Sample records for exact test odds

  1. Testing equality and interval estimation of the generalized odds ratio in ordinal data under a three-period crossover design.

    PubMed

    Lui, Kung-Jong; Chang, Kuang-Chao; Lin, Chii-Dean

    2017-06-01

    The crossover design can be of use to save the number of patients or improve power of a parallel groups design in studying treatments to noncurable chronic diseases. We propose using the generalized odds ratio for paired sample data to measure the relative effects in ordinal data between treatments and between periods. We show that one can apply the commonly used asymptotic and exact test procedures for stratified analysis in epidemiology to test non-equality of treatments in ordinal data, as well as obtain asymptotic and exact interval estimators for the generalized odds ratio under a three-period crossover design. We further show that one can apply procedures for testing the homogeneity of the odds ratio under stratified sampling to examine whether there are treatment-by-period interactions. We use the data taken from a three-period crossover trial studying the effects of low and high doses of an analgesic versus a placebo for the relief of pain in primary dysmenorrhea to illustrate the use of these test procedures and estimators proposed here.

  2. Test Procedures for Semiconductor Random Access Memories

    DTIC Science & Technology

    1979-11-01

    of each cell exactly complement to each other, the read operations on the base cell in (g) of step 2 following operations ko S odd and in (p) of step...contents of Sko (these cells this address. Furthermore, when more than one contained I at test time and even if the con- cell is accessed then the output

  3. Estimates of Pertussis Vaccine Effectiveness in United States Air Force Pediatric Dependents

    DTIC Science & Technology

    2015-06-22

    SAS 9.3 (SAS Institute Inc., Cary, NC). Chi- square and Fisher’s exact tests were used to examine demographic and vaccination status differences...members were sig- nificantly (95% CI: 1.70, 9.37; p < 0.001) protected from pertussis, having 74.9% reduced odds of disease (OR = 0.25). Latino ...children had higher odds of pertussis than non- Latinos (OR = 1.98, 95% CI: 0.66, 5.94; p = 0.22), a non-significant finding. No significant trends were

  4. Monte Carlo Simulations Comparing Fisher Exact Test and Unequal Variances t Test for Analysis of Differences Between Groups in Brief Hospital Lengths of Stay.

    PubMed

    Dexter, Franklin; Bayman, Emine O; Dexter, Elisabeth U

    2017-12-01

    We examined type I and II error rates for analysis of (1) mean hospital length of stay (LOS) versus (2) percentage of hospital LOS that are overnight. These 2 end points are suitable for when LOS is treated as a secondary economic end point. We repeatedly resampled LOS for 5052 discharges of thoracoscopic wedge resections and lung lobectomy at 26 hospitals. Unequal variances t test (Welch method) and Fisher exact test both were conservative (ie, type I error rate less than nominal level). The Wilcoxon rank sum test was included as a comparator; the type I error rates did not differ from the nominal level of 0.05 or 0.01. Fisher exact test was more powerful than the unequal variances t test at detecting differences among hospitals; estimated odds ratio for obtaining P < .05 with Fisher exact test versus unequal variances t test = 1.94, with 95% confidence interval, 1.31-3.01. Fisher exact test and Wilcoxon-Mann-Whitney had comparable statistical power in terms of differentiating LOS between hospitals. For studies with LOS to be used as a secondary end point of economic interest, there is currently considerable interest in the planned analysis being for the percentage of patients suitable for ambulatory surgery (ie, hospital LOS equals 0 or 1 midnight). Our results show that there need not be a loss of statistical power when groups are compared using this binary end point, as compared with either Welch method or Wilcoxon rank sum test.

  5. Effect of exact Coulomb-exchange calculations on band-head spectra of odd-proton nuclei

    NASA Astrophysics Data System (ADS)

    Koh, Meng-Hock; Nurhafiza, Mohamad Nor

    2017-10-01

    Previous calculations of band-head energy spectra of odd-mass heavy nuclei in the Hartree-Fock-plus-Bardeen-Cooper-Schrieffer (HF-BCS) framework showed that the agreement with data is better for odd-neutron as compared to odd-proton nuclei. The reason for a poorer agreement with data for the latter have been ascribed to the possible usage of the Slater approximation in calculating the Coulomb-exchange term. In this work, we report the effect of exact Coulomb-exchange calculations on band-head energy spectra of two odd-proton nuclei (namely 237Np and 241Am) as compared to the results obtained using the Slater approximation. We performed self-consistent blocking calculations while taking the breaking of time-reversal symmetry at the mean-field level into account due to the unpaired nucleon. The SkM* and SIII parametrizations of the Skyrme interaction have been employed to approximate the effective nucleon-nucleon interaction while a seniority force is used for the pairing channel. Contrary to what was expected, our preliminary results show no improvement on the band-head spectra as compared to data when the Coulomb-exchange term is calculated exactly.

  6. Local vs general anaesthesia in the development of neurosensory disturbances after mandibular third molars extraction: A retrospective study of 534 cases.

    PubMed

    Costantinides, F; Biasotto, M; Maglione, M; Di Lenarda, R

    2016-11-01

    The choice of the anaesthetic modality is one of the primary steps during planning of third molar surgery. The aim of the present study was to compare the risk of developing neurological injures of the inferior alveolar nerve (IAN) and lingual nerve (LN) in patients treated for wisdom teeth removal under general anaesthesia (GA) with a group treated under local anaesthesia (LA). This is an observational retrospective, unicentric study; between September 2013 and September 2014, 534 patients underwent third molar surgery, 194 (36,3%) under GA and 340 (63,7%) under LA by the same oral surgeon. Difference in the incidence of IAN and LN injures between groups have been statistically analyzed with Fisher exact test and estimated odd ratio for development of such complications has been calculated. In GA patients the incidence of IAN and LN injures was 4.6% and 2.1%, respectively while in the LA group it was and 0.3% and 0%, respectively. A significant difference in IAN and LN involvement between groups was observed (IAN lesion: Fisher exact test, p<0.001; LN lesions: Fisher exact test, p<0.05). The estimated odd ratio for development of IAN injures after GA was 16.49 (95% CI: 2.07-131.19) and was not calculable for LN injures because no cases were observed in the LA group. Since GA is a perioperative variable that seems to significantly increase the risk of developing IAN and LN lesions, when treating patients that request GA, they must be adequately informed that an higher incidence of post-surgical sensory disturbances is expected.

  7. Local vs general anaesthesia in the development of neurosensory disturbances after mandibular third molars extraction: A retrospective study of 534 cases

    PubMed Central

    Biasotto, Matteo; Maglione, Michele; Di Lenarda, Roberto

    2016-01-01

    Background The choice of the anaesthetic modality is one of the primary steps during planning of third molar surgery. The aim of the present study was to compare the risk of developing neurological injures of the inferior alveolar nerve (IAN) and lingual nerve (LN) in patients treated for wisdom teeth removal under general anaesthesia (GA) with a group treated under local anaesthesia (LA). Material and Methods This is an observational retrospective, unicentric study; between September 2013 and September 2014, 534 patients underwent third molar surgery, 194 (36,3%) under GA and 340 (63,7%) under LA by the same oral surgeon. Differences in the incidence of IAN and LN injures between groups have been statistically analyzed with Fisher exact test and estimated odd ratio for development of such complications has been calculated. Results In GA patients the incidence of IAN and LN injures was 4.6% and 2.1%, respectively while in the LA group it was and 0.3% and 0%, respectively. A significant difference in IAN and LN involvement between groups was observed (IAN lesion: Fisher exact test, p<0.001; LN lesions: Fisher exact test, p<0.05). The estimated odd ratio for development of IAN injures after GA was 16.49 (95% CI: 2.07-131.19) and was not calculable for LN injures because no cases were observed in the LA group. Conclusions Since GA is a perioperative variable that seems to significantly increase the risk of developing IAN and LN lesions, when treating patients that request GA, they must be adequately informed that an higher incidence of post-surgical sensory disturbances is expected. Key words:Third molars, general anaesthesia, local anaesthesia, inferior alveolar nerve, lingual nerve. PMID:27694783

  8. Statistical analyses of the relative risk.

    PubMed Central

    Gart, J J

    1979-01-01

    Let P1 be the probability of a disease in one population and P2 be the probability of a disease in a second population. The ratio of these quantities, R = P1/P2, is termed the relative risk. We consider first the analyses of the relative risk from retrospective studies. The relation between the relative risk and the odds ratio (or cross-product ratio) is developed. The odds ratio can be considered a parameter of an exponential model possessing sufficient statistics. This permits the development of exact significance tests and confidence intervals in the conditional space. Unconditional tests and intervals are also considered briefly. The consequences of misclassification errors and ignoring matching or stratifying are also considered. The various methods are extended to combination of results over the strata. Examples of case-control studies testing the association between HL-A frequencies and cancer illustrate the techniques. The parallel analyses of prospective studies are given. If P1 and P2 are small with large samples sizes the appropriate model is a Poisson distribution. This yields a exponential model with sufficient statistics. Exact conditional tests and confidence intervals can then be developed. Here we consider the case where two populations are compared adjusting for sex differences as well as for the strata (or covariate) differences such as age. The methods are applied to two examples: (1) testing in the two sexes the ratio of relative risks of skin cancer in people living in different latitudes, and (2) testing over time the ratio of the relative risks of cancer in two cities, one of which fluoridated its drinking water and one which did not. PMID:540589

  9. Relative Moldiness Index as Predictor of Childhood Respiratory Illness

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

    Vesper, Sephen J.; McKinstry, Craig A.; Haugland, Richard A.

    2007-01-01

    This study compared two classification methods to evaluate the mold condition in 271 homes of infants, 144 of which later developed symptoms of respiratory illness. A method using on-site visual mold inspection was compared to another method using a quantitative index of moldiness, calculated from mold specific quantitative PCR (MSQPCR) measurements on the concentration of 36 species of molds in floor dust samples called the EPA relative moldiness index© (ERMI©). The binary classification of homes as either moldy or non-moldy by on-site visual home inspection was not predictive of the development of wheeze and/or rhinitis. The odds-ratio of moldy vs.more » non-moldy homes to experience respiratory illness was estimated at 1.33 (p=0.27, Fisher’s exact test). Further, this method offers little flexibility in how it may be applied in support of decisions on mold remediation. On the other hand, a method developed and validated in this paper using the ERMI© index fit to a logistic function, can be used to predict the occurrence of illness in homes and allows stake holders to choose among various levels of risk. An example is given where an ERMI© value of -4.29 is used as a threshold for binary classification of homes producing an odds ratio of 2.53 (p=0.003, Fisher’s exact test). The ERMI© based methods presented here provide a new and more flexible platform to support mold remediation decisions.« less

  10. Clinical significance of prominent retraction clefts in invasive urothelial carcinoma.

    PubMed

    Shah, Tanmay S; Kaag, Matthew; Raman, Jay D; Chan, Wilson; Tran, Truc; Kunchala, Sudhir; Shuman, Lauren; DeGraff, David J; Chen, Guoli; Warrick, Joshua I

    2017-03-01

    Micropapillary morphology in invasive urothelial carcinoma is an established predictor of aggressive disease. It is unknown, however, if prominent retraction is associated with more aggressive disease in the absence of classic micropapillary morphology. We reviewed a retrospective series of 309 radical cystectomy specimens with clinical follow-up data and documented the presence or absence of invasive urothelial carcinoma with prominent retraction clefts, defined as invasive carcinoma with retraction involving the majority of invasive tumor nests in at least one 100× field but without classic micropapillary morphology. Invasive carcinomas with plasmacytoid, sarcomatoid, nested, and small cell morphology were excluded, as were cases without lymph node sampling. In invasive conventional urothelial carcinoma, the presence of prominent retraction clefts was associated lymph node metastasis (odds ratio 4.7, P = .0015, Fisher exact test) but not pathologic tumor stage or several other oncologic parameters (all Ps > .10). Similarly, invasive urothelial carcinoma with micropapillary morphology had lymph node metastasis more frequently than conventional urothelial carcinoma without prominent retraction clefts (P < .001, Fisher exact test), but there was no difference in pathologic tumor stage or oncologic parameters (all Ps > .10). There was no statistically significant difference in rates of lymph node metastasis between invasive urothelial carcinoma with micropapillary morphology and conventional urothelial carcinoma with prominent retraction clefts (P = .54, Fisher exact test). The findings suggest that prominent retraction in invasive urothelial carcinoma may be associated with more aggressive disease, even in the absence of classic micropapillary morphology. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. The yield of colorectal cancer among fast track patients with normocytic and microcytic anaemia.

    PubMed

    Panagiotopoulou, I G; Fitzrol, D; Parker, R A; Kuzhively, J; Luscombe, N; Wells, A D; Menon, M; Bajwa, F M; Watson, M A

    2014-05-01

    We receive fast track referrals on the basis of iron deficiency anaemia (IDA) for patients with normocytic anaemia or for patients with no iron studies. This study examined the yield of colorectal cancer (CRC) among fast track patients to ascertain whether awaiting confirmation of IDA is necessary prior to performing bowel investigations. A review was undertaken of 321 and 930 consecutive fast track referrals from Centre A and Centre B respectively. Contingency tables were analysed using Fisher's exact test. Logistic regression analyses were performed to investigate significant predictors of CRC. Overall, 229 patients were included from Centre A and 689 from Centre B. The odds ratio for microcytic anaemia versus normocytic anaemia in the outcome of CRC was 1.3 (95% confidence interval [CI]: 0.5-3.9) for Centre A and 1.6 (95% CI: 0.8-3.3) for Centre B. In a logistic regression analysis (Centre B only), no significant difference in CRC rates was seen between microcytic and normocytic anaemia (adjusted odds ratio: 1.9, 95% CI: 0.9-3.9). There was no statistically significant difference in the yield of CRC between microcytic and normocytic anaemia (p=0.515, Fisher's exact test) in patients with anaemia only and no colorectal symptoms. Finally, CRC cases were seen in both microcytic and normocytic groups with or without low ferritin. There is no significant difference in the yield of CRC between fast track patients with microcytic and normocytic anaemia. This study provides insufficient evidence to support awaiting confirmation of IDA in fast track patients with normocytic anaemia prior to requesting bowel investigations.

  12. Novel Soft-Pion Theorem for Long-Range Nuclear Parity Violation.

    PubMed

    Feng, Xu; Guo, Feng-Kun; Seng, Chien-Yeah

    2018-05-04

    The parity-odd effect in the standard model weak neutral current reveals itself in the long-range parity-violating nuclear potential generated by the pion exchanges in the ΔI=1 channel with the parity-odd pion-nucleon coupling constant h_{π}^{1}. Despite decades of experimental and theoretical efforts, the size of this coupling constant is still not well understood. In this Letter, we derive a soft-pion theorem relating h_{π}^{1} and the neutron-proton mass splitting induced by an artificial parity-even counterpart of the ΔI=1 weak Lagrangian and demonstrate that the theorem still holds exact at the next-to-leading order in the chiral perturbation theory. A considerable amount of simplification is expected in the study of h_{π}^{1} by using either lattice or other QCD models following its reduction from a parity-odd proton-neutron-pion matrix element to a simpler spectroscopic quantity. The theorem paves the way to much more precise calculations of h_{π}^{1}, and thus a quantitative test of the strangeness-conserving neutral current interaction of the standard model is foreseen.

  13. Novel Soft-Pion Theorem for Long-Range Nuclear Parity Violation

    NASA Astrophysics Data System (ADS)

    Feng, Xu; Guo, Feng-Kun; Seng, Chien-Yeah

    2018-05-01

    The parity-odd effect in the standard model weak neutral current reveals itself in the long-range parity-violating nuclear potential generated by the pion exchanges in the Δ I =1 channel with the parity-odd pion-nucleon coupling constant hπ1 . Despite decades of experimental and theoretical efforts, the size of this coupling constant is still not well understood. In this Letter, we derive a soft-pion theorem relating hπ1 and the neutron-proton mass splitting induced by an artificial parity-even counterpart of the Δ I =1 weak Lagrangian and demonstrate that the theorem still holds exact at the next-to-leading order in the chiral perturbation theory. A considerable amount of simplification is expected in the study of hπ1 by using either lattice or other QCD models following its reduction from a parity-odd proton-neutron-pion matrix element to a simpler spectroscopic quantity. The theorem paves the way to much more precise calculations of hπ1, and thus a quantitative test of the strangeness-conserving neutral current interaction of the standard model is foreseen.

  14. Risk factors of fatal occupational accidents in Iran.

    PubMed

    Asady, Hadi; Yaseri, Mehdi; Hosseini, Mostafa; Zarif-Yeganeh, Morvarid; Yousefifard, Mahmoud; Haghshenas, Mahin; Hajizadeh-Moghadam, Parisa

    2018-01-01

    Occupational accidents are of most important consequences of globalization in developing countries. Therefore, investigating the causes of occupational accidents for improving the job situation and making operational policy is necessary. So the aim of this study was to investigate factors affecting the fatal occupational accidents and also calculate the years of life lost for dead workers. This cross-sectional study was conducted on data related to the 6052 injured workers that was registered in the 2013 registry system of the Ministry of Health and Medical Education of Iran. Variables including sex, education, age, job tenure, injury cause, referred location of injured workers, occupation, shift work, season, accident day, damaged part of the body were chosen as independent variables. The Chi-squared and Fisher exact tests were used for univariate analysis and then exact multiple logistic regression was carried out to identify independent risk factors of fatal occupational accidents. Finally, for dead workers, years of life lost, according to the injury causes was calculated. Among the 6052 accidents reported, 33 deaths were recorded. Chi-square and Fisher exact tests showed that factors including: current job tenure ( p  = 0.01), damaged parts of the body ( p  < 0.001) and injury cause ( p  < 0.001) are associated with the fatal accidents. Also exact multiple logistic regression analysis showed a significant association between electric shocks as a cause of injury (OR = 7.04; 95% CI: 1.01-43.74; p  = 0.02) and current job tenure more than 1 year (OR = 0.21; 95% CI: 0.05-0.70; p  = 0.005) with the fatal accidents. The total amount of years of life lost based on causes of injuries was estimated 1289.12 years. In Iran, fatal accident odds in workers with job tenure more than 1 year was less in comparing to the workers with job tenure less and equal to 1 year. Also odd of death for electrical shock was more than other causes of injuries. So it seems that employing of workers who have more than one-year work experience in a specific job and using of appropriate safeguards will be useful for the reducing of fatal occupational accidents.

  15. Factors affecting poor nutritional status after small bowel resection in patients with Crohn disease.

    PubMed

    Jang, Ki Ung; Yu, Chang Sik; Lim, Seok-Byung; Park, In Ja; Yoon, Yong Sik; Kim, Chan Wook; Lee, Jong Lyul; Yang, Suk-Kyun; Ye, Byong Duk; Kim, Jin Cheon

    2016-07-01

    In Crohn disease, bowel-preserving surgery is necessary to prevent short bowel syndrome due to repeated operations. This study aimed to determine the remnant small bowel length cut-off and to evaluate the clinical factors related to nutritional status after small bowel resection in Crohn disease.We included 394 patients (69.3% male) who underwent small bowel resection for Crohn disease between 1991 and 2012. Patients who were classified as underweight (body mass index < 17.5) or at high risk of nutrition-related problems (modified nutritional risk index < 83.5) were regarded as having a poor nutritional status. Preliminary remnant small bowel length cut-offs were determined using receiver operating characteristic curves. Variables associated with poor nutritional status were assessed retrospectively using Student t tests, chi-squared tests, Fisher exact tests, and logistic regression analyses.The mean follow-up period was 52.9 months and the mean patient ages at the time of the last bowel surgery and last follow-up were 31.2 and 35.7 years, respectively. The mean remnant small bowel length was 331.8 cm. Forty-three patients (10.9%) underwent ileostomy, 309 (78.4%) underwent combined small bowel and colon resection, 111 (28.2%) had currently active disease, and 105 (26.6%) underwent at least 2 operations for recurrent disease. The mean body mass index and modified nutritional risk index were 20.6 and 100.8, respectively. The independent factors affecting underweight status were remnant small bowel length ≤240 cm (odds ratio: 4.84, P < 0.001), ileostomy (odds ratio: 4.70, P < 0.001), and currently active disease (odds ratio: 4.16, P < 0.001). The independent factors affecting high nutritional risk were remnant small bowel length ≤230 cm (odds ratio: 2.84, P = 0.012), presence of ileostomy (odds ratio: 3.36, P = 0.025), and currently active disease (odds ratio: 4.90, P < 0.001).Currently active disease, ileostomy, and remnant small bowel length ≤230 cm are risk factors affecting the poor nutritional status of patients with Crohn disease after small bowel resection.

  16. Banding the Sleeve Improves Weight Loss in Midterm Follow-up.

    PubMed

    Fink, Jodok M; Hoffmann, Natalie; Kuesters, Simon; Seifert, Gabriel; Laessle, Claudia; Glatz, Torben; Hopt, Ulrich T; Konrad Karcz, W; Marjanovic, Goran

    2017-04-01

    Laparoscopic sleeve gastrectomy (LSG) can achieve excellent weight loss, yet sleeve dilatation with concomitant weight regain proves to be a relevant issue. Hence, additional restriction might improve results after LSG. In a retrospective matched-pair analysis, 42 patients who underwent banded LSG (BLSG) using a MiniMizer® ring between January 2012 and October 2014 were analysed regarding weight loss, complications and comorbidity. Median follow-up was 3 years. Forty-two patients who had undergone conventional LSG were selected as matched pairs. Mean preoperative BMI was 54.93 ± 7.42 kg/m 2 for BLSG and 53.46 ± 6.69 kg/m 2 for LSG (Mann-Whitney P = 0.540). Total weight loss (%TWL) was significantly greater in the BLSG group 3 years after surgery (BLSG 38.22% ± 7.26; n = 26 vs. LSG 32.69 ± 9.47; n = 26; P = 0.0154). Ring placement had no relevant impact on new-onset reflux (Fisher's exact test P = 1.0) but a tendency towards reflux improvement when reflux pre-existed (odds ratio 1.96). The major side effect of ring implantation was regurgitation with over 44% of patients presenting with regurgitation >1 per week (Fisher's exact test P = 0.0019, odds ratio 18.07). BLSG is a safe procedure showing similar comorbidity to conventional LSG. However, BLSG leads to a higher rate of postoperative regurgitation. Weight loss is significantly improved 3 years after surgery. Hence, additional ring implantation might be an option for increased restriction in LSG surgery.

  17. An open-label randomized controlled trial of low molecular weight heparin compared to heparin and coumadin for the treatment of venous thromboembolic events in children: the REVIVE trial.

    PubMed

    Massicotte, Patricia; Julian, Jim A; Gent, Michael; Shields, Karen; Marzinotto, Velma; Szechtman, Barbara; Andrew, Maureen

    2003-01-25

    Venous thromboembolic events (VTE) are serious complications in children and for which the standard of care, unfractionated heparin followed by oral anticoagulation (UFH/OA), is problematic. The objective of REVIVE was to compare the efficacy and safety of a low molecular weight heparin (reviparin-sodium) to UFH/OA for the treatment of VTE in children. This multicenter, open-label study, with blinded central outcome adjudication, randomized patients with objectively confirmed VTE to receive either reviparin-sodium or UFH/OA. Dose adjustments were made using nomograms. The efficacy outcome was based on recurrent VTE and death due to VTE during the 3-month treatment period. The safety outcomes were major bleeding, minor bleeding and death. Due to slow patient accrual, REVIVE was closed prematurely. At 3 months, with reviparin-sodium, 2/36 patients (5.6%) had recurrent VTE or death compared to 4/40 patients (10.0%) receiving UFH/OA (odds ratio=0.53; 95% CI=(0.05, 4.00); Fisher's exact test: 2P=0.677). There were 7 major bleeds, 2/36 (5.6%) in the reviparin-sodium group and 5/40 (12.5%) in UFH/OA group (odds ratio=0.41; 95% confidence interval 0.04, 2.76); Fisher's exact test: P=0.435). There were 5 deaths during the study period, 1 (2.8%) in the reviparin-sodium group and 4 (10.0%) in the UFH/OA group. All five deaths were unrelated to VTE but one was due to an intracranial hemorrhage in the UFH/OA group. Although limited by small sample size, REVIVE provides valuable information on the incidence of recurrent VTE, major bleeding and problematic issues associated with therapy of VTE in children.

  18. Bright, dark and W-shaped solitons with extended nonlinear Schrödinger's equation for odd and even higher-order terms

    NASA Astrophysics Data System (ADS)

    Bendahmane, Issam; Triki, Houria; Biswas, Anjan; Saleh Alshomrani, Ali; Zhou, Qin; Moshokoa, Seithuti P.; Belic, Milivoj

    2018-02-01

    We present solitary wave solutions of an extended nonlinear Schrödinger equation with higher-order odd (third-order) and even (fourth-order) terms by using an ansatz method. The including high-order dispersion terms have significant physical applications in fiber optics, the Heisenberg spin chain, and ocean waves. Exact envelope solutions comprise bright, dark and W-shaped solitary waves, illustrating the potentially rich set of solitary wave solutions of the extended model. Furthermore, we investigate the properties of these solitary waves in nonlinear and dispersive media. Moreover, specific constraints on the system parameters for the existence of these structures are discussed exactly. The results show that the higher-order dispersion and nonlinear effects play a crucial role for the formation and properties of propagating waves.

  19. Computer search for binary cyclic UEP codes of odd length up to 65

    NASA Technical Reports Server (NTRS)

    Lin, Mao-Chao; Lin, Chi-Chang; Lin, Shu

    1990-01-01

    Using an exhaustive computation, the unequal error protection capabilities of all binary cyclic codes of odd length up to 65 that have minimum distances at least 3 are found. For those codes that can only have upper bounds on their unequal error protection capabilities computed, an analytic method developed by Dynkin and Togonidze (1976) is used to show that the upper bounds meet the exact unequal error protection capabilities.

  20. Cerebrovascular accidents in patients treated for choroidal neovascularization with ranibizumab in randomized controlled trials.

    PubMed

    Bressler, Neil M; Boyer, David S; Williams, David F; Butler, Steven; Francom, Steven F; Brown, Benton; Di Nucci, Flavia; Cramm, Timothy; Tuomi, Lisa L; Ianchulev, Tsontcho; Rubio, Roman G

    2012-10-01

    To analyze cerebrovascular accidents (CVAs) pooled from large, randomized, controlled clinical trials of ranibizumab treatment for neovascular age-related macular degeneration. Events in five trials (FOCUS, MARINA, ANCHOR, PIER, and SAILOR) were analyzed using a standard safety monitoring process. Exact methods, stratified by study, were used to test for treatment differences based on odds ratios. A stepwise logistic regression model was fit to classify subjects' risk for CVA based on medical history. Treatment differences in CVA rates at 1 year or 2 years were evaluated within risk groups using stratified exact methods. Pooled 2-year CVA rates were <3%; odds ratios (95% confidence intervals) for CVA risk were 1.2 (0.4-4.4) for ranibizumab 0.3-mg versus control, 2.2 (0.8-7.1) for 0.5 mg versus control, and 1.5 (0.8-3.0) for 0.5-mg versus 0.3-mg ranibizumab. No substantial increased risk of CVA for 0.5 mg versus 0.3 mg was identified in pooled analyses or any of the individual trials. In pooled analyses, the difference between 0.5-mg ranibizumab and control was larger (7.7 [1.2-177]) among high-risk CVA patients. This analysis provided some evidence, although not definitive, of a potential increased risk of CVA with ranibizumab versus control or with 0.5-mg versus 0.3-mg ranibizumab. Continued monitoring for CVA within clinical trials seems warrented.

  1. Nonlinear oscillator with power-form elastic-term: Fourier series expansion of the exact solution

    NASA Astrophysics Data System (ADS)

    Beléndez, Augusto; Francés, Jorge; Beléndez, Tarsicio; Bleda, Sergio; Pascual, Carolina; Arribas, Enrique

    2015-05-01

    A family of conservative, truly nonlinear, oscillators with integer or non-integer order nonlinearity is considered. These oscillators have only one odd power-form elastic-term and exact expressions for their period and solution were found in terms of Gamma functions and a cosine-Ateb function, respectively. Only for a few values of the order of nonlinearity, is it possible to obtain the periodic solution in terms of more common functions. However, for this family of conservative truly nonlinear oscillators we show in this paper that it is possible to obtain the Fourier series expansion of the exact solution, even though this exact solution is unknown. The coefficients of the Fourier series expansion of the exact solution are obtained as an integral expression in which a regularized incomplete Beta function appears. These coefficients are a function of the order of nonlinearity only and are computed numerically. One application of this technique is to compare the amplitudes for the different harmonics of the solution obtained using approximate methods with the exact ones computed numerically as shown in this paper. As an example, the approximate amplitudes obtained via a modified Ritz method are compared with the exact ones computed numerically.

  2. Predicting the presence of sleep-disordered breathing in children with Down syndrome.

    PubMed

    Nehme, Joy; LaBerge, Robert; Pothos, Mary; Barrowman, Nick; Hoey, Lynda; Monsour, Andrea; Kukko, Madelaine; Katz, Sherri Lynne

    2017-08-01

    Sleep-disordered breathing (SDB) is highly prevalent in children with Down syndrome. Given the scarcity of resources and the presence of risk factors for SDB in this population, the objective of this study is to identify the clinical predictors of SDB, which would assist prioritization of children with Down syndrome for SDB evaluation. A retrospective cohort study was conducted on children enrolled in the Down syndrome clinic at CHEO who underwent polysomnography in 2004-2014. Total apnea-hypopnea index (AHI) or obstructive AHI (OAHI) > 5 events/hour was considered clinically significant. Associations between SDB and concurrent diagnoses, referral reasons, and sleep symptoms assessed by questionnaire were examined using Pearson's chi-square test or Fisher's exact test as appropriate. Univariate and multivariate logistic regression analyses were used to examine the predictors of SDB. SDB was present in 42.9% of 119 children, with its highest prevalence at age 8 years. Symptoms were not significantly associated with AHI > 5 events/hour or OAHI > 5 events/hour. Gastroesophageal reflux was associated with lower odds of OAHI > 5 events/hour on univariate testing (odds ratio 0.16, 95% CI 0.04-0.72; p = 0.02) and multivariate analysis (odds ratio 0.05, 95% CI 0.0006-0.50; p = 0.002). SDB is highly prevalent at all ages in children with Down syndrome. Symptoms did not predict SDB in this population, although gastroesophageal reflux may mimic SDB, which indicates that clinicians should continue to perform ongoing surveillance for SDB throughout the lifespan of children with Down syndrome. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Exact renormalization group in Batalin-Vilkovisky theory

    NASA Astrophysics Data System (ADS)

    Zucchini, Roberto

    2018-03-01

    In this paper, inspired by the Costello's seminal work [11], we present a general formulation of exact renormalization group (RG) within the Batalin-Vilkovisky (BV) quantization scheme. In the spirit of effective field theory, the BV bracket and Laplacian structure as well as the BV effective action (EA) depend on an effective energy scale. The BV EA at a certain scale satisfies the BV quantum master equation at that scale. The RG flow of the EA is implemented by BV canonical maps intertwining the BV structures at different scales. Infinitesimally, this generates the BV exact renormalization group equation (RGE). We show that BV RG theory can be extended by augmenting the scale parameter space R to its shifted tangent bundle T [1]ℝ. The extra odd direction in scale space allows for a BV RG supersymmetry that constrains the structure of the BV RGE bringing it to Polchinski's form [6]. We investigate the implications of BV RG supersymmetry in perturbation theory. Finally, we illustrate our findings by constructing free models of BV RG flow and EA exhibiting RG supersymmetry in the degree -1 symplectic framework and studying the perturbation theory thereof. We find in particular that the odd partner of effective action describes perturbatively the deviation of the interacting RG flow from its free counterpart.

  4. Increased prevalence of abnormal glucose tolerance among obese siblings of children with type 2 diabetes.

    PubMed

    Magge, Sheela N; Stettler, Nicolas; Jawad, Abbas F; Levitt Katz, Lorraine E

    2009-04-01

    To test the hypothesis that overweight siblings of children with type 2 diabetes mellitus (T2DM) have a higher prevalence of abnormal glucose tolerance (AGT) compared with other overweight children. This was a cross-sectional study of overweight (body mass index [BMI] >or= 95(th) percentile) subjects, age 8 to 17 years, with at least 1 sibling age >or= 12 years. The primary outcome was AGT, as assessed by the oral glucose tolerance test (2-hour glucose >or= 140 mg/dL). The secondary outcome was insulin resistance by homeostasis model assessment (HOMA). The sibling (n=20) and control (n=42) groups were similar in terms of age, sex, racial distribution (largely African American), pubertal status, and BMI. The prevalence of AGT in the sibling group was 40.0% (n=8), compared with 14.3% (n=6) in controls (P= .048, Fisher exact test; unadjusted odds ratio=4.0; 95% confidence interval=1.2 to 13.5). Univariate analysis did not identify confounders for either outcome. There were no significant differences in HOMA or hemoglobin A1c between the 2 groups. Overweight siblings of children with T2DM had 4 times greater odds of having AGT compared with other overweight children. This group may represent a particularly high-risk population to target for screening and pediatric T2DM prevention.

  5. High-spin level structure and Ground-state phase transition in the odd-mass 103-109Rh isotopes in the framework of exactly solvable sdg interacting boson-fermion model

    NASA Astrophysics Data System (ADS)

    Ghapanvari, M.; Ghorashi, A. H.; Ranjbar, Z.; Jafarizadeh, M. A.

    2018-03-01

    In this article, the negative-parity states in the odd-mass 103 - 109Rh isotopes in terms of the sd and sdg interacting-boson fermion models were studied. The transitional interacting boson-fermion model Hamiltonians in sd and sdg-IBFM versions based on affine SU (1 , 1) Lie Algebra were employed to describe the evolution from the spherical to deformed gamma unstable shapes along with the chain of Rh isotopes. In this method, sdg-IBFM Hamiltonian, which is a three level pairing Hamiltonian was determined easily via the exactly solvable method. Some observables of the shape phase transitions such as energy levels, the two neutron separation energies, signature splitting of the γ-vibrational band, the α-decay and double β--decay energies were calculated and examined for these isotopes. The present calculation correctly reproduces the spherical to gamma-soft phase transition in the Rh isotopes. Some comparisons were made with sd-IBFM.

  6. Interferometric space-mode multiplexing based on binary phase plates and refractive phase shifters.

    PubMed

    Liñares, Jesús; Prieto-Blanco, Xesús; Moreno, Vicente; Montero-Orille, Carlos; Mouriz, Dolores; Nistal, María C; Barral, David

    2017-05-15

    A Mach-Zehnder interferometer (MZI) that includes in an arm either a reflective image inverter or a Gouy phase shifter (RGPS) can (de)multiplex many types of modes of a few mode fiber without fundamental loss. The use of RGPSs in combination with binary phase plates for multiplexing purposes is studied for the first time, showing that the particular RGPS that shifts π the odd modes only multiplexes accurately low order modes. To overcome such a restriction, we present a new exact refractive image inverter, more compact and flexible than its reflective counterpart. Moreover, we show that these interferometers remove or reduce the crosstalk that the binary phase plates could introduce between the multiplexed modes. Finally, an experimental analysis of a MZI with both an approximated and an exact refractive image inverter is presented for the case of a bimodal multiplexing. Likewise, it is proven experimentally that a RGPS that shifts π/2 demultiplexes two odd modes which can not be achieved by any image inverter.

  7. The association between primary open-angle glaucoma and fall: an observational study.

    PubMed

    Tanabe, Sachiko; Yuki, Kenya; Ozeki, Naoki; Shiba, Daisuke; Tsubota, Kazuo

    2012-01-01

    Falls are among the most serious public health concerns for the elderly. Information conveyed via the visual sense is relevant to postural balance and movement, and proper visual function is essential to avoid falls. Here we investigated the prevalence of injurious falls among patients with primary open-angle glaucoma (POAG) who were more than 45 years old, compared with comparably aged healthy subjects. This is a cross-sectional study. Consecutive patients who visited the Tanabe Eye Clinic, Yamanashi, Japan between January 1 and March 30, 2009 were screened for eligibility by ophthalmic examination. A total of 117 control subjects (77 men, 40 women; aged 60.2 ± 7.5 years) who were free of ocular disease and 101 POAG patients (58 men, 43 women; aged 62.3 ± 8.7 years) were consecutively enrolled. Participants answered a questionnaire on injurious fall experience during the previous 10 years. The prevalence of injurious fall in subjects with POAG versus healthy controls was examined with Fisher's exact test. Adjusted odds ratios and 95% confidence intervals were estimated with logistic regression models for the subjects with POAG (factors: age, gender, mean deviation in the better eye or worse eye). The self-reported prevalence of injurious fall was 0.9% (1/117) in the control group and 6.9% (7/101) in the POAG group. The association between injurious fall and POAG was statistically significant (P = 0.026, Fisher's exact test). Within the POAG patients, the group reporting falls was significantly older and had a lower BMI, worse BCVA, and worse mean deviation in both the better and worse eye than the group reporting no falls. Worse mean deviation in the eye with the better visual field (odds ratios 0.75; 95% confidence intervals: 0.57 to 0.99; P = 0.036) was a significant risk factor for injurious falls in subjects with POAG. POAG was significantly associated with injurious falls.

  8. Risk factors for new-onset late postpartum preeclampsia in women without a history of preeclampsia.

    PubMed

    Bigelow, Catherine A; Pereira, Guilherme A; Warmsley, Amber; Cohen, Jennifer; Getrajdman, Chloe; Moshier, Erin; Paris, Julia; Bianco, Angela; Factor, Stephanie H; Stone, Joanne

    2014-04-01

    Risk factors for the development of new-onset late postpartum preeclampsia (LPP) in women without any history of preeclampsia are not known. Because identification of women who are at risk may lead to an earlier diagnosis of disease and improved maternal outcomes, this study identified risk factors (associated patient characteristics) for new-onset LPP. A case-control study of 34 women with new-onset LPP and 68 women without new-onset LPP after normal delivery, who were matched on date of delivery, was conducted at Mount Sinai Hospital, New York, NY. Data were collected by chart review. Exact conditional logistic regression identified patient characteristics that were associated with new-onset LPP. New-onset LPP was associated with age ≥40 years (adjusted odds ratio, 24.83; 95% confidence interval [CI], 1.43-infinity; P = .03), black race (adjusted odds ratio, 78.35; 95% CI, 7.25-infinity; P < .001), Latino ethnicity (adjusted odds ratio, 19.08; 95% CI, 2.73-infinity; P = .001), final pregnancy body mass index of ≥30 kg/m(2) (adjusted odds ratio, 13.38; 95% CI, 1.87-infinity; P = .01), and gestational diabetes mellitus (adjusted odds ratio, 72.91; 95% CI, 5.52-infinity; P < .001). As predictive tests for new-onset LPP, the sensitivity and specificity of having ≥1 of these characteristics was 100% and 59%, respectively, and the sensitivity and specificity of having ≥2 was 56% and 93%, respectively. Older age, black race, Latino ethnicity, obesity, and a pregnancy complicated by gestational diabetes mellitus all are associated positively with the development of new-onset LPP. Closer observation may be warranted in these populations. Copyright © 2014 Mosby, Inc. All rights reserved.

  9. Even and odd normalized zero modes in random interacting Majorana models respecting the parity P and the time-reversal-symmetry T

    NASA Astrophysics Data System (ADS)

    Monthus, Cécile

    2018-06-01

    For random interacting Majorana models where the only symmetries are the parity P and the time-reversal-symmetry T, various approaches are compared to construct exact even and odd normalized zero modes Γ in finite size, i.e. Hermitian operators that commute with the Hamiltonian, that square to the identity, and that commute (even) or anticommute (odd) with the parity P. Even normalized zero-modes are well known under the name of ‘pseudo-spins’ in the field of many-body-localization or more precisely ‘local integrals of motion’ (LIOMs) in the many-body-localized-phase where the pseudo-spins happens to be spatially localized. Odd normalized zero-modes are popular under the name of ‘Majorana zero modes’ or ‘strong zero modes’. Explicit examples for small systems are described in detail. Applications to real-space renormalization procedures based on blocks containing an odd number of Majorana fermions are also discussed.

  10. Predictors of timing of pregnancy discovery.

    PubMed

    McCarthy, Molly; Upadhyay, Ushma; Biggs, M Antonia; Anthony, Renaisa; Holl, Jennifer; Roberts, Sarah Cm

    2018-04-01

    Earlier pregnancy discovery is important in the context of prenatal and abortion care. We evaluated characteristics associated with later pregnancy discovery among women seeking abortion care. Data come from a survey of women seeking abortion care at four family planning facilities in Utah. The participants completed a survey during the state-mandated abortion information visit they are required to complete prior to having an abortion. The outcome in this study was pregnancy discovery before versus after 6 weeks since respondents' last menstrual period (LMP). We used logistic regression to estimate the relationship between sociodemographic and health-related independent variables of interest and pregnancy discovery before versus after 6 weeks. Among the 458 women in the sample, 28% discovered their pregnancy later than 6 weeks since LMP. Most (n=366, 80%) knew the exact date of their LMP and a significant minority estimated it (n=92, 20%). Those who estimated the date of their LMP had higher odds of later pregnancy discovery than those who knew the exact date (adjusted odds ratio (aOR)=1.81[1.07-3.07]). Those who used illicit drugs weekly, daily, or almost daily had higher odds of later pregnancy discovery (aOR=6.33[2.44, 16.40]). Women who did not track their menstrual periods and those who frequently used drugs had higher odds of discovering their pregnancies later. Women who estimated the date of their LMP and who frequently used drugs may benefit from strategies to help them recognize their pregnancies earlier and link them to care when they discover their pregnancies later. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Autosomal Dominant Hyper-IgE Syndrome in the USIDNET Registry.

    PubMed

    Gernez, Yael; Freeman, Alexandra F; Holland, Steven M; Garabedian, Elizabeth; Patel, Niraj C; Puck, Jennifer M; Sullivan, Kathleen E; Akhter, Javeed; Secord, Elizabeth; Chen, Karin; Buckley, Rebecca; Haddad, Elie; Ochs, Hans D; Fuleihan, Ramsay; Routes, John; Muskat, Mica; Lugar, Patricia; Mancini, Julien; Cunningham-Rundles, Charlotte

    Autosomal dominant hyper-IgE syndrome (AD-HIES) is a rare condition. Data from the USIDNET Registry provide a resource to examine the characteristics of patients with rare immune deficiency diseases. A query was submitted to the USIDNET requesting deidentified data for patients with physician-diagnosed AD-HIES through July 2016. Data on 85 patients diagnosed with AD-HIES (50 males; 35 females) born between 1950 and 2013, collected by 14 physicians from 25 states and Quebec, were entered into the USIDNET Registry by July 2016. Cumulative follow-up was 2157 years. Of these patients, 45.9% had a family history of HIES. The complications reported included skin abscesses (74.4%), eczema (57.7%), retained primary teeth (41.4%), fractures (39%), scoliosis (34.1%), and cancer (7%). Reported allergic diseases included food (37.8%), environmental (18%), and drugs (42.7%). The mean serum IgE level was 8383.7 kU/mL and was inversely correlated to the patient's age. A total of 49.4% had eosinophilia; 56% were known to be on trimethoprim-sulfamethoxazole, 26.6% on antifungal coverage, and 30.6% on immunoglobulin replacement therapy. Pneumonias were more commonly attributed to Staphylococcus aureus (55.3%) or Aspergillus fumigatus (22.4%); 19.5% had a history of lung abscess; these were most often associated with Pseudomonas aeruginosa (P Fisher's exact test = .029) or A. fumigatus (P Fisher's exact test = .016). Lung abscesses were significantly associated with drug reactions (P χ 2  = .01; odds ratio: 4.03 [1.2-12.97]), depression (P Fisher's exact test = .036), and lower Karnofsky index scores (P Mann-Whitney = .007). Data from the USIDNET Registry summarize the currently reported clinical characteristics of a large cohort of subjects with AD-HIES. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. All rights reserved.

  12. Magnetic Resonance Imaging Assessment of Lipomatous Soft-tissue Tumors

    PubMed Central

    CORAN, ALESSANDRO; ORTOLAN, PAOLO; ATTAR, SHADY; ALBERIOLI, ENRICO; PERISSINOTTO, EGLE; TOSI, ANNA LISA; MONTESCO, MARIA CRISTINA; ROSSI, CARLO RICCARDO; TROPEA, SAVERIA; RASTRELLI, MARCO; STRAMARE, ROBERTO

    2017-01-01

    To establish the accuracy of magnetic resonance imaging (MRI) in distinguishing between benign and malignant lipomatous tumors; to evaluate the reproducibility of the MRI interpretation assessing the agreement between judgments of two radiologists with the same experience in soft-tissue sarcomas; to identify an association among MRI findings (size, depth, septa, nodules, signal homogeneity) and nature of the lesion. Materials and Methods: A total of 54 patients (28 men and 26 women), with a mean age of 56 (range=27-84) were included years. All subjects followed-up by the Multidisciplinary Sarcoma Group. The following MRI findings were judged in a blind study by two radiologists: size, localization, septa, nodules and signal homogeneity. A diagnostic indication was then given from among lipoma, atypical lipomatous tumour (ALT) and liposarcoma. Accuracy in distinguishing between benign and malignant lesions, and between lipoma and ALT (Fisher’s exact test), inter-operator agreement (Cohen’s kappa), association of MRI findings and malignancy of the lesion (Fisher’s exact test and odds ratio) were evaluated. Results: The inter-operator agreement was complete (100%). The agreement between diagnostic hypothesis and histological diagnosis was statistically significant (p<0.05). Among the radiological findings taken into account, only septa and signal homogeneity were significantly associated with the malignancy of the lesion (p<0.05). Conclusion: MRI could be helpful in distinguishing lipomatous tumors, allowing biopsy to be avoided in some cases (negative predictive value=100%). PMID:28438867

  13. A Cross-border Comparison of Hepatitis B Testing Among Chinese Residing in Canada and the United States

    PubMed Central

    Tu, Shin-Ping; Li, Lin; Tsai, Jenny Hsin-Chun; Yip, Mei-Po; Terasaki, Genji; Teh, Chong; Yasui, Yutaka; Hislop, T Gregory; Taylor, Vicky

    2013-01-01

    Background The Western Pacific region has the highest level of endemic hepatitis B virus (HBV) infection in the world, with the Chinese representing nearly one-third of infected persons globally. HBV carriers are potentially infectious to others and have an increased risk of chronic active hepatitis, cirrhosis, and hepatocellular carcinoma. Studies from the U.S. and Canada demonstrate that immigrants, particularly from Asia, are disproportionately affected by liver cancer. Purpose Given the different health care systems in Seattle and Vancouver, two geographically proximate cities, we examined HBV testing levels and factors associated with testing among Chinese residents of these cities. Methods We surveyed Chinese living in areas of Seattle and Vancouver with relatively high proportions of Chinese residents. In-person interviews were conducted in Cantonese, Mandarin, or English. Our bivariate analyses consisted of the chi-square test, with Fisher’s Exact test as necessary. We then performed unconditional logistic regression, first examining only the city effect as the sole explanatory variable of the model, then assessing the adjusted city effect in a final main-effects model that was constructed through backward selection to select statistically significant variables at alpha = 0.05. Results Survey cooperation rates for Seattle and Vancouver were 58% and 59%, respectively. In Seattle, 48% reported HBV testing, whereas in Vancouver, 55% reported testing. HBV testing in Seattle was lower than in Vancouver, with a crude odds ratio of 0.73 (95% CI = 0.56, 0.94). However after adjusting for demographic, health care access, knowledge, and social support variables, we found no significant differences in HBV testing between the two cities. In our logistic regression model, the odds of HBV testing were greatest when the doctor recommended the test, followed by when the employer asked for the test. Discussion Findings from this study support the need for additional research to examine the effectiveness of clinic-based and workplace interventions to promote HBV testing among immigrants to North America. PMID:19640196

  14. A cross-border comparison of hepatitis B testing among chinese residing in Canada and the United States.

    PubMed

    Tu R, Shin-Ping; Li, Lin; Tsai, Jenny Hsin-Chun; Yip, Mei-Po; Terasaki, Genji; Teh, Chong; Yasui, Yutaka; Hislop, T Gregory; Taylor, Vicky

    2009-01-01

    The Western Pacific region has the highest level of endemic hepatitis B virus (HBV) infection in the world, with the Chinese representing nearly one-third of infected persons globally. HBV carriers are potentially infectious to others and have an increased risk of chronic active hepatitis, cirrhosis, and hepatocellular carcinoma. Studies from the U.S. and Canada demonstrate that immigrants, particularly from Asia, are disproportionately affected by liver cancer. Given the different health care systems in Seattle and Vancouver, two geographically proximate cities, we examined HBV testing levels and factors associated with testing among Chinese residents of these cities. We surveyed Chinese living in areas of Seattle and Vancouver with relatively high proportions of Chinese residents. In-person interviews were conducted in Cantonese, Mandarin, or English. Our bivariate analyses consisted of the chi-square test, with Fisher's Exact test as necessary. We then performed unconditional logistic regression, first examining only the city effect as the sole explanatory variable of the model, then assessing the adjusted city effect in a final main-effects model that was constructed through backward selection to select statistically significant variables at alpha=0.05. Survey cooperation rates for Seattle and Vancouver were 58% and 59%, respectively. In Seattle, 48% reported HBV testing, whereas in Vancouver, 55% reported testing. HBV testing in Seattle was lower than in Vancouver, with a crude odds ratio of 0.73 (95% CI = 0.56, 0.94). However after adjusting for demographic, health care access, knowledge, and social support variables, we found no significant differences in HBV testing between the two cities. In our logistic regression model, the odds of HBV testing were greatest when the doctor recommended the test, followed by when the employer asked for the test. Findings from this study support the need for additional research to examine the effectiveness of clinic-based and workplace interventions to promote HBV testing among immigrants to North America.

  15. CD8+ and FoxP3+ T-cell infiltration in actinic cheilitis.

    PubMed

    Rojas, Isolde G; Spencer, Maria L; Zapata, Paulina A; Martínez, Alejandra; Alarcón, Rosario; Marchesani, Francisco J; Tezal, Mine

    2017-01-01

    Differences in immune profile between actinic cheilitis (AC), a precursor of lip squamous cell carcinoma, and normal lip vermillion (NL) have not been elucidated. To compare density, distribution, and ratios of CD8+ and FoxP3+ cells between AC and NL and assess their associations with clinicopathologic variables. Samples of AC and NL obtained between 2001 and 2013 at the College of Dentistry of the University of Concepcion, Chile, were retrospectively analyzed for immunohistochemical detection of CD8+ and FoxP3+ cells. Differences between groups were tested by Mann-Whitney U and Fisher's exact tests. Independent effects of cell densities and CD8/FoxP3 ratio with AC were assessed by multiple logistic regression analysis after adjustment for potential confounding. A total of 62 AC and 24 NL biopsies were included. Densities of CD8+ and FoxP3+ cells in AC were significantly higher than in NL. Conversely, the CD8+/FoxP3+ ratio was significantly lower in AC as compared to NL. After adjustment for sun exposure, age, gender, and smoking status, a stromal FoxP3+ cell density higher than 0.35 cells/field was significantly associated with increased odds of AC (odds ratio [OR] = 5.01, 95% confidence interval [CI]: 1.18-21.31), while a stromal CD8+/FoxP3+ ratio higher than 5.91 was associated with decreased odds of AC (OR = 0.29, 95% CI: 0.08-1.08). AC is characterized by increased FoxP3+ cell infiltration and a reduced CD8/FoxP3 ratio as compared to NL. Therefore, increased infiltration of FoxP3+ cells relative to CD8+ cells may contribute to the transition from normal to preneoplastic stages in lip carcinogenesis. © 2016 The International Society of Dermatology.

  16. Exact probability distribution functions for Parrondo's games

    NASA Astrophysics Data System (ADS)

    Zadourian, Rubina; Saakian, David B.; Klümper, Andreas

    2016-12-01

    We study the discrete time dynamics of Brownian ratchet models and Parrondo's games. Using the Fourier transform, we calculate the exact probability distribution functions for both the capital dependent and history dependent Parrondo's games. In certain cases we find strong oscillations near the maximum of the probability distribution with two limiting distributions for odd and even number of rounds of the game. Indications of such oscillations first appeared in the analysis of real financial data, but now we have found this phenomenon in model systems and a theoretical understanding of the phenomenon. The method of our work can be applied to Brownian ratchets, molecular motors, and portfolio optimization.

  17. Exact probability distribution functions for Parrondo's games.

    PubMed

    Zadourian, Rubina; Saakian, David B; Klümper, Andreas

    2016-12-01

    We study the discrete time dynamics of Brownian ratchet models and Parrondo's games. Using the Fourier transform, we calculate the exact probability distribution functions for both the capital dependent and history dependent Parrondo's games. In certain cases we find strong oscillations near the maximum of the probability distribution with two limiting distributions for odd and even number of rounds of the game. Indications of such oscillations first appeared in the analysis of real financial data, but now we have found this phenomenon in model systems and a theoretical understanding of the phenomenon. The method of our work can be applied to Brownian ratchets, molecular motors, and portfolio optimization.

  18. Quantum phase transitions and string orders in the spin-1/2 Heisenberg-Ising alternating chain with Dzyaloshinskii-Moriya interaction.

    PubMed

    Liu, Guang-Hua; You, Wen-Long; Li, Wei; Su, Gang

    2015-04-29

    Quantum phase transitions (QPTs) and the ground-state phase diagram of the spin-1/2 Heisenberg-Ising alternating chain (HIAC) with uniform Dzyaloshinskii-Moriya (DM) interaction are investigated by a matrix-product-state (MPS) method. By calculating the odd- and even-string order parameters, we recognize two kinds of Haldane phases, i.e. the odd- and even-Haldane phases. Furthermore, doubly degenerate entanglement spectra on odd and even bonds are observed in odd- and even-Haldane phases, respectively. A rich phase diagram including four different phases, i.e. an antiferromagnetic (AF), AF stripe, odd- and even-Haldane phases, is obtained. These phases are found to be separated by continuous QPTs: the topological QPT between the odd- and even-Haldane phases is verified to be continuous and corresponds to conformal field theory with central charge c = 1; while the rest of the phase transitions in the phase diagram are found to be c = 1/2. We also revisit, with our MPS method, the exactly solvable case of HIAC model with DM interactions only on odd bonds and find that the even-Haldane phase disappears, but the other three phases, i.e. the AF, AF stripe and odd-Haldane phases, still remain in the phase diagram. We exhibit the evolution of the even-Haldane phase by tuning the DM interactions on the even bonds gradually.

  19. Stratified exact tests for the weak causal null hypothesis in randomized trials with a binary outcome.

    PubMed

    Chiba, Yasutaka

    2017-09-01

    Fisher's exact test is commonly used to compare two groups when the outcome is binary in randomized trials. In the context of causal inference, this test explores the sharp causal null hypothesis (i.e. the causal effect of treatment is the same for all subjects), but not the weak causal null hypothesis (i.e. the causal risks are the same in the two groups). Therefore, in general, rejection of the null hypothesis by Fisher's exact test does not mean that the causal risk difference is not zero. Recently, Chiba (Journal of Biometrics and Biostatistics 2015; 6: 244) developed a new exact test for the weak causal null hypothesis when the outcome is binary in randomized trials; the new test is not based on any large sample theory and does not require any assumption. In this paper, we extend the new test; we create a version of the test applicable to a stratified analysis. The stratified exact test that we propose is general in nature and can be used in several approaches toward the estimation of treatment effects after adjusting for stratification factors. The stratified Fisher's exact test of Jung (Biometrical Journal 2014; 56: 129-140) tests the sharp causal null hypothesis. This test applies a crude estimator of the treatment effect and can be regarded as a special case of our proposed exact test. Our proposed stratified exact test can be straightforwardly extended to analysis of noninferiority trials and to construct the associated confidence interval. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  20. US-guided percutaneous cholecystostomy: features predicting culture-positive bile and clinical outcome.

    PubMed

    Sosna, Jacob; Kruskal, Jonathan B; Copel, Laurian; Goldberg, S Nahum; Kane, Robert A

    2004-03-01

    To assess sonographic and clinical features that might be used to predict infected bile and/or patient outcome from ultrasonography (US)-guided percutaneous cholecystostomy. Between February 1997 and August 2002 at one institution, 112 patients underwent US-guided percutaneous cholecystostomy (59 men, 53 women; average age, 69.3 years). All US images were scored on a defined semiquantitative scale according to preset parameters: (a) gallbladder distention, (b) sludge and/or stones, (c) wall appearance, (d) pericholecystic fluid, and (e) common bile duct size and/or choledocholithiasis. Separate and total scores were generated. Retrospective evaluation of (a) the bacteriologic growth of aspirated bile and its color and (b) clinical indices (fever, white blood cell count, bilirubin level, liver function test results) was conducted by reviewing medical records. For each patient, the clinical manifestation was classified into four groups: (a) localized right upper quadrant symptoms, (b) generalized abdominal symptoms, (c) unexplained sepsis, or (d) sepsis with other known infection. Logistic regression models, exact Wilcoxon-Mann-Whitney test, and the Kruskal-Wallis test were used. Forty-seven (44%) of 107 patients had infected bile. A logistic regression model showed that wall appearance, distention, bile color, and pericholecystic fluid were not individually significant predictors for culture-positive bile, leaving sludge and/or stones (P =.003, odds ratio = 1.647), common bile duct status (P =.02, odds ratio = 2.214), and total score (P =.007, odds ratio = 1.267). No US covariates or clinical indices predicted clinical outcome. Clinical manifestation was predictive of clinical outcome (P =.001) and aspirating culture-positive bile (P =.008); specifically, 30 (86%) of 35 patients with right upper quadrant symptoms had their condition improve, compared with one (7%) of 15 asymptomatic patients with other known causes of infection. US variables can be used to predict culture-positive bile but not patient outcome. Clinical manifestation is important because patients with right upper quadrant symptoms have the best clinical outcome. Copyright RSNA, 2004

  1. The association between glomus tumors and neurofibromatosis.

    PubMed

    Harrison, Bridget; Moore, Amy M; Calfee, Ryan; Sammer, Douglas M

    2013-08-01

    To determine whether an epidemiologic association exists between glomus tumors and neurofibromatosis. Using a pathology database, we established a study cohort consisting of all patients who had undergone excision of a glomus tumor of the hand between 1995 and 2010. We created a control cohort by randomly selecting 200 patients who had undergone excision of a ganglion cyst over the same period. We reviewed medical records for each cohort to identify patients with a diagnosis of neurofibromatosis. We calculated the odds ratio was calculated and performed Fisher's exact test to determine the significance of the association. We identified 21 patients with glomus tumors of the hand. Six of these patients carried the diagnosis of neurofibromatosis (29%). In contrast, no patients in the control group carried the diagnosis of neurofibromatosis. The odds ratio for a diagnosis of neurofibromatosis in association with a glomus tumor compared with controls was 168:1. This study provides evidence of a strong epidemiologic association between glomus tumors and neurofibromatosis. Glomus tumor should be included in the differential diagnosis in neurofibromatosis patients who present with a painful lesion of the hand or finger. Diagnostic III. Copyright © 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  2. Gender-specific relationships between socioeconomic disadvantage and obesity in elementary school students.

    PubMed

    Zahnd, Whitney E; Rogers, Valerie; Smith, Tracey; Ryherd, Susan J; Botchway, Albert; Steward, David E

    2015-12-01

    To assess the gender-specific effect of socioeconomic disadvantage on obesity in elementary school students. We evaluated body mass index (BMI) data from 2,648 first- and fourth-grade students (1,377 male and 1,271 female students) in eight elementary schools in Springfield, Illinois, between 2012 and 2014. Other factors considered in analysis were grade level, year of data collection, school, race/ethnicity, gender, and socioeconomic disadvantage (SD). Students were considered SD if they were eligible for free/reduced price lunch, a school-based poverty measure. We performed Fisher's exact test or chi-square analysis to assess differences in gender and obesity prevalence by the other factors and gender-stratified logistic regression analysis to determine if SD contributed to increased odds of obesity. A higher proportion of SD female students (20.8%) were obese compared to their non-SD peers (15.2%) (p=0.01). Unadjusted and adjusted logistic regression analysis indicated no difference in obesity in SD and non-SD male students. However, in both unadjusted and adjusted analyses, SD female students had higher odds of obesity than their peers. Even after controlling for grade level, school, year of data collection, and race/ethnicity, SD female students had 49% higher odds of obesity than their non-SD classmates (odds ratio:1.49; 95% confidence interval: 1.09-2.04). Obesity was elevated in SD female students, even after controlling for factors such as race/ethnicity, but such an association was not seen in male students. Further study is warranted to determine the cause of this disparity, and interventions should be developed to target SD female students. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Black hole perturbations in vector-tensor theories: the odd-mode analysis

    NASA Astrophysics Data System (ADS)

    Kase, Ryotaro; Minamitsuji, Masato; Tsujikawa, Shinji; Zhang, Ying-li

    2018-02-01

    In generalized Proca theories with vector-field derivative couplings, a bunch of hairy black hole solutions have been derived on a static and spherically symmetric background. In this paper, we formulate the odd-parity black hole perturbations in generalized Proca theories by expanding the corresponding action up to second order and investigate whether or not black holes with vector hair suffer ghost or Laplacian instabilities. We show that the models with cubic couplings G3(X), where X=‑AμAμ/2 with a vector field Aμ, do not provide any additional stability condition as in General Relativity. On the other hand, the exact charged stealth Schwarzschild solution with a nonvanishing longitudinal vector component A1, which originates from the coupling to the Einstein tensor GμνAμ Aν equivalent to the quartic coupling G4(X) containing a linear function of X, is unstable in the vicinity of the event horizon. The same instability problem also persists for hairy black holes arising from general quartic power-law couplings G4(X) ⊃ β4 Xn with the nonvanishing A1, while the other branch with A1=0 can be consistent with conditions for the absence of ghost and Laplacian instabilities. We also discuss the case of other exact and numerical black hole solutions associated with intrinsic vector-field derivative couplings and show that there exists a wide range of parameter spaces in which the solutions suffer neither ghost nor Laplacian instabilities against odd-parity perturbations.

  4. A note on Poisson goodness-of-fit tests for ionizing radiation induced chromosomal aberration samples.

    PubMed

    Higueras, Manuel; González, J E; Di Giorgio, Marina; Barquinero, J F

    2018-06-13

    To present Poisson exact goodness-of-fit tests as alternatives and complements to the asymptotic u-test, which is the most widely used in cytogenetic biodosimetry, to decide whether a sample of chromosomal aberrations in blood cells comes from an homogeneous or inhomogeneous exposure. Three Poisson exact goodness-of-fit test from the literature are introduced and implemented in the R environment. A Shiny R Studio application, named GOF Poisson, has been updated for the purpose of giving support to this work. The three exact tests and the u-test are applied in chromosomal aberration data from clinical and accidental radiation exposure patients. It is observed how the u-test is not an appropriate approximation in small samples with small yield of chromosomal aberrations. Tools are provided to compute the three exact tests, which is not as trivial as the implementation of the u-test. Poisson exact goodness-of-fit tests should be considered jointly to the u-test for detecting inhomogeneous exposures in the cytogenetic biodosimetry practice.

  5. Magnetic Resonance Imaging Assessment of Lipomatous Soft-tissue Tumors.

    PubMed

    Coran, Alessandro; Ortolan, Paolo; Attar, Shady; Alberioli, Enrico; Perissinotto, Egle; Tosi, Anna Lisa; Montesco, Maria Cristina; Rossi, Carlo Riccardo; Tropea, Saveria; Rastrelli, Marco; Stramare, Roberto

    2017-01-01

    To establish the accuracy of magnetic resonance imaging (MRI) in distinguishing between benign and malignant lipomatous tumors; to evaluate the reproducibility of the MRI interpretation assessing the agreement between judgments of two radiologists with the same experience in soft-tissue sarcomas; to identify an association among MRI findings (size, depth, septa, nodules, signal homogeneity) and nature of the lesion. A total of 54 patients (28 men and 26 women), with a mean age of 56 (range=27-84) were included years. All subjects followed-up by the Multidisciplinary Sarcoma Group. The following MRI findings were judged in a blind study by two radiologists: size, localization, septa, nodules and signal homogeneity. A diagnostic indication was then given from among lipoma, atypical lipomatous tumour (ALT) and liposarcoma. Accuracy in distinguishing between benign and malignant lesions, and between lipoma and ALT (Fisher's exact test), inter-operator agreement (Cohen's kappa), association of MRI findings and malignancy of the lesion (Fisher's exact test and odds ratio) were evaluated. The inter-operator agreement was complete (100%). The agreement between diagnostic hypothesis and histological diagnosis was statistically significant (p<0.05). Among the radiological findings taken into account, only septa and signal homogeneity were significantly associated with the malignancy of the lesion (p<0.05). MRI could be helpful in distinguishing lipomatous tumors, allowing biopsy to be avoided in some cases (negative predictive value=100%). Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  6. [Induced abortion and use of contraceptive methods among prostitutes in Almería (Spain)].

    PubMed

    Cabrerizo Egea, María Jesús; Barroso García, María Pilar; Rodríguez-Contreras Pelayo, Rafael

    2015-01-01

    To analyze the performance of induced abortion (IA) in prostitutes in Almería (Spain) and its association with the use of contraceptive methods. A cross-sectional study was conducted in 110 women. A bivariate analyses using either the χ(2) test or Fisher's exact test was carried out (significance level <0.05), with calculation of odds ratios and 95% confidence intervals. A total of 52.7% of women had undergone at least one IA. All of these women used condoms and 35.5% of them also used another contraceptive method. No statistically significant association was found between condom breakage and the performance of IA or in the use of other contraceptive methods. A high percentage of this group of women had undergone IA, despite widespread condom use. However, there was a high percentage of condom breakage and a low percentage of use of emergency contraceptive pills after risky sexual relationships. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  7. [Socializing groups as protective factor against depression in elderly people. Barranquilla, Colombia].

    PubMed

    Tuesca-Molina, Rafael; Fierro Herrera, Norma; Molinares Sosa, Alexandra; Oviedo Martínez, Fernando; Polo Arjona, Yesid; Polo Cueto, José; Sierra Manrique, Ivan

    2003-01-01

    The depression is a principal problem of public health. The principal aim of this study is to determine the role of the social groups as factor protective in elderly, to evaluate the agreement by American Psychiatric Association Criterions and Hamilton Depression test, and also to determine other socio-cultural risk factors associated with depressive syndrome in elderly. Cross-sectional survey. The sample consisted of 602 elderly people (eligible subjects) were men (223) and women (379) between 60 and 94 years (males and females), residents in the south-west of Barranquilla, Colombia. A previously tested, self answer questionnaire was used, therefore, we needed a report consent. Risk measures: Odds Ratio (OR-95% Confidence intervalue), Kappa test to agreement by the nine criteria of the American Psychiatric Association and Hamilton test so, screening testing. The participation in social groups was a protector factor. (Odds Ratio = 0.5; 95% CI 0.34-0.73, p = 0.001). The rate 29.9% was obtained with prevalence of depression in elderly (21.4%-39.4%) affecting principally males (32.7%). The agreement by Kappa test = 0.63 was very important or good. Sensibility = 56.1% (48.5%-63.4%) Specificity = 0.93% (97.8%-99.8%) and Predictive Positive Value = 97.1% (91.2%-99.3%). This survey was to determine risk factors related to depression in elderly in anyway can be potentially modifiable. The familiar disfunction by moderate and serious, the lack as blindness and deafness, the loneliness, the housingness and low incomes were obtained with risk factors associated to depression. The participation in a social group is a protective factor to depression syndrome in elders. The nine criteria of the American Psychiatric Association to allow the depressed patient exactly as sick even though is not necessary to screening because this test is low sensibility for used in a population elderly.

  8. Fetal and neonatal deaths of children of patients classified as near miss.

    PubMed

    Nardello, Daniele Marin; Guimarães, Alzira Maria D Avila Nery; Barreto, Ikaro Daniel de Carvalho; Gurgel, Ricardo Queiroz; Ribeiro, Eleonora Ramos de Oliveira; Gois, Cristiane Franca Lisboa

    2017-01-01

    identify the epidemiological aspects of early fetal and neonatal deaths in children of patients classified with near miss and the factors associated with this outcome. a cross-sectional study of 79 women identified with near miss and their newborns. The variables were analyzed using Fisher's exact test. Risk factors were estimated based on unadjusted and adjusted odds ratios, and by means of multiple correspondence analysis, with significance for p <0.05. hypertensive disorders totaled 40.5%; Of these, 58.3% had adverse fetal and neonatal outcome. The newborns admitted to the Neonatal Intensive Care Unit proved to be significant for the outcome (70.8%), gestational age <32 weeks (41.6%), birth weight <2500 (66.7%), neonatal asphyxia (50%) and early respiratory discomfort (72.2%). prematurity, neonatal asphyxia, and early respiratory distress were significant characteristics for the outcome among newborns.

  9. Extended nonlinear Schrödinger equation with higher-order odd and even terms and its rogue wave solutions.

    PubMed

    Ankiewicz, Adrian; Wang, Yan; Wabnitz, Stefan; Akhmediev, Nail

    2014-01-01

    We consider an extended nonlinear Schrödinger equation with higher-order odd (third order) and even (fourth order) terms with variable coefficients. The resulting equation has soliton solutions and approximate rogue wave solutions. We present these solutions up to second order. Moreover, specific constraints on the parameters of higher-order terms provide integrability of the resulting equation, providing a corresponding Lax pair. Particular cases of this equation are the Hirota and the Lakshmanan-Porsezian-Daniel equations. The resulting integrable equation admits exact rogue wave solutions. In particular cases, mentioned above, these solutions are reduced to the rogue wave solutions of the corresponding equations.

  10. Evaluating guideline adherence regarding empirical vancomycin use in patients with neutropenic fever.

    PubMed

    Chastain, Daniel B; Wheeler, Sarah; Franco-Paredes, Carlos; Olubajo, Babatunde; Hawkins, W Anthony

    2018-04-01

    The purpose of this study was to evaluate the use of empirical vancomycin for patients with neutropenic fever (NF) with regard to adherence to treatment guidelines. Adult patients with a diagnosis of neutropenia, who met the definition of NF as per treatment guidelines, were identified. Use of vancomycin was evaluated as part of empirical therapy and again after 72h. Outcomes were assessed using descriptive statistics, the Chi-square or Fisher's exact test, and univariate exact logistic regression analyses. Sixty-four patients were included. Overall, inappropriate empirical vancomycin use was observed in more than 30% of patients. Of 35 patients with indications for empirical vancomycin, only 68% received it. At 72h, appropriate vancomycin continuation, de-escalation, or discontinuation occurred in 21 of 33 patients. On univariate regression, hematological malignancy was associated with appropriate empirical vancomycin prescribing, whether initiating or withholding (odds ratio 4.0, 95% confidence interval 1.31-12.1). No variable was independently associated with inappropriate continuation at 72h. There is poor guideline adherence to vancomycin prescribing as empirical therapy and at 72-h reassessment in patients with NF. Further efforts are needed to foster a more rational use of vancomycin in patients with NF. Copyright © 2018. Published by Elsevier Ltd.

  11. Exact Bayesian p-values for a test of independence in a 2 × 2 contingency table with missing data.

    PubMed

    Lin, Yan; Lipsitz, Stuart R; Sinha, Debajyoti; Fitzmaurice, Garrett; Lipshultz, Steven

    2017-01-01

    Altham (Altham PME. Exact Bayesian analysis of a 2 × 2 contingency table, and Fisher's "exact" significance test. J R Stat Soc B 1969; 31: 261-269) showed that a one-sided p-value from Fisher's exact test of independence in a 2 × 2 contingency table is equal to the posterior probability of negative association in the 2 × 2 contingency table under a Bayesian analysis using an improper prior. We derive an extension of Fisher's exact test p-value in the presence of missing data, assuming the missing data mechanism is ignorable (i.e., missing at random or completely at random). Further, we propose Bayesian p-values for a test of independence in a 2 × 2 contingency table with missing data using alternative priors; we also present results from a simulation study exploring the Type I error rate and power of the proposed exact test p-values. An example, using data on the association between blood pressure and a cardiac enzyme, is presented to illustrate the methods.

  12. Fixation and its role in the causation, laterality and location of pterygium: a study in amblyopes and non-amblyopes.

    PubMed

    Sudhalkar, A

    2012-03-01

    To evaluate the role of fixation in causing pterygium and determining its laterality and location. This is a prospective, observational, case-control study. Cases were defined as patients with primary pterygium who had unilateral amblyopia with eccentric fixation. Controls were age-matched patients with primary pterygium, but without amblyopia and eccentric fixation. All patients underwent complete ocular, orthoptic, and systemic examination and a detailed risk-factor assessment (latitude of residence, exposure to sunlight, sand, and a high-reflectance environment). The role of fixation in the causation, laterality and location of pterygium was evaluated. Fisher's exact test, the unpaired t-test, and odds ratio (OR) were carried out to determine the significance of the observations. The mean age of subjects was 47.1±5.25 years in cases (n=107) and 48.2±4.75 years in controls (n=310; P=0.78). As far as known risk factors were concerned, both groups were evenly matched. Among the cases, 88 (82.2%) patients demonstrated suppression of the amblyopic eye and 19 (17.8%) patients had abnormal retinal correspondence (ARC). Patients with suppression had a unilateral pterygium in the better (fixating) eye, whereas those with ARC had bilateral pterygia. Among the controls, 192 (61.9%) eyes had bilateral pterygia and 118 (38.1%) eyes had unilateral pterygium. In controls, the dominant eye had a higher prevalence of pterygium. All patients in both groups had a nasal pterygium. Pterygium and fixation were strongly associated (P=0.007; Fisher's exact test; OR -15.98; P=0.008). Fixation appears to have an important role in causing pterygium and determining its location and laterality.

  13. Exact p-values for pairwise comparison of Friedman rank sums, with application to comparing classifiers.

    PubMed

    Eisinga, Rob; Heskes, Tom; Pelzer, Ben; Te Grotenhuis, Manfred

    2017-01-25

    The Friedman rank sum test is a widely-used nonparametric method in computational biology. In addition to examining the overall null hypothesis of no significant difference among any of the rank sums, it is typically of interest to conduct pairwise comparison tests. Current approaches to such tests rely on large-sample approximations, due to the numerical complexity of computing the exact distribution. These approximate methods lead to inaccurate estimates in the tail of the distribution, which is most relevant for p-value calculation. We propose an efficient, combinatorial exact approach for calculating the probability mass distribution of the rank sum difference statistic for pairwise comparison of Friedman rank sums, and compare exact results with recommended asymptotic approximations. Whereas the chi-squared approximation performs inferiorly to exact computation overall, others, particularly the normal, perform well, except for the extreme tail. Hence exact calculation offers an improvement when small p-values occur following multiple testing correction. Exact inference also enhances the identification of significant differences whenever the observed values are close to the approximate critical value. We illustrate the proposed method in the context of biological machine learning, were Friedman rank sum difference tests are commonly used for the comparison of classifiers over multiple datasets. We provide a computationally fast method to determine the exact p-value of the absolute rank sum difference of a pair of Friedman rank sums, making asymptotic tests obsolete. Calculation of exact p-values is easy to implement in statistical software and the implementation in R is provided in one of the Additional files and is also available at http://www.ru.nl/publish/pages/726696/friedmanrsd.zip .

  14. Cost and lack of insurance coverage are prohibitive to having dental implants after resections for benign mandibular neoplasms.

    PubMed

    Peacock, Zachary S; Ji, Yisi D

    2017-06-01

    To assess how often patients receive dental implants after mandibular resection for benign neoplasms and to determine barriers to completion of functional reconstruction. This was a retrospective cohort study of patients who underwent resection for benign mandibular neoplasms between 2005 and 2014. Demographic variables included age, sex, and race. Outcome variables include rates of implant placement, implant restoration, and reasons for not having implants. Fisher's exact test and odds ratios were calculated. In all, 52 subjects (age 47.1 ± 19.2 years) were included. Twenty (38.6%) received dental implants. Race was associated with the likelihood of receiving implants (P = .0302). African Americans (1/11, 9.1%) were least likely compared to all other racial groups to have implants (odds ratio = 0.1158; P = .035; 95% confidence interval 0.013-0.989). Caucasians (17/35, 48.6%) were 4.41 times more likely to receive implants compared to all other races (odds ratio = 4.41; 95% confidence interval 1.073-18.093; P = .038). Of the 20 patients who received implants, 10 went on to have dental prostheses. The most common reason for not having implants was cost (37.5% overall), cited by 50% of black and 16.7% of white patients. Patients do not typically go on to dental reconstruction after mandibular resection, with cost as a major barrier. African Americans were least likely to complete full reconstruction. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Notes on testing non-inferiority under the partial verification design with a confirmatory procedure limited to screen positives.

    PubMed

    Lui, Kung-Jong

    2012-05-01

    When a new test with fewer invasions or less expenses to administer than the traditional test is developed, we may be interested in testing whether the former is non-inferior to the latter with respect to test accuracy. We define non-inferiority via both the odds ratio (OR) of correctly identifying a case and the OR of correctly identifying a non-case between two tests under comparison. We focus our discussion on testing the non-inferiority of a new screening test to a traditional screening test when a confirmatory procedure is performed only on patients with screen positives. On the basis of well-established methods for paired-sample data, we derive an asymptotic test procedure and an exact test procedure with respect to the two ORs defined here. Using Monte Carlo simulation, we evaluate the performance of these test procedures in a variety of situations. We note that the test procedures proposed here can also be applicable if we are interested in testing non-inferiority with respect to the ratio of sensitivities and the ratio of specificities. We discuss interval estimation of these ORs and sample size calculation based on the asymptotic test procedure considered here. We use the data taken from a study of the prostate-specific-antigen (PSA) test and the digital rectal examination (DRE) test to illustrate the practical use of these test procedures, interval estimators and sample size calculation formula. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. Stability analysis solutions and optical solitons in extended nonlinear Schrödinger equation with higher-order odd and even terms

    NASA Astrophysics Data System (ADS)

    Peng, Wei-Qi; Tian, Shou-Fu; Zou, Li; Zhang, Tian-Tian

    2018-01-01

    In this paper, the extended nonlinear Schrödinger equation with higher-order odd (third order) and even (fourth order) terms is investigated, whose particular cases are the Hirota equation, the Sasa-Satsuma equation and Lakshmanan-Porsezian-Daniel equation by selecting some specific values on the parameters of higher-order terms. We first study the stability analysis of the equation. Then, using the ansatz method, we derive its bright, dark solitons and some constraint conditions which can guarantee the existence of solitons. Moreover, the Ricatti equation extension method is employed to derive some exact singular solutions. The outstanding characteristics of these solitons are analyzed via several diverting graphics.

  17. An 'unconditional-like' structure for the conditional estimator of odds ratio from 2 x 2 tables.

    PubMed

    Hanley, James A; Miettinen, Olli S

    2006-02-01

    In the estimation of the odds ratio (OR), the conditional maximum-likelihood estimate (cMLE) is preferred to the more readily computed unconditional one (uMLE). However, the exact cMLE does not have a closed form to help divine it from the uMLE or to understand in what circumstances the difference between the two is appreciable. Here, the cMLE is shown to have the same 'ratio of cross-products' structure as its unconditional counterpart, but with two of the cell frequencies augmented, so as to shrink the unconditional estimator towards unity. The augmentation involves a factor, similar to the finite population correction, derived from the minimum of the marginal totals.

  18. Orientifolding of the ABJ Fermi gas

    NASA Astrophysics Data System (ADS)

    Okuyama, Kazumi

    2016-03-01

    The grand partition functions of ABJ theory can be factorized into even and odd parts under the reflection of fermion coordinate in the Fermi gas approach. In some cases, the even/odd part of ABJ grand partition function is equal to that of {N}=5O(n)× USp({n}^') theory, hence it is natural to think of the even/odd projection of grand partition function as an orientifolding of ABJ Fermi gas system. By a systematic WKB analysis, we determine the coefficients in the perturbative part of grand potential of such orientifold ABJ theory. We also find the exact form of the first few "half-instanton" corrections coming from the twisted sector of the reflection of fermion coordinate. For the Chern-Simons level k = 2 ,4 ,8 we find closed form expressions of the grand partition functions of orientifold ABJ theory, and for k = 2 , 4 we prove the functional relations among the grand partition functions conjectured in arXiv:1410.7658.

  19. An Unconditional Test for Change Point Detection in Binary Sequences with Applications to Clinical Registries.

    PubMed

    Ellenberger, David; Friede, Tim

    2016-08-05

    Methods for change point (also sometimes referred to as threshold or breakpoint) detection in binary sequences are not new and were introduced as early as 1955. Much of the research in this area has focussed on asymptotic and exact conditional methods. Here we develop an exact unconditional test. An unconditional exact test is developed which assumes the total number of events as random instead of conditioning on the number of observed events. The new test is shown to be uniformly more powerful than Worsley's exact conditional test and means for its efficient numerical calculations are given. Adaptions of methods by Berger and Boos are made to deal with the issue that the unknown event probability imposes a nuisance parameter. The methods are compared in a Monte Carlo simulation study and applied to a cohort of patients undergoing traumatic orthopaedic surgery involving external fixators where a change in pin site infections is investigated. The unconditional test controls the type I error rate at the nominal level and is uniformly more powerful than (or to be more precise uniformly at least as powerful as) Worsley's exact conditional test which is very conservative for small sample sizes. In the application a beneficial effect associated with the introduction of a new treatment procedure for pin site care could be revealed. We consider the new test an effective and easy to use exact test which is recommended in small sample size change point problems in binary sequences.

  20. Increased levels of N(ε)- Carboxy methyl lysine (N(ε)-CML) are associated with topographic alterations in retinal pigment epithelium: A preliminary study.

    PubMed

    Mishra, Nibha; Saxena, Sandeep; Ruia, Surabhi; Prasad, Senthamizh; Singh, Vinita; Khanna, Vinay; Staffa, Robert; Gaspar, Ludovit; Kruzliak, Peter

    2016-07-01

    To evaluate the association of serum levels of N(ε)- Carboxy methyl lysine (N(ε)-CML), an advanced glycation end product with topographic alterations in retinal pigment epithelium (RPE) in diabetic retinopathy on spectral domain optical coherence tomography (SD-OCT). Consecutive cases of type 2 diabetes mellitus with no retinopathy (n=20); non-proliferative diabetic retinopathy (n=20); proliferative diabetic retinopathy (n=20) and healthy controls (n=20) between the ages of 40 and 65years were included. RPE alterations were graded on segmentation map of SD-OCT: grade 0, No RPE alterations; grade 1, RPE alterations in up to two quadrants and grade 2, RPE alterations in more than two quadrants. Serum level of N(ε)-CML and glycated hemoglobin (HbA1c) was analyzed using the standard protocol. Statistical analysis was done. Significant increase in N(ε)-CML was observed with increased severity of diabetic retinopathy (F=34.1; p<0.0001). Fisher exact test revealed significant increase in grades of RPE alterations with increased severity of diabetic retinopathy (p<0.001). Univariate ordinal regression analysis was done to calculate the risk of progression in grades of RPE alteration with individual changes in variables like duration of diabetes (odds ratio=1.37; p=0.001), HbA1c (odds ratio=1.37; p=0.002) and Nε-CML (odds ratio=1.37; p<0.0001). Multivariate ordinal regression analysis for predicting progression in grades of RPE alteration revealed Nε-CML to be an independent predictor of increase in grades of RPE alteration (adjusted odds ratio=1.07; p<0.01) when duration of diabetes and HbA1c were held constant. Increase in serum levels of N(ε)- Carboxy methyl lysine is significantly associated with topographic alterations in RPE. Grades of RPE alteration increase significantly with increased severity of diabetic retinopathy. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Disordered Weight Management Behaviors, Nonprescription Steroid Use, and Weight Perception in Transgender Youth.

    PubMed

    Guss, Carly E; Williams, David N; Reisner, Sari L; Austin, S Bryn; Katz-Wise, Sabra L

    2017-01-01

    Disordered weight management behaviors are prevalent among youth; recent case reports suggested that these behaviors might also be common in transgender youth. We studied associations of gender identity with disordered weight management behaviors, nonprescription steroid use, and weight perception among transgender and cisgender (nontransgender) high-school students in Massachusetts. Data were analyzed from the 2013 Massachusetts Youth Health Survey, an anonymous survey in a random sample of Massachusetts public high schools. Respondents were divided into three groups: transgender (n = 67), cisgender male (n = 1,117), and cisgender female (n = 1,289). Fisher's exact tests and multivariable logistic regression models were used to examine unhealthy weight management behaviors in the past 30 days: fasting >24 hours, vomiting, diet pill use, and laxative use; nonprescription steroid use; and self-perceived weight status. Analyses controlled for age, race/ethnicity, and body mass index. Compared with cisgender males, transgender adolescents had higher odds of fasting >24 hours (adjusted odds ratio [AOR] = 2.9, confidence interval [CI] = 1.1-7.8), using diet pills (AOR = 8.9, 95% CI = 2.3-35.2) and taking laxatives (AOR = 7.2, 95% CI = 1.4-38.4). Transgender youth had higher odds of lifetime use of steroids without a prescription than male cisgender respondents (AOR = 26.6, 95% CI = 3.5-200.1). Compared with cisgender females, transgender respondents had higher odds of perceiving themselves as healthy weight/underweight when they were overweight/obese (AOR = 2.4, 95% CI = 1.5-4.1). Transgender youth disproportionately self-reported unsafe weight management behaviors and nonprescription steroid use compared with cisgender youth. Clinicians should be aware of this increased risk among transgender youth. Research is needed to further understand these disparities and to inform future interventions. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  2. Bendectin and human congenital malformations.

    PubMed

    Shiono, P H; Klebanoff, M A

    1989-08-01

    The relationship between Bendectin exposure during the first trimester of pregnancy and the occurrence of congenital malformations was prospectively studied in 31,564 newborns registered in the Northern California Kaiser Permanente Birth Defects Study. The odds ratio for any major malformation and Bendectin use was 1.0 (95% confidence interval 0.8-1.4). There were 58 categories of congenital malformations; three of them were statistically associated with Bendectin exposure (microcephaly--odds ratio = 5.3, 95% confidence interval = 1.8-15.6; congenital cataract--odds ratio = 5.3, 95% confidence interval = 1.2-24.3; lung malformations (ICD-8 codes 484.4-484.8)--odds ratio = 4.6, 95% confidence interval = 1.9-10.9). This is exactly the number of associations that would be expected by chance. An independent study (the Collaborative Perinatal Project) was used to determine whether vomiting during pregnancy in the absence of Bendectin use was associated with these three malformations. Two of the three (microcephaly and cataract) had strong positive associations with vomiting in the absence of Bendectin use. We conclude that there is no increase in the overall rate of major malformations after exposure to Bendectin and that the three associations found between Bendectin and individual malformations are unlikely to be causal.

  3. The exact analysis of contingency tables in medical research.

    PubMed

    Mehta, C R

    1994-01-01

    A unified view of exact nonparametric inference, with special emphasis on data in the form of contingency tables, is presented. While the concept of exact tests has been in existence since the early work of RA Fisher, the computational complexity involved in actually executing such tests precluded their use until fairly recently. Modern algorithmic advances, combined with the easy availability of inexpensive computing power, has renewed interest in exact methods of inference, especially because they remain valid in the face of small, sparse, imbalanced, or heavily tied data. After defining exact p-values in terms of the permutation principle, we reference algorithms for computing them. Several data sets are then analysed by both exact and asymptotic methods. We end with a discussion of the available software.

  4. Association between polycystic ovary syndrome and hot flash presentation during the midlife period.

    PubMed

    Yin, Ophelia; Zacur, Howard A; Flaws, Jodi A; Christianson, Mindy S

    2018-06-01

    Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in reproductive-aged women; however, the impact of PCOS on menopausal symptoms remains poorly understood. This study aims to determine the influence of PCOS on hot flash presentation in midlife women. Participants were recruited from the Midlife Women's Health Study involving 780 women aged 45 to 54 years. All women completed detailed questionnaires on hot flash symptoms. Between June 2014 and March 2015, participants were screened for history of PCOS based on the Rotterdam criteria. Fisher's exact tests and Wilcoxon rank-sum tests were used for analysis. Multivariate logistic regression was performed to identify factors associated with hot flashes at midlife. In all, 453 women (69%) consented to the telephone interview and 9.3% (n = 42) met diagnostic criteria for PCOS; 411 were included as controls. Mean age was 48.0 and body mass index was 27.3 for women with PCOS. The majority of participants were white (72%). There was no difference between PCOS and control women for levels of follicle-stimulating hormone, testosterone, progesterone, or estradiol. Multivariate logistic regression demonstrated that PCOS was not associated with increased odds of hot flash incidence. Smoking was the only variable associated with experiencing hot flashes (odds ratio 2.0, 95% confidence interval 1.05-3.98). A history of PCOS was not associated with increased hot flash symptoms during the midlife period. Additional research should continue to investigate the health and quality of life associated with a history of PCOS in the aging population.

