2014-01-01
Background The UK Clinical Aptitude Test (UKCAT) was introduced to facilitate widening participation in medical and dental education in the UK by providing universities with a continuous variable to aid selection; one that might be less sensitive to the sociodemographic background of candidates compared to traditional measures of educational attainment. Initial research suggested that males, candidates from more advantaged socioeconomic backgrounds and those who attended independent or grammar schools performed better on the test. The introduction of the A* grade at A level permits more detailed analysis of the relationship between UKCAT scores, secondary educational attainment and sociodemographic variables. Thus, our aim was to further assess whether the UKCAT is likely to add incremental value over A level (predicted or actual) attainment in the selection process. Methods Data relating to UKCAT and A level performance from 8,180 candidates applying to medicine in 2009 who had complete information relating to six key sociodemographic variables were analysed. A series of regression analyses were conducted in order to evaluate the ability of sociodemographic status to predict performance on two outcome measures: A level ‘best of three’ tariff score; and the UKCAT scores. Results In this sample A level attainment was independently and positively predicted by four sociodemographic variables (independent/grammar schooling, White ethnicity, age and professional social class background). These variables also independently and positively predicted UKCAT scores. There was a suggestion that UKCAT scores were less sensitive to educational background compared to A level attainment. In contrast to A level attainment, UKCAT score was independently and positively predicted by having English as a first language and male sex. Conclusions Our findings are consistent with a previous report; most of the sociodemographic factors that predict A level attainment also predict UKCAT performance. However, compared to A levels, males and those speaking English as a first language perform better on UKCAT. Our findings suggest that UKCAT scores may be more influenced by sex and less sensitive to school type compared to A levels. These factors must be considered by institutions utilising the UKCAT as a component of the medical and dental school selection process. PMID:24400861
Malka, D; Boige, V; Jacques, N; Vimond, N; Adenis, A; Boucher, E; Pierga, J Y; Conroy, T; Chauffert, B; François, E; Guichard, P; Galais, M P; Cvitkovic, F; Ducreux, M; Farace, F
2012-04-01
We investigated whether circulating endothelial cells (CECs) predict clinical outcome of first-line chemotherapy and bevacizumab in metastatic colorectal cancer (mCRC) patients. In a substudy of the randomized phase II FNCLCC ACCORD 13/0503 trial, CECs (CD45- CD31+ CD146+ 7-amino-actinomycin- cells) were enumerated in 99 patients by four-color flow cytometry at baseline and after one cycle of treatment. We correlated CEC levels with objective response rate (ORR), 6-month progression-free survival (PFS) rate (primary end point of the trial), PFS, and overall survival (OS). Multivariate analyses of potential prognostic factors, including CEC counts and Köhne score, were carried out. By multivariate analysis, high baseline CEC levels were the only independent prognostic factor for 6-month PFS rate (P < 0.01) and were independently associated with worse PFS (P = 0.02). High CEC levels after one cycle were the only independent prognostic factor for ORR (P = 0.03). High CEC levels at both time points independently predicted worse ORR (P = 0.025), 6-month PFS rate (P = 0.007), and PFS (P = 0.02). Köhne score was the only variable associated with OS. CEC levels at baseline and after one treatment cycle may independently predict ORR and PFS in mCRC patients starting first-line bevacizumab and chemotherapy.
Czarnuch, Stephen; Ricciardelli, Rose; Mihailidis, Alex
2016-07-20
The population of people with dementia is not homogeneous. People with dementia exhibit a wide range of needs, each characterized by diverse factors including age, sex, ethnicity, and place of residence. These needs and characterizing factors may influence the applicability, and ultimately the acceptance, of assistive technologies developed to support the independence of people with dementia. Accordingly, predicting the needs of users before developing the technologies may increase the applicability and acceptance of assistive technologies. Current methods of prediction rely on the difficult collection of subjective, potentially invasive information. We propose a method of prediction that uses objective, unobtrusive, easy to collect information to help inform the development of assistive technologies. We develop a set of models that can predict the level of independence of people with dementia during 20 activities of daily living using simple, objective information. Using data collected from a Canadian survey conducted with caregivers of people with dementia, we create an ordered logistic regression model for each of the twenty daily tasks in the Bristol ADL scale. Data collected from 430 Canadian caregivers of people with dementia were analyzed to reveal: most care recipients were mothers or husbands, married, living in private housing with their caregivers, English-speaking, Canadian born, clinically diagnosed with dementia 1 to 6 years prior to the study, and were dependent on their caregiver. Next, we developed models that use 13 factors to predict a person with dementia's ability to complete the 20 Bristol activities of daily living independently. The 13 factors include caregiver relation, age, marital status, place of residence, language, housing type, proximity to caregiver, service use, informal primary caregiver, diagnosis of Alzheimer's disease or dementia, time since diagnosis, and level of dependence on caregiver. The resulting models predicted the aggregate level of independence correctly for 88 of 100 total responses categories, marginally for nine, and incorrectly for three. Objective, easy to collect information can predict caregiver-reported level of task independence for a person with dementia. Knowledge of task independence can then inform the development of assistive technologies for people with dementia, improving their applicability and acceptance.
Effects of perceived stress and uplifts on inflammation and coagulability.
Jain, Shamini; Mills, Paul J; von Känel, Roland; Hong, Suzi; Dimsdale, Joel E
2007-01-01
We investigated whether depressed mood and chronic hassles and uplifts predicted levels of hemostasis markers D-Dimer and type-1 plasminogen activator inhibitor (PAI-1), as well as the proinflammatory markers interleukin-6 (IL-6) and soluble intercellular adhesion molecule-1 (sICAM-1) in 108 healthy individuals. One hundred eight African-American and Euro-American men and women were studied (58 men, 50 women; mean age = 36.5 +/- 8 years). D-Dimer, PAI-1, IL-6, and sICAM-1 plasma levels were analyzed from fasting venous blood samples. Data were analyzed via hierarchical linear regression and followed with partial correlation analysis. Regression analyses combined with partial correlation analyses suggested that increases in hassle frequency predicted elevated levels of sICAM-1 (p= .034), and increases in hassle severity predicted elevated levels of D-Dimer (p= .017). Increases in uplift intensity predicted lower levels of PAI-1 (p= .004) as well as showed a trend for decreased IL-6 (p= .069). Depressed mood did not significantly predict any dependent variable. These results were independent of sociodemographic, biological, and other related mood variables. The findings suggest that for even relatively healthy persons, increased perceptions of hassles are independently associated with greater inflammation and hypercoagulability, whereas increased perceptions of uplifts are independently associated with decreased hypercoagulability.
Xia, Ming-Feng; Bian, Hua; Zhu, Xiao-Peng; Yan, Hong-Mei; Chang, Xin-Xia; Zhang, Lin-Shan; Lin, Huan-Dong; Hu, Xi-Qi; Gao, Xin
2017-06-28
Non-alcoholic fatty liver disease (NAFLD) is a common and strong risk factor for cardiovascular disease and hepatocellular carcinoma. The rapid acceleration of the increase in NAFLD prevalence has exceeded the trends observed for obesity, and has been driven by multiple factors. The aim of this study was to investigate the correlation between the serum levels of folic acid, the endogenous source of methyl groups for DNA methylation, and NAFLD in Chinese adults. The correlations between the serum folic acid levels and NAFLD were investigated in two independent cohorts of 70 subjects who underwent a liver biopsy and 130 subjects with varying liver fat contents, as measured using proton magnetic resonance spectroscopy ( 1 H-MRS). Independent correlations between serum folic acid levels and liver steatosis grades were detected using a multivariate ordinal regression analysis. The diagnostic performances of serum folic acid levels alone and in combination with existing NAFLD prediction scores were compared with those of traditional NAFLD prediction parameters using receiver operating characteristic (ROC) curve analyses. Serum folic acid concentrations were inversely correlated with liver histological steatosis grades (ρ = -0.371, P < 0.001) and the 1 H-MRS-measured liver fat content (r = -0.199, P = 0.038). According to the multivariate ordinal regression analysis, serum folic acid levels were inversely correlated with liver steatosis grades (OR 0.739 [0.594-0.918], P = 0.006) independent of age, gender, BMI, components of metabolic syndrome and the serum TC, LDL-c and HOMA-IR levels. The AUROC of serum folic acid for the diagnosis of NAFLD was 0.75 (0.65-0.83), and the addition of serum folic acid to NAFLD prediction scores significantly improved the diagnostic prediction of NAFLD (AUROC = 0.88 [0.81-0.94]). Low serum folic acid levels were identified as an independent risk factor for NAFLD in the Chinese population. The addition of the serum folic acid levels to the current existing NAFLD prediction scores significantly improved the prediction of NAFLD. Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
Parental Activity as a Determinant of Activity Level and Patterns of Activity in Obese Children.
ERIC Educational Resources Information Center
Kalakanis, Lisa E.; Goldfield, Gary S.; Paluch, Rocco A.; Epstein, Leonard H.
2001-01-01
Investigated the level and pattern of moderate-to-vigorous physical activity (MVPA) in obese children, examining predictors of their activity. Children and their parents wore accelerometers for several days and provided demographic data. Parental activity levels significantly and independently predicted and improved the prediction of children's…
Malec, J F; Buffington, A L; Moessner, A M; Degiorgio, L
2000-08-01
To evaluate initial placement and 1-year employment outcomes of a Medical/Vocational Case Coordination System (MVCCS) for persons with brain injury (BI) that provides: (1) early case identification and coordination, (2) appropriate medical and vocational rehabilitation interventions, (3) work trials, and (4) supported employment interventions including job coaching. One hundred fourteen Minnesota residents, ages 18 to 65 years, with acquired BI. Five levels of Vocational Independence Scale (VIS). Preinjury employment status (VIS) and years of education, severity of initial injury, time since injury, current impairment/disability as measured by the Rasch-analyzed Staff Mayo-Portland Adaptability Inventory (MPAI), and impaired self-awareness measured by staff rating and the difference between Staff MPAI and Survivor MPAI. At placement, 46% in independent work; 25% in transitional placements; 9% in long-term supported employment; 10% in sheltered work; and 10% not placed. At 1-year follow-up (n = 101), 53% in independent work; 19% in transitional placement; 9% in supported work; 6% in sheltered work; and 13% unemployed. Regression analyses showed time since injury and Rasch Staff MPAI predicted VIS at placement; only VIS at placement independently predicted VIS at 1-year follow-up; Rasch Staff MPAI and preinjury education level predicted time to placement. The MVCCS optimized vocational outcome after BI. Time since injury and impairment/disability best predicted vocational placement. Level of initial placement best predicted employment status at follow-up. Persons with greater disability required more extended time and more extensive rehabilitation services before placement.
Ruttle, Paula L; Klein, Marjorie H; Slattery, Marcia J; Kalin, Ned H; Armstrong, Jeffrey M; Essex, Marilyn J
2014-09-01
Prior research has linked either basal cortisol levels or stress-induced cortisol responses to adiposity; however, it remains to be determined whether these distinct cortisol measures exert joint or independent effects. Further, it is unclear how they interact with individual and environmental characteristics to predict adiposity. The present study aims to address whether morning cortisol levels and cortisol responses to a psychosocial stressor independently and/or interactively influence body mass index (BMI) in 218 adolescents (117 female) participating in a longitudinal community study, and whether associations are moderated by sex and exposure to early maternal depression. Reports of maternal depressive symptoms were obtained in infancy and preschool. Salivary cortisol measures included a longitudinal morning cortisol measure comprising sampling points across ages 11, 13, 15, and 18 and measures of stress-induced cortisol responses assessed via the Trier Social Stress Test (TSST) at age 18. Lower morning cortisol and higher TSST cortisol reactivity independently predicted higher age 18 BMI. Morning cortisol also interacted with sex and exposure to early maternal depression to predict BMI. Specifically, girls exposed to lower levels of early maternal depression displayed a strong negative morning cortisol-BMI association, and girls exposed to higher levels of maternal depression demonstrated a weaker negative association. Among boys, those exposed to lower levels of maternal depression displayed no association, while those exposed to higher levels of maternal depression displayed a negative morning cortisol-BMI association. Results point to the independent, additive effects of morning and reactive cortisol in the prediction of BMI and suggest that exposure to early maternal depression may exert sexually dimorphic effects on normative cortisol-BMI associations. Copyright © 2014 Elsevier Ltd. All rights reserved.
Kong, Peng-Zhou; Li, Guang-Ming; Tian, Yin; Song, Bin; Shi, RuYi
2016-08-23
Forkhead box F2 (FOXF2) is relatively limited to the adult lung, but its contribution to non-small cell lung cancer (NSCLC) prognosis is unclear. FOXF2 mRNA levels in NSCLC were lower than that in paired normal lung tissues (P = 0.012). The FOXF2low patients had shorter survival time than the FOXF2high patients (P = 0.024) especially in stage I (P = 0.002), chemotherapy (P = 0.018) and < 60 age groups (P = 0.002). Lower FOXF2 mRNA levels could independently predict poorer survival for patients with NSCLC (HR = 2.384, 95% CI = 1.241-4.577; P = 0.009), especially in stage I (HR =4.367, 95% CI =1.599-11.925; P = 0.004). The two independent datasets confirmed our findings. We examined FOXF2 mRNA levels in 84 primary NSCLC and 8 normal lung tissues using qRT-PCR. Rank-sum tests and chi-square tests were used to assess the differences among groups with various clinicopathological factors. Kaplan-Meier tests were used to compare survival status in patients with different FOXF2 mRNA levels. Cox proportional hazards regression model was used to evaluate the predictive value of FOXF2 mRNA level in NSCLC patients. Independent validation was performed using an independent dataset (98 samples) and an online survival analysis software Kaplan-Meier plotter (1928 samples). Our results demonstrated that decreased FOXF2 expression is an independent predictive factor for poor prognosis of patients with NSCLC, especially in stage I NSCLC.
Rane, Smita; Prabhakar, Bala
2013-07-01
The aim of this study was to investigate the combined influence of 3 independent variables in the preparation of paclitaxel containing pH-sensitive liposomes. A 3 factor, 3 levels Box-Behnken design was used to derive a second order polynomial equation and construct contour plots to predict responses. The independent variables selected were molar ratio phosphatidylcholine:diolylphosphatidylethanolamine (X1), molar concentration of cholesterylhemisuccinate (X2), and amount of drug (X3). Fifteen batches were prepared by thin film hydration method and evaluated for percent drug entrapment, vesicle size, and pH sensitivity. The transformed values of the independent variables and the percent drug entrapment were subjected to multiple regression to establish full model second order polynomial equation. F was calculated to confirm the omission of insignificant terms from the full model equation to derive a reduced model polynomial equation to predict the dependent variables. Contour plots were constructed to show the effects of X1, X2, and X3 on the percent drug entrapment. A model was validated for accurate prediction of the percent drug entrapment by performing checkpoint analysis. The computer optimization process and contour plots predicted the levels of independent variables X1, X2, and X3 (0.99, -0.06, 0, respectively), for maximized response of percent drug entrapment with constraints on vesicle size and pH sensitivity.
Yáñez, Yania; Hervás, David; Grau, Elena; Oltra, Silvestre; Pérez, Gema; Palanca, Sarai; Bermúdez, Mar; Márquez, Catalina; Cañete, Adela; Castel, Victoria
2016-03-01
In metastatic neuroblastoma (NB) patients, accurate risk stratification and disease monitoring would reduce relapse probabilities. This study aims to evaluate the independent prognostic significance of detecting tyrosine hydroxylase (TH) and doublecortin (DCX) mRNAs by reverse transcriptase quantitative polymerase chain reaction (RT-qPCR) in peripheral blood (PB) and bone marrow (BM) samples from metastatic NB patients. RT-qPCR was performed on PB and BM samples from metastatic NB patients at diagnosis, post-induction therapy and at the end of treatment for TH and DCX mRNAs detection. High levels of TH and DCX mRNAs when detected in PB and BM at diagnosis independently predicted worse outcome in a cohort of 162 metastatic NB. In the subgroup of high-risk metastatic NB, TH mRNA detected in PB remained as independent predictor of EFS and OS at diagnosis. After the induction therapy, high levels of TH mRNA in PB and DCX mRNA in BM independently predicted poor EFS and OS. Furthermore TH mRNA when detected in BM predicted worse EFS. TH mRNA in PB samples at the end of treatment is an independent predictor of worse outcome. TH and DCX mRNAs levels in PB and BM assessed by RT-qPCR should be considered in new pre-treatment risk stratification strategies to reliable estimate outcome differences in metastatic NB patients. In those high-risk metastatic NB, TH and DCX mRNA quantification could be used for the assessment of response to treatment and for early detection of progressive disease or relapses.
Rengo, Giuseppe; Pagano, Gennaro; Filardi, Pasquale Perrone; Femminella, Grazia Daniela; Parisi, Valentina; Cannavo, Alessandro; Liccardo, Daniela; Komici, Klara; Gambino, Giuseppina; D’Amico, Maria Loreta; de Lucia, Claudio; Paolillo, Stefania; Trimarco, Bruno; Vitale, Dino Franco; Ferrara, Nicola; Koch, Walter J; Leosco, Dario
2016-01-01
Rationale Sympathetic nervous system (SNS) hyperactivity is associated with poor prognosis in patients with HF, yet routine assessment of SNS activation is not recommended for clinical practice. Myocardial G protein-coupled receptor kinase 2 (GRK2) is up-regulated in heart failure (HF) patients, causing dysfunctional β-adrenergic receptor signaling. Importantly, myocardial GRK2 levels correlate with levels found in peripheral lymphocytes of HF patients. Objective The independent prognostic value of blood GRK2 measurements in HF patients has never been investigated, thus, the purpose of the present study was to evaluate whether lymphocyte GRK2 levels predict clinical outcome in HF patients. Methods and Results We prospectively studied 257 HF patients with mean left ventricular ejection fraction (LVEF) of 31.4±8.5%. At the time of enrollment, plasma norepinephrine, serum NT-proBNP and lymphocyte GRK2 levels, as well as clinical and instrumental variables were measured. The prognostic value of GRK2 to predict cardiovascular (CV) death and all-cause mortality was assessed using the Cox proportional hazard model including demographic, clinical, instrumental and laboratory data. Over a mean follow-up period of 37.5±20.2 months (range: 3–60 months) there were 102 CV deaths. Age, LVEF, NYHA class, Chronic Obstructive Pulmonary Disease, Chronic Kidney Disease, N-terminal-pro Brain Natriuretic Peptide, and lymphocyte GRK2 protein levels were independent predictors of CV mortality in HF patients. GRK2 levels showed an additional prognostic and clinical value over demographic and clinical variables. The independent prognostic value of lymphocyte GRK2 levels was also confirmed for all-cause mortality. Conclusion Lymphocyte GRK2 protein levels can independently predict prognosis in patients with HF. PMID:26884616
The nature and use of prediction skills in a biological computer simulation
NASA Astrophysics Data System (ADS)
Lavoie, Derrick R.; Good, Ron
The primary goal of this study was to examine the science process skill of prediction using qualitative research methodology. The think-aloud interview, modeled after Ericsson and Simon (1984), let to the identification of 63 program exploration and prediction behaviors.The performance of seven formal and seven concrete operational high-school biology students were videotaped during a three-phase learning sequence on water pollution. Subjects explored the effects of five independent variables on two dependent variables over time using a computer-simulation program. Predictions were made concerning the effect of the independent variables upon dependent variables through time. Subjects were identified according to initial knowledge of the subject matter and success at solving three selected prediction problems.Successful predictors generally had high initial knowledge of the subject matter and were formal operational. Unsuccessful predictors generally had low initial knowledge and were concrete operational. High initial knowledge seemed to be more important to predictive success than stage of Piagetian cognitive development.Successful prediction behaviors involved systematic manipulation of the independent variables, note taking, identification and use of appropriate independent-dependent variable relationships, high interest and motivation, and in general, higher-level thinking skills. Behaviors characteristic of unsuccessful predictors were nonsystematic manipulation of independent variables, lack of motivation and persistence, misconceptions, and the identification and use of inappropriate independent-dependent variable relationships.
Halimi-Asl, Aliasghar; Hosseini, Amir Hossein; Nabavizadeh, Pooneh
2014-08-01
Recently, new predictors of vesicoureteral reflux (VUR) in children with a first febrile UTI such as Procalcitonin (PCT) were introduced as selective approaches for cystography. This study wants to show the capability of PCT in predicting presence of VUR at the first febrile UTI in children. Patients between 1 month and 15 years of age with febrile UTI were included in this prospective study. PCT values were measured through a semi-quantitative method in four grades comprising values less than 0.5, 0.5-2.0, 2.0-10.0 and above 10.0 ng/ml. The independence of PCT levels in predicting VUR were assessed after adjustment for all potential confounders using a logistic-regression model. A total of 68 patients, 54 (79.4%) girls and 14 (20.6%) boys were evaluated. PCT level demonstrated a significant difference between patients with positive VUR and those with negative VUR (P=0.012). To calculate the independent factors that may predict the presence of VUR, all included variables were adjusted for age and sex. Results of logistic regression showed that a PCT level between 2.0 and 10.0 ng/mL could independently predict presence of VUR (Odds ratio=6.11, CI 95%= 1.22-30.77, P=0.03). Our finding in this study showed that readily available semi-quantitative measures for PCT are feasible for detecting patients with VUR. We suggest that in semi-quantitative measurements of PCT, levels between 2.0 and 10.0 ng/ml could be an independent predictor of positive VUR.
Cui, Xianping; Wu, Yaguang; Wang, Zhiyi; Liu, Xin; Wang, Shikang; Qin, Chengkun
2015-05-01
The prognosis of hepatocellular carcinoma (HCC) treated by radiofrequency ablation (RFA) is mainly associated with tumor recurrence. So far, no tissue biomarker of recurrence has been confirmed in biopsy specimens. Previous studies have reported that aberrant expression of microRNA-34a (miR-34a) is involved in oncogenesis and progression of HCC. The aim of this study was to investigate the prognostic value of tissue miR-34a expression in patients with HCC treated with RFA. Patients with early-stage single-nodule HCC treated with RFA were included, and tissue expression of miR-34a were assessed by quantitative reverse-transcription polymerase chain reaction. Main clinical endpoints were overall and early recurrence. The Kaplan-Meier method was used to plot recurrence curves and univariable and multivariable Cox regression analyses were performed to assess independent predictive factors for recurrence. Of 120 patients, recurrence occurred in 67 patients (55.8 %) with a median follow-up of 31 months. Forty-one patients (34.2 %) recurred within 2 years after RFA. The median miR-34a level was 0.87 (range 0.06-21.54). Low miR-34a level was associated with larger tumor size (P = 0.033) and higher serum alpha-fetoprotein (AFP) level (P = 0.004). When analyzed with a Cox regression model, the two independent predictive factors for overall recurrence were high serum AFP level (hazard ratio [HR] = 1.21; 95 % confidence interval [CI] = 1.04-1.36; P = 0.039) and low miR-34a level (HR = 1.44; 95 % CI = 1.13-1.72; P = 0.011). The expression of miR-34a was also an independent predictive factor for early recurrence (HR = 1.49; 95 % CI = 1.15-1.79; P = 0.008). Taken together, this study suggests that the expression of miR-34a in HCC biopsy specimens has an independent predictive value of early recurrence after RFA.
Shen, Jiayun; Shang, Qing; Wong, Chun-Kwok; Li, Edmund K; Wang, Shang; Li, Rui-Jie; Lee, Ka-Lai; Leung, Ying-Ying; Ying, King-Yee; Yim, Cheuk-Wan; Kun, Emily W; Leung, Moon-Ho; Li, Martin; Li, Tena K; Zhu, Tracy Y; Yu, Shui-Lian; Kuan, Woon-Pang; Yu, Cheuk-Man; Tam, Lai-Shan
2015-08-01
To study the association between the baseline IL-33 and soluble ST2 (sST2) levels with disease remission and progression of carotid atherosclerosis in early rheumatoid arthritis (ERA) patients. A total of 98 ERA patients were enrolled. Disease activity and the presence of carotid plaque were evaluated at baseline and 12 months later. Plasma IL-33 and sST2 levels were determined using enzyme-linked immunosorbent assay kits. Baseline IL-33 and sST2 levels were associated with inflammatory markers and cardiovascular (CV) risk factors. Overall, 44(45%), 18(18%), and 21(21%) patients achieved remission based on 28-joint disease activity score (DAS28), Boolean, and simplified disease activity score (SDAI) criteria at 12 months, respectively. Patients with detectable IL-33 at baseline were less likely to achieve DAS28 (P = 0.010) and SDAI remission (P = 0.021), while a lower baseline sST2 level was able to predict DAS28, Boolean, and SDAI remission (P = 0.005, 0.001, and <0.001, respectively). Using multivariate analysis, a lower baseline sST2 level independently predict Boolean (OR = 0.789; P = 0.005) and SDAI remission (0.812; P = 0.008). Regarding carotid atherosclerosis, 9/98(9.2%) patients had plaque progression at 12 months. Baseline IL-33 was detectable in 8/9(89%) and 42/83(51%) of patients with and without plaque progression respectively (P = 0.029). Baseline detectable IL-33 was an independent predictor for plaque progression after adjusting for traditional CV risk factors (P = 0.017). Lower baseline sST2 levels independently predict disease remission and baseline detectable IL-33 independently predicts carotid plaque progression in ERA patients. This study suggests that inflammation induced by the IL-33/ST2 axis may play a significant role in the development of cardiovascular disease in RA. Copyright © 2015 Elsevier Inc. All rights reserved.
Leng, Xiaoyan; La Monte, Michael J.; Tindle, Hilary A.; Cochrane, Barbara B.; Shumaker, Sally A.
2016-01-01
Abstract Background. We examined physical functioning (PF) trajectories (maintaining, slowly declining, and rapidly declining) spanning 15 years in older women aged 65–80 and protective factors that predicted better current levels and less decline in functional independence outcomes after age 80. Methods. Women’s Health Initiative extension participants who met criteria (enrolled in either the clinical trial or observational study cohort, >80 years at the data release cutoff, PF survey data from initial enrollment to age 80, and functional independence survey data after age 80) were included in these analyses (mean [ SD ] age = 84.0 [1.4] years; N = 10,478). PF was measured with the SF-36 (mean = 4.9 occasions). Functional independence was measured by self-reported level of dependence in basic and instrumental activities of daily living (ADLs and IADLs) (mean = 3.4 and 3.3 occasions). Results. Maintaining consistent PF in older adulthood extends functional independence in ADL and IADL in late-life. Protective factors shared by ADL and IADL include maintaining PF over time, self-reported excellent or very good health, no history of hip fracture after age 55, and no history of cardiovascular disease. Better IADL function is uniquely predicted by a body mass index less than 25 and no depression. Less ADL and IADL decline is predicted by better self-reported health, and less IADL decline is uniquely predicted by having no history of hip fracture after age 55. Conclusions. Maintaining or improving PF and preventing injury and disease in older adulthood (ages 65–80) has far-reaching implications for improving late-life (after age 80) functional independence. PMID:26858328
Vaughan, Leslie; Leng, Xiaoyan; La Monte, Michael J; Tindle, Hilary A; Cochrane, Barbara B; Shumaker, Sally A
2016-03-01
We examined physical functioning (PF) trajectories (maintaining, slowly declining, and rapidly declining) spanning 15 years in older women aged 65-80 and protective factors that predicted better current levels and less decline in functional independence outcomes after age 80. Women's Health Initiative extension participants who met criteria (enrolled in either the clinical trial or observational study cohort, >80 years at the data release cutoff, PF survey data from initial enrollment to age 80, and functional independence survey data after age 80) were included in these analyses (mean [SD] age = 84.0 [1.4] years; N = 10,478). PF was measured with the SF-36 (mean = 4.9 occasions). Functional independence was measured by self-reported level of dependence in basic and instrumental activities of daily living (ADLs and IADLs) (mean = 3.4 and 3.3 occasions). Maintaining consistent PF in older adulthood extends functional independence in ADL and IADL in late-life. Protective factors shared by ADL and IADL include maintaining PF over time, self-reported excellent or very good health, no history of hip fracture after age 55, and no history of cardiovascular disease. Better IADL function is uniquely predicted by a body mass index less than 25 and no depression. Less ADL and IADL decline is predicted by better self-reported health, and less IADL decline is uniquely predicted by having no history of hip fracture after age 55. Maintaining or improving PF and preventing injury and disease in older adulthood (ages 65-80) has far-reaching implications for improving late-life (after age 80) functional independence. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Methodology for Software Reliability Prediction. Volume 2.
1987-11-01
The overall acquisition ,z program shall include the resources, schedule, management, structure , and controls necessary to ensure that specified AD...Independent Verification/Validation - Programming Team Structure - Educational Level of Team Members - Experience Level of Team Members * Methods Used...Prediction or Estimation Parameter Supported: Software - Characteristics 3. Objectives: Structured programming studies and Government Ur.’.. procurement
Temperament and Parenting during the First Year of Life Predict Future Child Conduct Problems
ERIC Educational Resources Information Center
Lahey, Benjamin B.; Van Hulle, Carol A.; Keenan, Kate; Rathouz, Paul J.; D'Onofrio, Brian M.; Rodgers, Joseph Lee; Waldman, Irwin D.
2008-01-01
Predictive associations between parenting and temperament during the first year of life and child conduct problems were assessed longitudinally in 1,863 offspring of a representative sample of women. Maternal ratings of infant fussiness, activity level, predictability, and positive affect each independently predicted maternal ratings of conduct…
Laboratory markers of cardiovascular risk in pediatric SLE: the APPLE baseline cohort.
Ardoin, S P; Schanberg, L E; Sandborg, C; Yow, E; Barnhart, H X; Mieszkalski, K l; Ilowite, N T; von Scheven, E; Eberhard, A; Levy, D M; Kimura, Y; Silverman, E; Bowyer, S L; Punaro, L; Singer, N G; Sherry, D D; McCurdy, D; Klein-Gitelman, M; Wallace, C; Silver, R; Wagner-Weiner, L; Higgins, G C; Brunner, H I; Jung, L K; Imundo, L; Soep, J B; Reed, A M
2010-10-01
As part of the Atherosclerosis Prevention in Pediatric Lupus Erythematosus (APPLE) Trial, a prospective multicenter cohort of 221 children and adolescents with systemic lupus erythematosus (SLE) (mean age 15.7 years, 83% female) underwent baseline measurement of markers of cardiovascular risk, including fasting levels of high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TG), lipoprotein A (Lpa), homocysteine and high-sensitivity C-reactive protein (hs-CRP). A cross-sectional analysis of the baseline laboratory values and clinical characteristics of this cohort was performed. Univariable relationships between the cardiovascular markers of interest and clinical variables were assessed, followed by multivariable linear regression modeling. Mean levels of LDL, HDL, Lpa, TG, hs-CRP and homocysteine were in the normal or borderline ranges. In multivariable analysis, increased Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), prednisone dose, and hypertension (HTN) were independently associated with higher LDL levels. Higher hs-CRP and creatinine clearance were independently related to lower HDL levels. Higher body mass index (BMI), prednisone dose, and homocysteine levels were independently associated with higher TG levels. Only Hispanic or non-White status predicted higher Lpa levels. Proteinuria, higher TG and lower creatinine clearance were independently associated with higher homocysteine levels, while use of multivitamin with folate predicted lower homocysteine levels. Higher BMI, lower HDL, and longer SLE disease duration, but not SLEDAI, were independently associated with higher hs-CRP levels. The R(2) for these models ranged from 7% to 23%. SLE disease activity as measured by the SLEDAI was associated only with higher LDL levels and not with hs-CRP. Markers of renal injury (HTN, proteinuria, and creatinine clearance) were independently associated with levels of LDL, HDL, and homocysteine, highlighting the importance of renal status in the cardiovascular health of children and adolescents with SLE. Future longitudinal analysis of the APPLE cohort is needed to further examine these relationships.
Lipoprotein(a) levels predict adverse vascular events after acute myocardial infarction.
Mitsuda, Takayuki; Uemura, Yusuke; Ishii, Hideki; Takemoto, Kenji; Uchikawa, Tomohiro; Koyasu, Masayoshi; Ishikawa, Shinji; Miura, Ayako; Imai, Ryo; Iwamiya, Satoshi; Ozaki, Yuta; Kato, Tomohiro; Shibata, Rei; Watarai, Masato; Murohara, Toyoaki
2016-12-01
Lipoprotein(a) [Lp(a)], which is genetically determined, has been reported as an independent risk factor for atherosclerotic vascular disease. However, the prognostic value of Lp(a) for secondary vascular events in patients after coronary artery disease has not been fully elucidated. This 3-year observational study included a total of 176 patients with ST-elevated myocardial infarction (STEMI), whose Lp(a) levels were measured within 24 h after primary percutaneous coronary intervention. We divided enrolled patients into two groups according to Lp(a) level and investigated the association between Lp(a) and the incidence of major adverse cardiac and cerebrovascular events (MACCE). A Kaplan-Meier analysis demonstrated that patients with higher Lp(a) levels had a higher incidence of MACCE than those with lower Lp(a) levels (log-rank P = 0.034). A multivariate Cox regression analysis revealed that Lp(a) levels were independently correlated with the occurrence of MACCE after adjusting for other classical risk factors of atherosclerotic vascular diseases (hazard ratio 1.030, 95 % confidence interval: 1.011-1.048, P = 0.002). In receiver-operating curve analysis, the cutoff value to maximize the predictive power of Lp(a) was 19.0 mg/dl (area under the curve = 0.674, sensitivity 69.2 %, specificity 62.0 %). Evaluation of Lp(a) in addition to the established coronary risk factors improved their predictive value for the occurrence of MACCE. In conclusion, Lp(a) levels at admission independently predict secondary vascular events in patients with STEMI. Lp(a) might provide useful information for the development of secondary prevention strategies in patients with myocardial infarction.
Crop status evaluations and yield predictions
NASA Technical Reports Server (NTRS)
Haun, J. R.
1975-01-01
A model was developed for predicting the day 50 percent of the wheat crop is planted in North Dakota. This model incorporates location as an independent variable. The Julian date when 50 percent of the crop was planted for the nine divisions of North Dakota for seven years was regressed on the 49 variables through the step-down multiple regression procedure. This procedure begins with all of the independent variables and sequentially removes variables that are below a predetermined level of significance after each step. The prediction equation was tested on daily data. The accuracy of the model is considered satisfactory for finding the historic dates on which to initiate yield prediction model. Growth prediction models were also developed for spring wheat.
Social organizational stressors and post-disaster mental health disturbances: a longitudinal study.
van der Velden, Peter G; Bosmans, Mark W G; Bogaerts, Stefan; van Veldhoven, Marc J P M
2014-09-30
Social organizational stressors are well-known predictors of mental health disturbances (MHD). However, to what extent these stressors predict post-disaster MHD among employed victims hardly received scientific attention and is clearly understudied. For this purpose we examined to what extent these stressors independently predict MHD 1.5 years post-disaster over and above well-known risk factors such as disaster exposure, initial MHD and lack of general social support, life-events in the past 12 months and demographics (N=423). Exposure, social organizational stressors and support were significantly associated with almost all examined mental health disturbances on a bi-variate level. Multivariate logistic regression analyses showed that these stressors, i.e. problems with colleagues, independently predicted anxiety (Adj. OR=5.93), depression (Adj. OR=4.21), hostility (Adj. OR=2.85) and having two or more mental health disturbances (Adj. OR=3.39) in contrast to disaster exposure. Disaster exposure independently predicted symptoms of PTSD symptoms (Adj. OR=2.47) and agoraphobia (Adj. OR=2.15) in contrast to social organizational stressors. Importantly, levels of disaster exposure were not associated nor correlated with (levels of) social organizational stressors. Findings suggest that post-disaster mental health care programs aimed at employed affected residents, should target social organizational stressors besides disaster-related stressors and lack of general social support. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Predicting impending death: inconsistency in speed is a selective and early marker.
Macdonald, Stuart W S; Hultsch, David F; Dixon, Roger A
2008-09-01
Among older adults, deficits in both level and variability of speeded performance are linked to neurological impairment. This study examined whether and when speed (rate), speed (inconsistency), and traditional accuracy-based markers of cognitive performance foreshadow terminal decline and impending death. Victoria Longitudinal Study data spanning 12 years (5 waves) of measurement were assembled for 707 adults aged 59 to 95 years. Whereas 442 survivors completed all waves and relevant measures, 265 decedents participated on at least 1 occasion and subsequently died. Four main results were observed. First, Cox regressions evaluating the 3 cognitive predictors of mortality replicated previous results for cognitive accuracy predictors. Second, level (rate) of speeded performance predicted survival independent of demographic indicators, cardiovascular health, and cognitive performance level. Third, inconsistency in speed predicted survival independent of all influences combined. Fourth, follow-up random-effects models revealed increases in inconsistency in speed per year closer to death, with advancing age further moderating the accelerated growth. Hierarchical prediction patterns support the view that inconsistency in speed is an early behavioral marker of neurological dysfunction associated with impending death. (c) 2008 APA, all rights reserved
Predicting Impending Death: Inconsistency in Speed is a Selective and Early Marker
MacDonald, Stuart W.S.; Hultsch, David F.; Dixon, Roger A.
2008-01-01
Among older adults, deficits in both level and variability of speeded performance are linked to neurological impairment. This study examined whether and when speed (rate), speed (inconsistency), and traditional accuracy-based markers of cognitive performance foreshadow terminal decline and impending death. Victoria Longitudinal Study data spanning 12 years (5 waves) of measurement were assembled for 707 adults aged 59 to 95 years. Whereas 442 survivors completed all waves and relevant measures, 265 decedents participated on at least one occasion and subsequently died. Four main results were observed. First, Cox regressions evaluating the three cognitive predictors of mortality replicated previous results for cognitive accuracy predictors. Second, level (rate) of speeded performance predicted survival independent of demographic indicators, cardiovascular health, and cognitive performance level. Third, inconsistency in speed predicted survival independent of all influences combined. Fourth, follow-up random-effects models revealed increases in inconsistency in speed per year closer to death, with advancing age further moderating the accelerated growth. Hierarchical prediction patterns support the view that inconsistency in speed is an early behavioral marker of neurological dysfunction associated with impending death. PMID:18808249
Parental overprotection and metacognitions as predictors of worry and anxiety.
Spada, Marcantonio M; Caselli, Gabriele; Manfredi, Chiara; Rebecchi, Daniela; Rovetto, Francesco; Ruggiero, Giovanni M; Nikčević, Ana V; Sassaroli, Sandra
2012-05-01
Parental overprotection may have a direct effect on worry through hindering children's exploration experiences and preventing the learning of action-oriented coping strategies (Cheron, Ehrenreich and Pincus, 2009; Nolen-Hoeksema, Wolfson, Mumme and Guskin, 1995) and an indirect effect through fostering the development of maladaptive metacognitions that are associated with the activation of worry and the escalation of anxiety (Wells, 2000). The aim was to investigate the relative contribution of recalled parental overprotection in childhood and metacognitions in predicting current levels of worry. A community sample (n = 301) was administered four self-report instruments to assess parental overprotection, metacognitions, anxiety and worry. Metacognitions were found to predict levels of worry independently of gender, anxiety and parental overprotection. They were also found to predict anxiety independently of gender, worry and parental overprotection. The combination of a family environment perceived to be characterized by overprotection and high levels of maladaptive metacognitions are a risk factor for the development of worry.
Damian, Rodica Ioana; Su, Rong; Shanahan, Michael; Trautwein, Ulrich; Roberts, Brent W
2015-09-01
This study investigated the interplay of family background and individual differences, such as personality traits and intelligence (measured in a large U.S. representative sample of high school students; N = 81,000) in predicting educational attainment, annual income, and occupational prestige 11 years later. Specifically, we tested whether individual differences followed 1 of 3 patterns in relation to parental socioeconomic status (SES) when predicting attained status: (a) the independent effects hypothesis (i.e., individual differences predict attainments independent of parental SES level), (b) the resource substitution hypothesis (i.e., individual differences are stronger predictors of attainments at lower levels of parental SES), and (c) the Matthew effect hypothesis (i.e., "the rich get richer"; individual differences are stronger predictors of attainments at higher levels of parental SES). We found that personality traits and intelligence in adolescence predicted later attained status above and beyond parental SES. A standard deviation increase in individual differences translated to up to 8 additional months of education, $4,233 annually, and more prestigious occupations. Furthermore, although we did find some evidence for both the resource substitution and the Matthew effect hypotheses, the most robust pattern across all models supported the independent effects hypothesis. Intelligence was the exception, the interaction models being more robust. Finally, we found that although personality traits may help compensate for background disadvantage to a small extent, they do not usually lead to a "full catch-up" effect, unlike intelligence. This was the first longitudinal study of status attainment to test interactive models of individual differences and background factors. (c) 2015 APA, all rights reserved).
Damian, Rodica Ioana; Su, Rong; Shanahan, Michael; Trautwein, Ulrich; Roberts, Brent W.
2014-01-01
This paper investigates the interplay of family background and individual differences, such as personality traits and intelligence (measured in a large US representative sample of high school students; N = 81,000) in predicting educational attainment, annual income, and occupational prestige eleven years later. Specifically, we tested whether individual differences followed one of three patterns in relation to parental SES when predicting attained status: (a) the independent effects hypothesis (i.e., individual differences predict attainments independent of parental SES level), (b) the resource substitution hypothesis (i.e., individual differences are stronger predictors of attainments at lower levels of parental SES), and (c) the Matthew effect hypothesis (i.e., “the rich get richer,” individual differences are stronger predictors of attainments at higher levels of parental SES). We found that personality traits and intelligence in adolescence predicted later attained status above and beyond parental SES. A standard deviation increase in individual differences translated to up to 8 additional months of education, $4,233 annually, and more prestigious occupations. Furthermore, although we did find some evidence for both the resource substitution and the Matthew effect hypotheses, the most robust pattern across all models supported the independent effects hypothesis. Intelligence was the exception, where interaction models were more robust. Finally, we found that although personality traits may help compensate for background disadvantage to a small extent, they do not usually lead to a “full catch up” effect, unlike intelligence. This was the first longitudinal study of status attainment to test interactive models of individual differences and background factors. PMID:25402679
The relationship between separation anxiety and impairment
Foley, Debra L; Rowe, Richard; Maes, Hermine; Silberg, Judy; Eaves, Lindon; Pickles, Andrew
2009-01-01
The goal of this study was to characterize the contemporaneous and prognostic relationship between symptoms of separation anxiety disorder (SAD) and associated functional impairment. The sample comprised n=2067 8–16 year-old twins from a community-based registry. Juvenile subjects and their parents completed a personal interview on two occasions, separated by an average follow-up period of 18 months, about the subject’s current history of SAD and associated functional impairment. Results showed that SAD symptoms typically caused very little impairment but demonstrated significant continuity over time. Older youth had significantly more persistent symptoms than younger children. Prior symptom level independently predicted future symptom level and diagnostic symptom threshold, with and without impairment. Neither diagnostic threshold nor severity of impairment independently predicted outcomes after taking account of prior symptom levels. The results indicate that impairment may index current treatment need but symptom levels provide the best information about severity and prognosis. PMID:17658718
Transthyretin Concentrations in Acute Stroke Patients Predict Convalescent Rehabilitation.
Isono, Naofumi; Imamura, Yuki; Ohmura, Keiko; Ueda, Norihide; Kawabata, Shinji; Furuse, Motomasa; Kuroiwa, Toshihiko
2017-06-01
For stroke patients, intensive nutritional management is an important and effective component of inpatient rehabilitation. Accordingly, acute care hospitals must detect and prevent malnutrition at an early stage. Blood transthyretin levels are widely used as a nutritional monitoring index in critically ill patients. Here, we had analyzed the relationship between the transthyretin levels during the acute phase and Functional Independence Measure in stroke patients undergoing convalescent rehabilitation. We investigated 117 patients who were admitted to our hospital with acute ischemic or hemorrhagic stroke from February 2013 to October 2015 and subsequently transferred to convalescent hospitals after receiving acute treatment. Transthyretin concentrations were evaluated at 3 time points as follows: at admission, and 5 and 10 days after admission. After categorizing patients into 3 groups according to the minimum transthyretin level, we analyzed the association between transthyretin and Functional Independence Measure. In our patients, transthyretin levels decreased during the first 5 days after admission and recovered slightly during the subsequent 5 days. Notably, Functional Independence Measure efficiency was significantly associated with the decrease in transthyretin levels during the 5 days after admission. Patients with lower transthyretin levels had poorer Functional Independence Measure outcomes and tended not to be discharged to their own homes. A minimal transthyretin concentration (<10 mg/dL) is predictive of a poor outcome in stroke patients undergoing convalescent rehabilitation. In particular, an early decrease in transthyretin levels suggests restricted rehabilitation efficiency. Accordingly, transthyretin levels should be monitored in acute stroke patients to indicate mid-term rehabilitation prospects. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.
Rampazzo, Enrica; Del Bianco, Paola; Bertorelle, Roberta; Boso, Caterina; Perin, Alessandro; Spiro, Giovanna; Bergamo, Francesca; Belluco, Claudio; Buonadonna, Angela; Palazzari, Elisa; Leonardi, Sara; De Paoli, Antonino; Pucciarelli, Salvatore; De Rossi, Anita
2018-01-01
Background: Preoperative chemoradiotherapy (CRT) followed by surgery is the standard care for locally advanced rectal cancer, but tumour response to CRT and disease outcome are variable. The current study aimed to investigate the effectiveness of plasma telomerase reverse transcriptase (TERT) levels in predicting tumour response and clinical outcome. Methods: 176 rectal cancer patients were included. Plasma samples were collected at baseline (before CRT=T0), 2 weeks after CRT was initiated (T1), post-CRT and before surgery (T2), and 4–8 months after surgery (T3) time points. Plasma TERT mRNA levels and total cell-free RNA were determined using real-time PCR. Results: Plasma levels of TERT were significantly lower at T2 (P<0.0001) in responders than in non-responders. Post-CRT TERT levels and the differences between pre- and post-CRT TERT levels independently predicted tumour response, and the prediction model had an area under curve of 0.80 (95% confidence interval (CI) 0.73–0.87). Multiple analysis demonstrated that patients with detectable TERT levels at T2 and T3 time points had a risk of disease progression 2.13 (95% CI 1.10–4.11)-fold and 4.55 (95% CI 1.48–13.95)-fold higher, respectively, than those with undetectable plasma TERT levels. Conclusions: Plasma TERT levels are independent markers of tumour response and are prognostic of disease progression in rectal cancer patients who undergo neoadjuvant therapy. PMID:29449673
A comparison of modified versions of the Static-99 and the Sex Offender Risk Appraisal Guide.
Nunes, Kevin L; Firestone, Philip; Bradford, John M; Greenberg, David M; Broom, Ian
2002-07-01
The predictive validity of 2 risk assessment instruments for sex offenders, modified versions of the Static-99 and the Sex Offender Risk Appraisal Guide, was examined and compared in a sample of 258 adult male sex offenders. In addition, the independent contributions to the prediction of recidivism made by each instrument and by various phallometric indices were explored. Both instruments demonstrated moderate levels of predictive accuracy for sexual and violent (including sexual) recidivism. They were not significantly different in terms of their predictive accuracy for sexual or violent recidivism, nor did they contribute independently to the prediction of sexual or violent recidivism. Of the phallometric indices examined, only the pedophile index added significantly to the prediction of sexual recidivism, but not violent recidivism, above the Static-99 alone.
Disorganized attachment and inhibitory capacity: predicting externalizing problem behaviors.
Bohlin, Gunilla; Eninger, Lilianne; Brocki, Karin Cecilia; Thorell, Lisa B
2012-04-01
The aim of the present study was to investigate whether attachment insecurity, focusing on disorganized attachment, and the executive function (EF) component of inhibition, assessed at age 5, were longitudinally related to general externalizing problem behaviors as well as to specific symptoms of ADHD and Autism spectrum disorder (ASD), and callous-unemotional (CU) traits. General externalizing problem behaviors were also measured at age 5 to allow for a developmental analysis. Outcome variables were rated by parents and teachers. The sample consisted of 65 children with an oversampling of children with high levels of externalizing behaviors. Attachment was evaluated using a story stem attachment doll play procedure. Inhibition was measured using four different tasks. The results showed that both disorganized attachment and poor inhibition were longitudinally related to all outcome variables. Controlling for initial level of externalizing problem behavior, poor inhibition predicted ADHD symptoms and externalizing problem behaviors, independent of disorganized attachment, whereas for ASD symptoms no predictive relations remained. Disorganized attachment independently predicted CU traits.
Ryd, Charlotta; Nygård, Louise; Malinowsky, Camilla; Öhman, Annika; Kottorp, Anders
2017-03-01
The number of older adults living with mild cognitive impairment (MCI) or mild-stage Alzheimer's disease (AD) is increasing and they are often expected to live in their own homes without support, despite limited ability to perform daily life activities. The Everyday Technology Use Questionnaire (ETUQ) has proven to be able to separate these groups and might also have potential to predict overall functional level (need of assistance in daily life activities) among them. To investigate whether the ETUQ can predict overall functional level among older adults with MCI or mild-stage AD. Participants were older adults with a mean age of 76 years with MCI (n = 28) or mild-stage AD (n = 39). A three-step scale indicating (i) independence, (ii) need for minimal assistance or (iii) need for moderate to maximal assistance in daily life was dichotomised in two ways and used as outcome variables in two logistic regression models. Predictors in both models were perceived ability to use everyday technology (ET) and amount of relevant everyday technologies measured by the ETUQ. Ethical approval was obtained from the regional Ethical Committee. Perceived ability to use ET discriminated individuals who were independent or in need of minimal support from those in need of moderate to maximal assistance (OR = 1.82, p < 0.01, confidence interval = 95%; 1.76-2.82). The amount of relevant everyday technologies discriminated individuals who were independent from those in need of assistance at any level (OR = 1.39; p < 0.01; confidence interval = 95%; 1.11-1.75). Both perceived ability to use ET and amount of relevant everyday technologies had potential to predict overall function but at different levels. The findings support the predictive validity of the ETUQ and suggest further research for the development of clinical cut-off criteria. © 2016 Nordic College of Caring Science.
Vermaat, Joost S; Gerritse, Frank L; van der Veldt, Astrid A; Roessingh, Wijnand M; Niers, Tatjana M; Oosting, Sjoukje F; Sleijfer, Stefan; Roodhart, Jeanine M; Beijnen, Jos H; Schellens, Jan H; Gietema, Jourik A; Boven, Epie; Richel, Dick J; Haanen, John B; Voest, Emile E
2012-10-01
We recently identified apolipoprotein A2 (ApoA2) and serum amyloid α (SAA) as independent prognosticators in metastatic renal cell carcinoma (mRCC) patients, thereby improving the accuracy of the Memorial-Sloan Kettering Cancer Center (MSKCC) model. Validate these results prospectively in a separate cohort of mRCC patients treated with tyrosine kinase inhibitors (TKIs). For training we used 114 interferon-treated mRCC patients (inclusion 2001-2006). For validation we studied 151 TKI-treated mRCC patients (inclusion 2003-2009). Using Cox proportional hazards regression analysis, SAA and ApoA2 were associated with progression-free survival (PFS) and overall survival (OS). In 72 TKI-treated patients, SAA levels were analyzed longitudinally as a potential early marker for treatment effect. Baseline ApoA2 and SAA levels significantly predicted PFS and OS in the training and validation cohorts. Multivariate analysis identified SAA in both separate patient sets as a robust and independent prognosticator for PFS and OS. In contrast to our previous findings, ApoA2 interacted with SAA in the validation cohort and did not contribute to a better predictive accuracy than SAA alone and was therefore excluded from further analysis. According to the tertiles of SAA levels, patients were categorized in three risk groups, demonstrating accurate risk prognostication. SAA as a single biomarker showed equal prognostic accuracy when compared with the multifactorial MSKCC risk mode. Using receiver operating characteristic analysis, SAA levels >71 ng/ml were designated as the optimal cut-off value in the training cohort, which was confirmed for its significant sensitivity and specificity in the validation cohort. Applying SAA >71 ng/ml as an additional risk factor significantly improved the predictive accuracy of the MSKCC model in both independent cohorts. Changes in SAA levels after 6-8 wk of TKI treatment had no value in predicting treatment outcome. SAA but not ApoA2 was shown to be a robust and independent prognosticator for PFS and OS in mRCC patients. When incorporated in the MSKCC model, SAA showed additional prognostic value for patient management. Copyright © 2012 European Association of Urology. Published by Elsevier B.V. All rights reserved.
Wettlaufer, Jillian; Klingel, Michelle; Yau, Yvonne; Stanojevic, Sanja; Tullis, Elizabeth; Ratjen, Felix; Waters, Valerie
2017-01-01
Previous studies have shown an association between higher Stenotrophomonas maltophilia antibody levels and decreased lung function in patients with cystic fibrosis (CF). The purpose of this study was to assess the serologic response to S. maltophilia over time and to determine whether changes in antibody levels could predict clinical outcomes. Changes in S. maltophilia antibody levels in adult and pediatric patients with CF from 2008 to 2014 were assessed between groups of infection patterns. Regression models accounting for repeated measures were used to assess whether antibody levels could predict subsequent S. maltophilia microbiological status, and whether they are associated with lung function and subsequent pulmonary exacerbation. A total of 409 S. maltophilia antibody samples from 135 CF patients showed that antibody levels did not change significantly between study visits, regardless of infection group. Higher antibody levels were independently associated with future culture positivity (OR 1.62; 95% CI 1.09, 2.41; p=0.02). While higher antibody levels were not independently associated with decreases in FEV 1 % predicted, they were associated with an increased hazard ratio for subsequent pulmonary exacerbation (HR 1.3; 95% CI 1.1, 1.6; p<0.001). S. maltophilia antibody levels may be helpful to identify individuals at risk of exacerbation who may benefit from earlier antimicrobial treatment. Copyright © 2016 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.
Mollborn, Stefanie; Domingue, Benjamin W; Boardman, Jason D
2014-06-01
Researchers seeking to understand teen sexual behaviors often turn to age norms, but they are difficult to measure quantitatively. Previous work has usually inferred norms from behavioral patterns or measured group-level norms at the individual level, ignoring multiple reference groups. Capitalizing on the multilevel design of the Add Health survey, we measure teen pregnancy norms perceived by teenagers, as well as average norms at the school and peer network levels. School norms predict boys' perceived norms, while peer network norms predict girls' perceived norms. Peer network and individually perceived norms against teen pregnancy independently and negatively predict teens' likelihood of sexual intercourse. Perceived norms against pregnancy predict increased likelihood of contraception among sexually experienced girls, but sexually experienced boys' contraceptive behavior is more complicated: When both the boy and his peers or school have stronger norms against teen pregnancy he is more likely to contracept, and in the absence of school or peer norms against pregnancy, boys who are embarrassed are less likely to contracept. We conclude that: (1) patterns of behavior cannot adequately operationalize teen pregnancy norms, (2) norms are not simply linked to behaviors through individual perceptions, and (3) norms at different levels can operate independently of each other, interactively, or in opposition. This evidence creates space for conceptualizations of agency, conflict, and change that can lead to progress in understanding age norms and sexual behaviors.
Mollborn, Stefanie; Domingue, Benjamin W.; Boardman, Jason D.
2014-01-01
Researchers seeking to understand teen sexual behaviors often turn to age norms, but they are difficult to measure quantitatively. Previous work has usually inferred norms from behavioral patterns or measured group-level norms at the individual level, ignoring multiple reference groups. Capitalizing on the multilevel design of the Add Health survey, we measure teen pregnancy norms perceived by teenagers, as well as average norms at the school and peer network levels. School norms predict boys’ perceived norms, while peer network norms predict girls’ perceived norms. Peer network and individually perceived norms against teen pregnancy independently and negatively predict teens’ likelihood of sexual intercourse. Perceived norms against pregnancy predict increased likelihood of contraception among sexually experienced girls, but sexually experienced boys’ contraceptive behavior is more complicated: When both the boy and his peers or school have stronger norms against teen pregnancy he is more likely to contracept, and in the absence of school or peer norms against pregnancy, boys who are embarrassed are less likely to contracept. We conclude that: (1) patterns of behavior cannot adequately operationalize teen pregnancy norms, (2) norms are not simply linked to behaviors through individual perceptions, and (3) norms at different levels can operate independently of each other, interactively, or in opposition. This evidence creates space for conceptualizations of agency, conflict, and change that can lead to progress in understanding age norms and sexual behaviors. PMID:25104920
A panel to predict long-term outcome of infliximab therapy for patients with ulcerative colitis.
Arias, Maria Theresa; Vande Casteele, Niels; Vermeire, Séverine; de Buck van Overstraeten, Anthony; Billiet, Thomas; Baert, Filip; Wolthuis, Albert; Van Assche, Gert; Noman, Maja; Hoffman, Ilse; D'Hoore, Andre; Gils, Ann; Rutgeerts, Paul; Ferrante, Marc
2015-03-01
Infliximab is effective for patients with refractory ulcerative colitis (UC), but few factors have been identified that predict long-term outcome of therapy. We aimed to identify a panel of markers associated with outcome of infliximab therapy to help physicians make personalized treatment decisions. We collected data from the first 285 patients with refractory UC (41% female; median age, 39 y) treated with infliximab before July 2012 at University Hospitals Leuven, in Belgium. We performed a Cox regression analysis to identify independent factors that predicted relapse-free and colectomy-free survival, and used these factors to create a panel of markers (risk panel). During a median follow-up period of 5 years, 61% of patients relapsed and 20% required colectomy. Independent predictors of relapse-free survival included short-term complete clinical response (odds ratio [OR], 3.75; 95% confidence interval [CI], 2.35-5.97; P < .001), mucosal healing (OR, 1.87; 95% CI, 1.17-2.98; P = .009), and absence of atypical perinuclear antineutrophil cytoplasmic antibodies (pANCA) (OR, 1.96; 95% CI, 1.23-3.12; P = .005). Independent predictors of colectomy-free survival included short-term clinical response (OR, 7.74; 95% CI, 2.76-21.68; P < .001), mucosal healing (OR, 4.02; 95% CI, 1.16-13.97; P = .028), baseline level of C-reactive protein (CRP) of 5 mg/L or less (OR, 2.95; 95% CI, 1.26-6.89; P = .012), and baseline level of albumin of 35 g/L or greater (OR, 3.03; 95% CI, 1.12-8.22; P = .029). Based on serologic analysis of a subgroup of 112 patients, levels of infliximab greater than 2.5 μg/mL at week 14 of treatment predicted relapse-free survival (P < .001) and colectomy-free survival (P = .034). A risk panel that included levels of pANCA, CRP, albumin, clinical response, and mucosal healing identified patients at risk for UC relapse or colectomy (both P < .001). Clinical response and mucosal healing were confirmed as independent predictors of long-term outcome from infliximab therapy in patients with UC. We identified additional factors (levels of pANCA, CRP, and albumin) to create a risk panel that predicts long-term outcomes of therapy. Serum levels of infliximab at week 14 of treatment also were associated with patient outcomes. Our risk panel and short-term serum levels of infliximab therefore might be used to guide therapy. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.
Dai, Danian; Chen, Bo; Wang, Bin; Tang, Hailin; Li, Xing; Zhao, Zhiping; Li, Xuan; Xie, Xiaoming; Wei, Weidong
2016-01-01
Previous studies have reported that the triacylglycerol (TG) level and high-density lipoprotein cholesterol (HDL-C) are connected with breast cancer. However, the prognostic utility of the TG level and the TG/HDL-C ratio (THR) as conventional biomarkers in patients with triple negative breast cancer (TNBC) has not been elucidated. In this research, we investigate and compare the predictive value of the pretreatment serum TG level and THR in TNBC patients. We evaluated 221 patients with TNBC who had pretreatment conventional blood biochemical examinations and calculated the THR. Univariate and multivariate logistic regression analyses were used to assess the effect of the TG level and the THR on overall survival (OS) and disease-free survival (DFS). The optimal cutoff values of the TG level and the THR were determined to be 0.935 mmol/L and 0.600, respectively. As shown in a Kaplan-Meier analysis, TNBC patients with a high TG level and THR had shorter OS and DFS than patients in the low-level groups ( p < 0.05). The multivariate analysis suggested that the pretreatment THR level is an independent prognostic factor of OS (HR: 1.935; 95%CI: 1.032-3.629; p = 0.040) in TNBC patients. In conclusion, our data indicate that a high THR is an independent predictor and is superior to the TG level for predicting poor clinical outcomes in TNBC patients.
Sprint, Gina; Cook, Diane J.; Weeks, Douglas L.; Borisov, Vladimir
2016-01-01
Evaluating patient progress and making discharge decisions regarding inpatient medical rehabilitation rely upon standard clinical assessments administered by trained clinicians. Wearable inertial sensors can offer more objective measures of patient movement and progress. We undertook a study to investigate the contribution of wearable sensor data to predict discharge functional independence measure (FIM) scores for 20 patients at an inpatient rehabilitation facility. The FIM utilizes a 7-point ordinal scale to measure patient independence while performing several activities of daily living, such as walking, grooming, and bathing. Wearable inertial sensor data were collected from ecological ambulatory tasks at two time points mid-stay during inpatient rehabilitation. Machine learning algorithms were trained with sensor-derived features and clinical information obtained from medical records at admission to the inpatient facility. While models trained only with clinical features predicted discharge scores well, we were able to achieve an even higher level of prediction accuracy when also including the wearable sensor-derived features. Correlations as high as 0.97 for leave-one-out cross validation predicting discharge FIM motor scores are reported. PMID:27054054
Predicting True Reading Gains After Remedial Tutoring.
ERIC Educational Resources Information Center
Dahlke, Anita B.
Using selected student variables, an attempt was made to predict retarded readers' true reading gains after remedial tutoring. The independent variables consisted of IQ and subtest scores obtained on the Wechsler Intelligence Scale for Children (WISC), pretutoring reading levels on the individually administered Diagnostic Reading Scales test, age,…
ERIC Educational Resources Information Center
Charlton, John P.; Barrow, Corinne; Hornby-Atkinson, Pat
2006-01-01
Demographic, psychological and secondary level examination measures were obtained at the start of undergraduate courses in an attempt to predict first-year higher education (HE) withdrawal. As usual, withdrawal was greatest for males. Overall, intrinsic motivation and independent study expectations were better predictors of withdrawal than…
Multi-Scale Mapping of Vegetation Biomass
NASA Astrophysics Data System (ADS)
Hudak, A. T.; Fekety, P.; Falkowski, M. J.; Kennedy, R. E.; Crookston, N.; Smith, A. M.; Mahoney, P.; Glenn, N. F.; Dong, J.; Kane, V. R.; Woodall, C. W.
2016-12-01
Vegetation biomass mapping at multiple scales is important for carbon inventory and monitoring, reporting, and verification (MRV). Project-level lidar collections allow biomass estimation with high confidence where associated with field plot measurements. Predictive models developed from such datasets are customarily used to generate landscape-scale biomass maps. We tested the feasibility of predicting biomass in landscapes surveyed with lidar but without field plots, by withholding plot datasets from a reduced model applied to the landscapes, and found support for a generalized model in the northern Idaho ecoregion. We are also upscaling a generalized model to all forested lands in Idaho. Our regional modeling approach is to sample the 30-m biomass predictions from the landscape-scale maps and use them to train a regional biomass model, using Landsat time series, topographic derivatives, and climate variables as predictors. Our regional map validation approach is to aggregate the regional, annual biomass predictions to the county level and compare them to annual county-level biomass summarized independently from systematic, field-based, annual inventories conducted by the US Forest Inventory and Analysis (FIA) Program nationally. A national-scale forest cover map generated independently from 2010 PALSAR data at 25-m resolution is being used to mask non-forest pixels from the aggregations. Effects of climate change on future regional biomass stores are also being explored, using biomass estimates projected from stand-level inventory data collected in the National Forests and comparing them to FIA plot data collected independently on public and private lands, projected under the same climate change scenarios, with disturbance trends extracted from the Landsat time series. Our ultimate goal is to demonstrate, focusing on the ecologically diverse Northwest region of the USA, a carbon monitoring system (CMS) that is accurate, objective, repeatable, and transparent.
Documentation of a spreadsheet for time-series analysis and drawdown estimation
Halford, Keith J.
2006-01-01
Drawdowns during aquifer tests can be obscured by barometric pressure changes, earth tides, regional pumping, and recharge events in the water-level record. These stresses can create water-level fluctuations that should be removed from observed water levels prior to estimating drawdowns. Simple models have been developed for estimating unpumped water levels during aquifer tests that are referred to as synthetic water levels. These models sum multiple time series such as barometric pressure, tidal potential, and background water levels to simulate non-pumping water levels. The amplitude and phase of each time series are adjusted so that synthetic water levels match measured water levels during periods unaffected by an aquifer test. Differences between synthetic and measured water levels are minimized with a sum-of-squares objective function. Root-mean-square errors during fitting and prediction periods were compared multiple times at four geographically diverse sites. Prediction error equaled fitting error when fitting periods were greater than or equal to four times prediction periods. The proposed drawdown estimation approach has been implemented in a spreadsheet application. Measured time series are independent so that collection frequencies can differ and sampling times can be asynchronous. Time series can be viewed selectively and magnified easily. Fitting and prediction periods can be defined graphically or entered directly. Synthetic water levels for each observation well are created with earth tides, measured time series, moving averages of time series, and differences between measured and moving averages of time series. Selected series and fitting parameters for synthetic water levels are stored and drawdowns are estimated for prediction periods. Drawdowns can be viewed independently and adjusted visually if an anomaly skews initial drawdowns away from 0. The number of observations in a drawdown time series can be reduced by averaging across user-defined periods. Raw or reduced drawdown estimates can be copied from the spreadsheet application or written to tab-delimited ASCII files.
Predicting the synergy of multiple stress effects
NASA Astrophysics Data System (ADS)
Liess, Matthias; Foit, Kaarina; Knillmann, Saskia; Schäfer, Ralf B.; Liess, Hans-Dieter
2016-09-01
Toxicants and other, non-chemical environmental stressors contribute to the global biodiversity crisis. Examples include the loss of bees and the reduction of aquatic biodiversity. Although non-compliance with regulations might be contributing, the widespread existence of these impacts suggests that for example the current approach of pesticide risk assessment fails to protect biodiversity when multiple stressors concurrently affect organisms. To quantify such multiple stress effects, we analysed all applicable aquatic studies and found that the presence of environmental stressors increases individual sensitivity to toxicants (pesticides, trace metals) by a factor of up to 100. To predict this dependence, we developed the “Stress Addition Model” (SAM). With the SAM, we assume that each individual has a general stress capacity towards all types of specific stress that should not be exhausted. Experimental stress levels are transferred into general stress levels of the SAM using the stress-related mortality as a common link. These general stress levels of independent stressors are additive, with the sum determining the total stress exerted on a population. With this approach, we provide a tool that quantitatively predicts the highly synergistic direct effects of independent stressor combinations.
ERIC Educational Resources Information Center
Rostampour, Mohammad; Niroomand, Seyyedeh Mitra
2014-01-01
Cognitive styles influence the performance of language learners and can predict their success in the process of language learning. Considering field dependence/independence cognitive styles, this study aims at determining if they are significant in English vocabulary knowledge. A number of EFL university students took part in the study. The…
Jiang, Yanlin; Xu, Hong; Zhang, Hao; Ou, Xunyan; Xu, Zhen; Ai, Liping; Sun, Lisha; Liu, Caigang
2017-09-22
The current management of the axilla in level 1 node-positive breast cancer patients is axillary lymph node dissection regardless of the status of the level 2 axillary lymph nodes. The goal of this study was to develop a nomogram predicting the probability of level 2 axillary lymph node metastasis (L-2-ALNM) in patients with level 1 axillary node-positive breast cancer. We reviewed the records of 974 patients with pathology-confirmed level 1 node-positive breast cancer between 2010 and 2014 at the Liaoning Cancer Hospital and Institute. The patients were randomized 1:1 and divided into a modeling group and a validation group. Clinical and pathological features of the patients were assessed with uni- and multivariate logistic regression. A nomogram based on independent predictors for the L-2-ALNM identified by multivariate logistic regression was constructed. Independent predictors of L-2-ALNM by the multivariate logistic regression analysis included tumor size, Ki-67 status, histological grade, and number of positive level 1 axillary lymph nodes. The areas under the receiver operating characteristic curve of the modeling set and the validation set were 0.828 and 0.816, respectively. The false-negative rates of the L-2-ALNM nomogram were 1.82% and 7.41% for the predicted probability cut-off points of < 6% and < 10%, respectively, when applied to the validation group. Our nomogram could help predict L-2-ALNM in patients with level 1 axillary lymph node metastasis. Patients with a low probability of L-2-ALNM could be spared level 2 axillary lymph node dissection, thereby reducing postoperative morbidity.
Arikan, Hakki; Koc, Mehmet; Tuglular, Serhan; Ozener, Cetin; Akoglu, Emel
2009-01-01
Elevated plasminogen activator inhibitor-1 (PAI-1) levels are associated with increased cardiovascular (CV) risk in the general population. It has been shown that peritoneal dialysis (PD) patients have increased plasma levels of PAI-1. The aim of this study was to investigate whether PAI-1 independently predicted CV outcome in PD patients. Seventy-two PD patients (53% females, mean age 49.9 +/- 16.1 years) were studied. Twelve patients who underwent kidney transplantation and 14 patients who transferred to hemodialysis during follow-up were excluded from the analysis. The remaining 46 patients (54% female, mean age 54 +/- 16 years, dialytic age 42 +/- 30 months) were followed a mean time of 45.4 +/- 19.4 months (range 8-71 months). Baseline PAI-1, clinical, and laboratory parameters were assessed in all patients. Survival analyses were made with Kaplan-Meier and Cox regression analysis, with all-cause mortality and CV mortality and CV events (CVEs) as clinical end points. During the follow-up, 29 patients died (17 from CV causes), and 28 fatal and non-fatal CVEs were recorded. The patients were divided according to plasma PAI-1 levels (i.e.,
Hohl, Alexandre; Zanela, Fernando Areas; Ghisi, Gabriela; Ronsoni, Marcelo Fernando; Diaz, Alexandre Paim; Schwarzbold, Marcelo Liborio; Dafre, Alcir Luiz; Reddi, Benjamin; Lin, Kátia; Pizzol, Felipe Dal; Walz, Roger
2018-01-01
Traumatic brain injury (TBI) is a worldwide core public health problem affecting mostly young male subjects. An alarming increase in incidence has turned TBI into a leading cause of morbidity and mortality in young adults as well as a tremendous resource burden on the health and welfare sector. Hormone dysfunction is highly prevalent during the acute phase of severe TBI. In particular, investigation of the luteinizing hormone (LH) and testosterone levels during the acute phase of severe TBI in male has identified a high incidence of low testosterone levels in male patients (36.5–100%) but the prognostic significance of which remains controversial. Two independent studies showed that normal or elevated levels of LH levels earlier during hospitalization are significantly associated with higher mortality/morbidity. The association between LH levels and prognosis was independent of other predictive variables such as neuroimaging, admission Glasgow coma scale, and pupillary reaction. The possible mechanisms underlying this association and further research directions in this field are discussed. Overall, current data suggest that LH levels during the acute phase of TBI might contribute to accurate prognostication and further prospective multicentric studies are required to develop more sophisticated predictive models incorporating biomarkers such as LH in the quest for accurate outcome prediction following TBI. Moreover, the potential therapeutic benefits of modulating LH during the acute phase of TBI warrant investigation. PMID:29487565
Galimberti, Daniela; Fumagalli, Giorgio G; Fenoglio, Chiara; Cioffi, Sara M G; Arighi, Andrea; Serpente, Maria; Borroni, Barbara; Padovani, Alessandro; Tagliavini, Fabrizio; Masellis, Mario; Tartaglia, Maria Carmela; van Swieten, John; Meeter, Lieke; Graff, Caroline; de Mendonça, Alexandre; Bocchetta, Martina; Rohrer, Jonathan D; Scarpini, Elio
2018-02-01
We investigated whether progranulin plasma levels are predictors of the presence of progranulin gene (GRN) null mutations or of the development of symptoms in asymptomatic at risk members participating in the Genetic Frontotemporal Dementia Initiative, including 19 patients, 64 asymptomatic carriers, and 77 noncarriers. In addition, we evaluated a possible role of TMEM106B rs1990622 as a genetic modifier and correlated progranulin plasma levels and gray-matter atrophy. Plasma progranulin mean ± SD plasma levels in patients and asymptomatic carriers were significantly decreased compared with noncarriers (30.5 ± 13.0 and 27.7 ± 7.5 versus 99.6 ± 24.8 ng/mL, p < 0.00001). Considering the threshold of >61.55 ng/mL, the test had a sensitivity of 98.8% and a specificity of 97.5% in predicting the presence of a mutation, independent of symptoms. No correlations were found between progranulin plasma levels and age, years from average age at onset in each family, or TMEM106B rs1990622 genotype (p > 0.05). Plasma progranulin levels did not correlate with brain atrophy. Plasma progranulin levels predict the presence of GRN null mutations independent of proximity to symptoms and brain atrophy. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.
Predictive factors for cosmetic surgery: a hospital-based investigation.
Li, Jun; Li, Qian; Zhou, Bei; Gao, Yanli; Ma, Jiehua; Li, Jingyun
2016-01-01
Cosmetic surgery is becoming increasingly popular in China. However, reports on the predictive factors for cosmetic surgery in Chinese individuals are scarce in the literature. We retrospectively analyzed 4550 cosmetic surgeries performed from January 2010 to December 2014 at a single center in China. Data collection included patient demographics and type of cosmetic surgery. Predictive factors were age, sex, marital status, occupational status, educational degree, and having had children. Predictive factors for the three major cosmetic surgeries were determined using a logistic regression analysis. Patients aged 19-34 years accounted for the most popular surgical procedures (76.9 %). The most commonly requested procedures were eye surgery, Botox injection, and nevus removal. Logistic regression analysis showed that higher education level (college, P = 0.01, OR 1.21) was predictive for eye surgery. Age (19-34 years, P = 0.00, OR 33.39; 35-50, P = 0.00, OR 31.34; ≥51, P = 0.00, OR 16.42), female sex (P = 0.00, OR 9.19), employment (service occupations, P = 0.00, OR 2.31; non-service occupations, P = 0.00, OR 1.76), and higher education level (college, P = 0.00, OR 1.39) were independent predictive factors for Botox injection. Married status (P = 0.00, OR 1.57), employment (non-service occupations, P = 0.00, OR 1.50), higher education level (masters, P = 0.00, OR 6.61), and having children (P = 0.00, OR 1.45) were independent predictive factors for nevus removal. The principal three cosmetic surgeries (eye surgery, Botox injection, and nevus removal) were associated with multiple variables. Patients employed in non-service occupations were more inclined to undergo Botox injection and nevus removal. Cohort study, Level III.
Multiple linear regression models are often used to predict levels of fecal indicator bacteria (FIB) in recreational swimming waters based on independent variables (IVs) such as meteorologic, hydrodynamic, and water-quality measures. The IVs used for these analyses are traditiona...
Biomass Estimation for some Shrubs from Northeastern Minnesota
David F. Grigal; Lewis F. Ohmann
1977-01-01
Biomass prediction equations were developed for 23 northeastern Minnesota shrub species. The allowmetric function was used to predict leaf, current annual woody twig, stem, and total woody biomass (dry grass), using stem diameter class estimated to the nearest 0.25 cm class at 15 cm above ground level as the independent variable.
ERIC Educational Resources Information Center
McDonnall, Michele Capella
2011-01-01
The study reported here identified factors that predict employment for transition-age youths with visual impairments. Logistic regression was used to predict employment at two levels. Significant variables were early and recent work experiences, completion of a postsecondary program, difficulty with transportation, independent travel skills, and…
Feldman, Arthur M; Mann, Douglas L; She, Lilin; Bristow, Michael R; Maisel, Alan S; McNamara, Dennis M; Walsh, Ryan; Lee, Dorellyn L; Wos, Stanislaw; Lang, Irene; Wells, Gretchen; Drazner, Mark H; Schmedtje, John F; Pauly, Daniel F; Sueta, Carla A; Di Maio, Michael; Kron, Irving L; Velazquez, Eric J; Lee, Kerry L
2013-05-01
Patients with heart failure and coronary artery disease often undergo coronary artery bypass grafting, but assessment of the risk of an adverse outcome in these patients is difficult. To evaluate the ability of biomarkers to contribute independent prognostic information in these patients, we measured levels in patients enrolled in the biomarker substudies of the Surgical Treatment for Ischemic Heart Failure (STICH) trials. Patients in STICH Hypothesis 1 were randomized to medical therapy or coronary artery bypass grafting, whereas those in STICH Hypothesis 2 were randomized to coronary artery bypass grafting or coronary artery bypass grafting with left ventricular reconstruction. In substudy patients assigned to STICH Hypothesis 1 (n=606), plasma levels of soluble tumor necrosis factor-α receptor-1 (sTNFR-1) and brain natriuretic peptide (BNP) were highly predictive of the primary outcome variable of mortality by univariate analysis (BNP: χ(2)=40.6; P<0.0001 and sTNFR-1: χ(2)=38.9; P<0.0001). When considered in the context of multivariable analysis, both BNP and sTNFR-1 contributed independent prognostic information beyond the information provided by a large array of clinical factors independent of treatment assignment. Consistent results were seen when assessing the predictive value of BNP and sTNFR-1 in patients assigned to STICH Hypothesis 2 (n=626). Both plasma levels of BNP (χ(2)=30.3) and sTNFR-1 (χ(2)=45.5) were highly predictive in univariate analysis (P<0.0001) and in multivariable analysis for the primary end point of death or cardiac hospitalization. In multivariable analysis, the prognostic information contributed by BNP (χ(2)=6.0; P=0.049) and sTNFR-1 (χ(2)=8.8; P=0.003) remained statistically significant even after accounting for other clinical information. Although the biomarkers added little discriminatory improvement to the clinical factors (increase in c-index ≤0.1), net reclassification improvement for the primary end points was 0.29 for BNP and 0.21 for sTNFR-1 in the Hypothesis 1 cohort, and 0.15 for BNP and 0.30 for sTNFR-1 in the Hypothesis 2 cohort, reflecting important predictive improvement. Elevated levels of sTNFR-1 and BNP are strongly associated with outcomes, independent of therapy, in 2 large and independent studies, thus providing important cross-validation for the prognostic importance of these 2 biomarkers.
Feldman, Arthur M.; Mann, Douglas L.; She, Lilin; Bristow, Michael R.; Maisel, Alan S.; McNamara, Dennis M.; Walsh, Ryan; Lee, Dorellyn L.; Wos, Stanislaw; Lang, Irene; Wells, Gretchen; Drazner, Mark H.; Schmedtje, John F.; Pauly, Daniel F.; Sueta, Carla A.; Di Maio, Michael; Kron, Irving L.; Velazquez, Eric J.; Lee, Kerry L.
2013-01-01
Background Patients with heart failure and coronary artery disease often undergo coronary artery bypass grafting (CABG) but assessment of the risk of an adverse outcome in these patients is difficult. To evaluate the ability of biomarkers to contribute independent prognostic information in these patients, we measured levels in patients enrolled in the Biomarker Sub-studies of the Surgical Treatment for Ischemic Heart Failure (STICH) trials. Patients in STICH Hypothesis 1 were randomized to medical therapy or CABG whereas those in STICH Hypothesis 2 were randomized to CABG or CABG with left ventricular reconstruction. Methods and Results In sub-study patients assigned to STICH Hypothesis 1 (n=606), plasma levels of sTNFR-1 and BNP were highly predictive of the primary outcome variable of mortality by univariate analysis (BNP χ2=40.6; p<0.0001: sTNFR-1 χ2=38,9; p<0.0001). When considered in the context of multivariable analysis, both BNP and sTNFR-1 contributed independent prognostic information beyond the information provided by a large array of clinical factors independent of treatment assignment. Consistent results were seen when assessing the predictive value of BNP and sTNFR-1 in patients assigned to STICH Hypothesis 2 (n=626). Both plasma levels of BNP (χ2=30.3) and sTNFR-1 (χ2=45.5) were highly predictive in univariate analysis (p<0.0001) as well as in multivariable analysis for the primary endpoint of death or cardiac hospitalization. In multivariable analysis, the prognostic information contributed by BNP (χ2=6.0; p=0.049) and sTNFR-1 (χ2=8.8; p=0.003) remained statistically significant even after accounting for other clinical information. Although the biomarkers added little discriminatory improvement to the clinical factors (increase in c-index ≤ 0.1), Net Reclassification Improvement (NRI) for the primary endpoints was 0.29 for BNP and 0.21 for sTNFR-1in the Hypothesis 1 cohort, and 0.15 for BNP and 0.30 for sTNFR-1 in the Hypothesis 2 cohort, reflecting important predictive improvement. Conclusions Elevated levels of sTNFR-1 and BNP are strongly associated with outcomes, independent of therapy, in two large and independent studies, thus providing important cross-validation for the prognostic importance of these two biomarkers. PMID:23584092
Timkova, Jana; Fojtikova, Ivana; Pacherova, Petra
2017-01-01
The purpose of the study is to determine radon-prone areas in the Czech Republic based on the measurements of indoor radon concentration and independent predictors (rock type and permeability of the bedrock, gamma dose rate, GPS coordinates and the average age of family houses). The relationship between the mean observed indoor radon concentrations in monitored areas (∼22% municipalities) and the independent predictors was modelled using a bagged neural network. Levels of mean indoor radon concentration in the unmonitored areas were predicted using the bagged neural network model fitted for the monitored areas. The propensity to increased indoor radon was determined by estimated probability of exceeding the action level of 300Bq/m 3 . Copyright © 2016 Elsevier Ltd. All rights reserved.
Onat, Altan; Uyarel, Hüseyin; Hergenç, Gülay; Karabulut, Ahmet; Albayrak, Sinan; Can, Günay
2007-03-01
We aimed to investigate determinants of abdominal obesity and its clinical impact on metabolic syndrome (MS), diabetes (DM) and coronary heart disease (CHD) in men. Prospective evaluation of 1638 male participants (aged 48.5+/-12.3), representative of Turkey's men who have a high prevalence of MS. For components of MS, criteria of NCEP guidelines were adopted, modified for abdominal obesity. Follow-up constituted 9650 person-years. Insulin level (relative risk [RR] 1.40 for doubling), C-reactive protein (CRP) and heavy smoking (protective) were independent predictors of newly developing abdominal obesity. High triglyceride and low HDL-cholesterol were significantly associated already with waist girth quartile II, apolipoprotein B with quartile III. Waist girth significantly predicted future MS from quartile II on, independent of insulin resistance (IR) by homeostatic model assessment, whereby its hazard ratio (HR, 2.6) exceeded double that of HOMA. CRP independently predicted MS. Age-adjusted HR of waist girth (1.59) was significant in predicting DM. Age- and smoking-adjusted top waist quartile conferred significant risk for incident CHD (RR 1.71) but not for overall mortality. As judged by sensitivity and specificity rates for future CHD, DM and MS, abdominal obesity was most appropriately defined with a waist girth of >or=95 cm, and an action level 1 of >or=87 cm was proposed for MS in this population. Serum insulin, CRP levels and (inversely) heavy smoking are predictors for abdominal obesity in Turkish men. Atherogenic dyslipidemia and elevated blood pressure are associated significantly already with modest rises in waist girth adjusted for age and smoking. Abdominal obesity shows substantial independence of IR in the development of MS. Increasing waist girth was predictive of MS, more strongly than of DM. Risk for CHD imparted by abdominal obesity is essentially mediated by risk factors it induces.
ERIC Educational Resources Information Center
Rikli, Roberta E.; Jones, C. Jessie
2013-01-01
Purpose: To develop and validate criterion-referenced fitness standards for older adults that predict the level of capacity needed for maintaining physical independence into later life. The proposed standards were developed for use with a previously validated test battery for older adults--the Senior Fitness Test (Rikli, R. E., & Jones, C. J.…
Reading and writing skills in young adults with spina bifida and hydrocephalus.
Barnes, Marcia; Dennis, Maureen; Hetherington, Ross
2004-09-01
Reading and writing were studied in 31 young adults with spina bifida and hydrocephalus (SBH). Like children with this condition, young adults with SBH had better word decoding than reading comprehension, and, compared to population means, had lower scores on a test of writing fluency. Reading comprehension was predicted by word decoding and listening comprehension. Writing was predicted by fine motor finger function, verbal intelligence, and short-term and working memory. These findings are consistent with cognitive models of reading and writing. Writing, but not reading, was related to highest level of education achieved and writing fluency predicted several aspects of functional independence. Reading comprehension and writing remain deficient in adults with SBH and have consequences for educational attainments and functional independence.
