Diagnosis, monitoring and management of immune-related adverse drug reactions of anti-PD-1 antibody therapy.

PubMed

Eigentler, Thomas K; Hassel, Jessica C; Berking, Carola; Aberle, Jens; Bachmann, Oliver; Grünwald, Viktor; Kähler, Katharina C; Loquai, Carmen; Reinmuth, Niels; Steins, Martin; Zimmer, Lisa; Sendl, Anna; Gutzmer, Ralf

2016-04-01

PD-1 checkpoint inhibitors are associated with a specific spectrum of immune-related adverse events. This spectrum is different from toxicities known for kinase inhibitors or cytotoxic drugs. Since PD-1 directed therapies show effectivity in an increasing number of malignant diseases, their clinical usage will increase rapidly. Therefore clinicians from different specialities such as medical oncology, internal medicine, family doctors and emergency unit staff should be aware of the adverse effects of PD-1 checkpoint inhibitors to avoid delays in diagnosis and treatment. Based on pooled data from pivotal trials as reported by the European Medicines Agency, the present paper reviews incidences and kinetics of onset and resolution of immune-mediated "adverse events of specific interest" (AEOSI) of both approved PD-1 inhibitors nivolumab and pembrolizumab. In general, the severity of AEOSI is mild to moderate (grade 1-2); the frequency of immune-mediated but also idiopathic grade 3-4 adverse drug reactions is ⩽2% for any event term. Recommendations for the diagnosis, monitoring and management of the relevant dermatological, gastrointestinal, pulmonary, endocrine, renal and hepatic toxicities are convened by an expert panel that consolidated and clarified treatment recommendations after the onset of AEOSI. Although the time of onset is not predictable - the medians range from 1 to 6months - the huge majority of events is reversible, with no impact of the time of onset. By the systemic use of glucocorticoids, notably methylprednisolone or equivalents, most AEOSI are well manageable. Non-steroidal immunosuppressants may be used in certain cases of refractory/recalcitrant, long-lasting immune toxicities. With regard to the outstanding clinical activity of the anti-PD-1 antibodies, therapy restart is the principal therapeutic option after recovery of grade 2 AEOSI, or diminution of higher grade skin or endocrine events to mild severity. Early diagnosis and close clinical monitoring are essential for successful management of immune-related adverse events. Copyright © 2016 Elsevier Ltd. All rights reserved.

Using 4+ to grade near-normal muscle strength does not improve agreement.

PubMed

O'Neill, Søren; Jaszczak, Sofie Louise Thomsen; Steffensen, Anne Katrine Søndergaard; Debrabant, Birgit

2017-01-01

Manual assessment of muscle strength is often graded using the ordinal Medical Research Council (MRC) scale. The scale has a number of inherent weaknesses, including poorly defined limits between grades '4' and '5' and very large differences in the span of muscle strength encompassed by each of the six grades. It is not necessarily obvious how to convert a manual muscle test finding into an MRC grade. Several modifications which include intermediate grades have been suggested to improve the MRC scale and the current study examines whether agreement improves and variation in ratings decrease, with an intermediate grade between '4' and '5', in circumstances where such a grade would seem appropriate. The present study examined the hypothesis, that a modified MRC-scale which included the commonly used '4+' option, resulted in greater agreement between clinicians compared to the standard MRC-scale. A questionnaire containing five simple clinical cases were distributed to a large convenience sample of chiropractors in Northern Europe, with instructions to grade the described muscle strength findings using the MRC scale. The scale was adapted (with/without an intermediate '4+' grade) depending on the preference of the individual respondent. The cases were designed in such a way as to suggest a muscle weakness in the grey area between '4' and '5', i.e. grade '4+' on the modified MRC scale. A total of 225 questionnaires were returned (7% response rate). The average percentage agreement (across cases) in the standard MRC group was 64% [range 51%: 73%] (grade '4' in all cases). In the modified MRC group, the corresponding findings was 48% [38%: 74%] (grade '4' or '4+' in all cases). The mean average deviation analogue in the standard MRC group was 0.34 (range 0.34: 0.40), compared to 0.51 (range 0.39: 0.73) in the modified MRC group, indicating greater dispersion of scores in the modified MRC group. The Fleiss kappa was 0.02 ( p  < 0.001) and 0.13 ( p  < 0.001), respectively. Contrary to the original hypothesis, introduction of a '4+' grade did not clearly improve agreement or variability of ratings, despite eliminating the physical muscle testing by providing written descriptions of test findings and specifically designing these to suggest a weakness of grade '4+'.

Relations of Parenting and Negative Life Events to Cognitive Diatheses for Depression in Children

ERIC Educational Resources Information Center

Bruce, Alanna E.; Cole, David A.; Dallaire, Danielle H.; Jacquez, Farrah M.; Pineda, Ashley Q.; LaGrange, Beth

2006-01-01

In a sample of 299 children (grades 2, 4, and 6), we examined parenting and negative life events as predictors of depressive cognitions, specifically low self-perceived competence, depressive cognitive schemas, and depressogenic attributional style. We also examined developmental trends in these relations. Children completed measures of parenting,…

Development of an Electromechanical Grade to Assess Human Knee Articular Cartilage Quality.

PubMed

Sim, Sotcheadt; Hadjab, Insaf; Garon, Martin; Quenneville, Eric; Lavigne, Patrick; Buschmann, Michael D

2017-10-01

Quantitative assessments of articular cartilage function are needed to aid clinical decision making. Our objectives were to develop a new electromechanical grade to assess quantitatively cartilage quality and test its reliability. Electromechanical properties were measured using a hand-held electromechanical probe on 200 human articular surfaces from cadaveric donors and osteoarthritic patients. These data were used to create a reference electromechanical property database and to compare with visual arthroscopic International Cartilage Repair Society (ICRS) grading of cartilage degradation. The effect of patient-specific and location-specific characteristics on electromechanical properties was investigated to construct a continuous and quantitative electromechanical grade analogous to ICRS grade. The reliability of this novel grade was assessed by comparing it with ICRS grades on 37 human articular surfaces. Electromechanical properties were not affected by patient-specific characteristics for each ICRS grade, but were significantly different across the articular surface. Electromechanical properties varied linearly with ICRS grade, leading to a simple linear transformation from one scale to the other. The electromechanical grade correlated strongly with ICRS grade (r = 0.92, p < 0.0001). Additionally, the electromechanical grade detected lesions that were not found visually. This novel grade can assist the surgeon in assessing human knee cartilage by providing a quantitative and reliable grading system.

MO19390 (SAiL): bleeding events in a phase IV study of first-line bevacizumab with chemotherapy in patients with advanced non-squamous NSCLC.

PubMed

Dansin, Eric; Cinieri, Saverio; Garrido, Pilar; Griesinger, Frank; Isla, Dolores; Koehler, Manfred; Kohlhaeufl, Martin

2012-06-01

The clinical benefit and safety profile associated with first-line bevacizumab with doublet chemotherapy in patients with advanced non-squamous non-small cell lung cancer (NSCLC) was established in two large phase III studies, E4599 and AVAiL. SAiL, a single-arm phase IV study, was conducted to evaluate bevacizumab with a range of first-line chemotherapy regimens in a routine oncology practice setting. This analysis of the SAiL data was undertaken to specifically evaluate bleeding adverse events (AEs) in this study, and to explore potential associations between bleeding and baseline patient and disease characteristics. In total, 2212 patients were evaluated. Bleeding AEs (any grade) occurred in 38.2% of patients (grade ≥ 3 bleeding AEs: 3.6%). Grade ≥ 3 pulmonary hemorrhage and central nervous system bleeding events were observed in 0.7% and 0.1% of patients, respectively. The incidence of grade ≥ 3 bleeding AEs was comparable across patient subgroups defined by central tumor location, tumor cavitation, histology, concomitant anticoagulation therapy and age. The majority (88.6%) of bleeding events resolved or improved, 10.2% persisted and 1.3% led to death; 10.2% of bleeding events required bevacizumab interruption or discontinuation. This analysis from the SAiL trial reaffirms a comparable incidence of clinically significant bleeding associated with first-line bevacizumab and chemotherapy as previous phase III studies in NSCLC patients despite less stringent first-line selection criteria. Grade ≥ 3 bleeding appears to be comparable when analyzed for patient and tumor characteristics, including tumor cavitation and concomitant anticoagulation therapy. Most bleeding events resolved or improved, and interruption/discontinuation of bevacizumab was infrequent in a standard oncology practice setting. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Preparing for Euro 2012: developing a hazard risk assessment.

PubMed

Wong, Evan G; Razek, Tarek; Luhovy, Artem; Mogilevkina, Irina; Prudnikov, Yuriy; Klimovitskiy, Fedor; Yutovets, Yuriy; Khwaja, Kosar A; Deckelbaum, Dan L

2015-04-01

Risk assessment is a vital step in the disaster-preparedness continuum as it is the foundation of subsequent phases, including mitigation, response, and recovery. To develop a risk assessment tool geared specifically towards the Union of European Football Associations (UEFA) Euro 2012. In partnership with the Donetsk National Medical University, Donetsk Research and Development Institute of Traumatology and Orthopedics, Donetsk Regional Public Health Administration, and the Ministry of Emergency of Ukraine, a table-based tool was created, which, based on historical evidence, identifies relevant potential threats, evaluates their impacts and likelihoods on graded scales based on previous available data, identifies potential mitigating shortcomings, and recommends further mitigation measures. This risk assessment tool has been applied in the vulnerability-assessment-phase of the UEFA Euro 2012. Twenty-three sub-types of potential hazards were identified and analyzed. Ten specific hazards were recognized as likely to very likely to occur, including natural disasters, bombing and blast events, road traffic collisions, and disorderly conduct. Preventative measures, such as increased stadium security and zero tolerance for impaired driving, were recommended. Mitigating factors were suggested, including clear, incident-specific preparedness plans and enhanced inter-agency communication. This hazard risk assessment tool is a simple aid in vulnerability assessment, essential for disaster preparedness and response, and may be applied broadly to future international events.

Comparative evaluation of H&H and WFNS grading scales with modified H&H (sans systemic disease): A study on 1000 patients with subarachnoid hemorrhage.

PubMed

Aggarwal, Ashish; Dhandapani, Sivashanmugam; Praneeth, Kokkula; Sodhi, Harsimrat Bir Singh; Pal, Sudhir Singh; Gaudihalli, Sachin; Khandelwal, N; Mukherjee, Kanchan K; Tewari, M K; Gupta, Sunil Kumar; Mathuriya, S N

2018-01-01

The comparative studies on grading in subarachnoid hemorrhage (SAH) had several limitations such as the unclear grading of Glasgow Coma Scale 15 with neurological deficits in World Federation of Neurosurgical Societies (WFNS), and the inclusion of systemic disease in Hunt and Hess (H&H) scales. Their differential incremental impacts and optimum cut-off values for unfavourable outcome are unsettled. This is a prospective comparison of prognostic impacts of grading schemes to address these issues. SAH patients were assessed using WFNS, H&H (including systemic disease), modified H&H (sans systemic disease) and followed up with Glasgow Outcome Score (GOS) at 3 months. Their performance characteristics were analysed as incremental ordinal variables and different grading scale dichotomies using rank-order correlation, sensitivity, specificity, positive predictive value, negative predictive value, Youden's J and multivariate analyses. A total of 1016 patients were studied. As univariate incremental variable, H&H sans systemic disease had the best negative rank-order correlation coefficient (-0.453) with respect to lower GOS (p < 0.001). As univariate dichotomized category, WFNS grades 3-5 had the best performance index of 0.39 to suggest unfavourable GOS with a specificity of 89% and sensitivity of 51%. In multivariate incremental analysis, H&H sans systemic disease had the greatest adjusted incremental impact of 0.72 (95% confidence interval (CI) 0.54-0.91) against a lower GOS as compared to 0.6 (95% CI 0.45-0.74) and 0.55 (95% CI 0.42-0.68) for H&H and WFNS grades, respectively. In multivariate categorical analysis, H&H grades 4-5 sans systemic disease had the greatest impact on unfavourable GOS with an adjusted odds ratio of 6.06 (95% CI 3.94-9.32). To conclude, H&H grading sans systemic disease had the greatest impact on unfavourable GOS. Though systemic disease is an important prognostic factor, it should be considered distinctly from grading. Appropriate cut-off values suggesting unfavourable outcome for H&H and WFNS were 4-5 and 3-5, respectively, indicating the importance of neurological deficits in addition to level of consciousness.

Effects of decompressive craniectomy on functional outcomes and death in poor-grade aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis.

PubMed

Alotaibi, Naif M; Elkarim, Ghassan Awad; Samuel, Nardin; Ayling, Oliver G S; Guha, Daipayan; Fallah, Aria; Aldakkan, Abdulrahman; Jaja, Blessing N R; de Oliveira Manoel, Airton Leonardo; Ibrahim, George M; Macdonald, R Loch

2017-12-01

OBJECTIVE Patients with poor-grade aneurysmal subarachnoid hemorrhage (aSAH) (World Federation of Neurosurgical Societies Grade IV or V) are often considered for decompressive craniectomy (DC) as a rescue therapy for refractory intracranial hypertension. The authors performed a systematic review and meta-analysis to assess the impact of DC on functional outcome and death in patients after poor-grade aSAH. METHODS A systematic review and meta-analysis were performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Articles were identified through the Ovid Medline, Embase, Web of Science, and Cochrane Library databases from inception to October 2015. Only studies dedicated to patients with poor-grade aSAH were included. Primary outcomes were death and functional outcome assessed at any time period. Patients were grouped as having a favorable outcome (modified Rankin Scale [mRS] Scores 1-3, Glasgow Outcome Scale [GOS] Scores 4 and 5, extended Glasgow Outcome Scale [GOSE] Scores 5-8) or unfavorable outcome (mRS Scores 4-6, GOS Scores 1-3, GOSE Scores 1-4). Pooled estimates of event rates and odds ratios with 95% confidence intervals were calculated using the random-effects model. RESULTS Fifteen studies encompassing 407 patients were included in the meta-analysis (all observational cohorts). The pooled event rate for poor outcome across all studies was 61.2% (95% CI 52%-69%) and for death was 27.8% (95% CI 21%-35%) at a median of 12 months after aSAH. Primary (or early) DC resulted in a lower overall event rate for unfavorable outcome than secondary (or delayed) DC (47.5% [95% CI 31%-64%] vs 74.4% [95% CI 43%-91%], respectively). Among studies with comparison groups, there was a trend toward a reduced mortality rate 1-3 months after discharge among patients who did not undergo DC (OR 0.58 [95% CI 0.27-1.25]; p = 0.168). However, this trend was not sustained at the 1-year follow-up (OR 1.09 [95% CI 0.55-2.13]; p = 0.79). CONCLUSIONS Results of this study summarize the best evidence available in the literature for DC in patients with poor-grade aSAH. DC is associated with high rates of unfavorable outcome and death. Because of the lack of robust control groups in a majority of the studies, the effect of DC on functional outcomes versus that of other interventions for refractory intracranial hypertension is still unknown. A randomized trial is needed.

Long-term psychosocial impact of alternative management policies in women with low-grade abnormal cervical cytology referred for colposcopy: a randomised controlled trial.

PubMed

Sharp, L; Cotton, S; Gray, N; Avis, M; Russell, I; Walker, L; Waugh, N; Whynes, D; Woolley, C; Thornton, A; Smart, L; Cruickshank, M; Little, J

2011-01-18

The debate continues regarding the best management for women with low-grade abnormal cervical cytology attending colposcopy. We compared psychosocial outcomes of alternative management policies in these women. In all, 989 women, aged 20-59 years, with low-grade abnormal cytology, were randomised to immediate large loop excision (LLETZ) or two to four targeted punch biopsies taken immediately with recall for LLETZ if these showed cervical intra-epithelial neoplasia 2/3. At 6 weeks after the last procedure, women completed the hospital anxiety and depression scale (HADS) and the impact of event scale (IES). At 12, 18, 24 and 30 months post recruitment, women completed the HADS and process outcome specific measure (POSM). Prevalence of significant depression (≥ 8), significant anxiety (≥ 11) and distress (≥ 9) and median POSM scores were compared between arms. Multivariate odds ratios (ORs) for immediate LLETZ vs biopsy and recall were computed. Over the entire follow-up, there was no significant difference between arms in cumulative prevalence or risk of significant depression (OR=0.78, 95% CI 0.52-1.17) or significant anxiety (OR=0.83, 95% CI 0.57-1.19). At 6 weeks post procedure, distress did not differ significantly between arms. At later time points, 8-11% had significant depression and 14-16% had significant anxiety but with no differences between arms. The POSM scores did not differ between the arms. There is no difference in long- or short-term psychosocial outcomes of immediate LLETZ and punch biopsies with selective recall.

Comparison of Standardized Clinical Classification with Fundus Photograph Grading for the assessment of Diabetic Retinopathy and Diabetic Macular Edema Severity

PubMed Central

Gangaputra, Sapna; Lovato, James F.; Hubbard, Larry; Davis, Matthew D; Esser, Barbara A; Ambrosius, Walter T.; Chew, Emily Y.; Greven, Craig; Perdue, Letitia H; Wong, Wai T.; Condren, Audree; Wilkinson, Charles P.; Agrón, Elvira; Adler, Sharon; Danis, Ronald P

2013-01-01

Purpose To compare evaluation by clinical examination with image grading at a reading center (RC) for the classification of diabetic retinopathy (DR) and diabetic macular edema (DME). Methods ACCORD and FIND had similar methods of clinical and fundus photograph evaluation. For analysis purposes the photographic grading scales were condensed to correspond to the clinical scales and agreement between clinicians and reading center classification were compared. Results 6902 eyes of ACCORD participants and 3638 eyes of FIND participants were analyzed for agreement (percent, kappa) on DR on a 5 level scale. Exact agreement between clinicians and RC on DR severity category was 69% in ACCORD and 74% in FIND (Kappa 0.42 and 0.65). Sensitivity of the clinical grading to identify presence of mild nonproliferative retinopathy or worse was 0.53 in ACCORD and 0.84 in FIND. Specificities were 0.97 and 0.96, respectively. DME agreement in 6649 eyes of ACCORD participants and 3366 eyes of FIND participants was similar in both studies (Kappa 0.35 and 0.41). Sensitivities of the clinical grading to identify DME were 0.44 and 0.53 and specificities were 0.99 and 0.94, respectively. Conclusion Our results support the use of clinical information for defining broad severity categories, but not for documenting small to moderate changes in DR over time. PMID:23615341

Development and Assessment of Memorial Sloan Kettering Cancer Center’s Surgical Secondary Events Grading System

PubMed Central

Strong, Vivian E.; Selby, Luke V.; Sovel, Mindy; Disa, Joseph J.; Hoskins, William; DeMatteo, Ronald; Scardino, Peter; Jaques, David P.

2015-01-01

Background Studying surgical secondary events is an evolving effort with no current established system for database design, standard reporting, or definitions. Using the Clavien-Dindo classification as a guide, in 2001 we developed a Surgical Secondary Events database based on grade of event and required intervention to begin prospectively recording and analyzing all surgical secondary events (SSE). Study Design Events are prospectively entered into the database by attending surgeons, house staff, and research staff. In 2008 we performed a blinded external audit of 1,498 operations that were randomly selected to examine the quality and reliability of the data. Results 1,498 of 4,284 operations during the 3rd quarter of 2008 were audited. 79% (N=1,180) of the operations did not have a secondary event while 21% (N=318) of operations had an identified event. 91% (1,365) of operations were correctly entered into the SSE database. 97% (129/133) of missed secondary events were Grades I and II. Three Grade III (2%) and one Grade IV (1%) secondary event were missed. There were no missed Grade 5 secondary events. Conclusion Grade III – IV events are more accurately collected than Grade I – II events. Robust and accurate secondary events data can be collected by clinicians and research staff and these data can safely be used for quality improvement projects and research. PMID:25319579

Development and assessment of Memorial Sloan Kettering Cancer Center's Surgical Secondary Events grading system.

PubMed

Strong, Vivian E; Selby, Luke V; Sovel, Mindy; Disa, Joseph J; Hoskins, William; Dematteo, Ronald; Scardino, Peter; Jaques, David P

2015-04-01

Studying surgical secondary events is an evolving effort with no current established system for database design, standard reporting, or definitions. Using the Clavien-Dindo classification as a guide, in 2001 we developed a Surgical Secondary Events database based on grade of event and required intervention to begin prospectively recording and analyzing all surgical secondary events (SSE). Events are prospectively entered into the database by attending surgeons, house staff, and research staff. In 2008 we performed a blinded external audit of 1,498 operations that were randomly selected to examine the quality and reliability of the data. Of 4,284 operations, 1,498 were audited during the third quarter of 2008. Of these operations, 79 % (N = 1,180) did not have a secondary event while 21 % (N = 318) had an identified event; 91 % of operations (1,365) were correctly entered into the SSE database. Also 97 % (129 of 133) of missed secondary events were grades I and II. There were 3 grade III (2 %) and 1 grade IV (1 %) secondary event that were missed. There were no missed grade 5 secondary events. Grade III-IV events are more accurately collected than grade I-II events. Robust and accurate secondary events data can be collected by clinicians and research staff, and these data can safely be used for quality improvement projects and research.

Detection of right-to-left shunts: comparison between the International Consensus and Spencer Logarithmic Scale criteria.

PubMed

Lao, Annabelle Y; Sharma, Vijay K; Tsivgoulis, Georgios; Frey, James L; Malkoff, Marc D; Navarro, Jose C; Alexandrov, Andrei V

2008-10-01

International Consensus Criteria (ICC) consider right-to-left shunt (RLS) present when Transcranial Doppler (TCD) detects even one microbubble (microB). Spencer Logarithmic Scale (SLS) offers more grades of RLS with detection of >30 microB corresponding to a large shunt. We compared the yield of ICC and SLS in detection and quantification of a large RLS. We prospectively evaluated paradoxical embolism in consecutive patients with ischemic strokes or transient ischemic attack (TIA) using injections of 9 cc saline agitated with 1 cc of air. Results were classified according to ICC [negative (no microB), grade I (1-20 microB), grade II (>20 microB or "shower" appearance of microB), and grade III ("curtain" appearance of microB)] and SLS criteria [negative (no microB), grade I (1-10 microB), grade II (11-30 microB), grade III (31100 microB), grade IV (101300 microB), grade V (>300 microB)]. The RLS size was defined as large (>4 mm) using diameter measurement of the septal defects on transesophageal echocardiography (TEE). TCD comparison to TEE showed 24 true positive, 48 true negative, 4 false positive, and 2 false negative cases (sensitivity 92.3%, specificity 92.3%, positive predictive value (PPV) 85.7%, negative predictive value (NPV) 96%, and accuracy 92.3%) for any RLS presence. Both ICC and SLS were 100% sensitive for detection of large RLS. ICC and SLS criteria yielded a false positive rate of 24.4% and 7.7%, respectively when compared to TEE. Although both grading scales provide agreement as to any shunt presence, using the Spencer Scale grade III or higher can decrease by one-half the number of false positive TCD diagnoses to predict large RLS on TEE.

Image Guided Hypofractionated Postprostatectomy Intensity Modulated Radiation Therapy for Prostate Cancer

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

Lewis, Stephen L.; Patel, Pretesh; Song, Haijun

2016-03-01

Purpose: Hypofractionated radiation therapy (RT) has promising long-term biochemical relapse-free survival (bRFS) with comparable toxicity for definitive treatment of prostate cancer. However, data reporting outcomes after adjuvant and salvage postprostatectomy hypofractionated RT are sparse. Therefore, we report the toxicity and clinical outcomes after postprostatectomy hypofractionated RT. Methods and Materials: From a prospectively maintained database, men receiving image guided hypofractionated intensity modulated RT (HIMRT) with 2.5-Gy fractions constituted our study population. Androgen deprivation therapy was used at the discretion of the radiation oncologist. Acute toxicities were graded according to the Common Terminology Criteria for Adverse Events version 4.0. Late toxicities weremore » scored using the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer scale. Biochemical recurrence was defined as an increase of 0.1 in prostate-specific antigen (PSA) from posttreatment nadir or an increase in PSA despite treatment. The Kaplan-Meier method was used for the time-to-event outcomes. Results: Between April 2008 and April 2012, 56 men received postoperative HIMRT. The median follow-up time was 48 months (range, 21-67 months). Thirty percent had pre-RT PSA <0.1; the median pre-RT detectable PSA was 0.32 ng/mL. The median RT dose was 65 Gy (range, 57.5-65 Gy). Ten patients received neoadjuvant and concurrent hormone therapy. Posttreatment acute urinary toxicity was limited. There was no acute grade 3 toxicity. Late genitourinary (GU) toxicity of any grade was noted in 52% of patients, 40% of whom had pre-RT urinary incontinence. The 4-year actuarial rate of late grade 3 GU toxicity (exclusively gross hematuria) was 28% (95% confidence interval [CI], 16%-41%). Most grade 3 GU toxicity resolved; only 7% had persistent grade ≥3 toxicity at the last follow-up visit. Fourteen patients experienced biochemical recurrence at a median of 20 months after radiation. The 4-year bPFS rate was 75% (95% CI, 63%-87%). Conclusions: The biochemical control in this series appears promising, although relatively short follow-up may lead to overestimation. Late grade 3 GU toxicity was higher than anticipated with hypofractionated radiation of 65 Gy to the prostate bed, although most resolved.« less

A study in the use of the position of discrepant events in the teaching of science

NASA Astrophysics Data System (ADS)

Frassinelli, John James

The purpose of this study was to determine whether alternative placement of discrepant events would impact affective and cognitive outcomes of ninth-grade physical science students grouped into intact classes and classified as either "high" or "low" in prior academic achievement. Although researchers have found discrepant events to be effective in terms of cognition and recall, their chronological placement within science lessons had not been empirically researched. In this study, discrepant events were presented before, during, and after specific science lessons involving thermodynamics and heat. Discrepant events were withheld from the control group. To measure affective outcomes, the "enjoyment" and "motivation" scales taken from Sandman's (1973) Attitudes Towards Science Inventory (ATSI) were used to index subjects' global feelings about studying science, while a 20-item set of Semantic Differential (SD) scales was employed to determine their attitudes regarding the specific subject matter taught. To measure cognitive outcomes, a 20-item, selected response test was constructed by the researcher, with 6 items intended to assess subjects' knowledge of unit materials, and 14 items designed to query their understanding of unit concepts. Each subject (N = 131) was administered identical forms of each test in both pre-and post-test formats, both before and after the four-week study. Analyzed using a 4 x 2 mixed Analysis of Variance (ANOVA) model, data pertinent to the ATSI suggested neither between- nor within-group differences in subjects' global attitudes about studying science, although data pertinent to the SD scales indicated generally improved attitudes about studying thermodynamics and heat (F (1,122) = 2.759, p < .10). On the cognitive pretests and posttests, significant two-way interactions were observed for the overall test and experimental condition (F (3,121) = 4.068, p < .01), as well as for the overall test and higher prior achievement in physical science (F (1,121) = 7.059,p < .01). As contrasted with negligible changes in the control group's scores, robust mean-difference effect sizes were observed for all three treatment groups---"beginning" (d = 1.24), "during" (d = 0.70), and "after" ( d = 0.78)---but particularly for the "beginning" group. Subsequent analysis revealed that the apparent advantage of the "beginning" group was largely attributable to a particularly strong showing on the six test items concerned with knowledge (d = 2.06).

The Relationship Between Serum Neuron-Specific Enolase Levels and Severity of Bleeding and Functional Outcomes in Patients With Nontraumatic Subarachnoid Hemorrhage.

PubMed

Tawk, Rabih G; Grewal, Sanjeet S; Heckman, Michael G; Rawal, Bhupendra; Miller, David A; Edmonston, Drucilla; Ferguson, Jennifer L; Navarro, Ramon; Ng, Lauren; Brown, Benjamin L; Meschia, James F; Freeman, William D

2016-04-01

The value of neuron-specific enolase (NSE) in predicting clinical outcomes has been investigated in a variety of neurological disorders. To investigate the associations of serum NSE with severity of bleeding and functional outcomes in patients with subarachnoid hemorrhage (SAH). We retrospectively reviewed the records of patients with SAH from June 2008 to June 2012. The severity of SAH bleeding at admission was measured radiographically with the Fisher scale and clinically with the Glasgow Coma Scale, Hunt and Hess grade, and World Federation of Neurologic Surgeons scale. Outcomes were assessed with the modified Rankin Scale at discharge. We identified 309 patients with nontraumatic SAH, and 71 had NSE testing. Median age was 54 years (range, 23-87 years), and 44% were male. In multivariable analysis, increased NSE was associated with a poorer Hunt and Hess grade (P = .003), World Federation of Neurologic Surgeons scale score (P < .001), and Glasgow Coma Scale score (P = .003) and worse outcomes (modified Rankin Scale at discharge; P = .001). There was no significant association between NSE level and Fisher grade (P = .81) in multivariable analysis. We found a significant association between higher NSE levels and poorer clinical presentations and worse outcomes. Although it is still early for any relevant clinical conclusions, our results suggest that NSE holds promise as a tool for screening patients at increased risk of poor outcomes after SAH.

Inflammation-Related Morbidity and Mortality Among HIV-Positive Adults: How Extensive Is It?

PubMed

Hart, Brian B; Nordell, Anna D; Okulicz, Jason F; Palfreeman, Adrian; Horban, Andrzej; Kedem, Eynat; Neuhaus, Jacqueline; Jacobs, David R; Duprez, Daniel A; Neaton, James D

2018-01-01

To determine the rate of grade 4, potentially life-threatening events not attributable to AIDS, cardiovascular disease (CVD), or non-AIDS cancer among participants on antiretroviral therapy and to describe associations of these events with interleukin-6 (IL-6) and D-dimer. Cohort study. HIV-infected participants on antiretroviral therapy (N = 3568) with an HIV-RNA level ≤ 500 copies/mL were followed for grade 4, AIDS, CVD, non-AIDS cancer, and all-cause mortality events. Grade 4 events were further classified masked to biomarker levels as reflecting chronic inflammation-related disease (ChrIRD) or not (non-ChrIRD). Associations of baseline IL-6 and D-dimer with events were studied using Cox models. Over a median follow-up of 4.3 years, 339 participants developed a grade 4 event (22.9 per 1000 person-years); 165 participants developed a ChrIRD grade 4 event (10.7 per 1000 person-years). Grade 4 events were more common than AIDS (54 participants), CVD (132), and non-AIDS cancer (80) events, any of which developed in 252 participants (17.1 per 1000 person-years). Grade 4 and AIDS events were associated with similar risks of death. Higher IL-6 [hazard ratio (HR) = 1.19 per doubling of biomarker; P = 0.003] and D-dimer (HR = 1.23; P < 0.001) levels were associated with an increased risk of grade 4 events. IL-6 associations were stronger for ChrIRD (HR = 1.38; P < 0.001) than non-ChrIRD grade 4 events (HR = 1.11; P = 0.21). Morbidity and mortality associated with activation of inflammatory and coagulation pathways include conditions other than AIDS, CVD, and non-AIDS cancer events. Effective inflammation-dampening interventions could greatly affect the health of people with HIV.

Using the Big Six Information Skills as a Metacognitive Scaffold To Solve Information Based Problems.

ERIC Educational Resources Information Center

Wolf, Sara Elizabeth; Brush, Thomas

The purpose of this research study was to determine whether a specific information problem-solving skills model was an effective metacognitive scaffold for students solving information-based problems. Specifically, 35 eighth grade students in two intact classes were asked to write newspaper articles that summarized the events surrounding the Selma…

Lower physical activity is a strong predictor of cardiovascular events in elderly patients with type 2 diabetes mellitus beyond traditional risk factors: the Japanese Elderly Diabetes Intervention Trial.

PubMed

Iijima, Katsuya; Iimuro, Satoshi; Shinozaki, Tomohiro; Ohashi, Yasuo; Sakurai, Takashi; Umegaki, Hiroyuki; Araki, Atsushi; Ouchi, Yasuyoshi; Ito, Hideki

2012-04-01

It is well known that a decline in physical activity is associated with lifestyle-related diseases including cardiovascular (CV) events. However, little is known about the association between physical activity and CV events in elderly patients, because recent accumulating reports have mainly dealt with middle-aged populations. In this study, we investigated the correlation between physical activity and CV events in Japanese elderly patients with type 2 diabetes mellitus (T2DM). A total of 938 Japanese elderly patients with T2DM (447 men and 491 women, mean age 71.9 years) enrolled (2000-2002) in the Japanese Elderly Diabetes Intervention Trial (J-EDIT) were used in this study. Physical activity consisting of three components, work, sports and leisure-time, of their lifestyle was evaluated using the Baecke questionnaire at baseline. Total activity score (TAS) as a sum of each activity score was divided into four quartiles (Q1 to Q4). During a follow-up period of 65.2 months, 165 events and 71 deaths in total occurred. Higher TAS grade was associated with reduced risk of all events (hazard ratios: 0.82, 0.77 and 0.54 in Q2, Q3 and Q4, respectively) with statistical significance. Even after multivariate adjustment for covariates, higher TAS grade was a strong predictor of all events, and the prediction by TAS of cerebrovascular events was more effective than that of cardiac events. In contrast, all-cause mortality gradually decreased according to TAS grade; however, no statistical significance was found. Among the four grades of TAS, no significant change in several parameters, such as profiles of lipid and glucose metabolism, blood pressure, physical measurements, cognitive function and depression scale, was found throughout the follow-up period, suggesting that the higher level of physical activity itself was associated with the risk reduction of primary events. Lower physical activity is a strong and independent predictor of all CV events in the elderly with T2DM beyond traditional risk factors. In addition to strict management of each atherosclerotic risk factor, engagement with patients to augment and maintain the level of physical activity in their lifestyle is also essential in clinical practice. © 2012 Japan Geriatrics Society.

Electrical response grading versus House-Brackmann scale for evaluation of facial nerve injury after Bell's palsy: a comparative study.

PubMed

Huang, Bin; Zhou, Zhang-ling; Wang, Li-li; Zuo, Cong; Lu, Yan; Chen, Yong

2014-07-01

There are no convenient techniques to evaluate the degree of facial nerve injury during a course of acupuncture treatment for Bell's palsy. Our previous studies found that observing the electrical response of specific facial muscles provided reasonable correlation with the prognosis of electroacupuncture treatment. Hence, we used the new method to evaluate the degree of facial nerve injury in patients with Bell's palsy in comparison with the House-Brackmann scale. The relationship between therapeutic effects and prognosis was analyzed to explore an objective method for evaluating Bell's palsy. The facial nerve function of 68 patients with Bell's palsy was assessed with both electrical response grading and the House-Brackmann scale before treatment. Then differences in evaluation results of the two methods were compared. All enrolled patients received electroacupuncture treatment with disperse-dense wave at 1/100 Hz for 4 weeks. After treatment, correlation analysis was conducted to find the relationship between electrical response and therapeutic effects or prognosis. Checking consistency between electrical response grading and House-Brackmann scale: Kappa value 0.028 (P = 0.578). Correlation analysis: the two methods were correlated with the prognosis, and electrical response grading (rER = 0.789) was better than the House-Brackmann scale (rHB = 0.423). Electrical response grading is superior to the House-Brackmann scale in efficacy and reliability, and can conveniently assess the degree of facial nerve injury. The House-Brackmann scale is suitable for the patients with mild facial nerve injury, but its evaluation quality for severe facial nerve injury is poor.

Unique case of oligoastrocytoma with recurrence and grade progression: Exhibiting differential expression of high mobility group-A1 and human telomerase reverse transcriptase

PubMed Central

Gandhi, Puneet; Khare, Richa; Niraj, Kavita; Garg, Nitin; Sorte, Sandeep K; Gulwani, Hanni

2016-01-01

Mixed gliomas, primarily oligoastrocytomas, account for about 5%-10% of all gliomas. Distinguishing oligoastrocytoma based on histological features alone has limitations in predicting the exact biological behavior, necessitating ancillary markers for greater specificity. In this case report, human telomerase reverse transcriptase (hTERT) and high mobility group-A1 (HMGA1); markers of proliferation and stemness, have been quantitatively analyzed in formalin-fixed paraffin-embedded tissue samples of a 34 years old patient with oligoastrocytoma. Customized florescence-based immunohistochemistry protocol with enhanced sensitivity and specificity is used in the study. The patient presented with a history of generalized seizures and his magnetic resonance imaging scans revealed infiltrative ill-defined mass lesion with calcified foci within the left frontal white matter, suggestive of glioma. He was surgically treated at our center for four consecutive clinical events. Histopathologically, the tumor was identified as oligoastrocytoma-grade II followed by two recurrence events and final progression to grade III. Overall survival of the patient without adjuvant therapy was more than 9 years. Glial fibrillary acidic protein, p53, Ki-67, nuclear atypia index, pre-operative neutrophil-lymphocyte ratio, are the other parameters assessed. Findings suggest that hTERT and HMGA1 are linked to tumor recurrence and progression. Established markers can assist in defining precise histopathological grade in conjuction with conventional markers in clinical setup. PMID:27672647

The Origins of the Cold War: A Unit of Study for Grades 9-12.

ERIC Educational Resources Information Center

King, Lisa

This unit is one of a series that represents specific moments in history from which students focus on the meanings of landmark events. The events of 1945 are regarded widely as a turning point in 20th century history, a point when the United States unequivocally took its place as a world power, at a time when Americans had a strong but…

Conners' Teacher Rating Scale for Preschool Children: A Revised, Brief, Age-Specific Measure

ERIC Educational Resources Information Center

Purpura, David J.; Lonigan, Christopher J.

2009-01-01

The Conners' Teacher Rating Scale-Revised (CTRS-R) is one of the most commonly used measures of child behavior problems. However, the scale length and the appropriateness of some of the items on the scale may reduce the usefulness of the CTRS-R for use with preschoolers. In this study, a Graded Response Model analysis based on Item Response Theory…

Light's Retention Scale [and] Recording Form.

ERIC Educational Resources Information Center

Light, H. Wayne

Light's Retention Scale, consisting of 19 evaluation categories, is designed for use by teachers and school psychologists to determine whether a student should be retained in grade or promoted. Another suggested use is for nonprofessionals to determine what educational and psychological research discloses about a specific retention candidate in…

Early Jamestown: A Unit of Study for Grades 5-8.

ERIC Educational Resources Information Center

Pearson, Jim; Watkins, Bryna

This unit is one of a series that represents specific moments in history from which students focus on the meanings of landmark events. By studying a crucial turning point in history students become aware that choices had to be made by real human beings, that those decisions were the result of specific factors, and that they set in motion a series…

Abraham Lincoln and Slavery: A Unit of Study for Grades 8-12.

ERIC Educational Resources Information Center

Ankeney, Kirk; Vigilante, David

This document is one of a series that represents specific moments in history from which students focus on the meanings of landmark events. Students become aware that choices had to be made by real human beings, that those decisions were the result of specific factors, and that they set in motion a series of historical consequences. By analyzing…

Associations between glutathione S-transferase pi Ile105Val and glyoxylate aminotransferase Pro11Leu and Ile340Met polymorphisms and early-onset oxaliplatin-induced neuropathy.

PubMed

Kanai, Masashi; Yoshioka, Akira; Tanaka, Shiro; Nagayama, Satoshi; Matsumoto, Shigemi; Nishimura, Takafumi; Niimi, Miyuki; Teramukai, Satoshi; Takahashi, Ryo; Mori, Yukiko; Kitano, Toshiyuki; Ishiguro, Hiroshi; Yanagihara, Kazuhiro; Chiba, Tsutomu; Fukushima, Masanori; Matsuda, Fumihiko

2010-04-01

Although the risk of oxaliplatin-induced neuropathy depends on cumulative oxaliplatin dose, susceptibility to this adverse event differs greatly among patients. In this study, we investigated the associations between oxaliplatin-induced neuropathy and the following polymorphisms: glutathione S-transferase pi (GSTP1) Ile(105)Val, and glyoxylate aminotransferase (AGXT) Pro(11)Leu and AGXT Ile(340)Met. Eighty-two Japanese patients with histologically confirmed colorectal cancer who received at least six cycles of the modified FOLFOX6 (m-FOLFOX6) regimen were enrolled. To minimize differences in cumulative oxaliplatin dose between patients, oxaliplatin-induced neuropathy was evaluated using an oxaliplatin-specific scale during the 2-week period after completion of the sixth cycle of treatment. Forty-four patients developed grade 2/3 oxaliplatin-induced neuropathy. There were more patients carrying at least one GSTP1(105)Val allele among the group with grade 2/3 neuropathy (18/44, 41%) than among the group with grade 1 neuropathy (9/38, 24%), although the difference was not statistically significant (P=0.098). There were similar numbers of patients carrying at least one AGXT(105)Met allele in the grade 2/3 neuropathy (7/44, 16%) and grade 1 neuropathy groups (5/38, 13%; P=0.725). The AGXT(11)Leu allele was not found in any of our patients or controls. We found no significant association between oxaliplatin-induced neuropathy and the GSTP1 Ile(105)Val and AGXT Ile(340)Met polymorphisms. Given that no AGXT(11)Leu allele was found among our study population (n=177), evaluating this polymorphism in Japanese patients in future studies is likely to be uninformative.

CDKN2D-WDFY2 is a cancer-specific fusion gene recurrent in high-grade serous ovarian carcinoma.

PubMed

Kannan, Kalpana; Coarfa, Cristian; Rajapakshe, Kimal; Hawkins, Shannon M; Matzuk, Martin M; Milosavljevic, Aleksandar; Yen, Laising

2014-03-01

Ovarian cancer is the fifth leading cause of cancer death in women. Almost 70% of ovarian cancer deaths are due to the high-grade serous subtype, which is typically detected only after it has metastasized. Characterization of high-grade serous cancer is further complicated by the significant heterogeneity and genome instability displayed by this cancer. Other than mutations in TP53, which is common to many cancers, highly recurrent recombinant events specific to this cancer have yet to be identified. Using high-throughput transcriptome sequencing of seven patient samples combined with experimental validation at DNA, RNA and protein levels, we identified a cancer-specific and inter-chromosomal fusion gene CDKN2D-WDFY2 that occurs at a frequency of 20% among sixty high-grade serous cancer samples but is absent in non-cancerous ovary and fallopian tube samples. This is the most frequent recombinant event identified so far in high-grade serous cancer implying a major cellular lineage in this highly heterogeneous cancer. In addition, the same fusion transcript was also detected in OV-90, an established high-grade serous type cell line. The genomic breakpoint was identified in intron 1 of CDKN2D and intron 2 of WDFY2 in patient tumor, providing direct evidence that this is a fusion gene. The parental gene, CDKN2D, is a cell-cycle modulator that is also involved in DNA repair, while WDFY2 is known to modulate AKT interactions with its substrates. Transfection of cloned fusion construct led to loss of wildtype CDKN2D and wildtype WDFY2 protein expression, and a gain of a short WDFY2 protein isoform that is presumably under the control of the CDKN2D promoter. The expression of short WDFY2 protein in transfected cells appears to alter the PI3K/AKT pathway that is known to play a role in oncogenesis. CDKN2D-WDFY2 fusion could be an important molecular signature for understanding and classifying sub-lineages among heterogeneous high-grade serous ovarian carcinomas.

The Role of Crk Adaptor Proteins in Breast Tumorigenesis and Bone Metastasis

DTIC Science & Technology

2012-09-01

purchased from Asterand (Detroit, MI, USA) in 2009 and cultured as in [17] from freeze downs from 2009. Both cell lines under- went standard mouse antibody ...directed muta- genesis using the QuickChange Multi Site-Directed Mutagenesis Kit from Stratagene (La Jolla, CA, USA). Antibodies included: CrkI/II...Ki67, CrkI/II, CrkII or CrkL specific antibodies in high (Grade 3) and low (Grade 1) grade tumors. Images taken using ImageScope; scale bar

The Precambrian terranes of Yemen and their correlation with those of Saudi Arabia and Somalia: Implications for the accretion of Gondwana

USGS Publications Warehouse

Windley, B.F.; Whitehouse, M.J.; Stoeser, D.B.; Al-Khirbash, S.; Ba-Bttat, M. A. O.; Al-Ghotbah, A.

2001-01-01

Most of the basement of Yemen consists of early Precambrian continental high-grade terranes and Neoproterozoic low-grade island arcs that were accreted together to form an arc-continent collage during the Pan-African orogeny (Windley et al., 1996; Whitehouse et al., 1998; Whitehouse et al., in press). The suture zones between the arc and gneiss terranes are major crustal- scale tectonic boundaries. The terranes are situated east of the Nabitah suture and of the collage of low-grade, mainly island arc terranes of the Arabian Shield, but they have been reworked by a Neoproterozoic event associated with island arc accretion. Further east in Yemen are mostly unconformable, very weakly deformed and very low-grade or unmetamorphosed sediments. Thus Yemen provides key information on the broad zone of Neoproterozoic reworking associated with the collisional boundary between western and eastern Gondwana. 

Patient-identified events implicated in the development of body dysmorphic disorder.

PubMed

Weingarden, Hilary; Curley, Erin E; Renshaw, Keith D; Wilhelm, Sabine

2017-06-01

Little is known about the causes of body dysmorphic disorder (BDD), but researchers have proposed a diathesis-stress model. This study uses a patient-centered approach to identify stressful events to which patients attribute the development of their BDD symptoms. An Internet-recruited sample of 165 adults with BDD participated. A large minority of participants attributed the development of their BDD to a triggering event. Bullying experiences were the most commonly described type of event. Additionally, most events were interpersonal and occurred during grade school or middle school. There were no differences in severity of psychosocial outcomes between participants who did or did not attribute their BDD to a specific triggering event. However, participants who specifically attributed their BDD development to a bullying experience had poorer psychosocial outcomes (i.e., perceived social support, depression severity, functional impairment, quality of life) compared to those who attributed their BDD development to another type of triggering event. Copyright © 2017 Elsevier Ltd. All rights reserved.

Stressful life events and leucocyte telomere length: Do lifestyle factors, somatic and mental health, or low grade inflammation mediate this relationship? Results from a cohort of Danish men born in 1953.

PubMed

Osler, Merete; Bendix, Laila; Rask, Lene; Rod, Naja Hulvej

2016-11-01

Exposure to psychosocial stress is associated with increased risk of a number of somatic and mental disorders with relation to immune system functioning. We aimed to explore whether stressful events in early and recent life was associated with leucocyte telomere length (TL), which is assumed to reflect the accumulated burden of inflammation and oxidative stress occurring during the life course. We specifically aimed to address whether childhood constitutes a sensitive period and how much of the relation between stressful life events and TL is mediated through somatic and mental health, lifestyle, and markers of low-grade inflammation. A cohort of Danish men born in 1953 has been followed since birth in the Metropolit Cohort. These men underwent a health examination including blood sampling in 2010 and a subset of 324 also had a quantitative PCR-based measurement of TL. The relation between stressful life events and TL was analysed using structural equation modelling, which also provided an estimate of the proportion of the total effect mediated by somatic and mental health (cardiovascular disease, body mass and depressive mood), lifestyle factors, and low grade inflammation (C-reactive protein (CRP), interleukin (IL)-6 and IL-10). Total number of stressful events experienced during the life course was not associated with TL. In terms of sensitive periods, we found that number of stressful events in childhood was associated with shorter TL (β per number stressful events in childhood =-0.02(SE=-0.02); P=0.05). This relation was particularly strong for being placed away from home (β=-0.16; P<0.000). Thirty percent of the total effect of stressful events in childhood on TL was mediated by the included variables, with the largest proportion being mediated through depressive mood (16%) and CRP (9%). This study suggests that stressful events in childhood are associated with shorter TL in middle-aged men and that part of this relation is explained by depressive mood and low grade inflammation. Copyright © 2016 Elsevier Inc. All rights reserved.

Congress Debates Slavery, 1790-1800: A Unit of Study for Grades 10-12.

ERIC Educational Resources Information Center

Laichas, Tom; Ingersoll, Tom

This unit is one of a series that represents specific moments in history from which students focus on the meanings of landmark events. By studying primary sources of a crucial turning point in history, students become aware that choices had to be made by real human beings, that those decisions were the result of specific factors, and that they set…

Evaluating the impact of a switch to nilotinib on imatinib-related chronic low-grade adverse events in patients with CML-CP: the ENRICH study

PubMed Central

Cortes, Jorge E.; Lipton, Jeffrey H.; Miller, Carole B.; Busque, Lambert; Akard, Luke P.; Pinilla-Ibarz, Javier; Keir, Christopher; Warsi, Ghulam; Lin, Felice P.; Mauro, Michael J.

2016-01-01

Background Many patients with chronic myeloid leukemia in chronic phase (CML-CP) experience chronic treatment-related adverse events (AEs) on imatinib therapy. These AEs can impair quality of life (QOL) and lead to reduced treatment adherence, which is associated with poor clinical outcomes. Patients and Methods In the phase 2 Exploring Nilotinib to Reduce Imatinib Related Chronic Adverse Events (ENRICH) study (N = 52), the impact of switching patients with imatinib-related chronic low-grade nonhematologic AEs from imatinib to nilotinib was evaluated. Results Three months after switching to nilotinib, 84.6% of patients had overall improvement in imatinib-related AEs (primary endpoint). Of 210 imatinib-related AEs identified at baseline, 62.9% resolved within 3 months of switching to nilotinib. Among evaluable patients, most had improvements in overall QOL after switching to nilotinib. At screening, 65.4% of evaluable patients had a major molecular response (MMR; BCR-ABL1 ≤ 0.1% on the International Scale). After switching to nilotinib, the rate of MMR was 76.1% at 3 months and 87.8% at 12 months. Treatment-emergent AEs reported on nilotinib were typically grade 1/2; however, some patients developed more serious AEs, and 8 patients discontinued nilotinib due to new or worsening AEs. Conclusions Overall, results from ENRICH demonstrated that switching to nilotinib can mitigate imatinib-related chronic low-grade nonhematologic AEs in patients with CML-CP in conjunction with acceptable safety and achievement of molecular responses. This trial was registered at www.clinicaltrials.gov as NCT00980018. PMID:26993758

Predicting Mathematics Achievement by Motivation and Self-Efficacy across Gender and Achievement Levels

ERIC Educational Resources Information Center

Sartawi, AbdelAziz; Alsawaie, Othman N.; Dodeen, Hamzeh; Tibi, Sana; Alghazo, Iman M.

2012-01-01

This study investigated the extent to which self-efficacy and motivation served as a predictor for mathematics achievement of fifth grade students in United Arab Emirates (UAE) across gender and achievement levels. Self-efficacy was measured by two scales, which differed in levels of specificity--Category Specific and Task Specific. Motivation was…

Exploring the Relationship between Social Capitals and English Language Achievement within a Specific Grade and Context

ERIC Educational Resources Information Center

Khodadady, Ebrahim; Pishghadam, Reza; Alaee, Farnaz Farokh

2012-01-01

An achievement test based on schema theory (S-Test) was developed on the passages comprising the English textbook taught at grade three in state high schools in Iran and administered concurrently with a validated and reliable Social Capital Scale (SCS) to four hundred seventy seven male and female participants. The Z-scores obtained on the S-Test…

Neurotrauma pediatric scales

PubMed Central

Alexandru, Vlad Ciurea; Aurelia, Mihaela Sandu; Mihai, Popescu; Stefan, Mircea Iencean; Bogdan, Davidescu

2008-01-01

Cranial traumas have different particularities in infants, toddlers, preschool child, school child and teenagers. The assessment of these cases must be individualized according to age. It is completely different in children that in adults. Trauma scales, very useful in grading the severity and predicting outcome in traumatic brain injury, used in adults must be adapted in children. Children have age-related specificity and anatomic particularities, for each of this period of development. Neurotrauma scales, specific for infants and children, such as Pediatric Coma Scale, Children’s Coma Score, Trauma Infant Neurological Score, Glasgow Coma Scale, Liege Scale are reviewed, as well as neurotrauma outcome scales, like Glasgow Outcome Scale, modified Rankin score, KOSCHI score and Barthel Index. The authors present these scales in an exhaustive manner for thoroughgoing pediatric neurotrauma standards. PMID:20108520

Conceptual Modeling of a Quantum Key Distribution Simulation Framework Using the Discrete Event System Specification

DTIC Science & Technology

2014-09-18

and full/scale experimental verifications towards ground/ satellite quantum key distribution0 Oat Qhotonics 4235>9+7,=5;9!អ \\58^ Zin K. Dao Z. Miu T...Conceptual Modeling of a Quantum Key Distribution Simulation Framework Using the Discrete Event System Specification DISSERTATION Jeffrey D. Morris... QUANTUM KEY DISTRIBUTION SIMULATION FRAMEWORK USING THE DISCRETE EVENT SYSTEM SPECIFICATION DISSERTATION Presented to the Faculty Department of Systems

Physical Education Activities Book for the Primary Grades.

ERIC Educational Resources Information Center

Green, Arthur S.

The guide is divided into 10 chapters, the first on general program organization, the rest on specific activities. The nine activities are as follows: posture; calisthenics; active recreational games; stunts, tumbling, and apparatus skills; track and field events; team sports; fundamental and creative or interpretive rhythms; dramatized rhythms;…

Teaching Technical Competencies for Fluid Mechanics Research

NASA Astrophysics Data System (ADS)

Tagg, Randall

2014-11-01

We are developing an ``on demand'' framework for students to learn techniques used in fluid mechanics research. The site for this work is a university-grade laboratory situated next to Gateway High School in Aurora, Colorado. Undergraduate university students work with K-12 students on research and technical innovation projects. Both groups need customized training as their projects proceed. A modular approach allows particular competencies such as pump selection, construction of flow piping and channels, flow visualization, and specific flow measurement methods to be acquired through focused lessons. These lessons can be learned in either a stand-alone fashion or assembled into units for formal courses. A research example was a student project on diffusion of infectious material in micro-gravity in the event of an intestinal puncture wound. A curriculum example is a 9-week quarter of high-school instruction on instrumentation that uses small-scale water treatment systems as a case study.

The Evolution of the Bill of Rights. A Unit of Study for Grades 8-12.

ERIC Educational Resources Information Center

Vigilante, David

This unit is one of a series that presents specific moments in history from which students focus on the meanings of landmark events. By studying a crucial turning-point in history, students become aware that choices had to be made by real human beings, that those decisions were the result of specific factors, and that they set in motion a series…

Development of a Culture Specific Critical Thinking Ability Test and Using It as a Supportive Diagnostic Test for Giftedness

ERIC Educational Resources Information Center

Köksal, Mustafa Serdar

2016-01-01

The purposes of this study were to develop a culture specific critical thinking ability test for 6, 7, and 8. grade students in Turkey and to use it as an assessment instrument for giftedness. For these purposes, item pool involving 22 items was formed by writing items focusing on the current and common events presented in (Turkish) media from…

The Port Royal Experiment: Forty Acres and a Mule? A Unit of Study for Grades 8-12.

ERIC Educational Resources Information Center

Vigilante, David

This unit is one of a series that represents specific moments in history from which students focus on the meanings of landmark events. By studying a crucial turning-point in history, students become aware that choices had to be made by real human beings, that those decisions were the result of specific factors, and that they set in motion a series…

The Code of Hammurabi: Law of Mesopotamia. A Unit of Study for Grades 9-12.

ERIC Educational Resources Information Center

Woodard, Jo Ann A.

This unit is one of a series that represents specific moments in history from which students focus on the meanings of landmark events. By studying a crucial turning point in history, students become aware that choices had to be made by real human beings, that those decisions were the result of specific factors, and that they set in motion a series…

Combined immunotherapy with granulocyte-macrophage colony-stimulating factor-transduced allogeneic prostate cancer cells and ipilimumab in patients with metastatic castration-resistant prostate cancer: a phase 1 dose-escalation trial.

PubMed

van den Eertwegh, Alfons J M; Versluis, Jurjen; van den Berg, H Pieter; Santegoets, Saskia J A M; van Moorselaar, R Jeroen A; van der Sluis, Tim M; Gall, Helen E; Harding, Thomas C; Jooss, Karin; Lowy, Israel; Pinedo, Herbert M; Scheper, Rik J; Stam, Anita G M; von Blomberg, B Mary E; de Gruijl, Tanja D; Hege, Kristen; Sacks, Natalie; Gerritsen, Winald R

2012-05-01

The granulocyte-macrophage colony-stimulating factor-transduced allogeneic prostate cancer cells vaccine (GVAX) has antitumour activity against prostate cancer; preclinical studies have shown potent synergy when combined with ipilimumab, an antibody that blocks cytotoxic T-lymphocyte antigen 4. We aimed to assess the safety of combined treatment with GVAX and ipilimumab in patients with metastatic castration-resistant prostate cancer (mCRPC). We did an open-labelled, single-centre, dose-escalation study of ipilimumab concurrent with a fixed dose of GVAX, with a subsequent expansion phase, both at the VU University Medical Centre (Amsterdam, Netherlands). Eligible patients had documented mCRPC and had not been previously treated with chemotherapy. All patients received a 5×10(8) cell priming dose of GVAX intradermally on day 1 with subsequent intradermal injections of 3×10(8) cells every 2 weeks for 24 weeks. The vaccinations were combined with intravenous ipilimumab every 4 weeks. We enrolled patients in cohorts of three; each cohort received an escalating dose of ipilimumab at 0·3, 1·0, 3·0, or 5·0 mg/kg. Our primary endpoint was safety. This study is registered with ClinicalTrials.gov, number NCT01510288. We enrolled 12 patients into our dose-escalation cohort. We did not record any severe immune-related adverse events at the first two dose levels. At the 3·0 mg/kg dose level, one patient had grade 2 and two patients grade 3 hypophysitis; at the 5·0 mg/kg dose level, two patients had grade 3 hypophysitis and one patient developed grade 4 sarcoid alveolitis (a dose-limiting toxic effect). Due to observed clinical activity and toxic events, we decided to expand the 3·0 mg/kg dose level, rather than enrol a further three patients at the 5·0 mg/kg level. 16 patients were enrolled in the expansion cohort, two of whom developed grade 2 hypophysitis, three colitis (one grade 1 and two grade 2), and one grade 3 hepatitis--all immune-related adverse events. The most common adverse events noted in all 28 patients were injection-site reactions (grade 1-2 events seen in all patients), fatigue (grade 1-2 in 20 patients, grade 3 in two), and pyrexia (grade 1-2 in 15 patients, grade 3 in one). 50% or greater declines in prostate-specific antigen from baseline was recorded in seven patients (25%); all had received 3·0 mg/kg or 5·0 mg/kg ipilimumab. GVAX combined with 3·0 mg/kg ipilimumab is tolerable and safe for patients with mCRPC. Further research on the combined treatment of patients with mCRPC with vaccination and ipilimumab is warranted. Cell Genesys Inc, Prostate Cancer Foundation, Dutch Cancer Society (KWF-VU 2006-3697), and Foundation Stichting VUmc Cancer Center Amsterdam. Copyright © 2012 Elsevier Ltd. All rights reserved.

Efficacy and safety of sugammadex versus neostigmine in reversing neuromuscular blockade in adults.

PubMed

Hristovska, Ana-Marija; Duch, Patricia; Allingstrup, Mikkel; Afshari, Arash

2017-08-14

Acetylcholinesterase inhibitors, such as neostigmine, have traditionally been used for reversal of non-depolarizing neuromuscular blocking agents. However, these drugs have significant limitations, such as indirect mechanisms of reversal, limited and unpredictable efficacy, and undesirable autonomic responses. Sugammadex is a selective relaxant-binding agent specifically developed for rapid reversal of non-depolarizing neuromuscular blockade induced by rocuronium. Its potential clinical benefits include fast and predictable reversal of any degree of block, increased patient safety, reduced incidence of residual block on recovery, and more efficient use of healthcare resources. The main objective of this review was to compare the efficacy and safety of sugammadex versus neostigmine in reversing neuromuscular blockade caused by non-depolarizing neuromuscular agents in adults. We searched the following databases on 2 May 2016: Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE (WebSPIRS Ovid SP), Embase (WebSPIRS Ovid SP), and the clinical trials registries www.controlled-trials.com, clinicaltrials.gov, and www.centerwatch.com. We re-ran the search on 10 May 2017. We included randomized controlled trials (RCTs) irrespective of publication status, date of publication, blinding status, outcomes published, or language. We included adults, classified as American Society of Anesthesiologists (ASA) I to IV, who received non-depolarizing neuromuscular blocking agents for an elective in-patient or day-case surgical procedure. We included all trials comparing sugammadex versus neostigmine that reported recovery times or adverse events. We included any dose of sugammadex and neostigmine and any time point of study drug administration. Two review authors independently screened titles and abstracts to identify trials for eligibility, examined articles for eligibility, abstracted data, assessed the articles, and excluded obviously irrelevant reports. We resolved disagreements by discussion between review authors and further disagreements through consultation with the last review author. We assessed risk of bias in 10 methodological domains using the Cochrane risk of bias tool and examined risk of random error through trial sequential analysis. We used the principles of the GRADE approach to prepare an overall assessment of the quality of evidence. For our primary outcomes (recovery times to train-of-four ratio (TOFR) > 0.9), we presented data as mean differences (MDs) with 95 % confidence intervals (CIs), and for our secondary outcomes (risk of adverse events and risk of serious adverse events), we calculated risk ratios (RRs) with CIs. We included 41 studies (4206 participants) in this updated review, 38 of which were new studies. Twelve trials were eligible for meta-analysis of primary outcomes (n = 949), 28 trials were eligible for meta-analysis of secondary outcomes (n = 2298), and 10 trials (n = 1647) were ineligible for meta-analysis.We compared sugammadex 2 mg/kg and neostigmine 0.05 mg/kg for reversal of rocuronium-induced moderate neuromuscular blockade (NMB). Sugammadex 2 mg/kg was 10.22 minutes (6.6 times) faster then neostigmine 0.05 mg/kg (1.96 vs 12.87 minutes) in reversing NMB from the second twitch (T2) to TOFR > 0.9 (MD 10.22 minutes, 95% CI 8.48 to 11.96; I 2 = 84%; 10 studies, n = 835; GRADE: moderate quality).We compared sugammadex 4 mg/kg and neostigmine 0.07 mg/kg for reversal of rocuronium-induced deep NMB. Sugammadex 4 mg/kg was 45.78 minutes (16.8 times) faster then neostigmine 0.07 mg/kg (2.9 vs 48.8 minutes) in reversing NMB from post-tetanic count (PTC) 1 to 5 to TOFR > 0.9 (MD 45.78 minutes, 95% CI 39.41 to 52.15; I 2 = 0%; two studies, n = 114; GRADE: low quality).For our secondary outcomes, we compared sugammadex, any dose, and neostigmine, any dose, looking at risk of adverse and serious adverse events. We found significantly fewer composite adverse events in the sugammadex group compared with the neostigmine group (RR 0.60, 95% CI 0.49 to 0.74; I 2 = 40%; 28 studies, n = 2298; GRADE: moderate quality). Risk of adverse events was 28% in the neostigmine group and 16% in the sugammadex group, resulting in a number needed to treat for an additional beneficial outcome (NNTB) of 8. When looking at specific adverse events, we noted significantly less risk of bradycardia (RR 0.16, 95% CI 0.07 to 0.34; I 2 = 0%; 11 studies, n = 1218; NNTB 14; GRADE: moderate quality), postoperative nausea and vomiting (PONV) (RR 0.52, 95% CI 0.28 to 0.97; I 2 = 0%; six studies, n = 389; NNTB 16; GRADE: low quality) and overall signs of postoperative residual paralysis (RR 0.40, 95% CI 0.28 to 0.57; I 2 = 0%; 15 studies, n = 1474; NNTB 13; GRADE: moderate quality) in the sugammadex group when compared with the neostigmine group. Finally, we found no significant differences between sugammadex and neostigmine regarding risk of serious adverse events (RR 0.54, 95% CI 0.13 to 2.25; I 2 = 0%; 10 studies, n = 959; GRADE: low quality).Application of trial sequential analysis (TSA) indicates superiority of sugammadex for outcomes such as recovery time from T2 to TOFR > 0.9, adverse events, and overall signs of postoperative residual paralysis. Review results suggest that in comparison with neostigmine, sugammadex can more rapidly reverse rocuronium-induced neuromuscular block regardless of the depth of the block. Sugammadex 2 mg/kg is 10.22 minutes (˜ 6.6 times) faster in reversing moderate neuromuscular blockade (T2) than neostigmine 0.05 mg/kg (GRADE: moderate quality), and sugammadex 4 mg/kg is 45.78 minutes (˜ 16.8 times) faster in reversing deep neuromuscular blockade (PTC 1 to 5) than neostigmine 0.07 mg/kg (GRADE: low quality). With an NNTB of 8 to avoid an adverse event, sugammadex appears to have a better safety profile than neostigmine. Patients receiving sugammadex had 40% fewer adverse events compared with those given neostigmine. Specifically, risks of bradycardia (RR 0.16, NNTB 14; GRADE: moderate quality), PONV (RR 0.52, NNTB 16; GRADE: low quality), and overall signs of postoperative residual paralysis (RR 0.40, NNTB 13; GRADE: moderate quality) were reduced. Both sugammadex and neostigmine were associated with serious adverse events in less than 1% of patients, and data showed no differences in risk of serious adverse events between groups (RR 0.54; GRADE: low quality).

Developmental Dynamics of General and School-Subject-Specific Components of Academic Self-Concept, Academic Interest, and Academic Anxiety

PubMed Central

Gogol, Katarzyna; Brunner, Martin; Preckel, Franzis; Goetz, Thomas; Martin, Romain

2016-01-01

The present study investigated the developmental dynamics of general and subject-specific (i.e., mathematics, French, and German) components of students' academic self-concept, anxiety, and interest. To this end, the authors integrated three lines of research: (a) hierarchical and multidimensional approaches to the conceptualization of each construct, (b) longitudinal analyses of bottom-up and top-down developmental processes across hierarchical levels, and (c) developmental processes across subjects. The data stemmed from two longitudinal large-scale samples (N = 3498 and N = 3863) of students attending Grades 7 and 9 in Luxembourgish schools. Nested-factor models were applied to represent each construct at each grade level. The analyses demonstrated that several characteristics were shared across constructs. All constructs were multidimensional in nature with respect to the different subjects, showed a hierarchical organization with a general component at the apex of the hierarchy, and had a strong separation between the subject-specific components at both grade levels. Further, all constructs showed moderate differential stabilities at both the general (0.42 < r < 0.55) and subject-specific levels (0.45 < r < 0.73). Further, little evidence was found for top-down or bottom-up developmental processes. Rather, general and subject-specific components in Grade 9 proved to be primarily a function of the corresponding components in Grade 7. Finally, change in several subject-specific components could be explained by negative effects across subjects. PMID:27014162

Developmental Dynamics of General and School-Subject-Specific Components of Academic Self-Concept, Academic Interest, and Academic Anxiety.

PubMed

Gogol, Katarzyna; Brunner, Martin; Preckel, Franzis; Goetz, Thomas; Martin, Romain

2016-01-01

The present study investigated the developmental dynamics of general and subject-specific (i.e., mathematics, French, and German) components of students' academic self-concept, anxiety, and interest. To this end, the authors integrated three lines of research: (a) hierarchical and multidimensional approaches to the conceptualization of each construct, (b) longitudinal analyses of bottom-up and top-down developmental processes across hierarchical levels, and (c) developmental processes across subjects. The data stemmed from two longitudinal large-scale samples (N = 3498 and N = 3863) of students attending Grades 7 and 9 in Luxembourgish schools. Nested-factor models were applied to represent each construct at each grade level. The analyses demonstrated that several characteristics were shared across constructs. All constructs were multidimensional in nature with respect to the different subjects, showed a hierarchical organization with a general component at the apex of the hierarchy, and had a strong separation between the subject-specific components at both grade levels. Further, all constructs showed moderate differential stabilities at both the general (0.42 < r < 0.55) and subject-specific levels (0.45 < r < 0.73). Further, little evidence was found for top-down or bottom-up developmental processes. Rather, general and subject-specific components in Grade 9 proved to be primarily a function of the corresponding components in Grade 7. Finally, change in several subject-specific components could be explained by negative effects across subjects.

Single Nucleotide Polymorphism TGFβ1 R25P Correlates with Acute Toxicity during Neoadjuvant Chemoradiotherapy in Rectal Cancer Patients

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

Smith, J. Joshua; Wasserman, Isaac; Icahn School of Medicine at Mount Sinai, New York, New York

Purpose: To validate the finding of an association between single nucleotide polymorphisms (SNPs) and toxicity during chemoradiotherapy (CRT) in rectal cancer patients, in an independent population. Methods and Materials: The cohort consisted of 165 patients who received CRT for rectal cancer from 2006 to 2012. Prospectively recorded toxicity information, graded according to the Common Terminology Criteria for Adverse Events version 3.0, was retrieved from the medical record. Additionally, a subset of 52 patients recorded their gastrointestinal symptoms weekly during CRT, using the 7-item Bowel Problems Scale. Deoxyribonucleic acid was extracted from normal tissue in the proctectomy specimens and screened for 3more » SNPs: XRCC1 R399Q, XPD K751Q, and TGFβ1 R25P. Univariable and multivariable logistic regression models were constructed. Results: The median radiation dose was 50.4 Gy, and all patients received concurrent chemotherapy. Toxicities measured by the Common Terminology Criteria for Adverse Events were closely associated with patient-reported outcomes for the patients who completed the 7-item Bowel Problems Scale. Grade ≥3 toxicity occurred during CRT in 14 patients (8%). All 14 patients had either XRCC1 R399Q or TGFβ1 R25P polymorphisms. The TGFβ1 R25P polymorphism was significantly associated with grade ≥3 toxicity (odds ratio [OR] 3.47, P=.04) and, in patients who completed the Bowel Problems Scale, with grade ≥4 toxicity (OR 5.61, P=.02). The latter finding persisted in a multivariable logistic regression model controlling for ethnicity, age, and sex (adjusted OR 1.83, P=.02). Conclusions: We have validated the correlation between the TGFβ1 R25P SNP and acute toxicity during CRT in an independent cohort using both clinician- and patient-reported toxicity. The information from our study could be used as a basis to formulate a prospective trial testing the utility of this SNP as a biomarker of acute toxicity during neoadjuvant treatment in locally advanced rectal cancer.« less

Comparison of graded exercise and graded exposure clinical outcomes for patients with chronic low back pain.

PubMed

George, Steven Z; Wittmer, Virgil T; Fillingim, Roger B; Robinson, Michael E

2010-11-01

Quasi-experimental clinical trial. This study compared outcomes from graded exercise and graded exposure activity prescriptions for patients participating in a multidisciplinary rehabilitation program for chronic low back pain. Our primary purpose was to investigate whether pain and disability outcomes differed based on treatment received (graded exercise or graded exposure). Our secondary purpose was to investigate if changes in selected psychological factors were associated with pain and disability outcomes. Behavioral interventions have been advocated for decreasing pain and disability from low back pain, yet relatively few comparative studies have been reported in the literature. Consecutive sample with chronic low back pain recruited over a 16-month period from an outpatient chronic pain clinic. Patients received physical therapy supplemented with either graded exercise (n=15) or graded exposure (n=18) principles. Graded exercise included general therapeutic activities and was progressed with a quota-based system. Graded exposure included specific activities that were feared due to back pain and was progressed with a hierarchical exposure paradigm. Psychological measures were pain-related fear (Fear-Avoidance Beliefs Questionnaire, Tampa Scale for Kinesiophobia, Fear of Pain Questionnaire), pain catastrophizing (Coping Strategies Questionnaire), and depressive symptoms (Beck Depression Inventory). Primary outcome measures were pain intensity (visual analog scale) and self-report of disability (modified Oswestry Disability Questionnaire). Statistically significant improvements (P<.01) were observed for pain intensity and disability at discharge. The rate of improvement did not differ based on behavioral intervention received (P>.05 for these comparisons). Overall, 50% of patients met criterion for minimally important change for pain intensity, while 30% met this criterion for disability. Change in depressive symptoms was associated with change in pain intensity, while change in pain catastrophizing was associated with change in disability. Physical therapy supplemented with graded exercise or graded exposure resulted in equivalent clinical outcomes for pain intensity and disability. The overall treatment effects were modest in this setting. Instead of being associated with a specific behavioral intervention, reductions in pain and disability were associated with reductions in depressive symptoms and pain catastrophizing, respectively. Therapy, level 2b–.

The Grades Transfer from One Grading Scale to Other Algorithmization

ERIC Educational Resources Information Center

Lieponiene, Jurgita; Kulvietiene, Regina

2011-01-01

The article presents the consideration of grading scales used for education outcomes in different countries, describes likeness and differences of applied grading scales. Application of the European Credit Transfer and Accumulation System (ECTS) grading scale is investigated according of the analysis of scientific literature as well as cases of…

Association of nutritional status-related indices and chemotherapy-induced adverse events in gastric cancer patients.

PubMed

Seo, Seung Hee; Kim, Sung-Eun; Kang, Yoon-Koo; Ryoo, Baek-Yeol; Ryu, Min-Hee; Jeong, Jae Ho; Kang, Shin Sook; Yang, Mihi; Lee, Jung Eun; Sung, Mi-Kyung

2016-11-18

Malnutrition in gastrectomized patients receiving chemotherapy is associated with the susceptibility to chemotherapy-related adverse events. This study evaluated pre-operative nutritional status-related indices associated with adverse events in post-operation gastric cancer patients receiving chemotherapy. Medical records of 234 gastrectomized patients under adjuvant tegafur/gimeracil/oteracil chemotherapy with extended lymph node dissection were analyzed. Nutritional status assessment included Patient-Generated Subjective Global Assessment (PG-SGA), body weight, body mass index, serum albumin concentration, and Nutrition Risk Index (NRI). Chemotherapy-originated adverse events were determined using Common Terminology Criteria for Adverse Events. PG-SGA indicated 59% of the patients were malnourished, and 27.8% of the patients revealed serious malnutrition with PG-SGA score of ≥9. Fifteen % of patients lost ≥10% of the initial body weight, 14.5% of the patients had hypoalbuminemia (<3.5 g/dL), and 66.2% had NRI score less than 97.5 indicating moderate to severe malnutrition. Hematological adverse events were present in 94% (≥grade 1) and 16.2% (≥grade 3). Non-hematological adverse events occurred in 95.7% (≥grade1) and 16.7% (≥grade 3) of the patients. PG-SGA and NRI score was not associated with treatment-induced adverse events. Multivariate analyses indicated that female, low body mass index, and hypoalbuminemia were independent risk factors for grade 3/4 hematological adverse events. Age was an independent risk factor for grade 3/4 non-hematological adverse events. Neutropenia was the most frequently occurring adverse event, and associated risk factors were female, total gastrectomy, and hypoalbuminemia. Hypoalbuminemia, not PG-SGA or NRI may predict chemotherapy-induced adverse events in gastrectomized cancer patients.

Meta-analysis of the ocular biocompatibility of a new multipurpose lens care system.

PubMed

Reindel, William; Merchea, Mohinder M; Rah, Marjorie J; Zhang, Lening

2013-01-01

The purpose of this paper is to evaluate the biocompatibility of a novel multipurpose solution (MPS) with a dual disinfectant system containing polyaminopropyl biguanide and polyquaternium-1 (Biotrue®) by analysis of biomicroscopy signs and adverse events in six large clinical trials. Data from six consecutive, prospective clinical trials conducted from February 2008 to March 2010 were combined for meta-analysis. Subjects used the new MPS daily for periods of 2 weeks to 6 months. Slit-lamp signs were graded at each follow-up visit using an ordinal scale (0, one; 1, trace; 2, mild; 3, moderate; 4, severe). Analysis for biocompatibility included tracking of greater than grade 2 slit-lamp findings and number of adverse events. A total of 1,567 subjects (3,134 eyes) and 81 clinical investigators participated in the six studies, with 1,499 subjects completing the studies. Based on subject days in the studies, there were 72,904 exposures to the MPS and 7,212 biomicroscopy examinations. The completion rate for the studies was 96.3%. Per observation incidence of any finding greater than grade 2 at the follow-up visits were: corneal staining 0.08%, limbal injection 0.04%, bulbar injection 0.04%, tarsal conjunctiva abnormality 0.09%, and neovascularization 0.01%. There were no other slit-lamp signs greater than grade 2 and no statistically significant difference between hydrogels and silicone hydrogels for any finding. There were no reports of adverse events during the trials. Analysis of over 72,000 daily exposures and 7,212 eye examinations showed that the novel MPS exhibited excellent biocompatibility in subjects using daily wear hydrogel or silicone hydrogel lenses.

Examining the Value of Menopausal Symptom Relief Among US Women.

PubMed

Craig, Benjamin M; Mitchell, Sandra A

2016-01-01

Menopausal symptoms can cause significant distress to women, yet little is known about the value women place on these symptoms. In April 2013, 3397 US women, aged 40 to 69 years, completed an online survey that included 30 paired comparisons. Specifically, respondents were shown two menopausal symptoms described using the Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events and asked, "Which do you prefer?" From their choices, we estimated a generalized linear model to assess the values women place on symptom relief in terms of quality-adjusted life-years (QALYs). Approximately half the respondents (1753 of 3397 [52%]) always preferred a reduced lifespan (up to 90 days) instead of experiencing menopausal symptoms at their worst for 30 days. For most of the symptoms (248 of 263 [94%]), including low-grade events, QALYs were significantly reduced (P < 0.05). The value women placed on relief ranged widely by symptom domain: the relief from depression, problems with memory, headache, pain in abdomen, problems with anger, and vomiting were the most valuable. Overall, the value women place on menopausal symptom relief is surprisingly high. As the first national study to directly ask women about their preferences and to estimate the value of menopausal symptom relief on a QALY scale, this work provides critical evidence for health outcomes research in midlife women and can be applied in the evaluation of treatments that reduce or eliminate menopausal symptoms. This work also provides proof-of-concept for an approach to value Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events responses on a QALY scale. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Paraplegia-quadriplegia Independently Increases All Percutaneous Nephrolithotomy Complications: A Comparative Study Using the Modified Clavien System.

PubMed

Danawala, Zeeshan A; Singh, Dinesh

2015-05-01

To investigate the perioperative complication rates for paraplegic-quadriplegic patients (PQPs) undergoing percutaneous nephrolithotomy (PCNL) as compared with non-PQPs using a standardized method of complication reporting via the Clavien system. Two hundred thirteen consecutive PCNLs performed by a single surgeon were analyzed. There were 31 and 115 patients separated into PQP and non-PQP groups, respectively. Data collection included demographic and clinical factors, as well as perioperative and delayed complications. Complications were organized by the Clavien grade. All- and initial-procedure complications were analyzed. The rate of adverse events for each Clavien grade was calculated, and statistical comparisons were made. The relationship between PQP and complication severity was investigated using univariate and multivariate analyses. There were 38 and 43 initial-procedure complications in the PQP and non-PQP groups, respectively. The rate of adverse events was higher across the spectrum of Clavien grades for the PQP group, specifically grade 1 (48.4% vs 20.2%; P = .002), grade 2 (22.6% vs 5.3%; P = .004), grade 3b (12.9% vs 2.6%; P = .038), grade 4a (6.5% vs 0%), and grade 4b (9.7% vs 1.8%; P = .066). Approximately 51.6% and 31.5% of PQPs and non-PQPs experienced ≥ 1 complications, respectively (odds ratio = 2.34; P = .05). Multivariate analysis demonstrated paraplegia or quadriplegia status to be an independent risk factor for the development of perioperative complications after adjusting for confounding factors (odds ratio = 2.91; P = .040). PCNL complication rates are higher in PQPs compared with non-PQPs. This study is one of the first in PCNL to use a standardized reporting system to highlight high-risk individuals within the stone population. Copyright © 2015 Elsevier Inc. All rights reserved.

11C choline PET guided salvage radiotherapy with volumetric modulation arc therapy and hypofractionation for recurrent prostate cancer after HIFU failure: preliminary results of tolerability and acute toxicity.

PubMed

Alongi, Filippo; Liardo, Rocco L E; Iftode, Cristina; Lopci, Egesta; Villa, Elisa; Comito, Tiziana; Tozzi, Angelo; Navarria, Pierina; Ascolese, Anna M; Mancosu, Pietro; Tomatis, Stefano; Bellorofonte, Carlo; Arturo, Chiti; Scorsetti, Marta

2014-10-01

The purpose of this work was to evaluate tolerance, feasibility and acute toxicity in patients undergoing salvage radiotherapy after high-intensity focused ultrasound (HIFU) failure. From 2005 to 2011 a total of 15 patients were treated with HIFU as primary radical treatment. Between July 2011 and February 2013, all 15 patients presented biochemical relapse after HIFU and 11C choline PET documenting intrapostatic-only failure. Salvage EBRT was performed with moderate hypofractionation schedule in 28 fractions with volumetric modulation arc therapy (VMAT). Genito-urinary (GU) and rectal and bowel toxicity were scored by common terminology criteria for adverse events version 4 (CTCAE V.4) scale. Biochemical response was assessed by ASTRO Phoenix criteria. Median age of patients was 67 years (range: 53-85). The median Gleason score was 7 (range: 6-9). The median prostate specific antigen (PSA) at the time of biochemical relapse after HIFU was 5.2 ng/mL (range: 2-64.2). Seven of the 15 patients received androgen deprivation therapy (ADT) started after HIFU failure, interrupted before 11C choline PET and radiotherapy. Median prescribed dose was 71.4 Gy (range: 71.4-74.2 Gy) in 28 fractions. No radiation related major upper gastrointestinal (GI), rectal and GU toxicity were experienced. GU, acute grade 1 and grade 2 toxicities were recorded in 7/15 and 4/15 respectively; bowel acute grade 1 and grade 2 toxicities in 4/15 and 1/15; rectal acute grade 1 and grade 2 toxicities in 3/15 and 2/15 respectively. No grade 3 or greater acute or late toxicities occurred. Biochemical control was assessed in 12/15 (80%) patients. With a median follow up of 12 months, three out of 15 patients, with biochemical relapse, showed lymph-nodal recurrence. Our early clinical results and biochemical data confirm the feasibility and show a good tolerance of the 11C choline PET guided salvage radiation therapy after HIFU failure. The findings of low acute toxicity is encouraging, but longer follow-up is needed to assess late toxicity and definitive outcomes.

Steady growth or fits and starts: observing the style of and controls on carbonate crystallization in an Alpine fold and thrust belt

NASA Astrophysics Data System (ADS)

Lloyd, M. K.; Akker, V.; Herwegh, M.; Eiler, J. M.

2017-12-01

Shallow-water carbonates are the principal archive of ancient earth-surface conditions, but all have been subjected to subsurface modification in the intervening time. In order to extract primary depositional signals in carbonate minerals, it is necessary to understand the mechanisms by which they are overprinted during post-depositional recrystallization. Open questions inlcude: Do carbonate grains grow continously when residing at elevated temperatures, or episodically, in response to discrete events? In addition to T, P, and t, how do confounding variables such as strain, lithology, mineralogy, or fluid content affect this process? We measured phase-specific clumped isotope (Δ47) temperatures from carbonate-bearing units in the Helvetic nappes and Infrahelvetic complex of the Glarus alps, Switzerland. Here, Mesozoic carbonates were metamorphosed to at most lower-greenschist facies in the Late Eocene, and discordantly thrust over Mesozoic-Tertiary flysch along the Oligocene-Miocene-aged Glarus fault. In broad agreement with conventional thermal maturity proxies, calcite Δ47-based temperatures increase to the south and with stratigraphic depth, from 45 °C at the northenmost terminus of the nappes to 210 °C in the southermost exposures of the Infrahelvetic complex. Within the colder sections, however, calcite Δ47 temperatures are highly heterogeneous and vary by up to 50 °C across m-scale lithological transitions. A strong positive correlation between crystallization temperature and fluid d18O values at these scales suggests that local fluid content is a primary control on the suceptability of carbonates grains to recrystallization and coarsening in shallow burial environments. The loss of outcrop-scale calcite Δ47 heterogeneity with increasing metamorphic grade suggests that variable fluid-rock ratios do not preclude pervasive recystallization in calcite above 100 °C. Dolomite Δ47-based temperatures are 50-150 °C colder than coexisting calcite temperatures in flysch units where peak conditions exceeded 200 °C. Barring a late addition of cold, retrograde dolomite, these discrepancies indicate that carbonate recrystallization is also phase-specific, and that dolomite is uniquely resistant to recrystallization during low-grade metamorphism in major fold-and-thrust belts.

Effect of a Scalp Cooling Device on Alopecia in Women Undergoing Chemotherapy for Breast Cancer: The SCALP Randomized Clinical Trial.

PubMed

Nangia, Julie; Wang, Tao; Osborne, Cynthia; Niravath, Polly; Otte, Kristen; Papish, Steven; Holmes, Frankie; Abraham, Jame; Lacouture, Mario; Courtright, Jay; Paxman, Richard; Rude, Mari; Hilsenbeck, Susan; Osborne, C Kent; Rimawi, Mothaffar

2017-02-14

Chemotherapy may induce alopecia. Although scalp cooling devices have been used to prevent this alopecia, efficacy has not been assessed in a randomized clinical trial. To assess whether a scalp cooling device is effective at reducing chemotherapy-induced alopecia and to assess adverse treatment effects. Multicenter randomized clinical trial of women with breast cancer undergoing chemotherapy. Patients were enrolled from December 9, 2013, to September 30, 2016. One interim analysis was planned to allow the study to stop early for efficacy. Data reported are from the interim analysis. This study was conducted at 7 sites in the United States, and 182 women with breast cancer requiring chemotherapy were enrolled and randomized. Participants were randomized to scalp cooling (n = 119) or control (n = 63). Scalp cooling was done using a scalp cooling device. The primary efficacy end points were successful hair preservation assessed using the Common Terminology Criteria for Adverse Events version 4.0 scale (grade 0 [no hair loss] or grade 1 [<50% hair loss not requiring a wig] were considered to have hair preservation) at the end of 4 cycles of chemotherapy by a clinician unaware of treatment assignment, and device safety. Secondary end points included wig use and scores on the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30, Hospital Anxiety and Depression Scale, and a summary scale of the Body Image Scale. At the time of the interim analysis, 142 participants were evaluable. The mean (SD) age of the patients was 52.6 (10.1) years; 36% (n = 51) received anthracycline-based chemotherapy and 64% (n = 91) received taxane-based chemotherapy. Successful hair preservation was found in 48 of 95 women with cooling (50.5%; 95% CI, 40.7%-60.4%) compared with 0 of 47 women in the control group (0%; 95% CI, 0%-7.6%) (success rate difference, 50.5%; 95% CI, 40.5%-60.6%). Because the 1-tailed P value from the Fisher exact test was <.001, which crossed the superiority boundary (P = .0061), the data and safety monitoring board recommended study termination on September 26, 2016. There were no statistically significant differences in changes in any of the scales of quality of life from baseline to chemotherapy cycle 4 among the scalp cooling and control groups. Only adverse events related to device use were collected; 54 adverse events were reported in the cooling group, all grades 1 and 2. There were no serious adverse device events. Among women with stage I to II breast cancer receiving chemotherapy with a taxane, anthracycline, or both, those who underwent scalp cooling were significantly more likely to have less than 50% hair loss after the fourth chemotherapy cycle compared with those who received no scalp cooling. Further research is needed to assess longer-term efficacy and adverse effects. clinicaltrials.gov Identifier: NCT01986140.