  5. Identification of six polymorphisms as novel susceptibility loci for ischemic or hemorrhagic stroke by exome-wide association studies

    PubMed Central

    Yamada, Yoshiji; Sakuma, Jun; Takeuchi, Ichiro; Yasukochi, Yoshiki; Kato, Kimihiko; Oguri, Mitsutoshi; Fujimaki, Tetsuo; Horibe, Hideki; Muramatsu, Masaaki; Sawabe, Motoji; Fujiwara, Yoshinori; Taniguchi, Yu; Obuchi, Shuichi; Kawai, Hisashi; Shinkai, Shoji; Mori, Seijiro; Arai, Tomio; Tanaka, Masashi

    2017-01-01

    In this study, we performed exome-wide association studies (EWASs) to identify genetic variants that confer susceptibility to ischemic stroke, intracerebral hemorrhage (ICH), or subarachnoid hemorrhage (SAH). EWAS for ischemic stroke was performed using 1,575 patients with this condition and 9,210 controls, and EWASs for ICH and SAH were performed using 673 patients with ICH, 265 patients with SAH and 9,158 controls. Analyses were performed with Illumina HumanExome-12 DNA Analysis BeadChip or Infinium Exome-24 BeadChip arrays. The relation of allele frequencies for 41,339 or 41,332 single nucleotide polymorphisms (SNPs) that passed quality control to ischemic or hemorrhagic stroke, respectively, was examined with Fisher's exact test. Based on Bonferroni's correction, a P-value of <1.21×10−6 was considered statistically significant. EWAS for ischemic stroke revealed that 77 SNPs were significantly associated with this condition. Multivariable logistic regression analysis with adjustment for age, sex and the prevalence of hypertension and diabetes mellitus revealed that 4 of these SNPs [rs3212335 of GABRB3 (P=0.0036; odds ratio, 1.29), rs147783135 of TMPRSS7 (P=0.0024; odds ratio, 0.37), rs2292661 of PDIA5 (P=0.0054; odds ratio, 0.35) and rs191885206 of CYP4F12 (P=0.0082; odds ratio, 2.60)] were related (P<0.01) to ischemic stroke. EWASs for ICH or SAH revealed that 48 and 12 SNPs, respectively, were significantly associated with these conditions. Multivariable logistic regression analysis with adjustment for age, sex and the prevalence of hypertension revealed that rs138533962 of STYK1 (P<1.0×10−23; odds ratio, 111.3) was significantly (P<2.60×10−4) associated with ICH and that rs117564807 of COL17A1 (P=0.0009; odds ratio, 2.23×10−8) was significantly (P<0.0010) associated with SAH. GABRB3, TMPRSS7, PDIA5 and CYP4F12 may thus be novel susceptibility loci for ischemic stroke, whereas STYK1 and COL17A1 may be such loci for ICH and SAH, respectively. PMID:28487959

  6. Perturbational blowup solutions to the compressible Euler equations with damping.

    PubMed

    Cheung, Ka Luen

    2016-01-01

    The N-dimensional isentropic compressible Euler system with a damping term is one of the most fundamental equations in fluid dynamics. Since it does not have a general solution in a closed form for arbitrary well-posed initial value problems. Constructing exact solutions to the system is a useful way to obtain important information on the properties of its solutions. In this article, we construct two families of exact solutions for the one-dimensional isentropic compressible Euler equations with damping by the perturbational method. The two families of exact solutions found include the cases [Formula: see text] and [Formula: see text], where [Formula: see text] is the adiabatic constant. With analysis of the key ordinary differential equation, we show that the classes of solutions include both blowup type and global existence type when the parameters are suitably chosen. Moreover, in the blowup cases, we show that the singularities are of essential type in the sense that they cannot be smoothed by redefining values at the odd points. The two families of exact solutions obtained in this paper can be useful to study of related numerical methods and algorithms such as the finite difference method, the finite element method and the finite volume method that are applied by scientists to simulate the fluids for applications.

  7. The Preschool-Aged and School-Aged Children Present Different Odds of Mortality than Adults in Southern Taiwan: A Cross-Sectional Retrospective Analysis.

    PubMed

    Peng, Shu-Hui; Huang, Chun-Ying; Hsu, Shiun-Yuan; Yang, Li-Hui; Hsieh, Ching-Hua

    2018-04-25

    Background : This study aimed to profile the epidemiology of injury among preschool-aged and school-aged children in comparison to those in adults. Methods : According to the Trauma Registry System of a level I trauma center, the medical data were retrieved from 938 preschool-aged children (aged less than seven years), 670 school-aged children (aged 7⁻12 years), and 16,800 adults (aged 20⁻64 years) between 1 January 2009 and 31 December 2016. Two-sided Pearson’s, chi-squared, and Fisher’s exact tests were used to compare categorical data. A one-way analysis of variance (ANOVA) with the Games-Howell post-hoc test was used to assess the differences in continuous variables among different groups of patients. The mortality outcomes of different subgroups were assessed by a multivariable regression model under the adjustment of sex, injury mechanisms, and injury severity. Results : InFsupppjury mechanisms in preschool-aged and school-aged children were remarkably different from that in adults; in preschool-aged children, burns were the most common cause of injury requiring hospitalization (37.4%), followed by falls (35.1%) and being struck by/against objects (11.6%). In school-aged children, injuries were most commonly sustained from falls (47.8%), followed by bicycle accidents (14%) and being struck by/against objects (12.5%). Compared to adults, there was no significant difference of the adjusted mortality of the preschool-aged children (AOR = 0.9; 95% CI 0.38⁻2.12; p = 0.792) but there were lower adjusted odds of mortality of the school-aged children (AOR = 0.4; 95% CI 0.10⁻0.85; p = 0.039). The school-aged children had lower odds of mortality than adults (OR, 0.2; 95% CI, 0.06⁻0.74; p = 0.012), but such lower odds of risk of mortality were not found in preschool-aged children (OR, 0.7; 95% CI, 0.29⁻1.81; p = 0.646). Conclusions : This study suggests that specific types of injuries from different injury mechanisms are predominant among preschool-aged and school-aged children. The school-aged children had lower odds of mortality than adults; nonetheless there was no difference in mortality rates of preschool-aged children than adults, with or without controlling for sex, injury mechanisms and ISS. These results highlight the importance of injury prevention, particularly for preschool-aged children in Southern Taiwan.

  8. Same Abbreviated Injury Scale Values May Be Associated with Different Risks to Mortality in Trauma Patients: A Cross-Sectional Retrospective Study Based on the Trauma Registry System in a Level I Trauma Center.

    PubMed

    Rau, Cheng-Shyuan; Wu, Shao-Chun; Kuo, Pao-Jen; Chen, Yi-Chun; Chien, Peng-Chen; Hsieh, Hsiao-Yun; Hsieh, Ching-Hua

    2017-12-11

    The Abbreviated Injury Scale (AIS) measures injury severity of a trauma patient with a numeric method for ranking anatomy-based specific injuries. The summation of the squares of the three most severe injuries in the AIS of six predefined body regions comprises the Injury Severity Score (ISS). It assumes that the mortality of a given AIS value is similar across all body regions. However, such an assumption is less explored in the literature. In this study, we aimed to compare the mortality rates of the patients with the same AIS value in different injured body regions in a level I trauma center. Hospitalized adult trauma patients with isolated serious to critical injury (AIS of 3 to 5) between 1 January 2009, and 31 December 2016, from the Trauma Registry System in a level I trauma center were grouped according to the injured body regions (including, the head/neck, thorax, abdomen, or extremities) and were exclusively compared according to their AIS stratum. Categorical data were compared using the two-sided Fisher exact or Pearson chi-square tests. ANOVA with Games-Howell post hoc test was performed to assess the differences in continuous data of the patients with injury in different body regions. The primary outcome of the study was in-hospital mortality. The adjusted odds ratios (AORs) were estimated using a stepwise selection of a multivariable regression model adjusted by controlling the confounding variables such as sex, age, comorbidities, and ISS. Survival curves were estimated with the Kaplan-Meier approach with a corresponding log-rank test. The patients with AIS of 5 for abdomen injury and those with AIS of 3 for extremity injury had a significantly lower odds of adjusted mortality (adjusted odds ratio (AOR) 0.1, 95% confidence interval (CI) 0.01-0.39, p = 0.004 and AOR 0.3, 95% CI 0.15-0.51, p < 0.001, respectively) than that of the patients with head/neck injury. However, the patients with AIS of 4 for extremity injury demonstrated significantly higher odds of adjusted mortality (AOR 8.4, 95% CI 2.84-25.07, p < 0.001) than the patients with head/neck injury. This study found that the risks to mortality in the patients with a given AIS value of serious to critical injury in different injured body regions were not the same, even after controlling for confounding variables such as sex, age, comorbidities, and ISS.

  9. Same Abbreviated Injury Scale Values May Be Associated with Different Risks to Mortality in Trauma Patients: A Cross-Sectional Retrospective Study Based on the Trauma Registry System in a Level I Trauma Center

    PubMed Central

    Rau, Cheng-Shyuan; Wu, Shao-Chun; Kuo, Pao-Jen; Chen, Yi-Chun; Chien, Peng-Chen; Hsieh, Hsiao-Yun

    2017-01-01

    The Abbreviated Injury Scale (AIS) measures injury severity of a trauma patient with a numeric method for ranking anatomy-based specific injuries. The summation of the squares of the three most severe injuries in the AIS of six predefined body regions comprises the Injury Severity Score (ISS). It assumes that the mortality of a given AIS value is similar across all body regions. However, such an assumption is less explored in the literature. In this study, we aimed to compare the mortality rates of the patients with the same AIS value in different injured body regions in a level I trauma center. Hospitalized adult trauma patients with isolated serious to critical injury (AIS of 3 to 5) between 1 January 2009, and 31 December 2016, from the Trauma Registry System in a level I trauma center were grouped according to the injured body regions (including, the head/neck, thorax, abdomen, or extremities) and were exclusively compared according to their AIS stratum. Categorical data were compared using the two-sided Fisher exact or Pearson chi-square tests. ANOVA with Games-Howell post hoc test was performed to assess the differences in continuous data of the patients with injury in different body regions. The primary outcome of the study was in-hospital mortality. The adjusted odds ratios (AORs) were estimated using a stepwise selection of a multivariable regression model adjusted by controlling the confounding variables such as sex, age, comorbidities, and ISS. Survival curves were estimated with the Kaplan–Meier approach with a corresponding log-rank test. The patients with AIS of 5 for abdomen injury and those with AIS of 3 for extremity injury had a significantly lower odds of adjusted mortality (adjusted odds ratio (AOR) 0.1, 95% confidence interval (CI) 0.01–0.39, p = 0.004 and AOR 0.3, 95% CI 0.15–0.51, p < 0.001, respectively) than that of the patients with head/neck injury. However, the patients with AIS of 4 for extremity injury demonstrated significantly higher odds of adjusted mortality (AOR 8.4, 95% CI 2.84–25.07, p < 0.001) than the patients with head/neck injury. This study found that the risks to mortality in the patients with a given AIS value of serious to critical injury in different injured body regions were not the same, even after controlling for confounding variables such as sex, age, comorbidities, and ISS. PMID:29232883

  10. Macroscopic findings in collagenous colitis: a multi-center, retrospective, observational cohort study

    PubMed Central

    Koulaouzidis, Anastasios; Yung, Diana E.; Nemeth, Artur; Sjöberg, Klas; Giannakou, Andry; Qureshi, Raheel; Bartzis, Leonidas; McNeill, Morna; Johansson, Gabriele Wurm; Lucendo, Alfredo J.; Fineron, Paul; Trimble, Ken C.; Saeed, Athar; Plevris, John N.; Toth, Ervin

    2017-01-01

    Background Collagenous colitis (CC) is by definition a histological diagnosis. However, colonoscopy often reveals characteristic endoscopic findings. The aim of this study was to evaluate the frequency and type of endoscopic findings in patients diagnosed with CC in 4 participating centers. Methods This was a retrospective study; the databases of 2 university hospitals in Edinburgh (Scotland) and Malmö (Sweden), and 2 district general hospitals in Tomelloso (Spain) and Gateshead (England) were interrogated for patients diagnosed with CC between May 2008 and August 2013. Endoscopy reports and images were retrieved and reviewed; data on lesions, sedation, bowel preparation and endoscopist experience were abstracted. Categorical data are reported as mean±SD. Fischer’s exact, chi-square and t (unpaired) tests were used to compare datasets. A two-tailed P-value of <0.05 was considered statistically significant. Results 607 patients (149 male, mean age 66.9±12.25 years) were diagnosed with CC. A total of 108/607 (17.8%) patients had one or more suggestive endoscopy findings: i.e., mucosal erythema/edema, 91/607 (15%); linear colonic mucosal defects, 12/607 (2%); or mucosal scarring, 5/607 (0.82%). For colonic mucosa erythema, there was no difference in the odds of finding erythema with the use of different bowel preparation methods (P=0.997). For colonic mucosal defects there was some evidence (P=0.005) that patients colonoscoped by experienced endoscopists had 87% less odds of developing such defects. Moreover, there was evidence that analgesia reduced the odds of developing mucosal defects by 84%. Conclusion A significant minority of patients with CC have endoscopic findings in colonoscopy. The description of such findings appears to be related to the endoscopist’s experience. PMID:28469361

  11. F-Test Alternatives to Fisher's Exact Test and to the Chi-Square Test of Homogeneity in 2x2 Tables.

    ERIC Educational Resources Information Center

    Overall, John E.; Starbuck, Robert R.

    1983-01-01

    An alternative to Fisher's exact test and the chi-square test for homogeneity in two-by-two tables is developed. The method provides for Type I error rates which are closer to the stated alpha level than either of the alternatives. (JKS)

  12. The Recipient Venule in Supermicrosurgical Lymphaticovenular Anastomosis: Flow Dynamic Classification and Correlation with Surgical Outcomes.

    PubMed

    Visconti, Giuseppe; Salgarello, Marzia; Hayashi, Akitatsu

    2018-05-12

     Venules have been usually neglected in the literature on lymphaticovenular anastomosis (LVA). The aim of this study was to analyze the flow dynamic of recipient venules in LVA and their impact on the surgical outcomes.  Data from 128 patients affected by extremity lymphedema, who underwent LVA, were collected in two institutions from August 2014 to May 2016. Recipient venules were classified according to their flow dynamic into backflow, slack, and outlet (BSO classification). Quantitative (lower extremity lymphedema/upper extremity lymphedema index) and qualitative outcomes (needing of compression garment and compression garment class) were evaluated. Chi-square test or Fisher's exact test was used for categorical variables and independent-samples t -test for continuous variables. The association between lymphatic collector degeneration status (normal, ectasis, contractile, sclerotic type [NECST]) and BSO classification with the outcomes was analyzed by the Mantel-Haenszel test.  On a total of 128 patients, 37 suffered from upper and 91 from lower limb lymphedema. An average number of four LVA were performed for each patient (range: 2-8). A significant association was observed between NECST and BSO categories and the outcomes were evaluated. Patients with contractile and sclerotic collectors had 2.24 times the odd of having poor composite outcome compared with those with normal-to-ectasis collectors ( p  < 0.05). Patients with backflow venules had 3.32 times the odd of having poor composite outcome compared with those without outlet or slack pattern ( p  < 0.05).  The subtype of recipient venule flow dynamic has a significant impact on the surgical outcome of patients undergoing LVA for the treatment of lymphedema, regardless of the lymphatic collector degeneration status. Locating favorable venules in the preoperative mapping might enhance the surgical outcomes. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  13. Overlaps with arbitrary two-site states in the XXZ spin chain

    NASA Astrophysics Data System (ADS)

    Pozsgay, B.

    2018-05-01

    We present a conjectured exact formula for overlaps between the Bethe states of the spin-1/2 XXZ chain and generic two-site states. The result takes the same form as in the previously known cases: it involves the same ratio of two Gaudin-like determinants, and a product of single-particle overlap functions, which can be fixed using a combination of the quench action and quantum transfer matrix methods. Our conjecture is confirmed by numerical data from exact diagonalization. For one-site states, the formula is found to be correct even in chains with odd length. It is also pointed out that the ratio of the Gaudin-like determinants plays a crucial role in the overlap sum rule: it guarantees that in the thermodynamic limit there remains no term in the quench action.

  14. Closed-Suction Drainage and Cerebrospinal Fluid Leakage Following Microvascular Decompression : A Retrospective Comparison Study

    PubMed Central

    Kim, Young-Hoon; Kim, Chae-Yong; Oh, Chang Wan

    2013-01-01

    Objective We performed this study to investigate whether the use of closed-suction drainage following microvascular decompression (MVD) causes cerebrospinal fluid (CSF) leakage. Methods Between 2004 and 2011, a total of 157 patients with neurovascular compression were treated with MVD. MVD was performed for hemifacial spasm in 150 (95.5%) cases and for trigeminal neuralgia in 7 (4.5%) cases. The mean age of the patients was 49.8±9.6 years (range, 20-69). Dural substitutes were used in 44 (28.0%) patients. Ninety-two patients (58.6%) were underwent a 4-5 cm craniotomy using drainage (drainage group), and 65 (41.4%) did a small 2-2.5 cm retromastoid craniectomy without closed-suction drainage (no-drainage group). Results Eleven (7.0%) patients experienced CSF leakage following MVD based on the criteria of this study; all of these patients were in the drainage group. In the unadjusted analyses, the incidence of CSF leakage was significantly related with the use of closed-suction drainage following MVD (12.0% in the drainage group vs. 0% in the no-drainage group, respectively; p=0.003; Fisher's exact test). Those who received dural substitutes and the elderly (cut-off value=60 years) exhibited a tendency to develop CSF leakage (p=0.075 and p=0.090, respectively; Fisher's exact test). In the multivariate analysis, only the use of closed-suction drainage was significantly and independently associated with the development of CSF leakage following MVD (odds ratio=9.900; 95% confidence interval, 1.418 to infinity; p=0.017). Conclusion The use of closed-suction drainage following MVD appears to be related to the development of CSF leakage. PMID:24175025

  15. Effect of paraoxonase 1 gene polymorphisms on clinical course of Henoch-Schönlein purpura.

    PubMed

    Yilmaz, Alev; Emre, Sevinc; Agachan, Bedia; Bilge, Ilmay; Yilmaz, Hulya; Ergen, Arzu; Isbir, Turgay; Sirin, Aydan

    2009-01-01

    Henoch-Schönlein purpura (HSP) is a systemic vasculitis; its pathogenesis is still unknown. Oxidative stress may play a role in the pathogenesis of HSP. Paraoxonase1 (PON1) is an antioxidant enzyme. Two polymorphisms have been defined in the coding region of the PON1 gene, Q/R192 and L/M55. In the present study, we aimed to investigate the effect of PON1 gene polymorphisms on the course and renal involvement of HSP in Turkish children. Forty-six patients with HSP were compared with 34 healthy children regarding the distribution of PON1 polymorphisms. PON1 Q/R192 genotype distribution was 58.6% QQ, 32.6% QR and 8.8% RR in the HSP group and 14.3% QQ, 50% QR and 35.7% RR in the control group. The frequency of QQ genotype was higher in the HSP group, and the presence of QQ genotype increased the risk by 3.42-fold for developing HSP (p=0.000, Fisher exact test; odds ratio [OR] = 2.048; 95% confidence interval [95% CI], 1.396-3.00). PON1 L/M55 genotype distribution was 50% LL, 43.5% LM and 6.5% MM in the HSP group and 48% LL, 26% LM and 26% MM in the control group. The frequency of MM genotype was lower in the HSP group, and the presence of MM genotype decreased the risk by 7.38-fold for developing HSP (p=0.009, Fisher exact test; OR=7.380, 95% CI, 1.474-36.953). PON1 polymorphisms may contribute to the pathogenesis and course of HSP, but we suggest that further investigations with larger patient groups are required to confirm our results.

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

    Singleton, Jr., Robert; Israel, Daniel M.; Doebling, Scott William

    For code verification, one compares the code output against known exact solutions. There are many standard test problems used in this capacity, such as the Noh and Sedov problems. ExactPack is a utility that integrates many of these exact solution codes into a common API (application program interface), and can be used as a stand-alone code or as a python package. ExactPack consists of python driver scripts that access a library of exact solutions written in Fortran or Python. The spatial profiles of the relevant physical quantities, such as the density, fluid velocity, sound speed, or internal energy, are returnedmore » at a time specified by the user. The solution profiles can be viewed and examined by a command line interface or a graphical user interface, and a number of analysis tools and unit tests are also provided. We have documented the physics of each problem in the solution library, and provided complete documentation on how to extend the library to include additional exact solutions. ExactPack’s code architecture makes it easy to extend the solution-code library to include additional exact solutions in a robust, reliable, and maintainable manner.« less

  17. Association between digital dermatoglyphics and handedness among Sinhalese in Sri Lanka

    PubMed Central

    Wijerathne, Buddhika TB; Rathnayake, Geetha K

    2013-01-01

    Background The relationship between handedness and digital dermatoglyphic patterns has never been investigated in the Sinhalese population. The goal of this study is to establish the above mentioned relationship, which would positively aid personal identification.  Findings One hundred forty Sinhalese students (70 right-handed and 70 left-handed) were studied for their digital dermatoglyphic pattern distribution. The results show that a statistically significant correlation exists for; digit 5 (Ulnar loop; P= 0.0449 and radial loop; P= 0.0248 by Fisher’s exact test) of the right hand in female, digit 1 (radial loop; P=0.0248 by Fisher’s exact test) and digit 2 (Ulnar loop; P=0.0306) of the left hand in females, digit 3 (Ulnar loop; P= 0.0486 and whorl; P= 0.0356 by Fisher’s exact test) and digit 4 (Ulnar loop; P= 0.0449 and whorl; P= 0.0301 by Fisher’s exact test) of the right hand in males, digit 4 (whorl; P=0.0160 by Fisher’s exact test) of the left hand in males. Conclusions  Statistically significant differences in handedness and digital dermatoglyphic patterns were evident among Sinhalese people. Further study with a larger sample size is recommended. PMID:24627780

  18. Investigation of the two-quasiparticle bands in the doubly-odd nucleus 166Ta using a particle-number conserving cranked shell model

    NASA Astrophysics Data System (ADS)

    Zhang, ZhenHua

    2016-07-01

    The high-spin rotational properties of two-quasiparticle bands in the doubly-odd 166Ta are analyzed using the cranked shell model with pairing correlations treated by a particle-number conserving method, in which the blocking effects are taken into account exactly. The experimental moments of inertia and alignments and their variations with the rotational frequency hω are reproduced very well by the particle-number conserving calculations, which provides a reliable support to the configuration assignments in previous works for these bands. The backbendings in these two-quasiparticle bands are analyzed by the calculated occupation probabilities and the contributions of each orbital to the total angular momentum alignments. The moments of inertia and alignments for the Gallagher-Moszkowski partners of these observed two-quasiparticle rotational bands are also predicted.

  19. Analysis of Multiple Contingency Tables by Exact Conditional Tests for Zero Partial Association.

    ERIC Educational Resources Information Center

    Kreiner, Svend

    The tests for zero partial association in a multiple contingency table have gained new importance with the introduction of graphical models. It is shown how these may be performed as exact conditional tests, using as test criteria either the ordinary likelihood ratio, the standard x squared statistic, or any other appropriate statistics. A…

  20. Detection Rate and Sonographic Signs of Trisomy 21 Fetuses at 14-17 Weeks of Gestation.

    PubMed

    Bronshtein, Eliezer; Solt, Ido; Bronshtein, Moshe; Gover, Ayala; Wolman, Igal; Blumenfeld, Zeev

    2017-01-01

    Early prenatal ultrasound is an important part of prenatal screening in Israel. No studies have described the rate of trisomy 21 [T21] identification at 14-17 weeks gestation. To describe the rate of T21 identification by transvaginal sonograms (TVS) at 14-17 weeks gestation. We conducted a historical prospective study. Since 1986, early TVS of 72,000 fetuses at 14-17 weeks gestation have been prospectively recorded together with prenatal screening data at a private ultrasound center (AL-KOL, Haifa). We calculated the fraction of T21 cases by dividing the total number of cases with abnormal sonographic findings by the total number of diagnosed T21 cases. We also examined the percentage of verified T21 cases that had completely normal prenatal screening tests prior to the early prenatal TVS, thus revealing the contribution of this examination to the existing prenatal screening. Fisher's exact test was used to calculate odds ratios for each sonographic marker. Of 137 T21 fetuses, 123 had sonographic markers on early TVS, yielding a prediction capability of at least 89.87%. Of all T21 cases, 14% had completely normal nuchal translucency/first-trimester screening prior to the abnormal 14-17 week TVS findings. Isolated abnormal sonographic findings, which were found to increase the risk for T21, were common atrioventricular septal canal (odds ratio 88.88), duodenal atresia (OR 88.23), nuchal edema (OR 39.14), and hydrocephalus (OR 15.78). Fetal hydronephrosis/pyelectasis was non-significant when isolated (OR 1), and cardiac echogenic focus was associated with a decreased risk (OR 0.13). Early prenatal TVS at 14-17 weeks may identify almost 90% of T21 and adds 14% to the identification rate at the first-trimester screening.

  1. Improving geriatric trauma outcomes: A small step toward a big problem.

    PubMed

    Hammer, Peter M; Storey, Annika C; Bell, Teresa; Bayt, Demetria; Hockaday, Melissa S; Zarzaur, Ben L; Feliciano, David V; Rozycki, Grace S

    2016-07-01

    Because of the unique physiology and comorbidities of injured geriatric patients, specific interventions are needed to improve outcomes. The purpose of this study was to assess the effect of a change in triage criteria for injured geriatric patients evaluated at an American College of Surgeons Level I trauma center. As of October 1, 2013, all injured patients 70 years or older were mandated to have the highest-level trauma activation upon emergency department (ED) arrival regardless of physiology or mechanism of injury. Patients admitted before that date were designated as PRE; those admitted after were designated as POST. The study period was from October 1, 2011, through April 30, 2015. Data collected included demographics, mechanism of injury, hypotension on admission, comorbidities, Injury Severity Score (ISS), ED length of stay (LOS), complications, and mortality. Bivariate and multivariable analyses were used to compare outcomes between the study groups (p < 0.05 was considered significant). χ or Fisher's exact test was used as appropriate for bivariate analyses of categorical variables; patients' ages were compared using the Wilcoxon rank-sum test. A total of 2,269 patients (mean, 80.63 years; mean ISS, 12.2; PRE, 1,271; POST, 933) were included in the study. On multivariable analysis, increasing age, higher ISS, and hypotension were associated with higher mortality. POST patients were more likely to have an ED LOS of 2 hours or shorter (odds ratio, 1.614; 95% confidence interval, 1.088-2.394) after controlling for hypotension, ISS, and comorbidities. POST mortality significantly decreased (odds ratio, 0.689; 95% confidence interval, 0.484-0.979). Based on age alone, the focused intervention of a higher level of trauma activation decreased ED LOS and mortality in injured geriatric patients. Therapeutic/care management study, level IV.

  2. A novel Markov Blanket-based repeated-fishing strategy for capturing phenotype-related biomarkers in big omics data.

    PubMed

    Li, Hongkai; Yuan, Zhongshang; Ji, Jiadong; Xu, Jing; Zhang, Tao; Zhang, Xiaoshuai; Xue, Fuzhong

    2016-03-09

    We propose a novel Markov Blanket-based repeated-fishing strategy (MBRFS) in attempt to increase the power of existing Markov Blanket method (DASSO-MB) and maintain its advantages in omic data analysis. Both simulation and real data analysis were conducted to assess its performances by comparing with other methods including χ(2) test with Bonferroni and B-H adjustment, least absolute shrinkage and selection operator (LASSO) and DASSO-MB. A serious of simulation studies showed that the true discovery rate (TDR) of proposed MBRFS was always close to zero under null hypothesis (odds ratio = 1 for each SNPs) with excellent stability in all three scenarios of independent phenotype-related SNPs without linkage disequilibrium (LD) around them, correlated phenotype-related SNPs without LD around them, and phenotype-related SNPs with strong LD around them. As expected, under different odds ratio and minor allel frequency (MAFs), MBRFS always had the best performances in capturing the true phenotype-related biomarkers with higher matthews correlation coefficience (MCC) for all three scenarios above. More importantly, since proposed MBRFS using the repeated fishing strategy, it still captures more phenotype-related SNPs with minor effects when non-significant phenotype-related SNPs emerged under χ(2) test after Bonferroni multiple correction. The various real omics data analysis, including GWAS data, DNA methylation data, gene expression data and metabolites data, indicated that the proposed MBRFS always detected relatively reasonable biomarkers. Our proposed MBRFS can exactly capture the true phenotype-related biomarkers with the reduction of false negative rate when the phenotype-related biomarkers are independent or correlated, as well as the circumstance that phenotype-related biomarkers are associated with non-phenotype-related ones.

  3. Breast cancer knowledge, attitudes, and early detection practices in United States-Mexico border Latinas.

    PubMed

    Banegas, Matthew P; Bird, Yelena; Moraros, John; King, Sasha; Prapsiri, Surasri; Thompson, Beti

    2012-01-01

    Evidence suggests Latinas residing along the United States-Mexico border face higher breast cancer mortality rates compared to Latinas in the interior of either country. The purpose of this study was to investigate breast cancer knowledge, attitudes, and use of breast cancer preventive screening among U.S. Latina and Mexican women residing along the U.S.-Mexico border. For this binational cross-sectional study, 265 participants completed an interviewer-administered questionnaire that obtained information on sociodemographic characteristics, knowledge, attitudes, family history, and screening practices. Differences between Mexican (n=128) and U.S. Latina (n=137) participants were assessed by Pearson's chi-square, Fischer's exact test, t tests, and multivariate regression analyses. U.S. Latinas had significantly increased odds of having ever received a mammogram/breast ultrasound (adjusted odds ratio [OR]=2.95) and clinical breast examination (OR=2.67) compared to Mexican participants. A significantly greater proportion of Mexican women had high knowledge levels (54.8%) compared to U.S. Latinas (45.2%, p<0.05). Age, education, and insurance status were significantly associated with breast cancer screening use. Despite having higher levels of breast cancer knowledge than U.S. Latinas, Mexican women along the U.S.-Mexico border are not receiving the recommended breast cancer screening procedures. Although U.S. border Latinas had higher breast cancer screening levels than their Mexican counterparts, these levels are lower than those seen among the general U.S. Latina population. Our findings underscore the lack of access to breast cancer prevention screening services and emphasize the need to ensure that existing breast cancer screening programs are effective in reaching women along the U.S.-Mexico border.

  4. Study of the relationship of psychosocial disorders to bruxism in adolescents.

    PubMed

    Katayoun, E; Sima, F; Naser, V; Anahita, D

    2008-01-01

    Bruxism has been defined as a diurnal or nocturnal parafunctional habit. Etiology of bruxism has remained controversial and some investigators believe that psychological factors may play a major role in promoting and perpetuating this habit. The aim of this case-control study was to assess the existence of an association between bruxism and psychosocial disorders in adolescents., Participants were chosen among 114, 12-14 year old students (girls). They were divided into two groups, bruxers and nonbruxers, on the basis of both validated clinical criteria and interview with each patient. A few participants were excluded on the basis of presence of systemic disorders, TMJ disorders, other oral habits, primary teeth, defective restorations and premature contacts. Following matching of two groups in regard to parent's age and education, mother's marital status, child support status, mother's employment status, and socio-economical status, 25 cases and 25 controls were enlisted. A self report validated questionnaire (YSR, 11-18 yr) was then filled out by both groups for the evaluation of 12 psychosocial symptoms. Remarkable differences in certain psychosocial aspects were found between the two groups. Prevalence of psychosocial disorders including Thought Disorders (P < 0.005), Conduct Disorders (P < 0.05), Antisocial Disorders (P < 0.06) as identified by YSR was significantly higher in bruxers. Significant differences between the two groups also emerged in total YSR scores (P < 0.005). The results of Odds Ratio revealed that a bruxer adolescent has 16 times greater probability for psychosocial disorders than a non-bruxer one. Fischer exact test and T-test were used and Odds Ratio and Confidence Interval was estimated. Support to the existence of an association between bruxism and psychosocial disorders has been provided.

  5. Breast cancer subtypes can be determinant in the decision making process to avoid surgical axillary staging: A retrospective cohort study.

    PubMed

    Marrazzo, Antonio; Boscaino, Giovanni; Marrazzo, Emilia; Taormina, Pietra; Toesca, Antonio

    2015-09-01

    The need for performing axillary lymph-node dissection in early breast cancer when the sentinel lymph node (SLN) is positive has been questioned in recent years. The purpose of this study was to identify a low-risk subgroup of early breast cancer patients in whom surgical axillary staging could be avoided, and to assess the probability of having a positive lymph-node (LN). We evaluated the cohort of 612 consecutive women affected by early breast cancer. We considered age, tumor size, histological grade, vascular invasion, lymphatic invasion and cancer subtype (Luminal A, Luminal B HER-2+, Luminal B HER-2-, HER-2+, and Triple Negative) as variables for univariate and multivariate analyses to assess probability of there being a positive SLN o nonsentinel lymph node (NSLN). Chi-square, Fisher's Exact test and Student's t tests were used to investigate the relationship between variables; whereas logit models were used to estimate and quantify the strength of the relationship among some covariates and SLN or the number of metastases. A significant positive effect of vascular invasion and lymphatic invasion (odds ratios are 4 and 6), and a negative effect of TN (odds ratios is 10) were noted. With respect to positive NSLN, size alone has a significant (positive) effect on tumor presence, but focusing on the number of metastases, also age has a (negative) significant effect. This work shows correlation between subtypes and the probability of having positive SLN. Patients not expressing vascular invasion, lymphatic invasion and, moreover, a triple-negative tumor subtype may be good candidates for breast conservative surgery without axillary surgical staging. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  6. Breast Cancer Knowledge, Attitudes, and Early Detection Practices in United States-Mexico Border Latinas

    PubMed Central

    Bird, Yelena; Moraros, John; King, Sasha; Prapsiri, Surasri; Thompson, Beti

    2012-01-01

    Abstract Introduction Evidence suggests Latinas residing along the United States-Mexico border face higher breast cancer mortality rates compared to Latinas in the interior of either country. The purpose of this study was to investigate breast cancer knowledge, attitudes, and use of breast cancer preventive screening among U.S. Latina and Mexican women residing along the U.S.-Mexico border. Methods For this binational cross-sectional study, 265 participants completed an interviewer-administered questionnaire that obtained information on sociodemographic characteristics, knowledge, attitudes, family history, and screening practices. Differences between Mexican (n=128) and U.S. Latina (n=137) participants were assessed by Pearson's chi-square, Fischer's exact test, t tests, and multivariate regression analyses. Results U.S. Latinas had significantly increased odds of having ever received a mammogram/breast ultrasound (adjusted odds ratio [OR]=2.95) and clinical breast examination (OR=2.67) compared to Mexican participants. A significantly greater proportion of Mexican women had high knowledge levels (54.8%) compared to U.S. Latinas (45.2%, p<0.05). Age, education, and insurance status were significantly associated with breast cancer screening use. Conclusions Despite having higher levels of breast cancer knowledge than U.S. Latinas, Mexican women along the U.S.-Mexico border are not receiving the recommended breast cancer screening procedures. Although U.S. border Latinas had higher breast cancer screening levels than their Mexican counterparts, these levels are lower than those seen among the general U.S. Latina population. Our findings underscore the lack of access to breast cancer prevention screening services and emphasize the need to ensure that existing breast cancer screening programs are effective in reaching women along the U.S.-Mexico border. PMID:21970564

  7. Synchronization scenarios in the Winfree model of coupled oscillators

    NASA Astrophysics Data System (ADS)

    Gallego, Rafael; Montbrió, Ernest; Pazó, Diego

    2017-10-01

    Fifty years ago Arthur Winfree proposed a deeply influential mean-field model for the collective synchronization of large populations of phase oscillators. Here we provide a detailed analysis of the model for some special, analytically tractable cases. Adopting the thermodynamic limit, we derive an ordinary differential equation that exactly describes the temporal evolution of the macroscopic variables in the Ott-Antonsen invariant manifold. The low-dimensional model is then thoroughly investigated for a variety of pulse types and sinusoidal phase response curves (PRCs). Two structurally different synchronization scenarios are found, which are linked via the mutation of a Bogdanov-Takens point. From our results, we infer a general rule of thumb relating pulse shape and PRC offset with each scenario. Finally, we compare the exact synchronization threshold with the prediction of the averaging approximation given by the Kuramoto-Sakaguchi model. At the leading order, the discrepancy appears to behave as an odd function of the PRC offset.

  8. Changes in stereoacuity following implantable Collamer lens implantation in patients with myopia

    PubMed Central

    Khokhar, Sudarshan; Gupta, Shikha; Gogia, Varun; Tewari, Ruchir; Agarwal, Tushar

    2015-01-01

    The study evaluated the impact of implantable Collamer lens (ICL) implantation on stereoacuity in myopes in a retrospective case series. Ninety-five eyes of 48 patients were recruited. Distance and near stereoacuity were measured using distance Randot stereotest and TNO test, respectively, before surgery and at 4 weeks postoperatively. Mean age of the patients was 23.67 ± 3.7 years. Mean uncorrected distance visual acuity (UDVA) was 1.28 ± 0.37 logarithm of the minimum angle of resolution (logMAR) (median: 1.3; range: 0.3–1.8), and median best-corrected distance visual acuity (BDVA) was 0.18 logMAR (range: 0–0.6). There was a significant improvement in both UDVA and BDVA postsurgery (P < 0.001; Wilcoxon signed rank test). The overall improvement in stereopsis was observed in 15/48 (31.25%) and 13/48 (27.10%) subjects for near and distance, respectively, with no significant difference between the two (P = 0.82; Fisher's exact test). Among stereoblind individuals, the odd's ratio for near stereoacuity to improve in comparison to distance stereoacuity was 8.85 (95% confidence interval: 1.68–46.70; P = 0.01). ICL implantation for refractive correction aided stereoacuity improvement in myopes more so for near. PMID:26655005

  9. Some Exact Conditional Tests of Independence for R X C Cross-Classification Tables

    ERIC Educational Resources Information Center

    Agresti, Alan; Wackerly, Dennis

    1977-01-01

    Exact conditional tests of independence in cross-classification tables are formulated based on chi square and other statistics with stronger operational interpretations, such as some nominal and ordinal measures of association. Guidelines for table dimensions and sample sizes for which the tests are economically implemented on a computer are…

  10. Standardized Definitions for Code Verification Test Problems

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

    Doebling, Scott William

    This document contains standardized definitions for several commonly used code verification test problems. These definitions are intended to contain sufficient information to set up the test problem in a computational physics code. These definitions are intended to be used in conjunction with exact solutions to these problems generated using Exact- Pack, www.github.com/lanl/exactpack.

  11. Missed opportunities for concurrent HIV-STD testing in an academic emergency department.

    PubMed

    Klein, Pamela W; Martin, Ian B K; Quinlivan, Evelyn B; Gay, Cynthia L; Leone, Peter A

    2014-01-01

    We evaluated emergency department (ED) provider adherence to guidelines for concurrent HIV-sexually transmitted disease (STD) testing within an expanded HIV testing program and assessed demographic and clinical factors associated with concurrent HIV-STD testing. We examined concurrent HIV-STD testing in a suburban academic ED with a targeted, expanded HIV testing program. Patients aged 18-64 years who were tested for syphilis, gonorrhea, or chlamydia in 2009 were evaluated for concurrent HIV testing. We analyzed demographic and clinical factors associated with concurrent HIV-STD testing using multivariate logistic regression with a robust variance estimator or, where applicable, exact logistic regression. Only 28.3% of patients tested for syphilis, 3.8% tested for gonorrhea, and 3.8% tested for chlamydia were concurrently tested for HIV during an ED visit. Concurrent HIV-syphilis testing was more likely among younger patients aged 25-34 years (adjusted odds ratio [AOR] = 0.36, 95% confidence interval [CI] 0.78, 2.10) and patients with STD-related chief complaints at triage (AOR=11.47, 95% CI 5.49, 25.06). Concurrent HIV-gonorrhea/chlamydia testing was more likely among men (gonorrhea: AOR=3.98, 95% CI 2.25, 7.02; chlamydia: AOR=3.25, 95% CI 1.80, 5.86) and less likely among patients with STD-related chief complaints at triage (gonorrhea: AOR=0.31, 95% CI 0.13, 0.82; chlamydia: AOR=0.21, 95% CI 0.09, 0.50). Concurrent HIV-STD testing in an academic ED remains low. Systematic interventions that remove the decision-making burden of ordering an HIV test from providers may increase HIV testing in this high-risk population of suspected STD patients.

  12. Decline in Tested and Self-Reported Cognitive Functioning After Prophylactic Cranial Irradiation for Lung Cancer: Pooled Secondary Analysis of Radiation Therapy Oncology Group Randomized Trials 0212 and 0214

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

    Gondi, Vinai, E-mail: vgondi@chicagocancer.org; University of Wisconsin Comprehensive Cancer Center, Madison, Wisconsin; Paulus, Rebecca

    Purpose: To assess the impact of prophylactic cranial irradiation (PCI) on self-reported cognitive functioning (SRCF), a functional scale on the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30). Methods and Materials: Radiation Therapy Oncology Group (RTOG) protocol 0214 randomized patients with locally advanced non-small cell lung cancer to PCI or observation; RTOG 0212 randomized patients with limited-disease small cell lung cancer to high- or standard-dose PCI. In both trials, Hopkins Verbal Learning Test (HVLT)-Recall and -Delayed Recall and SRCF were assessed at baseline (after locoregional therapy but before PCI or observation) and atmore » 6 and 12 months. Patients developing brain relapse before follow-up evaluation were excluded. Decline was defined using the reliable change index method and correlated with receipt of PCI versus observation using logistic regression modeling. Fisher's exact test correlated decline in SRCF with HVLT decline. Results: Of the eligible patients pooled from RTOG 0212 and RTOG 0214, 410 (93%) receiving PCI and 173 (96%) undergoing observation completed baseline HVLT or EORTC QLQ-C30 testing and were included in this analysis. Prophylactic cranial irradiation was associated with a higher risk of decline in SRCF at 6 months (odds ratio 3.60, 95% confidence interval 2.34-6.37, P<.0001) and 12 months (odds ratio 3.44, 95% confidence interval 1.84-6.44, P<.0001). Decline on HVLT-Recall at 6 and 12 months was also associated with PCI (P=.002 and P=.002, respectively) but was not closely correlated with decline in SRCF at the same time points (P=.05 and P=.86, respectively). Conclusions: In lung cancer patients who do not develop brain relapse, PCI is associated with decline in HVLT-tested and self-reported cognitive functioning. Decline in HVLT and decline in SRCF are not closely correlated, suggesting that they may represent distinct elements of the cognitive spectrum.« less

  13. Work accidents and self-esteem of nursing professional in hospital settings.

    PubMed

    Santos, Sérgio Valverde Marques Dos; Macedo, Flávia Ribeiro Martins; Silva, Luiz Almeida da; Resck, Zelia Marilda Rodrigues; Nogueira, Denismar Alves; Terra, Fábio de Souza

    2017-04-20

    to analyze the occurrence of work accidents and the self-esteem of nurses in hospitals of a municipality of Minas Gerais. descriptive-analytical and cross-sectional study developed with 393 nursing professionals from three hospitals of a municipality in southern Minas Gerais. The Rosenberg Self-Esteem Scale and a questionnaire to characterize the population and work accidents were used for data collection. Data analysis was performed using Person's chi-squared test, Fisher's exact test, Cronbach's alpha, odds ratio and logistic regression. of the professionals studied, 15% had suffered an accident at work and 70.2% presented high self-esteem. Through the analysis, it was observed that smoking, religious belief and an outstanding event in the career were significantly associated with work accidents. In relation to self-esteem, family income, length of time working in the profession and an outstanding event in the career presented significant associations. factors such as smoking, religious belief, family income, length of time working in the profession and an outstanding event in the career can cause professionals to have accidents and/or cause changes in self-esteem, which can compromise their physical and mental health and their quality of life and work.

  14. Work accidents and self-esteem of nursing professional in hospital settings

    PubMed Central

    dos Santos, Sérgio Valverde Marques; Macedo, Flávia Ribeiro Martins; da Silva, Luiz Almeida; Resck, Zelia Marilda Rodrigues; Nogueira, Denismar Alves; Terra, Fábio de Souza

    2017-01-01

    Abstract Objective: to analyze the occurrence of work accidents and the self-esteem of nurses in hospitals of a municipality of Minas Gerais. Method: descriptive-analytical and cross-sectional study developed with 393 nursing professionals from three hospitals of a municipality in southern Minas Gerais. The Rosenberg Self-Esteem Scale and a questionnaire to characterize the population and work accidents were used for data collection. Data analysis was performed using Person's chi-squared test, Fisher's exact test, Cronbach's alpha, odds ratio and logistic regression. Results: of the professionals studied, 15% had suffered an accident at work and 70.2% presented high self-esteem. Through the analysis, it was observed that smoking, religious belief and an outstanding event in the career were significantly associated with work accidents. In relation to self-esteem, family income, length of time working in the profession and an outstanding event in the career presented significant associations. Conclusion: factors such as smoking, religious belief, family income, length of time working in the profession and an outstanding event in the career can cause professionals to have accidents and/or cause changes in self-esteem, which can compromise their physical and mental health and their quality of life and work. PMID:28443993

  15. Oral habits as risk factors for anterior open bite in the deciduous and mixed dentition - cross-sectional study.

    PubMed

    Urzal, V; Braga, A C; Ferreira, A P

    2013-12-01

    Anterior open bite (AOB) is an occlusal anomaly commonly associated with oral habits (OH). The aim of this study was to determine the prevalence of OH as a risk factor for the AOB. A group of children aged between 3 and 12 years were observed. The statistical methodology included independent chi-square test, Fisher's exact test and binary logistic regression. The frequency of oral habits was of 43.5% in the deciduous dentition and 54.2% in the mixed dentition. There was a statistically significant association of pacifier sucking: 61.7 and 16.1 odd ratios (OR), and tongue thrust: 3.9 and 9.2 OR with AOB in both groups, respectively. Thumb sucking occurred only in the deciduous dentition with 5.6 OR. OH and AOB have a high frequency in children. They hinder the normal development of dental and skeletal structures. As OH are risk factors for AOB, the damaging habits most frequently associated are: pacifier sucking, thumb sucking, and tongue thrust. Due to the correlation between the prevalence of AOB and OH, prevention strategies incorporating psychological data related to children should be integrated into a national public health programme.

  16. Exact exchange potential evaluated from occupied Kohn-Sham and Hartree-Fock solutions

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

    Cinal, M.; Holas, A.

    2011-06-15

    The reported algorithm determines the exact exchange potential v{sub x} in an iterative way using energy shifts (ESs) and orbital shifts (OSs) obtained with finite-difference formulas from the solutions (occupied orbitals and their energies) of the Hartree-Fock-like equation and the Kohn-Sham-like equation, the former used for the initial approximation to v{sub x} and the latter for increments of ES and OS due to subsequent changes of v{sub x}. Thus, the need for solution of the differential equations for OSs, used by Kuemmel and Perdew [Phys. Rev. Lett. 90, 043004 (2003)], is bypassed. The iterated exchange potential, expressed in terms ofmore » ESs and OSs, is improved by modifying ESs at odd iteration steps and OSs at even steps. The modification formulas are related to the optimized-effective-potential equation (satisfied at convergence) written as the condition of vanishing density shift (DS). They are obtained, respectively, by enforcing its satisfaction through corrections to approximate OSs and by determining the optimal ESs that minimize the DS norm. The proposed method, successfully tested for several closed-(sub)shell atoms, from Be to Kr, within the density functional theory exchange-only approximation, proves highly efficient. The calculations using the pseudospectral method for representing orbitals give iterative sequences of approximate exchange potentials (starting with the Krieger-Li-Iafrate approximation) that rapidly approach the exact v{sub x} so that, for Ne, Ar, and Zn, the corresponding DS norm becomes less than 10{sup -6} after 13, 13, and 9 iteration steps for a given electron density. In self-consistent density calculations, orbital energies of 10{sup -4} hartree accuracy are obtained for these atoms after, respectively, 9, 12, and 12 density iteration steps, each involving just two steps of v{sub x} iteration, while the accuracy limit of 10{sup -6} to 10{sup -7} hartree is reached after 20 density iterations.« less

  17. Exact exchange potential evaluated from occupied Kohn-Sham and Hartree-Fock solutions

    NASA Astrophysics Data System (ADS)

    Cinal, M.; Holas, A.

    2011-06-01

    The reported algorithm determines the exact exchange potential vx in an iterative way using energy shifts (ESs) and orbital shifts (OSs) obtained with finite-difference formulas from the solutions (occupied orbitals and their energies) of the Hartree-Fock-like equation and the Kohn-Sham-like equation, the former used for the initial approximation to vx and the latter for increments of ES and OS due to subsequent changes of vx. Thus, the need for solution of the differential equations for OSs, used by Kümmel and Perdew [Phys. Rev. Lett.PRLTAO0031-900710.1103/PhysRevLett.90.043004 90, 043004 (2003)], is bypassed. The iterated exchange potential, expressed in terms of ESs and OSs, is improved by modifying ESs at odd iteration steps and OSs at even steps. The modification formulas are related to the optimized-effective-potential equation (satisfied at convergence) written as the condition of vanishing density shift (DS). They are obtained, respectively, by enforcing its satisfaction through corrections to approximate OSs and by determining the optimal ESs that minimize the DS norm. The proposed method, successfully tested for several closed-(sub)shell atoms, from Be to Kr, within the density functional theory exchange-only approximation, proves highly efficient. The calculations using the pseudospectral method for representing orbitals give iterative sequences of approximate exchange potentials (starting with the Krieger-Li-Iafrate approximation) that rapidly approach the exact vx so that, for Ne, Ar, and Zn, the corresponding DS norm becomes less than 10-6 after 13, 13, and 9 iteration steps for a given electron density. In self-consistent density calculations, orbital energies of 10-4 hartree accuracy are obtained for these atoms after, respectively, 9, 12, and 12 density iteration steps, each involving just two steps of vx iteration, while the accuracy limit of 10-6 to 10-7 hartree is reached after 20 density iterations.

  18. Parenting Practices and Associations with Development Delays among Young Children in Dominican Republic.

    PubMed

    Uwemedimo, Omolara Thomas; Howlader, Afrin; Pierret, Giselina

    According to the World Health Organization, >200 million children in low- and middle-income countries experience developmental delays. However, household structure and parenting practices have been minimally explored as potential correlates of developmental delay in low- and middle-income countries, despite potential as areas for intervention. The objective of the study was to examine associations of developmental delays with use of World Health Organization-recommended parenting practices among a clinic-based cohort of children aged 6-60 months attending in La Romana, Dominican Republic. This study was conducted among 74 caregiver-child pairs attending the growth-monitoring clinic at Hospital Francisco Gonzalvo in June 2015. The Malawi Developmental Assessment Tool was adapted and performed on each child to assess socioadaptive, fine motor, gross motor, and language development. The IMCI Household Level Survey Questionnaire was used to assess parenting practices. Fisher's exact test was used to determine associations significant at P < .05. Significant variables were then entered into a multivariable logistic regression. Almost two-thirds of children had a delay in at least 1 developmental domain. Most caregivers used scolding (43.2%) or spanking (44%) for child discipline. Children who were disciplined by spanking and scolding were more likely to have language delay (P = .007) and socioadaptive delay (P = .077), respectively. On regression analysis, children with younger primary caregivers had 7 times higher odds of language delay (adjusted odds ratio [AOR]: 7.35, 95% confidence interval [CI]: 1.52-35.61) and 4 times greater odds of any delay (AOR: 4.72, 95% CI: 1.01-22.22). In addition, children punished by spanking had 5 times higher odds of having language delay (AOR: 5.04, 95% CI: 1.13-22.39). Parenting practices such as harsh punishment and lack of positive parental reinforcement were found to have strong associations with language and socioadaptive delays. Likewise, delays were also more common among children with younger caregivers. Copyright © 2017 Icahn School of Medicine at Mount Sinai. Published by Elsevier Inc. All rights reserved.

  19. A deformation of Sasakian structure in the presence of torsion and supergravity solutions

    NASA Astrophysics Data System (ADS)

    Houri, Tsuyoshi; Takeuchi, Hiroshi; Yasui, Yukinori

    2013-07-01

    A deformation of Sasakian structure in the presence of totally skew-symmetric torsion is discussed on odd-dimensional manifolds whose metric cones are Kähler with torsion. It is shown that such a geometry inherits similar properties to those of Sasakian geometry. As their example, we present an explicit expression of local metrics. It is also demonstrated that our example of the metrics admits the existence of hidden symmetry described by non-trivial odd-rank generalized closed conformal Killing-Yano tensors. Furthermore, using these metrics as an ansatz, we construct exact solutions in five-dimensional minimal gauged/ungauged supergravity and 11-dimensional supergravity. Finally, the global structures of the solutions are discussed. We obtain regular metrics on compact manifolds in five dimensions, which give natural generalizations of Sasaki-Einstein manifolds Yp, q and La, b, c. We also briefly discuss regular metrics on non-compact manifolds in 11 dimensions.

  20. Exact Green's function method of solar force-free magnetic-field computations with constant alpha. I - Theory and basic test cases

    NASA Technical Reports Server (NTRS)

    Chiu, Y. T.; Hilton, H. H.

    1977-01-01

    Exact closed-form solutions to the solar force-free magnetic-field boundary-value problem are obtained for constant alpha in Cartesian geometry by a Green's function approach. The uniqueness of the physical problem is discussed. Application of the exact results to practical solar magnetic-field calculations is free of series truncation errors and is at least as economical as the approximate methods currently in use. Results of some test cases are presented.

  1. Acquired urethral obstruction in New World camelids: 34 cases (1995-2008).

    PubMed

    Duesterdieck-Zellmer, K F; Van Metre, D C; Cardenas, A; Cebra, C K

    2014-08-01

    Document the clinical features, short- and long-term outcomes and prognostic factors in New World camelids with acquired urethral obstruction. Retrospective case study. Case data from medical records of 34 New World camelids presenting with acquired urethral obstruction were collected and follow-up information on discharged patients was obtained. Associations with short- and long-term survival were evaluated using Wilcoxon rank-sum tests, exact-logistic regressions and Kaplan-Meier survival curves. Of the 34 New World camelids 23 were intact males and 11 were castrated; 4 animals were euthanased upon presentation, 7 were treated medically and 23 surgically, including urethrotomy, bladder marsupialisation, tube cystostomy alone or combined with urethrotomy, urethrostomy or penile reefing. Necrosis of the distal penis was found in 4 animals and all were short-term non-survivors. Short-term survival for surgical cases was 65%, and 57% for medical cases. Incomplete urethral obstruction at admission and surgical treatment were associated with increased odds of short-term survival. Of 14 records available for long-term follow-up, 6 animals were alive and 8 were dead (median follow-up 4.5 years, median survival time 2.5 years). Recurrence of urethral obstruction was associated with long-term non-survival. Surgically treated New World camelids with incomplete urethral obstruction have the best odds of short-term survival and those with recurrence of urethral obstruction have a poor prognosis for long-term survival. © 2014 Australian Veterinary Association.

  2. Factors associated with HIV testing among men who have sex with men in Western Kenya: a cross-sectional study.

    PubMed

    Shangani, Sylvia; Naanyu, Violet; Mwangi, Ann; Vermandere, Heleen; Mereish, Ethan; Obala, Andrew; Vanden Broeck, Davy; Sidle, John; Operario, Don

    2017-02-01

    HIV diagnosis is an important step in the HIV cascade of prevention and treatment. However, men who have sex with men in low- and middle-income countries have limited access to HIV care services. We examined factors associated with prior HIV testing among men who have sex with men in western Kenya. We recruited 95 men who have sex with men aged 18 years and older, and who reported at least one sexual contact with a man in the past 6 months; however, this analysis is restricted to 89 participants who completed questions on HIV testing. Logistic regression model was used to determine factors associated with HIV testing in the past one year. Results indicate that 23 (26%) had not been tested in the past 12 months. Bivariate analyses demonstrated that condomless anal sex (odds ratio = 3.29, 95% confidence interval = 1.18-9.17) and comfort with healthcare providers (odds ratio = 1.15, 95 % CI = 1.05-1.26) were associated with higher odds of HIV testing in the past 12 months. Experiencing social stigma was associated with lower odds of HIV testing in the last 12 months (odds ratio = 0.91, 95% confidence interval = 0.84-0.94). In multivariable models, social stigma remained significantly associated with lower odds of HIV testing in the last 12 months odds ratio = 0.90, 95% confidence interval = 0.82-0.99) after inclusion of sexual risk and individual level variables. Development of men who have sex with men-sensitive HIV-testing services, addressing stigma, and training healthcare workers to provide culturally sensitive services may assist in effectively engaging men who have sex with men in the HIV treatment cascade.

  3. Exact consideration of data redundancies for spiral cone-beam CT

    NASA Astrophysics Data System (ADS)

    Lauritsch, Guenter; Katsevich, Alexander; Hirsch, Michael

    2004-05-01

    In multi-slice spiral computed tomography (CT) there is an obvious trend in adding more and more detector rows. The goals are numerous: volume coverage, isotropic spatial resolution, and speed. Consequently, there will be a variety of scan protocols optimizing clinical applications. Flexibility in table feed requires consideration of data redundancies to ensure efficient detector usage. Until recently this was achieved by approximate reconstruction algorithms only. However, due to the increasing cone angles there is a need of exact treatment of the cone beam geometry. A new, exact and efficient 3-PI algorithm for considering three-fold data redundancies was derived from a general, theoretical framework based on 3D Radon inversion using Grangeat's formula. The 3-PI algorithm possesses a simple and efficient structure as the 1-PI method for non-redundant data previously proposed. Filtering is one-dimensional, performed along lines with variable tilt on the detector. This talk deals with a thorough evaluation of the performance of the 3-PI algorithm in comparison to the 1-PI method. Image quality of the 3-PI algorithm is superior. The prominent spiral artifacts and other discretization artifacts are significantly reduced due to averaging effects when taking into account redundant data. Certainly signal-to-noise ratio is increased. The computational expense is comparable even to that of approximate algorithms. The 3-PI algorithm proves its practicability for applications in medical imaging. Other exact n-PI methods for n-fold data redundancies (n odd) can be deduced from the general, theoretical framework.

  4. Exact tests using two correlated binomial variables in contemporary cancer clinical trials.

    PubMed

    Yu, Jihnhee; Kepner, James L; Iyer, Renuka

    2009-12-01

    New therapy strategies for the treatment of cancer are rapidly emerging because of recent technology advances in genetics and molecular biology. Although newer targeted therapies can improve survival without measurable changes in tumor size, clinical trial conduct has remained nearly unchanged. When potentially efficacious therapies are tested, current clinical trial design and analysis methods may not be suitable for detecting therapeutic effects. We propose an exact method with respect to testing cytostatic cancer treatment using correlated bivariate binomial random variables to simultaneously assess two primary outcomes. The method is easy to implement. It does not increase the sample size over that of the univariate exact test and in most cases reduces the sample size required. Sample size calculations are provided for selected designs.

  5. Exact and Monte carlo resampling procedures for the Wilcoxon-Mann-Whitney and Kruskal-Wallis tests.

    PubMed

    Berry, K J; Mielke, P W

    2000-12-01

    Exact and Monte Carlo resampling FORTRAN programs are described for the Wilcoxon-Mann-Whitney rank sum test and the Kruskal-Wallis one-way analysis of variance for ranks test. The program algorithms compensate for tied values and do not depend on asymptotic approximations for probability values, unlike most algorithms contained in PC-based statistical software packages.

  6. Exact Tests for the Rasch Model via Sequential Importance Sampling

    ERIC Educational Resources Information Center

    Chen, Yuguo; Small, Dylan

    2005-01-01

    Rasch proposed an exact conditional inference approach to testing his model but never implemented it because it involves the calculation of a complicated probability. This paper furthers Rasch's approach by (1) providing an efficient Monte Carlo methodology for accurately approximating the required probability and (2) illustrating the usefulness…

  7. Fine structure of spectrum of twist-three operators in QCD

    NASA Astrophysics Data System (ADS)

    Belitsky, A. V.

    1999-04-01

    We unravel the structure of the spectrum of the anomalous dimensions of the quark-gluon twist-3 operators which are responsible for the multiparton correlations in hadrons and enter as a leading contribution to several physical cross sections. The method of analysis is based on the recent finding of a non-trivial integral of motion for the corresponding Hamiltonian problem in multicolour limit which results into exact integrability of the three-particle system. Quasiclassical expansion is used for solving the problem. We address the chiral-odd sector as a case of study.

  8. The odd-even effect in Sudoku puzzles: effects of working memory, aging, and experience.

    PubMed

    Chang, Hye-Sang; Gibson, Janet M

    2011-01-01

    The odd-even effect in numerical processing has been explained as the easier processing of even numbers compared with odd numbers. We investigated this effect in Sudoku puzzles, a reasoning problem that uses numbers but does not require arithmetic operations. Specifically, we asked whether the odd-even effect occurred with Sudoku puzzles and whether individual differences in working memory (WM), aging, and experience with Sudoku modulated this effect. We manipulated the presence of odd and even numbers in Sudoku puzzles, measured WM with the Wisconsin Card Sorting Test and backward digit span task, tested older and younger adults, and collected Sudoku experience frequency. Performance on Sudoku was more accurate for even puzzles than odd ones. Younger, experienced, and higher-WM participants were more accurate on Sudoku, but these individual difference variables did not interact with the odd-even effect. Odd numbers may impose more cognitive load than even numbers, but future research is needed to examine how age, experience, or WM may influence the odd-even effect.

  9. Tuberculin skin testing and T-SPOT.TB in internationally adopted children.

    PubMed

    Spicer, Kevin B; Turner, Joanne; Wang, Shu-Hua; Koranyi, Katalin; Powell, Dwight A

    2015-06-01

    Diagnosis of latent tuberculosis infection is a problem in children because of lack of a diagnostic standard and potential impact of previous Bacille Calmette-Guérin vaccination and exposure to environmental mycobacteria. Effectiveness and usefulness of interferon-gamma release assays in infants and younger children have yet to be clearly demonstrated. Prospective cohort study including 109 children (4 months to 16 years) seen in an international adoption clinic at Nationwide Children's Hospital, Columbus, OH. Children were adopted from 14 countries, mostly (72.5%) from China, Russia and Ethiopia. Correspondence between tuberculin skin test (TST) and the T-SPOT.TB assay was evaluated. Factors associated with positive results on the TST and T-SPOT.TB were determined, and the impact of age on test performance was specifically addressed. TST was positive in 23.4% (25 of 107). T-SPOT.TB was positive in 4.6% (5 of 109). Overall agreement between TST and T-SPOT.TB was 71%, with prevalence-adjusted, bias-adjusted Kappa of 0.68. History of Mycobacterium tuberculosis exposure was associated with positive results on TST (odds ratio: 25.4, 95% confidence interval: 4.8-261.6, exact logistic regression) and T-SPOT.TB (odds ratio: 78.9, 95% confidence interval: 9.7-∞). All 5 children with positive T-SPOT.TB had TST induration ≥15 mm. No patient less than 1 year of age (n = 17) had positive TST or T-SPOT.TB. Positive TST was not associated with Bacille Calmette-Guérin vaccination or scar. TST was positive in a significant percentage of international adoptees. T-SPOT.TB was rarely positive and discordant results reflected negative T-SPOT.TB with positive TST. In this population latent tuberculosis infection may be over-estimated by TST. Regardless, in our context at the time of the study, treatment decisions were based upon TST results, not results of the T-SPOT.TB assay. Age was consistently associated with findings on TST and T-SPOT.TB with no positive result on either test for any child <1 year of age.

  10. Normal stress differences from Oldroyd 8-constant framework: Exact analytical solution for large-amplitude oscillatory shear flow

    NASA Astrophysics Data System (ADS)

    Saengow, C.; Giacomin, A. J.

    2017-12-01

    The Oldroyd 8-constant framework for continuum constitutive theory contains a rich diversity of popular special cases for polymeric liquids. In this paper, we use part of our exact solution for shear stress to arrive at unique exact analytical solutions for the normal stress difference responses to large-amplitude oscillatory shear (LAOS) flow. The nonlinearity of the polymeric liquids, triggered by LAOS, causes these responses at even multiples of the test frequency. We call responses at a frequency higher than twice the test frequency higher harmonics. We find the new exact analytical solutions to be compact and intrinsically beautiful. These solutions reduce to those of our previous work on the special case of the corotational Maxwell fluid. Our solutions also agree with our new truncated Goddard integral expansion for the special case of the corotational Jeffreys fluid. The limiting behaviors of these exact solutions also yield new explicit expressions. Finally, we use our exact solutions to see how η∞ affects the normal stress differences in LAOS.

  11. A Note on Monotonicity Assumptions for Exact Unconditional Tests in Binary Matched-pairs Designs

    PubMed Central

    Li, Xiaochun; Liu, Mengling; Goldberg, Judith D.

    2011-01-01

    Summary Exact unconditional tests have been widely applied to test the difference between two probabilities for 2×2 matched-pairs binary data with small sample size. In this context, Lloyd (2008, Biometrics 64, 716–723) proposed an E + M p-value, that showed better performance than the existing M p-value and C p-value. However, the analytical calculation of the E + M p-value requires that the Barnard convexity condition be satisfied; this can be challenging to prove theoretically. In this paper, by a simple reformulation, we show that a weaker condition, conditional monotonicity, is sufficient to calculate all three p-values (M, C and E + M) and their corresponding exact sizes. Moreover, this conditional monotonicity condition is applicable to non-inferiority tests. PMID:21466507

  12. Symmetries and exact solutions of a class of nonlocal nonlinear Schrödinger equations with self-induced parity-time-symmetric potential.

    PubMed

    Sinha, Debdeep; Ghosh, Pijush K

    2015-04-01

    A class of nonlocal nonlinear Schrödinger equations (NLSEs) is considered in an external potential with a space-time modulated coefficient of the nonlinear interaction term as well as confining and/or loss-gain terms. This is a generalization of a recently introduced integrable nonlocal NLSE with self-induced potential that is parity-time-symmetric in the corresponding stationary problem. Exact soliton solutions are obtained for the inhomogeneous and/or nonautonomous nonlocal NLSE by using similarity transformation, and the method is illustrated with a few examples. It is found that only those transformations are allowed for which the transformed spatial coordinate is odd under the parity transformation of the original one. It is shown that the nonlocal NLSE without the external potential and a (d+1)-dimensional generalization of it admits all the symmetries of the (d+1)-dimensional Schrödinger group. The conserved Noether charges associated with the time translation, dilatation, and special conformal transformation are shown to be real-valued in spite of being non-Hermitian. Finally, the dynamics of different moments are studied with an exact description of the time evolution of the "pseudowidth" of the wave packet for the special case in which the system admits a O(2,1) conformal symmetry.

  13. Spirituality/religiosity, substance use, and HIV testing among young black men who have sex with men.

    PubMed

    Carrico, Adam W; Storholm, Erik David; Flentje, Annesa; Arnold, Emily A; Pollack, Lance M; Neilands, Torsten B; Rebchook, Gregory M; Peterson, John L; Eke, Agatha; Johnson, Wayne; Kegeles, Susan M

    2017-05-01

    Spirituality and religiosity may serve as both a resource and a barrier to HIV prevention with young black men who have sex with men (YBMSM). We examined indices of spirituality/religiosity as correlates of binge drinking, stimulant use, and recent HIV testing in a sample of YBMSM. From 2011-2013, annual venue-based surveys of sexually active YBMSM ages 18-29 were conducted in Dallas and Houston, Texas. Binge drinking and stimulant use were assessed in the past two months. Participants recently tested for HIV (i.e., within the past six months) were compared to those without recent HIV testing (i.e., never tested or tested more than six months ago). Among the 1565 HIV-negative or HIV-unknown YBMSM enrolled, more engagement in spiritual and religious activities was associated with greater odds of reporting stimulant use (Adjusted Odds Ratio [AOR]=1.20; 95% CI=1.04-1.40) while higher spiritual coping was associated with lower odds of reporting stimulant use (AOR=0.66; 95% CI=0.56-0.78). Binge drinking was independently associated with 29% lower odds of recent HIV testing (AOR=0.71; 95% CI=0.55-0.92), but lower odds of binge drinking did not mediate the association of engagement in spiritual and religious activities with 27% greater odds of recent HIV testing (AOR=1.27; 95% CI=1.11-1.46). Among YBMSM, culturally tailored approaches addressing spirituality/religiosity could support prevention of stimulant use and increase HIV testing. In particular, expanded efforts are needed to promote HIV testing in binge drinkers. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Comparison of Ferric Sulfate Combined Mineral Trioxide Aggregate Pulpotomy and Zinc Oxide Eugenol Pulpectomy of Primary Maxillary Incisors: An 18-month Randomized, Controlled Trial.

    PubMed

    Nguyen, Trang D; Judd, Peter L; Barrett, Edward J; Sidhu, Nicole; Casas, Michael J

    2017-01-15

    The purpose of this study was to compare outcomes and survival of ferric sulfate with mineral trioxide aggregate (FS+MTA) pulpotomy and root canal therapy (RCT) in carious vital primary maxillary incisors. In this parallel group noninferiority trial, asymptomatic carious vital primary incisors with pulp exposure in healthy 18- to 46-month-olds were allocated randomly to receive FS+MTA pulpotomy or RCT between September 2010 and September 2012. Each incisor was classified into one of the following radiographic outcomes: N (incisor without pathologic change); Po (pathologic change present, follow-up recommended); Px (pathologic change present, extract.) Clinical findings and incisor survival were secondary outcomes. Seventy subjects were enrolled with a total of 172 incisors. Twelve- and 18-month radiographic outcomes demonstrated no statistical difference between FS+MTA pulpotomy and RCT incisors for Px outcomes (P=0.38; odds ratio equals 0.60; 95 percent confidence interval equals 0.19 to 1.89; chi-square test). There was no statistical differences in clinical outcomes for FS+MTA pulpotomy and RCT at 12 and 18 months (P=0.51; Fisher's exact test) or survival for FS+MTA pulpotomy and RCT incisors (P=0.11; log-rank test). Ferric Sulfate with Mineral Trioxide Aggregate (FS+MTA) is an alternative to RCT for vital primary incisors.

  15. Evaluation of Clinical Outcomes and Renal Vascular Pathology among Patients with Lupus

    PubMed Central

    Barber, Claire; Herzenberg, Andrew; Aghdassi, Ellie; Su, Jiandong; Lou, Wendy; Qian, Gan; Yip, Jonathan; Nasr, Samih H.; Thomas, David; Scholey, James W.; Wither, Joan; Urowitz, Murray; Gladman, Dafna; Reich, Heather

    2012-01-01

    Summary Background and objectives The objective of this study was to determine the clinical significance of renal vascular lesions in lupus nephritis. Design, setting, participants, & measurements Renal vascular lesions defined as thrombotic microangiopathy, lupus vasculopathy, uncomplicated vascular immune deposits, and arterial sclerosis were evaluated in relation to renal and vascular morbidity and overall mortality. Results Biopsies from 161 patients revealed thrombotic microangiopathy (13), lupus vasculopathy (5), and arterial sclerosis (93). No renal vascular lesions were found in 24.8% of patients. At the time of biopsy, arterial sclerosis or lupus vasculopathy patients were older (arterial sclerosis=37.9±13.0 and lupus vasculopathy=44.4±8.9 versus controls=33.1±8.9 years, P<0.05), and the mean arterial pressure was higher in all groups compared with controls. Nephritis subtype, activity indices, and proteinuria were similar between groups, estimated GFR was lower in arterial sclerosis (70.5±33.3 versus 84.5±26.6 ml/min per 1.73 m2, P=0.03), and chronicity index (thrombotic microangiopathy=3.5, lupus vasculopathy=4.5, and arterial sclerosis=2.5) was higher in all renal vascular lesions subgroups versus controls (1.0, P<0.05). In 133 patients with similar follow-up, the association between renal vascular lesions and vascular events was significant (Fisher exact test, P=0.002) and remained so after multivariate analysis (exact conditional scores test, P=0.04), where the difference between arterial sclerosis and uncomplicated vascular immune deposits was most noticeable (odds ratio [95% confidence interval]=8.35[0.98, 83.12], P=0.05). The associations between renal vascular lesions, renal outcomes, and death were not significant, likely because of insufficient power. Conclusions Renal vascular lesions are common in SLE patients with nephritis and may be associated with arterial vascular events. PMID:22442181

  16. Test Control Center

    NASA Image and Video Library

    2000-10-25

    At the test observation periscope in the Test Control Center exhibit in StenniSphere at the John C. Stennis Space Center in Hancock County, Miss., visitors can observe a test of a Space Shuttle Main Engine exactly as test engineers might see it during a real engine test. The Test Control Center exhibit exactly simulates not only the test control environment, but also the procedure of testing a rocket engine. Designed to entertain while educating, StenniSphere includes informative dispays and exhibits from NASA's lead center for rocket propulsion and remote sensing applications. StenniSphere is open free of charge from 9 a.m. to 5 p.m. daily.

  17. Epidemiology of Bone Fracture in Female Trauma Patients Based on Risks of Osteoporosis Assessed using the Osteoporosis Self-Assessment Tool for Asians Score

    PubMed Central

    Rau, Cheng-Shyuan; Wu, Shao-Chun; Kuo, Pao-Jen; Chen, Yi-Chun; Chien, Peng-Chen; Hsieh, Hsiao-Yun

    2017-01-01

    Background: Osteoporotic fractures are defined as low-impact fractures resulting from low-level trauma. However, the exclusion of high-level trauma fractures may result in underestimation of the contribution of osteoporosis to fractures. In this study, we aimed to investigate the fracture patterns of female trauma patients with various risks of osteoporosis based on the Osteoporosis Self-Assessment Tool for Asians (OSTA) score. Methods: According to the data retrieved from the Trauma Registry System of a Level I trauma center between 1 January 2009 and 31 December 2015, a total of 6707 patients aged ≥40 years and hospitalized for the treatment of traumatic bone fracture were categorized as high-risk (OSTA < −4, n = 1585), medium-risk (−1 ≥ OSTA ≥ −4, n = 1985), and low-risk (OSTA > −1, n = 3137) patients. Two-sided Pearson’s, chi-squared, or Fisher’s exact tests were used to compare categorical data. Unpaired Student’s t-test and Mann–Whitney U-test were used to analyze normally and non-normally distributed continuous data, respectively. Propensity-score matching in a 1:1 ratio was performed with injury mechanisms as adjusted variables to evaluate the effects of OSTA-related grouping on the fracture patterns. Results: High- and medium-risk patients were significantly older, had higher incidences of comorbidity, and were more frequently injured from a fall and bicycle accident than low-risk patients did. Compared to low-risk patients, high- and medium-risk patients had a higher injury severity and mortality. In the propensity-score matched population, the incidence of fractures was only different in the extremity regions between high- and low-risk patients as well as between medium- and low-risk patients. The incidences of femoral fractures were significantly higher in high-risk (odds ratio [OR], 3.4; 95% confidence interval [CI], 2.73–4.24; p < 0.001) and medium-risk patients (OR, 1.4; 95% CI, 1.24–1.54; p < 0.001) than in low-risk patients. In addition, high-risk patients had significantly lower odds of humeral, radial, patellar, and tibial fractures; however, such lower odds were not found in medium- risk than low-risk patients. Conclusions: The fracture patterns of female trauma patients with high- and medium-risk osteoporosis were different from that of low-risk patients exclusively in the extremity region. PMID:29137199

  18. Internet and Social Media Access Among Youth Experiencing Homelessness: Mixed-Methods Study.

    PubMed

    VonHoltz, Lauren A Houdek; Frasso, Rosemary; Golinkoff, Jesse M; Lozano, Alicia J; Hanlon, Alexandra; Dowshen, Nadia

    2018-05-22

    Youth experiencing homelessness are at a risk for a variety of adverse outcomes. Given the widespread use of the internet and social media, these new technologies may be used to address their needs and for outreach purposes. However, little is known about how this group uses these resources. This study investigated how homeless adolescents use these technologies for general and health-related purposes, whether the scope of their use changes with housing status, and their interest in a website dedicated to youth experiencing homelessness. A convenience sample of youth aged 18 to 21 years was recruited from a youth-specific homeless shelter. All participants completed a 47-item survey, with 10 individuals completing a semistructured interview. Descriptive statistics, exact testing, logistic regression, and generalized estimating equation modeling was performed for quantitative data analysis. Interviews were transcribed verbatim, and NVivo 10 (QSR International) was employed to facilitate double coding and thematic analysis. A total of 87 participants completed the survey with a mean age of 19.4 (SD 1.1) years. While experiencing homelessness, 56% (49/87) accessed the internet at least once a day, with 86% (75/87) accessing once a week. Access to a smartphone was associated with a 3.03 greater odds of accessing the internet and was the most frequently used device (66% of participants, 57/87). While experiencing homelessness, subjects reported a 68% decreased odds in internet access frequency (odds ratio [OR] 0.32, P<.001), 75% decreased odds in spending greater amounts of time on the internet (OR 0.25, P<.001), and an 87% decreased odds of social media use (OR 0.13, P=.01). Ten participants completed the semistructured interview. Several themes were identified, including (1) changes in internet behaviors while experiencing homelessness, (2) health status as a major concern and reason for Internet use, and (3) interest in a website dedicated to youth experiencing homelessness. While experiencing homelessness, participants indicated their behaviors were more goal-oriented and less focused on leisure or entertainment activities. While homeless youth experience changes in the frequency, amount of time, and specific uses of the internet and social media, study participants were able to access the internet regularly. The internet was used to search health-related topics. Given the importance of smartphones in accessing the internet, mobile-optimized websites may be an effective method for reaching this group. ©Lauren A Houdek VonHoltz, Rosemary Frasso, Jesse M Golinkoff, Alicia J Lozano, Alexandra Hanlon, Nadia Dowshen. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 22.05.2018.

  19. Fetal macrosomia as a risk factor for shoulder dystocia during vacuum extraction.

    PubMed

    Herzberg, Shmuel; Kabiri, Doron; Mordechai, Tzlil; Haj Yahya, Rani; Chill, Henry; Levitt, Lorinne; Amsalem, Hagai; Ezra, Yossef

    2017-08-01

    Vacuum extraction of a macrosomic fetus is considered a risk factor for shoulder dystocia (SD). We evaluated maternal and fetal outcomes following vacuum extraction of macrosomic infants. A retrospective cohort study conducted in two large teaching hospitals. All deliveries of macrosomic infants by vacuum extraction and vaginal delivery were compared. The primary outcome measure was SD. Secondary outcome measures were severe perineal lacerations and postpartum hemorrhage. For statistical analysis, we used McNemar's test and χ 2 or Fisher's exact tests. Odds ratios were analyzed via a logistic regression model. From 2003 to 2013, there were 6019 (5.45%) deliveries of macrosomic fetuses, and 230 (0.21%) were delivered by vacuum extraction. There were 23 (10%) and seven (3.04%) cases of SD in the study and control groups, respectively. The risk of SD was significantly higher in the study group (p > 0.05). We found a significant association between SD and vacuum delivery [p = 0.003; OR = 3.54 (95% CI: 1.49-8.42)]. The composite adverse neonatal outcome rate was 6.5% (15/230) and 1.7% (4/230) in the study and control groups, respectively (p = 0.009). Vacuum extraction of a macrosomic infant is a risk factor for shoulder dystocia but not for postpartum hemorrhage or severe vaginal tears.

  20. [The impact of breastfeeding promotion in women with formal employment].

    PubMed

    Brasileiro, Aline Alves; Possobon, Rosana de Fátima; Carrascoza, Karina Camilo; Ambrosano, Gláucia Maria Bovi; Moraes, Antônio Bento Alves de

    2010-09-01

    This study focused on programs to promote breastfeeding in order to prevent early weaning of working mothers' infant children. A non-randomized intervention study was conducted using a survey of mothers who had returned to work after childbirth, including both participants and non-participants in a program to promote breastfeeding. The sample consisted of 200 mothers of infants ranging from 6 to 10 months of age. Factors associated with early weaning were analyzed with the chi-square and Fisher's exact tests and multiple logistic regression (α = 0.05). The results showed statistical differences between the groups in relation to exclusive breastfeeding (p < 0.0001) and breastfeeding (p < 0.0001). There was a statistically significant difference (p = 0.0056) between the groups in relation to time between childbirth and return to work. There was no difference between the end of maternity leave and weaning time. Mothers that were unable to nurse their infants during the work shift showed 4.98 times higher odds (95%CI: 1.27-19.61) of weaning them before the fourth month of age.

  1. Is a Trineutron Resonance Lower in Energy than a Tetraneutron Resonance?

    NASA Astrophysics Data System (ADS)

    Gandolfi, S.; Hammer, H.-W.; Klos, P.; Lynn, J. E.; Schwenk, A.

    2017-06-01

    We present quantum Monte Carlo calculations of few-neutron systems confined in external potentials based on local chiral interactions at next-to-next-to-leading order in chiral effective field theory. The energy and radial densities for these systems are calculated in different external Woods-Saxon potentials. We assume that their extrapolation to zero external-potential depth provides a quantitative estimate of three- and four-neutron resonances. The validity of this assumption is demonstrated by benchmarking with an exact diagonalization in the two-body case. We find that the extrapolated trineutron resonance, as well as the energy for shallow well depths, is lower than the tetraneutron resonance energy. This suggests that a three-neutron resonance exists below a four-neutron resonance in nature and is potentially measurable. To confirm that the relative ordering of three- and four-neutron resonances is not an artifact of the external confinement, we test that the odd-even staggering in the helium isotopic chain is reproduced within this approach. Finally, we discuss similarities between our results and ultracold Fermi gases.

  2. Is a Trineutron Resonance Lower in Energy than a Tetraneutron Resonance?

    DOE PAGES

    Gandolfi, Stefano; Hammer, Hans -Werner; Klos, P.; ...

    2017-06-08

    Here, we present quantum Monte Carlo calculations of few-neutron systems confined in external potentials based on local chiral interactions at next-to-next-to-leading order in chiral effective field theory. The energy and radial densities for these systems are calculated in different external Woods-Saxon potentials. We assume that their extrapolation to zero external-potential depth provides a quantitative estimate of three- and four-neutron resonances. The validity of this assumption is demonstrated by benchmarking with an exact diagonalization in the two-body case. We find that the extrapolated trineutron resonance, as well as the energy for shallow well depths, is lower than the tetraneutron resonance energy.more » This suggests that a three-neutron resonance exists below a four-neutron resonance in nature and is potentially measurable. To confirm that the relative ordering of three- and four-neutron resonances is not an artifact of the external confinement, we test that the odd-even staggering in the helium isotopic chain is reproduced within this approach. Finally, we discuss similarities between our results and ultracold Fermi gases.« less

  3. Evaluation of Factors Influencing Accuracy of Principal Procedure Coding Based on ICD-9-CM: An Iranian Study

    PubMed Central

    Farzandipour, Mehrdad; Sheikhtaheri, Abbas

    2009-01-01

    To evaluate the accuracy of procedural coding and the factors that influence it, 246 records were randomly selected from four teaching hospitals in Kashan, Iran. “Recodes” were assigned blindly and then compared to the original codes. Furthermore, the coders' professional behaviors were carefully observed during the coding process. Coding errors were classified as major or minor. The relations between coding accuracy and possible effective factors were analyzed by χ2 or Fisher exact tests as well as the odds ratio (OR) and the 95 percent confidence interval for the OR. The results showed that using a tabular index for rechecking codes reduces errors (83 percent vs. 72 percent accuracy). Further, more thorough documentation by the clinician positively affected coding accuracy, though this relation was not significant. Readability of records decreased errors overall (p = .003), including major ones (p = .012). Moreover, records with no abbreviations had fewer major errors (p = .021). In conclusion, not using abbreviations, ensuring more readable documentation, and paying more attention to available information increased coding accuracy and the quality of procedure databases. PMID:19471647

  4. Filaggrin haploinsufficiency is highly penetrant and is associated with increased severity of eczema: further delineation of the skin phenotype in a prospective epidemiological study of 792 school children

    PubMed Central

    Brown, SJ; Relton, CL; Liao, H; Zhao, Y; Sandilands, A; McLean, WHI; Cordell, HJ; Reynolds, NJ

    2009-01-01

    Background Null mutations within the filaggrin gene (FLG) cause ichthyosis vulgaris and are associated with atopic eczema. However, the dermatological features of filaggrin haploinsufficiency have not been clearly defined. Objectives This study investigated the genotype–phenotype association between detailed skin phenotype and FLG genotype data in a population-based cohort of children. Methods Children (n= 792) aged 7–9 years were examined by a dermatologist. Features of ichthyosis vulgaris, atopic eczema and xerosis were recorded and eczema severity graded using the Three Item Severity score. Each child was genotyped for the six most prevalent FLG null mutations (R501X, 2282del4, R2447X, S3247X, 3702delG, 3673delC). Fisher’s exact test was used to compare genotype frequencies in phenotype groups; logistic regression analysis was used to estimate odds ratios and penetrance of the FLG null genotype and a permutation test performed to investigate eczema severity in different genotype groups. Results Ten children in this cohort had ichthyosis vulgaris, of whom five had mild–moderate eczema. The penetrance of FLG null mutations with respect to flexural eczema was 55·6% in individuals with two mutations, 16·3% in individuals with one mutation and 14·2% in wild-type individuals. Summating skin features known to be associated with FLG null mutations (ichthyosis, keratosis pilaris, palmar hyperlinearity and flexural eczema) showed a penetrance of 100% in children with two FLG mutations, 87·8% in children with one FLG mutation and 46·5% in wild-type individuals (P< 0·0001, Fisher exact test). FLG null mutations were associated with more severe eczema (P= 0·0042) but the mean difference was only 1–2 points in severity score. Three distinct patterns of palmar hyperlinearity were observed and these are reported for the first time. Conclusions Filaggrin haploinsufficiency appears to be highly penetrant when all relevant skin features are included in the analysis. FLG null mutations are associated with more severe eczema, but the effect size is small in a population setting. PMID:19681860

  5. Invasive placenta previa: Placental bulge with distorted uterine outline and uterine serosal hypervascularity at 1.5T MRI - useful features for differentiating placenta percreta from placenta accreta.

    PubMed

    Chen, Xin; Shan, Ruiqin; Zhao, Lianxin; Song, Qingxu; Zuo, Changting; Zhang, Xinjuan; Wang, Shanshan; Shi, Honglu; Gao, Fei; Qian, Tianyi; Wang, Guangbin; Limperopoulos, Catherine

    2018-02-01

    To characterise MRI features of invasive placenta previa and to identify specific features for differentiating placenta percreta (PP) from placenta accreta (PA). Forty-five women with PP and 93 women with PA who underwent 1.5T placental MRI were included. Two radiologists independently evaluated the MRI features of invasive placenta previa, including our novel type of placental bulge (i.e. placental bulge type-II, characterized by placental bulge with distorted uterine outline). Pearson's chi-squared or Fisher's two-sided exact test was performed to compare the MRI features between PP and PA. Logistic stepwise regression analysis and the area under the receiver operating characteristic curve (AUC) were performed to select the optimal features for differentiating PP from PA. Significant differences were found in nine MRI features between women with PP and those with PA (P <0.05). Placental bulge type-II and uterine serosal hypervascularity were independently associated with PP (odds ratio = 48.618, P < 0.001; odds ratio = 4.165, P = 0.018 respectively), and the combination of the two MRI features to distinguish PP from PA yielded an AUC of 0.92 for its predictive performance. Placental bulge type-II and uterine serosal hypervascularity are useful MRI features for differentiating PP from PA. • Placental bulge type-II demonstrated the strongest independent association with PP. • Uterine serosal hypervascularity is a useful feature for differentiating PP from PA. • MRI features associated with abnormal vessels increase the risk of massive haemorrhage.

