individually and in combination. After three years, we measured ANPP by harvesting up to 16 individual ramets, tillers and rhizomes for each of 7 plant species, including two deciduous shrubs, two graminoids, two evergreen shrubs and one forb during peak season. Our results show that ANPP per stem summed across the 7 species increased when snow melt occurred earlier. However, standing biomass, excluding current year growth, was also greater. The ratio of ANPP/standing biomass decreased in all treatments compared to the control. ANPP per unit standing biomass summed for the four shrub species decreases due to summer warming alone or in combination with early snowmelt; however early snowmelt alone did not lead to lower ANPP for the shrubs. ANPP per tiller or rhizome summed for the three herbaceous species increased in response to summer warming. Understanding the differential response of plants to changing seasonality will inform predictions of future Arctic plant community structure and function.

Social Competence in Preschool Children: Replication of Results and Clarification of a Hierarchical Measurement Model

ERIC Educational Resources Information Center

Santos, Antonio J.; Peceguina, Ines; Daniel, Joao R.; Shin, Nana; Vaughn, Brian E.

2013-01-01

This study tested assumptions and conclusions reached in an earlier confirmatory factor analysis (CFA) study of the social competence (SC) construct for preschool children. Two samples (total N = 408; a new Portuguese sample and one from US samples that had participated in the original study) contributed data. Seven SC indicators were tested for…

Giant-Magnetoresistance(GMR) Siegel KEY FIRST Experimental Discovery Decade-Earlier PRE-``Fert"-``Gruenberg" in Nuc"el"ar ``Super"alloys: Science?;``SEANCE!!!; Ethics?; SHMETHICS!!!

NASA Astrophysics Data System (ADS)

Hoffman, R.; Siegel, E.

2010-03-01

(So MIScalled) ``Fert"-``Grunberg"[PRL(1988;1989)] GMR 2007 physics Nobel/Wolf/Japan-Prizes VS. decade-earlier(1973-1977) KEY FIRST Siegel at:Westin"kl"ouse/PSEG/IAEA/ABB[google:``Martin Ebner"(94-04) in financial media]/Vattenfall/Wallenbergs/nuc"el"ar-DoE Labs[at flickr.com, search on ``Giant- Magnotoresistance''; find: Intl.Conf.Mag.Alloys & Oxides(ICMAO), Haifa(Aug./1977); J.Mag.Mag.Mtls,(JMMM)7,312(1978)``unavailable: not yet scanned''/modified(last R(H) GMR Figs(7;8) deleted!!!) on JMMM/Reed-Elsevier website until 7/29/08 conveniently one- half-year after last (Nobel)award(12/2007); conveniently effectively deleted!!!; google: ``If Leaks Could Kill''; many APS/MRS Mtgs(1970s)<<<1988/1989] decade-earlier GMR: (1978)<<< (1988); 1988-1978 =10 years = one full decadeprecedence!!!] first experimental discovery in (so MIScalled) ``super''alloys [182/82, Hastelloy-X, 600, 690(!!!), Stainless-Steels: ANY/ALL!!!] generic endemic Wigner's[JAP,17,857(1946)]- disease/Ostwald-ripening/spinodal-decomposition/overageing- embrittlement/ thermo-mechanical-INstability!

Field evidence for earlier leaf-out dates in alpine grassland on the eastern Tibetan Plateau from 1990 to 2006.

PubMed

Zhou, H K; Yao, B Q; Xu, W X; Ye, X; Fu, J J; Jin, Y X; Zhao, X Q

2014-08-01

Worldwide, many plant species are experiencing an earlier onset of spring phenophases due to climate warming. Rapid recent temperature increases on the Tibetan Plateau (TP) have triggered changes in the spring phenology of the local vegetation. However, remote sensing studies of the land surface phenology have reached conflicting interpretations about green-up patterns observed on the TP since the mid-1990s. We investigated this issue using field phenological observations from 1990 to 2006, for 11 dominant plants on the TP at the levels of species, families (Gramineae-grasses and Cyperaceae-sedges) and vegetation communities (alpine meadow and alpine steppe). We found a significant trend of earlier leaf-out dates for one species (Koeleria cristata). The leaf-out dates of both Gramineae and Cyperaceae had advanced (the latter significantly, starting an average of 9 days later per year than the former), but the correlation between them was significant. The leaf-out dates of both vegetation communities also advanced, but the pattern was only significant in the alpine meadow. This study provides the first field evidence of advancement in spring leaf phenology on the TP and suggests that the phenology of the alpine steppe can differ from that of the alpine meadow. These findings will be useful for understanding ecosystem responses to climate change and for grassland management on the TP. © 2014 The Author(s) Published by the Royal Society. All rights reserved.

Bootstrap and Counter-Bootstrap approaches for formation of the cortege of Informative indicators by Results of Measurements

NASA Astrophysics Data System (ADS)

Artemenko, M. V.; Chernetskaia, I. E.; Kalugina, N. M.; Shchekina, E. N.

2018-04-01

This article describes the solution of the actual problem of the productive formation of a cortege of informative measured features of the object of observation and / or control using author's algorithms for the use of bootstraps and counter-bootstraps technologies for processing the results of measurements of various states of the object on the basis of different volumes of the training sample. The work that is presented in this paper considers aggregation by specific indicators of informative capacity by linear, majority, logical and “greedy” methods, applied both individually and integrally. The results of the computational experiment are discussed, and in conclusion is drawn that the application of the proposed methods contributes to an increase in the efficiency of classification of the states of the object from the results of measurements.

Extremely Soft X-Ray Flash as the Indicator of Off-axis Orphan GRB Afterglow

NASA Astrophysics Data System (ADS)

Urata, Yuji; Huang, Kuiyun; Yamazaki, Ryo; Sakamoto, Takanori

2015-06-01

We verified the off-axis jet model of X-ray flashes (XRFs) and examined a discovery of off-axis orphan gamma-ray burst (GRB) afterglows. The XRF sample was selected on the basis of the following three factors: (1) a constraint on the lower peak energy of the prompt spectrum {E}{obs}{src}, (2) redshift measurements, and (3) multicolor observations of an earlier (or brightening) phase. XRF 020903 was the only sample selected on the basis of these criteria. A complete optical multicolor afterglow light curve of XRF 020903 obtained from archived data and photometric results in the literature showed an achromatic brightening around 0.7 days. An off-axis jet model with a large observing angle (0.21 rad, which is twice the jet opening half-angle, {θ }{jet}) can naturally describe the achromatic brightening and the prompt X-ray spectral properties. This result indicates the existence of off-axis orphan GRB afterglow light curves. Events with a larger viewing angle (\\gt ∼ 2{θ }{jet}) could be discovered using an 8 m class telescope with wide-field imagers such as the Subaru Hyper-Suprime-Cam and the Large Synoptic Survey Telescope.

Assessment of risk factors for earlier onset of sporadic Alzheimer's disease dementia.

PubMed

de Oliveira, Fabricio Ferreira; Bertolucci, Paulo Henrique Ferreira; Chen, Elizabeth Suchi; Smith, Marilia Cardoso

2014-01-01

Pharmacological treatment has mild effects for patients with Alzheimer's disease dementia (AD); therefore, the search for modifiable risk factors is an important challenge. Though risk factors for AD are widely recognized, elements that influence the time of dementia onset have not been comprehensively reported. We aimed to investigate which risk factors might be related to the age of onset of AD in a sample of patients with highly variable educational levels, taking into account the Framingham risk scoring as the sole measure of vascular risk. We included 209 consecutive late-onset AD patients to find out which factors among educational levels, coronary heart disease risk estimated by way of Framingham risk scores, history of head trauma or depression, surgical procedures under general anesthesia, family history of neurodegenerative diseases, gender, marital status and APOE haplotypes might be related to the age of dementia onset in this sample of patients with low mean schooling. Mean age of AD onset was 73.38±6.5 years old, unaffected by schooling or family history of neurodegenerative diseases. Patients who were APOE-ε4 carriers, married, or with history of depression, had earlier onset of AD, particularly when they were women. Coronary heart disease risk was marginally significant for later onset of AD. APOE haplotypes, marital status and history of depression were the most important factors to influence the age of AD onset in this sample. While midlife cerebrovascular risk factors may increase incidence of AD, they may lead to later dementia onset when present in late life.

Effects of the 2008 Global Economic Crisis on National Health Indicators: Results from the Korean National Health and Nutrition Examination Survey

PubMed Central

Shin, Jung-Hyun; Lee, Gyeongsil; Kim, Jun-Suk; Oh, Hyung-Seok; Lee, Keun-Seung; Hur, Yong

2015-01-01

Background The relationship between economics and health has been of great interest throughout the years. The accumulated data is not sufficient enough to carry out long-term studies from the viewpoint of morbidity, although Korea National Health and Nutrition Examination Survey (KNHANES) was carried out yearly since 1998 in Korea. Thus, we investigated the effect of the 2008 global economic crisis on health indicators of Korea. Methods Health indicators were selected by paired t-test based on 2007 and 2009 KNHANES data. Age, gender, body mass index (BMI), smoking, drinking, exercise, education, income, working status, and stress were used as confounding factors, which were analyzed with logistic and probit analyses. Validation was done by comparing gross domestic product (GDP) growth rates and probit analyses results of 2007-2012 KNHANES data. Results Among several health indicators, the prevalence of hypertension and stress perception was higher after the economic crisis. Factors related with higher hypertension prevalence include older age, male gender, higher BMI, no current tobacco use, recent drinking, lower education levels, and stress perception. Factors related with more stress perception were younger age, female gender, current smoking, lower education levels, and lower income. GDP growth rates, a macroeconomic indicator, are inversely associated with hypertension prevalence with a one-year lag, and also inversely associated with stress perception without time lag. Conclusion The economic crisis increased the prevalence of hypertension and stress perception. In the case of GDP growth rate change, hypertension was an inversely lagging indicator and stress perception was an inversely-related coincident indicator. PMID:26217479

Influence of garlic, synthetic 1,2,4-triasole derivative and herbal preparation echinovit C on selected indices of turkey-hens non-specific immunity.

PubMed

Truchliński, J; Krauze, M; Cendrowska-Pinkosz, M; Modzelewska-Banachiewicz, B

2006-01-01

Successful results of earlier studies on testing the immune-modulating and anti-microbial properties of 1,2,4-triasole derivative as well as benefitial application of natural bio-stimulators in animal's prophylaxis and treatment inspired us to undertake further investigations. The aim of the present study was to evaluate and compare the prophylaxis effects of two natural immune-modulating agents, garlic (Allium sativum) extract and Echinovit C preparation and synthetic derivative of 1,2,4-triasole on non-specific immunity indices in slaughter turkey-hens. The results obtained suggest that the strongest stimulatory effect is exerted by garlic followed by 1,2,4-triasole derivative and Echinacea juice. Immune-modulating action of the substances applied was manifested by an increase in cellular immune parameters: the percentage of phagocyting cells, NBT-positive granulocytes and lysozyme level.

White shrimp Litopenaeus vannamei that had received the hot-water extract of Spirulina platensis showed earlier recovery in immunity and up-regulation of gene expressions after pH stress.

PubMed

Lin, Yong-Chin; Tayag, Carina Miranda; Huang, Chien-Lun; Tsui, Wen-Ching; Chen, Jiann-Chu

2010-12-01

White shrimp Litopenaeus vannamei which had been immersed in seawater (35‰, pH 8.2) containing the hot-water extract of Spirulina platensis at 0 (control), 200, 400, and 600 mg L(-1) for 3 h, were transferred to seawater at pH 6.8, and the immune parameters and transcripts of the lipopolysaccharide- and β-glucan-binding protein (LGBP), peroxinectin (PX), and integrin β (IB) were examined 6-96 h post-transfer. Shrimp with no exposure to the hot-water extract and no pH change served as the background control. Results indicated that the hyaline cells, granular cells (including semi-granular cells), total haemocyte count, phenoloxidase activity, respiratory burst, superoxide dismutase activity, glutathione peroxidase activity, and lysozyme activity of shrimp transferred to seawater at pH 6.8 significantly decreased to the lowest at 6 h post-transfer. These immune parameters of shrimp immersed in 600 mg L(-1) of the extract were significantly higher than those of control shrimp at 24-96 h post-transfer, and had returned to the background values earlier at 48-72 h post-transfer with significant transcripts of LGBP, PX, and IB at 24, 6, and 24 h, respectively, whereas these parameters of control shrimp returned to the original values at ≥96 h post-transfer. Copyright © 2010 Elsevier Ltd. All rights reserved.

Earlier response assessment in invasive aspergillosis based on the kinetics of serum Aspergillus galactomannan: proposal for a new definition.

PubMed

Nouér, Simone A; Nucci, Marcio; Kumar, Naveen Sanath; Grazziutti, Monica; Barlogie, Bart; Anaissie, Elias

2011-10-01

Current criteria for assessing treatment response of invasive aspergillosis (IA) rely on nonspecific subjective parameters. We hypothesized that an Aspergillus-specific response definition based on the kinetics of serum Aspergillus galactomannan index (GMI) would provide earlier and more objective response assessment. We compared the 6-week European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) response criteria with GMI-based response among 115 cancer patients with IA. Success according to GMI required survival with repeatedly negative GMI for ≥2 weeks. Time to response and agreement between the 2 definitions were the study endpoints. Success according to EORTC/MSG and GMI criteria was observed in 73 patients (63%) and 83 patients (72%), respectively. The GMI-based response was determined at a median of 21 days after treatment initiation (range, 15-41 days), 3 weeks before the EORTC/MSG time point, in 72 (87%) of 83 responders. Agreement between definitions was shown in all 32 nonresponders and in 73 of the 83 responders (91% overall), with an excellent κ correlation coefficient of 0.819. Among 10 patients with discordant response (EORTC/MSG failure, GMI success), 1 is alive without IA 3 years after diagnosis; for the other, aspergillosis could not be detected at autopsy. The presence of other life-threatening complications in the remaining 8 patients indicates that IA had resolved. The Aspergillus-specific GMI-based criteria compare favorably to current response definitions for IA and significantly shorten time to response assessment. These criteria rely on a simple, reproducible, objective, and Aspergillus-specific test and should serve as the primary endpoint in trials of IA.

A new predictive indicator for development of pressure ulcers in bedridden patients based on common laboratory tests results.

PubMed

Hatanaka, N; Yamamoto, Y; Ichihara, K; Mastuo, S; Nakamura, Y; Watanabe, M; Iwatani, Y

2008-04-01

Various scales have been devised to predict development of pressure ulcers on the basis of clinical and laboratory data, such as the Braden Scale (Braden score), which is used to monitor activity and skin conditions of bedridden patients. However, none of these scales facilitates clinically reliable prediction. To develop a clinical laboratory data-based predictive equation for the development of pressure ulcers. Subjects were 149 hospitalised patients with respiratory disorders who were monitored for the development of pressure ulcers over a 3-month period. The proportional hazards model (Cox regression) was used to analyse the results of 12 basic laboratory tests on the day of hospitalisation in comparison with Braden score. Pressure ulcers developed in 38 patients within the study period. A Cox regression model consisting solely of Braden scale items showed that none of these items contributed to significantly predicting pressure ulcers. Rather, a combination of haemoglobin (Hb), C-reactive protein (CRP), albumin (Alb), age, and gender produced the best model for prediction. Using the set of explanatory variables, we created a new indicator based on a multiple logistic regression equation. The new indicator showed high sensitivity (0.73) and specificity (0.70), and its diagnostic power was higher than that of Alb, Hb, CRP, or the Braden score alone. The new indicator may become a more useful clinical tool for predicting presser ulcers than Braden score. The new indicator warrants verification studies to facilitate its clinical implementation in the future.

Resistance to Fusarium verticillioides and fumonisin accumulation in maize inbred lines involves an earlier and enhanced expression of lipoxygenase (LOX) genes.

PubMed

Maschietto, Valentina; Marocco, Adriano; Malachova, Alexandra; Lanubile, Alessandra

2015-09-01

Fusarium verticillioides causes ear rot in maize and contaminates the kernels with the fumonisin mycotoxins. It is known that plant lipoxygenase (LOX)-derived oxylipins regulate defence against pathogens and that the host-pathogen lipid cross-talk influences the pathogenesis. The expression profiles of fifteen genes of the LOX pathway were studied in kernels of resistant and susceptible maize lines, grown in field condition, at 3, 7 and 14 days post inoculation (dpi) with F. verticillioides. Plant defence responses were correlated with the pathogen growth, the expression profiles of fungal FUM genes for fumonisin biosynthesis and fumonisin content in the kernels. The resistant genotype limited fungal growth and fumonisin accumulation between 7 and 14 dpi. Pathogen growth became exponential in the susceptible line after 7 dpi, in correspondence with massive transcription of FUM genes and fumonisins augmented exponentially at 14 dpi. LOX pathway genes resulted strongly induced after pathogen inoculation in the resistant line at 3 and 7 dpi, whilst in the susceptible line the induction was reduced or delayed at 14 dpi. In addition, all genes resulted overexpressed before infection in kernels of the resistant genotype already at 3 dpi. The results suggest that resistance in maize may depend on an earlier activation of LOX genes and genes for jasmonic acid biosynthesis. Copyright © 2015 Elsevier GmbH. All rights reserved.

Reanalysis of the occurrence of back pain among construction workers: modelling for the interdependent effects of heavy physical work, earlier back accidents, and aging.

PubMed

Nurminen, M

1997-11-01

To re-examine the relation between heavy physical work and the occurrence of sciatic pain among construction workers reported previously to be absent in an epidemiological study. METHODS-Poisson log linear regression was used to model for the frequency of sciatic pain among concrete reinforcement workers and maintenance house painters with adjustment for the interactive effects of earlier back accidents and aging that modified the relation. Concrete reinforcement work not only had a direct effect on the frequency of sciatic pain, but it also contributed significantly to the risk indirectly through earlier back accidents. The risk of sciatic pain increased from age 25 to 54 in a different manner for a worker depending on his occupational group and record of back accidents. Epidemiological studies on low back pain need to be analysed with sound methodology. This is important in view of future meta-analyses that will be performed for the purpose of providing guidelines on the prevention of back disorders in heavy physical work.

[Liver transplantation--indications, surgical technique, results--the analysis of a clinical series of 200 cases].

PubMed

Popescu, I; Ionescu, M; Braşoveanu, V; Hrehoreţ, D; Matei, E; Dorobantu, B; Zamfir, R; Alexandrescu, S; Grigorie, M; Tulbure, D; Popa, L; Ungureanu, M; Tomescu, D; Droc, G; Popescu, H; Cristea, A; Gheorghe, L; Iacob, S; Gheorghe, C; Boroş, M; Lupescu, I; Vlad, L; Herlea, V; Croitoru, M; Platon, P; Alloub, A

2010-01-01

Initially considered experimental, liver transplantation (LT) has become the treatment of choice for the patients with end-stage liver diseases. Between April 2000 and October 2009, 200 LTs (10 reLTs) were performed in 190 patients, this study being retrospective. There were transplanted 110 men and 80 women, 159 adults and 31 children with the age between 1 and 64 years old (mean age--39.9). The main indication in the adult group was represented by viral cirrhosis, while the pediatric series the etiology was mainly glycogenosis and biliary atresia. There were performed 143 whole graft LTs, 46 living donor LTs, 6 split LTs, 4 reduced LTs and one domino LT RESULTS: The postoperative survival was 90% (170 patients). The patient and graft one-year and five-year survivals were 76.9%, 73.6% and 71%, 68.2%, respectively. The early complications occurred in 127 patients (67%). The late complications were recorded in 71 patients (37.3%). The intraoperative and early postoperative mortality rate was 9.5% (18 patients). The Romanian liver transplantation program from Fundeni includes all types of current surgical techniques and the results are comparable with those from other international centers.

Developing a European urban health indicator system: results of EURO-URHIS 1.

PubMed

Patterson, Lesley; Heller, Richard; Robinson, Jude; Birt, Christopher A; van Ameijden, Erik; Bocsan, Ioan; White, Chris; Skalkidis, Yannis; Bothra, Vinay; Onyia, Ifeoma; Hellmeier, Wolfgang; Lyshol, Heidi; Gemmell, Isla; Spencer, Angela; Klumbiene, Jurate; Krampac, Igor; Rajnicova, Iveta; Macherianakis, Alexis; Bourke, Michael; Harrison, Annie; Verma, Arpana

2017-05-01

More than half of the world's population now live in cities, including over 70% in Europe. Cities bring opportunities but can be unhealthy places to live. The poorest urban dwellers live in the worst environments and are at the greatest risk of poor health outcomes. EURO-URHIS 1 set out to compile a cross-EU inventory of member states use of measures of urban health in order to support policymakers and improve public health policy. Following a literature review to define terms and find an appropriate model to guide urban health research, EURO-URHIS Urban Areas in all EU member states except Luxembourg, as well as Croatia, Turkey, Macedonia, Iceland and Norway, were defined and selected in collaboration with project partners. Following piloting of the survey tool, a the EURO-URHIS 45 data collection tool was sent out to contacts in all countries with identified EUA's, asking for data on 45 Urban Health Indicators (UHI) and 10 other indicators. 60 questionnaires were received from 30 countries, giving information on local health indicator availability, definitions and sources. Telephone interviews were also conducted with 14 respondents about their knowledge of sources of urban health data and barriers or problems experienced when collecting the data. Most participants had little problem identifying the sources of data, though some found that data was not always routinely recorded and was held by diverse sources or not at local level. Some participants found the data collection instrument to not be user-friendly and with UHI definitions that were sometimes unclear. However, the work has demonstrated that urban health and its measurement is of major relevance and importance for Public Health across Europe. The current study has constructed an initial system of European UHIs to meet the objectives of the project, but has also clearly demonstrated that further development work is required. The importance and value of examining UHIs has been confirmed, and the scene has

Complementary functions of the two brain hemispheres: comparisons with earlier conceptions and implications for individual and society.

PubMed

Zeier, H

1989-07-01

The concept of different functions for the left and right cerebral hemispheres coincides in an astonishing way with earlier philosophical and psychological work which divided the human mind into two complementary functions without having a neurophysiological explanation. Representative are the ideas of Fichte, Hegel and Jung. The latter postulated the two subsystems Ego and Self and associated the conscious functions of the Ego with the intellect, the capacity for rational thought, and the Self with the mind, which also includes the emotional feelings. For the harmonic development and self-realization of man the functions of both systems in complementary interaction are required. Therefore, the current overaccentuation of the intellect and of progress directed technical-scientific thinking should be corrected by making better use of the much neglected functions of the right hemisphere.

Releasing the Results of Investigations

DTIC Science & Technology

2010-03-01

allow for lessons to be learned. RELEASING THE RESULTS OF INVESTIGATIONS On December 21, 2009, Gilbert Arenas – star basketball player for the...joke.1 Earlier in the month Mr. Arenas and teammate Javaris Crittenton – with only two years of NBA experience – “got into an argument over a card...Senior military leaders are analogous to NBA stars as both sets of professionals have risen through the ranks above their peers; they’ve reached the

Results of a Quality of Work Life Index in Spain. A Comparison of Survey Results and Aggregate Social Indicators

ERIC Educational Resources Information Center

Royuela, Vicente; Lopez-Tamayo, Jordi; Surinach, Jordi

2009-01-01

The European Union launched the Lisbon Strategy in 2000 with the aim of establishing itself as the world's most powerful economy. The importance of job quality has returned to the top of the European employment and social policy agenda. As targets are set, significant progress has been made in the creation of indicators. In this study, we compute…

Quality indicators and their regular use in clinical practice: results from a survey among users of two cardiovascular National Registries in Sweden.

PubMed

Algurén, Beatrix; Andersson-Gäre, Boel; Thor, Johan; Andersson, Ann-Christine

2018-05-14

To examine the regular use of quality indicators from Swedish cardiovascular National Quality Registries (NQRs) by clinical staff; particularly differences in use between the two NQRs and between nurses and physicians. Cross-sectional online survey study. Two Swedish cardiovascular NQRs: (a) Swedish Heart Failure Registry and (b) Swedeheart. Clinicians (n =185; 70% nurses, 26% physicians) via the NQRs' email networks. Frequency of NQR use for (a) producing healthcare activity statistics; (b) comparing results between similar departments; (c) sharing results with colleagues; (d) identifying areas for quality improvement (QI); (e) surveilling the impact of QI efforts; (f) monitoring effects of implementation of new treatment methods; (g) doing research and (h) educating and informing healthcare professionals and patients. Median use of NQRs was 10 times a year (25th and 75th percentiles range: 3-23 times/year). Quality indicators from the NQRs were used mainly for producing healthcare activity statistics. Median use of Swedeheart was six times greater than Swedish Heart Failure Registry (SwedeHF; P < 0.000). Physicians used the NQRs more than twice as often as nurses (18 vs. 7.5 times/year; P < 0.000) and perceived NQR work more often as meaningful. Around twice as many Swedeheart users had the role to participate in data analysis and in QI efforts compared to SwedeHF users. Most respondents used quality indicators from the two cardiovascular NQRs infrequently (<3 times/year). The results indicate that linking registration of quality indicators to using them for QI activities increases their routine use and makes them meaningful tools for professionals.

[Effect of indications and pre-existing conditions on the result of McDonald's cervix-closure surgery].

PubMed

Avar, Z; Tóth, B; Zacher, P

1979-01-01

Authors have performed the McDonald cerclage operation on 172 gravidae because of cervical incompetence. From these pregnancies 80.2 per cent of the infants have survived over the sixth day. While with operations performed on the basis of extended indications for surgery an effect of 56.5 per cent was achieved, it was in cases of classical ones 92.8 per cent. Two complicated cases are reported caused by blastospores or bacteria respectively, isolated also in the vaginal secretion which have ascended into the uterine cavity. Both cases resulted in fetal death and in a septic condition of the mother. It is emphasized that the normal vaginal bioflora is essential condition for the cervical suture.

New Local, National and Regional Cereal Price Indices for Improved Identification of Food Insecurity

NASA Technical Reports Server (NTRS)

Brown, Molly E.; Tondel, Fabien; Thorne, Jennifer A.; Essam, Timothy; Mann, Bristol F.; Stabler, Blake; Eilerts, Gary

2011-01-01

Large price increases over a short time period can be indicative of a deteriorating food security situation. Food price indices developed by the United Nations Food and Agriculture Organization (FAO) are used to monitor food price trends at a global level, but largely reflect supply and demand conditions in export markets. However, reporting by the United States Agency for International Development (USAID)'s Famine Early Warning Systems Network (FEWS NET) indicates that staple cereal prices in many markets of the developing world, especially in surplus-producing areas, often have a delayed and variable response to international export market price trends. Here we present new price indices compiled for improved food security monitoring and assessment, and specifically for monitoring conditions of food access across diverse food insecure regions. We found that cereal price indices constructed using market prices within a food insecure region showed significant differences from the international cereals price, and had a variable price dispersion across markets within each marketshed. Using satellite-derived remote sensing information that estimates local production and the FAO Cereals Index as predictors, we were able to forecast movements of the local or national price indices in the remote, arid and semi-arid countries of the 38 countries examined. This work supports the need for improved decision-making about targeted aid and humanitarian relief, by providing earlier early warning of food security crises.

Indicators for evaluating cancer organizations' support services: performance and associations with empowerment.

PubMed

Lauzier, Sophie; Campbell, H Sharon; Livingston, Patricia M; Maunsell, Elizabeth

2014-10-15

Community-based cancer organizations provide services to support patients. An anticipated benefit of these services is patient empowerment. However, this outcome has not been evaluated because of the lack of validated health-related empowerment questionnaires in the cancer context. In this validation study, the authors assessed the extent to which 16 indicators used by the Canadian Cancer Society (CCS) and the Cancer Council Victoria, Australia (CCV) to evaluate their services were associated with health-related empowerment. Cancer patients/survivors who were diagnosed < 3 years earlier and who used CCS programs completed a questionnaire that included the 16 CCS-CCV indicators and 5 scales from the Health Education Impact Questionnaire (heiQ) measuring key dimensions of empowerment. To determine whether the CCS-CCV indicators captured empowerment, differences in heiQ scores were compared between 2 groups: those with higher levels of agreement (agreeing or agreeing strongly) with an indicator and those with lower levels of agreement (agreeing slightly or disagreeing to any degree). Participation was 72% (207 of 289 eligible CCS users). Compared with participants who had lower levels of agreement on CCS-CCV indicators, those who had higher levels of agreement were more likely to report higher levels of empowerment on the different heiQ scales. For 15 of 16 indicators, these differences were significant (Wilcoxon rank-sum test; P < .10) on ≥ 1 of 5 heiQ scales and for 10 of 16 indicators on ≥ 3 of 5 heiQ scales. Two indicators were associated significantly with all 5 heiQ scales (cope better and feel more in control). Using CCS-CCV indicators to evaluate community-based cancer organizations' services will help determine whether these services are reaching one of their important goals: namely empowering patients. © 2014 American Cancer Society.

[Indications for genetic amniocentesis investigated at the Department of Gynecology, Obstetrics, and Oncologic Gynecology, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz].

PubMed

Sadłecki, Paweł; Walentowicz-Sadłecka, Małgorzata; Pasińska, Magdalena; Adamczak, Rafał; Grabiec, Marek

2014-06-01

Genetic amniocentesis (GA) is the most common prenatal diagnostic test. One of the main indications for GA is maternal age of > or = 35 years. In many countries, the age indication has been replaced by an assessment of individual risk for chromosomal abnormalities, calculated on the basis of maternal age, pregnancy duration, as well as a combination of biochemical and ultrasound markers. The aim of the study was to investigate indications for and results of GA performed between 2010-2012 at the Department of Gynecology Obstetrics, and Oncologic Gynecology Nicolaus Copernicus University Collegium Medicum, Bydgoszcz. A total of 632 GA tests were performed at the Department of Gynecology Obstetrics, and Oncologic Gynecology Nicolaus Copernicus University Collegium Medicum, Bydgoszcz. Average maternal age was 34 (between 17 and 47 years), with patients < 35 constituting 47.9% (N = 303), and patients > or = 35 constituting 52.1% (N = 329) of the investigated group. Indications for GA as well as test results were analyzed in relation to maternal age. The result of earlier non-invasive tests were also analyzed. Abnormal ultrasound findings, combined with abnormal first-trimester screening results, were the most common indication (46.53%) for GA in patients < 35 years, whereas abnormal first-trimester screening results, combined with a history of obstetric complications, were the reason for GA in patients > or = 35 years. Mean time of GA was 16 gestational weeks in both groups. Abnormal karyotype was detected in 74 (11.7%) cases. 13 or any other abnormal karyotypes occurrence were observed in both age groups. GA-related complications (miscarriage/intrauterine fetal death) occurred in 9 (1.42%) cases. If performed properly GA between 15 and 20 weeks of pregnancy is a harmless procedure both, for the mother and the fetus, associated with an acceptable complication rate. Prenatal screening for the most common malformations and chromosomal aberrations should be offered to all

Quality indicators for pharmaceutical care: a comprehensive set with national scores for Dutch community pharmacies.

PubMed

Teichert, Martina; Schoenmakers, Tim; Kylstra, Nico; Mosk, Berend; Bouvy, Marcel L; van de Vaart, Frans; De Smet, Peter A G M; Wensing, Michel

2016-08-01

Background The quality of pharmaceutical care in community pharmacies in the Netherlands has been assessed annually since 2008. The initial set has been further developed with pharmacists and patient organizations, the healthcare inspectorate, the government and health insurance companies. The set over 2012 was the first set of quality indicators for community pharmacies which was validated and supported by all major stakeholders. The aims of this study were to describe the validated set of quality indicators for community pharmacies and to report their scores over 2012. In subanalyses the score development over 5 years was described for those indicators, that have been surveyed before and remained unchanged. Methods Community pharmacists in the Netherlands were invited in 2013 to provide information for the set of 2012. Quality indicators were mapped by categories relevant for pharmaceutical care and defined for structures, processes and dispensing outcomes. Scores for categorically-measured quality indicators were presented as the percentage of pharmacies reporting the presence of a quality aspect. For numerical quality indicators, the mean of all reported scores was expressed. In subanalyses for those indicators that had been questioned previously, scores were collected from earlier measurements for pharmacies providing their scores in 2012. Multilevel analysis was used to assess the consistency of scores within one pharmacy over time by the intra-class correlation coefficient (ICC). Results For the set in 2012, 1739 Dutch community pharmacies (88 % of the total) provided information for 66 quality indicators in 10 categories. Indicator scores on the presence of quality structures showed relatively high quality levels. Scores for processes and dispensing outcomes were lower. Subanalyses showed that overall indicators scores improved within pharmacies, but this development differed between pharmacies. Conclusions A set of validated quality indicators provided

Identifying the most significant indicators of the total road safety performance index.

PubMed

Tešić, Milan; Hermans, Elke; Lipovac, Krsto; Pešić, Dalibor

2018-04-01

The review of the national and international literature dealing with the assessment of the road safety level has shown great efforts of the authors who tried to define the methodology for calculating the composite road safety index on a territory (region, state, etc.). The procedure for obtaining a road safety composite index of an area has been largely harmonized. The question that has not been fully resolved yet concerns the selection of indicators. There is a wide range of road safety indicators used to show a road safety situation on a territory. Road safety performance index (RSPI) obtained on the basis of a larger number of safety performance indicators (SPIs) enable decision makers to more precisely define the earlier goal- oriented actions. However, recording a broader comprehensive set of SPIs helps identify the strengths and weaknesses of a country's road safety system. Providing high quality national and international databases that would include comparable SPIs seems to be difficult since a larger number of countries dispose of a small number of identical indicators available for use. Therefore, there is a need for calculating a road safety performance index with a limited number of indicators (RSPI ln n ) which will provide a comparison of a sufficient quality, of as many countries as possible. The application of the Data Envelopment Analysis (DEA) method and correlative analysis has helped to check if the RSPI ln n is likely to be of sufficient quality. A strong correlation between the RSPI ln n and the RSPI has been identified using the proposed methodology. Based on this, the most contributing indicators and methodologies for gradual monitoring of SPIs, have been defined for each country analyzed. The indicator monitoring phases in the analyzed countries have been defined in the following way: Phase 1- the indicators relating to alcohol, speed and protective systems; Phase 2- the indicators relating to roads and Phase 3- the indicators relating to

Mississippian subadults from the Middle Cumberland and Eastern regions of Tennessee: Biological indicators of population interaction.