Dutch normal-pressure hydrocephalus study: prediction of outcome after shunting by resistance to outflow of cerebrospinal fluid.

PubMed

Boon, A J; Tans, J T; Delwel, E J; Egeler-Peerdeman, S M; Hanlo, P W; Wurzer, H A; Avezaat, C J; de Jong, D A; Gooskens, R H; Hermans, J

1997-11-01

The authors examined whether measurement of resistance to outflow of cerebrospinal fluid (Rcsf) predicts outcome after shunting for patients with normal-pressure hydrocephalus (NPH). In four centers 101 patients (most of whom had idiopathic NPH) who fulfilled strict entry criteria underwent shunt placement irrespective of their level of Rcsf obtained by lumbar constant flow infusion. Gait disturbance and dementia were quantified by using an NPH scale and the patient's level of disability was assessed by using the modified Rankin scale (mRS). In addition the Modified Mini-Mental State Examination was performed. Patients were assessed prior to and 1, 3, 6, 9, and 12 months after surgery. Primary outcome measures were based on differences between the preoperative and last NPH scale scores and mRS grades. Improvement was defined as a change measuring at least 15% in the NPH scale score and at least one mRS grade. Intention-to-treat analysis of all patients at 1 year yielded improvement for 57% in NPH scale score and 59% in mRS grade. Efficacy analysis, excluding serious events and deaths that were unrelated to NPH, was performed for 95 patients. Improvement rose to 76% in NPH scale score and 69% in mRS grade. Six cut-off levels of Rcsf were related to improvement in NPH scale score using two-by-two tables. Positive predictive values were approximately 80% for an Rcsf of 10, 12, or 15 mm Hg/ml/minute, 92% for an Rcsf of 18 mm Hg/ml/minute, and 100% for an Rcsf of 24 mm Hg/ml/minute. Negative predictive values were low. More important was the highest likelihood ratio of 3.5 for an Rcsf of 18 mm Hg/ml/minute. Extensive comorbidity was a major prognostic factor. Measurement of Rcsf reliably predicts outcome if the limit for shunting is raised to 18 mm Hg/ml/minute. At lower Rcsf values the decision depends mainly on the extent to which clinical and computerized tomography findings are typical of NPH.

Developing a Teacher Administered Anxiety Rating Scale Suitable for Five to Seven-Year-Old Children

ERIC Educational Resources Information Center

Goulet, Joseph

2013-01-01

This paper presents results of twin studies pertinent to the development of a rating scale designed for use by teachers to identify anxious and shy children, aged 5 to 7 years, in Kindergarten and Grade One. Currently, no instruments designed specifically for this purpose exist. Children experiencing difficulty with internalizing disorders such as…

Sub-ply level scaling approach investigated for graphite-epoxy composite beam columns

NASA Technical Reports Server (NTRS)

Jackson, Karen E.; Kellas, Sotiris

1994-01-01

Scale model graphite-epoxy composite specimens were fabricated using the 'sub-ply level' approach and tested as beam-columns under an eccentric axial load to determine the effect of specimen size on flexural response and failure. In the current research project, although the fiber diameters are not scaled, the thickness of the pre-preg material itself has been scaled by adjusting the number of fibers through the thickness of a single ply. Three different grades of graphite-epoxy composite material (AS4/3502) were obtained from Hercules, Inc., in which the number of fibers through the thickness of a single ply was reduced (Grade 190 with 12 to 16 fibers, Grade 95 with 6 to 8 fibers, and Grade 48 with 3 to 4 fibers). Thus, using the sub-ply level approach, a baseline eight ply quasi-isotropic laminate could be fabricated using either the Grade 48 or Grade 95 material and the corresponding full-scale laminate would be constructed from Grade 95 or standard Grade 190 material, respectively. Note that in the sub-ply level approach, the number of ply interfaces is constant for the baseline and full-scale laminates. This is not true for the ply level and sublaminate level scaled specimens. The three grades of graphite-epoxy composite material were used to fabricate scale model beam-column specimens with in-plane dimensions of 0.5*n x 5.75*n, where n=1,2,4 corresponsing to 1/4, 1/2, and full-scale factors. Angle ply, cross ply, and quasi-isotropic laminate stacking sequences were chosen for the investigation and the test matrices for each laminate type are given. Specimens in each laminate family with the same in-plane dimensions but different thicknesses were tested to isolate the influence of the thickness dimension on the flexural response and failure. Also, specific lay-ups were chosen with blocked plies and dispersed plies for each laminate type. Specimens were subjected to an eccentric axial load until failure. The load offset was introduced through a set of hinges which were attached to the platens of a standard load test machine. Three sets of geometrically scaled hinges were used to ensure that scaled loading conditions were applied. This loading condition was chosen because it promotes large flexural deformations and specimens fail at the center of the beam, away from the grip supports. Five channels of data including applied vertical load, end shortening displacement, strain from gages applied back-to-back at the midspan of the beam, and rotation of the hinge from a bubble inclinometer were recorded for each specimen. The beam-column test configuration was used previously to study size effects in ply level scaled composite specimens of the same material system, sizes, and stacking sequences. Thus, a direct comparison between the two scaling approaches is possible. Ply level scaled beam-columns with angle ply, cross ply, and quasi-isotropic lay-ups exhibited no size dependencies in the flexural response, but significant size effects in strength. The reduction in strength with increasing specimen size was not predicted successfully by analysis techniques. It is anticipated that results from this investigation will lead to a better understanding of the strength scale effect in composite structures.

Translation and psychometric evaluation of Persian versions of Burn Specific Pain Anxiety Scale and Impact of Event Scale.

PubMed

Ghezeljeh, Tahereh Najafi; Ardebili, Fatimah Mohades; Rafii, Forough; Hagani, Hamid

2013-09-01

Burn as a traumatic life incident manifests severe pain and psychological problems. Specific instruments are needed to evaluate burn patients' psychological issues related to the injury. The aim of this study was to translate and evaluate the reliability and validity of the Persian versions of Impact of Burn Specific Pain Anxiety scale (BSPAS) and Impact of Event Scale (IES). In this cross-sectional study, convenience sampling method was utilized to select 55 Iranian hospitalized burn patients. Combined translation was utilized for translating scales. Alpha cronbach, item-total correlation, convergent and discriminative validity were evaluated. The Cronbach's α for both BSPAS- and IES-Persian version was 0.96. Item-total correlation coefficients ranged from 0.70 to 0.90. Convergent construct validity was confirmed by indicating high correlation between the scales designed to measure the same concepts. The mean score of BSPAS- and IES-Persian version was lower for individuals with a lower TBSA burn percentage which assessed discriminative construct validity of scales. BSPAS- and IES-Persian version showed high internal consistency and good validity for the assessment of burn psychological outcome in hospitalized burn patients. Future studies are needed to determine repeatability, factor structure, sensitivity and specificity of the scales. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

MRI-guided brachytherapy in locally advanced cervical cancer: Small bowel [Formula: see text] and [Formula: see text] are not predictive of late morbidity.

PubMed

Petit, Claire; Dumas, Isabelle; Chargari, Cyrus; Martinetti, Florent; Maroun, Pierre; Doyeux, Kaya; Tailleur, Anne; Haie-Meder, Christine; Mazeron, Renaud

2016-01-01

To establish dose-volume effect correlations for late small bowel (SB) toxicities in patients treated for locally advanced cervical cancer with concomitant chemoradiation followed by pulsed-dose rate MRI-guided adaptive brachytherapy. Patients treated with curative intent and followed prospectively were included. The SB loops closed to CTV were delineated, but no specific dose constraint was applied. The dosimetric data, converted in 2-Gy equivalent, were confronted with the occurrence of late morbidity assessed using the CTC-AE 3.0. Dose-effect relationships were assessed using mean-dose comparisons, log-rank tests on event-free periods, and probit analyses. A total of 115 patients with a median followup of 35.5 months were included. Highest grade per patient was: Grades 0 for 17, 1 for 75, 2 for 20, and 3 for 3. The mean [Formula: see text] and [Formula: see text] were, respectively, 68.7 ± 13.6 Gy and 85.8 ± 33.1 Gy and did not differ according to event severity (p = 0.47 and p = 0.52), even when comparing Grades 0-1 vs. 2-4 events (68.0 ± 12.4 vs. 71.4 ± 17.7 Gy; p = 0.38 and 83.7 ± 26.4 vs. 94.5 ± 51.9 Gy; p = 0.33). Log-rank tests were performed after splitting the cohort according to four [Formula: see text] levels: >80 Gy, 70-79 Gy, 60-70 Gy, and <60 Gy. No difference was observed for Grades 1-4, Grades 2-4, or Grades 3-4 (p = 0.21-0.52). Probit analyses showed no correlation between the dosimetric parameters and probability of Grades 1-4, 2-4, or 3-4 events (p = 0.19-0.48). No significant dose-volume effect relationships were demonstrated between the [Formula: see text] and [Formula: see text] and the probability of late SB morbidity. These parameters should not limit the pulsed-dose rate brachytherapy optimization process. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Interobserver Agreement in Clinical Grading of Vitreous Haze Using Alternative Grading Scales

PubMed Central

Hornbeak, Dana M; Payal, Abhishek; Pistilli, Maxwell; Biswas, Jyotirmay; Ganesh, Sudha K; Gupta, Vishali; Rathinam, Sivakumar R; Davis, Janet L; Kempen, John H

2014-01-01

Purpose To evaluate the reliability of clinical grading of vitreous haze using a new 9-step ordinal scale vs. the existing 6-step ordinal scale. Design Evaluation of Diagnostic Test (interobserver agreement study). Participants 119 consecutive patients (204 uveitic eyes) presenting for uveitis subspecialty care on the study day at one of three large uveitis centers. Methods Five pairs of uveitis specialists clinically graded vitreous haze in the same eyes, one after the other using the same equipment, using the 6- and 9-step scales. Main Outcome Measures Agreement in vitreous haze grade between each pair of specialists was evaluated by the κ statistic (exact agreement and agreement within one or two grades). Results The scales correlated well (Spearman’s ρ=0.84). Exact agreement was modest using both the 6-step and 9-step scales: average κ=0.46 (range 0.28–0.81) and κ=0.40 (range 0.15–0.63), respectively. Within-1-grade agreement was slightly more favorable for the scale with fewer steps, but values were excellent for both scales: κ=0.75 (range 0.66–0.96) and κ=0.62 (range 0.38–0.87), respectively. Within-2-grade agreement for the 9-step scale also was excellent [κ=0.85 (range 0.79–0.92)]. Two-fold more cases were potentially clinical trial eligible based on the 9- than the 6-step scale (p<0.001). Conclusions Both scales are sufficiently reproducible using clinical grading for clinical and research use with the appropriate threshold (a ≥2 and ≥3 step differences for the 6-step and 9-step scales respectively). The results suggest that more eyes are likely to meet eligibility criteria for trials using the 9-step scale. The 9-step scale appears to have higher reproducibility with Reading Center grading than clinical grading, suggesting Reading Center grading may be preferable for clinical trials. PMID:24697913

Spatial scale effect on sediment dynamics in basin-wide floods within a typical agro-watershed: A case study in the hilly loess region of the Chinese Loess Plateau.

PubMed

Zhang, Le-Tao; Li, Zhan-Bin; Wang, Shan-Shan

2016-12-01

Scale issues, which have been extensively studied in the domain of soil erosion, are considerably significant in geomorphologic processes and hydrologic modelling. However, relatively scarce efforts have been made to quantify the spatial scale effect on event-based sediment dynamics in basin-wide floods. To address this issue, sediment-runoff yield data of 44 basin-wide flood events were collected from gauging stations at the Chabagou river basin, a typical agro-basin (unmanaged) in the hilly loess region of the Chinese Loess Plateau. Thus, the spatial scale effect on event-based sediment dynamics was investigated in the basin system across three different spatial scales from sublateral to basin outlet. Results showed that the event-based suspended sediment concentration, as well as the intra- and inter-scale flow-sediment relationships remained spatially constant. Hence, almost all the sediment-laden flows can reach at the detachment-limited maximum concentration across scales, specifically for hyperconcentrated flows. Consequently, limited influence was exerted by upstream sediment-laden flow on downstream sediment output, particularly for major sediment-producing events. However, flood peak discharge instead of total flood runoff amount can better interpret the dynamics of sediment yield across scales. As a composite parameter, the proposed stream energy factor combines flood runoff depth and flood peak discharge, thereby showing more advantages to describe the event-based inter-scale flow-sediment relationship than other flow-related variables. Overall, this study demonstrates the process-specific characteristics of soil erosion by water flows in the basin system. Therefore, event-based sediment control should be oriented by the process to cut off the connectivity of hyperconcentrated flows and redistribute the erosive energy of flowing water in terms of temporality and spatiality. Furthermore, evaluation of soil conservation benefits should be based on the process of runoff regulation to comprehensively assess the efficiency of anti-erosion strategies in sediment control at the basin scale. Copyright © 2016. Published by Elsevier B.V.

Large-scale Meteorological Patterns Associated with Extreme Precipitation Events over Portland, OR

NASA Astrophysics Data System (ADS)

Aragon, C.; Loikith, P. C.; Lintner, B. R.; Pike, M.

2017-12-01

Extreme precipitation events can have profound impacts on human life and infrastructure, with broad implications across a range of stakeholders. Changes to extreme precipitation events are a projected outcome of climate change that warrants further study, especially at regional- to local-scales. While global climate models are generally capable of simulating mean climate at global-to-regional scales with reasonable skill, resiliency and adaptation decisions are made at local-scales where most state-of-the-art climate models are limited by coarse resolution. Characterization of large-scale meteorological patterns associated with extreme precipitation events at local-scales can provide climatic information without this scale limitation, thus facilitating stakeholder decision-making. This research will use synoptic climatology as a tool by which to characterize the key large-scale meteorological patterns associated with extreme precipitation events in the Portland, Oregon metro region. Composite analysis of meteorological patterns associated with extreme precipitation days, and associated watershed-specific flooding, is employed to enhance understanding of the climatic drivers behind such events. The self-organizing maps approach is then used to characterize the within-composite variability of the large-scale meteorological patterns associated with extreme precipitation events, allowing us to better understand the different types of meteorological conditions that lead to high-impact precipitation events and associated hydrologic impacts. A more comprehensive understanding of the meteorological drivers of extremes will aid in evaluation of the ability of climate models to capture key patterns associated with extreme precipitation over Portland and to better interpret projections of future climate at impact-relevant scales.

The Scientific Revolution: A Unit of Study for Grades 7-10.

ERIC Educational Resources Information Center

Frick, Carole Collier

This unit is one of a series that presents specific moments in history from which students focus on the meanings of landmark events. The purpose of this unit is for the student to explore the advances in scientific knowledge made in Europe in the mid-sixteenth to mid-seventeenth centuries. These advances, beginning with Copernicus, radically…

Women in the Progressive Era. A Unit of Study for Grades 9-12.

ERIC Educational Resources Information Center

Jason, Alli; Strickland, Louise; McMillen, Margaret

A specific dramatic episode in history that allows students to delve into the deeper meanings of selected landmark events and explore a wider context of historical narrative is represented within this supplementary teaching unit. This approach helps students materialize history as an ongoing, open-ended process that is based upon decisions made in…

Using Fiction to Teach American History in Middle School: Affects on Student Engagement

ERIC Educational Resources Information Center

Elias, Anjuli Rose

2010-01-01

This research highlights the effects of using literature and relevant curriculum to teach history in grade levels 6 through 8, and analyzes how students respond when learning complicated themes and events through the medium of historic fiction. Specifically, my research seeks to inform secondary educators concerning the use of the narrative and…

The comparative efficacy and safety of sugammadex and neostigmine in reversing neuromuscular blockade in adults. A Cochrane systematic review with meta-analysis and trial sequential analysis.

PubMed

Hristovska, A-M; Duch, P; Allingstrup, M; Afshari, A

2018-05-01

We compared the efficacy and safety of sugammadex and neostigmine in reversing neuromuscular blockade in adults. Our outcomes were: recovery time from second twitch to train-of-four ratio > 0.9; recovery time from post-tetanic count 1-5 to train-of-four ratio > 0.9; and risk of composite adverse and serious adverse events. We searched for randomised clinical trials irrespective of publication status and date, blinding status, outcomes reported or language. We included 41 studies with 4206 participants. Time to reversal of neuromuscular blockade from second twitch to a train-of-four ratio > 0.9 was 2.0 min with sugammadex 2 mg.kg -1 and 12.9 min with neostigmine 0.05 mg.kg -1 , with a mean difference (MD) (95%CI)) of 10.2 (8.5-12.0) (I 2  = 84%, 10 studies, n = 835, Grades of Recommendation, Assessment, Development and Evaluation (GRADE): moderate quality). Time to reversal of neuromuscular blockade from a post-tetanic count of 1-5 to a train-of-four ratio > 0.9 was 2.9 min with sugammadex 4 mg.kg -1 and 48.8 min with neostigmine 0.07 mg.kg -1 , with a MD (95%CI) of 45.8 (39.4-52.2) (I 2  = 0%, 2 studies, n = 114, GRADE: low quality). There were significantly fewer composite adverse events in the sugammadex group compared with neostigmine, with a risk ratio (95%CI) of 0.60 (0.49-0.74) (I 2  = 40%, 28 studies, n = 2298, number needed to treat (NNT): 8, GRADE: moderate quality). Specifically, the risk of bradycardia (RR (95%CI) 0.16 (0.07-0.34), n = 1218, NNT: 14, GRADE: moderate quality), postoperative nausea and vomiting (RR (95%CI) 0.52 (0.28-0.97), n = 389, NNT: 16, GRADE: low quality) and overall signs of postoperative residual paralysis (RR (95%CI) 0.40 (0.28-0.57), n = 1474, NNT: 13, GRADE: moderate quality) were all reduced. There was no significant difference regarding the risk of serious adverse events (RR 0.54, 95%CI 0.13-2.25, I 2  = 0%, n = 959, GRADE: low quality). Sugammadex reverses neuromuscular blockade more rapidly than neostigmine and is associated with fewer adverse events. © 2017 The Association of Anaesthetists of Great Britain and Ireland.

A Life Events Scale for Armed Forces personnel

PubMed Central

Chaudhury, Suprakash; Srivastava, Kalpana; Raju, M.S.V. Kama; Salujha, S.K.

2006-01-01

Background: Armed Forces personnel are routinely exposed to a number of unique stressful life events. None of the available scales are relevant to service personnel. Aim: To construct a scale to measure life events in service personnel. Methods: In the first stage of the study open-ended questions along with items generated by the expert group by consensus method were administered to 50 soldiers. During the second stage a scale comprising 59 items and open-ended questions was administered to 165 service personnel. The final scale of 52 items was administered to 200 service personnel in group setting. Weightage was assigned on a 0 to 100 range. For normative study the Armed Forces Medical College Life Events Scale (AFMC LES) was administered to 1200 Army, 100 Air Force and 100 Navy personnel. Results: Service personnel experience an average of 4 life events in past one year and 13 events in a life-time. On an average service personnel experience 115 life change unit scores in past one year and 577 life change unit scores in life-time on the AFMC LES. The scale has concurrent validity when compared with the Presumptive Stressful Life Events Scale (PSLES). There is internal consistency in the scale with the routine items being rated very low. There is a pattern of uniformity with the civilian counterparts along with differences in the items specific to service personnel. Conclusions: The AFMC LES includes the unique stresses of service personnel that are not included in any life events scale available in India or in the west and should be used to assess stressful life events in service personnel. PMID:20844647

Effects of Engineering Design-Based Science on Elementary School Science Students' Engineering Identity Development across Gender and Grade

NASA Astrophysics Data System (ADS)

Capobianco, Brenda M.; Yu, Ji H.; French, Brian F.

2015-04-01

The integration of engineering concepts and practices into elementary science education has become an emerging concern for science educators and practitioners, alike. Moreover, how children, specifically preadolescents (grades 1-5), engage in engineering design-based learning activities may help science educators and researchers learn more about children's earliest identification with engineering. The purpose of this study was to examine the extent to which engineering identity differed among preadolescents across gender and grade, when exposing students to engineering design-based science learning activities. Five hundred fifty preadolescent participants completed the Engineering Identity Development Scale (EIDS), a recently developed measure with validity evidence that characterizes children's conceptions of engineering and potential career aspirations. Data analyses of variance among four factors (i.e., gender, grade, and group) indicated that elementary school students who engaged in the engineering design-based science learning activities demonstrated greater improvements on the EIDS subscales compared to those in the comparison group. Specifically, students in the lower grade levels showed substantial increases, while students in the higher grade levels showed decreases. Girls, regardless of grade level and participation in the engineering learning activities, showed higher scores in the academic subscale compared to boys. These findings suggest that the integration of engineering practices in the science classroom as early as grade one shows potential in fostering and sustaining student interest, participation, and self-concept in engineering and science.

Deformation sequences of the Day Nui Con Voi metamorphic belt, northern Vietnam

NASA Astrophysics Data System (ADS)

Yeh, M. W.; Lee, T. Y.; Lo, C. H.; Chung, S. L.; Lan, C. Y.; Lee, J. C.; Lin, T. S.; Lin, Y. J.

2003-04-01

The correlation of structure, microstructure and metamorphic assemblages is of fundamental importance to the understanding of the complex tectonic history and kinematics of the Day Nui Con Voi (DNCV) metamorphic belt in Vietnam along the Ailao Shan-Red River (ASRR) shear zone as it provides constraints on the relative timing of the deformation, kinematics and metamorphism. High-grade metamorphic rocks of amphibolite faces showed consistent deformation sequences of three folding events followed by one brittle deformation through all four cross sections from Lao Cai to Viet Tri indicated the DNCV belt experienced similar deformation condition throughout its length. The first deformation event, D1, produced up-right folds (locally preserved) with sub-vertical, NE-SW striking axial planes with dextral sense of shear probably formed during the early phase of the lowermost Triassic Indosinian orogeny. Followed by this compressional event is a gravitational collapsing event, D2, which is the major deformation and metamorphic event characterized by kyanite grade metamorphism and large scale horizontal folds with NW-SE (320) striking sub-horizontal axial pane showing sinsistral sense of shear most likely formed during the Oligocene-Miocene SE extrusion of Indochina peninsula. The 3rd folding event, D3, is a post-metamorphism doming event with NW-SE (310) striking sub-vertical axial plane that folded/tilted the once sub-horizontal D2 axial planes into shallowly (<30 degrees) NE dipping on the NE limb, and SW dipping on the SW limb possibly due to left-lateral movement of the N-S trending Xian Shui He fault system in Mid-Miocene. The outward decreasing of the metamorphic grade from kyanite to garnet then biotite indicated the D3 occurred post metamorphism. Reactivation of the sub-horizontal D2 fold axial planes showed dextral sense of shear possibly due to Late Miocene-Pliocene right-lateral movement of the ASRR shear zone. This right lateral movement continuously deformed the DNCV with brittle fractures such as joints and normal faults (D4) striking NE-SW to E-W and NW-SE.

Investigating Variation in Teaching with Technology-Rich Intervention: What Matters in Teaching and Teacher Training at Scale?

ERIC Educational Resources Information Center

Dunn, Margaret Breslin

2009-01-01

A main question this dissertation addresses is: what variation in teaching and teacher training matter? This question is examined within a specific but important context: the scale-up of a technology-rich intervention focused on the algebra strand of 8th grade mathematics. I conducted a multi-level case study by gathering and analyzing data at…

Accelerated Radiotherapy, Carbogen, and Nicotinamide (ARCON) in the Treatment of Advanced Bladder Cancer: Mature Results of a Phase II Nonrandomized Study

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

Hoskin, Peter; Marie Curie Research Wing, Mount Vernon Hospital, Northwood, Middx; Rojas, Ana Ph.D.

2009-04-01

Purpose: We previously showed that accelerated radiotherapy combined with carbogen and nicotinamide (ARCON) was an effective approach to use in the radical treatment of patients with advanced bladder carcinoma. Interim analysis from this Phase II study showed that it achieved a high level of locoregional control and overall survival (OS) and an acceptable level of adverse events. Methods and Materials: From 1994 to 2000, a total of 105 consecutive patients with high-grade superficial or muscle-invasive bladder carcinoma were given accelerated radiotherapy (50-55 Gy in 4 weeks) with carbogen alone or ARCON. End points of the study were OS, disease-specific, andmore » local regional relapse-free survival, and for late adverse events, urinary (altered urination frequency, incontinence, hematuria, and urgency) and bowel dysfunction (stool frequency and blood loss). Results: At 5 and 10 years, local regional relapse-free survival rates were 44% after ARCON excluding the effect of salvage treatment and 62% after ARCON including the effect of salvage treatment (p = 0.04). Five- and 10-year rates were 35% and 27% for OS and 47% and 46% for disease-specific survival. The highest actuarial rate for Grade 3 or worse late urinary or bowel dysfunction was observed for altered urinary frequency (44% of patients had urinary events every 1 hour or less) and stool frequency of four or more events (26% at 5 years). Conclusions: Historic comparisons with other studies indicate no evidence of an increase in severe or worse adverse events and good permanent control of bladder disease after ARCON radiotherapy.« less

Enhanced protective role in materials with gradient structural orientations: Lessons from Nature.

PubMed

Liu, Zengqian; Zhu, Yankun; Jiao, Da; Weng, Zhaoyong; Zhang, Zhefeng; Ritchie, Robert O

2016-10-15

Living organisms are adept at resisting contact deformation and damage by assembling protective surfaces with spatially varied mechanical properties, i.e., by creating functionally graded materials. Such gradients, together with multiple length-scale hierarchical structures, represent the two prime characteristics of many biological materials to be translated into engineering design. Here, we examine one design motif from a variety of biological tissues and materials where site-specific mechanical properties are generated for enhanced protection by adopting gradients in structural orientation over multiple length-scales, without manipulation of composition or microstructural dimension. Quantitative correlations are established between the structural orientations and local mechanical properties, such as stiffness, strength and fracture resistance; based on such gradients, the underlying mechanisms for the enhanced protective role of these materials are clarified. Theoretical analysis is presented and corroborated through numerical simulations of the indentation behavior of composites with distinct orientations. The design strategy of such bioinspired gradients is outlined in terms of the geometry of constituents. This study may offer a feasible approach towards generating functionally graded mechanical properties in synthetic materials for improved contact damage resistance. Living organisms are adept at resisting contact damage by assembling protective surfaces with spatially varied mechanical properties, i.e., by creating functionally-graded materials. Such gradients, together with multiple length-scale hierarchical structures, represent the prime characteristics of many biological materials. Here, we examine one design motif from a variety of biological tissues where site-specific mechanical properties are generated for enhanced protection by adopting gradients in structural orientation at multiple length-scales, without changes in composition or microstructural dimension. The design strategy of such bioinspired gradients is outlined in terms of the geometry of constituents. This study may offer a feasible approach towards generating functionally-graded mechanical properties in synthetic materials for improved damage resistance. Published by Elsevier Ltd.

[Design and validation of the scales for the assessment of the psychological impact of past life events: the role of ruminative thought and personal growth].

PubMed

Fernández-Fernández, Virginia; Márquez-González, María; Losada-Baltar, Andrés; García, Pablo E; Romero-Moreno, Rosa

2013-01-01

Older people's emotional distress is often related to rumination processes focused on past vital events occurred during their lives. The specific coping strategies displayed to face those events may contribute to explain older adults' current well-being: they can perceive that they have obtained personal growth after those events and/or they can show a tendency to have intrusive thoughts about those events. This paper describes the development and analysis of the psychometric properties of the Scales for the Assessment of the Psychological Impact of Past Life Events (SAPIPLE): the past life events-occurrence scale (LE-O), ruminative thought scale (LE-R) and personal growth scale (LE-PG). Participants were 393 community dwelling elderly (mean age=71.5 years old; SD=6.9). In addition to the SAPIPLE scales, depressive symptomatology, anxiety, psychological well-being, life satisfaction, physical function and vitality have been assessed. The inter-rater agreement's analysis suggests the presence of two factors in the LE-O: positive and negative vital events. Confirmatory Factor Analysis (CFA) supported this two-dimensional structure for both the LE-R and the LE-PG. Good internal consistency indexes have been obtained for each scale and subscale, as well as good criterion and concurrent validity indexes. Both ruminative thoughts about past life events and personal growth following those events are related to older adults' current well-being. The SAPIPLE presents good psychometric properties that justify its use for elderly people. Copyright © 2012 SEGG. Published by Elsevier Espana. All rights reserved.

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

Kittel, Jeffrey A.; Reddy, Chandana A.; Smith, Kristin L.

Purpose/Objectives: To report long-term efficacy and toxicity for a single-institution cohort of patients treated with low-dose-rate prostate brachytherapy permanent implant (PI) monotherapy. Methods and Materials: From 1996 to 2007, 1989 patients with low-risk (61.3%), intermediate-risk (29.8%), high-intermediate-risk (4.5%), and high-risk prostate cancer (4.4%) were treated with PI and followed up prospectively in a registry. All patients were treated with {sup 125}I monotherapy to 144 Gy. Late toxicity was coded retrospectively according to a modified Common Terminology Criteria for Adverse Events 4.0 scale. The rates of biochemical relapse-free survival (bRFS), distant metastasis-free survival (DMFS), overall survival (OS), and prostate cancer–specific mortality (PCSM)more » were calculated. We identified factors associated with late grade ≥3 genitourinary (GU) and gastrointestinal (GI) toxicity, bRFS, DMFS, OS, PCSM, and incontinence. Results: The median age of the patients was 67 years, and the median overall and prostate-specific antigen follow-up times were 6.8 years and 5.8 years, respectively. The overall 5-year rates for bRFS, DMFS, OS, and PCSM were 91.9%, 97.8%, 93.7%, and 0.71%, respectively. The 10-year rates were 81.5%, 91.5%, 76.1%, and 2.5%, respectively. The overall rates of late grade ≥3 GU and GI toxicity were 7.6% and 0.8%, respectively. On multivariable analysis, age and prostate length were significantly associated with increased risk of late grade ≥3 GU toxicity. The risk of incontinence was highly correlated with both pre-PI and post-PI transurethral resection of the prostate. Conclusions: Prostate brachytherapy as monotherapy is an effective treatment for low-risk and low-intermediate-risk prostate cancer and appears promising as a treatment for high-intermediate-risk and high-risk prostate cancer. Significant long-term toxicities are rare when brachytherapy is performed as monotherapy.« less

Relationship between boys' normative beliefs about aggression and their physical, verbal, and indirect aggressive behaviors.

PubMed

Lim, Si Huan; Ang, Rebecca P

2009-01-01

This study examined the contribution of general normative beliefs about aggression and specific normative beliefs about retaliatory aggression in predicting physical, verbal, and indirect aggressive behaviors. Two hundred and forty-nine Grade 4 and Grade 5 boys completed the Normative Beliefs about Aggression Scale (NOBAGS) and provided self-reports on the frequency of their physical, verbal, and indirect aggressive behaviors. A series of hierarchical multiple regression analyses revealed that general normative beliefs about aggression contributed significantly in predicting all three types of aggressive behaviors. When general normative beliefs about aggression were controlled for, specific normative beliefs about retaliatory aggression against males but not specific normative beliefs about retaliatory aggression against females, contributed significantly to predict physical, verbal, and indirect aggressive behaviors. Implications for intervention programs are discussed.

Grading dermatologic adverse events of cancer treatments: the Common Terminology Criteria for Adverse Events Version 4.0.

PubMed

Chen, Alice P; Setser, Ann; Anadkat, Milan J; Cotliar, Jonathan; Olsen, Elise A; Garden, Benjamin C; Lacouture, Mario E

2012-11-01

Dermatologic adverse events to cancer therapies have become more prevalent and may to lead to dose modifications or discontinuation of life-saving or prolonging treatments. This has resulted in a new collaboration between oncologists and dermatologists, which requires accurate cataloging and grading of side effects. The Common Terminology Criteria for Adverse Events Version 4.0 is a descriptive terminology and grading system that can be used for uniform reporting of adverse events. A proper understanding of this standardized classification system is essential for dermatologists to properly communicate with all physicians caring for patients with cancer. Copyright © 2012 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Efficacy of diode laser (810 and 940 nm) for facial skin tightening.

PubMed

Voravutinon, Nataya; Seawthaweesin, Kanikar; Bureethan, Apron; Srivipatana, Anchisa; Vejanurug, Patnapa

2015-12-01

Laser treatment has been introduced for facial skin tightening. However, no prior study has used a diode laser to treat facial skin laxity. To evaluate the efficacy and safety of a 810- and 940-nm diode laser (MeDioStarNeXT) for treating facial skin laxity. Thirty patients, with facial skin laxity grading scale II-IV, were enrolled in this study. Each patient underwent four sessions with a 810- and 940-nm diode laser (MeDioStarNeXT) treatment over 3-week intervals. Improvement in the laxity of facial skin was evaluated using a Cutometer MPA 580, spectrophotometer, and a grading scale. Significant improvement was observed with the Cutometer F3 and R7 parameters at 1 and 3 months after complete treatment, respectively. Physician assessment showed significant improvement in the laxity scale at 1 and 6 months after treatment. Approximately 10% of the patients reported mild pain or minor adverse events. Ninety-eight percent of the patients were satisfied with the treatments. Treatment with a diode laser (810 and 940 nm) is safe and may be effective for facial skin tightening. Maintenance treatment is necessary to sustain the effect of treatment. © 2015 Wiley Periodicals, Inc.

Comparison of gray-scale contrast-enhanced ultrasonography with contrast-enhanced computed tomography in different grading of blunt hepatic and splenic trauma: an animal experiment.

PubMed

Tang, Jie; Li, Wenxiu; Lv, Faqin; Zhang, Huiqin; Zhang, Lihai; Wang, Yuexiang; Li, Junlai; Yang, Li

2009-04-01

To compare the diagnostic value of contrast-enhanced ultrasonography (CEUS) with contrast-enhanced computed tomography (CECT) for the detection of different grading of solid organ injuries in blunt abdominal trauma in animals. A self-made miniature tools were used as models to simulate a blunt hepatic or splenic trauma in 16 and 14 anesthetized dogs, respectively. Baseline ultrasound, CEUS and CECT were used to detect traumatic injuries of livers and spleens. The degree of injuries was determined by CEUS according to the American Association for the Surgery of Trauma (AAST) scale and the results compared with injury scale based on CECT evaluation. CEUS showed 22 hepatic injury sites in 16 animals and 17 splenic injury sites in other 14 animals. According to AAST scale, 2 grade I, 4 grade II, 3 grade III, 5 grade IV and 2 grade V hepatic lesions were present in 16 animals; 2 grade I, 4 grade II, 6 grade III and 2 grade IV splenic lesions in 14 animals. On CECT scan, 21 hepatic and 17 splenic injuries were demonstrated. According to Becker CT scaling for hepatic injury, 1 grade I, 2 grade II, 4 grade III, 5 grade IV and 2 grade V hepatic injuries were present. On the basis of Buntain spleen scaling, 2 grade I, 5 grade II, 5 grade III, 2 grade IV splenic injuries were showed. After Spearman rank correlation analysis, the agreement of CEUS with CECT on the degree of hepatic and splenic injury is 93.3% and 92.9%, respectively. CT is currently considered as the reference method for grading blunt abdominal trauma, according to experiment results, CEUS grading showed high levels of concordance with CECT. CEUS can accurately determine the degree of injury and will play an important role in clinical application.

Relative Time-scale for Channeling Events Within Chaotic Terrains, Margaritifer Sinus, Mars

NASA Technical Reports Server (NTRS)

Janke, D.

1985-01-01

A relative time scale for ordering channel and chaos forming events was constructed for areas within the Margaritifer Sinus region of Mars. Transection and superposition relationships of channels, chaotic terrain, and the surfaces surrounding them were used to create the relative time scale; crater density studies were not used. Channels and chaos in contact with one another were treated as systems. These systems were in turn treated both separately (in order to understand internal relationships) and as members of the suite of Martian erosional forms (in order to produce a combined, master time scale). Channeling events associated with chaotic terrain development occurred over an extended geomorphic period. The channels can be divided into three convenient groups: those that pre-date intercrater plains development post-plains, pre-chasma systems; and those associated with the development of the Vallis Marineris chasmata. No correlations with cyclic climatic changes, major geologic events in other regions on Mars, or triggering phenomena (for example, specific impact events) were found.

Epistaxis grading in Osler's disease: comparison of comprehensive scores with detailed bleeding diaries.

PubMed

Parzefall, Thomas; Wolf, Axel; Frei, Klemens; Kaider, Alexandra; Riss, Dominik

2017-03-01

Use of reliable grading scores to measure epistaxis severity in hereditary hemorrhagic telangiectasia (HHT) is essential in clinical routine and for scientific purposes. For practical reasons, visual analog scale (VAS) scoring and the Epistaxis Severity Score (ESS) are widely used. VAS scores are purely subjective, and a potential shortcoming of the ESS is that it is based on self-reported anamnestic bleeding data. The aim of this study was to validate the level of correlation between VAS scores, the ESS, and actual bleeding events, based on detailed epistaxis diaries of patients. Records from daily epistaxis diaries maintained by 16 HHT patients over 112 consecutive days were compared with the monthly ESS and daily VAS scores in the corresponding time period. The Spearman rank correlation coefficient, analysis of variance models, and multiple R 2 measures were used for statistical analysis. Although the ESS and VAS scores generally showed a high degree of correlation with actual bleeding events, mild events were underrepresented in both scores. Our results highlight the usefulness of the ESS as a standard epistaxis score in cohorts with moderate to severe degrees of epistaxis. The use of detailed epistaxis diaries should be considered when monitoring patients and cohorts with mild forms of HHT. © 2016 ARS-AAOA, LLC.

A Generic Method for Distribution and Transfer of ECTS and Other Norm-Referenced Grades within Student Cohorts

ERIC Educational Resources Information Center

Warfvinge, Per

2008-01-01

The ECTS grade transfer scale is an interface grade scale to help European universities, students and employers to understand the level of student achievement. Hence, the ECTS scale can be seen as an interface, transforming local scales to a common system where A-E denote passing grades. By definition, ECTS should distribute the passing students…

Readability of Healthcare Literature for Hepatitis B and C.

PubMed

Meillier, Andrew; Patel, Shyam; Al-Osaimi, Abdullah M S

2015-12-01

Patients increasingly use the Internet for educational material concerning health and diseases. This information can be utilized to teach the population of hepatitis B and C if properly written at the necessary grade level of the intended patient population. We explored the readability of online resources concerning hepatitis B and C. Google searches were performed for "Hepatitis B" and "Hepatitis C." The Internet resources that were intended for patient education were used with specific exclusions. Articles were taken from 19 and 23 different websites focusing on the symptoms, diagnosis, and treatment of hepatitis B and C, respectively. The articles were analyzed using Readability Studio Professional Edition (Oleander Solutions, Vandalia, OH) using 10 different readability scales. The results were compared and averaged to identify the anticipated academic grade level required to understand the information. The average readability scores of the 10 scales had ranges of 9.7-16.4 for hepatitis B and 9.2-16.4 for hepatitis C. The average academic reading grade level for hepatitis B was 12.6 ± 2.1 and for hepatitis C was 12.7 ± 2.1. There was no significant discrepancy between the hepatitis B and C Internet resource averaged grade levels. The resources accessed by patients are higher than the previously determined necessary grade level for patients to properly understand the intended information. The American Medical Association recommends material should be simplified to grade levels below the sixth grade level to benefit the ideal proportion of the patient population.

Development and validation of the Questionnaire of Stressful Life Events (QSLE).

PubMed

Butjosa, Anna; Gómez-Benito, Juana; Myin-Germeys, Inez; Barajas, Ana; Baños, Iris; Usall, Judith; Grau, Norma; Granell, Luis; Sola, Andrea; Carlson, Janina; Dolz, Montserrat; Sánchez, Bernardo; Haro, Josep Maria; Ochoa, Susana

2017-12-01

Stressful life events (SLEs) are important indicators prior to the onset of first-episode psychosis (FEP). Although there are well-validated interviews and self-reports for assessing SLE on proximate events, unfortunately there are no instruments to assess SLE covering an entire lifetime. This study includes detailed specific items of childhood, adolescence, and adulthood focused on the presence of SLE, emotional impact (stressfulness), and the age at which the event occurred. Our research describes 2 studies designed to develop and validate a new scale to assess SLE: the Questionnaire of Stressful Life Events (QSLE). In Study 1, an over-inclusive item pool was generated based on review of group of experts at Parc Sanitari Sant Joan de Déu and content validity was examined by an Expert Survey. The whole scale represents the content domain. In Study 2, item-level analyses revealed good distributional properties, intra-rater reliability, and convergent and discriminant validity. In the sensitivity and specificity analysis, 18 items had high relevance in the discriminability between patients with FEP and healthy controls. We note that there was an AUC of 0.676, indicating a good predictor. Using 7 as a cutoff to predict an individual as a patient would yield a sensitivity of 64.8% and a specificity of 65%. Overall, the QSLE displayed satisfactory psychometric characteristics in a Spanish population. These results suggest that QSLE gives us the opportunity to investigate childhood, adolescent, and adult life events by measuring the stress and age at the moment on a continuous scale. Copyright © 2017 Elsevier Ltd. All rights reserved.

Natural history of severe atheromatous disease of the thoracic aorta: a transesophageal echocardiographic study.

PubMed

Montgomery, D H; Ververis, J J; McGorisk, G; Frohwein, S; Martin, R P; Taylor, W R

1996-01-01

This study sought to prospectively observe the morphologic and clinical natural history of severe atherosclerotic disease of the thoracic aorta as defined by transesophageal echocardiography. Atherosclerosis of the thoracic aorta has been shown to be highly associated with risk for embolic events in transesophageal studies, but the natural history of the disease under clinical conditions has not been reported. During a 20-month period, 191 of 264 patients undergoing transesophageal echocardiography had adequate visualization of the aorta to allow atherosclerotic severity to be graded as follows: grade I = normal (44 patients); grade II = intimal thickening (52 patients); grade III = atheroma < 5 mm (62 patients); grade IV = atheroma > or = 5 mm (19 patients); grade V = mobile lesion (14 patients). All available patients with grades IV (8 patients) and V (10 patients) disease as well as a subgroup of 12 patients with grade III disease had follow-up transesophageal echocardiographic studies (mean [+/- SD] 11.7 +/- 0.9 months, range 6 to 22). Of 30 patients undergoing follow-up transesophageal echocardiographic studies, 20 (66%) had no change in atherosclerotic severity grade. Of the remaining 10 patients, atherosclerotic severity progressed one grade in 7 and decreased in 3 with resolved mobile lesions. Of 18 patients with grade IV or V disease of the aorta who underwent a follow-up study, 11 (61%) demonstrated formation of new mobile lesions. Of 10 patients with grade V disease on initial study who underwent follow-up study, 7 (70%) demonstrated resolution of a specific previously documented mobile lesion. However, seven patients (70%) with grade V disease also demonstrated development of a new mobile lesion. Of 33 patients with grade IV or V disease, 8 (24%) died during the study period, and 1 (3%) had a clinical embolic event. The presence of severe atherosclerotic disease of the thoracic aorta as defined by transesophageal echocardiography is associated with a high mortality rate. Although the morphologic natural history of the disease process itself is marked by stability over a 1-year period, individual lesion morphology is dynamic, with formation and resolution of mobile components occurring frequently over the same period. The dynamic nature of individual lesion morphology potentially enhances the possibility of developing a successful therapeutic strategy.

Elevated expression of LSD1 (Lysine-specific demethylase 1) during tumour progression from pre-invasive to invasive ductal carcinoma of the breast

PubMed Central

2012-01-01

Background Lysine-specific demethylase1 (LSD1) is a nuclear protein which belongs to the aminooxidase-enzymes playing an important role in controlling gene expression. It has also been found highly expressed in several human malignancies including breast carcinoma. Our aim was to detect LSD1 expression also in pre-invasive neoplasias of the breast. In the current study we therefore analysed LSD1 protein expression in ductal carcinoma in situ (DCIS) in comparison to invasive ductal breast cancer (IDC). Methods Using immunohistochemistry we systematically analysed LSD1 expression in low grade DCIS (n = 27), intermediate grade DCIS (n = 30), high grade DCIS (n = 31) and in invasive ductal breast cancer (n = 32). SPSS version 18.0 was used for statistical analysis. Results LSD1 was differentially expressed in DCIS and invasive ductal breast cancer. Interestingly, LSD1 was significantly overexpressed in high grade DCIS versus low grade DCIS. Differences in LSD1 expression levels were also statistically significant between low/intermediate DCIS and invasive ductal breast carcinoma. Conclusions LSD1 is also expressed in pre-invasive neoplasias of the breast. Additionally, there is a gradual increase of LSD1 expression within tumour progression from pre-invasive DCIS to invasive ductal breast carcinoma. Therefore upregulation of LSD1 may be an early tumour promoting event. PMID:22920283

Elevated expression of LSD1 (Lysine-specific demethylase 1) during tumour progression from pre-invasive to invasive ductal carcinoma of the breast.

PubMed

Serce, Nuran; Gnatzy, Annette; Steiner, Susanne; Lorenzen, Henning; Kirfel, Jutta; Buettner, Reinhard

2012-08-24

Lysine-specific demethylase1 (LSD1) is a nuclear protein which belongs to the aminooxidase-enzymes playing an important role in controlling gene expression. It has also been found highly expressed in several human malignancies including breast carcinoma. Our aim was to detect LSD1 expression also in pre-invasive neoplasias of the breast. In the current study we therefore analysed LSD1 protein expression in ductal carcinoma in situ (DCIS) in comparison to invasive ductal breast cancer (IDC). Using immunohistochemistry we systematically analysed LSD1 expression in low grade DCIS (n = 27), intermediate grade DCIS (n = 30), high grade DCIS (n = 31) and in invasive ductal breast cancer (n = 32). SPSS version 18.0 was used for statistical analysis. LSD1 was differentially expressed in DCIS and invasive ductal breast cancer. Interestingly, LSD1 was significantly overexpressed in high grade DCIS versus low grade DCIS. Differences in LSD1 expression levels were also statistically significant between low/intermediate DCIS and invasive ductal breast carcinoma. LSD1 is also expressed in pre-invasive neoplasias of the breast. Additionally, there is a gradual increase of LSD1 expression within tumour progression from pre-invasive DCIS to invasive ductal breast carcinoma. Therefore upregulation of LSD1 may be an early tumour promoting event.

A model of return intervals between earthquake events

NASA Astrophysics Data System (ADS)

Zhou, Yu; Chechkin, Aleksei; Sokolov, Igor M.; Kantz, Holger

2016-06-01

Application of the diffusion entropy analysis and the standard deviation analysis to the time sequence of the southern California earthquake events from 1976 to 2002 uncovered scaling behavior typical for anomalous diffusion. However, the origin of such behavior is still under debate. Some studies attribute the scaling behavior to the correlations in the return intervals, or waiting times, between aftershocks or mainshocks. To elucidate a nature of the scaling, we applied specific reshulffling techniques to eliminate correlations between different types of events and then examined how it affects the scaling behavior. We demonstrate that the origin of the scaling behavior observed is the interplay between mainshock waiting time distribution and the structure of clusters of aftershocks, but not correlations in waiting times between the mainshocks and aftershocks themselves. Our findings are corroborated by numerical simulations of a simple model showing a very similar behavior. The mainshocks are modeled by a renewal process with a power-law waiting time distribution between events, and aftershocks follow a nonhomogeneous Poisson process with the rate governed by Omori's law.

Victimization and PTSD-like states in an Icelandic youth probability sample.

PubMed

Bödvarsdóttir, Iris; Elklit, Ask

2007-10-01

Although adolescence in many cases is a period of rebellion and experimentation with new behaviors and roles, the exposure of adolescents to life-threatening and violent events has rarely been investigated in national probability studies using a broad range of events. In an Icelandic national representative sample of 206 9th-grade students (mean = 14.5 years), the prevalence of 20 potentially traumatic events and negative life events was reported, along with the psychological impact of these events. Seventy-four percent of the girls and 79 percent of the boys were exposed to at least one event. The most common events were the death of a family member, threat of violence, and traffic accidents. The estimated lifetime prevalence of posttraumatic stress disorder-like states (PTSD; DSM-IV, APA, 1994 1) was 16 percent, whereas another 12 percent reached a sub-clinical level of PTSD-like states (missing the full diagnosis with one symptom). Following exposure, girls suffered from PTSD-like states almost twice as often as boys. Gender, mothers' education, and single-parenthood were associated with specific events. The odds ratios and 95% CI for PTSD-like states given a specific event are reported. Being exposed to multiple potentially traumatic events was associated with an increase in PTSD-like states. The findings indicate substantial mental health problems in adolescents that are associated with various types of potentially traumatic exposure.

Early Botulinum Toxin Injections in Infants With Musculoskeletal Disorders: A Systematic Review of Safety and Effectiveness.

PubMed

Bourseul, Jean-Sébastien; Molina, Anais; Lintanf, Mael; Houx, Laetitia; Chaléat-Valayer, Emmanuelle; Pons, Christelle; Brochard, Sylvain

2018-06-01

To report current evidence regarding the safety of intramuscular botulinum toxin injection (BTI) in children with orthopedic- and neurologic-related musculoskeletal disorders >2 years of age. PubMed, Cochrane Library, and ScienceDirect, Google Scholar, and Web of Science. Two reviewers independently selected studies based on predetermined inclusion criteria. Data relating to the aim were extracted. Methodologic quality was graded independently by 2 reviewers using the Physiotherapy Evidence Database scale for randomized controlled trials (RCTs) and the Downs and Black evaluation tool for non-RCTs. Level of evidence was determined using the modified Sackett scale. Data of 473 infants were analyzed. Fifty-five infants had cerebral palsy, 112 had obstetric brachial plexus palsy, 257 had clubfoot, and 44 had congenital torticollis. No studies reported any severe adverse event that could be attributed to the BTI. The rate of mild to moderate adverse events reported varied from 5% to 25%. Results regarding efficacy were preliminary, dependent on the pathology, and limited by the small number of studies and their low levels of evidence. BTI is already widely used as an early treatment for this age group. The safety profile of BTI in infants appears similar to that of older children and risks appear more related to the severity of the pathology and the location of the injections than to the toxin itself. Regarding effectiveness, other studies with higher levels of evidence should be carried out for each specific pathology. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Correlation of quantitative sensorimotor tractography with clinical grade of cerebral palsy.

PubMed

Trivedi, Richa; Agarwal, Shruti; Shah, Vipul; Goyel, Puneet; Paliwal, Vimal K; Rathore, Ram K S; Gupta, Rakesh K

2010-08-01

The purpose of this study was to determine whether tract-specific diffusion tensor imaging measures in somatosensory and motor pathways correlate with clinical grades as defined using the Gross Motor Function Classification System (GMFCS) in cerebral palsy (CP) children. Quantitative diffusion tensor tractography was performed on 39 patients with spastic quadriparesis (mean age = 8 years) and 14 age/sex-matched controls. All patients were graded on the basis of GMFCS scale into grade II (n = 12), grade IV (n = 22), and grade V (n = 5) CP and quantitative analysis reconstruction of somatosensory and motor tracts performed. Significant inverse correlation between clinical grade and fractional anisotropy (FA) was observed in both right and left motor and sensory tracts. A significant direct correlation of mean diffusivity values from both motor and sensory tracts was also observed with clinical grades. Successive decrease in FA values was observed in all tracts except for left motor tracts moving from age/sex-matched controls to grade V through grades II and IV. We conclude that white matter tracts from both the somatosensory and the motor cortex play an important role in the pathophysiology of motor disability in patients with CP.

Autobiographical memory, interpersonal problem solving, and suicidal behavior in adolescent inpatients.

PubMed

Arie, Miri; Apter, Alan; Orbach, Israel; Yefet, Yael; Zalsman, Gil; Zalzman, Gil

2008-01-01

The aim of the study was to test Williams' (Williams JMG. Depression and the specificity of autobiographical memory. In: Rubin D, ed. Remembering Our Past: Studies in Autobiographical Memory. London: Cambridge University Press; 1996:244-267.) theory of suicidal behavior in adolescents and young adults by examining the relationship among suicidal behaviors, defective ability to retrieve specific autobiographical memories, impaired interpersonal problem solving, negative life events, repression, and hopelessness. Twenty-five suicidal adolescent and young adult inpatients (16.5 y +/- 2.5) were compared with 25 nonsuicidal adolescent and young adult inpatients (16.5 y +/- 2.5) and 25 healthy controls. Autobiographical memory was tested by a word association test; problem solving by the means-ends problem solving technique; negative life events by the Coddington scale; repression by the Life Style Index; hopelessness by the Beck scale; suicidal risk by the Plutchik scale, and suicide attempt by clinical history. Impairment in the ability to produce specific autobiographical memories, difficulties with interpersonal problem solving, negative life events, and repression were all associated with hopelessness and suicidal behavior. There were significant correlations among all the variables except for repression and negative life events. These findings support Williams' notion that generalized autobiographical memory is associated with deficits in interpersonal problem solving, negative life events, hopelessness, and suicidal behavior. The finding that defects in autobiographical memory are associated with suicidal behavior in adolescents and young adults may lead to improvements in the techniques of cognitive behavioral therapy in this age group.

Structural development of high-temperature mylonites in the Archean Wyoming province, northwestern Madison Range, Montana

USGS Publications Warehouse

Kellogg, Karl S.; Mogk, David W.

2009-01-01

The Crooked Creek mylonite, in the northwestern Madison Range, southwestern Montana, is defined by several curved lenses of high non-coaxial strain exposed over a 7-km-wide, northeast-trending strip. The country rocks, part of the Archean Wyoming province, are dominantly trondhjemitic to granitic orthogneiss with subordinate amphibolite, quartzite, aluminous gneiss, and sills of metabasite (mafic granulite). Data presented here support an interpretation that the mylonite formed during a period of rapid, heterogeneous strain at near-peak metamorphic conditions during an early deformational event (D1) caused by northwest–southeast-directed transpression. The mylonite has a well-developed L-S tectonite fabric and a fine-grained, recrystallized (granoblastic) texture. The strong linear fabric, interpreted as the stretching direction, is defined by elongate compositional “fish,” fold axes, aligned elongate minerals, and mullion axes. The margins of the mylonitic zones are concordant with and grade into regions of unmylonitized gneiss. A second deformational event (D2) has folded the mylonite surface to produce meter- to kilometer-scale, tight-to-isoclinal, gently plunging folds in both the mylonite and country rock, and represents a northwest–southeast shortening event. Planar or linear fabrics associated with D2 are remarkably absent. A third regional deformational event (D3) produced open, kilometer-scale folds generally with gently north-plunging fold axes. Thermobarometric measurements presented here indicate that metamorphic conditions during D1 were the same in both the mylonite and the country gneiss, reaching upper amphibolite- to lower granulite-facies conditions: 700 ± 50° C and 8.5 ± 0.5 kb. Previous geochronological studies of mylonitic and cross-cutting rocks in the Jerome Rock Lake area, east of the Crooked Creek mylonite, bracket the timing of this high-grade metamorphism and mylonitization between 2.78 and 2.56 Ga, nearly a billion years before the 1.78-Ga Big Sky orogeny, which overprinted the basement rocks exposed in adjacent ranges of the Wyoming province.

Implicit Theories of Intelligence and Academic Achievement: A Meta-Analytic Review

PubMed Central

Costa, Ana; Faria, Luísa

2018-01-01

The current study intended to model the link between implicit theories of intelligence (ITI) and students' academic achievement, within a meta-analytic review procedure. To assess studies' effect size, the Pearson's correlation coefficient (r) was used. The review of 46 studies (94 effect sizes) with 412,022 students presented a low-to-moderate association between the ITI and students' academic achievement. The results indicated that incremental theorists are more likely to have higher grades in specific subjects (verbal and quantitative) and in overall achievement. The entity beliefs were positively associated with students' specific verbal and quantitative domains but at a lower magnitude than incremental beliefs. Moreover, the moderator effect analyses results indicated that the link between ITI and students' achievement was not moderated by gender, but there was a moderate association in student's middle school grade. Additionally, the ITI assessment based on the most recent versions of Dweck's scales, the use of specific academic scales instead of general ITI scales, and the use of the original measures rather than adapted versions strongly moderated the link between ITI and achievement. Moreover, students from Eastern continents (Asia and Oceania) reported a positive association between incremental beliefs and achievement, Europe displayed a positive link between entity beliefs and achievement, whereas North America presented negative correlations between entity perspectives and academic achievement. This meta-analysis updates the current evidence supporting the direct link of ITI and students' academic achievement and acknowledges specific effects that ITI could have in different academic outcomes. PMID:29922195

Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy: American Society of Clinical Oncology Clinical Practice Guideline.

PubMed

Brahmer, Julie R; Lacchetti, Christina; Schneider, Bryan J; Atkins, Michael B; Brassil, Kelly J; Caterino, Jeffrey M; Chau, Ian; Ernstoff, Marc S; Gardner, Jennifer M; Ginex, Pamela; Hallmeyer, Sigrun; Holter Chakrabarty, Jennifer; Leighl, Natasha B; Mammen, Jennifer S; McDermott, David F; Naing, Aung; Nastoupil, Loretta J; Phillips, Tanyanika; Porter, Laura D; Puzanov, Igor; Reichner, Cristina A; Santomasso, Bianca D; Seigel, Carole; Spira, Alexander; Suarez-Almazor, Maria E; Wang, Yinghong; Weber, Jeffrey S; Wolchok, Jedd D; Thompson, John A

2018-06-10

Purpose To increase awareness, outline strategies, and offer guidance on the recommended management of immune-related adverse events in patients treated with immune checkpoint inhibitor (ICPi) therapy. Methods A multidisciplinary, multi-organizational panel of experts in medical oncology, dermatology, gastroenterology, rheumatology, pulmonology, endocrinology, urology, neurology, hematology, emergency medicine, nursing, trialist, and advocacy was convened to develop the clinical practice guideline. Guideline development involved a systematic review of the literature and an informal consensus process. The systematic review focused on guidelines, systematic reviews and meta-analyses, randomized controlled trials, and case series published from 2000 through 2017. Results The systematic review identified 204 eligible publications. Much of the evidence consisted of systematic reviews of observational data, consensus guidelines, case series, and case reports. Due to the paucity of high-quality evidence on management of immune-related adverse events, recommendations are based on expert consensus. Recommendations Recommendations for specific organ system-based toxicity diagnosis and management are presented. While management varies according to organ system affected, in general, ICPi therapy should be continued with close monitoring for grade 1 toxicities, with the exception of some neurologic, hematologic, and cardiac toxicities. ICPi therapy may be suspended for most grade 2 toxicities, with consideration of resuming when symptoms revert to grade 1 or less. Corticosteroids may be administered. Grade 3 toxicities generally warrant suspension of ICPis and the initiation of high-dose corticosteroids (prednisone 1 to 2 mg/kg/d or methylprednisolone 1 to 2 mg/kg/d). Corticosteroids should be tapered over the course of at least 4 to 6 weeks. Some refractory cases may require infliximab or other immunosuppressive therapy. In general, permanent discontinuation of ICPis is recommended with grade 4 toxicities, with the exception of endocrinopathies that have been controlled by hormone replacement. Additional information is available at www.asco.org/supportive-care-guidelines and www.asco.org/guidelineswiki .

Pharmacologic Treatment of Hypertension in Adults Aged 60 Years or Older to Higher Versus Lower Blood Pressure Targets: A Clinical Practice Guideline From the American College of Physicians and the American Academy of Family Physicians.

PubMed

Qaseem, Amir; Wilt, Timothy J; Rich, Robert; Humphrey, Linda L; Frost, Jennifer; Forciea, Mary Ann

2017-03-21

The American College of Physicians (ACP) and the American Academy of Family Physicians (AAFP) jointly developed this guideline to present the evidence and provide clinical recommendations based on the benefits and harms of higher versus lower blood pressure targets for the treatment of hypertension in adults aged 60 years or older. This guideline is based on a systematic review of published randomized, controlled trials for primary outcomes and observational studies for harms only (identified through EMBASE, the Cochrane Database of Systematic Reviews, MEDLINE, and ClinicalTrials.gov), from database inception through January 2015. The MEDLINE search was updated through September 2016. Evaluated outcomes included all-cause mortality, morbidity and mortality related to stroke, major cardiac events (fatal and nonfatal myocardial infarction and sudden cardiac death), and harms. This guideline grades the evidence and recommendations using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) method. The target audience for this guideline includes all clinicians, and the target patient population includes all adults aged 60 years or older with hypertension. ACP and AAFP recommend that clinicians initiate treatment in adults aged 60 years or older with systolic blood pressure persistently at or above 150 mm Hg to achieve a target systolic blood pressure of less than 150 mm Hg to reduce the risk for mortality, stroke, and cardiac events. (Grade: strong recommendation, high-quality evidence). ACP and AAFP recommend that clinicians select the treatment goals for adults aged 60 years or older based on a periodic discussion of the benefits and harms of specific blood pressure targets with the patient. ACP and AAFP recommend that clinicians consider initiating or intensifying pharmacologic treatment in adults aged 60 years or older with a history of stroke or transient ischemic attack to achieve a target systolic blood pressure of less than 140 mm Hg to reduce the risk for recurrent stroke. (Grade: weak recommendation, moderate-quality evidence). ACP and AAFP recommend that clinicians select the treatment goals for adults aged 60 years or older based on a periodic discussion of the benefits and harms of specific blood pressure targets with the patient. ACP and AAFP recommend that clinicians consider initiating or intensifying pharmacologic treatment in some adults aged 60 years or older at high cardiovascular risk, based on individualized assessment, to achieve a target systolic blood pressure of less than 140 mm Hg to reduce the risk for stroke or cardiac events. (Grade: weak recommendation, low-quality evidence). ACP and AAFP recommend that clinicians select the treatment goals for adults aged 60 years or older based on a periodic discussion of the benefits and harms of specific blood pressure targets with the patient.

Psychiatric disorders in children at one year after the tsunami disaster in Thailand.

PubMed

Piyasil, Vinadda; Ketumarn, Panom; Prubrukarn, Ratanotai; Pacharakaew, Siripapa; Dumrongphol, Hattaya; Rungsri, Sarinee; Sitdhiraksa, Nantawat; Pitthayaratsathien, Nattorn; Prasertvit, Jiraporn; Sudto, Korapin; Theerawongseree, Siriporn; Aowjinda, Sumitra; Thaeramanophab, Somchit; Jotipanu, Vajiraporn; Chatchavalitsakul, Wilairatana

2008-10-01

The tsunami that struck Thailand on 26th December 2004 was the greatest natural disaster in the country's history. It left in its wake unprecedented damage and destruction. Children suffered the loss of parents or guardians, and survivors were left to cope with psychological trauma of the disaster To assess the psychiatric disorders in tsunami victim children at one year after the event. A cross sectional study was done. One thousand three hundred and sixty-four students from 2 schools were enrolled. Three tests were used according to the students' grades, pediatric symptoms checklist, Childhood Depressive Inventory and the Revised Child Impact of Events scale (CRIES). Psychiatric disorders were diagnosed by child and adolescent psychiatrists, using criteria from the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM IV). Analysis data by using SPSS version 10.0 and Chi-square test. The results were presented as percentage and p-value. Psychiatric disorders were found in 142 students or 10.4 percents of all students at one year after the tsunami disaster. Not all the students who had psychiatric disorders developed them as the result of the tsunami disaster However, ninety students or 6.3 percent of all the students did have psychiatric disorders resulting from the tsunami disaster The most common psychiatric problem was post traumatic stress disorder Ten percent of grade 4-6 students and 11 percent of grade 7-9 students had psychiatric disorders. The prevalence was lower in kindergarten and grade 1-3 students of which the percentage was 2.3 and 3.8 respectively. The prevalence of psychiatric disorders at 1 year after the tsunami disaster was 10.4 percent of all the students or 33.1 percent of victims. The prevalence of psychiatric disorders in grade 4-6 and 7-9 students was higher than in kindergarten and grade 1-3 students. The most common psychiatric problem is post traumatic stress disorder.

Long-term Outcomes and Quality of Life of 186 Patients With Primary Parotid Carcinoma Treated With Surgery and Radiotherapy at the Daniel den Hoed Cancer Center

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

Al-Mamgani, Abrahim, E-mail: a.al-mamgani@erasmusmc.nl; Rooij, Peter van; Verduijn, Gerda M.

2012-09-01

Purpose: To assess the outcomes, toxicity, and quality of life (QOL) of patients with primary parotid carcinoma treated with surgery and postoperative radiotherapy at the Daniel den Hoed Cancer Center. Methods and Materials: Between 1995 and 2010, 186 patients with parotid carcinoma were treated with parotidectomy with or without neck dissection, followed by radiotherapy. Elective nodal irradiation (ENI) was applied to high-risk, node-negative disease. End points were locoregional control (LRC), disease-free survival (DFS), cause-specific survival (CSS), and overall survival (OS), late toxicity, and QOL. Results: After a median follow-up of 58 months (range, 4-172 months), the 5-year Kaplan-Meier estimates formore » LRC, DFS, CSS, and OS were 89%, 83%, 80%, and 68%, respectively. Forty-five events were reported: 24 distant metastases (DM) and 21 locoregional failures (LRF). Event-free survival rates by histological types were 89%, 78%, 76%, 74%, and 70% for acinic cell, mucoepidermoid, adenoid cystic, adenocarcinoma, and squamous cell carcinoma, respectively. More LRF were reported in patients with squamous cell and high-grade mucoepidermoid carcinoma (21% and 19%, respectively) than in patients with other histological types (p = 0.04) and more DM in patients with adenoid cystic and adenocarcinoma (20% and 19%, respectively) than in patients with other types (p = 0.03). None of the high-risk node-negative patients who received ENI developed regional failure. On multivariate analysis, T stage, N stage, grade, and presence of perineural invasion and facial paralysis correlated significantly with DFS. The 5-year cumulative incidence of grade {>=}2 late toxicity was 8%. QOL scores deteriorate during and shortly after treatment but returned in almost all scales to baseline scores within 6 months. Conclusions: Of the entire group, surgery and postoperative radiotherapy resulted in excellent outcomes with minimal side effects and preservation of good QOL scores. However, in view of the pattern of failures observed in this study, the role of adjuvant systemic or targeted therapy in patients at high risk of DM should be investigated in prospective trials.« less

Growth of multi-component alloy films with controlled graded chemical composition on sub-nanometer scale

DOEpatents

Bajt, Sasa; Vernon, Stephen P.

2005-03-15

The chemical composition of thin films is modulated during their growth. A computer code has been developed to design specific processes for producing a desired chemical composition for various deposition geometries. Good agreement between theoretical and experimental results was achieved.

Reconsidering the logic of World Federation of Neurosurgical Societies grading in patients with severe subarachnoid hemorrhage.

PubMed

Fung, Christian; Inglin, Fabienne; Murek, Michael; Balmer, Mathias; Abu-Isa, Janine; Z'Graggen, Werner J; Ozdoba, Christoph; Gralla, Jan; Jakob, Stephan M; Takala, Jukka; Beck, Jürgen; Raabe, Andreas

2016-02-01

Current data show a favorable outcome in up to 50% of patients with World Federation of Neurosurgical Societies (WFNS) Grade V subarachnoid hemorrhage (SAH) and a rather poor prediction of worst cases. Thus, the usefulness of the current WFNS grading system for identifying the worst scenarios for clinical studies and for making treatment decisions is limited. One reason for this lack of differentiation is the use of "negative" or "silent" diagnostic signs as part of the WFNS Grade V definition. The authors therefore reevaluated the WFNS scale by using "positive" clinical signs and the logic of the Glasgow Coma Scale as a progressive herniation score. The authors performed a retrospective analysis of 182 patients with SAH who had poor grades on the WFNS scale. Patients were graded according to the original WFNS scale and additionally according to a modified classification, the WFNS herniation (hWFNS) scale (Grade IV, no clinical signs of herniation; Grade V, clinical signs of herniation). The prediction of poor outcome was compared between these two grading systems. The positive predictive values of Grade V for poor outcome were 74.3% (OR 3.79, 95% CI 1.94-7.54) for WFNS Grade V and 85.7% (OR 8.27, 95% CI 3.78-19.47) for hWFNS Grade V. With respect to mortality, the positive predictive values were 68.3% (OR 3.9, 95% CI 2.01-7.69) for WFNS Grade V and 77.9% (OR 6.22, 95% CI 3.07-13.14) for hWFNS Grade V. Limiting WFNS Grade V to the positive clinical signs of the Glasgow Coma Scale such as flexion, extension, and pupillary abnormalities instead of including "no motor response" increases the prediction of mortality and poor outcome in patients with severe SAH.

Physical and chemical controls on ore shoots - insights from 3D modeling of an orogenic gold deposit

NASA Astrophysics Data System (ADS)

Vollgger, S. A.; Tomkins, A. G.; Micklethwaite, S.; Cruden, A. R.; Wilson, C. J. L.

2016-12-01

Many ore deposits have irregular grade distributions with localized elongate and well-mineralized rock volumes commonly referred to as ore shoots. The chemical and physical processes that control ore shoot formation are rarely understood, although transient episodes of elevated permeability are thought to be important within the brittle and brittle-ductile crust, due to faulting and fracturing associated with earthquake-aftershock sequences or earthquake swarms. We present data from an orogenic gold deposit in Australia where the bulk of the gold is contained in abundant fine arsenopyrite crystals associated with a fault-vein network within tight upright folds. The deposit-scale fault network is connected to a deeper network of thrust faults (tens of kilometers long). Using 3D implicit modeling of geochemical data, based on radial basis functions, gold grades and gold-arsenic element ratios were interpolated and related to major faults, vein networks and late intrusions. Additionally, downhole bedding measurements were used to model first order (mine-scale) fold structures. The results show that ore shoot plunges are not parallel with mine-scale or regional fold plunges, and that bedding parallel faults related to flexural slip folding play a pivotal role on ore shoot attitudes. 3D fault slip and dilation tendency analysis indicate that fault reactivation and formation of linking faults are associated with large volumes of high-grade ore. We suggest slip events on the large-scale thrust network allowed mineralizing fluids to rapidly migrate over large distances and become supersaturated in elements such as gold, promoting widespread precipitation and high nucleation densities of arsenopyrite upon fluid-rock interaction at trap sites within the deposit.

The Constitution in Crisis: The Red Scare of 1919-1920. A Unit of Study for Grades 9-12.

ERIC Educational Resources Information Center

Vigilante, David

This unit is one of a series that represents specific moments in history from which students focus on the meanings of landmark events. Continuing narrative provides context for the dramatic moment. By studying a crucial turning-point in history, students become aware that choices had to be made by real human beings, that those decisions were the…

The Role of Women in Medieval Europe: A Unit of Study for Grades 10-12.

ERIC Educational Resources Information Center

Himmell, Rhoda

This unit is one of a series that represents specific moments in history from which students focus on the meanings of landmark events. This unit consists of lessons focused on selected topics in medieval history that define and describe the roles of women. The lessons examine the roles of women in the Early Middle Ages with particular emphasis on…

Images of the Orient: Nineteenth-Century European Travelers to Muslim Lands. A Unit of Study for Grades 9-12.

ERIC Educational Resources Information Center

Douglass, Susan L.

This teaching unit represents a specific "dramatic moment" in history that can allow students to delve into the deeper meanings of selected landmark events and explore their wider context in the great historical narrative. Studying a crucial turning point in history helps students realize that history is an ongoing, open-ended process,…

High-dose-rate stereotactic body radiation therapy for postradiation therapy locally recurrent prostatic carcinoma: Preliminary prostate-specific antigen response, disease-free survival, and toxicity assessment.

PubMed

Fuller, Donald B; Wurzer, James; Shirazi, Reza; Bridge, Stephen S; Law, Jonathan; Mardirossian, George

2015-01-01

Patients with locally recurrent adenocarcinoma of the prostate following radiation therapy (RT) present a challenging problem. We prospectively evaluated the use of "high-dose-rate-like" prostate stereotactic body RT (SBRT) salvage for this circumstance, evaluating prostate-specific antigen response, disease-free survival, and toxicity. Between February 2009 and March 2014, 29 patients with biopsy-proven recurrent locally prostate cancer >2 years post-RT were treated. Median prior RT dose was 73.8 Gy and median interval to SBRT salvage was 88 months. Median recurrence Gleason score was 7 (79% was ≥7). Pre-existing RT toxicity >grade 1 was a reason for exclusion. Magnetic resonance imaging-defined prostate volume including any suspected extraprostatic extension, comprising the planning target volume. A total of 34 Gy/5 fractions was given, delivering a heterogeneous, high-dose-rate-like dose-escalation pattern. Toxicities were assessed using Common Terminology Criteria for Adverse Events, version 3.0, criteria. Twenty-nine treated patients had a median 24-month follow-up (range, 3-60 months). A median pre-SBRT salvage baseline prostate-specific antigen level of 3.1 ng/mL decreased to 0.65 ng/mL and 0.16 ng/mL at 1 and 2 years, respectively. Actuarial 2-year biochemical disease-free survival measured 82%, with no local failures. Toxicity >grade 1 was limited to the genitourinary domain, with 18% grade 2 or higher and 7% grade 3 or higher. No gastrointestinal toxicity >grade 1 occurred. Two-year disease-free survival is encouraging, and the prostate-specific antigen response kinetic appears comparable with that seen in de novo patients treated with SBRT, albeit still a preliminary finding. Grade ≥2 genitourinary toxicity was occasionally seen with no obvious predictive factor. Noting that our only brachytherapy case was 1 of the 2 cases with ≥grade 3 genitourinary toxicity, caution is recommended treating these patients. SBRT salvage of post-RT local recurrence appears clinically feasible, with longer term evaluation required to assess ultimate efficacy and late toxicity rates. Copyright © 2015 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

The Influence of Negative Life Events and Problem Behavior on Grades in Early Adolescence: Pathways to Academic Risk in the Middle Grades

ERIC Educational Resources Information Center

Mann, Michael J.; Kristjansson, Alfgeir L.; Smith, Megan L.; Sigfusdottir, Inga Dora

2016-01-01

Younger adolescents demonstrate a greater vulnerability to negative life events than do older adolescents and adults. The authors examined whether this heightened vulnerability includes a greater likelihood for participating in problem behaviors associated with poor academic outcomes and receiving lower grades. The study was conducted using data…

Student Interactions, Attitudes, and Engagement during Literacy Events in a Second Grade Classroom: A Case Study of Five Struggling Readers

ERIC Educational Resources Information Center

Lehman, Margaret A.

2012-01-01

This study investigated the student-student interactions, attitudes toward reading and engagement during literacy events in a second grade classroom. The literacy environment and the teacher's conceptualization of her role as a reading instructor were also part of this investigation. Five second grade struggling readers and their teacher,…

Internet addiction, adolescent depression, and the mediating role of life events: finding from a sample of Chinese adolescents.

PubMed

Yang, Linsheng; Sun, Liang; Zhang, Zhihua; Sun, Yehuan; Wu, Hongyan; Ye, Dongqing

2014-10-01

The aim of this study is to examine the mediating role of life events in the relation between Internet addiction and depression using an adolescent sample in China. A total of 3507 urban adolescent students were asked to complete the questionnaires including Young's Internet Addiction Scale, Adolescent Self-Rating Life Events Checklist, and Center for Epidemiologic Studies Depression Scale, Parent-Child Conflict Tactics Scales, and demographic characteristics. Path analyses demonstrated that life events fully mediated the relationship between Internet addiction and adolescent depression. Specificity for the mediating role of life events was demonstrated in comparison to alternative competing mediation models. The findings support our hypothesis that the effect of Internet addiction on adolescent depression is mediated by the life events. Further research is required to test the temporal relationship between Internet addiction and adolescent depression and explore mechanisms underlying the pathways leading to adolescent depression. © 2014 International Union of Psychological Science.

Quantifying and Qualifying USGS ShakeMap Uncertainty

USGS Publications Warehouse

Wald, David J.; Lin, Kuo-Wan; Quitoriano, Vincent

2008-01-01

We describe algorithms for quantifying and qualifying uncertainties associated with USGS ShakeMap ground motions. The uncertainty values computed consist of latitude/longitude grid-based multiplicative factors that scale the standard deviation associated with the ground motion prediction equation (GMPE) used within the ShakeMap algorithm for estimating ground motions. The resulting grid-based 'uncertainty map' is essential for evaluation of losses derived using ShakeMaps as the hazard input. For ShakeMap, ground motion uncertainty at any point is dominated by two main factors: (i) the influence of any proximal ground motion observations, and (ii) the uncertainty of estimating ground motions from the GMPE, most notably, elevated uncertainty due to initial, unconstrained source rupture geometry. The uncertainty is highest for larger magnitude earthquakes when source finiteness is not yet constrained and, hence, the distance to rupture is also uncertain. In addition to a spatially-dependant, quantitative assessment, many users may prefer a simple, qualitative grading for the entire ShakeMap. We developed a grading scale that allows one to quickly gauge the appropriate level of confidence when using rapidly produced ShakeMaps as part of the post-earthquake decision-making process or for qualitative assessments of archived or historical earthquake ShakeMaps. We describe an uncertainty letter grading ('A' through 'F', for high to poor quality, respectively) based on the uncertainty map. A middle-range ('C') grade corresponds to a ShakeMap for a moderate-magnitude earthquake suitably represented with a point-source location. Lower grades 'D' and 'F' are assigned for larger events (M>6) where finite-source dimensions are not yet constrained. The addition of ground motion observations (or observed macroseismic intensities) reduces uncertainties over data-constrained portions of the map. Higher grades ('A' and 'B') correspond to ShakeMaps with constrained fault dimensions and numerous stations, depending on the density of station/data coverage. Due to these dependencies, the letter grade can change with subsequent ShakeMap revisions if more data are added or when finite-faulting dimensions are added. We emphasize that the greatest uncertainties are associated with unconstrained source dimensions for large earthquakes where the distance term in the GMPE is most uncertain; this uncertainty thus scales with magnitude (and consequently rupture dimension). Since this distance uncertainty produces potentially large uncertainties in ShakeMap ground-motion estimates, this factor dominates over compensating constraints for all but the most dense station distributions.

An autostratigraphic view of the long-term dynamics of delta distributary channels: A new step forward with the grade index model

NASA Astrophysics Data System (ADS)

Naruse, H.; Muto, T.

2017-12-01

Autostratigraphy is the stratigraphy that is generated by large-scale, deterministic autogenic processes of depositional systems, based on the full recognition of non-equilibrium behavior in response to steady external forcing. Recent experimental studies to explore the effects of basin water depth on the dynamics of distributary channels have brought a new geometrical scheme, here referred to as the grade index model, which is expected to make a significant step forward for development of the autostratigraphy of river deltas. Grade index (0 ≤ Gindex ≤1) is a dimensionless number that describes how close the alluvial river is to a graded state and is given as the ratio of subaerial allocation of the supplied sediment to both subaerial and subaqueous allocation of the sediment, in the form of a function of dimensionless basin water depth (h*). The grade index model for a particular geometrical setting suggests that as h* increase toward +∞, all of dimensionless magnitudes of delta progradation rate (Rpro*), alluvial aggradation rate (Ragg*), channel migration rate (Rmig*), avulsion frequency decrease toward 0, and all of dimensionless timescales of channel shifting (τs*), recurrence of channels (τr*), channel avulsion (τA*) increase toward +∞, and also that Rpro* = Ragg* = Rmig* = fA* = (τs*)-1 = (τr*)-1 = (τA* )-1 = Gindex. This grade index model, despite its simple structure, offers deep insight into the rationale of shoreline autoretreat, a typical large-scale, deterministic autogenic process that is realized by non-equilibrium response to steady base level rise. A simple geometrical modeling leads to a finding that Ppro* = (1 - Ab*) Gindex, where Ab* is a dimensionless form of the bottom surface of the deltaic deposit (Ab) given by dividing Ab with the square of autostratigraphic length scale (Λ). As the delta grows with base level rise, Ab progressively increases and then inevitably meets an event that Ab* exceeds 1 (i.e. Ab exceeds Λ2). We also find that Pagg* = A* + (1 - Ab*) Gindex, where A* is a dimensionless horizontal area of the deltaplain (A* = A/Λ2). At the moment of autodrowning, A* becomes 0, Ab* takes a positive value larger than one, h* is infinitely large, and thus and Gindex takes a value close to zero. Thus, shoreline autoretreat and autodrowning of the delta are closely related to grade index.

Combined image and genomic analysis of high-grade serous ovarian cancer reveals PTEN loss as a common driver event and prognostic classifier.

PubMed

Martins, Filipe C; Santiago, Ines de; Trinh, Anne; Xian, Jian; Guo, Anne; Sayal, Karen; Jimenez-Linan, Mercedes; Deen, Suha; Driver, Kristy; Mack, Marie; Aslop, Jennifer; Pharoah, Paul D; Markowetz, Florian; Brenton, James D

2014-12-17

TP53 and BRCA1/2 mutations are the main drivers in high-grade serous ovarian carcinoma (HGSOC). We hypothesise that combining tissue phenotypes from image analysis of tumour sections with genomic profiles could reveal other significant driver events. Automatic estimates of stromal content combined with genomic analysis of TCGA HGSOC tumours show that stroma strongly biases estimates of PTEN expression. Tumour-specific PTEN expression was tested in two independent cohorts using tissue microarrays containing 521 cases of HGSOC. PTEN loss or downregulation occurred in 77% of the first cohort by immunofluorescence and 52% of the validation group by immunohistochemistry, and is associated with worse survival in a multivariate Cox-regression model adjusted for study site, age, stage and grade. Reanalysis of TCGA data shows that hemizygous loss of PTEN is common (36%) and expression of PTEN and expression of androgen receptor are positively associated. Low androgen receptor expression was associated with reduced survival in data from TCGA and immunohistochemical analysis of the first cohort. PTEN loss is a common event in HGSOC and defines a subgroup with significantly worse prognosis, suggesting the rational use of drugs to target PI3K and androgen receptor pathways for HGSOC. This work shows that integrative approaches combining tissue phenotypes from images with genomic analysis can resolve confounding effects of tissue heterogeneity and should be used to identify new drivers in other cancers.

Life review based on remembering specific positive events in active aging.

PubMed

Latorre, José M; Serrano, Juan P; Ricarte, Jorge; Bonete, Beatriz; Ros, Laura; Sitges, Esther

2015-02-01

The aim of this study is to evaluate the effectiveness of life review (LR) based on specific positive events in non-depressed older adults taking part in an active aging program. Fifty-five older adults were randomly assigned to an experimental group or an active control (AC) group. A six-session individual training of LR based on specific positive events was carried out with the experimental group. The AC group undertook a "media workshop" of six sessions focused on learning journalistic techniques. Pre-test and post-test measures included life satisfaction, depressive symptoms, experiencing the environment as rewarding, and autobiographical memory (AM) scales. LR intervention decreased depressive symptomatology, improved life satisfaction, and increased specific memories. The findings suggest that practice in AM for specific events is an effective component of LR that could be a useful tool in enhancing emotional well-being in active aging programs, thus reducing depressive symptoms. © The Author(s) 2014.

Constancy and Variability: Dialogic Literacy Events as Sites for Improvisation in Two 3rd-Grade Classrooms

ERIC Educational Resources Information Center

Jordan, Michelle E.; Santori, Diane

2015-01-01

This multisite study investigates dialogic literacy events that revolved around narrative and informational texts in two 3rd-grade classrooms. The authors offer a metaphor of musical improvisation to contemplate dialogic literacy events as part of the repertoire of teaching and learning experiences. In literacy learning, where there is much…

A Comparison of Student Academic Motivations across Three Course Disciplines

ERIC Educational Resources Information Center

Maurer, Trent W.; Allen, Deborah; Gatch, Delena Bell; Shankar, Padmini; Sturges, Diana

2013-01-01

Intrinsic and extrinsic motivations of undergraduate students enrolled in human anatomy and physiology, physics, and nutrition courses were explored with course discipline-specific adapted versions of the Academic Motivation Scale. Information on students' study habits and efforts, and final course grades were also collected. Results revealed the…

Personal and Contextual Factors Associated with Students' Cheating in Science

ERIC Educational Resources Information Center

Tas, Yasemin; Tekkaya, Ceren

2010-01-01

The authors conducted a correlational study to investigate the relations among seventh-grade Turkish students' cheating behavior, academic self-efficacy beliefs, usage of self-handicapping strategies, personal goal orientations, and classroom goal structures specific to the science domain. The Patterns of Adaptive Learning Scales was administered…

A Study of Taiwanese Teens' Traditional and Cyberbullying Behaviors

ERIC Educational Resources Information Center

Yang, Shu Ching; Lin, Chia-Ying; Chen, An-Sing

2014-01-01

This study examined several types of teen behaviors, specifically bullying, being bullied, and witnessing bullying, and analyzed teens' judgments of the seriousness of the bullying. A Bullying Behaviors Scale (BBS) was designed to investigate both traditional bullying (TB) and cyberbullying (CB) behaviors among teens in grades 5 through 11. The…

Low cost automated whole smear microscopy screening system for detection of acid fast bacilli.