Li, Feiming; Gimpel, John R; Arenson, Ethan; Song, Hao; Bates, Bruce P; Ludwin, Fredric
2014-04-01
Few studies have investigated how well scores from the Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) series predict resident outcomes, such as performance on board certification examinations. To determine how well COMLEX-USA predicts performance on the American Osteopathic Board of Emergency Medicine (AOBEM) Part I certification examination. The target study population was first-time examinees who took AOBEM Part I in 2011 and 2012 with matched performances on COMLEX-USA Level 1, Level 2-Cognitive Evaluation (CE), and Level 3. Pearson correlations were computed between AOBEM Part I first-attempt scores and COMLEX-USA performances to measure the association between these examinations. Stepwise linear regression analysis was conducted to predict AOBEM Part I scores by the 3 COMLEX-USA scores. An independent t test was conducted to compare mean COMLEX-USA performances between candidates who passed and who failed AOBEM Part I, and a stepwise logistic regression analysis was used to predict the log-odds of passing AOBEM Part I on the basis of COMLEX-USA scores. Scores from AOBEM Part I had the highest correlation with COMLEX-USA Level 3 scores (.57) and slightly lower correlation with COMLEX-USA Level 2-CE scores (.53). The lowest correlation was between AOBEM Part I and COMLEX-USA Level 1 scores (.47). According to the stepwise regression model, COMLEX-USA Level 1 and Level 2-CE scores, which residency programs often use as selection criteria, together explained 30% of variance in AOBEM Part I scores. Adding Level 3 scores explained 37% of variance. The independent t test indicated that the 397 examinees passing AOBEM Part I performed significantly better than the 54 examinees failing AOBEM Part I in all 3 COMLEX-USA levels (P<.001 for all 3 levels). The logistic regression model showed that COMLEX-USA Level 1 and Level 3 scores predicted the log-odds of passing AOBEM Part I (P=.03 and P<.001, respectively). The present study empirically supported the predictive and discriminant validities of the COMLEX-USA series in relation to the AOBEM Part I certification examination. Although residency programs may use COMLEX-USA Level 1 and Level 2-CE scores as partial criteria in selecting residents, Level 3 scores, though typically not available at the time of application, are actually the most statistically related to performances on AOBEM Part I.
Ghasemzadeh, Nima; Hritani, Abdul Wahab; De Staercke, Christine; Eapen, Danny J; Veledar, Emir; Al Kassem, Hatem; Khayata, Mohamed; Zafari, A Maziar; Sperling, Laurence; Hooper, Craig; Vaccarino, Viola; Mavromatis, Kreton; Quyyumi, Arshed A
2015-01-01
Stromal derived factor-1α/CXCL12 is a chemoattractant responsible for homing of progenitor cells to ischemic tissues. We aimed to investigate the association of plasma CXCL12 with long-term cardiovascular outcomes in patients with coronary artery disease (CAD). 785 patients aged: 63 ± 12 undergoing coronary angiography were independently enrolled into discovery (N = 186) and replication (N = 599) cohorts. Baseline levels of plasma CXCL12 were measured using Quantikine CXCL12 ELISA assay (R&D systems). Patients were followed for cardiovascular death and/or myocardial infarction (MI) for a mean of 2.6 yrs. Cox proportional hazard was used to determine independent predictors of cardiovascular death/MI. The incidence of cardiovascular death/MI was 13% (N = 99). High CXCL12 level based on best discriminatory threshold derived from the ROC analysis predicted risk of cardiovascular death/MI (HR = 4.81, p = 1 × 10(-6)) independent of traditional risk factors in the pooled cohort. Addition of CXCL12 to a baseline model was associated with a significant improvement in c-statistic (AUC: 0.67-0.73, p = 0.03). Addition of CXCL12 was associated with correct risk reclassification of 40% of events and 10.5% of non-events. Similarly for the outcome of cardiovascular death, the addition of the CXCL12 to the baseline model was associated with correct reclassification of 20.7% of events and 9% of non-events. These results were replicated in two independent cohorts. Plasma CXCL12 level is a strong independent predictor of adverse cardiovascular outcomes in patients with CAD and improves risk reclassification. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
A neighborhood statistics model for predicting stream pathogen indicator levels.
Pandey, Pramod K; Pasternack, Gregory B; Majumder, Mahbubul; Soupir, Michelle L; Kaiser, Mark S
2015-03-01
Because elevated levels of water-borne Escherichia coli in streams are a leading cause of water quality impairments in the U.S., water-quality managers need tools for predicting aqueous E. coli levels. Presently, E. coli levels may be predicted using complex mechanistic models that have a high degree of unchecked uncertainty or simpler statistical models. To assess spatio-temporal patterns of instream E. coli levels, herein we measured E. coli, a pathogen indicator, at 16 sites (at four different times) within the Squaw Creek watershed, Iowa, and subsequently, the Markov Random Field model was exploited to develop a neighborhood statistics model for predicting instream E. coli levels. Two observed covariates, local water temperature (degrees Celsius) and mean cross-sectional depth (meters), were used as inputs to the model. Predictions of E. coli levels in the water column were compared with independent observational data collected from 16 in-stream locations. The results revealed that spatio-temporal averages of predicted and observed E. coli levels were extremely close. Approximately 66 % of individual predicted E. coli concentrations were within a factor of 2 of the observed values. In only one event, the difference between prediction and observation was beyond one order of magnitude. The mean of all predicted values at 16 locations was approximately 1 % higher than the mean of the observed values. The approach presented here will be useful while assessing instream contaminations such as pathogen/pathogen indicator levels at the watershed scale.
Sato, N; Kenjo, A; Kimura, T; Okada, R; Ishigame, T; Kofunato, Y; Shimura, T; Abe, K; Ohira, H; Marubashi, S
2018-04-23
Liver fibrosis is a risk factor for hepatectomy but cannot be determined accurately before hepatectomy because diagnostic procedures are too invasive. Magnetic resonance elastography (MRE) can determine liver stiffness (LS), a surrogate marker for assessing liver fibrosis, non-invasively. The aim of this study was to investigate whether the LS value determined by MRE is predictive of major complications after hepatectomy. This prospective study enrolled consecutive patients who underwent hepatic resection between April 2013 and August 2016. LS values were measured by imaging shear waves by MRE in the liver before hepatectomy. The primary endpoint was major complications, defined as Clavien-Dindo grade IIIa or above. Logistic regression analysis identified independent predictive factors, from which a logistic model to estimate the probability of major complications was constructed. A total of 96 patients were included in the study. Major complications were observed in 15 patients (16 per cent). Multivariable logistic analysis confirmed that higher LS value (P = 0·021) and serum albumin level (P = 0·009) were independent predictive factors for major complications after hepatectomy. Receiver operating characteristic (ROC) analysis showed that the best LS cut-off value was 4·3 kPa for detecting major complications, comparable to liver fibrosis grade F4, with a sensitivity of 80 per cent and specificity of 82 per cent. A logistic model using the LS value and serum albumin level to estimate the probability of major complications was constructed; the area under the ROC curve for predicting major complications was 0·84. The LS value determined by MRE in patients undergoing hepatectomy was an independent predictive factor for major complications. © 2018 BJS Society Ltd Published by John Wiley & Sons Ltd.
2013-01-01
Background S100A12 protein is an endogenous receptor ligand for advanced glycation end products. In this study, the plasma S100A12 level was assessed as an independent predictor of mortality, and its utility in clinical settings was examined. Methods In a previous cross-sectional study, plasma S100A12 levels were measured in 550 maintenance hemodialysis patients to determine the association between S100A12 and the prevalence of cardiovascular diseases (CVD). In this prospective study, the risk of mortality within a two-year period was determined. An integer scoring system was developed to predict mortality on the basis of the plasma S100A12 levels. Results Higher plasma S100A12 levels (≥18.79 ng/mL) were more closely associated with higher all-cause mortality than lower plasma S100A12 levels (<18.79 ng/mL; P = 0.001). Multivariate Cox proportional hazards analysis revealed higher plasma S100A12 levels [hazard ratio (HR), 2.267; 95% confidence interval (CI), 1.195–4.302; P = 0.012], age ≥65 years (HR, 1.961; 95%CI, 1.017–3.781; P = 0.044), serum albumin levels <3.5 g/dL (HR, 2.198; 95%CI, 1.218–3.968; P = 0.012), and history of CVD (HR, 2.068; 95%CI, 1.146–3.732; P = 0.016) to be independent predictors of two-year all-cause mortality. The integer score was derived by assigning points to these factors and determining total scores. The scoring system revealed trends across increasing scores for predicting the all-cause mortality [c-statistic = 0.730 (0.656–0.804)]. The resulting model demonstrated good discriminative power for distinguishing the validation population of 303 hemodialysis patients [c-statistic = 0.721 (0.627–0.815)]. Conclusion The results indicate that plasma S100A12 level is an independent predictor for two-year all-cause mortality. A simple integer scoring system was therefore established for predicting mortality on the basis of plasma S100A12 levels. PMID:23324110
Chua, Michael E; Tanseco, Patrick P; Mendoza, Jonathan S; Castillo, Josefino C; Morales, Marcelino L; Luna, Saturnino L
2015-04-01
To configure and validate a novel prostate disease nomogram providing prostate biopsy outcome probabilities from a prospective study correlating clinical indicators and diagnostic parameters among Filipino adult male with elevated serum total prostate specific antigen (PSA) level. All men with an elevated serum total PSA underwent initial prostate biopsy at our institution from January 2011 to August 2014 were included. Clinical indicators, diagnostic parameters, which include PSA level and PSA-derivatives, were collected as predictive factors for biopsy outcome. Multiple logistic-regression analysis involving a backward elimination selection procedure was used to select independent predictors. A nomogram was developed to calculate the probability of the biopsy outcomes. External validation of the nomogram was performed using separate data set from another center for determination of sensitivity and specificity. A receiver-operating characteristic (ROC) curve was used to assess the accuracy in predicting differential biopsy outcome. Total of 552 patients was included. One hundred and ninety-one (34.6%) patients had benign prostatic hyperplasia, and 165 (29.9%) had chronic prostatitis. The remaining 196 (35.5%) patients had prostate adenocarcinoma. The significant independent variables used to predict biopsy outcome were age, family history of prostate cancer, prior antibiotic intake, PSA level, PSA-density, PSA-velocity, echogenic findings on ultrasound, and DRE status. The areas under the receiver-operating characteristic curve for prostate cancer using PSA alone and the nomogram were 0.688 and 0.804, respectively. The nomogram configured based on routinely available clinical parameters, provides high predictive accuracy with good performance characteristics in predicting the prostate biopsy outcome such as presence of prostate cancer, high Gleason prostate cancer, benign prostatic hyperplasia, and chronic prostatitis.
Scrutinio, Domenico; Lanzillo, Bernardo; Guida, Pietro; Mastropasqua, Filippo; Monitillo, Vincenzo; Pusineri, Monica; Formica, Roberto; Russo, Giovanna; Guarnaschelli, Caterina; Ferretti, Chiara; Calabrese, Gianluigi
2017-12-01
Prediction of outcome after stroke rehabilitation may help clinicians in decision-making and planning rehabilitation care. We developed and validated a predictive tool to estimate the probability of achieving improvement in physical functioning (model 1) and a level of independence requiring no more than supervision (model 2) after stroke rehabilitation. The models were derived from 717 patients admitted for stroke rehabilitation. We used multivariable logistic regression analysis to build each model. Then, each model was prospectively validated in 875 patients. Model 1 included age, time from stroke occurrence to rehabilitation admission, admission motor and cognitive Functional Independence Measure scores, and neglect. Model 2 included age, male gender, time since stroke onset, and admission motor and cognitive Functional Independence Measure score. Both models demonstrated excellent discrimination. In the derivation cohort, the area under the curve was 0.883 (95% confidence intervals, 0.858-0.910) for model 1 and 0.913 (95% confidence intervals, 0.884-0.942) for model 2. The Hosmer-Lemeshow χ 2 was 4.12 ( P =0.249) and 1.20 ( P =0.754), respectively. In the validation cohort, the area under the curve was 0.866 (95% confidence intervals, 0.840-0.892) for model 1 and 0.850 (95% confidence intervals, 0.815-0.885) for model 2. The Hosmer-Lemeshow χ 2 was 8.86 ( P =0.115) and 34.50 ( P =0.001), respectively. Both improvement in physical functioning (hazard ratios, 0.43; 0.25-0.71; P =0.001) and a level of independence requiring no more than supervision (hazard ratios, 0.32; 0.14-0.68; P =0.004) were independently associated with improved 4-year survival. A calculator is freely available for download at https://goo.gl/fEAp81. This study provides researchers and clinicians with an easy-to-use, accurate, and validated predictive tool for potential application in rehabilitation research and stroke management. © 2017 American Heart Association, Inc.
Roy-O'Reilly, Meaghan; Ritzel, Rodney M; Conway, Sarah E; Staff, Ilene; Fortunato, Gilbert; McCullough, Louise D
2017-12-01
Circulating levels of the pro-inflammatory cytokine C-C motif chemokine 11 (CCL11, also known as eotaxin-1) are increased in several animal models of neuroinflammation, including traumatic brain injury and Alzheimer's disease. Increased levels of CCL11 have also been linked to decreased neurogenesis in mice. We hypothesized that circulating CCL11 levels would increase following ischemic stroke in mice and humans, and that higher CCL11 levels would correlate with poor long-term recovery in patients. As predicted, circulating levels of CCL11 in both young and aged mice increased significantly 24 h after experimental stroke. However, ischemic stroke patients showed decreased CCL11 levels compared to controls 24 h after stroke. Interestingly, lower post-stroke CCL11 levels were predictive of increased stroke severity and independently predictive of poorer functional outcomes in patients 12 months after ischemic stroke. These results illustrate important differences in the peripheral inflammatory response to ischemic stroke between mice and human patients. In addition, it suggests CCL11 as a candidate biomarker for the prediction of acute and long-term functional outcomes in ischemic stroke patients.
[Effect of vitamin D deficiency on hypocalcaemia after total thyroidectomy due to benign goitre].
Díez, Manuel; Vera, Cristina; Ratia, Tomás; Diego, Lucía; Mendoza, Fernando; Guillamot, Paloma; San Román, Rosario; Mugüerza, José M; Rodríguez, Angel; Medina, Carlos; Gómez, Beatriz; Granell, Javier
2013-04-01
The purpose of this study was to analyse the relationship between preoperative serum levels of vitamin D and postoperative hypocalcaemia after total thyroidectomy. A prospective observational study was conducted on 113 patients treated by total thyroidectomy due to benign disease. Preoperative vitamin D serum levels and postoperative albumin-corrected calcium and parathormone (PTH) levels were determined. Sensitivity, specificity, positive predictive value and negative predictive value of vitamin D and PTH levels, respectively, in the diagnosis of postoperative hypocalcaemia were calculated. Hypocalcaemia was diagnosed in 44 (38.9%) patients. Vitamin D levels were significantly higher in the group of patients with normal postoperative calcium (median: 25.4pg/mL; range: 4-60), compared to those who developed hypocalcaemia (median: 16.4pg/mL; range: 6.3-46.9) (P=.001). Postoperative hypocalcaemia was more frequent in patients with vitamin D < 30ng/mL (39/78) (50%), than among those with normal levels (5/35) (14.2%) (P=.001). Sensitivity, specificity, positive predictive value and negative predictive value were 88% and 68%, 43% and 82%, 50% and 71%, and 85% and 80% for vitamin D and PTH, respectively. Vitamin D and PTH showed independent prognostic values on the risk of hypocalcaemia. The OR associated with vitamin D < 30ng/mL was 4.25 (95% CI: 1.31-13.78) (P=.016), and the OR of PTH<13pg/mL was 15.4 (95% CI: 4.83-49.1) (P<.001). Vitamin D deficiency is a risk factor of hypocalcaemia after total thyroidectomy for benign goitre. The vitamin D level provides independent prognostic information, which is complementary to that given by PTH. Copyright © 2012 AEC. Published by Elsevier Espana. All rights reserved.
Goei, Dustin; Flu, Willem-Jan; Hoeks, Sanne E; Galal, Wael; Dunkelgrun, Martin; Boersma, Eric; Kuijper, Ruud; van Kuijk, Jan-Peter; Winkel, Tamara A; Schouten, Olaf; Bax, Jeroen J; Poldermans, Don
2009-11-01
N-terminal pro-B-type natriuretic peptide (NT-proBNP) predicts adverse cardiac outcome in patients undergoing vascular surgery. However, several conditions might influence this prognostic value, including anemia. In this study, we evaluated whether anemia confounds the prognostic value of NT-proBNP for predicting cardiac events in patients undergoing vascular surgery. A detailed cardiac history, resting echocardiography, and hemoglobin and NT-proBNP levels were obtained in 666 patients before vascular surgery. Anemia was defined as serum hemoglobin <13 g/dL for men and <12 g/dL for women. Troponin T measurements and 12-lead electrocardiograms were performed on postoperative days 1, 3, 7, and 30 and whenever clinically indicated. The primary end point of the study was the composite of 30-day postoperative cardiovascular death, nonfatal myocardial infarction, and troponin T release. Receiver operating characteristic curve analysis was used to assess the optimal cutoff value of NT-proBNP for the prediction of the composite end point. Multivariable regression analysis was used to assess the additional value of NT-proBNP for the prediction of postoperative cardiac events in nonanemic and anemic patients. Anemia was present in 206 patients (31%) before surgery. Hemoglobin level was inversely related with the NT-proBNP levels (beta coefficient = -2.242; P = 0.025). The optimal predictive cutoff value of NT-proBNP for predicting the composite cardiovascular outcome was 350 pg/mL. After adjustment for clinical cardiac risk factors, both anemia (odds ratio [OR] 1.53; 95% confidence interval [CI]: 1.07-2.99) and increased levels of NT-proBNP (OR 4.09; 95% CI: 2.19-7.64) remained independent predictors for postoperative cardiac events. However, increased levels of NT-proBNP were not predictive for the risk of adverse cardiac events in the subgroup of anemic patients (OR 2.16; 95% CI: 0.90-5.21). Both anemia and NT-proBNP are independently associated with an increased risk for postoperative cardiac events in patients undergoing vascular surgery. NT-proBNP has less predictive value in anemic patients.
Self-perceptions and their Prediction of Aggression in Male Juvenile Offenders.
Smith, Stephanie D; Lynch, Rebecca J; Stephens, Haley F; Kistner, Janet A
2015-08-01
This study evaluated multiple facets of self-perceptions that have been theorized and shown to play a contributory role in the development of aggression for less clinically severe populations in a sample of youths from the juvenile justice system. Independent and unique associations of low self-esteem and inflated self-perceptions with aggression were examined in a sample of male juvenile offenders (N = 119; Mean age = 16.74 years) using a longitudinal study design. Latent growth curve modeling analyses revealed that self-esteem, adaptive and maladaptive narcissism independently predicted juvenile offenders' initial levels of aggression. It was also found that perceptual bias independently predicted changes in aggression over time. With the inclusion of all variables in the same model, self-esteem was no longer associated with aggression; however, all other relationships remained significant. The implications of these findings as well as the importance of interventions targeting self-perceptions to decrease aggression among high-risk youths are discussed.
Evidence against associative blocking as a cause of cue-independent retrieval-induced forgetting.
Hulbert, Justin C; Shivde, Geeta; Anderson, Michael C
2012-01-01
Selectively retrieving an item from long-term memory reduces the accessibility of competing traces, a phenomenon known as retrieval-induced forgetting (RIF). RIF exhibits cue independence, or the tendency for forgetting to generalize to novel test cues, suggesting an inhibitory basis for this phenomenon. An alternative view (Camp, Pecher, & Schmidt, 2007; Camp et al., 2009; Perfect et al., 2004) suggests that using novel test cues to measure cue independence actually engenders associative interference when participants covertly supplement retrieval with practiced cues that then associatively block retrieval. Accordingly, the covert-cueing hypothesis assumes that the relative strength of the practiced items at final test – and not the inhibition levied on the unpracticed items during retrieval practice – underlies cue-independent forgetting. As such, this perspective predicts that strengthening practiced items by any means, even if not via retrieval practice, should induce forgetting. Contrary to these predictions, however, we present clear evidence that cue-independent forgetting is induced by retrieval practice and not by repeated study exposures. This dissociation occurred despite significant, comparable levels of strengthening of practiced items in each case, and despite the use of Anderson and Spellman's original (1995) independent probe method criticized by covert-cueing theorists as being especially conducive to associative blocking. These results demonstrate that cue-independent RIF is unrelated to the strengthening of practiced items, and thereby fail to support a key prediction of the covert-cueing hypothesis. The results, instead, favor a role of inhibition in resolving retrieval interference. © 2011 Hogrefe Publishing
Bouhajja, Houda; Abdelhedi, Rania; Amouri, Ali; Hadj Kacem, Faten; Marrakchi, Rim; Safi, Wajdi; Mrabet, Houcem; Chtourou, Lassaad; Charfi, Nadia; Fourati, Mouna; Bensassi, Salwa; Jamoussi, Kamel; Abid, Mohamed; Ayadi, Hammadi; Feki, Mouna Mnif; Elleuch, Noura Bougacha
2018-03-10
The relationship between liver enzymes and type 2 diabetes (T2D) risk is inconclusive. We aimed to evaluate the association between liver markers and risk of carbohydrate metabolism disorders and their discriminatory power for T2D prediction. This cross-sectional study enrolled 216 participants classified as normoglycemic, prediabetes, newly-diagnosed diabetes and diagnosed diabetes. All participants underwent anthropometric and biochemical measurements. The relationship between hepatic enzymes and glucose metabolism markers was evaluated by ANCOVA analyses. The associations between liver enzymes and incident carbohydrate metabolism disorders were analyzed through logistic regression and their discriminatory capacity for T2D by receiver operating characteristic (ROC) analysis. High alkaline phosphatase (AP), alanine aminotransferase (ALT), γ-glutamyltransferase (γGT) and aspartate aminotrasferase (AST) levels were independently related to decreased insulin sensitivity. Interestingly, higher AP level was significantly associated with increased risk of prediabetes (p=0.017), newly-diagnosed diabetes (p=0.004) and T2D (p=0.007). Elevated γGT level was an independent risk factor for T2D (p=0.032) and undiagnosed-T2D (p=0.010) in prediabetic and normoglycemic subjects, respectively. In ROC analysis, AP was a powerful predictor of incident diabetes and significantly improved T2D prediction. Liver enzymes within normal range, specifically AP levels, are associated with increased risk of carbohydrate metabolism disorders and significantly improved T2D prediction.
Besser, Avi; Priel, Beatriz
2011-01-01
This study evaluated the intervening role of meaning-making processes in emotional responses to negative life events based on Blatt's (1974, 2004) formulations concerning the role of personality predispositions in depression. In a pre/post within-subject study design, a community sample of 233 participants reacted to imaginary scenarios of interpersonal rejection and achievement failure. Meaning-making processes relating to threats to self-definition and interpersonal relatedness were examined following the exposure to the scenarios. The results indicated that the personality predisposition of Dependency, but not Self-Criticism predicted higher levels of negative affect following the interpersonal rejection event, independent of baseline levels of negative affect. This effect was mediated by higher levels of negative meaning-making processes related to the effect of the interpersonal rejection scenario on Dependent individuals' senses of interpersonal relatedness and self-worth. In addition, both Self-Criticism and Dependency predicted higher levels of negative affect following the achievement failure event, independent of baseline levels of negative affect. Finally, the effect of Self-Criticism was mediated by higher levels of negative meaning-making processes related to the effect of the achievement failure scenario on self-critical individuals' senses of self-definition.
Designing collective behavior in a termite-inspired robot construction team.
Werfel, Justin; Petersen, Kirstin; Nagpal, Radhika
2014-02-14
Complex systems are characterized by many independent components whose low-level actions produce collective high-level results. Predicting high-level results given low-level rules is a key open challenge; the inverse problem, finding low-level rules that give specific outcomes, is in general still less understood. We present a multi-agent construction system inspired by mound-building termites, solving such an inverse problem. A user specifies a desired structure, and the system automatically generates low-level rules for independent climbing robots that guarantee production of that structure. Robots use only local sensing and coordinate their activity via the shared environment. We demonstrate the approach via a physical realization with three autonomous climbing robots limited to onboard sensing. This work advances the aim of engineering complex systems that achieve specific human-designed goals.
Development and verification of NRC`s single-rod fuel performance codes FRAPCON-3 AND FRAPTRAN
DOE Office of Scientific and Technical Information (OSTI.GOV)
Beyer, C.E.; Cunningham, M.E.; Lanning, D.D.
1998-03-01
The FRAPCON and FRAP-T code series, developed in the 1970s and early 1980s, are used by the US Nuclear Regulatory Commission (NRC) to predict fuel performance during steady-state and transient power conditions, respectively. Both code series are now being updated by Pacific Northwest National Laboratory to improve their predictive capabilities at high burnup levels. The newest versions of the codes are called FRAPCON-3 and FRAPTRAN. The updates to fuel property and behavior models are focusing on providing best estimate predictions under steady-state and fast transient power conditions up to extended fuel burnups (> 55 GWd/MTU). Both codes will be assessedmore » against a data base independent of the data base used for code benchmarking and an estimate of code predictive uncertainties will be made based on comparisons to the benchmark and independent data bases.« less
Shelledy, D C; Mikles, S P; May, D F; Youtsey, J W
1992-01-01
Increased stress, burnout, and lack of job satisfaction may contribute to a decline in work performance, absenteeism, and intent to leave one's job or field. We undertook to determine organizational, job-specific, and personal predictors of level of burnout among respiratory care practitioners (RCPs). We also examined the relationships among burnout, job satisfaction (JS), absenteeism, and RCPs' intent to leave their job or the field. A pilot-tested assessment instrument was mailed to all active NBRC-credentialed RCPs in Georgia (n = 788). There were 458 usable returns (58% response rate). A random sample of 10% of the nonrespondents (n = 33) was then surveyed by telephone, and the results were compared to those of the mail respondents. Variables were compared to burnout and JS scores by correlational analysis, which was followed by stepwise multiple regression analyses to determine the ability of the independent variables to predict burnout and JS scores when used in combination. There were no significant differences between respondents and sampled nonrespondents in burnout scores (p = 0.56) or JS (p = 0.24). Prediction of burnout: The coefficient of multiple correlation, R2, indicated that in combination the independent variables accounted for 61% of the variance in burnout scores. The strongest predictor of burnout was job stress. Other job-related predictors of burnout were size of department, satisfaction with work, satisfaction with co-workers and co-worker support, job independence and job control, recognition by nursing, and role clarity. Personal-variable predictors were age, number of previous jobs held, social support, and intent to leave the field of respiratory care. Prediction of job satisfaction: R2 indicated that, in combination, the independent variables accounted for 63% of the variance observed in satisfaction with work, 36% of the variance observed in satisfaction with pay, 36% of the variance in satisfaction with promotions, 62% of the variance in satisfaction with supervision, and 48% of the variance in satisfaction with co-workers. Predictors of work-satisfaction level were recognition by physicians and nursing, age, burn-out level, absenteeism, and intent to leave the field. Predictors of level of satisfaction with pay were actual salary, job independence, organizational climate, ease of obtaining time off, job stress, absenteeism, intent to leave the field, and number of dependent children. Predictors of level of satisfaction with promotions were recognition by nursing, participation in decision making, job stress, intent to leave the field, past turnover rates, and absenteeism. Predictors of level of satisfaction with supervision included supervisor support, role clarity, independence, and ease of obtaining time off. The strongest predictor of level of satisfaction with co-workers was co-worker support. As overall level of JS increased, level of burnout decreased significantly (r = -0.59, p less than 0.001). As burnout level increased, increases occurred in absenteeism (r = 0.22, p less than 0.001), intent to leave the job (r = 0.48, p less than 0.001), and intent to leave the field (r = 0.51, p less than 0.001). Reduced job stress, increased job independence and job control, improved role clarity, and higher levels of JS were all associated with lower levels of burnout. Managerial attention to these factors may improve patient care and reduce absenteeism and turnover among RCPs.
NASA Astrophysics Data System (ADS)
Wu, Xing-Gang; Shen, Jian-Ming; Du, Bo-Lun; Brodsky, Stanley J.
2018-05-01
As a basic requirement of the renormalization group invariance, any physical observable must be independent of the choice of both the renormalization scheme and the initial renormalization scale. In this paper, we show that by using the newly suggested C -scheme coupling, one can obtain a demonstration that the principle of maximum conformality prediction is scheme-independent to all-orders for any renormalization schemes, thus satisfying all of the conditions of the renormalization group invariance. We illustrate these features for the nonsinglet Adler function and for τ decay to ν + hadrons at the four-loop level.
Prentice, J C; Pizer, S D; Conlin, P R
2016-12-01
To characterize the relationship between HbA 1c variability and adverse health outcomes among US military veterans with Type 2 diabetes. This retrospective cohort study used Veterans Affairs and Medicare claims for veterans with Type 2 diabetes taking metformin who initiated a second diabetes medication (n = 50 861). The main exposure of interest was HbA 1c variability during a 3-year baseline period. HbA 1c variability, categorized into quartiles, was defined as standard deviation, coefficient of variation and adjusted standard deviation, which accounted for the number and mean number of days between HbA 1c tests. Cox proportional hazard models predicted mortality, hospitalization for ambulatory care-sensitive conditions, and myocardial infarction or stroke and were controlled for mean HbA 1c levels and the direction of change in HbA 1c levels during the baseline period. Over a mean 3.3 years of follow-up, all HbA 1c variability measures significantly predicted each outcome. Using the adjusted standard deviation measure for HbA 1c variability, the hazard ratios for the third and fourth quartile predicting mortality were 1.14 (95% CI 1.04, 1.25) and 1.42 (95% CI 1.28, 1.58), for myocardial infarction and stroke they were 1.25 (95% CI 1.10, 1.41) and 1.23 (95% CI 1.07, 1.42) and for ambulatory-care sensitive condition hospitalization they were 1.10 (95% CI 1.03, 1.18) and 1.11 (95% CI 1.03, 1.20). Higher baseline HbA 1c levels independently predicted the likelihood of each outcome. In veterans with Type 2 diabetes, greater HbA 1c variability was associated with an increased risk of adverse long-term outcomes, independently of HbA 1c levels and direction of change. Limiting HbA 1c fluctuations over time may reduce complications. © 2016 Diabetes UK.
Ogawa, K
1992-01-01
This paper proposes a new evaluation and prediction method for computer usability. This method is based on our two previously proposed information transmission measures created from a human-to-computer information transmission model. The model has three information transmission levels: the device, software, and task content levels. Two measures, called the device independent information measure (DI) and the computer independent information measure (CI), defined on the software and task content levels respectively, are given as the amount of information transmitted. Two information transmission rates are defined as DI/T and CI/T, where T is the task completion time: the device independent information transmission rate (RDI), and the computer independent information transmission rate (RCI). The method utilizes the RDI and RCI rates to evaluate relatively the usability of software and device operations on different computer systems. Experiments using three different systems, in this case a graphical information input task, confirm that the method offers an efficient way of determining computer usability.
Low bioavailable testosterone levels predict future height loss in postmenopausal women.
Jassal, S K; Barrett-Connor, E; Edelstein, S L
1995-04-01
The objective of this study was to examine the relation of endogenous sex hormones to subsequent height loss in postmenopausal women, in whom height loss is usually a surrogate for osteoporotic vertebral fractures. This was a prospective, community-based study. The site chosen was Rancho Bernardo, an upper middle class community in Southern California. A total of 170 postmenopausal women participated, aged 55-80 years. None of them were taking exogenous estrogen between 1972 and 1974. Plasma was obtained for sex hormone and sex hormone-binding globulin (SHBG) assays. Estradiol/SHBG and testosterone/SHBG ratios were used to estimate biologically available hormone levels; bioavailable (non-SHBG-bound) testosterone was measured directly in 60 women. Height loss was based on height measurements taken 16 years apart. Height loss was strongly correlated with age (p = 0.001). These women lost an average 0.22 cm/year in height. Neither estrone nor estradiol levels were significantly and independently related to height loss. Both estimated bioavailable testosterone (testosterone/SHBG ratio) and measured bioavailable testosterone levels predicted future height loss (p = 0.02 and 0.08, respectively) independent of age, obesity, cigarette smoking, alcohol intake, and use of thiazides and estrogen. We conclude that bioavailable testosterone is an independent predictor of height loss in elderly postmenopausal women. The reduced height loss is compatible with a direct effect of testosterone on bone mineral density or bone remodeling.
Serum immunoglobulin levels predict fibrosis in patients with non-alcoholic fatty liver disease.
McPherson, Stuart; Henderson, Elsbeth; Burt, Alastair D; Day, Christopher P; Anstee, Quentin M
2014-05-01
A third of the population are estimated to have NAFLD of varying severity. Serum immunoglobulins are frequently elevated in patients with chronic liver disease, but little is known about serum immunoglobulin levels in patients with NAFLD. Aim of this study was to evaluate serum immunoglobulin levels (IgA, IgG, and IgM) in a large cohort of patients with biopsy-proven NAFLD and determine if immunoglobulin levels are associated with clinical or histological features. Patients seen in a tertiary fatty liver clinic between 1999 and 2009 were included. Liver biopsies were assessed using the Kleiner score. Immunoglobulin levels and other blood tests were taken at time of biopsy. 285 patients (110 simple steatosis and 175 NASH) had serum immunoglobulins measured within 6months of liver biopsy. 130 (46%) patients had elevated (>1× upper limit of normal) serum IgA levels, 28 (10%) patients had elevated IgG and 22 (8%) raised IgM. Serum IgA levels were elevated more frequently in patients with NASH compared with subjects with simple steatosis (55% vs. 31%, p<0.001). Overall, 55 (19%) patients had advanced liver fibrosis (Kleiner stage 3-4). There was a significant positive association between serum IgA levels and the stage of fibrosis (p<0.001). Serum IgA, age, platelets, AST/ALT ratio and BMI were all independently with advanced fibrosis following multivariate analysis. A model constructed from these independent predictors accurately predicted advanced fibrosis (AUROC 0.87). The serum IgA level was frequently elevated in patients with NAFLD and was an independent predictor of advanced fibrosis. Copyright © 2014 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
First Principle Predictions of Isotopic Shifts in H2O
NASA Technical Reports Server (NTRS)
Schwenke, David W.; Kwak, Dochan (Technical Monitor)
2002-01-01
We compute isotope independent first and second order corrections to the Born-Oppenheimer approximation for water and use them to predict isotopic shifts. For the diagonal correction, we use icMRCI wavefunctions and derivatives with respect to mass dependent, internal coordinates to generate the mass independent correction functions. For the non-adiabatic correction, we use scaled SCF/CIS wave functions and a generalization of the Handy method to obtain mass independent correction functions. We find that including the non-adiabatic correction gives significantly improved results compared to just including the diagonal correction when the Born-Oppenheimer potential energy surface is optimized for H2O-16. The agreement with experimental results for deuterium and tritium containing isotopes is nearly as good as our best empirical correction, however, the present correction is expected to be more reliable for higher, uncharacterized levels.
Fluid mechanical model of the Helmholtz resonator
NASA Technical Reports Server (NTRS)
Hersh, A. S.; Walker, B.
1977-01-01
A semi-empirical fluid mechanical model of the acoustic behavior of Helmholtz resonators is presented which predicts impedance as a function of the amplitude and frequency of the incident sound pressure field and resonator geometry. The model assumes that the particle velocity approaches the orifice in a spherical manner. The incident and cavity sound fields are connected by solving the governing oscillating mass and momentum conservation equations. The model is in agreement with the Rayleigh slug-mass model at low values of incident sound pressure level. At high values, resistance is predicted to be independent of frequency, proportional to the square root of the amplitude of the incident sound pressure field, and virtually independent of resonator geometry. Reactance is predicted to depend in a very complicated way upon resonator geometry, incident sound pressure level, and frequency. Nondimensional parameters are defined that divide resonator impedance into three categories corresponding to low, moderately low, and intense incident sound pressure amplitudes. The two-microphone method was used to measure the impedance of a variety of resonators. The data were used to refine and verify the model.
Future Nuisance Flooding at Boston Caused by Astronomical Tides Alone
NASA Technical Reports Server (NTRS)
Ray, Richard D.; Foster, Grant
2016-01-01
Sea level rise necessarily triggers more occurrences of minor, or nuisance, flooding events along coastlines, a fact well documented in recent studies. At some locations nuisance flooding can be brought about merely by high spring tides, independent of storms, winds, or other atmospheric conditions. Analysis of observed water levels at Boston indicates that tidal flooding began to occur there in 2011 and will become more frequent in subsequent years. A compilation of all predicted nuisance-flooding events, induced by astronomical tides alone, is presented through year 2050. The accuracy of the tide prediction is improved when several unusual properties of Gulf of Maine tides, including secular changes, are properly accounted for. Future mean sea-level rise at Boston cannot be predicted with comparable confidence, so two very different climate scenarios are adopted; both predict a large increase in the frequency and the magnitude of tidal flooding events.
Diagnostic properties of C-reactive protein for detecting pneumonia in children.
Koster, Madieke J; Broekhuizen, Berna D L; Minnaard, Margaretha C; Balemans, Walter A F; Hopstaken, Rogier M; de Jong, Pim A; Verheij, Theo J M
2013-07-01
The diagnostic value of C-reactive protein (CRP) level for pneumonia in children is unknown. As a first step in the assessment of the value of CRP, a diagnostic study was performed in children at an emergency department (ED). In this cross-sectional study, data were retrospectively collected from children presenting with suspected pneumonia at the ED of Antonius Hospital Nieuwegein in The Netherlands between January 2007 and January 2012. Diagnostic outcome was pneumonia yes/no according to independent radiologist. (Un)adjusted association between CRP level and pneumonia and diagnostic value of CRP were calculated. Of 687 presenting children, 286 underwent both CRP measurement and chest radiography. 148 had pneumonia (52%). The proportion of pneumonia increased with CRP level. Negative predictive values declined, but positive predictive values increased with higher CRP thresholds. Univariable odds ratio for the association between CRP level and pneumonia was 1.2 (95% CI 1.11-1.21) per 10 mg/L increase. After adjustment for baseline characteristics CRP level remained associated with pneumonia. CRP level has independent diagnostic value for pneumonia in children presenting at the ED with suspected pneumonia, but low levels do not exclude pneumonia in this setting. These results prompt evaluation of CRP in primary care children with LRTI. Copyright © 2013 Elsevier Ltd. All rights reserved.
James, D; Chilvers, C
2001-11-01
To identify academic and non-academic predictors of success of entrants to the Nottingham medical course over the first 25 completed years of the course's existence. SETTING, DESIGN AND MAIN OUTCOME MEASURES: Retrospective study of academic and non-academic characteristics of 2270 entrants between 1970 and 1990, and their subsequent success. Analyses were undertaken of two cohorts (entrants between 1970 and 1985 and entrants between 1986 and 1990). Overall, 148 of 2270 (6.5%) entrants left the course, with the highest proportion being from the first 6 years (10.7%). Of the 148 leavers, 58 (39.2%) did so after obtaining their BMedSci degree. Concerning non-academic factors, in the 1970-85 cohort, applicants from the later years and those not taking a year out were more successful. However, these two factors had no influence on outcome in 1986-90. In contrast, ethnicity and gender were highly significant predictors of success in obtaining honours at BMBS in 1986-90 but at no other exam nor in the earlier years. Older, mature or graduate entrants were more successful at obtaining a first-class degree at BMedSci for the whole 21 years. However, they were less likely to be successful at passing the BMBS. With regard to academic factors, overall, A grades at Ordinary level/General Certificate of Secondary Education (O-Level/GCSE) were inconsistent independent predictors of success. However, for 1986-90, high grades at O-Level/GCSE chemistry and biology were strong independent predictors of success at BMedSci and BMBS. Very few Advanced level (A-Level) criteria were independent predictors of success for 1970-85. In contrast, for 1986-90 entrants, achieving a high grade at A-Level chemistry predicted success at obtaining a first-class degree at BMedSci, and a high grade at A-Level biology predicted success at BMBS. Over the 21 years, the majority of entrants achieved significantly lower grades at A-Level than predicted. General Studies A-Level was a poor predictor of achievement. On balance our current GCSE A-grade requirements should remain. Biology should be added to Chemistry as a compulsory A-Level subject. If predicted A-Level grades are borderline then the lower estimate should be used. General Studies should continue not to be used in selection. Performance of more recent mature entrants at BMBS needs further study. The recent gender and ethnic biases in obtaining honours at BMBS is currently being examined. The motivation of applicants planning to take deferred entry should be carefully explored at interview.
ERIC Educational Resources Information Center
Moore, Graham F.; Littlecott, Hannah J.
2015-01-01
Background: Interventions to address inequalities in adolescent health behaviors often target children from less affluent families, or schools in poorer areas. Few studies have examined whether school- or family-level affluence predicts health behaviors independently, or in combination. Methods: This article reports secondary analysis of the Welsh…
Jeppesen, Kelly Marvin; Coyle, James D.; Miser, William F.
2009-01-01
PURPOSE Limited health literacy is increasingly recognized as a barrier to receiving adequate health care. Identifying patients at risk of poor health outcomes secondary to limited health literacy is currently the responsibility of clinicians. Our objective was to identify which screening questions and demographics independently predict limited health literacy and could thus help clinicians individualize their patient education. METHODS Between August 2006 and July 2007, we asked 225 patients being treated for diabetes at an academic primary care office several questions regarding their reading ability as part of a larger study (57% response rate). We built a logistic regression model predicting limited health literacy to determine the independent predictive properties of these questions and demographic variables. Patients were classified as having limited health literacy if they had a Short Test of Functional Health Literacy in Adults (S-TOFHLA) score of less than 23. The potential predictors evaluated were self-rated reading ability, highest education level attained, Single-Item Literacy Screener (SILS) result, patients’ reading enjoyment, age, sex, and race. RESULTS Overall, 15.1% of the patients had limited health literacy. In the final model, 5 of the potential predictors were independently associated with increased odds of having limited health literacy. Specifically, patients were more likely to have limited health literacy if they had a poorer self-rated reading ability (odds ratio [OR] per point increase in the model = 3.37; 95% confidence interval [CI], 1.71–6.63), more frequently needed help reading written health materials (assessed by the SILS) (OR = 2.03; 95% CI, 1.26–3.26), had a lower education level (OR = 1.89; 95% CI, 1.12–3.18), were male (OR = 4.46; 95% CI, 1.53–12.99), and were of nonwhite race (OR = 3.73; 95% CI, 1.04–13.40). These associations were not confounded by age. The area under the receiver operating characteristic curve was 0.9212. CONCLUSIONS Self-rated reading ability, SILS result, highest education level attained, sex, and race independently predict whether a patient has limited health literacy. Clinicians should be aware of these associations and ask questions to identify patients at risk. We propose an “SOS” mnemonic based on these findings to help clinicians wishing to individualize patient education. PMID:19139446
Dodson, John A; Arnold, Suzanne V; Reid, Kimberly J; Gill, Thomas M; Rich, Michael W; Masoudi, Frederick A; Spertus, John A; Krumholz, Harlan M; Alexander, Karen P
2012-05-01
Acute myocardial infarction (AMI) may contribute to health status declines including "independence loss" and "physical function decline." Despite the importance of these outcomes for prognosis and quality of life, their incidence and predictors have not been well described. We studied 2,002 patients with AMI enrolled across 24 sites in the TRIUMPH registry who completed assessments of independence and physical function at the time of AMI and 1 year later. Independence was evaluated by the EuroQol-5D (mobility, self-care, and usual activities), and physical function was assessed with the Short Form-12 physical component score. Declines in ≥1 level on EuroQol-5D and >5 points in PCS were considered clinically significant changes. Hierarchical, multivariable, modified Poisson regression models accounting for within-site variability were used to identify predictors of independence loss and physical function decline. One-year post AMI, 43.0% of patients experienced health status declines: 12.8% independence loss alone, 15.2% physical function decline alone, and 15.0% both. After adjustment, variables that predicted independence loss included female sex, nonwhite race, unmarried status, uninsured status, end-stage renal disease, and depression. Variables that predicted physical function decline were uninsured status, lack of cardiac rehabilitation referral, and absence of pre-AMI angina. Age was not predictive of either outcome after adjustment. >40% of patients experience independence loss or physical function decline 1 year after AMI. These changes are distinct but can occur simultaneously. Although some risk factors are not modifiable, others suggest potential targets for strategies to preserve patients' health status. Copyright © 2012 Mosby, Inc. All rights reserved.
Formulation of topical bioadhesive gel of aceclofenac using 3-level factorial design.
Singh, Sanjay; Parhi, Rabinarayan; Garg, Anuj
2011-01-01
The objective of this work was to develop bioadhesive topical gel of Aceclofenac with the help of response-surface approach. Experiments were performed according to a 3-level factorial design to evaluate the effects of two independent variables [amount of Poloxamer 407 (PL-407 = X1) and hydroxypropylmethyl cellulose K100 M (HPMC = X2)] on the bioadhesive character of gel, rheological property of gel (consistency index), and in-vitro drug release. The best model was selected to fit the data. Mathematical equation was generated by Design Expert® software for the model which assists in determining the effect of independent variables. Response surface plots were also generated by the software for analyzing effect of the independent variables on the response. Quadratic model was found to be the best for all the responses. Both independent variable (X1 and X2) were found to have synergistic effect on bioadhesion (Y1) but the effect of HPMC was more pronounced than PL-407. Consistency index was enhanced by increasing the level of both independent variables. An antagonistic effect of both independent variables was found on cumulative percentage release of drug in 2 (Y3) and 8 h (Y4). Both independent variables approximately equally contributed the antagonistic effect on Y3 whereas antagonistic effect of HPMC was more pronounced than PL-407. The effect of formulation variables on the product characteristics can be easily predicted and precisely interpreted by using a 3-level factorial experimental design and generated quadratic mathematical equations.
Yates, Janet; Smith, Jennifer; James, David; Ferguson, Eamonn
2009-01-21
It has been suggested that studying non-science subjects at A-level should be compulsory for medical students. Our admissions criteria specify only Biology, Chemistry and one or more additional subjects. This study aimed to determine whether studying a non-science subject for A-level is an independent predictor of achievement on the undergraduate medical course. The subjects of this retrospective cohort study were 164 students from one entry-year group (October 2000), who progressed normally on the 5-year undergraduate medical course at Nottingham. Pre-admission academic and socio-demographic data and undergraduate course marks were obtained. T-test and hierarchical multiple linear regression analyses were undertaken to identify independent predictors of five course outcomes at different stages throughout the course. There was no evidence that the choice of science or non-science as the third or fourth A-level subject had any influence on course performance. Demographic variables (age group, sex, and fee status) had some predictive value but ethnicity did not. Pre-clinical course performance was the strongest predictor in the clinical phases (pre-clinical Themes A&B (knowledge) predicted Clinical Knowledge, p < 0.001, and pre-clinical Themes C&D (skills) predicted Clinical Skills, p = or< 0.01). This study of one year group at Nottingham Medical School provided no evidence that the admissions policy on A-level requirements should specify the choice of third or fourth subject.
Yates, Janet; Smith, Jennifer; James, David; Ferguson, Eamonn
2009-01-01
Background It has been suggested that studying non-science subjects at A-level should be compulsory for medical students. Our admissions criteria specify only Biology, Chemistry and one or more additional subjects. This study aimed to determine whether studying a non-science subject for A-level is an independent predictor of achievement on the undergraduate medical course. Methods The subjects of this retrospective cohort study were 164 students from one entry-year group (October 2000), who progressed normally on the 5-year undergraduate medical course at Nottingham. Pre-admission academic and socio-demographic data and undergraduate course marks were obtained. T-test and hierarchical multiple linear regression analyses were undertaken to identify independent predictors of five course outcomes at different stages throughout the course. Results There was no evidence that the choice of science or non-science as the third or fourth A-level subject had any influence on course performance. Demographic variables (age group, sex, and fee status) had some predictive value but ethnicity did not. Pre-clinical course performance was the strongest predictor in the clinical phases (pre-clinical Themes A&B (knowledge) predicted Clinical Knowledge, p < 0.001, and pre-clinical Themes C&D (skills) predicted Clinical Skills, p = < 0.01). Conclusion This study of one year group at Nottingham Medical School provided no evidence that the admissions policy on A-level requirements should specify the choice of third or fourth subject. PMID:19159444
Elmer, Jonathan; Jeong, Kwonho; Abebe, Kaleab Z; Guyette, Francis X; Murugan, Raghavan; Callaway, Clifton W; Rittenberger, Jon C
2016-01-01
In the first days after cardiac arrest, accurate prognostication is challenging. Serum biomarkers are a potentially attractive adjunct for prognostication and risk stratification. Our primary objective in this exploratory study was to identify novel early serum biomarkers that predict survival after cardiac arrest earlier than currently possible. Prospective, observational study. A single academic medical center. Adult subjects who sustained cardiac arrest with return of spontaneous circulation. None. We obtained blood samples from each subject at enrollment, 6, 12, 24, 48, and 72 hours after return of spontaneous circulation. We measured the serum levels of novel biomarkers, including neutrophil gelatinase-associated lipocalin, high-mobility group protein B1, intracellular cell adhesion molecule-1, and leptin, as well as previously characterized biomarkers, including neuron-specific enolase and S100B protein. Our primary outcome of interest was survival-to-hospital discharge. We compared biomarker concentrations at each time point between survivors and nonsurvivors and used logistic regression to test the unadjusted associations of baseline clinical characteristics and enrollment biomarker levels with survival. Finally, we constructed a series of adjusted models to explore the independent association of each enrollment biomarker level with survival. A total of 86 subjects were enrolled. Enrollment levels of high-mobility group protein B1, neutrophil gelatinase-associated lipocalin, and S100B were higher in nonsurvivors than survivors. Enrollment leptin, neuron-specific enolase, and intracellular cell adhesion molecule-1 levels did not differ between nonsurvivors and survivors. The discriminatory power of enrollment neutrophil gelatinase-associated lipocalin level was the greatest (c-statistic, 0.78 [95% CI, 0.66-0.90]) and remained stable across all time points. In our adjusted models, enrollment neutrophil gelatinase-associated lipocalin level was independently associated with survival even after controlling for the development of acute kidney injury, and its addition to clinical models improved overall predictive accuracy. Serum neutrophil gelatinase-associated lipocalin levels are strongly predictive of survival-to-hospital discharge after cardiac arrest.
Xu, Xiao; Tian, Xue; Chen, Yuan; Yang, Zhi-Kai; Qu, Zhen; Dong, Jie
2018-04-19
Although the association between adipokines such as adiponectin, leptin, and body composition has been noted, whether they could predict the change of fat mass and lean body mass is unknown. We aimed to examine these associations in patients on peritoneal dialysis (PD) through a prospective cohort study. Body composition (by dual-energy x-ray absorptiometry) including fat mass and lean body mass were examined at baseline and then at year 3. Serum leptin and adiponectin levels were measured. Demographic data, comorbidity, biochemical data, inflammation (high-sensitive C-reactive protein [hs-CRP]) and insulin resistance (homeostatic model assessment [HOMA-IR]) were also examined. At baseline, serum adiponectin levels were significantly inversely correlated with weight, lean body mass index (LBMI), fat mass index (FMI), lean body mass (LBM), and fat mass (FM) in 213 prevalent patients. At year 3, FMI, LBMI, FM, and the percentage of FM (FM%) increased while the percentage of LBM (LBM%) significantly decreased despite unchanged weight and LBM among the remaining 112 patients. After adjustment for demographic data, comorbidities, hs-CRP, HOMA-IR, and daily energy intake (DEI), serum adiponectin at baseline was not associated with increases in LBMI, FMI, and FM, but independently associated with an increase in FM% and a decrease in LBM%. The predictive effect of high-serum adiponectin level on mortality disappeared after adjusting for diabetes and cardiovascular disease. Serum leptin was not associated with any changes in body composition during the follow-up, nor with the mortality in this cohort. A high adiponectin level could predict an increase in FM% and a decrease in LBM% during a 3-year follow-up in PD patients. Serum adiponectin could not independently predict mortality in PD patients.
Rueger, Sandra Yu; Chen, Pan; Jenkins, Lyndsay N; Choe, Hyung Joon
2014-04-01
The transition to middle school can be a significant stressor for young adolescents, leading to increases in depression for those who are vulnerable. The current study examined how perceived support from mothers, fathers, and teachers independently and interactively predicted developmental patterns of depressive symptoms during adolescents' transition to middle school, and gender differences in these effects of social support. Four timepoints of data were collected from 1,163 participants (48.5 % boys) enrolled in an ethnically diverse suburban middle school in the Midwest between 1.25 and 20.50 months after these participants entered the 7th grade. The results from growth curve modeling indicated that levels of depressive symptoms decreased over time for boys but remained stable for girls during the developmental period examined. There is also evidence that support from mothers, fathers, and teachers independently and inversely predicted levels of depressive symptoms at the beginning of the 7th grade, and support from both mothers and fathers predicted changes in these symptoms. Effects of mothers' support and teachers' support, but not the effect of fathers' support, remained significant in reducing levels of depressive symptoms at 20.50 months from middle school entry. Furthermore, the protective effect of mothers' support was stronger for girls than for boys. Finally, mothers' support interacted with fathers' support and teachers' support to predict levels of depressive symptoms. Specifically, the protective effect of mothers' support was more salient when fathers' support was low, and vice versa. In contrast, support from mothers and teachers had an amplifying, synergistic effect.
Facchinello, Yann; Beauséjour, Marie; Richard-Denis, Andreane; Thompson, Cynthia; Mac-Thiong, Jean-Marc
2017-10-25
Predicting the long-term functional outcome following traumatic spinal cord injury is needed to adapt medical strategies and to plan an optimized rehabilitation. This study investigates the use of regression tree for the development of predictive models based on acute clinical and demographic predictors. This prospective study was performed on 172 patients hospitalized following traumatic spinal cord injury. Functional outcome was quantified using the Spinal Cord Independence Measure collected within the first-year post injury. Age, delay prior to surgery and Injury Severity Score were considered as continuous predictors while energy of injury, trauma mechanisms, neurological level of injury, injury severity, occurrence of early spasticity, urinary tract infection, pressure ulcer and pneumonia were coded as categorical inputs. A simplified model was built using only injury severity, neurological level, energy and age as predictor and was compared to a more complex model considering all 11 predictors mentioned above The models built using 4 and 11 predictors were found to explain 51.4% and 62.3% of the variance of the Spinal Cord Independence Measure total score after validation, respectively. The severity of the neurological deficit at admission was found to be the most important predictor. Other important predictors were the Injury Severity Score, age, neurological level and delay prior to surgery. Regression trees offer promising performances for predicting the functional outcome after a traumatic spinal cord injury. It could help to determine the number and type of predictors leading to a prediction model of the functional outcome that can be used clinically in the future.
I predict that some portion of the Virginia bald eagle population will exhibit levels at or above those considered detrimental to productivity and reproductive success. The analysis of independent variables and their relationship to elevated blood mercury levels will help t...
Kim, Dong Hun; Choi, Dong-Hyun; Kim, Hyun-Wook; Choi, Seo-Won; Kim, Bo-Bae; Chung, Joong-Wha; Koh, Young-Youp; Chang, Kyong-Sig; Hong, Soon-Pyo
2014-07-01
The aim of the present study was to evaluate the relationship between thyroid hormone levels and infarct severity in patients with ST-elevation myocardial infarction (STEMI). We retrospectively reviewed thyroid hormone levels, infarct severity, and the extent of transmurality in 40 STEMI patients evaluated via contrast-enhanced cardiac magnetic resonance imaging. The high triiodothyronine (T3) group (≥ 68.3 ng/dL) exhibited a significantly higher extent of transmural involvement (late transmural enhancement > 75% after administration of gadolinium contrast agent) than did the low T3 group (60% vs. 15%; p = 0.003). However, no significant difference was evident between the high- and low-thyroid-stimulating hormone/free thyroxine (FT4) groups. When the T3 cutoff level was set to 68.3 ng/dL using a receiver operating characteristic curve, the sensitivity was 80% and the specificity 68% in terms of differentiating between those with and without transmural involvement. Upon logistic regression analysis, high T3 level was an independent predictor of transmural involvement after adjustment for the presence of diabetes mellitus (DM) and the use of glycoprotein IIb/IIIa inhibitors (odds ratio, 40.62; 95% confidence interval, 3.29 to 502; p = 0.004). The T3 level predicted transmural involvement that was independent of glycoprotein IIb/IIIa inhibitor use and DM positivity.
Suárez-Ortegón, M F; Arbeláez, A; Mosquera, M; Méndez, F; Aguilar-de Plata, C
2012-08-01
Ferritin levels have been associated with metabolic syndrome and insulin resistance. The aim of the present study was to evaluate the prediction of ferritin levels by variables related to cardiometabolic disease risk in a multivariate analysis. For this aim, 123 healthy women (72 premenopausal and 51 posmenopausal) were recruited. Data were collected through procedures of anthropometric measurements, questionnaires for personal/familial antecedents, and dietary intake (24-h recall), and biochemical determinations (ferritin, C reactive protein (CRP), glucose, insulin, and lipid profile) in blood serum samples obtained. Multiple linear regression analysis was used and variables with no normal distribution were log-transformed for this analysis. In premenopausal women, a model to explain log-ferritin levels was found with log-CRP levels, heart attack familial history, and waist circumference as independent predictors. Ferritin behaves as other cardiovascular markers in terms of prediction of its levels by documented predictors of cardiometabolic disease and related disorders. This is the first report of a relationship between heart attack familial history and ferritin levels. Further research is required to evaluate the mechanism to explain the relationship of central body fat and heart attack familial history with body iron stores values.
Gastric sensorimotor functions and hormone profile in normal weight, overweight, and obese people.
Vazquez Roque, Maria I; Camilleri, Michael; Stephens, Debra A; Jensen, Michael D; Burton, Duane D; Baxter, Kari L; Zinsmeister, Alan R
2006-12-01
Peptide YY (PYY) levels are reported to be decreased in obesity. The relation between gastric functions, satiation, and gut hormones in obesity is incompletely understood. The aim of this study was to compare gastric volumes, emptying, maximum tolerated volumes, postchallenge symptoms, and selected gut hormones in normal, overweight, or obese healthy volunteers. In 73 nonbulimic normal, overweight, or obese participants weighing less than 137 kg, we measured gastric emptying of solids and liquids by scintigraphy (gastric emptying half-time [GE t(1/2)]); gastric volumes by single-photon emission computed tomography; maximum tolerated volumes and symptoms by satiation test; and plasma leptin, ghrelin, insulin, glucagon-like peptide 1, and PYY levels. Groups were compared using 1-way analysis of covariance adjusted for sex. Univariate associations among measured responses were assessed using Spearman correlations. Multiple linear regression models, adjusting for weight and sex, assessed the independent ability of gastric functions and hormones to predict satiation volume. Obese and overweight subjects had significantly lower postprandial gastric volumes, higher fasting and postprandial insulin and leptin levels, and lower fasting ghrelin and lower postprandial reduction in ghrelin levels. PYY levels were not different in obese or overweight subjects compared with controls. The GE t(1/2) was correlated inversely with postprandial PYY; increased body weight was associated with faster GE t(1/2) of solids (r(s) = 0.33, P = .005) and liquids (r(s) = 0.24, P = .04). Postprandial changes in gastric volume and PYY were independent predictors of satiation (both P = .01). Overweight or obesity are associated with lower postprandial gastric volumes and normal PYY levels. Gastric emptying influences postprandial PYY levels. Postprandial PYY and gastric volume independently predict satiation volume in nonbulimic people across a wide body mass index range.
Eapen, Danny J; Manocha, Pankaj; Ghasemzadeh, Nima; Ghasemzedah, Nima; Patel, Riyaz S; Al Kassem, Hatem; Hammadah, Muhammad; Veledar, Emir; Le, Ngoc-Anh; Pielak, Tomasz; Thorball, Christian W; Velegraki, Aristea; Kremastinos, Dimitrios T; Lerakis, Stamatios; Sperling, Laurence; Quyyumi, Arshed A
2014-10-23
Soluble urokinase plasminogen activator receptor (suPAR) is an emerging inflammatory and immune biomarker. Whether suPAR level predicts the presence and the severity of coronary artery disease (CAD), and of incident death and myocardial infarction (MI) in subjects with suspected CAD, is unknown. We measured plasma suPAR levels in 3367 subjects (67% with CAD) recruited in the Emory Cardiovascular Biobank and followed them for adverse cardiovascular (CV) outcomes of death and MI over a mean 2.1±1.1 years. Presence of angiographic CAD (≥50% stenosis in ≥1 coronary artery) and its severity were quantitated using the Gensini score. Cox's proportional hazard survival and discrimination analyses were performed with models adjusted for established CV risk factors and C-reactive protein levels. Elevated suPAR levels were independently associated with the presence of CAD (P<0.0001) and its severity (P<0.0001). A plasma suPAR level ≥3.5 ng/mL (cutoff by Youden's index) predicted future risk of MI (hazard ratio [HR]=3.2; P<0.0001), cardiac death (HR=2.62; P<0.0001), and the combined endpoint of death and MI (HR=1.9; P<0.0001), even after adjustment of covariates. The C-statistic for a model based on traditional risk factors was improved from 0.72 to 0.74 (P=0.008) with the addition of suPAR. Elevated levels of plasma suPAR are associated with the presence and severity of CAD and are independent predictors of death and MI in patients with suspected or known CAD. © 2014 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.
Eapen, Danny J.; Manocha, Pankaj; Ghasemzedah, Nima; Patel, Riyaz S.; Al Kassem, Hatem; Hammadah, Muhammad; Veledar, Emir; Le, Ngoc‐Anh; Pielak, Tomasz; Thorball, Christian W.; Velegraki, Aristea; Kremastinos, Dimitrios T.; Lerakis, Stamatios; Sperling, Laurence; Quyyumi, Arshed A.
2014-01-01
Introduction Soluble urokinase plasminogen activator receptor (suPAR) is an emerging inflammatory and immune biomarker. Whether suPAR level predicts the presence and the severity of coronary artery disease (CAD), and of incident death and myocardial infarction (MI) in subjects with suspected CAD, is unknown. Methods and Results We measured plasma suPAR levels in 3367 subjects (67% with CAD) recruited in the Emory Cardiovascular Biobank and followed them for adverse cardiovascular (CV) outcomes of death and MI over a mean 2.1±1.1 years. Presence of angiographic CAD (≥50% stenosis in ≥1 coronary artery) and its severity were quantitated using the Gensini score. Cox's proportional hazard survival and discrimination analyses were performed with models adjusted for established CV risk factors and C‐reactive protein levels. Elevated suPAR levels were independently associated with the presence of CAD (P<0.0001) and its severity (P<0.0001). A plasma suPAR level ≥3.5 ng/mL (cutoff by Youden's index) predicted future risk of MI (hazard ratio [HR]=3.2; P<0.0001), cardiac death (HR=2.62; P<0.0001), and the combined endpoint of death and MI (HR=1.9; P<0.0001), even after adjustment of covariates. The C‐statistic for a model based on traditional risk factors was improved from 0.72 to 0.74 (P=0.008) with the addition of suPAR. Conclusion Elevated levels of plasma suPAR are associated with the presence and severity of CAD and are independent predictors of death and MI in patients with suspected or known CAD. PMID:25341887
MacPhail, Mariana; Mullan, Barbara; Sharpe, Louise; MacCann, Carolyn; Todd, Jemma
2014-01-01
Background The purpose of this study was to explore the predictive utility of the Health Action Process Approach (HAPA) and test a HAPA-based healthy eating intervention, in adults with type 2 diabetes mellitus. Materials and methods The study employed a prospective, randomized, controlled trial design. The 4-month intervention consisted of self-guided HAPA-based workbooks in addition to two telephone calls to assist participants with the program implementation, and was compared to “treatment as usual”. Participants (n=87) completed health measures (diet, body mass index [BMI], waist circumference, blood pressure, blood glucose levels, lipid levels, and diabetes distress) and HAPA measures prior to the intervention and again upon completion 4 months later. Results The overall HAPA model predicted BMI, although only risk awareness and recovery self-efficacy were significant independent contributors. Risk awareness, intentions, and self-efficacy were also independent predictors of health outcomes; however, the HAPA did not predict healthy eating. No significant time × condition interaction effects were found for diet or any HAPA outcome measures. Conclusion Despite the success of HAPA in predicting health outcomes for those with type 2 diabetes mellitus, the intervention was unsuccessful in changing healthy eating or any of the other measured variables, and alternative low-cost health interventions for those with type 2 diabetes mellitus should be explored. PMID:25342914
Rodriguez, Christina M; Gracia, Enrique; Lila, Marisol
2016-10-01
The vast majority of research on child abuse potential has concentrated on women demonstrating varying levels of risk of perpetrating physical child abuse. In contrast, the current study considered factors predictive of physical child abuse potential in a group of 70 male intimate partner violence offenders, a group that would represent a likely high risk group. Elements of Social Information Processing theory were evaluated, including pre-existing schemas of empathy, anger, and attitudes approving of parent-child aggression considered as potential moderators of negative attributions of child behavior. To lend methodological rigor, the study also utilized multiple measures and multiple methods, including analog tasks, to predict child abuse risk. Contrary to expectations, findings did not support the role of anger independently predicting child abuse risk in this sample of men. However, preexisting beliefs approving of parent-child aggression, lower empathy, and more negative child behavior attributions independently predicted abuse potential; in addition, greater anger, poorer empathy, and more favorable attitudes toward parent-child aggression also exacerbated men's negative child attributions to further elevate their child abuse risk. Future work is encouraged to consider how factors commonly considered in women parallel or diverge from those observed to elevate child abuse risk in men of varying levels of risk. Copyright © 2016 Elsevier Ltd. All rights reserved.
Prior nonhip limb fracture predicts subsequent hip fracture in institutionalized elderly people.
Nakamura, K; Takahashi, S; Oyama, M; Oshiki, R; Kobayashi, R; Saito, T; Yoshizawa, Y; Tsuchiya, Y
2010-08-01
This 1-year cohort study of nursing home residents revealed that historical fractures of upper limbs or nonhip lower limbs were associated with hip fracture (hazard ratio = 2.14), independent of activities of daily living (ADL), mobility, dementia, weight, and type of nursing home. Prior nonhip fractures are useful for predicting of hip fracture in institutional settings. The aim of this study was to evaluate the utility of fracture history for the prediction of hip fracture in nursing home residents. This was a cohort study with a 1-year follow-up. Subjects were 8,905 residents of nursing homes in Niigata, Japan (mean age, 84.3 years). Fracture histories were obtained from nursing home medical records. ADL levels were assessed by caregivers. Hip fracture diagnosis was based on hospital medical records. Subjects had fracture histories of upper limbs (5.0%), hip (14.0%), and nonhip lower limbs (4.6%). Among historical single fractures, only prior nonhip lower limbs significantly predicted subsequent fracture (adjusted hazard ratio, 2.43; 95% confidence interval (CI), 1.30-4.57). The stepwise method selected the best model, in which a combined historical fracture at upper limbs or nonhip lower limbs (adjusted hazard ratio, 2.14; 95% CI, 1.30-3.52), dependence, ADL levels, mobility, dementia, weight, and type of nursing home independently predicted subsequent hip fracture. A fracture history at upper or nonhip lower limbs, in combination with other known risk factors, is useful for the prediction of future hip fracture in institutional settings.
Pang, Li; Wang, He-Lei; Wang, Zhi-Hao; Wu, Yang; Dong, Ning; Xu, Da-Hai; Wang, Da-Wei; Xu, Hong; Zhang, Nan
2014-09-01
The present study was designed to assess the usefulness of measuring plasma levels of copeptin (a peptide co-released with the hypothalamic stress hormone vasopressin) as a biomarker for the severity of carbon monoxide (CO) poisoning and for predicting delayed neurological sequelae (DNS). Seventy-two patients with CO poisoning and 72 sex and age matched healthy individuals were recruited. Plasma copeptin levels were measured on admission from CO poisoning patients and for healthy individuals at study entry by using a sandwich immunoassay. The CO poisoning patients were divided into two groups according to severity (unconscious and conscious) and occurrence of DNS. The mean plasma copeptin levels (52.5±18.5 pmol/L) in the unconscious group were significantly higher than in the conscious group (26.3±12.7 pmol/L) (P<0.001). Plasma copeptin levels of more than 39.0 pmol/L detected CO poisoning with severe neurological symptoms e.g. unconsciousness (sensitivity 84.6% and specificity 81.4%). The plasma copeptin levels were higher in patients with DNS compared to patients without DNS (52.2±20.6 pmol/L vs. 27.9±14.8 pmol/L, P<0.001). Plasma copeptin levels higher than 40.5 pmol/L predicted the development of DNS (sensitivity 77.8%, specificity 82.1%). Plasma copeptin levels were identified as an independent predictor for intoxication severity [odds ratio (OR) 1.261, 95% confidence interval (CI) 1.112-1.638, P=0.002] and DNS (OR 1.313, 95% CI 1.106-1.859, P=0.001). Thus, plasma copeptin levels independently related to intoxication severity and were identified as a novel biomarker for predicting DNS after acute CO poisoning. Copyright © 2014 Elsevier Inc. All rights reserved.
Subharmonic Imaging and Pressure Estimation for Monitoring Neoadjuvant Chemotherapy
2014-09-01
and therapy response [10]. However, the level of IFP has been shown to predict disease free survival for cervix cancer (34% disease free survival...p. 1951-1961. 11. Milosevic M, et al., Interstitial fluid pressure predicts survival in patients with cervix cancer independent of clinical...12b. DISTRIBUTION CODE 13. ABSTRACT (Maximum 200 Words) Neoadjuvant chemotherapy is currently the standard of care for locally advanced breast cancer
Prediction system of hydroponic plant growth and development using algorithm Fuzzy Mamdani method
NASA Astrophysics Data System (ADS)
Sudana, I. Made; Purnawirawan, Okta; Arief, Ulfa Mediaty
2017-03-01
Hydroponics is a method of farming without soil. One of the Hydroponic plants is Watercress (Nasturtium Officinale). The development and growth process of hydroponic Watercress was influenced by levels of nutrients, acidity and temperature. The independent variables can be used as input variable system to predict the value level of plants growth and development. The prediction system is using Fuzzy Algorithm Mamdani method. This system was built to implement the function of Fuzzy Inference System (Fuzzy Inference System/FIS) as a part of the Fuzzy Logic Toolbox (FLT) by using MATLAB R2007b. FIS is a computing system that works on the principle of fuzzy reasoning which is similar to humans' reasoning. Basically FIS consists of four units which are fuzzification unit, fuzzy logic reasoning unit, base knowledge unit and defuzzification unit. In addition to know the effect of independent variables on the plants growth and development that can be visualized with the function diagram of FIS output surface that is shaped three-dimensional, and statistical tests based on the data from the prediction system using multiple linear regression method, which includes multiple linear regression analysis, T test, F test, the coefficient of determination and donations predictor that are calculated using SPSS (Statistical Product and Service Solutions) software applications.
Liu, Jessica; Hu, Hui-Han; Lee, Mei-Hsuan; Korenaga, Masaaki; Jen, Chin-Lan; Batrla-Utermann, Richard; Lu, Sheng-Nan; Wang, Li-Yu; Mizokami, Masashi; Chen, Chien-Jen; Yang, Hwai-I
2017-10-30
This study examines the role of M2BPGi, a novel seromarker for chronic hepatitis, in predicting hepatocellular carcinoma (HCC) among untreated chronic hepatitis B (CHB) patients. In this nested case-control study, 1070 samples were assayed for M2BPGi, including 357 samples from HCC cases, and 713 samples from non-HCC controls, collected at various times throughout follow-up. HCC case samples were stratified according to years prior to diagnosis. Associations between M2BPGi and HCC were examined with multivariate logistic regression. M2BPGi, α-fetoprotein (AFP), and hepatitis B surface antigen (HBsAg) levels were significant independent short-term predictors of HCC, while M2BPGi was insignificant in long-term analyses. Compared to M2BPGi levels <1.0 cut-off index (COI), those with levels ≥2.0 COI had multivariate odds ratios (95% CI) for HCC of 7.40 (2.40-22.78), 6.46 (2.58-16.18), and 2.24 (0.97-5.15), respectively, for prediction of HCC within 1-2, 2-5, and ≥5 years. Higher proportions of individuals had M2BPGi levels ≥2.0 COI in samples closer to HCC diagnosis. Areas under receiver operating characteristic curves for models with M2BPGi, AFP, and HBsAg levels predicting HCC within 1-2, 2-5, and >5 years were 0.84, 0.81, and 0.75. M2BPGi is a strong and independent short-term predictor of HCC in CHB patients.
Tuñón, José; Cristóbal, Carmen; Tarín, Nieves; Aceña, Álvaro; González-Casaus, María Luisa; Huelmos, Ana; Alonso, Joaquín; Lorenzo, Óscar; González-Parra, Emilio; Mahíllo-Fernández, Ignacio; Pello, Ana María; Carda, Rocío; Farré, Jerónimo; Rodríguez-Artalejo, Fernando
2014-01-01
Objective Vitamin D and fibroblast growth factor-23 (FGF-23) are related with cardiovascular disorders. We have investigated the relationship of calcidiol (vitamin D metabolite) and FGF-23 plasma levels with the incidence of adverse outcomes in patients with coronary artery disease. Methods Prospective follow-up study of 704 outpatients, attending the departments of Cardiology of four hospitals in Spain, 6–12 months after an acute coronary event. Baseline calcidiol, FGF-23, parathormone, and phosphate plasma levels were assessed. The outcome was the development of acute ischemic events (any acute coronary syndrome, stroke, or transient ischemic attack), heart failure, or death. Cox regression adjusted for the main confounders was performed. Results Calcidiol levels showed a moderate-severe decrease in 57.3% of cases. Parathormone, FGF-23, and phosphate levels were increased in 30.0%, 11.5% and 0.9% of patients, respectively. Only 22.4% of patients had glomerular filtration rate<60 ml/min1.73 m2. After a mean follow-up was 2.15±0.99 years, 77 patients developed the outcome. Calcidiol (hazard ratio [HR] = 0.67; 95% confidence interval [CI] = 0.48–0.94; p = 0.021) and FGF-23 (HR = 1.13; 95% CI = 1.04–1.23; p = 0.005) plasma levels predicted independently the outcome. There was a significant interaction between calcidiol and FGF-23 levels (p = 0.025). When the population was divided according to FGF-23 levels, calcidiol still predicted the outcome independently in patients with FGF-23 levels higher than the median (HR = 0.50; 95% CI = 0.31–0.80; p = 0.003) but not in those with FGF-23 levels below this value (HR = 1.03; 95% CI = 0.62–1.71; p = 0.904). Conclusions Abnormalities in mineral metabolism are frequent in patients with stable coronary artery disease. In this population, low calcidiol plasma levels predict an adverse prognosis in the presence of high FGF-23 levels. PMID:24748388
Alvarez, George A.; Nakayama, Ken; Konkle, Talia
2016-01-01
Visual search is a ubiquitous visual behavior, and efficient search is essential for survival. Different cognitive models have explained the speed and accuracy of search based either on the dynamics of attention or on similarity of item representations. Here, we examined the extent to which performance on a visual search task can be predicted from the stable representational architecture of the visual system, independent of attentional dynamics. Participants performed a visual search task with 28 conditions reflecting different pairs of categories (e.g., searching for a face among cars, body among hammers, etc.). The time it took participants to find the target item varied as a function of category combination. In a separate group of participants, we measured the neural responses to these object categories when items were presented in isolation. Using representational similarity analysis, we then examined whether the similarity of neural responses across different subdivisions of the visual system had the requisite structure needed to predict visual search performance. Overall, we found strong brain/behavior correlations across most of the higher-level visual system, including both the ventral and dorsal pathways when considering both macroscale sectors as well as smaller mesoscale regions. These results suggest that visual search for real-world object categories is well predicted by the stable, task-independent architecture of the visual system. NEW & NOTEWORTHY Here, we ask which neural regions have neural response patterns that correlate with behavioral performance in a visual processing task. We found that the representational structure across all of high-level visual cortex has the requisite structure to predict behavior. Furthermore, when directly comparing different neural regions, we found that they all had highly similar category-level representational structures. These results point to a ubiquitous and uniform representational structure in high-level visual cortex underlying visual object processing. PMID:27832600
Early Predictors of Hypocalcemia After Total Thyroidectomy
Noureldine, Salem I.; Genther, Dane J.; Lopez, Michael; Agrawal, Nishant; Tufano, Ralph P.
2015-01-01
IMPORTANCE Postoperative hypocalcemia is common after total thyroidectomy, and perioperative monitoring of serum calcium levels is arguably the primary reason for overnight hospitalization. Confidently predicting which patients will not develop significant hypocalcemia may allow for a safe earlier discharge. OBJECTIVE To examine associations of patient characteristics with hypocalcemia, duration of hospitalization, and postoperative intact parathyroid hormone (IPTH) level after total thyroidectomy. DESIGN, SETTING, AND PARTICIPANTS Retrospective study of consecutive patients who underwent total thyroidectomy by a single high-volume surgeon between February 1, 2010, and November 30, 2012. Postoperative serum 25-hydroxyvitamin D (vitamin D), calcium, and IPTH levels were tested within 6 to 8 hours after surgery. Mild hypocalcemia was defined as any postoperative serum calcium level of less than 8.4 to 8.0 mg/dL. Significant hypocalcemia was defined as any postoperative serum calcium level of less than 8.0 mg/dL or the development of hypocalcemia-related symptoms. INTERVENTIONS Total thyroidectomy. MAIN OUTCOMES AND MEASURES Associations of patient demographic and clinical characteristics and laboratory values with postoperative mild and significant hypocalcemia were examined using univariate analysis, and independent predictors of hypocalcemia, duration of hospitalization, and IPTH level were determined using multivariate analysis. RESULTS Overall, 304 total thyroidectomies were performed. Mild and significant hypocalcemia occurred in 68 (22.4%) and 91 (29.9%) patients, respectively, of which the majority were female (P = .003). The development of significant hypocalcemia was associated with postoperative IPTH level (P < .001). On multivariate analysis, males had a decreased risk of developing mild (odds ratio, 0.37 [95% CI, 0.16–0.85]) and significant (odds ratio, 0.57 [95% CI, 0.09–0.78]) hypocalcemia. Every 10-pg/mL increase in postoperative IPTH level predicted a 43% decreased risk of significant hypocalcemia (P < .001) and an 18% decreased risk of hospitalization beyond 24 hours (P = .03). Presence of malignant neoplasm carried a 27% risk of mild hypocalcemia (P = .02). There was a progressively increasing risk of lower IPTH levels for each parathyroid gland inadvertently resected or autotransplanted. Male sex and African American race were independently predictive of higher IPTH levels. CONCLUSIONS AND RELEVANCE Low postoperative IPTH level, female sex, and presence of malignant neoplasm are all significant, independent predictors of hypocalcemia after total thyroidectomy. Clinicians should consider these variables when deciding how to best manage or prevent postoperative hypocalcemia. PMID:25321339
Self-Rated Activity Levels and Longevity: Evidence from a 20 Year Longitudinal Study
ERIC Educational Resources Information Center
Mullee, Mark A.; Coleman, Peter G.; Briggs, Roger S. J.; Stevenson, James E.; Turnbull, Joanne C.
2008-01-01
The study reports on factors predicting the longevity of 328 people over the age of 65 drawn from an English city and followed over 20 years. Both the reported activities score and the individual's comparative evaluation of their own level of activity independently reduced the risk of death, even when health and cognitive status were taken into…
Zhao, Xin; Chen, Yun-Xia; Li, Chun-Sheng
2015-04-01
To investigate changes in circulating complement component C3, membrane attack complex (MAC), and mannose-binding lectin (MBL) in patients with sepsis-induced disseminated intravascular coagulation (DIC). Adult septic patients admitted to the emergency department (ED) of Beijing Chao-Yang Hospital were enrolled. A DIC score of 5 or higher was considered sepsis-induced DIC. Circulating C3, MAC, and MBL levels were detected on ED arrival and compared between patients with and without DIC. The predictive value of C3, MAC, and MBL for sepsis-induced DIC at ED arrival and development of DIC after admission were assessed by receiver operating characteristic curve and logistic regression. We enrolled 267 septic patients between February and December 2013. Complement 3, MAC, and MBL were higher in the DIC group (P < .01). Membrane attack complex was the independent predictor of sepsis-induced DIC. The area under the curve of MAC in predicting sepsis-induced DIC was 0.793. During hospitalization, 25 patients without DIC at enrollment developed DIC. Membrane attack complex and Sequential Organ Failure Assessment independently predicted progress to DIC. The area under the curve of MAC was 0.741. Complement 3, MAC, and MBL were significantly increased in septic patients with DIC. Membrane attack complex independently predicted sepsis-induced DIC and development of DIC after ED admission. Copyright © 2014 Elsevier Inc. All rights reserved.
Sanchís-Bonet, A; Arribas-Gómez, I; Sánchez-Rodríguez, C; Sánchez-Chapado, M
2015-03-01
To evaluate the oncological profile and risk of biochemical recurrence of patients with prostate cancer who underwent radical prostatectomy based on the time period in which the patients were operated. To evaluate the differences in prostate-specific antigen (PSA) at diagnosis of patients with or without biochemical recurrence based on these time periods. Observation carried forward study of a cohort of 972 radical prostatectomies performed during 3 time periods (1994-2000, 2001-2006, 2007-2011). The importance of PSA at diagnosis on the time periods and on biochemical recurrence was assessed using a generalized linear model. The independent predictive behavior of biochemical recurrence was analyzed using Cox regression. The median follow-up was 38 (16-76) months. PSA levels at diagnosis were higher in the period 1994-2000 (12.97ng/mL, P<.001). Seventy-two percent of the patients from the period 2007-2011 were diagnosed as clinical stage T1c (P<.001), compared with 55% from the period 1994-2000. The percentage of extracapsular extension in the specimen decreased from 27% to 18% from the period 1994-2000 to the period 2007-2011 (p<.001). The percentage of patients with biochemical recurrence went from 38% to 14% from the first to the third period (P>.001). The difference between PSA levels at diagnosis for the patients with or without biochemical recurrence was independent of the period (P=.84). The period during which surgery was performed was not an independent predictive factor for biochemical recurrence (P=.09). Patients from the 2007-2011 period had less extracapsular disease in the radical prostatectomy. The period was not an independent predictive factor for biochemical recurrence. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.
Hattori, Yosuke; Kojima, Toshihisa; Kaneko, Atsushi; Kida, Daihei; Hirano, Yuji; Fujibayashi, Takayoshi; Yabe, Yuichiro; Oguchi, Takeshi; Kanayama, Yasuhide; Miyake, Hiroyuki; Kato, Takefumi; Takagi, Hideki; Hayashi, Masatoshi; Ito, Takayasu; Shioura, Tomone; Takahashi, Nobunori; Ishikawa, Hisato; Funahashi, Koji; Ishiguro, Naoki
2018-01-01
This study aimed to determine whether serum matrix metalloproteinase-3 (MMP-3) levels can predict remission in rheumatoid arthritis (RA) patients treated with adalimumab (ADA). Subjects were 114 RA patients continuously treated with ADA for 52 weeks. Predictive factors at baseline and 4 weeks after initiation of ADA therapy for the achievement of remission (28-point count Disease Activity Score-CRP (DAS28-CRP) < 2.3) at 52 weeks were evaluated by multivariate logistic regression analysis. DAS28-CRP at 4 weeks (odds ratio (OR) 0.614, 95% confidence interval (CI) 0.382-0.988) and improvement in serum MMP-3 levels at 4 weeks (OR 1.057, 95% CI 1.002-1.032) were independent predictors of remission at 52 weeks. The best cut-off level of DAS28-CRP and improvement in serum MMP-3 levels at 4 weeks for predicting remission at 52 weeks was 3.73 (sensitivity: 90%, specificity: 50%, area under the receiver operating characteristic curve (AUC): 62%) and 39.93% (sensitivity: 47%, specificity: 83%, AUC: 64%), respectively. Our findings suggest that a high rate of improvement in serum MMP-3 levels at 4 weeks after initiation of ADA therapy can predict remission at 52 weeks in RA patients.
[Serum PTH levels as a predictive factor of hypocalcaemia after total thyroidectomy].
Díez Alonso, Manuel; Sánchez López, José Daniel; Sánchez-Seco Peña, María Isabel; Ratia Jiménez, Tomás; Arribas Gómez, Ignacio; Rodríguez Pascual, Angel; Martín-Duce, Antonio; Guadalix Hidalgo, Gregorio; Hernández Domínguez, Sara; Granell Vicent, Javier
2009-02-01
Postoperative parathyroid hormone (PTH) levels as a predictor of hypocalcaemia in patients subjected to total thyroidectomy is analyzed. Prospective study involving 67 patients who underwent total thyroidectomy due to a benign disease. Serum PTH and ionised calcium were measured 20 h after surgery. Sensitivity, specificity and predictive values of PTH and ionised calcium levels were calculated to predict clinical and analytical hypocalcaemia. A total of 42 (62.7%) patients developed hypocalcaemia (ionised calcium<0.95 mmol/l), but only 20 (29.9%) presented with symptoms. PTH concentration the day after surgery was significantly lower in the group that developed symptomatic hypocalcaemia (5.57+/-6.4 pg/ml) than in the asymptomatic (21.5+/-15.3 pg/ml) or normocalcaemic (26.8+/-24.9 pg/ml) groups (p=0.001). Taking the value of 13 pg/ml as a cut-off point of PTH levels, sensitivity, specificity, positive predictive value and negative predictive value were 54%, 72%, 76% and 48%, respectively. On the other hand, sensitivity for predicting symptomatic hypocalcaemia was 95% and specificity was 76%. The test showed a high incidence of false positives (11/30, 36%). Negative predictive value was 97% and positive predictive value was 65%. In multivariate analysis, PTH and ionised calcium were the only perioperative factors that showed an independent predictive value as risk indicators of symptomatic hypocalcaemia. Normal PTH levels 20 h after surgery practically rule out the subsequent appearance of hypocalcaemia symptoms. On the other hand, low PTH levels are not necessarily associated to symptomatic hypocalcaemia due to the high number of false positives.