PubMed

Scopa Kelso, Rebecca

2018-06-01

Human subadult skeletal remains can provide a unique perspective into biosocial aspects of Mississippian period population interactions within and between the Middle Cumberland (MCR) and Eastern Tennessee Regions (ETR). The majority of previous studies have concentrated on adult skeletal remains, leaving out a large and extremely important population segment. Skeletal indicators of disease, growth, body proportions, and metabolic stress were collected from subadult remains from five archaeological sites over several temporal periods. Crucial to overcoming limitations associated with the osteological paradox, the biological results were placed into an archaeological context based on prior studies as well as paleoclimatological data. Results reveal homogeneity both within and between regions for most skeletal indicators. However, MCR individuals exhibit a higher frequency of pathology than those from ETC, while stature is significantly lower in younger subadults from the MCR. Within the ETR, there is no evidence for biological differences between Early Dallas and subsequent Late Dallas and Mouse Creek cultural phases. Despite presumed signs of increased conflict at the Dallas site, frequencies and types of skeletal pathology and growth disruptions are comparable to other regional sites. These findings suggest that despite cultural differences between the ETR and MCR, there was no large-scale intrusion from an outside population into the ETR during the Late Mississippian Period, or if one occurred, it is biologically invisible. Combined with climatic and archaeobotanical data, results suggest the MCR subadults were under increased stress in their earlier years. This may have been associated with increased interpersonal violence and dependence on few food sources occurring with greater scarcity. © 2018 Wiley Periodicals, Inc.

2011 Annual Survey of Journalism and Mass Communication Enrollments: Enrollments Decline, Reversing the Increase of a Year Earlier, and Suggesting Slow Growth for Future

ERIC Educational Resources Information Center

Becker, Lee B.; Vlad, Tudor; Kalpen, Konrad

2012-01-01

Enrollments in journalism and mass communication programs declined in the autumn of 2011, compared to a year earlier. Enrollments were down slightly at the senior and junior levels and substantially at the freshman level. Enrollment increased at the sophomore level. The majority of administrators say they have made curricular changes in the past…

Bowel cancer screening is safe, detects earlier stage cancer and adenomas in 50% of cases: experience of the prevalent round of screening from two first wave centres in the North East of England.

PubMed

Rajasekhar, P T; Clifford, G M; Lee, T J W; Rutter, M D; Waddup, G; Ritchie, M; Nylander, D; Painter, J; Singh, J; Ward, I; Dempsey, N; Bowes, J; Handley, G; Henry, J; Rees, C J

2012-01-01

The NHS Bowel Cancer Screening Programme (BCSP) began roll-out in 2006 aiming to reduce cancer mortality through detection at an earlier stage. We report results from the prevalent round of screening at two first wave centres and compare with the UK pilot study. This is a service evaluation study. Data were collected prospectively for all individuals undergoing faecal occult blood testing (FOBt) and colonoscopy including: uptake and outcomes of FOBt, colonoscopic performance, findings, histological data and complications. Continuous data were compared using a two-tailed test of two proportions. The South of Tyne and Tees Bowel Cancer Screening centres. Participants of the BCSP. 1) Colonoscopy Quality Assurance and 2) Cancer stage shift. 195,772 individuals were invited to participate. Uptake was 54% and FOBt positivity 1.7%. 1524 underwent colonoscopy with caecal intubation in 1485 (97%). 180 (12%) cancers were detected. Dukes stages were: 76 (42%) A; 47 (26%) B; 47 (26%) C; 8 (4%) D and 2 (1%) unknown. This demonstrates a significantly earlier stage at diagnosis compared with data from 2867 non-screening detected cancers (p<0.001). Adenomas were detected in 758 (50%). One perforation occurred (0.07%) and two intermediate bleeds requiring transfusion only (0.12%). Both caecal intubation and adenoma detection were significantly higher than in the UK pilot study (p<0.001). The prevalent round of screening demonstrates a high adenoma and cancer detection rate and significantly earlier stage at diagnosis. Complications were few providing reassurance regarding safety. Efforts are required to improve uptake.

Ecoclimatic indicators to study crop suitability in present and future climatic conditionsTIC CONDITIONS

NASA Astrophysics Data System (ADS)

Caubel, Julie; Garcia de Cortazar Atauri, Inaki; Huard, Frédéric; Launay, Marie; Ripoche, Dominique; Gouache, David; Bancal, Marie-Odile; Graux, Anne-Isabelle; De Noblet, Nathalie

2013-04-01

simulated by the STICS, CERES and PANORAMIX crop models with the same input climatic data. Results showed that phenological stages tend to be reached earlier in the future. Significant differences were noted between indicators calculated for invariable calendar periods and indicators calculated during phenological phases. Therefore, ecoclimatic indicators are relevant to provide accurate information about crop suitability in the context of climate change. Whereas most of the indicators do not indicate any significant changes in the future, plant mortality due to frost risks from emergence to ear 1 cm tends to decrease and water supply tends to be more limiting in the future. These indicators do not replace models but represent additional tools for understanding and spatializing some results obtained by models. Their use can provide a spatial distribution of crops according to their suitability in present or future climatic conditions and enable us to minimize the risk of crop failure. It would be interesting to consider the response uncertainties according to the uncertainties we have in future climatic predictions by using different greenhouse emission scenarios and downscaling methods.

Clinical indications for antibiotic use in Danish general practice: results from a nationwide electronic prescription database.

PubMed

Aabenhus, Rune; Hansen, Malene Plejdrup; Siersma, Volkert; Bjerrum, Lars

2017-06-01

To assess the availability and applicability of clinical indications from electronic prescriptions on antibiotic use in Danish general practice. Retrospective cohort register-based study including the Danish National Prescription Register. Population-based study of routine electronic antibiotic prescriptions from Danish general practice. All 975,626 patients who redeemed an antibiotic prescription at outpatient pharmacies during the 1-year study period (July 2012 to June 2013). Number of prescriptions per clinical indication. Number of antibiotic prescriptions per 1000 inhabitants by age and gender. Logistic regression analysis estimated the association between patient and provider factors and missing clinical indications on antibiotic prescriptions. A total of 2.381.083 systemic antibiotic prescriptions were issued by Danish general practitioners in the study period. We identified three main clinical entities: urinary tract infections (n = 506.634), respiratory tract infections (n = 456.354) and unspecified infections (n = 416.354). Women were more exposed to antibiotics than men. Antibiotic use was high in children under 5 years and even higher in elderly people. In 32% of the issued prescriptions, the clinical indication was missing. This was mainly associated with antibiotic types. We found that a prescription for a urinary tract agent without a specific clinical indication was uncommon. Clinical indications from electronic prescriptions are accessible and available to provide an overview of drug use, in casu antibiotic prescriptions, in Danish general practice. These clinical indications may be further explored in detail to assess rational drug use and congruence with guidelines, but validation and optimisation of the system is preferable.

Sexual Violence Victimization History and Sexual Risk Indicators in a Community-Based Urban Cohort of “Mostly Heterosexual” and Heterosexual Young Women

PubMed Central

Austin, S. Bryn; Roberts, Andrea L.; Corliss, Heather L.; Molnar, Beth E.

2008-01-01

Objectives. We sought to examine sexual violence victimization in childhood and sexual risk indicators in young adulthood in a primarily Latina and Black cohort of “mostly heterosexual” and heterosexual women in the Project on Human Development in Chicago Neighborhoods (PHDCN). Methods. In 2000, a comprehensive survey that assessed sexual orientation, sexual risk indicators, and sexual abuse victimization was completed by 391 young women (aged 18 to 24 years) who had participated in PHDCN. We used multivariable regression methods to examine sexual orientation group differences in sexual risk indicators and to assess whether childhood sexual abuse may mediate relationships. Results. Compared with self-reported heterosexual women, self-reported “mostly heterosexual” women were more likely to report having been the victim of childhood sexual abuse, to have had a sexually transmitted infection, to report an earlier age of first sexual intercourse, and to have had more sexual partners. Childhood sexual abuse did not mediate relationships between sexual orientation and sexual risk indicators. Conclusions. Our findings add to the evidence that “mostly heterosexual” women experience greater health risk than do heterosexual women. In addition, “mostly heterosexual” women are at high risk for having experienced childhood sexual abuse. PMID:17901440

Results of the Simulation of the HTR-Proteus Core 4.2 Using PEBBED-COMBINE: FY10 Report

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

Hans Gougar

2010-07-01

ABSTRACT The Idaho National Laboratory’s deterministic neutronics analysis codes and methods were applied to the computation of the core multiplication factor of the HTR-Proteus pebble bed reactor critical facility. This report is a follow-on to INL/EXT-09-16620 in which the same calculation was performed but using earlier versions of the codes and less developed methods. In that report, results indicated that the cross sections generated using COMBINE-7.0 did not yield satisfactory estimates of keff. It was concluded in the report that the modeling of control rods was not satisfactory. In the past year, improvements to the homogenization capability in COMBINE havemore » enabled the explicit modeling of TRIS particles, pebbles, and heterogeneous core zones including control rod regions using a new multi-scale version of COMBINE in which the 1-dimensional discrete ordinate transport code ANISN has been integrated. The new COMBINE is shown to yield benchmark quality results for pebble unit cell models, the first step in preparing few-group diffusion parameters for core simulations. In this report, the full critical core is modeled once again but with cross sections generated using the capabilities and physics of the improved COMBINE code. The new PEBBED-COMBINE model enables the exact modeling of the pebbles and control rod region along with better approximation to structures in the reflector. Initial results for the core multiplication factor indicate significant improvement in the INL’s tools for modeling the neutronic properties of a pebble bed reactor. Errors on the order of 1.6-2.5% in keff are obtained; a significant improvement over the 5-6% error observed in the earlier This is acceptable for a code system and model in the early stages of development but still too high for a production code. Analysis of a simpler core model indicates an over-prediction of the flux in the low end of the thermal spectrum. Causes of this discrepancy are under investigation

[Utilization of antibiotics according to most frequent indications at Hungarian hospitals and results of surveys].

PubMed

Ternák, G; Almási, I

1997-05-25

Antibiotic utilisation of 8 Hungarian hospitals was analyzed examining the case histories of patients who were discharged between January 1 and 31, 1995. Usage of antibiotics in the most frequent indications is reported in this paper. Majority of the prescriptions for the treatment of upper and lower respiratory tract infections were broad spectrum beta lactams. Higher rate of penicillin usage was found only in tonsillitis cases. Besides II. generation cephalosporins (22.7% of 730 prescriptions), beta-lactamase inhibitor + aminopenicillin combinations (13.4%) and III. generation cephalosporins (9.5%) considerable quantity of aminoglycosides (14.9%) and quinolones (9.5%) were found in pneumonia. Relatively high rate of aminoglycosides in the treatment of lower respiratory infections is inconsistent with therapeutic guidelines in force. Co-trimoxazol and quinolones were most frequently prescribed for the treatment of lower urinary tract infections. Traditional urodesinficients were on the first place only at one hospital. Treatment of frequently occurring nosocomial infections was compared with those of community acquired at the same site. There was not significant difference in the utilisation rates of the most of antibiotic groups regarding place of disease acquisition. 44% of the 1373 prescriptions for perioperative profilaxis was indicated for clean operations where benefit of antibiotic administration is questionable. Duration of antibiotic profilaxis was more than 48 hours in 59% of prescriptions. Drugs most frequently used for perioperative profilaxis were II. generation cephalosporins (23.7%), metronidazol (16.7%), aminoglycosides (9.6%) and III. generation cephalosporines (9.6%). The authors compare their results to the literature. They suggest the setting up of "infection control committees" to organise the antibiotic policies in hospitals.

Male-Specific Coliphages as Indicators of Thermal Inactivation of Pathogens in Biosolids

PubMed Central

Nappier, Sharon P.; Aitken, Michael D.; Sobsey, Mark D.

2006-01-01

Male-specific (F+) coliphages have been proposed as a candidate indicator of fecal contamination and of virus reduction in waste treatment. However, in this and earlier work with a laboratory thermophilic anaerobic digester, a heat-resistant fraction of F+ coliphage populations indigenous to municipal wastewater and sludge was evident. We therefore isolated coliphages from municipal wastewater sludge and from biosolid samples after thermophilic anaerobic digestion to evaluate the susceptibility of specific groups to thermal inactivation. Similar numbers of F+ DNA and F+ RNA coliphages were found in untreated sludge, but the majority of isolates in digested biosolids were group I F+ RNA phages. Separate experiments on individual isolates at 53°C confirmed the apparent heat resistance of group I F+ RNA coliphages as well as the susceptibility of group III F+ RNA coliphages. Although few F+ DNA coliphages were recovered from the treated biosolid samples, thermal inactivation experiments indicated heat resistance similar to that of group I F+ RNA phages. Hence, F+ DNA coliphage reductions during thermophilic anaerobic digestion are probably related to mechanisms other than thermal inactivation. Further studies should focus on the group III F+ RNA coliphages as potential indicators of reductions of heat-resistant pathogens in thermal processes for sludge treatment. PMID:16597945

Southern Phosphorus Indices, Water Quality Data, and Modeling (APEX, APLE, and TBET) Results: A Comparison.

PubMed

Osmond, Deanna; Bolster, Carl; Sharpley, Andrew; Cabrera, Miguel; Feagley, Sam; Forsberg, Adam; Mitchell, Charles; Mylavarapu, Rao; Oldham, J Larry; Radcliffe, David E; Ramirez-Avila, John J; Storm, Dan E; Walker, Forbes; Zhang, Hailin

2017-11-01

Phosphorus (P) Indices in the southern United States frequently produce different recommendations for similar conditions. We compared risk ratings from 12 southern states (Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, and Texas) using data collected from benchmark sites in the South (Arkansas, Georgia, Mississippi, North Carolina, Oklahoma, and Texas). Phosphorus Index ratings were developed using both measured erosion losses from each benchmark site and Revised Universal Soil Loss Equation 2 predictions; mostly, there was no difference in P Index outcome. The derived loss ratings were then compared with measured P loads at the benchmark sites by using equivalent USDA-NRCS P Index ratings and three water quality models (Annual P Loss Estimator [APLE], Agricultural Policy Environmental eXtender [APEX], and Texas Best Management Practice Evaluation Tool [TBET]). Phosphorus indices were finally compared against each other using USDA-NRCS loss ratings model estimate correspondence with USDA-NRCS loss ratings. Correspondence was 61% for APEX, 48% for APLE, and 52% for TBET, with overall P index correspondence at 55%. Additive P Indices (Alabama and Texas) had the lowest USDA-NRCS loss rating correspondence (31%), while the multiplicative (Arkansas, Florida, Louisiana, Mississippi, South Carolina, and Tennessee) and component (Georgia, Kentucky, and North Carolina) indices had similar USDA-NRCS loss rating correspondence-60 and 64%, respectively. Analysis using Kendall's modified Tau suggested that correlations between measured and calculated P-loss ratings were similar or better for most P Indices than the models. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

Science Indicators, 1972.

ERIC Educational Resources Information Center

National Science Foundation, Washington, DC. National Science Board.

In this report the National Science Board presents the first results from a newly initiated effort to develop indicators of the state of the scientific enterprise in the Unite States. The ultimate goal of this effort is a set of indices which will reveal the strengths and weaknesses of U.S. science and technology, in terms of the capacity and…

2-DE analysis indicates that Acinetobacter baumannii displays a robust and versatile metabolism

PubMed Central

Soares, Nelson C; Cabral, Maria P; Parreira, José R; Gayoso, Carmen; Barba, Maria J; Bou, Germán

2009-01-01

Background Acinetobacter baumannii is a nosocomial pathogen that has been associated with outbreak infections in hospitals. Despite increasing awareness about this bacterium, its proteome remains poorly characterised, however recently the complete genome of A. baumannii reference strain ATCC 17978 has been sequenced. Here, we have used 2-DE and MALDI-TOF/TOF approach to characterise the proteome of this strain. Results The membrane and cytoplasmatic protein extracts were analysed separately, these analyses revealed the reproducible presence of 239 and 511 membrane and cytoplamatic protein spots, respectively. MALDI-TOF/TOF characterisation identified a total of 192 protein spots (37 membrane and 155 cytoplasmatic) and revealed that the identified membrane proteins were mainly transport-related proteins, whereas the cytoplasmatic proteins were of diverse nature, although mainly related to metabolic processes. Conclusion This work indicates that A. baumannii has a versatile and robust metabolism and also reveal a number of proteins that may play a key role in the mechanism of drug resistance and virulence. The data obtained complements earlier reports of A. baumannii proteome and provides new tools to increase our knowledge on the protein expression profile of this pathogen. PMID:19785748

Health Disparities in Mid-to-Late Life: The Role of Earlier Life Family and Neighborhood Socioeconomic Conditions

PubMed Central

Johnson, Rucker C.; Schoeni, Robert F.; Rogowski, Jeannette A.

2012-01-01

The relationship between neighborhoods of residence in young adulthood and health in mid to late life in the United States are examined using the 1968-2005 waves of the Panel Study of Income Dynamics (PSID). The sample consists of persons who were aged 20-30 in 1968 and are followed for a period of 38 years (N=2,730). Four-level hierarchical random effects models of self-assessed general health status as a function of individual, family, and neighborhood factors are estimated. Using the original sampling design of the PSID, we analyze adult health trajectories of married couples and neighbors followed from young adulthood through elderly ages to assess the magnitudes of the possible causal effects of family and neighborhood characteristics in young adulthood on health in mid to late life. Estimates suggest disparities in neighborhood conditions in young adulthood account for one-quarter of the variation in mid-to-late-life health. Living in poor neighborhoods during young adulthood is strongly associated with negative health outcomes in later life. This result is robust even in the presence of a reasonably large amount of potential unobservable individual and family factors that may significantly affect both neighborhood of residence and subsequent health status. Racial differences in health status in mid to late life are also associated with family and neighborhood socioeconomic conditions earlier in life. Three quarters of the black-white gap in health status at ages over 55 can be accounted for by differences in childhood socioeconomic status and neighborhood and family factors in young adulthood. PMID:22212443

Colorectal Cancer Screening Programme in Spain: Results of Key Performance Indicators After Five Rounds (2000-2012).

PubMed

Binefa, Gemma; Garcia, Montse; Milà, Núria; Fernández, Esteve; Rodríguez-Moranta, Francisco; Gonzalo, Núria; Benito, Llúcia; Clopés, Ana; Guardiola, Jordi; Moreno, Víctor

2016-01-20

Effective quality assurance is essential in any screening programme. This article provides a unique insight into key quality indicators of five rounds of the first population-based colorectal cancer screening programme implemented in Spain (2000-2012), providing the results according to the type of screening (prevalent or first screen and incident or subsequent screen) and test (guaiac or immunochemical). The total crude participation rate increased from 17.2% (11,011) in the first round to 35.9% (22,988) in the last one. Rescreening rate was very high (88.6% in the fifth round). Positivity rate was superior with the faecal immunochemical test (6.2%) than with the guaiac-based test (0.7%) (p < 0.0001) and detection rates were also better with the immunochemical test. The most significant rise in detection rate was observed for high risk adenoma in men (45.5 per 1,000 screened). Most cancers were diagnosed at an early stage (61.4%) and there was a statistically significant difference between those detected in first or subsequent screening (52.6% and 70.0% respectively; p = 0.024). The availability of these results substantially improves data comparisons and the exchange of experience between screening programmes.

Adiposity indices in German children and adolescents with genetically confirmed Prader-Willi syndrome (PWS).

PubMed

Hauffa, B P; Schlippe, G; Gillessen-Kaesbach, G

2001-05-01

Morbid obesity develops as a result of hyperphagia and compulsive eating behavior in patients with Prader-Willi syndrome (PWS), if caloric intake is not rigorously controlled. PWS-specific centile curves for adiposity indices constructed in the past were based on clinically diagnosed patients. With the advent of molecular genetic methods, allowing for an unequivocal diagnosis, new PWS curves based exclusively on molecularly diagnosed patients are becoming available, eliminating a potential diagnostic bias. To compare fat distribution in molecularly confirmed German PWS patients to that of clinically diagnosed American PWS patients and a healthy reference population. Cross-sectional anthropometric study. One hundred German patients (49 F) with molecularly confirmed PWS (age: <30 y). Triceps (subscapular) skinfold thickness, waist and hip circumference. Skinfold thickness was massively elevated in the majority of the molecularly confirmed German PWS patients compared to a healthy reference population. Whereas triceps skinfold thickness was in good agreement with American PWS patients, subscapular skinfold thickness in German girls rose earlier than in American PWS girls, indicating possible differences between caloric intake or the proportion of patients entering puberty spontaneously. Waist circumference and waist-hip ratio (n=89) were elevated in a relative small proportion of patients only and did not reflect lower abdominal fat. This may be due to the peculiar shape of many patients with a typical fat accumulation around the buttocks. In addition to body mass index, use of skinfold thickness is recommended for follow-up of dietary interventions in PWS.

The underutilization of street markets as a source of food security indicators in famine early warning systems: a case study of Ethiopia.

PubMed

Companion, Michèle

2008-09-01

Famine Early Warning Systems (EWS) are reliant on data aggregated from multiple sources. Consequently, they are often insensitive to localized changes in food security status, leading to delayed response or interventions. While price and infrastructural data are often gathered, this case study suggests that local street markets and vendor knowledge are underutilized. Few efforts have been made to monitor systematically the street markets as an indicator of local stressors. Findings from Ethiopia show that knowledge generated by expanding food security indicators in this sector can be used in combination with EWS to facilitate earlier intervention in, or to monitor more effectively, on-going humanitarian crises. Indicators developed from this study are accurate, cost effective, and sensitive to local climatic and food stressors.

Detection, attribution, and sensitivity of trends toward earlier streamflow in the Sierra Nevada

USGS Publications Warehouse

Maurer, E.P.; Stewart, I.T.; Bonfils, Celine; Duffy, P.B.; Cayan, D.

2007-01-01

Observed changes in the timing of snowmelt dominated streamflow in the western United States are often linked to anthropogenic or other external causes. We assess whether observed streamflow timing changes can be statistically attributed to external forcing, or whether they still lie within the bounds of natural (internal) variability for four large Sierra Nevada (CA) basins, at inflow points to major reservoirs. Streamflow timing is measured by "center timing" (CT), the day when half the annual flow has passed a given point. We use a physically based hydrology model driven by meteorological input from a global climate model to quantify the natural variability in CT trends. Estimated 50-year trends in CT due to natural climate variability often exceed estimated actual CT trends from 1950 to 1999. Thus, although observed trends in CT to date may be statistically significant, they cannot yet be statistically attributed to external influences on climate. We estimate that projected CT changes at the four major reservoir inflows will, with 90% confidence, exceed those from natural variability within 1-4 decades or 4-8 decades, depending on rates of future greenhouse gas emissions. To identify areas most likely to exhibit CT changes in response to rising temperatures, we calculate changes in CT under temperature increases from 1 to 5??. We find that areas with average winter temperatures between -2??C and -4??C are most likely to respond with significant CT shifts. Correspondingly, elevations from 2000 to 2800 in are most sensitive to temperature increases, with CT changes exceeding 45 days (earlier) relative to 1961-1990. Copyright 2007 by the American Geophysical Union.

Metamorphosis Is Ancestral for Crown Euarthropods, and Evolved in the Cambrian or Earlier.

PubMed

Wolfe, Joanna M

2017-09-01

Macroevolutionary developmental biology employs fossilized ontogenetic data and phylogenetic comparative methods to probe the evolution of development at ancient nodes. Despite the prevalence of ecologically differentiated larval forms in marine invertebrates, it has been frequently presumed that the ancestors of arthropods were direct developers, and that metamorphosis may not have evolved until the Ordovician or later. Using fossils and new dated phylogenies, I infer that metamorphosis was likely ancestral for crown arthropods, contradicting this assumption. Based on a published morphological dataset encompassing 217 exceptionally preserved fossil and 96 extant taxa, fossils were directly incorporated into both the topology and age estimates, as in "tip dating" analyses. Using data from post-embryonic fossils representing 25 species throughout stem and crown arthropod lineages (as well as most of the 96 extant taxa), characters for metamorphosis were assigned based on inferred ecological changes in development (e.g., changes in habitat and adaptive landscape). Under all phylogenetic hypotheses, metamorphosis was supported as most likely ancestral to both ecdysozoans and euarthropods. Care must be taken to account for potential drastic post-embryonic morphological changes in evolutionary analyses. Many stem group euarthrpods may have had ecologically differentiated larval stages that did not preserve in the fossil record. Moreover, a complex life cycle and planktonic ecology may have evolved in the Ediacaran or earlier, and may have typified the pre-Cambrian explosion "wormworld" prior to the origin of crown group euarthropods. © The Author 2017. Published by Oxford University Press on behalf of the Society for Integrative and Comparative Biology. All rights reserved. For permissions please email: journals.permissions@oup.com.

Chemistry, physiology and neuropsychology of schizophrenia: towards an earlier diagnosis of schizophrenia I.

PubMed

Kornhuber, H H

1983-01-01

Data supporting the glutamate hypothesis of schizophrenia are presented. The glutamate hypothesis is linked to the dopamine hypothesis by the fact that dopamine synapses inhibit the release of glutamate in the striate and mesolimbic system. The glutamate hypothesis of schizophrenia may open a way to find better drugs for treatment. The concept of schizophrenia I is described. It consists of "negative symptoms" such as disconcentration or reduction of energy. Schizophrenia I precedes and follows schizophrenia II with "positive symptoms," e.g. hallucinations and delusions. Schizophrenia I so far cannot be diagnosed as schizophrenia unless schizophrenia II appears. Chemical, physiological or neuropsychological methods for the diagnosis of schizophrenia I would render an earlier treatment of schizophrenia possible and thus make social and occupational rehabilitation more efficient. An objective diagnosis of schizophrenia I may also elucidate the mode of genetic transmission of schizophrenia. Several neuropsychological methods distinguish schizophrenic patients as a group from normals. Some of them are based on a specific disturbance of long term concentration. The EEG also distinguishes schizophrenics from normals when analyzed during voluntary movement. For schizophrenics it takes more effort to initiate a voluntary movement, and there are several features of the EEG correlated to this. Moreover, the longer motor reaction time of schizophrenics is paralleled by a longer duration of the Bereitschaftspotential in schizophrenia. Furthermore, there is a difference in the theta rhythm between schizophrenic patients and normals in a task which requires concentration. Some of the children of schizophrenic parents show a disturbance of concentration in both reaction time tasks and the d 2 test.(ABSTRACT TRUNCATED AT 250 WORDS)

Evaluating the ClimEx Single Model large ensemble in comparison with EURO-CORDEX results of heatwave and drought indicators

NASA Astrophysics Data System (ADS)

von Trentini, F.; Schmid, F. J.; Braun, M.; Frigon, A.; Leduc, M.; Martel, J. L.; Willkofer, F.; Wood, R. R.; Ludwig, R.

2017-12-01

Meteorological extreme events seem to become more frequent in the present and future, and a seperation of natural climate variability and a clear climate change effect on these extreme events gains more and more interest. Since there is only one realisation of historical events, natural variability in terms of very long timeseries for a robust statistical analysis is not possible with observation data. A new single model large ensemble (SMLE), developed for the ClimEx project (Climate change and hydrological extreme events - risks and perspectives for water management in Bavaria and Québec) is supposed to overcome this lack of data by downscaling 50 members of the CanESM2 (RCP 8.5) with the Canadian CRCM5 regional model (using the EURO-CORDEX grid specifications) for timeseries of 1950-2099 each, resulting in 7500 years of simulated climate. This allows for a better probabilistic analysis of rare and extreme events than any preceding dataset. Besides seasonal sums, several indicators concerning heatwave frequency, duration and mean temperature a well as number and maximum length of dry periods (cons. days <1mm) are calculated for the ClimEx ensemble and several EURO-CORDEX runs. This enables us to investigate the interaction between natural variability (as it appears in the CanESM2-CRCM5 members) and a climate change signal of those members for past, present and future conditions. Adding the EURO-CORDEX results to this, we can also assess the role of internal model variability (or natural variability) in climate change simulations. A first comparison shows similar magnitudes of variability of climate change signals between the ClimEx large ensemble and the CORDEX runs for some indicators, while for most indicators the spread of the SMLE is smaller than the spread of different CORDEX models.

Indication and method of frozen section in vaginal radical trachelectomy.

PubMed

Chênevert, Jacinthe; Têtu, Bernard; Plante, Marie; Roy, Michel; Renaud, Marie-Claude; Grégoire, Jean; Grondin, Katherine; Dubé, Valérie

2009-09-01

Vaginal radical trachelectomy (VRT) is a fertility-sparing surgical technique used as an alternative to radical hysterectomy in early stage cervical carcinoma. With the advent of VRT, preoperative evaluation of the surgical margin has become imperative, because if the tumor is found within 5 mm of the endocervical margin, additional surgical resection is required. In a study published earlier from our center, we came to the conclusion that a frozen section should be conducted only when a cancerous lesion is grossly visible, and that it could be omitted in normal-looking specimens or VRT with nonspecific lesions. Since then, 53 VRT have been performed in our center, and frozen sections were conducted according to these recommendations. Fifteen VRT were grossly normal, 24 had a nonspecific lesion and 14 showed a grossly visible lesion. Final margins were satisfactory on all 15 grossly normal specimens. Of the 24 VRT with nonspecific lesions, 2 cases for which no frozen section was performed had unsatisfactory final margins (<5 mm). Of the 14 VRT with grossly visible lesions, 3 cases were inadequately evaluated by frozen section due to sampling errors, which led to unsatisfactory final margin assessment. These results confirm that a frozen section can be omitted on normal looking VRT specimens, but contrary to results published earlier, we recommend that a frozen section be performed on all VRT with nonspecific lesions. As for VRT with a grossly visible lesion, frozen section evaluation is still warranted, and we recommend increasing the sampling to improve the adequacy of frozen sections.

Measurements of the degree of development of rigor mortis as an indicator of stress in slaughtered pigs.

PubMed

Warriss, P D; Brown, S N; Knowles, T G

2003-12-13

The degree of development of rigor mortis in the carcases of slaughter pigs was assessed subjectively on a three-point scale 35 minutes after they were exsanguinated, and related to the levels of cortisol, lactate and creatine kinase in blood collected at exsanguination. Earlier rigor development was associated with higher concentrations of these stress indicators in the blood. This relationship suggests that the mean rigor score, and the frequency distribution of carcases that had or had not entered rigor, could be used as an index of the degree of stress to which the pigs had been subjected.

Earlier onset of motor deficits in mice with double mutations in Dyt1 and Sgce.

PubMed

Yokoi, Fumiaki; Yang, Guang; Li, Jindong; DeAndrade, Mark P; Zhou, Tong; Li, Yuqing

2010-10-01

DYT1 early-onset generalized torsion dystonia is an inherited movement disorder caused by mutations in DYT1 coding for torsinA with ∼30% penetrance. Most of the DYT1 dystonia patients exhibit symptoms during childhood and adolescence. On the other hand, DYT1 mutation carriers without symptoms during these periods mostly do not exhibit symptoms later in their life. Little is known about what controls the timing of the onset, a critical issue for DYT1 mutation carriers. DYT11 myoclonus-dystonia is caused by mutations in SGCE coding for ε-sarcoglycan. Two dystonia patients from a single family with double mutations in DYT1 and SGCE exhibited more severe symptoms. A recent study suggested that torsinA contributes to the quality control of ε-sarcoglycan. Here, we derived mice carrying mutations in both Dyt1 and Sgce and found that these double mutant mice showed earlier onset of motor deficits in beam-walking test. A novel monoclonal antibody against mouse ε-sarcoglycan was developed by using Sgce knock-out mice to avoid the immune tolerance. Western blot analysis suggested that functional deficits of torsinA and ε-sarcoglycan may independently cause motor deficits. Examining additional mutations in other dystonia genes may be beneficial to predict the onset in DYT1 mutation carriers.

Retrieval of canopy water content of different crop types with two new hyperspectral indices: Water Absorption Area Index and Depth Water Index

NASA Astrophysics Data System (ADS)

Pasqualotto, Nieves; Delegido, Jesús; Van Wittenberghe, Shari; Verrelst, Jochem; Rivera, Juan Pablo; Moreno, José

2018-05-01

Crop canopy water content (CWC) is an essential indicator of the crop's physiological state. While a diverse range of vegetation indices have earlier been developed for the remote estimation of CWC, most of them are defined for specific crop types and areas, making them less universally applicable. We propose two new water content indices applicable to a wide variety of crop types, allowing to derive CWC maps at a large spatial scale. These indices were developed based on PROSAIL simulations and then optimized with an experimental dataset (SPARC03; Barrax, Spain). This dataset consists of water content and other biophysical variables for five common crop types (lucerne, corn, potato, sugar beet and onion) and corresponding top-of-canopy (TOC) reflectance spectra acquired by the hyperspectral HyMap airborne sensor. First, commonly used water content index formulations were analysed and validated for the variety of crops, overall resulting in a R2 lower than 0.6. In an attempt to move towards more generically applicable indices, the two new CWC indices exploit the principal water absorption features in the near-infrared by using multiple bands sensitive to water content. We propose the Water Absorption Area Index (WAAI) as the difference between the area under the null water content of TOC reflectance (reference line) simulated with PROSAIL and the area under measured TOC reflectance between 911 and 1271 nm. We also propose the Depth Water Index (DWI), a simplified four-band index based on the spectral depths produced by the water absorption at 970 and 1200 nm and two reference bands. Both the WAAI and DWI outperform established indices in predicting CWC when applied to heterogeneous croplands, with a R2 of 0.8 and 0.7, respectively, using an exponential fit. However, these indices did not perform well for species with a low fractional vegetation cover (<30%). HyMap CWC maps calculated with both indices are shown for the Barrax region. The results confirmed the

Regionalizing indicators for marine ecosystems: Bering Sea–Aleutian Island seabirds, climate, and competitors

USGS Publications Warehouse

Sydeman, William J.; Thompson, Sarah Ann; Piatt, John F.; García-Reyes, Marisol; Zador, Stephani; Williams, Jeffrey C.; Romano, Marc; Renner, Heather

2017-01-01

Seabirds are thought to be reliable, real-time indicators of forage fish availability and the climatic and biotic factors affecting pelagic food webs in marine ecosystems. In this study, we tested the hypothesis that temporal trends and interannual variability in seabird indicators reflect simultaneously occurring bottom-up (climatic) and competitor (pink salmon) forcing of food webs. To test this hypothesis, we derived multivariate seabird indicators for the Bering Sea–Aleutian Island (BSAI) ecosystem and related them to physical and biological conditions known to affect pelagic food webs in the ecosystem. We examined covariance in the breeding biology of congeneric pelagic gulls (kittiwakes Rissa tridactyla and R. brevirostris) andauks (murres Uria aalge and U. lomvia), all of whichare abundant and well-studiedinthe BSAI. At the large ecosystem scale, kittiwake and murre breeding success and phenology (hatch dates) covaried among congeners, so data could be combined using multivariate techniques, but patterns of responsedifferedsubstantially betweenthe genera.Whiledata fromall sites (n = 5)inthe ecosystemcould be combined, the south eastern Bering Sea shelf colonies (St. George, St. Paul, and Cape Peirce) provided the strongest loadings on indicators, and hence had the strongest influence on modes of variability. The kittiwake breeding success mode of variability, dominated by biennial variation, was significantly related to both climatic factors and potential competitor interactions. The murre indicator mode was interannual and only weakly related to the climatic factors measured. The kittiwake phenology indicator mode of variability showed multi-year periods (“stanzas”) of late or early breeding, while the murre phenology indicator showed a trend towards earlier timing. Ocean climate relationships with the kittiwake breeding success indicator suggestthat early-season (winter–spring) environmental conditions and the abundance of pink salmon affect the

Increased body mass index is associated with earlier time to loss of response to infliximab in patients with inflammatory bowel disease.

