Latino children's body mass index at 2-3.5 years predicts sympathetic nervous system activity at 5 years.

PubMed

Alkon, Abbey; Harley, Kim G; Neilands, Torsten B; Tambellini, Katelyn; Lustig, Robert H; Boyce, W Thomas; Eskenazi, Brenda

2014-06-01

To understand whether the relationship between young children's autonomic nervous system (ANS) responses predicted their BMI, or vice versa, the association between standardized BMI (zBMI) at 2, 3.5, and 5 years of age and ANS reactivity at 3.5-5 years of age, and whether zBMI predicts later ANS reactivity or whether early ANS reactivity predicts later zBMI, was studied. Low-income, primarily Latino children (n=112) were part of a larger cohort study of mothers recruited during early pregnancy. Study measures included maternal prenatal weight, children's health behaviors (i.e., time watching television, fast food consumption, and time playing outdoors), children's height and weight at 2, 3.5, and 5 years, and children's ANS reactivity at 3.5 and 5 years. ANS measures of sympathetic nervous system (i.e., pre-ejection period) and parasympathetic nervous system (i.e., respiratory sinus arrhythmia) activity were monitored during rest and four challenges. Reactivity was calculated as the difference between mean challenge response and rest. Structural equation models analyzed the relationship between children's zBMI at 2, 3.5, and 5 years and ANS reactivity at 3.5 and 5 years, adjusting for mother's BMI, children's behaviors, and changes in height. There was no association between zBMI and ANS cross-sectionally. Children with high zBMI at 2 or 3.5 years or large zBMI increases from 2 to 3.5 years of age had decreased sympathetic activity at 5 years. Neither sympathetic nor parasympathetic reactivity at 3.5 years predicted later zBMI. Increased zBMI early in childhood may dampen young children's SNS responses later in life.

External validation of a 5-year survival prediction model after elective abdominal aortic aneurysm repair.

PubMed

DeMartino, Randall R; Huang, Ying; Mandrekar, Jay; Goodney, Philip P; Oderich, Gustavo S; Kalra, Manju; Bower, Thomas C; Cronenwett, Jack L; Gloviczki, Peter

2018-01-01

The benefit of prophylactic repair of abdominal aortic aneurysms (AAAs) is based on the risk of rupture exceeding the risk of death from other comorbidities. The purpose of this study was to validate a 5-year survival prediction model for patients undergoing elective repair of asymptomatic AAA <6.5 cm to assist in optimal selection of patients. All patients undergoing elective repair for asymptomatic AAA <6.5 cm (open or endovascular) from 2002 to 2011 were identified from a single institutional database (validation group). We assessed the ability of a prior published Vascular Study Group of New England (VSGNE) model (derivation group) to predict survival in our cohort. The model was assessed for discrimination (concordance index), calibration (calibration slope and calibration in the large), and goodness of fit (score test). The VSGNE derivation group consisted of 2367 patients (70% endovascular). Major factors associated with survival in the derivation group were age, coronary disease, chronic obstructive pulmonary disease, renal function, and antiplatelet and statin medication use. Our validation group consisted of 1038 patients (59% endovascular). The validation group was slightly older (74 vs 72 years; P < .01) and had a higher proportion of men (76% vs 68%; P < .01). In addition, the derivation group had higher rates of advanced cardiac disease, chronic obstructive pulmonary disease, and baseline creatinine concentration (1.2 vs 1.1 mg/dL; P < .01). Despite slight differences in preoperative patient factors, 5-year survival was similar between validation and derivation groups (75% vs 77%; P = .33). The concordance index of the validation group was identical between derivation and validation groups at 0.659 (95% confidence interval, 0.63-0.69). Our validation calibration in the large value was 1.02 (P = .62, closer to 1 indicating better calibration), calibration slope of 0.84 (95% confidence interval, 0.71-0.97), and score test of P = .57 (>.05

A Five-Year CMAQ PM2.5 Model Performance for Wildfires and Prescribed Fires

NASA Astrophysics Data System (ADS)

Wilkins, J. L.; Pouliot, G.; Foley, K.; Rappold, A.; Pierce, T. E.

2016-12-01

Biomass burning has been identified as an important contributor to the degradation of air quality because of its impact on ozone and particulate matter. Two components of the biomass burning inventory, wildfires and prescribed fires are routinely estimated in the national emissions inventory. However, there is a large amount of uncertainty in the development of these emission inventory sectors. We have completed a 5 year set of CMAQ model simulations (2008-2012) in which we have simulated regional air quality with and without the wildfire and prescribed fire inventory. We will examine CMAQ model performance over regions with significant PM2.5 and Ozone contribution from prescribed fires and wildfires. We will also review plume rise to see how it affects model bias and compare CMAQ current fire emissions input to an hourly dataset from FLAMBE.

Examining a conceptual model of parental nurturance, parenting practices and physical activity among 5-6 year olds.

PubMed

Sebire, Simon J; Jago, Russell; Wood, Lesley; Thompson, Janice L; Zahra, Jezmond; Lawlor, Deborah A

2016-01-01

Parenting is an often-studied correlate of children's physical activity, however there is little research examining the associations between parenting styles, practices and the physical activity of younger children. This study aimed to investigate whether physical activity-based parenting practices mediate the association between parenting styles and 5-6 year-old children's objectively-assessed physical activity. 770 parents self-reported parenting style (nurturance and control) and physical activity-based parenting practices (logistic and modeling support). Their 5-6 year old child wore an accelerometer for five days to measure moderate-to-vigorous physical activity (MVPA). Linear regression was used to examine direct and indirect (mediation) associations. Data were collected in the United Kingdom in 2012/13 and analyzed in 2014. Parent nurturance was positively associated with provision of modeling (adjusted unstandardized coefficient, β = 0.11; 95% CI = 0.02, 0.21) and logistic support (β = 0.14; 0.07, 0.21). Modeling support was associated with greater child MVPA (β = 2.41; 0.23, 4.60) and a small indirect path from parent nurturance to child's MVPA was identified (β = 0.27; 0.04, 0.70). Physical activity-based parenting practices are more strongly associated with 5-6 year old children's MVPA than parenting styles. Further research examining conceptual models of parenting is needed to understand in more depth the possible antecedents to adaptive parenting practices beyond parenting styles. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Marker-based or model-based RSA for evaluation of hip resurfacing arthroplasty? A clinical validation and 5-year follow-up.

PubMed

Lorenzen, Nina Dyrberg; Stilling, Maiken; Jakobsen, Stig Storgaard; Gustafson, Klas; Søballe, Kjeld; Baad-Hansen, Thomas

2013-11-01

The stability of implants is vital to ensure a long-term survival. RSA determines micro-motions of implants as a predictor of early implant failure. RSA can be performed as a marker- or model-based analysis. So far, CAD and RE model-based RSA have not been validated for use in hip resurfacing arthroplasty (HRA). A phantom study determined the precision of marker-based and CAD and RE model-based RSA on a HRA implant. In a clinical study, 19 patients were followed with stereoradiographs until 5 years after surgery. Analysis of double-examination migration results determined the clinical precision of marker-based and CAD model-based RSA, and at the 5-year follow-up, results of the total translation (TT) and the total rotation (TR) for marker- and CAD model-based RSA were compared. The phantom study showed that comparison of the precision (SDdiff) in marker-based RSA analysis was more precise than model-based RSA analysis in TT (p CAD < 0.001; p RE = 0.04) and TR (p CAD = 0.01; p RE < 0.001). The clinical precision (double examination in 8 patients) comparing the precision SDdiff was better evaluating the TT using the marker-based RSA analysis (p = 0.002), but showed no difference between the marker- and CAD model-based RSA analysis regarding the TR (p = 0.91). Comparing the mean signed values regarding the TT and the TR at the 5-year follow-up in 13 patients, the TT was lower (p = 0.03) and the TR higher (p = 0.04) in the marker-based RSA compared to CAD model-based RSA. The precision of marker-based RSA was significantly better than model-based RSA. However, problems with occluded markers lead to exclusion of many patients which was not a problem with model-based RSA. HRA were stable at the 5-year follow-up. The detection limit was 0.2 mm TT and 1° TR for marker-based and 0.5 mm TT and 1° TR for CAD model-based RSA for HRA.

Examining a conceptual model of parental nurturance, parenting practices and physical activity among 5–6 year olds

PubMed Central

Sebire, Simon J.; Jago, Russell; Wood, Lesley; Thompson, Janice L.; Zahra, Jezmond; Lawlor, Deborah A.

2016-01-01

Rationale Parenting is an often-studied correlate of children's physical activity, however there is little research examining the associations between parenting styles, practices and the physical activity of younger children. Objective This study aimed to investigate whether physical activity-based parenting practices mediate the association between parenting styles and 5–6 year-old children's objectively-assessed physical activity. Methods 770 parents self-reported parenting style (nurturance and control) and physical activity-based parenting practices (logistic and modeling support). Their 5–6 year old child wore an accelerometer for five days to measure moderate-to-vigorous physical activity (MVPA). Linear regression was used to examine direct and indirect (mediation) associations. Data were collected in the United Kingdom in 2012/13 and analyzed in 2014. Results Parent nurturance was positively associated with provision of modeling (adjusted unstandardized coefficient, β = 0.11; 95% CI = 0.02, 0.21) and logistic support (β = 0.14; 0.07, 0.21). Modeling support was associated with greater child MVPA (β = 2.41; 0.23, 4.60) and a small indirect path from parent nurturance to child's MVPA was identified (β = 0.27; 0.04, 0.70). Conclusions Physical activity-based parenting practices are more strongly associated with 5–6 year old children's MVPA than parenting styles. Further research examining conceptual models of parenting is needed to understand in more depth the possible antecedents to adaptive parenting practices beyond parenting styles. PMID:26647364

Risk factors for breast cancer in postmenopausal Caucasian and Chinese-Canadian women.

PubMed

Tam, Carolyn Y; Martin, Lisa J; Hislop, Gregory; Hanley, Anthony J; Minkin, Salomon; Boyd, Norman F

2010-01-01

Striking differences exist between countries in the incidence of breast cancer. The causes of these differences are unknown, but because incidence rates change in migrants, they are thought to be due to lifestyle rather than genetic differences. The goal of this cross-sectional study was to examine breast cancer risk factors in populations with different risks for breast cancer. We compared breast cancer risk factors among three groups of postmenopausal Canadian women at substantially different risk of developing breast cancer - Caucasians (N = 413), Chinese women born in the West or who migrated to the West before age 21 (N = 216), and recent Chinese migrants (N = 421). Information on risk factors and dietary acculturation were collected by telephone interviews using questionnaires, and anthropometric measurements were taken at a home visit. Compared to Caucasians, recent Chinese migrants weighed on average 14 kg less, were 6 cm shorter, had menarche a year later, were more often parous, less often had a family history of breast cancer or a benign breast biopsy, a higher Chinese dietary score, and a lower Western dietary score. For most of these variables, Western born Chinese and early Chinese migrants had values intermediate between those of Caucasians and recent Chinese migrants. We estimated five-year absolute risks for breast cancer using the Gail Model and found that risk estimates in Caucasians would be reduced by only 11% if they had the risk factor profile of recent Chinese migrants for the risk factors in the Gail Model. Our results suggest that in addition to the risk factors in the Gail Model, there likely are other factors that also contribute to the large difference in breast cancer risk between Canada and China.

29 CFR 4010.5 - Information year.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 9 2012-07-01 2012-07-01 false Information year. 4010.5 Section 4010.5 Labor Regulations... REQUIREMENTS ANNUAL FINANCIAL AND ACTUARIAL INFORMATION REPORTING § 4010.5 Information year. (a) Determinations based on information year. An information year is used under this part to determine which persons are...

29 CFR 4010.5 - Information year.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 9 2013-07-01 2013-07-01 false Information year. 4010.5 Section 4010.5 Labor Regulations... REQUIREMENTS ANNUAL FINANCIAL AND ACTUARIAL INFORMATION REPORTING § 4010.5 Information year. (a) Determinations based on information year. An information year is used under this part to determine which persons are...

29 CFR 4010.5 - Information year.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 9 2010-07-01 2010-07-01 false Information year. 4010.5 Section 4010.5 Labor Regulations... REQUIREMENTS ANNUAL FINANCIAL AND ACTUARIAL INFORMATION REPORTING § 4010.5 Information year. (a) Determinations based on information year. An information year is used under this part to determine which persons are...

Lomb-Scargle periodogram analysis of the periods around 5.5 year and 11 year in the international sunspot numbers

NASA Astrophysics Data System (ADS)

Zhu, F. R.; Jia, H. Y.

2018-07-01

The New International Sunspot Numbers (NISNs) have been successfully compiled and can be downloaded from the World Data Center-Sunspot index and Long-term Solar Observations, Royal Observatory of Belgium, Brussels. The periods in these NISNs have been studied by using the Lomb-Scargle periodogram. The results show that the international sunspot numbers have a lot of periods. Of the various periods, the most outstanding period around 11 year is 10.108 year after removing the 10.862 year signal from the time series of sunspot numbers, while the periods of 11.988 year, 7.990 year, 9.612 year, 5.445 year, 8.915 year, 5.792 year are also found with the period of 5.445 year being stronger than those of 5.792 year and 8.915 year. However, the period of 5.445 year is still much weaker than the period of 10.862 year. It is evident that the periods around 11 year and 5.5 year in the revised international sunspot numbers obtained by using the Lomb-Scargle periodogram method is somewhat different from the ones in previous studies.

Development and external validation of a risk-prediction model to predict 5-year overall survival in advanced larynx cancer.

PubMed

Petersen, Japke F; Stuiver, Martijn M; Timmermans, Adriana J; Chen, Amy; Zhang, Hongzhen; O'Neill, James P; Deady, Sandra; Vander Poorten, Vincent; Meulemans, Jeroen; Wennerberg, Johan; Skroder, Carl; Day, Andrew T; Koch, Wayne; van den Brekel, Michiel W M

2018-05-01

TNM-classification inadequately estimates patient-specific overall survival (OS). We aimed to improve this by developing a risk-prediction model for patients with advanced larynx cancer. Cohort study. We developed a risk prediction model to estimate the 5-year OS rate based on a cohort of 3,442 patients with T3T4N0N+M0 larynx cancer. The model was internally validated using bootstrapping samples and externally validated on patient data from five external centers (n = 770). The main outcome was performance of the model as tested by discrimination, calibration, and the ability to distinguish risk groups based on tertiles from the derivation dataset. The model performance was compared to a model based on T and N classification only. We included age, gender, T and N classification, and subsite as prognostic variables in the standard model. After external validation, the standard model had a significantly better fit than a model based on T and N classification alone (C statistic, 0.59 vs. 0.55, P < .001). The model was able to distinguish well among three risk groups based on tertiles of the risk score. Adding treatment modality to the model did not decrease the predictive power. As a post hoc analysis, we tested the added value of comorbidity as scored by American Society of Anesthesiologists score in a subsample, which increased the C statistic to 0.68. A risk prediction model for patients with advanced larynx cancer, consisting of readily available clinical variables, gives more accurate estimations of the estimated 5-year survival rate when compared to a model based on T and N classification alone. 2c. Laryngoscope, 128:1140-1145, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Creation of mortality risk charts using 123I meta-iodobenzylguanidine heart-to-mediastinum ratio in patients with heart failure: 2- and 5-year risk models.

PubMed

Nakajima, Kenichi; Nakata, Tomoaki; Matsuo, Shinro; Jacobson, Arnold F

2016-10-01

(123)I meta-iodobenzylguanidine (MIBG) imaging has been extensively used for prognostication in patients with chronic heart failure (CHF). The purpose of this study was to create mortality risk charts for short-term (2 years) and long-term (5 years) prediction of cardiac mortality. Using a pooled database of 1322 CHF patients, multivariate analysis, including (123)I-MIBG late heart-to-mediastinum ratio (HMR), left ventricular ejection fraction (LVEF), and clinical factors, was performed to determine optimal variables for the prediction of 2- and 5-year mortality risk using subsets of the patients (n = 1280 and 933, respectively). Multivariate logistic regression analysis was performed to create risk charts. Cardiac mortality was 10 and 22% for the sub-population of 2- and 5-year analyses. A four-parameter multivariate logistic regression model including age, New York Heart Association (NYHA) functional class, LVEF, and HMR was used. Annualized mortality rate was <1% in patients with NYHA Class I-II and HMR ≥ 2.0, irrespective of age and LVEF. In patients with NYHA Class III-IV, mortality rate was 4-6 times higher for HMR < 1.40 compared with HMR ≥ 2.0 in all LVEF classes. Among the subset of patients with b-type natriuretic peptide (BNP) results (n = 491 and 359 for 2- and 5-year models, respectively), the 5-year model showed incremental value of HMR in addition to BNP. Both 2- and 5-year risk prediction models with (123)I-MIBG HMR can be used to identify low-risk as well as high-risk patients, which can be effective for further risk stratification of CHF patients even when BNP is available. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Cardiology.

A scoring system to predict breast cancer mortality at 5 and 10 years.

PubMed

Paredes-Aracil, Esther; Palazón-Bru, Antonio; Folgado-de la Rosa, David Manuel; Ots-Gutiérrez, José Ramón; Compañ-Rosique, Antonio Fernando; Gil-Guillén, Vicente Francisco

2017-03-24

Although predictive models exist for mortality in breast cancer (BC) (generally all cause-mortality), they are not applicable to all patients and their statistical methodology is not the most powerful to develop a predictive model. Consequently, we developed a predictive model specific for BC mortality at 5 and 10 years resolving the above issues. This cohort study included 287 patients diagnosed with BC in a Spanish region in 2003-2016. time-to-BC death. Secondary variables: age, personal history of breast surgery, personal history of any cancer/BC, premenopause, postmenopause, grade, estrogen receptor, progesterone receptor, c-erbB2, TNM stage, multicentricity/multifocality, diagnosis and treatment. A points system was constructed to predict BC mortality at 5 and 10 years. The model was internally validated by bootstrapping. The points system was integrated into a mobile application for Android. Mean follow-up was 8.6 ± 3.5 years and 55 patients died of BC. The points system included age, personal history of BC, grade, TNM stage and multicentricity. Validation was satisfactory, in both discrimination and calibration. In conclusion, we constructed and internally validated a scoring system for predicting BC mortality at 5 and 10 years. External validation studies are needed for its use in other geographical areas.

Prenatal Caffeine Exposure and Child IQ at Age 5.5 Years: The EDEN Mother-Child Cohort.

PubMed

Galéra, Cédric; Bernard, Jonathan Y; van der Waerden, Judith; Bouvard, Manuel-Pierre; Lioret, Sandrine; Forhan, Anne; De Agostini, Maria; Melchior, Maria; Heude, Barbara

2016-11-01

Evidence from animal studies suggests maternal caffeine intake during pregnancy has detrimental effects on subsequent brain development in offspring. However, human data in this area are limited. The aim of this study was to assess whether caffeine intake by women during pregnancy is associated with impaired cognitive development in offspring at age 5.5 years. Multivariate modeling was conducted using data of 1083 mother-child pairs from a population-based birth cohort in France followed from pregnancy to age 5.5 years of the children. Measures included an estimate of maternal caffeine intake during pregnancy, children's IQ at age 5.5, and individual and family characteristics. Prenatal caffeine exposure was common in the sample (91%) with 12% displaying an intake ≥200 mg/day (high). Multivariable modeling showed a significant negative relationship between caffeine intake and children's IQ at 5.5 years (-.94 [95% confidence interval = -1.70, -.17] full IQ unit per 100 mg daily caffeine intake). In particular, children of mothers consuming ≥200 mg/day were more likely to have borderline or lower IQ compared with children of mothers consuming <100 mg/day (13.5% vs. 7.3%; odds ratio = 2.30, 95% confidence interval = 1.13, 4.69). We found an association between caffeine intake during pregnancy and impaired cognitive development in offspring, a result in line with animal data. More epidemiologic and biologically grounded research is needed to determine whether this association is causal. This finding suggests that conservative guidelines regarding the maximum caffeine intake recommended in pregnancy (i.e., 200 mg/day) should be maintained. Copyright © 2015 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

The Effect of Teaching Model ‘Learning Cycles 5E’ toward Students’ Achievement in Learning Mathematic at X Years Class SMA Negeri 1 Banuhampu 2013/2014 Academic Year

NASA Astrophysics Data System (ADS)

Yeni, N.; Suryabayu, E. P.; Handayani, T.

2017-02-01

Based on the survey showed that mathematics teacher still dominated in teaching and learning process. The process of learning is centered on the teacher while the students only work based on instructions provided by the teacher without any creativity and activities that stimulate students to explore their potential. Realized the problem above the writer interested in finding the solution by applying teaching model ‘Learning Cycles 5E’. The purpose of his research is to know whether teaching model ‘Learning Cycles 5E’ is better than conventional teaching in teaching mathematic. The type of the research is quasi experiment by Randomized Control test Group Only Design. The population in this research were all X years class students. The sample is chosen randomly after doing normality, homogeneity test and average level of students’ achievement. As the sample of this research was X.7’s class as experiment class used teaching model learning cycles 5E and X.8’s class as control class used conventional teaching. The result showed us that the students achievement in the class that used teaching model ‘Learning Cycles 5E’ is better than the class which did not use the model.

A 5-year longitudinal analysis of modifiable predictors for outdoor play and screen-time of 2- to 5-year-olds.

PubMed

Xu, Huilan; Wen, Li Ming; Hardy, Louise L; Rissel, Chris

2016-08-26

Early childhood is a critical time for establishing physical activity and sedentary behaviours. Identifying modifiable predictors of physical activity and sedentary behaviours in the early life stages can inform the development of early intervention programs. The aim of this study was to identify modifiable predictors of outdoor play (a proxy of physical activity) and screen-time in 2- to 5-year-olds. A longitudinal data analysis was conducted using 5-year follow-up data from the Healthy Beginnings Trial undertaken in Sydney, Australia from 2007 to 2013. A total of 667 pregnant women were recruited for the study. Information on mothers' demographics, physical activity, screen-time, knowledge of child development, and awareness of childhood obesity during pregnancy (at baseline); children's tummy time (a colloquial term describing the time when a baby is placed on his or her stomach while awake and supervised) at 6 months old and screen-time at 1 year old was collected via interviews with participating mothers as potential modifiable predictors. Main outcomes were children's outdoor playtime and screen-time at ages 2, 3.5, and 5 years. Mixed linear and logistic regression models were built to determine these modifiable predictors. Mothers' screen-time during pregnancy (β = 2.1, 95 % CI 0.17-4.12; P = 0.030) and children's daily screen-time at age 1 year (β = 15.2, 95 % CI 7.28-23.11; P < 0.0001) predicted children's daily screen-time across ages 2 to 5 years after controlling for confounding factors. Practising tummy time daily (β = 13.4, 95 % CI 1.26-25.52; P = 0.030), mother's physical activity level (β = 3.9, 95 % CI 0.46-7.28; P = 0.026), and having been informed about playing with child at baseline (β = 11.6, 95 % CI 1.56-21.54; P = 0.023) predicted children's outdoor playtime across ages 2 to 5 years. Mothers played an important role in their children's outdoor play and screen-time in the first years of

Predicting severe motor impairment in preterm children at age 5 years.

PubMed

Synnes, Anne; Anderson, Peter J; Grunau, Ruth E; Dewey, Deborah; Moddemann, Diane; Tin, Win; Davis, Peter G; Doyle, Lex W; Foster, Gary; Khairy, May; Nwaesei, Chukwuma; Schmidt, Barbara

2015-08-01

To determine whether the ability to predict severe motor impairment at age 5 years improves between birth and 18 months. Ancillary study of the Caffeine for Apnea of Prematurity Trial. International cohort of very low birth weight children who were assessed sequentially from birth to 5 years. Severe motor impairment was defined as a score <5th percentile on the Movement Assessment Battery of Children (MABC), or inability to complete the MABC because of cerebral palsy. Multivariable logistic regression cumulative risk models used four sets of predictor variables: early neonatal risk factors, risk factors at 36 weeks' postmenstrual age, risk factors at a corrected age of 18 months, and sociodemographic variables. A receiver operating characteristic curve (ROC) was generated for each model, and the four ROC curves were compared to determine if the addition of the new set of predictors significantly increased the area under the curve (AUC). Of 1469 children, 291 (19.8%) had a severe motor impairment at 5 years. The AUC increased from 0.650 soon after birth, to 0.718 (p<0.001) at 36 weeks' postmenstrual age, and to 0.797 at 18 months (p<0.001). Sociodemographic variables did not significantly improve the AUC (AUC=0.806; p=0.07). Prediction of severe motor impairment at 5 years of age using a cumulative risk model improves significantly from birth to 18 months of age in children with birth weights between 500 g and 1250 g. ClinicalTrials.gov number NCT00182312. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Insight, psychopathology, explanatory models and outcome of schizophrenia in India: a prospective 5-year cohort study.

PubMed

Johnson, Shanthi; Sathyaseelan, Manoranjitham; Charles, Helen; Jeyaseelan, Visalakshi; Jacob, Kuruthukulangara Sebastian

2012-09-27

The sole focus of models of insight on bio-medical perspectives to the complete exclusion of local, non-medical and cultural constructs mandates review. This study attempted to investigate the impact of insight, psychopathology, explanatory models of illness on outcome of first episode schizophrenia. Patients diagnosed to have DSM IV schizophrenia (n = 131) were assessed prospectively for insight, psychopathology, explanatory models of illness at baseline, 6, 12 and 60 months using standard instruments. Multiple linear and logistic regression and generalized estimating equations (GEE) were employed to assess predictors of outcome. We could follow up 95 (72.5%) patients. Sixty-five of these patients (68.4%) achieved remission. There was a negative relationship between psychosis rating and insight scores. Urban residence, fluctuating course of the initial illness, and improvement in global functioning at 6 months and lower psychosis rating at 12 months were significantly related to remission at 5 years. Insight scores, number of non-medical explanatory models and individual explanatory models held during the later course of the illness were significantly associated with outcome. Analysis of longitudinal data using GEE showed that women, rural residence, insight scores and number of non-medical explanatory models of illness held were significantly associated with BPRS scores during the study period. Insight, the disease model and the number of non-medical model positively correlated with improvement in psychosis arguing for a complex interaction between the culture, context and illness variables. These finding argue that insight and explanatory models are secondary to psychopathology, course and outcome of the illness. The awareness of mental illness is a narrative act in which people make personal sense of the many challenges they face. The course and outcome of the illness, cultural context, acceptable cultural explanations and the prevalent social stigma

Equatorial Annual Oscillation with QBO-driven 5-year Modulation in NCEP Data

NASA Technical Reports Server (NTRS)

Mayr, H. G.; Mengel, J. G.; Huang, F. T.; Nash, E. R.

2007-01-01

An analysis is presented of the zonal wind and temperature variations supplied by the National Center for Environmental Prediction (NCEP), which have been assimilated in the Reanalysis and the Climate Prediction Center (CCP) data sets. The derived zonal-mean variations are employed. Stimulated by modeling studies, the data are separated into the hemispherically symmetric and anti-symmetric components, and spectral analysis is applied to study the annual 12-month oscillation and Quasi-biennial Oscillation (QBO). For data samples that cover as much as 40 years, the results reveal a pronounced 5-year modulation of the symmetric AO in the lower stratosphere, which is confined to equatorial latitudes. This modulation is also inferred for the temperature variations but extends to high latitudes, qualitatively consistent with published model results. A comparison between different data samples indicates that the signature of the 5-year oscillation is larger when the QBO of 30 months is more pronounced. Thus there is circumstantial evidence that this periodicity of the QBO is involved in generating the oscillation. The spectral analysis shows that there is a weak anti-symmetric 5-year oscillation in the zonal winds, which could interact with the large antisymmetric A0 to produce the modulation of the symmetric AO as was shown in earlier modeling studies. According to these studies, the 30-month QBO tends to be synchronized by the equatorial Semi-annual Oscillation (SAO), and this would explain why the inferred 5-year modulation is observed to persist and is phase locked over several cycles.

One vs. Two Breast Density Measures to Predict 5- and 10- Year Breast Cancer Risk

PubMed Central

Kerlikowske, Karla; Gard, Charlotte C.; Sprague, Brian L.; Tice, Jeffrey A.; Miglioretti, Diana L.

2015-01-01

Background One measure of Breast Imaging Reporting and Data System (BI-RADS) breast density improves 5-year breast cancer risk prediction, but the value of sequential measures is unknown. We determined if two BI-RADS density measures improves the predictive accuracy of the Breast Cancer Surveillance Consortium 5-year risk model compared to one measure. Methods We included 722,654 women aged 35–74 years with two mammograms with BI-RADS density measures on average 1.8 years apart; 13,715 developed invasive breast cancer. We used Cox regression to estimate the relative hazards of breast cancer for age, race/ethnicity, family history of breast cancer, history of breast biopsy, and one or two density measures. We developed a risk prediction model by combining these estimates with 2000–2010 Surveillance, Epidemiology, and End Results incidence and 2010 vital statistics for competing risk of death. Results The two-measure density model had marginally greater discriminatory accuracy than the one-measure model (AUC=0.640 vs. 0.635). Of 18.6% of women (134,404/722,654) who decreased density categories, 15.4% (20,741/134,404) of women whose density decreased from heterogeneously or extremely dense to a lower density category with one other risk factor had a clinically meaningful increase in 5-year risk from <1.67% with the one-density model to ≥1.67% with the two-density model. Conclusion The two-density model has similar overall discrimination to the one-density model for predicting 5-year breast cancer risk and improves risk classification for women with risk factors and a decrease in density. Impact A two-density model should be considered for women whose density decreases when calculating breast cancer risk. PMID:25824444

One versus Two Breast Density Measures to Predict 5- and 10-Year Breast Cancer Risk.

PubMed

Kerlikowske, Karla; Gard, Charlotte C; Sprague, Brian L; Tice, Jeffrey A; Miglioretti, Diana L

2015-06-01

One measure of Breast Imaging Reporting and Data System (BI-RADS) breast density improves 5-year breast cancer risk prediction, but the value of sequential measures is unknown. We determined whether two BI-RADS density measures improve the predictive accuracy of the Breast Cancer Surveillance Consortium 5-year risk model compared with one measure. We included 722,654 women of ages 35 to 74 years with two mammograms with BI-RADS density measures on average 1.8 years apart; 13,715 developed invasive breast cancer. We used Cox regression to estimate the relative hazards of breast cancer for age, race/ethnicity, family history of breast cancer, history of breast biopsy, and one or two density measures. We developed a risk prediction model by combining these estimates with 2000-2010 Surveillance, Epidemiology, and End Results incidence and 2010 vital statistics for competing risk of death. The two-measure density model had marginally greater discriminatory accuracy than the one-measure model (AUC, 0.640 vs. 0.635). Of 18.6% of women (134,404 of 722,654) who decreased density categories, 15.4% (20,741 of 134,404) of women whose density decreased from heterogeneously or extremely dense to a lower density category with one other risk factor had a clinically meaningful increase in 5-year risk from <1.67% with the one-density model to ≥1.67% with the two-density model. The two-density model has similar overall discrimination to the one-density model for predicting 5-year breast cancer risk and improves risk classification for women with risk factors and a decrease in density. A two-density model should be considered for women whose density decreases when calculating breast cancer risk. ©2015 American Association for Cancer Research.

Effects of body habitus on internal radiation dose calculations using the 5-year-old anthropomorphic male models.

PubMed

Xie, Tianwu; Kuster, Niels; Zaidi, Habib

2017-07-13

Computational phantoms are commonly used in internal radiation dosimetry to assess the amount and distribution pattern of energy deposited in various parts of the human body from different internal radiation sources. Radiation dose assessments are commonly performed on predetermined reference computational phantoms while the argument for individualized patient-specific radiation dosimetry exists. This study aims to evaluate the influence of body habitus on internal dosimetry and to quantify the uncertainties in dose estimation correlated with the use of fixed reference models. The 5-year-old IT'IS male phantom was modified to match target anthropometric parameters, including body weight, body height and sitting height/stature ratio (SSR), determined from reference databases, thus enabling the creation of 125 5-year-old habitus-dependent male phantoms with 10th, 25th, 50th, 75th and 90th percentile body morphometries. We evaluated the absorbed fractions and the mean absorbed dose to the target region per unit cumulative activity in the source region (S-values) of F-18 in 46 source regions for the generated 125 anthropomorphic 5-year-old hybrid male phantoms using the Monte Carlo N-Particle eXtended general purpose Monte Carlo transport code and calculated the absorbed dose and effective dose of five 18 F-labelled radiotracers for children of various habitus. For most organs, the S-value of F-18 presents stronger statistical correlations with body weight, standing height and sitting height than BMI and SSR. The self-absorbed fraction and self-absorbed S-values of F-18 and the absorbed dose and effective dose of 18 F-labelled radiotracers present with the strongest statistical correlations with body weight. For 18 F-Amino acids, 18 F-Brain receptor substances, 18 F-FDG, 18 F-L-DOPA and 18 F-FBPA, the mean absolute effective dose differences between phantoms of different habitus and fixed reference models are 11.4%, 11.3%, 10.8%, 13.3% and 11.4%, respectively. Total

Effects of body habitus on internal radiation dose calculations using the 5-year-old anthropomorphic male models

NASA Astrophysics Data System (ADS)

Xie, Tianwu; Kuster, Niels; Zaidi, Habib

2017-08-01

Computational phantoms are commonly used in internal radiation dosimetry to assess the amount and distribution pattern of energy deposited in various parts of the human body from different internal radiation sources. Radiation dose assessments are commonly performed on predetermined reference computational phantoms while the argument for individualized patient-specific radiation dosimetry exists. This study aims to evaluate the influence of body habitus on internal dosimetry and to quantify the uncertainties in dose estimation correlated with the use of fixed reference models. The 5-year-old IT’IS male phantom was modified to match target anthropometric parameters, including body weight, body height and sitting height/stature ratio (SSR), determined from reference databases, thus enabling the creation of 125 5-year-old habitus-dependent male phantoms with 10th, 25th, 50th, 75th and 90th percentile body morphometries. We evaluated the absorbed fractions and the mean absorbed dose to the target region per unit cumulative activity in the source region (S-values) of F-18 in 46 source regions for the generated 125 anthropomorphic 5-year-old hybrid male phantoms using the Monte Carlo N-Particle eXtended general purpose Monte Carlo transport code and calculated the absorbed dose and effective dose of five 18F-labelled radiotracers for children of various habitus. For most organs, the S-value of F-18 presents stronger statistical correlations with body weight, standing height and sitting height than BMI and SSR. The self-absorbed fraction and self-absorbed S-values of F-18 and the absorbed dose and effective dose of 18F-labelled radiotracers present with the strongest statistical correlations with body weight. For 18F-Amino acids, 18F-Brain receptor substances, 18F-FDG, 18F-L-DOPA and 18F-FBPA, the mean absolute effective dose differences between phantoms of different habitus and fixed reference models are 11.4%, 11.3%, 10.8%, 13.3% and 11.4%, respectively. Total body

Modelling the 5-year cost effectiveness of tiotropium, salmeterol and ipratropium for the treatment of chronic obstructive pulmonary disease in Spain

PubMed Central

Oostenbrink, Jan B.; Miravitlles, Marc; Monz, Brigitta U.

2007-01-01

Our objective was to assess the 5-year cost effectiveness of bronchodilator therapy with tiotropium, salmeterol or ipratropium for chronic obstructive pulmonary disease (COPD) from the perspective of the Spanish National Health System (NHS). A probabilistic Markov model was designed wherein patients moved between moderate, severe or very severe COPD and had the risk of exacerbation and death. Probabilities were derived from clinical trials. Spanish healthcare utilisation, costs and utilities were estimated for each COPD and exacerbation state. Outcomes were exacerbations, exacerbation-free months, quality-adjusted life years (QALYs), and cost(-effectiveness). The mean (SE) 5-year number of exacerbations was 3.50 (0.14) for tiotropium, 4.16 (0.40) for salmeterol and 4.71 (0.54) for ipratropium. The mean (SE) number of QALYs was 3.15 (0.08), 3.02 (0.15) and 3.00 (0.20), respectively. Mean (SE) 5-year costs were €6,424 (€305) for tiotropium, €5,869 (€505) for salmeterol, and €5,181 (€682) for ipratropium (2005 values). Ipratropium and tiotropium formed the cost-effectiveness frontier, with tiotropium being preferred when willingness to pay (WTP) exceeded €639 per exacerbation-free month and €8,157 per QALY. In Spain, tiotropium demonstrated the highest expected net benefit for ratios of the willingness to pay per QALY, well within accepted limits. PMID:17370096

Speech concerns at 5 years and adult educational and mental health outcomes.

PubMed

Muir, Colette; O'Callaghan, Michael J; Bor, William; Najman, Jake M; Williams, Gail M

2011-07-01

To determine if parent-reported speech concerns at 5 years predict poorer educational and mental health outcomes at 21 years independent of social context and child's receptive language, behaviour and motor concerns at 5 years. To determine if these adult outcomes are mediated by school performance at 14 years.   Information on speech concerns at 5- and 21-year outcomes was available for 3193 participants from a birth cohort of 7223 infants. At 5, child behaviour was measured using a behavioural checklist, and at 21 years, it was measured by the Young Adult Self-Report. Peabody Picture Vocabulary Test-Revised at 5 years was not available for all children. Maternal mental health and social information at 5 years and educational outcomes at 14 years and 21 years were collected prospectively by questionnaire. Potential confounding and mediating factors were analysed using logistic regression. Children with speech concerns were less likely to have completed secondary school (P < 0.01) or gained better overall position (OP) scores (P < 0.001). OP scores rank students in Queensland applying for tertiary entrance. There was no association with mental health outcomes. Findings were independent of maternal and social factors, and motor concerns, though attenuated by behaviour and Peabody Picture Vocabulary Test-Revised scores. In the model adjusted for these factors, any concerns predicted OP score 1-11 (odds ratio 0.58; 95% confidence interval 0.42, 0.79), though if academic functioning at 14 was included, no associations were significant. Maternal-reported speech concerns at 5 years predict poorer educational though not adult mental health outcomes. © 2011 The Authors. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Alemtuzumab CARE-MS II 5-year follow-up

PubMed Central

Cohen, Jeffrey A.; Fox, Edward J.; Giovannoni, Gavin; Hartung, Hans-Peter; Havrdova, Eva; Schippling, Sven; Selmaj, Krzysztof W.; Traboulsee, Anthony; Compston, D. Alastair S.; Margolin, David H.; Thangavelu, Karthinathan; Chirieac, Madalina C.; Jody, Darlene; Xenopoulos, Panos; Hogan, Richard J.; Panzara, Michael A.; Arnold, Douglas L.

2017-01-01

Objective: To evaluate 5-year efficacy and safety of alemtuzumab in patients with active relapsing-remitting multiple sclerosis and inadequate response to prior therapy. Methods: In the 2-year Comparison of Alemtuzumab and Rebif Efficacy in Multiple Sclerosis (CARE-MS) II study (NCT00548405), alemtuzumab-treated patients received 2 courses (baseline and 12 months later). Patients could enter an extension (NCT00930553), with as-needed alemtuzumab retreatment for relapse or MRI activity. Annualized relapse rate (ARR), 6-month confirmed disability worsening (CDW; ≥1-point Expanded Disability Status Scale [EDSS] score increase [≥1.5 if baseline EDSS = 0]), 6-month confirmed disability improvement (CDI; ≥1-point EDSS decrease [baseline score ≥2.0]), no evidence of disease activity (NEDA), brain volume loss (BVL), and adverse events (AEs) were assessed. Results: Most alemtuzumab-treated patients (92.9%) who completed CARE-MS II entered the extension; 59.8% received no alemtuzumab retreatment. ARR was low in each extension year (years 3–5: 0.22, 0.23, 0.18). Through 5 years, 75.1% of patients were free of 6-month CDW; 42.9% achieved 6-month CDI. In years 3, 4, and 5, proportions with NEDA were 52.9%, 54.2%, and 58.2%, respectively. Median yearly BVL remained low in the extension (years 1–5: −0.48%, −0.22%, −0.10%, −0.19%, −0.07%). AE exposure-adjusted incidence rates in the extension were lower than in the core study. Thyroid disorders peaked at year 3, declining thereafter. Conclusions: Alemtuzumab provides durable efficacy through 5 years in patients with an inadequate response to prior therapy in the absence of continuous treatment. Classification of evidence: This study provides Class III evidence that alemtuzumab provides efficacy and slowing of brain atrophy through 5 years. PMID:28835403

General paediatric surgery for patients aged under 5 years: a 5-year experience at a district general hospital.

PubMed

Kwok, C-S; Gordon, A C

2016-09-01

Introduction The gradual shift of general paediatric surgery (GPS) provision from district general hospitals (DGH) to specialised units is well recognised in the UK. The consequences of centralisation include a reduction in exposure to GPS for current surgical trainees. The GPS practice of a DGH is examined here. Methods All operations performed on children aged under 5 years over a 5-year period were identified using the local electronic operation database. Electronic hospital records and clinic letters were accessed to collect data on demographics, operations performed and outcome measures. Results 472 GPS operations were performed on children between the age of 22 days and 5 years between 2009 and 2014, of which 43 were on an emergency basis and 105 were performed on patients aged less than 1 year. Three patients were admitted following day case surgery. Six patients were readmitted within 30 days. Complication rates for all procedures and the four most common procedures were similar to those found in published literature. Conclusions GPS for patients aged less than 5 years is comparatively safe in the DGH setting. The training opportunities available at DGHs are invaluable to surgical trainees and vital for sustaining the future provision of GPS by such hospitals.

Exploring Stage I non-small-cell lung cancer: development of a prognostic model predicting 5-year survival after surgical resection†.

PubMed

Guerrera, Francesco; Errico, Luca; Evangelista, Andrea; Filosso, Pier Luigi; Ruffini, Enrico; Lisi, Elena; Bora, Giulia; Asteggiano, Elena; Olivetti, Stefania; Lausi, Paolo; Ardissone, Francesco; Oliaro, Alberto

2015-06-01

Despite impressive results in diagnosis and treatment of non-small-cell lung cancer (NSCLC), more than 30% of patients with Stage I NSCLC die within 5 years after surgical treatment. Identification of prognostic factors to select patients with a poor prognosis and development of tailored treatment strategies are then advisable. The aim of our study was to design a model able to define prognosis in patients with Stage I NSCLC, submitted to surgery with curative intent. A retrospective analysis of two surgical registries was performed. Predictors of survival were investigated using the Cox model with shared frailty (accounting for the within-centre correlation). Candidate predictors were: age, gender, smoking habit, morbidity, previous malignancy, Eastern Cooperative Oncology Group performance status, clinical N stage, maximum standardized uptake value (SUV(max)), forced expiratory volume in 1 s, carbon monoxide lung diffusion capacity (DLCO), extent of surgical resection, systematic lymphadenectomy, vascular invasion, pathological T stage, histology and histological grading. The final model included predictors with P < 0.20, after a backward selection. Missing data in evaluated predictors were multiple-imputed and combined estimates were obtained from 10 imputed data sets. Analysis was performed on 848 consecutive patients. The median follow-up was 48 months. Two hundred and nine patients died (25%), with a 5-year overall survival (OS) rate of 74%. The final Cox model demonstrated that mortality was significantly associated with age, male sex, presence of cardiac comorbidities, DLCO (%), SUV(max), systematic nodal dissection, presence of microscopic vascular invasion, pTNM stage and histological grading. The final model showed a fair discrimination ability (C-statistic = 0.69): the calibration of the model indicated a good agreement between observed and predicted survival. We designed an effective prognostic model based on clinical, pathological and surgical

5 years after an ACE: what happens then?

PubMed

Chong, Clara; Featherstone, Neil; Sharif, Shazia; Cherian, Abraham; Cuckow, Peter; Mushtaq, Imran; De Coppi, Paolo; Cross, Kate; Curry, Joseph

2016-04-01

Antegrade continence enema (ACE) revolutionised the lives of children with chronic constipation and soiling. Parents often ask how long the ACE will be required. We looked at our patients 5 years after ACE formation to answer the question. We reviewed clinical notes of all patients undergoing ACE procedure during January 1990 to December 2010. Only patients with >5 years follow-up were included. Data are given as median (range). 133 patients were included with >5 years of follow-up. Primary pathology was anorectal anomaly (ARA) 64 (48%); spinal dysraphism (SD) 40 (30%); functional constipation (FC) 14 (10%); Hirschsprung's Disease (HD) 10 (8%) and others 5 (4%). Median follow-up was 7 years (5-17 years). Overall 74% still use their ACE; whilst 26% no longer access their stoma, of whom 47% recovered normal colonic function. 50% of HD patient recover colonic function. FC has the highest failure rate at 21%. Overall 86% achieved excellent clinical outcome with 74% of patient still using their ACE at 5 years. HD has the highest recovery rate of 50%. FC has a more unreliable clinical outcome with 21% recovered colonic function and 21% failed. Outcome varied dependent on the background diagnosis.

Emotion Dialogues between Mothers and Children at 4.5 and 7.5 Years: Relations with Children's Attachment at 1 Year

ERIC Educational Resources Information Center

Oppenheim, David; Koren-Karie, Nina; Sagi-Schwartz, Abraham

2007-01-01

It was examined whether secure infant-mother attachment contributes to emotionally congruent and organized mother-child dialogues about emotions in later years. The attachment of 99 children was assessed using the Strange Situation at the age of 1 year and their emotion dialogues with their mothers were assessed at the ages of 4.5 and 7.5 years.…

Ages and Stages Questionnaire at 3 Years for Predicting IQ at 5-6 Years.

PubMed

Charkaluk, Marie-Laure; Rousseau, Jessica; Calderon, Johanna; Bernard, Jonathan Y; Forhan, Anne; Heude, Barbara; Kaminski, Monique

2017-04-01

To assess the predictive value of the 36-month Ages & Stages Questionnaire (ASQ) score for IQ score at age 5 to 6 years in the general population and to identify factors associated with IQ <85 once the ASQ score is taken into account. Data were collected from 939 children enrolled in a population-based prospective cohort study. Developmental outcomes at 36 months were assessed via the ASQ and at 5 to 6 years via the Wechsler Preschool and Primary Scale of Intelligence. The ASQ threshold was identified via the receiver operating characteristic curve. Additional predictive factors to obtain an IQ <85 were investigated, and their interaction with ASQ score was studied. Sixty-nine children (7.3%) had an IQ <85. A 36-month ASQ score threshold of 270 was optimal to identify children with an IQ <85 at 5 to 6 years, with a 0.77 ± 0.11 sensitivity and 0.68 ± 0.03 specificity. Maternal educational level and occupational activity at the time of ASQ completion were associated with the risk of an IQ <85 at a given ASQ level. In the multivariate model, no interaction between the studied factors and ASQ score reached significance. In the general pediatric population, 36-month ASQ parental reports could be used to identify children at later risk of cognitive delay. Low maternal education level should also be considered as a major risk factor for lower IQ in preschool children regardless of ASQ score. Copyright © 2017 by the American Academy of Pediatrics.

Trends in asthma mortality in the 0- to 4-year and 5- to 34-year age groups in Brazil

PubMed Central

Graudenz, Gustavo Silveira; Carneiro, Dominique Piacenti; Vieira, Rodolfo de Paula

2017-01-01

ABSTRACT Objective: To provide an update on trends in asthma mortality in Brazil for two age groups: 0-4 years and 5-34 years. Methods: Data on mortality from asthma, as defined in the International Classification of Diseases, were obtained for the 1980-2014 period from the Mortality Database maintained by the Information Technology Department of the Brazilian Unified Health Care System. To analyze time trends in standardized asthma mortality rates, we conducted an ecological time-series study, using regression models for the 0- to 4-year and 5- to 34-year age groups. Results: There was a linear trend toward a decrease in asthma mortality in both age groups, whereas there was a third-order polynomial fit in the general population. Conclusions: Although asthma mortality showed a consistent, linear decrease in individuals ≤ 34 years of age, the rate of decline was greater in the 0- to 4-year age group. The 5- to 34-year group also showed a linear decline in mortality, and the rate of that decline increased after the year 2004, when treatment with inhaled corticosteroids became more widely available. The linear decrease in asthma mortality found in both age groups contrasts with the nonlinear trend observed in the general population of Brazil. The introduction of inhaled corticosteroid use through public policies to control asthma coincided with a significant decrease in asthma mortality rates in both subsets of individuals over 5 years of age. The causes of this decline in asthma-related mortality in younger age groups continue to constitute a matter of debate. PMID:28380185

The development of regulatory functions from birth to 5 years: insights from premature infants.

PubMed

Feldman, Ruth

2009-01-01

This study examined physiological, emotional, and attentional regulatory functions as predictors of self-regulation in 125 infants followed 7 times from birth to 5 years. Physiological regulation was assessed by neonatal vagal tone and sleep-wake cyclicity; emotion regulation by response to stress at 3, 6, and 12 months; and attention regulation by focused attention and delayed response in the 2nd year. Executive functions, behavior adaptation, and self-restraint were measured at 5 years. Regulatory functions showed stability across time, measures, and levels. Structural modeling demonstrated both mediated paths from physiological to self-regulation through emotional and attentional processes and direct continuity between vagal tone and each level of regulation. Results support the coherence of the regulation construct and are consistent with neurobiological models on self and consciousness.

Patient-reported outcomes 5 years after laser in situ keratomileusis.

PubMed

Schallhorn, Steven C; Venter, Jan A; Teenan, David; Hannan, Stephen J; Hettinger, Keith A; Pelouskova, Martina; Schallhorn, Julie M

2016-06-01

To assess vision-related, quality-of-life outcomes 5 years after laser in situ keratomileusis (LASIK) and determine factors predictive of patient satisfaction. Optical Express, Glasgow, Scotland. Retrospective case series. Data from patients who had attended a clinical examination 5 years after LASIK were analyzed. All treatments were performed using the Visx Star S4 IR excimer laser. Patient-reported satisfaction, the effect of eyesight on various activities, visual phenomena, and ocular discomfort were evaluated 5 years postoperatively. Multivariate regression analysis was performed to determine factors affecting patient satisfaction. The study comprised 2530 patients (4937 eyes) who had LASIK. The mean age at the time of surgery was 42.4 years ± 12.5 (SD), and the preoperative manifest spherical equivalent ranged from -11.0 diopters (D) to +4.88 D. Five years postoperatively, 79.3% of eyes were within ±0.50 D of emmetropia and 77.7% of eyes achieved monocular uncorrected distance visual acuity (UDVA) and 90.6% of eyes achieved binocular UDVA of 20/20 or better. Of the patients, 91.0% said they were satisfied with their vision and 94.9% did not wear distance correction. Less than 2.0% of patients noticed visual phenomena, even with spectacle correction. Major predictors of patient satisfaction 5 years postoperatively were postoperative binocular UDVA (37.6% variance explained by regression model), visual phenomena (relative contribution of 15.0%), preoperative and postoperative sphere and their interactions (11.6%), and eyesight-related difficulties with various activities such as night driving, outdoor activities, and reading (10.2%). Patient-reported quality-of-life and satisfaction rates remained high 5 years after LASIK. Uncorrected vision was the strongest predictor of satisfaction. Dr. S.C. Schallhorn is a consultant to Abbott Medical Optics, Inc., Zeiss Meditec AG, and Autofocus Inc. and a global medical director for Optical Express. No other

Projections of Rainfall and Surface Temperature from CMIP5 Models under RCP4.5 and 8.5 over BIMSTEC Countries

NASA Astrophysics Data System (ADS)

Charan Pattnayak, Kanhu; Kar, Sarat Chandra; Kumari Pattnayak, Rashmita

2015-04-01

Rainfall and surface temperature are the most important climatic variables in the context of climate change. Thus, these variables simulated from fifth phase of the Climate Model Inter-comparison Project (CMIP5) models have been compared against Climatic Research Unit (CRU) observed data and projected for the twenty first century under the Representative Concentration Pathways (RCPs) 4.5 and 8.5 emission scenarios. Results for the seven countries under Bay of Bengal Initiative for Multi-Sectoral Technical and Economic Cooperation (BIMSTEC) such as Bangladesh, Bhutan, India, Myanmar, Nepal, Sri Lanka and Thailand have been examined. Six CMIP5 models namely GFDL-CM3, GFDL-ESM2M, GFDL-ESM2G, HadGEM2-AO, HadGEM2-CC and HadGEM2-ES have been chosen for this study. The study period has been considered is from 1861 to 2100. From this period, initial 145 years i.e. 1861 to 2005 is reference or historical period and the later 95 years i.e. 2005 to 2100 is projected period. The climate change in the projected period has been examined with respect to the reference period. In order to validate the models, the mean annual rainfall and temperature has been compared with CRU over the reference period 1901 to 2005. Comparison reveals that most of the models are able to capture the spatial distribution of rainfall and temperature over most of the regions of BIMSTEC countries. Therefore these model data can be used to study the future changes in the 21st Century. Four out six models shows that the rainfall over Central and North India, Thailand and eastern part of Myanmar shows decreasing trend and Bangladesh, Bhutan, Nepal and Sri Lanka shows an increasing trend in both RCP 4.5 and 8.5 scenarios. In case of temperature, all of the models show an increasing trend over all the BIMSTEC countries in both scenarios, however, the rate of increase is relatively less over Sri Lanka than the other countries. Annual cycles of rainfall and temperature over Bangladesh, Myanmar and Thailand

Preliminary evaluation of the publicly available Laboratory for Breast Radiodensity Assessment (LIBRA) software tool: comparison of fully automated area and volumetric density measures in a case-control study with digital mammography.