PubMed

Law, Yan Nei; Jian, Hanbin; Lo, Norman W S; Ip, Margaret; Chan, Mia Mei Yuk; Kam, Kai Man; Wu, Xiaohua

2018-01-01

In countries with high tuberculosis (TB) burden, there is urgent need for rapid, large-scale screening to detect smear-positive patients. We developed a computer-aided whole smear screening system that focuses in real-time, captures images and provides diagnostic grading, for both bright-field and fluorescence microscopy for detection of acid-fast-bacilli (AFB) from respiratory specimens. To evaluate the performance of dual-mode screening system in AFB diagnostic algorithms on concentrated smears with auramine O (AO) staining, as well as direct smears with AO and Ziehl-Neelsen (ZN) staining, using mycobacterial culture results as gold standard. Adult patient sputum samples requesting for M. tuberculosis cultures were divided into three batches for staining: direct AO-stained, direct ZN-stained and concentrated smears AO-stained. All slides were graded by an experienced microscopist, in parallel with the automated whole smear screening system. Sensitivity and specificity of a TB diagnostic algorithm in using the screening system alone, and in combination with a microscopist, were evaluated. Of 488 direct AO-stained smears, 228 were culture positive. These yielded a sensitivity of 81.6% and specificity of 74.2%. Of 334 direct smears with ZN staining, 142 were culture positive, which gave a sensitivity of 70.4% and specificity of 76.6%. Of 505 concentrated smears with AO staining, 250 were culture positive, giving a sensitivity of 86.4% and specificity of 71.0%. To further improve performance, machine grading was confirmed by manual smear grading when the number of AFBs detected fell within an uncertainty range. These combined results gave significant improvement in specificity (AO-direct:85.4%; ZN-direct:85.4%; AO-concentrated:92.5%) and slight improvement in sensitivity while requiring only limited manual workload. Our system achieved high sensitivity without substantially compromising specificity when compared to culture results. Significant improvement in specificity was obtained when uncertain results were confirmed by manual smear grading. This approach had potential to substantially reduce workload of microscopists in high burden countries.

Cognitive function and distress after common whiplash injury.

PubMed

Smed, A

1997-02-01

In a prospective study 29 patients fulfilled the criteria of Whiplash-Associated Disorders grade III in the Quebec classification. One month postinjury, computerized neuropsychological tests, a clinical interview and the symptom checklist SCL-90-R were administered. Three whiplash scales were extrapolated from SCL-90-R: pain, subjective cognitive difficulties and sleep disorders. SCL-90-R was repeated 6 months later. One month after the accident, 85% of the patients had resumed work. Subjective cognitive disturbances, however, were frequent but unrelated to test performances, which were within the normal range. Patients reporting stressful life events unrelated to the injury had more symptoms and elevated levels of distress on all SCL-90-R syndrome scales. At follow-up their distress was unchanged, and subjective cognitive function had deteriorated. Stressful life events unrelated to the accident and a high level of distress 1 month postinjury may augment the risk of "late whiplash syndrome". Reassessment 3-6 weeks postinjury as recommended by the Quebec Task Force should include assessment of complicating social factors and a psychological symptom checklist.

Heterogeneous strain and composite P-T paths: the key for unravelling complex tectonic histories in polymetamorphic high-grade terrains

NASA Astrophysics Data System (ADS)

van Reenen, Dirk D.; Smit, C. Andre

2010-05-01

Leonid Perchuk calculated the first P-T paths for eclogites almost 40 years ago [1] and since then he has shown that P-T paths if correctly constructed, represent an accurate record of the thermal and dynamic evolution of high-grade metamorphic complexes [2]. This implies that P-T paths might serve as the basis for geodynamic models for the formation and exhumation of such complexes from the lower crustal levels [2]. His continued research in the Limpopo Complex of southern Africa also played an important role in the next direction in the study of complex high-grade polymetamorphic complexes. This new direction involves the link between composite (kinked) P-T paths [5; 6; 8] and the critical role of heterogeneous strain in the development and preservation of distinct granulite facies events at the regional, outcrop, hand specimen, and thin section scales [7; 9; 10]. Heterogeneous deformation that operated on the thin section scale allowed the construction of kinked P-T paths from single thin sections [5; 6; 9] and the integration of the P-T data with structural and isotopic geochronology [7; 9; 10]. D-P-T-t paths thus constructed not only allow the nature of polymetamorphism in the Limpopo Complex of southern Africa to be established, but also assisted in the construction of tectonic models for the evolution of this complex high-grade polymetamorphic complex. This complex evolution is demonstrated by the configuration of a kinked P-T path (5; 9) that reflects the following distinct stages of the multi-cycle D-P-T-t evolution of the Central Zone: (i) the earliest DC1 path reflects the emplacement before ~2.63Ga of the Limpopo Complex at the crustal level of ~20km. The DC1 stage of the D1/M1 exhumation event was accompanied by the formation of early D2A isoclinal folds; (ii) The DC2 stage of the D1/M1 exhumation event reflects the emplacement before ~2.61Ga of the rocks at the crustal level of ~15km. The DC2 stage was accompanied by the formation of major D2B sheath folds; (iii) the high-grade rocks resided and cooled at this crustal level in the Central Zone of the Limpopo Complex for more than 600Ma before the rocks were again reheated at ~2.02Ga during a superimposed D2/M2 high-grade event. This event is reflected by an isobaric-heating (IC) P-T path that resulted in the widespread formation of polymetamorphic granulites; (iv) the IC path was followed a DC3 P-T path that reflects the final exhumation of the rocks to the upper crustal level during the D2/M2 event. High-grade D3A shear zones controlled the final exhumation of the rocks. Isobaric heating (IC) thus links Pmin (D1/M1) to Pmax (D2/M2) that resulted in a kinked configuration of the DC1/2=>IC=>DC3 P-T path. The end of the high-grade tectono-metamorphic event is signified by the development at ~2.01Ga of completely undeformed melt patches that destroy the D2B and D3A gneissic fabric of the rocks in which they are developed. Reactivation of SW-NE-trending high-grade D3A shear zones at ~1.9Ga resulted in the formation of upper crustal mylonitic shear zones that define the present belt-like geometry of the SW-NE trending Limpopo Complex. The successful link of composite (kinked) P-T paths with structural (D) and geochronological (t) data t formed the basis for the construction of D-P-T-t diagrams that demonstrate the polymetamorphic evolution of the Limpopo Complex as the result of superimposed Neoarchaean and Paleoproterozoic high-grade events. References: [1] Perchuk L.L. Physics of the Earth and Planetary Interiors, 1976. 13, 232-239. [2] Perchuk L.L. (1989) Geol. Soc. London. Special Publication. 2(20). 275-291. [3] Roering, C., Van Reenen, D.D., Smit, C.A., Barton, J.M. jr., de Beer, J.H., de Wit, M.J., Stettler, E.H., van Schalkwyk., J.F., Stevens, G., and Pretorius, S. 1992. Precambrian Research, 55, 539-552. [4] Gerya, T.V., Perchuk, L.L., Van Reenen, D.D., and Smit, C.A. 2000. J. Geodynamics, 30, 17-35. [5] Perchuk L.L. (2005) Dokl. Earth Sciences. 401. 311-314. [6] Perchuk, L.L., Gerya, T.V., Van Reenen, D.D., and Smit, C.A. 2006. Petrology, v. 14, no. 2, 131-167. [7] Mahan, K. H., Goncalves, P., Flowers, R. M., Williams, M. L., and Hoffman-Setka, D., 2008. Journal of Metamorphic Geology, DOI:10.1111/j.1525-1314. [8] Perchuk, L. L., van Reenen, D. D., Varlamov, D. A., van Kal, S. M., Tabatabaeimanesh, S. M., and Boshoff, R., 2008. Lithos, v. 103, p. 70-105. [9] Perchuk, L.L. and Van Reenen, D.D., 2008. Lithos, 106, 403-410. [10]. Van Reenen, D. D., Boshoff, R., Smit, C. A., Perchuk, L.L., Kramers, J. D.,McCourt, S. M., and Armstrong, R. A., 2008. Gondwana Research, v.14, p. 644-662.

Efficacy and safety of fractional carbon dioxide laser for treatment of unwanted facial freckles in phototypes II-IV: a pilot study.

PubMed

El Zawahry, Bakr; Zaki, Naglaa; Hafez, Vanessa; Abdel Hay, Rania; Hay, Rania Abdel; Fahim, Aya

2014-11-01

Facial freckles are a cosmetic concern to Egyptians, particularly young females. Several therapeutic lines exist with variable response rates and limitations. Fractional carbon dioxide (FCO2) laser provides minimal ablation and therefore less down time and less side effects. The efficacy and safety of this laser technology have still not been studied in freckles. The aim of this study is to assess the efficacy and safety of FCO2 laser in the treatment of unwanted facial freckles in Egyptians. Twenty patients undergone a single session of FCO2 laser and then were followed up clinically a month later. Photographs were taken before treatment and at follow-up visit and were assessed by three blinded investigators. Percent of global improvement was measured on a 4-point grading scale. Patient's satisfaction and adverse events were recorded. Two patients (10 %) showed grade 1 improvement, while eight patients (40 %) showed grade 2 improvement. Nine patients (45 %) showed grade 3 improvement, and only one patient (5 %) showed grade 4 improvement. FCO2 laser resurfacing is effective and safe in treatment of facial freckles in skin phototypes II-IV. It can offer a more practical alternative to topical treatments, and a cheaper alternative to Q-switched lasers.

School performance after experiencing trauma: a longitudinal study of school functioning in survivors of the Utøya shootings in 2011.

PubMed

Strøm, Ida Frugård; Schultz, Jon-Håkon; Wentzel-Larsen, Tore; Dyb, Grete

2016-01-01

The psychological impact on survivors of terrorism has been well documented. However, studies on adolescent survivors and the academic performance of high school students following a terrorist attack are lacking. This study investigated academic performance, absenteeism, and school support amongst survivors of a terrorist attack in Norway. Data from a longitudinal interview study were linked to officially registered grades of students (N=64) who successfully completed their 3-year senior high school program. Statistical tests of mean differences and linear regression were used to compare the survivors' registered grades with the national grade point average, before and after the event, as well as to assess absenteeism, self-reported grades and to test the association with school support. The students' grades were lower the year after the event than they had been the year before, and they were also lower than the national grade point average (p<0.001). However, their grades improved in the last year of high school, indicating possible recovery. Absence from school increased after the event, compared to the previous year. However, students reported high satisfaction with school support. The results indicate that academic functioning was reduced in the year after the traumatic event, but for students who successfully completed high school, the school situation improved 2 years after the event. The findings underscore the importance of keeping trauma-exposed students in school and providing support over time. A more defined educational approach to maintaining school attendance and educational measures which compensate for learning loss are needed in trauma-sensitive teaching.

Assessment of the amount of tooth wear on dental casts and intra-oral photographs.

PubMed

Wetselaar, P; Wetselaar-Glas, M J M; Koutris, M; Visscher, C M; Lobbezoo, F

2016-08-01

Tooth wear is a multifactorial condition, leading to the loss of dental hard tissues. Many grading scales are available to assess the amount of tooth wear, one of which is the tooth wear evaluation system (TWES). A grading scale can be used chairside, on casts and on photographs. The aim was to test whether the grading scales of the TWES, used on casts and on photographs, resulted in comparable scores. In addition, it was tested whether these scales can be used to assess tooth wear reliably on photographs. Of 75 tooth wear patients, sets of casts and series of photographs were obtained and graded. Comparison of the grading on casts and on photographs revealed equal median values and percentiles for both occlusal/incisal grading and non-occlusal/non-incisal grading. The grading on casts and on photographs showed a high correlation for the occlusal/incisal grading and a low correlation for the non-occlusal/non-incisal grading (Spearman's rho = 0·74 and rho = 0·47; P < 0·001). Concerning the grading on photographs, the interexaminer reliability was fair-to-good (ICC = 0·41 to ICC = 0·55) while the intra-examiner reliability was fair-to-good to excellent (ICC = 0·68 to ICC = 0·86) for the occlusal/incisal grading. For the non-occlusal/non-incisal grading, the interexaminer reliability was poor to fair-to-good (ICC = 0·22 to ICC = 0·59), while the intra-examiner reliability was fair-to-good to excellent (ICC = 0·64 to ICC = 0·82). It was concluded that the scores obtained with the grading scales of the TWES on casts and on photographs are comparable. The grading scales can be used in a reliable way on photographs, which is especially the case for occlusal/incisal grading. © 2016 John Wiley & Sons Ltd.

Green lumber grade yields from factory grade logs of three oak species

Treesearch

Daniel A. Yaussy

1986-01-01

Multivariate regression models were developed to predict green board foot yields for the seven common factory lumber grades processed from white, black, and chestnut oak factory grade logs. These models use the standard log measurements of grade, scaling diameter, log length, and proportion of scaling defect. Any combination of lumber grades (such as 1 Common and...

Validity Issues Involved in Cross-Grade Statements about NAEP Results

ERIC Educational Resources Information Center

Thissen, David

2012-01-01

The reading and mathematics measures of the National Assessment of Educational Progress (NAEP) have been, and continue to be, reported on scales that appear to have the properties of "cross-grade" scales: Reported scores are higher for 8th-grade students than for 4th-grade students, and higher for 12th-grade students than for 8th-grade students.…

Mother-to-infant emotional involvement at birth.

PubMed

Figueiredo, Bárbara; Costa, Raquel; Pacheco, Alexandra; Pais, Alvaro

2009-07-01

To study mother-to-infant emotional involvement at birth, namely factors (socio-demographics, previous life events, type of delivery, pain at childbirth, support from partner, infant characteristics, early experiences with the newborn, and mother's mood) that interfere with the mother's positive, negative and not clear emotions toward the newborn. The Bonding Scale (an extended Portuguese version of the 'New Mother-to-Infant Bonding Scale') and the Edinburgh Postnatal Depression Scale were administrated during the first after delivery days to 315 mothers recruited at Júlio Dinis Maternity Hospital (MJD, Porto, Portugal). A worse emotional involvement with the newborn was observed when the mother was unemployed, unmarried, had less than grade 9, previous obstetrical/psychological problems or was depressed, as well as when the infant was female, had neonatal problems or was admitted in the intensive care unit. Lower total bonding results were significantly predicted when the mother was depressed and had a lower educational level; being depressed, unemployed and single predicted more negative emotions toward the infant as well. No significant differences in the mother-to-infant emotional involvement were obtained for events related to childbirth, such as type of delivery, pain and partner support, or early experiences with the newborn; these events do not predict mother's bonding results either. The study results support the need for screening and supporting depressed, unemployed and single mothers, in order to prevent bonding difficulties with the newborn at birth.

Graded zooming

DOEpatents

Coffland, Douglas R.

2006-04-25

A system for increasing the resolution in the far field resolution of video or still frame images, while maintaining full coverage in the near field. The system includes a camera connected to a computer. The computer applies a specific zooming scale factor to each of line of pixels and continuously increases the scale factor of the line of pixels from the bottom to the top to capture the scene in the near field, yet maintain resolution in the scene in the far field.

Dose-Escalated Stereotactic Body Radiation Therapy for Patients With Intermediate- and High-Risk Prostate Cancer: Initial Dosimetry Analysis and Patient Outcomes

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

Kotecha, Rupesh; Djemil, Toufik; Tendulkar, Rahul D.

Purpose: To report the short-term clinical outcomes and acute and late treatment-related genitourinary (GU) and gastrointestinal (GI) toxicities in patients with intermediate- and high-risk prostate cancer treated with dose-escalated stereotactic body radiation therapy (SBRT). Methods and Materials: Between 2011 and 2014, 24 patients with prostate cancer were treated with SBRT to the prostate gland and proximal seminal vesicles. A high-dose avoidance zone (HDAZ) was created by a 3-mm expansion around the rectum, urethra, and bladder. Patients were treated to a minimum dose of 36.25 Gy in 5 fractions, with a simultaneous dose escalation to a dose of 50 Gy to the targetmore » volume away from the HDAZ. Acute and late GU and GI toxicity outcomes were measured according to the National Cancer Institute Common Terminology Criteria for Adverse Events toxicity scale, version 4. Results: The median follow-up was 25 months (range, 18-45 months). Nine patients (38%) experienced an acute grade 2 GU toxicity, which was medically managed, and no patients experienced an acute grade 2 GI toxicity. Two patients (8%) experienced late grade 2 GU toxicity, and 2 patients (8%) experienced late grade 2 GI toxicity. No acute or late grade ≥3 GU or GI toxicities were observed. The 24-month prostate-specific antigen relapse-free survival outcome for all patients was 95.8% (95% confidence interval 75.6%-99.4%), and both biochemical failures occurred in patients with high-risk disease. All patients are currently alive at the time of this analysis and continue to be followed. Conclusions: A heterogeneous prostate SBRT planning technique with differential treatment volumes (low dose: 36.25 Gy; and high dose: 50 Gy) with an HDAZ provides a safe method of dose escalation. Favorable rates of biochemical control and acceptably low rates of acute and long-term GU and GI toxicity can be achieved in patients with intermediate- and high-risk prostate cancer treated with SBRT.« less

The Golden Age of Greece: Imperial Democracy 500-400 B.C. A Unit of Study for Grades 6-12.

ERIC Educational Resources Information Center

Cheoros, Peter; And Others

This unit is one of a series that represents specific moments in history from which students focus on the meanings of landmark events. This unit explores Greece's most glorious century, the high point of Athenian culture. Rarely has so much genius been concentrated in one small region over such a short period of time. Students discover in studying…

Understanding Interest and Self-Efficacy in the Reading and Writing of Students with Persisting Specific Learning Disabilities during Middle Childhood and Early Adolescence

ERIC Educational Resources Information Center

Abbott, Robert; Mickail, Terry; Richards, Todd; Renninger, K. Ann; Hidi, Suzanne E.; Beers, Scott; Berninger, Virginia

2017-01-01

Three methodological approaches were applied to understand the role of interest and self-efficacy in reading and/or writing in students without and with persisting specific learning disabilities (SLDs) in literacy. For each approach students in grades 4 to 9 completed a survey in which they rated 10 reading items and 10 writing items on a Scale 1…

King's Parkinson's disease pain scale, the first scale for pain in PD: An international validation.

PubMed

Chaudhuri, K Ray; Rizos, A; Trenkwalder, C; Rascol, O; Pal, S; Martino, D; Carroll, C; Paviour, D; Falup-Pecurariu, C; Kessel, B; Silverdale, M; Todorova, A; Sauerbier, A; Odin, P; Antonini, A; Martinez-Martin, P

2015-10-01

Pain is a key unmet need and a major aspect of non-motor symptoms of Parkinson's disease (PD). No specific validated scales exist to identify and grade the various types of pain in PD. We report an international, cross-sectional, open, multicenter, one-point-in-time evaluation with retest study of the first PD-specific pain scale, the King's PD Pain Scale. Its seven domains include 14 items, each item scored by severity (0-3) multiplied by frequency (0-4), resulting in a subscore of 0 to 12, with a total possible score range from 0 to 168. One hundred seventy-eight PD patients with otherwise unexplained pain (age [mean ± SD], 64.38 ± 11.38 y [range, 29-85]; 62.92% male; duration of disease, 5.40 ± 4.93 y) and 83 nonspousal non-PD controls, matched by age (64.25 ± 11.10 y) and sex (61.45% males) were studied. No missing data were noted, and floor effect was observed in all domains. The difference between mean and median King's PD Pain Scale total score was less than 10% of the maximum observed value. Skewness was marginally high (1.48 for patients). Factor analysis showed four factors in the King's PD Pain Scale, explaining 57% of the variance (Kaiser-Mayer-Olkin, 0.73; sphericity test). Cronbach's alpha was 0.78, item-total correlation mean value 0.40, and item homogeneity 0.22. Correlation coefficients of the King's PD Pain Scale domains and total score with other pain measures were high. Correlation with the Scale for Outcomes in PD-Motor, Non-Motor Symptoms Scale total score, and quality of life measures was high. The King's PD Pain Scale seems to be a reliable and valid scale for grade rating of various types of pain in PD. © 2015 International Parkinson and Movement Disorder Society.

Direct behavior rating as a school-based behavior universal screener: replication across sites.

PubMed

Kilgus, Stephen P; Riley-Tillman, T Chris; Chafouleas, Sandra M; Christ, Theodore J; Welsh, Megan E

2014-02-01

The purpose of this study was to evaluate the utility of Direct Behavior Rating Single Item Scale (DBR-SIS) targets of disruptive, engaged, and respectful behavior within school-based universal screening. Participants included 31 first-, 25 fourth-, and 23 seventh-grade teachers and their 1108 students, sampled from 13 schools across three geographic locations (northeast, southeast, and midwest). Each teacher rated approximately 15 of their students across three measures, including DBR-SIS, the Behavioral and Emotional Screening System (Kamphaus & Reynolds, 2007), and the Student Risk Screening Scale (Drummond, 1994). Moderate to high bivariate correlations and area under the curve statistics supported concurrent validity and diagnostic accuracy of DBR-SIS. Receiver operating characteristic curve analyses indicated that although respectful behavior cut scores recommended for screening remained constant across grade levels, cut scores varied for disruptive behavior and academic engaged behavior. Specific cut scores for first grade included 2 or less for disruptive behavior, 7 or greater for academically engaged behavior, and 9 or greater for respectful behavior. In fourth and seventh grades, cut scores changed to 1 or less for disruptive behavior and 8 or greater for academically engaged behavior, and remained the same for respectful behavior. Findings indicated that disruptive behavior was particularly appropriate for use in screening at first grade, whereas academically engaged behavior was most appropriate at both fourth and seventh grades. Each set of cut scores was associated with acceptable sensitivity (.79-.87), specificity (.71-.82), and negative predictive power (.94-.96), but low positive predictive power (.43-.44). DBR-SIS multiple gating procedures, through which students were only considered at risk overall if they exceeded cut scores on 2 or more DBR-SIS targets, were also determined acceptable in first and seventh grades, as the use of both disruptive behavior and academically engaged behavior in defining risk yielded acceptable conditional probability indices. Overall, the current findings are consistent with previous research, yielding further support for the DBR-SIS as a universal screener. Limitations, implications for practice, and directions for future research are discussed. Copyright © 2013 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

Grading Rigor in Counselor Education: A Specifications Grading Framework

ERIC Educational Resources Information Center

Bonner, Matthew W.

2016-01-01

According to accreditation and professional bodies, evaluation and grading are a high priority in counselor education. Specifications grading, an evaluative tool, can be used to increase grading rigor. This article describes the components of specifications grading and applies the framework of specifications grading to a counseling theories course.

Evaluation of novel scoring system named 5-5-5 exacerbation grading scale for allergic conjunctivitis disease.

PubMed

Shoji, Jun; Inada, Noriko; Sawa, Mitsuru

2009-12-01

The objective of this study is to evaluate the practical usefulness of a scoring system using the 5-5-5 exacerbation grading scale for allergic conjunctivitis disease (ACD). Subjects were 103 patients with ACD including 40 patients with vernal keratoconjunctivitis (VKC), 20 patients with atopic keratoconjunctivitis (AKC), and 43 patients with allergic conjunctivitis (AC). The 5-5-5 exacerbation grading scale consists of the following 3 graded groups of clinical observations: the 100-point-grade group (100 points for each observation) includes active giant papillae, gelatinous infiltrates of the limbus, exfoliative epithelial keratopathy, shield ulcer and papillary proliferation at lower palpebral conjunctiva; the 10-point-grade group (10 points for each observation) includes blepharitis, papillary proliferation with velvety appearance, Horner-Trantas spots, edema of bulbal conjunctiva, and superficial punctate keratopathy; and the 1-point-grade group (1 point for each observation) includes papillae at upper palpebral conjunctiva, follicular lesion at lower palpebral conjunctiva, hyperemia of palpebral conjunctiva, hyperemia of bulbal conjunctiva, and lacrimal effusion. The total points in each grade group were determined as the severity score of the 5-5-5 exacerbation grading scale. The median severity scores of the 5-5-5 exacerbation grading scale in VKC, AKC and AC were 243 (range: 12-444), 32.5 (11-344), and 13 (2-33), respectively. The severity score of each ACD disease type was significantly different (P < 0.001, Kruskal-Wallis test). The severity of each type of ACD was classified as severe, moderate, or mild according to the severity score. The 5-5-5 exacerbation grading scale is a useful clinical tool for grading the severity of each type of ACD.

The Use of Illustrations in Large-Scale Science Assessment: A Comparative Study

ERIC Educational Resources Information Center

Wang, Chao

2012-01-01

This dissertation addresses the complexity of test illustrations design across cultures. More specifically, it examines how the characteristics of illustrations used in science test items vary across content areas, assessment programs, and cultural origins. It compares a total of 416 Grade 8 illustrated items from the areas of earth science, life…

Language Use and Sustainability Status of Indigenous Languages in Sarawak, Malaysia

ERIC Educational Resources Information Center

Ting, Su-Hie; Ling, Teck-Yee

2013-01-01

The study examines the sustainability status of Sarawak indigenous languages through a survey on adolescents' language use using the Expanded Graded Intergenerational Disruption Scale (EGIDS). The specific aspects examined were: the presence of ethnic languages in relation to other languages in selected domains of language use; the adolescents'…

Separate versus Concurrent Calibration Methods in Vertical Scaling.

ERIC Educational Resources Information Center

Karkee, Thakur; Lewis, Daniel M.; Hoskens, Machteld; Yao, Lihua; Haug, Carolyn

Two methods to establish a common scale across grades within a content area using a common item design (separate and concurrent) have previously been studied under simulated conditions. Separate estimation is accomplished through separate calibration and grade-by-grade chained linking. Concurrent calibration established the vertical scale in a…

Patterns of Incorrect Responses on the FCI and Course Success

NASA Astrophysics Data System (ADS)

Wells, James; Mokaya, Fridah; Valente, Diego

The Force Concept Inventory (FCI) is often used to measure the effectiveness of instructional pedagogy in introductory physics courses both at the algebra- and calculus-based level. Scores on the FCI are correlated with the performance of students in a class, as measured by their final course grade. We have collected data from several semesters of first-semester introductory mechanics courses at a public 4-year university, taught in large-scale classrooms with pedagogy including elements of Just-in-Time Teaching pedagogy along with active learning course components. The data collected includes pre- and post-test FCI scores, midterm exam grades, and final course grades. We examine whether certain patterns of incorrect answers on the FCI post-test are predictive of course grades, indicating whether certain specific student preconceptions are more detrimental than others to the success of students in an introductory mechanics course. Funding from UConn - College of Liberal Arts and Sciences (CLAS).

Phase II Trial of Combined High-Dose-Rate Brachytherapy and External Beam Radiotherapy for Adenocarcinoma of the Prostate: Preliminary Results of RTOG 0321

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

Hsu, I-Chow, E-mail: ihsu@radonc.ucsf.ed; Bae, Kyounghwa; Shinohara, Katsuto

2010-11-01

Purpose: To estimate the rate of late Grade 3 or greater genitourinary (GU) and gastrointestinal (GI) adverse events (AEs) after treatment with external beam radiotherapy and prostate high-dose-rate (HDR) brachytherapy. Methods and Materials: Each participating institution submitted computed tomography-based HDR brachytherapy dosimetry data electronically for credentialing and for each study patient. Patients with locally confined Stage T1c-T3b prostate cancer were eligible for the present study. All patients were treated with 45 Gy in 25 fractions using external beam radiotherapy and one HDR implant delivering 19 Gy in two fractions. All AEs were graded according to the Common Terminology Criteria formore » Adverse Events, version 3.0. Late GU/GI AEs were defined as those occurring >9 months from the start of the protocol treatment, in patients with {>=}18 months of potential follow-up. Results: A total of 129 patients from 14 institutions were enrolled in the present study. Of the 129 patients, 125 were eligible, and AE data were available for 112 patients at analysis. The pretreatment characteristics of the patients were as follows: Stage T1c-T2c, 91%; Stage T3a-T3b, 9%; prostate-specific antigen level {<=}10 ng/mL, 70%; prostate-specific antigen level >10 but {<=}20 ng/mL, 30%; and Gleason score 2-6, 10%; Gleason score 7, 72%; and Gleason score 8-10, 18%. At a median follow-up of 29.6 months, three acute and four late Grade 3 GU/GI AEs were reported. The estimated rate of late Grade 3-5 GU and GI AEs at 18 months was 2.56%. Conclusion: This is the first prospective, multi-institutional trial of computed tomography-based HDR brachytherapy and external beam radiotherapy. The technique and doses used in the present study resulted in acceptable levels of AEs.« less

The FIFA Women's World Cup in Germany 2011--a practical example for tailoring an event-specific enhanced infectious disease surveillance system.

PubMed

Takla, Anja; Velasco, Edward; Benzler, Justus

2012-07-31

Mass gatherings require a decision from public health authorities on how to monitor infectious diseases during the event. The appropriate level of enhanced surveillance depends on parameters like the scale of the event (duration, spatial distribution, season), participants' origin, amount of public attention, and baseline disease activity in the host country. For the FIFA Men's World Cup 2006, Germany implemented enhanced surveillance. As the scale of the FIFA Women's World Cup (June 26 - July 17, 2011) was estimated to be substantially smaller in size, visitors and duration, it was not feasible to simply adopt the previously implemented measures. Our aim was therefore to develop a strategy to tailor an event-specific enhanced surveillance for this smaller-scale mass gathering. Based on the enhanced surveillance measures during the Men's Cup, we conducted a needs assessment with the district health authorities in the 9 host cities in March 2011. Specific measures with a majority consent were implemented. After the event, we surveyed the 9 district and their corresponding 7 state health authorities to evaluate the implemented measures. All 9 district health authorities participated in the pre-event needs assessment. The majority of sites consented to moving from weekly to daily (Monday-Friday) notification reporting of routine infectious diseases, receiving regular feedback on those notification reports and summaries of national/international World Cup-relevant epidemiological incidents, e.g. outbreaks in countries of participating teams. In addition, we decided to implement twice-weekly reports of "unusual events" at district and state level. This enhanced system would commence on the first day and continue to one day following the tournament. No World Cup-related infectious disease outbreaks were reported during this time period. Eight of 9 district and 6 of 8 state health authorities participated in the final evaluation. The majority perceived the implemented measures as adequate. Our approach to tailor an event-specific enhanced surveillance concept worked well. Involvement of the participating stakeholders early-on in the planning phase secured ownership of and guaranteed support for the chosen strategy. The enhanced surveillance for this event resulted as a low-level surveillance. However, we included mechanisms for rapid upscaling if the situation would require adaptations.

Unfairness of Certain Events in the Olympic Games

PubMed Central

Khosla, T.

1968-01-01

Boxing, weight-lifting, wrestling, and judo are graded events in that opponents are matched by weight. If protection were to be denied by removing this restriction such sports would overwhelmingly favour the heavyweights. Data on Olympic winners show that many running and jumping events are seriously biased in favour of the very tall. It is suggested that the rules of these events should be revised to include a grading by height. This would remedy an element of unfairness in many athletic contests, beginning at school. PMID:5696539

Unfairness of certain events in the Olympic games.

PubMed

Khosla, T

1968-10-12

Boxing, weight-lifting, wrestling, and judo are graded events in that opponents are matched by weight. If protection were to be denied by removing this restriction such sports would overwhelmingly favour the heavyweights. Data on Olympic winners show that many running and jumping events are seriously biased in favour of the very tall. It is suggested that the rules of these events should be revised to include a grading by height. This would remedy an element of unfairness in many athletic contests, beginning at school.

Automated diabetic retinopathy detection in smartphone-based fundus photography using artificial intelligence.

PubMed

Rajalakshmi, Ramachandran; Subashini, Radhakrishnan; Anjana, Ranjit Mohan; Mohan, Viswanathan

2018-06-01

To assess the role of artificial intelligence (AI)-based automated software for detection of diabetic retinopathy (DR) and sight-threatening DR (STDR) by fundus photography taken using a smartphone-based device and validate it against ophthalmologist's grading. Three hundred and one patients with type 2 diabetes underwent retinal photography with Remidio 'Fundus on phone' (FOP), a smartphone-based device, at a tertiary care diabetes centre in India. Grading of DR was performed by the ophthalmologists using International Clinical DR (ICDR) classification scale. STDR was defined by the presence of severe non-proliferative DR, proliferative DR or diabetic macular oedema (DME). The retinal photographs were graded using a validated AI DR screening software (EyeArt TM ) designed to identify DR, referable DR (moderate non-proliferative DR or worse and/or DME) or STDR. The sensitivity and specificity of automated grading were assessed and validated against the ophthalmologists' grading. Retinal images of 296 patients were graded. DR was detected by the ophthalmologists in 191 (64.5%) and by the AI software in 203 (68.6%) patients while STDR was detected in 112 (37.8%) and 146 (49.3%) patients, respectively. The AI software showed 95.8% (95% CI 92.9-98.7) sensitivity and 80.2% (95% CI 72.6-87.8) specificity for detecting any DR and 99.1% (95% CI 95.1-99.9) sensitivity and 80.4% (95% CI 73.9-85.9) specificity in detecting STDR with a kappa agreement of k = 0.78 (p < 0.001) and k = 0.75 (p < 0.001), respectively. Automated AI analysis of FOP smartphone retinal imaging has very high sensitivity for detecting DR and STDR and thus can be an initial tool for mass retinal screening in people with diabetes.

M-Health for Improving Screening Accuracy of Acute Malnutrition in a Community-Based Management of Acute Malnutrition Program in Mumbai Informal Settlements.

PubMed

Chanani, Sheila; Wacksman, Jeremy; Deshmukh, Devika; Pantvaidya, Shanti; Fernandez, Armida; Jayaraman, Anuja

2016-12-01

Acute malnutrition is linked to child mortality and morbidity. Community-Based Management of Acute Malnutrition (CMAM) programs can be instrumental in large-scale detection and treatment of undernutrition. The World Health Organization (WHO) 2006 weight-for-height/length tables are diagnostic tools available to screen for acute malnutrition. Frontline workers (FWs) in a CMAM program in Dharavi, Mumbai, were using CommCare, a mobile application, for monitoring and case management of children in combination with the paper-based WHO simplified tables. A strategy was undertaken to digitize the WHO tables into the CommCare application. To measure differences in diagnostic accuracy in community-based screening for acute malnutrition, by FWs, using a mobile-based solution. Twenty-seven FWs initially used the paper-based tables and then switched to an updated mobile application that included a nutritional grade calculator. Human error rates specifically associated with grade classification were calculated by comparison of the grade assigned by the FW to the grade each child should have received based on the same WHO tables. Cohen kappa coefficient, sensitivity and specificity rates were also calculated and compared for paper-based grade assignments and calculator grade assignments. Comparing FWs (N = 14) who completed at least 40 screenings without and 40 with the calculator, the error rates were 5.5% and 0.7%, respectively (p < .0001). Interrater reliability (κ) increased to an almost perfect level (>.90), from .79 to .97, after switching to the mobile calculator. Sensitivity and specificity also improved significantly. The mobile calculator significantly reduces an important component of human error in using the WHO tables to assess acute malnutrition at the community level. © The Author(s) 2016.

Pediatric airway study: Endoscopic grading system for quantifying tonsillar size in comparison to standard adenotonsillar grading systems.

PubMed

Patel, Neha A; Carlin, Kristen; Bernstein, Joseph M

Current grading systems may not allow clinicians to reliably document and communicate adenotonsillar size in the clinical setting. A validated endoscopic grading system may be useful for reporting tonsillar size in future clinical outcome studies. This is especially important as tonsillar enlargement is the cause of a substantial health care burden on children. To propose and validate an easy-to-use flexible fiberoptic endoscopic grading system that provides physicians with a more accurate sense of the three-dimensional relationship of the tonsillar fossa to the upper-airway. 50 consecutive pediatric patients were prospectively recruited between February 2015 and February 2016 at a pediatric otolaryngology outpatient clinic. The patients had no major craniofacial abnormalities and were aged 1 to 16years. Each patient had data regarding BMI, Friedman palate position, OSA-18 survey results collected. For each child, digital video clips of fiberoptic nasopharyngeal, oropharyngeal and laryngeal exams were presented to 2 examiners. Examiners were asked to independently use the proposed Endoscopic tonsillar grading system, the Brodsky tonsillar grading scale, the Modified Brodsky tonsillar grading scale with a tongue depressor, and the Parikh adenoid grading system to rate adenotonsillar hypertrophy. Cohen's Kappa and weighted Kappa scores were used to assess interrater reliability for each of the four grading scales. The Spearman correlation was used to test the associations between each scale and OSA-18 scores, as well as Body Mass Index (BMI). 50 pediatric patients were included in this study (mean age 6.1years, range of 1year to 16years). The average BMI was 20. The average OSA-18 score was 61.7. The average Friedman palate position score was 1.34. Twelve percent of the patients had a Friedman palate position score≥3, which made traditional Brodsky grading of their tonsils impossible without a tongue depressor. All four scales showed strong agreement between the two raters. The weighted Kappa was 0.83 for the Modified Brodsky scale, 0.89 for the Brodsky scale, 0.94 for the Parikh scale to 0.98 for the Endoscopic scale (almost perfect agreement). The Endoscopic scale showed the most consistent agreement between the raters during the study. There was a moderate association between the Parikh adenoid grading system with OSA-18 scores (Spearman's ρ=0.58, p<0.001) compared to a low association of the tonsillar grading systems with OSA- 18 scores. None of the scales correlated with patient BMI. The proposed Endoscopic tonsillar grading system is as reliable of a method of grading tonsillar size as conventional grading systems. It offers the advantage of allowing for critical evaluation of the tonsils without any anatomic distortion which may occur with the use of a tongue blade. This new validated endoscopic grading system provides a tool for communicating the degree of airway obstruction at the level of the oropharynx regardless of Friedman palate position and may be used in future outcomes projects. Copyright © 2017 Elsevier Inc. All rights reserved.

A Gold Standards Approach to Training Instructors to Evaluate Crew Performance

NASA Technical Reports Server (NTRS)

Baker, David P.; Dismukes, R. Key

2003-01-01

The Advanced Qualification Program requires that airlines evaluate crew performance in Line Oriented Simulation. For this evaluation to be meaningful, instructors must observe relevant crew behaviors and evaluate those behaviors consistently and accurately against standards established by the airline. The airline industry has largely settled on an approach in which instructors evaluate crew performance on a series of event sets, using standardized grade sheets on which behaviors specific to event set are listed. Typically, new instructors are given a class in which they learn to use the grade sheets and practice evaluating crew performance observed on videotapes. These classes emphasize reliability, providing detailed instruction and practice in scoring so that all instructors within a given class will give similar scores to similar performance. This approach has value but also has important limitations; (1) ratings within one class of new instructors may differ from those of other classes; (2) ratings may not be driven primarily by the specific behaviors on which the company wanted the crews to be scored; and (3) ratings may not be calibrated to company standards for level of performance skill required. In this paper we provide a method to extend the existing method of training instructors to address these three limitations. We call this method the "gold standards" approach because it uses ratings from the company's most experienced instructors as the basis for training rater accuracy. This approach ties the training to the specific behaviors on which the experienced instructors based their ratings.

Design Against Propagating Shear Failure in Pipelines

NASA Astrophysics Data System (ADS)

Leis, B. N.; Gray, J. Malcolm

Propagating shear failure can occur in gas and certain hazardous liquid transmission pipelines, potentially leading to a large long-burning fire and/or widespread pollution, depending on the transported product. Such consequences require that the design of the pipeline and specification of the steel effectively preclude the chance of propagating shear failure. Because the phenomenology of such failures is complex, design against such occurrences historically has relied on full-scale demonstration experiments coupled with empirically calibrated analytical models. However, as economic drivers have pushed toward larger diameter higher pressure pipelines made of tough higher-strength grades, the design basis to ensure arrest has been severely compromised. Accordingly, for applications where the design basis becomes less certain, as has occurred increasing as steel grade and toughness has increased, it has become necessary to place greater reliance on the use and role of full-scale testing.

School performance after experiencing trauma: a longitudinal study of school functioning in survivors of the Utøya shootings in 2011

PubMed Central

Strøm, Ida Frugård; Schultz, Jon-Håkon; Wentzel-Larsen, Tore; Dyb, Grete

2016-01-01

Background The psychological impact on survivors of terrorism has been well documented. However, studies on adolescent survivors and the academic performance of high school students following a terrorist attack are lacking. Objective This study investigated academic performance, absenteeism, and school support amongst survivors of a terrorist attack in Norway. Method Data from a longitudinal interview study were linked to officially registered grades of students (N=64) who successfully completed their 3-year senior high school program. Statistical tests of mean differences and linear regression were used to compare the survivors’ registered grades with the national grade point average, before and after the event, as well as to assess absenteeism, self-reported grades and to test the association with school support. Results The students’ grades were lower the year after the event than they had been the year before, and they were also lower than the national grade point average (p<0.001). However, their grades improved in the last year of high school, indicating possible recovery. Absence from school increased after the event, compared to the previous year. However, students reported high satisfaction with school support. Conclusion The results indicate that academic functioning was reduced in the year after the traumatic event, but for students who successfully completed high school, the school situation improved 2 years after the event. The findings underscore the importance of keeping trauma-exposed students in school and providing support over time. A more defined educational approach to maintaining school attendance and educational measures which compensate for learning loss are needed in trauma-sensitive teaching. Highlights of the article School functioning among high school students following a terrorist attack. The findings showed a decline in school performance and increased absence after the event. For students who successfully completed high school, high satisfaction with school support was reported and an improvement in grades could be observed over time, indicating possible recovery. The findings underscore the importance of keeping trauma-exposed students in schools and providing support over time. PMID:27171613

Low Interrater Reliability in Grading of Rectal Bleeding Using National Cancer Institute Common Toxicity Criteria and Radiation Therapy Oncology Group Toxicity Scales: A Survey of Radiation Oncologists

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

Huynh-Le, Minh-Phuong; Zhang, Zhe; Tran, Phuoc T.

2014-12-01

Purpose: To measure concordance among genitourinary radiation oncologists in using the National Cancer Institute Common Toxicity Criteria (NCI CTC) and Radiation Therapy Oncology Group (RTOG) grading scales to grade rectal bleeding. Methods and Materials: From June 2013 to January 2014, a Web-based survey was sent to 250 American and Canadian academic radiation oncologists who treat prostate cancer. Participants were provided 4 case vignettes in which patients received radiation therapy and developed rectal bleeding and were asked for management plans and to rate the bleeding according to NCI CTC v.4 and RTOG late toxicity grading (scales provided). In 2 cases, participantsmore » were also asked whether they would send the patient for colonoscopy. A multilevel, random intercept modeling approach was used to assess sources of variation (case, respondent) in toxicity grading to calculate the intraclass correlation coefficient (ICC). Agreement on a dichotomous grading scale (low grades 1-2 vs high grades 3-4) was also assessed, using the κ statistic for multiple respondents. Results: Seventy-two radiation oncologists (28%) completed the survey. Forty-seven (65%) reported having either written or been principal investigator on a study using these scales. Agreement between respondents was moderate (ICC 0.52, 95% confidence interval [CI] 0.47-0.58) when using NCI CTC and fair using the RTOG scale (ICC 0.28, 95% CI 0.20-0.40). Respondents who chose an invasive management were more likely to select a higher toxicity grade (P<.0001). Using the dichotomous scale, we observed moderate agreement (κ = 0.42, 95% CI 0.40-0.44) with the NCI CTC scale, but only slight agreement with the RTOG scale (κ = 0.19, 95% CI 0.17-0.21). Conclusion: Low interrater reliability was observed among radiation oncologists grading rectal bleeding using 2 common scales. Clearer definitions of late rectal bleeding toxicity should be constructed to reduce this variability and avoid ambiguity in both reporting and interpretation.« less

QUANTIFICATION OF STRESSFUL LIFE EVENTS IN SERVICE PERSONNEL

PubMed Central

Raju, M.S.V.K.; Srivastava, Kalpana; Chaudhury, S.; Salujha, S.K.

2001-01-01

The role of stressful life events in the etiology of various disorders has been of interest to investigators attempting to establish a link between stressful life events and disorders. None of the available scales are relevant to service personnel. In the present study an attempt was made to construct a scale to measure stressful life events in service personnel. In the first stage of study open-ended questions along with items generated by the expert group by consensus method were administered to 50 soldiers. During the second stage the scale comprising of 59 items was administered in group setting to 165 service personnel. Weightage was assigned on 0-100 range Frequency of occurrence of life events within past one year and lifetime was also noted. Findings revealed that service personnel experience more number of life events within a year as well as in lifetime. Some general items, which are common to civilians are having consistency of weightage being assigned. There is a pattern of uniformity with the civilian counterparts along with differences in the items specific to service personnel. PMID:21407857

Clinical utility of the impact of event scale: psychometrics in the general population.

PubMed

Briere, J; Elliott, D M

1998-06-01

The Impact of Event Scale (IES; Horowitz, Wilner, & Alvarez, 1979), Trauma Symptom Inventory (TSI; Briere, 1995), Los Angeles Symptom Checklist (LASC; Foy, Sipprelle, Rueger, & Carroll, 1984), and Traumatic Events Survey (TES; Elliott, 1992) were administered to a sample of 505 participants from the general population. In this application of the IES, participants reported on "an upsetting event," as opposed to a specific stressor. The IES was found to be reliable and to have concurrent validity with respect to the TSI and LASC. IES scores varied as a function of race, but this relationship disappeared once race differences in exposure to potentially traumatic events (PTEs) were taken into account. Although the IES was predictive of PTEs, the traumatic stress scales of the TSI had more predictive and incremental validity than the IES. The current data suggest that an "upsetting event" version of the IES may be useful as a brief screen for nonarousal-related posttraumatic stress, but that its potential limitations should be taken into account. Normative data on this version of the IES are presented.

Fisher Grading Scale Associated with Language Disorders in Patients with Anterior Circulation Aneurysmal Subarachnoid Hemorrhage.

PubMed

de Souza, Moysés Loiola Ponte; Vieira, Ana Cláudia C; Andrade, Gustavo; Quinino, Saul; de Fátima Leal Griz, Maria; Azevedo-Filho, Hildo R C

2015-08-01

To associate the presence of language deficits with varying scores of the Fisher grading scale in patients with subarachnoid hemorrhage in the period preceding the treatment of aneurysm in the anterior circulation, as well as to compare the scores of this scale, identifying the grades more associated with the decline of language. Database analysis of 185 preoperative evaluations of language, through the Montreal Toulouse Protocol Alpha version and verbal fluency through CERAD battery, of patients from "Hospital da Restauração" with aneurysmal subarachnoid hemorrhage, divided according to the Fisher grading scale (Fisher I, II, III, or IV) and compared with a control group of individuals considered normal. The various scores of the Fisher grading scale have different levels of language deficits, more pronounced as the amount of blood increases. Fisher III and IV scores are most associated with the decline of language. Our study made it possible to obtain information not yet available in the literature, by correlating the various scores of the Fisher grading scale with language yet in the period preceding treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

Objective assessment of isotretinoin-associated cheilitis: Isotretinoin Cheilitis Grading Scale.

PubMed

Ornelas, Jennifer; Rosamilia, Lorraine; Larsen, Larissa; Foolad, Negar; Wang, Quinlu; Li, Chin-Shang; Sivamani, Raja K

2016-01-01

Isotretinoin remains an effective treatment for severe acne. Despite its effectiveness, it includes many side effects, of which cheilitis is the most common. To develop an objective grading scale for assessment of isotretinoin-associated cheilitis. Cross-sectional clinical grading study. UC Davis Dermatology clinic. Subjects were older than 18 years old and actively treated with oral isotretinoin. Oral Isotretinoin. We developed an Isotretinoin Cheilitis Grading Scale (ICGS) incorporating the following four characteristics: erythema, scale/crust, fissures and inflammation of the commissures. Three board-certified dermatologists independently graded photographs of the subjects. The Kendall's coefficient of concordance (KCC) for the ICGS was 0.88 (p < 0.0001). The Kendall's coefficient was ≥0.72 (p < 0.0001) for each of the four characteristics included in the grading scale. An image-based measurement for lip roughness statistically significantly correlated with the lip scale/crusting assessment (r = 0.52, p < 0.05). The ICGS is reproducible and relatively simple to use. It can be incorporated as an objective tool to aid in the assessment of isotretinoin associated cheilitis.

Exploratory double-blind, parallel-group, placebo-controlled study of edaravone (MCI-186) in amyotrophic lateral sclerosis (Japan ALS severity classification: Grade 3, requiring assistance for eating, excretion or ambulation).

PubMed

2017-10-01

Our objective was to explore the efficacy and safety of edaravone in amyotrophic lateral sclerosis (ALS) patients with a Japan ALS severity classification of Grade 3. In a 24-week, double-blind, randomized study, 25 patients who met all of the following criteria were enrolled: Japan ALS severity classification Grade 3; definite, probable, or probable-laboratory supported ALS (El Escorial/revised Airlie House); forced vital capacity (%FVC) ≥60%; duration of disease ≤3 years at consent; and change in the revised ALS functional rating scale (ALSFRS-R) score of -1 to -4 points during the 12-week pre-observation period. Patients received edaravone (n = 13) or placebo (n = 12) for six cycles. The efficacy outcome was change in the ALSFRS-R score. The least-squares mean change in the ALSFRS-R score ± standard error during the 24-week treatment was -6.52 ± 1.78 in the edaravone group and -6.00 ± 1.83 in the placebo group; the difference of -0.52 ± 2.46 was not statistically significant (p = 0.835). Incidence of adverse events was 92.3% (12/13) in the edaravone group and 100.0% (12/12) in the placebo group. There was no intergroup difference in the changes in the ALSFRS-R score. The incidences of adverse events were similar in the two groups.

Increased risk of adverse drug events secondary to bevacizumab treatment in patients with advanced or metastatic breast cancer: a meta-analysis of randomized controlled trials.

PubMed

Shin, Sooyoung; Noh, Yoojin

2018-01-01

Several clinical trials have shown an increased risk of hypertension with bevacizumab when added to chemotherapy in different types of malignancy; however, the risks of other significant adverse events besides hypertension, specifically in breast cancer, have not been completely elucidated. This study was conducted with the aim, primarily, to assess the overall incidence and risk of common toxicities associated with bevacizumab in patients with advanced or metastatic breast cancer and, secondarily, to descriptively review study results concerning a potential correlation between bevacizumab-induced hypertension and its efficacy for breast cancer treatment. We carried out a meta-analysis of relevant randomized controlled trials (RCTs) identified from a database search (Cochrane Library and PubMed) and, additionally, by reviewing previous reviews and meta-analyses. Overall incidence rates, odds ratios (ORs), and 95% confidence intervals (CIs) were assessed with the random- or fixed-effect models, depending on the level of heterogeneity across the included trials. The primary clinical outcomes were high-grade adverse events commonly reported with bevacizumab therapy. We included 6,260 patients with advanced-stage breast cancer from 12 RCTs in the meta-analysis. Five types of high-grade (Grade 3 or 4) adverse drug events were identified as being correlated with bevacizumab treatment versus alternative treatment with statistical significance: hypertension (OR 5.67, 95% CI 3.02-10.65), proteinuria (OR 10.09, 95% CI 4.79-21.27), bleeding (OR 3.45, 95% CI 2.25-5.30), cardiac toxicity (OR 2.15, 95% CI 1.29-3.59), and neutropenic fever (OR 1.51, 95% CI 1.15-2.00). The prognostic value of bevacizumab-induced hypertension for its antitumor efficacy among patients with breast cancer remains controversial, with mixed results presented in the five retrospective studies that were identified from our additional literature search. The addition of bevacizumab to anticancer therapy was associated with a significant increase in the risk of high-grade adverse events, including hypertension, proteinuria, bleeding, cardiac toxicity, and neutropenic fever among patients with advanced-stage breast cancer. Although several retrospective studies suggested a predictive importance of hypertension secondary to bevacizumab therapy, the role of elevated blood pressure as a prognostic biomarker for its antitumor efficacy remains controversial, and further prospective trials are required to confirm such a correlation.

Healthy Lifestyles of University Students in China and Influential Factors

PubMed Central

Xing, Xiao-Hui; Wu, Xian-Bo

2013-01-01

This study was conducted to analyze to what extent university students exhibit healthy lifestyles and which sociodemographic variables influence healthy lifestyles. 4809 university students randomly selected were measured by use of the Healthy Lifestyle Scale for University Students questionnaire. When controlling for the other variables, the total healthy lifestyles score was predicted by gender, grade, father's level of education, and type of institution; exercise behaviour was partially predicted by gender, grade, type of institution, and family monthly income; regular behaviour was modulated by gender, grade, type of institution, family monthly income, and father's educational level; nutrition behaviour was partially affected by type of institution, family monthly income, and father's educational level; health risk behaviour was modulated by gender, mother's level of education, and family monthly income; health responsibility was modulated by gender, grade, type of institution, and father's educational level; social support was modulated by gender, grade, and father's educational level; stress management was modulated by gender, grade, type of institution, and mother's education level; life appreciation was modulated by grade, type of institution, and mother's educational level. These influences should be taken into account in designing interventions for specific socio-demographic profiles that might be at higher risk for certain behaviours. PMID:23935418

Sedimentological and geochemical support for a large flood ca. 4400 cy BP in the coastal southwest United States (Lake Elsinore, CA): Evidence for a Drought Buster Atmospheric River Storm?

NASA Astrophysics Data System (ADS)

Kirby, M. E.; Patterson, W. P.

2015-12-01

As serious a threat drought is to the coastal southwest United States (US), floods represent an equally formidable threat. So significant is this risk that the USGS has created the ARkStorm Project. This project aims to prepare California for a future storm(s) on the scale of the disastrous 1861-1862 A.D. events. Unfortunately, our knowledge of pre-measurement floods in the coastal southwest US is not well known, excepting seven identified flood layers in the Santa Barbara Basin, which span the past 2000 years. As an alternative to marine archives, the lakes of the coastal southwest US represent untapped resources for pre-measurement flood reconstructions. Here, we present evidence for a flood ca. 4400 cal yrs BP using sediments from Lake Elsinore. Core LEGC03-4 was collected in 4.0 m water depth using a push core with a hollow stemmed augur; the core is 994 cm in length. The core is predominantly clayey silt with occasional sandy silt units of variable cm-scale thickness. Here we focus on a specific core section between 315 and 350 cm where a ~11 cm thick "unusual" sediment unit (319-330 cm) is well preserved and complete. The core section was digitally photographed, described, and sampled at 1 cm contiguous intervals for a variety of physical and chemical properties including: magnetic susceptibility, loss-on-Ignition (LOI) 550 and 950 °C, grain size, CN ratios, and d13Cbulk organics. The data suggest rapid deposition of sediment with classic "Bouma" sequence preservation. The unit is characterized by an erosional basal contact and flame structures. It is normally graded with laminae occurring in the upper section of the unit. It contains predominantly terrestrial organic matter and the upper boundary is gradational. The cause of this event unit is speculative but potentially associated with San Jacinto River flooding in response to a large atmospheric river storm. Curiously, the 1861-1862 A.D. events are not observed in the sediment core suggesting that this 4400 yr event was different (larger magnitude?) than anything observed in historic times. This event's timing is compared to regional paleoclimatic reconstructions and examined in the context of potential forcings.

Is fasting safe? A chart review of adverse events during medically supervised, water-only fasting.

PubMed

Finnell, John S; Saul, Bradley C; Goldhamer, Alan C; Myers, Toshia R

2018-02-20

Evidence suggests that fasting, during which only water is consumed, results in potentially health promoting physiological effects. However, peer-reviewed research assessing the safety of water-only fasting is lacking. To address this, we conducted a chart review to describe adverse events (AEs) that occurred during medically supervised, water-only fasting. Electronic charts from patient visits to a residential medical facility from 2006 to 2011 were reviewed. Patients who were at least 21 years of age and water-only fasted for ≥2 consecutive days with a refeeding period equal to half of the fast length were included. Out of 2539 charts, 768 visits met our inclusion and exclusion criteria. AEs were abstracted from chart notes and classified according to CTCAE (v4.03) and MedDRA (v12.1) terminology. Descriptive analysis of AEs is reported. During the protocol period, the highest grade AE (HGAE) in 555 visits was a grade 2 event or lower, in 212 visits it was a grade 3 event, in 1 visit it was a grade 4 event, and there were no grade 5 events. There were 2 (0.002%) visits with a serious adverse event (SAE). The majority of AEs identified were mild (n = 4490, 75%) in nature and known reactions to fasting. To our knowledge, this is the most comprehensive analysis of AEs experienced during medically supervised, water-only fasting conducted to date. Overall, our data indicate that the majority of AEs experienced were mild to moderate and known reactions to fasting. This suggests that the protocol used in this study can be safely implemented in a medical setting with minimal risk of a SAE.

Grading Practices and Distributions Across Internal Medicine Clerkships.

PubMed

Fazio, Sara B; Torre, Dario M; DeFer, Thomas M

2016-01-01

Clerkship evaluation and grading practices vary widely between U.S. medical schools. Grade inflation continues to exist, and grade distribution is likely to be different among U.S. medical schools. Increasing the number of available grades curtails "grade inflation." A national survey of all Clerkship Directors in Internal Medicine members was administered in 2011. The authors assessed key aspects of grading. Response rate was 76%. Among clerkship directors (CDs), 61% of respondents agreed that grade inflation existed in the internal medicine clerkship at their school, and 43% believed that it helped students obtain better residency positions. With respect to grading practices, 79% of CDs define specific behaviors needed to achieve each grade, and 36% specify an ideal grade distribution. In addition, 44% have a trained core faculty responsible for evaluating students, 35% describe formal grading meetings, and 39% use the Reporter-Interpreter-Manager-Educator (RIME) scheme. Grading scales were described as follows: 4% utilize a pass/fail system, 13% a 3-tier (e.g., Honors/Pass/Fail), 45% 4-tier, 35% 5-tier, and 4% 6+-tier system. There was a trend to higher grades with more tiers available. Grade inflation continues in the internal medicine clerkship. Almost half of CDs feel that this practice assists students to obtain better residency positions. A minority of programs have a trained core faculty who are responsible for evaluation. About one third have formal grading meetings and use the RIME system; both have been associated with more robust and balanced grading practices. In particular, there is a wide variation between schools in the percentage of students who are awarded the highest grade, which has implications for residency applications. Downstream users of clinical clerkship grades must be fully aware of these variations in grading in order to appropriately judge medical student performance.

Assessing Agreement between Multiple Raters with Missing Rating Information, Applied to Breast Cancer Tumour Grading

PubMed Central

Ellis, Ian O.; Green, Andrew R.; Hanka, Rudolf

2008-01-01

Background We consider the problem of assessing inter-rater agreement when there are missing data and a large number of raters. Previous studies have shown only ‘moderate’ agreement between pathologists in grading breast cancer tumour specimens. We analyse a large but incomplete data-set consisting of 24177 grades, on a discrete 1–3 scale, provided by 732 pathologists for 52 samples. Methodology/Principal Findings We review existing methods for analysing inter-rater agreement for multiple raters and demonstrate two further methods. Firstly, we examine a simple non-chance-corrected agreement score based on the observed proportion of agreements with the consensus for each sample, which makes no allowance for missing data. Secondly, treating grades as lying on a continuous scale representing tumour severity, we use a Bayesian latent trait method to model cumulative probabilities of assigning grade values as functions of the severity and clarity of the tumour and of rater-specific parameters representing boundaries between grades 1–2 and 2–3. We simulate from the fitted model to estimate, for each rater, the probability of agreement with the majority. Both methods suggest that there are differences between raters in terms of rating behaviour, most often caused by consistent over- or under-estimation of the grade boundaries, and also considerable variability in the distribution of grades assigned to many individual samples. The Bayesian model addresses the tendency of the agreement score to be biased upwards for raters who, by chance, see a relatively ‘easy’ set of samples. Conclusions/Significance Latent trait models can be adapted to provide novel information about the nature of inter-rater agreement when the number of raters is large and there are missing data. In this large study there is substantial variability between pathologists and uncertainty in the identity of the ‘true’ grade of many of the breast cancer tumours, a fact often ignored in clinical studies. PMID:18698346

Impact of Sequencing Radiation Therapy and Chemotherapy on Long-Term Local Toxicity for Early Breast Cancer: Results of a Randomized Study at 15-Year Follow-Up

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

Pinnarò, Paola; Giordano, Carolina; Farneti, Alessia

Purpose: To compare long-term late local toxicity after either concomitant or sequential chemoradiation therapy after breast-conserving surgery. Methods and Materials: From 1997 to 2002, women aged 18 to 75 years who underwent breast-conserving surgery and axillary dissection for early breast cancer and in whom CMF (cyclophosphamide, methotrexate, and 5-fluorouracil) chemotherapy was planned were randomized between concomitant and sequential radiation therapy. Radiation therapy was delivered to the whole breast through tangential fields to 50 Gy in 20 fractions over a period of 4 weeks, followed by an electron boost. Surviving patients were tentatively contacted and examined between March and September 2014. Patients in whom progressive diseasemore » had developed or who had undergone further breast surgery were excluded. Local toxicity (fibrosis, telangiectasia, and breast atrophy or retraction) was scored blindly to the treatment received. A logistic regression was run to investigate the effect of treatment sequence after correction for several patient-, treatment-, and tumor-related covariates on selected endpoints. The median time to cross-sectional analysis was 15.7 years (range, 12.0-17.8 years). Results: Of 206 patients randomized, 154 (74.8%) were potentially eligible. Of these, 43 (27.9%) refused participation and 4 (2.6%) had been lost to follow-up, and for 5 (3.2%), we could not restore planning data; thus, the final number of analyzed patients was 102. No grade 4 toxicity had been observed, whereas the number of grade 3 toxicity events was low (<8%) for each item, allowing pooling of grade 2 and 3 events for further analysis. Treatment sequence (concomitant vs sequential) was an independent predictor of grade 2 or 3 fibrosis according to both the National Cancer Institute Common Terminology Criteria for Adverse Events (odds ratio [OR], 4.05; 95% confidence interval [CI], 1.34-12.2; P=.013) and the SOMA (Subjective, Objective, Management and Analytic) scale (OR, 3.75; 95% CI, 1.19-11.79; P=.018), as well as grade 2 or 3 breast atrophy or retraction (OR, 3.87; 95% CI, 1.42-10.56; P=.008). No effect on telangiectasia was detected. Conclusions: At long-term follow-up, concomitant chemoradiation therapy has a detrimental effect on both fibrosis and retraction with an approximately 4-fold increase in the odds of grade 2 or 3 toxicity.« less

The FIFA Women’s World Cup in Germany 2011 – A practical example for tailoring an event-specific enhanced infectious disease surveillance system

PubMed Central

2012-01-01

Background Mass gatherings require a decision from public health authorities on how to monitor infectious diseases during the event. The appropriate level of enhanced surveillance depends on parameters like the scale of the event (duration, spatial distribution, season), participants’ origin, amount of public attention, and baseline disease activity in the host country. For the FIFA Men’s World Cup 2006, Germany implemented enhanced surveillance. As the scale of the FIFA Women’s World Cup (June 26 – July 17, 2011) was estimated to be substantially smaller in size, visitors and duration, it was not feasible to simply adopt the previously implemented measures. Our aim was therefore to develop a strategy to tailor an event-specific enhanced surveillance for this smaller-scale mass gathering. Methods Based on the enhanced surveillance measures during the Men’s Cup, we conducted a needs assessment with the district health authorities in the 9 host cities in March 2011. Specific measures with a majority consent were implemented. After the event, we surveyed the 9 district and their corresponding 7 state health authorities to evaluate the implemented measures. Results All 9 district health authorities participated in the pre-event needs assessment. The majority of sites consented to moving from weekly to daily (Monday-Friday) notification reporting of routine infectious diseases, receiving regular feedback on those notification reports and summaries of national/international World Cup-relevant epidemiological incidents, e.g. outbreaks in countries of participating teams. In addition, we decided to implement twice-weekly reports of “unusual events” at district and state level. This enhanced system would commence on the first day and continue to one day following the tournament. No World Cup-related infectious disease outbreaks were reported during this time period. Eight of 9 district and 6 of 8 state health authorities participated in the final evaluation. The majority perceived the implemented measures as adequate. Conclusions Our approach to tailor an event-specific enhanced surveillance concept worked well. Involvement of the participating stakeholders early-on in the planning phase secured ownership of and guaranteed support for the chosen strategy. The enhanced surveillance for this event resulted as a low-level surveillance. However, we included mechanisms for rapid upscaling if the situation would require adaptations. PMID:22849632

Species-Specific Exon Loss in Human Transcriptomes

PubMed Central

Wang, Jinkai; Lu, Zhi-xiang; Tokheim, Collin J.; Miller, Sara E.; Xing, Yi

2015-01-01

Changes in exon–intron structures and splicing patterns represent an important mechanism for the evolution of gene functions and species-specific regulatory networks. Although exon creation is widespread during primate and human evolution and has been studied extensively, much less is known about the scope and potential impact of human-specific exon loss events. Historically, transcriptome data and exon annotations are significantly biased toward humans over nonhuman primates. This ascertainment bias makes it challenging to discover human-specific exon loss events. We carried out a transcriptome-wide search of human-specific exon loss events, by taking advantage of RNA sequencing (RNA-seq) as a powerful and unbiased tool for exon discovery and annotation. Using RNA-seq data of humans, chimpanzees, and other primates, we reconstructed and compared transcript structures across the primate phylogeny. We discovered 33 candidate human-specific exon loss events, among which six exons passed stringent experimental filters for the complete loss of splicing activities in diverse human tissues. These events may result from human-specific deletion of genomic DNA, or small-scale sequence changes that inactivated splicing signals. The impact of human-specific exon loss events is predominantly regulatory. Three of the six events occurred in the 5′ untranslated region (5′-UTR) and affected cis-regulatory elements of mRNA translation. In SLC7A6, a gene encoding an amino acid transporter, luciferase reporter assays suggested that both a human-specific exon loss event and an independent human-specific single nucleotide substitution in the 5′-UTR increased mRNA translational efficiency. Our study provides novel insights into the molecular mechanisms and evolutionary consequences of exon loss during human evolution. PMID:25398629

Examining Behavioral Risk and Academic Performance for Students Transitioning from Elementary to Middle School

ERIC Educational Resources Information Center

Lane, Kathleen Lynne; Oakes, Wendy Peia; Carter, Erik W.; Messenger, Mallory

2015-01-01

We studied the transition from elementary to middle school for 74 fifth-grade students. Specifically, we examined how behavioral risk evident in the elementary years, as measured by the "Student Risk Screening Scale" (SRSS), impacts students transitioning from elementary to middle school. First, we examined how student risk status shifts…

Leaving No American Indian/Alaska Native Behind: Identifying Reading Strengths and Needs

ERIC Educational Resources Information Center

Buly, Marsha Riddle

2005-01-01

American Indian/Alaska Native (AI/AN) students are often labeled as struggling readers based on the results of large-scale standardized tests yet little empirical data about specific strengths and needs exists. In the present study we looked beyond high-stakes assessment to highlight reading strengths and needs for a group of fourth grade American…

Relationship between acne and psychological burden evaluated by ASLEC and HADS surveys in high school and college students from central China.

PubMed

Wen, Li; Jiang, Guangbin; Zhang, Xiaoming; Lai, Ruiping; Wen, Xiaoyi

2015-03-01

Previously, acne and its effects on psychological well-being have mostly been studied unilaterally in the western population. This study was aimed to investigate bidirectional relationship between acne and stress using Adolescent Self-Rating Life Events Check (ASLEC) and Hospital Anxiety and Depression Scale (HADS) surveys from inhabitants of central China. An on-line survey of 2,284 high school and college students from central China was conducted using three questionnaires posted on Chinese professional survey website, the Questionnaire Web. The prevalence and severity of acne were determined using the Pillsbury grading, whereas, the role of stress in acne formation was ascertained by the ASLEC scale. The HADS was employed to assess the psychological well-being. A total of 50.61 % of high school and college students in central China were found to be suffering from acne for more than 6 months, and 19.72 % of them were graded as having severe acne. Negative life events were found to accelerate the occurrence and exacerbation of the condition. Acne-affected groups showed significantly higher HADS-A (HADS-anxiety) and HADS-D (HADS-depression) scores than the controls (7.31 and 7.28 vs. 4.37 and 3.85, respectively; p < 0.01). Despite the apparent neglect of acne in Chinese high school and college students, a close bidirectional relationship was found to exist between stress and acne. It is incumbent on the healthcare professional to introduce school-based educational programs to help students with knowledge and management of acne and prevent the consequent psychological disorders.

Development of a database and processing method for detecting hematotoxicity adverse drug events.

PubMed

Shimai, Yoshie; Takeda, Toshihiro; Manabe, Shirou; Teramoto, Kei; Mihara, Naoki; Matsumura, Yasushi

2015-01-01

Adverse events are detected by monitoring the patient's status, including blood test results. However, it is difficult to identify all adverse events based on recognition by individual doctors. We developed a system that can be used to detect hematotoxicity adverse events according to blood test results recorded in an electronic medical record system. The blood test results were graded based on Common Terminology Criteria for Adverse Events (CTCAE) and changes in the blood test results (Up, Down, Flat) were assessed according to the variation in the grade. The changes in the blood test and injection data were stored in a database. By comparing the date of injection and start and end dates of the change in the blood test results, adverse events related to a designated drug were detected. Using this method, we searched for the occurrence of serious adverse events (CTCAE Grades 3 or 4) concerning WBC, ALT and creatinine related to paclitaxel at Osaka University Hospital. The rate of occurrence of a decreased WBC count, increased ALT level and increased creatinine level was 36.0%, 0.6% and 0.4%, respectively. This method is useful for detecting and estimating the rate of occurrence of hematotoxicity adverse drug events.

Laser versus stapler: outcomes in endoscopic repair of Zenker diverticulum.

PubMed

Adam, Stewart I; Paskhover, Boris; Sasaki, Clarence T

2012-09-01

To analyze a single surgeon's experience with endoscopic CO(2) laser and stapler repair of Zenker diverticulum (ZD) by comparing dysphagia and regurgitation outcomes. Retrospective chart review of 148 patient charts. Medical records of all patients receiving endoscopic repair of ZD with either CO(2) laser (61 patients) or stapler (67 patients) were reviewed. Additional data included demographics (age and sex), size (cm), preoperative and postoperative symptoms, need for revision, and complications. Symptoms of dysphagia were graded based on a modified Functional Oral Intake Scale 1 to 4 scale (1 = normal intake; 4 = severely limited/G-tube dependent). Regurgitation was also graded on a 1 to 4 scale (1 = no regurgitation; 4 = aspiration events). We noted no difference in patient age or defect size (laser, 3.26 cm; stapler, 3.53 cm; P .135). Significant differences were noted in return trips to the operating room for failed procedures (laser, 0; stapler, 7; P = .009), length of stay (laser, 3.19 days; stapler, 1.29 days; P < .001), time to oral intake (laser, 3.01 days; stapler, 1.22 days; P < .001). Significant improvement occurred in laser and staple patient symptom scales following surgery (P < .001). Laser dysphagia and regurgitation scores showed greater improvement when compared to stapler scores (P < .001). Endoscopic CO(2) laser and staple methods are effective in treating ZD. The laser can have greater efficacy and result in lower recurrence rates. Both methods are analyzed and compared. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

Violence from young women involuntarily admitted for severe drug abuse.

PubMed

Palmstierna, T; Olsson, D

2007-01-01

To simultaneously evaluate actuarial and dynamic predictors of severe in-patient violence among women involuntarily admitted for severe drug abuse. All patients admitted to special facilities for involuntary treatment of absconding-prone, previously violent, drug abusing women in Sweden were assessed with the Staff Observation Aggression Scale, revised. Actuarial data on risk factors for violence were collected and considered in an extended Cox proportional hazards model with multiple events and daily assessments of the Broset Violence Checklist as time-dependent covariates. Low-grade violence and being influenced by illicit drugs were the best predictors of severe violence within 24 h. Significant differences in risk for violence between different institutions were also found. In-patient violence risk is rapidly varying over time with being influenced by illicit drugs and exhibiting low-grade violence being significant dynamic predictors. Differences in violence between patients could not be explained by patient characteristics.

[Factors associated with the psychological impact of the Great East Japan earthquake on high school students 1 year and 4 months after the disaster].

PubMed

Funakoshi, Shunichi; Ohno, Takashi; Kodaka, Akira; Okuyama, Junko; Honda, Nami; Inoue, Takao; Sato, Yuki; Miyajima, Maki; Tomita, Hiroaki; Denda, Kenzou; Matsuoka, Hiroo

2014-01-01

The purpose of this study was to investigate factors associated with the psychological impact of the Great East Japan Earthquake on high school students 1 year and 4 months after the disaster, and clarify support needs of the students. In the outreach program for students of three high schools in coastal areas of southern Miyagi Prefecture, Japan, 1,973 students were surveyed after obtaining informed consent for participation. Questionnaires included: the Quick Inventory of Depressive Symptomatology (QIDS-J), Self-rating Anxiety Scale (SAS), Impact of Event Scale-revised (IES-R), and Connor-Davidson Resilience Scale (CD-RISC10). All scores were compared using SPSS 20.0 J between school grades, locations of the schools, and extent of damage due to the Great East Japan Earthquake. Our analysis showed a significant positive correlation between school grades and the level of anxiety. PTSR scores, but not anxiety nor depressive scores, of students whose lives have suffered extensive damage were significantly higher than those of students who have not. Students of high schools which have suffered extensive damage and use temporary buildings showed significantly higher levels of depression and anxiety, and significantly lower resilience, compared to students of high schools which were not damaged. Although previous findings demonstrated that younger children have a higher risk of being influenced by disasters, symptoms related to PTSR and depression were found frequently in the high school students as well. Among the high school students, our analysis showed a positive correlation between the level of anxiety and school grades, probably because the disaster has affected an influential and pivotal point in their lives.

Prolonged episodic Paleoproterozoic metamorphism in the Thelon Tectonic Zone, Canada: an in-situ SHRIMP/EPMA monazite geochronology study

NASA Astrophysics Data System (ADS)

Mitchell, Rhea; William, Davis; Robert, Berman; Sharon, Carr; Michael, Jercinovic

2017-04-01

The Thelon Tectonic zone (TTZ), Nunavut, Canada, is a >500km long geophysically, lithologically and structurally distinct N-NNE striking Paleoproterozoic boundary zone between the Slave and Rae Archean provinces. The TTZ has been interpreted as a ca. 2.0 Ga continental arc on the western edge of the Rae craton, that was deformed during collision with the Slave craton ca. 1.97 Ga. Alternatively, the Slave-Rae collision is interpreted as occurring during the 2.35 Ga Arrowsmith orogeny while the 1.9-2.0 Ga TTZ represents an intra-continental orogenic belt formed in previously thinned continental crust, postdating the Slave-Rae collision. The central part of the TTZ comprises three >100 km long, 10-20 km wide belts of ca. 2.0 Ga, mainly charnockitic plutonic rocks, and a ca. 1910 Ma garnet-leucogranite belt. Metamorphism throughout these domains is upper-amphibolite to granulite-facies, with metasedimentary rocks occurring as volumetrically minor enclaves and strands of migmatites. The Ellice River domain occurs between the western and central plutonic belts. It contains ca. 1950 Ma ultramafic to dacitic volcanic rocks and foliated Paleoproterozoic psammitic metasedimentary rocks at relatively lower grade with lower to middle amphibolite-facies metamorphic assemblages. In-situ U-Pb analyses of monazite using a combination of Sensitive High-Resolution Ion Microprobe (SHRIMP) and Electron Probe Microanalyzer (EPMA) were carried out on high-grade metasedimentary rocks from seventeen samples representing the eastern margin of the Slave Province and all major lithological domains of the TTZ. 207Pb/206Pb monazite ages from SHRIMP analysis form the foundation of this dataset, while EPMA ages are supplementary. The smaller <6µm spot size of EPMA allowed for further constraint on ages of micro-scale intra-crystalline domains in some samples. Monazite ages define four distinct Paleoproterozoic metamorphic events and one Archean metamorphic event at ca. 2580 Ma. The latter is recorded exclusively along the eastern margin of the Slave Province. Metamorphism ca. 1996 Ma, recorded in one high-grade gneiss from the central plutonic belt appears to reflect a regional contact metamorphism associated with intrusion of 2000 Ma plutons. Throughout the TTZ, a selection of monazite grains included in garnet porphyroblasts define a metamorphic event ca. 1962 Ma. One sample from the eastern margin of the Slave Province similarly records metamorphism at 1961 Ma in monazite grains in the matrix. This sample interestingly does not record the ca. 2580 Ma metamorphism typical of the Slave Province. The longest lived and most wide spread metamorphic event in the TTZ occurred ca. 1922 to 1883 Ma. This event is interpreted as the main compressional/collisional and anatectic event, with partial melting forming the extensive ca. 1910 Ma garnet-leucogranite belts. Three samples, located in the eastern margin of the Slave province, the Ellice River domain and the eastern plutonic belt, record younger metamorphism at ca. 1814 Ma. These events may represent post-collisional transpression coeval with movement along nearby regional-scale faults.

A Seven-Year Longitudinal Study of the Research Outcomes for the CASPER Physics Circus

NASA Astrophysics Data System (ADS)

Carmona-Reyes, Jorge; Land-Zandstra, Anna; Stark, Gary; Tarman, Lisa; Menefee, Matt; Wang, Li; Cook, Mike; Schmoke, Jimmy; Matthews, Lorin; Hyde, Truell

2014-10-01

The CASPER Physics Circus was specifically designed to increase student interest in science, technology, engineering and mathematics (STEM) careers where the current generation of scientists and engineers is rapidly approaching retirement age. The Physics Circus followed Waco and LaVega ISD students starting in the sixth grade and ending in the twelfth grade with this cohort group attending the Physics Circus event on the Baylor University campus, interacting with CASPER graduate students and participating in hands-on instructional activities. The event was designed as an informal learning environment intervention and operated under the discovery, project and guided-inquiry base framework wrapped in a learner-center ideology. Participating students were allowed to experiment with hands-on manipulatives while interacting with physicists, science educators and graduate students in both STEM and science education fields. Professional Development was also a part of the Physics Circus for all science teachers within the cohort. This paper presents the results of a seven-year longitudinal study on the Physics Circus and presents future plans to expand the program's effectiveness and impact.

Alienation, learning or grade orientation, and achievement as correlates of attitudes toward cheating.

PubMed

Roig, M; Neaman, M A

1994-06-01

154 undergraduate students were given Gardner and Melvin's Attitudes Toward Cheating Scale, Ray's General Alienation Scale, and Eison's Learning Orientation/Grade Orientation Scale. Scores indicating condemnatory (unfavorable) attitudes toward cheating were positively correlated with grade point average and negatively correlated with alienation. Our results are consistent with a previous study which showed an association between cheating and alienation.

An Analysis of Large-Scale Writing Assessments in Canada (Grades 5-8)

ERIC Educational Resources Information Center

Peterson, Shelley Stagg; McClay, Jill; Main, Kristin

2011-01-01

This paper reports on an analysis of large-scale assessments of Grades 5-8 students' writing across 10 provinces and 2 territories in Canada. Theory, classroom practice, and the contributions and constraints of large-scale writing assessment are brought together with a focus on Grades 5-8 writing in order to provide both a broad view of…

Objective Assessment of Isotretinoin-Associated Cheilitis: Isotretinoin Cheilitis Grading Scale

PubMed Central

Ornelas, Jennifer; Rosamilia, Lorraine; Larsen, Larissa; Foolad, Negar; Wang, Quinlu; Li, Chin-Shang; Sivamani, Raja K.

2016-01-01

Importance Isotretinoin remains an effective treatment for severe acne. Despite its effectiveness, it includes many side effects, of which cheilitis is the most common. Objective To develop an objective grading scale for assessment of isotretinoin-associated cheilitis, Design Cross-sectional clinical grading study. Setting UC Davis Dermatology clinic. Participants Subjects were older than 18 years old and actively treated with oral isotretinoin. Exposures Oral Isotretinoin. Main outcomes and Measures We developed an isotretinoin cheilitis grading scale (ICGS) incorporating the following four characteristics: erythema, scale/crust, fissures, and inflammation of the commissures. Three board-certified dermatologists independently graded photographs of the subjects. Results The Kendall’s coefficient of concordance (KCC) for the ICGS was 0.88 (p<0.0001). The Kendall’s coefficient was ≥ 0.72 (p<0.0001) for each of the four characteristics included in the grading scale. An image-based measurement for lip roughness statistically significantly correlated with the lip scale/crusting assessment (r = 0.52, p <0.05). Conclusion and Relevance The ICGS is reproducible and relatively simple to use. It can be incorporated as an objective tool to aid in the assessment of isotretinoin associated cheilitis. PMID:26395167

Developmental Change in the Influence of Domain-General Abilities and Domain-Specific Knowledge on Mathematics Achievement: An Eight-Year Longitudinal Study

PubMed Central

Geary, David C.; Nicholas, Alan; Li, Yaoran; Sun, Jianguo

2016-01-01

The contributions of domain-general abilities and domain-specific knowledge to subsequent mathematics achievement were longitudinally assessed (n = 167) through 8th grade. First grade intelligence and working memory and prior grade reading achievement indexed domain-general effects and domain-specific effects were indexed by prior grade mathematics achievement and mathematical cognition measures of prior grade number knowledge, addition skills, and fraction knowledge. Use of functional data analysis enabled grade-by-grade estimation of overall domain-general and domain-specific effects on subsequent mathematics achievement, the relative importance of individual domain-general and domain-specific variables on this achievement, and linear and non-linear across-grade estimates of these effects. The overall importance of domain-general abilities for subsequent achievement was stable across grades, with working memory emerging as the most important domain-general ability in later grades. The importance of prior mathematical competencies on subsequent mathematics achievement increased across grades, with number knowledge and arithmetic skills critical in all grades and fraction knowledge in later grades. Overall, domain-general abilities were more important than domain-specific knowledge for mathematics learning in early grades but general abilities and domain-specific knowledge were equally important in later grades. PMID:28781382

Gender Differences in Perceived Social Support and Stressful Life Events in Depressed Patients.

PubMed

Soman, S; Bhat, S M; Latha, K S; Praharaj, S K

2016-03-01

To study the gender differences in perceived social support and life events in patients with depression. A total of 118 patients aged 18 to 60 years, with depressive disorder according to the DSM-IV-TR, were evaluated using the Multidimensional Scale of Perceived Social Support and Presumptive Stressful Life Events Scale. The perceived social support score was significantly higher in males than females (p < 0.001). Males perceived significantly higher social support from friends than females (p < 0.001), whereas support from significant others was higher in females. There was a higher mean number of total life events as well as specific type of life events in males that became apparent after controlling for education (p < 0.05). Financial loss or problems was the most commonly reported life event in both males and females. Work-related problems were more commonly reported by males, whereas family and marital conflict were more frequently reported by females. Perceived social support and stressful life events were higher in males with depression than females.

Ratings of Severity of Life Events by Ninth-Grade Students.

ERIC Educational Resources Information Center

Hutton, Jerry B.; And Others

1987-01-01

Special education, basic, and honors ninth-grade students (n=60) rated the severity of stress for each of the life events on the Source of Stress Inventory (Chandler, 1981). There was a significant positive relationship between the Chandler rankings (teachers and mental health workers) and the student rankings. (Author/NB)

Cognitive and Life Event Correlates of Depressive Symptoms in Children.

ERIC Educational Resources Information Center

Mullins, Larry L.; And Others

The present study examines the relationship of various cognitive and life event variables to depressive symptoms in children. The variables studied are locus of control, interpersonal and impersonal problem-solving ability, and objective and subjective life stress. Subjects were 47 students in the fourth grade, 58 students in the fifth grade, and…

Building a knowledge base of severe adverse drug events based on AERS reporting data using semantic web technologies.

PubMed

Jiang, Guoqian; Wang, Liwei; Liu, Hongfang; Solbrig, Harold R; Chute, Christopher G

2013-01-01

A semantically coded knowledge base of adverse drug events (ADEs) with severity information is critical for clinical decision support systems and translational research applications. However it remains challenging to measure and identify the severity information of ADEs. The objective of the study is to develop and evaluate a semantic web based approach for building a knowledge base of severe ADEs based on the FDA Adverse Event Reporting System (AERS) reporting data. We utilized a normalized AERS reporting dataset and extracted putative drug-ADE pairs and their associated outcome codes in the domain of cardiac disorders. We validated the drug-ADE associations using ADE datasets from SIDe Effect Resource (SIDER) and the UMLS. We leveraged the Common Terminology Criteria for Adverse Event (CTCAE) grading system and classified the ADEs into the CTCAE in the Web Ontology Language (OWL). We identified and validated 2,444 unique Drug-ADE pairs in the domain of cardiac disorders, of which 760 pairs are in Grade 5, 775 pairs in Grade 4 and 2,196 pairs in Grade 3.

Incidence and risk factors of bleeding-related adverse events in patients with chronic lymphocytic leukemia treated with ibrutinib.

PubMed

Lipsky, Andrew H; Farooqui, Mohammed Z H; Tian, Xin; Martyr, Sabrina; Cullinane, Ann M; Nghiem, Khanh; Sun, Clare; Valdez, Janet; Niemann, Carsten U; Herman, Sarah E M; Saba, Nakhle; Soto, Susan; Marti, Gerald; Uzel, Gulbu; Holland, Steve M; Lozier, Jay N; Wiestner, Adrian

2015-12-01

Ibrutinib is associated with bleeding-related adverse events of grade ≤ 2 in severity, and infrequently with grade ≥ 3 events. To investigate the mechanisms of bleeding and identify patients at risk, we prospectively assessed platelet function and coagulation factors in our investigator-initiated trial of single-agent ibrutinib for chronic lymphocytic leukemia. At a median follow-up of 24 months we recorded grade ≤ 2 bleeding-related adverse events in 55% of 85 patients. No grade ≥ 3 events occurred. Median time to event was 49 days. The cumulative incidence of an event plateaued by 6 months, suggesting that the risk of bleeding decreases with continued therapy. At baseline, von Willebrand factor and factor VIII levels were often high and normalized on treatment. Platelet function measured via the platelet function analyzer (PFA-100™) was impaired in 22 patients at baseline and in an additional 19 patients on ibrutinib (often transiently). Collagen and adenosine diphosphate induced platelet aggregation was tested using whole blood aggregometry. Compared to normal controls, response to both agonists was decreased in all patients with chronic lymphocytic leukemia, whether on ibrutinib or not. Compared to untreated chronic lymphocytic leukemia patients, response to collagen showed a mild further decrement on ibrutinib, while response to adenosine diphosphate improved. All parameters associated with a significantly increased risk of bleeding-related events were present at baseline, including prolonged epinephrine closure time (HR 2.74, P=0.012), lower levels of von Willebrand factor activity (HR 2.73, P=0.009) and factor VIII (HR 3.73, P=0.0004). In conclusion, both disease and treatment-related factors influence the risk of bleeding. Patients at greater risk for bleeding of grade ≤ 2 can be identified by clinical laboratory tests and counseled to avoid aspirin, non-steroidal anti-inflammatory drugs and fish oils. ClinicalTrials.gov identifier NCT01500733. Copyright© Ferrata Storti Foundation.