PubMed

Harper, Jason W; Sinanan, Mika N; Zisman, Timothy L

2013-09-01

Obesity is an emerging problem in the care of inflammatory bowel disease (IBD) patients and has been associated with a diminished response to adalimumab. Whether obesity influences the response to infliximab (IFX) is not known. A retrospective cohort of 124 subjects with IBD initiating IFX, naive to biologic therapy, was identified. Subjects were stratified according to their weight and body mass index (BMI). The primary outcome was the first occurrence of an IBD flare defined as dose escalation of IFX, corticosteroid use, discontinuation of IFX, hospitalization, or surgery. Multivariable logistic regression was performed considering body mass and BMI as categorical and continuous variables. Obese (BMI > 30 kg/m) patients with Crohn's disease were more likely to have an IBD flare than nonobese patients (adjusted hazard ratio [HR]: 3.03, P < 0.001); overweight (BMI > 25 kg/m) patients with ulcerative colitis trended toward a similar observation (HR: 9.68, P = 0.06). When considered as continuous variables, increasing mass and BMI were associated with earlier IBD flare in both Crohn's disease (adjusted HR: 1.06 per unit increase in BMI [P = 0.02] and 1.02 per kg increase in body mass [P = 0.02]) and ulcerative colitis (adjusted HR: 1.3 per unit increase in BMI [P = 0.01] and 1.11 per kg increase in body mass [P = 0.004]). Increased body weight is associated with an earlier time to loss of response to IFX in Crohn's disease and ulcerative colitis, a novel finding given that IFX is the only antitumor necrosis factor agent whose dosing reflects increased body weight.

Effects of the 2008 Global Economic Crisis on National Health Indicators: Results from the Korean National Health and Nutrition Examination Survey.

PubMed

Shin, Jung-Hyun; Lee, Gyeongsil; Kim, Jun-Suk; Oh, Hyung-Seok; Lee, Keun-Seung; Hur, Yong; Cho, Be-Long

2015-07-01

The relationship between economics and health has been of great interest throughout the years. The accumulated data is not sufficient enough to carry out long-term studies from the viewpoint of morbidity, although Korea National Health and Nutrition Examination Survey (KNHANES) was carried out yearly since 1998 in Korea. Thus, we investigated the effect of the 2008 global economic crisis on health indicators of Korea. Health indicators were selected by paired t-test based on 2007 and 2009 KNHANES data. Age, gender, body mass index (BMI), smoking, drinking, exercise, education, income, working status, and stress were used as confounding factors, which were analyzed with logistic and probit analyses. Validation was done by comparing gross domestic product (GDP) growth rates and probit analyses results of 2007-2012 KNHANES data. Among several health indicators, the prevalence of hypertension and stress perception was higher after the economic crisis. Factors related with higher hypertension prevalence include older age, male gender, higher BMI, no current tobacco use, recent drinking, lower education levels, and stress perception. Factors related with more stress perception were younger age, female gender, current smoking, lower education levels, and lower income. GDP growth rates, a macroeconomic indicator, are inversely associated with hypertension prevalence with a one-year lag, and also inversely associated with stress perception without time lag. The economic crisis increased the prevalence of hypertension and stress perception. In the case of GDP growth rate change, hypertension was an inversely lagging indicator and stress perception was an inversely-related coincident indicator.

Platelet-rich plasma in tendon-related disorders: results and indications.

PubMed

Filardo, Giuseppe; Di Matteo, Berardo; Kon, Elizaveta; Merli, Giulia; Marcacci, Maurilio

2016-09-24

Platelet-rich plasma (PRP) is currently the most exploited strategy in the clinical practice to provide a regenerative stimulus for tendon healing. The aim of the present study was to systematically review the available evidence on the treatment of the main tendon disorders where PRP is currently applied. A systematic review of the literature was performed on the use of PRP as a treatment for tendinopathies focusing on the following sites: Achilles tendon, patellar tendon, rotator cuff tendons, and lateral elbow tendons. The following inclusion criteria for relevant articles were used: clinical trials written in English language up to 21 June 2016 on the use of PRP in the conservative or surgical treatment of the aforementioned tendinopathies. The research identified the following clinical trials dealing with the application of PRP in the selected tendons: 19 papers on patellar tendon (6 being RCTs: 4 dealing with PRP conservative application and 2 surgical), 24 papers on Achilles tendon (4 RCTs: 3 conservative and 1 surgical), 29 on lateral elbow tendons (17 RCTs, all conservative), and 32 on rotator cuff (22 RCTs: 18 surgical and 3 conservative). Patellar tendons seem to benefit from PRP injections, whereas in the Achilles tendon, PRP application is not indicated neither as a conservative approach nor as a surgical augmentation. Lateral elbow tendinopathy showed an improvement in most of the high-level studies, but the lack of proven superiority with respect to the more simple whole-blood injections still questions its use in the clinical practice. With regard to rotator cuff pathology, the vast majority of surgical RCTs documented a lack of beneficial effects, whereas there is still inconclusive evidence concerning its conservative application in rotator cuff disorders. Systematic review of level I-IV trials, Level IV.

Characterization of IGH locus breakpoints in multiple myeloma indicates a subset of translocations appear to occur in pregerminal center B cells.

PubMed

Walker, Brian A; Wardell, Christopher P; Johnson, David C; Kaiser, Martin F; Begum, Dil B; Dahir, Nasrin B; Ross, Fiona M; Davies, Faith E; Gonzalez, David; Morgan, Gareth J

2013-04-25

Translocations in myeloma are thought to occur solely in mature B cells in the germinal center through class switch recombination (CSR). We used a targeted captured technique followed by massively parallel sequencing to determine the exact breakpoints in both the immunoglobulin heavy chain (IGH) locus and the partner chromosome in 61 presentation multiple myeloma samples. The majority of samples (62%) have a breakpoint within the switch regions upstream of the IGH constant genes and are generated through CSR in a mature B cell. However, the proportion of CSR translocations is not consistent between cytogenetic subgroups. We find that 100% of t(4;14) are CSR-mediated; however, 21% of t(11;14) and 25% of t(14;20) are generated through DH-JH recombination activation gene-mediated mechanisms, indicating they occur earlier in B-cell development at the pro-B-cell stage in the bone marrow. These 2 groups also generate translocations through receptor revision, as determined by the breakpoints and mutation status of the segments used in 10% and 50% of t(11;14) and t(14;20) samples, respectively. The study indicates that in a significant number of cases the translocation-based etiological events underlying myeloma may arise at the pro-B-cell hematological progenitor cell level, much earlier in B-cell development than was previously thought.

Do the bullies survive? A five-year, three-wave prospective study of indicators of expulsion in working life among perpetrators of workplace bullying

PubMed Central

GLAMBEK, Mats; SKOGSTAD, Anders; EINARSEN, Ståle

2015-01-01

In recent series of studies, we have shown that targets of workplace bullying are at risk of expulsion in working life, both from current employment (e.g. in terms of changing employer) and from working life itself (e.g. becoming unemployed). The most recent of these, Take It or Leave: A Five-Year Prospective Study of Workplace Bullying and Indicators of Expulsion in Working Life was recently published in Industrial Health, and the present short communication aims to follow up that paper, investigating the possible job “survival” of the perpetrators. A nationally representative sample was employed (n=1,613), and responses were gathered at three time points with a two-year and a five-year time-lag. Outcomes were intention to leave and sickness absence at T1, and sickness absence, change of employer, disability benefit recipiency and unemployment at T2 and T3. The results of regression analyses clearly indicate that the perpetrators’ occupational status is largely unchanged, and remains so over time, as opposed to earlier findings regarding the targets of bullying. PMID:26320732

The radon indicator

NASA Astrophysics Data System (ADS)

Samuelsson, L.

2005-11-01

The radon indicator is an efficient instrument for measuring the radon daughter concentrations in a house or dwelling. Physics or environmental science students could build a radon indicator as a student project. Another possibility would be to use a radon indicator in a student investigation of radon levels in different houses. Finally the radon indicator is an excellent device for producing a radioactive source, free of charge, for the study of α-, β- and γ-radiation. The half-life of the activity collected is approximately 40 min. The radon indicator makes use of an electrostatic method by which charged particles are drawn to a small aluminium plate with a high negative voltage (-5 kV), thus creating a strong electric field between the plate and a surrounding copper wire. The radioactivity on the plate is subsequently measured by a GM-counter and the result calculated in Bq m-3. The collecting time is just 5.5 min and therefore the instrument is only suitable for use in a short-time method for indicating the radon concentration. An improved diagram, ground-radon and/or wall-radon in houses, is presented on the basis of the author's measurements recorded with the radon indicator over many years. This diagram is very useful when discussing how to reduce radiation levels in homes.

Evaluating area-based socioeconomic status indicators for monitoring disparities within health care systems: results from a primary care network.

PubMed

Berkowitz, Seth A; Traore, Carine Y; Singer, Daniel E; Atlas, Steven J

2015-04-01

To determine which area-based socioeconomic status (SES) indicator is best suited to monitor health care disparities from a delivery system perspective. 142,659 adults seen in a primary care network from January 1, 2009 to December 31, 2011. Cross-sectional, comparing associations between area-based SES indicators and patient outcomes. Address data were geocoded to construct area-based SES indicators at block group (BG), census tract (CT), and ZIP code (ZIP) levels. Data on health outcomes were abstracted from electronic records. Relative indices of inequality (RIIs) were calculated to quantify disparities detected by area-based SES indicators and compared to RIIs from self-reported educational attainment. ZIP indicators had less missing data than BG or CT indicators (p < .0001). Area-based SES indicators were strongly associated with self-report educational attainment (p < .0001). ZIP, BG, and CT indicators all detected expected SES gradients in health outcomes similarly. Single-item, cut point defined indicators performed as well as multidimensional indices and quantile indicators. Area-based SES indicators detected health outcome differences well and may be useful for monitoring disparities within health care systems. Our preferred indicator was ZIP-level median household income or percent poverty, using cut points. © Health Research and Educational Trust.

[The continent ileostomy--indication and results].

PubMed

Säuberli, H; Akovbiantz, A; Hahnloser, P

1982-01-01

Proctocolectomy with conventional ileostomy cures patients with severe ulcerative colitis, however ileostomy appliances had to be worn for the rest of their lives. The continent ileostomy as devised by Kock provides the patient with an intraabdominal ileal reservoir and a valve constructed by invaginating the efferent ileal segment into the reservoir. The patient empties his reservoir 2 to 3 times a day by inserting a catheter through the valve. Our experience with 45 patients is reported. In most cases the continent ileostomy was constructed as a second procedure after proctocolectomy. The construction of a continent ileostomy as a secondary procedure can be recommended in patients with proctocolectomy. It offers patients a life situation differing only insignificantly from that of normal persons.

The compartment bag test (CBT) for enumerating fecal indicator bacteria: Basis for design and interpretation of results.

PubMed

Gronewold, Andrew D; Sobsey, Mark D; McMahan, Lanakila

2017-06-01

For the past several years, the compartment bag test (CBT) has been employed in water quality monitoring and public health protection around the world. To date, however, the statistical basis for the design and recommended procedures for enumerating fecal indicator bacteria (FIB) concentrations from CBT results have not been formally documented. Here, we provide that documentation following protocols for communicating the evolution of similar water quality testing procedures. We begin with an overview of the statistical theory behind the CBT, followed by a description of how that theory was applied to determine an optimal CBT design. We then provide recommendations for interpreting CBT results, including procedures for estimating quantiles of the FIB concentration probability distribution, and the confidence of compliance with recognized water quality guidelines. We synthesize these values in custom user-oriented 'look-up' tables similar to those developed for other FIB water quality testing methods. Modified versions of our tables are currently distributed commercially as part of the CBT testing kit. Published by Elsevier B.V.

Modular bicompartmental knee arthroplasty : Indications, technique, prosthetic design, and results.

PubMed

Kanna, R

2017-03-01

The shifting demographics of patients with localized knee arthritis, including younger, more active patients, is a chief motivation for mounting interest in tissue preserving surgical substitutes for total knee arthroplasty (TKA). Unlinked, modular bi-compartmental knee arthroplasty (MBKA) is an emerging knee-resurfacing approach that provides a conservative alternative to TKA. Arthritis involving both patellofemoral and either medial or lateral tibiofemoral compartments, with no significant deformity or bone deficiency, preserved motion, and intact cruciate ligaments, can be effectively managed with MBKA. It is tailored to treat the pathologic areas of knees with bicompartmental arthritis with the benefit of improved function and tissue conservation. MBKA done in appropriate patients, using precise technique, with appropriate implants has shown to give good short and long term functional results. Long term results using modern MBKA implants are awaited and may further establish the durability and success of the procedure.

[Implementation of performance indicators in the Czech Breast Cancer Screening Programme -  results of the regular monitoring].

PubMed

Májek, O; Bartoňková, H; Daneš, J; Skovajsová, M; Dušek, L

2014-01-01

The Czech organised breast cancer screening programme was initiated in 2002. Collection of data on screening mammography examinations, subsequent diagnostic procedures, and final dia-gnosis is an indispensable part of the programme. Data collection is obligatory for all accredited centres, in accordance with regulations issued by the Czech Ministry of Health. This contribution aims to demonstrate the recent results of quality monitoring of the accredited centres. Quality indicators, whose definition complies with international standards, involve the women's participation, the volume of performed examinations, the accuracy of screening mammography, the use of preoperative diagnostics, and the proportion of early detected tumours. Our evaluation documents a continuous improvement in quality of the Czech mammography screening programme, which is thereby in full agreement with international recommendations on quality assurance.

Evaluation and selection of indicators for land degradation and desertification monitoring: types of degradation, causes, and implications for management.

PubMed

Kairis, Or; Kosmas, C; Karavitis, Ch; Ritsema, C; Salvati, L; Acikalin, S; Alcalá, M; Alfama, P; Atlhopheng, J; Barrera, J; Belgacem, A; Solé-Benet, A; Brito, J; Chaker, M; Chanda, R; Coelho, C; Darkoh, M; Diamantis, I; Ermolaeva, O; Fassouli, V; Fei, W; Feng, J; Fernandez, F; Ferreira, A; Gokceoglu, C; Gonzalez, D; Gungor, H; Hessel, R; Juying, J; Khatteli, H; Khitrov, N; Kounalaki, A; Laouina, A; Lollino, P; Lopes, M; Magole, L; Medina, L; Mendoza, M; Morais, P; Mulale, K; Ocakoglu, F; Ouessar, M; Ovalle, C; Perez, C; Perkins, J; Pliakas, F; Polemio, M; Pozo, A; Prat, C; Qinke, Y; Ramos, A; Ramos, J; Riquelme, J; Romanenkov, V; Rui, L; Santaloia, F; Sebego, R; Sghaier, M; Silva, N; Sizemskaya, M; Soares, J; Sonmez, H; Taamallah, H; Tezcan, L; Torri, D; Ungaro, F; Valente, S; de Vente, J; Zagal, E; Zeiliguer, A; Zhonging, W; Ziogas, A

2014-11-01

Indicator-based approaches are often used to monitor land degradation and desertification from the global to the very local scale. However, there is still little agreement on which indicators may best reflect both status and trends of these phenomena. In this study, various processes of land degradation and desertification have been analyzed in 17 study sites around the world using a wide set of biophysical and socioeconomic indicators. The database described earlier in this issue by Kosmas and others (Environ Manage, 2013) for defining desertification risk was further analyzed to define the most important indicators related to the following degradation processes: water erosion in various land uses, tillage erosion, soil salinization, water stress, forest fires, and overgrazing. A correlation analysis was applied to the selected indicators in order to identify the most important variables contributing to each land degradation process. The analysis indicates that the most important indicators are: (i) rain seasonality affecting water erosion, water stress, and forest fires, (ii) slope gradient affecting water erosion, tillage erosion and water stress, and (iii) water scarcity soil salinization, water stress, and forest fires. Implementation of existing regulations or policies concerned with resources development and environmental sustainability was identified as the most important indicator of land protection.

[Earlier steps of the soil ecosystem evolution].

PubMed

Ponomarenko, A G

2013-01-01

Fossil soils are known since early Praecambrian, long before the occurrence of higher terrestrial plants on the Earth. Primeval biocoenoses on the land and in continental water bodies were floating and bottom prokaryotic mats and films which produced the majority of biomass and with regard to specific productivity were not inferior to any other photosynthetics. Before the occurrence of higher plants, erosion was very strong, resulting in flat relief, absence of permanent streams, domination of wandering rivers and surface runoff; all water bodies were muddy. When floods occurred, which was quite so often, clay particles of muddy water streams isolated bottom-mats from the light and then their considerable part perished. The result was not soil as a uniform bioinert body but rather a "puff pie" consisted of layers of unoxidized charred organic matter and clay prolayers. The burial of unoxidized organic matter contributed to enrichment of the atmosphere with oxygen. Worms and arthropods, which came out to the land and continental water bodies during Cambrian period, mixed up the organic matter with mineral components strengthening the process of soil forming considerably. Soils of the modern type appeared after higher plants expanded in Devonian and displaced bottom-mats in shallow waters. The soil fauna that existed at this time was not so different from the modern one with regard to its evolutionary level.

Evaluating Area-Based Socioeconomic Status Indicators for Monitoring Disparities within Health Care Systems: Results from a Primary Care Network

PubMed Central

Berkowitz, Seth A; Traore, Carine Y; Singer, Daniel E; Atlas, Steven J

2015-01-01

Objective To determine which area-based socioeconomic status (SES) indicator is best suited to monitor health care disparities from a delivery system perspective. Data Sources/Study Setting 142,659 adults seen in a primary care network from January 1, 2009 to December 31, 2011. Study Design Cross-sectional, comparing associations between area-based SES indicators and patient outcomes. Data Collection Address data were geocoded to construct area-based SES indicators at block group (BG), census tract (CT), and ZIP code (ZIP) levels. Data on health outcomes were abstracted from electronic records. Relative indices of inequality (RIIs) were calculated to quantify disparities detected by area-based SES indicators and compared to RIIs from self-reported educational attainment. Principal Findings ZIP indicators had less missing data than BG or CT indicators (p < .0001). Area-based SES indicators were strongly associated with self-report educational attainment (p < .0001). ZIP, BG, and CT indicators all detected expected SES gradients in health outcomes similarly. Single-item, cut point defined indicators performed as well as multidimensional indices and quantile indicators. Conclusions Area-based SES indicators detected health outcome differences well and may be useful for monitoring disparities within health care systems. Our preferred indicator was ZIP-level median household income or percent poverty, using cut points. PMID:25219917

Earlier disability of the patients followed in Multiple Sclerosis centers compared to outpatients.

PubMed

Debouverie, M; Laforest, L; Van Ganse, E; Guillemin, F

2009-02-01

The currently published works regarding the multiple sclerosis (MS) natural history report data were collected most often on population of patients recruited in MS centers. The aim was to compare the natural history of a population of patients followed in a MS centre (MSC) with patients followed outside a MS centre (NMSC). Cases were identified through the LORSEP cohort, a network of neurologists (private ambulatory practice, hospitals, and MS centers) in France. A total of 3602 patients had been analyzed: 1036 MSC patients and 2566 NMSC patients. No difference was observed regarding gender and initial symptoms. Conversely, MSC patients were younger at MS onset and were more likely to have a primary progressive initial form. Median times (years) to the EDSS scores of 3, 4, and 6 were 5.8 (5.0-6.8), 8.4 (7.9-9.0), 16.0 (14.8-18.1) in the MSC group, respectively, whereas corresponding times were 8.4 (7.9-9.0), 12.3 (11.4-13.4), 19.1 (18.0-20.2) in the NMSC group. These differences according to the type of MS supervision were statistically significant for EDSS3 (P < 0.0001), EDSS4 (P < 0.0001), and EDSS6 (P = 0.01), respectively. These findings were confirmed in Cox multivariate models. The patients followed in a MS centre had earlier disability than patients managed otherwise. Analyses exclusively conducted in patients with MS supervised in specialized centers may falsely misestimate the times needed to reach major disability landmarks. Before using registries to study the natural history of MS, efforts should be performed to verify in how far data are exhaustive and to understand the local health care system.

Experimental results for a 1.5 MW, 110 GHz gyrotron oscillator with reduced mode competition

NASA Astrophysics Data System (ADS)

Choi, E. M.; Marchewka, C. D.; Mastovsky, I.; Sirigiri, J. R.; Shapiro, M. A.; Temkin, R. J.

2006-02-01

A new result from a 110GHz gyrotron at MIT is reported with an output power of 1.67MW and an efficiency of 42% when operated at 97kV and 41A for 3μs pulses in the TE22,6 mode. These results are a major improvement over results obtained with an earlier cavity design, which produced 1.43MW of power at 37% efficiency. These new results were obtained using a cavity with a reduced output taper angle and a lower ohmic loss when compared with the earlier cavity. The improved operation is shown experimentally to be the result of reduced mode competition from the nearby TE19,7 mode. The reduced mode competition agrees well with an analysis of the startup scenario based on starting current simulations. The present results should prove useful in planning long pulse and CW versions of the 110GHz gyrotron.

Evaluation of Physiological Indices to Indicate Sleepy or Relaxed States Using Illuminance Stimulation

NASA Astrophysics Data System (ADS)

Shibagaki, Yumi; Ogawa, Kozue; Hagiwara, Hiroshi

The purpose of the present study was to clarify the ability of physiological indices to reflect the degree of sleepiness or relaxation of an individual due to stress, fatigue and other factors. Several studies have investigated the use of high-frequency (HF) components (0.15-0.40Hz) in heart rate variability to evaluate parasympathetic nervous activity. However, it has been difficult to assess the differences between states of sleepiness and relaxation using this method. In the present study, in order to evaluate the indices, two experimental illuminance conditions, 100 and 1,500 lx, reflecting differing states of arousal, were used during a cognitive judgment test lasting for 30 minutes. During the cognitive judgment test, electroencephalograms (EEG), electrocardiograms (ECG), physiological state and reaction time were measured, and results indicated that the two illuminance conditions could be differentiated from the recorded physiological data. More specifically, in the 1,500-lx condition, arousal level, activity level and test performance increased, and the level of HF components decreased. Opposite tendencies were observed in the 100-lx condition. Two indices of Lorenz plots (LP) at ECG RR intervals, center (C of LP) and ellipse area (S of LP), were subsequently determined from the physiological data. Subjects were then divided according to these LP indices based on their exhibited physiological responses, and we evaluated the effectiveness of the indices in differentiating between states of sleepiness and relaxation by comparing arousal level, psychological state, and reaction time. Results indicated that the C of LP and S of LP are possible indices for evaluating sleepiness or relaxation and suggest that these two indices may also be able to evaluate the relationship between physiological changes and other, subjective feelings.

Dental caries risk indicators in early childhood and their association with caries polarization in adolescence: a cross-sectional study.

PubMed

Zemaitiene, Migle; Grigalauskiene, Ruta; Andruskeviciene, Vilija; Matulaitiene, Zivile Kristina; Zubiene, Jurate; Narbutaite, Julija; Slabsinskiene, Egle

2016-07-02

Based on the hypothesis that biological and social risks accumulate during life, it is important to identify possible dental caries risk indicators from the life course of early childhood and assess their association with caries polarization in adolescence. A cross-sectional design was applied to the study, and a multistage cluster sampling method used to draw a representative sample of 1063 18-year-old Lithuanian adolescents. The dental examinations were performed according to the methodology for oral status evaluation recommended by the World Health Organization. Parents of the participating adolescents completed a self-administered questionnaire about their children's life course during early childhood. The interdependence of characteristics was evaluated by chi-square (χ (2)) and Student's (t) criteria. A multivariate logistic regression model with the Significant Caries (SiC) index as an outcome was performed. The mean scores for the number of decayed, missing, and filled teeth (DMFT) and decayed teeth (DT) in the SiC positive group were higher than the corresponding values in the SiC negative group (6.14 [SD, 2.30] and 1.67 [SD, 2.02] vs 1.28 [SD, 1.11] and 0.34 [SD, 0.69], p < 0.001, respectively). Three dental caries risk indicators were identified that were independently associated with a SiC positive outcome: gender(OR = 1.32 [95 % CI: 1.01-1.73]), earlier eruption of the first primary tooth(OR = 1.43 [95 % CI: 1.03-1.97]), and past caries experience in the primary dentition (OR = 1.62 [95 % CI:1.22-2.14]). These study findings provide reliable evidence that gender, earlier eruption of the first primary tooth, and past caries experience in the primary dentition should be considered to be dental caries risk indicators and may have an adverse effect on caries polarization in adolescence.

What You See Depends on Your Point of View: Comparison of Greenness Indices Across Spatial and Temporal Scales and What That Means for Mule Deer Migration and Fitness

NASA Astrophysics Data System (ADS)

Miller, B. W.; Chong, G.; Steltzer, H.; Aikens, E.; Morisette, J. T.; Talbert, C.; Talbert, M.; Shory, R.; Krienert, J. M.; Gurganus, D.

2015-12-01

Climate change models for the north­ern Rocky Mountains predict warming and changes in water availability that may alter vegetation. Changes to vegetation may include timing of plant life-history events, or phenology, such as green-up, flower­ing, and senescence. These changes could make forage available earlier in the growing season, but shifts in phenol­ogy may also result in earlier senescence (die-off or dormancy) and reduced overall production. Greenness indices such as the normalized difference vegetation index (NDVI) are regularly used to quantify greenness over large areas using remotely sensed reflectance data. The timing and scale of current satellite data, however, may be insufficient to capture fine-scale differences in phenology that are important indicators of habitat quality. The Wyoming Range Mule Deer herd is one of the largest in the west but it declined precipitously in the early 1990s and has not recovered. Accurate measurement of greenness over space and time would allow managers to better understand the role of plant phenology and productivity in mule deer population dynamics, for example. To connect spatial and temporal patterns of plant productivity with habitat quality, we compare greenness patterns (MODIS data) with migratory mule deer movement (GPS collars). Sagebrush systems provide winter habitat for mule deer. To understand sagebrush phenology as an indicator of productivity, we constructed NDVI time series and compared dates of phenological stages and magnitudes of greenness from three perspectives: at-surface/species-specific (mantis sensors: downward looking, <1m above vegetation); near surface/site-specific (PhenoCam: oblique, 2m); and satellite/landscape-scale (varied platforms). Greenness indices from these sensors contribute unique insights to understanding vegetation phenology, snow cover and reflectance. Understanding phenology and productivity at multiple scales can help guide resource management decisions related to

Evaluation of various approaches for assessing dose indicators and patient organ doses resulting from radiotherapy cone-beam CT

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

Rampado, Osvaldo, E-mail: orampado@cittadellasalute.to.it; Giglioli, Francesca Romana; Rossetti, Veronica

Purpose: The aim of this study was to evaluate various approaches for assessing patient organ doses resulting from radiotherapy cone-beam CT (CBCT), by the use of thermoluminescent dosimeter (TLD) measurements in anthropomorphic phantoms, a Monte Carlo based dose calculation software, and different dose indicators as presently defined. Methods: Dose evaluations were performed on a CBCT Elekta XVI (Elekta, Crawley, UK) for different protocols and anatomical regions. The first part of the study focuses on using PCXMC software (PCXMC 2.0, STUK, Helsinki, Finland) for calculating organ doses, adapting the input parameters to simulate the exposure geometry, and beam dose distribution inmore » an appropriate way. The calculated doses were compared to readouts of TLDs placed in an anthropomorphic Rando phantom. After this validation, the software was used for analyzing organ dose variability associated with patients’ differences in size and gender. At the same time, various dose indicators were evaluated: kerma area product (KAP), cumulative air-kerma at the isocenter (K{sub air}), cone-beam dose index, and central cumulative dose. The latter was evaluated in a single phantom and in a stack of three adjacent computed tomography dose index phantoms. Based on the different dose indicators, a set of coefficients was calculated to estimate organ doses for a range of patient morphologies, using their equivalent diameters. Results: Maximum organ doses were about 1 mGy for head and neck and 25 mGy for chest and pelvis protocols. The differences between PCXMC and TLDs doses were generally below 10% for organs within the field of view and approximately 15% for organs at the boundaries of the radiation beam. When considering patient size and gender variability, differences in organ doses up to 40% were observed especially in the pelvic region; for the organs in the thorax, the maximum differences ranged between 20% and 30%. Phantom dose indexes provided better correlation with

Late introduction of fish and eggs is associated with increased risk of allergy development - results from the FARMFLORA birth cohort.

PubMed

Jonsson, K; Barman, M; Brekke, H K; Hesselmar, B; Johansen, S; Sandberg, A-S; Wold, A E

2017-01-01

The prevalence of allergy is markedly low in children growing up on farms. An increasing number of studies indicate that the timing of food introduction may affect allergy development. We aimed to investigate if protection against allergy in farm environments may be mediated through differences in food-introduction practices between farm and non-farm families, using an explorative approach. Twenty-eight farm and 37 non-farm children were included in the FARMFLORA birth cohort. Practices of breastfeeding and introduction of formulas and complementary foods were collected by questionnaires at 6, 12, and 18 months of age. Allergy was diagnosed by pediatricians at 3 years of age. The only difference in food-introduction practices observed between farm and non-farm children was an earlier introduction of nuts in farmers (median month: 11 [IQR: 8-6] in farmers, 15 [12-19] in non-farmers). One farm child (4%) and 10 non-farm children (27%) were allergic at 3 years of age. Lower risk of allergy development was associated with early exclusive breastfeeding (continuous variable; OR = 0.59, 95% CI: 0.39-0.89), but also having received eggs (OR = 0.08, 95% CI: 0.13-0.54) and fish (logistic regression not applicable, P  = 0.01 in likelihood ratio testing [χ 2 ]) at 10 months of age or earlier compared to later. Our results were not affected by reverse causation, as judged by a questionnaire sent to the families in retrospect. Timing of introduction of complementary foods is unlikely to contribute to the lower risk of allergy among farm children. Although early exclusive breastfeeding was associated with a lower rate of allergy development, postponed introduction of complementary foods might increase the risk of developing allergy. Owing to the limited sample size, our results are only indicative, but support prior findings.

Indicators of food and water security in an Arctic Health context--results from an international workshop discussion.

PubMed

Nilsson, Lena Maria; Berner, James; Dudarev, Alexey A; Mulvad, Gert; Odland, Jon Øyvind; Parkinson, Alan; Rautio, Arja; Tikhonov, Constantine; Evengård, Birgitta

2013-01-01

In August 2012, a literature search with the aim of describing indicators on food and water security in an Arctic health context was initialized in collaboration between the Arctic Human Health Expert Group, SDWG/AHHEG and the AMAP (Arctic Monitoring and Assessment Programme within the Arctic Council) Human Health Assessment Group, AMAP/HHAG. In December 2012, workshop discussions were performed with representatives from both of these organizations, including 7 Arctic countries. The aim of this article is to describe the workshop discussions and the rational for the 12 indicators selected and the 9 rejected and to discuss the potential feasibility of these. Advantages and disadvantages of candidate indicators were listed. Informative value and costs for collecting were estimated separately on a 3-level scale: low, medium and high. Based on these reviews, the final selection of promoted and rejected indicators was performed and summarized in tables. Among 10 suggested indicators of food security, 6 were promoted: healthy weight, traditional food proportion in diet, monetary food costs, non-monetary food accessibility, food-borne diseases and food-related contaminants. Four were rejected: per-person dietary energy supply, food security modules, self-estimated food safety and healthy eating. Among 10 suggested indicators of water security, 6 were promoted: per-capita renewable water, accessibility of running water, waterborne diseases, drinking-water-related contaminants, authorized water quality assurance and water safety plans. Four were rejected: water consumption, types of water sources, periodic water shortages and household water costs.

Comparative usefulness of inflammatory markers to indicate bacterial infection-analyzed according to blood culture results and related clinical factors.

PubMed

Nishikawa, Hirokazu; Shirano, Michinori; Kasamatsu, Yu; Morimura, Ayumi; Iida, Ko; Kishi, Tomomi; Goto, Tetsushi; Okamoto, Saki; Ehara, Eiji

2016-01-01

To assess relationships of inflammatory markers and 2 related clinical factors with blood culture results, we retrospectively investigated inpatients' blood culture and blood chemistry findings that were recorded from January to December 2014 using electronic medical records and analyzed the data of 852 subjects (426 culture-positive and 426 culture-negative). Results suggested that the risk of positive blood culture statistically increased as inflammatory marker levels and the number of related factors increased. Concerning the effectiveness of inflammatory markers, when the outcome definition was also changed for C-reactive protein (CRP), the odds ratio had a similar value, whereas when the outcome definition of blood culture positivity was used for procalcitonin (PCT), the greatest effectiveness of that was detected. Therefore, the current results suggest that PCT is more useful than CRP as an auxiliary indication of bacterial infection. Copyright © 2016 Elsevier Inc. All rights reserved.

Acceptance, Prevalence and Indications for Robot-Assisted Laparoscopy - Results of a Survey Among Urologists in Germany, Austria and Switzerland.