Kumar, Ravindra; Kumari, Bandana; Srivastava, Abhishikha; Kumar, Manish
2014-10-29
Nuclear receptor proteins (NRP) are transcription factor that regulate many vital cellular processes in animal cells. NRPs form a super-family of phylogenetically related proteins and divided into different sub-families on the basis of ligand characteristics and their functions. In the post-genomic era, when new proteins are being added to the database in a high-throughput mode, it becomes imperative to identify new NRPs using information from amino acid sequence alone. In this study we report a SVM based two level prediction systems, NRfamPred, using dipeptide composition of proteins as input. At the 1st level, NRfamPred screens whether the query protein is NRP or non-NRP; if the query protein belongs to NRP class, prediction moves to 2nd level and predicts the sub-family. Using leave-one-out cross-validation, we were able to achieve an overall accuracy of 97.88% at the 1st level and an overall accuracy of 98.11% at the 2nd level with dipeptide composition. Benchmarking on independent datasets showed that NRfamPred had comparable accuracy to other existing methods, developed on the same dataset. Our method predicted the existence of 76 NRPs in the human proteome, out of which 14 are novel NRPs. NRfamPred also predicted the sub-families of these 14 NRPs.
Interleukin-6 predicts recurrence and survival among head and neck cancer patients.
Duffy, Sonia A; Taylor, Jeremy M G; Terrell, Jeffrey E; Islam, Mozaffarul; Li, Yun; Fowler, Karen E; Wolf, Gregory T; Teknos, Theodoros N
2008-08-15
Increased pretreatment serum interleukin (IL)-6 levels among patients with head and neck squamous cell carcinoma (HNSCC) have been shown to correlate with poor prognosis, but sample sizes in prior studies have been small and thus unable to control for other known prognostic variables. A longitudinal, prospective cohort study determined the correlation between pretreatment serum IL-6 levels, and tumor recurrence and all-cause survival in a large population (N = 444) of previously untreated HNSCC patients. Control variables included age, sex, smoking, cancer site and stage, and comorbidities. Kaplan-Meier plots and univariate and multivariate Cox proportional hazards models were used to study the association between IL-6 levels, control variables, and time to recurrence and survival. The median serum IL-6 level was 13 pg/mL (range, 0-453). The 2-year recurrence rate was 35.2% (standard error, 2.67%). The 2-year death rate was 26.5% (standard error, 2.26%). Multivariate analyses showed that serum IL-6 levels independently predicted recurrence at significant levels [hazard ratio (HR) = 1.32; 95% confidence interval (CI), 1.11 to 1.58; P = .002] as did cancer site (oral/sinus). Serum IL-6 level was also a significant independent predictor of poor survival (HR = 1.22; 95% CI, 1.02 to 1.46; P = .03), as were older age, smoking, cancer site (oral/sinus), higher cancer stage, and comorbidities. Pretreatment serum IL-6 could be a valuable biomarker for predicting recurrence and overall survival among HNSCC patients. Using IL-6 as a biomarker for recurrence and survival may allow for earlier identification and treatment of disease relapse. 2008 American Cancer Society
Tsai, Keng-Chang; Jian, Jhih-Wei; Yang, Ei-Wen; Hsu, Po-Chiang; Peng, Hung-Pin; Chen, Ching-Tai; Chen, Jun-Bo; Chang, Jeng-Yih; Hsu, Wen-Lian; Yang, An-Suei
2012-01-01
Non-covalent protein-carbohydrate interactions mediate molecular targeting in many biological processes. Prediction of non-covalent carbohydrate binding sites on protein surfaces not only provides insights into the functions of the query proteins; information on key carbohydrate-binding residues could suggest site-directed mutagenesis experiments, design therapeutics targeting carbohydrate-binding proteins, and provide guidance in engineering protein-carbohydrate interactions. In this work, we show that non-covalent carbohydrate binding sites on protein surfaces can be predicted with relatively high accuracy when the query protein structures are known. The prediction capabilities were based on a novel encoding scheme of the three-dimensional probability density maps describing the distributions of 36 non-covalent interacting atom types around protein surfaces. One machine learning model was trained for each of the 30 protein atom types. The machine learning algorithms predicted tentative carbohydrate binding sites on query proteins by recognizing the characteristic interacting atom distribution patterns specific for carbohydrate binding sites from known protein structures. The prediction results for all protein atom types were integrated into surface patches as tentative carbohydrate binding sites based on normalized prediction confidence level. The prediction capabilities of the predictors were benchmarked by a 10-fold cross validation on 497 non-redundant proteins with known carbohydrate binding sites. The predictors were further tested on an independent test set with 108 proteins. The residue-based Matthews correlation coefficient (MCC) for the independent test was 0.45, with prediction precision and sensitivity (or recall) of 0.45 and 0.49 respectively. In addition, 111 unbound carbohydrate-binding protein structures for which the structures were determined in the absence of the carbohydrate ligands were predicted with the trained predictors. The overall prediction MCC was 0.49. Independent tests on anti-carbohydrate antibodies showed that the carbohydrate antigen binding sites were predicted with comparable accuracy. These results demonstrate that the predictors are among the best in carbohydrate binding site predictions to date. PMID:22848404
Rashad, Nearmeen M; El-Shal, Amal S; Etewa, Rasha L; Wadea, Fady M
2017-02-01
Obesity and diabetes are increasing in epidemic proportions globally. Lipocalin-2 (LCN-2) is an inflammatory adipocytokine and obesity-related marker of low-grade inflammation. We aimed to investigate, for first time, the possible role of LCN-2 expression and serum levels in prediction of impaired glucose tolerance (IGT) and type 2 diabetes mellitus (T2DM) among obese Egyptian women. This study included 188 obese women and 180 controls. Obese women were subdivided into three subgroups according to their fasting blood glucose, normal glucose tolerance (NGT), IGT and T2DM. Circulating LCN-2 expression levels were determined by real time polymerase chain reaction. Serum LCN-2 concentrations were assessed by ELISA. Our findings revealed that LCN-2 expression and serum levels were higher in obese women compared to lean controls. They were higher in IGT and T2DM obese cases than in NGT obese women. Receiver operating characteristic analyses revealed that LCN-2 expression level was a useful biomarker discriminating IGT from NGT and T2DM from IGT obese women (AUC were 0.735 and 0.740, respectively). It was an independent predictor of IGT and T2DM among obese women. Serum LCN-2 level was a useful biomarker discriminating IGT from NGT and T2DM from IGT obese women (AUC were 0.705 and 0.728, respectively). It was independent predictor of T2DM without predicting IGT among obese women. The power of combined LCN-2 serum levels and expression in discriminating between IGT from NGT and T2DM from IGT obese women was high (AUC = 0.717 and 0.741, respectively). In conclusion, LCN-2 expression and serum levels could discriminate IGT from NGT and T2DM from IGT obese women and early predicting T2DM among obese women. While, LCN-2 expression level was the independent predictor of IGT in obese women. Combination of both LCN-2 expression and serum levels improved their diagnostic value in early detection of IGT and T2DM among obese women. © 2017 IUBMB Life, 69(2):88-97, 2017. © 2017 International Union of Biochemistry and Molecular Biology.
Park, Jung Jae; Kim, Chan Kyo; Park, Sung Yoon; Park, Byung Kwan; Lee, Hyun Moo; Cho, Seong Whi
2014-05-01
The purpose of this study is to retrospectively investigate whether pretreatment multiparametric MRI findings can predict biochemical recurrence in patients who underwent radical prostatectomy (RP) for localized prostate cancer. In this study, 282 patients with biopsy-proven prostate cancer who received RP underwent pretreatment MRI using a phased-array coil at 3 T, including T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and dynamic contrast-enhanced MRI (DCE-MRI). MRI variables included apparent tumor presence on combined imaging sequences, extracapsular extension, and tumor size on DWI or DCE-MRI. Clinical variables included baseline prostate-specific antigen (PSA) level, clinical stage, and Gleason score at biopsy. The relationship between clinical and imaging variables and biochemical recurrence was evaluated using Cox regression analysis. After a median follow-up of 26 months, biochemical recurrence developed in 61 patients (22%). Univariate analysis revealed that all the imaging and clinical variables were significantly associated with biochemical recurrence (p < 0.01). On multivariate analysis, however, baseline PSA level (p = 0.002), Gleason score at biopsy (p = 0.024), and apparent tumor presence on combined T2WI, DWI, and DCE-MRI (p = 0.047) were the only significant independent predictors of biochemical recurrence. Of the independent predictors, apparent tumor presence on combined T2WI, DWI, and DCE-MRI showed the highest hazard ratio (2.38) compared with baseline PSA level (hazard ratio, 1.05) and Gleason score at biopsy (hazard ratio, 1.34). The apparent tumor presence on combined T2WI, DWI, and DCE-MRI of pretreatment MRI is an independent predictor of biochemical recurrence after RP. This finding may be used to construct a predictive model for biochemical recurrence after surgery.
Huang, Yanqi; He, Lan; Dong, Di; Yang, Caiyun; Liang, Cuishan; Chen, Xin; Ma, Zelan; Huang, Xiaomei; Yao, Su; Liang, Changhong; Tian, Jie; Liu, Zaiyi
2018-02-01
To develop and validate a radiomics prediction model for individualized prediction of perineural invasion (PNI) in colorectal cancer (CRC). After computed tomography (CT) radiomics features extraction, a radiomics signature was constructed in derivation cohort (346 CRC patients). A prediction model was developed to integrate the radiomics signature and clinical candidate predictors [age, sex, tumor location, and carcinoembryonic antigen (CEA) level]. Apparent prediction performance was assessed. After internal validation, independent temporal validation (separate from the cohort used to build the model) was then conducted in 217 CRC patients. The final model was converted to an easy-to-use nomogram. The developed radiomics nomogram that integrated the radiomics signature and CEA level showed good calibration and discrimination performance [Harrell's concordance index (c-index): 0.817; 95% confidence interval (95% CI): 0.811-0.823]. Application of the nomogram in validation cohort gave a comparable calibration and discrimination (c-index: 0.803; 95% CI: 0.794-0.812). Integrating the radiomics signature and CEA level into a radiomics prediction model enables easy and effective risk assessment of PNI in CRC. This stratification of patients according to their PNI status may provide a basis for individualized auxiliary treatment.
Detection of Growth Hormone Deficiency in Adults with Chronic Traumatic Brain Injury
Griesbach, Grace S.; Ashley, Mark J.
2016-01-01
Abstract This study examined the prevalence of growth hormone deficiency (GHD) in patients with traumatic brain injury (TBI) during the post-acute phase of recovery and whether GHD was associated with increased disability, decreased independence, and depression. A secondary objective was to determine the accuracy of insulin-like growth factor-1 (IGF-1) levels in predicting GHD in patients with TBI. Anterior pituitary function was assessed in 235 adult patients with TBI through evaluation of fasting morning hormone levels. GH levels were assessed through provocative testing, specifically the glucagon stimulation test. GHD was diagnosed in a significant number of patients, with 45% falling into the severe GHD (≤3 μg/L) category. IGF-1 levels were not predictive of GHD. Patients with GHD were more disabled and less independent compared with those patients who were not GHD. Those patients with more severe GHD also showed decreased levels of cortisol and testosterone. Symptoms of depression were also more prevalent in this group. In addition, patients with severe GHD had delayed admission to post-acute rehabilitation. This study confirms the high prevalence of GHD in patients with TBI and the necessity to monitor clinical symptoms and perform provocative testing to definitively diagnose GHD. PMID:26414093
Serum Albumin and Disease Severity of Non-Cystic Fibrosis Bronchiectasis.
Lee, Seung Jun; Kim, Hyo-Jung; Kim, Ju-Young; Ju, Sunmi; Lim, Sujin; Yoo, Jung Wan; Nam, Sung-Jin; Lee, Gi Dong; Cho, Hyun Seop; Kim, Rock Bum; Cho, Yu Ji; Jeong, Yi Yeong; Kim, Ho Cheol; Lee, Jong Deog
2017-08-01
A clinical classification system has been developed to define the severity and predict the prognosis of subjects with non-cystic fibrosis (CF) bronchiectasis. We aimed to identify laboratory parameters that are correlated with the bronchiectasis severity index (BSI) and FACED score. The medical records of 107 subjects with non-CF bronchiectasis for whom BSI and FACED scores could be calculated were retrospectively reviewed. The correlations between the laboratory parameters and BSI or FACED score were assessed, and multiple-linear regression analysis was performed to identify variables independently associated with BSI and FACED score. An additional subgroup analysis was performed according to sex. Among all of the enrolled subjects, 49 (45.8%) were male and 58 (54.2%) were female. The mean BSI and FACED scores were 9.43 ± 3.81 and 1.92 ± 1.59, respectively. The serum albumin level (r = -0.49), bilirubin level (r = -0.31), C-reactive protein level (r = 0.22), hemoglobin level (r = -0.2), and platelet/lymphocyte ratio (r = 0.31) were significantly correlated with BSI. Meanwhile, serum albumin (r = -0.37) and bilirubin level (r = -0.25) showed a significant correlation with the FACED score. Multiple-linear regression analysis showed that the serum bilirubin level was independently associated with BSI, and the serum albumin level was independently associated with both scoring systems. Subgroup analysis revealed that the level of uric acid was also a significant variable independently associated with the BSI in male bronchiectasis subjects. Several laboratory variables were identified as possible prognostic factors for non-CF bronchiectasis. Among them, the serum albumin level exhibited the strongest correlation and was identified as an independent variable associated with the BSI and FACED scores. Copyright © 2017 by Daedalus Enterprises.
Renormalization group independence of Cosmological Attractors
NASA Astrophysics Data System (ADS)
Fumagalli, Jacopo
2017-06-01
The large class of inflationary models known as α- and ξ-attractors gives identical cosmological predictions at tree level (at leading order in inverse power of the number of efolds). Working with the renormalization group improved action, we show that these predictions are robust under quantum corrections. This means that for all the models considered the inflationary parameters (ns , r) are (nearly) independent on the Renormalization Group flow. The result follows once the field dependence of the renormalization scale, fixed by demanding the leading log correction to vanish, satisfies a quite generic condition. In Higgs inflation (which is a particular ξ-attractor) this is indeed the case; in the more general attractor models this is still ensured by the renormalizability of the theory in the effective field theory sense.
Tsuzaki, Kokoro; Kotani, Kazuhiko; Yamada, Kazunori; Sakane, Naoki
2016-09-01
Although a postprandial increment in triglyceride (TG) levels is considered to be a risk factor for atherogenesis, tests (e.g., fat load) to assess postprandial changes in TG levels cannot be easily applied to clinical practice. Therefore, fasting markers that predict postprandial TG states are needed to be developed. One current candidate is lipoprotein lipase (LPL) protein, a molecule that hydrides TGs. This study investigated whether fasting LPL levels could predict postprandial TG levels. A total of 17 subjects (11 men, 6 women, mean age 52 ± 11 years) with normotriglyceridemia during fasting underwent the meal test. Several fasting parameters, including LPL, were measured for the area under the curve of postprandial TGs (AUC-TG). The subjects' mean fasting TG level was 1.30 mmol/l, and their mean LPL level was 41.6 ng/ml. The subjects' TG levels increased after loading (they peaked after two postprandial hours). Stepwise multiple regression analysis demonstrated that fasting TG levels were a predictor of the AUC-TG. In addition, fasting LPL mass levels were found to be a predictor of the AUC-TG (β = 0.65, P < 0.01), and this relationship was independent of fasting TG levels. Fasting LPL levels may be useful to predict postprandial TG increment in this population. © 2015 Wiley Periodicals, Inc.
Adjusted neutropenia is associated with early serious infection in systemic lupus erythematosus.
Lee, Sang-Won; Park, Min-Chan; Lee, Soo-Kon; Park, Yong-Beom
2013-05-01
The susceptibility to infection increases in systemic lupus erythematosus (SLE) patients with neutropenia, but the link between infection risk and the cutoff neutrophil count still remains controversial. In this study, we investigated a valuable parameter associated with early serious infection in SLE patients during the first follow-up year. We reviewed the medical records of 160 patients with SLE. The initial levels were defined as the mean of the results of the first two consecutive tests. The adjusted levels were defined as the results of the accumulated area under the curve divided by interval follow-up days. Patients were divided into two groups according to early serious infection and initial and adjusted neutropenia and were then compared. Immunosuppressive-naïve SLE patients with early serious infection more frequently had initial, latest, and adjusted leukopenia and neutropenia (<2,500/mm(3)) and hypocomplementemia than those without. Adjusted neutropenia was the only independent predictive value for early serious infection [odds ratio (OR 11.366)]. Initial neutropenia was the independent predictive value for adjusted neutropenia (OR 6.504). We suggest that adjusted neutropenia is useful for predicting early serious infection in SLE patients during the first follow-up year.
Jerónimo, Teresa; Fragoso, André; Silva, Claudia; Guilherme, Patrícia; Santos, Nélio; Faísca, Marília; Neves, Pedro
2015-01-01
Background. Mitral valve calcification and intima media thickness (IMT) are common complications of chronic kidney disease (CKD) implicated with high cardiovascular mortality. Objective. To investigate the implication of magnesium and fibroblast growth factor-23 (FGF-23) levels with mitral valve calcification and IMT in CKD diabetic patients. Methods. Observational, prospective study involving 150 diabetic patients with mild to moderate CKD, divided according to Wilkins Score. Carotid-echodoppler and transthoracic echocardiography were used to assess calcification. Statistical tests used to establish comparisons between groups, to identify risk factors, and to establish cut-off points for prediction of mitral valve calcification. Results. FGF-23 values continually increased with higher values for both IMT and calcification whereas the opposite trend was observed for magnesium. FGF-23 and magnesium were found to independently predict mitral valve calcification and IMT (P < 0.05). Using Kaplan-Meier analysis, the number of deaths was higher in patients with lower magnesium levels and poorer Wilkins score. The mean cut-off value for FGF-23 was 117 RU/mL and for magnesium 1.7 mg/dL. Conclusions. Hypomagnesemia and high FGF-23 levels are independent predictors of mitral valve calcification and IMT and are risk factors for cardiovascular mortality in this population. They might be used as diagnostic/therapeutic targets in order to better manage the high cardiovascular risk in CKD patients. PMID:26089881
Predicting helix–helix interactions from residue contacts in membrane proteins
Lo, Allan; Chiu, Yi-Yuan; Rødland, Einar Andreas; Lyu, Ping-Chiang; Sung, Ting-Yi; Hsu, Wen-Lian
2009-01-01
Motivation: Helix–helix interactions play a critical role in the structure assembly, stability and function of membrane proteins. On the molecular level, the interactions are mediated by one or more residue contacts. Although previous studies focused on helix-packing patterns and sequence motifs, few of them developed methods specifically for contact prediction. Results: We present a new hierarchical framework for contact prediction, with an application in membrane proteins. The hierarchical scheme consists of two levels: in the first level, contact residues are predicted from the sequence and their pairing relationships are further predicted in the second level. Statistical analyses on contact propensities are combined with other sequence and structural information for training the support vector machine classifiers. Evaluated on 52 protein chains using leave-one-out cross validation (LOOCV) and an independent test set of 14 protein chains, the two-level approach consistently improves the conventional direct approach in prediction accuracy, with 80% reduction of input for prediction. Furthermore, the predicted contacts are then used to infer interactions between pairs of helices. When at least three predicted contacts are required for an inferred interaction, the accuracy, sensitivity and specificity are 56%, 40% and 89%, respectively. Our results demonstrate that a hierarchical framework can be applied to eliminate false positives (FP) while reducing computational complexity in predicting contacts. Together with the estimated contact propensities, this method can be used to gain insights into helix-packing in membrane proteins. Availability: http://bio-cluster.iis.sinica.edu.tw/TMhit/ Contact: tsung@iis.sinica.edu.tw Supplementary information:Supplementary data are available at Bioinformatics online. PMID:19244388
Tamayo, Pablo; Cho, Yoon-Jae; Tsherniak, Aviad; Greulich, Heidi; Ambrogio, Lauren; Schouten-van Meeteren, Netteke; Zhou, Tianni; Buxton, Allen; Kool, Marcel; Meyerson, Matthew; Pomeroy, Scott L.; Mesirov, Jill P.
2011-01-01
Purpose Despite significant progress in the molecular understanding of medulloblastoma, stratification of risk in patients remains a challenge. Focus has shifted from clinical parameters to molecular markers, such as expression of specific genes and selected genomic abnormalities, to improve accuracy of treatment outcome prediction. Here, we show how integration of high-level clinical and genomic features or risk factors, including disease subtype, can yield more comprehensive, accurate, and biologically interpretable prediction models for relapse versus no-relapse classification. We also introduce a novel Bayesian nomogram indicating the amount of evidence that each feature contributes on a patient-by-patient basis. Patients and Methods A Bayesian cumulative log-odds model of outcome was developed from a training cohort of 96 children treated for medulloblastoma, starting with the evidence provided by clinical features of metastasis and histology (model A) and incrementally adding the evidence from gene-expression–derived features representing disease subtype–independent (model B) and disease subtype–dependent (model C) pathways, and finally high-level copy-number genomic abnormalities (model D). The models were validated on an independent test cohort (n = 78). Results On an independent multi-institutional test data set, models A to D attain an area under receiver operating characteristic (au-ROC) curve of 0.73 (95% CI, 0.60 to 0.84), 0.75 (95% CI, 0.64 to 0.86), 0.80 (95% CI, 0.70 to 0.90), and 0.78 (95% CI, 0.68 to 0.88), respectively, for predicting relapse versus no relapse. Conclusion The proposed models C and D outperform the current clinical classification schema (au-ROC, 0.68), our previously published eight-gene outcome signature (au-ROC, 0.71), and several new schemas recently proposed in the literature for medulloblastoma risk stratification. PMID:21357789
Martin, Benjamin T; Jager, Tjalling; Nisbet, Roger M; Preuss, Thomas G; Grimm, Volker
2013-04-01
Individual-based models (IBMs) are increasingly used to link the dynamics of individuals to higher levels of biological organization. Still, many IBMs are data hungry, species specific, and time-consuming to develop and analyze. Many of these issues would be resolved by using general theories of individual dynamics as the basis for IBMs. While such theories have frequently been examined at the individual level, few cross-level tests exist that also try to predict population dynamics. Here we performed a cross-level test of dynamic energy budget (DEB) theory by parameterizing an individual-based model using individual-level data of the water flea, Daphnia magna, and comparing the emerging population dynamics to independent data from population experiments. We found that DEB theory successfully predicted population growth rates and peak densities but failed to capture the decline phase. Further assumptions on food-dependent mortality of juveniles were needed to capture the population dynamics after the initial population peak. The resulting model then predicted, without further calibration, characteristic switches between small- and large-amplitude cycles, which have been observed for Daphnia. We conclude that cross-level tests help detect gaps in current individual-level theories and ultimately will lead to theory development and the establishment of a generic basis for individual-based models and ecology.
Dai, Yuxiang; Yang, Jun; Takagi, Atsutoshi; Konishi, Hakuoh; Miyazaki, Tetsuro; Masuda, Hiroshi; Shimada, Kazunori; Miyauchi, Katsumi; Daida, Hiroyuki
2017-08-01
Relative changes in B-type natriuretic peptide (BNP) and amino terminal pro-BNP (NT-proBNP) levels may help to assess the risk of congestive heart failure (CHF). However, whether these levels at the time of admission enable the prediction of outcomes with acute exacerbation remains unknown. The current study determined the abilities of BNP, NT-proBNP and their ratio to predict in-hospital and long-term outcomes of patients with CHF. Patients who were admitted to the cardiac care unit of Juntendo University Hospital (Tokyo, Japan) with acute CHF onset were consecutively enrolled into the present observational study. Serum levels of BNP and NT-proBNP were immediately measured on admission, and other biomarkers and clinical data were also investigated. Of 195 enrolled patients, 16 (8.2%) succumbed to CHF in hospital and 124 (69.3%) reached the endpoint of mortality or readmission following a median follow-up of 14 months. Multiple linear regression analysis revealed body mass index, low density lipoprotein cholesterol, hemoglobin, estimated glomerular filtration rate and C-reactive protein as independent predictors of the NT-proBNP/BNP ratio. BNP, NT-proBNP and their ratio were significantly higher among those who succumbed to CHF than in those who remained alive in hospital (P<0.05). Logistic regression analysis indicated that the ratio was an independent predictor for in-hospital mortality and long-term outcomes. In conclusion, the ratio of NT-proBNP to BNP more effectively predicts in-hospital outcomes than either factor alone and it may also help to predict outcomes among patients with acute exacerbation of HF.
Predictors of work status and quality of life 9-13 years after aneurysmal subarachnoid hemorrahage.
Vilkki, Juhani; Juvela, Seppo; Malmivaara, Kirsi; Siironen, Jari; Hernesniemi, Juha
2012-08-01
Aneurysmal subarachnoid hemorrhage (SAH) causes long-term psychosocial impairments even in patients who regain functional independence. Little is known about predictors of these impairments. We studied how early clinical data and neuropsychological results predict work status and health-related quality of life (HRQoL) 9-13 years after SAH. One hundred one patients performed a neuropsychological test battery and returned their self-rating and partner's rating of a psychosocial impairment questionnaire approximately 1 year after SAH. These data were analyzed for association to the patients' work status and self-rated HRQoL approximately 10 years later. Age inversely, lower levels of self-rated impairments, employment and higher levels of education at the first follow-up independently predicted employment at the long-term follow-up. Although most cognitive test results were significantly associated with employment status at the long-term follow-up, they were of limited additional value as predictors of work status. The best predictor combination for long-term high HRQoL was good performance in a face recognition test and lower levels of self-rated impairments at the first follow-up as well as male sex. Problems in usual activities at the long-term follow-up were predicted by poor results in the face recognition and in a word list-learning task. Questionnaire ratings of patients' psychosocial impairments 1 year after SAH give important information for the long-term prediction of their work status and HRQoL. In the long run, patients' unemployment becomes strongly associated with higher age, while their performance of usual activities can be predicted with learning and memory results.
ERIC Educational Resources Information Center
Lombardo, Marie
A study was undertaken to (1) examine the development and construction of a Group Informal Reading Inventory to predict the reading comprehension levels (independent, instructional, and frustration) of junior high school bilingual students for the purpose of reading instruction; and (2) validate the inventory through a three-way correlational…
Gabriel, Mark C; Kolka, Randy; Wickman, Trent; Nater, Ed; Woodruff, Laurel
2009-06-15
The primary objective of this research is to investigate relationships between mercury in upland soil, lake water and fish tissue and explore the cause for the observed spatial variation of THg in age one yellow perch (Perca flavescens) for ten lakes within the Superior National Forest. Spatial relationships between yellow perch THg tissue concentration and a total of 45 watershed and water chemistry parameters were evaluated for two separate years: 2005 and 2006. Results show agreement with other studies where watershed area, lake water pH, nutrient levels (specifically dissolved NO(3)(-)-N) and dissolved iron are important factors controlling and/or predicting fish THg level. Exceeding all was the strong dependence of yellow perch THg level on soil A-horizon THg and, in particular, soil O-horizon THg concentrations (Spearman rho=0.81). Soil B-horizon THg concentration was significantly correlated (Pearson r=0.75) with lake water THg concentration. Lakes surrounded by a greater percentage of shrub wetlands (peatlands) had higher fish tissue THg levels, thus it is highly possible that these wetlands are main locations for mercury methylation. Stepwise regression was used to develop empirical models for the purpose of predicting the spatial variation in yellow perch THg over the studied region. The 2005 regression model demonstrates it is possible to obtain good prediction (up to 60% variance description) of resident yellow perch THg level using upland soil O-horizon THg as the only independent variable. The 2006 model shows even greater prediction (r(2)=0.73, with an overall 10 ng/g [tissue, wet weight] margin of error), using lake water dissolved iron and watershed area as the only model independent variables. The developed regression models in this study can help with interpreting THg concentrations in low trophic level fish species for untested lakes of the greater Superior National Forest and surrounding Boreal ecosystem.
Fu, Shihui; Liu, Chunling; Luo, Leiming; Ye, Ping
2017-11-09
Predictive abilities of cardiovascular biomarkers to renal function decline are more significant in Chinese community-dwelling population without glomerular filtration rate (GFR) below 60 ml/min/1.73m 2 , and long-term prospective study is an optimal choice to explore this problem. Aim of this analysis was to observe this problem during the follow-up of 5 years. In a large medical check-up program in Beijing, there were 948 participants with renal function evaluated at baseline and follow-up of 5 years. Physical examinations were performed by well-trained physicians. Blood samples were analyzed by qualified technicians in central laboratory. Median rate of renal function decline was 1.46 (0.42-2.91) mL/min/1.73m 2 /year. Rapid decline of renal function had a prevalence of 23.5% (223 participants). Multivariate linear and Logistic regression analyses confirmed that age, sex, baseline GFR, homocysteine and N-terminal pro B-type natriuretic peptide (NT-proBNP) had independently predictive abilities to renal function decline rate and rapid decline of renal function (p < 0.05 for all). High-sensitivity cardiac troponin T (hs-cTnT), carotid femoral pulse wave velocity and central augmentation index had no statistically independent association with renal function decline rate and rapid decline of renal function (p > 0.05 for all). Homocysteine and NT-proBNP rather than hs-cTnT had independently predictive abilities to rapid decline of renal function in Chinese community-dwelling population without GFR below 60 ml/min/1.73m 2 . Baseline GFR was an independent factor predicting the rapid decline of renal function. Arterial stiffness and compliance had no independent effect on rapid decline of renal function. This analysis has a significant implication for public health, and changing the homocysteine and NT-proBNP levels might slow the rapid decline of renal function.
Chang, Chun; Zhu, Hong; Shen, Ning; Han, Xiang; Chen, Yahong; He, Bei
2014-01-01
OBJECTIVE: Frequent readmissions for acute exacerbations of COPD (AECOPD) are an independent risk factor for increased mortality and use of health-care resources. Disease severity and C-reactive protein (CRP) level are validated predictors of long-term prognosis in such patients. This study investigated the utility of combining serum CRP level with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) exacerbation risk classification for predicting readmission for AECOPD. METHODS: This was a prospective observational study of consecutive patients hospitalized for AECOPD at Peking University Third Hospital, in Beijing, China. We assessed patient age; gender; smoking status and history (pack-years); lung function; AECOPD frequency during the last year; quality of life; GOLD risk category (A-D; D indicating the greatest risk); and serum level of high-sensitivity CRP at discharge (hsCRP-D). RESULTS: The final sample comprised 135 patients. Of those, 71 (52.6%) were readmitted at least once during the 12-month follow-up period. The median (interquartile) time to readmission was 78 days (42-178 days). Multivariate analysis revealed that serum hsCRP-D ≥ 3 mg/L and GOLD category D were independent predictors of readmission (hazard ratio = 3.486; 95% CI: 1.968-6.175; p < 0.001 and hazard ratio = 2.201; 95% CI: 1.342-3.610; p = 0.002, respectively). The ordering of the factor combinations by cumulative readmission risk, from highest to lowest, was as follows: hsCRP-D ≥ 3 mg/L and GOLD category D; hsCRP-D ≥ 3 mg/L and GOLD categories A-C; hsCRP-D < 3 mg/L and GOLD category D; hsCRP-D < 3 mg/L and GOLD categories A-C. CONCLUSIONS: Serum hsCRP-D and GOLD classification are independent predictors of readmission for AECOPD, and their predictive value increases when they are used in combination. PMID:25410837
Anxious or Depressed and Still Happy?
Spinhoven, Philip; Elzinga, Bernet M.; Giltay, Erik; Penninx, Brenda W. J. H.
2015-01-01
This study aimed to examine cross-sectionally to what extent persons with higher symptom levels or a current or past emotional disorder report to be less happy than controls and to assess prospectively whether time-lagged measurements of extraversion and neuroticism predict future happiness independent of time-lagged measurements of emotional disorders or symptom severity. A sample of 2142 adults aged 18–65, consisting of healthy controls and persons with current or past emotional disorder according to DSM-IV criteria completed self-ratings for happiness and emotional well-being and symptom severity. Lagged measurements of personality, symptom severity and presence of anxiety and depressive disorder at T0 (year 0), T2 (year 2) and T4 (year 4) were used to predict happiness and emotional well-being at T6 (year 6) controlling for demographics. In particular persons with more depressive symptoms, major depressive disorder, social anxiety disorder and comorbid emotional disorders reported lower levels of happiness and emotional well-being. Depression symptom severity and to a lesser extent depressive disorder predicted future happiness and emotional well-being at T6. Extraversion and to a lesser extent neuroticism also consistently forecasted future happiness and emotional well-being independent of concurrent lagged measurements of emotional disorders and symptoms. A study limitation is that we only measured happiness and emotional well-being at T6 and our measures were confined to hedonistic well-being and did not include psychological and social well-being. In sum, consistent with the two continua model of emotional well-being and mental illness, a ‘happy’ personality characterized by high extraversion and to a lesser extent low neuroticism forecasts future happiness and emotional well-being independent of concurrently measured emotional disorders or symptom severity levels. Boosting positive emotionality may be an important treatment goal for persons personally inclined to lower levels of happiness. PMID:26461261
Functional brain imaging predicts public health campaign success
O’Donnell, Matthew Brook; Tompson, Steven; Gonzalez, Richard; Dal Cin, Sonya; Strecher, Victor; Cummings, Kenneth Michael; An, Lawrence
2016-01-01
Mass media can powerfully affect health decision-making. Pre-testing through focus groups or surveys is a standard, though inconsistent, predictor of effectiveness. Converging evidence demonstrates that activity within brain systems associated with self-related processing can predict individual behavior in response to health messages. Preliminary evidence also suggests that neural activity in small groups can forecast population-level campaign outcomes. Less is known about the psychological processes that link neural activity and population-level outcomes, or how these predictions are affected by message content. We exposed 50 smokers to antismoking messages and used their aggregated neural activity within a ‘self-localizer’ defined region of medial prefrontal cortex to predict the success of the same campaign messages at the population level (n = 400 000 emails). Results demonstrate that: (i) independently localized neural activity during health message exposure complements existing self-report data in predicting population-level campaign responses (model combined R2 up to 0.65) and (ii) this relationship depends on message content—self-related neural processing predicts outcomes in response to strong negative arguments against smoking and not in response to compositionally similar neutral images. These data advance understanding of the psychological link between brain and large-scale behavior and may aid the construction of more effective media health campaigns. PMID:26400858
Kim, Dong Hun; Kim, Hyun-Wook; Choi, Seo-Won; Kim, Bo-Bae; Chung, Joong-Wha; Koh, Young-Youp; Chang, Kyong-Sig; Hong, Soon-Pyo
2014-01-01
Background/Aims The aim of the present study was to evaluate the relationship between thyroid hormone levels and infarct severity in patients with ST-elevation myocardial infarction (STEMI). Methods We retrospectively reviewed thyroid hormone levels, infarct severity, and the extent of transmurality in 40 STEMI patients evaluated via contrast-enhanced cardiac magnetic resonance imaging. Results The high triiodothyronine (T3) group (≥ 68.3 ng/dL) exhibited a significantly higher extent of transmural involvement (late transmural enhancement > 75% after administration of gadolinium contrast agent) than did the low T3 group (60% vs. 15%; p = 0.003). However, no significant difference was evident between the high- and low-thyroid-stimulating hormone/free thyroxine (FT4) groups. When the T3 cutoff level was set to 68.3 ng/dL using a receiver operating characteristic curve, the sensitivity was 80% and the specificity 68% in terms of differentiating between those with and without transmural involvement. Upon logistic regression analysis, high T3 level was an independent predictor of transmural involvement after adjustment for the presence of diabetes mellitus (DM) and the use of glycoprotein IIb/IIIa inhibitors (odds ratio, 40.62; 95% confidence interval, 3.29 to 502; p = 0.004). Conclusions The T3 level predicted transmural involvement that was independent of glycoprotein IIb/IIIa inhibitor use and DM positivity. PMID:25045293
NASA Astrophysics Data System (ADS)
Jeuck, James A.
This dissertation consists of research projects related to forest land use / land cover (LULC): (1) factors predicting LULC change and (2) methodology to predict particular forest use, or "potential working timberland" (PWT), from current forms of land data. The first project resulted in a published paper, a meta-analysis of 64 econometric models from 47 studies predicting forest land use changes. The response variables, representing some form of forest land change, were organized into four groups: forest conversion to agriculture (F2A), forestland to development (F2D), forestland to non-forested (F2NF) and undeveloped (including forestland) to developed (U2D) land. Over 250 independent econometric variables were identified, from 21 F2A models, 21 F2D models, 12 F2NF models, and 10 U2D models. These variables were organized into a hierarchy of 119 independent variable groups, 15 categories, and 4 econometric drivers suitable for conducting simple vote count statistics. Vote counts were summarized at the independent variable group level and formed into ratios estimating the predictive success of each variable group. Two ratio estimates were developed based on (1) proportion of times independent variables successfully achieved statistical significance (p ≤0.10), and (2) proportion of times independent variables successfully met the original researchers'expectations. In F2D models, popular independent variables such as population, income, and urban proximity often achieved statistical significance. In F2A models, popular independent variables such as forest and agricultural rents and costs, governmental programs, and site quality often achieved statistical significance. In U2D models, successful independent variables included urban rents and costs, zoning issues concerning forestland loss, site quality, urban proximity, population, and income. F2NF models high success variables were found to be agricultural rents, site quality, population, and income. This meta-analysis provides insight into the general success of econometric independent variables for future forest use or cover change research. The second part of this dissertation developed a method for predicting area estimates and spatial distribution of PWT in the US South. This technique determined land use from USFS Forest Inventory and Analysis (FIA) and land cover from the National Land Cover Database (NLCD). Three dependent variable forms (DV Forms) were derived from the FIA data: DV Form 1, timberland, other; DV Form 2, short timberland, tall timberland, agriculture, other; and DV Form 3, short hardwood (HW) timberland, tall HW timberland, short softwood (SW) timberland, tall SW timberland, agriculture, other. The prediction accuracy of each DV Form was investigated using both random forest model and logistic regression model specifications and data optimization techniques. Model verification employing a "leave-group-out" Monte Carlo simulation determined the selection of a stratified version of the random forest model using one-year NLCD observations with an overall accuracy of 0.53-0.94. The lower accuracy side of the range was when predictions were made from an aggregated NLCD land cover class "grass_shrub". The selected model specification was run using 2011 NLCD and the other predictor variables to produce three levels of timberland prediction and probability maps for the US South. Spatial masks removed areas unlikely to be working forests (protected and urbanized lands) resulting in PWT maps. The area of the resulting maps compared well with USFS area estimates and masked PWT maps and had an 8-11% reduction of the USFS timberland estimate for the US South compared to the DV Form. Change analysis of the 2011 NLCD to PWT showed (1) the majority of the short timberland came from NLCD grass_shrub; (2) the majority of NLCD grass_shrub predicted into tall timberland, and (3) NLCD grass_shrub was more strongly associated with timberland in the Coastal Plain. Resulting map products provide practical analytical tools for those interested in studying the area and distribution of PWT in the US South.
Procalcitonin as a potential predicting factor for prognosis in bacterial meningitis.
Park, Bong Soo; Kim, Si Eun; Park, Si Hyung; Kim, Jinseung; Shin, Kyong Jin; Ha, Sam Yeol; Park, JinSe; Kim, Sung Eun; Lee, Byung In; Park, Kang Min
2017-02-01
We investigated the potential role of serum procalcitonin in differentiating bacterial meningitis from viral meningitis, and in predicting the prognosis in patients with bacterial meningitis. This was a retrospective study of 80 patients with bacterial meningitis (13 patients died). In addition, 58 patients with viral meningitis were included as the disease control groups for comparison. The serum procalcitonin level was measured in all patients at admission. Differences in demographic and laboratory data, including the procalcitonin level, were analyzed between the groups. We used the mortality rate during hospitalization as a marker of prognosis in patients with bacterial meningitis. Multiple logistic regression analysis showed that high serum levels of procalcitonin (>0.12ng/mL) were an independently significant variable for differentiating bacterial meningitis from viral meningitis. The risk of having bacterial meningitis with high serum levels of procalcitonin was at least 6 times higher than the risk of having viral meningitis (OR=6.76, 95% CI: 1.84-24.90, p=0.004). In addition, we found that high levels of procalcitonin (>7.26ng/mL) in the blood were an independently significant predictor for death in patients with bacterial meningitis. The risk of death in patients with bacterial meningitis with high serum levels of procalcitonin may be at least 9 times higher than those without death (OR=9.09, 95% CI: 1.74-47.12, p=0.016). We found that serum procalcitonin is a useful marker for differentiating bacterial meningitis from viral meningitis, and it is also a potential predicting factor for prognosis in patients with bacterial meningitis. Copyright © 2016 Elsevier Ltd. All rights reserved.
Hyung, Seok-Won; Lee, Min Young; Yu, Jong-Han; Shin, Byunghee; Jung, Hee-Jung; Park, Jong-Moon; Han, Wonshik; Lee, Kyung-Min; Moon, Hyeong-Gon; Zhang, Hui; Aebersold, Ruedi; Hwang, Daehee; Lee, Sang-Won; Yu, Myeong-Hee; Noh, Dong-Young
2011-01-01
Prediction of the responses to neoadjuvant chemotherapy (NACT) can improve the treatment of patients with advanced breast cancer. Genes and proteins predictive of chemoresistance have been extensively studied in breast cancer tissues. However, noninvasive serum biomarkers capable of such prediction have been rarely exploited. Here, we performed profiling of N-glycosylated proteins in serum from fifteen advanced breast cancer patients (ten patients sensitive to and five patients resistant to NACT) to discover serum biomarkers of chemoresistance using a label-free liquid chromatography-tandem MS method. By performing a series of statistical analyses of the proteomic data, we selected thirteen biomarker candidates and tested their differential serum levels by Western blotting in 13 independent samples (eight patients sensitive to and five patients resistant to NACT). Among the candidates, we then selected the final set of six potential serum biomarkers (AHSG, APOB, C3, C9, CP, and ORM1) whose differential expression was confirmed in the independent samples. Finally, we demonstrated that a multivariate classification model using the six proteins could predict responses to NACT and further predict relapse-free survival of patients. In summary, global N-glycoproteome profile in serum revealed a protein pattern predictive of the responses to NACT, which can be further validated in large clinical studies. PMID:21799047
Plasticity Regulators Modulate Specific Root Traits in Discrete Nitrogen Environments
Gifford, Miriam L.; Banta, Joshua A.; Katari, Manpreet S.; Hulsmans, Jo; Chen, Lisa; Ristova, Daniela; Tranchina, Daniel; Purugganan, Michael D.; Coruzzi, Gloria M.; Birnbaum, Kenneth D.
2013-01-01
Plant development is remarkably plastic but how precisely can the plant customize its form to specific environments? When the plant adjusts its development to different environments, related traits can change in a coordinated fashion, such that two traits co-vary across many genotypes. Alternatively, traits can vary independently, such that a change in one trait has little predictive value for the change in a second trait. To characterize such “tunability” in developmental plasticity, we carried out a detailed phenotypic characterization of complex root traits among 96 accessions of the model Arabidopsis thaliana in two nitrogen environments. The results revealed a surprising level of independence in the control of traits to environment – a highly tunable form of plasticity. We mapped genetic architecture of plasticity using genome-wide association studies and further used gene expression analysis to narrow down gene candidates in mapped regions. Mutants in genes implicated by association and expression analysis showed precise defects in the predicted traits in the predicted environment, corroborating the independent control of plasticity traits. The overall results suggest that there is a pool of genetic variability in plants that controls traits in specific environments, with opportunity to tune crop plants to a given environment. PMID:24039603
A whole blood gene expression-based signature for smoking status
2012-01-01
Background Smoking is the leading cause of preventable death worldwide and has been shown to increase the risk of multiple diseases including coronary artery disease (CAD). We sought to identify genes whose levels of expression in whole blood correlate with self-reported smoking status. Methods Microarrays were used to identify gene expression changes in whole blood which correlated with self-reported smoking status; a set of significant genes from the microarray analysis were validated by qRT-PCR in an independent set of subjects. Stepwise forward logistic regression was performed using the qRT-PCR data to create a predictive model whose performance was validated in an independent set of subjects and compared to cotinine, a nicotine metabolite. Results Microarray analysis of whole blood RNA from 209 PREDICT subjects (41 current smokers, 4 quit ≤ 2 months, 64 quit > 2 months, 100 never smoked; NCT00500617) identified 4214 genes significantly correlated with self-reported smoking status. qRT-PCR was performed on 1,071 PREDICT subjects across 256 microarray genes significantly correlated with smoking or CAD. A five gene (CLDND1, LRRN3, MUC1, GOPC, LEF1) predictive model, derived from the qRT-PCR data using stepwise forward logistic regression, had a cross-validated mean AUC of 0.93 (sensitivity=0.78; specificity=0.95), and was validated using 180 independent PREDICT subjects (AUC=0.82, CI 0.69-0.94; sensitivity=0.63; specificity=0.94). Plasma from the 180 validation subjects was used to assess levels of cotinine; a model using a threshold of 10 ng/ml cotinine resulted in an AUC of 0.89 (CI 0.81-0.97; sensitivity=0.81; specificity=0.97; kappa with expression model = 0.53). Conclusion We have constructed and validated a whole blood gene expression score for the evaluation of smoking status, demonstrating that clinical and environmental factors contributing to cardiovascular disease risk can be assessed by gene expression. PMID:23210427
Kundi, Harun; Gok, Murat; Kiziltunc, Emrullah; Topcuoglu, Canan; Cetin, Mustafa; Cicekcioglu, Hulya; Ugurlu, Burcu; Ulusoy, Feridun Vasfi
2017-07-01
The aim of this study was to investigate the relationship between endocan levels with the presence of slow coronary flow (SCF). In this cross-sectional study, a total of 88 patients, who admitted to our hospital, were included in this study. Of these, 53 patients with SCF and 35 patients with normal coronary flow were included in the final analysis. Coronary flow rates of all patients were determined by the Timi Frame Count (TFC) method. In correlation analysis, endocan levels revealed a significantly positive correlation with high sensitive C-reactive protein and corrected TFC. In multivariate logistic regression analysis, the endocan levels were found as independently associated with the presence of SCF. Finally, using a cutoff level of 2.3, endocan level predicted the presence of SCF with a sensitivity of 77.2% and specificity of 75.2%. In conclusion, our study showed that higher endocan levels were significantly and independently related to the presence of SCF.
Laurinavicius, Arvydas; Plancoulaine, Benoit; Rasmusson, Allan; Besusparis, Justinas; Augulis, Renaldas; Meskauskas, Raimundas; Herlin, Paulette; Laurinaviciene, Aida; Abdelhadi Muftah, Abir A; Miligy, Islam; Aleskandarany, Mohammed; Rakha, Emad A; Green, Andrew R; Ellis, Ian O
2016-04-01
Proliferative activity, assessed by Ki67 immunohistochemistry (IHC), is an established prognostic and predictive biomarker of breast cancer (BC). However, it remains under-utilized due to lack of standardized robust measurement methodologies and significant intratumor heterogeneity of expression. A recently proposed methodology for IHC biomarker assessment in whole slide images (WSI), based on systematic subsampling of tissue information extracted by digital image analysis (DIA) into hexagonal tiling arrays, enables computation of a comprehensive set of Ki67 indicators, including intratumor variability. In this study, the tiling methodology was applied to assess Ki67 expression in WSI of 152 surgically removed Ki67-stained (on full-face sections) BC specimens and to test which, if any, Ki67 indicators can predict overall survival (OS). Visual Ki67 IHC estimates and conventional clinico-pathologic parameters were also included in the study. Analysis revealed linearly independent intrinsic factors of the Ki67 IHC variance: proliferation (level of expression), disordered texture (entropy), tumor size and Nottingham Prognostic Index, bimodality, and correlation. All visual and DIA-generated indicators of the level of Ki67 expression provided significant cutoff values as single predictors of OS. However, only bimodality indicators (Ashman's D, in particular) were independent predictors of OS in the context of hormone receptor and HER2 status. From this, we conclude that spatial heterogeneity of proliferative tumor activity, measured by DIA of Ki67 IHC expression and analyzed by the hexagonal tiling approach, can serve as an independent prognostic indicator of OS in BC patients that outperforms the prognostic power of the level of proliferative activity.
Callous and unemotional traits in children and adolescents living in Great Britain.
Moran, Paul; Ford, Tamsin; Butler, Georgia; Goodman, Robert
2008-01-01
Few studies have assessed psychopathic traits in community samples of young people. We investigated the predictive utility of callous and unemotional traits in a representative sample of 5,770 young people from Great Britain. Teachers provided information on the presence of callous and unemotional traits and parents completed the Strengths and Difficulties Questionnaire to determine the level and impact of psychiatric problems at baseline, 12 and 24 months later. Baseline callous and unemotional trait scores independently predicted the number and intensity of conduct, emotional and hyperactivity symptoms at follow-up. Callous and unemotional traits are longitudinally associated with the level and impact of childhood psychiatric problems.
Positive life events predict salivary cortisol in pregnant women.
Pluess, Michael; Wurmser, Harald; Buske-Kirschbaum, Angelika; Papousek, Mechthild; Pirke, Karl-Martin; Hellhammer, Dirk; Bolten, Margarete
2012-08-01
Maternal stress during pregnancy has been repeatedly associated with problematic child development. According to the fetal programming hypothesis adverse experiences during pregnancy increase maternal cortisol, which is then assumed to exert a negative effect on fetal development. Recent studies in non-pregnant women report significant associations between positive emotionality and low cortisol levels. We tested in a sample of 60 pregnant women whether both negative and positive life events independently predicted third-trimester baseline awakening cortisol levels. While the effect of negative life events proved unrelated positive life events significantly predicted lower cortisol levels. These findings suggest that positive experiences are of relevance regarding maternal morning cortisol levels in pregnancy reflecting a resource with potentially beneficial effects for the mother and the developing fetus. It might be promising for psychological intervention programs to focus on increasing positive experiences of the expecting mother rather than exclusively trying to reduce maternal stress during pregnancy. Copyright © 2012 Elsevier Ltd. All rights reserved.
Seitz, Jochen; Bühren, Katharina; Biemann, Ronald; Timmesfeld, Nina; Dempfle, Astrid; Winter, Sibylle Maria; Egberts, Karin; Fleischhaker, Christian; Wewetzer, Christoph; Herpertz-Dahlmann, Beate; Hebebrand, Johannes; Föcker, Manuel
2016-09-01
Elevated serum leptin levels following rapid therapeutically induced weight gain in anorexia nervosa (AN) patients are discussed as a potential biomarker for renewed weight loss as a result of leptin-related suppression of appetite and increased energy expenditure. This study aims to analyze the predictive value of leptin levels at discharge as well as the average rate of weight gain during inpatient or day patient treatment for body weight at 1-year follow-up. 121 patients were recruited from the longitudinal Anorexia Nervosa Day patient versus Inpatient (ANDI) trial. Serum leptin levels were analyzed at referral and discharge. A multiple linear regression analysis to predict age-adjusted body mass index (BMI-SDS) at 1-year follow-up was performed. Leptin levels, the average rate of weight gain, premorbid BMI-SDS, BMI-SDS at referral, age and illness duration were included as independent variables. Neither leptin levels at discharge nor rate of weight gain significantly predicted BMI-SDS at 1-year follow-up explaining only 1.8 and 0.4 % of the variance, respectively. According to our results, leptin levels at discharge and average rate of weight gain did not exhibit any value in predicting weight at 1-year follow-up in our longitudinal observation study of adolescent patients with AN. Thus, research should focus on other potential factors to predict weight at follow-up. As elevated leptin levels and average rate of weight gain did not pose a risk for reduced weight, we found no evidence for the beneficial effect of slow refeeding in patients with acute AN.
Predictors of health-related quality of life among low-income midlife women.
Ham, Ok Kyung
2011-02-01
The purpose of this study was to determine whether any of the sociodemographic, biomedical, psychosocial, and medical-care factors independently predict health-related quality of life (HRQoL) among low-income women. Cross-sectional data were used to predict factors that determine HRQoL. A survey was conducted targeting a convenience sample of 200 midlife women. Blood samples were drawn from all participants, who also received a physical examination. Hierarchical multiple regression analysis was used to test the independent effects of each factor. The study found that sociodemographic and psychosocial factors were independently associated with HRQoL. Compared to married women, widowed or divorced women had significantly lower HRQoL, whereas those with higher levels of stress perception and those not performing regular exercise had significantly lower HRQoL (p < .01). The full model accounted for 44.7% of the variance in HRQoL. The HRQoL of low-income midlife women was associated with multiple factors, with stress perception exerting the major influence.
Birkeland, Marianne Skogbrott; Nielsen, Morten Birkeland; Knardahl, Stein; Heir, Trond
2015-01-01
Experiencing terrorism is associated with high levels of psychological distress among survivors. The aim of the present study was to examine whether work environmental factors such as role clarity and predictability, role conflicts, and leader support may protect against elevated levels of psychological distress after a workplace terrorist attack. Data from approximately 1800 ministerial employees were collected ten months after the 2011 Oslo bombing attack which targeted the Norwegian ministries. The results show that after a traumatic event, lower role conflicts, higher role clarity, higher predictability, and higher leader support were independently associated with lower psychological distress. These findings suggest that the workplace environment may be a facilitator of employees' mental health after stressful events.
Haga, Yoshio; Ikejiri, Koji; Wada, Yasuo; Ikenaga, Masakazu; Koike, Shoichiro; Nakamura, Seiji; Koseki, Masato
2015-06-01
Surgical audit is an essential task for the estimation of postoperative outcome and comparison of quality of care. Previous studies on surgical audits focused on short-term outcomes, such as postoperative mortality. We propose a surgical audit evaluating long-term outcome following colorectal cancer surgery. The predictive model for this audit is designated as 'Estimation of Postoperative Overall Survival for Colorectal Cancer (EPOS-CC)'. Thirty-one tumor-related and physiological variables were prospectively collected in 889 patients undergoing elective resection for colorectal cancer between April 2005 and April 2007 in 16 Japanese hospitals. Postoperative overall survival was assessed over a 5-years period. The EPOS-CC score was established by selecting significant variables in a uni- and multivariate analysis and allocating a risk-adjusted multiplication factor to each variable using Cox regression analysis. For validation, the EPOS-CC score was compared to the predictive power of UICC stage. Inter-hospital variability of the observed-to-estimated 5-years survival was assessed to estimate quality of care. Among the 889 patients, 804 (90%) completed the 5-years follow-up. Univariate analysis displayed a significant correlation with 5-years survival for 14 physiological and nine tumor-related variables (p < 0.005). Highly significant p-values below 0.0001 were found for age, ASA score, severe pulmonary disease, respiratory history, performance status, hypoalbuminemia, alteration of hemoglobin, serum sodium level, and for all histological variables except tumor location. Age, TNM stage, lymphatic invasion, performance status, and serum sodium level were independent variables in the multivariate analysis and were entered the EPOS-CC model for the prediction of survival. Risk-adjusted multiplication factors between 1.5 (distant metastasis) and 0.16 (serum sodium level) were accorded to the different variables. The predictive power of EPOS-CC was superior to the one of UICC stage; area under the curve 0.87, 95% CI 0.85-0.90 for EPOS-CC, and 0.80, 0.76-0.83 for UICC stage, p < 0.001. Quality of care did not differ between hospitals. The EPOS-CC score including the independent variables age, performance status, serum sodium level, TNM stage, and lymphatic invasion is superior to the UICC stage in the prediction of 5-years overall survival. This higher accuracy might be explained by the inclusion of physiological factors, thus also taking non-tumor-associated deaths into account. Furthermore, EPOS-CC score may compare quality of care among different institutions. Future studies are necessary to further evaluate this score and help improving the prediction of long-term survival following colorectal cancer surgery.
Wada, Takeshi; Jesmin, Subrina; Gando, Satoshi; Yanagida, Yuichiro; Mizugaki, Asumi; Sultana, Sayeeda N; Zaedi, Sohel; Yokota, Hiroyuki
2012-09-29
Post-cardiac arrest syndrome (PCAS) often leads to multiple organ dysfunction syndrome (MODS) with a poor prognosis. Endothelial and leukocyte activation after whole-body ischemia/reperfusion following resuscitation from cardiac arrest is a critical step in endothelial injury and related organ damage. Angiogenic factors, including vascular endothelial growth factor (VEGF) and angiopoietin (Ang), and their receptors play crucial roles in endothelial growth, survival signals, pathological angiogenesis and microvascular permeability. The aim of this study was to confirm the efficacy of angiogenic factors and their soluble receptors in predicting organ dysfunction and mortality in patients with PCAS. A total of 52 resuscitated patients were divided into two subgroups: 23 survivors and 29 non-survivors. The serum levels of VEGF, soluble VEGF receptor (sVEGFR)1, sVEGFR2, Ang1, Ang2 and soluble Tie2 (sTie2) were measured at the time of admission (Day 1) and on Day 3 and Day 5. The ratio of Ang2 to Ang1 (Ang2/Ang1) was also calculated. This study compared the levels of angiogenic factors and their soluble receptors between survivors and non-survivors, and evaluated the predictive value of these factors for organ dysfunction and 28-day mortality. The non-survivors demonstrated more severe degrees of organ dysfunction and a higher prevalence of MODS. Non-survivors showed significant increases in the Ang2 levels and the Ang2/Ang1 ratios compared to survivors. A stepwise logistic regression analysis demonstrated that the Ang2 levels or the Ang2/Ang1 ratios on Day 1 independently predicted the 28-day mortality. The receiver operating characteristic curves of the Ang2 levels, and the Ang2/Ang1 ratios on Day 1 were good predictors of 28-day mortality. The Ang2 levels also independently predicted increases in the Sequential Organ Failure Assessment (SOFA) scores. We observed a marked imbalance between Ang1 and Ang2 in favor of Ang2 in PCAS patients, and the effect was more prominent in non-survivors. Angiogenic factors and their soluble receptors, particularly Ang2 and Ang2/Ang1, are considered to be valuable predictive biomarkers in the development of organ dysfunction and poor outcomes in PCAS patients.
Hwang, Sejin; Jeon, Seong Woo; Kwon, Joong Goo; Lee, Dong Wook; Ha, Chang Yoon; Cho, Kwang Bum; Jang, ByungIk; Park, Jung Bae; Park, Youn Sun
2016-07-01
Although the mortality rates for non-variceal upper gastrointestinal bleeding (NVUGIB) have recently decreased, it remains a significant medical problem. The main aim of this prospective multicenter database study was to construct a clinically useful predictive scoring system by using our predictors and compare its prognostic accuracy with that of the Rockall scoring system. Data were collected from consecutive patients with NVUGIB. Logistic regression analysis was performed to identify the independent predictors of 30-day mortality. Each independent predictor was assigned an integral point proportional to the odds ratio (OR) and we used the area under the curve to compare the discrimination ability between the new predictive model and the Rockall score. The independent predictors of mortality included age >65 years [OR 2.627; 95 % confidence interval (CI) 1.298-5.318], hemodynamic instability (OR 2.217; 95 % CI 1.069-4.597), serum blood urea nitrogen level >40 mg/dL (OR 1.895; 95 % CI 1.029-3.490), active bleeding at endoscopy (OR 2.434; 95 % CI 1.283-4.616), transfusions (OR 3.811; 95 % CI 1.640-8.857), comorbidities (OR 3.481; 95 % CI 1.405-8.624), and rebleeding (OR 10.581; 95 % CI 5.590-20.030). The new predictive model showed a high discrimination capability and was significantly superior to the Rockall score in predicting the risk of death (OR 0.837;95 % CI 0.818-0.855 vs. 0.761; 0.739-0.782; P = 0.0123). The new predictive score was significantly more accurate than the Rockall score in predicting death in NVUGIB patients. We need to prospectively validate the accuracy of this score for predicting mortality in NVUGIB patients.
Park, Yune-Jung; Yoo, Seung-Ah; Kim, Ga-Ram; Cho, Chul-Soo; Kim, Wan-Uk
2016-10-12
Previously, we demonstrated that the urine proteome signature of patients with rheumatoid arthritis (RA) reflects inflammation-related cellular processes. Here, we measured interleukin (IL)-6, IL-8, and chemokine ligand 2 (CCL2) concentrations in the urine of RA patients and prospectively investigated their role in predicting RA activity and prognosis. One hundred seventy-three RA patients and 62 non-RA controls were recruited. Urinary IL-6, CCL2, and IL-8 levels were elevated in RA patients and correlated well with disease activity. Urinary IL-6 level at presentation was an independent risk factor of radiographic progression at 1 and 3 years. High urinary IL-6 level increased the risk ratio of radiographic progression by 2.9-fold, which was comparable to high serum CRP. Moreover, combination of urinary IL-6 and serum CRP measures synergistically increased the predictability of radiographic progression. In a subgroup with normal ESR, patients with the highest tertile of urinary IL-6 were at 6.4-fold greater risk of radiographic progression. Conclusively, high urinary IL-6 level at presentation is an independent risk factor for radiographic progression of RA, reflecting disease activity. Urinary IL-6 in combination with serum CRP may be a useful parameter for estimating RA prognosis.
Berdanier, Aaron B; Miniat, Chelcy F; Clark, James S
2016-08-01
Accurately scaling sap flux observations to tree or stand levels requires accounting for variation in sap flux between wood types and by depth into the tree. However, existing models for radial variation in axial sap flux are rarely used because they are difficult to implement, there is uncertainty about their predictive ability and calibration measurements are often unavailable. Here we compare different models with a diverse sap flux data set to test the hypotheses that radial profiles differ by wood type and tree size. We show that radial variation in sap flux is dependent on wood type but independent of tree size for a range of temperate trees. The best-fitting model predicted out-of-sample sap flux observations and independent estimates of sapwood area with small errors, suggesting robustness in the new settings. We develop a method for predicting whole-tree water use with this model and include computer code for simple implementation in other studies. Published by Oxford University Press 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.
Cosmological implications of a large complete quasar sample.
Segal, I E; Nicoll, J F
1998-04-28
Objective and reproducible determinations of the probabilistic significance levels of the deviations between theoretical cosmological prediction and direct model-independent observation are made for the Large Bright Quasar Sample [Foltz, C., Chaffee, F. H., Hewett, P. C., MacAlpine, G. M., Turnshek, D. A., et al. (1987) Astron. J. 94, 1423-1460]. The Expanding Universe model as represented by the Friedman-Lemaitre cosmology with parameters qo = 0, Lambda = 0 denoted as C1 and chronometric cosmology (no relevant adjustable parameters) denoted as C2 are the cosmologies considered. The mean and the dispersion of the apparent magnitudes and the slope of the apparent magnitude-redshift relation are the directly observed statistics predicted. The C1 predictions of these cosmology-independent quantities are deviant by as much as 11sigma from direct observation; none of the C2 predictions deviate by >2sigma. The C1 deviations may be reconciled with theory by the hypothesis of quasar "evolution," which, however, appears incapable of being substantiated through direct observation. The excellent quantitative agreement of the C1 deviations with those predicted by C2 without adjustable parameters for the results of analysis predicated on C1 indicates that the evolution hypothesis may well be a theoretical artifact.
Nagai, Takashi; De Schamphelaere, Karel A C
2016-11-01
The authors investigated the effect of binary mixtures of zinc (Zn), copper (Cu), cadmium (Cd), and nickel (Ni) on the growth of a freshwater diatom, Navicula pelliculosa. A 7 × 7 full factorial experimental design (49 combinations in total) was used to test each binary metal mixture. A 3-d fluorescence microplate toxicity assay was used to test each combination. Mixture effects were predicted by concentration addition and independent action models based on a single-metal concentration-response relationship between the relative growth rate and the calculated free metal ion activity. Although the concentration addition model predicted the observed mixture toxicity significantly better than the independent action model for the Zn-Cu mixture, the independent action model predicted the observed mixture toxicity significantly better than the concentration addition model for the Cd-Zn, Cd-Ni, and Cd-Cu mixtures. For the Zn-Ni and Cu-Ni mixtures, it was unclear which of the 2 models was better. Statistical analysis concerning antagonistic/synergistic interactions showed that the concentration addition model is generally conservative (with the Zn-Ni mixture being the sole exception), indicating that the concentration addition model would be useful as a method for a conservative first-tier screening-level risk analysis of metal mixtures. Environ Toxicol Chem 2016;35:2765-2773. © 2016 SETAC. © 2016 SETAC.
Wu, Shuang; Yang, Yan-Min; Zhu, Jun; Ren, Jia-Meng; Wang, Juan; Zhang, Han; Shao, Xing-Hui
2018-05-01
The prognostic role of big endothelin-1 (ET-1) in atrial fibrillation (AF) is unclear. We aimed to assess its predictive value in patients with AF. A total of 716 AF patients were enrolled and divided into two groups based on the optimal cut-off value of big ET-1 in predicting all-cause mortality. The primary outcomes were all-cause mortality and major adverse events (MAEs). Cox regression analysis and net reclassification improvement (NRI) analysis were performed to assess the predictive value of big ET-1 on outcomes. With the optimal cut-off value of 0.55 pmol/L, 326 patients were classified into the high big ET-1 levels group. Cardiac dysfunction and left atrial dilation were factors related to high big ET-1 levels. During a median follow-up of 3 years, patients with big ET-1 ≥ 0.55 pmol/L had notably higher risk of all-cause death (44.8% vs. 11.5%, p < 0.001), MAEs (51.8% vs. 17.4%, p < 0.001), cardiovascular death, major bleeding, and tended to have higher thromboembolic risk. After adjusting for confounding factors, high big ET-1 level was an independent predictor of all-cause mortality (hazard ratio (HR) 2.11, 95% confidence interval (CI) 1.46-3.05; p < 0.001), MAEs (HR 2.05, 95% CI 1.50-2.80; p = 0.001), and cardiovascular death (HR 2.44, 95% CI 1.52-3.93; p < 0.001). NRI analysis showed that big ET-1 allowed a significant improvement of 0.32 in the accuracy of predicting the risk of both all-cause mortality and MAEs. Elevated big ET-1 levels is an independent predictor of long-term all-cause mortality, MAEs, and cardiovascular death in patients with AF. Copyright © 2018 Elsevier B.V. All rights reserved.
Circulating CD147 predicts mortality in advanced hepatocellular carcinoma.
Lee, Aimei; Rode, Anthony; Nicoll, Amanda; Maczurek, Annette E; Lim, Lucy; Lim, Seok; Angus, Peter; Kronborg, Ian; Arachchi, Niranjan; Gorelik, Alexandra; Liew, Danny; Warner, Fiona J; McCaughan, Geoffrey W; McLennan, Susan V; Shackel, Nicholas A
2016-02-01
The glycoprotein CD147 has a role in tumor progression, is readily detectable in the circulation, and is abundantly expressed in hepatocellular carcinoma (HCC). Advanced HCC patients are a heterogeneous group with some individuals having dismal survival. The aim of this study was to examine circulating soluble CD147 levels as a prognostic marker in HCC patients. CD147 was measured in 277 patients (110 HCC, 115 chronic liver disease, and 52 non-liver disease). Clinical data included etiology, tumor progression, Barcelona Clinic Liver Cancer (BCLC) stage, and treatment response. Patients with HCC were stratified into two groups based upon the 75th percentile of CD147 levels (24 ng/mL). CD147 in HCC correlated inversely with poor survival (P = 0.031). Increased CD147 predicted poor survival in BCLC stages C and D (P = 0.045), and CD147 levels >24 ng/mL predicted a significantly diminished 90-day and 180-day survival time (hazard ratio [HR] = 6.1; 95% confidence interval [CI]: 2.1-63.2; P = 0.0045 and HR = 2.8; 95% CI: 1.2-12.6; P = 0.028, respectively). In BCLC stage C, CD147 predicted prognosis; levels >24 ng/mL were associated with a median survival of 1.5 months compared with 6.5 months with CD147 levels ≤24 ng/mL (P = 0.03). CD147 also identified patients with a poor prognosis independent from treatment frequency, modality, and tumor size. Circulating CD147 is an independent marker of survival in advanced HCC. CD147 requires further evaluation as a potential new prognostic measure in HCC to identify patients with advanced disease who have a poor prognosis. © 2015 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.
Concomitant prediction of function and fold at the domain level with GO-based profiles.
Lopez, Daniel; Pazos, Florencio
2013-01-01
Predicting the function of newly sequenced proteins is crucial due to the pace at which these raw sequences are being obtained. Almost all resources for predicting protein function assign functional terms to whole chains, and do not distinguish which particular domain is responsible for the allocated function. This is not a limitation of the methodologies themselves but it is due to the fact that in the databases of functional annotations these methods use for transferring functional terms to new proteins, these annotations are done on a whole-chain basis. Nevertheless, domains are the basic evolutionary and often functional units of proteins. In many cases, the domains of a protein chain have distinct molecular functions, independent from each other. For that reason resources with functional annotations at the domain level, as well as methodologies for predicting function for individual domains adapted to these resources are required.We present a methodology for predicting the molecular function of individual domains, based on a previously developed database of functional annotations at the domain level. The approach, which we show outperforms a standard method based on sequence searches in assigning function, concomitantly predicts the structural fold of the domains and can give hints on the functionally important residues associated to the predicted function.
An online air pollution forecasting system using neural networks.
Kurt, Atakan; Gulbagci, Betul; Karaca, Ferhat; Alagha, Omar
2008-07-01
In this work, an online air pollution forecasting system for Greater Istanbul Area is developed. The system predicts three air pollution indicator (SO(2), PM(10) and CO) levels for the next three days (+1, +2, and +3 days) using neural networks. AirPolTool, a user-friendly website (http://airpol.fatih.edu.tr), publishes +1, +2, and +3 days predictions of air pollutants updated twice a day. Experiments presented in this paper show that quite accurate predictions of air pollutant indicator levels are possible with a simple neural network. It is shown that further optimizations of the model can be achieved using different input parameters and different experimental setups. Firstly, +1, +2, and +3 days' pollution levels are predicted independently using same training data, then +2 and +3 days are predicted cumulatively using previously days predicted values. Better prediction results are obtained in the cumulative method. Secondly, the size of training data base used in the model is optimized. The best modeling performance with minimum error rate is achieved using 3-15 past days in the training data set. Finally, the effect of the day of week as an input parameter is investigated. Better forecasts with higher accuracy are observed using the day of week as an input parameter.
Infurna, Frank J; Ram, Nilam; Gerstorf, Denis
2013-10-01
Perceived control plays an important role for health across adulthood and old age. However, little is known about the factors that account for such associations and whether changes in control (or control trajectory) uniquely predict major health outcomes over and above mean levels of control. Using data from the nationwide Americans' Changing Lives Study (House et al., 1990; N = 2,840, M age at T2: 56.32 years, range: 28-99, 64% women), we examined the extent to which mean levels and rates of change in perceived control over 16 years predict all-cause mortality over a 19-year follow-up period. Shared growth-survival models revealed that higher levels of and more positive changes in perceived control were associated with longer survival times, independent of sociodemographic correlates. We found that level effects of control were accounted for by well-being and health factors, whereas the change effects of control were not. Analyses also indicated an age-differential pattern, with the predictive effects of both levels and trajectories of control declining in old age. We discuss possible pathways through which perceived control operates to facilitate key health outcomes and consider how their malleability and effectiveness may change with increasing age.
Does early functional outcome predict 1-year mortality in elderly patients with hip fracture?
Dubljanin-Raspopović, Emilija; Marković-Denić, Ljiljana; Marinković, Jelena; Nedeljković, Una; Bumbaširević, Marko
2013-08-01
Hip fractures in the elderly are followed by considerable risk of functional decline and mortality. The purposes of this study were to (1) explore predictive factors of functional level at discharge, (2) evaluate 1-year mortality after hip fracture compared with that of the general population, and (3) evaluate the affect of early functional outcome on 1-year mortality in patients operated on for hip fractures. A total of 228 consecutive patients (average age, 77.6 ± 7.4 years) with hip fractures who met the inclusion criteria were enrolled in an open, prospective, observational cohort study. Functional level at discharge was measured with the motor Functional Independence Measure (FIM) score, which is the most widely accepted functional assessment measure in use in the rehabilitation community. Mortality rates in the study population were calculated in absolute numbers and as the standardized mortality ratio. Multivariate regression analysis was used to explore predictive factors for motor FIM score at discharge and for 1-year mortality adjusted for important baseline variables. Age, health status, cognitive level, preinjury functional level, and pressure sores after hip fracture surgery were independently related to lower discharge motor FIM scores. At 1-year followup, 57 patients (25%; 43 women and 14 men) had died. The 1-year hip fracture mortality rate compared with that of the general population was 31% in our population versus 7% for men and 23% in our population versus 5% for women 65 years or older. The 1-year standardized mortality rate was 341.3 (95% CI, 162.5-520.1) for men and 301.6 (95% CI, 212.4-391.8) for women, respectively. The all-cause mortality rate observed in this group was higher in all age groups and in both sexes when compared with the all-cause age-adjusted mortality of the general population. Motor FIM score at discharge was the only independent predictor of 1-year mortality after hip fracture. Functional level at discharge is the main determinant of long-term mortality in patients with hip fracture. Motor FIM score at discharge is a reliable predictor of mortality and can be recommended for clinical use.
Temperament and Parenting during the First Year of Life Predict Future Child Conduct Problems
Lahey, Benjamin B.; Van Hulle, Carol A.; Keenan, Kate; Rathouz, Paul J.; D’Onofrio, Brian M.; Rodgers, Joseph Lee; Waldman, Irwin D.
2010-01-01
Predictive associations between parenting and temperament during the first year of life and child conduct problems were assessed longitudinally in 1,863 offspring of a representative sample of women. Maternal ratings of infant fussiness, activity level, predictability, and positive affect each independently predicted maternal ratings of conduct problems during ages 4–13 years. Furthermore, a significant interaction indicated that infants who were both low in fussiness and high in predictability were at very low risk for future conduct problems. Fussiness was a stronger predictor of conduct problems in boys whereas fearfulness was a stronger predictor in girls. Conduct problems also were robustly predicted by low levels of early mother-report cognitive stimulation. Interviewer-rated maternal responsiveness was a robust predictor of conduct problems, but only among infants low in fearfulness. Spanking during infancy predicted slightly more severe conduct problems, but the prediction was moderated by infant fussiness and positive affect. Thus, individual differences in risk for mother-rated conduct problems across childhood are already partly evident in maternal ratings of temperament during the first year of life and are predicted by early parenting and parenting-by-temperament interactions. PMID:18568397
Plasma neutrophil gelatinase-associated lipocalin: a marker of acute pyelonephritis in children.
Kim, Byung Kwan; Yim, Hyung Eun; Yoo, Kee Hwan
2017-03-01
This study was designed to compare the diagnostic accuracy of plasma neutrophil gelatinase-associated lipocalin (NGAL) with procalcitonin (PCT), C-reactive protein (CRP), and white blood cells (WBCs) for predicting acute pyelonephritis (APN) in children with febrile urinary tract infections (UTIs). In total, 138 children with febrile UTIs (APN 59, lower UTI 79) were reviewed retrospectively. Levels of NGAL, PCT, CRP, and WBCs in blood were measured on admission. The diagnostic accuracy of the biomarkers was investigated. Independent predictors of APN were identified by multivariate logistic regression analysis. Receiver operating curve (ROC) analyses showed good diagnostic profiles of NGAL, PCT, CRP, and WBCs for identifying APN [area under the curve (AUC) 0.893, 0.855, 0.879, and 0.654, respectively]. However, multivariate analysis revealed only plasma NGAL level was an independent predictor of APN (P = 0.006). At the best cutoff values of all examined biomarkers for identifying APN, sensitivity (86 %), specificity (85 %), positive predictive value (81 %), and negative predictive value (89 %) of plasma NGAL levels were the highest. The optimal NGAL cutoff value was 117 ng/ml. The positive likelihood ratio [odds ratio (OR) 5.69, 95 % confidence interval (CI) 3.56-8.78], and negative likelihood ratio (OR 0.16, 95 % CI 0.08-0.29) of plasma NGAL for APN diagnosis also showed it seemed to be more accurate than serum PCT, CRP, and WBCs. Plasma NGAL can be more useful than serum PCT, CRP, and WBC levels for identifying APN in children with febrile UTIs.
Eminaga, Okyaz; Wei, Wei; Hawley, Sarah J; Auman, Heidi; Newcomb, Lisa F; Simko, Jeff; Hurtado-Coll, Antonio; Troyer, Dean A; Carroll, Peter R; Gleave, Martin E; Lin, Daniel W; Nelson, Peter S; Thompson, Ian M; True, Lawrence D; McKenney, Jesse K; Feng, Ziding; Fazli, Ladan; Brooks, James D
2016-01-01
The uncertainties inherent in clinical measures of prostate cancer (CaP) aggressiveness endorse the investigation of clinically validated tissue biomarkers. MUC1 expression has been previously reported to independently predict aggressive localized prostate cancer. We used a large cohort to validate whether MUC1 protein levels measured by immunohistochemistry (IHC) predict aggressive cancer, recurrence and survival outcomes after radical prostatectomy independent of clinical and pathological parameters. MUC1 IHC was performed on a multi-institutional tissue microarray (TMA) resource including 1,326 men with a median follow-up of 5 years. Associations with clinical and pathological parameters were tested by the Chi-square test and the Wilcoxon rank sum test. Relationships with outcome were assessed with univariable and multivariable Cox proportional hazard models and the Log-rank test. The presence of MUC1 expression was significantly associated with extracapsular extension and higher Gleason score, but not with seminal vesicle invasion, age, positive surgical margins or pre-operative serum PSA levels. In univariable analyses, positive MUC1 staining was significantly associated with a worse recurrence free survival (RFS) (HR: 1.24, CI 1.03-1.49, P = 0.02), although not with disease specific survival (DSS, P>0.5). On multivariable analyses, the presence of positive surgical margins, extracapsular extension, seminal vesicle invasion, as well as higher pre-operative PSA and increasing Gleason score were independently associated with RFS, while MUC1 expression was not. Positive MUC1 expression was not independently associated with disease specific survival (DSS), but was weakly associated with overall survival (OS). In our large, rigorously designed validation cohort, MUC1 protein expression was associated with adverse pathological features, although it was not an independent predictor of outcome after radical prostatectomy.
Fang, Li-Min; Lin, Min
2009-08-01
For the rapid detection of the ethanol, pH and rest sugar in red wine, infrared (IR) spectra of 44 wine samples were analyzed. The algorithm of fast independent component analysis (FastICA) was used to decompose the data of IR spectra, and their independent components and the mixing matrix were obtained. Then, the ICA-NNR calibration model with three-level artificial neural network (ANN) structure was built by using back-propagation (BP) algorithm. The models were used to estimate the contents of ethanol, pH and rest sugar in red wine samples for both in calibration set and predicted set. Correlation coefficient (r) of prediction and root mean square error of prediction (RMSEP) were used as the evaluation indexes. The results indicate that the r and RMSEP for the prediction of ethanol content, pH and rest sugar content are 0.953, 0.983 and 0.994, and 0.161, 0.017 and 0.181, respectively. The maximum relative deviations between the ICA-NNR method predicted value and referenced value of the 22 samples in predicted set are less than 4%. The results of this paper provide a foundation for the application and further development of IR on-line red wine analyzer.
Nematollahi, M; Akbari, R; Nikeghbalian, S; Salehnasab, C
2017-01-01
Kidney transplantation is the treatment of choice for patients with end-stage renal disease (ESRD). Prediction of the transplant survival is of paramount importance. The objective of this study was to develop a model for predicting survival in kidney transplant recipients. In a cross-sectional study, 717 patients with ESRD admitted to Nemazee Hospital during 2008-2012 for renal transplantation were studied and the transplant survival was predicted for 5 years. The multilayer perceptron of artificial neural networks (MLP-ANN), logistic regression (LR), Support Vector Machine (SVM), and evaluation tools were used to verify the determinant models of the predictions and determine the independent predictors. The accuracy, area under curve (AUC), sensitivity, and specificity of SVM, MLP-ANN, and LR models were 90.4%, 86.5%, 98.2%, and 49.6%; 85.9%, 76.9%, 97.3%, and 26.1%; and 84.7%, 77.4%, 97.5%, and 17.4%, respectively. Meanwhile, the independent predictors were discharge time creatinine level, recipient age, donor age, donor blood group, cause of ESRD, recipient hypertension after transplantation, and duration of dialysis before transplantation. SVM and MLP-ANN models could efficiently be used for determining survival prediction in kidney transplant recipients.
Paschka, Peter; Marcucci, Guido; Ruppert, Amy S.; Whitman, Susan P.; Mrózek, Krzysztof; Maharry, Kati; Langer, Christian; Baldus, Claudia D.; Zhao, Weiqiang; Powell, Bayard L.; Baer, Maria R.; Carroll, Andrew J.; Caligiuri, Michael A.; Kolitz, Jonathan E.; Larson, Richard A.; Bloomfield, Clara D.
2008-01-01
Purpose To analyze the prognostic impact of Wilms’ tumor 1 (WT1) gene mutations in cytogenetically normal acute myeloid leukemia (CN-AML). Patients and Methods We studied 196 adults younger than 60 years with newly diagnosed primary CN-AML, who were treated similarly on Cancer and Leukemia Group B (CALGB) protocols 9621 and 19808, for WT1 mutations in exons 7 and 9. The patients also were assessed for the presence of FLT3 internal tandem duplications (FLT3-ITD), FLT3 tyrosine kinase domain mutations (FLT3-TKD), MLL partial tandem duplications (MLL-PTD), NPM1 and CEBPA mutations, and for the expression levels of ERG and BAALC. Results Twenty-one patients (10.7%) harbored WT1 mutations. Complete remission rates were not significantly different between patients with WT1 mutations and those with unmutated WT1 (P = .36; 76% v 84%). Patients with WT1 mutations had worse disease-free survival (DFS; P < .001; 3-year rates, 13% v 50%) and overall survival (OS; P < .001; 3-year rates, 10% v 56%) than patients with unmutated WT1. In multivariable analyses, WT1 mutations independently predicted worse DFS (P = .009; hazard ratio [HR] = 2.7) when controlling for CEBPA mutational status, ERG expression level, and FLT3-ITD/NPM1 molecular-risk group (ie, FLT3-ITDnegative/NPM1mutated as low risk v FLT3-ITDpositive and/or NPM1wild-type as high risk). WT1 mutations also independently predicted worse OS (P < .001; HR = 3.2) when controlling for CEBPA mutational status, FLT3-ITD/NPM1 molecular-risk group, and white blood cell count. Conclusion We report the first evidence that WT1 mutations independently predict extremely poor outcome in intensively treated, younger patients with CN-AML. Future trials should include testing for WT1 mutations as part of molecularly based risk assessment and risk-adapted treatment stratification of patients with CN-AML. PMID:18559874
WANG, JIN-YOU; ZHANG, HAI-LIANG; ZHU, YAO; QIN, XIAO-JIAN; DAI, BO; YE, DING-WEI
2016-01-01
Malignant ureteral obstruction (MUO) is an unpropitious sign that is commonly observed in patients with advanced incurable cancer. The present study aimed to evaluate predictive factors for the failure of retrograde ureteral stent insertion in the management of MUO in outpatients. A total of 164 patients with MUO were retrospectively assessed in this study. Clinical factors, including age, gender, type of malignancy, level of obstruction, cause of obstruction, pre-operative creatinine level, degree of hydronephrosis, condition of the contralateral ureter, prior radiotherapy, Eastern Cooperative Oncology Group performance status (ECOG PS), bladder wall invasion and technical failure, were recorded for each case. Univariate and multivariate logistic regression analyses were used to investigate the risk factors for predicting the failure of retrograde ureteral stent insertion. In total, 38 out of 164 patients experienced bilateral obstruction, therefore, a total of 202 ureteral units were available for data analysis. The rate of insertion failure in MUO was 34.65%. Multivariate analyses identified ECOG PS, degree of hydronephrosis and bladder wall invasion as independent predictors for insertion failure. Overall, the present study found that rate of retrograde ureteral stent insertion failure is high in outpatients with MUO, and that ECOG PS, degree of hydronephrosis and bladder invasion are potential independent predictors of insertion failure. PMID:26870299
Atar, Aslı Inci; Yılmaz, Omer Cağlar; Akın, Kayıhan; Selçoki, Yusuf; Er, Okan; Eryonucu, Beyhan
2013-03-01
A link between uric acid levels and cardiovascular diseases has been previously reported. Coronary artery calcium score (CACS) is a marker of atherosclerotic disease and a predictor of cardiovascular events. We sought to determine if serum uric acid level is an independent risk factor for the presence of calcium in coronary arteries. Four hundred and forty-two patients who were evaluated in the cardiology outpatient clinic for suspected coronary heart disease with a low-moderate risk for coronary artery disease were included in this observational case-controlled study. Serum uric acid levels were measured with colorimetric methods. CACS were performed using a 64-slice CT scanner. Patients were divided to 3 groups according to their CACS value (Group 1: CACS=0, Group 2: CACS 1-100, Group 3: CACS>100). The demographical characteristics and laboratory findings of 3 groups were similar, except age, fasting glucose levels and serum uric acid levels. Serum uric acid levels were found to increase significantly with increasing CACS (p=0.001). Patients were grouped according to presence CAC (CACS=0 and CACS≥1) and in the multiple regression analysis, age (OR, 1.11, 95% CI, 1.07-1.16), smoking (OR, 3.83, 95% CI, 2.06-7.09), serum uric acid levels (OR, 1.26, 95% CI, 1.04-1.54) and average 10-year total risk of Framingham risk score (OR, 1.13, 95% CI, 1.04-1.09) appeared as independent factors predictive of presence of CAC (p<0.05). Serum uric acid level is an independent risk factor for presence of coronary calcium. Moreover, increasing levels of serum uric acid are associated with increasing CACS.