Incidence and risk factors of bleeding-related adverse events in patients with chronic lymphocytic leukemia treated with ibrutinib

PubMed Central

Lipsky, Andrew H.; Farooqui, Mohammed Z.H.; Tian, Xin; Martyr, Sabrina; Cullinane, Ann M.; Nghiem, Khanh; Sun, Clare; Valdez, Janet; Niemann, Carsten U.; Herman, Sarah E. M.; Saba, Nakhle; Soto, Susan; Marti, Gerald; Uzel, Gulbu; Holland, Steve M.; Lozier, Jay N.; Wiestner, Adrian

2015-01-01

Ibrutinib is associated with bleeding-related adverse events of grade ≤2 in severity, and infrequently with grade ≥3 events. To investigate the mechanisms of bleeding and identify patients at risk, we prospectively assessed platelet function and coagulation factors in our investigator-initiated trial of single-agent ibrutinib for chronic lymphocytic leukemia. At a median follow-up of 24 months we recorded grade ≤2 bleeding-related adverse events in 55% of 85 patients. No grade ≥3 events occurred. Median time to event was 49 days. The cumulative incidence of an event plateaued by 6 months, suggesting that the risk of bleeding decreases with continued therapy. At baseline, von Willebrand factor and factor VIII levels were often high and normalized on treatment. Platelet function measured via the platelet function analyzer (PFA-100™) was impaired in 22 patients at baseline and in an additional 19 patients on ibrutinib (often transiently). Collagen and adenosine diphosphate induced platelet aggregation was tested using whole blood aggregometry. Compared to normal controls, response to both agonists was decreased in all patients with chronic lymphocytic leukemia, whether on ibrutinib or not. Compared to untreated chronic lymphocytic leukemia patients, response to collagen showed a mild further decrement on ibrutinib, while response to adenosine diphosphate improved. All parameters associated with a significantly increased risk of bleeding-related events were present at baseline, including prolonged epinephrine closure time (HR 2.74, P=0.012), lower levels of von Willebrand factor activity (HR 2.73, P=0.009) and factor VIII (HR 3.73, P=0.0004). In conclusion, both disease and treatment-related factors influence the risk of bleeding. Patients at greater risk for bleeding of grade ≤2 can be identified by clinical laboratory tests and counseled to avoid aspirin, non-steroidal anti-inflammatory drugs and fish oils. ClinicalTrials.gov identifier NCT01500733 PMID:26430171

[Study on the correlation among adolescents' family function, negative life events stress amount and suicide ideation].

PubMed

Zhang, Dongdong; Chen, Ling; Yin, Dan; Miao, Jinping; Sun, Yehuan

2014-07-01

To explore the correlation between suicide ideation and family function & negative life events, as well as other influential factors in adolescents, thus present a theoretical base for clinicians and school staff to develop intervention for those problems. By adopting current situation random sampling method, Self-Rating Idea of Suicide Scale, Adolescent Self-Rating Life Events Check List and Family APGAR Index were used to assess adolescents at random in a hygiene vocational school in Changzhou City, Jiangsu Province and a collage in Wuhu City, Anhui Province. 3700 questionnaires were granted, 3675 questionnaires were collected, among which 3620 were valid. Chi-square test, t-test, and univariate logistic regression were employed in univariate analysis, multivariate logistic regression was used in multivariate analysis. The detection rate of suicide ideation is 7.0%, and the top five suicide ideation characteristics were: poor academic performance (33.6%), serious family functional impairment (25.8%), lower-middle academic performance (11.7%), bad economic conditions (10.8%) and study in Grade Three (9.9%). Multiple logistic regression showed that the following three high-level stress amount in negative life events are most crucial for suicide ideation. They are "relationships" (OR = 1.135, 95% CI 1.071 - 1. 202), "academic pressure" (OR = 1.169, 95% CI 1.101 - 1.241), and "external events" (OR = 1.278, 95% CI 1.187 - 1.376). What' s more, the stress of attending higher grades (OR = 1.980, 95% CI 1.302 - 3.008), poor academic performance (OR = 7.206, 95% CI 1.745 - 9.789), moderate family functional impairment (OR = 2.562, 95% CI 1.527 - 2.892) and its serious level (OR = 8.287, 95% CI 3.154 - 6.917) are also influential factors for suicide ideation. Severe family functional impairment and high-level stress amount of negative life events produced the main factors of suicide ideation. Therefore, necessary and sufficient support should be given to adolescents by families and schools.

Combination of 595-nm pulsed dye laser, long-pulsed 755-nm alexandrite laser, and microdermabrasion treatment for keratosis pilaris: retrospective analysis of 26 Korean patients.

PubMed

Lee, Sang Ju; Choi, Min Ju; Zheng, Zhenlong; Chung, Won Soon; Kim, Young Koo; Cho, Sung Bin

2013-06-01

Keratosis pilaris (KP) has beenpresented as small keratotic follicular papules with or without surrounding erythema. Various treatments with laser or light therapy have been used for the management of KP with various clinical outcomes. In the present study, we investigated the efficacy and safety of a combination therapy for KP. A total of 29 anatomical sites with KP in 26 patients were treated using a 595-nm pulsed dye laser (PDL) with nonpurpuragenic fluences, a long-pulsed 755-nm alexandrite laser, and microdermabrasion. Clinical improvement was assessed by comparing preand posttreatment clinical photographs and patient satisfaction rates. Evaluation of the clinical results three months after the treatments showed that 12 of the 29 anatomical sites (41.4%) demonstrated Grade 3 clinical improvement, ten (34.5%) had Grade 2 clinical improvement, four (13.8%) showed Grade 1 improvement, and three (10.3%) showed Grade 4 improvement. We observed that KP lesions improved not only in erythema and skin texture, but also in brownish dyschromias. Potential adverse events were not observed, except prolonged posttherapy scaling. Our observations demonstrate that combination therapy using a 595-nm PDL, a long-pulsed 755-nm alexandrite laser, and microdermabrasion can have a positive therapeutic effect on KP.

Ultrasonographic evaluation of vincristine-induced gastric hypomotility and the prokinetic effect of mosapride in dogs.

PubMed

Tsukamoto, A; Ohno, K; Tsukagoshi, T; Maeda, S; Nakashima, K; Fukushima, K; Fujino, Y; Takeuchi, A; Tsujimoto, H

2011-01-01

Vincristine induces gastrointestinal motility disorders in humans. Adverse gastrointestinal events are commonly observed in dogs receiving vincristine. To evaluate gastric motility after vincristine administration in dogs and the prophylactic effect of a prokinetic agent, mosapride. Five healthy Beagle dogs. Five dogs received vincristine i.v. at a dosage of 0.75 mg/m(2). The motility index (MI) of the antral contraction was ultrasonographically evaluated 30 minutes postfeeding before administration of vincristine and for 6 days after vincristine treatment. After a 6-week washout period, the dogs received vincristine with mosapride (2 mg/kg p.o., q24h for 6 days), and the MI was re-evaluated. Adverse gastrointestinal events were evaluated according to the Veterinary Co-operative Group Common Terminology Criteria for Adverse Events (VCOG-CTCAE). After vincristine administration, a significant decrease (P < .05) in MI was observed on days 3 (6.64 ± 0.30) and 4 (8.02 ± 0.94), compared with pretreatment levels (10.00 ± 0.62). Gastrointestinal adverse events were observed in 4 dogs (grade 2 decreased appetite: 3 dogs; grade 1 vomiting: 2 dogs; and grade 1 diarrhea and grade 2 hematochezia: 1 dog). When mosapride citrate was administered with vincristine and for the next 5 days, no decrease in MI was observed. Furthermore, adverse gastrointestinal events occurred less frequently (grade 1 vomiting and grade 2 hematochezia in 1 dog each). Vincristine (0.75 mg/m(2)) induces gastric hypomotility in dogs. Preventive administration of mosapride citrate (2.0 mg/kg p.o., q24h) improves hypomotility and may decrease the adverse gastrointestinal effects of vincristine. Copyright © 2011 by the American College of Veterinary Internal Medicine.

IMPACT: Imaging and Molecular Markers for Patients with Lung Cancer: Approaches with Molecular Targets, Complementary/Innovative Treatments, and Therapeutic Modalities

DTIC Science & Technology

2016-04-01

Hypomagnesemia, Grade 3 in 1 patient • Hypokalemia, Grade 3 in 2 patient • Pneumonia , Grade 3 in 7 patients • Dehydration, Grade 3 in 3 patients. Once...improvements on lab- scale radiosynthesis (Fig. 9) so that it is readily scaled up and adopted by the cGMP manufacturing. We are working on an automated...reproducibly building at the nanometer scale , including the need for streamlined and “bottom-up” approaches for assembling nanoparticle architectures, the

Perioperative fever and outcome in surgical patients with aneurysmal subarachnoid hemorrhage.

PubMed

Todd, Michael M; Hindman, Bradley J; Clarke, William R; Torner, James C; Weeks, Julie B; Bayman, Emine O; Shi, Qian; Spofford, Christina M

2009-05-01

We examined the incidence of perioperative fever and its relationship to outcome among patients enrolled in the Intraoperative Hypothermia for Aneurysm Surgery Trial. One thousand patients with initial World Federation of Neurological Surgeons grades of I to III undergoing clipping of intracranial aneurysms after subarachnoid hemorrhage were randomized to intraoperative normothermia (36 degrees C-37 degrees C) or hypothermia (32.5 degrees C-33.5 degrees C). Fever (> or =38.5 degrees C) and other complications (including infections) occurring between admission and discharge (or death) were recorded. Functional and neuropsychologic outcomes were assessed 3 months postoperatively. The primary outcome variable for the trial was dichotomized Glasgow Outcome Scale (good outcome versus all others). Fever was reported in 41% of patients. In 97% of these, fever occurred in the postoperative period. The median time from surgery to first fever was 3 days. All measures of outcome were worse in patients who developed fever, even in those without infections or who were World Federation of Neurological Surgeons grade I. Logistic regression analyses were performed to adjust for differences in preoperative factors (e.g., age, Fisher grade, initial neurological status). This demonstrated that fever continued to be significantly associated with most outcome measures, even when infection was added to the model. An alternative stepwise model selection process including all fever-related measures from the preoperative and intraoperative period (e.g., hydrocephalus, duration of surgery, intraoperative blood loss) resulted in the loss of significance for dichotomized Glasgow Outcome Scale, but significant associations between fever and several other outcome measures remained. After adding postoperative delayed ischemic neurological deficits to the model, only worsened National Institutes of Health Stroke Scale score, Barthel Activities of Daily Living index, and discharge destination (home versus other) remained independently associated with fever. These findings suggest that fever is associated with worsened outcome in surgical subarachnoid hemorrhage patients, although, because the association between fever and the primary outcome measure for the trial is dependent on the covariates used in the analysis (particularly operative events and delayed ischemic neurological deficits), we cannot rule out the possibility that fever is a marker for other events. Only a formal trial of fever treatment or prevention can address this issue.

Sex, grade, and course differences in attitudes that are related to cognitive performance in secondary science

NASA Astrophysics Data System (ADS)

Levin, James; Seymour Fowler, H.

The purpose of this study was to collect and analyze data on sexual differences in secondary school students' attitudes towards science. Attitudinal differences were also analyzed for the independent variables of science programs and grade levels. Data were collected from 988 students using a modified version of the Fennema-Sherman Mathematics Attitude Scales to represent attitudes toward science. Reliabilities of the modified science subscales were all high ( > 0.83). Multivariate analysis of variance (MANOVA) was used to analyze the data for the main and interaction effects of the independent variables of sex (male, female), grade level (10th, 11th, 12th), and science program (advanced placement, academic, general, terminal). Significant differences (p < 0.05) were indicated for all main effects (sex, grade, science program). Interaction effects were not found. Mean separations for the various levels of sex, grade, and science program were performed for all attitudinal subscales. Females evidenced a significantly more positive attitude (p 0.01) than males on three subscales: Attitude Toward Success in Science Scale, Science as a Male Domain Scale, and Teacher Scale. Although not significant, males evidenced more positive attitudes on all the remaining five subscales. Eleventh graders evidenced significantly more positive attitudes than tenth graders on all but the Effectance Motivation Scale. Students in 11th grade had more positive attitudes than 12th-grade students on all scales but Science as a Male Domain Scale; however, these differences were not significant. Tenth graders differed significantly from 12th graders on three subscales; Science Usefulness Scale, Confidence in Learning Science Scale, and Teacher Scale. Positive attitudes decreased from advanced placement to terminal programs. Academic students did not differ significantly from general students except on the Father Scale; however, they were significantly different (more positive) from the terminal students for all subscales. General students were also significantly different from terminal students except on the three subscales of Attitudes Toward Success in Science, Science as a Male Domain, and Effectance Motivation.

[Specific clinical signs suggestive of endometriosis (excluding adenomyosis) and questionnaires of symptoms, pain and quality of life: CNGOF-HAS Endometriosis Guidelines].

PubMed

Huchon, C; Aubry, G; Ploteau, S; Fauconnier, A

2018-03-01

In case of consultation for chronic pelvic pain or suspicion of endometriosis, it is recommended to evaluate the pain (intensity, resonance) and to search out the evocative and localizing symptoms of endometriosis (Grade B). The main symptoms suggestive of endometriosis are: severe dysmenorrhea (NP2), deep dyspareunia (NP2), painful defecation during menstruation (NP2), urinary tract symptoms during menstruation (NP2) and infertility (NP2). In patients with chronic pelvic pain, it is recommended to search deep infiltrating endometriosis in patients with painful defecation during menstruation or severe deep dyspareunia (Grade B). It is recommended to search symptoms suggestive of sensitization in painful patients with endometriosis (Grade B). When suggestive symptoms of endometriosis are present, a directed gynecological examination is recommended, where possible, including examination of the posterior vaginal cul-de-sac (Grade C). In assessing pain intensity or evaluating analgesic effectiveness of a treatment, it is recommended to use a scale to measure the intensity of pain (Grade A). In the management of symptomatic endometriosis, it is recommended to evaluate the quality of life (Grade C). Copyright © 2018 Elsevier Masson SAS. All rights reserved.

The Longitudinal Structure of General and Specific Anxiety Dimensions in Children: Testing a Latent Trait-State-Occasion Model

ERIC Educational Resources Information Center

Olatunji, Bunmi O.; Cole, David A.

2009-01-01

In an 8-wave, 4-year longitudinal study, 787 children (Grades 3-6) completed the Revised Children's Manifest Anxiety Scale (C. R. Reynolds & B. O. Richmond, 1985), a measure of the Physiological Reactivity, Worry-Oversensitivity, and Social Alienation dimensions of anxiety. A latent variable (trait-state-occasion) model and a latent growth curve…

Grade 1 to 6 Thai Students' Existing Ideas about Energy

ERIC Educational Resources Information Center

Yuenyong, Chokchai; Yuenyong, Jirakarn

2007-01-01

This study explored 30 Grade 1 to 6 (6-12 years old) Thai students' existing ideas about energy. The study employed the Interview about Event (IAE) approach. During IAE, the cards of an event or things were showed to students in order to probe their views of energy concepts. Findings indicated that young students held various alternative…

Toxicity Assessment of Pelvic Intensity-Modulated Radiotherapy With Hypofractionated Simultaneous Integrated Boost to Prostate for Intermediate- and High-Risk Prostate Cancer

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

McCammon, Robert; Rusthoven, Kyle E.; Kavanagh, Brian

Purpose: To evaluate the toxicity of pelvic intensity-modulated radiotherapy (IMRT) with hypofractionated simultaneous integrated boost (SIB) to the prostate for patients with intermediate- to high-risk prostate cancer. Methods and Materials: A retrospective toxicity analysis was performed in 30 consecutive patients treated definitively with pelvic SIB-IMRT, all of whom also received androgen suppression. The IMRT plans were designed to deliver 70 Gy in 28 fractions (2.5 Gy/fraction) to the prostate while simultaneously delivering 50.4 Gy in 28 fractions (1.8 Gy/fraction) to the pelvic lymph nodes. The National Cancer Institute Common Terminology Criteria for Adverse Events, version 3.0, was used to scoremore » toxicity. Results: The most common acute Grade 2 events were cystitis (36.7%) and urinary frequency/urgency (26.7%). At a median follow-up of 24 months, late toxicity exceeding Grade 2 in severity was uncommon, with two Grade 3 events and one Grade 4 event. Grade 2 or greater acute bowel toxicity was associated with signficantly greater bowel volume receiving {>=}25 Gy (p = .04); Grade 2 or greater late bowel toxicity was associated with a higher bowel maximal dose (p = .04) and volume receiving {>=}50 Gy (p = .02). Acute or late bladder and rectal toxicity did not correlate with any of the dosimetric parameters examined. Conclusion: Pelvic IMRT with SIB to the prostate was well tolerated in this series, with low rates of Grade 3 or greater acute and late toxicity. SIB-IMRT combines pelvic radiotherapy and hypofractionation to the primary site and offers an accelerated approach to treating intermediate- to high-risk disease. Additional follow-up is necessary to fully define the long-term toxicity after hypofractionated, whole pelvic treatment combined with androgen suppression.« less

North American extreme temperature events and related large scale meteorological patterns: A review of statistical methods, dynamics, modeling, and trends

DOE PAGES

Grotjahn, Richard; Black, Robert; Leung, Ruby; ...

2015-05-22

This paper reviews research approaches and open questions regarding data, statistical analyses, dynamics, modeling efforts, and trends in relation to temperature extremes. Our specific focus is upon extreme events of short duration (roughly less than 5 days) that affect parts of North America. These events are associated with large scale meteorological patterns (LSMPs). Methods used to define extreme events statistics and to identify and connect LSMPs to extreme temperatures are presented. Recent advances in statistical techniques can connect LSMPs to extreme temperatures through appropriately defined covariates that supplements more straightforward analyses. A wide array of LSMPs, ranging from synoptic tomore » planetary scale phenomena, have been implicated as contributors to extreme temperature events. Current knowledge about the physical nature of these contributions and the dynamical mechanisms leading to the implicated LSMPs is incomplete. There is a pressing need for (a) systematic study of the physics of LSMPs life cycles and (b) comprehensive model assessment of LSMP-extreme temperature event linkages and LSMP behavior. Generally, climate models capture the observed heat waves and cold air outbreaks with some fidelity. However they overestimate warm wave frequency and underestimate cold air outbreaks frequency, and underestimate the collective influence of low-frequency modes on temperature extremes. Climate models have been used to investigate past changes and project future trends in extreme temperatures. Overall, modeling studies have identified important mechanisms such as the effects of large-scale circulation anomalies and land-atmosphere interactions on changes in extreme temperatures. However, few studies have examined changes in LSMPs more specifically to understand the role of LSMPs on past and future extreme temperature changes. Even though LSMPs are resolvable by global and regional climate models, they are not necessarily well simulated so more research is needed to understand the limitations of climate models and improve model skill in simulating extreme temperatures and their associated LSMPs. Furthermore, the paper concludes with unresolved issues and research questions.« less

Gaining Ground in the Middle Grades: Why Some Schools Do Better. A Large-Scale Study of Middle Grades Practices and Student Outcomes. Technical Appendix B

ERIC Educational Resources Information Center

EdSource, 2010

2010-01-01

This appendix focuses on the descriptive statistics of the middle study schools that participated in the "Gaining Ground in the Middle Grades: Why Some Schools Do Better. A Large-Scale Study of Middle Grades Practices and Student Outcomes. Initial Research." This appendix contains the following figures: (1) Student…

Readability of Online Patient Educational Resources Found on NCI-Designated Cancer Center Web Sites.

PubMed

Rosenberg, Stephen A; Francis, David; Hullett, Craig R; Morris, Zachary S; Fisher, Michael M; Brower, Jeffrey V; Bradley, Kristin A; Anderson, Bethany M; Bassetti, Michael F; Kimple, Randall J

2016-06-01

The NIH and Department of Health & Human Services recommend online patient information (OPI) be written at a sixth grade level. We used a panel of readability analyses to assess OPI from NCI-Designated Cancer Center (NCIDCC) Web sites. Cancer.gov was used to identify 68 NCIDCC Web sites from which we collected both general OPI and OPI specific to breast, prostate, lung, and colon cancers. This text was analyzed by 10 commonly used readability tests: the New Dale-Chall Readability Formula, Flesch Reading Ease scale, Flesch-Kinaid Grade Level, FORCAST scale, Fry Readability Graph, Simple Measure of Gobbledygook test, Gunning Frequency of Gobbledygook index, New Fog Count, Raygor Readability Estimate Graph, and Coleman-Liau Index. We tested the hypothesis that the readability of NCIDCC OPI was written at the sixth grade level. Secondary analyses were performed to compare readability of OPI between comprehensive and noncomprehensive centers, by region, and to OPI produced by the American Cancer Society (ACS). A mean of 30,507 words from 40 comprehensive and 18 noncomprehensive NCIDCCs was analyzed (7 nonclinical and 3 without appropriate OPI were excluded). Using a composite grade level score, the mean readability score of 12.46 (ie, college level: 95% CI, 12.13-12.79) was significantly greater than the target grade level of 6 (middle-school: P<.001). No difference between comprehensive and noncomprehensive centers was identified. Regional differences were identified in 4 of the 10 readability metrics (P<.05). ACS OPI provides easier language, at the seventh to ninth grade level, across all tests (P<.01). OPI from NCIDCC Web sites is more complex than recommended for the average patient. Copyright © 2016 by the National Comprehensive Cancer Network.

Impact of chemotherapy-induced neutropenia on quality of life: a prospective pilot investigation.

PubMed

Fortner, Barry V; Schwartzberg, Lee; Tauer, Kurt; Houts, Arthur C; Hackett, James; Stolshek, Brad S

2005-07-01

In this exploratory, prospective study evaluated quality of life (QoL) changes in patients with diverse cancers during the first cycle of myelosuppressive chemotherapy. Of 80 patients enrolled, 71 were observed during one of five chemotherapy regimens: docetaxel; CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone); carboplatin-paclitaxel; carboplatin-docetaxel; and carboplatin-gemcitabine. Complete blood counts were taken weekly. QoL and symptom burden measures were administered at baseline and throughout the cycle, and included SF-36, Cancer Care Monitor (CCM), Hospital Anxiety and Depression Scale (HADS), and Psychosocial Adjustment to Illness Scale (PAIS). Using generalized estimating equations, we modeled the change in each measure from baseline to the end of each week using the following covariates: baseline QoL measure, baseline SF-36 Physical and Mental Health Summary scores, sex, age, cycle week, grade 4 neutropenia any time in the past 7 days (yes/no), and the interaction of the latter two covariates. Of the 71 patients observed, 33 developed grade 4 neutropenia during the first 2 weeks. Changes from baseline in SF-36 Bodily Pain, HADS Anxiety, and PAIS Social Environment scores were significantly less favorable (P<0.05) when patients experienced grade 4 neutropenia any time in the past 7 days compared to when they did not (grade 0-3). A similar, but non-significant, trend was also observed for 12 other QoL measures. QoL may be adversely affected up to 7 days after patients experience grade 4 (versus grade 0-3) neutropenia. Such findings need to be examined further in studies with adequate statistical power to test a priori hypotheses regarding specific QoL measures.

Inter-Rater Reliability of the Modified Ashworth Scale and Modified Modified Ashworth Scale in Assessing Poststroke Elbow Flexor Spasticity

ERIC Educational Resources Information Center

Kaya, Taciser; Goksel Karatepe, Altinay; Gunaydin, Rezzan; Koc, Aysegul; Altundal Ercan, Ulku

2011-01-01

The Modified Ashworth Scale (MAS) is commonly used in clinical practice for grading spasticity. However, it was modified recently by omitting grade "1+" of the MAS and redefining grade "2". The aim of this study was to investigate the inter-rater reliability of MAS and modified MAS (MMAS) for the assessment of poststroke elbow flexor spasticity.…

Weekly docetaxel versus CMF as adjuvant chemotherapy for elderly breast cancer patients: safety data from the multicentre phase 3 randomised ELDA trial.

PubMed

Nuzzo, Francesco; Morabito, Alessandro; De Maio, Ermelinda; Di Rella, Francesca; Gravina, Adriano; Labonia, Vincenzo; Landi, Gabriella; Pacilio, Carmen; Piccirillo, Maria Carmela; Rossi, Emanuela; D'Aiuto, Giuseppe; Thomas, Renato; Gori, Stefania; Colozza, Mariantonietta; De Placido, Sabino; Lauria, Rossella; Signoriello, Giuseppe; Gallo, Ciro; Perrone, Francesco; de Matteis, Andrea

2008-05-01

Within an ongoing multicentre phase 3 randomised trial (ELDA, cancertrials.gov ID: NCT00331097), early breast cancer patients, 65-79 years old, with average to high risk of recurrence, are randomly assigned to receive CMF (cyclophosphamide 600 mg/m2, methotrexate 40 mg/m2, fluorouracil 600 mg/m2, days 1-8) or docetaxel (35 mg/m2 days 1-8-15), every 4 weeks. Here we report an unplanned safety analysis prompted by an amendment introducing creatinine clearance as a tool to adjust methotrexate dose. Before such change, 101 patients with a median age of 70 were randomly assigned CMF (53 patients) or docetaxel (48 patients). At least one grades 3-4 toxic event of any type was reported in 40 (75.5%) and 19 (39.6%) patients with CMF and docetaxel, respectively (p=0.0002). Grades 3-4 hematological events were observed in 37 (69.8%) vs. 4 (8.3%) cases (p<0.0001) and grades 3-4 non-hematological toxicity in 12 (22.6%) vs. 15 (31.2%) patients (p=0.11), with CMF and docetaxel, respectively. A higher incidence of anemia, neutropenia, thrombocytopenia and febrile neutropenia was reported with CMF. Constipation, mucositis, nausea and vomiting were more common with CMF; diarrhoea, abdominal pain, dysgeusia, neuropathy and liver toxicity were more frequent with docetaxel. No significant interaction was found between the occurrence of severe toxicity and baseline variables, including creatinine clearance and geriatric activity scales. In conclusion, weekly docetaxel appears to be less toxic than CMF in terms of hematological toxicity.

Evaluation of an oral health scale of infectious potential using a telematic survey of visual diagnosis

PubMed Central

Relvas, Marta; Limeres, Jacobo; Cabral, Cristina; Velazco, Corsina; Diz, Pedro

2013-01-01

Objective: To compare the results of a subjective estimation of oral health through review of a set of intraoral photographs with those of an objective oral health scale of infectious potential. Method: The pool of patients was made up of 100 adults. Using an infectious-potential scale based on dental and periodontal variables, we assigned 1 of the 4 grades of the scale (range, 0 to 3; 0 corresponds to an excellent oral health status and 3 to the poorest oral health status) to each subject. A total of 20 representative subjects were selected from the pool of patients, 5 subjects for each one of the grades of the scale, and a standardized photographic record was made. One thousand dentists practicing in Spain were sent the survey by e-mail and 174 completed forms were received. We then calculated the concordance of the oral health status indicated by the respondents after visualising the photographs on comparison with the results of the oral health scale of infectious potential; concordance was termed correct grade allocation (CGA). Results: The majority of respondents (69.1%) achieved a CGA in 8 to 12 cases and none achieved more than 15 CGAs. The poorest CGA rates were found with grades 1 and 2, with a mean of 1.74 ± 1.09 and 1.87 ± 1.18, respectively, out of a maximum of 5. The concordance in terms of CGA was high for grade 0 (70.5%), very low for grade 1 (10.8%), low for grade 2 (37.3%), and moderate for grade 3 (42.6%). Conclusion: In comparison with visual examination of the oral cavity, the use of objective scale that establishes a reliable diagnosis of oral health in terms of infectious potential was found to be advantageous. Key words:Diagnosis, intraoral photographies, oral health scale, objective estimation, visual examination. PMID:23524432

Effect of Kangfuxin Solution on Chemo/Radiotherapy-Induced Mucositis in Nasopharyngeal Carcinoma Patients: A Multicenter, Prospective Randomized Phase III Clinical Study

PubMed Central

Luo, Yangkun; Feng, Mei; Fan, Zixuan; Zhu, Xiaodong; Jin, Feng; Li, Rongqing; Wu, Jingbo; Yang, Xia; Jiang, Qinghua; Bai, Hongfang; Huang, Yecai; Lang, Jinyi

2016-01-01

Objective. To evaluate the efficacy and safety of Kangfuxin Solution, a pure Chinese herbal medicine, on mucositis induced by chemoradiotherapy in nasopharyngeal carcinoma patients. Methods. A randomized, parallel-group, multicenter clinical study was performed. A total of 240 patients were randomized to receive either Kangfuxin Solution (test group) or compound borax gargle (control group) during chemoradiotherapy. Oral mucositis, upper gastrointestinal mucositis, and oral pain were evaluated by Common Terminology Criteria for Adverse Events (CTCAE) v3.0 and the Verbal Rating Scale (VRS). Results. Of 240 patients enrolled, 215 were eligible for efficacy analysis. Compared with the control group, the incidence and severity of oral mucositis in the test group were significantly reduced (P = 0.01). The time to different grade of oral mucositis occurrence (grade 1, 2, or 3) was longer in test group (P < 0.01), and the accumulated radiation dose was also higher in test group comparing to the control group (P < 0.05). The test group showed lower incidence of oral pain and gastrointestinal mucositis than the control group (P < 0.01). No significant adverse events were observed. Conclusion. Kangfuxin Solution demonstrated its superiority to compound borax gargle on mucositis induced by chemoradiotherapy. Its safety is acceptable for clinical application. PMID:27375766

Pre-Himalayan tectono-magmatic imprints in the Darjeeling-Sikkim Himalaya (DSH) constrained by 40Ar/39Ar dating of muscovite

NASA Astrophysics Data System (ADS)

Acharyya, Subhrangsu K.; Ghosh, Subhajit; Mandal, Nibir; Bose, Santanu; Pande, Kanchan

2017-09-01

The Lower Lesser Himalayan Sequence (L-LHS) in Darjeeling-Sikkim Himalaya (DSH) displays intensely deformed, low-grade meta-sedimentary rocks, frequently intervened by granite intrusives of varied scales. The principal motivation of our present study is to constrain the timing of this granitic event. Using 40Ar/39Ar geochronology, we dated muscovite from pegmatites emplaced along the earliest fabric in the low grade Daling phyllite, and obtained ∼1850 Ma Ar-Ar muscovite cooling age, which is broadly coeval with crystallization ages of Lingtse granite protolith (e.g., 1800-1850 Ma U-Pb zircon ages) reported from the L-LHS. We present here field observations to show the imprints (tectonic fabrics) of multiple ductile deformation episodes in the LHS terrain. The earliest penetrative fabric, axial planar to N-S trending reclined folds, suggest a regional tectonic event in the DSH prior to the active phase of Indo-Asia collision. Based on the age of granitic bodies and their structural correlation with the earliest fabric, we propose that the L-LHS as a distinct convergent tectono-magmatic belt, delineating the northern margin of Indian craton in the framework of the ∼1850 Ma Columbia supercontinent assembly.

The Application of the Novel Grading Scale (Lawton-Young Grading System) to Predict the Outcome of Brain Arteriovenous Malformation.

PubMed

Hafez, Ahmad; Koroknay-Pál, Päivi; Oulasvirta, Elias; Elseoud, Ahmed Abou; Lawton, Michael T; Niemelä, Mika; Laakso, Aki

2018-05-04

A supplementary grading scale (Supplemented Spetzler-Martin grade, Supp-SM) was introduced in 2010 as a refinement of the SM system to improve preoperative risk prediction of brain arteriovenous malformations (AVMs). To determine the ability to predict surgical outcomes using the Supp-SM grading scale. This retrospective study was conducted on 200 patients admitted to the Helsinki University Hospital between 2000 and 2014. The validity of the Supp-SM and SM grading systems was compared using the area under the receiver operating characteristic (AUROC) curves, with respect to the change between preoperative and early (3-4 mo) as well as final postoperative modified Rankin Scale (mRS) scores. The performance of the Supp-SM was superior to that of the SM grading scale in the early follow-up (3-4 mo): AUROC = 0.57 (95% confidence interval [CI]: 0.49-0.65) for SM and AUROC = 0.67 (95% CI: 0.60-0.75) for Supp-SM. The Supp-SM performance continued improving over SM at the late follow-up: AUROC = 0.63 (95% CI: 0.55-0.71) for SM and AUROC = 0.70 (95% CI: 0.62-0.77) for Supp-SM. The perforating artery supply, which is not part of either grading system, plays an important role in the early follow-up outcome (P = .008; odds ratio: 2.95; 95% CI: 1.32-6.55) and in the late follow-up outcome (P < .001; odds ratio: 5.89; 95% CI: 2.49-13.91). The Supp-SM grading system improves the outcome prediction accuracy and is a feasible alternative to the SMS, even for series with higher proportion of high-grade AVMs. However, perforators play important role on the outcome.

Synoptic and Mesoscale Climatologies of Severe Local Storms for the American Midwest.

NASA Astrophysics Data System (ADS)

Arnold, David Leslie

This study investigates the synoptic and mesoscale environments associated with severe local storms (SELS) in the heart of the American Midwest. This region includes west-central Illinois, most of Indiana, the extreme western counties of Ohio, and a small part of northeastern Kentucky. The primary objectives of this study are to determine the surface and middle-tropospheric synoptic circulation patterns and thermodynamic and kinematic environments associated with SELS event types (tornadoes, hail, severe straight -line winds), and to assess the degree to which the synoptic circulation patterns and meso-beta scale kinematic and thermodynamic climatology of the Midwest differ from that of the Great Plains. A secondary objective is to investigate the possible role that land-surface atmosphere interactions play in the spatial distribution of SELS. A new subjective synoptic typing scheme is developed and applied to determine the synoptic-scale circulation patterns associated with the occurrence of SELS event types. This scheme is based on a combination of surface and middle -tropospheric patterns. Thermodynamic and kinematic parameters are analyzed to determine meso-scale environments favorable for the development of SELS. Results indicate that key synoptic-scale circulation patterns, and specific ranges of thermodynamic and kinematic parameters are related to specific SELS event types. These circulation types and ranges of thermodynamic and kinematic parameters may be used to help improve the medium-range forecasting of severe local storms. Results of the secondary objective reveal that the spatial distribution of SELS events is clustered within the study region, and most occur under a negative climate division-level soil moisture gradient; that is, a drier upwind division than the division in which the event occurs. Moreover, the spatial distribution of SELS events is compared against a map of soil types and vegetation. The resulting distribution depicts a visual correlation between the primary soil and vegetative boundaries and clusters of SELS. This supports the likely role of meso-scale land-surface-atmosphere interactions in severe weather development for humid lowlands of the Midwest United States.

Reduced autobiographical memory specificity in bereaved Afghan adolescents.

PubMed

Neshat Doost, Hamid Taher; Yule, William; Kalantari, Mehrdad; Rezvani, Sayed Rohollah; Dyregrov, Atle; Jobson, Laura

2014-01-01

This study investigated the effect of bereavement (father death due to war in Afghanistan) on autobiographical memory specificity in Afghan adolescents living in Iran. Participants consisted of bereaved (n=70) and non-bereaved (n=33) Afghan adolescents. The measures included Farsi versions of the Autobiographical Memory Test, Mood and Feeling Questionnaire, Revised Children's Manifest Anxiety Scale, and Impact of Event Scale. Results indicated that the bereaved group retrieved a significantly lower proportion of specific memories and a significantly greater proportion of extended and categoric memories than the non-bereaved group. Additionally, depression symptoms and reduced autobiographical memory specificity were significantly correlated. These findings suggest that bereaved adolescents have impaired autobiographical memory specificity.

Gastrointestinal and hematologic adverse events after administration of vincristine, cyclophosphamide, and doxorubicin in dogs with lymphoma that underwent a combination multidrug chemotherapy protocol.

PubMed

Tomiyasu, Hirotaka; Takahashi, Masashi; Fujino, Yasuhito; Ohno, Koichi; Tsujimoto, Hajime

2010-11-01

The present study aimed to objectively evaluate the adverse events after the administration of chemotherapeutic agents used in the University of Wisconsin (UW)-Madison chemotherapy protocol (UW-25) for canine lymphoma, using the Veterinary Co-operative Oncology Group common terminology criteria for adverse events (VCOG-CTCAE). The medical records of 40 dogs with multicentric high-grade lymphoma that underwent UW-25 were reviewed. Gastrointestinal adverse events of grade 2 and above and blood/bone marrow adverse events of all grades were evaluated. Gastrointestinal adverse events occurring at least once during the entire period of UW-25 were observed in 50% (20/40), 17.9% (7/39), and 8.1% (3/37) of the dogs after the administration of vincristine (VCR), cyclophosphamide (CPA), and doxorubicin (DXR), respectively. Blood/bone marrow adverse events occurring at least once during UW-25 were observed in 57.5% (23/40), 41% (16/39), and 8.1% (3/37) of the dogs after the administration of VCR, CPA, and DXR, respectively. The rate of patients that experienced gastrointestinal adverse events was higher after the first administration of VCR than after the first administration of DXR. Findings obtained in this study will be helpful in predicting the adverse events that could occur when dogs with lymphoma are treated with UW-25.

Herbalife hepatotoxicity: Evaluation of cases with positive reexposure tests.

PubMed

Teschke, Rolf; Frenzel, Christian; Schulze, Johannes; Schwarzenboeck, Alexander; Eickhoff, Axel

2013-07-27

To analyze the validity of applied test criteria and causality assessment methods in assumed Herbalife hepatotoxicity with positive reexposure tests. We searched the Medline database for suspected cases of Herbalife hepatotoxicity and retrieved 53 cases including eight cases with a positive unintentional reexposure and a high causality level for Herbalife. First, analysis of these eight cases focused on the data quality of the positive reexposure cases, requiring a baseline value of alanine aminotransferase (ALT) < 5 upper limit of normal (N) before reexposure, with N as the upper limit of normal, and a doubling of the ALT value at reexposure as compared to the ALT value at baseline prior to reexposure. Second, reported methods to assess causality in the eight cases were evaluated, and then the liver specific Council for International Organizations of Medical Sciences (CIOMS) scale validated for hepatotoxicity cases was used for quantitative causality reevaluation. This scale consists of various specific elements with scores provided through the respective case data, and the sum of the scores yields a causality grading for each individual case of initially suspected hepatotoxicity. Details of positive reexposure test conditions and their individual results were scattered in virtually all cases, since reexposures were unintentional and allowed only retrospective rather than prospective assessments. In 1/8 cases, criteria for a positive reexposure were fulfilled, whereas in the remaining cases the reexposure test was classified as negative (n = 1), or the data were considered as uninterpretable due to missing information to comply adequately with the criteria (n = 6). In virtually all assessed cases, liver unspecific causality assessment methods were applied rather than a liver specific method such as the CIOMS scale. Using this scale, causality gradings for Herbalife in these eight cases were probable (n = 1), unlikely (n = 4), and excluded (n = 3). Confounding variables included low data quality, alternative diagnoses, poor exclusion of important other causes, and comedication by drugs and herbs in 6/8 cases. More specifically, problems were evident in some cases regarding temporal association, daily doses, exact start and end dates of product use, actual data of laboratory parameters such as ALT, and exact dechallenge characteristics. Shortcomings included scattered exclusion of hepatitis A-C, cytomegalovirus and Epstein Barr virus infection with only globally presented or lacking parameters. Hepatitis E virus infection was considered in one single patient and found positive, infections by herpes simplex virus and varicella zoster virus were excluded in none. Only one case fulfilled positive reexposure test criteria in initially assumed Herbalife hepatotoxicity, with lower CIOMS based causality gradings for the other cases than hitherto proposed.

Pain is Associated With Poorer Grades, Reduced Emotional Well-Being, and Attention Problems in Adolescents.

PubMed

Voerman, Jessica S; de Klerk, Cora; Vander Heyden, Karin M; Passchier, Jan; Idema, Wietske; Timman, Reinier; Jolles, Jelle

2017-01-01

The purpose of the present study was to determine whether pain is associated with specific aspects of academic performance, that is, poorer grades, and with factors critical to an adolescent's academic performance, that is, decreased emotional well-being and attention problems. We hypothesized that the association between pain and school grades is mediated by emotional well-being and attention problems. In a cross-sectional study, we collected data from 2215 pupils, ages 12 to 13 years. Pain (no, occasional, and frequent), emotional well-being, and attention problems were measured with self-rating scales. Dutch, English, and math grades were taken as an index of academic performance. Frequent pain in adolescents was associated with poorer grades (Dutch P=0.02 and math P=0.01). Both occasional and frequent pain were associated with reduced emotional well-being (P<0.001) and reduced self-reported attention (P<0.001). However, the association between pain and lower grades disappeared when controlling for emotional well-being and attention. The present study shows that the association between pain and Dutch adolescents grades is mediated by reduced emotional well-being and attention problems. The association between pain and math grades is mediated by emotional problems. The results suggest that an intervention targeted at pain in adolescents could have a positive effect on their emotional well-being, attention, and school performance.

Power Doppler ultrasound of rheumatoid synovitis: quantification of vascular signal and analysis of interobserver variability.

PubMed

Kamishima, Tamotsu; Tanimura, Kazuhide; Henmi, Mihoko; Narita, Akihiro; Sakamoto, Fumihiko; Terae, Satoshi; Shirato, Hiroki

2009-05-01

The objective of this study was to assess interobserver uncertainties in power Doppler (PD) examination of the fingers of patients with rheumatoid arthritis (RA), by separating the source of the discrepancy into (1) acquisition of the images and (2) criteria for assessment of the images. Twenty patients who had been diagnosed with RA were enrolled in this study. Ultrasound examinations were performed by one inexperienced and two experienced sonographers. Interobserver variation was measured using a conventional semiquantitative image grading scale. Interobserver variation of the quantitative PD (QPD) index (the summation of the colored pixels in a region of interest) was also assessed. The agreement was higher between the two experienced sonographers (kappa value of 0.8) than between experienced and inexperienced sonographers (kappa value, 0.6-0.7) in the semiquantitative image grading scale. Results suggest that the difference in the assessment on the image grading scale was due more to the difference in the acquisition of the images than to variations in the grading criteria between sonographers. An excellent relationship was noted between the image grading scale and the QPD index for Doppler signal with a Spearman's coefficient of rank correlation of 0.83 (P < 0.0001). Interobserver discrepancies in the image grading and QPD index methods were due more to the difference in the acquisition of the image than to the grading criteria used. The QPD index seems to be as reliable as the image grading scale with reasonable interobserver agreement between experienced sonographers.

Spider Transcriptomes Identify Ancient Large-Scale Gene Duplication Event Potentially Important in Silk Gland Evolution

PubMed Central

Clarke, Thomas H.; Garb, Jessica E.; Hayashi, Cheryl Y.; Arensburger, Peter; Ayoub, Nadia A.

2015-01-01

The evolution of specialized tissues with novel functions, such as the silk synthesizing glands in spiders, is likely an influential driver of adaptive success. Large-scale gene duplication events and subsequent paralog divergence are thought to be required for generating evolutionary novelty. Such an event has been proposed for spiders, but not tested. We de novo assembled transcriptomes from three cobweb weaving spider species. Based on phylogenetic analyses of gene families with representatives from each of the three species, we found numerous duplication events indicative of a whole genome or segmental duplication. We estimated the age of the gene duplications relative to several speciation events within spiders and arachnids and found that the duplications likely occurred after the divergence of scorpions (order Scorpionida) and spiders (order Araneae), but before the divergence of the spider suborders Mygalomorphae and Araneomorphae, near the evolutionary origin of spider silk glands. Transcripts that are expressed exclusively or primarily within black widow silk glands are more likely to have a paralog descended from the ancient duplication event and have elevated amino acid replacement rates compared with other transcripts. Thus, an ancient large-scale gene duplication event within the spider lineage was likely an important source of molecular novelty during the evolution of silk gland-specific expression. This duplication event may have provided genetic material for subsequent silk gland diversification in the true spiders (Araneomorphae). PMID:26058392

Examining Fifth-Grade Students' Level of Associating Some Daily-Life Events with "Changes of State"

ERIC Educational Resources Information Center

Cengiz, Ekrem; Ayvaci, Hakan Sevki

2017-01-01

This study aims to examine fifth grade students' level of associating daily life events with the subject "changes of state" in the science curriculum. Among the qualitative research methods, special case method was used in the study. Seven open-ended questions about the changing states of matter were used for data collection. These…

Utilization of Genomic Signatures to Direct Use of Primary Chemotherapy in Early Stage Breast Cancer

DTIC Science & Technology

2012-07-01

those seen with standard dose AC and TC  By chemotherapy:  AC: 11 of 19 with grade 3 or 4 adverse events (all neutropenia except one treatment...unrelated PE)  TC: 8 of 20 with grade 3 or 4 adverse events (all neutropenia except one docetaxel reaction)  By arm:  Genomically-guided: 14

Development and validation of the trait and state versions of the Post-Event Processing Inventory.

PubMed

Blackie, Rebecca A; Kocovski, Nancy L

2017-03-01

Post-event processing (PEP) refers to negative and prolonged rumination following anxiety-provoking social situations. Although there are scales to assess PEP, they are situation-specific, some targeting only public-speaking situations. Furthermore, there are no trait measures to assess the tendency to engage in PEP. The purpose of this research was to create a new measure of PEP, the Post-Event Processing Inventory (PEPI), which can be employed following all types of social situations and includes both trait and state forms. Over two studies (study 1, N = 220; study 2, N = 199), we explored and confirmed the factor structure of the scale with student samples. For each form of the scale, we found and confirmed that a higher-order, general PEP factor could be inferred from three sub-domains (intensity, frequency, and self-judgment). We also found preliminary evidence for the convergent, concurrent, discriminant/divergent, incremental, and predictive validity for each version of the scale. Both forms of the scale demonstrated excellent internal consistency and the trait form had excellent two-week test-retest reliability. Given the utility and versatility of the scale, the PEPI may provide a useful alternative to existing measures of PEP and rumination.

Electronic Medical Record-Based Radiation Oncology Toxicity Recording Instrument Aids Benchmarking and Quality Improvement in the Clinic.

PubMed

Albuquerque, Kevin; Rodgers, Kellie; Spangler, Ann; Rahimi, Asal; Willett, DuWayne

2018-03-01

The on-treatment visit (OTV) for radiation oncology is essential for patient management. Radiation toxicities recorded during the OTV may be inconsistent because of the use of free text and the lack of treatment site-specific templates. We developed a radiation oncology toxicity recording instrument (ROTOX) in a health system electronic medical record (EMR). Our aims were to assess improvement in documentation of toxicities and to develop clinic toxicity benchmarks. A ROTOX that was based on National Cancer Institute Common Terminology Criteria for Adverse Events (version 4.0) with flow-sheet functionality was developed in the EMR. Improvement in documentation was assessed at various time intervals. High-grade toxicities (ie, grade ≥ 3 by CTCAE) by site were audited to develop benchmarks and to track nursing and physician actions taken in response to these. A random sample of OTV notes from each clinic physician before ROTOX implementation was reviewed and assigned a numerical document quality score (DQS) that was based on completeness and comprehensiveness of toxicity grading. The mean DQS improved from an initial level of 41% to 99% (of the maximum possible DQS) when resampled at 6 months post-ROTOX. This high-level DQS was maintained 3 years after ROTOX implementation at 96% of the maximum. For months 7 to 9 after implementation (during a 3-month period), toxicity grading was recorded in 4,443 OTVs for 698 unique patients; 107 episodes of high-grade toxicity were identified during this period, and toxicity-specific intervention was documented in 95%. An EMR-based ROTOX enables consistent recording of treatment toxicity. In a uniform sample of patients, local population toxicity benchmarks can be developed, and clinic response can be tracked.

The reasons for Chinese nursing staff to report adverse events: a questionnaire survey.

PubMed

Hong, Su; Li, QiuJie

2017-04-01

To investigate the impact of nurses' perception of patient safety culture and adverse event reporting, and demographic factors on adverse event reporting in Chinese hospitals. Accurate and timely adverse event reporting is integral in promoting patient safety and professional learning around the incident. In a cross-sectional survey, a sample of 919 nurses completed a structured questionnaire composed of two validated instruments measuring nurses' perception of patient safety culture and adverse event reporting. Associations between the variables were examined using multiple linear regression analysis. The positive response rates of five dimensions of the Patient Safety Culture Assessment Scale varied from 47.55% to 80.62%. The accuracy rate of Adverse Event Reporting Perception Scale was 63.16%. Five hundred and thirty-one (58.03%) nurses did not report adverse event in past 12 months. Six variables were found to be associated with nurses' adverse event reporting: total work experience (P = 0.003), overall patient safety culture score (P < 0.001), safety climate (P < 0.001), teamwork climate (P < 0.001), overall the adverse event reporting perception scale score (P = 0.003) and importance or reporting (P = 0.002). The results confirmed that improvements in the patient safety culture and nurses' perception of adverse event reporting were related to an increase in voluntary adverse event reporting. The knowledge of adverse event reporting should be integrated into the patient safety curriculum. Interventions that target a specific domain are necessary to improve the safety culture. © 2017 John Wiley & Sons Ltd.

Cost and economic burden of adverse events associated with metastatic melanoma treatments in five countries.

PubMed

Vouk, Katja; Benter, Ursula; Amonkar, Mayur M; Marocco, Alessia; Stapelkamp, Ceilidh; Pfersch, Sylvie; Benjamin, Laure

2016-09-01

To estimate per-event cost and economic burden associated with managing the most common and/or severe metastatic melanoma (MM) treatment-related adverse events (AEs) in Australia, France, Germany, Italy, and the UK. AEs associated with chemotherapy (dacarbazine, paclitaxel, fotemustine), immunotherapy (ipilimumab), and targeted therapy (vemurafenib) were identified by literature review. Medical resource use data associated with managing AEs were collected through two blinded Delphi panel cycles in each of the five countries. Published costs were used to estimate per-event costs and combined with AEs incidence, treatment usage, and MM prevalence to estimate the economic burden for each country. The costliest AEs were grade 3/4 events due to immunotherapy (Australia/France: colitis; UK: diarrhea) and chemotherapy (Germany/Italy: neutropenia/leukopenia). Treatment of AEs specific to chemotherapy (Australia/Germany/Italy/France: neutropenia/leukopenia) and targeted therapy (UK: squamous cell carcinoma) contributed heavily to country-specific economic burden. Economic burden was estimated assuming that each patient experienced an AE only once. In addition, the context of settings was heterogeneous and the number of Delphi panel experts was limited. Management costs for MM treatment-associated AEs can be substantial. Results could be incorporated in economic models that support reimbursement dossiers. With the availability of newer treatments, establishment of a baseline measure of the economic burden of AEs will be crucial for assessing their impact on patients and regional healthcare systems.

Analysis of Seismic Moment Tensor and Finite-Source Scaling During EGS Resource Development at The Geysers, CA

NASA Astrophysics Data System (ADS)

Boyd, O. S.; Dreger, D. S.; Gritto, R.

2015-12-01

Enhanced Geothermal Systems (EGS) resource development requires knowledge of subsurface physical parameters to quantify the evolution of fracture networks. We investigate seismicity in the vicinity of the EGS development at The Geysers Prati-32 injection well to determine moment magnitude, focal mechanism, and kinematic finite-source models with the goal of developing a rupture area scaling relationship for the Geysers and specifically for the Prati-32 EGS injection experiment. Thus far we have analyzed moment tensors of M ≥ 2 events, and are developing the capability to analyze the large numbers of events occurring as a result of the fluid injection and to push the analysis to smaller magnitude earthquakes. We have also determined finite-source models for five events ranging in magnitude from M 3.7 to 4.5. The scaling relationship between rupture area and moment magnitude of these events resembles that of a published empirical relationship derived for events from M 4.5 to 8.3. We plan to develop a scaling relationship in which moment magnitude and corner frequency are predictor variables for source rupture area constrained by the finite-source modeling. Inclusion of corner frequency in the empirical scaling relationship is proposed to account for possible variations in stress drop. If successful, we will use this relationship to extrapolate to the large numbers of events in the EGS seismicity cloud to estimate the coseismic fracture density. We will present the moment tensor and corner frequency results for the micro earthquakes, and for select events, finite-source models. Stress drop inferred from corner frequencies and from finite-source modeling will be compared.

High-Dose-Rate Monotherapy for Localized Prostate Cancer: 10-Year Results

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

Hauswald, Henrik; Kamrava, Mitchell R.; Fallon, Julia M.

2016-03-15

Purpose: High-dose-rate (HDR) brachytherapy was originally used with external beam radiation therapy (EBRT) to increase the dose to the prostate without injuring the bladder or rectum. Numerous studies have reported HDR brachytherapy is safe and effective. We adapted it for use without EBRT for cases not requiring lymph node treatment. Patients and Methods: We entered the patient demographics, disease characteristics, and treatment parameters into a prospective registry and serially added follow-up data for 448 men with low-risk (n=288) and intermediate-risk (n=160) prostate cancer treated from 1996 to 2009. Their median age was 64 years (range 42-90). The median prostate-specific antigen (PSA)more » level was 6.0 ng/mL (range 0.2-18.2). The Gleason score was ≤6 in 76% and 7 in 24%. The median dose was 43.5 Gy in 6 fractions. The clinical and biochemical disease control and survival rates were calculated. Adverse events were graded according to the Common Toxicity Criteria of Adverse Events. Results: The median follow-up period was 6.5 years (range 0.3-15.3). The actuarial 6- and 10-year PSA progression-free survival was 98.6% (95% confidence interval [CI] 96.9%-99.4%) and 97.8% (95% CI 95.5%-98.9%). Overall survival at 10 years was 76.7% (95% CI 69.9%-82.2%). The local control, distant metastasis-free survival, and cause-specific survival were 99.7% (95% CI 97.9%-99.9%), 98.9% (95% CI 96.3%-99.7%), and 99.1% (95% CI 95.8%-99.8%). T stage, initial PSA level, Gleason score, National Comprehensive Cancer Network risk group, patient age, and androgen deprivation therapy did not significantly correlate with disease control or survival. No late grade 3 to 4 rectal toxicities developed. Late grade 3 to 4 genitourinary toxicity occurred in 4.9% (grade 3 in 4.7%). Conclusions: HDR monotherapy is a safe and highly effective treatment of low- and intermediate-risk prostate cancer.« less

The Geological Grading Scale: Every million Points Counts!

NASA Astrophysics Data System (ADS)

Stegman, D. R.; Cooper, C. M.

2006-12-01

The concept of geological time, ranging from thousands to billions of years, is naturally quite difficult for students to grasp initially, as it is much longer than the timescales over which they experience everyday life. Moreover, universities operate on a few key timescales (hourly lectures, weekly assignments, mid-term examinations) to which students' maximum attention is focused, largely driven by graded assessment. The geological grading scale exploits the overwhelming interest students have in grades as an opportunity to instill familiarity with geological time. With the geological grading scale, the number of possible points/marks/grades available in the course is scaled to 4.5 billion points --- collapsing the entirety of Earth history into one semester. Alternatively, geological time can be compressed into each assignment, with scores for weekly homeworks not worth 100 points each, but 4.5 billion! Homeworks left incomplete with questions unanswered lose 100's of millions of points - equivalent to missing the Paleozoic era. The expected quality of presentation for problem sets can be established with great impact in the first week by docking assignments an insignificant amount points for handing in messy work; though likely more points than they've lost in their entire schooling history combined. Use this grading scale and your students will gradually begin to appreciate exactly how much time represents a geological blink of the eye.

Class Size Effects on Literacy Skills and Literacy Interest in First Grade: A Large-Scale Investigation

ERIC Educational Resources Information Center

Ecalle, Jean; Magnan, Annie; Gibert, Fabienne

2006-01-01

This article examines the impact of class size on literacy skills and on literacy interest in beginning readers from zones with specific educational needs in France. The data came from an experiment involving first graders in which teachers and pupils were randomly assigned to the different class types (small classes of 10-12 pupils vs. regular…

Submarine Pyroclastic Flow Deposits; July 2003 Dome Collapse Event of the Soufrière Hills Volcano, Montserrat, West Indies

NASA Astrophysics Data System (ADS)

Trofimovs, J.; Sparks, S.; Talling, P.

2006-12-01

What happens when pyroclastic flows enter the ocean? To date, the subject of submarine pyroclastic flow behaviour has been controversial. Ambiguity arises from inconclusive evidence of a subaqueous depositional environment in ancient successions, to difficulty in sampling the in situ products of modern eruptions. A research voyage of the RRS James Clark Ross (9-18 May 2005) sampled 52 sites offshore from the volcanic island of Montserrat. The Soufrière Hills volcano, Montserrat, has been active since 1995 with eruptive behaviour dominated by andesite lava dome growth and collapse. Over 90% of the pyroclastic material produced has been deposited into the ocean. In July 2003 the Soufrière Hills volcano produced the largest historically documented dome collapse event. 210 x 106 m3 of pyroclastic material avalanched down the Tar River Valley, southeast Montserrat, to be deposited into the ocean. Bathymetric imaging and coring of offshore pyroclastic deposits, with a specific focus on the July 2003 units, reveals that the pyroclastic flows mix rapidly and violently with the water as they enter the ocean. Mixing takes place between the shore and 500 m depth where the deposition of basal coarse-grained parts of the flow initiates on slopes of 15° or less. The coarse components (pebbles to boulders) are deposited proximally from dense basal slurries to form steep sided, near linear ridges that amalgamate to form a kilometer-scale submarine fan. These proximal deposits contain <1% of ash-grade material. The finer components (dominantly ash-grade) are mixed into the overlying water column to form turbidity currents that flow distances >40 km from source. The total volume of pyroclastic material deposited within the submarine environment during this event exceeds 170 x 106 m3, with 65% deposited in proximal lobes and 35% deposited as distal turbidites. This broadly correlates with the block and ash components respectively, of the source subaerial pyroclastic flow. However, the efficient sorting and physical differentiation of the submarine flows, in comparison to the original mixture of their subaerial counterparts, suggests that the pyroclastic flows mix thoroughly with seawater and generate sediment gravity currents which are stratified in grain size and concentration.

Contribution of regional-scale fire events to ozone and PM2.5 air quality estimated by photochemical modeling approaches

EPA Science Inventory

Two specific fires from 2011 are tracked for local to regional scale contribution to ozone (O3) and fine particulate matter (PM2.5) using a freely available regulatory modeling system that includes the BlueSky wildland fire emissions tool, Spare Matrix Operator Kernel Emissions (...

[Study on procedure of seed quality testing and seed grading scale of Phellodendron amurense].

PubMed

Liu, Yanlu; Zhang, Zhao; Dai, Lingchao; Zhang, Bengang; Zhang, Xiaoling; Wang, Han

2011-12-01

To study the procedure of seed quality testing and seed grading scale of Phellodendron amurense. Seed quality testing methods were developed, which included the test of sampling, seed purity, weight per 1 000 seeds, seed moisture, seed viability and germination rate. The related data from 62 cases of seed specimens of P. amurense were analyzed by cluster analysis. The seed quality test procedure was developed, and the seed quality grading scale was formulated.

Inheritance, Variscan tectonometamorphic evolution and Permian to Mesozoic rejuvenations in the metamorphic basement complexes of the Romanian Carpathians revealed by monazite microprobe geochronology

NASA Astrophysics Data System (ADS)

Săbău, Gavril; Negulescu, Elena

2014-05-01

Monazite U-Th-Pb chemical dating reaches an acceptable compromise between precision and accuracy on one side, and spatial resolution and textural constraints on the other side. Thus it has a powerful potential in testing the coherence of individual metamorphic basement units, and enabling correlations among them. Yet, sensitivity and specificity issues in monazite response to thermotectonic events, especially in the case of superposed effects, remain still unclear. Monazite dating at informative to detailed scale in the main metamorphic basement units of the Carpathians resulted in complex age spectra. In the main, the spectra are dominated by the most pervasive thermal and structural overprint, as checked against independent geochronological data. Post-peak age resetting is mostly present, but statistically subordinate. Resetting in case of superposed events is correlated with the degree of textural and paragenetic overprinting, inheritances being always indicated by more or less well-defined age clusters. The lack of relict ages correlating with prograde structural and porphyroblast zonation patterns is indicative for juvenile formations. Age data distribution in the Carpathians allowed distinction of pre-Variscan events, syn-metamorphic Variscan tectonic stacking of juvenile and reworked basement, post-Variscan differential tectonic uplift, as well as prograde metamorphic units ranging down to Upper Cretaceous ages. In the South Carpathians, the Alpine Danubian domain consists of several Variscan and Alpine thrust sheets containing a metamorphic complex dominated by Upper Proterozoic to Lower Cambrian metamorphic and magmatic ages (Lainici-Păiuş), and several complexes with metamorphic overprints ranging from Carboniferous to Lower Permian. Any correlation among these units, as well as geotectonic models placing a Lower Paleozoic oceanic domain between pre-existing Lainici-Păiuş and Drăgşan terranes are precluded by the age data. Other basement of the South Carpathians contain lower Paleozoic or older units intruded by Ordovician granitoids, imbricated with juvenile Variscan slivers, the structural sequence differing in individual basement complexes. So, in the Leaota Massif the lowermost term of the sequence is prograde Variscan, tectonically overlain by reworked lower Paleozoic gneisses, supporting thrust sheets with very low- to low-grade Variscan schists. In the Făgăraş Massif a lower Paleozoic (Cumpăna) complex bearing a strong Variscan overprint, straddles Variscan juvenile rocks, and the lowermost visible structural level is assumed by upper Carboniferous to Permian juvenile medium-grade metamorphic schists. In the Lotru Metamorphic Suite of the Alpine Getic Nappe, the Variscan stacking is overprinted by post-orogenic differential uplift, documented by the correlation among younging ages, structural and metamorphic low-pressure overprints, recording often higher metamorphic temperatures. The most spectacular structure is Upper Jurassic in age, contains high-grade metamorphic rocks and peraluminous anatectic granitoids, is outlined by a deformed boundary evolving from ductile to brittle regime during cooling, and induces a thermal overprint in the neighbouring rocks. In the basement units thrust over the Getic Nappe, the Sibişel unit yielded Permian prograde peak metamorphic ages and Triassic post-peak overprints, while an adjacent gneissic unit (Laz) delivered an exclusively Cretaceous age pattern. Unexpectedly young metamorphic ages resulted also for the East Carpathians and the Apuseni Mountains. While most of the ages obtained so far correspond to Variscan retrogression of older basement units, the lowermost structural unit of the infra-Bucovinian nappe system in the East Carpathians yielded Upper Cretaceous metamorphic ages in apparently monometamorphic medium-grade schists. In the Apuseni Mountains, schists of the Baia de Arieş Unit display an Upper Jurassic age spectrum, corresponding to a clearly prograde medium-grade event. The ages recorded not only question some of the currently accepted correlations among basement units, but urge to reconsideration of the way in which the basement-cover relationships are interpreted and extrapolated.

College Students' Categorical Perceptions of Grades: It's Simply "Good" vs. "Bad"

ERIC Educational Resources Information Center

Boatright-Horowitz, Su L.; Arruda, Chris

2013-01-01

College students' categorical perceptions of numeric and alphabetic grades were examined by assigning participants to one of four conditions: numeric grades alphabetic grades, numeric non-grades and alphabetic non-grades. They were then asked to give ratings for each possible grade or non-grade, using a 10-point scale. Factor analysis revealed…

Acupuncture for stroke rehabilitation.

PubMed

Yang, Ai; Wu, Hong Mei; Tang, Jin-Ling; Xu, Li; Yang, Ming; Liu, Guan J

2016-08-26

Stroke is the second most common cause of death in the world and in China it has now become the main cause of death. It is also a main cause of adult disability and dependency. Acupuncture for stroke has been used in China for hundreds of years and is increasingly practiced in some Western countries. This is an update of the Cochrane review originally published in 2006 . To determine the efficacy and safety of acupuncture therapy in people with subacute and chronic stroke. We intended to test the following hypotheses: 1) acupuncture can reduce the risk of death or dependency in people with subacute and chronic stroke at the end of treatment and at follow-up; 2) acupuncture can improve neurological deficit and quality of life after treatment and at the end of follow-up; 3) acupuncture can reduce the number of people requiring institutional care; and 4) acupuncture is not associated with any intolerable adverse effects. We searched the Cochrane Stroke Group Trials Register (June 2015), the Cochrane Central Register of Controlled Trials (CENTRAL; Cochrane Library 2015, Issue 7), MEDLINE (1966 to July 2015, Ovid), EMBASE (1980 to July 2015, Ovid), CINAHL (1982 to July 2015, EBSCO), and AMED (1985 to July 2015, Ovid). We also searched the following four Chinese medical databases: China Biological Medicine Database (July 2015); Chinese Science and Technique Journals Database (July 2015); China National Infrastructure (July 2015), and Wan Fang database (July 2015). Truly randomised unconfounded clinical trials among people with ischaemic or haemorrhagic stroke, in the subacute or chronic stage, comparing acupuncture involving needling with placebo acupuncture, sham acupuncture, or no acupuncture. Two review authors independently selected trials for inclusion, assessed quality, extracted and cross-checked the data. We included 31 trials with a total of 2257 participants in the subacute or chronic stages of stroke. The methodological quality of most of the included trials was not high. The quality of evidence for the main outcomes was low or very low based on the assessment by the system of Grades of Recommendation, Assessment, Development and Evaluation (GRADE).Two trials compared real acupuncture plus baseline treatment with sham acupuncture plus baseline treatment. There was no evidence of differences in the changes of motor function and quality of life between real acupuncture and sham acupuncture for people with stroke in the convalescent stage.Twenty-nine trials compared acupuncture plus baseline treatment versus baseline treatment alone. Compared with no acupuncture, for people with stroke in the convalescent phase, acupuncture had beneficial effects on the improvement of dependency (activity of daily living) measured by Barthel Index (nine trials, 616 participants; mean difference (MD) 9.19, 95% confidence interval (CI) 4.34 to 14.05; GRADE very low), global neurological deficiency (seven trials, 543 participants; odds ratio (OR) 3.89, 95% CI 1.78 to 8.49; GRADE low), and specific neurological impairments including motor function measured by Fugl-Meyer Assessment (four trials, 245 participants; MD 6.16, 95% CI 4.20 to 8.11; GRADE low), cognitive function measured by the Mini-Mental State Examination (five trials, 278 participants; MD 2.54, 95% CI 0.03 to 5.05; GRADE very low), depression measured by the Hamilton Depression Scale (six trials, 552 participants; MD -2.58, 95% CI -3.28 to -1.87; GRADE very low), swallowing function measured by drinking test (two trials, 200 participants; MD -1.11, 95% CI -2.08 to -0.14; GRADE very low), and pain measured by the Visual Analogue Scale (two trials, 118 participants; MD -2.88, 95% CI -3.68 to -2.09; GRADE low). Sickness caused by acupuncture and intolerance of pain at acupoints were reported in a few participants with stroke in the acupuncture groups. No data on death, the proportion of people requiring institutional care or requiring extensive family support, and all-cause mortality were available in all included trials. From the available evidence, acupuncture may have beneficial effects on improving dependency, global neurological deficiency, and some specific neurological impairments for people with stroke in the convalescent stage, with no obvious serious adverse events. However, most included trials were of inadequate quality and size. There is, therefore, inadequate evidence to draw any conclusions about its routine use. Rigorously designed, randomised, multi-centre, large sample trials of acupuncture for stroke are needed to further assess its effects.

"We Were Slow; It Was Challenging" and "It Was Hard Not to Make Knots": Crocheting as a Literacy Event in a Second Grade Classroom Community

ERIC Educational Resources Information Center

Kneller, Sarah A.; Boyd, Maureen P.

2008-01-01

This paper describes a "crazy about crocheting class" and shows how crocheting became a literacy event that promoted student empowerment and classroom community while engaging second grade students in authentic literacy practices. We document how crocheting evolved from a classroom management activity that also encouraged fine motor skills to a…

Review of the GMD Benchmark Event in TPL-007-1

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

Backhaus, Scott N.; Rivera, Michael Kelly

2015-07-21

Los Alamos National Laboratory (LANL) examined the approaches suggested in NERC Standard TPL-007-1 for defining the geo-electric field for the Benchmark Geomagnetic Disturbance (GMD) Event. Specifically; 1. Estimating 100-year exceedance geo-electric field magnitude; The scaling of the GMD Benchmark Event to geomagnetic latitudes below 60 degrees north; and 3. The effect of uncertainties in earth conductivity data on the conversion from geomagnetic field to geo-electric field. This document summarizes the review and presents recommendations for consideration

Extreme weather: Subtropical floods and tropical cyclones

NASA Astrophysics Data System (ADS)

Shaevitz, Daniel A.

Extreme weather events have a large effect on society. As such, it is important to understand these events and to project how they may change in a future, warmer climate. The aim of this thesis is to develop a deeper understanding of two types of extreme weather events: subtropical floods and tropical cyclones (TCs). In the subtropics, the latitude is high enough that quasi-geostrophic dynamics are at least qualitatively relevant, while low enough that moisture may be abundant and convection strong. Extratropical extreme precipitation events are usually associated with large-scale flow disturbances, strong ascent, and large latent heat release. In the first part of this thesis, I examine the possible triggering of convection by the large-scale dynamics and investigate the coupling between the two. Specifically two examples of extreme precipitation events in the subtropics are analyzed, the 2010 and 2014 floods of India and Pakistan and the 2015 flood of Texas and Oklahoma. I invert the quasi-geostrophic omega equation to decompose the large-scale vertical motion profile to components due to synoptic forcing and diabatic heating. Additionally, I present model results from within the Column Quasi-Geostrophic framework. A single column model and cloud-revolving model are forced with the large-scale forcings (other than large-scale vertical motion) computed from the quasi-geostrophic omega equation with input data from a reanalysis data set, and the large-scale vertical motion is diagnosed interactively with the simulated convection. It is found that convection was triggered primarily by mechanically forced orographic ascent over the Himalayas during the India/Pakistan flood and by upper-level Potential Vorticity disturbances during the Texas/Oklahoma flood. Furthermore, a climate attribution analysis was conducted for the Texas/Oklahoma flood and it is found that anthropogenic climate change was responsible for a small amount of rainfall during the event but the intensity of this event may be greatly increased if it occurs in a future climate. In the second part of this thesis, I examine the ability of high-resolution global atmospheric models to simulate TCs. Specifically, I present an intercomparison of several models' ability to simulate the global characteristics of TCs in the current climate. This is a necessary first step before using these models to project future changes in TCs. Overall, the models were able to reproduce the geographic distribution of TCs reasonably well, with some of the models performing remarkably well. The intensity of TCs varied widely between the models, with some of this difference being due to model resolution.

Spinal projection neurons control turning behaviors in zebrafish.

PubMed

Huang, Kuo-Hua; Ahrens, Misha B; Dunn, Timothy W; Engert, Florian

2013-08-19

Discrete populations of brainstem spinal projection neurons (SPNs) have been shown to exhibit behavior-specific responses during locomotion [1-9], suggesting that separate descending pathways, each dedicated to a specific behavior, control locomotion. In an alternative model, a large variety of motor outputs could be generated from different combinations of a small number of basic motor pathways. We examined this possibility by studying the precise role of ventromedially located hindbrain SPNs (vSPNs) in generating turning behaviors. We found that unilateral laser ablation of vSPNs reduces the tail deflection and cycle period specifically during the first undulation cycle of a swim bout, whereas later tail movements are unaffected. This holds true during phototaxic [10], optomotor [11], dark-flash-induced [12], and spontaneous turns [13], suggesting a universal role of these neurons in controlling turning behaviors. Importantly, we found that the ablation not only abolishes turns but also results in a dramatic increase in the number of forward swims, suggesting that these neurons transform forward swims into turns by introducing turning kinematics into a basic motor pattern of symmetric tail undulations. Finally, we show that vSPN activity is direction specific and graded by turning angle. Together, these results provide a clear example of how a specific motor pattern can be transformed into different behavioral events by the graded activation of a small set of SPNs. Copyright © 2013 The Authors. Published by Elsevier Inc. All rights reserved.

Spinal Projection Neurons Control Turning Behaviors in Zebrafish

PubMed Central

Huang, Kuo-Hua; Ahrens, Misha B.; Dunn, Timothy W.; Engert, Florian

2013-01-01

Summary Discrete populations of brainstem spinal projection neurons (SPNs) have been shown to exhibit behavior-specific responses during locomotion [1–9], suggesting that separate descending pathways, each dedicated to a specific behavior, control locomotion. In an alternative model, a large variety of motor outputs could be generated from different combinations of a small number of basic motor pathways. We examined this possibility by studying the precise role of ventromedially located hindbrain SPNs (vSPNs) in generating turning behaviors. We found that unilateral laser ablation of vSPNs reduces the tail deflection and cycle period specifically during the first undulation cycle of a swim bout, whereas later tail movements are unaffected. This holds true during phototaxic [10], optomotor [11], dark-flash-induced [12], and spontaneous turns [13], suggesting a universal role of these neurons in controlling turning behaviors. Importantly, we found that the ablation not only abolishes turns but also results in a dramatic increase in the number of forward swims, suggesting that these neurons transform forward swims into turns by introducing turning kinematics into a basic motor pattern of symmetric tail undulations. Finally, we show that vSPN activity is direction specific and graded by turning angle. Together, these results provide a clear example of how a specific motor pattern can be transformed into different behavioral events by the graded activation of a small set of SPNs. PMID:23910662

The Development and Validation of a Pictorial Self-Concept Scale for Children in K-4.

ERIC Educational Resources Information Center

Bolea, Angelo S.; And Others

The study discusses the development of a self-concept measure for children in kindergarten and the lower elementary grades. A scale (Pictorial Self-Concept Scale), was constructed from children's statements about themselves. This scale was administered to kindergarten through fourth grade subjects. Each child separated 50 cartoon picture cards…

Measuring Students' Writing Ability on a Computer-Analytic Developmental Scale: An Exploratory Validity Study

ERIC Educational Resources Information Center

Burdick, Hal; Swartz, Carl W.; Stenner, A. Jackson; Fitzgerald, Jill; Burdick, Don; Hanlon, Sean T.

2013-01-01

The purpose of the study was to explore the validity of a novel computer-analytic developmental scale, the Writing Ability Developmental Scale. On the whole, collective results supported the validity of the scale. It was sensitive to writing ability differences across grades and sensitive to within-grade variability as compared to human-rated…

Improving patient safety via automated laboratory-based adverse event grading.

PubMed

Niland, Joyce C; Stiller, Tracey; Neat, Jennifer; Londrc, Adina; Johnson, Dina; Pannoni, Susan

2012-01-01

The identification and grading of adverse events (AEs) during the conduct of clinical trials is a labor-intensive and error-prone process. This paper describes and evaluates a software tool developed by City of Hope to automate complex algorithms to assess laboratory results and identify and grade AEs. We compared AEs identified by the automated system with those previously assessed manually, to evaluate missed/misgraded AEs. We also conducted a prospective paired time assessment of automated versus manual AE assessment. We found a substantial improvement in accuracy/completeness with the automated grading tool, which identified an additional 17% of severe grade 3-4 AEs that had been missed/misgraded manually. The automated system also provided an average time saving of 5.5 min per treatment course. With 400 ongoing treatment trials at City of Hope and an average of 1800 laboratory results requiring assessment per study, the implications of these findings for patient safety are enormous.

Transplantation of autologous peripheral blood mononuclear cells in the subarachnoid space for amyotrophic lateral sclerosis: a safety analysis of 14 patients

PubMed Central

Li, Xiao-yan; Liang, Zhan-hua; Han, Chao; Wei, Wen-juan; Song, Chun-li; Zhou, Li-na; Liu, Yang; Li, Ying; Ji, Xiao-fei; Liu, Jing

2017-01-01

There is a small amount of clinical data regarding the safety and feasibility of autologous peripheral blood mononuclear cell transplantation into the subarachnoid space for the treatment of amyotrophic lateral sclerosis. The objectives of this retrospective study were to assess the safety and efficacy of peripheral blood mononuclear cell transplantation in 14 amyotrophic lateral sclerosis patients to provide more objective data for future clinical trials. After stem cell mobilization and collection, autologous peripheral blood mononuclear cells (1 × 109) were isolated and directly transplanted into the subarachnoid space of amyotrophic lateral sclerosis patients. The primary outcome measure was incidence of adverse events. Secondary outcome measures were electromyography 1 week before operation and 4 weeks after operation, Functional Independence Measurement, Berg Balance Scale, and Dysarthria Assessment Scale 1 week preoperatively and 1, 2, 4 and 12 weeks postoperatively. There was no immediate or delayed transplant-related cytotoxicity. The number of leukocytes, serum alanine aminotransferase and creatinine levels, and body temperature were within the normal ranges. Radiographic evaluation showed no serious transplant-related adverse events. Muscle strength grade, results of Functional Independence Measurement, Berg Balance Scale, and Dysarthria Assessment Scale were not significantly different before and after treatment. These findings suggest that peripheral blood mononuclear cell transplantation into the subarachnoid space for the treatment of amyotrophic lateral sclerosis is safe, but its therapeutic effect is not remarkable. Thus, a large-sample investigation is needed to assess its efficacy further. PMID:28469667

The Earth Observatory Natural Event Tracker (EONET): An API for Matching Natural Events to GIBS Imagery

NASA Astrophysics Data System (ADS)

Ward, K.

2015-12-01

Hidden within the terabytes of imagery in NASA's Global Imagery Browse Services (GIBS) collection are hundreds of daily natural events. Some events are newsworthy, devastating, and visibly obvious at a global scale, others are merely regional curiosities. Regardless of the scope and significance of any one event, it is likely that multiple GIBS layers can be viewed to provide a multispectral, dataset-based view of the event. To facilitate linking between the discrete event and the representative dataset imagery, NASA's Earth Observatory Group has developed a prototype application programming interface (API): the Earth Observatory Natural Event Tracker (EONET). EONET supports an API model that allows users to retrieve event-specific metadata--date/time, location, and type (wildfire, storm, etc.)--and web service layer-specific metadata which can be used to link to event-relevant dataset imagery in GIBS. GIBS' ability to ingest many near real time datasets, combined with its growing archive of past imagery, means that API users will be able to develop client applications that not only show ongoing events but can also look at imagery from before and after. In our poster, we will present the API and show examples of its use.

Contribution of hydrological data to the understanding of the spatio-temporal dynamics of F-specific RNA bacteriophages in river water during rainfall-runoff events.

PubMed

Fauvel, Blandine; Cauchie, Henry-Michel; Gantzer, Christophe; Ogorzaly, Leslie

2016-05-01

Heavy rainfall events were previously reported to bring large amounts of microorganisms in surface water, including viruses. However, little information is available on the origin and transport of viral particles in water during such rain events. In this study, an integrative approach combining microbiological and hydrological measurements was investigated to appreciate the dynamics and origins of F-specific RNA bacteriophage fluxes during two distinct rainfall-runoff events. A high frequency sampling (automatic sampler) was set up to monitor the F-specific RNA bacteriophages fluxes at a fine temporal scale during the whole course of the rainfall-runoff events. A total of 276 rainfall-runoff samples were collected and analysed using both infectivity and RT-qPCR assays. The results highlight an increase of 2.5 log10 and 1.8 log10 of infectious F-specific RNA bacteriophage fluxes in parallel of an increase of the water flow levels for both events. Faecal pollution was characterised as being mainly from anthropic origin with a significant flux of phage particles belonging to the genogroup II. At the temporal scale, two successive distinct waves of phage pollution were established and identified through the hydrological measurements. The first arrival of phages in the water column was likely to be linked to the resuspension of riverbed sediments that was responsible for a high input of genogroup II. Surface runoff contributed further to the second input of phages, and more particularly of genogroup I. In addition, an important contribution of infectious phage particles has been highlighted. These findings imply the existence of a close relationship between the risk for human health and the viral contamination of flood water. Copyright © 2016 Luxembourg institute of Science and Technology. Published by Elsevier Ltd.. All rights reserved.

Strategies and Exemplars for Public Outreach Events: Planning, Implementation, Evaluation

NASA Astrophysics Data System (ADS)

Cobb, W. H.; Buxner, S.; Shipp, S. S.; Shebby, S.

2015-12-01

IntroductionEach year the National Aeronautics and Space Administration (NASA) sponsors a variety of public outreach events to share information with educators, students, and the general public. These events are designed to increase interest in and awareness of the mission and goals of NASA. Planning and implementation best practices gleaned from the NASA SMD Education's review of large-scale events, "Best Practices in Outreach Events" will be shared. Outcomes from an event, i C Ceres, celebrating the Dawn mission's arrival at dwarf planet Ceres that utilized these strategies will be shared. Best practices included can be pertinent for all event organizers and evaluators regardless of event size. BackgroundThe literature review focused on identifying evaluations of large-scale public outreach events—and, within these evaluations, identifying best practices. The following criteria for identifying journal articles and reports to potentially include: Public, science-related events open to adults and children. Events with more than 1,000 attendees. Events that occurred during the last 5 years. Evaluations that included information on data collected from visitors and/or volunteers. Evaluations that specified the type of data collected, methodology, and associated results. Planning and Implementation Best PracticesThe literature review revealed key considerations for planning and of large-scale events implementing events. A summary of related best practices is presented below. 1) Advertise the event 2) Use and advertise access to scientists 3) Recruit scientists using these findings 4) Ensure that the event is group and particularly child friendly 5) Target specific event outcomes Best Practices Informing Real-world Planning, Implementation and EvaluationDawn mission's collaborative design of a series of events, i C Ceres, including in-person, interactive events geared to families and live presentations will be shared. Outcomes and lessons learned will be imparted rising from these events and their evaluation. There will be a focus on the family event, in particular the evidence that scientist participation was a particular driver for the event's impact and success.

Wingspan Stent for High-Grade Symptomatic Vertebrobasilar Artery Atherosclerotic Stenosis

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

Li Jian, E-mail: ns981212@yahoo.com.cn; Zhao Zhenwei, E-mail: zzwzc@sina.com; Gao Guodong, E-mail: gaoguo_dong@163.com

2012-04-15

Purpose: This study was designed to present the treatment outcomes with Wingspan stent angioplasty of high-grade intracranial vertebrobasilar artery (VBA) stenosis in symptomatic patients. Methods: Between 2007 and 2010, the records of 30 patients with 31 intracranial high-grade VBA stenoses (all{>=}70%) who underwent elective stenting due to the failure of medical therapy were retrospectively reviewed. Clinical evaluation was performed based on the modified Rankin scale and the National Institutes of Health Stroke Scale. Results: In all cases, the stent deployment was technically successful. The mean stenosis decreased significantly from 82.28 {+-} 8.02% (range, 72-99%) to 11.18 {+-} 7.28% (range, 0-25%)more » after stent-assisted angioplasty (P < 0.05). Periprocedure complications occurred in 3 (10%) of 30 patients; there were 2 cases of perforator strokes and 1 case of transient flow insufficiency with stent overlap. Clinical follow-up (mean, 17.81 {+-} 11.49 months; range, 5-40 months) was available for 27 patients, and angiographic follow-up (mean, 9.95 {+-} 5.74 months, range, 5-20 months) was available for 19 patients. Only one case demonstrated recurrent symptoms with restenosis ({>=}50%). There were no recurrent ischemic events and no cases of restenosis in the other patients. Conclusions: According to our data, the Wingspan stent for symptomatic intracranial VBA stenoses is a safe and efficacious treatment alternative in cases with recurrent symptoms despite medical therapy. However, the improvement of outcome requires the reduction in the rate of procedure-related complications and long-term outcomes still have to be demonstrated.« less

Stressful life events increase aggression and alcohol use in young carriers of the GABRA2 rs279826/rs279858 A-allele.

PubMed

Kiive, Evelyn; Laas, Kariina; Vaht, Mariliis; Veidebaum, Toomas; Harro, Jaanus

2017-08-01

Research of GABRA2 gene in alcohol use and impulse control suggests its role in aggressive behaviour. The purpose of the present study was to examine the effects of GABRA2 genotype and stressful life events on aggressive behaviour, alcohol use frequency and occurrence of alcohol use disorder in a population representative sample of adolescents followed up from third grade to 25 years of age. The sample consisted of the younger cohort of the longitudinal Estonian Children Personality, Behaviour and Health Study. Aggressive behaviour was rated with the activity scale of af Klinteberg, Illinois Bully Scale and Buss-Perry Aggression Questionnaire. Stressful life events and alcohol use were self-reported. Life history of aggression and lifetime occurrence of psychiatric disorders were estimated in a structured interview. The sample was genotyped for GABRA2 rs279826 and rs279858 polymorphisms that are in strong linkage disequilibrium and yielded very similar findings: Higher number of stressful life events reported at age 15 was associated with increased fighting in A-allele carriers, but not in GG homozygotes. At age 25, A-allele carriers with more stressful life events scored higher on physical aggression than those with less stress, and this was also observed regarding life history of aggression. A-allele carriers exposed to higher stress had consumed alcoholic beverages more frequently at age 15, and by age 25, they had alcohol use disorder with higher prevalence. The results of the present study suggest that the GABRA2 genotype interacts with stress in young people with impact on the development of alcohol use and aggressive behaviour. Copyright © 2017 Elsevier B.V. and ECNP. All rights reserved.

The Nine-Step Minnesota Grading System for Eyebank Eyes With Age Related Macular Degeneration: A Systematic Approach to Study Disease Stages.