PubMed

Keller, Brad M; Chen, Jinbo; Daye, Dania; Conant, Emily F; Kontos, Despina

2015-08-25

Breast density, commonly quantified as the percentage of mammographically dense tissue area, is a strong breast cancer risk factor. We investigated associations between breast cancer and fully automated measures of breast density made by a new publicly available software tool, the Laboratory for Individualized Breast Radiodensity Assessment (LIBRA). Digital mammograms from 106 invasive breast cancer cases and 318 age-matched controls were retrospectively analyzed. Density estimates acquired by LIBRA were compared with commercially available software and standard Breast Imaging-Reporting and Data System (BI-RADS) density estimates. Associations between the different density measures and breast cancer were evaluated by using logistic regression after adjustment for Gail risk factors and body mass index (BMI). Area under the curve (AUC) of the receiver operating characteristic (ROC) was used to assess discriminatory capacity, and odds ratios (ORs) for each density measure are provided. All automated density measures had a significant association with breast cancer (OR = 1.47-2.23, AUC = 0.59-0.71, P < 0.01) which was strengthened after adjustment for Gail risk factors and BMI (OR = 1.96-2.64, AUC = 0.82-0.85, P < 0.001). In multivariable analysis, absolute dense area (OR = 1.84, P < 0.001) and absolute dense volume (OR = 1.67, P = 0.003) were jointly associated with breast cancer (AUC = 0.77, P < 0.01), having a larger discriminatory capacity than models considering the Gail risk factors alone (AUC = 0.64, P < 0.001) or the Gail risk factors plus standard area percent density (AUC = 0.68, P = 0.01). After BMI was further adjusted for, absolute dense area retained significance (OR = 2.18, P < 0.001) and volume percent density approached significance (OR = 1.47, P = 0.06). This combined area-volume density model also had a significantly (P < 0.001) improved discriminatory capacity (AUC = 0.86) relative to a model considering the Gail risk factors plus BMI (AUC = 0

Multi-year application of WRF-CAM5 over East Asia-Part I: Comprehensive evaluation and formation regimes of O 3 and PM 2.5

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

He, Jian; Zhang, Yang; Wang, Kai

Accurate simulations of air quality and climate require robust model parameterizations on regional and global scales. The Weather Research and Forecasting model with Chemistry version 3.4.1 has been coupled with physics packages from the Community Atmosphere Model version 5 (CAM5) (WRF-CAM5) to assess the robustness of the CAM5 physics package for regional modeling at higher grid resolutions than typical grid resolutions used in global modeling. In this two-part study, Part I describes the application and evaluation of WRF-CAM5 over East Asia at a horizontal resolution of 36-km for six years: 2001, 2005, 2006, 2008, 2010, and 2011. The simulations aremore » evaluated comprehensively with a variety of datasets from surface networks, satellites, and aircraft. The results show that meteorology is relatively well simulated by WRF-CAM5. However, cloud variables are largely or moderately underpredicted, indicating uncertainties in the model treatments of dynamics, thermodynamics, and microphysics of clouds/ices as well as aerosol-cloud interactions. For chemical predictions, the tropospheric column abundances of CO, NO2, and O3 are well simulated, but those of SO2 and HCHO are moderately overpredicted, and the column HCHO/NO2 indicator is underpredicted. Large biases exist in the surface concentrations of CO, NO2, and PM10 due to uncertainties in the emissions as well as vertical mixing. The underpredictions of NO lead to insufficient O3 titration, thus O3 overpredictions. The model can generally reproduce the observed O3 and PM indicators. These indicators suggest to control NOx emissions throughout the year, and VOCs emissions in summer in big cities and in winter over North China Plain, North/South Korea, and Japan to reduce surface O3, and to control SO2, NH3, and NOx throughout the year to reduce inorganic surface PM.« less

Your Child's Development: 2.5 Years (30 Months)

MedlinePlus

... Safe Videos for Educators Search English Español Your Child’s Development: 2.5 Years (30 Months) KidsHealth / For Parents / Your Child’s Development: 2.5 Years (30 Months) Print en español ...

Developmental milestones record - 5 years

MedlinePlus

... Strongly identifies with the parent of the same sex Has a group of friends Likes to imagine and pretend while playing (for example, pretends to take a trip to the moon) Ways to encourage a 5-year-old's development include: Reading together Providing enough space for ...

The population benefit of evidence-based radiotherapy: 5-Year local control and overall survival benefits.

PubMed

Hanna, T P; Shafiq, J; Delaney, G P; Vinod, S K; Thompson, S R; Barton, M B

2018-02-01

To describe the population benefit of radiotherapy in a high-income setting if evidence-based guidelines were routinely followed. Australian decision tree models were utilized. Radiotherapy alone (RT) benefit was defined as the absolute proportional benefit of radiotherapy compared with no treatment for radical indications, and of radiotherapy over surgery alone for adjuvant indications. Chemoradiotherapy (CRT) benefit was the absolute incremental benefit of concurrent chemoradiotherapy over RT. Five-year local control (LC) and overall survival (OS) benefits were measured. Citation databases were systematically queried for benefit data. Meta-analysis and sensitivity analysis were performed. 48% of all cancer patients have indications for radiotherapy, 34% curative and 14% palliative. RT provides 5-year LC benefit in 10.4% of all cancer patients (95% Confidence Interval 9.3, 11.8) and 5-year OS benefit in 2.4% (2.1, 2.7). CRT provides 5-year LC benefit in an additional 0.6% of all cancer patients (0.5, 0.6), and 5-year OS benefit for an additional 0.3% (0.2, 0.4). RT benefit was greatest for head and neck (LC 32%, OS 16%), and cervix (LC 33%, OS 18%). CRT LC benefit was greatest for rectum (6%) and OS for cervix (3%) and brain (3%). Sensitivity analysis confirmed a robust model. Radiotherapy provides significant 5-year LC and OS benefits as part of evidence-based cancer care. CRT provides modest additional benefits. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

Modelling of the urban concentrations of PM2.5 on a high resolution for a period of 35 years, for the assessment of lifetime exposure and health effects

NASA Astrophysics Data System (ADS)

Kukkonen, Jaakko; Kangas, Leena; Kauhaniemi, Mari; Sofiev, Mikhail; Aarnio, Mia; Jaakkola, Jouni J. K.; Kousa, Anu; Karppinen, Ari

2018-06-01

Reliable and self-consistent data on air quality are needed for an extensive period of time for conducting long-term, or even lifetime health impact assessments. We have modelled the urban-scale concentrations of fine particulate matter (PM2.5) in the Helsinki Metropolitan Area for a period of 35 years, from 1980 to 2014. The regional background concentrations were evaluated based on reanalyses of the atmospheric composition on global and European scales, using the SILAM model. The high-resolution urban computations included both the emissions originated from vehicular traffic (separately exhaust and suspension emissions) and those from small-scale combustion, and were conducted using the road network dispersion model CAR-FMI and the multiple-source Gaussian dispersion model UDM-FMI. The modelled concentrations of PM2.5 agreed fairly well with the measured data at a regional background station and at four urban measurement stations, during 1999-2014. The modelled concentration trends were also evaluated for earlier years, until 1988, using proxy analyses. There was no systematic deterioration of the agreement of predictions and data for earlier years (the 1980s and 1990s), compared with the results for more recent years (2000s and early 2010s). The local vehicular emissions were about 5 times higher in the 1980s, compared with the emissions during the latest considered years. The local small-scale combustion emissions increased slightly over time. The highest urban concentrations of PM2.5 occurred in the 1980s; these have since decreased to about to a half of the highest values. In general, regional background was the largest contribution in this area. Vehicular exhaust has been the most important local source, but the relative shares of both small-scale combustion and vehicular non-exhaust emissions have increased in time. The study has provided long-term, high-resolution concentration databases on regional and urban scales that can be used for the assessment of

Prenatal and childhood perfluoroalkyl substances exposures and children's reading skills at ages 5 and 8years.

PubMed

Zhang, Hongmei; Yolton, Kimberly; Webster, Glenys M; Ye, Xiaoyun; Calafat, Antonia M; Dietrich, Kim N; Xu, Yingying; Xie, Changchun; Braun, Joseph M; Lanphear, Bruce P; Chen, Aimin

2018-02-01

Exposure to perfluoroalkyl substances (PFASs) may impact children's neurodevelopment. To examine the association of prenatal and early childhood serum PFAS concentrations with children's reading skills at ages 5 and 8years. We used data from 167 mother-child pairs recruited during pregnancy (2003-2006) in Cincinnati, OH, quantified prenatal serum PFAS concentrations at 16±3weeks of gestation and childhood sera at ages 3 and 8years. We assessed children's reading skills using Woodcock-Johnson Tests of Achievement III at age 5years and Wide Range Achievement Test-4 at age 8years. We used general linear regression to quantify the covariate-adjusted associations between natural log-transformed PFAS concentrations and reading skills, and used multiple informant model to identify the potential windows of susceptibility. Median serum PFASs concentrations were PFOS>PFOA>PFHxS>PFNA in prenatal, 3-year, and 8-year children. The covariate-adjusted general linear regression identified positive associations between serum PFOA, PFOS and PFNA concentrations and children's reading scores at ages 5 and 8years, but no association between any PFHxS concentration and reading skills. The multiple informant model showed: a) Prenatal PFOA was positively associated with higher children's scores in Reading Composite (β: 4.0, 95% CI: 0.6, 7.4 per a natural log unit increase in exposure) and Sentence Comprehension (β: 4.2, 95% CI: 0.5, 8.0) at age 8years; b) 3-year PFOA was positively associated with higher children's scores in Brief Reading (β: 7.3, 95% CI: 0.9, 13.8), Letter Word Identification (β: 6.6, 95% CI: 1.1, 12.0), and Passage Comprehension (β: 5.9, 95% CI: 1.5, 10.2) at age 5years; c) 8-year PFOA was positively associated with higher children's Word Reading scores (β: 5.8, 95% CI: 0.8, 10.7) at age 8years. Prenatal PFOS and PFNA were positively associated with children's reading abilities at age 5years, but not at age 8years; 3-year PFOS and PFNA were positively associated

Potential impact of initialization on decadal predictions as assessed for CMIP5 models

NASA Astrophysics Data System (ADS)

Branstator, Grant; Teng, Haiyan

2012-06-01

To investigate the potential for initialization to improve decadal range predictions, we quantify the initial value predictability of upper 300 m temperature in the two northern ocean basins for 12 models from Coupled Model Intercomparison Project phase 5 (CMIP5), and we contrast it with the forced predictability in Representative Concentration Pathways (RCP) 4.5 climate change projections. We use a recently introduced method that produces predictability estimates from long control runs. Many initial states are considered, and we find on average 1) initialization has the potential to improve skill in the first 5 years in the North Pacific and the first 9 years in the North Atlantic, and 2) the impact from initialization becomes secondary compared to the impact of RCP4.5 forcing after 6 1/2 and 8 years in the two basins, respectively. Model-to-model and spatial variations in these limits are, however, substantial.

7 CFR 1219.5 - Crop year.

Code of Federal Regulations, 2010 CFR

2010-01-01

... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE HASS AVOCADO PROMOTION, RESEARCH, AND INFORMATION Hass Avocado Promotion, Research, and Information Order Definitions § 1219.5 Crop year...

7 CFR 1219.5 - Crop year.

Code of Federal Regulations, 2013 CFR

2013-01-01

... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE HASS AVOCADO PROMOTION, RESEARCH, AND INFORMATION Hass Avocado Promotion, Research, and Information Order Definitions § 1219.5 Crop year...

7 CFR 1219.5 - Crop year.

Code of Federal Regulations, 2012 CFR

2012-01-01

... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE HASS AVOCADO PROMOTION, RESEARCH, AND INFORMATION Hass Avocado Promotion, Research, and Information Order Definitions § 1219.5 Crop year...

7 CFR 1219.5 - Crop year.

Code of Federal Regulations, 2011 CFR

2011-01-01

... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE HASS AVOCADO PROMOTION, RESEARCH, AND INFORMATION Hass Avocado Promotion, Research, and Information Order Definitions § 1219.5 Crop year...

7 CFR 1219.5 - Crop year.

Code of Federal Regulations, 2014 CFR

2014-01-01

... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE HASS AVOCADO PROMOTION, RESEARCH, AND INFORMATION Hass Avocado Promotion, Research, and Information Order Definitions § 1219.5 Crop year...

Comparing self-reported health status and diagnosis-based risk adjustment to predict 1- and 2 to 5-year mortality.

PubMed

Pietz, Kenneth; Petersen, Laura A

2007-04-01

To compare the ability of two diagnosis-based risk adjustment systems and health self-report to predict short- and long-term mortality. Data were obtained from the Department of Veterans Affairs (VA) administrative databases. The study population was 78,164 VA beneficiaries at eight medical centers during fiscal year (FY) 1998, 35,337 of whom completed an 36-Item Short Form Health Survey for veterans (SF-36V) survey. We tested the ability of Diagnostic Cost Groups (DCGs), Adjusted Clinical Groups (ACGs), SF-36V Physical Component score (PCS) and Mental Component Score (MCS), and eight SF-36V scales to predict 1- and 2-5 year all-cause mortality. The additional predictive value of adding PCS and MCS to ACGs and DCGs was also evaluated. Logistic regression models were compared using Akaike's information criterion, the c-statistic, and the Hosmer-Lemeshow test. The c-statistics for the eight scales combined with age and gender were 0.766 for 1-year mortality and 0.771 for 2-5-year mortality. For DCGs with age and gender the c-statistics for 1- and 2-5-year mortality were 0.778 and 0.771, respectively. Adding PCS and MCS to the DCG model increased the c-statistics to 0.798 for 1-year and 0.784 for 2-5-year mortality. The DCG model showed slightly better performance than the eight-scale model in predicting 1-year mortality, but the two models showed similar performance for 2-5-year mortality. Health self-report may add health risk information in addition to age, gender, and diagnosis for predicting longer-term mortality.

A 50-year precipitation analysis over Europe at 5.5km within the UERRA project

NASA Astrophysics Data System (ADS)

Bazile, Eric; Abida, Rachid; Soci, Cornel; Verrelle, Antoine; Szczypta, Camille; Le Moigne, Patrick

2017-04-01

The UERRA project is a 4-year project (2014-2017) financed by the European Union under its 7th Framework Programme SPACE. One of its main objectives is to provide a 50-year reanalysis dataset of surface essential climate variables (ECV) at 5.5km grid at European scale, together with, as much as possible, uncertainty estimates. One of the ECV is the precipitation and this variable is of essential interest in weather forecasting, climate study and to "drive" hydrological model for water management, or agrometeorology. After a brief description of the method used for the precipitation analysis (Soci et al. 2016)during this project, the preliminary results will be presented. The estimation of uncertainties will be also discussed associated with the problem of the evolution of the observation density network and its impact on the long term series. Additional information about the UERRA project can be found at http://www.uerra.eu The research leading to these results has received funding from the European Union, Seventh Framework Programme (FP7-SPACE-2013-1) under grant agreement no 607193.

Gene Methylation and Cytological Atypia in Random Fine Needle Aspirates for Assessment of Breast Cancer Risk

PubMed Central

Hafeez, Sidra; Bujanda, Zoila Lopez; Chatterton, Robert T.; Jacobs, Lisa K.; Khouri, Nagi F.; Ivancic, David; Kenney, Kara; Shehata, Christina; Jeter, Stacie C.; Wolfman, Judith A.; Zalles, Carola M.; Huang, Peng

2016-01-01

Methods to determine individualized breast cancer risk lack sufficient sensitivity to select women most likely to benefit from preventive strategies. Alterations in DNA methylation occur early in breast cancer. We hypothesized that cancer-specific methylation markers could enhance breast cancer risk assessment. We evaluated 380 women without a history of breast cancer. We determined their menopausal status or menstrual cycle phase, risk of developing breast cancer (Gail model), and breast density, and obtained random fine needle aspiration (rFNA) samples for assessment of cytopathology and cumulative methylation index (CMI). Eight methylated gene markers were identified through whole genome methylation analysis and included novel and previously established breast cancer detection genes. We performed correlative and multivariate linear regression analyses to evaluate DNA methylation of a gene panel as a function of clinical factors associated with breast cancer risk. CMI and individual gene methylation were independent of age, menopausal status or menstrual phase, lifetime Gail risk score, and breast density. CMI and individual gene methylation for the eight genes increased significantly (p<0.001) with increasing cytological atypia. The findings were verified with multivariate analyses correcting for age, log (Gail), log (percent density), rFNA cell number and BMI. Our results demonstrate a significant association between cytological atypia and high CMI, which does not vary with menstrual phase or menopause and is independent of Gail risk and mammographic density. Thus CMI is an excellent candidate breast cancer risk biomarker, warranting larger prospective studies to establish its utility for cancer risk assessment. PMID:27261491

Climate modeling for Yamal territory using supercomputer atmospheric circulation model ECHAM5-wiso

NASA Astrophysics Data System (ADS)

Denisova, N. Y.; Gribanov, K. G.; Werner, M.; Zakharov, V. I.

2015-11-01

Dependences of monthly means of regional averages of model atmospheric parameters on initial and boundary condition remoteness in the past are the subject of the study. We used atmospheric general circulation model ECHAM5-wiso for simulation of monthly means of regional averages of climate parameters for Yamal region and different periods of premodeling. Time interval was varied from several months to 12 years. We present dependences of model monthly means of regional averages of surface temperature, 2 m air temperature and humidity for December of 2000 on duration of premodeling. Comparison of these results with reanalysis data showed that best coincidence with true parameters could be reached if duration of pre-modelling is approximately 10 years.

Adult Development: Implications for Adult Education. Overview. ERIC Digest No. 41.

ERIC Educational Resources Information Center

Naylor, Michele

Various researchers, including Carl Jung, Charlotte Buhler, Erik Erikson, and Robert Havighurst, have formulated sequential models of adult development. More recent investigators, such as Daniel Levinson, Roger Gould, and Gail Sheehy have formulated age-related sequential models of adult development that view the various stages of adulthood in…

Trends in one-year mortality for stroke in a tertiary academic center in Saudi Arabia: a 5-year retrospective analysis.

PubMed

Almekhlafi, Mohammed A

2016-01-01

Numerous studies have reported a decline in stroke-related mortality in developed countries. To assess trends in one-year mortality following a stroke diagnosis in Saudi Arabia. Retrospective longitudinal cohort study. Single tertiary care center from 2010 through 2014. All patients admitted with a primary admitting diagnosis of stroke. Demographic data (age, gender, nationality), risk factor profile, stroke subtypes, in-hospital complications and mortality data as well as cause of death were collected for all patients. A multivariable logistic regression model was used to assess factors associated with one-year mortality following a stroke admission. One-year mortality. In 548 patients with a mean age of 62.9 years (SD 16.9), the most frequent vascular risk factors were hypertension (90.6%), diabetes (65.5%), and hyperlipidemia (27.2%). Hemorrhagic stroke was diagnosed in 9.9%. The overall mortality risk was 26.9%. Non-Saudis had a significantly higher one-year mortality risk compared with Saudis (25% vs. 16.8%, respectively; P=.025). The most frequently reported causes of mortality were neurological and related to the underlying stroke (32%), sepsis (30%), and cardiac or other organ dysfunction-related (each 9%) in addition to other etiologies (collectively 9.5%) such as pulmonary embolism or an underlying malignancy. Significant predictors in the multivariate model were age (P < .0001), non-Saudi nationality (OR 1.8, CI 95 1.1 to 2.9; P=.019), and hospital length of stay (OR 1.01, CI 95 1 to 1.004; P=.001). We observed no decline in stroke mortality in our center over the 5-year span. The establishment of stroke systems of care, use of thrombolytic agents, and opening of a stroke unit should play an important role in a decline in stroke mortality. Retrospective single center study. Mortality data were available only for patients who died in our hospital.

Comparing Self-Reported Health Status and Diagnosis-Based Risk Adjustment to Predict 1- and 2 to 5-Year Mortality

PubMed Central

Pietz, Kenneth; Petersen, Laura A

2007-01-01

Objectives To compare the ability of two diagnosis-based risk adjustment systems and health self-report to predict short- and long-term mortality. Data Sources/Study Setting Data were obtained from the Department of Veterans Affairs (VA) administrative databases. The study population was 78,164 VA beneficiaries at eight medical centers during fiscal year (FY) 1998, 35,337 of whom completed an 36-Item Short Form Health Survey for veterans (SF-36V) survey. Study Design We tested the ability of Diagnostic Cost Groups (DCGs), Adjusted Clinical Groups (ACGs), SF-36V Physical Component score (PCS) and Mental Component Score (MCS), and eight SF-36V scales to predict 1- and 2–5 year all-cause mortality. The additional predictive value of adding PCS and MCS to ACGs and DCGs was also evaluated. Logistic regression models were compared using Akaike's information criterion, the c-statistic, and the Hosmer–Lemeshow test. Principal Findings The c-statistics for the eight scales combined with age and gender were 0.766 for 1-year mortality and 0.771 for 2–5-year mortality. For DCGs with age and gender the c-statistics for 1- and 2–5-year mortality were 0.778 and 0.771, respectively. Adding PCS and MCS to the DCG model increased the c-statistics to 0.798 for 1-year and 0.784 for 2–5-year mortality. Conclusions The DCG model showed slightly better performance than the eight-scale model in predicting 1-year mortality, but the two models showed similar performance for 2–5-year mortality. Health self-report may add health risk information in addition to age, gender, and diagnosis for predicting longer-term mortality. PMID:17362210

Climate of the past 2000 years in IPCC AR5 (Invited)

NASA Astrophysics Data System (ADS)

Masson-Delmotte, V.

2013-12-01

Different aspects of the climate of the past 2000 years are covered in several chapters of the Fifth Assessment Report (AR5) of the Intergovernmental Panel on Climate Change, including information from paleoclimate archives, changes in the carbon and biogeochemical cycles, changes in sea level, climate model evaluation and detection and attribution. This presentation will summarize the main findings regarding pre-industrial changes in radiative forcings, reconstructed and simulated temperature variations at the hemispheric and regional scales, as well as global sea level for the past 2000 years, in the perspective of the current and earlier interglacial periods.

Dental Health Services Research Unit celebrates 30 years: Report of conference to mark the 30th anniversary of the Dental Health Services Research Unit (DHSRU) at Dundee, held on 1st December 2008.

PubMed

Eaton, Kenneth A; Pitts, Nigel B

2009-04-01

Over the years, several members of the staff of the Dental Health Services Research Unit (DHSRU) at Dundee have published papers in Primary Dental Care. Furthermore, its Director, Professor Nigel Pitts, together with Drs Jan Clarkson and Gail Topping have co-edited a number of the Faculty of General Dental Practice (UK)'s standards manuals and contributed to others. It had been suggested to the Unit by several parties that, having been in funded existence for some 30 years, it would be appropriate to mark this anniversary with a conference to explore 'Dental Health Services Research: After 30 years, what was the impact, what have we learned and where are we going?' So, following a range of consultations, the conference was convened at the West Park Conference Centre in Dundee with a mixed audience representing both dental research and dental practice.

75 FR 69158 - Quarterly Publication of Individuals, Who Have Chosen To Expatriate, as Required by Section 6039G

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-10

... Claudia Burger Elizabeth Joyce Callaghan John Arthur Campeau Pamela Gail Cannon Ralph George Carlson Helma... Given Gail Kathleen Gorr Marc-Andrew George Grace John S. Graf Robert Henri Grau Joachim Gray Laurence... Ellen Mary Hampton Peter Henry Han Choi Sang Han Richard Jin Soo Hare David Edwin George Harmon Sangboon...

Neoatherosclerosis 5 Years After Bioresorbable Vascular Scaffold Implantation.

PubMed

Moriyama, Noriaki; Shishido, Koki; Tanaka, Yutaka; Yokota, Shohei; Hayashi, Takahiro; Miyashita, Hirokazu; Koike, Tatsuya; Yokoyama, Hiroaki; Takada, Takuma; Nishimoto, Takashi; Ochiai, Tomoki; Tobita, Kazuki; Yamanaka, Futoshi; Mizuno, Shingo; Murakami, Masato; Takahashi, Saeko; Saito, Shigeru

2018-05-01

Data regarding neoatherosclerosis after everolimus-eluting bioresorbable vascular scaffold (BVS) (ABSORB BVS Rev. 1.1, Abbott Vascular, Santa Clara, California) implantation are limited. This study investigated the findings of neoatherosclerosis at 5 years after BVS 1.1 implantation by using multi-imaging modalities, including optical coherence tomography (OCT). Patients included in the ABSORB EXTEND (ABSORB EXTEND Clinical Investigation) trial at Shonan Kamakura General Hospital underwent OCT at baseline after the index procedure and at 1 and 5 years. Intimal plaque distributions in the in-scaffold and out-scaffold segments were analyzed. Twenty patients (22 lesions) with stable angina pectoris were enrolled. The median follow-up duration was 67 months (interquartile range: 65 to 69 months), and the mean age was 69 ± 8 years. Patients with diabetes mellitus (25%) were included. Based on the baseline angiogram, 10 (46%) lesions were type B2/C lesions. At 1 and 5 years of follow-up, significant differences in the prevalence of in-scaffold lipid-laden neointima (17% vs. 61%; p = 0.04), calcification (28% vs. 94%; p < 0.01), neovascularization (6% vs. 78%; p < 0.01), and thin-cap fibroatheroma (0% vs. 22%; p = 0.02) were found. In the out-scaffold segments, no significant difference in the plaque prevalence between 1 and 5 years was noted. The occurrence and progression of in-scaffold neoatherosclerosis with luminal narrowing was observed at 5 years after BVS 1.1 implantation. The small size of the current study warrants confirmation in larger study. (ABSORB EXTEND Clinical Investigation [ABSORB EXTEND]; NCT01023789). Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Year 5 Booster Units. The National Literacy Strategy.

ERIC Educational Resources Information Center

Department for Education and Employment, London (England).

The eight units of work in this document are designed to complement existing literacy booster units. Each unit is based on teaching objectives from the National Literacy Strategy Framework. They have been produced with the help of Year 5 teachers and have been trialled with pupils in a range of schools. The units support teachers' work with Year 5…

Impact of functional determinants on 5.5-year mortality in Amazon riparian elderly.

PubMed

Antonini, Tiago C; de Paz, Jose A; Ribeiro, Euler E; Brito, Elorídes; Mota, Kennya S; Silva, Terezinha L; Cristi-Monteiro, Carlos; Jung, Pedro V C; da Cruz, Ivana B M

2016-08-01

Objective To ascertain whether modifiable physical performance-based measurements predicted 5.5-year mortality in a riparian elderly cohort in the Amazon rainforest region. Methods A longitudinal study evaluating the impact of functional determinants on 5.5-year mortality in a riparian elderly cohort from Maués City in the state of Amazonas, Brazil, was performed. The study was a follow-up of a previous observational investigation that evaluated various fitness tests in 630 Amazonian riparian elderly (291 males and 339 females) aged 72.3 ± 8.0 (60-99) years old. The cohort was selected for its adverse environmental conditions, which increased the risk of falls yet required maintenance of good physical condition for carrying out relatively rigorous daily activities, and restricted access to specialized health services. Official death records were obtained from the Maués Municipal Health Department. Results A total of 80 study participants (12.7%) died over the 5.5-year study period. Kaplan-Meier regression analysis showed significant association between Timed Up and Go (TUG) test scores ≥ 14 seconds and mortality risk, independent of sex, age, and other health variables. Conclusions The study results suggest that the TUG test can be used as an indicator for initiating therapeutic and preventive actions, including conducting exercises or physical activities adapted to the health and functional conditions of the elderly, by identifying elderly people with a higher relative risk of mortality.

Influence of Climate on PM2.5 Concentrations over Europe : a Meteorological Analysis using a 9-year Model Simulation

NASA Astrophysics Data System (ADS)

Lecoeur, À.; Seigneur, C.; Terray, L.; Pagé, C.

2012-04-01

experimentally verify some intuitive results: weather regimes associated with weak (resp. high) precipitation, wind and low (resp. high) temperatures correspond to higher (resp. lower) PM2.5 concentrations. We also observe that rain rate is the variable that impacts PM2.5 concentrations the most. Next, we search for better relationships by adding this second variable to the classification: we therefore build new weather regimes, called weather types. Because of the low number of the EMEP observations, we compute PM2.5 concentrations with the Polyphemus/Polair3D CTM for years between 2000 and 2008 in order to obtain a spatially and temporally complete dataset of PM2.5 concentrations and chemical components, which can be used to relate PM2.5 concentrations to meteorological regimes and specific variables. By classifying both a large-scale variable and a local variable that influence the PM2.5 concentrations and using gridded data of the modeled concentrations of PM2.5, we obtain a more robust analysis. The results of this work will provide the basis to predict the effects of climate change (via the evolution of weather regimes/types frequencies) on PM2.5 chemical composition and concentrations.

The Predictors of Diet Quality among Australian Children Aged 3.5 Years.

PubMed

Collins, Laura J; Lacy, Kathleen E; Campbell, Karen J; McNaughton, Sarah A

2016-07-01

It is critical to promote healthy eating early in life. The aim of this study was to examine diet quality and its predictors among Australian preschool-aged children. Diet was assessed at age 3.5 years using multiple 24-hour recalls. Diet quality was assessed using an adapted version of the Revised Children's Diet Quality Index (RC-DQI). Potential predictors of diet quality were from questionnaires at age 3, 9, and 18 months and informed by the ecologic model of childhood overweight. Potential predictors included child's sex, age of introduction to solid foods, breastfeeding status, food acceptance, maternal nutrition knowledge, modeling of healthy eating, self-efficacy, education, and home food availability. Data from 244 children participating in the Melbourne Infant Feeding, Activity, and Nutrition Trial in 2008-2010 and follow-up data collection in 2011-2013 were examined. Diet quality at age 3.5 years. Bivariate logistic regression was performed to assess the relationship between diet quality and each predictor. A multivariable logistic regression model accounting for influences of covariates, treatment arm, and clustering by group tested associations between diet quality and significant predictors from bivariate analyses. RC-DQI scores had a mean±standard deviation score of 62.8±8.3 points out of a maximum of 85 points. Breastfeeding status (odds ratio [OR] 2.34, 95% CI 1.33 to 4.10) and maternal modeling of healthy eating (OR 1.75, 95% CI 1.01 to 3.03) were positively associated with RC-DQI scores. Both breastfeeding status (OR 3.09, 95% CI 1.63 to 5.85) and modeling (OR 2.01, 95% CI 1.04 to 3.88) remained positively associated with diet quality after adjustment for child age, body mass index z score, energy intake, treatment arm, and clustering. Breastfeeding status and modeling of healthy eating were independently associated with children's diet quality. Early intervention could assist mothers to practice these behaviors to provide support for improving

Migration of the Duraloc cup after 5 years.

PubMed

Stihsen, Christoph; Pabinger, Christof; Radl, Roman; Rehak, Peter; Windhager, Reinhard

2008-12-01

The Duraloc cup is a frequently used metal-backed, porous-coated, hemispherical, press-fit acetabular component. Published data on loosening rates are contradictory. In this study we investigated migration patterns with computer-assisted Einzel-Bild-Roentgen-Analyse (EBRA) of 67 Duraloc 100 cups. Cup migration and clinical scores were analysed over a 5-year follow-up period. Median total migration of the Duraloc 100 cup was 1.21 mm at 5 years. Seventy-five percent of implants were radiologically stable at 2 years and 90% at 4 years. One cup loosened aseptically at 60 months, requiring revision. Cup diameters > or = 54 mm migrated significantly more than cups < 54 mm in diameter (p = 0.029 at 4 years). There was a significant correlation between high polyethylene wear and further migrating cups within the first post-operative year (p = 0.035 at 12 months). Our analysis revealed significantly higher wear in males (p = 0.029 at 4 years). Radiological loosening at two years could be calculated using receiver-operating characteristic curve analysis, and 1.2 mm as an adequate threshold value (sensitivity = 100%, specificity = 89%).

20-Year Risks of Breast-Cancer Recurrence after Stopping Endocrine Therapy at 5 Years.

PubMed

Pan, Hongchao; Gray, Richard; Braybrooke, Jeremy; Davies, Christina; Taylor, Carolyn; McGale, Paul; Peto, Richard; Pritchard, Kathleen I; Bergh, Jonas; Dowsett, Mitch; Hayes, Daniel F

2017-11-09

The administration of endocrine therapy for 5 years substantially reduces recurrence rates during and after treatment in women with early-stage, estrogen-receptor (ER)-positive breast cancer. Extending such therapy beyond 5 years offers further protection but has additional side effects. Obtaining data on the absolute risk of subsequent distant recurrence if therapy stops at 5 years could help determine whether to extend treatment. In this meta-analysis of the results of 88 trials involving 62,923 women with ER-positive breast cancer who were disease-free after 5 years of scheduled endocrine therapy, we used Kaplan-Meier and Cox regression analyses, stratified according to trial and treatment, to assess the associations of tumor diameter and nodal status (TN), tumor grade, and other factors with patients' outcomes during the period from 5 to 20 years. Breast-cancer recurrences occurred at a steady rate throughout the study period from 5 to 20 years. The risk of distant recurrence was strongly correlated with the original TN status. Among the patients with stage T1 disease, the risk of distant recurrence was 13% with no nodal involvement (T1N0), 20% with one to three nodes involved (T1N1-3), and 34% with four to nine nodes involved (T1N4-9); among those with stage T2 disease, the risks were 19% with T2N0, 26% with T2N1-3, and 41% with T2N4-9. The risk of death from breast cancer was similarly dependent on TN status, but the risk of contralateral breast cancer was not. Given the TN status, the factors of tumor grade (available in 43,590 patients) and Ki-67 status (available in 7692 patients), which are strongly correlated with each other, were of only moderate independent predictive value for distant recurrence, but the status regarding the progesterone receptor (in 54,115 patients) and human epidermal growth factor receptor type 2 (HER2) (in 15,418 patients in trials with no use of trastuzumab) was not predictive. During the study period from 5 to 20 years, the

Change in employment status of 5-year cancer survivors.

PubMed

Torp, Steffen; Nielsen, Roy A; Fosså, Sophie D; Gudbergsson, Saevar B; Dahl, Alv A

2013-02-01

To follow the employment status of 5-year cancer survivors for 5 years after diagnosis with their first lifetime invasive cancer and to identify socio-demographic, work-related and cancer-related predictors of employment status after 5 years. This prospective registry study concerned all 3278 people in Norway (18-61 years old) diagnosed with their first lifetime invasive cancer in 1999 and alive in 2004 and a cancer-free control group (n = 6368) matched by sex, age, educational level and employment status in 1998. The employment rate among male cancer survivors declined steadily every year, from 94% the year before diagnosis (1998) to 77% 5 years after diagnosis (2004). This change did not differ significantly from that of male controls. The employment rate of female survivors also declined steadily, from 87% (1998) to 69% (2004). This decline was greater than that among female controls, and in 2004 survivors had a significantly lower employment rate. For both men and women, the significant pre-diagnosis predictors of being employed in 2004 concerned higher socio-economic position. For both sexes, lung cancer survivors had the highest decline in employment rate, and male skin cancer survivors had a lower decline in employment rate than controls. Socio-demographic and work-related factors explained more of the variance in employment status than did cancer diagnosis. The employment rate among 5-year cancer survivors did not change significantly except for female survivors. Low socio-economic position is a risk factor for decline in employment rate and should be focused on to prevent cancer-related inequity.

Atypia and DNA methylation in nipple duct lavage in relation to predicted breast cancer risk.

PubMed

Euhus, David M; Bu, Dawei; Ashfaq, Raheela; Xie, Xian-Jin; Bian, Aihua; Leitch, A Marilyn; Lewis, Cheryl M

2007-09-01

Tumor suppressor gene (TSG) methylation is identified more frequently in random periareolar fine needle aspiration samples from women at high risk for breast cancer than women at lower risk. It is not known whether TSG methylation or atypia in nipple duct lavage (NDL) samples is related to predicted breast cancer risk. 514 NDL samples obtained from 150 women selected to represent a wide range of breast cancer risk were evaluated cytologically and by quantitative multiplex methylation-specific PCR for methylation of cyclin D2, APC, HIN1, RASSF1A, and RAR-beta2. Based on methylation patterns and cytology, NDL retrieved cancer cells from only 9% of breasts ipsilateral to a breast cancer. Methylation of >/=2 genes correlated with marked atypia by univariate analysis, but not multivariate analysis, that adjusted for sample cellularity and risk group classification. Both marked atypia and TSG methylation independently predicted abundant cellularity in multivariate analyses. Discrimination between Gail lower-risk ducts and Gail high-risk ducts was similar for marked atypia [odds ratio (OR), 3.48; P = 0.06] and measures of TSG methylation (OR, 3.51; P = 0.03). However, marked atypia provided better discrimination between Gail lower-risk ducts and ducts contralateral to a breast cancer (OR, 6.91; P = 0.003, compared with methylation OR, 4.21; P = 0.02). TSG methylation in NDL samples does not predict marked atypia after correcting for sample cellularity and risk group classification. Rather, both methylation and marked atypia are independently associated with highly cellular samples, Gail model risk classifications, and a personal history of breast cancer. This suggests the existence of related, but independent, pathogenic pathways in breast epithelium.

Gene Methylation and Cytological Atypia in Random Fine-Needle Aspirates for Assessment of Breast Cancer Risk.

PubMed

Stearns, Vered; Fackler, Mary Jo; Hafeez, Sidra; Bujanda, Zoila Lopez; Chatterton, Robert T; Jacobs, Lisa K; Khouri, Nagi F; Ivancic, David; Kenney, Kara; Shehata, Christina; Jeter, Stacie C; Wolfman, Judith A; Zalles, Carola M; Huang, Peng; Khan, Seema A; Sukumar, Saraswati

2016-08-01

Methods to determine individualized breast cancer risk lack sufficient sensitivity to select women most likely to benefit from preventive strategies. Alterations in DNA methylation occur early in breast cancer. We hypothesized that cancer-specific methylation markers could enhance breast cancer risk assessment. We evaluated 380 women without a history of breast cancer. We determined their menopausal status or menstrual cycle phase, risk of developing breast cancer (Gail model), and breast density and obtained random fine-needle aspiration (rFNA) samples for assessment of cytopathology and cumulative methylation index (CMI). Eight methylated gene markers were identified through whole-genome methylation analysis and included novel and previously established breast cancer detection genes. We performed correlative and multivariate linear regression analyses to evaluate DNA methylation of a gene panel as a function of clinical factors associated with breast cancer risk. CMI and individual gene methylation were independent of age, menopausal status or menstrual phase, lifetime Gail risk score, and breast density. CMI and individual gene methylation for the eight genes increased significantly (P < 0.001) with increasing cytological atypia. The findings were verified with multivariate analyses correcting for age, log (Gail), log (percent density), rFNA cell number, and body mass index. Our results demonstrate a significant association between cytological atypia and high CMI, which does not vary with menstrual phase or menopause and is independent of Gail risk and mammographic density. Thus, CMI is an excellent candidate breast cancer risk biomarker, warranting larger prospective studies to establish its utility for cancer risk assessment. Cancer Prev Res; 9(8); 673-82. ©2016 AACR. ©2016 American Association for Cancer Research.

Alternative models of DSM-5 PTSD: Examining diagnostic implications.

PubMed

Murphy, Siobhan; Hansen, Maj; Elklit, Ask; Yong Chen, Yoke; Raudzah Ghazali, Siti; Shevlin, Mark

2018-04-01

The factor structure of DSM-5 posttraumatic stress disorder (PTSD) has been extensively debated with evidence supporting the recently proposed seven-factor Hybrid model. However, despite myriad studies examining PTSD symptom structure few have assessed the diagnostic implications of these proposed models. This study aimed to generate PTSD prevalence estimates derived from the 7 alternative factor models and assess whether pre-established risk factors associated with PTSD (e.g., transportation accidents and sexual victimisation) produce consistent risk estimates. Seven alternative models were estimated within a confirmatory factor analytic framework using the PTSD Checklist for DSM-5 (PCL-5). Data were analysed from a Malaysian adolescent community sample (n = 481) of which 61.7% were female, with a mean age of 17.03 years. The results indicated that all models provided satisfactory model fit with statistical superiority for the Externalising Behaviours and seven-factor Hybrid models. The PTSD prevalence estimates varied substantially ranging from 21.8% for the DSM-5 model to 10.0% for the Hybrid model. Estimates of risk associated with PTSD were inconsistent across the alternative models, with substantial variation emerging for sexual victimisation. These findings have important implications for research and practice and highlight that more research attention is needed to examine the diagnostic implications emerging from the alternative models of PTSD. Copyright © 2017 Elsevier B.V. All rights reserved.

26 CFR 1.960-5 - Credit for taxable year of inclusion binding for taxable year of exclusion.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 26 Internal Revenue 10 2014-04-01 2013-04-01 true Credit for taxable year of inclusion binding for taxable year of exclusion. 1.960-5 Section 1.960-5 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT... Corporations § 1.960-5 Credit for taxable year of inclusion binding for taxable year of exclusion. (a) Taxes...

26 CFR 1.960-5 - Credit for taxable year of inclusion binding for taxable year of exclusion.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 10 2012-04-01 2012-04-01 false Credit for taxable year of inclusion binding for taxable year of exclusion. 1.960-5 Section 1.960-5 Internal Revenue INTERNAL REVENUE SERVICE... Corporations § 1.960-5 Credit for taxable year of inclusion binding for taxable year of exclusion. (a) Taxes...

26 CFR 1.960-5 - Credit for taxable year of inclusion binding for taxable year of exclusion.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 10 2013-04-01 2013-04-01 false Credit for taxable year of inclusion binding for taxable year of exclusion. 1.960-5 Section 1.960-5 Internal Revenue INTERNAL REVENUE SERVICE... Corporations § 1.960-5 Credit for taxable year of inclusion binding for taxable year of exclusion. (a) Taxes...

26 CFR 1.960-5 - Credit for taxable year of inclusion binding for taxable year of exclusion.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 10 2011-04-01 2011-04-01 false Credit for taxable year of inclusion binding for taxable year of exclusion. 1.960-5 Section 1.960-5 Internal Revenue INTERNAL REVENUE SERVICE... Corporations § 1.960-5 Credit for taxable year of inclusion binding for taxable year of exclusion. (a) Taxes...

26 CFR 1.960-5 - Credit for taxable year of inclusion binding for taxable year of exclusion.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 10 2010-04-01 2010-04-01 false Credit for taxable year of inclusion binding for taxable year of exclusion. 1.960-5 Section 1.960-5 Internal Revenue INTERNAL REVENUE SERVICE... § 1.960-5 Credit for taxable year of inclusion binding for taxable year of exclusion. (a) Taxes not...

Amyloid imaging and CSF biomarkers in predicting cognitive impairment up to 7.5 years later

PubMed Central

Fagan, Anne M.; Grant, Elizabeth A.; Hassenstab, Jason; Moulder, Krista L.; Maue Dreyfus, Denise; Sutphen, Courtney L.; Benzinger, Tammie L.S.; Mintun, Mark A.; Holtzman, David M.; Morris, John C.

2013-01-01

Objectives: We compared the ability of molecular biomarkers for Alzheimer disease (AD), including amyloid imaging and CSF biomarkers (Aβ42, tau, ptau181, tau/Aβ42, ptau181/Aβ42), to predict time to incident cognitive impairment among cognitively normal adults aged 45 to 88 years and followed for up to 7.5 years. Methods: Longitudinal data from Knight Alzheimer's Disease Research Center participants (N = 201) followed for a mean of 3.70 years (SD = 1.46 years) were used. Participants with amyloid imaging and CSF collection within 1 year of a clinical assessment indicating normal cognition were eligible. Cox proportional hazards models tested whether the individual biomarkers were related to time to incident cognitive impairment. “Expanded” models were developed using the biomarkers and participant demographic variables. The predictive values of the models were compared. Results: Abnormal levels of all biomarkers were associated with faster time to cognitive impairment, and some participants with abnormal biomarker levels remained cognitively normal for up to 6.6 years. No differences in predictive value were found between the individual biomarkers (p > 0.074), nor did we find differences between the expanded biomarker models (p > 0.312). Each expanded model better predicted incident cognitive impairment than the model containing the biomarker alone (p < 0.005). Conclusions: Our results indicate that all AD biomarkers studied here predicted incident cognitive impairment, and support the hypothesis that biomarkers signal underlying AD pathology at least several years before the appearance of dementia symptoms. PMID:23576620

Migration of the Duraloc cup after 5 years

PubMed Central

Stihsen, Christoph; Pabinger, Christof; Radl, Roman; Rehak, Peter

2007-01-01

The Duraloc cup is a frequently used metal-backed, porous-coated, hemispherical, press-fit acetabular component. Published data on loosening rates are contradictory. In this study we investigated migration patterns with computer-assisted Einzel-Bild-Roentgen-Analyse (EBRA) of 67 Duraloc 100 cups. Cup migration and clinical scores were analysed over a 5-year follow-up period. Median total migration of the Duraloc 100 cup was 1.21 mm at 5 years. Seventy-five percent of implants were radiologically stable at 2 years and 90% at 4 years. One cup loosened aseptically at 60 months, requiring revision. Cup diameters ≥54 mm migrated significantly more than cups <54 mm in diameter (p = 0.029 at 4 years). There was a significant correlation between high polyethylene wear and further migrating cups within the first post-operative year (p = 0.035 at 12 months). Our analysis revealed significantly higher wear in males (p = 0.029 at 4 years). Radiological loosening at two years could be calculated using receiver-operating characteristic curve analysis, and 1.2 mm as an adequate threshold value (sensitivity = 100%, specificity = 89%). PMID:17609953

Individual factors, neighborhood social context and asthma at age 5 years.

PubMed

Vo, Phuong; Bair-Merritt, Megan; Camargo, Carlos A; Eisenberg, Staci; Long, Webb

2017-04-01

Childhood asthma is a major public health problem and its development is multifactorial. We examined whether neighborhood cohesion and disorder were associated with caregiver-report of asthma at age 5 years. This study is a secondary data analysis of the 2011-2012 United States National Survey of Children's Health. Data were available for 4680 children, age 5 years old born at term or preterm with birthweight >2500 g. Neighborhood disorder and cohesion were assessed based on caregivers' responses to validated questionnaires. Child asthma diagnosis was reported by the caregiver. Multivariable logistic regression was used to examine the relationship between these neighborhood factors and caregiver-report of child asthma, while accounting for individual level covariates. Approximately two-thirds of the 4680 children were White and lived in households with income >400% of federal poverty line. Asthma was present in 399 (9%) children. Child female sex was associated with reduced risk of caregiver-reported asthma while non-Hispanic Black race and having smokers in the household were independently associated with increased risk in multivariable models. In these models, neighborhood disorder was significantly associated with asthma (adjusted Odds Ratio [aOR] 1.70, 95% Confidence Interval [CI] 1.04-2.78), while neighborhood cohesion was not (aOR 0.93, 95% CI 0.51-1.68). Even after adjustment for several individual level factors, neighborhood disorder was associated with caregiver-report of asthma in this nationally representative sample of 5-year-old children. Further research is needed to better understand how risk factors at different levels of the socio-ecological framework may interact to affect childhood asthma development.

Asian-specific total knee system: 5-14 year follow-up study.

PubMed

Hosaka, Kunihiro; Saito, Shu; Ishii, Takao; Mori, Sei; Sumino, Takanobu; Tokuhashi, Yasuaki

2011-11-02

Knee size and body size differ in Asians compared with Caucasians. Nevertheless, many total knee arthroplasty (TKA) prostheses used worldwide are made for Western Caucasian subjects. As a result, an Asian's knee might not fit these prostheses. We studied the Flexible Nichidai Knee (FNK) system, a new model of TKA for Asian patients. The purpose of this report is to investigate the outcomes of this prosthesis retrospectively. We investigated 1055 primary TKAs in 595 patients who underwent FNK for osteoarthritis (OA) in Japan and were followed for > 5 years. The knee score and function score were used for clinical evaluation. We examined the range of motion (ROM) preoperatively and at final follow-up and radiographic assessments. In addition, postoperative complications were investigated. A survivorship analysis was also conducted using two endpoints: revision for any reason and aseptic failure. 890 knees in 502 patients were available for study (follow-up rate of 96.0%). The mean follow-up term was 8.3 years (range, 5.0-14.1 years). The knee and function score significantly improved from 41.3 to 90.3 and from 39.1 to 76.2 points, respectively (p < 0.001). The mean ROM in FNK posterior cruciate retaining (CR) type and FNK posterior-stabilized (PS) type ameliorated significantly from 107.8° and 95.6° to 110.7° and 110.4°, respectively (p < 0.01). Ten knees underwent revision surgery (infection in 3 cases, instability in 2, loosening in 2, and non-union of femoral supracondylar fracture, severe pain, and recurrent hemarthrosis in 1 each). The survivorship rate was 99.4% (95% CI, 99.0-99.8) at 5 years (n = 952 patients at risk) and 96.2% (95% CI, 91.9-100) at 12.5 years (n = 49 patients at risk). The FNK prosthesis for Asians achieved excellent mid- to long-term survivorship and clinical results.

Growth and Mortality Outcomes for Different Antiretroviral Therapy Initiation Criteria in Children aged 1–5 Years: A Causal Modelling Analysis

PubMed Central

Schomaker, Michael; Davies, Mary-Ann; Malateste, Karen; Renner, Lorna; Sawry, Shobna; N’Gbeche, Sylvie; Technau, Karl-Günter; Eboua, François; Tanser, Frank; Sygnaté-Sy, Haby; Phiri, Sam; Amorissani-Folquet, Madeleine; Cox, Vivian; Koueta, Fla; Chimbete, Cleophas; Lawson-Evi, Annette; Giddy, Janet; Amani-Bosse, Clarisse; Wood, Robin; Egger, Matthias; Leroy, Valeriane

2017-01-01

Background There is limited evidence regarding the optimal timing of initiating antiretroviral therapy (ART) in children. We conducted a causal modelling analysis in children aged 1–5 years from the International Epidemiologic Databases to Evaluate AIDS West/Southern-Africa collaboration to determine growth and mortality differences related to different CD4-based treatment initiation criteria, age groups and regions. Methods ART-naïve children of age 12–59 months at enrollment with at least one visit before ART initiation and one follow-up visit were included. We estimated 3-year growth and cumulative mortality from the start of follow-up for different CD4 criteria using g-computation. Results About one quarter of the 5826 included children was from West Africa (24.6%). The median (first; third quartile) CD4% at the first visit was 16% (11%;23%), the median weight-for-age z-scores and height-for-age z-scores were −1.5 (−2.7; −0.6) and −2.5 (−3.5; −1.5), respectively. Estimated cumulative mortality was higher overall, and growth was slower, when initiating ART at lower CD4 thresholds. After 3 years of follow-up, the estimated mortality difference between starting ART routinely irrespective of CD4 count and starting ART if either CD4 count<750 cells/mm3 or CD4%<25% was 0.2% (95%CI: −0.2%;0.3%), and the difference in the mean height-for-age z-scores of those who survived was −0.02 (95%CI: −0.04;0.01). Younger children aged 1–2 and children in West Africa had worse outcomes. Conclusions Our results demonstrate that earlier treatment initiation yields overall better growth and mortality outcomes, though we could not show any differences in outcomes between immediate ART and delaying until CD4 count/% falls below750/25%. PMID:26479876

Stimulant Treatment over 5 Years: Effects on Growth

ERIC Educational Resources Information Center

Charach, Alice; Figueroa, Max; Chen, Shirley; Ickowicz, Abel; Schachar, Russell

2006-01-01

Objective: Long-term effects of psychostimulants on growth in height and in weight are investigated in children with attention-deficit/hyperactivity disorder. Method: Participants were 79 children, 6 to 12 years of age, with attention-deficit/hyperactivity disorder, who were followed annually for up to 5 years, between the years 1993 and 1994 and…

7 CFR 5.5 - Publication of season average, calendar year, and parity price data.

Code of Federal Regulations, 2010 CFR

2010-01-01

... cases where preliminary marketing season average price data are used in estimating the adjusted base... parity price data. 5.5 Section 5.5 Agriculture Office of the Secretary of Agriculture DETERMINATION OF PARITY PRICES § 5.5 Publication of season average, calendar year, and parity price data. (a) New adjusted...

Repeated Random Sampling in Year 5

ERIC Educational Resources Information Center

Watson, Jane M.; English, Lyn D.

2016-01-01

As an extension to an activity introducing Year 5 students to the practice of statistics, the software "TinkerPlots" made it possible to collect repeated random samples from a finite population to informally explore students' capacity to begin reasoning with a distribution of sample statistics. This article provides background for the…

A systematic review of breast cancer incidence risk prediction models with meta-analysis of their performance.

PubMed

Meads, Catherine; Ahmed, Ikhlaaq; Riley, Richard D

2012-04-01

A risk prediction model is a statistical tool for estimating the probability that a currently healthy individual with specific risk factors will develop a condition in the future such as breast cancer. Reliably accurate prediction models can inform future disease burdens, health policies and individual decisions. Breast cancer prediction models containing modifiable risk factors, such as alcohol consumption, BMI or weight, condom use, exogenous hormone use and physical activity, are of particular interest to women who might be considering how to reduce their risk of breast cancer and clinicians developing health policies to reduce population incidence rates. We performed a systematic review to identify and evaluate the performance of prediction models for breast cancer that contain modifiable factors. A protocol was developed and a sensitive search in databases including MEDLINE and EMBASE was conducted in June 2010. Extensive use was made of reference lists. Included were any articles proposing or validating a breast cancer prediction model in a general female population, with no language restrictions. Duplicate data extraction and quality assessment were conducted. Results were summarised qualitatively, and where possible meta-analysis of model performance statistics was undertaken. The systematic review found 17 breast cancer models, each containing a different but often overlapping set of modifiable and other risk factors, combined with an estimated baseline risk that was also often different. Quality of reporting was generally poor, with characteristics of included participants and fitted model results often missing. Only four models received independent validation in external data, most notably the 'Gail 2' model with 12 validations. None of the models demonstrated consistently outstanding ability to accurately discriminate between those who did and those who did not develop breast cancer. For example, random-effects meta-analyses of the performance of the

To which extent social withdrawal at the age of 1 year is associated with IQ at 5-6 years old? Results of the EDEN mother-child cohort.