Porcaro, Antonio B; Petrozziello, Aldo; Migliorini, Filippo; Lacola, Vincenzo; Romano, Mario; Sava, Teodoro; Ghimenton, Claudio; Caruso, Beatrice; Zecchini Antoniolli, Stefano; Rubilotta, Emanuele; Monaco, Carmelo; Comunale, Luigi
2011-01-01
To explore, in operated prostate cancer patients, functional relationships of total testosterone (tt) predicting free testosterone (ft) and total PSA. 128 operated prostate cancer patients were simultaneously investigated for tt, ft and PSA before surgery. Patients were not receiving 5α-reductase inhibitors, LH-releasing hormone analogues and testosterone replacement treatment. Scatter plots including ft and PSA versus tt were computed in order to assess the functional relationship of the variables. Linear regression analysis of tt predicting ft and PSA was computed. tt was a significant predictor of the response variable (ft) and different subsets of the patient population were assessed according to the ft to tt ratio. PSA was related to tt according to a nonlinear law. tt was a significant predictor of PSA according to an inversely nonlinear law and different significant clusters of the patient population were assessed according to the different constant of proportionality computed from experimental data. In our prostate cancer population, ft was significantly predicted by tt according to a linear law, and the ft/tt ratio was a significant parameter for assessing the different clusters. Also, tt was a significant variable predicting PSA by a nonlinear law and different clusters of the patient population were assessed by the different constants of proportionality. As a theory, we explain the nonlinear relation of tt in predicting PSA as follows: (a) the number of androgen-independent prostate cancer cells increases as tumor volume and PSA serum levels rise, (b) the prevalence of androgen-independent cells producing a substance which inhibits serum LH, and (c) as a result lower levels of serum tt are detected. Copyright © 2011 S. Karger AG, Basel.
Reliable prediction intervals with regression neural networks.
Papadopoulos, Harris; Haralambous, Haris
2011-10-01
This paper proposes an extension to conventional regression neural networks (NNs) for replacing the point predictions they produce with prediction intervals that satisfy a required level of confidence. Our approach follows a novel machine learning framework, called Conformal Prediction (CP), for assigning reliable confidence measures to predictions without assuming anything more than that the data are independent and identically distributed (i.i.d.). We evaluate the proposed method on four benchmark datasets and on the problem of predicting Total Electron Content (TEC), which is an important parameter in trans-ionospheric links; for the latter we use a dataset of more than 60000 TEC measurements collected over a period of 11 years. Our experimental results show that the prediction intervals produced by our method are both well calibrated and tight enough to be useful in practice. Copyright © 2011 Elsevier Ltd. All rights reserved.
Functional brain imaging predicts public health campaign success.
Falk, Emily B; O'Donnell, Matthew Brook; Tompson, Steven; Gonzalez, Richard; Dal Cin, Sonya; Strecher, Victor; Cummings, Kenneth Michael; An, Lawrence
2016-02-01
Mass media can powerfully affect health decision-making. Pre-testing through focus groups or surveys is a standard, though inconsistent, predictor of effectiveness. Converging evidence demonstrates that activity within brain systems associated with self-related processing can predict individual behavior in response to health messages. Preliminary evidence also suggests that neural activity in small groups can forecast population-level campaign outcomes. Less is known about the psychological processes that link neural activity and population-level outcomes, or how these predictions are affected by message content. We exposed 50 smokers to antismoking messages and used their aggregated neural activity within a 'self-localizer' defined region of medial prefrontal cortex to predict the success of the same campaign messages at the population level (n = 400,000 emails). Results demonstrate that: (i) independently localized neural activity during health message exposure complements existing self-report data in predicting population-level campaign responses (model combined R(2) up to 0.65) and (ii) this relationship depends on message content-self-related neural processing predicts outcomes in response to strong negative arguments against smoking and not in response to compositionally similar neutral images. These data advance understanding of the psychological link between brain and large-scale behavior and may aid the construction of more effective media health campaigns. © The Author (2015). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.
van der Put, Claudia E; Assink, Mark; Boekhout van Solinge, Noëlle F
2017-11-01
Risk assessment is crucial in preventing child maltreatment since it can identify high-risk cases in need of child protection intervention. Despite widespread use of risk assessment instruments in child welfare, it is unknown how well these instruments predict maltreatment and what instrument characteristics are associated with higher levels of predictive validity. Therefore, a multilevel meta-analysis was conducted to examine the predictive accuracy of (characteristics of) risk assessment instruments. A literature search yielded 30 independent studies (N=87,329) examining the predictive validity of 27 different risk assessment instruments. From these studies, 67 effect sizes could be extracted. Overall, a medium significant effect was found (AUC=0.681), indicating a moderate predictive accuracy. Moderator analyses revealed that onset of maltreatment can be better predicted than recurrence of maltreatment, which is a promising finding for early detection and prevention of child maltreatment. In addition, actuarial instruments were found to outperform clinical instruments. To bring risk and needs assessment in child welfare to a higher level, actuarial instruments should be further developed and strengthened by distinguishing risk assessment from needs assessment and by integrating risk assessment with case management. Copyright © 2017 Elsevier Ltd. All rights reserved.
Vrshek-Schallhorn, S; Doane, L D; Mineka, S; Zinbarg, R E; Craske, M G; Adam, E K
2013-03-01
The cortisol awakening response (CAR) has been shown to predict major depressive episodes (MDEs) over a 1-year period. It is unknown whether this effect: (a) is stable over longer periods of time; (b) is independent of prospective stressful life events; and (c) differentially predicts first onsets or recurrences of MDEs. A total of 270 older adolescents (mean age 17.06 years at cortisol measurement) from the larger prospective Northwestern-UCLA Youth Emotion Project completed baseline diagnostic and life stress interviews, questionnaires, and a 3-day cortisol sampling protocol measuring the CAR and diurnal rhythm, as well as up to four annual follow-up interviews of diagnoses and life stress. Non-proportional person-month survival analyses revealed that higher levels of the baseline CAR significantly predict MDEs for 2.5 years following cortisol measurement. However, the strength of prediction of depressive episodes significantly decays over time, with the CAR no longer significantly predicting MDEs after 2.5 years. Elevations in the CAR did not significantly increase vulnerability to prospective major stressful life events. They did, however, predict MDE recurrences more strongly than first onsets. These results suggest that a high CAR represents a time-limited risk factor for onsets of MDEs, which increases risk for depression independently of future major stressful life events. Possible explanations for the stronger effect of the CAR for predicting MDE recurrences than first onsets are discussed.
Jiang, Rong; Brummett, Beverly H; Hauser, Elizabeth R; Babyak, Michael A; Siegler, Ilene C; Singh, Abanish; Astrup, Arne; Pedersen, Oluf; Hansen, Torben; Holst, Claus; Sørensen, Thorkild I A; Williams, Redford B
2013-04-01
TOMM40 SNP rs157580 has been associated with triglyceride levels in genome-wide association studies (GWAS). Chronic caregiving stress moderates the association between triglyceride levels and a nearby SNP rs439401 that is associated with triglyceride levels in GWAS. Here, we report data from two independent Caucasian samples (242 U.S. women and men; 466 Danish men) testing the hypothesis that chronic family stress also moderates the association between rs157580 and triglyceride levels. The interaction of rs157580 and family stress in predicting triglyceride levels was statistically significant in the U.S. sample (p=0.004) and marginally significant (p=0.075) in the Danish sample. The G allele of rs157580 was associated with increased triglyceride levels among family stressed cases in both samples compared with A/A cases, but not among controls. Chronic family stress moderates the association of rs157580 variants with triglyceride levels and should be taken into account for disease risk assessment and potential intervention. Copyright © 2013 Elsevier B.V. All rights reserved.
Hishikari, Keiichi; Hikita, Hiroyuki; Nakamura, Shun; Nakagama, Shun; Mizusawa, Masahumi; Yamamoto, Tasuku; Doi, Junichi; Hayashi, Yosuke; Utsugi, Yuya; Araki, Makoto; Sudo, Yuta; Kimura, Shigeki; Takahashi, Atsushi; Ashikaga, Takashi; Isobe, Mitsuaki
2017-10-01
There are no biological markers to predict the onset of acute kidney injury (AKI) in patients with acute decompensated heart failure (ADHF). Liver-type fatty acid-binding protein (L-FABP) levels are markedly upregulated in the proximal tubules after renal ischemia. We investigated whether urinary L-FABP is a suitable marker to predict AKI in ADHF patients. We examined 281 consecutive patients with ADHF. Serum creatinine (Cr) and L-FABP levels were measured at admission and 24 and 48 h after admission. AKI developed in 104 patients (37%). Urinary L-FABP levels at admission were significantly higher in patients with AKI than in those without (33.0 vs. 5.2 μg/g Cr; p < 0.001). Multivariate analysis showed that baseline urinary L-FABP level was an independent predictor of AKI in ADHF patients (odds ratio 1.08, 95% confidence interval 1.05-1.12; p < 0.001). Receiver operating characteristic analysis showed that baseline urinary L-FABP level exhibited 94.2% sensitivity and 87.0% specificity at a cutoff value of 12.5 μg/g Cr. Urinary L-FABP level is useful for predicting the onset of AKI in patients with ADHF. The results of our study could help clinicians diagnose AKI in ADHF patients earlier, leading to possible improvements in the treatment of this group of patients.
Spelt, Lidewij; Sasor, Agata; Ansari, Daniel; Andersson, Roland
2016-10-01
To identify significant predictive factors for overall survival (OS) and disease-free survival (DFS) after liver resection for colon cancer metastases, with special focus on features of the primary colon cancer, such as lymph node ratio (LNR), vascular invasion, and perineural invasion. Patients operated for colonic cancer liver metastases between 2006 and 2014 were included. Details on patient characteristics, the primary colon cancer operation and metastatic disease were collected. Multivariate analysis was performed to select predictive variables for OS and DFS. Median OS and DFS were 67 and 20 months, respectively. 1-, 3- and 5-year OS were 97, 76, and 52%. 1-, 3- and 5-year DFS were 65, 42, and 37%. Multivariate analysis showed LNR to be an independent predictive factor for DFS but not for OS. Other identified predictive factors were vascular and perineural invasion of the primary colon cancer, size of the largest metastasis and severe complications after liver surgery for OS, and perineural invasion, number of liver metastases and preoperative CEA-level for DFS. Traditional N-stage was also considered to be an independent predictive factor for DFS in a separate multivariate analysis. LNR and perineural invasion of the primary colon cancer can be used as a prognostic variable for DFS after a concomitant liver resection for colon cancer metastases. Vascular and perineural invasion of the primary colon cancer are predictive for OS.
ERIC Educational Resources Information Center
Lam, Brian Trung
2005-01-01
This prospective study examined whether interdependent self-construal (collectivism), independent self-construal (individualism), family cohesion, and social support would predict levels of self-esteem among Vietnamese American adolescents. Standardized self-report measures of family cohesion, social support, and self-esteem, as well as a measure…
Criminal Victimization and Crime Risk Perception: A Multilevel Longitudinal Study
ERIC Educational Resources Information Center
Russo, Silvia; Roccato, Michele; Vieno, Alessio
2013-01-01
In a national sample of the Italian population, surveyed four times between October 2002 and January 2007 (N = 2,008), we performed a multilevel longitudinal study aimed at predicting the increase in crime risk perception as a function of three families of independent variables, respectively lying at the within individual level (direct…
Visual Prediction Error Spreads Across Object Features in Human Visual Cortex
Summerfield, Christopher; Egner, Tobias
2016-01-01
Visual cognition is thought to rely heavily on contextual expectations. Accordingly, previous studies have revealed distinct neural signatures for expected versus unexpected stimuli in visual cortex. However, it is presently unknown how the brain combines multiple concurrent stimulus expectations such as those we have for different features of a familiar object. To understand how an unexpected object feature affects the simultaneous processing of other expected feature(s), we combined human fMRI with a task that independently manipulated expectations for color and motion features of moving-dot stimuli. Behavioral data and neural signals from visual cortex were then interrogated to adjudicate between three possible ways in which prediction error (surprise) in the processing of one feature might affect the concurrent processing of another, expected feature: (1) feature processing may be independent; (2) surprise might “spread” from the unexpected to the expected feature, rendering the entire object unexpected; or (3) pairing a surprising feature with an expected feature might promote the inference that the two features are not in fact part of the same object. To formalize these rival hypotheses, we implemented them in a simple computational model of multifeature expectations. Across a range of analyses, behavior and visual neural signals consistently supported a model that assumes a mixing of prediction error signals across features: surprise in one object feature spreads to its other feature(s), thus rendering the entire object unexpected. These results reveal neurocomputational principles of multifeature expectations and indicate that objects are the unit of selection for predictive vision. SIGNIFICANCE STATEMENT We address a key question in predictive visual cognition: how does the brain combine multiple concurrent expectations for different features of a single object such as its color and motion trajectory? By combining a behavioral protocol that independently varies expectation of (and attention to) multiple object features with computational modeling and fMRI, we demonstrate that behavior and fMRI activity patterns in visual cortex are best accounted for by a model in which prediction error in one object feature spreads to other object features. These results demonstrate how predictive vision forms object-level expectations out of multiple independent features. PMID:27810936
Development and validation of a prognostic nomogram for terminally ill cancer patients.
Feliu, Jaime; Jiménez-Gordo, Ana María; Madero, Rosario; Rodríguez-Aizcorbe, José Ramón; Espinosa, Enrique; Castro, Javier; Acedo, Jesús Domingo; Martínez, Beatriz; Alonso-Babarro, Alberto; Molina, Raquel; Cámara, Juan Carlos; García-Paredes, María Luisa; González-Barón, Manuel
2011-11-02
Determining life expectancy in terminally ill cancer patients is a difficult task. We aimed to develop and validate a nomogram to predict the length of survival in patients with terminal disease. From February 1, 2003, to December 31, 2005, 406 consecutive terminally ill patients were entered into the study. We analyzed 38 features prognostic of life expectancy among terminally ill patients by multivariable Cox regression and identified the most accurate and parsimonious model by backward variable elimination according to the Akaike information criterion. Five clinical and laboratory variables were built into a nomogram to estimate the probability of patient survival at 15, 30, and 60 days. We validated and calibrated the nomogram with an external validation cohort of 474 patients who were treated from June 1, 2006, through December 31, 2007. The median overall survival was 29.1 days for the training set and 18.3 days for the validation set. Eastern Cooperative Oncology Group performance status, lactate dehydrogenase levels, lymphocyte levels, albumin levels, and time from initial diagnosis to diagnosis of terminal disease were retained in the multivariable Cox proportional hazards model as independent prognostic factors of survival and formed the basis of the nomogram. The nomogram had high predictive performance, with a bootstrapped corrected concordance index of 0.70, and it showed good calibration. External independent validation revealed 68% predictive accuracy. We developed a highly accurate tool that uses basic clinical and analytical information to predict the probability of survival at 15, 30, and 60 days in terminally ill cancer patients. This tool can help physicians making decisions on clinical care at the end of life.
Malacarne, D; Pesenti, R; Paolucci, M; Parodi, S
1993-01-01
For a database of 826 chemicals tested for carcinogenicity, we fragmented the structural formula of the chemicals into all possible contiguous-atom fragments with size between two and eight (nonhydrogen) atoms. The fragmentation was obtained using a new software program based on graph theory. We used 80% of the chemicals as a training set and 20% as a test set. The two sets were obtained by random sorting. From the training sets, an average (8 computer runs with independently sorted chemicals) of 315 different fragments were significantly (p < 0.125) associated with carcinogenicity or lack thereof. Even using this relatively low level of statistical significance, 23% of the molecules of the test sets lacked significant fragments. For 77% of the molecules of the test sets, we used the presence of significant fragments to predict carcinogenicity. The average level of accuracy of the predictions in the test sets was 67.5%. Chemicals containing only positive fragments were predicted with an accuracy of 78.7%. The level of accuracy was around 60% for chemicals characterized by contradictory fragments or only negative fragments. In a parallel manner, we performed eight paired runs in which carcinogenicity was attributed randomly to the molecules of the training sets. The fragments generated by these pseudo-training sets were devoid of any predictivity in the corresponding test sets. Using an independent software program, we confirmed (for the complex biological endpoint of carcinogenicity) the validity of a structure-activity relationship approach of the type proposed by Klopman and Rosenkranz with their CASE program. Images Figure 1. Figure 2. Figure 3. Figure 4. Figure 5. Figure 6. PMID:8275991
Denovan, Andrew; Dagnall, Neil; Drinkwater, Kenneth; Parker, Andrew; Clough, Peter
2017-01-01
The present study assessed the degree to which probabilistic reasoning performance and thinking style influenced perception of risk and self-reported levels of terrorism-related behavior change. A sample of 263 respondents, recruited via convenience sampling, completed a series of measures comprising probabilistic reasoning tasks (perception of randomness, base rate, probability, and conjunction fallacy), the Reality Testing subscale of the Inventory of Personality Organization (IPO-RT), the Domain-Specific Risk-Taking Scale, and a terrorism-related behavior change scale. Structural equation modeling examined three progressive models. Firstly, the Independence Model assumed that probabilistic reasoning, perception of risk and reality testing independently predicted terrorism-related behavior change. Secondly, the Mediation Model supposed that probabilistic reasoning and reality testing correlated, and indirectly predicted terrorism-related behavior change through perception of risk. Lastly, the Dual-Influence Model proposed that probabilistic reasoning indirectly predicted terrorism-related behavior change via perception of risk, independent of reality testing. Results indicated that performance on probabilistic reasoning tasks most strongly predicted perception of risk, and preference for an intuitive thinking style (measured by the IPO-RT) best explained terrorism-related behavior change. The combination of perception of risk with probabilistic reasoning ability in the Dual-Influence Model enhanced the predictive power of the analytical-rational route, with conjunction fallacy having a significant indirect effect on terrorism-related behavior change via perception of risk. The Dual-Influence Model possessed superior fit and reported similar predictive relations between intuitive-experiential and analytical-rational routes and terrorism-related behavior change. The discussion critically examines these findings in relation to dual-processing frameworks. This includes considering the limitations of current operationalisations and recommendations for future research that align outcomes and subsequent work more closely to specific dual-process models.
Kim, Yong-Hyun; Shim, Wan-Joo; Kim, Myung-A; Hong, Kyung-Soon; Shin, Mi-Seung; Park, Seong-Mi; Cho, Kyoung Im; Kim, Mina; Kim, Sihun; Kim, Hak-Lyoung; Yoon, Hyun-Ju; Na, Jin-Oh; Kim, Sung-Eun
2016-06-01
Pretest probability (PTP) and an exercise treadmill test (ETT) are recommended for the initial evaluation of possible coronary artery disease (CAD), but the applicability of these tests in Korean women has not been evaluated. Korean women with PTP, ETT, and invasive coronary angiography results were enrolled. Across all PTP levels, PTP and ETT statistics were evaluated and independent CAD predictors obtained. Of the 335 patients (mean age 58.0 ± 10.2 years), 99 and 236 were in the low (LPTP) and intermediate PTP (IPTP) groups, respectively. The observed prevalence of CAD was significantly lower than the PTP. (7.1% vs. 9.1 ± 4.9% in LPTP, p < 0.001; 23.3% vs. 33.0 ± 15.1% in IPTP, p < 0.001) The ETT's sensitivity and positive predictive values (PPVs) appeared lower than previously reported (LPTP: 42.9% and 16.7%; IPTP: 61.8% and 37.0%), whereas the negative predictive values (NPVs) were higher (LPTP: 95.1%; IPTP: 85.4%). After multivariate adjustments, positive ETT (odds ratio 3.276, 95% confidence interval 1.643-6.532, p = 0.001) independently predicted the presence of CAD, but the PTP showed only marginal predictability (odds ratio 1.019, 95% confidence interval 0.998-1.041, p = 0.069). In Korean women, the observed prevalence of CAD was lower than the PTP, and PTP showed only marginal CAD predictability. Although a positive ETT independently predicted CAD, the ETT showed lower sensitivity and PPVs than previously reported. Despite the limited value of PTP and ETT, the high NPVs of ETT appear useful for saving patients from unnecessary further examinations.
Denovan, Andrew; Dagnall, Neil; Drinkwater, Kenneth; Parker, Andrew; Clough, Peter
2017-01-01
The present study assessed the degree to which probabilistic reasoning performance and thinking style influenced perception of risk and self-reported levels of terrorism-related behavior change. A sample of 263 respondents, recruited via convenience sampling, completed a series of measures comprising probabilistic reasoning tasks (perception of randomness, base rate, probability, and conjunction fallacy), the Reality Testing subscale of the Inventory of Personality Organization (IPO-RT), the Domain-Specific Risk-Taking Scale, and a terrorism-related behavior change scale. Structural equation modeling examined three progressive models. Firstly, the Independence Model assumed that probabilistic reasoning, perception of risk and reality testing independently predicted terrorism-related behavior change. Secondly, the Mediation Model supposed that probabilistic reasoning and reality testing correlated, and indirectly predicted terrorism-related behavior change through perception of risk. Lastly, the Dual-Influence Model proposed that probabilistic reasoning indirectly predicted terrorism-related behavior change via perception of risk, independent of reality testing. Results indicated that performance on probabilistic reasoning tasks most strongly predicted perception of risk, and preference for an intuitive thinking style (measured by the IPO-RT) best explained terrorism-related behavior change. The combination of perception of risk with probabilistic reasoning ability in the Dual-Influence Model enhanced the predictive power of the analytical-rational route, with conjunction fallacy having a significant indirect effect on terrorism-related behavior change via perception of risk. The Dual-Influence Model possessed superior fit and reported similar predictive relations between intuitive-experiential and analytical-rational routes and terrorism-related behavior change. The discussion critically examines these findings in relation to dual-processing frameworks. This includes considering the limitations of current operationalisations and recommendations for future research that align outcomes and subsequent work more closely to specific dual-process models. PMID:29062288
Williams, Simon G; Jackson, Mark; Ng, Leong L; Barker, Diane; Patwala, Ashish; Tan, Lip-Bun
2005-01-01
It is a prevailing concept in chronic heart failure (CHF) that ventricular remodelling (evaluated via imaging) and neurohormonal activation (via biomarkers) exert major influences, such that the need to subject patients to haemodynamic evaluations and exercise testing has been questioned. We sought to investigate whether exercise and haemodynamic parameters lack independent prognostic value in a cohort of unselected ambulatory patients with mild-moderate CHF. Eighty-five consecutive patients with stable CHF in New York Heart Association functional classes I-IV, aged 55 +/- 12 years, 84% males, left ventricular ejection fraction (LVEF) 37 +/- 15%, participated in this study. Survivors were followed for a median of 5.08 years. All subjects underwent cardiopulmonary exercise testing to measure standard parameters including peak oxygen consumption, exercise duration and blood pressure. A sample of venous blood was taken to determine the N-terminal pro-brain natriuretic peptide (N-BNP) level. Echocardiography was performed at rest to measure LVEF. Predictors of mortality were sought using the Cox proportional hazards model. All-cause mortality was 19% (16 deaths, 95% CI 11-29%). Age and LVEF did not independently predict mortality. Although various parameters including New York Heart Association class, peak oxygen consumption and N-BNP level were all predictive of outcome on univariate analysis, multivariate analysis identified reduced exercise duration and peak systolic blood pressure (SBP) to be the only independent predictors of all-cause mortality. Hazard ratios of 0.78 (95% CI 0.65-0.93, p = 0.007) and 0.79 (95% CI 0.66-0.95, p = 0.01) were associated with an increase in exercise duration of 1 min and 10 mm Hg peak SBP, respectively. Two simple parameters (exercise duration and peak SBP) that are easily measured by standard exercise testing are the strongest independent predictors of mortality which outperform LVEF and N-BNP in ambulatory patients with mild-moderate CHF. Copyright (c) 2005 S. Karger AG, Basel.
Lee, Chi Ho; Woo, Yu Cho; Chow, Wing Sun; Cheung, Chloe Yu Yan; Fong, Carol Ho Yi; Yuen, Michele Mae Ann; Xu, Aimin; Tse, Hung Fat; Lam, Karen Siu Ling
2017-06-06
Fibroblast growth factor 21 (FGF21) has demonstrated beneficial effects on lipid and carbohydrate metabolism. In cross-sectional studies, an association of raised circulating FGF21 levels with coronary heart disease (CHD) was found in some but not all studies. Here we investigated prospectively whether baseline serum FGF21 levels could predict incident CHD in subjects with type 2 diabetes mellitus and no known cardiovascular diseases. Baseline serum FGF21 levels were measured in 3528 Chinese subjects with type 2 diabetes mellitus recruited from the Hong Kong West Diabetes Registry. The role of baseline serum FGF21 levels in predicting incident CHD over a median follow-up of 3.8 years was analyzed using Cox regression analysis. Among 3528 recruited subjects without known cardiovascular diseases, 147 (4.2%) developed CHD over a mean follow-up of 4 years. Baseline serum log-transformed FGF21 levels were significantly higher in those who had incident CHD than those who did not (222.7 pg/mL [92.8-438.4] versus 151.1 pg/mL [75.6-274.6]; P <0.001). On multivariable Cox regression analysis, baseline serum FGF21 levels, using an optimal cutoff of 206.22 pg/mL derived from our study, independently predicted incident CHD (hazard ratio, 1.55; 95% CI, 1.10-2.19; P =0.013) and significantly improved net reclassification index and integrated discrimination improvement after adjustment for conventional cardiovascular risk factors. We have demonstrated, for the first time, that serum FGF21 level is an independent predictor of incident CHD and might be usefully utilized as a biomarker for identifying type 2 diabetes mellitus subjects with raised CHD risk, for primary prevention. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Guiu, Boris, E-mail: boris.guiu@chu-dijon.fr; Deschamps, Frederic; Boulin, Mathieu
Purpose: An Asian study showed that gamma glutamyl transpeptidase (GGT) can predict survival after transarterial chemoembolization (TACE) of hepatocellular carcinoma (HCC). This study was designed to validate in a European population this biomarker as an independent predictor of outcome after TACE of HCC and to determine a threshold value for clinical use. Methods: In 88 consecutive patients treated by TACE for HCC, the optimal threshold for GGT serum level was determined by a ROC analysis. Endpoints were time-to-treatment failure (TTTF) and overall survival (OS). All multivariate models were internally validated using bootstrapping (90 replications). Results: Median follow-up lasted 373 days,more » and median overall survival was 748 days. The optimal threshold for GGT was 165 U/L (sensitivity: 89.3%; specificity: 56.7%; area under the ROC curve: 0.7515). Median TTTF was shorter when GGT was {>=}165 U/L (281 days vs. 850 days; P < 0.001). GGT {>=}165 U/L (hazard ratio (HR) = 2.06; P = 0.02), WHO PS of 2 (HR = 5.4; P = 0.002), and tumor size (HR = 1.12; P = 0.014) were independently associated with shorter TTTF. Median OS was shorter when GGT was {>=}165 U/L (508 days vs. not reached; P < 0.001). GGT {>=} 165 U/L (HR = 3.05; P = 0.029), WHO PS of 2 (HR = 12.95; P < 0.001), alfa-fetoprotein (HR = 2.9; P = 0.01), and tumor size (HR = 1.096; P = 0.013) were independently associated with shorter OS. The results were confirmed by bootstrapping. Conclusions: Our results provide in a European population the external validation of GGT as an independent predictor of outcome after TACE of HCC. A serum level of GGT {>=} 165 U/L is independently associated with both shorter TTTF and OS.« less
Ryu, In Sun; Kim, Jae Seung; Roh, Jong-Lyel; Cho, Kyung-Ja; Choi, Seung-Ho; Nam, Soon Yuhl; Kim, Sang Yoon
2014-03-01
Metabolic tumour volume (MTV) and total lesion glycolysis (TLG) from (18)F-FDG PET/CT are emerging prognostic biomarkers in human solid cancers; yet few studies have investigated their clinical and prognostic significance in oral cavity squamous cell carcinoma (OSCC). The present retrospective study evaluated the utility of pretreatment MTV and TLG measured by (18)F-FDG PET/CT to predict survival and occult metastasis (OM) in OSCC. Of 162 patients with OSCC evaluated preoperatively by (18)F-FDG PET/CT, 105 who underwent definitive surgery with or without adjuvant therapy were eligible. Maximum standardized uptake value (SUVmax), MTV and TLG were measured. For calculation of MTV, 3-D regions of interest were drawn and a SUV threshold of 2.5 was used for defining regions. Univariate and multivariate analyses identified clinicopathological and imaging variables associated with OM, disease-free survival (DFS) and overall survival (OS). The median (range) SUVmax, MTV and TLG were 7.3 (0.7-41.9), 4.5 ml (0.7-115.1 ml) and 18.3 g (2.4-224.1 g), respectively. Of 53 patients with clinically negative lymph nodes, OM was detected in 19 (36%). By univariate and multivariate analyses, MTV (P = 0.018) and TLG (P = 0.011) were both independent predictive factors for OM, although they were not independent of each other. The 4-year DFS and OS rates were 53.0% and 62.0%, respectively. Univariate and multivariate analyses revealed that MTV (P = 0.001) and TLG (P = 0.006), with different cut-off levels, were both independent predictive factors for DFS, although they were not independent of each other, and MTV (P = 0.001), TLG (P = 0.002) and the involved resection margin (P = 0.007) were independent predictive factors for OS. Pretreatment MTV and TLG may be useful in stratifying the likelihood of survival and predicting OM in OSCC.
Bustamante, Alejandro; Vilar-Bergua, Andrea; Guettier, Sophie; Sánchez-Poblet, Josep; García-Berrocoso, Teresa; Giralt, Dolors; Fluri, Felix; Topakian, Raffi; Worthmann, Hans; Hug, Andreas; Molnar, Tihamer; Waje-Andreassen, Ulrike; Katan, Mira; Smith, Craig J; Montaner, Joan
2017-04-01
We conducted a systematic review and individual participant data meta-analysis to explore the role of C-reactive protein (CRP) in early detection or prediction of post-stroke infections. CRP, an acute-phase reactant binds to the phosphocholine expressed on the surface of dead or dying cells and some bacteria, thereby activating complement and promoting phagocytosis by macrophages. We searched PubMed up to May-2015 for studies measuring CRP in stroke and evaluating post-stroke infections. Individual participants' data were merged into a single database. CRP levels were standardized and divided into quartiles. Factors independently associated with post-stroke infections were determined by logistic regression analysis and the additional predictive value of CRP was assessed by comparing areas under receiver operating characteristic curves and integrated discrimination improvement index. Data from seven studies including 699 patients were obtained. Standardized CRP levels were higher in patients with post-stroke infections beyond 24 h. Standardized CRP levels in the fourth quartile were independently associated with infection in two different logistic regression models, model 1 [stroke severity and dysphagia, odds ratio = 9.70 (3.10-30.41)] and model 2 [age, sex, and stroke severity, odds ratio = 3.21 (1.93-5.32)]. Addition of CRP improved discrimination in both models [integrated discrimination improvement = 9.83% (0.89-18.77) and 5.31% (2.83-7.79), respectively], but accuracy was only improved for model 1 (area under the curve 0.806-0.874, p = 0.036). In this study, CRP was independently associated with development of post-stroke infections, with the optimal time-window for measurement at 24-48 h. However, its additional predictive value is moderate over clinical information. Combination with other biomarkers in a panel seems a promising strategy for future studies. © 2017 International Society for Neurochemistry.
Validation of Fatigue Modeling Predictions in Aviation Operations
NASA Technical Reports Server (NTRS)
Gregory, Kevin; Martinez, Siera; Flynn-Evans, Erin
2017-01-01
Bio-mathematical fatigue models that predict levels of alertness and performance are one potential tool for use within integrated fatigue risk management approaches. A number of models have been developed that provide predictions based on acute and chronic sleep loss, circadian desynchronization, and sleep inertia. Some are publicly available and gaining traction in settings such as commercial aviation as a means of evaluating flight crew schedules for potential fatigue-related risks. Yet, most models have not been rigorously evaluated and independently validated for the operations to which they are being applied and many users are not fully aware of the limitations in which model results should be interpreted and applied.
Validation of High-Resolution CFD Method for Slosh Damping Extraction of Baffled Tanks
NASA Technical Reports Server (NTRS)
Yang, H. Q.; West, Jeff
2016-01-01
The predicted slosh damping values from Loci-Stream-VOF agree with experimental data very well for all fill levels in the vicinity of the baffle. Grid refinement study is conducted and shows that the current predictions are grid independent. The increase of slosh damping due to the baffle is shown to arise from: a) surface breakup; b) cascade of energy from the low order slosh mode to higher modes; and c) recirculation inside liquid phase around baffle. The damping is a function of slosh amplitude, consistent with previous observation. Miles equation under predicts damping in the upper dome section.
Gabriel, M.C.; Kolka, R.; Wickman, T.; Nater, E.; Woodruff, Laurel G.
2009-01-01
The primary objective of this research is to investigate relationships between mercury in upland soil, lake water and fish tissue and explore the cause for the observed spatial variation of THg in age one yellow perch (Perca flavescens) for ten lakes within the Superior National Forest. Spatial relationships between yellow perch THg tissue concentration and a total of 45 watershed and water chemistry parameters were evaluated for two separate years: 2005 and 2006. Results show agreement with other studies where watershed area, lake water pH, nutrient levels (specifically dissolved NO3−-N) and dissolved iron are important factors controlling and/or predicting fish THg level. Exceeding all was the strong dependence of yellow perch THg level on soil A-horizon THg and, in particular, soil O-horizon THg concentrations (Spearman ρ = 0.81). Soil B-horizon THg concentration was significantly correlated (Pearson r = 0.75) with lake water THg concentration. Lakes surrounded by a greater percentage of shrub wetlands (peatlands) had higher fish tissue THg levels, thus it is highly possible that these wetlands are main locations for mercury methylation. Stepwise regression was used to develop empirical models for the purpose of predicting the spatial variation in yellow perch THg over the studied region. The 2005 regression model demonstrates it is possible to obtain good prediction (up to 60% variance description) of resident yellow perch THg level using upland soil O-horizon THg as the only independent variable. The 2006 model shows even greater prediction (r2 = 0.73, with an overall 10 ng/g [tissue, wet weight] margin of error), using lake water dissolved iron and watershed area as the only model independent variables. The developed regression models in this study can help with interpreting THg concentrations in low trophic level fish species for untested lakes of the greater Superior National Forest and surrounding Boreal ecosystem.
Roy, Monique S; Janal, Malvin N; Crosby, Juan; Donnelly, Robert
2016-04-01
To determine whether plasma levels of markers of inflammation are predictive of the incidence of cardiovascular disease (CVD), hypertension, or mortality in African Americans with type 1 diabetes mellitus. A total of 484 African Americans with type 1 diabetes were included. At baseline and 6-year follow-up, a clinical interview and examination were conducted to document CVD and systemic hypertension. Venous blood for glycated hemoglobin and cholesterol was obtained and albumin excretion rate measured. Mortality was assessed annually between baseline and 6-year follow-up by review of the social security death index. Baseline plasma levels of 28 inflammatory biomarkers were measured using multiplex bead analysis system. After adjusting for baseline age and other confounders, African Americans with type 1 diabetes in the highest quartile of plasma interferon-inducible protein 10 (IP-10) were three times more likely to develop CVD than those in the lowest quartile. African Americans with type 1 diabetes in the lowest quartiles of plasma stromal derived factor-1 (SDF-1) had a 75% higher risk of death than patients in the highest quartile, independently of age, low density lipoprotein cholesterol, body mass index, hypertension, and albuminuria. In African Americans with type 1 diabetes, high plasma IP-10 is an independent predictor for incident CVD and low SDF-1 an independent predictor for mortality. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Uchino, Bert N; Ruiz, John M; Smith, Timothy W; Smyth, Joshua M; Taylor, Daniel J; Allison, Matthew; Ahn, Chul
2015-10-01
Although the quality of one's social relationships has been linked to important physical health outcomes, less work has been conducted examining family and friends that differ in their underlying positivity and negativity. The main aim of this study was to examine the association between supportive, aversive, and ambivalent family/friends with levels of C-reactive proteins. Three hundred participants from the North Texas Heart Study completed the social relationships index and a blood draw to assess high-sensitivity C-reactive proteins (hs-CRPs). After standard controls, the number of supportive family members predicted lower hs-CRP levels, whereas the number of ambivalent family members predicted higher hs-CRP levels. These links were independent of depressive symptoms and perceived stress. These data highlight the importance of considering specific types of relationships and their underlying positive and negative aspects in research on social ties and physical health.
A levels and intelligence as predictors of medical careers in UK doctors: 20 year prospective study
McManus, I C; Smithers, Eleni; Partridge, Philippa; Keeling, A; Fleming, Peter R
2003-01-01
Objective To assess whether A level grades (achievement) and intelligence (ability) predict doctors' careers. Design Prospective cohort study with follow up after 20 years by postal questionnaire. Setting A UK medical school in London. Participants 511 doctors who had entered Westminster Medical School as clinical students between 1975 and 1982 were followed up in January 2002. Main outcome measures Time taken to reach different career grades in hospital or general practice, postgraduate qualifications obtained (membership/fellowships, diplomas, higher academic degrees), number of research publications, and measures of stress and burnout related to A level grades and intelligence (result of AH5 intelligence test) at entry to clinical school. General health questionnaire, Maslach burnout inventory, and questionnaire on satisfaction with career at follow up. Results 47 (9%) doctors were no longer on the Medical Register. They had lower A level grades than those who were still on the register (P < 0.001). A levels also predicted performance in undergraduate training, performance in postregistration house officer posts, and time to achieve membership qualifications (Cox regression, P < 0.001; b=0.376, SE=0.098, exp(b)=1.457). Intelligence did not independently predict dropping off the register, career outcome, or other measures. A levels did not predict diploma or higher academic qualifications, research publications, or stress or burnout. Diplomas, higher academic degrees, and research publications did, however, significantly correlate with personality measures. Conclusions Results of achievement tests, in this case A level grades, which are particularly used for selection of students in the United Kingdom, have long term predictive validity for undergraduate and postgraduate careers. In contrast, a test of ability or aptitude (AH5) was of little predictive validity for subsequent medical careers. PMID:12869457
Schoeppe, Stephanie; Duncan, Mitch J; Badland, Hannah M; Alley, Stephanie; Williams, Susan; Rebar, Amanda L; Vandelanotte, Corneel
2015-07-22
In developed countries, children's independent mobility levels are low. Built environmental factors and parental safety concerns are well-known to predict the level of independent mobility adults grant to children. In contrast, the influence of adults' socio-demographic characteristics and neighbourhood social cohesion on children's independent mobility is largely unexplored. This study investigated the influence of adults' socio-demographic factors and neighbourhood social cohesion on distances they would permit children for independent travel and outdoor play. In 2013, a random sample of 1293 Australian adults (mean age: 56.1 years, 52 % male, 81 % parents) participated in the Queensland Social Survey (QSS) via computer-assisted telephone interview. Socio-demographic factors measured included age, sex, parental status, education and area-level socio-economic disadvantage. Perceived neighbourhood social cohesion was assessed using a standardised scale. Adults reported the distances children aged 8-12 years should be allowed to walk/cycle to places, and play outdoors without adults. Responses were categorised into 'within sight', < 0.5 kilometres (km) , 0.5-1 km and >1 km. Ordinal logistic regression was used to assess associations of socio-demographic factors and neighbourhood social cohesion with distances adults would permit for children's independent travel and outdoor play. Parents and adults with lower education were less likely to permit greater distances for children's independent travel (OR 0.57 and OR = 0.59, respectively). Women, parents and adults with lower education were less likely to grant children greater distances for independent outdoor play (OR = 0.61, OR = 0.50 and OR = 0.60, respectively). In contrast, adults with higher perceptions of neighbourhood social cohesion were more likely to permit children greater distances for independent travel (OR = 1.05)and outdoor play (OR = 1.05). Adult age and area-level socio-economic disadvantage were not associated with distances adults would permit for independent travel and outdoor play. Women, parents (particularly those of younger children), adults with lower education and those who perceived neighbourhood social cohesion as being lower were less willing to let children independently travel further away from home. Interventions to increase children's independent mobility may be more effective if targeted to these groups. In addition, increasing neighbourhood social cohesion may help increase adults' willingness to grant children greater independent mobility.
Perron, Isaac J; Keenan, Brendan T; Chellappa, Karthikeyani; Lahens, Nicholas F; Yohn, Nicole L; Shockley, Keith R; Pack, Allan I; Veasey, Sigrid C
2018-01-01
Associated with numerous metabolic and behavioral abnormalities, obesity is classified by metrics reliant on body weight (such as body mass index). However, overnutrition is the common cause of obesity, and may independently contribute to these obesity-related abnormalities. Here, we use dietary challenges to parse apart the relative influence of diet and/or energy balance from body weight on various metabolic and behavioral outcomes. Seventy male mice (mus musculus) were subjected to the diet switch feeding paradigm, generating groups with various body weights and energetic imbalances. Spontaneous activity patterns, blood metabolite levels, and unbiased gene expression of the nutrient-sensing ventral hypothalamus (using RNA-sequencing) were measured, and these metrics were compared using standardized multivariate linear regression models. Spontaneous activity patterns were negatively related to body weight (p<0.0001) but not diet/energy balance (p = 0.63). Both body weight and diet/energy balance predicted circulating glucose and insulin levels, while body weight alone predicted plasma leptin levels. Regarding gene expression within the ventral hypothalamus, only two genes responded to diet/energy balance (neuropeptide y [npy] and agouti-related peptide [agrp]), while others were related only to body weight. Collectively, these results demonstrate that individual components of obesity-specifically obesogenic diets/energy imbalance and elevated body mass-can have independent effects on metabolic and behavioral outcomes. This work highlights the shortcomings of using body mass-based indices to assess metabolic health, and identifies novel associations between blood biomarkers, neural gene expression, and animal behavior following dietary challenges.
Prognostic value of serum thioredoxin levels in ischemic stroke.
Yu, Tieer; Zhang, Wanli; Lin, Yuanshao; Li, Qian; Xue, Jie; Cai, Zhengyi; Cheng, Yifan; Shao, Bei
2017-11-01
Thioredoxin (Trx) is one of significant antioxidative molecules to diminish oxidative stress. Current evidence suggests that Trx is a potent antioxidant with cytoprotective functions. The aim of our study was to investigate specifically the association between serum Trx levels and acute ischemic stroke (AIS) patients. 198 AIS patients and 75 controls were enrolled to the study. Serum Trx levels were measured using an enzyme-linked immunosorbent assay (ELISA). Stroke severity was assessed with the National Institutes of Health Stroke Scale (NIHSS) score on admission. Clinical endpoint was functional outcome measured by Barthel Index (BI) 3 months after admission. Multivariate binary logistic regression analyses were performed to identify predictors. We found that serum Trx levels were significantly increased in patients as compared to controls. Serum Trx was an independent biomarker to predict ischemic stroke (OR, 1.264; 95% CI, 1.04-1.537; P = 0.019). In addition, there was a negative correlation between NIHSS score at admission and serum Trx levels in cardioembolic stroke patients (r = -0.422; P = 0.013). Furthermore, higher serum Trx levels in AIS patients were associated with favorable functional outcome. Serum Trx was an independent predictor for the functional outcome (OR, 0.862; 95% CI, 0.75-0.991; P = 0.037). Serum Trx might be as a biomarker of cardioembolic stroke severity. Increased serum Trx levels could be a useful tool to predict good prognosis in patients with AIS.
Predicting relative sea level changes at the aftermath of Marinoan (635 Ma) Snowball meltdown
NASA Astrophysics Data System (ADS)
Irie, Y.; Nakada, M.; Okuno, J.; Bao, H.
2016-12-01
Earth system recovery from a Snowball state constitutes one of the best tests of the resilience of life on planet Earth. A distinct and probably brief relative sea level (RSL) drop has been identified in the cap dolostones deposited in a general transgression sequence at the aftermath of Marinoan Snowball meltdown in South China and other late Neoproterozoic blocks. However, the magnitude and duration or the very existence of this RSL drop event can vary at different geographical sites because of spatial and temporal variations in sea level due to glacial isostatic adjustment (GIA) even for tectonically stable areas. An accurate prediction of this drop can in turn help us infer independently the rate of dynamic recovery of the Earth system from a Snowball state, e.g. the timing and duration of the Marinoan 17O depletion (MOSD) event that was also closely linked to the rise and drawdown of atmospheric O2 and CO2, respectively. Here we model the RSL changes by considering all GIA-related relaxation processes. We evaluated the RSL to the sea level at 10 Myr after the complete glacial meltdown and tested slightly different paleogeographic configurations. Our modeling results show that the RSL drop occurs in the syn-deglacial phase (melting phase) for the inland regions and in the post-deglacial phase (time after the complete melting) for continental margins. The RSL drop in the post-deglacial phase is mainly determined by the relaxation processes with a timescale of longer than 20 kyr. The predicted RSL change in South China for lower mantle viscosity of 1022-1023 Pa s and a syn-deglacial time of <100 kyr is consistent with the observationally inferred RSL change regardless of uncertainties on the length of the continental shelf or the paleogeography of South China. A comparison between our model predicted and sedimentary-record inferred RSL change in South China put an independent constraint on the duration of the MOSD event at 70 kyr or shorter.
Zhang, Y Y; Li, X; Lin, W H; Liu, J J; Jing, R; Lu, Y J; Di, C Y; Shi, H Y; Gao, P
2018-01-16
Objective: To further evaluate the clinical value of epicardial adipose tissue volume (EATV) in predicting the prognosis of coronary heart disease (CHD) after percutaneous coronary intervention (PCI). Methods: From July 2013 to July 2016 in TEDA International Cardiovascular Disease Hospital, a total of 474 patients diagnosed with CHD were included in this study.According to the result of EATV, patients were divided into three groups, group A (EATV≤75 ml), group B (75 ml
Low Serum Interleukin-13 Levels Correlate with Poorer Prognoses for Colorectal Cancer Patients
Saigusa, Susumu; Tanaka, Koji; Inoue, Yasuhiro; Toiyama, Yuji; Okugawa, Yoshinaga; Iwata, Takashi; Mohri, Yasuhiko; Kusunoki, Masato
2014-01-01
Interleukin-13 (IL-13) is an immunosuppressive cytokine produced by several immune cells and cancer cells. The aim of this retrospective study was to determine if serum IL-13 levels have an association with clinical outcome in patients with colorectal cancer. A total of 241 patients with colorectal cancer were enrolled in the present study. Preoperative serum IL-13 concentrations were measured by enzyme-linked immunosorbent assay. We analyzed the association of serum IL-13 levels with clinicopathological variables. Patients with lymph node metastasis, lymphatic invasion, vascular invasion, distant metastases or advanced stage of disease had significantly lower serum IL-13 levels. Low serum IL-13 was significantly associated with both poor recurrence-free and overall survival. Multivariate analysis showed that low IL-13 levels were an independent predictive marker for poor prognosis. In conclusion, our data suggest that low serum IL-13 levels may be a useful predictive marker for poor prognosis in colorectal cancer. PMID:24833143
Zheng, Yuan-Bo; Ruan, Guo-Mo; Fu, Jia-Xing; Su, Zhong-Liang; Cheng, Peng; Lu, Jian-Zuo
2016-04-01
Oxidative stress may be involved in occurrence of postoperative delirium (POD) and cognitive dysfunction (POCD). 8-iso-Prostaglandin F2α (8-iso-PGF2α), an isoprostane derived from arachidonic acid via lipid peroxidation, is considered a gold standard for measuring oxidative stress. The present study aimed to investigate the ability of postoperative plasma 8-iso-PGF2α levels to predict POD and POCD in elderly patients undergoing hip fracture surgery. Postoperative plasma 8-iso-PGF2α levels of 182 patients were measured by an enzyme-linked immunosorbent assay. We assessed the relationships between plasma 8-iso-PGF2α levels and the risk of POD and POCD using a multivariate analysis. Plasma 8-iso-PGF2α levels and age were identified as the independent predictors for POD and POCD. Based on areas under receiver operating characteristic curve, the predictive values of 8-iso-PGF2α were obviously higher than those of age for POD and POCD. In a combined logistic-regression model, 8-iso-PGF2α significantly enhanced the areas under curve of age for prediction of POD and POCD. Postoperative plasma 8-iso-PGF2α levels may have the potential to predict POD and POCD in elder patients undergoing hip fracture surgery. Copyright © 2016 Elsevier B.V. All rights reserved.
Patient volume per surgeon does not predict survival in adult level I trauma centers.
Margulies, D R; Cryer, H G; McArthur, D L; Lee, S S; Bongard, F S; Fleming, A W
2001-04-01
The 1999 American College of Surgeons resources for optimal care document added the requirement that Level I trauma centers admit over 240 patients with Injury Severity Score (ISS) > 15 per year or that trauma surgeons care for at least 35 patients per year. The purpose of this study was to test the hypothesis that high volume of patients with ISS > 15 per individual trauma surgeon is associated with improved outcome. Data were obtained from the trauma registry of the five American College of Surgeons-verified adult Level I trauma centers in our mature trauma system between January 1, 1998, and March 31, 1999. Data abstracted included age, sex, Glasgow Coma Scale (GCS) score, intensive care unit length of stay, hospital length of stay, probability of survival (Ps), mechanism of injury, number of patients per each trauma surgeon and institution, and mortality. Multiple logistic regression was performed to select independent variables for modeling of survival. From the five Level I centers there were 11,932 trauma patients in this time interval; of these, 1,754 patients (14.7%) with ISS > 15 were identified and used for analysis. Patients with ISS > 15 varied from 173 to 625 per institution; trauma surgeons varied from 8 to 25 per institution; per-surgeon patient volume varied from 0.8 to 96 per year. Logistic regression analysis revealed that the best independent predictors of survival were Ps, GCS score, age, mechanism of injury, and institutional volume (p < 0.01). Age and institutional volume correlated negatively with survival. Analysis of per-surgeon patient caseload added no additional predictive value (p = 0.44). The significant independent predictors of survival in severely injured trauma patients are Ps, GCS score, age, mechanism of injury, and institutional volume. We found no statistically meaningful contribution to the prediction of survival on the basis of per-surgeon patient volume. Since this volume criterion for surgeon enpanelment and trauma center designation would not be expected to improve outcome, such a requirement should be justified by other measures or abandoned.
Cosmological implications of a large complete quasar sample
Segal, I. E.; Nicoll, J. F.
1998-01-01
Objective and reproducible determinations of the probabilistic significance levels of the deviations between theoretical cosmological prediction and direct model-independent observation are made for the Large Bright Quasar Sample [Foltz, C., Chaffee, F. H., Hewett, P. C., MacAlpine, G. M., Turnshek, D. A., et al. (1987) Astron. J. 94, 1423–1460]. The Expanding Universe model as represented by the Friedman–Lemaitre cosmology with parameters qo = 0, Λ = 0 denoted as C1 and chronometric cosmology (no relevant adjustable parameters) denoted as C2 are the cosmologies considered. The mean and the dispersion of the apparent magnitudes and the slope of the apparent magnitude–redshift relation are the directly observed statistics predicted. The C1 predictions of these cosmology-independent quantities are deviant by as much as 11σ from direct observation; none of the C2 predictions deviate by >2σ. The C1 deviations may be reconciled with theory by the hypothesis of quasar “evolution,” which, however, appears incapable of being substantiated through direct observation. The excellent quantitative agreement of the C1 deviations with those predicted by C2 without adjustable parameters for the results of analysis predicated on C1 indicates that the evolution hypothesis may well be a theoretical artifact. PMID:9560182
Shen, Wei-Chih; Chen, Shang-Wen; Liang, Ji-An; Hsieh, Te-Chun; Yen, Kuo-Yang; Kao, Chia-Hung
2017-09-01
In this study, we investigated the correlation between the lymph node (LN) status or histological types and textural features of cervical cancers on 18 F-fluorodeoxyglucose positron emission tomography/computed tomography. We retrospectively reviewed the imaging records of 170 patients with International Federation of Gynecology and Obstetrics stage IB-IVA cervical cancer. Four groups of textural features were studied in addition to the maximum standardized uptake value (SUV max ), metabolic tumor volume, and total lesion glycolysis (TLG). Moreover, we studied the associations between the indices and clinical parameters, including the LN status, clinical stage, and histology. Receiver operating characteristic curves were constructed to evaluate the optimal predictive performance among the various textural indices. Quantitative differences were determined using the Mann-Whitney U test. Multivariate logistic regression analysis was performed to determine the independent factors, among all the variables, for predicting LN metastasis. Among all the significant indices related to pelvic LN metastasis, homogeneity derived from the gray-level co-occurrence matrix (GLCM) was the sole independent predictor. By combining SUV max , the risk of pelvic LN metastasis can be scored accordingly. The TLG mean was the independent feature of positive para-aortic LNs. Quantitative differences between squamous and nonsquamous histology can be determined using short-zone emphasis (SZE) from the gray-level size zone matrix (GLSZM). This study revealed that in patients with cervical cancer, pelvic or para-aortic LN metastases can be predicted by using textural feature of homogeneity from the GLCM and TLG mean, respectively. SZE from the GLSZM is the sole feature associated with quantitative differences between squamous and nonsquamous histology.
Bidirectional Prospective Associations Between Cardiac Autonomic Activity and Inflammatory Markers.
Hu, Mandy Xian; Lamers, Femke; Neijts, Melanie; Willemsen, Gonneke; de Geus, Eco J C; Penninx, Brenda W J H
2018-06-01
Autonomic nervous system (ANS) imbalance has been cross-sectionally associated with inflammatory processes. Longitudinal studies are needed to shed light on the nature of this relationship. We examined cross-sectional and bidirectional prospective associations between cardiac autonomic measures and inflammatory markers. Analyses were conducted with baseline (n = 2823), 2-year (n = 2099), and 6-year (n = 1774) data from the Netherlands Study of Depression and Anxiety. To compare the pattern of results, prospective analyses with ANS (during sleep, leisure time, and work) and inflammation were conducted in two data sets from the Netherlands Twin Register measured for 4.9 years (n = 356) and 5.4 years (n = 472). Autonomic nervous system measures were heart rate (HR) and respiratory sinus arrhythmia (RSA). Inflammatory markers were C-reactive protein (CRP) and interleukin (IL)-6. The Netherlands Study of Depression and Anxiety results showed that higher HR and lower RSA were cross-sectionally significantly associated with higher inflammatory levels. Higher HR predicted higher levels of CRP (B = .065, p < .001) and IL-6 (B = .036, p = .014) at follow-up. Higher CRP levels predicted lower RSA (B = -.024, p = .048) at follow-up. The Netherlands Twin Register results confirmed that higher HR was associated with higher CRP and IL-6 levels 4.9 years later. Higher IL-6 levels predicted higher HR and lower RSA at follow-up. Autonomic imbalance is associated with higher levels of inflammation. Independent data from two studies converge in evidence that higher HR predicts subsequent higher levels of CRP and IL-6. Inflammatory markers may also predict future ANS activity, but evidence for this was less consistent.
Academic Self-Handicapping and Achievement Goals: A Further Examination.
Midgley, Carol; Urdan, Tim
2001-01-01
This study extends previous research on the relations among students' personal achievement goals, perceptions of the classroom goal structure, and reports of the use of self-handicapping strategies. Surveys, specific to the math domain, were given to 484 7th-grade students in nine middle schools. Personal performance-avoid goals positively predicted handicapping, whereas personal performance-approach goals did not. Personal task goals negatively predicted handicapping. Perceptions of a performance goal structure positively predicted handicapping, and perceptions of a task goal structure negatively predicted handicapping, independent of personal goals. Median splits used to examine multiple goal profiles revealed that students high in performance-avoid goals used handicapping more than did those low in performance-avoid goals regardless of the level of task goals. Students low in performance-avoid goals and high in task goals handicapped less than those low in both goals. Level of performance-approach goals had little effect on the relation between task goals and handicapping. Copyright 2001 Academic Press.
Loss of Bad expression confers poor prognosis in non-small cell lung cancer.
Huang, Yi; Liu, Dan; Chen, Bojiang; Zeng, Jing; Wang, Lei; Zhang, Shangfu; Mo, Xianming; Li, Weimin
2012-09-01
Proapoptotic BH-3-only protein Bad (Bcl-Xl/Bcl-2-associated death promoter homolog, Bad) initiates apoptosis in human cells, and contributes to tumorigenesis and chemotherapy resistant in malignancies. This study explored association between the Bad expression level and prognosis in patients with non-small cell lung cancer (NSCLC). In our study, a cohort of 88 resected primary NSCLC cases were collected and analyzed. Bad expression level was determined via immunohistochemical staining assay. The prognostic significances of Bad expression were evaluated with univariate and multivariate survival analysis. The results showed that compared with normal lung tissues, Bad expression level significantly decreased in NSCLC (P < 0.05). Bad expression was associated with adjuvant therapy status. Loss of Bad independently predicted poor prognosis in whole NSCLC cohort and early stage subjects (T1 + T2 and N0 + N1) (all P < 0.05). Overall survival time was also drastically shortened for Bad negative phenotype in NSCLC patients with smoking history, especially lung squamous cell carcinoma (all P < 0.05). In conclusion, this study provided clinical evidence that loss of Bad is an independent and powerful predictor of adverse prognosis in NSCLC. Bad protein could be a new biomarker for selecting individual therapy strategies and predicting therapeutic response in subjects with NSCLC.
A new approach to modeling the influence of image features on fixation selection in scenes
Nuthmann, Antje; Einhäuser, Wolfgang
2015-01-01
Which image characteristics predict where people fixate when memorizing natural images? To answer this question, we introduce a new analysis approach that combines a novel scene-patch analysis with generalized linear mixed models (GLMMs). Our method allows for (1) directly describing the relationship between continuous feature value and fixation probability, and (2) assessing each feature's unique contribution to fixation selection. To demonstrate this method, we estimated the relative contribution of various image features to fixation selection: luminance and luminance contrast (low-level features); edge density (a mid-level feature); visual clutter and image segmentation to approximate local object density in the scene (higher-level features). An additional predictor captured the central bias of fixation. The GLMM results revealed that edge density, clutter, and the number of homogenous segments in a patch can independently predict whether image patches are fixated or not. Importantly, neither luminance nor contrast had an independent effect above and beyond what could be accounted for by the other predictors. Since the parcellation of the scene and the selection of features can be tailored to the specific research question, our approach allows for assessing the interplay of various factors relevant for fixation selection in scenes in a powerful and flexible manner. PMID:25752239
Kolomeyevskaya, Nonna; Eng, Kevin H.; Khan, Anm Nazmul H.; Grzankowski, Kassondra S.; Singel, Kelly L.; Moysich, Kirsten; Segal, Brahm H.
2015-01-01
Objectives Epithelial ovarian cancer (EOC) typically presents with advanced disease. Even with optimal debulking and response to adjuvant chemotherapy, the majority of patients will have disease relapse. We evaluated cytokine and chemokine profiles in ascites at primary surgery as biomarkers for progression-free survival (PFS) and overall survival (OS) in patients with advanced EOC. Methods Retrospective analysis of patients (n =70) who underwent surgery at Roswell Park Cancer Institute between 2002-12, followed by platinum-based chemotherapy. Results The mean age at diagnosis was 61.8 years, 85.3% had serous EOC, and 95.7% had stage IIIB, IIIC, or IV disease. Univariate analysis showed that ascites levels of tumor necrosis factor (TNF)-α were associated with reduced PFS after primary surgery. Although the ascites concentration of interleukin (IL)-6 was not by itself predictive of PFS, we found that stratifying patients by high TNF-α and high IL-6 levels identified a sub-group of patients at high risk for rapid disease relapse. This effect was largely independent of clinical prognostic variables. Conclusions The combination of high TNF-α and high IL-6 ascites levels at primary surgery predicts worse PFS in patients with advanced EOC. These results suggest an interaction between ascites TNF-α and IL-6 in driving tumor progression and resistance to chemotherapy in advanced EOC, and raise the potential for pre-treatment ascites levels of these cytokines as prognostic biomarkers. This study involved a small sample of patients and was an exploratory analysis; therefore, findings require validation in a larger independent cohort. PMID:26001328
Kolomeyevskaya, Nonna; Eng, Kevin H; Khan, Anm Nazmul H; Grzankowski, Kassondra S; Singel, Kelly L; Moysich, Kirsten; Segal, Brahm H
2015-08-01
Epithelial ovarian cancer (EOC) typically presents with advanced disease. Even with optimal debulking and response to adjuvant chemotherapy, the majority of patients will have disease relapse. We evaluated cytokine and chemokine profiles in ascites at primary surgery as biomarkers for progression-free survival (PFS) and overall survival (OS) in patients with advanced EOC. Retrospective analysis of patients (n =70) who underwent surgery at Roswell Park Cancer Institute between 2002 and 2012, followed by platinum-based chemotherapy. The mean age at diagnosis was 61.8 years, 85.3% had serous EOC, and 95.7% had stage IIIB, IIIC, or IV disease. Univariate analysis showed that ascites levels of tumor necrosis factor (TNF)-α were associated with reduced PFS after primary surgery. Although the ascites concentration of interleukin (IL)-6 was not by itself predictive of PFS, we found that stratifying patients by high TNF-α and high IL-6 levels identified a sub-group of patients at high risk for rapid disease relapse. This effect was largely independent of clinical prognostic variables. The combination of high TNF-α and high IL-6 ascites levels at primary surgery predicts worse PFS in patients with advanced EOC. These results suggest an interaction between ascites TNF-α and IL-6 in driving tumor progression and resistance to chemotherapy in advanced EOC, and raise the potential for pre-treatment ascites levels of these cytokines as prognostic biomarkers. This study involved a small sample of patients and was an exploratory analysis; therefore, findings require validation in a larger independent cohort. Copyright © 2015 Elsevier Inc. All rights reserved.
Lee, Han Hee; Park, Jae Myung; Lee, Soon-Wook; Kang, Seung Hun; Lim, Chul-Hyun; Cho, Yu Kyung; Lee, Bo-In; Lee, In Seok; Kim, Sang Woo; Choi, Myung-Gyu
2015-05-01
In patients with acute nonvariceal upper gastrointestinal bleeding, rebleeding after an initial treatment is observed in 10-20% and is associated with mortality. To investigate whether the initial serum C-reactive protein level could predict the risk of rebleeding in patients with acute nonvariceal upper gastrointestinal bleeding. This was a retrospective study using prospectively collected data for upper gastrointestinal bleeding. Initial clinical characteristics, endoscopic features, and C-reactive protein levels were compared between those with and without 30-day rebleeding. A total of 453 patients were included (mean age, 62 years; male, 70.9%). The incidence of 30-day rebleeding was 15.9%. The mean serum C-reactive protein level was significantly higher in these patients than in those without rebleeding (P<0.001). The area under the receiver operating characteristics curve with a cutoff value of 0.5mg/dL was 0.689 (P<0.001). High serum C-reactive protein level (odds ratio, 2.98; confidence interval, 1.65-5.40) was independently associated with the 30-day rebleeding risk after adjustment for the main confounding risk factors, including age, blood pressure, and initial haemoglobin level. The serum C-reactive protein was an independent risk factor for 30-day rebleeding in patients with acute nonvariceal upper gastrointestinal bleeding, indicating a possible role as a useful screening indicator for predicting the risk of rebleeding. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
ERIC Educational Resources Information Center
Archila-Suerte, Pilar; Zevin, Jason; Bunta, Ferenc; Hernandez, Arturo E.
2012-01-01
Sensorimotor processing in children and higher-cognitive processing in adults could determine how non-native phonemes are acquired. This study investigates how age-of-acquisition (AOA) and proficiency-level (PL) predict native-like perception of statistically dissociated L2 categories, i.e., within-category and between-category. In a similarity…
Deep Learning Questions Can Help Selection of High Ability Candidates for Universities
ERIC Educational Resources Information Center
Mellanby, Jane; Cortina-Borja, Mario; Stein, John
2009-01-01
Selection of students for places at universities mainly depends on GCSE grades and predictions of A-level grades, both of which tend to favour applicants from independent schools. We have therefore developed a new type of test that would measure candidates' "deep learning" approach since this assesses the motivation and creative thinking…
Feedback: Progress Report on the Science Academy of Austin.
ERIC Educational Resources Information Center
Williams-Robertson, Lydia
The achievement of students at the Science Academy of Austin, an academy located within a high school, is profiled. A study was conducted to compare Science Academy students to other high-achieving students in the Austin (Texas) Independent School District (AISD) and to predict levels of achievement. The results of this study indicate that Academy…
Hydraulic integration and shrub growth form linked across continental aridity gradients
H. Jochen Schenk; Christine M. Goedhart; Marisa Nordenstahl; Hugo I. Martinez Cabrera; Cynthia S. Jones
2008-01-01
Both engineered hydraulic systems and plant hydraulic systems are protected against failure by resistance, reparability, and redundancy. A basic rule of reliability engineering is that the level of independent redundancy should increase with increasing risk of fatal system failure. Here we show that hydraulic systems of plants function as predicted by this engineering...
Hu, Hai-Jie; Mao, Hui; Tan, Yong-Qiong; Shrestha, Anuj; Ma, Wen-Jie; Yang, Qin; Wang, Jun-Ke; Cheng, Nan-Sheng; Li, Fu-Yu
2016-01-01
To examine the predictive value of tumor markers for evaluating tumor resectability in patients with hilar cholangiocarcinoma and to explore the prognostic effect of various preoperative factors on resectability in patients with potentially resectable tumors. Patients with potentially resectable tumors judged by radiologic examination were included. The receiver operating characteristic (ROC) analysis was conducted to evaluate serum carbohydrate antigenic determinant 19-9 (CA 19-9), carbohydrate antigen 125 (CA 125) and carcino embryonie antigen levels on tumor resectability. Univariate and multivariate logistic regression models were also conducted to analysis the correlation of preoperative factors with resectability. In patients with normal bilirubin levels, ROC curve analysis calculated the ideal CA 19-9 cut-off value of 203.96 U/ml in prediction of resectability, with a sensitivity of 83.7 %, specificity of 80 %, positive predictive value of 91.1 % and negative predictive value of 66.7 %. Meanwhile, the optimal cut-off value for CA 125 to predict resectability was 25.905 U/ml (sensitivity, 78.6 %; specificity, 67.5 %). In a multivariate logistic regression model, tumor size ≤3 cm (OR 4.149, 95 % CI 1.326-12.981, P = 0.015), preoperative CA 19-9 level ≤200 U/ml (OR 20.324, 95 % CI 6.509-63.467, P < 0.001), preoperative CA 125 levels ≤26 U/ml (OR 8.209, 95 % CI 2.624-25.677, P < 0.001) were independent determinants of resectability in patients diagnosed as hilar cholangiocarcinoma. Preoperative CA 19-9 and CA 125 levels predict resectability in patients with radiological resectable hilar cholangiocarcinoma. Increased preoperative CA 19-9 levels and CA 125 levels are associated with poor resectability rate.
Haralambieva, Iana H.; Salk, Hannah M.; Lambert, Nathaniel D.; Ovsyannikova, Inna G.; Kennedy, Richard B.; Warner, Nathaniel D.; Pankratz, V.Shane; Poland, Gregory A.
2014-01-01
Introduction Immune response variations after vaccination are influenced by host genetic factors and demographic variables, such as race, ethnicity and sex. The latter have not been systematically studied in regard to live rubella vaccine, but are of interest for developing next generation vaccines for diverse populations, for predicting immune responses after vaccination, and for better understanding the variables that impact immune response. Methods We assessed associations between demographic variables, including race, ethnicity and sex, and rubella-specific neutralizing antibody levels and secreted cytokines (IFN! , IL-6) in two independent cohorts (1,994 subjects), using linear and linear mixed models approaches, and genetically defined racial and ethnic categorizations. Results Our replicated findings in two independent, large, racially diverse cohorts indicate that individuals of African descent have significantly higher rubella-specific neutralizing antibody levels compared to individuals of European descent and/or Hispanic ethnicity (p! 0.001). Conclusion Our study provides consistent evidence for racial/ethnic differences in humoral immune response following rubella vaccination. PMID:24530932
Poststroke Fatigue: Who Is at Risk for an Increase in Fatigue?
van Eijsden, Hanna Maria; van de Port, Ingrid Gerrie Lambert; Visser-Meily, Johanna Maria August; Kwakkel, Gert
2012-01-01
Background. Several studies have examined determinants related to post-stroke fatigue. However, it is unclear which determinants can predict an increase in poststroke fatigue over time. Aim. This prospective cohort study aimed to identify determinants which predict an increase in post-stroke fatigue. Methods. A total of 250 patients with stroke were examined at inpatient rehabilitation discharge (T0) and 24 weeks later (T1). Fatigue was measured using the Fatigue Severity Scale (FSS). An increase in post-stroke fatigue was defined as an increase in the FSS score beyond the 95% limits of the standard error of measurement of the FSS (i.e., 1.41 points) between T0 and T1. Candidate determinants included personal factors, stroke characteristics, physical, cognitive, and emotional functions, and activities and participation and were assessed at T0. Factors predicting an increase in fatigue were identified using forward multivariate logistic regression analysis. Results. The only independent predictor of an increase in post-stroke fatigue was FSS (OR 0.50; 0.38–0.64, P < 0.001). The model including FSS at baseline correctly predicted 7.9% of the patients who showed increased fatigue at T1. Conclusion. The prognostic model to predict an increase in fatigue after stroke has limited predictive value, but baseline fatigue is the most important independent predictor. Overall, fatigue levels remained stable over time. PMID:22028989
Herbert, Vanessa; Pratt, Daniel; Emsley, Richard; Kyle, Simon D.
2017-01-01
This study sought to examine predictors of subjective/objective sleep discrepancy in poor sleepers. Forty-two individuals with insomnia symptoms (mean age = 36.2 years, 81% female) were recruited to take part in a prospective study which combined seven days of actigraphy with daily assessment of sleep perceptions, self-reported arousal, sleep effort, and mood upon awakening. A high level of intra-individual variability in measures of sleep discrepancy was observed. Multilevel modelling revealed that higher levels of pre-sleep cognitive activity and lower mood upon awakening were significantly and independently predictive of the underestimation of total sleep time. Greater levels of sleep effort predicted overestimation of sleep onset latency. These results indicate that psychophysiological variables are related to subjective/objective sleep discrepancy and may be important therapeutic targets in the management of insomnia. PMID:28282912
Thermodynamic models for bounding pressurant mass requirements of cryogenic tanks
NASA Technical Reports Server (NTRS)
Vandresar, Neil T.; Haberbusch, Mark S.
1994-01-01
Thermodynamic models have been formulated to predict lower and upper bounds for the mass of pressurant gas required to pressurize a cryogenic tank and then expel liquid from the tank. Limiting conditions are based on either thermal equilibrium or zero energy exchange between the pressurant gas and initial tank contents. The models are independent of gravity level and allow specification of autogenous or non-condensible pressurants. Partial liquid fill levels may be specified for initial and final conditions. Model predictions are shown to successfully bound results from limited normal-gravity tests with condensable and non-condensable pressurant gases. Representative maximum collapse factor maps are presented for liquid hydrogen to show the effects of initial and final fill level on the range of pressurant gas requirements. Maximum collapse factors occur for partial expulsions with large final liquid fill fractions.
How We Choose One over Another: Predicting Trial-by-Trial Preference Decision
Bhushan, Vidya; Saha, Goutam; Lindsen, Job; Shimojo, Shinsuke; Bhattacharya, Joydeep
2012-01-01
Preference formation is a complex problem as it is subjective, involves emotion, is led by implicit processes, and changes depending on the context even within the same individual. Thus, scientific attempts to predict preference are challenging, yet quite important for basic understanding of human decision making mechanisms, but prediction in a group-average sense has only a limited significance. In this study, we predicted preferential decisions on a trial by trial basis based on brain responses occurring before the individuals made their decisions explicit. Participants made a binary preference decision of approachability based on faces while their electrophysiological responses were recorded. An artificial neural network based pattern-classifier was used with time-frequency resolved patterns of a functional connectivity measure as features for the classifier. We were able to predict preference decisions with a mean accuracy of 74.3±2.79% at participant-independent level and of 91.4±3.8% at participant-dependent level. Further, we revealed a causal role of the first impression on final decision and demonstrated the temporal trajectory of preference decision formation. PMID:22912859
Specific Coping Behaviors in Relation to Adolescent Depression and Suicidal Ideation
Horwitz, Adam G.; Hill, Ryan M.; King, Cheryl A.
2010-01-01
The coping strategies used by adolescents to deal with stress may have implications for the development of depression and suicidal ideation. This study examined coping categories and specific coping behaviors used by adolescents to assess the relation of coping to depression and suicidal ideation. In hierarchical regression models, the specific coping behaviors of behavioral disengagement and self-blame were predictive of higher levels of depression; depression and using emotional support were predictive of suicidal ideation. Results suggest that specific behaviors within the broad coping categories of emotion-focused coping (e.g., self-blame) and avoidant coping (e.g., behavioral disengagement) account for these categories’ associations with depression and suicidal ideation. Specific problem-focused coping strategies did not independently predict lower levels of depression or suicidal ideation. It may be beneficial for interventions to focus on eliminating maladaptive coping behaviors in addition to introducing or enhancing positive coping behaviors. PMID:21074841
Cultural Variability in the Link Between Environmental Concern and Support for Environmental Action.
Eom, Kimin; Kim, Heejung S; Sherman, David K; Ishii, Keiko
2016-10-01
Research on sustainability behaviors has been based on the assumption that increasing personal concerns about the environment will increase proenvironmental action. We tested whether this assumption is more applicable to individualistic cultures than to collectivistic cultures. In Study 1, we compared 47 countries ( N = 57,268) and found that they varied considerably in the degree to which environmental concern predicted support for proenvironmental action. National-level individualism explained the between-nation variability above and beyond the effects of other cultural values and independently of person-level individualism. In Study 2, we compared individualistic and collectivistic nations (United States vs. Japan; N = 251) and found culture-specific predictors of proenvironmental behavior. Environmental concern predicted environmentally friendly consumer choice among European Americans but not Japanese. For Japanese participants, perceived norms about environmental behavior predicted proenvironmental decision making. Facilitating sustainability across nations requires an understanding of how culture determines which psychological factors drive human action.
Pulmonary function levels as predictors of mortality in a national sample of US adults.
Neas, L M; Schwartz, J
1998-06-01
Single breath pulmonary diffusing capacity for carbon monoxide (DL(CO)) was examined as a predictor of all-cause mortality among 4,333 subjects who were aged 25-74 years at baseline in the First National Health and Nutrition Examination Survey (NHANES I) conducted from 1971 to 1975. The relation of the percentage of predicted DL(CO) to all-cause mortality was examined in a Cox proportional hazard model that included age, sex, race, current smoking status, systolic blood pressure, serum cholesterol, alcohol consumption, body mass index, percentage of predicted forced vital capacity (FVC), and the ratio of forced expiratory volume at 1 second (FEV1) to FVC. Mortality had a linear association with the percentage of predicted FVC (rate ratio (RR) = 1.12, 95% confidence interval (CI) 1.08-1.17, for a 10% decrement) and a significantly nonlinear association with the percentage of predicted DL(CO) with an adverse effect that was clearly evident for levels below 85% of those predicted (RR = 1.24, 95% CI 1.12-1.37 for a 10% decrement). The relative hazard for the percentage of predicted DL(CO) below 85% was not modified by sex, smoking status, or exclusion of subjects with clinical respiratory disease on the initial examination. This association with the percentage of predicted DL(CO) was present among 3,005 subjects with FEV1 levels above 90% of those predicted. Thus, pulmonary diffusing capacity below 85% of predicted levels is a significant predictor of the all-cause mortality rate within the general US population independent of standard spirometry measures and even in the absence of apparent clinical respiratory disease.
Koven, Nancy S; Max, Laura K
2014-06-01
A wealth of literature suggests that oxytocin is an important mediator of social cognition, but much of the research to date has relied on pharmaceutical administration methods that can raise oxytocin to artificially high levels. The present study builds upon previous work by examining whether basal oxytocin level predicts intra- and extra-personal (i.e., self- and other-focused) elements of emotional intelligence (EI), independent of shared variance with current mood. The sample included 71 healthy young adults (46 women). Assessment measures included the Mayer-Salovey-Caruso Emotional Intelligence Test Version 2.0 (MSCEIT), the Trait Meta-Mood Scale, and the Profile of Mood States. Peripheral oxytocin levels were examined with enzyme-linked immunosorbent assay from saliva after solid phase extraction. Oxytocin level was unrelated to TMMS scores but was positively associated with performance in the Experiential EI domain of the MSCEIT. However, total mood disturbance was positively related to MSCEIT scores. Hierarchical regression analysis indicated that oxytocin level added unique variance to the prediction of MSCEIT performance beyond that of current mood. These results confirm an association between endogenous levels of oxytocin in healthy adults and a subset of EI abilities, including extra-personal emotion recognition and the channeling of emotions to enhance social proficiency. Copyright © 2014 Elsevier Ltd. All rights reserved.
Du, Tianchuan; Liao, Li; Wu, Cathy H
2016-12-01
Identifying the residues in a protein that are involved in protein-protein interaction and identifying the contact matrix for a pair of interacting proteins are two computational tasks at different levels of an in-depth analysis of protein-protein interaction. Various methods for solving these two problems have been reported in the literature. However, the interacting residue prediction and contact matrix prediction were handled by and large independently in those existing methods, though intuitively good prediction of interacting residues will help with predicting the contact matrix. In this work, we developed a novel protein interacting residue prediction system, contact matrix-interaction profile hidden Markov model (CM-ipHMM), with the integration of contact matrix prediction and the ipHMM interaction residue prediction. We propose to leverage what is learned from the contact matrix prediction and utilize the predicted contact matrix as "feedback" to enhance the interaction residue prediction. The CM-ipHMM model showed significant improvement over the previous method that uses the ipHMM for predicting interaction residues only. It indicates that the downstream contact matrix prediction could help the interaction site prediction.
Increased leptin levels in preeclampsia: associations with BMI, estrogen and SHBG levels.
Acromite, Michael; Ziotopoulou, Mary; Orlova, Christine; Mantzoros, Christos
2004-01-01
Leptin is secreted mainly by the white adipose tissue but is also synthesized in several non-adipose tissue organs including the placenta. Serum leptin levels are increased in normal pregnancies and are higher in preeclamptic than normal pregnant women. There is, however, a lack of empirical evidence of an independent association of serum leptin levels and preeclamsia. We have studied cross-sectionally 18 3rd trimester preeclamptic women, 28 3rd trimester and 30 2nd trimester control women to confirm the reported increase of serum leptin in preeclampsia and to assess whether elevated leptin levels in preeclampsia increase the variance explained by body mass index (BMI), androgens, estrogens and/or sex hormone binding globulin (SHBG). Anthropometric, demographic and hormonal data were analyzed using linear and logistic regression models. Leptin is significantly increased in preeclampsia by univariate analysis, but use of multivariate analysis indicates that the elevated leptin levels are not associated with preeclampsia independently from BMI, estrogens and SHBG. This study confirms that leptin levels are higher in women with preeclampsia than in controls and demonstrates that serum leptin levels do not add to the prediction of preeclampsia after accounting for BMI, estrogen and SHBG levels of preeclamptic women.
miR-185 is an independent prognosis factor and suppresses tumor metastasis in gastric cancer.
Tan, Zhiqin; Jiang, Hao; Wu, Youhua; Xie, Liming; Dai, Wenxiang; Tang, Hailin; Tang, Sanyuan
2014-01-01
miR-185 has been identified as an important factor in several cancers such as breast cancer, ovarial cancer, and prostate cancer. However, its effect and prognostic value in gastric cancer are still poorly known. In this study, we found that the expression levels of miR-185 were strongly downregulated in gastric cancer and associated with clinical stage and the presence of lymph node metastases. Moreover, miR-185 might independently predict OS and RFS in gastric cancer. We further found that upregulation of miR-185 inhibited the proliferation and metastasis of gastric cancer cells in vitro and in vivo. Taken together, our findings demonstrate that the miR-185 is important for gastric cancer initiation and progression and holds promise as a prognostic biomarker to predict survival and relapse in gastric cancer. It is also a potential therapeutic tool to improve clinical outcomes in the above disease.
Henning, Daniel J.; Oedorf, Kimie; Day, Danielle E.; Redfield, Colby S.; Huguenel, Colin J.; Roberts, Jonathan C.; Sanchez, Leon D.; Wolfe, Richard E.; Shapiro, Nathan I.
2015-01-01
Introduction Strategies to identify high-risk emergency department (ED) patients often use markedly abnormal vital signs and serum lactate levels. Risk stratifying such patients without using the presence of shock is challenging. The objective of the study is to identify independent predictors of in-hospital adverse outcomes in ED patients with abnormal vital signs or lactate levels, but who are not in shock. Methods We performed a prospective observational study of patients with abnormal vital signs or lactate level defined as heart rate ≥130 beats/min, respiratory rate ≥24 breaths/min, shock index ≥1, systolic blood pressure <90mm/Hg, or lactate ≥4mmole/L. We excluded patients with isolated atrial tachycardia, seizure, intoxication, psychiatric agitation, or tachycardia due to pain (ie: extremity fracture). The primary outcome was deterioration, defined as development of acute renal failure (creatinine 2× baseline), non-elective intubation, vasopressor requirement, or mortality. Independent predictors of deterioration after hospitalization were determined using logistic regression. Results Of 1,152 consecutive patients identified with abnormal vital signs or lactate level, 620 were excluded, leaving 532 for analysis. Of these, 53/532 (9.9±2.5%) deteriorated after hospital admission. Independent predictors of in-hospital deterioration were: lactate >4.0mmol/L (OR 5.1, 95% CI [2.1–12.2]), age ≥80 yrs (OR 1.9, CI [1.0–3.7]), bicarbonate <21mEq/L (OR 2.5, CI [1.3–4.9]), and initial HR≥130 (OR 3.1, CI [1.5–6.1]). Conclusion Patients exhibiting abnormal vital signs or elevated lactate levels without shock had significant rates of deterioration after hospitalization. ED clinical data predicted patients who suffered adverse outcomes with reasonable reliability. PMID:26759655
McHugh, Joanna Edel; Lawlor, Brian A
2016-01-01
Self-rated health, as distinct from objective measures of health, is a clinically informative metric among older adults. The purpose of our study was to examine the cognitive and psychosocial factors associated with self-rated health. 624 participants over the age of 60 were assessed at baseline, and of these, 510 were contacted for a follow-up two years later. Measures of executive function and self-rated health were assessed at baseline, and self-rated health was assessed at follow-up. We employed multiple linear regression analyses to investigate the relationship between executive functioning and self-rated health, while controlling for demographic, psychosocial and biological variables. Controlling for other relevant variables, executive functioning independently and solely predicted self-rated health, both at a cross-sectional level, and also over time. Loneliness was also found to cross-sectionally predict self-rated health, although this relationship was not present at a longitudinal level. Older adults' self-rated health may be related to their executive functioning and to their loneliness. Self-rated health appeared to improve over time, and the extent of this improvement was also related to executive functioning at baseline. Self-rated health may be a judgement made of one's functioning, especially executive functioning, which changes with age and therefore may be particularly salient in the reflections of older adults.
Ellenbogen, Mark A; Hodgins, Sheilagh
2009-06-01
Recent studies suggest that childhood exposure to adversity influences later functioning of the hypothalamic-pituitary-adrenal (HPA) axis. Parenting style in childhood, a putative moderator of adversity, may be important in determining HPA reactivity in adolescence. As part of a prospective, longitudinal study, saliva was collected at awakening and 30 and 60 min later over 2 days among 27 offspring of parents with bipolar disorder (high risk; 16.7+/-1.5 years) and 26 offspring of parents with no mental disorders (low risk; 16.2+/-1.7 years). In addition, 24 of the high risk and 22 of the low risk adolescents completed the "Trier Social Stress Test" (TSST). Parents had rated their parenting style when their offspring were 6-13 years of age. Low levels of structure (i.e. organization and consistency) provided by parents in middle childhood were predictive of an elevated cortisol response following awakening (beta=-0.36; p<0.05) and during the TSST (beta=-0.33; p<0.05), even while controlling for risk group. These associations were independent of other indices of environmental risk, and of adolescents' mood and behavior. The level of structure provided by parents in childhood predicted independent measures of cortisol reactivity in adolescence, suggesting that parenting style may regulate different aspects of HPA reactivity.