PubMed

Imkamp, Florian; Herrmann, Thomas R W; Tolkach, Yuri; Dziuba, Sebastian; Stolzenburg, Jens U; Rassweiler, Jens; Sulser, Tullio; Zimmermann, Uwe; Merseburger, Axel S; Kuczyk, Markus A; Burchardt, Martin

2015-01-01

Robotic-assisted laparoscopy (RAL) is being widely accepted in the field of urology as a replacement for conventional laparoscopy (CL). Nevertheless, the process of its integration in clinical routines has been rather spontaneous. To determine the prevalence of robotic systems (RS) in urological clinics in Germany, Austria and Switzerland, the acceptance of RAL among urologists as a replacement for CL and its current use for 25 different urological indications. To elucidate the practice patterns of RAL, a survey at hospitals in Germany, Austria and Switzerland was conducted. All surgically active urology departments in Germany (303), Austria (37) and Switzerland (84) received a questionnaire with questions related to the one-year period prior to the survey. The response rate was 63%. Among the participants, 43% were universities, 45% were tertiary care centres, and 8% were secondary care hospitals. A total of 60 RS (Germany 35, Austria 8, Switzerland 17) were available, and the majority (68%) were operated under public ownership. The perception of RAL and the anticipated superiority of RAL significantly differed between robotic and non-robotic surgeons. For only two urologic indications were more than 50% of the procedures performed using RAL: pyeloplasty (58%) and transperitoneal radical prostatectomy (75%). On average, 35% of robotic surgeons and only 14% of non-robotic surgeons anticipated RAL superiority in some of the 25 indications. This survey provides a detailed insight into RAL implementation in Germany, Austria and Switzerland. RAL is currently limited to a few urological indications with a small number of high-volume robotic centres. These results might suggest that a saturation of clinics using RS has been achieved but that the existing robotic capacities are being utilized ineffectively. The possible reasons for this finding are discussed, and certain strategies to solve these problems are offered. © 2015 S. Karger AG, Basel.

Impact of 6-month earlier versus postponed initiation of rotigotine on long-term outcome: post hoc analysis of patients with early Parkinson's disease with mild symptom severity.

PubMed

Timmermann, Lars; Asgharnejad, Mahnaz; Boroojerdi, Babak; Dohin, Elisabeth; Woltering, Franz; Elmer, Lawrence W

2015-01-01

Investigate impact of 6-month earlier versus postponed initiation of rotigotine in patients with early Parkinson's disease (PD) with mild symptom severity. Long-term benefit of rotigotine in early-PD has been demonstrated: SP702 (NCT00594165) and SP716 (NCT00599196) were long-term, open-label extensions of double-blind, placebo-controlled studies of 6-month maintenance; rotigotine was well tolerated for up to 6 years, and demonstrated efficacy (Unified Parkinson's Disease Rating Scale [UPDRS] II + III below baseline) for ∼ 2 years (SP702) and ∼ 4 years (SP716). Post hoc analysis of patients at Hoehn and Yahr 1-2; groups defined by treatment received in 6-month double-blind studies: 'Rotigotine-Rotigotine' received rotigotine (n = 221), 'Placebo-Rotigotine' received placebo (n = 125). At the start of open-label rotigotine maintenance, UPDRS II + III mean ± SD change from double-blind baseline was: -8.5 ± 10.6 'Rotigotine-Rotigotine', -7.7 ± 9.0 'Placebo-Rotigotine.' After this initial improvement scores gradually increased: It took ∼ 45 months for mean scores to cross baseline in 'Rotigotine-Rotigotine', and ∼ 21 months in 'Placebo-Rotigotine.' At the time mean UPDRS II + III had crossed baseline in 'Placebo-Rotigotine' (open-label week 84; ∼ 21 months), treatment difference (LS-mean) to 'Rotigotine-Rotigotine' change from baseline was -3.89 (95% CI -6.94, -0.84); p = 0.013. In this post hoc analysis, 6-month earlier initiation of rotigotine resulted in slower return to baseline mean UPDRS II + III; initiation of rotigotine in patients with minimal/no functional disability or impairment may lead to an extended benefit.

[Differences of vegetation phenology monitoring by remote sensing based on different spectral vegetation indices.

PubMed

Zuo, Lu; Wang, Huan Jiong; Liu, Rong Gao; Liu, Yang; Shang, Rong

2018-02-01

Vegetation phenology is a comprehensive indictor for the responses of terrestrial ecosystem to climatic and environmental changes. Remote sensing spectrum has been widely used in the extraction of vegetation phenology information. However, there are many differences between phenology extracted by remote sensing and site observations, with their physical meaning remaining unclear. We selected one tile of MODIS data in northeastern China (2000-2014) to examine the SOS and EOS differences derived from the normalized difference vegetation index (NDVI) and the simple ratio vegetation index (SR) based on both the red and near-infrared bands. The results showed that there were significant differences between NDVI-phenology and SR-phenology. SOS derived from NDVI averaged 18.9 days earlier than that from SR. EOS derived from NDVI averaged 19.0 days later than from SR. NDVI-phenology had a longer growing season. There were significant differences in the inter-annual variation of phenology from NDVI and SR. More than 20% of the pixel SOS and EOS derived from NDVI and SR showed the opposite temporal trend. These results caused by the seasonal curve characteristics and noise resistance differences of NDVI and SR. The observed data source of NDVI and SR were completely consistent, only the mathematical expressions were different, but phenology results were significantly different. Our results indicated that vegetation phenology monitoring by remote sensing is highly dependent on the mathematical expression of vegetation index. How to establish a reliable method for extracting vegetation phenology by remote sensing needs further research.

The cortical representation of the speech envelope is earlier for audiovisual speech than audio speech.

PubMed

Crosse, Michael J; Lalor, Edmund C

2014-04-01

Visual speech can greatly enhance a listener's comprehension of auditory speech when they are presented simultaneously. Efforts to determine the neural underpinnings of this phenomenon have been hampered by the limited temporal resolution of hemodynamic imaging and the fact that EEG and magnetoencephalographic data are usually analyzed in response to simple, discrete stimuli. Recent research has shown that neuronal activity in human auditory cortex tracks the envelope of natural speech. Here, we exploit this finding by estimating a linear forward-mapping between the speech envelope and EEG data and show that the latency at which the envelope of natural speech is represented in cortex is shortened by >10 ms when continuous audiovisual speech is presented compared with audio-only speech. In addition, we use a reverse-mapping approach to reconstruct an estimate of the speech stimulus from the EEG data and, by comparing the bimodal estimate with the sum of the unimodal estimates, find no evidence of any nonlinear additive effects in the audiovisual speech condition. These findings point to an underlying mechanism that could account for enhanced comprehension during audiovisual speech. Specifically, we hypothesize that low-level acoustic features that are temporally coherent with the preceding visual stream may be synthesized into a speech object at an earlier latency, which may provide an extended period of low-level processing before extraction of semantic information.

Soil Quality as an Indicator of Forest Health: an Overview and Initial Results from the USFS Forest Inventory and Analysis Soil Indicator Program

Treesearch

Katherine O' Neill; Michael Amacher; Craig Palmer; Barbara Conkling; Greg C. Liknes

2003-01-01

The Montreal Process was formed in 1994 to develop an internationally agreed upon set of criteria and indicators for the conservation and sustainable management of temperate and boreal forests. In response to this effort, the USDA Forest Service Forest Inventory and Analysis (FIA) and Forest Health Monitonhg (FHM) programs implemented a national soil monitoring program...

Indications and organisational methods for autologous blood transfusion procedures in Italy: results of a national survey.

PubMed

Catalano, Liviana; Campolongo, Alessandra; Caponera, Maurizio; Berzuini, Alessandra; Bontadini, Andrea; Furlò, Giuseppe; Pasqualetti, Patrizio; Liumbruno, Giancarlo M

2014-10-01

Pre-operative donation of autologous blood is a practice that is now being abandoned. Alternative methods of transfusing autologous blood, other than predeposited blood, do however play a role in limiting the need for transfusion of allogeneic blood. This survey of autologous blood transfusion practices, promoted by the Italian Society of Transfusion Medicine and Immunohaematology more than 2 years after the publication of national recommendations on the subject, was intended to acquire information on the indications for predeposit in Italy and on some organisational aspects of the alternative techniques of autotransfusion. A structured questionnaire consisting of 22 questions on the indications and organisational methods of autologous blood transfusion was made available on a web platform from 15 January to 15 March, 2013. The 232 Transfusion Services in Italy were invited by e-mail to complete the online survey. Of the 232 transfusion structures contacted, 160 (69%) responded to the survey, with the response rate decreasing from the North towards the South and the Islands. The use of predeposit has decreased considerably in Italy and about 50% of the units collected are discarded because of lack of use. Alternative techniques (acute isovolaemic haemodilution and peri-operative blood salvage) are used at different frequencies across the country. The data collected in this survey can be considered representative of national practice; they show that the already very limited indications for predeposit autologous blood transfusion must be adhered to even more scrupulously, also to avoid the notable waste of resources due to unused units.Users of alternative autotransfusion techniques must be involved in order to gain a full picture of the degree of use of such techniques; multidisciplinary agreement on the indications for their use is essential in order for these indications to have an effective role in "patient blood management" programmes.

Does patient reporting lead to earlier detection of drug safety signals? A retrospective comparison of time to reporting between patients and healthcare professionals in a global database.

PubMed

Rolfes, Leàn; van Hunsel, Florence; Caster, Ola; Taavola, Henric; Taxis, Katja; van Puijenbroek, Eugène

2018-03-09

To explore if there is a difference between patients and healthcare professionals (HCPs) in time to reporting drug-adverse drug reaction (ADR) associations that led to drug safety signals. This was a retrospective comparison of time to reporting selected drug-ADR associations which led to drug safety signals between patients and HCPs. ADR reports were selected from the World Health Organization Global database of individual case safety reports, VigiBase. Reports were selected based on drug-ADR associations of actual drug safety signals. Primary outcome was the difference in time to reporting between patients and HCPs. The date of the first report for each individual signal was used as time zero. The difference in time between the date of the reports and time zero was calculated. Statistical differences in timing were analysed on the corresponding survival curves using a Mann-Whitney U test. In total, 2822 reports were included, of which 52.7% were patient reports, with a median of 25% for all included signals. For all signals, median time to signal detection was 10.4 years. Overall, HCPs reported earlier than patients: median 7.0 vs. 8.3 years (P < 0.001). Patients contributed a large proportion of reports on drug-ADR pairs that eventually became signals. HCPs reported 1.3 year earlier than patients. These findings strengthen the evidence on the value of patient reporting in signal detection and highlight an opportunity to encourage patients to report suspected ADRs even earlier in the future. © 2018 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society.

Same-Sex Behavior and Health Indicators of Sexually Experienced Filipino Young Adults.

PubMed

Cheng, Chia-Hsin Emily; Gipson, Jessica D; Perez, Tita Lorna; Cochran, Susan D

2016-08-01

The Philippines is one of seven countries in which HIV incidence has recently increased-much of this increase has been among men who have sex with men. Despite this trend, knowledge on sexuality and same-sex behaviors in the Philippines is limited. This study examines same-sex behavior, sexual outcomes, substance use, and psychological distress among young adults participating in the 2005 Cebu Longitudinal Health and Nutrition Survey (CLHNS). We use gender-stratified, multivariate models to compare young adults who reported same-sex behaviors and those who did not. Among a cohort of 1,912 Filipino young adults (ages 20-22), 58.2 % were sexually experienced and 15.1 % of them reported same-sex sexual contacts or romantic relationships. Compared to females, more males reported same-sex sexual contact (19.4 vs. 2.3 %) or same-sex romantic relationships (9.2 vs. 4.1 %). Young adults reporting same-sex behavior had higher odds of smoking, drug use, perceived stress, and more sexual partners as compared to their peers. Males who reported same-sex behavior initiated sex earlier than those males who did not report same-sex behaviors. There were no significant differences in depressive distress. Earlier sexual initiation and higher levels of substance use among Filipino young adults engaging in same-sex behavior highlight the need to address unique health issues within this population. Mixed findings for depressive distress and perceived stress indicate that further investigation is needed to explore the potential impacts of same-sex status on mental health outcomes, particularly in lower- and middle-income countries such as the Philippines.

Titan's atmosphere (clouds and composition): new results

NASA Astrophysics Data System (ADS)

Griffith, C. A.

Titan's atmosphere potentially sports a cycle similar to the hydrologic one on Earth with clouds, rain and seas, but with methane playing the terrestrial role of water. Over the past ten years many independent efforts indicated no strong evidence for cloudiness until some unique spectra were analyzed in 1998 (Griffith et al.). These surprising observations displayed enhanced fluxes of 14-200 % on two nights at precisely the wavelengths (windows) that sense Titan's lower altitude where clouds might reside. The morphology of these enhancements in all 4 windows observed indicate that clouds covered ~6-9 % of Titan's surface and existed at ~15 km altitude. Here I discuss new observations recorded in 1999 aimed to further characterize Titan's clouds. While we find no evidence for a massive cloud system similar to the one observed previously, 1%-4% fluctuations in flux occur daily. These modulations, similar in wavelength and morphology to the more pronounced ones observed earlier, suggest the presence of clouds covering ≤1% of Titan's disk. The variations are too small to have been detected by most prior measurements. Repeated observations, spaced 30 minutes apart, indicate a temporal variability observable in the time scale of a couple of hours. The cloud heights hint that convection might govern their evolution. Their short lives point to the presence of rain.

Electronic health indicators in the selected countries: Are these indicators the best?

PubMed Central

Afshari, Somaye; Khorasani, Elahe; Yarmohammadian, Mohammad Hossein; Atighechian, Golrokh; Darab, Mohsen Ghaffari

2013-01-01

Background: Many changes have been made in different sciences by developing and advancing information and communication technology in last two decades. E-health is a very broad term that includes many different activities related to the use of electronic devices, software as well as hardware in health organizations. Aims: The aim of this study is comparing electronic health indicators in the selected countries and discussion on the best indicators. Settings and Design: This study has chosen 12 countries randomly based on the regional division of the WHO. The relevant numbers of health indicators and general indicators and information technology indicators are extracted of these countries. We use data from the Bitarf's comparative study, which is conducted by the Iranian Supreme Council of Information Technology in 2007. Materials and Methods: By using Pearson correlation test, the relations between health general indicators and IT indicators are studied. Statistical Analysis Used: Data was analyzed based on the research objectives using SPSS software and in accordance with research questions Pearson correlation test were used. Results: The findings show that there is a positive relation between indicators related to IT and “Total per capita health, healthy life expectancy, percent literacy”. Furthermore, there is a mutual relation between IT indicators and “mortality indicator”. Conclusion: This study showed differences between selective indicators among different countries. The modern world, with its technological advances, is not powerless in the face of these geographic and health disparity challenges. Researchers must not rely on the available indicators. They must consider indicators like e-business companies, electronic data internet, medical supplies, health electronic record, health information system, etc., In future, continuous studies in this field, to provide the exact and regular reports of amount of using of these indicators through different

Sociometric Indicators of Leadership: An Exploratory Analysis

DTIC Science & Technology

2018-01-01

streamline existing observational protocols and assessment methods . This research provides an initial test of sociometric badges in the context of the U.S...understand, the requirements of the mission. Traditional research and assessment methods focusing on leader and follower interactions require direct...based methods of social network analysis. Novel Measures of Leadership Building on these findings and earlier research , it is apparent that

Results from a U.S. absolute gravity survey

NASA Astrophysics Data System (ADS)

Zumberge, M. A.; Faller, J. E.; Gschwind, J.

Using the recently completed JILA absolute gravity meter, we made a survey of twelve sites in the United States. Over a period of eight weeks, the instrument was driven a total distance of nearly 20,000 km to sites in California, New Mexico, Colorado, Wyoming, Maryland and Massachusetts. The time spent in carrying out a measurement at a single location was typically one day. We report the results of the measurements in this survey along with earlier measurements made with the instrument, discuss the measurement accuracy and compare our results with other measurements.

Combining in Vitro Diagnostics with in Vivo Imaging for Earlier Detection of Pancreatic Ductal Adenocarcinoma: Challenges and Solutions

PubMed Central

Laeseke, Paul F.; Chen, Ru; Jeffrey, R. Brooke; Brentnall, Teresa A.

2015-01-01

Pancreatic ductal adenocarcinoma (PDAC) is the fourth-leading cause of cancer-related death in the United States and is associated with a dismal prognosis, particularly when diagnosed at an advanced stage. Overall survival is significantly improved if PDAC is detected at an early stage prior to the onset of symptoms. At present, there is no suitable screening strategy for the general population. Available diagnostic serum markers are not sensitive or specific enough, and clinically available imaging modalities are inadequate for visualizing early-stage lesions. In this article, the role of currently available blood biomarkers and imaging tests for the early detection of PDAC will be reviewed. Also, the emerging biomarkers and molecularly targeted imaging agents being developed to improve the specificity of current imaging modalities for PDAC will be discussed. A strategy incorporating blood biomarkers and molecularly targeted imaging agents could lead to improved screening and earlier detection of PDAC in the future. © RSNA, 2015 PMID:26599925

Verbal abuse, like physical and sexual abuse, in childhood is associated with an earlier onset and more difficult course of bipolar disorder.

PubMed

Post, Robert M; Altshuler, Lori L; Kupka, Ralph; McElroy, Susan L; Frye, Mark A; Rowe, Michael; Leverich, Gabriele S; Grunze, Heinz; Suppes, Trisha; Keck, Paul E; Nolen, Willem A

2015-05-01

Physical or sexual abuse in childhood is known to have an adverse effect on the course of bipolar disorder, but the impact of verbal abuse has not been well elucidated. We examined the occurrence and frequency (never to frequently) of each type of abuse in childhood in 634 US adult outpatients (average age 40 years). Patients gave informed consent and provided information about their age of onset and course of illness prior to study entry. Verbal abuse alone occurred in 24% of the patients. Similar to a history of physical or sexual abuse, a history of verbal abuse was related to an earlier age of onset of bipolar disorder and other poor prognosis characteristics, including anxiety and substance abuse comorbidity, rapid cycling, and a deteriorating illness course as reflected in ratings of increasing frequency or severity of mania and depression. A lasting adverse impact of the experience of verbal abuse in childhood is suggested by its relationship to an earlier age of onset of bipolar disorder, other poor prognosis factors, and a deteriorating course of illness. Verbal abuse is a common confound in comparison groups defined by a lack of physical or sexual abuse. Ameliorating the impact of verbal abuse on the unfolding course of bipolar disorder appears to be an important target of therapeutics and worthy of attempts at primary and secondary prophylaxis. Family-based treatments that focus on psychoeducation, enhancing intra-family communication, and coping skills may be particularly helpful. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Solar System Observations with Spitzer Space Telescope: Preliminary Results

NASA Technical Reports Server (NTRS)

Cruikshank, Dale P.

2005-01-01

The programs of observations of Solar System bodies conducted in the first year of the operation of the Spitzer Space Telescope as part of the Guaranteed Observing Time allocations are described. Initial results include the determination of the albedos of a number of Kuiper Belt objects and Centaurs from observations of their flux densities at 24 and 70 microns, and the detection of emission bands in the spectra of several distant asteroids (Trojans) around 10 and 25 microns. The 10 Kuiper Belt objects observed to date have albedos in the range 0.08 - 0.15, significantly higher than the earlier estimated 0.04. An additional KBO [(55565) 2002 AW(sub l97)] has an albedo of 0.17 plus or minus 0.03. The emission bands in the asteroid spectra are indicative of silicates, but specific minerals have not yet been identified. The Centaur/comet 29P/Schwassmann-Wachmann 1 has a nucleus surface albedo of 0.025 plus or minus 0.01, and its dust production rate was calculated from the properties of the coma. Several other investigations are in progress as the incoming data are processed and analyzed.

GIS Teacher Training: Empirically-Based Indicators of Effectiveness

ERIC Educational Resources Information Center

Höhnle, Steffen; Fögele, Janis; Mehren, Rainer; Schubert, Jan Christoph

2016-01-01

In spite of various actions, the implementation of GIS (geographic information systems) in German schools is still very low. In the presented research, teaching experts as well as teaching novices were presented with empirically based constraints for implementation stemming from an earlier survey. In the process of various group discussions, the…

Results of Russian geomagnetic observatories in the 19th century: magnetic activity, 1841-1862

NASA Astrophysics Data System (ADS)

Nevanlinna, H.; Häkkinen, L.

2010-04-01

Hourly (spot readings) magnetic data (H- and D-components) were digitized from Russian yearbook tables for the years 1850-1862 from four observatories. The pdf pictures for digitization were taken by a normal digital camera. The database obtained consists of about 900 000 single data points. The time series of hourly magnetic values reveal slow secular variations (declination only) as well as transient and regular geomagnetic variations of external origin. The quality and homogeneity of the data is satisfactory. Daily Ak-indices were calculated using the index algorithm that has been earlier applied to 19th century data from Helsinki (Finland) as well as modern magnetic observatory recordings. The activity index series derived from the Russian data is consistent with earlier activity index series for 1850-1862. The digitized index data series derived in this study was extended back to 1841 by including magnetic C9 activity index data available from a Russian observatory (St. Petersburg). Magnetic data rescued here is well suitable for various reconstructions for studies of the long-term variation of the space weather in the 19th century.

Southern phosphorus indices, water quality data, and modeling (APEX, APLE, and TBET) results: A comparison

USDA-ARS?s Scientific Manuscript database

Phosphorus (P) indices in the southern United States frequently produce different recommendations for similar conditions. After assembling data from benchmark southern sites (Arkansas, Georgia, Mississippi, North Carolina, Oklahoma, and Texas), land treatment information was used in the 12 southern...

Science Indicators and Science Priorities.

ERIC Educational Resources Information Center

Brooks, Harvey

1982-01-01

Discusses science/society interface and difficulties involved in developing realistic science indicators. Topics include: intrinsic vs. extrinsic indicators; four problems society faces as a result of technological activities (toxic chemicals, radioactive wastes, auto safety, cancer); research and development (R&D) priorities; international…

Cholesteatoma has a high prevalence in Turner syndrome, highlighting the need for earlier diagnosis and the potential benefits of otoscopy training for paediatricians.

PubMed

Lim, D B N; Gault, E J; Kubba, H; Morrissey, M S C; Wynne, D M; Donaldson, M D C

2014-07-01

Girls with Turner syndrome are prone to cholesteatoma, a serious suppurative middle ear disease. We aimed to confirm its high prevalence in Turner syndrome, identify risk factors and suggest possible strategies for earlier detection. We reviewed 179 girls with Turner syndrome between 1989 and 2012 to identify cases of cholesteatoma. Seven girls (3.9%) had cholesteatoma (index girls) and each was compared with three age-matched girls without cholesteatoma (comparison girls). All the index girls had either the 45,X or 45,X/46X,i(Xq) karyotypes. Nine ears were initially affected, with three recurrences in two girls. Median age at first cholesteatoma presentation was 11.9 years (range: 7.5-15.2), with otorrhoea for three (range: one to seven) months in all 12 affected ears. Index girls had a significantly higher proportion of previous recurrent acute (p = 0.007) and chronic otitis media (p = 0.008), chronic perforation (p = 0.038) aural polyps (p < 0.0001) and tympanic membrane retraction (p = 0.0001) than comparison girls. Cholesteatoma has a high prevalence in Turner syndrome. Risk factors include 45,X and 46,XiXq karyotypes; a history of chronic otitis media, tympanic membrane retraction and persistent otorrhoea; and older age. Earlier recognition of ear disease is needed and otoscopy training for paediatricians caring for Turner syndrome patients may be beneficial. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

A study of the academic performance of medical students in the comprehensive examination of the basic sciences according to the indices of emotional intelligence and educational status

PubMed Central

Moslehi, Mohsen; Samouei, Rahele; Tayebani, Tayebeh; Kolahduz, Sima

2015-01-01

Background: Considering the increasing importance of emotional intelligence (EI) in different aspects of life, such as academic achievement, the present survey is aimed to predict academic performance of medical students in the comprehensive examination of the basic sciences, according to the indices of emotional intelligence and educational status. Materials and Methods: The present survey is a descriptive, analytical, and cross-sectional study performed on the medical students of Isfahan, Tehran, and Mashhad Universities of Medical Sciences. Sampling the universities was performed randomly after which selecting the students was done, taking into consideration the limitation in their numbers. Based on the inclusion criteria, all the medical students, entrance of 2005, who had attended the comprehensive basic sciences examination in 2008, entered the study. The data collection tools included an Emotional Intelligence Questionnaire (standardized in Isfahan), the average score of the first to fifth semesters, total average of each of the five semesters, and the grade of the comprehensive basic sciences examination. The data were analyzed through stepwise regression coefficient by SPSS software version 15. Results: The results indicated that the indicators of independence from an emotional intelligence test and average scores of the first and third academic semesters were significant in predicting the students’ academic performance in the comprehensive basic sciences examination. Conclusion: According to the obtained results, the average scores of students, especially in the earlier semesters, as well as the indicators of independence and the self-esteem rate of students can influence their success in the comprehensive basic sciences examination. PMID:26430693

The comparison of road safety survey answers between web-panel and face-to-face; Dutch results of SARTRE-4 survey.

PubMed

Goldenbeld, C; de Craen, S

2013-09-01

In the Netherlands, a comparison of an online and a face-to-face sample of car drivers was made to study differences on a number of selected questions from the SARTRE-4 road safety survey. Contrary to expectations, there was no indication that online respondents were more likely to come from higher educated or more privileged social groups. Confirming earlier research, the results indicated that online respondents were less inclined to give socially desirable answers and were less inclined to use more extreme ratings in their opinions about measures. Contrary to expectations, face-to-face respondents did not tend to give more positive answers in judgment of road safety measures. Weighting to make samples comparable on gender, age, and education had almost no effect on outcomes. The implications for a transition from face-to-face survey to online panel method are discussed. Copyright © 2013 National Safety Council and Elsevier Ltd. All rights reserved.

Analyses of Old “Prokaryotic” Proteins Indicate Functional Diversification in Arabidopsis and Oryza sativa

PubMed Central

Singh, Anupama; Jethva, Minesh; Singla-Pareek, Sneh L.; Pareek, Ashwani; Kushwaha, Hemant R.

2016-01-01

During evolution, various processes such as duplication, divergence, recombination, and many other events leads to the evolution of new genes with novel functions. These evolutionary events, thus significantly impact the evolution of cellular, physiological, morphological, and other phenotypic trait of organisms. While evolving, eukaryotes have acquired large number of genes from the earlier prokaryotes. This work is focused upon identification of old “prokaryotic” proteins in Arabidopsis and Oryza sativa genome, further highlighting their possible role(s) in the two genomes. Our results suggest that with respect to their genome size, the fraction of old “prokaryotic” proteins is higher in Arabidopsis than in Oryza sativa. The large fractions of such proteins encoding genes were found to be localized in various endo-symbiotic organelles. The domain architecture of the old “prokaryotic” proteins revealed similar distribution in both Arabidopsis and Oryza sativa genomes showing their conserved evolution. In Oryza sativa, the old “prokaryotic” proteins were more involved in developmental processes, might be due to constant man-made selection pressure for better agronomic traits/productivity. While in Arabidopsis, these proteins were involved in metabolic functions. Overall, the analysis indicates the distinct pattern of evolution of old “prokaryotic” proteins in Arabidopsis and Oryza sativa. PMID:27014324

A study of the academic performance of medical students in the comprehensive examination of the basic sciences according to the indices of emotional intelligence and educational status.

PubMed

Moslehi, Mohsen; Samouei, Rahele; Tayebani, Tayebeh; Kolahduz, Sima

2015-01-01

Considering the increasing importance of emotional intelligence (EI) in different aspects of life, such as academic achievement, the present survey is aimed to predict academic performance of medical students in the comprehensive examination of the basic sciences, according to the indices of emotional intelligence and educational status. The present survey is a descriptive, analytical, and cross-sectional study performed on the medical students of Isfahan, Tehran, and Mashhad Universities of Medical Sciences. Sampling the universities was performed randomly after which selecting the students was done, taking into consideration the limitation in their numbers. Based on the inclusion criteria, all the medical students, entrance of 2005, who had attended the comprehensive basic sciences examination in 2008, entered the study. The data collection tools included an Emotional Intelligence Questionnaire (standardized in Isfahan), the average score of the first to fifth semesters, total average of each of the five semesters, and the grade of the comprehensive basic sciences examination. The data were analyzed through stepwise regression coefficient by SPSS software version 15. The results indicated that the indicators of independence from an emotional intelligence test and average scores of the first and third academic semesters were significant in predicting the students' academic performance in the comprehensive basic sciences examination. According to the obtained results, the average scores of students, especially in the earlier semesters, as well as the indicators of independence and the self-esteem rate of students can influence their success in the comprehensive basic sciences examination.

Rapakivi texture: An indication of the crystallization of hydrosilicates, II

NASA Astrophysics Data System (ADS)

Elliston, John N.

1985-05-01

a montmorillonite-rich rim which it is suggested crystallizes together with the illitic cores to form mantled or polymantled feldspar ovoids. Crystallization of the rapakivi massif is associated with strong temperature rise stemming from exothermic crystallization of the close-packed metastable colloids. This follows the development of the characteristic texture. The rounded and rimmed precursor accretions are formed during earlier lower-temperature episodes of thixotropic liquefaction which are isothermal. The fluidity is an earlier event. There is high temperature dependent on the rate of water loss but no molten stage. Forty-six typical features of rapakivi texture are described and illustrated, each of which is directly attributable to specific interactions in an alternately dynamic and static colloidal system. Individual correlation between each observed distinctive feature of the rapakivi texture and the well-documented physico-chemical process is complete. For sediment-derived granites, therefore, the rapakivi texture can confidently be assumed to be an indication of the crystallization of their sedimentary hydrosilicate precursors.

Mars Science Laboratory relative humidity observations: Initial results.

PubMed

Harri, A-M; Genzer, M; Kemppinen, O; Gomez-Elvira, J; Haberle, R; Polkko, J; Savijärvi, H; Rennó, N; Rodriguez-Manfredi, J A; Schmidt, W; Richardson, M; Siili, T; Paton, M; Torre-Juarez, M De La; Mäkinen, T; Newman, C; Rafkin, S; Mischna, M; Merikallio, S; Haukka, H; Martin-Torres, J; Komu, M; Zorzano, M-P; Peinado, V; Vazquez, L; Urqui, R

2014-09-01

The Mars Science Laboratory (MSL) made a successful landing at Gale crater early August 2012. MSL has an environmental instrument package called the Rover Environmental Monitoring Station (REMS) as a part of its scientific payload. REMS comprises instrumentation for the observation of atmospheric pressure, temperature of the air, ground temperature, wind speed and direction, relative humidity (REMS-H), and UV measurements. We concentrate on describing the REMS-H measurement performance and initial observations during the first 100 MSL sols as well as constraining the REMS-H results by comparing them with earlier observations and modeling results. The REMS-H device is based on polymeric capacitive humidity sensors developed by Vaisala Inc., and it makes use of transducer electronics section placed in the vicinity of the three humidity sensor heads. The humidity device is mounted on the REMS boom providing ventilation with the ambient atmosphere through a filter protecting the device from airborne dust. The final relative humidity results appear to be convincing and are aligned with earlier indirect observations of the total atmospheric precipitable water content. The water mixing ratio in the atmospheric surface layer appears to vary between 30 and 75 ppm. When assuming uniform mixing, the precipitable water content of the atmosphere is ranging from a few to six precipitable micrometers. Atmospheric water mixing ratio at Gale crater varies from 30 to 140 ppmMSL relative humidity observation provides good dataHighest detected relative humidity reading during first MSL 100 sols is RH75.

Reproducibility Analysis of Diffusion Tensor Indices and Fiber Architecture of Human Calf Muscles in vivo at 1.5 Tesla in Neutral and Plantarflexed Ankle Positions at Rest

PubMed Central

Sinha, Shantanu; Sinha, Usha

2011-01-01

Purpose To investigate the reproducibility of diffusion tensor imaging (DTI) derived indices and fiber architecture of calf muscles at 1.5 Tesla, to establish an imaging based method to confirm ankle position, and to compare fiber architecture at different ankle positions. Materials and Methods Six subjects were imaged at 1.5T with the foot in neutral and plantarflexed positions. DTI indices were calculated in four muscle compartments (medial and lateral gastrocnemius (MG, LG), superficial and deep anterior tibialis (AT-S, AT-D). Two subjects were scanned on three days to calculate the coefficient of variability (CV) and the repeatability coefficient (RC). Results DTI indices were close to the values obtained in earlier 3T and 1.5 T studies. FA decreased significantly in the MG and increased significantly in the AT-S and AT-D compartments while fiber orientation with respect to the magnet Z-axis increased significantly in the MG and decreased significantly in the AT-S compartment with plantarflexion. The CV and RC for the DTI indices and fiber orientations were comparable to 3T studies. Fiber lengths and orientation angles in the MG matched corresponding measures from ultrasound studies. Conclusion DTI at 1.5 Tesla provides reproducible measures of diffusion indices and fiber architecture of calf muscle at different muscle lengths. PMID:21608064

Rapid and improved recovery rate of Mycobacterium tuberculosis in Mycobacteria Growth Indicator Tube combined with solid Löwenstein Jensen medium.

PubMed

Rivera, A B; Tupasi, T E; Grimaldo, E R; Cardano, R C; Co, V M

1997-10-01

Clinical microbiology laboratory with limited resources in a developing country. To determine the recovery rate of Mycobacterium tuberculosis (MTB) in Mycobacteria Growth Indicator Tube (MGIT) combined with Löwenstein Jensen (LJ) culture medium. Stock cultures and reference strains of mycobacteria and clinical specimens were inoculated into MGIT and onto LJ. The combined recovery rate was determined and time to positive culture in each medium was compared. All known stock and reference cultures of mycobacteria grew in both media. MGIT combined with LJ increased the recovery rate from 109 (63.4%) to 122 (70.9%) of 172 clinical specimens. Of those isolated, the yield in MGIT (99.2%) exceeded that in LJ (89.3%). The average day to detection of MTB in MGIT was earlier by 14.2 days compared to LJ (15.7 days vs. 29.9 days). For mycobacteria other than tuberculosis (MOTT), there was little difference in the recovery time, except for M. kansasii where growth in MGIT was earlier by one week and M. triviale where growth in MGIT was detected later than LJ. MGIT is an excellent system for the rapid isolation of mycobacteria. It increases the recovery rate of MTB when combined with LJ.

[The age and sex indicators of mortality of population and years of life lost as a result of premature mortality in the Russian Federation in 2012].