PubMed

Guedeney, Antoine; Doukhan, Sarah; Forhan, Anne; Heude, Barbara; Peyre, Hugo

2017-11-01

The present study aims to determine to which extent social withdrawal at 1 year is associated with the child's IQ at the end of the preschool period. Children (N = 1045) from the EDEN mother-child cohort were assessed for social withdrawal behaviours at 1 year by trained midwives using the Alarm Distress BaBy (ADBB) scale. Midwives also examined infants' language and motor development at 1 year. At the age 5-6 years, IQ scores were based on the WPPSI-III. Linear regression models were used to determine the association between IQ and ADBB, adjusted for a broad range of pre- and postnatal environmental factors and for language and motor skills scores at 1 year. After adjusting for environmental factors, children with social withdrawal at 1 years (ADBB ≥5; N = 195) had significantly lower IQ scores at 5-6 years (-2.81 IQ points; p value 0.007) compared to children without social withdrawal (ADBB <5; N = 847). When motor and language skills at 1 year were included in the previous model, no association between social withdrawal and IQ at 5-6 years was found. Being socially withdrawn at 1 year is associated with lower IQ scores at 5-6 years. The potential influence of these developmental aspects on each other (withdrawal behaviour and language/motor skills) may occur early in development. Our results improve our understanding of the outcomes of early social withdrawal behaviour and call for early detection of delay in acquisition of language/motor skills among socially withdrawn young children.

A multivariate method for estimating mortality rates among children under 5 years from health and social indicators in Iraq.

PubMed

Garfield, R; Leu, C S

2000-06-01

Many reports on Iraq suggest that a rise in rates of death and disease have occurred since the Gulf War of January/February 1991 and the economic sanctions that followed it. Four preliminary models, based on unadjusted projections, were developed. A logistic regression model was then developed on the basis of six social variables in Iraq and comparable information from countries in the State of the World's Children report. Missing data were estimated for this model by a multiple imputation procedure. The final model depends on three socio-medical indicators: adult literacy, nutritional stunting of children under 5 years, and access to piped water. The model successfully predicted both the mortality rate in 1990, under stable conditions, and in 1991, following the Gulf War. For 1996, after 5 years of sanctions and prior to receipt of humanitarian food via the oil for food programme, this model shows mortality among children under 5 to have reached an estimated 87 per 1000, a rate last experienced more than 30 years ago. Accurate and timely estimates of mortality levels in developing countries are costly and require considerable methodological expertise. A rapid estimation technique like the one developed here may be a useful tool for quick and efficient estimation of mortality rates among under 5 year olds in countries where good mortality data are not routinely available. This is especially true for countries with complex humanitarian emergencies where information on mortality changes can guide interventions and the social stability to use standard demographic methods does not exist.

Identifying longitudinal trajectories of emotional distress symptoms 5 years after traumatic brain injury.

PubMed

Sigurdardottir, S; Andelic, N; Roe, C; Schanke, A K

2014-01-01

To evaluate longitudinal trajectories of emotional distress symptoms after traumatic brain injury (TBI). Longitudinal study. Patients with mild-to-severe TBI, 118 patients participated at 3 months, 109 attended at 1-year and 89 attended the 5-year follow-up. Emotional distress was measured with the Impact of Event Scale-Revised. Patients were also assessed for coping style, anxiety, depression, substance abuse and trauma severity. Based on growth mixture modelling, four trajectories of emotional distress symptoms were identified: 73.5% of patients were characterized by a pattern of resilience, 6.8% by a pattern of delayed distress, 14.6% by recovery and 5.1% by chronic distress. Relative to the resilience trajectory, avoidant-coping style and psychiatric problems were related to recovery and chronic trajectories. The delayed trajectory was similar to the resilience trajectory, except for elevated depressive and anxiety symptoms at 1- and 5-years. Demographics and injury-related variables were not significantly associated with emotional distress trajectories. Resilience was the most common trajectory following TBI. Patients characterized by recovery and chronic trajectories required attention and long-term clinical monitoring of their symptoms. Future research would benefit from longitudinal studies to analyse emotional distress symptoms and the strength of resilience over time.

Your Child's Development: 1.5 Years (18 Months)

MedlinePlus

... 5 Years (18 Months) Print en español El desarrollo de su hijo: 1,5 años (18 meses) ... takes off some clothes scribbles with a crayon Social and Emotional Development begins to engage in pretend ...

Direct Costs of Very Old Persons with Subsyndromal Depression: A 5-Year Prospective Study.

PubMed

Ludvigsson, Mikael; Bernfort, Lars; Marcusson, Jan; Wressle, Ewa; Milberg, Anna

2018-03-15

This study aimed to compare, over a 5-year period, the prospective direct healthcare costs and service utilization of persons with subsyndromal depression (SSD) and non-depressive persons (ND), in a population of very old persons. A second aim was to develop a model that predicts direct healthcare costs in very old persons with SSD. A prospective population-based study was undertaken on 85-year-old persons in Sweden. Depressiveness was screened with the Geriatric Depression Scale at baseline and at 1-year follow-up, and the results were classified into ND, SSD, and syndromal depression. Data on individual healthcare costs and service use from a 5-year period were derived from national database registers. Direct costs were compared between categories using Mann-Whitney U tests, and a prediction model was identified with linear regression. For persons with SSD, the direct healthcare costs per month of survival exceeded those of persons with ND by a ratio 1.45 (€634 versus €436), a difference that was significant even after controlling for somatic multimorbidity. The final regression model consisted of five independent variables predicting direct healthcare costs: male sex, activities of daily living functions, loneliness, presence of SSD, and somatic multimorbidity. SSD among very old persons is associated with increased direct healthcare costs independently of somatic multimorbidity. The associations between SSD, somatic multimorbidity, and healthcare costs in the very old need to be analyzed further in order to better guide allocation of resources in health policy. Copyright © 2018 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Admission glucose does not improve GRACE score at 6 months and 5 years after myocardial infarction.

PubMed

de Mulder, Maarten; van der Ploeg, Tjeerd; de Waard, Guus A; Boersma, Eric; Umans, Victor A

2011-01-01

Admission plasma glucose (APG) is a biomarker that predicts mortality in myocardial infarction (MI) patients. Therefore, APG may improve risk stratification based on the GRACE risk score. We collected data on baseline characteristics and long-term (median 55 months) outcome of 550 MI patients who entered our hospital in 2003 and 2006. We determined the GRACE risk score at admission for each patient, which was entered in a logistic regression model, together with APG, to evaluate their prognostic value for 6-month and 5-year mortality. Patients with APG ≥7.8 mmol/l had a higher mortality than those with APG levels <7.8 mmol/l; 6 months: 13.7 versus 3.6%, p value <0.001; 5 years: 20.4 versus 11.1%, p value 0.003. After adjustment for the GRACE risk score variables, APG appeared a significant predictor of 6-month and 5-year mortality, adjusted OR 1.17 (1.06-1.29) and 1.12 (1.03-1.22). The combination of the GRACE risk score and APG increased the model's performance (discrimination C-index 0.87 vs. 0.85), although the difference was not significant (p = 0.095). Combining the GRACE risk score and APG reclassified 12.9% of the patients, but the net reclassification improvement was nonsignificant (p = 0.146). APG is a predictor of 6-month and 5-year mortality, each mmol/l increase in APG being associated with a mortality increase of 17 and 12%, respectively, independent of the GRACE risk score. However, adding APG to the GRACE model did not result in significantly improved clinical risk stratification. Copyright © 2012 S. Karger AG, Basel.

Anti-Müllerian hormone, follicle stimulating hormone, antral follicle count, and risk of menopause within 5 years.

PubMed

Kim, Catherine; Slaughter, James C; Wang, Erica T; Appiah, Duke; Schreiner, Pamela; Leader, Benjamin; Calderon-Margalit, Ronit; Sternfeld, Barbara; Siscovick, David; Wellons, Melissa

2017-08-01

To evaluate the ability of concentration of anti-Müllerian hormone (AMH), antral follicle count (AFC), and concentration of follicle stimulating hormone (FSH) to predict the onset of menopause. The Coronary Artery Risk Development in Young Adults Study (CARDIA) Women's Study was an ancillary study to CARDIA, a population-based study of adults aged 18-30 years followed for 3 decades. For this report, participants were women (n=426) who had attended the CARDIA year 15-16 (2000-2001) examination, had at least one ovary, were not pregnant, and underwent serum AMH and FSH measurement and transvaginal ultrasonography in 2002-2003. The probability of menopause in 5 years based upon AMH, FSH, and AFC. The mean age of the women at the time of AMH, FSH, and AFC assessment was 43 years. The cumulative incidence of menopause at 25 years (or follow-up) was 27% (n=426), and the incidence within 5 years was 13% (n=55). Among women aged 45-49 years, undetectable AMH concentrations were associated with a greater than 60% probability of menopause within 5 years, whereas approximately 1/3 of women with no or just one antral follicle experienced menopause within 5 years. Both low and high concentrations of FSH were associated with greater odds of menopause than intermediate concentrations. Models with multiple markers did not improve the prediction of menopause over that afforded by models with single markers. The ability to predict onset of menopause was improved with any of the three menopausal markers in addition to age. AMH concentrations were more closely associated with menopause than AFC or FSH. Copyright © 2017 Elsevier B.V. All rights reserved.

Long-Term Omalizumab Treatment: A Multicenter, Real-Life, 5-Year Trial.

PubMed

Yorgancıoğlu, Arzu; Öner Erkekol, Ferda; Mungan, Dilşad; Erdinç, Münevver; Gemicioğlu, Bilun; Özşeker, Zeynep Ferhan; Bayrak Değirmenci, Papatya; Naycı, Sibel; Çilli, Aykut; Erdenen, Füsun; Kırmaz, Cengiz; Ediger, Dane; Yalçın, Arzu Didem; Büyüköztürk, Suna; Öztürk, Sami; Güleç, Mustafa; Işık, Sacide Rana; Kalyoncu, Ali Fuat; Göksel, Özlem; Aydın, Ömür; Havlucu, Yavuz; Baloğlu Ar, İdilhan; Erdoğdu, Ahmet

2018-05-17

Omalizumab has demonstrated therapeutic benefits both in controlled clinical trials and real-life studies. However, research concerning the long-term effects and tolerability of omalizumab is needed. The main objective of this study was to evaluate the effectiveness and tolerability of treatment with omalizumab for up to 5 years. A multicenter, retrospective, chart-based study was carried out to compare documented exacerbations, hospitalizations, systemic steroid requirement, FEV1, and asthma control test (ACT) results during 1 year prior to omalizumab treatment versus at 1, 3, and 5 years of treatment. Adverse events and reasons for discontinuation were also recorded at each time point. Four hundred and sixty-five patients were enrolled in the study. Outcome variables had improved after the 1st year and were sustained after the 3rd and 5th years of treatment with omalizumab. Omalizumab treatment reduced the asthma exacerbation rate by 71.3% (p < 0.001) at 1 year, 64.3% (p < 0.001) at 3 years, and 54.8% (p = 0.002) at 5 years. The hospitalization rate also decreased; by the 5th year of the treatment no patients were hospitalized. ACT results had also improved significantly: 12 (p < 0.001) at 1 year, 12 (p < 0.001) at 3 years, and 12 (p = 0.002) at 5 years. Overall, 12.7% of patients reported adverse events (most of these were mild-to-moderate) and the overall dropout rate was 9.0%. Omalizumab had a significant effect on asthma outcomes and this effect was maintained over 5 years. The drug was found to be generally safe and treatment compliance was good. © 2018 S. Karger AG, Basel.

A New Hybrid Spatio-temporal Model for Estimating Daily Multi-year PM2.5 Concentrations Across Northeastern USA Using High Resolution Aerosol Optical Depth Data

NASA Technical Reports Server (NTRS)

Kloog, Itai; Chudnovsky, Alexandra A.; Just, Allan C.; Nordio, Francesco; Koutrakis, Petros; Coull, Brent A.; Lyapustin, Alexei; Wang, Yujie; Schwartz, Joel

2014-01-01

The use of satellite-based aerosol optical depth (AOD) to estimate fine particulate matter PM(sub 2.5) for epidemiology studies has increased substantially over the past few years. These recent studies often report moderate predictive power, which can generate downward bias in effect estimates. In addition, AOD measurements have only moderate spatial resolution, and have substantial missing data. We make use of recent advances in MODIS satellite data processing algorithms (Multi-Angle Implementation of Atmospheric Correction (MAIAC), which allow us to use 1 km (versus currently available 10 km) resolution AOD data.We developed and cross validated models to predict daily PM(sub 2.5) at a 1X 1 km resolution across the northeastern USA (New England, New York and New Jersey) for the years 2003-2011, allowing us to better differentiate daily and long term exposure between urban, suburban, and rural areas. Additionally, we developed an approach that allows us to generate daily high-resolution 200 m localized predictions representing deviations from the area 1 X 1 km grid predictions. We used mixed models regressing PM(sub 2.5) measurements against day-specific random intercepts, and fixed and random AOD and temperature slopes. We then use generalized additive mixed models with spatial smoothing to generate grid cell predictions when AOD was missing. Finally, to get 200 m localized predictions, we regressed the residuals from the final model for each monitor against the local spatial and temporal variables at each monitoring site. Our model performance was excellent (mean out-of-sample R(sup 2) = 0.88). The spatial and temporal components of the out-of-sample results also presented very good fits to the withheld data (R(sup 2) = 0.87, R(sup)2 = 0.87). In addition, our results revealed very little bias in the predicted concentrations (Slope of predictions versus withheld observations = 0.99). Our daily model results show high predictive accuracy at high spatial resolutions

A New Hybrid Spatio-Temporal Model For Estimating Daily Multi-Year PM2.5 Concentrations Across Northeastern USA Using High Resolution Aerosol Optical Depth Data

PubMed Central

Kloog, Itai; Chudnovsky, Alexandra A.; Just, Allan C.; Nordio, Francesco; Koutrakis, Petros; Coull, Brent A.; Lyapustin, Alexei; Wang, Yujie; Schwartz, Joel

2017-01-01

Background The use of satellite-based aerosol optical depth (AOD) to estimate fine particulate matter (PM2.5) for epidemiology studies has increased substantially over the past few years. These recent studies often report moderate predictive power, which can generate downward bias in effect estimates. In addition, AOD measurements have only moderate spatial resolution, and have substantial missing data. Methods We make use of recent advances in MODIS satellite data processing algorithms (Multi-Angle Implementation of Atmospheric Correction (MAIAC), which allow us to use 1 km (versus currently available 10 km) resolution AOD data. We developed and cross validated models to predict daily PM2.5 at a 1×1km resolution across the northeastern USA (New England, New York and New Jersey) for the years 2003–2011, allowing us to better differentiate daily and long term exposure between urban, suburban, and rural areas. Additionally, we developed an approach that allows us to generate daily high-resolution 200 m localized predictions representing deviations from the area 1×1 km grid predictions. We used mixed models regressing PM2.5 measurements against day-specific random intercepts, and fixed and random AOD and temperature slopes. We then use generalized additive mixed models with spatial smoothing to generate grid cell predictions when AOD was missing. Finally, to get 200 m localized predictions, we regressed the residuals from the final model for each monitor against the local spatial and temporal variables at each monitoring site. Results Our model performance was excellent (mean out-of-sample R2=0.88). The spatial and temporal components of the out-of-sample results also presented very good fits to the withheld data (R2=0.87, R2=0.87). In addition, our results revealed very little bias in the predicted concentrations (Slope of predictions versus withheld observations = 0.99). Conclusion Our daily model results show high predictive accuracy at high spatial resolutions

A New Hybrid Spatio-Temporal Model For Estimating Daily Multi-Year PM2.5 Concentrations Across Northeastern USA Using High Resolution Aerosol Optical Depth Data.

PubMed

Kloog, Itai; Chudnovsky, Alexandra A; Just, Allan C; Nordio, Francesco; Koutrakis, Petros; Coull, Brent A; Lyapustin, Alexei; Wang, Yujie; Schwartz, Joel

2014-10-01

The use of satellite-based aerosol optical depth (AOD) to estimate fine particulate matter (PM 2.5 ) for epidemiology studies has increased substantially over the past few years. These recent studies often report moderate predictive power, which can generate downward bias in effect estimates. In addition, AOD measurements have only moderate spatial resolution, and have substantial missing data. We make use of recent advances in MODIS satellite data processing algorithms (Multi-Angle Implementation of Atmospheric Correction (MAIAC), which allow us to use 1 km (versus currently available 10 km) resolution AOD data. We developed and cross validated models to predict daily PM 2.5 at a 1×1km resolution across the northeastern USA (New England, New York and New Jersey) for the years 2003-2011, allowing us to better differentiate daily and long term exposure between urban, suburban, and rural areas. Additionally, we developed an approach that allows us to generate daily high-resolution 200 m localized predictions representing deviations from the area 1×1 km grid predictions. We used mixed models regressing PM 2.5 measurements against day-specific random intercepts, and fixed and random AOD and temperature slopes. We then use generalized additive mixed models with spatial smoothing to generate grid cell predictions when AOD was missing. Finally, to get 200 m localized predictions, we regressed the residuals from the final model for each monitor against the local spatial and temporal variables at each monitoring site. Our model performance was excellent (mean out-of-sample R 2 =0.88). The spatial and temporal components of the out-of-sample results also presented very good fits to the withheld data (R 2 =0.87, R 2 =0.87). In addition, our results revealed very little bias in the predicted concentrations (Slope of predictions versus withheld observations = 0.99). Our daily model results show high predictive accuracy at high spatial resolutions and will be useful in

7 CFR 5.3 - Selection of calendar year price data.

Code of Federal Regulations, 2010 CFR

2010-01-01

... year price data. In computing the adjusted base price for those commodities for which calendar year price data are used, “* * * the average of the prices received by farmers for such commodity, at such... 7 Agriculture 1 2010-01-01 2010-01-01 false Selection of calendar year price data. 5.3 Section 5.3...

7 CFR 5.3 - Selection of calendar year price data.

Code of Federal Regulations, 2014 CFR

2014-01-01

... payments as provided by section 301(a)(1)(B). For Maryland Tobacco, type 32, the price data for each... 7 Agriculture 1 2014-01-01 2014-01-01 false Selection of calendar year price data. 5.3 Section 5.3... year price data. In computing the adjusted base price for those commodities for which calendar year...

Effectiveness of Multipurpose Unit Early Classroom Intervention Program for 4-5-Year-Old Children

ERIC Educational Resources Information Center

Celebioglu Morkoc, Ozlem; Aktan Acar, Ebru

2014-01-01

This research examined the effectiveness of Multipurpose Unit Early Classroom Intervention Program (MUECIP) prepared for 4-5-year-old (48-60 months) children whose development is at risk because of their families' socioeconomic conditions. The research adopted a preliminary test-final test control group trial model. The research participants were…

The 5'×5' global geoid model GGM2016

NASA Astrophysics Data System (ADS)

Shen, WenBin; Han, Jiancheng

2016-04-01

We provide an updated 5'×5' global geoid model GGM2016, which is determined based on the shallow layer method (Shen 2006). We choose an inner surface S below the EGM2008 geoid, and the layer bounded by the inner surface S and the Earth's geographical surface E is referred to as the shallow layer. The Earth's geographical surface E is determined by the digital topographic model DTM2006.0 combining with the DNSC2008 mean sea surface. We determine the 3D shallow layer model (SLM) using the refined crust density model CRUST1.0-5min, which is an improved 5'×5' density model of the CRUST1.0 with taking into account the corrections of the areas covered by ice sheets and the land-ocean crossing regions. Based on the SLM and the gravity field EGM2008 defined outside the Earth's geographical surface E, we determine the gravity field EGM2008S defined in the region outside the inner surface S, extending the gravity field's definition domain from the domain outside E to the domain outside S. Based on the geodetic equation W(P)=W0, where W0 is the geopotential constant on the geoid, we determine a 5'×5' global geoid model GGM2016, which provides both the 5'×5' grid values and spherical harmonic coefficient expressions. Comparisons show that the GGM2016 fits the globally available GPS/leveling points better than the EGM2008 geoid. This study is supported by National 973 Project China (grant Nos. 2013CB733301 and 2013CB733305), NSFC (grant Nos. 41174011, 41210006, 41429401, 41128003, 41021061).

Using Photographs from American Memory.

ERIC Educational Resources Information Center

Singleton, Laurel R., Ed.

2001-01-01

This publication contains teaching ideas generated by classroom teachers. For grades K-4, elementary teacher Doris Waud and media specialist Gail Petri developed "Celebrate America with Symbols from American Memory," in which students explore the American memory and symbols. For grades 5-8, media specialist Mary Alice Anderson developed…

Increasing insulin resistance accentuates the effect of triglyceride-associated loci on serum triglycerides during 5 years.

PubMed

Justesen, Johanne M; Andersson, Ehm A; Allin, Kristine H; Sandholt, Camilla H; Jørgensen, Torben; Linneberg, Allan; Jørgensen, Marit E; Hansen, Torben; Pedersen, Oluf; Grarup, Niels

2016-12-01

Blood concentrations of triglycerides are influenced by genetic factors as well as a number of environmental factors, including adiposity and glucose homeostasis. The aim was to investigate the association between a serum triglyceride weighted genetic risk score (wGRS) and changes in fasting serum triglyceride level over 5 years and to test whether the effect of the wGRS was modified by 5 year changes of adiposity, insulin resistance, and lifestyle factors. A total of 3,474 nondiabetic individuals from the Danish Inter99 cohort participated in both the baseline and 5 year follow-up physical examinations and had information on the wGRS comprising 39 genetic variants. In a linear regression model adjusted for age, sex, and baseline serum triglyceride, the wGRS was associated with increased serum triglyceride levels over 5 years [per allele effect = 1.3% (1.0-1.6%); P = 1.0 × 10 -17 ]. This triglyceride-increasing effect of the wGRS interacted with changes in insulin resistance (P interaction = 1.5 × 10 -6 ). This interaction indicated that the effect of the wGRS was stronger in individuals who became more insulin resistant over 5 years. In conclusion, our findings suggest that increased genetic risk load is associated with a larger increase in fasting serum triglyceride levels in nondiabetic individuals during 5 years of follow-up. This effect of the wGRS is accentuated by increasing insulin resistance. Copyright © 2016 by the American Society for Biochemistry and Molecular Biology, Inc.

Increase of body mass index (BMI) from 1.5 to 3 years of age augments the degree of insulin resistance corresponding to BMI at 12 years of age.

PubMed

Arisaka, Osamu; Sairenchi, Toshimi; Ichikawa, Go; Koyama, Satomi

2017-04-01

To elucidate the effect of early growth patterns on the metabolic sensitivity to adiposity, we examined the relationship between the homeostatic model assessment of insulin resistance (HOMA-IR) and body mass index (BMI) levels at 12 years of age in 101 boys and 91 girls in a birth cohort. Children with an increase in BMI from the ages of 1.5 to 3 years exhibited a greater increase of HOMA-IR per BMI increase at 12 years of age compared to those with a decrease in BMI or stable BMI from 1.5 to 3 years. This suggests that children who show an increase in BMI from 1.5 to 3 years, a period normally characterized by a decreased or stable BMI, are more prone to developing insulin resistance at 12 years of age.

5-Year Reoperation Risk and Causes for Revision After Idiopathic Scoliosis Surgery.

PubMed

Ahmed, Syed Imraan; Bastrom, Tracey P; Yaszay, Burt; Newton, Peter O

2017-07-01

An actuarial "survivorship" analysis. The aim of this study was to define the incidence and cause of surgical revision 5 years after scoliosis surgery. Data on contemporary revision surgery rates after idiopathic scoliosis surgery beyond the 2 years postoperatively in the adolescent and young adult population are limited. Patients enrolled in a prospective, multicenter, idiopathic scoliosis surgical registry from 1995 to 2009 were reviewed. Any spine reoperation was defined as a "terminal event." An actuarial survivorship analysis that adjusts for patients lost to follow-up was performed to determine cumulative survival. Time intervals were defined as 0 to <3 months, 3 months to <1 year, 1 to <2 years, 2 to <5 years, and 5 to 10 years. Registry data and radiographs were reviewed and five categories for reoperation assigned: 1) implant failure and/or pseudarthrosis, 2) implant misplacement and/or prominence, 3) wound complication and/or infection, 4) residual deformity and/or progression, and 5) other. One thousand four hundred thirty-five patients from 12 sites were included. The majority were female (80%), with major thoracic curves (76% Lenke 1-4), and average age of 15 ± 2 years (10-22) at surgery. Most had posterior spinal instrumentation and fusion (81%). At this time, 75 (5.2%) patients required reoperation. Twenty-two occurred within 3 months postop, 10 more before 1 year, 12 more before 2 years, another 20 by 5 years, and 10 more after 5 years. This corresponded to an actuarial cumulative survival of 98.3% at 3 months, 97.5% at 1 year, 96.6% at 2 years, 93.9% at 5 years, and 89.8% at the final interval (5-10 yrs). Revisions for scoliosis continue to occur well after 2 years with a 5-year survivorship of 93.9%. Reasons for reoperation are not uniformly distributed over time, with implant-related issues and infection the leading cause for early revision, while late infection was the most common cause after 2 years. Long-term follow-up of these

If I Had a Hammer (and Several Million Dollars): The Saga of the AIHEC Cultural Learning Centers.

ERIC Educational Resources Information Center

Edinger, Anne; Ambler, Marjane

2002-01-01

Presents an interview with Gail Bruce and Anne Ediger, who, in the early 1990s, conceived the idea of building cultural centers on 30 tribal college campuses. States that they imagined the centers would simply serve as repositories for Indian artifacts; however, after years of fund-raising efforts and program obstacles, the buildings transformed…

Using Dynamic Transmission Modeling to Determine Vaccination Coverage Rate Based on 5-Year Economic Burden of Infectious Disease: An Example of Pneumococcal Vaccine.

PubMed

Wen, Yu-Wen; Wu, Hsin; Chang, Chee-Jen

2015-05-01

Vaccination can reduce the incidence and mortality of an infectious disease and thus increase the years of life and productivity for the entire society. But when determining the vaccination coverage rate, its economic burden is usually not taken into account. This article aimed to use a dynamic transmission modeling (DTM), which is based on a susceptible-infectious-recovered model and is a system of differential equations, to find the optimal vaccination coverage rate based on the economic burden of an infectious disease. Vaccination for pneumococcal diseases was used as an example to demonstrate the main purpose. 23-Valent pneumococcal polysaccharide vaccines (PPV23) and 13-valent pneumococcal conjugate vaccines (PCV13) have shown their cost-effectiveness in elderly and children, respectively. Scenarios analysis of PPV23 to elderly aged 65+ years and of PCV13 to children aged 0 to 4 years was applied to assess the optimal vaccination coverage rate based on the 5-year economic burden. Model parameters were derived from Taiwan's National Health Insurance Research Database, government data, and published literature. Various vaccination coverage rates, the vaccine efficacy, and all epidemiologic parameters were substituted into DTM, and all differential equations were solved in R Statistical Software. If the coverage rate of PPV23 for the elderly and of PCV13 for the children both reach 50%, the economic burden due to pneumococcal disease will be acceptable. This article provided an alternative perspective from the economic burden of diseases to obtain a vaccination coverage rate using the DTM. This will provide valuable information for vaccination policy decision makers. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Change in health status (EQ-5D) over 5 years among individuals with and without type 2 diabetes mellitus in the SHIELD longitudinal study.

PubMed

Grandy, Susan; Fox, Kathleen M

2012-08-21

Health-related quality of life studies among adults with type 2 diabetes mellitus, using the EQ-5D, have been short term and have not assessed change over years. This study assessed the change in health status and health-related quality of life over 5 years among individuals with and without diabetes. Respondents to the US Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD) completed the EuroQol-5D (EQ-5D) at baseline (2004) and 5 years later (2009). Visual analog scale (VAS) score and health index score were computed at baseline and year 5, and the change over 5 years was measured for individuals with type 2 diabetes mellitus (T2DM) and those without diabetes, and T2DM adults with and without diabetic complications. Linear regression models were used to determine change in EQ-5D score, controlling for age, gender, race, education, household income, and body mass index (BMI). There was significantly greater decline in the EQ-5D index score in the T2DM group (-0.031 [SD 0.158]), compared with those without diabetes (-0.016 [0.141], p = 0.001). Compared with respondents without diabetes, those with T2DM had a larger reduction in EQ-5D index score, after controlling for demographics (p = 0.001). EQ-5D VAS score declined over 5 years for both groups: -1.42 (18.1) for the T2DM group, and -0.63 (15.8) for the group without diabetes, but the between-group difference was not significant either before (p = 0.09) or after (p = 0.12), controlling for demographics. T2DM respondents with diabetic complications had a greater decline in EQ-5D scores than T2DM respondents without complications (p < 0.05). Over a 5-year period, health status of respondents with T2DM declined significantly compared with those with no diabetes, indicating that the burden of the disease has a long-term detrimental impact. This decline in health status is likely to impact utility scores (fewer quality-adjusted life years) for economic

National Surgical Adjuvant Breast and Bowel Project Study of Tamoxifen and Raloxifene trial: Advancing the science of recruitment and breast cancer risk assessment in minority communities

PubMed Central

McCaskill-Stevens, Worta; Wilson, John W; Cook, Elise D; Edwards, Cora L; Gibson, Regina V; McElwain, Diane L; Figueroa-Moseley, Colmar D; Paskett, Electra D; Roberson, Noma L; Wickerham, D Lawrence; Wolmark, Norman

2014-01-01

Background One of the first chemoprevention trials conducted in the western hemisphere, the National Surgical Adjuvant Breast and Bowel Project’s (NSABP) Breast Cancer Prevention Trial (BCPT), demonstrated the need to evaluate all aspects of recruitment in real time and to implement strategies to enroll racial and ethnic minority women. Purpose The purpose of this report is to review various patient recruitment efforts the NSABP developed to enhance the participation of racial and ethnic minority women in the Study of Tamoxifen and Raloxifene (STAR) trial and to describe the role that the recruitment process played in the implementation and understanding of breast cancer risk assessment in minority communities. Methods The NSABP STAR trial was a randomized, double-blinded study comparing the use of tamoxifen 20 mg/day to raloxifene 60 mg/day, for a 5-year period, to reduce the risk of developing invasive breast cancer. Eligible postmenopausal women were required to have a 5-year predicted breast cancer risk of 1.66% based on the modified Gail Model. For the current report, eligibility and enrollment data were tabulated by race/ethnicity for women who submitted STAR risk assessment forms (RAFs). Results A total of 184,460 RAFs were received, 145,550 (78.9%) from white women and 38,910 (21.1%) from minority women. Of the latter group, 21,444 (11.6%) were from African Americans/blacks, 7913 (4.5%) from Hispanics/Latinas, and 9553 (5.2%) from other racial or ethnic groups. The percentages of risk-eligible women among African Americans, Hispanics/Latinas, others, and whites were 14.2%, 23.3%, 13.7%, and 57.4%, respectively. Programs targeting minority enrollment submitted large numbers of RAFs, but the eligibility rates of the women referred from those groups tended to be lower than the rates among women referred outside of those programs. The average number of completed risk assessments increased among minority women over the course of the recruitment period compared

Classification Rule for 5-year Cardiovascular Diseases Risk using decision tree in Primary Care Chinese Patients with Type 2 Diabetes Mellitus.

PubMed

Wan, Eric Yuk Fai; Fong, Daniel Yee Tak; Fung, Colman Siu Cheung; Yu, Esther Yee Tak; Chin, Weng Yee; Chan, Anca Ka Chun; Lam, Cindy Lo Kuen

2017-11-10

Cardiovascular disease(CVD) is the leading cause of mortality among patients with type 2 diabetes mellitus(T2DM), and a risk classification model for CVD among primary care diabetic patients is pivotal for risk-based interventions and patient information. This study developed a simple tool for a 5-year CVD risk prediction for primary care Chinese patients with T2DM. A retrospective cohort study was conducted on 137,935 primary care Chinese T2DM patients aged 18-79 years without history of CVD between 1 January 2010 and 31 December 2010. New events of CVD of the cohort over a median follow up of 5 years were extracted from the medical records. A classification rule of 5-year CVD risk was obtained from the derivation cohort and validated in the validation cohort. Significant risk factors included in decision tree were age, gender, smoking status, diagnosis duration, obesity, unsatisfactory control on haemoglobin A1c and cholesterol, albuminuria and stage of chronic kidney disease, which categorized patients into five 5-year CVD risk groups(<5%; 5-9%; 10-14%; 15-19% and ≥20%). Taking the group with the lowest CVD risk, the hazard ratios varied from 1.92(1.77,2.08) to 8.46(7.75,9.24). The present prediction model performed comparable discrimination and better calibration from the plot compared to other current existing models.

AdS5×S(5) mirror model as a string sigma model.

PubMed

Arutyunov, Gleb; van Tongeren, Stijn J

2014-12-31

Doing a double Wick rotation in the world sheet theory of the light cone AdS5×S(5) superstring results in an inequivalent, so-called mirror theory that plays a central role in the field of integrability in the AdS-CFT correspondence. We show that this mirror theory can be interpreted as the light cone theory of a free string on a different background. This background is related to dS5×H(5) by a double T-duality, and has hidden supersymmetry. The geometry can also be extracted from an integrable deformation of the AdS5×S(5) sigma model, and we prove the observed mirror duality of these deformed models at the bosonic level as a byproduct. While we focus on AdS5×S(5), our results apply more generally.

Kidney Outcomes 5 Years After Pediatric Cardiac Surgery

PubMed Central

Greenberg, Jason H.; Zappitelli, Michael; Devarajan, Prasad; Thiessen-Philbrook, Heather R.; Krawczeski, Catherine; Li, Simon; Garg, Amit X.; Coca, Steve; Parikh, Chirag R.

2017-01-01

IMPORTANCE Acute kidney injury (AKI) after pediatric cardiac surgery is associated with high short-term morbidity and mortality; however, the long-term kidney outcomes are unclear. OBJECTIVE To assess long-term kidney outcomes after pediatric cardiac surgery and to determine if perioperative AKI is associated with worse long-term kidney outcomes. DESIGN, SETTING, AND PARTICIPANTS This prospective multicenter cohort study recruited children between ages 1 month to 18 years who underwent cardiopulmonary bypass for cardiac surgery and survived hospitalization from 3 North American pediatric centers between July 2007 and December 2009. Children were followed up with telephone calls and an in-person visit at 5 years after their surgery. EXPOSURES Acute kidney injury defined as a postoperative serum creatinine rise from preoperative baseline by 50% or 0.3 mg/dL or more during hospitalization for cardiac surgery. MAIN OUTCOMES AND MEASURES Hypertension (blood pressure ≥95th percentile for height, age, sex, or self-reported hypertension), microalbuminuria (urine albumin to creatinine ratio >30 mg/g), and chronic kidney disease (serum creatinine estimated glomerular filtration rate [eGFR] <90 mL/min/1.73 m2 or microalbuminuria). RESULTS Overall, 131 children (median [interquartile range] age, 7.7 [5.9–9.9] years) participated in the 5-year in-person follow-up visit; 68 children (52%) were male. Fifty-seven of 131 children (44%) had postoperative AKI. At follow-up, 22 children (17%) had hypertension (10 times higher than the published general pediatric population prevalence), while 9 (8%), 13 (13%), and 1 (1%) had microalbuminuria, an eGFR less than 90 mL/min/1.73 m2, and an eGFR less than 60 mL/min/1.73 m2, respectively. Twenty-one children (18%) had chronic kidney disease. Only 5 children (4%) had been seen by a nephrologist during follow-up. There was no significant difference in renal outcomes between children with and without postoperative AKI. CONCLUSIONS AND

The Future of Drought in the Southeastern U.S.: Projections from downscaled CMIP5 models

NASA Astrophysics Data System (ADS)

Keellings, D.; Engstrom, J.

2017-12-01

The Southeastern U.S. has been repeatedly impacted by severe droughts that have affected the environment and economy of the region. In this study the ability of 32 downscaled CMIP5 models, bias corrected using localized constructed analogs (LOCA), to simulate historical observations of dry spells from 1950-2005 are assessed using Perkins skill scores and significance tests. The models generally simulate the distribution of dry days well but there are significant differences between the ability of the best and worst performing models, particularly when it comes to the upper tail of the distribution. The best and worst performing models are then projected through 2099, using RCP 4.5 and 8.5, and estimates of 20 year return periods are compared. Only the higher skill models provide a good estimate of extreme dry spell lengths with simulations of 20 year return values within ± 5 days of observed values across the region. Projected return values differ by model grouping, but all models exhibit significant increases.

A risk management model for familial breast cancer: A new application using Fuzzy Cognitive Map method.

PubMed

Papageorgiou, Elpiniki I; Jayashree Subramanian; Karmegam, Akila; Papandrianos, Nikolaos

2015-11-01

Breast cancer is the most deadly disease affecting women and thus it is natural for women aged 40-49 years (who have a family history of breast cancer or other related cancers) to assess their personal risk for developing familial breast cancer (FBC). Besides, as each individual woman possesses different levels of risk of developing breast cancer depending on their family history, genetic predispositions and personal medical history, individualized care setting mechanism needs to be identified so that appropriate risk assessment, counseling, screening, and prevention options can be determined by the health care professionals. The presented work aims at developing a soft computing based medical decision support system using Fuzzy Cognitive Map (FCM) that assists health care professionals in deciding the individualized care setting mechanisms based on the FBC risk level of the given women. The FCM based FBC risk management system uses NHL to learn causal weights from 40 patient records and achieves a 95% diagnostic accuracy. The results obtained from the proposed model are in concurrence with the comprehensive risk evaluation tool based on Tyrer-Cuzick model for 38/40 patient cases (95%). Besides, the proposed model identifies high risk women by calculating higher accuracy of prediction than the standard Gail and NSAPB models. The testing accuracy of the proposed model using 10-fold cross validation technique outperforms other standard machine learning based inference engines as well as previous FCM-based risk prediction methods for BC. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

A Five- Year CMAQ Model Performance for Wildfires and ...

EPA Pesticide Factsheets

Biomass burning has been identified as an important contributor to the degradation of air quality because of its impact on ozone and particulate matter. Two components of the biomass burning inventory, wildfires and prescribed fires are routinely estimated in the national emissions inventory. However, there is a large amount of uncertainty in the development of these emission inventory sectors. We have completed a 5 year set of CMAQ model simulations (2008-2012) in which we have simulated regional air quality with and without the wildfire and prescribed fire inventory. We will examine CMAQ model performance over regions with significant PM2.5 and Ozone contribution from prescribed fires and wildfires. The National Exposure Research Laboratory (NERL) Computational Exposure Division (CED) develops and evaluates data, decision-support tools, and models to be applied to media-specific or receptor-specific problem areas. CED uses modeling-based approaches to characterize exposures, evaluate fate and transport, and support environmental diagnostics/forensics with input from multiple data sources. It also develops media- and receptor-specific models, process models, and decision support tools for use both within and outside of EPA.

Global determinants of mortality in under 5s: 10 year worldwide longitudinal study.

PubMed

Hanf, Matthieu; Nacher, Mathieu; Guihenneuc, Chantal; Tubert-Bitter, Pascale; Chavance, Michel

2013-11-08

To assess at country level the association of mortality in under 5s with a large set of determinants. Longitudinal study. 193 United Nations member countries, 2000-09. Yearly data between 2000 and 2009 based on 12 world development indicators were used in a multivariable general additive mixed model allowing for non-linear relations and lag effects. National rate of deaths in under 5s per 1000 live births The model retained the variables: gross domestic product per capita; percentage of the population having access to improved water sources, having access to improved sanitation facilities, and living in urban areas; adolescent fertility rate; public health expenditure per capita; prevalence of HIV; perceived level of corruption and of violence; and mean number of years in school for women of reproductive age. Most of these variables exhibited non-linear behaviours and lag effects. By providing a unified framework for mortality in under 5s, encompassing both high and low income countries this study showed non-linear behaviours and lag effects of known or suspected determinants of mortality in this age group. Although some of the determinants presented a linear action on log mortality indicating that whatever the context, acting on them would be a pertinent strategy to effectively reduce mortality, others had a threshold based relation potentially mediated by lag effects. These findings could help designing efficient strategies to achieve maximum progress towards millennium development goal 4, which aims to reduce mortality in under 5s by two thirds between 1990 and 2015.

DTU candidate field models for IGRF-12 and the CHAOS-5 geomagnetic field model

NASA Astrophysics Data System (ADS)

Finlay, Christopher C.; Olsen, Nils; Tøffner-Clausen, Lars

2015-07-01

We present DTU's candidate field models for IGRF-12 and the parent field model from which they were derived, CHAOS-5. Ten months of magnetic field observations from ESA's Swarm mission, together with up-to-date ground observatory monthly means, were used to supplement the data sources previously used to construct CHAOS-4. The internal field part of CHAOS-5, from which our IGRF-12 candidate models were extracted, is time-dependent up to spherical harmonic degree 20 and involves sixth-order splines with a 0.5 year knot spacing. In CHAOS-5, compared with CHAOS-4, we update only the low-degree internal field model (degrees 1 to 24) and the associated external field model. The high-degree internal field (degrees 25 to 90) is taken from the same model CHAOS-4h, based on low-altitude CHAMP data, which was used in CHAOS-4. We find that CHAOS-5 is able to consistently fit magnetic field data from six independent low Earth orbit satellites: Ørsted, CHAMP, SAC-C and the three Swarm satellites (A, B and C). It also adequately describes the secular variation measured at ground observatories. CHAOS-5 thus contributes to an initial validation of the quality of the Swarm magnetic data, in particular demonstrating that Huber weighted rms model residuals to Swarm vector field data are lower than those to Ørsted and CHAMP vector data (when either one or two star cameras were operating). CHAOS-5 shows three pulses of secular acceleration at the core surface over the past decade; the 2006 and 2009 pulses have previously been documented, but the 2013 pulse has only recently been identified. The spatial signature of the 2013 pulse at the core surface, under the Atlantic sector where it is strongest, is well correlated with the 2006 pulse, but anti-correlated with the 2009 pulse.

Rules of the Game for Women

ERIC Educational Resources Information Center

Canty, Becky

2005-01-01

In "Play Like a Man, Win Like a Woman," Gail Evans' matter-of-fact directness contributes so many helpful hints about success that women need to learn. Playing to their strengths and characteristics as women is important to enhance their professional success. In the author's working life as a superintendent (which included three years as a theatre…

Spontaneous resolution of chalazion after 3 to 5 years.

PubMed

Honda, Michio; Honda, Kyoko

2010-07-01

To report the first three cases of spontaneous resolution of chalazia after 3 to 5 years. Patients with chalazia who visited Honda Eye Clinic were observed and treated between 1991 and 2008. Chalazia were diagnosed by deliberate palpation of lids and observation of external appearance of lids. Histopathologic examination of excised specimens was performed to confirm the diagnosis. All data were obtained from the regular daily clinical practices and recordings with informed consent. Three chalazia completely resolved without medications or surgical interventions after 3 to 5 years. Excisions of chalazia of patients aged older than 50 years were few. Chalazion may be a self-limiting disorder even in the long-term.

Association between Infancy BMI Peak and Body Composition and Blood Pressure at Age 5–6 Years

PubMed Central

Hof, Michel H. P.; Vrijkotte, Tanja G. M.; de Hoog, Marieke L. A.; van Eijsden, Manon; Zwinderman, Aeilko H.

2013-01-01

Introduction The development of overweight is often measured with the body mass index (BMI). During childhood the BMI curve has two characteristic points: the adiposity rebound at 6 years and the BMI peak at 9 months of age. In this study, the associations between the BMI peak and body composition measures and blood pressure at age 5–6 years were investigated. Methods Measurements from the Amsterdam Born Children and their Development (ABCD) study were available for this study. Blood pressure (systolic and diastolic) and body composition measures (BMI, waist-to-height ratio, fat percentage) were gathered during a health check at about 6 years of age (n = 2822). All children had multiple BMI measurements between the 0–4 years of age. For boys and girls separately, child-specific BMI peaks were extracted from mixed effect models. Associations between the estimated BMI peak and the health check measurements were analysed with linear models. In addition, we investigated the potential use of the BMI at 9 months as a surrogate measure for the magnitude of the BMI peak. Results After correction for the confounding effect of fetal growth, both timing and magnitude of the BMI peak were significantly and positively associated (p<0.001) with all body composition measures at the age of 5–6 years. The BMI peak showed no direct association with blood pressure at the age 5–6 year, but was mediated by the current BMI. The correlation between the magnitude of the BMI peak and BMI at 9 months was approximately 0.93 and similar associations with the measures at 5–6 years were found. Conclusion The magnitude of the BMI peak was associated with body composition measures at 5–6 years of age. Moreover, the BMI at 9 months could be used as surrogate measure for the magnitude of the BMI peak. PMID:24324605

Graves' disease in 2.5 years old girl - 6-years-long observation.

PubMed

Jonak, Olimpia; Połubok, Joanna; Barg, Ewa

2016-01-01

Pediatric Graves' disease is rare in young children, more frequent in children with other autoimmune diseases or with family history of autoimmune thyroid disease. The 2.5 year old girl was admitted to the hospital with tachycardia and subfebrile temperature. The girl presented symptoms of atopic dermatitis. Child's mother was diagnosed with Hashimoto disease two months after the child's diagnosis. In physical examination of the child, enlarged thyroid was found. At the admission, the laboratory tests revealed decreased TSH (0.001 uIU/ml), increased both FT3 (>30 pg/ml) and FT4 (3.43 ng/dl), but normal levels of anti-thyreoglobulin antibodies (ATG - 0.64 IU/ml) and anti-thyroid peroxidase antibodies (ATPO - 0 IU/ml); thyrotropin receptor antibodies (TRAb) were not identified. The Graves' disease was diagnosed. The girl started treatment with methimazole (2x5mg) and propranolol (due to tachycardia, 2x5mg). The thyroid function (TSH, FT4 and FT3) normalized 1 year after diagnosis and hormone levels remained within normal reference values, but she received methimazole for 18 months. At presen, the patient is 8 years old. She is not receiving any treatment and her thyroid function is correct. The girl still presents symptoms of atopy. In case of symptoms of tachycardia in children, the hyperthyroidism should be taken into consideration. Numerous methods of treatment provide a therapy appropriate to the age and condition of patients. Long remission after treatment with antithyroid drugs could also be achieved in younger (prepubertal) children. © Polish Society for Pediatric Endocrinology and Diabetology.

CRUST 5.1: A global crustal model at 5° x 5°

USGS Publications Warehouse

Mooney, Walter D.; Laske, Gabi; Masters, T. Guy

1998-01-01

We present a new global model for the Earth's crust based on seismic refraction data published in the period 1948–1995 and a detailed compilation of ice and sediment thickness. An extensive compilation of seismic refraction measurements has been used to determine the crustal structure on continents and their margins. Oceanic crust is modeled with both a standard model for normal oceanic crust, and variants for nonstandard regions, such as oceanic plateaus. Our model (CRUST 5.1) consists of 2592 5° × 5° tiles in which the crust and uppermost mantle are described by eight layers: (1) ice, (2) water, (3) soft sediments, (4) hard sediments, (5) crystalline upper, (6) middle, (7) lower crust, and (8) uppermost mantle. Topography and bathymetry are adopted from a standard database (ETOPO-5). Compressional wave velocity in each layer is based on field measurements, and shear wave velocity and density are estimated using recently published empirical Vp- Vs and Vp-density relationships. The crustal model differs from previous models in that (1) the thickness and seismic/density structure of sedimentary basins is accounted for more completely, (2) the velocity structure of unmeasured regions is estimated using statistical averages that are based on a significantly larger database of crustal structure, (3) the compressional wave, shear wave, and density structure have been explicitly specified using newly available constraints from field and laboratory studies. Thus this global crustal model is based on substantially more data than previous models and differs from them in many important respects. A new map of the thickness of the Earth's crust is presented, and we illustrate the application of this model by using it to provide the crustal correction for surface wave phase velocity maps. Love waves at 40 s are dominantly sensitive to crustal structure, and there is a very close correspondence between observed phase velocities at this period and those predicted by CRUST 5

Assessment of dental caries predictors in 6-year-old school children - results from 5-year retrospective cohort study

PubMed Central

2012-01-01

Background This was a retrospective cohort study undertaken to assess the rate and pattern of dental caries development in 6-year-old school children followed-up for a period of 5 years, and to identify baseline risk factors that were associated with 5 years caries experience in Malaysian children. Methods This 5-years retrospective cohort study comprised primary school children initially aged 6 years in 2004. Caries experience of each child was recorded annually using World Health Organization criteria. The rates of dental caries were recorded in prevalence and incidence density of carious lesions from baseline to final examination. Risk assessment was done to assess relative risk for caries after 5 years in children with baseline caries status. Simple and multiple logistic regression analysis were performed to identify significant independent risk factors for caries. Results The sample consisted of 1830 school children. All components of DMFT showed significant differences between baseline and final examination. Filled teeth (FT) component of the DMFT showed the greatest increases. Results revealed the initial baseline caries level in permanent dentition was a strong predictor for future caries after 5 years (RR=3.78, 95% CI=3.48-4.10, P<0.001). Logistic regression analysis showed significant association between caries occurrence and residence (urban/rural) (OR=1.80, P<0.001). However, it was not significantly associated with gender and ethnicity. The incidence density of caries, affected persons (IDp) observed from baseline and after 5 years was 5.80 persons/100 person-year of observation. The rate of new caries-affected tooth (IDt) in the period from baseline and after 5-years was 0.76 teeth/100 teeth-year of observation. Conclusion The majority of 12-year-old school children (70%) were caries-free and most of the caries were concentrated in only a small proportion (30%) of them. We found that the presence of caries in permanent teeth at the age of 6 years was

Projection of heat waves over China for eight different global warming targets using 12 CMIP5 models

NASA Astrophysics Data System (ADS)

Guo, Xiaojun; Huang, Jianbin; Luo, Yong; Zhao, Zongci; Xu, Ying

2017-05-01

Simulation and projection of the characteristics of heat waves over China were investigated using 12 CMIP5 global climate models and the CN05.1 observational gridded dataset. Four heat wave indices (heat wave frequency, longest heat wave duration, heat wave days, and high temperature days) were adopted in the analysis. Evaluations of the 12 CMIP5 models and their ensemble indicated that the multi-model ensemble could capture the spatiotemporal characteristics of heat wave variation over China. The inter-decadal variations of heat waves during 1961-2005 can be well simulated by multi-model ensemble. Based on model projections, the features of heat waves over China for eight different global warming targets (1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 4.5, and 5.0 °C) were explored. The results showed that the frequency and intensity of heat waves would increase more dramatically as the global mean temperature rise attained higher warming targets. Under the RCP8.5 scenario, the four China-averaged heat wave indices would increase from about 1.0 times/year, 2.5, 5.4, and 13.8 days/year to about 3.2 times/year, 14.0, 32.0, and 31.9 days/year for 1.5 and 5.0 °C warming targets, respectively. Those regions that suffer severe heat waves in the base climate would experience the heat waves with greater frequency and severity following global temperature rise. It is also noteworthy that the areas in which a greater number of severe heat waves occur displayed considerable expansion. Moreover, the model uncertainties exhibit a gradual enhancement with projected time extending from 2006 to 2099.

Projections of Rainfall and Temperature from CMIP5 Models over BIMSTEC Countries

NASA Astrophysics Data System (ADS)

Pattnayak, K. C.; Kar, S. C.; Ragi, A. R.

2014-12-01

Rainfall and surface temperature are the most important climatic variables in the context of climate change. Thus, these variables simulated from fifth phase of the Climate Model Inter-comparison Project (CMIP5) models have been compared against Climatic Research Unit (CRU) observed data and projected for the twenty first century under the Representative Concentration Pathways (RCPs) 4.5 and 8.5 emission scenarios. Results for the seven countries under Bay of Bengal Initiative for Multi-Sectoral Technical and Economic Cooperation (BIMSTEC) such as Bangladesh, Bhutan, India, Myanmar, Nepal, Sri Lanka and Thailand have been examined. Six CMIP5 models namely GFDL-CM3, GFDL-ESM2M, GFDL-ESM2G, HadGEM2-AO, HadGEM2-CC and HadGEM2-ES have been chosen for this study. The study period has been considered is from 1861 to 2100. From this period, initial 145 years i.e. 1861 to 2005 is reference or historical period and the later 95 years i.e. 2005 to 2100 is projected period. The climate change in the projected period has been examined with respect to the reference period. In order to validate the models, the mean annual rainfall and temperature has been compared with CRU over the reference period 1901 to 2005. Comparison reveals that most of the models are able to capture the spatial distribution of rainfall and temperature over most of the regions of BIMSTEC countries. Therefore these model data can be used to study the future changes in the 21st Century. Four out six models shows that the rainfall over Central and North India, Thailand and eastern part of Myanmar shows decreasing trend and Bangladesh, Bhutan, Nepal and Sri Lanka shows an increasing trend in both RCP 4.5 and 8.5 scenarios. In case of temperature, all of the models show an increasing trend over all the BIMSTEC countries in both scenarios, however, the rate of increase is relatively less over Sri Lanka than the other countries. Annual cycles of rainfall and temperature over Bangladesh, Myanmar and Thailand

Lead exposure in young children over a 5-year period from urban environments using alternative exposure measures with the US EPA IEUBK model - A trial.