Yoshizawa, Kai; Abe, Hiroshi; Aida, Yuta; Ishiguro, Haruya; Ika, Makiko; Shimada, Noritomo; Tsubota, Akihito; Aizawa, Yoshio
2013-07-01
Host lipoprotein metabolism is associated closely with the life cycle of hepatitis C virus (HCV), and serum lipid profiles have been linked to the response to pegylated interferon (Peg-IFN) plus ribavirin (RBV) therapy. Polymorphisms in the human IL28B gene and amino acid substitutions in the core and interferon sensitivity-determining region (ISDR) in NS5A of HCV genotype 1b (G1b) were also shown to strongly affect the outcome of Peg-IFN plus RBV therapy. In this study, an observational cohort study was performed in 247 HCV G1b-infected patients to investigate whether the response to Peg-IFN and RBV combination therapy in these patients is independently associated with the level of lipid factors, especially apolipoprotein B-100 (apoB-100), an obligatory structural component of very low density lipoprotein and low density lipoprotein. The multivariate logistic analysis subsequently identified apoB-100 (odds ratio (OR), 1.602; 95% confidence interval (CI), 1.046-2.456), alpha-fetoprotein (OR, 0.764; 95% CI, 0.610-0.958), non-wild-type ISDR (OR, 5.617; 95% CI, 1.274-24.754), and the rs8099917 major genotype (OR, 34.188; 95% CI, 10.225-114.308) as independent factors affecting rapid initial virological response (decline in HCV RNA levels by ≥3-log10 at week 4). While lipid factors were not independent predictors of complete early or sustained virological response, the serum apoB-100 level was an independent factor for sustained virological response in patients carrying the rs8099917 hetero/minor genotype. Together, we conclude that serum apoB-100 concentrations could predict virological response to Peg-IFN plus RBV combination therapy in patients infected with HCV G1b, especially in those with the rs8099917 hetero/minor genotype. Copyright © 2013 Wiley Periodicals, Inc.
Multi-level machine learning prediction of protein-protein interactions in Saccharomyces cerevisiae.
Zubek, Julian; Tatjewski, Marcin; Boniecki, Adam; Mnich, Maciej; Basu, Subhadip; Plewczynski, Dariusz
2015-01-01
Accurate identification of protein-protein interactions (PPI) is the key step in understanding proteins' biological functions, which are typically context-dependent. Many existing PPI predictors rely on aggregated features from protein sequences, however only a few methods exploit local information about specific residue contacts. In this work we present a two-stage machine learning approach for prediction of protein-protein interactions. We start with the carefully filtered data on protein complexes available for Saccharomyces cerevisiae in the Protein Data Bank (PDB) database. First, we build linear descriptions of interacting and non-interacting sequence segment pairs based on their inter-residue distances. Secondly, we train machine learning classifiers to predict binary segment interactions for any two short sequence fragments. The final prediction of the protein-protein interaction is done using the 2D matrix representation of all-against-all possible interacting sequence segments of both analysed proteins. The level-I predictor achieves 0.88 AUC for micro-scale, i.e., residue-level prediction. The level-II predictor improves the results further by a more complex learning paradigm. We perform 30-fold macro-scale, i.e., protein-level cross-validation experiment. The level-II predictor using PSIPRED-predicted secondary structure reaches 0.70 precision, 0.68 recall, and 0.70 AUC, whereas other popular methods provide results below 0.6 threshold (recall, precision, AUC). Our results demonstrate that multi-scale sequence features aggregation procedure is able to improve the machine learning results by more than 10% as compared to other sequence representations. Prepared datasets and source code for our experimental pipeline are freely available for download from: http://zubekj.github.io/mlppi/ (open source Python implementation, OS independent).
Lu, Xiangfeng; Huang, Jianfeng; Mo, Zengnan; He, Jiang; Wang, Laiyuan; Yang, Xueli; Tan, Aihua; Chen, Shufeng; Chen, Jing; Gu, C Charles; Chen, Jichun; Li, Ying; Zhao, Liancheng; Li, Hongfan; Hao, Yongchen; Li, Jianxin; Hixson, James E; Li, Yunzhi; Cheng, Min; Liu, Xiaoli; Cao, Jie; Liu, Fangcao; Huang, Chen; Shen, Chong; Shen, Jinjin; Yu, Ling; Xu, Lihua; Mu, Jianjun; Wu, Xianping; Ji, Xu; Guo, Dongshuang; Zhou, Zhengyuan; Yang, Zili; Wang, Renping; Yang, Jun; Yan, Weili; Peng, Xiaozhong; Gu, Dongfeng
2016-02-01
Multiple genetic loci associated with lipid levels have been identified predominantly in Europeans, and the issue of to what extent these genetic loci can predict blood lipid levels increases over time and the incidence of future hyperlipidemia remains largely unknown. We conducted a meta-analysis of genome-wide association studies of lipid levels in 8344 subjects followed by replication studies including 14 739 additional individuals. We replicated 17 previously reported loci. We also newly identified 3 Chinese-specific variants in previous regions (HLA-C, LIPG, and LDLR) with genome-wide significance. Almost all the variants contributed to lipid levels change and incident hyperlipidemia >8.1-year follow-up among 6428 individuals of a prospective cohort study. The strongest associations for lipid levels change were detected at LPL, TRIB1, APOA1-C3-A4-A5, LIPC, CETP, and LDLR (P range from 4.84×10(-4) to 4.62×10(-18)), whereas LPL, TRIB1, ABCA1, APOA1-C3-A4-A5, CETP, and APOE displayed significant strongest associations for incident hyperlipidemia (P range from 1.20×10(-3) to 4.67×10(-16)). The 4 lipids genetic risk scores were independently associated with linear increases in their corresponding lipid levels and risk of incident hyperlipidemia. A C-statistics analysis showed significant improvement in the prediction of incident hyperlipidemia on top of traditional risk factors including the baseline lipid levels. These findings identified some evidence for allelic heterogeneity in Chinese when compared with Europeans in relation to lipid associations. The individual variants and those cumulative effects were independent risk factors for lipids increase and incident hyperlipidemia. © 2015 American Heart Association, Inc.
Lysaker, Paul H; Kukla, Marina; Dubreucq, Julien; Gumley, Andrew; McLeod, Hamish; Vohs, Jenifer L; Buck, Kelly D; Minor, Kyle S; Luther, Lauren; Leonhardt, Bethany L; Belanger, Elizabeth A; Popolo, Raffaele; Dimaggio, Giancarlo
2015-10-01
The recalcitrance of negative symptoms in the face of pharmacologic treatment has spurred interest in understanding the psychological factors that contribute to their formation and persistence. Accordingly, this study investigated whether deficits in metacognition, or the ability to form integrated ideas about oneself, others, and the world, prospectively predicted levels of negative symptoms independent of deficits in neurocognition, affect recognition and defeatist beliefs. Participants were 53 adults with a schizophrenia spectrum disorder. Prior to entry into a rehabilitation program, all participants completed concurrent assessments of metacognition with the Metacognitive Assessment Scale-Abbreviated, negative symptoms with the Positive and Negative Syndrome Scale, neurocognition with the MATRICS battery, affect recognition with the Bell Lysaker Emotion Recognition Task, and one form of defeatist beliefs with the Recovery Assessment Scale. Negative symptoms were then reassessed one week, 9weeks, and 17weeks after entry into the program. A mixed effects regression model revealed that after controlling for baseline negative symptoms, a general index of neurocognition, defeatist beliefs and capacity for affect recognition, lower levels of metacognition predicted higher levels of negative symptoms across all subsequent time points. Poorer metacognition was able to predict later levels of elevated negative symptoms even after controlling for initial levels of negative symptoms. Results may suggest that metacognitive deficits are a risk factor for elevated levels of negative symptoms in the future. Clinical implications are also discussed. Published by Elsevier B.V.
Kozdag, Guliz; Ertas, Gokhan; Kilic, Teoman; Acar, Eser; Sahin, Tayfun; Ural, Dilek
2010-01-01
Although low levels of free triiodothyronine and high levels of brain natriuretic peptide have been shown as independent predictors of death in chronic heart failure patients, few studies have compared their prognostic values. The aim of this prospective study was to measure free triiodothyronine and brain natriuretic peptide levels and to compare their prognostic values among such patients.A total of 334 patients (mean age, 62 ± 13 yr; 218 men) with ischemic and nonischemic dilated cardiomyopathy were included in the study. The primary endpoint was a major cardiac event.During the follow-up period, 92 patients (28%) experienced a major cardiac event. Mean free triiodothyronine levels were lower and median brain natriuretic peptide levels were higher in patients with major cardiac events than in those without. A significant negative correlation was found between free triiodothyronine and brain natriuretic peptide levels. Receiver operating characteristic curve analysis showed that the predictive cutoff values were < 2.12 pg/mL for free triiodothyronine and > 686 pg/mL for brain natriuretic peptide. Cumulative survival was significantly lower among patients with free triiodothyronine < 2.12 pg/mL and among patients with brain natriuretic peptide > 686 pg/mL. In multivariate analysis, the significant independent predictors of major cardiac events were age, free triiodothyronine, and brain natriuretic peptide.In the present study, free triiodothyronine and brain natriuretic peptide had similar prognostic values for predicting long-term prognosis in chronic heart failure patients. These results also suggested that combining these biomarkers may provide an important risk indicator for patients with heart failure.
Gon, Y; Sakaguchi, M; Takasugi, J; Kawano, T; Kanki, H; Watanabe, A; Oyama, N; Terasaki, Y; Sasaki, T; Mochizuki, H
2017-03-01
Cancer patients with cryptogenic stroke often have high plasma D-dimer levels and lesions in multiple vascular regions. Hence, if patients with cryptogenic stroke display such characteristics, occult cancer could be predicted. This study aimed to investigate the clinical characteristics of cryptogenic stroke as the first manifestation of occult cancer and to determine whether plasma D-dimer levels and lesions in multiple vascular regions can predict occult cancer in patients with cryptogenic stroke. Between January 2006 and October 2015, data on 1225 patients with acute ischaemic stroke were extracted from the stroke database of Osaka University Hospital. Among them, 184 patients were classified as having cryptogenic stroke, and 120 patients without a diagnosis of cancer at stroke onset were identified. Clinical variables were analyzed between cryptogenic stroke patients with and without occult cancer. Among 120 cryptogenic stroke patients without a diagnosis of cancer, 12 patients had occult cancer. The body mass index, hemoglobin levels and albumin levels were lower; plasma D-dimer and high-sensitivity C-reactive protein levels were higher; and lesions in multiple vascular regions were more common in patients with than in those without occult cancer. Multiple logistic regression analysis revealed that plasma D-dimer levels (odds ratio, 3.48; 95% confidence interval, 1.68-8.33; P = 0.002) and lesions in multiple vascular regions (odds ratio, 7.40; 95% confidence interval, 1.70-39.45; P = 0.01) independently predicted occult cancer. High plasma D-dimer levels and lesions in multiple vascular regions can be used to predict occult cancer in patients with cryptogenic stroke. © 2016 EAN.
Kaderi, Mohd Arifin; Kanduri, Meena; Buhl, Anne Mette; Sevov, Marie; Cahill, Nicola; Gunnarsson, Rebeqa; Jansson, Mattias; Smedby, Karin Ekström; Hjalgrim, Henrik; Jurlander, Jesper; Juliusson, Gunnar; Mansouri, Larry; Rosenquist, Richard
2011-08-01
The expression levels of LPL, ZAP70, TCL1A, CLLU1 and MCL1 have recently been proposed as prognostic factors in chronic lymphocytic leukemia. However, few studies have systematically compared these different RNA-based markers. Using real-time quantitative PCR, we measured the mRNA expression levels of these genes in unsorted samples from 252 newly diagnosed chronic lymphocytic leukemia patients and correlated our data with established prognostic markers (for example Binet stage, CD38, IGHV gene mutational status and genomic aberrations) and clinical outcome. High expression levels of all RNA-based markers, except MCL1, predicted shorter overall survival and time to treatment, with LPL being the most significant. In multivariate analysis including the RNA-based markers, LPL expression was the only independent prognostic marker for overall survival and time to treatment. When studying LPL expression and the established markers, LPL expression retained its independent prognostic strength for overall survival. All of the RNA-based markers, albeit with varying ability, added prognostic information to established markers, with LPL expression giving the most significant results. Notably, high LPL expression predicted a worse outcome in good-prognosis subgroups, such as patients with mutated IGHV genes, Binet stage A, CD38 negativity or favorable cytogenetics. In particular, the combination of LPL expression and CD38 could further stratify Binet stage A patients. LPL expression is the strongest RNA-based prognostic marker in chronic lymphocytic leukemia that could potentially be applied to predict outcome in the clinical setting, particularly in the large group of patients with favorable prognosis.
Klein, Anke M; Kleinherenbrink, Annelies V; Simons, Carlijn; de Gier, Erwin; Klein, Steven; Allart, Esther; Bögels, Susan M; Becker, Eni S; Rinck, Mike
2012-09-01
Several information-processing models highlight the independent roles of controlled and automatic processes in explaining fearful behavior. Therefore, we investigated whether direct measures of controlled processes and indirect measures of automatic processes predict unique variance components of children's spider fear-related behavior. Seventy-seven children between 8 and 13 years performed an Affective Priming Task (APT) measuring associative bias, a pictorial version of the Emotional Stroop Task (EST) measuring attentional bias, filled out the Spider Anxiety and Disgust Screening for Children (SADS-C) in order to assess self-perceived fear, and took part in a Behavioral Assessment Test (BAT) to measure avoidance of spiders. The SADS-C, EST, and APT did not correlate with each other. Spider fear-related behavior was best explained by SADS-C, APT, and EST together; they explained 51% of the variance in BAT behavior. No children with clinical levels of spider phobia were tested. The direct and the different indirect measures did no correlate with each other. These results indicate that both direct and indirect measures are useful for predicting unique variance components of fear-related behavior in children. The lack of relations between direct and indirect measures may explain why some earlier studies did not find stronger color-naming interference or stronger fear associations in children with high levels of self-reported fear. It also suggests that children with high levels of spider-fearful behavior have different fear-related associations and display higher interference by spider stimuli than children with non-fearful behavior. Copyright © 2012 Elsevier Ltd. All rights reserved.
Predictive value of high sensitivity CRP in patients with diastolic heart failure.
Michowitz, Yoav; Arbel, Yaron; Wexler, Dov; Sheps, David; Rogowski, Ori; Shapira, Itzhak; Berliner, Shlomo; Keren, Gad; George, Jacob; Roth, Arie
2008-04-25
C-reactive protein (CRP) has been tested in patients with systolic heart failure (HF) and mixed results have been obtained with regards to its potential predictive value. However, the role of C-reactive protein (CRP) in patients with diastolic HF is not established. We studied the predictive role of high sensitivity CRP (hsCRP) in patients with diastolic HF. HsCRP levels were measured in a cohort of CHF outpatients, 77 patients with diastolic HF and 217 patients with systolic HF. Concentrations were compared to a large cohort of healthy population (n=7701) and associated with the HF admissions and mortality of the patients. Levels of hsCRP did not differ between patients with systolic and diastolic HF and were significantly elevated compared to the cohort of healthy subjects even after adjustment to various clinical parameters (p<0.0001). In patients with diastolic HF, hsCRP levels associated with New York Heart Association functional class (NYHA-FC) (r=0.31 p=0.01). On univariate Cox regression model hsCRP levels independently predicted hospitalizations in patients with systolic but not diastolic HF (p=0.047). HsCRP concentrations are elevated in patients with diastolic HF and correlate with disease severity; their prognostic value in this patient population should be further investigated.
2017-12-01
peptide in tumors that was linearly correlated with HER3 levels. Biodistribution analysis revealed low off-target accumulation and rapid clearance...Internal Lab 15-22 Dr. Larimer 5 Stock) Subtask 2: Correlate changes in peptide uptake with protein expression and cell signaling changes ex vivo...signal for each individual tumor was plotted against its corresponding HER3 protein level, the TBR correlated linearly with the amount of protein
Personality factors and posttraumatic stress: associations in civilians one year after air attacks.
Lecic-Tosevski, Dusica; Gavrilovic, Jelena; Knezevic, Goran; Priebe, Stefan
2003-12-01
There is an ongoing debate on which risk factors for developing posttraumatic stress symptoms are more important--personality traits reflecting vulnerability, previous stressful experiences or characteristics of the traumatic event. In this study, posttraumatic stress symptoms and their relationship with personality traits, previous stressful experiences and exposure to stressful events during air attacks in Yugoslavia were investigated. The Millon Clinical Multiaxial Inventory (MCMI; Millon, 1983), Impact of Events Scale (IES; Horowitz, Wilner, & Alvarez, 1979), Life Stressor Checklist Revised (LSCL-R; Wolfe & Kimerling, 1997), and List of Stressors were administered to a homogeneous group of medical students 1 year after the attacks. In multiple regression analyses, compulsive and passive-aggressive personality traits and a higher level of exposure to stressors during air attacks independently predicted the degree of intrusion symptoms. Avoidance symptoms were predicted by avoidant personality traits and a higher exposure to stressors both previously in life and during the attacks. In the next step, we tested in analyses of variance whether personality traits, previous stressful experiences, and stressful events during attacks as independent variables interact in predicting intrusion and avoidance symptoms. For this, students were clustered into three groups depending on their predominant personality traits. In addition to direct predictive effects, there were significant interaction effects in predicting both intrusion and avoidance. The findings suggest that each of the tested factors, i.e., personality traits, previous stressful experiences, and exposure to traumatic events may have an independent and direct influence on developing posttraumatic stress. However, the effect of these factors cannot just be added up. Rather, the factors interact in their impact on posttraumatic stress symptoms. Bigger samples and longitudinal designs will be required to understand precisely how different personality traits influence response to stressful events.
First French Pilot Quality Assessment of the EndoPredict Test for Early Luminal Breast Carcinoma.
Lehmann-Che, Jacqueline; Miquel, Catherine; Wong, Jennifer; Callens, Celine; Rouleau, Etienne; Quillien, Veronique; Lozano, Nicolas; Cayre, Anne; Lacroix, Ludovic; Bieche, Ivan; Bertheau, Philippe; Teixeira, Luis; Llorca, Frederique Penault; Lamy, Pierre Jean; DE Cremoux, Patricia
2018-05-01
Genomic signatures are needed for the determination of prognosis in patients with early stage, estrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancers. EndoPredict test is a RNA-based multigene assay that assesses the risk of 10-year relapse in this context. Quality assessment is a mandatory requirement for a laboratory to address the analytical quality of these molecular analyses. The aim of the study was to demonstrate the robustness of this prognostic test, its usefulness for the patient's treatment strategy, at the national level. This study presents a pilot quality assessment (QA) of the EndoPredict test using composite design, including the follow-up of internal control values (qREF) of the 12 genes of the assay for 151 independent tests and one formalin-fixed paraffin embedded (FFPE) breast cancer sample. The evaluation of the test was performed by comparing the results of six independent medical laboratories. All measures were highly reproducible and quantification of the qREF showed a standard deviation of less than 0.50 and a coefficient of variation always of <2%. All laboratories found concordant results for the breast cancer samples. The mean EndoPredict (EP) score for the breast cancer sample was 4.97±0.24. The mean of EPclin score was 3.07±0.05. This first French independent reported QA assessed the robustness and reproducibility of the EndoPredict test. Such a simple composite design could represent an adapted QA for an expensive diagnostic test. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.
Chan, Sheng-Chieh; Chang, Kai-Ping; Fang, Yu-Hua Dean; Tsang, Ngan-Ming; Ng, Shu-Hang; Hsu, Cheng-Lung; Liao, Chun-Ta; Yen, Tzu-Chen
2017-01-01
Plasma Epstein-Barr virus (EBV) DNA concentrations predict prognosis in patients with nasopharyngeal carcinoma (NPC). Recent evidence also indicates that intratumor heterogeneity on F-18 fluorodeoxyglucose positron emission tomography ( 18 F-FDG PET) scans is predictive of treatment outcomes in different solid malignancies. Here, we sought to investigate the prognostic value of heterogeneity parameters in patients with primary NPC. Retrospective cohort study. We examined 101 patients with primary NPC who underwent pretreatment 18 F-FDG PET/computed tomography. Circulating levels of EBV DNA were measured in all participants. The following PET heterogeneity parameters were collected: histogram-based heterogeneity parameters, second-order texture features (uniformity, contrast, entropy, homogeneity, dissimilarity, inverse difference moment), and higher-order (coarseness, contrast, busyness, complexity, strength) texture features. The median follow-up time was 5.14 years. Total lesion glycolysis (TLG), tumor heterogeneity measured by histogram-based parameter skewness, and the majority of second-order or higher-order texture features were significantly associated with overall survival (OS) and/or recurrence-free survival (RFS). In multivariate analysis, age (P =.005), EBV DNA load (P = .0002), and uniformity (P = .001) independently predicted OS. Only skewness retained the independent prognostic significance for RFS. Tumor stage, standardized uptake value, or TLG did not show an independent association with survival endpoints. The combination of uniformity, EBV DNA load, and age resulted in a more reliable prognostic stratification (P < .001). Tumor heterogeneity is superior to traditional PET parameters for predicting outcomes in primary NPC. The combination of uniformity with EBV DNA load can improve prognostic stratification in this clinical entity. 4 Laryngoscope, 127:E22-E28, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.
NASA Technical Reports Server (NTRS)
Denner, Brett William
1989-01-01
An approximate method was developed to analyze and predict the acoustics of a counterrotating propeller configuration. The method employs the analytical techniques of Lock and Theodorsen as described by Davidson to predict the steady performance of a counterrotating configuration. Then, a modification of the method of Lesieutre is used to predict the unsteady forces on the blades. Finally, the steady and unsteady loads are used in the numerical method of Succi to predict the unsteady acoustics of the propeller. The numerical results are compared with experimental acoustic measurements of a counterrotating propeller configuration by Gazzaniga operating under several combinations of advance ratio, blade pitch, and number of blades. In addition, a constant-speed commuter-class propeller configuration was designed with the Davidson method and the acoustics analyzed at three advance ratios. Noise levels and frequency spectra were calculated at a number of locations around the configuration. The directivity patterns of the harmonics in both the horizontal and vertical planes were examined, with the conclusion that the noise levels of the even harmonics are relatively independent of direction whereas the noise levels of the odd harmonics are extremely dependent on azimuthal direction in the horizontal plane. The equations of Succi are examined to explain this behavior.
Dynamic model predicting overweight, obesity, and extreme obesity prevalence trends.
Thomas, Diana M; Weedermann, Marion; Fuemmeler, Bernard F; Martin, Corby K; Dhurandhar, Nikhil V; Bredlau, Carl; Heymsfield, Steven B; Ravussin, Eric; Bouchard, Claude
2014-02-01
Obesity prevalence in the United States appears to be leveling, but the reasons behind the plateau remain unknown. Mechanistic insights can be provided from a mathematical model. The objective of this study is to model known multiple population parameters associated with changes in body mass index (BMI) classes and to establish conditions under which obesity prevalence will plateau. A differential equation system was developed that predicts population-wide obesity prevalence trends. The model considers both social and nonsocial influences on weight gain, incorporates other known parameters affecting obesity trends, and allows for country specific population growth. The dynamic model predicts that: obesity prevalence is a function of birthrate and the probability of being born in an obesogenic environment; obesity prevalence will plateau independent of current prevention strategies; and the US prevalence of overweight, obesity, and extreme obesity will plateau by about 2030 at 28%, 32%, and 9% respectively. The US prevalence of obesity is stabilizing and will plateau, independent of current preventative strategies. This trend has important implications in accurately evaluating the impact of various anti-obesity strategies aimed at reducing obesity prevalence. Copyright © 2013 The Obesity Society.
Testing chemical carcinogenicity by using a transcriptomics HepaRG-based model?
Doktorova, T. Y.; Yildirimman, Reha; Ceelen, Liesbeth; Vilardell, Mireia; Vanhaecke, Tamara; Vinken, Mathieu; Ates, Gamze; Heymans, Anja; Gmuender, Hans; Bort, Roque; Corvi, Raffaella; Phrakonkham, Pascal; Li, Ruoya; Mouchet, Nicolas; Chesne, Christophe; van Delft, Joost; Kleinjans, Jos; Castell, Jose; Herwig, Ralf; Rogiers, Vera
2014-01-01
The EU FP6 project carcinoGENOMICS explored the combination of toxicogenomics and in vitro cell culture models for identifying organotypical genotoxic- and non-genotoxic carcinogen-specific gene signatures. Here the performance of its gene classifier, derived from exposure of metabolically competent human HepaRG cells to prototypical non-carcinogens (10 compounds) and hepatocarcinogens (20 compounds), is reported. Analysis of the data at the gene and the pathway level by using independent biostatistical approaches showed a distinct separation of genotoxic from non-genotoxic hepatocarcinogens and non-carcinogens (up to 88 % correct prediction). The most characteristic pathway responding to genotoxic exposure was DNA damage. Interlaboratory reproducibility was assessed by blindly testing of three compounds, from the set of 30 compounds, by three independent laboratories. Subsequent classification of these compounds resulted in correct prediction of the genotoxicants. As expected, results on the non-genotoxic carcinogens and the non-carcinogens were less predictive. In conclusion, the combination of transcriptomics with the HepaRG in vitro cell model provides a potential weight of evidence approach for the evaluation of the genotoxic potential of chemical substances. PMID:26417288
Graham, Kathryn; Bernards, Sharon; Osgood, D Wayne; Wells, Samantha
2006-11-01
To clarify environmental predictors of bar-room aggression by differentiating relationships due to nightly variations versus across bar variations, frequency versus severity of aggression and patron versus staff aggression. Male-female pairs of researcher-observers conducted 1334 observations in 118 large capacity (> 300) bars and clubs in Toronto, Canada. Observers independently rated aspects of the environment (e.g. crowding) at every visit and wrote detailed narratives of each incident of aggression that occurred. Measures of severity of aggression for the visit were calculated by aggregating ratings for each person in aggressive incidents. Although bivariate analyses confirmed the significance of most environmental predictors of aggression identified in previous research, multivariate analyses identified the following key visit-level predictors (controlling for bar-level relationships): rowdiness/permissive environment and people hanging around after closing predicted both frequency and severity of aggression; sexual activity, contact and competition and people with two or more drinks at closing predicted frequency but not severity of aggression; lack of staff monitoring predicted more severe patron aggression, while having more and better coordinated staff predicted more severe staff aggression. Intoxication of patrons was significantly associated with more frequent and severe patron aggression at the bar level (but not at the visit level) in the multivariate analyses and negatively associated with severity of staff aggression at the visit level. The results demonstrate clearly the importance of the immediate environment (not just the type of bar or characteristics of usual patrons) and the importance of specific environmental factors, including staff behaviour, in predicting both frequency and severity of aggression.
Dubow, Eric F; Boxer, Paul; Huesmann, L Rowell
2009-07-01
We examine the prediction of individuals' educational and occupational success at age 48 from contextual and personal variables assessed during their middle childhood and late adolescence. We focus particularly on the predictive role of the parents' educational level during middle childhood, controlling for other indices of socioeconomic status and children's IQ, and the mediating roles of negative family interactions, childhood behavior, and late adolescent aspirations. Data come from the Columbia County Longitudinal Study, which began in 1960 when all 856 third graders in a semi-rural county in New York State were interviewed along with their parents; participants were reinterviewed at ages 19, 30, and 48 (Eron et al, 1971; Huesmann et al., 2002). Parents' educational level when the child was 8 years old significantly predicted educational and occupational success for the child 40 years later. Structural models showed that parental educational level had no direct effects on child educational level or occupational prestige at age 48 but had significant indirect effects that were independent of the other predictor variables' effects. These indirect effects were mediated through age 19 educational aspirations and age 19 educational level. These results provide strong support for the unique predictive role of parental education on adult outcomes 40 years later and underscore the developmental importance of mediators of parent education effects such as late adolescent achievement and achievement-related aspirations.
Singh, Kunwar P; Rai, Premanjali; Pandey, Priyanka; Sinha, Sarita
2012-01-01
The present research aims to investigate the individual and interactive effects of chlorine dose/dissolved organic carbon ratio, pH, temperature, bromide concentration, and reaction time on trihalomethanes (THMs) formation in surface water (a drinking water source) during disinfection by chlorination in a prototype laboratory-scale simulation and to develop a model for the prediction and optimization of THMs levels in chlorinated water for their effective control. A five-factor Box-Behnken experimental design combined with response surface and optimization modeling was used for predicting the THMs levels in chlorinated water. The adequacy of the selected model and statistical significance of the regression coefficients, independent variables, and their interactions were tested by the analysis of variance and t test statistics. The THMs levels predicted by the model were very close to the experimental values (R(2) = 0.95). Optimization modeling predicted maximum (192 μg/l) TMHs formation (highest risk) level in water during chlorination was very close to the experimental value (186.8 ± 1.72 μg/l) determined in laboratory experiments. The pH of water followed by reaction time and temperature were the most significant factors that affect the THMs formation during chlorination. The developed model can be used to determine the optimum characteristics of raw water and chlorination conditions for maintaining the THMs levels within the safe limit.
NASA Astrophysics Data System (ADS)
Uzunova, Yordanka; Prodanova, Krasimira; Spassov, Lubomir
2016-12-01
Orthotopic liver transplantation (OLT) is the only curative treatment for end-stage liver disease. Early diagnosis and treatment of infections after OLT are usually associated with improved outcomes. This study's objective is to identify reliable factors that can predict postoperative infectious morbidity. 27 children were included in the analysis. They underwent liver transplantation in our department. The correlation between two parameters (the level of blood glucose at 5th postoperative day and the duration of the anhepatic phase) and postoperative infections was analyzed, using univariate analysis. In this analysis, an independent predictive factor was derived which adequately identifies patients at risk of infectious complications after a liver transplantation.
NASA Astrophysics Data System (ADS)
Davis, Tom R.; Harasti, David; Smith, Stephen D. A.; Kelaher, Brendan P.
2016-11-01
Climate change induced sea level rise will affect shallow estuarine habitats, which are already under threat from multiple anthropogenic stressors. Here, we present the results of modelling to predict potential impacts of climate change associated processes on seagrass distributions. We use a novel application of relative environmental suitability (RES) modelling to examine relationships between variables of physiological importance to seagrasses (light availability, wave exposure, and current flow) and seagrass distributions within 5 estuarine embayments. Models were constructed separately for Posidonia australis and Zostera muelleri subsp. capricorni using seagrass data from Port Stephens estuary, New South Wales, Australia. Subsequent testing of models used independent datasets from four other estuarine embayments (Wallis Lake, Lake Illawarra, Merimbula Lake, and Pambula Lake) distributed along 570 km of the east Australian coast. Relative environmental suitability models provided adequate predictions for seagrass distributions within Port Stephens and the other estuarine embayments, indicating that they may have broad regional application. Under the predictions of RES models, both sea level rise and increased turbidity are predicted to cause substantial seagrass losses in deeper estuarine areas, resulting in a net shoreward movement of seagrass beds. Seagrass species distribution models developed in this study provide a valuable tool to predict future shifts in estuarine seagrass distributions, allowing identification of areas for protection, monitoring and rehabilitation.
Lamba, Jatinder K; Crews, Kristine R; Pounds, Stanley B; Cao, Xueyuan; Gandhi, Varsha; Plunkett, William; Razzouk, Bassem I; Lamba, Vishal; Baker, Sharyn D; Raimondi, Susana C; Campana, Dario; Pui, Ching-Hon; Downing, James R; Rubnitz, Jeffrey E; Ribeiro, Raul C
2011-01-01
Aim To identify gene-expression signatures predicting cytarabine response by an integrative analysis of multiple clinical and pharmacological end points in acute myeloid leukemia (AML) patients. Materials & methods We performed an integrated analysis to associate the gene expression of diagnostic bone marrow blasts from acute myeloid leukemia (AML) patients treated in the discovery set (AML97; n = 42) and in the independent validation set (AML02; n = 46) with multiple clinical and pharmacological end points. Based on prior biological knowledge, we defined a gene to show a therapeutically beneficial (detrimental) pattern of association of its expression positively (negatively) correlated with favorable phenotypes such as intracellular cytarabine 5´-triphosphate levels, morphological response and event-free survival, and negatively (positively) correlated with unfavorable end points such as post-cytarabine DNA synthesis levels, minimal residual disease and cytarabine LC50. Results We identified 240 probe sets predicting a therapeutically beneficial pattern and 97 predicting detrimental pattern (p ≤ 0.005) in the discovery set. Of these, 60 were confirmed in the independent validation set. The validated probe sets correspond to genes involved in PIK3/PTEN/AKT/mTOR signaling, G-protein-coupled receptor signaling and leukemogenesis. This suggests that targeting these pathways as potential pharmacogenomic and therapeutic candidates could be useful for improving treatment outcomes in AML. Conclusion This study illustrates the power of integrated data analysis of genomic data as well as multiple clinical and pharmacologic end points in the identification of genes and pathways of biological relevance. PMID:21449673
Wilcox, D.A.; Xie, Y.
2007-01-01
Integrated, GIS-based, wetland predictive models were constructed to assist in predicting the responses of wetland plant communities to proposed new water-level regulation plans for Lake Ontario. The modeling exercise consisted of four major components: 1) building individual site wetland geometric models; 2) constructing generalized wetland geometric models representing specific types of wetlands (rectangle model for drowned river mouth wetlands, half ring model for open embayment wetlands, half ellipse model for protected embayment wetlands, and ellipse model for barrier beach wetlands); 3) assigning wetland plant profiles to the generalized wetland geometric models that identify associations between past flooding / dewatering events and the regulated water-level changes of a proposed water-level-regulation plan; and 4) predicting relevant proportions of wetland plant communities and the time durations during which they would be affected under proposed regulation plans. Based on this conceptual foundation, the predictive models were constructed using bathymetric and topographic wetland models and technical procedures operating on the platform of ArcGIS. An example of the model processes and outputs for the drowned river mouth wetland model using a test regulation plan illustrates the four components and, when compared against other test regulation plans, provided results that met ecological expectations. The model results were also compared to independent data collected by photointerpretation. Although data collections were not directly comparable, the predicted extent of meadow marsh in years in which photographs were taken was significantly correlated with extent of mapped meadow marsh in all but barrier beach wetlands. The predictive model for wetland plant communities provided valuable input into International Joint Commission deliberations on new regulation plans and was also incorporated into faunal predictive models used for that purpose.
Frankenstein, Lutz; Nelles, Manfred; Slavutsky, Maxim; Schellberg, Dieter; Doesch, Andreas; Katus, Hugo; Remppis, Andrew; Zugck, Christian
2007-10-01
In chronic heart failure (CHF), the physiologic effects of natriuretic peptides and catecholamines are interdependent. Furthermore, reports state an agent-dependent effect of individual beta-blockers on biomarkers. Data on the short-term and long-term predictive power comparing these biomarkers as well as accounting for the influence of beta-blocker treatment both on the marker or the resultant prognostic information are scarce. We included 513 consecutive patients with systolic CHF, measured atrial natriuretic peptide (ANP), N-terminal prohormone brain natriuretic peptide (NTproBNP), noradrenaline, and adrenaline, and monitored them for 90 +/- 25 months. Death or the combination of death and cardiac transplantation at 1 year, 5 years, and overall follow-up were considered end points. Compared with patients not taking beta-blockers, patients taking beta-blockers had significantly lower levels of catecholamines but not natriuretic peptides. Only for adrenaline was the amount of this effect related to the specific beta-blocker chosen. Receiver operating characteristic curves demonstrated superior prognostic accuracy for NTproBNP both at the 1- and 5-year follow-up compared with ANP, noradrenaline, and adrenaline. In multivariate analysis including established risk markers (New York Heart Association functional class, left ventricular ejection fraction, peak oxygen uptake, and 6-minute walk test), of all neurohumoral parameters, only NTproBNP remained an independent predictor for both end points. Long-term beta-blocker therapy is associated with decreased levels of plasma catecholamines but not natriuretic peptides. This effect is independent from the actual beta-blocker chosen for natriuretic peptides and noradrenaline. In multivariate analysis, both for short-term and long-term prediction of mortality or the combined end point of death and cardiac transplantation, only NTproBNP remained independent from established clinical risk markers.
Rikli, Roberta E; Jones, C Jessie
2013-04-01
To develop and validate criterion-referenced fitness standards for older adults that predict the level of capacity needed for maintaining physical independence into later life. The proposed standards were developed for use with a previously validated test battery for older adults-the Senior Fitness Test (Rikli, R. E., & Jones, C. J. (2001). Development and validation of a functional fitness test for community--residing older adults. Journal of Aging and Physical Activity, 6, 127-159; Rikli, R. E., & Jones, C. J. (1999a). Senior fitness test manual. Champaign, IL: Human Kinetics.). A criterion measure to assess physical independence was identified. Next, scores from a subset of 2,140 "moderate-functioning" older adults from a larger cross-sectional database, together with findings from longitudinal research on physical capacity and aging, were used as the basis for proposing fitness standards (performance cut points) associated with having the ability to function independently. Validity and reliability analyses were conducted to test the standards for their accuracy and consistency as predictors of physical independence. Performance standards are presented for men and women ages 60-94 indicating the level of fitness associated with remaining physically independent until late in life. Reliability and validity indicators for the standards ranged between .79 and .97. The proposed standards provide easy-to-use, previously unavailable methods for evaluating physical capacity in older adults relative to that associated with physical independence. Most importantly, the standards can be used in planning interventions that target specific areas of weakness, thus reducing risk for premature loss of mobility and independence.
Bossola, Maurizio; Vulpio, Carlo; Colacicco, Luigi; Scribano, Donata; Zuppi, Cecilia; Tazza, Luigi
2012-02-11
The aim of our study was to measure reactive oxygen metabolites (ROMs) in chronic hemodialysis (HD) patients and evaluate the possible association with cardiovascular disease (CVD) and mortality. We measured ROMs in 76 HD patients and correlated with CVD, cardiovascular (CV) events in the follow-up and all-cause and CVD-related mortality. The levels of ROMs presented a median value of 270 (238.2-303.2) CARR U (interquartile range). We created a ROC curve (ROMs levels vs. CVD) and we identified a cut-off point of 273 CARR U. Patients with ROMs levels ≥273 CARR U were significantly older, had higher C-reactive protein levels and lower creatinine concentrations. The prevalence of CVD was higher in patients with ROMs levels ≥273 (87.1%) than in those with ROMs levels <273 CARR U (17.7%; p<0.0001). ROMs levels were significantly higher in patients with CVD (317±63.8) than in those without (242.7±49.1; p<0.0001). At multiple regression analysis, age, creatinine and C-reactive protein were independent factors associated with ROMs. At multiple logistic regression analysis the association between ROMs and CVD was independent (OR: 1.02, 95% CI: 1.00-1.05; p=0.03). Twenty six patients developed cardiovascular (CV) events during the follow-up. Of these, seven were in the group with ROMs levels <273 CARR U and 19 in the group with ROMs levels ≥273 CARR U. The logistic regression analysis showed that both age (OR: 1.06, 95% CI: 1.01-1.12; p=0.013) and ROMs levels (OR: 1.10, 95% CI: 1.00-1.02; p=0.045) were independently associated with CV events in the follow-up. ROMs are independently associated with CVD and predict CV events in chronic HD patients.
ERIC Educational Resources Information Center
Goodman, Anna; Ford, Tamsin
2008-01-01
Emotional and behavioural difficulties (EBD) are common in children, and forecasting their prevalence in schools is of interest to both academic researchers and local authorities. Percentage of pupils eligible for free school meals is one measure often used for this purpose. The article presents the first independent validation of a simple…
Curtis L. Vanderschaaf
2008-01-01
Mixed effects models can be used to obtain site-specific parameters through the use of model calibration that often produces better predictions of independent data. This study examined whether parameters of a mixed effect height-diameter model estimated using loblolly pine plantation data but calibrated using sweetgum plantation data would produce reasonable...
Chen, Yu-Ting; Hsiao, Fei-Hsiu; Miao, Nae-Fang; Chen, Ping-Ling
2013-01-07
Parental smoking is the major source of children's secondhand smoke exposure and is influenced by parents' perception of children's exposure. However, the factors associated with these perceptions remain unclear. The objective of this study was to examine factors associated with parents' perceptions about parental smoking in the presence of children and its consequences. We conducted a cross-sectional study on parents' perceptions of parental smoking and measured their evaluations of its consequences using a self-report questionnaire. Other variables include socio-demographic characteristics and smoking-related experience. Results show that parents' gender, education level, occupational type, smoking status, and agreement on a home smoking ban independently predict parents' evaluation of the consequences of parental smoking in the presence of children. Parents' gender, education level, annual family income, smoking status, agreement on a home smoking ban, and evaluation of the consequences of parental smoking independently predicted parents' perceptions. Findings indicated that a specific group expressed greater acceptance of parental smoking and was less aware of its risks. Motivating parents to create a smoke-free home and increasing awareness of the adverse consequences of parental smoking is beneficial in reinforcing attitudes opposed to parental smoking.
Chen, Yu-Ting; Hsiao, Fei-Hsiu; Miao, Nae-Fang; Chen, Ping-Ling
2013-01-01
Parental smoking is the major source of children’s secondhand smoke exposure and is influenced by parents’ perception of children’s exposure. However, the factors associated with these perceptions remain unclear. The objective of this study was to examine factors associated with parents’ perceptions about parental smoking in the presence of children and its consequences. We conducted a cross-sectional study on parents’ perceptions of parental smoking and measured their evaluations of its consequences using a self-report questionnaire. Other variables include socio-demographic characteristics and smoking-related experience. Results show that parents’ gender, education level, occupational type, smoking status, and agreement on a home smoking ban independently predict parents’ evaluation of the consequences of parental smoking in the presence of children. Parents’ gender, education level, annual family income, smoking status, agreement on a home smoking ban, and evaluation of the consequences of parental smoking independently predicted parents’ perceptions. Findings indicated that a specific group expressed greater acceptance of parental smoking and was less aware of its risks. Motivating parents to create a smoke-free home and increasing awareness of the adverse consequences of parental smoking is beneficial in reinforcing attitudes opposed to parental smoking. PMID:23296207
Kluzek, Stefan; Bay-Jensen, Anne-Christine; Judge, Andrew; Karsdal, Morten A.; Shorthose, Matthew; Spector, Tim; Hart, Deborah; Newton, Julia L.; Arden, Nigel K.
2015-01-01
Abstract Context and objective: We evaluated the predictive value of serum cartilage oligomeric matrix protein (sCOMP) levels over 20 years on the development of radiographic (RKOA) and painful knee osteoarthritis (KOA) in a longitudinal cohort of middle-aged women. Materials and methods: Five hundred and ninety-three women with no baseline KOA underwent 5-year knee radiographs over 20-years and were asked about knee pain a month before each assessment. A repeated measures logistic regression model was used where the outcomes were recorded at 5, 10, 15 and 20-years follow-up. Results: The highest quartile of sCOMP was associated with increased risk of RKOA with overall OR of 1.97 (95% CI: 1.33–2.91) over 20 years when compared with the lowest sCOMP quartile. The association with painful KOA was similar and also independent, but only when the fourth and third sCOMP quartiles were compared. Discussion and conclusion: This study demonstrates that sCOMP levels are predictive of subsequent structural changes and incidence of painful KOA, independently of age and BMI. PMID:26848781
NT-pro-BNP is an independent predictor of mortality in patients with end-stage renal disease.
Svensson, M; Gorst-Rasmussen, A; Schmidt, E B; Jorgensen, K A; Christensen, J H
2009-04-01
Patients with end-stage renal disease (ESRD) have an increased mortality from cardiovascular disease (CVD). N-terminal pro-brain natriuretic peptide (NT-pro-BNP) is an independent predictor of mortality in patients with ischemic heart disease and congestive heart failure. Previous data have shown markedly elevated levels of NT-pro-BNP in patients with ESRD, while the prognostic value of elevated levels of NT-pro-BNP in patients with ESRD is largely unknown. The aim of the present study was to examine if the level of NT-pro-BNP predicts mortality in patients with ERSD and CVD. We prospectively followed 206 patients with ESRD and documented CVD. Levels of NT-pro-BNP were measured at baseline, and patients were followed for 2 years or until they reached the predefined endpoint of all-cause mortality. During follow-up, the total mortality was 44% (90/206). Patients who died were followed for a median of 314 days (interquartile range 179 - 530). Using Cox regression analysis, age, female sex, systolic blood pressure, dialysis efficiency and plasma levels of NT-pro-BNP were independent prognostic risk factors of mortality. In receiver operating characteristic curve analysis a cut off value for NT-pro-BNP was determined. Patients with values of NT-pro-BNP above 12.200 pg/ml had a 3 times higher risk of death than patients below the cut-off value (HR 3.05 95% CI 1.96 - 4.77, p < 0.0001). In spite of generally elevated levels of NT-pro-BNP, NT-pro-BNP is still an independent predictor of mortality and might add prognostic information in patients with ESRD and documented CVD.
Lala, Radu Ioan; Darabantiu, Dan; Pilat, Luminita; Puschita, Maria
2016-02-01
Heart failure is accompanied by abnormalities in ventricular-vascular interaction due to increased myocardial and arterial stiffness. Galectin-3 is a recently discovered biomarker that plays an important role in myocardial and vascular fibrosis and heart failure progression. The aim of this study was to determine whether galectin-3 is correlated with arterial stiffening markers and impaired ventricular-arterial coupling in decompensated heart failure patients. A total of 79 inpatients with acute decompensated heart failure were evaluated. Serum galectin-3 was determined at baseline, and during admission, transthoracic echocardiography and measurements of vascular indices by Doppler ultrasonography were performed. Elevated pulse wave velocity and low arterial carotid distensibility are associated with heart failure in patients with preserved ejection fraction (p = 0.04, p = 0.009). Pulse wave velocity, carotid distensibility and Young's modulus did not correlate with serum galectin-3 levels. Conversely, raised galectin-3 levels correlated with an increased ventricular-arterial coupling ratio (Ea/Elv) p = 0.047, OR = 1.9, 95% CI (1.0‑3.6). Increased galectin-3 levels were associated with lower rates of left ventricular pressure rise in early systole (dp/dt) (p=0.018) and raised pulmonary artery pressure (p = 0.046). High galectin-3 levels (p = 0.038, HR = 3.07) and arterial pulmonary pressure (p = 0.007, HR = 1.06) were found to be independent risk factors for all-cause mortality and readmissions. This study showed no significant correlation between serum galectin-3 levels and arterial stiffening markers. Instead, high galectin-3 levels predicted impaired ventricular-arterial coupling. Galectin-3 may be predictive of raised pulmonary artery pressures. Elevated galectin-3 levels correlate with severe systolic dysfunction and together with pulmonary hypertension are independent markers of outcome.
Delacrétaz, Aurélie; Lagares Santos, Patricia; Saigi Morgui, Nuria; Vandenberghe, Frederik; Glatard, Anaïs; Gholam-Rezaee, Mehdi; von Gunten, Armin; Conus, Philippe; Eap, Chin B
2017-12-01
Dyslipidemia represents a major health issue in psychiatry. We determined whether weighted polygenic risk scores (wPRSs) combining multiple single-nucleotide polymorphisms (SNPs) associated with lipid levels in the general population are associated with lipid levels [high-density lipoprotein (HDL), low-density lipoprotein (LDL), total cholesterol (TC), and triglycerides] and/or dyslipidemia in patients receiving weight gain-inducing psychotropic drugs. We also determined whether genetics improve the predictive power of dyslipidemia. The influence of wPRS on lipid levels was firstly assessed in a discovery psychiatric sample (n=332) and was then tested for replication in an independent psychiatric sample (n=140). The contribution of genetic markers to predict dyslipidemia was evaluated in the combined psychiatric sample. wPRSs were significantly associated with the four lipid traits in the discovery (P≤0.02) and in the replication sample (P≤0.03). Patients whose wPRS was higher than the median wPRS had significantly higher LDL, TC, and triglyceride levels (0.20, 0.32 and 0.26 mmol/l, respectively; P≤0.004) and significantly lower HDL levels (0.13 mmol/l; P<0.0001) compared with others. Adding wPRS to clinical data significantly improved dyslipidemia prediction of HDL (P=0.03) and a trend for improvement was observed for the prediction of TC dyslipidemia (P=0.08). Population-based wPRSs have thus significant effects on lipid levels in the psychiatric population. As genetics improved the predictive power of dyslipidemia development, only 24 patients need to be genotyped to prevent the development of one case of HDL hypocholesterolemia. If confirmed by further prospective investigations, the present results could be used for individualizing psychotropic treatment.
Cystatin C and Cardiac Measures in Children and Adolescents With CKD.
Brady, Tammy M; Townsend, Kelly; Schneider, Michael F; Cox, Christopher; Kimball, Thomas; Madueme, Peace; Warady, Bradley; Furth, Susan; Mitsnefes, Mark
2017-02-01
Cardiovascular disease (CVD) is highly prevalent among children with chronic kidney disease (CKD). Cystatin C is an established marker of kidney function and an emerging biomarker for CVD events. We quantified the relationship between cystatin C level and cardiac structure and function over time among children with CKD and assessed whether cystatin C level and diastolic function retained an association after accounting for kidney function. Prospective cohort study. 678 children and adolescents with mild to moderate CKD enrolled in the CKD in Children (CKiD) Study with 1,228 echocardiographically obtained cardiac structure and function measurements. Serum cystatin C (mg/L) measured annually. Cardiac structure (left ventricular mass index [g/m 2.7 ]) and cardiac function (shortening fraction; E/A, E'/A', E/E' ratios) measured every other year. Demographics and anthropometrics, measured glomerular filtration rate (mGFR), heart rate, blood pressure, hemoglobin z score, serum albumin level, and calcium-phosphorus product. Independent of time, each 1-mg/L increase in cystatin C level was independently associated with a concurrent 7.7% (95% CI, 5.3%-10.0%) increase in left ventricular mass index, a -4.7% (95% CI, -7.0% to -2.4%) change in E/A ratio, a -6.6% (95% CI, -9.0% to -4.2%) change in E'/A' ratio, and a 2.5% (95% CI, 0.3%-4.7%) increase in E/E' ratio. mGFR was also independently associated with E'/A' ratio. When cystatin C level and mGFR were included in the same model, cystatin C level remained independently associated with E'/A' ratio, whereas mGFR was not. 24% of the cohort was missing data for outcomes of interest or measurements; study population includes only children and adolescents with mild to moderate CKD. In this study of children and adolescents with mild to moderate CKD, cystatin C level was independently associated with cardiac structure and diastolic function. Cystatin C level remained able to predict diastolic function decline via E'/A' ratio even after adjusting for mGFR, suggesting that cystatin C level may have an independent role in CVD risk stratification among children and adolescents with CKD. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
Soluble E-cadherin is an independent pretherapeutic factor for long-term survival in gastric cancer.
Chan, Annie On-On; Chu, Kent-Man; Lam, Shiu-Kum; Wong, Benjamin Chun-Yu; Kwok, Ka-Fai; Law, Simon; Ko, Samuel; Hui, Wai-Mo; Yueng, Yui-Hung; Wong, John
2003-06-15
To evaluate whether pretherapeutic serum soluble E-cadherin is an independent factor predicting long-term survival in gastric cancer. Gastric cancer remains the second leading cause of cancer-related deaths in the world, but a satisfactory tumor marker is currently unavailable for gastric cancer. Soluble E-cadherin has recently been found to have prognostic value in gastric cancer. One hundred sixteen patients with histologically proven gastric adenocarcinoma were included in the trial. Pretherapeutic serum was collected, and soluble E-cadherin was assayed using a commercially available enzyme-linked immunosorbent assay kit. The patients were followed up prospectively at the outpatient clinic. There were 75 men and 41 women, with a mean (+/- SD) age of 66 +/- 14 years. Forty-eight percent of tumors were located in the gastric antrum. The median survival time was 11 months. The mean pretherapeutic value of soluble E-cadherin was 9,159 ng/mL (range, 6,002 to 10,025 ng/mL), and the mean pretherapeutic level of carcinoembryonic antigen was 11 ng/mL (range, 0.3 to 4,895 ng/mL). On multivariate analysis, soluble E-cadherin is an independent factor predicting long-term survival. Ninety percent of patients with a serum level of E-cadherin greater than 10,000 ng/mL had a survival time of less than 3 years (P =.009). Soluble E-cadherin is a potentially valuable pretherapeutic prognostic factor in patients with gastric cancer.
Stakanov, A V; Potseluev, E A; Musaeva, T S
2013-01-01
Purpose of the study was to identify prediction possibility of direct current potential level for intra-abdominal hypertension risk in patients with acute colonic obstruction under preoperative epidural analgesia. Prospective analysis of the preoperative period was carried out in 140 patients with acute colonic obstruction caused by colon cancer. Relations between preoperative level of permanent capacity and risk of intra-abdominal hypertension was identified Direct current potential level is an independent predictor of intra-abdominal hypertension. Diagnostic significance increases from first to fifth hour of preoperative period according to AUROC data from 0.821 to 0.905 and calibration 6.9 (p > 0.37) and 4.7 (p > 0.54) by Hosmer-Lemeshou criteria. The use of epidural analgesia in the complex intensive preoperative preparation is pathogenically justified. It reduces intra-abdominal hypertension in patients with acute colonic obstruction.
Stewart, Eric A.; Simons, Ronald L.
2011-01-01
The study outlined in this article drew on Elijah Anderson’s (1999) code of the street perspective to examine the impact of neighborhood street culture on violent delinquency. Using data from more than 700 African American adolescents, we examined 1) whether neighborhood street culture predicts adolescent violence above and beyond an adolescent’s own street code values and 2) whether neighborhood street culture moderates individual-level street code values on adolescent violence. Consistent with Anderson’s hypotheses, neighborhood street culture significantly predicts violent delinquency independent of individual-level street code effects. Additionally, neighborhood street culture moderates individual-level street code values on violence in neighborhoods where the street culture is widespread. In particular, the effect of street code values on violence is enhanced in neighborhoods where the street culture is endorsed widely. PMID:21666759
Learning under uncertainty in smart home environments.
Zhang, Shuai; McClean, Sally; Scotney, Bryan; Nugent, Chris
2008-01-01
Technologies and services for the home environment can provide levels of independence for elderly people to support 'ageing in place'. Learning inhabitants' patterns of carrying out daily activities is a crucial component of these technological solutions with sensor technologies being at the core of such smart environments. Nevertheless, identifying high-level activities from low-level sensor events can be a challenge, as information may be unreliable resulting in incomplete data. Our work addresses the issues of learning in the presence of incomplete data along with the identification and the prediction of inhabitants and their activities under such uncertainty. We show via the evaluation results that our approach also offers the ability to assess the impact of various sensors in the activity recognition process. The benefit of this work is that future predictions can be utilised in a proposed intervention mechanism in a real smart home environment.
Djuričić, Goran J; Radulovic, Marko; Sopta, Jelena P; Nikitović, Marina; Milošević, Nebojša T
2017-01-01
The prediction of induction chemotherapy response at the time of diagnosis may improve outcomes in osteosarcoma by allowing for personalized tailoring of therapy. The aim of this study was thus to investigate the predictive potential of the so far unexploited computational analysis of osteosarcoma magnetic resonance (MR) images. Fractal and gray level cooccurrence matrix (GLCM) algorithms were employed in retrospective analysis of MR images of primary osteosarcoma localized in distal femur prior to the OsteoSa induction chemotherapy. The predicted and actual chemotherapy response outcomes were then compared by means of receiver operating characteristic (ROC) analysis and accuracy calculation. Dbin, Λ, and SCN were the standard fractal and GLCM features which significantly associated with the chemotherapy outcome, but only in one of the analyzed planes. Our newly developed normalized fractal dimension, called the space-filling ratio (SFR) exerted an independent and much better predictive value with the prediction significance accomplished in two of the three imaging planes, with accuracy of 82% and area under the ROC curve of 0.20 (95% confidence interval 0-0.41). In conclusion, SFR as the newly designed fractal coefficient provided superior predictive performance in comparison to standard image analysis features, presumably by compensating for the tumor size variation in MR images.
NASA Astrophysics Data System (ADS)
Yunardi, Y.; Munawar, Edi; Rinaldi, Wahyu; Razali, Asbar; Iskandar, Elwina; Fairweather, M.
2018-02-01
Soot prediction in a combustion system has become a subject of attention, as many factors influence its accuracy. An accurate temperature prediction will likely yield better soot predictions, since the inception, growth and destruction of the soot are affected by the temperature. This paper reported the study on the influences of turbulence closure and surface growth models on the prediction of soot levels in turbulent flames. The results demonstrated that a substantial distinction was observed in terms of temperature predictions derived using the k-ɛ and the Reynolds stress models, for the two ethylene flames studied here amongst the four types of surface growth rate model investigated, the assumption of the soot surface growth rate proportional to the particle number density, but independent on the surface area of soot particles, f ( A s ) = ρ N s , yields in closest agreement with the radial data. Without any adjustment to the constants in the surface growth term, other approaches where the surface growth directly proportional to the surface area and square root of surface area, f ( A s ) = A s and f ( A s ) = √ A s , result in an under- prediction of soot volume fraction. These results suggest that predictions of soot volume fraction are sensitive to the modelling of surface growth.
Rosa-Jiménez, Francisco; Rosa-Jiménez, Ascensión; Lozano-Rodríguez, Aquiles; Santoro-Martínez, María Del Carmen; Duro-López, María Del Carmen; Carreras-Álvarez de Cienfuegos, Amelia
2015-01-01
To compare the efficacy of the most familiar clinical prediction rules in combination with D-dimer testing to rule out a diagnosis of deep vein thrombosis (DVT) in a hospital emergency department. Retrospective cross-sectional analysis of the case records of all patients attending a hospital emergency department with suspected lower-limb DVT between 1998 and 2002. Ten clinical prediction scores were calculated and D-dimer levels were available for all patients. The gold standard was ultrasound diagnosis of DVT by an independent radiologist who was blinded to clinical records. For each prediction rule, we analyzed the effectiveness of the prediction strategy defined by "low clinical probability and negative D-dimer level" against the ultrasound diagnosis. A total of 861 case records were reviewed and 577 cases were selected; the mean (SD) age was 66.7 (14.2) years. DVT was diagnosed in 145 patients (25.1%). Only the Wells clinical prediction rule and 4 other models had a false negative rate under 2%. The Wells criteria and the score published by Johanning and colleagues identified higher percentages of cases (15.6% and 11.6%, respectively). This study shows that several clinical prediction rules can be safely used in the emergency department, although none of them have proven more effective than the Wells criteria.
Wirtz, Petra H; Ehlert, Ulrike; Emini, Luljeta; Rüdisüli, Katharina; Groessbauer, Sara; Mausbach, Brent T; von Känel, Roland
2006-12-01
Systemic hypertension confers a hypercoagulable state. We hypothesized that resting mean blood pressure (MBP) interacts with stress hormones in predicting coagulation activity at rest and with acute mental stress. We measured plasma clotting factor VII activity (FVII:C), FVIII:C, fibrinogen, D-dimer, epinephrine and norepinephrine, and saliva cortisol in 42 otherwise healthy normotensive and hypertensive medication-free men (mean age 43 +/- 14 years) at rest, immediately after stress, and twice during 60 min of recovery from stress. At rest, the MBP-by-epinephrine interaction predicted FVII:C (beta = -0.33, P < 0.04) and D-dimer (beta = 0.26, P < 0.05), and the MBP-by-cortisol interaction predicted D-dimer (beta = 0.43, P = 0.001), all independent of age and body mass index (BMI). Resting norepinephrine predicted fibrinogen (beta = 0.42, P < 0.01) and D-dimer (beta = 0.37, P < 0.03), both independent of MBP. MBP predicted FVIII:C change from rest to immediately post-stress independent of epinephrine (beta = -0.37, P < 0.03) and norepinephrine (beta = -0.38, P < 0.02). Cortisol change predicted FVIII:C change (beta = -0.30, P < 0.05) independent of age, BMI and MBP. Integrated norepinephrine change from rest to recovery (area under the curve, AUC) predicted D-dimer AUC (beta = 0.34, P = 0.04) independent of MBP. The MBP-by-epinephrine AUC interaction predicted FVII:C AUC (beta = 0.28) and fibrinogen AUC (beta = -0.30), and the MBP-by-norepinephrine AUC interaction predicted FVIII:C AUC (beta = -0.28), all with borderline significance (Ps < 0.09) and independent of age and BMI. MBP significantly altered the association between stress hormones and coagulation activity at rest and, with borderline significance, across the entire stress and recovery interval. Independent of MBP, catecholamines were associated with procoagulant effects and cortisol reactivity dampened the acute procoagulant stress response.
Domínguez, Ximena; Vitiello, Virginia E; Fuccillo, Janna M; Greenfield, Daryl B; Bulotsky-Shearer, Rebecca J
2011-04-01
Research suggests that promoting adaptive approaches to learning early in childhood may help close the gap between advantaged and disadvantaged children. Recent research has identified specific child-level and classroom-level variables that are significantly associated with preschoolers' approaches to learning. However, further research is needed to understand the interactive effects of these variables and determine whether classroom-level variables buffer the detrimental effects of child-level risk variables. Using a largely urban and minority sample (N=275) of preschool children, the present study examined the additive and interactive effects of children's context-specific problem behaviors and classroom process quality dimensions on children's approaches to learning. Teachers rated children's problem behavior and approaches to learning and independent assessors conducted classroom observations to assess process quality. Problem behaviors in structured learning situations and in peer and teacher interactions were found to negatively predict variance in approaches to learning. Classroom process quality domains did not independently predict variance in approaches to learning. Nonetheless, classroom process quality played an important role in these associations; high emotional support buffered the detrimental effects of problem behavior, whereas high instructional support exacerbated them. The findings of this study have important implications for classroom practices aimed at helping children who exhibit problem behaviors. Copyright © 2010 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.
NASA Technical Reports Server (NTRS)
Morey, Susan; Prevot, Thomas; Mercer, Joey; Martin, Lynne; Bienert, Nancy; Cabrall, Christopher; Hunt, Sarah; Homola, Jeffrey; Kraut, Joshua
2013-01-01
A human-in-the-loop simulation was conducted to examine the effects of varying levels of trajectory prediction uncertainty on air traffic controller workload and performance, as well as how strategies and the use of decision support tools change in response. This paper focuses on the strategies employed by two controllers from separate teams who worked in parallel but independently under identical conditions (airspace, arrival traffic, tools) with the goal of ensuring schedule conformance and safe separation for a dense arrival flow in en route airspace. Despite differences in strategy and methods, both controllers achieved high levels of schedule conformance and safe separation. Overall, results show that trajectory uncertainties introduced by wind and aircraft performance prediction errors do not affect the controllers' ability to manage traffic. Controller strategies were fairly robust to changes in error, though strategies were affected by the amount of delay to absorb (scheduled time of arrival minus estimated time of arrival). Using the results and observations, this paper proposes an ability to dynamically customize the display of information including delay time based on observed error to better accommodate different strategies and objectives.
Hoffman, R.A.; Kothari, S.; Phan, J.H.; Wang, M.D.
2016-01-01
Computational analysis of histopathological whole slide images (WSIs) has emerged as a potential means for improving cancer diagnosis and prognosis. However, an open issue relating to the automated processing of WSIs is the identification of biological regions such as tumor, stroma, and necrotic tissue on the slide. We develop a method for classifying WSI portions (512x512-pixel tiles) into biological regions by (1) extracting a set of 461 image features from each WSI tile, (2) optimizing tile-level prediction models using nested cross-validation on a small (600 tile) manually annotated tile-level training set, and (3) validating the models against a much larger (1.7x106 tile) data set for which ground truth was available on the whole-slide level. We calculated the predicted prevalence of each tissue region and compared this prevalence to the ground truth prevalence for each image in an independent validation set. Results show significant correlation between the predicted (using automated system) and reported biological region prevalences with p < 0.001 for eight of nine cases considered. PMID:27532012
Hoffman, R A; Kothari, S; Phan, J H; Wang, M D
Computational analysis of histopathological whole slide images (WSIs) has emerged as a potential means for improving cancer diagnosis and prognosis. However, an open issue relating to the automated processing of WSIs is the identification of biological regions such as tumor, stroma, and necrotic tissue on the slide. We develop a method for classifying WSI portions (512x512-pixel tiles) into biological regions by (1) extracting a set of 461 image features from each WSI tile, (2) optimizing tile-level prediction models using nested cross-validation on a small (600 tile) manually annotated tile-level training set, and (3) validating the models against a much larger (1.7x10 6 tile) data set for which ground truth was available on the whole-slide level. We calculated the predicted prevalence of each tissue region and compared this prevalence to the ground truth prevalence for each image in an independent validation set. Results show significant correlation between the predicted (using automated system) and reported biological region prevalences with p < 0.001 for eight of nine cases considered.
Cuff, Derek J; O'Brien, Kathleen C; Pupello, Derek R; Santoni, Brandon G
2016-07-01
To evaluate multiple preoperative and operative factors that may be predictive of and correlate with acute postoperative pain levels after arthroscopic rotator cuff repair. One hundred eighty-one patients underwent arthroscopic rotator cuff surgery along with subacromial decompression and met the inclusion criteria for this study. Postoperative visual analog scale (VAS) scores were obtained on postoperative days 1, 7, and 90. Multivariate linear regression analysis was used to correlate postoperative VAS scores with multiple independent factors, including preoperative subjective pain tolerance, preoperative VAS score, preoperative narcotic use, sex, smoking status, number of suture anchors used, tear size, single- or double-row repair, and patient age. Preoperative subjective pain tolerance, notably those patients rating themselves as having an extremely high pain tolerance, was the most significant predictor of high VAS pain scores on both postoperative day 1 (P = .0001) and postoperative day 7 (P < .0001). Preoperative narcotic use was also significantly predictive (P = .010) of high pain scores on postoperative day 1 and day 7 (P = .019), along with nonsmokers (P = .008) and younger patients (P = .006) being predictive on day 7. There were no patient factors that were predictive of VAS scores 3 months postoperatively (P = .567). Preoperative subjective pain tolerance, notably those patients rating themselves as having an extremely high pain tolerance, was the strongest factor predicting high acute pain levels after arthroscopic rotator cuff surgery. Preoperative narcotic use, smokers, and younger patients were also predictive of higher pain levels during the first postoperative week. Level IV, prognostic case series. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
Late-Life Drinking Problems: The Predictive Roles of Drinking Level vs. Drinking Pattern.
Holahan, Charles J; Brennan, Penny L; Schutte, Kathleen K; Holahan, Carole K; Hixon, J Gregory; Moos, Rudolf H
2017-05-01
Research on late-middle-aged and older adults has focused primarily on average level of alcohol consumption, overlooking variability in underlying drinking patterns. The purpose of the present study was to examine the independent contributions of an episodic heavy pattern of drinking versus a high average level of drinking as prospective predictors of drinking problems. The sample comprised 1,107 adults ages 55-65 years at baseline. Alcohol consumption was assessed at baseline, and drinking problems were indexed across 20 years. We used prospective negative binomial regression analyses controlling for baseline drinking problems, as well as for demographic and health factors, to predict the number of drinking problems at each of four follow-up waves (1, 4, 10, and 20 years). Across waves where the effects were significant, a high average level of drinking (coefficients of 1.56, 95% CI [1.24, 1.95]; 1.48, 95% CI [1.11, 1.98]; and 1.85, 95% CI [1.23, 2.79] at 1, 10, and 20 years) and an episodic heavy pattern of drinking (coefficients of 1.61, 95% CI [1.30, 1.99]; 1.61, 95% CI [1.28, 2.03]; and 1.43, 95% CI [1.08, 1.90] at 1, 4, and 10 years) each independently increased the number of drinking problems by more than 50%. Information based only on average consumption underestimates the risk of drinking problems among older adults. Both a high average level of drinking and an episodic heavy pattern of drinking pose prospective risks of later drinking problems among older adults.
Independent Factors for Prediction of Poor Outcomes in Patients with Febrile Neutropenia
Günalp, Müge; Koyunoğlu, Merve; Gürler, Serdar; Koca, Ayça; Yeşilkaya, İlker; Öner, Emre; Akkaş, Meltem; Aksu, Nalan Metin; Demirkan, Arda; Polat, Onur; Elhan, Atilla Halil
2014-01-01
Background Febrile neutropenia (FN) is a life-threatening condition that requires urgent management in the emergency department (ED). Recent progress in the treatment of neutropenic fever has underscored the importance of risk stratification. In this study, we aimed to determine independent factors for prediction of poor outcomes in patients with FN. Material/Methods We retrospectively evaluated 200 chemotherapy-induced febrile neutropenic patients who visited the ED. Upon arrival at the ED, clinical data, including sex, age, vital signs, underlying systemic diseases, laboratory test results, estimated GFR, blood cultures, CRP, radiologic examinations, and Multinational Association of Supportive Care in Cancer (MASCC) score of all febrile neutropenic patients were obtained. Outcomes were categorized as “poor” if serious complications during hospitalization, including death, occurred. Results The platelet count <50 000 cells/mm3 (OR 3.90, 95% CI 1.62–9.43), pulmonary infiltration (OR 3.45, 95% CI 1.48–8.07), hypoproteinemia <6 g/dl (OR 3.30, 95% CI 1.27–8.56), respiratory rate >24/min (OR 8.75, 95% CI 2.18–35.13), and MASCC score <21 (OR 9.20, 95% CI 3.98–21.26) were determined as independent risk factors for the prediction of death. The platelet count <50 000 cells/mm3 (OR 3.93, 95% CI 1.42–10.92), serum CRP >50 mg/dl (OR 3.80, 95% CI 1.68–8.61), hypoproteinemia (OR 7.81, 95% CI 3.43–17.78), eGFR ≤90 ML/min/1.73 m2 (OR 3.06, 95% CI 1.13–8.26), and MASCC score <21 (OR 3.45, 95% CI 1.53–7.79) were determined as independent risk factors for the prediction of poor clinical outcomes of FN patients. Platelet count, protein level, respiratory rate, pulmonary infiltration, CRP, MASCC score, and eGFR were shown to have a significant association with outcome. Conclusions The results of our study may help emergency medicine physicians to prevent serious complications with proper use of simple independent risk factors besides MASCC score. PMID:25282155
Yokoyama, Yukihiro; Ebata, Tomoki; Igami, Tsuyoshi; Sugawara, Gen; Mizuno, Takashi; Yamaguchi, Junpei; Nagino, Masato
2016-06-01
Postoperative liver failure (PHLF) is one of the most common complications following major hepatectomy. The preoperative assessment of future liver remnant (FLR) function is critical to predict the incidence of PHLF. To determine the efficacy of the plasma clearance rate of indocyanine green clearance of FLR (ICGK-F) in predicting PHLF in cases of highly invasive hepatectomy with extrahepatic bile duct resection. Five hundred and eighty-five patients who underwent major hepatectomy with extrahepatic bile duct resection, from 2002 to 2014 in a single institution, were evaluated. Among them, 192 patients (33 %) had PHLF. The predictive value of ICGK-F for PHLF was determined and compared with other risk factors for PHLF. The incidence of PHLF was inversely proportional to the level of ICGK-F. With multivariate logistic regression analysis, ICGK-F, combined pancreatoduodenectomy, the operation time, and blood loss were identified as independent risk factors of PHLF. The risk of PHLF increased according to the decrement of ICGK-F (the odds ratio of ICGK-F for each decrement of 0.01 was 1.22; 95 % confidence interval 1.12-1.33; P < 0.001). Low ICGK-F was also identified as an independent risk factor predicting the postoperative mortality. ICGK-F is useful in predicting the PHLF and mortality in patients undergoing major hepatectomy with extrahepatic bile duct resection. This criterion may be useful for highly invasive hepatectomy, such as that with extrahepatic bile duct resection.
Timmons, Shelly D; Bee, Tiffany; Webb, Sharon; Diaz-Arrastia, Ramon R; Hesdorffer, Dale
2011-11-01
Prediction of outcome after traumatic brain injury (TBI) remains elusive. We tested the use of a single hospital Glasgow Coma Scale (GCS) Score, GCS Motor Score, and the Head component of the Abbreviated Injury Scale (AIS) Score to predict 2-week cumulative mortality in a large cohort of TBI patients admitted to the eight U.S. Level I trauma centers in the TBI Clinical Trials Network. Data on 2,808 TBI patients were entered into a centralized database. These TBI patients were categorized as severe (GCS score, 3-8), moderate (9-12), or complicated mild (13-15 with positive computed tomography findings). Intubation and chemical paralysis were recorded. The cumulative incidence of mortality in the first 2 weeks after head injury was calculated using Kaplan-Meier survival analysis. Cox proportional hazards regression was used to estimate the magnitude of the risk for 2-week mortality. Two-week cumulative mortality was independently predicted by GCS, GCS Motor Score, and Head AIS. GCS Severity Category and GCS Motor Score were stronger predictors of 2-week mortality than Head AIS. There was also an independent effect of age (<60 vs. ≥60) on mortality after controlling for both GCS and Head AIS Scores. Anatomic and physiologic scales are useful in the prediction of mortality after TBI. We did not demonstrate any added benefit to combining the total GCS or GCS Motor Scores with the Head AIS Score in the short-term prediction of death after TBI.
How accurate is our clinical prediction of "minimal prostate cancer"?
Leibovici, Dan; Shikanov, Sergey; Gofrit, Ofer N; Zagaja, Gregory P; Shilo, Yaniv; Shalhav, Arieh L
2013-07-01
Recommendations for active surveillance versus immediate treatment for low risk prostate cancer are based on biopsy and clinical data, assuming that a low volume of well-differentiated carcinoma will be associated with a low progression risk. However, the accuracy of clinical prediction of minimal prostate cancer (MPC) is unclear. To define preoperative predictors for MPC in prostatectomy specimens and to examine the accuracy of such prediction. Data collected on 1526 consecutive radical prostatectomy patients operated in a single center between 2003 and 2008 included: age, body mass index, preoperative prostate-specific antigen level, biopsy Gleason score, clinical stage, percentage of positive biopsy cores, and maximal core length (MCL) involvement. MPC was defined as < 5% of prostate volume involvement with organ-confined Gleason score < or = 6. Univariate and multivariate logistic regression analyses were used to define independent predictors of minimal disease. Classification and Regression Tree (CART) analysis was used to define cutoff values for the predictors and measure the accuracy of prediction. MPC was found in 241 patients (15.8%). Clinical stage, biopsy Gleason's score, percent of positive biopsy cores, and maximal involved core length were associated with minimal disease (OR 0.42, 0.1, 0.92, and 0.9, respectively). Independent predictors of MPC included: biopsy Gleason score, percent of positive cores and MCL (OR 0.21, 095 and 0.95, respectively). CART showed that when the MCL exceeded 11.5%, the likelihood of MPC was 3.8%. Conversely, when applying the most favorable preoperative conditions (Gleason < or = 6, < 20% positive cores, MCL < or = 11.5%) the chance of minimal disease was 41%. Biopsy Gleason score, the percent of positive cores and MCL are independently associated with MPC. While preoperative prediction of significant prostate cancer was accurate, clinical prediction of MPC was incorrect 59% of the time. Caution is necessary when implementing clinical data as selection criteria for active surveillance.
A decline in prosocial language helps explain public disapproval of the US Congress.
Frimer, Jeremy A; Aquino, Karl; Gebauer, Jochen E; Zhu, Luke Lei; Oakes, Harrison
2015-05-26
Talking about helping others makes a person seem warm and leads to social approval. This work examines the real world consequences of this basic, social-cognitive phenomenon by examining whether record-low levels of public approval of the US Congress may, in part, be a product of declining use of prosocial language during Congressional debates. A text analysis of all 124 million words spoken in the House of Representatives between 1996 and 2014 found that declining levels of prosocial language strongly predicted public disapproval of Congress 6 mo later. Warm, prosocial language still predicted public approval when removing the effects of societal and global factors (e.g., the September 11 attacks) and Congressional efficacy (e.g., passing bills), suggesting that prosocial language has an independent, direct effect on social approval.
Galán, Chardée A; Choe, Daniel Ewon; Forbes, Erika E; Shaw, Daniel S
2017-12-01
Although resting heart rate (RHR) and empathy are independently and negatively associated with violent behavior, relatively little is known about the interplay between these psychophysiological and temperament-related risk factors. Using a sample of 160 low-income, racially diverse men followed prospectively from infancy through early adulthood, this study examined whether RHR and empathy during early adolescence independently and interactively predict violent behavior and related correlates in late adolescence and early adulthood. Controlling for child ethnicity, family income, and child antisocial behavior at age 12, empathy inversely predicted moral disengagement and juvenile petitions for violent crimes, while RHR was unrelated to all measures of violent behavior. Interactive effects were also evident such that among men with lower but not higher levels of RHR, lower empathy predicted increased violent behavior, as indexed by juvenile arrests for violent offenses, peer-reported violent behavior at age 17, self-reported moral disengagement at age 17, and self-reported violent behavior at age 20. Implications for prevention and intervention are considered. Specifically, targeting empathic skills among individuals at risk for violent behavior because of specific psychophysiological profiles may lead to more impactful interventions. © 2017 Association for Child and Adolescent Mental Health.
Constraint shapes convergence in tetrodotoxin-resistant sodium channels of snakes.
Feldman, Chris R; Brodie, Edmund D; Brodie, Edmund D; Pfrender, Michael E
2012-03-20
Natural selection often produces convergent changes in unrelated lineages, but the degree to which such adaptations occur via predictable genetic paths is unknown. If only a limited subset of possible mutations is fixed in independent lineages, then it is clear that constraint in the production or function of molecular variants is an important determinant of adaptation. We demonstrate remarkably constrained convergence during the evolution of resistance to the lethal poison, tetrodotoxin, in six snake species representing three distinct lineages from around the globe. Resistance-conferring amino acid substitutions in a voltage-gated sodium channel, Na(v)1.4, are clustered in only two regions of the protein, and a majority of the replacements are confined to the same three positions. The observed changes represent only a small fraction of the experimentally validated mutations known to increase Na(v)1.4 resistance to tetrodotoxin. These results suggest that constraints resulting from functional tradeoffs between ion channel function and toxin resistance led to predictable patterns of evolutionary convergence at the molecular level. Our data are consistent with theoretical predictions and recent microcosm work that suggest a predictable path is followed during an adaptive walk along a mutational landscape, and that natural selection may be frequently constrained to produce similar genetic outcomes even when operating on independent lineages.
Li, Feng-Cai; Li, Yue-Kai; Fan, Yu-Chen; Wang, Kai
2018-05-26
Acute-on-chronic hepatitis B liver failure (ACHBLF) has high 1-month mortality but it is difficult to predict. This present study was aimed to determine the diagnostic value of plasma diamine oxidase (DAO) in predicting the 1-month mortality of ACHBLF. A total of 106 consecutive newly diagnosed ACHBLF patients were retrospectively collected. The plasma expression of DAO was determined using enzyme-linked immunosorbent assay (ELISA). The plasma DAO level of survivals [14.0 (7.1; 26.5) ng/mL] was significantly lower than the nonsurvivals [58.6 (32.5; 121.3) ng/mL, P < .001]. The plasma DAO level, hepatic encephalopathy, spontaneous bacterial peritonitis and model for end-stage liver disease (MELD) score were independent factors associated with the 1-month mortality for ACHBLF. The cut-off point of 15.2 ng/mL for plasma DAO level with sensitivity of 95.45%, specificity of 62.5%, 22.6 for MELD score with sensitivity of 90.91%, specificity of 67.5%, 0.07 for DAO plus MELD with sensitivity of 87.88%, specificity of 80% were selected to discriminate 1-month morality of ACHBLF. Furthermore, DAO plus MELD score showed high AUROC than MELD score for predicting 1-month (0.916 vs. 0.843, P < .01). The plasma DAO level plus MELD > 0.07 predicts poor 1-month mortality of ACHBLF. Copyright © 2018 Elsevier B.V. All rights reserved.
Mercer, Sterett H.
2008-01-01
This study assessed the importance of teacher preference of individual students, relative to peer rejection and student aggression, as an independent predictor of children's emotional adjustment and grades. First, a longitudinal, cross-lagged path analysis was conducted to determine the patterns of influence among teacher preference, peer rejection, and student aggression. Then, parallel growth analyses were examined to test whether lower initial and declining teacher preference, beyond the influence of initial-level and change in peer rejection and student aggression, predicted change in loneliness, depression, social anxiety, and grades. Social adjustment, emotional adjustment, and academic adjustment were assessed in the fall and spring of two consecutive school years with 1,193 third-grade students via peer-, teacher-, and self-report instruments as well as school records. In the cross-lagged path analysis, reciprocal influence over time between teacher preference and peer rejection was found, and student aggression predicted lower teacher preference and higher peer rejection. In the growth analyses, initial and declining teacher preference were independent predictors of increasing loneliness and declining grades. Discussion focuses on the relevance of the results within a transactional model of school adaptation. PMID:19083378
Mercer, Sterett H; DeRosier, Melissa E
2008-12-01
This study assessed the importance of teacher preference of individual students, relative to peer rejection and student aggression, as an independent predictor of children's emotional adjustment and grades. First, a longitudinal, cross-lagged path analysis was conducted to determine the patterns of influence among teacher preference, peer rejection, and student aggression. Then, parallel growth analyses were examined to test whether lower initial and declining teacher preference, beyond the influence of initial level and change in peer rejection and student aggression, predicted change in loneliness, depression, social anxiety, and grades. Social adjustment, emotional adjustment, and academic adjustment were assessed in the fall and spring of two consecutive school years with 1193 third-grade students via peer-, teacher-, and self-report instruments as well as school records. In the cross-lagged path analysis, reciprocal influence over time between teacher preference and peer rejection was found, and student aggression predicted lower teacher preference and higher peer rejection. In the growth analyses, initial and declining teacher preference were independent predictors of increasing loneliness and declining grades. Discussion focuses on the relevance of the results within a transactional model of school adaptation.
Suicidal Ideation in Anxiety-Disordered Youth: Identifying Predictors of Risk
O'Neil Rodriguez, Kelly A.; Kendall, Philip C.
2014-01-01
Objective Evidence is mixed regarding an independent association between anxiety and suicidality. Beyond associations with demographic factors and depression, do anxiety disorders increase risk for suicidality in youth? Given that not all anxiety-disordered youth experience suicidal ideation, potential predictors of risk also require investigation. Method The present study examined (a) the independent relationship between anxiety and suicidal ideation and (b) emotion dysregulation and distress intolerance as predictors of risk for suicidal ideation in a sample of anxiety-disordered youth aged 7-17 (N = 86, M = 11.5). Youth and their parents reported on suicidality, emotion dysregulation, and distress intolerance. Distress tolerance was also measured by a computerized behavioral task. Results Results support an independent relationship between anxiety symptomatology and youth-reported suicidal ideation, controlling for depressive symptoms. Youth self-report of emotion dysregulation and distress intolerance predicted higher levels of suicidal ideation in univariate analyses. In a multivariate analysis including all significant predictors, only anxiety symptomatology uniquely predicted suicidal ideation. Conclusions Results provide recommendations for the assessment and treatment of suicidality in anxiety-disordered youth. Suggestions for future research investigating the relationship between anxiety and suicidal ideation are offered. PMID:24156368
Landau-Zener transitions and Dykhne formula in a simple continuum model
NASA Astrophysics Data System (ADS)
Dunham, Yujin; Garmon, Savannah
The Landau-Zener model describing the interaction between two linearly driven discrete levels is useful in describing many simple dynamical systems; however, no system is completely isolated from the surrounding environment. Here we examine a generalizations of the original Landau-Zener model to study simple environmental influences. We consider a model in which one of the discrete levels is replaced with a energy continuum, in which we find that the survival probability for the initially occupied diabatic level is unaffected by the presence of the continuum. This result can be predicted by assuming that each step in the evolution for the diabatic state evolves independently according to the Landau-Zener formula, even in the continuum limit. We also show that, at least for the simplest model, this result can also be predicted with the natural generalization of the Dykhne formula for open systems. We also observe dissipation as the non-escape probability from the discrete levels is no longer equal to one.