  6. Has Their Son Been Vaccinated? Beliefs About Other Parents Matter for Human Papillomavirus Vaccine.

    PubMed

    Schuler, Christine L; Coyne-Beasley, Tamera

    2016-07-01

    The goal of this study was to determine if parents' beliefs about social norms of human papillomavirus (HPV) vaccination for sons were associated with knowledge of HPV, intention to vaccinate sons, or beliefs about side effects. A cross-sectional, survey-based study of parents with sons was performed in 2010. Fisher's exact tests were used to examine associations between demographics and responses about social norms. Multivariate logistic regression models examined beliefs about social norms of male HPV vaccination and primary outcomes. Few parents agreed that others were vaccinating sons (n = 31/267, 12%), including 1% responding strongly agree and 11% responding agree. Most parents, 52%, disagreed that others were vaccinating (40% disagree, 11% strongly disagree), and 37% chose prefer not to answer regarding others' vaccination practices. Hispanic parents and those with a high school education or less were significantly more likely to choose prefer not to answer than their respective counterparts regarding vaccination norms. In multivariate models, parents agreeing others were vaccinating sons had greater odds of having high knowledge of HPV (adjusted odds ratio [aOR] high vs low knowledge 3.15, 95% confidence interval [CI] 1.13, 8.77) and increased intention to vaccinate sons (n = 243, aOR = 4.41, 95% CI = 1.51, 12.89). Beliefs about side effects were not significantly associated with beliefs about social norms. Parents' beliefs about others' vaccination practices are important with regard to knowledge of HPV and intention to vaccinate sons. Studying how various public messages about HPV vaccine may influence normative beliefs could be relevant to improving vaccination coverage. © The Author(s) 2015.

  7. Haemodialysis-membrane biocompatibility and mortality of patients with dialysis-dependent acute renal failure: a prospective randomised multicentre trial. International Multicentre Study Group.

    PubMed

    Jörres, A; Gahl, G M; Dobis, C; Polenakovic, M H; Cakalaroski, K; Rutkowski, B; Kisielnicka, E; Krieter, D H; Rumpf, K W; Guenther, C; Gaus, W; Hoegel, J

    1999-10-16

    There is controversy as to whether haemodialysis-membrane biocompatibility (ie, the potential to activate complement and neutrophils) influences mortality of patients with acute renal failure. We did a prospective randomised multicentre trial in patients with dialysis-dependent acute renal failure treated with two different types of low-flux membrane. 180 patients with acute renal failure were randomly assigned bioincompatible Cuprophan (n=90) or polymethyl-methacrylate (n=90) membranes. The main outcome was survival 14 days after the end of therapy (treatment success). Odds ratios for survival were calculated and the two groups were compared by Fisher's exact test. Analyses were based on patients treated according to protocol (76 Cuprophan, 84 polymethyl methacrylate). At the start of dialysis, the groups did not differ significantly in age, sex, severity of illness (as calculated by APACHE II scores), prevalence of oliguria, or biochemical measures of acute renal failure. 44 patients (58% [95% CI 46-69]) assigned Cuprophan membranes and 50 patients (60% [48-70]) assigned polymethyl-methacrylate membranes survived. The odds ratio for treatment failure on Cuprophan compared with polymethyl-methacrylate membranes was 1.07 (0.54-2.11; p=0.87). No difference between Cuprophan and polymethyl-methacrylate membranes was detected when the analysis was adjusted for age and APACHE II score. 18 patients in the Cuprophan group and 20 in the polymethyl-methacrylate group had clinical complications of therapy (mainly hypotension). There were no differences in outcome for patients with dialysis-dependent acute renal failure between those treated with Cuprophan membranes and those treated with polymethyl-methacrylate membranes.

  8. Dual method use for protection of pregnancy and disease prevention among HIV-infected women in South East Nigeria

    PubMed Central

    2014-01-01

    Background sub-Saharan Africa continue to bear the greatest burden of HIV/AIDS epidemic due to its large population, high fertility rate and unmet contraceptive need, most especially with poor uptake of dual methods (use of condom and another effective family planning method) which protects against STIs/HIV and unplanned pregnancy. The aim of this study was to assess the awareness, pattern and practice of dual methods by HIV infected women, and factors influencing its use in southeast Nigeria. Methods This was a cross sectional descriptive study of 658 HIV positive women attending the PMTCT/postnatal/family planning clinics in three health facilities in southeast Nigeria. An interviewer administered semi-structured questionnaire was used to abstract needed information. The data were analyzed with Epi-info™ version 7.0 (Centers for Disease Control and Prevention, Atlanta, GA, USA), Odd ratio was determined and the test of statistical significance was with Fisher exact test at 95% CI. Results The mean age of the participants was 29 ± 4.3 years. All the respondents were aware of their HIV status, 62.4% did not know their partners status; 23.1% were sero-concordant, while 14.5% were sero-discordant. Most (67.9%) of the respondents lack awareness on dual methods with only 179/658 (27.2%) practicing it. The commonest (141/179; 78.9%) dual method used was a combination of condom and injectable hormonal contraceptives. Lack of awareness (222/479; 46.3%) and non disclosure (133/479; 27.8%) were the main reasons for non use of dual method in the present study. STI’s was higher amongst non users with odd ratio of 1.74 (1.26-2.41), p-value < 0.0004. Unplanned pregnancy was higher in non users with odd ratio of 3.89 (2.52-6.00), p-value < 0.0000 at 95% CI. Conclusions The awareness and uptake of dual methods amongst HIV infected women in southeast Nigeria is still low and thus associated with a higher risk of STIs and unplanned pregnancy. It is expected that increased awareness, uptake and consistent use will help prevention new infections of HIV/STIs and unplanned pregnancy. PMID:24602410

  9. On the modular structure of the genus-one Type II superstring low energy expansion

    NASA Astrophysics Data System (ADS)

    D'Hoker, Eric; Green, Michael B.; Vanhove, Pierre

    2015-08-01

    The analytic contribution to the low energy expansion of Type II string amplitudes at genus-one is a power series in space-time derivatives with coefficients that are determined by integrals of modular functions over the complex structure modulus of the world-sheet torus. These modular functions are associated with world-sheet vacuum Feynman diagrams and given by multiple sums over the discrete momenta on the torus. In this paper we exhibit exact differential and algebraic relations for a certain infinite class of such modular functions by showing that they satisfy Laplace eigenvalue equations with inhomogeneous terms that are polynomial in non-holomorphic Eisenstein series. Furthermore, we argue that the set of modular functions that contribute to the coefficients of interactions up to order are linear sums of functions in this class and quadratic polynomials in Eisenstein series and odd Riemann zeta values. Integration over the complex structure results in coefficients of the low energy expansion that are rational numbers multiplying monomials in odd Riemann zeta values.

  10. Strong-coupling phases of the spin-orbit-coupled spin-1 Bose-Hubbard chain: Odd-integer Mott lobes and helical magnetic phases

    NASA Astrophysics Data System (ADS)

    Pixley, J. H.; Cole, William S.; Spielman, I. B.; Rizzi, Matteo; Das Sarma, S.

    2017-10-01

    We study the odd-integer filled Mott phases of a spin-1 Bose-Hubbard chain and determine their fate in the presence of a Raman induced spin-orbit coupling which has been achieved in ultracold atomic gases; this system is described by a quantum spin-1 chain with a spiral magnetic field. The spiral magnetic field initially induces helical order with either ferromagnetic or dimer order parameters, giving rise to a spiral paramagnet at large field. The spiral ferromagnet-to-paramagnet phase transition is in a universality class with critical exponents associated with the divergence of the correlation length ν ≈2 /3 and the order-parameter susceptibility γ ≈1 /2 . We solve the effective spin model exactly using the density-matrix renormalization group, and compare with both a large-S classical solution and a phenomenological Landau theory. We discuss how these exotic bosonic magnetic phases can be produced and probed in ultracold atomic experiments in optical lattices.

  11. FAST TRACK COMMUNICATION: Superintegrability of the Tremblay-Turbiner-Winternitz quantum Hamiltonians on a plane for odd k

    NASA Astrophysics Data System (ADS)

    Quesne, C.

    2010-02-01

    In a recent communication paper by Tremblay et al (2009 J. Phys. A: Math. Theor. 42 205206), it has been conjectured that for any integer value of k, some novel exactly solvable and integrable quantum Hamiltonian Hk on a plane is superintegrable and that the additional integral of motion is a 2kth-order differential operator Y2k. Here we demonstrate the conjecture for the infinite family of Hamiltonians Hk with odd k >= 3, whose first member corresponds to the three-body Calogero-Marchioro-Wolfes model after elimination of the centre-of-mass motion. Our approach is based on the construction of some D2k-extended and invariant Hamiltonian {\\cal H}_k, which can be interpreted as a modified boson oscillator Hamiltonian. The latter is then shown to possess a D2k-invariant integral of motion {\\cal Y}_{2k}, from which Y2k can be obtained by projection in the D2k identity representation space.

  12. Cytologically diagnosed Gardnerella vaginalis infection and cervical (pre)neoplasia as established in population-based cervical screening.

    PubMed

    Klomp, Johanna M; Boon, Mathilde E; Van Haaften, Maarten; Heintz, A Peter M

    2008-11-01

    Cervical inflammation has been proposed as a cofactor in the development of cervical cancer. The purpose of this study was to document the prevalence of cervical (pre)neoplastic changes in asymptomatic women with a cytologically diagnosed Gardnerella vaginalis infection. Data were collected from 800,498 Dutch asymptomatic women, participating in the Dutch national screening program. Prevalences of (pre)neoplasia were calculated for G vaginalis smears using a healthy flora as reference. The prevalence of G vaginalis infection was 0.6 per thousand. The odds ratio for (pre)neoplasia was significantly higher in smears with G vaginalis infection compared with smears of women with a healthy vaginal flora (odds ratio, 10.3; 95% confidence interval, 6.6-16.1). Cytologically diagnosed G vaginalis smears show a strong covariation with the presence of cervical (pre)neoplasia. Future research should therefore focus on the exact causal relation between cytologic G vaginalis infection and the presence of (pre)neoplastic changes of the cervix.

  13. Development and validation of a whole-exome sequencing test for simultaneous detection of point mutations, indels and copy-number alterations for precision cancer care

    PubMed Central

    Rennert, Hanna; Eng, Kenneth; Zhang, Tuo; Tan, Adrian; Xiang, Jenny; Romanel, Alessandro; Kim, Robert; Tam, Wayne; Liu, Yen-Chun; Bhinder, Bhavneet; Cyrta, Joanna; Beltran, Himisha; Robinson, Brian; Mosquera, Juan Miguel; Fernandes, Helen; Demichelis, Francesca; Sboner, Andrea; Kluk, Michael; Rubin, Mark A; Elemento, Olivier

    2016-01-01

    We describe Exome Cancer Test v1.0 (EXaCT-1), the first New York State-Department of Health-approved whole-exome sequencing (WES)-based test for precision cancer care. EXaCT-1 uses HaloPlex (Agilent) target enrichment followed by next-generation sequencing (Illumina) of tumour and matched constitutional control DNA. We present a detailed clinical development and validation pipeline suitable for simultaneous detection of somatic point/indel mutations and copy-number alterations (CNAs). A computational framework for data analysis, reporting and sign-out is also presented. For the validation, we tested EXaCT-1 on 57 tumours covering five distinct clinically relevant mutations. Results demonstrated elevated and uniform coverage compatible with clinical testing as well as complete concordance in variant quality metrics between formalin-fixed paraffin embedded and fresh-frozen tumours. Extensive sensitivity studies identified limits of detection threshold for point/indel mutations and CNAs. Prospective analysis of 337 cancer cases revealed mutations in clinically relevant genes in 82% of tumours, demonstrating that EXaCT-1 is an accurate and sensitive method for identifying actionable mutations, with reasonable costs and time, greatly expanding its utility for advanced cancer care. PMID:28781886

  14. Polymorphisms of RDH16 and VEGFR1 influence M. trapezius steatosis in Japanese Black carcass.

    PubMed

    Ishida, Takafumi; Noda, Kosuke; Jomane, Fortune Ntengwa; Tokunaga, Tadaaki

    2017-08-01

    The exact cause of steatosis, one of defects in Japanese beef carcasses, has not been elucidated to date, because it is very difficult to diagnose cyclopedically with certain reproducibility due to the bias in the outbreak. Therefore, the objective of this study was to assess the influence of polymorphisms in retinol dehydrogenase 16 (RDH16), myoferlin (MYOF) and vascular endothelial growth factor receptors 1 and 2 (VEGFR1, VEGFR2) on carcass-graded Musculus trapezius steatosis. For logistic regression analysis, 646 carcasses shipped from 29 farms in Miyazaki, Japan, were used. The GG genotype in RDH16 showed significant odds ratios against AA and AG. In VEGFR1, CT had a significant odds ratio against CC. After evaluating for interaction, highly significant odds ratios were observed in the combinations that included the GG risk genotype in RDH16. It is noteworthy that there was no steatosis in the combination GG (RDH16) and CC (VEGFR1). It may be concluded that there is a possibility that steatosis can be suppressed by the CC genotype in VEGFR1. The current study revealed the influence of genetic polymorphisms on M. trapezius steatosis that had not been reported until now, and may help elucidate the cause of steatosis. © 2016 Japanese Society of Animal Science.

  15. Propagation effects in the generation process of high-order vortex harmonics.

    PubMed

    Zhang, Chaojin; Wu, Erheng; Gu, Mingliang; Liu, Chengpu

    2017-09-04

    We numerically study the propagation of a Laguerre-Gaussian beam through polar molecular media via the exact solution of full-wave Maxwell-Bloch equations where the rotating-wave and slowly-varying-envelope approximations are not included. It is found that beyond the coexistence of odd-order and even-order vortex harmonics due to inversion asymmetry of the system, the light propagation effect results in the intensity enhancement of a high-order vortex harmonics. Moreover, the orbital momentum successfully transfers from the fundamental laser driver to the vortex harmonics which topological charger number is directly proportional to its order.

  16. Investigation of Change in the Computational Technique of the Sun’s Physical Ephemeris in The Astronomical Almanac

    DTIC Science & Technology

    2007-03-22

    the new method. Initially, Fig. 1 might look a little odd since one might expect P to show a signature of the obliquity , that is, a 23.5◦ oscillation... ecliptic . To clarify the changes and to ensure that the program is working as expected, it is useful to set the Sun’s pole orthogonal to the ecliptic ...Figure 2 shows the same data as Fig. 1, but with this change. The dot-dash line in Fig. 2 shows the effect of obliquity , exactly as expected. The

  17. On some labelings of triangular snake and central graph of triangular snake graph

    NASA Astrophysics Data System (ADS)

    Agasthi, P.; Parvathi, N.

    2018-04-01

    A Triangular snake Tn is obtained from a path u 1 u 2 … u n by joining ui and u i+1 to a new vertex wi for 1≤i≤n‑1. A Central graph of Triangular snake C(T n ) is obtained by subdividing each edge of Tn exactly once and joining all the non adjacent vertices of Tn . In this paper the ways to construct square sum, square difference, Root Mean square, strongly Multiplicative, Even Mean and Odd Mean labeling for Triangular Snake and Central graph of Triangular Snake graphs are reported.

  18. The optimal power puzzle: scrutiny of the monotone likelihood ratio assumption in multiple testing.

    PubMed

    Cao, Hongyuan; Sun, Wenguang; Kosorok, Michael R

    2013-01-01

    In single hypothesis testing, power is a non-decreasing function of type I error rate; hence it is desirable to test at the nominal level exactly to achieve optimal power. The puzzle lies in the fact that for multiple testing, under the false discovery rate paradigm, such a monotonic relationship may not hold. In particular, exact false discovery rate control may lead to a less powerful testing procedure if a test statistic fails to fulfil the monotone likelihood ratio condition. In this article, we identify different scenarios wherein the condition fails and give caveats for conducting multiple testing in practical settings.

  19. Emotional Regulation and Executive Function Deficits in Unmedicated Chinese Children with Oppositional Defiant Disorder.

    PubMed

    Jiang, Wenqing; Li, Yan; Du, Yasong; Fan, Juan

    2016-05-01

    This study aims to explore the feature of emotional regulation and executive functions in oppositional defiant disorder (ODD) children. The emotional regulation and executive functions of adolescents with ODD, as well as the relationship between the two factors were analyzed using tools including Adolescent Daily Emotional Regulation Questionnaire (ADERQ), Wisconsin Card Sorting Test (WCST) and Cambridge Neuropsychological Test Automated Battery (CANTAB), in comparison with attention deficit hyperactivity disorder (ADHD) children without behavioral problem and healthy children; the ADERQ assessed emotional regulation ability and others were used to assess executive function. Compared to normal children, the ODD group displayed significant differences in the scores of cognitive reappraisal, rumination, expressive suppression, and revealing of negative emotions, as well as in the score of cognitive reappraisal of positive emotions. WCST perseverative errors were well correlated with rumination of negative emotions (r=0.47). Logistic regression revealed that the minimum number of moves in the Stocking of Cambridge (SOC) test (one test in CANTAB) and negative emotion revealing, were strongly associated with ODD diagnosis. Children with ODD showed emotion dysregulation, with negative emotion dysregulation as the main feature. Emotion dysregulation and the lack of ability to plan lead to executive function deficits. The executive function deficits may guide us to understand the deep mechanism under ODD.

  20. Glucose Metabolism Disorders, HIV and Antiretroviral Therapy among Tanzanian Adults

    PubMed Central

    Maganga, Emmanuel; Smart, Luke R.; Kalluvya, Samuel; Kataraihya, Johannes B.; Saleh, Ahmed M.; Obeid, Lama; Downs, Jennifer A.; Fitzgerald, Daniel W.; Peck, Robert N.

    2015-01-01

    Introduction Millions of HIV-infected Africans are living longer due to long-term antiretroviral therapy (ART), yet little is known about glucose metabolism disorders in this group. We aimed to compare the prevalence of glucose metabolism disorders among HIV-infected adults on long-term ART to ART-naïve adults and HIV-negative controls, hypothesizing that the odds of glucose metabolism disorders would be 2-fold greater even after adjusting for possible confounders. Methods In this cross-sectional study conducted between October 2012 and April 2013, consecutive adults (>18 years) attending an HIV clinic in Tanzania were enrolled in 3 groups: 153 HIV-negative controls, 151 HIV-infected, ART-naïve, and 150 HIV-infected on ART for ≥ 2 years. The primary outcome was the prevalence of glucose metabolism disorders as determined by oral glucose tolerance testing. We compared glucose metabolism disorder prevalence between each HIV group vs. the control group by Fisher’s exact test and used multivariable logistic regression to determine factors associated with glucose metabolism disorders. Results HIV-infected adults on ART had a higher prevalence of glucose metabolism disorders (49/150 (32.7%) vs.11/153 (7.2%), p<0.001) and frank diabetes mellitus (27/150 (18.0%) vs. 8/153 (5.2%), p = 0.001) than HIV-negative adults, which remained highly significant even after adjusting for age, gender, adiposity and socioeconomic status (OR = 5.72 (2.78–11.77), p<0.001). Glucose metabolism disorders were significantly associated with higher CD4+ T-cell counts. Awareness of diabetes mellitus was <25%. Conclusions HIV-infected adults on long-term ART had 5-fold greater odds of glucose metabolism disorders than HIV-negative controls but were rarely aware of their diagnosis. Intensive glucose metabolism disorder screening and education are needed in HIV clinics in sub-Saharan Africa. Further research should determine how glucose metabolism disorders might be related to immune reconstitution. PMID:26287742

  1. Using data from a multi-hospital clinical network to explore prevalence of pediatric rickets in Kenya

    PubMed Central

    Karuri, Stella W.; Murithi, Maureen K.; Irimu, Grace; English, Mike

    2017-01-01

    Background: Nutritional rickets is a public health concern in developing countries despite tropical climates and a re-emerging issue in developed countries. In this study, we reviewed pediatric admission data from the Clinical Information Network (CIN) to help determine hospital and region based prevalence of rickets in three regions of Kenya (Central Kenya, Western Kenya and Nairobi County). We also examine the association of rickets with other diagnosis, such as malnutrition and pneumonia, and study the effect of rickets on regional hospital stays. Methods: We analyzed discharge records for children aged 1 month to 5 years from county (formerly district) hospitals in the CIN, with admissions from February 1 st 2014 to February 28 th 2015. The strength of the association between rickets and key demographic factors, as well as with malnutrition and pneumonia, was assessed using odds ratios. The Fisher exact test was used to test the significance of the estimated odd ratios. Kaplan-Meier curves were used to analyze length of hospital stays. Results: There was a marked difference in prevalence across the three regions, with Nairobi having the highest number of cases of rickets at a proportion of 4.01%, followed by Central Region at 0.92%. Out of 9756 admissions in the Western Region, there was only one diagnosis of rickets. Malnutrition was associated with rickets; this association varied regionally. Pneumonia was found to be associated with rickets in Central Kenya. Children diagnosed with rickets had longer hospital stays, even when cases of malnutrition and pneumonia were excluded in the analysis. Conclusion: There was marked regional variation in hospital based prevalence of rickets, but in some regions it is a common clinical diagnosis suggesting the need for targeted public health interventions. Factors such as maternal and child nutrition, urbanization and cultural practices might explain these differences. PMID:29062911

  2. Prevalence of Giardia infection in households of Giardia cases and risk factors for household transmission.

    PubMed

    Waldram, Alison; Vivancos, Roberto; Hartley, Catherine; Lamden, Kenneth

    2017-07-11

    Giardia is a leading but neglected cause of infectious gastroenteritis worldwide and is treatable. There is a substantial burden of undetected Giardia in the UK and for every one case of Giardia reported to national surveillance there are 14 cases in the community. We aimed to ascertain the prevalence of, and risk factors associated with secondary household Giardia infections to assess the burden of infection and inform control measures. We identified all giardiasis cases notified in nine local authorities in Lancashire between June 2014 and June 2015, and invited their household contacts to submit faecal specimens for Giardia testing and complete a risk factor questionnaire. We estimated the proportion of households with additional Giardia infection. We compared household risk factors between households with and without additional Giardia using Fisher's exact test. We used multivariable logistic regression to identify independent risk factors for additional Giardia infections. We identified additional Giardia infections in 30% (27/91) of included households. A total of 41 infections were found from 212 household members, of which 37 were asymptomatic. The majority of infections were assemblage B (57%) but there were also a high number of mixed infections (20%). Risk factors significantly associated with additional household infections were; having children under 5 years in the household (odds ratio 42; 95% confidence intervals 10-178) and the presence of gastrointestinal illness in the household before the onset of the index case (odds ratio 9; 95% confidence intervals 1.5-48). Our finding of a high household prevalence of asymptomatic infection has raised the public health question of whether treatment of asymptomatic household contacts may be justified in preventing Giardia re-infection of the index case or in preventing secondary cases and household clusters. We recommend the communication of this risk in household contacts of Giardia and reinforcement of standard hygiene controls.

  3. Infection Rates in Arthroscopic Versus Open Rotator Cuff Repair.

    PubMed

    Hughes, Jonathan D; Hughes, Jessica L; Bartley, Justin H; Hamilton, William P; Brennan, Kindyle L

    2017-07-01

    The prevalence of rotator cuff repair continues to rise, with a noted transition from open to arthroscopic techniques in recent years. One reported advantage of arthroscopic repair is a lower infection rate. However, to date, the infection rates of these 2 techniques have not been directly compared with large samples at a single institution with fully integrated medical records. To retrospectively compare postoperative infection rates between arthroscopic and open rotator cuff repair. Cohort study; Level of evidence, 3. From January 2003 until May 2011, a total of 1556 patients underwent rotator cuff repair at a single institution. These patients were divided into an arthroscopic repair group and an open group. A Pearson chi-square test and Fisher exact test were used, with a subgroup analysis to segment the open repair group into mini-open and open procedures. The odds ratio and 95% CI of developing a postoperative infection was calculated for the 2 groups. A multiple-regressions model was then utilized to identify predictors of the presence of infection. Infection was defined as only those treated with surgical intervention, thus excluding superficial infections treated with antibiotics alone. A total of 903 patients had an arthroscopic repair, while 653 had open repairs (600 mini-open, 53 open). There were 4 confirmed infections in the arthroscopic group and 16 in the open group (15 mini-open, 1 open), resulting in postoperative infection rates of 0.44% and 2.45%, respectively. Subgroup analysis of the mini-open and open groups demonstrated a postoperative infection rate of 2.50% and 1.89%, respectively. The open group had an odds ratio of 5.645 (95% CI, 1.9-17.0) to develop a postoperative infection compared with the arthroscopic group. Patients undergoing open rotator cuff repair had a significantly higher rate of postoperative infection compared with those undergoing arthroscopic rotator cuff repair.

  4. A retrospective study of horses investigated for weight loss despite a good appetite (2002-2011).

    PubMed

    Metcalfe, L V A; More, S J; Duggan, V; Katz, L M

    2013-05-01

    Weight loss despite a good appetite is a frequent diagnostic challenge for equine veterinarians; however, there are few objective reports and little descriptive information regarding risk factors and prognostic indicators. To provide a descriptive epidemiological analysis of horses evaluated for weight loss despite a good appetite and evaluate relationships between historical and clinicopathological findings and final outcome (survival vs. nonsurvival) to identify risk factors and prognostic indicators. Medical records of horses referred for investigation of weight loss despite a good appetite were reviewed. Data collated included history, case details, clinical and diagnostic findings, diagnoses and outcome. Univariable associations were evaluated with a Mann-Whitney U test (continuous data), Fisher's exact test (categorical or binary data) or Pearson's rank correlation (continuous data), with P≤0.05 significant. Forty cases met the inclusion criteria. Total protein (P = 0.004) and albumin concentrations (P = 0.0008) at admission were higher in survivors than nonsurvivors, with total protein (r(2) = 0.31; P = 0.002) and albumin (r(2) = 0.36; P = 0.0002) positively correlated with outcome. Hypoproteinaemic (P = 0.008, odds ratio (OR) = 12, 95% confidence interval (CI) = 1.99-72.4) and hypoalbuminaemic (P = 0.0009, OR = 28, 95% CI = 2.94-266.6) animals were at greater odds for nonsurvival. Body condition score was positively correlated with total protein (r(2) = 0.16; P = 0.05) and albumin (r(2) = 0.53; P<0.0001) concentrations at admission and duration of clinical signs (r(2) = 0.19; P = 0.03). The severity of hypoproteinaemia and hypoalbuminaemia were related with nonsurvival. Body condition score and albumin concentration could potentially be used as prognostic indicators for survival. These findings highlight the importance of body condition assessment in conjunction with clinicopathological evaluation in horses with weight loss despite a good appetite. © 2012 EVJ Ltd.

  5. Using Observational Data to Estimate the Effect of Hand Washing and Clean Delivery Kit Use by Birth Attendants on Maternal Deaths after Home Deliveries in Rural Bangladesh, India and Nepal

    PubMed Central

    Seward, Nadine; Prost, Audrey; Copas, Andrew; Corbin, Marine; Li, Leah; Colbourn, Tim; Osrin, David; Neuman, Melissa; Azad, Kishwar; Kuddus, Abdul; Nair, Nirmala; Tripathy, Prasanta; Manandhar, Dharma; Costello, Anthony; Cortina-Borja, Mario

    2015-01-01

    Background Globally, puerperal sepsis accounts for an estimated 8–12% of maternal deaths, but evidence is lacking on the extent to which clean delivery practices could improve maternal survival. We used data from the control arms of four cluster-randomised controlled trials conducted in rural India, Bangladesh and Nepal, to examine associations between clean delivery kit use and hand washing by the birth attendant with maternal mortality among home deliveries. Methods We tested associations between clean delivery practices and maternal deaths, using a pooled dataset for 40,602 home births across sites in the three countries. Cross-sectional data were analysed by fitting logistic regression models with and without multiple imputation, and confounders were selected a priori using causal directed acyclic graphs. The robustness of estimates was investigated through sensitivity analyses. Results Hand washing was associated with a 49% reduction in the odds of maternal mortality after adjusting for confounding factors (adjusted odds ratio (AOR) 0.51, 95% CI 0.28–0.93). The sensitivity analysis testing the missing at random assumption for the multiple imputation, as well as the sensitivity analysis accounting for possible misclassification bias in the use of clean delivery practices, indicated that the association between hand washing and maternal death had been over estimated. Clean delivery kit use was not associated with a maternal death (AOR 1.26, 95% CI 0.62–2.56). Conclusions Our evidence suggests that hand washing in delivery is critical for maternal survival among home deliveries in rural South Asia, although the exact magnitude of this effect is uncertain due to inherent biases associated with observational data from low resource settings. Our findings indicating kit use does not improve maternal survival, suggests that the soap is not being used in all instances that kit use is being reported. PMID:26295838

  6. Community pharmacists' knowledge of Alzheimer disease care in high- and low-income Chicago.

    PubMed

    Marvanova, Marketa; Henkel, Paul Jacob

    This pilot study examined community pharmacists' knowledge to provide care and services for persons with Alzheimer disease (AD) and area income-based disparities in knowledge and availability of cognitive enhancers. A cross-sectional telephone survey of pharmacies (n = 137) in high- and low-income areas in Chicago was conducted on pharmacists' degree, experience, and continuing education, as well as knowledge of AD disease and treatment expectations, adverse effects (AEs) of donepezil, and self-care recommendations for insomnia. Pharmacies were selected from highest- and lowest-income zip code areas, defined using household area median incomes from the 2008-2012 American Community Survey 5-Year Estimates. In-stock availability of select cognitive enhancers was obtained. Chi-square, Fisher exact test, and simple and multiple logistic regression analyses were performed with the use of Stata 10.1. Odds were 70% lower that pharmacists in low-income areas would say there was nothing to reverse the course of AD (odds ratio [OR] 0.30, 95% confidence interval [CI] 0.13-0.70) and 7 times greater that they would recommend a medication to reverse the course of AD (OR 7.04, 95% CI 2.19-22.62) compared with pharmacists in high-income areas. Odds were more than 50% lower that pharmacists in low-income areas would name at least 1 adverse effect for donepezil (OR 0.42, 95% CI 0.19-0.92) compared with peers in high-income areas. Pharmacies in low-income areas had lower odds of having 4 of the 5 surveyed formulations of cognitive enhancers in stock. It is concerning that 20%-30% of pharmacists recommended a medication to "reverse" the course of AD, about one-half of pharmacists could not mention a single adverse effect of donepezil, and more than one-fourth of pharmacists made an inappropriate self-care sleep aid recommendation for a person with AD who was using rivastigmine patch. Although overall results regarding pharmacists' knowledge were poor, performance was significantly poorer in low-income areas. As our AD population increases, we need to strengthen pharmacists' knowledge on and competencies important for pharmacy-related AD care. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  7. Exact moments of the Sachdev-Ye-Kitaev model up to order 1 /N 2

    NASA Astrophysics Data System (ADS)

    García-García, Antonio M.; Jia, Yiyang; Verbaarschot, Jacobus J. M.

    2018-04-01

    We analytically evaluate the moments of the spectral density of the q-body Sachdev-Ye-Kitaev (SYK) model, and obtain order 1 /N 2 corrections for all moments, where N is the total number of Majorana fermions. To order 1 /N, moments are given by those of the weight function of the Q-Hermite polynomials. Representing Wick contractions by rooted chord diagrams, we show that the 1 /N 2 correction for each chord diagram is proportional to the number of triangular loops of the corresponding intersection graph, with an extra grading factor when q is odd. Therefore the problem of finding 1 /N 2 corrections is mapped to a triangle counting problem. Since the total number of triangles is a purely graph-theoretic property, we can compute them for the q = 1 and q = 2 SYK models, where the exact moments can be obtained analytically using other methods, and therefore we have solved the moment problem for any q to 1 /N 2 accuracy. The moments are then used to obtain the spectral density of the SYK model to order 1 /N 2. We also obtain an exact analytical result for all contraction diagrams contributing to the moments, which can be evaluated up to eighth order. This shows that the Q-Hermite approximation is accurate even for small values of N.

  8. Prevalence and risk factors for brucellosis in goats in areas of Mexico with and without brucellosis control campaign.

    PubMed

    Oseguera Montiel, David; Frankena, Klaas; Udo, Henk; Keilbach Baer, Nícola Maria; van der Zijpp, Akke

    2013-08-01

    Brucellosis is a major constraint for small-scale goat farming systems in Mexico. This study estimated the prevalence of testing positive to brucellosis and identified and quantified risk factors in goats from small-scale farms of Michoacán that had participated in a brucellosis campaign (i.e. vaccination, serological testing, culling and awareness) and of Jalisco that had negligible brucellosis campaign participation. A cross-sectional serological survey was conducted among 1,713 goats of 83 flocks. The prevalence of testing positive to brucellosis was higher (38%) in Jalisco than in Michoacán (11%). Logistic regression analysis indicated that goats from Michoacán had lower odds to test positive for brucellosis (odds ratio (OR) = 0.32, 95% confidence interval (CI) 0.21-0.48) compared to goats from Jalisco. Goats in zero-grazing systems had lower odds than goats in grazing systems (OR = 0.22, 95% CI 0.09-0.57). When goats were kept in pens with low density (0.002 to 0.22 goat/m(2)), odds was lower (OR = 0.44, 95% CI 0.28-0.67) compared to goats kept in pens with higher density (0.23 to 1 goat/m(2)). Odds was higher for testing positive when farmers bought goats from goat traders (OR = 1.82, 95% CI 1.15-2.87) compared to farmers who did not. If scavenger poultry had access to goat pens, the odds was half (OR = 0.52, 95% CI 0.33-0.83) of those where poultry had no access. Regular disinfection of the pen reduced the odds (OR = 0.66, 95% CI 0.44-0.99) compared to where disinfection was not regular. The brucellosis control campaign was effective in reducing brucellosis seropositivity.

  9. [The relationship between Ridit analysis and rank sum test for one-way ordinal contingency table in medical research].

    PubMed

    Wang, Ling; Xia, Jie-lai; Yu, Li-li; Li, Chan-juan; Wang, Su-zhen

    2008-06-01

    To explore several numerical methods of ordinal variable in one-way ordinal contingency table and their interrelationship, and to compare corresponding statistical analysis methods such as Ridit analysis and rank sum test. Formula deduction was based on five simplified grading approaches including rank_r(i), ridit_r(i), ridit_r(ci), ridit_r(mi), and table scores. Practical data set was verified by SAS8.2 in clinical practice (to test the effect of Shiwei solution in treatment for chronic tracheitis). Because of the linear relationship of rank_r(i) = N ridit_r(i) + 1/2 = N ridit_r(ci) = (N + 1) ridit_r(mi), the exact chi2 values in Ridit analysis based on ridit_r(i), ridit_r(ci), and ridit_r(mi), were completely the same, and they were equivalent to the Kruskal-Wallis H test. Traditional Ridit analysis was based on ridit_r(i), and its corresponding chi2 value calculated with an approximate variance (1/12) was conservative. The exact chi2 test of Ridit analysis should be used when comparing multiple groups in the clinical researches because of its special merits such as distribution of mean ridit value on (0,1) and clear graph expression. The exact chi2 test of Ridit analysis can be output directly by proc freq of SAS8.2 with ridit and modridit option (SCORES =). The exact chi2 test of Ridit analysis is equivalent to the Kruskal-Wallis H test, and should be used when comparing multiple groups in the clinical researches.

  10. Real-world injury patterns associated with Hybrid III sternal deflections in frontal crash tests.

    PubMed

    Brumbelow, Matthew L; Farmer, Charles M

    2013-01-01

    This study investigated the relationship between the peak sternal deflection measurements recorded by the Hybrid III 50th percentile male anthropometric test device (ATD) in frontal crash tests and injury and fatality outcomes for drivers in field crashes. ATD sternal deflection data were obtained from the Insurance Institute for Highway Safety's 64 km/h, 40 percent overlap crashworthiness evaluation tests for vehicles with seat belt crash tensioners, load limiters, and good-rated structure. The National Automotive Sampling System Crashworthiness Data System (NASS-CDS) was queried for frontal crashes of these vehicles in which the driver was restrained by a seat belt and air bag. Injury probability curves were calculated by frontal crash type using the injuries coded in NASS-CDS and peak ATD sternal deflection data. Fatality Analysis Reporting System (FARS) front-to-front crashes with exactly one driver death were also studied to determine whether the difference in measured sternal deflections for the 2 vehicles was related to the odds of fatality. For center impacts, moderate overlaps, and large overlaps in NASS-CDS, the probability of the driver sustaining an Abbreviated Injury Scale (AIS) score ≥ 3 thoracic injury, or any nonextremity AIS ≥ 3 injury, increased with increasing ATD sternal deflection measured in crash tests. For small overlaps, however, these probabilities decreased with increasing deflection. For FARS crashes, the fatally injured driver more often was in the vehicle with the lower measured deflection in crash tests (55 vs. 45%). After controlling for other factors, a 5-mm difference in measured sternal deflections between the 2 vehicles was associated with a fatality odds ratio of 0.762 for the driver in the vehicle with the greater deflection (95% confidence interval = 0.373, 1.449). Restraint systems that reduce peak Hybrid III sternal deflection in a moderate overlap crash test are beneficial in real-world crashes with similar or greater overlap but likely have a disbenefit in crashes with small overlap. This may occur because belt-force limiters employed to control deflections allow excursion that could produce contact with interior vehicle components in small overlaps, given the more oblique occupant motion and potential inboard movement of the air bag. Although based on a limited number of cases, this interpretation is supported by differences in skeletal fracture locations among drivers in crashes with different overlaps. Current restraint systems could be improved by designs that reduce sternal deflection in moderate and large overlap crashes without increasing occupant excursion in small overlap crashes.

  11. Exact mean-energy expansion of Ginibre's gas for coupling constants Γ =2 ×(oddinteger)

    NASA Astrophysics Data System (ADS)

    Salazar, R.; Téllez, G.

    2017-12-01

    Using the approach of a Vandermonde determinant to the power Γ =Q2/kBT expansion on monomial functions, a way to find the excess energy Uexc of the two-dimensional one-component plasma (2DOCP) on hard and soft disks (or a Dyson gas) for odd values of Γ /2 is provided. At Γ =2 , the present study not only corroborates the result for the particle-particle energy contribution of the Dyson gas found by Shakirov [Shakirov, Phys. Lett. A 375, 984 (2011), 10.1016/j.physleta.2011.01.004] by using an alternative approach, but also provides the exact N -finite expansion of the excess energy of the 2DOCP on the hard disk. The excess energy is fitted to the ansatz of the form Uexc=K1N +K2√{N }+K3+K4/N +O (1 /N2) to study the finite-size correction, with Ki coefficients and N the number of particles. In particular, the bulk term of the excess energy is in agreement with the well known result of Jancovici for the hard disk in the thermodynamic limit [Jancovici, Phys. Rev. Lett. 46, 386 (1981), 10.1103/PhysRevLett.46.386]. Finally, an expression is found for the pair correlation function which still keeps a link with the random matrix theory via the kernel in the Ginibre ensemble [Ginibre, J. Math. Phys. 6, 440 (1965), 10.1063/1.1704292] for odd values of Γ /2 . A comparison between the analytical two-body density function and histograms obtained with Monte Carlo simulations for small systems and Γ =2 ,6 ,10 ,... shows that the approach described in this paper may be used to study analytically the crossover behavior from systems in the fluid phase to small crystals.

  12. A Formula to Calculate Standard Liver Volume Using Thoracoabdominal Circumference.

    PubMed

    Shaw, Brian I; Burdine, Lyle J; Braun, Hillary J; Ascher, Nancy L; Roberts, John P

    2017-12-01

    With the use of split liver grafts as well as living donor liver transplantation (LDLT) it is imperative to know the minimum graft volume to avoid complications. Most current formulas to predict standard liver volume (SLV) rely on weight-based measures that are likely inaccurate in the setting of cirrhosis. Therefore, we sought to create a formula for estimating SLV without weight-based covariates. LDLT donors underwent computed tomography scan volumetric evaluation of their livers. An optimal formula for calculating SLV using the anthropomorphic measure thoracoabdominal circumference (TAC) was determined using leave-one-out cross-validation. The ability of this formula to correctly predict liver volume was checked against other existing formulas by analysis of variance. The ability of the formula to predict small grafts in LDLT was evaluated by exact logistic regression. The optimal formula using TAC was determined to be SLV = (TAC × 3.5816) - (Age × 3.9844) - (Sex × 109.7386) - 934.5949. When compared to historic formulas, the current formula was the only one which was not significantly different than computed tomography determined liver volumes when compared by analysis of variance with Dunnett posttest. When evaluating the ability of the formula to predict small for size syndrome, many (10/16) of the formulas tested had significant results by exact logistic regression, with our formula predicting small for size syndrome with an odds ratio of 7.94 (95% confidence interval, 1.23-91.36; P = 0.025). We report a formula for calculating SLV that does not rely on weight-based variables that has good ability to predict SLV and identify patients with potentially small grafts.

  13. Sexual orientation and sexual health services utilization among women in the United States

    PubMed Central

    Agénor, Madina; Muzny, Christina A.; Schick, Vanessa; Austin, Erika L.; Potter, Jennifer

    2017-01-01

    Although sexual minority women are at risk of sexually transmitted infections (STIs) and cervical cancer, few nationally representative studies have assessed sexual orientation disparities in sexual health care among women. Using data from the 2011–2013 and 2013–2015 waves of the National Survey of Family Growth, which provide a national probability sample of U.S. women aged 15–44 years (N=11,300), we used multivariable logistic regression to examine the associations between sexual behavior and sexual identity (modeled separately) and STI testing in the past year, Pap test use in the last 3 years, lifetime HIV testing, and lifetime human papillomavirus (HPV) testing. Women with male and female lifetime sexual partners had higher adjusted odds of being tested for STIs ([odds ratio:] 1.61; [95% confidence interval:] 1.37–1.89), HIV (1.66; 1.29–2.14), and HPV (1.79; 1.41–2.25) and similar adjusted odds of obtaining a Pap test (0.98; 0.76–1.27) than women with only male lifetime sexual partners. Self-identified bisexual women had higher adjusted odds of obtaining an STI (1.43; 1.10–1.86) and HIV (1.69; 1.24–2.30) test but lower adjusted odds of obtaining a Pap test in the last 3 years (0.66; 0.47–0.93) than heterosexual-identified women. Women with only female lifetime sexual partners had lower adjusted odds of receiving an STI (0.14; 0.07–0.28) and Pap (0.10; 0.03–0.27) test than women with only male lifetime sexual partners. Results comparing self-identified lesbian and heterosexual women were similar. Health care facilities should monitor and address sexual orientation disparities in women’s sexual health care and ensure the provision of high-quality sexual health services to all women. PMID:27932056

  14. Sexual orientation and sexual health services utilization among women in the United States.

    PubMed

    Agénor, Madina; Muzny, Christina A; Schick, Vanessa; Austin, Erika L; Potter, Jennifer

    2017-02-01

    Although sexual minority women are at risk of sexually transmitted infections (STIs) and cervical cancer, few nationally representative studies have assessed sexual orientation disparities in sexual health care among women. Using data from the 2011-2013 and 2013-2015 waves of the National Survey of Family Growth, which provide a national probability sample of U.S. women aged 15-44years (N=11,300), we used multivariable logistic regression to examine the associations between sexual behavior and sexual identity (modeled separately) and STI testing in the past year, Pap test use in the last 3years, lifetime HIV testing, and lifetime human papillomavirus (HPV) testing. Women with male and female lifetime sexual partners had higher adjusted odds of being tested for STIs ([odds ratio:] 1.61; [95% confidence interval:] 1.37-1.89), HIV (1.66; 1.29-2.14), and HPV (1.79; 1.41-2.25) and similar adjusted odds of obtaining a Pap test (0.98; 0.76-1.27) than women with only male lifetime sexual partners. Self-identified bisexual women had higher adjusted odds of obtaining an STI (1.43; 1.10-1.86) and HIV (1.69; 1.24-2.30) test but lower adjusted odds of obtaining a Pap test in the last 3years (0.66; 0.47-0.93) than heterosexual-identified women. Women with only female lifetime sexual partners had lower adjusted odds of receiving an STI (0.14; 0.07-0.28) and Pap (0.10; 0.03-0.27) test than women with only male lifetime sexual partners. Results comparing self-identified lesbian and heterosexual women were similar. Health care facilities should monitor and address sexual orientation disparities in women's sexual health care and ensure the provision of high-quality sexual health services to all women. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. The special case of the 2 × 2 table: asymptotic unconditional McNemar test can be used to estimate sample size even for analysis based on GEE.

    PubMed

    Borkhoff, Cornelia M; Johnston, Patrick R; Stephens, Derek; Atenafu, Eshetu

    2015-07-01

    Aligning the method used to estimate sample size with the planned analytic method ensures the sample size needed to achieve the planned power. When using generalized estimating equations (GEE) to analyze a paired binary primary outcome with no covariates, many use an exact McNemar test to calculate sample size. We reviewed the approaches to sample size estimation for paired binary data and compared the sample size estimates on the same numerical examples. We used the hypothesized sample proportions for the 2 × 2 table to calculate the correlation between the marginal proportions to estimate sample size based on GEE. We solved the inside proportions based on the correlation and the marginal proportions to estimate sample size based on exact McNemar, asymptotic unconditional McNemar, and asymptotic conditional McNemar. The asymptotic unconditional McNemar test is a good approximation of GEE method by Pan. The exact McNemar is too conservative and yields unnecessarily large sample size estimates than all other methods. In the special case of a 2 × 2 table, even when a GEE approach to binary logistic regression is the planned analytic method, the asymptotic unconditional McNemar test can be used to estimate sample size. We do not recommend using an exact McNemar test. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Theoretical test of Jarzynski's equality for reversible volume-switching processes of an ideal gas system.

    PubMed

    Sung, Jaeyoung

    2007-07-01

    We present an exact theoretical test of Jarzynski's equality (JE) for reversible volume-switching processes of an ideal gas system. The exact analysis shows that the prediction of JE for the free energy difference is the same as the work done on the gas system during the reversible process that is dependent on the shape of path of the reversible volume-switching process.

  17. Investigating the within-herd prevalence and risk factors for ketosis in dairy cattle in Ontario as diagnosed by the test-day concentration of β-hydroxybutyrate in milk.

    PubMed

    Tatone, Elise H; Duffield, Todd F; LeBlanc, Stephen J; DeVries, Trevor J; Gordon, Jessica L

    2017-02-01

    An observational study of 790 to over 3,000 herds was conducted to estimate the within-herd prevalence and cow-level risk factors for ketosis in dairy cattle in herds that participate in a Dairy Herd Improvement Association (DHIA) program. Ketosis or hyperketolactia (KET) was diagnosed as milk β-hydroxybutyrate ≥0.15 mmol/L at first DHIA test when tested within the first 30 d in milk. Seven hundred ninety-five herds providing at least 61 first milk tests from June 2014 to December 2015 were used to estimate the provincial within-herd prevalence of KET. All herds on DHIA in Ontario (n = 3,042) were used to construct cow-level multilevel logistic regression models to investigate the association of DHIA collected variables with the odds of KET at first DHIA milk test. Primiparous and multiparous animals were modeled independently. The cow-level KET prevalence in Ontario was 21%, with an average within-herd prevalence of 21% (standard deviation = 10.6) for dairy herds enrolled in a DHIA program. The prevalence of KET had a distinct seasonality with the lowest prevalence occurring from July to November. Automatic milking systems (AMS) were associated with increased within-herd prevalence, as well as increased odds of KET in multiparous animals at first test (odds ratio: 1.45; 95% confidence interval: 1.30 to 1.63). Jersey cattle had over 1.46 times higher odds of KET than Holstein cattle. Milk fat yield ≥1.12 kg/d at the last test of the previous lactation was associated with decreased odds of KET in the current lactation (odds ratio: 0.56; 95% confidence interval: 0.53 to 0.59). Increased days dry and longer calving intervals, for multiparous animals, and older age at first calving for primiparous animals increased the odds of KET at first test. This study confirms previous findings that increased days dry, longer calving intervals, and increased age at first calving are associated with increased odds of KET and is the first report of increased KET in herds with AMS and in relation to milk fat yield at the final test of the previous lactation. Feeding management on AMS herds likely contributes to the increased prevalence of KET and further work is required to investigate modifications to current management to minimize risk. Milk fat yield during the previous lactation may be representative of energy partitioning. Copyright © 2017 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  18. An Astronomical Test of CCD Photometric Precision

    NASA Technical Reports Server (NTRS)

    Koch, David; Dunham, Edward; Borucki, William; Jenkins, Jon; DeVingenzi, D. (Technical Monitor)

    1998-01-01

    This article considers a posteriori error estimation of specified functionals for first-order systems of conservation laws discretized using the discontinuous Galerkin (DG) finite element method. Using duality techniques. we derive exact error representation formulas for both linear and nonlinear functionals given an associated bilinear or nonlinear variational form. Weighted residual approximations of the exact error representation formula are then proposed and numerically evaluated for Ringleb flow, an exact solution of the 2-D Euler equations.

  19. Clinical Phenotype of Dementia after Traumatic Brain Injury

    PubMed Central

    Sayed, Nasreen; Culver, Carlee; Dams-O'Connor, Kristen; Hammond, Flora

    2013-01-01

    Abstract Traumatic brain injury (TBI) in early to mid-life is associated with an increased risk of dementia in late life. It is unclear whether TBI results in acceleration of Alzheimer's disease (AD)-like pathology or has features of another dementing condition, such as chronic traumatic encephalopathy, which is associated with more-prominent mood, behavior, and motor disturbances than AD. Data from the National Alzheimer's Coordinating Center (NACC) Uniform Data Set was obtained over a 5-year period. Categorical data were analyzed using Fisher's exact test. Continuous parametric data were analyzed using the Student's t-test. Nonparametric data were analyzed using Mann-Whitney's test. Overall, 877 individuals with dementia who had sustained TBI were identified in the NACC database. Only TBI with chronic deficit or dysfunction was associated with increased risk of dementia. Patients with dementia after TBI (n=62) were significantly more likely to experience depression, anxiety, irritability, and motor disorders than patients with probable AD. Autopsy data were available for 20 of the 62 TBI patients. Of the patients with TBI, 62% met National Institute of Aging-Reagan Institute “high likelihood” criteria for AD. We conclude that TBI with chronic deficit or dysfunction is associated with an increased odds ratio for dementia. Clinically, patients with dementia associated with TBI were more likely to have symptoms of depression, agitation, irritability, and motor dysfunction than patients with probable AD. These findings suggest that dementia in individuals with a history of TBI may be distinct from AD. PMID:23374007

  20. IFN-γ Release Assay Result Is Associated with Disease Site and Death in Active Tuberculosis.

    PubMed

    Auld, Sara C; Lee, Scott H; Click, Eleanor S; Miramontes, Roque; Day, Cheryl L; Gandhi, Neel R; Heilig, Charles M

    2016-12-01

    The IFN-γ release assays and tuberculin skin tests are used to support the diagnosis of both latent and active tuberculosis. However, we previously demonstrated that a negative tuberculin test in active tuberculosis is associated with disseminated disease and death. It is unknown whether the same associations exist for IFN-γ release assays. To determine the association between these tests and site of tuberculosis and death among persons with active tuberculosis. We analyzed IFN-γ release assays and tuberculin test results for all persons with culture-confirmed tuberculosis reported to the U.S. National Tuberculosis Surveillance System from 2010 to 2014. We used logistic regression to calculate the association between these tests and site of disease and death. A total of 24,803 persons with culture-confirmed tuberculosis had either of these test results available for analysis. Persons with a positive tuberculin test had lower odds of disseminated disease (i.e., miliary or combined pulmonary and extrapulmonary disease), but there was no difference in the odds of disseminated disease with a positive IFN-γ release assay. However, persons who were positive to either of these tests had lower odds of death. An indeterminate IFN-γ release assay result was associated with greater odds of both disseminated disease and death. Despite perceived equivalence in clinical practice, IFN-γ release assays and tuberculin test results have different associations with tuberculosis site, yet similar associations with the risk of death. Furthermore, an indeterminate IFN-γ release assay result in a person with active tuberculosis is not unimportant, and rather carries greater odds of disseminated disease and death. Prospective study may improve our understanding of the underlying mechanisms by which these tests are associated with disease localization and death.

  1. The human sex odds at birth after the atmospheric atomic bomb tests, after Chernobyl, and in the vicinity of nuclear facilities.

    PubMed

    Scherb, Hagen; Voigt, Kristina

    2011-06-01

    Ever since the discovery of the mutagenic properties of ionizing radiation, the possibility of birth sex odds shifts in exposed human populations was considered in the scientific community. Positive evidence, however weak, was obtained after the atomic bombing of Japan. We previously investigated trends in the sex odds before and after the Chernobyl Nuclear Power Plant accident. In a pilot study, combined data from the Czech Republic, Denmark, Finland, Germany, Hungary, Norway, Poland, and Sweden between 1982 and 1992 showed a downward trend in the sex odds and a significant jump in 1987, the year immediately after Chernobyl. Moreover, a significant positive association of the sex odds between 1986 and 1991 with Chernobyl fallout at the district level in Germany was observed. Both of these findings, temporality (effect after exposure) and dose response association, yield evidence of causality. The primary aim of this study was to investigate longer time periods (1950-2007) in all of Europe and in the USA with emphasis on the global atmospheric atomic bomb test fallout and on the Chernobyl accident. To obtain further evidence, we also analyze sex odds data near nuclear facilities in Germany and Switzerland. DATA AND STATISTICAL METHODS: National gender-specific annual live births data for 39 European countries from 1975 to 2007 were compiled using the pertinent internet data bases provided by the World Health Organization, United Nations, Council of Europe, and EUROSTAT. For a synoptic re-analysis of the period 1950 to 1990, published data from the USA and from a predominantly western and less Chernobyl-exposed part of Europe were studied additionally. To assess spatial, temporal, as well as spatial-temporal trends in the sex odds and to investigate possible changes in those trends after the atomic bomb tests, after Chernobyl, and in the vicinity of nuclear facilities, we applied ordinary linear logistic regression. Region-specific and eventually changing spatial-temporal trends were analyzed using dummy variables coding for continents, countries, districts, municipalities, time periods, and appropriate spatial-temporal interactions. The predominantly western European sex odds trend together with the US sex odds trend (1950-1990 each) show a similar behavior. Both trends are consistent with a uniform reduction from 1950 to 1964, an increase from 1964 to 1975 that may be associated with delayed global atomic bomb test fallout released prior to the Partial Test Ban Treaty in 1963 and again a more or less constant decrease from 1975 to 1990. In practically all of Europe, including eastern European countries, from 1975 to 1986, and in the USA from 1975 to 2002, there were highly significant uniform downward trends in the sex odds with a reduction of 0.22% to 0.25% per 10 years. In contrast to the USA, in Europe there was a highly significant jump of the sex odds of 0.20% in the year 1987 following Chernobyl. From 1987 to 2000, the European sex odds trend reversed its sign and went upward, highly significantly so, with 0.42% per 10 years relative to the downward trend before Chernobyl. The global secular trend analyses are corroborated by the analysis of spatial-temporal sex odds trends near nuclear facilities (NF) in Germany and Switzerland. Within 35 km distance from those NF, the sex odds increase significantly in the range of 0.30% to 0.40% during NF operating time. The atmospheric atomic bomb test fallout affected the human sex odds at birth overall, and the Chernobyl fallout had a similar impact in Europe and parts of Asia. The birth sex odds near nuclear facilities are also distorted. The persistently disturbed secular human sex odds trends allow the estimation of the global deficit of births in the range of several millions.

  2. Regular STI testing amongst men who have sex with men and use social media is suboptimal - a cross-sectional study.

    PubMed

    Frankis, Jamie; Goodall, Lisa; Clutterbuck, Dan; Abubakari, Abdul-Razak; Flowers, Paul

    2017-05-01

    Sexually transmitted infections (STIs) disproportionately affect men who have sex with men, with marked increases in most STIs in recent years. These are likely underpinned by coterminous increases in behavioural risks which have coincided with the development of Internet and geospatial sociosexual networking. Current guidelines advocate regular, annual sexually transmitted infection testing amongst sexually active men who have sex with men (MSM), as opposed to symptom-driven testing. This paper explores sexually transmitted infection testing regularity amongst MSM who use social and sociosexual media. Data were collected from 2668 men in Scotland, Wales, Northern Ireland and the Republic of Ireland, recruited via social and gay sociosexual media. Only one-third of participants report regular (yearly or more frequent) STI testing, despite relatively high levels of male sex partners, condomless anal intercourse and high-risk unprotected anal intercourse. The following variables were associated with regular STI testing; being more 'out' (adjusted odds ratio = 1.79; confidence interval = 1.20-2.68), HIV-positive (adjusted odds ratio = 14.11; confidence interval = 7.03-28.32); reporting ≥10 male sex partners (adjusted odds ratio = 2.15; confidence interval = 1.47-3.14) or regular HIV testing (adjusted odds ratio = 48.44; confidence interval = 28.27-83.01). Men reporting long-term sickness absence from work/carers (adjusted odds ratio = 0.03; confidence interval = 0.00-0.48) and men aged ≤25 years (adjusted odds ratio = 0.36; 95% confidence interval = 0.19-0.69) were less likely to test regularly for STIs. As such, we identify a complex interplay of social, health and behavioural factors that each contribute to men's STI testing behaviours. In concert, these data suggest that the syndemics placing men at elevated risk may also mitigate against access to testing and prevention services. Moreover, successful reduction of STI transmission amongst MSM will necessitate a comprehensive range of approaches which address these multiple interrelated factors that underpin MSM's STI testing.

  3. What exactly do numbers mean?

    PubMed Central

    Huang, Yi Ting; Spelke, Elizabeth; Snedeker, Jesse

    2014-01-01

    Number words are generally used to refer to the exact cardinal value of a set, but cognitive scientists disagree about their meanings. Although most psychological analyses presuppose that numbers have exact semantics (two means EXACTLY TWO), many linguistic accounts propose that numbers have lower-bounded semantics (AT LEAST TWO), and that speakers restrict their reference through a pragmatic inference (scalar implicature). We address this debate through studies of children who are in the process of acquiring the meanings of numbers. Adults and 2- and 3-year-olds were tested in a novel paradigm that teases apart semantic and pragmatic aspects of interpretation (the covered box task). Our findings establish that when scalar implicatures are cancelled in the critical trials of this task, both adults and children consistently give exact interpretations for number words. These results, in concert with recent work on real-time processing, provide the first unambiguous evidence that number words have exact semantics. PMID:25285053

  4. On the testing of Hardy-Weinberg proportions and equality of allele frequencies in males and females at biallelic genetic markers.

    PubMed

    Graffelman, Jan; Weir, Bruce S

    2018-02-01

    Standard statistical tests for equality of allele frequencies in males and females and tests for Hardy-Weinberg equilibrium are tightly linked by their assumptions. Tests for equality of allele frequencies assume Hardy-Weinberg equilibrium, whereas the usual chi-square or exact test for Hardy-Weinberg equilibrium assume equality of allele frequencies in the sexes. In this paper, we propose ways to break this interdependence in assumptions of the two tests by proposing an omnibus exact test that can test both hypotheses jointly, as well as a likelihood ratio approach that permits these phenomena to be tested both jointly and separately. The tests are illustrated with data from the 1000 Genomes project. © 2017 The Authors Genetic Epidemiology Published by Wiley Periodicals, Inc.

  5. [Incidence and distribution of Streptococcus pyogenes type M in patients treated at the Dr. Fran Mihaljević Infectious Disease Clinic in Zagreb from 1990 to 1996].

    PubMed

    Bejuk, Danijela; Begovac, Josip

    2002-01-01

    The aim of this study was to estimate the changes in the appearance and distribution of M types of Streptococcus pyogenes in different cultures from 78 patients treated during the 1990-1996 period at the Dr. Fran Mihaljević University Hospital for Infectious Diseases in Zagreb. Isolates were characterized by the T-agglutination pattern and M type and/or opacity factor type using the standards recommended by two World Health Organization Collaborating Centers for Reference and Research on streptococci from Minneapolis and Prague. In this study, 19% (15/79) of isolates were recovered from normally sterile sites, 26.6% (21/79) came from skin and 54.4% (43/79) from throat swabs. In one patient isolates from the skin and blood culture were analyzed. Of all, 92.4% (73/79) of the isolates were typed by T-agglutination pattern and 73.5% (58/79) by M protein and/or OF typing. The results of M typing showed 14 M types: M1, M3, M4, M5, M6, M11, M12, M28, M57, M58, M60, M75, M76 and M78. The most commonly isolated types were M1 and M3 (13.8%, 8/58 each), followed by M28 found in 12.1% (7/58), and M6 and M12 in 10.3% (6/58) each. These five M types accounted for 60.3% (35/58) of all isolates. Analysis to changes in the distribution of M1 and M3 types during the 1990-1991 and 1992-1993 periods revealed a significantly greater proportion of M1 and M3 isolates in the former (Fisher's two-tailed exact test, p = 0.018). A significantly greater proportion of M1 and M3 isolates was also recorded in the 1990-1991, than in 1994-1996 period. (Fisher's two-tailed exact test, P = 0.021). It was investigated whether Streptococcus pyogenes M1 and M3 types were associated with toxic and invasive infection. There were 28.2% (22/78) of patients with toxic and invasive infection: 31.9% (7/22) of them with the diagnosis of scarlet fever, whereas 68.1% (15/22) of the strains were obtained from normally sterile sites. There were 45.5% (10/22) of M1 and M3 types from patients with toxic and invasive infections. Types M6, M28 and M76 were found in an equal proportion of 9.1% (2/22), and M4, M12 and M 60 of 4.5% (1/22) each. In three strains, M type could not be identified (T8/25 SOR+, T25 SOR+ and T11 SOR+). M1 and M3 types were isolated from 10.3% (6/56) of patients with other streptococcal infections. A significantly greater proportion of M1 and M3 types was recorded in patients with toxic and invasive infections than in those with other streptococcal infections (Fisher's two-tailed exact test, p = 0.004). A multivariate logistic regression model was used to assess whether the increased proportion of streptococcal M types 1 and 3 was associated with the 1990-1991 period, or with the infection characteristics. The changes in the distribution of M types 1 and 3 were found to be significantly associated only with toxic and invasive infections (odds ratio 4.35, p = 0.025). Odds ratio suggests that patients with toxic and invasive infections had a 4.35--fold increased risk of infections caused by types M1 and M3 found in patients with other streptococcal infections. The increased proportion of M types 1 and 3 during the 1990-1991 period was more significantly associated with the characteristics of infection than with the study period.

  6. Full counting statistics of a charge pump in the Coulomb blockade regime

    NASA Astrophysics Data System (ADS)

    Andreev, A. V.; Mishchenko, E. G.

    2001-12-01

    We study full charge counting statistics (FCCS) of a charge pump based on a nearly open single electron transistor. The problem is mapped onto an exactly soluble problem of a nonequilibrium g=1/2 Luttinger liquid with an impurity. We obtain an analytic expression for the generating function of the transmitted charge for an arbitrary pumping strength. Although this model contains fractionally charged excitations only integer transmitted charges can be observed. In the weak pumping limit FCCS correspond to a Poissonian transmission of particles with charge e*=e/2 from which all events with odd numbers of transferred particles are excluded.

  7. Radiative origin of all quark and lepton masses through dark matter with flavor symmetry.

    PubMed

    Ma, Ernest

    2014-03-07

    The fundamental issue of the origin of mass for all quarks and leptons (including Majorana neutrinos) is linked to dark matter, odd under an exactly conserved Z2 symmetry which may or may not be derivable from an U(1)D gauge symmetry. The observable sector interacts with a proposed dark sector which consists of heavy neutral singlet Dirac fermions and suitably chosen new scalars. Flavor symmetry is implemented in a renormalizable context with just the one Higgs doublet (ϕ(+), ϕ(0)) of the standard model in such a way that all observed fermions obtain their masses radiatively through dark matter.

  8. Intraoperative Gastric Suctioning and Postoperative Nausea, Retching, and Vomiting.

    DTIC Science & Technology

    1984-07-01

    the experimental group, and the stomach was evacuated. The anesthetic technique of oxygen/nitrous oxide/methohexital/succinylcholine/fentanyl was...Way Analysis of Variance. Based on the Fisher’s Exact Test, nausea occurred less frequently in the experimental group than in the control group for...Fisher’s Exact Test, nausea occurred less f quently in the experimental group than in the control roup for the re- covery room time-frame (p - 0.0371

  9. A default normal chest CT structured reporting field for coronary calcifications does not cause excessive false-negative reporting.

    PubMed

    Walter, William R; Goldberg-Stein, Shlomit; Levsky, Jeffrey M; Cohen, Hillel W; Scheinfeld, Meir H

    2015-08-01

    The aim of this study was to compare the accuracy of coronary atherosclerosis reporting before and after the implementation of a structured reporting chest CT template. A noncardiac, noncontrast chest CT structured reporting template was developed and mandated for department-wide use at a large academic center. The template included the statement "There are no coronary artery calcifications." All noncardiac, noncontrast chest CT examinations reported over 3 days, 1 month after template implementation (structured template group), and from a 3-day period 1 year prior (control group) were retrospectively collected. Final radiology reports were reviewed and designated positive or negative for coronary calcifications. CT images were reviewed in consensus by 2 radiologists, who scored each case for the presence or absence of coronary calcifications, blinded to the original report. Statistical analysis was performed using Pearson χ(2) and Fisher exact tests. Sixty-five percent (69 of 106) of structured template group and 58% (62 of 106) of control group cases had coronary calcifications. Reports from the structured template group were more likely to correctly state the presence or absence of coronary atherosclerosis compared with those from the control group (96.2% vs 85.8%; odds ratio, 4.2; 95% confidence interval, 1.3-13.1; P = .008). Structured template group reports were less likely to be falsely negative compared with control group reports (3.8% vs 11.7%; odds ratio, 3.4; 95% confidence interval, 1.0-10.8; P = .03). Implementing a structured reporting template improves reporting accuracy of coronary calcifications. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  10. Differential effects of severe vs mild GBA mutations on Parkinson disease.

    PubMed

    Gan-Or, Ziv; Amshalom, Idan; Kilarski, Laura L; Bar-Shira, Anat; Gana-Weisz, Mali; Mirelman, Anat; Marder, Karen; Bressman, Susan; Giladi, Nir; Orr-Urtreger, Avi

    2015-03-03

    To better define the genotype-phenotype correlations between the type of GBA (glucosidase, beta, acid) mutation, severe or mild, and the risk and age at onset (AAO), and potential mechanism of Parkinson disease (PD). We analyzed 1,000 patients of Ashkenazi-Jewish descent with PD for 7 founder GBA mutations, and conducted a meta-analysis of risk and AAO according to GBA genotype (severe or mild mutation). The meta-analysis included 11,453 patients with PD and 14,565 controls from worldwide populations. The statistical analysis was done with and without continuity correction (constant or empirical), considering biases that could potentially affect the results. Among Ashkenazi-Jewish patients with PD, the odds ratios for PD were 2.2 and 10.3 for mild and severe GBA mutation carriers, respectively. The observed frequency of severe GBA mutation carriers among patients with PD was more than 4-fold than expected (4.4% vs 0.9%, respectively, p < 0.0001, Fisher exact test). In the different models of the meta-analysis, the odds ratios for PD ranged between 2.84 and 4.94 for mild GBA mutation carriers and 9.92 and 21.29 for severe GBA mutation carriers (p < 1 × 10(-6) for all analyses). Pooled analysis demonstrated AAO of 53.1 (±11.2) and 58.1 (±10.6) years for severe and mild GBA mutation carriers, respectively (p = 4.3 × 10(-5)). These data demonstrate that mild and severe heterozygous GBA mutations differentially affect the risk and the AAO of PD. Our results have important implications for genetic counseling and clinical follow-up. © 2015 American Academy of Neurology.

  11. Prenatal versus Postnatal Tobacco Smoke Exposure and Intensive Care Use in Children Hospitalized with Bronchiolitis

    PubMed Central

    Stevenson, Michelle D.; Mansbach, Jonathan M.; Mowad, Eugene; Dunn, Michelle; Clark, Sunday; Piedra, Pedro A.; Sullivan, Ashley F.; Camargo, Carlos A.

    2016-01-01

    Objective Among children hospitalized with bronchiolitis, we examined the associations between in utero exposure to maternal cigarette smoking, postnatal tobacco smoke exposure, and risk of admission to the intensive care unit (ICU). Methods We performed a 16-center, prospective cohort study of hospitalized children age <2 years with a physician admitting diagnosis of bronchiolitis. For 3 consecutive years, from November 1, 2007 until March 31, 2010, site teams collected data from participating families, including information about prenatal maternal smoking and postnatal tobacco exposure. Analyses used χ2, Fisher's exact, and Kruskal-Wallis tests and multivariable logistic regression. Results Among 2,207 enrolled children, 216 (10%) had isolated in utero exposure to maternal smoking, 168 (8%) had isolated postnatal tobacco exposure, while 115 (5%) experienced both. Adjusting for age, sex, race, birth weight, viral etiology, apnea, initial severity of retractions, initial oxygen saturation, oral intake, and postnatal tobacco exposure, children with in utero exposure to maternal smoking had greater odds of being admitted to the ICU (adjusted odds ratio (aOR) 1.51 [95% CI 1.14-2.00]). Among children with in utero exposure to maternal smoking, those with additional postnatal tobacco exposure had a greater likelihood of ICU admission (aOR 1.95 [95% CI 1.13-3.37]) compared with children without postnatal tobacco smoke exposure (aOR 1.47 [95% CI 1.05-2.04]). Conclusions Maternal cigarette smoking during pregnancy puts children hospitalized with bronchiolitis at significantly higher risk of requiring intensive care use. Postnatal tobacco smoke exposure may exacerbate this risk. Health care providers should incorporate this information into counseling messages. PMID:26555856

  12. Relationship Between Visceral Infarction and Ischemic Stroke Subtype.

    PubMed

    Finn, Caitlin; Hung, Peter; Patel, Praneil; Gupta, Ajay; Kamel, Hooman

    2018-03-01

    Most cryptogenic strokes are thought to have an embolic source. We sought to determine whether cryptogenic strokes are associated with visceral infarcts, which are usually embolic. Among patients prospectively enrolled in CAESAR (Cornell Acute Stroke Academic Registry), we selected those with a contrast-enhanced abdominal computed tomographic scan within 1 year of admission. Our exposure variable was adjudicated stroke subtype per the Trial of ORG 10172 in Acute Stroke Treatment classification. Our outcome was renal or splenic infarction as assessed by a single radiologist blinded to stroke subtype. We used Fisher exact test and multiple logistic regression to compare the prevalence of visceral infarcts among cardioembolic strokes, strokes of undetermined etiology, and noncardioembolic strokes (large- or small-vessel strokes). Among 227 patients with ischemic stroke and a contrast-enhanced abdominal computed tomographic scan, 59 had a visceral infarct (35 renal and 27 splenic). The prevalence of visceral infarction was significantly different among cardioembolic strokes (34.2%; 95% confidence interval [CI], 23.7%-44.6%), strokes of undetermined etiology (23.9%; 95% CI, 15.0%-32.8%), and strokes from large-artery atherosclerosis or small-vessel occlusion (12.5%; 95% CI, 1.8%-23.2%; P =0.03). In multiple logistic regression models adjusted for demographics and vascular comorbidities, we found significant associations with visceral infarction for both cardioembolic stroke (odds ratio, 3.5; 95% CI, 1.2-9.9) and stroke of undetermined source (odds ratio, 3.3; 95% CI, 1.1-10.5) as compared with noncardioembolic stroke. The prevalence of visceral infarction differed significantly across ischemic stroke subtypes. Cardioembolic and cryptogenic strokes were associated with a higher prevalence of visceral infarcts than noncardioembolic strokes. © 2018 American Heart Association, Inc.

  13. Higher dimensional Taub-NUT spaces and applications

    NASA Astrophysics Data System (ADS)

    Stelea, Cristian Ionut

    In the first part of this thesis we discuss classes of new exact NUT-charged solutions in four dimensions and higher, while in the remainder of the thesis we make a study of their properties and their possible applications. Specifically, in four dimensions we construct new families of axisymmetric vacuum solutions using a solution-generating technique based on the hidden SL(2,R) symmetry of the effective action. In particular, using the Schwarzschild solution as a seed we obtain the Zipoy-Voorhees generalisation of the Taub-NUT solution and of the Eguchi-Hanson soliton. Using the C-metric as a seed, we obtain and study the accelerating versions of all the above solutions. In higher dimensions we present new classes of NUT-charged spaces, generalising the previously known even-dimensional solutions to odd and even dimensions, as well as to spaces with multiple NUT-parameters. We also find the most general form of the odd-dimensional Eguchi-Hanson solitons. We use such solutions to investigate the thermodynamic properties of NUT-charged spaces in (A)dS backgrounds. These have been shown to yield counter-examples to some of the conjectures advanced in the still elusive dS/CFT paradigm (such as the maximal mass conjecture and Bousso's entropic N-bound). One important application of NUT-charged spaces is to construct higher dimensional generalisations of Kaluza-Klein magnetic monopoles, generalising the known 5-dimensional Kaluza-Klein soliton. Another interesting application involves a study of time-dependent higher-dimensional bubbles-of-nothing generated from NUT-charged solutions. We use them to test the AdS/CFT conjecture as well as to generate, by using stringy Hopf-dualities, new interesting time-dependent solutions in string theory. Finally, we construct and study new NUT-charged solutions in higher-dimensional Einstein-Maxwell theories, generalising the known Reissner-Nordstrom solutions.

  14. Health-Related Information-Seeking Behaviors and Preferences Among Mexican Patients with Cancer.

    PubMed

    Soto-Perez-de-Celis, Enrique; Perez-Montessoro, Viridiana; Rojo-Castillo, Patricia; Chavarri-Guerra, Yanin

    2018-06-01

    Understanding the preferred sources of health-related information among patients with cancer is essential for designing successful cancer education and prevention strategies. However, little is known about health-related information-seeking practices among patients living in low- and middle-income countries. We studied the preferred sources of health-related information among Mexican patients with cancer and explored which factors influence these choices. The health-related information-seeking practices among patients with cancer treated at a public hospital in Mexico City were evaluated using questions from the Spanish Version of the Health Information National Trends Survey. The characteristics of patients who sought health-related information, and of those who chose the internet as their preferred source of information, were analyzed. Fisher's exact test and logistic regression were used for statistical analyses. One hundred forty-eight patients answered the survey (median age 60 years, 70% female), of which 88 (59%) had sought for health-related information. On multivariate analysis, the only characteristic associated with lower odds of seeking health-related information was increasing age (OR 0.93, 95% CI 0.90-0.97). Sixty-one respondents (69%) listed the internet as their preferred source of health-related information. On multivariate analysis, only being of the female gender (OR 4.9, 95% CI 1.3-18.3) was related with higher odds of preferring other sources of information over the internet. Among Mexican patients with cancer, the Internet is the most widely used information source. Older age was the characteristic most strongly associated with not seeking health-related information, while being female was strongly associated with preferring other sources of information over the Internet.

  15. Prevalence of, and risk factors for, presenting visual impairment: findings from a vision screening programme based on UK NSC guidance in a multi-ethnic population.

    PubMed

    Bruce, Alison; Santorelli, Gillian; Wright, John; Bradbury, John; Barrett, Brendan T; Bloj, Marina; Sheldon, Trevor A

    2018-06-13

    To determine presenting visual acuity levels and explore the factors associated with failing vision screening in a multi-ethnic population of UK children aged 4-5 years. Visual acuity (VA) using the logMAR Crowded Test was measured in 16,541 children in a population-based vision screening programme. Referral for cycloplegic examination was based on national recommendations (>0.20logMAR in one or both eyes). Presenting visual impairment (PVI) was defined as VA >0.3logMAR in the better eye. Multivariable logistic regression was used to assess the association of ethnicity, maternal, and early-life factors with failing vision screening and PVI in participants of the Born in Bradford birth cohort. In total, 2467/16,541 (15%) failed vision screening, 732 (4.4%) had PVI. Children of Pakistani (OR: 2.49; 95% CI: 1.74-3.60) and other ethnicities (OR: 2.00; 95% CI: 1.28-3.12) showed increased odds of PVI compared to white children. Children born to older mothers (OR: 1.63; 95% CI: 1.19-2.24) and of low birth weight (OR: 1.52; 95% CI: 1.00-2.34) also showed increased odds. Follow-up results were available for 1068 (43.3%) children, 993 (93%) were true positives; 932 (94%) of these had significant refractive error. Astigmatism (>1DC) (44%) was more common in children of Pakistani ethnicity and hypermetropia (>3.0DS) (27%) in white children (Fisher's exact, p < 0.001). A high prevalence of PVI is reported. Failing vision screening and PVI were highly associated with ethnicity. The positive predictive value of the vision screening programme was good, with only 7% of children followed up confirmed as false positives.

  16. Changing epidemiology of Pneumocystis pneumonia, Northern Ireland, UK and implications for prevention, 1 July 2011-31 July 2012.

    PubMed

    Patterson, Lynsey; Coyle, Peter; Curran, Tanya; Verlander, Neville Q; Johnston, Jillian

    2017-11-01

    There is a lack of consensus about which non-human immunodeficiency virus (HIV) patient groups would benefit from prophylaxis. Here, we analysed an enhanced Pneumocystis jirovecii database to describe the epidemiology of Pneumocystis pneumonia (PCP) and P. jirovecii colonizations in Northern Ireland (NI) with a view to identifying risk groups who may benefit from prophylaxis. We prospectively collected information on demographics, clinical severity and clinical features for all hospital inpatients in NI aged ≥18 years with P. jirovecii confirmed in any respiratory tract sample. We defined P. jirovecii colonization or PCP according to clinical symptoms and radiological findings. We compared P. jirovecii colonization to PCP using exact logistic regression and presented the odds ratios (OR), 95 % confidence intervals (CI) and likelihood ratio test P-values.Results/Key findings. Overall, 36/49 (73 %) of P. jirovecii detections were categorized as PCP. A total of 28/36 (78 %) were in non-HIV patients, of which 18 (64 %) had cancer. The odds of PCP compared to P. jirovecii colonization were eight times higher in those with current exposure to chemotherapy (OR 8.73; 95 % CI 0.84, ∞), 16 times higher for those diagnosed with HIV (OR 16.2; 95 % CI 1.71, ∞) and 12 times higher for those ever exposed to another immunosuppressive drug (OR 12.1; 95 % CI 1.94, ∞). The greatest burden of PCP is now in the non-HIV group, particularly cancer patients. We recommend increasing clinician awareness of PCP risk and strengthening prevention guidelines in non-HIV patients, and promoting the consideration of prophylaxis on a case-by-case basis.

  17. Spectroscopy of a one-dimensional V-shaped quantum well with a point impurity

    NASA Astrophysics Data System (ADS)

    Fassari, S.; Gadella, M.; Glasser, M. L.; Nieto, L. M.

    2018-02-01

    We consider the one-dimensional Hamiltonian with a V-shaped potential H0 = 1/2 [ -d2/dx2 + | x | ], decorated with a point impurity of either δ-type, or local δ‧-type or even nonlocal δ‧-type, thus yielding three exactly solvable models. We analyse the behaviour of the change in the energy levels when an interaction of the type - λ δ(x) or - λ δ(x -x0) is switched on. In the first case, even energy levels, pertaining to antisymmetric bound states, remain invariant with respect to λ even though odd energy levels, pertaining to symmetric bound states, decrease as λ increases. In the second, all energy levels decrease when the factor λ increases. A similar study has been performed for the so-called nonlocal δ‧ interaction, requiring a coupling constant renormalisation, which implies the replacement of the form factor λ by a renormalised form factor β. In terms of β, odd energy levels are unchanged. However, we show the existence of level crossings: after a fixed value of β the energy of each even level, with the natural exception of the first one, becomes lower than the constant energy of the previous odd level. Finally, we consider an interaction of the type - λδ(x) + μδ‧(x) , and analyse in detail the discrete spectrum of the resulting self-adjoint Hamiltonian.

  18. Multi-loop control of UPS inverter with a plug-in odd-harmonic repetitive controller.

    PubMed

    Razi, Reza; Karbasforooshan, Mohammad-Sadegh; Monfared, Mohammad

    2017-03-01

    This paper proposes an improved multi-loop control scheme for the single-phase uninterruptible power supply (UPS) inverter by using a plug-in odd-harmonic repetitive controller to regulate the output voltage. In the suggested control method, the output voltage and the filter capacitor current are used as the outer and inner loop feedback signals, respectively and the instantaneous value of the reference voltage feedforwarded to the output of the controller. Instead of conventional linear (proportional-integral/-resonant) and conventional repetitive controllers, a plug-in odd-harmonic repetitive controller is employed in the outer loop to regulate the output voltage, which occupies less memory space and offers faster tracking performance compared to the conventional one. Also, a simple proportional controller is used in the inner loop for active damping of possible resonances and improving the transient performance. The feedforward of the converter reference voltage enhances the robust performance of the system and simplifies the system modelling and the controller design. A step-by-step design procedure is presented for the proposed controller, which guarantees stability of the system under worst-case scenarios. Simulation and experimental results validate the excellent steady-state and transient performance of the proposed control scheme and provide the exact comparison of the proposed method with the conventional multi-loop control method. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

  19. The use of quilting suture in abdominoplasty does not require aspiratory drainage for prevention of seroma.

    PubMed

    Arantes, Henrique Lopes; Rosique, Rodrigo Gouvêa; Rosique, Marina Junqueira Ferreira; Mélega, Jose Marcos

    2010-02-01

    The formation of seromas after abdominoplasty is a highly prevalent complication that disturbs both the patient and the surgeon. Aspiratory drainage and adhesion sutures (Baroudi suture) are widely used to prevent this complication. This study evaluated the effectiveness of drains in preventing seromas. This retrospective study investigated women submitted to classic abdominoplasty with adhesion sutures. The women were divided into two groups. Group 1 comprised 28 individuals who received no drains, and group 2 consisted of 32 patients that had drains placed. Clinical evaluation of the patients was performed 7 days, 14 days, 1 month, 2 months, 4 months, and 6 months postoperatively. Statistical analysis was accomplished via Fisher's exact test. Group 1 had one case of seroma (3.5%), clinically detected between the first and second postoperative months, whereas group 2 had one case (3.12%) detected 14 days postoperatively. Fisher's test showed a P value of 1.000 (not statistically significant), for a 95% confidence interval of 0.05 to 14.08 and an odds ratio of 0.8387. Clinical evaluation showed no statistical difference in the incidence of seromas after abdominoplasty with adhesion sutures between the patients who received drains and those who did not. The use of adhesion sutures is an effective measure for preventing seromas with no need for additional surgical measures.

  20. Model error in covariance structure models: Some implications for power and Type I error

    PubMed Central

    Coffman, Donna L.

    2010-01-01

    The present study investigated the degree to which violation of the parameter drift assumption affects the Type I error rate for the test of close fit and power analysis procedures proposed by MacCallum, Browne, and Sugawara (1996) for both the test of close fit and the test of exact fit. The parameter drift assumption states that as sample size increases both sampling error and model error (i.e. the degree to which the model is an approximation in the population) decrease. Model error was introduced using a procedure proposed by Cudeck and Browne (1992). The empirical power for both the test of close fit, in which the null hypothesis specifies that the Root Mean Square Error of Approximation (RMSEA) ≤ .05, and the test of exact fit, in which the null hypothesis specifies that RMSEA = 0, is compared with the theoretical power computed using the MacCallum et al. (1996) procedure. The empirical power and theoretical power for both the test of close fit and the test of exact fit are nearly identical under violations of the assumption. The results also indicated that the test of close fit maintains the nominal Type I error rate under violations of the assumption. PMID:21331302

  1. Density-based empirical likelihood procedures for testing symmetry of data distributions and K-sample comparisons.

    PubMed

    Vexler, Albert; Tanajian, Hovig; Hutson, Alan D

    In practice, parametric likelihood-ratio techniques are powerful statistical tools. In this article, we propose and examine novel and simple distribution-free test statistics that efficiently approximate parametric likelihood ratios to analyze and compare distributions of K groups of observations. Using the density-based empirical likelihood methodology, we develop a Stata package that applies to a test for symmetry of data distributions and compares K -sample distributions. Recognizing that recent statistical software packages do not sufficiently address K -sample nonparametric comparisons of data distributions, we propose a new Stata command, vxdbel, to execute exact density-based empirical likelihood-ratio tests using K samples. To calculate p -values of the proposed tests, we use the following methods: 1) a classical technique based on Monte Carlo p -value evaluations; 2) an interpolation technique based on tabulated critical values; and 3) a new hybrid technique that combines methods 1 and 2. The third, cutting-edge method is shown to be very efficient in the context of exact-test p -value computations. This Bayesian-type method considers tabulated critical values as prior information and Monte Carlo generations of test statistic values as data used to depict the likelihood function. In this case, a nonparametric Bayesian method is proposed to compute critical values of exact tests.

  2. Statistical tests to compare motif count exceptionalities

    PubMed Central

    Robin, Stéphane; Schbath, Sophie; Vandewalle, Vincent

    2007-01-01

    Background Finding over- or under-represented motifs in biological sequences is now a common task in genomics. Thanks to p-value calculation for motif counts, exceptional motifs are identified and represent candidate functional motifs. The present work addresses the related question of comparing the exceptionality of one motif in two different sequences. Just comparing the motif count p-values in each sequence is indeed not sufficient to decide if this motif is significantly more exceptional in one sequence compared to the other one. A statistical test is required. Results We develop and analyze two statistical tests, an exact binomial one and an asymptotic likelihood ratio test, to decide whether the exceptionality of a given motif is equivalent or significantly different in two sequences of interest. For that purpose, motif occurrences are modeled by Poisson processes, with a special care for overlapping motifs. Both tests can take the sequence compositions into account. As an illustration, we compare the octamer exceptionalities in the Escherichia coli K-12 backbone versus variable strain-specific loops. Conclusion The exact binomial test is particularly adapted for small counts. For large counts, we advise to use the likelihood ratio test which is asymptotic but strongly correlated with the exact binomial test and very simple to use. PMID:17346349

  3. Adoption of Gene Expression Profile Testing and Association With Use of Chemotherapy Among Women With Breast Cancer

    PubMed Central

    Hassett, Michael J.; Silver, Samuel M.; Hughes, Melissa E.; Blayney, Douglas W.; Edge, Stephen B.; Herman, James G.; Hudis, Clifford A.; Marcom, P. Kelly; Pettinga, Jane E.; Share, David; Theriault, Richard; Wong, Yu-Ning; Vandergrift, Jonathan L.; Niland, Joyce C.; Weeks, Jane C.

    2012-01-01

    Purpose Gene expression profile (GEP) testing is a relatively new technology that offers the potential of personalized medicine to patients, yet little is known about its adoption into routine practice. One of the first commercially available GEP tests, a 21-gene profile, was developed to estimate the benefit of adjuvant chemotherapy for hormone receptor–positive breast cancer (HR-positive BC). Patients and Methods By using a prospective registry data set outlining the routine care provided to women diagnosed from 2006 to 2008 with HR-positive BC at 17 comprehensive and community-based cancer centers, we assessed GEP test adoption and the association between testing and chemotherapy use. Results Of 7,375 women, 20.4% had GEP testing and 50.2% received chemotherapy. Over time, testing increased (14.7% in 2006 to 27.5% in 2008; P < .01) and use of chemotherapy decreased (53.9% in 2006 to 47.0% in 2008; P < .01). Characteristics independently associated with lower odds of testing included African American versus white race (odds ratio [OR], 0.70; 95% CI, 0.54 to 0.92) and high school or less versus more than high school education (OR, 0.63; 95% CI, 0.52 to 0.76). Overall, testing was associated with lower odds of chemotherapy use (OR, 0.70; 95% CI, 0.62 to 0.80). Stratified analyses demonstrated that for small, node-negative cancers, testing was associated with higher odds of chemotherapy use (OR, 11.13; 95% CI, 5.39 to 22.99), whereas for node-positive and large node-negative cancers, testing was associated with lower odds of chemotherapy use (OR, 0.11; 95% CI, 0.07 to 0.17). Conclusion There has been a progressive increase in use of this GEP test and an associated shift in the characteristics of and overall reduction in the proportion of women with HR-positive BC receiving adjuvant chemotherapy. PMID:22585699

  4. An exact computational method for performance analysis of sequential test algorithms for detecting network intrusions

    NASA Astrophysics Data System (ADS)

    Chen, Xinjia; Lacy, Fred; Carriere, Patrick

    2015-05-01

    Sequential test algorithms are playing increasingly important roles for quick detecting network intrusions such as portscanners. In view of the fact that such algorithms are usually analyzed based on intuitive approximation or asymptotic analysis, we develop an exact computational method for the performance analysis of such algorithms. Our method can be used to calculate the probability of false alarm and average detection time up to arbitrarily pre-specified accuracy.