PubMed

Olsen, Timothy W; Liao, Albert; Robinson, Hershonna S; Palejwala, Neal V; Sprehe, Nicholas

2017-10-01

To refine the Minnesota Grading System (MGS) using definitions from the Age-Related Eye Disease Studies (AREDS) into a nine-step grading scale (MGS-9). A nine-step grading scale descriptive analysis using three key phenotypic features (total drusen area, increased, and decreased pigmentation) of human eyebank eyes that were graded according to definitions from the AREDS criteria in order to harmonize studies of disease progression for research involving human tissue. From 2005 through February 2017, we have analyzed 1159 human eyes, procured from two eyebanks. Each macula was imaged using high-resolution, stereoscopic color fundus photography with both direct- and transillumination. Fundus images were digitally overlaid with a grading template and triangulated for foveal centration. We documented and stratified risk for each globe by applying the AREDS nine-step grading scale to the key clinical features from the MGS-9. We found a good distribution within the MGS categories (1-9) with few level eight globes. Eyes were processed within 12.1 ± 6.3, hours from the time of death through imaging, dissection, and freezing or fixation. Applying the MGS-9 to 331 pairs (662 eyes were simultaneously graded), 84% were within one-grading step and 93% within two steps of the fellow eye. We also document reticular pseudodrusen, basal laminar drusen, and pattern dystrophy. The MGS nine-step grading scale enables researchers using human tissue to refine the risk assessment of donor tissue. This analysis will harmonize results among researchers when grading human tissue using MGS criteria. Most importantly, the MGS-9 links directly to the known risk for progression from the AREDS.

Anthropometrics and Body Composition in Adults with High-Grade Gliomas: Effects of Disease-Related Variables.

PubMed

Bertoli, Simona; Battezzati, Alberto; Petruzzi, Alessandra; Leone, Alessandro; De Amicis, Ramona; Tramacere, Elena; Meda, Maddalena; Foppiani, Andrea; Silvani, Antonio; Lamperti, Elena

2018-04-01

Nutritional status in adults with high-grade gliomas (HGGs) has been poorly investigated. We studied anthropometrics and fat mass (FM), fat free mass (FFM), and body water in HGGs patients also in relation to disease-related variables. Fifty-one patients (17 III and 34 IV-grade) and fifty-one control group (CG) matched for sex, age, and BMI were enrolled. Neurological scales, anthropometry, bioimpedance, and blood sampling were performed and analyzed according to grade, lesion location, extent of resection, phase of treatment, current steroids and antiepileptic therapy, and age of patient. 41.2% were overweight and 15.7% obese. Compared to the CG, HGGs had similar anthropometrics and body composition. IV-grade, compared to the III, had higher BMI, waist circumference, FM and lower FFM. Only patients during concomitant radio and chemotherapy showed a negative BMI variation from baseline. In conclusion, overnutrition occurs in almost 6 out of 10 HGGs patients and is more relevant in IV-grade. Throughout all the treatment phases, there is a higher risk of weight loss occurred only during concomitant radio and chemotherapy. Body composition showed no specific features compared to controls. These results may assist intervention studies directed towards neurometabolic dietary treatment. Nutritional screening is warranted during the time course of disease.

Skin elasticity as a measure of radiation fibrosis: is it reproducible and does it correlate with patient and physician-reported measures?

PubMed

Nguyen, Nhu-Tram A; Roberge, David; Freeman, Carolyn R; Wong, Cindy; Hines, Jerod; Turcotte, Robert E

2014-10-01

Current means of measuring RT-induced fibrosis are subjective. We evaluated the DermaLab suction cup system to measure objectively skin deflection as a surrogate for fibrosis. Sixty-nine patients with E-STS were treated with limb-sparing surgery and 50-66 Grays (Gy) of RT. Using a "scleroderma" DermaLab Suction Cup, the skin stiffness was measured by two clinicians. The National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) scale, the Musculoskeletal Tumor Rating Scale (MSTS) and Toronto Extremity Salvage Score (TESS) questionnaires were completed for each patient. Levels of agreement between measurers were estimated using the Kappa (k) coefficient and the concordance correlation coefficient (CCC). All sixty-nine patients were included. The level of agreement between measurers for NCI-CTCAE grading was moderate (range k = 0.41-0.59). The CCC for the elasticity measurements were higher, with CCC = 0.82 for fibrotic skin and CCC 5 0.84 for normal skin. The elasticity measurements were significantly higher when MSTS scores were <30 and or TESS scores were <90. Suction Cup measurement of skin elasticity is more reproducible than CTCAE grading and shows promise in generating reproducible measurements for radiation-induced skin fibrosis. Furthermore, it correlates well with the MSTS and TESS.

Resetting of RbSr ages of volcanic rocks by low-grade burial metamorphism

USGS Publications Warehouse

Asmeroma, Y.; Damon, P.; Shafiqullah, M.; Dickinson, W.R.; Zartman, R.E.

1991-01-01

We report a nine-point RbSr whole-rock isochron age of 70??3 Ma (MSWD 3.97) for Mid-Jurassic volcanic rocks. The same rocks have also been dated by the UThPb method on zircon, giving a crystallization age of 166 ?? 11 Ma, over twice as old as the RbSr age. The data demonstrate that whole-rock RbSr ages of volcanic rocks, even lava flows with SiO2 content as low as 57 wt.%, are susceptible to complete resetting. The rocks range in composition from rhyodacite tuffs to andesite lavas. The complete breakdown of all major minerals that contain Rb and Sr resulted in an alteration mineral assemblage consisting of phengite, albite, secondary quartz, and minor amounts of chlorite and epidote. Phengite is the K-bearing product of the breakdown of biotite and K-feldspar. Pressure during low-grade metamorphism of the volcanic rocks, estimated from phengite composition to have been in the range of 4 to 6 kbar, points to thrust-related burial as the main cause of resetting. Consequently, such reset isochrons may date large-scale events such as regional thrusting and metamorphism. The coherent resetting of the RbSr isochron suggests large-scale pervasive fluid movement during thrust-related burial metamorphism. ?? 1991.

A Shortened Version of the Suicide Cognitions Scale for Identifying Chronic Pain Patients at Risk for Suicide.

PubMed

Bryan, Craig J; Kanzler, Kathryn E; Grieser, Emily; Martinez, Annette; Allison, Sybil; McGeary, Donald

2017-03-01

Research in psychiatric outpatient and inpatient populations supports the utility of the Suicide Cognitions Scale (SCS) as an indicator of current and future risk for suicidal thoughts and behaviors. Designed to assess suicide-specific thoughts and beliefs, the SCS has yet to be evaluated among chronic pain patients, a group with elevated risk for suicide. The purpose of the present study was to develop and test a shortened version of the SCS (the SCS-S). A total of 228 chronic pain patients completed a battery of self-report surveys before or after a scheduled appointment. Three outpatient medical clinics (pain medicine, orofacial pain, and clinical health psychology). Confirmatory factor analysis, multivariate regression, and graded item response theory model analyses. Results of the CFAs suggested that a 3-factor solution was optimal. A shortened 9-item scale was identified based on the results of graded item response theory model analyses. Correlation and multivariate analyses supported the construct and incremental validity of the SCS-S. Results support the reliability and validity of the SCS-S among chronic pain patients, and suggest the scale may be a useful method for identifying high-risk patients in medical settings. © 2016 World Institute of Pain.

A novel clinical grading scale to guide the management of crusted scabies.

PubMed

Davis, Joshua S; McGloughlin, Steven; Tong, Steven Y C; Walton, Shelley F; Currie, Bart J

2013-01-01

Crusted scabies, or hyperinfestation with Sarcoptes scabiei, occurs in people with an inadequate immune response to the mite. In recent decades, data have emerged suggesting that treatment of crusted scabies with oral ivermectin combined with topical agents leads to lower mortality, but there are no generally accepted tools for describing disease severity. Here, we describe a clinical grading scale for crusted scabies and its utility in real world practice. In 2002, Royal Darwin Hospital (RDH), a hospital in tropical Australia developed and began using a clinical grading scale to guide the treatment of crusted scabies. We conducted a retrospective observational study including all episodes of admission to RDH for crusted scabies during the period October 2002-December 2010 inclusive. Patients who were managed according to the grading scale were compared with those in whom the scale was not used at the time of admission but was calculated retrospectively. There were 49 admissions in 30 patients during the study period, of which 49 (100%) were in Indigenous Australians, 29 (59%) were male and the median age was 44.1 years. According to the grading scale, 8 (16%) episodes were mild, 24 (49%) were moderate, and 17 (35%) were severe. Readmission within the study period was significantly more likely with increasing disease severity, with an odds ratio (95% CI) of 12.8 (1.3-130) for severe disease compared with mild. The patients managed according to the grading scale (29 episodes) did not differ from those who were not (20 episodes), but they received fewer doses of ivermectin and had a shorter length of stay (11 vs. 16 days, p = 0.02). Despite this the outcomes were no different, with no deaths in either group and a similar readmission rate. Our grading scale is a useful tool for the assessment and management of crusted scabies.

A Novel Clinical Grading Scale to Guide the Management of Crusted Scabies

PubMed Central

Tong, Steven Y. C.; Walton, Shelley F.; Currie, Bart J.

2013-01-01

Background Crusted scabies, or hyperinfestation with Sarcoptes scabiei, occurs in people with an inadequate immune response to the mite. In recent decades, data have emerged suggesting that treatment of crusted scabies with oral ivermectin combined with topical agents leads to lower mortality, but there are no generally accepted tools for describing disease severity. Here, we describe a clinical grading scale for crusted scabies and its utility in real world practice. Methodology/Principal Findings In 2002, Royal Darwin Hospital (RDH), a hospital in tropical Australia developed and began using a clinical grading scale to guide the treatment of crusted scabies. We conducted a retrospective observational study including all episodes of admission to RDH for crusted scabies during the period October 2002–December 2010 inclusive. Patients who were managed according to the grading scale were compared with those in whom the scale was not used at the time of admission but was calculated retrospectively. There were 49 admissions in 30 patients during the study period, of which 49 (100%) were in Indigenous Australians, 29 (59%) were male and the median age was 44.1 years. According to the grading scale, 8 (16%) episodes were mild, 24 (49%) were moderate, and 17 (35%) were severe. Readmission within the study period was significantly more likely with increasing disease severity, with an odds ratio (95% CI) of 12.8 (1.3–130) for severe disease compared with mild. The patients managed according to the grading scale (29 episodes) did not differ from those who were not (20 episodes), but they received fewer doses of ivermectin and had a shorter length of stay (11 vs. 16 days, p = 0.02). Despite this the outcomes were no different, with no deaths in either group and a similar readmission rate. Conclusions/Significance Our grading scale is a useful tool for the assessment and management of crusted scabies. PMID:24069468

Evidence-based risk assessment and recommendations for physical activity: arthritis, osteoporosis, and low back pain.

PubMed

Chilibeck, Philip D; Vatanparast, Hassanali; Cornish, Stephen M; Abeysekara, Saman; Charlesworth, Sarah

2011-07-01

We systematically reviewed the safety of physical activity (PA) for people with arthritis, osteoporosis, and low back pain. We searched PubMed, MEDLINE, Sport Discus, and the Cochrane Central Register of Controlled Trials (1966 through March 2008) for relevant articles on PA and adverse events. A total of 111 articles met our inclusion criteria. The incidence for adverse events during PA was 3.4%-11% (0.06%-2.4% serious adverse events) and included increased joint pain, fracture, and back pain for those with arthritis, osteoporosis, and low back pain, respectively. Recommendations were based on the Appraisal of Guidelines for Research and Evaluation, which applies Levels of Evidence based on type of study ranging from high-quality randomized controlled trials (Level 1) to anecdotal evidence (Level 4) and Grades from A (strong) to C (weak). Our main recommendations are that (i) arthritic patients with highly progressed forms of disease should avoid heavy load-bearing activities, but should participate in non-weight-bearing activities (Level 2, Grade A); and (ii) patients with osteoporosis should avoid trunk flexion (Level 2, Grade A) and powerful twisting of the trunk (Level 3, Grade C); (iii) patients with acute low back pain can safely do preference-based PA (i.e., PA that does not induce pain), including low back extension and flexion (Level 2, Grade B); (iv) arthritic patients with stable disease without progressive joint damage and patients with stable osteoporosis or low back pain can safely perform a variety of progressive aerobic or resistance-training PAs (Level 2, Grades A and B). Overall, the adverse event incidence from reviewed studies was low. PA can safely be done by most individuals with musculoskeletal conditions.

Construction and Validation of an Instrument to Measure Taiwanese Elementary Students' Attitudes toward Their Science Class

NASA Astrophysics Data System (ADS)

Wang, Tzu-Ling; Berlin, Donna

2010-12-01

The main purpose of this study is to develop a valid and reliable instrument for measuring the attitudes toward science class of fourth- and fifth-grade students in an Asian school culture. Specifically, the development focused on three science attitude constructs-science enjoyment, science confidence, and importance of science as related to science class experiences. A total of 265 elementary school students in Taiwan responded to the instrument developed. Data analysis indicated that the instrument exhibited satisfactory validity and reliability with the Taiwan population used. The Cronbach's alpha coefficient was 0.93 for the entire instrument indicating a satisfactory level of internal consistency. However, both principal component analysis and parallel analysis showed that the three attitude scales were not unique and should be combined and used as a general "attitudes toward science class" scale. The analysis also showed that there were no gender or grade-level differences in students' overall attitudes toward science class.

Agreement between the Facial Nerve Grading System 2.0 and the House-Brackmann Grading System in Patients with Bell Palsy.

PubMed

Lee, Ho Yun; Park, Moon Suh; Byun, Jae Yong; Chung, Ji Hyun; Na, Se Young; Yeo, Seung Geun

2013-09-01

We have analyzed the correlation between the House-Brackmann (HB) scale and Facial Nerve Grading System 2.0 (FNGS 2.0) in patients with Bell palsy, and evaluated the usefulness of the new grading system. Sixty patients diagnosed with Bell palsy from May 2009 to December 2010 were evaluated using the HB scale and FNGS 2.0 scale during their initial visit, and after 3 and 6 weeks and 3 months. The overall intraclass correlation coefficient (ICC) was 0.908 (P=0.000) and the Spearman correlation coefficient (SCC) was 0.912 (P<0.05). ICC and SCC displayed differences over time, being 0.604 and 0.626, respectively, at first visit; 0.834 and 0.843, respectively, after 3 weeks; 0.844 and 0.848, respectively, after 6 weeks; and 0.808 and 0.793, respectively, after 3 months. There was a significant difference in full recovery, depending on the scale used (HB, P=0.000; FNGS 2.0, P<0.05). The exact agreements between regional assessment and FNGS 2.0 for the mouth, eyes, and brow were 72%, 63%, and 52%, respectively. FNGS 2.0 shows moderate agreement with HB grading. Regional assessment, rather than HB grading, yields stricter evaluation, resulting in better prognosis and determination of grade.

The Relevancy of Large-Scale, Quantitative Methodologies in Middle Grades Education Research

ERIC Educational Resources Information Center

Mertens, Steven B.

2006-01-01

This article examines the relevancy of large-scale, quantitative methodologies in middle grades education research. Based on recommendations from national advocacy organizations, the need for more large-scale, quantitative research, combined with the application of more rigorous methodologies, is presented. Subsequent sections describe and discuss…

The new large-scale sweet sorghum industry in the USA

USDA-ARS?s Scientific Manuscript database

Sweet sorghum (Sorghum bicolor) has been widely recognized as a promising sugar feedstock crop for the large-scale manufacture of food-grade and non food-grade bioproducts in the USA. Heckemeyer Mill, located in Sikeston, Missouri, has built and equipped the largest, commercial-scale sweet sorghum ...

Characteristics of Third-Grade Learning Disabled Children.

ERIC Educational Resources Information Center

Cullen, Joy L.; And Others

1981-01-01

The Developmental Test of Visual-Motor Integration, the Wide Range Achievement Test, and the Student's Perception of Ability Scale were administreed to 70 learning disabled and 73 normally achieving third-grade children who had been stratified on full scale Wechsler Intelligence Scale for Children-Revised (WISC-R) IQ scores. (Author)

Dynamic Imaging Grade of Swallowing Toxicity (DIGEST): Scale Development and Validation

PubMed Central

Hutcheson, Katherine A.; Barrow, Martha P.; Barringer, Denise A.; Knott, Jodi K.; Lin, Heather Y.; Weber, Randal S.; Fuller, Clifton D.; Lai, Stephen Y.; Alvarez, Clare; Raut, Janhavi; Lazarus, Cathy L.; May, Annette; Patterson, JoAnne; Roe, Justin W.G.; Starmer, Heather M.; Lewin, Jan S.

2016-01-01

Purpose NCI’s Common Terminology Criteria for Adverse Events (CTCAE) is the universal framework for toxicity reporting in oncology trials. We sought to develop a CTCAE-compatible modified barium swallow (MBS) grade for the purpose of grading pharyngeal dysphagia as a toxicity endpoint in cooperative group organ preservation trials for head and neck cancer (HNC). We hypothesized that a 5-point CTCAE-compatible MBS grade (“DIGEST”) based on the interaction of pharyngeal residue and laryngeal penetration/aspiration ratings is feasible and psychometrically sound. Methods A modified Delphi exercise was conducted for content validation, expert consensus, and operationalization of DIGEST criteria. Two blinded raters scored 100 MBS conducted before or after surgical or non-surgical organ preservation. Intra- and inter-rater reliability were tested by weighted Kappa. Criterion validity against OPSE, MBSImP™©, MDADI, and PSS-HN was assessed with one-way ANOVA and post hoc pairwise comparisons between DIGEST grades. Results Intra-rater reliability was excellent (weighted Kappa=0.82–0.84) with substantial to almost perfect agreement between raters (weighted Kappa=0.67–0.81). DIGEST significantly discriminated levels of pharyngeal pathophysiology (MBSImP™©: r=0.77, p<0.0001), swallow efficiency (OPSE: r=−0.56, p<0.0001), perceived dysphagia (MDADI: r=−0.41, p<0.0001), and oral intake (PSS-HN diet: r=−0.49, p<0.0001). Conclusions With the development of DIGEST, we have adapted MBS rating to the CTCAE nomenclature of ordinal toxicity grading used in oncology trials. DIGEST offers a psychometrically sound measure for HNC clinical trials and investigations of toxicity profiles, dose-response, and predictive modeling. PMID:27564246

Scaling up ATLAS Event Service to production levels on opportunistic computing platforms

NASA Astrophysics Data System (ADS)

Benjamin, D.; Caballero, J.; Ernst, M.; Guan, W.; Hover, J.; Lesny, D.; Maeno, T.; Nilsson, P.; Tsulaia, V.; van Gemmeren, P.; Vaniachine, A.; Wang, F.; Wenaus, T.; ATLAS Collaboration

2016-10-01

Continued growth in public cloud and HPC resources is on track to exceed the dedicated resources available for ATLAS on the WLCG. Examples of such platforms are Amazon AWS EC2 Spot Instances, Edison Cray XC30 supercomputer, backfill at Tier 2 and Tier 3 sites, opportunistic resources at the Open Science Grid (OSG), and ATLAS High Level Trigger farm between the data taking periods. Because of specific aspects of opportunistic resources such as preemptive job scheduling and data I/O, their efficient usage requires workflow innovations provided by the ATLAS Event Service. Thanks to the finer granularity of the Event Service data processing workflow, the opportunistic resources are used more efficiently. We report on our progress in scaling opportunistic resource usage to double-digit levels in ATLAS production.

Quantitative Skeletal Muscle MRI: Part 1, Derived T2 Fat Map in Differentiation Between Boys With Duchenne Muscular Dystrophy and Healthy Boys.

PubMed

Johnston, Jennifer H; Kim, Hee Kyung; Merrow, Arnold C; Laor, Tal; Serai, Suraj; Horn, Paul S; Kim, Dong Hoon; Wong, Brenda L

2015-08-01

The purpose of this study was to validate derived T2 maps as an objective measure of muscular fat for discrimination between boys with Duchenne muscular dystrophy (DMD) and healthy boys. Forty-two boys with DMD (mean age, 9.9 years) and 31 healthy boys (mean age, 11.4 years) were included in the study. Age, body mass index, and clinical function scale grade were evaluated. T1-weighted MR images and T2 maps with and without fat suppression were obtained. Fatty infiltration was graded 0-4 on T1-weighted images, and derived T2 fat values (difference between mean T2 values from T2 maps with and without fat suppression) of the gluteus maximus and vastus lateralis muscles were calculated. Group comparisons were performed. The upper limit of the 95% reference interval of T2 fat values from the control group was applied. There was no significant difference in age or body mass index between groups. All healthy boys and 19 boys (45.2%) with DMD had a normal clinical function scale grade. Grade 1 fatty infiltration was seen in 90.3% (gluteus maximus) and 71.0% (vastus lateralis) of healthy boys versus 33.3% (gluteus maximus) and 52.4% (vastus lateralis) of boys with DMD. T2 fat values of boys with DMD were significantly longer than in the control group (p < 0.001). Using a 95% reference interval for healthy boys for the gluteus maximus (28.3 milliseconds) allowed complete separation from boys with DMD (100% sensitivity, 100% specificity), whereas the values for the vastus lateralis (7.28 milliseconds) resulted in 83.3% sensitivity and 100% specificity. Measurement of muscular fat with T2 maps is accurate for differentiating boys with DMD from healthy boys.

Spider Transcriptomes Identify Ancient Large-Scale Gene Duplication Event Potentially Important in Silk Gland Evolution.

PubMed

Clarke, Thomas H; Garb, Jessica E; Hayashi, Cheryl Y; Arensburger, Peter; Ayoub, Nadia A

2015-06-08

The evolution of specialized tissues with novel functions, such as the silk synthesizing glands in spiders, is likely an influential driver of adaptive success. Large-scale gene duplication events and subsequent paralog divergence are thought to be required for generating evolutionary novelty. Such an event has been proposed for spiders, but not tested. We de novo assembled transcriptomes from three cobweb weaving spider species. Based on phylogenetic analyses of gene families with representatives from each of the three species, we found numerous duplication events indicative of a whole genome or segmental duplication. We estimated the age of the gene duplications relative to several speciation events within spiders and arachnids and found that the duplications likely occurred after the divergence of scorpions (order Scorpionida) and spiders (order Araneae), but before the divergence of the spider suborders Mygalomorphae and Araneomorphae, near the evolutionary origin of spider silk glands. Transcripts that are expressed exclusively or primarily within black widow silk glands are more likely to have a paralog descended from the ancient duplication event and have elevated amino acid replacement rates compared with other transcripts. Thus, an ancient large-scale gene duplication event within the spider lineage was likely an important source of molecular novelty during the evolution of silk gland-specific expression. This duplication event may have provided genetic material for subsequent silk gland diversification in the true spiders (Araneomorphae). © The Author(s) 2015. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution.

Drug and herb induced liver injury: Council for International Organizations of Medical Sciences scale for causality assessment

PubMed Central

Teschke, Rolf; Wolff, Albrecht; Frenzel, Christian; Schwarzenboeck, Alexander; Schulze, Johannes; Eickhoff, Axel

2014-01-01

Causality assessment of suspected drug induced liver injury (DILI) and herb induced liver injury (HILI) is hampered by the lack of a standardized approach to be used by attending physicians and at various subsequent evaluating levels. The aim of this review was to analyze the suitability of the liver specific Council for International Organizations of Medical Sciences (CIOMS) scale as a standard tool for causality assessment in DILI and HILI cases. PubMed database was searched for the following terms: drug induced liver injury; herb induced liver injury; DILI causality assessment; and HILI causality assessment. The strength of the CIOMS lies in its potential as a standardized scale for DILI and HILI causality assessment. Other advantages include its liver specificity and its validation for hepatotoxicity with excellent sensitivity, specificity and predictive validity, based on cases with a positive reexposure test. This scale allows prospective collection of all relevant data required for a valid causality assessment. It does not require expert knowledge in hepatotoxicity and its results may subsequently be refined. Weaknesses of the CIOMS scale include the limited exclusion of alternative causes and qualitatively graded risk factors. In conclusion, CIOMS appears to be suitable as a standard scale for attending physicians, regulatory agencies, expert panels and other scientists to provide a standardized, reproducible causality assessment in suspected DILI and HILI cases, applicable primarily at all assessing levels involved. PMID:24653791

The Test Anxiety Measure for Adolescents (TAMA): Examination of the Reliability and Validity of the Scores of a New Multidimensional Measure of Test Anxiety for Middle and High School Students

ERIC Educational Resources Information Center

Lowe, Patricia A.

2014-01-01

A new multidimensional measure of test anxiety, the Test Anxiety Measure for Adolescents (TAMA), specifically designed for U.S. adolescents in Grades 6 to 12 was developed and its psychometric properties were examined. The TAMA consists of five scales (Cognitive Interference, Physiological Hyperarousal, Social Concerns, Task Irrelevant Behavior,…

New clinical grading scales and objective measurement for conjunctival injection.

PubMed

Park, In Ki; Chun, Yeoun Sook; Kim, Kwang Gi; Yang, Hee Kyung; Hwang, Jeong-Min

2013-08-05

To establish a new clinical grading scale and objective measurement method to evaluate conjunctival injection. Photographs of conjunctival injection with variable ocular diseases in 429 eyes were reviewed. Seventy-three images with concordance by three ophthalmologists were classified into a 4-step and 10-step subjective grading scale, and used as standard photographs. Each image was quantified in four ways: the relative magnitude of the redness component of each red-green-blue (RGB) pixel; two different algorithms based on the occupied area by blood vessels (K-means clustering with LAB color model and contrast-limited adaptive histogram equalization [CLAHE] algorithm); and the presence of blood vessel edges, based on the Canny edge-detection algorithm. Area under the receiver operating characteristic curves (AUCs) were calculated to summarize diagnostic accuracies of the four algorithms. The RGB color model, K-means clustering with LAB color model, and CLAHE algorithm showed good correlation with the clinical 10-step grading scale (R = 0.741, 0.784, 0.919, respectively) and with the clinical 4-step grading scale (R = 0.645, 0.702, 0.838, respectively). The CLAHE method showed the largest AUC, best distinction power (P < 0.001, ANOVA, Bonferroni multiple comparison test), and high reproducibility (R = 0.996). CLAHE algorithm showed the best correlation with the 10-step and 4-step subjective clinical grading scales together with high distinction power and reproducibility. CLAHE algorithm can be a useful for method for assessment of conjunctival injection.

Best Practices in Pulic Outreach Events

NASA Astrophysics Data System (ADS)

Cobb, Whitney; Buxner, Sanlyn; Shipp, Stephanie

2015-11-01

IntroductionEach year the National Aeronautics and Space Administration (NASA) sponsors public outreach events designed to increase student, educator, and general public engagement in its missions and goals. NASA SMD Education’s review of large-scale events, “Best Practices in Outreach Events,” highlighted planning and implementation best practices, which were used by the Dawn mission to strategize and implement its Ceres arrival celebration event, i C Ceres.BackgroundThe literature review focused on best identifying practices rising from evaluations of large-scale public outreach events. The following criteria guided the study:* Public, science-related events open to adults and children* Events that occurred during the last 5 years* Evaluations that included information on data collected from visitors and/or volunteers* Evaluations that specified the type of data collected, methodology, and associated resultsBest Practices: Planning and ImplementationThe literature review revealed key considerations for planning implement large-scale events. Best practices included can be pertinent for all event organizers and evaluators regardless of event size. A summary of related best practices is presented below.1) Advertise the event2) Use and advertise access to scientists* Attendees who reported an interaction with a science professional were 15% to 19% more likely to report positive learning impacts, (SFA, 2012, p. 24).3) Recruit scientists using findings such as:* High percentages of scientists (85% to 96%) from most events were interested in participating again (SFA, 2012).4) Ensure that the event is group and, particularly, child friendly5) Target specific event outcomesBest Practices Informing Real-world Planning, Implementation and EvaluationDawn mission’s collaborative design of a series of events, i C Ceres, including in-person, interactive events geared to families and live presentations, will be shared, with focus on the family event, and the evidence that scientist participation was a particular driver for the event’s impact and success.Science Festival Alliance (SFA). (2012). Get inspired: A first look at science festivals. Retrieved from http://sciencefestivals.org/news_item/get-inspired

A Comparison of Rubrics and Graded Category Rating Scales with Various Methods Regarding Raters' Reliability

ERIC Educational Resources Information Center

Dogan, C. Deha; Uluman, Müge

2017-01-01

The aim of this study was to determine the extent at which graded-category rating scales and rubrics contribute to inter-rater reliability. The research was designed as a correlational study. Study group consisted of 82 students attending sixth grade and three writing course teachers in a private elementary school. A performance task was…

Spatial and Temporal Coordination of Bone Marrow-Derived Cell Activity During Arteriogenesis: Regulation of the Endogenous Response and Therapeutic Implications

PubMed Central

Meisner, Joshua K.; Price, Richard J.

2010-01-01

Arterial occlusive disease (AOD) is the leading cause of morbidity and mortality through the developed world, which creates a significant need for effective therapies to halt disease progression. Despite success of animal and small-scale human therapeutic arteriogenesis studies, this promising concept for treating AOD has yielded largely disappointing results in large-scale clinical trials. One reason for this lack of successful translation is that endogenous arteriogenesis is highly dependent on a poorly understood sequence of events and interactions between bone marrow derived cells (BMCs) and vascular cells, which makes designing effective therapies difficult. We contend that the process follows a complex, ordered sequence of events with multiple, specific BMC populations recruited at specific times and locations. Here we present the evidence suggesting roles for multiple BMC populations from neutrophils and mast cells to progenitor cells and propose how and where these cell populations fit within the sequence of events during arteriogenesis. Disruptions in these various BMC populations can impair the arteriogenesis process in patterns that characterize specific patient populations. We propose that an improved understanding of how arteriogenesis functions as a system can reveal individual BMC populations and functions that can be targeted for overcoming particular impairments in collateral vessel development. PMID:21044213

Laboratory Activity: Specific Heat by Change in Internal Energy of Silly Putty

ERIC Educational Resources Information Center

Koser, John

2011-01-01

Students in introductory physics courses often don't study thermodynamics or thermodynamic events. If any thermal physics is taught in introductory courses (e.g., Physics 101 for Liberal Arts Majors), it usually involves the concepts of specific heat and various temperature scales. Seldom are the first and second laws of thermodynamics taught in…

Ten Steps to Conducting a Large, Multi-Site, Longitudinal Investigation of Language and Reading in Young Children

PubMed Central

Farquharson, Kelly; Murphy, Kimberly A.

2016-01-01

Purpose: This paper describes methodological procedures involving execution of a large-scale, multi-site longitudinal study of language and reading comprehension in young children. Researchers in the Language and Reading Research Consortium (LARRC) developed and implemented these procedures to ensure data integrity across multiple sites, schools, and grades. Specifically, major features of our approach, as well as lessons learned, are summarized in 10 steps essential for successful completion of a large-scale longitudinal investigation in early grades. Method: Over 5 years, children in preschool through third grade were administered a battery of 35 higher- and lower-level language, listening, and reading comprehension measures (RCM). Data were collected from children, their teachers, and their parents/guardians at four sites across the United States. Substantial and rigorous effort was aimed toward maintaining consistency in processes and data management across sites for children, assessors, and staff. Conclusion: With appropriate planning, flexibility, and communication strategies in place, LARRC developed and executed a successful multi-site longitudinal research study that will meet its goal of investigating the contribution and role of language skills in the development of children's listening and reading comprehension. Through dissemination of our design strategies and lessons learned, research teams embarking on similar endeavors can be better equipped to anticipate the challenges. PMID:27064308

Finding the signal in the noise: Could social media be utilized for early hospital notification of multiple casualty events?

PubMed Central

Moore, Sara; Wakam, Glenn; Hubbard, Alan E.; Cohen, Mitchell J.

2017-01-01

Introduction Delayed notification and lack of early information hinder timely hospital based activations in large scale multiple casualty events. We hypothesized that Twitter real-time data would produce a unique and reproducible signal within minutes of multiple casualty events and we investigated the timing of the signal compared with other hospital disaster notification mechanisms. Methods Using disaster specific search terms, all relevant tweets from the event to 7 days post-event were analyzed for 5 recent US based multiple casualty events (Boston Bombing [BB], SF Plane Crash [SF], Napa Earthquake [NE], Sandy Hook [SH], and Marysville Shooting [MV]). Quantitative and qualitative analysis of tweet utilization were compared across events. Results Over 3.8 million tweets were analyzed (SH 1.8 m, BB 1.1m, SF 430k, MV 250k, NE 205k). Peak tweets per min ranged from 209–3326. The mean followers per tweeter ranged from 3382–9992 across events. Retweets were tweeted a mean of 82–564 times per event. Tweets occurred very rapidly for all events (<2 mins) and represented 1% of the total event specific tweets in a median of 13 minutes of the first 911 calls. A 200 tweets/min threshold was reached fastest with NE (2 min), BB (7 min), and SF (18 mins). If this threshold was utilized as a signaling mechanism to place local hospitals on standby for possible large scale events, in all case studies, this signal would have preceded patient arrival. Importantly, this threshold for signaling would also have preceded traditional disaster notification mechanisms in SF, NE, and simultaneous with BB and MV. Conclusions Social media data has demonstrated that this mechanism is a powerful, predictable, and potentially important resource for optimizing disaster response. Further investigated is warranted to assess the utility of prospective signally thresholds for hospital based activation. PMID:28982201

Antenatal depressive symptoms associated with specific life events and sources of social support among Italian women.

PubMed

Agostini, Francesca; Neri, Erica; Salvatori, Paola; Dellabartola, Sara; Bozicevic, Laura; Monti, Fiorella

2015-05-01

This study aimed to identify different kinds of stressful life events and social support associated with antenatal depressive symptoms in a sample of pregnant Italian women. We conducted the study at a primary health-care centre in an urban area (northeast Italy). Mainly recruited at antenatal classes, 404 eligible pregnant women completed a socio-demographic questionnaire that included questions about the present pregnancy, the Edinburgh Depression Scale (EDS) to estimate the prevalence of depressive symptoms, the Multidimensional Scale of Perceived Social Support and List of Threatening Experiences Questionnaire to investigate the quality and nature of social support and recent negative life events. Of the 404 women, 60 (14.9 %) scored 13 or higher on the EDS. This group reported significantly lower social support from various sources-family, friends, and significant others; only in primiparous women were depressive symptoms significantly related to lower support from friends. Women with EDS scores equal or higher than 13 also reported a higher occurrence of recent stressful life events-specifically, death or a serious problem with a close friend or relative, unemployment, financial problems, and moving or housing difficulties. Regression analyses showed that women with high levels of social support or with a positive experience of pregnancy were less likely to experience antenatal depressive symptoms. Our results underscore the associations among antenatal depression, specific life stressors, and low social support from various sources. Clinical attention to these psychosocial correlates is recommended toward detecting vulnerability to antenatal depressive symptoms.

Perioperative analgesia for patients undergoing endoscopic sinus surgery: an evidence-based review.

PubMed

Svider, Peter F; Nguyen, Brandon; Yuhan, Brian; Zuliani, Giancarlo; Eloy, Jean Anderson; Folbe, Adam J

2018-04-12

Misuse and diversion of prescription opioids have been critical in facilitating the opioid epidemic. Our objective was to perform a systematic evidence-based review delineating perioperative regimens (including opioid alternatives) evaluated for endoscopic sinus surgery. PubMed/MEDLINE, Cochrane Library, and EmBase databases were evaluated for studies detailing analgesics employed after endoscopic sinus surgery. Studies were assessed for level of evidence. Bias risk was evaluated using the Cochrane Bias tool and GRADE criteria. Medication, administration, adverse effects, pain scores, and rescue analgesic consumption were evaluated. A summary of evidence detailing benefits, harm, and cost was prepared. Thirty-two studies encompassing 1812 patients were included. The GRADE criteria determined the overall evidence to be of moderate quality. Perioperative acetaminophen had few adverse events and reduced immediate need for opioid rescue after sinus surgery; studies evaluating acetaminophen demonstrate a preponderance of benefit over harm. Nonsteroidal anti-inflammatory drugs (NSAIDs) also reduce postoperative opioid consumption, although a small portion of patients undergoing sinus surgery harbor the potential for NSAID intolerance. The aggregate level of evidence for studies evaluating NSAIDs was grade A, whereas the aggregate grade of evidence for several other agents was grade B. There is evidence supporting the use of NSAIDs and gabapentin for the control of pain after endoscopic sinus surgery. Acetaminophen, α-agonists, and local anesthetics are also viable options for postoperative analgesia. Familiarity with these data is essential to facilitate the use of opioid alternatives. Further large-scale, multi-institutional, randomized trials are needed to provide conclusive recommendations for these perioperative analgesics. © 2018 ARS-AAOA, LLC.

[Development of an activity of daily living scale for patients with COPD: the Activity of Daily Living Dyspnea scale].

PubMed

Yoza, Yoshiyasu; Ariyoshi, Koya; Honda, Sumihisa; Taniguchi, Hiroyuki; Senjyu, Hideaki

2009-10-01

Patients with COPD often experience restriction in their activities of daily living (ADL) due to dyspnea. This type of restriction is unique to patients with COPD and cannot be adequately evaluated by the generic ADL scales. This study developed an ADL scale (the Activity of Daily Living Dyspnea scale [ADL-D scale]) for patients with COPD and investigated its validity and internal consistency. Patients with stable COPD were recruited and completed a pilot 26-item questionnaire. Patients also performed the Incremental Shuttle Walk Test (ISWT), and completed the St George's Respiratory Questionnaire (SGRQ), and Medical Research Council (MRC) dyspnea grade. There were 83 male participants who completed the pilot questionnaire. Following the pilot, 8 items that were not undertaken by the majority of subjects, and 3 items judged to be of low clinical importance by physical therapists were removed from the pilot questionnaire. The final ADL-D scale contained 15 items. Scores obtained with the ADL-D scale were significantly correlated with the MRC dyspnea grades, distance walked on the ISWT and SGRQ scores. The ADL-D scores were significantly different across the five grades of the MRC dyspnea grade. The ADL-D scale showed high consistency (Chronbach's alpha coefficient of 0.96). The ADL-D scale is a useful scale for assessing impairments in ADL in Japanese male patients with COPD.

Factor Analysis of Traffic Safety in Urban Roads Based on FTA-LEC

NASA Astrophysics Data System (ADS)

Shuicheng, TIAN; Xingbo, YANG; Xiaoqing, SHEN; Detao, ZHANG

2018-05-01

In order to reduce the number and the loss of urban road traffic accidents in our country, improve the safety of road traffic, a statistical analysis of the research report on major road traffic accidents in 2016 was conducted. The risk factors affecting urban road traffic in China were analyzed by using FTA to find the basic hidden events. Secondly, the risk value of the identified hidden danger events were calculated and classified into four levels I, II, III and IV through the LEC evaluation method. Finally, the graded results of risk factors are verified through a case of specific accidents in Beijing. The results show that: the case verified the scientificalness and effectiveness of hazard classification and provided guidance for urban road traffic management.

A Meta-Analysis of Growth Trends from Vertically Scaled Assessments

ERIC Educational Resources Information Center

Dadey, Nathan; Briggs, Derek C.

2012-01-01

A vertical scale, in principle, provides a common metric across tests with differing difficulties (e.g., spanning multiple grades) so that statements of "absolute" growth can be made. This paper compares 16 states' 2007-2008 effect size growth trends on vertically scaled reading and math assessments across grades 3 to 8. Two patterns…

Cost-effectiveness of New Surgical Treatments for Hemorrhoidal Disease: A Multicentre Randomized Controlled Trial Comparing Transanal Doppler-guided Hemorrhoidal Artery Ligation With Mucopexy and Circular Stapled Hemorrhoidopexy.

PubMed

Lehur, Paul A; Didnée, Anne S; Faucheron, Jean-Luc; Meurette, Guillaume; Zerbib, Philippe; Siproudhis, Laurent; Vinson-Bonnet, Béatrice; Dubois, Anne; Casa, Christine; Hardouin, Jean-Benoit; Durand-Zaleski, Isabelle

2016-11-01

To compare Doppler-guided hemorrhoidal artery ligation (DGHAL) with circular stapled hemorrhoidopexy (SH) in the treatment of grade II/III hemorrhoidal disease (HD). DGHAL is a treatment option for symptomatic HD; existing studies report limited risk and satisfactory outcomes. DGHAL has never before been compared with SH in a large-scale multi-institutional randomized clinical trial. Three hundred ninety-three grade II/III HD patients recruited in 22 centers from 2010 to 2013 were randomized to DGHAL (n = 197) or SH (n = 196). The primary endpoint was operative-related morbidity at 3 months (D.90) based on the Clavien-Dindo surgical complications grading. Total cost, cost-effectiveness, and clinical outcome were assessed at 1 year. At D.90, operative-related adverse events occurred after DGHAL and SH, respectively, in 47 (24%) and 50 (26%) patients (P = 0.70). DGHAL resulted in longer mean operating time (44±16 vs 30±14 min; P < 0.001), less pain (postoperative and at 2 wks visual analogic scale: 2.2 vs 2.8; 1.3 vs 1.9; P = 0.03; P = 0.013) and shorter sick leave (12.3 vs 14.8 d; P = 0.045). At 1 year, DGHAL led to more residual grade III HD (15% vs 5%) and a higher reoperation rate (8% vs 4%). Patient satisfaction was >90% for both procedures. Total cost at 1 year was greater for DGHAL [&OV0556;2806 (&OV0556;2670; 2967) vs &OV0556;2538 (&OV0556;2386; 2737)]. The D.90, incremental cost-effectiveness ratio (ICER) was &OV0556;7192 per averted complication. At 1 year DGHAL strategy was dominated. DGHAL and SH are viable options in grade II/III HD with no significant difference in operative-related risk. Although resulting in less postoperative pain and shorter sick leave, DGHAL was more expensive, took longer, and provided a possible inferior anatomical correction suggesting an increased risk of recurrence.

Sports injury or trauma? Injuries of the competition off-road motorcyclist.

PubMed

Colburn, Nona T; Meyer, Richard D

2003-03-01

A prospective analysis of the injuries of off-road competition motorcyclist at four International Six Day Enduro (ISDE) events was performed utilizing the injury severity score (ISS) and the abbreviated injury scale (AIS). Of the 1787 participants, approximately 10% received injuries that required attention from a medical response unit. The majority (85%) sustained a mild injury (mean ISS 3.9). Loss of control while jumping and striking immovable objects were important risk determinants for serious injury. Although seasoned in off-road experiences, mean 15.3 years, 54% of those injured were first year rookies to the ISDE event. Speeds were below 50 km/h in the majority of accidents (80%), and were not statistically correlated with severity. The most frequently injured anatomical regions were the extremities (57%). The most common types of injury were ligamentous (50%). Seventy-seven percent of all fractures were AIS grades 1 and 2. The most common fractures were those of the foot and ankle (36%). Multiple fractures involving different anatomical regions, or a combination of serious injuries was seen with only one rider. When compared to the injuries of the street motorcyclist, competition riders had lower AIS grades of head and limb trauma. Off-road motorcycle competition is a relatively safe sport with injury rates comparably less than those of contact sports such as American football and hockey.

A dynamical systems approach to studying midlatitude weather extremes

NASA Astrophysics Data System (ADS)

Messori, Gabriele; Caballero, Rodrigo; Faranda, Davide

2017-04-01

Extreme weather occurrences carry enormous social and economic costs and routinely garner widespread scientific and media coverage. The ability to predict these events is therefore a topic of crucial importance. Here we propose a novel predictability pathway for extreme events, by building upon recent advances in dynamical systems theory. We show that simple dynamical systems metrics can be used to identify sets of large-scale atmospheric flow patterns with similar spatial structure and temporal evolution on time scales of several days to a week. In regions where these patterns favor extreme weather, they afford a particularly good predictability of the extremes. We specifically test this technique on the atmospheric circulation in the North Atlantic region, where it provides predictability of large-scale wintertime surface temperature extremes in Europe up to 1 week in advance.

Development and validation of a visual grading scale for assessing image quality of AP pelvis radiographic images.

PubMed

Mraity, Hussien A A B; England, Andrew; Cassidy, Simon; Eachus, Peter; Dominguez, Alejandro; Hogg, Peter

2016-01-01

The aim of this article was to apply psychometric theory to develop and validate a visual grading scale for assessing the visual perception of digital image quality anteroposterior (AP) pelvis. Psychometric theory was used to guide scale development. Seven phantom and seven cadaver images of visually and objectively predetermined quality were used to help assess scale reliability and validity. 151 volunteers scored phantom images, and 184 volunteers scored cadaver images. Factor analysis and Cronbach's alpha were used to assess scale validity and reliability. A 24-item scale was produced. Aggregated mean volunteer scores for each image correlated with the rank order of the visually and objectively predetermined image qualities. Scale items had good interitem correlation (≥0.2) and high factor loadings (≥0.3). Cronbach's alpha (reliability) revealed that the scale has acceptable levels of internal reliability for both phantom and cadaver images (α = 0.8 and 0.9, respectively). Factor analysis suggested that the scale is multidimensional (assessing multiple quality themes). This study represents the first full development and validation of a visual image quality scale using psychometric theory. It is likely that this scale will have clinical, training and research applications. This article presents data to create and validate visual grading scales for radiographic examinations. The visual grading scale, for AP pelvis examinations, can act as a validated tool for future research, teaching and clinical evaluations of image quality.

Development and validation of a visual grading scale for assessing image quality of AP pelvis radiographic images

PubMed Central

England, Andrew; Cassidy, Simon; Eachus, Peter; Dominguez, Alejandro; Hogg, Peter

2016-01-01

Objective: The aim of this article was to apply psychometric theory to develop and validate a visual grading scale for assessing the visual perception of digital image quality anteroposterior (AP) pelvis. Methods: Psychometric theory was used to guide scale development. Seven phantom and seven cadaver images of visually and objectively predetermined quality were used to help assess scale reliability and validity. 151 volunteers scored phantom images, and 184 volunteers scored cadaver images. Factor analysis and Cronbach's alpha were used to assess scale validity and reliability. Results: A 24-item scale was produced. Aggregated mean volunteer scores for each image correlated with the rank order of the visually and objectively predetermined image qualities. Scale items had good interitem correlation (≥0.2) and high factor loadings (≥0.3). Cronbach's alpha (reliability) revealed that the scale has acceptable levels of internal reliability for both phantom and cadaver images (α = 0.8 and 0.9, respectively). Factor analysis suggested that the scale is multidimensional (assessing multiple quality themes). Conclusion: This study represents the first full development and validation of a visual image quality scale using psychometric theory. It is likely that this scale will have clinical, training and research applications. Advances in knowledge: This article presents data to create and validate visual grading scales for radiographic examinations. The visual grading scale, for AP pelvis examinations, can act as a validated tool for future research, teaching and clinical evaluations of image quality. PMID:26943836

National Earthquake Information Center Seismic Event Detections on Multiple Scales

NASA Astrophysics Data System (ADS)

Patton, J.; Yeck, W. L.; Benz, H.; Earle, P. S.; Soto-Cordero, L.; Johnson, C. E.

2017-12-01

The U.S. Geological Survey National Earthquake Information Center (NEIC) monitors seismicity on local, regional, and global scales using automatic picks from more than 2,000 near-real time seismic stations. This presents unique challenges in automated event detection due to the high variability in data quality, network geometries and density, and distance-dependent variability in observed seismic signals. To lower the overall detection threshold while minimizing false detection rates, NEIC has begun to test the incorporation of new detection and picking algorithms, including multiband (Lomax et al., 2012) and kurtosis (Baillard et al., 2014) pickers, and a new bayesian associator (Glass 3.0). The Glass 3.0 associator allows for simultaneous processing of variably scaled detection grids, each with a unique set of nucleation criteria (e.g., nucleation threshold, minimum associated picks, nucleation phases) to meet specific monitoring goals. We test the efficacy of these new tools on event detection in networks of various scales and geometries, compare our results with previous catalogs, and discuss lessons learned. For example, we find that on local and regional scales, rapid nucleation of small events may require event nucleation with both P and higher-amplitude secondary phases (e.g., S or Lg). We provide examples of the implementation of a scale-independent associator for an induced seismicity sequence (local-scale), a large aftershock sequence (regional-scale), and for monitoring global seismicity. Baillard, C., Crawford, W. C., Ballu, V., Hibert, C., & Mangeney, A. (2014). An automatic kurtosis-based P-and S-phase picker designed for local seismic networks. Bulletin of the Seismological Society of America, 104(1), 394-409. Lomax, A., Satriano, C., & Vassallo, M. (2012). Automatic picker developments and optimization: FilterPicker - a robust, broadband picker for real-time seismic monitoring and earthquake early-warning, Seism. Res. Lett. , 83, 531-540, doi: 10.1785/gssrl.83.3.531.

An outcomes-based grading scale for the evaluation of cerebral aneurysms treated with flow diversion.

PubMed

Park, Min S; Mazur, Marcus D; Moon, Karam; Nanaszko, Michael J; Kestle, John R W; Shah, Lubdha M; Winegar, Blair; Albuquerque, Felipe C; Taussky, Philipp; McDougall, Cameron G

2017-11-01

Despite the popularity of flow-diverting stents for the treatment of cerebral aneurysms, there is no widely accepted scale for the characterization of results. We present an outcomes-based grading scale that considers factors related to failure of flow diversion. The grading scale was developed using the results from consecutive patients at two institutions who were treated with flow diversion for a cerebral aneurysm. The initial treatment results were graded on patient, aneurysm, and treatment characteristics. A 6-point grading scale was developed based on these data. One hundred and seventy-one patients were included in the patient cohort. When compared by multivariate analysis with patients without residuals, patients with aneurysm residuals were found to be older (age ≥60 years, p=0.01, OR 1.17, 95% CI 1.03 to 1.33), to have larger aneurysms (size ≥15 mm, p<0.01, OR 1.38, 95% CI 1.17 to 1.62), to have aneurysms with associated side branches (p=0.02, OR 1.17, 95% CI 1.03 to 1.33), and to have a post-treatment Raymond score of 2 or 3 (p=0.01, OR 1.28, 95% CI 1.06 to 1.56). Using the Raymond score (1-3) as the foundation for the grading scale, additional points (0 or 1) were given for the other three identified factors, creating a 6-point scale. We found that patients with residual aneurysms had statistically higher final tabulated scores (p<0.01). We propose a novel straightforward outcomes-based scale to characterize results after flow diversion treatment of cerebral aneurysms. This scale may provide the basis for the common reporting of results in future studies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Measuring Vincristine-Induced Peripheral Neuropathy in Children with Acute Lymphoblastic Leukemia

PubMed Central

Lavoie Smith, Ellen M.; Li, Lang; Hutchinson, Raymond J.; Ho, Richard; Burnette, W. Bryan; Wells, Elizabeth; Bridges, Celia; Renbarger, Jamie

2014-01-01

Background Vincristine-induced peripheral neuropathy (VIPN) is difficult to quantify in children. Objective The study objective was to examine the reliability, validity, and clinical feasibility of several VIPN measures for use in children with acute lymphoblastic leukemia. Interventions/Methods Children (N = 65) aged 1–18 years receiving vincristine at four academic centers participated in the study. Baseline and pre-vincristine VIPN assessments were obtained using the Total Neuropathy Score-Pediatric Vincristine (TNS-PV), the National Cancer Institute Common Terminology Criteria for Adverse Events, the Balis grading scale, and the FACES pain scale. TNS-PV scores (n = 806) were obtained over 15 weeks. Blood was obtained at several time-points to quantify pharmacokinetic parameters. Results Cronbach’s alpha for a reduced TNS-PV scale was 0.84. TNS-PV scores correlated with cumulative vincristine dosage (r = 0.53, p = 0.01), pharmacokinetic parameters (r = 0.41, p = 0.05), and grading scale scores (r = 0.46 – 0.52; p = 0.01). FACES scores correlated with the TNS-PV neuropathic pain item (r = 0.48; p = 0.01), and were attainable in all ages. A 2-item V-Rex score (vibration and reflex items) was the most responsive to change (es 0.65, p < 0.001). TNS-PV scores were attainable in 95% of children ≥ 6 years. Conclusions The TNS-PV is reliable and valid for measuring VIPN. It is sensitive to change over time (15 weeks) and feasible for use in children ≥ 6 years of age. Implications for Practice The TNS-PV may be a useful tool for assessing vincristine toxicity in children with acute lymphoblastic leukemia. PMID:23842524

On the feasibility of using satellite gravity observations for detecting large-scale solid mass transfer events

NASA Astrophysics Data System (ADS)

Peidou, Athina C.; Fotopoulos, Georgia; Pagiatakis, Spiros

2017-10-01

The main focus of this paper is to assess the feasibility of utilizing dedicated satellite gravity missions in order to detect large-scale solid mass transfer events (e.g. landslides). Specifically, a sensitivity analysis of Gravity Recovery and Climate Experiment (GRACE) gravity field solutions in conjunction with simulated case studies is employed to predict gravity changes due to past subaerial and submarine mass transfer events, namely the Agulhas slump in southeastern Africa and the Heart Mountain Landslide in northwestern Wyoming. The detectability of these events is evaluated by taking into account the expected noise level in the GRACE gravity field solutions and simulating their impact on the gravity field through forward modelling of the mass transfer. The spectral content of the estimated gravity changes induced by a simulated large-scale landslide event is estimated for the known spatial resolution of the GRACE observations using wavelet multiresolution analysis. The results indicate that both the Agulhas slump and the Heart Mountain Landslide could have been detected by GRACE, resulting in {\\vert }0.4{\\vert } and {\\vert }0.18{\\vert } mGal change on GRACE solutions, respectively. The suggested methodology is further extended to the case studies of the submarine landslide in Tohoku, Japan, and the Grand Banks landslide in Newfoundland, Canada. The detectability of these events using GRACE solutions is assessed through their impact on the gravity field.

North American Extreme Temperature Events and Related Large Scale Meteorological Patterns: A Review of Statistical Methods, Dynamics, Modeling, and Trends

NASA Technical Reports Server (NTRS)

Grotjahn, Richard; Black, Robert; Leung, Ruby; Wehner, Michael F.; Barlow, Mathew; Bosilovich, Michael G.; Gershunov, Alexander; Gutowski, William J., Jr.; Gyakum, John R.; Katz, Richard W.;

Feasibility study of contralateral risk-reducing mastectomy with breast reconstruction for breast cancer patients with BRCA mutations in Japan.

PubMed

Yoshimura, Akiyo; Okumura, Seiko; Sawaki, Masataka; Hattori, Masaya; Ishiguro, Junko; Adachi, Yayoi; Kotani, Haruru; Gondo, Naomi; Kataoka, Ayumi; Iwase, Madoka; Onishi, Sakura; Sugino, Kayoko; Terada, Mitsuo; Horisawa, Nanae; Mori, Makiko; Takaiso, Nobue; Hyodo, Ikuo; Iwata, Hiroji

2018-03-08

Contralateral risk-reducing mastectomy (CRRM) for breast cancer patients with BRCA mutations has been reported to not only reduce breast cancer incidence but also to improve survival. The National Comprehensive Cancer Network guidelines recommend providing CRRM to women with BRCA mutations who desire CRRM after risk-reduction counseling. However, in Japan, CRRM cannot be performed generally because it is not covered by health insurance. Thus, we conducted a feasibility study to confirm the safety of CRRM. CRRM with bilateral breast reconstructions were performed for breast cancer patients with BRCA mutations. The primary endpoint was early adverse events within 3 months, and secondary endpoints were late adverse events. Between August 2014 and November 2016, ten patients were enrolled. The median age was 37.5 years, and five of the patients had the BRCA1 mutation while five had the BRCA2 mutation. Six patients received neoadjuvant chemotherapy. Eight patients selected silicone breast implants, and two patients selected transverse rectus abdominis myocutaneous flap reconstruction. Pathological findings showed no evidence of occult breast cancers in any of the patients. At a median of 25.5 months follow-up time, CRRM-related early adverse events were hematoma (subsequently removed by re-operation; grade 2, n = 1), wound infection (grade 2, n = 1), skin ulceration (grade 1, n = 2) and wound pain (grade 1, n = 1). Overall, there were no grade 3 or more severe adverse events. Our results confirm that CRRM with reconstruction could be performed safely.

Life events and Tourette syndrome.

PubMed

Steinberg, Tamar; Shmuel-Baruch, Sharona; Horesh, Netta; Apter, Alan

2013-07-01

Tourette syndrome (TS) is a neuropsychiatric developmental disorder characterized by the presence of multiple motor tics and one or more vocal tics. Although TS is primarily biological in origin, stress-diatheses interactions most probably play a role in the course of the illness. The precise influence of the environment on this basically biological disorder is difficult to ascertain, particularly when TS is complicated by comorbidities. Among the many questions that remain unresolved are the differential impact of positive and negative events and specific subtypes of events, and the importance of major crucial events relative to minor daily ones to tic severity. To examine the relationships between life events, tic severity and comorbid disorders in Tourette Syndrome (TS), including OCD, ADHD, anxiety, depression and rage attacks. Life events were classified by quantity, quality (positive or negative) and classification types of events (family, friends etc.). Sixty patients aged 7-17 years with Tourette syndrome or a chronic tic disorder were recruited from Psychological Medicine Clinic in Schneider Children's Medical Center of Israel. Yale Global Tic Severity Scale; Children's Yale Brown Obsessive Compulsive Scale; Life Experiences Survey; Brief Adolescent Life Events Scale; Screen for Child Anxiety Related Emotional Disorders; Child Depression Inventory/Beck Depression Inventory; ADHD Rating Scale IV; Overt Aggression Scale. Regarding tics and minor life events, there was a weak but significant correlation between severity of motor tics and the quantity of negative events. No significant correlation was found between tic severity and quantity of positive events. Analysis of the BALES categories yielded a significant direct correlation between severity of vocal tics and quantity of negative events involving friends. Regarding comorbidities and minor life events, highly significant correlations were found with depression and anxiety. Regarding tics and major life events, significant correlation was found between the quantity of major life events and the severity of motor tics, but not vocal tics. Regarding comorbidities and major life events, significant correlation was found between the severity of compulsions, ADHD, and aggression and the subjects' personal evaluation of the effect of negative major life events on their lives. Minor life events appear to be correlated with tic severity and comorbidities in children and adolescents with Tourette syndrome. The lack of an association between major life events and tic severity further emphasizes the salient impact of minor life events that occur in temporal proximity to the assessment of tic severity. Clinically, the results match our impression from patient narratives wherein they "blamed" the exacerbations in tics on social interactions. The high correlation between negative life events and depression, anxiety and compulsions symptoms, were reported also in previous studies. In conclusion, These findings may have clinical implications for planning supportive psychotherapy or cognitive behavioral therapy for this patient population. Copyright © 2013 Elsevier Inc. All rights reserved.

An Evaluation of Departmental Radiation Oncology Incident Reports: Anticipating a National Reporting System

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

Terezakis, Stephanie A., E-mail: stereza1@jhmi.edu; Harris, Kendra M.; Ford, Eric

Purpose: Systems to ensure patient safety are of critical importance. The electronic incident reporting systems (IRS) of 2 large academic radiation oncology departments were evaluated for events that may be suitable for submission to a national reporting system (NRS). Methods and Materials: All events recorded in the combined IRS were evaluated from 2007 through 2010. Incidents were graded for potential severity using the validated French Nuclear Safety Authority (ASN) 5-point scale. These incidents were categorized into 7 groups: (1) human error, (2) software error, (3) hardware error, (4) error in communication between 2 humans, (5) error at the human-software interface,more » (6) error at the software-hardware interface, and (7) error at the human-hardware interface. Results: Between the 2 systems, 4407 incidents were reported. Of these events, 1507 (34%) were considered to have the potential for clinical consequences. Of these 1507 events, 149 (10%) were rated as having a potential severity of ≥2. Of these 149 events, the committee determined that 79 (53%) of these events would be submittable to a NRS of which the majority was related to human error or to the human-software interface. Conclusions: A significant number of incidents were identified in this analysis. The majority of events in this study were related to human error and to the human-software interface, further supporting the need for a NRS to facilitate field-wide learning and system improvement.« less

Herbalife hepatotoxicity: Evaluation of cases with positive reexposure tests

PubMed Central

Teschke, Rolf; Frenzel, Christian; Schulze, Johannes; Schwarzenboeck, Alexander; Eickhoff, Axel

2013-01-01

AIM: To analyze the validity of applied test criteria and causality assessment methods in assumed Herbalife hepatotoxicity with positive reexposure tests. METHODS: We searched the Medline database for suspected cases of Herbalife hepatotoxicity and retrieved 53 cases including eight cases with a positive unintentional reexposure and a high causality level for Herbalife. First, analysis of these eight cases focused on the data quality of the positive reexposure cases, requiring a baseline value of alanine aminotransferase (ALT) < 5 upper limit of normal (N) before reexposure, with N as the upper limit of normal, and a doubling of the ALT value at reexposure as compared to the ALT value at baseline prior to reexposure. Second, reported methods to assess causality in the eight cases were evaluated, and then the liver specific Council for International Organizations of Medical Sciences (CIOMS) scale validated for hepatotoxicity cases was used for quantitative causality reevaluation. This scale consists of various specific elements with scores provided through the respective case data, and the sum of the scores yields a causality grading for each individual case of initially suspected hepatotoxicity. RESULTS: Details of positive reexposure test conditions and their individual results were scattered in virtually all cases, since reexposures were unintentional and allowed only retrospective rather than prospective assessments. In 1/8 cases, criteria for a positive reexposure were fulfilled, whereas in the remaining cases the reexposure test was classified as negative (n = 1), or the data were considered as uninterpretable due to missing information to comply adequately with the criteria (n = 6). In virtually all assessed cases, liver unspecific causality assessment methods were applied rather than a liver specific method such as the CIOMS scale. Using this scale, causality gradings for Herbalife in these eight cases were probable (n = 1), unlikely (n = 4), and excluded (n = 3). Confounding variables included low data quality, alternative diagnoses, poor exclusion of important other causes, and comedication by drugs and herbs in 6/8 cases. More specifically, problems were evident in some cases regarding temporal association, daily doses, exact start and end dates of product use, actual data of laboratory parameters such as ALT, and exact dechallenge characteristics. Shortcomings included scattered exclusion of hepatitis A-C, cytomegalovirus and Epstein Barr virus infection with only globally presented or lacking parameters. Hepatitis E virus infection was considered in one single patient and found positive, infections by herpes simplex virus and varicella zoster virus were excluded in none. CONCLUSION: Only one case fulfilled positive reexposure test criteria in initially assumed Herbalife hepatotoxicity, with lower CIOMS based causality gradings for the other cases than hitherto proposed. PMID:23898368

Bidirectionality and gender differences in emotional disturbance associations with obesity among Taiwanese schoolchildren.

PubMed

Chiang, Po-Huang; Huang, Lin-Yuan; Lo, Yuan-Ting; Lee, Meei-Shyuan; Wahlqvist, Mark L

2013-10-01

Childhood obesity is associated with psychological problems, but little is known about its association with emotional disturbance (ED) in the educational setting, especially by gender. In the population representative Elementary School Children's Nutrition and Health Survey in Taiwan 2001-2002 of children aged 6-13 (n=2283), we have considered whether ED is associated with obesity by gender. Schoolchildren were assessed with the modified scale for assessing emotional disturbance questionnaires. For some subscales, boys and girls had ED associations with obesity which were bidirectional. With normal weight as referent and relevant adjustments, the significant ED subscales predictable by obesity were relationship problems (RP) in boys (odds ratio, OR=1.89 with 95% CI: 1.08-3.30) and inappropriate behavior (IB) in girls (OR=2.88: 95% CI: 1.47-5.61). Conversely, with 'no-specific-ED' as referent, obesity was predictable by fully-adjusted specific-EDs in the same subscales, namely RP in boys (OR=1.88 with 95% CI: 1.13-3.13) and IB in girls (OR=3.03: 95% CI: 1.57-5.85). Child obesity prevalence showed no trend with school grade from 1 to 6, but for aggregate ED and most of its subscales the prevalence increased with grade (P for trend <0.01). Thus, there is some dissociation of obesity and ED as judged by their trend presence with school grade. Where obesity and ED occurred together (for inability-to-learn and unhappiness or depression), there were upward trends with grade (P<0.01). There are probably some selected bidirectional pathogenicities for obesity-ED associations with different expression in boys and girls and during elementary education. This provides some policy direction while mechanisms and causality require elucidation. Copyright © 2013 Elsevier Ltd. All rights reserved.

Declines in arrestin and rhodopsin in the macula with progression of age-related macular degeneration.

PubMed

Ethen, Cheryl M; Feng, Xiao; Olsen, Timothy W; Ferrington, Deborah A

2005-03-01

Biochemical analysis of age-related macular degeneration (AMD) at distinct stages of the disease will help further understanding of the molecular events associated with disease progression. This study was conducted to determine the ability of a new grading system for eye bank eyes, the Minnesota Grading System (MGS), to discern distinct stages of AMD so that retinal region-specific changes in rod photoreceptor protein expression from donors could be determined. Donor eyes were assigned to a specific level of AMD by using the MGS. Expression of the rod photoreceptor proteins rhodopsin and arrestin was evaluated by Western immunoblot analysis in the macular and peripheral regions of the neurosensory retina from donors at different stages of AMD. A significant linear decline in both arrestin and rhodopsin content correlated with progressive MGS levels in the macula. In contrast, the peripheral region showed no significant correlation between MGS level and the content of either protein. The statistically significant relationship between decreasing macular rod photoreceptor proteins and progressive MGS levels of AMD demonstrates the utility of the clinically based MGS to correspond with specific protein changes found at known, progressive stages of degeneration. Future biochemical analysis of clinically characterized donor eyes will further understanding of the pathobiochemistry of AMD.

Application of Nano-Scale Precipitate Engineering of TiN-NbC Composite in 32mm K60-E2 Grade Plate Rolling

NASA Astrophysics Data System (ADS)

Subramanian, S. V.; Xiaoping, Ma; Wenjin, Nie; Xiaobing, Zhang

A cost effective alloy design based on niobium microalloying was developed by Shagang for the production of 32 mm gage K60-E2 steel plate for manufacturing LSAW pipes of 1422 mm diameter. Two metallurgical challenges are (i) to meet enhanced CTOD toughness and (ii) to ensure consistent DWTT performance in accordance with the specification laid out by Gazprom Vniigaz.

Temporal Lobe Toxicity Analysis After Proton Radiation Therapy for Skull Base Tumors

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

Pehlivan, Berrin; Ares, Carmen, E-mail: carmen.ares@psi.ch; Lomax, Antony J.

2012-08-01

Purpose: Temporal lobe (TL) parenchyma toxicity constitutes one of the most frequent late adverse event in high-dose proton therapy (PT) for tumors of the skull base. We analyzed clinical events with dosimetric parameters in our patients treated for skull base tumors with spot-scanning PT. Methods and Materials: Between 1998 and 2005, a total of 62 patients received PT to a median dose of 71.7 Gy (relative biologic effectiveness [RBE]) (range, 63-74 Gy). The dose-volume histogram of each TL and the entire brain parenchyma (BP) were analyzed according to maximum, mean, and minimum dose as well as doses to 0.5, 1,more » 2, and 3 cc of brain volume (D{sub 0.5}, D{sub 1}, D{sub 2}, D{sub 3}) and correlated with clinical events. Generalized equivalent uniform dose (gEUD) values were calculated. Results: At a mean follow-up of 38 months (range, 14-92 months), 2 patients had developed symptomatic Grade 3 and 5 patients asymptomatic Grade 1 TL toxicity. Mean doses to a 2-cc volume of BP increased from 71 {+-} 5 Gy (RBE) for no toxicity to 74 {+-} 5 Gy (RBE) for Grade 1 and to 76 {+-} 2 Gy (RBE) for Grade 3 toxicity. TL events occurred in 6 of 7 patients (86%) at or above dose levels of {>=}64 Gy (RBE) D{sub 3}, {>=}68 Gy (RBE) D{sub 2}, {>=}72 Gy (RBE) D{sub 1}, and {>=}73 Gy (RBE) D{sub 0.5}, respectively (p = NS). No statistically significant dose/volume threshold was detected between patients experiencing no toxicity vs. Grade 1 or Grade 3. A strong trend for Grade 1 and 3 events was observed, when the gEUD was 60 Gy. Conclusions: A statistically significant normal tissue threshold dose for BP has not been successfully defined. However, our data suggest that tolerance of TL and BP to fractionated radiotherapy appears to be correlated with tissue volume included in high-dose regions. Additional follow-up time and patient accrual is likely needed to achieve clinical significance for these dose-volume parameters investigated. Our findings support the importance of establishing an organ-at-risk maximally permissible dose for BP.« less

Alternatively Spliced Homologous Exons Have Ancient Origins and Are Highly Expressed at the Protein Level

PubMed Central

Abascal, Federico; Ezkurdia, Iakes; Rodriguez-Rivas, Juan; Rodriguez, Jose Manuel; del Pozo, Angela; Vázquez, Jesús; Valencia, Alfonso; Tress, Michael L.

2015-01-01

Alternative splicing of messenger RNA can generate a wide variety of mature RNA transcripts, and these transcripts may produce protein isoforms with diverse cellular functions. While there is much supporting evidence for the expression of alternative transcripts, the same is not true for the alternatively spliced protein products. Large-scale mass spectroscopy experiments have identified evidence of alternative splicing at the protein level, but with conflicting results. Here we carried out a rigorous analysis of the peptide evidence from eight large-scale proteomics experiments to assess the scale of alternative splicing that is detectable by high-resolution mass spectroscopy. We find fewer splice events than would be expected: we identified peptides for almost 64% of human protein coding genes, but detected just 282 splice events. This data suggests that most genes have a single dominant isoform at the protein level. Many of the alternative isoforms that we could identify were only subtly different from the main splice isoform. Very few of the splice events identified at the protein level disrupted functional domains, in stark contrast to the two thirds of splice events annotated in the human genome that would lead to the loss or damage of functional domains. The most striking result was that more than 20% of the splice isoforms we identified were generated by substituting one homologous exon for another. This is significantly more than would be expected from the frequency of these events in the genome. These homologous exon substitution events were remarkably conserved—all the homologous exons we identified evolved over 460 million years ago—and eight of the fourteen tissue-specific splice isoforms we identified were generated from homologous exons. The combination of proteomics evidence, ancient origin and tissue-specific splicing indicates that isoforms generated from homologous exons may have important cellular roles. PMID:26061177

[Violence and post-traumatic stress disorder in childhood].

PubMed

Ximenes, Liana Furtado; de Oliveira, Raquel de Vasconcelos Carvalhães; de Assis, Simone Gonçalves

2009-01-01

This study presents the prevalence of symptoms of Posttraumatic Stress Disorder (PTSD) in 500 schoolchildren (6-13 years old) in São Gonçalo, Rio de Janeiro. It also investigates the association between PTSD, violence and other adverse events in the lives of these children. The multi-stage cluster sampling strategy involved three selection stages. Parents were interviewed about their children's behavior. The instrument used to screen symptoms of PTSD was the Child Behavior Checklist-Posttraumatic Stress Disorder Scale (CBCL-PTSD). Conflict Tactics Scales (CTS) were applied to evaluate family violence and other scales to investigate the socioeconomic profile, familiar relationship, characteristics and adverse events in the lives of the children. Multivariate analysis was performed using a hierarchical model with a significance level of 5%. The prevalence of clinical symptoms of PTSD was of 6.5%. The multivariate analysis suggested an explanation model of PTSD characterized by 18 variables, such as the child's characteristics; specific life events; family violence; and other family factors. The results reveal that it is necessary to work with the child in particularly difficult moments of his/her life in order to prevent or minimize the impact of adverse events on their mental and social functioning.

Measuring Listening Comprehension Skills of 5th Grade School Students with the Help of Web Based System

ERIC Educational Resources Information Center

Acat, M. Bahaddin; Demiral, Hilmi; Kaya, Mehmet Fatih

2016-01-01

The main purpose of this study is to measure listening comprehension skills of 5th grade school students with the help of web based system. This study was conducted on 5th grade students studying at the primary schools of Eskisehir. The scale used in the process of the study is "Web Based Listening Scale". In the process of the study,…

Inferior turbinate classification system, grades 1 to 4: development and validation study.

PubMed

Camacho, Macario; Zaghi, Soroush; Certal, Victor; Abdullatif, Jose; Means, Casey; Acevedo, Jason; Liu, Stanley; Brietzke, Scott E; Kushida, Clete A; Capasso, Robson

2015-02-01

To develop a validated inferior turbinate grading scale. Development and validation study. Phase 1 development (alpha test) consisted of a proposal of 10 different inferior turbinate grading scales (>1,000 clinic patients). Phase 2 validation (beta test) utilized 10 providers grading 27 standardized endoscopic photos of inferior turbinates using two different classification systems. Phase 3 validation (pilot study) consisted of 100 live consecutive clinic patients (n = 200 inferior turbinates) who were each prospectively graded by 18 different combinations of two independent raters, and grading was repeated by each of the same two raters, two separate times for each patient. In the development phase, 25% (grades 1-4) and 33% (grades 1-4) were the most useful systems. In the validation phase, the 25% classification system was found to be the best balance between potential clinical utility and ability to grade; the photo grading demonstrated a Cohen's kappa (κ) = 0.4671 ± 0.0082 (moderate inter-rater agreement). Live-patient grading with the 25% classification system demonstrated an overall inter-rater reliability of 71.5% (95% confidence interval [CI]: 64.8-77.3), with overall substantial agreement (κ = 0.704 ± 0.028). Intrarater reliability was 91.5% (95% CI: 88.7-94.3). Distribution for the 200 inferior turbinates was as follows: 25% quartile = grade 1, 50% quartile (median) = grade 2, 75% quartile = grade 3, and 90% quartile = grade 4. Mean turbinate size was 2.22 (95% CI: 2.07-2.34; standard deviation 1.02). Categorical κ was as follows: grade 1, 0.8541 ± 0.0289; grade 2, 0.7310 ± 0.0289; grade 3, 0.6997 ± 0.0289, and grade 4, 0.7760 ± 0.0289. The 25% (grades 1-4) inferior turbinate classification system is a validated grading scale with high intrarater and inter-rater reliability. This system can facilitate future research by tracking the effect of interventions on inferior turbinates. 2c. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

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

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

Chen, Chien Peter; Weinberg, Vivian; Shinohara, Katsuto

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

Academic performance in human anatomy and physiology classes: a 2-yr study of academic motivation and grade expectation.

PubMed

Sturges, Diana; Maurer, Trent W; Allen, Deborah; Gatch, Delena Bell; Shankar, Padmini

2016-03-01

This project used a nonexperimental design with a convenience sample and studied the relationship between academic motivation, grade expectation, and academic performance in 1,210 students enrolled in undergraduate human anatomy and physiology (HAP) classes over a 2-yr period. A 42-item survey that included 28 items of the adapted academic motivation scale for HAP based on self-determination theory was administered in class during the first 3 wk of each semester. Students with higher grade point averages, who studied for longer hours and reported to be more motivated to succeed, did better academically in these classes. There was a significant relationship between students' scores on the adapted academic motivation scale and performance. Students were more extrinsically motivated to succeed in HAP courses than intrinsically motivated to succeed, and the analyses revealed that the most significant predictor of final grade was within the extrinsic scale (introjected and external types). Students' motivations remained stable throughout the course sequence. The data showed a significant relationship between HAP students' expected grade and their final grade in class. Finally, 65.5% of students overestimated their final grade, with 29% of students overestimating by two to four letter grades. Copyright © 2016 The American Physiological Society.

Development of a Nomogram for Predicting Severe Neutropenia Associated With Docetaxel-Based Chemotherapy in Patients With Castration-Resistant Prostate Cancer.

PubMed

Hirasawa, Yosuke; Nakashima, Jun; Sugihara, Toru; Takizawa, Issei; Gondo, Tatsuo; Nakagami, Yoshihiro; Horiguchi, Yutaka; Ohno, Yoshio; Namiki, Kazunori; Ohori, Makoto; Tachibana, Masaaki

2017-02-01

Neutropenia is a major adverse event of docetaxel-based chemotherapy. The present study was undertaken to evaluate the incidence of neutropenia and to develop a nomogram for predicting Grade 4 neutropenia during the first cycle of docetaxel-based chemotherapy in patients with castration-resistant prostate cancer (CRPC). This study included 112 patients with CRPC treated with docetaxel-based systemic chemotherapy. We evaluated the incidence and risk factors for Grade 4 neutropenia in the first cycle of chemotherapy. Sixty-two of 112 patients (55.4%) developed Grade 4 neutropenia in the first cycle of docetaxel-based chemotherapy. There were significant differences in age, baseline white blood cell count, and baseline neutrophil count between patients with non-Grade 4 neutropenia and those with Grade 4 neutropenia in univariate analyses. The serum prostate-specific antigen level, hemoglobin level, creatinine, albumin, Eastern Cooperative Oncology Group performance status, metastatic sites, extent of disease, and history of external beam radiotherapy to the prostate were not significantly different between the 2 groups. Multivariate logistic regression analysis showed that age (odds ratio [OR], 1.08; P = .019) and baseline neutrophil counts (OR, 0.79; P = .045) were significant independent risk factors for severe neutropenia. A nomogram and a calibration plot on the basis of these results were developed from a multivariate logistic regression analysis to predict the probability of Grade 4 neutropenia. Age and baseline neutrophil counts were significant independent risk factors for Grade 4 neutropenia. The nomogram to predict it provides useful information for the management of patients with CRPC treated with docetaxel chemotherapy. Copyright © 2016 Elsevier Inc. All rights reserved.

Toward automating Hammersmith pulled-to-sit examination of infants using feature point based video object tracking.

PubMed

Dogra, Debi P; Majumdar, Arun K; Sural, Shamik; Mukherjee, Jayanta; Mukherjee, Suchandra; Singh, Arun

2012-01-01

Hammersmith Infant Neurological Examination (HINE) is a set of tests used for grading neurological development of infants on a scale of 0 to 3. These tests help in assessing neurophysiological development of babies, especially preterm infants who are born before (the fetus reaches) the gestational age of 36 weeks. Such tests are often conducted in the follow-up clinics of hospitals for grading infants with suspected disabilities. Assessment based on HINE depends on the expertise of the physicians involved in conducting the examinations. It has been noted that some of these tests, especially pulled-to-sit and lateral tilting, are difficult to assess solely based on visual observation. For example, during the pulled-to-sit examination, the examiner needs to observe the relative movement of the head with respect to torso while pulling the infant by holding wrists. The examiner may find it difficult to follow the head movement from the coronal view. Video object tracking based automatic or semi-automatic analysis can be helpful in this case. In this paper, we present a video based method to automate the analysis of pulled-to-sit examination. In this context, a dynamic programming and node pruning based efficient video object tracking algorithm has been proposed. Pulled-to-sit event detection is handled by the proposed tracking algorithm that uses a 2-D geometric model of the scene. The algorithm has been tested with normal as well as marker based videos of the examination recorded at the neuro-development clinic of the SSKM Hospital, Kolkata, India. It is found that the proposed algorithm is capable of estimating the pulled-to-sit score with sensitivity (80%-92%) and specificity (89%-96%).

Four-Year Efficacy, Cosmesis, and Toxicity Using Three-Dimensional Conformal External Beam Radiation Therapy to Deliver Accelerated Partial Breast Irradiation

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

Chen, Peter Y.; Wallace, Michelle; Mitchell, Christina

2010-03-15

Purpose: This prospective study examines the use of three-dimensional conformal external beam radiation therapy (3D-CRT) to deliver accelerated partial breast irradiation (APBI). Four-year data on efficacy, cosmesis, and toxicity are presented. Methods: Patients with Stage O, I, or II breast cancer with lesions <=3 cm, negative margins, and negative nodes were eligible. The 3D-CRT delivered was 38.5 Gy in 3.85 Gy/fraction. Ipsilateral breast, ipsilateral nodal, contralateral breast, and distant failure (IBF, INF, CBF, DF) were estimated using the cumulative incidence method. Disease-free, overall, and cancer-specific survival (DFS, OS, CSS) were recorded. The National Cancer Institute Common Terminology Criteria for Adversemore » Events (version 3) toxicity scale was used to grade acute and late toxicities. Results: Ninety-four patients are evaluable for efficacy. Median patient age was 62 years with the following characteristics: 68% tumor size <1 cm, 72% invasive ductal histology, 77% estrogen receptor (ER) (+), 88% postmenopausal; 88% no chemotherapy and 44% with no hormone therapy. Median follow-up was 4.2 years (range, 1.3-8.3). Four-year estimates of efficacy were IBF: 1.1% (one local recurrence); INF: 0%; CBF: 1.1%; DF: 3.9%; DFS: 95%; OS: 97%; and CSS: 99%. Four (4%) Grade 3 toxicities (one transient breast pain and three fibrosis) were observed. Cosmesis was rated good/excellent in 89% of patients at 4 years. Conclusions: Four-year efficacy, cosmesis, and toxicity using 3D-CRT to deliver APBI appear comparable to other experiences with similar follow-up. However, additional patients, further follow-up, and mature Phase III data are needed to evaluate thoroughly the extent of application, limitations, and complete value of this particular form of APBI.« less

Outcome of transarterial treatment of dural arteriovenous fistulas with direct or indirect cortical venous drainage.

PubMed

Mantilla, Daniel; Le Corre, Marine; Cagnazzo, Federico; Gascou, Gregory; Eker, Omer; Machi, Paolo; Riquelme, Carlos; Dargazanli, Cyril; Costalat, Vincent; Bonafe, Alain; Lefevre, Pierre-Henri

2018-01-30

Transarterial Onyx embolization is an effective treatment for patients with intracranial dural arteriovenous fistula (DAVF). A study was performed to determine whether the clinical and radiological outcomes after transarterial Onyx treatment were affected by the type of cortical venous drainage (direct vs indirect) of high-grade DAVF. Between May 2006 and December 2014, demographic data, clinical presentation, angiographic characteristics, and treatment-related outcomes were collected for 54 patients divided into two groups (intracranial DAVF with direct and indirect cortical venous drainage). Continuous variables were compared with the two-tailed t test and categorical variables with the χ 2 test. Statistical significance was set at P<0.05. Fifty-two patients (71% with direct and 29% with indirect cortical venous drainage) underwent Onyx embolization. Immediate complete occlusion after treatment was observed in about 55% of patients without between-group difference. During the long-term follow-up, complete angiographic occlusion was achieved in 83% of patients. Specifically, 15 additional patients (40%) in the direct cortical venous drainage group progressed to complete occlusion, but only one (6%) in the indirect cortical venous drainage group. Overall, the rate of complete occlusion was higher in patients with DAVF with direct cortical venous drainage (92%) than in those with DAVF with indirect cortical venous drainage (62.5%) (P=0.01). The rate of permanent treatment-related complications was 4%, mostly related to ischemic events. Overall, 80.5% of patients had a good neurological outcome (modified Rankin Scale score 0-2). Transarterial Onyx embolization of intracranial high-grade DAVF is safe and effective, particularly for lesions with direct cortical venous drainage. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Smile line assessment comparing quantitative measurement and visual estimation.

PubMed

Van der Geld, Pieter; Oosterveld, Paul; Schols, Jan; Kuijpers-Jagtman, Anne Marie

2011-02-01

Esthetic analysis of dynamic functions such as spontaneous smiling is feasible by using digital videography and computer measurement for lip line height and tooth display. Because quantitative measurements are time-consuming, digital videography and semiquantitative (visual) estimation according to a standard categorization are more practical for regular diagnostics. Our objective in this study was to compare 2 semiquantitative methods with quantitative measurements for reliability and agreement. The faces of 122 male participants were individually registered by using digital videography. Spontaneous and posed smiles were captured. On the records, maxillary lip line heights and tooth display were digitally measured on each tooth and also visually estimated according to 3-grade and 4-grade scales. Two raters were involved. An error analysis was performed. Reliability was established with kappa statistics. Interexaminer and intraexaminer reliability values were high, with median kappa values from 0.79 to 0.88. Agreement of the 3-grade scale estimation with quantitative measurement showed higher median kappa values (0.76) than the 4-grade scale estimation (0.66). Differentiating high and gummy smile lines (4-grade scale) resulted in greater inaccuracies. The estimation of a high, average, or low smile line for each tooth showed high reliability close to quantitative measurements. Smile line analysis can be performed reliably with a 3-grade scale (visual) semiquantitative estimation. For a more comprehensive diagnosis, additional measuring is proposed, especially in patients with disproportional gingival display. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Comparative prediction of nonepileptic events using MMPI-2 clinical scales, Harris Lingoes subscales, and restructured clinical scales.

PubMed

Yamout, Karim Z; Heinrichs, Robin J; Baade, Lyle E; Soetaert, Dana K; Liow, Kore K

2017-03-01

The Minnesota Multiphasic Personality Inventory-2 (MMPI-2) is a psychological testing tool used to measure psychological and personality constructs. The MMPI-2 has proven helpful in identifying individuals with nonepileptic events/nonepileptic seizures. However, the MMPI-2 has had some updates that enhanced its original scales. The aim of this article was to test the utility of updated MMPI-2 scales in predicting the likelihood of non-epileptic seizures in individuals admitted to an EEG video monitoring unit. We compared sensitivity, specificity, and likelihood ratios of traditional MMPI-2 Clinical Scales against more homogenous MMPI-2 Harris-Lingoes subscales and the newer Restructured Clinical (RC) scales. Our results showed that the Restructured Scales did not show significant improvement over the original Clinical scales. However, one Harris-Lingoes subscale (HL4 of Clinical Scale 3) did show improved predictive utility over the original Clinical scales as well as over the newer Restructured Clinical scales. Our study suggests that the predictive utility of the MMPI-2 can be improved using already existing scales. This is particularly useful for those practitioners who are not invested in switching over to the newly developed MMPI-2 Restructured Form (MMPI-2 RF). Copyright © 2016 Elsevier Inc. All rights reserved.

Developing a post-fire flood chronology and recurrence probability from alluvial stratigraphy in the Buffalo Creek watershed, Colorado, USA

USGS Publications Warehouse

Elliott, J.G.; Parker, R.S.