PubMed

Gulson, Brian; Taylor, Alan; Stifelman, Marc

2018-02-01

The US Environmental Protection Agency (EPA) Integrated Exposure Uptake Biokinetic (IEUBK) model has been widely used to predict blood lead (PbB) levels in children especially around industrial sites. Exposure variables have strongly focussed on the major contribution of lead (Pb) in soil and interior dust to total intake and, in many studies, site-specific data for air, water, diet and measured PbB were not available. We have applied the IEUBK model to a comprehensive data set, including measured PbB, for 108 children monitored over a 5-year period in Sydney, New South Wales, Australia. To use this data set, we have substituted available data (with or without modification) for standard inputs as needed. For example, as an alternative measure for soil Pb concentration (μg/g), we have substituted exterior dust sweepings Pb concentration (μg/g). As alternative measures for interior dust Pb concentration (μg/g) we have used 1) 30-day cumulative petri dish deposition data (PDD) (as µg Pb/m 2 /30days), or 2) hand wipe data (as μg Pb/hand). For comparison, simulations were also undertaken with estimates of dust Pb concentration derived from a prior regression of dust Pb concentration (μg/g) on dust Pb loading (μg/ft 2 ) as concentration is the unit specified for the Model. Simulations for each subject using observed data aggregated over the 5-year interval of the study, the most usual application of the IEUBK model, showed using Wilcoxon tests that there was a significant difference between the observed values and the values predicted by the Model containing soil with hand wipes (p < 0.001), and soil and PDD (p = 0.026) but not those for the other two sets of predictors, based on sweepings and PDD or sweepings and wipes. Overall, simulations of the Model using alternative exposure measures of petri dish dust (and possibly hand wipes) instead of vacuum cleaner dust and dust sweepings instead of soil provide predicted PbB which are generally consistent with each

Increasing insulin resistance accentuates the effect of triglyceride-associated loci on serum triglycerides during 5 years[S

PubMed Central

Justesen, Johanne M.; Andersson, Ehm A.; Allin, Kristine H.; Sandholt, Camilla H.; Jørgensen, Torben; Linneberg, Allan; Jørgensen, Marit E.; Hansen, Torben; Pedersen, Oluf; Grarup, Niels

2016-01-01

Blood concentrations of triglycerides are influenced by genetic factors as well as a number of environmental factors, including adiposity and glucose homeostasis. The aim was to investigate the association between a serum triglyceride weighted genetic risk score (wGRS) and changes in fasting serum triglyceride level over 5 years and to test whether the effect of the wGRS was modified by 5 year changes of adiposity, insulin resistance, and lifestyle factors. A total of 3,474 nondiabetic individuals from the Danish Inter99 cohort participated in both the baseline and 5 year follow-up physical examinations and had information on the wGRS comprising 39 genetic variants. In a linear regression model adjusted for age, sex, and baseline serum triglyceride, the wGRS was associated with increased serum triglyceride levels over 5 years [per allele effect = 1.3% (1.0–1.6%); P = 1.0 × 10−17]. This triglyceride-increasing effect of the wGRS interacted with changes in insulin resistance (Pinteraction = 1.5 × 10−6). This interaction indicated that the effect of the wGRS was stronger in individuals who became more insulin resistant over 5 years. In conclusion, our findings suggest that increased genetic risk load is associated with a larger increase in fasting serum triglyceride levels in nondiabetic individuals during 5 years of follow-up. This effect of the wGRS is accentuated by increasing insulin resistance. PMID:27777317

49 CFR 537.7 - Pre-model year and mid-model year reports.

Code of Federal Regulations, 2010 CFR

2010-10-01

... TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AUTOMOTIVE FUEL ECONOMY REPORTS § 537.7 Pre... manufacturer's light trucks for the current model year. (b) Projected average and required fuel economy. (1) State the projected average fuel economy for the manufacturer's automobiles determined in accordance...

49 CFR 537.7 - Pre-model year and mid-model year reports.

Code of Federal Regulations, 2012 CFR

2012-10-01

... TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AUTOMOTIVE FUEL ECONOMY REPORTS § 537.7 Pre... manufacturer's light trucks for the current model year. (b) Projected average and required fuel economy. (1) State the projected average fuel economy for the manufacturer's automobiles determined in accordance...

49 CFR 537.7 - Pre-model year and mid-model year reports.

Code of Federal Regulations, 2011 CFR

2011-10-01

... TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AUTOMOTIVE FUEL ECONOMY REPORTS § 537.7 Pre... manufacturer's light trucks for the current model year. (b) Projected average and required fuel economy. (1) State the projected average fuel economy for the manufacturer's automobiles determined in accordance...

Fleet Compliance Annual Report: Model Year 2015, Fiscal Year 2016

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

None

The U.S. Department of Energy (DOE) regulates covered state government and alternative fuel provider fleets, pursuant to the Energy Policy Act of 1992 (EPAct), as amended. This report details compliance for model year 2015, fiscal year 2016.

The Active for Life Year 5 (AFLY5) school-based cluster randomised controlled trial: effect on potential mediators.

PubMed

Lawlor, Debbie A; Howe, Laura D; Anderson, Emma L; Kipping, Ruth R; Campbell, Rona; Wells, Sian; Chittleborough, Catherine R; Peters, Tim J; Jago, Russell

2016-01-22

Active for life year 5 (AFLY5) is a school-based intervention, based on social cognitive theory, which aims to promote healthy levels of physical activity and healthy eating by improving a child's self-efficacy to make healthy choices, their knowledge of how to make such choices and prompting parents to support their children to make healthy choices. Previously published results showed no effect on the three primary outcomes and beneficial effects on three of nine secondary outcomes (time spent screen-viewing at weekends, consumption of snacks and of high energy drinks). This paper aims to determine the effect of the intervention on potential mediators. We conducted a cluster RCT of a school-based intervention, with allocation concealed by use of a remote system. The study was undertaken in the South West of England between 2011 and 2013. Participants were school children who were age 8-9 years at baseline assessment and 9-10 years during the intervention. Potential mediators were assessed at the end of the intervention. The intervention consisted of teacher training, provision of all materials required for lessons and homeworks and written materials for school newsletters and parents. The ten potential mediators were child-reported self-efficacy for physical activity and fruit and vegetable consumption, perceived parental logistic support and modelling for their child's physical activity, parental efforts to limit their child's sedentary behaviour and modelling of healthy fruit and vegetable consumption, together with a knowledge assessment. We successfully recruited 60 schools with over 2,221 children; valid data for the 10 mediators were available for 87 % to 96 % of participants. Three of the ten potential mediators were greater in the intervention, compared with the control group: fruit and vegetable self-efficacy 2.2 units (95 % CI: 0.7 to 3.8), assessed on a scale 26 to 130; child-reported maternal limitation of sedentary behaviour 0.5 (0.1 to 0.8), scale 4

First 5 Kern Annual Report: Fiscal Year 2013-2014

ERIC Educational Resources Information Center

Wang, Jianjun

2015-01-01

Proposition 10, also known as the California Children and Families Act of 1998, is the legislation for creating Kern County Children and Families Commission (First 5 Kern). Over the past 15 years, First 5 Kern administered a trust fund from a $.50 per pack tax on cigarettes or equivalent tobacco products to support children ages 0-5 and their…

Bayley-III motor scale and neurological examination at 2 years do not predict motor skills at 4.5 years.

PubMed

Burakevych, Nataliia; Mckinlay, Christopher Joel Dorman; Alsweiler, Jane Marie; Wouldes, Trecia Ann; Harding, Jane Elizabeth

2017-02-01

To determine whether Bayley Scales of Infant and Toddler Development (3rd edition) (Bayley-III) motor scores and neurological examination at 2 years corrected age predict motor difficulties at 4.5 years corrected age. A prospective cohort study of children born at risk of neonatal hypoglycaemia in Waikato Hospital, Hamilton, New Zealand. Assessment at 2 years was performed using the Bayley-III motor scale and neurological examination, and at 4.5 years using the Movement Assessment Battery for Children (2nd edition) (MABC-2). Of 333 children, 8 (2%) had Bayley-III motor scores below 85, and 50 (15%) had minor deficits on neurological assessment at 2 years; 89 (27%) scored less than or equal to the 15th centile, and 54 (16%) less than or equal to the 5th centile on MABC-2 at 4.5 years. Motor score, fine and gross motor subtest scores, and neurological assessments at 2 years were poorly predictive of motor difficulties at 4.5 years, explaining 0 to 7% of variance in MABC-2 scores. A Bayley-III motor score below 85 predicted MABC-2 scores less than or equal to the 15th centile with a positive predictive value of 30% and a negative predictive value of 74% (7% sensitivity and 94% specificity). Bayley-III motor scale and neurological examination at 2 years were poorly predictive of motor difficulties at 4.5 years. © 2016 Mac Keith Press.

Bayley-III motor scale and neurological examination at 2 years do not predict motor skills at 4.5 years

PubMed Central

Burakevych, Nataliia; Mckinlay, Christopher Joel Dorman; Alsweiler, Jane Marie; Wouldes, Trecia An; Harding, Jane Elizabeth

2016-01-01

Aim To determine whether Bayley Scales of Infant and Toddler Development (3rd edition) (Bayley-III) motor scores and neurological examination at 2 years' corrected age predict motor difficulties at 4.5 years' corrected age. Method A prospective cohort study of children born at risk of neonatal hypoglycaemia in Waikato Hospital, Hamilton, New Zealand. Assessment at 2 years was performed using the Bayley-III motor scale and neurological examination, and at 4.5 years using the Movement Assessment Battery for Children (2nd edition) (MABC-2). Results Of 333 children, 8 (2%) had Bayley-III motor scores below 85, and 50 (15%) had minor deficits on neurological assessment at 2 years; 89 (27%) scored less than or equal to the 15th centile, and 54 (16%) less than or equal to the 5th centile on MABC-2 at 4.5 years. Motor score, fine and gross motor subtest scores, and neurological assessments at 2 years were poorly predictive of motor difficulties at 4.5 years, explaining 0 to 7% of variance in MABC-2 scores. A Bayley-III motor score below 85 predicted MABC-2 scores less than or equal to the 15th centile with a positive predictive value of 30% and a negative predictive value of 74% (7% sensitivity and 94% specificity). Interpretation Bayley-III motor scale and neurological examination at 2 years were poorly predictive of motor difficulties at 4.5 years. PMID:27543144

High Performance Active Database Management on a Shared-Nothing Parallel Processor

DTIC Science & Technology

1998-05-01

either stored or virtual. A stored node is like a materialized view. It actually contains the specified tuples. A virtual node is like a real view...90292-6695 DL-5 COLUMBIA UNIV/DEPT COMPUTER SCIENCi ATTN: OR GAIL £. KAISER 450 COMPUTER SCIENCE 3LDG 500 WEST 12ÖTH STRSET NEW YORK NY 10027

Parental depressive symptoms and marital intimacy at 4.5 years: joint contributions to mother-child and father-child interaction at 6.5 years.

PubMed

Engle, Jennifer M; McElwain, Nancy L

2013-12-01

Using data from a subset of 606 families who participated in the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development, we assessed emotional intimacy in the marriage as a buffer of the negative effects of parental depression on the quality of parent-child interaction. Maternal and paternal depressive symptoms and perceptions of emotional intimacy in the marriage were assessed via self-reports when children were 4.5 years old, and parental sensitive scaffolding and child task orientation were observed during mother-child and father-child interaction tasks at 4.5 years and again at 6.5 years. Path analyses indicated that marital intimacy moderated the longitudinal association between parental depressive symptoms and parent-child interaction, controlling for parent or child behavior at 4.5 years. The pattern of this interaction, however, differed for mothers and fathers. Paternal depressive symptoms predicted less child task orientation with fathers when marital intimacy was low and more child task orientation when marital intimacy was high. In contrast, maternal depressive symptoms predicted less sensitive scaffolding by mothers and less child task orientation with mothers when mothers reported moderate to high levels of marital intimacy. Results are discussed with respect to the buffering role of marital intimacy for children of depressed fathers and compensatory processes that may unfold for depressed mothers. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Relationship between X(5) models and the interacting boson model

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

Barea, Jose; Departamento de Fisica Atomica, Molecular y Nuclear, Facultad de Fisica, Universidad de Sevilla, Apartado 1065, E-41080 Sevilla; Arias, Jose M.

2010-08-15

The connections between the X(5) models [the original X(5) using an infinite square well, X(5)-{beta}{sup 8}, X(5)-{beta}{sup 6}, X(5)-{beta}{sup 4}, and X(5)-{beta}{sup 2}], based on particular solutions of the geometrical Bohr Hamiltonian with harmonic potential in the {gamma} degree of freedom, and the interacting boson model (IBM) are explored. This work is the natural extension of the work presented in Garcia-Ramos and Arias, Phys. Rev. C 77, 054307 (2008) for the E(5) models. For that purpose, a quite general one- and two-body IBM Hamiltonian is used and a numerical fit to the different X(5) model energies is performed; then themore » obtained wave functions are used to calculate B(E2) transition rates. It is shown that within the IBM one can reproduce well the results for energies and B(E2) transition rates obtained with all these X(5) models, although the agreement is not so impressive as for the E(5) models. From the fitted IBM parameters the corresponding energy surface can be extracted and, surprisingly, only the X(5) case corresponds in the moderately large N limit to an energy surface very close to the one expected for a critical point, whereas the rest of models are situated a little further away.« less

Discovery of Sound in the Sea 2014 Annual Report

DTIC Science & Technology

2014-09-30

Gail Scowcroft Graduate School of Oceanography University of Rhode Island Narragansett, RI 02882 phone: (401) 874-6724 fax: (401) 874-6486 email...past twelve years, Marine Acoustics, Inc. (MAI) and the University of Rhode Island’s Graduate School of Oceanography (GSO) have developed a...Peter Worcester (Scripps Institution of Oceanography), James H. Miller ( University of Rhode Island), and Darlene Ketten (Harvard University Medical

A 5-Year follow-up of internet-based cognitive behavior therapy for social anxiety disorder.

PubMed

Hedman, Erik; Furmark, Tomas; Carlbring, Per; Ljótsson, Brjánn; Rück, Christian; Lindefors, Nils; Andersson, Gerhard

2011-06-15

Internet-based cognitive behavior therapy (CBT) has been shown to be a promising method to disseminate cognitive behavior therapy for social anxiety disorder (SAD). Several trials have demonstrated that Internet-based CBT can be effective for SAD in the shorter term. However, the long-term effects of Internet-based CBT for SAD are less well known. Our objective was to investigate the effect of Internet-based CBT for SAD 5 years after completed treatment. We conducted a 5-year follow-up study of 80 persons with SAD who had undergone Internet-based CBT. The assessment comprised a diagnostic interview and self-report questionnaires. The main outcome measure was the Liebowitz Social Anxiety Scale-Self-Report (LSAS-SR). Additional measures of social anxiety were the Social Interaction Anxiety Scale (SIAS) and the Social Phobia Scale (SPS). Attrition rates were low: 89% (71/80) of the participants completed the diagnostic interview and 80% (64/80) responded to the questionnaires. Mixed-effect models analysis showed a significant effect of time on the three social anxiety measures, LSAS-SR, SIAS, and SPS (F(3,98-102) = 16.05 - 29.20, P < .001) indicating improvement. From baseline to 5-year follow-up, participants' mean scores on the LSAS-SR were reduced from 71.3 (95% confidence interval [CI] 66.1-76.5) to 40.3 (95% CI 35.2 - 45.3). The effect sizes of the LSAS-SR were large (Cohen's d range 1.30 - 1.40, 95% CI 0.77 - 1.90). Improvements gained at the 1-year follow-up were sustained 5 years after completed treatment. Internet-based CBT for SAD is a treatment that can result in large and enduring effects. Clinicaltrials.gov NCT01145690; http://clinicaltrials.gov/ct2/show/NCT01145690 (Archived by WebCite at http://www.webcitation.org/5ygRxDLfK).

EVALUATION OF THE COMMUNITY MULTISCALE AIR QUALITY (CMAQ) MODEL VERSION 4.5: UNCERTAINTIES AND SENSITIVITIES IMPACTING MODEL PERFORMANCE: PART II - PARTICULATE MATTER

EPA Science Inventory

This paper presents an analysis of the CMAQ v4.5 model performance for particulate matter and its chemical components for the simulated year 2001. This is part two is two part series of papers that examines the model performance of CMAQ v4.5.

A YEAR-LONG MM5 EVALUATION USING A MODEL EVALUATION TOOLKIT

EPA Science Inventory

Air quality modeling has expanded in both sophistication and application over the past decade. Meteorological and air quality modeling tools are being used for research, forecasting, and regulatory related emission control strategies. Results from air quality simulations have far...

40 CFR 600.512-86 - Model year report.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 1978 Passenger Automobiles and for 1979 and Later Model Year Automobiles (Light Trucks and Passenger Automobiles)-Procedures for Determining Manufacturer's Average Fuel Economy § 600.512-86 Model year report. (a... for passenger automobiles and light trucks (as identified in § 600.510). (c) The model year report...

Comparison of Basic and Ensemble Data Mining Methods in Predicting 5-Year Survival of Colorectal Cancer Patients.

PubMed

Pourhoseingholi, Mohamad Amin; Kheirian, Sedigheh; Zali, Mohammad Reza

2017-12-01

Colorectal cancer (CRC) is one of the most common malignancies and cause of cancer mortality worldwide. Given the importance of predicting the survival of CRC patients and the growing use of data mining methods, this study aims to compare the performance of models for predicting 5-year survival of CRC patients using variety of basic and ensemble data mining methods. The CRC dataset from The Shahid Beheshti University of Medical Sciences Research Center for Gastroenterology and Liver Diseases were used for prediction and comparative study of the base and ensemble data mining techniques. Feature selection methods were used to select predictor attributes for classification. The WEKA toolkit and MedCalc software were respectively utilized for creating and comparing the models. The obtained results showed that the predictive performance of developed models was altogether high (all greater than 90%). Overall, the performance of ensemble models was higher than that of basic classifiers and the best result achieved by ensemble voting model in terms of area under the ROC curve (AUC= 0.96). AUC Comparison of models showed that the ensemble voting method significantly outperformed all models except for two methods of Random Forest (RF) and Bayesian Network (BN) considered the overlapping 95% confidence intervals. This result may indicate high predictive power of these two methods along with ensemble voting for predicting 5-year survival of CRC patients.

Trends in asthma mortality in the 0- to 4-year and 5- to 34-year age groups in Brazil.

PubMed

Graudenz, Gustavo Silveira; Carneiro, Dominique Piacenti; Vieira, Rodolfo de Paula

2017-01-01

To provide an update on trends in asthma mortality in Brazil for two age groups: 0-4 years and 5-34 years. Data on mortality from asthma, as defined in the International Classification of Diseases, were obtained for the 1980-2014 period from the Mortality Database maintained by the Information Technology Department of the Brazilian Unified Health Care System. To analyze time trends in standardized asthma mortality rates, we conducted an ecological time-series study, using regression models for the 0- to 4-year and 5- to 34-year age groups. There was a linear trend toward a decrease in asthma mortality in both age groups, whereas there was a third-order polynomial fit in the general population. Although asthma mortality showed a consistent, linear decrease in individuals ≤ 34 years of age, the rate of decline was greater in the 0- to 4-year age group. The 5- to 34-year group also showed a linear decline in mortality, and the rate of that decline increased after the year 2004, when treatment with inhaled corticosteroids became more widely available. The linear decrease in asthma mortality found in both age groups contrasts with the nonlinear trend observed in the general population of Brazil. The introduction of inhaled corticosteroid use through public policies to control asthma coincided with a significant decrease in asthma mortality rates in both subsets of individuals over 5 years of age. The causes of this decline in asthma-related mortality in younger age groups continue to constitute a matter of debate. Apresentar uma atualização das tendências da mortalidade da asma no Brasil em duas faixas etárias: 0-4 anos e 5-34 anos. Dados relativos ao período de 1980 a 2014 referentes à mortalidade da asma, conforme se definiu na Classificação Internacional de Doenças, foram extraídos Sistema de Informação sobre Mortalidade do Departamento de Tecnologia da Informação do Sistema Único de Saúde. Para analisar as tendências temporais das taxas

Pediatric epilepsy surgery: long-term 5-year seizure remission and medication use.

PubMed

Hauptman, Jason S; Pedram, Kayvon; Sison, Christia Angela; Sankar, Raman; Salamon, Noriko; Vinters, Harry V; Mathern, Gary W

2012-11-01

It is unclear whether long-term seizure outcomes in children are similar to those in adult epilepsy surgery patients. To determine 5-year outcomes and antiepilepsy drug (AED) use in pediatric epilepsy surgery patients from a single institution. The cohort consisted of children younger than 18 years of age whose 5-year outcome data would have been available by 2010. Comparisons were made between patients with and without 5-year data (n = 338), patients with 5-year data for seizure outcome (n = 257), and seizure-free patients on and off AEDs (n = 137). Five-year data were available from 76% of patients. More seizure-free patients with focal resections for hippocampal sclerosis and tumors lacked 5-year data compared with other cases. Of those with 5-year data, 53% were continuously seizure free, 18% had late seizure recurrence, 3% became seizure free after initial failure, and 25% were never seizure free. Patients were more likely to be continuously seizure free if their surgery was performed during the period 2001 to 2005 (68%) compared with surgery performed from 1996 to 2000 (61%), 1991 to 1995 (36%), and 1986 to 1990 (46%). More patients had 1 or fewer seizures per month in the late seizure recurrence (47%) compared with the not seizure-free group (20%). Four late deaths occurred in the not seizure-free group compared with 1 in the seizure-free group. Of patients who were continuously seizure free, 55% were not taking AEDs, and more cortical dysplasia patients (74%) had stopped taking AEDs compared with hemimegalencephaly patients (18%). In children, 5-year outcomes improved over 20 years of clinical experience. Our results are similar to those of adult epilepsy surgery patients despite mostly extratemporal and hemispheric operations for diverse developmental etiologies.

Stochastic modelling of basal temperatures in divide regions of the Antarctic ice sheet over the last 1.5 million years

NASA Astrophysics Data System (ADS)

Van Liefferinge, Brice; Pattyn, Frank; Cavitte, Marie G. P.; Young, Duncan A.; Roberts, Jason L.

2017-04-01

The quest for oldest ice in Antarctica has recently been launched through an EU H2020 project (Beyond EPICA - Oldest Ice) and aims at identifying suitable areas for a potential future drilling. Retrieving an ice core of such age is essential to understand the relation between orbital changes and atmospheric composition during the mid-Pliocene transition. However, sites for a potential undisturbed record of 1.5 million-year old ice in Antarctica are difficult to find and require slow-moving ice (preferably an ice divide) and basal conditions that are not disturbed by large topographic variations. Furthermore, ice should be sufficiently thick but cold basal conditions should still prevail, since basal melting would destroy the bottom layers. Therefore, ice-flow conditions and thermodynamic characteristics are crucial for identifying potential locations of undisturbed ice. Van Liefferinge and Pattyn (2013) identified suitable areas based on a pan-Antarctic simplified thermodynamic ice sheet model and demonstrated that uncertainty in geothermal conditions remain a major unknown. In order to refine these estimates, and provide uncertainties, we employ a full thermo-mechanically coupled higher-order ice sheet model (Pattyn, 2003; Pattyn et al., 2004). Initial conditions for the calculations are based on an inversion of basal slipperiness, based on observed surface topography (Pollard and DeConto, 2012; Pattyn, in prep.). Uncertainties in geothermal conditions are introduced using the convolution of two Gaussian probability density functions: (a) the reconstruction of the Antarctic ice sheet geometry and testing ice thickness variability over the last 2 million years (Pollard and DeConto, 2009) and (b) the surface temperature reconstruction over the same period (Snyder et al., 2016). The standard deviation, the skewness and the kurtosis of the whole Antarctic ice sheet are analyzed to observe likely probable melt conditions. Finally, we focus on model results in the

Maternal Depression Trajectories and Children's Behavior at Age 5 Years.

PubMed

van der Waerden, Judith; Galéra, Cédric; Larroque, Béatrice; Saurel-Cubizolles, Marie-Josèphe; Sutter-Dallay, Anne-Laure; Melchior, Maria

2015-06-01

To assess the relationship between trajectories of maternal depression from pregnancy to the child's age of 5 years and children's emotional and behavioral difficulties at age 5 years. Mother-child pairs (n = 1183) from the EDEN mother-child birth cohort study based in France were followed from 24 to 28 weeks of pregnancy to the child's fifth birthday. Children's behavior at age 5 years was assessed with the Strengths and Difficulties Questionnaire. Maternal depression was assessed repeatedly with the Center for Epidemiological Studies Depression questionnaire (pregnancy, 3, and 5 years of age) and the Edinburgh Postnatal Depression Scale (4, 8, and 12 months postpartum). Homogeneous latent trajectory groups of maternal depression were identified within the study population and correlated with Strengths and Difficulties Questionnaire scores by the use of multivariate linear regression analyzes. Five trajectories of maternal symptoms of depression were identified: no symptoms (62.0%); persistent intermediate-level depressive symptoms (25.3%); persistent high depressive symptoms (4.6%); high symptoms in pregnancy only (3.6%); and high symptoms in the child's preschool period only (4.6%). Children whose mothers had persistent depressive symptoms--either intermediate or high--had the greatest levels of emotional and behavioral difficulties at age 5 years. In addition, compared with children whose mothers were never depressed, those whose mothers had high symptoms in the preschool period also had increased levels of emotional symptoms, conduct problems, and peer problems. Maternal depression symptoms are related to children's emotional and behavioral problems, particularly if they are persistent (29.9%) or occur during early childhood (4.6%). Copyright © 2015 Elsevier Inc. All rights reserved.

Inconsistent Strategies to Spin up Models in CMIP5: Implications for Ocean Biogeochemical Model Performance Assessment

NASA Technical Reports Server (NTRS)

Seferian, Roland; Gehlen, Marion; Bopp, Laurent; Resplandy, Laure; Orr, James C.; Marti, Olivier; Dunne, John P.; Christian, James R.; Doney, Scott C.; Ilyina, Tatiana;

GEOS-5 Chemistry Transport Model User's Guide

NASA Technical Reports Server (NTRS)

Kouatchou, J.; Molod, A.; Nielsen, J. E.; Auer, B.; Putman, W.; Clune, T.

2015-01-01

The Goddard Earth Observing System version 5 (GEOS-5) General Circulation Model (GCM) makes use of the Earth System Modeling Framework (ESMF) to enable model configurations with many functions. One of the options of the GEOS-5 GCM is the GEOS-5 Chemistry Transport Model (GEOS-5 CTM), which is an offline simulation of chemistry and constituent transport driven by a specified meteorology and other model output fields. This document describes the basic components of the GEOS-5 CTM, and is a user's guide on to how to obtain and run simulations on the NCCS Discover platform. In addition, we provide information on how to change the model configuration input files to meet users' needs.

Implementation and Refinement of a Problem-based Learning Model: A Ten-Year Experience

PubMed Central

Crabtree, Brian L.; Theilman, Gary D.; Ross, Brendan S.; Cleary, John D.; Byrd, H. Joseph

2007-01-01

Objectives To evaluate the effectiveness of a problem-based learning (PBL) model implemented in 1995 at the University of Mississippi School of Pharmacy. Design The third-professional (P3) year curriculum was reoriented from a faculty-centered model of teaching to a student-centered model of learning. Didactic lectures and structured classroom time were diminished. Small student groups were organized and a faculty facilitator monitored each group's discussions and provided individual student assessments. At the end of each 8-week block, students were assessed on group participation, disease and drug content knowledge, and problem-solving abilities. Faculty and student input was solicited at the end of each year to aid programmatic improvement. In 2000, a formal 5-year review of the PBL program was conducted. Assessment Recommendations for improvement included clarifying course objectives, adopting a peer-review process for examination materials, refining the group assessment instruments, and providing an opportunity for student remediation after a course was failed. A weekly case conference presided over by a faculty content expert was also recommended. Ongoing critical evaluation during the following 5-year period was provided by graduates of the program, faculty participants, and accreditation reviews. Conclusion Over our 10-year experience with a PBL model of P3 education, we found that although the initial challenges of increased demands on personnel and teaching space were easily overcome, student acceptance of the program depended on their acknowledgment of the practical benefits of active learning and on the value afforded their input on curricular development. PMID:17429517

The Amphibian Research and Monitoring Initiative (ARMI): 5-year report

USGS Publications Warehouse

Muths, Erin; Gallant, Alisa L.; Campbell Grant, Evan H.; Battaglin, William A.; Green, David E.; Staiger, Jennifer S.; Walls, Susan C.; Gunzburger, Margaret S.; Kearney, Rick F.

2006-01-01

This report is a 5-year retrospective of the structure, methodology, progress, and contributions to the broader scientific community that have resulted from this national USGS program. We evaluate ARMI’s success to date, with regard to the challenges faced by the program and the strengths that have emerged. We chart objectives for the next 5 years that build on current accomplishments, highlight areas meriting further research, and direct efforts to overcome existing weaknesses.

True or False: Do 5-Year-Olds Understand Belief?

ERIC Educational Resources Information Center

Fabricius, William V.; Boyer, Ty W.; Weimer, Amy A.; Carroll, Kathleen

2010-01-01

In 3 studies (N = 188) we tested the hypothesis that children use a perceptual access approach to reason about mental states before they understand beliefs. The perceptual access hypothesis predicts a U-shaped developmental pattern of performance in true belief tasks, in which 3-year-olds who reason about reality should succeed, 4- to 5-year-olds…

First 5 Kern Annual Report, Fiscal Year 2011-2012

ERIC Educational Resources Information Center

Wang, Jianjun

2013-01-01

Scientific discoveries repeatedly confirmed the importance of brain growth during the first 5 years of child life. To support early childhood development, California voters passed Proposition 10 in 1998 to collect a 50 cent per pack tax on cigarettes and other tobacco products. Kern County Children and Families Commission (First 5 Kern) was…

Multi-year downscaling application of two-way coupled WRF v3.4 and CMAQ v5.0.2 over east Asia for regional climate and air quality modeling: model evaluation and aerosol direct effects

NASA Astrophysics Data System (ADS)

Hong, Chaopeng; Zhang, Qiang; Zhang, Yang; Tang, Youhua; Tong, Daniel; He, Kebin

2017-06-01

In this study, a regional coupled climate-chemistry modeling system using the dynamical downscaling technique was established by linking the global Community Earth System Model (CESM) and the regional two-way coupled Weather Research and Forecasting - Community Multi-scale Air Quality (WRF-CMAQ) model for the purpose of comprehensive assessments of regional climate change and air quality and their interactions within one modeling framework. The modeling system was applied over east Asia for a multi-year climatological application during 2006-2010, driven with CESM downscaling data under Representative Concentration Pathways 4.5 (RCP4.5), along with a short-term air quality application in representative months in 2013 that was driven with a reanalysis dataset. A comprehensive model evaluation was conducted against observations from surface networks and satellite observations to assess the model's performance. This study presents the first application and evaluation of the two-way coupled WRF-CMAQ model for climatological simulations using the dynamical downscaling technique. The model was able to satisfactorily predict major meteorological variables. The improved statistical performance for the 2 m temperature (T2) in this study (with a mean bias of -0.6 °C) compared with the Coupled Model Intercomparison Project Phase 5 (CMIP5) multi-models might be related to the use of the regional model WRF and the bias-correction technique applied for CESM downscaling. The model showed good ability to predict PM2. 5 in winter (with a normalized mean bias (NMB) of 6.4 % in 2013) and O3 in summer (with an NMB of 18.2 % in 2013) in terms of statistical performance and spatial distributions. Compared with global models that tend to underpredict PM2. 5 concentrations in China, WRF-CMAQ was able to capture the high PM2. 5 concentrations in urban areas. In general, the two-way coupled WRF-CMAQ model performed well for both climatological and air quality applications. The coupled

Treatment of selective mutism: a 5-year follow-up study.

PubMed

Oerbeck, Beate; Overgaard, Kristin Romvig; Stein, Murray B; Pripp, Are Hugo; Kristensen, Hanne

2018-01-22

Selective mutism (SM) has been defined as an anxiety disorder in the diagnostic and statistical manual of mental disorders (DSM-5). Cognitive behavioral therapy (CBT) is the recommended approach for SM, but prospective long-term outcome studies are lacking. Reports from the children themselves, and the use of more global quality of life measures, are also missing in the literature. We have developed a school-based CBT intervention previously found to increase speech in a pilot efficacy study and a randomized controlled treatment study. Continued progress was found in our 1-year follow-up studies, where older age and more severe SM had a significant negative effect upon outcome. In the present study, we provide 5-year outcome data for 30 of these 32 children with SM who completed the same CBT for mean 21 weeks (sd 5, range 8-24) at mean age 6 years (10 boys). Mean age at the 5-year follow-up was 11 years (range 8-14). Outcome measures were diagnostic status, the teacher- and parent-rated selective mutism questionnaires, and child rated quality of life and speaking behavior. At the 5-year follow-up, 21 children were in full remission, five were in partial remission and four fulfilled diagnostic criteria for SM. Seven children (23%) fulfilled criteria for social phobia, and separation anxiety disorder, specific phobia and/or enuresis nocturna were found in a total of five children (17%). Older age and severity at baseline and familial SM were significant negative predictors of outcome. Treatment gains were maintained on the teacher- and parent questionnaires. The children rated their overall quality of life as good. Although most of them talked outside of home, 50% still experienced it as somewhat challenging. These results point to the long-term effectiveness of CBT for SM, but also highlight the need to develop more effective interventions for the subset of children with persistent symptoms.Clinical trials registration NCT01002196.

First 5 Kern Annual Report: Fiscal Year 2012-2013

ERIC Educational Resources Information Center

Wang, Jianjun

2014-01-01

Scientific discoveries indicated the importance of brain growth during the first 5 years of child life. To support early childhood development, California voter passed Proposition 10 in 1998 to collect a 50 cent per pack tax on cigarettes and other tobacco products. Kern County Children and Families Commission (First 5 Kern) receives funding from…

Short-course chemotherapy for paediatric respiratory tuberculosis: 5-year report.

PubMed

Swaminathan, S; Raghavan, A; Duraipandian, M; Kripasankar, A S; Ramachandran, P

2005-06-01

This report presents the 5-year follow-up of 137 children with respiratory tuberculosis enrolled in a randomised clinical trial of two different anti-tuberculosis regimens 9HR and 2HRZ3/4RH2. Both regimens had similar cure rates, with low relapse rates and mortality. Of 134 children followed up to 5 years, 86% had normal radiographs, with more sequelae in the 9HR group (15% vs. 1.5%, P < 0.01). One patient relapsed and there was one accidental death. Short-course chemotherapy in children is safe, effective and well tolerated, and leads to excellent long-term results, with a small proportion of children left with radiological sequelae.

An assessment of historical Antarctic precipitation and temperature trend using CMIP5 models and reanalysis datasets

NASA Astrophysics Data System (ADS)

Tang, Malcolm S. Y.; Chenoli, Sheeba Nettukandy; Samah, Azizan Abu; Hai, Ooi See

2018-03-01

The study of Antarctic precipitation has attracted a lot of attention recently. The reliability of climate models in simulating Antarctic precipitation, however, is still debatable. This work assess the precipitation and surface air temperature (SAT) of Antarctica (90 oS to 60 oS) using 49 Coupled Model Intercomparison Project phase 5 (CMIP5) global climate models and the European Centre for Medium-range Weather Forecasts "Interim" reanalysis (ERA-Interim); the National Centers for Environmental Prediction Climate Forecast System Reanalysis (CFSR); the Japan Meteorological Agency 55-year Reanalysis (JRA-55); and the Modern Era Retrospective-analysis for Research and Applications (MERRA) datasets for 1979-2005 (27 years). For precipitation, the time series show that the MERRA and JRA-55 have significantly increased from 1979 to 2005, while the ERA-Int and CFSR have insignificant changes. The reanalyses also have low correlation with one another (generally less than +0.69). 37 CMIP5 models show increasing trend, 18 of which are significant. The resulting CMIP5 MMM also has a significant increasing trend of 0.29 ± 0.06 mm year-1. For SAT, the reanalyses show insignificant changes and have high correlation with one another, while the CMIP5 MMM shows a significant increasing trend. Nonetheless, the variability of precipitation and SAT of MMM could affect the significance of its trend. One of the many reasons for the large differences of precipitation is the CMIP5 models' resolution.

[Estimation of individual breast cancer risk: relevance and limits of risk estimation models].

PubMed

De Pauw, A; Stoppa-Lyonnet, D; Andrieu, N; Asselain, B

2009-10-01

Several risk estimation models for breast or ovarian cancers have been developed these last decades. All these models take into account the family history, with different levels of sophistication. Gail model was developed in 1989 taking into account the family history (0, 1 or > or = 2 affected relatives) and several environmental factors. In 1990, Claus model was the first to integrate explicit assumptions about genetic effects, assuming a single gene dominantly inherited occurring with a low frequency in the population. BRCAPRO model, posterior to the identification of BRCA1 and BRCA2, assumes a restricted transmission with only these two dominantly inherited genes. BOADICEA model adds the effect of a polygenic component to the effect of BRCA1 and BRCA2 to explain the residual clustering of breast cancer. At last, IBIS model assumes a third dominantly inherited gene to explain this residual clustering. Moreover, this model incorporates environmental factors. We applied the Claus, BRCAPRO, BOADICEA and IBIS models to four clinical situations, corresponding to more or less heavy family histories, in order to study the consistency of the risk estimates. The three more recent models (BRCAPRO, BOADICEA and IBIS) gave the closer estimations. These estimates could be useful in clinical practice in front of complex analysis of breast and/or ovarian cancers family history.

40 CFR 86.410-90 - Emission standards for 1990 and later model year motorcycles.

Code of Federal Regulations, 2010 CFR

2010-07-01

... petroleum gas-fueled motorcycles): (i) Hydrocarbons. 5.0 grams per vehicle kilometer. (ii) Carbon monoxide. 12 grams per vehicle kilometer. (2) Exhaust emissions from 1990 and later model year methanol-fueled motorcycles shall not exceed: (i) Total hydrocarbon equivalent. 5.0 grams per vehicle kilometer. (ii) Carbon...

40 CFR 86.410-90 - Emission standards for 1990 and later model year motorcycles.

Code of Federal Regulations, 2013 CFR

2013-07-01

... petroleum gas-fueled motorcycles): (i) Hydrocarbons. 5.0 grams per vehicle kilometer. (ii) Carbon monoxide. 12 grams per vehicle kilometer. (2) Exhaust emissions from 1990 and later model year methanol-fueled motorcycles shall not exceed: (i) Total hydrocarbon equivalent. 5.0 grams per vehicle kilometer. (ii) Carbon...

40 CFR 86.410-90 - Emission standards for 1990 and later model year motorcycles.

Code of Federal Regulations, 2012 CFR

2012-07-01

... petroleum gas-fueled motorcycles): (i) Hydrocarbons. 5.0 grams per vehicle kilometer. (ii) Carbon monoxide. 12 grams per vehicle kilometer. (2) Exhaust emissions from 1990 and later model year methanol-fueled motorcycles shall not exceed: (i) Total hydrocarbon equivalent. 5.0 grams per vehicle kilometer. (ii) Carbon...

40 CFR 86.410-90 - Emission standards for 1990 and later model year motorcycles.

Code of Federal Regulations, 2014 CFR

2014-07-01

... petroleum gas-fueled motorcycles): (i) Hydrocarbons. 5.0 grams per vehicle kilometer. (ii) Carbon monoxide. 12 grams per vehicle kilometer. (2) Exhaust emissions from 1990 and later model year methanol-fueled motorcycles shall not exceed: (i) Total hydrocarbon equivalent. 5.0 grams per vehicle kilometer. (ii) Carbon...

40 CFR 86.410-90 - Emission standards for 1990 and later model year motorcycles.

Code of Federal Regulations, 2011 CFR

2011-07-01

... petroleum gas-fueled motorcycles): (i) Hydrocarbons. 5.0 grams per vehicle kilometer. (ii) Carbon monoxide. 12 grams per vehicle kilometer. (2) Exhaust emissions from 1990 and later model year methanol-fueled motorcycles shall not exceed: (i) Total hydrocarbon equivalent. 5.0 grams per vehicle kilometer. (ii) Carbon...

Soviet business chaos seen lasting 5 years

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

Not Available

1991-12-16

This paper reports that companies seeking work in the collapsing Soviet Union can expect political uncertainty for another 5 years. PW discussed changes in the Soviet Union and offered advice on dealing with officials of the central government and Soviet republics at a recent meeting in Houston with executives of oil field service companies. That meeting preceded reports of the Russian federation, Ukraine, and Byelorussia agreeing to form a Slavic commonwealth.

Girl-child marriage and its association with morbidity and mortality of children under 5 years of age in a nationally-representative sample of Pakistan.

PubMed

Nasrullah, Muazzam; Zakar, Rubeena; Zakar, Muhammad Zakria; Krämer, Alexander

2014-03-01

To determine the relationship between child marriage (before age 18 years) and morbidity and mortality of children under 5 years of age in Pakistan beyond those attributed to social vulnerabilities. Nationally-representative cross-sectional observational survey data from Pakistan Demographic and Health Survey, 2006-2007 was limited to children from the past 5 years, reported by ever-married women aged 15-24 years (n = 2630 births of n = 2138 mothers) to identify differences in infectious diseases in past 2 weeks (diarrhea, acute respiratory infection [ARI], ARI with fever), under 5 years of age and infant mortality, and low birth weight by early (<18) vs adult (≥ 18) age at marriage. Associations between child marriage and mortality and morbidity of children under 5 years of age were assessed by calculating adjusted OR using logistic regression models after controlling for maternal and child demographics. Majority (74.5%) of births were from mothers aged <18 years. Marriage before age 18 years increased the likelihood of recent diarrhea among children born to young mothers (adjusted OR = 1.59; 95% CI: 1.18-2.14). Even though maternal child marriage was associated with infant mortality and mortality of children under 5 years of age in unadjusted models, association was lost in the adjusted models. We did not find a relation between girl-child marriage and low birth weight infants, and ARI. Girl-child marriage increases the likelihood of recent diarrhea among children born to young mothers. Further qualitative and prospective quantitative studies are needed to understand the factors that may drive child morbidity and mortality among those married as children vs adults in Pakistan. Copyright © 2014 Mosby, Inc. All rights reserved.

Risk prediction models of breast cancer: a systematic review of model performances.

PubMed

Anothaisintawee, Thunyarat; Teerawattananon, Yot; Wiratkapun, Chollathip; Kasamesup, Vijj; Thakkinstian, Ammarin

2012-05-01

The number of risk prediction models has been increasingly developed, for estimating about breast cancer in individual women. However, those model performances are questionable. We therefore have conducted a study with the aim to systematically review previous risk prediction models. The results from this review help to identify the most reliable model and indicate the strengths and weaknesses of each model for guiding future model development. We searched MEDLINE (PubMed) from 1949 and EMBASE (Ovid) from 1974 until October 2010. Observational studies which constructed models using regression methods were selected. Information about model development and performance were extracted. Twenty-five out of 453 studies were eligible. Of these, 18 developed prediction models and 7 validated existing prediction models. Up to 13 variables were included in the models and sample sizes for each study ranged from 550 to 2,404,636. Internal validation was performed in four models, while five models had external validation. Gail and Rosner and Colditz models were the significant models which were subsequently modified by other scholars. Calibration performance of most models was fair to good (expected/observe ratio: 0.87-1.12), but discriminatory accuracy was poor to fair both in internal validation (concordance statistics: 0.53-0.66) and in external validation (concordance statistics: 0.56-0.63). Most models yielded relatively poor discrimination in both internal and external validation. This poor discriminatory accuracy of existing models might be because of a lack of knowledge about risk factors, heterogeneous subtypes of breast cancer, and different distributions of risk factors across populations. In addition the concordance statistic itself is insensitive to measure the improvement of discrimination. Therefore, the new method such as net reclassification index should be considered to evaluate the improvement of the performance of a new develop model.

The Spelling Bee and Me: A Real-Life Adventure in Learning

ERIC Educational Resources Information Center

Small, Gail; Yoshinaga, Kendra

2006-01-01

This book documents the real-life story of Kendra Yoshinaga, a young speller who won her first qualifying bee at the young age of nine. Now eleven years old, she is preparing for future events after tying for 27th in the 2004 National Spelling Bee. Gail Small, author of Joyful Learning: No One Ever Wants To Go To Recess!, taught Kendra for first,…

Returning to work after severe multiple injuries: multidimensional functioning and the trajectory from injury to work at 5 years.

PubMed

Soberg, Helene L; Roise, Olav; Bautz-Holter, Erik; Finset, Arnstein

2011-08-01

The process of returning to work (RTW) after multiple injuries is lengthy. Prospective studies with follow-up times of up to 5 years are necessary but lacking. The aim of this study was to describe the trajectory of RTW and to examine the factors that predicted RTW over 5 years for patients with multiple injuries using a prospective cohort design. One-hundred one patients aged 18 years to 67 years who had been admitted to a trauma referral center with a New Injury Severity Score >15 starting January 2002 through June 2003 were included. The follow-up rate at 5 years was 79%. Outcomes were assessed 6 weeks after discharge and at 1 year, 2 years, and 5 years postinjury. The instruments used to assess patient status were the Short Form 36, the World Health Organization Disability Assessment Schedule II cognitive subscale, a Cognitive Function Scale, and the Brief Approach/Avoidance Coping Questionnaire. Repeated measures analyses of categorical correlated data were applied. Patient's mean age was 34.5 years (SD, 13.5); 83% were men and 25% had a university or college education; 66% were blue-collar workers. Mean New Injury Severity Score was 35.1 (SD, 12.7). RTW rates were 28% at 1 year, 43% at 2 years, and 49% at 5 years postinjury. There were differences among patients in RTW status, and personal factors and physical and psychosocial functioning. Predictors of RTW were as follows: measurement occasion, education (high/low), coping, and physical and cognitive functioning. The proportion of unexplained variation between subjects in the models was 31% to 55%. Of the patients included in this study, 49% achieved RTW, and 23% received full disability benefits. Higher education; better physical, social, and cognitive functioning; and coping strategies all predicted RTW.

The GEOS-5 Atmospheric General Circulation Model: Mean Climate and Development from MERRA to Fortuna

NASA Technical Reports Server (NTRS)

Molod, Andrea; Takacs, Lawrence; Suarez, Max; Bacmeister, Julio; Song, In-Sun; Eichmann, Andrew

2012-01-01

This report is a documentation of the Fortuna version of the GEOS-5 Atmospheric General Circulation Model (AGCM). The GEOS-5 AGCM is currently in use in the NASA Goddard Modeling and Assimilation Office (GMAO) for simulations at a wide range of resolutions, in atmosphere only, coupled ocean-atmosphere, and data assimilation modes. The focus here is on the development subsequent to the version that was used as part of NASA s Modern-Era Retrospective Analysis for Research and Applications (MERRA). We present here the results of a series of 30-year atmosphere-only simulations at different resolutions, with focus on the behavior of the 1-degree resolution simulation. The details of the changes in parameterizations subsequent to the MERRA model version are outlined, and results of a series of 30-year, atmosphere-only climate simulations at 2-degree resolution are shown to demonstrate changes in simulated climate associated with specific changes in parameterizations. The GEOS-5 AGCM presented here is the model used for the GMAO s atmosphere-only and coupled CMIP-5 simulations.

Refractive surgery for accommodative esotropia: 5-year follow-up.

PubMed

Magli, Adriano; Forte, Raimondo; Gallo, Flavio; Carelli, Roberta

2014-02-01

To assess the long-term effectiveness and safety of refractive surgery with LASIK or photorefractive keratectomy (PRK) for treating accommodative esotropia in adults. All patients with accommodative esotropia treated with LASIK or PRK until December 2007 and with a minimum follow-up of 5 years were retrospectively included. LASIK was performed on 44 eyes of 22 patients (12 women, 10 men; mean age: 22.7 ± 2.9 years). Mean postoperative follow-up was 62.1 ± 3.2 months. PRK was performed on 16 eyes of 8 patients (4 women, 4 men; mean age: 23.7 ± 1.7 years). Mean postoperative follow-up was 61.3 ± 2.8 months. At the 5-year follow-up, the mean cycloplegic refraction was more hyperopic in the PRK group (0.3 ± 0.8 vs 0.06 ± 0.3 diopters, P = .01). Correction of esotropia to esophoria or orthotropia was present in 21 patients (95.4%) treated with LASIK and in all patients treated with PRK. Both LASIK and PRK were effective in the long-term reduction of accommodative esotropia. Copyright 2014, SLACK Incorporated.

26 CFR 1.410(a)-5 - Year of service; break in service.

Code of Federal Regulations, 2010 CFR

2010-04-01

... under this subparagraph by reason of any prior break in service. (ii) Examples. The rules of this... 26 Internal Revenue 5 2010-04-01 2010-04-01 false Year of service; break in service. 1.410(a)-5... service; break in service. (a) Year of service. For the rules relating to years of service under...

Climate change projections using the IPSL-CM5 Earth System Model: from CMIP3 to CMIP5

NASA Astrophysics Data System (ADS)

Dufresne, J.-L.; Foujols, M.-A.; Denvil, S.; Caubel, A.; Marti, O.; Aumont, O.; Balkanski, Y.; Bekki, S.; Bellenger, H.; Benshila, R.; Bony, S.; Bopp, L.; Braconnot, P.; Brockmann, P.; Cadule, P.; Cheruy, F.; Codron, F.; Cozic, A.; Cugnet, D.; de Noblet, N.; Duvel, J.-P.; Ethé, C.; Fairhead, L.; Fichefet, T.; Flavoni, S.; Friedlingstein, P.; Grandpeix, J.-Y.; Guez, L.; Guilyardi, E.; Hauglustaine, D.; Hourdin, F.; Idelkadi, A.; Ghattas, J.; Joussaume, S.; Kageyama, M.; Krinner, G.; Labetoulle, S.; Lahellec, A.; Lefebvre, M.-P.; Lefevre, F.; Levy, C.; Li, Z. X.; Lloyd, J.; Lott, F.; Madec, G.; Mancip, M.; Marchand, M.; Masson, S.; Meurdesoif, Y.; Mignot, J.; Musat, I.; Parouty, S.; Polcher, J.; Rio, C.; Schulz, M.; Swingedouw, D.; Szopa, S.; Talandier, C.; Terray, P.; Viovy, N.; Vuichard, N.

2013-05-01

We present the global general circulation model IPSL-CM5 developed to study the long-term response of the climate system to natural and anthropogenic forcings as part of the 5th Phase of the Coupled Model Intercomparison Project (CMIP5). This model includes an interactive carbon cycle, a representation of tropospheric and stratospheric chemistry, and a comprehensive representation of aerosols. As it represents the principal dynamical, physical, and bio-geochemical processes relevant to the climate system, it may be referred to as an Earth System Model. However, the IPSL-CM5 model may be used in a multitude of configurations associated with different boundary conditions and with a range of complexities in terms of processes and interactions. This paper presents an overview of the different model components and explains how they were coupled and used to simulate historical climate changes over the past 150 years and different scenarios of future climate change. A single version of the IPSL-CM5 model (IPSL-CM5A-LR) was used to provide climate projections associated with different socio-economic scenarios, including the different Representative Concentration Pathways considered by CMIP5 and several scenarios from the Special Report on Emission Scenarios considered by CMIP3. Results suggest that the magnitude of global warming projections primarily depends on the socio-economic scenario considered, that there is potential for an aggressive mitigation policy to limit global warming to about two degrees, and that the behavior of some components of the climate system such as the Arctic sea ice and the Atlantic Meridional Overturning Circulation may change drastically by the end of the twenty-first century in the case of a no climate policy scenario. Although the magnitude of regional temperature and precipitation changes depends fairly linearly on the magnitude of the projected global warming (and thus on the scenario considered), the geographical pattern of these changes

Atomic and electronic structure of a copper/graphene interface as prepared and 1.5 years after

NASA Astrophysics Data System (ADS)

Boukhvalov, D. W.; Bazylewski, P. F.; Kukharenko, A. I.; Zhidkov, I. S.; Ponosov, Yu. S.; Kurmaev, E. Z.; Cholakh, S. O.; Lee, Y. H.; Chang, G. S.

2017-12-01

We report the results of X-ray spectroscopy and Raman measurements of as-prepared graphene on a high quality copper surface and the same materials after 1.5 years under different conditions (ambient and low humidity). The obtained results were compared with density functional theory calculations of the formation energies and electronic structures of various structural defects in graphene/Cu interfaces. For evaluation of the stability of the carbon cover, we propose a two-step model. The first step is oxidation of the graphene, and the second is perforation of graphene with the removal of carbon atoms as part of the carbon dioxide molecule. Results of the modeling and experimental measurements provide evidence that graphene grown on high-quality copper substrate becomes robust and stable in time (1.5 years). However, the stability of this interface depends on the quality of the graphene and the number of native defects in the graphene and substrate. The effect of the presence of a metallic substrate with defects on the stability and electronic structure of graphene is also discussed

Reference aquaplanet climate in the Community Atmosphere Model, Version 5

DOE PAGES

Medeiros, Brian; Williamson, David L.; Olson, Jerry G.