  5. Exact solution for spin precession in the radiationless relativistic Kepler problem

    NASA Astrophysics Data System (ADS)

    Mane, S. R.

    2014-11-01

    There is interest in circulating beams of polarized particles in all-electric storage rings to search for nonzero permanent electric dipole moments of subatomic particles. To this end, it is helpful to derive exact analytical solutions of the spin precession in idealized models, both for pedagogical reasons and to serve as benchmark tests for analysis and design of experiments. This paper derives exact solutions for the spin precession in the relativistic Kepler problem. Some counterintuitive properties of the solutions are pointed out.

  6. The outcome of apical microsurgery using MTA as the root-end filling material: 2- to 6-year follow-up study.

    PubMed

    Çalışkan, M K; Tekin, U; Kaval, M E; Solmaz, M C

    2016-03-01

    To evaluate the influence of various predictors on the healing outcome 2-6 years after apical microsurgery (AMS) using MTA as the root-end filling material. A total of 90 anterior teeth with asymptomatic persistent periradicular periodontitis of strictly endodontic origin that failed after either nonsurgical or surgical treatment were included. Surgery was completed under local anaesthesia using a standardized clinical protocol. Clinical and radiographic measures as well as the follow-up period were used to determine the healing outcome. For statistical analysis of the predictors, the outcome was dichotomized into healed cases and nonhealed cases. Odds ratios were calculated, and Pearson chi-square or Fisher's exact tests were used to analyse the data. Clinical and radiographic assessment of AMS revealed that 80% were healed, 14.4% were nonhealed, whilst 5.6% were judged to be uncertain. None of the various predictors investigated had a significant influence on the outcome of AMS. The results of this clinical study demonstrated that 80% of cases that received apical microsurgery healed when using MTA as the root-end filling material. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  7. Superconducting proximity in three-dimensional Dirac materials: Odd-frequency, pseudoscalar, pseudovector, and tensor-valued superconducting orders

    NASA Astrophysics Data System (ADS)

    Faraei, Zahra; Jafari, S. A.

    2017-10-01

    We find that a conventional s -wave superconductor in proximity to a three-dimensional Dirac material (3DDM), to all orders of perturbation in tunneling, induces a combination of s - and p -wave pairing only. We show that the Lorentz invariance of the superconducting pairing prevents the formation of Cooper pairs with higher orbital angular momenta in the 3DDM. This no-go theorem acquires stronger form when the probability of tunneling from the conventional superconductor to positive and negative energy states of 3DDM are equal. In this case, all the p -wave contribution except for the lowest order, identically vanish and hence we obtain an exact result for the induced p -wave superconductivity in 3DDM. Fierz decomposing the superconducting matrix we find that the temporal component of the vector superconducting order and the spatial components of the pseudovector order have odd-frequency pairing symmetry. We find that the latter is odd with respect to exchange of position and chirality of the electrons in the Cooper pair and is a spin-triplet, which is necessary for NMR detection of such an exotic pseudovector pairing. Moreover, we show that the tensorial order breaks into a polar vector and an axial vector and both of them have conventional pairing symmetry except for being a spin triplet. According to our study, for gapless 3DDM, the tensorial superconducting order will be the only order that is odd with respect to the chemical potential μ . Therefore we predict that a transverse p -n junction binds Majorana fermions. This effect can be used to control the neutral Majorana fermions with electric fields.

  8. Ictal semiology in hippocampal versus extrahippocampal temporal lobe epilepsy.

    PubMed

    Gil-Nagel, A; Risinger, M W

    1997-01-01

    We have analysed retrospectively the clinical features and electroencephalograms in 35 patients with complex partial seizures of temporal lobe origin who were seizure-free after epilepsy surgery. Two groups were differentiated for statistical analysis: 16 patients had hippocampal temporal lobe seizures (HTS) and 19 patients had extrahippocampal temporal lobe seizures (ETS) associated with a small tumour of the lateral or inferior temporal cortex. All patients in the HTS group had ictal onset verified with intracranial recordings (depth or subdural electrodes). In the ETS group, extrahippocampal onset was verified with intracranial recordings in eight patients and assumed, because of failure of a previous amygdalohippocampectomy, in one patient. Historical information, ictal semiology and ictal EEG of typical seizures were analysed in each patient. The occurrence of early and late oral automatisms and dystonic posturing of an upper extremity was analysed separately. A prior history of febrile convulsions was obtained in 13 HTS patients (81.3%) but in none with ETS (P < 0.0001, Fisher's exact test). An epigastric aura preceded seizures in five patients with HTS (31.3%) and none with ETS (P = 0.0135, Fisher's exact test), while an aura with experiential content was recalled by nine patients with ETS (47.4%) and none with HTS (P = 0.0015), Fisher's exact test). Early oral automatisms occurred in 11 patients with HTS (68.8%) and in two with ETS (10.5%) (P = 0.0005, Fisher's exact test). Early motor involvement of the contralateral upper extremity without oral automatisms occurred in three patients with HTS (18.8%) and in 10 with ETS (52.6%) (P = 0.0298, Fisher's exact test). Arrest reaction, vocalization, speech, facial grimace, postictal cough, late oral automatisms and late motor involvement of the contralateral arm and hand occurred with similar frequency in both groups. These observations show that the early clinical features of HTS and ETS are different.

  9. Constructing the Exact Significance Level for a Person-Fit Statistic.

    ERIC Educational Resources Information Center

    Liou, Michelle; Chang, Chih-Hsin

    1992-01-01

    An extension is proposed for the network algorithm introduced by C.R. Mehta and N.R. Patel to construct exact tail probabilities for testing the general hypothesis that item responses are distributed according to the Rasch model. A simulation study indicates the efficiency of the algorithm. (SLD)

  10. Charge transfer excitations from exact and approximate ensemble Kohn-Sham theory

    NASA Astrophysics Data System (ADS)

    Gould, Tim; Kronik, Leeor; Pittalis, Stefano

    2018-05-01

    By studying the lowest excitations of an exactly solvable one-dimensional soft-Coulomb molecular model, we show that components of Kohn-Sham ensembles can be used to describe charge transfer processes. Furthermore, we compute the approximate excitation energies obtained by using the exact ensemble densities in the recently formulated ensemble Hartree-exchange theory [T. Gould and S. Pittalis, Phys. Rev. Lett. 119, 243001 (2017)]. Remarkably, our results show that triplet excitations are accurately reproduced across a dissociation curve in all cases tested, even in systems where ground state energies are poor due to strong static correlations. Singlet excitations exhibit larger deviations from exact results but are still reproduced semi-quantitatively.

  11. Reproductive Health-Care Utilization of Young Adults Insured as Dependents.

    PubMed

    Andrasfay, Theresa

    2018-05-01

    The common practice of sending an explanation of benefits to policyholders may inadvertently disclose sensitive services to the parents of dependents, making confidentiality a potential barrier to reproductive health care. This study compares the reproductive health-care utilization of young adult dependents and young adult policyholders using nationally representative data collected after full implementation of the Affordable Care Act. Data from 2,108 young adults aged 18-25 years in the 2015 National Health Interview Survey were analyzed. Logistic regressions predicted utilization of two preventive services (general doctor visit and flu vaccination) and four reproductive health services (HIV testing, obstetrician/gynecologist visit, hormonal contraceptive use, and Pap testing) from the insurance type of the young adult (dependent, privately insured policyholder, or Medicaid). In unadjusted analyses, young adult dependents had lower utilization of HIV tests than their peers who were privately insured or Medicaid policyholders. Young women dependents had lower utilization of Pap tests than young women on Medicaid. Once controls were included, young adult dependents did not have significantly lower odds of obtaining reproductive health care than privately insured policyholders. Dependent young men still had marginally lower odds of ever having an HIV test (adjusted odds ratio = .65, p = .08) and dependent young women still had marginally lower odds of ever having a Pap test (adjusted odds ratio = .58, p = .06) than comparable Medicaid policyholders. Despite confidentiality concerns, young adults insured as dependents have utilization of several reproductive health services similar to that of comparable young adult policyholders. Copyright © 2017 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  12. The Sequential Probability Ratio Test: An efficient alternative to exact binomial testing for Clean Water Act 303(d) evaluation.

    PubMed

    Chen, Connie; Gribble, Matthew O; Bartroff, Jay; Bay, Steven M; Goldstein, Larry

    2017-05-01

    The United States's Clean Water Act stipulates in section 303(d) that states must identify impaired water bodies for which total maximum daily loads (TMDLs) of pollution inputs into water bodies are developed. Decision-making procedures about how to list, or delist, water bodies as impaired, or not, per Clean Water Act 303(d) differ across states. In states such as California, whether or not a particular monitoring sample suggests that water quality is impaired can be regarded as a binary outcome variable, and California's current regulatory framework invokes a version of the exact binomial test to consolidate evidence across samples and assess whether the overall water body complies with the Clean Water Act. Here, we contrast the performance of California's exact binomial test with one potential alternative, the Sequential Probability Ratio Test (SPRT). The SPRT uses a sequential testing framework, testing samples as they become available and evaluating evidence as it emerges, rather than measuring all the samples and calculating a test statistic at the end of the data collection process. Through simulations and theoretical derivations, we demonstrate that the SPRT on average requires fewer samples to be measured to have comparable Type I and Type II error rates as the current fixed-sample binomial test. Policymakers might consider efficient alternatives such as SPRT to current procedure. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Advanced Joining of Aerospace Metallic Materials.

    DTIC Science & Technology

    1986-07-01

    uniaxial tensile test with varying temperature and cyclic loading. This simple test problem excercises maray aspects of the phenomena. suOn- ,Ual Yield...6vidence Ia seconde configuration apparait plus n~ faste . 5.3. Ents-e-igne-men-t-s s-u r a dyna-mique de. bain-s de fu-sion A lusage il svest r~vle que la...scanning system for fast and exact alignment of the EB-qun is used. In a fixture the cleaned detail parts are positioned exactly and clamped for welding. At

  14. Clinical, Radiologic, and Legal Significance of "Extensor Response" in Posttraumatic Coma.

    PubMed

    Firsching, Raimund; Woischneck, Dieter; Langejürgen, Alexander; Parreidt, Andreas; Bondar, Imre; Skalej, Martin; Röhl, Friedrich; Voellger, Benjamin

    2015-11-01

    The timely detection of neurologic deterioration can be critical for the survival of a neurosurgical patient following head injury. Because little reliable evidence is available on the prognostic value of the clinical sign "extensor response" in comatose posttraumatic patients, we investigated the correlation of this clinical sign with outcome and with early radiologic findings from magnetic resonance imaging (MRI). This retrospective analysis of prospectively obtained data included 157 patients who had remained in a coma for a minimum of 24 hours after traumatic brain injury. All patients received a 1.5-T MRI within 10 days (median: 2 days) of the injury. The correlations between clinical findings 12 and 24 hours after the injury-in particular, extensor response and pupillary function, MRI findings, and outcome after 1 year-were investigated. Statistical analysis included contingency tables, Fisher exact test, odds ratios (ORs) with confidence intervals (CIs), and weighted κ values. There were 48 patients with extensor response within the first 24 hours after the injury. Patients with extensor response (World Federation of Neurosurgical Societies coma grade III) statistically were significantly more likely to harbor MRI lesions in the brainstem when compared with patients in a coma who had no further deficiencies (coma grade I; p = 0.0004 by Fisher exact test, OR 10.8 with 95% CI, 2.7-42.5) and patients with unilateral loss of pupil function (coma grade II; p = 0.0187, OR 2.8 with 95% CI, 1.2-6.5). The correlation of brainstem lesions as found by MRI and outcome according to the Glasgow Outcome Scale after 1 year was also highly significant (p ≤ 0.016). The correlation of extensor response and loss of pupil function with an unfavorable outcome and with brainstem lesions revealed by MRI is highly significant. Their sudden onset may be associated with the sudden onset of brainstem dysfunction and should therefore be regarded as one of the most fundamental warning signs in the clinical monitoring of comatose patients. Georg Thieme Verlag KG Stuttgart · New York.

  15. [The situation and associated factors of facility-based HIV testing among men who sex with men in Beijing].

    PubMed

    Ren, X L; Mi, G D; Zhao, Y; Rou, K M; Zhang, D P; Geng, L; Chen, Z H; Wu, Z Y

    2017-04-06

    Objective: To understand the prevalence of facility-based HIV testing and its associated factors among men who have sex with men (MSM) in Beijing city. Methods: An application-based cross-sectional survey was employed to understand HIV site test situation and associated factors. The survey was carried out from May 14(th) to 21(st), 2016. Users of a smart phone application for gay dating were recruited and those eligible for this survey were investigated with an online self-administered questionnaire. Information of demographics, sexual behaviors, facility-based HIV testing history and recreational drug abuses were collected. The multivariate logistic regression was used to make comparison among different groups and assess associated factors. Results: A total of 7 494 participants were enrolled in the survey with mean age of (28.81 ± 7.38) years, 87.14% (6 530/7 494) sought sexual partners through internet. The proportion of facility-based HIV testing in 1 year was 42.55% (3 189/7 494), MSM who were 25-29 years had higher proportion of facility-based HIV testing in 1 year, the proportion was 45.56%(1 104/2 423). Among MSM who could insist in using condom during anal sex (50.46% (1 539/3 050)), the proportion of HIV site testing in 1 year was higher. The MSM who reported seeking healthcare for symptoms of a sexually transmitted infections (STIs) in the past year or ever using recreational drug had higher proportion of facility-based HIV testing, the proportions were 56.81% (409/720) and 52.00% (1 340/4 917), respectively. Compared with alone cohabitation, cohabitating was associated with decreased odds of HIV facility-based testing in past 1 year(odds ratio ( OR )= 0.79, P< 0.001). Compared with homosexual sexual orientation, bisexual sexual orientation was associated with decreased odds of facility-based HIV testing ( OR= 0.83, P= 0.004). With the increasing of number of male anal sex partners, the odds of HIV facility-based testing was increasing ( OR= 1.31, P< 0.001) But with the decreasing of the frequency of condom using with male anal sex partners, the odds of facility-based HIV testing was decreasing ( OR= 0.85, P= 0.014). Using recreational drugs ( OR= 1.36, P< 0.001) and seeking healthcare for symptoms of a STI in the past 1 year ( OR= 1.73, P< 0.001) were associated with decreased odds of HIV site testing. Conclusion: MSM in Beijing had lower proportion of facility-based HIV testing in past 1 year. Multiple anal sex partners, using recreational drugs, seeking healthcare for symptoms of a STI in the past year, cohabitating, bisexual sexual orientation, and lower frequency of condom using with male anal sex partners were associated with the odds of HIV facility-based testing in past 1 year.

  16. Disparities in chlamydia testing among young women with sexually transmitted infection symptoms.

    PubMed

    Wiehe, Sarah E; Rosenman, Marc B; Wang, Jane; Fortenberry, J Dennis

    2010-12-01

    Diagnostic chlamydia testing is recommended for all young women demonstrating sexually transmitted infection (STI) symptoms. Differential testing among symptomatic women may contribute to disparities in chlamydia rates. Our objective was to determine whether providers test young women with STI symptoms for chlamydia differently by age, race/ethnicity, or insurance status, and whether testing patterns differ by documentation of previous STI. Retrospective cohort analysis using electronic medical records and billing data of women 14 to 25 years old with one or more diagnostic or procedure codes indicative of STI symptoms (N = 61,498 women). Random effects logistic regression analysis was performed to assess the odds of chlamydia testing given a woman presented for a nonpregnancy-related visit with STI symptoms. All analyses controlled for history of STI, setting, and year, and adjusted for within-person correlation. A chlamydia test was performed in 38% of visits with codes indicating STI symptoms. Women aged <18 or >19 were less likely to be tested than women aged 18 to 19, with young women aged 14 to 15 having the lowest odds of being tested (Odd Ratio [OR]: 0.52). Providers were more likely to test minority (ORblack: 2.87; ORLatina: 2.10) compared with white women. Women were also more likely to be tested if they had public insurance (OR: 2.41) or were self-pay (OR: 2.35) compared with if they had private insurance. Women aged 14 to 15 and 16 to 17 with prior history of STI had increased odds of chlamydia testing (OR: 1.79 and 1.43, respectively) compared with women aged 18 to 19, changing the overall direction of association compared with women with no history of STI. The odds of testing were dramatically reduced for minority and nonprivately insured young women with history of STI, although significant differences persisted. Provider chlamydia testing differs by age, race/ethnicity, and insurance status when a woman presents with STI symptoms and no prior history of STI. This bias may contribute to higher reported rates of chlamydia among younger, minority, and poor women.

  17. SLDAssay: A software package and web tool for analyzing limiting dilution assays.

    PubMed

    Trumble, Ilana M; Allmon, Andrew G; Archin, Nancie M; Rigdon, Joseph; Francis, Owen; Baldoni, Pedro L; Hudgens, Michael G

    2017-11-01

    Serial limiting dilution (SLD) assays are used in many areas of infectious disease related research. This paper presents SLDAssay, a free and publicly available R software package and web tool for analyzing data from SLD assays. SLDAssay computes the maximum likelihood estimate (MLE) for the concentration of target cells, with corresponding exact and asymptotic confidence intervals. Exact and asymptotic goodness of fit p-values, and a bias-corrected (BC) MLE are also provided. No other publicly available software currently implements the BC MLE or the exact methods. For validation of SLDAssay, results from Myers et al. (1994) are replicated. Simulations demonstrate the BC MLE is less biased than the MLE. Additionally, simulations demonstrate that exact methods tend to give better confidence interval coverage and goodness-of-fit tests with lower type I error than the asymptotic methods. Additional advantages of using exact methods are also discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Building and Solving Odd-One-Out Classification Problems: A Systematic Approach

    ERIC Educational Resources Information Center

    Ruiz, Philippe E.

    2011-01-01

    Classification problems ("find the odd-one-out") are frequently used as tests of inductive reasoning to evaluate human or animal intelligence. This paper introduces a systematic method for building the set of all possible classification problems, followed by a simple algorithm for solving the problems of the R-ASCM, a psychometric test derived…

  19. Impact of organizational factors on adherence to laboratory testing protocols in adult HIV care in Lusaka, Zambia.

    PubMed

    Deo, Sarang; Topp, Stephanie M; Westfall, Andrew O; Chiko, Matimbo M; Wamulume, Chibesa S; Morris, Mary; Reid, Stewart

    2012-05-02

    Previous operational research studies have demonstrated the feasibility of large-scale public sector ART programs in resource-limited settings. However, organizational and structural determinants of quality of care have not been studied. We estimate multivariate regression models using data from 13 urban HIV treatment facilities in Zambia to assess the impact of structural determinants on health workers' adherence to national guidelines for conducting laboratory tests such as CD4, hemoglobin and liver function and WHO staging during initial and follow-up visits as part of Zambian HIV care and treatment program. CD4 tests were more routinely ordered during initial history and physical (IHP) than follow-up (FUP) visits (93.0 % vs. 85.5 %; p < 0.01). More physical space, higher staff turnover and greater facility experience with ART was associated with greater odds of conducting tests. Higher staff experience decreased the odds of conducting CD4 tests in FUP (OR 0.93; p < 0.05) and WHO staging in IHP visit (OR 0.90; p < 0.05) but increased the odds of conducting hemoglobin test in IHP visit (OR 1.05; p < 0.05). Higher staff burnout increased the odds of conducting CD4 test during FUP (OR 1.14; p < 0.05) but decreased the odds of conducting hemoglobin test in IHP visit (0.77; p < 0.05) and CD4 test in IHP visit (OR 0.78; p < 0.05). Physical space plays an important role in ensuring high quality care in resource-limited setting. In the context of protocolized care, new staff members are likely to be more diligent in following the protocol verbatim rather than relying on memory and experience thereby improving adherence. Future studies should use prospective data to confirm the findings reported here.

  20. Exact Distributions of Intraclass Correlation and Cronbach's Alpha with Gaussian Data and General Covariance

    ERIC Educational Resources Information Center

    Kistner, Emily O.; Muller, Keith E.

    2004-01-01

    Intraclass correlation and Cronbach's alpha are widely used to describe reliability of tests and measurements. Even with Gaussian data, exact distributions are known only for compound symmetric covariance (equal variances and equal correlations). Recently, large sample Gaussian approximations were derived for the distribution functions. New exact…

  1. A Comparison of Lord's Chi Square and Raju's Area Measures in Detection of DIF.

    ERIC Educational Resources Information Center

    Cohen, Allan S.; Kim, Seock-Ho

    1993-01-01

    The effectiveness of two statistical tests of the area between item response functions (exact signed area and exact unsigned area) estimated in different samples, a measure of differential item functioning (DIF), was compared with Lord's chi square. Lord's chi square was found the most effective in determining DIF. (SLD)

  2. New exact periodic solitary-wave solutions for the new (3+1)-dimensional generalized Kadomtsev-Petviashvili equation in multi-temperature electron plasmas

    NASA Astrophysics Data System (ADS)

    Liu, Jian-Guo; Tian, Yu; Zeng, Zhi-Fang

    2017-10-01

    In this paper, we aim to introduce a new form of the (3+1)-dimensional generalized Kadomtsev-Petviashvili equation for the long waves of small amplitude with slow dependence on the transverse coordinate. By using the Hirota's bilinear form and the extended homoclinic test approach, new exact periodic solitary-wave solutions for the new (3+1)-dimensional generalized Kadomtsev-Petviashvili equation are presented. Moreover, the properties and characteristics for these new exact periodic solitary-wave solutions are discussed with some figures.

  3. Mixing times in quantum walks on two-dimensional grids

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

    Marquezino, F. L.; Portugal, R.; Abal, G.

    2010-10-15

    Mixing properties of discrete-time quantum walks on two-dimensional grids with toruslike boundary conditions are analyzed, focusing on their connection to the complexity of the corresponding abstract search algorithm. In particular, an exact expression for the stationary distribution of the coherent walk over odd-sided lattices is obtained after solving the eigenproblem for the evolution operator for this particular graph. The limiting distribution and mixing time of a quantum walk with a coin operator modified as in the abstract search algorithm are obtained numerically. On the basis of these results, the relation between the mixing time of the modified walk and themore » running time of the corresponding abstract search algorithm is discussed.« less

  4. Mixing times in quantum walks on two-dimensional grids

    NASA Astrophysics Data System (ADS)

    Marquezino, F. L.; Portugal, R.; Abal, G.

    2010-10-01

    Mixing properties of discrete-time quantum walks on two-dimensional grids with toruslike boundary conditions are analyzed, focusing on their connection to the complexity of the corresponding abstract search algorithm. In particular, an exact expression for the stationary distribution of the coherent walk over odd-sided lattices is obtained after solving the eigenproblem for the evolution operator for this particular graph. The limiting distribution and mixing time of a quantum walk with a coin operator modified as in the abstract search algorithm are obtained numerically. On the basis of these results, the relation between the mixing time of the modified walk and the running time of the corresponding abstract search algorithm is discussed.

  5. Gas Evolution Dynamics in Godunov-Type Schemes and Analysis of Numerical Shock Instability

    NASA Technical Reports Server (NTRS)

    Xu, Kun

    1999-01-01

    In this paper we are going to study the gas evolution dynamics of the exact and approximate Riemann solvers, e.g., the Flux Vector Splitting (FVS) and the Flux Difference Splitting (FDS) schemes. Since the FVS scheme and the Kinetic Flux Vector Splitting (KFVS) scheme have the same physical mechanism and similar flux function, based on the analysis of the discretized KFVS scheme the weakness and advantage of the FVS scheme are closely observed. The subtle dissipative mechanism of the Godunov method in the 2D case is also analyzed, and the physical reason for shock instability, i.e., carbuncle phenomena and odd-even decoupling, is presented.

  6. Channel surface plasmons in a continuous and flat graphene sheet

    NASA Astrophysics Data System (ADS)

    Chaves, A. J.; Peres, N. M. R.; da Costa, D. R.; Farias, G. A.

    2018-05-01

    We derive an integral equation describing surface-plasmon polaritons in graphene deposited on a substrate with a planar surface and a dielectric protrusion in the opposite surface of the dielectric slab. We show that the problem is mathematically equivalent to the solution of a Fredholm equation, which we solve exactly. In addition, we show that the dispersion relation of the channel surface plasmons is determined by the geometric parameters of the protrusion alone. We also show that such a system supports both even and odd modes. We give the electrostatic potential and the intensity plot of the electrostatic field, which clearly show the transverse localized nature of the surface plasmons in a continuous and flat graphene sheet.

  7. The Risk Factors and Clinical Course of Asthma with Fixed Airflow Limitation.

    PubMed

    Pothirat, Chaicharn; Chaiwong, Warawut; Liwsrisakun, Chalerm; Bumroongkit, Chaiwat; Deesomchok, Athavudh; Theerakittikul, Theerakorn; Limsukon, Atikun; Phetsuk, Nittaya

    2016-07-01

    To identify risk factors and clinical course of asthma with fixed airflow limitation. A retrospective case-control study of asthma patients was conducted over a 15-month period. Asthma with fixed airflow limitation patients were defined as chronic asthmatics who had both post-bronchodilator (BD) and on-treatment ratio of forced expiratory in first second (FEV1)/forced vital capacity (FVC) persistently less than 0.7, whereas usual chronic asthma patients had post-BD and/or on-treatment ratio of FEV1/FVC more than 0.7. Serial asthma control tests (ACT), medication used, exacerbations were assessed. The risk factors were analyzed using logistic regression. Clinical characteristics between groups were compared using Student’s t-test and Fisher’s exact test. One hundred twenty from 142 eligible subjects were enrolled. They had asthma with fixed airflow limitation (n = 40) and usual chronic asthma (n = 80). Potential risk factors of asthma with fixed airflow limitation included early disease onset (age <15 years) [(adjusted odd ratio (OR) = 3.9, 95% confidence interval (CI) 1.9-8.3)] with longer disease duration (adjusted OR = 8.4, 95% CI 4.6-15.4 for >30 years). Asthma with fixed airflow limitation patients had lower ACT scores (p<0.001), lower level of asthma control (p<0.001), required more asthma medications (p = 0.002), and higher rates of hospitalization (p = 0.001) than usual chronic asthma. The potential risk factors of asthma with fixed airflow limitation were earlier disease onset and longer disease duration. They had poorer asthma control, more medications needed, and higher rates of exacerbation than usual chronic asthma.

  8. Pearson's random walk in the space of the CMB phases: Evidence for parity asymmetry

    NASA Astrophysics Data System (ADS)

    Hansen, M.; Frejsel, A. M.; Kim, J.; Naselsky, P.; Nesti, F.

    2011-05-01

    The temperature fluctuations of the cosmic microwave background (CMB) are supposed to be distributed randomly in both magnitude and phase, following to the simplest model of inflation. In this paper, we look at the odd and even multipoles of the spherical harmonic decomposition of the CMB, and the different characteristics of these, giving rise to a parity asymmetry. We compare the even and odd multipoles in the CMB power spectrum, and also the even and odd mean angles. We find for the multipoles of the power spectrum that there is power excess in odd multipoles, compared to even ones, meaning that we have a parity asymmetry. Further, for the phases, we present a random walk for the mean angles, and find a significant separation for even/odd mean angles, especially so for galactic coordinates. This is further tested and confirmed with a directional parity test, comparing the parity asymmetry in galactic and ecliptic coordinates.

  9. Computing exact bundle compliance control charts via probability generating functions.

    PubMed

    Chen, Binchao; Matis, Timothy; Benneyan, James

    2016-06-01

    Compliance to evidenced-base practices, individually and in 'bundles', remains an important focus of healthcare quality improvement for many clinical conditions. The exact probability distribution of composite bundle compliance measures used to develop corresponding control charts and other statistical tests is based on a fairly large convolution whose direct calculation can be computationally prohibitive. Various series expansions and other approximation approaches have been proposed, each with computational and accuracy tradeoffs, especially in the tails. This same probability distribution also arises in other important healthcare applications, such as for risk-adjusted outcomes and bed demand prediction, with the same computational difficulties. As an alternative, we use probability generating functions to rapidly obtain exact results and illustrate the improved accuracy and detection over other methods. Numerical testing across a wide range of applications demonstrates the computational efficiency and accuracy of this approach.

  10. Valence-bond theory of linear Hubbard and Pariser-Parr-Pople models

    NASA Astrophysics Data System (ADS)

    Soos, Z. G.; Ramasesha, S.

    1984-05-01

    The ground and low-lying states of finite quantum-cell models with one state per site are obtained exactly through a real-space basis of valence-bond (VB) diagrams that explicitly conserve the total spin. Regular and alternating Hubbard and Pariser-Parr-Pople (PPP) chains and rings with Ne electrons on N(<=12) sites are extrapolated to infinite arrays. The ground-state energy and optical gap of regular U=4|t| Hubbard chains agree with exact results, suggesting comparable accuracy for alternating Hubbard and PPP models, but differ from mean-field results. Molecular PPP parameters describe well the excitations of finite polyenes, odd polyene ions, linear cyanine dyes, and slightly overestimate the absorption peaks in polyacetylene (CH)x. Molecular correlations contrast sharply with uncorrelated descriptions of topological solitons, which are modeled by regular polyene radicals and their ions for both wide and narrow alternation crossovers. Neutral solitons have no midgap absorption and negative spin densities, while the intensity of the in-gap excitation of charged solitons is not enhanced. The properties of correlated states in quantum-cell models with one valence state per site are discussed in the adiabatic limit for excited-state geometries and instabilities to dimerization.

  11. Density-Functional Theory description of transport in the single-electron transistor

    NASA Astrophysics Data System (ADS)

    Zawadzki, Krissia; Oliveira, Luiz N.

    The Kondo effect governs the low-temperature transport properties of the single electron transistor (SET), a quantum dot bridging two electron gases. In the weak coupling limit, for odd dot occupation, the gate-potential profile of the conductance approaches a step, known as the Kondo plateau. The plateau and other SET properties being well understood on the basis of the Anderson model, more realistic (i. e., DFT) descriptions of the device are now desired. This poses a challenge, since the SET is strongly correlated. DFT computations that reproduce the conductance plateau have been reported, e. g., by, which rely on the exact functional provided by the Bethe-Ansatz solution for the Anderson model. Here, sticking to DFT tradition, we employ a functional derived from a homogeneous system: the parametrization of the Lieb-Wu solution for the Hubbard model due to. Our computations reproduce the plateau and yield other results in accurate agreement with the exact diagonalization of the Anderson Hamiltonian. The prospects for extensions to realistic descriptions of two-dimensional nanostructured devices will be discussed. Luiz N. Oliveira thanks CNPq (312658/2013-3) and Krissia Zawadzki thanks CNPq (140703/2014-4) for financial support.

  12. A risk score for predicting coronary artery disease in women with angina pectoris and abnormal stress test finding.

    PubMed

    Lo, Monica Y; Bonthala, Nirupama; Holper, Elizabeth M; Banks, Kamakki; Murphy, Sabina A; McGuire, Darren K; de Lemos, James A; Khera, Amit

    2013-03-15

    Women with angina pectoris and abnormal stress test findings commonly have no epicardial coronary artery disease (CAD) at catheterization. The aim of the present study was to develop a risk score to predict obstructive CAD in such patients. Data were analyzed from 337 consecutive women with angina pectoris and abnormal stress test findings who underwent cardiac catheterization at our center from 2003 to 2007. Forward selection multivariate logistic regression analysis was used to identify the independent predictors of CAD, defined by ≥50% diameter stenosis in ≥1 epicardial coronary artery. The independent predictors included age ≥55 years (odds ratio 2.3, 95% confidence interval 1.3 to 4.0), body mass index <30 kg/m(2) (odds ratio 1.9, 95% confidence interval 1.1 to 3.1), smoking (odds ratio 2.6, 95% confidence interval 1.4 to 4.8), low high-density lipoprotein cholesterol (odds ratio 2.9, 95% confidence interval 1.5 to 5.5), family history of premature CAD (odds ratio 2.4, 95% confidence interval 1.0 to 5.7), lateral abnormality on stress imaging (odds ratio 2.8, 95% confidence interval 1.5 to 5.5), and exercise capacity <5 metabolic equivalents (odds ratio 2.4, 95% confidence interval 1.1 to 5.6). Assigning each variable 1 point summed to constitute a risk score, a graded association between the score and prevalent CAD (ptrend <0.001). The risk score demonstrated good discrimination with a cross-validated c-statistic of 0.745 (95% confidence interval 0.70 to 0.79), and an optimized cutpoint of a score of ≤2 included 62% of the subjects and had a negative predictive value of 80%. In conclusion, a simple clinical risk score of 7 characteristics can help differentiate those more or less likely to have CAD among women with angina pectoris and abnormal stress test findings. This tool, if validated, could help to guide testing strategies in women with angina pectoris. Copyright © 2013 Elsevier Inc. All rights reserved.

  13. HLA variants rs9271366 and rs9275328 are associated with systemic lupus erythematosus susceptibility in Malays and Chinese.

    PubMed

    Chai, H C; Phipps, M E; Othman, I; Tan, L P; Chua, K H

    2013-02-01

    Human leukocyte antigen (HLA) antigens and genes have long been reported associated with systemic lupus erythematosus (SLE) susceptibility in many populations. With the advance in technologies such as genome-wide association studies, many newly discovered SLE-associated single-nucleotide polymorphisms (SNPs) have been reported in recent years. These include HLA-DRB1/HLA-DQA1 rs9271366 and HLA-DQB1/HLA-DQA2 rs9275328. Our aim was to investigate these SNPs in a Malaysian SLE cohort. SNPs rs9271366 and rs9275328 were screened across 790 Malaysian citizens from three ethnic groups (360 patients and 430 healthy volunteers) by Taqman SNP genotyping assays. Allele and genotyping frequencies, Hardy-Weinberg equilibrium, Fisher's exact test and odds ratio were calculated for each SNP and ethnic group. Linkage disequilibrium and interaction between the two SNPs were also evaluated. The minor allele G and its homozygous genotype GG of HLA-DRB1/HLA-DQA1 rs9271366 significantly increased the SLE susceptibility in Malaysian patients, including those of Malay and Chinese ethnicity (odds ratio (OR) > 1, p < 0.05). As for HLA-DQB1/HLA-DQA2 rs9275328, the minor allele T and the heterozygous genotype CT conferred protective effect to SLE in Malaysians, as well as in Malays and Chinese, by having OR < 1 and p value <0.05. Both SNPs did not show associations to SLE in Indians. D' and r (2) values for the two SNPs in LD analysis were 0.941 and 0.065, respectively, with haplotype GC and AT being significantly associated with SLE (p < 5.0 × 10(-4)) after 10,000 permutations were performed. The MDR test clustered the genotype combinations of GG and CC, and AG and CC of rs9271366 and rs9275328, accordingly, as high-risk group, and the two SNPs interacted redundantly by removing 1.96% of the entropy. Our findings suggest that in addition to some classical HLA variants, rs9271366 and rs9275328 are additional polymorphisms worth considering in the Malaysian and possibly in a larger Asian SLE scenario.

  14. Anterior-Inferior Plating Results in Fewer Secondary Interventions Compared to Superior Plating for Acute Displaced Midshaft Clavicle Fractures.

    PubMed

    Serrano, Rafael; Borade, Amrut; Mir, Hassan; Shah, Anjan; Watson, David; Infante, Anthony; Frankle, Mark A; Mighell, Mark A; Sagi, H Claude; Horwitz, Daniel S; Sanders, Roy W

    2017-09-01

    To determine whether a difference in plate position for fixation of acute, displaced, midshaft clavicle fractures would affect the rate of secondary intervention. Retrospective Comparative Study. Two academic Level 1 Regional Trauma Centers. Five hundred ten patients treated surgically for an acutely displaced midshaft clavicle fracture between 2000 and 2013 were identified and reviewed retrospectively at a minimum of 24 months follow-up (F/U). Fractures were divided into 2 cohorts, according to plate position: Anterior-Inferior (AI) or Superior (S). Exclusion criteria included age <16 years, incomplete data records, and loss to F/U. Group analysis included demographics (age, sex, body mass index), fracture characteristics (mechanism of injury, open or closed), hand dominance, ipsilateral injuries, time between injury to surgery, time to radiographic union, length of F/U, and frequency of secondary procedures. Patients were treated either with AI or S clavicle plating at the treating surgeon's discretion. Rate and reason for secondary intervention. Fisher exact test, t test. and odds ratio were used for statistical analysis. Final analysis included 252 fractures/251 patients. One hundred eighteen (47%) were in group AI; 134 (53%) were in group S. No differences in demographics, fracture characteristics, time to surgery, time to union, or length of F/U existed between groups. Seven patients/7 fractures (5.9%) in Group AI underwent a secondary surgery whereas 30 patients/30 fractures (22.3%) in group S required a secondary surgery. An additional intervention secondary to superior plate placement was highly statistically significant (P < 0.001). Furthermore, because 80% of these subsequent interventions were a result of plate irritation with patient discomfort, the odds ratio for a second procedure was 5 times greater in those fractures treated with a superior plate. This comparative analysis indicates that AI plating of midshaft clavicle fractures seems to lessen clinical irritation and results in significantly fewer secondary interventions. Considering patient satisfaction and a reduced financial burden to the health care system, we recommend routine AI plate application when open reduction internal fixation of the clavicle is indicated. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

  15. Urine testing and urinary tract infections in febrile infants seen in office settings: the Pediatric Research in Office Settings' Febrile Infant Study.

    PubMed

    Newman, Thomas B; Bernzweig, Jane A; Takayama, John I; Finch, Stacia A; Wasserman, Richard C; Pantell, Robert H

    2002-01-01

    To determine the predictors and results of urine testing of young febrile infants seen in office settings. Prospective cohort study. Offices of 573 pediatric practitioners from 219 practices in the American Academy of Pediatrics Pediatric Research in Office Settings' research network. A total of 3066 infants 3 months or younger with temperatures of 38 degrees C or higher were evaluated and treated according to the judgment of their practitioners. Urine testing results, early and late urinary tract infections (UTIs), and UTIs with bacteremia. Fifty-four percent of the infants initially had urine tested, of whom 10% had a UTI. The height of the fever was associated with urine testing and a UTI among those tested (adjusted odds ratio per degree Celsius, 2.2 for both). Younger age, ill appearance, and lack of a fever source were associated with urine testing but not with a UTI, whereas lack of circumcision (adjusted odds ratio, 11.6), female sex (adjusted odds ratio, 5.4), and longer duration of fever (adjusted odds ratio, 1.8 for fever lasting > or = 24 hours) were not associated with urine testing but were associated with a UTI. Bacteremia accompanied the UTI in 10% of the patients, including 17% of those younger than 1 month. Among 807 infants not initially tested or treated with antibiotics, only 2 had a subsequent documented UTI; both did well. Practitioners order urine tests selectively, focusing on younger and more ill-appearing infants and on those without an apparent fever source. Such selective urine testing, with close follow-up, was associated with few late UTIs in this large study. Urine testing should focus particularly on uncircumcised boys, girls, the youngest and sickest infants, and those with persistent fever.

  16. Post-traumatic acute kidney injury: a cross-sectional study of trauma patients.

    PubMed

    Lai, Wei-Hung; Rau, Cheng-Shyuan; Wu, Shao-Chun; Chen, Yi-Chun; Kuo, Pao-Jen; Hsu, Shiun-Yuan; Hsieh, Ching-Hua; Hsieh, Hsiao-Yun

    2016-11-22

    The causes of post-traumatic acute kidney injury (AKI) are multifactorial, and shock associated with major trauma has been proposed to result in inadequate renal perfusion and subsequent AKI in trauma patients. This study aimed to investigate the true incidence and clinical presentation of post-traumatic AKI in hospitalized adult patients and its association with shock at a Level I trauma center. Detailed data of 78 trauma patients with AKI and 14,504 patients without AKI between January 1, 2009 and December 31, 2014 were retrieved from the Trauma Registry System. Patients with direct renal trauma were excluded from this study. Two-sided Fisher's exact or Pearson's chi-square tests were used to compare categorical data, unpaired Student's t-test was used to analyze normally distributed continuous data, and Mann-Whitney's U test was used to compare non-normally distributed data. Propensity score matching with a 1:1 ratio with logistic regression was used to evaluate the effect of shock on AKI. Patients with AKI presented with significantly older age, higher incidence rates of pre-existing comorbidities, higher odds of associated injures (subdural hematoma, intracerebral hematoma, intra-abdominal injury, and hepatic injury), and higher injury severity than patients without AKI. In addition, patients with AKI had a longer hospital stay (18.3 days vs. 9.8 days, respectively; P < 0.001) and intensive care unit (ICU) stay (18.8 days vs. 8.6 days, respectively; P < 0. 001), higher proportion of admission into the ICU (57.7% vs. 19.0%, respectively; P < 0.001), and a higher odds ratio (OR) of short-term mortality (OR 39.0; 95% confidence interval, 24.59-61.82; P < 0.001). However, logistic regression analysis of well-matched pairs after propensity score matching did not show a significant influence of shock on the occurrence of AKI. We believe that early and aggressive resuscitation, to avoid prolonged untreated shock, may help to prevent the occurrence of post-traumatic AKI. However, more evidence is required to support this observation. Compared to patients without AKI, patients with AKI presented with different injury characteristics and worse outcome. However, an association between shock and post-traumatic AKI could not be identified.

  17. HIV/AIDS Services in Private Substance Abuse Treatment Programs

    PubMed Central

    Abraham, Amanda J.; O’Brien, Lauren A.; Bride, Brian E.; Roman, Paul M.

    2010-01-01

    Background HIV infection among substance abusers is a growing concern in the United States. Little research, however, has examined the provision of HIV/AIDS services in substance abuse treatment programs. Methods This study examines the provision of onsite HIV/AIDS services in a nationally representative sample of 345 privately funded substance abuse treatment programs. Data were collected via face-to-face interviews with administrators and clinical directors of treatment programs in 2007–2008. Results Results show that larger programs and programs with a higher percentage of both African American and injection drug using (IDU) patients were more likely to offer onsite HIV/AIDS support groups and a dedicated HIV/AIDS treatment track. Multinomial logistic regression reveals that the odds of offering onsite HIV testing services were higher for hospital based programs, programs providing medical services onsite, and programs with higher percentages of African American patients, relative to the odds of offering no HIV testing or referring patients to an external provider for HIV testing services. The odds of providing onsite testing were lower for outpatient-only treatment programs, relative to the odds of offering no HIV testing or referring patients to an external provider for HIV testing services. Conclusions Our findings highlight critical barriers to the adoption of onsite HIV/AIDS services and suggest treatment programs are missing the opportunity to significantly impact HIV-related health outcomes. PMID:21145179

  18. Construct Validity of ADHD/ODD Rating Scales: Recommendations for the Evaluation of Forthcoming DSM-V ADHD/ODD Scales

    ERIC Educational Resources Information Center

    Burns, G. Leonard; Walsh, James A.; Servera, Mateu; Lorenzo-Seva, Urbano; Cardo, Esther; Rodriguez-Fornells, Antoni

    2013-01-01

    Exploratory structural equation modeling (SEM) was applied to a multiple indicator (26 individual symptom ratings) by multitrait (ADHD-IN, ADHD-HI and ODD factors) by multiple source (mothers, fathers and teachers) model to test the invariance, convergent and discriminant validity of the Child and Adolescent Disruptive Behavior Inventory with 872…

  19. Constructing exact symmetric informationally complete measurements from numerical solutions

    NASA Astrophysics Data System (ADS)

    Appleby, Marcus; Chien, Tuan-Yow; Flammia, Steven; Waldron, Shayne

    2018-04-01

    Recently, several intriguing conjectures have been proposed connecting symmetric informationally complete quantum measurements (SIC POVMs, or SICs) and algebraic number theory. These conjectures relate the SICs to their minimal defining algebraic number field. Testing or sharpening these conjectures requires that the SICs are expressed exactly, rather than as numerical approximations. While many exact solutions of SICs have been constructed previously using Gröbner bases, this method has probably been taken as far as is possible with current computer technology (except in special cases where there are additional symmetries). Here, we describe a method for converting high-precision numerical solutions into exact ones using an integer relation algorithm in conjunction with the Galois symmetries of an SIC. Using this method, we have calculated 69 new exact solutions, including nine new dimensions, where previously only numerical solutions were known—which more than triples the number of known exact solutions. In some cases, the solutions require number fields with degrees as high as 12 288. We use these solutions to confirm that they obey the number-theoretic conjectures, and address two questions suggested by the previous work.

  20. A weighted exact test for mutually exclusive mutations in cancer

    PubMed Central

    Leiserson, Mark D.M.; Reyna, Matthew A.; Raphael, Benjamin J.

    2016-01-01

    Motivation: The somatic mutations in the pathways that drive cancer development tend to be mutually exclusive across tumors, providing a signal for distinguishing driver mutations from a larger number of random passenger mutations. This mutual exclusivity signal can be confounded by high and highly variable mutation rates across a cohort of samples. Current statistical tests for exclusivity that incorporate both per-gene and per-sample mutational frequencies are computationally expensive and have limited precision. Results: We formulate a weighted exact test for assessing the significance of mutual exclusivity in an arbitrary number of mutational events. Our test conditions on the number of samples with a mutation as well as per-event, per-sample mutation probabilities. We provide a recursive formula to compute P-values for the weighted test exactly as well as a highly accurate and efficient saddlepoint approximation of the test. We use our test to approximate a commonly used permutation test for exclusivity that conditions on per-event, per-sample mutation frequencies. However, our test is more efficient and it recovers more significant results than the permutation test. We use our Weighted Exclusivity Test (WExT) software to analyze hundreds of colorectal and endometrial samples from The Cancer Genome Atlas, which are two cancer types that often have extremely high mutation rates. On both cancer types, the weighted test identifies sets of mutually exclusive mutations in cancer genes with fewer false positives than earlier approaches. Availability and Implementation: See http://compbio.cs.brown.edu/projects/wext for software. Contact: braphael@cs.brown.edu Supplementary information: Supplementary data are available at Bioinformatics online. PMID:27587696

  1. Drug Violations and Aviation Accidents: Findings from the U.S. Mandatory Drug Testing Programs

    PubMed Central

    Li, Guohua; Baker, Susan P.; Zhao, Qi; Brady, Joanne E.; Lang, Barbara H.; Rebok, George W.; DiMaggio, Charles

    2012-01-01

    Aims To assess the role of drug violations in aviation accidents. Design Case-control analysis. Setting Commercial aviation in the United States. Participants Aviation employees who were tested for drugs during 1995 through 2005 under the post-accident testing program (cases, n=4,977) or under the random testing program (controls, n=1,129,922). Measurements Point prevalence of drug violations, odds ratio of accident involvement, and attributable risk in the population. A drug violation was defined as a confirmed positive test for marijuana (≥ 50 ng/ml), cocaine (≥ 300 ng/ml), amphetamines (≥1000 ng/ml), opiates (≥ 2000 ng/ml), or phencyclidine (≥ 25 ng/ml). Findings The prevalence of drug violations was 0.64% [95% confidence interval (CI), 0.62–0.65%] in random drug tests and 1.82% (95% CI, 1.47–2.24%) in post-accident tests. The odds of accident involvement for employees who tested positive for drugs was almost three times the odds for those who tested negative (odds ratio 2.90, 95% CI, 2.35–3.57), with an estimated attributable risk of 1.2%. Marijuana accounted for 67.3% of the illicit drugs detected. The proportion of illicit drugs represented by amphetamines increased progressively during the study period, from 3.4% in 1995 to 10.3% in 2005 (p<0.0001). Conclusions Use of illicit drugs by aviation employees is associated with a significantly increased risk of accident involvement. Due to the very low prevalence, drug violations contribute to only a small fraction of aviation accidents. PMID:21306594

  2. Factors Associated with Returning At-Home Specimen Collection Kits for HIV Testing among Internet-Using Men Who Have Sex with Men.

    PubMed

    Ricca, Alexandra V; Hall, Eric W; Khosropour, Christine M; Sullivan, Patrick S

    2016-11-01

    In the United States, men who have sex with men (MSM) are known to disproportionately have HIV. The authors sought to describe the acceptability of providing at-home dried blood spot specimen collection kits for HIV testing among MSM. Between August 2010 and December 2010, the authors recruited Internet-using, HIV-negative or -unknown MSM to participate in a 12-month study of behavioral risks. Eligible participants were mailed an at-home HIV test. Of the 896 men who were sent a test kit, 735 (82%) returned the kit. Returning a test kit was significantly associated with race (P = .002), highest level of education (P = .012), and annual income (P = .026). The adjusted odds of black, non-Hispanic men returning a test kit were about half of the odds of white, non-Hispanic men returning a test kit (adjusted odds ratios: 0.49; 95% confidence intervals: 0.31-0.78). Men who have sex with men are willing to provide biological specimens as part of an Internet-based HIV prevention study. © The Author(s) 2016.

  3. A revisit to contingency table and tests of independence: bootstrap is preferred to Chi-square approximations as well as Fisher's exact test.

    PubMed

    Lin, Jyh-Jiuan; Chang, Ching-Hui; Pal, Nabendu

    2015-01-01

    To test the mutual independence of two qualitative variables (or attributes), it is a common practice to follow the Chi-square tests (Pearson's as well as likelihood ratio test) based on data in the form of a contingency table. However, it should be noted that these popular Chi-square tests are asymptotic in nature and are useful when the cell frequencies are "not too small." In this article, we explore the accuracy of the Chi-square tests through an extensive simulation study and then propose their bootstrap versions that appear to work better than the asymptotic Chi-square tests. The bootstrap tests are useful even for small-cell frequencies as they maintain the nominal level quite accurately. Also, the proposed bootstrap tests are more convenient than the Fisher's exact test which is often criticized for being too conservative. Finally, all test methods are applied to a few real-life datasets for demonstration purposes.

  4. Correlates of HIV Testing Among Abused Women in South Africa

    PubMed Central

    Adams, Julie L.; Hansen, Nathan B.; Fox, Ashley M.; Taylor, Baishakhi B.; van Rensburg, Madri Jansen; Mohlahlane, Rakgadi; Sikkema, Kathleen J.

    2012-01-01

    Gender-based violence increases a woman’s risk for HIV but little is known about her decision to get tested. We interviewed 97 women seeking abuse-related services from a nongovernmental organization (NGO) in Johannesburg, South Africa. Forty-six women (47%) had been tested for HIV. Caring for children (odds ratio [OR] = 0.27, 95% confidence interval [CI] = [0.07, 1.00]) and conversing with partner about HIV (OR = 0.13, 95% CI = [0.02, 0.85]) decreased odds of testing. Stronger risk-reduction intentions (OR = 1.27, 95% CI = [1.01, 1.60]) and seeking help from police (OR = 5.51, 95% CI = [1.18, 25.76]) increased odds of testing. Providing safe access to integrated services and testing may increase testing in this population. Infection with HIV is highly prevalent in South Africa where an estimated 16.2% of adults between the ages of 15 and 49 have the virus. The necessary first step to stemming the spread of HIV and receiving life-saving treatment is learning one’s HIV serostatus through testing. Many factors may contribute to someone’s risk of HIV infection and many barriers may prevent testing. One factor that does both is gender-based violence. PMID:21727154

  5. SNAP-Based Incentive Programs at Farmers' Markets: Adaptation Considerations for Temporary Assistance for Needy Families (TANF) Recipients.

    PubMed

    Wetherill, Marianna S; Williams, Mary B; Gray, Karen A

    2017-10-01

    To describe the design, implementation, and consumer response to a coupon-style intervention aimed to increase Supplemental Nutrition Assistance Program (SNAP) use at a farmers' market (FM) among Temporary Assistance for Needy Families (TANF) participants. A quasi-experimental trial to evaluate redemption response to 2 coupon interventions; baseline surveys characterized coupon redeemers and non-redeemers. Urban. The TANF recipients were assigned to either a plain (n = 124) or targeted marketing coupon intervention (n = 130). Both groups received 10 $2 coupons to double fruit and vegetable SNAP purchases at the FM. The targeted marketing group also received an oral presentation designed to reduce perceived barriers to FM use. Coupon redemption. The researchers used t tests and chi-square/Fisher exact tests to examine associations between redeemers and non-redeemers; logistic regression was used to adjust for the intervention. No male and few female participants redeemed coupons (6.3%). Among women, those with knowledge of vegetable preparation were 3 times more likely to redeem coupons than were those with little or no knowledge (odds ratio = 3.77; 95% confidence interval, 1.03-13.77). Stand-alone coupon incentive programs may not be a high-reach strategy for encouraging FM use among the population using TANF. Complementary strategies to build vegetable preparation knowledge and skills are needed. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  6. Association between IL-1β polymorphisms and gastritis risk: A meta-analysis.

    PubMed

    Sun, Xiaoming; Cai, Hongxing; Li, Zhouru; Li, Shanshan; Yin, Wenjiang; Dong, Guokai; Kuai, Jinxia; He, Yihui; Jia, Jing

    2017-02-01

    Helicobacter pylori (H. pylori) infection of the human stomach regularly leads to chronic gastric inflammation. The cytokine gene interleukin (IL)-1β has been implicated in influencing the pathology of inflammation induced by H. pylori infection. Currently, several studies have been carried out to investigate the association of IL-1β-511 (rs16944) and IL-1β-31 (rs1143627) polymorphisms with gastritis risk; however, the results are inconsistent and inconclusive. To assess the effect of IL-1β polymorphisms on gastritis susceptibility, we conducted a meta-analysis. Up to March 15, 2016, 2205 cases and 2289 controls were collected from 12 published case-control studies. Summarized odds ratios and corresponding 95% confidence intervals (CIs) for IL-1β-511 and IL-1β-31 polymorphisms and gastritis risk were estimated using fixed- or random-effects models when appropriate. Heterogeneity was assessed by chi-squared-based Q-statistic test, and the sources of heterogeneity were explored by subgroup analyses and logistic meta-regression analyses. Publication bias was evaluated by Begg funnel plot and Egger test. Sensitivity analyses were also performed. The results provided evidences that the single nucleotide polymorphisms (SNPs) in IL-1β-31 might be associated with the gastritis risk, especially in the Caucasian population, while SNPs in the IL-1β-511 might not be. Our studies may be helpful in supplementing the disease monitoring of gastritis in the future, and additional studies to determine the exact molecular mechanisms might inspire interventions to protect the susceptible subgroups.

  7. Incidence and risk factors for retinopathy of prematurity in a Brazilian reference service.

    PubMed

    Gonçalves, Eduardo; Násser, Luciano Sólia; Martelli, Daniella Reis; Alkmim, Isadora Ramos; Mourão, Thalita Veloso; Caldeira, Antônio Prates; Martelli, Hercílio

    2014-01-01

    Retinopathy of prematurity (ROP) is a known cause of blindness in which diagnosis and timely treatment can prevent serious harm to the child. This study aimed to evaluate the incidence of ROP and its association with known risk factors. Longitudinal incidence study in the neonatal intensive care unit (NICU) of Universidade Estadual de Montes Claros. Newborns admitted to the NICU with gestational age less than 32 weeks and/or birth weight less than 1,500 grams, were followed up over a two-year period. The assessment and diagnosis of ROP were defined in accordance with a national protocol. The chi-square test or Fisher's exact test were used to determine associations between independent variables and ROP. Analysis on the independent effect of the variables on the results was performed using multiple logistic regression. The incidence of ROP was 44.5% (95% confidence interval, CI = 35.6-46.1) in the study population. The risk factors associated with the risk of developing the disease were: birth weight less than 1,000 grams (odds ratio, OR = 4.14; 95% CI = 1.34-12.77); gestational age less than 30 weeks (OR = 6.69; 95% CI = 2.10-21.31); use of blood derivatives (OR = 4.14; 95% CI = 2.99-8.99); and presence of sepsis (OR = 1.99; 95% CI = 1.45-2.40). The incidence of ROP was higher than that found in the literature. The main risk factors were related to extreme prematurity.

  8. Child rearing practices amongst brothel based commercial sex workers.

    PubMed

    Pardeshi, Geeta; Bhattacharya, S

    2006-07-01

    The experiences of the commercial sex workers as they fulfill the role of being a parent, have rarely been reported. Considering their socioeconomic background, profession and work pattern, the women are bound to face major challenges. To describe child bearing, family support, dietary practices and various placement options for raising children. A cross-sectional descriptive study of brothel-based commercial sex workers. X2 test, Fisher's Exact test. Some commercial sex workers continued pregnancy with the hope of security and support, while others were compelled to do so, as they report late for medical termination of pregnancy. A group of sex workers (Devdasis) received support during pregnancy, delivery, puerperium and child-rearing. The role and responsibilities of raising the child, depended upon the kind of family support available to the mothers. Being a single parent, stigma of the profession, odd working hours and variable family support were major challenges, while the fact that the women were earning, availability of rehabilitation centers, the homogeneous groups within the brothels, supportive peers and local non governmental organizations were factors which helped them in the process of raising their children. Day care centers and night shelters should be opened up in the red light area where the children can be looked after, during the working hours. The sex workers should be educated about weaning and nutrition. The role of peer workers and NGOs was very important in helping the women raise their children.

  9. Body image dissatisfaction and anthropometric indicators in male children and adolescents.

    PubMed

    Ferrari, E P; Minatto, G; Berria, J; Silva, S F Dos S; Fidelix, Y L; Ribeiro, R R; Santos, K D; Petroski, E L

    2015-10-01

    The aim of this study was to investigate the association between body image dissatisfaction and body mass index (BMI) and body fat percentage (BF%) and to identify which of these anthropometric indicators are more strongly associated, and finally to estimate the prevalence of overweight and high body adiposity in male children and adolescents, according to maturational stages. Overall, 1499 students aged from 7 to 17 years from Cascavel, PR, Brazil, were evaluated. Body image was self-rated through the body silhouette scale. Body weight, height and triceps and subscapular skinfolds were measured and BMI and BF% were calculated. Sexual maturity was self-assessed by the development of pubic hair. Data analysis used the Fisher exact test, the χ(2)-test and multinomial logistic regression. Body image dissatisfaction because of excess weight was associated with BMI and BF%, whereas in prepubertal students, this association did not remain in the adjusted analysis. In pubescent students, both BMI (odds ratio (OR)=5.25, confidence interval (CI) 95%=3.06-9.01) and BF% (OR=2.42, CI 95%=1.60-3.66), and in post-pubescent students for BMI (OR=3.77, CI 95%=1.33-10.70), the association remained. Body image dissatisfaction because of thinness was associated only with BF% in pubescent (OR=0.50, CI 95%= 0.33-0.75) and post-pubescent students (OR=0.38, CI 95%= 0.16-0.94). Body image dissatisfaction was associated with BMI and BF%, especially in pubescent and post-pubescent students.

  10. Exact deconstruction of the 6D (2,0) theory

    NASA Astrophysics Data System (ADS)

    Hayling, J.; Papageorgakis, C.; Pomoni, E.; Rodríguez-Gómez, D.

    2017-06-01

    The dimensional-deconstruction prescription of Arkani-Hamed, Cohen, Kaplan, Karch and Motl provides a mechanism for recovering the A-type (2,0) theories on T 2, starting from a four-dimensional N=2 circular-quiver theory. We put this conjecture to the test using two exact-counting arguments: in the decompactification limit, we compare the Higgs-branch Hilbert series of the 4D N=2 quiver to the "half-BPS" limit of the (2,0) superconformal index. We also compare the full partition function for the 4D quiver on S 4 to the (2,0) partition function on S 4 × T 2. In both cases we find exact agreement. The partition function calculation sets up a dictionary between exact results in 4D and 6D.

  11. Low utilization of HIV testing during pregnancy: What are the barriers to HIV testing for women in rural India?

    PubMed

    Sinha, Gita; Dyalchand, Ashok; Khale, Manisha; Kulkarni, Gopal; Vasudevan, Shubha; Bollinger, Robert C

    2008-02-01

    Sixty percent of India's HIV cases occur in rural residents. Despite government policy to expand antenatal HIV screening and prevention of maternal-to-child transmission (PMTCT), little is known about HIV testing among rural women during pregnancy. Between January and March 2006, a cross-sectional sample of 400 recently pregnant women from rural Maharashtra was administered a questionnaire regarding HIV awareness, risk, and history of antenatal HIV testing. Thirteen women (3.3%) reported receiving antenatal HIV testing. Neither antenatal care utilization nor history of sexually transmitted infection (STI) symptoms influenced odds of receiving HIV testing. Women who did not receive HIV testing, compared with women who did, were 95% less likely to have received antenatal HIV counseling (odds ratio = 0.05, 95% confidence interval: 0.02 to 0.17) and 80% less aware of an existing HIV testing facility (odds ratio = 0.19, 95% confidence interval: 0.04 to 0.75). Despite measurable HIV prevalence, high antenatal care utilization, and STI symptom history, recently pregnant rural Indian women report low HIV testing. Barriers to HIV testing during pregnancy include lack of discussion by antenatal care providers and lack of awareness of existing testing services. Provider-initiated HIV counseling and testing during pregnancy would optimize HIV prevention for women throughout rural India.

  12. Evolution of nuclear structure in neutron-rich odd-Zn isotopes and isomers

    NASA Astrophysics Data System (ADS)

    Wraith, C.; Yang, X. F.; Xie, L.; Babcock, C.; Bieroń, J.; Billowes, J.; Bissell, M. L.; Blaum, K.; Cheal, B.; Filippin, L.; Garcia Ruiz, R. F.; Gins, W.; Grob, L. K.; Gaigalas, G.; Godefroid, M.; Gorges, C.; Heylen, H.; Honma, M.; Jönsson, P.; Kaufmann, S.; Kowalska, M.; Krämer, J.; Malbrunot-Ettenauer, S.; Neugart, R.; Neyens, G.; Nörtershäuser, W.; Nowacki, F.; Otsuka, T.; Papuga, J.; Sánchez, R.; Tsunoda, Y.; Yordanov, D. T.

    2017-08-01

    Collinear laser spectroscopy was performed on Zn (Z = 30) isotopes at ISOLDE, CERN. The study of hyperfine spectra of nuclei across the Zn isotopic chain, N = 33- 49, allowed the measurement of nuclear spins for the ground and isomeric states in odd-A neutron-rich nuclei up to N = 50. Exactly one long-lived (>10 ms) isomeric state has been established in each 69-79Zn isotope. The nuclear magnetic dipole moments and spectroscopic quadrupole moments are well reproduced by large-scale shell-model calculations in the f5pg9 and fpg9d5 model spaces, thus establishing the dominant term in their wave function. The magnetic moment of the intruder Iπ = 1 /2+ isomer in 79Zn is reproduced only if the νs1/2 orbital is added to the valence space, as realized in the recently developed PFSDG-U interaction. The spin and moments of the low-lying isomeric state in 73Zn suggest a strong onset of deformation at N = 43, while the progression towards 79Zn points to the stability of the Z = 28 and N = 50 shell gaps, supporting the magicity of 78Ni.

  13. Multi-instantons and exact results III: Unification of even and odd anharmonic oscillators

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

    Jentschura, Ulrich D.; Surzhykov, Andrey; GSI Helmholtzzentrum fuer Schwerionenforschung, 64291 Darmstadt

    2010-05-15

    This is the third article in a series of three papers on the resonance energy levels of anharmonic oscillators. Whereas the first two papers mainly dealt with double-well potentials and modifications thereof [see J. Zinn-Justin, U.D. Jentschura, Ann. Phys. (N.Y.) 313 (2004) 197 and 269], we here focus on simple even and odd anharmonic oscillators for arbitrary magnitude and complex phase of the coupling parameter. A unification is achieved by the use of PT-symmetry inspired dispersion relations and generalized quantization conditions that include instanton configurations. Higher-order formulas are provided for the oscillators of degrees 3 to 8, which lead tomore » subleading corrections to the leading factorial growth of the perturbative coefficients describing the resonance energies. Numerical results are provided, and higher-order terms are found to be numerically significant. The resonances are described by generalized expansions involving intertwined nonanalytic exponentials, logarithmic terms and power series. Finally, we summarize spectral properties and dispersion relations of anharmonic oscillators, and their interconnections. The purpose is to look at one of the classic problems of quantum theory from a new perspective, through which we gain systematic access to the phenomenologically significant higher-order terms.« less

  14. Dietary Intake, Nutritional Status, and Body Composition in Children With End-Stage Kidney Disease on Hemodialysis or Peritoneal Dialysis.

    PubMed

    Pontón-Vázquez, Consuelo; Vásquez-Garibay, Edgar Manuel; Hurtado-López, Erika Fabiola; de la Torre Serrano, Adriana; García, Germán Patiño; Romero-Velarde, Enrique

    2017-05-01

    This study aimed to demonstrate that dietary intake, anthropometric indicators, and body composition in children with end-stage kidney disease differs between those on peritoneal dialysis (PD) and those on hemodialysis (HD). This was a cross-sectional and consecutive study that included 55 children and adolescents with end-stage kidney disease who were undergoing replacement therapy (22 PD patients and 33 HD patients). Two 24-hour dietary recall surveys were conducted for each patient. Anthropometric, biochemical, and body composition indicators were estimated. A Student's t-test and a Mann-Whitney U test were used for the parametric variables, whereas association tests were estimated for the nonparametric variables (i.e., χ 2 , Fisher exact test, and odds ratio). Regression models were designed to predict dietary intake on anthropometric and body composition indicators. The mid-upper arm circumference was greater on the patients undergoing HD than on the PD patients (odds ratio = 15.8 [95% confidence interval (CI): 2.9, 85.1], P < .001); the arm muscular area was greater in the HD patients than in the PD patients (P = .07). Children on PD had significantly greater creatinine concentration (8.4 ± 3.0 mg/dL vs. 4.6 ± 1.2 mg/dL, P < .001), urea (101 ± 27 mg/dL vs. 50 ± 17 mg/dL, P < .001), and glucose (87 ± 14.4 mg/dL vs. 77 ± 10.2 mg/dL, P = .003). Children on PD had lower lipid intake (31.2 ± 15.8 vs. 40.9 ± 19.1 g/day, P = .032), lower percentage of adequacy of vitamin C (128 ± 66 vs. 146 ± 70, P = .046), and lower sodium (62 ± 43 vs. 79 ± 42, P = .044) than children on HD. Dietary intake predicted 40% to 80% of the variability in the nutritional status in children on PD and 28% to 60% in children on HD. Nutritional status is affected in most patients on dialysis treatment, which differs significantly among those who are undergoing PD or HD. Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  15. Assessing changes in knowledge, attitude and practices on dengue diagnosis and management among primary care physicians after the largest dengue epidemic in Singapore.

    PubMed

    Pang, Junxiong; Hildon, Zoe Jane-Lara; Thein, Tun Linn; Jin, Jing; Leo, Yee Sin

    2017-06-15

    Dengue results in high morbidity and mortality globally. The knowledge, attitude and practices (KAP) of dengue management, including diagnosis, among primary care physicians (PCPs) are important to reduce dengue transmission and burden. However, there is a lack of understanding on the impact of dengue epidemic on dengue management. Hence, the aim of this study is to examine the changes in KAP on dengue management among PCPs before and after the largest dengue epidemic in 2013 in Singapore. Surveys were mailed to 2000 and 1514 PCPs registered under the Singapore Medical Council in March of year 2011 and 2014, respectively. Survey data were then collected between April and June of that year. Chi-square or Fisher's exact test was used for comparing categorical variables. A multivariate logistic regression model was implemented to determine independent factors for frequent use of dengue diagnostic tests (DDTs). All tests were conducted at 5% level of significance. Adjusted odds ratio and corresponding 95% confidence intervals were reported, where applicable. Qualitative data were descriptively coded for themes and analysis. Among PCPs surveyed in 2011 and 2014, 89.9% and 86% had good knowledge on dengue management respectively. The usage of DDTs had increased significantly in 2014 (N = 164;56%) as compared to 2011 (N = 107;29.5%) in both private and public clinics (p < 0.001). Dengue Duo point-of-care test (POCT) kits was independently associated with frequent use of DDTs (adjusted odds ratio = 2.15; 95% confidence interval = 1.25-3.69). There was a significant reduction in referral of dengue patients to hospital (31.4% in 2011; 13.3% in 2014; p < 0.001), and a significant increase in frequency of clinic follow-ups (18.4% in 2011; 28.5% in 2014; p = 0.003). One key theme highlighted was that dengue management can be improved with availability of POCT kit, better awareness of the disease and any revised clinical guidelines. The knowledge on dengue management remained high, while the attitude and practices, particularly on the usage of DDTs improved significantly after a large epidemic. Furthermore, PCPs had more confident in managing dengue patients in primary care settings and in educating patients on the importance of vector control and dengue warning signs to reduce dengue transmission and burden.

  16. Dieting and smoking initiation in early adolescent girls and boys: a prospective study.

    PubMed Central

    Austin, S B; Gortmaker, S L

    2001-01-01

    OBJECTIVES: This analysis tested the relation between dieting frequency and risk of smoking initiation in a longitudinal sample of adolescents. METHODS: From 1995 to 1997, 1295 middle school girls and boys participated in a nutrition and physical activity intervention study. The prospective association between dieting frequency at baseline and smoking initiation 2 years later was tested. RESULTS: Compared with girls who reported no dieting at baseline, girls who dieted up to once per week had 2 times the adjusted odds of becoming smokers (odds ratio = 2.0; 95% confidence interval = 1.1, 3.5), and girls who dieted more often had 4 times the adjusted odds of becoming smokers (odds ratio = 3.9; 95% confidence interval = 1.5, 10.4). CONCLUSIONS: Dieting among girls may exacerbate risk of initiating smoking, with increasing risk with greater dieting frequency. PMID:11236412

  17. Electronic medical record features and seven quality of care measures in physician offices.

    PubMed

    Hsiao, Chun-Ju; Marsteller, Jill A; Simon, Alan E

    2014-01-01

    The effect of electronic medical records (EMRs) on quality of care in physicians' offices is uncertain. This study used the 2008-2009 National Ambulatory Medical Care Survey to examine the relationship between EMRs features and quality in physician offices. The relationship between selected EMRs features and 7 quality measures was evaluated by testing 25 associations in multivariate models. Significant relationships include reminders for guideline-based interventions or screening tests associated with lower odds of inappropriate urinalysis and prescription of antibiotics for upper respiratory infection (URI), prescription order entry associated with lower odds of prescription of antibiotics for URI, and patient problem list associated with higher odds of inappropriate prescribing for elderly patients. EMRs system level was associated with lower odds of blood pressure check, inappropriate urinalysis, and prescription of antibiotics for URI compared with no EMRs. The results show both positive and inverse relationships between EMRs features and quality of care.

  18. History of falls, gait, balance, and fall risks in older cancer survivors living in the community.

    PubMed

    Huang, Min H; Shilling, Tracy; Miller, Kara A; Smith, Kristin; LaVictoire, Kayle

    2015-01-01

    Older cancer survivors may be predisposed to falls because cancer-related sequelae affect virtually all body systems. The use of a history of falls, gait speed, and balance tests to assess fall risks remains to be investigated in this population. This study examined the relationship of previous falls, gait, and balance with falls in community-dwelling older cancer survivors. At the baseline, demographics, health information, and the history of falls in the past year were obtained through interviewing. Participants performed tests including gait speed, Balance Evaluation Systems Test, and short-version of Activities-specific Balance Confidence scale. Falls were tracked by mailing of monthly reports for 6 months. A "faller" was a person with ≥1 fall during follow-up. Univariate analyses, including independent sample t-tests and Fisher's exact tests, compared baseline demographics, gait speed, and balance between fallers and non-fallers. For univariate analyses, Bonferroni correction was applied for multiple comparisons. Baseline variables with P<0.15 were included in a forward logistic regression model to identify factors predictive of falls with age as covariate. Sensitivity and specificity of each predictor of falls in the model were calculated. Significance level for the regression analysis was P<0.05. During follow-up, 59% of participants had one or more falls. Baseline demographics, health information, history of falls, gaits speed, and balance tests did not differ significantly between fallers and non-fallers. Forward logistic regression revealed that a history of falls was a significant predictor of falls in the final model (odds ratio =6.81; 95% confidence interval =1.594-29.074) (P<0.05). Sensitivity and specificity for correctly identifying a faller using the positive history of falls were 74% and 69%, respectively. Current findings suggested that for community-dwelling older cancer survivors with mixed diagnoses, asking about the history of falls may help detect individuals at risk of falling.

  19. History of falls, gait, balance, and fall risks in older cancer survivors living in the community

    PubMed Central

    Huang, Min H; Shilling, Tracy; Miller, Kara A; Smith, Kristin; LaVictoire, Kayle

    2015-01-01

    Older cancer survivors may be predisposed to falls because cancer-related sequelae affect virtually all body systems. The use of a history of falls, gait speed, and balance tests to assess fall risks remains to be investigated in this population. This study examined the relationship of previous falls, gait, and balance with falls in community-dwelling older cancer survivors. At the baseline, demographics, health information, and the history of falls in the past year were obtained through interviewing. Participants performed tests including gait speed, Balance Evaluation Systems Test, and short-version of Activities-specific Balance Confidence scale. Falls were tracked by mailing of monthly reports for 6 months. A “faller” was a person with ≥1 fall during follow-up. Univariate analyses, including independent sample t-tests and Fisher’s exact tests, compared baseline demographics, gait speed, and balance between fallers and non-fallers. For univariate analyses, Bonferroni correction was applied for multiple comparisons. Baseline variables with P<0.15 were included in a forward logistic regression model to identify factors predictive of falls with age as covariate. Sensitivity and specificity of each predictor of falls in the model were calculated. Significance level for the regression analysis was P<0.05. During follow-up, 59% of participants had one or more falls. Baseline demographics, health information, history of falls, gaits speed, and balance tests did not differ significantly between fallers and non-fallers. Forward logistic regression revealed that a history of falls was a significant predictor of falls in the final model (odds ratio =6.81; 95% confidence interval =1.594–29.074) (P<0.05). Sensitivity and specificity for correctly identifying a faller using the positive history of falls were 74% and 69%, respectively. Current findings suggested that for community-dwelling older cancer survivors with mixed diagnoses, asking about the history of falls may help detect individuals at risk of falling. PMID:26425079

  20. The escape of high explosive products: An exact-solution problem for verification of hydrodynamics codes

    DOE PAGES

    Doebling, Scott William

    2016-10-22

    This paper documents the escape of high explosive (HE) products problem. The problem, first presented by Fickett & Rivard, tests the implementation and numerical behavior of a high explosive detonation and energy release model and its interaction with an associated compressible hydrodynamics simulation code. The problem simulates the detonation of a finite-length, one-dimensional piece of HE that is driven by a piston from one end and adjacent to a void at the other end. The HE equation of state is modeled as a polytropic ideal gas. The HE detonation is assumed to be instantaneous with an infinitesimal reaction zone. Viamore » judicious selection of the material specific heat ratio, the problem has an exact solution with linear characteristics, enabling a straightforward calculation of the physical variables as a function of time and space. Lastly, implementation of the exact solution in the Python code ExactPack is discussed, as are verification cases for the exact solution code.« less

  1. Two simple clinical tests for predicting onset of medial tibial stress syndrome: shin palpation test and shin oedema test.

    PubMed

    Newman, Phil; Adams, Roger; Waddington, Gordon

    2012-09-01

    To examine the relationship between two clinical test results and future diagnosis of (Medial Tibial Stress Syndrome) MTSS in personnel at a military trainee establishment. Data from a preparticipation musculoskeletal screening test performed on 384 Australian Defence Force Academy Officer Cadets were compared against 693 injuries reported by 326 of the Officer Cadets in the following 16 months. Data were held in an Injury Surveillance database and analysed using χ² and Fisher's Exact tests, and Receiver Operating Characteristic Curve analysis. Diagnosis of MTSS, confirmed by an independent blinded health practitioner. Both the palpation and oedema clinical tests were each found to be significant predictors for later onset of MTSS. Specifically: Shin palpation test OR 4.63, 95% CI 2.5 to 8.5, Positive Likelihood Ratio 3.38, Negative Likelihood Ratio 0.732, Pearson χ² p<0.001; Shin oedema test OR 76.1 95% CI 9.6 to 602.7, Positive Likelihood Ratio 7.26, Negative Likelihood Ratio 0.095, Fisher's Exact p<0.001; Combined Shin Palpation Test and Shin Oedema Test Positive Likelihood Ratio 7.94, Negative Likelihood Ratio <0.001, Fisher's Exact p<0.001. Female gender was found to be an independent risk factor (OR 2.97, 95% CI 1.66 to 5.31, Positive Likelihood Ratio 2.09, Negative Likelihood Ratio 0.703, Pearson χ² p<0.001) for developing MTSS. The tests for MTSS employed here are components of a normal clinical examination used to diagnose MTSS. This paper confirms that these tests and female gender can also be confidently applied in predicting those in an asymptomatic population who are at greater risk of developing MTSS symptoms with activity at some point in the future.

  2. Epidemiology of Human Papillomavirus Detected in the Oral Cavity and Fingernails of Mid-Adult Women.

    PubMed

    Fu, Tsung-chieh Jane; Hughes, James P; Feng, Qinghua; Hulbert, Ayaka; Hawes, Stephen E; Xi, Long Fu; Schwartz, Stephen M; Stern, Joshua E; Koutsky, Laura A; Winer, Rachel L

    2015-12-01

    Oral and fingernail human papillomavirus (HPV) detection may be associated with HPV-related carcinoma risk at these nongenital sites and foster transmission to the genitals. We describe the epidemiology of oral and fingernail HPV among mid-adult women. Between 2011 and 2012, 409 women aged 30 to 50 years were followed up for 6 months. Women completed health and behavior surveys and provided self-collected oral, fingernail, and vaginal specimens at enrollment and exit for type-specific HPV DNA testing. Concordance of type-specific HPV detection across anatomical sites was described with κ statistics. Using generalized estimating equations or exact logistic regression, we measured the univariate associations of various risk factors with type-specific oral and fingernail HPV detection. Prevalence of detecting HPV in the oral cavity (2.4%) and fingernails (3.8%) was low compared with the vagina (33.1%). Concordance across anatomical sites was poor (κ < 0.20 for all comparisons). However, concurrent vaginal infection with the same HPV type (odds ratio [OR], 101.0; 95% confidence interval [CI], 31.4-748.6) and vaginal HPV viral load (OR per 1 log10 viral load increase, 2.2; 95% CI, 1.5-5.5) were each associated with fingernail HPV detection. Abnormal Papanicolaou history (OR, 11.1; 95% CI, 2.8-infinity), lifetime number of male vaginal sex partners at least 10 (OR vs. 0-3 partners, 5.0; 95% CI, 1.2-infinity), and lifetime number of open-mouth kissing partners at least 16 (OR vs. 0-15 partners, infinity; 95% CI, 2.6-infinity, by exact logistic regression) were each associated with oral HPV detection. Although our findings support HPV DNA deposition or autoinoculation between anatomical sites in mid-adult women, the rarity of HPV in the oral cavity and fingernails suggests that oral/fingernail HPV does not account for a significant fraction of HPV in genital sites.

  3. Risk factors for the breakdown of perineal laceration repair after vaginal delivery.

    PubMed

    Williams, Meredith K; Chames, Mark C

    2006-09-01

    The purpose of this study was to identify risk factors that are associated with the breakdown of perineal laceration repair in the postpartum period. We conducted a retrospective, case-control study to review perineal laceration repair breakdown in patients who were delivered between September 1995 and February 2005 at the University of Michigan. Bivariate analysis with chi-square test and t-test and stepwise logistic regression analysis were performed. Fifty-nine cases and 118 control deliveries were identified from a total of 14,124 vaginal deliveries. Risk factors were longer second stage of labor (142 vs 87 minutes; P = .001), operative vaginal delivery (odds ratio, 3.6; 95% CI, 1.8-7.3), mediolateral episiotomy (odds ratio, 6.9; 95% CI, 2.6-18.7), third- or fourth-degree laceration (odds ratio, 3.1; 95% CI, 1.5-6.4), and meconium-stained amniotic fluid (odds ratio, 3.0; 95% CI, 1.1-7.9). Previous vaginal delivery was protective (odds ratio, 0.38; 95% CI, 0.18-0.84). Logistic regression showed the most significant factor to be an interaction between operative vaginal delivery and mediolateral episiotomy (odd ratio, 6.36; 95% CI, 2.18-18.57). The most significant events were mediolateral episiotomy, especially in conjunction with operative vaginal delivery, third- and fourth-degree lacerations, and meconium.

  4. Nonalgebraic integrability of one reversible dynamical system of the Cremona type

    NASA Astrophysics Data System (ADS)

    Rerikh, K. V.

    1998-05-01

    A reversible dynamical system (RDS) and a system of nonlinear functional equations, defined by a certain rational quadratic Cremona mapping and arising from the static model of the dispersion approach in the theory of strong interactions [the Chew-Low-type equations with crossing-symmetry matrix A(l,1)], are considered. This RDS is split into one- and two-dimensional ones. An explicit Cremona transformation that completely determines the exact solution of the two-dimensional system is found. This solution depends on an odd function satisfying a nonlinear autonomous three-point functional equation. Nonalgebraic integrability of RDS under consideration is proved using the method of Poincaré normal forms and the Siegel theorem on biholomorphic linearization of a mapping at a nonresonant fixed point.

  5. Nonequilibrium Energy Transfer at Nanoscale: A Unified Theory from Weak to Strong Coupling

    NASA Astrophysics Data System (ADS)

    Wang, Chen; Ren, Jie; Cao, Jianshu

    2015-07-01

    Unraveling the microscopic mechanism of quantum energy transfer across two-level systems provides crucial insights to the optimal design and potential applications of low-dimensional nanodevices. Here, we study the non-equilibrium spin-boson model as a minimal prototype and develop a fluctuation-decoupled quantum master equation approach that is valid ranging from the weak to the strong system-bath coupling regime. The exact expression of energy flux is analytically established, which dissects the energy transfer as multiple boson processes with even and odd parity. Our analysis provides a unified interpretation of several observations, including coherence-enhanced heat flux and negative differential thermal conductance. The results will have broad implications for the fine control of energy transfer in nano-structural devices.

  6. Generalization of Faddeev-Popov rules in Yang-Mills theories: N = 3,4 BRST symmetries

    NASA Astrophysics Data System (ADS)

    Reshetnyak, Alexander

    2018-01-01

    The Faddeev-Popov rules for a local and Poincaré-covariant Lagrangian quantization of a gauge theory with gauge group are generalized to the case of an invariance of the respective quantum actions, S(N), with respect to N-parametric Abelian SUSY transformations with odd-valued parameters λp, p = 1,…,N and generators sp: spsq + sqsp = 0, for N = 3, 4, implying the substitution of an N-plet of ghost fields, Cp, instead of the parameter, ξ, of infinitesimal gauge transformations: ξ = Cpλ p. The total configuration spaces of fields for a quantum theory of the same classical model coincide in the N = 3 and N = 4 symmetric cases. The superspace of N = 3 SUSY irreducible representation includes, in addition to Yang-Mills fields 𝒜μ, (3 + 1) ghost odd-valued fields Cp, B̂ and 3 even-valued Bpq for p, q = 1, 2, 3. To construct the quantum action, S(3), by adding to the classical action, S0(𝒜), of an N = 3-exact gauge-fixing term (with gauge fermion), a gauge-fixing procedure requires (1 + 3 + 3 + 1) additional fields, Φ¯(3): antighost C¯, 3 even-valued Bp, 3 odd-valued B̂pq and Nakanishi-Lautrup B fields. The action of N = 3 transformations on new fields as N = 3-irreducible representation space is realized. These transformations are the N = 3 BRST symmetry transformations for the vacuum functional, Z3(0) =∫dΦ(3)dΦ¯(3)exp{(ı/ℏ)S(3)}. The space of all fields (Φ(3),Φ¯(3)) proves to be the space of an irreducible representation of the fields Φ(4) for N = 4-parametric SUSY transformations, which contains, in addition to 𝒜μ the (4 + 6 + 4 + 1) ghost-antighost, Cr = (Cp,C¯), even-valued, Brs = -Bsr = (Bpq,Bp4 = Bp), odd-valued B̂r = (B̂,B̂pq) and B fields. The quantum action is constructed by adding to S0(𝒜) an N = 4-exact gauge-fixing term with a gauge boson, F(4). The N = 4 SUSY transformations are by N = 4 BRST transformations for the vacuum functional, Z4(0) =∫dΦ(4)exp{(ı/ℏ)S(4)}. The procedures are valid for any admissible gauge. The equivalence with N = 1 BRST-invariant quantization method is explicitly found. The finite N = 3, 4 BRST transformations are derived and the Jacobians for a change of variables related to them but with field-dependent parameters in the respective path integral are calculated. They imply the presence of a corresponding modified Ward identity related to a new form of the standard Ward identities and describe the problem of a gauge-dependence. An introduction into diagrammatic Feynman techniques for N = 3, 4 BRST invariant quantum actions for Yang-Mills theory is suggested.

  7. Clinical and Radiologic Predictive Factors of Rib Fractures in Outpatients With Chest Pain.

    PubMed

    Zhang, Liang; McMahon, Colm J; Shah, Samir; Wu, Jim S; Eisenberg, Ronald L; Kung, Justin W

    To identify the clinical and radiologic predictive factors of rib fractures in stable adult outpatients presenting with chest pain and to determine the utility of dedicated rib radiographs in this population of patients. Following Institutional Review Board approval, we performed a retrospective review of 339 consecutive cases in which a frontal chest radiograph and dedicated rib series had been obtained for chest pain in the outpatient setting. The frontal chest radiograph and dedicated rib series were sequentially reviewed in consensus by two fellowship-trained musculoskeletal radiologists blinded to the initial report. The consensus interpretation of the dedicated rib series was used as the gold standard. Multiple variable logistic regression analysis assessed clinical and radiological factors associated with rib fractures. Fisher exact test was used to assess differences in medical treatment between the 2 groups. Of the 339 patients, 53 (15.6%) had at least 1 rib fracture. Only 20 of the 53 (37.7%) patients' fractures could be identified on the frontal chest radiograph. The frontal chest radiograph had a sensitivity of 38% and specificity of 100% when using the rib series as the reference standard. No pneumothorax, new mediastinal widening or pulmonary contusion was identified. Multiple variable logistic regression analysis of clinical factors associated with the presence of rib fractures revealed a significant association of trauma history (odds ratio 5.7 [p < 0.05]) and age ≥40 (odds radio 3.1 [p < 0.05]). Multiple variable logistic regression analysis of radiographic factors associated with rib fractures in this population demonstrated a significant association of pleural effusion with rib fractures (odds ratio 18.9 [p < 0.05]). Patients with rib fractures received narcotic analgesia in 47.2% of the cases, significantly more than those without rib fractures (21.3%, p < 0.05). None of the patients required hospitalization. In the stable outpatient setting, rib fractures have a higher association with a history of minor trauma and age ≥40 in the adult population. Radiographic findings associated with rib fractures include pleural effusion. The frontal chest radiograph alone has low sensitivity in detecting rib fractures. The dedicated rib series detected a greater number of rib fractures. Although no patients required hospitalization, those with rib fractures were more likely to receive narcotic analgesia. Copyright © 2018 Elsevier Inc. All rights reserved.