2001-01-01

Stratigraphic and geomorphic evidence indicate floods that occur soon after forest fires have been intermittent but common events in many mountainous areas during the past several thousand years. The magnitude and recurrence of these post-fire flood events reflects the joint probability between the recurrence of fires and the recurrence of subsequent rainfall events of varying magnitude and intensity. Following the May 1996 Buffalo Creek, Colorado, forest fire, precipitation amounts and intensities that generated very little surface runoff outside of the burned area resulted in severe hillslope erosion, floods, and streambed sediment entrainment in the rugged, severely burned, 48 km2 area. These floods added sediment to many existing alluvial fans, while simultaneously incising other fans and alluvial deposits. Incision of older fans revealed multiple sequences of fluvially transported sandy gravel that grade upward into charcoal-rich, loamy horizons. We interpret these sequences to represent periods of high sediment transport and aggradation during floods, followed by intervals of quiescence and relative stability in the watershed until a subsequent fire occurred. An alluvial sequence near the mouth of a tributary draining a 0??82 km2 area indicated several previous post-fire flood cycles in the watershed. Dendrochronologic and radiocarbon ages of material in this deposit span approximately 2900 years, and define three aggradational periods. The three general aggradational periods are separated by intervals of approximately nine to ten centuries and reflect a 'millennium-scale' geomorphic response to a closely timed sequence of events: severe and intense, watershed-scale, stand-replacing fires and subsequent rainstorms and flooding. Millennium-scale aggradational units at the study site may have resulted from a scenario in which the initial runoff from the burned watershed transported and deposited large volumes of sediment on downstream alluvial surfaces and tributary fans. Subsequent storm runoff may have produced localized incision and channelization, preventing additional vertical aggradation on the sampled alluvial deposit for several centuries. Two of the millennium-scale aggradational periods at the study site consist of multiple gravel and loam sequences with similar radiocarbon ages. These closely dated sequences may reflect a 'multidecade-scale' geomorphic response to more frequent, but aerially limited and less severe fires, followed by rainstorms of relatively common recurrence. Published in 2001 by John Wiley and Sons, Ltd.

Classifying hydrological events to quantify their impact on nitrate leaching across three spatial scales

NASA Astrophysics Data System (ADS)

Bauwe, Andreas; Tiemeyer, Bärbel; Kahle, Petra; Lennartz, Bernd

2015-12-01

Nitrate is one of the most important sources of pollution for surface waters in tile-drained agricultural areas. In order to develop appropriate management strategies to reduce nitrate losses, it is crucial to first understand the underlying hydrological processes. In this study, we used Principle Component Analysis (PCA) and Linear Discriminant Analysis (LDA) to analyze 212 discharge events between 2004 and 2011 across three spatial scales (68 events at the collector drain, 72 at the ditch, and 72 at the brook) to identify the controlling factors for hydrograph response characteristics and their influence on nitrate concentration patterns. Our results showed that the 212 hydrological events can be classified into six different types: summer events (28%), snow-dominated events (10%), events controlled by rainfall duration (16%), rainfall totals (8%), dry antecedent conditions (10%), and events controlled by wet antecedent conditions (14%). The relatively large number of unclassified events (15%) demonstrated the difficulty in separating event types due to mutually influencing variables. NO3-N concentrations showed a remarkably consistent pattern during the discharge events regardless of event type, with minima at the beginning, increasing concentrations at the rising limb, and maxima around peak discharge. However, the level of NO3-N concentrations varied notably among the event types. The highest average NO3-N concentrations were found for events controlled by rainfall totals (NO3-N = 17.1 mg/l), events controlled by wet antecedent conditions (NO3-N = 17.1 mg/l), and snowmelt (NO3-N = 15.2 mg/l). Average maximum NO3-N concentrations were significantly lower during summer events (NO3-N = 10.2 mg/l) and events controlled by dry antecedent conditions (NO3-N = 11.7 mg/l). The results have furthermore shown that similar hydrological and biogeochemical processes determine the hydrograph and NO3-N response on storm events at various spatial scales. The management of tile-drained agricultural land to reduce NO3-N losses should focus explicitly on flow events and, more specifically, active management should preferably be conducted in the winter season for discharge events after snowmelt, after heavy rain storms and when the soil moisture conditions are wet.

A promising new treatment for solar lentigines.

PubMed

Colby, S I; Schwartzel, E H; Huber, F J; Highton, A; Altman, D J; Epinette, W W; Lyon, E

2003-04-01

The purpose of this open-label study was to determine the adverse event rate of topical 4HA/tretinoin when used twice daily for up to 24 weeks with concomitant sunscreen in the treatment of solar lentigines and related hyperpigmented lesions. There were two treatment areas: bilateral dorsal forearms, including the back of the hands; and the face, including the forehead and cheek areas. Each treatment area had a target lesion at least 5 mm in diameter and was moderately darker than the surrounding skin. A nine-point bipolar scale was used for evaluation of Target Lesion Pigmentation (0 = extremely lighter than pigment of the surrounding skin, 4 = equal with pigment of surrounding skin, 8 = extremely darker than pigment of surrounding skin). The other solar lentigines present in the treatment areas also had to have an overall pigmentation grade of at least Grade 6. Twice daily applications to individual lesions in each treatment area were made for up to 24 weeks followed by a 4-week follow-up phase. Sunscreen applications (sunscreen with sun protection factor (SPF) 25 or greater) were made every morning and reapplied after six hours if additional sun exposure was expected. Clinical evaluations were performed at weeks 0, 4, 8, 16, 24 and 28. The clinical signs of Target Lesion Pigmentation and Overall Lesion Pigmentation were evaluated at each visit. A total of 96 subjects were enrolled at four study centers; 77 (80%) subjects completed the study. Treatment-related adverse events (AEs) for 4HA/tretinoin included erythema, burning/stinging/tingling, desquamation, pruritus, skin irritation, halo hypopigmentation and hypopigmentation. Five (5%) subjects discontinued from the study due to adverse events considered to be related to study medication. When used with sunscreen of SPF 25 or greater, 4HA/tretinoin was safe and well tolerated and did not produce any unexpected or unusual adverse events.

Subchondral bone histology and grading in osteoarthritis

PubMed Central

Aho, Olli-Matti; Finnilä, Mikko; Thevenot, Jerome; Saarakkala, Simo; Lehenkari, Petri

2017-01-01

Objective Osteoarthritis (OA) has often regarded as a disease of articular cartilage only. New evidence has shifted the paradigm towards a system biology approach, where also the surrounding tissue, especially bone is studied more vigorously. However, the histological features of subchondral bone are only poorly characterized in current histological grading scales of OA. The aim of this study is to specifically characterize histological changes occurring in subchondral bone at different stages of OA and propose a simple grading system for them. Design 20 patients undergoing total knee replacement surgery were randomly selected for the study and series of osteochondral samples were harvested from the tibial plateaus for histological analysis. Cartilage degeneration was assessed using the standardized OARSI grading system, while a novel four-stage grading system was developed to illustrate the changes in subchondral bone. Subchondral bone histology was further quantitatively analyzed by measuring the thickness of uncalcified and calcified cartilage as well as subchondral bone plate. Furthermore, internal structure of calcified cartilage-bone interface was characterized utilizing local binary patterns (LBP) based method. Results The histological appearance of subchondral bone changed drastically in correlation with the OARSI grading of cartilage degeneration. As the cartilage layer thickness decreases the subchondral plate thickness and disorientation, as measured with LBP, increases. Calcified cartilage thickness was highest in samples with moderate OA. Conclusion The proposed grading system for subchondral bone has significant relationship with the corresponding OARSI grading for cartilage. Our results suggest that subchondral bone remodeling is a fundamental factor already in early stages of cartilage degeneration. PMID:28319157

The relationship between professional behaviour grades and tutor performance ratings in problem-based learning.

PubMed

Dolmans, Diana Hjm; Luijk, Scheltus J; Wolfhagen, Ineke Hap; Scherpbier, Albert Jja

2006-02-01

We investigated the influence of harsh grading by tutors on tutor performance rating by students. A total of 187 tutors assessed students' professional behaviour in tutorial groups. Students rated tutor performance after receiving their grades for professional behaviour. In addition, students were asked to indicate whether they perceived their professional behaviour grades as too positive, adequate or too negative. This was considered to reflect tutors' harshness of grading. Students also rated the quality of the feedback they received from tutors with respect to their grades. Professional behaviour grades that students perceived as too negative, adequate or too positive were associated with tutor performance ratings of 7.4 (SD = 0.9, scale 1-10, n = 33), 7.7 (SD = 0.9, scale 1-10, n = 95) and 7.5 (SD = 0.8, scale 1-10, n = 59), respectively. Harshness of grading did not influence tutor performance ratings significantly. Tutor ratings were predicted more effectively by the quality of the feedback tutors provided on grades than by the harshness of grading. Tutor performance ratings were not related significantly to harshness of grading. Two explanations can be given: (1) tutor performance ratings were based on rating by groups of students and (2) the percentage of tutors who rated students' professional behaviour as unsatisfactory was low. The strong relationship between tutor performance ratings and the adequacy of the feedback given by tutors suggests that the tutor performance ratings collected in this study are a valid measure of the quality of their teaching, although, for a full picture of teaching quality, more measures will be needed.

Materials Organization, Planning, and Homework Completion in Middle School Students with ADHD: Impact on Academic Performance.

PubMed

Langberg, Joshua M; Epstein, Jeffery N; Girio, Erin L; Becker, Stephen P; Vaughn, Aaron J; Altaye, Mekibib

2011-06-01

This study evaluated the homework functioning of middle school students with ADHD to determine what aspects are most predictive of school grades and the best source (e.g., parents or teachers) for obtaining this information. Students with ADHD in grades 5-8 ( N = 57) and their parents and teachers completed the Children's Organization Skills Scales (COSS) to measure materials organization, planning, and time-management, and parents completed the Homework Problems Checklist (HPC) to examine homework completion and homework materials management behaviors. Regression analyses revealed that parent-rated homework materials management and teacher-rated memory and materials management were the best predictors of school grades. These findings suggest that organization of materials is a critical component of the homework completion process for students with ADHD and an important target for intervention. Teachers were the best source of information regarding materials organization and planning, whereas parents were a valuable source of information for specific homework materials management problems.

Materials Organization, Planning, and Homework Completion in Middle School Students with ADHD: Impact on Academic Performance

PubMed Central

Langberg, Joshua M.; Epstein, Jeffery N.; Girio, Erin L.; Becker, Stephen P.; Vaughn, Aaron J.; Altaye, Mekibib

2013-01-01

This study evaluated the homework functioning of middle school students with ADHD to determine what aspects are most predictive of school grades and the best source (e.g., parents or teachers) for obtaining this information. Students with ADHD in grades 5–8 (N = 57) and their parents and teachers completed the Children’s Organization Skills Scales (COSS) to measure materials organization, planning, and time-management, and parents completed the Homework Problems Checklist (HPC) to examine homework completion and homework materials management behaviors. Regression analyses revealed that parent-rated homework materials management and teacher-rated memory and materials management were the best predictors of school grades. These findings suggest that organization of materials is a critical component of the homework completion process for students with ADHD and an important target for intervention. Teachers were the best source of information regarding materials organization and planning, whereas parents were a valuable source of information for specific homework materials management problems. PMID:23577045

Assessing Gifted Students' Beliefs about Intelligence with a Psychometrically Defensible Scale

ERIC Educational Resources Information Center

Park, Sunhee; Callahan, Carolyn M.; Ryoo, Ji Hoon

2016-01-01

The psychometric qualities of the six- and eight-item implicit theories of intelligence scales that Dweck suggested were compared using a confirmatory factor analysis with data from 239 gifted students (100 students in Grades 5-7, 139 students in Grades 8-11). The results indicate that the six-item scale fits the data better than the eight-item…

Short Personality and Life Event scale for detection of suicide attempters.

PubMed

Artieda-Urrutia, Paula; Delgado-Gómez, David; Ruiz-Hernández, Diego; García-Vega, Juan Manuel; Berenguer, Nuria; Oquendo, Maria A; Blasco-Fontecilla, Hilario

2015-01-01

To develop a brief and reliable psychometric scale to identify individuals at risk for suicidal behaviour. Case-control study. 182 individuals (61 suicide attempters, 57 psychiatric controls, and 64 psychiatrically healthy controls) aged 18 or older, admitted to the Emergency Department at Puerta de Hierro University Hospital in Madrid, Spain. All participants completed a form including their socio-demographic and clinical characteristics, and the Personality and Life Events scale (27 items). To assess Axis I diagnoses, all psychiatric patients (including suicide attempters) were administered the Mini International Neuropsychiatric Interview. Descriptive statistics were computed for the socio-demographic factors. Additionally, χ(2) independence tests were applied to evaluate differences in socio-demographic and clinical variables, and the Personality and Life Events scale between groups. A stepwise linear regression with backward variable selection was conducted to build the Short Personality Life Event (S-PLE) scale. In order to evaluate the accuracy, a ROC analysis was conducted. The internal reliability was assessed using Cronbach's α, and the external reliability was evaluated using a test-retest procedure. The S-PLE scale, composed of just 6 items, showed good performance in discriminating between medical controls, psychiatric controls and suicide attempters in an independent sample. For instance, the S-PLE scale discriminated between past suicide and past non-suicide attempters with sensitivity of 80% and specificity of 75%. The area under the ROC curve was 88%. A factor analysis extracted only one factor, revealing a single dimension of the S-PLE scale. Furthermore, the S-PLE scale provides values of internal and external reliability between poor (test-retest: 0.55) and acceptable (Cronbach's α: 0.65) ranges. Administration time is about one minute. The S-PLE scale is a useful and accurate instrument for estimating the risk of suicidal behaviour in settings where the time is scarce. Copyright © 2015 SEP y SEPB. Published by Elsevier España. All rights reserved.

Explaining social class differences in depression and well-being.

PubMed

Stansfeld, S A; Head, J; Marmot, M G

1998-01-01

Work characteristics, including skill discretion and decision authority, explain most of the socioeconomic status gradient in well-being and depression in middle-aged British civil servants from the Whitehall II Study, London. Social support explained about one-third of the gradient, life events and material difficulties less than one-third. Socioeconomic status was measured by employment grade. Work characteristics were based on the Karasek model, social support was measured by the Close Persons Questionnaire, depression by the General Health Questionnaire and well-being by the Affect Balance Scale. Despite a small contribution from social selective factors measured by upward mobility, the psychosocial work environment explained most of the cross-sectional socioeconomic status gradient in well-being and depression.

Relationship of pass/fail grading and curriculum structure with well-being among preclinical medical students: a multi-institutional study.

PubMed

Reed, Darcy A; Shanafelt, Tait D; Satele, Daniel W; Power, David V; Eacker, Anne; Harper, William; Moutier, Christine; Durning, Steven; Massie, F Stanford; Thomas, Matthew R; Sloan, Jeff A; Dyrbye, Liselotte N

2011-11-01

Psychological distress is common among medical students. Curriculum structure and grading scales are modifiable learning environment factors that may influence student well-being. The authors sought to examine relationships among curriculum structures, grading scales, and student well-being. The authors surveyed 2,056 first- and second-year medical students at seven U.S. medical schools in 2007. They used the Perceived Stress Scale, Maslach Burnout Inventory, and Medical Outcomes Study Short Form (SF-8) to measure stress, burnout, and quality of life, respectively. They measured curriculum structure using hours spent in didactic, clinical, and testing experiences. Grading scales were categorized as two categories (pass/fail) versus three or more categories (e.g., honors/pass/fail). Of the 2,056 students, 1,192 (58%) responded. In multivariate analyses, students in schools using grading scales with three or more categories had higher levels of stress (beta 2.65; 95% CI 1.54-3.76, P<.0001), emotional exhaustion (beta 5.35; 95% CI 3.34-7.37, P<.0001), and depersonalization (beta 1.36; 95% CI 0.53-2.19, P=.001) and were more likely to have burnout (OR 2.17; 95% CI 1.41-3.35, P=.0005) and to have seriously considered dropping out of school (OR 2.24; 95% CI 1.54-3.27, P<.0001) compared with students in schools using pass/fail grading. There were no relationships between time spent in didactic and clinical experiences and well-being. How students are evaluated has a greater impact than other aspects of curriculum structure on their well-being. Curricular reform intended to enhance student well-being should incorporate pass/fail grading.

Middle Grades Ideas.

ERIC Educational Resources Information Center

Classroom Computer Learning, 1984

1984-01-01

Presents five activities suitable for middle grades. These include listings for a car race (BASIC) and poetry (Pilot) programs, and activities on graphics without programing, new meanings (related to computers) of old words, and developing a list of historical events. (JN)

Good Manufacturing Practices production and analysis of a DNA vaccine against dental caries.

PubMed

Yang, Ya-ping; Li, Yu-hong; Zhang, Ai-hua; Bi, Lan; Fan, Ming-wen

2009-11-01

To prepare a clinical-grade anti-caries DNA vaccine pGJA-P/VAX and explore its immune effect and protective efficacy against a cariogenic bacterial challenge. A large-scale industrial production process was developed under Good Manufacturing Practices (GMP) by combining and optimizing common unit operations such as alkaline lysis, precipitation, endotoxin removal and column chromatography. Quality controls of the purified bulk and final lyophilized vaccine were conducted according to authoritative guidelines. Mice and gnotobiotic rats were intranasally immunized with clinical-grade pGJA-P/VAX with chitosan. Antibody levels of serum IgG and salivary SIgA were assessed by an enzyme-linked immunosorbent assay (ELISA), and caries activity was evaluated by the Keyes method. pGJA-P/VAX and pVAX1 prepared by a laboratory-scale commercial kit were used as controls. The production process proved to be scalable and reproducible. Impurities including host protein, residual RNA, genomic DNA and endotoxin in the purified plasmid were all under the limits of set specifications. Intranasal vaccination with clinical-grade pGJA-P/VAX induced higher serum IgG and salivary SIgA in both mice and gnotobiotic rats. While in the experimental caries model, the enamel (E), dentinal slight (Ds), and dentinal moderate (Dm) caries lesions were reduced by 21.1%, 33.0%, and 40.9%, respectively. The production process under GMP was efficient in preparing clinical-grade pGJA-P/VAX with high purity and intended effectiveness, thus facilitating future clinical trials for the anti-caries DNA vaccine.

Onyx Embolization Before the Surgical Treatment of Grade III Spetzler-Martin Brain Arteriovenous Malformations: Single-Center Experience and Technical Nuances.

PubMed

Luzzi, Sabino; Del Maestro, Mattia; Bongetta, Daniele; Zoia, Cesare; Giordano, Aldo V; Trovarelli, Donatella; Raysi Dehcordi, Sohelia; Galzio, Renato J

2018-05-09

Grade III Spetzler-Martin brain arteriovenous malformations (AVMs) are a specific set of AVMs with high variability in terms of site, size, angioarchitecture, flow dynamics, and involvement of eloquent areas. Surgery preceded by preoperative embolization has been reported as a useful treatment option for these lesions. The aim of this study is to report outcomes and personal experience of combined preoperative Onyx embolization and surgical resection on a consecutive series of grade III brain AVMs. Between 2005 and 2017, 27 grade III AVMs were treated by means of a staged Onyx embolization and subsequent surgical treatment. Site and size of the AVMs, embolization, and surgical specifics as well as complications and outcomes were retrospectively reviewed. All AVMs were supratentorial, 13 of which were hemorrhagic. Mean nidal volume was 19.5 mL. Average embolization sessions were 1.6. Mean embolization-related obliteration rate and morbidity were 28.8% and 3.7%, respectively. Surgery was performed within 3.7 days on average. In our experience, Onyx embolization made the nidus excision easier, facilitated the hemostasis, and contributed to the early identification of the lesion in cases of small or racemose nidus. The surgical obliteration rate was 92.6%. A good overall outcome (modified Rankin Scale score 0-2) was achieved in 70.4% of patients. In our experience, preoperative Onyx embolization helped the surgical management of grade III Spetzler-Martin brain AVMs. Careful evaluation of the angioarchitecture, a tailored strategy in the embolization process, and full cooperation within the neurosurgical-neuroendovascular team are mandatory. Copyright © 2018 Elsevier Inc. All rights reserved.

A 9-protein biomarker molecular signature for predicting histologic type in endometrial carcinoma by immunohistochemistry.

PubMed

Santacana, Maria; Maiques, Oscar; Valls, Joan; Gatius, Sònia; Abó, Ana Isabel; López-García, María Ángeles; Mota, Alba; Reventós, Jaume; Moreno-Bueno, Gema; Palacios, Jose; Bartosch, Carla; Dolcet, Xavier; Matias-Guiu, Xavier

2014-12-01

Histologic typing may be difficult in a subset of endometrial carcinoma (EC) cases. In these cases, interobserver agreement improves when immunohistochemistry (IHC) is used. A series of endometrioid type (EEC) grades 1, 2, and 3 and serous type (SC) were immunostained for p53, p16, estrogen receptor, PTEN, IMP2, IMP3, HER2, cyclin B2 and E1, HMGA2, FolR1, MSLN, Claudins 3 and 4, and NRF2. Nine biomarkers showed significant differences with thresholds in IHC value scale between both types (p53 ≥ 20, IMP2 ≥ 115, IMP3 ≥ 2, cyclin E1 ≥ 220, HMGA2 ≥ 30, FolR1 ≥ 50, p16 ≥ 170, nuclear PTEN ≥ 2 and estrogen receptor ≤ 50; P < .005). This combination led to increased discrimination when considering cases satisfying 0 to 5 conditions predicted as EEC and those satisfying 6 to 9 conditions predicted as SC. This signature correctly predicted all 48 EEC grade 1-2 cases and 18 SC cases, but 3 SC cases were wrongly predicted as EEC. Sensitivity was 86% (95% confidence interval [CI], 64%-97%), and specificity was 100% (95% CI, 89%-100%). The classifier correctly predicted all 28 EEC grade 3 cases but only identified the EEC and SC components in 4 of 9 mixed EEC-SC. An independent validation series (29 EEC grades 1-2, 28 EEC grade 3, and 31 SC) showed 100% sensitivity (95% CI, 84%-100%) and 83% specificity (95% CI, 64%-94%). We propose an internally and externally validated 9-protein biomarker signature to predict the histologic type of EC (EEC or SC) by IHC. The results also suggest that mixed EEC-SC is molecularly ambiguous. Copyright © 2014 Elsevier Inc. All rights reserved.

Suicidal events in the Treatment for Adolescents With Depression Study (TADS).

PubMed

Vitiello, Benedetto; Silva, Susan G; Rohde, Paul; Kratochvil, Christopher J; Kennard, Betsy D; Reinecke, Mark A; Mayes, Taryn L; Posner, Kelly; May, Diane E; March, John S

2009-04-21

The Treatment for Adolescents with Depression Study (TADS) database was analyzed to determine whether suicidal events (attempts and ideation) occurred early in treatment, could be predicted by severity of depression or other clinical characteristics, and were preceded by clinical deterioration or symptoms of increased irritability, akathisia, sleep disruption, or mania. TADS was a 36-week randomized, controlled clinical trial of pharmacologic and psychotherapeutic treatments involving 439 youths with major depressive disorder (DSM-IV criteria). Suicidal events were defined according to the Columbia Classification Algorithm of Suicidal Assessment. Patients were randomly assigned into the study between spring 2000 and summer 2003. Forty-four patients (10.0%) had at least 1 suicidal event (no suicide occurred). Events occurred 0.4 to 31.1 weeks (mean +/- SD = 11.9 +/- 8.2) after starting TADS treatment, with no difference in event timing for patients receiving medication versus those not receiving medication. Severity of self-rated pretreatment suicidal ideation (Suicidal Ideation Questionnaire adapted for adolescents score > or = 31) and depressive symptoms (Reynolds Adolescent Depression Scale score > or = 91) predicted occurrence of suicidal events during treatment (P < .05). Patients with suicidal events were on average still moderately ill prior to the event (mean +/- SD Clinical Global Impressions-Severity of Illness scale score = 4.0 +/- 1.3) and only minimally improved (mean +/- SD Clinical Global Impressions-Improvement scale score = 3.2 +/- 1.1). Events were not preceded by increased irritability, akathisia, sleep disturbance, or manic signs. Specific interpersonal stressors were identified in 73% of cases (N = 44). Of the events, 55% (N = 24) resulted in overnight hospitalization. Most suicidal events occurred in the context of persistent depression and insufficient improvement without evidence of medication-induced behavioral activation as a precursor. Severity of self-rated suicidal ideation and depressive symptoms predicted emergence of suicidality during treatment. Risk for suicidal events did not decrease after the first month of treatment, suggesting the need for careful clinical monitoring for several months after starting treatment. Copyright 2009 Physicians Postgraduate Press, Inc.

Acoustic Reflex and House-Brackmann Rating Scale as Prognostic Indicators of Peripheral Facial Palsy in Neuroborreliosis.

PubMed

Sekelj, Alen; Đanić, Davorin

2017-09-01

Lyme borreliosis is a vector-borne infectious disease characterized by three disease stages. In the areas endemic for borreliosis, every acute facial palsy indicates serologic testing and implies specific approach to the disease. Th e aim of the study was to identify and confirm the value of acoustic refl ex and House-Brackman (HB) grading scale as prognostic indicators of facial palsy in neuroborreliosis. Th e study included 176 patients with acute facial palsy divided into three groups based on serologic testing: borreliosis, Bell's palsy, and facial palsy caused by herpes simplex virus type 1 (HSV-1). Study patients underwent baseline audiometry with tympanometry and acoustic reflex, whereas current state of facial palsy was assessed by the HB scale. Subsequently, the same tests were obtained on three occasions, i.e. in week 3, 6 and 12 of presentation. Th e patients diagnosed with borreliosis, Bell's palsy and HSV-1 differed according to the time to acoustic refl ex recovery, which took longest time in patients with borreliosis. Th ese patients had the highest percentage of suprastapedial lesions at all time points and recovery was achieved later as compared with the other two diagnoses. Th e mean score on the HB scale declined with time, also at a slower rate in borreliosis patients. Th e prognosis of acoustic refl ex and facial palsy recovery according to HB scale was not associated with the length of elapsed time. The results obtained in the present study strongly confirmed the role of acoustic reflex and HB grading scale as prognostic indicators of facial palsy in neuroborreliosis.

Proton Therapy for Spinal Ependymomas: Planning, Acute Toxicities, and Preliminary Outcomes

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

Amsbaugh, Mark J.; Grosshans, David R., E-mail: dgrossha@mdanderson.org; McAleer, Mary Frances

2012-08-01

Purpose: To report acute toxicities and preliminary outcomes for pediatric patients with ependymomas of the spine treated with proton beam therapy at the MD Anderson Cancer Center. Methods and Materials: Eight pediatric patients received proton beam irradiation between October 2006 and September 2010 for spinal ependymomas. Toxicity data were collected weekly during radiation therapy and all follow-up visits. Toxicities were graded according to the Common Terminology Criteria for Adverse Events version 3.0. Results: All patients had surgical resection of the tumor before irradiation (7 subtotal resection and 1 gross total resection). Six patients had World Health Organization Grade I ependymomas,more » and two had World Health Organization Grade II ependymomas. Patients had up to 3 surgical interventions before radiation therapy (range, 1-3; median, 1). Three patients received proton therapy after recurrence and five as part of their primary management. The entire vertebral body was treated in all but 2 patients. The mean radiation dose was 51.1 cobalt gray equivalents (range, 45 to 54 cobalt gray equivalents). With a mean follow-up of 26 months from the radiation therapy start date (range, 7-51 months), local control, event-free survival, and overall survival rates were all 100%. The most common toxicities during treatment were Grade 1 or 2 erythema (75%) and Grade 1 fatigue (38%). No patients had a Grade 3 or higher adverse event. Proton therapy dramatically reduced dose to all normal tissues anterior to the vertebral bodies in comparison to photon therapy. Conclusion: Preliminary outcomes show the expected control rates with favorable acute toxicity profiles. Proton beam therapy offers a powerful treatment option in the pediatric population, where adverse events related to radiation exposure are of concern. Extended follow-up will be required to assess for late recurrences and long-term adverse effects.« less

Endocrine-related adverse events associated with immune checkpoint blockade and expert insights on their management.

PubMed

Sznol, Mario; Postow, Michael A; Davies, Marianne J; Pavlick, Anna C; Plimack, Elizabeth R; Shaheen, Montaser; Veloski, Colleen; Robert, Caroline

2017-07-01

Agents that modulate immune checkpoint proteins, such as cytotoxic T-lymphocyte antigen-4 (CTLA-4) and programmed death receptor-1 (PD-1), have become a mainstay in cancer treatment. The clinical benefit afforded by immune checkpoint inhibitors can be accompanied by immune-related adverse events (irAE) that affect the skin, gastrointestinal tract, liver, and endocrine system. The types of irAEs associated with immune checkpoint inhibitors are generally consistent across tumor types. Immune-related endocrine events can affect the pituitary, thyroid, and adrenal glands, as well as other downstream target organs. These events are unique when compared with other irAEs because the manifestations are often irreversible. Immune-related endocrine events are typically grade 1/2 in severity and often present with non-specific symptoms, making them difficult to diagnose. The mechanisms underlying immune-related target organ damage in select individuals remain mostly undefined. Management includes close patient monitoring, appropriate laboratory testing for endocrine function, replacement of hormones, and consultation with an endocrinologist when appropriate. An awareness of the symptoms and management of immune-related endocrine events may aid in the safe and appropriate use of immune checkpoint inhibitors in clinical practice. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

The ASVAB (Armed Services Vocational Aptitude Battery) Score Scales. 1980 and World War II

DTIC Science & Technology

1986-07-01

TABLE B-3 ASVAB 14 (A, B, & C) MECHANICAL & CRAFTS (MC) COMPOSITE PERCENTILE NORMS BY SEX AND GRADE Females Grade Males Total Standard Grade...COMPOSITE PERCENTILE NORMS BY SEX AND GRADE Females Grade Males Total Standard Grade Grade Standard Score 11th 12th nth 12th nth 12th Score 24 24...Standard Scores. B-8 TABLE B-3 ASVAB 14 (A. B,&C) ELECTRONIC & ELECTRICAL (EE) COMPOSITE PERCENTILE NORMS BY SEX AND GRADE Females Grade Males

Anticipating flash-floods: Multi-scale aspects of the social response

NASA Astrophysics Data System (ADS)

Lutoff, Céline; Creutin, Jean-Dominique; Ruin, Isabelle; Borga, Marco

2016-10-01

This paper aims at exploring the anticipation phase before a flash flood, corresponding to the time between the first climatic signs and the peak-flow. We focus the analysis on people's behaviors observing how they use this period to organize themselves for facing the event. The analysis is made through the definition of three specific scales: the timeliness scale, an analytical scale of anticipatory actions and the scale of human response network. Using a cross-scale and cross level analysis enables to define different phases in the anticipation period where different kind of environmental precursors are mobilized by the actors in order to make sense of the situation and adapt. Three main points deserve attention at the end: firstly, the concepts of timeliness, anticipatory actions and crisis network scales enable to understand differently what happens both physically and socially during an extreme event; secondly, analyzing the precursors shows that each level of crisis network uses different kinds of signs for estimating the situation, organizing and reacting; thirdly, there is a potential for improvement in observation on both social and physical processes at different scales, for verifying the theory of the anticipatory phases.

Classifying hydrological events to quantify their impact on nitrate leaching across three spatial scales

NASA Astrophysics Data System (ADS)

Bauwe, Andreas; Tiemeyer, Bärbel; Kahle, Petra; Lennartz, Bernd

2015-04-01

Nitrate is one of the most important sources of pollution for surface waters in tile-drained agricultural areas. In order to develop appropriate management strategies to reduce nitrate losses, it is crucial to first understand the underlying hydrological processes. In this study, we used Principle Component Analysis (PCA) and Linear Discriminant Analysis (LDA) to analyze 212 storm events between 2004 and 2011 across three spatial scales (collector drain, ditch, and brook) to identify the controlling factors for hydrograph response characteristics and their influence on nitrate concentration patterns. Our results showed that the 212 hydrological events can be classified into six different types: summer events (28%), snow-dominated events (10%), events controlled by rainfall duration (16%), rainfall totals (8%), dry antecedent conditions (10%), and events controlled by wet antecedent conditions (14%). The relatively large number of unclassified events (15%) demonstrated the difficulty in separating event types due to mutually influencing variables. NO3-N concentrations showed a remarkably consistent pattern during the discharge events regardless of event type, with minima at the beginning, increasing concentrations at the rising limb, and maxima around peak discharge. However, the level of NO3-N concentrations varied notably among the event types. The highest average NO3-N concentrations were found for events controlled by rainfall totals (NO3-N=17.1 mg/l), events controlled by wet antecedent conditions (NO3-N=17.1 mg/l), and snowmelt (NO3-N=15.2 mg/l). Average maximum NO3-N concentrations were significantly lower during summer events (NO3-N=10.2 mg/l) and events controlled by dry antecedent conditions (NO3-N=11.7 mg/l). The results have furthermore shown that similar hydrological and biogeochemical processes determine the hydrograph and NO3-N response on storm events at various spatial scales. The management of tile-drained agricultural land to reduce NO3-N losses should focus explicitly on flow events and, more specifically, active management should preferably be conducted in the winter season for discharge events after snowmelt, after heavy rain storms and when the soil moisture conditions are wet.

Reach-scale channel sensitivity to multiple human activities and natural events: Lower Santa Clara River, California, USA

NASA Astrophysics Data System (ADS)

Downs, Peter W.; Dusterhoff, Scott R.; Sears, William A.

2013-05-01

Understanding the cumulative impact of natural and human influences on the sensitivity of channel morphodynamics, a relative measure between the drivers for change and the magnitude of channel response, requires an approach that accommodates spatial and temporal variability in the suite of primary stressors. Multiple historical data sources were assembled to provide a reach-scale analysis of the lower Santa Clara River (LSCR) in Ventura County, California, USA. Sediment supply is naturally high due to tectonic activity, earthquake-generated landslides, wildfires, and high magnitude flow events during El Niño years. Somewhat typically for the region, the catchment has been subject to four reasonably distinct land use and resource management combinations since European-American settlement. When combined with analysis of channel morphological response (quantifiable since ca. 1930), reach-scale and temporal differences in channel sensitivity become apparent. Downstream reaches have incised on average 2.4 m and become narrower by almost 50% with changes focused in a period of highly sensitive response after about 1950 followed by forced insensitivity caused by structural flood embankments and a significant grade control structure. In contrast, the middle reaches have been responsive but are morphologically resilient, and the upstream reaches show a mildly sensitive aggradational trend. Superimposing the natural and human drivers for change reveals that large scale stressors (related to ranching and irrigation) have been replaced over time by a suite of stressors operating at multiple spatial scales. Lower reaches have been sensitive primarily to 'local' scale impacts (urban growth, flood control, and aggregate mining) whereas, upstream, catchment-scale influences still prevail (including flow regulation and climate-driven sediment supply factors). These factors illustrate the complexity inherent to cumulative impact assessment in fluvial systems, provide evidence for a distinct Anthropocene fluvial response, and underpin the enormity of the challenge faced in trying to sustainably manage and restore rivers.

Ediacaran ( 620 Ma) high grade regional metamorphism in the northern Arabian Nubian Shield: U/Th-Pb monazite ages of the Elat schist

NASA Astrophysics Data System (ADS)

Elisha, Bar; Katzir, Yaron; Kylander-Clark, Andrew

2017-04-01

Ediacaran times witnessed a hemisphere-scale orogenesis forming the extensive Pan-African mountain ranges and resulting in the final assembly of Gondwana supercontinent. The Elat metamorphic basement (S Israel) located at the northernmost tip of a major Pan-African orogenic suture, the Arabian Nubian Shield (ANS), comprises amphibolite facies schists and gneisses and was most likely shaped by this major continental collision. However the timing, number and duration of metamorphic events in Elat and elsewhere in the ANS are non-conclusive and a major emphasis was given to pre-Ediacaran island-arc related tectonics. This is mostly because U-Pb dating of zircon, widely used in Elat and elsewhere, is very successful in constraining the ages of the igneous and sedimentary protoliths, but is 'blind' to metamorphism at grades lower than granulite. Here U/Th-Pb dating of monazite, a precise chronometer of metamorphic mineral growth, is systematically applied to the Elat schist and unveils the tectono-metamorphic evolution of the Elat basement. Previous U-Pb dating of detrital zircon has shown that the sedimentary protoliths of the Elat schist are the oldest basement components (≥800 Ma), and detailed structural observations of the schists portrayed a complex deformation history including four successive phases (Shimron, 1972). The earliest three phases were defined as ductile and penetrative, but some of the available geochronological data apparently contradict field relations. In-situ analysis of metamorphic monazites by LASS (Laser Ablation Split Stream) involves simultaneous measurement of U/Th-Pb isotope ratios and REE contents in a single 10 μm sized grain or domain, thus allowing determining the age of specific texture and metamorphic assemblage. Monazite dating of the Elat schist yielded two concordant age clusters at 712±6 and 613±5 Ma. The corresponding REE patterns of the dated monazite grains indicate that porphyroblast growth, either garnet or staurolite, took place only during the younger event (M2). Likewise the regional south dipping penetrative foliation, common to the Elat schist and to all of the rocks of the Elat association, formed during the Ediacaran event (M2). This profound event started at 630 Ma and reached peak conditions of mid amphibolite facies at 620 Ma. Retrogression and stress relaxation shortly followed, involving overprint of staurolite schists by a cordierite-bearing assemblage at 613 Ma (M3), and was contemporaneous with the intrusion of andesitic dykes that were immediately metamorphosed to low-amphibolite. This metamorphic P-T-t path corresponds to the collision of East- and West-Gondwana as constrained by large goechronological database of post collision batholiths from all around the Arabian-Nubian Shield.

The Spatial Scaling of Global Rainfall Extremes

NASA Astrophysics Data System (ADS)

Devineni, N.; Xi, C.; Lall, U.; Rahill-Marier, B.

2013-12-01

Floods associated with severe storms are a significant source of risk for property, life and supply chains. These property losses tend to be determined as much by the duration of flooding as by the depth and velocity of inundation. High duration floods are typically induced by persistent rainfall (upto 30 day duration) as seen recently in Thailand, Pakistan, the Ohio and the Mississippi Rivers, France, and Germany. Events related to persistent and recurrent rainfall appear to correspond to the persistence of specific global climate patterns that may be identifiable from global, historical data fields, and also from climate models that project future conditions. A clear understanding of the space-time rainfall patterns for events or for a season will enable in assessing the spatial distribution of areas likely to have a high/low inundation potential for each type of rainfall forcing. In this paper, we investigate the statistical properties of the spatial manifestation of the rainfall exceedances. We also investigate the connection of persistent rainfall events at different latitudinal bands to large-scale climate phenomena such as ENSO. Finally, we present the scaling phenomena of contiguous flooded areas as a result of large scale organization of long duration rainfall events. This can be used for spatially distributed flood risk assessment conditional on a particular rainfall scenario. Statistical models for spatio-temporal loss simulation including model uncertainty to support regional and portfolio analysis can be developed.

Ancillary outcome measures for assessment of individuals with cervical spondylotic myelopathy.

PubMed

Kalsi-Ryan, Sukhvinder; Singh, Anoushka; Massicotte, Eric M; Arnold, Paul M; Brodke, Darrel S; Norvell, Daniel C; Hermsmeyer, Jeffrey T; Fehlings, Michael G

2013-10-15

Narrative review. To identify suitable outcome measures that can be used to quantify neurological and functional impairment in the management of cervical spondylotic myelopathy (CSM). CSM is the leading cause of acquired spinal cord disability, causing varying degrees of neurological impairment which impact on independence and quality of life. Because this impairment can have a heterogeneous presentation, a single outcome measure cannot define the broad range of deficits seen in this population. Therefore, it is necessary to define outcome measures that characterize the deficits with greater validity and sensitivity. This review was conducted in 3 stages. Stage I: To evaluate the current use of outcome measures in CSM, PubMed was searched using the name of the outcome measure and the common abbreviation combined with "CSM" or "myelopathy." Stage II: Having identified a lack of appropriate outcome measures, we constructed criteria by which measures appropriate for assessing the various aspects of CSM could be identified. Stage III: A second literature search was then conducted looking at specified outcomes that met these criteria. All literature was reviewed to determine specificity and psychometric properties of outcomes for CSM. Nurick grade, modified Japanese Orthopaedic Association Scale, visual analogue scale (VAS) for pain, Short Form (36) Health Survey (SF-36), and Neck Disability Index were the most commonly cited measures. The Short-Form 36 Health Survey and Myelopathy Disability Index have been validated in the CSM population with multiple studies, whereas the modified Japanese Orthopaedic Association Scale score, Nurick grade, and European Myelopathy Scale each had only one study assessing psychometric characteristics. No validity, reliability, or responsiveness studies were found for the VAS or Neck Disability Index in the CSM population. We recommend that the modified Japanese Orthopaedic Association Scale, Nurick grade, Myelopathy Disability Index, Neck Disability Index, and 30-Meter Walk Test are most appropriate for the assessment of CSM. However, 6 additional outcome measures (QuickDASH, Berg Balance Scale, Graded Redefined Assessment of Strength Sensibility and Prehension, Grip Dynamometer, and GAITRite Analysis) were identified, which provide complementary assessments for CSM. SUMMARY STATEMENTS: There does not exist a single or composite of outcome instruments that measures myelopathy impairment, function/disability, and participation that have also demonstrated reliability, validity, and responsiveness in a CSM population. More work in the development and psychometric evaluation of new or existing measures is necessary to identify the ideal composite of measures to be used in the clinical and research settings. The mJOA, Nurick grade, NDI, MDI, and 30MWT should be adopted in any clinical practice that treats CSM both for screening and clinical follow-up. We propose that clinicians and researchers consider using the ancillary measures identified, such as the QuickDASH, Berg Balance Scale, GRASSP version 1.0, Grip Strength, and GAITRite Analysis. It is highly recommended that baseline and follow-up measurements should be performed in patients with CSM.

Microgravity

NASA Image and Video Library

2001-05-02

Suzarne Nichols (12th grade) from DuPont Manual High School in Louisville, Kentucky, asks a question of on of the on-line lecturers during the Pan-Pacific Basin Workshop on Microgravity Sciences held in Pasadena, California. The event originated at the California Science Center in Los Angeles. The DuPont Manual students patched in to the event through the distance learning lab at the Louisville Science Center. Jie Ma (grade 10, at right) waits her turn to ask a question. This image is from a digital still camera; higher resolution is not available.

Short-term rainfall: its scaling properties over Portugal

NASA Astrophysics Data System (ADS)

de Lima, M. Isabel P.

2010-05-01

The characterization of rainfall at a variety of space- and time-scales demands usually that data from different origins and resolution are explored. Different tools and methodologies can be used for this purpose. In regions where the spatial variation of rain is marked, the study of the scaling structure of rainfall can lead to a better understanding of the type of events affecting that specific area, which is essential for many engineering applications. The relevant factors affecting rain variability, in time and space, can lead to contrasting statistics which should be carefully taken into account in design procedures and decision making processes. One such region is Mainland Portugal; the territory is located in the transitional region between the sub-tropical anticyclone and the subpolar depression zones and is characterized by strong north-south and east-west rainfall gradients. The spatial distribution and seasonal variability of rain are particularly influenced by the characteristics of the global circulation. One specific feature is the Atlantic origin of many synoptic disturbances in the context of the regional geography (e.g. latitude, orography, oceanic and continental influences). Thus, aiming at investigating the statistical signature of rain events of different origins, resulting from the large number of mechanisms and factors affecting the rainfall climate over Portugal, scale-invariant analyses of the temporal structure of rain from several locations in mainland Portugal were conducted. The study used short-term rainfall time series. Relevant scaling ranges were identified and characterized that help clarifying the small-scale behaviour and statistics of this process.

Evidence for multiple metamorphic events in the Adirondack Mountains, N. Y

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

McLelland, J.; Lochhead, A.; Vyhnal, C.

1988-05-01

Field evidence consisting of: (1) rotated, foliated xenoliths, (2) country rock foliation truncated by isoclinally folded igneous intrusions bearing granulite facies assemblages document one, or more, early dynamothermal event(s) of regional scale and high grade. Early metamorphism resulted in pronounced linear and planar fabric throughout the Adirondacks and preceded the emplacement of the anorthosite-mangerite-charnockite-granite-alaskite (AMCA) suite which contains xenoliths of the metamorphosed rocks. Olivine metagabbros, believed to be approximately contemporaneous with the AMCA-suite, also crosscut and contain xenoliths of, strongly foliated metasediments. These intrusive rocks caused contact metamorphism in the metasediments which locally exhibit both anatectite and restite assemblages. Subsequently,more » this already complex framework underwent three phases of folding, including an early recumbent isoclinical event, and was metamorphosed to granulite facies P,T conditions. The age of the early metamorphism cannot yet be narrowly constrained, but isotopic results suggest that it may be as young as approx. 1200 Ma or older than approx. 1420 Ma. U-Pb zircon ages indicate emplacement of the AMCA-(metagabbro)-suite in the interval 1160-1130 Ma and place the peak of granulite facies metamorphism between 1070-1025 Ma. The anorogenic character of the AMCA-suite, and the occurrence of metadiabase dike swarms within it, are further evidence of the separate nature of the metamorphic events that precede and postdate AMCA emplacement.« less

The pharmacology and management of the vitamin K antagonists: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy.

PubMed

Ansell, Jack; Hirsh, Jack; Poller, Leon; Bussey, Henry; Jacobson, Alan; Hylek, Elaine

2004-09-01

This article concerning the pharmacokinetics and pharmacodynamics of vitamin K antagonists (VKAs) is part of the Seventh American College of Chest Physicians Conference on Antithrombotic and Thrombolytic Therapy: Evidence-Based Guidelines. The article describes the antithrombotic effect of VKAs, the monitoring of anticoagulation intensity, the clinical applications of VKA therapy, and the optimal therapeutic range of VKAs, and provides specific management recommendations. Grade 1 recommendations are strong, and indicate that the benefits do, or do not, outweigh the risks, burdens, and costs. Grade 2 suggests that individual patient's values may lead to different choices (for a full understanding of the grading see Guyatt et al, CHEST 2004; 126:179S-187S). Among the key recommendations in this article are the following: for dosing of VKAs, we suggest the initiation of oral anticoagulation therapy with doses between 5 and 10 mg for the first 1 or 2 days for most individuals, with subsequent dosing based on the international normalized ratio (INR) response (Grade 2B). In the elderly and in other patient subgroups with an elevated bleeding risk, we suggest a starting dose at < or = 5 mg (Grade 2C). We recommend basing subsequent doses after the initial two or three doses on the results of INR monitoring (Grade 1C). The article also includes several specific recommendations for the management of patients with INRs above the therapeutic range and for patients requiring invasive procedures. For example, in patients with mild to moderately elevated INRs without major bleeding, we suggest that when vitamin K is to be given it be administered orally rather than subcutaneously (Grade 1A). For the management of patients with a low risk of thromboembolism, we suggest stopping warfarin therapy approximately 4 days before they undergo surgery (Grade 2C). For patients with a high risk of thromboembolism, we suggest stopping warfarin therapy approximately 4 days before surgery, to allow the INR to return to normal, and beginning therapy with full-dose unfractionated heparin or full-dose low-molecular-weight heparin as the INR falls (Grade 2C). In patients undergoing dental procedures, we suggest the use of tranexamic acid mouthwash (Grade 2B) or epsilon amino caproic acid mouthwash without interrupting anticoagulant therapy (Grade 2B) if there is a concern for local bleeding. For most patients who have a lupus inhibitor, we suggest a therapeutic target INR of 2.5 (range, 2.0 to 3.0) [Grade 2B]. In patients with recurrent thromboembolic events with a therapeutic INR or other additional risk factors, we suggest a target INR of 3.0 (range, 2.5 to 3.5) [Grade 2C]. As models of anticoagulation monitoring and management, we recommend that clinicians incorporate patient education, systematic INR testing, tracking, and follow-up, and good communication with patients concerning results and dosing decisions (Grade 1C+).

Newcomer immigrant adolescents: A mixed-methods examination of family stressors and school outcomes.

PubMed

Patel, Sita G; Clarke, Annette V; Eltareb, Fazia; Macciomei, Erynn E; Wickham, Robert E

2016-06-01

Family stressors predict negative psychological outcomes for immigrant adolescents, yet little is known about how such stressors interact to predict school outcomes. The purpose of this study was to explore the interactive role of family stressors on school outcomes for newcomer adolescent immigrants. Using a convergent parallel mixed-methods design, we used quantitative methods to explore interactions between family separation, acculturative family conflict, and family life events to predict 2 school outcomes, academic achievement (via grade point average [GPA]), and externalizing problems (student- and teacher-reported). The sample included 189 newcomer immigrant public high school students from 34 countries of origin. Quantitative measures included the Multicultural Events Scale for Adolescents, Family Conflicts Scale, and the Achenbach System of Empirically Based Assessment (ASEBA). Qualitative data were collected through a semi-structured interview. Quantitative results found that more family life events were associated with lower GPA, but this association was weaker for participants who had been separated from their parents. More family conflict was associated with more externalizing symptoms (both youth- and teacher-reported). However, the association between family conflict and teacher-reported externalizing symptoms was found only among participants reporting a greater than average number of life events. Qualitative results show that separation from extended family networks was among the most stressful of experiences, and demonstrate the highly complex nature of each family stressor domain. At a time when immigration is rapidly changing our school system, a better understanding of early risk factors for new immigrants can help teachers, administrators, and mental health practitioners to identify students with greatest need to foster behavioral, academic, and emotional well-being. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Reduced NK cell IFN-γ secretion and psychological stress are independently associated with herpes zoster.

PubMed

Kim, Choon Kwan; Choi, Youn Mi; Bae, Eunsin; Jue, Mihn Sook; So, Hyung Seok; Hwang, Eung-Soo

2018-01-01

The pathogenesis of herpes zoster is closely linked to reduced varicella-zoster virus-specific cell-mediated immunity. However, little is known about the interplay between natural killer cells and psychological stress in the pathogenesis of herpes zoster. This study aimed to investigate possible associations among natural killer cells, T cells and psychological stress in herpes zoster. Interferon-gamma secretion from natural killer cell, psychological stress events, stress cognition scale scores and cytomegalovirus-specific cell-mediated immunity were compared between 44 patients with herpes zoster and 44 age- and gender-matched control subjects. A significantly lower median level of interferon-gamma secreted by natural killer cells was observed in patients with a recent diagnosis of herpes zoster than in control subjects (582.7 pg/ml vs. 1783 pg/ml; P = 0.004), whereas cytomegalovirus-specific cell-mediated immunity was not associated with herpes zoster. Psychological stress events and high stress cognition scale scores were significantly associated in patients with herpes zoster (P<0.001 and P = 0.037, respectively). However, reduced interferon-gamma secretion from natural killer cell and psychological stress were not associated. In conclusion, patients with a recent diagnosis of herpes zoster display reduced interferon-gamma secretion from natural killer cells and frequent previous psychological stress events compared with controls. However, reduced natural killer cell activity is not an immunological mediator between psychological stress and herpes zoster.

Reduced NK cell IFN-γ secretion and psychological stress are independently associated with herpes zoster

PubMed Central

Kim, Choon Kwan; Choi, Youn Mi; Bae, Eunsin; Jue, Mihn Sook; So, Hyung Seok

2018-01-01

The pathogenesis of herpes zoster is closely linked to reduced varicella-zoster virus-specific cell-mediated immunity. However, little is known about the interplay between natural killer cells and psychological stress in the pathogenesis of herpes zoster. This study aimed to investigate possible associations among natural killer cells, T cells and psychological stress in herpes zoster. Interferon-gamma secretion from natural killer cell, psychological stress events, stress cognition scale scores and cytomegalovirus-specific cell-mediated immunity were compared between 44 patients with herpes zoster and 44 age- and gender-matched control subjects. A significantly lower median level of interferon-gamma secreted by natural killer cells was observed in patients with a recent diagnosis of herpes zoster than in control subjects (582.7 pg/ml vs. 1783 pg/ml; P = 0.004), whereas cytomegalovirus-specific cell-mediated immunity was not associated with herpes zoster. Psychological stress events and high stress cognition scale scores were significantly associated in patients with herpes zoster (P<0.001 and P = 0.037, respectively). However, reduced interferon-gamma secretion from natural killer cell and psychological stress were not associated. In conclusion, patients with a recent diagnosis of herpes zoster display reduced interferon-gamma secretion from natural killer cells and frequent previous psychological stress events compared with controls. However, reduced natural killer cell activity is not an immunological mediator between psychological stress and herpes zoster. PMID:29466462

Stressful Life Events, Social Support, and Achievement: A Study of Three Grade Levels in a Multicultural Environment.

ERIC Educational Resources Information Center

Levitt, Mary J.; And Others

This study assessed the extent to which support exerts direct or indirect effects on child and adolescent achievement (grade point average and Statistical Aptitude Test scores). Personal interviews were conducted with 120 African American, 101 Anglo-European American, and 112 Latin American students (151 males and 182 females) in grades 1-2,…

Evaluation of Bortezomib-Induced Neuropathy Using Total Neuropathy Score (Reduced and Clinical Versions) and NCI CTCAE v4.0 in Newly Diagnosed Patients With Multiple Myeloma Receiving Bortezomib-Based Induction.

PubMed

Lakshman, Arjun; Modi, Manish; Prakash, Gaurav; Malhotra, Pankaj; Khadwal, Alka; Jain, Sanjay; Kumari, Savita; Varma, Neelam; Varma, Subhash

2017-08-01

Bortezomib-induced peripheral neuropathy (BiPN) is a dose-limiting adverse effect of bortezomib-based therapy for multiple myeloma (MM). The reporting of BiPN is variable because of the use of different neuropathy scales. Most investigators use the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE). We prospectively evaluated the incidence of BiPN in treatment-naive patients with MM receiving weekly cyclophosphamide, bortezomib, and dexamethasone (CyBorD) in 28-day cycles using 3 neuropathy scores: Total Neuropathy Score-reduced (TNSr) and -clinical (TNSc), and NCI CTCAE v4.0. Twenty-six patients received CyBorD. Twenty patients completed follow-up. The rates of occurrence of BiPN were as follows: TNSr - 55% (n = 11), TNSc - 40% (n = 8), and NCI CTCAE - 45% (n = 9). All 3 scales showed worsening after treatment (P < .01). When compared to BiPN by TNSr, sensitivities for NCI CTCAE and TNSc were 77.8% and 88.9%, respectively. Specificity was 63.3% for both NCI CTCAE and TNSc. Among 12 patients who did not have BiPN by NCI CTCAE scale, 41.7% (n = 5) and 16.7% (n = 2) patients satisfied the criteria for BiPN by TNSr and TNSc, respectively. The higher detection rate of neuropathy by TNSr and TNSc is probably due to increment in scores that are allotted for increase in anatomic extent of sensorimotor involvement, unlike the NCI CTCAE scale, which requires functional limitation for increase in grade. NCI CTCAE may be suboptimal in comparison to TNSr and TNSc in assessment of BiPN because it may miss worsening neuropathy without functional limitation. Copyright © 2017 Elsevier Inc. All rights reserved.

Simulating recurrent event data with hazard functions defined on a total time scale.

PubMed

Jahn-Eimermacher, Antje; Ingel, Katharina; Ozga, Ann-Kathrin; Preussler, Stella; Binder, Harald

2015-03-08

In medical studies with recurrent event data a total time scale perspective is often needed to adequately reflect disease mechanisms. This means that the hazard process is defined on the time since some starting point, e.g. the beginning of some disease, in contrast to a gap time scale where the hazard process restarts after each event. While techniques such as the Andersen-Gill model have been developed for analyzing data from a total time perspective, techniques for the simulation of such data, e.g. for sample size planning, have not been investigated so far. We have derived a simulation algorithm covering the Andersen-Gill model that can be used for sample size planning in clinical trials as well as the investigation of modeling techniques. Specifically, we allow for fixed and/or random covariates and an arbitrary hazard function defined on a total time scale. Furthermore we take into account that individuals may be temporarily insusceptible to a recurrent incidence of the event. The methods are based on conditional distributions of the inter-event times conditional on the total time of the preceeding event or study start. Closed form solutions are provided for common distributions. The derived methods have been implemented in a readily accessible R script. The proposed techniques are illustrated by planning the sample size for a clinical trial with complex recurrent event data. The required sample size is shown to be affected not only by censoring and intra-patient correlation, but also by the presence of risk-free intervals. This demonstrates the need for a simulation algorithm that particularly allows for complex study designs where no analytical sample size formulas might exist. The derived simulation algorithm is seen to be useful for the simulation of recurrent event data that follow an Andersen-Gill model. Next to the use of a total time scale, it allows for intra-patient correlation and risk-free intervals as are often observed in clinical trial data. Its application therefore allows the simulation of data that closely resemble real settings and thus can improve the use of simulation studies for designing and analysing studies.

Stress sensitivity mediates the relationship between traumatic life events and attenuated positive psychotic symptoms differentially by gender in a college population sample.

PubMed

Gibson, Lauren E; Anglin, Deidre M; Klugman, Joshua T; Reeves, Lauren E; Fineberg, Anna M; Maxwell, Seth D; Kerns, Connor M; Ellman, Lauren M

2014-06-01

The purpose of this study was to investigate whether stress sensitivity mediates the relationship between traumatic life events and total attenuated positive psychotic symptoms, as well as the relationship between traumatic life events and endorsement of 8 or more attenuated positive psychotic symptoms as distressing (a threshold that has been associated with higher risk for psychosis in clinical groups). Participants (n = 671, aged 17-35, 29% male) were college students who were administered the Prodromal Questionnaire, the Perceived Stress Scale and the Life Events Checklist. Bootstrapping results indicated that stress sensitivity significantly mediated the relationships between traumatic life events and the number of attenuated positive psychotic symptoms endorsed and between traumatic life events and those who endorsed 8 or more distressing attenuated positive psychotic symptoms. Stratified gender analyses indicated the findings were specific to females. Results suggest that stress sensitivity may represent a specific vulnerability factor for risk of attenuated psychotic symptoms in those previously exposed to traumatic life events and that this liability appears stronger in females. Copyright © 2014 Elsevier Ltd. All rights reserved.

Differential Item Functioning by Gender on a Large-Scale Science Performance Assessment: A Comparison across Grade Levels.

ERIC Educational Resources Information Center

Holweger, Nancy; Taylor, Grace

The fifth-grade and eighth-grade science items on a state performance assessment were compared for differential item functioning (DIF) due to gender. The grade 5 sample consisted of 8,539 females and 8,029 males and the grade 8 sample consisted of 7,477 females and 7,891 males. A total of 30 fifth grade items and 26 eighth grade items were…

PCSK9 monoclonal antibodies for the primary and secondary prevention of cardiovascular disease.

PubMed

Schmidt, Amand F; Pearce, Lucy S; Wilkins, John T; Overington, John P; Hingorani, Aroon D; Casas, Juan P

2017-04-28

Despite the availability of effective drug therapies that reduce low-density lipoprotein (LDL)-cholesterol (LDL-C), cardiovascular disease (CVD) remains an important cause of mortality and morbidity. Therefore, additional LDL-C reduction may be warranted, especially for patients who are unresponsive to, or unable to take, existing LDL-C-reducing therapies. By inhibiting the proprotein convertase subtilisin/kexin type 9 (PCSK9) enzyme, monoclonal antibodies (PCSK9 inhibitors) may further reduce LDL-C, potentially reducing CVD risk as well. Primary To quantify short-term (24 weeks), medium-term (one year), and long-term (five years) effects of PCSK9 inhibitors on lipid parameters and on the incidence of CVD. Secondary To quantify the safety of PCSK9 inhibitors, with specific focus on the incidence of type 2 diabetes, cognitive function, and cancer. Additionally, to determine if specific patient subgroups were more or less likely to benefit from the use of PCSK9 inhibitors. We identified studies by systematically searching the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and Web of Science. We also searched Clinicaltrials.gov and the International Clinical Trials Registry Platform and screened the reference lists of included studies. We identified the studies included in this review through electronic literature searches conducted up to May 2016, and added three large trials published in March 2017. All parallel-group and factorial randomised controlled trials (RCTs) with a follow-up time of at least 24 weeks were eligible. Two review authors independently reviewed and extracted data. When data were available, we calculated pooled effect estimates. We included 20 studies with data on 67,237 participants (median age 61 years; range 52 to 64 years). Twelve trials randomised participants to alirocumab, three trials to bococizumab, one to RG7652, and four to evolocumab. Owing to the small number of trials using agents other than alirocumab, we did not differentiate between types of PCSK9 inhibitors used. We compared PCSK9 inhibitors with placebo (thirteen RCTs), ezetimibe (two RCTs) or ezetimibe and statins (five RCTs).Compared with placebo, PCSK9 inhibitors decreased LDL-C by 53.86% (95% confidence interval (CI) 58.64 to 49.08; eight studies; 4782 participants; GRADE: moderate) at 24 weeks; compared with ezetimibe, PCSK9 inhibitors decreased LDL-C by 30.20% (95% CI 34.18 to 26.23; two studies; 823 participants; GRADE: moderate), and compared with ezetimibe and statins, PCSK9 inhibitors decreased LDL-C by 39.20% (95% CI 56.15 to 22.26; five studies; 5376 participants; GRADE: moderate).Compared with placebo, PCSK9 inhibitors decreased the risk of CVD events, with a risk difference (RD) of 0.91% (odds ratio (OR) of 0.86, 95% CI 0.80 to 0.92; eight studies; 59,294 participants; GRADE: moderate). Compared with ezetimibe and statins, PCSK9 inhibitors appeared to have a stronger protective effect on CVD risk, although with considerable uncertainty (RD 1.06%, OR 0.45, 95% CI 0.27 to 0.75; three studies; 4770 participants; GRADE: very low). No data were available for the ezetimibe only comparison. Compared with placebo, PCSK9 probably had little or no effect on mortality (RD 0.03%, OR 1.02, 95% CI 0.91 to 1.14; 12 studies; 60,684 participants; GRADE: moderate). Compared with placebo, PCSK9 inhibitors increased the risk of any adverse events (RD 1.54%, OR 1.08, 95% CI 1.04 to 1.12; 13 studies; 54,204 participants; GRADE: low). Similar effects were observed for the comparison of ezetimibe and statins: RD 3.70%, OR 1.18, 95% CI 1.05 to 1.34; four studies; 5376 participants; GRADE: low. Clinical event data were unavailable for the ezetimibe only comparison. Over short-term to medium-term follow-up, PCSK9 inhibitors reduced LDL-C. Studies with medium-term follow-up time (longest median follow-up recorded was 26 months) reported that PCSK9 inhibitors (compared with placebo) decreased CVD risk but may have increased the risk of any adverse events (driven by SPIRE-1 and -2 trials). Available evidence suggests that PCSK9 inhibitor use probably leads to little or no difference in mortality. Evidence on relative efficacy and safety when PCSK9 inhibitors were compared with active treatments was of low to very low quality (GRADE); follow-up times were short and events were few. Large trials with longer follow-up are needed to evaluate PCSK9 inhibitors versus active treatments as well as placebo. Owing to the predominant inclusion of high-risk patients in these studies, applicability of results to primary prevention is limited. Finally, estimated risk differences indicate that PCSK9 inhibitors only modestly change absolute risks (often to less than 1%).

Does a combination of physical training, specific exercises and pain education improve health-related quality of life in patients with chronic neck pain? A randomised control trial with a 4-month follow up.

PubMed

Ris, I; Søgaard, K; Gram, B; Agerbo, K; Boyle, E; Juul-Kristensen, B

2016-12-01

To investigate the effect of combining pain education, specific exercises and graded physical activity training (exercise) compared with pain education alone (control) on physical health-related quality of life (HR-QoL) in chronic neck pain patients. A multicentre randomised controlled trial of 200 neck pain patients receiving pain education. The exercise group received additional exercises for neck/shoulder, balance and oculomotor function, plus graded physical activity training. Patient-reported outcome measures (Short Form-36 Physical and Mental component summary scores, EuroQol-5D, Beck Depression Inventory-II, Neck Disability Index, Pain Bothersomeness, Patient-Specific Functioning Scale, Tampa Scale of Kinesiophobia, Global Perceived Effect) and clinical tests (Aastrand Physical Fitness, cervical Range of Motion, Pressure Pain Threshold at infraspinatus, tibialis anterior and cervical spine, Cranio-cervical Flexion, Cervical Extension muscle function, and oculomotion) were recorded at baseline and after 4 months. The exercise group showed statistically significant improvement in physical HR-QoL, mental HR-QoL, depression, cervical pressure pain threshold, cervical extension movement, muscle function, and oculomotion. Per protocol analyses confirmed these results with additional significant improvements in the exercise group compared with controls. This multimodal intervention may be an effective intervention for chronic neck pain patients. The trial was registered on www.ClinicalTrials.govNCT01431261 and at the Regional Scientific Ethics Committee of Southern Denmark S-20100069. Copyright © 2016 Elsevier Ltd. All rights reserved.

Survey of quality, readability, and social reach of websites on osteosarcoma in adolescents.

PubMed

Lam, Catherine G; Roter, Debra L; Cohen, Kenneth J

2013-01-01

Little is known about Internet resources for adolescent patients. This study assessed the quality, readability, and social reach of websites on an illustrative adolescent cancer diagnosis, osteosarcoma. The top 50 results from four queries in two search engines were screened. Quality and readability were determined using standard DISCERN tool, Flesch Reading Ease and Flesch-Kinkaid Grade. Social reach was gauged by social networking links, global website traffic, and a pilot adolescent-specificity measure. Of 400 websites assessed, 56 (14%) met inclusion criteria. Websites' mean quality was fair (49.8 on 75-point scale; range 31.0-66.0, poor to excellent); 86% failed readability standards (Grade>8); 75% offered at least one social networking link; and 34% offered site-specific social media. More than 60% received over 50,000 visits in the past month. Only 12.5% included adolescent-specific content. Of the 10 websites ranked highest for quality, only one achieved both readability targets and adolescent-specific content. Although some patient-oriented websites on osteosarcoma are of acceptable quality, most failed readability targets, and few appeared to address adolescents. Better awareness of Internet health resources and social media for adolescents with cancer is needed to address gaps, promote health literacy and facilitate patient-provider communication. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Urethral toxicity after LDR brachytherapy: experience in Japan.

PubMed

Tanaka, Nobumichi; Asakawa, Isao; Hasegawa, Masatoshi; Fujimoto, Kiyohide

2015-01-01

Urinary toxicity is common after low-dose-rate (LDR) brachytherapy, and the resolution of urinary toxicity is a concern. In particular, urinary frequency is the most common adverse event among the urinary toxicities. We have previously reported that approximately 70% of patients experience urinary frequency during the first 6 months after seed implantation. Most urinary adverse events were classified as Grade 1, and Grade 2 or higher adverse events were rare. The incidence of urinary retention was approximately 2-4%. A high International Prostate Symptom Score before seed implantation was an independent predictor of acute urinary toxicity of Grade 2 or higher. Several previous reports from the United States also supported this trend. In Japan, LDR brachytherapy was legally approved in 2003. A nationwide prospective cohort study entitled Japanese Prostate Cancer Outcome Study of Permanent Iodine-125 Seed Implantation was initiated in July 2005. It is an important issue to limit urinary toxicities in patients who undergo LDR brachytherapy. Copyright © 2015 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

F7. SEX DIFFERENCES IN THE ASSOCIATION BETWEEN SELF-REPORTS OF CHILDHOOD ADVERSITIES AND SCHIZOTYPAL PERSONALITY TRAITS

PubMed Central

Toutountzidis, Diamantis; Gale, Tim; Irvine, Karen; Sharma, Shivani; Laws, Keith

2018-01-01

Abstract Background While it has been repeatedly documented that people with schizophrenia report higher levels of adverse events in childhood (emotional, physical and sexual abuse), this has not been extensively examined in healthy individuals who score highly on schizotypal personality traits. The continuum hypothesis of psychosis and schizophrenia suggests it is important to assess the relationship in those who are healthy but who experience some psychotic-like symptoms. Of course, it is problematic to rely upon the veracity of events that anyone might recall from their childhood, but this is likely to be compounded by the presence of well-documented memory and executive problems, as well as symptoms such as delusional thinking, in some adults with psychosis. One advantage of examining healthy participants is that recall is not affected by the condition itself or memory- and executive-function problems. As there is evidence that the expression of psychotic disorders differ between males and females, the etiological mechanisms and pathways to the development and experience of psychotic symptoms may equally differ. Indeed, sex differences in the association between childhood trauma and psychotic symptoms have been noted. The aim of this present study was to investigate any links between childhood trauma and psychotic-like symptoms in healthy individuals. Based on previous research the expectation is that associations will be found between self-reports of childhood trauma and schizotypal personality traits. These associations would be expected to differ between males and females. Methods The sample consisted of 320 participants (221 females, 99 males) with a mean age of 28.24 (SD 12.76). Childhood traumatic events were assessed by three sub-scales (Physical Punishment; Emotional Abuse; and Sexual Events) of the Early Trauma Inventory Self Report-Short Form (ETISR-SF; Bremner et al., 2007). Schizotypal personality traits were assessed using the Five Factor Schizotypal Inventory (FFSI; Edmundson et al., 2011). This consists of nine subscales (Interpersonal Suspiciousness; Social Anhedonia; Social Isolation and Withdrawal; Physical Anhedonia; Social Anxiousness; Social Discomfort; Odd and Eccentric; Aberrant Ideas; and Aberrant Perceptions) which were constructed as schizotypic variants of respective facets of the five factor personality model. Results The relationship between childhood trauma and schizotypy was examined using Spearman’s bivariate correlation analyses. Males showed significant positive correlations (ranging from .28 to .39) between Emotional Abuse and seven out of nine schizotypal sub-scales. The other two childhood trauma scales were not associated with any schizotypal sub-scales in males. Females showed significant positive correlations (ranging from .19 to .34) between Physical Punishment and eight out of nine schizotypal sub-scales. Additionally, females showed significant positive correlations (ranging from .26 to .35) between Emotional Abuse and all schizotypal sub-scales. Sexual Events positively correlated with two schizotypal sub-scales (Aberrant Ideas and Aberrant Perceptions) in females. Discussion From the results of this study it appears that emotional abuse was linked to the expression of psychotic-like symptoms in both sexes across a wide array of symptomatology. Therefore, any effect of emotional abuse should not be considered sex or symptom specific. By contrast, physical abuse appeared to be sex specific – affecting only females – but not symptom specific. Finally, sexual abuse appeared to have a specific link with disorganized thoughts and hallucination-like experiences in females.

Characterizing the cancer genome in lung adenocarcinoma

PubMed Central

Weir, Barbara A.; Woo, Michele S.; Getz, Gad; Perner, Sven; Ding, Li; Beroukhim, Rameen; Lin, William M.; Province, Michael A.; Kraja, Aldi; Johnson, Laura A.; Shah, Kinjal; Sato, Mitsuo; Thomas, Roman K.; Barletta, Justine A.; Borecki, Ingrid B.; Broderick, Stephen; Chang, Andrew C.; Chiang, Derek Y.; Chirieac, Lucian R.; Cho, Jeonghee; Fujii, Yoshitaka; Gazdar, Adi F.; Giordano, Thomas; Greulich, Heidi; Hanna, Megan; Johnson, Bruce E.; Kris, Mark G.; Lash, Alex; Lin, Ling; Lindeman, Neal; Mardis, Elaine R.; McPherson, John D.; Minna, John D.; Morgan, Margaret B.; Nadel, Mark; Orringer, Mark B.; Osborne, John R.; Ozenberger, Brad; Ramos, Alex H.; Robinson, James; Roth, Jack A.; Rusch, Valerie; Sasaki, Hidefumi; Shepherd, Frances; Sougnez, Carrie; Spitz, Margaret R.; Tsao, Ming-Sound; Twomey, David; Verhaak, Roel G. W.; Weinstock, George M.; Wheeler, David A.; Winckler, Wendy; Yoshizawa, Akihiko; Yu, Soyoung; Zakowski, Maureen F.; Zhang, Qunyuan; Beer, David G.; Wistuba, Ignacio I.; Watson, Mark A.; Garraway, Levi A.; Ladanyi, Marc; Travis, William D.; Pao, William; Rubin, Mark A.; Gabriel, Stacey B.; Gibbs, Richard A.; Varmus, Harold E.; Wilson, Richard K.; Lander, Eric S.; Meyerson, Matthew

2008-01-01

Somatic alterations in cellular DNA underlie almost all human cancers1. The prospect of targeted therapies2 and the development of high-resolution, genome-wide approaches3–8 are now spurring systematic efforts to characterize cancer genomes. Here we report a large-scale project to characterize copy-number alterations in primary lung adenocarcinomas. By analysis of a large collection of tumors (n = 371) using dense single nucleotide polymorphism arrays, we identify a total of 57 significantly recurrent events. We find that 26 of 39 autosomal chromosome arms show consistent large-scale copy-number gain or loss, of which only a handful have been linked to a specific gene. We also identify 31 recurrent focal events, including 24 amplifications and 7 homozygous deletions. Only six of these focal events are currently associated with known mutations in lung carcinomas. The most common event, amplification of chromosome 14q13.3, is found in ~12% of samples. On the basis of genomic and functional analyses, we identify NKX2-1 (NK2 homeobox 1, also called TITF1), which lies in the minimal 14q13.3 amplification interval and encodes a lineage-specific transcription factor, as a novel candidate proto-oncogene involved in a significant fraction of lung adenocarcinomas. More generally, our results indicate that many of the genes that are involved in lung adenocarcinoma remain to be discovered. PMID:17982442

Large-scale transcriptome sequencing and gene analyses in the crab-eating macaque (Macaca fascicularis) for biomedical research

PubMed Central

2012-01-01

Background As a human replacement, the crab-eating macaque (Macaca fascicularis) is an invaluable non-human primate model for biomedical research, but the lack of genetic information on this primate has represented a significant obstacle for its broader use. Results Here, we sequenced the transcriptome of 16 tissues originated from two individuals of crab-eating macaque (male and female), and identified genes to resolve the main obstacles for understanding the biological response of the crab-eating macaque. From 4 million reads with 1.4 billion base sequences, 31,786 isotigs containing genes similar to those of humans, 12,672 novel isotigs, and 348,160 singletons were identified using the GS FLX sequencing method. Approximately 86% of human genes were represented among the genes sequenced in this study. Additionally, 175 tissue-specific transcripts were identified, 81 of which were experimentally validated. In total, 4,314 alternative splicing (AS) events were identified and analyzed. Intriguingly, 10.4% of AS events were associated with transposable element (TE) insertions. Finally, investigation of TE exonization events and evolutionary analysis were conducted, revealing interesting phenomena of human-specific amplified trends in TE exonization events. Conclusions This report represents the first large-scale transcriptome sequencing and genetic analyses of M. fascicularis and could contribute to its utility for biomedical research and basic biology. PMID:22554259

Accuracy of Computed Tomography for Predicting Pathologic Nodal Extracapsular Extension in Patients With Head-and-Neck Cancer Undergoing Initial Surgical Resection

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

Prabhu, Roshan S., E-mail: roshansprabhu@gmail.com; Winship Cancer Institute, Emory University, Atlanta, Georgia; Magliocca, Kelly R.

2014-01-01

Purpose: Nodal extracapsular extension (ECE) in patients with head-and-neck cancer increases the loco-regional failure risk and is an indication for adjuvant chemoradiation therapy (CRT). To reduce the risk of requiring trimodality therapy, patients with head-and-neck cancer who are surgical candidates are often treated with definitive CRT when preoperative computed tomographic imaging suggests radiographic ECE. The purpose of this study was to assess the accuracy of preoperative CT imaging for predicting pathologic nodal ECE (pECE). Methods and Materials: The study population consisted of 432 consecutive patients with oral cavity or locally advanced/nonfunctional laryngeal cancer who underwent preoperative CT imaging before initialmore » surgical resection and neck dissection. Specimens with pECE had the extent of ECE graded on a scale from 1 to 4. Results: Radiographic ECE was documented in 46 patients (10.6%), and pECE was observed in 87 (20.1%). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 43.7%, 97.7%, 82.6%, and 87.3%, respectively. The sensitivity of radiographic ECE increased from 18.8% for grade 1 to 2 ECE, to 52.9% for grade 3, and 72.2% for grade 4. Radiographic ECE criteria of adjacent structure invasion was a better predictor than irregular borders/fat stranding for pECE. Conclusions: Radiographic ECE has poor sensitivity, but excellent specificity for pECE in patients who undergo initial surgical resection. PPV and NPV are reasonable for clinical decision making. The performance of preoperative CT imaging increased as pECE grade increased. Patients with resectable head-and-neck cancer with radiographic ECE based on adjacent structure invasion are at high risk for high-grade pECE requiring adjuvant CRT when treated with initial surgery; definitive CRT as an alternative should be considered where appropriate.« less

Growth trajectories of mathematics achievement: Longitudinal tracking of student academic progress.

PubMed

Mok, Magdalena M C; McInerney, Dennis M; Zhu, Jinxin; Or, Anthony

2015-06-01

A number of methods to investigate growth have been reported in the literature, including hierarchical linear modelling (HLM), latent growth modelling (LGM), and multidimensional scaling applied to longitudinal profile analysis (LPAMS). This study aimed at modelling the mathematics growth of students over a span of 6 years from Grade 3 to Grade 9. The sample comprised secondary longitudinal data collected in three waves from n = 866 Hong Kong students when they were in Grade 3, Grade 6, and Grade 9. Mathematics achievement was measured thrice on a vertical scale linked with anchor items. Linear and nonlinear latent growth models were used to assess students' growth. Gender differences were also examined. A nonlinear latent growth curve with a decelerated rate had a good fit to the data. Initial achievement and growth rate were negatively correlated. No gender difference was found. Mathematics growth from Grade 6 to Grade 9 was slower than that from Grade 3 to Grade 6. Students with lower initial achievement improved at a faster rate than those who started at a higher level. Gender did not affect growth rate. © 2014 The British Psychological Society.

ZEB1 drives epithelial-to-mesenchymal transition in lung cancer. | Office of Cancer Genomics

Cancer.gov

Increased expression of zinc finger E-box binding homeobox 1 (ZEB1) is associated with tumor grade and metastasis in lung cancer, likely due to its role as a transcription factor in epithelial-to-mesenchymal transition (EMT). Here, we modeled malignant transformation in human bronchial epithelial cells (HBECs) and determined that EMT and ZEB1 expression are early, critical events in lung cancer pathogenesis. Specific oncogenic mutations in TP53 and KRAS were required for HBECs to engage EMT machinery in response to microenvironmental (serum/TGF-β) or oncogenetic (MYC) factors.

Discrimination Evidence for Examining Fourth Grade Students' Learning Disability Problems

ERIC Educational Resources Information Center

Hassan, Abdulhameed S.; Al-Harthy, Ibrahim S.

2014-01-01

This study investigated the ability of discriminate variables (perceptual-motor, hyperactivity disorder, neurological and psychological skills) to distinguish between normal (n = 68) and students with learning disabilities (n = 72) in fourth grade. Three instruments were developed: perceptual-motor scale, hyperactivity disorder scale, skills test…

Accuracy and reliability of retinal photo grading for diabetic retinopathy: Remote graders from a developing country and standard retinal photo grader in Australia.

PubMed

Islam, Fakir M Amirul

2017-01-01

To evaluate the accuracy and reliability of fundus retinal photos graded by local graders in Bangladesh with those graded by an expert at the Centre for Eye Research Australia (CERA) in the context of mass scale diabetic retinopathy (DR) screening in Bangladesh. A population-based cross-sectional study of 3,104 adults identified 213 (7.2%) eligible patients with diabetes of age ≥ 40 years in 2012-2013. Retinal photographs were collected using a non-mydriatic digital fundus retinal camera and a two-field imaging protocol. The photos were graded by two remote graders (G1 and G2) who were trained by a retinal specialist (RS) in Bangladesh, by the RS himself, and by a Centre for Eye Research Australia (CERA) grader. The local graders up skilled their grading ability by comparing 30% of the photos graded by the CERA grader with their own grades. Learning from that exercise was applied to the remaining 70% of photos, which were re-graded. Reliability and accuracy of grading amongst the graders were reported using cross tabulation, inter- and intra-grader reliability, and with sensitivity and specificity. Of 122 eyes from 61 patients, the mild (R1) DR was estimated to be 14 to 25%, pre-proliferative (R2) DR 4-8%, and proliferative (R3) DR 0.8 to 1.6%, whereas 25%, 8%, 18%, and 15% were found to be ungradable by CERA, RS, G1, and G2, respectively. Of 8 (6.6%) eyes identified as R2 by the CERA grader, 5 (63%), 3 (38%) and 3 (38%) were correctly classified as R2, whereas the rest were classified either as R1 or R3 but none were classified as no DR (R0) or ungradable by the RS, G1 and G2, respectively. After getting experience reviewing the 30% test set graded by the CERA grader, the local graders graded moderate and severe DR with 100% accuracy. After excluding ungradable photos, the sensitivity (specificity) relative to the CERA grader was 82% (88%) before and 80% (93%) after training for G1 and 56% (87%) before and 77% (90%) after training for G2. In case of maculopathy, the CERA grader reported 11.2% eyes with maculopathy, which included 100% of the 4.9% by RS, 6.6% by G1, and 7.4% by G2. Local graders in Bangladesh are able to grade retinal photos with high accuracy if the DR is at least of a moderate level. With appropriate training and experience, local graders have the ability to contribute significantly to the grading of millions of retinal photos, which required grading in resource- poor countries.

Incidence of hypocalcemia in patients receiving denosumab for prevention of skeletal-related events in bone metastasis.

PubMed

Yerram, Prakirthi; Kansagra, Shraddha; Abdelghany, Osama

2017-04-01

Background Denosumab therapy is commonly used for the prevention of skeletal-related events in patients with bone metastasis. However, a common side effect of denosumab is hypocalcemia. Objective The aim of the study is to determine the incidence of hypocalcemia in patients receiving denosumab for prevention of skeletal-related events in bone metastasis and evaluate risk factors for developing hypocalcemia. Methods This was a retrospective medication use evaluation reviewing the incidence of hypocalcemia in patients receiving outpatient denosumab for prevention of skeletal-related events at Yale-New Haven Hospital. Additionally, various risk factors were reviewed to determine their risk of developing hypocalcemia. Results As per Common Terminology Criteria for Adverse Events v4.03, of the 106 patients included in the study population, 37 (35%) patients had an incidence of hypocalcemia within 30 days of denosumab administration. Fourteen patients (13.2%) had an incidence of grade 1, 13 patients (12.3%) had an incidence of grade 2 hypocalcemia, and 7 patients (6.6%) had an incidence of grade 3 hypocalcemia. Grade 4 hypocalcemia occurred in three (2.8%) patients. Calcium supplementation did not decrease the risk of developing hypocalcemia. Patients who had one or more episodes of acute kidney insufficiency were at a higher risk of developing hypocalcemia (odds ratio = 7.5 (95% confidence interval = 1.8-36.3), p = 0.001). Conclusion This study found that the overall incidence of hypocalcemia and severe hypocalcemia was higher than reported in clinical trials. Additionally, calcium supplementation did not have an effect on incidence of hypocalcemia, while patients who experienced acute kidney insufficiency while on denosumab had a higher likelihood of developing hypocalcemia.

Multifractal characterisation of a simulated surface flow: A case study with Multi-Hydro in Jouy-en-Josas, France

NASA Astrophysics Data System (ADS)

Gires, Auguste; Abbes, Jean-Baptiste; da Silva Rocha Paz, Igor; Tchiguirinskaia, Ioulia; Schertzer, Daniel

2018-03-01

In this paper we suggest to innovatively use scaling laws and more specifically Universal Multifractals (UM) to analyse simulated surface runoff and compare the retrieved scaling features with the rainfall ones. The methodology is tested on a 3 km2 semi-urbanised with a steep slope study area located in the Paris area along the Bièvre River. First Multi-Hydro, a fully distributed model is validated on this catchment for four rainfall events measured with the help of a C-band radar. The uncertainty associated with small scale unmeasured rainfall, i.e. occurring below the 1 km × 1 km × 5 min observation scale, is quantified with the help of stochastic downscaled rainfall fields. It is rather significant for simulated flow and more limited on overland water depth for these rainfall events. Overland depth is found to exhibit a scaling behaviour over small scales (10 m-80 m) which can be related to fractal features of the sewer network. No direct and obvious dependency between the overland depth multifractal features (quality of the scaling and UM parameters) and the rainfall ones was found.

Safety of pazopanib and sunitinib in treatment-naive patients with metastatic renal cell carcinoma: Asian versus non-Asian subgroup analysis of the COMPARZ trial.

PubMed

Guo, Jun; Jin, Jie; Oya, Mototsugu; Uemura, Hirotsugu; Takahashi, Shunji; Tatsugami, Katsunori; Rha, Sun Young; Lee, Jae-Lyun; Chung, Jinsoo; Lim, Ho Yeong; Wu, Hsi Chin; Chang, Yen Hwa; Azad, Arun; Davis, Ian D; Carrasco-Alfonso, Marlene J; Nanua, Bhupinder; Han, Jackie; Ahmad, Qasim; Motzer, Robert

2018-05-22

The international, phase 3 COMPARZ study demonstrated that pazopanib and sunitinib have comparable efficacy as first-line therapy in patients with advanced renal cell carcinoma, but that safety and quality-of-life profiles favor pazopanib. Our report analyzed pazopanib and sunitinib safety in Asian and non-Asian subpopulations. Patients were randomized 1:1 to receive pazopanib 800 mg once daily (continuous dosing) or sunitinib 50 mg once daily in 6-week cycles (4 weeks on, 2 weeks off). Safety population was composed of 363 Asian patients and 703 non-Asian patients. Asian patients had similar duration of exposure to either drug compared with non-Asian patients, although Asian patients had a higher frequency of dose modifications. Overall, hematologic toxicities, cytopenias, increased AST/ALT, and palmar-plantar erythrodysesthesia (PPE) were more prevalent in Asian patients, whereas gastrointestinal toxicities were more prevalent in non-Asian patients. Among Asian patients, hematologic adverse events and most non-hematologic AEs were more common in sunitinib-treated versus pazopanib-treated patients. Among Asian patients, the most common grade 3/4 AEs with pazopanib were hypertension (grade 3, 22%) and alanine aminotransferase increased (grade 3, 12%; grade 4, 1%); the most common grade 3/4 AEs with sunitinib were thrombocytopenia/platelet count decreased (grade 3, 36%; grade 4, 10%), neutropenia/neutrophil count decreased (grade 3, 24%; grade 4, 3%) hypertension (grade 3, 20%), and PPE (grade 3, 15%). A distinct pattern and severity of adverse events was observed in Asians when compared with non-Asians with both pazopanib and sunitinib. However, the two drugs were well tolerated in both subpopulations. ClinicalTrials.gov, NCT00720941 , Registered July 22, 2008 ClinicalTrials.gov, NCT01147822 , Registered June 22, 2010.