2016-03-18

In this study, fundamental characteristics of the aquaplanet climate simulated by the Community Atmosphere Model, Version 5.3 (CAM5.3) are presented. The assumptions and simplifications of the configuration are described. A 16 year long, perpetual equinox integration with prescribed SST using the model’s standard 18 grid spacing is presented as a reference simulation. Statistical analysis is presented that shows similar aquaplanet configurations can be run for about 2 years to obtain robust climatological structures, including global and zonal means, eddy statistics, and precipitation distributions. Such a simulation can be compared to the reference simulation to discern differences in the climate, includingmore » an assessment of confidence in the differences. To aid such comparisons, the reference simulation has been made available via earthsystemgrid.org. Examples are shown comparing the reference simulation with simulations from the CAM5 series that make different microphysical assumptions and use a different dynamical core.« less

Evaluating wind extremes in CMIP5 climate models

NASA Astrophysics Data System (ADS)

Kumar, Devashish; Mishra, Vimal; Ganguly, Auroop R.

2015-07-01

Wind extremes have consequences for renewable energy sectors, critical infrastructures, coastal ecosystems, and insurance industry. Considerable debates remain regarding the impacts of climate change on wind extremes. While climate models have occasionally shown increases in regional wind extremes, a decline in the magnitude of mean and extreme near-surface wind speeds has been recently reported over most regions of the Northern Hemisphere using observed data. Previous studies of wind extremes under climate change have focused on selected regions and employed outputs from the regional climate models (RCMs). However, RCMs ultimately rely on the outputs of global circulation models (GCMs), and the value-addition from the former over the latter has been questioned. Regional model runs rarely employ the full suite of GCM ensembles, and hence may not be able to encapsulate the most likely projections or their variability. Here we evaluate the performance of the latest generation of GCMs, the Coupled Model Intercomparison Project phase 5 (CMIP5), in simulating extreme winds. We find that the multimodel ensemble (MME) mean captures the spatial variability of annual maximum wind speeds over most regions except over the mountainous terrains. However, the historical temporal trends in annual maximum wind speeds for the reanalysis data, ERA-Interim, are not well represented in the GCMs. The historical trends in extreme winds from GCMs are statistically not significant over most regions. The MME model simulates the spatial patterns of extreme winds for 25-100 year return periods. The projected extreme winds from GCMs exhibit statistically less significant trends compared to the historical reference period.

First 5 Kern Annual Report: Fiscal Year 2014-2015

ERIC Educational Resources Information Center

Wang, Jianjun

2016-01-01

The California Children and Families Act of 1998 led to creation of the Kern County Children and Families Commission (First 5 Kern) to support early childhood service programs in Kern County, the third largest county in California that spread a land area as large as the state of New Jersey. In Fiscal Year 2014-15, First 5 Kern administered more…

First 5 Kern Annual Report: Fiscal Year 2015-2016

ERIC Educational Resources Information Center

Wang, Jianjun

2017-01-01

In Fiscal Year 2015-16, the California Children and Families Act has appropriated an average of $440 per child from the state tobacco tax revenue to support early development of children ages 0-5. Based on the proportion of live births in each county, First 5 Kern administered over $10 million of the state funding to support 41 programs in Child…

Estimated exposures to perfluorinated compounds in infancy predict attenuated vaccine antibody concentrations at age 5-years.

PubMed

Grandjean, Philippe; Heilmann, Carsten; Weihe, Pal; Nielsen, Flemming; Mogensen, Ulla B; Timmermann, Amalie; Budtz-Jørgensen, Esben

2017-12-01

Perfluorinated alkylate substances (PFASs) are highly persistent and may cause immunotoxic effects. PFAS-associated attenuated antibody responses to childhood vaccines may be affected by PFAS exposures during infancy, where breastfeeding adds to PFAS exposures. Of 490 members of a Faroese birth cohort, 275 and 349 participated in clinical examinations and provided blood samples at ages 18 months and 5 years. PFAS concentrations were measured at birth and at the clinical examinations. Using information on duration of breastfeeding, serum-PFAS concentration profiles during infancy were estimated. As outcomes, serum concentrations of antibodies against tetanus and diphtheria vaccines were determined at age 5. Data from a previous cohort born eight years earlier were available for pooled analyses. Pre-natal exposure showed inverse associations with the antibody concentrations five years later, with decreases by up to about 20% for each two-fold higher exposure, while associations for serum concentrations at ages 18 months and 5 years were weaker. Modeling of serum-PFAS concentration showed levels for age 18 months that were similar to those measured. Concentrations estimated for ages 3 and 6 months showed the strongest inverse associations with antibody concentrations at age 5 years, particularly for tetanus. Joint analyses showed statistically significant decreases in tetanus antibody concentrations by 19-29% at age 5 for each doubling of the PFAS exposure in early infancy. These findings support the notion that the developing adaptive immune system is particularly vulnerable to immunotoxicity during infancy. This vulnerability appears to be the greatest during the first 6 months after birth, where PFAS exposures are affected by breast-feeding.

Associations between teacher emotional support and depressive symptoms in Australian adolescents: a 5-year longitudinal study.

PubMed

Pössel, Patrick; Rudasill, Kathleen Moritz; Sawyer, Michael G; Spence, Susan H; Bjerg, Annie C

2013-11-01

Approximately 1/5 of adolescents develop depressive symptoms. Given that youths spend a good deal of their lives at school, it seems plausible that supportive relationships with teachers could benefit their emotional well-being. Thus, the purpose of this study is to examine the association between emotionally supportive teacher relationships and depression in adolescence. The so-called principle-effect and stress-buffer models could explain relationships between teacher emotional support and depressive symptoms, yet no study has used both models to test bidirectional relationships between teacher support and depressive symptoms in students separately by sex. Four-thousand three-hundred forty-one students (boys: n = 2,063; girls: n = 2,278) from Grades 8 to 12 completed the Center for Epidemiological Studies Depression Scale (CES-D), List of Threatening Experiences Questionnaire (LTEQ), and an instrument developed for the study to measure teacher support annually for 5 years. Results support neither of the 2 proposed models. Instead, they indicate that in the 1st years of high school, students of both sexes with average and high numbers of stressful events benefit from teacher support, while teacher support might have iatrogenic effects on students experiencing low numbers of stressful events. Possible explanations for the findings and future research are discussed.

Story Contexts Increase Susceptibility to the DRM Illusion in 5-Year-Olds

ERIC Educational Resources Information Center

Dewhurst, Stephen A.; Pursglove, Rhian C.; Lewis, Charlie

2007-01-01

False recognition in children aged 5, 8, and 11 years was investigated using the standard version of the Deese-Roediger-McDermott (DRM) procedure and an alternative version in which the DRM stimuli were embedded in stories designed to emphasize their overall theme. Relative to the 8- and 11-year-olds, the 5-year-olds falsely recognized fewer…

Longitudinal study of DNA methylation during the first 5 years of life.

PubMed

Urdinguio, Rocio G; Torró, María Isabel; Bayón, Gustavo F; Álvarez-Pitti, Julio; Fernández, Agustín F; Redon, Pau; Fraga, Mario F; Lurbe, Empar

2016-06-03

Early life epigenetic programming influences adult health outcomes. Moreover, DNA methylation levels have been found to change more rapidly during the first years of life. Our aim was the identification and characterization of the CpG sites that are modified with time during the first years of life. We hypothesize that these DNA methylation changes would lead to the detection of genes that might be epigenetically modulated by environmental factors during early childhood and which, if disturbed, might contribute to susceptibility to diseases later in life. The study of the DNA methylation pattern of 485577 CpG sites was performed on 30 blood samples from 15 subjects, collected both at birth and at 5 years old, using Illumina(®) Infinium 450 k array. To identify differentially methylated CpG (dmCpG) sites, the methylation status of each probe was examined using linear models and the Empirical Bayes Moderated t test implemented in the limma package of R/Bioconductor. Surogate variable analysis was used to account for batch effects. DNA methylation levels significantly changed from birth to 5 years of age in 6641 CpG sites. Of these, 36.79 % were hypermethylated and were associated with genes related mainly to developmental ontology terms, while 63.21 % were hypomethylated probes and associated with genes related to immune function. Our results suggest that DNA methylation alterations with age during the first years of life might play a significant role in development and the regulation of leukocyte-specific functions. This supports the idea that blood leukocytes experience genome remodeling related to their interaction with environmental factors, underlining the importance of environmental exposures during the first years of life and suggesting that new strategies should be take into consideration for disease prevention.

Global, Regional, and National Estimates of Rotavirus Mortality in Children <5 Years of Age, 2000-2013.

PubMed

Tate, Jacqueline E; Burton, Anthony H; Boschi-Pinto, Cynthia; Parashar, Umesh D

2016-05-01

Rotavirus vaccine is recommended for routine use in all countries globally. To facilitate decision making on rotavirus vaccine adoption by countries, help donors prioritize investments in health interventions, and monitor vaccine impact, we estimated rotavirus mortality for children <5 years of age from 2000 to 2013. We searched PubMed using the keyword "rotavirus" to identify studies that met each of the following criteria: data collection midpoint in year 1998 or later, study period of a 12-month increment, and detection of rotavirus infection by enzyme immunoassay in at least 100 children <5 years of age who were hospitalized with diarrhea and systematically enrolled through active surveillance. We also included data from countries that participated in the World Health Organization (WHO)-coordinated rotavirus surveillance network between 2008 and 2013 that met these criteria. To predict the proportion of diarrhea due to rotavirus, we constructed a multiple linear regression model. To determine the number of rotavirus deaths in children <5 years of age from 2000 to 2013, we multiplied annual, country-specific estimates of the proportion of diarrhea due to rotavirus from the regression model by the annual number of WHO-estimated child deaths caused by diarrhea in each country. Globally, we estimated that the number of rotavirus deaths in children <5 years of age declined from 528 000 (range, 465 000-591 000) in 2000 to 215 000 (range, 197 000-233 000) in 2013. The predicted annual rotavirus detection rate from these studies declined slightly over time from 42.5% (95% confidence interval [CI], 37.4%-47.5%) in 2000 to 37.3% (95% CI, 34.2%-40.5%) in 2013 globally. In 2013, an estimated 47 100 rotavirus deaths occurred in India, 22% of all rotavirus deaths that occurred globally. Four countries (India, Nigeria, Pakistan, and Democratic Republic of Congo) accounted for approximately half (49%) of all estimated rotavirus deaths in 2013. While rotavirus vaccine had been

Outpatient follow-up after treatment for early breast cancer: updated results after 5 years.

PubMed

Churn, M; Kelly, V

2001-01-01

The value of frequent outpatient follow-up in the first few years after primary treatment for early breast cancer is a controversial issue. Schedules involving 3-4 monthly visits in the first 2-3 years and 6-monthly from years 3-5 are still commonplace. In this study we audited such a policy from a single cancer centre, identifying a cohort of all 612 patients with early breast cancer (pT(1-3)pN(0-1)NxM0) referred for adjuvant therapy in 1993. The hospital records were reviewed to ascertain patient and tumour characteristics, the surgical and adjuvant treatment received, the timing and sequencing of recurrences and their mode of detection. Five hundred and five patients had breast conservation surgery. The actuarial local recurrence-free survival rate at 5 years in this group was 94.5%. Twenty-five of the 31 local recurrences that occurred were the first site of relapse. Eight (32%) of these were detected at routine clinic appointments, seven (28%) by routine mammography, and nine (36%) were interim referrals. Significant risk factors for local recurrence identified were lymph node status (P = 0.03) and tumour grade (P = 0.04). One hundred and four patients underwent mastectomy. The actuarial local recurrence-free survival at 5 years in this group was 85.4%. Nine of the 13 local recurrences were the first site of relapse. Six (66.7%) of these were detected at routine appointments. The significant risk factor for local recurrence identified was tumour grade (P = 0.03). Overall, 60.1% of metastases presented as interim referrals. Nodal status, tumour grade and tumour stage were confirmed as significant risk factors for metastasis (P < or = 0.001). Hazard rate analysis demonstrated a peak incidence of both local and metastatic recurrences in the second year, diminishing thereafter. This peak was largely confined to patients with tumours with poor prognostic features. We identified only eight patients out of a total of 612 followed up as outpatients for 5 years who had

A 5-year follow-up study of 117 battered women.

PubMed Central

Bergman, B; Brismar, B

1991-01-01

This paper reports register data concerning somatic and psychiatric hospital care on 117 battered women who were identified in a surgical emergency department and offered a treatment program. Data were collected during a period of 10 years before to 5 years after the battering in question. It was concluded that the battered woman seeks hospital care much more than the average woman of the same age. It is, however, not only traumatic injuries that bring her to the hospital, but also medical, gynecological, psychiatric, and unspecified disorders and suicide attempts. In this study it was hypothesized that this overuse of hospital care reflects the situation at home characterized by ongoing battering and other psychosocial problems. During the 5 years following the battering, the women did not show any signs of reducing their use of hospital care. It is alarming that this high use of medical care continues over years, and doctors should consider battering as one possible explanation for this phenomenon. PMID:1951810

General Principles for 5-year Regional Haze Progress Reports

EPA Pesticide Factsheets

This guidance document was developed by the U.S. EPA for EPA Regional Offices and states in preparing and reviewing the 5-year progress reports for the initial regional haze state implementation plans.

Time of emergence in regional precipitation changes: an updated assessment using the CMIP5 multi-model ensemble

NASA Astrophysics Data System (ADS)

Nguyen, Thuy-Huong; Min, Seung-Ki; Paik, Seungmok; Lee, Donghyun

2018-01-01

This study conducted an updated time of emergence (ToE) analysis of regional precipitation changes over land regions across the globe using multiple climate models from the Coupled Model Intercomparison Project phase 5 (CMIP5). ToEs were estimated for 14 selected hotspots over two seasons of April to September (AS) and October to March (OM) from three RCP scenarios representing low (RCP2.6), medium (RCP4.5), and high (RCP8.5) emissions. Results from the RCP8.5 scenario indicate that ToEs would occur before 2040 over seven hotspots including three northern high-latitude regions (OM wettening), East Africa (OM wettening), South Asia (AS wettening), East Asia (AS wettening) and South Africa (AS drying). The Mediterranean (both OM and AS drying) is expected to experience ToEs in the mid-twenty-first century (2040-2080). In order to measure possible benefits from taking low-emission scenarios, ToE differences were examined between the RCP2.6 scenario and the RCP4.5 and RCP8.5 scenarios. Significant ToE delays from 26 years to longer than 67 years were identified over East Africa (OM wettening), the Mediterranean (both AS and OM drying), South Asia (AS wettening), and South Africa (AS drying). Further, we investigated ToE differences between CMIP3-based and CMIP5-based models using the same number of models for the comparable scenario pairs (SRESA2 vs. RCP8.5, and SRESB1 vs. RCP4.5). Results were largely consistent between two model groups, indicating the robustness of ToE results. Considerable differences in ToEs (larger than 20 years) between two model groups appeared over East Asia and South Asia (AS wettening) and South Africa (AS drying), which were found due to stronger signals in CMIP5 models. Our results provide useful information on the timing of emerging signals in regional and seasonal hydrological changes, having important implications for associated adaptation and mitigation plans.

An anatomy of the projected North Atlantic warming hole in CMIP5 models

NASA Astrophysics Data System (ADS)

Menary, Matthew B.; Wood, Richard A.

2018-04-01

Global mean surface air temperature has increased over the past century and climate models project this trend to continue. However, the pattern of change is not homogeneous. Of particular interest is the subpolar North Atlantic, which has cooled in recent years and is projected to continue to warm less rapidly than the global mean. This is often termed the North Atlantic warming hole (WH). In climate model projections, the development of the WH is concomitant with a weakening of the Atlantic meridional overturning circulation (AMOC). Here, we further investigate the possible link between the AMOC and WH and the competing drivers of vertical mixing and surface heat fluxes. Across a large ensemble of 41 climate models we find that the spatial structure of the WH varies considerably from model to model but is generally upstream of the simulated deep water formation regions. A heat budget analysis suggests the formation of the WH is related to changes in ocean heat transport. Although the models display a plethora of AMOC mean states, they generally predict a weakening and shallowing of the AMOC also consistent with the evolving depth structure of the WH. A lagged regression analysis during the WH onset phase suggests that reductions in wintertime mixing lead a weakening of the AMOC by 5 years in turn leading initiation of the WH by 5 years. Inter-model differences in the evolution and structure of the WH are likely to lead to somewhat different projected climate impacts in nearby Europe and North America.

Non-stationary Return Levels of CMIP5 Multi-model Temperature Extremes

DOE PAGES

Cheng, L.; Phillips, T. J.; AghaKouchak, A.

2015-05-01

The objective of this study is to evaluate to what extent the CMIP5 climate model simulations of the climate of the twentieth century can represent observed warm monthly temperature extremes under a changing environment. The biases and spatial patterns of 2-, 10-, 25-, 50- and 100-year return levels of the annual maxima of monthly mean temperature (hereafter, annual temperature maxima) from CMIP5 simulations are compared with those of Climatic Research Unit (CRU) observational data considered under a non-stationary assumption. The results show that CMIP5 climate models collectively underestimate the mean annual maxima over arid and semi-arid regions that are mostmore » subject to severe heat waves and droughts. Furthermore, the results indicate that most climate models tend to underestimate the historical annual temperature maxima over the United States and Greenland, while generally disagreeing in their simulations over cold regions. Return level analysis shows that with respect to the spatial patterns of the annual temperature maxima, there are good agreements between the CRU observations and most CMIP5 simulations. However, the magnitudes of the simulated annual temperature maxima differ substantially across individual models. Discrepancies are generally larger over higher latitudes and cold regions.« less

3 to 5 Years Later: Long-term Effects of Prophylactic Bilateral Salpingectomy on Ovarian Function.

PubMed

Venturella, Roberta; Lico, Daniela; Borelli, Massimo; Imbrogno, Maria G; Cevenini, Gabriele; Zupi, Errico; Zullo, Fulvio; Morelli, Michele

2017-01-01

, 2.80% ± 5.32%; flow index, 19.37 ± 5.88; and vascular flow index, 0.56 ± 1.12. Analysis of covariance disclosed that PBS and control women do not exhibit different behaviors (p = .900) within OvAge/age relation. According to our model, the addition of PBS to TLH in the late reproductive years does not modify the ovarian age of treated women up to 3 to 5 years after surgery. Copyright © 2016 AAGL. Published by Elsevier Inc. All rights reserved.

Constraint on a varying proton-electron mass ratio 1.5 billion years after the big bang.

PubMed

Bagdonaite, J; Ubachs, W; Murphy, M T; Whitmore, J B

2015-02-20

A molecular hydrogen absorber at a lookback time of 12.4 billion years, corresponding to 10% of the age of the Universe today, is analyzed to put a constraint on a varying proton-electron mass ratio, μ. A high resolution spectrum of the J1443+2724 quasar, which was observed with the Very Large Telescope, is used to create an accurate model of 89 Lyman and Werner band transitions whose relative frequencies are sensitive to μ, yielding a limit on the relative deviation from the current laboratory value of Δμ/μ=(-9.5 ± 5.4(stat)± 5.3(syst))×10(-6).

Prenatal Lead Exposure and Weight of 0- to 5-Year-Old Children in Mexico City

PubMed Central

Peterson, Karen E.; Sánchez, Brisa N.; Cantonwine, David; Lamadrid-Figueroa, Héctor; Schnaas, Lourdes; Ettinger, Adrienne S.; Hernández-Avila, Mauricio; Hu, Howard; Téllez-Rojo, Martha M.

2011-01-01

Background: Cumulative prenatal lead exposure, as measured by maternal bone lead burden, has been associated with smaller weight of offspring at birth and 1 month of age, but no study has examined whether this effect persists into early childhood. Objective: We investigated the association of perinatal maternal bone lead, a biomarker of cumulative prenatal lead exposure, with children’s attained weight over time from birth to 5 years of age. Methods: Children were weighed at birth and at several intervals up until 60 months. Maternal tibia and patella lead were measured at 1 month postpartum using in vivo K-shell X-ray fluorescence. We used varying coefficient models with random effects to assess the association of maternal bone lead with weight trajectories of 522 boys and 477 girls born between 1994 and 2005 in Mexico City. Results: After controlling for breast-feeding duration, maternal anthropometry, and sociodemographic characteristics, a 1-SD increase in maternal patella lead (micrograms per gram) was associated with a 130.9-g decrease in weight [95% confidence interval (CI), –227.4 to –34.4 g] among females and a 13.0-g nonsignificant increase in weight among males (95% CI, –73.7 to 99.9 g) at 5 years of age. These associations were similar after controlling for concurrent blood lead levels between birth and 5 years. Conclusions: Maternal bone lead was associated with lower weight over time among female but not male children up to 5 years of age. Given that the association was evident for patellar but not tibial lead levels, and was limited to females, results need to be confirmed in other studies. PMID:21715242

49 CFR 543.5 - Petition: General requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... § 543.5 Petition: General requirements. (a) For each model year, a manufacturer may petition NHTSA for... manufacturer may not petition NHTSA for an exemption for model years before model year 2006. (b) Each petition... specified under paragraph (5) of § 543.5(b) for the first model year in which the petitioner wishes those...

Computed tomography screening for lung cancer: results of ten years of annual screening and validation of cosmos prediction model.

PubMed

Veronesi, G; Maisonneuve, P; Rampinelli, C; Bertolotti, R; Petrella, F; Spaggiari, L; Bellomi, M

2013-12-01

It is unclear how long low-dose computed tomographic (LDCT) screening should continue in populations at high risk of lung cancer. We assessed outcomes and the predictive ability of the COSMOS prediction model in volunteers screened for 10 years. Smokers and former smokers (>20 pack-years), >50 years, were enrolled over one year (2000-2001), receiving annual LDCT for 10 years. The frequency of screening-detected lung cancers was compared with COSMOS and Bach risk model estimates. Among 1035 recruited volunteers (71% men, mean age 58 years) compliance was 65% at study end. Seventy-one (6.95%) lung cancers were diagnosed, 12 at baseline. Disease stage was: IA in 48 (66.6%); IB in 6; IIA in 5; IIB in 2; IIIA in 5; IIIB in 1; IV in 5; and limited small cell cancer in 3. Five- and ten-year survival were 64% and 57%, respectively, 84% and 65% for stage I. Ten (12.1%) received surgery for a benign lesion. The number of lung cancers detected during the first two screening rounds was close to that predicted by the COSMOS model, while the Bach model accurately predicted frequency from the third year on. Neither cancer frequency nor proportion at stage I decreased over 10 years, indicating that screening should not be discontinued. Most cancers were early stage, and overall survival was high. Only a limited number of invasive procedures for benign disease were performed. The Bach model - designed to predict symptomatic cancers - accurately predicted cancer frequency from the third year, suggesting that overdiagnosis is a minor problem in lung cancer screening. The COSMOS model - designed to estimate screening-detected lung cancers - accurately predicted cancer frequency at baseline and second screening round. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Longitudinal trajectories of mental health in Australian children aged 4-5 to 14-15 years.

PubMed

Christensen, Daniel; Fahey, Michael T; Giallo, Rebecca; Hancock, Kirsten J

2017-01-01

Mental health can affect young people's sense of wellbeing and life satisfaction, their ability to participate in employment and education, and their onward opportunities in life. This paper offers a rare opportunity to longitudinally examine mental health in a population-representative study of children aged 4-5 years to 14-15 years. Using data from the Longitudinal Study of Australian Children (LSAC), this study examined maternally-reported child mental health over a 10 year period, in order to understand their initial mental health status early in life and its change over time, as measured by the Strengths and Difficulties Questionnaire. Longitudinal models were fitted from ages 4-5 to 14-15 years. Results showed that child sex, maternal mental health, socio-economic status (family income, maternal education, neighbourhood disadvantage), maternal hostility, and child temperament (persistence, sociability, reactivity) are all independent contributors to child mental health at age 4. These effects largely persist over time, with the effects of maternal mental health increasing slightly over time. Persistence of these effects suggests the need for early intervention and supports. The independent contribution of these factors to child mental health suggests that multi-faceted approaches to child and maternal mental health are needed.

Prediction of outcome at 5 years from assessments at 2 years among extremely preterm children: a Norwegian national cohort study.

PubMed

Leversen, Katrine Tyborg; Sommerfelt, Kristian; Elgen, Irene Bircow; Eide, Geir Egil; Irgens, Lorentz M; Júlíusson, Pétur B; Markestad, Trond

2012-03-01

To examine the predictive value of early assessments on developmental outcome at 5 years in children born extremely preterm. This is a prospective observational study of all infants born in Norway in 1999-2000 with gestational age (GA) <28 weeks or birth weight (BW) <1000 g. At 2 years of age, paediatricians assessed mental and motor development from milestones. At 5 years, parents completed questionnaires on development and professional support before cognitive function was assessed with Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI-R) and motor function with the Movement Assessment Battery for children (ABC test). Twenty-six of 373 (7%) children had cerebral palsy at 2 and 29 of 306 (9%) children at 5 years. Of children without major impairments, 51% (95% CI 35-67) of those with and 22% (95% CI 16-28) without mental delay at 2 years had IQ <85 at 5 years, and 36% (95% CI 20-53 with and 16% (95% CI 11-21) without motor delay at 2 years had an ABC score >95th percentile (poor function). Approximately half of those without major impairments but IQ <85 or ABC score >95th percentile had received support or follow-up beyond routine primary care. Previous assessments had limited value in predicting cognitive and motor function at 5 years in these extremely preterm children without major impairments. © 2011 The Author(s)/Acta Paediatrica © 2011 Foundation Acta Paediatrica.

A probabilistic model framework for evaluating year-to-year variation in crop productivity

NASA Astrophysics Data System (ADS)

Yokozawa, M.; Iizumi, T.; Tao, F.

2008-12-01

Most models describing the relation between crop productivity and weather condition have so far been focused on mean changes of crop yield. For keeping stable food supply against abnormal weather as well as climate change, evaluating the year-to-year variations in crop productivity rather than the mean changes is more essential. We here propose a new framework of probabilistic model based on Bayesian inference and Monte Carlo simulation. As an example, we firstly introduce a model on paddy rice production in Japan. It is called PRYSBI (Process- based Regional rice Yield Simulator with Bayesian Inference; Iizumi et al., 2008). The model structure is the same as that of SIMRIW, which was developed and used widely in Japan. The model includes three sub- models describing phenological development, biomass accumulation and maturing of rice crop. These processes are formulated to include response nature of rice plant to weather condition. This model inherently was developed to predict rice growth and yield at plot paddy scale. We applied it to evaluate the large scale rice production with keeping the same model structure. Alternatively, we assumed the parameters as stochastic variables. In order to let the model catch up actual yield at larger scale, model parameters were determined based on agricultural statistical data of each prefecture of Japan together with weather data averaged over the region. The posterior probability distribution functions (PDFs) of parameters included in the model were obtained using Bayesian inference. The MCMC (Markov Chain Monte Carlo) algorithm was conducted to numerically solve the Bayesian theorem. For evaluating the year-to-year changes in rice growth/yield under this framework, we firstly iterate simulations with set of parameter values sampled from the estimated posterior PDF of each parameter and then take the ensemble mean weighted with the posterior PDFs. We will also present another example for maize productivity in China. The

The Treatment of Parasomnias with Hypnosis: a 5-Year Follow-Up Study

PubMed Central

Hauri, Peter J.; Silber, Michael H.; Boeve, Bradley F.

2007-01-01

Study Objectives: This study involves a replication and extension of a previous one reported by Hurwitz et al (1991) on the treatment of certain parasomnias with hypnosis. Methods: Thirty-six patients (17 females), mean age 32.7 years (range 6–71). Four were children aged 6 to 16. All had chronic, “functionally autonomous” (self-sustaining) parasomnias. All underwent 1 or 2 hypnotherapy sessions and were then followed by questionnaire for 5 years. Results: Of the 36 patients, 45.4% were symptom-free or at least much improved at the 1-month follow-up, 42.2% at the 18-month follow-up, and 40.5% at the 5-year follow-up. Conclusions: One or 2 sessions of hypnotherapy might be an efficient first-line therapy for patients with certain types of parasomnias. Citation: Hauri PJ; Silber MH; Boeve BF. The treatment of parasomnias with hypnosis: a 5-year follow-up study. J Clin Sleep Med 2007;3(4):369-373. PMID:17694725

Clubfoot Does Not Impair Gross Motor Development in 5-Year-Olds.

PubMed

Zapata, Karina A; Karol, Lori A; Jeans, Kelly A; Jo, Chan-Hee

2018-04-01

To evaluate the gross motor development of 5-year-olds using the Peabody Developmental Motor Scales, 2nd Edition (PDMS-2), test after initial nonoperative management of clubfoot as infants. The PDMS-2 Stationary, Locomotion, and Object Manipulation subtests were assessed on 128 children with idiopathic clubfeet at the age of 5 years. Children were categorized by their initial clubfoot severity as greater than 13, unilateral or bilateral involvement, and required surgery. Children with treated clubfeet had average gross motor scores (99 Gross Motor Quotient) compared with age-matched normative scores. Children with more severe clubfeet required surgery significantly more than children with less severe scores (P < .01). Peabody scores were not significantly different according to initial clubfoot severity, unilateral versus bilateral involvement, and surgical versus nonsurgical outcomes. Clubfoot does not significantly impair gross motor development in 5-year-olds.

Urbanization factors associated with childhood asthma and prematurity: a population-based analysis aged from 0 to 5 years in Taiwan by using Cox regression within a hospital cluster model.

PubMed

Lin, Sheng-Chieh; Lin, Hui-Wen

2015-04-01

Childhood asthma and premature birth are both common; however, no studies have reported urbanization association between asthma and prematurity and the duration of prematurity affect asthma development. We use Taiwan Longitudinal Health Insurance Database (LHID) to explore association between asthma and prematurity among children by using a population-based analysis. This is a retrospective cohort study with registration data derived from Taiwan LHID. We evaluated prematurely born infants and children aged <5 years (n = 532) and age-matched control patients (n = 60505) using Cox proportional hazard regression analysis within a hospital cluster model. Of the 61 037 examinees, 14 012 experienced asthma during the 5-year follow-up, including 161 (72.26 per 1000 person-years) infants and children born prematurely and 13 851 (40.27 per 1000 person-years) controls. The hazard ratio for asthma during 5-year follow-up period was 1.95 (95% confidence interval = 1.67-2.28) among children born prematurely. Boys born prematurely aged 0-2 years were associated with higher asthma rates compared with girls in non-premature and premature groups. Living in urban areas, those born prematurely were associated with higher rates of asthma compared with non-prematurity. Those born prematurely lived in northern region had higher asthma hazard ratio than other regions. Our analyses indicated that sex, age, urbanization level, and geographic region are significantly associated with prematurity and asthma. Based on cumulative asthma-free survival curve generated using the Kaplan-Meier method, infants born prematurely should be closely monitored to see if they would develop asthma until the age of 6 years.

Glycemic Control Over 5 Years in 4,900 People With Type 2 Diabetes

PubMed Central

Best, James D.; Drury, Paul L.; Davis, Timothy M.E.; Taskinen, Marja-Riitta; Kesäniemi, Y. Antero; Scott, Russell; Pardy, Christopher; Voysey, Merryn; Keech, Anthony C.

2012-01-01

OBJECTIVE Glycemic control in type 2 diabetes generally worsens over time, requiring intensification of therapy. The Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) trial provided the opportunity to observe glycemic control in a real-world setting. We assessed the adequacy of metformin, sulfonylureas, and insulin to maintain glycemic control and their effects on weight. RESEARCH DESIGN AND METHODS Diabetes control was measured at baseline and yearly for a median of 5 years in the 4,900 patients from the nonintervention arm of this study allocated to placebo. RESULTS Median HbA1c was 6.9% at baseline and increased by an average of 0.22% over 5 years (P < 0.001). Median weight was 86.3 kg at baseline and decreased by 0.4 kg over 5 years (P = 0.002). Baseline therapy was lifestyle measures only in 27%, oral agents without insulin in 59%, and insulin in 14% (7% also taking oral agents). Over 5 years, insulin use increased to 32% (21% also taking oral agents). Use of oral agents remained similar at 56%. Only 2% of patients at baseline and 4% after 5 years were taking oral agents other than metformin or sulfonylureas. Initiation of insulin therapy in 855 patients produced a sustained reduction of HbA1c from a median of 8.2 to 7.7%, with a weight gain of 4.6 kg over 5 years. CONCLUSIONS With intensification of traditional therapies, glycemic control deteriorated very little over 5 years in a large cohort of type 2 diabetes. However, the requirement for insulin therapy doubled, at the expense of significant weight gain and risk of hypoglycemia. PMID:22432105

Impact of 5 years of lean six sigma in a University Medical Center.

PubMed

Niemeijer, Gerard C; Trip, Albert; de Jong, Laura J; Wendt, Klaus W; Does, Ronald J M M

2012-01-01

Lean Six Sigma (LSS) is an originally industry-based methodology for cost reduction and quality improvement. In more recent years, LSS was introduced in health care as well. This article describes the experiences of the University Medical Center Groningen, the second largest hospital in the Netherlands, with LSS. It was introduced in 2007 to create the financial possibility to develop innovations. In this article, we describe how LSS was introduced, and how it developed in the following years. We zoom in at the traumatology department, where all main processes have been analyzed and improved. An evaluation after 5 years shows that LSS helped indeed reducing cost and improving quality. Moreover, it aided the transition of the organization from purely problem oriented to more process oriented, which in turn is helpful in eliminating waste and finding solutions for difficult problems. A major benefit of the program is that own employees are trained to become project leaders for improvement. Several people from the primary process were thus stimulated and equipped to become role models for continuous improvement.

The cost-utility of photodynamic therapy in eyes with neovascular macular degeneration--a value-based reappraisal with 5-year data.

PubMed

Brown, Gary C; Brown, Melissa M; Campanella, Joseph; Beauchamp, George R

2005-10-01

To assess the value conferred by photodynamic therapy (PDT) and the cost-utility of PDT for the treatment of classic, subfoveal choroidal neovascularization associated with age-related macular degeneration (ARMD). Average cost-utility analysis utilizing clinical trial data, patient-based time tradeoff utility preferences, and a third party insurer cost perspective. Five-year visual acuity data from the TAP (Treatment of Age-related Macular Degeneration With Photodynamic Therapy) Investigation were modeled into a 12-year, value-based, reference case, cost-utility model utilizing year 2004 Medicare costs and an outcome of dollar/QALY (dollars/quality-adjusted life-year). Discounting of outcomes and costs using net present value analysis with a 3% annual rate was performed as recommended by the Panel for Cost-Effectiveness in Health and Medicine. PDT with verteporfin (Visudyne) dye for classic subfoveal choroidal neovascularization confers an 8.1% quality of life (value) improvement over the 12-year life expectancy of the reference case, while during the last 8 years the value improvement is 9.5%. The average cost-utility of the intervention is dollar 31,103/QALY (quality-adjusted life-year). Extensive one-way sensitivity analysis values range from dollar 20,736/QALY if treatment efficacy is increased by 50% to dollar 62,207 if treatment efficacy is decreased by 50%, indicating robustness of the model. PDT using verteporfin dye to treat classic subfoveal choroidal neovascularization is a very cost-effective treatment by conventional standards. The marked improvement in cost-effectiveness compared with a previous report results from the facts that the treatment benefit increasingly accrues during 5 years of follow-up while the number of yearly treatments diminishes markedly during that time.

A 10-year epidemiologic review of homicide cases in children younger than 5 years in Fulton County, GA: 1996-2005.

PubMed

Fajardo, Geroncio Cagigas; Hanzlick, Randy L

2010-12-01

The primary purpose of this study was to present the epidemiologic review of homicide deaths certified by the Fulton County Medical Examiner's Office from January 1, 1996 through December 31, 2005 in children younger than 5 years. The secondary purpose of this study was to determine if the observed cases of homicide deaths among children younger than 5 years in Fulton County are significantly greater than expected when compared with those in the State of Georgia. For purposes of this study, only homicide deaths of Fulton County residents were included. The authors reviewed all homicide cases in children younger than 5 years: infancy (<1 year) and early childhood (1-4 years). χ values were calculated using Epi Info (version 3.4.1; Centers for Disease Control and Prevention, Atlanta, Ga) to determine differences in homicide among age group, race, and sex variables. In addition, a χ test at the α level of 0.05 was done to determine if the observed cases of homicide deaths among children younger than 5 years in Fulton County were significantly greater than expected when compared with those in the State of Georgia. There were 49 homicide cases in children younger than 5 years identified over this 10-year period. The yearly distribution of these 49 homicide deaths ranged from 1 death in 2003 to 9 deaths in 2004. Most of the patients were male (n=29, 59.2%) and black (n=44, 89.8%). Between infancy and early childhood cases, homicide victims were nearly equally divided between the 2 groups. However, χ values showed that decedents younger than 5 years are more likely to have died of homicide compared with decedents 5 years or older (odds ratio [OR], 1.74; 95% confidence interval [CI], 1.29-2.35). Black decedents younger than 5 years are more likely to have died of homicide compared with other races (OR, 3.21; 95% CI, 1.21-9.28). Male and female decedents are equally at risk to have died of homicide (OR, 1.14; 95% CI, 0.61-2.11). The authors also determined that the

Expanding the 5E Model.

ERIC Educational Resources Information Center

Eisenkraft, Arthur

2003-01-01

Amends the current 5E learning cycle and instructional model to a 7E model. Changes ensure that instructors do not omit crucial elements for learning from their lessons while under the incorrect assumption that they are meeting the requirements of the learning cycle. The proposed 7E model includes: (1) engage; (2) explore; (3) explain; (4) elicit;…

Income, Family Context, and Self-Regulation in 5-Year-Old Children.

PubMed

Li, Mengying; Riis, Jenna L; Ghazarian, Sharon R; Johnson, Sara B

Self-regulation (SR) is a core aspect of child development with enduring effects on health and wellbeing across the lifespan. Early childhood poverty may shape SR development. This study examined the cross-sectional relationship among family income, family context, and SR in 5-year-old children. A total of 140 five-year-old children and their mothers participated in the study. Children completed a battery of SR tasks; mothers completed questionnaires. Cognitive and emotional SR composite scores were generated based on a principal component analysis of the SR tasks. The SR scores were first regressed on family income (in 10 levels ranging from <5000 to 150,000+) adjusting for age, sex, and race of the child; family context variables were subsequently added to the models. Controlling for age, sex, and race, each level increase in family income was associated with 0.04 SD increase in emotional SR (p = .32) and 0.08 SD increase in cognitive SR (p = .01). In fully adjusted models, exposure to household instability and experiencing 10 or more negative life events was associated with worse emotional SR; exposure to mother's depressive symptoms was associated with worse cognitive SR. Higher income buffered children's SR from some contextual risk factors. Family contextual variables explained 62% of the correlation between higher income and better cognitive SR scores. Income-based cognitive SR disparities were associated with family contextual factors. Screening for family adversity in pediatric care and linking families to needed resources may protect children's developing SR capacities, with benefits to health and well-being.

Evaluation of a new, low-dose levonorgestrel intrauterine contraceptive system over 5 years of use.

PubMed

Gemzell-Danielsson, Kristina; Apter, Dan; Dermout, Sylvia; Faustmann, Thomas; Rosen, Kimberly; Schmelter, Thomas; Merz, Martin; Nelson, Anita

2017-03-01

To evaluate the efficacy and safety of a new, low-dose levonorgestrel intrauterine contraceptive system (LNG-IUS 12) for up to 5 years of use. In this Phase III study, 2885 nulliparous and parous women aged 18-35 years were randomized to LNG-IUS 8 or LNG-IUS 12 for 3 years. After 3 years, women using LNG-IUS 12 could continue for up to 2 additional years (5 years total). The primary outcome was occurrence of pregnancy (Pearl Index). Secondary outcomes included safety, bleeding, dysmenorrhea, discontinuations, and user satisfaction. From August 2007 through May 2008, out of 2885 women who were enrolled, 1453 were randomized to LNG-IUS 12. Placement was attempted in 1452/1453 (full analysis set). Mean age at baseline was 27.1 years; 39.5% were nulliparous. The cumulative 5-year Pearl Index (PI) was 0.29; the 5-year cumulative failure rate was 1.4%. The 5-year PI for ectopic pregnancy was 0.18. Over 5 years, 55.3% of women reported study drug-related treatment-emergent adverse events (TEAEs). Crude incidences of pelvic inflammatory disease, uterine perforation, and complete/partial LNG-IUS 12 expulsion were 0.6%, 0.2%, and 3.7%, respectively. Women using LNG-IUS 12 generally experienced less frequent bleeding over time. The incidence of amenorrhea during the last 90-day reference interval (end of Year 5) was 22.6%. Overall, 870 (59.9%) and 550 (37.9%) women completed 3 and 5 years of treatment, respectively; 77.8% of women who entered the extension phase completed 5 years of use. Over 5 years, 22.6% discontinued due to TEAEs, including 13 women who discontinued due to pregnancy; 76 discontinued due to bleeding problems including amenorrhea; and 163 discontinued due to desire for pregnancy, 71.2% of whom conceived within 12 months. In this study including parous and nulliparous women, LNG-IUS 12 was highly effective over 5 years of use and associated with a favorable safety profile. LNG-IUS 12 offers women a low-dose contraceptive option for up to 5 years. Copyright �

Actual 5-Year Nutritional Outcomes of Patients with Gastric Cancer.

PubMed

Kim, Ki Hyun; Park, Dong Jin; Park, Young Suk; Ahn, Sang Hoon; Park, Do Joong; Kim, Hyung Ho

2017-06-01

In this study, we aimed to evaluate the rarely reported long-term nutritional results of patients with gastric cancer after curative gastrectomy. We retrospectively reviewed the prospectively collected medical records of 658 patients who underwent radical gastrectomy with curative intent for gastric cancer from January 2008 to December 2009 and had no recurrences. All patients were followed for 5 years. Nutritional statuses were assessed using measurements of body weight, serum hemoglobin, total lymphocyte count (TLC), protein, albumin, cholesterol, and nutritional risk index (NRI). Patients who underwent total gastrectomy had lower body weights, hemoglobin, protein, albumin, and cholesterol levels. TLC and NRI valued after the first postoperative year (P<0.05), and lower hemoglobin and NRI valued during the fifth postoperative year than patients who underwent distal gastrectomy (P<0.05). Patients who received adjuvant chemotherapy after gastrectomy had lower hemoglobin, protein, albumin, and cholesterol levels. TLC and NRI valued during the first postoperative year, than those who underwent gastrectomy only (P<0.05). Regarding post-distal gastrectomy reconstruction, those who underwent Roux-en-Y had lower cholesterol levels than did those who underwent Billroth-I and Billroth-II reconstruction at the first and fifth years after gastrectomy, respectively (P<0.05). Patients undergoing total or distal gastrectomy with Roux-en-Y anastomosis or adjuvant chemotherapy after surgery should be monitored carefully for malnutrition during the first postoperative year, and patients undergoing total gastrectomy should be monitored for malnutrition and anemia for 5 years.

Tooth brushing frequency and use of fluoride lozenges in children from 1.5 to 5 years of age: a longitudinal study.

PubMed

Wigen, Tove I; Wang, Nina J

2014-10-01

The purpose of the analyses was to study development, stability and changes in oral health behaviour - tooth brushing frequency, use of fluoride lozenges and fluoridated toothpaste in children from 1.5 to 5 years of age - and to study associations between oral health behaviour and family characteristics. This study was based on data from the Norwegian Mother and Child Cohort Study conducted by the Norwegian Institute of Public Health and data from the Public Dental Services. A total of 771 children were followed from 1.5 to 5 years of age. Questionnaires regarding oral health behaviour in children were completed by the parents three times during preschool age. More than half of the children (52%) had their teeth brushed twice daily at 1.5 years of age, increasing to 61% at 3 years and 76% at 5 years of age. At 1.5 years of age, 37% of the children used fluoride lozenges daily, increasing to 74% at 3 years and 75% at 5 years of age. The majority of the children who had started brushing twice daily and used fluoride lozenges daily at 1.5 years of age continued these behaviours until the age of 5 years. At 1.5 years of age, children who brushed twice daily were more likely to use fluoride lozenges daily than children who brushed less frequently (P = 0.03). Multiple logistic regression showed that the probability of a child having its teeth brushed twice daily continuously during preschool age was higher when both parents were of western origin [odds ratios (OR) 4.0, confidence intervals (CI) 1.3-11.9] than when one or both parents were of non-western origin. Children with one older sibling brushed more frequently (OR 1.4, CI 1.0-1.9) and used fluoride lozenges more often (OR 1.6, CI 1.1-2.2) during preschool age than children without older siblings. Oral health behaviour established in early life was stable during preschool age. The results indicate that tooth brushing frequency and use of fluoride lozenges were not in accordance with the present recommendations based

Tooth brushing frequency and use of fluoride lozenges in children from 1.5 to 5 years of age. A longitudinal study

PubMed Central

Wigen, Tove I; Wang, Nina J

2014-01-01

Objectives The purpose of the analyses was to study development, stability and changes in oral health behaviour; tooth brushing frequency, use of fluoride lozenges and fluoridated tooth paste in children from 1.5 to 5 years of age, and to study associations between oral health behaviour and family characteristics. Methods This study was based on data from the Norwegian Mother and Child Cohort Study conducted by the Norwegian Institute of Public Health and data from the Public Dental Services. A total of 771 children were followed from 1.5 to 5 years of age. Questionnaires regarding oral health behaviour in children were completed by the parents three times during preschool age. Results More than half of the children (52%) had their teeth brushed twice daily at 1.5 years of age, increasing to 61% at 3 years and 76% at 5 years of age. At 1.5 years of age 37% of the children used fluoride lozenges daily, increasing to 74% at 3 years and 75% at 5 years of age. The majority of the children who had started brushing twice daily and used fluoride lozenges daily at 1.5 year of age continued these behaviours until the age of 5 years. At 1.5 years of age, children who brushed twice daily were more likely to use fluoride lozenges daily than children who brushed less frequently (p = 0.03). Multiple logistic regression showed that the probability of a child having its teeth brushed twice daily continuously during preschool age was higher when both parents were of western origin (OR 4.0, CI 1.3 – 11.9) than when one or both parents were of non-western origin. Children with one older sibling brushed more frequently (OR 1.4, CI 1.0 – 1.9) and used fluoride lozenges more often (OR 1.6, CI 1.1 – 2.2) during preschool age than children without older siblings. Conclusions Oral health behaviour established in early life was stable during preschool age. The results indicate that tooth brushing frequency and use of fluoride lozenges were not in accordance with the present

Identifying cost-effective treatment with raloxifene in postmenopausal women using risk algorithms for fractures and invasive breast cancer.

PubMed

Ivergård, M; Ström, O; Borgström, F; Burge, R T; Tosteson, A N A; Kanis, J

2010-11-01

The National Osteoporosis Foundation (NOF) recommends considering treatment in women with a 20% or higher 10-year probability of a major fracture. However, raloxifene reduces both the risk of vertebral fractures and invasive breast cancer so that raloxifene treatment may be clinically appropriate and cost-effective in women who do not meet a 20% threshold risk. The aim of this study was to identify cost-effective scenarios of raloxifene treatment compared to no treatment in younger postmenopausal women at increased risk of invasive breast cancer and fracture risks below 20%. A micro-simulation model populated with data specific to American Caucasian women was used to quantify the costs and benefits of 5-year raloxifene treatment. The population evaluated was selected based on 10-year major fracture probability as estimated with FRAX® being below 20% and 5-year invasive breast cancer risk as estimated with the Gail risk model ranging from 1% to 5%. The cost per QALY gained ranged from US $22,000 in women age 55 with 5% invasive breast cancer risk and 15-19.9% fracture probability, to $110,000 in women age 55 with 1% invasive breast cancer risk and 5-9.9% fracture probability. Raloxifene was progressively cost-effective with increasing fracture risk and invasive breast cancer risk for a given age cohort. At lower fracture risk in combination with lower invasive breast cancer risk or when no preventive raloxifene effect on invasive breast cancer was assumed, the cost-effectiveness of raloxifene worsened markedly and was not cost-effective given a willingness-to-pay of US $50,000. At fracture risk of 15-19.9% raloxifene was cost-effective also in women at lower invasive breast cancer risk. Raloxifene is potentially cost-effective in cohorts of young postmenopausal women, who do not meet the suggested NOF 10-year fracture risk threshold. The cost-effectiveness is contingent on their 5-year invasive breast cancer risk. The result highlights the importance of considering

Development of a five-year mortality model in systemic sclerosis patients by different analytical approaches.

PubMed

Beretta, Lorenzo; Santaniello, Alessandro; Cappiello, Francesca; Chawla, Nitesh V; Vonk, Madelon C; Carreira, Patricia E; Allanore, Yannick; Popa-Diaconu, D A; Cossu, Marta; Bertolotti, Francesca; Ferraccioli, Gianfranco; Mazzone, Antonino; Scorza, Raffaella

2010-01-01

Systemic sclerosis (SSc) is a multiorgan disease with high mortality rates. Several clinical features have been associated with poor survival in different populations of SSc patients, but no clear and reproducible prognostic model to assess individual survival prediction in scleroderma patients has ever been developed. We used Cox regression and three data mining-based classifiers (Naïve Bayes Classifier [NBC], Random Forests [RND-F] and logistic regression [Log-Reg]) to develop a robust and reproducible 5-year prognostic model. All the models were built and internally validated by means of 5-fold cross-validation on a population of 558 Italian SSc patients. Their predictive ability and capability of generalisation was then tested on an independent population of 356 patients recruited from 5 external centres and finally compared to the predictions made by two SSc domain experts on the same population. The NBC outperformed the Cox-based classifier and the other data mining algorithms after internal cross-validation (area under receiving operator characteristic curve, AUROC: NBC=0.759; RND-F=0.736; Log-Reg=0.754 and Cox= 0.724). The NBC had also a remarkable and better trade-off between sensitivity and specificity (e.g. Balanced accuracy, BA) than the Cox-based classifier, when tested on an independent population of SSc patients (BA: NBC=0.769, Cox=0.622). The NBC was also superior to domain experts in predicting 5-year survival in this population (AUROC=0.829 vs. AUROC=0.788 and BA=0.769 vs. BA=0.67). We provide a model to make consistent 5-year prognostic predictions in SSc patients. Its internal validity, as well as capability of generalisation and reduced uncertainty compared to human experts support its use at bedside. Available at: http://www.nd.edu/~nchawla/survival.xls.

Development and verification of child observation sheet for 5-year-old children.

PubMed

Fujimoto, Keiko; Nagai, Toshisaburo; Okazaki, Shin; Kawajiri, Mie; Tomiwa, Kiyotaka

2014-02-01

The aim of the study was to develop a newly devised child observation sheet (COS-5) as a scoring sheet, based on the Childhood Autism Rating Scale (CARS), for use in the developmental evaluation of 5-year-old children, especially focusing on children with autistic features, and to verify its validity. Seventy-six children were studied. The children were recruited among participants of the Japan Children's Cohort Study, a research program implemented by the Research Institute of Science and Technology for Society (RISTEX) from 2004 to 2009. The developmental evaluation procedure was performed by doctors, clinical psychologists, and public health nurses. The COS-5 was also partly based on the Kyoto Scale of Psychological Development 2001 (Kyoto Scale 2001). Further, the Developmental Disorders Screening Questionnaire for 5-Years-Olds, PDD-Autism Society Japan Rating Scale (PARS), doctor interview questions and neurological examination for 5-year-old children, and the Draw-a-Man Test (DAM) were used as evaluation scales. Eighteen (25.4%) children were rated as Suspected, including Suspected PDD, Suspected ADHD and Suspected MR. The COS-5 was suggested to be valid with favorable reliability (α=0.89) and correlation with other evaluation scales. The COS-5 may be useful, with the following advantages: it can be performed within a shorter time frame; it facilitates the maintenance of observation quality; it facilitates sharing information with other professions; and it is reliable to identify the autistic features of 5-year-old children. In order to verify its wider applications including the screening of infants (18months to 3years old) by adjusting the items of younger age, additional study is needed. Copyright © 2013 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Uroflowmetry nomograms for healthy children 5 to 15 years old.