  8. Identification of EGFLAM, SPATC1L and RNASE13 as novel susceptibility loci for aortic aneurysm in Japanese individuals by exome-wide association studies

    PubMed Central

    Yamada, Yoshiji; Sakuma, Jun; Takeuchi, Ichiro; Yasukochi, Yoshiki; Kato, Kimihiko; Oguri, Mitsutoshi; Fujimaki, Tetsuo; Horibe, Hideki; Muramatsu, Masaaki; Sawabe, Motoji; Fujiwara, Yoshinori; Taniguchi, Yu; Obuchi, Shuichi; Kawai, Hisashi; Shinkai, Shoji; Mori, Seijiro; Arai, Tomio; Tanaka, Masashi

    2017-01-01

    We performed an exome-wide association study (EWAS) to identify genetic variants - in particular, low-frequency or rare variants with a moderate to large effect size - that confer susceptibility to aortic aneurysm with 8,782 Japanese subjects (456 patients with aortic aneurysm, 8,326 control individuals) and with the use of Illumina HumanExome-12 DNA Analysis BeadChip or Infinium Exome-24 BeadChip arrays. The correlation of allele frequencies for 41,432 single nucleotide polymorphisms (SNPs) that passed quality control to aortic aneurysm was examined with Fisher's exact test. Based on Bonferroni's correction, a P-value of <1.21×10−6 was considered statistically significant. The EWAS revealed 59 SNPs that were significantly associated with aortic aneurysm. None of these SNPs was significantly (P<2.12×10−4) associated with aortic aneurysm by multivariable logistic regression analysis with adjustment for age, gender and hypertension, although 8 SNPs were related (P<0.05) to this condition. Examination of the correlation of these latter 8 SNPs to true or dissecting aortic aneurysm separately showed that rs1465567 [T/C (W229R)] of the EGF-like, fibronectin type III, and laminin G domains gene (EGFLAM) (dominant model; P=0.0014; odds ratio, 1.63) was significantly (P<0.0016) associated with true aortic aneurysm. We next performed EWASs for true or dissecting aortic aneurysm separately and found that 45 and 19 SNPs were significantly associated with these conditions, respectively. Multivariable logistic regression analysis with adjustment for covariates revealed that rs113710653 [C/T (E231K)] of the spermatogenesis- and centriole associated 1-like gene (SPATC1L) (dominant model; P=0.0002; odds ratio, 5.32) and rs143881017 [C/T (R140H)] of the ribonuclease A family member 13 gene (RNASE13) (dominant model; P=0.0006; odds ratio, 5.77) were significantly (P<2.78×10−4 or P<6.58×10−4, respectively) associated with true or dissecting aortic aneurysm, respectively. EGFLAM and SPATC1L may thus be susceptibility loci for true aortic aneurysm and RNASE13 may be such a locus for dissecting aneurysm in Japanese individuals. PMID:28339009

  9. Gravitoelectromagnetic analogy based on tidal tensors

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

    Costa, L. Filipe O.; Herdeiro, Carlos A. R.

    2008-07-15

    We propose a new approach to a physical analogy between general relativity and electromagnetism, based on tidal tensors of both theories. Using this approach we write a covariant form for the gravitational analogues of the Maxwell equations, which makes transparent both the similarities and key differences between the two interactions. The following realizations of the analogy are given. The first one matches linearized gravitational tidal tensors to exact electromagnetic tidal tensors in Minkowski spacetime. The second one matches exact magnetic gravitational tidal tensors for ultrastationary metrics to exact magnetic tidal tensors of electromagnetism in curved spaces. In the third wemore » show that our approach leads to a two-step exact derivation of Papapetrou's equation describing the force exerted on a spinning test particle. Analogous scalar invariants built from tidal tensors of both theories are also discussed.« less

  10. Computer Analysis of 400 HZ Aircraft Electrical Generator Test Data.

    DTIC Science & Technology

    1980-06-01

    Data Acquisition System. ............ 6 3 Voltage Waveform with Data Points. ....... 19 14 Zero Crossover Interpolation. ........ 20 5 Numerical...difference between successive positive-sloped zero crossovers of the waveform. However, the exact time of zero crossover is not known. This is because...data sampling and the generator output are not synchronized. This unsynchronization means that data points which correspond with an exact zero crossover

  11. Computer calculation of Witten's 3-manifold invariant

    NASA Astrophysics Data System (ADS)

    Freed, Daniel S.; Gompf, Robert E.

    1991-10-01

    Witten's 2+1 dimensional Chern-Simons theory is exactly solvable. We compute the partition function, a topological invariant of 3-manifolds, on generalized Seifert spaces. Thus we test the path integral using the theory of 3-manifolds. In particular, we compare the exact solution with the asymptotic formula predicted by perturbation theory. We conclude that this path integral works as advertised and gives an effective topological invariant.

  12. On the Model-Based Bootstrap with Missing Data: Obtaining a "P"-Value for a Test of Exact Fit

    ERIC Educational Resources Information Center

    Savalei, Victoria; Yuan, Ke-Hai

    2009-01-01

    Evaluating the fit of a structural equation model via bootstrap requires a transformation of the data so that the null hypothesis holds exactly in the sample. For complete data, such a transformation was proposed by Beran and Srivastava (1985) for general covariance structure models and applied to structural equation modeling by Bollen and Stine…

  13. Exact relativistic Toda chain eigenfunctions from Separation of Variables and gauge theory

    NASA Astrophysics Data System (ADS)

    Sciarappa, Antonio

    2017-10-01

    We provide a proposal, motivated by Separation of Variables and gauge theory arguments, for constructing exact solutions to the quantum Baxter equation associated to the N-particle relativistic Toda chain and test our proposal against numerical results. Quantum Mechanical non-perturbative corrections, essential in order to obtain a sensible solution, are taken into account in our gauge theory approach by considering codimension two defects on curved backgrounds (squashed S 5 and degenerate limits) rather than flat space; this setting also naturally incorporates exact quantization conditions and energy spectrum of the relativistic Toda chain as well as its modular dual structure.

  14. Multilevel predictors of colorectal cancer testing modality among publicly and privately insured people turning 50.

    PubMed

    Wheeler, Stephanie B; Kuo, Tzy-Mey; Meyer, Anne Marie; Martens, Christa E; Hassmiller Lich, Kristen M; Tangka, Florence K L; Richardson, Lisa C; Hall, Ingrid J; Smith, Judith Lee; Mayorga, Maria E; Brown, Paul; Crutchfield, Trisha M; Pignone, Michael P

    2017-06-01

    Understanding multilevel predictors of colorectal cancer (CRC) screening test modality can help inform screening program design and implementation. We used North Carolina Medicare, Medicaid, and private, commercially available, health plan insurance claims data from 2003 to 2008 to ascertain CRC test modality among people who received CRC screening around their 50th birthday, when guidelines recommend that screening should commence for normal risk individuals. We ascertained receipt of colonoscopy, fecal occult blood test (FOBT) and fecal immunochemical test (FIT) from billing codes. Person-level and county-level contextual variables were included in multilevel random intercepts models to understand predictors of CRC test modality, stratified by insurance type. Of 12,570 publicly-insured persons turning 50 during the study period who received CRC testing, 57% received colonoscopy, whereas 43% received FOBT/FIT, with significant regional variation. In multivariable models, females with public insurance had lower odds of colonoscopy than males (odds ratio [OR] = 0.68; p < 0.05). Of 56,151 privately-insured persons turning 50 years old who received CRC testing, 42% received colonoscopy, whereas 58% received FOBT/FIT, with significant regional variation. In multivariable models, females with private insurance had lower odds of colonoscopy than males (OR = 0.43; p < 0.05). People living 10-15 miles away from endoscopy facilities also had lower odds of colonoscopy than those living within 5 miles (OR = 0.91; p < 0.05). Both colonoscopy and FOBT/FIT are widely used in North Carolina among insured persons newly age-eligible for screening. The high level of FOBT/FIT use among privately insured persons and women suggests that renewed emphasis on FOBT/FIT as a viable screening alternative to colonoscopy may be important.

  15. Hot and Cool Executive Functions in Children with Attention-Deficit/Hyperactivity Disorder and Comorbid Oppositional Defiant Disorder.

    PubMed

    Antonini, Tanya N; Becker, Stephen P; Tamm, Leanne; Epstein, Jeffery N

    2015-09-01

    While neuropsychological deficits in both "hot" and "cool" executive functions (EFs) have been documented among individuals with attention-deficit/hyperactivity disorder (ADHD), these EF deficits are not universal across all individuals with this diagnosis. One potential moderator of executive dysfunction may be the presence of comorbid oppositional defiant disorder (ODD). This study examined the association between "hot" and "cool" EFs and comorbid ODD in children with ADHD. Thirty-three children with ADHD and comorbid ODD (ADHD+ODD), 67 with ADHD without ODD (ADHD-ODD), and 30 typically developing controls participated. Children were 7-12 years of age. "Cool" EFs were assessed with a spatial span task and a card sorting test. "Hot" EFs were assessed using a delay discounting task and a gambling task. ADHD-ODD and ADHD+ODD groups performed more poorly on "cool" EF tasks than controls, but did not differ from each other. Furthermore, the number of ADHD symptoms, but not ODD symptoms, was associated with "cool" EF scores. The three groups did not differ on "hot" EF tasks and the number of ADHD or ODD symptoms was unrelated to "hot" EF scores. In sum, children with ADHD presented with "cool" EF deficits which appear to be unrelated to ODD comorbidity. However, "hot" EF deficits were not present among children with ADHD, irrespective of comorbid ODD status.

  16. Graduated driver license compliant teens involved in fatal motor vehicle crashes.

    PubMed

    Pressley, Joyce C; Addison, Diane; Dawson, Patrick; Nelson, Sharifa S

    2015-09-01

    Significant reductions in motor vehicle injury mortality have been reported for teen drivers after passage of graduated driver licensing (GDL), seat belt, and no tolerance alcohol and drug laws. Despite this, teen drivers remain a vulnerable population with elevated fatal crash involvement. This study examines driver, vehicle, and crash characteristics of GDL-compliant, belted, and unimpaired teen drivers with the goal of identifying areas where further improvements might be realized. The Fatality Analysis Reporting System (FARS) for 2007 to 2009 was used to examine and classify driver violations/errors in compliant teen drivers (n = 1,571) of passenger vehicles involved in a fatal collision. Teens driving unbelted, non-GDL compliant, or impaired by alcohol or drugs were excluded. Statistical analysis used χ, Fisher's exact and multivariable logistic regression. Odds ratios are reported with 95% confidence intervals. Significance was defined as p < 0.05. Nearly one third (n = 1,571) of teen drivers involved in a fatal motor vehicle crash were GDL compliant, unimpaired, and belted. The majority held an intermediate GDL license (90.6%). Crash-related factors were identified for 63.1% of fatal crashes. Age- and sex-adjusted odds identified overcorrecting, speeding, lane errors, school morning crashes, distractions, and driving on slippery surfaces as having increased odds of fatality for the teen driver as well as newer vehicle models and heavier vehicle weight as protective. Among compliant drivers, weekday crashes before and after school and committing a driving violation at the time of crash were associated with increased risk of driver death and higher incidence of incapacitating injury in surviving drivers. Therapeutic study, level V.

  17. Perceived everyday racism, residential segregation, and HIV testing among patients at a sexually transmitted disease clinic.

    PubMed

    Ford, Chandra L; Daniel, Mark; Earp, Jo Anne L; Kaufman, Jay S; Golin, Carol E; Miller, William C

    2009-04-01

    More than one quarter of HIV-infected people are undiagnosed and therefore unaware of their HIV-positive status. Blacks are disproportionately infected. Although perceived racism influences their attitudes toward HIV prevention, how racism influences their behaviors is unknown. We sought to determine whether perceiving everyday racism and racial segregation influence Black HIV testing behavior. This was a clinic-based, multilevel study in a North Carolina city. Eligibility was limited to Blacks (N = 373) seeking sexually transmitted disease diagnosis or screening. We collected survey data, block group characteristics, and lab-confirmed HIV testing behavior. We estimated associations using logistic regression with generalized estimating equations. More than 90% of the sample perceived racism, which was associated with higher odds of HIV testing (odds ratio = 1.64; 95% confidence interval = 1.07, 2.52), after control for residential segregation, and other covariates. Neither patient satisfaction nor mechanisms for coping with stress explained the association. Perceiving everyday racism is not inherently detrimental. Perceived racism may improve odds of early detection of HIV infection in this high-risk population. How segregation influences HIV testing behavior warrants further research.

  18. Clinical outcomes after magnetic resonance angiography (MRA) versus computed tomographic angiography (CTA) for pulmonary embolism evaluation.

    PubMed

    Repplinger, Michael D; Nagle, Scott K; Harringa, John B; Broman, Aimee T; Lindholm, Christopher R; François, Christopher J; Grist, Thomas M; Reeder, Scott B; Schiebler, Mark L

    2018-05-10

    To compare patient outcomes following magnetic resonance angiography (MRA) versus computed tomographic angiography (CTA) ordered for suspected pulmonary embolism (PE). In this IRB-approved, single-center, retrospective, case-control study, we reviewed the medical records of all patients evaluated for PE with MRA during a 5-year period along with age- and sex-matched controls evaluated with CTA. Only the first instance of PE evaluation during the study period was included. After application of our exclusion criteria to both study arms, the analysis included 1173 subjects. The primary endpoint was major adverse PE-related event (MAPE), which we defined as major bleeding, venous thromboembolism, or death during the 6 months following the index imaging test (MRA or CTA), obtained through medical record review. Logistic regression, chi-square test for independence, and Fisher's exact test were used with a p < 0.05 threshold. The overall 6-month MAPE rate following MRA (5.4%) was lower than following CTA (13.6%, p < 0.01). Amongst outpatients, the MAPE rate was lower for MRA (3.7%) than for CTA (8.0%, p = 0.01). Accounting for age, sex, referral source, BMI, and Wells' score, patients were less likely to suffer MAPE than those who underwent CTA, with an odds ratio of 0.44 [0.24, 0.80]. Technical success rate did not differ significantly between MRA (92.6%) and CTA (90.5%) groups (p = 0.41). Within the inherent limitations of a retrospective case-controlled analysis, we observed that the rate of MAPE was lower (more favorable) for patients following pulmonary MRA for the primary evaluation of suspected PE than following CTA.

  19. Urine culture guided antibiotic interventions: A pharmacist driven antimicrobial stewardship effort in the ED.

    PubMed

    Zhang, Xi; Rowan, Nicole; Pflugeisen, Bethann Mangel; Alajbegovic, Sanjin

    2017-04-01

    Antibiotics are overprescribed for abnormal urine tests including asymptomatic bacteriuria (AB), contributing to rising antimicrobial resistance rates. Pharmacists reviewed urine cultures daily from emergency department (ED) encounters to assess antibiotic appropriateness. We studied antibiotic prescribing practices and assessed compliance to national guidelines, correlations with urine analysis (UA) components, and opportunities for antimicrobial stewardship in the ED. This quality improvement project (QIP) was a prospective cohort study at a community hospital ED, with data collected from finalized urine cultures resulting October 30, 2014 through January 5, 2015. Analyses were conducted using Chi-squared and Fisher Exact tests and stepwise multiple logistic regression. Urine cultures from 457 encounters were reviewed, of which 136 met the inclusion criteria as non-pregnant and asymptomatic for urinary tract infection (UTI). 43% of 136 patients were treated with antibiotics, for a total of 426 antibiotic days. Pharmacist interventions for these patients resulted in 122/426 (29%) of potential antibiotic days saved. Factors found to significantly increase the odds of antibiotic prescribing in asymptomatic patients included presence of leukocyte esterase (OR=4.5, 95% CI: 1.2-17.2; p=0.03) or nitrites (OR=10.8, 95% CI: 1.7-68.1; p=0.01) in the urine and age≥75 (OR=3.5, 95% CI: 1.2-9.6, p=0.02). Pharmacist intervention in discontinuing or modifying antibiotics for asymptomatic patients with urine cultures reduced unnecessary antibiotic exposure and was a first step in antimicrobial stewardship efforts in the ED. Future work includes limiting urine tests and subsequent antibiotic therapy for non-pregnant asymptomatic patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Appropriateness of gram-negative agent use at a tertiary care hospital in the setting of significant antimicrobial resistance.

    PubMed

    Vora, Neil M; Kubin, Christine J; Furuya, E Yoko

    2015-01-01

    Background.  Practicing antimicrobial stewardship in the setting of widespread antimicrobial resistance among gram-negative bacilli, particularly in urban areas, is challenging. Methods.  We conducted a retrospective cross-sectional study at a tertiary care hospital with an established antimicrobial stewardship program in New York, New York to determine appropriateness of use of gram-negative antimicrobials and to identify factors associated with suboptimal antimicrobial use. Adult inpatients who received gram-negative agents on 2 dates, 1 June 2010 or 1 December 2010, were identified through pharmacy records. Clinical data were collected for each patient. Use of gram-negative agents was deemed optimal or suboptimal through chart review and according to hospital guidelines. Data were compared using χ(2) or Fischer's exact test for categorical variables and Student t test or Mann-Whitney U test for continuous variables. Results.  A total of 356 patients were included who received 422 gram-negative agents. Administration was deemed suboptimal in 26% of instances, with the most common reason being spectrum of activity too broad. In multivariable analysis, being in an intensive care unit (adjusted odds ratio [aOR], .49; 95% confidence interval [CI], .29-.84), having an infectious diseases consultation within the previous 7 days (aOR, .52; 95% CI, .28-.98), and having a history of multidrug-resistant gram-negative bacilli within the past year (aOR, .24; 95% CI, .09-.65) were associated with optimal gram-negative agent use. Beta-lactam/beta-lactamase inhibitor combination drug use (aOR, 2.6; 95% CI, 1.35-5.16) was associated with suboptimal use. Conclusions.  Gram-negative agents were used too broadly despite numerous antimicrobial stewardship program activities.

  1. Estimation of the Incidence of Bacterial Vaginosis and other Vaginal Infections and its Consequences on Maternal/Fetal Outcome in Pregnant Women Attending an Antenatal Clinic in a Tertiary Care Hospital in North India

    PubMed Central

    Lata, Indu; Pradeep, Yashodhara; Sujata; Jain, Amita

    2010-01-01

    Aims: This study was undertaken to estimate the incidence of bacterial vaginosis (BV) and other vaginal infections during pregnancy and its association with urinary tract infections (UTI) and its consequences on pregnancy outcome, maternal and fetal morbidity and mortality. Settings and Design: Prospective cohort study. Materials and Methods: The present prospective cohort study was conducted on 200 women attending the antenatal clinic (ANC) of a tertiary hospital. All pertinent obstetric and neonatal data covering antenatal events during the course of pregnancy, delivery, puerperium and condition of each newborn at the time of birth were collected. BV was detected by both Gram stain and gold standard clinical criteria (Amsel’s composite criteria). Statistical analysis used: Data were analyzed using SPSS version 9. Fischer’s exact test, chi square tests and Student’s’ test has been used for analysis. The probability of 5% was considered as significant for continuous variables such as age, period of gestation and birth weight. Odds ratio (OR) and confidence interval (CI) with 95% probability were determined. Results: The incidence of bacterial vaginosis was 41 in 200 patients. Adverse outcomes such as preterm labor, PROM and fetal complications were found more in pregnant women who had bacterial vaginosis (N=41), bacterial vaginosis with UTI (N=14) as compared to those without bacterial vaginosis (N=118). Conclusions: The incidence of poor pregnancy outcome was higher in bacterial vaginosis with UTI. Prevention of BV and UTI is cost effective to minimize the pregnancy-related complications and preterm labor to decrease in perinatal and maternal mortality and morbidity. We recommend all antenatal patients should be screened for the presence of bacterial vaginosis, other infections and UTI. PMID:20922108

  2. Estimation of the Incidence of Bacterial Vaginosis and other Vaginal Infections and its Consequences on Maternal/Fetal Outcome in Pregnant Women Attending an Antenatal Clinic in a Tertiary Care Hospital in North India.

    PubMed

    Lata, Indu; Pradeep, Yashodhara; Sujata; Jain, Amita

    2010-04-01

    This study was undertaken to estimate the incidence of bacterial vaginosis (BV) and other vaginal infections during pregnancy and its association with urinary tract infections (UTI) and its consequences on pregnancy outcome, maternal and fetal morbidity and mortality. Prospective cohort study. The present prospective cohort study was conducted on 200 women attending the antenatal clinic (ANC) of a tertiary hospital. All pertinent obstetric and neonatal data covering antenatal events during the course of pregnancy, delivery, puerperium and condition of each newborn at the time of birth were collected. BV was detected by both Gram stain and gold standard clinical criteria (Amsel's composite criteria). Data were analyzed using SPSS version 9. Fischer's exact test, chi square tests and Student's' test has been used for analysis. The probability of 5% was considered as significant for continuous variables such as age, period of gestation and birth weight. Odds ratio (OR) and confidence interval (CI) with 95% probability were determined. The incidence of bacterial vaginosis was 41 in 200 patients. Adverse outcomes such as preterm labor, PROM and fetal complications were found more in pregnant women who had bacterial vaginosis (N=41), bacterial vaginosis with UTI (N=14) as compared to those without bacterial vaginosis (N=118). The incidence of poor pregnancy outcome was higher in bacterial vaginosis with UTI. Prevention of BV and UTI is cost effective to minimize the pregnancy-related complications and preterm labor to decrease in perinatal and maternal mortality and morbidity. We recommend all antenatal patients should be screened for the presence of bacterial vaginosis, other infections and UTI.

  3. Qualitative and Semiquantitative Elastography for the Diagnosis of Intermediate Suspicious Thyroid Nodules Based on the 2015 American Thyroid Association Guidelines.

    PubMed

    Yang, Bo Ra; Kim, Eun-Kyung; Moon, Hee Jung; Yoon, Jung Hyun; Park, Vivian Y; Kwak, Jin Young

    2018-04-01

    To evaluate qualitative and semiquantitative elastography for the diagnosis of intermediate suspicious thyroid nodules based on the 2015 American Thyroid Association (ATA) guidelines. Through a retrospective search of our institutional database, 746 solid thyroid nodules found on grayscale ultrasonography, strain elastography, and ultrasound-guided fine-needle aspiration between June and November 2009 were collected. Among them, 80 nodules from 80 patients with an intermediate suspicion of malignancy based on the 2015 ATA guidelines that were 10 mm or larger were recruited as the final study nodules. Elastographic findings were categorized according to the criteria of Rago et al (J Clin Endocrinol Metab 2007; 92:2917-2922) and Asteria et al (Thyroid 2008; 18:523-531), and strain ratio values were calculated and recorded. The independent 2-sample t test and χ 2 test (or Fisher exact test) were used to evaluate differences in clinical parameters between benign and malignant thyroid nodules. All variables were compared by univariate and multivariate logistic regression analyses, and odds ratios with 95% confidence intervals were calculated. Of the 80 nodules, 6 (7.5%) were malignant, and 74 (92.5%) were benign. No significant differences were observed in age, sex, nodule size, elasticity score, and strain ratio between benign and malignant nodules. No variables significantly predicted thyroid malignancy on the univariate analysis. On the multivariate logistic regression analysis, there were no independent variables associated with thyroid malignancy, including the elasticity score and strain ratio (all P > .05). Elastographic analysis using the elasticity score and strain ratio has limited ability to characterize the benignity or malignancy of thyroid nodules with an intermediate suspicion of malignancy based on the 2015 ATA guidelines. © 2017 by the American Institute of Ultrasound in Medicine.

  4. Multidetector CT features of pulmonary focal ground-glass opacity: differences between benign and malignant

    PubMed Central

    Fan, L; Liu, S-Y; Li, Q-C; Yu, H; Xiao, X-S

    2012-01-01

    Objective To evaluate different features between benign and malignant pulmonary focal ground-glass opacity (fGGO) on multidetector CT (MDCT). Methods 82 pathologically or clinically confirmed fGGOs were retrospectively analysed with regard to demographic data, lesion size and location, attenuation value and MDCT features including shape, margin, interface, internal characteristics and adjacent structure. Differences between benign and malignant fGGOs were analysed using a χ2 test, Fisher's exact test or Mann–Whitney U-test. Morphological characteristics were analysed by binary logistic regression analysis to estimate the likelihood of malignancy. Results There were 21 benign and 61 malignant lesions. No statistical differences were found between benign and malignant fGGOs in terms of demographic data, size, location and attenuation value. The frequency of lobulation (p=0.000), spiculation (p=0.008), spine-like process (p=0.004), well-defined but coarse interface (p=0.000), bronchus cut-off (p=0.003), other air-containing space (p=0.000), pleural indentation (p=0.000) and vascular convergence (p=0.006) was significantly higher in malignant fGGOs than that in benign fGGOs. Binary logistic regression analysis showed that lobulation, interface and pleural indentation were important indicators for malignant diagnosis of fGGO, with the corresponding odds ratios of 8.122, 3.139 and 9.076, respectively. In addition, a well-defined but coarse interface was the most important indicator of malignancy among all interface types. With all three important indicators considered, the diagnostic sensitivity, specificity and accuracy were 93.4%, 66.7% and 86.6%, respectively. Conclusion An fGGO with lobulation, a well-defined but coarse interface and pleural indentation gives a greater than average likelihood of being malignant. PMID:22128130

  5. Association between childbirth attitudes and fear on birth preferences of a future generation of Australian parents.

    PubMed

    Hauck, Yvonne L; Stoll, Kathrin H; Hall, Wendy A; Downie, Jill

    2016-12-01

    The reality of childbirth fear is recognised for expectant parents but we lack knowledge about the childbirth attitudes of the next generation of Australian parents. Examination of adults' attitudes toward childbirth including influencing contributing factors, fear scores, birth preferences and reasons for this preference. A cross-sectional online study was conducted with 654 Western Australian students attending one tertiary institution. Students (male and female) were eligible to participate if they were less than 40 years of age and did not currently have children but confirmed their intention to become parents. To assess associations or comparison of means, bi-variable analyses (Chi square test, Fisher's Exact test, Independent Student's t-test or one way ANOVA) were used. Factors associated with childbirth fear and birth preferences were assessed with binary logistic regression analysis. Childbirth attitudes were shaped by family members' (82.0%) and friends' experiences (64.4%) plus media (TV, YouTube, and movies) (63.5%). Furthermore, 15.6% of adults indicated a preference for a caesarean birth, even without obstetric complications. Likewise, 26.1% reported elevated fear; students with elevated fear scores had 2.6 times greater odds of wanting a caesarean birth. Only 23.4% of students felt confident about their childbirth knowledge. Adults reported fear levels that warrant attention prior to a future pregnancy. Although the majority would choose a vaginal birth, they require awareness of benefits and risks for both vaginal and caesarean births to ensure their decisions reflect informed choice rather than influences of inadequate knowledge or fear. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  6. The ADA*2 allele of the adenosine deaminase gene (20q13.11) and recurrent spontaneous abortions: an age-dependent association

    PubMed Central

    Nunes, Daniela Prudente Teixeira; Spegiorin, Lígia Cosentino Junqueira Franco; de Mattos, Cinara Cássia Brandão; Oliani, Antonio Helio; Vaz-Oliani, Denise Cristina Mós; de Mattos, Luiz Carlos

    2011-01-01

    OBJECTIVE: Adenosine deaminase acts on adenosine and deoxyadenosine metabolism and modulates the immune response. The adenosine deaminase G22A polymorphism (20q.11.33) influences the level of adenosine deaminase enzyme expression, which seems to play a key role in maintaining pregnancy. The adenosine deaminase 2 phenotype has been associated with a protective effect against recurrent spontaneous abortions in European Caucasian women. The aim of this study was to investigate whether the G22A polymorphism of the adenosine deaminase gene is associated with recurrent spontaneous abortions in Brazilian women. METHODS: A total of 311 women were recruited to form two groups: G1, with a history of recurrent spontaneous abortions (N = 129), and G2, without a history of abortions (N = 182). Genomic DNA was extracted from peripheral blood with a commercial kit and PCR-RFLP analysis was used to identify the G22A genetic polymorphism. Fisher's exact test and odds ratio values were used to compare the proportions of adenosine deaminase genotypes and alleles between women with and without a history of recurrent spontaneous abortion (p<0.05). The differences between mean values for categorical data were calculated using unpaired t tests. The Hardy-Weinberg equilibrium was assessed with a chi-square test. RESULTS: Statistically significant differences were identified for the frequencies of adenosine deaminase genotypes and alleles between the G1 and G2 groups when adjusted for maternal age. CONCLUSIONS: The results suggest that the adenosine deaminase *2 allele is associated with a low risk for recurrent spontaneous abortions, but this association is dependent on older age. PMID:22086524

  7. Health Literacy and Willingness to Use Online Health Information by Teens with Asthma and Diabetes

    PubMed Central

    Hardin, Dana S.; McCoy, Karen S.; Johnson, Lauren D.; McAlearney, Ann Scheck; Gardner, William

    2011-01-01

    Abstract Objective: This study measured health literacy in a population of teens in treatment for asthma or diabetes and tested the association between health literacy and willingness to use online health resources. Materials and Methods: About 180 patients aged 13–18 years treated for asthma or diabetes in specialty care clinics completed assessments of demographic characteristics, health literacy, and Internet access and use. Teens were provided a resource page listing selected publically available health-related Web sites and asked about perceived ease of use, perceived usefulness, and intent to use the listed Web sites. The relationship between demographic characteristics, health literacy, and online health information use was tested using chi-squared or Fisher's exact test. Predictors of intent to use resource page Web sites were assessed using bivariate and multivariate ordinal logistic regression. Results: About 92% of participants had adequate health literacy. Over 50% of participants had previously searched online for health information. Older age was the only significant predictor of health information search. Most teens (79%) reported intent to use at least one Web site from the resource page at least occasionally within the next 3 months. Higher health literacy (odds ratio [OR]=6.24, p<0.01) and stronger perceived usefulness (OR=1.74, p=0.01) were associated with greater intent for regular use, after controlling for demographic and Internet access variables. Conclusions: Teens with lower health literacy searched online for health information as often as peers with higher literacy, but were less likely to express the intent to use recommended sites. Belief in the usefulness of a Web site is the strongest attitudinal predictor of intended future use. PMID:21943161

  8. Comparison of Clinical Factors Between Patients With Angiotensin-Converting Enzyme Inhibitor-Induced Angioedema and Cough.

    PubMed

    Hallberg, Pär; Nagy, Julia; Karawajczyk, Malgorzata; Nordang, Leif; Islander, Gunilla; Norling, Pia; Johansson, Hans-Erik; Kämpe, Mary; Hugosson, Svante; Yue, Qun-Ying; Wadelius, Mia

    2017-04-01

    Angioedema is a rare and serious adverse drug reaction (ADR) to angiotensin-converting enzyme (ACE) inhibitor treatment. Dry cough is a common side effect of ACE inhibitors and has been identified as a possible risk factor for angioedema. We compared characteristics between patients with ACE inhibitor-induced angioedema and cough with the aim of identifying risk factors that differ between these adverse events. Data on patients with angioedema or cough induced by ACE inhibitors were collected from the Swedish database of spontaneously reported ADRs or from collaborating clinicians. Wilcoxon rank sum test, Fisher's exact test, and odds ratios (ORs) with 95% CIs were used to test for between-group differences. The significance threshold was set to P <0.00128 to correct for multiple comparisons. Clinical characteristics were compared between 168 patients with angioedema and 121 with cough only. Smoking and concomitant selective calcium channel blocker treatment were more frequent among patients with angioedema than cough: OR = 4.3, 95% CI = 2.1-8.9, P = 2.2 × 10 -5 , and OR = 3.7, 95% CI = 2.0-7.0, P = 1.7 × 10 -5 . Angioedema cases were seen more often in male patients (OR = 2.2, 95% CI = 1.4-3.6, P = 1.3 × 10 -4 ) and had longer time to onset and higher doses than those with cough ( P = 3.2 × 10 -10 and P = 2.6 × 10 -4 ). A multiple model containing the variables smoking, concurrent calcium channel blocker treatment, male sex, and time to onset accounted for 26% of the variance between the groups. Smoking, comedication with selective calcium channel blockers, male sex, and longer treatment time were associated with ACE inhibitor-induced angioedema rather than cough.

  9. Predictors of Postoperative Complications After Trimodality Therapy for Esophageal Cancer

    PubMed Central

    Wang, Jingya; Wei, Caimiao; Tucker, Susan L.; Myles, Bevan; Palmer, Matthew; Hofstetter, Wayne L.; Swisher, Stephen G.; Ajani, Jaffer A.; Cox, James D.; Komaki, Ritsuko; Liao, Zhongxing; Lin, Steven H.

    2013-01-01

    Purpose While trimodality therapy for esophageal cancer has improved patient outcomes, surgical complication rates remain high. The goal of this study was to identify modifiable factors associated with postoperative complications after neoadjuvant chemoradiation. Methods and Materials From 1998 to 2011, 444 patients were treated at our institution with surgical resection after chemoradiation. Postoperative (pulmonary, gastrointestinal [GI], cardiac, wound healing) complications were recorded up to 30 days postoperatively. Kruskal-Wallis tests and χ2 or Fisher exact tests were used to assess associations between continuous and categorical variables. Multivariate logistic regression tested the association between perioperative complications and patient or treatment factors that were significant on univariate analysis. Results The most frequent postoperative complications after trimodality therapy were pulmonary (25%) and GI (23%). Lung capacity and the type of radiation modality used were independent predictors of pulmonary and GI complications. After adjusting for confounding factors, pulmonary and GI complications were increased in patients treated with 3-dimensional conformal radiation therapy (3D-CRT) versus intensity modulated radiation therapy (IMRT; odds ratio [OR], 2.018; 95% confidence interval [CI], 1.104–3.688; OR, 1.704; 95% CI, 1.03–2.82, respectively) and for patients treated with 3D-CRT versus proton beam therapy (PBT; OR, 3.154; 95% CI, 1.365–7.289; OR, 1.55; 95% CI, 0.78–3.08, respectively). Mean lung radiation dose (MLD) was strongly associated with pulmonary complications, and the differences in toxicities seen for the radiation modalities could be fully accounted for by the MLD delivered by each of the modalities. Conclusions The radiation modality used can be a strong mitigating factor of postoperative complications after neoadjuvant chemoradiation. PMID:23845841

  10. Predictors of Postoperative Complications After Trimodality Therapy for Esophageal Cancer

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

    Wang, Jingya; Wei, Caimiao; Tucker, Susan L.

    2013-08-01

    Purpose: While trimodality therapy for esophageal cancer has improved patient outcomes, surgical complication rates remain high. The goal of this study was to identify modifiable factors associated with postoperative complications after neoadjuvant chemoradiation. Methods and Materials: From 1998 to 2011, 444 patients were treated at our institution with surgical resection after chemoradiation. Postoperative (pulmonary, gastrointestinal [GI], cardiac, wound healing) complications were recorded up to 30 days postoperatively. Kruskal-Wallis tests and χ{sup 2} or Fisher exact tests were used to assess associations between continuous and categorical variables. Multivariate logistic regression tested the association between perioperative complications and patient or treatment factorsmore » that were significant on univariate analysis. Results: The most frequent postoperative complications after trimodality therapy were pulmonary (25%) and GI (23%). Lung capacity and the type of radiation modality used were independent predictors of pulmonary and GI complications. After adjusting for confounding factors, pulmonary and GI complications were increased in patients treated with 3-dimensional conformal radiation therapy (3D-CRT) versus intensity modulated radiation therapy (IMRT; odds ratio [OR], 2.018; 95% confidence interval [CI], 1.104-3.688; OR, 1.704; 95% CI, 1.03-2.82, respectively) and for patients treated with 3D-CRT versus proton beam therapy (PBT; OR, 3.154; 95% CI, 1.365-7.289; OR, 1.55; 95% CI, 0.78-3.08, respectively). Mean lung radiation dose (MLD) was strongly associated with pulmonary complications, and the differences in toxicities seen for the radiation modalities could be fully accounted for by the MLD delivered by each of the modalities. Conclusions: The radiation modality used can be a strong mitigating factor of postoperative complications after neoadjuvant chemoradiation.« less

  11. Very advanced maternal age and morbidity in Victoria, Australia: a population based study

    PubMed Central

    2013-01-01

    Background In Australia, approximately 0.1% of births occur to women 45 years or older and this rate has been increasing in recent years. There are however, few population based studies examining perinatal outcomes among this age group. The aim of this study was to determine the maternal and perinatal outcomes of pregnancies in women aged 45 years or older compared to women aged 30–34 years. Methods Data on births at 20 or more weeks’ gestation were obtained from the Victorian Perinatal Data Collection for the years 2005 and 2006. We examined selected maternal and perinatal outcomes for women of very advanced maternal age (VAMA) aged 45 years or older (n = 217) and compared them to women aged 30–34 years (n = 48,909). Data were summarised using numbers and percentages. Categorical data were analysed by Chi-square tests and Fisher’s exact test. Comparisons are presented using unadjusted odds ratios, 95 percent confidence intervals (CIs) and p-values. Results Women aged 45 years and older had higher odds of gestational diabetes (OR 2.05; 95% CI 1.3–3.3); antepartum haemorrhage (OR 1.89; 95% CI 1.01–3.5), and placenta praevia (OR 4.88; 95% CI 2.4–9.5). The older age-group also had higher odds of preterm birth between 32–36 weeks (OR 2.61; 95% CI 1.8–3.8); low birth-weight (<2,500 gr) (OR 2.22; 95% CI 1.5–3.3) and small for gestational age (OR 1.53; 95% CI 1.0–2.3). Stratified analysis revealed that VAMA was most strongly associated with caesarean section in primiparous women (OR 8.24; 95% CI 4.5, 15.4) and those using ART (OR 5.75; 95% CI 2.5, 13.3), but the relationship persisted regardless of parity, ART use and plurality. Low birthweight was associated with VAMA only in first births (OR 3.90; 95% CI 2.3, 6.6), while preterm birth was more common in older women for both first (OR 3.13; 95% CI 1.8, 5.3) and subsequent (OR 2.08; 95% CI 1.2, 3.5) births, and for those having singleton births (OR 2.11; 95% CI 1.3, 3.4), and those who did not use ART (OR 2.10; 95% CI 1.3, 3.4). Preterm birth was very common in multiple births and following ART use, regardless of maternal age. Conclusions This study demonstrates that women aged 45 years and older, in Victoria, Australia, have higher rates of pregnancy and perinatal complications, compared to women aged 30–34 years. PMID:23537152

  12. Permutational distribution of the log-rank statistic under random censorship with applications to carcinogenicity assays.

    PubMed

    Heimann, G; Neuhaus, G

    1998-03-01

    In the random censorship model, the log-rank test is often used for comparing a control group with different dose groups. If the number of tumors is small, so-called exact methods are often applied for computing critical values from a permutational distribution. Two of these exact methods are discussed and shown to be incorrect. The correct permutational distribution is derived and studied with respect to its behavior under unequal censoring in the light of recent results proving that the permutational version and the unconditional version of the log-rank test are asymptotically equivalent even under unequal censoring. The log-rank test is studied by simulations of a realistic scenario from a bioassay with small numbers of tumors.

  13. Fluconazole use and birth defects in the National Birth Defects Prevention Study.

    PubMed

    Howley, Meredith M; Carter, Tonia C; Browne, Marilyn L; Romitti, Paul A; Cunniff, Christopher M; Druschel, Charlotte M

    2016-05-01

    Low-dose fluconazole is used commonly to treat vulvovaginal candidiasis, a condition occurring frequently during pregnancy. Conflicting information exists on the association between low-dose fluconazole use among pregnant women and the risk of major birth defects. We used data from the National Birth Defects Prevention Study to examine this association. The National Birth Defects Prevention Study is a multisite, population-based, case-control study that includes pregnancies with estimated delivery dates from 1997 to 2011. Information on fluconazole use in early pregnancy was collected by self-report from 31,645 mothers of birth defect cases and 11,612 mothers of unaffected controls. Adjusted odds ratios and 95% confidence intervals were estimated for birth defects with 5 or more exposed cases; crude odds ratios and exact 95% confidence intervals were estimated for birth defects with 3-4 exposed cases. Of the 43,257 mothers analyzed, 44 case mothers and 6 control mothers reported using fluconazole. Six exposed infants had cleft lip with cleft palate, 4 had an atrial septal defect, and each of the following defects had 3 exposed cases: hypospadias, tetralogy of Fallot, d-transposition of the great arteries, and pulmonary valve stenosis. Fluconazole use was associated with cleft lip with cleft palate (odds ratio = 5.53; confidence interval = 1.68-18.24) and d-transposition of the great arteries (odds ratio = 7.56; confidence interval = 1.22-35.45). The associations between fluconazole and both cleft lip with cleft palate and d-transposition of the great arteries are consistent with earlier published case reports but not recent epidemiologic studies. Despite the larger sample size of the National Birth Defects Prevention Study, fluconazole use was rare. Further investigation is needed in large studies, with particular emphasis on oral clefts and conotruncal heart defects. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Influence of abutment type and esthetic veneering on preload maintenance of abutment screw of implant-supported crowns.

    PubMed

    Delben, Juliana Aparecida; Barão, Valentim Adelino Ricardo; Dos Santos, Paulo Henrique; Assunção, Wirley Gonçalves

    2014-02-01

    The effect of veneering materials on screw joint stability remains inconclusive. Thus, this study evaluated the preload maintenance of abutment screws of single crowns fabricated with different abutments and veneering materials. Sixty crowns were divided into five groups (n = 12): UCLA abutment in gold alloy with ceramic (group GC) and resin (group GR) veneering, UCLA abutment in titanium with ceramic (group TiC) and resin (group TiR) veneering, and zirconia abutment with ceramic veneering (group ZiC). Abutment screws made of gold were used with a 35 Ncm insertion torque. Detorque measurements were obtained initially and after mechanical cycling. Data were analyzed by ANOVA and Fisher's exact test at a significance level of 5%. For the initial detorque means (in Ncm), group TiC (21.4 ± 1.78) exhibited statistically lower torque maintenance than groups GC (23.9 ± 0.91), GR (24.1 ± 1.34), and TiR (23.2 ± 1.33) (p < 0.05, Fisher's exact test). Group ZiC (21.9 ± 2.68) exhibited significantly lower torque maintenance than groups GC, GR, and TiR (p < 0.05, Fisher's exact test). After mechanical cycling, there was a statistically significant difference between groups TiC (22.1 ± 1.86) and GR (23.8 ± 1.56); between groups ZiC (21.7 ± 2.02) and GR; and also between groups ZiC and TiR (23.6 ± 1.30) (p < 0.05, Fisher's exact test). Detorque reduction occurred regardless of abutment type and veneering material. More irregular surfaces in the hexagon area of the castable abutments were observed. The superiority of any veneering material concerning preload maintenance was not established. © 2013 by the American College of Prosthodontists.

  15. HLA-Cw*0602 associates with a twofold higher prevalence of positive streptococcal throat swab at the onset of psoriasis: a case control study.

    PubMed

    Mallbris, Lotus; Wolk, Katarina; Sánchez, Fabio; Ståhle, Mona

    2009-05-29

    The influence of streptococcal infections in the pathogenesis of psoriasis is not yet understood. In vitro data suggest that streptococcal factors influence T-cell function in psoriasis in a HLA-dependent manner, but studies designed to measure the HLA-C/Streptococci interaction are lacking. In the present study, we hypothesized that there is a statistical interaction between the result of streptococcal throat cultures and the presence of the HLA-Cw*0602 allele in psoriasis patients. We performed a case control study using the "Stockholm Psoriasis Cohort" consisting of patients consecutively recruited within 12 months of disease onset (Plaque psoriasis = 439, Guttate psoriasis = 143), matched to healthy controls (n = 454) randomly chosen from the Swedish Population Registry. All individuals underwent physical examination including throat swabs and DNA isolation for HLA-Cw*0602 genotyping. The prevalence of positive streptococcal throat swabs and HLA-Cw*0602 was compared between patients and controls and expressed as odds ratios with 95% confidence intervals. Associations were evaluated separately for guttate and plaque psoriasis by Fisher's exact test. Regardless of disease phenotype, the prevalence of positive streptococcal throat swabs in HLA-Cw*0602 positive patients was twice the prevalence among HLA-Cw*0602 negative patients (OR = 5.8 C.I. = 3.57-9.67, p < 0.001), while no difference was observed among Cw*0602 positive versus negative controls. The corresponding odds ratios for the guttate and plaque psoriasis phenotypes were 3.5 (CI = 1.5-8.7, p = 0.01) and 2.3 (CI = 1.0-5.1, p = 0.02) respectively. These findings suggest that among HLA-Cw*0602 positive psoriasis patients, streptococci may contribute to the onset or exacerbation of the inflammatory process independent of the disease phenotype. However, studies on the functional interaction between HLA-C and streptococcal factors are needed.

  16. HLA-Cw*0602 associates with a twofold higher prevalence of positive streptococcal throat swab at the onset of psoriasis: a case control study

    PubMed Central

    Mallbris, Lotus; Wolk, Katarina; Sánchez, Fabio; Ståhle, Mona

    2009-01-01

    Background The influence of streptococcal infections in the pathogenesis of psoriasis is not yet understood. In vitro data suggest that streptococcal factors influence T-cell function in psoriasis in a HLA-dependent manner, but studies designed to measure the HLA-C/Streptococci interaction are lacking. In the present study, we hypothesized that there is a statistical interaction between the result of streptococcal throat cultures and the presence of the HLA-Cw*0602 allele in psoriasis patients. Methods We performed a case control study using the "Stockholm Psoriasis Cohort" consisting of patients consecutively recruited within 12 months of disease onset (Plaque psoriasis = 439, Guttate psoriasis = 143), matched to healthy controls (n = 454) randomly chosen from the Swedish Population Registry. All individuals underwent physical examination including throat swabs and DNA isolation for HLA-Cw*0602 genotyping. The prevalence of positive streptococcal throat swabs and HLA-Cw*0602 was compared between patients and controls and expressed as odds ratios with 95% confidence intervals. Associations were evaluated separately for guttate and plaque psoriasis by Fisher's exact test. Results Regardless of disease phenotype, the prevalence of positive streptococcal throat swabs in HLA-Cw*0602 positive patients was twice the prevalence among HLA-Cw*0602 negative patients (OR = 5.8 C.I. = 3.57–9.67, p < 0.001), while no difference was observed among Cw*0602 positive versus negative controls. The corresponding odds ratios for the guttate and plaque psoriasis phenotypes were 3.5 (CI = 1.5–8.7, p = 0.01) and 2.3 (CI = 1.0–5.1, p = 0.02) respectively. Conclusion These findings suggest that among HLA-Cw*0602 positive psoriasis patients, streptococci may contribute to the onset or exacerbation of the inflammatory process independent of the disease phenotype. However, studies on the functional interaction between HLA-C and streptococcal factors are needed. PMID:19480679

  17. A comparison of exact tests for trend with binary endpoints using Bartholomew's statistic.

    PubMed

    Consiglio, J D; Shan, G; Wilding, G E

    2014-01-01

    Tests for trend are important in a number of scientific fields when trends associated with binary variables are of interest. Implementing the standard Cochran-Armitage trend test requires an arbitrary choice of scores assigned to represent the grouping variable. Bartholomew proposed a test for qualitatively ordered samples using asymptotic critical values, but type I error control can be problematic in finite samples. To our knowledge, use of the exact probability distribution has not been explored, and we study its use in the present paper. Specifically we consider an approach based on conditioning on both sets of marginal totals and three unconditional approaches where only the marginal totals corresponding to the group sample sizes are treated as fixed. While slightly conservative, all four tests are guaranteed to have actual type I error rates below the nominal level. The unconditional tests are found to exhibit far less conservatism than the conditional test and thereby gain a power advantage.

  18. Relationship between a Centers for Disease Control and Prevention expanded HIV testing initiative and past-year testing by race/ethnicity: a multilevel analysis of the Behavioral Risk Factor Surveillance System.

    PubMed

    Gaines, Tommi L; Caldwell, Julia T; Ford, Chandra L; Mulatu, Mesfin S; Godette, Dionne C

    2016-01-01

    The Centers for Disease Control and Prevention's (CDC) expanded testing initiative (ETI) aims to bolster HIV testing among populations disproportionately affected by the HIV epidemic by providing additional funding to health departments serving these communities. ETI prioritizes testing in clinical settings; therefore, we examined the relationship between state-level ETI participation and past-year HIV testing among a racially/ethnically diverse sample of adult respondents to the 2012 Behavioral Risk Factor Surveillance System who accessed health services within the 12 months prior to being interviewed. Controlling for individual- and state-level characteristics in a multilevel logistic regression model, ETI participation was independently and positively associated with past-year testing, but this association varied by race/ethnicity. Hispanics had higher odds (adjusted odds ratio [AOR]: 1.49; 95% CI: 1.11-2.02) and American Indian/Alaska Natives had lower odds (AOR: 0.66; 95% CI: 0.43-0.99) of testing if they resided in states with (vs. without) ETI participation. State-level ETI participation did not significantly alter past-year testing among other racial/ethnic groups. Prioritizing public health resources in states most affected by HIV can improve testing patterns, but other mechanisms likely influence which racial/ethnic groups undergo testing.

  19. [The influence of caregivers' anxiety and the home environment on child abuse. A study of children attending child-care centers].

    PubMed

    Mochizuki, Yukiko; Tanaka, Emiko; Shinohara, Ryoji; Sugisawa, Yuka; Tomisaki, Etsuko; Watanabe, Taeko; Tokutake, Kentaro; Matsumoto, Misako; Sugita, Chihiro; Anme, Tokie

    2014-01-01

    The prevalence of child abuse is increasing in Japan. Therefore, we need appropriate and practical approaches for implementing feasible prevention, early detection, and support services for abused children. The purpose of this study was to examine child-rearing anxieties and the home environment as factors affecting caregivers of suspected abused children who attend child-care centers . First, we applied the millennium edition of the Japan Child and Family Research Institute (JCFRI) Child Rearing Support Questionnaire, and the Index of Child Care Environment (ICCE), for 1,801 caregivers whose children were enrolled in child-care centers based in City A. The millennium edition of the JCFRI Child Rearing Support Questionnaire measures difficulties in childcare for caregivers in terms of feelings, anxiety, and tendencies toward depression. The ICCE measures the quality and frequency of involvement of caregivers with their children and the child-care environment. Next, we interviewed the directors and child-care professionals in the centers to collect information on child abuse. The children were divided into two groups: abused and non-abused. The "abused group" consisted of the children whom the directors and professionals of the child-care centers suspected of being "possibly abused" and so had been placed under the protection of the center; furthermore, the center exchanged information with the City A Municipality "City A municipal government" about these children. We conducted Fisher's exact test to examine the relationship between the "abused group" and the "non-abused group," in relation to child-rearing anxiety and the children's home environments. Questionnaire scores from the two groups were assessed. We calculated odds ratios to examine the significant factors related to child abuse. Our dependent variable was child abuse, our main independent variables were items related to child-care difficulties and the child-care environment, and the moderating variables were age and gender. We used multiple logistic regression to assess the actual child abuse predictors. The odds ratios obtained by comparing the "abused group" with the "non-abused group" showed that the caregivers of children in the "abused group" had a 5.5-fold greater odds of saying, "I am riddled with uneasiness and awful feelings," and a 4.6-fold greater odds of saying, "I do not have anyone to look after my child except a child-care center." The moderating variables (age and gender) were not significant. Child-care professionals have a policy for ensuring there is concrete and usable support for caregivers, depending on the relationship between the abused child and the difficulties present in the child's environment. We suggest that awareness of these relationships can be promoted as an aid for early child abuse detection, support, and prevention.

  20. TVT-Exact and midurethral sling (SLING-IUFT) operative procedures: a randomized study

    PubMed Central

    Aniulis, Povilas; Skaudickas, Darijus

    2015-01-01

    Objectives The aim of the study is to compare results, effectiveness and complications of TVT exact and midurethral sling (SLING-IUFT) operations in the treatment of female stress urinary incontinence (SUI). Methods A single center nonblind, randomized study of women with SUI who were randomized to TVT-Exact and SLING-IUFT was performed by one surgeon from April 2009 to April 2011. SUI was diagnosed on coughing and Valsalva test and urodynamics (cystometry and uroflowmetry) were assessed before operation and 1 year after surgery. This was a prospective randomized study. The follow up period was 12 months. 76 patients were operated using the TVT-Exact operation and 78 patients – using the SLING-IUFT operation. There was no statistically significant differences between groups for BMI, parity, menopausal status and prolapsed stage (no patients had cystocele greater than stage II). Results Mean operative time was significantly shorter in the SLING-IUFT group (19 ± 5.6 min.) compared with the TVT-Exact group (27 ± 7.1 min.). There were statistically significant differences in the effectiveness of both procedures: TVT-Exact – at 94.5% and SLING-IUFT – at 61.2% after one year. Hospital stay was statistically significantly shorter in the SLING-IUFT group (1. 2 ± 0.5 days) compared with the TVT-Exact group (3.5 ± 1.5 days). Statistically significantly fewer complications occurred in the SLING-IUFT group. Conclusion the TVT-Exact and SLING-IUFT operations are both effective for surgical treatment of female stress urinary incontinence. The SLING-IUFT involved a shorter operation time and lower complications rate., the TVT-Exact procedure had statistically significantly more complications than the SLING-IUFT operation, but a higher effectiveness. PMID:28352711

  1. TVT-Exact and midurethral sling (SLING-IUFT) operative procedures: a randomized study.

    PubMed

    Aniuliene, Rosita; Aniulis, Povilas; Skaudickas, Darijus

    2015-01-01

    The aim of the study is to compare results, effectiveness and complications of TVT exact and midurethral sling (SLING-IUFT) operations in the treatment of female stress urinary incontinence (SUI). A single center nonblind, randomized study of women with SUI who were randomized to TVT-Exact and SLING-IUFT was performed by one surgeon from April 2009 to April 2011. SUI was diagnosed on coughing and Valsalva test and urodynamics (cystometry and uroflowmetry) were assessed before operation and 1 year after surgery. This was a prospective randomized study. The follow up period was 12 months. 76 patients were operated using the TVT-Exact operation and 78 patients - using the SLING-IUFT operation. There was no statistically significant differences between groups for BMI, parity, menopausal status and prolapsed stage (no patients had cystocele greater than stage II). Mean operative time was significantly shorter in the SLING-IUFT group (19 ± 5.6 min.) compared with the TVT-Exact group (27 ± 7.1 min.). There were statistically significant differences in the effectiveness of both procedures: TVT-Exact - at 94.5% and SLING-IUFT - at 61.2% after one year. Hospital stay was statistically significantly shorter in the SLING-IUFT group (1. 2 ± 0.5 days) compared with the TVT-Exact group (3.5 ± 1.5 days). Statistically significantly fewer complications occurred in the SLING-IUFT group. the TVT-Exact and SLING-IUFT operations are both effective for surgical treatment of female stress urinary incontinence. The SLING-IUFT involved a shorter operation time and lower complications rate., the TVT-Exact procedure had statistically significantly more complications than the SLING-IUFT operation, but a higher effectiveness.

  2. A mechanism of wave drag reduction in the thermal energy deposition experiments

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

    Markhotok, A., E-mail: amarhotk@phys.washington.edu

    2015-06-15

    Many experimental studies report reduced wave drag when thermal energy is deposited in the supersonic flow upstream of a body. Though a large amount of research on this topic has been accumulated, the exact mechanism of the drag reduction is still unknown. This paper is to fill the gap in the understanding connecting multiple stages of the observed phenomena with a single mechanism. The proposed model provides an insight on the origin of the chain of subsequent transformations in the flow leading to the reduction in wave drag, such as typical deformations of the front, changes in the gas pressuremore » and density in front of the body, the odd shapes of the deflection signals, and the shock wave extinction in the plasma area. The results of numerical simulation based on the model are presented for three types of plasma parameter distribution. The spherical and cylindrical geometry has been used to match the data with the experimental observations. The results demonstrate full ability of the model to exactly explain all the features observed in the drag reduction experiments. Analytical expressions used in the model allow separating out a number of adjustment parameters that can be used to optimize thermal energy input and thus achieve fundamentally lower drag values than that of conventional approaches.« less

  3. What's Wrong with Teaching to the Test?

    ERIC Educational Resources Information Center

    Posner, Dave

    2004-01-01

    Opponents of so-called high-stakes testing complain that such intense pressure causes teachers to devote virtually all classroom time and resources to preparing students for the standardized test. This phenomenon is called "teaching to the test." Proponents of high-stakes testing respond that that is exactly as it should be. They argue…

  4. Mathematics: Algebra and Geometry. GED Scoreboost.

    ERIC Educational Resources Information Center

    Hoyt, Cathy

    GED "Scoreboost" materials target exactly the skills one needs to pass the General Educational Development (GED) tests. This book focuses on the GED Mathematics test. To prepare for the test, the test taker needs to learn skills in number and operation sense, data and statistics, geometry and measurement, and algebra. To pass the test,…

  5. Extending the Testing Effect to Self-Regulated Learning

    ERIC Educational Resources Information Center

    Fernandez, Jonathan; Jamet, Eric

    2017-01-01

    In addition to serving summative assessment purposes, testing has turned out to be a powerful learning tool. However, while the beneficial effect of testing on learning performances has been confirmed in a large body of literature, the question of exactly how testing influences cognitive and metacognitive processes remains unclear. We therefore…

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

    Doebling, Scott William

    This paper documents the escape of high explosive (HE) products problem. The problem, first presented by Fickett & Rivard, tests the implementation and numerical behavior of a high explosive detonation and energy release model and its interaction with an associated compressible hydrodynamics simulation code. The problem simulates the detonation of a finite-length, one-dimensional piece of HE that is driven by a piston from one end and adjacent to a void at the other end. The HE equation of state is modeled as a polytropic ideal gas. The HE detonation is assumed to be instantaneous with an infinitesimal reaction zone. Viamore » judicious selection of the material specific heat ratio, the problem has an exact solution with linear characteristics, enabling a straightforward calculation of the physical variables as a function of time and space. Lastly, implementation of the exact solution in the Python code ExactPack is discussed, as are verification cases for the exact solution code.« less

  7. HIV testing practices and the potential role of HIV self-testing among men who have sex with men in Mexico.

    PubMed

    Oldenburg, Catherine E; Biello, Katie B; Perez-Brumer, Amaya G; Rosenberger, Joshua; Novak, David S; Mayer, Kenneth H; Mimiaga, Matthew J

    2017-03-01

    The objective of this study was to characterize HIV testing practices among men who have sex with men in Mexico and intention to use HIV self-testing. In 2012, members of one of the largest social/sexual networking websites for men who have sex with men in Latin America completed an anonymous online survey. This analysis was restricted to HIV-uninfected men who have sex with men residing in Mexico. Multivariable logistic regression models were fit to assess factors associated with HIV testing and intention to use a HIV self-test. Of 4537 respondents, 70.9% reported ever having a HIV test, of whom 75.5% reported testing at least yearly. The majority (94.3%) indicated that they would use a HIV home self-test if it were available. Participants identifying as bisexual less often reported ever HIV testing compared to those identifying as gay/homosexual (adjusted odds ratio = 0.52, 95% confidence interval: 0.44-0.62). Having a physical exam in the past year was associated with increased ever HIV testing (adjusted odds ratio = 4.35, 95% confidence interval: 3.73-5.07), but associated with decreased interest in HIV self-testing (adjusted odds ratio = 0.66, 95% confidence interval: 0.48-0.89). The high intention to use HIV home self-testing supports the use of this method as an acceptable alternative to clinic- or hospital-based HIV testing.

  8. Disparities between malaria infection and treatment rates: Evidence from a cross-sectional analysis of households in Uganda.

    PubMed

    Saran, Indrani; Cohen, Jessica

    2017-01-01

    In Sub-Saharan Africa, both under-treatment and over-treatment of malaria are common since illnesses are often diagnosed and treated on the basis of symptoms. We investigate whether malaria treatment rates among febrile individuals correspond to observed patterns of malaria infection by age and by local prevalence. We use data on treatment of febrile illnesses from a household survey that was conducted between March and May 2012 in 92 villages in six districts in Eastern Uganda. All household members were also tested for malaria using a rapid diagnostic test. We show that both the age of the febrile individual and the village prevalence rate are strongly associated with the odds that a febrile patient was infected with malaria, but not with the odds of ACT treatment. Compared to individuals who were aged 15 or above, febrile individuals aged 5-14 had 3.21 times the odds of testing positive for malaria (95% CI: [2.36 4.37], P<0·001), and febrile individuals who were under age 5 had 2.66 times the odds of testing positive for malaria (95% CI: [1.99 3.56], P<0·001). However, ACT treatment rates for febrile illnesses were not significantly higher for either children ages 5-14 (Unadjusted OR: 1.19, 95% CI: [0.88 1.62], P = 0.255) or children under the age of 5 (Unadjusted OR: 1.24, 95% CI: [0.92 1.68], P = 0·154). A one standard deviation increase in the village malaria prevalence rate was associated with a 2.03 times higher odds that a febrile individual under the age of five tested positive for malaria (95% CI: [1.63 2.54], p<0·001), but was not significantly associated with the odds of ACT treatment (Un-adjusted OR: 0.83, 95% CI: [0.66 1.05], P = 0·113). We present some evidence that this discrepancy may be because caregivers do not suspect a higher likelihood of malaria infection, conditional on fever, in young children or in high-prevalence villages. Our findings suggest that households have significant mis-perceptions about malaria likelihood that may contribute to the under-treatment of malaria. Policies are needed to encourage caregivers to seek immediate diagnostic testing and treatment for febrile illnesses, particularly among young children.

  9. Products of composite operators in the exact renormalization group formalism

    NASA Astrophysics Data System (ADS)

    Pagani, C.; Sonoda, H.

    2018-02-01

    We discuss a general method of constructing the products of composite operators using the exact renormalization group formalism. Considering mainly the Wilson action at a generic fixed point of the renormalization group, we give an argument for the validity of short-distance expansions of operator products. We show how to compute the expansion coefficients by solving differential equations, and test our method with some simple examples.

  10. Testing and testing positive: childhood adversities and later life HIV status among Kenyan women and their partners.

    PubMed

    Goodman, Michael L; Raimer-Goodman, Lauren; Chen, Catherine X; Grouls, Astrid; Gitari, Stanley; Keiser, Philip H

    2017-12-01

    Adverse childhood experiences are a critical feature of lifelong health. No research assesses whether childhood adversities predict HIV-testing behaviors, and little research analyzes childhood adversities and later life HIV status in sub-Saharan Africa. We use regression models with cross-sectional data from a representative sample (n = 1974) to analyze whether adverse childhood experiences, separately or as cumulative exposures, predict reports of later life HIV testing and testing HIV+ among semi-rural Kenyan women and their partners. No significant correlation was observed between thirteen cumulative childhood adversities and reporting prior HIV testing for respondent or partner. Separately, childhood sexual abuse and emotional neglect predicted lower odds of reporting having previously been tested for HIV. Witnessing household violence during one's childhood predicted significantly higher odds of reporting HIV+. Sexual abuse predicted higher odds of reporting a partner tested HIV+. Preventing sexual abuse and household violence may improve HIV testing and test outcomes among Kenyan women. More research is required to understand pathways between adverse childhood experiences and partner selection within Kenya and sub-Saharan Africa, and data presented here suggest understanding pathways may help improve HIV outcomes. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Penetrable square-well fluids: exact results in one dimension.

    PubMed

    Santos, Andrés; Fantoni, Riccardo; Giacometti, Achille

    2008-05-01

    We introduce a model of attractive penetrable spheres by adding a short-range attractive square well outside a penetrable core, and we provide a detailed analysis of structural and thermodynamical properties in one dimension using the exact impenetrable counterpart as a starting point. The model is expected to describe star polymers in regimes of good and moderate solvent under dilute conditions. We derive the exact coefficients of a low-density expansion up to second order for the radial distribution function and up to fourth order in the virial expansion. These exact results are used as a benchmark to test the reliability of approximate theories (Percus-Yevick and hypernetted chain). Notwithstanding the lack of an exact solution for arbitrary densities, our results are expected to be rather precise within a wide range of temperatures and densities. A detailed analysis of some limiting cases is carried out. In particular, we provide a complete solution of the sticky penetrable-sphere model in one dimension up to the same order in density. The issue of Ruelle's thermodynamics stability is analyzed and the region of a well-defined thermodynamic limit is identified.

  12. A low-dispersion, exactly energy-charge-conserving semi-implicit relativistic particle-in-cell algorithm

    NASA Astrophysics Data System (ADS)

    Chen, Guangye; Luis, Chacon; Bird, Robert; Stark, David; Yin, Lin; Albright, Brian

    2017-10-01

    Leap-frog based explicit algorithms, either ``energy-conserving'' or ``momentum-conserving'', do not conserve energy discretely. Time-centered fully implicit algorithms can conserve discrete energy exactly, but introduce large dispersion errors in the light-wave modes, regardless of timestep sizes. This can lead to intolerable simulation errors where highly accurate light propagation is needed (e.g. laser-plasma interactions, LPI). In this study, we selectively combine the leap-frog and Crank-Nicolson methods to produce a low-dispersion, exactly energy-and-charge-conserving PIC algorithm. Specifically, we employ the leap-frog method for Maxwell equations, and the Crank-Nicolson method for particle equations. Such an algorithm admits exact global energy conservation, exact local charge conservation, and preserves the dispersion properties of the leap-frog method for the light wave. The algorithm has been implemented in a code named iVPIC, based on the VPIC code developed at LANL. We will present numerical results that demonstrate the properties of the scheme with sample test problems (e.g. Weibel instability run for 107 timesteps, and LPI applications.

  13. Eigenstates and dynamics of Hooke's atom: Exact results and path integral simulations

    NASA Astrophysics Data System (ADS)

    Gholizadehkalkhoran, Hossein; Ruokosenmäki, Ilkka; Rantala, Tapio T.

    2018-05-01

    The system of two interacting electrons in one-dimensional harmonic potential or Hooke's atom is considered, again. On one hand, it appears as a model for quantum dots in a strong confinement regime, and on the other hand, it provides us with a hard test bench for new methods with the "space splitting" arising from the one-dimensional Coulomb potential. Here, we complete the numerous previous studies of the ground state of Hooke's atom by including the excited states and dynamics, not considered earlier. With the perturbation theory, we reach essentially exact eigenstate energies and wave functions for the strong confinement regime as novel results. We also consider external perturbation induced quantum dynamics in a simple separable case. Finally, we test our novel numerical approach based on real-time path integrals (RTPIs) in reproducing the above. The RTPI turns out to be a straightforward approach with exact account of electronic correlations for solving the eigenstates and dynamics without the conventional restrictions of electronic structure methods.

  14. Impact of HIV knowledge and stigma on the uptake of HIV testing – Results from a community-based participatory research survey among migrants from sub-Saharan Africa in Germany

    PubMed Central

    Koschollek, Carmen; Santos-Hövener, Claudia; Thorlie, Adama; Müllerschön, Johanna; Mputu Tshibadi, Christina; Mayamba, Pierre; Batemona-Abeke, Helene; Amoah, Stephen; Wangare Greiner, Virginia; Dela Bursi, Taty; Bremer, Viviane

    2018-01-01

    Background In 2015, 3,674 new HIV diagnoses were notified in Germany; 16% of those newly diagnosed cases originated from sub-Saharan Africa (sSA). One quarter of the newly diagnosed cases among migrants from sSA (MisSA) are notified as having acquired the HIV infection in Germany. In order to reach MisSA with HIV testing opportunities, we aimed to identify which determinants influence the uptake of HIV testing among MisSA in Germany. Methods To identify those determinants, we conducted a quantitative cross-sectional survey among MisSA in Germany. The survey was designed in a participatory process that included MisSA and other stakeholders in HIV-prevention. Peer researchers recruited participants to complete standardized questionnaires on HIV knowledge and testing. We conducted multivariable analyses (MVA) to identify determinants associated with ever having attended voluntary HIV testing; and another MVA to identify determinant associated with having had the last voluntary HIV test in Germany. Results Peer researchers recruited 2,782 participants eligible for inclusion in the MVA. Of these participants, 59.9% (1,667/2,782) previously had an HIV test. For each general statement about HIV that participants knew prior to participation in the study, the odds of having been tested increased by 19% (OR 1.19; 95%-CI: 1.11–1.27). Participants reporting that HIV is a topic that is discussed in their community had 92% higher odds of having been tested for HIV (OR 1.92; 95%-CI: 1.60–2.31). Migrants living in Germany for less than a year had the lowest odds of having had their last HIV test in Germany (OR 0.17; 95%-CI: 0.11–0.27). Additionally, MisSA 18 to 25 years (OR 0.55; 95%-CI: 0.42–0.73) and participants with varied sexual partners and inconsistent condom use (OR 0.75; 95%-CI: 0.44–0.97) had significantly lower odds of having had their last HIV test in Germany. Discussion Through participatory research, we were able to show that knowledge about HIV and discussing HIV in communities increased the odds of having attended HIV testing among MisSA. However, recent migrants and young sexually active people are among the least reached by testing offers in Germany. Community-based interventions may present opportunities to reach such migrants and improve knowledge and increase discussion about HIV. PMID:29641527

  15. Toward Exact Number: Young Children Use One-to-one Correspondence to Measure Set Identity but not Numerical Equality

    PubMed Central

    Izard, Véronique; Streri, Arlette; Spelke, Elizabeth S.

    2014-01-01

    Exact integer concepts are fundamental to a wide array of human activities, but their origins are obscure. Some have proposed that children are endowed with a system of natural number concepts, whereas others have argued that children construct these concepts by mastering verbal counting or other numeric symbols. This debate remains unresolved, because it is difficult to test children’s mastery of the logic of integer concepts without using symbols to enumerate large sets, and the symbols themselves could be a source of difficulty for children. Here, we introduce a new method, focusing on large quantities and avoiding the use of words or other symbols for numbers, to study children’s understanding of an essential property underlying integer concepts: the relation of exact numerical equality. Children aged 32-36 months, who possessed no symbols for exact numbers beyond 4, were given one-to-one correspondence cues to help them track a set of puppets, and their enumeration of the set was assessed by a non-verbal manual search task. Children used one-to-one correspondence relations to reconstruct exact quantities in sets of 5 or 6 objects, as long as the elements forming the sets remained the same individuals. In contrast, they failed to track exact quantities when one element was added, removed, or substituted for another. These results suggest an alternative to both nativist and symbol-based constructivist theories of the development of natural number concepts: Before learning symbols for exact numbers, children have a partial understanding of the properties of exact numbers. PMID:24680885

  16. Exact quantization of Einstein-Rosen waves coupled to massless scalar matter.

    PubMed

    Barbero G, J Fernando; Garay, Iñaki; Villaseñor, Eduardo J S

    2005-07-29

    We show in this Letter that gravity coupled to a massless scalar field with full cylindrical symmetry can be exactly quantized by an extension of the techniques used in the quantization of Einstein-Rosen waves. This system provides a useful test bed to discuss a number of issues in quantum general relativity, such as the emergence of the classical metric, microcausality, and large quantum gravity effects. It may also provide an appropriate framework to study gravitational critical phenomena from a quantum point of view, issues related to black hole evaporation, and the consistent definition of test fields and particles in quantum gravity.

  17. Religion and HIV Sexual Risk Among Men Who Have Sex With Men in China.

    PubMed

    Pan, Stephen W; Zhang, Zheng; Li, Dongliang; Carpiano, Richard M; Schechter, Martin T; Ruan, Yuhua; Spittal, Patricia M

    2016-12-01

    Religion can profoundly impact the sociocultural contexts that shape sexual HIV vulnerability among men who have sex with men (MSM). However, the relationship between religion and HIV vulnerability remains poorly understood for MSM in China, where religious affiliations and practices are rapidly increasing. Using cross-sectional survey data collected in Beijing and Tianjin, China, from 2013 to 2014 (n = 400), this study tests 3 hypotheses regarding religion and HIV sexual risk: (1) HIV vulnerabilities and testing patterns among religiously affiliated MSM are lower than for areligious MSM, (2) religiosity is inversely associated with HIV vulnerabilities and testing, and (3) the magnitude of inverse association between religiosity and HIV vulnerabilities/testing will be stronger among Christian and Muslim MSM than Buddhist and areligious MSM. Compared with areligious participants, Buddhists had higher odds of reporting unprotected anal intercourse [adjusted odds ratio (AOR): 2.06, 95% confidence interval (CI): 1.13 to 3.75] and more male sex partners (AOR: 1.95, 1.16-3.27), whereas Muslims had lower odds of reporting unprotected anal intercourse (AOR: 0.33, 95% CI: 0.15 to 0.73) and higher odds of reporting male circumcision (AOR: 3.04, 95% CI: 1.45 to 6.40). Reporting of forced sex was associated with more frequent participation in social religious activities (AOR: 1.25, 95% CI: 1.02 to 1.52) and private religious activities (AOR: 1.30, 95% CI: 1.04 to 1.61). Among Christians, participation in private religious activities was associated with lower odds of reporting anal intercourse (AOR: 0.49, 95% CI: 0.27 to 0.88). The sustained growth of multiple religious traditions in China appears to have important implications for HIV vulnerability among religious minority MSM.

  18. Conscious Sedation Procedures Using Intravenous Midazolam for Dental Care in Patients with Different Cognitive Profiles: A Prospective Study of Effectiveness and Safety

    PubMed Central

    Collado, Valérie; Faulks, Denise; Nicolas, Emmanuel; Hennequin, Martine

    2013-01-01

    The use of midazolam for dental care in patients with intellectual disability is poorly documented. This study aimed to evaluate the effectiveness and safety of conscious sedation procedures using intravenous midazolam in adults and children with intellectual disability (ID) compared to dentally anxious patients (DA). Ninety-eight patients with ID and 44 patients with DA programmed for intravenous midazolam participated in the study over 187 and 133 sessions, respectively. Evaluation criteria were success of dental treatment, cooperation level (modified Venham scale), and occurrence of adverse effects. The mean intravenous dose administered was 8.8±4.9 mg and 9.8±4.1 mg in ID and DA sessions respectively (t-test, NS). 50% N2O/O2 was administered during cannulation in 51% of ID sessions and 61% of DA sessions (NS, Fisher exact test). Oral or rectal midazolam premedication was administered for cannulation in 31% of ID sessions and 3% of DA sessions (p<0,001, Fisher exact test). Dental treatment was successful in 9 out of 10 sessions for both groups. Minor adverse effects occurred in 16.6% and 6.8% of ID and DA sessions respectively (p = 0.01, Fisher exact test). Patients with ID were more often very disturbed during cannulation (25.4% ID vs. 3.9% DA sessions) and were less often relaxed after induction (58.9% ID vs. 90.3% DA) and during dental treatment (39.5% ID vs. 59.7% DA) (p<0.001, Fisher exact test) than patients with DA. When midazolam sedation was repeated, cooperation improved for both groups. Conscious sedation procedures using intravenous midazolam, with or without premedication and/or inhalation sedation (50% N2O/O2), were shown to be safe and effective in patients with intellectual disability when administered by dentists. PMID:23940729

  19. The comparison of humeral intraosseous and intravenous administration of vasopressin on return of spontaneous circulation and pharmacokinetics in a hypovolemic cardiac arrest swine model.

    PubMed

    Wimmer, Mark H; Heffner, Kenneth; Smithers, Michael; Culley, Richard; Coyner, Jennifer; Loughren, Michael; Johnson, Don

    2016-01-01

    The American Heart Association (AHA) recommends intravenous (IV) or intraosseous (IO) vasopressin in Advanced Cardiac Life Support (ACLS). Obtaining IV access in hypovolemic cardiac arrest patients can be difficult, and IO access is often obtained in these life threatening situations. No studies have been conducted to determine the effects of humeral IO (HIO) access with vasopressin in the return of spontaneous circulation (ROSC). Our study compared the kinetics of vasopressin and ROSC with HIO with IV access in the hypovolemic swine model. Twenty-two Yorkshire swine were divided into three groups: HIO (n = 7), IV (n = 8), and a control group (n = 7). The IV and HIO group received vasopressin and cardiopulmonary resuscitation (CPR), while the control group received only CPR. All subjects were exsanguinated 31 percent of their blood volume, placed in cardiac arrest, and resuscitated per ACLS. Subjects that achieved ROSC were then monitored for 20 minutes. Blood samples (10 mL) collected at 0.5, 1, 1.5, 2, 2.5, 3, and 4 minutes after vasopressin injection and analyzed for maximum concentration (Cmax) and time to maximum concentration (Tmax). Data were analyzed using a multivariate analysis of variance (MANOVA) and a Fisher's Exact Test. ROSC was achieved in every subject that received vasopressin via the HIO route. Data analysis using a MANOVA pairwise comparison revealed no difference between mean Cmax (p = 0.601) and Tmax (p = 0.771) of vasopressin administered IV versus HIO routes. Analysis of the mean serum concentrations at time intervals using a repeated measures analysis of variance found no difference (p > 0.05). A Fisher's Exact Test revealed no difference in rate of ROSC between HIO and IV groups (p > 0.05). Odds ratio determined that there was a 33 times higher chance of survival among HIO subjects versus control (CPR and Defibrillation; p = 0.03) and no difference in the survivability of the HIO or IV groups (p = 0.52). The data from this study strongly suggest that there is no significant difference in ROSC, time to ROSC, hemodynamics, or pharmacokinetics between HIO vasopressin and IV vasopressin. This research reinforces current AHA guidelines recommending the use of HIO route early over delaying care awaiting IV access.

  20. Ancestry informative markers and selected single nucleotide polymorphisms in immunoregulatory genes on preterm labor and preterm premature rupture of membranes: a case control study.

    PubMed

    Ramos, Bruna Ribeiro de Andrade; Mendes, Niele Dias; Tanikawa, Aline Aki; Amador, Marcos Antônio Trindade; dos Santos, Ney Pereira Carneiro; dos Santos, Sidney Emanuel Batista; Castelli, Erick C; Witkin, Steven S; da Silva, Márcia Guimarães

    2016-02-05

    A genetic predisposition to Preterm Labor (PTL) and Preterm Premature Rupture of Membranes (PPROM) has been suggested; however the relevance of polymorphisms and ancestry to susceptibility to PTL and PPROM in different populations remains unclear. The aim of this study was to evaluate the contribution of maternal and fetal SNPs in the IL1B, IL6, IL6R, TNFA, TNFR, IL10, TLR2, TLR4, MMP9, TIMP1 and TIMP2 genes and the influence of ancestry background in the susceptibility to PTL or PPROM in Brazilian women. Case-control study conducted at a tertiary hospital in São Paulo State, Brazil. We included women with PTL or PPROM and their babies (PTL: 136 women and 88 babies; PPROM: 65 women and 44 babies). Control group included 402 mother-babies pairs of term deliveries. Oral swabs were collected for identification of AIMs by fragment analysis and SNPs by Taqman® SNP Genotyping Assays and PCR. Linkage Disequilibrium and Hardy-Weinberg proportions were evaluated using Genepop 3.4. Haplotypes were inferred using the PHASE algorithm. Allele, genotype and haplotype frequencies were compared by Fisher's exact test or χ (2) and Odds Ratio. Logistic regression was performed. Clinical and sociodemographic data were analyzed by Fisher's exact test and Mann-Whitney. PTL was associated with European ancestry and smoking while African ancestry was protective. The fetal alleles IL10-592C (rs800872) and IL10-819C (rs1800871) were also associated with PTL and the maternal haplotype TNFA-308G-238A was protective. Maternal presence of IL10-1082G (rs1800896) and TLR2A (rs4696480) alleles increased the risk for PPROM while TNFA-238A (rs361525) was protective. Family history of PTL/PPROM was higher in cases, and time to delivery was influenced by IL1B-31T (rs1143627) and TLR4-299G (rs4986790). There is an association between European ancestry and smoking and PTL in our Brazilian population sample. The presence of maternal or fetal alleles that modify the inflammatory response increase the susceptibility to PTL and PPROM. The family history of PTL/PPROM reinforces a role for genetic polymorphisms in susceptibility to these outcomes.

  1. The rockets' red glare, the bombs bursting in air: fireworks-related injuries to children.

    PubMed

    Smith, G A; Knapp, J F; Barnett, T M; Shields, B J

    1996-07-01

    To describe the epidemiology of fireworks-related injuries to children treated in a pediatric emergency department. A descriptive study of a consecutive series of patients. The emergency department of a large urban children's hospital. Children treated for injuries associated with fireworks during the 22-year period from 1972 through 1993. Three hundred sixteen children were treated for fireworks-related injuries. Ninety-five percent of patients were injured during the 3-week period of June 22 to July 14 during the study years. Seventy-one percent of patients were male, and the average age was 8.5 years, with a range of 1 month to 17 years. The child was a bystander in 26% of cases, and adult supervision was present in 54% of cases. One patient died, and 11% of children required admission to the hospital, with an average length of stay of 7.8 days (range, 1 to 37 days). Fifteen children (5%) went to the operating room for treatment of injuries. Thirty-three patients (10%) had permanent sequelae from their injuries, including 7 children (2%) with complete or partial loss of vision in one eye. The eyes were injured in 29% of cases, followed by hands and fingers (22%), other head and face sites (18%), and lower extremities (16%). The primary injury was a burn in 72% of cases. Firecrackers were associated with 42% of injuries, followed by bottle rockets (12%), other types of rockets (7%), Roman candles (11%), sparklers (7%), fountains (5%), jumping jacks (4%), and class B (illegal) fireworks (4%). Sixty-seven percent of sparkler-related injuries occurred among children 5 years and younger (Fisher's exact test, P = .000002; odds ratio [OR] = 10.00, 95% confidence interval 3.52 < OR < 29.24). Permanent sequelae were more common for eye injuries caused by rockets than eye injuries caused by other types of fireworks (Fisher's exact test, P = .03; OR = 6.72, 95% confidence interval 1.18 < OR < 38.18). Charges for medical care of a fireworks-related injury averaged $1385 per patient (range, $44 to $15 071). Fireworks are associated with serious injuries. Findings of this large consecutive series describe the epidemiology of these injuries. Children and their families should be encouraged to enjoy fireworks at public fireworks displays conducted by professionals. Fireworks for individual private use should be banned.

  2. Analytical solutions for efficient interpretation of single-well push-pull tracer tests

    EPA Science Inventory

    Single-well push-pull tracer tests have been used to characterize the extent, fate, and transport of subsurface contamination. Analytical solutions provide one alternative for interpreting test results. In this work, an exact analytical solution to two-dimensional equations descr...

  3. Exact Turbulence Law in Collisionless Plasmas: Hybrid Simulations

    NASA Astrophysics Data System (ADS)

    Hellinger, P.; Verdini, A.; Landi, S.; Franci, L.; Matteini, L.

    2017-12-01

    An exact vectorial law for turbulence in homogeneous incompressible Hall-MHD is derived and tested in two-dimensional hybrid simulations of plasma turbulence. The simulations confirm the validity of the MHD exact law in the kinetic regime, the simulated turbulence exhibits a clear inertial range on large scales where the MHD cascade flux dominates. The simulation results also indicate that in the sub-ion range the cascade continues via the Hall term and that the total cascade rate tends to decrease at around the ion scales, especially in high-beta plasmas. This decrease is like owing to formation of non-thermal features, such as collisionless ion energization, that can not be retained in the Hall MHD approximation.

  4. Near-exact distributions for the block equicorrelation and equivariance likelihood ratio test statistic

    NASA Astrophysics Data System (ADS)

    Coelho, Carlos A.; Marques, Filipe J.

    2013-09-01

    In this paper the authors combine the equicorrelation and equivariance test introduced by Wilks [13] with the likelihood ratio test (l.r.t.) for independence of groups of variables to obtain the l.r.t. of block equicorrelation and equivariance. This test or its single block version may find applications in many areas as in psychology, education, medicine, genetics and they are important "in many tests of multivariate analysis, e.g. in MANOVA, Profile Analysis, Growth Curve analysis, etc" [12, 9]. By decomposing the overall hypothesis into the hypotheses of independence of groups of variables and the hypothesis of equicorrelation and equivariance we are able to obtain the expressions for the overall l.r.t. statistic and its moments. From these we obtain a suitable factorization of the characteristic function (c.f.) of the logarithm of the l.r.t. statistic, which enables us to develop highly manageable and precise near-exact distributions for the test statistic.

  5. Pearson-type goodness-of-fit test with bootstrap maximum likelihood estimation.

    PubMed

    Yin, Guosheng; Ma, Yanyuan

    2013-01-01

    The Pearson test statistic is constructed by partitioning the data into bins and computing the difference between the observed and expected counts in these bins. If the maximum likelihood estimator (MLE) of the original data is used, the statistic generally does not follow a chi-squared distribution or any explicit distribution. We propose a bootstrap-based modification of the Pearson test statistic to recover the chi-squared distribution. We compute the observed and expected counts in the partitioned bins by using the MLE obtained from a bootstrap sample. This bootstrap-sample MLE adjusts exactly the right amount of randomness to the test statistic, and recovers the chi-squared distribution. The bootstrap chi-squared test is easy to implement, as it only requires fitting exactly the same model to the bootstrap data to obtain the corresponding MLE, and then constructs the bin counts based on the original data. We examine the test size and power of the new model diagnostic procedure using simulation studies and illustrate it with a real data set.

  6. Einstein-aether theory: dynamics of relativistic particles with spin or polarization in a Gödel-type universe

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

    Balakin, Alexander B.; Popov, Vladimir A., E-mail: alexander.balakin@kpfu.ru, E-mail: vladipopov@mail.ru

    In the framework of the Einstein-aether theory we consider a cosmological model, which describes the evolution of the unit dynamic vector field with activated rotational degree of freedom. We discuss exact solutions of the Einstein-aether theory, for which the space-time is of the Gödel-type, the velocity four-vector of the aether motion is characterized by a non-vanishing vorticity, thus the rotational vectorial modes can be associated with the source of the universe rotation. The main goal of our paper is to study the motion of test relativistic particles with a vectorial internal degree of freedom (spin or polarization), which is coupledmore » to the unit dynamic vector field. The particles are considered as the test ones in the given space-time background of the Gödel-type; the spin (polarization) coupling to the unit dynamic vector field is modeled using exact solutions of three types. The first exact solution describes the aether with arbitrary Jacobson's coupling constants; the second one relates to the case, when the Jacobson's constant responsible for the vorticity is vanishing; the third exact solution is obtained using three constraints for the coupling constants. The analysis of the exact expressions, which are obtained for the particle momentum and for the spin (polarization) four-vector components, shows that the interaction of the spin (polarization) with the unit vector field induces a rotation, which is additional to the geodesic precession of the spin (polarization) associated with the universe rotation as a whole.« less

  7. Use of prostate-specific antigen testing as a disease surveillance tool following radical prostatectomy

    PubMed Central

    Trantham, Laurel Clayton; Nielsen, Matthew E.; Mobley, Lee R.; Wheeler, Stephanie B.; Carpenter, William R.; Biddle, Andrea K.

    2013-01-01

    Background Prostate-specific antigen (PSA) testing is recommended every 6 to 12 months for the first 5 years following radical prostatectomy as a means to detect potential disease recurrence. Despite substantial research on factors affecting treatment decisions, recurrence, and mortality, little is known about whether men receive guideline-concordant surveillance testing or whether receipt varies by year of diagnosis, time since treatment, or other individual characteristics. Methods Surveillance testing following radical prostatectomy among elderly men was examined using Surveillance, Epidemiology, and End Results cancer registry data linked to Medicare claims. Multivariate logistic regression was used to examine the effect of demographic, tumor, and county-level characteristics on the odds of receiving surveillance testing within a given one-year period following treatment. Results Overall, receipt of surveillance testing was high, with 96% of men receiving at least one test the first year after treatment and approximately 80% receiving at least one test in the fifth year after treatment. Odds of not receiving a test declined with time since treatment. Non-married men, men with less advanced disease, and non-Hispanic Blacks and Hispanics had higher odds of not receiving a surveillance test. Year of diagnosis did not affect the receipt of surveillance tests. Conclusion Most men receive guideline-concordant surveillance PSA testing after prostatectomy, although evidence of a racial disparity between non-Hispanic Whites and some minority groups exists. The decline in surveillance over time suggests the need for well-designed long-term surveillance plans following radical prostatectomy. PMID:23893821

  8. Repeated significance tests of linear combinations of sensitivity and specificity of a diagnostic biomarker

    PubMed Central

    Wu, Mixia; Shu, Yu; Li, Zhaohai; Liu, Aiyi

    2016-01-01

    A sequential design is proposed to test whether the accuracy of a binary diagnostic biomarker meets the minimal level of acceptance. The accuracy of a binary diagnostic biomarker is a linear combination of the marker’s sensitivity and specificity. The objective of the sequential method is to minimize the maximum expected sample size under the null hypothesis that the marker’s accuracy is below the minimal level of acceptance. The exact results of two-stage designs based on Youden’s index and efficiency indicate that the maximum expected sample sizes are smaller than the sample sizes of the fixed designs. Exact methods are also developed for estimation, confidence interval and p-value concerning the proposed accuracy index upon termination of the sequential testing. PMID:26947768

  9. Nonequilibrium Energy Transfer at Nanoscale: A Unified Theory from Weak to Strong Coupling

    PubMed Central

    Wang, Chen; Ren, Jie; Cao, Jianshu

    2015-01-01

    Unraveling the microscopic mechanism of quantum energy transfer across two-level systems provides crucial insights to the optimal design and potential applications of low-dimensional nanodevices. Here, we study the non-equilibrium spin-boson model as a minimal prototype and develop a fluctuation-decoupled quantum master equation approach that is valid ranging from the weak to the strong system-bath coupling regime. The exact expression of energy flux is analytically established, which dissects the energy transfer as multiple boson processes with even and odd parity. Our analysis provides a unified interpretation of several observations, including coherence-enhanced heat flux and negative differential thermal conductance. The results will have broad implications for the fine control of energy transfer in nano-structural devices. PMID:26152705

  10. Green's-function theory of dirty two-band superconductivity

    NASA Astrophysics Data System (ADS)

    Asano, Yasuhiro; Golubov, Alexander A.