PubMed

Boiytsov, S A; Samorodskaya, I V

2014-01-01

The age-specific mortality coefficients and years of life lost as a result of premature mortality are among important medical demographic characteristics of population health. The study analyzed age and sex indicators of mortality of population in the Russian Federation. The number of years of life lost as a result of premature mortality is calculated. The comparison of values of years of life lost in various subjects of the Russian Federation was carried out. The data of Rosstat concerning population size and number of the deceased in year age groups in the Russian Federation and subjects of the Russian Federation in 2012 was used. The indicator was calculated on the basis of technique included into "The global burden of diseases report" (2010). The minimal indicators of mortality of males are noted at the age of 11 years (25.4 per 100 000 of population) and females at the age of 10 years (18.2 per 100 000 of population). The maximal differences in indicators of mortality of males and females are marked in the age group 20-29 years (314.5 of males and 92.3 of females per 100 000 of population). The percentage of deceased prior 70 years consists 63.2% among males and 29.9% among females. The total number of years of life lost in the Russian Federation consisted 36 864 309 and out of them 24 321 992 (65.9%) as a result of death of males and 12 542 317 (34.1%) as a result of death of females. The maximum percentage of years of life lost among males is marked in the age group of 51-60 years (24.61%) and among females in the age group of 71-80 years (22.38%). The indicator of years of life lost per 100 000 of population consisted 25769 for total population, 36 753 for male population and 16 314 for female population. The highest rate of indicator of years of life lost is marked in the Chukchi Autonomous Okrug and the lowest rate in the Republics of the Northern Caucasus and Moscow. However, in all subjects of the Russian Federation indicator of years of life lost is

Cesarean section indications and anthropometric parameters in Rwandan nulliparae: preliminary results from a longitudinal survey.

PubMed

Kakoma, Jean-Baptiste

2016-01-01

Maternal anthropometric parameters as risk factors for cesarean section have always been a matter of interest and concern for obstetricians. Some of these parameters have been shown to be predictors of dystocia. This study aims at showing the relationship between cesarean section indications and anthropometric parameters sizes in Rwandan nulliparae for the purpose of comparison and appropriate recommendations. A cross-sectional and analytical study was made on data collected from 32 operated patients among 152 nulliparae with singleton pregnancy at term and vertex presentation. Concerned anthropometric parameters were height, weight and six pelvic distances. Fisher exact and Student's tests were used to compare observed proportions and mean values, respectively. Findings were as follows: 1) the overall cesarean section rate was 21.05%; 2) acute fetal distress (31.3 %), generally contracted pelvis (28.1 %), and engagement failure (25%) were the most frequent indications of cesarean section; 3) all patients ≤ 145 cm tall were operated on for general pelvis contraction whose proportion was significantly higher in them than in the others (p < 0.01); 4) more than half of pelvis contraction cases were observed in patients weighing ≤ 50 kg, but the difference with other weight categories was not significant; 5) considered external pelvic diameters but the Biiliac Diameter displayed average measurements smaller in clinically contracted pelvis than in other CS indications. External pelvimetry associated with specific other anthropometric parameters could be helpful in the screening of generally contracted pelves, and consequently pregnancies at high risk of cephalopelvic disproportion in nulliparous women, particularly in developing countries with limited resources. Further investigations are requested to deal with this topic in depth.

[Endoprosthesis of the ankle joint. Indications and long-term results].

PubMed

Endrich, B; Terbrüggen, D

1991-10-01

The treatment of a post-traumatic, progressively more painful ankle joint causes increasing disablement. It might require alternatives to conventional surgery if a patient does not consent to ankle arthrodesis to alleviate the pain. Therefore, we report on a retrospective study of 10 patients (age 25-73 years at the time of surgery). All of them refused arthrodesis; thus 10 total ankle arthroplasties were performed between 1982 and 1989. 5 women and 5 men were treated who have been suffering from severe post-traumatic arthrosis for 3-46 years. Since performance of a single-axis arthroplasty (ICLH prosthesis) in each patient, the mean follow-up has been 4.6 years. One year after surgery, the results could be considered good or excellent in 9 of the 10 patients; only 1 person experienced local wound infection, which led to removal of the implant 4 months later and ultimately to arthrodesis. Two years later, 7 patients are eligible for follow-up because 1 underwent surgery in February 1989. Another patient experienced aseptic loosening after 18 months; he was admitted to our hospital for arthrodesis. Three years after endoprosthetic surgery, all except 1 woman with occasional pain and stiffness were found to have satisfactory results on follow-up. The relief of pain was gratifying in all patients, with ankle function well maintained (at least 0-0-30 degrees). At present, the prosthesis is still functional in 6 patients (surgery 1.5-8 years ago). They can go about their usual daily business without apparent pain and with appropriate function; 2 of them, however, show radiolucent lines on standard X-rays of the ankle, suggesting some loosening.(ABSTRACT TRUNCATED AT 250 WORDS)

Indicators of food and water security in an Arctic Health context – results from an international workshop discussion

PubMed Central

Nilsson, Lena Maria; Berner, James; Dudarev, Alexey A.; Mulvad, Gert; Odland, Jon Øyvind; Parkinson, Alan; Rautio, Arja; Tikhonov, Constantine; Evengård, Birgitta

2013-01-01

In August 2012, a literature search with the aim of describing indicators on food and water security in an Arctic health context was initialized in collaboration between the Arctic Human Health Expert Group, SDWG/AHHEG and the AMAP (Arctic Monitoring and Assessment Programme within the Arctic Council) Human Health Assessment Group, AMAP/HHAG. In December 2012, workshop discussions were performed with representatives from both of these organizations, including 7 Arctic countries. The aim of this article is to describe the workshop discussions and the rational for the 12 indicators selected and the 9 rejected and to discuss the potential feasibility of these. Advantages and disadvantages of candidate indicators were listed. Informative value and costs for collecting were estimated separately on a 3-level scale: low, medium and high. Based on these reviews, the final selection of promoted and rejected indicators was performed and summarized in tables. Among 10 suggested indicators of food security, 6 were promoted: healthy weight, traditional food proportion in diet, monetary food costs, non-monetary food accessibility, food-borne diseases and food-related contaminants. Four were rejected: per-person dietary energy supply, food security modules, self-estimated food safety and healthy eating. Among 10 suggested indicators of water security, 6 were promoted: per-capita renewable water, accessibility of running water, waterborne diseases, drinking-water-related contaminants, authorized water quality assurance and water safety plans. Four were rejected: water consumption, types of water sources, periodic water shortages and household water costs. PMID:23940840

A seismic study of Yucca Mountain and vicinity, southern Nevada; data report and preliminary results

USGS Publications Warehouse

Hoffman, L.R.; Mooney, W.D.

1983-01-01

From 1980 to 1982, the U.S. Geological Survey conducted seismic refraction studies at the Nevada Test Site to aid in an investigation of the regional crustal structure at a possible nuclear waste repository site near Yucca Mountain. Two regionally distributed deployments and one north-south deployment recorded nuclear events. First arrival times from these deployments were plotted on a location map and contoured to determine traveltime delays. The results indicate delays as large as 0.5 s in the Yucca Mountain and Crater Flat areas relative to the Jackass Flats area. A fourth east-west deployment recorded a chemical explosion and was interpreted using a two-dimensional computer raytracing technique. Delays as high as 0.7 s were observed over Crater Flat and Yucca Mountain. The crustal model derived from this profile indicates that Paleozoic rocks, which outcrop to the east at Skull Mountain and the Calico Hills, and to the west at Bare Mountain, lie at a minimum depth of 3 km beneath part of Yucca Mountain. These results confirm earlier estimates based on the modeling of detailed gravity data. A mid-crustal boundary at 15 ? 2 km beneath Yucca Mountain is evidenced by a prominent reflection recorded beyond 43 km range at 1.5 s reduced time. Other mid-crustal boundaries have been identified at 24 and 30 km and the total crustal thickness is 35 km.

Elbow hemiarthroplasty for the management of distal humeral fractures: current technique, indications and results.

PubMed

Phadnis, Joideep; Watts, Adam C; Bain, Gregory I

2016-07-01

There has been a growing recent interest in the use of elbow hemiarthroplasty for the treatment of distal humeral trauma in select patients. However, the current available evidence regarding outcome after elbow hemiarthroplasty is limited to case series and biomechanical data. Consequently, the procedure remains unfamiliar to many surgeons. The aim of the present review is to outline the evidence regarding elbow hemiarthroplasty and to use this, along with the author's experience, to better describe the indications, surgical technique and outcomes after this procedure.

Elbow hemiarthroplasty for the management of distal humeral fractures: current technique, indications and results

PubMed Central

Watts, Adam C; Bain, Gregory I

2016-01-01

There has been a growing recent interest in the use of elbow hemiarthroplasty for the treatment of distal humeral trauma in select patients. However, the current available evidence regarding outcome after elbow hemiarthroplasty is limited to case series and biomechanical data. Consequently, the procedure remains unfamiliar to many surgeons. The aim of the present review is to outline the evidence regarding elbow hemiarthroplasty and to use this, along with the author’s experience, to better describe the indications, surgical technique and outcomes after this procedure. PMID:27583016

Towards earlier inclusion of Children in Tuberculosis (TB) drugs trials: Consensus statements from an Expert Panel

PubMed Central

Nachman, Sharon; Ahmed, Amina; Amanullah, Farhana; Becerra, Mercedes C; Botgros, Radu; Brigden, Grania; Browning, Renee; Gardiner, Elizabeth; Hafner, Richard; Hesseling, Anneke; How, Cleotilde; Jean-Philippe, Patrick; Lessem, Erica; Makhene, Mamodikoe; Mbelle, Nontombi; Marais, Ben; McIlleron, Helen; Mc Neeley, David F; Mendel, Carl; Murray, Stephen; Navarro, Eileen; Oramasionwu, Gloria E; Porcalla, Ariel R; Powell, Clydette; Powell, Mair; Rigaud, Mona; Rouzier, Vanessa; Samson, Pearl; Schaaf, H. Simon; Shah, Seema; Starke, Jeff; Swaminathan, Soumya; Wobudeya, Eric; Worrell, Carol

2015-01-01

Children represent a significant proportion of the global tuberculosis (TB) burden, and may be disproportionately more affected by its most severe clinical manifestations. Currently available treatments for pediatric drug-susceptible (DS) and drug-resistant (DR) TB, albeit generally effective, are hampered by high pill burden, long duration of treatment, coexistent toxicities, and an overall lack of suitable, child-friendly formulations. The complex and burdensome nature of administering the existing regimens to treat DS TB also contributes to the rise of DR TB strains. Despite the availability and use of these therapies for decades, a dearth of dosing evidence in children underscores the importance of sustained efforts for TB drug development to better meet the treatment needs of children with TB. Several new TB drugs and regimens with promising activity against both DS and DR TB strains have recently entered clinical development and are in various phases of clinical evaluation in adults or have received marketing authorization for adults. However, initiation of clinical trials to evaluate these drugs in children is often deferred, pending the availability of complete safety and efficacy data in adults or after drug approval. This document summarizes consensus statements from an international panel of childhood TB opinion leaders which support the initiation of evaluation of new TB drugs and regimens in children at earlier phases of the TB Drug development cycle. PMID:25957923

Analysis on pile testing results of post-grouting bored pile

NASA Astrophysics Data System (ADS)

Zheng, A. R.

2017-04-01

Based on static load test results, the bearing capacity of bored piles with pile-toe and pile-shaft post-grouting has been analyzed. The analysis reveals that: with post-grouting, the interface between pile and surrounding soil are strengthened and the relative sliding displacement in between is reduced; end resistance of pile is enhanced and can be mobilized at earlier stage with smaller sliding displacement. As a result, the performance of bored pile is improved with increased bearing capacity and reduced settlement.

[Radical resection of a hilar cholangiocarcinoma. Indications and results].

PubMed

Lladó, Laura; Ramos, Emilio; Torras, Jaume; Fabregat, Joan; Jorba, Rosa; Valls, Carles; Julià, David; Serrano, Teresa; Figueras, Joan; Rafecas, Antoni

2008-03-01

The objective of the study is to review our experience in the surgical treatment of Klatskin tumours, after the systematic application of the current concepts of radicalism. Sixty-one patients resected using these criteria are presented. We have studied 154 patients. Surgery was ruled out in 59 (41%) of them, and a liver transplant was performed on 9; of the 86 patients operated on, 25 were resectable. Resectability was 71% (of the 86 patients operated on) and was 39% of the total patients. The results during two periods are compared, 1989-1998 (pre-99) and 1999-2007 (post-99). On comparing the two periods, resectability increased from 26% to 53% (p = 0.01), the percentage of exploratory laparotomies decreasing (pre: 45% vs post: 22%; p = 0.04). Hepatectomy was performed in 53 cases (87%), being most frequent post-99 (pre: 66% vs post: 91%; p = 0.02). Resection of the caudate was performed in 48 cases (90%), being most frequent in the post-99 period (pre: 40% vs pos: 89%; p = 0.005). Post-operative morbidity was 77%, with 28% the patients being re-operated on, and the post-operative mortality was 16.4%, with no significant differences between the periods. Actuarial survival at 5 years increases in the post-99 period (pre: 26% vs post: 51%; p = 0.06). Adequate staging, associated with an aggressive surgical strategy can achieve a greater than 50% resectability rate. The post-operative morbidity and mortality of this strategy is high, but the survival that it achieves justifies this.

Prehistoric contacts over the Straits of Gibraltar indicated by genetic analysis of Iberian Bronze Age cattle

PubMed Central

Anderung, Cecilia; Bouwman, Abigail; Persson, Per; Carretero, José Miguel; Ortega, Ana Isabel; Elburg, Rengert; Smith, Colin; Arsuaga, Juan Luis; Ellegren, Hans; Götherström, Anders

2005-01-01

The geographic situation of the Iberian Peninsula makes it a natural link between Europe and North Africa. However, it is a matter of debate to what extent African influences via the Straits Gibraltar have affected Iberia's prehistoric development. Because early African pastoralist communities were dedicated to cattle breeding, a possible means to detect prehistoric African–Iberian contacts might be to analyze the origin of cattle breeds on the Iberian Peninsula. Some contemporary Iberian cattle breeds show a mtDNA haplotype, T1, that is characteristic to African breeds, generally explained as being the result of the Muslim expansion of the 8th century A.D., and of modern imports. To test a possible earlier African influence, we analyzed mtDNA of Bronze Age cattle from the Portalón cave at the Atapuerca site in northern Spain. Although the majority of samples showed the haplotype T3 that dominates among European breeds of today, the T1 haplotype was found in one specimen radiocarbon dated 1800 calibrated years B.C. Accepting T1 as being of African origin, this result indicates prehistoric African–Iberian contacts and lends support to archaeological finds linking early African and Iberian cultures. We also found a wild ox haplotype in the Iberian Bronze Age sample, reflecting local hybridization or backcrossing or that aurochs were hunted by these farming cultures. PMID:15941827

Maximal Power of the Lower Limbs of Youth Gymnasts and Biomechanical Indicators of the Forward Handspring Vault Versus the Sports Result

PubMed Central

Kochanowicz, Andrzej; Kochanowicz, Kazimierz; Mieszkowski, Jan; Aschenbrenner, Piotr; Bielec, Grzegorz; Szark-Eckardt, Mirosława

2016-01-01

Abstract The aim of the study was to define the relationship between maximal power of lower limbs, the biomechanics of the forward handspring vault and the score received during a gymnastics competition. The research involved 42 gymnasts aged 9-11 years competing in the Poland’s Junior Championships. The study consisted of three stages: first -estimating the level of indicators of maximal power of lower limbs tested on a force plate during the countermovement jump; second - estimating the level of biomechanical indicators of the front handspring vault. For both mentioned groups of indicators and the score received by gymnasts during the vault, linear correlation analyses were made. The last stage consisted of conducting multiple regression analysis in order to predict the performance level of the front handspring vault. Results showed a positive correlation (0.401, p < 0.05) of lower limbs’ maximal power (1400 ± 502 W) with the judges’ score for the front handstand vault (13.38 ± 1.02 points). However, the highest significant (p < 0.001) correlation with the judges’ score was revealed in the angle of the hip joint in the second phase of the flight (196.00 ± 16.64°) and the contact time of hands with the vault surface (0.264 ± 0.118 s), where correlation coefficients were: -0.671 and -0.634, respectively. In conclusion, the angles of the hip joint in the second phase of the flight and when the hands touched the vault surface proved to be the most important indicators for the received score. PMID:28149408

Progressively implementation of the new degrees at E.T.S. of Agriculture Engineering and extinction of the earlier degrees

NASA Astrophysics Data System (ADS)

Arce, A.; Caniego, J.; Vazquez, J.; Serrano, A.; Tarquis, A. M.; Cartagena, M. C.

2012-04-01

The Bologna process is to improve the quality of education, mobility, diversity and the competitiveness and involves three fundamental changes: transform of the structure of titles, changing in methods of teaching and implementation of the systems of quality assurance. Once that the new degrees have been implemented with this structure, and began at E.T.S. of Agriculture Engineering (ETSIA) at Madrid from 2010-2011 course, the main aim of this work is to deeply study the changes in teaching methodology as well as progressively implementation of the educational planning of the three new degrees: Engineering and Agronomic Graduate, Food Industry Engineering Graduate and Agro-environmental Graduate. Each one of them presents 240 ECTS with a common first course and will have access to an official Master in Agronomic Engineering. As part as an educational innovation project awarded by the Technical University of Madrid (UPM) to improve educational quality, the second course has been designed with the main objective to continue the educative model implemented last course. This model identifies several teaching activities and represents a proper teaching style at ETSIA-UPM. At the same time, a monitoring and development coordination plans have been established. On the other hand, a procedure to extinguish the earlier plans of Agriculture Engineering was also defined. Other activities related to this Project were the information improvement of the grades, in particular at High Schools centers, improving the processes of reception, counseling and tutoring and mentoring. Likewise, cooperative working workshops and programs to support the teaching of English language were implemented. Satisfaction surveys and opinion polls were done to professors and students involved in first course in order to test several aspects of this project. The students surveys were analyzed taking in account the academic results and their participation in mentoring activities giving a highly

Effects of an advanced temperature cycle on smolt development and endocrinology indicate that temperature is not a zeitgeber for smolting in Atlantic salmon

USGS Publications Warehouse

McCormick, S.D.; Shrimpton, J.M.; Moriyama, S.; Bjornsson, Bjorn Thrandur

2002-01-01

Atlantic salmon (Salmo salar) juveniles were reared under simulated conditions of normal photoperiod (LDN) or short days (LD 9:15) and ambient temperature (AMB: normal temperature increases in April) or an advanced temperature cycle (ADV: temperature increases in February). Under both photoperiod conditions, the timing of increased and peak levels of gill Na+,K+-ATPase activity were not altered by temperature, although the rate of increase was initially greater under ADV. ADV/LD 9:15 resulted in peak gill Na+,K+-ATPase activity that was half of that seen under normal photoperiod and temperature conditions. Plasma growth hormone (GH) levels increased threefold in late March under ADV/LDN, but not under ADV/LD 9:15, indicating that there is a photoperiod-dependent effect of temperature on levels of this hormone. Plasma insulin-like growth factor I (IGF-I) increased in spring in all groups, with increases occurring significantly earlier in the ADV/LDN group. In each photoperiod condition, the advanced temperature cycle resulted in large decreases in plasma thyroxine (T4) levels in March, which subsequently recovered, whereas plasma 3,5,3???-triiodo-L-thyronine (T3) levels were not substantially affected by either photoperiod or temperature. There was no consistent pattern of change in plasma cortisol levels. The results do not provide support for the role of temperature as a zeitgeber, but do indicate that temperature has a role in the timing of smolting by affecting the rate of development and interacting with the photoperiod.

Evaluating the ClimEx Single Model Large Ensemble in Comparison with EURO-CORDEX Results of Seasonal Means and Extreme Precipitation Indicators

NASA Astrophysics Data System (ADS)

von Trentini, F.; Schmid, F. J.; Braun, M.; Brisette, F.; Frigon, A.; Leduc, M.; Martel, J. L.; Willkofer, F.; Wood, R. R.; Ludwig, R.

2017-12-01

Meteorological extreme events seem to become more frequent in the present and future, and a seperation of natural climate variability and a clear climate change effect on these extreme events gains more and more interest. Since there is only one realisation of historical events, natural variability in terms of very long timeseries for a robust statistical analysis is not possible with observation data. A new single model large ensemble (SMLE), developed for the ClimEx project (Climate change and hydrological extreme events - risks and perspectives for water management in Bavaria and Québec) is supposed to overcome this lack of data by downscaling 50 members of the CanESM2 (RCP 8.5) with the Canadian CRCM5 regional model (using the EURO-CORDEX grid specifications) for timeseries of 1950-2099 each, resulting in 7500 years of simulated climate. This allows for a better probabilistic analysis of rare and extreme events than any preceding dataset. Besides seasonal sums, several extreme indicators like R95pTOT, RX5day and others are calculated for the ClimEx ensemble and several EURO-CORDEX runs. This enables us to investigate the interaction between natural variability (as it appears in the CanESM2-CRCM5 members) and a climate change signal of those members for past, present and future conditions. Adding the EURO-CORDEX results to this, we can also assess the role of internal model variability (or natural variability) in climate change simulations. A first comparison shows similar magnitudes of variability of climate change signals between the ClimEx large ensemble and the CORDEX runs for some indicators, while for most indicators the spread of the SMLE is smaller than the spread of different CORDEX models.

Additional road markings as an indication of speed limits: results of a field experiment and a driving simulator study.

PubMed

Daniels, Stijn; Vanrie, Jan; Dreesen, An; Brijs, Tom

2010-05-01

Although speed limits are indicated by road signs, road users are not always aware, while driving, of the actual speed limit on a given road segment. The Roads and Traffic Agency developed additional road markings in order to support driver decisions on speed on 70 km/h roads in Flanders-Belgium. In this paper the results are presented of two evaluation studies, both a field study and a simulator study, on the effects of the additional road markings on speed behaviour. The results of the field study showed no substantial effect of the markings on speed behaviour. Neither did the simulator study, with slightly different stimuli. Nevertheless an effect on lateral position was noticed in the simulator study, showing at least some effect of the markings. The role of conspicuity of design elements and expectations towards traffic environments is discussed. Both studies illustrate well some strengths and weaknesses of observational field studies compared to experimental simulator studies. Copyright (c) 2009 Elsevier Ltd. All rights reserved.

Delivering Quality and Choice. How Performance Indicators Help and How Performance Indicators Hinder. Research Report

ERIC Educational Resources Information Center

Perry, Adrian; Simpson, Matthew

2006-01-01

This document reports on a research project held in 2005, which looked to see how performance indicators related to area needs. It shows the results of research across four Learning and Skills Council (LSC) areas, with contributions also from national stakeholders and other witnesses. Findings include: (1) Performance indicators are regarded as…

Posttraumatic impingement syndrome of the ankle--indication and results of arthroscopic therapy.

PubMed

Arnold, Heino

2011-06-01

Persisting pain after an ankle sprain is often caused by the development of intraarticular fibrous scars or even tibiotalar spurs due to repetitive trauma. This may result in a posttraumatic impingement syndrome of the ankle. Pain is typically provoked by dorsiflexion of the ankle and palpation of the tibiotalar anterior joint space. The study evaluates the outcome of arthroscopic treatment of the ankle impingement syndrome. 32 patients are included (16-65 years, mean age 38 years) who underwent an arthroscopic operation because of an impingement syndrome of the ankle grades I-III (Scranton) due to a trauma without therapeutic response to conservative therapy over 3 months. Diagnostic criteria were palpatoric anterior ankle joint pain and pain provoked by dorsiflexion, in cases of grades II and III lesions spurs on the X-ray as well. The mean follow-up time was 49 months. The evaluation of the results was done with the West Point Ankle Score. The study is designed as a retrospective case series. 26 patients reached more than 80 points in the West Point Ankle Score corresponding to a good or excellent result (mean result 86 points, ranging from 80 to 98 points). The preoperative mean score reached up to 64 points overall (57-70). Five patients rated the postoperative result fair, one bad with 73 points at mean (62-78). Preoperatively they reached 56 point on an average (48-62). The fair and the poor results were associated with severe ankle sprain leading to ligament ruptures or fractures where severe chondral lesions were to be found with arthroscopy. The results of the study show that ankle arthroscopy with resection of hypertrophic synovium and fibrous bands (type I) or tibial spurs (types II and III injuries) after an ankle sprain haven proven to be a reliable therapy for a posttraumatic impingement syndrome of the ankle that does not respond to conservative treatment. It is characterized by low morbidity and good to excellent results in most cases. The outcome

Managerial preferences in relation to financial indicators regarding the mitigation of global change.

PubMed

Maroušek, Josef; Hašková, Simona; Zeman, Robert; Vaníčková, Radka

2015-02-01

Biochar is a soil-improving substrate made from phytomass pyrolysis. In Southeast Asia, its application decreases due to the long-term growth of biochar cost and thus caused further prolongation of the payback period. In the Euro-American civilization the biochar application is already almost forgotten once it has been much earlier recognized that the crop yields can be increased much faster with higher doses of nutrients and other agrochemicals. The payback period can be expected in decades. Such a long-time investment into soil fertility raises also many ethical questions. The final decision combines issues of social responsibility, risk and other financial indicators as well as personal preferences and more. The attitudes of Western and Central European decision makers in the agriculture business segment were analyzed on the basis of electronic questionnaire survey and a subsequent interview through their local unions. According to the data, most of them did not know about the possibilities of a more environmentally friendly approach to soil enhancement based on the addition of a fertilizer in the form of biochar. Among others, the collected data also shows that the decision makers from Western Europe have a much different ethical approach to the land and financial indicators than the Central Europeans.

An integrated, indicator framework for assessing large-scale variations and change in seasonal timing and phenology (Invited)

NASA Astrophysics Data System (ADS)

Betancourt, J. L.; Weltzin, J. F.

2013-12-01

As part of an effort to develop an Indicator System for the National Climate Assessment (NCA), the Seasonality and Phenology Indicators Technical Team (SPITT) proposed an integrated, continental-scale framework for understanding and tracking seasonal timing in physical and biological systems. The framework shares several metrics with the EPA's National Climate Change Indicators. The SPITT framework includes a comprehensive suite of national indicators to track conditions, anticipate vulnerabilities, and facilitate intervention or adaptation to the extent possible. Observed, modeled, and forecasted seasonal timing metrics can inform a wide spectrum of decisions on federal, state, and private lands in the U.S., and will be pivotal for international efforts to mitigation and adaptation. Humans use calendars both to understand the natural world and to plan their lives. Although the seasons are familiar concepts, we lack a comprehensive understanding of how variability arises in the timing of seasonal transitions in the atmosphere, and how variability and change translate and propagate through hydrological, ecological and human systems. For example, the contributions of greenhouse warming and natural variability to secular trends in seasonal timing are difficult to disentangle, including earlier spring transitions from winter (strong westerlies) to summer (weak easterlies) patterns of atmospheric circulation; shifts in annual phasing of daily temperature means and extremes; advanced timing of snow and ice melt and soil thaw at higher latitudes and elevations; and earlier start and longer duration of the growing and fire seasons. The SPITT framework aims to relate spatiotemporal variability in surface climate to (1) large-scale modes of natural climate variability and greenhouse gas-driven climatic change, and (2) spatiotemporal variability in hydrological, ecological and human responses and impacts. The hierarchical framework relies on ground and satellite observations

New PIAAC Results: Care Is Needed in Reading Reports of International Surveys

ERIC Educational Resources Information Center

Evans, Jeff

2014-01-01

Results from the Survey of Adult Skills, also known as PIAAC (Programme for the International Assessment of Adult Competencies), were recently made available for 24 participating countries. PIAAC involves several developments in relation to the earlier international "adult skills" surveys (IALS in the 1990s and ALL in the 2000s), notably…

Impact of community-based interventions on maternal and neonatal health indicators: Results from a community randomized trial in rural Balochistan, Pakistan.

PubMed

Midhet, Farid; Becker, Stan

2010-11-05

Pakistan has high maternal mortality, particularly in the rural areas. The delay in decision making to seek medical care during obstetric emergencies remains a significant factor in maternal mortality. We present results from an experimental study in rural Pakistan. Village clusters were randomly assigned to intervention and control arms (16 clusters each). In the intervention clusters, women were provided information on safe motherhood through pictorial booklets and audiocassettes; traditional birth attendants were trained in clean delivery and recognition of obstetric and newborn complications; and emergency transportation systems were set up. In eight of the 16 intervention clusters, husbands also received specially designed education materials on safe motherhood and family planning. Pre- and post-intervention surveys on selected maternal and neonatal health indicators were conducted in all 32 clusters. A district-wide survey was conducted two years after project completion to measure any residual impact of the interventions. Pregnant women in intervention clusters received prenatal care and prophylactic iron therapy more frequently than pregnant women in control clusters. Providing safe motherhood education to husbands resulted in further improvement of some indicators. There was a small but significant increase in percent of hospital deliveries but no impact on the use of skilled birth attendants. Perinatal mortality reduced significantly in clusters where only wives received information and education in safe motherhood. The survey to assess residual impact showed similar results. We conclude that providing safe motherhood education increased the probability of pregnant women having prenatal care and utilization of health services for obstetric complications.

Mars Science Laboratory relative humidity observations: Initial results

PubMed Central

Harri, A-M; Genzer, M; Kemppinen, O; Gomez-Elvira, J; Haberle, R; Polkko, J; Savijärvi, H; Rennó, N; Rodriguez-Manfredi, JA; Schmidt, W; Richardson, M; Siili, T; Paton, M; Torre-Juarez, M De La; Mäkinen, T; Newman, C; Rafkin, S; Mischna, M; Merikallio, S; Haukka, H; Martin-Torres, J; Komu, M; Zorzano, M-P; Peinado, V; Vazquez, L; Urqui, R

2014-01-01

The Mars Science Laboratory (MSL) made a successful landing at Gale crater early August 2012. MSL has an environmental instrument package called the Rover Environmental Monitoring Station (REMS) as a part of its scientific payload. REMS comprises instrumentation for the observation of atmospheric pressure, temperature of the air, ground temperature, wind speed and direction, relative humidity (REMS-H), and UV measurements. We concentrate on describing the REMS-H measurement performance and initial observations during the first 100 MSL sols as well as constraining the REMS-H results by comparing them with earlier observations and modeling results. The REMS-H device is based on polymeric capacitive humidity sensors developed by Vaisala Inc., and it makes use of transducer electronics section placed in the vicinity of the three humidity sensor heads. The humidity device is mounted on the REMS boom providing ventilation with the ambient atmosphere through a filter protecting the device from airborne dust. The final relative humidity results appear to be convincing and are aligned with earlier indirect observations of the total atmospheric precipitable water content. The water mixing ratio in the atmospheric surface layer appears to vary between 30 and 75 ppm. When assuming uniform mixing, the precipitable water content of the atmosphere is ranging from a few to six precipitable micrometers. Key Points Atmospheric water mixing ratio at Gale crater varies from 30 to 140 ppm MSL relative humidity observation provides good data Highest detected relative humidity reading during first MSL 100 sols is RH75% PMID:26213667

Estimation of process capability indices from the results of limit gauge inspection of dimensional parameters in machining industry

NASA Astrophysics Data System (ADS)

Masterenko, Dmitry A.; Metel, Alexander S.

2018-03-01

The process capability indices Cp, Cpk are widely used in the modern quality management as statistical measures of the ability of a process to produce output X within specification limits. The customer's requirement to ensure Cp ≥ 1.33 is often applied in contracts. Capability indices estimates may be calculated with the estimates of the mean µ and the variability 6σ, and for it, the quality characteristic in a sample of pieces should be measured. It requires, in turn, using advanced measuring devices and well-qualified staff. From the other hand, quality inspection by attributes, fulfilled with limit gauges (go/no-go) is much simpler and has a higher performance, but it does not give the numerical values of the quality characteristic. The described method allows estimating the mean and the variability of the process on the basis of the results of limit gauge inspection with certain lower limit LCL and upper limit UCL, which separates the pieces into three groups: where X < LCL, number of pieces is n1, where LCL ≤ X < UCL, n2 pieces, and where X ≥ UCL, n3 pieces. So-called Pittman-type estimates, developed by the author, are functions of n1, n2, n3 and allow calculation of the estimated µ and σ. Thus, Cp and Cpk also may be estimated without precise measurements. The estimates can be used in quality inspection of lots of pieces as well as in monitoring and control of the manufacturing process. It is very important for improving quality of articles in machining industry through their tolerance.

Cost and results of information systems for health and poverty indicators in the United Republic of Tanzania.

PubMed Central

Rommelmann, Vanessa; Setel, Philip W.; Hemed, Yusuf; Angeles, Gustavo; Mponezya, Hamisi; Whiting, David; Boerma, Ties

2005-01-01

OBJECTIVE: To examine the costs of complementary information generation activities in a resource-constrained setting and compare the costs and outputs of information subsystems that generate the statistics on poverty, health and survival required for monitoring, evaluation and reporting on health programmes in the United Republic of Tanzania. METHODS: Nine systems used by four government agencies or ministries were assessed. Costs were calculated from budgets and expenditure data made available by information system managers. System coverage, quality assurance and information production were reviewed using questionnaires and interviews. Information production was characterized in terms of 38 key sociodemographic indicators required for national programme monitoring. FINDINGS: In 2002-03 approximately US$ 0.53 was spent per Tanzanian citizen on the nine information subsystems that generated information on 37 of the 38 selected indicators. The census and reporting system for routine health service statistics had the largest participating populations and highest total costs. Nationally representative household surveys and demographic surveillance systems (which are not based on nationally representative samples) produced more than half the indicators and used the most rigorous quality assurance. Five systems produced fewer than 13 indicators and had comparatively high costs per participant. CONCLUSION: Policy-makers and programme planners should be aware of the many trade-offs with respect to system costs, coverage, production, representativeness and quality control when making investment choices for monitoring and evaluation. In future, formal cost-effectiveness studies of complementary information systems would help guide investments in the monitoring, evaluation and planning needed to demonstrate the impact of poverty-reduction and health programmes. PMID:16184275

Review of Cuttability Indices and A New Rockmass Classification Approach for Selection of Surface Miners

NASA Astrophysics Data System (ADS)

Dey, Kaushik; Ghose, A. K.

2011-09-01

Rock excavation is carried out either by drilling and blasting or using rock-cutting machines like rippers, bucket wheel excavators, surface miners, road headers etc. Economics of mechanised rock excavation by rock-cutting machines largely depends on the achieved production rates. Thus, assessment of the performance (productivity) is important prior to deploying a rock-cutting machine. In doing so, several researchers have classified rockmass in different ways and have developed cuttability indices to correlate machine performance directly. However, most of these indices were developed to assess the performance of road headers/tunnel-boring machines apart from a few that were developed in the earlier days when the ripper was a popular excavating equipment. Presently, around 400 surface miners are in operation around the world amongst which, 105 are in India. Until now, no rockmass classification system is available to assess the performance of surface miners. Surface miners are being deployed largely on trial and error basis or based on the performance charts provided by the manufacturer. In this context, it is logical to establish a suitable cuttability index to predict the performance of surface miners. In this present paper, the existing cuttability indices are reviewed and a new cuttability indexes proposed. A new relationship is also developed to predict the output from surface miners using the proposed cuttability index.