PubMed

Gupta, Dheeraj Kumar; Sankhwar, Satya Narayan; Goel, Apul

2013-09-01

We determined flow rates and generated flow rate-voided volume nomograms based on healthy children 5 to 15 years old voiding spontaneously in their natural environment. A total of 824 healthy school children of both genders were enrolled. A single uroflow record from each child was evaluated. A total of 103 children with a voided volume of less than 50 ml and/or a staccato/interrupted uroflow pattern were excluded, and 721 records were analyzed. Data were evaluated using several mathematical formulas and goodness of fit was determined. Linear regression analysis was used to generate nomograms. Flow rates and voided volumes increased with increasing age, with the effect being more pronounced in girls. No significant difference was noted in uroflow rates from 5 to 10 years, but significant differences (p <0.001) started appearing at 11 to 15 years. Also no significant difference was noted in uroflow rates among children 11 to 15 years. Therefore, 2 age groups were designated, with group 1 consisting of patients 5 to 10 years old and group 2 consisting of patients 11 to 15 years old. There were 222 boys and 122 girls in group 1 and 240 boys and 137 girls in group 2. In group 1 the maximum and average ± SD flow rates were 15.26 ± 4.54 ml per second and 7.68 ± 3.26 ml per second, respectively, for boys and 17.98 ± 6.06 ml per second and 9.19 ± 4.23 ml per second, respectively, for girls. In group 2 these rates were 22.50 ± 7.24 ml per second and 10.78 ± 4.03 ml per second, respectively, for boys and 27.16 ± 9.37 ml per second and 13.48 ± 5.21 ml per second, respectively, for girls. This large study, which expands the scant existing literature on uroflow parameters in healthy children, will hopefully promote wider application of uroflowmetry testing in the pediatric population. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Quantitative assessment of AOD from 17 CMIP5 models based on satellite-derived AOD over India

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

Misra, Amit; Kanawade, Vijay P.; Tripathi, Sachchida Nand

Aerosol optical depth (AOD) values from 17 CMIP5 models are compared with Moderate Resolution Imaging Spectroradiometer (MODIS) and Multiangle Imaging Spectroradiometer (MISR) derived AODs over India. The objective is to identify the cases of successful AOD simulation by CMIP5 models, considering satellite-derived AOD as a benchmark. Six years of AOD data (2000–2005) from MISR and MODIS are processed to create quality-assured gridded AOD maps over India, which are compared with corresponding maps of 17 CMIP5 models at the same grid resolution. Intercomparison of model and satellite data shows that model-AOD is better correlated with MISR-derived AOD than MODIS. The correlation between model-AOD andmore » MISR-AOD is used to segregate the models into three categories identifying their performance in simulating the AOD over India. Maps of correlation between model-AOD and MISR-/MODIS-AOD are generated to provide quantitative information about the intercomparison. The two sets of data are examined for different seasons and years to examine the seasonal and interannual variation in the correlation coefficients. In conclusion, latitudinal and longitudinal variations in AOD as simulated by models are also examined and compared with corresponding variations observed by satellites.« less

Quantitative assessment of AOD from 17 CMIP5 models based on satellite-derived AOD over India

DOE PAGES

Misra, Amit; Kanawade, Vijay P.; Tripathi, Sachchida Nand

2016-08-03

Aerosol optical depth (AOD) values from 17 CMIP5 models are compared with Moderate Resolution Imaging Spectroradiometer (MODIS) and Multiangle Imaging Spectroradiometer (MISR) derived AODs over India. The objective is to identify the cases of successful AOD simulation by CMIP5 models, considering satellite-derived AOD as a benchmark. Six years of AOD data (2000–2005) from MISR and MODIS are processed to create quality-assured gridded AOD maps over India, which are compared with corresponding maps of 17 CMIP5 models at the same grid resolution. Intercomparison of model and satellite data shows that model-AOD is better correlated with MISR-derived AOD than MODIS. The correlation between model-AOD andmore » MISR-AOD is used to segregate the models into three categories identifying their performance in simulating the AOD over India. Maps of correlation between model-AOD and MISR-/MODIS-AOD are generated to provide quantitative information about the intercomparison. The two sets of data are examined for different seasons and years to examine the seasonal and interannual variation in the correlation coefficients. In conclusion, latitudinal and longitudinal variations in AOD as simulated by models are also examined and compared with corresponding variations observed by satellites.« less

The summer drought related hemlock (Tsuga canadensis) decline in eastern North America 5,700 to 5,100 years ago

Treesearch

Jean Nicolas Haas; John H. McAndrews

2000-01-01

High resolution paleoecological analyses from Shepherd Lake, Ontario, Canada, show that 10 to 100 year lake level fluctuations due to climatic change were responsible for alterations in the aquatic biodiversity 5,700 to 5,100 years ago. Thermophilic aquatics such as the Bushy pondweed Najas flexilis, charophyte algae and aquatic invertebrates...

Clinical consequences of untreated dental caries in German 5- and 8-year-olds.

PubMed

Grund, Katrin; Goddon, Inka; Schüler, Ina M; Lehmann, Thomas; Heinrich-Weltzien, Roswitha

2015-11-04

About half of all carious lesions in primary teeth of German 6- to 7-year-old children remain untreated, but no data regarding the clinical consequences of untreated dental caries are available. Therefore, this cross-sectional observational study aimed to assess the prevalence and experience of caries and odontogenic infections in the primary dentition of 5- and 8-year-old German children. Dental examinations were performed in 5-year-old pre-school children (n = 496) and in 8-year-old primary school children (n = 608) living in the Westphalian Ennepe-Ruhr district. Schools and preschools were selected by sociodemographic criteria including size, area, ownership, socio-economic status. Caries was recorded according to WHO criteria (1997). The Lorenz curves were used to display the polarisation of dental caries. Caries pattern in 5-year-olds was categorized by Wyne's (1997) definition of early childhood caries (ECC). Odontogenic infections as clinical consequence of untreated dental caries were assessed by the pufa index. The 'untreated caries-pufa ratio' was calculated, and the Spearman's rank correlation coefficient (ρ) was used for evaluating the correlation between dmft and pufa scores. Categorical data were compared between groups using the chi-square test and continuous data were analysed by t-test. Caries prevalence and experience in the primary dentition was 26.2 %/0.9 ± 2.0 dmft in 5-year-olds and 48.8 %/2.1 ± 2.8 dmft in 8-year-olds. ECC type I (22 %) was the prevalent caries pattern in 5-year-olds. About 30 % of the tooth decay was treated (5y: 29.7 %/8y: 39.3 %). The Lorenz curves showed a strong caries polarisation on 20 % of the children. Pufa prevalence and experience was 4.4 %/0.1 ± 0.5 pufa in 5-year-olds and 16.6 %/0.3 ± 0.9 pufa in 8-year-olds. In 5-year-olds 14.2 % and in 8-year-olds 34.2 % of the d-component had progressed mainly to the pulp. A significant correlation between dmft and pufa scores exists in

Intraindividual variability in reaction time predicts cognitive outcomes 5 years later.

PubMed

Bielak, Allison A M; Hultsch, David F; Strauss, Esther; Macdonald, Stuart W S; Hunter, Michael A

2010-11-01

Building on results suggesting that intraindividual variability in reaction time (inconsistency) is highly sensitive to even subtle changes in cognitive ability, this study addressed the capacity of inconsistency to predict change in cognitive status (i.e., cognitive impairment, no dementia [CIND] classification) and attrition 5 years later. Two hundred twelve community-dwelling older adults, initially aged 64-92 years, remained in the study after 5 years. Inconsistency was calculated from baseline reaction time performance. Participants were assigned to groups on the basis of their fluctuations in CIND classification over time. Logistic and Cox regressions were used. Baseline inconsistency significantly distinguished among those who remained or transitioned into CIND over the 5 years and those who were consistently intact (e.g., stable intact vs. stable CIND, Wald (1) = 7.91, p < .01, Exp(β) = 1.49). Average level of inconsistency over time was also predictive of study attrition, for example, Wald (1) = 11.31, p < .01, Exp(β) = 1.24. For both outcomes, greater inconsistency was associated with a greater likelihood of being in a maladaptive group 5 years later. Variability based on moderately cognitively challenging tasks appeared to be particularly sensitive to longitudinal changes in cognitive ability. Mean rate of responding was a comparable predictor of change in most instances, but individuals were at greater relative risk of being in a maladaptive outcome group if they were more inconsistent rather than if they were slower in responding. Implications for the potential utility of intraindividual variability in reaction time as an early marker of cognitive decline are discussed. (c) 2010 APA, all rights reserved

Trends in oral anticoagulant use in Qatar: a 5-year experience.

PubMed

Elewa, Hazem; Alhaddad, Amani; Al-Rawi, Safa; Nounou, Amir; Mahmoud, Hesham; Singh, Rajvir

2017-04-01

In Qatar, dabigatran was introduced in 2011 followed by rivaroxaban in 2014. In this study, we aim to explore the trends in oral anticoagulant use in Qatar over the past 5 years and to what extent did DOACs replace warfarin. We also explored the extent of switching between different anticoagulants (from warfarin to DOACs and vice versa). We collected all anticoagulant prescriptions dispensed as in- or out-patient from 2011 to 2015 in all Hamad Medical Corporation (HMC) hospitals. Overall number of patients using warfarin, dabigatran and rivaroxaban over the last 5 years collectively was calculated. Per each calendar year, we calculated the number of all 3 OAC used (warfarin, dabigatran and rivaroxaban), frequency of use of each one of the OAC prescribed and compared the change in proportion of DOACs to warfarin prescriptions over the years. Overall, 6961 patients were using OAC over the past 5 years among which 5849 (84%) used warfarin, 496 (7.1%) used dabigatran and 616 (8.8%) used rivaroxaban. Oral anticoagulants use increased gradually from 2091 in 2011 to 3688 in 2015. Number of patients receiving DOACs increased significantly compared to warfarin [11 (0.5%) in 2011 vs. 849 (23%) in 2015 (p < 0.0001)]. Since its introduction in 2014, number of rivaroxaban users increased significantly compared to dabigatran [212 (40.9%) in 2014 vs. 544 (64.1%) in 2015]. DOACs have been gradually replacing warfarin in Qatar and the trend of their use is similar to that reported in other countries. Warfarin remains the most commonly used oral anticoagulant.

The effect of year-to-year variability of leaf area index on Variable Infiltration Capacity model performance and simulation of runoff

NASA Astrophysics Data System (ADS)

Tesemma, Z. K.; Wei, Y.; Peel, M. C.; Western, A. W.

2015-09-01

This study assessed the effect of using observed monthly leaf area index (LAI) on hydrological model performance and the simulation of runoff using the Variable Infiltration Capacity (VIC) hydrological model in the Goulburn-Broken catchment of Australia, which has heterogeneous vegetation, soil and climate zones. VIC was calibrated with both observed monthly LAI and long-term mean monthly LAI, which were derived from the Global Land Surface Satellite (GLASS) leaf area index dataset covering the period from 1982 to 2012. The model performance under wet and dry climates for the two different LAI inputs was assessed using three criteria, the classical Nash-Sutcliffe efficiency, the logarithm transformed flow Nash-Sutcliffe efficiency and the percentage bias. Finally, the deviation of the simulated monthly runoff using the observed monthly LAI from simulated runoff using long-term mean monthly LAI was computed. The VIC model predicted monthly runoff in the selected sub-catchments with model efficiencies ranging from 61.5% to 95.9% during calibration (1982-1997) and 59% to 92.4% during validation (1998-2012). Our results suggest systematic improvements, from 4% to 25% in Nash-Sutcliffe efficiency, in sparsely forested sub-catchments when the VIC model was calibrated with observed monthly LAI instead of long-term mean monthly LAI. There was limited systematic improvement in tree dominated sub-catchments. The results also suggest that the model overestimation or underestimation of runoff during wet and dry periods can be reduced to 25 mm and 35 mm respectively by including the year-to-year variability of LAI in the model, thus reflecting the responses of vegetation to fluctuations in climate and other factors. Hence, the year-to-year variability in LAI should not be neglected; rather it should be included in model calibration as well as simulation of monthly water balance.

Multi-year objective analyses of warm season ground-level ozone and PM2.5 over North America using real-time observations and Canadian operational air quality models

NASA Astrophysics Data System (ADS)

Robichaud, A.; Ménard, R.

2014-02-01

Multi-year objective analyses (OA) on a high spatiotemporal resolution for the warm season period (1 May to 31 October) for ground-level ozone and for fine particulate matter (diameter less than 2.5 microns (PM2.5)) are presented. The OA used in this study combines model outputs from the Canadian air quality forecast suite with US and Canadian observations from various air quality surface monitoring networks. The analyses are based on an optimal interpolation (OI) with capabilities for adaptive error statistics for ozone and PM2.5 and an explicit bias correction scheme for the PM2.5 analyses. The estimation of error statistics has been computed using a modified version of the Hollingsworth-Lönnberg (H-L) method. The error statistics are "tuned" using a χ2 (chi-square) diagnostic, a semi-empirical procedure that provides significantly better verification than without tuning. Successful cross-validation experiments were performed with an OA setup using 90% of data observations to build the objective analyses and with the remainder left out as an independent set of data for verification purposes. Furthermore, comparisons with other external sources of information (global models and PM2.5 satellite surface-derived or ground-based measurements) show reasonable agreement. The multi-year analyses obtained provide relatively high precision with an absolute yearly averaged systematic error of less than 0.6 ppbv (parts per billion by volume) and 0.7 μg m-3 (micrograms per cubic meter) for ozone and PM2.5, respectively, and a random error generally less than 9 ppbv for ozone and under 12 μg m-3 for PM2.5. This paper focuses on two applications: (1) presenting long-term averages of OA and analysis increments as a form of summer climatology; and (2) analyzing long-term (decadal) trends and inter-annual fluctuations using OA outputs. The results show that high percentiles of ozone and PM2.5 were both following a general decreasing trend in North America, with the eastern

5-year survival and rehospitalization due to stroke recurrence among patients with hemorrhagic or ischemic strokes in Singapore.

PubMed

Sun, Yan; Lee, Sze Haur; Heng, Bee Hoon; Chin, Vivien S

2013-10-03

Stroke is the 4th leading cause of death and 1st leading cause of disability in Singapore. However the information on long-term post stroke outcomes for Singaporean patients was limited. This study aimed to investigate the post stroke outcomes of 5-year survival and rehospitalization due to stroke recurrence for hemorrhagic and ischemic stroke patients in Singapore. The outcomes were stratified by age, ethnic group, gender and stroke types. The causes of death and stroke recurrence were also explored in the study. A multi-site retrospective cohort study. Patients admitted for stroke at any of the three hospitals in the National Healthcare Group of Singapore were included in the study. All study patients were followed up to 5 years. Kaplan-Meier was applied to study the time to first event, death or rehospitalization due to stroke recurrence. Cox proportional hazard model was applied to study the time to death with adjustment for stroke type, age, sex, ethnic group, and admission year. Cumulative incidence model with competing risk was applied for comparing the risks of rehospitalization due to stroke recurrence with death as the competing risk. Totally 12,559 stroke patients were included in the study. Among them, 59.3% survived for 5 years; 18.4% were rehospitalized due to stroke recurrence in 5 years. The risk of stroke recurrence and mortality increased with age in all stroke types. Gender, ethnic group and admitting year were not significantly associated with the risk of mortality or stroke recurrence in hemorrhagic stroke. Male or Malay patient had higher risk of stroke recurrence and mortality in ischemic stroke. Hemorrhagic stroke had higher early mortality while ischemic stroke had higher recurrence and late mortality. The top cause of death among died stroke patients was cerebrovascular diseases, followed by pneumonia and ischemic heart diseases. The recurrent stroke was most likely to be the same type as the initial stroke among rehospitalized stroke

40 CFR 600.512-12 - Model year report.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 1978 Passenger Automobiles and for 1979 and Later Model Year Automobiles (Light Trucks and Passenger Automobiles)-Procedures for Determining Manufacturer's Average Fuel Economy § 600.512-12 Model year report. (a... must be submitted. (3) Separate reports shall be submitted for passenger automobiles and light trucks...

Soil microbial properties after 5 years of consecutive amendment with composted tannery sludge.

PubMed

Araujo, Ademir Sérgio Ferreira; Miranda, Ana Roberta Lima; Oliveira, Mara Lucia Jacinto; Santos, Vilma Maria; Nunes, Luís Alfredo Pinheiro Leal; Melo, Wanderley José

2015-01-01

Composting has been recognised an alternative method to tannery sludge recycling and afterwards to be used in agriculture. As the tannery sludge contains salts and chromium, the application of composted tannery sludge (CTS) should be performed carefully to minimise negative effects on soil microbial properties. Therefore, this study evaluated the effects of 5-year repeated CTS amendment on soil microbial biomass (SMB) and enzyme activities in a tropical soil. CTS was applied during 5 years at 0, 2.5, 5, 10 and 20 Mg ha(-1), and at the fifth year, the microbial biomass C (MBC) and N (MBN), basal and substrate-induced respiration (SIR), metabolic quotient (qCO₂) and dehydrogenase (DHA) and fluorescein diacetate (FDA) hydrolysis were determined in the soil samples. Soil MBC and MBN showed the highest values with the amendment of 5 Mg ha(-1) CTS. Soil respiration increased with the increase in CTS rates, while SIR showed the highest values with the amendment of 0, 2.5 and 5 Mg ha(-1) CTS. DHA activity showed the highest values with the amendment up to 2.5 Mg ha(-1), while FDA hydrolysis increased up to the rate of 5 Mg ha(-1) CTS. The results show that after 5 years of permanent amendment of CTS, soils amended with 2.5 Mg ha(-1) have SMB and enzymatic activities similar to those in unamended soil.

M5 model tree based predictive modeling of road accidents on non-urban sections of highways in India.

PubMed

Singh, Gyanendra; Sachdeva, S N; Pal, Mahesh

2016-11-01

This work examines the application of M5 model tree and conventionally used fixed/random effect negative binomial (FENB/RENB) regression models for accident prediction on non-urban sections of highway in Haryana (India). Road accident data for a period of 2-6 years on different sections of 8 National and State Highways in Haryana was collected from police records. Data related to road geometry, traffic and road environment related variables was collected through field studies. Total two hundred and twenty two data points were gathered by dividing highways into sections with certain uniform geometric characteristics. For prediction of accident frequencies using fifteen input parameters, two modeling approaches: FENB/RENB regression and M5 model tree were used. Results suggest that both models perform comparably well in terms of correlation coefficient and root mean square error values. M5 model tree provides simple linear equations that are easy to interpret and provide better insight, indicating that this approach can effectively be used as an alternative to RENB approach if the sole purpose is to predict motor vehicle crashes. Sensitivity analysis using M5 model tree also suggests that its results reflect the physical conditions. Both models clearly indicate that to improve safety on Indian highways minor accesses to the highways need to be properly designed and controlled, the service roads to be made functional and dispersion of speeds is to be brought down. Copyright © 2016 Elsevier Ltd. All rights reserved.

Inequalities in dental caries of 5-year-old children in Scotland, 1993-2003.

PubMed

Levin, Kate A; Davies, Carolyn A; Topping, Gail V A; Assaf, Andrea V; Pitts, Nigel B

2009-06-01

Previous research suggests there are significant differences between socio-economic groups in prevalence and amount of decayed missing and filled primary teeth (d3mft). The aim of this study was to describe the variation in obvious tooth decay experience amongst 5-year olds in Scotland and to look at the association between d3mft and deprivation in Scotland. Data derived from 1993 to 2003 National Dental Inspection Programme were modelled using Bayesian multilevel zero-inflated Negative Binomial models, adjusting for age, sex and the deprivation. Deprivation is positively and significantly associated with having d3mft; the odds of a child in DepCat 7 (most deprived) having d3mft in 1993 were 7.49 (5.03-11.15) that of a child in DepCat 1 (most affluent). Inequalities in the prevalence of d3mft have reduced and in 2003 the odds of a child in DepCat 7 having d3mft were 4.60 (3.47-6.14) that of a child in DepCat 1. However, socio-economic inequalities in the amount of d3mft for those with d3mft have seen no reduction and have in fact increased between 1993 and 2003, with this increase approaching significance. While socio-economic inequalities in prevalence of children with d3mft have decreased in recent years, socio-economic inequalities in the amount of d3mft for those with d3mft persist. This suggests that improvements are only seen for those children with the potential for low d3mft. High d3mft persists among children from more deprived areas. The national target conceals this apparent inconsistency.

Thinning cherry-maple stands in West Virginia: 5-year results

Treesearch

Neil I. Lamson; H. Clay. Smith; H. Clay. Smith

1988-01-01

In northern West Virginia, 60-year-old cherry-maple stands were thinned to 75,60, and 45 percent relative stand density. Analysis of 5-year growth data showed that basal-area growth was not reduced by thinning. Cubic-foot and board-foot volume growth decreased slightly. Individual-tree growth of all trees, dominant/codominant trees, and the 50 largest diameter trees...

40 CFR 600.512-08 - Model year report.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 1978 Passenger Automobiles and for 1979 and Later Model Year Automobiles (Light Trucks and Passenger Automobiles)-Procedures for Determining Manufacturer's Average Fuel Economy § 600.512-08 Model year report. (a... shall be submitted for passenger automobiles and light trucks (as identified in § 600.510). (c) The...

40 CFR 600.512-01 - Model year report.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 1978 Passenger Automobiles and for 1979 and Later Model Year Automobiles (Light Trucks and Passenger Automobiles)-Procedures for Determining Manufacturer's Average Fuel Economy § 600.512-01 Model year report. (a... shall be submitted for passenger automobiles and light trucks (as identified in § 600.510). (c) The...

Projections of annual rainfall and surface temperature from CMIP5 models over the BIMSTEC countries

NASA Astrophysics Data System (ADS)

Pattnayak, K. C.; Kar, S. C.; Dalal, Mamta; Pattnayak, R. K.

2017-05-01

Bay of Bengal Initiative for Multi-Sectoral Technical and Economic Cooperation (BIMSTEC) comprising Bangladesh, Bhutan, India, Myanmar, Nepal, Sri Lanka and Thailand brings together 21% of the world population. Thus the impact of climate change in this region is a major concern for all. To study the climate change, fifth phase of Climate Model Inter-comparison Project (CMIP5) models have been used to project the climate for the 21st century under the Representative Concentration Pathways (RCPs) 4.5 and 8.5 over the BIMSTEC countries for the period 1901 to 2100 (initial 105 years are historical period and the later 95 years are projected period). Climate change in the projected period has been examined with respect to the historical period. In order to validate the models, the mean annual rainfall has been compared with observations from multiple sources and temperature has been compared with the data from Climatic Research Unit (CRU) during the historical period. Comparison reveals that ensemble mean of the models is able to represent the observed spatial distribution of rainfall and temperature over the BIMSTEC countries. Therefore, data from these models may be used to study the future changes in the 21st century. Four out of six models show that the rainfall over India, Thailand and Myanmar has decreasing trend and Bangladesh, Bhutan, Nepal and Sri Lanka show an increasing trend in both the RCP scenarios. In case of temperature, all the models show an increasing trend over all the BIMSTEC countries in both the scenarios, however, the rate of increase is relatively less over Sri Lanka than the other countries. The rate of increase/decrease in rainfall and temperature are relatively more in RCP8.5 than RCP4.5 over all these countries. Inter-model comparison show that there are uncertainties within the CMIP5 model projections. More similar studies are required to be done for better understanding the model uncertainties in climate projections over this region.

A 5-year prospective study on single immediate implants in the aesthetic zone.

PubMed

Cosyn, Jan; Eghbali, Aryan; Hermans, Alexander; Vervaeke, Stijn; De Bruyn, Hugo; Cleymaet, Roberto

2016-08-01

There is a paucity of long-term data on soft tissue aesthetics of single immediate implants. The objective of this study was to evaluate the 5-year clinical and aesthetic outcome of this treatment concept. Twenty-two periodontally healthy patients (12 men, 10 women; mean age 50) with low risk for aesthetic complications (thick gingival biotype, intact buccal bone wall, both neighbouring teeth present) were consecutively treated with a single immediate implant in the aesthetic zone (15-25). Flapless surgery was performed and the gap between the implant and buccal bone wall was systematically filled with bovine bone particles. Implants were immediately non-functionally loaded with a screw-retained provisional crown. Cases demonstrating major alveolar process changes and/or advanced mid-facial recession (>1 mm) at 3 months were additionally treated with a connective tissue graft (CTG). Permanent crowns were installed at 6 months. The clinical and aesthetic results at 5 years were compared to those obtained at 1 year. Seventeen patients attended the 5-year re-assessment, of whom five had been treated with a CTG for early aesthetic complications. There was one early implant failure and one complication after 1 year (porcelain chipping). Mean marginal bone loss was 0.12 mm at 1 year and 0.19 mm at 5 years (p = 0.595) with the moment of implant installation as baseline. Papilla height increased between 1 and 5 years (p ≤ 0.007), whereas mid-facial contour (p = 0.005) and alveolar process deficiency (p = 0.008) deteriorated. Mean mid-facial recession was on average 0.28 mm (SD 0.48) at 1 year and 0.53 mm (SD 0.53) at 5 years (p = 0.072) with the preoperative status as baseline. Three implants demonstrated advanced mid-facial recession (>1 mm) at 5 years. All three were in a central incisor position and none had been treated with a CTG. Thus, 8/17 implants showed aesthetic complications (five early and three late aesthetic complications). Implants

Evaluation of nutrient status after laparoscopic sleeve gastrectomy 1, 3, and 5 years after surgery.

PubMed

Saif, Taha; Strain, Gladys W; Dakin, Gregory; Gagner, Michel; Costa, Ricardo; Pomp, Alfons

2012-01-01

Laparoscopic sleeve gastrectomy evolved as a primary bariatric procedure with little information on its nutritional effects. Our objective was to assess the longer term micronutrient and vitamin status after laparoscopic sleeve gastrectomy at a university hospital. Measurements of ferritin, iron, total iron binding capacity, hemoglobin, hematocrit, parathyroid hormone, albumin, calcium, magnesium, phosphorus, zinc, folate, and vitamins A, B1, B12, and D were obtained at baseline and 1, 3, and 5 years after surgery. Two-sample t tests with multiple adjusted comparisons and Fisher's exact test were used to determine deficiency. A total of 82 patients (67% women), with a mean age of 46.4 years and a baseline body mass index 55.7 kg/m2 were included in the present study (35 at 1, 27 at 3, and 30 at 5 years postoperatively). The percentage of excess body mass index loss was 58.5% at year 1 in 35 patients, 63.1% at year 3 in 27 patients, and 46.1% at year 5 in 30 patients. The parathyroid hormone level decreased from 75.0 to 49.6 ng/mL in year 1 to 40.7 ng/mL in year 3. The year 5 levels increased to 99.6 ng/mL. The mean vitamin D level increased from 23.6 ng/mL to 35.0, 32.1 and 34.8 at years 1, 3, and 5 (P = .05 for baseline to year 1). The vitamin D level was less than normal in 42% of the patients at year 5. After normalization from baseline, by year 5, parathyroid hormone had increased in 58.3% of patients. At year 5, vitamin B1 was less than normal in 30.8% of patients, and hemoglobin and hematocrit were less than normal in for 28.6% and 25% of patients, respectively. Finally, 28.9% of patients reported taking supplements in year 1, 42.9% in year 3, and 63.3% in year 5. The other variables were not significantly different. Laparoscopic sleeve gastrectomy resulted in health improvements through year 3. At year 5, the nutrient levels had reverted toward the baseline values. These observations provide focus for necessary clinical monitoring. Copyright © 2012 American

Population pharmacokinetic modelling of rupatadine solution in 6-11 year olds and optimisation of the experimental design in younger children.

PubMed

Santamaría, Eva; Estévez, Javier Alejandro; Riba, Jordi; Izquierdo, Iñaki; Valle, Marta

2017-01-01

To optimise a pharmacokinetic (PK) study design of rupatadine for 2-5 year olds by using a population PK model developed with data from a study in 6-11 year olds. The design optimisation was driven by the need to avoid children's discomfort in the study. PK data from 6-11 year olds with allergic rhinitis available from a previous study were used to construct a population PK model which we used in simulations to assess the dose to administer in a study in 2-5 year olds. In addition, an optimal design approach was used to determine the most appropriate number of sampling groups, sampling days, total samples and sampling times. A two-compartmental model with first-order absorption and elimination, with clearance dependent on weight adequately described the PK of rupatadine for 6-11 year olds. The dose selected for a trial in 2-5 year olds was 2.5 mg, as it provided a Cmax below the 3 ng/ml threshold. The optimal study design consisted of four groups of children (10 children each), a maximum sampling window of 2 hours in two clinic visits for drawing three samples on day 14 and one on day 28 coinciding with the final examination of the study. A PK study design was optimised in order to prioritise avoidance of discomfort for enrolled 2-5 year olds by taking only four blood samples from each child and minimising the length of hospital stays.

Prediction of transfer among multiple states of blood pressure based on Markov model: an 18-year cohort study.

PubMed

Wang, Yunfeng; Ma, Zhimin; Xu, Chaonan; Wang, ZiKun; Yang, Xinghua

2018-05-15

This study aimed to identify the rules of transition between normotension, prehypertension and hypertension states and to establish a prediction model for the incidence of prehypertension and hypertension. Data from the China Health and Nutrition Survey from 1991 to 2009 were used as training data to develop the model. Data of the year 2011 were used for model validation. The multistate Markov model was developed using the msm package in R software. A total of 5265 participants were included at baseline, with an average follow-up of 8.05 ± 5.27 years and 17 640 observations. The ratio of men to women was 1 : 1.17, and the mean age was 37.54 ± 13.80 years. Within 10 years, in men, from normotension, the average probability to prehypertension and hypertension are 34.5 and 35.25%, respectively; from prehypertension, the average probability of recovering to normotension and developing to hypertension are 17.78 and 43.85%, respectively. In women, the average probabilities are 27.49, 28.09, 29.11 and 39.05%. Fat consumption increasing was found to be a protective factor, with 4.5% lower rate of transferring from normotension to prehypertension for a quarter percentage increasing. The model showed a very good prediction ability within 10 years and provided good prediction of blood pressure in the 2011 cohort (χ = 0.781, P = 0.676). The multistate Markov model can be a useful tool to identify the rules of transition among multiple states of blood pressure and predict well prevalence of the normotension, prehypertension and hypertension in cohort populations.

Levonorgestrel release rates over 5 years with the Liletta® 52-mg intrauterine system.

PubMed

Creinin, Mitchell D; Jansen, Rolf; Starr, Robert M; Gobburu, Joga; Gopalakrishnan, Mathangi; Olariu, Andrea

2016-10-01

To understand the potential duration of action for Liletta®, we conducted this study to estimate levonorgestrel (LNG) release rates over approximately 5½years of product use. Clinical sites in the U.S. Phase 3 study of Liletta collected the LNG intrauterine systems (IUSs) from women who discontinued the study. We randomly selected samples within 90-day intervals after discontinuation of IUS use through 900days (approximately 2.5years) and 180-day intervals for the remaining duration through 5.4years (1980days) to evaluate residual LNG content. We also performed an initial LNG content analysis using 10 randomly selected samples from a single lot. We calculated the average ex vivo release rate using the residual LNG content over the duration of the analysis. We analyzed 64 samples within 90-day intervals (range 6-10 samples per interval) through 900days and 36 samples within 180-day intervals (6 samples per interval) for the remaining duration. The initial content analysis averaged 52.0±1.8mg. We calculated an average initial release rate of 19.5mcg/day that decreased to 17.0, 14.8, 12.9, 11.3 and 9.8mcg/day after 1, 2, 3, 4 and 5years, respectively. The 5-year average release rate is 14.7mcg/day. The estimated initial LNG release rate and gradual decay of the estimated release rate are consistent with the target design and function of the product. The calculated LNG content and release rate curves support the continued evaluation of Liletta as a contraceptive for 5 or more years of use. Liletta LNG content and release rates are comparable to published data for another LNG 52-mg IUS. The release rate at 5years is more than double the published release rate at 3years with an LNG 13.5-mg IUS, suggesting continued efficacy of Liletta beyond 5years. Copyright © 2016 Elsevier Inc. All rights reserved.

Changes in Weight over the School Year and Summer Vacation: Results of a 5-Year Longitudinal Study

ERIC Educational Resources Information Center

Moreno, Jennette P.; Johnston, Craig A.; Woehler, Deborah

2013-01-01

Background: Evidence suggests that children gain more weight during the summer months compared with the school year. To examine the impact of the school and summer environment on children's weight further, we conducted a 5-year longitudinal study examining changes in standardized BMI (zBMI) of students entering kindergarten. Methods: Heights and…

A 5-year evaluation of a smoking cessation incentive program for chemical employees.

PubMed

Olsen, G W; Lacy, S E; Sprafka, J M; Arceneaux, T G; Potts, T A; Kravat, B A; Gondek, M R; Bond, G G

1991-11-01

This 5-year study of the Dow Chemical Texas Operations 1984-1985 Smoking Cessation Incentive Program (SCIP) evaluated the smoking habits of 1,097 participants and 1,174 nonparticipants. We observed, via questionnaire and saliva cotinine data, that participants were 2.3 times more likely to be long-term (greater than or equal to 5 years) nonusers of tobacco than nonparticipants (10.2% vs 4.4%, P less than or equal to 0.01). However, smoking cessation rates for 3-4 years, 1-2 years, and less than 1 year were similar for participants who remained smokers at the conclusion of SCIP and nonparticipants. Age and the interaction between the management job category and having quit smoking for at least 30 days sometime prior to the worksite program were important predictors of smoking cessation among participants. Thirty-six percent of the participants who were considered exsmokers of 6 months duration at the conclusion of the program in 1985 remained long-term quitters 5 years later. Stress and enjoyment of smoking were the two most important reasons provided by participants for recidivism. The results of this 5-year evaluation demonstrate the heterogeneity of employee participation and success with a worksite smoking cessation program.

Income, family context and self-regulation in 5-year-old children

PubMed Central

Li, Mengying; Riis, Jenna L.; Ghazarian, Sharon R.; Johnson, Sara B.

2016-01-01

Objective Self-regulation (SR) is a core aspect of child development with enduring effects on health and wellbeing across the lifespan. Early childhood poverty may shape SR development. This study examined the cross-sectional relations among family income, family context and SR in five-year-old children. Method 140 five-year-old children and their mothers participated in the study. Children completed a battery of SR tasks; mothers completed questionnaires. Cognitive and emotional SR composite scores were generated based on a principal component analysis of the SR tasks. SR scores were first regressed on family income (in 10 levels ranging from <5,000 to 150,000+) adjusting for age, sex and race of the child; family context variables were subsequently added to the models. Results Controlling for age, sex and race, each level increase in family income was associated with 0.04 standard deviation (SD) increase in emotional SR (p=0.32) and 0.08 SD increase in cognitive SR (p=0.01). In fully adjusted models, exposure to household instability and experiencing 10 or more negative life events was associated with worse emotional SR; exposure to mother’s depressive symptoms was associated with worse cognitive SR. Higher income buffered children’s SR from some contextual risk factors. Family contextual variables explained 62% of the correlation between higher income and better cognitive SR scores. Conclusions Income-based cognitive SR disparities were associated with family contextual factors. Screening for family adversity in pediatric care and linking families to needed resources may protect children’s developing SR capacities, with benefits to health and well-being. PMID:28092295

Determinants of physical activity among women treated for breast cancer in a 5-year longitudinal follow-up investigation.

PubMed

Emery, Charles F; Yang, Hae-Chung; Frierson, Georita M; Peterson, Laura J; Suh, Sooyeon

2009-04-01

To estimate the 5-year trajectory of physical activity among women with breast cancer, and to evaluate biopsychosocial variables (health status, physical symptoms, health-related quality of life (HRQL), depressive symptoms, and social support), measured soon after breast cancer diagnosis, as predictors of the 5-year trajectory. Women diagnosed with Stage II or III regional breast cancer (n=227), surgically treated and awaiting the start of adjuvant therapy completed baseline assessments of medical, psychological, and behavioral functioning. Follow-up evaluations were conducted every 4 months during the first year and every 6 months during the subsequent 4 years (12 assessments total during the 5-year study). Mixed-effects modeling was utilized to estimate the baseline level of physical activity as well as rate of change over time. Measures of physical health status, HRQL, depressive symptoms, and social support were included as predictors of the physical activity trajectory. A curvilinear pattern of change in physical activity was evident over the 5-year follow-up (p=0.002). Physical activity increased gradually during the first 18 months, then declined steadily over the subsequent 42 months. Poor physical health, depressive symptoms, and lower emotional HRQL were associated with less physical activity. Higher family support was associated with a slower decline in physical activity in the latter 42 months of the study. Emotional HRQL following diagnosis with breast cancer appears to be important for sustaining physical activity in the first 1-2 years following diagnosis. Physical activity interventions among breast cancer survivors should address depressive symptoms early in the course of treatment. (c) 2009 John Wiley & Sons, Ltd.

The Influence of Internal Model Variability in GEOS-5 on Interhemispheric CO2 Exchange

NASA Technical Reports Server (NTRS)

Allen, Melissa; Erickson, David; Kendall, Wesley; Fu, Joshua; Ott, Leslie; Pawson, Steven

2012-01-01

An ensemble of eight atmospheric CO2 simulations was completed employing the National Aeronautics and Space Administration (NASA) Goddard Earth Observation System, Version 5 (GEOS-5) for the years 2000-2001, each with initial meteorological conditions corresponding to different days in January 2000 to examine internal model variability. Globally, the model runs show similar concentrations of CO2 for the two years, but in regions of high CO2 concentrations due to fossil fuel emissions, large differences among different model simulations appear. The phasing and amplitude of the CO2 cycle at Northern Hemisphere locations in all of the ensemble members is similar to that of surface observations. In several southern hemisphere locations, however, some of the GEOS-5 model CO2 cycles are out of phase by as much as four months, and large variations occur between the ensemble members. This result indicates that there is large sensitivity to transport in these regions. The differences vary by latitude-the most extreme differences in the Tropics and the least at the South Pole. Examples of these differences among the ensemble members with regard to CO2 uptake and respiration of the terrestrial biosphere and CO2 emissions due to fossil fuel emissions are shown at Cape Grim, Tasmania. Integration-based flow analysis of the atmospheric circulation in the model runs shows widely varying paths of flow into the Tasmania region among the models including sources from North America, South America, South Africa, South Asia and Indonesia. These results suggest that interhemispheric transport can be strongly influenced by internal model variability.

Prediction of 5-year overall survival in cervical cancer patients treated with radical hysterectomy using computational intelligence methods.

PubMed

Obrzut, Bogdan; Kusy, Maciej; Semczuk, Andrzej; Obrzut, Marzanna; Kluska, Jacek

2017-12-12

Computational intelligence methods, including non-linear classification algorithms, can be used in medical research and practice as a decision making tool. This study aimed to evaluate the usefulness of artificial intelligence models for 5-year overall survival prediction in patients with cervical cancer treated by radical hysterectomy. The data set was collected from 102 patients with cervical cancer FIGO stage IA2-IIB, that underwent primary surgical treatment. Twenty-three demographic, tumor-related parameters and selected perioperative data of each patient were collected. The simulations involved six computational intelligence methods: the probabilistic neural network (PNN), multilayer perceptron network, gene expression programming classifier, support vector machines algorithm, radial basis function neural network and k-Means algorithm. The prediction ability of the models was determined based on the accuracy, sensitivity, specificity, as well as the area under the receiver operating characteristic curve. The results of the computational intelligence methods were compared with the results of linear regression analysis as a reference model. The best results were obtained by the PNN model. This neural network provided very high prediction ability with an accuracy of 0.892 and sensitivity of 0.975. The area under the receiver operating characteristics curve of PNN was also high, 0.818. The outcomes obtained by other classifiers were markedly worse. The PNN model is an effective tool for predicting 5-year overall survival in cervical cancer patients treated with radical hysterectomy.

A 5-year comparison of ED visits by homeless and nonhomeless patients.

PubMed

Tadros, Allison; Layman, Shelley M; Brewer, Marissa Pantaleone; Davis, Stephen M

2016-05-01

A 2005 study examined emergency department (ED) utilization by homeless patients in the United States. Within the following 5 years, unemployment increased by 5%. The objective was to analyze changes in ED utilization between 2005 and 2010 by homeless patients and compare with nonhomeless visits. Data from the 2010 National Hospital Ambulatory Medical Care Survey were evaluated. Approximately 679854 visits were made by homeless patients, the majority of which were made by men (72.3%) and patients between the ages of 45 and 64 (50.5%). Homeless patients were twice as likely to be uninsured. ED visits by homeless patients had increased by 44% during the 5-year period. Arrival to the ED by ambulance increased by 14% between the study years, and homeless patients were less likely to be admitted. The number of visits by homeless patients in the ED increased proportionally to an overall increase in ED visits between 2005 and 2010. Copyright © 2016 Elsevier Inc. All rights reserved.

Tailored breast cancer screening program with microdose mammography, US, and MR Imaging: short-term results of a pilot study in 40-49-year-old women.

PubMed

Venturini, Elena; Losio, Claudio; Panizza, Pietro; Rodighiero, Maria Grazia; Fedele, Isabella; Tacchini, Simona; Schiani, Elena; Ravelli, Silvia; Cristel, Giulia; Panzeri, Marta Maria; De Cobelli, Francesco; Del Maschio, Alessandro

2013-08-01

To evaluate the feasibility, performance, and cost of a breast cancer screening program aimed at 40-49-year-old women and tailored to their risk profile with supplemental ultrasonography (US) and magnetic resonance (MR) imaging. The institutional review board approved this study, and informed written consent was obtained. A total of 3017 40-49-year-old women were invited to participate. The screening program was tailored to lifetime risk (Gail test) and mammographic density (according to Breast Imaging Reporting and Data Systems [BI-RADS] criteria) with supplemental US or MR imaging and bilateral two-view microdose mammography. The indicators suggested by European guidelines, US incremental cancer detection rate (CDR), and estimated costs were evaluated. A total of 1666 women (67.5% participation rate) were recruited. The average lifetime risk of breast cancer was 11.6%, and nine women had a high risk of breast cancer; 917 women (55.0%) had a high density score (BI-RADS density category 3 or 4). The average glandular dose for screening examinations was 1.49 mGy. Screening US was performed in 835 study participants (50.1%), mostly due to high breast density (800 of 1666 women [48.0%]). Screening MR imaging was performed in nine women (0.5%) at high risk for breast cancer. Breast cancer was diagnosed in 14 women (8.4 cases per 1000 women). Twelve diagnoses were made with microdose mammography, and two were made with supplemental US in dense breasts (2.4 cases per 1000 women). All patients were submitted for surgery, and 10 underwent breast-conserving surgery. The sentinel lymph node was evaluated in 11 patients, resulting in negative findings in six. Pathologic analysis resulted in the diagnosis of four ductal carcinomas in situ and 10 invasive carcinomas (five at stage I). A tailored breast cancer screening program in 40-49-year-old women yielded a greater-than-expected number of cancers, most of which were low-stage disease.

Maternal-infant relationship quality and risk of obesity at age 5.5 years in a national US cohort

PubMed Central

2014-01-01

Background Poor quality relationships between mothers and toddlers have been associated with higher risk for childhood obesity, but few prospective studies of obesity have assessed maternal-child relationship quality in infancy. In addition it is not known whether the increased risk is associated with the mother’s or the child’s contribution to the relationship quality. Methods We analyzed data (n = 5650) from the Early Childhood Longitudinal Study, Birth Cohort, a national study of U.S. children born in 2001 and followed until they entered kindergarten. At 9 months of age, the Nursing Child Assessment Teaching Scale (NCATS) was used to assess the quality of observed playtime interactions between mothers and infants, yielding separate scores for maternal and infant behaviors. Obesity (BMI ≥95th percentile) at age 5.5 years was based on measured weight and height. Results The prevalence (95% confidence interval) of obesity at 5.5 years of age was higher among children in the lowest quartile of maternal NCATS score (20.2% [95% CI: 17.2%, 23.2%]) than in the highest quartile (13.9% [11.3%, 16.5%]), but maternal NCATS score was not significantly associated with obesity after adjustment for race/ethnicity, maternal education and household income. The prevalence of obesity at 5.5 years of age was similar among children in the lowest quartile of infant NCATS score (17.4% [14.4%, 20.3%]) and in the highest quartile (17.6% 14.4%, 20.8%]), and was not changed with covariate adjustment. Conclusions Maternal-infant relationship quality, assessed by direct observation at 9 months of age in a national sample, was not associated with an increased risk of obesity at age 5.5 years after controlling for sociodemographic characteristics. PMID:24564412

10Be measured in a GRIP snow pit and modeled using the ECHAM5-HAM general circulation model

NASA Astrophysics Data System (ADS)

Heikkilä, U.; Beer, J.; Jouzel, J.; Feichter, J.; Kubik, P.

2008-03-01

10Be measured in a Greenland Ice Core Project (GRIP) snow pit (1986-1990) with a seasonal resolution is compared with the ECHAM5-HAM GCM run. The mean modeled 10Be concentration in ice (1.0.104 atoms/g) agrees well with the measured value (1.2.104 atoms/g). The measured 10Be deposition flux (88 atoms/m2/s) also agrees well with the modeled flux (69 atoms/m2/s) and the measured precipitation rate (0.67 mm/day) agrees with the modeled rate (0.61 mm/day). The mean surface temperature of -31°C estimated from δ 18O is lower than the temperature measured at a near-by weather station (-29°C) and the modeled temperature (-26°C). During the 5-year period the concentrations and deposition fluxes, both measured and modeled, show a decreasing trend consistent with the increase in the solar activity. The variability of the measured and modeled concentrations and deposition fluxes is very similar suggesting that the variability is linked to a variability in production rather than the local meteorology.

Spirometry in 3-5-year-old children with asthma.

PubMed

Nève, Véronique; Edmé, Jean-Louis; Devos, Patrick; Deschildre, Antoine; Thumerelle, Caroline; Santos, Clarisse; Methlin, Catherine-Marie; Matran, Murielle; Matran, Régis

2006-08-01

Spirometry with incentive games was applied to 207 2-5-year-old preschool children (PSC) with asthma in order to refine the quality-control criteria proposed by Aurora et al. (Am J Respir Crit Care Med 2004;169:1152-159). The data set in our study was much larger compared to that in Aurora et al. (Am J Respir Crit Care Med 2004;169:1152-159), where 42 children with cystic fibrosis and 37 healthy control were studied. At least two acceptable maneuvers were obtained in 178 (86%) children. Data were focused on 3-5-year-old children (n = 171). The proportion of children achieving a larger number of thresholds for each quality-control criterion (backward-extrapolated volume (Vbe), Vbe in percent of forced vital capacity (FVC, Vbe/FVC), time-to-peak expiratory flow (time-to-PEF), and difference (Delta) between the two FVCs (DeltaFVC), forced expiratory volume in 1 sec (DeltaFEV(1)), and forced expiratory volume in 0.5 sec (DeltaFEV(0.5)) from the two "best" curves) was calculated, and cumulative plots were obtained. The optimal threshold was determined for all ages by derivative function of rate of success-threshold curves, close to the inflexion point. The following thresholds were defined for acceptability: Vbe 5) 5%. These were obtained in 85%, 93%, 94%, 90%, and 89% of children, respectively. For practical reasons, we suggest choosing the same threshold for all repeatability criteria, i.e., DeltaFVC, DeltaFEV(1), and DeltaFEV(0.5)

Psychological recovery 5 years after the 2004 Niigata-Chuetsu earthquake in Yamakoshi, Japan.

PubMed

Nakamura, Kazutoshi; Kitamura, Kaori; Someya, Toshiyuki

2014-01-01

The 2004 Niigata-Chuetsu earthquake of Japan caused considerable damage. We assessed long-term changes in psychological distress among earthquake victims during the period 5 years after the earthquake. The participants were people aged 18 years or older living in Yamakoshi, a community in Niigata Prefecture near the epicenter. A self-administered questionnaire survey was conducted annually for 5 consecutive years after the earthquake. Response rates were 1316/1841 (71.5%) in 2005, 667/1381 (48.3%) in 2006, 753/1451 (51.9%) in 2007, 541/1243 (43.5%) in 2008, and 814/1158 (70.3%) in 2009. The questionnaire asked about demographic characteristics, including sex, age, employment status, social network, and psychological status. Psychological distress was assessed using the 12-item General Health Questionnaire and was defined as a total score of 4 or higher. The overall prevalence of psychological distress decreased (P < 0.0001) gradually from 2005 (51.0%) to 2008 (30.1%) but tended to increase from 2008 to 2009 (P = 0.1590). Subgroup analyses showed that prevalence did not decrease over the 5-year study period among participants with poor social contact (P = 0.0659). From 2008 to 2009 prevalence increased in women (+7.5%, P = 0.0403) and participants aged 65 years or older (+7.2%, P = 0.0400). The prevalence of psychological distress in Yamakoshi people decreased steadily during the 4 years immediately after the earthquake but appeared to increase thereafter. The earthquake victims are still reestablishing their lives. Thus, continued attention should be focused on maintaining and further assessing their mental health.

HIFU therapy for local recurrence of prostate cancer after external beam radiotherapy and radical prostatectomy - 5,5 years experience

NASA Astrophysics Data System (ADS)

Solovov, V. A.; Vozdvizhenskiy, M. O.; Matysh, Y. S.

2017-03-01

Objectives. To evaluate the clinical efficacy of high-intensity focused ultrasound ablation (HIFU) for local recurrence of prostate cancer after external beam radiotherapy (EBRT) and radical prostatectomy (RPE). Materials and Methods: During 2007-2013 years 47 patients with local recurrence of prostate cancer after EBRT and RPE undertook HIFU therapy on the system "Ablaterm» (EDAP, France). Relapse arose after an average of 2 years after EBRT and RPE. Median follow-up after HIFU therapy was 38 (12-60) months. The mean age was 68.5 ± 5.8 years. The median PSA level before HIFU - 15.4 (7-48) ng / mL. Results: In 34 patients (72.3%) at six months after treatment the median PSA was 0.4 (0-3.2) ng / mL, in 48 months - 0.9 (0.4-7.5) ng / mL. In 13 patients (27.7%) at 6 months was observed progression of the disease. In general, after a 5-year follow-up 72.3% of the patients had no data for the progression and recurrence. Conclusion: HIFU therapy in patients with local recurrence of prostate cancer after EBRT and RPE is minimally invasive and effective technology.

Influence of xerostomia on oral health-related quality of life in the elderly: a 5-year longitudinal study.

PubMed

Enoki, Kaori; Matsuda, Ken-Ich; Ikebe, Kazunori; Murai, Shunsuke; Yoshida, Minoru; Maeda, Yoshinobu; Thomson, William Murray

2014-06-01

Xerostomia and tooth loss are major oral health problems in the elderly. The aim of this longitudinal study was to characterize the influence of xerostomia on oral health-related quality of life (OHRQoL) among elderly Japanese people. A total of 99 community-dwelling, independently living individuals aged 60 years and older were interviewed and underwent dental examination at baseline and at a 5-year follow-up. The Oral Health Impact Profile-14 and the Xerostomia Inventory were used to assess OHRQoL and xerostomia severity, respectively. Participants whose xerostomia worsened over the 5-year period had a significantly poorer follow-up OHRQoL. Linear regression models showed that tooth loss and worsening xerostomia were significant predictors of poorer follow-up OHRQoL. Tooth loss and worsening xerostomia result in poorer OHRQoL among older Japanese people. Copyright © 2014 Elsevier Inc. All rights reserved.

Arthroscopic Labral Base Repair in the Hip: 5-Year Minimum Clinical Outcomes.

PubMed

Domb, Benjamin G; Yuen, Leslie C; Ortiz-Declet, Victor; Litrenta, Jody; Perets, Itay; Chen, Austin W

2017-10-01

Arthroscopic labral base repair (LBR) in the hip is a previously described technique designed to restore the native functional anatomy of the labrum by reproducing its seal against the femoral head. LBR has been shown to have good short-term outcomes. Hypothesis/Purpose: The purpose was to evaluate clinical outcomes of an LBR cohort with a minimum 5-year follow-up. It was hypothesized that patients who underwent LBR would continue to have significant improvement from their preoperative scores and maintain scores similar to their 2-year outcomes. Case series; Level of evidence, 4. Data for patients undergoing primary hip arthroscopic surgery with LBR from February 2008 to May 2011 with a minimum 5-year follow-up were prospectively collected and retrospectively reviewed. Patients with preoperative Tonnis osteoarthritis grade ≥2, previous hip conditions (slipped capital femoral epiphysis, avascular necrosis, Legg-Calv-Perthes disease), severe dysplasia (lateral center-edge angle <18°), or previous ipsilateral hip surgery were excluded. Statistical equivalence tests evaluated patient-reported outcomes (PROs) including the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sport-Specific Subscale (HOS-SSS), visual analog scale (VAS) for pain, and patient satisfaction (0-10 scale; 10 = very satisfied). Of the 70 patients (74 hips) who met inclusion and exclusion criteria, 60 (85.7%) patients (64 hips) were available at a minimum 5-year follow-up. All PRO scores significantly improved from preoperative values with a mean follow-up of 67.8 ± 7.4 months (range, 60.0-89.7 months). The mean mHHS increased from 64.4 ±13.8 to 85.3 ± 17.7 ( P < .001), the mean NAHS from 63.7 ± 17.0 to 87.0 ± 14.7 ( P < .001), and the mean HOS-SSS from 47.1 ± 23.2 to 76.5 ± 25.9 ( P < .001). The mean VAS score decreased from 5.9 ± 2.4 to 2.0 ± 2.1 ( P < .001). The mean patient satisfaction score was 8.1 ± 2.0. The improvement in PRO scores was

Spatiotemporal Patterns of Ground Monitored PM2.5 Concentrations in China in Recent Years

PubMed Central

Li, Junming; Han, Xiulan; Li, Xiao; Yang, Jianping; Li, Xuejiao

2018-01-01

This paper firstly explores the space-time evolution of city-level PM2.5 concentrations showed a very significant seasonal cycle type fluctuation during the period between 13 May 2014 and 30 May 2017. The period from October to April following each year was a heavy pollution period, whereas the phase from April to October of the current year was part of a light pollution period. The average monthly PM2.5 concentrations in mainland China based on ground monitoring, employing a descriptive statistics method and a Bayesian spatiotemporal hierarchy model. Daily and weekly average PM2.5 concentrations in 338 cities in mainland China presented no significant spatial difference during the severe pollution period but a large spatial difference during light pollution periods. The severe PM2.5 pollution areas were mainly distributed in the Beijing-Tianjin-Hebei urban agglomeration in the North China Plain during the beginning of each autumn-winter season (September), spreading to the Northeast Plains after October, then later continuing to spread to other cities in mainland China, eventually covering most cities. PM2.5 pollution in China appeared to be a cyclic characteristic of first spreading and then centralizing in the space in two spring-summer seasons, and showed an obvious process of first diffusing then transferring to shrinkage alternation during the spring-summer season of 2015, but showed no obvious diffusion during the spring-summer season of 2016, maintaining a stable spatial structure after the shrinkage in June, as well as being more concentrated. The heavily polluted areas are continuously and steadily concentrated in East China, Central China and Xinjiang Province. PMID:29324671

Effect of year-to-year variability of leaf area index on variable infiltration capacity model performance and simulation of streamflow during drought

NASA Astrophysics Data System (ADS)

Tesemma, Z. K.; Wei, Y.; Peel, M. C.; Western, A. W.