    2018-06-01

    We study the effects of random nonmagnetic impurities on the superconducting transition temperature Tc in a two-band superconductor, where we assume an equal-time spin-singlet s -wave pair potential in each conduction band and the hybridization between the two bands as well as the band asymmetry. In the clean limit, the phase of hybridization determines the stability of two states, called s++ and s+-. The interband impurity scatterings decrease Tc of the two states exactly in the same manner when time-reversal symmetry is preserved in the Hamiltonian. We find that a superconductor with larger hybridization shows more moderate suppression of Tc. This effect can be explained by the presence of odd-frequency Cooper pairs, which are generated by the band hybridization in the clean limit and are broken by impurities.

  11. Crossover between few and many fermions in a harmonic trap

    NASA Astrophysics Data System (ADS)

    Grining, Tomasz; Tomza, Michał; Lesiuk, Michał; Przybytek, Michał; Musiał, Monika; Moszynski, Robert; Lewenstein, Maciej; Massignan, Pietro

    2015-12-01

    The properties of a balanced two-component Fermi gas in a one-dimensional harmonic trap are studied by means of the coupled-cluster method. For few fermions we recover the results of exact diagonalization, yet with this method we are able to study much larger systems. We compute the energy, the chemical potential, the pairing gap, and the density profile of the trapped clouds, smoothly mapping the crossover between the few-body and many-body limits. The energy is found to converge surprisingly rapidly to the many-body result for every value of the interaction strength. Many more particles are instead needed to give rise to the nonanalytic behavior of the pairing gap, and to smoothen the pronounced even-odd oscillations of the chemical potential induced by the shell structure of the trap.

  12. Applying the theory of planned behaviour to explain HIV testing in antenatal settings in Addis Ababa - a cohort study

    PubMed Central

    2011-01-01

    Background To facilitate access to the prevention of mother-to-child HIV transmission (PMTCT) services, HIV counselling and testing are offered routinely in antenatal care settings. Focusing a cohort of pregnant women attending public and private antenatal care facilities, this study applied an extended version of the Theory of Planned Behaviour (TPB) to explain intended- and actual HIV testing. Methods A sequential exploratory mixed methods study was conducted in Addis Ababa in 2009. The study involved first time antenatal attendees from public- and private health care facilities. Three Focus Group Discussions were conducted to inform the TPB questionnaire. A total of 3033 women completed the baseline TPB interviews, including attitudes, subjective norms, perceived behavioural control and intention with respect to HIV testing, whereas 2928 completed actual HIV testing at follow up. Data were analysed using descriptive statistics, Chi-square tests, Fisher's Exact tests, Internal consistency reliability, Pearson's correlation, Linear regression, Logistic regression and using Epidemiological indices. P-values < 0.05 was considered significant and 95% Confidence Interval (CI) was used for the odds ratio. Results The TPB explained 9.2% and 16.4% of the variance in intention among public- and private health facility attendees. Intention and perceived barriers explained 2.4% and external variables explained 7% of the total variance in HIV testing. Positive and negative predictive values of intention were 96% and 6% respectively. Across both groups, subjective norm explained a substantial amount of variance in intention, followed by attitudes. Women intended to test for HIV if they perceived social support and anticipated positive consequences following test performance. Type of counselling did not modify the link between intended and actual HIV testing. Conclusion The TPB explained substantial amount of variance in intention to test but was less sufficient in explaining actual HIV testing. This low explanatory power of TPB was mainly due to the large proportion of low intenders that ended up being tested contrary to their intention before entering the antenatal clinic. PMTCT programs should strengthen women's intention through social approval and information that testing will provide positive consequences for them. However, women's rights to opt-out should be emphasized in any attempt to improve the PMTCT programs. PMID:21851613

  13. Perceived stress and gastrointestinal symptoms in nursing students in Korea: A cross-sectional survey

    PubMed Central

    2011-01-01

    Background Although nursing students experience a high level of stress during their training, there has been limited research on stress and its impact on the student's physical responses, such as gastrointestinal symptoms. The aims of this study are to assess the prevalence of GI symptoms in nursing students in Korea and to examine the association between the perceived stress and GI symptoms. Methods A cross-sectional descriptive study design was used. A total of 715 students of a three-year associate degree nursing program in a Korean college participated. The Perceived Stress Scale and a GI Symptoms Questionnaire were administered through a self-reported system. Chi-square tests, Fisher's exact test, and logistic regression analysis were performed using SPSS 17.0. Results Sixty-five percent of the nursing students experienced more than one GI symptom, with 31.1% of students reporting more than three GI symptoms. Most of the nursing students complained of upper dysmotility and bowel symptoms. In addition, students who reported higher perceived stress were significantly more likely to complain of GI symptoms. Compared to nursing students with the lowest perceived stress level, the adjusted odds ratio (OR) for GI symptoms in students with the highest perceived stress level was 3.52 times higher (95% CI = 2.05-6.06). Conclusions GI symptoms that are highly prevalent among nursing students are significantly associated with the perceived stress level. High perceived stress should be considered a risk factor for GI symptoms. To reduce perceived stress, stress management programs including cognitive reappraisal training are needed in nursing curriculum. PMID:22067441

  14. Antifungal prescribing pattern and attitude towards the treatment of oral candidiasis among dentists in Jordan.

    PubMed

    Al-Shayyab, Mohammad H; Abu-Hammad, Osama A; Al-Omiri, Mahmoud K; Dar-Odeh, Najla S

    2015-08-01

    The aim of this study was to evaluate the attitude of Jordanian dentists towards the treatment of oral candidiasis and their current antifungal prescribing habits, shedding more light on the possible influence of their socio-professional factors on the pattern of prescribing and practice. A structured validated questionnaire was developed and tested; it was then emailed to a random sample of 600 Jordanian dental practitioners during the period of this cross-sectional survey. The questionnaire recorded practitioners' personal details and their attitude and prescribing of antifungal therapy for oral candidiasis. Statistical significance was based on probability values of <0.05 and was measured using the chi-square and Fisher's exact tests. Multiple logistic regression analysis was used to analyse the influence of respondents' socio-professional factors on their attitude towards oral candidiasis. Of the 423 questionnaires returned, only 330 were included. The attitude of respondents was significantly influenced by their experience [odds ratio (OR) = 0.14; P < 0.001] and workplace (OR = 4.70; P < 0.001). Nystatin was the most commonly prescribed antifungal agent (78.2%), followed by miconazole (62.4%), which was prescribed for topical use. Systemic antifungals were prescribed by 21.2% of respondents, with a significant (P < 0.05) association with the country in which their qualification was obtained. The attitude towards the treatment of oral candidiasis is much better among the least-experienced dentists working in private practice. Nystatin and miconazole are the most popular choices of antifungal agents among Jordanian dentists. © 2015 FDI World Dental Federation.

  15. Association between IL-1β polymorphisms and gastritis risk

    PubMed Central

    Sun, Xiaoming; Cai, Hongxing; Li, Zhouru; Li, Shanshan; Yin, Wenjiang; Dong, Guokai; Kuai, Jinxia; He, Yihui; Jia, Jing

    2017-01-01

    Abstract Background: Helicobacter pylori (H. pylori) infection of the human stomach regularly leads to chronic gastric inflammation. The cytokine gene interleukin (IL)-1β has been implicated in influencing the pathology of inflammation induced by H. pylori infection. Currently, several studies have been carried out to investigate the association of IL-1β-511 (rs16944) and IL-1β-31 (rs1143627) polymorphisms with gastritis risk; however, the results are inconsistent and inconclusive. To assess the effect of IL-1β polymorphisms on gastritis susceptibility, we conducted a meta-analysis. Methods: Up to March 15, 2016, 2205 cases and 2289 controls were collected from 12 published case–control studies. Summarized odds ratios and corresponding 95% confidence intervals (CIs) for IL-1β-511 and IL-1β-31 polymorphisms and gastritis risk were estimated using fixed- or random-effects models when appropriate. Heterogeneity was assessed by chi-squared-based Q-statistic test, and the sources of heterogeneity were explored by subgroup analyses and logistic meta-regression analyses. Publication bias was evaluated by Begg funnel plot and Egger test. Sensitivity analyses were also performed. Results: The results provided evidences that the single nucleotide polymorphisms (SNPs) in IL-1β-31 might be associated with the gastritis risk, especially in the Caucasian population, while SNPs in the IL-1β-511 might not be. Conclusion: Our studies may be helpful in supplementing the disease monitoring of gastritis in the future, and additional studies to determine the exact molecular mechanisms might inspire interventions to protect the susceptible subgroups. PMID:28151895

  16. Sasang Constitution as a Risk Factor for Diabetes Mellitus: A Cross-Sectional Study

    PubMed Central

    Lee, Tae-Gyu; Koh, Byunghee

    2009-01-01

    Sasang Constitutional Medicine, which is a branch of traditional Korean medicine, states that medications for diabetes should be individualized according to the patient's individual constitution. However, the effect of constitution on diabetes has not been evaluated to date. Therefore, this study was conducted to determine if constitution is an independent risk factor for diabetes by comparing the prevalence and odds ratios (ORs) of the disease according to constitution. The medical records of 1443 adults who had been examined and classified based on their constitution at Kyung Hee University Hospital in Seoul, Korea were reviewed. A chi-squared test and Fisher's exact test were used to compare the prevalence of diabetes according to constitution, and multiple logistic regression was used to calculate the ORs for diabetes. The prevalence of diabetes differed significantly according to constitution (χ2 = 36.20, df = 2, P < 0.001). Specifically, the prevalence of the disease was higher in Tae-eumin (11.4%) individuals than in Soyangin (5.0%) or Soeumin (1.7%) individuals. In addition, multiple logistic regression revealed that Tae-eumin individuals had a greater risk for diabetes than Soeumin individuals. When compared to Soeumin individuals, the adjusted ORs were 2.01 (95% CI 0.77–5.26) for Soyangin individuals and 3.96 (95% CI 1.48–10.60) for Tae-eumin individuals. These results show that constitution has a significant and independent association with diabetes, which suggests that constitution is an independent risk factor for diabetes that should be considered when attempting to detect and prevent the disease. PMID:19745018

  17. Dental Anomalies in Different Types of Cleft Lip and Palate: Is There Any Relation?

    PubMed

    Germec Cakan, Derya; Nur Yilmaz, Rahime Burcu; Bulut, Feyza Nur; Aksoy, Ayca

    2018-02-26

    The aims of this study were to evaluate the prevalence of dental anomalies in Turkish patients with different types of cleft lip and palate (CLP) and investigate the relationship between the type of cleft and the dental anomaly. Eighty-eight patients with cleft lip and/or palate (mean age: 14.1 ± 6.4 years) were enrolled in this retrospective study. Dental models, panoramic radiographs, and intraoral photographs of these patients were evaluated to detect any maxillary dental anomaly (number and size anomalies). Two hundred fifty unaffected subjects (mean age: 15.2 ± 7.2 years) composed the control group. Data were evaluated using the independent t test, χ, Fischer exact test, and the odds ratio. Dental anomaly frequency was significantly higher in the cleft group compared with the control group. Tooth agenesis was the most common dental anomaly, followed by microdontia and supernumerary tooth. Lateral incisor agenesis was seen in 69% of the unilateral CLP, in 78% of the bilateral CLP, and in 18% of the cleft palate patients. A significant association was revealed between the right unilateral CLP and the right lateral incisor agenesis (P = 0.0001), the left unilateral CLP and the left lateral incisor agenesis (P = 0.002), and the bilateral CLP and the bilateral lateral incisor agenesis (P = 0.0001). Dental anomalies are more frequently seen in patients with CLP compared with the general population. There is a relationship between the cleft type and the ipsilateral lateral incisor agenesis.

  18. Association of duffy blood group gene polymorphisms with IL8 gene in chronic periodontitis.

    PubMed

    Sippert, Emília Ângela; de Oliveira e Silva, Cléverson; Visentainer, Jeane Eliete Laguila; Sell, Ana Maria

    2013-01-01

    The antigens of the Duffy blood group system (DARC) act as a receptor for the interleukin IL-8. IL-8 plays an important role in the pathogenesis of chronic periodontitis due to its chemotactic properties on neutrophils. The aim of this study was to investigate a possible association of Duffy blood group gene polymorphisms with the -353T>A, -845T>C and -738T>A SNPs of the IL8 gene in chronic periodontitis. One hundred and twenty-four individuals with chronic periodontitis and 187 controls were enrolled. DNA was extracted using the salting-out method. The Duffy genotypes and IL8 gene promoter polymorphisms were investigated by PCR-RFLP. Statistical analyses were conducted using the Chi square test with Yates correction or Fisher's Exact Test, and the possibility of associations were evaluated by odds ratio with a 95% confidence interval. When analyzed separately, for the Duffy blood group system, differences in the genotype and allele frequencies were not observed between all the groups analyzed; and, in nonsmokers, the -845C allele (3.6% vs. 0.4%), -845TC genotype (7.3% vs. 0.7%) and the CTA haplotype (3.6% vs. 0.4%) were positively associated with chronic periodontitis. For the first time to our knowledge, the polymorphisms of erythroid DARC plus IL8 -353T>A SNPs were associated with chronic periodontitis in Brazilian individuals. In Afro-Brazilians patients, the FY*02N.01 with IL8 -353A SNP was associated with protection to chronic periodontitis.

  19. What Are Women Told When Requesting Family Planning Services at Clinics Associated with Catholic Hospitals? A Mystery Caller Study.

    PubMed

    Guiahi, Maryam; Teal, Stephanie B; Swartz, Maryke; Huynh, Sandy; Schiller, Georgia; Sheeder, Jeanelle

    2017-12-01

    Catholic Church directives restrict family planning service provision at Catholic health care institutions. It is unclear whether obstetrics and gynecology clinics that are owned by or have business affiliations with Catholic hospitals offer family planning appointments. Mystery callers phoned 144 clinics nationwide that were found on Catholic hospital websites between December 2014 and February 2016, and requested appointments for birth control generally, copper IUD services specifically, tubal ligation and abortion. Chi-square and Fisher's exact tests assessed potential correlates of appointment availability, and multivariable logistic regressions were computed if bivariate testing suggested multiple correlates. Although 95% of clinics would schedule birth control appointments, smaller proportions would schedule appointments for copper IUDs (68%) or tubal ligation (58%); only 2% would schedule an abortion. Smaller proportions of Catholic-owned than of Catholic-affiliated clinics would schedule appointments for birth control (84% vs. 100%), copper IUDs (4% vs. 97%) and tubal ligation (29% vs. 72%); for birth control and copper IUD services, no other clinic characteristics were related to appointment availability. Multivariable analysis confirmed that tubal ligation appointments were less likely to be offered at Catholic-owned than at Catholic-affiliated clinics (odds ratio. 0.1); location and association with one of the top 10 Catholic health care systems also were significant. Adherence to church directives is inconsistent at Catholic-associated clinics. Women visiting such clinics who want highly effective methods may need to rely on less effective methods or delay method uptake while seeking services elsewhere. Copyright © 2017 by the Guttmacher Institute.

  20. Association of Duffy Blood Group Gene Polymorphisms with IL8 Gene in Chronic Periodontitis

    PubMed Central

    Sippert, Emília Ângela; de Oliveira e Silva, Cléverson; Visentainer, Jeane Eliete Laguila; Sell, Ana Maria

    2013-01-01

    The antigens of the Duffy blood group system (DARC) act as a receptor for the interleukin IL-8. IL-8 plays an important role in the pathogenesis of chronic periodontitis due to its chemotactic properties on neutrophils. The aim of this study was to investigate a possible association of Duffy blood group gene polymorphisms with the -353T>A, -845T>C and -738T>A SNPs of the IL8 gene in chronic periodontitis. One hundred and twenty-four individuals with chronic periodontitis and 187 controls were enrolled. DNA was extracted using the salting-out method. The Duffy genotypes and IL8 gene promoter polymorphisms were investigated by PCR-RFLP. Statistical analyses were conducted using the Chi square test with Yates correction or Fisher's Exact Test, and the possibility of associations were evaluated by odds ratio with a 95% confidence interval. When analyzed separately, for the Duffy blood group system, differences in the genotype and allele frequencies were not observed between all the groups analyzed; and, in nonsmokers, the -845C allele (3.6% vs. 0.4%), -845TC genotype (7.3% vs. 0.7%) and the CTA haplotype (3.6% vs. 0.4%) were positively associated with chronic periodontitis. For the first time to our knowledge, the polymorphisms of erythroid DARC plus IL8 -353T>A SNPs were associated with chronic periodontitis in Brazilian individuals. In Afro-Brazilians patients, the FY*02N.01 with IL8 -353A SNP was associated with protection to chronic periodontitis. PMID:24386171

  1. Prevalence of mental disorders among depressed coronary patients with and without Type D personality. Results of the multi-center SPIRR-CAD trial.

    PubMed

    Lambertus, Frank; Herrmann-Lingen, Christoph; Fritzsche, Kurt; Hamacher, Stefanie; Hellmich, Martin; Jünger, Jana; Ladwig, Karl-Heinz; Michal, Matthias; Ronel, Joram; Schultz, Jobst-Hendrik; Vitinius, Frank; Weber, Cora; Albus, Christian

    Type D personality, as with formal mental disorders, is linked to increased mortality in coronary heart disease (CHD). Our aim was to determine the prevalence of mental disorders among depressed CHD patients with and without Type D personality. Depressive symptoms (HADS, HAM-D), Type D personality (DS-14) and mental disorders based on DSM-IV (SCID I and II) were assessed. Results were calculated by Kruskal-Wallis tests, Fisher's exact tests and logistic regression analyses. 570 CHD patients were included (age 59.2±9.5years; male 78.9%, HADS-D depression 10.4±2.5; HAM-D 11.3±6.6; Type D 60.1%). 84.8% of patients with Type D personality and 79.3% of non-Type D patients suffered from at least one mental disorder (p=0.092), while 41.8% of Type D positives and 27.8% of Type D negatives had at least two mental disorders (p=0.001). Patients with Type D personality significantly more often had social phobia [odds ratio (95% confidence interval): 3.79 (1.1 to 13.12); p=0.035], dysthymia [1.78 (1.12 to 2.84); p=0.015], compulsive [2.25 (1.04 to 4.86); p=0.038] or avoidant [8.95 (2.08 to 38.49); p=0.003] personality disorder. Type D personality among depressed CHD patients is associated with more complex and enduring mental disorders. This implies higher treatment demands. ISRCTN 76240576; NCT00705965. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  2. Partial Failure of Milk Pasteurization as a Risk for the Transmission of Campylobacter From Cattle to Humans

    PubMed Central

    Fernandes, Anand M.; Balasegaram, Sooria; Willis, Caroline; Wimalarathna, Helen M. L.; Maiden, Martin C.; McCarthy, Noel D.

    2015-01-01

    Background. Cattle are the second most common source of human campylobacteriosis. However, routes to account for this scale of transmission have not been identified. In contrast to chicken, red meat is not heavily contaminated at point of sale. Although effective pasteurization prevents milk-borne infection, apparently sporadic infections may include undetected outbreaks from raw or perhaps incompletely pasteurized milk. Methods. A rise in Campylobacter gastroenteritis in an isolated population was investigated using whole-genome sequencing (WGS), an epidemiological study, and environmental investigations. Results. A single strain was identified in 20 cases, clearly distinguishable from other local strains and a reference population by WGS. A case-case analysis showed association of infection with the outbreak strain and milk from a single dairy (odds ratio, 8; Fisher exact test P value = .023). Despite temperature records indicating effective pasteurization, mechanical faults likely to lead to incomplete pasteurization of part of the milk were identified by further testing and examination of internal components of dairy equipment. Conclusions. Here, milk distribution concentrated on a small area, including school-aged children with low background incidence of campylobacteriosis, facilitated outbreak identification. Low-level contamination of widely distributed milk would not produce as detectable an outbreak signal. Such hidden outbreaks may contribute to the substantial burden of apparently sporadic Campylobacter from cattle where transmission routes are not certain. The effective discrimination of outbreak isolates from a reference population using WGS shows that integrating these data and approaches into surveillance could support the detection as well as investigation of such outbreaks. PMID:26063722

  3. Upper extremity deep venous thrombosis after port insertion: What are the risk factors?

    PubMed

    Tabatabaie, Omidreza; Kasumova, Gyulnara G; Kent, Tara S; Eskander, Mariam F; Fadayomi, Ayotunde B; Ng, Sing Chau; Critchlow, Jonathan F; Tawa, Nicholas E; Tseng, Jennifer F

    2017-08-01

    Totally implantable venous access devices (ports) are widely used, especially for cancer chemotherapy. Although their use has been associated with upper extremity deep venous thrombosis, the risk factors of upper extremity deep venous thrombosis in patients with a port are not studied adequately. The Healthcare Cost and Utilization Project's Florida State Ambulatory Surgery and Services Database was queried between 2007 and 2011 for patients who underwent outpatient port insertion, identified by Current Procedural Terminology code. Patients were followed in the State Ambulatory Surgery and Services Database, State Inpatient Database, and State Emergency Department Database for upper extremity deep venous thrombosis occurrence. The cohort was divided into a test cohort and a validation cohort based on the year of port placement. A multivariable logistic regression model was developed to identify risk factors for upper extremity deep venous thrombosis in patients with a port. The model then was tested on the validation cohort. Of the 51,049 patients in the derivation cohort, 926 (1.81%) developed an upper extremity deep venous thrombosis. On multivariate analysis, independently significant predictors of upper extremity deep venous thrombosis included age <65 years (odds ratio = 1.22), Elixhauser score of 1 to 2 compared with zero (odds ratio = 1.17), end-stage renal disease (versus no kidney disease; odds ratio = 2.63), history of any deep venous thrombosis (odds ratio = 1.77), all-cause 30-day revisit (odds ratio = 2.36), African American race (versus white; odds ratio = 1.86), and other nonwhite races (odds ratio = 1.35). Additionally, compared with genitourinary malignancies, patients with gastrointestinal (odds ratio = 1.55), metastatic (odds ratio = 1.76), and lung cancers (odds ratio = 1.68) had greater risks of developing an upper extremity deep venous thrombosis. This study identified major risk factors of upper extremity deep venous thrombosis. Further studies are needed to evaluate the appropriateness of thromboprophylaxis in patients at greater risk of upper extremity deep venous thrombosis. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Comparison of gestational age classifications: date of last menstrual period vs. clinical estimate.

    PubMed

    Wingate, Martha S; Alexander, Greg R; Buekens, Pierre; Vahratian, Anjel

    2007-06-01

    The purpose was to compare the two different measures of gestational age currently used on birth certificates (the duration of pregnancy based on the date of last menstrual period [LMP] and the clinical estimate [CE] as related to health status indicators. We contrasted these measures by race/ethnicity. NCHS natality files for 2000-2002 were used, selecting cases of single live birth to U.S. resident mothers with both LMP and CE gestational age information. Approximately 75% of the records had valid LMP and CE values and for approximately one-half of these, the LMP and CE values did not exactly agree. Overall and for each race and ethnic group, the LMP measures resulted in higher proportions of very preterm, preterm, postterm and SGA births. CE value provided preterm rates of 7.9% and for LMP, 9.9%. The odds ratio of preterm birth for African-Americans using the CE measure was 1.78 [95% Cl 1.77-1.79]. The odds ratio using LMP was 1.93 [95% Cl 1.92-1.94]. Whites were the referent population. Different measures of gestational age result in different overall and race-specific rates of very preterm, preterm, postterm, and SGA births. These findings indicate that substituting or combining these measures may have consequences.

  5. Offering self-administered oral HIV testing to truck drivers in Kenya to increase testing: a randomized controlled trial.

    PubMed

    Kelvin, Elizabeth A; George, Gavin; Mwai, Eva; Nyaga, Eston; Mantell, Joanne E; Romo, Matthew L; Odhiambo, Jacob O; Starbuck, Lila; Govender, Kaymarlin

    2018-01-01

    We conducted a randomized controlled trial among 305 truck drivers from two North Star Alliance roadside wellness clinics in Kenya to see if offering HIV testing choices would increase HIV testing uptake. Participants were randomized to be offered (1) a provider-administered rapid blood (finger-prick) HIV test (i.e., standard of care [SOC]) or (2) a Choice between SOC or a self-administered oral rapid HIV test with provider supervision in the clinic. Participants in the Choice arm who refused HIV testing in the clinic were offered a test kit for home use with phone-based posttest counseling. We compared HIV test uptake using the Mantel Haenszel odds ratio (OR) adjusting for clinic. Those in the Choice arm had higher odds of HIV test uptake than those in the SOC arm (OR = 1.5), but the difference was not statistically significant (p = 0.189). When adding the option to take an HIV test kit for home use, the Choice arm had significantly greater odds of testing uptake (OR = 2.8, p = 0.002). Of those in the Choice arm who tested, 26.9% selected the SOC test, 64.6% chose supervised self-testing in the clinic, and 8.5% took a test kit for home use. Participants varied in the HIV test they selected when given choices. Importantly, when participants who refused HIV testing in the clinic were offered a test kit for home use, an additional 8.5% tested. Offering truck drivers a variety of HIV testing choices may increase HIV testing uptake in this key population.

  6. Multi-Level Family Factors and Affective and Behavioral Symptoms of Oppositional Defiant Disorder in Chinese Children

    PubMed Central

    Tang, Yixin; Lin, Xiuyun; Chi, Peilian; Zhou, Qing; Hou, Xiangning

    2017-01-01

    Given the important role of family environment in children's psychological development, the objective of this study was to examine the linkages between family factors at the whole, dyadic, and individual levels and two dimensions (affective and behavioral) of Oppositional Defiant Disorder (ODD) symptoms in Chinese children. Participants comprised of 80 father-child dyads and 169 mother-child dyads from families with ODD children. The results indicated that multilevel family factors were differently associated with children's affective and behavioral ODD symptoms. All the family factors at the dyadic and individual levels were significantly associated with child affective ODD symptoms. However, only the most proximal factors (parent-child relationship and child emotion regulation, which were directly related to child) were significantly related to child behavioral ODD symptoms. The present study extends the current knowledge regarding the relationships between family factors and two dimensions of child ODD symptoms by testing the comprehensive multilevel family factors model. This study also recommends that future interventions for ODD children should consider the multi-level family factors to enhance intervention efficacy. PMID:28713321

  7. No Association between Mycotoxin Exposure and Autism: A Pilot Case-Control Study in School-Aged Children

    PubMed Central

    Duringer, Jennifer; Fombonne, Eric; Craig, Morrie

    2016-01-01

    Evaluation of environmental risk factors in the development of autism spectrum disorder (ASD) is needed for a more complete understanding of disease etiology and best approaches for prevention, diagnosis, and treatment. A pilot experiment in 54 children (n = 25 ASD, n = 29 controls; aged 12.4 ± 3.9 years) screened for 87 urinary mycotoxins via liquid chromatography-tandem mass spectrometry to assess current exposure. Zearalenone, zearalenone-4-glucoside, 3-acetyldeoxynivalenol, and altenuene were detected in 9/54 (20%) samples, most near the limit of detection. No mycotoxin/group of mycotoxins was associated with ASD-diagnosed children. To identify potential correlates of mycotoxin presence in urine, we further compared the nine subjects where a urinary mycotoxin was confirmed to the remaining 45 participants and found no difference based on the presence or absence of mycotoxin for age (t-test; p = 0.322), gender (Fisher’s exact test; p = 0.456), exposure or not to selective serotonin reuptake inhibitors (Fisher’s exact test; p = 0.367), or to other medications (Fisher’s exact test; p = 1.00). While no positive association was found, more sophisticated sample preparation techniques and instrumentation, coupled with selectivity for a smaller group of mycotoxins, could improve sensitivity and detection. Further, broadening sampling to in utero (mothers) and newborn-toddler years would cover additional exposure windows. PMID:27447670

  8. Toward exact number: young children use one-to-one correspondence to measure set identity but not numerical equality.

    PubMed

    Izard, Véronique; Streri, Arlette; Spelke, Elizabeth S

    2014-07-01

    Exact integer concepts are fundamental to a wide array of human activities, but their origins are obscure. Some have proposed that children are endowed with a system of natural number concepts, whereas others have argued that children construct these concepts by mastering verbal counting or other numeric symbols. This debate remains unresolved, because it is difficult to test children's mastery of the logic of integer concepts without using symbols to enumerate large sets, and the symbols themselves could be a source of difficulty for children. Here, we introduce a new method, focusing on large quantities and avoiding the use of words or other symbols for numbers, to study children's understanding of an essential property underlying integer concepts: the relation of exact numerical equality. Children aged 32-36 months, who possessed no symbols for exact numbers beyond 4, were given one-to-one correspondence cues to help them track a set of puppets, and their enumeration of the set was assessed by a non-verbal manual search task. Children used one-to-one correspondence relations to reconstruct exact quantities in sets of 5 or 6 objects, as long as the elements forming the sets remained the same individuals. In contrast, they failed to track exact quantities when one element was added, removed, or substituted for another. These results suggest an alternative to both nativist and symbol-based constructivist theories of the development of natural number concepts: Before learning symbols for exact numbers, children have a partial understanding of the properties of exact numbers. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

  9. Characteristics of users of online personalized genomic risk assessments: implications for physician-patient interactions.

    PubMed

    McBride, Colleen M; Alford, Sharon Hensley; Reid, Robert J; Larson, Eric B; Baxevanis, Andreas D; Brody, Lawrence C

    2009-08-01

    To evaluate what psychological and behavioral factors predict who is likely to seek SNP-based genetic tests for multiple common health conditions where feedback can be used to motivate primary prevention. Adults aged 25-40 years who were enrolled in a large managed care organization were surveyed. Those eligible could log on to a secure study Web site to review information about the risks and benefits of a SNP-based genetic test and request free testing. Two primary outcomes are addressed: accessing the Web (yes or no) and deciding to be tested (completed a blood draw at the clinic) Those considering genetic susceptibility testing did not hold genetically deterministic beliefs (0.42 on scale of 0 [behavior] to 1 [genetic]) but believed genetic information to be valuable and were confident they could understand such information. Individuals who believed it important to learn about genetics (odds ratio = 1.28), were confident they could understand genetics (odds ratio = 1.26), and reported the most health habits to change (odds ratio = 1.39) were most likely to get tested. Individuals who present to health care providers with online genetics information may be among the most motivated to take steps toward healthier lifestyles. These motives might be leveraged by health care providers to promote positive health outcomes.

  10. Herd-level risk factors for Campylobacter fetus infection, Brucella seropositivity and within-herd seroprevalence of brucellosis in cattle in northern Nigeria.

    PubMed

    Mai, H M; Irons, P C; Kabir, J; Thompson, P N

    2013-09-01

    Brucellosis and campylobacteriosis are economically important diseases affecting bovine reproductive efficiency in Nigeria. A questionnaire-based survey was conducted in 271 cattle herds in Adamawa, Kaduna and Kano states of northern Nigeria using multistage cluster sampling. Serum from 4745 mature animals was tested for Brucella antibodies using the Rose-Bengal plate test and positives were confirmed in series-testing protocol using competitive enzyme-linked immunosorbent assay. Preputial scrapings from 602 bulls were tested using culture and identification for Campylobacter fetus. For each disease, a herd was classified as positive if one or more animals tested positive. For each herd, information on potential managemental and environmental risk factors was collected through a questionnaire administered during an interview with the manager, owner or herdsman. Multiple logistic regression models were used to model the odds of herd infection for each disease. A zero-inflated Poisson model was used to model the count of Brucella-positive animals within herds, with the number tested as an exposure variable. The presence of small ruminants (sheep and/or goats) on the same farm, and buying-in of >3 new animals in the previous year or failure to practice quarantine were associated with increased odds of herd-level campylobacteriosis and brucellosis, as well as increased within-herd counts of Brucella-positive animals. In addition, high rainfall, initial acquisition of animals from markets, practice of gynaecological examination and failure to practice herd prophylactic measures were positively associated with the odds of C. fetus infection in the herd. Herd size of >15, pastoral management system and presence of handling facility on the farm were associated with increased odds, and gynaecological examination with reduced odds of herd-level Brucella seropositivity. Furthermore, the zero-inflated Poisson model showed that borrowing or sharing of bulls was associated with higher counts, and provision of mineral supplement with lower counts of Brucella-positive cattle within herds. Identification of risk factors for bovine campylobacteriosis and brucellosis can help to identify appropriate control measures, and the use of zero-inflated count model can provide more specific information on these risk factors. Copyright © 2013 Elsevier B.V. All rights reserved.

  11. Functional non-synonymous variants of ABCG2 and gout risk.

    PubMed

    Stiburkova, Blanka; Pavelcova, Katerina; Zavada, Jakub; Petru, Lenka; Simek, Pavel; Cepek, Pavel; Pavlikova, Marketa; Matsuo, Hirotaka; Merriman, Tony R; Pavelka, Karel

    2017-11-01

    Common dysfunctional variants of ATP binding cassette subfamily G member 2 (Junior blood group) (ABCG2), a high-capacity urate transporter gene, that result in decreased urate excretion are major causes of hyperuricemia and gout. In the present study, our objective was to determine the frequency and effect on gout of common and rare non-synonymous and other functional allelic variants in the ABCG2 gene. The main cohort recruited from the Czech Republic consisted of 145 gout patients; 115 normouricaemic controls were used for comparison. We amplified, directly sequenced and analysed 15 ABCG2 exons. The associations between genetic variants and clinical phenotype were analysed using the t-test, Fisher's exact test and a logistic and linear regression approach. Data from a New Zealand Polynesian sample set and the UK Biobank were included for the p.V12M analysis. In the ABCG2 gene, 18 intronic (one dysfunctional splicing) and 11 exonic variants were detected: 9 were non-synonymous (2 common, 7 rare including 1 novel), namely p.V12M, p.Q141K, p.R147W, p.T153M, p.F373C, p.T434M, p.S476P, p.D620N and p.K360del. The p.Q141K (rs2231142) variant had a significantly higher minor allele frequency (0.23) in the gout patients compared with the European-origin population (0.09) and was significantly more common among gout patients than among normouricaemic controls (odds ratio = 3.26, P < 0.0001). Patients with non-synonymous allelic variants had an earlier onset of gout (42 vs 48 years, P = 0.0143) and a greater likelihood of a familial history of gout (41% vs 27%, odds ratio = 1.96, P = 0.053). In a meta-analysis p.V12M exerted a protective effect from gout (P < 0.0001). Genetic variants of ABCG2, common and rare, increased the risk of gout. Non-synonymous allelic variants of ABCG2 had a significant effect on earlier onset of gout and the presence of a familial gout history. ABCG2 should thus be considered a common and significant risk factor for gout. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  12. Open versus laparoscopic unilateral inguinal hernia repairs: defining the ideal BMI to reduce complications.

    PubMed

    Willoughby, Ashley D; Lim, Robert B; Lustik, Michael B

    2017-01-01

    Open inguinal hernia repair is felt to be a less expensive operation than a laparoscopic one. Performing open repair on patients with an obese body mass index (BMI) results in longer operative times, longer hospital stay, and complications that will potentially impose higher cost to the facility and patient. This study aims to define the ideal BMI at which a laparoscopic inguinal hernia repair will be advantageous over open inguinal hernia repair. The NSQIP database was analyzed for (n = 64,501) complications, mortality, and operating time for open and laparoscopic inguinal hernia repairs during the time period from 2005 to 2012. Bilateral and recurrent hernias were excluded. Chi-square tests and Fisher's exact tests were used to assess associations between type of surgery and categorical variables including demographics, risk factors, and 30-day outcomes. Multivariable regression analyses were performed to determine whether odds ratios differed by level of BMI. The HCUP database was used for determining difference in cost and length of stay between open and laparoscopic procedures. There were 17,919 laparoscopic repairs and 46,582 open repairs in the study period. The overall morbidity (across all BMI categories) is statistically greater in the open repair group when compared to the laparoscopic group (p = 0.03). Postoperative complications (including wound disruption, failure to wean from the ventilator, and UTI) were greater in the open repair group across all BMI categories. Deep incisional surgical site infections (SSI) were more common in the overweight open repair group (p = 0.026). The return to the operating room across all BMI categories was statistically significant for the open repair group (n = 269) compared to the laparoscopic repair group (n = 70) with p = 0.003. There was no difference in the return to operating room between the BMI categories. The odds ratio (OR) was found to be statistically significant when comparing the obese category to both normal and overweight populations for the open procedure. Open hernia repairs have more complications than do laparoscopic ones; however, there does not appear to be a difference in treating obese patients with hernias using a laparoscopic approach versus an open one. One may consider using a laparoscopic approach in overweight patients (BMI 25-29.9) as there appears to be fewer deep SSI.

  13. Reliability of the Client-Centeredness of Goal Setting (C-COGS) Scale in Acquired Brain Injury Rehabilitation.

    PubMed

    Doig, Emmah; Prescott, Sarah; Fleming, Jennifer; Cornwell, Petrea; Kuipers, Pim

    2016-01-01

    To examine the internal reliability and test-retest reliability of the Client-Centeredness of Goal Setting (C-COGS) scale. The C-COGS scale was administered to 42 participants with acquired brain injury after completion of multidisciplinary goal planning. Internal reliability of scale items was examined using item-partial total correlations and Cronbach's α coefficient. The scale was readministered within a 1-mo period to a subsample of 12 participants to examine test-retest reliability by calculating exact and close percentage agreement for each item. After examination of item-partial total correlations, test items were revised. The revised items demonstrated stronger internal consistency than the original items. Preliminary evaluation of test-retest reliability was fair, with an average exact percent agreement across all test items of 67%. Findings support the preliminary reliability of the C-COGS scale as a tool to evaluate and promote client-centered goal planning in brain injury rehabilitation. Copyright © 2016 by the American Occupational Therapy Association, Inc.

  14. Eczema Is Associated with Childhood Speech Disorder: A Retrospective Analysis from the National Survey of Children's Health and the National Health Interview Survey.

    PubMed

    Strom, Mark A; Silverberg, Jonathan I

    2016-01-01

    To determine if eczema is associated with an increased risk of a speech disorder. We analyzed data on 354,416 children and adolescents from 19 US population-based cohorts: the 2003-2004 and 2007-2008 National Survey of Children's Health and 1997-2013 National Health Interview Survey, each prospective, questionnaire-based cohorts. In multivariate survey logistic regression models adjusting for sociodemographics and comorbid allergic disease, eczema was significantly associated with higher odds of speech disorder in 12 of 19 cohorts (P < .05). The pooled prevalence of speech disorder in children with eczema was 4.7% (95% CI 4.5%-5.0%) compared with 2.2% (95% CI 2.2%-2.3%) in children without eczema. In pooled multivariate analysis, eczema was associated with increased odds of speech disorder (aOR [95% CI] 1.81 [1.57-2.05], P < .001). In a single study assessing eczema severity, mild (1.36 [1.02-1.81], P = .03) and severe eczema (3.56 [1.70-7.48], P < .001) were associated with higher odds of speech disorder. History of eczema was associated with moderate (2.35 [1.34-4.10], P = .003) and severe (2.28 [1.11-4.72], P = .03) speech disorder. Finally, significant interactions were found, such that children with both eczema and attention deficit disorder with or without hyperactivity or sleep disturbance had vastly increased risk of speech disorders than either by itself. Pediatric eczema may be associated with increased risk of speech disorder. Further, prospective studies are needed to characterize the exact nature of this association. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Eczema Is Associated with Childhood Speech Disorder: A Retrospective Analysis from the National Survey of Children’s Health and the National Health Interview Survey

    PubMed Central

    Strom, Mark A.; Silverberg, Jonathan I.

    2016-01-01

    Objective To determine if eczema is associated with an increased risk of a speech disorder. Study design We analyzed data on 354 416 children and adolescents from 19 US population-based cohorts: the 2003–2004 and 2007–2008 National Survey of Children’s Health and 1997–2013 National Health Interview Survey, each prospective, questionnaire-based cohorts. Results In multivariate survey logistic regression models adjusting for sociodemographics and comorbid allergic disease, eczema was significantly associated with higher odds of speech disorder in 12 of 19 cohorts (P < .05). The pooled prevalence of speech disorder in children with eczema was 4.7% (95% CI 4.5%–5.0%) compared with 2.2% (95% CI 2.2%–2.3%) in children without eczema. In pooled multivariate analysis, eczema was associated with increased odds of speech disorder (aOR [95% CI] 1.81 [1.57–2.05], P < .001). In a single study assessing eczema severity, mild (1.36 [1.02–1.81], P = .03) and severe eczema (3.56 [1.70–7.48], P < .001) were associated with higher odds of speech disorder. History of eczema was associated with moderate (2.35 [1.34–4.10], P = .003) and severe (2.28 [1.11–4.72], P = .03) speech disorder. Finally, significant interactions were found, such that children with both eczema and attention deficit disorder with or without hyperactivity or sleep disturbance had vastly increased risk of speech disorders than either by itself. Conclusions Pediatric eczema may be associated with increased risk of speech disorder. Further, prospective studies are needed to characterize the exact nature of this association. PMID:26520915

  16. The impact of inpatient palliative care on end of life care among older trauma patients who die after hospital discharge.

    PubMed

    Lilley, Elizabeth J; Lee, Katherine C; Scott, John W; Krumrei, Nicole J; Haider, Adil H; Salim, Ali; Gupta, Rajan; Cooper, Zara

    2018-05-30

    Palliative care is associated with lower intensity treatment and better outcomes at the end of life. Trauma surgeons play a critical role in end-of-life (EOL) care, however the impact of PC on healthcare utilization at the end of life has yet to be characterized in older trauma patients. This retrospective cohort study using 2006-2011 national Medicare claims included trauma patients ≥65 years who died within 180 days after discharge. The exposure of interest was inpatient palliative care during the trauma admission. A non-PC control group was developed by exact-matching for age, comorbidity, admission year, injury severity, length of stay, and post-discharge survival. We employed logistic regression to evaluate six EOL care outcomes: discharge to hospice, rehospitalization, skilled nursing facility (SNF) or long-term acute care hospital (LTACH) admission, death in an institutional setting, and intensive care unit (ICU) admission or receipt of life-sustaining treatments (LST) during a subsequent hospitalization. Of 294,665 patients who died within 180 days after discharge, 2.1% received inpatient PC. Among 5,693 matched pairs, inpatient PC was associated with increased odds of discharge to hospice (odds ratio [95% confidence interval] = 3.80 [3.54-4.09]) and reduced odds of rehospitalization (0.17[0.15-0.20]), SNF/LTACH admission (0.43[0.39-0.47]), death in an institutional setting (0.34[0.30-0.39]), subsequent ICU admission (0.51[0.36-0.72]), or receiving LST (0.56[0.39-0.80]). Inpatient palliative care is associated with lower intensity and less burdensome EOL care in the geriatric trauma population. Nonetheless, it remains underutilized among those who die within 6 months after discharge. Level III STUDY TYPE: Prognostic.

  17. Prediction for the Flow-induced Gravity Field of Saturn: Implications for Cassini’s Grand Finale

    NASA Astrophysics Data System (ADS)

    Galanti, Eli; Kaspi, Yohai

    2017-07-01

    The Cassini measurements of Saturn’s gravity field during its Grand Finale might shed light on a long-standing question regarding the flow on Saturn. While the cloud-level winds are well known, little is known about whether these winds are confined to the outer layers of the planet or penetrate deep into the interior. An additional complexity is added by the uncertainty in the exact rotation period of Saturn, a key factor in determining the cloud-level winds, with an effect on the north-south symmetric part of the winds. Using Saturn’s cloud-level winds we relate the flow to the gravity harmonics. We give a prediction for the odd harmonics {J}3,{J}5,{J}7,{and} {J}9 as a function of the flow depth, identifying three ranges of depths. Since the odd harmonics depend solely on the flow, and are not influenced by Saturn’s shape and static density distribution, any measured value of the odd harmonics by Cassini can be used to uniquely determine the depth of the flow. We also discuss the flow-induced even harmonics {{Δ }}{J}2,{{Δ }}{J}4,\\ldots ,{{Δ }}{J}12 that are affected by Saturn’s rotation period. While the high-degree even harmonics might also be used to determine the flow depth, the lower-degree even harmonics serve as uncertainties for analysis of the planet’s interior structure and composition. Thus, the gravity harmonics measured during the Cassini Grand Finale may be used to get a first-order estimate of the flow structure and to better constrain the planet’s density structure and composition.

  18. Prediction of ocular irritancy of 26 chemicals and 26 cosmetic products with isolated rabbit eye (IRE) test.

    PubMed

    Guo, Xiang; Yang, Xing Fen; Yang, Ying; Hans, Raabe; Cai, Jing Heng; Xue, Jin Yu; Tan, Xiao Hua; Xie, Xiao Ping; Xiong, Xi Kun; Huang, Jun Ming

    2012-06-01

    This study aims to establish and evaluate the methodology of isolated rabbit eye (IRE) test. IRE test was performed according to modifications of the in vitro toxicology (INVITTOX) Protocol No.85: Rabbit enucleated eye test by European Centre for the Validation of Alternative Methods (ECVAM), and then 26 chemicals and 26 cosmetic products were tested in both in vitro IRE and in vivo Draize tests. A statistical analysis was conducted to determine the relevance of the IRE test to the data generated in the Draize test. IRE test was established successfully in our laboratory. It was shown that ranking correlation and class concordance were fairly well between the IRE test and the Draize test for 26 reference chemicals (Fisher's Exact Test χ(2)=51.314, P<0.001; McNemar P=0.261; Gamma=0.960, P<0.001; Kappa=0.843, P<0.001) and 26 cosmetic products (Fisher's Exact Test χ(2)=15.522, P<0.001; McNemar P=0.311; Gamma=0.967, P<0.001; Kappa=0.611, P<0.001). IRE test was established successfully for in vitro testing of eye irritation as an alternative to Draize test. Copyright © 2012 The Editorial Board of Biomedical and Environmental Sciences. Published by Elsevier B.V. All rights reserved.

  19. Allergic rhinitis and dental caries in preschool children

    PubMed Central

    Bakhshaee, Mehdi; Ashtiani, Sara Jafari; Hossainzadeh, Mana; Sehatbakhsh, Samineh; Najafi, Mona Najaf; Salehi, Maryam

    2017-01-01

    Background: Allergic rhinitis (AR) may be overdocumented in cases of dental caries because of controversies in the literature This study was conducted to investigate the potential relationship between AR and dental caries in children. Materials and Methods: A total of 296 children were included in this cross-sectional study. Participants were evaluated using the decay-missing-filled (DMF) index, and their AR status was evaluated by physical examination and through a standard questionnaire. Baseline demographics and clinical characteristics were compared among groups using Student's t-test or the Mann–Whitney U-test, the Chi-square test, and/or Fisher's exact test as appropriate. A level of P < 0.05 was regarded as statistically significant. Results: Evidence of AR was found in 77 (35.1%) participants. There was no significant difference in the rate of tooth decay or DMF between participants with or without AR (P = 0.07), but a significant difference was observed in the number of missing and filled teeth between those with and without AR (P < 0.05). There were no significant differences in educational level, family income, milk intake, use of pacifier, use of a toothbrush, saliva secretion, or body mass index (P > 0.05 in all cases) between AR-positive and AR-negative patients. Fluoride therapy and oral breathing were identified as confounding factors and controlled using log-linear analysis. The mean rate of DMF in patients who also had AR was 20% greater than in the AR-negative group (odds ratio [OR] = 1.21, confidence interval [CI]: 1.05–1.35) and 15% greater in among children who breathed orally than those who did not (OR = 1.15 CI: 1.02–1.31). Conclusion: AR and oral breathing may have an effect on oral health and dental condition, leading to an increased rate of tooth loss, oral fillings, and development of dental caries. PMID:29238375

  20. An exact stiffness theory for unidirectional xFRP composites

    NASA Astrophysics Data System (ADS)

    Klasztorny, M.; Konderla, P.; Piekarski, R.

    2009-01-01

    UD xFRP composites, i.e., isotropic plastics reinforced with long transversely isotropic fibres packed unidirectionally according to the hexagonal scheme are considered. The constituent materials are geometrically and physically linear. The previous formulations of the exact stiffness theory of such composites are revised, and the theory is developed further based on selected boundary-value problems of elasticity theory. The numerical examples presented are focussed on testing the theory with account of previous variants of this theory and experimental values of the effective elastic constants. The authors have pointed out that the exact stiffness theory of UD xFRP composites, with the modifications proposed in our study, will be useful in the engineering practice and in solving the current problems of the mechanics of composite materials.

  1. Numerical Activities and Information Learned at Home Link to the Exact Numeracy Skills in 5–6 Years-Old Children

    PubMed Central

    Benavides-Varela, Silvia; Butterworth, Brian; Burgio, Francesca; Arcara, Giorgio; Lucangeli, Daniela; Semenza, Carlo

    2016-01-01

    It is currently accepted that certain activities within the family environment contribute to develop early numerical skills before schooling. However, it is unknown whether this early experience influences both the exact and the approximate representation of numbers, and if so, which is more important for numerical tasks. In the present study the mathematical performance of 110 children (mean age 5 years 11 months) was evaluated using a battery that included tests of approximate and exact numerical abilities, as well as everyday numerical problems. Moreover, children were assessed on their knowledge of number information learned at home. The parents of the participants provided information regarding daily activities of the children and socio-demographic characteristics of the family. The results showed that the amount of numerical information learned at home was a significant predictor of participants' performance on everyday numerical problems and exact number representations, even after taking account of age, memory span and socio-economic and educational status of the family. We also found that particular activities, such as board games, correlate with the children's counting skills, which are foundational for arithmetic. Crucially, tests relying on approximate representations were not predicted by the numerical knowledge acquired at home. The present research supports claims about the importance and nature of home experiences in the child's acquisition of mathematics. PMID:26903902

  2. Diagnosis of Esophageal Motility Disorders: Esophageal Pressure Topography vs. Conventional Line Tracing.

    PubMed

    Carlson, Dustin A; Ravi, Karthik; Kahrilas, Peter J; Gyawali, C Prakash; Bredenoord, Arjan J; Castell, Donald O; Spechler, Stuart J; Halland, Magnus; Kanuri, Navya; Katzka, David A; Leggett, Cadman L; Roman, Sabine; Saenz, Jose B; Sayuk, Gregory S; Wong, Alan C; Yadlapati, Rena; Ciolino, Jody D; Fox, Mark R; Pandolfino, John E

    2015-07-01

    Enhanced characterization of esophageal peristaltic and sphincter function provided by esophageal pressure topography (EPT) offers a potential diagnostic advantage over conventional line tracings (CLT). However, high-resolution manometry (HRM) and EPT require increased equipment costs over conventional systems and evidence demonstrating a significant diagnostic advantage of EPT over CLT is limited. Our aim was to investigate whether the inter-rater agreement and/or accuracy of esophageal motility diagnosis differed between EPT and CLT. Forty previously completed patient HRM studies were selected for analysis using a customized software program developed to perform blinded independent interpretation in either EPT or CLT (six pressure sensors) format. Six experienced gastroenterologists with a clinical focus in esophageal disease (attendings) and six gastroenterology trainees with minimal manometry experience (fellows) from three academic centers interpreted each of the 40 studies using both EPT and CLT formats. Rater diagnoses were assessed for inter-rater agreement and diagnostic accuracy, both for exact diagnosis and for correct identification of a major esophageal motility disorder. The total group agreement was moderate (κ=0.57; 95% CI: 0.56-0.59) for EPT and fair (κ=0.32; 0.30-0.33) for CLT. Inter-rater agreement between attendings was good (κ=0.68; 0.65-0.71) for EPT and moderate (κ=0.46; 0.43-0.50) for CLT. Inter-rater agreement between fellows was moderate (κ=0.48; 0.45-0.50) for EPT and poor to fair (κ=0.20; 0.17-0.24) for CLT. Among all raters, the odds of an incorrect exact esophageal motility diagnosis were 3.3 times higher with CLT assessment than with EPT (OR: 3.3; 95% CI: 2.4-4.5; P<0.0001), and the odds of incorrect identification of a major motility disorder were 3.4 times higher with CLT than with EPT (OR: 3.4; 2.4-5.0; P<0.0001). Superior inter-rater agreement and diagnostic accuracy of esophageal motility diagnoses were demonstrated with analysis using EPT over CLT among our selected raters. On the basis of these findings, EPT may be the preferred assessment modality of esophageal motility.

  3. Convergence of high order memory kernels in the Nakajima-Zwanzig generalized master equation and rate constants: Case study of the spin-boson model.

    PubMed

    Xu, Meng; Yan, Yaming; Liu, Yanying; Shi, Qiang

    2018-04-28

    The Nakajima-Zwanzig generalized master equation provides a formally exact framework to simulate quantum dynamics in condensed phases. Yet, the exact memory kernel is hard to obtain and calculations based on perturbative expansions are often employed. By using the spin-boson model as an example, we assess the convergence of high order memory kernels in the Nakajima-Zwanzig generalized master equation. The exact memory kernels are calculated by combining the hierarchical equation of motion approach and the Dyson expansion of the exact memory kernel. High order expansions of the memory kernels are obtained by extending our previous work to calculate perturbative expansions of open system quantum dynamics [M. Xu et al., J. Chem. Phys. 146, 064102 (2017)]. It is found that the high order expansions do not necessarily converge in certain parameter regimes where the exact kernel show a long memory time, especially in cases of slow bath, weak system-bath coupling, and low temperature. Effectiveness of the Padé and Landau-Zener resummation approaches is tested, and the convergence of higher order rate constants beyond Fermi's golden rule is investigated.

  4. Convergence of high order memory kernels in the Nakajima-Zwanzig generalized master equation and rate constants: Case study of the spin-boson model

    NASA Astrophysics Data System (ADS)

    Xu, Meng; Yan, Yaming; Liu, Yanying; Shi, Qiang

    2018-04-01

    The Nakajima-Zwanzig generalized master equation provides a formally exact framework to simulate quantum dynamics in condensed phases. Yet, the exact memory kernel is hard to obtain and calculations based on perturbative expansions are often employed. By using the spin-boson model as an example, we assess the convergence of high order memory kernels in the Nakajima-Zwanzig generalized master equation. The exact memory kernels are calculated by combining the hierarchical equation of motion approach and the Dyson expansion of the exact memory kernel. High order expansions of the memory kernels are obtained by extending our previous work to calculate perturbative expansions of open system quantum dynamics [M. Xu et al., J. Chem. Phys. 146, 064102 (2017)]. It is found that the high order expansions do not necessarily converge in certain parameter regimes where the exact kernel show a long memory time, especially in cases of slow bath, weak system-bath coupling, and low temperature. Effectiveness of the Padé and Landau-Zener resummation approaches is tested, and the convergence of higher order rate constants beyond Fermi's golden rule is investigated.

  5. Against All Odds

    ERIC Educational Resources Information Center

    Manzo, Kathleen Kennedy

    2005-01-01

    More than a decade ago, no one held out much hope for the poor, immigrant children at Kennedy Middle School. Nobody thinks that now. This article presents how Kennedy Middle School transformed and beat all the odds to be a "school to watch." In many ways, Kennedy Middle School has become a model of middle-grades improvement. Test scores,…

  6. Does Comorbid Disruptive Behavior Modify the Effects of Atomoxetine on ADHD Symptoms as Measured by a Continuous Performance Test and a Motion Tracking Device?

    PubMed

    Wehmeier, Peter M; Kipp, Laura; Banaschewski, Tobias; Dittmann, Ralf W; Schacht, Alexander

    2015-07-01

    To compare the reduction of ADHD symptoms under atomoxetine in patients with and without comorbid oppositional defiant disorder (ODD) or conduct disorder (CD) using a computer-based continuous performance test (cb-CPT) combined with an infrared motion tracking (MT) device. Secondary analysis of a placebo-controlled study in ADHD patients (6-12 years old) treated with atomoxetine (target dose: 1.2 mg/kg per day). Cb-CPT/MT scores were analyzed using ANCOVA (last observation carried forward [LOCF]). The data (N = 125) suggested a more pronounced atomoxetine effect in the group with comorbid ODD/CD as measured by all cb-CPT/MT parameters except for "normalized variation of reaction time" (nVRT). The results showed that atomoxetine reduced ADHD severity as measured by cb-CPT and MT parameters regardless of whether comorbid ODD/CD was present. The treatment effect of atomoxetine on hyperactivity appears to be more pronounced in the subgroup of patients with comorbid ODD/CD than in the subgroup without this comorbidity. © 2012 SAGE Publications.

  7. Same-Sex and Race-Based Disparities in Statutory Rape Arrests.

    PubMed

    Chaffin, Mark; Chenoweth, Stephanie; Letourneau, Elizabeth J

    2016-01-01

    This study tests a liberation hypothesis for statutory rape incidents, specifically that there may be same-sex and race/ethnicity arrest disparities among statutory rape incidents and that these will be greater among statutory rape than among forcible sex crime incidents. 26,726 reported incidents of statutory rape as defined under state statutes and 96,474 forcible sex crime incidents were extracted from National Incident-Based Reporting System data sets. Arrest outcomes were tested using multilevel modeling. Same-sex statutory rape pairings were rare but had much higher arrest odds. A victim-offender romantic relationship amplified arrest odds for same-sex pairings, but damped arrest odds for male-on-female pairings. Same-sex disparities were larger among statutory than among forcible incidents. Female-on-male incidents had uniformly lower arrest odds. Race/ethnicity effects were smaller than gender effects and more complexly patterned. The findings support the liberation hypothesis for same-sex statutory rape arrest disparities, particularly among same-sex romantic pairings. Support for race/ethnicity-based arrest disparities was limited and mixed. © The Author(s) 2014.

  8. Artistic creativity and risk for schizophrenia, bipolar disorder and unipolar depression: a Swedish population-based case-control study and sib-pair analysis.

    PubMed

    MacCabe, J H; Sariaslan, A; Almqvist, C; Lichtenstein, P; Larsson, H; Kyaga, S

    2018-06-01

    Many studies have addressed the question of whether mental disorder is associated with creativity, but high-quality epidemiological evidence has been lacking.AimsTo test for an association between studying a creative subject at high school or university and later mental disorder. In a case-control study using linked population-based registries in Sweden (N = 4 454 763), we tested for associations between tertiary education in an artistic field and hospital admission with schizophrenia (N = 20 333), bipolar disorder (N = 28 293) or unipolar depression (N = 148 365). Compared with the general population, individuals with an artistic education had increased odds of developing schizophrenia (odds ratio = 1.90, 95% CI = [1.69; 2.12]) bipolar disorder (odds ratio = 1.62 [1.50; 1.75]) and unipolar depression (odds ratio = 1.39 [1.34; 1.44]. The results remained after adjustment for IQ and other potential confounders. Students of artistic subjects at university are at increased risk of developing schizophrenia, bipolar disorder and unipolar depression in adulthood.Declaration of interestNone.

  9. A more powerful exact test of noninferiority from binary matched-pairs data.

    PubMed

    Lloyd, Chris J; Moldovan, Max V

    2008-08-15

    Assessing the therapeutic noninferiority of one medical treatment compared with another is often based on the difference in response rates from a matched binary pairs design. This paper develops a new exact unconditional test for noninferiority that is more powerful than available alternatives. There are two new elements presented in this paper. First, we introduce the likelihood ratio statistic as an alternative to the previously proposed score statistic of Nam (Biometrics 1997; 53:1422-1430). Second, we eliminate the nuisance parameter by estimation followed by maximization as an alternative to the partial maximization of Berger and Boos (Am. Stat. Assoc. 1994; 89:1012-1016) or traditional full maximization. Based on an extensive numerical study, we recommend tests based on the score statistic, the nuisance parameter being controlled by estimation followed by maximization. 2008 John Wiley & Sons, Ltd

  10. Use of prostate-specific antigen testing as a disease surveillance tool following radical prostatectomy.

    PubMed

    Trantham, Laurel Clayton; Nielsen, Matthew E; Mobley, Lee R; Wheeler, Stephanie B; Carpenter, William R; Biddle, Andrea K

    2013-10-01

    Prostate-specific antigen (PSA) testing is recommended every 6 to 12 months for the first 5 years following radical prostatectomy as a means to detect potential disease recurrence. Despite substantial research on factors affecting treatment decisions, recurrence, and mortality, little is known about whether men receive guideline-concordant surveillance testing or whether receipt varies by year of diagnosis, time since treatment, or other individual characteristics. Surveillance testing following radical prostatectomy among elderly men was examined using Surveillance, Epidemiology, and End Results cancer registry data linked to Medicare claims. Multivariate logistic regression was used to examine the effect of demographic, tumor, and county-level characteristics on the odds of receiving surveillance testing within a given 1-year period following treatment. Overall, receipt of surveillance testing was high, with 96% of men receiving at least one test the first year after treatment and approximately 80% receiving at least one test in the fifth year after treatment. Odds of not receiving a test declined with time since treatment. Nonmarried men, men with less-advanced disease, and non-Hispanic blacks and Hispanics had higher odds of not receiving a surveillance test. Year of diagnosis did not affect the receipt of surveillance tests. Most men receive guideline-concordant surveillance PSA testing after prostatectomy, although evidence of a racial disparity between non-Hispanic whites and some minority groups exists. The decline in surveillance over time suggests the need for well-designed long-term surveillance plans following radical prostatectomy. Cancer 2013;119:3523-3530.. © 2013 American Cancer Society. Copyright © 2013 American Cancer Society.

  11. Towards an exact correlated orbital theory for electrons

    NASA Astrophysics Data System (ADS)

    Bartlett, Rodney J.

    2009-12-01

    The formal and computational attraction of effective one-particle theories like Hartree-Fock and density functional theory raise the question of how far such approaches can be taken to offer exact results for selected properties of electrons in atoms, molecules, and solids. Some properties can be exactly described within an effective one-particle theory, like principal ionization potentials and electron affinities. This fact can be used to develop equations for a correlated orbital theory (COT) that guarantees a correct one-particle energy spectrum. They are built upon a coupled-cluster based frequency independent self-energy operator presented here, which distinguishes the approach from Dyson theory. The COT also offers an alternative to Kohn-Sham density functional theory (DFT), whose objective is to represent the electronic density exactly as a single determinant, while paying less attention to the energy spectrum. For any estimate of two-electron terms COT offers a litmus test of its accuracy for principal Ip's and Ea's. This feature for approximating the COT equations is illustrated numerically.

  12. How Accurately Does the Free Complement Wave Function of a Helium Atom Satisfy the Schroedinger Equation?

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

    Nakashima, Hiroyuki; Nakatsuji, Hiroshi

    2008-12-12

    The local energy defined by H{psi}/{psi} must be equal to the exact energy E at any coordinate of an atom or molecule, as long as the {psi} under consideration is exact. The discrepancy from E of this quantity is a stringent test of the accuracy of the calculated wave function. The H-square error for a normalized {psi}, defined by {sigma}{sup 2}{identical_to}<{psi}|(H-E){sup 2}|{psi}>, is also a severe test of the accuracy. Using these quantities, we have examined the accuracy of our wave function of a helium atom calculated using the free complement method that was developed to solve the Schroedinger equation.more » Together with the variational upper bound, the lower bound of the exact energy calculated using a modified Temple's formula ensured the definitely correct value of the helium fixed-nucleus ground state energy to be -2.903 724 377 034 119 598 311 159 245 194 4 a.u., which is correct to 32 digits.« less

  13. Determining the sample size for co-dominant molecular marker-assisted linkage detection for a monogenic qualitative trait by controlling the type-I and type-II errors in a segregating F2 population.

    PubMed

    Hühn, M; Piepho, H P

    2003-03-01

    Tests for linkage are usually performed using the lod score method. A critical question in linkage analyses is the choice of sample size. The appropriate sample size depends on the desired type-I error and power of the test. This paper investigates the exact type-I error and power of the lod score method in a segregating F(2) population with co-dominant markers and a qualitative monogenic dominant-recessive trait. For illustration, a disease-resistance trait is considered, where the susceptible allele is recessive. A procedure is suggested for finding the appropriate sample size. It is shown that recessive plants have about twice the information content of dominant plants, so the former should be preferred for linkage detection. In some cases the exact alpha-values for a given nominal alpha may be rather small due to the discrete nature of the sampling distribution in small samples. We show that a gain in power is possible by using exact methods.

  14. Explaining efficient search for conjunctions of motion and form: evidence from negative color effects.

    PubMed

    Dent, Kevin

    2014-05-01

    Dent, Humphreys, and Braithwaite (2011) showed substantial costs to search when a moving target shared its color with a group of ignored static distractors. The present study further explored the conditions under which such costs to performance occur. Experiment 1 tested whether the negative color-sharing effect was specific to cases in which search showed a highly serial pattern. The results showed that the negative color-sharing effect persisted in the case of a target defined as a conjunction of movement and form, even when search was highly efficient. In Experiment 2, the ease with which participants could find an odd-colored target amongst a moving group was examined. Participants searched for a moving target amongst moving and stationary distractors. In Experiment 2A, participants performed a highly serial search through a group of similarly shaped moving letters. Performance was much slower when the target shared its color with a set of ignored static distractors. The exact same displays were used in Experiment 2B; however, participants now responded "present" for targets that shared the color of the static distractors. The same targets that had previously been difficult to find were now found efficiently. The results are interpreted in a flexible framework for attentional control. Targets that are linked with irrelevant distractors by color tend to be ignored. However, this cost can be overridden by top-down control settings.

  15. Increased prevalence of third-degree atrioventricular block in patients with type II diabetes mellitus.

    PubMed

    Movahed, Mohammad-Reza; Hashemzadeh, Mehrtash; Jamal, M Mazen

    2005-10-01

    Diabetes mellitus (DM) is a major risk for cardiovascular disease and mortality. There is some evidence that third-degree atrioventricular (AV) block occurs more commonly in patients with DM. In this study, we evaluated any possible association between DM and third-degree AV block using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes in a very large inpatient database. We used patient treatment files containing discharge diagnoses using ICD-9 codes of inpatient treatment from all Veterans Health Administration hospitals. The cohort was stratified using the ICD-9-CM code for DM (n = 293,124), a control group with hypertension but no DM (n = 552,623), and the ICD-9 code for third-degree AV block (426.0) and smoking (305.1, V15.82). We performed multivariate analysis adjusting for coronary artery disease, congestive heart failure, smoking, and hyperlipidemia. Continuous and binary variables were analyzed using chi2 and Fisher exact tests. Third-degree AV block diagnosis was present in 3,240 of DM patients (1.1%) vs 3,367 patients (0.6%) in the control group. Using multivariate analysis, DM remained strongly associated with third-degree AV block (odds ratio, 3.1; 95% confidential interval, 3.0 to 3.3; p < 0.0001). Third-degree AV block occurs significantly more in patients with DM. This finding may, in part, explain the high cardiovascular mortality in DM patients.

  16. Prosociality and negative emotionality mediate the association of serotonin transporter genotype with childhood ADHD and ODD.

    PubMed

    Brammer, Whitney A; Lee, Steve S

    2013-01-01

    Although there is evidence that the promoter polymorphism of the serotonin transporter (5-HTTLPR) gene is associated with attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD), the pathways underlying these associations are largely unknown. Given their theoretical and biological plausibility, we tested whether individual differences in key temperament dimensions (i.e., prosociality, negative emotionality, daring) constituted potential pathways from 5-HTTLPR to ADHD and ODD. Using a well-characterized sample of 194 six to nine-year-old children with and without ADHD, we utilized multiple mediation procedures with bootstrapping to evaluate prosociality, negative emotionality, and daring as independent mediators of 5-HTTLPR with separate parent and teacher ratings of ADHD and ODD. Controlling for ODD, prosociality and negative emotionality significantly mediated the association of 5-HTTLPR and parent-reported ADHD. Similarly, controlling for ADHD, prosociality and negative emotionality each uniquely mediated the association of 5-HTTLPR and parent-reported ODD. For teacher-reported ADHD, prosociality significantly mediated the association of 5-HTTLPR (controlling for ODD) whereas controlling for ODD, negative emotionality significantly mediated the prediction of teacher-reported ODD from 5-HTTLPR. Specifically, the number of 5-HTTLPR long alleles was inversely associated with prosociality and positively associated with negative emotionality; prosociality was inversely associated and negative emotionality was positively associated with ADHD and ODD. We consider the role of temperament in genetically sensitive designs as well as its potential value in the development and delivery of effective interventions.

  17. Odd versus even: a scientific study of the ‘rules’ of plating

    PubMed Central

    Michel, Charles; Spence, Charles

    2016-01-01

    We report on the results of a series of large-scale computer-based preference tests (conducted at The Science Museum in London and online) that evaluated the widely-held belief that food should be plated in odd rather than even numbers of elements in order to maximize the visual appeal of a dish. Participants were presented with pairs of plates of food showing odd versus even number of seared scallops (3 vs. 4; 1–6 in Experiment 7), arranged in a line, as a polygon or randomly, on either a round or square white plate. No consistent evidence for a preference for odd or even numbers of food items was found, thus questioning the oft-made assertion that odd number of items on a plate looks better than an even number. The implications of these results are discussed. PMID:26839741

  18. Patient Use of Complementary and Alternative Medicines in an Outpatient Pediatric Neurology Clinic.

    PubMed

    Kenney, Daniel; Jenkins, Sarah; Youssef, Paul; Kotagal, Suresh

    2016-05-01

    This article describes the use of complementary and alternative medicines in an outpatient pediatric neurology clinic, and assesses family attitudes toward the efficacy of complementary and alternative medicines versus prescription medications. Complementary and alternative medicine is an important element of the modern health care landscape. There is limited information about whether, and to what extent, families perceive its utility in childhood neurological disorders. Surveys were distributed to 500 consecutive patients at a child neurology clinic in Rochester, Minnesota. Questions pertained to the child's diagnoses, use of complementary and alternative medicines, and the specific complementary and alternative medicine modalities that were used. Opinions were also gathered on the perceived efficacy of complementary and alternative medicines and prescription medications. Data were compared using χ(2) or Fisher exact tests as indicated. A total of 484 surveys were returned, of which 327 were usable. Only 17.4% admitted to use of complementary and alternative medicine to treat neurological problems. However, in follow-up questioning, actually 41.6% of patients recognized that they were using one or more types of complementary and alternative medicines. Disorders associated with a statistically significant increased prevalence of complementary and alternative medicine use were headache (50.8% with headache used complementary and alternative medicine versus 35.7% without headache; P = 0.008, Fisher exact test), chronic fatigue (63.2% vs 38.8%; P = 0.005, Fisher exact test), and sleep disorders (77.1% vs 37.3%; P < 0.0001, Fisher exact test). A large proportion of pediatric neurology patients in our clinic are also using complementary and alternative medicine. Only 38.5% of these recognize themselves as using complementary and alternative medicine, underlining the need to inquire in-depth about its use. Patients who are less satisfied with their prescription medications are more likely to use complementary and alternative medicine, perhaps reflecting the less tractable nature of their disorders. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Conservative self-force correction to the innermost stable circular orbit: Comparison with multiple post-Newtonian-based methods

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

    Favata, Marc

    2011-01-15

    Barack and Sago [Phys. Rev. Lett. 102, 191101 (2009)] have recently computed the shift of the innermost stable circular orbit (ISCO) of the Schwarzschild spacetime due to the conservative self-force that arises from the finite-mass of an orbiting test-particle. This calculation of the ISCO shift is one of the first concrete results of the self-force program, and provides an exact (fully relativistic) point of comparison with approximate post-Newtonian (PN) computations of the ISCO. Here this exact ISCO shift is compared with nearly all known PN-based methods. These include both 'nonresummed' and 'resummed' approaches (the latter reproduce the test-particle limit bymore » construction). The best agreement with the exact (Barack-Sago) result is found when the pseudo-4PN coefficient of the effective-one-body (EOB) metric is fit to numerical relativity simulations. However, if one considers uncalibrated methods based only on the currently known 3PN-order conservative dynamics, the best agreement is found from the gauge-invariant ISCO condition of Blanchet and Iyer [Classical Quantum Gravity 20, 755 (2003)], which relies only on the (nonresummed) 3PN equations of motion. This method reproduces the exact test-particle limit without any resummation. A comparison of PN methods with the ISCO in the equal-mass case (computed via sequences of numerical relativity initial-data sets) is also performed. Here a (different) nonresummed method also performs very well (as was previously shown). These results suggest that the EOB approach - while exactly incorporating the conservative test-particle dynamics and having several other important advantages - does not (in the absence of calibration) incorporate conservative self-force effects more accurately than standard PN methods. I also consider how the conservative self-force ISCO shift, combined in some cases with numerical relativity computations of the ISCO, can be used to constrain our knowledge of (1) the EOB effective metric, (2) phenomenological inspiral-merger-ringdown templates, and (3) 4PN- and 5PN-order terms in the PN orbital energy. These constraints could help in constructing better gravitational-wave templates. Lastly, I suggest a new method to calibrate unknown PN terms in inspiral templates using numerical-relativity calculations.« less

  20. Ethnic differences in cross-sectional associations between impaired glucose regulation, identified by oral glucose tolerance test or HbA1c values, and cardiovascular disease in a cohort of European and South Asian origin.

    PubMed

    Eastwood, S V; Tillin, T; Mayet, J; Shibata, D K; Wright, A; Heasman, J; Beauchamp, N; Forouhi, N G; Hughes, A D; Chaturvedi, N

    2016-03-01

    We contrasted impaired glucose regulation (prediabetes) prevalence, defined according to oral glucose tolerance test or HbA1c values, and studied cross-sectional associations between prediabetes and subclinical/clinical cardiovascular disease (CVD) in a cohort of European and South Asian origin. For 682 European and 520 South Asian men and women, aged 58-85 years, glycaemic status was determined by oral glucose tolerance test or HbA1c thresholds. Questionnaires, record review, coronary artery calcification scores and cerebral magnetic resonance imaging established clinical plus subclinical coronary heart and cerebrovascular disease. Prediabetes was more prevalent in South Asian participants when defined by HbA1c rather than by oral glucose tolerance test criteria. Accounting for age, sex, smoking, systolic blood pressure, triglycerides and waist-hip ratio, prediabetes was associated with coronary heart disease and cerebrovascular disease in European participants, most obviously when defined by HbA1c rather than by oral glucose tolerance test [odds ratios for HbA1c -defined prediabetes 1.60 (95% CI 1.07, 2.39) for coronary heart disease and 1.57 (95% CI 1.00, 2.51) for cerebrovascular disease]. By contrast, non-significant associations were present between oral glucose tolerance test-defined prediabetes only and coronary heart disease [odds ratio 1.41 (95% CI 0.84, 2.36)] and HbA1c -defined prediabetes only and cerebrovascular disease [odds ratio 1.39 (95% CI 0.69, 2.78)] in South Asian participants. Prediabetes defined by HbA1c or oral glucose tolerance test criteria was associated with cardiovascular disease (defined as coronary heart and/or cerebrovascular disease) in Europeans [odds ratio 1.95 (95% CI 1.31, 2.91) for HbA1c prediabetes criteria] but not in South Asian participants [odds ratio 1.00 (95% CI 0.62, 2.66); ethnicity interaction P = 0.04]. Prediabetes appeared to be less associated with cardiovascular disease in the South Asian than in the European group. These findings have implications for screening, and early cardiovascular prevention strategies in South Asian populations. © 2015 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.

  1. Power, effects, confidence, and significance: an investigation of statistical practices in nursing research.

    PubMed

    Gaskin, Cadeyrn J; Happell, Brenda

    2014-05-01

    To (a) assess the statistical power of nursing research to detect small, medium, and large effect sizes; (b) estimate the experiment-wise Type I error rate in these studies; and (c) assess the extent to which (i) a priori power analyses, (ii) effect sizes (and interpretations thereof), and (iii) confidence intervals were reported. Statistical review. Papers published in the 2011 volumes of the 10 highest ranked nursing journals, based on their 5-year impact factors. Papers were assessed for statistical power, control of experiment-wise Type I error, reporting of a priori power analyses, reporting and interpretation of effect sizes, and reporting of confidence intervals. The analyses were based on 333 papers, from which 10,337 inferential statistics were identified. The median power to detect small, medium, and large effect sizes was .40 (interquartile range [IQR]=.24-.71), .98 (IQR=.85-1.00), and 1.00 (IQR=1.00-1.00), respectively. The median experiment-wise Type I error rate was .54 (IQR=.26-.80). A priori power analyses were reported in 28% of papers. Effect sizes were routinely reported for Spearman's rank correlations (100% of papers in which this test was used), Poisson regressions (100%), odds ratios (100%), Kendall's tau correlations (100%), Pearson's correlations (99%), logistic regressions (98%), structural equation modelling/confirmatory factor analyses/path analyses (97%), and linear regressions (83%), but were reported less often for two-proportion z tests (50%), analyses of variance/analyses of covariance/multivariate analyses of variance (18%), t tests (8%), Wilcoxon's tests (8%), Chi-squared tests (8%), and Fisher's exact tests (7%), and not reported for sign tests, Friedman's tests, McNemar's tests, multi-level models, and Kruskal-Wallis tests. Effect sizes were infrequently interpreted. Confidence intervals were reported in 28% of papers. The use, reporting, and interpretation of inferential statistics in nursing research need substantial improvement. Most importantly, researchers should abandon the misleading practice of interpreting the results from inferential tests based solely on whether they are statistically significant (or not) and, instead, focus on reporting and interpreting effect sizes, confidence intervals, and significance levels. Nursing researchers also need to conduct and report a priori power analyses, and to address the issue of Type I experiment-wise error inflation in their studies. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  2. 40 CFR 790.85 - Submission of equivalence data.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... sought. The exact type of identifying data required will be specified in the test rule, but may include... 40 Protection of Environment 32 2011-07-01 2011-07-01 false Submission of equivalence data. 790.85... Test Rules § 790.85 Submission of equivalence data. If EPA requires in a test rule promulgated under...

  3. 40 CFR 790.85 - Submission of equivalence data.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... sought. The exact type of identifying data required will be specified in the test rule, but may include... 40 Protection of Environment 32 2014-07-01 2014-07-01 false Submission of equivalence data. 790.85... Test Rules § 790.85 Submission of equivalence data. If EPA requires in a test rule promulgated under...

  4. An exact plane-stress solution for a class of problems in orthotropic elasticity

    NASA Technical Reports Server (NTRS)

    Erb, D. A.; Cooper, P. A.; Weisshaar, T. A.

    1982-01-01

    An exact solution for the stress field within a rectangular slab of orthotropic material is found using a two dimensional Fourier series formulation. The material is required to be in plane stress, with general stress boundary conditions, and the principle axes of the material must be parallel to the sides of the rectangle. Two load cases similar to those encountered in materials testing are investigated using the solution. The solution method has potential uses in stress analysis of composite structures.

  5. Associations of Time-Related Deployment Variables With Risk of Suicide Attempt Among Soldiers: Results From the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS).

    PubMed

    Ursano, Robert J; Kessler, Ronald C; Naifeh, James A; Herberman Mash, Holly; Fullerton, Carol S; Aliaga, Pablo A; Wynn, Gary H; Ng, Tsz Hin H; Dinh, Hieu M; Sampson, Nancy A; Kao, Tzu-Cheg; Bliese, Paul D; Stein, Murray B

    2018-06-01

    There has been limited systematic examination of whether risk of suicide attempt (SA) among US Army soldiers is associated with time-related deployment variables, such as time in service before first deployment, duration of first deployment, and dwell time (DT) (ie, length of time between deployments). To examine the associations of time-related deployment variables with subsequent SA among soldiers who had deployed twice. Using administrative data from January 1, 2004, through December 31, 2009, this longitudinal, retrospective cohort study identified person-month records of active-duty Regular Army enlisted soldiers who had served continuously in the US Army for at least 2 years and deployed exactly twice. The dates of analysis were March 1 to December 1, 2017. There were 593 soldiers with a medically documented SA during or after their second deployment. An equal-probability sample of control person-months was selected from other soldiers with exactly 2 deployments (n = 19 034). Logistic regression analyses examined the associations of time in service before first deployment, duration of first deployment, and DT with subsequent SA. Suicide attempts during or after second deployment were identified using US Department of Defense Suicide Event Report records and International Classification of Diseases, Ninth Revision, Clinical Modification E950 to E958 diagnostic codes. Independent variables were constructed from US Army personnel records. Among 593 SA cases, most were male (513 [86.5%]), white non-Hispanic (392 [66.1%]), at least high school educated (477 [80.4%]), currently married (398 [67.1%]), and younger than 21 years when they entered the US Army (384 [64.8%]). In multivariable models adjusting for sociodemographics, service-related characteristics, and previous mental health diagnosis, odds of SA during or after second deployment were higher among soldiers whose first deployment occurred within the first 12 months of service vs after 12 months (odds ratio, 2.0; 95% CI, 1.6-2.4) and among those with a DT of 6 months or less vs longer than 6 months (odds ratio, 1.6; 95% CI, 1.2-2.0). Duration of first deployment was not associated with subsequent SA. Analysis of 2-way interactions indicated that the associations of early deployment and DT with SA risk were not modified by other characteristics. Multivariable population-attributable risk proportions were 14.2% for deployment within the first 12 months of service and 4.0% for DT of 6 months or less. Time in service before first deployment and DT are modifiable risk factors for SA risk among soldiers.

  6. Brief Report: Stigma and HIV Care Continuum Outcomes Among Ethiopian Adults Initiating ART.

    PubMed

    Hoffman, Susie; Tymejczyk, Olga; Kulkarni, Sarah; Lahuerta, Maria; Gadisa, Tsigereda; Remien, Robert H; Melaku, Zenebe; Nash, Denis; Elul, Batya

    2017-12-01

    Stigma harms the mental health of HIV-positive individuals and reduces adherence to antiretroviral therapy (ART), but less is known about stigma and other outcomes across the HIV care continuum. Among 1180 Ethiopian adults initiating ART at 6 urban HIV clinics, we examined the relationship of internalized, anticipated, and enacted stigma to HIV care-related outcomes ascertained by interview (repeat HIV-positive testing, provider vs. self-referred testing, missed clinic visit before ART initiation, eagerness to begin ART), and by abstraction of routinely collected clinical data (late ART initiation, 3-month gap in care following ART initiation). Logistic regression was used to assess the association of each type of stigma with each outcome, adjusting for potential confounders. Scoring higher on each stigma domain was associated with 50%-90% higher odds of repeat HIV-positive testing. High internalized stigma was associated with higher odds of provider vs. self-referred test [adjusted odds ratio (aOR)high vs. low: 1.7; 95% confidence interval (CI): 1.3 to 2.2]. Higher anticipated stigma was associated with lower eagerness to begin ART (aORhigh vs. low: 0.55; 0.35-0.87; aORmedium vs. low: 0.45; 95% CI: 0.30 to 0.69). Any enacted stigma was associated with higher odds of a missed visit (aORany vs. none 1.8; 1.2-2.8). Stigma was not associated with late ART-initiation or with a subsequent gap in care. These findings provide further evidence of the importance of measuring and addressing stigma across the entire care continuum. Future work should test hypotheses about specific stigma domains and outcomes in prospective intervention or observational studies.

  7. Impact of oppositional defiant disorder dimensions on the temporal ordering of conduct problems and depression across childhood and adolescence in girls.

    PubMed

    Hipwell, Alison E; Stepp, Stephanie; Feng, Xin; Burke, Jeff; Battista, Deena R; Loeber, Rolf; Keenan, Kate

    2011-10-01

    Little is known about the role of oppositional defiant disorder (ODD) dimensions on the temporal unfolding of conduct disorder (CD) and depression in girls between childhood and adolescence. The year-to-year associations between CD and depressive symptomatology were examined using nine waves of annually collected data (ages 8 through 16 years) from 1215 participants of the Pittsburgh Girls Study. A series of autoregressive path models were tested that included ODD-Emotion Dysregulation (ODD-ED) and ODD-Defiance, as time-varying covariates on CD predicting depression severity in the following year, and vice versa. Conduct problems, depression, and ODD dimensions were relatively stable throughout childhood and adolescence, and a moderate degree of covariance was observed between these variables. Path analyses showed that CD often preceded depression across this developmental period, although the effect sizes were small. There was less consistent prediction from depression to CD. The overlap between ODD-ED and CD partially explained the prospective relations from CD to depression, whereas these paths were fully explained by the overlap between ODD-ED and depression. The overlap between ODD-Defiance and CD did not account for the prospective relations from CD to depression. In contrast, the overlap between ODD-Defiance and depression accounted for virtually all paths from CD to depression. Accounting for the overlap between ODD dimensions and both CD and depression eliminated all significant predictive paths. Symptoms of CD tend to precede depression in girls during childhood and adolescence. However, covariance between depression and both ODD-ED and ODD-Defiance accounts for these prospective relations. ODD dimensions should be assessed when evaluating risk for comorbid depression in girls with conduct problems, and emotion dysregulation and defiance aspects of ODD should be identified as targets for treatment in order to prevent depression in the future. © 2011 The Authors. Journal of Child Psychology and Psychiatry © 2011 Association for Child and Adolescent Mental Health.

  8. Construct validity of ADHD/ODD rating scales: recommendations for the evaluation of forthcoming DSM-V ADHD/ODD scales.

    PubMed

    Burns, G Leonard; Walsh, James A; Servera, Mateu; Lorenzo-Seva, Urbano; Cardo, Esther; Rodríguez-Fornells, Antoni

    2013-01-01

    Exploratory structural equation modeling (SEM) was applied to a multiple indicator (26 individual symptom ratings) by multitrait (ADHD-IN, ADHD-HI and ODD factors) by multiple source (mothers, fathers and teachers) model to test the invariance, convergent and discriminant validity of the Child and Adolescent Disruptive Behavior Inventory with 872 Thai adolescents and the ADHD Rating Scale-IV and ODD scale of the Disruptive Behavior Inventory with 1,749 Spanish children. Most of the individual ADHD/ODD symptoms showed convergent and discriminant validity with the loadings and thresholds being invariant over mothers, fathers and teachers in both samples (the three latent factor means were higher for parents than teachers). The ADHD-IN, ADHD-HI and ODD latent factors demonstrated convergent and discriminant validity between mothers and fathers within the two samples. Convergent and discriminant validity between parents and teachers for the three factors was either absent (Thai sample) or only partial (Spanish sample). The application of exploratory SEM to a multiple indicator by multitrait by multisource model should prove useful for the evaluation of the construct validity of the forthcoming DSM-V ADHD/ODD rating scales.

  9. Testing Spatial Symmetry Using Contingency Tables Based on Nearest Neighbor Relations

    PubMed Central

    Ceyhan, Elvan

    2014-01-01

    We consider two types of spatial symmetry, namely, symmetry in the mixed or shared nearest neighbor (NN) structures. We use Pielou's and Dixon's symmetry tests which are defined using contingency tables based on the NN relationships between the data points. We generalize these tests to multiple classes and demonstrate that both the asymptotic and exact versions of Pielou's first type of symmetry test are extremely conservative in rejecting symmetry in the mixed NN structure and hence should be avoided or only the Monte Carlo randomized version should be used. Under RL, we derive the asymptotic distribution for Dixon's symmetry test and also observe that the usual independence test seems to be appropriate for Pielou's second type of test. Moreover, we apply variants of Fisher's exact test on the shared NN contingency table for Pielou's second test and determine the most appropriate version for our setting. We also consider pairwise and one-versus-rest type tests in post hoc analysis after a significant overall symmetry test. We investigate the asymptotic properties of the tests, prove their consistency under appropriate null hypotheses, and investigate finite sample performance of them by extensive Monte Carlo simulations. The methods are illustrated on a real-life ecological data set. PMID:24605061

  10. Like-charge attraction in a one-dimensional setting: the importance of being odd

    NASA Astrophysics Data System (ADS)

    Trizac, Emmanuel; Téllez, Gabriel

    2018-03-01

    From cement cohesion to DNA condensation, a proper statistical physics treatment of systems with long-range forces is important for a number of applications in physics, chemistry, and biology. We compute here the effective force between fixed charged macromolecules, screened by oppositely charged mobile ions (counterions). We treat the problem in a one-dimensional configuration that allows for interesting discussion and derivation of exact results, remaining at a level of mathematical difficulty compatible with an undergraduate course. Emphasis is put on the counterintuitive but fundamental phenomenon of like-charge attraction, which our treatment brings for the first time to the level of undergraduate teaching. The parity of the number of counterions is shown to play a prominent role, which sheds light on the binding mechanism at work when like-charge macromolecules do attract.