Earlier defibrotide initiation post-diagnosis of veno-occlusive disease/sinusoidal obstruction syndrome improves Day +100 survival following haematopoietic stem cell transplantation.

PubMed

Richardson, Paul G; Smith, Angela R; Triplett, Brandon M; Kernan, Nancy A; Grupp, Stephan A; Antin, Joseph H; Lehmann, Leslie; Miloslavsky, Maja; Hume, Robin; Hannah, Alison L; Nejadnik, Bijan; Soiffer, Robert J

2017-07-01

Hepatic veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) is a progressive, potentially fatal complication of conditioning for haematopoietic stem cell transplant (HSCT). The VOD/SOS pathophysiological cascade involves endothelial-cell activation and damage, and a prothrombotic-hypofibrinolytic state. Severe VOD/SOS (typically characterized by multi-organ dysfunction) may be associated with >80% mortality. Defibrotide is approved for treating severe hepatic VOD/SOS post-HSCT in the European Union, and for hepatic VOD/SOS with renal or pulmonary dysfunction post-HSCT in the United States. Previously, defibrotide (25 mg/kg/day in 4 divided doses for a recommended ≥21 days) was available through an expanded-access treatment protocol for patients with VOD/SOS. Data from this study were examined post-hoc to determine if the timing of defibrotide initiation post-VOD/SOS diagnosis affected Day +100 survival post-HSCT. Among 573 patients, defibrotide was started on the day of VOD/SOS diagnosis in approximately 30%, and within 7 days in >90%. The relationship between Day +100 survival and treatment initiation before/after specific days post-diagnosis showed superior survival when treatment was initiated closer to VOD/SOS diagnosis with a statistically significant trend over time for better outcomes with earlier treatment initiation (P < 0·001). These results suggest that initiation of defibrotide should not be delayed after diagnosis of VOD/SOS. © 2017 The Authors. British Journal of Haematology published by John Wiley & Sons Ltd.

49 CFR 236.762 - Locking, indication.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Locking, indication. 236.762 Section 236.762 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Locking, indication. Electric locking which prevents manipulation of levers that would result in an unsafe...

The Modern U.S. High School Astronomy Course, Its Status and Makeup II: Additional Results

ERIC Educational Resources Information Center

Krumenaker, Larry

2009-01-01

A postal survey of high school astronomy teachers strongly confirms many results of an earlier electronic survey. Additional and new results include a measure of the level of inquiry (more structured inquiry and teacher-led) in the classroom as well as data showing that more emphasis is given to traditional topics than to contemporary astronomy…

Further results on the stagnation point boundary layer with hydrogen injection.

NASA Technical Reports Server (NTRS)

Wu, P.; Libby, P. A.

1972-01-01

The results of an earlier paper on the behavior of the boundary layer at an axisymmetric stagnation with hydrogen injection into a hot external airstream are extended to span the entire range from essentially frozen to essentially equilibrium flow. This extension is made possible by the employment of finite difference methods; the accurate treatment of the boundary conditions at 'infinity,' the differencing technique employed and the formulation resulting in block tri-diagonal matrices are slight variants in the present work.

Early warning indicators for process failure due to organic overloading by rapeseed oil in one-stage continuously stirred tank reactor, sewage sludge and waste digesters.

PubMed

Kleyböcker, A; Liebrich, M; Verstraete, W; Kraume, M; Würdemann, H

2012-11-01

Early warning indicators for process failures were investigated to develop a reliable method to increase the production efficiency of biogas plants. Organic overloads by the excessive addition of rapeseed oil were used to provoke the decrease in the gas production rate. Besides typical monitoring parameters, as pH, methane and hydrogen contents, biogas production rate and concentrations of fatty acids; carbon dioxide content, concentrations of calcium and phosphate were monitored. The concentration ratio of volatile fatty acids to calcium acted as an early warning indicator (EWI-VFA/Ca). The EWI-VFA/Ca always clearly and reliably indicated a process imbalance by exhibiting a 2- to 3-fold increase 3-7days before the process failure occurred. At this time, it was still possible to take countermeasures successfully. Furthermore, increases in phosphate concentration and in the concentration ratio of phosphate to calcium also indicated a process failure, in some cases, even earlier than the EWI-VFA/Ca. Copyright © 2012 Elsevier Ltd. All rights reserved.

Extracorporeal shock wave lithotripsy of gallstones with oral dissolution. Results in course of ten years in Czech Republic in correlation to indication criteria.

PubMed

Benes, J; Chmel, J; Blazek, O; Marecek, Z

2001-01-01

We compared the results of treatment of gallbladder stones by extracorporeal shock wave lithotripsy with dissolution during two periods to different criteria of indication. In the first period (1990-1991) we treated patients with stones up to 3 cm in diameter. In the second period (1992-1994) the indication included stones up to 1.5 cm with gallbladder contraction on cholecystography, which was also quantitatively determined by USG exceeding 60% of fasting volume. We used Czech made lithotriptors MEDILIT. The shock waves (SW) are produced by an underwater high voltage discharge and the concentration of SW is achieved by reflection. The localization of stones is performed by means of a sonographic probe. After stone localization usually 700 SW are applied to a patient lying in prone position. Oral dissolution was started in both groups of patients two weeks before shock wave application. Ursodeoxycholic acid and chenodeoxycholic were administered in doses of 7.5 mg/kg body weight/day. In the first group of 260 patients (average age 42), which had moderate indication criteria, disappearance of fragments during one year was found only in 148 (57%). The remaining patients were treated symptomatically or recommended to cholecystectomy. In a second group of 160 patients (average age 45), disappearance of fragments during one year was achieved in 125 (78%). We used stricter indication criteria and our results are much better compared to the first group. Only 208 patients from both groups were controlled for more 5 years, in 89 cases of this number was a recidivity of lithiasis and at 20 of them we indicated cholecystectomy, 22 of the patients refused to continue in the therapy, because the stones are asymptomatic. In our opinion, this therapy (ESWL combined with oral dissolution) is suitable in 7% patients with gallbladder stones. Its side effects are very small, practically negligible. It can be performed without general anaesthesia and on an out-patient basis. After the

Sexual Function Is an Indicator of Central Arterial Stiffness and Arterial Stiffness Gradient in Japanese Adult Men.

PubMed

Kumagai, Hiroshi; Yoshikawa, Toru; Myoenzono, Kanae; Kosaki, Keisei; Akazawa, Nobuhiko; Asako, Zempo-Miyaki; Tsujimoto, Takehiko; Kidokoro, Tetsuhiro; Tanaka, Kiyoji; Maeda, Seiji

2018-05-05

As arterial stiffness increases in the absence of subjective symptoms, a personal indicator that reflects increased risk of cardiovascular disease is necessary. Penile erection is regulated by vascular function, and atherosclerosis affects the penile artery earlier than it affects the coronary and carotid arteries. Therefore, we hypothesized that deterioration of erectile function could be a marker of increased risk for cardiovascular disease. To test our hypothesis, we assessed erectile function and arterial stiffness in a cross-sectional study. Carotid-femoral pulse wave velocity (PWV), brachial-ankle PWV, femoral-ankle PWV, and arterial stiffness gradient (PWV ratio: carotid-femoral PWV/femoral-ankle PWV) were measured as indexes of central, systemic, and peripheral arterial stiffness and peripheral organ damage, respectively, in 317 adult men. In addition, erectile function was assessed by using the questionnaire International Index of Erectile Function 5 (a descending score indicates worsening of erectile function). The scores of male sexual function were inversely correlated with carotid-femoral PWV ( r s =-0.41), brachial-ankle PWV ( r s =-0.35), femoral-ankle PWV ( r s =-0.19), and PWV ratio ( r s =-0.33). Furthermore, multivariate linear regression analyses revealed that International Index of Erectile Function 5 scores were significantly associated with carotid-femoral PWV (β=-0.22) and PWV ratio (β=-0.25), but not with brachial-ankle PWV and femoral-ankle PWV. Our results indicated that erectile function is independently associated with central arterial stiffness and peripheral organ damage. These findings suggest that male sexual function could be an easily identifiable and independent marker of increased central arterial stiffness and peripheral organ damage. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Oral Exposure to Paraquat Triggers Earlier Expression of Phosphorylated α-Synuclein in the Enteric Nervous System of A53T Mutant Human α-Synuclein Transgenic Mice

PubMed Central

Naudet, Nicolas; Antier, Emilie; Gaillard, Damien; Morignat, Eric; Lakhdar, Latifa; Baron, Thierry; Bencsik, Anna

2017-01-01

Abstract The misfolded α-synuclein protein, phosphorylated at serine 129 (pSer129 α-syn), is the hallmark of Parkinson disease (PD). Detected also in the enteric nervous system (ENS), it supports the recent theory that PD could start in the gut, rather than the brain. In a previous study, using a transgenic mouse model of human synucleinopathies expressing the A53T mutant α-synuclein (TgM83), in which a neurodegenerative process associated with α-synuclein occurs spontaneously in the brain, we have shown earlier onset of pSer129 α-syn in the ENS. Here, we used this model to study the impact of paraquat (PQ) a neurotoxic herbicide incriminated in PD in agricultural workers) on the enteric pSer129 α-syn expression in young mice. Orally delivered in the drinking water at 10 mg/kg/day for 6–8 weeks, the impact of PQ was measured in a time-dependent manner on weight, locomotor abilities, pSer129 α-syn, and glial fibrillary acidic protein (GFAP) expression levels in the ENS. Remarkably, pSer129 α-syn was detected in ENS earlier under PQ oral exposure and enteric GFAP expression was also increased. These findings bring additional support to the theory that neurotoxic agents such as PQ initiate idiopathic PD after oral delivery. PMID:29040593

Oral Exposure to Paraquat Triggers Earlier Expression of Phosphorylated α-Synuclein in the Enteric Nervous System of A53T Mutant Human α-Synuclein Transgenic Mice.

PubMed

Naudet, Nicolas; Antier, Emilie; Gaillard, Damien; Morignat, Eric; Lakhdar, Latifa; Baron, Thierry; Bencsik, Anna

2017-12-01

The misfolded α-synuclein protein, phosphorylated at serine 129 (pSer129 α-syn), is the hallmark of Parkinson disease (PD). Detected also in the enteric nervous system (ENS), it supports the recent theory that PD could start in the gut, rather than the brain. In a previous study, using a transgenic mouse model of human synucleinopathies expressing the A53T mutant α-synuclein (TgM83), in which a neurodegenerative process associated with α-synuclein occurs spontaneously in the brain, we have shown earlier onset of pSer129 α-syn in the ENS. Here, we used this model to study the impact of paraquat (PQ) a neurotoxic herbicide incriminated in PD in agricultural workers) on the enteric pSer129 α-syn expression in young mice. Orally delivered in the drinking water at 10 mg/kg/day for 6-8 weeks, the impact of PQ was measured in a time-dependent manner on weight, locomotor abilities, pSer129 α-syn, and glial fibrillary acidic protein (GFAP) expression levels in the ENS. Remarkably, pSer129 α-syn was detected in ENS earlier under PQ oral exposure and enteric GFAP expression was also increased. These findings bring additional support to the theory that neurotoxic agents such as PQ initiate idiopathic PD after oral delivery. © 2017 American Association of Neuropathologists, Inc.

Adaption of cardio-respiratory balance during day-rest compared to deep sleep--an indicator for quality of life?

PubMed

von Bonin, Dietrich; Grote, Vincent; Buri, Caroline; Cysarz, Dirk; Heusser, Peter; Moser, Max; Wolf, Ursula; Laederach, Kurt

2014-11-30

Heart rate and breathing rate fluctuations represent interacting physiological oscillations. These interactions are commonly studied using respiratory sinus arrhythmia (RSA) of heart rate variability (HRV) or analyzing cardiorespiratory synchronization. Earlier work has focused on a third type of relationship, the temporal ratio of respiration rate and heart rate (HRR). Each method seems to reveal a specific aspect of cardiorespiratory interaction and may be suitable for assessing states of arousal and relaxation of the organism. We used HRR in a study with 87 healthy subjects to determine the ability to relax during 5 day-resting periods in comparison to deep sleep relaxation. The degree to which a person during waking state could relax was compared to somatic complaints, health-related quality of life, anxiety and depression. Our results show, that HRR is barely connected to balance (LF/HF) in HRV, but significantly correlates to the perception of general health and mental well-being as well as to depression. If relaxation, as expressed in HRR, during day-resting is near to deep sleep relaxation, the subjects felt healthier, indicated better mental well-being and less depressive moods. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Customising turnaround time indicators to requesting clinician: a 10-year study through balanced scorecard indicators.

PubMed

Salinas, Maria; López-Garrigós, Maite; Santo-Quiles, Ana; Gutierrez, Mercedes; Lugo, Javier; Lillo, Rosa; Leiva-Salinas, Carlos

2014-09-01

The purpose of this study is, first to present a 10-year monitoring of postanalytical turnaround time (TAT) adapted to different clinicians and patient situations, second to evaluate and analyse the indicators results during that period of time, and finally to show a synthetic appropriate indicator to be included in the balanced scorecard management system. TAT indicator for routine samples was devised as the percentage of certain key tests that were verified before a specific time on the phlebotomy day. A weighted mean synthetic indicator was also designed. They were calculated for inpatients at 15:00 and 12:00 and for primary care patients only at 15:00. The troponin TAT of emergency department patients, calculated as the difference between the troponin verification and registration time, was selected as the stat laboratory TAT indicator. The routine and stat TAT improved along the 10-year study period. The synthetic indicator showed the same trend. The implementation of systematic and continuous monitoring over years, promoted a continuous improvement in TAT which will probably benefit patient outcome and safety.

Late introduction of fish and eggs is associated with increased risk of allergy development – results from the FARMFLORA birth cohort

PubMed Central

Jonsson, K.; Barman, M.; Brekke, H. K.; Hesselmar, B.; Johansen, S.; Sandberg, A.-S.; Wold, A. E.

2017-01-01

ABSTRACT The prevalence of allergy is markedly low in children growing up on farms. An increasing number of studies indicate that the timing of food introduction may affect allergy development. We aimed to investigate if protection against allergy in farm environments may be mediated through differences in food-introduction practices between farm and non-farm families, using an explorative approach. Twenty-eight farm and 37 non-farm children were included in the FARMFLORA birth cohort. Practices of breastfeeding and introduction of formulas and complementary foods were collected by questionnaires at 6, 12, and 18 months of age. Allergy was diagnosed by pediatricians at 3 years of age. The only difference in food-introduction practices observed between farm and non-farm children was an earlier introduction of nuts in farmers (median month: 11 [IQR: 8–6] in farmers, 15 [12–19] in non-farmers). One farm child (4%) and 10 non-farm children (27%) were allergic at 3 years of age. Lower risk of allergy development was associated with early exclusive breastfeeding (continuous variable; OR = 0.59, 95% CI: 0.39–0.89), but also having received eggs (OR = 0.08, 95% CI: 0.13–0.54) and fish (logistic regression not applicable, P = 0.01 in likelihood ratio testing [χ2]) at 10 months of age or earlier compared to later. Our results were not affected by reverse causation, as judged by a questionnaire sent to the families in retrospect. Timing of introduction of complementary foods is unlikely to contribute to the lower risk of allergy among farm children. Although early exclusive breastfeeding was associated with a lower rate of allergy development, postponed introduction of complementary foods might increase the risk of developing allergy. Owing to the limited sample size, our results are only indicative, but support prior findings. PMID:29151834

Evaluating Training by Four Economic Indices.

ERIC Educational Resources Information Center

Rosentreter, Gary

1979-01-01

This study was intended to demonstrate the effectiveness of four selected economic indicators as criteria for evaluation of a manufacturing firm's management training program in communication skills. Though the results indicated that the program effected change only in employee turnover, the study supports the measurement of training by economic…

Sexual violence victimization history and sexual risk indicators in a community-based urban cohort of "mostly heterosexual" and heterosexual young women.

PubMed

Austin, S Bryn; Roberts, Andrea L; Corliss, Heather L; Molnar, Beth E

2008-06-01

We sought to examine sexual violence victimization in childhood and sexual risk indicators in young adulthood in a primarily Latina and Black cohort of "mostly heterosexual" and heterosexual women in the Project on Human Development in Chicago Neighborhoods (PHDCN). In 2000, a comprehensive survey that assessed sexual orientation, sexual risk indicators, and sexual abuse victimization was completed by 391 young women (aged 18 to 24 years) who had participated in PHDCN. We used multivariable regression methods to examine sexual orientation group differences in sexual risk indicators and to assess whether childhood sexual abuse may mediate relationships. Compared with self-reported heterosexual women, self-reported "mostly heterosexual" women were more likely to report having been the victim of childhood sexual abuse, to have had a sexually transmitted infection, to report an earlier age of first sexual intercourse, and to have had more sexual partners. Childhood sexual abuse did not mediate relationships between sexual orientation and sexual risk indicators. Our findings add to the evidence that "mostly heterosexual" women experience greater health risk than do heterosexual women. In addition, "mostly heterosexual" women are at high risk for having experienced childhood sexual abuse.

Indicators of Late Emerging Reading-Accuracy Difficulties in Australian Schools

ERIC Educational Resources Information Center

Galletly, Susan A.; Knight, Bruce Allen; Dekkers, John; Galletly, Tracey A.

2009-01-01

Late-emerging reading-accuracy difficulties are those found present in older students not showing reading-accuracy difficulties when tested in earlier years (Leach, Scarborough and Rescorla, 2003). This paper discusses the constructs of reading-accuracy and late-emerging reading-accuracy difficulties. It then discusses data from a cross-sectional…

Use of comparative performance indicators in rehabilitation.

PubMed

Zidarov, Diana; Poissant, Lise; Sicotte, Claude

The development of performance indicators that enable benchmarking between organizations is an important mechanism for accountability, organizational learning, and performance improvement. In the province of Quebec (Canada), 21 rehabilitation organizations developed a common set of performance indicators through interorganizational collaboration. The aims of this study were to describe the rehabilitation organizations' use of a common set of performance indicators and to identify the factors influencing such use. A qualitative survey was performed. Individual semistructured interviews were conducted with executives (n = 18) working at 16 rehabilitation organizations using a common set of performance indicators. A thematic analysis of the factors of use was performed according to the Consolidated Framework for Implementation Research. The use of performance indicators was categorized as purposeful, political, or passive. Our results showed that all organizations used the common set of performance indicators. Four factors were identified as important to all the rehabilitation organizations to explain their interest in comparative performance indicators: the need to develop their own performance indicators, the compatibility of performance information with organizational needs, complexity/simplicity of performance information, and the support offered by their common association. Sixty-three percent of rehabilitation organizations made purposeful or political use of performance indicators. Three main factors contributed to typify those organizations from the others: the perceived quality of the performance indicators, the leadership of decision makers, and the resources available. Our results showed that use of performance indicators can support the initiation of projects for improving the quality of care. Key recommendations are proposed to decision makers that may enhance performance indicators' use.

Hepatitis B and C virus prevalence in couples attending an in vitro fertilization clinic in a tertiary care hospital in Saudi Arabia: comparison with ten years earlier.

PubMed

Albadran, Asma; Hibshi, Ali; Saeed, Bahjat; Coskun, Serdar; Awartani, Khalid Arab

2017-01-01

Viral hepatitis B (HBV) and C (HCV) are a major public health problem in Saudi Arabia. Recent data has indicated a major reduction in viral hepatitis prevalence in Saudi population. However, there is limited data for infertile Saudi couples. To determine the prevalence of HCV and HBV attending an in vitro fertilization (IVF) clinic in Saudi Arabia between 2012 and 2015 to compare with the prevalence 10 years earlier in the same center. Retrospective prevalence study. Tertiary care center in Riyadh. Data on the prevalence of HBV and HCV was collected on all couples seen at the IVF unit between 2002-2005 and 2012-2015. Prevalence of HBV and HCV. In 4442 patients during 2002-2005 and 5747 patients during 2012-2015, the prevalence of HBV was significantly less in 2012-2015 compared with 2002-2005 (1.67% [97 patients] vs 4.7% [210 patients], P < .0001), respectively, but HCV prevalence was similar for the two periods (0.7% for both periods) (P=.887). The hepatitis B seroprevalence rate was higher in males compared to females during 2002-2005 (6.3% vs 3.1%) (P < .0001) and 2012-2015 (2.4% vs 1.1% ) (P < .0001), respectively. The significant drop in HBV prevalence was most likely due to the introduction of the vaccination program in 1989, while reasons for HCV prevalence remaining unchanged are unclear. No data on confounding factors that may have affected the prevalence.

Institutional Sources of Articles in the Rehabilitation Counseling Bulletin Revisited: 1971-76

ERIC Educational Resources Information Center

Rasch, John D.; Thomas, Kenneth R.

1978-01-01

This article is a follow-up to an earlier survey in which the institutional sources of scholarly contributions to the Rehabilitation Counseling Bulletin from 1962-71 were identified. Results for the last five years indicate both substantial similarities and differences from the earlier survey. (Author)

Developing transboundary river basin monitoring programmes using the DPSIR indicator framework.

PubMed

Timmerman, J G; Beinat, E; Termeer, C J A M; Cofino, W P

2011-10-01

Policymakers are often dissatisfied by the lack of what they consider useful information to support water management. Analysis of this 'water information gap' shows that this is caused by a lack of proper communication between information users and information producers. To improve this communication the process of specification of information needs has been structured. Earlier experiences showed that this not only entailed developing a structure to manage the process, but also developing a structure to guide the breakdown of policy objectives into information needs. Such a structure to organise the problem supports policy makers and monitoring specialists in their communication. This paper describes three pilot projects where the DPSIR indicator framework was used to organise the problem. It is concluded that the DPSIR framework is useful for improving the communication between information users and information producers and is helpful in breaking down policy objectives into information needs in a structured way. The structured approach in this way assists in narrowing the water information gap. Use of the DPSIR framework however leads to a bias towards water management problems and does not provide for all the relevant information needs.

Instrumental Landing Using Audio Indication

NASA Astrophysics Data System (ADS)

Burlak, E. A.; Nabatchikov, A. M.; Korsun, O. N.

2018-02-01

The paper proposes an audio indication method for presenting to a pilot the information regarding the relative positions of an aircraft in the tasks of precision piloting. The implementation of the method is presented, the use of such parameters of audio signal as loudness, frequency and modulation are discussed. To confirm the operability of the audio indication channel the experiments using modern aircraft simulation facility were carried out. The simulated performed the instrument landing using the proposed audio method to indicate the aircraft deviations in relation to the slide path. The results proved compatible with the simulated instrumental landings using the traditional glidescope pointers. It inspires to develop the method in order to solve other precision piloting tasks.

Quality indicators for eye bank.

PubMed

Acharya, Manisha; Biswas, Saurabh; Das, Animesh; Mathur, Umang; Dave, Abhishek; Singh, Ashok; Dubey, Suneeta

2018-03-01

The aim of this study is to identify quality indicators of the eye bank and validate their effectivity. Adverse reaction rate, discard rate, protocol deviation rate, and compliance rate were defined as Quality Indicators of the eye bank. These were identified based on definition of quality that captures two dimensions - "result quality" and "process quality." The indicators were measured and tracked as part of quality assurance (QA) program of the eye bank. Regular audits were performed to validate alignment of standard operating procedures (SOP) with regulatory and surgeon acceptance standards and alignment of activities performed in the eye bank with the SOP. Prospective study of the indicators was performed by comparing their observed values over the period 2011-2016. Adverse reaction rate decreased more than 8-fold (from 0.61% to 0.07%), discard rate decreased and stabilized at 30%, protocol deviation rate decreased from 1.05% to 0.08%, and compliance rate reported by annual quality audits improved from 59% to 96% at the same time. In effect, adverse reaction rate, discard rate, and protocol deviation rate were leading indicators, and compliance rate was the trailing indicator. These indicators fulfill an important gap in available literature on QA in eye banking. There are two ways in which these findings can be meaningful. First, eye banks which are new to quality measurement can adopt these indicators. Second, eye banks which are already deeply engaged in quality improvement can test these indicators in their eye bank, thereby incorporating them widely and improving them over time.

Third chronological supplement to the carcinogenic potency database: standardized results of animal bioassays published through December 1986 and by the National Toxicology Program through June 1987.

PubMed Central

Gold, L S; Slone, T H; Backman, G M; Eisenberg, S; Da Costa, M; Wong, M; Manley, N B; Rohrbach, L; Ames, B N

1990-01-01

This paper is the third chronological supplement to the Carcinogenic Potency Database that first appeared in this journal in 1984. We report here results of carcinogenesis bioassays published in the general literature between January 1985 and December 1986, and in Technical Reports of the National Toxicology Program between June 1986 and June 1987. This supplement includes results of 337 long-term, chronic experiments of 121 compounds, and reports the same information about each experiment in the same plot format as the earlier papers, e.g., the species and strain of animal, the route and duration of compound administration, dose level, and other aspects of experimental protocol, histopathology, and tumor incidence, TD50 (carcinogenic potency) and its statistical significance, dose response, opinion of the author about carcinogenicity, and literature citation. The reader needs to refer to the 1984 publication for a guide to the plot of the database, a complete description of the numerical index of carcinogenic potency, and a discussion of the sources of data, the rationale for the inclusion of particular experiments and particular target sites, and the conventions adopted in summarizing the literature. The four plots of the database are to be used together as results published earlier are not repeated. In all, the four plots include results for approximately 4000 experiments on 1050 chemicals. Appendix 14 of this paper is an alphabetical index to all chemicals in the database and indicates which plot(s) each chemical appears in. A combined plot of all results from the four separate papers, that is ordered alphabetically by chemical, is available from the first author, in printed form or on computer tape or diskette. PMID:2351123

[Indicator condition guided human immunodeficiency virus requesting in primary health care: results of a collaboration].

PubMed

Cayuelas-Redondo, Laia; Menacho-Pascual, Ignacio; Noguera-Sánchez, Pablo; Goicoa-Gago, Carmen; Pollio-Peña, Gernónimo; Blanco-Delgado, Rebeca; Barba-Ávila, Olga; Sequeira-Aymar, Ethel; Muns, Mercè; Clusa, Thais; García, Felipe; León, Agathe

2015-12-01

The search of HIV infected patients guided by indicator conditions (IC) is a strategy used to increase the early detection of HIV. The objective is to analyze whether a collaboration to raise awareness of the importance of early detection of HIV in 3 primary care centers influenced the proportion of HIV serology requested. Multicenter retrospective study was conducted comparing the baseline and a post-collaboration period. The collaboration consisted of training sessions and participation in the HIDES study (years 2009-2010). Patients between 18 and 64 years old with newly diagnosed herpes zoster, seborrheic eczema, mononucleosis syndrome, and leucopenia/thrombocytopenia in 3 primary care centers in 2008 (baseline period) and 2012 (post-collaboration period). The sociodemographic variables, HIV risk conditions, requests for HIV serology, and outcomes were evaluated. A total of 1,219 ICs were included (558 in 2008 and 661 in 2012). In 2008 the number of HIV tests in patients with an IC was 3.9%, and rose to 11.8% in 2012 (P<.0001). The HIV infection rate was 2.2% (95% CI: 0.4-7.3) (n=2). It was estimated that 25 new cases (12 in 2008 and 13 in 2012) would have been diagnosed if they had performed the test on all patients with IC. Predictors of HIV request were, having an IC in 2012, a younger age, having an mononucleosis syndrome, and not being Spanish. The HIV request demand tripled, after the collaboration with primary care centers, however in 88% the test was not requested, resulting in diagnostic losses. New strategies are needed to raise awareness of the importance of early detection of HIV. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Results from an absolute gravity survey in the United States

NASA Technical Reports Server (NTRS)

Zumberge, M. A.; Faller, J. E.; Gschwind, J.

1983-01-01

Using the recently completed JTLA absolute gravity meter, we made a survey of twelve sites in the United States. Over a period of eight weeks, the instrument was driven a total distance of nearly 20,000 km to sites in California, New Mexico, Colorado, Wyoming, Maryland and Massachusetts. The time spent in carrying out a measurement at a single location was typically one day. We report the results of the measurements in this survey along with earlier measurements made with the instrument, discuss the measurement accuracy and compare our results with other measurements. Previously announced in STAR as N83-20480

Results from an absolute gravity survey in the United States

NASA Astrophysics Data System (ADS)

Zumberge, M. A.; Faller, J. E.; Gschwind, J.

1983-09-01

Using the recently completed JTLA absolute gravity meter, we made a survey of twelve sites in the United States. Over a period of eight weeks, the instrument was driven a total distance of nearly 20,000 km to sites in California, New Mexico, Colorado, Wyoming, Maryland and Massachusetts. The time spent in carrying out a measurement at a single location was typically one day. We report the results of the measurements in this survey along with earlier measurements made with the instrument, discuss the measurement accuracy and compare our results with other measurements. Previously announced in STAR as N83-20480

"Beauty contest" indicator of cognitive ability and free riding strategies. Results from a scenario experiment about pandemic flu immunization.

PubMed

Rönnerstrand, Björn

2017-03-01

High immunization coverage rates are desirable in order to reduce total morbidity and mortality rates, but it may also provide an incentive for herd immunity free riding strategies. The aim of this paper was to investigate the link between cognitive ability and vaccination intention in a hypothetical scenario experiment about Avian Flu immunization. A between-subject scenario experiment was utilized to examine the willingness to undergo vaccination when the vaccination coverage was proclaimed to be 36, 62 and 88%. Respondents were later assigned to a "Beauty contest" experiment, an experimental game commonly used to investigate individual's cognitive ability. Results show that there was a significant negative effect of the proclaimed vaccination uptake among others on the vaccination intention. However, there were no significant association between the "Beauty contest" indicator of cognitive ability and the use of herd immunity free riding strategies.

Aircraft rate-of-climb indicators

NASA Technical Reports Server (NTRS)

Johnson, Daniel P

1939-01-01

The theory of the rate-of-climb indicator is developed in a form adapted for application to the instrument in its present-day form. Compensations for altitude, temperature, and rate of change of temperature are discussed from the designer's standpoint on the basis of this theory. Certain dynamic effects, including instrument lag, and the use of the rate-of-climb indicator as a statoscope are also considered. Modern instruments are described. A laboratory test procedure is outlined and test results are given.

Developing Scoring Algorithms (Earlier Methods)

Cancer.gov

We developed scoring procedures to convert screener responses to estimates of individual dietary intake for fruits and vegetables, dairy, added sugars, whole grains, fiber, and calcium using the What We Eat in America 24-hour dietary recall data from the 2003-2006 NHANES.

Classifying Cereal Data (Earlier Methods)

Cancer.gov

The DSQ includes questions about cereal intake and allows respondents up to two responses on which cereals they consume. We classified each cereal reported first by hot or cold, and then along four dimensions: density of added sugars, whole grains, fiber, and calcium.

Microbial Communities as Environmental Indicators of Ecological Disturbance in Restored Carbonate Fen-Results of 10 Years of Studies.

PubMed

Mieczan, Tomasz; Tarkowska-Kukuryk, Monika

2017-08-01

Interactions between bacteria and protists are essential to the ecosystem ecology of fens. Until now, however, there has been almost no information on how restoration procedures in carbonate fens affect the functioning of microbial food webs. Changes in vegetation patterns resulting from restoration may take years to be observed, whereas microbial processes display effects even after short-term exposure to changes in environmental conditions caused by restoration. Therefore, microbial processes and patterns can be used as sensitive indicators of changes in environmental conditions. The present study attempts to verify the hypothesis that the species richness and abundance of microbial loop components would differ substantially before and after restoration. The effect of restoration processes on the functioning of the food web was investigated for a 10 years in a carbonate-rich fen, before and after restoration. The restoration procedure (particularly the improvement in hydrological conditions) distinctly modified the taxonomic composition and functioning of microbial food webs. This is reflected in the increased abundance and diversity of testate amoeba, i.e. top predators, within the microbial food web and in the pronounced increase in the abundance of bacteria. This study suggests potential use of microbial loop components as bio-indicators and bio-monitoring tools for hydrological status of fens and concentrations of nutrients. Better understanding of what regulates microbial populations and activity in fens and unravelling of these fundamental mechanisms are particularly critical in order to more accurately predict how fens will respond to global change or anthropogenic disturbances.

ELUCIDATING THE MECHANISMS BEHIND SUCCESSFUL INDICATORS OF BIODIVERSITY

EPA Science Inventory

Groups of species have been proposed as indicators of biodiversity for use in conservation planning. Different tests of indicator groups have produced divergent results varying with taxonomy, methodology, scale, and location. At large scales, successful indicator groups should b...

Using the Theoretical Domains Framework (TDF) to understand adherence to multiple evidence-based indicators in primary care: a qualitative study.