2014-09-01

This study assessed the effect of using observed monthly leaf area index (LAI) on hydrologic model performance and the simulation of streamflow during drought using the variable infiltration capacity (VIC) hydrological model in the Goulburn-Broken catchment of Australia, which has heterogeneous vegetation, soil and climate zones. VIC was calibrated with both observed monthly LAI and long-term mean monthly LAI, which were derived from the Global Land Surface Satellite (GLASS) observed monthly LAI dataset covering the period from 1982 to 2012. The model performance under wet and dry climates for the two different LAI inputs was assessed using three criteria, the classical Nash-Sutcliffe efficiency, the logarithm transformed flow Nash-Sutcliffe efficiency and the percentage bias. Finally, the percentage deviation of the simulated monthly streamflow using the observed monthly LAI from simulated streamflow using long-term mean monthly LAI was computed. The VIC model predicted monthly streamflow in the selected sub-catchments with model efficiencies ranging from 61.5 to 95.9% during calibration (1982-1997) and 59 to 92.4% during validation (1998-2012). Our results suggest systematic improvements from 4 to 25% in the Nash-Sutcliffe efficiency in pasture dominated catchments when the VIC model was calibrated with the observed monthly LAI instead of the long-term mean monthly LAI. There was limited systematic improvement in tree dominated catchments. The results also suggest that the model overestimation or underestimation of streamflow during wet and dry periods can be reduced to some extent by including the year-to-year variability of LAI in the model, thus reflecting the responses of vegetation to fluctuations in climate and other factors. Hence, the year-to-year variability in LAI should not be neglected; rather it should be included in model calibration as well as simulation of monthly water balance.

Multi-year objective analyses of warm season ground-level ozone and PM2.5 over North America using real-time observations and Canadian operational air quality models

NASA Astrophysics Data System (ADS)

Robichaud, A.; Ménard, R.

2013-05-01

We present multi-year objective analyses (OA) on a high spatio-temporal resolution (15 or 21 km, every hour) for the warm season period (1 May-31 October) for ground-level ozone (2002-2012) and for fine particulate matter (diameter less than 2.5 microns (PM2.5)) (2004-2012). The OA used here combines the Canadian Air Quality forecast suite with US and Canadian surface air quality monitoring sites. The analysis is based on an optimal interpolation with capabilities for adaptive error statistics for ozone and PM2.5 and an explicit bias correction scheme for the PM2.5 analyses. The estimation of error statistics has been computed using a modified version of the Hollingsworth-Lönnberg's (H-L) method. Various quality controls (gross error check, sudden jump test and background check) have been applied to the observations to remove outliers. An additional quality control is applied to check the consistency of the error statistics estimation model at each observing station and for each hour. The error statistics are further tuned "on the fly" using a χ2 (chi-square) diagnostic, a procedure which verifies significantly better than without tuning. Successful cross-validation experiments were performed with an OA set-up using 90% of observations to build the objective analysis and with the remainder left out as an independent set of data for verification purposes. Furthermore, comparisons with other external sources of information (global models and PM2.5 satellite surface derived measurements) show reasonable agreement. The multi-year analyses obtained provide relatively high precision with an absolute yearly averaged systematic error of less than 0.6 ppbv (parts per billion by volume) and 0.7 μg m-3 (micrograms per cubic meter) for ozone and PM2.5 respectively and a random error generally less than 9 ppbv for ozone and under 12 μg m-3 for PM2.5. In this paper, we focus on two applications: (1) presenting long term averages of objective analysis and analysis increments

Subsequent Malignant Neoplasms in a Population-Based Cohort of Pediatric Cancer Patients: A Focus on the First 5 Years.

PubMed

Pole, Jason D; Gu, Lan Ying; Kirsh, Victoria; Greenberg, Mark L; Nathan, Paul C

2015-10-01

The purpose was to describe the development of subsequent malignant neoplasms (SMN) among a population-based cohort of pediatric cancer patients, with a focus on SMNs that occurred within the first 5 years from diagnosis. The cohort was identified from POGONIS, an active provincial registry. Cohort members were Ontario residents ages 0 to 14.9 years at primary diagnosis between January 1985 and December 2008. SMNs that developed <18 years were captured by POGONIS, whereas SMNs diagnosed later were identified through linkage. Cumulative incidence and standardized incidence ratios (SIR) were calculated, and proportional hazards models were estimated to examine factors associated with SMN development. A total of 7,920 patients were eligible. 2.4% (188/7,920) developed 197 SMNs. Mean follow-up time was 10.7 years (SD = 7.6 years; range, 0.0-26.4 years) with mean time to SMN of 8.5 years (SD = 6.3 years; range, 0.0-24.9 years). The SIR for the development of a SMN was 9.9 [95% confidence interval (CI), 8.6-11.4]. 40.6% of SMNs (80/197) developed within 5 years. Early SMNs were more likely to be leukemia and lymphoma. Factors associated with early SMN were primary diagnosis of a bone tumor (OR, 4.88; 95% CI, 1.52-15.60), exposure to radiotherapy (OR, 1.82; 95% CI, 1.02-3.22), and the highest dose of epipodophyllotoxin (OR, 3.74; 95% CI, 1.88-7.42). Over 40% of SMNs diagnosed in childhood cancer patients occurred in the first 5 years after diagnosis, suggesting a need for early and ongoing surveillance. The early development of certain SMNs reinforces the need for early and continued surveillance at all stages for pediatric cancer patients. ©2015 American Association for Cancer Research.

Multi-annual modes in the 20th century temperature variability in reanalyses and CMIP5 models

NASA Astrophysics Data System (ADS)

Järvinen, Heikki; Seitola, Teija; Silén, Johan; Räisänen, Jouni

2016-11-01

A performance expectation is that Earth system models simulate well the climate mean state and the climate variability. To test this expectation, we decompose two 20th century reanalysis data sets and 12 CMIP5 model simulations for the years 1901-2005 of the monthly mean near-surface air temperature using randomised multi-channel singular spectrum analysis (RMSSA). Due to the relatively short time span, we concentrate on the representation of multi-annual variability which the RMSSA method effectively captures as separate and mutually orthogonal spatio-temporal components. This decomposition is a unique way to separate statistically significant quasi-periodic oscillations from one another in high-dimensional data sets.The main results are as follows. First, the total spectra for the two reanalysis data sets are remarkably similar in all timescales, except that the spectral power in ERA-20C is systematically slightly higher than in 20CR. Apart from the slow components related to multi-decadal periodicities, ENSO oscillations with approximately 3.5- and 5-year periods are the most prominent forms of variability in both reanalyses. In 20CR, these are relatively slightly more pronounced than in ERA-20C. Since about the 1970s, the amplitudes of the 3.5- and 5-year oscillations have increased, presumably due to some combination of forced climate change, intrinsic low-frequency climate variability, or change in global observing network. Second, none of the 12 coupled climate models closely reproduce all aspects of the reanalysis spectra, although some models represent many aspects well. For instance, the GFDL-ESM2M model has two nicely separated ENSO periods although they are relatively too prominent as compared with the reanalyses. There is an extensive Supplement and YouTube videos to illustrate the multi-annual variability of the data sets.

Global Warming Induced Changes in Rainfall Characteristics in IPCC AR5 Models

NASA Technical Reports Server (NTRS)

Lau, William K. M.; Wu, Jenny, H.-T.; Kim, Kyu-Myong

2012-01-01

Changes in rainfall characteristic induced by global warming are examined from outputs of IPCC AR5 models. Different scenarios of climate warming including a high emissions scenario (RCP 8.5), a medium mitigation scenario (RCP 4.5), and 1% per year CO2 increase are compared to 20th century simulations (historical). Results show that even though the spatial distribution of monthly rainfall anomalies vary greatly among models, the ensemble mean from a sizable sample (about 10) of AR5 models show a robust signal attributable to GHG warming featuring a shift in the global rainfall probability distribution function (PDF) with significant increase (>100%) in very heavy rain, reduction (10-20% ) in moderate rain and increase in light to very light rains. Changes in extreme rainfall as a function of seasons and latitudes are also examined, and are similar to the non-seasonal stratified data, but with more specific spatial dependence. These results are consistent from TRMM and GPCP rainfall observations suggesting that extreme rainfall events are occurring more frequently with wet areas getting wetter and dry-area-getting drier in a GHG induced warmer climate.

North Atlantic deep water formation and AMOC in CMIP5 models

NASA Astrophysics Data System (ADS)

Heuzé, Céline; Wåhlin, Anna

2017-04-01

North Atlantic deep water formation processes and properties in climate models are indicative of their ability to simulate future ocean circulation, ventilation, carbon and heat uptake, and sea level rise. Historical time series of temperature, salinity, sea ice concentration and ocean transport in the North Atlantic subpolar gyre and Nordic Seas from 23 CMIP5 (Climate Model Intercomparison Project, phase 5) models are compared with observations to reveal the causes and consequences of North Atlantic deep water formation in models. Deep convection occurs at the sea ice edge and is most realistic in models with accurate sea ice extent, mostly those using the CICE model. The trigger of deep convection varies among models; for one third it is intense surface cooling only, while the remaining two thirds also need upward mixing of subsurface warm salty water. The models with the most intense deep convection have the most accurate deep water properties, which are warmer and fresher than in the other models. They also have the strongest Atlantic Meridional Overturning Circulation (AMOC). For over half of the models, 40% of the variability of the AMOC is explained by the volumes of deep water produced in the subpolar gyre and Nordic Seas, with 3 and 4 years lag respectively. Understanding the dynamical drivers of the AMOC in models is key to realistically forecast a possible slow down and its consequences on the global circulation and marine life.

Kidney injury biomarkers 5 years after AKI due to pediatric cardiac surgery.

PubMed

Greenberg, Jason H; Devarajan, Prasad; Thiessen-Philbrook, Heather R; Krawczeski, Catherine; Parikh, Chirag R; Zappitelli, Michael

2018-06-01

We previously reported that children undergoing cardiac surgery are at high risk for long-term chronic kidney disease (CKD) and hypertension, although postoperative acute kidney injury (AKI) is not a risk factor for worse long-term kidney outcomes. We report here our evaluation of renal injury biomarkers 5 years after cardiac surgery to determine whether they are associated with postoperative AKI or long-term CKD and hypertension. Children aged 1 month to 18 years old undergoing cardiopulmonary bypass were recruited to this prospective cohort study. At 5 years after cardiac surgery, we measured urine interleukin-18, kidney injury molecule-1, monocyte chemoattractant protein-1, YKL-40, and neutrophil gelatinase-associated lipocalin (NGAL). Biomarker levels were compared between patients with AKI and those without. We also performed a cross-sectional analysis of the association between these biomarkers with CKD and hypertension. Of the 305 subjects who survived hospitalization, four (1.3%) died after discharge, and 110 (36%) participated in the 5-year follow-up. Of these 110 patients, 49 (45%) had AKI. Patients with versus those without postoperative AKI did not have significantly different biomarker concentrations at 5 years after cardiac surgery. None of the biomarker concentrations were associated with CKD or hypertension at 5 years of follow-up, although CKD and hypertension were associated with a higher proportion of participants with abnormal NGAL levels. Postoperative pediatric AKI is not associated with urinary kidney injury biomarkers 5 years after surgery. This may represent a lack of chronic renal injury after AKI, imprecise estimation of the glomerular filtration rate, the need for longer follow-up to detect chronic renal damage, or that our studied biomarkers are inadequate for evaluating subclinical chronic renal injury.

An improved geographically weighted regression model for PM2.5 concentration estimation in large areas

NASA Astrophysics Data System (ADS)

Zhai, Liang; Li, Shuang; Zou, Bin; Sang, Huiyong; Fang, Xin; Xu, Shan

2018-05-01

Considering the spatial non-stationary contributions of environment variables to PM2.5 variations, the geographically weighted regression (GWR) modeling method has been using to estimate PM2.5 concentrations widely. However, most of the GWR models in reported studies so far were established based on the screened predictors through pretreatment correlation analysis, and this process might cause the omissions of factors really driving PM2.5 variations. This study therefore developed a best subsets regression (BSR) enhanced principal component analysis-GWR (PCA-GWR) modeling approach to estimate PM2.5 concentration by fully considering all the potential variables' contributions simultaneously. The performance comparison experiment between PCA-GWR and regular GWR was conducted in the Beijing-Tianjin-Hebei (BTH) region over a one-year-period. Results indicated that the PCA-GWR modeling outperforms the regular GWR modeling with obvious higher model fitting- and cross-validation based adjusted R2 and lower RMSE. Meanwhile, the distribution map of PM2.5 concentration from PCA-GWR modeling also clearly depicts more spatial variation details in contrast to the one from regular GWR modeling. It can be concluded that the BSR enhanced PCA-GWR modeling could be a reliable way for effective air pollution concentration estimation in the coming future by involving all the potential predictor variables' contributions to PM2.5 variations.

Effect of 5E Instructional Model in Student Success in Primary School 6th Year Circulatory System Topic

ERIC Educational Resources Information Center

Cardak, Osman; Dikmenli, Musa; Saritas, Ozge

2008-01-01

The aim of this study is to research the effect of the 5E instructional model on primary (sixth grade) student success during the circulatory system unit. This study was conducted with 38 students in two different classes by the same researcher in 2006-2007. One of the classes was assigned as the control group and the other as the experimental…

Upper Body Muscular Endurance Among Children 2-5 Years.

ERIC Educational Resources Information Center

Gabbard, Carl P.; And Others

The upper body muscular endurance of males and females 2-5 years of age was assessed, and relationships relative to sex, age, endurance and selected anthropometric measures were investigated. None of the relationships were found to be of practical predicative value; while upper body muscular strength increased with age, no significant differences…

Surgery Versus 5% Imiquimod for Nodular and Superficial Basal Cell Carcinoma: 5-Year Results of the SINS Randomized Controlled Trial.

PubMed

Williams, Hywel C; Bath-Hextall, Fiona; Ozolins, Mara; Armstrong, Sarah J; Colver, Graham B; Perkins, William; Miller, Paul S J

2017-03-01

We previously reported modest clinical 3-year benefit for topical imiquimod compared with surgery for superficial or nodular basal cell carcinoma at low-risk sites in our noninferiority randomized controlled SINS trial. Here we report 5-year data. Participants were randomized to imiquimod 5% cream once daily (superficial basal cell carcinoma, 6 weeks; nodular basal cell carcinoma, 12 weeks) or excisional surgery (4-mm margin). The primary outcome was clinical absence of initial failure or signs of recurrence at the 3-year dermatology review. Five-year success was defined as 3-year success plus absence of recurrences identified through hospital, histopathology, and general practitioner records. Of 501 participants randomized, 401 contributed to the modified intention-to-treat analyses at year 3 (primary outcome), 383 (96%) of whom had data at year 5. Five-year success rates for imiquimod were 82.5% (170/206) compared with 97.7% (173/177) for surgery (relative risk of imiquimod success = 0.84, 95% confidence interval = 0.77-0.91, P < 0.001). These were comparable to year 3 success rates of 83.6% (178/213) and 98.4% (185/188) for imiquimod and surgery, respectively. Most imiquimod treatment failures occurred in year 1. Although surgery is clearly superior to imiquimod, this study shows sustained benefit for lesions that respond early to topical imiquimod. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Incidence and predictors of suicide attempts in bipolar I and II disorders: A 5-year follow-up study.

PubMed

Pallaskorpi, Sanna; Suominen, Kirsi; Ketokivi, Mikko; Valtonen, Hanna; Arvilommi, Petri; Mantere, Outi; Leppämäki, Sami; Isometsä, Erkki

2017-02-01

Few long-term studies on bipolar disorder (BD) have investigated the incidence and risk factors of suicide attempts (SAs) specifically related to illness phases. We examined the incidence of SAs during different phases of BD in a long-term prospective cohort of bipolar I (BD-I) and bipolar II (BD-II) patients, and risk factors specifically for SAs during major depressive episodes (MDEs). In the Jorvi Bipolar Study (JoBS), 191 BD-I and BD-II patients were followed using life-chart methodology. Prospective information on SAs of 177 patients (92.7%) during different illness phases was available up to 5 years. The incidence of SAs and their predictors were investigated using logistic and Poisson regression models. Analyses of risk factors for SAs occurring during MDEs were conducted using two-level random-intercept logistic regression models. During the 5 years of follow-up, 90 SAs per 718 patient-years occurred. The incidence was highest, over 120-fold higher than in euthymia, during mixed states (765/1000 person-years; 95% confidence interval [CI] 461-1269 person-years), and also very high in MDEs, almost 60-fold higher than in euthymia (354/1000 person-years; 95% CI 277-451 person-years). For risk of SAs during MDEs, the duration of MDEs, severity of depression, and cluster C personality disorders were significant predictors. We confirmed in this long-term study that the highest incidences of SAs occur in mixed and major depressive illness phases. The variations in incidence rates between euthymia and illness phases were remarkably large, suggesting that the question "when" rather than "who" may be more relevant for suicide risk in BD. However, risk during MDEs is likely also influenced by personality factors. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Repair of symptomatic paraesophageal hernias in elderly (>70 years) patients results in sustained quality of life at 5 years and beyond.

PubMed

Merzlikin, Oleg V; Louie, Brian E; Farivar, Alexander S; Shultz, Dale; Aye, Ralph W

2017-10-01

Paraesophageal hernias (PEHs) involve herniation of stomach and/or other viscera into the mediastinum. These commonly occur in the elderly and can severely limit quality of life. Short term outcomes of repaired PEH demonstrated low morbidity and significant improvement in quality of life, but long-term data for all patients, especially the elderly, are lacking. Retrospective chart review of a prospectively collected database of patients aged 70 or greater with a symptomatic PEH repaired 5+ years ago. Quality of life data were assessed preoperatively, at 12-24 months, and at 5+ years using QOLRAD, GERD-HRQL, and DSS. We identified 137 patients who met the age criteria, with 69 patients undergoing surgery 5+ years ago. With ten patients were lost to follow-up, 59 patients were analyzed, including 24 males and 35 females. Median age at repair was 77 years. There were two 90-day mortalities, with one occurring within 30 days of surgery. Patients alive at evaluation had a median age of 74 years and were followed a median 7.4 years. From baseline, QOLRAD improved from 4 to 6.5, GERD-HRQL improved from 11 to 5, and swallowing improved from 11 to 38. During follow-up, 21 patients died. Deceased patients lived a median of 4 years after repair, with a median age at repair of 80 years. At a median time follow-up of 2 years, this group's QOLRAD improved from 5.1 to 7, GERD-HRQL improved from 16 to 4, and swallowing improved from 14.5 to 35. In elderly patients with symptomatic PEH undergoing surgical repair more than 5 years ago, there was sustained improvement in quality of life. This justifies surgical repair of symptomatic PEH in elderly patients.

Long-term thresholds of nonsteroidal permanent pacing leads: a 5-year study.

PubMed

Gumbrielle, T P; Bourke, J P; Sinkovic, M; Tynan, M; Kittpawong, P; Gold, R G

1996-05-01

The present commercial market supports many nonsteroidal endocardial pacing leads of differing construction. In order to compare the performance of these configurations, we studied the long-term pacing properties of three representative lead types by randomized clinical trial in 99 patients undergoing a first elective VVI implant. Thirty-one patients received sintered platinum leads, 36 activated pyrolytic carbon leads, and 32 vitreous carbon leads. All received generators capable of noninvasive threshold testing. Acute sensing parameters were R wave amplitude and ST segment elevation measured from the endocardial electrogram. Noninvasive voltage thresholds were measured at implantation, 2 days, 1, 3, and 6 months, and yearly thereafter for 5 years. There were no significant differences between leads in pacing or sensing capabilities at implantation. All three demonstrated similar increases in thresholds, peaking at 1 month, then falling to a plateau by 6 months and did not vary significantly thereafter. There were no significant differences in thresholds between leads during 5 years of follow-up. The lowest mean threshold at 5 years was 0.93 V at 0.5 ms. This study suggests that: (1) although these lead types all perform well, none offers any particular clinical advantage over another; (2) the degree of early threshold peaking precludes immediate postimplant output reduction, but later thresholds are sufficiently low to enable reductions in pacing output; (3) safe low energy pacing requires greater attention to the lead-generator combinations; (4) data obtained at subsequent annual follow-up provided no additional useful clinical information to that obtained at 1 year; and (5) in the absence of other differences, cost can be the deciding factor in lead selection.

The role of maternal education in the 15-year trajectory of malnutrition in children under 5 years of age in Bangladesh.

PubMed

Hasan, Md Tanvir; Soares Magalhaes, Ricardo J; Williams, Gail M; Mamun, Abdullah A

2016-10-01

Malnutrition in children under 5 years of age (U5s) is a serious public health problem in low- and middle-income countries including Bangladesh. Improved maternal education can contribute effectively to reduce child malnutrition. We examined the long-term impact of maternal education on the risk of malnutrition in U5s and quantified the level of education required for the mothers to reduce the risk. We used pooled data from five nationwide demographic and health surveys conducted in 1996-1997, 1999-2000, 2004, 2007 and 2011 in Bangladesh involving 28 941 U5s. A log-binomial regression model was used to examine the association between maternal education (no education, primary, secondary or more) and malnutrition in children, measured by stunting, underweight and wasting controlling for survey time, maternal age, maternal body mass index, maternal working status, parity, paternal education and wealth quintile. An overall improvement in maternal educational attainment was observed between 1996 and 2011. The prevalence of malnutrition although decreasing was consistently high among children of mothers with lower education compared with those of mothers with higher education. In adjusted models incorporating time effects, children of mothers with secondary or higher education were at lower risk of childhood stunting [risk ratio (RR): 0.86, 95% confidence interval (CI): 0.81, 0.89], underweight (RR: 0.83, 95% CI: 0.78, 0.88) and wasting (RR: 0.82, 95% CI: 0.74, 0.91) compared with children of mothers with no education. We demonstrated the importance of promoting women's education at least up to the secondary level as a means to tackle malnutrition in Bangladesh. © 2015 John Wiley & Sons Ltd.

Psychological Recovery 5 Years After the 2004 Niigata-Chuetsu Earthquake in Yamakoshi, Japan

PubMed Central

Nakamura, Kazutoshi; Kitamura, Kaori; Someya, Toshiyuki

2014-01-01

Background The 2004 Niigata-Chuetsu earthquake of Japan caused considerable damage. We assessed long-term changes in psychological distress among earthquake victims during the period 5 years after the earthquake. Methods The participants were people aged 18 years or older living in Yamakoshi, a community in Niigata Prefecture near the epicenter. A self-administered questionnaire survey was conducted annually for 5 consecutive years after the earthquake. Response rates were 1316/1841 (71.5%) in 2005, 667/1381 (48.3%) in 2006, 753/1451 (51.9%) in 2007, 541/1243 (43.5%) in 2008, and 814/1158 (70.3%) in 2009. The questionnaire asked about demographic characteristics, including sex, age, employment status, social network, and psychological status. Psychological distress was assessed using the 12-item General Health Questionnaire and was defined as a total score of 4 or higher. Results The overall prevalence of psychological distress decreased (P < 0.0001) gradually from 2005 (51.0%) to 2008 (30.1%) but tended to increase from 2008 to 2009 (P = 0.1590). Subgroup analyses showed that prevalence did not decrease over the 5-year study period among participants with poor social contact (P = 0.0659). From 2008 to 2009 prevalence increased in women (+7.5%, P = 0.0403) and participants aged 65 years or older (+7.2%, P = 0.0400). Conclusions The prevalence of psychological distress in Yamakoshi people decreased steadily during the 4 years immediately after the earthquake but appeared to increase thereafter. The earthquake victims are still reestablishing their lives. Thus, continued attention should be focused on maintaining and further assessing their mental health. PMID:24390416

Nut intake and 5-year changes in body weight and obesity risk in adults: results from the EPIC-PANACEA study.

PubMed

Freisling, Heinz; Noh, Hwayoung; Slimani, Nadia; Chajès, Véronique; May, Anne M; Peeters, Petra H; Weiderpass, Elisabete; Cross, Amanda J; Skeie, Guri; Jenab, Mazda; Mancini, Francesca R; Boutron-Ruault, Marie-Christine; Fagherazzi, Guy; Katzke, Verena A; Kühn, Tilman; Steffen, Annika; Boeing, Heiner; Tjønneland, Anne; Kyrø, Cecilie; Hansen, Camilla P; Overvad, Kim; Duell, Eric J; Redondo-Sánchez, Daniel; Amiano, Pilar; Navarro, Carmen; Barricarte, Aurelio; Perez-Cornago, Aurora; Tsilidis, Konstantinos K; Aune, Dagfinn; Ward, Heather; Trichopoulou, Antonia; Naska, Androniki; Orfanos, Philippos; Masala, Giovanna; Agnoli, Claudia; Berrino, Franco; Tumino, Rosario; Sacerdote, Carlotta; Mattiello, Amalia; Bueno-de-Mesquita, H Bas; Ericson, Ulrika; Sonestedt, Emily; Winkvist, Anna; Braaten, Tonje; Romieu, Isabelle; Sabaté, Joan

2017-07-21

There is inconsistent evidence regarding the relationship between higher intake of nuts, being an energy-dense food, and weight gain. We investigated the relationship between nut intake and changes in weight over 5 years. This study includes 373,293 men and women, 25-70 years old, recruited between 1992 and 2000 from 10 European countries in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Habitual intake of nuts including peanuts, together defined as nut intake, was estimated from country-specific validated dietary questionnaires. Body weight was measured at recruitment and self-reported 5 years later. The association between nut intake and body weight change was estimated using multilevel mixed linear regression models with center/country as random effect and nut intake and relevant confounders as fixed effects. The relative risk (RR) of becoming overweight or obese after 5 years was investigated using multivariate Poisson regressions stratified according to baseline body mass index (BMI). On average, study participants gained 2.1 kg (SD 5.0 kg) over 5 years. Compared to non-consumers, subjects in the highest quartile of nut intake had less weight gain over 5 years (-0.07 kg; 95% CI -0.12 to -0.02) (P trend = 0.025) and had 5% lower risk of becoming overweight (RR 0.95; 95% CI 0.92-0.98) or obese (RR 0.95; 95% CI 0.90-0.99) (both P trend <0.008). Higher intake of nuts is associated with reduced weight gain and a lower risk of becoming overweight or obese.

Depression subtypes and 5-year risk of dementia and Alzheimer disease in patients aged 70 years.

PubMed

Vilalta-Franch, Joan; López-Pousa, Secundino; Llinàs-Reglà, Jordi; Calvó-Perxas, Laia; Merino-Aguado, Javier; Garre-Olmo, Josep

2013-04-01

The objective of this study was to estimate several subtypes of depressive disorders as risk factors for dementia and Alzheimer disease (AD) specifically. This is a population-based cohort study using a sample of 451 non-demented older people. Adjusted Cox proportional hazard models were calculated to determine the association of depression with dementia or AD development after 5 years. Baseline evaluation included the Cambridge Mental Disorders of the Elderly Examination (CAMDEX). Depressive disorders (major episode [MD] and minor depressive disorders [MDDIS]) were assessed following DSM-IV criteria and further classified according to the age at onset (early versus late onset). In turn, all late-onset depressions were grouped as with or without depression-executive dysfunction syndrome (DEDS). Dementia (and dementia subtypes) diagnoses were made using the CAMDEX. When the patients were deceased, the Retrospective Collateral Dementia Interview was used. Late-onset depressions (both MD and MDDIS) were associated with increased dementia (hazard ratio [HR] = 2.635; 95% CI = 1.153-6.023; and HR = 2.517; 95% CI = 1.200-5.280, respectively), and AD (HR = 6.262; 95% CI = 2.017-19.446; and HR = 4.208; 95% CI = 1.828-9.685, respectively) after adjustment by age, gender, marital status, education, cognitive impairment, executive function and stroke history. A second model revealed that only late-onset depressions with DEDS increased the risk for both dementia (late-onset MD with DEDS: HR = 6.262; 95% CI = 2.017-19.446; late-onset MDDIS with DEDS: HR = 4.208; 95% CI = 1.828-9.685) and AD (late-onset MD with DEDS: HR = 7.807; 95% CI = 1.567-38.894; late-onset MDDIS with DEDS: HR = 6.099; 95% CI = 2.123-17.524). Late-onset depressive episodes with DEDS are risk factors for dementia and AD development, regardless of the severity of the depression. Copyright © 2012 John Wiley & Sons, Ltd.

Early intervention with tafamidis provides long-term (5.5-year) delay of neurologic progression in transthyretin hereditary amyloid polyneuropathy

PubMed Central

Waddington Cruz, Márcia; Amass, Leslie; Keohane, Denis; Schwartz, Jeffrey; Li, Huihua; Gundapaneni, Balarama

2016-01-01

Abstract Transthyretin hereditary amyloid polyneuropathy, also traditionally known as transthyretin familial amyloid polyneuropathy (ATTR-FAP), is a rare, relentless, fatal hereditary disorder. Tafamidis, an oral, non-NSAID, highly specific transthyretin stabilizer, demonstrated safety and efficacy in slowing neuropathy progression in early-stage ATTRV30M-FAP in a 1.5-year, randomized, double-blind, placebo-controlled trial, and 1-year open-label extension study, with a second long-term open-label extension study ongoing. Subgroup analysis of the effectiveness of tafamidis in the pivotal study and its open-label extensions revealed a relatively cohesive cohort of patients with mild neuropathy (i.e. Neuropathy Impairment Score for Lower Limbs [NIS-LL] ≤ 10) at the start of active treatment. Early treatment with tafamidis for up to 5.5 years (≥1 dose of tafamidis meglumine 20 mg once daily during the original trial or after switching from placebo in its extension) resulted in sustained delay in neurologic progression and long-term preservation of nutritional status in this cohort. Mean (95% CI) changes from baseline in NIS-LL and mBMI were 5.3 (1.6, 9.1) points and −7.8 (−44.3, 28.8) kg/m2 × g/L at 5.5 years, respectively. No new safety issues or side effects were identified. These data represent the longest prospective evaluation of tafamidis to date, confirm a favorable safety profile, and underscore the long-term benefits of early intervention with tafamidis. Trial Registration: ClincalTrials.gov Identifier: NCT00409175, NCT00791492, and NCT00925002. PMID:27494299

Early intervention with tafamidis provides long-term (5.5-year) delay of neurologic progression in transthyretin hereditary amyloid polyneuropathy.

PubMed

Waddington Cruz, Márcia; Amass, Leslie; Keohane, Denis; Schwartz, Jeffrey; Li, Huihua; Gundapaneni, Balarama

2016-09-01

Transthyretin hereditary amyloid polyneuropathy, also traditionally known as transthyretin familial amyloid polyneuropathy (ATTR-FAP), is a rare, relentless, fatal hereditary disorder. Tafamidis, an oral, non-NSAID, highly specific transthyretin stabilizer, demonstrated safety and efficacy in slowing neuropathy progression in early-stage ATTRV30M-FAP in a 1.5-year, randomized, double-blind, placebo-controlled trial, and 1-year open-label extension study, with a second long-term open-label extension study ongoing. Subgroup analysis of the effectiveness of tafamidis in the pivotal study and its open-label extensions revealed a relatively cohesive cohort of patients with mild neuropathy (i.e. Neuropathy Impairment Score for Lower Limbs [NIS-LL] ≤ 10) at the start of active treatment. Early treatment with tafamidis for up to 5.5 years (≥1 dose of tafamidis meglumine 20 mg once daily during the original trial or after switching from placebo in its extension) resulted in sustained delay in neurologic progression and long-term preservation of nutritional status in this cohort. Mean (95% CI) changes from baseline in NIS-LL and mBMI were 5.3 (1.6, 9.1) points and -7.8 (-44.3, 28.8) kg/m 2 × g/L at 5.5 years, respectively. No new safety issues or side effects were identified. These data represent the longest prospective evaluation of tafamidis to date, confirm a favorable safety profile, and underscore the long-term benefits of early intervention with tafamidis. ClincalTrials.gov Identifier: NCT00409175, NCT00791492, and NCT00925002.

A Longitudinal Assessment of the Relation between Executive Function and Theory of Mind at 3, 4, and 5 Years

PubMed Central

Marcovitch, Stuart; O’Brien, Marion; Calkins, Susan D.; Leerkes, Esther M.; Weaver, Jennifer M.; Levine, Douglas W.

2014-01-01

This longitudinal study contributes to the growing literature on the predictive nature of the relation between executive function (EF) and theory of mind (ToM). A latent variable model was fit to the data acquired from 226 socioeconomically and racially diverse children (52% female) at 3, 4, and 5 years of age on a number of age-appropriate tasks designed to assess EF and ToM. After controlling for sex, income-to-needs, and receptive language ability, there was substantial stability within each construct as children aged. In addition, EF at 3 years predicted ToM at 4 years but ToM did not predict EF, replicating earlier results. This pattern also appeared from 4 to 5 years of age, suggesting that the developmental precedence of EF persists later in development. Implications of these findings are discussed in terms of contemporary cognitive development theories, as well as the relation between EF and social reasoning in general. PMID:25642021

Changes in southern hemispheric polar amplification over the past 5 million years revealed by climate modelling

NASA Astrophysics Data System (ADS)

Hoencamp, Jori; Stap, Lennert; Tuenter, Erik; Lourens, Luc; van de Wal, Roderik

2016-04-01

Knowledge on polar amplification is important to relate high latitude climate records to global mean temperature changes. Several studies have pointed out that the strength of polar amplification in the Northern Hemisphere varies considerably due to the presence of large ice sheets and more sea ice during colder climate conditions. As a result, the polar amplification in the Northern Hemisphere decreases for warmer climates. In this study, we address the fact that these changes in the Northern Hemisphere also affect the polar amplification in the Southern Hemisphere. We study the Southern and Northern Hemisphere amplification together over the past 5 million years with the CLIMBER-2 intermediate complexity model. Radiation, land ice extent and height, and greenhouse gases are prescribed as forcing. We find that in contrast to the reduction in polar amplification in the Northern Hemisphere, polar amplification in the Southern Hemisphere increases for warmer climates. The amplification decreases in the Northern Hemisphere from 2.7 during glacial conditions to 1.6 for a pre-industrial climate, which is line with other climate simulations. Over the same CO2 range the southern hemispheric polar amplification increases from 1 to 1.6. This is caused by the fact that the atmospheric transport needed to balance the radiation surplus in the equatorial region needs to be compensated by relatively stronger transport of energy in Southern direction while the transport in Northern direction reduces. This reduction in Northern direction is driven by less (land and sea) ice resulting in a smaller meridional gradient in Northern direction and hence a smaller atmospheric transport. As a consequence, the traditional scaled (with LGM temperature) Dome C record needs to be corrected with a maximum of 0.6 degrees half-way glacial and interglacial conditions, if it is to be interpreted as global mean temperature change indicator. While this changes the amplitude, the phasing of

Pathways of Pb and Mn observed in a 5-year longitudinal investigation in young children and environmental measures from an urban setting.

PubMed

Gulson, Brian; Mizon, Karen; Taylor, Alan; Korsch, Michael; Davis, J Michael; Louie, Honway; Wu, Michael; Gomez, Laura; Antin, Luminita

2014-08-01

We monitored 108 children ≤5 years on a 6-month basis for up to 5 years in a major urban setting. Samples (n ∼ 7000) included blood, urine, handwipes (interior, and after exterior playing), 6-day duplicate diet, drinking water, interior house and day care dust-fall accumulation using petri dishes, exterior dust-fall accumulation, exterior dust sweepings, paint, soil and urban air. The geometric mean blood Pb (PbB) was 2.1 μg/dL and blood Mn (MnB) was 10.0 μg/L. Following a path modelling approach, mixed model analyses for a fully adjusted model showed the strongest associations for PbB were with interior house dust and soil; for MnB there were no significant associations with any predictors. Predictor variables only explained 9% of the variance for Pb and 0.7% for Mn. Relationships between environmental measures and PbB in children are not straightforward; soil and dust sweepings contribute only about 1/5th of the amounts to PbB found in other studies. Copyright © 2014 Elsevier Ltd. All rights reserved.

The western Pacific monsoon in CMIP5 models: Model evaluation and projections

NASA Astrophysics Data System (ADS)

Brown, Josephine R.; Colman, Robert A.; Moise, Aurel F.; Smith, Ian N.

2013-11-01

ability of 35 models from the Coupled Model Intercomparison Project Phase 5 (CMIP5) to simulate the western Pacific (WP) monsoon is evaluated over four representative regions around Timor, New Guinea, the Solomon Islands and Palau. Coupled model simulations are compared with atmosphere-only model simulations (with observed sea surface temperatures, SSTs) to determine the impact of SST biases on model performance. Overall, the CMIP5 models simulate the WP monsoon better than previous-generation Coupled Model Intercomparison Project Phase 3 (CMIP3) models, but some systematic biases remain. The atmosphere-only models are better able to simulate the seasonal cycle of zonal winds than the coupled models, but display comparable biases in the rainfall. The CMIP5 models are able to capture features of interannual variability in response to the El Niño-Southern Oscillation. In climate projections under the RCP8.5 scenario, monsoon rainfall is increased over most of the WP monsoon domain, while wind changes are small. Widespread rainfall increases at low latitudes in the summer hemisphere appear robust as a large majority of models agree on the sign of the change. There is less agreement on rainfall changes in winter. Interannual variability of monsoon wet season rainfall is increased in a warmer climate, particularly over Palau, Timor and the Solomon Islands. A subset of the models showing greatest skill in the current climate confirms the overall projections, although showing markedly smaller rainfall increases in the western equatorial Pacific. The changes found here may have large impacts on Pacific island countries influenced by the WP monsoon.

Acute Trauma Factor Associations With Suicidality Across the First 5 Years After Traumatic Brain Injury.

PubMed

Kesinger, Matthew R; Juengst, Shannon B; Bertisch, Hillary; Niemeier, Janet P; Krellman, Jason W; Pugh, Mary Jo; Kumar, Raj G; Sperry, Jason L; Arenth, Patricia M; Fann, Jesse R; Wagner, Amy K

2016-08-01

To determine whether severity of head and extracranial injuries (ECI) is associated with suicidal ideation (SI) or suicide attempt (SA) after traumatic brain injury (TBI). Factors associated with SI and SA were assessed in this inception cohort study using data collected 1, 2, and 5 years post-TBI from the National Trauma Data Bank and Traumatic Brain Injury Model Systems (TBIMS) databases. Level I trauma centers, inpatient rehabilitation centers, and the community. Participants with TBI from 15 TBIMS Centers with linked National Trauma Data Bank trauma data (N=3575). Not applicable. SI was measured via the Patient Health Questionnaire 9 (question 9). SA in the last year was assessed via interview. ECI was measured by the Injury Severity Scale (nonhead) and categorized as none, mild, moderate, or severe. There were 293 (8.2%) participants who had SI without SA and 109 (3.0%) who had SA at least once in the first 5 years postinjury. Random effects logit modeling showed a higher likelihood of SI when ECI was severe (odds ratio=2.73; 95% confidence interval, 1.55-4.82; P=.001). Drug use at time of injury was also associated with SI (odds ratio=1.69; 95% confidence interval, 1.11-2.86; P=.015). Severity of ECI was not associated with SA. Severe ECI carried a nearly 3-fold increase in the odds of SI after TBI, but it was not related to SA. Head injury severity and less severe ECI were not associated with SI or SA. These findings warrant additional work to identify factors associated with severe ECI that make individuals more susceptible to SI after TBI. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

75 FR 66724 - Endangered and Threatened Species; 5-Year Review

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-29

... extinction throughout its range. Therefore, the 5-year review recommends no change in listing. ADDRESSES... maintained. The list is published at 50 CFR 17.11 (for animals) and 17.12 (for plants). Section 4(c)(2) of...

The global chemistry transport model TM5: description and evaluation of the tropospheric chemistry version 3.0

NASA Astrophysics Data System (ADS)

Huijnen, V.; Williams, J.; van Weele, M.; van Noije, T.; Krol, M.; Dentener, F.; Segers, A.; Houweling, S.; Peters, W.; de Laat, J.; Boersma, F.; Bergamaschi, P.; van Velthoven, P.; Le Sager, P.; Eskes, H.; Alkemade, F.; Scheele, R.; Nédélec, P.; Pätz, H.-W.

2010-10-01

We present a comprehensive description and benchmark evaluation of the tropospheric chemistry version of the global chemistry transport model TM5 (Tracer Model 5, version TM5-chem-v3.0). A full description is given concerning the photochemical mechanism, the interaction with aerosol, the treatment of the stratosphere, the wet and dry deposition parameterizations, and the applied emissions. We evaluate the model against a suite of ground-based, satellite, and aircraft measurements of components critical for understanding global photochemistry for the year 2006. The model exhibits a realistic oxidative capacity at a global scale. The methane lifetime is ~8.9 years with an associated lifetime of methyl chloroform of 5.86 years, which is similar to that derived using an optimized hydroxyl radical field. The seasonal cycle in observed carbon monoxide (CO) is well simulated at different regions across the globe. In the Northern Hemisphere CO concentrations are underestimated by about 20 ppbv in spring and 10 ppbv in summer, which is related to missing chemistry and underestimated emissions from higher hydrocarbons, as well as to uncertainties in the seasonal variation of CO emissions. The model also captures the spatial and seasonal variation in formaldehyde tropospheric columns as observed by SCIAMACHY. Positive model biases over the Amazon and eastern United States point to uncertainties in the isoprene emissions as well as its chemical breakdown. Simulated tropospheric nitrogen dioxide columns correspond well to observations from the Ozone Monitoring Instrument in terms of its seasonal and spatial variability (with a global spatial correlation coefficient of 0.89), but TM5 fields are lower by 25-40%. This is consistent with earlier studies pointing to a high bias of 0-30% in the OMI retrievals, but uncertainties in the emission inventories have probably also contributed to the discrepancy. TM5 tropospheric nitrogen dioxide profiles are in good agreement (within ~0

The global chemistry transport model TM5: description and evaluation of the tropospheric chemistry version 3.0

NASA Astrophysics Data System (ADS)

Huijnen, V.; Williams, J. E.; van Weele, M.; van Noije, T. P. C.; Krol, M. C.; Dentener, F.; Segers, A.; Houweling, S.; Peters, W.; de Laat, A. T. J.; Boersma, K. F.; Bergamaschi, P.; van Velthoven, P. F. J.; Le Sager, P.; Eskes, H. J.; Alkemade, F.; Scheele, M. P.; Nédélec, P.; Pätz, H.-W.

2010-07-01

We present a comprehensive description and benchmark evaluation of the tropospheric chemistry version of the global chemistry transport model TM5 (Tracer Model 5, version TM5-chem-v3.0). A full description is given concerning the photochemical mechanism, the interaction with aerosol, the treatment of the stratosphere, the wet and dry deposition parameterizations, and the applied emissions. We evaluate the model against a suite of ground-based, satellite, and aircraft measurements of components critical for understanding global photochemistry for the year 2006. The model exhibits a realistic oxidative capacity at a global scale. The methane lifetime is ~8.9 years with an associated lifetime of methyl chloroform of 5.86 years, which is similar to that derived using an optimized hydroxyl radical field. The seasonal cycle in observed carbon monoxide (CO) is well simulated at different regions across the globe. In the Northern Hemisphere CO concentrations are underestimated by about 20 ppbv in spring and 10 ppbv in summer, which is related to missing chemistry and underestimated emissions from higher hydrocarbons, as well as to uncertainties in the seasonal variation of CO emissions. The model also captures the spatial and seasonal variation in formaldehyde tropospheric columns as observed by SCIAMACHY. Positive model biases over the Amazon and eastern United States point to uncertainties in the isoprene emissions as well as its chemical breakdown. Simulated tropospheric nitrogen dioxide columns correspond well to observations from the Ozone Monitoring Instrument in terms of its seasonal and spatial variability (with a global spatial correlation coefficient of 0.89), but TM5 fields are lower by 25-40%. This is consistent with earlier studies pointing to a high bias of 0-30% in the OMI retrievals, but uncertainties in the emission inventories have probably also contributed to the discrepancy. TM5 tropospheric nitrogen dioxide profiles are in good agreement (within ~0

A 5-Year Investigation of Children's Adaptive Functioning Following Conformal Radiation Therapy for Localized Ependymoma

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

Netson, Kelli L.; Conklin, Heather M.; Wu Shengjie

2012-09-01

Purpose: Conformal and intensity modulated radiation therapies have the potential to preserve cognitive outcomes in children with ependymoma; however, functional behavior remains uninvestigated. This longitudinal investigation prospectively examined intelligence quotient (IQ) and adaptive functioning during the first 5 years after irradiation in children diagnosed with ependymoma. Methods and Materials: The study cohort consisted of 123 children with intracranial ependymoma. Mean age at irradiation was 4.60 years (95% confidence interval [CI], 3.85-5.35). Serial neurocognitive evaluations, including an age-appropriate IQ measure and the Vineland Adaptive Behavior Scales (VABS), were completed before irradiation, 6 months after treatment, and annually for 5 years. Amore » total of 579 neurocognitive evaluations were included in these analyses. Results: Baseline IQ and VABS were below normative means (P<.05), although within the average range. Linear mixed models revealed stable IQ and VABS across the follow-up period, except for the VABS Communication Index, which declined significantly (P=.015). Annual change in IQ (-.04 points) did not correlate with annual change in VABS (-.90 to +.44 points). Clinical factors associated with poorer baseline performance (P<.05) included preirradiation chemotherapy, cerebrospinal fluid shunt placement, number and extent of surgical resections, and younger age at treatment. No clinical factors significantly affected the rate of change in scores. Conclusions: Conformal and intensity modulated radiation therapies provided relative sparing of functional outcomes including IQ and adaptive behaviors, even in very young children. Communication skills remained vulnerable and should be the target of preventive and rehabilitative interventions.« less

North Atlantic deep water formation and AMOC in CMIP5 models

NASA Astrophysics Data System (ADS)

Heuzé, Céline

2017-07-01

Deep water formation in climate models is indicative of their ability to simulate future ocean circulation, carbon and heat uptake, and sea level rise. Present-day temperature, salinity, sea ice concentration and ocean transport in the North Atlantic subpolar gyre and Nordic Seas from 23 CMIP5 (Climate Model Intercomparison Project, phase 5) models are compared with observations to assess the biases, causes and consequences of North Atlantic deep convection in models. The majority of models convect too deep, over too large an area, too often and too far south. Deep convection occurs at the sea ice edge and is most realistic in models with accurate sea ice extent, mostly those using the CICE model. Half of the models convect in response to local cooling or salinification of the surface waters; only a third have a dynamic relationship between freshwater coming from the Arctic and deep convection. The models with the most intense deep convection have the warmest deep waters, due to a redistribution of heat through the water column. For the majority of models, the variability of the Atlantic Meridional Overturning Circulation (AMOC) is explained by the volumes of deep water produced in the subpolar gyre and Nordic Seas up to 2 years before. In turn, models with the strongest AMOC have the largest heat export to the Arctic. Understanding the dynamical drivers of deep convection and AMOC in models is hence key to realistically forecasting Arctic oceanic warming and its consequences for the global ocean circulation, cryosphere and marine life.

Mothers' Perceived Neighbourhood Environment and Outdoor Play of 2- to 3.5-Year-Old Children: Findings from the Healthy Beginnings Trial.

PubMed

Xu, Huilan; Wen, Li Ming; Hardy, Louise L; Rissel, Chris

2017-09-18

This study aims to investigate whether mothers' perceived neighbourhood environment is associated with outdoor playtime of 2- to 3.5-year-old children. Cross-sectional analyses were conducted using data from the Healthy Beginnings Trial (HBT). Data on children's outdoor playtime and mothers' perceived neighbourhood environment were collected through face-to-face interviews with mothers when their children were 2 and 3.5 years old. Walk score was obtained from a publicly available website and population density data were obtained from Australian Census data. Multiple logistic regression models were built to investigate these associations. A total of 497 and 415 mother-child dyads were retained at 2 years and 3.5 years. After adjusting for intervention group allocation and other confounding factors, at 2 years, mothers' perceptions that 'the neighbourhood is a good place to bring up children', 'it is safe to play outside during the day', and 'there are good parks or playgrounds in neighbourhood' were positively associated with children's outdoor playtime. At 3.5 years, living in a free-standing house was associated with more children's outdoor playtime. Children may benefit from living in a neighbourhood that supports active lifestyle. Improving social and physical environments in neighbourhoods could be an important strategy for improving young children's physical activity.

Causes of deaths in children younger than 5 years in China in 2008.

PubMed

Rudan, Igor; Chan, Kit Yee; Zhang, Jian S F; Theodoratou, Evropi; Feng, Xing Lin; Salomon, Joshua A; Lawn, Joy E; Cousens, Simon; Black, Robert E; Guo, Yan; Campbell, Harry

2010-03-27

Previous estimates of the global burden of disease for children have not included much information from China, leading to a large gap in data. We identified the main causes of deaths in neonates (<1 month), postneonatal infants (1-11 months), and children (<5 years) in China using information that was available to the public. The Child Health Epidemiology Reference Group in collaboration with colleagues from Peking University systematically searched Chinese databases that were available to the public. Information was obtained from the Chinese Ministry of Health and Bureau of Statistics websites, Chinese National Knowledge Infrastructure database, and Chinese Health Statistics yearbooks for 1990-2008. We also obtained information from 206 high-quality community-based longitudinal studies of different causes of deaths in children (<5 years) that were written in the Chinese language. A statistical model was developed to estimate the total number of deaths in children according to provinces, age groups, and main causes. During 1990-2008, the mortality rates in neonates, postneonatal infants, and children were reduced by 70% (from 34.0 to 10.2 per 1000 livebirths), 72% (from 53.5 to 14.9 per 1000 livebirths), and 71% (from 64.6 to 18.5 per 1000 livebirths), respectively, meeting the targets set in the Millennium Development Goal 4. The leading causes of deaths in 2008 were pneumonia, birth asphyxia, and preterm birth complications, each accounting for 15-17% of all deaths. Congenital abnormalities and accidents increased in importance during this period, contributing to 11% and 10% of child deaths, respectively. Sudden infant death syndrome contributed to 5% of deaths in children. Publically available Chinese databases contain much important information that has been underused in the estimation of global and regional burden of disease. On the basis of trends, preterm birth complications are expected to become the leading cause of child mortality in China, whereas deaths

Parental stress and perceived vulnerability at 5 and 10 years after pediatric SCT.

PubMed

Vrijmoet-Wiersma, C M J; Egeler, R M; Koopman, H M; Bresters, D; Norberg, A L; Grootenhuis, M A

2010-06-01

With the aim of assessing parental stress after SCT, 73 parents of children and adolescents who underwent SCT 5 or 10 years ago responded to questionnaires on general distress (General Health Questionnaire (GHQ)), disease-related stress (Pediatric Inventory for Parents-short form (PIP-SF)) and perceptions of child vulnerability (Child Vulnerability Scale (CVS)). General distress scores were comparable with the reference groups, but 40% of the mothers at 5 years after SCT reported increased stress levels as compared with 26% in the community-based reference group. Disease-related stress was comparable with the reference group of parents of children who were just off cancer treatment, 5 years after SCT. At 10 years after SCT, scores were lower than the reference group. Perceived child vulnerability did diminish over time, but remained high in parents of SCT survivors, compared with parents of healthy children: 96% of the parents at 5 years after SCT and 76% of the parents at 10 years after SCT scored above the cutoff point. Perceived vulnerability was found to be a predictor for parental disease-related stress. To conclude, although most parents of SCT survivors are resilient, the majority of parents perceive their child to be much more vulnerable as compared with parents of healthy children. This perception is associated with disease-related stress and may induce overprotective parenting.

Australian children with cleft palate achieve age-appropriate speech by 5 years of age.

PubMed

Chacon, Antonia; Parkin, Melissa; Broome, Kate; Purcell, Alison

2017-12-01

Children with cleft palate demonstrate atypical speech sound development, which can influence their intelligibility, literacy and learning. There is limited documentation regarding how speech sound errors change over time in cleft palate speech and the effect that these errors have upon mono-versus polysyllabic word production. The objective of this study was to examine the phonetic and phonological speech skills of children with cleft palate at ages 3 and 5. A cross-sectional observational design was used. Eligible participants were aged 3 or 5 years with a repaired cleft palate. The Diagnostic Evaluation of Articulation and Phonology (DEAP) Articulation subtest and a non-standardised list of mono- and polysyllabic words were administered once for each child. The Profile of Phonology (PROPH) was used to analyse each child's speech. N = 51 children with cleft palate participated in the study. Three-year-old children with cleft palate produced significantly more speech errors than their typically-developing peers, but no difference was apparent at 5 years. The 5-year-olds demonstrated greater phonetic and phonological accuracy than the 3-year-old children. Polysyllabic words were more affected by errors than monosyllables in the 3-year-old group only. Children with cleft palate are prone to phonetic and phonological speech errors in their preschool years. Most of these speech errors approximate typically-developing children by 5 years. At 3 years, word shape has an influence upon phonological speech accuracy. Speech pathology intervention is indicated to support the intelligibility of these children from their earliest stages of development. Copyright © 2017 Elsevier B.V. All rights reserved.