Palamar, Joseph J.; Calzada, Esther J.; Theise, Rachelle; Huang, Keng-Yen; Petkova, Eva; Brotman, Laurie Miller
2017-01-01
Minority children attending schools in urban socioeconomically disadvantaged neighborhoods are at high risk for conduct problems. Although a number of family and neighborhood characteristics have been implicated in the onset and progression of conduct problems, there remains incomplete understanding of the unique contributions of poverty-related factors early in development. This prospective study of 298 black public school children considered family- and neighborhood-level predictors of teacher-reported conduct problems from pre-kindergarten through first grade. Results from multi-level analyses indicate that percentage of poor residents in a student’s neighborhood made a robust independent contribution to the prediction of development of conduct problems, over and above family- and other neighborhood-level demographic factors. For children of single parents, the percentage of black residents in the neighborhood also predicted the development of conduct problems. School-based interventions to prevent conduct problems should consider impact for children at highest risk based on neighborhood poverty. PMID:24673380
Palamar, Joseph J; Calzada, Esther J; Theise, Rachelle; Huang, Keng-Yen; Petkova, Eva; Brotman, Laurie Miller
2015-01-01
Minority children attending schools in urban socioeconomically disadvantaged neighborhoods are at high risk for conduct problems. Although a number of family and neighborhood characteristics have been implicated in the onset and progression of conduct problems, there remains incomplete understanding of the unique contributions of poverty-related factors early in development. This prospective study of 298 black public school children considered family- and neighborhood-level predictors of teacher-reported conduct problems from pre-kindergarten through first grade. Results from multi-level analyses indicate that percentage of poor residents in a student's neighborhood made a robust independent contribution to the prediction of development of conduct problems, over and above family- and other neighborhood-level demographic factors. For children of single parents, the percentage of black residents in the neighborhood also predicted the development of conduct problems. School-based interventions to prevent conduct problems should consider impact for children at highest risk based on neighborhood poverty.
Improving membrane protein expression by optimizing integration efficiency
2017-01-01
The heterologous overexpression of integral membrane proteins in Escherichia coli often yields insufficient quantities of purifiable protein for applications of interest. The current study leverages a recently demonstrated link between co-translational membrane integration efficiency and protein expression levels to predict protein sequence modifications that improve expression. Membrane integration efficiencies, obtained using a coarse-grained simulation approach, robustly predicted effects on expression of the integral membrane protein TatC for a set of 140 sequence modifications, including loop-swap chimeras and single-residue mutations distributed throughout the protein sequence. Mutations that improve simulated integration efficiency were 4-fold enriched with respect to improved experimentally observed expression levels. Furthermore, the effects of double mutations on both simulated integration efficiency and experimentally observed expression levels were cumulative and largely independent, suggesting that multiple mutations can be introduced to yield higher levels of purifiable protein. This work provides a foundation for a general method for the rational overexpression of integral membrane proteins based on computationally simulated membrane integration efficiencies. PMID:28918393
Xiong, Yao; Liu, Bian; Hao, Zilong; Tao, Wendan; Liu, Ming
2016-01-01
Background and Objective Elevated levels of high sensitivity cardiac troponin T (hs-cTnT) occur in a substantial proportion of patients with acute ischemic stroke (AIS) and can predict poor outcome and mortality after stroke. Whether elevated hs-cTnT levels can also predict hemorrhagic transformation (HT) or prognosis in AIS patients with rheumatic heart disease (RHD) remains unclear. Methods Data from the Chengdu Stroke Registry on consecutive AIS patients with RHD admitted to West China Hospital within1 month of stroke onset from October 2011 to February 2014 were examined. Clinico-demographic characteristics, HT, functional outcomes and stroke recurrence were compared between patients with elevated hs-cTnT levels(≥14ng/L) and patients with normal hs-cTnT levels (<14ng/L). Results The final analysis involved 84 patients (31 males; mean age, 61.6±12.2years), of whom serum hs-cTnT levels were elevated in 58.3%. Renal impairment was independently associated with elevated hs-cTnT levels (OR 4.184, 95%CI 1.17 to 15.01, P = 0.028), and patients with elevated hs-cTnT levels were at significantly higher risk of HT, 3-month mortality and 3-month disability/mortality (all P≤0.029). After controlling for age, sex, hypertension, renal impairment and National Institutes of Health Stroke Scale score on admission, the risk of HT and 3-month mortality was, respectively, 4.0- and 5.5-fold higher in patients with elevated hs-cTnT levels than in patients with normal hs-cTnT levels. Conclusion Elevated hs-cTnT levels are independently associated with HT and 3-month mortality in AIS patients with RHD. These results with a small cohort should be verified and extended in large studies. PMID:26849554
Liu, Junfeng; Wang, Deren; Xiong, Yao; Liu, Bian; Hao, Zilong; Tao, Wendan; Liu, Ming
2016-01-01
Elevated levels of high sensitivity cardiac troponin T (hs-cTnT) occur in a substantial proportion of patients with acute ischemic stroke (AIS) and can predict poor outcome and mortality after stroke. Whether elevated hs-cTnT levels can also predict hemorrhagic transformation (HT) or prognosis in AIS patients with rheumatic heart disease (RHD) remains unclear. Data from the Chengdu Stroke Registry on consecutive AIS patients with RHD admitted to West China Hospital within 1 month of stroke onset from October 2011 to February 2014 were examined. Clinico-demographic characteristics, HT, functional outcomes and stroke recurrence were compared between patients with elevated hs-cTnT levels (≥14 ng/L) and patients with normal hs-cTnT levels (<14 ng/L). The final analysis involved 84 patients (31 males; mean age, 61.6±12.2 years), of whom serum hs-cTnT levels were elevated in 58.3%. Renal impairment was independently associated with elevated hs-cTnT levels (OR 4.184, 95%CI 1.17 to 15.01, P = 0.028), and patients with elevated hs-cTnT levels were at significantly higher risk of HT, 3-month mortality and 3-month disability/mortality (all P≤0.029). After controlling for age, sex, hypertension, renal impairment and National Institutes of Health Stroke Scale score on admission, the risk of HT and 3-month mortality was, respectively, 4.0- and 5.5-fold higher in patients with elevated hs-cTnT levels than in patients with normal hs-cTnT levels. Elevated hs-cTnT levels are independently associated with HT and 3-month mortality in AIS patients with RHD. These results with a small cohort should be verified and extended in large studies.
Mahon, Marrita M; Cox, I Jane; Dina, Roberto; Soutter, W Patrick; McIndoe, G Angus; Williams, Andreanna D; deSouza, Nandita M
2004-03-01
To compare in vivo (1)H magnetic resonance (MR) spectra of preinvasive and invasive cervical lesions with ex vivo magic angle spinning (MAS) spectra of intact biopsies from the same subjects and to establish the effects of tumor load in the tissue sampled on the findings. A total of 51 subjects (nine with normal cervix, 10 with cervical intraepithelial neoplasia [CIN], and 32 with cervical cancer) underwent endovaginal MR at 1.5 T. Single-voxel (3.4 cm(3)) (1)H MR spectra were acquired and voxel tumor load was calculated (tumor volume within voxel as a percentage of voxel volume). Resonances from triglycerides -CH(2) and -CH(3) and choline-containing compounds (Cho) were correlated with voxel tumor load. Biopsies analyzed by (1)H MAS-MR spectroscopy (MRS) had metabolite levels correlated with tumor load in the sample at histology. In vivo studies detected Cho in normal, CIN, and cancer patients with no significant differences in levels (P = 0.93); levels were independent of voxel tumor load. Triglyceride -CH(2) and -CH(3) signals in-phase with Cho were present in 77% and 29%, respectively, of cancer subjects (but not in normal women or those with CIN), but did not correlate with voxel tumor load. Ex vivo cancer biopsies showed levels of triglycerides -CH(2) and -CH(3) and of Cho that were significantly greater than in normal or CIN biopsies (P < 0.05); levels were independent of the tumor load in the sample. The presence of -CH(2) in vivo predicted the presence of cancer with a sensitivity and specificity of 77.4% and 93.8% respectively, positive (PPV) and negative (NPV) predictive values were 96% and 68.2%; for -CH(2) ex vivo, sensitivity was 100%; specificity, 69%; PPV, 82%; and NPV, 100%. Elevated lipid levels are detected by MRS in vivo and ex vivo in cervical cancer and are independent of tumor load in the volume of tissue sampled. Copyright 2004 Wiley-Liss, Inc.
CALCULATION OF NONLINEAR CONFIDENCE AND PREDICTION INTERVALS FOR GROUND-WATER FLOW MODELS.
Cooley, Richard L.; Vecchia, Aldo V.
1987-01-01
A method is derived to efficiently compute nonlinear confidence and prediction intervals on any function of parameters derived as output from a mathematical model of a physical system. The method is applied to the problem of obtaining confidence and prediction intervals for manually-calibrated ground-water flow models. To obtain confidence and prediction intervals resulting from uncertainties in parameters, the calibrated model and information on extreme ranges and ordering of the model parameters within one or more independent groups are required. If random errors in the dependent variable are present in addition to uncertainties in parameters, then calculation of prediction intervals also requires information on the extreme range of error expected. A simple Monte Carlo method is used to compute the quantiles necessary to establish probability levels for the confidence and prediction intervals. Application of the method to a hypothetical example showed that inclusion of random errors in the dependent variable in addition to uncertainties in parameters can considerably widen the prediction intervals.
Hoglund, Wendy L; Leadbeater, Bonnie J
2004-07-01
This study tested the independent and interactive influences of classroom (concentrations of peer prosocial behaviors and victimization), family (household moves, mothers' education), and school (proportion of students receiving income assistance) ecologies on changes in children's social competence (e.g., interpersonal skills, leadership abilities), emotional problems (e.g., anxious, withdrawn behaviors), and behavioral problems (e.g., disruptiveness, aggressiveness) in first grade. Higher classroom concentrations of prosocial behaviors and victimization predicted increases in social competence, and greater school disadvantage predicted decreases. Multiple household moves and greater school disadvantage predicted increases in behavioral problems. Multiple household moves and low levels of mothers' education predicted increases in emotional problems for children in classrooms with few prosocial behaviors. Greater school disadvantage predicted increases in emotional problems for children in classrooms with low prosocial behaviors and high victimization. Policy implications of these findings are considered. Copyright 2004 APA, all rights reserved
Fang, Wen-Feng; Douglas, Ivor S.; Chen, Yu-Mu; Lin, Chiung-Yu; Kao, Hsu-Ching; Fang, Ying-Tang; Huang, Chi-Han; Chang, Ya-Ting; Huang, Kuo-Tung; Wang, Yi-His; Wang, Chin-Chou
2017-01-01
Background Sepsis-induced immune dysfunction ranging from cytokines storm to immunoparalysis impacts outcomes. Monitoring immune dysfunction enables better risk stratification and mortality prediction and is mandatory before widely application of immunoadjuvant therapies. We aimed to develop and validate a scoring system according to patients’ immune dysfunction status for 28-day mortality prediction. Methods A prospective observational study from a cohort of adult sepsis patients admitted to ICU between August 2013 and June 2016 at Kaohsiung Chang Gung Memorial Hospital in Taiwan. We evaluated immune dysfunction status through measurement of baseline plasma Cytokine levels, Monocyte human leukocyte-DR expression by flow cytometry, and stimulated immune response using post LPS stimulated cytokine elevation ratio. An immune dysfunction score was created for 28-day mortality prediction and was validated. Results A total of 151 patients were enrolled. Data of the first consecutive 106 septic patients comprised the training cohort, and of other 45 patients comprised the validation cohort. Among the 106 patients, 21 died and 85 were still alive on day 28 after ICU admission. (mortality rate, 19.8%). Independent predictive factors revealed via multivariate logistic regression analysis included segmented neutrophil-to-monocyte ratio, granulocyte-colony stimulating factor, interleukin-10, and monocyte human leukocyte antigen-antigen D–related levels, all of which were selected to construct the score, which predicted 28-day mortality with area under the curve of 0.853 and 0.789 in the training and validation cohorts, respectively. Conclusions The immune dysfunction scoring system developed here included plasma granulocyte-colony stimulating factor level, interleukin-10 level, serum segmented neutrophil-to-monocyte ratio, and monocyte human leukocyte antigen-antigen D–related expression appears valid and reproducible for predicting 28-day mortality. PMID:29073262
Predictive factors for work capacity in patients with musculoskeletal disorders.
Lydell, Marie; Baigi, Amir; Marklund, Bertil; Månsson, Jörgen
2005-09-01
To identify predictive factors for work capacity in patients with musculoskeletal disorders. A descriptive, evaluative, quantitative study. The study was based on 385 patients who participated in a rehabilitation programme. Patients were divided into 2 groups depending on their ability to work. The groups were compared with each other with regard to sociodemographic factors, diagnoses, disability pension and number of sick days. The patient's level of exercise habits, ability to undertake activities, physical capacity, pain and quality of life were compared further using logistic regression analysis. Predictive factors for work capacity, such as ability to undertake activities, quality of life and fitness on exercise, were identified as important independent factors. Other well-known factors, i.e. gender, age, education, pain and earlier sickness certification periods, were also identified. Factors that were not significantly different between the groups were employment status, profession, diagnosis and levels of exercise habits. Identifying predictors for ability to return to work is an essential task for deciding on suitable individual rehabilitation. This study identified new predictive factors, such as ability to undertake activities, quality of life and fitness on exercise.
Takada, Hitomi; Tsuchiya, Kaoru; Yasui, Yutaka; Nakakuki, Natsuko; Tamaki, Nobuharu; Suzuki, Shoko; Nakanishi, Hiroyuki; Itakura, Jun; Takahashi, Yuka; Kurosaki, Masayuki; Asahina, Yasuhiro; Enomoto, Nobuyuki; Izumi, Namiki
2016-11-01
Radiofrequency ablation (RFA) is considered the most effective treatment for early-stage hepatocellular carcinoma (HCC) patients unsuitable for resection. However, poor outcome after RFA has occasionally been reported worldwide. To predict such an outcome, we investigated imaging findings using contrast-enhanced ultrasonography (CEUS) with Sonazoid and serum tumor markers before RFA. This study included 176 early-stage HCC patients who had initially achieved successful RFA. Patients were examined using CEUS; their levels of alpha-fetoprotein (AFP), Lens culinaris agglutinin-reactive fraction of AFP (AFP-L3), and des-gamma-carboxy prothrombin before RFA were measured. Sonazoid provided parenchyma-specific contrast imaging and facilitated tumor vascular architecture imaging through maximum intensity projection (MIP). Kaplan-Meier analysis examined cumulative rates of local tumor progression, intrasubsegmental recurrence, and survival; factors associated with these were determined with Cox proportional hazards analysis. Local tumor progression (n = 15), intrasubsegmental recurrence (n = 46), and death (n = 18) were observed. Irregular pattern in MIP classification and serum AFP-L3 level (>10%) before RFA were identified as independent risk factors for local tumor progression and intrasubsegmental recurrence. These two factors were independently associated with poor survival after RFA (irregular pattern in MIP: hazard ratio, (HR) = 8.26; 95% confidence interval, (CI) = 2.24-30.3; P = 0.002 and AFP-L3 > 10%: HR = 2.94; 95% CI = 1.09-7.94; P = 0.033). Irregular MIP pattern by CEUS and high level of serum AFP-L3 were independent risk factors for poor outcome after successful RFA. The Patients with these findings should be considered as special high-risk group in early-stage HCC. © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
Inflammatory response in mixed viral-bacterial community-acquired pneumonia.
Bello, Salvador; Mincholé, Elisa; Fandos, Sergio; Lasierra, Ana B; Ruiz, María A; Simon, Ana L; Panadero, Carolina; Lapresta, Carlos; Menendez, Rosario; Torres, Antoni
2014-07-29
The role of mixed pneumonia (virus+bacteria) in community-acquired pneumonia (CAP) has been described in recent years. However, it is not known whether the systemic inflammatory profile is different compared to monomicrobial CAP. We wanted to investigate this profile of mixed viral-bacterial infection and to compare it to monomicrobial bacterial or viral CAP. We measured baseline serum procalcitonin (PCT), C reactive protein (CRP), and white blood cell (WBC) count in 171 patients with CAP with definite etiology admitted to a tertiary hospital: 59 (34.5%) bacterial, 66 (39.%) viral and 46 (27%) mixed (viral-bacterial). Serum PCT levels were higher in mixed and bacterial CAP compared to viral CAP. CRP levels were higher in mixed CAP compared to the other groups. CRP was independently associated with mixed CAP. CRP levels below 26 mg/dL were indicative of an etiology other than mixed in 83% of cases, but the positive predictive value was 45%. PCT levels over 2.10 ng/mL had a positive predictive value for bacterial-involved CAP versus viral CAP of 78%, but the negative predictive value was 48%. Mixed CAP has a different inflammatory pattern compared to bacterial or viral CAP. High CRP levels may be useful for clinicians to suspect mixed CAP.
Han, Biao; VanRullen, Rufin
2017-01-01
Predictive coding is an influential model emphasizing interactions between feedforward and feedback signals. Here, we investigated the temporal dynamics of these interactions. Two gray disks with different versions of the same stimulus, one enabling predictive feedback (a 3D-shape) and one impeding it (random-lines), were simultaneously presented on the left and right of fixation. Human subjects judged the luminance of the two disks while EEG was recorded. The choice of 3D-shape or random-lines as the brighter disk was used to assess the influence of feedback signals on sensory processing in each trial (i.e., as a measure of post-stimulus predictive coding efficiency). Independently of the spatial response (left/right), we found that this choice fluctuated along with the pre-stimulus phase of two spontaneous oscillations: a ~5 Hz oscillation in contralateral frontal electrodes and a ~16 Hz oscillation in contralateral occipital electrodes. This pattern of results demonstrates that predictive coding is a rhythmic process, and suggests that it could take advantage of faster oscillations in low-level areas and slower oscillations in high-level areas. PMID:28262824
Inadequate hepcidin serum concentrations predict incident type 2 diabetes mellitus.
Pechlaner, Raimund; Weiss, Günter; Bansal, Sukhvinder; Mayr, Manuel; Santer, Peter; Pallhuber, Barbara; Notdurfter, Marlene; Bonora, Enzo; Willeit, Johann; Kiechl, Stefan
2016-02-01
Type 2 diabetes mellitus (T2DM) is closely associated with elevated body iron stores. The hormone hepcidin is the key regulator of iron homeostasis. Inadequately low hepcidin levels were recently reported in subjects with manifest T2DM. We investigated whether alterations of hepcidin levels precede the manifestation of T2DM and predict T2DM development independently of established risk conditions. This prospective population-based study included 675 subjects aged 50-89 years, 51.9% of whom were female. Hepcidin levels were measured by gold standard tandem mass spectrometry. Diabetes was diagnosed according to American Diabetes Association criteria, and incident diabetes was recorded between baseline in 2000 and 2010. The baseline hepcidin-to-ferritin ratio in subjects that subsequently developed diabetes during follow-up was reduced on average by 29.8% as compared with subjects with normal glucose tolerance (95% confidence interval, -50.7% to -0.2%; p = 0.049). After adjustment for age, sex, and serum ferritin, higher hepcidin levels were associated with reduced risk of incident diabetes (hazard ratio per 1-unit higher log2 hepcidin, 0.80; 95% confidence interval, 0.64-0.98; p = 0.035; 33 events). Additional adjustment for established diabetes risk factors and determinants of hepcidin concentration did not appreciably change these results (HR, 0.81; 95% CI, 0.66-0.99). Likewise, inadequately low hepcidin levels were also detected in subjects with prevalent T2DM (n = 76). Hepcidin levels that are inadequately low in relation to body iron stores are an independent predictor for incident T2DM and may contribute to diabetes-related tissue iron overload. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
Small apolipoprotein(a) size predicts mortality in end-stage renal disease: The CHOICE study.
Longenecker, J Craig; Klag, Michael J; Marcovina, Santica M; Powe, Neil R; Fink, Nancy E; Giaculli, Federico; Coresh, Josef
2002-11-26
The high mortality rate in end-stage renal disease has engendered interest in nontraditional atherosclerotic cardiovascular disease (ASCVD) risk factors that are more prevalent in end-stage renal disease, such as elevated lipoprotein(a) [Lp(a)] levels. Previous studies suggest that high Lp(a) levels and small apolipoprotein(a) [apo(a)] isoform size are associated with ASCVD, but none have investigated the relationship between Lp(a) level, apo(a) size, and mortality. An inception cohort of 864 incident dialysis patients was followed prospectively. Lp(a) was measured by an apo(a) size-independent ELISA and apo(a) size by Western blot after SDS-agarose gel electrophoresis. Comorbid conditions were determined by medical record review. Time to death was ascertained through dialysis clinic and Health Care Financing Administration follow-up. Survival analyses were performed with adjustment for baseline demographic, comorbid conditions, albumin, and lipids. Median follow-up was 33.7 months, with 346 deaths, 162 transplantations, and 10 losses to follow-up during 1999 person-years of follow-up. Cox regression analysis showed no association between Lp(a) level and mortality. However, an association between small apo(a) isoform size and mortality was found (hazard ratio, 1.36; P=0.004) after adjusting for age, race, sex, comorbidity score, cause of renal disease, and congestive heart failure. The association was somewhat lower in white patients (hazard ratio 1.34; P=0.019) than in black patients (1.69; P=0.04). No interaction by age, race, sex, diabetes, ASCVD, or Lp(a) level was present. Small apo(a) size, but not Lp(a) level, independently predicts total mortality risk in dialysis patients.
Zhao, Zhigang; Zeng, Guohua; Zhong, Wen
2010-12-01
Early prostate cancer antigen (EPCA), a nuclear matrix protein, has been recently suggested as a novel biomarker in malignant lesions of the prostate. This study was to determine whether preoperative serum EPCA levels predicted the presence of incidental prostate cancer (IPCa) in patients undergoing TURP for BPH. Serum EPCA levels were measured by ELISA in 449 consecutive patients with symptomatic BPH treated with TURP and 112 healthy men. Predictive performance of serum EPCA levels for IPCa were evaluated. With a cutoff of 10ng/ml, serum EPCA protein had a 100% specificity for the healthy men and a 98% specificity and a 100% sensitivity in separating men with IPCa from those without. Serum EPCA levels in patients with IPCa were significantly higher than in those without and in healthy controls (17.63±2.42ng/ml vs. 5.58±1.61 ng/ml and 4.95±1.43 ng/ml, all P<0.001), whereas an indwelling transurethral catheter presence and 5α-reductase inhibitor therapy had no effect on EPCA levels (P=0.144 and P=0.238, respectively). The area under ROC curves (AUC) showed that serum EPCA level had the best predictive accuracy of all IPCa (AUC: 0.952, 95% CI: 0.912-0.981, P<0.001). Univariate and multivariate Cox regression analyses further demonstrated the independently predictive performance by preoperative serum EPCA (Hazards Ratio: 4.23, 95% CI: 3.62-6.46, P<0.001). This study firstly shows that EPCA might be used as a highly sensitive and specific serum biomarker to predict IPCa presence and to help reduce the unnecessary biopsies taken before TURP in patients with BPH. © 2010 Wiley-Liss, Inc.
Liu, Shou-Hsuan; Chen, Chao-Yu; Li, Yi-Jung; Wu, Hsin-Hsu; Lin, Chan-Yu; Chen, Yung-Chang; Chang, Ming-Yang; Hsu, Hsiang-Hao; Ku, Cheng-Lung; Tian, Ya-Chung
2017-01-01
C-reactive protein (CRP) is a useful biomarker for prediction of long-term outcomes in patients undergoing chronic dialysis. This observational cohort study evaluated whether the time-averaged serum high-sensitivity CRP (HS-CRP) level was a better predictor of clinical outcomes than a single HS-CRP level in patients undergoing peritoneal dialysis (PD). We classified 335 patients into three tertiles according to the time-averaged serum HS-CRP level and followed up regularly from January 2010 to December 2014. Clinical outcomes such as cardiovascular events, infection episodes, newly developed malignancy, encapsulating peritoneal sclerosis (EPS), dropout (death plus conversion to hemodialysis), and mortality were assessed. During a 5-year follow-up, 164 patients (49.0%) ceased PD; this included 52 patient deaths (15.5%), 100 patients (29.9%) who converted to hemodialysis, and 12 patients (3.6%) who received a kidney transplantation. The Kaplan-Meier survival analysis and log-rank test revealed a significantly worse survival accumulation in patients with high time-average HS-CRP levels. A multivariate Cox regression analysis revealed that a higher time-averaged serum HS-CRP level, older age, and the occurrence of cardiovascular events were independent mortality predictors. A higher time-averaged serum HS-CRP level, the occurrence of cardiovascular events, infection episodes, and EPS were important predictors of dropout. The receiver operating characteristic analysis verified that the value of the time-average HS-CRP level in predicting the 5-year mortality and dropout was superior to a single serum baseline HS-CRP level. This study shows that the time-averaged serum HS-CRP level is a better marker than a single baseline measurement in predicting the 5-year mortality and dropout in PD patients.
Estimating dead-space fraction for secondary analyses of ARDS clinical trials
Beitler, Jeremy R.; Thompson, B. Taylor; Matthay, Michael A.; Talmor, Daniel; Liu, Kathleen D.; Zhuo, Hanjing; Hayden, Douglas; Spragg, Roger G.; Malhotra, Atul
2015-01-01
Objective Pulmonary dead-space fraction is one of few lung-specific independent predictors of mortality from acute respiratory distress syndrome (ARDS). However, it is not measured routinely in clinical trials and thus altogether ignored in secondary analyses that shape future research directions and clinical practice. This study sought to validate an estimate of dead-space fraction for use in secondary analyses of clinical trials. Design Analysis of patient-level data pooled from ARDS clinical trials. Four approaches to estimate dead-space fraction were evaluated: three required estimating metabolic rate; one estimated dead-space fraction directly. Setting U.S. academic teaching hospitals. Patients Data from 210 patients across three clinical trials were used to compare performance of estimating equations with measured dead-space fraction. A second cohort of 3,135 patients from six clinical trials without measured dead-space fraction was used to confirm whether estimates independently predicted mortality. Interventions None. Measurements and Main Results Dead-space fraction estimated using the unadjusted Harris-Benedict equation for energy expenditure was unbiased (mean ± SD Harris-Benedict 0.59 ± 0.13; measured 0.60 ± 0.12). This estimate predicted measured dead-space fraction to within ± 0.10 in 70% of patients and ± 0.20 in 95% of patients. Measured dead-space fraction independently predicted mortality (OR 1.36 per 0.05 increase in dead-space fraction, 95% CI 1.10–1.68; p < .01). The Harris-Benedict estimate closely approximated this association with mortality in the same cohort (OR 1.55, 95% CI 1.21–1.98; p < .01) and remained independently predictive of death in the larger ARDSNet cohort. Other estimates predicted measured dead-space fraction or its association with mortality less well. Conclusions Dead-space fraction should be measured in future ARDS clinical trials to facilitate incorporation into secondary analyses. For analyses where dead-space fraction was not measured, the Harris-Benedict estimate can be used to estimate dead-space fraction and adjust for its association with mortality. PMID:25738857
DOE Office of Scientific and Technical Information (OSTI.GOV)
Ozaki, Toshiro, E-mail: ganronbun@amail.plala.or.jp; Seki, Hiroshi; Shiina, Makoto
2009-09-15
The purpose of the present study was to elucidate a method for predicting the intrahepatic arteriovenous shunt rate from computed tomography (CT) images and biochemical data, instead of from arterial perfusion scintigraphy, because adverse exacerbated systemic effects may be induced in cases where a high shunt rate exists. CT and arterial perfusion scintigraphy were performed in patients with liver metastases from gastric or colorectal cancer. Biochemical data and tumor marker levels of 33 enrolled patients were measured. The results were statistically verified by multiple regression analysis. The total metastatic hepatic tumor volume (V{sub metastasized}), residual hepatic parenchyma volume (V{sub residual};more » calculated from CT images), and biochemical data were treated as independent variables; the intrahepatic arteriovenous (IHAV) shunt rate (calculated from scintigraphy) was treated as a dependent variable. The IHAV shunt rate was 15.1 {+-} 11.9%. Based on the correlation matrixes, the best correlation coefficient of 0.84 was established between the IHAV shunt rate and V{sub metastasized} (p < 0.01). In the multiple regression analysis with the IHAV shunt rate as the dependent variable, the coefficient of determination (R{sup 2}) was 0.75, which was significant at the 0.1% level with two significant independent variables (V{sub metastasized} and V{sub residual}). The standardized regression coefficients ({beta}) of V{sub metastasized} and V{sub residual} were significant at the 0.1 and 5% levels, respectively. Based on this result, we can obtain a predicted value of IHAV shunt rate (p < 0.001) using CT images. When a high shunt rate was predicted, beneficial and consistent clinical monitoring can be initiated in, for example, hepatic arterial infusion chemotherapy.« less
Kushiyama, Akifumi; Kikuchi, Takako; Tanaka, Kentaro; Tahara, Tazu; Takao, Toshiko; Onishi, Yukiko; Yoshida, Yoko; Kawazu, Shoji; Iwamoto, Yasuhiko
2016-06-10
To investigate whether active glucagon-like peptide-1 (GLP-1) is a prediction Factor of Effect of sitagliptin on patients with type 2 diabetes mellitus (GLP-1 FEST:UMIN000010645). Seventy-six patients with type 2 diabetes, who had insufficient glycemic control [Hemoglobin A1c (HbA1c) ≥ 7%] in spite of treatment with metformin and/or sulfonylurea, were included in the investigation. Patients were divided into three groups by tertiles of fasting plasma active GLP-1 level, before the administration of 50 mg sitagliptin. At baseline, body mass index, serum UA, insulin and HOMA-IR were higher in the high active GLP-1 group than in the other two groups. The high active GLP-1 group did not show any decline of HbA1c (7.6% ± 1.4% to 7.5% ± 1.5%), whereas the middle and low groups indicated significant decline of HbA1c (7.4 ± 0.7 to 6.8 ± 0.6 and 7.4 ± 1.2 to 6.9 ± 1.3, respectively) during six months. Only the low and middle groups showed a significant increment of active GLP-1, C-peptide level, a decreased log and proinsulin/insulin ratio after administration. In logistic analysis, the low or middle group is a significant explanatory variable for an HbA1c decrease of ≥ 0.5%, and its odds ratio is 4.5 (1.40-17.6) (P = 0.01) against the high active GLP-1 group. This remains independent when adjusted for HbA1c level before administration, patients' medical history, medications, insulin secretion and insulin resistance. Plasma fasting active GLP-1 is an independent predictive marker for the efficacy of dipeptidyl peptidase 4 inhibitor sitagliptin.
Kang, Minyong; Lee, Jung Keun; Im, Young Jae; Choi, Hwang; Park, Kwanjin
2016-04-01
We delineated clinical features and determined predictors of chronic kidney disease during long-term postpubertal followup in patients with vesicoureteral reflux treated surgically. We analyzed the data of 101 patients who were surgically treated for vesicoureteral reflux and had gone through puberty. Patients underwent preoperative and postoperative voiding cystourethrography to assess reflux status, and dimercaptosuccinic acid scan to assess renal cortical defects. We compared several variables preoperatively and postpubertally, including body mass index; blood urea nitrogen, creatinine and uric acid levels; estimated glomerular filtration rate; microalbuminuria; blood pressure; renal function and renal scarring. Kaplan-Meier analysis was used to predict chronic kidney disease-free survival rates throughout the followup periods. Cox regression model was adopted to identify independent predictors of chronic kidney disease. We defined chronic kidney disease as estimated glomerular filtration rate less than 60 ml/minute/1.73 m(2). Median followup was 100.0 months (IQR 69.0 to 136.5). Median age was 16 years at last followup (IQR 14 to 18). A total of 11 patients (10.9%) were diagnosed with de novo chronic kidney disease during postpubertal followup. It is noteworthy that serum uric acid levels (HR 1.96) and presence of high grade reflux (HR 7.40) were significant predictors of chronic kidney disease on multivariate analysis. In children who were treated surgically for vesicoureteral reflux preoperative uric acid levels and high grade reflux were independent predictors of de novo chronic kidney disease during postpubertal followup. Our results offer valuable information for predicting long-term renal outcomes in patients with vesicoureteral reflux treated surgically. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Low T3 syndrome as a predictor of poor prognosis in chronic lymphocytic leukemia.
Gao, Rui; Chen, Rui-Ze; Xia, Yi; Liang, Jin-Hua; Wang, Li; Zhu, Hua-Yuan; Zhu Wu, Jia-; Fan, Lei; Li, Jian-Yong; Yang, Tao; Xu, Wei
2018-02-19
Low triiodothyronine (T3) state is associated with poor prognosis in critical acute and prolonged illness. However, the information on thyroid dysfunction and cancer is limited. The aim of our study was to evaluate the prognostic value of low T3 syndrome in chronic lymphocytic leukemia (CLL). Two hundred and fifty-eight patients with detailed thyroid hormone profile at CLL diagnosis were enrolled. Low T3 syndrome was defined by low free T3 (FT3) level accompanied by normal-to-low free tetraiodothyronine (FT4) and thyroid-stimulating hormone (TSH) levels. A propensity score-matched method was performed to balance the baseline characteristics. Multivariate Cox regression analyses screened the independent prognostic factors related to time-to-first-treatment (TTFT) and cancer-specific survival (CSS). Area under the curve (AUC) assessed the predictive accuracy of CLL-International Prognostic Index (IPI) together with low T3 syndrome. The results showed that 37 (14.34%) patients had low T3 syndrome, which was significantly associated with unfavorable TTFT and CSS in the propensity-matched cohort, and it was an independent prognostic indicator for both TTFT and CSS. Serum FT3 level was positively related to protein metabolism and anemia, and inversely related to inflammatory state. Patients with only low FT3 demonstrated better survival than those with synchronously low FT3 and FT4, while those with synchronously low FT3, FT4 and TSH had the worst clinical outcome. Low T3 syndrome together with CLL-IPI had larger AUCs compared with CLL-IPI alone in TTFT and CSS prediction. In conclusion, low T3 syndrome may be a good candidate for predicting prognosis in future clinical practice of CLL. © 2018 UICC.
A Distributed Approach to System-Level Prognostics
NASA Technical Reports Server (NTRS)
Daigle, Matthew J.; Bregon, Anibal; Roychoudhury, Indranil
2012-01-01
Prognostics, which deals with predicting remaining useful life of components, subsystems, and systems, is a key technology for systems health management that leads to improved safety and reliability with reduced costs. The prognostics problem is often approached from a component-centric view. However, in most cases, it is not specifically component lifetimes that are important, but, rather, the lifetimes of the systems in which these components reside. The system-level prognostics problem can be quite difficult due to the increased scale and scope of the prognostics problem and the relative Jack of scalability and efficiency of typical prognostics approaches. In order to address these is ues, we develop a distributed solution to the system-level prognostics problem, based on the concept of structural model decomposition. The system model is decomposed into independent submodels. Independent local prognostics subproblems are then formed based on these local submodels, resul ting in a scalable, efficient, and flexible distributed approach to the system-level prognostics problem. We provide a formulation of the system-level prognostics problem and demonstrate the approach on a four-wheeled rover simulation testbed. The results show that the system-level prognostics problem can be accurately and efficiently solved in a distributed fashion.
Mesquita, R; Gonçalves, C G; Hayashi, D; Costa, V de S P; Teixeira, D de C; de Freitas, E R F S; Felcar, J M; Pitta, F; Molari, M; Probst, V S
2015-03-01
To investigate the relationship between smoking status and exercise capacity, physical activity in daily life and health-related quality of life in physically independent, elderly (≥60 years) individuals. Cross-sectional, observational study. Community-dwelling, elderly individuals. One hundred and fifty-four elderly individuals were categorised into four groups according to their smoking status: never smokers (n=57), passive smokers (n=30), ex-smokers (n=45) and current smokers (n=22). Exercise capacity [6-minute walk test (6MWT)], physical activity in daily life (step counting) and health-related quality of life [36-Item Short Form Health Survey (SF-36) questionnaire] were assessed. Current and ex-smokers had lower mean exercise capacity compared with never smokers: 90 [standard deviation (SD) 10] % predicted, 91 (SD 12) % predicted and 100 (SD 13) % predicted distance on 6MWT, respectively [mean differences -9.8%, 95% confidence intervals (CI) -17.8 to -1.8 and -9.1%, 95% CI -15.4 to -2.7, respectively; P<0.05 for both]. The level of physical activity did not differ between the groups, but was found to correlate negatively with the level of nicotine dependence in current smokers (r=-0.47, P=0.03). The median score for the mental health dimension of SF-36 was worse in passive {72 [interquartile range (IQR) 56 to 96] points} and current [76 (IQR 55 to 80) points] smokers compared with ex-smokers [88 (IQR 70 to 100) points] (median differences -16 points, 95% CI -22.2 to -3.0 and -12 points, 95% CI -22.8 to -2.4, respectively; P<0.05 for both). Among elderly individuals, current smokers had lower exercise capacity than never smokers. Although the level of physical activity did not differ between the groups, an association was found with smoking. Tobacco exposure was associated with worse scores for the mental health dimension of SF-36 in physically independent, elderly individuals. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.
Pinder, John E; Rowan, David J; Rasmussen, Joseph B; Smith, Jim T; Hinton, Thomas G; Whicker, F W
2014-08-01
Data from published studies and World Wide Web sources were combined to produce and test a regression model to predict Cs concentration ratios for freshwater fish species. The accuracies of predicted concentration ratios, which were computed using 1) species trophic levels obtained from random resampling of known food items and 2) K concentrations in the water for 207 fish from 44 species and 43 locations, were tested against independent observations of ratios for 57 fish from 17 species from 25 locations. Accuracy was assessed as the percent of observed to predicted ratios within factors of 2 or 3. Conservatism, expressed as the lack of under prediction, was assessed as the percent of observed to predicted ratios that were less than 2 or less than 3. The model's median observed to predicted ratio was 1.26, which was not significantly different from 1, and 50% of the ratios were between 0.73 and 1.85. The percentages of ratios within factors of 2 or 3 were 67 and 82%, respectively. The percentages of ratios that were <2 or <3 were 79 and 88%, respectively. An example for Perca fluviatilis demonstrated that increased prediction accuracy could be obtained when more detailed knowledge of diet was available to estimate trophic level. Copyright © 2014 Elsevier Ltd. All rights reserved.
Janiszewski, Peter M; Janssen, Ian; Ross, Robert
2009-07-01
Erectile dysfunction (ED) is common among men with an elevated body mass index (BMI). However, a high waist circumference (WC) and low levels of physical activity may predict ED independently of BMI. We investigated the independent relationships between BMI, WC, and physical activity with ED. Subjects consisted of 3,941 adult men (age > or = 20 years) with no history of prostate cancer from the 2001-2004 National Health and Nutrition Examination Survey. Logistic regression analyses were used to examine the relative odds of ED association with categories of BMI, WC, and physical activity. Established thresholds were used to divide subjects into three WC and BMI categories. Physical activity level was divided into active (> or =150 min/week), moderately active (30-149 min/week), and inactive (<30 min/week) categories. A single survey question was used to assess the presence of ED. After control for potential confounders, men with either a high WC or an obese BMI had an approximately 50% higher odds of having ED compared with men with a low WC or a normal BMI, respectively. Further, moderately active or inactive men had an approximately 40-60% greater odds of ED compared with active men. When all three predictors (WC, BMI, and physical activity level) were entered into the same logistic regression model, both a high WC and low physical activity level (moderately active and inactive) were independently associated with a greater odds of ED, whereas BMI level was not. Maintaining a WC level below 102 cm and achieving the recommended amount of moderate-intensity physical activity (>or =150 min/week) is associated with the maintenance of proper erectile function, regardless of BMI level. These findings suggest that the clinical screening for ED risk should include the assessment of WC and physical activity level in addition to BMI.
Stürmer, Stefan; Benbow, Alison E F; Siem, Birte; Barth, Markus; Bodansky, Alexander N; Lotz-Schmitt, Katharina
2013-11-01
Building on an integration of research findings on intergroup behavior from multiple fields of scientific inquiry (biological and cultural paleoanthropology, social psychology), as well as research on the HEXACO personality framework (e.g., Ashton & Lee, 2007), 3 independent studies (total N = 1,007) were conducted to introduce and test a fresh personality perspective on human xenophilia. Even though the studies focused on different criteria (Study 1: favorable attitudes toward contact with immigrants, Study 2: habitual cross-cultural exploration, Study 3: favorable attitudes toward contact with indigenous people) and employed different operationalizations of major personality traits (the HEXACO Personality Inventory-Revised [HEXACO-PI-R], the 10-item Big Five Inventory [BFI-10]) results were remarkably similar. First, path analyses confirmed that major personality traits were significant and direct predictors of xenophilia that were independent of the contributions of individual differences commonly predicting xenophobic reactions across studies. Second, and in line with the authors' more specific hypotheses, hierarchical regression analyses also corroborated that individual differences in the levels of endeavor-related personality traits (i.e., eXtraversion, Openness, and Conscientiousness) had a substantially greater power in predicting individual differences in xenophilia than individual differences in levels of altruism/cooperation-related traits (i.e., Honesty-Humility, Emotionality, and Agreeableness). The implications of these findings for more general psychological theorizing on human sociality are discussed. PsycINFO Database Record (c) 2013 APA, all rights reserved
A Stress-Coping Model of Mental Illness Stigma: I. Predictors of Cognitive Stress Appraisal
Rüsch, Nicolas; Corrigan, Patrick W.; Wassel, Abigail; Michaels, Patrick; Olschewski, Manfred; Wilkniss, Sandra; Batia, Karen
2009-01-01
Stigma can be a major stressor for individuals with schizophrenia and other mental illnesses. It is unclear, however, why some stigmatized individuals appraise stigma as more stressful, while others feel they can cope with the potential harm posed by public prejudice. We tested the hypothesis that the level of perceived public stigma and personal factors such as rejection sensitivity, perceived legitimacy of discrimination and ingroup perceptions (group value; group identification; entitativity, or the perception of the ingroup of people with mental illness as a coherent unit) predict the cognitive appraisal of stigma as a stressor. Stigma stress appraisal refers to perceived stigma-related harm exceeding perceived coping resources. Stress appraisal, stress predictors and social cue recognition were assessed in 85 people with schizophrenia, schizoaffective or affective disorders. Stress appraisal did not differ between diagnostic subgroups, but was positively correlated with rejection sensitivity. Higher levels of perceived societal stigma and holding the group of people with mental illness in low regard (low group value) independently predicted high stigma stress appraisal. These predictors remained significant after controlling for social cognitive deficits, depressive symptoms and diagnosis. Our findings support the model that public and personal factors predict stigma stress appraisal among people with mental illness, independent of diagnosis and clinical symptoms. Interventions that aim to reduce the impact of stigma on people with mental illness could focus on variables such as rejection sensitivity, a personal vulnerability factor, low group value and the cognitive appraisal of stigma as a stressor. PMID:19269140
Noh, Hyunkyung; Chang, Eunbi; Jang, Yoojin; Lee, Ji Hae; Lee, Sang Min
2016-02-01
Statistical suppressor effects in prediction models can provide evidence of the interdependent relationship of independent variables. In this study, the suppressor effects of positive and negative religious coping on academic burnout were examined using longitudinal data. First, 388 middle school students reported their type of religion and use of positive and negative religious coping strategies. Four months later, they also reported their level of academic burnout. From structural equation modeling, significant suppressor effects were found among religious students. That is, the coefficients became larger when both positive and negative religious coping predicted academic burnout simultaneously, compared to when each religious coping predicted academic burnout alone. However, suppressor effects were not found among non-religious students.
Personality-Relationship transaction in young adulthood.
Neyer, F J; Asendorpf, J B
2001-12-01
Personality and social relationships were assessed twice across a 4-year period in a general population sample of 489 German young adults. Two kinds of personality-relationship transaction were observed. First, mean-level change in personality toward maturity (e.g., increase in Conscientiousness and decrease in Neuroticism) was moderated by the transition to partnership but was independent of other developmental transitions. Second, individual differences in personality traits predicted social relationships much better than vice versa. Specifically, once initial correlations were controlled for, Extraversion, Shyness, Neuroticism, self-esteem, and Agreeableness predicted change in various qualities of relationships (especially with friends and colleagues), whereas only quality of relationships with preschool children predicted later Extraversion and Neuroticism. Consequences for the transactional view of personality in young adulthood are discussed.
The importance of measuring growth in response to intervention models: Testing a core assumption✩
Schatschneider, Christopher; Wagner, Richard K.; Crawford, Elizabeth C.
2011-01-01
A core assumption of response to instruction or intervention (RTI) models is the importance of measuring growth in achievement over time in response to effective instruction or intervention. Many RTI models actively monitor growth for identifying individuals who need different levels of intervention. A large-scale (N=23,438), two-year longitudinal study of first grade children was carried out to compare the predictive validity of measures of achievement status, growth in achievement, and their combination for predicting future reading achievement. The results indicate that under typical conditions, measures of growth do not make a contribution to prediction that is independent of measures of achievement status. These results question the validity of a core assumption of RTI models. PMID:22224065
Larter, Maximilian; Dunbar-Wallis, Amy; Berardi, Andrea E; Smith, Stacey D
2018-06-07
The predictability of evolution, or whether lineages repeatedly follow the same evolutionary trajectories during phenotypic convergence remains an open question of evolutionary biology. In this study, we investigate evolutionary convergence at the biochemical pathway level and test the predictability of evolution using floral anthocyanin pigmentation, a trait with a well-understood genetic and regulatory basis. We reconstructed the evolution of floral anthocyanin content across 28 species of the Andean clade Iochrominae (Solanaceae) and investigated how shifts in pigmentation are related to changes in expression of 7 key anthocyanin pathway genes. We used phylogenetic multivariate analysis of gene expression to test for phenotypic and developmental convergence at a macroevolutionary scale. Our results show that the four independent losses of the ancestral pigment delphinidin involved convergent losses of expression of the three late pathway genes (F3'5'h, Dfr and Ans). Transitions between pigment types affecting floral hue (e.g. blue to red) involve changes to the expression of branching genes F3'h and F3'5'h, while the expression levels of early steps of the pathway are strongly conserved in all species. These patterns support the idea that the macroevolution of floral pigmentation follows predictable evolutionary trajectories to reach convergent phenotype space, repeatedly involving regulatory changes. This is likely driven by constraints at the pathway level, such as pleiotropy and regulatory structure.
Esteves, William A M; Lodi-Junqueira, Lucas; Neto, Cirilo P Fonseca; Tan, Timothy C; Nascimento, Bruno R; Mehrotra, Praveen; Barbosa, Marcia M; Ribeiro, Antonio Luiz P; Nunes, Maria Carmo P
2013-10-01
We aimed to explore the relationship between brain natriuretic peptide (BNP) levels and right ventricular (RV) function in patients with mitral stenosis (MS), and to investigate the hemodynamic parameters that predict reduction of BNP levels after percutaneous mitral valvuloplasty (PMV). Few studies have evaluated BNP in the context of MS, specifically the impact of the RV stroke work (RVSW) on serum BNP levels has not been defined. Thirty patients with symptomatic rheumatic MS in sinus rhythm who were referred for a PMV were enrolled. Right and left heart pressures were obtained before and after valvuloplasty. RVSW index (RVSWI) was calculated by cardiac catheterization. Basal BNP levels were elevated in MS patients and correlated with several hemodynamic parameters including pulmonary pressure, pulmonary vascular resistance index, cardiac index (CI), and RVSWI. In multivariate analysis, CI and RVSWI were independent predictors of raised basal BNP levels. PMV resulted in a significant decrease in the RVSWI with a concurrent increase in CI (2.4 ± 0.43 to 2.9 ± 0.8 L/min/m(2), P = 0.010). Overall, plasma BNP levels significantly decreased from 124 (63/234) to 73 (48/148) pg/ml postvalvuloplasty. Multivariate analysis revealed that the reduction of left atrial (LA) pressure post-PMV was an independent predictor of change in BNP levels. Elevated baseline BNP level in MS patients was independently associated with CI and RVSWI. Plasma BNP levels were reduced after successful PMV, which was associated with the reduction of the LA pressure. © 2013, Wiley Periodicals, Inc.
Structure-Based Predictions of Activity Cliffs
Husby, Jarmila; Bottegoni, Giovanni; Kufareva, Irina; Abagyan, Ruben; Cavalli, Andrea
2015-01-01
In drug discovery, it is generally accepted that neighboring molecules in a given descriptors' space display similar activities. However, even in regions that provide strong predictability, structurally similar molecules can occasionally display large differences in potency. In QSAR jargon, these discontinuities in the activity landscape are known as ‘activity cliffs’. In this study, we assessed the reliability of ligand docking and virtual ligand screening schemes in predicting activity cliffs. We performed our calculations on a diverse, independently collected database of cliff-forming co-crystals. Starting from ideal situations, which allowed us to establish our baseline, we progressively moved toward simulating more realistic scenarios. Ensemble- and template-docking achieved a significant level of accuracy, suggesting that, despite the well-known limitations of empirical scoring schemes, activity cliffs can be accurately predicted by advanced structure-based methods. PMID:25918827
Sonmez, Alper; Yilmaz, Mahmut Ilker; Saglam, Mutlu; Unal, Hilmi Umut; Gok, Mahmut; Cetinkaya, Hakki; Karaman, Murat; Haymana, Cem; Eyileten, Tayfun; Oguz, Yusuf; Vural, Abdulgaffar; Rizzo, Manfredi; Toth, Peter P
2015-04-16
Cardiovascular disease (CVD) risk is substantially increased in subjects with chronic kidney disease (CKD). The Triglycerides (TG) to High-Density Lipoprotein Cholesterol (HDL-C) ratio is an indirect measure of insulin resistance and an independent predictor of cardiovascular risk. No study to date has been performed to evaluate whether the TG/HDL-C ratio predicts CVD risk in patients with CKD. A total of 197 patients (age 53±12 years) with CKD Stages 1 to 5, were enrolled in this longitudinal, observational, retrospective study. TG/HDL-C ratio, HOMA-IR indexes, serum asymmetric dimethyl arginine (ADMA), high sensitivity C-reactive protein (CRP), parathyroid hormone (PTH), calcium, phosphorous, estimated glomerular filtration rate (eGFR), and albumin levels were measured. Flow mediated vasodilatation (FMD) of the brachial artery was assessed by using high-resolution ultrasonography. A total of 11 cardiovascular (CV) deaths and 43 nonfatal CV events were registered in a mean follow-up period of 30 (range 9 to 35) months. Subjects with TG/HDL-C ratios above the median values (>3.29) had significantly higher plasma ADMA, PTH, and phosphorous levels (p=0.04, p=0.02, p=0.01 respectively) and lower eGFR and FMD values (p=0.03, p<0.001 respectively). The TG/HDL-C ratio was an independent determinant of FMD (β=-0.25 p=0.02) along with TG, HDL-C, hsCRP, serum albumin, phosphate levels, systolic blood pressure, PTH, eGFR and the presence of diabetes mellitus. The TG/HDL-C ratio was also a significant independent determinant of cardiovascular outcomes [HR: 1.36 (1.11-1.67) (p=0.003)] along with plasma ADMA levels [HR: 1.31 (1.13-1.52) (p<0.001)] and a history of diabetes mellitus [HR: 4.82 (2.80-8.37) (p<0.001)]. This study demonstrates that the elevated TG/HDL-C ratio predicts poor CVD outcome in subjects with CKD. Being a simple, inexpensive, and reproducible marker of CVD risk, the TG/HDL-C ratio may emerge as a novel and reliable indicator among the many well-established markers of CVD risk in CKD. Clinical trial registration number and date: NCT02113462 / 10-04-2014.
Powell, J; Kitchen, N; Heslin, J; Greenwood, R
2002-01-01
Objectives: To investigate (1) the prevalence of various aspects of cognitive and psychosocial dysfunction, including post-traumatic stress symptoms, over nine months after subarachnoid haemorrhage (SAH); (2) whether SAH is preceded by increased life stress; (3) to what extent adverse outcomes may be predicted from preillness life stress, early neurological impairment, age, and sex; and (4) relations between emotional and functional outcomes. Methods: 52 patients with good neurological recovery after surgery for SAH were each matched for age, sex, and occupation with a healthy control participant. SAH patients were assessed three and nine months postdischarge on measures of cognitive functioning, mood, and social functioning. Objective stressors and subjective life change during the preceding year were rated retrospectively. Controls completed measures of mood and social functioning once only. Results: Compared with controls, SAH patients showed increased mood disturbance, subtle cognitive impairment, and abnormally low independence and participation on measures of social functioning. 60% showed clinically significant post-traumatic stress symptomatology (intrusive thoughts or avoidance of reminders) at three months and 30% at nine months. Independence in activities of daily living was greatly reduced in half to a third of the sample at both three and nine months. Productive employment was below the 10th percentile of the control group for 75% of patients at three months and for 56% at nine months; this outcome could not be predicted from selected demographic, premorbid, or clinical variables but dependence on others for organisational activities was predicted by impaired prose recall. Mood at nine months was strongly predicted by prior mental health problems, poor physical health, dysphasia, and impaired prose recall at three months. There was no evidence of an abnormally high level of stressful life events in the year before SAH, although patients rated their subjective level of stress in this period slightly more highly than did the control participants. Conclusions: These findings highlight the need for structured support and treatment after surgery for SAH to reduce persisting mood disturbance and increase independence and participation. PMID:12023423
Childhood bullying involvement predicts low-grade systemic inflammation into adulthood
Copeland, William E.; Wolke, Dieter; Lereya, Suzet Tanya; Shanahan, Lilly; Worthman, Carol; Costello, E. Jane
2014-01-01
Bullying is a common childhood experience that involves repeated mistreatment to improve or maintain one’s status. Victims display long-term social, psychological, and health consequences, whereas bullies display minimal ill effects. The aim of this study is to test how this adverse social experience is biologically embedded to affect short- or long-term levels of C-reactive protein (CRP), a marker of low-grade systemic inflammation. The prospective population-based Great Smoky Mountains Study (n = 1,420), with up to nine waves of data per subject, was used, covering childhood/adolescence (ages 9–16) and young adulthood (ages 19 and 21). Structured interviews were used to assess bullying involvement and relevant covariates at all childhood/adolescent observations. Blood spots were collected at each observation and assayed for CRP levels. During childhood and adolescence, the number of waves at which the child was bullied predicted increasing levels of CRP. Although CRP levels rose for all participants from childhood into adulthood, being bullied predicted greater increases in CRP levels, whereas bullying others predicted lower increases in CRP compared with those uninvolved in bullying. This pattern was robust, controlling for body mass index, substance use, physical and mental health status, and exposures to other childhood psychosocial adversities. A child’s role in bullying may serve as either a risk or a protective factor for adult low-grade inflammation, independent of other factors. Inflammation is a physiological response that mediates the effects of both social adversity and dominance on decreases in health. PMID:24821813
Childhood bullying involvement predicts low-grade systemic inflammation into adulthood.
Copeland, William E; Wolke, Dieter; Lereya, Suzet Tanya; Shanahan, Lilly; Worthman, Carol; Costello, E Jane
2014-05-27
Bullying is a common childhood experience that involves repeated mistreatment to improve or maintain one's status. Victims display long-term social, psychological, and health consequences, whereas bullies display minimal ill effects. The aim of this study is to test how this adverse social experience is biologically embedded to affect short- or long-term levels of C-reactive protein (CRP), a marker of low-grade systemic inflammation. The prospective population-based Great Smoky Mountains Study (n = 1,420), with up to nine waves of data per subject, was used, covering childhood/adolescence (ages 9-16) and young adulthood (ages 19 and 21). Structured interviews were used to assess bullying involvement and relevant covariates at all childhood/adolescent observations. Blood spots were collected at each observation and assayed for CRP levels. During childhood and adolescence, the number of waves at which the child was bullied predicted increasing levels of CRP. Although CRP levels rose for all participants from childhood into adulthood, being bullied predicted greater increases in CRP levels, whereas bullying others predicted lower increases in CRP compared with those uninvolved in bullying. This pattern was robust, controlling for body mass index, substance use, physical and mental health status, and exposures to other childhood psychosocial adversities. A child's role in bullying may serve as either a risk or a protective factor for adult low-grade inflammation, independent of other factors. Inflammation is a physiological response that mediates the effects of both social adversity and dominance on decreases in health.
Risk factors for deep venous thrombosis in women with ovarian cancer
Ebina, Yasuhiko; Uchiyama, Mihoko; Imafuku, Hitomi; Suzuki, Kaho; Miyahara, Yoshiya; Yamada, Hideto
2018-01-01
Abstract We aim to clarify the incidence of deep venous thrombosis (DVT) before treatment in women with ovarian cancer and identify risk factors for DVT. In this prospective study, 110 women underwent venous ultrasonography before cancer treatment and D-dimer levels were measured. We investigated factors predicting DVT by logistic regression. DVT was detected in 25 of 110 women (22.7%) and pulmonary thromboembolism was coexisted in 2 women (1.8%). A total of 21 women (84.4%) with DVT were asymptomatic. D-dimer levels in women with DVT (median, 10.9; range, <0.5–98.2 μg/mL) were significantly higher than those in women without DVT (2.0; <0.5–60.8 μg/mL; P < .01). When 10.9 μg/mL was used as a cutoff value for D-dimer levels to predict DVT, specificity, sensitivity, and positive and negative predictive values were 92.9%, 52.0%, 68.4%, and 86.8%, respectively. The multivariate analysis demonstrated that D-dimer level (odds ratio [OR], 19.7; 95% confidence interval [CI], 5.89–76.76) and clear cell histology (OR, 7.1; 95% CI, 2.12–25.67) were independent factors predicting DVT. Asymptomatic DVT occurred with great frequency before treatment in patients with ovarian cancer. High D-dimer level and clear cell pathology is associated with a higher DVT risk. PMID:29879062
Yang, Ding-Bo; Yu, Wen-Hua; Dong, Xiao-Qiao; Du, Quan; Shen, Yong-Feng; Zhang, Zu-Yong; Zhu, Qiang; Che, Zhi-Hao; Liu, Qun-Jie; Wang, Hao; Jiang, Li; Du, Yuan-Feng
2014-08-01
Higher plasma copeptin levels correlate with poor clinical outcomes after traumatic brain injury. Nevertheless, their links with acute traumatic coagulopathy and progressive hemorrhagic injury are unknown. Therefore, we aimed to investigate the relationship between plasma copeptin levels, acute traumatic coagulopathy and progressive hemorrhagic injury in patients with severe traumatic brain injury. We prospectively studied 100 consecutive patients presenting within 6h from head trauma. Progressive hemorrhagic injury was present when the follow-up computerized tomography scan reported any increase in size or number of the hemorrhagic lesion, including newly developed ones. Acute traumatic coagulopathy was defined as an activated partial thromboplastic time greater than 40s and/or international normalized ratio greater than 1.2 and/or a platelet count less than 120×10(9)/L. We measured plasma copeptin levels on admission using an enzyme-linked immunosorbent assay in a blinded fashion. In multivariate logistic regression analysis, plasma copeptin level emerged as an independent predictor of progressive hemorrhagic injury and acute traumatic coagulopathy. Using receiver operating characteristic curves, we calculated areas under the curve for progressive hemorrhagic injury and acute traumatic coagulopathy. The predictive performance of copeptin was similar to that of Glasgow Coma Scale score. However, copeptin did not obviously improve the predictive value of Glasgow Coma Scale score. Thus, copeptin may help in the prediction of progressive hemorrhagic injury and acute traumatic coagulopathy after traumatic brain injury. Copyright © 2014 Elsevier Inc. All rights reserved.
Kwon, Richard S; Young, Benjamin E; Marsteller, William F; Lawrence, Christopher; Wu, Bechien U; Lee, Linda S; Mullady, Daniel; Klibansky, David A; Gardner, Timothy B; Simeone, Diane M
2016-09-01
This study aimed to determine if the improved pain response to endoscopic retrograde cholangiopancreatogrphy (ERCP) and pancreatic stent placement (EPS) predicts pain response in patients with chronic pancreatitis after modified lateral pancreaticojejunostomy (LPJ). A multi-institutional, retrospective review of patients who underwent successful EPS before LPJ between 2001 and 2010 was performed. The primary outcome was narcotic independence (NI) within 2 months after ERCP or LPJ. A total of 31 narcotic-dependent patients with chronic pancreatitis underwent successful EPS before LPJ. Ten (32%) achieved post-LPJ NI (median follow-up, 8.5 months; interquartile range [IQR], 2-38 months). Eight (80%) of 10 patients with NI post-ERCP achieved NI post-LPJ. Two (10%) without NI post-ERCP achieved NI post-LPJ. Narcotic independence post-EPS was associated strongly with NI post-LPJ with an odds ratio of 38 (P = 0.0025) and predicted post-LPJ NI with a sensitivity, specificity, positive predictive value, and negative predictive value of 80%, 90.5%, 80%, and 90.5%, respectively. Narcotic independence after EPS is associated with NI after LPJ. Failure to achieve NI post-ERCP predicts failure to achieve NI post-LPJ. These results support the need for larger studies to confirm the predictive value of pancreatic duct stenting for better selection of chronic pancreatitis patients who will benefit from LPJ.
Hirasawa, Yosuke; Nakashima, Jun; Sugihara, Toru; Takizawa, Issei; Gondo, Tatsuo; Nakagami, Yoshihiro; Horiguchi, Yutaka; Ohno, Yoshio; Namiki, Kazunori; Ohori, Makoto; Tachibana, Masaaki
2017-02-01
Neutropenia is a major adverse event of docetaxel-based chemotherapy. The present study was undertaken to evaluate the incidence of neutropenia and to develop a nomogram for predicting Grade 4 neutropenia during the first cycle of docetaxel-based chemotherapy in patients with castration-resistant prostate cancer (CRPC). This study included 112 patients with CRPC treated with docetaxel-based systemic chemotherapy. We evaluated the incidence and risk factors for Grade 4 neutropenia in the first cycle of chemotherapy. Sixty-two of 112 patients (55.4%) developed Grade 4 neutropenia in the first cycle of docetaxel-based chemotherapy. There were significant differences in age, baseline white blood cell count, and baseline neutrophil count between patients with non-Grade 4 neutropenia and those with Grade 4 neutropenia in univariate analyses. The serum prostate-specific antigen level, hemoglobin level, creatinine, albumin, Eastern Cooperative Oncology Group performance status, metastatic sites, extent of disease, and history of external beam radiotherapy to the prostate were not significantly different between the 2 groups. Multivariate logistic regression analysis showed that age (odds ratio [OR], 1.08; P = .019) and baseline neutrophil counts (OR, 0.79; P = .045) were significant independent risk factors for severe neutropenia. A nomogram and a calibration plot on the basis of these results were developed from a multivariate logistic regression analysis to predict the probability of Grade 4 neutropenia. Age and baseline neutrophil counts were significant independent risk factors for Grade 4 neutropenia. The nomogram to predict it provides useful information for the management of patients with CRPC treated with docetaxel chemotherapy. Copyright © 2016 Elsevier Inc. All rights reserved.
Udachina, Alisa; Thewissen, Viviane; Myin-Germeys, Inez; Fitzpatrick, Sam; O'kane, Aisling; Bentall, Richard P
2009-09-01
Hypothesized relationships between experiential avoidance (EA), self-esteem, and paranoia were tested using structural equation modeling in a sample of student participants (N = 427). EA in everyday life was also investigated using the Experience Sampling Method in a subsample of students scoring high (N = 17) and low (N = 15) on paranoia. Results showed that paranoid students had lower self-esteem and reported higher levels of EA than nonparanoid participants. The interactive influence of EA and stress predicted negative self-esteem: EA was particularly damaging at high levels of stress. Greater EA and higher social stress independently predicted lower positive self-esteem. Low positive self-esteem predicted engagement in EA. A direct association between EA and paranoia was also found. These results suggest that similar mechanisms may underlie EA and thought suppression. Although people may employ EA to regulate self-esteem, this strategy is maladaptive as it damages self-esteem, incurs cognitive costs, and fosters paranoid thinking.
Trute, Barry; Hiebert-Murphy, Diane; Levine, Kathryn
2007-03-01
Parental positive and negative appraisals of the family impact of childhood disability are tested as early predictors of parental self-esteem and overall family adjustment in households with young children with intellectual and developmental disabilities. Within 103 Canadian families, 103 mothers and 55 fathers independently completed interviews in their home at two time points: 6 months after their child entered childhood disability services (T1), and one year later (T2). Longer-term family adjustment was found to be predicted by level of parental negative appraisal of the family impact of disability, and by level of self-esteem, for both mothers and fathers. For mothers, positive appraisal of childhood disability was also found to predict early family adjustment and was related to enhanced self-esteem. Gender differences in parental appraisal of the family impact of childhood disability appear to merge over time. Both positive and negative appraisals appear to coexist and are predictive of mothers' and fathers' perceived overall family adjustment in the longer term.
Pinder, John E; Rowan, David J; Smith, Jim T
2016-02-01
Data from published studies and World Wide Web sources were combined to develop a regression model to predict (137)Cs concentration ratios for saltwater fish. Predictions were developed from 1) numeric trophic levels computed primarily from random resampling of known food items and 2) K concentrations in the saltwater for 65 samplings from 41 different species from both the Atlantic and Pacific Oceans. A number of different models were initially developed and evaluated for accuracy which was assessed as the ratios of independently measured concentration ratios to those predicted by the model. In contrast to freshwater systems, were K concentrations are highly variable and are an important factor in affecting fish concentration ratios, the less variable K concentrations in saltwater were relatively unimportant in affecting concentration ratios. As a result, the simplest model, which used only trophic level as a predictor, had comparable accuracies to more complex models that also included K concentrations. A test of model accuracy involving comparisons of 56 published concentration ratios from 51 species of marine fish to those predicted by the model indicated that 52 of the predicted concentration ratios were within a factor of 2 of the observed concentration ratios. Copyright © 2015 Elsevier Ltd. All rights reserved.
Vaphiades, Michael S.; Kline, Lanning B.; McGwin, Gerald; Owsley, Cynthia; Shah, Ritu; Wood, Joanne M.
2014-01-01
Background. This study aimed to determine whether it is possible to predict driving safety of individuals with homonymous hemianopia or quadrantanopia based upon a clinical review of neuroimages that are routinely available in clinical practice. Methods. Two experienced neuroophthalmologists viewed a summary report of the CT/MRI scans of 16 participants with homonymous hemianopic or quadrantanopic field defects which indicated the site and extent of the lesion and they made predictions regarding whether participants would be safe/unsafe to drive. Driving safety was independently defined at the time of the study using state-recorded motor vehicle crashes (all crashes and at-fault) for the previous 5 years and ratings of driving safety determined through a standardized on-road driving assessment by a certified driving rehabilitation specialist. Results. The ability to predict driving safety was highly variable regardless of the driving safety measure, ranging from 31% to 63% (kappa levels ranged from −0.29 to 0.04). The level of agreement between the neuroophthalmologists was only fair (kappa = 0.28). Conclusions. Clinical evaluation of summary reports of currently available neuroimages by neuroophthalmologists is not predictive of driving safety. Future research should be directed at identifying and/or developing alternative tests or strategies to better enable clinicians to make these predictions. PMID:24683493
Vaphiades, Michael S; Kline, Lanning B; McGwin, Gerald; Owsley, Cynthia; Shah, Ritu; Wood, Joanne M
2014-01-01
Background. This study aimed to determine whether it is possible to predict driving safety of individuals with homonymous hemianopia or quadrantanopia based upon a clinical review of neuroimages that are routinely available in clinical practice. Methods. Two experienced neuroophthalmologists viewed a summary report of the CT/MRI scans of 16 participants with homonymous hemianopic or quadrantanopic field defects which indicated the site and extent of the lesion and they made predictions regarding whether participants would be safe/unsafe to drive. Driving safety was independently defined at the time of the study using state-recorded motor vehicle crashes (all crashes and at-fault) for the previous 5 years and ratings of driving safety determined through a standardized on-road driving assessment by a certified driving rehabilitation specialist. Results. The ability to predict driving safety was highly variable regardless of the driving safety measure, ranging from 31% to 63% (kappa levels ranged from -0.29 to 0.04). The level of agreement between the neuroophthalmologists was only fair (kappa = 0.28). Conclusions. Clinical evaluation of summary reports of currently available neuroimages by neuroophthalmologists is not predictive of driving safety. Future research should be directed at identifying and/or developing alternative tests or strategies to better enable clinicians to make these predictions.
Hutchinson, Jayne; White, Piran C L; Graham, Hilary
2014-12-01
To determine the social patterning of active travel of short journeys for urban and rural residents in a large UK representative sample. Associations between frequently walking or cycling short journeys and socio-demographic factors in the UK Household Longitudinal Study were determined using logistic regression. Urban residents were 64 % more likely to frequently engage in active travel than rural residents (95 % CI 1.52, 1.77). Being younger, male, without full-time employment and having a lower income independently predicted greater active travel for both urban and rural residents. Degree level education and not having children were independent predictors for urban, but not rural residents. Actively travelling short journeys is less common and independently associated with fewer socio-demographic factors in rural than in urban populations.
Baldwin, Keith D; Brusalis, Christopher M; Nduaguba, Afamefuna M; Sankar, Wudbhav N
2016-05-04
Differentiating between septic arthritis and Lyme disease of the knee in endemic areas can be challenging and has major implications for patient management. The purpose of this study was to identify a prediction rule to differentiate septic arthritis from Lyme disease in children presenting with knee pain and effusion. We retrospectively reviewed the records of patients younger than 18 years of age with knee effusions who underwent arthrocentesis at our institution from 2005 to 2013. Patients with either septic arthritis (positive joint fluid culture or synovial white blood-cell count of >60,000 white blood cells/mm(3) with negative Lyme titer) or Lyme disease (positive Lyme immunoglobulin G on Western blot analysis) were included. To avoid misclassification bias, undiagnosed knee effusions and joints with both a positive culture and positive Lyme titers were excluded. Historical, clinical, and laboratory data were compared between groups to identify variables for comparison. Binary logistic regression analysis was used to identify independent predictive variables. One hundred and eighty-nine patients were studied: 23 with culture-positive septic arthritis, 26 with culture-negative septic arthritis, and 140 with Lyme disease. Multivariate binary logistic regression identified pain with short arc motion, history of fever reported by the patient or a family member, C-reactive protein of >4 mg/L, and age younger than 2 years as independent predictive factors for septic arthritis. A simpler model was developed that showed that the risk of septic arthritis with none of these factors was 2%, with 1 of these factors was 18%, with 2 of these factors was 45%, with 3 of these factors was 84%, or with all 4 of these factors was 100%. Although septic arthritis of the knee and Lyme monoarthritis share common features that can make them difficult to distinguish clinically, the presence of pain with short arc motion, C-reactive protein of >4.0 mg/L, patient-reported history of fever, and age younger than 2 years were independent predictive factors of septic arthritis in pediatric patients. The more factors that are present, the higher the risk of having septic arthritis. Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.
Lansford, Jennifer E.; Criss, Michael M.; Laird, Robert D.; Shaw, Daniel S.; Pettit, Gregory S.; Bates, John E.; Dodge, Kenneth A.
2010-01-01
Using data from two long-term longitudinal projects, we investigated reciprocal relations between maternal reports of physical discipline and teacher and self ratings of child externalizing behavior, accounting for continuity in both discipline and externalizing over time. In Study 1, which followed a community sample of 562 boys and girls from age 6–9, high levels of physical discipline in a given year predicted high levels of externalizing behavior in the next year, and externalizing behavior in a given year predicted high levels of physical discipline in the next year. In Study 2, which followed an independent sample of 290 lower income, higher risk boys from age 10–15, mother-reported physical discipline in a given year predicted child ratings of antisocial behavior in the next year, but child antisocial behavior in a given year did not predict parents’ use of physical discipline in the next year. In neither sample was there evidence that associations between physical discipline and child externalizing changed as the child aged, and findings were not moderated by gender, race, socioeconomic status, or the severity of the physical discipline. Implications for the reciprocal nature of the socialization process and the risks associated with physical discipline are discussed. PMID:21262050
Lansford, Jennifer E; Criss, Michael M; Laird, Robert D; Shaw, Daniel S; Pettit, Gregory S; Bates, John E; Dodge, Kenneth A
2011-02-01
Using data from two long-term longitudinal projects, we investigated reciprocal relations between maternal reports of physical discipline and teacher and self-ratings of child externalizing behavior, accounting for continuity in both discipline and externalizing over time. In Study 1, which followed a community sample of 562 boys and girls from age 6 to 9, high levels of physical discipline in a given year predicted high levels of externalizing behavior in the next year, and externalizing behavior in a given year predicted high levels of physical discipline in the next year. In Study 2, which followed an independent sample of 290 lower income, higher risk boys from age 10 to 15, mother-reported physical discipline in a given year predicted child ratings of antisocial behavior in the next year, but child antisocial behavior in a given year did not predict parents' use of physical discipline in the next year. In neither sample was there evidence that associations between physical discipline and child externalizing changed as the child aged, and findings were not moderated by gender, race, socioeconomic status, or the severity of the physical discipline. Implications for the reciprocal nature of the socialization process and the risks associated with physical discipline are discussed.
Huang, Jui-Hua; Huang, Shu-Ling; Li, Ren-Hau; Wang, Ling-Hui; Chen, Yu-Ling; Tang, Feng-Cheng
2014-04-29
Workplace health promotion programs should be tailored according to individual needs and efficient intervention. This study aimed to determine the effects of nutrition and exercise health behaviors on predicted risk for cardiovascular disease (CVD) when body mass index (BMI) is considered. In total, 3350 Taiwanese workers were included in this cross-sectional study. A self-reported questionnaire was used to measure their nutrition and exercise behaviors. Data on anthropometric values, biochemical blood determinations, and predicted CVD risk (using the Framingham risk score) were collected. In multiple regression analyses, the nutrition behavior score was independently and negatively associated with CVD risk. Exercise was not significantly associated with the risk. However, the interactive effect of exercise and BMI on CVD risk was evident. When stratified by BMI levels, associations between exercise and CVD risk were statistically significant for ideal weight and overweight subgroups. In conclusion, nutrition behavior plays an important role in predicting the CVD risk. Exercise behavior is also a significant predictor for ideal weight and overweight workers. Notably, for underweight or obese workers, maintaining health-promoting exercise seems insufficient to prevent the CVD. In order to improve workers' cardiovascular health, more specific health-promoting strategies should be developed to suit the different BMI levels.
Lee, Chee Khoon; Davies, Lucy; Gebski, Val J; Lord, Sarah J; Di Leo, Angelo; Johnston, Stephen; Geyer, Charles; Cameron, David; Press, Michael F; Ellis, Catherine; Loi, Sherene; Marschner, Ian; Simes, John; de Souza, Paul
2016-03-20
We examined the prognostic and predictive value of serum human epidermal growth factor 2 (HER2) extracellular domain (sHER2) in patients with advanced breast cancer treated with lapatinib using data from three randomized trials. We analyzed sHER2 and tissue HER2 (tHER2) data from 1,902 patients (84%) who were randomly assigned to receive lapatinib or control in the trials EGF30001, EGF30008, and EGF100151. Cox regression analyses were performed to correlate both biomarkers with progression-free survival (PFS) and overall survival (OS). Median sHER2 levels were 25.1 and 10.1 ng/mL in tHER2-amplified (tHER-positive) and nonamplified (tHER-negative) populations, respectively (r = 0.42 for sHER2-tHER2 correlation). Lapatinib had significant PFS benefit over control (hazard ratio [HR], 0.855; P = .004), but not OS (HR, 0.941; P = .33). Lapatinib PFS benefit is independently predicted by higher sHER2 values (HR per 10-ng/mL increase in sHER2: lapatinib-containing therapies, 1.009 v nonlapatinib-containing therapies, 1.044; P(interaction) < .001) and by positive tHER2 (HR [lapatinib v nonlapatinib]: tHER2 positive, 0.638 v tHER2 negative, 0.940; P(interaction) = .001). Within the tHER2-positive subpopulation (n = 515), higher sHER2 values still independently predicted lapatinib PFS benefit (HR per 10-ng/mL increase in sHER2: lapatinib-containing therapies, 1.017 v nonlapatinib-containing therapies, 1.041; P(interaction) = .008). In control arms (n = 936), higher sHER2 was associated with worse prognosis in multivariable analyses (PFS HR per 10 ng/mL: PFS, 1.024; P < .001; and OS, 1.018; P < .001). Higher sHER2 predicts greater PFS benefit with lapatinib independent of tHER2 status. High sHER2 is also independently prognostic for worse survival in patients who received nonlapatinib-containing therapies. The predictive role of sHER2 for other anti-HER2 agents requires further research. © 2016 by American Society of Clinical Oncology.
Gross, Alden L; Rebok, George W; Unverzagt, Frederick W; Willis, Sherry L; Brandt, Jason
2011-09-01
The present study sought to predict changes in everyday functioning using cognitive tests. Data from the Advanced Cognitive Training for Independent and Vital Elderly trial were used to examine the extent to which competence in different cognitive domains--memory, inductive reasoning, processing speed, and global mental status--predicts prospectively measured everyday functioning among older adults. Coefficients of determination for baseline levels and trajectories of everyday functioning were estimated using parallel process latent growth models. Each cognitive domain independently predicts a significant proportion of the variance in baseline and trajectory change of everyday functioning, with inductive reasoning explaining the most variance (R2 = .175) in baseline functioning and memory explaining the most variance (R2 = .057) in changes in everyday functioning. Inductive reasoning is an important determinant of current everyday functioning in community-dwelling older adults, suggesting that successful performance in daily tasks is critically dependent on executive cognitive function. On the other hand, baseline memory function is more important in determining change over time in everyday functioning, suggesting that some participants with low baseline memory function may reflect a subgroup with incipient progressive neurologic disease.
Dynamic Model Predicting Overweight, Obesity, and Extreme Obesity Prevalence Trends
Thomas, Diana M.; Weedermann, Marion; Fuemmeler, Bernard F.; Martin, Corby K.; Dhurandhar, Nikhil V.; Bredlau, Carl; Heymsfield, Steven B.; Ravussin, Eric; Bouchard, Claude
2013-01-01
Objective Obesity prevalence in the United States (US) appears to be leveling, but the reasons behind the plateau remain unknown. Mechanistic insights can be provided from a mathematical model. The objective of this study is to model known multiple population parameters associated with changes in body mass index (BMI) classes and to establish conditions under which obesity prevalence will plateau. Design and Methods A differential equation system was developed that predicts population-wide obesity prevalence trends. The model considers both social and non-social influences on weight gain, incorporates other known parameters affecting obesity trends, and allows for country specific population growth. Results The dynamic model predicts that: obesity prevalence is a function of birth rate and the probability of being born in an obesogenic environment; obesity prevalence will plateau independent of current prevention strategies; and the US prevalence of obesity, overweight, and extreme obesity will plateau by about 2030 at 28%, 32%, and 9%, respectively. Conclusions The US prevalence of obesity is stabilizing and will plateau, independent of current preventative strategies. This trend has important implications in accurately evaluating the impact of various anti-obesity strategies aimed at reducing obesity prevalence. PMID:23804487
Reknes, Iselin; Einarsen, Ståle; Knardahl, Stein; Lau, Bjørn
2014-02-01
In line with the "Work environment hypothesis," role stressors have been proposed as important antecedents of bullying in the workplace. Only a few longitudinal studies on the relationship between role stressors and bullying exist, however, and earlier studies have largely been cross-sectional. The aim of the present prospective study was to determine whether role stressors at baseline predict new cases of workplace bullying at follow-up. A total of 2,835 Norwegian employees participated at both baseline and follow-up, with an interval of two years between the measurements. The study supports the hypotheses that role ambiguity and role conflict, independently, contribute to subsequent new reports of workplace bullying. However, there was a weak reverse effect: reporting being bullied at work at baseline predicted reporting increased levels of role ambiguity and role conflict at follow-up. Even though the results may indicate a circular relationship between the variables at hand, the weak reverse relationship seems to have little practical impact compared to the stronger relationship from role stressors to bullying. Hence, the results mainly support the hypotheses stating that role ambiguity and role conflict, independently, predict subsequent exposure to workplace bullying.
Predictors of symptom severity in patients with chronic prostatitis and interstitial cystitis.
Clemens, J Quentin; Brown, Sheila O; Kozloff, Lara; Calhoun, Elizabeth A
2006-03-01
Numerous studies have been performed to identify potential risk factors for CP/CPPS and IC. However, few studies have been done to identify predictors of disease severity. A total of 174 men with CP/CPPS and 111 women with IC completed questionnaires to quantify symptom severity and identify demographic, medical and psychosocial characteristics. Symptom severity was assessed with the National Institutes of Health CPSI in men, and the O'Leary-Sant ICSI and problem index in women. Univariate and multivariate analyses were performed to identify characteristics predictive of worse symptoms. The mean National Institutes of Health CPSI score in men was 15.32, and the mean O'Leary-Sant ICSI and problem index in women was 19.17. The most commonly reported comorbidities were allergies, sinusitis, erectile dysfunction and irritable bowel syndrome in men, and allergies, urinary incontinence, sinusitis and irritable bowel syndrome in women. In the 2 sexes self-reported urinary frequency and urgency, worse depression scores and lower education level were independent predictors of worse symptom severity. In men additional independent predictors were self-reported pelvic pain, fibromyalgia and previous heart attack, and in women an additional independent predictor was postmenopausal status. There are several common medical conditions associated with urological pelvic pain syndromes in men and women. Few of them were predictive of symptoms severity in this analysis. Self-reported pelvic pain symptoms, education and depression severity were the factors most strongly predictive of symptom severity in patients with CP/CPPS and IC.
Rosenthal, M P; Marquette, P A; Diamond, J J
1996-06-01
To examine whether medical students' levels of debt have an influence on selection of family practice careers, independent of other factors. Data from the Jefferson Longitudinal Study were analyzed for 1,350 graduates from the classes of 1987-1993 at Jefferson Medical College of Thomas Jefferson University; a focused analysis for 326 graduates from the classes of 1992 and 1993 was specifically performed to identify recent trends. A binary logistic regression equation was used to predict the probability of a graduate's entrance into a family practice residency based on first-year preference for family practice, income expectation, debt level, age, and gender. A high level of indebtedness (at least $75,000) was a significant independent predictor of specialty choice (away from family practice); first-year preference for family practice and income expectation were also significant independent predictors. Combining these three factors (debt, specialty preference, and income expectation) led to a greater than 12-fold difference in specialty selection of family practice. Notably, 36% of the students graduating in 1992-1993 had debts of at least $75,000, more than three times the percentage in the classes graduating in 1987-1989. High levels of debt had a significant negative effect on family practice specialty, choice among recent Jefferson graduates. An increase in the number of students with such debt carries strong implications for the selection of careers in family practice.
Jeong, Jong Cheol; Kim, Ji-Eun; Gu, Ja-Yoon; Yoo, Hyun Ju; Ryu, Ji Won; Kim, Dong Ki; Joo, Kwon Wook; Kim, Hyun Kyung
2016-01-01
Neutrophils can release the DNA-histone complex into circulation following exposure to inflammatory stimuli. This prospective study investigated whether the DNA-histone complex and other biomarkers could predict major cardiovascular adverse events (MACEs) in hemodialysis (HD) patients. The levels of circulating DNA-histone complexes, cell-free DNA, interleukin (IL)-6, and neutrophil elastase were measured in 60 HD patients and 28 healthy controls. MACE was assessed at 24 months. Uremic toxin-induced neutrophil released contents were measured in vitro. Compared with controls, HD patients showed higher levels of DNA-histone complexes and IL-6. The DNA-histone complex level was inversely associated with the Kt/V. In a multivariable Cox analysis, the high level of DNA-histone complexes was a significant independent predictor of MACE. The uremic toxins induced DNA-histone complex formation in normal neutrophils in vitro. The DNA-histone complex is a potentially useful marker to predict MACE in HD patients. Uremic toxins induced DNA-histone complex formation in vitro. © 2015 S. Karger AG, Basel.
Serum tenascin-C predicts severity and outcome of acute intracerebral hemorrhage.
Wang, Lin-Guo; Huangfu, Xue-Qin; Tao, Bo; Zhong, Guan-Jin; Le, Zhou-Di
2018-06-01
Tenascin-C is a matricellular protein related to brain injury. We studied serum tenascin-C in acute intracerebral hemorrhage (ICH) and examined the associations with severity and outcome following the acute event. Tenascin-C samples were obtained from 162 patients with acute hemorrhagic stroke and 162 healthy controls. Poor 90-day functional outcome was defined as modified Rankin Scale score > 2. Early neurological deterioration (END) and hematoma growth (HG) were recorded at 24 h. Patients had higher tenascin-C levels than controls. Tenascin-C levels were positively correlated with hematoma volume or National Institutes of Health Stroke Scale score at baseline. Elevated tenascin-C levels were independently associated with END, HG, 90-day mortality and poor functional outcome. Moreover, tenascin-C levels significantly predicted END, HG and 90-day outcomes under receiver operating characteristic curves. An increase in serum tenascin-C level is associated with an adverse outcome in ICH patients, supporting the potential role of serum tenascin-C as a prognostic biomarker for hemorrhagic stroke. Copyright © 2018 Elsevier B.V. All rights reserved.
Independent data validation of an in vitro method for ...