  11. The single-ion anisotropy effects in the mixed-spin ternary-alloy

    NASA Astrophysics Data System (ADS)

    Albayrak, Erhan

    2018-04-01

    The effect of single-ion anisotropy on the thermal properties of the ternary-alloy in the form of ABpC1-p is investigated on the Bethe lattice (BL) in terms of exact recursion relations. The simulation on the BL consists of placing A atoms (spin-1/2) on the odd shells and randomly placing B (spin-3/2) or C (spin-5/2) atoms with concentrations p and 1 - p, respectively, on the even shells. The phase diagrams are calculated in possible planes spanned by the system parameters: temperature, single-ion anisotropy, concentration and ratio of the bilinear interaction parameters for z = 3 corresponding to the honeycomb lattice. It is found that the crystal field drives the system to the lowest possible state therefore reducing the temperatures of the critical lines in agreement with the literature.

  12. Tests of Independence in Contingency Tables with Small Samples: A Comparison of Statistical Power.

    ERIC Educational Resources Information Center

    Parshall, Cynthia G.; Kromrey, Jeffrey D.

    1996-01-01

    Power and Type I error rates were estimated for contingency tables with small sample sizes for the following four types of tests: (1) Pearson's chi-square; (2) chi-square with Yates's continuity correction; (3) the likelihood ratio test; and (4) Fisher's Exact Test. Various marginal distributions, sample sizes, and effect sizes were examined. (SLD)

  13. Explaining Discrepancies Between the Digit Triplet Speech-in-Noise Test Score and Self-Reported Hearing Problems in Older Adults.

    PubMed

    Pronk, Marieke; Deeg, Dorly J H; Kramer, Sophia E

    2018-04-17

    The purpose of this study is to determine which demographic, health-related, mood, personality, or social factors predict discrepancies between older adults' functional speech-in-noise test result and their self-reported hearing problems. Data of 1,061 respondents from the Longitudinal Aging Study Amsterdam were used (ages ranged from 57 to 95 years). Functional hearing problems were measured using a digit triplet speech-in-noise test. Five questions were used to assess self-reported hearing problems. Scores of both hearing measures were dichotomized. Two discrepancy outcomes were created: (a) being unaware: those with functional but without self-reported problems (reference is aware: those with functional and self-reported problems); (b) reporting false complaints: those without functional but with self-reported problems (reference is well: those without functional and self-reported hearing problems). Two multivariable prediction models (logistic regression) were built with 19 candidate predictors. The speech reception threshold in noise was kept (forced) as a predictor in both models. Persons with higher self-efficacy (to initiate behavior) and higher self-esteem had a higher odds to being unaware than persons with lower self-efficacy scores (odds ratio [OR] = 1.13 and 1.11, respectively). Women had a higher odds than men (OR = 1.47). Persons with more chronic diseases and persons with worse (i.e., higher) speech-in-noise reception thresholds in noise had a lower odds to being unaware (OR = 0.85 and 0.91, respectively) than persons with less diseases and better thresholds, respectively. A higher odds to reporting false complaints was predicted by more depressive symptoms (OR = 1.06), more chronic diseases (OR = 1.21), and a larger social network (OR = 1.02). Persons with higher self-efficacy (to complete behavior) had a lower odds (OR = 0.86), whereas persons with higher self-esteem had a higher odds to report false complaints (OR = 1.21). The explained variance of both prediction models was small (Nagelkerke R2 = .11 for the unaware model, and .10 for the false complaints model). The findings suggest that a small proportion of the discrepancies between older individuals' results on a speech-in-noise screening test and their self-reports of hearing problems can be explained by the unique context of these individuals. The likelihood of discrepancies partly depends on a person's health (chronic diseases), demographics (gender), personality (self-efficacy to initiate behavior and to persist in adversity, self-esteem), mood (depressive symptoms), and social situation (social network size). Implications are discussed.

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

    Scherrer, Arne; UMR 8640 ENS-CNRS-UPMC, Département de Chimie, 24 rue Lhomond, École Normale Supérieure, 75005 Paris; UPMC Université Paris 06, 4, Place Jussieu, 75005 Paris

    The nuclear velocity perturbation theory (NVPT) for vibrational circular dichroism (VCD) is derived from the exact factorization of the electron-nuclear wave function. This new formalism offers an exact starting point to include correction terms to the Born-Oppenheimer (BO) form of the molecular wave function, similar to the complete-adiabatic approximation. The corrections depend on a small parameter that, in a classical treatment of the nuclei, is identified as the nuclear velocity. Apart from proposing a rigorous basis for the NVPT, we show that the rotational strengths, related to the intensity of the VCD signal, contain a new contribution beyond-BO that canmore » be evaluated with the NVPT and that only arises when the exact factorization approach is employed. Numerical results are presented for chiral and non-chiral systems to test the validity of the approach.« less

  15. JANUS: a bit-wise reversible integrator for N-body dynamics

    NASA Astrophysics Data System (ADS)

    Rein, Hanno; Tamayo, Daniel

    2018-01-01

    Hamiltonian systems such as the gravitational N-body problem have time-reversal symmetry. However, all numerical N-body integration schemes, including symplectic ones, respect this property only approximately. In this paper, we present the new N-body integrator JANUS , for which we achieve exact time-reversal symmetry by combining integer and floating point arithmetic. JANUS is explicit, formally symplectic and satisfies Liouville's theorem exactly. Its order is even and can be adjusted between two and ten. We discuss the implementation of JANUS and present tests of its accuracy and speed by performing and analysing long-term integrations of the Solar system. We show that JANUS is fast and accurate enough to tackle a broad class of dynamical problems. We also discuss the practical and philosophical implications of running exactly time-reversible simulations.

  16. Cyberbullying, depression, and problem alcohol use in female college students: a multisite study.

    PubMed

    Selkie, Ellen M; Kota, Rajitha; Chan, Ya-Fen; Moreno, Megan

    2015-02-01

    Cyberbullying and its effects have been studied largely in middle and high school students, but less is known about cyberbullying in college students. This cross-sectional study investigated the relationship between involvement in cyberbullying and depression or problem alcohol use among college females. Two hundred and sixty-five female students from four colleges completed online surveys assessing involvement in cyberbullying behaviors. Participants also completed the Patient Health Questionnaire-9 (PHQ-9) to assess depressive symptoms and the Alcohol Use Disorder Identification Test (AUDIT) to assess problem drinking. Logistic regression tested associations between involvement in cyberbullying and either depression or problem drinking. Results indicated that 27% of participants had experienced cyberbullying in college; 17.4% of all participants met the criteria for depression (PHQ-9 score ≥10), and 37.5% met the criteria for problem drinking (AUDIT score ≥8). Participants with any involvement in cyberbullying had increased odds of depression. Those involved in cyberbullying as bullies had increased odds of both depression and problem alcohol use. Bully/victims had increased odds of depression. The four most common cyberbullying behaviors were also associated with increased odds for depression, with the highest odds among those who had experienced unwanted sexual advances online or via text message. Findings indicate that future longitudinal study of cyberbullying and its effects into late adolescence and young adulthood could contribute to the prevention of associated comorbidities in this population.

  17. Influence of genetic discrimination perceptions and knowledge on cancer genetics referral practice among clinicians.

    PubMed

    Lowstuter, Katrina J; Sand, Sharon; Blazer, Kathleen R; MacDonald, Deborah J; Banks, Kimberly C; Lee, Carol A; Schwerin, Barbara U; Juarez, Margaret; Uman, Gwen C; Weitzel, Jeffrey N

    2008-09-01

    To describe nongenetics clinicians' perceptions and knowledge of cancer genetics and laws prohibiting genetic discrimination, attitudes toward the use of cancer genetic testing, and referral practices. Invitations to participate were sent to a random stratified sample of California Medical Association members and to all members of California Association of Nurse Practitioners and California Latino Medical Association. Responders in active practice were eligible and completed a 47-item survey. There were 1181 qualified participants (62% physicians). Although 96% viewed genetic testing as beneficial for their patients, 75% believed fear of genetic discrimination would cause patients to decline testing. More than 60% were not aware of federal or California laws prohibiting health insurance discrimination--concern about genetic discrimination was selected as a reason for nonreferral by 11%. A positive attitude toward genetic testing was the strongest predictor of referral (odds ratio: 3.55 [95% confidence interval: 2.24-5.63], P < 0.001) in stepwise logistic regression analyses. The higher the belief in genetic discrimination, the less likely a participant was to refer (odds ratio: 0.72 [95% confidence interval: 0.518-0.991], P < 0.05), whereas more knowledge of genetic discrimination law was associated with comfort recommending (odds ratio: 1.18 [95% confidence interval: 1.11-1.25], P < 0.001) and actual referral (odds ratio: 3.55 [95% confidence interval: 2.24-5.63], P < 0.001). Concerns about genetic discrimination and knowledge deficits may be barriers to cancer genetics referrals. Clinician education may help promote access to cancer screening and prevention.

  18. HIV resistance testing and detected drug resistance in Europe.

    PubMed

    Schultze, Anna; Phillips, Andrew N; Paredes, Roger; Battegay, Manuel; Rockstroh, Jürgen K; Machala, Ladislav; Tomazic, Janez; Girard, Pierre M; Januskevica, Inga; Gronborg-Laut, Kamilla; Lundgren, Jens D; Cozzi-Lepri, Alessandro

    2015-07-17

    To describe regional differences and trends in resistance testing among individuals experiencing virological failure and the prevalence of detected resistance among those individuals who had a genotypic resistance test done following virological failure. Multinational cohort study. Individuals in EuroSIDA with virological failure (>1 RNA measurement >500 on ART after >6 months on ART) after 1997 were included. Adjusted odds ratios (aORs) for resistance testing following virological failure and aORs for the detection of resistance among those who had a test were calculated using logistic regression with generalized estimating equations. Compared to 74.2% of ART-experienced individuals in 1997, only 5.1% showed evidence of virological failure in 2012. The odds of resistance testing declined after 2004 (global P < 0.001). Resistance was detected in 77.9% of the tests, NRTI resistance being most common (70.3%), followed by NNRTI (51.6%) and protease inhibitor (46.1%) resistance. The odds of detecting resistance were lower in tests done in 1997-1998, 1999-2000 and 2009-2010, compared to those carried out in 2003-2004 (global P < 0.001). Resistance testing was less common in Eastern Europe [aOR 0.72, 95% confidence interval (CI) 0.55-0.94] compared to Southern Europe, whereas the detection of resistance given that a test was done was less common in Northern (aOR 0.29, 95% CI 0.21-0.39) and Central Eastern (aOR 0.47, 95% CI 0.29-0.76) Europe, compared to Southern Europe. Despite a concurrent decline in virological failure and testing, drug resistance was commonly detected. This suggests a selective approach to resistance testing. The regional differences identified indicate that policy aiming to minimize the emergence of resistance is of particular relevance in some European regions, notably in the countries in Eastern Europe.

  19. Background parenchymal enhancement over exam time in patients with and without breast cancer.

    PubMed

    Melsaether, Amy; Pujara, Akshat C; Elias, Kristin; Pysarenko, Kristine; Gudi, Anjali; Dodelzon, Katerina; Babb, James S; Gao, Yiming; Moy, Linda

    2017-01-01

    To compare background parenchymal enhancement (BPE) over time in patients with and without breast cancer. This retrospective Institutional Review Board (IRB)-approved, Health Insurance Portability and Accountability Act (HIPAA)-compliant study included 116 women (25-84 years, mean 54 years) with breast cancer who underwent breast magnetic resonance imaging at 3T between 1/2/2009 and 12/29/2009 and 116 age and date-of-exam-matched women without breast cancer (23-84 years, mean 51 years). Two independent, blinded readers (R1, R2) recorded BPE (minimal, mild, moderate, marked) at three times (100, 210, and 320 seconds postcontrast). Subsequent cancers were diagnosed in 9/96 control patients with follow up (12.6-93.0 months, mean 63.6 months). Exact Mann-Whitney, Fisher's exact, and McNemar tests were performed. Mean BPE was not found to be different between patients with and without breast cancer at any time (P = 0.36-0.64). At time 2 as compared with time 1, there were significantly more patients, both with and without breast cancer, with BPE >minimal (R1: 90 vs. 41 [P < 0.001] and 81 vs. 36 [P < 0.001]; R2: 84 vs. 52 [P < 0.001] and 79 vs. 43 [P < 0.001]) and BPE >mild (R1: 59 vs. 10 [P < 0.001] and 47 vs. 13 [P < 0.001]; R2: 49 vs. 12 [P < 0.001] and 41 vs. 18 [P < 0.001]). BPE changes between times 2 and 3 were not significant (P = 0.083-1.0). Odds ratios for control patients developing breast cancer were significant only for R2 and ranged up to 7.67 (1.49, 39.5; P < 0.01) for BPE >mild at time 2. BPE changes between the first and second postcontrast scans and stabilizes thereafter in most patients. Further investigation into the most clinically relevant timepoint for BPE assessment is warranted. 3 J. Magn. Reson. Imaging 2017;45:74-83. © 2016 International Society for Magnetic Resonance in Medicine.

  20. Testicular cancer

    MedlinePlus

    Cancer - testes; Germ cell tumor; Seminoma testicular cancer; Nonseminoma testicular cancer; Testicular neoplasm ... The exact cause of testicular cancer is unknown. Factors that may ... Abnormal testicle development Exposure to certain chemicals ...

  1. The Q Exactive HF, a Benchtop Mass Spectrometer with a Pre-filter, High-performance Quadrupole and an Ultra-high-field Orbitrap Analyzer*

    PubMed Central

    Scheltema, Richard Alexander; Hauschild, Jan-Peter; Lange, Oliver; Hornburg, Daniel; Denisov, Eduard; Damoc, Eugen; Kuehn, Andreas; Makarov, Alexander; Mann, Matthias

    2014-01-01

    The quadrupole Orbitrap mass spectrometer (Q Exactive) made a powerful proteomics instrument available in a benchtop format. It significantly boosted the number of proteins analyzable per hour and has now evolved into a proteomics analysis workhorse for many laboratories. Here we describe the Q Exactive Plus and Q Exactive HF mass spectrometers, which feature several innovations in comparison to the original Q Exactive instrument. A low-resolution pre-filter has been implemented within the injection flatapole, preventing unwanted ions from entering deep into the system, and thereby increasing its robustness. A new segmented quadrupole, with higher fidelity of isolation efficiency over a wide range of isolation windows, provides an almost 2-fold improvement of transmission at narrow isolation widths. Additionally, the Q Exactive HF has a compact Orbitrap analyzer, leading to higher field strength and almost doubling the resolution at the same transient times. With its very fast isolation and fragmentation capabilities, the instrument achieves overall cycle times of 1 s for a top 15 to 20 higher energy collisional dissociation method. We demonstrate the identification of 5000 proteins in standard 90-min gradients of tryptic digests of mammalian cell lysate, an increase of over 40% for detected peptides and over 20% for detected proteins. Additionally, we tested the instrument on peptide phosphorylation enriched samples, for which an improvement of up to 60% class I sites was observed. PMID:25360005

  2. UV-VIS depolarization from Arizona Test Dust particles at exact backscattering angle

    NASA Astrophysics Data System (ADS)

    Miffre, Alain; Mehri, Tahar; Francis, Mirvatte; Rairoux, Patrick

    2016-01-01

    In this paper, a controlled laboratory experiment is performed to accurately evaluate the depolarization from mineral dust particles in the exact backward scattering direction (ϴ=180.0±0.2°). The experiment is carried out at two wavelengths simultaneously (λ=355 nm, λ=532 nm), on a determined size and shape distribution of Arizona Test Dust (ATD) particles, used as a proxy for mineral dust particles. After validating the set-up on spherical water droplets, two determined ATD-particle size distributions, representative of mineral dust after long-range transport, are generated to accurately retrieve the UV-VIS depolarization from ATD-particles at exact backscattering angle, which is new. The measured depolarization reaches at most 37.5% at λ=355 nm (35.5% at λ=532 nm), and depends on the particle size distribution. Moreover, these laboratory findings agree with T-matrix numerical simulations, at least for a determined particle size distribution and at a determined wavelength, showing the ability of the spheroidal model to reproduce mineral dust particles in the exact backward scattering direction. However, the spectral dependence of the measured depolarization could not be reproduced with the spheroidal model, even for not evenly distributed aspect ratios. Hence, these laboratory findings can be used to evaluate the applicability of the spheroidal model in the backward scattering direction and moreover, to invert UV-VIS polarization lidar returns, which is useful for radiative transfer and climatology, in which mineral dust particles are strongly involved.

  3. A field study to determine the prevalence, dairy herd management systems, and fresh cow clinical conditions associated with ketosis in western European dairy herds.

    PubMed

    Berge, Anna C; Vertenten, Geert

    2014-01-01

    The aim of this study was to determine the prevalence, major management systems, and fresh cow clinical conditions associated with ketosis in western European dairy herds. A total of 131 dairies were enrolled in Germany, France, Italy, the Netherlands, and the United Kingdom during 2011 to 2012. A milk-based test for ketones (Keto-Test; Sanwa Kagaku Kenkyusho Co. Ltd., Nagoya, Japan; distributed by Elanco Animal Health, Antwerp, Belgium) was used for screening cows between d 7 and 21 after calving and ketosis was defined as a Keto-Test ≥100µmol/L. Study cows were observed for clinical disease up to 35d postcalving. Multivariate analysis (generalized estimating equation logistic regression) was performed to determine country, farm, management, feed, and cow factors associated with ketosis and to determine associations between ketosis and fresh cow diseases. Thirty-nine percent of the cows were classified as having ketosis. The herd average of ketosis was 43% in Germany, 53% in France, 31% in Italy, 46% in the Netherlands, and 31% in the United Kingdom. Of the 131 farms, 112 (85%) had 25% or more of their fresh cows resulting as positive for ketosis. Clinical ketosis was not reported in most farms and the highest level of clinical ketosis reported was 23%. The risks of ketosis were significantly lower in Italy and the United Kingdom compared with France, the Netherlands, and Germany. Larger herd size was associated with a decreased risk of ketosis. The farms that fed partially mixed rations had 1.5 times higher odds of ketosis than those that fed total mixed rations. Cows that calved in April to June had the highest odds of ketosis, with about twice as high odds compared with cows that calved in July to September. The cows that calved in January to March tended to have 1.5 times higher risk of ketosis compared with cows that calved in July to September. The odds of ketosis in parity 2 and parity 3 to 7 was significantly higher (1.5 and 2.8 times higher, respectively) than the odds of ketosis in parity 1. The odds of ketosis was significantly smaller in parity 2 compared with parity 3 to 7. Ketosis was associated with significantly higher odds of all common fresh cow conditions: metritis, mastitis, displaced abomasum, clinical ketosis, lameness, and gastrointestinal disorders. Odds of ketosis in cows having had twins or dystocia were not increased, whereas higher odds of ketosis were observed in cows with milk fever or retained placenta. Copyright © 2014 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  4. A prospective randomized single blind trial of Fleet phosphate enema versus glycerin suppositories as preparation for flexible sigmoidoscopy.

    PubMed

    Underwood, D; Makar, R R; Gidwani, A L; Najfi, S M; Neilly, P; Gilliland, R

    2010-03-01

    This study compared the efficacy and patient acceptability of two methods of bowel preparation for flexible sigmoidoscopy. Patients attending for outpatient flexible sigmoidoscopy were prospectively randomized to receive one Fleet ready-to-use enema or 2 x 4 g glycerin suppositories, 2 h preprocedure. Patient and endoscopist questionnaires were used to compare the outcomes. From November 2000 to August 2001, 203 (male = 95; female = 108) patients were randomized. Patient data available for 163 patients (enema = 93; suppository = 70) revealed: ease of use (enema = 52; suppository = 25; P < 0.02, Fisher's exact); assistance required (enema = 19; suppository = 3; P < 0.005, Fisher's exact); grade of effectiveness (enema = 83; suppository = 44; P < 0.0001, Fisher's exact), and whether patients wished to try another preparation in future (enema = 16; suppository = 24; P = 0.016, Fisher's exact). Endoscopist data available for 151 patients (enema = 76; suppository = 75) revealed: average depth of insertion (enema = 53.6 +/- 11.6 cm; suppository 46.3 +/- 13.7 cm; P < 0.001, Student's t test); acceptable (excellent + good) quality of preparation [enema = 60 (78.9%); suppository = 34 (45.3%); P < 0.0001, Fisher's exact]. Bowel preparation for flexible sigmoidoscopy using a single Fleet enema is acceptable to patients and more effective than glycerin suppositories.

  5. R. & D. in Psychometrics: Technical Reports on Latent Structure Models.

    ERIC Educational Resources Information Center

    Wilcox, Rand R.

    This document contains three papers from the Methodology Project of the Center for the Study of Evaluation. Methods for characterizing test accuracy are reported in the first two papers. "Bounds on the K Out of N Reliability of a Test, and an Exact Test for Hierarchically Related Items" describes and illustrates how an extension of a…

  6. Sample Size Calculation for Estimating or Testing a Nonzero Squared Multiple Correlation Coefficient

    ERIC Educational Resources Information Center

    Krishnamoorthy, K.; Xia, Yanping

    2008-01-01

    The problems of hypothesis testing and interval estimation of the squared multiple correlation coefficient of a multivariate normal distribution are considered. It is shown that available one-sided tests are uniformly most powerful, and the one-sided confidence intervals are uniformly most accurate. An exact method of calculating sample size to…

  7. Exact test-based approach for equivalence test with parameter margin.

    PubMed

    Cassie Dong, Xiaoyu; Bian, Yuanyuan; Tsong, Yi; Wang, Tianhua

    2017-01-01

    The equivalence test has a wide range of applications in pharmaceutical statistics which we need to test for the similarity between two groups. In recent years, the equivalence test has been used in assessing the analytical similarity between a proposed biosimilar product and a reference product. More specifically, the mean values of the two products for a given quality attribute are compared against an equivalence margin in the form of ±f × σ R , where ± f × σ R is a function of the reference variability. In practice, this margin is unknown and is estimated from the sample as ±f × S R . If we use this estimated margin with the classic t-test statistic on the equivalence test for the means, both Type I and Type II error rates may inflate. To resolve this issue, we develop an exact-based test method and compare this method with other proposed methods, such as the Wald test, the constrained Wald test, and the Generalized Pivotal Quantity (GPQ) in terms of Type I error rate and power. Application of those methods on data analysis is also provided in this paper. This work focuses on the development and discussion of the general statistical methodology and is not limited to the application of analytical similarity.

  8. Correlates of HIV testing uptake among kothi-identified men who have sex with men in public sex environments in Chennai, India.

    PubMed

    Woodford, Michael R; Newman, Peter A; Chakrapani, Venkatesan; Shunmugam, Murali; Kakinami, Lisa

    2012-01-01

    Kothi-identified men who have sex with men in India are highly marginalized and are at high-risk for HIV. This study examines HIV testing among 132 self-reported HIV-negative and unknown serostatus kothis recruited from public sex environments in Chennai, India. Using logistic regression we identified variables associated with HIV testing uptake (i.e., being tested and knowing the result). Sixty-one percent reported HIV testing uptake. At the bivariate level, married men, those with low HIV transmission knowledge, those who engaged in unprotected anal sex and unprotected receptive anal sex were at lower odds of reporting testing uptake. In multivariate analysis, married men and those with low levels of HIV transmission knowledge were at decreased odds of being tested, as were kothis who experienced forced sex. Culturally competent programs engaging married kothis are needed. Interventions to facilitate HIV prevention education and systemic interventions to combat sexual violence may facilitate HIV testing uptake among kothis.

  9. Glauber-based evaluations of the odd moments of the initial eccentricity relative to the even order participant plates

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

    Lacey, R.; Wei, R.; Ajitanand, N.

    2011-09-01

    Monte Carlo simulations are used to compute the centrality dependence of the odd moments of the initial eccentricity {var_epsilon}{sub n+1}, relative to the even-order (n) participant planes {Psi}{sub n} in Au + Au collisions. The results obtained for two models of the eccentricity - the Glauber and the factorized Kharzeev-Levin-Nardi (fKLN) models - indicate magnitudes which are essentially zero. They suggest that a possible correlation between the orientations of the odd and even participant planes ({Psi}{sub n+1} and {Psi}{sub n}, respectively) does not have a significant influence on the calculated eccentricities. An experimental verification test for correlations between the orientationsmore » of the odd and even participant planes is also proposed.« less

  10. Parent- and Self-Reported Dimensions of Oppositionality in Youth: Construct Validity, Concurrent Validity, and the Prediction of Criminal Outcomes in Adulthood

    ERIC Educational Resources Information Center

    Aebi, Marcel; Plattner, Belinda; Metzke, Christa Winkler; Bessler, Cornelia; Steinhausen, Hans-Christoph

    2013-01-01

    Background: Different dimensions of oppositional defiant disorder (ODD) have been found as valid predictors of further mental health problems and antisocial behaviors in youth. The present study aimed at testing the construct, concurrent, and predictive validity of ODD dimensions derived from parent- and self-report measures. Method: Confirmatory…

  11. Evaluation of the importance of fever with respect to dengue prognosis according to the 2009 WHO classification: a retrospective study.

    PubMed

    Tukasan, Caroline; Furlan, Nathália Barbosa; Estofolete, Cássia Fernanda; Nogueira, Maurício Lacerda; da Silva, Natal Santos

    2017-01-04

    The 2009 revised World Health Organization (WHO) guidelines for dengue describe fever as the core symptom. Accordingly, the diagnosis of non-febrile patients is complicated. The aim of this study was to evaluate the importance of fever in patients with dengue according to the 2009 revised WHO classification. In this study, we assessed 30,670 dengue cases using enzyme-linked immunosorbent assay, detection of the non-structural protein 1, or polymerase chain reaction for diagnostic confirmation. Fisher's exact test was used to evaluate associations between fever and related clinical manifestations. The Mann-Whitney U test was used to assess the association of dengue classification with fever and time to treatment. The effects of fever and time to treatment on the risk of progression were analyzed using an ordinal logistic regression to stereotype the model. Disease classification was found to associate significantly with both fever and time to treatment (both P < 0.001). Non-febrile patients were nearly four-fold more likely to exhibit "dengue without warning signs" than "severe dengue" (odds ratio [OR] = 3.74; 95% confidence interval [CI]: 3.20-4.36). Patients who received treatment within 7 days were twice as likely to have "dengue without warning signs" as opposed to "severe dengue" when compared to those who waited >7 days (OR = 2.23; 95% CI: 1.78-2.80). However, this difference was negligible in the multivariate analysis (OR = 1.02; 95% CI: 0.98-1.07). Fever is a risk factor for disease progression in patients with dengue. However, non-febrile patients should not be neglected because this may delay treatment and could lead to more severe disease.

  12. Polydyne displacement interferometer using frequency-modulated light

    NASA Astrophysics Data System (ADS)

    Arablu, Masoud; Smith, Stuart T.

    2018-05-01

    A radio-frequency Frequency-Modulated (FM) signal is used to diffract a He-Ne laser beam through an Acousto-Optic Modulator (AOM). Due to the modulation of the FM signal, the measured spectra of the diffracted beams comprise a series of phase-synchronized harmonics that have exact integer frequency separation. The first diffraction side-beam emerging from the AOM is selected by a slit to be used in a polydyne displacement interferometer in a Michelson interferometer topology. The displacement measurement is derived from the phase measurement of selected modulation harmonic pairs. Individual harmonic frequency amplitudes are measured using discrete Fourier transform applied to the signal from a single photodetector. Phase signals are derived from the changes in the amplitudes of different harmonic pairs (typically odd-even pairs) with the phase being extracted using a standard quadrature method. In this study, two different modulation frequencies of 5 and 10 kHz are used at different modulation depths. The measured displacements by different harmonic pairs are compared with a commercial heterodyne interferometer being used as a reference for these studies. Measurements obtained from five different harmonic pairs when the moving mirror of the interferometer is scanned over ranges up to 10 μm all show differences of less than 50 nm from the reference interferometer measurements. A drift test was also used to evaluate the differences between the polydyne interferometer and reference measurements that had different optical path lengths of approximately 25 mm and 50 mm, respectively. The drift test results indicate that about half of the differences can be attributed to temperature, pressure, and humidity variations. Other influences include Abbe and thermal expansion effects. Rough magnitude estimates using simple models for these two effects can account for remaining observed deviations.

  13. Nigerian Immigrant Population in Spain Is Little Sensitized to Living-Related Kidney Donation.

    PubMed

    Ríos, A; Carrillo, J; López-Navas, A I; Ayala, M A; Garrido, G; Sebastián, M J; Martínez-Alarcón, L; Ramis, G; Hernández, A M; Ramírez, P; Parrilla, P

    2018-03-01

    The Nigerian population is an emerging group in Spain and in Europe, but their sensitization toward living kidney donation has not been studied. The aim of this work was to analyze the attitude toward related renal donation while alive among the population born in Nigeria resident in Spain. A population older than 15 years born in Nigeria and resident in Spain, stratified by age and sex, was studied with the use of the attitude questionnaire about living kidney donation, "PCID-DVR-Ríos." People were randomly selected based on stratification. African immigration support associations advised on the location of potential respondents. Completion of the questionnaire was anonymous and self-administered. Verbal consent was requested to assist in the study. Statistical methods included Student t test, χ 2 , Fisher exact test, and logistic regression analysis. A total of 179 respondents were included in the study: 70% (n = 125) were in favor of living-related kidney donation, and 30% (n = 54) remained against or undecided. This attitude was associated with different psychosocial factors: marital status (P = .001), having offspring (P = .029), risk assessment of live donation (P < .001), partner's opinion about donation (P < .001), previous relationship with donation and/or transplantation (P < .001), religion (P < .001), and fear of mutilation after donation (P < .001). In the multivariate analysis, the previous relationship with donation and/or transplantation (odds ratio, 8.064) persisted as the main related factor. The Nigerian immigrant population in Spain has a less favorable attitude toward living kidney donation than the native western European and Spanish population. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Impact of introduction of endoscopic ultrasound on volume, success, and complexity of endoscopic retrograde cholangiopancreatography in a tertiary referral center.

    PubMed

    Yandrapu, Harathi; Elhanafi, Sherif; Chowdhury, Farhanaz; Liu, Jiayang; Onate, Eduardo J; Dwivedi, Alok; Othman, Mohamed O

    2017-01-01

    Endoscopic ultrasound (EUS) is commonly used to examine pancreaticobiliary disorders. We hypothesize that the introduction of EUS service may change the pattern and the complexity of endoscopic retrograde cholangiopancreatographies (ERCPs) performed. The aim of this study is to assess the impact of introducing EUS on the volume, success, and complexity of ERCP. This is a single-center retrospective data review of ERCP procedures done "before" and "after" the introduction of EUS (before EUS and after EUS). Patients' demographics, ERCP indications, types of sedation, therapeutic interventions, outcomes, complications, and complexity of ERCP were collected. The categorical and continuous variables were compared using Fisher's exact test and the unpaired t-test, respectively. Multivariable logistic regression analysis was used to compare ERCP outcomes. A total of 945 ERCPs performed over a 3-year period between January 2010 and January 2013 (411 and 534 in the "before EUS" and "after EUS" time periods, respectively) were included in this study. There was a 30% relative increase in the volume of ERCPs after the introduction of EUS. ERCP success rate was higher after the introduction of EUS, even after adjusting the complexity grade [odds ratio (OR) = 4.54, P = 0.001]. Significant increase in the complexity of ERCP was observed after the introduction of EUS service. The OR of performing grade 4 ERCP was 4.44 (P = 0.0005) after the introduction of EUS. The introduction of a new EUS service in our tertiary referral university medical center is associated with an increase in the volume, success, and complexity of ERCP procedures. EUS expertise may be valuable for better ERCP outcomes.

  15. Visual outcomes of bilateral congenital and developmental cataracts in young children in south India and causes of poor outcome.

    PubMed

    Khanna, Rohit C; Foster, Allen; Krishnaiah, Sannapaneni; Mehta, Manohar K; Gogate, Parikshit M

    2013-02-01

    Bilateral pediatric cataracts are important cause of visual impairment in children. To study the outcome of bilateral pediatric cataract surgery in young children. Retrospective case series in a tertiary center. Records of pediatric cataracts operated between January 2001 and December 2003, with a minimum follow-up of 3 months, were reviewed retrospectively. Independent sample t-test, Fisher's exact test, and logistic regression using SPSS (Statistical Package for Social Science, Chicago, USA) version 12. 215/257 (83.7%) patients had a minimum follow-up of 3 months. The mean age of presentation to the hospital was 53 months (range: 0-168 months). Congenital cataract was present in 107 patients (58.2%) and developmental cataract in 77 patients (41.8%). The mean age at surgery was 55.2 months (range: 1-168 months). Out of 430 eyes, 269 (62.6%) had an intraocular lens implanted. The mean duration of follow-up was 13.1 months (range: 3-38 months). Pre-operatively, 102 patients (47.3%) had visual acuity <6/60, in the better eye, compared to 37 patients (17.2%) post-operatively ( P < 0.001). Eighty-five patients (39.5%) had visual acuity >6/18. The most common early post-operative complication was fibrinous uveitis in 57 eyes (13.3%) and the most common delayed post-operative complication was posterior capsular opacification in 118 eyes (27.4%). The most important prognostic factor for poor outcome was congenital cataract (odds ratio [OR]: 26.3; 95% confidence interval [CI], 4.4-158.5) and total cataract (OR: 4.8; 95% CI, 1.3-17). Nearly half of the eyes had visual acuity >6/18. The outcome was poorer in congenital cataracts, especially those operated after >1 year of age.

  16. Visual outcomes of bilateral congenital and developmental cataracts in young children in south India and causes of poor outcome

    PubMed Central

    Khanna, Rohit C; Foster, Allen; Krishnaiah, Sannapaneni; Mehta, Manohar K; Gogate, Parikshit M

    2013-01-01

    Context: Bilateral pediatric cataracts are important cause of visual impairment in children. Aim: To study the outcome of bilateral pediatric cataract surgery in young children. Setting and Design: Retrospective case series in a tertiary center. Materials and Methods: Records of pediatric cataracts operated between January 2001 and December 2003, with a minimum follow-up of 3 months, were reviewed retrospectively. Statistical Methods: Independent sample t-test, Fisher's exact test, and logistic regression using SPSS (Statistical Package for Social Science, Chicago, USA) version 12. Results: 215/257 (83.7%) patients had a minimum follow-up of 3 months. The mean age of presentation to the hospital was 53 months (range: 0-168 months). Congenital cataract was present in 107 patients (58.2%) and developmental cataract in 77 patients (41.8%). The mean age at surgery was 55.2 months (range: 1-168 months). Out of 430 eyes, 269 (62.6%) had an intraocular lens implanted. The mean duration of follow-up was 13.1 months (range: 3-38 months). Pre-operatively, 102 patients (47.3%) had visual acuity <6/60, in the better eye, compared to 37 patients (17.2%) post-operatively (P < 0.001). Eighty-five patients (39.5%) had visual acuity >6/18. The most common early post-operative complication was fibrinous uveitis in 57 eyes (13.3%) and the most common delayed post-operative complication was posterior capsular opacification in 118 eyes (27.4%). The most important prognostic factor for poor outcome was congenital cataract (odds ratio [OR]: 26.3; 95% confidence interval [CI], 4.4-158.5) and total cataract (OR: 4.8; 95% CI, 1.3-17). PMID:23412523

  17. Impact of post-traumatic stress disorder on oral health.

    PubMed

    de Oliveira Solis, Ana Cristina; Araújo, Álvaro Cabral; Corchs, Felipe; Bernik, Marcio; Duran, Érica Panzani; Silva, Cláudio; Lotufo-Neto, Francisco

    2017-09-01

    The stress experienced as an intense and traumatic event can increase the odds of orofacial pain, affect the biomechanics of masticatory system and compromise the periodontal health. This study was conducted to investigate the impact of post-traumatic stress disorder (PTSD) on oral health. A case-control study with a convenience sample was designed. Probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing, and plaque were recorded at 6 sites per tooth. A visual analog scale (VAS) was used to evaluate the pain after probing. The Research Diagnostic Criteria for Temporomandibular Disorders Axis II (RDC/TMD Axis II) and Structured Clinical Interview (DSM-IV) were also applied. The final sample comprised 38 PTSD patients and 38 controls. Patients with PTSD had a higher degree of chronic pain, more depression and nonspecific physical symptoms (including and excluding pain) compared with the control group (Fisher exact test p < 0.001, and Chi-squared test, p < 0.001, < 0.001, < 0.001, respectively). Patients with PTSD also had more pain after periodontal probing compared with controls (Mann-Whitney, p = 0.037). The prevalence of sites with CAL or PPD ≥ 4, ≥ 5, ≥ 6 were not different between the groups. Age was associated with moderate periodontitis (multivariable logistic regression model, OR = 3.33, 95% CI = 1.03-10.75, p = 0.04). The severity of PTSD precluded an ample sample size. Patients with PTSD presented a worse RDC/TMD Axis II profile, more pain after periodontal probing, and no difference related to periodontal clinical parameters. More studies are needed to confirm these findings. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Neurodevelopmental delay in children exposed in utero to hyperemesis gravidarum.

    PubMed

    Fejzo, Marlena S; Magtira, Aromalyn; Schoenberg, Frederic Paik; Macgibbon, Kimber; Mullin, Patrick M

    2015-06-01

    The purpose of this study is to determine the frequency of emotional, behavioral, and learning disorders in children exposed in utero to hyperemesis gravidarum (HG) and to identify prognostic factors for these disorders. Neurodevelopmental outcomes of 312 children from 203 mothers with HG were compared to neurodevelopmental outcomes from 169 children from 89 unaffected mothers. Then the clinical profiles of patients with HG and a normal child outcome were compared to the clinical profiles of patients with HG and a child with neurodevelopmental delay to identify prognostic factors. Binary responses were analyzed using either a Chi-square or Fisher Exact test and continuous responses were analyzed using a t-test. Children exposed in utero to HG have a 3.28-fold increase in odds of a neurodevelopmental diagnosis including attention disorders, learning delay, sensory disorders, and speech and language delay (P<0.0005). Among characteristics of HG pregnancies, only early onset of symptoms (prior to 5 weeks gestation) was significantly linked to neurodevelopmental delay. We found no evidence for increased risk of 13 emotional, behavioral, and learning disorders, including autism, intellectual impairment, and obsessive-compulsive disorder. However, the study was not sufficiently powered to detect rare conditions. Medications, treatments, and preterm birth were not associated with an increased risk for neurodevelopmental delay. Women with HG are at a significantly increased risk of having a child with neurodevelopmental delay. Common antiemetic treatments were not linked to neurodevelopmental delay, but early symptoms may play a role. There is an urgent need to address whether aggressive treatment that includes vitamin and nutrient supplementation in women with early symptoms of severe nausea of pregnancy decreases the risk of neurodevelopmental delay. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  19. Patient Characteristics and Outcomes After Hemorrhagic Stroke in Pregnancy.

    PubMed

    Leffert, Lisa R; Clancy, Caitlin R; Bateman, Brian T; Cox, Margueritte; Schulte, Phillip J; Smith, Eric E; Fonarow, Gregg C; Schwamm, Lee H; Kuklina, Elena V; George, Mary G

    2015-10-01

    Hospitalizations for pregnancy-related stroke are rare but increasing. Hemorrhagic stroke (HS), ie, subarachnoid hemorrhage and intracerebral hemorrhage, is more common than ischemic stroke in pregnant versus nonpregnant women, reflecting different phenotypes or risk factors. We compared stroke risk factors and outcomes in pregnant versus nonpregnant HS in the Get With The Guidelines-Stroke Registry. Using medical history or International Classification of Diseases-Ninth Revision codes, we identified 330 pregnant and 10 562 nonpregnant female patients aged 18 to 44 years with HS in Get With The Guidelines-Stroke (2008-2014). Differences in patient and care characteristics were compared by χ(2) or Fisher exact test (categorical variables) or Wilcoxon rank-sum (continuous variables) tests. Conditional logistic regression assessed the association of pregnancy with outcomes conditional on categorical age and further adjusted for patient and hospital characteristics. Pregnant versus nonpregnant HS patients were younger with fewer pre-existing stroke risk factors and medications. Pregnant versus nonpregnant subarachnoid hemorrhage patients were less impaired at arrival, and less than half met blood pressure criteria for severe preeclampsia. In-hospital mortality was lower in pregnant versus nonpregnant HS patients: adjusted odds ratios (95% CI) for subarachnoid hemorrhage 0.17 (0.06-0.45) and intracerebral hemorrhage 0.57 (0.34-0.94). Pregnant subarachnoid hemorrhage patients also had a higher likelihood of home discharge (2.60 [1.67-4.06]) and independent ambulation at discharge (2.40 [1.56-3.70]). Pregnant HS patients are younger and have fewer risk factors than their nonpregnant counterparts, and risk-adjusted in-hospital mortality is lower. Our findings suggest possible differences in underlying disease pathophysiology and challenges to identifying at-risk patients. © 2015 American Heart Association, Inc.

  20. Killer cell immunoglobulin-like receptor gene polymorphisms predispose susceptibility to Epstein-Barr virus associated hemophagocytic lymphohistiocytosis in Chinese children.

    PubMed

    Qiang, Qin; Zhengde, Xie; Chunyan, Liu; Zhizhuo, Huang; Junmei, Xu; Junhong, Ai; Zheng, Chengyun; Henter, Jan-Inge; Kunling, Shen

    2012-06-01

    Epstein-Barr virus associated hemophagocytic lymphohistiocytosis (EBV-HLH) has a high mortality rate among children. The pathogenesis of, and underlying predisposing factors for, EBV-HLH are as yet unclear; however, natural killer cells may play a key role in progression of the disease. This study attempted to determine whether killer cell immunoglobulin-like receptor (KIR) gene polymorphisms are responsible for susceptibility to EBV-HLH. Of the 125 children with EBV infection studied, 59 had EBV-HLH and 66 patients had EBV associated infectious mononucleosis (IM) without HLH. The control group was 146 normal children without immune deficiency. KIR polymorphisms were determined by polymerase chain reaction with sequence-specific primers. KIR polymorphism data were analyzed using the X(2) test or Fisher's exact test. The overall observed carrier frequency (OF) of KIR2DS5 was significantly higher in EBV-HLH patients than in IM patients and normal controls (49.2% versus 31.8%, P = 0.048; 49.2% versus 31.5%, P = 0.018, respectively), and the odds ratios (95% confidence interval) were 2.071 (1.001-4.286) and 2.101(1.132-3.900) respectively. The OF of KIR3DS1 was significantly higher in the EBV-HLH patients than in the IM patients (47.4% versus 24.6%, P = 0.012), but not different from normal controls. In summary, KIR polymorphisms may be involved in the development of EBV-HLH, with KIR2DS5 promoting susceptibility to this disease. The obtained KIR data will enrich the understanding of genetic relationships among diseases associated with EBV infection in children. © 2012 The Societies and Blackwell Publishing Asia Pty Ltd.

  1. Partial Failure of Milk Pasteurization as a Risk for the Transmission of Campylobacter From Cattle to Humans.

    PubMed

    Fernandes, Anand M; Balasegaram, Sooria; Willis, Caroline; Wimalarathna, Helen M L; Maiden, Martin C; McCarthy, Noel D

    2015-09-15

    Cattle are the second most common source of human campylobacteriosis. However, routes to account for this scale of transmission have not been identified. In contrast to chicken, red meat is not heavily contaminated at point of sale. Although effective pasteurization prevents milk-borne infection, apparently sporadic infections may include undetected outbreaks from raw or perhaps incompletely pasteurized milk. A rise in Campylobacter gastroenteritis in an isolated population was investigated using whole-genome sequencing (WGS), an epidemiological study, and environmental investigations. A single strain was identified in 20 cases, clearly distinguishable from other local strains and a reference population by WGS. A case-case analysis showed association of infection with the outbreak strain and milk from a single dairy (odds ratio, 8; Fisher exact test P value = .023). Despite temperature records indicating effective pasteurization, mechanical faults likely to lead to incomplete pasteurization of part of the milk were identified by further testing and examination of internal components of dairy equipment. Here, milk distribution concentrated on a small area, including school-aged children with low background incidence of campylobacteriosis, facilitated outbreak identification. Low-level contamination of widely distributed milk would not produce as detectable an outbreak signal. Such hidden outbreaks may contribute to the substantial burden of apparently sporadic Campylobacter from cattle where transmission routes are not certain. The effective discrimination of outbreak isolates from a reference population using WGS shows that integrating these data and approaches into surveillance could support the detection as well as investigation of such outbreaks. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.

  2. Transcatheter Arterial Embolization for Gastrointestinal Bleeding Associated with Gastric Carcinoma: Prognostic Factors Predicting Successful Hemostasis and Survival.

    PubMed

    Park, Sangik; Shin, Ji Hoon; Gwon, Dong-Il; Kim, Hyoung Jung; Sung, Kyu-Bo; Yoon, Hyun-Ki; Ko, Gi-Young; Ko, Heung Kyu

    2017-07-01

    To evaluate outcomes of transcatheter arterial embolization (TAE) for gastric cancer-related gastrointestinal (GI) bleeding and factors associated with successful TAE and improved survival after TAE. This retrospective study included 43 patients (34 men; age 60.6 y ± 13.6) with gastric cancer-related GI bleeding undergoing angiography between January 2000 and December 2015. Clinical course, laboratory findings, and TAE characteristics were reviewed. Technical success of TAE was defined as target area devascularization, and clinical success was defined as bleeding cessation with hemodynamic stability during 72 hours after TAE. Student t test was used for comparison of continuous variables, and Fisher exact test was used for categorical variables. Univariate and multivariate analysis were performed to identify predictors of successful TAE and 30-day survival after TAE. TAE was performed in 40 patients. Technical and clinical success rates of TAE were 85.0% and 65.0%, respectively. Splenic infarction occurred in 2 patients as a minor complication. Rebleeding after TAE occurred in 7 patients. Death related to bleeding occurred in 5 patients. Active bleeding (P = .044) and higher transfusion requirement (3.3 U ± 2.6 vs 1.8 U ± 1.7; P = .039) were associated with TAE failure. Successful TAE predicted improved 30-day survival after TAE on univariate and multivariate analysis (P = .018 and P = .022; odds ratio, 0.132). TAE for gastric cancer-associated GI bleeding may be a lifesaving procedure. Severe bleeding with a higher transfusion requirement and active bleeding on angiography predicted TAE failure. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

  3. Tryptophan Hydroxylase 2 Gene Polymorphism in Anxiety and Depressive Disorder in Kashmiri Population

    PubMed Central

    Shoib, Sheikh; Shah, Tabindah; Mushtaq, Sahil

    2014-01-01

    Background: The gene of tryptophan hydroxylase is widely recognized as a major candidate gene in many psychiatric disorders. However, no study has been done which investigates tryptophan hydroxylase 2 gene polymorphism in anxiety and depressive disorders in Kashmiri population (India). Objectives: To study tryptophan hydroxylase 2 (TPH2) C 11993 A gene polymorphism in anxiety and depressive disorders. Method: Sixty patients of depression disorder, 60 patients of anxiety disorder and 40 unrelated healthy volunteers (control) were studied in a case control design. Polymorphism was determined using polymerase chain reaction (PCR) and agarose gel electrophoresis after digestion with HAP II enzyme. Genotypes and allele frequencies were compared using Chi-square tests, Fischer’s exact test, odds ratio, 95% confidence interval (C.I) and p-value of <0.05 was considered to be statistical significant. Results: The mean age ± SD of anxiety, depression and control group was 32.73±10.99, 32.20±10 and 29.75±10.12 respectively and the difference was found to be statistically non significant (p=0.349).The mean HAM-A (Hamilton rating scale for anxiety) score and HAM-D (Hamilton rating scale for depression) score was high in both groups (anxiety and depression) and found to be statistically significant (p=0.001).Depression group had AA genotype (55.2%) than control (37.5%) and was found to be statistically non significant (p=0.890).Comparison of allelic frequency revealed no association of A allele in anxiety group (76.67%) compared with control (75.5%) and was found to be statistically non significant (p= 0.866), OR 1.09 (0.56-2.11). Conclusion: TPH2C 11993 A gene was not found to be associated with major depressive disorder (MDD) and anxiety disorder in Kashmiri population. PMID:25121048

  4. Hypoxia-inducible vascular endothelial growth factor gene therapy using the oxygen-dependent degradation domain in myocardial ischemia.

    PubMed

    Kim, Hyun Ah; Lim, Soyeon; Moon, Hyung-Ho; Kim, Sung Wan; Hwang, Ki-Chul; Lee, Minhyung; Kim, Sun Hwa; Choi, Donghoon

    2010-10-01

    A hypoxia-inducible VEGF expression system with the oxygen-dependent degradation (ODD) domain was constructed and tested to be used in gene therapy for ischemic myocardial disease. Luciferase and VEGF expression vector systems were constructed with or without the ODD domain: pEpo-SV-Luc (or pEpo-SV-VEGF) and pEpo-SV-Luc-ODD (or pEpo-SV-VEGF-ODD). In vitro gene expression efficiency of each vector type was evaluated in HEK 293 cells under both hypoxic and normoxic conditions. The amount of VEGF protein was estimated by ELISA. The VEGF expression vectors with or without the ODD domain were injected into ischemic rat myocardium. Fibrosis, neovascularization, and cardiomyocyte apoptosis were assessed using Masson's trichrome staining, α-smooth muscle actin (α-SMA) immunostaining, and the TUNEL assay, respectively. The plasmid vectors containing ODD significantly improved the expression level of VEGF protein in hypoxic conditions. The enhancement of VEGF protein production was attributed to increased protein stability due to oxygen deficiency. In a rat model of myocardial ischemia, the pEpo-SV-VEGF-ODD group exhibited less myocardial fibrosis, higher microvessel density, and less cardiomyocyte apoptosis compared to the control groups (saline and pEpo-SV-VEGF treatments). An ODD-mediated VEGF expression system that facilitates VEGF-production under hypoxia may be useful in the treatment of ischemic heart disease.

  5. A Statistical Procedure for Testing Unusually Frequent Exactly Matching Responses and Nearly Matching Responses. Research Report. ETS RR-17-23

    ERIC Educational Resources Information Center

    Haberman, Shelby J.; Lee, Yi-Hsuan

    2017-01-01

    In investigations of unusual testing behavior, a common question is whether a specific pattern of responses occurs unusually often within a group of examinees. In many current tests, modern communication techniques can permit quite large numbers of examinees to share keys, or common response patterns, to the entire test. To address this issue,…

  6. Oscillating potential well in the complex plane and the adiabatic theorem

    NASA Astrophysics Data System (ADS)

    Longhi, Stefano

    2017-10-01

    A quantum particle in a slowly changing potential well V (x ,t ) =V ( x -x0(ɛ t ) ) , periodically shaken in time at a slow frequency ɛ , provides an important quantum mechanical system where the adiabatic theorem fails to predict the asymptotic dynamics over time scales longer than ˜1 /ɛ . Specifically, we consider a double-well potential V (x ) sustaining two bound states spaced in frequency by ω0 and periodically shaken in a complex plane. Two different spatial displacements x0(t ) are assumed: the real spatial displacement x0(ɛ t ) =A sin(ɛ t ) , corresponding to ordinary Hermitian shaking, and the complex one x0(ɛ t ) =A -A exp(-i ɛ t ) , corresponding to non-Hermitian shaking. When the particle is initially prepared in the ground state of the potential well, breakdown of adiabatic evolution is found for both Hermitian and non-Hermitian shaking whenever the oscillation frequency ɛ is close to an odd resonance of ω0. However, a different physical mechanism underlying nonadiabatic transitions is found in the two cases. For the Hermitian shaking, an avoided crossing of quasienergies is observed at odd resonances and nonadiabatic transitions between the two bound states, resulting in Rabi flopping, can be explained as a multiphoton resonance process. For the complex oscillating potential well, breakdown of adiabaticity arises from the appearance of Floquet exceptional points at exact quasienergy crossing.

  7. A Randomized Study of How Physicians Interpret Research Funding Disclosures

    PubMed Central

    Kesselheim, Aaron S.; Robertson, Christopher T.; Myers, Jessica A.; Rose, Susannah L.; Gillet, Victoria; Ross, Kathryn M.; Glynn, Robert J.; Joffe, Steven; Avorn, Jerry

    2012-01-01

    BACKGROUND The effects of clinical-trial funding on the interpretation of trial results are poorly understood. We examined how such support affects physicians’ reactions to trials with a high, medium, or low level of methodologic rigor. METHODS We presented 503 board-certified internists with abstracts that we designed describing clinical trials of three hypothetical drugs. The trials had high, medium, or low methodologic rigor, and each report included one of three support disclosures: funding from a pharmaceutical company, NIH funding, or none. For both factors studied (rigor and funding), one of the three possible variations was randomly selected for inclusion in the abstracts. Follow-up questions assessed the physicians’ impressions of the trials’ rigor, their confidence in the results, and their willingness to prescribe the drugs. RESULTS The 269 respondents (53.5% response rate) perceived the level of study rigor accurately. Physicians reported that they would be less willing to prescribe drugs tested in low-rigor trials than those tested in medium-rigor trials (odds ratio, 0.64; 95% confidence interval [CI], 0.46 to 0.89; P = 0.008) and would be more willing to prescribe drugs tested in high-rigor trials than those tested in medium-rigor trials (odds ratio, 3.07; 95% CI, 2.18 to 4.32; P<0.001). Disclosure of industry funding, as compared with no disclosure of funding, led physicians to downgrade the rigor of a trial (odds ratio, 0.63; 95% CI, 0.46 to 0.87; P = 0.006), their confidence in the results (odds ratio, 0.71; 95% CI, 0.51 to 0.98; P = 0.04), and their willingness to prescribe the hypothetical drugs (odds ratio, 0.68; 95% CI, 0.49 to 0.94; P = 0.02). Physicians were half as willing to prescribe drugs studied in industry-funded trials as they were to prescribe drugs studied in NIH-funded trials (odds ratio, 0.52; 95% CI, 0.37 to 0.71; P<0.001). These effects were consistent across all levels of methodologic rigor. CONCLUSIONS Physicians discriminate among trials of varying degrees of rigor, but industry sponsorship negatively influences their perception of methodologic quality and reduces their willingness to believe and act on trial findings, independently of the trial’s quality. These effects may influence the translation of clinical research into practice. PMID:22992075

  8. EHR based Genetic Testing Knowledge Base (iGTKB) Development

    PubMed Central

    2015-01-01

    Background The gap between a large growing number of genetic tests and a suboptimal clinical workflow of incorporating these tests into regular clinical practice poses barriers to effective reliance on advanced genetic technologies to improve quality of healthcare. A promising solution to fill this gap is to develop an intelligent genetic test recommendation system that not only can provide a comprehensive view of genetic tests as education resources, but also can recommend the most appropriate genetic tests to patients based on clinical evidence. In this study, we developed an EHR based Genetic Testing Knowledge Base for Individualized Medicine (iGTKB). Methods We extracted genetic testing information and patient medical records from EHR systems at Mayo Clinic. Clinical features have been semi-automatically annotated from the clinical notes by applying a Natural Language Processing (NLP) tool, MedTagger suite. To prioritize clinical features for each genetic test, we compared odds ratio across four population groups. Genetic tests, genetic disorders and clinical features with their odds ratios have been applied to establish iGTKB, which is to be integrated into the Genetic Testing Ontology (GTO). Results Overall, there are five genetic tests operated with sample size greater than 100 in 2013 at Mayo Clinic. A total of 1,450 patients who was tested by one of the five genetic tests have been selected. We assembled 243 clinical features from the Human Phenotype Ontology (HPO) for these five genetic tests. There are 60 clinical features with at least one mention in clinical notes of patients taking the test. Twenty-eight clinical features with high odds ratio (greater than 1) have been selected as dominant features and deposited into iGTKB with their associated information about genetic tests and genetic disorders. Conclusions In this study, we developed an EHR based genetic testing knowledge base, iGTKB. iGTKB will be integrated into the GTO by providing relevant clinical evidence, and ultimately to support development of genetic testing recommendation system, iGenetics. PMID:26606281

  9. EHR based Genetic Testing Knowledge Base (iGTKB) Development.

    PubMed

    Zhu, Qian; Liu, Hongfang; Chute, Christopher G; Ferber, Matthew

    2015-01-01

    The gap between a large growing number of genetic tests and a suboptimal clinical workflow of incorporating these tests into regular clinical practice poses barriers to effective reliance on advanced genetic technologies to improve quality of healthcare. A promising solution to fill this gap is to develop an intelligent genetic test recommendation system that not only can provide a comprehensive view of genetic tests as education resources, but also can recommend the most appropriate genetic tests to patients based on clinical evidence. In this study, we developed an EHR based Genetic Testing Knowledge Base for Individualized Medicine (iGTKB). We extracted genetic testing information and patient medical records from EHR systems at Mayo Clinic. Clinical features have been semi-automatically annotated from the clinical notes by applying a Natural Language Processing (NLP) tool, MedTagger suite. To prioritize clinical features for each genetic test, we compared odds ratio across four population groups. Genetic tests, genetic disorders and clinical features with their odds ratios have been applied to establish iGTKB, which is to be integrated into the Genetic Testing Ontology (GTO). Overall, there are five genetic tests operated with sample size greater than 100 in 2013 at Mayo Clinic. A total of 1,450 patients who was tested by one of the five genetic tests have been selected. We assembled 243 clinical features from the Human Phenotype Ontology (HPO) for these five genetic tests. There are 60 clinical features with at least one mention in clinical notes of patients taking the test. Twenty-eight clinical features with high odds ratio (greater than 1) have been selected as dominant features and deposited into iGTKB with their associated information about genetic tests and genetic disorders. In this study, we developed an EHR based genetic testing knowledge base, iGTKB. iGTKB will be integrated into the GTO by providing relevant clinical evidence, and ultimately to support development of genetic testing recommendation system, iGenetics.

  10. Gravity Gradient Tensor of Arbitrary 3D Polyhedral Bodies with up to Third-Order Polynomial Horizontal and Vertical Mass Contrasts

    NASA Astrophysics Data System (ADS)

    Ren, Zhengyong; Zhong, Yiyuan; Chen, Chaojian; Tang, Jingtian; Kalscheuer, Thomas; Maurer, Hansruedi; Li, Yang

    2018-03-01

    During the last 20 years, geophysicists have developed great interest in using gravity gradient tensor signals to study bodies of anomalous density in the Earth. Deriving exact solutions of the gravity gradient tensor signals has become a dominating task in exploration geophysics or geodetic fields. In this study, we developed a compact and simple framework to derive exact solutions of gravity gradient tensor measurements for polyhedral bodies, in which the density contrast is represented by a general polynomial function. The polynomial mass contrast can continuously vary in both horizontal and vertical directions. In our framework, the original three-dimensional volume integral of gravity gradient tensor signals is transformed into a set of one-dimensional line integrals along edges of the polyhedral body by sequentially invoking the volume and surface gradient (divergence) theorems. In terms of an orthogonal local coordinate system defined on these edges, exact solutions are derived for these line integrals. We successfully derived a set of unified exact solutions of gravity gradient tensors for constant, linear, quadratic and cubic polynomial orders. The exact solutions for constant and linear cases cover all previously published vertex-type exact solutions of the gravity gradient tensor for a polygonal body, though the associated algorithms may differ in numerical stability. In addition, to our best knowledge, it is the first time that exact solutions of gravity gradient tensor signals are derived for a polyhedral body with a polynomial mass contrast of order higher than one (that is quadratic and cubic orders). Three synthetic models (a prismatic body with depth-dependent density contrasts, an irregular polyhedron with linear density contrast and a tetrahedral body with horizontally and vertically varying density contrasts) are used to verify the correctness and the efficiency of our newly developed closed-form solutions. Excellent agreements are obtained between our solutions and other published exact solutions. In addition, stability tests are performed to demonstrate that our exact solutions can safely be used to detect shallow subsurface targets.

  11. Aesthetic Responses to Exact Fractals Driven by Physical Complexity

    PubMed Central

    Bies, Alexander J.; Blanc-Goldhammer, Daryn R.; Boydston, Cooper R.; Taylor, Richard P.; Sereno, Margaret E.

    2016-01-01

    Fractals are physically complex due to their repetition of patterns at multiple size scales. Whereas the statistical characteristics of the patterns repeat for fractals found in natural objects, computers can generate patterns that repeat exactly. Are these exact fractals processed differently, visually and aesthetically, than their statistical counterparts? We investigated the human aesthetic response to the complexity of exact fractals by manipulating fractal dimensionality, symmetry, recursion, and the number of segments in the generator. Across two studies, a variety of fractal patterns were visually presented to human participants to determine the typical response to exact fractals. In the first study, we found that preference ratings for exact midpoint displacement fractals can be described by a linear trend with preference increasing as fractal dimension increases. For the majority of individuals, preference increased with dimension. We replicated these results for other exact fractal patterns in a second study. In the second study, we also tested the effects of symmetry and recursion by presenting asymmetric dragon fractals, symmetric dragon fractals, and Sierpinski carpets and Koch snowflakes, which have radial and mirror symmetry. We found a strong interaction among recursion, symmetry and fractal dimension. Specifically, at low levels of recursion, the presence of symmetry was enough to drive high preference ratings for patterns with moderate to high levels of fractal dimension. Most individuals required a much higher level of recursion to recover this level of preference in a pattern that lacked mirror or radial symmetry, while others were less discriminating. This suggests that exact fractals are processed differently than their statistical counterparts. We propose a set of four factors that influence complexity and preference judgments in fractals that may extend to other patterns: fractal dimension, recursion, symmetry and the number of segments in a pattern. Conceptualizations such as Berlyne’s and Redies’ theories of aesthetics also provide a suitable framework for interpretation of our data with respect to the individual differences that we detect. Future studies that incorporate physiological methods to measure the human aesthetic response to exact fractal patterns would further elucidate our responses to such timeless patterns. PMID:27242475

  12. Improved method for implicit Monte Carlo

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

    Brown, F. B.; Martin, W. R.

    2001-01-01

    The Implicit Monte Carlo (IMC) method has been used for over 30 years to analyze radiative transfer problems, such as those encountered in stellar atmospheres or inertial confinement fusion. Reference [2] provided an exact error analysis of IMC for 0-D problems and demonstrated that IMC can exhibit substantial errors when timesteps are large. These temporal errors are inherent in the method and are in addition to spatial discretization errors and approximations that address nonlinearities (due to variation of physical constants). In Reference [3], IMC and four other methods were analyzed in detail and compared on both theoretical grounds and themore » accuracy of numerical tests. As discussed in, two alternative schemes for solving the radiative transfer equations, the Carter-Forest (C-F) method and the Ahrens-Larsen (A-L) method, do not exhibit the errors found in IMC; for 0-D, both of these methods are exact for all time, while for 3-D, A-L is exact for all time and C-F is exact within a timestep. These methods can yield substantially superior results to IMC.« less

  13. Barriers to HIV testing, linkage to care, and treatment adherence: a cross-sectional study from a large urban center of Brazil.

    PubMed

    MacCarthy, Sarah; Hoffmann, Michael; Nunn, Amy; Silva, Luís Augusto Vasconcelos da; Dourado, Ines

    2016-12-01

    Early, continued engagement with the HIV treatment continuum can help achieve viral suppression, though few studies have explored how risk factors for delays differ across the continuum. The objective of this study was to identify predictors of delayed diagnosis, delayed linkage to care, and nonadherence to treatment in the city of Salvador, Bahia, Brazil. Data were collected during 2010 in a cross-sectional study with a sample (n = 1 970) of HIV-infected individuals enrolled in care. Multiple logistic regression analyses identified sociodemographic variables, behaviors, and measures of health service quality that were associated with delayed diagnosis, delayed linkage to care, and treatment nonadherence. For delayed diagnosis, male gender (adjusted odds ratio (AOR), 3.02; 95% confidence interval (CI), 2.0-4.6); age 45 years and older (AOR, 1.67; 95% CI, 1.1-2.5); and provider-initiated testing (AOR, 3.00; 95% CI, 2.1-4.4) increased odds, while drug use (AOR, 0.29; 95% CI, 0.2-0.5) and receiving results in a private space (AOR, 0.37; 95% CI, 0.2-0.8) decreased odds. For delayed linkage to care, unemployment (AOR, 1.42; 95% CI, 1.07-1.9) and difficulty understanding or speaking with a health care worker (AOR, 1.61; 95% CI, 1.2-2.1) increased odds, while posttest counseling (AOR, 0.49; 95% CI, 0.3-0.7) decreased odds. For nonadherence, experiencing verbal or physical discrimination related to HIV (AOR, 1.94; 95% CI, 1.3-3.0) and feeling mistreated or not properly attended to at HIV care (AOR, 1.60; 95% CI, 1.0-2.5) increased odds, while posttest counseling (AOR, 0.34; 95% CI, 0.2-0.6) decreased odds. More attention is needed on how policies, programs, and research can provide tailored support across the treatment continuum.

  14. Alignments of parity even/odd-only multipoles in CMB

    NASA Astrophysics Data System (ADS)

    Aluri, Pavan K.; Ralston, John P.; Weltman, Amanda

    2017-12-01

    We compare the statistics of parity even and odd multipoles of the cosmic microwave background (CMB) sky from Planck full mission temperature measurements. An excess power in odd multipoles compared to even multipoles has previously been found on large angular scales. Motivated by this apparent parity asymmetry, we evaluate directional statistics associated with even compared to odd multipoles, along with their significances. Primary tools are the Power tensor and Alignment tensor statistics. We limit our analysis to the first 60 multipoles i.e. l = [2, 61]. We find no evidence for statistically unusual alignments of even parity multipoles. More than one independent statistic finds evidence for alignments of anisotropy axes of odd multipoles, with a significance equivalent to ∼2σ or more. The robustness of alignment axes is tested by making Galactic cuts and varying the multipole range. Very interestingly, the region spanned by the (a)symmetry axes is found to broadly contain other parity (a)symmetry axes previously observed in the literature.

  15. Recession and Divorce in the United States, 2008-2011

    PubMed Central

    Cohen, Philip N.

    2015-01-01

    Recession may increase divorce through a stress mechanism, or reduce divorce by exacerbating cost barriers or strengthening family bonds. After establishing an individual-level model predicting U.S. women's divorce, the paper tests period effects, and whether unemployment and foreclosures are associated with the odds of divorce using the 2008-2011 American Community Survey. Results show a downward spike in the divorce rate after 2008, almost recovering to the expected level by 2011, which suggests a negative recession effect. On the other hand, state foreclosure rates are positively associated with the odds of divorce with individual controls, although this effect is not significant when state fixed effects are introduced. State unemployment rates show no effect on odds of divorce. Future research will have to determine why national divorce odds fell during the recession while state-level economic indicators were not strongly associated with divorce. Exploratory analysis which shows unemployment decreasing divorce odds for those with college degrees, while foreclosures have the opposite effect, provides one possible avenue for such research. PMID:26023246

  16. The Impact of Homophobia and HIV Stigma on HIV Testing Uptake Among Chinese Men Who Have Sex With Men: a Mediation Analysis.

    PubMed

    Wei, Chongyi; Cheung, Doug H; Yan, Hongjing; Li, Jianjun; Shi, Ling-en; Raymond, Henry F

    2016-01-01

    Gay and HIV-related stigma and discrimination are major barriers to accessing HIV prevention services among Men Who Have Sex with Men (MSM) worldwide. We aimed to identify modifiable factors that mediate the relationships between gay and HIV-related stigma and discrimination and HIV testing uptake among Chinese MSM. We conducted a cross-sectional survey study of 523 HIV-uninfected or unknown HIV status MSM in Jiangsu Province, China between November 2013 and January 2014. Multivariable analyses were conducted to examine the associations among experienced homophobia, HIV stigma, and recent HIV testing. Causal mediation parametric analyses were conducted to assess whether depression and social norms mediated hypothesized associations. Stronger subjective norms toward testing was associated with higher odds of recent HIV testing (adjusted odds ratio [AOR]: 1.10, 95% confidence interval [CI]: 1.01 to 1.21), whereas increasing levels of depression and HIV stigma were both associated with lower odds of recent testing (AOR: 0.96, 95% CI: 0.92 to 0.99; and AOR: 0.91, 95% CI: 0.84 to 0.99, respectively). There was an indirect relationship (natural indirect effect [NIE]) of experienced homophobia on recent testing (ORNIE: 0.96, 95% CI: 0.93 to 0.98) mediated (35.0%) through depression. Furthermore, there was an indirect relationship of HIV stigma on recent testing (ORNIE: 0.98, 95% CI: 0.95 to 0.99) mediated (19.2%) through subjective norms. Depression and social norms are important mediators of HIV testing uptake among stigmatized Chinese MSM. Therefore, in addition to advocacy efforts and policies that address social-level stigma and discrimination, HIV prevention programs should also address mental health issues and incorporate community-based approaches to changing social norms toward HIV testing.

  17. Exact simulation of integrate-and-fire models with exponential currents.

    PubMed

    Brette, Romain

    2007-10-01

    Neural networks can be simulated exactly using event-driven strategies, in which the algorithm advances directly from one spike to the next spike. It applies to neuron models for which we have (1) an explicit expression for the evolution of the state variables between spikes and (2) an explicit test on the state variables that predicts whether and when a spike will be emitted. In a previous work, we proposed a method that allows exact simulation of an integrate-and-fire model with exponential conductances, with the constraint of a single synaptic time constant. In this note, we propose a method, based on polynomial root finding, that applies to integrate-and-fire models with exponential currents, with possibly many different synaptic time constants. Models can include biexponential synaptic currents and spike-triggered adaptation currents.

  18. Expression of Hypoxia-Associated Protein HIF-1α in Follicular Thyroid Cancer is Associated with Distant Metastasis.

    PubMed

    Klaus, Aumayr; Fathi, Osmen; Tatjana, Traub-Weidinger; Bruno, Niederle; Oskar, Koperek

    2018-04-01

    Follicular thyroid carcinomas (FTCs) are the second most common malignant neoplasia of the thyroid and in general its prognosis is quite favorable. However, the occurrence of metastases or non-responsiveness to radioiodine therapy worsens the prognosis considerably. We evaluated immunohistochemically the expression of hypoxia-associated proteins by hypoxia-induced factor 1α (HIF-1α), the stroma-remodeling marker Tenascin C, as well as markers for the epithelial-mesenchymal transition (EMT), namely E-cadherin and slug in a series of 59 sporadic FTCs. In addition, various clinicopathologic parameters were assessed like TNM-staging, age, tumor size as well as tumor characteristics like desmoplasia, necrosis, and calcification. Overexpression of HIF-1α was seen in 29 of 59 tumors (49.2%) including 21 (35.6%) FTC with strong expression of tumor cell groups. HIF-1α correlated significantly with metastasis (p < 0.001; Mann-Whitney U test), degree of desmoplasia (p = 0.042, Kruskal-Wallis test), tenascin C expression (p = 0.042, Kruskal-Wallis test), calcification (p < 0.025, Kruskal-Wallis test), necrosis (p = 0.002), age (p = 0.011, Kruskal-Wallis test) and tumor stage UICC (p = 0.022, Kruskal-Wallis test). Furthermore, metastasis was associated with the degree of desmoplasia (p = 0.014; Fisher's exact test), calcification (p = 0.008, Fisher's exact test), necrosis (p = 0.042, Fisher's exact test), tumor size (p = 0.015, Mann-Whitney U test), and age (p = 0.001, Mann-Whitney U test). In a Cox proportional hazards model, only metastasis remained as an independent risk factor for overall survival (hazard rate: 10.2 [95% CI, 02.19 to 47.26]; p = 0.003). Our data suggest that HIF-1α plays a critical role in the remodeling of the extracellular matrix as well as metastasizing process of follicular thyroid carcinoma and targeting hypoxia-associated and -regulated proteins may be considered as potential targets for personalized medicine.

  19. Exact transition probabilities in a 6-state Landau–Zener system with path interference

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

    Sinitsyn, Nikolai A.

    2015-04-23

    In this paper, we identify a nontrivial multistate Landau–Zener (LZ) model for which transition probabilities between any pair of diabatic states can be determined analytically and exactly. In the semiclassical picture, this model features the possibility of interference of different trajectories that connect the same initial and final states. Hence, transition probabilities are generally not described by the incoherent successive application of the LZ formula. Finally, we discuss reasons for integrability of this system and provide numerical tests of the suggested expression for the transition probability matrix.

  20. Volumetric formulation for a class of kinetic models with energy conservation.

    PubMed

    Sbragaglia, M; Sugiyama, K

    2010-10-01

    We analyze a volumetric formulation of lattice Boltzmann for compressible thermal fluid flows. The velocity set is chosen with the desired accuracy, based on the Gauss-Hermite quadrature procedure, and tested against controlled problems in bounded and unbounded fluids. The method allows the simulation of thermohydrodyamical problems without the need to preserve the exact space-filling nature of the velocity set, but still ensuring the exact conservation laws for density, momentum, and energy. Issues related to boundary condition problems and improvements based on grid refinement are also investigated.

  1. An exact solution for a thick domain wall in general relativity

    NASA Technical Reports Server (NTRS)

    Goetz, Guenter; Noetzold, Dirk

    1989-01-01

    An exact solution of the Einstein equations for a static, planar domain wall with finite thickness is presented. At infinity, density and pressure vanish and the space-time tends to the Minkowski vacuum on one side of the wall and to the Taub vacuum on the other side. A surprising feature of this solution is that the density and pressure distribution are symmetric about the central plane of the wall whereas the space-time metric and therefore also the gravitational field experienced by a test particle is asymmetric.

  2. Sexually transmitted infection testing practices among 'money boys' and general men who have sex with men in Shanghai, China: objective versus self-reported status.

    PubMed

    Lin, Lavinia; Nehl, Eric J; Tran, Alvin; He, Na; Zheng, Tony; Wong, Frank Y

    2014-03-01

    Little is known about sexually transmitted infection (STI) testing among Chinese men who have sex with men (MSM). This study describes the prevalence of STI testing, associated factors and the validity of STI self-reporting among Chinese MSM. Findings indicated a high prevalence of STIs and low testing rates among MSM in Shanghai. Monthly income was significantly associated with STI testing (odds ratio: 0.37, 95% confidence interval (CI): 0.18 to 0.76). Depression was significantly associated with STI testing for general MSM (odds ratio: 1.09, 95% CI: 1.01 to 1.17). Syphilis self-reported status had the highest validity (k=0.33, χ(2)=3.76, 95% CI: -0.003 to 0.65). Efforts are needed to ensure that STI testing services are accessible to MSM in China. Future HIV and STI interventions should be tailored to the needs of different subsets of MSM.

  3. Recent HIV Testing Among Young Men Who Have Sex with Men in Bangkok and Chiang Mai: HIV Testing and Prevention Strategies Must Be Enhanced in Thailand.

    PubMed

    Johnston, Lisa G; Steinhaus, Mara C; Sass, Justine; Sirinirund, Petchsri; Lee, Catherine; Benjarattanaporn, Patchara; Gass, Robert

    2016-09-01

    HIV infection among men who have sex with men, particularly in Thai urban settings and among younger cohorts, is escalating. HIV testing and counseling (HTC) are important for prevention and obtaining treatment and care. We examine data from a 2013 survey of males, 15-24 years, reporting past-year sex with a male and living in Bangkok or Chiang Mai. Almost three quarters of young MSM (YMSM) in Bangkok and only 27 % in Chiang Mai had an HIV test in the previous year. Associations for HIV testing varied between cities, although having employment increased the odds of HIV testing for both cities. In Bangkok, family knowledge of same sex attraction and talking to parents/guardians about HIV/AIDS had higher odds of HIV testing. Expanded HTC coverage is needed for YMSM in Chiang Mai. All health centers providing HTC, including those targeting MSM, need to address the specific needs of younger cohorts.

  4. School Tax Elections: Testing Messages and Targeting Voters

    ERIC Educational Resources Information Center

    Senden, J. Bradford; Lifto, Don E.

    2010-01-01

    Anticipating a substantially larger voter turnout in the upcoming election, district officials needed to probe--more precisely than in past tax elections--exactly what demographic groups would most likely go to the polls and support the tax proposal. Message testing and voter targeting became critical components in building a foundation for…

  5. Computerized Diagnostic Testing: Problems and Possibilities.

    ERIC Educational Resources Information Center

    McArthur, David L.

    The use of computers to build diagnostic inferences is explored in two contexts. In computerized monitoring of liquid oxygen systems for the space shuttle, diagnoses are exact because they can be derived within a world which is closed. In computerized classroom testing of reading comprehension, programs deliver a constrained form of adaptive…

  6. Orbital Roof Fractures as an Indicator for Concomitant Ocular Injury

    DTIC Science & Technology

    2017-11-12

    between these two groups to indicate a statistically significant difference in mechanism of injury, subjective symptoms, CT and exam findings, and...using Pearson’s x2 test or Fisher’s exact test to indicate a statistically significant difference in mechanism of injury, subjective symptoms, CT and

  7. Risk factors of bronchial hyperresponsiveness in children with wheezing-associated respiratory infection.

    PubMed

    Futrakul, Sitthivuddhi; Deerojanawong, Jitladda; Prapphal, Nuanchan

    2005-07-01

    The objectives of this study were to identify possible risk factors of bronchial hyperesponsiveness (BHR) in children up to 5 years of age with wheezing-associated respiratory infection (WARI), and to study the prevalence of BHR. Children up to 5 years of age with WARI were enrolled in the study. The parents or caregivers of children were asked about their demographic data and clinical histories. Physical examination and clinical score assessment were performed. Pulmonary function tests, i.e., tidal breathing flow volume (TBFV), were performed to measure tidal breathing parameters before and after salbutamol nebulization. If volume at peak tidal expiratory flow/expiratory tidal volume and time to peak expiratory flow/total expiratory time increased > or = 20%, or tidal expiratory flow at 25% of tidal volume/peak tidal expiratory flow increased > or = 20% after nebulization therapy, BHR was diagnosed. The number in the positive BHR group was used to calculate the prevalence of BHR, and clinical features were compared with those of the negative BHR group. Categorical data were analyzed for statistical significance (P < 0.05) by chi-square test or Fisher's exact test, or Student's t-test, as appropriate. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for those with statistical significance. One hundred and six wheezing children underwent pulmonary function tests before and after salbutamol nebulization. With the aforementioned criteria, 41 cases (38.7%) were diagnosed with BHR. History of reactive airway disease, (OR, 6.31; 95% CI, 1.68-25), maternal history of asthma (OR, 3.45; 95% CI, 1.34-9), breastfeeding less than 3 months (OR, 3.18; 95% CI, 1.26-8.12), and passive smoking (OR, 3; 95% CI, 1.15-7.62) were significant risk factors of BHR. The eosinophil count was significantly higher in the BHR (+) group particularly, in children 1-5 years of age (P < or = 0.01). Patchy infiltrates were more commonly found in patients with negative BHR but not statistically significant. In conclusion, a history of reactive airway disease, maternal history, breastfeeding less than 3 months, and passive smoking were significant risk factors for BHR. Copyright 2005 Wiley-Liss, Inc.

  8. Pap Test

    MedlinePlus

    ... exact term or phrase, no variations. Use multiple keywords separated by spaces (e.g. kidney renal ) for ... higher those with all or most of the keywords. Plurals and other variations are automatically included. To ...

  9. Minimal intervention dentistry for early childhood caries and child dental anxiety: a randomized controlled trial.

    PubMed

    Arrow, P; Klobas, E

    2017-06-01

    To compare changes in child dental anxiety after treatment for early childhood caries (ECC) using two treatment approaches. Children with ECC were randomized to test (atraumatic restorative treatment (ART)-based approach) or control (standard care approach) groups. Children aged 3 years or older completed a dental anxiety scale at baseline and follow up. Changes in child dental anxiety from baseline to follow up were tested using the chi-squared statistic, Wilcoxon rank sum test, McNemar's test and multinomial logistic regression. Two hundred and fifty-four children were randomized (N = 127 test, N = 127 control). At baseline, 193 children completed the dental anxiety scale, 211 at follow up and 170 completed the scale on both occasions. Children who were anxious at baseline (11%) were no longer anxious at follow up, and 11% non-anxious children became anxious. Multinomial logistic regression found each increment in the number of visits increased the odds of worsening dental anxiety (odds ratio (OR), 2.2; P < 0.05), whereas each increment in the number of treatments lowered the odds of worsening anxiety (OR, 0.50; P = 0.05). The ART-based approach to managing ECC resulted in similar levels of dental anxiety to the standard treatment approach and provides a valuable alternative approach to the management of ECC in a primary dental care setting. © 2016 Australian Dental Association.

  10. A Novel Approach to Prediction of Mild Obstructive Sleep Disordered Breathing in a Population-Based Sample: The Sleep Heart Health Study

    PubMed Central

    Caffo, Brian; Diener-West, Marie; Punjabi, Naresh M.; Samet, Jonathan

    2010-01-01

    This manuscript considers a data-mining approach for the prediction of mild obstructive sleep disordered breathing, defined as an elevated respiratory disturbance index (RDI), in 5,530 participants in a community-based study, the Sleep Heart Health Study. The prediction algorithm was built using modern ensemble learning algorithms, boosting in specific, which allowed for assessing potential high-dimensional interactions between predictor variables or classifiers. To evaluate the performance of the algorithm, the data were split into training and validation sets for varying thresholds for predicting the probability of a high RDI (≥ 7 events per hour in the given results). Based on a moderate classification threshold from the boosting algorithm, the estimated post-test odds of a high RDI were 2.20 times higher than the pre-test odds given a positive test, while the corresponding post-test odds were decreased by 52% given a negative test (sensitivity and specificity of 0.66 and 0.70, respectively). In rank order, the following variables had the largest impact on prediction performance: neck circumference, body mass index, age, snoring frequency, waist circumference, and snoring loudness. Citation: Caffo B; Diener-West M; Punjabi NM; Samet J. A novel approach to prediction of mild obstructive sleep disordered breathing in a population-based sample: the Sleep Heart Health Study. SLEEP 2010;33(12):1641-1648. PMID:21120126

  11. Perceived Discrimination and Reported Delay of Pharmacy Prescriptions and Medical Tests

    PubMed Central

    Van Houtven, Courtney Harold; Voils, Corrine I; Oddone, Eugene Z; Weinfurt, Kevin P; Friedman, Joëlle Y; Schulman, Kevin A; Bosworth, Hayden B

    2005-01-01

    BACKGROUND Access to health care varies according to a person's race and ethnicity. Delaying treatment is one measure of access with important health consequences. OBJECTIVE Determine whether perceptions of unfair treatment because of race or ethnicity are associated with reported treatment delays, controlling for economic constraints, self-reported health, depression, and demographics. DESIGN Cross-sectional, observational study. PARTICIPANTS A randomly selected community sample of 181 blacks, 148 Latinos, and 193 whites in Durham County, NC. MEASUREMENTS A phone survey conducted in 2002 to assess discrimination, trust in medical care, quality of care, and access to care. Treatment delays were measured by whether or not a person reported delaying or forgoing filling a prescription and delaying or forgoing having a medical test/treatment in the past 12 months. Perceived discrimination was measured as unfair treatment in health care and as racism in local health care institutions. RESULTS The odds of delaying filling prescriptions were significantly higher (odds ratio (OR)=2.02) for persons who perceived unfair treatment, whereas the odds of delaying tests or treatments were significantly higher (OR=2.42) for persons who thought racism was a problem in health care locally. People with self-reported depression and people who reported not working had greater odds of delaying both types of care. CONCLUSIONS A prospective cohort study with both personal and macro measures of discrimination, as well as more refined measures of treatment delays, would help us better understand the relationship between perceived discrimination and treatment delays. PMID:16050850

  12. Identification of Conflicting Questions in the PARES System

    ERIC Educational Resources Information Center

    Tsinakos, Avgoustos; Kazanidis, Ioannis

    2012-01-01

    Student testing and knowledge assessment is a significant aspect of the learning process. In a number of cases, it is expedient not to present the exact same test to all learners all the time (Pritchett, 1999). This may be desired so that cheating in the exam is made harder to carry out or so that the learners can take several practice tests on…

  13. Increased hallux angle in children and its association with insufficient length of footwear: a community based cross-sectional study.

    PubMed

    Klein, Christian; Groll-Knapp, Elisabeth; Kundi, Michael; Kinz, Wieland

    2009-12-17

    Wearing shoes of insufficient length during childhood has often been cited as leading to deformities of the foot, particularly to the development of hallux valgus disorders. Until now, these assumptions have not been confirmed through scientific research. This study aims to investigate whether this association can be statistically proven, and if children who wear shoes of insufficient length actually do have a higher risk of a more pronounced lateral deviation of the hallux. 858 pre-school children were included in the study. The study sample was stratified by sex, urban/rural areas and Austrian province. The hallux angle and the length of the feet were recorded. The inside length of the children's footwear (indoor shoes worn in pre-school and outdoor shoes) were assessed. Personal data and different anthropometric measurements were taken. The risk of hallux valgus deviation was statistically tested by a stepwise logistic regression analysis and the relative risk (odds ratio) for a hallux angle > or = 4 degrees was calculated. Exact examinations of the hallux angle could be conducted on a total of 1,579 individual feet. Only 23.9% out of 1,579 feet presented a straight position of the great toe. The others were characterized by lateral deviations (valgus position) at different degrees, equalling 10 degrees or greater in 14.2% of the children's feet.88.8% of 808 children examined wore indoor footwear that was of insufficient length, and 69.4% of 812 children wore outdoor shoes that were too short. A significant relationship was observed between the lengthwise fit of the shoes and the hallux angle: the shorter the shoe, the higher the value of the hallux angle. The relative risk (odds ratio) of a lateral hallux deviation of > or = 4 degrees in children wearing shoes of insufficient length was significantly increased. There is a significant relationship between the hallux angle in children and footwear that is too short in length. The fact that the majority of the children examined were wearing shoes of insufficient length makes the issue particularly significant. Our results emphasize the importance of ensuring that children's footwear fits properly.

  14. Technological Advancements and Error Rates in Radiation Therapy Delivery

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

    Margalit, Danielle N., E-mail: dmargalit@partners.org; Harvard Cancer Consortium and Brigham and Women's Hospital/Dana Farber Cancer Institute, Boston, MA; Chen, Yu-Hui

    2011-11-15

    Purpose: Technological advances in radiation therapy (RT) delivery have the potential to reduce errors via increased automation and built-in quality assurance (QA) safeguards, yet may also introduce new types of errors. Intensity-modulated RT (IMRT) is an increasingly used technology that is more technically complex than three-dimensional (3D)-conformal RT and conventional RT. We determined the rate of reported errors in RT delivery among IMRT and 3D/conventional RT treatments and characterized the errors associated with the respective techniques to improve existing QA processes. Methods and Materials: All errors in external beam RT delivery were prospectively recorded via a nonpunitive error-reporting system atmore » Brigham and Women's Hospital/Dana Farber Cancer Institute. Errors are defined as any unplanned deviation from the intended RT treatment and are reviewed during monthly departmental quality improvement meetings. We analyzed all reported errors since the routine use of IMRT in our department, from January 2004 to July 2009. Fisher's exact test was used to determine the association between treatment technique (IMRT vs. 3D/conventional) and specific error types. Effect estimates were computed using logistic regression. Results: There were 155 errors in RT delivery among 241,546 fractions (0.06%), and none were clinically significant. IMRT was commonly associated with errors in machine parameters (nine of 19 errors) and data entry and interpretation (six of 19 errors). IMRT was associated with a lower rate of reported errors compared with 3D/conventional RT (0.03% vs. 0.07%, p = 0.001) and specifically fewer accessory errors (odds ratio, 0.11; 95% confidence interval, 0.01-0.78) and setup errors (odds ratio, 0.24; 95% confidence interval, 0.08-0.79). Conclusions: The rate of errors in RT delivery is low. The types of errors differ significantly between IMRT and 3D/conventional RT, suggesting that QA processes must be uniquely adapted for each technique. There was a lower error rate with IMRT compared with 3D/conventional RT, highlighting the need for sustained vigilance against errors common to more traditional treatment techniques.« less

  15. Homonegative Attitudes and Risk Behaviors for HIV and Other Sexually Transmitted Infections Among Sexually Active Men in the United States

    PubMed Central

    Johnson, Oshea D.