PubMed

Lawton, Rebecca; Heyhoe, Jane; Louch, Gemma; Ingleson, Emma; Glidewell, Liz; Willis, Thomas A; McEachan, Rosemary R C; Foy, Robbie

2016-08-08

There are recognised gaps between evidence and practice in general practice, a setting posing particular implementation challenges. We earlier screened clinical guideline recommendations to derive a set of 'high-impact' indicators based upon criteria including potential for significant patient benefit, scope for improved practice and amenability to measurement using routinely collected data. Here, we explore health professionals' perceived determinants of adherence to these indicators, examining the degree to which determinants were indicator-specific or potentially generalisable across indicators. We interviewed 60 general practitioners, practice nurses and practice managers in West Yorkshire, the UK, about adherence to four indicators: avoidance of risky prescribing; treatment targets in type 2 diabetes; blood pressure targets in treated hypertension; and anticoagulation in atrial fibrillation. Interview questions drew upon the Theoretical Domains Framework (TDF). Data were analysed using framework analysis. Professional role and identity and environmental context and resources featured prominently across all indicators whilst the importance of other domains, for example, beliefs about consequences, social influences and knowledge varied across indicators. We identified five meta-themes representing more general organisational and contextual factors common to all indicators. The TDF helped elicit a wide range of reported determinants of adherence to 'high-impact' indicators in primary care. It was more difficult to pinpoint which determinants, if targeted by an implementation strategy, would maximise change. The meta-themes broadly underline the need to align the design of interventions targeting general practices with higher level supports and broader contextual considerations. However, our findings suggest that it is feasible to develop interventions to promote the uptake of different evidence-based indicators which share common features whilst also including

High Pressure Experimental Studies on CuO: Indication of Re-entrant Multiferroicity at Room Temperature

PubMed Central

Jana, Rajesh; Saha, Pinku; Pareek, Vivek; Basu, Abhisek; Kapri, Sutanu; Bhattacharyya, Sayan; Mukherjee, Goutam Dev

2016-01-01

We have carried out detailed experimental investigations on polycrystalline CuO using dielectric constant, dc resistance, Raman spectroscopy and X-ray diffraction measurements at high pressures. Observation of anomalous changes both in dielectric constant and dielectric loss in the pressure range 3.7–4.4 GPa and reversal of piezoelectric current with reversal of poling field direction indicate to a change in ferroelectric order in CuO at high pressures. A sudden jump in Raman integrated intensity of Ag mode at 3.4 GPa and observation of Curie-Weiss type behaviour in dielectric constant below 3.7 GPa lends credibility to above ferroelectric transition. A slope change in the linear behaviour of the Ag mode and a minimum in the FWHM of the same indicate indirectly to a change in magnetic ordering. Since all the previous studies show a strong spin-lattice interaction in CuO, observed change in ferroic behaviour at high pressures can be related to a reentrant multiferroic ordering in the range 3.4 to 4.4 GPa, much earlier than predicted by theoretical studies. We argue that enhancement of spin frustration due to anisotropic compression that leads to change in internal lattice strain brings the multiferroic ordering to room temperature at high pressures. PMID:27530329

Psychological health in siblings who lost a brother or sister to cancer 2 to 9 years earlier.

PubMed

Eilegård, Alexandra; Steineck, Gunnar; Nyberg, Tommy; Kreicbergs, Ulrika

2013-03-01

The objective of this study was to assess long-term psychological distress in siblings who lost a brother or sister to cancer 2 to 9 years earlier, as compared with a control group of non-bereaved siblings from the general population. During 2009, we conducted a nationwide follow-up study in Sweden by using an anonymous study-specific questionnaire. Siblings who had lost a brother or sister to cancer between the years 2000 and 2007 and also a control group of non-bereaved siblings from the general population were invited to participate. The Hospital Anxiety and Depression Scale (HADS) was used to measure psychological distress, and to test for differences in the ordinal outcome responses between the groups, we used Wilcoxon-Mann-Whitney rank-sum test. Among the bereaved siblings, 174/240 (73%) participated and 219/293 (75%) among the non-bereaved. Self-assessed low self-esteem (p = 0.002), difficulties falling asleep (p = 0.005), and low level of personal maturity (p = 0.007) at follow-up were more prevalent among bereaved siblings. However, anxiety (p = 0.298) and depression (p = 0.946), according to HADS, were similar. Bereaved siblings are at increased risk of low self-esteem, low level of personal maturity and difficulties falling asleep as compared with non-bereaved peers. Yet, the bereaved were not more likely to report anxiety or depression. Copyright © 2012 John Wiley & Sons, Ltd.

Determinants of child maltreatment in Nepal: Results from the 2014 Nepal multiple indicator cluster survey (the 2014 NMICS).

PubMed

Atteraya, Madhu Sudhan; Ebrahim, Nasser B; Gnawali, Shreejana

2018-02-01

We examined the prevalence of child maltreatment as measured by the level of physical (moderate to severe) and emotional abuse and child labor, and the associated household level determinants of child maltreatment in Nepal. We used a nationally representative data set from the fifth round of the Nepal Multiple Indicator Cluster Survey (the 2014 NMICS). The main independent variables were household level characteristics. Dependent variables included child experience of moderate to severe physical abuse, emotional abuse, and child labor (domestic work and economic activities). Bivariate analyses and logistic regressions were used to examine the associations between independent and dependent variables. The results showed that nearly half of the children (49.8%) had experienced moderate physical abuse, 21.5% experienced severe physical abuse, and 77.3% experienced emotional abuse. About 27% of the children had engaged in domestic work and 46.7% in various economic activities. At bivariate level, educational level of household's head and household wealth status had shown significant statistical association with child maltreatment (p<0.001). Results from multivariate logistic regressions showed that higher education levels and higher household wealth status protected children from moderate to severe physical abuse, emotional abuse and child labor. In general, child maltreatment is a neglected social issue in Nepal and the high rates of child maltreatment calls for mass awareness programs focusing on parents, and involving all stakeholders including governments, local, and international organizations. Copyright © 2017 Elsevier Ltd. All rights reserved.

Epiphyseal maturity indicators at the knee and their relationship to chronological age: results of an Irish population study.

PubMed

O'Connor, Jean E; Coyle, Joseph; Spence, Liam D; Last, Jason

2013-09-01

Skeletal maturation is divisible to three main components; the time of appearance of an ossification center, its change in morphology and time of fusion to a primary ossification center. With regard to the knee, the intermediate period between appearance and fusion of the ossification centers extends over a period of greater than 10 years. This study aims to investigate radiographically the age at which morphological changes of the epiphyses at the knee occur in a modern Irish population. Radiographs of 221 subjects (137 males; 84 females) aged 9-19 years were examined. Seven nonmetric indicators of maturity were assessed using criteria modified from the Roche, Wainer, and Thissen method and Pyle and Hoerr's atlas of the knee. Reference charts are presented which display the timeline for each of the grades of development of the seven indicators. Mean age was found to increase significantly with successive grades of development of each of the seven indicators. A significant difference was noted between males and females at the same grade of development for six of the seven indicators. The narrowest age range reported for a single grade of development was 2.2 years for Grade 2 of development of the tibial tuberosity for males. The information on changing morphology of the epiphyses at the knee in the present study may provide an adjunct to methods used for evaluation of skeletal maturity before surgery for orthopedic disorders or to evaluate skeletal age in clinical scenarios where either delayed or precocious skeletal maturation is suspected. Copyright © 2012 Wiley Periodicals, Inc.

Fragile X mental retardation protein knockdown in the developing Xenopus tadpole optic tectum results in enhanced feedforward inhibition and behavioral deficits.

PubMed

Truszkowski, Torrey L S; James, Eric J; Hasan, Mashfiq; Wishard, Tyler J; Liu, Zhenyu; Pratt, Kara G; Cline, Hollis T; Aizenman, Carlos D

2016-08-08

Fragile X Syndrome is the leading monogenetic cause of autism and most common form of intellectual disability. Previous studies have implicated changes in dendritic spine architecture as the primary result of loss of Fragile X Mental Retardation Protein (FMRP), but recent work has shown that neural proliferation is decreased and cell death is increased with either loss of FMRP or overexpression of FMRP. The purpose of this study was to investigate the effects of loss of FMRP on behavior and cellular activity. We knocked down FMRP expression using morpholino oligos in the optic tectum of Xenopus laevis tadpoles and performed a series of behavioral and electrophysiological assays. We investigated visually guided collision avoidance, schooling, and seizure propensity. Using single cell electrophysiology, we assessed intrinsic excitability and synaptic connectivity of tectal neurons. We found that FMRP knockdown results in decreased swimming speed, reduced schooling behavior and decreased seizure severity. In single cells, we found increased inhibition relative to excitation in response to sensory input. Our results indicate that the electrophysiological development of single cells in the absence of FMRP is largely unaffected despite the large neural proliferation defect. The changes in behavior are consistent with an increase in inhibition, which could be due to either changes in cell number or altered inhibitory drive, and indicate that FMRP can play a significant role in neural development much earlier than previously thought.

[Indication, type of resection and results of surgery in cases of lung tuberculosis. A historical and regional overview].

PubMed

Hillejan, L; Nemat, A; Marra, A; Stamatis, G

2002-06-01

Pulmonary tuberculosis has become a rare indication for surgical intervention in all industrial nations. Over a period of 10 years we overview 193 patients who were suffering this disease and underwent thoracotomy. Main indication (79.8 %) was pulmonary nodules, of unknown origin. In this cases wedge resection was performed. Expanded resectional techniques were necessary in cases of cavernes, superinfected bronchiectasis, bronchial stenosis, hemoptysis and destroyed lungs due to tuberculosis. Considering the heterogenous groups of patients, the perioperative morbidity (21.8 %) and mortality (0.5 %) has to be regarded in comparison to the data found in the literature.

Density- and luminosity-functions for UBV-photometric discand halo-stars in SA 54, compared with earlier RGU-results in this field

NASA Astrophysics Data System (ADS)

Fenkart, R.; Esin-Yilmaz, F.

1983-12-01

Space density- and luminosity-functions for the photometric halo- and disc-populations in the test-field SA 54 of the Basle Halo Program have been derived on the basis of UBV observations of the same 1377 stars used already for the corresponding RGU investigation by Fenkart (1968). The statistical method for separating the photometrically defined populations and for attributing absolute magnitudes to their members developed, described and first applied to SA 51 in RGU by Becker (1965) has been adapted for use in the UBV system. The (U-B, B- V) diagrams for consecutive intervals in apparent V-magnitude of figures 2a to f contain, contrary to what was first expected in this system, substantial numbers of stars in the < blanketing-region above and to the right of the late branch of the two-colour diagram main-sequence. The density-functions for different MVintervals within the overall interval < 3m, 7m> covered by this investigation for halo and disc are given in tables IIa and b, and plotted in figures 3 and 4, respectively. The corresponding luminosity-functions within the partial volume up to 1 kpc from the sun over the same overall MVinterval are given together with Glieses (1969) solar values for population I, in table III, and plotted in figure 5. The overall density-functions (3m ≦ MV ≦ 7m) for both populations can be and are compared with the corresponding ones (3m ≦ MG ≦ 8m) in RGU (last column in table II) in figures 6 and 7, for halo and disc, respectively. The coincidence of the density results between UBV and RGU is much better for both populations than the mean misidentification rate per system derived in section 5 would let us expect, suggesting a statistically fairly repartition of the misidentifications with respect to absolute magnitudes and distances.

Indications and results of pancreatic stump duct occlusion after duodenopancreatectomy.

PubMed

Alfieri, Sergio; Quero, Giuseppe; Rosa, Fausto; Di Miceli, Dario; Tortorelli, Antonio Pio; Doglietto, Giovanni Battista

2016-09-01

Severe post-operative complications after pancreaticoduodenectomy (PD) are largely due to pancreatic fistula onset. The occlusion of the main pancreatic duct using synthetic glue may prevent these complications. Aim of this study is to describe this technique and to report short- and long-term results as well as the post-operative endocrine and exocrine insufficiency. Two hundred and four patients who underwent PD with occlusion of the main pancreatic duct in a period of 15 years were retrospectively analyzed. Post-operative complications and their management were the main aim of the study with particular focus on pancreatic fistula incidence and its treatment. At 1-year follow-up endocrine and exocrine functions were analyzed. We observed a 54 % pancreatic fistula incidence, most of which (77/204 patients) were a grade A fistula with little change in medical management. Twenty-eight patients developed a grade B fistula while only 2 % of patients (5/204) developed a grade C fistula. Nine patients required re-operation, 5 of whom had a post-operative grade C fistula. Post-operative mortality was 3.4 %. At 1-year follow-up, 31 % of patients developed a post-operative diabetes while exocrine insufficiency was encountered in 88 % of patients. The occlusion of the main pancreatic duct after PD can be considered a relatively safe and easy-to-perform procedure. It should be reserved to selected patients, especially in case of soft pancreatic texture and small pancreatic duct and in elderly patients with comorbidities, in whom pancreatic fistula-related complications could be life threatening.

Microbial Substrate Usage Indicated by C-14 Contents of Phospholipid Fatty Acids From Soil Organic Matter

NASA Astrophysics Data System (ADS)

Rethemeyer, J.; Nadeau, M. J.; Grootes, P. M.; Kramer, C.; Gleixner, G.

2004-05-01

Phospholipid fatty acids (PLFA's) are generally associated with viable (bacterial) cell membranes. They are thought to be short-lived under normal soil conditions. We compare the C-14 levels in PLFA's obtained from soil samples from the,clean" experimental site at Rotthalmünster (Germany) with those from the agricultural research station at Halle (Germany), where the soil is contaminated with,old" carbon from lignite mining and industry. The most abundant PLFA's were isolated via preparative capillary gas chromatography of their methyl-esters at the Max-Planck Institute, Jena, and their C-14 concentration was determined via accelerator mass spectrometry at the Leibniz-Labor, Kiel. The C-14 levels of three mono-unsaturated fatty acids (n-C17:1, n-C18:1 (and n-C16:1)) are not statistically significant different from those of the contemporaneous atmosphere, indicating these fatty acids were derived from fresh plant material. C-14 levels significantly above those of the atmosphere in three saturated fatty acids (i/a-C15:0, n-C16:0 and cy-C18:0) from the surface soil of Rotthalmünster must derive from carbon fixed from the atmosphere several years earlier, when levels of bomb-C-14, remaining from the atmospheric nuclear weapons tests, especially of the early 1960's, were still higher. Lower C-14 levels in the same compounds from the Halle surface soil indicate the incorporation of "old" contaminant carbon. A below- atmospheric C-14 concentration in n-C18:0 in Rotthalmünster surface soil may reflect the partial incorporation of carbon from older, pre-bomb times. The C-14 concentrations show these PLFA's were synthesized predominantly from recent to sub-recent photosynthetic compounds, while the significant differences in C-14 concentration, observed between the PLFA's, indicate their production from soil organic matter fractions of different (recent) age and C-14 content. The Halle results show "old" carbon may be incorporated into PLFA's and thus reenter the soil

Development of Mental Health Indicators in Korea

PubMed Central

Han, Hyeree; Ahn, Dong Hyun; Song, Jinhee; Hwang, Tae Yeon

2012-01-01

Objective Promoting mental health and preventing mental health problems are important tasks for international organizations and nations. Such goals entail the establishment of active information networks and effective systems and indicators to assess the mental health of populations. This being said, there is a need in Korea develop ways to measure the state of mental health in Korea. Methods This paper reviews the mental health indicator development policies and practices of seven organizations, countries, and regions: WHO, OECD, EU, United States, Australia, UK, and Scotland. Using Delphi method, we conducted two surveys of mental health indicators for experts in the field of mental health. The survey questionnaire included 5 domains: mental health status, mental health factor, mental health system, mental health service, and quality of mental health services. We considered 124 potential mental health indicators out of more than 600 from indicators of international organizations and foreign countries. Results We obtained the top 30 mental health indicators from the surveys. Among them, 10 indicators belong to the mental health system. The most important five mental health indicators are suicide rate, rate of increase in mental disorder treatment, burden caused by mental disorders, adequacy of identifying problems of mental health projects and deriving solutions, and annual prevalence of mental disorders. Conclusion Our study provides information about the process for indicator development and the use of survey results to measure the mental health status of the Korean population. The aim of mental health indicator development is to improve the mental health system by better grasping the current situation. We suggest these mental health indicators can monitor progress in efforts to implement reform policies, provide community services, and involve users, families and other stakeholders in mental health promotion, prevention, care and rehabilitation. PMID:23251193

Outcomes of Medically Indicated Preterm Births Differ by Indication.

PubMed

Wang, Michelle J; Kuper, Spencer G; Steele, Robin; Sievert, Rachel A; Tita, Alan T; Harper, Lorie M

2018-07-01

 We aim to examine whether outcomes of preterm birth (PTB) are further modified by the indication for delivery.  We performed a retrospective cohort study of all singletons delivered at 23 to 34 weeks from 2011 to 2014. Women were classified by their primary indication for delivery: maternal (preeclampsia) or fetal/obstetric (growth restriction, nonreassuring fetal status, and vaginal bleeding). The primary neonatal outcome was a composite of neonatal death, cord pH <7 or base excess < - 12, 5-minute Apgar ≤3, C-reactive protein during resuscitation, culture-proven sepsis, intraventricular hemorrhage, and necrotizing enterocolitis. Secondary outcomes included the individual components of the primary outcome. Groups were compared using Student's t -test and chi-squared tests. Logistic regression was used to adjust for confounding variables.  Of 528 women, 395 (74.8%) were delivered for maternal and 133 (25.2%) for fetal/obstetric indications. Compared with those delivered for a maternal indication, those with a fetal/obstetric indication for delivery had an increased risk of the composite neonatal outcome (adjusted odds ratio [AOR]: 1.9, 95% confidence interval [CI]: 1.13-3.21) and acidemia at birth (AOR: 4.2, 95% CI: 1.89-9.55).  Preterm infants delivered for fetal/obstetric indications have worsened outcomes compared with those delivered for maternal indications. Additional research is needed to further tailor counseling specific to the indication for delivery. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Higher dose rate Gamma Knife radiosurgery may provide earlier and longer-lasting pain relief for patients with trigeminal neuralgia.

PubMed

Lee, John Y K; Sandhu, Sukhmeet; Miller, Denise; Solberg, Timothy; Dorsey, Jay F; Alonso-Basanta, Michelle

2015-10-01

Gamma Knife radiosurgery (GKRS) utilizes cobalt-60 as its radiation source, and thus dose rate varies as the fixed source decays over its half-life of approximately 5.26 years. This natural decay results in increasing treatment times when delivering the same cumulative dose. It is also possible, however, that the biological effective dose may change based on this dose rate even if the total dose is kept constant. Because patients are generally treated in a uniform manner, radiosurgery for trigeminal neuralgia (TN) represents a clinical model whereby biological efficacy can be tested. The authors hypothesized that higher dose rates would result in earlier and more complete pain relief but only if measured with a sensitive pain assessment tool. One hundred thirty-three patients were treated with the Gamma Knife Model 4C unit at a single center by a single neurosurgeon during a single cobalt life cycle from January 2006 to May 2012. All patients were treated with 80 Gy with a single 4-mm isocenter without blocking. Using an output factor of 0.87, dose rates ranged from 1.28 to 2.95 Gy/min. The Brief Pain Inventory (BPI)-Facial was administered before the procedure and at the first follow-up office visit 1 month from the procedure (mean 1.3 months). Phone calls were made to evaluate patients after their procedures as part of a retrospective study. Univariate and multivariate linear regression was performed on several independent variables, including sex, age in deciles, diagnosis, follow-up duration, prior surgery, and dose rate. In the short-term analysis (mean 1.3 months), patients' self-reported pain intensity at its worst was significantly correlated with dose rate on multivariate analysis (p = 0.028). Similarly, patients' self-reported interference with activities of daily living was closely correlated with dose rate on multivariate analysis (p = 0.067). A 1 Gy/min decrease in dose rate resulted in a 17% decrease in pain intensity at its worst and a 22% decrease

Modern reaction-based indicator systems†

PubMed Central

2010-01-01

Traditional analyte-specific synthetic receptors or sensors have been developed on the basis of supramolecular interactions (e.g., hydrogen bonding, electrostatics, weak coordinative bonds). Unfortunately, this approach is often subject to limitations. As a result, increasing attention within the chemical sensor community is turning to the use of analyte-specific molecular indicators, wherein substrate-triggered reactions are used to signal the presence of a given analyte. This tutorial review highlights recent reaction-based indicator systems that have been used to detect selected anions, cations, reactive oxygen species, and neutral substrates. PMID:19587959

Developing indicators for European birds

PubMed Central

Gregory, Richard D; van Strien, Arco; Vorisek, Petr; Gmelig Meyling, Adriaan W; Noble, David G; Foppen, Ruud P.B; Gibbons, David W

2005-01-01

The global pledge to deliver ‘a significant reduction in the current rate of biodiversity loss by 2010’ is echoed in a number of regional and national level targets. There is broad consensus, however, that in the absence of conservation action, biodiversity will continue to be lost at a rate unprecedented in the recent era. Remarkably, we lack a basic system to measure progress towards these targets and, in particular, we lack standard measures of biodiversity and procedures to construct and assess summary statistics. Here, we develop a simple classification of biodiversity indicators to assist their development and clarify purpose. We use European birds, as example taxa, to show how robust indicators can be constructed and how they can be interpreted. We have developed statistical methods to calculate supranational, multi-species indices using population data from national annual breeding bird surveys in Europe. Skilled volunteers using standardized field methods undertake data collection where methods and survey designs differ slightly across countries. Survey plots tend to be widely distributed at a national level, covering many bird species and habitats with reasonable representation. National species' indices are calculated using log-linear regression, which allows for plot turnover. Supranational species' indices are constructed by combining the national species' indices weighted by national population sizes of each species. Supranational, multi-species indicators are calculated by averaging the resulting indices. We show that common farmland birds in Europe have declined steeply over the last two decades, whereas woodland birds have not. Evidence elsewhere shows that the main driver of farmland bird declines is increased agricultural intensification. We argue that the farmland bird indicator is a useful surrogate for trends in other elements of biodiversity in this habitat. PMID:15814345

Effect of laser infrared therapy on several rheological indices of blood and on the homeostasis of patients with post-infarction cardiosclerosis

NASA Astrophysics Data System (ADS)

Volov, N. A.; Kudinova, M. A.; Fedulaeva, A. I.; Fedulaev, Yu. N.; Gordeev, I. G.

2001-04-01

An investigation was made on 38 patients affected by exertion angina pectoris of the I-III functional classes. The patients survived a Q-associated myocardial infarction not earlier than 1 year ago. The patients were treated according to a 10-session course of laser infrared therapy. The dynamics of several hemorheological indices (such as blood viscosity, the hematocrit of venous blood, fibrinogen, fibronectine, thrombocyte aggregation, antithrombin III, and the activated partial thrombplastin time) was estimated prior to the treatment, 5 - 7 days after the beginning of laser therapy, and 30 days after the beginning of laser therapy treatment. It was found that laser therapy was capable of producing a significant decrease in the blood viscosity, fibrinogen level, and in the aggregation of thrombocytes. Moreover, laser infrared therapy carried out on patients affected by post-infarction cardiosclerosis and by stable exertion stenocardia of the I-III functional classes produced a reliable normalization of hemorheological indices of the blood.

Aberrant proteins featured in the saliva of habitual betel quid chewers: an indication of early oral premalignancy?

PubMed

Jessie, Kala; Jayapalan, Jaime Jacqueline; Rahim, Zubaidah Haji Abdul; Hashim, Onn Haji

2014-12-01

Prolonged chewing of betel quid is known to cause oral diseases, including cancer. The present study was performed to screen for aberrant proteins in the saliva of habitual betel quid chewers compared to nonchewers. Saliva of female subjects (n = 10) who had been chewing betel quid for more than 20 years and nonbetel quid chewers (n = 10) of the same gender and range of age was analyzed by gel-based proteomics. Increased structural microheterogeneity of saliva haptoglobin beta chains indicated by shifts of focused spots similar to that earlier reported in patients with oral squamous cell carcinoma, and their relatively higher abundance compared to nonbetel quid chewers, were detected in saliva protein profiles of all chewers. In addition, the majority of the betel quid chewers also showed significant higher abundance of hemopexin, alpha-1B glycoprotein, alpha1-antitrypsin, complement C3, and transthyretin. These proteins had previously been associated with several different cancers. Our data demonstrated different forms of protein aberration in the saliva of betel quid chewers, which may be indicative of early oral precancerous conditions. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Community indicators

PubMed Central

Flynn, Andrea; Wells, Samantha

2014-01-01

Community indicators are used to assess the impact of alcohol on communities. This article reviews the main data sources for community indicators, discusses their strengths and limitations, and discusses indicators used in reference to four main topics relating to alcohol use and problems at the community level: alcohol use, patterns, and problems; alcohol availability; alcohol-related health outcomes/trauma; and alcohol-related crime and enforcement. It also reviews the challenges associated with collecting community indicator data, along with important innovations in the field that have contributed to better knowledge of how to collect and analyze community-level data on the impact of alcohol. PMID:24881322

Verification of the ages of supercentenarians in the United States: results of a matching study.

PubMed

Rosenwaike, Ira; Stone, Leslie F

2003-11-01

Unprecedented declines in mortality among the very old have led to the emergence of "true" supercentenarians (persons aged 110 and over). The ages of these individuals have been well-documented in European countries with a history of birth registration, but have not been systematically studied in the United States, which lacks similar documentation and where the inaccuracy of age reporting has been an issue. To verify age, we linked records from the Social Security Administration for close to 700 individuals who died from 1980 to 1999 purportedly at ages 110 and older to records of the U.S. censuses of 1880 and 1900, conducted when these individuals were children. This group was a residual group from an earlier file that was reduced by the SSA after data checks that eliminated incorrect records. The results of the matched records for the residual file indicate that over 90% of the whites were accurately reported as supercentenarians, but only half of the blacks appeared to have attained age 110. The verification of age shows that the United States has more "true" supercentenarians than do other nations.

QSPR modeling: graph connectivity indices versus line graph connectivity indices

PubMed

Basak; Nikolic; Trinajstic; Amic; Beslo

2000-07-01

Five QSPR models of alkanes were reinvestigated. Properties considered were molecular surface-dependent properties (boiling points and gas chromatographic retention indices) and molecular volume-dependent properties (molar volumes and molar refractions). The vertex- and edge-connectivity indices were used as structural parameters. In each studied case we computed connectivity indices of alkane trees and alkane line graphs and searched for the optimum exponent. Models based on indices with an optimum exponent and on the standard value of the exponent were compared. Thus, for each property we generated six QSPR models (four for alkane trees and two for the corresponding line graphs). In all studied cases QSPR models based on connectivity indices with optimum exponents have better statistical characteristics than the models based on connectivity indices with the standard value of the exponent. The comparison between models based on vertex- and edge-connectivity indices gave in two cases (molar volumes and molar refractions) better models based on edge-connectivity indices and in three cases (boiling points for octanes and nonanes and gas chromatographic retention indices) better models based on vertex-connectivity indices. Thus, it appears that the edge-connectivity index is more appropriate to be used in the structure-molecular volume properties modeling and the vertex-connectivity index in the structure-molecular surface properties modeling. The use of line graphs did not improve the predictive power of the connectivity indices. Only in one case (boiling points of nonanes) a better model was obtained with the use of line graphs.

Real refractive indices of infrared-characterized nitric-acid/ice films: Implications for optical measurements of polar stratospheric clouds

NASA Technical Reports Server (NTRS)

Middlebrook, Ann M.; Berland, Brian S.; George, Steven M.; Tolbert, Margaret A.; Toon, Owen B.

1994-01-01

The infrared spectra of nitric-acid/ice films representative of polar stratospheric clouds (PSCs) were collected with simultaneous optical interference measurements to determine the real refractive indices at lambda = 632 nm. Ice and amphorous nitric-acid/ice films were prepared by condensation of water and nitric acid vapors onto a wedged Al2O3 substrate. The real refractive indices of these films were determined from the optical interference of a reflected helium-neon laser during film growth. The indices of the amphorous films varied smoothly from n = 1.30 for ice to n = 1.49 for nitric acid, similar to observations in previous work. We were unable to obtain the refractive index of crystlline films during adsorption because of optical scattering caused by surface roughness. Therefore crystlline nitric acid hydrate films were prepared by annealing amphorous nitric-acid/ice films. Further heating caused desorption of the crystalline hydrate films. During desorption, the refractive indices for ice, NAM (nitric acid monohydrate), alpha- and beta-NAT (nitric acid trihydrate) films were measured using the optical interference technique. In agreement with earlier data, the real refractive indices for ice and NAM determined in desorption were n = 1.30 +/- 0.01 and n = 1.53 +/- 0.03, respectively. The real refractive indices for alpha- and beta-NAT were found to be n = 1.51 +/- 0.01 and n greater than or equal to 1.46, respectively. Our measurements also suggest that the shape of crystalline nitric acid particles may depend on whether they nucleate from the liquid or by vapor deposition. If confirmed by future studies, this observation may provide a means of distinguishing the nucleation mechanism of crystalline PSCs.

Coping and emotional distress during acute hospitalization in older persons with earlier trauma: the case of Holocaust survivors.

PubMed

Kimron, Lee; Cohen, Miri

2012-06-01

Older persons with earlier trauma are often more vulnerable to stresses of old age. To examine the levels of emotional distress in relation to cognitive appraisal of acute hospitalization and coping strategies in Holocaust survivors compared with an age- and education-matched group of elderly persons without Holocaust experience. This is a cross-sectional study of 63 Holocaust survivors, 65 years and older, hospitalized for an acute illness, and 57 age-, education- and hospital unit-matched people without Holocaust experience. Participants completed appraisal and coping strategies (COPE) questionnaires, and the brief symptoms inventory (BSI-18). Holocaust survivors reported higher levels of emotional distress, appraised the hospitalization higher as a threat and lower as a challenge, and used more emotion-focused and less problem-focused or support-seeking coping strategies than the comparison group. Study variables explained 65% of the variance of emotional distress; significant predictors of emotional distress in the final regression model were not having a partner and more use of emotion-focused coping. The latter mediated the relation of group variable and challenge appraisal to emotional distress. Health professionals must be aware of the potential impact of the hospital environment on the survivors of Holocaust as well as survivors of other trauma. Being sensitive to their specific needs may reduce the negative impact of hospitalization.

Bilateral breast calciphylaxis in a patient who survived earlier extensive tissue necrosis 5 years previously: A case report.

PubMed

Verstappen, E M J; Maaskant-Braat, A J G; Scheltinga, M R

2018-05-07

Calciphylaxis is a rare condition including patchy dermal necrosis that mostly affects chronic hemodialysis patients. The syndrome usually heralds impending death although patients may survive following a set of measures including an adapted dialysis regimen. The present case is a unique patient who recovered from an earlier episode of upper leg calciphylaxis 5 years previously but developed fatal bilateral breast necrosis. A 69 year old Caucasian woman with a history of atrial fibrillation, hypertension, CVA, hyperparathyroidectomy for secondary hyperparathyroidism and end stage renal disease with hemodialysis recovered in 2012 from extensive symptomatic left upper leg necrosis due to calciphylaxis. In 2017, she developed painful, necrotic ulcers on both breasts, again due to calciphylaxis. She had no history of anticoagulants use but she did use prednisolone 5mg/day. She received adequate wound care, pain medication, antibiotics and dialysis frequency was increased with an addition of sodium thiosulfate. A bilateral ablation was discussed but she decided to stop all treatment following pulmonary aspiration and passed away one week later. Calciphylaxis is a rare diagnosis that should be considered in patients with renal insufficiency developing painful patches of skin necrosis. A multidisciplinary treatment approach including hyperparathyroidectomy, modified hemodialysis and wound treatment is recommended. There is limited evidence for surgical intervention. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Filarial parasites develop faster and reproduce earlier in response to host immune effectors that determine filarial life expectancy.

PubMed

Babayan, Simon A; Read, Andrew F; Lawrence, Rachel A; Bain, Odile; Allen, Judith E

2010-10-19

Humans and other mammals mount vigorous immune assaults against helminth parasites, yet there are intriguing reports that the immune response can enhance rather than impair parasite development. It has been hypothesized that helminths, like many free-living organisms, should optimize their development and reproduction in response to cues predicting future life expectancy. However, immune-dependent development by helminth parasites has so far eluded such evolutionary explanation. By manipulating various arms of the immune response of experimental hosts, we show that filarial nematodes, the parasites responsible for debilitating diseases in humans like river blindness and elephantiasis, accelerate their development in response to the IL-5 driven eosinophilia they encounter when infecting a host. Consequently they produce microfilariae, their transmission stages, earlier and in greater numbers. Eosinophilia is a primary host determinant of filarial life expectancy, operating both at larval and at late adult stages in anatomically and temporally separate locations, and is implicated in vaccine-mediated protection. Filarial nematodes are therefore able to adjust their reproductive schedules in response to an environmental predictor of their probability of survival, as proposed by evolutionary theory, thereby mitigating the effects of the immune attack to which helminths are most susceptible. Enhancing protective immunity against filarial nematodes, for example through vaccination, may be less effective at reducing transmission than would be expected and may, at worst, lead to increased transmission and, hence, pathology.

Three Cs in Measurement Models: Causal Indicators, Composite Indicators, and Covariates

PubMed Central

Bollen, Kenneth A.; Bauldry, Shawn

2013-01-01

In the last two decades attention to causal (and formative) indicators has grown. Accompanying this growth has been the belief that we can classify indicators into two categories, effect (reflective) indicators and causal (formative) indicators. This paper argues that the dichotomous view is too simple. Instead, there are effect indicators and three types of variables on which a latent variable depends: causal indicators, composite (formative) indicators, and covariates (the “three Cs”). Causal indicators have conceptual unity and their effects on latent variables are structural. Covariates are not concept measures, but are variables to control to avoid bias in estimating the relations between measures and latent variable(s). Composite (formative) indicators form exact linear combinations of variables that need not share a concept. Their coefficients are weights rather than structural effects and composites are a matter of convenience. The failure to distinguish the “three Cs” has led to confusion and questions such as: are causal and formative indicators different names for the same indicator type? Should an equation with causal or formative indicators have an error term? Are the coefficients of causal indicators less stable than effect indicators? Distinguishing between causal and composite indicators and covariates goes a long way toward eliminating this confusion. We emphasize the key role that subject matter expertise plays in making these distinctions. We provide new guidelines for working with these variable types, including identification of models, scaling latent variables, parameter estimation, and validity assessment. A running empirical example on self-perceived health illustrates our major points. PMID:21767021

Three Cs in measurement models: causal indicators, composite indicators, and covariates.

PubMed

Bollen, Kenneth A; Bauldry, Shawn

2011-09-01

In the last 2 decades attention to causal (and formative) indicators has grown. Accompanying this growth has been the belief that one can classify indicators into 2 categories: effect (reflective) indicators and causal (formative) indicators. We argue that the dichotomous view is too simple. Instead, there are effect indicators and 3 types of variables on which a latent variable depends: causal indicators, composite (formative) indicators, and covariates (the "Three Cs"). Causal indicators have conceptual unity, and their effects on latent variables are structural. Covariates are not concept measures, but are variables to control to avoid bias in estimating the relations between measures and latent variables. Composite (formative) indicators form exact linear combinations of variables that need not share a concept. Their coefficients are weights rather than structural effects, and composites are a matter of convenience. The failure to distinguish the Three Cs has led to confusion and questions, such as, Are causal and formative indicators different names for the same indicator type? Should an equation with causal or formative indicators have an error term? Are the coefficients of causal indicators less stable than effect indicators? Distinguishing between causal and composite indicators and covariates goes a long way toward eliminating this confusion. We emphasize the key role that subject matter expertise plays in making these distinctions. We provide new guidelines for working with these variable types, including identification of models, scaling latent variables, parameter estimation, and validity assessment. A running empirical example on self-perceived health illustrates our major points.

Accuracy of ECG indices for diagnosis of left ventricular hypertrophy in people >65 years: results from the ActiFE study.