In vitro bioaccessibility assays (IVBA) estimate arsenic (As) relative bioavailability (RBA) in contaminated soils to improve the accuracy of site-specific human exposure assessments and risk calculations. For an IVBA assay to gain acceptance for use in risk assessment, it must be shown to reliably predict in vivo RBA that is determined in an established animal model. Previous studies correlating soil As IVBA with RBA have been limited by the use of few soil types as the source of As. Furthermore, the predictive value of As IVBA assays has not been validated using an independent set of As-contaminated soils. Therefore, the current study was undertaken to develop a robust linear model to predict As RBA in mice using an IVBA assay and to independently validate the predictive capability of this assay using a unique set of As-contaminated soils. Thirty-six As-contaminated soils varying in soil type, As contaminant source, and As concentration were included in this study, with 27 soils used for initial model development and nine soils used for independent model validation. The initial model reliably predicted As RBA values in the independent data set, with a mean As RBA prediction error of 5.3% (range 2.4 to 8.4%). Following validation, all 36 soils were used for final model development, resulting in a linear model with the equation: RBA = 0.59 * IVBA + 9.8 and R2 of 0.78. The in vivo-in vitro correlation and independent data validation presented here provide
Kubo, Sachimi; Kitamura, Akihiko; Imano, Hironori; Cui, Renzhe; Yamagishi, Kazumasa; Umesawa, Mitsumasa; Muraki, Isao; Kiyama, Masahiko; Okada, Takeo
2016-01-01
Aim: It is important to explore predictive markers other than conventional cardiovascular risk factors for early detection and treatment of chronic kidney disease (CKD), a major risk factor for end-stage renal failure. We hypothesized that serum albumin and high-sensitivity C-reactive protein (hs-CRP) to be independent markers, and examined their associations with the risk of CKD. Methods: We examined the associations of serum albumin and hs-CRP levels with the risk of incident CKD, in 2535 Japanese adults aged 40–69 years without CKD at baseline during a median 9.0-year follow-up after adjustment for known cardiovascular risk factors. Results: During the follow-up period, 367 cases of CKD developed. In multivariable analyses adjusted for known risk factors, the CKD hazard ratios (95% confidence intervals) for the highest versus lowest quartiles of serum albumin levels were 0.69 (0.40–1.17) for men and 0.42 (0.28–0.64) for women. Corresponding values for hs-CRP were 0.95 (0.54–1.67) for men and 1.85 (1.25 -2.75) for women. The association of combined serum albumin and hs-CRP with the risk of CKD was examined for women. The hazard ratio was 1.72 (1.17–2.54) for low versus higher albumin levels at lower hs-CRP levels, but such an association was not observed at high hs-CRP level. The hazard ratio was 1.96 (1.44–2.66) for high versus lower hs-CRP levels at higher serum albumin levels, but such association was not observed at low serum albumin level. Conclusion: Both low serum albumin and high hs-CRP levels were predictive of CKD for women. PMID:26911856
Which employment interview skills best predict the employability of schizophrenic patients?
Charisiou, J; Jackson, H J; Boyle, G J; Burgess, P M; Minas, I H; Joshua, S D
1989-06-01
To examine the effects of verbal and nonverbal interview microbehaviors and interview characteristics on employability, Simulated Employment Interviews were conducted with 46 psychiatric inpatients who each met the DSM-III criteria for a diagnosis of schizophrenia. Each interview was videotaped and shown to two raters, who generated independent ratings for six microbehaviors (eye-contact, facial gestures, body posture, verbal content, voice volume, and length of speech) and six subject characteristics (motivation, self-confidence, ability to communicate, manifest adjustment, manifest intelligence and overall interview skill). A panel of three Commonwealth Employment Service psychologists viewed the same videotaped interviews and generated employability ratings. Verbal and nonverbal microbehaviors were relatively independent while subject characteristics were highly interdependent. Microbehaviors and characteristics correlated at a high level. Of the 12 interview microbehaviors and characteristics, manifest adjustment and ability to communicate accounted for 64% of the total variance in predicting employability. Interviewees who were perceived as behaving in an adjusted manner and as being good communicators were rated as more employable.
Desire thinking: A risk factor for binge eating?
Spada, Marcantonio M; Caselli, Gabriele; Fernie, Bruce A; Manfredi, Chiara; Boccaletti, Fabio; Dallari, Giulia; Gandini, Federica; Pinna, Eleonora; Ruggiero, Giovanni M; Sassaroli, Sandra
2015-08-01
In the current study we explored the role of desire thinking in predicting binge eating independently of Body Mass Index, negative affect and irrational food beliefs. A sample of binge eaters (n=77) and a sample of non-binge eaters (n=185) completed the following self-report instruments: Hospital Anxiety and Depression Scale, Irrational Food Beliefs Scale, Desire Thinking Questionnaire, and Binge Eating Scale. Mann-Whitney U tests revealed that all variable scores were significantly higher for binge eaters than non-binge eaters. A logistic regression analysis indicated that verbal perseveration was a predictor of classification as a binge eater over and above Body Mass Index, negative affect and irrational food beliefs. A hierarchical regression analysis, on the combined sample, indicated that verbal perseveration predicted levels of binge eating independently of Body Mass Index, negative affect and irrational food beliefs. These results highlight the possible role of desire thinking as a risk factor for binge eating. Copyright © 2015 Elsevier Ltd. All rights reserved.
Sánchez-Rodríguez, Ángel; Willis, Guillermo B; Rodríguez-Bailón, Rosa
2017-07-03
Previous research has shown that economic inequality influences how people are related with others. In this article, we suggest that perceived economic inequality influences self-construal. Specifically, we propose that higher economic inequality leads to an independent self-construal, whereas lower economic inequality leads to an interdependent self-construal. Correlational data from Studies 1a and 1b revealed that people who perceive lower levels of economic inequality tend to show higher levels of interdependent self-construal, even after controlling for social class. In Study 2, using an experimental design, we found that perceived high economic inequality leads to a more independent and less interdependent self-construal compared to the low economic inequality condition. These results expand the literature bridging the gap between a macro-social factor, such as economic inequality, and a micro-social factor, such as self-construal. © 2017 International Union of Psychological Science.
Kim, Hyunsoo; Yu, Su Jong; Yeo, Injun; Cho, Young Youn; Lee, Dong Hyeon; Cho, Yuri; Cho, Eun Ju; Lee, Jeong-Hoon; Kim, Yoon Jun; Lee, Sungyoung; Jun, Jongsoo; Park, Taesung; Yoon, Jung-Hwan; Kim, Youngsoo
2017-07-01
Sorafenib is the only standard treatment for unresectable hepatocellular carcinoma (HCC), but it provides modest survival benefits over placebo, necessitating predictive biomarkers of the response to sorafenib. Serum samples were obtained from 115 consecutive patients with HCC before sorafenib treatment and analyzed by multiple reaction monitoring-mass spectrometry (MRM-MS) and ELISA to quantify candidate biomarkers. We verified a triple-marker panel to be predictive of the response to sorafenib by MRM-MS, comprising CD5 antigen-like (CD5L), immunoglobulin J (IGJ), and galectin-3-binding protein (LGALS3BP), in HCC patients. This panel was a significant predictor (AUROC > 0.950) of the response to sorafenib treatment, having the best cut-off value (0.4) by multivariate analysis. In the training set, patients who exceeded this cut-off value had significantly better overall survival (median, 21.4 months) than those with lower values (median, 8.6 months; p = 0.001). Further, a value that was lower than this cutoff was an independent predictor of poor overall survival [hazard ratio (HR), 2.728; 95% confidence interval (CI), 1.312-5.672; p = 0.007] and remained an independent predictive factor of rapid progression (HR, 2.631; 95% CI, 1.448-4.780; p = 0.002). When applied to the independent validation set, levels of the cut-off value for triple-marker panel maintained their prognostic value for poor clinical outcomes. On the contrast, the triple-marker panel was not a prognostic factor for patients who were treated with transarterial chemoembolization (TACE). The discriminatory signature of a triple-marker panel provides new insights into targeted proteomic biomarkers for individualized sorafenib therapy. © 2017 by The American Society for Biochemistry and Molecular Biology, Inc.
Latent fluctuation periods and long-term forecasting of the level of Markakol lake
NASA Astrophysics Data System (ADS)
Madibekov, A. S.; Babkin, A. V.; Musakulkyzy, A.; Cherednichenko, A. V.
2018-01-01
The analysis of time series of the level of Markakol Lake by the method of “Periodicities” reveals in its variations the harmonics with the periods of 12 and 14 years, respectively. The verification forecasts of the lake level by the trend tendency and by its combination with these sinusoids were computed with the lead time of 5 and 10 years. The estimation of the forecast results by the new independent data permitted to conclude that forecasts by the combination of the sinusoids and trend tendency are better than by the trend tendency only. They are no worse than the mean value prediction.
Huang, Wei Ying; Liu, Fei; Liu, Shu Shen; Ge, Hui Lin; Chen, Hong Han
2011-09-01
The predictions of mixture toxicity for chemicals are commonly based on two models: concentration addition (CA) and independent action (IA). Whether the CA and IA can predict mixture toxicity of phenolic compounds with similar and dissimilar action mechanisms was studied. The mixture toxicity was predicted on the basis of the concentration-response data of individual compounds. Test mixtures at different concentration ratios and concentration levels were designed using two methods. The results showed that the Weibull function fit well with the concentration-response data of all the components and their mixtures, with all relative coefficients (Rs) greater than 0.99 and root mean squared errors (RMSEs) less than 0.04. The predicted values from CA and IA models conformed to observed values of the mixtures. Therefore, it can be concluded that both CA and IA can predict reliable results for the mixture toxicity of the phenolic compounds with similar and dissimilar action mechanisms. Copyright © 2011 Elsevier Inc. All rights reserved.
More than maths and mindreading: sex differences in empathizing/systemizing covariance.
Valla, Jeffrey M; Ganzel, Barbara L; Yoder, Keith J; Chen, Grace M; Lyman, Laura T; Sidari, Anthony P; Keller, Alex E; Maendel, Jeffrey W; Perlman, Jordan E; Wong, Stephanie K L; Belmonte, Matthew K
2010-08-01
Empathizing-Systemizing theory posits a continuum of cognitive traits extending from autism into normal cognitive variation. Covariance data on empathizing and systemizing traits have alternately suggested inversely dependent, independent, and sex-dependent (one sex dependent, the other independent) structures. A total of 144 normal undergraduates (65 men, 79 women) completed the Reading the Mind in the Eyes, Embedded Figures, and Benton face recognition tests, the Autism Spectrum Quotient, and measures of digit length ratio and field of study; some also completed tests of motion coherence threshold (64) and go/no-go motor inhibition (128). Empathizing and systemizing traits were independent in women, but largely dependent in men. In men, level of systemizing skill required by field of study was directly related to social interactive and mindreading deficits; men's social impairments correlated with prolonged go/no-go response times, and men tended to apply systemizing strategies to solve problems of empathizing or global processing: rapid perceptual disembedding predicted heightened sensitivity to facial emotion. In women, level of systemizing in field was related to male-typical digit ratios and autistic superiorities in detail orientation, but not to autistic social and communicative impairments; and perceptual disembedding was related to social interactive skills but independent of facial emotion and visual motion perception.
Luoma, Pekka; Natschläger, Thomas; Malli, Birgit; Pawliczek, Marcin; Brandstetter, Markus
2018-05-12
A model recalibration method based on additive Partial Least Squares (PLS) regression is generalized for multi-adjustment scenarios of independent variance sources (referred to as additive PLS - aPLS). aPLS allows for effortless model readjustment under changing measurement conditions and the combination of independent variance sources with the initial model by means of additive modelling. We demonstrate these distinguishing features on two NIR spectroscopic case-studies. In case study 1 aPLS was used as a readjustment method for an emerging offset. The achieved RMS error of prediction (1.91 a.u.) was of similar level as before the offset occurred (2.11 a.u.). In case-study 2 a calibration combining different variance sources was conducted. The achieved performance was of sufficient level with an absolute error being better than 0.8% of the mean concentration, therefore being able to compensate negative effects of two independent variance sources. The presented results show the applicability of the aPLS approach. The main advantages of the method are that the original model stays unadjusted and that the modelling is conducted on concrete changes in the spectra thus supporting efficient (in most cases straightforward) modelling. Additionally, the method is put into context of existing machine learning algorithms. Copyright © 2018 Elsevier B.V. All rights reserved.
Oliveira, Ricardo; Krauss, Margot; Essama-Bibi, Suzanne; Hofer, Cristina; Harris, D. Robert; Tiraboschi, Adriana; de Souza, Ricardo; Marques, Heloisa; Succi, Regina; Abreu, Thalita; Della Negra, Marinella; Hazra, Rohan; Mofenson, Lynne M.; Siberry, George K.
2010-01-01
Background. Many resource-limited countries rely on clinical and immunological monitoring without routine virological monitoring for human immunodeficiency virus (HIV)-infected children receiving highly active antiretroviral therapy (HAART). We assessed whether HIV load had independent predictive value in the presence of immunological and clinical data for the occurrence of new World Health Organization (WHO) stage 3 or 4 events (hereafter, WHO events) among HIV-infected children receiving HAART in Latin America. Methods. The NISDI (Eunice Kennedy Shriver National Institute of Child Health and Human Development International Site Development Initiative) Pediatric Protocol is an observational cohort study designed to describe HIV-related outcomes among infected children. Eligibility criteria for this analysis included perinatal infection, age <15 years, and continuous HAART for ≥6 months. Cox proportional hazards modeling was used to assess time to new WHO events as a function of immunological status, viral load, hemoglobin level, and potential confounding variables; laboratory tests repeated during the study were treated as time-varying predictors. Results. The mean duration of follow-up was 2.5 years; new WHO events occurred in 92 (15.8%) of 584 children. In proportional hazards modeling, most recent viral load >5000 copies/mL was associated with a nearly doubled risk of developing a WHO event (adjusted hazard ratio, 1.81; 95% confidence interval, 1.05–3.11; P = .033), even after adjustment for immunological status defined on the basis of CD4 T lymphocyte value, hemoglobin level, age, and body mass index. Conclusions. Routine virological monitoring using the WHO virological failure threshold of 5000 copies/mL adds independent predictive value to immunological and clinical assessments for identification of children receiving HAART who are at risk for significant HIV-related illness. To provide optimal care, periodic virological monitoring should be considered for all settings that provide HAART to children. PMID:21039218
Nie, Zhi; Vairavan, Srinivasan; Narayan, Vaibhav A; Ye, Jieping; Li, Qingqin S
2018-01-01
Identification of risk factors of treatment resistance may be useful to guide treatment selection, avoid inefficient trial-and-error, and improve major depressive disorder (MDD) care. We extended the work in predictive modeling of treatment resistant depression (TRD) via partition of the data from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) cohort into a training and a testing dataset. We also included data from a small yet completely independent cohort RIS-INT-93 as an external test dataset. We used features from enrollment and level 1 treatment (up to week 2 response only) of STAR*D to explore the feature space comprehensively and applied machine learning methods to model TRD outcome at level 2. For TRD defined using QIDS-C16 remission criteria, multiple machine learning models were internally cross-validated in the STAR*D training dataset and externally validated in both the STAR*D testing dataset and RIS-INT-93 independent dataset with an area under the receiver operating characteristic curve (AUC) of 0.70-0.78 and 0.72-0.77, respectively. The upper bound for the AUC achievable with the full set of features could be as high as 0.78 in the STAR*D testing dataset. Model developed using top 30 features identified using feature selection technique (k-means clustering followed by χ2 test) achieved an AUC of 0.77 in the STAR*D testing dataset. In addition, the model developed using overlapping features between STAR*D and RIS-INT-93, achieved an AUC of > 0.70 in both the STAR*D testing and RIS-INT-93 datasets. Among all the features explored in STAR*D and RIS-INT-93 datasets, the most important feature was early or initial treatment response or symptom severity at week 2. These results indicate that prediction of TRD prior to undergoing a second round of antidepressant treatment could be feasible even in the absence of biomarker data.
Preoperative frailty assessment predicts loss of independence after vascular surgery.
Donald, Graham W; Ghaffarian, Amir A; Isaac, Farid; Kraiss, Larry W; Griffin, Claire L; Smith, Brigitte K; Sarfati, Mark R; Beckstrom, Julie L; Brooke, Benjamin S
2018-05-14
Frailty, a clinical syndrome associated with loss of metabolic reserves, is prevalent among patients who present to vascular surgery clinics for evaluation. The Clinical Frailty Scale (CFS) is a rapid assessment method shown to be highly specific for identifying frail patients. In this study, we sought to evaluate whether the preoperative CFS score could be used to predict loss of independence after major vascular procedures. We identified all patients living independently at home who were prospectively assessed using the CFS before undergoing an elective major vascular surgery procedure (admitted for >24 hours) at an academic medical center between December 2015 and December 2017. Patient- and procedure-level clinical data were obtained from our institutional Vascular Quality Initiative registry database. The composite outcome of discharge to a nonhome location or 30-day mortality was evaluated using bivariate and multivariate regression models. A total of 134 independent patients were assessed using the CFS before they underwent elective open abdominal aortic aneurysm repair (8%), endovascular aneurysm repair (26%), thoracic endovascular aortic repair (6%), suprainguinal bypass (6%), infrainguinal bypass (16%), carotid endarterectomy (19%), or peripheral vascular intervention (20%). Among 39 (29%) individuals categorized as being frail using the CFS, there was no significant difference in age or ASA physical status compared with nonfrail patients. However, frail patients were significantly more likely to need mobility assistance after surgery (62% frail vs 22% nonfrail; P < .01) and to be discharged to a nonhome location (22% frail vs 6% nonfrail; P = .01) or to die within 30 days after surgery (8% frail vs 0% nonfrail; P < .01). Preoperative frailty was associated with a >12-fold higher risk (odds ratio, 12.1; 95% confidence interval, 2.17-66.96; P < .01) of 30-day mortality or loss of independence, independent of the vascular procedure undertaken. The CFS is a practical tool for assessing preoperative frailty among patients undergoing elective major vascular surgery and can be used to predict likelihood of requiring discharge to a nursing facility or death after surgery. The identification of frail patients before major surgery can help manage postoperative expectations and optimize transitions of care. Published by Elsevier Inc.
Hung, Ming-Jui; Hsu, Kuang-Hung; Hu, Wei-Syun; Chang, Nen-Chung; Hung, Ming-Yow
2013-01-01
While hypertension is negatively associated with coronary artery spasm (CAS), scarce data are available on diabetes mellitus in relation to CAS. In addition, outcome prediction in patients with CAS is challenging due to the lack of appropriate biomarkers. Therefore, we sought to identify the roles that gender, high-sensitivity C-reactive protein (hs-CRP), diabetes mellitus and hypertension play in CAS development and prognosis. Patients (350 women and 547 men) undergoing diagnostic coronary angiography with or without proven CAS but without obstructive stenosis were evaluated at long-term follow-up (median 102 months). Diabetic women and diabetic men with low hs-CRP levels had a low and high risk of CAS (odds ratio [OR]: 0.16, 95% confidence interval [CI]: 0.01-1.88 and OR: 5.02, 95% CI: 1.03-24.54, respectively). The ORs of CAS in both women and men with the highest hs-CRP tertile (>3 mg/L) reduced from 4.41 to 1.45 and 2.98 to 1.52, respectively, if they had diabetes mellitus, and from 9.68 to 2.43 and 2.60 to 1.75, respectively, if they had hypertension. Hypertension had a more negative effect on CAS development in diabetic than non-diabetic women, which was not observed in men. The highest hs-CRP tertile was an independent predictor of adverse outcomes. Patients with the highest hs-CRP tertile had more coronary events than patients with the lowest hs-CRP tertitle (p = 0.021, log-rank test). Diabetes mellitus contributes to CAS development in men with low hs-CRP levels, but not in women. There are negative effects of diabetes mellitus and hypertension on CAS development in patients with high hs-CRP levels and especially in women. Elevated hs-CRP level independently predicts adverse outcomes.
Representing northern peatland microtopography and hydrology within the Community Land Model
Shi, Xiaoying; Thornton, Peter E.; Ricciuto, Daniel M.; ...
2015-11-12
Predictive understanding of northern peatland hydrology is a necessary precursor to understanding the fate of massive carbon stores in these systems under the influence of present and future climate change. Current models have begun to address microtopographic controls on peatland hydrology, but none have included a prognostic calculation of peatland water table depth for a vegetated wetland, independent of prescribed regional water tables. We introduce here a new configuration of the Community Land Model (CLM) which includes a fully prognostic water table calculation for a vegetated peatland. Our structural and process changes to CLM focus on modifications needed to representmore » the hydrologic cycle of bogs environment with perched water tables, as well as distinct hydrologic dynamics and vegetation communities of the raised hummock and sunken hollow microtopography characteristic of peatland bogs. The modified model was parameterized and independently evaluated against observations from an ombrotrophic raised-dome bog in northern Minnesota (S1-Bog), the site for the Spruce and Peatland Responses Under Climatic and Environmental Change experiment (SPRUCE). Simulated water table levels compared well with site-level observations. The new model predicts hydrologic changes in response to planned warming at the SPRUCE site. At present, standing water is commonly observed in bog hollows after large rainfall events during the growing season, but simulations suggest a sharp decrease in water table levels due to increased evapotranspiration under the most extreme warming level, nearly eliminating the occurrence of standing water in the growing season. Simulated soil energy balance was strongly influenced by reduced winter snowpack under warming simulations, with the warming influence on soil temperature partly offset by the loss of insulating snowpack in early and late winter. Furthermore, the new model provides improved predictive capacity for seasonal hydrological dynamics in northern peatlands, and provides a useful foundation for investigation of northern peatland carbon exchange.« less
Representing northern peatland microtopography and hydrology within the Community Land Model
Shi, X.; Thornton, P. E.; Ricciuto, D. M.; ...
2015-02-20
Predictive understanding of northern peatland hydrology is a necessary precursor to understanding the fate of massive carbon stores in these systems under the influence of present and future climate change. Current models have begun to address microtopographic controls on peatland hydrology, but none have included a prognostic calculation of peatland water table depth for a vegetated wetland, independent of prescribed regional water tables. We introduce here a new configuration of the Community Land Model (CLM) which includes a fully prognostic water table calculation for a vegetated peatland. Our structural and process changes to CLM focus on modifications needed to representmore » the hydrologic cycle of bogs environment with perched water tables, as well as distinct hydrologic dynamics and vegetation communities of the raised hummock and sunken hollow microtopography characteristic of peatland bogs. The modified model was parameterized and independently evaluated against observations from an ombrotrophic raised-dome bog in northern Minnesota (S1-Bog), the site for the Spruce and Peatland Responses Under Climatic and Environmental Change experiment (SPRUCE). Simulated water table levels compared well with site-level observations. The new model predicts significant hydrologic changes in response to planned warming at the SPRUCE site. At present, standing water is commonly observed in bog hollows after large rainfall events during the growing season, but simulations suggest a sharp decrease in water table levels due to increased evapotranspiration under the most extreme warming level, nearly eliminating the occurrence of standing water in the growing season. Simulated soil energy balance was strongly influenced by reduced winter snowpack under warming simulations, with the warming influence on soil temperature partly offset by the loss of insulating snowpack in early and late winter. The new model provides improved predictive capacity for seasonal hydrological dynamics in northern peatlands, and provides a useful foundation for investigation of northern peatland carbon exchange.« less
Ekblom-Bak, Elin; Hellénius, Mai-Lis; Ekblom, Orjan; Engström, Lars-Magnus; Ekblom, Björn
2010-04-01
Uncertainty still exists whether physical activity (PA) and cardiovascular fitness (CF) contribute separately to cardiovascular disease (CVD) risk. This study examined the associations of PA and CF on individual as well as clustered CVD risk factors. Cross-sectional. Seven hundred and eighty-one men and 890 women, aged 20-65 years, from two random population-based samples of Swedish women and men were included. PA was assessed by questionnaire and CF was predicted by a submaximal cycle ergometry test. Waist circumference, blood pressure, and fasting levels of blood lipids were assessed and dichotomized by conventional cut-off points. Participants reporting high PA level benefited from lower triglycerides and atherogenic cholesterol levels, regardless of CF. Higher CF level was, regardless of PA, associated with lower risk for all risk factors. With regard to clustering of risk factors, each higher CF level was associated with a gradually reduced risk by half or more, independent of PA. Furthermore, being unfit but reporting high PA was associated with a 50% lower risk compared with being unfit and inactive. Furthermore, high reported PA was associated with an additional reduced risk among fit participants. In addition, an excess risk of interaction was found for waist circumference, triglycerides, and the clustered CVD risk between neither being sufficiently active nor being fit. This study suggests that both PA and CF are independently associated with lower cardiovascular risk, and that both variables should be taken into account when CVD risk is estimated.
Kitayama, Shinobu; King, Anthony; Yoon, Carolyn; Tompson, Steve; Huff, Sarah; Liberzon, Israel
2014-06-01
Prior research suggests that cultural groups vary on an overarching dimension of independent versus interdependent social orientation, with European Americans being more independent, or less interdependent, than Asians. Drawing on recent evidence suggesting that the dopamine D4 receptor gene (DRD4) plays a role in modulating cultural learning, we predicted that carriers of DRD4 polymorphisms linked to increased dopamine signaling (7- or 2-repeat alleles) would show higher levels of culturally dominant social orientations, compared with noncarriers. European Americans and Asian-born Asians (total N = 398) reported their social orientation on multiple scales. They were also genotyped for DRD4. As in earlier work, European Americans were more independent, and Asian-born Asians more interdependent. This cultural difference was significantly more pronounced for carriers of the 7- or 2-repeat alleles than for noncarriers. Indeed, no cultural difference was apparent among the noncarriers. Implications for potential coevolution of genes and culture are discussed. © The Author(s) 2014.
Application of Box-Behnken design to prepare gentamicin-loaded calcium carbonate nanoparticles.
Maleki Dizaj, Solmaz; Lotfipour, Farzaneh; Barzegar-Jalali, Mohammad; Zarrintan, Mohammad-Hossein; Adibkia, Khosro
2016-09-01
The aim of this research was to prepare and optimize calcium carbonate (CaCO3) nanoparticles as carriers for gentamicin sulfate. A chemical precipitation method was used to prepare the gentamicin sulfate-loaded CaCO3 nanoparticles. A 3-factor, 3-level Box-Behnken design was used for the optimization procedure, with the molar ratio of CaCl2: Na2CO3 (X1), the concentration of drug (X2), and the speed of homogenization (X3) as the independent variables. The particle size and entrapment efficiency were considered as response variables. Mathematical equations and response surface plots were used, along with the counter plots, to relate the dependent and independent variables. The results indicated that the speed of homogenization was the main variable contributing to particle size and entrapment efficiency. The combined effect of all three independent variables was also evaluated. Using the response optimization design, the optimized Xl-X3 levels were predicted. An optimized formulation was then prepared according to these levels, resulting in a particle size of 80.23 nm and an entrapment efficiency of 30.80%. It was concluded that the chemical precipitation technique, together with the Box-Behnken experimental design methodology, could be successfully used to optimize the formulation of drug-incorporated calcium carbonate nanoparticles.
NASA Astrophysics Data System (ADS)
van Kamp, Irene; Job, R. F. Soames; Hatfield, Julie; Haines, Mary; Stellato, Rebecca K.; Stansfeld, Stephen A.
2004-12-01
In order to examine the role of noise sensitivity in response to environmental noise, this paper presents detailed comparisons of socio-acoustic studies conducted around international airports in Amsterdam, Sydney, and London. Earlier findings that noise sensitivity moderates the effect of noise on annoyance were examined to see if they could be replicated in each of the datasets, independent of the technique of measuring noise sensitivity. The relation between exposure to aircraft noise and noise annoyance was studied separately for groups of individuals with low, medium, and high noise sensitivity, with statistical adjustment for relevant confounders. Results support the previous findings that noise sensitivity is an independent predictor of annoyance and adds to the prediction of noise annoyance afforded by noise exposure level by up to 26% of explained variance. There is no evidence of a moderating effect, whereby the covariation between noise exposure level and annoyance is weak for people who score at the extreme high or low end of the sensitivity scale, and strong for people who score in the middle of the sensitivity scale. Generally, noise sensitivity appears to increase annoyance independently of the level of noise exposure after adjustment for relevant confounders. These findings were consistent across the three datasets. .
Dadds, Mark R; Allen, Jennifer L; McGregor, Kimberley; Woolgar, Matthew; Viding, Essi; Scott, Stephen
2014-07-01
We previously hypothesised that the early development of psychopathy is associated with a failure to attend to the eyes of attachment figures, and we have presented preliminary data from a parent-child 'love' scenario in support of this. Here, we confirm the association in a larger sample and test mechanisms of impaired eye contact during expressions of love in control and behaviourally disturbed children. Oppositional defiant disorder children, assessed for callous-unemotional (CU) traits, and controls, were observed in a brief interaction task where the mother was asked to show love to her child. Eye contact and affection were measured for each dyad. As predicted, there were no group differences in affection and eye contact expressed by mothers; levels of CU traits predicted low levels of eye contact towards their mothers across all groups of children. As expected, low eye contact was correlated with psychopathic fearlessness in their fathers, and maternal reports of negative feelings towards the child. Independent observations showed that child's behaviour largely drives the low eye contact associated with CU traits, and low eye contact was not associated with independent observations of the quality of attachment-related behaviours in mothers. Impaired eye contact is a unique characteristic of children with CU traits; these impairments are largely independent of maternal behaviour, but associated with psychopathic traits in the fathers. These impairments should be tested for functional significance and amenability to change in longitudinal and treatment studies. © 2013 The Authors. Journal of Child Psychology and Psychiatry © 2013 Association for Child and Adolescent Mental Health.
DuBois, Steven G.; London, Wendy B.; Zhang, Yang; Matthay, Katherine K.; Monclair, Tom; Ambros, Peter F.; Cohn, Susan L.; Pearson, Andrew; Diller, Lisa
2009-01-01
Background Neuroblastoma is the most common extracranial pediatric solid cancer. Lung metastasis is rarely detected in children with newly diagnosed neuroblastoma. We aimed to describe the incidence, clinical characteristics, and outcome of patients with lung metastasis at initial diagnosis using a large international database. Procedure The subset of patients from the International Neuroblastoma Risk Group database with INSS stage 4 neuroblastoma and known data regarding lung metastasis at diagnosis was selected for analysis. Clinical and biological characteristics were compared between patients with and without lung metastasis. Survival for patients with and without lung metastasis was estimated by Kaplan-Meier methods. Cox proportional hazards methods were used to determine the independent prognostic value of lung metastasis at diagnosis. Results Of the 2,808 patients with INSS stage 4 neuroblastoma diagnosed between 1990 and 2002, 100 patients (3.6%) were reported to have lung metastasis at diagnosis. Lung metastasis was more common among patients with MYCN amplified tumors, adrenal primary tumors, or elevated lactate dehydrogenase (LDH) levels (p < 0.02 in each case). Five-year overall survival ± standard error for patients with lung metastasis was 34.5% ± 6.8% compared to 44.7% ± 1.3% for patients without lung metastasis (p=0.0002). However, in multivariable analysis, the presence of lung metastasis was not independently predictive of outcome. Conclusions Lung metastasis at initial diagnosis of neuroblastoma is associated with MYCN amplification and elevated LDH levels. Although lung metastasis at diagnosis was not independently predictive of outcome in this analysis, it remains a useful prognostic marker of unfavorable outcome. PMID:18649370
Longitudinal relations between forgiveness and conflict resolution in marriage.
Fincham, Frank D; Beach, Steven R H; Davila, Joanne
2007-09-01
Does forgiveness predict later conflict resolution in married couples? Twelve-month follow-up data on conflict resolution were collected from the couples studied by F. D. Fincham, S. R. Beach, and J. Davila, who had provided earlier reports of forgiveness and conflict resolution. For wives, the positive dimension of forgiveness or benevolence predicted husbands' later reports of better conflict resolution controlling for initial levels of conflict resolution. This finding was independent of wives' marital satisfaction and the degree of hurt engendered by husbands' transgressions. For husbands, the only predictor of wives' reports of later conflict resolution was initial level of conflict resolution. The findings are discussed in terms of the direction of effect between forgiveness and conflict resolution and of the mechanisms that might link them. PsycINFO Database Record (c) 2007 APA, all rights reserved
A decline in prosocial language helps explain public disapproval of the US Congress
Frimer, Jeremy A.; Aquino, Karl; Gebauer, Jochen E.; Zhu, Luke (Lei); Oakes, Harrison
2015-01-01
Talking about helping others makes a person seem warm and leads to social approval. This work examines the real world consequences of this basic, social-cognitive phenomenon by examining whether record-low levels of public approval of the US Congress may, in part, be a product of declining use of prosocial language during Congressional debates. A text analysis of all 124 million words spoken in the House of Representatives between 1996 and 2014 found that declining levels of prosocial language strongly predicted public disapproval of Congress 6 mo later. Warm, prosocial language still predicted public approval when removing the effects of societal and global factors (e.g., the September 11 attacks) and Congressional efficacy (e.g., passing bills), suggesting that prosocial language has an independent, direct effect on social approval. PMID:25964358
Block, H C; Klopfenstein, T J; Erickson, G E
2006-04-01
Two data sets were developed to evaluate and refine feed energy predictions with the beef National Research Council (NRC, 1996) model level 1. The first data set included pen means of group-fed cattle from 31 growing trials (201 observations) and 17 finishing trials (154 observations) representing over 7,700 animals fed outside in dirt lots. The second data set consisted of 15 studies with individually fed cattle (916 observations) fed in a barn. In each data set, actual ADG was compared with ADG predicted with the NRC model level 1, assuming thermoneutral environmental conditions. Next, the observed ADG (kg), TDN intake (kg/d), and TDN concentration (kg/kg of DM) were used to develop equations to adjust the level 1 predicted diet NEm and NEg (diet NE adjusters) to be applied to more accurately predict ADG. In both data sets, the NRC (1996) model level 1 inaccurately predicted ADG (P < 0.001 for slope = 1; intercept = 0 when observed ADG was regressed on predicted ADG). The following nonlinear relationships to adjust NE based on observed ADG, TDN intake, and TDN concentration were all significant (P < 0.001): NE adjuster = 0.7011 x 10(-0.8562 x ADG) + 0.8042, R2 = 0.325, s(y.x) = 0.136 kg; NE adjuster = 4.795 10(-0.3689 x TDN intake) + 0.8233, R2 x = 0.714, s(y.x) = 0.157 kg; and NE adjuster = 357 x 10(-5.449 x TDN concentration) + 0.8138, R2 = 0.754, s(y.x) = 0.127 kg. An NE adjuster < 1 indicates overprediction of ADG. The average NE adjustment required for the pen-fed finishing trials was 0.820, whereas the (P < 0.001) adjustment of 0.906 for individually fed cattle indicates that the pen-fed environment increased NE requirements. The use of these equations should improve ADG prediction by the NRC (1996) model level 1, although the equations reflect limitations of the data from which they were developed and are appropriate only over the range of the developmental data set. There is a need for independent evaluation of the ability of the equations to improve ADG prediction by the NRC (1996) model level 1.
Tsochatzis, Emmanuel A.; Feudjo, Maurille; Rigamonti, Cristina; Vlachogiannakos, Jiannis; Carpenter, James R.; Burroughs, Andrew K.
2013-01-01
Background/Aim. In randomised controlled trials (RCTs) of ursodeoxycholic acid (UDCA), although serum bilirubin is frequently reduced, its effect on disease progression and mortality is unclear. As serum albumin is an established independent prognostic marker, one might expect less deterioration of serum albumin values in a UDCA-treated group. We therefore modelled the typical evolution of serum bilirubin and albumin levels over time in UDCA-untreated patients and compared it with the observed levels in UDCA RCTs. Methods. Multilevel modelling was used to relate the evolution of serum albumin to serum bilirubin and time since patient referral. For each considered RCT, the derived model was used to predict the relationship between final mean serum albumin and bilirubin concentration, adjusted for mean serum albumin at referral and followup duration. Results. Five RCTs were eligible in terms of available data, of which two had long followup. In all trials, serum albumin did not significantly differ between UDCA- and placebo-treated patients, despite the UDCA effect on serum bilirubin. Therefore, there is no evidence over time for changes or maintenance of albumin levels for UDCA-treated patients above the levels predicted for placebo-treated patients. Conclusions. Our findings suggest that UDCA does not alter serum albumin in a way that is consistent with its effect on serum bilirubin. Therefore, reductions in serum bilirubin of UDCA-treated PBC do not parallel another validated and independent prognostic marker, further questioning the validity of serum bilirubin reduction with UDCA as a surrogate therapeutic marker. PMID:23984317
Schell, Carl Otto; Reilly, Marie; Rosling, Hans; Peterson, Stefan; Ekström, Anna Mia
2007-01-01
To reach the Millennium Development Goals for health, influential international bodies advocate for more resources to be directed to the health sector, in particular medical treatment. Yet, health has many determinants beyond the health sector that are less evident than proximate predictors. To assess the relative importance of major socioeconomic determinants of population health, measured as infant mortality rate (IMR), at country level. National-level data from 152 countries based on World Development Indicators 2003 were used for multivariate linear regression analyses of five socioeconomic predictors of IMR: public spending on health, GNI/capita, poverty rate, income equality (Gini index), and young female illiteracy rate. Analyses were performed on a global level and stratified for low-, middle-, and high-income countries. In order of importance, GNI/capita, young female illiteracy, and income equality predicted 92% of the variation in national IMR whereas public spending on health and poverty rate were non-significant determinants when adjusted for confounding. In low-income countries, female illiteracy was more important than GNI/capita. Income equality (Gini index) was an independent predictor of IMR in middle-income countries only. In high-income countries none of these predictors was significant. The relative importance of major health determinants varies between income levels, thus extrapolating health policies from high- to low-income countries is problematic. Since the size, per se, of public health spending does not independently predict health outcomes, functioning health systems are necessary to make health investments efficient. Potential health gains from improved female education and economic growth should be considered in low- and middle-income countries.
Arenillas, Juan F; Alvarez-Sabín, José; Molina, Carlos A; Chacón, Pilar; Fernández-Cadenas, Israel; Ribó, Marc; Delgado, Pilar; Rubiera, Marta; Penalba, Anna; Rovira, Alex; Montaner, Joan
2008-05-01
The molecular pathways involved in the progression of intracranial large artery atherosclerosis (ILA) are largely unknown. Our objective was to prospectively study the relationship between circulating levels of inflammatory markers and fibrinolysis inhibitors, and the risk of progression of symptomatic ILA. Seventy-five consecutive patients with first-ever symptomatic intracranial atherostenosis were studied. Blood levels of C-reactive protein (CRP), E-selectin, monocyte chemoattractant protein-1, intercellular adhesion molecule-1, matrix metalloproteinases 1, 2, 3, 8, 9, 10, and 13, plasminogen activator inhibitor-1 (PAI-1), and lipoprotein(a) were measured 3 months after the qualifying stroke or transient ischemic attack. Thereafter, patients underwent long-term transcranial Doppler follow-up to detect progression of ILA. During a median follow-up time of 23 months, 25 (33%) patients showed ILA progression. Multivariable adjusted Cox regression models and Kaplan-Meier curves showed that high baseline level of CRP, E-selectin, intercellular adhesion molecule-1, matrix metalloproteinase 9, PAI-1, and lipoprotein(a) predicted ILA progression independently of vascular risk factors. Of them, only CRP (CRP>5.5 mg/L; HR, 5.4 [2.3 to 12.7]; P=0.0001) and PAI-1 (PAI-1>23.1 ng/mL; HR, 2.4 [1.0 to 5.8]; P=0.05) predicted ILA progression also independently of the other studied molecules. Progression of symptomatic ILA is associated with a proinflammatory state, as reflected by high levels of inflammatory markers, and with defective fibrinolysis, as indicated by raised concentrations of endogenous fibrinolysis inhibitors.
Ahmed, Issaq; Ashton, Fiona; Robinson, Christopher Michael
2012-07-18
Arthroscopic Bankart repair and capsular shift is a well-established technique for the treatment of anterior shoulder instability. The purpose of this study was to evaluate the outcomes following arthroscopic Bankart repair and capsular shift and to identify risk factors that are predictive of recurrence of glenohumeral instability. We performed a retrospective review of a prospectively collected database consisting of 302 patients who had undergone arthroscopic Bankart repair and capsular shift for the treatment of recurrent anterior glenohumeral instability. The prevalence of patient and injury-related risk factors for recurrence was assessed. Cox proportional hazards models were used to estimate the predicted probability of recurrence within two years. The chief outcome measures were the risk of recurrence and the two-year functional outcomes assessed with the Western Ontario shoulder instability index (WOSI) and disabilities of the arm, shoulder and hand (DASH) scores. The rate of recurrent glenohumeral instability after arthroscopic Bankart repair and capsular shift was 13.2%. The median time to recurrence was twelve months, and this complication developed within one year in 55% of these patients. The risk of recurrence was independently predicted by the patient's age at surgery, the severity of glenoid bone loss, and the presence of an engaging Hill-Sachs lesion (all p < 0.001). These variables were incorporated into a model to provide an estimate of the risk of recurrence after surgery. Varying the cutoff level for the predicted probability of recurrence in the model from 50% to lower values increased the sensitivity of the model to detect recurrences but decreased the positive predictive value of the model to correctly predict failed repairs. There was a significant improvement in the mean WOSI and DASH scores at two years postoperatively (both p < 0.001), but the mean scores in the group with recurrence were significantly lower than those in the group without recurrence (both p < 0.001). Our study identified factors that are independently associated with a higher risk of recurrence following arthroscopic Bankart repair and capsular shift. These data can be useful for counseling patients undergoing this procedure for the treatment of recurrent glenohumeral instability and individualizing treatment options for particular groups of patients. Prognostic level I. See Instructions for authors for a complete description of levels of evidence.
Testing the Interpersonal Theory of Suicide in Chronic Pain.
Wilson, Keith G; Heenan, Adam; Kowal, John; Henderson, Peter R; McWilliams, Lachlan A; Castillo, Dyana
2017-08-01
The interpersonal theory of suicide offers a conceptual framework for understanding suicidal ideation (SI) that may be applicable to individuals with chronic pain. The theory emphasizes the importance of 2 interpersonal constructs as precursors to SI: perceived burdensomeness (the belief that one has become a burden to others) and thwarted belongingness (a lack of social integration or connection). Our objective was to test the interpersonal theory of suicide in people with chronic pain. Hierarchical regression analysis was used in a cross-sectional study of 282 patients of an interdisciplinary pain clinic. The Beck Scale for Suicide Ideation was the criterion measure of SI, and independent variables included both general and pain-specific predictors. After adjusting for other known or putative risk factors related to pain and mental health, perceived burdensomeness significantly predicted SI, whereas thwarted belongingness did not. As expected according to theory, the interaction between perceived burdensomeness and thwarted belongingness was also significant; perceived burdensomeness was a strong predictor of SI at high levels of thwarted belongingness, but only marginally at low levels. Other independent predictors were male sex, number of prior suicide attempts, and hopelessness. These findings are in line with some, but not all, of the major predictions of the interpersonal theory of suicide. In general, however, they support the relevance of the theory for individuals with chronic pain.
Åstrøm, Anne N; Lie, Stein A; Mbawalla, Hawa
2016-08-01
This study aimed to assess the longitudinal validity of the oral impacts on daily performance (OIDP) and to identify psychosocial determinants, in terms of self-efficacy and depressive symptoms, of the OIDP across time. Following conceptual frameworks of oral health, it was hypothesized that sociodemographic, clinical, and psychosocial factors predict oral impacts across time at both population- averaged and person-specific levels. Whether the effects of sociodemographic and clinical factors were accounted for, totally or in part, by psychosocial factors were also investigated. Self administered questionnaires and oral clinical examinations at baseline (2009) and follow-up (2011) were completed by 1,714 and 727 secondary school students, respectively. Generalized equalized equations and a random intercept model were used to account for the dependency in repeated observations. Mean OIDP change scores were negative (worsened) among those who reported worsened self-reported oral health. Psychosocial, clinical, and sociodemographic factors were independently associated with oral impacts at the population-averaged and person-specific levels. Mediation of sociodemographic and clinical variables according to psychosocial variables was not observed. Satisfactory longitudinal evaluative properties of the OIDP, and independent effects of psychosocial factors on oral impacts across time, were confirmed among secondary school students in Tanzania. © 2016 Eur J Oral Sci.
Predictors of cultural capital on science academic achievement at the 8th grade level
NASA Astrophysics Data System (ADS)
Misner, Johnathan Scott
The purpose of the study was to determine if students' cultural capital is a significant predictor of 8th grade science achievement test scores in urban locales. Cultural capital refers to the knowledge used and gained by the dominant class, which allows social and economic mobility. Cultural capital variables include magazines at home and parental education level. Other variables analyzed include socioeconomic status (SES), gender, and English language learners (ELL). This non-experimental study analyzed the results of the 2011 Eighth Grade Science National Assessment of Educational Progress (NAEP). The researcher analyzed the data using a multivariate stepwise regression analysis. The researcher concluded that the addition of cultural capital factors significantly increased the predictive power of the model where magazines in home, gender, student classified as ELL, parental education level, and SES were the independent variables and science achievement was the dependent variable. For alpha=0.05, the overall test for the model produced a R2 value of 0.232; therefore the model predicted 23.2% of variance in science achievement results. Other major findings include: higher measures of home resources predicted higher 2011 NAEP eighth grade science achievement; males were predicted to have higher 2011 NAEP 8 th grade science achievement; classified ELL students were predicted to score lower on the NAEP eight grade science achievement; higher parent education predicted higher NAEP eighth grade science achievement; lower measures of SES predicted lower 2011 NAEP eighth grade science achievement. This study contributed to the research in this field by identifying cultural capital factors that have been found to have statistical significance on predicting eighth grade science achievement results, which can lead to strategies to help improve science academic achievement among underserved populations.
Eguchi, Keisuke; Oyama, Takahiko; Tajima, Atsushi; Abiko, Tomohiro; Sawafuji, Makoto; Horio, Hirotoshi; Hashizume, Toshinori; Matsutani, Noriyuki; Kato, Ryoichi; Nakayama, Mitsuo; Kawamura, Masafumi; Kobayashi, Koichi
2015-01-01
This investigation was conducted to assess the use of the intratumoral mRNA expression levels of nucleic acid-metabolizing enzymes as biomarkers of adjuvant chemotherapy for non-small cell lung cancer (NSCLC) using uracil-tegafur in a multi-institutional prospective study. 236 patients with a completely resected NSCLC (adenocarcinoma and squamous cell carcinoma) of pathological stage IA (maximum tumor diameter of 2 cm or greater), IB, and II tumors were given a dose of 250 mg of uracil-tegafur per square meter of body surface area per day orally for two years after surgery. Intratumoral mRNA levels of thymidylate synthase (TS), dihydropyrimidine dehydrogenase (DPD), orotate phosphoribosyltransferase (OPRT), and thymidine phosphorylase (TP) genes relative to an internal standard, β-actin, were determined using laser-capture microdissection and fluorescence-based real time PCR detection systems. Among 5-FU target enzymes, TS was the only one that showed a significant difference in the level of gene expression between the high and low gene expression groups, for both disease-free survival (DFS) and overall survival (OS), when patients were divided according to median values; 5-year DFS rates in high/low TS gene expression were 60.4% and 72.6%, respectively (p=0.050), 5-year OS rates were 78.1% and 88.6%, respectively (p=0.011). Cox's proportional hazard model indicated that the pathological stage and TS gene expression level were independent values for predicting DFS. The TS gene expression level was shown to be an independent predictive factor for DFS in stage I and II NSCLC patients who were treated with uracil-tegafur following surgery. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Independent predictors of fibrosis in patients with nonalcoholic fatty liver disease.
Hossain, Noreen; Afendy, Arian; Stepanova, Maria; Nader, Fatema; Srishord, Manirath; Rafiq, Nila; Goodman, Zachary; Younossi, Zobair
2009-11-01
Nonalcoholic fatty liver disease (NAFLD) is a common cause of chronic liver disease. We investigated factors associated with advanced fibrosis in NAFLD. The study included 432 patients with histologically proven NAFLD (26.8% with nonalcoholic steatohepatitis [NASH] and 17.4% with moderate-to severe fibrosis). NASH was defined as steatosis, lobular inflammation, and ballooning degeneration with or without Mallory-Denk bodies and/or fibrosis. Fibrosis was classified into 2 groups: those with no or minimal fibrosis and those with moderate-to-severe fibrosis. Groups were compared using Mann-Whitney and chi-square method analyses. A model was constructed using a stepwise bidirectional method; its predictive power was measured using a 10-fold cross-validation technique. Patients with NASH were more likely to be male (P < .0001); have lower hip-to-waist ratios (P = .03); were less likely to be African American (P = .06); have higher levels of alanine aminotransferase (ALT; P < .0001), aspartate aminotransferase (AST; P < .0001), and serum triglycerides (P = .0154), but lower levels of high-density lipoprotein cholesterol (P < .0001). Patients with moderate-to-severe fibrosis were older (P = .0245); more likely to be male (P = .0189), Caucasian (P = .0382), have diabetes mellitus (P = .0238), and hypertension (P = .0375); and have a lower hip-to-waist ratio (P = .0077) but higher serum AST (P < .0001) and ALT (P < .0001) levels. The multivariate analysis model to predict moderate-to-severe fibrosis included male sex, Caucasian ethnicity, diabetes mellitus, and increased AST and ALT levels (model P value < .0001). In patients with NAFLD, diabetes mellitus and aminotransferase levels are independent predictors of moderate-to-severe fibrosis. They can be used to identify NAFLD patients at risk for advanced fibrosis.
Association of Big Endothelin-1 with Coronary Artery Calcification.
Qing, Ping; Li, Xiao-Lin; Zhang, Yan; Li, Yi-Lin; Xu, Rui-Xia; Guo, Yuan-Lin; Li, Sha; Wu, Na-Qiong; Li, Jian-Jun
2015-01-01
The coronary artery calcification (CAC) is clinically considered as one of the important predictors of atherosclerosis. Several studies have confirmed that endothelin-1(ET-1) plays an important role in the process of atherosclerosis formation. The aim of this study was to investigate whether big ET-1 is associated with CAC. A total of 510 consecutively admitted patients from February 2011 to May 2012 in Fu Wai Hospital were analyzed. All patients had received coronary computed tomography angiography and then divided into two groups based on the results of coronary artery calcium score (CACS). The clinical characteristics including traditional and calcification-related risk factors were collected and plasma big ET-1 level was measured by ELISA. Patients with CAC had significantly elevated big ET-1 level compared with those without CAC (0.5 ± 0.4 vs. 0.2 ± 0.2, P<0.001). In the multivariate analysis, big ET-1 (Tertile 2, HR = 3.09, 95% CI 1.66-5.74, P <0.001, Tertile3 HR = 10.42, 95% CI 3.62-29.99, P<0.001) appeared as an independent predictive factor of the presence of CAC. There was a positive correlation of the big ET-1 level with CACS (r = 0.567, p<0.001). The 10-year Framingham risk (%) was higher in the group with CACS>0 and the highest tertile of big ET-1 (P<0.01). The area under the receiver operating characteristic curve for the big ET-1 level in predicting CAC was 0.83 (95% CI 0.79-0.87, p<0.001), with a sensitivity of 70.6% and specificity of 87.7%. The data firstly demonstrated that the plasma big ET-1 level was a valuable independent predictor for CAC in our study.
Afarideh, Mohsen; Aryan, Zahra; Ghajar, Alireza; Noshad, Sina; Nakhjavani, Manouchehr; Baber, Usman; Mechanick, Jeffrey I; Esteghamati, Alireza
2016-11-01
We aimed to determine the prospective association between baseline serum levels of alanine aminotransferase (ALT) and the incident cardiovascular disease (CVD) in people with type 2 diabetes. In an open cohort setting, people with type 2 diabetes were followed for their first ever CVD presentation from 1995 to 2015. Statistical methods included Cox regression analysis for reporting of hazard ratios (HRs), artificial neural network modelings, and risk reclassification analyses. We found a nearly constant CVD hazard with baseline serum ALT levels below the 30 IU/L mark, whereas baseline serum ALT levels ≥ 30 IU/L remained an independent predictor of lower CVD rates in patients with type 2 diabetes in the final multivariate Cox proportional hazards regression model (HR: 0.204, 95%CI [0.060-0.689], p for trend value = 0.006). Age, male gender and fasting plasma insulin levels independently predicted baseline serum ALT ≥ 30 IU/L among the population cohort. Augmentation of serum ALT into the weighted Framingham risk score resulted in a considerable net reclassification improvement (NRI) of coronary heart disease (CHD) risk prediction in the study population (NRI = 9.05% (8.01%-10.22%), p value < 0.05). Serum ALT could successfully reclassify about 9% of the population with type 2 diabetes across the CHD-affected and CHD-free categories. Overall, our findings demonstrate a complex and nonlinear relationship for the risk of future CVD by baseline serum ALT levels in patients with type 2 diabetes. Further studies are warranted to confirm whether this complex association could be translated into a clearly visible U or J-shaped figure. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Šabanagić-Hajrić, Selma; Alajbegović, Azra
2015-02-01
To evaluate the impacts of education level and employment status on health-related quality of life (HRQoL) in multiple sclerosis patients. This study included 100 multiple sclerosis patients treated at the Department of Neurology, Clinical Center of the University of Sarajevo. Inclusion criteria were the Expanded Disability Status Scale (EDSS) score between 1.0 and 6.5, age between 18 and 65 years, stable disease on enrollment. Quality of life (QoL) was evaluated by the Multiple Sclerosis Quality of Life-54 questionnaire (MSQoL-54). Mann-Whitney and Kruskal-Wallis test were used for comparisons. Linear regression analyses were performed to evaluate prediction value of educational level and employment status in predicting MSQOL-54 physical and mental composite scores. Full employment status had positive impact on physical health (54.85 vs. 37.90; p les than 0.001) and mental health (59.55 vs. 45.90; p les than 0.001) composite scores. Employment status retained its independent predictability for both physical (r(2)=0.105) and mental (r(2)=0.076) composite scores in linear regression analysis. Patients with college degree had slightly higher median value of physical (49.36 vs. 45.30) and mental health composite score (66.74 vs. 55.62) comparing to others, without statistically significant difference. Employment proved to be an important factor in predicting quality of life in multiple sclerosis patients. Higher education level may determine better QOL but without significant predictive value. Sustained employment and development of vocational rehabilitation programs for MS patients living in the country with high unemployment level is an important factor in improving both physical and mental health outcomes in MS patients.
Predictable Phenotypes of Antibiotic Resistance Mutations.
Knopp, M; Andersson, D I
2018-05-15
Antibiotic-resistant bacteria represent a major threat to our ability to treat bacterial infections. Two factors that determine the evolutionary success of antibiotic resistance mutations are their impact on resistance level and the fitness cost. Recent studies suggest that resistance mutations commonly show epistatic interactions, which would complicate predictions of their stability in bacterial populations. We analyzed 13 different chromosomal resistance mutations and 10 host strains of Salmonella enterica and Escherichia coli to address two main questions. (i) Are there epistatic interactions between different chromosomal resistance mutations? (ii) How does the strain background and genetic distance influence the effect of chromosomal resistance mutations on resistance and fitness? Our results show that the effects of combined resistance mutations on resistance and fitness are largely predictable and that epistasis remains rare even when up to four mutations were combined. Furthermore, a majority of the mutations, especially target alteration mutations, demonstrate strain-independent phenotypes across different species. This study extends our understanding of epistasis among resistance mutations and shows that interactions between different resistance mutations are often predictable from the characteristics of the individual mutations. IMPORTANCE The spread of antibiotic-resistant bacteria imposes an urgent threat to public health. The ability to forecast the evolutionary success of resistant mutants would help to combat dissemination of antibiotic resistance. Previous studies have shown that the phenotypic effects (fitness and resistance level) of resistance mutations can vary substantially depending on the genetic context in which they occur. We conducted a broad screen using many different resistance mutations and host strains to identify potential epistatic interactions between various types of resistance mutations and to determine the effect of strain background on resistance phenotypes. Combinations of several different mutations showed a large amount of phenotypic predictability, and the majority of the mutations displayed strain-independent phenotypes. However, we also identified a few outliers from these patterns, illustrating that the choice of host organism can be critically important when studying antibiotic resistance mutations. Copyright © 2018 Knopp and Andersson.
Hlaing, Naomi Khaing Than; Banerjee, Debolina; Mitrani, Robert; Arker, Soe Htet; Win, Kyaw San; Tun, Nyan Lin; Thant, Zaw; Win, Khin Maung; Reddy, K Rajender
2016-01-01
AIM To investigate peg-interferon (peg-IFN) and ribavirin (RBV) therapy in Myanmar and to predict sustained virologic response (SVR). METHODS This single-center, open-label, study was conducted in Myanmar between 2009 and 2014. A total of 288 patients infected with HCV genotypes 1, 2, 3 and 6 were treated with peg-IFN alpha-2a (180 μg/wk) or alpha-2b (50 to 100 μg as a weight-based dose) and RBV as a weight-based dose (15 mg/kg/d). Treatment duration was 48 wk for genotypes 1 and 6, 24 wk for genotype 2, and 24 or 48 wk for genotype 3 based on rapid virologic response (RVR). Those co-infected with hepatitis B received 48 wk of therapy. RESULTS Overall, SVR was achieved for 82% of patients and the therapy was well tolerated. All patients achieved SVR at equivalent rates regardless of HCV genotype (P = 0.314). Low fibrosis scores (P < 0.001), high baseline albumin levels (P = 0.028) and low baseline viral loads (P = 0.029) all independently predicted SVR. On the other hand, IL-28B TT and CC genotypes were not found to significantly predict SVR (P = 0.634; P = 0.618). Among those who completed treatment, the occurrence of RVR showed a > 96% positive predictive value for achieving SVR. Treatment duration did not significantly impact the likelihood of achieving SVR for patients infected with genotype 3 HCV (P = 0.371). The most common adverse events were fatigue (71%) and poor appetite (60%). Among patients with genotype 3 HCV, more patients in the 48-wk treatment group required erythropoietin than in the 24-wk treatment group (61.1% vs 49.2%). CONCLUSION SVR rates were high with peg-IFN and RBV therapy in Myanmar. Fibrosis scores, baseline albumin, HCV RNA levels and RVR independently predicted SVR. PMID:27920482
Hlaing, Naomi Khaing Than; Banerjee, Debolina; Mitrani, Robert; Arker, Soe Htet; Win, Kyaw San; Tun, Nyan Lin; Thant, Zaw; Win, Khin Maung; Reddy, K Rajender
2016-11-21
To investigate peg-interferon (peg-IFN) and ribavirin (RBV) therapy in Myanmar and to predict sustained virologic response (SVR). This single-center, open-label, study was conducted in Myanmar between 2009 and 2014. A total of 288 patients infected with HCV genotypes 1, 2, 3 and 6 were treated with peg-IFN alpha-2a (180 μg/wk) or alpha-2b (50 to 100 μg as a weight-based dose) and RBV as a weight-based dose (15 mg/kg/d). Treatment duration was 48 wk for genotypes 1 and 6, 24 wk for genotype 2, and 24 or 48 wk for genotype 3 based on rapid virologic response (RVR). Those co-infected with hepatitis B received 48 wk of therapy. Overall, SVR was achieved for 82% of patients and the therapy was well tolerated. All patients achieved SVR at equivalent rates regardless of HCV genotype ( P = 0.314). Low fibrosis scores ( P < 0.001), high baseline albumin levels ( P = 0.028) and low baseline viral loads ( P = 0.029) all independently predicted SVR. On the other hand, IL-28B TT and CC genotypes were not found to significantly predict SVR ( P = 0.634; P = 0.618). Among those who completed treatment, the occurrence of RVR showed a > 96% positive predictive value for achieving SVR. Treatment duration did not significantly impact the likelihood of achieving SVR for patients infected with genotype 3 HCV ( P = 0.371). The most common adverse events were fatigue (71%) and poor appetite (60%). Among patients with genotype 3 HCV, more patients in the 48-wk treatment group required erythropoietin than in the 24-wk treatment group (61.1% vs 49.2%). SVR rates were high with peg-IFN and RBV therapy in Myanmar. Fibrosis scores, baseline albumin, HCV RNA levels and RVR independently predicted SVR.
[Procalcitonin as a predictor of trauma severity and post-traumatic sepsis in children].
Liu, Shao-Feng; Yuan, Gao-Pin; Yang, Jian; He, Tao-Zhen; Feng, Hai-Huan; Liu, Min
2012-09-01
To determine the association of procalcitonin (PCT) with trauma severity and post traumatic sepsis in children. The blood samples of 30 children with acute trauma in a Pediatric unit were collected for four consecutive days. The levels of PCT, IL-6, CRP and WBC were measured. The pediatric trauma score (PTS), length of stay in hospital, incidence of sepsis and clinical outcomes of the children were recorded. The value of PCT for predicting prognosis of children with trauma was compared with other inflammatory markers. Plasma PCT levels increased significantly in the patients in our study. Sepsis occurred in 23.33% of the patients. The patients with sepsis had higher levels of PCT than those with and without systemic inflammatory response syndrome (SIRS) and the healthy controls (P < 0.05). The peak level of PCT emerged on day 2 after trauma. The plasma PCT levels were positively correlated with trauma severity. The level of PCT on day 2 was an independent predictor for post-trauma sepsis and SIRS. Plasma PCT levels increase markedly in post trauma children. Plasma PCT of day 2 after trauma is an independent predictor of post-traumatic sepsis and SIRS complications. There is a significant correlation between the severity of injury and plasma PCT.
Dong, Zuoli; Zhang, Naiqian; Li, Chun; Wang, Haiyun; Fang, Yun; Wang, Jun; Zheng, Xiaoqi
2015-06-30
An enduring challenge in personalized medicine is to select right drug for individual patients. Testing drugs on patients in large clinical trials is one way to assess their efficacy and toxicity, but it is impractical to test hundreds of drugs currently under development. Therefore the preclinical prediction model is highly expected as it enables prediction of drug response to hundreds of cell lines in parallel. Recently, two large-scale pharmacogenomic studies screened multiple anticancer drugs on over 1000 cell lines in an effort to elucidate the response mechanism of anticancer drugs. To this aim, we here used gene expression features and drug sensitivity data in Cancer Cell Line Encyclopedia (CCLE) to build a predictor based on Support Vector Machine (SVM) and a recursive feature selection tool. Robustness of our model was validated by cross-validation and an independent dataset, the Cancer Genome Project (CGP). Our model achieved good cross validation performance for most drugs in the Cancer Cell Line Encyclopedia (≥80% accuracy for 10 drugs, ≥75% accuracy for 19 drugs). Independent tests on eleven common drugs between CCLE and CGP achieved satisfactory performance for three of them, i.e., AZD6244, Erlotinib and PD-0325901, using expression levels of only twelve, six and seven genes, respectively. These results suggest that drug response could be effectively predicted from genomic features. Our model could be applied to predict drug response for some certain drugs and potentially play a complementary role in personalized medicine.
Neonatal Pulmonary MRI of Bronchopulmonary Dysplasia Predicts Short-term Clinical Outcomes.
Higano, Nara S; Spielberg, David R; Fleck, Robert J; Schapiro, Andrew H; Walkup, Laura L; Hahn, Andrew D; Tkach, Jean A; Kingma, Paul S; Merhar, Stephanie L; Fain, Sean B; Woods, Jason C
2018-05-23
Bronchopulmonary dysplasia (BPD) is a serious neonatal pulmonary condition associated with premature birth, but the underlying parenchymal disease and trajectory are poorly characterized. The current NICHD/NHLBI definition of BPD severity is based on degree of prematurity and extent of oxygen requirement. However, no clear link exists between initial diagnosis and clinical outcomes. We hypothesized that magnetic resonance imaging (MRI) of structural parenchymal abnormalities will correlate with NICHD-defined BPD disease severity and predict short-term respiratory outcomes. Forty-two neonates (20 severe BPD, 6 moderate, 7 mild, 9 non-BPD controls; 40±3 weeks post-menstrual age) underwent quiet-breathing structural pulmonary MRI (ultrashort echo-time and gradient echo) in a NICU-sited, neonatal-sized 1.5T scanner, without sedation or respiratory support unless already clinically prescribed. Disease severity was scored independently by two radiologists. Mean scores were compared to clinical severity and short-term respiratory outcomes. Outcomes were predicted using univariate and multivariable models including clinical data and scores. MRI scores significantly correlated with severities and predicted respiratory support at NICU discharge (P<0.0001). In multivariable models, MRI scores were by far the strongest predictor of respiratory support duration over clinical data, including birth weight and gestational age. Notably, NICHD severity level was not predictive of discharge support. Quiet-breathing neonatal pulmonary MRI can independently assess structural abnormalities of BPD, describe disease severity, and predict short-term outcomes more accurately than any individual standard clinical measure. Importantly, this non-ionizing technique can be implemented to phenotype disease and has potential to serially assess efficacy of individualized therapies.
Tic Tac TOE: Effects of Predictability and Importance on Acoustic Prominence in Language Production
ERIC Educational Resources Information Center
Watson, Duane G.; Arnold, Jennifer E.; Tanenhaus, Michael K.
2008-01-01
Importance and predictability each have been argued to contribute to acoustic prominence. To investigate whether these factors are independent or two aspects of the same phenomenon, naive participants played a verbal variant of Tic Tac Toe. Both importance and predictability contributed independently to the acoustic prominence of a word, but in…
Satilmisoglu, Muhammet Hulusi; Ozyilmaz, Sinem Ozbay; Gul, Mehmet; Ak Yildirim, Hayriye; Kayapinar, Osman; Gokturk, Kadir; Aksu, Huseyin; Erkanli, Korhan; Eksik, Abdurrahman
2017-01-01
Purpose To determine the predictive values of D-dimer assay, Global Registry of Acute Coronary Events (GRACE) and Thrombolysis in Myocardial Infarction (TIMI) risk scores for adverse outcome in patients with non-ST-segment elevation myocardial infarction (NSTEMI). Patients and methods A total of 234 patients (mean age: 57.2±11.7 years, 75.2% were males) hospitalized with NSTEMI were included. Data on D-dimer assay, GRACE and TIMI risk scores were recorded. Logistic regression analysis was conducted to determine the risk factors predicting increased mortality. Results Median D-dimer levels were 349.5 (48.0–7,210.0) ng/mL, the average TIMI score was 3.2±1.2 and the GRACE score was 90.4±27.6 with high GRACE scores (>118) in 17.5% of patients. The GRACE score was correlated positively with both the D-dimer assay (r=0.215, P=0.01) and TIMI scores (r=0.504, P=0.000). Multivariate logistic regression analysis revealed that higher creatinine levels (odds ratio =18.465, 95% confidence interval: 1.059–322.084, P=0.046) constituted the only significant predictor of increased mortality risk with no predictive values for age, D-dimer assay, ejection fraction, glucose, hemoglobin A1c, sodium, albumin or total cholesterol levels for mortality. Conclusion Serum creatinine levels constituted the sole independent determinant of mortality risk, with no significant values for D-dimer assay, GRACE or TIMI scores for predicting the risk of mortality in NSTEMI patients. PMID:28408834
Menk, Mario; Giebelhäuser, Lena; Vorderwülbecke, Gerald; Gassner, Martina; Graw, Jan A; Weiss, Björn; Zimmermann, Mathias; Wernecke, Klaus-D; Weber-Carstens, Steffen
2018-03-27
Nucleated red blood cells (NRBCs) in critically ill patients are associated with increased mortality and poor outcome. The aim of the present study was to evaluate the predictive value of NRBCs in patients with acute respiratory distress syndrome (ARDS). This observational study was conducted at an ARDS referral center and included patients from 2007 to 2014. Daily NRBC counts were assessed and the predictive validity of NRBCs on mortality was statistically evaluated. A cutoff for prediction of mortality based on NRBCs was evaluated using ROC analysis and specified according to Youden's method. Multivariate nonparametric analysis for longitudinal data was applied to prove for differences between groups over the whole time course. Independent predictors of mortality were identified with multiple logistic and Cox' regression analyses. Kaplan-Meier estimations visualized the survival; the corresponding curves were tested for differences with the log-rank test. A total of 404 critically ill ARDS patients were analyzed. NRBCs were found in 75.5% of the patients, which was associated with longer length of ICU stay [22 (11; 39) vs. 14 (7; 26) days; p < 0.05] and higher mortality rates (50.8 vs. 27.3%; p < 0.001). Logistic regression analysis with mortality as response showed NRBC positivity per se to be an independent risk factor for mortality in ARDS with a doubled risk for ICU death (OR 2.03; 95% CI 1.16-3.55; p < 0.05). Also, NRBC value at ICU admission was found to be an independent risk factor for mortality (OR 3.25; 95% CI 1.09-9.73, p = 0.035). A cutoff level of 220 NRBC/µl was associated with a more than tripled risk of ICU death (OR 3.2; 95% CI 1.93-5.35; p < 0.0001). ARDS patients below this threshold level had a significant survival advantage (median survival 85 days vs. 29 days; log rank p < 0.001). Presence of a severe ARDS was identified as independent risk factor for the occurrence of NRBCs > 220/µl (OR 1.81; 95% CI 1.1-2.97; p < 0.05). NRBCs may predict mortality in ARDS with high prognostic power. The presence of NRBCs in the blood might be regarded as a marker of disease severity indicating a higher risk of ICU death.
Qiu, Yajuan; Zhou, Zhiyuan; Li, Zhaoming; Lu, Lisha; Li, Ling; Li, Xin; Wang, Xinhua; Zhang, Mingzhi
2017-03-01
The aim of the present study was to identify the potential relevant biomarkers to predict the therapeutic response of advanced extranodal natural killer/T cell lymphoma(ENKTL) treated with asparaginase-based treatment. Proteomic technology is used to identify differentially expressed proteins between chemotherapy-resistant and chemotherapy-sensitive patients. Then enzyme-linked immunosorbent assay is used to validate the predictive value of selective biomarkers. A total of 61 upregulated and 22 downregulated proteins are identified in chemotherapy-resistant patients compared with chemotherapy-sensitive patients. Furthermore, they validated that pretreatment high level 14-3-3 epsilon(ε)(≥61.95 ng/mL, 84.0 and 95.2% for sensitivity and specificity, respectively) is associated with poor 2-year overall survival (OS) (5.3 vs 68.8%, p<0.0001) and PFS (4.5 vs 76.9%, p<0.0001). In multivariate survival analysis, pretreatment high level 14-3-3 epsilon significantly is correlated with both inferior OS (p = 0.033) and PFS (p = 0.005). These findings indicate that pretreatment high level 14-3-3 epsilon is an independent predictor of chemotherapy-resistance and poor prognosis for patients with advanced ENKTL in the era of asparaginase. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Li, Jiejie; Wang, Yilong; Lin, Jinxi; Wang, David; Wang, Anxin; Zhao, Xingquan; Liu, Liping; Wang, Chunxue; Wang, Yongjun
2015-07-01
Elevated soluble CD40 ligand (sCD40L) was shown to be related to cardiovascular events, but the role of sCD40L in predicting recurrent stroke remains unclear. Baseline sCD40L levels were measured in 3044 consecutive patients with acute minor stroke and transient ischemic attack, who had previously been enrolled in the Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events (CHANCE) trial. Cox proportional-hazards model was used to assess the association of sCD40L with recurrent stroke. Patients in the top tertile of sCD40L levels had increased risk of recurrent stroke comparing with those in the bottom tertile, after adjusted for conventional confounding factors (hazard ratio, 1.49; 95% confidence interval, 1.11-2.00; P=0.008). The patients with elevated levels of both sCD40L and high-sensitive C-reactive protein also had increased risk of recurrent stroke (hazard ratio, 1.81; 95% confidence interval, 1.23-2.68; P=0.003). Elevated sCD40L levels independently predict recurrent stroke in patients with minor stroke and transient ischemic attack. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00979589. © 2015 American Heart Association, Inc.
Decruyenaere, M; Evers-Kiebooms, G; Boogaerts, A; Cassiman, J J; Cloostermans, T; Demyttenaere, K; Dom, R; Fryns, J P; Van den Berghe, H
1996-01-01
For people at risk for Huntington's disease, the anxiety and uncertainty about the future may be very burdensome and may be an obstacle to personal decision making about important life issues, for example, procreation. For some at risk persons, this situation is the reason for requesting predictive DNA testing. The aim of this paper is two-fold. First, we want to evaluate whether knowing one's carrier status reduces anxiety and uncertainty and whether it facilitates decision making about procreation. Second, we endeavour to identify pretest predictors of psychological adaptation one year after the predictive test (psychometric evaluation of general anxiety, depression level, and ego strength). The impact of the predictive test result was assessed in 53 subjects tested, using pre- and post-test psychometric measurement and self-report data of follow up interviews. Mean anxiety and depression levels were significantly decreased one year after a good test result; there was no significant change in the case of a bad test result. The mean personality profile, including ego strength, remained unchanged one year after the test. The study further shows that the test result had a definite impact on reproductive decision making. Stepwise multiple regression analyses were used to select the best predictors of the subject's post-test reactions. The results indicate that a careful evaluation of pretest ego strength, depression level, and coping strategies may be helpful in predicting post-test reactions, independently of the carrier status. Test result (carrier/ non-carrier), gender, and age did not significantly contribute to the prediction. About one third of the variance of post-test anxiety and depression level and more than half of the variance of ego strength was explained, implying that other psychological or social aspects should also be taken into account when predicting individual post-test reactions. PMID:8880572
Do positive schizotypal symptoms predict false perceptual experiences in nonclinical populations?
Tsakanikos, Elias; Reed, Phil
2005-12-01
We examined whether positive schizotypy (i.e., reports of hallucinatory and delusional-like experiences) in nonclinical participants could predict false perceptual experiences during detection of fast-moving words beyond a possible response bias. The participants (N = 160) were assigned to one of two conditions: they were asked either to make presence/absence judgments (loose criterion) or to read aloud every detected word (strict criterion). Regression analysis showed that high levels of positive schizotypy predicted false alarms in the loose condition and false perceptions of words in the strict condition. The obtained effects were independent of detection accuracy, task order, impulsivity, and social desirability. We discuss the results in the context of information processing biases linked to the positive symptomatology of schizophrenia. Clinical and theoretical implications are also considered.
2013-01-01
The spotted sand bass (Paralabrax maculatofasciatus) is an important recreational sport and subsistence food fish within San Diego Bay, a large industrialized harbor in San Diego, California. Despite this importance, few studies examining the species life history relative to pollutant tissue concentrations and the consumptive fishery exist. This study utilized data from three independent spotted sand bass studies from 1989 to 2002 to investigate PCB, DDT, and mercury tissue concentrations relative to spotted sand bass age and growth in San Diego Bay, with subsequent comparisons to published pollutant advisory levels and fishery regulations for recreational and subsistence consumption of the species. Subsequent analysis focused on examining temporal and spatial differences for different regions of San Diego Bay. Study results for growth confirmed previous work, finding the species to exhibit highly asymptotic growth, making tissue pollutant concentrations at initial take size difficult if not impossible to predict. This was corroborated by independent tissue concentration results for mercury, which found no relationship between fish size and pollutant bioaccumulation observed. However, a positive though highly variable relationship was observed between fish size and PCB tissue concentration. Despite these findings, a significant proportion of fish exhibited pollutant levels above recommended state recreational angler consumption advisory levels for PCBs and mercury, especially for fish above the minimum take size, making the necessity of at-size predictions less critical. Lastly, no difference in tissue concentration was found temporally or spatially within San Diego Bay. PMID:24282672
Loflen, Chad L
2013-01-01
The spotted sand bass (Paralabrax maculatofasciatus) is an important recreational sport and subsistence food fish within San Diego Bay, a large industrialized harbor in San Diego, California. Despite this importance, few studies examining the species life history relative to pollutant tissue concentrations and the consumptive fishery exist. This study utilized data from three independent spotted sand bass studies from 1989 to 2002 to investigate PCB, DDT, and mercury tissue concentrations relative to spotted sand bass age and growth in San Diego Bay, with subsequent comparisons to published pollutant advisory levels and fishery regulations for recreational and subsistence consumption of the species. Subsequent analysis focused on examining temporal and spatial differences for different regions of San Diego Bay. Study results for growth confirmed previous work, finding the species to exhibit highly asymptotic growth, making tissue pollutant concentrations at initial take size difficult if not impossible to predict. This was corroborated by independent tissue concentration results for mercury, which found no relationship between fish size and pollutant bioaccumulation observed. However, a positive though highly variable relationship was observed between fish size and PCB tissue concentration. Despite these findings, a significant proportion of fish exhibited pollutant levels above recommended state recreational angler consumption advisory levels for PCBs and mercury, especially for fish above the minimum take size, making the necessity of at-size predictions less critical. Lastly, no difference in tissue concentration was found temporally or spatially within San Diego Bay.
Deutscher, Susan L; Dickerson, Marie; Gui, Gerald; Newton, Jessica; Holm, Jeffrey E; Vogeltanz-Holm, Nancy; Kliethermes, Beth; Hewett, John E; Kumar, Senthil R; Quinn, Thomas P; Sauter, Edward R
2010-10-01
The goal of this prospective study was to determine (a) concentrations of the carbohydrate biomarkers Thomsen Friedenreich (TF) antigen and its precursor, Tn antigen, in nipple discharge (ND) collected from women requiring biopsy because of a suspicious breast lesion; and (b) if concentration levels predicted pathologic diagnosis. Adult women requiring biopsy to exclude breast cancer were enrolled and ND obtained. The samples from 124 women were analyzed using an anti-TF and anti-Tn monoclonal antibodies in direct immunoassay. The highest median concentration in ND for TF and Tn was in women with ductal carcinoma in situ (DCIS). TF was higher in women with 1) cancer (DCIS or invasive) vs. either no cancer (atypia or benign pathology, p = .048), or benign pathology (p = .018); and 2) abnormal (atypia or cancer) versus benign pathology (p = .016); and was more predictive of atypia or cancer in post- compared to premenopausal women. Tn was not predictive of disease. High TF concentration and age were independent predictors of disease, correctly classifying either cancer or abnormal vs. benign pathology 83% of the time in postmenopausal women. TF concentrations in ND were higher in women with precancer and cancer compared to women with benign disease, and TF was an independent predictor of breast atypia and cancer. TF may prove useful in early breast cancer detection.
Knowledge-transfer learning for prediction of matrix metalloprotease substrate-cleavage sites.
Wang, Yanan; Song, Jiangning; Marquez-Lago, Tatiana T; Leier, André; Li, Chen; Lithgow, Trevor; Webb, Geoffrey I; Shen, Hong-Bin
2017-07-18
Matrix Metalloproteases (MMPs) are an important family of proteases that play crucial roles in key cellular and disease processes. Therefore, MMPs constitute important targets for drug design, development and delivery. Advanced proteomic technologies have identified type-specific target substrates; however, the complete repertoire of MMP substrates remains uncharacterized. Indeed, computational prediction of substrate-cleavage sites associated with MMPs is a challenging problem. This holds especially true when considering MMPs with few experimentally verified cleavage sites, such as for MMP-2, -3, -7, and -8. To fill this gap, we propose a new knowledge-transfer computational framework which effectively utilizes the hidden shared knowledge from some MMP types to enhance predictions of other, distinct target substrate-cleavage sites. Our computational framework uses support vector machines combined with transfer machine learning and feature selection. To demonstrate the value of the model, we extracted a variety of substrate sequence-derived features and compared the performance of our method using both 5-fold cross-validation and independent tests. The results show that our transfer-learning-based method provides a robust performance, which is at least comparable to traditional feature-selection methods for prediction of MMP-2, -3, -7, -8, -9 and -12 substrate-cleavage sites on independent tests. The results also demonstrate that our proposed computational framework provides a useful alternative for the characterization of sequence-level determinants of MMP-substrate specificity.
Noone, Jack; O'Loughlin, Kate; Kendig, Hal
2012-09-01
Research from around the Western World has shown that psychological, socioeconomic and demographic factors can influence levels of financial planning. This study aims to determine how these factors interrelate to predict planning outcomes. Data from the Ageing Baby Boomers in Australia Study were used to examine the effects of multiple factors on financial planning for 709 employed Australians nearing retirement. The results showed that higher income, future time perspective (FTP) and financial knowledge independently predicted levels of retirement planning. The effects of FTP and financial knowledge on financial planning were consistent across levels of socioeconomic status. While similar issues in financial planning appeared across socioeconomic status, a 'one size fits all' approach to retirement policy may not be effective. Instead, policy should be targeted towards the diverse needs of different groups. Raising public awareness of FTP and financial knowledge may provide a useful starting point. © 2012 The Authors. Australasian Journal on Ageing © 2012 ACOTA.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Hu, Zhi; Huang, Ge; Sadanandam, Anguraj
Introduction: HJURP (Holliday Junction Recognition Protein) is a newly discovered gene reported to function at centromeres and to interact with CENPA. However its role in tumor development remains largely unknown. The goal of this study was to investigate the clinical significance of HJURP in breast cancer and its correlation with radiotherapeutic outcome. Methods: We measured HJURP expression level in human breast cancer cell lines and primary breast cancers by Western blot and/or by Affymetrix Microarray; and determined its associations with clinical variables using standard statistical methods. Validation was performed with the use of published microarray data. We assessed cell growthmore » and apoptosis of breast cancer cells after radiation using high-content image analysis. Results: HJURP was expressed at higher level in breast cancer than in normal breast tissue. HJURP mRNA levels were significantly associated with estrogen receptor (ER), progesterone receptor (PR), Scarff-Bloom-Richardson (SBR) grade, age and Ki67 proliferation indices, but not with pathologic stage, ERBB2, tumor size, or lymph node status. Higher HJURP mRNA levels significantly decreased disease-free and overall survival. HJURP mRNA levels predicted the prognosis better than Ki67 proliferation indices. In a multivariate Cox proportional-hazard regression, including clinical variables as covariates, HJURP mRNA levels remained an independent prognostic factor for disease-free and overall survival. In addition HJURP mRNA levels were an independent prognostic factor over molecular subtypes (normal like, luminal, Erbb2 and basal). Poor clinical outcomes among patients with high HJURP expression werevalidated in five additional breast cancer cohorts. Furthermore, the patients with high HJURP levels were much more sensitive to radiotherapy. In vitro studies in breast cancer cell lines showed that cells with high HJURP levels were more sensitive to radiation treatment and had a higher rate of apoptosis than those with low levels. Knock down of HJURP in human breast cancer cells using shRNA reduced the sensitivity to radiation treatment. HJURP mRNA levels were significantly correlated with CENPA mRNA levels. Conclusions: HJURP mRNA level is a prognostic factor for disease-free and overall survival in patients with breast cancer and is a predictive biomarker for sensitivity to radiotherapy.« less
Sonuga-Barke, Edmund J S; Dalen, Lindy; Remington, Bob
2003-11-01
To test whether deficits in executive function and delay aversion make independent contributions to levels of attention-deficit/hyperactivity disorder (ADHD) symptoms exhibited by preschool children. One hundred fifty-six children between 3 and 5.5 years old (78 girls and 78 boys) selected from the community completed an age-appropriate battery of tests measuring working memory, set shifting, planning, delay of gratification, and preference for delayed rewards. Parents completed a clinical interview about their children's ADHD symptoms. Analysis of test performance revealed two factors: executive dysfunction and delay aversion. Multivariate analysis demonstrated that when other factors (i.e., age, IQ, and conduct problems) were controlled, executive dysfunction and delay aversion each made significant independent contributions to predictions of ADHD symptoms. Preschool ADHD symptoms are psychologically heterogeneous. Executive dysfunction and delay aversion may represent two distinct and early appearing neurodevelopmental bases for ADHD symptoms.
Identification of Hemoglobin Levels Based on Anthropometric Indices in Elderly Koreans
Kim, Jong Yeol
2016-01-01
Objectives Anemia is independently and strongly associated with an increased risk of mortality in older people and is also strongly associated with obesity. The objectives of the present study were to examine the associations between the hemoglobin level and various anthropometric indices, to predict low and normal hemoglobin levels using combined anthropometric indices, and to assess differences in the hemoglobin level and anthropometric indices between Korean men and women. Methods A total of 7,156 individuals ranging in age from 53–90 years participated in this retrospective cross-sectional study. Binary logistic regression (LR) and naïve Bayes (NB) models were used to identify significant differences in the anthropometric indices between subjects with low and normal hemoglobin levels and to assess the predictive power of these indices for the hemoglobin level. Results Among all of the variables, age displayed the strongest association with the hemoglobin level in both men (p < 0.0001, odds ratio [OR] = 0.487, area under the receiver operating characteristic curve based on the LR [LR-AUC] = 0.702, NB-AUC = 0.701) and women (p < 0.0001, OR = 0.636, LR-AUC = 0.625, NB-AUC = 0.624). Among the anthropometric indices, weight and body mass index (BMI) were the best predictors of the hemoglobin level. The predictive powers of all of the variables were higher in men than in women. The AUC values for the NB-Wrapper and LR-Wrapper predictive models generated using combined anthropometric indices were 0.734 and 0.723, respectively, for men and 0.649 and 0.652, respectively, for women. The use of combined anthropometric indices may improve the predictive power for the hemoglobin level. Discussion Among the various anthropometric indices, with the exception of age, we did not identify any indices that were better predictors than weight and BMI for low and normal hemoglobin levels. In addition, none of the ratios between pairs of indices were good indicators of the hemoglobin level. Finally, the Korean men tended to have higher associations between the anthropometric indices and anemia than the women. PMID:27812118
A novel prognostic six-CpG signature in glioblastomas.