    2015-01-01

    Objectives. We examined associations between homonegative attitudes and HIV and other sexually transmitted infection (HIV/STI) risk behaviors among sexually active US men. Methods. We used the 2006–2010 National Survey of Family Growth (n = 10 403) and multivariable logistic regression models to examine homonegative attitudes in relation to condom use, number of past-year sex partners, HIV/STI testing, and STI diagnoses. Results. Among men who had sex with men, homonegative attitudes were associated with lower odds of condom use during anal sex with women (before the past year) and past-year STI testing. Among men who had sex with men and women, homonegative attitudes were associated with lower odds of condom use during vaginal sex and sex with men, having 4 or more partners, and HIV testing ever. Among men who had sex with women, homonegative attitudes were associated with lower odds of condom use during vaginal sex and sex with men (before the past year), HIV testing ever, and contracting herpes, human papillomavirus, or syphilis. Conclusions. Homonegative attitudes may promote HIV/STI acquisition and transmission among sexually active men of all sexual orientations. Interventions should address homonegative attitudes in the United States. PMID:26469637

  16. Cyberbullying, Depression, and Problem Alcohol Use in Female College Students: A Multisite Study

    PubMed Central

    Kota, Rajitha; Chan, Ya-Fen; Moreno, Megan

    2015-01-01

    Abstract Cyberbullying and its effects have been studied largely in middle and high school students, but less is known about cyberbullying in college students. This cross-sectional study investigated the relationship between involvement in cyberbullying and depression or problem alcohol use among college females. Two hundred and sixty-five female students from four colleges completed online surveys assessing involvement in cyberbullying behaviors. Participants also completed the Patient Health Questionnaire-9 (PHQ-9) to assess depressive symptoms and the Alcohol Use Disorder Identification Test (AUDIT) to assess problem drinking. Logistic regression tested associations between involvement in cyberbullying and either depression or problem drinking. Results indicated that 27% of participants had experienced cyberbullying in college; 17.4% of all participants met the criteria for depression (PHQ-9 score ≥10), and 37.5% met the criteria for problem drinking (AUDIT score ≥8). Participants with any involvement in cyberbullying had increased odds of depression. Those involved in cyberbullying as bullies had increased odds of both depression and problem alcohol use. Bully/victims had increased odds of depression. The four most common cyberbullying behaviors were also associated with increased odds for depression, with the highest odds among those who had experienced unwanted sexual advances online or via text message. Findings indicate that future longitudinal study of cyberbullying and its effects into late adolescence and young adulthood could contribute to the prevention of associated comorbidities in this population. PMID:25684608

  17. Role of 5-HTTLPR polymorphism in the development of the inward/outward personality organization: a genetic association study.

    PubMed

    Nardi, Bernardo; Marini, Alessandra; Turchi, Chiara; Arimatea, Emidio; Tagliabracci, Adriano; Bellantuono, Cesario

    2013-01-01

    Reciprocity with primary caregivers affects subjects' adaptive abilities toward the construction of the most useful personal meaning organization (PMO) with respect to their developmental environment. Within cognitive theory the post-rationalist approach has outlined two basic categories of identity construction and of regulation of cognitive and emotional processes: the Outward and the Inward PMO. The presence of different, consistent clinical patterns in Inward and Outward subjects is paralleled by differences in cerebral activation during emotional tasks on fMRI and by different expression of some polymorphisms in serotonin pathways. Since several lines of evidence support a role for the 5-HTTLPR polymorphism in mediating individual susceptibility to environmental emotional stimuli, this study was conducted to investigate its influence in the development of the Inward/Outward PMO. PMO was assessed and the 5-HTTLPR polymorphism investigated in 124 healthy subjects who were subdivided into an Inward (n = 52) and an Outward (n = 72) group. Case-control comparisons of short allele (S) frequencies showed significant differences between Inwards and Outwards (p = 0.036, χ2 test; p = 0.026, exact test). Genotype frequencies were not significantly different although values slightly exceeded p ≤ 0.05 (p = 0.056, χ2 test; p = 0.059, exact test). Analysis of the 5-HTTLPR genotypes according to the recessive inheritance model showed that the S/S genotype increased the likelihood of developing an Outward PMO (p = 0.0178, χ2 test; p = 0.0143, exact test; OR = 3.43, CI (95%) = 1.188-9.925). A logistic regression analysis confirmed the association between short allele and S/S genotypes with the Outward PMO also when gender and age were considered. However none of the differences remained significant after correction for multiple testing, even though using the recessive model they approach significance. Overall our data seem to suggest a putative genetic basis for interindividual differences in PMO development.

  18. Role of 5-HTTLPR Polymorphism in the Development of the Inward/Outward Personality Organization: A Genetic Association Study

    PubMed Central

    Nardi, Bernardo; Marini, Alessandra; Turchi, Chiara; Arimatea, Emidio; Tagliabracci, Adriano; Bellantuono, Cesario

    2013-01-01

    Reciprocity with primary caregivers affects subjects' adaptive abilities toward the construction of the most useful personal meaning organization (PMO) with respect to their developmental environment. Within cognitive theory the post-rationalist approach has outlined two basic categories of identity construction and of regulation of cognitive and emotional processes: the Outward and the Inward PMO. The presence of different, consistent clinical patterns in Inward and Outward subjects is paralleled by differences in cerebral activation during emotional tasks on fMRI and by different expression of some polymorphisms in serotonin pathways. Since several lines of evidence support a role for the 5-HTTLPR polymorphism in mediating individual susceptibility to environmental emotional stimuli, this study was conducted to investigate its influence in the development of the Inward/Outward PMO. PMO was assessed and the 5-HTTLPR polymorphism investigated in 124 healthy subjects who were subdivided into an Inward (n = 52) and an Outward (n = 72) group. Case-control comparisons of short allele (S) frequencies showed significant differences between Inwards and Outwards (p = 0.036, χ2 test; p = 0.026, exact test). Genotype frequencies were not significantly different although values slightly exceeded p≤0.05 (p = 0.056, χ2 test; p = 0.059, exact test). Analysis of the 5-HTTLPR genotypes according to the recessive inheritance model showed that the S/S genotype increased the likelihood of developing an Outward PMO (p = 0.0178, χ2 test; p = 0.0143, exact test; OR = 3.43, CI (95%) = 1.188–9.925). A logistic regression analysis confirmed the association between short allele and S/S genotypes with the Outward PMO also when gender and age were considered. However none of the differences remained significant after correction for multiple testing, even though using the recessive model they approach significance. Overall our data seem to suggest a putative genetic basis for interindividual differences in PMO development. PMID:24358153

  19. Influence of socioeconomic and demographic status on spirometry testing in patients initiating medication targeting obstructive lung disease: a population-based cohort study.

    PubMed

    Koefoed, Mette M; Søndergaard, Jens; Christensen, René dePont; Jarbøl, Dorte E

    2013-06-14

    Socioeconomic status is known to influence the prevalence, severity and mortality of obstructive lung diseases, but it is uncertain whether it affects the use of diagnostic spirometry in patients initiating treatment for these conditions. The objective of this paper was to examine a possible association between education, income, labour market affiliation, cohabitation status and having spirometry performed when initiating medication targeting obstructive pulmonary disease. We conducted a population-based cohort study. Danish national registers were linked, retrieving data on prescriptions, spirometry testing, socioeconomic and demographic variables in all first time users of medication targeting obstructive lung disease in 2008. A total of 37,734 persons were included and approximately half of the cohort had spirometry performed. Among medication users under 65 years of age, being unemployed was significantly associated with reduced odds of having spirometry performed, the strongest association was seen in men (OR = 0.82, CI = 0.73-0.91). Medium income was associated with increased odds of having spirometry performed in men (OR =1.18, CI = 1.06-1.30) and high educational level (>12 years) was associated with reduced odds of having spirometry performed in women (OR = 0.86, CI = 0.78-0.94). Cohabitation status was not associated with having spirometry performed. Among medication users over 65 years of age, living alone was associated with reduced odds of having spirometry performed among men (OR = 0.78, CI = 0.69-0.88). Social inequity in spirometry testing among patients initiating medication targeting obstructive lung disease was confirmed in this study. Increased focus on spirometry testing among elderly men living alone, among the unemployed and among women with higher education is required when initiating medication.

  20. Bacterial and dye penetration through interim restorations used during endodontic treatment of molar teeth.

    PubMed

    Chailertvanitkul, Pattama; Abbott, Paul V; Riley, Thomas V; Sooksuntisakoonchai, Namchai

    2009-07-01

    The purpose of this study was to investigate the association between dye and bacterial penetration through interim restorations used during endodontic treatment. Sixty-four extracted human teeth were used, with 2 teeth each as positive and negative controls. Endodontic access with a mesio-occluso-distal cavity was prepared. Palatal cusps of maxillary molars and buccal cusps of mandibular molars were removed. Cotton was placed over the canals and covered with Cavit. Thirty teeth were restored with Ketac Silver (KS) and 30 with KS reinforced with a stainless steel band (KSSB). Samples were submersed in India ink mixed with brain heart infusion broth containing Streptococcus gordonii. After 3 months of simulated chewing, structural integrity and dye and bacterial penetration were assessed. Positive controls had both dye and bacterial penetration. Negative controls had no dye or bacterial penetration. All KS restorations debonded, whereas 18 KSSB restorations (60%) debonded. KS restorations were 1.67 times more likely to debond than KSSB restorations (Fisher exact test). KS was 1.3 times more likely to have dye penetration than KSSB (Fisher exact test) and 3 times more likely to have bacterial penetration, although not statistically significant (chi(2) test). Overall, 88.3% of specimens had dye penetration, and 20% had bacterial penetration. This 68.3% difference indicated no association between dye and bacterial penetration (exact McNemar test). Stainless steel bands helped maintain structural integrity of KS restorations under masticatory function. Bands helped prevent dye penetration but not bacterial penetration. There was no association between dye and bacterial penetration.

  1. The role of clinically significant antiphospholipid antibodies in systemic lupus erythematosus.

    PubMed

    Taraborelli, M; Lazzaroni, M G; Martinazzi, N; Fredi, M; Cavazzana, I; Franceschini, F; Tincani, A

    2016-12-16

    The objective is to investigate the role of clinically significant antiphospholipid antibodies (aPL) in a cohort of systemic lupus erythematosus (SLE) patients. All SLE patients followed for at least 5 years and with available aPL profile at the beginning of the follow-up in our center were studied. Clinically significant aPL were defined as: positive lupus anticoagulant test, anti-cardiolipin and/or anti- β2Glycoprotein I IgG/IgM >99th percentile on two or more occasions at least 12 weeks apart. Patients with and without clinically significant aPL were compared by univariate (Chi square or Fisher's exact test for categorical variables and Student's t or Mann-Whitney test for continuous variables) and multivariate analysis (logistic regression analysis). P values <0.05 were considered significant. Among 317 SLE patients studied, 117 (37%) had a clinically significant aPL profile at baseline. Such patients showed at univariate analysis an increased prevalence of deep venous thrombosis, pulmonary embolism, cardiac valvular disease, cognitive dysfunction and antiphospholipid syndrome (APS), but a reduced prevalence of acute cutaneous lupus and anti-extractable nuclear antigens (ENA) when compared with patients without clinically significant aPL. Multivariate analysis confirmed the association between clinically significant aPL and reduced risk of acute cutaneous lupus [p=0.003, odds ratio (OR) 0.43] and ENA positivity (p<0.001, OR 0.37), with increased risk of cardiac valvular disease (p=0.024, OR 3.1) and APS (p<0.0001, OR 51.12). Triple positivity was the most frequent profile and was significantly associated to APS (p<0.0001, OR 28.43). Our study showed that one third of SLE patients had clinically significant aPL, and that this is associated with an increased risk, especially for triple positive, of APS, and to a different clinical and serological pattern of disease even in the absence of APS.

  2. Prevalence of malaria and anaemia among HIV infected pregnant women receiving co-trimoxazole prophylaxis in Tanzania: a cross sectional study in Kinondoni Municipality.

    PubMed

    Manyanga, Vicent P; Minzi, Omary; Ngasala, Billy

    2014-04-24

    HIV-infected pregnant women are particularly more susceptible to the deleterious effects of malaria infection particularly anaemia. In order to prevent opportunistic infections and malaria, a policy of daily co-trimoxazole prophylaxis without the standard Suphadoxine-Pyrimethamine intermittent preventive treatment (SP-IPT) was introduced to all HIV infected pregnant women in the year 2011. However, there is limited information about the effectiveness of this policy. This was a cross sectional study conducted among HIV-infected pregnant women receiving co-trimoxazole prophylaxis in eight public health facilities in Kinondoni Municipality from February to April 2013. Blood was tested for malaria infection and anaemia (haemoglobin <11 g/dl). Data were collected on the adherence to co-trimoxazole prophylaxis and other risk factors for malaria infection and anaemia. Pearson chi-square test, Fischer's exact test and multivariate logistic regression were used in the statistical analysis. This study enrolled 420 HIV infected pregnant women. The prevalence of malaria infection was 4.5%, while that of anaemia was 54%. The proportion of subjects with poor adherence to co-trimoxazole was 50.5%. As compared to HIV infected pregnant women with good adherence to co-trimoxazole prophylaxis, the poor adherents were more likely to have a malaria infection (Adjusted Odds Ratio, AOR = 6.81, 95% CI = 1.35-34.43, P = 0.02) or anaemia (AOR = 1.75, 95% CI = 1.03-2.98, P = 0.039). Other risk factors associated with anaemia were advanced WHO clinical stages, current malaria infection and history of episodes of malaria illness during the index pregnancy. The prevalence of malaria was low; however, a significant proportion of subjects had anaemia. Good adherence to co-trimoxazole prophylaxis was associated with reduction of both malaria infection and anaemia among HIV infected pregnant women.

  3. Prevalence of malaria and anaemia among HIV infected pregnant women receiving co-trimoxazole prophylaxis in Tanzania: a cross sectional study in Kinondoni Municipality

    PubMed Central

    2014-01-01

    Background HIV-infected pregnant women are particularly more susceptible to the deleterious effects of malaria infection particularly anaemia. In order to prevent opportunistic infections and malaria, a policy of daily co-trimoxazole prophylaxis without the standard Suphadoxine-Pyrimethamine intermittent preventive treatment (SP-IPT) was introduced to all HIV infected pregnant women in the year 2011. However, there is limited information about the effectiveness of this policy. Methods This was a cross sectional study conducted among HIV-infected pregnant women receiving co-trimoxazole prophylaxis in eight public health facilities in Kinondoni Municipality from February to April 2013. Blood was tested for malaria infection and anaemia (haemoglobin <11 g/dl). Data were collected on the adherence to co-trimoxazole prophylaxis and other risk factors for malaria infection and anaemia. Pearson chi-square test, Fischer’s exact test and multivariate logistic regression were used in the statistical analysis. Results This study enrolled 420 HIV infected pregnant women. The prevalence of malaria infection was 4.5%, while that of anaemia was 54%. The proportion of subjects with poor adherence to co-trimoxazole was 50.5%. As compared to HIV infected pregnant women with good adherence to co-trimoxazole prophylaxis, the poor adherents were more likely to have a malaria infection (Adjusted Odds Ratio, AOR = 6.81, 95% CI = 1.35-34.43, P = 0.02) or anaemia (AOR = 1.75, 95% CI = 1.03-2.98, P = 0.039). Other risk factors associated with anaemia were advanced WHO clinical stages, current malaria infection and history of episodes of malaria illness during the index pregnancy. Conclusion The prevalence of malaria was low; however, a significant proportion of subjects had anaemia. Good adherence to co-trimoxazole prophylaxis was associated with reduction of both malaria infection and anaemia among HIV infected pregnant women. PMID:24761799

  4. Clinicopathological parameters associated with histological background and recurrence after surgical intervention of vocal cord leukoplakia.

    PubMed

    Cui, Weixin; Xu, Wen; Yang, Qingwen; Hu, Rong

    2017-06-01

    Histological examination of biopsy shows usefulness in the diagnosis of vocal cord leukoplakia; however, in considerable amount of cases, the examination cannot provide definitive diagnosis of malignancy from benign conditions such as hyperplasia and dysplasia. The present work therefore was aimed to identify clinicopathological factors and molecular markers predictive of recurrence and malignant transformation of vocal cord leukoplakia.Clinical data of 555 cases of vocal cord leukoplakia enrolled from July 1999 to June 2014 were analyzed. The cohort consisted of keratosis (n = 137), hyperplasia (n = 139), dysplasia (n = 177), and primary (n = 10) and invasive (n = 46) carcinoma. Correlations between patients' backgrounds, clinicopathological factors, molecular markers (p53, p16, Ki67, cytokeratin, and proliferating cell nuclear antigen), and histology backgrounds were examined using by Pearson Chi-squared or Fisher exact test. Reflux symptom index (RSI) and reflux finding score (RFS) before and after treatment were compared using Wilcoxon signed-rank test. Risk factors for disease recurrence were identified using Cox proportional hazards models of multivariate analysis. Time to recurrence was analyzed using log-rank test of Kaplan-Meier method.In the present cohort, alcohol drinking was found associated with GRBAS grade (P = .0258) and the site (P = .0298) of leukoplakia. For the different disease types, chief complaint (P = .0179), GRBAS grade (P = .0101), mucosal wave (P < .0001), and molecular markers p53 (P < .0001) and Ki67 (P < .0001) were identified as correlates. RSI and RFS were significantly lowered by surgical intervention. A single side of leukoplakia was predictive of a lower risk of recurrence (odds ratio, 0.378; 95% confidence interval, 0.197-0.723; P = .0033). Absence of mucosal wave was associated with a shorter time-to-recurrence (P = .0357).The present work identified clinicopathological factors and molecular markers associated with the different histology of vocal cord leukoplakia, and also the prognostic factor for the low risk of recurrence after surgery.

  5. Differences in Kaposi sarcoma-associated herpesvirus-specific and –nonspecific immune responses in classic Kaposi sarcoma cases and matched controls in Sicily

    PubMed Central

    Amodio, Emanuele; Goedert, James J.; Barozzi, Patrizia; Riva, Giovanni; Firenze, Alberto; Bonura, Filippa; Viviano, Enza; Romano, Nino; Luppi, Mario

    2011-01-01

    SUMMARY Kaposi sarcoma (KS) may develop because of incompetent immune responses, both nonspecifically and specifically against the KS-associated herpes virus (KSHV). Peripheral blood mononuclear cells from 15 classic (non-AIDS) KS cases, 13 KSHV seropositives (without KS), and 15 KSHV-seronegative controls were tested for interferon-γ T-cell (Elispot) responses to KSHV-LANA, KSHV-K8.1, and CMV/EBV peptide pools. The forearm and thigh of each participant also was tested for delayed-type hypersensitivity (DTH) against common recall antigens. Groups were compared with Fisher exact test and multinomial logistic regression to calculate odds ratios (OR) and 95% confidence intervals (CI). KSHV Elispot response was detected in 10 (67%) classic KS cases, 11 (85%) KSHV seropositives (without KS), and 2 (13%) seronegative controls. All 4 cases with KSHV-LANA responses had current KS lesions, whereas 5 of 6 cases with KSHV-K8.1 responses had no lesions (P=0.048). No case responded to both LANA and K8.1. Compared to seronegative controls, risk for classic KS was inversely related to DTH in the thigh (OR 0.71, 95% CI 0.55–0.94, P=0.01), directly associated with DTH in the forearm (OR 1.35, 95% CI 1.02–1.80, P=0.04), and tended to be increased 5-fold per KSHV Elispot response (OR 5.13, 95% CI 0.86–30.77, P=0.07). Compared to KSHV seropositives (without KS), risk for classic KS, was reduced 5-fold (OR 0.20, CI 0.03–0.77, P=0.04) per KSHV response. CMV/EBV Elispot responses were irrelevant. Deficiency of both KSHV-specific and –nonspecific immunity is associated with classic KS. This may clarify why Kaposi sarcoma responds to immune reconstitution. PMID:21740480

  6. Lesion stiffness measured by shear-wave elastography: Preoperative predictor of the histologic underestimation of US-guided core needle breast biopsy.

    PubMed

    Park, Ah Young; Son, Eun Ju; Kim, Jeong-Ah; Han, Kyunghwa; Youk, Ji Hyun

    2015-12-01

    To determine whether lesion stiffness measured by shear-wave elastography (SWE) can be used to predict the histologic underestimation of ultrasound (US)-guided 14-gauge core needle biopsy (CNB) for breast masses. This retrospective study enrolled 99 breast masses from 93 patients, including 40 high-risk lesions and 59 ductal carcinoma in situ (DCIS), which were diagnosed by US-guided 14-gauge CNB. SWE was performed for all breast masses to measure quantitative elasticity values before US-guided CNB. To identify the preoperative factors associated with histologic underestimation, patients' age, symptoms, lesion size, B-mode US findings, and quantitative SWE parameters were compared according to the histologic upgrade after surgery using the chi-square test, Fisher's exact test, or independent t-test. The independent factors for predicting histologic upgrade were evaluated using multivariate logistic regression analysis. The underestimation rate was 28.3% (28/99) in total, 25.0% (10/40) in high-risk lesions, and 30.5% (18/59) in DCIS. All elasticity values of the upgrade group were significantly higher than those of the non-upgrade group (P<0.001). On multivariate analysis, the mean (Odds ratio [OR]=1.021, P=0.001), maximum (OR=1.015, P=0.008), and minimum (OR=1.028, P=0.001) elasticity values were independently associated with histologic underestimation. The patients' age, lesion size, and final assessment category on US of the upgrade group were higher than those of the non-upgrade group (P=0.046 for age; P=0.021 for lesion size; P=0.030 for US category), but these were not independent predictors of histologic underestimation on multivariate analysis. Breast lesion stiffness quantitatively measured by SWE could be helpful to predict the underestimation of malignancy in US-guided 14-gauge CNB. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  7. Interactions between malaria and HIV infections in pregnant women: a first report of the magnitude, clinical and laboratory features, and predictive factors in Kinshasa, the Democratic Republic of Congo.

    PubMed

    Wumba, Roger D; Zanga, Josué; Aloni, Michel N; Mbanzulu, Kennedy; Kahindo, Aimé; Mandina, Madone N; Ekila, Mathilde B; Mouri, Oussama; Kendjo, Eric

    2015-02-18

    HIV and malaria are among the leading causes of morbidity and mortality during pregnancy in Africa. However, data from Congolese pregnant women are lacking. The aim of the study was to determine the magnitude, predictive factors, clinical, biologic and anthropometric consequences of malaria infection, HIV infection, and interactions between malaria and HIV infections in pregnant women. A cross-sectional study was conducted among pregnant women admitted and followed up at Camp Kokolo Military Hospital from 2009 to 2012 in Kinshasa, the Democratic Republic of Congo. Differences in means between malaria-positive and malaria-negative cases or between HIV-positive and HIV-negative cases were compared using the Student's t-test or a non-parametric test, if appropriate. Categorical variables were compared using the Chi-square or Fisher's exact test, if appropriate. Backward multivariable analysis was used to evaluate the potential risk factors of malaria and HIV infections. The odds ratios with their 95% confidence interval (95% CI) were estimated to measure the strengths of the associations. Analyses resulting in values of P < 0.05 were considered significant. A malaria infection was detected in 246/332 (74.1%) pregnant women, and 31.9% were anaemic. Overall, 7.5% (25/332) of mothers were infected by HIV, with a median CD4 count of 375 (191; 669) cells/μL. The mean (±SD) birth weight was 2,613 ± 227 g, with 35.7% of newborns weighing less than 2,500 g (low birth weight). Low birth weight, parity and occupation were significantly different between malaria-infected and uninfected women in adjusted models. However, fever, anemia, placenta previa, marital status and district of residence were significantly associated to HIV infection. The prevalence of malaria infection was high in pregnant women attending the antenatal facilities or hospitalized and increased when associated with HIV infection.

  8. High-grade squamous intraepithelial lesions in pregnant and non-pregnant women.

    PubMed

    Xavier-Júnior, José Cândido C; Dufloth, Rozany M; do Vale, Diama B; Tavares, Thalita A; Zeferino, Luiz C

    2014-04-01

    To evaluate if the prevalence of cervical smear results varies between pregnant and non-pregnant women stratified by age group. Observational analytical study with a total sample of 1,336,180 pregnant and non-pregnant women, aged between 20 and 34 years, who underwent cervical cancer screening in the Primary Health Care of the national health system in the area of Campinas in Brazil during the period of 2005-2009. The source is the information system for cervical cancer screening. Data collected on abnormal cervical smears were analyzed using the Chi-square test and Fisher's exact test and the magnitude of the association between pregnancy and high-grade squamous epithelial lesions was analyzed by odds ratio (OR) and estimated values with confidence intervals (CI) of 95%. 15,190 pregnant women and 395,961 non-pregnant women were analyzed and fulfilled the inclusion criteria. Regardless of age, no statistical differences were observed for high-grade squamous intraepithelial lesion prevalence (OR 0.90; CI 0.66-1.23). Taking into account the five-year age groups, however, low-grade squamous intraepithelial lesion was less prevalent in pregnant women aged 20-24 (OR 0.71; 0.54-0.95) and 25-29 years (OR 0.56; 0.35-0.89); also, atypical squamous cells of undetermined significance was more prevalent in non-pregnant women aged 25-29 years (OR 0.72; 0.54-0.97). The study showed that the cytological prevalence of high-grade squamous intraepithelial lesion was similar in pregnant and non-pregnant women, regardless of age. The results indicate that there are no reasons for specific approaches to cervical cancer screening for pregnant women. The examination should be carried out only on pregnant women who have not been tested according to current recommendations. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  9. Psychopathic Traits Mediate the Association of Serotonin Transporter Genotype and Child Externalizing Behavior

    PubMed Central

    Brammer, Whitney A.; Jezior, Kristen L.; Lee, Steve S.

    2016-01-01

    Although the promoter polymorphism of the serotonin transporter (5-HTTLPR) gene is associated with externalizing behavior, its mediating pathways are unknown. Given their sensitivity to serotonin neurotransmission and unique association with attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD), we tested callous-unemotional (CU) traits and narcissism as separate mediators of the association of 5-HTTLPR with ADHD and ODD. We evaluated 209 5–9 year-old children with and without ADHD at baseline; approximately two years later (i.e., Wave 2), parents and teachers separately rated ADHD and ODD symptoms and youth self-reported antisocial behavior. Controlling for race-ethnicity and baseline ADHD/ODD, narcissism uniquely mediated predictions of multi-informant rated Wave 2 ADHD and ODD from variation in 5-HTTLPR; CU traits mediated predictions of Wave 2 ADHD from variations in 5-HTTLPR, but did not mediate the associations of 5-HTTLPR with ODD or youth self-reported antisocial behavior. Specifically, the number of 5-HTTLPR long alleles positively predicted CU traits and narcissism; narcissism was positively associated with Wave 2 ADHD and ODD symptoms, whereas CU traits were positively associated with Wave 2 ADHD. Child sex also moderated indirect effects of CU traits and narcissism, such that narcissism mediated predictions of ADHD/ODD in girls but not boys. Psychopathic traits may represent a relevant pathway underlying predictions of prospective change in ADHD and ODD from 5-HTTLPR, particularly in girls. We consider the role of psychopathic traits as a potential intermediate phenotype in genetically-sensitive studies of child psychopathology. PMID:26990675

  10. Electromagnetic duality and entanglement anomalies

    NASA Astrophysics Data System (ADS)

    Donnelly, William; Michel, Ben; Wall, Aron C.

    2017-08-01

    Duality is an indispensable tool for describing the strong-coupling dynamics of gauge theories. However, its actual realization is often quite subtle: quantities such as the partition function can transform covariantly, with degrees of freedom rearranged in a nonlocal fashion. We study this phenomenon in the context of the electromagnetic duality of Abelian p -forms. A careful calculation of the duality anomaly on an arbitrary D -dimensional manifold shows that the effective actions agree exactly in odd D , while in even D they differ by a term proportional to the Euler number. Despite this anomaly, the trace of the stress tensor agrees between the dual theories. We also compute the change in the vacuum entanglement entropy under duality, relating this entanglement anomaly to the duality of an "edge mode" theory in two fewer dimensions. Previous work on this subject has led to conflicting results; we explain and resolve these discrepancies.

  11. Moments of zeta functions associated to hyperelliptic curves over finite fields

    PubMed Central

    Rubinstein, Michael O.; Wu, Kaiyu

    2015-01-01

    Let q be an odd prime power, and denote the set of square-free monic polynomials D(x)∈Fq[x] of degree d. Katz and Sarnak showed that the moments, over , of the zeta functions associated to the curves y2=D(x), evaluated at the central point, tend, as , to the moments of characteristic polynomials, evaluated at the central point, of matrices in USp(2⌊(d−1)/2⌋). Using techniques that were originally developed for studying moments of L-functions over number fields, Andrade and Keating conjectured an asymptotic formula for the moments for q fixed and . We provide theoretical and numerical evidence in favour of their conjecture. In some cases, we are able to work out exact formulae for the moments and use these to precisely determine the size of the remainder term in the predicted moments. PMID:25802418

  12. Radiative-photochemical response of the mesosphere to dynamical forcing

    NASA Technical Reports Server (NTRS)

    Frederick, J. E.

    1981-01-01

    Combination of the chemical continuity equation for odd oxygen with the second law of thermodynamics yields analytic solutions which describe the coupled behavior of temperature and ozone perturbations in response to an externally specified forcing. The results appear in a form which allows easy physical interpretation of the coupling between radiative and photochemical processes. When the forcing is chosen to mimic a planetary scale wave, the theory shows that photochemical acceleration of radiative damping reduces the amplitude of the temperature perturbation by an amount which increases with the wave period. Although ozone fluctuations are anti-correlated with those in temperature, minima in ozone do not coincide exactly in longitude with temperature maxima. The percentage variation in ozone increases upward and is always larger than that in temperature at the same pressure. This demonstrates that variations in ozone on constant pressure surfaces may serve as a sensitive indicator of wave activity in the mesosphere.

  13. Depression and Anxiety in Polycystic Ovary Syndrome: Etiology and Treatment.

    PubMed

    Cooney, Laura G; Dokras, Anuja

    2017-09-20

    Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive age women and is associated with an increased prevalence of depression and anxiety symptoms. This review presents potential mechanisms for this increased risk and outlines treatment options. Women with PCOS have increased odds of depressive symptoms (OR 3.78; 95% CI 3.03-4.72) and anxiety symptoms (OR 5.62; 95% CI 3.22-9.80). Obesity, insulin resistance, and elevated androgens may partly contribute to this association. Therefore, in addition to established treatment options, treatment of PCOS-related symptoms with lifestyle modification and/or oral contraceptive pills may be of benefit. Screening for anxiety and depression is recommended in women with PCOS at the time of diagnosis. The exact etiology for the increased risk in PCOS is still unclear. Moreover, there is a paucity of published data on the most effective behavioral, pharmacological, or physiological treatment options specifically in women with PCOS.

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

    Aliev, Alikram N., E-mail: alikram.n.aliev@gmail.com

    We examine the black hole bomb model which consists of a rotating black hole of five-dimenensional minimal ungauged supergravity and a reflecting mirror around it. For low-frequency scalar perturbations, we find solutions to the Klein-Gordon equation in the near-horizon and far regions of the black hole spacetime. To avoid solutions with logarithmic terms, we assume that the orbital quantum number l takes on nearly, but not exactly, integer values and perform the matching of these solutions in an intermediate region. This allows us to calculate analytically the frequency spectrum of quasinormal modes, taking the limits as l approaches even ormore » odd integers separately. We find that all l modes of scalar perturbations undergo negative damping in the regime of superradiance, resulting in exponential growth of their amplitudes. Thus, the model under consideration would exhibit the superradiant instability, eventually behaving as a black hole bomb in five dimensions.« less

  15. Spin-triplet superconductivity in a weak-coupling Hubbard model for the quasi-one-dimensional compound Li0.9Mo6O17

    NASA Astrophysics Data System (ADS)

    Cho, Weejee; Platt, Christian; McKenzie, Ross H.; Raghu, Srinivas

    2015-10-01

    The purple bronze Li0.9Mo6O17 is of interest due to its quasi-one-dimensional electronic structure and the possible Luttinger liquid behavior resulting from it. For sufficiently low temperatures, it is a superconductor with a pairing symmetry that is still to be determined. To shed light on this issue, we analyze a minimal Hubbard model for this material involving four molybdenum orbitals per unit cell near quarter filling, using asymptotically exact perturbative renormalization group methods. We find that spin-triplet odd-parity superconductivity is the dominant instability. Approximate nesting properties of the two quasi-one-dimensional Fermi surfaces enhance certain second-order processes, which play crucial roles in determining the structure of the pairing gap. Notably, we find that the gap has more sign changes than required by the point-group symmetry.

  16. Spin triplet superconductivity in a weak-coupling Hubbard model for the quasi-one-dimensional compound Li0.9 Mo6 O17

    NASA Astrophysics Data System (ADS)

    Platt, Christian; Cho, Weejee; McKenzie, Ross H.; Raghu, Sri

    The purple bronze Li0.9Mo6O17 is of interest due to its quasi-one-dimensional electronic structure and the possible Luttinger liquid behavior resulting from it. For sufficiently low temperatures, it is a superconductor with a pairing symmetry that is still to be determined. To shed light on this issue, we analyze a minimal Hubbard model for this material involving four Molybdenum orbitals per unit cell near quarter filling, using asymptotically exact perturbative renormalization group methods. We find that spin triplet odd-parity superconductivity is the dominant instability. Approximate nesting properties of the two quasi-one-dimensional Fermi surfaces enhance certain second-order processes, which play crucial roles in determining the structure of the pairing gap. Notably, we find that the gap has accidental nodes, i.e. it has more sign changes than required by the point-group symmetry.

  17. Boundary conformal anomalies on hyperbolic spaces and Euclidean balls

    NASA Astrophysics Data System (ADS)

    Rodriguez-Gomez, Diego; Russo, Jorge G.

    2017-12-01

    We compute conformal anomalies for conformal field theories with free conformal scalars and massless spin 1/2 fields in hyperbolic space ℍ d and in the ball B^d , for 2≤d≤7. These spaces are related by a conformal transformation. In even dimensional spaces, the conformal anomalies on ℍ2 n and B^{2n} are shown to be identical. In odd dimensional spaces, the conformal anomaly on B^{2n+1} comes from a boundary contribution, which exactly coincides with that of ℍ2 n + 1 provided one identifies the UV short-distance cutoff on B^{2n+1} with the inverse large distance IR cutoff on ℍ2 n + 1, just as prescribed by the conformal map. As an application, we determine, for the first time, the conformal anomaly coefficients multiplying the Euler characteristic of the boundary for scalars and half-spin fields with various boundary conditions in d = 5 and d = 7.

  18. Stability of the wobbling motion in the triaxially deformed odd-A nucleus

    NASA Astrophysics Data System (ADS)

    Tanabe, Kosai; Sugawara-Tanabe, Kazuko

    2017-12-01

    In order to analyze the content of the exact solutions for particle-rotor models with both the rigid and the hydrodynamical moments of inertia (MoI), as a theoretical probe we apply the Holstein-Primakoff (HP) boson expansion method to the total angular momentum I and the single-particle angular momentum j. We study the competition between Coriolis force and the single-particle potential by employing the different choices of the diagonal HP boson representations for the components of I and j along a common coordinate axis, and along perpendicular axes. We do not find any wobbling level sequence associated with the rotation around the principal axis with the medium MoI. The staggering in the alignments of I about the axis with the medium MoI is found in the limited range of I, while the vector R(=I-j) is confined about the axis with the largest MoI.

  19. EXACT DISTRIBUTIONS OF INTRACLASS CORRELATION AND CRONBACH'S ALPHA WITH GAUSSIAN DATA AND GENERAL COVARIANCE.

    PubMed

    Kistner, Emily O; Muller, Keith E

    2004-09-01

    Intraclass correlation and Cronbach's alpha are widely used to describe reliability of tests and measurements. Even with Gaussian data, exact distributions are known only for compound symmetric covariance (equal variances and equal correlations). Recently, large sample Gaussian approximations were derived for the distribution functions. New exact results allow calculating the exact distribution function and other properties of intraclass correlation and Cronbach's alpha, for Gaussian data with any covariance pattern, not just compound symmetry. Probabilities are computed in terms of the distribution function of a weighted sum of independent chi-square random variables. New F approximations for the distribution functions of intraclass correlation and Cronbach's alpha are much simpler and faster to compute than the exact forms. Assuming the covariance matrix is known, the approximations typically provide sufficient accuracy, even with as few as ten observations. Either the exact or approximate distributions may be used to create confidence intervals around an estimate of reliability. Monte Carlo simulations led to a number of conclusions. Correctly assuming that the covariance matrix is compound symmetric leads to accurate confidence intervals, as was expected from previously known results. However, assuming and estimating a general covariance matrix produces somewhat optimistically narrow confidence intervals with 10 observations. Increasing sample size to 100 gives essentially unbiased coverage. Incorrectly assuming compound symmetry leads to pessimistically large confidence intervals, with pessimism increasing with sample size. In contrast, incorrectly assuming general covariance introduces only a modest optimistic bias in small samples. Hence the new methods seem preferable for creating confidence intervals, except when compound symmetry definitely holds.

  20. Osmolality urine test

    MedlinePlus

    ... balance and urine concentration. Osmolality is a more exact measurement of urine concentration than the urine specific ... must be authorized in writing by ADAM Health Solutions. About MedlinePlus Site Map FAQs Customer Support Get ...

  1. Evidence for the Trait-Impulsivity Etiological Model in a Clinical Sample: Bifactor Structure and Its Relation to Impairment and Environmental Risk.

    PubMed

    Rodenacker, Klaas; Hautmann, Christopher; Görtz-Dorten, Anja; Döpfner, Manfred

    2018-05-01

    The trait-impulsivity etiological model assumes that a general factor (trait-impulsivity) underlies attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and other externalizing disorders. We investigated the plausibility of this assumption by testing the factor structure of ADHD and ODD in a bifactor framework for a clinical sample of 1420 children between 6 and 18 years of age (M = 9.99, SD = 3.34; 85% male). Further, the trait-impulsivity etiological model assumes that ODD emerges only if environmental risk factors are present. Our results support the validity of the trait-impulsivity etiological model, as they confirm that ADHD and ODD share a strong general factor of disruptive behavior (DB) in this clinical sample. Furthermore, unlike the subdimensions of ADHD, we found that the specific ODD factor explained as much true score variance as the general DB factor. This suggests that a common scale of ADHD and ODD may prove to be as important as a separate ODD subscale to assess externalizing problems in school-age children. However, all other subscales of ADHD may not explain sufficient true score variance once the impact of the general DB factor has been taken into consideration. In accordance with the trait-impulsivity model, we also showed that all factors, but predominantly the general factor and specific inattention factor, predicted parent-rated impairment, and that predominantly ODD and impulsivity are predicted by environmental risk factors.

  2. The relationship between area deprivation and contact with community intellectual disability psychiatry.

    PubMed

    Nicholson, L; Hotchin, H

    2015-05-01

    People with intellectual disabilities (ID) have high rates of psychiatric illness and are known to live in more deprived areas than the general population. This study investigated the relationship between area deprivation and contact with ID psychiatry. Psychiatric case notes and electronic records were used to identify all patients who had face-to-face contact with community ID psychiatric services over 1 year in the North East Community Health Partnership of Greater Glasgow and Clyde (estimated population 177,867). The Scottish Index of Multiple Deprivation (SIMD) were determined for the patient sample and for the general population living in the same area. Between 1 June 2012 and 1 June 2013, 184 patients were seen by ID psychiatry over a total of 553 contacts, with valid SIMD data for 179 patients and 543 contacts. Fifty-two per cent of patients (n = 93) lived in the most deprived SIMD decile, and 90.5% (n = 152) in the lowest 5 deciles. Compared with the general population, there were significantly more patients than expected living in the most deprived decile (Fisher's Exact test, P = 0.009) and in the most deprived 5 deciles (Fisher's Exact test, P = 0.001). The median number of contacts was 2 (interquartile range = 1-3). There was no significant association between the number of contacts and SIMD decile. Forty-eight point one per cent (n = 261) of all contacts were with patients living in the most deprived decile and 88.6% (n = 481) in the most deprived 5 deciles. This was significantly more than expected compared with general population data (Fisher's Exact test, P = 0.008 and Fisher's Exact test, P ≤ 0.001). In the area under study, contact with ID psychiatry was greater in more deprived areas. Given the high psychiatric morbidity of people with ID, if services do not adjust for deprivation, this may lead to further discrimination in an already disadvantaged population. © 2014 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  3. Quasi-integrability in deformed sine-Gordon models and infinite towers of conserved charges

    NASA Astrophysics Data System (ADS)

    Blas, Harold; Callisaya, Hector Flores

    2018-02-01

    We have studied the space-reflection symmetries of some soliton solutions of deformed sine-Gordon models in the context of the quasi-integrability concept. Considering a dual pair of anomalous Lax representations of the deformed model we compute analytically and numerically an infinite number of alternating conserved and asymptotically conserved charges through a modification of the usual techniques of integrable field theories. The charges associated to two-solitons with a definite parity under space-reflection symmetry, i.e. kink-kink (odd parity) and kink-antikink (even parity) scatterings with equal and opposite velocities, split into two infinite towers of conserved and asymptotically conserved charges. For two-solitons without definite parity under space-reflection symmetry (kink-kink and kink-antikink scatterings with unequal and opposite velocities) our numerical results show the existence of the asymptotically conserved charges only. However, we show that in the center-of-mass reference frame of the two solitons the parity symmetries and their associated set of exactly conserved charges can be restored. Moreover, the positive parity breather-like (kink-antikink bound state) solution exhibits a tower of exactly conserved charges and a subset of charges which are periodic in time. We back up our results with extensive numerical simulations which also demonstrate the existence of long lived breather-like states in these models. The time evolution has been simulated by the 4th order Runge-Kutta method supplied with non-reflecting boundary conditions.

  4. Overlap between Parkinson disease and Alzheimer disease in ABCA7 functional variants

    PubMed Central

    Nuytemans, Karen; Maldonado, Lizmarie; Ali, Aleena; John-Williams, Krista; Beecham, Gary W.; Martin, Eden; Scott, William K.

    2016-01-01

    Objective: Given their reported function in phagocytosis and clearance of protein aggregates in Alzheimer disease (AD), we hypothesized that variants in ATP-binding cassette transporter A7 (ABCA7) might be involved in Parkinson disease (PD). Methods: ABCA7 variants were identified using whole-exome sequencing (WES) on 396 unrelated patients with PD and 222 healthy controls. In addition, we used the publicly available WES data from the Parkinson's Progression Markers Initiative (444 patients and 153 healthy controls) as a second, independent data set. Results: We observed a higher frequency of loss-of-function (LOF) variants and rare putative highly functional variants (Combined Annotation Dependent Depletion [CADD] >20) in clinically diagnosed patients with PD than in healthy controls in both data sets. Overall, we identified LOF variants in 11 patients and 1 healthy control (odds ratio [OR] 4.94, Fisher exact p = 0.07). Four of these variants have been previously implicated in AD risk (p.E709AfsX86, p.W1214X, p.L1403RfsX7, and rs113809142). In addition, rare variants with CADD >20 were observed in 19 patients vs 3 healthy controls (OR 2.85, Fisher exact p = 0.06). Conclusion: The presence of ABCA7 LOF variants in clinically defined PD suggests that they might be risk factors for neurodegeneration in general, especially those variants hallmarked by protein aggregation. More studies will be needed to evaluate the overall impact of this transporter in neurodegenerative disease. PMID:27066581

  5. Significant lexical relationships

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

    Pedersen, T.; Kayaalp, M.; Bruce, R.

    Statistical NLP inevitably deals with a large number of rare events. As a consequence, NLP data often violates the assumptions implicit in traditional statistical procedures such as significance testing. We describe a significance test, an exact conditional test, that is appropriate for NLP data and can be performed using freely available software. We apply this test to the study of lexical relationships and demonstrate that the results obtained using this test are both theoretically more reliable and different from the results obtained using previously applied tests.

  6. 9 CFR 147.52 - Approved tests.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... for use. The cooperating laboratories must perform the assay exactly as stated in the supplied instructions. Each laboratory must test a panel of at least 25 known positive clinical samples supplied by the...) H7L4S3. (3) DuPont Qualicon BAX Polymerase Chain Reaction (PCR)-based assay for Salmonella, DuPont...

  7. 9 CFR 147.52 - Approved tests.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... for use. The cooperating laboratories must perform the assay exactly as stated in the supplied instructions. Each laboratory must test a panel of at least 25 known positive clinical samples supplied by the...) H7L4S3. (3) DuPont Qualicon BAX Polymerase Chain Reaction (PCR)-based assay for Salmonella, DuPont...

  8. Automated Simultaneous Assembly of Multistage Testlets for a High-Stakes Licensing Examination

    ERIC Educational Resources Information Center

    Breithaupt, Krista; Hare, Donovan R.

    2007-01-01

    Many challenges exist for high-stakes testing programs offering continuous computerized administration. The automated assembly of test questions to exactly meet content and other requirements, provide uniformity, and control item exposure can be modeled and solved by mixed-integer programming (MIP) methods. A case study of the computerized…

  9. Best Practices for Administering Concept Inventories

    ERIC Educational Resources Information Center

    Madsen, Adrian; McKagan, Sarah B.; Sayre, Eleanor C.

    2017-01-01

    There is a plethora of concept inventories available for faculty to use, but it is not always clear exactly why you would use these tests, or how you should administer them and interpret the results. These research-based tests about physics and astronomy concepts are valuable because they allow for standardized comparisons among institutions,…

  10. Invisibility: An Unintended Consequence of Standards, Tests, and Mandates

    ERIC Educational Resources Information Center

    Elish-Piper, Laurie; Matthews, Mona W.; Risko, Victoria J.

    2013-01-01

    As elementary and middle school teachers and students face standards, high-stakes testing, accountability, and one-size-fits all curricula, concerns have arisen that these practices limit the relevance and efficacy of teaching and learning. In this paper, we argue that such practices exact personal costs on students and the teachers expected to…

  11. A Novel Polygonal Finite Element Method: Virtual Node Method

    NASA Astrophysics Data System (ADS)

    Tang, X. H.; Zheng, C.; Zhang, J. H.

    2010-05-01

    Polygonal finite element method (PFEM), which can construct shape functions on polygonal elements, provides greater flexibility in mesh generation. However, the non-polynomial form of traditional PFEM, such as Wachspress method and Mean Value method, leads to inexact numerical integration. Since the integration technique for non-polynomial functions is immature. To overcome this shortcoming, a great number of integration points have to be used to obtain sufficiently exact results, which increases computational cost. In this paper, a novel polygonal finite element method is proposed and called as virtual node method (VNM). The features of present method can be list as: (1) It is a PFEM with polynomial form. Thereby, Hammer integral and Gauss integral can be naturally used to obtain exact numerical integration; (2) Shape functions of VNM satisfy all the requirements of finite element method. To test the performance of VNM, intensive numerical tests are carried out. It found that, in standard patch test, VNM can achieve significantly better results than Wachspress method and Mean Value method. Moreover, it is observed that VNM can achieve better results than triangular 3-node elements in the accuracy test.

  12. Evidence against the "booty pack": Trichomonas not associated with gonorrhea or Chlamydia.

    PubMed

    Wegner, Stephen; Yen, M Jim; Witting, Michael

    2009-08-01

    Many Emergency Physicians armed with a positive Trichomonas wet mount will also treat for Neisseria gonorrhea (GC) and Chlamydia trachomatis (CT). This study estimates the association between Trichomonas microscopy result and a DNA test result for GC or CT. Using laboratory records from patients who had simultaneous sampling for all three infections, we calculated an odds ratio for the association between the Trichomonas result and a positive test for either GC or CT. Among 795 eligible females, 105 (13%) had Trichomonas, 74 (9%) had CT, and 35 (4%) had GC. Whereas CT and GC were strongly associated with each other (odds ratio 5.9, 95% confidence interval 2.8-12.4, p < 0.0001), Trichomonas infection was unrelated to infection with either GC or CT (odds ratio 1.1, 95% confidence interval 0.6-2, p = 0.9). Trichomonas results do not predict results for GC and CT; they should not influence the decision to treat for GC and CT.

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

    PubMed Central

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

    1989-01-01

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

  14. An approach for generating trajectory-based dynamics which conserves the canonical distribution in the phase space formulation of quantum mechanics. II. Thermal correlation functions.

    PubMed

    Liu, Jian; Miller, William H

    2011-03-14

    We show the exact expression of the quantum mechanical time correlation function in the phase space formulation of quantum mechanics. The trajectory-based dynamics that conserves the quantum canonical distribution-equilibrium Liouville dynamics (ELD) proposed in Paper I is then used to approximately evaluate the exact expression. It gives exact thermal correlation functions (of even nonlinear operators, i.e., nonlinear functions of position or momentum operators) in the classical, high temperature, and harmonic limits. Various methods have been presented for the implementation of ELD. Numerical tests of the ELD approach in the Wigner or Husimi phase space have been made for a harmonic oscillator and two strongly anharmonic model problems, for each potential autocorrelation functions of both linear and nonlinear operators have been calculated. It suggests ELD can be a potentially useful approach for describing quantum effects for complex systems in condense phase.

  15. Visual Form Perception Can Be a Cognitive Correlate of Lower Level Math Categories for Teenagers.

    PubMed

    Cui, Jiaxin; Zhang, Yiyun; Cheng, Dazhi; Li, Dawei; Zhou, Xinlin

    2017-01-01

    Numerous studies have assessed the cognitive correlates of performance in mathematics, but little research has been conducted to systematically examine the relations between visual perception as the starting point of visuospatial processing and typical mathematical performance. In the current study, we recruited 223 seventh graders to perform a visual form perception task (figure matching), numerosity comparison, digit comparison, exact computation, approximate computation, and curriculum-based mathematical achievement tests. Results showed that, after controlling for gender, age, and five general cognitive processes (choice reaction time, visual tracing, mental rotation, spatial working memory, and non-verbal matrices reasoning), visual form perception had unique contributions to numerosity comparison, digit comparison, and exact computation, but had no significant relation with approximate computation or curriculum-based mathematical achievement. These results suggest that visual form perception is an important independent cognitive correlate of lower level math categories, including the approximate number system, digit comparison, and exact computation.

  16. AESS: Accelerated Exact Stochastic Simulation

    NASA Astrophysics Data System (ADS)

    Jenkins, David D.; Peterson, Gregory D.

    2011-12-01

    The Stochastic Simulation Algorithm (SSA) developed by Gillespie provides a powerful mechanism for exploring the behavior of chemical systems with small species populations or with important noise contributions. Gene circuit simulations for systems biology commonly employ the SSA method, as do ecological applications. This algorithm tends to be computationally expensive, so researchers seek an efficient implementation of SSA. In this program package, the Accelerated Exact Stochastic Simulation Algorithm (AESS) contains optimized implementations of Gillespie's SSA that improve the performance of individual simulation runs or ensembles of simulations used for sweeping parameters or to provide statistically significant results. Program summaryProgram title: AESS Catalogue identifier: AEJW_v1_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/AEJW_v1_0.html Program obtainable from: CPC Program Library, Queen's University, Belfast, N. Ireland Licensing provisions: University of Tennessee copyright agreement No. of lines in distributed program, including test data, etc.: 10 861 No. of bytes in distributed program, including test data, etc.: 394 631 Distribution format: tar.gz Programming language: C for processors, CUDA for NVIDIA GPUs Computer: Developed and tested on various x86 computers and NVIDIA C1060 Tesla and GTX 480 Fermi GPUs. The system targets x86 workstations, optionally with multicore processors or NVIDIA GPUs as accelerators. Operating system: Tested under Ubuntu Linux OS and CentOS 5.5 Linux OS Classification: 3, 16.12 Nature of problem: Simulation of chemical systems, particularly with low species populations, can be accurately performed using Gillespie's method of stochastic simulation. Numerous variations on the original stochastic simulation algorithm have been developed, including approaches that produce results with statistics that exactly match the chemical master equation (CME) as well as other approaches that approximate the CME. Solution method: The Accelerated Exact Stochastic Simulation (AESS) tool provides implementations of a wide variety of popular variations on the Gillespie method. Users can select the specific algorithm considered most appropriate. Comparisons between the methods and with other available implementations indicate that AESS provides the fastest known implementation of Gillespie's method for a variety of test models. Users may wish to execute ensembles of simulations to sweep parameters or to obtain better statistical results, so AESS supports acceleration of ensembles of simulation using parallel processing with MPI, SSE vector units on x86 processors, and/or using NVIDIA GPUs with CUDA.

  17. Gender and ethnic differences in chronic myelogenous leukemia prognosis and treatment response: a single-institution retrospective study

    PubMed Central

    Lee, Justin P; Birnstein, Elliott; Masiello, David; Yang, Dongyun; Yang, Allen S

    2009-01-01

    Background In the last decade the importance of ethnicity, socio-economic and gender differences in relation to disease incidence, diagnosis, and prognosis has been realized. Differences in these areas have become a major health policy focus in the United States. Our study was undertaken to examine the demographic and clinical features of chronic myelogenous leukemia (CML) patients presenting initially at the LAC+USC Medical Center, which serves an ethnically diverse population. Results Patients were evenly split by gender, overwhelmingly Hispanic (60.9%), and quite young (median age 39, range 17–65) compared with previously reported CML patient populations. Previous CML studies identified significant anemia (Hgb <12 g/dl), significant thrombocytosis (platelets >450 × 109/l), and significant leukocytosis (WBC >50 × 109/l) as significant adverse pretreatment prognostic factors. Using these indicators, in addition to the validated Hasford and Sokal scores, patients were stratified and analyzed via gender and ethnicity. A significantly greater proportion of women presented with significant anemia (p = 0.019, Fisher's exact test) and significant thrombocytosis (p = 0.041, Fisher's exact test) compared to men, although no differences were found in risk stratification or treatment response. MCV values for women were significantly (p = 0.02, 2-sample t-test) lower than those for men, suggesting iron deficiency anemia. Focusing on ethnicity, Hispanics as a whole had significantly lower Hasford risk stratification (p = 0.046, Fisher's exact test), and significantly greater likelihood (p = 0.016, Fisher's exact test) of achieving 3-month complete haematological remission (CHR) compared with non-Hispanics at LAC+USC Medical Center, though differences in treatment outcome were no longer significant with analysis limited to patients treated with first-line imatinib. Conclusion Female CML patients at LAC+USC Medical Center present with more significant adverse pre-treatment prognostic factors compared to men, but achieve comparable outcomes. Hispanic patients present with lower risk profile CML and achieve better treatment responses compared to non-Hispanic patients as a whole; these ethnic differences are no longer significant when statistical analysis is limited to patients given imatinib as first-line therapy. Our patients achieve response rates inferior to those of large-scale national studies. This constellation of findings has not been reported in previous studies, and is likely reflective of a unique patient population. PMID:19630970

  18. The Effects of Small Sample Size on Identifying Polytomous DIF Using the Liu-Agresti Estimator of the Cumulative Common Odds Ratio

    ERIC Educational Resources Information Center

    Carvajal, Jorge; Skorupski, William P.

    2010-01-01

    This study is an evaluation of the behavior of the Liu-Agresti estimator of the cumulative common odds ratio when identifying differential item functioning (DIF) with polytomously scored test items using small samples. The Liu-Agresti estimator has been proposed by Penfield and Algina as a promising approach for the study of polytomous DIF but no…

  19. Lower eccentric hamstring strength and single leg hop for distance predict hamstring injury in PETE students.

    PubMed

    Goossens, L; Witvrouw, E; Vanden Bossche, L; De Clercq, D

    2015-01-01

    Hamstring injuries have not been under research in physical education teacher education (PETE) students so far. Within the frame of the development of an injury prevention program, for this study we conducted an analysis of modifiable risk factors for hamstring injuries in PETE students. Hamstring injuries of 102 freshmen bachelor PETE students were registered prospectively during one academic year. Eighty-one students completed maximum muscle strength tests of hip extensors, hamstrings, quadriceps (isometric) and hamstrings (eccentric) at the start of the academic year. Sixty-nine of the latter completed a single leg hop for distance (SLHD). Risk factors for hamstring injuries were statistically detected using logistic regression. Sixteen hamstring injuries (0.16 injuries/student/academic year; 0.46 injuries/1000 h) occurred to 10 participants. Eight cases were included in the risk factor analysis. Lower eccentric hamstring strength (odds ratio (ODD) = 0.977; p = 0.043), higher isometric/eccentric hamstring strength ratio (ODD = 970.500; p = 0.019) and lower score on the SLHD (ODD = 0.884; p = 0.005) were significant risk factors for hamstring injury. A combination of eccentric hamstring strength test and SLHD could give a good risk analysis of hamstring injuries in PETE students. This might offer great perspectives for easily applicable screening in a clinical setting.

  20. The Risk of Adverse Impact in Selections Based on a Test with Known Effect Size

    ERIC Educational Resources Information Center

    De Corte, Wilfried; Lievens, Filip

    2005-01-01

    The authors derive the exact sampling distribution function of the adverse impact (AI) ratio for single-stage, top-down selections using tests with known effect sizes. Subsequently, it is shown how this distribution function can be used to determine the risk that a future selection decision on the basis of such tests will result in an outcome that…

  1. 47 CFR 11.61 - Tests of EAS procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... EAS header codes, Attention Signal, Test Script and EOM code. (i) Tests in odd numbered months shall... substitute for a monthly test, activation must include transmission of the EAS header codes, Attention Signal, emergency message and EOM code and comply with the visual message requirements in § 11.51. To substitute for...

  2. The mechanical and microbiological integrity of surgical gloves.

    PubMed

    Jamal, Ala; Wilkinson, Stephen

    2003-03-01

    Several manufacturers supply surgical gloves that have been individually tested (IT) for leaks. Other manufacturers supply gloves in which sample gloves from each batch are tested for leaks (batch tested: BT). The latter brands may be rejected by surgeons because of presumed increased risk of wound infection and staff exposure to patient pathogens. The influence of differences between glove brands on performance in surgery has not been extensively studied. The aims of the present study were to test the mechanical and microbiological integrity of IT compared to BT gloves. A total of 110 unused gloves from each of an IT and a BT brand were tested for leaks, first, by observation of water-jets from water-filled gloves and second, by measuring electrical resistance between inside and outside the glove surfaces, to give a baseline measure. A total of 304 IT and 280 BT gloves were then similarly leak-tested after 98 clean surgical procedures. The hands and gloves of scrub team members were cultured postsurgery. A total of 1/110 BT and 0/110 IT unused gloves contained leaks (NS, Fisher's exact test). Operative perforation rates were lower for BT compared with IT (8/280 cf. 22/304; P < 0.05 Fisher's exact test). There was no bias in types of operations or scrub team members to account for the difference. Growth of normal skin flora was found on virtually every wearer's hands post-operatively. Similar bacteria were frequently cultured from the outside of gloves at the conclusion of surgery (111/152 pairs IT cf. 122/140 pairs BT; P < 0.01, Fisher's exact test). This study provides evidence that the clinical performance of BT gloves is no different to IT gloves. There was no significant difference in mechanical leak rates for unused gloves. Paradoxically, although IT gloves were more likely to show macro-perforations after surgery, the incidence of contamination on the surface of BT gloves was greater, possibly reflecting a qualitative difference in glove material. This study suggests that both types of gloves develop microporosity during use, which may allow transfer of bacteria from the surgeon's skin to the surface of the glove.

  3. Bottom-up attention capture with distractor and target singletons defined in the same (color) dimension is not a matter of feature uncertainty.

    PubMed

    Weichselbaum, Hanna; Ansorge, Ulrich

    2018-05-18

    In visual search, attention capture by an irrelevant color-singleton distractor in another feature dimension than the target is dependent on whether or not the distractor changes its feature: Capture is present if the irrelevant color distractor can take on different features across trials, but absent if the distractor takes on only one feature throughout all trials. This influence could be due to down-weighting of the entire color map. Here we tested whether a similar effect could also be brought about by down-weighting of specific color channels within the same maps. We investigated whether a similar dependence of capture on color certainty might hold true if the distractor were defined in the same (color) dimension as the target. At odds with this possibility, in the first and third blocks-in which feature uncertainty was absent-an irrelevant distractor of a certain color captured attention. In addition, in a second block, varying the distractor color created feature uncertainty, but this did not increase capture. Repeating the exact same procedure with the same participants after one week confirmed the stability of the results. The present study showed that a color distractor presented in the same (color) dimension as the target captures attention independent of feature uncertainty. Thus, the down-weighting of single irrelevant color channels within the same feature map used for target search is not a matter of feature uncertainty.

  4. Characteristics of pyogenic liver abscess patients with and without diabetes mellitus.

    PubMed

    Foo, Ning-Ping; Chen, Kuo-Tai; Lin, Hung-Jung; Guo, How-Ran

    2010-02-01

    Pyogenic liver abscess (PLA) is relatively common in patients with diabetes mellitus (DM), but it is unclear whether there are differences between patients with and without DM. We conducted a study to identify the possible differences and factors that affect fatality. We included PLA patients treated at a medical center from April 2001 to March 2004 and compared the clinical characteristics of patients with and without DM. We applied chi-square, Fisher's exact, and t-tests to evaluate the differences between the two groups and used logistic regressions to identify predictors of fatality. Of the 377 patients included, 182 (48.3%) had DM. Patients with DM had higher prevalence rates of cryptogenic etiology, gas-forming nature, thrombocytopenia, hyperglycemia, growth of Klebsiella pneumonia in blood cultures, metastatic infection, and bacteremia, but lower prevalence rates of biliary origin, right upper quadrant pain, and growth of Escherichia coli in pus cultures. Whereas creatinine >1.3 mg/dl (adjusted odds ratio (OR) 7.3, 95% confidence interval (CI) 2.2-24.5) and gas-forming nature (adjusted OR 9.4, 95% CI 3.0-24.5) were predictors of fatality, DM was not. We discovered that C-reactive protein and neutrophil were good biomarkers of PLA, but not asparate aminotransferase and alanine aminotransferase. PLA patients with and without DM have different clinical characteristics, but DM is not a predictor of fatality. We have identified several biomarkers that might help reduce the misdiagnosis of PLA.

  5. A Standardized DNA Variant Scoring System for Pathogenicity Assessments in Mendelian Disorders

    PubMed Central

    Karbassi, Izabela; Maston, Glenn A.; Love, Angela; DiVincenzo, Christina; Braastad, Corey D.; Elzinga, Christopher D.; Bright, Alison R.; Previte, Domenic; Zhang, Ke; Rowland, Charles M.; McCarthy, Michele; Lapierre, Jennifer L.; Dubois, Felicita; Medeiros, Katelyn A.; Batish, Sat Dev; Jones, Jeffrey; Liaquat, Khalida; Hoffman, Carol A.; Jaremko, Malgorzata; Wang, Zhenyuan; Sun, Weimin; Buller‐Burckle, Arlene; Strom, Charles M.; Keiles, Steven B.

    2015-01-01

    ABSTRACT We developed a rules‐based scoring system to classify DNA variants into five categories including pathogenic, likely pathogenic, variant of uncertain significance (VUS), likely benign, and benign. Over 16,500 pathogenicity assessments on 11,894 variants from 338 genes were analyzed for pathogenicity based on prediction tools, population frequency, co‐occurrence, segregation, and functional studies collected from internal and external sources. Scores were calculated by trained scientists using a quantitative framework that assigned differential weighting to these five types of data. We performed descriptive and comparative statistics on the dataset and tested interobserver concordance among the trained scientists. Private variants defined as variants found within single families (n = 5,182), were either VUS (80.5%; n = 4,169) or likely pathogenic (19.5%; n = 1,013). The remaining variants (n = 6,712) were VUS (38.4%; n = 2,577) or likely benign/benign (34.7%; n = 2,327) or likely pathogenic/pathogenic (26.9%, n = 1,808). Exact agreement between the trained scientists on the final variant score was 98.5% [95% confidence interval (CI) (98.0, 98.9)] with an interobserver consistency of 97% [95% CI (91.5, 99.4)]. Variant scores were stable and showed increasing odds of being in agreement with new data when re‐evaluated periodically. This carefully curated, standardized variant pathogenicity scoring system provides reliable pathogenicity scores for DNA variants encountered in a clinical laboratory setting. PMID:26467025

  6. A Standardized DNA Variant Scoring System for Pathogenicity Assessments in Mendelian Disorders.

    PubMed

    Karbassi, Izabela; Maston, Glenn A; Love, Angela; DiVincenzo, Christina; Braastad, Corey D; Elzinga, Christopher D; Bright, Alison R; Previte, Domenic; Zhang, Ke; Rowland, Charles M; McCarthy, Michele; Lapierre, Jennifer L; Dubois, Felicita; Medeiros, Katelyn A; Batish, Sat Dev; Jones, Jeffrey; Liaquat, Khalida; Hoffman, Carol A; Jaremko, Malgorzata; Wang, Zhenyuan; Sun, Weimin; Buller-Burckle, Arlene; Strom, Charles M; Keiles, Steven B; Higgins, Joseph J

    2016-01-01

    We developed a rules-based scoring system to classify DNA variants into five categories including pathogenic, likely pathogenic, variant of uncertain significance (VUS), likely benign, and benign. Over 16,500 pathogenicity assessments on 11,894 variants from 338 genes were analyzed for pathogenicity based on prediction tools, population frequency, co-occurrence, segregation, and functional studies collected from internal and external sources. Scores were calculated by trained scientists using a quantitative framework that assigned differential weighting to these five types of data. We performed descriptive and comparative statistics on the dataset and tested interobserver concordance among the trained scientists. Private variants defined as variants found within single families (n = 5,182), were either VUS (80.5%; n = 4,169) or likely pathogenic (19.5%; n = 1,013). The remaining variants (n = 6,712) were VUS (38.4%; n = 2,577) or likely benign/benign (34.7%; n = 2,327) or likely pathogenic/pathogenic (26.9%, n = 1,808). Exact agreement between the trained scientists on the final variant score was 98.5% [95% confidence interval (CI) (98.0, 98.9)] with an interobserver consistency of 97% [95% CI (91.5, 99.4)]. Variant scores were stable and showed increasing odds of being in agreement with new data when re-evaluated periodically. This carefully curated, standardized variant pathogenicity scoring system provides reliable pathogenicity scores for DNA variants encountered in a clinical laboratory setting. © 2015 The Authors. **Human Mutation published by Wiley Periodicals, Inc.

  7. The TNF-α -308 polymorphism may affect the severity of Crohn's disease

    PubMed Central

    Santana, Genoile; Bendicho, Maria Teresita; Santana, Tamara Celi; dos Reis, Lidiane Bianca; Lemaire, Denise; Lyra, André Castro

    2011-01-01

    OBJECTIVE: The goal of this project was to analyze the association between Crohn's disease, its clinical features, and the tumor necrosis factor alpha (TNF-α) -308 polymorphism. METHODS: This is a case-control and cross-sectional study that enrolled 91 patients with Crohn's disease and 91 controls. Patients with Crohn's disease were characterized according to the Montreal Classification, along with their clinical and surgical treatment history. Analysis of the TNF-α -308 polymorphism was performed using a commercial kit. A stratified analysis was applied using an OR (odds ratio) with a 95% confidence interval. The chi-square and Fisher's exact tests were utilized for analysis of the association between the polymorphism and the clinical features of Crohn's disease. RESULTS: The low producer predicted phenotype was present in 76.9% of Crohn's disease cases and 75.8% of controls (OR 0.94 [0.45-1.97]). The TNF2 allele and the high producer predicted phenotype were more frequent among patients with Crohn's disease penetrating behavior (p = 0.004). The TNF2 allele and the high producer predicted phenotype were also associated with a history of colectomy (p = 0.02), and the TNF2 allele was associated with small bowel resection (p = 0.03). CONCLUSIONS: The TNF-α -308 polymorphism appears to affect the severity of the disease. However, TNF-α -308 polymorphism does not appear to be important for the susceptibility in the development of Crohn's disease. PMID:21915486

  8. Déjà vu? A Comparison of Syphilis Outbreaks in Houston, Texas.

    PubMed

    Hallmark, Camden J; Hill, Mandy J; Luswata, Charles; Watkins, Kellie L; Thornton, Lupita; McNeese, Marlene; Ross, Michael W

    2016-09-01

    After reaching an all-time low in 2000, syphilis incidence in the United States has increased as the burden shifted from heterosexuals to men who have sex with men (MSM). Houston, Texas, experienced 2 outbreaks of syphilis during this transformation in trends. Further evaluation is necessary to determine if these outbreaks occurred among the same subpopulations. Surveillance data collected on all reported infectious syphilis cases in Houston from 1971 to 2013 were analyzed. Trends in incidence among MSM and human immunodeficiency virus-positive Houston residents were examined. Peak syphilis years subsequent to 1999, years 2007 and 2012, were compared to determine if outbreaks arose in distinctive subpopulations. Categorical variables between these years were compared using chi-square and Fisher's exact tests, whereas further associations between the years were evaluated using multivariable logistic regression. Incidence among MSM was 20.9 to 32.1 times higher than other men from 2005 to 2013. After adjusting for covariates, cases in 2012 were significantly more likely to be Hispanic (adjusted odds ratio [AOR] = 1.61; 95% confidence interval [95% CI], 1.03-2.53), reported meeting partners via the Internet (AOR, 1.74; 95% CI, 1.18-2.58), and engaged in anonymous sex (AOR, 1.92; 95% CI, 1.40-2.63) in comparison to cases in 2007. We found marked disparities of syphilis by subpopulation in Houston. Herein, we present evidence that outbreaks have been distinct in a major southern city with a high burden of syphilis.

  9. Outbreak of diffuse lamellar keratitis caused by marking-pen toxicity.

    PubMed

    Hadden, Osmond Bruce; McGhee, Charles N J; Morris, Antony Trevor; Gray, Trevor Buchanan; Ring, Charles Peter; Watson, Adam Stewart John

    2008-07-01

    To examine the evidence that a series of cases of diffuse lamellar keratitis (DLK) after laser in situ keratomileusis (LASIK) was caused by a type of marker pen. Eye Institute, Auckland, New Zealand. During a 10-week period, 522 consecutive LASIK procedures were performed using a 60 Hz IntraLase femtosecond laser (IntraLase Corp.) to create the LASIK flap and a 217Z 100 Hz excimer laser (Bausch & Lomb) to perform the refractive ablation. As standard practice, a marking pen was used to enable accurate flap realignment. Three weeks after a sudden increase in the incidence of DLK was identified, one of the 5 surgeons performed 5 consecutive bilateral cases using the marking pen in the right eyes but not in the left eyes. Of the 522 LASIK cases (119 without marking pen, 403 with marking pen), DLK developed in 49 (9.4%). No eye treated without the marking pen developed DLK; of those in which the marking pen was used, 49 (12.2%) developed DLK (P<0.0001, Fischer exact test; odds ratio, 27). In the 5 consecutive bilateral cases in which the marking pen was used in the right eye but not the left eye, 4 right eyes and no left eye developed DLK (P=0.03). Forty-five of the 49 eyes with DLK quickly recovered. The other 4 developed central toxic keratopathy. There is strong statistical evidence that the marking pen was a factor in the occurrence of DLK.

  10. Ethnic Differences for Developing Rheumatic Fever in a Low-Income Group Living in Hawaii

    PubMed Central

    Kurahara, David K.; Grandinetti, Andrew; Galario, Judith; Reddy, D. Venu; Tokuda, Angela; Langan, Susan; Tanabe, Brian; Yamamoto, Kara S.; Yamaga, Karen M.

    2006-01-01

    The risk factors responsible for acute rheumatic fever (ARF) are complex, in part, because group A streptococcus (GAS) infection is a prerequisite for this disease. We attempted to differentiate socioeconomic from genetic risk factors by studying subjects in a Hawaii pediatric cardiology clinic who qualified for Medicaid. This ethnically diverse group was unique because they maintained a low socioeconomic but generally healthy lifestyle with more limited risks than those living in extremely impoverished conditions. Methods Questionnaires were administered to consenting subjects in the clinic, who were divided into those diagnosed with ARF (n=26) and those with other (primarily congenital) heart diseases (n=41). Results The socioeconomic status of the ARF and non-ARF groups was lower than that of the Hawaii population in general, and little differences were noted between the groups. The ARF group, however, had slightly larger household sizes and more children than the non-ARF group. The greatest difference was in ethnicity. By the Fisher exact test, the number of Polynesians belonging to the ARF group was significantly greater than all other ethnicities (P=.005). Polynesians had an odds ratio >4.80 of developing ARF, which increased to 6.33 when number of children per household was considered. Conclusion The potential contribution of genetic predisposing factors for developing ARF was analyzed in subjects living in a homogeneously low socioeconomic level relative to the general Hawaii population. Polynesians were at highest risk when compared to other ethnicities living in similar socioeconomic conditions. PMID:17200684

  11. Noise-induced hearing loss still a problem in shipbuilders: a cross-sectional study in goa, India.

    PubMed

    Bhumika, N; Prabhu, Gv; Ferreira, Am; Kulkarni, Mk

    2013-01-01

    Workplace safety regulations seek to mitigate noise-induced hearing loss (NIHL), conventionally associated with the shipbuilding industry. Despite this, are workers still predisposed to NIHL? To study the prevalence of NIHL among noise-exposed subjects in the shipbuilding industry in Goa and to compare it with that among the non-exposed population working in the same industry in relation to certain relevant factors. This is a cross-sectional study in the shipbuilding industry, Goa This study examined 552 workers: 276 shipbuilders and 276 office staff, of similar age, duration of employment and socio-economic status working at a shipbuilding enterprise. An interviewer-administered questionnaire was followed by audiometry. Values were presented as percentages, Mean (SD) and odds ratio (OR) and its 95% confidence interval (CI) (Woolfe's method). Fisher's exact test and binary logistic regression were used. P value of < 0.05 was taken as significant. SPSS version 16 was used. NIHL was found in 17 (6%) shipbuilders, while no office staff was detected to have this condition (OR = 37.29, 95% CI 22.42-62.18). The shipbuilders with NIHL were 52.5 years of age and had been employed for 30.4 years, on an average. None of the 17 cases of NIHL were found to be using earplugs consistently; 11 reported using them "sometimes" and six "never" used them. NIHL continues to affect shipbuilders, owing their non-compliance to workplace regulation. Health education is the need of the hour.

  12. Prevalence and risk factors for Staphylococcus aureus and methicillin-resistant Staphylococcus aureus nasal carriage inpatients in a tertiary care hospital's chest clinic in Turkey.

    PubMed

    Oguzkaya-Artan, M; Artan, C; Baykan, Z

    2016-01-01

    We aimed to determine the prevalence and associated risk factors for nasal methicillin-sensitive and methicillin-resistant Staphylococcus aureus (MSSA/MRSA) carriage among patients admitted to a chest clinic of a tertiary care hospital in this study. Nasal samples were taken from anterior nares were cultured in CHROMagar S. aureus plates, MRSA was determined by disc diffusion method (cefoxitin 30 μg) according to the Clinical and Laboratory Standards Institute guidelines and CHROMagar MRSA plates. A questionnaire was applied to determine the demographic characteristics of the participants and risk factors for carriage. Fisher's exact test, univariate and multivariate logistic regression analysis were used. A P < 0.05 indicated a statistically significant difference. This is a cross-sectional study covering all the patients (n = 431) admitted to Kayseri Training and Research Hospital's Chest Clinic from January 1st to 31st 2014. Of all these patients 55 (12.8%) were nasal S. aureus carriers. MRSA positivity was in five among these patients. In multivariate analysis, being under 65 years of age (odds ratio [OR], 1.9; 95% confidence interval [CI], 1.0-3.3), and having prosthesis (OR, 4.8; 95% CI, 1.6-13.9) were found as risk factors for MSSA colonization. The prevalence of nasal carriage of MSSA was low in our study population. The only risk factors playing role in carriage were found as being under the age of 65 and having prosthesis.

  13. Quick Phases of Infantile Nystagmus Show the Saccadic Inhibition Effect

    PubMed Central

    Harrison, James J.; Sumner, Petroc; Dunn, Matt J.; Erichsen, Jonathan T.; Freeman, Tom C. A.

    2015-01-01

    Purpose. Infantile nystagmus (IN) is a pathological, involuntary oscillation of the eyes consisting of slow, drifting eye movements interspersed with rapid reorienting quick phases. The extent to which quick phases of IN are programmed similarly to saccadic eye movements remains unknown. We investigated whether IN quick phases exhibit ‘saccadic inhibition,' a phenomenon typically related to normal targeting saccades, in which the initiation of the eye movement is systematically delayed by task-irrelevant visual distractors. Methods. We recorded eye position from 10 observers with early-onset idiopathic nystagmus while task-irrelevant distractor stimuli were flashed along the top and bottom of a large screen at ±10° eccentricity. The latency distributions of quick phases were measured with respect to these distractor flashes. Two additional participants, one with possible albinism and one with fusion maldevelopment nystagmus syndrome, were also tested. Results. All observers showed that a distractor flash delayed the execution of quick phases that would otherwise have occurred approximately 100 ms later, exactly as in the standard saccadic inhibition effect. The delay did not appear to differ between the two main nystagmus types under investigation (idiopathic IN with unidirectional and bidirectional jerk). Conclusions. The presence of the saccadic inhibition effect in IN quick phases is consistent with the idea that quick phases and saccades share a common programming pathway. This could allow quick phases to take on flexible, goal-directed behavior, at odds with the view that IN quick phases are stereotyped, involuntary eye movements. PMID:25670485

  14. IMPACT OF INTERNAL LIMITING MEMBRANE PEELING ON MACULAR HOLE REOPENING: A Systematic Review and Meta-Analysis.

    PubMed

    Rahimy, Ehsan; McCannel, Colin A

    2016-04-01

    To assess the literature regarding macular hole reopening rates stratified by whether the internal limiting membrane (ILM) was peeled during vitrectomy surgery. Systematic review and meta-analysis of studies reporting on macular hole reopenings among previously surgically closed idiopathic macular holes. A comprehensive literature search using the National Library of Medicine PubMed interface was used to identify potentially eligible publications in English. The minimum mean follow-up period for reports to be included in this study was 12 months. Analysis was divided into eyes that underwent vitrectomy with and without ILM peeling. The primary outcome parameter was the proportion of macular hole reopenings among previously closed holes between the two groups. Secondary outcome parameters included duration from initial surgery to hole reopening and preoperative and postoperative best-corrected correct visual acuities among the non-ILM peeling and ILM peeling groups. A total of 50 publications reporting on 5,480 eyes met inclusion criteria and were assessed in this meta-analysis. The reopening rate without ILM peeling was 7.12% (125 of 1,756 eyes), compared with 1.18% (44 of 3,724 eyes) with ILM peeling (odds ratio: 0.16; 95% confidence interval: 0.11-0.22; Fisher's exact test: P < 0.0001). There were no other identifiable associations or risk factors for reopening. The results of this meta-analysis support the concept that ILM peeling during macular hole surgery reduces the likelihood of macular hole reopening.

  15. EFHC1 variants in juvenile myoclonic epilepsy: reanalysis according to NHGRI and ACMG guidelines for assigning disease causality.

    PubMed

    Bailey, Julia N; Patterson, Christopher; de Nijs, Laurence; Durón, Reyna M; Nguyen, Viet-Huong; Tanaka, Miyabi; Medina, Marco T; Jara-Prado, Aurelio; Martínez-Juárez, Iris E; Ochoa, Adriana; Molina, Yolli; Suzuki, Toshimitsu; Alonso, María E; Wight, Jenny E; Lin, Yu-Chen; Guilhoto, Laura; Targas Yacubian, Elza Marcia; Machado-Salas, Jesús; Daga, Andrea; Yamakawa, Kazuhiro; Grisar, Thierry M; Lakaye, Bernard; Delgado-Escueta, Antonio V

    2017-02-01

    EFHC1 variants are the most common mutations in inherited myoclonic and grand mal clonic-tonic-clonic (CTC) convulsions of juvenile myoclonic epilepsy (JME). We reanalyzed 54 EFHC1 variants associated with epilepsy from 17 cohorts based on National Human Genome Research Institute (NHGRI) and American College of Medical Genetics and Genomics (ACMG) guidelines for interpretation of sequence variants. We calculated Bayesian LOD scores for variants in coinheritance, unconditional exact tests and odds ratios (OR) in case-control associations, allele frequencies in genome databases, and predictions for conservation/pathogenicity. We reviewed whether variants damage EFHC1 functions, whether efhc1 -/- KO mice recapitulate CTC convulsions and "microdysgenesis" neuropathology, and whether supernumerary synaptic and dendritic phenotypes can be rescued in the fly model when EFHC1 is overexpressed. We rated strengths of evidence and applied ACMG combinatorial criteria for classifying variants. Nine variants were classified as "pathogenic," 14 as "likely pathogenic," 9 as "benign," and 2 as "likely benign." Twenty variants of unknown significance had an insufficient number of ancestry-matched controls, but ORs exceeded 5 when compared with racial/ethnic-matched Exome Aggregation Consortium (ExAC) controls. NHGRI gene-level evidence and variant-level evidence establish EFHC1 as the first non-ion channel microtubule-associated protein whose mutations disturb R-type VDCC and TRPM2 calcium currents in overgrown synapses and dendrites within abnormally migrated dislocated neurons, thus explaining CTC convulsions and "microdysgenesis" neuropathology of JME.Genet Med 19 2, 144-156.

  16. Analysis of a RECQL splicing mutation, c.1667_1667+3delAGTA, in breast cancer patients and controls from Central Europe.

    PubMed

    Bogdanova, Natalia; Pfeifer, Katja; Schürmann, Peter; Antonenkova, Natalia; Siggelkow, Wulf; Christiansen, Hans; Hillemanns, Peter; Park-Simon, Tjoung-Won; Dörk, Thilo

    2017-04-01

    RECQL is a DNA helicase required for genomic stability. Two studies have recently identified RECQL as a novel breast cancer susceptibility gene. The most common RECQL mutation, the 4 bp-deletion c.1667_1667+3delAGTA, was five-fold enriched in Polish breast cancer patients, but the exact magnitude of the risk is uncertain. We investigated two hospital-based breast cancer case-control series from Belarus and Germany, respectively, comprising a total of 2596 breast cancer patients and 2132 healthy females. The mutation was found in 9 cases and 6 controls, with an adjusted Odds Ratio 1.23 (95% CI 0.44-3.47; p = 0.69) in the combined analysis. Among the cases, heterozygosity for c.1667_1667+3delAGTA was linked with estrogen-receptor positive breast cancer. There was no significant difference in age at diagnosis between carriers and non-carriers, and only one of the carriers reported a first-degree family history. Meta-analysis with the initial study from Poland suggests an about two-fold increase in risk for this mutation (OR 2.51; 95% CI 1.13-5.57, p = 0.02). Altogether, the data indicate that RECQL* c.1667_1667+3delAGTA is not a high-risk mutation for breast cancer though it could represent a moderate-risk breast cancer susceptibility allele. Further studies will be required to determine the clinical significance of testing for this RECQL mutation.

  17. Relationship between funding source and conclusion among nutrition-related scientific articles.

    PubMed

    Lesser, Lenard I; Ebbeling, Cara B; Goozner, Merrill; Wypij, David; Ludwig, David S

    2007-01-01

    Industrial support of biomedical research may bias scientific conclusions, as demonstrated by recent analyses of pharmaceutical studies. However, this issue has not been systematically examined in the area of nutrition research. The purpose of this study is to characterize financial sponsorship of scientific articles addressing the health effects of three commonly consumed beverages, and to determine how sponsorship affects published conclusions. Medline searches of worldwide literature were used to identify three article types (interventional studies, observational studies, and scientific reviews) about soft drinks, juice, and milk published between 1 January, 1999 and 31 December, 2003. Financial sponsorship and article conclusions were classified by independent groups of coinvestigators. The relationship between sponsorship and conclusions was explored by exact tests and regression analyses, controlling for covariates. 206 articles were included in the study, of which 111 declared financial sponsorship. Of these, 22% had all industry funding, 47% had no industry funding, and 32% had mixed funding. Funding source was significantly related to conclusions when considering all article types (p = 0.037). For interventional studies, the proportion with unfavorable conclusions was 0% for all industry funding versus 37% for no industry funding (p = 0.009). The odds ratio of a favorable versus unfavorable conclusion was 7.61 (95% confidence interval 1.27 to 45.73), comparing articles with all industry funding to no industry funding. Industry funding of nutrition-related scientific articles may bias conclusions in favor of sponsors' products, with potentially significant implications for public health.

  18. Associations Between Religion-Related Factors and Cervical Cancer Screening Among Muslims in Greater Chicago

    PubMed Central

    Padela, Aasim I.; Peek, Monica; Johnson-Agbakwu, Crista E.; Hosseinian, Zahra; Curlin, Farr

    2015-01-01

    Objective This study aimed to assess rates of Papanicolaou (Pap) testing and associations between religion-related factors and these rates among a racially and ethnically diverse sample of American Muslim women. Materials and Methods A community-based participatory research design was used in partnering with the Council of Islamic Organizations of Greater Chicago to recruit Muslim women attending mosque and community events. These participants self-administered surveys incorporating measures of fatalism, religiosity, perceived discrimination, Islamic modesty, and a marker of Pap test use. Results A total of 254 survey respondents were collected with nearly equal numbers of Arabs, South Asians, and African American respondents. Of these respondents, 84% had obtained a Pap test in their lifetime, with individuals who interpret disease as a manifestation of God’s punishment having a lower odds of having had Pap testing after controlling for sociodemographic factors (odds ratio [OR] = 0.87, 95% CI = 0.77–1.0). In multivariate models, living in the United States for more than 20 years (OR = 4.7, 95% CI = 1.4–16) and having a primary care physician (OR = 7.7, 95% CI = 2.5–23.4) were positive predictors of having had a Pap test. Ethnicity, fatalistic beliefs, perceived discrimination, and modesty levels were not significantly associated with Pap testing rates. Conclusions To our knowledge, this is the first study to assess Pap testing behaviors among a diverse sample of American Muslim women and to observe that negative religious coping (e.g., viewing health problems as a punishment from God) is associated with a lower odds of obtaining a Pap test. The relationship between religious coping and cancer screening behaviors deserves further study so that religious values can be appropriately addressed through cancer screening programs. PMID:24914883

  19. Using permutations to detect dependence between time series

    NASA Astrophysics Data System (ADS)

    Cánovas, Jose S.; Guillamón, Antonio; Ruíz, María del Carmen

    2011-07-01

    In this paper, we propose an independence test between two time series which is based on permutations. The proposed test can be carried out by means of different common statistics such as Pearson’s chi-square or the likelihood ratio. We also point out why an exact test is necessary. Simulated and real data (return exchange rates between several currencies) reveal the capacity of this test to detect linear and nonlinear dependences.

  20. Risk factors for genital human papillomavirus among men in Tanzania.

    PubMed

    Olesen, Tina Bech; Mwaiselage, Julius; Iftner, Thomas; Kahesa, Crispin; Rasch, Vibeke; Frederiksen, Kirsten; Munk, Christian; Kjaer, Susanne K

    2017-02-01

    The objective of the study was to assess risk factors for Human Papillomavirus (HPV) among men in Tanzania, both overall and in relation to HIV status. In a cross-sectional study conducted among 1,813 men in Tanzania, penile swabs were tested for HPV using Hybrid Capture 2 (HC2). Study participants were offered HIV testing. Risk factors for HPV (HC2 high-risk and/or low-risk positivity) were assessed using logistic regression with adjustment for age, lifetime number of sexual partners, and HIV status. Altogether, 372 men (20.5%) were HPV-positive. Among men tested for HIV (n = 1,483), the HIV prevalence was 9.4%. The odds ratio (OR) of HPV increased with increasing age. HIV-positivity was associated with an increased odds ratio of HPV (OR = 1.91; 95%CI: 1.30-2.82), whereas the odds of HPV tended to be lower in circumcised men than in uncircumcised men (OR = 0.77; 95%CI: 0.54-1.09). When stratifying by HIV status, we found lower odds of HPV in overweight HIV-positive men (BMI > 25) than in normal weight HIV-positive men (OR = 0.25; 95%CI: 0.08-0.78). This did not apply to HIV-negative men. Circumcision tended to decrease the odds of HPV both in HIV-positive men and in HIV-negative men, although not being statistically significant. In conclusion, HIV is a strong risk factor for HPV among men in Tanzania. Additionally, in HIV-positive men a high BMI seems to be associated with a lower risk of HPV. Finally, we observed a tendency toward a lower risk of HPV both among HIV-positive and HIV-negative circumcised men compared to their uncircumcised counterparts. J. Med. Virol. 89:345-351, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

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