Comparison between urine albumin-to-creatinine ratio and urine protein dipstick testing for prevalence and ability to predict the risk for chronic kidney disease in the general population (Iwate-KENCO study): a prospective community-based cohort study.

PubMed

Koeda, Yorihiko; Tanaka, Fumitaka; Segawa, Toshie; Ohta, Mutsuko; Ohsawa, Masaki; Tanno, Kozo; Makita, Shinji; Ishibashi, Yasuhiro; Itai, Kazuyoshi; Omama, Shin-Ichi; Onoda, Toshiyuki; Sakata, Kiyomi; Ogasawara, Kuniaki; Okayama, Akira; Nakamura, Motoyuki

2016-05-12

This study compared the combination of estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) vs. eGFR and urine protein reagent strip testing to determine chronic kidney disease (CKD) prevalence, and each method's ability to predict the risk for cardiovascular events in the general Japanese population. Baseline data including eGFR, UACR, and urine dipstick tests were obtained from the general population (n = 22 975). Dipstick test results (negative, trace, positive) were allocated to three levels of UACR (<30, 30-300, >300), respectively. In accordance with Kidney Disease Improving Global Outcomes CKD prognosis heat mapping, the cohort was classified into four risk grades (green: grade 1; yellow: grade 2; orange: grade 3, red: grade 4) based on baseline eGFR and UACR levels or dipstick tests. During the mean follow-up period of 5.6 years, 708 new onset cardiovascular events were recorded. For CKD identified by eGFR and dipstick testing (dipstick test ≥ trace and eGFR <60 mL/min/1.73 m(2)), the incidence of CKD was found to be 9 % in the general population. In comparison to non-CKD (grade 1), although cardiovascular risk was significantly higher in risk grades ≥3 (relative risk (RR) = 1.70; 95 % CI: 1.28-2.26), risk predictive ability was not significant in risk grade 2 (RR = 1.20; 95 % CI: 0.95-1.52). When CKD was defined by eGFR and UACR (UACR ≥30 mg/g Cr and eGFR <60 mL/min/1.73 m(2)), prevalence was found to be 29 %. Predictive ability in risk grade 2 (RR = 1.41; 95 % CI: 1.19-1.66) and risk grade ≥3 (RR = 1.76; 95 % CI: 1.37-2.28) were both significantly greater than for non-CKD. Reclassification analysis showed a significant improvement in risk predictive abilities when CKD risk grading was based on UACR rather than on dipstick testing in this population (p < 0.001). Although prevalence of CKD was higher when detected by UACR rather than urine dipstick testing, the predictive ability for cardiovascular events from UACR-based risk grading was superior to that of dipstick-based risk grading in the general population.

A Comprehensive Safety Evaluation of 68Ga-Labeled Ligand Prostate-Specific Membrane Antigen 11 PET/CT in Prostate Cancer: The Results of 2 Prospective, Multicenter Trials.

PubMed

Nielsen, Julie B; Zacho, Helle D; Haberkorn, Uwe; Nielsen, Karin M; Dettmann, Katja; Langkilde, Niels C; Petersen, Lars J

2017-07-01

The aim of this study was to evaluate the clinical safety profile of the Ga-PSMA-11 ligand for PET/CT imaging in prospective clinical trials. Eighty-eight patients with newly diagnosed or recurrent prostate cancer participated in 2 prospective trials. Safety reporting was identical in the 2 trials. The Ga-PSMA-11 ligand was administered as 2 MBq/kg body weight (mean, 9.2 μg, 9.7 nmol). The reporting of clinical adverse events (AEs) and the measurement of blood pressure (BP) and heart rate (HR) were performed prior to injection (baseline); immediately after injection of Ga-PSMA-11 (postinjection); at 1, 10, and 60 minutes after injection; and after acquisition of the PET/CT scan (postscan). All hemodynamic assessments were performed in the supine position, except for the postscan measurement (sitting). The patients were interviewed regarding any AEs at baseline, postinjection, or postscan. In addition, the patients were instructed to report any AEs during the investigation and to contact the investigator if AEs occurred during the rest of the day. Adverse events were classified as mild, moderate, or severe by the patients and categorized by the investigator using the CTCAE (Common Terminology Criteria for Adverse Events) version 4.0. There were no reported clinical AEs. There were significant decreases in systolic BP (P < 0.001) and HR (P < 0.001) over time. In comparison, the diastolic BP increased significantly (P < 0.001). After removal of the last observation (supine position), there was no time-dependent change in systolic or diastolic BP, but the significant change in HR remained. The mean changes over the entire observation period were minimal (systolic BP, -6 to 5 mm Hg; diastolic BP, -2 to 3 mm Hg; HR, decrease of 5 beats/min). No patients developed hypotension. Fifty-five patients presented with hypertension at baseline, which increased by 1 CTCAE grade in 15 patients and by 2 grades in 2 patients. A large number of cases of asymptomatic (grade 1) bradycardia were observed, primarily in patients with preexisting bradycardia. One patient developed transient grade 1 tachycardia. No patients required medical intervention for cardiovascular perturbations. Ga-PSMA-11 PET/CT was very well tolerated. We consider Ga-PSMA-11 to be safe for human application.

Prediction of PTSD in police officers after six months--a prospective study.

PubMed

Schütte, Nils; Bär, Olaf; Weiss, Udo; Heuft, Gereon

2012-11-01

The aim of this prospective study was to explore the predictors for the development of PTSD in police officers six months after encountering situations of a potentially traumatic nature. Fifty-nine police officers were studied immediately after the event (T1) and six months later (T2). At T2 PTSD was assessed using the Structured Clinical Interview for DSM-IV (SCID-I). PTSD was predicted by intrusions (Impact of Event Scale-Revised; IES-R), the impairment scale (is), global assessment of functioning scale (GAF), gender, age and sense of coherence scale (SOC). The diagnosis of an acute stress disorder (ASD) at T1 had a high specificity for identifying PTSD at T2. The strongest predictor for the development of PTSD was found to be the factor intrusions. Contrary to our expectations, age was not a significant predictive factor for PTSD. Thus, acute stress disorder (ASD) and a high degree of intrusions experienced immediately after a traumatic incident helped to identify early police officers at risk of developing chronic PTSD.

A Comparative Phase I Study of Combination, Homologous Subtype-C DNA, MVA, and Env gp140 Protein/Adjuvant HIV Vaccines in Two Immunization Regimes

PubMed Central

Joseph, Sarah; Quinn, Killian; Greenwood, Aldona; Cope, Alethea V.; McKay, Paul F.; Hayes, Peter J.; Kopycinski, Jakub T.; Gilmour, Jill; Miller, Aleisha N.; Geldmacher, Christof; Nadai, Yuka; Ahmed, Mohamed I. M.; Montefiori, David C.; Dally, Len; Bouliotis, George; Lewis, David J. M.; Tatoud, Roger; Wagner, Ralf; Esteban, Mariano; Shattock, Robin J.; McCormack, Sheena; Weber, Jonathan

2017-01-01

There remains an urgent need for a prophylactic HIV vaccine. We compared combined MVA and adjuvanted gp140 to sequential MVA/gp140 after DNA priming. We expected Env-specific CD4+ T-cells after DNA and MVA priming, and Env-binding antibodies in 100% individuals after boosting with gp140 and that combined vaccines would not compromise safety and might augment immunogenicity. Forty volunteers were primed three times with DNA plasmids encoding (CN54) env and (ZM96) gag-pol-nef at 0, 4 and 8 weeks then boosted with MVA-C (CN54 env and gag-pol-nef) and glucopyranosyl lipid adjuvant—aqueous formulation (GLA-AF) adjuvanted CN54gp140. They were randomised to receive them in combination at the same visit at 16 and 20 weeks (accelerated) or sequentially with MVA-C at 16, 20, and GLA-AF/gp140 at 24 and 28 weeks (standard). All vaccinations were intramuscular. Primary outcomes included ≥grade 3 safety events and the titer of CN54gp140-specific binding IgG. Other outcomes included neutralization, binding antibody specificity and T-cell responses. Two participants experienced asymptomatic ≥grade 3 transaminitis leading to discontinuation of vaccinations, and three had grade 3 solicited local or systemic reactions. A total of 100% made anti-CN54gp140 IgG and combining vaccines did not significantly alter the response; geometric mean titer 6424 (accelerated) and 6578 (standard); neutralization of MW965.2 Tier 1 pseudovirus was superior in the standard group (82 versus 45% responders, p = 0.04). T-cell ELISpot responses were CD4+ and Env-dominant; 85 and 82% responding in the accelerated and standard groups, respectively. Vaccine-induced IgG responses targeted multiple regions within gp120 with the V3 region most immunodominant and no differences between groups detected. Combining MVA and gp140 vaccines did not result in increased adverse events and did not significantly impact upon the titer of Env-specific binding antibodies, which were seen in 100% individuals. The approach did however affect other immune responses; neutralizing antibody responses, seen only to Tier 1 pseudoviruses, were poorer when the vaccines were combined and while T-cell responses were seen in >80% individuals in both groups and similarly CD4 and Env dominant, their breadth/polyfunctionality tended to be lower when the vaccines were combined, suggesting attenuation of immunogenicity and cautioning against this accelerated regimen. PMID:28275375

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

Martin, R. C. G., E-mail: rcmart03@gwise.louisville.ed; Howard, J.; Tomalty, D.

PurposeTo evaluate the predictors of toxicity of drug-eluting beads loaded with irinotecan (DEBIRI) in the treatment of hepatic malignancies.Materials and MethodsA total of 330 patients were enrolled in a prospective, open-label, multicenter, multinational, single-arm study administering two types of drug-eluting beads (DEBIRI and drug-eluting beads loaded with doxorubicin). Complications were graded by Cancer Therapy Evaluation Program's Common Terminology Criteria for Adverse Events (CTCAE) version 3.0. All events requiring additional physician treatment or requiring extended hospital stay or readmission within 30 days were included.ResultsA total of 109 patients received 187 DEBIRI treatments (range 1 to 5 per patient). The most commonmore » histology was metastatic colorectal cancer in 76% of patients, cholangiocarcinoma in 7% of patients, and other metastatic disease in 17% of patients. There were 35 patients (19%) with irinotecan treatments who sustained 158 treatment-related adverse events, with the median CTCAE event grade being CTCAE grade 2 (range 1 to 5). The most common adverse events were postembolic symptoms (42%). Multivariate analysis identified pretreatment and treatment-related risk factors as follows: lack of pretreatment with hepatic arterial lidocaine (p = 0.005), {>=}3 treatments (p = 0.05), achievement of complete stasis (p = 0.04), treatment with >100 mg DEBIRI in 1 treatment (p = 0.03), and bilirubin >2.0 {mu}g/dl with >50% liver involvement (p = 0.05). These factors were predictive of adverse events and significantly greater hospital length of stay.ConclusionsDEBIRI is safe when appropriate technique and treatment are used. Adverse events can be predicted based on pretreatment- and treatment-related factors, and their occurrence can become part of the informed consent process. Continued standardization of this treatment will lead to fewer adverse events and improved patient quality of life.« less

Aftershock Sequences and Seismic-Like Organization of Acoustic Events Produced by a Single Propagating Crack

NASA Astrophysics Data System (ADS)

Alizee, D.; Bonamy, D.

2017-12-01

In inhomogeneous brittle solids like rocks, concrete or ceramics, one usually distinguish nominally brittle fracture, driven by the propagation of a single crack from quasibrittle one, resulting from the accumulation of many microcracks. The latter goes along with intermittent sharp noise, as e.g. revealed by the acoustic emission observed in lab scale compressive fracture experiments or at geophysical scale in the seismic activity. In both cases, statistical analyses have revealed a complex time-energy organization into aftershock sequences obeying a range of robust empirical scaling laws (the Omori-Utsu, productivity and Bath's law) that help carry out seismic hazard analysis and damage mitigation. These laws are usually conjectured to emerge from the collective dynamics of microcrack nucleation. In the experiments presented at AGU, we will show that such a statistical organization is not specific to the quasi-brittle multicracking situations, but also rules the acoustic events produced by a single crack slowly driven in an artificial rock made of sintered polymer beads. This simpler situation has advantageous properties (statistical stationarity in particular) permitting us to uncover the origins of these seismic laws: Both productivity law and Bath's law result from the scale free statistics for event energy and Omori-Utsu law results from the scale-free statistics of inter-event time. This yields predictions on how the associated parameters are related, which were analytically derived. Surprisingly, the so-obtained relations are also compatible with observations on lab scale compressive fracture experiments, suggesting that, in these complex multicracking situations also, the organization into aftershock sequences and associated seismic laws are also ruled by the propagation of individual microcrack fronts, and not by the collective, stress-mediated, microcrack nucleation. Conversely, the relations are not fulfilled in seismology signals, suggesting that additional ingredient should be taken into account.

Can we perceptually rate alaryngeal voice? Developing the Sunderland Tracheoesophageal Voice Perceptual Scale.

PubMed

Hurren, A; Hildreth, A J; Carding, P N

2009-12-01

To investigate the inter and intra reliability of raters (in relation to both profession and expertise) when judging two alaryngeal voice parameters: 'Overall Grade' and 'Neoglottal Tonicity'. Reliable perceptual assessment is essential for surgical and therapeutic outcome measurement but has been minimally researched to date. Test of inter and intra rater agreement from audio recordings of 55 tracheoesophageal speakers. Cancer Unit. Twelve speech and language therapists and ten Ear, Nose and Throat surgeons. Perceptual voice parameters of 'Overall Grade' rated with a 0-3 equally appearing interval scale and 'Neoglottal Tonicity' with an 11-point bipolar semantic scale. All raters achieved 'good' agreement for 'Overall Grade' with mean weighted kappa coefficients of 0.78 for intra and 0.70 for inter-rater agreement. All raters achieved 'good' intra-rater agreement for 'Neoglottal Tonicity' (0.64) but inter-rater agreement was only 'moderate' (0.40). However, the expert speech and language therapists sub-group attained 'good' inter-rater agreement with this parameter (0.63). The effect of 'Neoglottal Tonicity' on 'Overall Grade' was examined utilising only expert speech and language therapists data. Linear regression analysis resulted in an r-squared coefficient of 0.67. Analysis of the perceptual impression of hypotonicity and hypertonicity in relation to mean 'Overall Grade' score demonstrated neither tone was linked to a more favourable grade (P = 0.42). Expert speech and language therapist raters may be the optimal judges for tracheoesophageal voice assessment. Tonicity appears to be a good predictor of 'Overall Grade'. These scales have clinical applicability to investigate techniques that facilitate optotonic neoglottal voice quality.

Lumber recovery from ponderosa pine in western Montana.

Treesearch

Marlin E. Plank

1982-01-01

Lumber grade yields and recovery ratios are shown for a sample of ponderosa pine (Pinus ponderosa Dougl. ex Laws.) in western Montana. About 9 percent of the lumber produced was in Select grades, 48 percent in Shop grades, and 43 percent in Common grades. Information on log scale and yield is presented in tables by log grade and diameter class....

Effects of Teacher Science Support on Student Science Support in Selected Tenth Grade Biology Classes.

ERIC Educational Resources Information Center

Simpson, Ronald Dale

The objectives of this study were (1) to assess the effects of teacher science support, as measured by the Science Support Scale (Tri-S scale), on student science support and (2) to gain normative data on the Science Support Scale as an instrument for use with high school students. Twenty-four 10th grade biology teachers were given the Tri-S scale…

North Carolina Linking Study: A Study of the Alignment of the NWEA RIT Scale with the North Carolina State End of Grade (EOG) Testing Program

ERIC Educational Resources Information Center

Northwest Evaluation Association, 2014

2014-01-01

Recently, the Northwest Evaluation Association (NWEA) completed a study to connect the scale of the North Carolina State End of Grade (EOG) Testing Program used for North Carolina's mathematics and reading assessments with NWEA's Rausch Interval Unit (RIT) scale. Information from the state assessments was used in a study to establish…

Interventions for self-harm in children and adolescents.

PubMed

Hawton, Keith; Witt, Katrina G; Taylor Salisbury, Tatiana L; Arensman, Ella; Gunnell, David; Townsend, Ellen; van Heeringen, Kees; Hazell, Philip

2015-12-21

Self-harm (SH; intentional self-poisoning or self-injury) is common in children and adolescents, often repeated, and strongly associated with suicide. This is an update of a broader Cochrane review on psychosocial and pharmacological treatments for deliberate SH first published in 1998 and previously updated in 1999. We have now divided the review into three separate reviews; this review is focused on psychosocial and pharmacological interventions for SH in children and adolescents. To identify all randomised controlled trials of psychosocial interventions, pharmacological agents, or natural products for SH in children and adolescents, and to conduct meta-analyses (where possible) to compare the effects of specific treatments with comparison types of treatment (e.g., treatment as usual (TAU), placebo, or alternative pharmacological treatment) for children and adolescents who SH. For this update the Cochrane Depression, Anxiety and Neurosis Group (CCDAN) Trials Search Co-ordinator searched the CCDAN Specialised Register (30 January 2015). We included randomised controlled trials comparing psychosocial or pharmacological treatments with treatment as usual, alternative treatments, or placebo or alternative pharmacological treatment in children and adolescents (up to 18 years of age) with a recent (within six months) episode of SH resulting in presentation to clinical services. Two reviewers independently selected trials, extracted data, and appraised study quality, with consensus. For binary outcomes, we calculated odds ratios (OR) and their 95% confidence intervals (CI). For continuous outcomes measured using the same scale we calculated the mean difference (MD) and 95% CI; for those measured using different scales we calculated the standard mean difference (SMD) and 95% CI. Meta-analysis was only possible for two interventions: dialectical behaviour therapy for adolescents and group-based psychotherapy. For these analyses, we pooled data using a random-effects model. We included 11 trials, with a total of 1,126 participants. The majority of participants were female (mean = 80.6% in 10 trials reporting gender). All trials were of psychosocial interventions; there were none of pharmacological treatments. With the exception of dialectical behaviour therapy for adolescents (DBT-A) and group-based therapy, assessments of specific interventions were based on single trials. We downgraded the quality of evidence owing to risk of bias or imprecision for many outcomes.Therapeutic assessment appeared to increase adherence with subsequent treatment compared with TAU (i.e., standard assessment; n = 70; k = 1; OR = 5.12, 95% CI 1.70 to 15.39), but this had no apparent impact on repetition of SH at either 12 (n = 69; k = 1; OR 0.75, 95% CI 0.18 to 3.06; GRADE: low quality) or 24 months (n = 69; k = 1; OR = 0.69, 05% CI 0.23 to 2.14; GRADE: low quality evidence). These results are based on a single cluster randomised trial, which may overestimate the effectiveness of the intervention.For patients with multiple episodes of SH or emerging personality problems, mentalisation therapy was associated with fewer adolescents scoring above the cut-off for repetition of SH based on the Risk-Taking and Self-Harm Inventory 12 months post-intervention (n = 71; k = 1; OR = 0.26, 95% CI 0.09 to 0.78; GRADE: moderate quality). DBT-A was not associated with a reduction in the proportion of adolescents repeating SH when compared to either TAU or enhanced usual care (n = 104; k = 2; OR 0.72, 95% CI 0.12 to 4.40; GRADE: low quality). In the latter trial, however, the authors reported a significantly greater reduction over time in frequency of repeated SH in adolescents in the DBT condition, in whom there were also significantly greater reductions in depression, hopelessness, and suicidal ideation.We found no significant treatment effects for group-based therapy on repetition of SH for individuals with multiple episodes of SH at either the six (n = 430; k = 2; OR 1.72, 95% CI 0.56 to 5.24; GRADE: low quality) or 12 month (n = 490; k = 3; OR 0.80, 95% CI 0.22 to 2.97; GRADE: low quality) assessments, although considerable heterogeneity was associated with both (I(2) = 65% and 77% respectively). We also found no significant differences between the following treatments and TAU in terms of reduced repetition of SH: compliance enhancement (three month follow-up assessment: n = 63; k = 1; OR = 0.67, 95% CI 0.15 to 3.08; GRADE: very low quality), CBT-based psychotherapy (six month follow-up assessment: n = 39; k = 1; OR = 1.88, 95% CI 0.30 to 11.73; GRADE: very low quality), home-based family intervention (six month follow-up assessment: n = 149; k = 1; OR = 1.02, 95% CI 0.41 to 2.51; GRADE: low quality), and provision of an emergency card (12 month follow-up assessment: n = 105, k = 1; OR = 0.50, 95% CI 0.12 to 2.04; GRADE: very low quality). No data on adverse effects, other than the planned outcomes relating to suicidal behaviour, were reported. There are relatively few trials of interventions for children and adolescents who have engaged in SH, and only single trials contributed to all but two comparisons in this review. The quality of evidence according to GRADE criteria was mostly very low. There is little support for the effectiveness of group-based psychotherapy for adolescents with multiple episodes of SH based on the results of three trials, the evidence from which was of very low quality according to GRADE criteria. Results for therapeutic assessment, mentalisation, and dialectical behaviour therapy indicated that these approaches warrant further evaluation. Despite the scale of the problem of SH in children and adolescents there is a paucity of evidence of effective interventions. Further large-scale trials, with a range of outcome measures including adverse events, and investigation of therapeutic mechanisms underpinning these interventions, are required. It is increasingly apparent that development of new interventions should be done in collaboration with patients to ensure that these are likely to meet their needs. Use of an agreed set of outcome measures would assist evaluation and both comparison and meta-analysis of trials.

Evaluating the implementation of a national disclosure policy for large-scale adverse events in an integrated health care system: identification of gaps and successes.

PubMed

Maguire, Elizabeth M; Bokhour, Barbara G; Wagner, Todd H; Asch, Steven M; Gifford, Allen L; Gallagher, Thomas H; Durfee, Janet M; Martinello, Richard A; Elwy, A Rani

2016-11-11

Many healthcare organizations have developed disclosure policies for large-scale adverse events, including the Veterans Health Administration (VA). This study evaluated VA's national large-scale disclosure policy and identifies gaps and successes in its implementation. Semi-structured qualitative interviews were conducted with leaders, hospital employees, and patients at nine sites to elicit their perceptions of recent large-scale adverse events notifications and the national disclosure policy. Data were coded using the constructs of the Consolidated Framework for Implementation Research (CFIR). We conducted 97 interviews. Insights included how to handle the communication of large-scale disclosures through multiple levels of a large healthcare organization and manage ongoing communications about the event with employees. Of the 5 CFIR constructs and 26 sub-constructs assessed, seven were prominent in interviews. Leaders and employees specifically mentioned key problem areas involving 1) networks and communications during disclosure, 2) organizational culture, 3) engagement of external change agents during disclosure, and 4) a need for reflecting on and evaluating the policy implementation and disclosure itself. Patients shared 5) preferences for personal outreach by phone in place of the current use of certified letters. All interviewees discussed 6) issues with execution and 7) costs of the disclosure. CFIR analysis reveals key problem areas that need to be addresses during disclosure, including: timely communication patterns throughout the organization, establishing a supportive culture prior to implementation, using patient-approved, effective communications strategies during disclosures; providing follow-up support for employees and patients, and sharing lessons learned.

Agent based models for testing city evacuation strategies under a flood event as strategy to reduce flood risk

NASA Astrophysics Data System (ADS)

Medina, Neiler; Sanchez, Arlex; Nokolic, Igor; Vojinovic, Zoran

2016-04-01

This research explores the uses of Agent Based Models (ABM) and its potential to test large scale evacuation strategies in coastal cities at risk from flood events due to extreme hydro-meteorological events with the final purpose of disaster risk reduction by decreasing human's exposure to the hazard. The first part of the paper corresponds to the theory used to build the models such as: Complex adaptive systems (CAS) and the principles and uses of ABM in this field. The first section outlines the pros and cons of using AMB to test city evacuation strategies at medium and large scale. The second part of the paper focuses on the central theory used to build the ABM, specifically the psychological and behavioral model as well as the framework used in this research, specifically the PECS reference model is cover in this section. The last part of this section covers the main attributes or characteristics of human beings used to described the agents. The third part of the paper shows the methodology used to build and implement the ABM model using Repast-Symphony as an open source agent-based modelling and simulation platform. The preliminary results for the first implementation in a region of the island of Sint-Maarten a Dutch Caribbean island are presented and discussed in the fourth section of paper. The results obtained so far, are promising for a further development of the model and its implementation and testing in a full scale city

On-site detection of stacked genetically modified soybean based on event-specific TM-LAMP and a DNAzyme-lateral flow biosensor.

PubMed

Cheng, Nan; Shang, Ying; Xu, Yuancong; Zhang, Li; Luo, Yunbo; Huang, Kunlun; Xu, Wentao

2017-05-15

Stacked genetically modified organisms (GMO) are becoming popular for their enhanced production efficiency and improved functional properties, and on-site detection of stacked GMO is an urgent challenge to be solved. In this study, we developed a cascade system combining event-specific tag-labeled multiplex LAMP with a DNAzyme-lateral flow biosensor for reliable detection of stacked events (DP305423× GTS 40-3-2). Three primer sets, both event-specific and soybean species-specific, were newly designed for the tag-labeled multiplex LAMP system. A trident-like lateral flow biosensor displayed amplified products simultaneously without cross contamination, and DNAzyme enhancement improved the sensitivity effectively. After optimization, the limit of detection was approximately 0.1% (w/w) for stacked GM soybean, which is sensitive enough to detect genetically modified content up to a threshold value established by several countries for regulatory compliance. The entire detection process could be shortened to 120min without any large-scale instrumentation. This method may be useful for the in-field detection of DP305423× GTS 40-3-2 soybean on a single kernel basis and on-site screening tests of stacked GM soybean lines and individual parent GM soybean lines in highly processed foods. Copyright © 2017 Elsevier B.V. All rights reserved.

The Multidimensional Loss Scale: validating a cross-cultural instrument for measuring loss.

PubMed

Vromans, Lyn; Schweitzer, Robert D; Brough, Mark

2012-04-01

The Multidimensional Loss Scale (MLS) represents the first instrument designed specifically to index Experience of Loss Events and Loss Distress across multiple domains (cultural, social, material, and intrapersonal) relevant to refugee settlement. Recently settled Burmese adult refugees (N = 70) completed a questionnaire battery, including MLS items. Analyses explored MLS internal consistency, convergent and divergent validity, and factor structure. Cronbach alphas indicated satisfactory internal consistency for Experience of Loss Events (0.85) and Loss Distress (0.92), reflecting a unitary construct of multidimensional loss. Loss Distress did not correlate with depression or anxiety symptoms and correlated moderately with interpersonal grief and trauma symptoms, supporting divergent and convergent validity. Factor analysis provided preliminary support for a five-factor model: Loss of Symbolic Self, Loss of Interdependence, Loss of Home, Interpersonal Loss, and Loss of Intrapersonal Integrity. Received well by participants, the new scale shows promise for application in future research and practice.

Modeling of copper sorption onto GFH and design of full-scale GFH adsorbers.

PubMed

Steiner, Michele; Pronk, Wouter; Boller, Markus A

2006-03-01

During rain events, copper wash-off occurring from copper roofs results in environmental hazards. In this study, columns filled with granulated ferric hydroxide (GFH) were used to treat copper-containing roof runoff. It was shown that copper could be removed to a high extent. A model was developed to describe this removal process. The model was based on the Two Region Model (TRM), extended with an additional diffusion zone. The extended model was able to describe the copper removal in long-term experiments (up to 125 days) with variable flow rates reflecting realistic runoff events. The four parameters of the model were estimated based on data gained with specific column experiments according to maximum sensitivity for each parameter. After model validation, the parameter set was used for the design of full-scale adsorbers. These full-scale adsorbers show high removal rates during extended periods of time.

Comparison of fall prediction by the Hessisch Oldendorf Fall Risk Scale and the Fall Risk Scale by Huhn in neurological rehabilitation: an observational study.

PubMed

Hermann, Olena; Schmidt, Simone B; Boltzmann, Melanie; Rollnik, Jens D

2018-05-01

To calculate scale performance of the newly developed Hessisch Oldendorf Fall Risk Scale (HOSS) for classifying fallers and non-fallers in comparison with the Risk of Falling Scale by Huhn (FSH), a frequently used assessment tool. A prospective observational trail was conducted. The study was performed in a large specialized neurological rehabilitation facility. The study population ( n = 690) included neurological and neurosurgery patients during neurological rehabilitation with varying levels of disability. Around the half of the study patients were independent and dependent in the activities of daily living (ADL), respectively. Fall risk of each patient was assessed by HOSS and FSH within the first seven days after admission. Event of fall during rehabilitation was compared with HOSS and FSH scores as well as the according fall risk. Scale performance including sensitivity and specificity was calculated for both scales. A total of 107 (15.5%) patients experienced at least one fall. In general, fallers were characterized by an older age, a prolonged length of stay, and a lower Barthel Index (higher dependence in the ADL) on admission than non-fallers. The verification of fall prediction for both scales showed a sensitivity of 83% and a specificity of 64% for the HOSS scale, and a sensitivity of 98% with a specificity of 12% for the FSH scale, respectively. The HOSS shows an adequate sensitivity, a higher specificity and therefore a better scale performance than the FSH. Thus, the HOSS might be superior to existing assessments.

NDT-Bobath method in normalization of muscle tone in post-stroke patients.

PubMed

Mikołajewska, Emilia

2012-01-01

Ischaemic stroke is responsible for 80-85% of strokes. There is great interest in finding effective methods of rehabilitation for post-stroke patients. The aim of this study was to assess the results of rehabilitation carried out in the normalization of upper limb muscle tonus in patients, estimated on the Ashworth Scale for Grading Spasticity. The examined group consisted of 60 patients after ischaemic stroke. 10 sessions of NDT-Bobath therapy were provided within 2 weeks (ten days of therapy). Patient examinations using the Ashworth Scale for Grading Spasticity were done twice: the first time on admission and the second after the last session of the therapy to assess rehabilitation effects. Among the patients involved in the study, the results measured on the Ashworth Scale (where possible) were as follows: recovery in 16 cases (26.67%), relapse in 1 case (1.67%), no measurable changes (or change within the same grade of the scale) in 8 cases (13.33%). Statistically significant changes were observed in the health status of the patients. These changes, in the area of muscle tone, were favorable and reflected in the outcomes of the assessment using the Ashworth Scale for Grading Spasticity.

Comparing catchment hydrologic response to a regional storm using specific conductivity sensors

USGS Publications Warehouse

Inserillo, Ashley; Green, Mark B.; Shanley, James B.; Boyer, Joseph

2017-01-01

A better understanding of stormwater generation and solute sources is needed to improve the protection of aquatic ecosystems, infrastructure, and human health from large runoff events. Much of our understanding of water and solutes produced during stormflow comes from studies of individual, small headwater catchments. This study compared many different types of catchments during a single large event to help isolate landscape controls on streamwater and solute generation, including human-impacted land cover. We used a distributed network of specific electrical conductivity sensors to trace storm response during the post-tropical cyclone Sandy event of October 2012 at 29 catchments across the state of New Hampshire. A citizen science sensor network, Lotic Volunteer for Temperature, Electrical Conductivity, and Stage, provided a unique opportunity to investigate high-temporal resolution stream behavior at a broad spatial scale. Three storm response metrics were analyzed in this study: (a) fraction of new water contributing to the hydrograph; (b) presence of first flush (mobilization of solutes during the beginning of the rain event); and (c) magnitude of first flush. We compared new water and first flush to 64 predictor attributes related to land cover, soil, topography, and precipitation. The new water fraction was positively correlated with low and medium intensity development in the catchment and riparian buffers and with the precipitation from a rain event 9 days prior to Sandy. The presence of first flush was most closely related (positively) to soil organic matter. Magnitude of first flush was not strongly related to any of the catchment variables. Our results highlight the potentially important role of human landscape modification in runoff generation at multiple spatial scales and the lack of a clear role in solute flushing. Further development of regional-scale in situ sensor networks will provide better understanding of stormflow and solute generation across a wide range of landscape conditions.

The MEGA Project: A Study of the Mechanisms Involved in the Genesis and Disease Course of Asthma. Asthma Cohort Creation and Long-Term Follow-Up.

PubMed

Muñoz, Xavier; Álvarez-Puebla, María José; Arismendi, Ebymar; Arochena, Lourdes; Ausín, María Del Pilar; Barranco, Pilar; Bobolea, Irina; Cañas, Jose Antonio; Cardaba, Blanca; Crespo, Astrid; Del Pozo, Victora; Domínguez-Ortega, Javier; Fernandez-Nieto, María Del Mar; Giner, Jordi; González-Barcala, Francisco Javier; Luna, Juan Alberto; Mullol, Joaquim; Ojanguren, Iñigo; Olaguibel, José María; Picado, César; Plaza, Vicente; Quirce, Santiago; Ramos, David; Rial, Manuel; Romero-Mesones, Christian; Salgado, Francisco Javier; San-José, María Esther; Sánchez-Diez, Silvia; Sastre, Beatriz; Sastre, Joaquin; Soto, Lorena; Torrejón, Montserrat; Urnadoz, Marisa; Valdes, Luis; Valero, Antonio; Cruz, María Jesús

2018-03-19

The general aim of this study is to create a cohort of asthma patients with varying grades of severity in order to gain greater insight into the mechanisms underlying the genesis and course of this disease. The specific objectives focus on various studies, including imaging, lung function, inflammation, and bronchial hyperresponsiveness, to determine the relevant events that characterize the asthma population, the long-term parameters that can determine changes in the severity of patients, and the treatments that influence disease progression. The study will also seek to identify the causes of exacerbations and how this affects the course of the disease. Patients will be contacted via the outpatient clinics of the 8 participating institutions under the auspices of the Spanish Respiratory Diseases Networking System (CIBER). In the inclusion visit, a standardized clinical history will be obtained, a clinical examination, including blood pressure, body mass index, complete respiratory function tests, and FENO will be performed, and the Asthma Control Test (ACT), Morisky-Green test, Asthma Quality of Life Questionnaire (Mini AQLQ), the Sino-Nasal Outcome Test 22 (SNOT-22), and the Hospital Anxiety and Depression scale (HADS) will be administered. A specific electronic database has been designed for data collection. Exhaled breath condensate, urine and blood samples will also be collected. Non-specific bronchial hyperresponsiveness testing with methacholine will be performed and an induced sputum sample will be collected at the beginning of the study and every 24 months. A skin prick test for airborne allergens and a chest CT will be performed at the beginning of the study and repeated every 5 years. Copyright © 2018 SEPAR. All rights reserved.

Testing for scale-invariance in extreme events, with application to earthquake occurrence

NASA Astrophysics Data System (ADS)

Main, I.; Naylor, M.; Greenhough, J.; Touati, S.; Bell, A.; McCloskey, J.

2009-04-01

We address the generic problem of testing for scale-invariance in extreme events, i.e. are the biggest events in a population simply a scaled model of those of smaller size, or are they in some way different? Are large earthquakes for example ‘characteristic', do they ‘know' how big they will be before the event nucleates, or is the size of the event determined only in the avalanche-like process of rupture? In either case what are the implications for estimates of time-dependent seismic hazard? One way of testing for departures from scale invariance is to examine the frequency-size statistics, commonly used as a bench mark in a number of applications in Earth and Environmental sciences. Using frequency data however introduces a number of problems in data analysis. The inevitably small number of data points for extreme events and more generally the non-Gaussian statistical properties strongly affect the validity of prior assumptions about the nature of uncertainties in the data. The simple use of traditional least squares (still common in the literature) introduces an inherent bias to the best fit result. We show first that the sampled frequency in finite real and synthetic data sets (the latter based on the Epidemic-Type Aftershock Sequence model) converge to a central limit only very slowly due to temporal correlations in the data. A specific correction for temporal correlations enables an estimate of convergence properties to be mapped non-linearly on to a Gaussian one. Uncertainties closely follow a Poisson distribution of errors across the whole range of seismic moment for typical catalogue sizes. In this sense the confidence limits are scale-invariant. A systematic sample bias effect due to counting whole numbers in a finite catalogue makes a ‘characteristic'-looking type extreme event distribution a likely outcome of an underlying scale-invariant probability distribution. This highlights the tendency of ‘eyeball' fits unconsciously (but wrongly in this case) to assume Gaussian errors. We develop methods to correct for these effects, and show that the current best fit maximum likelihood regression model for the global frequency-moment distribution in the digital era is a power law, i.e. mega-earthquakes continue to follow the Gutenberg-Richter trend of smaller earthquakes with no (as yet) observable cut-off or characteristic extreme event. The results may also have implications for the interpretation of other time-limited geophysical time series that exhibit power-law scaling.

Use of modeled and satelite soil moisture to estimate soil erosion in central and southern Italy.

NASA Astrophysics Data System (ADS)

Termite, Loris Francesco; Massari, Christian; Todisco, Francesca; Brocca, Luca; Ferro, Vito; Bagarello, Vincenzo; Pampalone, Vincenzo; Wagner, Wolfgang

2016-04-01

This study presents an accurate comparison between two different approaches aimed to enhance accuracy of the Universal Soil Loss Equation (USLE) in estimating the soil loss at the single event time scale. Indeed it is well known that including the observed event runoff in the USLE improves its soil loss estimation ability at the event scale. In particular, the USLE-M and USLE-MM models use the observed runoff coefficient to correct the rainfall erosivity factor. In the first case, the soil loss is linearly dependent on rainfall erosivity, in the second case soil loss and erosivity are related by a power law. However, the measurement of the event runoff is not straightforward or, in some cases, possible. For this reason, the first approach used in this study is the use of Soil Moisture For Erosion (SM4E), a recent USLE-derived model in which the event runoff is replaced by the antecedent soil moisture. Three kinds of soil moisture datasets have been separately used: the ERA-Interim/Land reanalysis data of the European Centre for Medium-range Weather Forecasts (ECMWF); satellite retrievals from the European Space Agency - Climate Change Initiative (ESA-CCI); modeled data using a Soil Water Balance Model (SWBM). The second approach is the use of an estimated runoff rather than the observed. Specifically, the Simplified Continuous Rainfall-Runoff Model (SCRRM) is used to derive the runoff estimates. SCRMM requires soil moisture data as input and at this aim the same three soil moisture datasets used for the SM4E have been separately used. All the examined models have been calibrated and tested at the plot scale, using data from the experimental stations for the monitoring of the erosive processes "Masse" (Central Italy) and "Sparacia" (Southern Italy). Climatic data and runoff and soil loss measures at the event time scale are available for the period 2008-2013 at Masse and for the period 2002-2013 at Sparacia. The results show that both the approaches can provide better results than the USLE. Specifically, the SM4E model has proven to be particularly effective at Masse, providing the best soil loss estimations, especially when the modeled soil moisture is used. In this case, the RSR index (ratio between the Root Mean Square Error and the Observed Standard deviation) is equal to 0.94. Instead, the SCRRM is able to better estimate the event runoff at Sparacia than at Masse, thus resulting in good performances of the USLE-derived models using the estimated runoff; however, even at Sparacia the SM4E with modeled soil moisture gives the better soil loss estimates, with RSR = 0.54. These results open an interesting scenario in the use of empirical models to determine soil loss at a large scale, since soil moisture is a not only a simple in situ measurement, but only a widely available information on a global scale from remote sensing.

Factors associated with psychological distress following colposcopy among women with low-grade abnormal cervical cytology: a prospective study within the Trial Of Management of Borderline and Other Low-grade Abnormal smears (TOMBOLA).

PubMed

Sharp, Linda; Cotton, Seonaidh; Carsin, Anne-Elie; Gray, Nicola; Thornton, Alison; Cruickshank, Margaret; Little, Julian

2013-02-01

Little is known about psychological after-effects of colposcopy and associated investigations and treatment in women with low-grade abnormal cervical cytology. We investigated psychological distress following colposcopy and related procedures. Nine hundred and eighty-nine women aged 20-59 years with routine cytology showing low-grade abnormalities were recruited to the Trial of Management of Borderline and other Low-grade Abnormal smears and attended colposcopy. If the cervical transformation zone (TZ) was colposcopically abnormal, women had immediate loop excision or diagnostic punch biopsies, with treatment if these showed cervical intraepithelial neoplasia grade 2/3 (CIN2/3). Women completed socio-demographic and psychosocial questionnaires at recruitment and before colposcopy. Six weeks after their last procedure, women completed the Impact of Event Scale (IES). Logistic regression was used to determine factors associated with significant psychological distress (IES ≥ 9). Analyses were stratified by colposcopic impression. The response rate was 74%. Six weeks after the last procedure, 86 (21%) of 391 women with a normal TZ had significant distress compared with 144 (42%) of 337 with an abnormal TZ. In both groups, significant distress was associated with anxiety pre-colposcopy and pain or discharge afterwards. Additional variables predicting distress in women with a normal TZ were worries about having sex and dissatisfaction with support from others. In women with an abnormal TZ, additional predictors of distress were younger age, CIN2/3, bleeding following colposcopy and worries about having cancer. Substantial proportions of women experience psychological distress after colposcopy and related procedures, even when the colposcopy is normal. This is an important cost of cervical screening. Interventions to alleviate these adverse psychological effects are required. Copyright © 2011 John Wiley & Sons, Ltd.

Assessment of ethnic differences in sunitinib outcome between Caucasian and Asian patients with metastatic renal cell carcinoma: a meta-analysis.

PubMed

Liu, Xiaoyan; Fiocco, Marta; Swen, Jesse J; Guchelaar, Henk-Jan

2017-04-01

An increasing number of studies have reported ethnic differences in sunitinib outcome in metastatic renal cell carcinoma (mRCC) patients. However, a comprehensive analysis is still lacking. Therefore, we systematically collected available published data and performed a meta-analysis to compare sunitinib efficacy and toxicity in Asian and Caucasian mRCC patients. Data were extracted from published results from clinical trials, expanded access program and real-world clinical practice. Progression-free survival (or time to tumor progression), overall survival, objective response rate and adverse events were used as endpoints to evaluate the differences of sunitinib outcome between the two ethnicities. For adverse events, we focused the following clinically relevant side effects: diarrhea, fatigue, mucositis/stomatitis, hand-foot syndrome, hypertension, leukopenia, neutropenia and thrombocytopenia. A total of 33 publications including 9977 patients were available for meta-analysis. The efficacy of sunitinib in Asian patients was similar to that in Caucasian patients. However, Asian patients showed a higher incidence of all grades toxicity of hand-foot syndrome, > grade 2 fatigue, > grade 2 hand-foot syndrome and > grade 2 thrombocytopenia. Ethnic differences in adverse events of sunitinib in mRCC patients existed and dose adjustment in Asian patients may be considered.

Management of Side Effects of Novel Therapies for Multiple Myeloma: Consensus Statements Developed by the International Myeloma Foundation’s Nurse Leadership Board

PubMed Central

Bertolotti, Page; Bilotti, Elizabeth; Colson, Kathleen; Curran, Kathleen; Doss, Deborah; Faiman, Beth; Gavino, Maria; Jenkins, Bonnie; Lilleby, Kathy; Love, Ginger; Mangan, Patricia A.; McCullagh, Emily; Miceli, Teresa; Miller, Kena; Rogers, Kathryn; Rome, Sandra; Sandifer, Stacey; Smith, Lisa C.; Tariman, Joseph D.; Westphal, Jeanne

2014-01-01

Nurses play an essential role in managing the care of patients with multiple myeloma, who require education and support to receive and adhere to optimal therapy. The International Myeloma Foundation created a Nurse Leadership Board comprised of oncology nurses from leading cancer centers and community practices. An assessment survey identified the need for specific recommendations for managing key side effects of novel antimyeloma agents. Myelosuppression, thromboembolic events, peripheral neuropathy, steroid toxicities, and gastrointestinal side effects were selected for the first consensus statements. The board developed recommendations for healthcare providers in any medical setting, including grading of side-effect toxicity and strategies for managing the side effects in general, with specific recommendations pertaining to the novel agents. PMID:18490252

Local Excision Alone Without Irradiation for Ductal Carcinoma In Situ of the Breast: A Trial of the Eastern Cooperative Oncology Group

PubMed Central

Hughes, Lorie L.; Wang, Molin; Page, David L.; Gray, Robert; Solin, Lawrence J.; Davidson, Nancy E.; Lowen, Mary Ann; Ingle, James N.; Recht, Abram; Wood, William C.

2009-01-01

Purpose To determine the risk of ipsilateral breast events in patients with ductal carcinoma in situ (DCIS) treated with local excision without irradiation. Patients and Methods Patients with either low- or intermediate-grade DCIS measuring 2.5 cm or smaller, or high-grade DCIS measuring 1 cm or smaller who had microscopic margin widths of 3 mm or wider and no residual calcifications on postoperative mammograms were eligible for a prospective trial conducted from 1997 to 2002 by the Eastern Cooperative Oncology Group and North Central Cancer Treatment Group. Patients entered in 2000 and later could take tamoxifen if they wished. Median age at last surgery for the entire population was 60 years (range, 28 to 88 years), and median tumor sizes in the two strata were 6 mm and 5 mm, respectively. Results With a median follow-up of 6.2 years, the 5-year rate of ipsilateral breast events in the 565 eligible patients in the low/intermediate grade stratum was 6.1% (95% CI, 4.1% to 8.2%). With a median follow-up of 6.7 years, this incidence for the 105 eligible patients in the high-grade stratum was 15.3% (95% CI, 8.2% to 22.5%). Conclusion Rigorously evaluated and selected patients with low- to intermediate-grade DCIS with margins 3 mm or wider had an acceptably low rate of ipsilateral breast events at 5 years after excision without irradiation. Patients with high-grade lesions had a much higher rate, suggesting that excision alone is inadequate treatment. Further follow-up is necessary to document long-term results. PMID:19826126

Toward assessing traumatic events and stress symptoms in preschool children from low-income families.

PubMed

Graham-Bermann, Sandra A; Howell, Kathryn; Habarth, Janice; Krishnan, Sandhya; Loree, Amy; Bermann, Eric A

2008-04-01

Traumatic events can seriously disrupt the development of preschool children. Yet few studies capture developmentally specific examples of traumas and the expression of distress for this age group. Mothers and teachers of 138 preschoolers from low-income families were interviewed about traumatic events and completed a new measure assessing their child's traumatic stress symptoms. They reported traumatic events as the death of a person, death of a pet, family violence, high conflict divorce, sudden family loss, accident or injury, and viewing the World Trade Center attack. Factor analysis of 17 trauma symptoms revealed three internally consistent and valid scales: Intrusions, Emotional Reactivity, and Fears, plus a Total omnibus score. Traumatic stress symptoms varied by the type of event. Scores were higher for traumatic events involving close family members than for distal events. Copyright 2008 APA, all rights reserved.

Flood damage: a model for consistent, complete and multipurpose scenarios

NASA Astrophysics Data System (ADS)

Menoni, Scira; Molinari, Daniela; Ballio, Francesco; Minucci, Guido; Mejri, Ouejdane; Atun, Funda; Berni, Nicola; Pandolfo, Claudia

2016-12-01

Effective flood risk mitigation requires the impacts of flood events to be much better and more reliably known than is currently the case. Available post-flood damage assessments usually supply only a partial vision of the consequences of the floods as they typically respond to the specific needs of a particular stakeholder. Consequently, they generally focus (i) on particular items at risk, (ii) on a certain time window after the occurrence of the flood, (iii) on a specific scale of analysis or (iv) on the analysis of damage only, without an investigation of damage mechanisms and root causes. This paper responds to the necessity of a more integrated interpretation of flood events as the base to address the variety of needs arising after a disaster. In particular, a model is supplied to develop multipurpose complete event scenarios. The model organizes available information after the event according to five logical axes. This way post-flood damage assessments can be developed that (i) are multisectoral, (ii) consider physical as well as functional and systemic damage, (iii) address the spatial scales that are relevant for the event at stake depending on the type of damage that has to be analyzed, i.e., direct, functional and systemic, (iv) consider the temporal evolution of damage and finally (v) allow damage mechanisms and root causes to be understood. All the above features are key for the multi-usability of resulting flood scenarios. The model allows, on the one hand, the rationalization of efforts currently implemented in ex post damage assessments, also with the objective of better programming financial resources that will be needed for these types of events in the future. On the other hand, integrated interpretations of flood events are fundamental to adapting and optimizing flood mitigation strategies on the basis of thorough forensic investigation of each event, as corroborated by the implementation of the model in a case study.

Development and external validation of new ultrasound-based mathematical models for preoperative prediction of high-risk endometrial cancer.

PubMed

Van Holsbeke, C; Ameye, L; Testa, A C; Mascilini, F; Lindqvist, P; Fischerova, D; Frühauf, F; Fransis, S; de Jonge, E; Timmerman, D; Epstein, E

2014-05-01

To develop and validate strategies, using new ultrasound-based mathematical models, for the prediction of high-risk endometrial cancer and compare them with strategies using previously developed models or the use of preoperative grading only. Women with endometrial cancer were prospectively examined using two-dimensional (2D) and three-dimensional (3D) gray-scale and color Doppler ultrasound imaging. More than 25 ultrasound, demographic and histological variables were analyzed. Two logistic regression models were developed: one 'objective' model using mainly objective variables; and one 'subjective' model including subjective variables (i.e. subjective impression of myometrial and cervical invasion, preoperative grade and demographic variables). The following strategies were validated: a one-step strategy using only preoperative grading and two-step strategies using preoperative grading as the first step and one of the new models, subjective assessment or previously developed models as a second step. One-hundred and twenty-five patients were included in the development set and 211 were included in the validation set. The 'objective' model retained preoperative grade and minimal tumor-free myometrium as variables. The 'subjective' model retained preoperative grade and subjective assessment of myometrial invasion. On external validation, the performance of the new models was similar to that on the development set. Sensitivity for the two-step strategy with the 'objective' model was 78% (95% CI, 69-84%) at a cut-off of 0.50, 82% (95% CI, 74-88%) for the strategy with the 'subjective' model and 83% (95% CI, 75-88%) for that with subjective assessment. Specificity was 68% (95% CI, 58-77%), 72% (95% CI, 62-80%) and 71% (95% CI, 61-79%) respectively. The two-step strategies detected up to twice as many high-risk cases as preoperative grading only. The new models had a significantly higher sensitivity than did previously developed models, at the same specificity. Two-step strategies with 'new' ultrasound-based models predict high-risk endometrial cancers with good accuracy and do this better than do previously developed models. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.

Movement Issues Identified in Movement ABC2 Checklist Parent Ratings for Students with Persisting Dysgraphia, Dyslexia, and OWL LD and Typical Literacy Learners.

PubMed

Nielsen, Kathleen; Henderson, Sheila; Barnett, Anna L; Abbott, Robert D; Berninger, Virginia

2018-01-01

Movement, which draws on motor skills and executive functions for managing them, plays an important role in literacy learning (e.g., movement of mouth during oral reading and movement of hand and fingers during writing); but relatively little research has focused on movement skills in students with specific learning disabilities as the current study did. Parents completed normed Movement Assessment Battery for Children Checklist, 2nd edition (ABC-2), ratings and their children in grades 4 to 9 ( M = 11 years, 11 months; 94 boys, 61 girls) completed diagnostic assessment used to assign them to diagnostic groups: control typical language learning ( N = 42), dysgraphia (impaired handwriting) ( N = 29), dyslexia (impaired word decoding/reading and spelling) ( N = 65), or oral and written language learning disability (OWL LD) (impaired syntax in oral and written language) ( N = 19). The research aims were to (a) correlate the Movement ABC-2 parent ratings for Scale A Static/Predictable Environment (15 items) and Scale B Dynamic/Unpredictable Environment (15 items) with reading and writing achievement in total sample varying within and across different skills; and (b) compare each specific learning disability group with the control group on Movement ABC-2 parent ratings for Scale A, Scale B, and Scale C Movement-Related (Non-Motor Executive Functions, or Self-Efficacy, or Affect) (13 items). At least one Movement ABC-2 parent rating was correlated with each assessed literacy achievement skill. Each of three specific learning disability groups differed from the control group on two Scale A (static/predictable environment) items (fastens buttons and forms letters with pencil or pen) and on three Scale C items (distractibility, overactive, and underestimates own ability); but only OWL LD differed from control on Scale B (dynamic/unpredictable environment) items. Applications of findings to assessment and instruction for students ascertained for and diagnosed with persisting specific learning disabilities in literacy learning, and future research directions are discussed.

Environmental forcing of terrestrial carbon isotope excursion amplification across five Eocene hyperthermals

NASA Astrophysics Data System (ADS)

Bowen, G. J.; Abels, H.

2015-12-01

Abrupt changes in the isotope composition of exogenic carbon pools accompany many major episodes of global change in the geologic record. The global expression of this change in substrates that reflect multiple carbon pools provides important evidence that many events reflect persistent, global redistribution of carbon between reduced and oxidized stocks. As the diversity of records documenting any event grows, however, discrepancies in the expression of carbon isotope change among substrates are almost always revealed. These differences in magnitude, pace, and pattern of change can complicate interpretations of global carbon redistribution, but under ideal circumstances can also provide additional information on changes in specific environmental and biogeochemical systems that accompanied the global events. Here we evaluate possible environmental influences on new terrestrial records of the negative carbon isotope excursions (CIEs) associated with multiple hyperthermals of the Early Eocene, which show a common pattern of amplified carbon isotope change in terrestrial paleosol carbonate records relative to that recorded in marine substrates. Scaling relationships between climate and carbon-cycle proxies suggest that that the climatic (temperature) impact of each event scaled proportionally with the magnitude of its marine CIE, likely implying that all events involved release of reduced carbon with a similar isotopic composition. Amplification of the terrestrial CIEs, however, does not scale with event magnitude, being proportionally less for the first, largest event (the PETM). We conduct a sensitivity test of a coupled plant-soil carbon isotope model to identify conditions that could account for the observed CIE scaling. At least two possibilities consistent with independent lines of evidence emerge: first, varying effects of pCO2 change on photosynthetic carbon isotope discrimination under changing background pCO2, and second, contrasting changes in regional hydroclimate during the PETM and subsequent hyperthermals. These mechanisms have very different implications for the reconstruction of environmental conditions, and resolving the correct interpretation will require new, complimentary records of plant and soil conditions associated with the Early Eocene hyperthermals.

Application of Satellite and Ozonesonde Data to the Study of Nighttime Tropospheric Ozone Impacts and Relationship to Air Quality

NASA Astrophysics Data System (ADS)

Osterman, G. B.; Eldering, A.; Neu, J. L.; Tang, Y.; McQueen, J.; Pinder, R. W.

2011-12-01

To help protect human health and ecosystems, regional-scale atmospheric chemistry models are used to forecast high ozone events and to design emission control strategies to decrease the frequency and severity of ozone events. Despite the impact that nighttime aloft ozone can have on surface ozone, regional-scale atmospheric chemistry models often do not simulate the nighttime ozone concentrations well and nor do they sufficiently capture the ozone transport patterns. Fully characterizing the importance of the nighttime ozone has been hampered by limited measurements of the vertical distribution of ozone and ozone-precursors. The main focus of this work is to begin to utilize remote sensing data sets to characterize the impact of nighttime aloft ozone to air quality events. We will describe our plans to use NASA satellite data sets, transport models and air quality models to study ozone transport, focusing primarily on nighttime ozone and provide initial results. We will use satellite and ozonesonde data to help understand how well the air quality models are simulating ozone in the lower free troposphere and attempt to characterize the impact of nighttime ozone to air quality events. Our specific objectives are: 1) Characterize nighttime aloft ozone using remote sensing data and sondes. 2) Evaluate the ability of the Community Multi-scale Air Quality (CMAQ) model and the National Air Quality Forecast Capability (NAQFC) model to capture the nighttime aloft ozone and its relationship to air quality events. 3) Analyze a set of air quality events and determine the relationship of air quality events to the nighttime aloft ozone. We will achieve our objectives by utilizing the ozone profile data from the NASA Earth Observing System (EOS) Tropospheric Emission Spectrometer (TES) and other sensors, ozonesonde data collected during the Aura mission (IONS), EPA AirNow ground station ozone data, the CMAQ continental-scale air quality model, and the National Air Quality Forecast model.

Postoperative pain treatment after total knee arthroplasty: A systematic review

PubMed Central

Wetterslev, Mik; Hansen, Signe Elisa; Hansen, Morten Sejer; Mathiesen, Ole; Dahl, Jørgen B.

2017-01-01

Introduction The aim of this systematic review was to document efficacy, safety and quality of evidence of analgesic interventions after total knee arthroplasty (TKA). Methods This PRISMA-compliant and PROSPERO-registered review includes all-language randomized controlled trials of medication-based analgesic interventions after TKA. Bias was evaluated according to Cochrane methodology. Outcomes were opioid consumption (primary), pain scores at rest and during mobilization, adverse events, and length of stay. Interventions investigated in three or more trials were meta-analysed. Outcomes were evaluated using forest plots, Grading of Recommendations Assessment, Development and Evaluation (GRADE), L’Abbe Plots and trial sequential analysis. Results The included 113 trials, investigating 37 different analgesic interventions, were characterized by unclear/high risk of bias, low assay sensitivity and considerable differences in pain assessment tools, basic analgesic regimens, and reporting of adverse events. In meta-analyses single and continuous femoral nerve block (FNB), intrathecal morphine, local infiltration analgesia, intraarticular injection of local anaesthetics, non-steroidal anti-inflammatory drugs, and gabapentinoids demonstrated significant analgesic effects. The 24-hour morphine-sparing effects ranged from 4.2 mg (CI: 1.3, 7.2; intraarticular local anaesthetics), to 16.6 mg (CI: 11.2, 22; single FNB). Pain relieving effects at rest at 6 hours ranged from 4 mm (CI: -10, 2; gabapentinoids), to 19 mm (CI: 8, 31; single FNB), and at 24 hours from 3 mm (CI: -2, 8; gabapentinoids), to 16 mm (CI: 8, 23; continuous FNB). GRADE-rated quality of evidence was generally low. Conclusion A low quality of evidence, small sample sizes and heterogeneity of trial designs prohibit designation of an optimal procedure-specific analgesic regimen after TKA. PMID:28273133

American Association for the Surgery of Trauma Organ Injury Scaling: 50th anniversary review article of the Journal of Trauma.

PubMed

Moore, Ernest E; Moore, Frederick A

2010-12-01

The purpose of a scaling system for specific injuries is to provide a common language to facilitate the clinical decisions and the investigative basis for this decision making. This brief overview describes the evolution of the Organ Injury Scaling (OIS) system developed by the American Association for the Surgery of Trauma. The OIS system is based on the magnitude of anatomic disruption and is graded as 1 (minimal), 2 (mild), 3 (moderate), 4 (severe), 5 (massive), and 6 (lethal). To date, the American Association for the Surgery of Trauma OIS system has been developed for visceral and vascular injuries of the neck, chest, abdomen, and extremities. The fundamental objective of OIS is to provide a common language to describe specific organ injuries. The primary purpose of OIS is to facilitate clinical decision making and the necessary research endeavors to improve this process. A good example of this concept is the tumor, node, metastasis classification for solid organ malignancies: a system used worldwide to guide patient care and clinical investigation.

Measuring Instructional Differentiation in a Large-Scale Experiment

ERIC Educational Resources Information Center

Williams, Ryan T.; Swanlund, Andrew; Miller, Shazia; Konstantopoulos, Spyros; Eno, Jared; van der Ploeg, Arie; Meyers, Coby

2014-01-01

This study operationalizes four measures of instructional differentiation: one for Grade 2 English language arts (ELA), one for Grade 2 mathematics, one for Grade 5 ELA, and one for Grade 5 mathematics. Our study evaluates their measurement properties of each measure in a large field experiment: the Indiana Diagnostic Assessment Tools Study, which…

Enhanced clinical-scale manufacturing of TCR transduced T-cells using closed culture system modules.

PubMed

Jin, Jianjian; Gkitsas, Nikolaos; Fellowes, Vicki S; Ren, Jiaqiang; Feldman, Steven A; Hinrichs, Christian S; Stroncek, David F; Highfill, Steven L

2018-01-24

Genetic engineering of T-cells to express specific T cell receptors (TCR) has emerged as a novel strategy to treat various malignancies. More widespread utilization of these types of therapies has been somewhat constrained by the lack of closed culture processes capable of expanding sufficient numbers of T-cells for clinical application. Here, we evaluate a process for robust clinical grade manufacturing of TCR gene engineered T-cells. TCRs that target human papillomavirus E6 and E7 were independently tested. A 21 day process was divided into a transduction phase (7 days) and a rapid expansion phase (14 days). This process was evaluated using two healthy donor samples and four samples obtained from patients with epithelial cancers. The process resulted in ~ 2000-fold increase in viable nucleated cells and high transduction efficiencies (64-92%). At the end of culture, functional assays demonstrated that these cells were potent and specific in their ability to kill tumor cells bearing target and secrete large quantities of interferon and tumor necrosis factor. Both phases of culture were contained within closed or semi-closed modules, which include automated density gradient separation and cell culture bags for the first phase and closed GREX culture devices and wash/concentrate systems for the second phase. Large-scale manufacturing using modular systems and semi-automated devices resulted in highly functional clinical-grade TCR transduced T-cells. This process is now in use in actively accruing clinical trials and the NIH Clinical Center and can be utilized at other cell therapy manufacturing sites that wish to scale-up and optimize their processing using closed systems.

A mixed-methods exploration of implementation of a comprehensive school healthy eating model one year after scale-up.

PubMed

Naylor, Patti-Jean; McKay, Heather A; Valente, Maria; Mâsse, Louise C

2016-04-01

To study the implementation of a school-based healthy eating (HE) model one year after scale-up in British Columbia (BC). Specifically, to examine implementation of Action Schools! BC (AS! BC) and its influence on implementation of classroom HE activities, and to explore factors associated with implementation. Diffusion of Innovations, Social Cognitive and Organizational Change theories guided our approach. We used a mixed-methods research design including focus group interviews (seven schools, sixty-two implementers) and a cross-sectional multistage survey to principals (n 36, 92 % response rate) and teachers of grades 4 to 7 (n 168, 70 % response rate). Self-reported implementation of classroom HE activities and reported use of specific AS! BC HE activities were primary implementation measures. Thematic analysis of focus group data and multilevel mixed-effect logistic regression analyses of survey data were conducted. Elementary schools across BC, Canada. Thirty-nine school districts, thirty-six principals, 168 grade 4 to 7 teachers. Forty-two per cent of teachers in registered schools were implementing AS! BC HE in their classrooms. Users were 6·25 times more likely to have delivered a HE lesson in the past week. Implementation facilitators were school champions, technical support and access to resources; barriers were lack of time, loss of leadership or momentum. Implementation predictors were teacher training, self-efficacy, experience with the physical activity component of AS! BC, supportive school climate and parental post-secondary education. Our findings reinforce that continued teacher training and support are important public health investments that contribute to successful implementation of school-based HE models after scale-up.

Efficacy and Safety of Oral and Transdermal Opioid Analgesics for Musculoskeletal Pain in Older Adults: A Systematic Review of Randomized, Placebo-Controlled Trials.

PubMed

Megale, Rodrigo Z; Deveza, Leticia A; Blyth, Fiona M; Naganathan, Vasi; Ferreira, Paulo H; McLachlan, Andrew J; Ferreira, Manuela L

2018-05-01

This systematic review with meta-analysis was performed to evaluate the efficacy and safety of using opioid analgesics in older adults with musculoskeletal pain. We searched Cochrane Library, MEDLINE, EMBASE, Web of Science, AMED, CINAHL, and LILACS for randomized controlled trials with mean population age of 60 years or older, comparing the efficacy and safety of opioid analgesics with placebo for musculoskeletal pain conditions. Reviewers extracted data, assessed risk of bias, and evaluated the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation approach. Random effects models were used to calculate standardized mean differences (when different scales were used across trials), mean differences and odds ratios with respective 95% confidence intervals (CIs). Meta-regressions were carried out to assess the influence of opioid analgesic daily dose and treatment duration on our main outcomes. We included 23 randomized placebo-controlled trials in the meta-analysis. Opioid analgesics had a small effect on decreasing pain intensity (standardized mean difference = -.27; 95% CI = -.33 to -.20) and improving function (standardized mean difference = -.27, 95% CI = -.36 to -.18), which was not associated with daily dose or treatment duration. The odds of adverse events were 3 times higher (odds ratio = 2.94; 95% CI = 2.33-3.72) and the odds of treatment discontinuation due to adverse events 4 times higher (odds ratio = 4.04; 95% CI = 3.10-5.25) in patients treated with opioid analgesics. The results show that in older adults suffering from musculoskeletal pain, using opioid analgesics had only a small effect on pain and function at the cost of a higher odds of adverse events and treatment discontinuation. For this specific population, the opioid-related risks may outweigh the benefits. The systematic review shows that, in older adults suffering from musculoskeletal conditions, opioid analgesics have only a small effect on pain and disability. Conversely, this population is at higher risk of adverse events. The results may reflect age-related physiological changes in pain processing, pharmacokinetics, and pharmacodynamics. Copyright © 2017 The American Pain Society. Published by Elsevier Inc. All rights reserved.

Meta-analysis of individual patient safety data from six randomized, placebo-controlled trials with the antiangiogenic VEGFR2-binding monoclonal antibody ramucirumab

PubMed Central

Arnold, D; Fuchs, C S; Tabernero, J; Ohtsu, A; Zhu, A X; Garon, E B; Mackey, J R; Paz-Ares, L; Baron, A D; Okusaka, T; Yoshino, T; Yoon, H H; Das, M; Ferry, D; Zhang, Y; Lin, Y; Binder, P; Sashegyi, A; Chau, I

2017-01-01

Abstract Background Ramucirumab, the human immunoglobulin G1 monoclonal antibody receptor antagonist of vascular endothelial growth factor receptor 2, has been approved for treating gastric/gastroesophageal junction, non-small-cell lung, and metastatic colorectal cancers. With the completion of six global, randomized, double-blind, placebo-controlled, phase III trials across multiple tumor types, an opportunity now exists to further establish the safety parameters of ramucirumab across a large patient population. Materials and methods An individual patient meta-analysis across the six completed phase III trials was conducted and the relative risk (RR) and associated 95% confidence intervals (CIs) were derived using fixed-effects or mixed-effects models for all-grade and high-grade adverse events (AEs) possibly related to vascular endothelial growth factor pathway inhibition. The number needed to harm was also calculable due to the placebo-controlled nature of all six registration standard trials. Results A total of 4996 treated patients (N = 2748 in the ramucirumab arm and N = 2248 in the control, placebo arm) were included in this meta-analysis. Arterial thromboembolic events [ATE; all-grade, RR: 0.8, 95% CI 0.5–1.3; high-grade (grade ≥3), RR: 0.9, 95% CI 0.5–1.7], venous thromboembolic events (VTE; all-grade, RR: 0.7, 95% CI 0.5–1.1; high-grade, RR: 0.7, 95% CI 0.4–1.2), high-grade bleeding (RR: 1.1, 95% CI 0.8–1.5), and high-grade gastrointestinal (GI) bleeding (RR: 1.1, 95% CI 0.7–1.7) did not demonstrate a definite increased risk with ramucirumab. A higher percentage of hypertension, proteinuria, low-grade (grade 1–2) bleeding, GI perforation, infusion-related reaction, and wound-healing complications were observed in the ramucirumab arm compared with the control arm. Conclusions Ramucirumab may be distinct among antiangiogenic agents in terms of ATE, VTE, high-grade bleeding, or high-grade GI bleeding by showing no clear evidence for an increased risk of these AEs in this meta-analysis of a large and diverse patient population. Ramucirumab is consistent with other angiogenic inhibitors in the risk of developing certain AEs. Clinical Trial Numbers: NCT00917384 (REGARD), NCT01170663 (RAINBOW), NCT01168973 (REVEL), NCT01183780 (RAISE), NCT01140347 (REACH), and NCT00703326 (ROSE). PMID:28950290

Method and apparatus for determination of mechanical properties of functionally-graded materials

DOEpatents

Giannakopoulos, Antonios E.; Suresh, Subra

1999-01-01

Techniques for the determination of mechanical properties of homogenous or functionally-graded materials from indentation testing are presented. The technique is applicable to indentation on the nano-scale through the macro-scale including the geological scale. The technique involves creating a predictive load/depth relationship for a sample, providing an experimental load/depth relationship, comparing the experimental data to the predictive data, and determining a physical characteristic from the comparison.

Associations Between Subjective Symptoms and Serum Immunoglobulin E Levels During Asian Dust Events

PubMed Central

Otani, Shinji; Onishi, Kazunari; Mu, Haosheng; Hosoda, Takenobu; Kurozawa, Youichi; Ikeguchi, Masahide

2014-01-01

Asian dust is a seasonal meteorological phenomenon caused by the displacement of atmospheric pollutants from the Mongolian and Chinese deserts. Although the frequency of Asian dust events and atmospheric dust levels have steadily increased in the eastern Asia region, the effects on human health remain poorly understood. In the present study, the impact of Asian dust on human health was determined in terms of allergic reactions. A total of 25 healthy volunteers were tested for a relationship between serum immunoglobulin E (IgE) levels and subjective symptoms during a 3-day Asian dust event recorded in April 2012. They filled daily questionnaires on the severity of nasal, pharyngeal, ocular, respiratory, and skin symptoms by a self-administered visual analog scale. Serum levels of non-specific IgE and 33 allergen-specific IgE molecules were analyzed. Spearman rank-correlation analysis revealed significant positive associations between nasal symptom scores and 2 microbial-specific IgE levels (Penicillium and Cladosporium). Microbes migrate vast distances during Asian dust events by attaching themselves to dust particles. Therefore, some of these symptoms may be associated with type 1 allergic reactions to certain type of microbes. PMID:25075882

Psychological and Physical Impacts of Extreme Events on Older Adults: Implications for Communications.

PubMed

McClelland, Erin; Amlôt, Richard; Rogers, M Brooke; Rubin, G James; Tesh, John; Pearce, Julia M

2017-02-01

In recent years, a series of large-scale, high-profile natural disasters and terrorist attacks have demonstrated the need for thorough and effective disaster preparedness. While these extreme events affect communities and societies as a whole, they also carry specific risks for particular population groups. Crises such as Hurricane Katrina and the 2011 earthquake and tsunami disaster in Japan have illustrated the risk of significant and disproportionate morbidity and mortality among older adults during disasters. Age does not necessarily equate to vulnerability, but many physical and psychological consequences of the aging process can increase the risk of adverse outcomes. As the older population grows, so too does the need to ensure that adequate, practical, and appropriate measures exist to offset the specific risks from extreme events associated with this subpopulation. Effective risk and crisis communication plays a key role in mitigating the extent to which older adults are differentially affected during extreme events. By identifying the specific issues affecting older adults, this review highlights important areas for action for practitioners and policy-makers, particularly in the realm of crisis communication. (Disaster Med Public Health Preparedness. 2017;11:127-134).

Time-varying causal network of the Korean financial system based on firm-specific risk premiums

NASA Astrophysics Data System (ADS)

Song, Jae Wook; Ko, Bonggyun; Cho, Poongjin; Chang, Woojin

2016-09-01

The aim of this paper is to investigate the Korean financial system based on time-varying causal network. We discover many stylized facts by utilizing the firm-specific risk premiums for measuring the causality direction from a firm to firm. At first, we discover that the interconnectedness of causal network is affected by the outbreak of financial events; the co-movement of firm-specific risk premium is strengthened after each positive event, and vice versa. Secondly, we find that the major sector of the Korean financial system is the Depositories, and the financial reform in June-2011 achieves its purpose by weakening the power of risk-spillovers of Broker-Dealers. Thirdly, we identify that the causal network is a small-world network with scale-free topology where the power-law exponents of out-Degree and negative event are more significant than those of in-Degree and positive event. Lastly, we discuss that the current aspects of causal network are closely related to the long-term future scenario of the KOSPI Composite index where the direction and stability are significantly affected by the power of risk-spillovers and the power-law exponents of degree distributions, respectively.

Remote Sensing the Patterns of Vector-borne Disease in El Nino and non-El Nino Years

NASA Technical Reports Server (NTRS)

Wood, B. L.; Chang, J.; Lobitz, B.; Beck, L.; DAntoni, Hector (Technical Monitor)

1997-01-01

The relationship between El Nino and non-El Nino and the patterns of vector-borne disease can be viewed at a variety of spatial and temporal scales. At one extreme are long term predictions of changing precipitation and temperature patterns at continental and global scales. At the opposite extreme are the local or site specific ecological changes associated with the long term events. In order to understand and address the human health consequences of El Nino events, especially the patterns of vector-borne diseases, it is necessary to combine both scales of observation. At a local or regional scale the patterns of vector-borne diseases are determined by temperature, precipitation, and habitat availability. These factors, as well as disease incidence can be altered by El Nino events. Remote sensing data such as that acquired by the NOAA AVHRR and Landsat TM sensors can be used to characterize and monitor changing ecological conditions and therefore predict vector-borne disease patterns. The authors present the results of preliminary work on the analysis of historical AVHRR and TM data acquired during El Nino and nonfatal Nino years to characterize ecological conditions in Peru on a monthly basis. This information will then be combined with disease data to determine the relationship between changes in ecological conditions and disease incidence. Our goal is to produce a sequence of remotely sensed images which can be used to show the ecological and disease patterns associated with long term El Nino events and predictions.

Multimedia Uses in Organizing Learning.

ERIC Educational Resources Information Center

Calvert, Sandra L.

The "preplay" technique, an advance organizer summarizing important plot events before sections of a story, is examined for its effectiveness in facilitating children's selective attention to and comprehension of televised stories. One hundred and sixty first through fourth grade children, equally distributed by grade and sex, were…

Readability analysis of healthcare-oriented education resources from the American Academy of Facial Plastic and Reconstructive Surgery.

PubMed

Misra, Poonam; Agarwal, Nitin; Kasabwala, Khushabu; Hansberry, David R; Setzen, Michael; Eloy, Jean Anderson

2013-01-01

Deficient health literacy remains a widespread public issue. As such, the National Institutes of Health (NIH) recommends that all patient resources should be written around a sixth-grade level. The authors evaluate healthcare-oriented resources specified for patient use on the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) Web site in order to identify potential areas of improvement and highlight those sections that may serve as paradigms for future revisions. Descriptive and correlational design. Seventeen healthcare-oriented resources specifically for patients were downloaded in February 2012 from the American Academy of Facial Plastic and Reconstructive Surgery Web site. Readability assessments of each article were performed using Readability Studio Professional Edition Version 2012.1. These tests included the Flesch Reading Ease, Flesch-Kincaid Grade Level, SMOG Grading, Coleman-Liau Index, Gunning-Fog Index, the New Fog Count, the New Dale-Chall Readability Formula, FORCAST formula, Raygor Readability Estimate, and the Fry Graph. Patient health education material found on the AAFPRS Web site has been found to be written at an average grade level of 12th grade using 10 different readability scales. Modifications of the patient education section of the AAFPRS Web site can increase the readability of the literature, and allow greater comprehension among a wider audience. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

Identification of coronal heating events in 3D simulations

NASA Astrophysics Data System (ADS)

Kanella, Charalambos; Gudiksen, Boris V.

2017-07-01

Context. The solar coronal heating problem has been an open question in the science community since 1939. One of the proposed models for the transport and release of mechanical energy generated in the sub-photospheric layers and photosphere is the magnetic reconnection model that incorporates Ohmic heating, which releases a part of the energy stored in the magnetic field. In this model many unresolved flaring events occur in the solar corona, releasing enough energy to heat the corona. Aims: The problem with the verification and quantification of this model is that we cannot resolve small scale events due to limitations of the current observational instrumentation. Flaring events have scaling behavior extending from large X-class flares down to the so far unobserved nanoflares. Histograms of observable characteristics of flares show powerlaw behavior for energy release rate, size, and total energy. Depending on the powerlaw index of the energy release, nanoflares might be an important candidate for coronal heating; we seek to find that index. Methods: In this paper we employ a numerical three-dimensional (3D)-magnetohydrodynamic (MHD) simulation produced by the numerical code Bifrost, which enables us to look into smaller structures, and a new technique to identify the 3D heating events at a specific instant. The quantity we explore is the Joule heating, a term calculated directly by the code, which is explicitly correlated with the magnetic reconnection because it depends on the curl of the magnetic field. Results: We are able to identify 4136 events in a volume 24 × 24 × 9.5 Mm3 (I.e., 768 × 786 × 331 grid cells) of a specific snapshot. We find a powerlaw slope of the released energy per second equal to αP = 1.5 ± 0.02, and two powerlaw slopes of the identified volume equal to αV = 1.53 ± 0.03 and αV = 2.53 ± 0.22. The identified energy events do not represent all the released energy, but of the identified events, the total energy of the largest events dominate the energy release. Most of the energy release happens in the lower corona, while heating drops with height. We find that with a specific identification method large events can be resolved into smaller ones, but at the expense of the total identified energy releases. The energy release that cannot be identified as an event favors a low energy release mechanism. Conclusions: This is the first step to quantitatively identify magnetic reconnection sites and measure the energy released by current sheet formation.

Crisis occurrence and resolution in patients with severe and persistent mental illness: the contribution of suicidality.

PubMed

Links, Paul S; Eynan, Rahel; Ball, Jeffrey S; Barr, Aiala; Rourke, Sean

2005-01-01

Assertive community treatment appears to have limited impact on the risk of suicide in persons with severe and persistent mental illness (SPMI). This exploratory prospective study attempts to understand this observation by studying the contribution of suicidality to the occurrence of crisis events in patients with SPMI. Specifically, an observer-rated measure of the need for hospitalization, the Crisis Triage Rating Scale, was completed at baseline, crisis occurrence, and resolution to determine how much the level of suicidality contributed to the deemed level of crisis. Second, observer-ratings of suicidal ideation, the Modified Scale for Suicide Ideation, and psychopathology and suicidality, Brief Psychiatric Rating Scale, were measured at baseline, crisis occurrence, and resolution. A self-report measure of distress, the Symptom Distress Scale, was completed at baseline, crisis occurrence, and resolution. Finally, the patients' crisis experiences were recorded qualitatively to compare with quantitative measures of suicidality. Almost 40% of the subjects experienced crisis events and more than a quarter of these events were judged to be severe enough to warrant the need for hospitalization. Our findings suggest that elevation of psychiatric symptoms is a major contributor to the crisis occurrences of individuals with SPMI; although the risk of suicide may have to be conceived as somewhat separate from crisis occurrence.

Learning Progressions, Vertical Scales, and Testable Hypotheses: Promising Intuitions and Points for Clarification

ERIC Educational Resources Information Center

Maul, Andrew

2015-01-01

Briggs and Peck [in "Using Learning Progressions to Design Vertical Scales That Support Coherent Inferences about Student Growth"] call for greater care in the conceptualization of the target attributes of students, or "what it is that is growing from grade to grade." In particular, they argue that learning progressions can…

The Need for Large-Scale, Longitudinal Empirical Studies in Middle Level Education Research

ERIC Educational Resources Information Center

Mertens, Steven B.; Caskey, Micki M.; Flowers, Nancy

2016-01-01

This essay describes and discusses the ongoing need for large-scale, longitudinal, empirical research studies focused on middle grades education. After a statement of the problem and concerns, the essay describes and critiques several prior middle grades efforts and research studies. Recommendations for future research efforts to inform policy…

Population Invariance of Vertical Scaling Results

ERIC Educational Resources Information Center

Powers, Sonya; Turhan, Ahmet; Binici, Salih

2012-01-01

The population sensitivity of vertical scaling results was evaluated for a state reading assessment spanning grades 3-10 and a state mathematics test spanning grades 3-8. Subpopulations considered included males and females. The 3-parameter logistic model was used to calibrate math and reading items and a common item design was used to construct…

Supporting local diversity of habitats and species on farmland: a comparison of three wildlife-friendly schemes.

PubMed

Hardman, Chloe J; Harrison, Dominic P G; Shaw, Pete J; Nevard, Tim D; Hughes, Brin; Potts, Simon G; Norris, Ken

2016-02-01

Restoration and maintenance of habitat diversity have been suggested as conservation priorities in farmed landscapes, but how this should be achieved and at what scale are unclear. This study makes a novel comparison of the effectiveness of three wildlife-friendly farming schemes for supporting local habitat diversity and species richness on 12 farms in England.The schemes were: (i) Conservation Grade (Conservation Grade: a prescriptive, non-organic, biodiversity-focused scheme), (ii) organic agriculture and (iii) a baseline of Entry Level Stewardship (Entry Level Stewardship: a flexible widespread government scheme). Conservation Grade farms supported a quarter higher habitat diversity at the 100-m radius scale compared to Entry Level Stewardship farms. Conservation Grade and organic farms both supported a fifth higher habitat diversity at the 250-m radius scale compared to Entry Level Stewardship farms. Habitat diversity at the 100-m and 250-m scales significantly predicted species richness of butterflies and plants. Habitat diversity at the 100-m scale also significantly predicted species richness of birds in winter and solitary bees. There were no significant relationships between habitat diversity and species richness for bumblebees or birds in summer.Butterfly species richness was significantly higher on organic farms (50% higher) and marginally higher on Conservation Grade farms (20% higher), compared with farms in Entry Level Stewardship. Organic farms supported significantly more plant species than Entry Level Stewardship farms (70% higher) but Conservation Grade farms did not (10% higher). There were no significant differences between the three schemes for species richness of bumblebees, solitary bees or birds. Policy implications . The wildlife-friendly farming schemes which included compulsory changes in management, Conservation Grade and organic, were more effective at increasing local habitat diversity and species richness compared with the less prescriptive Entry Level Stewardship scheme. We recommend that wildlife-friendly farming schemes should aim to enhance and maintain high local habitat diversity, through mechanisms such as option packages, where farmers are required to deliver a combination of several habitats.

Improving the Awareness of the Influence of Geography Upon Historical Events in Ancient Mesopotamia and in Ancient Egypt in Ninth Grade World History Students.

ERIC Educational Resources Information Center

Milton, Henry

This practicum was designed to incorporate the study of geography into a ninth grade world history class with the aim of improving student awareness of the influence of geography upon the historical development of ancient Mesopotamia and ancient Egypt. By means of a questionnaire and map tests it was determined that ninth grade world history…

Specifications-Based Grading in an Introduction to Proofs Course

ERIC Educational Resources Information Center

Williams, Kristopher

2018-01-01

This article describes a system of specifications-based grading used in an introduction to proofs course. The system was introduced to address two issues that arose in the course: how to spend less time grading and how to encourage use of feedback. We describe the implementation of the system and the results on grading and on students.

Heat Transfer Analysis of Localized Heat-Treatment for Grade 91 Steel

NASA Astrophysics Data System (ADS)

Walker, Jacob D.

Many of the projects utilizing Grade 91 steel are large in scale, therefore it is necessary to assemble on site. The assembly of the major pieces requires welding in the assembly; this drastically changes the superior mechanical properties of Grade 91 steel that it was specifically developed for. Therefore, because of the adverse effects of welding on the mechanical properties of Grade 91, it is necessary to do a localized post weld heat treatment. As with most metallic materials grade 91 steel requires a very specific heat treatment process. This process includes a specific temperature and duration at that temperature to achieve the heat treatment desired. Extensive research has been done to determine the proper temperatures and duration to provide the proper microstructure for the superior mechanical properties that are inherent to Grade 91 steel. The welded sections are typically large structures that require local heat treatments and cannot be placed in an oven. The locations of these structures vary from indoors in a controlled environment to outdoors with unpredictable environments. These environments can be controlled somewhat, however in large part the surrounding conditions are unchangeable. Therefore, there is a need to develop methods to accurately apply the surrounding conditions and geometries to a theoretical model in order to provide the proper requirements for the local heat treatment procedure. Within this requirement is the requirement to define unknowns used in the heat transfer equations so that accurate models can be produced and accurate results predicted. This study investigates experimentally and numerically the heat transfer and temperature fields of Grade 91 piping in a local heat treatment. The objective of this thesis research is to determine all of the needed heat transfer coefficients. The appropriate heat transfer coefficients are determined through the inverse heat conduction method utilizing a ceramic heat blanket. This will be done through an inverse method by collecting actual data from different conditions and temperatures. Then the heat transfer coefficients are used to set up a model to determine the appropriate post-weld heat treatment conditions for Grade 91 steel. This will enable one to use the derived coefficients to run a forward analysis with the specific geometry and conditions they will encounter in the heat treatment process for their application. The analysis will provide a theoretical determination of time and temperatures needed to maintain the temperature for the proper time needed to properly heat treat the welded section in the desired areas that have been joined together through a welding process. Finally time and temperature combinations are compared with experimentally measured data. The forward model code applied to the parameters of the heat-treatment can then appropriately assist to determine the proper post-weld heat treatment conditions for the desired toughness and creep properties. This research is very beneficial to the joining of metals industry because it provides a way to ensure the method used to heat treat the welded section is being properly done, and the required heat treatment is achieved. It is applicable to many different geometries so that it can be modified to specific situations.

A Shallow Underground Laboratory for Low-Background Radiation Measurements and Materials Development

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

Aalseth, Craig E.; Bonicalzi, Ricco; Cantaloub, Michael G.

Abstract: Pacific Northwest National Laboratory recently commissioned a new shallow underground laboratory, located at a depth of approximately 30 meters water-equivalent. This new addition to the small class of radiation measurement laboratories located at modest underground depths worldwide houses the latest generation of custom-made, high-efficiency, low-background gamma-ray spectrometers and gas proportional counters. This manuscript describes the unique capabilities present in the shallow underground laboratory; these include large-scale ultra-pure materials production and a suite of radiation detection systems. Reported data characterize the degree of background reduction achieved through a combination of underground location, graded shielding, and rejection of cosmic-ray events. Wemore » conclude by presenting measurement targets and future opportunities.« less

A Multi-Scale Structural Health Monitoring Approach for Damage Detection, Diagnosis and Prognosis in Aerospace Structures

DTIC Science & Technology

2012-01-20

ultrasonic Lamb waves to plastic strain and fatigue life. Theory was developed and validated to predict second harmonic generation for specific mode... Fatigue and damage generation and progression are processes consisting of a series of interrelated events that span large scales of space and time...strain and fatigue life A set of experiments were completed that worked to relate the acoustic nonlinearity measured with Lamb waves to both the

Evaluating 20th Century precipitation characteristics between multi-scale atmospheric models with different land-atmosphere coupling

NASA Astrophysics Data System (ADS)

Phillips, M.; Denning, A. S.; Randall, D. A.; Branson, M.