Predictors of ADHD Persistence in Girls at 5-Year Follow-Up

ERIC Educational Resources Information Center

Mick, Eric; Byrne, Deirdre; Fried, Ronna; Monuteaux, Michael; Faraone, Stephen V.; Biederman, Joseph

2011-01-01

Objective: The main aim of this study was to examine the age-dependent remission from ADHD in girls transitioning through childhood into adolescence and early adulthood. Method: We conducted a 5-year prospective follow-up study of 123 girls with ADHD and 106 non-ADHD control girls aged between 6 and 17 years at ascertainment. ADHD was considered…

The cost effectiveness of tacrolimus versus microemulsified cyclosporin: a 10-year model of renal transplantation outcomes.

PubMed

Orme, Michelle E; Jurewicz, Wieslaw A; Kumar, Nagappan; McKechnie, Tracy L

2003-01-01

In 1983, the launch of cyclosporin was a significant clinical advance for organ transplant recipients. Subsequent drug research led to further advances with the introduction of cyclosporin microemulsion (cyclosporin ME) and tacrolimus. This paper presents the results from a long-term model comparing the clinical and economic outcomes associated with cyclosporin ME and tacrolimus immunosuppression for the prevention of graft rejection following renal transplantation. A model was developed to project the costs and outcomes over a 10-year period following transplantation. The model was based on the results of a prospective, randomised study of 179 renal transplantation recipients receiving either cyclosporin ME or tacrolimus, which was conducted by the Welsh Transplantation Research Group (median follow-up: 2.7 years). The short-term costs and outcomes were the averages from the actual head-to-head trial data. From this, the long-term costs and outcomes were extrapolated based on the rate of change in patient and graft survival at 3, 5 and 10 years post transplant, as reported in the 1995 United Kingdom Transplant Support Service Authority Renal Transplant Audit. PERSPECTIVE AND YEAR OF COST DATA: The analysis was conducted from the perspective of a UK transplant unit. Costs were at 1999 prices (pounds sterling 1 = dollars US 1.42 = Euro 1.5) and costs and outcomes were discounted at 6% and 1.5%, respectively. The model estimated that 10 years after transplantation, the proportion of patients surviving was 56% of the cyclosporin ME cohort and 64% of the tacrolimus cohort. The cumulative cost of maintenance therapy at 10 years was pounds sterling 23204 per patient maintained on cyclosporin ME versus pounds sterling 23803 per patient on tacrolimus. The cost per survivor at 10 years was pounds sterling 37000 (tacrolimus) versus pounds sterling 41000 (cyclosporin ME) and the cost per patient with a functioning graft was pounds sterling 39000 versus pounds sterling 45000

Histological findings in protocol biopsies following pediatric liver transplant: Low incidence of abnormalities at 5 years.

PubMed

Sheikh, Amin; Chau, Kai Y; Evans, Helen M

2018-05-11

Histological abnormalities, including chronic hepatitis, fibrosis, and steatosis, are increasingly reported in liver biopsies of children after LT. These changes may be progressive and represent a form of rejection. Liver biochemistry is often initially normal. Our LT program began in 2002, utilizing tacrolimus and low-dose steroids for the first year post-LT. Patients undergo a protocol biopsy at 1 year post-LT prior to stopping steroids, then at 5 years and every 5 years thereafter. Target tacrolimus levels are 5-8 μg/L and 3-5 μg/L after 3 and 12 months, respectively. Between 2002 and 2009, 51 LT were performed; 50 (98%) and 49 (96%) patients survived for 1 and 5 years, respectively. A total of 43 patients (median age at LT 2.3 years) underwent a protocol biopsy at 1 year (16 male; median time post-LT 12.5 months), and 44 (20 male; median time post-LT 5.1 years) at 5 years. By 5 years, 3 had transferred to adult services; 1 was re-transplanted for graft failure and 1 moved overseas. Biopsies were reviewed by 2 pathologists. Most patients (31/44) were on tacrolimus monotherapy at 5 years. At 1 and 5 years, 29 of 43 (67.5%) and 31 of 44 (71%) biopsies were normal, respectively. Two of 44 had chronic allograft hepatitis at 5 years. Two of 43 and 1 of 44 had isolated fibrosis, 3 of 43 and 3 of 44 steatosis, and 3 of 43 and 4 of 44 acute rejection at 1 and 5 years, respectively. Other findings included predominantly biliary changes (6/43 & 3/44 at 1 and 5 years, respectively). Tacrolimus levels at 5 years were slightly higher than anticipated (median trough level 5.8 μg/L). With an immunosuppressive regimen of tacrolimus and low-dose steroids for 1 year followed by tacrolimus monotherapy thereafter, the majority of PLB were normal and no progressive changes were observed at 5 years. Compared to other LT programs, we have lower rates of chronic allograft hepatitis, steatosis, and fibrosis at 5 years. However, the tacrolimus levels at 5 years

40 CFR 600.512-12 - Model year report.

Code of Federal Regulations, 2013 CFR

2013-07-01

... CFR parts 531 or 533 as applicable, and the applicable fleet average CO2 emission standards. Model... standards. Model year reports shall include a statement that the method of measuring vehicle track width... models and the applicable in-use CREE emission standard. The list of models shall include the applicable...

40 CFR 600.512-12 - Model year report.

Code of Federal Regulations, 2012 CFR

2012-07-01

... CFR parts 531 or 533 as applicable, and the applicable fleet average CO2 emission standards. Model... standards. Model year reports shall include a statement that the method of measuring vehicle track width... models and the applicable in-use CREE emission standard. The list of models shall include the applicable...

40 CFR 600.512-12 - Model year report.

Code of Federal Regulations, 2014 CFR

2014-07-01

... CFR parts 531 or 533 as applicable, and the applicable fleet average CO2 emission standards. Model... standards. Model year reports shall include a statement that the method of measuring vehicle track width... models and the applicable in-use CREE emission standard. The list of models shall include the applicable...

49 CFR 543.5 - Petition: General requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

....5 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC... § 543.5 Petition: General requirements. (a) For each model year, a manufacturer may petition NHTSA for... manufacturer may not petition NHTSA for an exemption for model years before model year 2006. (b) Each petition...

Reptile-associated salmonellosis in children aged under 5 years in South West England.

PubMed

Murphy, Dan; Oshin, Femi

2015-04-01

To determine the proportion of Salmonella cases in children aged <5 years that were reptile-associated salmonellosis (RAS) and to compare the severity of illness. To analyse all cases of salmonellosis reported to public health authorities in children aged under 5 years in the South West of the UK from January 2010 to December 2013 for reptile exposure, age, serotype, hospitalisation and invasive disease. 48 of 175 (27%) Salmonella cases had exposure to reptiles. The median age of RAS cases was significantly lower than non-RAS cases (0.5 vs 1.0 year). RAS cases were 2.5 times more likely to be hospitalised (23/48) compared with non-RAS cases (25/127; p=0.0002). This trend continued in cases aged under 12 months, with significantly more RAS cases hospitalised (19/38) than non-RAS cases (8/42; p=0.003). Significantly more RAS cases had invasive disease (8/48: 5 bacteraemia, 2 meningitis, 1 colitis) than non-RAS cases (4/127: 3 bacteraemia, 1 meningitis). Reptile exposure was found in over a quarter of all reported Salmonella cases in children under 5 years of age. RAS is associated with young age, hospitalisation and invasive disease. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Treatment of Chronic PTSD by Cognitive Therapy and Exposure: 5-Year Follow-up

ERIC Educational Resources Information Center

Tarrier, Nicholas; Sommerfield, Claire

2004-01-01

Patients who had taken part in a randomized clinical trial of the treatment of chronic PTSD by either cognitive therapy or imaginal exposure were reassessed after 5 years. At 5-year follow-up a clear superiority of cognitive therapy over imaginal exposure emerged, although there had been no difference between the two treatment groups up to 12…

An integrated model of academic self-concept development: Academic self-concept, grades, test scores, and tracking over 6 years.

PubMed

Marsh, Herbert W; Pekrun, Reinhard; Murayama, Kou; Arens, A Katrin; Parker, Philip D; Guo, Jiesi; Dicke, Theresa

2018-02-01

Our newly proposed integrated academic self-concept model integrates 3 major theories of academic self-concept formation and developmental perspectives into a unified conceptual and methodological framework. Relations among math self-concept (MSC), school grades, test scores, and school-level contextual effects over 6 years, from the end of primary school through the first 5 years of secondary school (a representative sample of 3,370 German students, 42 secondary schools, 50% male, M age at grade 5 = 11.75) support the (1) internal/external frame of reference model: Math school grades had positive effects on MSC, but the effects of German grades were negative; (2) reciprocal effects (longitudinal panel) model: MSC was predictive of and predicted by math test scores and school grades; (3) big-fish-little-pond effect: The effects on MSC were negative for school-average achievement based on 4 indicators (primary school grades in math and German, school-track prior to the start of secondary school, math test scores in the first year of secondary school). Results for all 3 theoretical models were consistent across the 5 secondary school years: This supports the prediction of developmental equilibrium. This integration highlights the robustness of support over the potentially volatile early to middle adolescent period; the interconnectedness and complementarity of 3 ASC models; their counterbalancing strengths and weaknesses; and new theoretical, developmental, and substantive implications at their intersections. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Effect of HCV on fasting glucose, fasting insulin and peripheral insulin resistance in first 5 years of infection.

PubMed

Ahmed, Naeema; Rashid, Amir; Naveed, Abdul Khaliq; Bashir, Qudsia

2016-02-01

To assess the effects of hepatitis C virus infection in the first 5 years on fasting glucose, fasting insulin and peripheral insulin resistance. The case-control study was conducted at the Army Medical College, Rawalpindi, from December 2011 to November 2012, and comprised subjects recruited from a government hospital in Rawalpindi. The subjects included known cases of hepatitis C virus infection for at least 5 years, and normal healthy controls. Fasting blood samples of all the subjects were collected and analysed for serum fasting insulin and serum fasting glucose levels. Homeostatic model assessment-Insulin resistance was calculated SPSS 11 was used for statistical analysis. Of the 30 subjects, 20(66.6%) were cases, while 10(33.3%) were controls. Serum fasting glucose mean level in cases was 89.55±9.53 compared to 84.40±9.80 in the controls (p=0.188). The mean serum fasting insulin in controls was 7.52±3.23 and 6.79±3.30 in cases (p=0.567). Homeostatic model assessment-Insulin resistance level in controls was 1.60±0.76 and In the cases it was 1.49±0.74 (p=0.695). Peripheral insulin resistance and development of type 2 diabetes as a complication of hepatitis C virus infection was not likely at least within the first five years of infection.

Graphs to estimate an individualized risk of breast cancer.

PubMed

Benichou, J; Gail, M H; Mulvihill, J J

1996-01-01

Clinicians who counsel women about their risk for developing breast cancer need a rapid method to estimate individualized risk (absolute risk), as well as the confidence limits around that point. The Breast Cancer Detection Demonstration Project (BCDDP) model (sometimes called the Gail model) assumes no genetic model and simultaneously incorporates five risk factors, but involves cumbersome calculations and interpolations. This report provides graphs to estimate the absolute risk of breast cancer from the BCDDP model. The BCDDP recruited 280,000 women from 1973 to 1980 who were monitored for 5 years. From this cohort, 2,852 white women developed breast cancer and 3,146 controls were selected, all with complete risk-factor information. The BCDDP model, previously developed from these data, was used to prepare graphs that relate a specific summary relative-risk estimate to the absolute risk of developing breast cancer over intervals of 10, 20, and 30 years. Once a summary relative risk is calculated, the appropriate graph is chosen that shows the 10-, 20-, or 30-year absolute risk of developing breast cancer. A separate graph gives the 95% confidence limits around the point estimate of absolute risk. Once a clinician rules out a single gene trait that predisposes to breast cancer and elicits information on age and four risk factors, the tables and figures permit an estimation of a women's absolute risk of developing breast cancer in the next three decades. These results are intended to be applied to women who undergo regular screening. They should be used only in a formal counseling program to maximize a woman's understanding of the estimates and the proper use of them.

Cryptosporidiosis Risk in New Zealand Children Under 5 Years Old is Greatest in Areas with High Dairy Cattle Densities.

PubMed

Lal, Aparna; Dobbins, Timothy; Bagheri, Nasser; Baker, Michael G; French, Nigel P; Hales, Simon

2016-12-01

The public health risks associated with dairy farming intensification are an emerging concern. We examine the association between dairy cattle density and cryptosporidiosis risk in children <5 years old in New Zealand from 1997 to 2008, a period of rapid intensification of the dairy industry. Multi-level Poisson regression was used to model reported cryptosporidiosis (N = 3869 cases) incidence in relation to dairy cattle densities across urban and rural areas separately, after controlling for microbiological quality of public drinking water supplies and neighbourhood socio-economic factors using the Census Area Unit of residence. Within urban areas, the risk of cryptosporidiosis in children less than 5 years old was significantly, positively associated with medium and high dairy cattle density IRR 1.3 (95% CI 1.2, 1.5) and 1.5 (95% CI 1.2, 1.9) respectively, when compared to areas with no dairy cattle. Within rural areas, the incidence risk of cryptosporidiosis in children less than 5 years old were significantly, positively associated with medium and high dairy cattle density: IRR 1.7 (95% CI 1.3, 2.3) and 2.0 (95% CI 1.5, 2.8) respectively, when compared to areas with no dairy cattle. These results have public health implications for children living on and in proximity to intensively stocked dairy cattle farms.

Reduced Protection for Belted Occupants in Rear Seats Relative to Front Seats of New Model Year Vehicles

PubMed Central

Sahraei, Elham; Digges, Kennerly; Marzougui, Dhafer

2010-01-01

Effectiveness of the rear seat in protecting occupants of different age groups in frontal crashes for 2000–2009 model years (MY) of vehicles was estimated and compared to 1990–1999 model years of vehicles. The objective was to determine the effectiveness of the rear seat compared to the front seat for various age groups in newer model year vehicles. The double paired comparison method was used to estimate relative effectiveness. For belted adults of the 25–49 age group, the fatality reduction effectiveness of the rear seat compared to the right front seat was 25 % (CI 11% to 36%), in the 1990–1999 model year vehicles. The relative effectiveness was −31% (CI −63% to −5%) for the same population, in the 2000–2009 model year vehicles. For restrained children 0–8 years old, the relative effectiveness was 55% (CI 48% to 61%) when the vehicles were of the 1990–1999 period. The level of effectiveness for this age group was reduced to 25% (CI −4% to 46%) in the 2000–2009 MYs of vehicles. Results for other age groups of belted occupants have followed a similar trend. All belted adult occupants of 25+ years old were significantly less protected in rear seats as compared to right front seats in the 2000–2009 model years of vehicles. For unbelted occupants however, rear seats were still a safer position than front seats, even in the 2000–2009 model years of vehicles. PMID:21050599

Impact of Age on Change in Self-Image 5 Years After Complex Spinal Fusion (≥5 Levels).

PubMed

Elsamadicy, Aladine A; Adogwa, Owoicho; Sergesketter, Amanda; Behrens, Shay; Hobbs, Cassie; Bridwell, Keith H; Karikari, Isaac O

2017-01-01

Spinal deformities that require ≥5 fusion levels are difficult and challenging for both the surgeon and patient. Corrections of moderate to severe deformities have been shown to improve patient-reported outcomes (PROs), and provide patients with a better quality of life. Self-image is an important PRO because it sheds insight into the patient's perception of health, as well as serving as a proxy of satisfaction for patients with spine deformity undergoing corrective surgery. However, with an aging population, the impact of age on long-term change in self-image is unknown. The aim of this study is to determine the effects of age on self-image 5 years after undergoing an elective complex spinal fusion (≥5 levels). This was a retrospective analysis of prospectively collected data of 55 adult patients (≥18 years old) undergoing ≥5 levels of spinal fusion to the sacrum with iliac fixation from January 2002 to December 2008. Patients were grouped by age: young (<60 years old) and older (≥60 years old). Patient demographics, comorbidities, preoperative variables (sagittal and Cobb angles) and postoperative complication rates were collected. All patients had prospectively collected outcome measures and a minimum of 5 years follow-up. PRO instrument SRS-22r (function, self-image, mental health, and pain) was completed before surgery then at follow-up (at least 5 years after surgery). The primary outcome investigated in this study was the change in self-image after surgery. Baseline characteristics and preoperative variables were similar in both cohorts. There were no significant differences in intraoperative variables, including the mean ± standard deviation number of fusion levels between the cohorts (young, 11.2 ±4.3 vs. older, 12.1 ± 4.0; P = 0.42). Complication rates were similar between the cohorts, with no significant differences in the types of complications (young, 29.63% vs. older, 25.0%; P = 0.77). There were no significant differences in

POSTTRAUMATIC STRESS DISORDER AMONG INDONESIAN CHILDREN 5 YEARS AFTER THE TSUNAMI.

PubMed

Irwanto; Faisal; Zulfa, Hendra

2015-09-01

Children are at risk for developing posttraumatic stress disorder (PTSD) due to experiencing or living in a disaster area. The factors that increase the likelihood of a child developing PTSD need further clarification. We studied the factors associated with PTSD among children who experienced the tsunami in Sumatra, Indonesia. We conducted a cross sectional study in 2 subdistricts of Sumatra 5 years after experiencing a tsunami. Children aged 7-13 years were enrolled using stratified cluster sampling. A tsunami-modified version of The PsySTART Rapid Triage System was used to question children about their tsunami-specific traumatic experiences. Trauma symptoms were evaluated using the Trauma Symptom Checklist For Children (TSCC). The diagnosis of PTSD was made using the Child PTSD Symptom Scale (CPSS) and DSM-IV criteria. The data were analyzed with chi-square tests and multivariate logistic regression analysis with 95% confidence intervals (CI). A total of 262 children were enrolled in this study. The prevalence of PTSD in these children was 20.6%. On multivariate analysis, having experienced a delay in evacuation (PR = 4.5; 95% CI: 2.794-13.80; p < 0.001) and being unable to escape (PR = 13.07; 95% CI: 5.884-64; p < 0.001) were significantly associated with PTSD 5 years after the tsunami. Children who experienced a traumatic event in which they were unable to escape or when there is a delay in evacuation are at risk of developing PTSD and need appropriate treatment.

Selecting the minimum prediction base of historical data to perform 5-year predictions of the cancer burden: The GoF-optimal method.

PubMed

Valls, Joan; Castellà, Gerard; Dyba, Tadeusz; Clèries, Ramon

2015-06-01

Predicting the future burden of cancer is a key issue for health services planning, where a method for selecting the predictive model and the prediction base is a challenge. A method, named here Goodness-of-Fit optimal (GoF-optimal), is presented to determine the minimum prediction base of historical data to perform 5-year predictions of the number of new cancer cases or deaths. An empirical ex-post evaluation exercise for cancer mortality data in Spain and cancer incidence in Finland using simple linear and log-linear Poisson models was performed. Prediction bases were considered within the time periods 1951-2006 in Spain and 1975-2007 in Finland, and then predictions were made for 37 and 33 single years in these periods, respectively. The performance of three fixed different prediction bases (last 5, 10, and 20 years of historical data) was compared to that of the prediction base determined by the GoF-optimal method. The coverage (COV) of the 95% prediction interval and the discrepancy ratio (DR) were calculated to assess the success of the prediction. The results showed that (i) models using the prediction base selected through GoF-optimal method reached the highest COV and the lowest DR and (ii) the best alternative strategy to GoF-optimal was the one using the base of prediction of 5-years. The GoF-optimal approach can be used as a selection criterion in order to find an adequate base of prediction. Copyright © 2015 Elsevier Ltd. All rights reserved.

Sex Differences in the Management and 5-Year Outcome of Young Patients (<55 Years) with Acute Coronary Syndromes.

PubMed

Sabbag, Avi; Matetzky, Shlomi; Porter, Avital; Iakobishvili, Zaza; Moriel, Mady; Zwas, Donna; Fefer, Paul; Asher, Elad; Beigel, Roy; Gottlieb, Shmuel; Goldenberg, Ilan; Segev, Amit

2017-11-01

Young women are usually protected against coronary artery disease due to hormonal and risk-factor profile. Previous studies have suggested poorer outcome in women hospitalized with acute coronary syndrome as compared with men. However, when adjusted for age and other risk factors, this difference does not remain significant. We compared the risk profile and outcome between young (≤55 years) women and men admitted with acute coronary syndrome. We analyzed clinical characteristics, management strategies, and outcomes of men and women ≤55 years of age enrolled in the biennial Acute Coronary Syndrome Israeli Surveys between 2000 and 2013. Among 11,536 patients enrolled, 3949 (34%) were ≤55 years old (407 women, 3542 men). Women were slightly older (48.9 ± 5.7 vs 48.3 ± 5.5, P = .007) and suffered more from diabetes (34% vs 24%) and hypertension (47% vs 37%, P <.001 for both). Rates of prior myocardial infarction were high in both sexes (18% vs 21%). Women presented less often with ST-elevation myocardial infarction (50% vs 57%, P = .007) and with typical chest pain (73% vs 80%, P = .004), and had higher rates of Global Registry of Acute Coronary Events (GRACE) score ≥140 (19% vs 12%, P = .007). After adjustment for GRACE score, diabetes, and enrollment year, women had a lower likelihood to undergo coronary angiography during hospitalization (odds ratio 0.6, P = .007). Female sex was independently associated with higher risk of in-hospital mortality (hazard ratio [HR] 4.1; 95% confidence interval [CI], 1.15-14.0), 30-day major adverse cardiac and cerebral events (HR 2.1; 95% CI, 1.31-3.36), and 5-year mortality (HR 1.96; 95% CI, 1.3-2.8). Young women admitted with acute coronary syndrome are a unique high-risk group that presents a diagnostic challenge for clinicians. Women receive less invasive therapy during hospitalization and have worse in-hospital and long-term outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

Breast cancer, sickness absence, income and marital status. A study on life situation 1 year prior diagnosis compared to 3 and 5 years after diagnosis.

PubMed

Eaker, Sonja; Wigertz, Annette; Lambert, Paul C; Bergkvist, Leif; Ahlgren, Johan; Lambe, Mats

2011-03-30

Improved cancer survival poses important questions about future life conditions of the survivor. We examined the possible influence of a breast cancer diagnosis on subsequent working and marital status, sickness absence and income. We conducted a matched cohort study including 4,761 women 40-59 years of age and registered with primary breast cancer in a Swedish population-based clinical register during 1993-2003, and 2,3805 women without breast cancer. Information on socioeconomic standing was obtained from a social database 1 year prior and 3 and 5 years following the diagnosis. In Conditional Poisson Regression models, risk ratios (RRs) and 95% confidence intervals (CIs) were estimated to assess the impact of a breast cancer diagnosis. Three years after diagnosis, women who had had breast cancer more often had received sickness benefits (RR = 1.49, 95% CI 1.40-1.58) or disability pension (RR = 1.47, 95% CI 1.37-1.58) than had women without breast cancer. We found no effect on income (RR = 0.99), welfare payments (RR = 0.98), or marital status (RR = 1.02). A higher use of sickness benefits and disability pension was evident in all stages of the disease, although the difference in use of sickness benefits decreased after 5 years, whereas the difference in disability pension increased. For woman with early stage breast cancer, the sickness absence was higher following diagnosis among those with low education, who had undergone mastectomy, and had received chemo- or hormonal therapy. Neither tumour size nor presence of lymph nodes metastasis was associated with sickness absence after adjustment for treatment. Even in early stage breast cancer, a diagnosis negatively influences working capacity both 3 and 5 years after diagnosis, and it seems that the type of treatment received had the largest impact. A greater focus needs to be put on rehabilitation of breast cancer patients, work-place adaptations and research on long-term sequelae of treatment.

Social influence on 5-year survival in a longitudinal chemotherapy ward co-presence network.

PubMed

Lienert, Jeffrey; Marcum, Christopher Steven; Finney, John; Reed-Tsochas, Felix; Koehly, Laura

2017-09-01

Chemotherapy is often administered in openly designed hospital wards, where the possibility of patient-patient social influence on health exists. Previous research found that social relationships influence cancer patient's health; however, we have yet to understand social influence among patients receiving chemotherapy in the hospital. We investigate the influence of co-presence in a chemotherapy ward. We use data on 4,691 cancer patients undergoing chemotherapy in Oxfordshire, United Kingdom who average 59.8 years of age, and 44% are Male. We construct a network of patients where edges exist when patients are co-present in the ward, weighted by both patients' time in the ward. Social influence is based on total weighted co-presence with focal patients' immediate neighbors, considering neighbors' 5-year mortality. Generalized estimating equations evaluated the effect of neighbors' 5-year mortality on focal patient's 5-year mortality. Each 1,000-unit increase in weighted co-presence with a patient who dies within 5 years increases a patient's mortality odds by 42% ( β = 0.357, CI:0.204,0.510). Each 1,000-unit increase in co-presence with a patient surviving 5 years reduces a patient's odds of dying by 30% ( β = -0.344, CI:-0.538,0.149). Our results suggest that social influence occurs in chemotherapy wards, and thus may need to be considered in chemotherapy delivery.

Balanitis xerotica obliterans in children and its incidence under the age of 5 years.

PubMed

Jayakumar, S; Antao, B; Bevington, O; Furness, P; Ninan, G K

2012-06-01

To analyse the incidence of BXO among paediatric circumcisions for preputial pathology, in particular in children under the age of 5 years. Retrospective review revealed 1769 paediatric circumcisions performed between 1997 and 2008 at our institution. Data were collected on patient's age, date when sample received by pathology department and histological findings for all the foreskin samples received and examined during the study period. Epidemiological data were obtained from the Office for National Statistics, UK. A total of 346 foreskin samples were received and BXO was found in 182 (52.6%). There were 31 children under the age of 5 years circumcised for preputial pathology. BXO was reported in 6 (19.3%) and chronic inflammation in 16 (51.6%) of these patients. The foreskin was reported normal in 2 (6.5%) and the remaining 7 (22.6%) patients had preputial cysts or other pathology. Epidemiological population data analysis revealed the incidence of BXO per year to be 3.01 cases/1000 boys under 15 years of age and 0.322 cases/1000 boys under 5 years. The incidence of BXO in boys noted in our study is higher than previously reported. BXO can result in significant complications and should be considered in children even under 5 years. Copyright © 2011 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Application of Multi-Model CMIP5 Analysis in Future Drought Adaptation Strategies

NASA Astrophysics Data System (ADS)

Casey, M.; Luo, L.; Lang, Y.

2014-12-01

Drought influences the efficacy of numerous natural and artificial systems including species diversity, agriculture, and infrastructure. Global climate change raises concerns that extend well beyond atmospheric and hydrological disciplines - as climate changes with time, the need for system adaptation becomes apparent. Drought, as a natural phenomenon, is typically defined relative to the climate in which it occurs. Typically a 30-year reference time frame (RTF) is used to determine the severity of a drought event. This study investigates the projected future droughts over North America with different RTFs. Confidence in future hydroclimate projection is characterized by the agreement of long term (2005-2100) multi-model precipitation (P) and temperature (T) projections within the Coupled model Intercomparison Project Phase 5 (CMIP5). Drought severity and the propensity of extreme conditions are measured by the multi-scalar, probabilistic, RTF-based Standard Precipitation Index (SPI) and Standard Precipitation Evapotranspiration Index (SPEI). SPI considers only P while SPEI incorporates Evapotranspiration (E) via T; comparing the two reveals the role of temperature change in future hydroclimate change. Future hydroclimate conditions, hydroclimate extremity, and CMIP5 model agreement are assessed for each Representative Concentration Pathway (RCP 2.6, 4.5, 6.0, 8.5) in regions throughout North America for the entire year and for the boreal seasons. In addition, multiple time scales of SPI and SPEI are calculated to characterize drought at time scales ranging from short to long term. The study explores a simple, standardized method for considering adaptation in future drought assessment, which provides a novel perspective to incorporate adaptation with climate change. The result of the analysis is a multi-dimension, probabilistic summary of the hydrological (P, E) environment a natural or artificial system must adapt to over time. Studies similar to this with

Effect of breastfeeding on common pediatric infections: a 5-year prospective cohort study.

PubMed

Ardiç, Cüneyt; Yavuz, Erdinç

2018-04-01

The studies conducted revealed that breastfeeding duration has a reducing effect on common infectious diseases in the children during breastfeeding period. The aim of the present study was to address the association between breastfeeding duration and common infectious diseases in the children until 5 years of age to show long-term protective effects of the breast milk. The study included 411 infants who were born in Rize (Turkey) between January 2011 and December 2011. The present prospective-cohort study lasted for 5 years and 11 interviews were conducted with each mother of the infants during this period. The infants were divided into two groups as those who were breastfed more and less than 12 months and the association between breastfeeding and infections such as acute otitis media, acute gastroenteritis, acute respiratory tract infections and acute urinary system infections was investigated. Of 270 infants 193 (71.5%) were breastfed longer than 12 months and 77 (28.5%) were breastfed less than 12 months. Infants in the first group had less acute otitis media and acute gastroenteritis (n= 77, 28.52%) when compared with the infants breastfed less than 12 months during 5-year period (p <0.05). The present study detected that breastfeeding duration longer than 12 months significantly reduces the common childhood infections such as otitis media and gastroenteritis during the first 5 years of life. Sociedad Argentina de Pediatría.

Development problems were common five years after positive screening for language disorders and, or, autism at 2.5 years of age.

PubMed

Miniscalco, Carmela; Fernell, Elisabeth; Thompson, Lucy; Sandberg, Eva; Kadesjö, Björn; Gillberg, Christopher

2018-04-10

This study identified whether children who had screened positive for either developmental language disorder (DLD) or autism spectrum disorder (ASD) at the age of 2.5 years had neurodevelopmental assessments five years later. Our study cohort were 288 children born from 1 July 2008 to 20 June 2009 who screened positive for DLD and, or, ASD at 2.5 years. Of these, 237 children were referred to, and assessed, at the Paediatric Speech and Language Pathology clinic (n = 176) or the Child Neuropsychiatry Clinic (n = 61) at the Queen Silvia Children's Hospital, Gothenburg, Sweden. Clinical registers covering all relevant outpatient clinics were reviewed five years later with regard to established diagnoses. When the 237 were followed up five years later, 96 (40%) had established neurodevelopmental disorders or problems, often beyond DLD and ASD. Co-existing problems were common in this cohort and multidisciplinary assessments were indicated. The other 60% did not appear in subsequent clinic records. It is likely that this 40% was a minimum rate and that more children will be referred for developmental problems later. Five years after they had been screened positive for DLD and, or autism at 2.5 years, 40% of our cohort had remaining or other developmental problems. ©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

The German Lipoprotein Apheresis Registry (GLAR) - almost 5 years on.

PubMed

Schettler, V J J; Neumann, C L; Peter, C; Zimmermann, T; Julius, U; Roeseler, E; Heigl, F; Grützmacher, P; Blume, H; Vogt, A

2017-03-01

Since 2005 an interdisciplinary German apheresis working group has been established by members of both German Societies of Nephrology and of Lipidologists and completed the data set for the registry according to the current guidelines and the German indication guideline for apheresis in 2009. In 2011 the German Lipoprotein Apheresis Registry (GLAR) was launched and data are available over nearly 5 years now. During the time period 2012-2016, 71 German apheresis centers collected retrospective and prospective observational data of 1435 patients undergoing lipoprotein apheresis (LA) treatment of high LDL-C levels and/or high Lp (a) levels suffering from cardiovascular disease (CVD) or progressive CVD. A total of 15,527 completely documented LA treatments were entered into the database. All patients treated by LA showed a median LDL-C reduction rate of 67.5%, and a median Lp (a) reduction rate of 71.1%. Analog to the Pro(a)LiFe pattern, patient data were analyzed to the incidence rate of coronary events (MACE) 1 and 2 years before the beginning of LA treatment (y-2 and y‑1) and prospectively two years on LA treatment (y + 1 and y + 2). During two years of LA treatment a MACE reduction of 78% was observed. In the years considered, side effects of LA treatment were low (5.9%) and mainly comprised puncture problems. The data generated by the GLAR shows that LA lowers the incidence rate of cardiovascular events in patients with high LDL-C and/or high Lp (a) levels, progressive CVD, and maximally tolerated lipid lowering medication. In addition, LA treatments were found to be safe with a low rate of side effects.

5-Year Longitudinal Follow-up after Retropubic and Transobturator Midurethral Slings

PubMed Central

Kenton, Kimberly; Stoddard, Anne M.; Zyczynski, Halina; Albo, Michael; Rickey, Leslie; Norton, Peggy; Wai, Clifford; Kraus, Stephen R.; Sirls, Larry T.; Kusek, John W.; Litman, Heather J.; Chang, Robert P.; Richter, Holly E.

2014-01-01

Background Few studies have characterized longer-term outcomes after retropubic and transobturator midurethral slings. Methods Women completing 2-year participation in a randomized equivalence trial who had not received surgical retreatment for stress urinary incontinence were invited to participate in a 5-year observational cohort. The primary outcome, treatment success, was defined as no retreatment or self-reported stress incontinence symptoms. Secondary outcomes included urinary symptoms and quality of life, satisfaction, sexual function and adverse events. Results 404 of 597 (68%) women from the original trial enrolled. Five-years after surgical treatment, success was 7.9% greater in women assigned to retropubic-sling compared to transobturator-sling (51.3% vs 43.4%, 95% CI −1.4%, 17.2%) not meeting pre-specified criteria for equivalence. Satisfaction decreased over 5-years, but remained high and similar between arms (79%, retropubic-sling vs 85%, transobturator-sling groups, p=0.15). Urinary symptoms and quality of life worsened over time (p<0.001), and women with retropubic-sling reported greater urinary urgency (P=0.001), more negative quality of life impact (p=0.02), and worse sexual function (P=0.001). There was no difference in proportion of women experiencing at least 1 adverse event (p=0.17). Seven new mesh erosions were noted (retropubic-sling-3, transobturator-sling-4). Conclusion Treatment success declined over 5-years for retropubic and transobturator-slings and did not meet pre-specified criteria for equivalence with retropubic demonstrating a slight benefit. However, satisfaction remained high in both arms. Women undergoing transobturator-sling reported more sustained improvement in urinary symptoms and sexual function. New mesh erosions occurred in both arms over time, although at a similarly low rate. PMID:25158274

Mothers’ Perceived Neighbourhood Environment and Outdoor Play of 2- to 3.5-Year-Old Children: Findings from the Healthy Beginnings Trial

PubMed Central

Xu, Huilan; Wen, Li Ming; Hardy, Louise L.; Rissel, Chris

2017-01-01

Background: This study aims to investigate whether mothers’ perceived neighbourhood environment is associated with outdoor playtime of 2- to 3.5-year-old children. Methods: Cross-sectional analyses were conducted using data from the Healthy Beginnings Trial (HBT). Data on children’s outdoor playtime and mothers’ perceived neighbourhood environment were collected through face-to-face interviews with mothers when their children were 2 and 3.5 years old. Walk score was obtained from a publicly available website and population density data were obtained from Australian Census data. Multiple logistic regression models were built to investigate these associations. Results: A total of 497 and 415 mother-child dyads were retained at 2 years and 3.5 years. After adjusting for intervention group allocation and other confounding factors, at 2 years, mothers’ perceptions that ‘the neighbourhood is a good place to bring up children’, ‘it is safe to play outside during the day’, and ‘there are good parks or playgrounds in neighbourhood’ were positively associated with children’s outdoor playtime. At 3.5 years, living in a free-standing house was associated with more children’s outdoor playtime. Conclusions: Children may benefit from living in a neighbourhood that supports active lifestyle. Improving social and physical environments in neighbourhoods could be an important strategy for improving young children’s physical activity. PMID:28927015

The modelled surface mass balance of the Antarctic Peninsula at 5.5 km horizontal resolution

NASA Astrophysics Data System (ADS)

van Wessem, J. M.; Ligtenberg, S. R. M.; Reijmer, C. H.; van de Berg, W. J.; van den Broeke, M. R.; Barrand, N. E.; Thomas, E. R.; Turner, J.; Wuite, J.; Scambos, T. A.; van Meijgaard, E.

2016-02-01

This study presents a high-resolution (˜ 5.5 km) estimate of surface mass balance (SMB) over the period 1979-2014 for the Antarctic Peninsula (AP), generated by the regional atmospheric climate model RACMO2.3 and a firn densification model (FDM). RACMO2.3 is used to force the FDM, which calculates processes in the snowpack, such as meltwater percolation, refreezing and runoff. We evaluate model output with 132 in situ SMB observations and discharge rates from six glacier drainage basins, and find that the model realistically simulates the strong spatial variability in precipitation, but that significant biases remain as a result of the highly complex topography of the AP. It is also clear that the observations significantly underrepresent the high-accumulation regimes, complicating a full model evaluation. The SMB map reveals large accumulation gradients, with precipitation values above 3000 mm we yr-1 in the western AP (WAP) and below 500 mm we yr-1 in the eastern AP (EAP), not resolved by coarser data sets such as ERA-Interim. The average AP ice-sheet-integrated SMB, including ice shelves (an area of 4.1 × 105 km2), is estimated at 351 Gt yr-1 with an interannual variability of 58 Gt yr-1, which is dominated by precipitation (PR) (365 ± 57 Gt yr-1). The WAP (2.4 × 105 km2) SMB (276 ± 47 Gt yr-1), where PR is large (276 ± 47 Gt yr-1), dominates over the EAP (1.7 × 105 km2) SMB (75 ± 11 Gt yr-1) and PR (84 ± 11 Gt yr-1). Total sublimation is 11 ± 2 Gt yr-1 and meltwater runoff into the ocean is 4 ± 4 Gt yr-1. There are no significant trends in any of the modelled AP SMB components, except for snowmelt that shows a significant decrease over the last 36 years (-0.36 Gt yr-2).

Ready, Set, Grow! Health Education for 3-5 Year Olds.

ERIC Educational Resources Information Center

Peterson, Paula J.

Intended for use in family day care, preschool centers, professional preparation institutions, and in homes, this comprehensive health education curriculum for 3- through 5-year-old children contains units designed to sequentially teach concepts about physical health, mental health, family living, and safety. Contents include the following…

The two types of ENSO in CMIP5 models

NASA Astrophysics Data System (ADS)

Kim, Seon Tae; Yu, Jin-Yi

2012-06-01

In this study, we evaluate the intensity of the Central-Pacific (CP) and Eastern-Pacific (EP) types of El Niño-Southern Oscillation (ENSO) simulated in the pre-industrial, historical, and the Representative Concentration Pathways (RCP) 4.5 experiments of the Coupled Model Intercomparison Project Phase 5 (CMIP5). Compared to the CMIP3 models, the pre-industrial simulations of the CMIP5 models are found to (1) better simulate the observed spatial patterns of the two types of ENSO and (2) have a significantly smaller inter-model diversity in ENSO intensities. The decrease in the CMIP5 model discrepancies is particularly obvious in the simulation of the EP ENSO intensity, although it is still more difficult for the models to reproduce the observed EP ENSO intensity than the observed CP ENSO intensity. Ensemble means of the CMIP5 models indicate that the intensity of the CP ENSO increases steadily from the pre-industrial to the historical and the RCP4.5 simulations, but the intensity of the EP ENSO increases from the pre-industrial to the historical simulations and then decreases in the RCP4.5 projections. The CP-to-EP ENSO intensity ratio, as a result, is almost the same in the pre-industrial and historical simulations but increases in the RCP4.5 simulation.

The copper-7 intrauterine contraceptive device: 5-year evaluation.

PubMed Central

Sellors, J. W.

1981-01-01

Over a 5-year period a family practitioner inserted copper-7 (Cu-7 intrauterine contraceptive devices (IUDs) in 134 women. The rates of continued use after 2 years, 53.0% for the women's first IUD and 63.9% for all their IUDs, and of accidental pregnancy, 2.4%, are comparable to those in the literature. However, in this series the rate of expulsion was 0.8%, much lower than that in the literature. Fertility did not appear to be reduced in women who planned to have pregnancies after the device was removed. A carefully scrutinized technique of insertion and conscientious follow-up make the Cu-7 IUD an acceptable form of contraception for many patients in a family practice. PMID:7326653

Risk factors for atopic dermatitis in New Zealand children at 3.5 years of age.

PubMed

Purvis, D J; Thompson, J M D; Clark, P M; Robinson, E; Black, P N; Wild, C J; Mitchell, E A

2005-04-01

The prevalence of atopic dermatitis (AD) is increasing in Western societies. The hygiene hypothesis proposes that this is due to reduced exposure to environmental allergens and infections during early life. To examine factors associated with a diagnosis of AD at 3.5 years of age, especially those factors implicated by the hygiene hypothesis. The Auckland Birthweight Collaborative study is a case-control study of risk factors for small for gestational age babies. Cases were born at term with birthweight < or = 10th centile; controls were appropriate for gestational age, with birthweight > 10th centile. The infants were assessed at birth, 1 year and 3.5 years of age. Data were collected by parental interview and examination of the child. AD was defined as the presence of an itchy rash in the past 12 months with three or more of the following: history of flexural involvement; history of generally dry skin; history of atopic disease in parents or siblings; and visible flexural dermatitis as per photographic protocol. Statistical analyses took into account the disproportionate sampling of the study population. Analysis was restricted to European subjects. Eight hundred and seventy-one children were enrolled at birth, 744 (85.4%) participated at 1 year, and 550 (63.2%) at 3.5 years. AD was diagnosed in 87 (15.8%) children seen at 3.5 years. The prevalence of AD did not differ by birthweight. AD at 3.5 years was associated with raised serum IgE > 200 kU L(-1), and wheezing, asthma, rash or eczema at 1 year. In multivariate analysis, adjusted for parental atopy and breastfeeding, AD at 3.5 years was associated with atopic disease in the parents: maternal atopy only, adjusted odds ratio (OR) 3.83, 95% confidence interval (CI) 1.20-12.23; paternal atopy only, adjusted OR 3.59, 95% CI 1.09-11.75; both parents atopic, adjusted OR 6.12, 95% CI 2.02-18.50. There was a higher risk of AD with longer duration of breastfeeding: < 6 months, adjusted OR 6.13, 95% CI 1.45-25.86; > or

Progressive Tinnitus Management Level 3 Skills Education: A 5-Year Clinical Retrospective.

PubMed

Edmonds, Catherine M; Ribbe, Cheri; Thielman, Emily J; Henry, James A

2017-09-18

The primary purpose of this study was to determine whether progressive tinnitus management Level 3 skills education workshops conducted at the Bay Pines and Boston Veterans Affairs hospitals result in consistent use of the presented tinnitus management strategies by patients 1-5 years after completing the workshops. In fiscal year (FY) 2015, the tinnitus workshop follow-up form was mailed to all veterans who completed the Level 3 workshops between FY 2010 and FY 2014. Data were compiled to determine which, if any, of the skills taught in the workshops were being used 1-5 years after completion of the workshops and the impact on quality-of-life indicators. All self-management skills were being utilized up to 5 years postcompletion; therapeutic sound was utilized the most. The majority of patients reported an improved ability to manage reactions to tinnitus and improved quality-of-life indicators. Over 90% of patients from both sites recommended the program to others with tinnitus. The self-management skills taught in the progressive tinnitus management Level 3 workshops are sustained over time even when limited resources prevent the full complement of workshops or the involvement of mental health services. The workshops can also be successfully implemented through remote delivery via videoconferencing (telehealth). https://doi.org/10.23641/asha.5370883.

Shigella infection in children under 5 years old in western French Guiana.

PubMed

Parisot, M; Parez, N; Boukhari, R; Breurec, S; Jolivet, A

2018-04-15

French Guiana, a tropical country, is characterised by a young and multi-ethnic population. Difficulties in accessing safe water sources lead to outbreaks of gastroenteritis. The objectives of this study were (1) to describe the microbiological profile of shigella strains isolated in western French Guiana, including antimicrobial susceptibility and the distribution of strains in terms of species and serotypes and (2) to estimate the incidence of shigellosis in children under 5 years old. A retrospective observational study was conducted of 213 cases of shigellosis diagnosed in the biology department of the hospital centre for western French Guiana between 2000 and 2012 in children under 5 years old. The serogroups (formerly known as species) that predominates in French Guiana was Shigella flexneri. No resistance was observed to fluoroquinolones or to third-generation cephalosporins. The average incidence of shigellosis in children under 5 years old in western French Guiana was estimated at 189.6 cases per 100 000 inhabitants per year. Shigellosis is a public health problem in western French Guiana. These infections suggest the difficulties in accessing safe water sources and the lack of public sanitation. A quadrivalent vaccine containing Shigella sonnei and three serotypes of S. flexneri (S. flexneri 2a, 3a and 6) could provide broad coverage against shigella infections.

The effects of booster vaccination of hepatitis B vaccine on children 5-15 years after primary immunization: A 5-year follow-up study.

PubMed

Wu, Zikang; Yao, Jun; Bao, Hongdan; Chen, Yongdi; Lu, Shunshun; Li, Jing; Yang, Linna; Jiang, Zhenggang; Ren, Jingjing; Xu, Kai-Jin; Ruan, Bing; Yang, Shi-Gui; Xie, Tian-Sheng; Li, Qian

2018-05-04

The aim of this study was to evaluate changes in hepatitis B surface antibody titers (anti-HBs) after booster vaccinations in children aged 5-15 y and to provide suitable immunization strategies. A total of 2208 children were initially enrolled in screening, and 559 children were finally included. The participants were divided into 2 groups according to their pre-booster anti-HBs levels: Group I, <10 mIU/ml and Group II, ≥10 mIU/ml. Group I was administered 3 doses of booster hepatitis B vaccine (0-1-6 months, 10 μg), and Group II was administered 1 dose of booster hepatitis B vaccine (10 μg). The antibody titer changes were examined at 4 time points: 1 month after dose 1 and dose 3, and 1 year and 5 years after dose 3. The protective seroconversion rates at those points were 95.65%, 99.67%, 97.59% and 91.05% (p < 0.001), respectively, in Group I, and 100.00%, 99.87%, 99.66% and 98.21% (χ 2 = 6.04, p = 0.11), respectively, in Group II. The GMT in subjects aged 5-9 y were higher than that in subjects aged 10-15 y in both Group I and Group II at 1 month after dose 1, but no difference was observed at the other three time points. This study demonstrates that booster vaccination has a good medium-term effect. A booster dose for subjects with protective antibodies is not necessary but effective, and 3 doses of hepatitis B vaccination are recommended for those who have lost immunological memory. Receiving booster immunization at the age of 10-15 years may be more appropriate for individuals living in HBV high epidemic areas.

Scabies increased the risk of chronic kidney disease: a 5-year follow-up study.

PubMed

Chung, S-D; Wang, K-H; Huang, C-C; Lin, H-C

2014-03-01

The most documented complication of scabies has been reported to be infection by group A streptococci, which has in turn been suggested to contribute to the development of glomerulonephritis. This study aimed to investigate the risk of chronic kidney disease (CKD) subsequent to scabies utilizing a population-based dataset in Taiwan. This retrospective matched-cohort study included 5071 subjects with scabies and 25 355 randomly selected comparison subjects. We individually tracked each subject for a 5-year period to identify those who subsequently received a diagnosis of CKD during the follow-up period. Stratified Cox proportional hazards regressions were performed to compute the hazard ratio (HR) of CKD during the 5-year follow-up period. The incidence rate of CKD during the 5-year follow-up period was 9.66 (8.51-10.93) per 1,000 person-years and 6.24 (5.82-6.69) per 1000 person-years for subjects with and without scabies respectively. The HR for CKD during the 5-year follow-up period for subjects with scabies was 1.34 (95% CI = 1.15-1.56) that of comparison subjects after adjusting for monthly income, hypertension, diabetes, obesity, stroke, coronary heart disease, chronic obstructive pulmonary disease, tobacco use disorder, hyperlipidemia and alcohol abuse during the 5-year follow-up period. Male subjects with scabies were 1.40 (95% CI = 1.14-1.71) times more likely than comparison subjects to suffer from subsequent CKD, and female study subjects were 1.27 (95% CI = 1.05-1.61) times more likely. We concluded that there was an increased risk for CKD among patients suffering from scabies. © 2013 The Authors Journal of the European Academy of Dermatology and Venereology © 2013 European Academy of Dermatology and Venereology.

Model year 2002 fuel economy guide

DOT National Transportation Integrated Search

2001-01-01

The Fuel Economy Guide is published by the U.S. Department of Energy as an aid to consumers considering the purchase of a new vehicle. The Guide lists estimates of miles per gallon (mpg) for each vehicle available for the new model year. The Guide is...

Association of parents' and children's physical activity and sedentary time in Year 4 (8-9) and change between Year 1 (5-6) and Year 4: a longitudinal study.

PubMed

Jago, Russell; Solomon-Moore, Emma; Macdonald-Wallis, Corrie; Thompson, Janice L; Lawlor, Deborah A; Sebire, Simon J

2017-08-17

Parents could be important influences on child physical activity and parents are often encouraged to be more active with their child. This paper examined the association between parent and child physical activity and sedentary time in a UK cohort of children assessed when the children were in Year 1 (5-6 years old) and in Year 4 (8-9 years old). One thousand two hundred twenty three children and parents provided data in Year 4 and of these 685 participated in Year 1. Children and parents wore an accelerometer for five days including a weekend. Mean minutes of sedentary time and moderate-to-vigorous intensity physical activity (MVPA) were derived. Multiple imputation was used to impute all missing data and create complete datasets. Linear regression models examined whether parent MVPA and sedentary time at Year 4 and at Year 1 predicted child MVPA and sedentary time at Year 4. Change in parent MVPA and sedentary time was used to predict change in child MVPA and sedentary time between Year 1 and Year 4. Imputed data showed that at Year 4, female parent sedentary time was associated with child sedentary time (0.13, 95% CI = 0.00 to 0.27 mins/day), with a similar association for male parents (0.15, 95% CI = -0.02 to 0.32 mins/day). Female parent and child MVPA at Year 4 were associated (0.16, 95% CI = 0.08 to 0.23 mins/day) with a smaller association for male parents (0.08, 95% CI = -0.01 to 0.17 mins/day). There was little evidence that either male or female parent MVPA at Year 1 predicted child MVPA at Year 4 with similar associations for sedentary time. There was little evidence that change in parent MVPA or sedentary time predicted change in child MVPA or sedentary time respectively. Parents who were more physically active when their child was 8-9 years old had a child who was more active, but the magnitude of association was generally small. There was little evidence that parental activity from three years earlier predicted child activity at age 8-9, or

The development of personal models of diabetes in the first 2 years after diagnosis: a prospective longitudinal study.

PubMed

Lawson, V L; Bundy, C; Harvey, J N

2008-04-01

Personal models of diabetes comprise beliefs about symptoms, treatment effectiveness, consequences and emotional responses to possible future complications. They are associated with, and influence, self-care behaviour. Little work has examined potential influences on the development and maintenance of personal models. The aims of this study were: (i) to assess changes in personal models over 2 years from diagnosis of diabetes; and (ii) to examine the relative contributions of health threat communication (at diagnosis, since diagnosis, during follow-up care) and personality to personal models of diabetes 2 years post-diagnosis. Newly diagnosed patients were interviewed at diagnosis (< 3 months; time 1) and 6 months (time 2), 1 year (time 3) and 2 years (time 4) after diagnosis. Data were available for 158 patients at time 1 (32 Type 1 patients and 126 Type 2 patients), 147 at time 2, 142 at time 3 and 138 at time 4. Perceptions of symptoms, consequences, course and control of diabetes remained stable over time. Emotional responses decreased and illness coherence (perceived understanding) increased over time. Health threat communication was a stronger predictor of personal models than personality. Emotional responses to diabetes 2 years after diagnosis were predicted by perceptions of a threatening health message (at diagnosis 18%, at follow-up 5%). Health threat communication predicted perceptions of serious consequences (at diagnosis 5%, at follow-up 9%). Perceptions of a reassuring message during follow-up were related to beliefs of treatment effectiveness (26%). The communication of information and the way it is perceived is an important determinant of the patient's view of their diabetes. The initial effects of the education process at diagnosis persisted 2 years after diagnosis.

Cross-Scale Modelling of Subduction from Minute to Million of Years Time Scale

NASA Astrophysics Data System (ADS)

Sobolev, S. V.; Muldashev, I. A.

2015-12-01

Subduction is an essentially multi-scale process with time-scales spanning from geological to earthquake scale with the seismic cycle in-between. Modelling of such process constitutes one of the largest challenges in geodynamic modelling today.Here we present a cross-scale thermomechanical model capable of simulating the entire subduction process from rupture (1 min) to geological time (millions of years) that employs elasticity, mineral-physics-constrained non-linear transient viscous rheology and rate-and-state friction plasticity. The model generates spontaneous earthquake sequences. The adaptive time-step algorithm recognizes moment of instability and drops the integration time step to its minimum value of 40 sec during the earthquake. The time step is then gradually increased to its maximal value of 5 yr, following decreasing displacement rates during the postseismic relaxation. Efficient implementation of numerical techniques allows long-term simulations with total time of millions of years. This technique allows to follow in details deformation process during the entire seismic cycle and multiple seismic cycles. We observe various deformation patterns during modelled seismic cycle that are consistent with surface GPS observations and demonstrate that, contrary to the conventional ideas, the postseismic deformation may be controlled by viscoelastic relaxation in the mantle wedge, starting within only a few hours after the great (M>9) earthquakes. Interestingly, in our model an average slip velocity at the fault closely follows hyperbolic decay law. In natural observations, such deformation is interpreted as an afterslip, while in our model it is caused by the viscoelastic relaxation of mantle wedge with viscosity strongly varying with time. We demonstrate that our results are consistent with the postseismic surface displacement after the Great Tohoku Earthquake for the day-to-year time range. We will also present results of the modeling of deformation of the