PubMed

Laszlo, Roman; Kunz, Katia; Dallmeier, Dhayana; Klenk, Jochen; Denkinger, Michael; Koenig, Wolfgang; Rothenbacher, Dietrich; Steinacker, Juergen Michael

2017-10-01

The detection of left ventricular hypertrophy (LVH) is still a common objective of electrocardiography (ECG) in clinical practice. The aim of our study was to evaluate the accuracy of LVH ECG indices in people older than 65 recruited from a population-based cohort (ActiFE-Ulm study). In 432 subjects (mean age 76.2 ± 5.5 years, 51% male), left ventricular mass was echocardiographically determined (Devereux formula) and indexed (LVMI) to body surface area. Several LVH ECG indices (Lewis voltage, Gubner-Ungerleider voltage, Sokolow-Lyon voltage/product, Cornell voltage/product) were calculated with the help of resting ECG data and compared with the echocardiographic assessment. Despite echocardiographic signs of LVH [LVMI > 115 (♂) or >95 g/m 2 (♀)] in 47.5% of all subjects, diagnostic performance of all ECG indices was generally low. Magnitude of all LVH-indices was mainly predicted by frontal QRS axis in multivariate linear regression analysis. In comparison with the literature data from younger subjects, average frontal QRS axis turned counterclockwise. Most probably, age-related counterclockwise turn of frontal QRS axis is mainly explanatory for the decreased magnitude of LVH ECG indices and consecutive worse diagnostic performance of these indices in the elderly. ECG indices for detection of LVH have insufficient predictive values in geriatric subjects and should therefore not be used clinically for this purpose. Nevertheless, due to its established relevancy in cardiac risk stratification in this age group, usage of some established ECG indices might keep its significance even in the age of modern cardiac imaging.

Flexibility of Bricard's linkages and other structures via resultants and computer algebra.

PubMed

Lewis, Robert H; Coutsias, Evangelos A

2016-07-01

Flexibility of structures is extremely important for chemistry and robotics. Following our earlier work, we study flexibility using polynomial equations, resultants, and a symbolic algorithm of our creation that analyzes the resultant. We show that the software solves a classic arrangement of quadrilaterals in the plane due to Bricard. We fill in several gaps in Bricard's work and discover new flexible arrangements that he was apparently unaware of. This provides strong evidence for the maturity of the software, and is a wonderful example of mathematical discovery via computer assisted experiment.

Deprivation Indices, Population Health and Geography: An Evaluation of the Spatial Effectiveness of Indices at Multiple Scales

PubMed Central

Bell, Nathaniel; Dunn, James R.; Oliver, Lisa

2007-01-01

Area-based deprivation indices (ABDIs) have become a common tool with which to investigate the patterns and magnitude of socioeconomic inequalities in health. ABDIs are also used as a proxy for individual socioeconomic status. Despite their widespread use, comparably less attention has been focused on their geographic variability and practical concerns surrounding the Modifiable Area Unit Problem (MAUP) than on the individual attributes that make up the indices. Although scale is increasingly recognized as an important factor in interpreting mapped results among population health researchers, less attention has been paid specifically to ABDI and scale. In this paper, we highlight the effect of scale on indices by mapping ABDIs at multiple census scales in an urban area. In addition, we compare self-rated health data from the Canadian Community Health Survey with ABDIs at two census scales. The results of our analysis confirm the influence of spatial extent and scale on mapping population health—with potential implications for health policy implementation and resource distribution. PMID:17447145

The effect of early feeding practices on growth indices and obesity at preschool children from four European countries and UK schoolchildren and adolescents.

PubMed

Moschonis, George; de Lauzon-Guillain, Blandine; Jones, Louise; Oliveira, Andreia; Lambrinou, Christina-Paulina; Damianidi, Louiza; Lioret, Sandrine; Moreira, Pedro; Lopes, Carla; Emmett, Pauline; Charles, Marie Aline; Manios, Yannis

2017-09-01

Not only healthy growth but also childhood obesity partly originate from early life. The current work aimed to examine the association of feeding practices during infancy with growth and adiposity indices in preschool children from four European countries and in UK schoolchildren and adolescents. Existing data from four European birth cohorts (ALSPAC-UK, EDEN-France, EuroPrevall-Greece and Generation XXI-Portugal) were used. Anthropometrics and body composition indices were collected. Parallel multivariate regression analyses were performed to examine the research hypothesis. Overall, the analyses showed that breastfeeding and timing of complementary feeding were not consistently associated with height z-score, overweight/obesity, and body fat mass in children or adolescents. However, breastfeeding duration for less than 6 months was associated with lower height z-scores in 5-year-old French children (P < 0.001) but with higher height z-scores in 4-year-old UK children (P = 0.006). Furthermore, introduction of complementary foods earlier than 4 months of age was positively associated with fat mass levels in 5-year-old French children (P = 0.026). Early feeding practices, i.e., any breastfeeding duration and age of introduction of complementary foods, do not appear to be consistently associated with height z-score, overweight/obesity, and body fat mass in preschool children from four European countries and in UK schoolchildren and adolescents. What is known? • Healthy growth and childhood obesity partly originate from early life. What is new? • Breastfeeding duration less than 6 months was associated with lower height z-scores in 5-year-old French children, while the opposite was observed in 4-year-old British children. • Introduction of complementary foods earlier than 4 months was positively associated with fat mass levels in 5-year-old French children, but not in the other three countries. • Early feeding practices did not appear to be

Relative performance of three stream bed stability indices as indicators of stream health.

PubMed

Kusnierz, Paul C; Holbrook, Christopher M

2017-10-16

Bed stability is an important stream habitat attribute because it affects geomorphology and biotic communities. Natural resource managers desire indices of bed stability that can be used under a wide range of geomorphic conditions, are biologically meaningful, and are easily incorporated into sampling protocols. To eliminate potential bias due to presence of instream wood and increase precision of stability values, we modified a stream bed instability index (ISI) to include measurements of bankfull depth (d bf ) and median particle diameter (D 50 ) only in riffles and increased the pebble count to decrease variability (i.e., increase precision) in D 50 . The new riffle-based instability index (RISI) was compared to two established indices: ISI and the riffle stability index (RSI). RISI and ISI were strongly associated with each other but neither was closely associated with RSI. RISI and ISI were closely associated with both a diatom- and two macrovertebrate-based stream health indices, but RSI was only weakly associated with the macroinvertebrate indices. Unexpectedly, precision of D 50 did not differ between RISI and ISI. Results suggest that RISI is a viable alternative to both ISI and RSI for evaluating bed stability in multiple stream types. With few data requirements and a simple protocol, RISI may also better conform to riffle-based sampling methods used by some water quality practitioners.

Relative performance of three stream bed stability indices as indicators of stream health

USGS Publications Warehouse

Kusnierz, Paul C; Holbrook, Christopher

2017-01-01

Bed stability is an important stream habitat attribute because it affects geomorphology and biotic communities. Natural resource managers desire indices of bed stability that can be used under a wide range of geomorphic conditions, are biologically meaningful, and are easily incorporated into sampling protocols. To eliminate potential bias due to presence of instream wood and increase precision of stability values, we modified a stream bed instability index (ISI) to include measurements of bankfull depth (dbf) and median particle diameter (D50) only in riffles and increased the pebble count to decrease variability (i.e., increase precision) in D50.The new riffle-based instability index (RISI) was compared to two established indices: ISI and the riffle stability index (RSI). RISI and ISI were strongly associated with each other but neither was closely associated with RSI. RISI and ISI were closely associated with both a diatom- and two macrovertebrate-based stream health indices, but RSI was only weakly associated with the macroinvertebrate indices. Unexpectedly, precision of D50 did not differ between RISI and ISI. Results suggest that RISI is a viable alternative to both ISI and RSI for evaluating bed stability in multiple stream types. With few data requirements and a simple protocol, RISI may also better conform to riffle-based sampling methods used by some water quality practitioners.

Characterizing Drought Risk Management and Assessing the Robustness of Snowpack-based Drought Indicators in the Upper Colorado River Basin.

NASA Astrophysics Data System (ADS)

Livneh, B.; Badger, A.; Lukas, J.; Dilling, L.; Page, R.

2017-12-01

Drought conditions over the past two decades have arisen during a time of increasing water demands in the Upper Colorado River Basin. The Basin's highly allocated and diverse water systems raise the question of how drought-based information, such as snowpack, streamflow, and reservoir conditions, can be used to inform drought risk management. Like most of the western U.S., snow-water equivalent (SWE) at key dates during the year (e.g., April 1) is routinely used in water resource planning because it is often the highest observed value during the season and it embodies stored water to be released, through melt, during critical periods later in the summer. This presentation will first focus on how water managers on Colorado's Western Slope (a) perceive drought-related risk, (b) use and access drought information, and (c) respond to drought. Preliminary findings will be presented from in-person interviews, document analysis, observations of planning meetings, and other interactions with seven water-management entities across the Western Slope. The second part of the presentation will focus on how the predictive power of snowpack-based drought indicators—identified as the most useful and reliable drought indicator by regional water stakeholders—are expected change in a warmer world, i.e. where expectations are for more rain versus snow, smaller snowpacks, and earlier snowmelt and peak runoff. We will present results from hydrologic simulations using climate projection to examine how a warming climate will affect the robustness of these snowpack-based drought indicators by mid-century.

Development of Chemical Indicators of Groundwater Contamination Near the Carcass Burial Site

NASA Astrophysics Data System (ADS)

Kim, H.; Choi, J.; Kim, M.; Choi, J.; Lee, M.; Lee, H.; Jeon, S.; Bang, S.; Noh, H.; Yoo, J.; Park, S.; Kim, H.; Kim, D.; Lee, Y.; Han, J.

2011-12-01

A serious outbreak of foot and mouth disease (FMD) and avian influenza (AI) led to the culling of millions of livestock in South Korea from late 2010 to earlier 2011. Because of the scale of FMD and AI epidemic in Korea and rapid spread of the diseases, mass burial for the disposal of carcass was conducted to halt the outbreak. The improper construction of the burial site or inappropriate management of the carcass burial facility can cause the contamination of groundwater mainly due to the discharges of leachate through the base of disposal pit. The leachate from carcass burial contains by products of carcass decay such as amino acids, nitrate, ammonia and chloride. The presence of these chemical components in groundwater can be used as indicators demonstrating contamination of groundwater with leachate from carcass. The major concern about using these chemical indicators is that other sources including manures, fertilizers and waste waters from human or animal activities already exist in farming area. However, we lack the understanding of how groundwater contamination due to mass burial of carcass can be differentiated from the contamination due to livestock manures which shows similar chemical characteristics. The chemical compositions of the leachate from carcass burial site and the wastewater from livestock manure treatment facilities were compared. The chemical compositions considered include total organic carbon (TOC), total nitrogen (TN), nitrate, organic nitrogen (Organic nitrogen =TN-Ammonium Nitrogen- Nitrate nitrogen), ammonia, chloride, sodium, potassium and amino acids (20 analytes). The ratios of concentrations of the chemical compositions as indicators of contamination were determined to distinguish the sources of contamination in groundwater. Indicators which showed a linear relationship between two factors and revealed a distinct difference between the carcass leachate and livestock manure were chosen. In addition, the background level of the

Three Cs in Measurement Models: Causal Indicators, Composite Indicators, and Covariates

ERIC Educational Resources Information Center

Bollen, Kenneth A.; Bauldry, Shawn

2011-01-01

In the last 2 decades attention to causal (and formative) indicators has grown. Accompanying this growth has been the belief that one can classify indicators into 2 categories: effect (reflective) indicators and causal (formative) indicators. We argue that the dichotomous view is too simple. Instead, there are effect indicators and 3 types of…

Selection Indices and Multivariate Analysis Show Similar Results in the Evaluation of Growth and Carcass Traits in Beef Cattle

PubMed Central

Brito Lopes, Fernando; da Silva, Marcelo Corrêa; Magnabosco, Cláudio Ulhôa; Goncalves Narciso, Marcelo; Sainz, Roberto Daniel

2016-01-01

This research evaluated a multivariate approach as an alternative tool for the purpose of selection regarding expected progeny differences (EPDs). Data were fitted using a multi-trait model and consisted of growth traits (birth weight and weights at 120, 210, 365 and 450 days of age) and carcass traits (longissimus muscle area (LMA), back-fat thickness (BF), and rump fat thickness (RF)), registered over 21 years in extensive breeding systems of Polled Nellore cattle in Brazil. Multivariate analyses were performed using standardized (zero mean and unit variance) EPDs. The k mean method revealed that the best fit of data occurred using three clusters (k = 3) (P < 0.001). Estimates of genetic correlation among growth and carcass traits and the estimates of heritability were moderate to high, suggesting that a correlated response approach is suitable for practical decision making. Estimates of correlation between selection indices and the multivariate index (LD1) were moderate to high, ranging from 0.48 to 0.97. This reveals that both types of indices give similar results and that the multivariate approach is reliable for the purpose of selection. The alternative tool seems very handy when economic weights are not available or in cases where more rapid identification of the best animals is desired. Interestingly, multivariate analysis allowed forecasting information based on the relationships among breeding values (EPDs). Also, it enabled fine discrimination, rapid data summarization after genetic evaluation, and permitted accounting for maternal ability and the genetic direct potential of the animals. In addition, we recommend the use of longissimus muscle area and subcutaneous fat thickness as selection criteria, to allow estimation of breeding values before the first mating season in order to accelerate the response to individual selection. PMID:26789008

Selection Indices and Multivariate Analysis Show Similar Results in the Evaluation of Growth and Carcass Traits in Beef Cattle.

PubMed

Brito Lopes, Fernando; da Silva, Marcelo Corrêa; Magnabosco, Cláudio Ulhôa; Goncalves Narciso, Marcelo; Sainz, Roberto Daniel

2016-01-01

This research evaluated a multivariate approach as an alternative tool for the purpose of selection regarding expected progeny differences (EPDs). Data were fitted using a multi-trait model and consisted of growth traits (birth weight and weights at 120, 210, 365 and 450 days of age) and carcass traits (longissimus muscle area (LMA), back-fat thickness (BF), and rump fat thickness (RF)), registered over 21 years in extensive breeding systems of Polled Nellore cattle in Brazil. Multivariate analyses were performed using standardized (zero mean and unit variance) EPDs. The k mean method revealed that the best fit of data occurred using three clusters (k = 3) (P < 0.001). Estimates of genetic correlation among growth and carcass traits and the estimates of heritability were moderate to high, suggesting that a correlated response approach is suitable for practical decision making. Estimates of correlation between selection indices and the multivariate index (LD1) were moderate to high, ranging from 0.48 to 0.97. This reveals that both types of indices give similar results and that the multivariate approach is reliable for the purpose of selection. The alternative tool seems very handy when economic weights are not available or in cases where more rapid identification of the best animals is desired. Interestingly, multivariate analysis allowed forecasting information based on the relationships among breeding values (EPDs). Also, it enabled fine discrimination, rapid data summarization after genetic evaluation, and permitted accounting for maternal ability and the genetic direct potential of the animals. In addition, we recommend the use of longissimus muscle area and subcutaneous fat thickness as selection criteria, to allow estimation of breeding values before the first mating season in order to accelerate the response to individual selection.

Spatio-temporal mapping of Madagascar's Malaria Indicator Survey results to assess Plasmodium falciparum endemicity trends between 2011 and 2016.

PubMed

Kang, Su Yun; Battle, Katherine E; Gibson, Harry S; Ratsimbasoa, Arsène; Randrianarivelojosia, Milijaona; Ramboarina, Stéphanie; Zimmerman, Peter A; Weiss, Daniel J; Cameron, Ewan; Gething, Peter W; Howes, Rosalind E

2018-05-23

Reliable measures of disease burden over time are necessary to evaluate the impact of interventions and assess sub-national trends in the distribution of infection. Three Malaria Indicator Surveys (MISs) have been conducted in Madagascar since 2011. They provide a valuable resource to assess changes in burden that is complementary to the country's routine case reporting system. A Bayesian geostatistical spatio-temporal model was developed in an integrated nested Laplace approximation framework to map the prevalence of Plasmodium falciparum malaria infection among children from 6 to 59 months in age across Madagascar for 2011, 2013 and 2016 based on the MIS datasets. The model was informed by a suite of environmental and socio-demographic covariates known to influence infection prevalence. Spatio-temporal trends were quantified across the country. Despite a relatively small decrease between 2013 and 2016, the prevalence of malaria infection has increased substantially in all areas of Madagascar since 2011. In 2011, almost half (42.3%) of the country's population lived in areas of very low malaria risk (<1% parasite prevalence), but by 2016, this had dropped to only 26.7% of the population. Meanwhile, the population in high transmission areas (prevalence >20%) increased from only 2.2% in 2011 to 9.2% in 2016. A comparison of the model-based estimates with the raw MIS results indicates there was an underestimation of the situation in 2016, since the raw figures likely associated with survey timings were delayed until after the peak transmission season. Malaria remains an important health problem in Madagascar. The monthly and annual prevalence maps developed here provide a way to evaluate the magnitude of change over time, taking into account variability in survey input data. These methods can contribute to monitoring sub-national trends of malaria prevalence in Madagascar as the country aims for geographically progressive elimination.

Getting Skills Right: Skills for Jobs Indicators

ERIC Educational Resources Information Center

OECD Publishing, 2017

2017-01-01

This report describes the construction of the database of skill needs indicators, i.e. the OECD Skills for Jobs Database, and presents initial results and analysis. It identifies the existing knowledge gaps concerning skills imbalances, providing the rationale for the development of the new skill needs and mismatch indicators. Moreover, it…

ACOustic: A Nature-Inspired Exploration Indicator for Ant Colony Optimization.

PubMed

Sagban, Rafid; Ku-Mahamud, Ku Ruhana; Abu Bakar, Muhamad Shahbani

2015-01-01

A statistical machine learning indicator, ACOustic, is proposed to evaluate the exploration behavior in the iterations of ant colony optimization algorithms. This idea is inspired by the behavior of some parasites in their mimicry to the queens' acoustics of their ant hosts. The parasites' reaction results from their ability to indicate the state of penetration. The proposed indicator solves the problem of robustness that results from the difference of magnitudes in the distance's matrix, especially when combinatorial optimization problems with rugged fitness landscape are applied. The performance of the proposed indicator is evaluated against the existing indicators in six variants of ant colony optimization algorithms. Instances for travelling salesman problem and quadratic assignment problem are used in the experimental evaluation. The analytical results showed that the proposed indicator is more informative and more robust.

Performance indicators and indices of sludge management in urban wastewater treatment plants.

PubMed

Silva, C; Saldanha Matos, J; Rosa, M J

2016-12-15

Sludge (or biosolids) management is highly complex and has a significant cost associated with the biosolids disposal, as well as with the energy and flocculant consumption in the sludge processing units. The sludge management performance indicators (PIs) and indices (PXs) are thus core measures of the performance assessment system developed for urban wastewater treatment plants (WWTPs). The key PIs proposed cover the sludge unit production and dry solids concentration (DS), disposal/beneficial use, quality compliance for agricultural use and costs, whereas the complementary PIs assess the plant reliability and the chemical reagents' use. A key PI was also developed for assessing the phosphorus reclamation, namely through the beneficial use of the biosolids and the reclaimed water in agriculture. The results of a field study with 17 Portuguese urban WWTPs in a 5-year period were used to derive the PI reference values which are neither inherent to the PI formulation nor literature-based. Clusters by sludge type (primary, activated, trickling filter and mixed sludge) and by digestion and dewatering processes were analysed and the reference values for sludge production and dry solids were proposed for two clusters: activated sludge or biofilter WWTPs with primary sedimentation, sludge anaerobic digestion and centrifuge dewatering; activated sludge WWTPs without primary sedimentation and anaerobic digestion and with centrifuge dewatering. The key PXs are computed for the DS after each processing unit and the complementary PXs for the energy consumption and the operating conditions DS-determining. The PX reference values are treatment specific and literature based. The PI and PX system was applied to a WWTP and the results demonstrate that it diagnosis the situation and indicates opportunities and measures for improving the WWTP performance in sludge management. Copyright © 2016 Elsevier Ltd. All rights reserved.

On the use of Godhavn H-component as an indicator of the interplanetary sector polarity

NASA Technical Reports Server (NTRS)

Svalgaard, L.

1974-01-01

An objective method of inferring the polarity of the interplanetary magnetic field using the H-component at Godhavn is presented. The objectively inferred polarities are compared with a subjective index inferred earlier. It is concluded that no significant difference exists between the two methods. The inferred polarities derived from Godhavn H is biased by the (slp) sub q signature in the sense that during summer prolonged intervals of geomagnetic calm will result in inferred Away polarity regardless of the actual sector polarity. This bias does not significantly alter the large scale structure of the inferred sector structure.

Age at first marriage, education and divorce: the case of the U.S.A..

PubMed

Perreira, P T

1991-01-01

"This paper presents an analysis of the determinants of the age of marriage and the probability of divorce among women in the United States." The author hypothesizes that the possibility of divorce enters into women's decision to marry. "As expected, empirical results indicate that in the United States, where it is easier to obtain divorce, women tend to marry earlier. Furthermore, Catholic women tend to marry later....Results seem to indicate the age at marriage and education should not be considered to be exogenous in the study of the probability of divorce. Another important result is that women who marry earlier...show a lower probability of divorce...." excerpt

Microencapsulation of Corrosion Indicators for Smart Coatings

NASA Technical Reports Server (NTRS)

Li, Wenyan; Buhrow, Jerry W.; Jolley, Scott T.; Calle, Luz M.; Hanna,Joshua S.; Rawlins, James W.

2011-01-01

A multifunctional smart coating for the autonomous detection, indication, and control of corrosion is been developed based on microencapsulation technology. This paper summarizes the development, optimization, and testing of microcapsules specifically designed for early detection and indication of corrosion when incorporated into a smart coating. Results from experiments designed to test the ability of the microcapsules to detect and indicate corrosion, when blended into several paint systems, show that these experimental coatings generate a color change, indicative of spot specific corrosion events, that can be observed with the naked eye within hours rather than the hundreds of hours or months typical of the standard accelerated corrosion test protocols.. Key words: smart coating, corrosion detection, microencapsulation, microcapsule, pH-sensitive microcapsule, corrosion indicator, corrosion sensing paint

The fifth plot of the Carcinogenic Potency Database: results of animal bioassays published in the general literature through 1988 and by the National Toxicology Program through 1989.

PubMed Central

Gold, L S; Manley, N B; Slone, T H; Garfinkel, G B; Rohrbach, L; Ames, B N

1993-01-01

This paper is the fifth plot of the Carcinogenic Potency Database (CPDB) that first appeared in this journal in 1984 (1-5). We report here results of carcinogenesis bioassays published in the general literature between January 1987 and December 1988, and in technical reports of the National Toxicology Program between July 1987 and December 1989. This supplement includes results of 412 long-term, chronic experiments of 147 test compounds and reports the same information about each experiment in the same plot format as the earlier papers: the species and strain of test animal, the route and duration of compound administration, dose level and other aspects of experimental protocol, histopathology and tumor incidence, TD50 (carcinogenic potency) and its statistical significance, dose response, author's opinion about carcinogenicity, and literature citation. We refer the reader to the 1984 publications (1,5,6) for a guide to the plot of the database, a complete description of the numerical index of carcinogenic potency, and a discussion of the sources of data, the rationale for the inclusion of particular experiments and particular target sites, and the conventions adopted in summarizing the literature. The five plots of the database are to be used together, as results of individual experiments that were published earlier are not repeated. In all, the five plots include results of 4487 experiments on 1136 chemicals. Several analyses based on the CPDB that were published earlier are described briefly, and updated results based on all five plots are given for the following earlier analyses: the most potent TD50 value by species, reproducibility of bioassay results, positivity rates, and prediction between species.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8354183

Can competing diversity indices inform us about why ethnic diversity erodes social cohesion? A test of five diversity indices in Germany.

PubMed

Schaeffer, Merlin

2013-05-01

An ever-growing number of studies investigates the relation between ethnic diversity and social cohesion, but these studies have produced mixed results. In cross-national research, some scholars have recently started to investigate more refined and informative indices of ethnic diversity than the commonly used Hirschman-Herfindahl Index. These refined indices allow to test competing theoretical explanations of why ethnic diversity is associated with declines in social cohesion. This study assesses the applicability of this approach for sub-national analyses. Generally, the results confirm a negative association between social cohesion and ethnic diversity. However, the competing indices are empirically indistinguishable and thus insufficient to test different theories against one another. Follow-up simulations suggest the general conclusion that the competing indices are meaningful operationalizations only if a sample includes: (1) contextual units with small and contextual units with large minority shares, as well as (2) contextual units with diverse and contextual units with polarized ethnic compositions. The results are thus instructive to all researchers who wish to apply different diversity indices and thereby test competing theories. Copyright © 2013 Elsevier Inc. All rights reserved.

Thermal Control Materials on MISSE-5 with Comparison to Earlier Flight Data

NASA Technical Reports Server (NTRS)

Finckenor, Miria; Zwiener, James M.; Pippin, Gary

2007-01-01

A variety of thermal control materials were flown on the Materials on International Space Station Experiment (MISSE)-5. Several types of beta cloth, as used in multi-layer insulation blankets, were flown, including samples from the same batch as used on the International Space Station. Two candidate sunshade materials for the James Webb Space Telescope were also exposed on MISSE-5. The white thermal control coating AZ93 was applied to Kapton instead of aluminum; this sample maintained good solar absorptance and did not indicate any significant level of contamination to the MISSE-5 experiment. Marker coatings maintained their color. Thermo-optical properties are discussed, along with comparable data from MISSE-2 and the Passive Optical Sample Assembly (POSA) - I experiments.

Developing biodiversity indicators on a stakeholders' opinions basis: the gypsum industry Key Performance Indicators framework.

PubMed

Pitz, Carline; Mahy, Grégory; Vermeulen, Cédric; Marlet, Christine; Séleck, Maxime

2016-07-01

This study aims to establish a common Key Performance Indicators (KPIs) framework for reporting about the gypsum industry biodiversity at the European level. In order to integrate different opinions and to reach a consensus framework, an original participatory process approach has been developed among different stakeholder groups: Eurogypsum, European and regional authorities, university scientists, consulting offices, European and regional associations for the conservation of nature, and the extractive industry. The strategy is developed around four main steps: (1) building of a maximum set of indicators to be submitted to stakeholders based on the literature (Focus Group method); (2) evaluating the consensus about indicators through a policy Delphi survey aiming at the prioritization of indicator classes using the Analytic Hierarchy Process method (AHP) and of individual indicators; (3) testing acceptability and feasibility through analysis of Environmental Impact Assessments (EIAs) and visits to three European quarries; (4) Eurogypsum final decision and communication. The resulting framework contains a set of 11 indicators considered the most suitable for all the stakeholders. Our KPIs respond to European legislation and strategies for biodiversity. The framework aims at improving sustainability in quarries and at helping to manage biodiversity as well as to allow the creation of coherent reporting systems. The final goal is to allow for the definition of the actual biodiversity status of gypsum quarries and allow for enhancing it. The framework is adaptable to the local context of each gypsum quarry.

Correlation and network analysis of global financial indices

NASA Astrophysics Data System (ADS)

Kumar, Sunil; Deo, Nivedita

2012-08-01

Random matrix theory (RMT) and network methods are applied to investigate the correlation and network properties of 20 financial indices. The results are compared before and during the financial crisis of 2008. In the RMT method, the components of eigenvectors corresponding to the second largest eigenvalue form two clusters of indices in the positive and negative directions. The components of these two clusters switch in opposite directions during the crisis. The network analysis uses the Fruchterman-Reingold layout to find clusters in the network of indices at different thresholds. At a threshold of 0.6, before the crisis, financial indices corresponding to the Americas, Europe, and Asia-Pacific form separate clusters. On the other hand, during the crisis at the same threshold, the American and European indices combine together to form a strongly linked cluster while the Asia-Pacific indices form a separate weakly linked cluster. If the value of the threshold is further increased to 0.9 then the European indices (France, Germany, and the United Kingdom) are found to be the most tightly linked indices. The structure of the minimum spanning tree of financial indices is more starlike before the crisis and it changes to become more chainlike during the crisis. The average linkage hierarchical clustering algorithm is used to find a clearer cluster structure in the network of financial indices. The cophenetic correlation coefficients are calculated and found to increase significantly, which indicates that the hierarchy increases during the financial crisis. These results show that there is substantial change in the structure of the organization of financial indices during a financial crisis.

Correlation and network analysis of global financial indices.

PubMed

Kumar, Sunil; Deo, Nivedita

2012-08-01

Random matrix theory (RMT) and network methods are applied to investigate the correlation and network properties of 20 financial indices. The results are compared before and during the financial crisis of 2008. In the RMT method, the components of eigenvectors corresponding to the second largest eigenvalue form two clusters of indices in the positive and negative directions. The components of these two clusters switch in opposite directions during the crisis. The network analysis uses the Fruchterman-Reingold layout to find clusters in the network of indices at different thresholds. At a threshold of 0.6, before the crisis, financial indices corresponding to the Americas, Europe, and Asia-Pacific form separate clusters. On the other hand, during the crisis at the same threshold, the American and European indices combine together to form a strongly linked cluster while the Asia-Pacific indices form a separate weakly linked cluster. If the value of the threshold is further increased to 0.9 then the European indices (France, Germany, and the United Kingdom) are found to be the most tightly linked indices. The structure of the minimum spanning tree of financial indices is more starlike before the crisis and it changes to become more chainlike during the crisis. The average linkage hierarchical clustering algorithm is used to find a clearer cluster structure in the network of financial indices. The cophenetic correlation coefficients are calculated and found to increase significantly, which indicates that the hierarchy increases during the financial crisis. These results show that there is substantial change in the structure of the organization of financial indices during a financial crisis.

Geomorphic indices indicated differential active tectonics of the Longmen Shan

NASA Astrophysics Data System (ADS)

Gao, M.; Xu, X.; Tan, X.

2012-12-01

The Longmen Shan thrust belt is located at the eastern margin of the Tibetan Plateau. It is a region of rapid active tectonics with high erosion rates and dense vegetation. The structure of the Longmen Shan region is dominated by northeast-trending thrusts and overturned folds that verge to the east and southeast (Burchfiel et al. 1995, Chen and Wilson 1996). The Longmen Shan thrust belt consists of three major faults from west to east: back-range fault, central fault, and frontal-range fault. The Mw 7.9 Wenchuan earthquake ruptured two large thrust faults along the Longmen Shan thrust belt (Xiwei et al., 2009). In this paper, we focus on investigating the spatial variance of tectonic activeness from the back-range fault to the frontal-range fault, particular emphasis on the differential recent tectonic activeness reflected by the hypsometry and the asymmetric factor of the drainage. Results from asymmetric factor indicate the back-rannge thrust fault on the south of the Maoxian caused drainage basins tilted on the hanging wall. For the north of the Maoxian, the strike-slip fault controlled the shapes of the drainage basins. Constantly river capture caused the expansion of the drainage basins which traversed by the fault. The drainages on the central fault and the frontal-range fault are also controlled by the fault slip. The drainage asymmetric factor suggested the central and southern segments of the Longmen Shan are more active than the northern segment, which is coherence with results of Huiping et al. (2010). The results from hypsometry show the back-range fault is the most active fault among the three major faults. Central fault is less active than the back-range fault but more active than the frontal-range fault. Beichuan is identified as the most active area along the central fault. Our geomorphic indices reflect an overall eastward decreasing of tectonic activeness of the Longmen Shan thrust belt.

Inter-observer reliability of animal-based welfare indicators included in the Animal Welfare Indicators welfare assessment protocol for dairy goats.

PubMed

Vieira, A; Battini, M; Can, E; Mattiello, S; Stilwell, G

2018-01-08

This study was conducted within the context of the Animal Welfare Indicators (AWIN) project and the underlying scientific motivation for the development of the study was the scarcity of data regarding inter-observer reliability (IOR) of welfare indicators, particularly given the importance of reliability as a further step for developing on-farm welfare assessment protocols. The objective of this study is therefore to evaluate IOR of animal-based indicators (at group and individual-level) of the AWIN welfare assessment protocol (prototype) for dairy goats. In the design of the study, two pairs of observers, one in Portugal and another in Italy, visited 10 farms each and applied the AWIN prototype protocol. Farms in both countries were visited between January and March 2014, and all the observers received the same training before the farm visits were initiated. Data collected during farm visits, and analysed in this study, include group-level and individual-level observations. The results of our study allow us to conclude that most of the group-level indicators presented the highest IOR level ('substantial', 0.85 to 0.99) in both field studies, pointing to a usable set of animal-based welfare indicators that were therefore included in the first level of the final AWIN welfare assessment protocol for dairy goats. Inter-observer reliability of individual-level indicators was lower, but the majority of them still reached 'fair to good' (0.41 to 0.75) and 'excellent' (0.76 to 1) levels. In the paper we explore reasons for the differences found in IOR between the group and individual-level indicators, including how the number of individual-level indicators to be assessed on each animal and the restraining method may have affected the results. Furthermore, we discuss the differences found in the IOR of individual-level indicators in both countries: the Portuguese pair of observers reached a higher level of IOR, when compared with the Italian observers. We argue how the

Developing the use of quality indicators in sterilization practices.

PubMed

Jabbari, H; Alikhah, H; Sahebkaram Alamdari, N; Behzad, M Naghavi; Mehrabi, E; Borzui, L; Bakhshian, F

2012-01-01

Health-care-associated infections are a major threat to the safety of patient care. Control of such problem is a major criterion for hospital accreditation. This study was aimed to determine the developing use of chemical (class 6 products) and biological indicators in Tabriz district hospitals since 1997 to 2011. We conducted this time-trend interventional study with all of the public and private hospitals, which counted to 21 in Tabriz district as a sample. The situations of indicator use were presented for each time in the base of indicator groups. Furthermore, the results were showed in the base of hospital groups. All of district hospital (n=21) with 74 autoclave machine and 22 central sterilization room were studied. The result of second time study in 2008 showed a markedly improvement in the control of sterilization processes. Furthermore, we continued our intervention results 6 month later in 2009 and 2 years later in 2011. The most striking result were use of chemical indicator in 100% of hospitals. However, there are defects in the use of biological indicators (63.65%). The most obvious finding was significant improvement in sterilization control especially in development the use of chemical indicators. The finding of this study has a number of important implications for hospital managers and infection control practitioners such as continuous practical training of CSSD personnel in hospitals and mandating of indicator using in all sterilization process with controlling of this subject in evaluation and accreditation of hospital programs.