2016-12-01

Multi-scale models of the atmosphere provide an opportunity to investigate processes that are unresolved by traditional Global Climate Models while at the same time remaining viable in terms of computational resources for climate-length time scales. The MMF represents a shift away from large horizontal grid spacing in traditional GCMs that leads to overabundant light precipitation and lack of heavy events, toward a model where precipitation intensity is allowed to vary over a much wider range of values. Resolving atmospheric motions on the scale of 4 km makes it possible to recover features of precipitation, such as intense downpours, that were previously only obtained by computationally expensive regional simulations. These heavy precipitation events may have little impact on large-scale moisture and energy budgets, but are outstanding in terms of interaction with the land surface and potential impact on human life. Three versions of the Community Earth System Model were used in this study; the standard CESM, the multi-scale `Super-Parameterized' CESM where large-scale parameterizations have been replaced with a 2D cloud-permitting model, and a multi-instance land version of the SP-CESM where each column of the 2D CRM is allowed to interact with an individual land unit. These simulations were carried out using prescribed Sea Surface Temperatures for the period from 1979-2006 with daily precipitation saved for all 28 years. Comparisons of the statistical properties of precipitation between model architectures and against observations from rain gauges were made, with specific focus on detection and evaluation of extreme precipitation events.

Arthroscopic Ankle Arthrodesis: A 2-15 Year Follow-up Study.

PubMed

Jones, Christopher Robert; Wong, Eric; Applegate, Gregory R; Ferkel, Richard D

2018-05-01

The purpose of our study was to determine the results of arthroscopic ankle arthrodesis (AAA) and how the procedure affects adjoining joints and functional scores. Between 1993 and 2013, 116 patients (120 ankles) underwent AAA. Nineteen ankles were lost to follow-up due to death, insufficient radiographic studies, or inability to contact, resulting in 97 patients (101 ankles). Mean age at surgery was 61.1 years (range, 35.8-79.6 years); mean follow-up was 86 months (range, 24-247 months). Patients were assessed according to the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle and Hindfoot scale, Ankle Osteoarthritis Scale (AOS), and Foot and Ankle Outcome Score (FAOS) and underwent comprehensive clinical and radiographic examinations. A total of 94.6% of patients achieved ankle fusion on radiographs. Mean AOFAS score was 83.3 (standard deviation [SD], 13.2). Mean modified FAOS score was 87.4 (SD, 10.4). The AOS scoring system showed 75% good/excellent results. According to the Kellgren-Lawrence score and van Dijk osteoarthritis grading scale, 85% and 69% of patients had no change in talonavicular or subtalar grade of osteoarthritis, respectively. There were no cases of deep infection or other serious adverse events. All but 4 patients were able to return to work following AAA. AAA is an effective operation for treating degenerative ankle disease, even in cases of moderate tibiotalar coronal deformity. At a mean of 86 months postop, nearly three quarters of our patients had good/excellent functional outcomes. Arthritis found in the adjacent hindfoot joints at the time of tibiotalar fusion appears to be a function of preexisting arthritic change and not directly caused by the tibiotalar fusion. Level IV, therapeutic case series. Copyright © 2018 Arthroscopy Association of North America. All rights reserved.

Detection of high-grade small bowel obstruction on conventional radiography with convolutional neural networks.

PubMed

Cheng, Phillip M; Tejura, Tapas K; Tran, Khoa N; Whang, Gilbert

2018-05-01

The purpose of this pilot study is to determine whether a deep convolutional neural network can be trained with limited image data to detect high-grade small bowel obstruction patterns on supine abdominal radiographs. Grayscale images from 3663 clinical supine abdominal radiographs were categorized into obstructive and non-obstructive categories independently by three abdominal radiologists, and the majority classification was used as ground truth; 74 images were found to be consistent with small bowel obstruction. Images were rescaled and randomized, with 2210 images constituting the training set (39 with small bowel obstruction) and 1453 images constituting the test set (35 with small bowel obstruction). Weight parameters for the final classification layer of the Inception v3 convolutional neural network, previously trained on the 2014 Large Scale Visual Recognition Challenge dataset, were retrained on the training set. After training, the neural network achieved an AUC of 0.84 on the test set (95% CI 0.78-0.89). At the maximum Youden index (sensitivity + specificity-1), the sensitivity of the system for small bowel obstruction is 83.8%, with a specificity of 68.1%. The results demonstrate that transfer learning with convolutional neural networks, even with limited training data, may be used to train a detector for high-grade small bowel obstruction gas patterns on supine radiographs.

A vaccine targeting mutant IDH1 induces antitumour immunity.

PubMed

Schumacher, Theresa; Bunse, Lukas; Pusch, Stefan; Sahm, Felix; Wiestler, Benedikt; Quandt, Jasmin; Menn, Oliver; Osswald, Matthias; Oezen, Iris; Ott, Martina; Keil, Melanie; Balß, Jörg; Rauschenbach, Katharina; Grabowska, Agnieszka K; Vogler, Isabel; Diekmann, Jan; Trautwein, Nico; Eichmüller, Stefan B; Okun, Jürgen; Stevanović, Stefan; Riemer, Angelika B; Sahin, Ugur; Friese, Manuel A; Beckhove, Philipp; von Deimling, Andreas; Wick, Wolfgang; Platten, Michael

2014-08-21

Monoallelic point mutations of isocitrate dehydrogenase type 1 (IDH1) are an early and defining event in the development of a subgroup of gliomas and other types of tumour. They almost uniformly occur in the critical arginine residue (Arg 132) in the catalytic pocket, resulting in a neomorphic enzymatic function, production of the oncometabolite 2-hydroxyglutarate (2-HG), genomic hypermethylation, genetic instability and malignant transformation. More than 70% of diffuse grade II and grade III gliomas carry the most frequent mutation, IDH1(R132H) (ref. 3). From an immunological perspective, IDH1(R132H) represents a potential target for immunotherapy as it is a tumour-specific potential neoantigen with high uniformity and penetrance expressed in all tumour cells. Here we demonstrate that IDH1(R132H) contains an immunogenic epitope suitable for mutation-specific vaccination. Peptides encompassing the mutated region are presented on major histocompatibility complexes (MHC) class II and induce mutation-specific CD4(+) T-helper-1 (TH1) responses. CD4(+) TH1 cells and antibodies spontaneously occurring in patients with IDH1(R132H)-mutated gliomas specifically recognize IDH1(R132H). Peptide vaccination of mice devoid of mouse MHC and transgenic for human MHC class I and II with IDH1(R132H) p123-142 results in an effective MHC class II-restricted mutation-specific antitumour immune response and control of pre-established syngeneic IDH1(R132H)-expressing tumours in a CD4(+) T-cell-dependent manner. As IDH1(R132H) is present in all tumour cells of these slow-growing gliomas, a mutation-specific anti-IDH1(R132H) vaccine may represent a viable novel therapeutic strategy for IDH1(R132H)-mutated tumours.

Adverse events in vaccinations for travelers - a 1-year prospective survey in a travel clinic in Germany.

PubMed

Slesak, Günther; Fleck, Ralf; Scherbaum, Helmut; Blumenstock, Gunnar; Schäfer, Johannes

2018-01-01

The study goal was to assess and compare adverse events (AE) of current vaccinations for travelers under 'real-life conditions'. A prospective observational online questionnaire study was performed from May 2015 till April 2016 in a travel clinic in Germany. Online questionnaire links were sent 1 week after the first vaccination date. Severity was rated on a scale from 1 to 5 (minor to very severe AE). Of 1357 vaccinees 781 (57.6%) responded to the questionnaire, corresponding to 1415 vaccinations (1-7 simultaneous vaccinations). Responders were more often female (f:m = 1.29:1). Main age groups were 20-29 years old (36.1%). Most frequent vaccinations were against rabies (277; chick embryo cell vaccine (CEC): 97, human diploid cell vaccine (HDC): 180), yellow fever (250), typhoid fever (198), meningococcal meningitis (126) and Japanese encephalitis (104). A total of 217 vaccinees (27.8%) reported AE; 82 (10.5%) rated AE as more severe (grade 3: 61, grade 4: 18, grade 5: 3). No life-threatening AE was reported. Of 157 systemic AE the most frequent were: fatigue (75), headaches (46) and pyrexia (31). Of 94 local AE most frequently reported were pain (66), myalgia (25) and swelling (12). AE after single vaccinations were more often associated with rabies vaccine (OR 2.2; 1.2-4.2). AE increased with the number of simultaneous vaccinations (single vaccination: 24.1%, 88/365; 2 vaccinations: 26.6%, 73/274, ≥3 vaccinations: 39.4%, 56/142, χ2 = 12.24, P = 0.002, CCorr = 0.18), but more severe AE showed no association with the number of vaccinations (χ2 = 5.55, P = 0.06, CCorr = 0.12). Single and simultaneous vaccinations were overall well tolerated. AE were reported more frequently with rabies vaccinations in single vaccinations. Increased numbers of simultaneous vaccinations led to some incremental AE but not to more severe AE. Simultaneous vaccinations should be encouraged to reduce missed opportunities for immunizations.

Prompting methods affect the accuracy of children's school lunch recalls.

PubMed

Baxter, S D; Thompson, W O; Davis, H C

2000-08-01

To evaluate the feasibility of implementing 3 specific prompting methods among students in the first and fourth grades (mean age = 7.2 and 10.1 years, respectively), to validate recall accuracy of first- and fourth-grade students against observation, to develop a single measure of inaccuracy that cumulated errors in reporting food items and amounts without allowing underreporting and overreporting to cancel each other, and to establish information regarding the measure of inaccuracy for use in future studies. Children were interviewed the morning after they were observed eating lunch provided by the school. Interviews included free recall, nonsuggestive prompted recall, and specific prompted recall (either preference, food category, or visual). Ninety-six children (48 students per grade) were studied--32 per the specific prompting method--stratified by grade, sex, and ethnicity (African-American or white). Specific prompting method was randomly assigned to children within strata. Food items were categorized and weighted as: combination entree = 2, condiments = 1/3, and other = 1. To calculate inaccuracy of recall, absolute differences between amounts reported and observed eaten were calculated for each item and then multiplied by each item's weight; these values were then summed across all items for each child. Inaccuracy of recall was determined before specific prompting and after specific prompting and for the difference (inaccuracy after specific prompting minus inaccuracy before specific prompting). Before specific prompting, median inaccuracy was 2.7 servings for the 48 first-grade students and 1.7 servings for the 48 fourth-grade students. The median difference in inaccuracy from before to after specific prompting was 0 for both grades. Specific prompting increased recall accuracy for 9 first-graders and 12 fourth-graders, but decreased recall accuracy for 21 first-graders and 7 fourth-graders, and did not change recall accuracy for 18 first-graders and 29 fourth-graders. Among children whose recall accuracy increased after specific prompting, 5 first-graders and 8 fourth-graders received prompting for food category. Among first-grade students, specific prompting (either preference, food category, or visual) may hurt more than help recall accuracy. Among fourth-grade students, prompting for food category yields small gains in recall accuracy with minimal losses. Validation studies are needed with larger sample sizes to determine prompting methods that produce more accurate dietary recalls from children of various socioeconomic status groups, other racial/ethnic groups, and at other meals.

[The MMPI-2 test in the evaluation of the mobbing syndrome].

PubMed

Pappone, P; Santalucia, L; Del Castello, E; De Maino, V; Garofalo, E; Cappelluccio, R; Feola, D; Ruberto, M; Liotti, F

2007-01-01

MMPI-2 test is widely used in psychodiagnostic evaluation as well as in the evaluation of psychic pathologies related to psychosocial adversative events in working activities. A more efficacious use of MMPI-2 test in the working context can be achieved by the individuation of indexes able to facilitate the evaluation of mobbing syndrome. This work is based on the analysis of 150 cases (39.7% women and 60.7% men, 30 to 60 years of age), evaluated through an accurate examination of working history and a series of clinic conversations, followed by psychodiagnostic evaluation. The average of T-scores on the clinical scale, the content scale, the PK addition scale and the validation scale were calculated from tests. Pathologic high T-scores on the scales Hs, D. Hy e Pa were found in subjects having positive mobbing anamnesis. These results strongly indicate the presence of clinical specificities in workers exposed to working harassments, and that these specificities can be efficaciously evidenced by the MMPI-2 test.

Cognitive correlates of anxious and depressive symptomatology: an examination of the Helplessness/Hopelessness model.

PubMed

Waikar, S V; Craske, M G

1997-01-01

Expectancies about future life events were assessed in anxious and depressed patients to test predictions of the Helplessness/Hopelessness model of anxiety and depression (Alloy, Kelly, Mineka, & Clements, 1990). In addition to expectancies for future events, patients from affective and anxiety treatment clinics completed anxiety and depression symptom ratings and positive and negative affects scales. Findings revealed partial support for the model. Negative outcome and helplessness expectancies were related specifically to depression. Cognitions regarding future positive events were interrelated and associated with symptom measures more strongly than were cognitions regarding negative events. Additionally, positive affects was more strongly related to depression than to anxiety symptom ratings. Implications and limitations of these findings are discussed.

Extreme risk assessment based on normalized historic loss data

NASA Astrophysics Data System (ADS)

Eichner, Jan

2017-04-01

Natural hazard risk assessment and risk management focuses on the expected loss magnitudes of rare and extreme events. Such large-scale loss events typically comprise all aspects of compound events and accumulate losses from multiple sectors (including knock-on effects). Utilizing Munich Re's NatCatSERVICE direct economic loss data, we beriefly recap a novel methodology of peril-specific loss data normalization which improves the stationarity properties of highly non-stationary historic loss data (due to socio-economic growth of assets prone to destructive forces), and perform extreme value analysis (peaks-over-threshold method) to come up with return level estimates of e.g. 100-yr loss event scenarios for various types of perils, globally or per continent, and discuss uncertainty in the results.

Population-based HPV vaccination programmes are safe and effective: 2017 update and the impetus for achieving better global coverage.

PubMed

Brotherton, Julia M L; Bloem, Paul N

2018-02-01

Persistent oncogenic human papillomavirus (HPV) is the cause of cervical cancer, as well as cancers of the anus, penis, vulva, vagina and oropharynx. There is good evidence that prophylactic HPV vaccines are immunogenic and effective against targeted-type HPV infections and type-specific genital lesions, including high-grade cervical intraepithelial neoplasia (CIN), when administered prior to HPV infection. There is good evidence that HPV vaccines are safe in population usage, with the most frequent adverse event being injection-site reactions. There is evidence to support some cross-protection against non-targeted types occurring following the administration of HPV vaccines. There is limited evidence suggesting that HPV vaccines may be beneficial in preventing future disease in women treated for high-grade CIN. This chapter focuses on the accumulated evidence regarding the global use of the three licensed HPV vaccines including safety, immunogenicity, duration of protection, effectiveness, coverage to date and barriers to higher coverage. Copyright © 2018 Elsevier Ltd. All rights reserved.

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

Ahlawat, Stuti; Haffty, Bruce G.; Goyal, Sharad

Purpose: Conventionally fractionated whole-breast irradiation (WBI) with a boost takes approximately 6 to 7 weeks. We evaluated a short course of hypofractionated (HF), accelerated WBI in which therapy was completed in 3 weeks inclusive of a sequential boost. Methods and Materials: We delivered a whole-breast dose of 36.63 Gy in 11 fractions of 3.33 Gy over 11 days, followed by a lumpectomy bed boost in 4 fractions of 3.33 Gy delivered once daily for a total of 15 treatment days. Acute toxicities were scored using Common Terminology Criteria for Adverse Events version 4. Late toxicities were scored using the Radiation Therapy Oncology Group/European Organization for Researchmore » and Treatment of Cancer scale. Cosmesis was scored using the Harvard Cosmesis Scale. Our primary endpoint was freedom from locoregional failure; we incorporated early stopping criteria based on predefined toxicity thresholds. Cosmesis was examined as a secondary endpoint. Results: We enrolled 83 women with stages 0 to IIIa breast cancer. After a median follow-up of 40 months, 2 cases of isolated ipsilateral breast tumor recurrence occurred (2 of 83; crude rate, 2.4%). Three-year estimated local recurrence-free survival was 95.9% (95% confidence interval [CI]: 87.8%-98.7%). The 3-year estimated distant recurrence-free survival was 97.3% (95% CI: 89.8%-99.3%). Three-year secondary malignancy-free survival was 94.3% (95% CI: 85.3%-97.8%). Twenty-nine patients (34%) had grade 2 acute toxicity, and 1 patient had a late grade 2 toxicity (fibrosis). One patient had acute grade 3 dermatitis, whereas 2 patients experienced grade 3 late skin toxicity. Ninety-four percent of evaluable patients had good or excellent cosmesis. Conclusions: Our phase 2 institutional study offers one of the shortest courses of HF therapy, delivered in 15 fractions inclusive of a sequential boost. We demonstrated expected low toxicity and high local control rates with good to excellent cosmetic outcomes. This fractionation scheme is feasible and well tolerated and offers women WBI in a highly convenient schedule.« less

Short-Course Hypofractionated Radiation Therapy With Boost in Women With Stages 0 to IIIa Breast Cancer: A Phase 2 Trial.

PubMed

Ahlawat, Stuti; Haffty, Bruce G; Goyal, Sharad; Kearney, Thomas; Kirstein, Laurie; Chen, Chunxia; Moore, Dirk F; Khan, Atif J

2016-01-01

Conventionally fractionated whole-breast irradiation (WBI) with a boost takes approximately 6 to 7 weeks. We evaluated a short course of hypofractionated (HF), accelerated WBI in which therapy was completed in 3 weeks inclusive of a sequential boost. We delivered a whole-breast dose of 36.63 Gy in 11 fractions of 3.33 Gy over 11 days, followed by a lumpectomy bed boost in 4 fractions of 3.33 Gy delivered once daily for a total of 15 treatment days. Acute toxicities were scored using Common Terminology Criteria for Adverse Events version 4. Late toxicities were scored using the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer scale. Cosmesis was scored using the Harvard Cosmesis Scale. Our primary endpoint was freedom from locoregional failure; we incorporated early stopping criteria based on predefined toxicity thresholds. Cosmesis was examined as a secondary endpoint. We enrolled 83 women with stages 0 to IIIa breast cancer. After a median follow-up of 40 months, 2 cases of isolated ipsilateral breast tumor recurrence occurred (2 of 83; crude rate, 2.4%). Three-year estimated local recurrence-free survival was 95.9% (95% confidence interval [CI]: 87.8%-98.7%). The 3-year estimated distant recurrence-free survival was 97.3% (95% CI: 89.8%-99.3%). Three-year secondary malignancy-free survival was 94.3% (95% CI: 85.3%-97.8%). Twenty-nine patients (34%) had grade 2 acute toxicity, and 1 patient had a late grade 2 toxicity (fibrosis). One patient had acute grade 3 dermatitis, whereas 2 patients experienced grade 3 late skin toxicity. Ninety-four percent of evaluable patients had good or excellent cosmesis. Our phase 2 institutional study offers one of the shortest courses of HF therapy, delivered in 15 fractions inclusive of a sequential boost. We demonstrated expected low toxicity and high local control rates with good to excellent cosmetic outcomes. This fractionation scheme is feasible and well tolerated and offers women WBI in a highly convenient schedule. Copyright © 2016 Elsevier Inc. All rights reserved.

Resolving Conflicts. Lawyers Helping Young People Become Good Citizens.

ERIC Educational Resources Information Center

American Bar Association, Chicago, IL. Special Committee on Youth Education for Citizenship.

Organized around the theme of conflict resolution, this booklet provides teachers and lawyers with classroom materials for elementary grades K-3 (Level A), intermediate grades 4-6 (Level B), middle school grades 6-8 (Level C), and high school grades 9-12 (Level D). In addition, each level contains pages for the lawyer (marked by the scales of…

Pyroclastic density current hazard maps at Campi Flegrei caldera (Italy): the effects of event scale, vent location and time forecasts.

NASA Astrophysics Data System (ADS)

Bevilacqua, Andrea; Neri, Augusto; Esposti Ongaro, Tomaso; Isaia, Roberto; Flandoli, Franco; Bisson, Marina

2016-04-01

Today hundreds of thousands people live inside the Campi Flegrei caldera (Italy) and in the adjacent part of the city of Naples making a future eruption of such volcano an event with huge consequences. Very high risks are associated with the occurrence of pyroclastic density currents (PDCs). Mapping of background or long-term PDC hazard in the area is a great challenge due to the unknown eruption time, scale and vent location of the next event as well as the complex dynamics of the flow over the caldera topography. This is additionally complicated by the remarkable epistemic uncertainty on the eruptive record, affecting the time of past events, the location of vents as well as the PDCs areal extent estimates. First probability maps of PDC invasion were produced combining a vent-opening probability map, statistical estimates concerning the eruptive scales and a Cox-type temporal model including self-excitement effects, based on the eruptive record of the last 15 kyr. Maps were produced by using a Monte Carlo approach and adopting a simplified inundation model based on the "box model" integral approximation tested with 2D transient numerical simulations of flow dynamics. In this presentation we illustrate the independent effects of eruption scale, vent location and time of forecast of the next event. Specific focus was given to the remarkable differences between the eastern and western sectors of the caldera and their effects on the hazard maps. The analysis allowed to identify areas with elevated probabilities of flow invasion as a function of the diverse assumptions made. With the quantification of some sources of uncertainty in relation to the system, we were also able to provide mean and percentile maps of PDC hazard levels.

Utility and work productivity data for economic evaluation of breast cancer therapies in the Netherlands and Sweden.

PubMed

Frederix, Gerardus W J; Quadri, Nuz; Hövels, Anke M; van de Wetering, Fleur T; Tamminga, Hans; Schellens, Jan H M; Lloyd, Andrew J

2013-04-01

This study aimed to estimate utility values in laypeople and productivity loss for women with breast cancer in Sweden and the Netherlands. To capture utilities, validated health state vignettes were used, which were translated into Dutch and Swedish. They described progressive disease, stable disease, and 7 grade 3/4 adverse events. One hundred members of the general public in each country rated the states using the visual analog scale and time trade-off method. To assess productivity, women who had recently completed or were currently receiving treatment for early or advanced breast cancer (the Netherlands, n = 161; Sweden, n = 52) completed the Work Productivity and Activity Impairment-General Health (WPAI-GH) questionnaire. Data were analyzed using means (SD). The utility study showed that the Swedish sample rated progressive and stable disease (mean, 0.61 [0.07] and 0.81 [0.05], respectively) higher than did the Dutch sample (0.49 [0.06] and 0.69 [0.05]). The health states incorporating the toxicities in both countries produced similar mean scores. Results of the WPAI-GH showed that those currently receiving treatment reported productivity reductions of 69% (the Netherlands) and 72% (Sweden); those who had recently completed therapy reported reductions of 41% (the Netherlands) and 40% (Sweden). The differences in the utility scores between the 2 countries underline the importance of capturing country-specific values. The significant impact of adverse events on health-related quality of life was also highlighted. The WPAI-GH results demonstrated how the negative impact of breast cancer on productivity persists after women have completed their treatment. Copyright © 2013 Elsevier HS Journals, Inc. All rights reserved.

Continental-Scale Estimates of Runoff Using Future Climate ...

EPA Pesticide Factsheets

Recent runoff events have had serious repercussions to both natural ecosystems and human infrastructure. Understanding how shifts in storm event intensities are expected to change runoff responses are valuable for local, regional, and landscape planning. To address this challenge, relative changes in runoff using predicted future climate conditions were estimated over different biophysical areas for the CONterminous U.S. (CONUS). Runoff was estimated using the Curve Number (CN) developed by the USDA Soil Conservation Service (USDA, 1986). A seamless gridded dataset representing a CN for existing land use/land cover (LULC) across the CONUS was used along with two different storm event grids created specifically for this effort. The two storm event grids represent a 2- and a 100-year, 24-hour storm event under current climate conditions. The storm event grids were generated using a compilation of county-scale Texas USGS Intensity-Duration-Frequency (IDF) data (provided by William Asquith, USGS, Lubbock, Texas), and NOAA Atlas-2 and NOAA Atlas-14 gridded data sets. Future CN runoff was predicted using extreme storm events grids created using a method based on Kao and Ganguly (2011) where precipitation extremes reflect changes in saturated water vapor pressure of the atmosphere in response to temperature changes. The Clausius-Clapeyron relationship establishes that the total water vapor mass of fully saturated air increases with increasing temperature, leading to

Developmental Change in the Influence of Domain-General Abilities and Domain-Specific Knowledge on Mathematics Achievement: An Eight-Year Longitudinal Study

ERIC Educational Resources Information Center

Geary, David C.; Nicholas, Alan; Li, Yaoran; Sun, Jianguo

2017-01-01

The contributions of domain-general abilities and domain-specific knowledge to subsequent mathematics achievement were longitudinally assessed (n = 167) through 8th grade. First grade intelligence and working memory and prior grade reading achievement indexed domain-general effects, and domain-specific effects were indexed by prior grade…

The Predictive Validity of Four Intelligence Tests for School Grades: A Small Sample Longitudinal Study

PubMed Central

Gygi, Jasmin T.; Hagmann-von Arx, Priska; Schweizer, Florine; Grob, Alexander

2017-01-01

Intelligence is considered the strongest single predictor of scholastic achievement. However, little is known regarding the predictive validity of well-established intelligence tests for school grades. We analyzed the predictive validity of four widely used intelligence tests in German-speaking countries: The Intelligence and Development Scales (IDS), the Reynolds Intellectual Assessment Scales (RIAS), the Snijders-Oomen Nonverbal Intelligence Test (SON-R 6-40), and the Wechsler Intelligence Scale for Children (WISC-IV), which were individually administered to 103 children (Mage = 9.17 years) enrolled in regular school. School grades were collected longitudinally after 3 years (averaged school grades, mathematics, and language) and were available for 54 children (Mage = 11.77 years). All four tests significantly predicted averaged school grades. Furthermore, the IDS and the RIAS predicted both mathematics and language, while the SON-R 6-40 predicted mathematics. The WISC-IV showed no significant association with longitudinal scholastic achievement when mathematics and language were analyzed separately. The results revealed the predictive validity of currently used intelligence tests for longitudinal scholastic achievement in German-speaking countries and support their use in psychological practice, in particular for predicting averaged school grades. However, this conclusion has to be considered as preliminary due to the small sample of children observed. PMID:28348543

Duodenal Toxicity After Fractionated Chemoradiation for Unresectable Pancreatic Cancer

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

Kelly, Patrick; Das, Prajnan; Pinnix, Chelsea C.

2013-03-01

Purpose: Improving local control is critical to improving survival and quality of life for patients with locally advanced unresectable pancreatic cancer (LAPC). However, previous attempts at radiation dose escalation have been limited by duodenal toxicity. In order to guide future studies, we analyzed the clinical and dosimetric factors associated with duodenal toxicity in patients undergoing fractionated chemoradiation for LAPC. Methods and Materials: Medical records and treatment plans of 106 patients with LAPC who were treated with chemoradiation between July 2005 and June 2010 at our institution were reviewed. All patients received neoadjuvant and concurrent chemotherapy. Seventy-eight patients were treated withmore » conventional radiation to 50.4 Gy in 28 fractions; 28 patients received dose-escalated radiation therapy (range, 57.5-75.4 Gy in 28-39 fractions). Treatment-related toxicity was graded according to Common Terminology Criteria for Adverse Events, version 4.0. Univariate and multivariate analyses were performed to assess prognostic influence of clinical, pathologic, and treatment-related factors by using Kaplan-Meier and Cox regression methods. Results: Twenty patients had treatment-related duodenal toxicity events, such as duodenal inflammation, ulceration, and bleeding. Four patients had grade 1 events, 8 had grade 2, 6 had grade 3, 1 had grade 4, and 1 had grade 5. On univariate analysis, a toxicity grade ≥2 was associated with tumor location, low platelet count, an absolute volume (cm{sup 3}) receiving a dose of at least 55 Gy (V{sub 55} {sub Gy} > 1 cm{sup 3}), and a maximum point dose >60 Gy. Of these factors, only V{sub 55} {sub Gy} ≥1 cm{sup 3} was associated with duodenal toxicity on multivariate analysis (hazard ratio, 6.7; range, 2.0-18.8; P=.002). Conclusions: This study demonstrates that a duodenal V{sub 55} {sub Gy} >1 cm{sup 3} is an important dosimetric predictor of grade 2 or greater duodenal toxicity and establishes it as a dosimetric constraint when treating patients with unresectable pancreatic cancer with concurrent chemoradiation.« less

Assessing team effectiveness and affective learning in a datathon.

PubMed

Piza, Felipe Maia de Toledo; Celi, Leo Anthony; Deliberato, Rodrigo Octavio; Bulgarelli, Lucas; de Carvalho, Fabricio Rodrigues Torres; Filho, Roberto Rabello; de La Hoz, Miguel Angel Armengol; Kesselheim, Jennifer Cohn

2018-04-01

Datathons are increasingly organized in the healthcare field. The goal is to assemble people with different backgrounds to work together as a team and engage in clinically relevant research or develop algorithms using health-related datasets. Criteria to assess the return of investment on such events have traditionally included publications produced, patents for prediction, classification, image recognition and other types of software, and start-up companies around the application of machine learning in healthcare. Previous studies have not evaluated whether a datathon can promote affective learning and effective teamwork. Fifty participants of a health datathon event in São Paulo, Brazil at Hospital Israelita Albert Einstein (HIAE) were divided into 8 groups. A survey with 25 questions, using the Affective Learning Scale and Team-Review Questionnaire, was administered to assess team effectiveness and affective learning during the event. Multivariate regression models and Pearson's correlation tests were performed to evaluate the effect of affective learning on teamwork. Majority of the participants were male 76% (37/49); 32% (16/49) were physicians. The mean score for learning (scale from 1 to 10) was 8.38, while that for relevance of the perceived teamwork was 1.20 (scale from 1 to 5; "1" means most relevant). Pearson's correlation between the learning score and perception of teamwork showed moderate association (r = 0.36, p = 0.009). Five learning and 10 teamwork variables were on average positively graded in the event. The final regression model includes all learning and teamwork variables. Effective leadership was strongly correlated with affective learning (β = -0.27, p < 0.01, R 2  = 75%). Effective leadership, team accomplishment, criticism, individual development and creativity were the variables significantly associated with higher levels of affective learning. It is feasible to enhance affective knowledge and the skill to work in a team during a datathon. We found that teamwork is associated with higher affective learning from participants' perspectives. Effective leadership is essential for teamwork and is a significant predictor of learning. Copyright © 2018 Elsevier B.V. All rights reserved.

Safety of Abiraterone Acetate in Castration-resistant Prostate Cancer Patients With Concomitant Cardiovascular Risk Factors.

PubMed

Procopio, Giuseppe; Grassi, Paolo; Testa, Isabella; Verzoni, Elena; Torri, Valter; Salvioni, Roberto; Valdagni, Riccardo; de Braud, Filippo

2015-10-01

The aim of this study was to evaluate the safety profile of abiraterone acetate (AA) in metastatic castration-resistant prostate cancer (mCRPC) men with cardiovascular comorbidity, as little conclusive safety data are available in this patient subset. A retrospective analysis of mCRPC patients with controlled cardiovascular comorbidities, receiving AA 1000 mg administered orally once daily and prednisone 5 mg twice daily, between April 2011 and July 2012, was performed. All clinical and instrumental variables and toxicity data were analyzed by descriptive statistics: mean, standard deviation, minimum and maximum values for continuous variables, and absolute and relative frequencies for categorical variables. A total of 51 mCRPC patients were evaluated. Metastatic sites included the bone (74%), lungs, and liver (26%). All patients were previously treated with at least 2 lines of hormone and 1 docetaxel-based chemotherapy. Preexisting cardiac risk factors included hypertension (41%), cardiac ischemia (12%), arrhythmias (6%), dislipidemia (18%), and hyperglycemia (30%). No grade 3-4 adverse events were observed. Grade 1-2 adverse events included fluid retention (18%), asthenia (15%), and hypertension (16%). Median progression-free survival was 5.1 months (95% confidence interval, 0.5-12). Prostate specific antigen assessment revealed a good overall disease control rate (64%). AA appears to be safe and well tolerated even in patients with cardiovascular comorbidities or with increased risk factors for cardiovascular diseases.

Psychometric Properties of the Chinese Version of the Social Responsiveness Scale

ERIC Educational Resources Information Center

Gau, Susan Shur-Fen; Liu, Li-Ting; Wu, Yu-Yu; Chiu, Yen-Nan; Tsai, Wen-Che

2013-01-01

This study evaluated the psychometric properties of the Chinese version of the Social Responsiveness Scale (Chinese SRS). We assessed 1419 grade 1 to grade 8 students from northern Taiwan and 401 clinic-based participants (aged 3-20, male 90.3%). All clinic-based participants were clinically diagnosed with autism spectrum disorders (ASDs),…

Metaphors for Understanding Graphs: What You See Is What You See.

ERIC Educational Resources Information Center

Goldenberg, E. Paul; Kliman, Marlene

Computer graphing makes it easier for students and teachers to create and manipulate graphs. Scale issues are nearly unavoidable in the computer context. In interviews and protocol analysis with six students from grade 8, and 12 students from grades 11 and 12, it became apparent that some aspects of scale are clearly understood very early while…

A Small-Scale, Feasibility Study of Academic Language Time in Primary Grade Language Arts

ERIC Educational Resources Information Center

Roskos, Kathleen A.; Zuzolo, Nicole; Primm, Ashley

2017-01-01

A small-scale feasibility study was conducted to explore the implementation of academic language time (ALT) in primary grade classrooms with and without access to digital devices. Academic language time is a structural change that dedicates a portion of language arts instructional time to direct vocabulary instruction using evidence-based…

High School Students' Critical Thinking Related to Their Metacognitive Self-Regulation and Physics Self-Efficacy Beliefs

ERIC Educational Resources Information Center

Gurcay, Deniz; Ferah, Hatice Ozturk

2018-01-01

The purpose of this study is to examine the relationships between ninth grade students' metacognitive self-regulation skills and physics self-efficacy beliefs and their critical thinking. To this end, 162 students attending the ninth grade participated in the study. Critical thinking scale, metacognitive self-regulation scale and physics…

The Effect of Grade Norms in College Students: Using the Woodcock-Johnson III Tests of Achievement

ERIC Educational Resources Information Center

Cressman, Markus N.; Liljequist, Laura

2014-01-01

The "Woodcock-Johnson III" Tests of Achievement grade norms versus age norms were examined in the calculation of discrepancy scores in 202 college students. Difference scores were calculated between the "Wechsler Adult Intelligence Scale-3rd Edition" Full Scale IQ and the "Woodcock-Johnson III" Total Achievement,…

Adaptation and validation of the Spanish version of the graded chronic pain scale.

PubMed

Ferrer-Peña, Raúl; Gil-Martínez, Alfonso; Pardo-Montero, Joaquín; Jiménez-Penick, Virginia; Gallego-Izquierdo, Tomás; La Touche, Roy

2016-01-01

To adapt the Graded Chronic Pain Scale for use in Primary care patients in Spain, and to assess its psychometric properties. Clinical measures observational study investigating the severity of chronic pain. The methodology included a process of translation and back-translation following the international guidelines. Study participants were 75 patients who experienced lower back pain for more than six months and were sent to Primary Care physiotherapy units. Internal consistency, construct validity, test-retest reliability, floor and ceiling effects, and answering capacity were analysed. The Spanish version of the Graded Chronic Pain Scale had a high internal consistency, with a Cronbach's alpha of 0.87 and intraclass correlation coefficient of 0.81. Regarding construct validity, it was identified that two factors explained 72.37% of the variance. Convergent validity showed a moderate positive correlation with the Visual Analogue Scale, the activity avoidance subscale of the Tampa Scale of Kinesophobia, the Pain Catastrophizing Scale, the Roland-Morris Low Back Pain and Disability Questionnaire, and the FearAvoidance Beliefs Questionnaire. A moderate negative correlation was identified with the Chronic Pain Self-Efficacy Scale. The mean time of questionnaire administration was 2minutes and 28seconds. The Spanish version of the Graded Chronic Pain Scale appears to be a valid, reliable, and useful tool for measuring chronic pain at an early stage in Primary Care settings in Spain. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

Price projections for selected grades of Douglas-fir lumber.

Treesearch

Richard W. Haynes; Thomas D. Fahey; Roger D. Fight

1988-01-01

Grade-specific price projections were developed for Douglas-fir lumber produced in the Douglas-fir region. These grade-specific price projections can be used as an aid in evaluating management practices that will affect the quality of saw logs that are produced.

Platelet-Rich Plasma with Basic Fibroblast Growth Factor for Treatment of Wrinkles and Depressed Areas of the Skin.

PubMed

Kamakura, Tatsuro; Kataoka, Jiro; Maeda, Kazuhiko; Teramachi, Hideaki; Mihara, Hisayuki; Miyata, Kazuhiro; Ooi, Kouichi; Sasaki, Naomi; Kobayashi, Miyuki; Ito, Kouhei

2015-11-01

There are several treatments for wrinkles and depressed areas of the face, hands, and body. Hyaluronic acid is effective, but only for 6 months to 1 year. Autologous fat grafting may cause damage during tissue harvest. In this study, patients were injected with platelet-rich plasma plus basic fibroblast growth factor (bFGF). Platelet-rich plasma was prepared by collecting blood and extracting platelets using double centrifugation. Basic fibroblast growth factor diluted with normal saline was added to platelet-rich plasma. There were 2005 patients who received platelet-rich plasma plus bFGF therapy. Of the 2005 patients treated, 1889 were female and 116 were male patients; patients had a mean age of 48.2 years. Treated areas inlcuded 1461 nasolabial folds, 437 marionette lines, 1413 nasojugal grooves, 148 supraorbital grooves, 253 midcheek grooves, 304 foreheads, 49 temples, and 282 glabellae. Results on the Global Aesthetic Improvement Scale indicated that the level of patient satisfaction was 97.3 percent and the level of investigator satisfaction was 98.4 percent. The period for the therapy's effectiveness to become apparent was an average of 65.4 days. Platelet-rich plasma plus bFGF therapy resulted in an improved grade on the Wrinkle Severity Rating Scale. Improvement was 0.55 for a Wrinkle Severity Rating Scale grade of 2, 1.13 for a Wrinkle Severity Rating Scale grade of 3, 1.82 for a Wrinkle Severity Rating Scale grade of 4, and 2.23 for a Wrinkle Severity Rating Scale grade of 5. Platelet-rich plasma plus bFGF is effective in treating wrinkles and depressed areas of the skin of the face and body. The study revealed that platelet-rich plasma plus bFGF is an innovative therapy that causes minimal complications. Therapeutic, IV.

Geological evolution of the late Proterozoic ``Mozambique Belt'' of Kenya

NASA Astrophysics Data System (ADS)

Mosley, P. N.

1993-05-01

Within the "Mozambique Belt" of Kenya at least four distinct tectonothermal episodes are recognised on Rb-Sr isotopics. The dates are in broad agreement with those from surrounding countries; principal ages/age ranges being 830 - 800, ~ 760, 630 - 580 and 560 - 520 Ma. All except the last attained at least upper amphibolite/granulite grade (with local melts). The first event was responsible for the primary transformation of an essentially sedimentary sequence to paragneisses with an initial near-horizontal fabric parallel to the compositional layering. Associated with the later part of the first phase, and linked to the second, is the emplacement of allochthonous ophiolitic and volcanosedimentary "packages", coupled with thrusting and imbrication of the paragneiss groups. The subsequent phases record progressive shortening across the orogenic belt during collision between two major continental fragments (east and west Gondwana), involving extensive structural reorganisation and isotopic resetting. During the progressive 630 - 580 Ma event, regional N-S- to NNW-SSE-trending ductile shear zones (generally sinistral) were produced giving the dominant regional fabric (including a regional N-S-stretching lineation), and controlling the present gross distribution of gneiss groups. Cooling and uplift post a ~ 560 Ma thermal event has exposed high-grade gneisses with a distinct structural and metamorphic asymmetry across the orogen. The western part of the orogen shows clockwise P- T- t paths and involves overthrusting of, and imbrication with, the Tanzanian craton which probably obscures older (1900 and 1100 Ma) tectonothermal episodes. In contrast, the eastern part has anti-clockwise P- T- t paths, is characterised by extensive crustal melts, and retains the isotopic imprint of earlier Proterozoic events. The present level of uplift exposes tectonised high-grade gneisses of more than one age. Current evidence supports the suggestion that low-grade ophiolitic/volcanosedimentary sequences are allochthonous and structurally emplaced over the higher-grade gneisses.

NH4+ ad-/desorption in sequencing batch reactors: simulation, laboratory and full-scale studies.

PubMed

Schwitalla, P; Mennerich, A; Austermann-Haun, U; Müller, A; Dorninger, C; Daims, H; Holm, N C; Rönner-Holm, S G E

2008-01-01

Significant NH4-N balance deficits were found during the measurement campaigns for the data collection for dynamic simulation studies at five full-scale sequencing batch reactor (SBR) waste water treatment plants (WWTPs), as well as during subsequent calibrations at the investigated plants. Subsequent lab scale investigations showed high evidence for dynamic, cycle-specific NH4+ ad-/desorption to the activated flocs as one reason for this balance deficit. This specific dynamic was investigated at five full-scale SBR plants for the search of the general causing mechanisms. The general mechanism found was a NH4+ desorption from the activated flocs at the end of the nitrification phase with subsequent nitrification and a chemical NH4+ adsorption at the flocs in the course of the filling phases. This NH4+ ad-/desorption corresponds to an antiparallel K+ ad/-desorption.One reasonable full-scale application was investigated at three SBR plants, a controlled filling phase at the beginning of the sedimentation phase. The results indicate that this kind of filling event must be specifically hydraulic controlled and optimised in order to prevent too high waste water break through into the clear water phase, which will subsequently be discarded. IWA Publishing 2008.

[Correspondence analysis between traditional commercial specifications and quantitative quality indices of Notopterygii Rhizoma et Radix].

PubMed

Jiang, Shun-Yuan; Sun, Hong-Bing; Sun, Hui; Ma, Yu-Ying; Chen, Hong-Yu; Zhu, Wen-Tao; Zhou, Yi

2016-03-01

This paper aims to explore a comprehensive assessment method combined traditional Chinese medicinal material specifications with quantitative quality indicators. Seventy-six samples of Notopterygii Rhizoma et Radix were collected on market and at producing areas. Traditional commercial specifications were described and assigned, and 10 chemical components and volatile oils were determined for each sample. Cluster analysis, Fisher discriminant analysis and correspondence analysis were used to establish the relationship between the traditional qualitative commercial specifications and quantitative chemical indices for comprehensive evaluating quality of medicinal materials, and quantitative classification of commercial grade and quality grade. A herb quality index (HQI) including traditional commercial specifications and chemical components for quantitative grade classification were established, and corresponding discriminant function were figured out for precise determination of quality grade and sub-grade of Notopterygii Rhizoma et Radix. The result showed that notopterol, isoimperatorin and volatile oil were the major components for determination of chemical quality, and their dividing values were specified for every grade and sub-grade of the commercial materials of Notopterygii Rhizoma et Radix. According to the result, essential relationship between traditional medicinal indicators, qualitative commercial specifications, and quantitative chemical composition indicators can be examined by K-mean cluster, Fisher discriminant analysis and correspondence analysis, which provide a new method for comprehensive quantitative evaluation of traditional Chinese medicine quality integrated traditional commodity specifications and quantitative modern chemical index. Copyright© by the Chinese Pharmaceutical Association.

7 CFR 58.434 - Calcium chloride.

Code of Federal Regulations, 2013 CFR

2013-01-01

..., GENERAL SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Quality Specifications for Raw... Chemical Codex. ...

7 CFR 58.434 - Calcium chloride.

Code of Federal Regulations, 2014 CFR

2014-01-01

..., GENERAL SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Quality Specifications for Raw... Chemical Codex. ...

7 CFR 58.434 - Calcium chloride.

Code of Federal Regulations, 2012 CFR

2012-01-01

..., GENERAL SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Quality Specifications for Raw... Chemical Codex. ...

Clonal origins and parallel evolution of regionally synchronous colorectal adenoma and carcinoma.

PubMed

Kim, Tae-Min; An, Chang Hyeok; Rhee, Je-Keun; Jung, Seung-Hyun; Lee, Sung Hak; Baek, In-Pyo; Kim, Min Sung; Lee, Sug Hyung; Chung, Yeun-Jun

2015-09-29

Although the colorectal adenoma-to-carcinoma sequence represents a classical cancer progression model, the evolution of the mutational landscape underlying this model is not fully understood. In this study, we analyzed eight synchronous pairs of colorectal high-grade adenomas and carcinomas, four microsatellite-unstable (MSU) and four-stable (MSS) pairs, using whole-exome sequencing. In the MSU adenoma-carcinoma pairs, we observed no subclonal mutations in adenomas that became fixed in paired carcinomas, suggesting a 'parallel' evolution of synchronous adenoma-to-carcinoma, rather than a 'stepwise' evolution. The abundance of indel (in MSU and MSS pairs) and microsatellite instability (in MSU pairs) was noted in the later adenoma- or carcinoma-specific mutations, indicating that the mutational processes and functional constraints operative in early and late colorectal carcinogenesis are different. All MSU cases exhibited clonal, truncating mutations in ACVR2A, TGFBR2, and DNA mismatch repair genes, but none were present in APC or KRAS. In three MSS pairs, both APC and KRAS mutations were identified as both early and clonal events, often accompanying clonal copy number changes. An MSS case uniquely exhibited clonal ERBB2 amplification, followed by APC and TP53 mutations as carcinoma-specific events. Along with the previously unrecognized clonal origins of synchronous colorectal adenoma-carcinoma pairs, our study revealed that the preferred sequence of mutational events during colorectal carcinogenesis can be context-dependent.

Methods and reproducibility of grading optimized digital color fundus photographs in the Age-Related Eye Disease Study 2 (AREDS2 Report Number 2).

PubMed

Danis, Ronald P; Domalpally, Amitha; Chew, Emily Y; Clemons, Traci E; Armstrong, Jane; SanGiovanni, John Paul; Ferris, Frederick L

2013-07-08

To establish continuity with the grading procedures and outcomes from the historical data of the Age-Related Eye Disease Study (AREDS), color photographic imaging and evaluation procedures for the assessment of age-related macular degeneration (AMD) were modified for digital imaging in the AREDS2. The reproducibility of the grading of index AMD lesion components and for the AREDS severity scale was tested at the AREDS2 reading center. Digital color stereoscopic fundus photographs from 4203 AREDS2 subjects collected at baseline and annual follow-up visits were optimized for tonal balance and graded according to a standard protocol slightly modified from AREDS. The reproducibility of digital grading of AREDS2 images was assessed by reproducibility exercises, temporal drift (regrading a subset of baseline annually, n = 88), and contemporaneous masked regrading (ongoing, monthly regrade on 5% of submissions, n = 1335 eyes). In AREDS2, 91% and 96% of images received replicate grades within two steps of the baseline value on the AREDS severity scale for temporal drift and contemporaneous assessment, respectively (weighted Kappa of 0.73 and 0.76). Historical data for temporal drift in replicate gradings on the AREDS film-based images were 88% within two steps (weighted Kappa = 0.88). There was no difference in AREDS2-AREDS concordance for temporal drift (exact P = 0.57). Digital color grading has nearly the same reproducibility as historical film grading. There is substantial agreement for testing the predictive utility of the AREDS severity scale in AREDS2 as a clinical trial outcome. (ClinicalTrials.gov number, NCT00345176.)

Extreme climatic events drive mammal irruptions: regression analysis of 100-year trends in desert rainfall and temperature

PubMed Central

Greenville, Aaron C; Wardle, Glenda M; Dickman, Chris R

2012-01-01

Extreme climatic events, such as flooding rains, extended decadal droughts and heat waves have been identified increasingly as important regulators of natural populations. Climate models predict that global warming will drive changes in rainfall and increase the frequency and severity of extreme events. Consequently, to anticipate how organisms will respond we need to document how changes in extremes of temperature and rainfall compare to trends in the mean values of these variables and over what spatial scales the patterns are consistent. Using the longest historical weather records available for central Australia – 100 years – and quantile regression methods, we investigate if extreme climate events have changed at similar rates to median events, if annual rainfall has increased in variability, and if the frequency of large rainfall events has increased over this period. Specifically, we compared local (individual weather stations) and regional (Simpson Desert) spatial scales, and quantified trends in median (50th quantile) and extreme weather values (5th, 10th, 90th, and 95th quantiles). We found that median and extreme annual minimum and maximum temperatures have increased at both spatial scales over the past century. Rainfall changes have been inconsistent across the Simpson Desert; individual weather stations showed increases in annual rainfall, increased frequency of large rainfall events or more prolonged droughts, depending on the location. In contrast to our prediction, we found no evidence that intra-annual rainfall had become more variable over time. Using long-term live-trapping records (22 years) of desert small mammals as a case study, we demonstrate that irruptive events are driven by extreme rainfalls (>95th quantile) and that increases in the magnitude and frequency of extreme rainfall events are likely to drive changes in the populations of these species through direct and indirect changes in predation pressure and wildfires. PMID:23170202

Lymphocyte Nadir and Esophageal Cancer Survival Outcomes After Chemoradiation Therapy.

PubMed

Davuluri, Rajayogesh; Jiang, Wen; Fang, Penny; Xu, Cai; Komaki, Ritsuko; Gomez, Daniel R; Welsh, James; Cox, James D; Crane, Christopher H; Hsu, Charles C; Lin, Steven H

2017-09-01

Host immunity may affect the outcome in patients with esophageal cancer. We sought to identify factors that influenced absolute lymphocyte count (ALC) nadir during chemoradiation therapy (CRT) for esophageal cancer (EC) and looked for clinically relevant associations with survival. 504 patients with stage I-III EC (2007-2013) treated with neoadjuvant or definitive CRT with weekly ALC determinations made during treatment were analyzed. Grade of lymphopenia from ALC nadir during CRT was based on Common Terminology Criteria for Adverse Events version 4.0. Associations of ALC nadir with survival were examined using multivariate Cox proportional hazards analysis (MVA) and competing risks regression analysis. The median follow-up time was 36 months. The incidences of grade 1, 2, 3, and 4 ALC nadir during CRT were 2%, 12%, 59%, and 27%, respectively. The impact was lymphocyte-specific because this was not seen for monocyte or neutrophil count. On MVA, grade 4 ALC nadir (G4 nadir) was significantly associated with worse overall and disease-specific survival outcomes. Predictors of G4 nadir included distal tumor location, definitive CRT, taxane/5-fluorouracil chemotherapy, and photon-based radiation type (vs proton-based). Radiation type strongly influenced the mean body dose exposure, which was a strong predictor for G4 nadir (odds ratio 1.22 per Gray, P<.001). G4 nadir during CRT for EC was associated with poor outcomes, suggesting a role of host immunity in disease control. This observation provides a rationale to prospectively test chemotherapeutic and radiation treatment strategies that may have a lower impact on host immunity. Copyright © 2017 Elsevier Inc. All rights reserved.

Guided Writing Lessons: Second-Grade Students' Development of Strategic Behavior

ERIC Educational Resources Information Center

Gibson, Sharan A.

2008-01-01

This study describes intra-individual change in strategic behavior of five second-grade students during three months of guided writing instruction for informational text. Data sources included sequential coding of writing behavior from videotaped writing events and analytic assessment of writing products. Students' development of self-scaffolding…

Study of MGUS, Smoldering Myeloma, Early MDS and CLL to Assess Molecular Events of Progression and Clinical Outcome

ClinicalTrials.gov

2017-08-25

Monoclonal Gammopathy of Undetermined Significance (MGUS); Chronic Lymphocytic Leukemia (CLL); Myelodysplastic-Myeloproliferative Diseases; Hematological Malignancies; B-cell Malignancy, Low-grade; Myelodysplastic Syndrome With Low-grade Lesions; IgG Monoclonal Gammopathy of Uncertain Significance; Smoldering Multiple Myeloma; Waldenstrom Macroglobulinemia

Upregulation of ASCL1 and inhibition of Notch signaling pathway characterize progressive astrocytoma.

PubMed

Somasundaram, Kumaravel; Reddy, Sreekanth P; Vinnakota, Katyayni; Britto, Ramona; Subbarayan, Madhavan; Nambiar, Sandeep; Hebbar, Aparna; Samuel, Cini; Shetty, Mitesh; Sreepathi, Hari Kishore; Santosh, Vani; Hegde, Alangar Sathyaranjandas; Hegde, Sridevi; Kondaiah, Paturu; Rao, M R S

2005-10-27

Astrocytoma is the most common type of brain cancer constituting more than half of all brain tumors. With an aim to identify markers describing astrocytoma progression, we have carried out microarray analysis of astrocytoma samples of different grades using cDNA microarray containing 1152 cancer-specific genes. Data analysis identified several differentially regulated genes between normal brain tissue and astrocytoma as well as between grades II/III astrocytoma and glioblastoma multiforme (GBM; grade IV). We found several genes known to be involved in malignancy including Achaete-scute complex-like 1 (Drosophila) (ASCL1; Hash 1). As ASCL has been implicated in neuroendocrine, medullary thyroid and small-cell lung cancers, we chose to examine the role of ASCL1 in the astrocytoma development. Our data revealed that ASCL1 is overexpressed in progressive astrocytoma as evidenced by increased levels of ASCL1 transcripts in 85.71% (6/7) of grade II diffuse astrocytoma (DA), 90% (9/10) of grade III anaplastic astrocytoma (AA) and 87.5% (7/8) of secondary GBMs, while the majority of primary de novo GBMs expressed similar to or less than normal brain levels (66.67%; 8/12). ASCL1 upregulation in progressive astrocytoma is accompanied by inhibition of Notch signaling as seen by uninduced levels of HES1, a transcriptional target of Notch1, increased levels of HES6, a dominant-negative inhibitor of HES1-mediated repression of ASCL1, and increased levels of Notch ligand Delta1, which is capable of inhibiting Notch signaling by forming intracellular Notch ligand autonomous complexes. Our results imply that inhibition of Notch signaling may be an important early event in the development of grade II DA and subsequent progression to grade III AA and secondary GBM. Furthermore, ASCL1 appears to be a putative marker to distinguish primary GBM from secondary GBM.

Risk of fatigue in cancer patients receiving anti-EGFR monoclonal antibodies: results from a systematic review and meta-analysis of randomized controlled trial.

PubMed

Zhu, Jianhong; Zhao, Wenxia; Liang, Dan; Li, Guocheng; Qiu, Kaifeng; Wu, Junyan; Li, Jianfang

2018-04-01

To evaluate the association between fatigue and anti-epidermal growth factor receptor monoclonal antibodies (anti-EGFR MAbs), we conducted the first meta-analysis to access the incidence and risk of fatigue associated with anti-EGFR MAbs. Electronic databases were searched for randomized controlled trials (RCTs) published up to February 2017. Eligible studies were selected according to PRISMA statement. Incidence rates, risk ratio (RRs), and 95% confidence intervals (CIs) were calculated using fixed-effects or random-effects models. Outcomes of quality were summarized in accordance with the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) methodology. Thirty-five RCTs (including 15,622 patients) were included; median follow-up ranged from 8.1 to 71.4 months, and the fatigue events were recorded and graded according to the Common Toxicity Criteria for Adverse Events version 2.0 or 3.0 in most of the included trials. For patients receiving anti-EGFR MAbs, the overall incidence of all-grade and high-grade fatigue was 54.1% and 10.5%, respectively. Compared with control, anti-EGFR MAbs significantly increased the risk of all-grade fatigue (RR 1.10, 95% CI, 1.05-1.14, moderate-quality evidence) and high-grade fatigue (RR 1.31, 95% CI, 1.19-1.45, moderate-quality evidence). No significant differences among subgroup analyses (anti-EGFR MAbs, tumor type, and median follow-up) on high-grade fatigue were observed. No evidence of publication bias was observed. The present study suggested that anti-EGFR MAbs may increase the risk of fatigue in cancer patients.

Spatial Scaling of Global Rainfall and Flood Extremes

NASA Astrophysics Data System (ADS)

Devineni, Naresh; Lall, Upmanu; Xi, Chen; Ward, Philip

2014-05-01

Floods associated with severe storms are a significant source of risk for property, life and supply chains. These property losses tend to be determined as much by the duration and spatial extent of flooding as by the depth and velocity of inundation. High duration floods are typically induced by persistent rainfall (up to 30 day duration) as seen recently in Thailand, Pakistan, the Ohio and the Mississippi Rivers, France, and Germany. Events related to persistent and recurrent rainfall appear to correspond to the persistence of specific global climate patterns that may be identifiable from global, historical data fields, and also from climate models that project future conditions. In this paper, we investigate the statistical properties of the spatial manifestation of the rainfall exceedances and floods. We present the first ever results on a global analysis of the scaling characteristics of extreme rainfall and flood event duration, volumes and contiguous flooded areas as a result of large scale organization of long duration rainfall events. Results are organized by latitude and with reference to the phases of ENSO, and reveal surprising invariance across latitude. Speculation as to the potential relation to the dynamical factors is presented

Adherence and tolerance as key in brake on weight loss in cancer patients with nutritional risk after intervention with a high calorie nutritional and specific hyperproteic supplement

PubMed

García Almeida, Jose M; Lupiáñez Pérez, Yolanda; Blanco Naveira, Mercedes; Ruiz Nava, Josefina; Medina, José Antonio; Cornejo Pareja, Isabel; Gómez Pérez, Ana; Molina Vega, María; López-Medina, José A; Tinahones Madueño, Francisco

2017-06-05

Background: In patients with nutritional risk, the European Society for Clinical Nutrition and Metabolism (ESPEN) recommends nutritional supplements during cancer treatment to prevent weight loss. Objectives: Our goal is to determine the acceptability, compliance and tolerance of a hyperproteic, high-calorie, omega-3 enriched supplement in cancer patients. Methods: Unicentric, prospective observational study in cancer patients with hyperproteic, high-calorie, rich in omega 3 and low volume nutritional supplement. Thirty patients with malnutrition or risk of malnutrition were included. Supplementation lasted six days. Compliance (packaging used), acceptability (Madrid scale), anthropometric variables and gastrointestinal adverse events (AEs) were evaluated. Results: Seventy per cent were men, with an average age of 60 years (range 32-79), with lung (43.3%), ENT (26.7%) and breast neoplasms (13.3%), stage III-IV (56.7%), and treated with radiotherapy (93.3%), chemotherapy (60%) and surgery (16.7%). The product was accepted by all patients. A compliance rate of 100% was observed. Gastrointestinal AE (grade II) related to the supplement was observed in two patients (6.7%). Both subjects had previous gastrointestinal diseases. The median weight, body mass index (BMI) and protein intake increased during supplementation (0.2 kg, 0.1 kg/m2 and 6.2 g). No differences were observed regarding calorie, fat and carbohydrates intake. Conclusion: The high acceptance and compliance with the specific nutritional supplement was associated with an improved nutritional status for cancer patients, and reversed the weight loss without severe gastrointestinal problems, or producing intake displacement.

Interventional radiology peer, a newly developed peer-review scoring system designed for interventional radiology practice.

PubMed

d'Othée, Bertrand Janne; Haskal, Ziv J

2013-10-01

Existing diagnostic radiology peer-review systems do not address the specificities of interventional radiology (IR) practice. The purpose of this study was to assess the feasibility of a specifically developed interventional peer review method, IR Peer. Retrospective review of a prospectively encoded pilot database aimed at demonstrating the feasibility of IR Peer in a multiphysician practice was performed. This scoring system used morning peer review of selected IR cases from the previous day in the form of a five-item questionnaire and an ordinal answer scale that grades reviewers' agreement with imaging findings, procedural/technical management, early outcomes, and follow-up plan. Patient lists from IR Peer and morbidity and mortality (M&M) conferences were compared to evaluate the amount of overlap and capability of IR Peer to help detect adverse events (AEs). A total of 417 consecutive reviews of IR attending physician cases by peers were performed in 163 consecutive patients over 18 months, and 94% of cases were reviewed by two or three IR attending physicians. Each question was answered 99%-100% of the time. Answers showed disagreement in 10% of cases (2% by a single reviewer, 8% by several), most related to procedural technique. Overall AE incidence was 1.8%. IR Peer contributed 10.7% of cases to the M&M list. IR Peer is feasible, relevant, and easy to implement in a multiphysician IR practice. When used along with other quality-assurance processes, it might help in the detection of AEs for M&M; the latter will require further confirmatory research. © SIR, 2013.

MEMS and FOG Technologies for Tactical and Navigation Grade Inertial Sensors—Recent Improvements and Comparison

PubMed Central

Deppe, Olaf; Dorner, Georg; König, Stefan; Martin, Tim; Voigt, Sven; Zimmermann, Steffen

2017-01-01

In the following paper, we present an industry perspective of inertial sensors for navigation purposes driven by applications and customer needs. Microelectromechanical system (MEMS) inertial sensors have revolutionized consumer, automotive, and industrial applications and they have started to fulfill the high end tactical grade performance requirements of hybrid navigation systems on a series production scale. The Fiber Optic Gyroscope (FOG) technology, on the other hand, is further pushed into the near navigation grade performance region and beyond. Each technology has its special pros and cons making it more or less suitable for specific applications. In our overview paper, we present latest improvements at NG LITEF in tactical and navigation grade MEMS accelerometers, MEMS gyroscopes, and Fiber Optic Gyroscopes, based on our long-term experience in the field. We demonstrate how accelerometer performance has improved by switching from wet etching to deep reactive ion etching (DRIE) technology. For MEMS gyroscopes, we show that better than 1°/h series production devices are within reach, and for FOGs we present how limitations in noise performance were overcome by signal processing. The paper also intends a comparison of the different technologies, emphasizing suitability for different navigation applications, thus providing guidance to system engineers. PMID:28287483

Association between psychopathology and substance use among school-going adolescents in Cape Town, South Africa.

PubMed

Saban, Amina; Flisher, Alan J; Distiller, Greg

2010-12-01

Limited information exists regarding the association between psychopathology and specific substance use in young people both globally and locally. We examined the association between psychopathology and substance use in high school students to determine the nature of the associations and the role of demographic factors in these associations. Grade 8 (N=480) and Grade 11 (N=459) students from 39 high schools in Cape Town, South Africa, completed a self-administered questionnaire. Psychopathology information was obtained from total scores on the Harvard Trauma Questionnaire, Beck Depression Inventory and the Zung Self-Rating Anxiety Scale. Lifetime prevalence rates were calculated for tobacco, alcohol, cannabis and inhalant use. Associations between psychopathology and substance use were determined using regression analyses and structural equation modeling. On adjusting for demographic characteristics, significant associations were found between PTSD and all substance use, between depression, alcohol, cannabis and inhalant use, and between anxiety and cannabis use. The associations of PTSD and depression with alcohol and cannabis use, and between anxiety and cannabis use, were moderated by grade. Although psychopathology and substance use were associated with each other, these associations occurred in accordance with substance and grade. Roles for gender, age and ethnicity emerged in the associations, but further investigation is recommended to examine these.

Deep versus periventricular white matter lesions and cognitive function in a community sample of middle-aged participants.

PubMed

Soriano-Raya, Juan José; Miralbell, Júlia; López-Cancio, Elena; Bargalló, Núria; Arenillas, Juan Francisco; Barrios, Maite; Cáceres, Cynthia; Toran, Pere; Alzamora, Maite; Dávalos, Antoni; Mataró, Maria

2012-09-01

The association of cerebral white matter lesions (WMLs) with cognitive status is not well understood in middle-aged individuals. Our aim was to determine the specific contribution of periventricular hyperintensities (PVHs) and deep white matter hyperintensities (DWMHs) to cognitive function in a community sample of asymptomatic participants aged 50 to 65 years. One hundred stroke- and dementia-free adults completed a comprehensive neuropsychological battery and brain MRI protocol. Participants were classified according to PVH and DWMH scores (Fazekas scale). We dichotomized our sample into low grade WMLs (participants without or with mild lesions) and high grade WMLs (participants with moderate or severe lesions). Analyses were performed separately in PVH and DWMH groups. High grade DWMHs were associated with significantly lower scores in executive functioning (-0.45 standard deviations [SD]), attention (-0.42 SD), verbal fluency (-0.68 SD), visual memory (-0.52 SD), visuospatial skills (-0.79 SD), and psychomotor speed (-0.46 SD). Further analyses revealed that high grade DWMHs were also associated with a three- to fourfold increased risk of impaired scores (i.e.,<1.5 SD) in executive functioning, verbal fluency, visuospatial skills, and psychomotor speed. Our findings suggest that only DWMHs, not PVHs, are related to diminished cognitive function in middle-aged individuals. (JINS, 2012, 18, 1-12).

The Validity and Reliability of the Turkish Version of the Neonatal Skin Risk Assessment Scale.

PubMed

Sari, Çiğdem; Altay, Naime

2017-03-01

The study created a Turkish translation of the Neonatal Skin Risk Assessment Scale (NSRAS) that was developed by Huffines and Longsdon in 1997. Study authors used a cross-sectional survey design in order to determine the validity and reliability of the Turkish translation. The study was conducted at the neonatal intensive care unit of a university hospital in Ankara between March 15 and June 30, 2014. The research sample included 130 neonatal assessments from 17 patients. Data were collected by questionnaire regarding the characteristics of the participating neonates, 7 nurse observers, and the NSRAS and its subarticles. After translation and back-translation were performed to assess language validity of the scale, necessary corrections were made in line with expert suggestions, and content validity was ensured. Internal consistency of the scale was assessed by its homogeneity, Cronbach's α, and subarticle-general scale grade correlation. Cronbach's α for the scale overall was .88, and Cronbach's α values for the subarticles were between .83 and .90. Results showed a positive relationship among all the subarticles and the overall NSRAS scale grade (P < .01) with correlation values between 0.333 and 0.721. Explanatory and predicative factor analysis was applied for structural validity. Kaiser-Meyer-Olkin analysis was applied for sample sufficiency, and Bartlett test analysis was applied in order to assess the factor analysis of the sample. The Kaiser-Meyer-Olkin coefficient was 0.73, and the χ value found according to the Bartlett test was statistically significant at an advanced level (P < .05). In the 6 subarticles of the scale and in the general scale total grade, a high, positive, and significant relationship among the grades given by the researcher and the nurse observers was found (P < .05). The Turkish NSRAS is reliable and valid.

Are extreme events (statistically) special? (Invited)

NASA Astrophysics Data System (ADS)

Main, I. G.; Naylor, M.; Greenhough, J.; Touati, S.; Bell, A. F.; McCloskey, J.

2009-12-01

We address the generic problem of testing for scale-invariance in extreme events, i.e. are the biggest events in a population simply a scaled model of those of smaller size, or are they in some way different? Are large earthquakes for example ‘characteristic’, do they ‘know’ how big they will be before the event nucleates, or is the size of the event determined only in the avalanche-like process of rupture? In either case what are the implications for estimates of time-dependent seismic hazard? One way of testing for departures from scale invariance is to examine the frequency-size statistics, commonly used as a bench mark in a number of applications in Earth and Environmental sciences. Using frequency data however introduces a number of problems in data analysis. The inevitably small number of data points for extreme events and more generally the non-Gaussian statistical properties strongly affect the validity of prior assumptions about the nature of uncertainties in the data. The simple use of traditional least squares (still common in the literature) introduces an inherent bias to the best fit result. We show first that the sampled frequency in finite real and synthetic data sets (the latter based on the Epidemic-Type Aftershock Sequence model) converge to a central limit only very slowly due to temporal correlations in the data. A specific correction for temporal correlations enables an estimate of convergence properties to be mapped non-linearly on to a Gaussian one. Uncertainties closely follow a Poisson distribution of errors across the whole range of seismic moment for typical catalogue sizes. In this sense the confidence limits are scale-invariant. A systematic sample bias effect due to counting whole numbers in a finite catalogue makes a ‘characteristic’-looking type extreme event distribution a likely outcome of an underlying scale-invariant probability distribution. This highlights the tendency of ‘eyeball’ fits to unconsciously (but wrongly in this case) assume Gaussian errors. We develop methods to correct for these effects, and show that the current best fit maximum likelihood regression model for the global frequency-moment distribution in the digital era is a power law, i.e. mega-earthquakes continue to follow the Gutenberg-Richter trend of smaller earthquakes with no (as yet) observable cut-off or characteristic extreme event. The results may also have implications for the interpretation of other time-limited geophysical time series that exhibit power-law scaling.

Validation of automated screening for referable diabetic retinopathy with the IDx-DR device in the Hoorn Diabetes Care System.

PubMed

van der Heijden, Amber A; Abramoff, Michael D; Verbraak, Frank; van Hecke, Manon V; Liem, Albert; Nijpels, Giel

2018-02-01

To increase the efficiency of retinal image grading, algorithms for automated grading have been developed, such as the IDx-DR 2.0 device. We aimed to determine the ability of this device, incorporated in clinical work flow, to detect retinopathy in persons with type 2 diabetes. Retinal images of persons treated by the Hoorn Diabetes Care System (DCS) were graded by the IDx-DR device and independently by three retinal specialists using the International Clinical Diabetic Retinopathy severity scale (ICDR) and EURODIAB criteria. Agreement between specialists was calculated. Results of the IDx-DR device and experts were compared using sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), distinguishing between referable diabetic retinopathy (RDR) and vision-threatening retinopathy (VTDR). Area under the receiver operating characteristic curve (AUC) was calculated. Of the included 1415 persons, 898 (63.5%) had images of sufficient quality according to the experts and the IDx-DR device. Referable diabetic retinopathy (RDR) was diagnosed in 22 persons (2.4%) using EURODIAB and 73 persons (8.1%) using ICDR classification. Specific intergrader agreement ranged from 40% to 61%. Sensitivity, specificity, PPV and NPV of IDx-DR to detect RDR were 91% (95% CI: 0.69-0.98), 84% (95% CI: 0.81-0.86), 12% (95% CI: 0.08-0.18) and 100% (95% CI: 0.99-1.00; EURODIAB) and 68% (95% CI: 0.56-0.79), 86% (95% CI: 0.84-0.88), 30% (95% CI: 0.24-0.38) and 97% (95% CI: 0.95-0.98; ICDR). The AUC was 0.94 (95% CI: 0.88-1.00; EURODIAB) and 0.87 (95% CI: 0.83-0.92; ICDR). For detection of VTDR, sensitivity was lower and specificity was higher compared to RDR. AUC's were comparable. Automated grading using the IDx-DR device for RDR detection is a valid method and can be used in primary care, decreasing the demand on ophthalmologists. © 2017 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.

[Study on commercial specification of atractylodes based on Delphi method].

PubMed

Wang, Hao; Chen, Li-Xiao; Huang, Lu-Qi; Zhang, Tian-Tian; Li, Ying; Zheng, Yu-Guang

2016-03-01

This research adopts "Delphi method" to evaluate atractylodes traditional traits and rank correlation. By using methods of mathematical statistics the relationship of the traditional identification indicators and atractylodes goods rank correlation was analyzed, It is found that the main characteristics affectingatractylodes commodity specifications and grades of main characters wereoil points of transaction,color of transaction,color of surface,grain of transaction,texture of transaction andspoilage. The study points out that the original "seventy-six kinds of medicinal materials commodity specification standards of atractylodes differentiate commodity specification" is not in conformity with the actual market situation, we need to formulate corresponding atractylodes medicinal products specifications and grades.This study combined with experimental results "Delphi method" and the market actual situation, proposed the new draft atractylodes commodity specifications and grades, as the new atractylodes commodity specifications and grades standards. It provides a reference and theoretical basis. Copyright© by the Chinese Pharmaceutical Association.

CDC Kerala 3: At-risk baby clinic service using different screening tools--outcome at 12 months using Developmental Assessment Scale for Indian Infants.

PubMed

Nair, M K C; Krishnan, Rajee; Harikumaran Nair, G S; George, Babu; Bhaskaran, Deepa; Leena, M L; Russell, Paul Swamidhas Sudhakar

2014-12-01

To describe CDC Kerala experience of establishing an at-risk baby clinic and the comparison of different developmental screening tools at 12 mo against the gold standard Developmental Assessment Scale for Indian Infants (DASII). At risk baby clinic of CDC, Kerala was established as a facility for follow up of NICU graduates from Sree Avittam Thirunal Hospital at 2, 4, 6, 8 and 12 mo corrected age and during each visit the mother is taught the CDC model early stimulation by developmental therapists and encouraged to continue to do the same at home. At 12 mo, assessment results of four simple developmental tools were compared with the gold standard DASII administered by a senior developmental therapist. Out of a total of 800 babies, outcome measurements at 12 mo were available for 604 infants. The prevalence of developmental delay using the screening tools, CDC grading for standing, Amiel Tison angles and DDST II (Denver II) gross motor were 24.8, 24 and 24.3% respectively and using DASII, a diagnostic tool (13.3%). Also the combination of Amiel Tison angles, CDC standing grading and DDST gross motor against DASII motor DQ had high specificity (94.15%) and negative predictive value (NPV) (70.18%) but with a very low sensitivity of 14.58% and low positive predictive value (PPV) of 53.85%. It was observed that a significant odds ratio for DASII mental deviation quotient (DQ) was seen for neonatal seizures (2.34) and low birth weight (1.49). The prevalence of developmental delay using the screening tools, CDC grading for standing, Amiel Tison angles and DDST II (Denver II) gross motor were 24.8, 24 and 24.3% respectively and together they had a high specificity, NPV and accuracy against DASII motor DQ as gold standard at one year assessment.

A patient-specific model of the biomechanics of hip reduction for neonatal Developmental Dysplasia of the Hip: Investigation of strategies for low to severe grades of Developmental Dysplasia of the Hip.

PubMed

Huayamave, Victor; Rose, Christopher; Serra, Sheila; Jones, Brendan; Divo, Eduardo; Moslehy, Faissal; Kassab, Alain J; Price, Charles T

2015-07-16

A physics-based computational model of neonatal Developmental Dysplasia of the Hip (DDH) following treatment with the Pavlik Harness (PV) was developed to obtain muscle force contribution in order to elucidate biomechanical factors influencing the reduction of dislocated hips. Clinical observation suggests that reduction occurs in deep sleep involving passive muscle action. Consequently, a set of five (5) adductor muscles were identified as mediators of reduction using the PV. A Fung/Hill-type model was used to characterize muscle response. Four grades (1-4) of dislocation were considered, with one (1) being a low subluxation and four (4) a severe dislocation. A three-dimensional model of the pelvis-femur lower limb of a representative 10 week-old female was generated based on CT-scans with the aid of anthropomorphic scaling of anatomical landmarks. The model was calibrated to achieve equilibrium at 90° flexion and 80° abduction. The hip was computationally dislocated according to the grade under investigation, the femur was restrained to move in an envelope consistent with PV restraints, and the dynamic response under passive muscle action and the effect of gravity was resolved. Model results with an anteversion angle of 50° show successful reduction Grades 1-3, while Grade 4 failed to reduce with the PV. These results are consistent with a previous study based on a simplified anatomically-consistent synthetic model and clinical reports of very low success of the PV for Grade 4. However our model indicated that it is possible to achieve reduction of Grade 4 dislocation by hyperflexion and the resultant external rotation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Factors associated with clinical and radiological status on admission in patients with aneurysmal subarachnoid hemorrhage.

PubMed

Zumofen, Daniel W; Roethlisberger, Michel; Achermann, Rita; Bawarjan, Schatlo; Stienen, Martin N; Fung, Christian; D'Alonzo, Donato; Maldaner, Nicolai; Ferrari, Andrea; Corniola, Marco V; Schoeni, Daniel; Goldberg, Johannes; Valsecchi, Daniele; Robert, Thomas; Maduri, Rodolfo; Seule, Martin; Burkhardt, Jan-Karl; Marbacher, Serge; Bijlenga, Philippe; Blackham, Kristine A; Bucher, Heiner C; Mariani, Luigi; Guzman, Raphael

2018-02-10

Grading scales yield objective measure of the severity of aneurysmal subarachnoid hemorrhage and serve as to guide treatment decisions and for prognostication. The purpose of this cohort study was to determine what factors govern a patient's disease-specific admission scores in a representative Central European cohort. The Swiss Study of Subarachnoid Hemorrhage includes anonymized data from all tertiary referral centers serving subarachnoid hemorrhage patients in Switzerland. The 2009-2014 dataset was used to evaluate the impact of patient and aneurysm characteristics on the patients' status at admission using descriptive and multivariate regression analysis. The primary/co-primary endpoints were the GCS and the WFNS grade. The secondary endpoints were the Fisher grade, the presence of a thick cisternal or ventricular clot, the presence of a new focal neurological deficit or cranial nerve palsy, and the patient's intubation status. In our cohort of 1787 consecutive patients, increasing patient age by 10 years and low pre-ictal functional status (mRS 3-5) were inversely correlated with "high" GCS score (GCS ≥ 13) (OR 0.91, 95% CI 0.84-0.97 and OR 0.67, 95% CI 0.31-1.46), "low" WFNS grade (grade VI-V) (OR 1.21, 95% CI 1.04-1.20 and OR 1.47, 95% CI 0.66-3.27), and high Fisher grade (grade III-IV) (OR 1.08, 95% CI 1.00-1.17 and OR 1.54, 95% CI 0.55-4.32). Other independent predictors for the patients' clinical and radiological condition at admission were the ruptured aneurysms' location and its size. In sum, chronological age and pre-ictal functional status, as well as the ruptured aneurysm's location and size, determine the patients' clinical and radiological condition at admission to the tertiary referral hospital.

Does the school performance variable used in the International Health Behavior in School-Aged Children (HBSC) Study reflect students' school grades?

PubMed

Felder-Puig, Rosemarie; Griebler, Robert; Samdal, Oddrun; King, Matthew A; Freeman, John; Duer, Wolfgang

2012-09-01

Given the pressure that educators and policy makers are under to achieve academic standards for students, understanding the relationship of academic success to various aspects of health is important. The international Health Behavior in School-Aged Children (HBSC) questionnaire, being used in 41 countries with different school and grading systems, has contained an item assessing perceived school performance (PSP) since 1986. Whereas the test-retest reliability of this item has been reported previously, we determined its convergent and discriminant validity. This cross-sectional study used anonymous self-report data from Austrian (N = 266), Norwegian (N = 240), and Canadian (N = 9,717) samples. Students were between 10 and 17 years old. PSP responses were compared to the self-reported average school grades in 6 subjects (Austria) or 8 subjects (Norway), respectively, or to a general, 5-category-based appraisal of most recent school grades (Canada). Correlations between PSP and self-reported average school grade scores were between 0.51 and 0.65, representing large effect sizes. Differences between the median school grades in the 4 categories of the PSP item were statistically significant in all 3 samples. The PSP item showed predominantly small associations with some randomly selected HBSC items or scales designed to measure different concepts. The PSP item seems to be a valid and useful question that can distinguish groups of respondents that get good grades at school from those that do not. The meaning of PSP may be context-specific and may have different connotations across student populations from different countries with different school systems. © 2012, American School Health Association.

Abiraterone acetate for patients with metastatic castration-resistant prostate cancer progressing after chemotherapy: final analysis of a multicentre, open-label, early-access protocol trial.

PubMed

Sternberg, Cora N; Castellano, Daniel; Daugaard, Gedske; Géczi, Lajos; Hotte, Sebastien J; Mainwaring, Paul N; Saad, Fred; Souza, Ciro; Tay, Miah H; Garrido, José M Tello; Galli, Luca; Londhe, Anil; De Porre, Peter; Goon, Betty; Lee, Emma; McGowan, Tracy; Naini, Vahid; Todd, Mary B; Molina, Arturo; George, Daniel J

2014-10-01

In the final analysis of the phase 3 COU-AA-301 study, abiraterone acetate plus prednisone significantly prolonged overall survival compared with prednisone alone in patients with metastatic castration-resistant prostate cancer progressing after chemotherapy. Here, we present the final analysis of an early-access protocol trial that was initiated after completion of COU-AA-301 to enable worldwide preapproval access to abiraterone acetate in patients with metastatic castration-resistant prostate cancer progressing after chemotherapy. We did a multicentre, open-label, early-access protocol trial in 23 countries. We enrolled patients who had metastatic castration-resistant prostate cancer progressing after taxane chemotherapy. Participants received oral doses of abiraterone acetate (1000 mg daily) and prednisone (5 mg twice a day) in 28-day cycles until disease progression, development of sustained side-effects, or abiraterone acetate becoming available in the respective country. The primary outcome was the number of adverse events arising during study treatment and within 30 days of discontinuation. Efficacy measures (time to prostate-specific antigen [PSA] progression and time to clinical progression) were gathered to guide treatment decisions. We included in our analysis all patients who received at least one dose of abiraterone acetate. This study is registered with ClinicalTrials.gov, number NCT01217697. Between Nov 17, 2010, and Sept 30, 2013, 2314 patients were enrolled into the early-access protocol trial. Median follow-up was 5·7 months (IQR 3·5-10·6). 952 (41%) patients had a grade 3 or 4 treatment-related adverse event, and grade 3 or 4 serious adverse events were recorded in 585 (25%) people. The most common grade 3 and 4 adverse events were hepatotoxicity (188 [8%]), hypertension (99 [4%]), cardiac disorders (52 [2%]), osteoporosis (31 [1%]), hypokalaemia (28 [1%]), and fluid retention or oedema (23 [1%]). 172 (7%) patients discontinued the study because of adverse events (64 [3%] were drug-related), as assessed by the investigator, and 171 (7%) people died. The funder assessed causes of death, which were due to disease progression (85 [4%]), an unrelated adverse experience (72 [3%]), and unknown reasons (14 [1%]). Of the 86 deaths not attributable to disease progression, 18 (<1%) were caused by a drug-related adverse event, as assessed by the investigator. Median time to PSA progression was 8·5 months (95% CI 8·3-9·7) and median time to clinical progression was 12·7 months (11·8-13·8). No new safety signals or unexpected adverse events were found in this early-access protocol trial to assess abiraterone acetate for patients with metastatic castration-resistant prostate cancer who progressed after chemotherapy. Future work is needed to ascertain the most effective regimen of abiraterone acetate to optimise patients' outcomes. Janssen Research & Development. Copyright © 2014 Elsevier Ltd. All rights reserved.

Prevalence and Effects of Life Event Exposure among Undergraduate and Community College Students

ERIC Educational Resources Information Center

Anders, Samantha L.; Frazier, Patricia A.; Shallcross, Sandra L.

2012-01-01

The purposes of this study were to assess lifetime and recent exposure to various life events among undergraduate and community college students and to assess the relation between event exposure and a broad range of outcomes (i.e., mental and physical health, life satisfaction, grade point average). Undergraduate students from a midwestern…

The Relationship of Life Events to Academic Performance in College Students.

ERIC Educational Resources Information Center

Knapp, Samuel

Numerous studies have shown a correlation between life events and physical health, mental health, and behavioral measures such as impaired grade point average. Most of these studies have measured stressfulness by summing the total number of events experienced in a given time period. However, Vinokur and Selzer have shown that the amount of…

An event map of memory space in the hippocampus

PubMed Central

Deuker, Lorena; Bellmund, Jacob LS; Navarro Schröder, Tobias; Doeller, Christian F

2016-01-01

The hippocampus has long been implicated in both episodic and spatial memory, however these mnemonic functions have been traditionally investigated in separate research strands. Theoretical accounts and rodent data suggest a common mechanism for spatial and episodic memory in the hippocampus by providing an abstract and flexible representation of the external world. Here, we monitor the de novo formation of such a representation of space and time in humans using fMRI. After learning spatio-temporal trajectories in a large-scale virtual city, subject-specific neural similarity in the hippocampus scaled with the remembered proximity of events in space and time. Crucially, the structure of the entire spatio-temporal network was reflected in neural patterns. Our results provide evidence for a common coding mechanism underlying spatial and temporal aspects of episodic memory in the hippocampus and shed new light on its role in interleaving multiple episodes in a neural event map of memory space. DOI: http://dx.doi.org/10.7554/eLife.16534.001 PMID:27710766

Multivariate regression model for predicting lumber grade volumes of northern red oak sawlogs

Treesearch

Daniel A. Yaussy; Robert L. Brisbin

1983-01-01

A multivariate regression model was developed to predict green board-foot yields for the seven common factory lumber grades processed from northern red oak (Quercus rubra L.) factory grade logs. The model uses the standard log measurements of grade, scaling diameter, length, and percent defect. It was validated with an independent data set. The model...

Multivariate regression model for predicting yields of grade lumber from yellow birch sawlogs

Treesearch

Andrew F. Howard; Daniel A. Yaussy

1986-01-01

A multivariate regression model was developed to predict green board-foot yields for the common grades of factory lumber processed from yellow birch factory-grade logs. The model incorporates the standard log measurements of scaling diameter, length, proportion of scalable defects, and the assigned USDA Forest Service log grade. Differences in yields between band and...

7 CFR 58.721 - Salt.

Code of Federal Regulations, 2014 CFR

2014-01-01

... SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Quality Specifications for Raw Material § 58... The Food Chemical Codex. ...

7 CFR 58.721 - Salt.

Code of Federal Regulations, 2013 CFR

2013-01-01

... SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Quality Specifications for Raw Material § 58... The Food Chemical Codex. ...

7 CFR 58.721 - Salt.

Code of Federal Regulations, 2011 CFR

2011-01-01

... SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Quality Specifications for Raw Material § 58... The Food Chemical Codex. ...

7 CFR 58.721 - Salt.

Code of Federal Regulations, 2012 CFR

2012-01-01

... SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Quality Specifications for Raw Material § 58... The Food Chemical Codex. ...

State Test Score Trends through 2008-09, Part 4: Is Achievement Improving and Are Gaps Narrowing for Title I Students? Utah

ERIC Educational Resources Information Center

Center on Education Policy, 2011

2011-01-01

This paper profiles Utah's test score trends through 2008-09. In 2004, the mean scale score on the state 4th grade reading test was 167 for non-Title I students and 164 for Title I students. In 2009 the mean scale score in 4th grade reading was 168 for non-Title I students and 164 for Title I students. Between 2004 and 2009, the mean scale score…