Yin, An-An; Lu, Nan; Etcheverry, Amandine; Aubry, Marc; Barnholtz-Sloan, Jill; Zhang, Lu-Hua; Mosser, Jean; Zhang, Wei; Zhang, Xiang; Liu, Yu-He; He, Ya-Long
2018-03-01
We aimed to identify a clinically useful biomarker using DNA methylation-based information to optimize individual treatment of patients with glioblastoma (GBM). A six-CpG panel was identified by incorporating genome-wide DNA methylation data and clinical information of three distinct discovery sets and was combined using a risk-score model. Different validation sets of GBMs and lower-grade gliomas and different statistical methods were implemented for prognostic evaluation. An integrative analysis of multidimensional TCGA data was performed to molecularly characterize different risk tumors. The six-CpG risk-score signature robustly predicted overall survival (OS) in all discovery and validation cohorts and in a treatment-independent manner. It also predicted progression-free survival (PFS) in available patients. The multimarker epigenetic signature was demonstrated as an independent prognosticator and had better performance than known molecular indicators such as glioma-CpG island methylator phenotype (G-CIMP) and proneural subtype. The defined risk subgroups were molecularly distinct; high-risk tumors were biologically more aggressive with concordant activation of proangiogenic signaling at multimolecular levels. Accordingly, we observed better OS benefits of bevacizumab-contained therapy to high-risk patients in independent sets, supporting its implication in guiding usage of antiangiogenic therapy. Finally, the six-CpG signature refined the risk classification based on G-CIMP and MGMT methylation status. The novel six-CpG signature is a robust and independent prognostic indicator for GBMs and is of promising value to improve personalized management. © 2018 John Wiley & Sons Ltd.
Predicting age from cortical structure across the lifespan.
Madan, Christopher R; Kensinger, Elizabeth A
2018-03-01
Despite interindividual differences in cortical structure, cross-sectional and longitudinal studies have demonstrated a large degree of population-level consistency in age-related differences in brain morphology. This study assessed how accurately an individual's age could be predicted by estimates of cortical morphology, comparing a variety of structural measures, including thickness, gyrification and fractal dimensionality. Structural measures were calculated across up to seven different parcellation approaches, ranging from one region to 1000 regions. The age prediction framework was trained using morphological measures obtained from T1-weighted MRI volumes collected from multiple sites, yielding a training dataset of 1056 healthy adults, aged 18-97. Age predictions were calculated using a machine-learning approach that incorporated nonlinear differences over the lifespan. In two independent, held-out test samples, age predictions had a median error of 6-7 years. Age predictions were best when using a combination of cortical metrics, both thickness and fractal dimensionality. Overall, the results reveal that age-related differences in brain structure are systematic enough to enable reliable age prediction based on metrics of cortical morphology. © 2018 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.
Botta, C; Di Martino, M T; Ciliberto, D; Cucè, M; Correale, P; Rossi, M; Tagliaferri, P; Tassone, P
2016-12-16
Multiple myeloma (MM) is closely dependent on cross-talk between malignant plasma cells and cellular components of the inflammatory/immunosuppressive bone marrow milieu, which promotes disease progression, drug resistance, neo-angiogenesis, bone destruction and immune-impairment. We investigated the relevance of inflammatory genes in predicting disease evolution and patient survival. A bioinformatics study by Ingenuity Pathway Analysis on gene expression profiling dataset of monoclonal gammopathy of undetermined significance, smoldering and symptomatic-MM, identified inflammatory and cytokine/chemokine pathways as the most progressively affected during disease evolution. We then selected 20 candidate genes involved in B-cell inflammation and we investigated their role in predicting clinical outcome, through univariate and multivariate analyses (log-rank test, logistic regression and Cox-regression model). We defined an 8-genes signature (IL8, IL10, IL17A, CCL3, CCL5, VEGFA, EBI3 and NOS2) identifying each condition (MGUS/smoldering/symptomatic-MM) with 84% accuracy. Moreover, six genes (IFNG, IL2, LTA, CCL2, VEGFA, CCL3) were found independently correlated with patients' survival. Patients whose MM cells expressed high levels of Th1 cytokines (IFNG/LTA/IL2/CCL2) and low levels of CCL3 and VEGFA, experienced the longest survival. On these six genes, we built a prognostic risk score that was validated in three additional independent datasets. In this study, we provide proof-of-concept that inflammation has a critical role in MM patient progression and survival. The inflammatory-gene prognostic signature validated in different datasets clearly indicates novel opportunities for personalized anti-MM treatment.
Coping Trajectories in Later Life: A 20-Year Predictive Study
Brennan, Penny L.; Holland, Jason M.; Schutte, Kathleen K.; Moos, Rudolf H.
2012-01-01
Objectives and Method Information about aging-related change in coping is limited mainly to results of cross-sectional studies of age differences in coping, and no research has focused on predictors of aging-related change in coping behavior. To extend research in this area, we used longitudinal multilevel modeling to describe older adults’ (n=719; baseline M=61 years) 20-year, intra-individual approach and avoidance coping trajectories, and to determine the influence of two sets of predictors (threat appraisal and stressor characteristics; gender and baseline personal and social resources) on level and rate of change in these trajectories. Results Over the 20-year study interval participants declined in use of approach coping and most avoidance coping strategies, but there was significant variation in this trend. In simultaneous predictive models, female gender, more threat appraisal, stressor severity, social resources, and depressive symptoms; and fewer financial resources, were independently associated with higher initial levels of coping responses. Having more social resources, and fewer financial resources, at baseline in late-middle-age predicted faster decline over time in approach coping. Having more baseline depressive symptoms, and fewer baseline financial resources, hastened decline in use of avoidance coping. Independent of other variables in these models, decline over time in approach coping and avoidance coping remained statistically significant. Conclusion Overall decline in coping may be a normative pattern of coping change in later life. However, it also is modifiable by older adults’ stressor appraisals, their stressors, and the personal and social resources they possess at entry to later life, in late-middle age. PMID:22394319
Ferrara, Liberato Aldo; Wang, Hong; Umans, Jason G; Franceschini, Nora; Jolly, Stacey; Lee, Elisa T.; Yeh, Jeunliang; Devereux, Richard B.; Howard, Barbara V.; de Simone, Giovanni
2014-01-01
Objective To evaluate whether uric acid (UA) predicts 4-yr incidence of metabolic syndrome (MetS) in non-diabetic participants of the Strong Heart Study (SHS) cohort. Design and Methods In this population-based prospective study we analyzed 1499 American Indians (890 women), without diabetes or MetS, controlled during the 4th SHS exam and reexamined 4 years later during the 5th SHS exam. Participants were divided into sex-specific tertiles of UA and the first two tertiles (group N) were compared with the third tertile (group H). Results Body mass index (BMI =28.3±7 vs. 31.1±7 kg/m2), fat-free mass (FFM = 52.0±14 vs. 54.9±11 kg), waist-to-hip ratio, HOMA-IR (3.66 vs. 4.26), BP and indices of inflammation were significantly higher in group H than in group N (all p<0.001). Incident MetS at the time of the 5th exam was more frequent in group H than group N (35 vs. 28%, OR 1.44 (95% CI=1.10-1.91; p< 0.01). This association was still significant (OR= 1.13, p=0.04) independently of family relatedness, sex, history of hypertension, HOMA-IR, central adiposity and renal function, but disappeared when fat-free mass was included in the model. Conclusions In the SHS, UA levels are associated to parameters of insulin resistance and to indices of inflammation. UA levels, however, do not predict incident MetS independently of the initial obesity-related increased FFM. PMID:25063537
Song, Xiang; Tian, Shu-ping; Ju, Hai-yue; Zhang, Fan; Li, Ying-na; Wu, Fang; Yang, Li
2015-02-01
To explore the potential correlation between apolipoprotein (Apo) levels and coronary atherosclerosis and investigate its predictive value for coronary artery lesions in asymptomatic population without diabetes. We performed a retrospective analysis of data collected from 401 asymptomatic patients who took health check-ups. They were divided into atherosclerosis group (n=224)and control group (n=177) based on the outcome of CT angiography and blood biochemical findings. The risk factors, lipid profiles, and Apo levels were compared between these two groups. The best biochemical indicators for predicting the coronary atherosclerosis were explored. The levels of ApoB, ApoC2,ApoC3,and ApoE and ApoB/ApoA1 ratio were significantly higher in the atherosclerosis group than in the control group (all P<0.01), whereas the ApoA1,ApoA2, and lipoprotein a levels showed no such significant difference (all P>0.05). Logistic regression analysis revealed that age, male, hypertension,ApoC3(OR=1.572,95%CI 1.200-2.061) and ApoB/ApoA1 ratio (OR=1.767,95% CI 1.335-2.338) were independently correlated with coronary atherosclerosis (all P<0.01). In the prediction of the presence of plaque, ApoB had the largest area under curves, and the optimal cutoff point was 1.005 g/L. ApoC3 is closely associated with subclinical coronary atherosclerosis,while the decrease of ApoA1 level is not obvious during this period. Compared with other lipid indicators, ApoB is the strongest predictor for coronary atherosclerosis in asymptomatic non-diabetic population.
Measuring and assessing maintainability at the end of high level design
NASA Technical Reports Server (NTRS)
Briand, Lionel C.; Morasca, Sandro; Basili, Victor R.
1993-01-01
Software architecture appears to be one of the main factors affecting software maintainability. Therefore, in order to be able to predict and assess maintainability early in the development process we need to be able to measure the high-level design characteristics that affect the change process. To this end, we propose a measurement approach, which is based on precise assumptions derived from the change process, which is based on Object-Oriented Design principles and is partially language independent. We define metrics for cohesion, coupling, and visibility in order to capture the difficulty of isolating, understanding, designing and validating changes.
Imaging systems level consolidation of novel associate memories: A longitudinal neuroimaging study
Smith, Jason F; Alexander, Gene E; Chen, Kewei; Husain, Fatima T; Kim, Jieun; Pajor, Nathan; Horwitz, Barry
2010-01-01
Previously, a standard theory of systems level memory consolidation was developed to describe how memory recall becomes independent of the medial temporal memory system. More recently, an extended consolidation theory was proposed that predicts seven changes in regional neural activity and inter-regional functional connectivity. Using longitudinal event related functional magnetic resonance imaging of an associate memory task, we simultaneously tested all predictions and additionally tested for consolidation related changes in recall of associate memories at a sub-trial temporal resolution, analyzing cue, delay and target periods of each trial separately. Results consistent with the theoretical predictions were observed though two inconsistent results were also obtained. In particular, while recall-related delay period activity decreased with consolidation as predicted, visual cue activity increased for consolidated memories. Though the extended theory of memory consolidation is largely supported by our study, these results suggest the extended theory needs further refinement and the medial temporal memory system has multiple, temporally distinct roles in associate memory recall. Neuroimaging analysis at a sub-trial temporal resolution, as used here, may further clarify the role of the hippocampal complex in memory consolidation. PMID:19948227
Leitner, Jordan B; Hehman, Eric; Ayduk, Ozlem; Mendoza-Denton, Rodolfo
2016-10-20
Research suggests that, among Whites, racial bias predicts negative ingroup health outcomes. However, little is known about whether racial bias predicts ingroup health outcomes among minority populations. The aim of the current research was to understand whether racial bias predicts negative ingroup health outcomes for Blacks. We compiled racial bias responses from 250,665 Blacks and 1,391,632 Whites to generate county-level estimates of Blacks' and Whites' implicit and explicit biases towards each other. We then examined the degree to which these biases predicted ingroup death rate from circulatory-related diseases. In counties where Blacks harbored more implicit bias towards Whites, Blacks died at a higher rate. Additionally, consistent with previous research, in counties where Whites harbored more explicit bias towards Blacks, Whites died at a higher rate. These links between racial bias and ingroup death rate were independent of county-level socio-demographic characteristics, and racial biases from the outgroup in the same county. Findings indicate that racial bias is related to negative ingroup health outcomes for both Blacks and Whites, though this relationship is driven by implicit bias for Blacks, and explicit bias for Whites. Copyright © 2016 Elsevier Ltd. All rights reserved.
Unemployment in Iraqi Refugees: The Interaction of Pre and Post-Displacement Trauma
Wright, A. Michelle; Dhalimi, Abir; Lumley, Mark A.; Jamil, Hikmet; Pole, Nnamdi; Arnetz, Judith E.; Arnetz, Bengt B.
2016-01-01
Previous refugee research has been unable to link pre-displacement trauma with unemployment in the host country. The current study assessed the role of pre-displacement trauma, post-displacement trauma, and the interaction of both trauma types to prospectively examine unemployment in a random sample of newly-arrived Iraqi refugees. Participants (N=286) were interviewed three times over the first two years post-arrival. Refugees were assessed for pre-displacement trauma exposure, post-displacement trauma exposure, a history of unemployment in the country of origin and host country, and symptoms of posttraumatic stress disorder (PTSD) and depression. Analyses found that neither pre-displacement nor post-displacement trauma independently predicted unemployment 2 years post-arrival; however, the interaction of pre and post-displacement trauma predicted 2-year unemployment. Refugees with high levels of both pre and post-displacement trauma had a 91% predicted probability of unemployment, whereas those with low levels of both traumas had a 20% predicted probability. This interaction remained significant after controlling for sociodemographic variables and mental health upon arrival to the U.S. Resettlement agencies and community organizations should consider the interactive effect of encountering additional trauma after escaping the hardships of the refugee's country of origin. PMID:27535348
Acoustic and Lexical Representations for Affect Prediction in Spontaneous Conversations.
Cao, Houwei; Savran, Arman; Verma, Ragini; Nenkova, Ani
2015-01-01
In this article we investigate what representations of acoustics and word usage are most suitable for predicting dimensions of affect|AROUSAL, VALANCE, POWER and EXPECTANCY|in spontaneous interactions. Our experiments are based on the AVEC 2012 challenge dataset. For lexical representations, we compare corpus-independent features based on psychological word norms of emotional dimensions, as well as corpus-dependent representations. We find that corpus-dependent bag of words approach with mutual information between word and emotion dimensions is by far the best representation. For the analysis of acoustics, we zero in on the question of granularity. We confirm on our corpus that utterance-level features are more predictive than word-level features. Further, we study more detailed representations in which the utterance is divided into regions of interest (ROI), each with separate representation. We introduce two ROI representations, which significantly outperform less informed approaches. In addition we show that acoustic models of emotion can be improved considerably by taking into account annotator agreement and training the model on smaller but reliable dataset. Finally we discuss the potential for improving prediction by combining the lexical and acoustic modalities. Simple fusion methods do not lead to consistent improvements over lexical classifiers alone but improve over acoustic models.
Phadnis, Joideep; Arnold, Christine; Elmorsy, Ahmed; Flannery, Mark
2015-08-01
The redislocation rate after arthroscopic stabilization for anterior glenohumeral instability is up to 30%. The Instability Severity Index Score (ISIS) was developed to preoperatively rationalize the risk of failure, but it has not yet been validated by an independent group. To assess the utility of the ISIS in predicting failure of arthroscopic anterior shoulder stabilization and to identify other preoperative factors for failure. Case-control study; Level of evidence, 3. A case-control study was performed on 141 consecutive patients, comparing those who suffered failure of arthroscopic stabilization with those who had successful arthroscopic stabilization. The mean follow-up time was 47 months (range, 24-132 months). The ISIS was applied retrospectively, and an analysis was performed to establish independent risk factors for failure. A receiver operator coefficient curve was constructed to set a threshold ISIS for considering alternative surgery. Of 141 patients, 19 (13.5%) suffered recurrent instability. The mean ISIS of the failed stabilization group was higher than that of the successful stabilization group (5.1 vs 1.7; P < .001). Independent risk factors for failure were Hill-Sachs lesion (P < .001), glenoid bone loss (P < .001), age <21 years at the time of surgery (P < .001), age at first dislocation (P = .01), competitive-level participation in sports (P < .001), and participation in contact or overhead sports (P = .03). The presence of glenoid bone loss carried the highest risk of failure (70%). There was a 70% risk of failure if the ISIS was ≥4, as opposed to a 4% risk of failure if the ISIS was <4. This is the first completely independent study to confirm that the ISIS is a useful preoperative tool. It is recommended that surgeons consider alternative forms of stabilization if the ISIS is ≥4. © 2015 The Author(s).
Wei, Ta-Sen; Liu, Peng-Ta; Chang, Liang-Wey; Liu, Sen-Yung
2017-01-01
Background Falls are the leading cause of injury in stroke patients. However, the cause of a fall is complicated, and several types of risk factors are involved. Therefore, a comprehensive model to predict falls with high sensitivity and specificity is needed. Methods This study was a prospective study of 112 inpatients in a rehabilitation ward with follow-up interviews in patients’ homes. Evaluations were performed 1 month after stroke and included the following factors: (1) status of cognition, depression, fear of fall and limb spasticity; (2) functional assessments [walking velocity and the Functional Independence Measure (FIM)]; and (3) objective, computerized gait and balance analyses. The outcome variable was the number of accidental falls during the 6-month follow-up period after baseline measurements. Results The non-faller group exhibited significantly better walking velocity and FIM scale compared to the faller group (P < .001). The faller group exhibited higher levels of spasticity in the affected limbs, asymmetry of gait parameters in single support (P < .001), double support (P = .027), and step time (P = .003), and lower stability of center of gravity in the medial-lateral direction (P = .008). Psychological assessments revealed that the faller group exhibited more severe depression and lower confidence without falling. A multivariate logistic regression model identified three independent predictors of falls with high sensitivity (82.6%) and specificity (86.5%): the asymmetry ratio of single support [adjusted odds ratio, aOR = 2.2, 95% CI (1.2–3.8)], the level of spasticity in the gastrocnemius [aOR = 3.2 (1.4–7.3)], and the degree of depression [aOR = 1.4 (1.2–1.8)]. Conclusions This study revealed depression, in additional to gait asymmetry and spasticity, as another independent factor for predicting falls. These results suggest that appropriate gait training, reduction of ankle spasticity, and aggressive management of depression may be critical to prevent falls in stroke patients. PMID:28542281
Hanczakowski, Maciej; Mazzoni, Giuliana
2013-05-01
Retrieval-induced forgetting (RIF) is the finding of impaired memory performance for information stored in long-term memory due to retrieval of a related set of information. This phenomenon is often assigned to operations of a specialized mechanism recruited to resolve interference during retrieval by deactivating competing memory representations. This inhibitory account is supported by, among others, findings showing that RIF occurs with independent cues not used during retrieval practice. However, these findings are not always consistent. Recently, Norman, Newman, and Detre (2007) have proposed a model that aims at resolving discrepancies concerning cue-independence of RIF. The model predicts that RIF should be present with independent cues when episodic associations are created between independent cues and their targets in the same episodic context that is later used to cue memory during retrieval practice. In the present study we aimed to test this prediction. We associated studied items with semantically unrelated words during the main study phase of the retrieval practice paradigm, and we tested memory with both cues used during retrieval practice (Experiment 2) and episodic associates serving as independent cues (Experiments 3a and 3b). Although RIF was present when the same cues were used during retrieval practice and a final test, contrary to the prediction formulated by Norman et al., RIF failed to emerge when episodic associates were employed as independent cues.
Zhang, Jing; Wang, Wei-da; Geng, Qi-Rong; Wang, Liang; Chen, Xiao-Qin; Liu, Cheng-Cheng; Lv, Yue
2014-01-01
Interleukin-9 (IL-9) is more functionally diverse than previously expected, especially with regards to lymphomagenesis. However, the relationship between IL-9 and the clinicopathological features of extranodal NK/T-cell lymphoma is less well established. Patients with this lymphoma in Sun Yat-Sen University Cancer Center between January 2003 and March 2013 were systematically reviewed in an intention-to-treat analysis. Baseline serum IL-9 levels were determined using sandwich enzyme-linked immunosorbent assays. A total of seventy-four patients were enrolled in this study. The mean concentration of serum IL-9 for all patients was 6.48 pg/mL (range: 1.38-51.87 pg/mL). Age, B symptoms and local lymph node involvement were found to be related to high serum IL-9 levels. Patients with low IL-9 levels tended to have higher rates of complete remission. Notably, the median progression-free survival (PFS) and overall survival (OS) were longer in the low IL-9 level group than in the high IL-9 level group (PFS: 68.7 months vs. 28.3 months, P<0.001; OS: 86 months vs. 42.8 months, P = 0.001). Multivariate analysis revealed independent prognostic factors for PFS. Similarly, high IL-9 levels (P = 0.003) and old age (P = 0.007) were independently predictive of shorter OS. Serum IL-9 is closely related to several clinical features, such as age, B symptoms and local lymph node involvement. It can also be a significant independent prognostic factor for extranodal NK/T-cell lymphoma, which suggests a role for IL-9 in the pathogenesis of this disease and offers new insight into potential therapeutic strategies.
Mortality indicators and risk factors for intra-abdominal hypertension in severe acute pancreatitis.
Zhao, J G; Liao, Q; Zhao, Y P; Hu, Y
2014-01-01
This study assessed the risk factors associated with mortality and the development of intra-abdominal hypertension (IAH) in patients with severe acute pancreatitis (SAP). To identify significant risk factors, we assessed the following variables in 102 patients with SAP: age, gender, etiology, serum amylase level, white blood cell (WBC) count, serum calcium level, Acute Physiology and Chronic Health Evaluation II (APACHE-II) score, computed tomography severity index (CTSI) score, pancreatic necrosis, surgical interventions, and multiple organ dysfunction syndrome (MODS). Statistically significant differences were identified using the Student t test and the χ (2) test. Independent risk factors for survival were analyzed by Cox proportional hazards regression. The following variables were significantly related to both mortality and IAH: WBC count, serum calcium level, serum amylase level, APACHE-II score, CTSI score, pancreatic necrosis, pancreatic necrosis >50%, and MODS. However, it was found that surgical intervention had no significant association with mortality. MODS and pancreatic necrosis >50% were found to be independent risk factors for survival in patients with SAP. Mortality and IAH from SAP were significantly related to WBC count, serum calcium level, serum amylase level, APACHE-II score, CTSI score, pancreatic necrosis, and MODS. However, Surgical intervention did not result in higher mortality. Moreover, MODS and pancreatic necrosis >50% predicted a worse prognosis in SAP patients.
De Wit, Liesbet; Putman, Koen; Devos, Hannes; Brinkmann, Nadine; Dejaeger, Eddy; De Weerdt, Willy; Jenni, Walter; Lincoln, Nadina; Schuback, Birgit; Schupp, Wilfried
2014-01-01
To determine the prognostic value of single items of the Barthel Index (BI) at discharge from rehabilitation, in predicting independence in personal activities of daily living (ADL) (BI score ≥ 95/100) at five years after stroke. People with stroke were recruited consecutively from four European rehabilitation centres. BI was assessed on discharge and at five years after stroke. Stepwise multivariate logistic regression analysis was used to determine independent predictors of BI score ≥ 95/100 at five years after stroke. Thereupon, percentage chance of reaching BI ≥ 95/100 at five years after stroke was calculated. Data were available for 153 patients. Independence in dressing (odds ratio (OR)=5.22, 95% confidence interval (CI)=1.85-14.76, p=0.002) and bathing (OR=8.10, 95% CI=3.40-19.32, p<0.0001) were independent predictors. Independence in both items resulted in 74.1% (57.6-85.8) chance of reaching BI ≥ 95/100 at five years after stroke. Dependence in both items resulted in 6.3% (5.1-7.9) chance. Independence in bathing, but dependence in dressing resulted in 35.4% (30.7-40.4) chance whereas the opposite resulted in 26.1% (20.7-32.3) chance. Simple assessment of dressing and bathing on discharge from rehabilitation enables therapeutic staff to predict prognosis for long-term independence in personal ADL. This method can be used for early identification of persons with stroke who need intensive follow-up. Implications for Rehabilitation (In)dependence for dressing and bathing at discharge from a rehabilitation centre are significant factors in the prediction of (in)dependence in personal ADL at five years after stroke. This predictive tool can be used for targeting inpatient stroke rehabilitation and early identification of those patients who need intensive follow-up.
Genome-Wide Tuning of Protein Expression Levels to Rapidly Engineer Microbial Traits.
Freed, Emily F; Winkler, James D; Weiss, Sophie J; Garst, Andrew D; Mutalik, Vivek K; Arkin, Adam P; Knight, Rob; Gill, Ryan T
2015-11-20
The reliable engineering of biological systems requires quantitative mapping of predictable and context-independent expression over a broad range of protein expression levels. However, current techniques for modifying expression levels are cumbersome and are not amenable to high-throughput approaches. Here we present major improvements to current techniques through the design and construction of E. coli genome-wide libraries using synthetic DNA cassettes that can tune expression over a ∼10(4) range. The cassettes also contain molecular barcodes that are optimized for next-generation sequencing, enabling rapid and quantitative tracking of alleles that have the highest fitness advantage. We show these libraries can be used to determine which genes and expression levels confer greater fitness to E. coli under different growth conditions.
Jeong, Ki Young; Kim, Kyuseok; Kim, Tae Yun; Lee, Christopher C; Jo, Si On; Rhee, Joong Eui; Jo, You Hwan; Suh, Gil Joon; Singer, Adam J
2011-02-01
The prognostic role of N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with community-acquired pneumonia (CAP) has not been evaluated. The aim of the present study was to investigate whether NT-proBNP level could predict mortality in hospitalised CAP patients. We performed a structured medical record review of all hospitalised CAP patients from May 2003 to October 2006, and classified patients into the 30-day survival and non-survival group. Data included demographic and clinical characteristics, and laboratory findings including NT-proBNP levels. The APACHE II scores, PSI (pneumonia severity index) and CURB65 (confusion, urea, respiratory rate, blood pressure and aged 65 or more) scores were calculated. Comparisons between survivors and non-survivors were made with χ(2), non-parametric tests and logistic regression and ROC analysis were used to compare the ability of NT-proBNP (adjusted for age, heart failure and creatinine), APACHE II, PSI and CURB65 to predict mortality. Of 502 patients, 61 (12.2%) died within 30 days. NT-proBNP levels were measured in 167 patients and were significantly higher in non-survivors compared to survivors (median 841.7 (IQR 267.1-3137.3) pg/ml vs 3658.0 (1863.0-7025.0) pg/ml, p=0.019). NT-proBNP was an independent predictor of mortality (adjusted OR 1.53; 95% CI 1.16 to 2.02, p=0.002). The AUC for NT-proBNP was 0.712 (95% CI, 0.613 to 0.812), which was comparable to those of PSI (0.749, p=0.531) and CURB65 (0.698, p=0.693), but inferior to that of APACHE II (0.831, p=0.037). Adding NT-proBNP to APACHE II, PSI and CURB65 did not significantly increase the AUCs, respectively. NT-proBNP level is an independent predictor of mortality in hospitalised CAP patients. The performance of NT-proBNP level is comparable to those of PSI and CURB65 in predicting mortality.
Benhamou, Y; Boelle, P-Y; Baudin, B; Ederhy, S; Gras, J; Galicier, L; Azoulay, E; Provôt, F; Maury, E; Pène, F; Mira, J-P; Wynckel, A; Presne, C; Poullin, P; Halimi, J-M; Delmas, Y; Kanouni, T; Seguin, A; Mousson, C; Servais, A; Bordessoule, D; Perez, P; Hamidou, M; Cohen, A; Veyradier, A; Coppo, P
2015-02-01
Cardiac involvement is a major cause of mortality in patients with thrombotic thrombocytopenic purpura (TTP). However, diagnosis remains underestimated and delayed, owing to subclinical injuries. Cardiac troponin-I measurement (cTnI) on admission could improve the early diagnosis of cardiac involvement and have prognostic value. To assess the predictive value of cTnI in patients with TTP for death or refractoriness. The study involved a prospective cohort of adult TTP patients with acquired severe ADAMTS-13 deficiency (< 10%) and included in the registry of the French Reference Center for Thrombotic Microangiopathies. Centralized cTnI measurements were performed on frozen serum on admission. Between January 2003 and December 2011, 133 patients with TTP (mean age, 48 ± 17 years) had available cTnI measurements on admission. Thirty-two patients (24%) had clinical and/or electrocardiogram features. Nineteen (14.3%) had cardiac symptoms, mainly congestive heart failure and myocardial infarction. Electrocardiogram changes, mainly repolarization disorders, were present in 13 cases. An increased cTnI level (> 0.1 μg L(-1) ) was present in 78 patients (59%), of whom 46 (59%) had no clinical cardiac involvement. The main outcomes were death (25%) and refractoriness (17%). Age (P = 0.02) and cTnI level (P = 0.002) showed the greatest impact on survival. A cTnI level of > 0.25 μg L(-1) was the only independent factor in predicting death (odds ratio [OR] 2.87; 95% confidence interval [CI] 1.13-7.22; P = 0.024) and/or refractoriness (OR 3.03; 95% CI 1.27-7.3; P = 0.01). A CTnI level of > 0.25 μg L(-1) at presentation in patients with TTP appears to be an independent factor associated with a three-fold increase in the risk of death or refractoriness. Therefore, cTnI level should be considered as a prognostic indicator in patients diagnosed with TTP. © 2014 International Society on Thrombosis and Haemostasis.
Analysis of seismograms from a downhole array in sediments near San Francisco Bay
Joyner, William B.; Warrick, Richard E.; Oliver, Adolph A.
1976-01-01
A four-level downhole array of three-component instruments was established on the southwest shore of San Francisco Bay to monitor the effect of the sediments on low-amplitude seismic ground motion. The deepest instrument is at a depth of 186 meters, two meters below the top of the Franciscan bedrock. Earthquake data from regional distances (29 km ≤ Δ ≤ 485 km) over a wide range of azimuths are compared with the predictions of a simple plane-layered model with material properties independently determined. Spectral ratios between the surface and bedrock computed for the one horizontal component of motion that was analyzed agree rather well with the model predictions; the model predicts the frequencies of the first three peaks within 10 percent in most cases and the height of the peaks within 50 percent in most cases. Surface time histories computed from the theoretical model predict the time variations of amplitude and frequency content reasonably well, but correlations of individual cycles cannot be made between observed and predicted traces.
Subharmonic Imaging and Pressure Estimation for Monitoring Neoadjuvant Chemotherapy
2013-09-01
10]. However, the level of IFP has been shown to predict disease free survival for cervix cancer (34% disease free survival (DFS) if IFP > 19 mmHg...in patients with cervix cancer independent of clinical prognostic factors and tumor oxygen measurements. Cancer Res, 2001. 61(17): p. 6400-5. 12... cancer (LABC). Monitoring tumor response is advantageous for patients. This project aims to using the subharmonic signals from ultrasound contrast agents
NASA Astrophysics Data System (ADS)
Fouad, Geoffrey; Skupin, André; Hope, Allen
2016-04-01
The flow duration curve (FDC) is one of the most widely used tools to quantify streamflow. Its percentile flows are often required for water resource applications, but these values must be predicted for ungauged basins with insufficient or no streamflow data. Regional regression is a commonly used approach for predicting percentile flows that involves identifying hydrologic regions and calibrating regression models to each region. The independent variables used to describe the physiographic and climatic setting of the basins are a critical component of regional regression, yet few studies have investigated their effect on resulting predictions. In this study, the complexity of the independent variables needed for regional regression is investigated. Different levels of variable complexity are applied for a regional regression consisting of 918 basins in the US. Both the hydrologic regions and regression models are determined according to the different sets of variables, and the accuracy of resulting predictions is assessed. The different sets of variables include (1) a simple set of three variables strongly tied to the FDC (mean annual precipitation, potential evapotranspiration, and baseflow index), (2) a traditional set of variables describing the average physiographic and climatic conditions of the basins, and (3) a more complex set of variables extending the traditional variables to include statistics describing the distribution of physiographic data and temporal components of climatic data. The latter set of variables is not typically used in regional regression, and is evaluated for its potential to predict percentile flows. The simplest set of only three variables performed similarly to the other more complex sets of variables. Traditional variables used to describe climate, topography, and soil offered little more to the predictions, and the experimental set of variables describing the distribution of basin data in more detail did not improve predictions. These results are largely reflective of cross-correlation existing in hydrologic datasets, and highlight the limited predictive power of many traditionally used variables for regional regression. A parsimonious approach including fewer variables chosen based on their connection to streamflow may be more efficient than a data mining approach including many different variables. Future regional regression studies may benefit from having a hydrologic rationale for including different variables and attempting to create new variables related to streamflow.
Germaine, Stephen S.; Ignizio, Drew; Keinath, Doug; Copeland, Holly
2014-01-01
Species distribution models are an important component of natural-resource conservation planning efforts. Independent, external evaluation of their accuracy is important before they are used in management contexts. We evaluated the classification accuracy of two species distribution models designed to predict the distribution of pygmy rabbit Brachylagus idahoensis habitat in southwestern Wyoming, USA. The Nature Conservancy model was deductive and based on published information and expert opinion, whereas the Wyoming Natural Diversity Database model was statistically derived using historical observation data. We randomly selected 187 evaluation survey points throughout southwestern Wyoming in areas predicted to be habitat and areas predicted to be nonhabitat for each model. The Nature Conservancy model correctly classified 39 of 77 (50.6%) unoccupied evaluation plots and 65 of 88 (73.9%) occupied plots for an overall classification success of 63.3%. The Wyoming Natural Diversity Database model correctly classified 53 of 95 (55.8%) unoccupied plots and 59 of 88 (67.0%) occupied plots for an overall classification success of 61.2%. Based on 95% asymptotic confidence intervals, classification success of the two models did not differ. The models jointly classified 10.8% of the area as habitat and 47.4% of the area as nonhabitat, but were discordant in classifying the remaining 41.9% of the area. To evaluate how anthropogenic development affected model predictive success, we surveyed 120 additional plots among three density levels of gas-field road networks. Classification success declined sharply for both models as road-density level increased beyond 5 km of roads per km-squared area. Both models were more effective at predicting habitat than nonhabitat in relatively undeveloped areas, and neither was effective at accounting for the effects of gas-energy-development road networks. Resource managers who wish to know the amount of pygmy rabbit habitat present in an area or wanting to direct gas-drilling efforts away from pygmy rabbit habitat may want to consider both models in an ensemble manner, where more confidence is placed in mapped areas (i.e., pixels) for which both models agree than for areas where there is model disagreement.
Connectivity Predicts Deep Brain Stimulation Outcome in Parkinson Disease
Horn, Andreas; Reich, Martin; Vorwerk, Johannes; Li, Ningfei; Wenzel, Gregor; Fang, Qianqian; Schmitz-Hübsch, Tanja; Nickl, Robert; Kupsch, Andreas; Volkmann, Jens; Kühn, Andrea A.; Fox, Michael D.
2018-01-01
Objective The benefit of deep brain stimulation (DBS) for Parkinson disease (PD) may depend on connectivity between the stimulation site and other brain regions, but which regions and whether connectivity can predict outcome in patients remain unknown. Here, we identify the structural and functional connectivity profile of effective DBS to the subthalamic nucleus (STN) and test its ability to predict outcome in an independent cohort. Methods A training dataset of 51 PD patients with STN DBS was combined with publicly available human connectome data (diffusion tractography and resting state functional connectivity) to identify connections reliably associated with clinical improvement (motor score of the Unified Parkinson Disease Rating Scale [UPDRS]). This connectivity profile was then used to predict outcome in an independent cohort of 44 patients from a different center. Results In the training dataset, connectivity between the DBS electrode and a distributed network of brain regions correlated with clinical response including structural connectivity to supplementary motor area and functional anticorrelation to primary motor cortex (p<0.001). This same connectivity profile predicted response in an independent patient cohort (p<0.01). Structural and functional connectivity were independent predictors of clinical improvement (p<0.001) and estimated response in individual patients with an average error of 15% UPDRS improvement. Results were similar using connectome data from normal subjects or a connectome age, sex, and disease matched to our DBS patients. Interpretation Effective STN DBS for PD is associated with a specific connectivity profile that can predict clinical outcome across independent cohorts. This prediction does not require specialized imaging in PD patients themselves. PMID:28586141
A model for estimating pathogen variability in shellfish and predicting minimum depuration times.
McMenemy, Paul; Kleczkowski, Adam; Lees, David N; Lowther, James; Taylor, Nick
2018-01-01
Norovirus is a major cause of viral gastroenteritis, with shellfish consumption being identified as one potential norovirus entry point into the human population. Minimising shellfish norovirus levels is therefore important for both the consumer's protection and the shellfish industry's reputation. One method used to reduce microbiological risks in shellfish is depuration; however, this process also presents additional costs to industry. Providing a mechanism to estimate norovirus levels during depuration would therefore be useful to stakeholders. This paper presents a mathematical model of the depuration process and its impact on norovirus levels found in shellfish. Two fundamental stages of norovirus depuration are considered: (i) the initial distribution of norovirus loads within a shellfish population and (ii) the way in which the initial norovirus loads evolve during depuration. Realistic assumptions are made about the dynamics of norovirus during depuration, and mathematical descriptions of both stages are derived and combined into a single model. Parameters to describe the depuration effect and norovirus load values are derived from existing norovirus data obtained from U.K. harvest sites. However, obtaining population estimates of norovirus variability is time-consuming and expensive; this model addresses the issue by assuming a 'worst case scenario' for variability of pathogens, which is independent of mean pathogen levels. The model is then used to predict minimum depuration times required to achieve norovirus levels which fall within possible risk management levels, as well as predictions of minimum depuration times for other water-borne pathogens found in shellfish. Times for Escherichia coli predicted by the model all fall within the minimum 42 hours required for class B harvest sites, whereas minimum depuration times for norovirus and FRNA+ bacteriophage are substantially longer. Thus this study provides relevant information and tools to assist norovirus risk managers with future control strategies.
Wellons, Melissa F; Bates, Gordon Wright; Schreiner, Pamela J; Siscovick, David S; Sternfeld, Barbara; Lewis, Cora E
2013-08-01
The timing of menopause is associated with multiple chronic diseases. Tools that predict this milestone have relevance for clinical and research purposes. Among infertile women, a positive relationship exists between antral follicle count (AFC) and response to controlled ovarian hyperstimulation, a marker of ovarian reserve. However, an age-independent relationship between AFC and menopause has not been demonstrated. Thus, our objective was to evaluate the relationship between AFC measured in women aged 34 to 49 years and incident natural menopause during 7 years of follow-up. The Coronary Artery Risk Development in Young Adults Study is a longitudinal community-based study (Chicago, IL; Birmingham, AL; Minneapolis, MN; and Oakland, CA) begun in 1985-1986. In 2002-2003, the Coronary Artery Risk Development in Young Adults Women's Study measured follicle-stimulating hormone (FSH) levels and performed a transvaginal ultrasound protocol that included AFC (2-10 mm follicles on both ovaries). Incident natural menopause was assessed by surveys in 2005-2006 and 2009-2010. In our sample (n = 456), the median (interquartile range) AFC and FSH level were 5 (2-9) and 7.8 (5.6-11.0) mIU/mL, respectively, at a mean (range) age of 42 (34-49) years in 2002-2003. One hundred one women reported natural menopause by 2009-2010. In Cox models, current smoking, stable menses, FSH level higher than 13 mIU/mL, and AFC of 4 or less were independently associated with incident natural menopause. Compared with AFC higher than 4, those with an AFC of 4 or less were nearly twice as likely to have undergone menopause during 7 years of follow-up (hazard ratio, 1.89; 95% CI, 1.19-3.02) after adjustment for covariates. AFC has been found to be independently associated with natural menopause during 7 years of follow-up after controlling for other markers of ovarian aging.
Peters, Susan; Vermeulen, Roel; Portengen, Lützen; Olsson, Ann; Kendzia, Benjamin; Vincent, Raymond; Savary, Barbara; Lavoué, Jérôme; Cavallo, Domenico; Cattaneo, Andrea; Mirabelli, Dario; Plato, Nils; Fevotte, Joelle; Pesch, Beate; Brüning, Thomas; Straif, Kurt; Kromhout, Hans
2011-11-01
We describe an empirical model for exposure to respirable crystalline silica (RCS) to create a quantitative job-exposure matrix (JEM) for community-based studies. Personal measurements of exposure to RCS from Europe and Canada were obtained for exposure modelling. A mixed-effects model was elaborated, with region/country and job titles as random effect terms. The fixed effect terms included year of measurement, measurement strategy (representative or worst-case), sampling duration (minutes) and a priori exposure intensity rating for each job from an independently developed JEM (none, low, high). 23,640 personal RCS exposure measurements, covering a time period from 1976 to 2009, were available for modelling. The model indicated an overall downward time trend in RCS exposure levels of -6% per year. Exposure levels were higher in the UK and Canada, and lower in Northern Europe and Germany. Worst-case sampling was associated with higher reported exposure levels and an increase in sampling duration was associated with lower reported exposure levels. Highest predicted RCS exposure levels in the reference year (1998) were for chimney bricklayers (geometric mean 0.11 mg m(-3)), monument carvers and other stone cutters and carvers (0.10 mg m(-3)). The resulting model enables us to predict time-, job-, and region/country-specific exposure levels of RCS. These predictions will be used in the SYNERGY study, an ongoing pooled multinational community-based case-control study on lung cancer.
Oubaya, N; Dramé, M; Novella, J-L; Quignard, E; Cunin, C; Jolly, D; Mahmoudi, R
2017-11-01
To study the capacity of the SEGAm instrument to predict loss of independence among elderly community-dwelling subjects. The study was performed in four French departments (Ardennes, Marne, Meurthe-et-Moselle, Meuse). Subjects aged 65 years or more, living at home, who could read and understand French, with a degree of autonomy corresponding to groups 5 or 6 in the AGGIR autonomy evaluation scale were included. Assessment included demographic characteristics, comprehensive geriatric assessment, and the SEGAm instrument at baseline. Subjects had follow-up visits at home at 6 and 12 months. During follow-up, vital status and level of independence were recorded. Logistic regression was used to study predictive validity of the SEGAm instrument. Among the 116 subjects with complete follow-up, 84 (72.4%) were classed as not very frail at baseline, 23 (19.8%) as frail, and 9 (7.8%) as very frail; 63 (54.3%) suffered loss of at least one ADL or IADL at 12 months. By multivariable analysis, frailty status at baseline was significantly associated with loss of independence during the 12 months of follow-up (OR=4.52, 95% CI=1.40-14.68; p=0.01). We previously validated the SEGAm instrument in terms of feasibility, acceptability, internal structure validity, reliability, and discriminant validity. This instrument appears to be a suitable tool for screening frailty among community-dwelling elderly subjects, and could be used as a basis to plan early targeted interventions for subjects at risk of adverse outcome. Copyright © 2017 Elsevier B.V. All rights reserved.
Youn, Jong-Chan; Lee, Hye Sun; Choi, Suk-Won; Han, Seong-Woo; Ryu, Kyu-Hyung; Shin, Eui-Cheol; Kang, Seok-Min
2016-01-01
Post-exercise heart rate recovery (HRR) is an index of parasympathetic function associated with clinical outcome in patients with chronic heart failure. However, its relationship with the pro-inflammatory response and prognostic value in consecutive patients with acute decompensated heart failure (ADHF) has not been investigated. We measured HRR and pro-inflammatory markers in 107 prospectively and consecutively enrolled, recovered ADHF patients (71 male, 59 ± 15 years, mean ejection fraction 28.9 ± 14.2%) during the pre-discharge period. The primary endpoint included cardiovascular (CV) events defined as CV mortality, cardiac transplantation, or rehospitalization due to HF aggravation. The CV events occurred in 30 (28.0%) patients (5 cardiovascular deaths and 7 cardiac transplantations) during the follow-up period (median 214 days, 11-812 days). When the patients with ADHF were grouped by HRR according to the Contal and O'Quigley's method, low HRR was shown to be associated with significantly higher levels of serum monokine-induced by gamma interferon (MIG) and poor clinical outcome. Multivariate Cox regression analysis revealed that low HRR was an independent predictor of CV events in both enter method and stepwise method. The addition of HRR to a model significantly increased predictability for CV events across the entire follow-up period. Impaired post-exercise HRR is associated with a pro-inflammatory response and independently predicts clinical outcome in patients with ADHF. These findings may explain the relationship between autonomic dysfunction and clinical outcome in terms of the inflammatory response in these patients.
Ramchand, Jay; Patel, Sheila K; Srivastava, Piyush M; Farouque, Omar; Burrell, Louise M
2018-01-01
Angiotensin converting enzyme 2 (ACE2) is an endogenous regulator of the renin angiotensin system. Increased circulating ACE2 predicts adverse outcomes in patients with heart failure (HF), but it is unknown if elevated plasma ACE2 activity predicts major adverse cardiovascular events (MACE) in patients with obstructive coronary artery disease (CAD). We prospectively recruited patients with obstructive CAD (defined as ≥50% stenosis of the left main coronary artery and/or ≥70% stenosis in ≥ 1 other major epicardial vessel on invasive coronary angiography) and measured plasma ACE2 activity. Patients were followed up to determine if circulating ACE2 activity levels predicted the primary endpoint of MACE (cardiovascular mortality, HF or myocardial infarction). We recruited 79 patients with obstructive coronary artery disease. The median (IQR) plasma ACE2 activity was 29.3 pmol/ml/min [21.2-41.2]. Over a median follow up of 10.5 years [9.6-10.8years], MACE occurred in 46% of patients (36 events). On Kaplan-Meier analysis, above-median plasma ACE2 activity was associated with MACE (log-rank test, p = 0.035) and HF hospitalisation (p = 0.01). After Cox multivariable adjustment, log ACE2 activity remained an independent predictor of MACE (hazard ratio (HR) 2.4, 95% confidence interval (CI) 1.24-4.72, p = 0.009) and HF hospitalisation (HR: 4.03, 95% CI: 1.42-11.5, p = 0.009). Plasma ACE2 activity independently increased the hazard of adverse long-term cardiovascular outcomes in patients with obstructive CAD.
Yamakado, Minoru; Nagao, Kenji; Imaizumi, Akira; Tani, Mizuki; Toda, Akiko; Tanaka, Takayuki; Jinzu, Hiroko; Miyano, Hiroshi; Yamamoto, Hiroshi; Daimon, Takashi; Horimoto, Katsuhisa; Ishizaka, Yuko
2015-01-01
Plasma free amino acid (PFAA) profile is highlighted in its association with visceral obesity and hyperinsulinemia, and future diabetes. Indeed PFAA profiling potentially can evaluate individuals’ future risks of developing lifestyle-related diseases, in addition to diabetes. However, few studies have been performed especially in Asian populations, about the optimal combination of PFAAs for evaluating health risks. We quantified PFAA levels in 3,701 Japanese subjects, and determined visceral fat area (VFA) and two-hour post-challenge insulin (Ins120 min) values in 865 and 1,160 subjects, respectively. Then, models between PFAA levels and the VFA or Ins120 min values were constructed by multiple linear regression analysis with variable selection. Finally, a cohort study of 2,984 subjects to examine capabilities of the obtained models for predicting four-year risk of developing new-onset lifestyle-related diseases was conducted. The correlation coefficients of the obtained PFAA models against VFA or Ins120 min were higher than single PFAA level. Our models work well for future risk prediction. Even after adjusting for commonly accepted multiple risk factors, these models can predict future development of diabetes, metabolic syndrome, and dyslipidemia. PFAA profiles confer independent and differing contributions to increasing the lifestyle-related disease risks in addition to the currently known factors in a general Japanese population. PMID:26156880
Idris, Adi; Ghazali, Nur B; Said, Nadzirah M; Steele, Michael; Koh, David; Tuah, Nik A
2016-04-09
Early smoking is considered an indicator for risky behaviour in adolescents. Although social indicators predicting adolescent smoking are known, biological indicators have not been defined. This study aimed to establish whether salivary testosterone could be used as a "predictive biomarker" for smoking-associated peer pressure. Saliva samples were collected from Bruneian adolescents (aged 13-17 years) by the passive drool method. Salivary testosterone concentration was determined by enzyme-linked immunosorbent assay. Salivary testosterone concentration and smoking-associated peer pressure indicators were compared between adolescent males and females and statistical significance was determined by an independent samples t-test. A significant positive relationship between smoking-associated peer pressure and salivary testosterone levels in adolescents was found. However, this relationship was not significant when males and females were considered separately. Our data suggest that students who have tried cigarette smoking and have friends who are cigarette smokers have higher salivary testosterone levels.
A rare variant in APOC3 is associated with plasma triglyceride and VLDL levels in Europeans.
Timpson, Nicholas J; Walter, Klaudia; Min, Josine L; Tachmazidou, Ioanna; Malerba, Giovanni; Shin, So-Youn; Chen, Lu; Futema, Marta; Southam, Lorraine; Iotchkova, Valentina; Cocca, Massimiliano; Huang, Jie; Memari, Yasin; McCarthy, Shane; Danecek, Petr; Muddyman, Dawn; Mangino, Massimo; Menni, Cristina; Perry, John R B; Ring, Susan M; Gaye, Amadou; Dedoussis, George; Farmaki, Aliki-Eleni; Burton, Paul; Talmud, Philippa J; Gambaro, Giovanni; Spector, Tim D; Smith, George Davey; Durbin, Richard; Richards, J Brent; Humphries, Steve E; Zeggini, Eleftheria; Soranzo, Nicole
2014-09-16
The analysis of rich catalogues of genetic variation from population-based sequencing provides an opportunity to screen for functional effects. Here we report a rare variant in APOC3 (rs138326449-A, minor allele frequency ~0.25% (UK)) associated with plasma triglyceride (TG) levels (-1.43 s.d. (s.e.=0.27 per minor allele (P-value=8.0 × 10(-8))) discovered in 3,202 individuals with low read-depth, whole-genome sequence. We replicate this in 12,831 participants from five additional samples of Northern and Southern European origin (-1.0 s.d. (s.e.=0.173), P-value=7.32 × 10(-9)). This is consistent with an effect between 0.5 and 1.5 mmol l(-1) dependent on population. We show that a single predicted splice donor variant is responsible for association signals and is independent of known common variants. Analyses suggest an independent relationship between rs138326449 and high-density lipoprotein (HDL) levels. This represents one of the first examples of a rare, large effect variant identified from whole-genome sequencing at a population scale.
Autistic traits in children with ADHD index clinical and cognitive problems.
Cooper, Miriam; Martin, Joanna; Langley, Kate; Hamshere, Marian; Thapar, Anita
2014-01-01
Traits of autistic spectrum disorders (ASD) occur frequently in attention deficit hyperactivity disorder (ADHD), but the significance of their presence in terms of phenotype and underlying neurobiology is not properly understood. This analysis aimed to determine whether higher levels of autistic traits, as measured by the Social Communication Questionnaire (SCQ), index a more severe presentation in a large, rigorously phenotyped sample of children with ADHD (N=711). Regression analyses were used to examine association of SCQ scores with core ADHD features, clinical comorbidities and cognitive and developmental features, with adjustment for putative confounders. For outcomes showing association with total SCQ score, secondary analyses determined levels of differential association of the three ASD sub-domains. Results suggest that increasing ASD symptomatology within ADHD is associated with a more severe phenotype in terms of oppositional, conduct and anxiety symptoms, lower full-scale IQ, working memory deficits and general motor problems. These associations persisted after accounting for ADHD severity, suggesting that autistic symptomatology independently indexes the severity of comorbid impairments in the context of ADHD. Sub-domain scores did not show unique contributions to most outcomes, except that social deficits were independently associated with oppositional symptoms and repetitive behaviours independently predicted hyperactive-impulsive symptoms and motor problems. It would be worthwhile for clinicians to consider levels of socio-communicative and repetitive traits in those with ADHD who do not meet diagnostic criteria for ASD, as they index higher levels of phenotypic complexity, which may have implications for efficacy of interventions.
Predictive model of outcome of targeted nodal assessment in colorectal cancer.
Nissan, Aviram; Protic, Mladjan; Bilchik, Anton; Eberhardt, John; Peoples, George E; Stojadinovic, Alexander
2010-02-01
Improvement in staging accuracy is the principal aim of targeted nodal assessment in colorectal carcinoma. Technical factors independently predictive of false negative (FN) sentinel lymph node (SLN) mapping should be identified to facilitate operative decision making. To define independent predictors of FN SLN mapping and to develop a predictive model that could support surgical decisions. Data was analyzed from 2 completed prospective clinical trials involving 278 patients with colorectal carcinoma undergoing SLN mapping. Clinical outcome of interest was FN SLN(s), defined as one(s) with no apparent tumor cells in the presence of non-SLN metastases. To assess the independent predictive effect of a covariate for a nominal response (FN SLN), a logistic regression model was constructed and parameters estimated using maximum likelihood. A probabilistic Bayesian model was also trained and cross validated using 10-fold train-and-test sets to predict FN SLN mapping. Area under the curve (AUC) from receiver operating characteristics curves of these predictions was calculated to determine the predictive value of the model. Number of SLNs (<3; P = 0.03) and tumor-replaced nodes (P < 0.01) independently predicted FN SLN. Cross validation of the model created with Bayesian Network Analysis effectively predicted FN SLN (area under the curve = 0.84-0.86). The positive and negative predictive values of the model are 83% and 97%, respectively. This study supports a minimum threshold of 3 nodes for targeted nodal assessment in colorectal cancer, and establishes sufficient basis to conclude that SLN mapping and biopsy cannot be justified in the presence of clinically apparent tumor-replaced nodes.
Expectation and Surprise Determine Neural Population Responses in the Ventral Visual Stream
Egner, Tobias; Monti, Jim M.; Summerfield, Christopher
2014-01-01
Visual cortex is traditionally viewed as a hierarchy of neural feature detectors, with neural population responses being driven by bottom-up stimulus features. Conversely, “predictive coding” models propose that each stage of the visual hierarchy harbors two computationally distinct classes of processing unit: representational units that encode the conditional probability of a stimulus and provide predictions to the next lower level; and error units that encode the mismatch between predictions and bottom-up evidence, and forward prediction error to the next higher level. Predictive coding therefore suggests that neural population responses in category-selective visual regions, like the fusiform face area (FFA), reflect a summation of activity related to prediction (“face expectation”) and prediction error (“face surprise”), rather than a homogenous feature detection response. We tested the rival hypotheses of the feature detection and predictive coding models by collecting functional magnetic resonance imaging data from the FFA while independently varying both stimulus features (faces vs houses) and subjects’ perceptual expectations regarding those features (low vs medium vs high face expectation). The effects of stimulus and expectation factors interacted, whereby FFA activity elicited by face and house stimuli was indistinguishable under high face expectation and maximally differentiated under low face expectation. Using computational modeling, we show that these data can be explained by predictive coding but not by feature detection models, even when the latter are augmented with attentional mechanisms. Thus, population responses in the ventral visual stream appear to be determined by feature expectation and surprise rather than by stimulus features per se. PMID:21147999
The left inferior parietal lobe represents stored hand-postures for object use and action prediction
van Elk, Michiel
2014-01-01
Action semantics enables us to plan actions with objects and to predict others' object-directed actions as well. Previous studies have suggested that action semantics are represented in a fronto-parietal action network that has also been implicated to play a role in action observation. In the present fMRI study it was investigated how activity within this network changes as a function of the predictability of an action involving multiple objects and requiring the use of action semantics. Participants performed an action prediction task in which they were required to anticipate the use of a centrally presented object that could be moved to an associated target object (e.g., hammer—nail). The availability of actor information (i.e., presenting a hand grasping the central object) and the number of possible target objects (i.e., 0, 1, or 2 target objects) were independently manipulated, resulting in different levels of predictability. It was found that making an action prediction based on actor information resulted in an increased activation in the extrastriate body area (EBA) and the fronto-parietal action observation network (AON). Predicting actions involving a target object resulted in increased activation in the bilateral IPL and frontal motor areas. Within the AON, activity in the left inferior parietal lobe (IPL) and the left premotor cortex (PMC) increased as a function of the level of action predictability. Together these findings suggest that the left IPL represents stored hand-postures that can be used for planning object-directed actions and for predicting other's actions as well. PMID:24795681
Kanbay, Asiye; Kaya, Elif; Buyukoglan, Hakan; Ozdogan, Nezihe; Kaya, Mehmet Gungor; Oymak, Fatma Sema; Gulmez, Inci; Demir, Ramazan; Kokturk, Oguz
2011-04-01
Gamma glutamyl transferase (GGT) is a new marker for predicting myocardial infarction, stroke, cardiac death and inflammation. There is also a strong relationship between Obstructive Sleep Apnea Syndrome (OSAS) and cardiovascular disease. This study was designed to investigate the association between serum GGT levels and cardiovascular disease in patients with OSAS, and relationship between severity of OSAS and serum GGT level. We evaluated the medical records of 166 subjects who were admitted for sleep study. OSAS was diagnosed by polysomnography if Apnea-Hypopnea Index (AHI) > 5. According to AHI, individuals in whom AHI< 5 were recruited as group 1 (OSAS negative group), AHI = 5-15: group 2 (mild OSAS group), AHI = 15-30: group 3 (moderate OSAS group), AHI >30: group 4 (severe OSAS group). Cardiovascular disease was defined if the patients had heart failure, coronary artery disease or arrhythmia. Of the subjects, 112 (67.5%) were male and the mean age was 54.3 ± 12.2 years. There were 22 patients (13.2%), 17 patients (10.2%), 34 patients (20.4%) and 93 patients (56.2%) in group 1, 2, 3 and 4, respectively. There is a significant increase in serum GGT levels while AHI score increases (group 1 = 28.0 ± 10.1, group 2 = 33.8 ± 13.2, group 3 = 35.2 ± 8.5, group 4 = 40.0 ± 22.0; p for trend = 0.024). However, serum C-reactive protein (CRP), alanine aminotransferase and aspartate aminotransferase levels were similar in all groups (p > 0.05). There was a significant independent association between serum GGT levels and the severity of OSAS. Moreover, serum GGT levels were significantly high in patients with cardiovascular disease compared with patients without cardiovascular disease in severe-moderate-mild OSAS (p < 0.05) and OSAS negative groups while CRP levels were not. This was a significant independent association. The present study suggests that high serum GGT level, regardless of the other traditional risk factors, is an independent predictor of cardiovascular disease in patients with OSAS. The results should be confirmed with other randomized prospective studies. Copyright © 2010 Elsevier Ltd. All rights reserved.
Two zero-flow pressure intercepts exist in autoregulating isolated skeletal muscle.
Braakman, R; Sipkema, P; Westerhof, N
1990-06-01
The autoregulating vascular bed of the isolated canine extensor digitorum longus muscle was investigated for the possible existence of two positive zero-flow pressure axis intercepts, a tone-dependent one and a tone-independent one. An isolated preparation, perfused with autologous blood, was used to exclude effects of collateral flow and nervous and humoral regulation while autoregulation was left intact [mean autoregulatory gain 0.50 +/- 0.24 (SD)]. In a first series of experiments, the steady-state (zero flow) pressure axis intercept [mean 8.9 +/- 2.6 (SD) mmHg, tone independent] and the instantaneous (zero flow) pressure axis intercept [mean 28.5 +/- 9.9 (SD) mmHg, tone dependent] were determined as a function of venous pressure (range: 0-45 mmHg) and were independent of venous pressure until the venous pressure exceeded their respective values. Beyond this point the relations between the venous pressure and the steady-state and instantaneous pressure axis intercept followed the line of identity. The findings agree with the predictions of the vascular waterfall model. In a second series it was shown by means of administration of vasoactive drugs that the instantaneous pressure axis intercept is tone dependent, whereas the steady-state pressure axis intercept is not. It is concluded that there is a (proximal) tone-dependent zero-flow pressure at the arteriolar level and a (distal) tone-independent zero-flow pressure at the venous level.
Predictors of smoking lapse in a human laboratory paradigm.
Roche, Daniel J O; Bujarski, Spencer; Moallem, Nathasha R; Guzman, Iris; Shapiro, Jenessa R; Ray, Lara A
2014-07-01
During a smoking quit attempt, a single smoking lapse is highly predictive of future relapse. While several risk factors for a smoking lapse have been identified during clinical trials, a laboratory model of lapse was until recently unavailable and, therefore, it is unclear whether these characteristics also convey risk for lapse in a laboratory environment. The primary study goal was to examine whether real-world risk factors of lapse are also predictive of smoking behavior in a laboratory model of smoking lapse. After overnight abstinence, 77 smokers completed the McKee smoking lapse task, in which they were presented with the choice of smoking or delaying in exchange for monetary reinforcement. Primary outcome measures were the latency to initiate smoking behavior and the number of cigarettes smoked during the lapse. Several baseline measures of smoking behavior, mood, and individual traits were examined as predictive factors. Craving to relieve the discomfort of withdrawal, withdrawal severity, and tension level were negatively predictive of latency to smoke. In contrast, average number of cigarettes smoked per day, withdrawal severity, level of nicotine dependence, craving for the positive effects of smoking, and craving to relieve the discomfort of withdrawal were positively predictive of number of cigarettes smoked. The results suggest that real-world risk factors for smoking lapse are also predictive of smoking behavior in a laboratory model of lapse. Future studies using the McKee lapse task should account for between subject differences in the unique factors that independently predict each outcome measure.
Tada, Toshifumi; Kumada, Takashi; Toyoda, Hidenori; Saibara, Toshiji; Ono, Masafumi; Kage, Masayoshi
To establish a new scoring system as a noninvasive tool for predicting steatohepatitis and liver fibrosis in patients with nonalcoholic fatty liver disease (NAFLD). A total of 170 patients histologically diagnosed with nonalcoholic steatohepatitis (NASH) (n = 130) or nonalcoholic fatty liver (NAFL) (n = 40) were enrolled. We analyzed receiver operating characteristic (ROC) curves and performed multivariate analysis to predict steatohepatitis and liver fibrosis. Multivariate analysis showed that cytokeratin-18 fragment (CK18-F) levels (≥278 U/L) (odds ratio [OR], 4.46; 95% confidence interval [CI], 1.42-14.00; p = 0.010) and the FIB-4 index (≥1.46) (OR, 4.54; 95% CI, 1.93-29.50; p = 0.004) were independently associated with prediction of NASH. We then established a new scoring system (named the FIC-22 score) for predicting NASH using CK18-F levels and FIB-4 index. The areas under the ROC curve (AUROCs) of the FIC-22 score and NAFIC score were 0.82 (95% CI, 0.75-0.89) and 0.71 (95% CI, 0.62-0.78) (p = 0.044). Additionally, the AUROC of the FIC-22 score for predicting the presence of fibrosis (F ≥ 1) was 0.78 (95% CI, 0.70-0.85). In patients with NAFLD, the FIC-22 score had high predictive accuracy not only for steatohepatitis but also for the presence of liver fibrosis.
Marbach, Daniel; Roy, Sushmita; Ay, Ferhat; Meyer, Patrick E.; Candeias, Rogerio; Kahveci, Tamer; Bristow, Christopher A.; Kellis, Manolis
2012-01-01
Gaining insights on gene regulation from large-scale functional data sets is a grand challenge in systems biology. In this article, we develop and apply methods for transcriptional regulatory network inference from diverse functional genomics data sets and demonstrate their value for gene function and gene expression prediction. We formulate the network inference problem in a machine-learning framework and use both supervised and unsupervised methods to predict regulatory edges by integrating transcription factor (TF) binding, evolutionarily conserved sequence motifs, gene expression, and chromatin modification data sets as input features. Applying these methods to Drosophila melanogaster, we predict ∼300,000 regulatory edges in a network of ∼600 TFs and 12,000 target genes. We validate our predictions using known regulatory interactions, gene functional annotations, tissue-specific expression, protein–protein interactions, and three-dimensional maps of chromosome conformation. We use the inferred network to identify putative functions for hundreds of previously uncharacterized genes, including many in nervous system development, which are independently confirmed based on their tissue-specific expression patterns. Last, we use the regulatory network to predict target gene expression levels as a function of TF expression, and find significantly higher predictive power for integrative networks than for motif or ChIP-based networks. Our work reveals the complementarity between physical evidence of regulatory interactions (TF binding, motif conservation) and functional evidence (coordinated expression or chromatin patterns) and demonstrates the power of data integration for network inference and studies of gene regulation at the systems level. PMID:22456606
A four-gene signature predicts survival in clear-cell renal-cell carcinoma.
Dai, Jun; Lu, Yuchao; Wang, Jinyu; Yang, Lili; Han, Yingyan; Wang, Ying; Yan, Dan; Ruan, Qiurong; Wang, Shaogang
2016-12-13
Clear-cell renal-cell carcinoma (ccRCC) is the most common pathological subtype of renal cell carcinoma (RCC), accounting for about 80% of RCC. In order to find potential prognostic biomarkers in ccRCC, we presented a four-gene signature to evaluate the prognosis of ccRCC. SurvExpress and immunohistochemical (IHC) staining of tissue microarrays were used to analyze the association between the four genes and the prognosis of ccRCC. Data from TCGA dataset revealed a prognostic prompt function of the four genes (PTEN, PIK3C2A, ITPA and BCL3). Further discovery suggested that the four-gene signature predicted survival better than any of the four genes alone. Moreover, IHC staining demonstrated a consistent result with TCGA, indicating that the signature was an independent prognostic factor of survival in ccRCC. Univariate and multivariate Cox proportional hazard regression analysis were conducted to verify the association of clinicopathological variables and the four genes' expression levels with survival. The results further testified that the risk (four-gene signature) was an independent prognostic factors of both Overall Survival (OS) and Disease-free Survival (DFS) (P<0.05). In conclusion, the four-gene signature was correlated with the survival of ccRCC, and therefore, may help to provide significant clinical implications for predicting the prognosis of patients.
Seven benzimidazole pesticides combined at sub-threshold levels induce micronuclei in vitro
Ermler, Sibylle; Scholze, Martin; Kortenkamp, Andreas
2013-01-01
Benzimidazoles act by disrupting microtubule polymerisation and are capable of inducing the formation of micronuclei. Considering the similarities in their mechanisms of action (inhibition of microtubule assembly by binding to the colchicine-binding site on tubulin monomers), combination effects according to the principles of concentration addition might occur. If so, it is to be expected that several benzimidazoles contribute to micronucleus formation even when each single one is present at or below threshold levels. This would have profound implications for risk assessment, but the idea has never been tested rigorously. To fill this gap, we analysed micronucleus frequencies for seven benzimidazoles, including the fungicide benomyl, its metabolite carbendazim, the anthelmintics albendazole, albendazole oxide, flubendazole, mebendazole and oxibendazole. Thiabendazole was also tested but was inactive. We used the cytochalasin-blocked micronucleus assay with CHO-K1 cells according to OECD guidelines, and employed an automated micronucleus scoring system based on image analysis to establish quantitative concentration–response relationships for the seven active benzimidazoles. Based on this information, we predicted additive combination effects for a mixture of the seven benzimidazoles by using the concepts of concentration addition and independent action. The observed effects of the mixture agreed very well with those predicted by concentration addition. Independent action underestimated the observed combined effects by a large margin. With a mixture that combined all benzimidazoles at their estimated threshold concentrations for micronucleus induction, micronucleus frequencies of ~15.5% were observed, correctly anticipated by concentration addition. On the basis of independent action, this mixture was expected to produce no effects. Our data provide convincing evidence that concentration addition is applicable to combinations of benzimidazoles that form micronuclei by disrupting microtubule polymerisation. They present a rationale for grouping these chemicals together for the purpose of cumulative risk assessment. PMID:23547264
Ryan, Calen P; Dawson, Alistair; Sharp, Peter J; Meddle, Simone L; Williams, Tony D
2014-06-01
Clutch size is a fundamental predictor of avian fitness, widely-studied from evolutionary and ecological perspectives, but surprisingly little is known about the physiological mechanisms regulating clutch size variation. The only formal mechanistic hypothesis for avian clutch-size determination predicts an anti-gonadal effect of circulating prolactin (PRL) via the inhibition of luteinizing hormone (LH), and has become widely-accepted despite little experimental support. Here we investigated the relationship between pre-breeding and breeding plasma PRL and LH and clutch-size in captive-breeding female zebra finches (Taeniopygia guttata). Using a repeated-measures design, we followed individual females from pre-breeding, through multiple breeding attempts, and attempted to decrease PRL using the D2-receptor agonist, bromocriptine. Clutch size was independent of variation in pre-breeding PRL or LH, although pre-breeding LH was negatively correlated with the time between pairing and the onset of laying. Clutch size was independent of variation in plasma PRL on all days of egg-laying. Bromocriptine treatment had no effect on plasma PRL, but in this breeding attempt clutch size was also independent of plasma PRL. Finally, we found no evidence for an inverse relationship between plasma PRL and LH levels, as predicted if PRL had inhibitory effects via LH. Thus, our data fail to provide any support for the involvement of circulating PRL in clutch size determination. These findings suggest that alternative models for hormonal control of avian clutch size need to be considered, perhaps involving downstream regulation of plasma PRL at the level of the ovary, or other hormones that have not been considered to date. Copyright © 2014 Elsevier Inc. All rights reserved.
Lee, Chang Young; Bae, Mi Kyung; Lee, Jin Gu; Kim, Kwan-Wook; Park, In Kyu
2011-01-01
Background Cardiovascular complications are major causes of morbidity and mortality following non-cardiac thoracic operations. Recent studies have demonstrated that elevation of N-Terminal Pro-B-type natriuretic peptide (NT-proBNP) levels can predict cardiac complications following non-cardiac major surgery as well as cardiac surgery. However, there is little information on the correlation between lung resection surgery and NT-proBNP levels. We evaluated the role of NT-proBNP as a potential marker for the risk stratification of cardiac complications following lung resection surgery. Material and Methods Prospectively collected data of 98 patients, who underwent elective lung resection from August 2007 to February 2008, were analyzed. Postoperative adverse cardiac events were categorized as myocardial injury, ECG evidence of ischemia or arrhythmia, heart failure, or cardiac death. Results Postoperative cardiac complications were documented in 9 patients (9/98, 9.2%): Atrial fibrillation in 3, ECG-evidenced ischemia in 2 and heart failure in 4. Preoperative median NT-proBNP levels was significantly higher in patients who developed postoperative cardiac complications than in the rest (200.2 ng/L versus 45.0 ng/L, p=0.009). NT-proBNP levels predicted adverse cardiac events with an area under the receiver operating characteristic curve of 0.76 [95% confidence interval (CI) 0.545~0.988, p=0.01]. A preoperative NT-proBNP value of 160 ng/L was found to be the best cut-off value for detecting postoperative cardiac complication with a positive predictive value of 0.857 and a negative predictive value of 0.978. Other factors related to cardiac complications by univariate analysis were a higher American Society of Anesthesiologists grade, a higher NYHA functional class and a history of hypertension. In multivariate analysis, however, high preoperative NT-proBNP level (>160 ng/L) only remained significant. Conclusion An elevated preoperative NT-proBNP level is identified as an independent predictor of cardiac complications following lung resection surgery. PMID:22263123
Nafar, Mohsen; Farrokhi, Farhat; Vaezi, Mohammad; Entezari, Amir-Ebrahim; Pour-Reza-Gholi, Fatemeh; Firoozan, Ahmad; Eniollahi, Behzad
2009-01-01
Serum levels of soluble CD30 (sCD30) have been considered as a predictor of acute kidney allograft rejection. We have evaluated the pre-transplant and post-transplant levels of sCD30 with the aim of determining its value in predicting and diagnosing kidney rejection. We measured sCD30 serum levels before kidney transplantation, 5 days post-operatively, and at creatinine elevation episodes. The predictive value of sCD30 for diagnosing acute rejection (AR) within the first 6 post-operative months was assessed in 203 kidney recipients from living donors. Pre-transplant and post-operative levels of serum sCD30 were 58.10 +/- 52.55 and 51.55 +/- 49.65 U/ml, respectively (P = 0.12). Twenty-three patients experienced biopsy-proven acute rejection, and 28 had acute allograft dysfunction due to non-immunologic diseases. The pre-transplant sCD30 level was not different between patients with and without AR. However, post-transplant sCD30 was higher in the AR group. The median serum level of post-transplant sCD30 was 52 U/ml in the AR group and 26.3 U/ml in a control group (P < 0.001). The relative changes of sCD30 on day 5 were higher in patients with AR (P = 0.003). Based on post-transplant sCD30 levels, we were able to differentiate between kidney recipients who experienced an AR within 6 months post-surgery and those without an AR (cutoff value 41 U/ml; sensitivity 70%; specificity 71.7%). The level of sCD30 during periods of elevated serum creatinine was not independently associated with the diagnosis of AR. Post-transplant sCD30 levels and their relative changes are higher in patients experiencing AR. We propose further studies on the post-transplant trend of this marker for the prediction of AR.
Independent Predictors of Prognosis Based on Oral Cavity Squamous Cell Carcinoma Surgical Margins.
Buchakjian, Marisa R; Ginader, Timothy; Tasche, Kendall K; Pagedar, Nitin A; Smith, Brian J; Sperry, Steven M
2018-05-01
Objective To conduct a multivariate analysis of a large cohort of oral cavity squamous cell carcinoma (OCSCC) cases for independent predictors of local recurrence (LR) and overall survival (OS), with emphasis on the relationship between (1) prognosis and (2) main specimen permanent margins and intraoperative tumor bed frozen margins. Study Design Retrospective cohort study. Setting Tertiary academic head and neck cancer program. Subjects and Methods This study included 426 patients treated with OCSCC resection between 2005 and 2014 at University of Iowa Hospitals and Clinics. Patients underwent excision of OCSCC with intraoperative tumor bed frozen margin sampling and main specimen permanent margin assessment. Multivariate analysis of the data set to predict LR and OS was performed. Results Independent predictors of LR included nodal involvement, histologic grade, and main specimen permanent margin status. Specifically, the presence of a positive margin (odds ratio, 6.21; 95% CI, 3.3-11.9) or <1-mm/carcinoma in situ margin (odds ratio, 2.41; 95% CI, 1.19-4.87) on the main specimen was an independent predictor of LR, whereas intraoperative tumor bed margins were not predictive of LR on multivariate analysis. Similarly, independent predictors of OS on multivariate analysis included nodal involvement, extracapsular extension, and a positive main specimen margin. Tumor bed margins did not independently predict OS. Conclusion The main specimen margin is a strong independent predictor of LR and OS on multivariate analysis. Intraoperative tumor bed frozen margins do not independently predict prognosis. We conclude that emphasis should be placed on evaluating the main specimen margins when estimating prognosis after OCSCC resection.
Isolated rotor noise due to inlet distortion or turbulence
NASA Technical Reports Server (NTRS)
Mani, R.
1974-01-01
Theoretical formulation, analysis, and results are presented that are necessary to analyze quadrupole noise generated from a loaded, subsonic rotor because of its interaction with an inflow distortion or inlet turbulence. The ratio of quadrupole to dipole noise is largely a function of the axial Mach number, wheel tip Mach number, rotor solidity, and total pressure ratio across the rotor. It is relatively independent of the specific form of the inflow distortion or inlet turbulence. Comparisons with experimental data only succeed in predicting gross levels at a given speed and fail to predict the variation of noise at fixed speed with flow and pressure ratio. Likely sources of this discrepancy are discussed.
Polipanov, A G; Mamasaidov, Zh A; Geleskhanova, Yu N; Cheskidova, N B; Romanova, T A; Dzhumagulova, A S
2016-01-01
To estimate the possibility of predicting the presence and severity of coronary atherosclerosis from arterial stiffness characteristics and augmentation index (AIx) in patients with essential hypertension (EH) obtained under outpatient conditions. The general clinical examination of 15 patients aged 30-70 yr with EH was supplemented by measuring blood glucose and creatinine levels, the lipid status (LWLP, HDLP, TG), duplex scanning of carotid arteries, and evaluation of arterial stiffness by pulsed wave contour analysis. AIx and age were independent risk factors of coronary atherosclerosis in patients with EH and severity of its manifestations. AIx values over 25% were with high specificity (over 85%) associated with atherosclerotic lesions.
Counselling for burnout in Norwegian doctors: one year cohort study.
Rø, Karin E Isaksson; Gude, Tore; Tyssen, Reidar; Aasland, Olaf G
2008-11-11
To investigate levels and predictors of change in dimensions of burnout after an intervention for stressed doctors. Cohort study followed by self reported assessment at one year. Norwegian resource centre. 227 doctors participating in counselling intervention, 2003-5. Counselling (lasting one day (individual) or one week (group based)) aimed at motivating reflection on and acknowledgement of the doctors' situation and personal needs. Levels of burnout (Maslach burnout inventory) and predictors of reduction in emotional exhaustion investigated by linear regression. 185 doctors (81%, 88 men, 97 women) completed one year follow-up. The mean level of emotional exhaustion (scale 1-5) was significantly reduced from 3.00 (SD 0.94) to 2.53 (SD 0.76) (t=6.76, P<0.001), similar to the level found in a representative sample of 390 Norwegian doctors. Participants had reduced their working hours by 1.6 hours/week (SD 11.4). There was a considerable reduction in the proportion of doctors on full time sick leave, from 35% (63/182) at baseline to 6% (10/182) at follow-up and a parallel increase in the proportion who had undergone psychotherapy, from 20% (36/182) to 53% (97/182). In the whole cohort, reduction in emotional exhaustion was independently associated with reduced number of work hours/week (beta=0.17, P=0.03), adjusted for sex, age, and personality dimensions. Among men "satisfaction with the intervention" (beta=0.25, P=0.04) independently predicted reduction in emotional exhaustion. A short term counselling intervention could contribute to reduction in emotional exhaustion in doctors. This was associated with reduced working hours for the whole cohort and, in men, was predicted by satisfaction with the intervention.
Moller, Christina Strom; Byberg, Liisa; Sundstrom, Johan; Lind, Lars
2006-01-01
Background Most studies on risk factors for development of coronary heart disease (CHD) have been based on the clinical outcome of CHD. Our aim was to identify factors that could predict the development of ECG markers of CHD, such as abnormal Q/QS patterns, ST segment depression and T wave abnormalities, in 70-year-old men, irrespective of clinical outcome. Methods Predictors for development of different ECG abnormalities were identified in a population-based study using stepwise logistic regression. Anthropometrical and metabolic factors, ECG abnormalities and vital signs from a health survey of men at age 50 were related to ECG abnormalities identified in the same cohort 20 years later. Results At the age of 70, 9% had developed a major abnormal Q/QS pattern, but 63% of these subjects had not been previously hospitalized due to MI, while 57% with symptomatic MI between age 50 and 70 had no major Q/QS pattern at age 70. T wave abnormalities (Odds ratio 3.11, 95% CI 1.18–8.17), high lipoprotein (a) levels, high body mass index (BMI) and smoking were identified as significant independent predictors for the development of abnormal major Q/QS patterns. T wave abnormalities and high fasting glucose levels were significant independent predictors for the development of ST segment depression without abnormal Q/QS pattern. Conclusion T wave abnormalities on resting ECG should be given special attention and correlated with clinical information. Risk factors for major Q/QS patterns need not be the same as traditional risk factors for clinically recognized CHD. High lipoprotein (a) levels may be a stronger risk factor for silent myocardial infarction (MI) compared to clinically recognized MI. PMID:16519804
Shacham, Yacov; Leshem-Rubinow, Eran; Steinvil, Arie; Keren, Gad; Roth, Arie; Arbel, Yaron
2015-10-01
Elevated periprocedural high sensitive C-reactive protein (hs-CRP) was shown to be associated with an increased risk for acute kidney injury (AKI) in non-myocardial infarction (MI) patients undergoing percutaneous coronary intervention (PCI), however, no information to date is present regarding its predicting role for AKI in MI patients. We evaluated whether admission serum hs-CRP levels may predict risk of AKI among ST elevation MI (STEMI) patients undergoing primary PCI. Five hundred and sixty-two patients that were admitted with STEMI and treated with primary PCI were included in the study. Serum hs-CRP levels were determined from blood samples taken prior to PCI. Patients' medical records were reviewed for occurrence of AKI, in-hospital complications and 30 days mortality. Mean age was 62 ± 16 and 455 (80 %) were males. Patients were divided into two groups, according to their admission hs-CRP values: group 1: hs-CRP ≤9 mg/l (n = 394) and group 2: hs-CRP >9 mg/l (n = 168). Patients with hs-CRP >9 mg/l had significantly higher rate of AKI following PCI (17 vs. 6 %; p < 0.001), more in-hospital complications and higher30 -day mortality rate (11 vs. 1 %; p = 0.02). In a multivariable logistic regression model admission hs-CRP level >9 mg/l was an independent predictor for AKI (OR 2.7, 95 % CI: 1.39-5.29; p = 0.001) and a strong trend for 30 day mortality (OR 4.27, 95 % CI: 0.875-21.10; p = 0.07). Admission serum hs-CRP level >9 mg/l is an independent predictor for AKI following primary PCI in STEMI patients.
Stelmokas, Julija; Bieliauskas, Linas A; Kitchen Andren, Katherine A; Hogikyan, Robert; Alexander, Neil B
2017-11-01
To evaluate the differential value of a self-reported health and safety awareness measure relative to other medical, psychosocial, and cognitive factors in predicting level of care (LOC) needs after hospital discharge. Retrospective medical record review. Community living center postacute care (CLC-PAC) unit at a Veterans Affairs hospital. A total of 175 veterans admitted to the Veterans Affairs hospital or directly to the CLC-PAC from home. Cognitive status was assessed with the Mini-Mental State Examination, Digit Span Backward subtest, Trail Making Test (Part B), and Hopkins Verbal Learning Test-Revised. Self-report of health and safety awareness was measured with the Independent Living Scales Health and Safety (ILS-HS) subscale. Additional demographic and admission-related variables were coded, along with medical comorbidity, with the Charlson Comorbidity Index and depression using the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision Depression Checklist. Increased level of care was collected from social work and occupational therapy notes and defined as increased assistance with activities of daily living or nursing home placement comparing prehospitalization with CLC-PAC discharge. A total of 19% (n = 34) of residents required increased LOC on CLC-PAC discharge. The ILS-HS was a significant predictor of increased LOC above and beyond age and Mini Mental Status Examination score; for each standard deviation decrease in ILS-HS, there was an increased likelihood of greater LOC (odds ratio 0. 54, 95% confidence interval 0.35-0.83). Other neuropsychological tests (memory, executive functioning) did not significantly improve the model. The inclusion of the ILS-HS to a standard cognitive screen (Mini Mental Status Examination) can improve prediction of increased LOC. Although select aspects of memory and executive functioning independently contribute to increased LOC prediction, the ILS-HS likely measures a unique aspect of cognitive functioning that may be specific to discharge planning needs in CLC-PAC residents. II. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
Empirical prediction of the onset dates of South China Sea summer monsoon
NASA Astrophysics Data System (ADS)
Zhu, Zhiwei; Li, Tim
2017-03-01
The onset of South China Sea summer monsoon (SCSSM) signifies the commencement of the wet season over East Asia. Predicting the SCSSM onset date is of significant importance. In this study, we establish two different statistical models, namely the physical-empirical model (PEM) and the spatial-temporal projection model (STPM) to predict the SCSSM onset. The PEM is constructed from the seasonal prediction perspective. Observational diagnoses reveal that the early onset of the SCSSM is preceded by (a) a warming tendency in middle and lower troposphere (850-500 hPa) over central Siberia from January to March, (b) a La Niña-like zonal dipole sea surface temperature pattern over the tropical Pacific in March, and (c) a dipole sea level pressure pattern with negative center in subtropics and positive center over high latitude of Southern Hemisphere in January. The PEM built on these predictors achieves a cross-validated reforecast temporal correlation coefficient (TCC) skill of 0.84 for the period of 1979-2004, and an independent forecast TCC skill of 0.72 for the period 2005-2014. The STPM is built on the extended-range forecast perspective. Pentad data are used to predict a zonal wind index over the South China Sea region. Similar to PEM, the STPM is constructed using 1979-2004 data. Based on the forecasted zonal wind index, the independent forecast of the SCSSM onset dates achieves a TCC skill of 0.90 for 2005-2014. The STPM provides more detailed information for the intraseasonal evolution during the period of the SCSSM onset (pentad 25-35). The two models proposed herein are expected to facilitate the real-time prediction of the SCSSM onset.
Establishment of a mathematic model for predicting malignancy in solitary pulmonary nodules.
Zhang, Man; Zhuo, Na; Guo, Zhanlin; Zhang, Xingguang; Liang, Wenhua; Zhao, Sheng; He, Jianxing
2015-10-01
The aim of this study was to establish a model for predicting the probability of malignancy in solitary pulmonary nodules (SPNs) and provide guidance for the diagnosis and follow-up intervention of SPNs. We retrospectively analyzed the clinical data and computed tomography (CT) images of 294 patients with a clear pathological diagnosis of SPN. Multivariate logistic regression analysis was used to screen independent predictors of the probability of malignancy in the SPN and to establish a model for predicting malignancy in SPNs. Then, another 120 SPN patients who did not participate in the model establishment were chosen as group B and used to verify the accuracy of the prediction model. Multivariate logistic regression analysis showed that there were significant differences in age, smoking history, maximum diameter of nodules, spiculation, clear borders, and Cyfra21-1 levels between subgroups with benign and malignant SPNs (P<0.05). These factors were identified as independent predictors of malignancy in SPNs. The area under the curve (AUC) was 0.910 [95% confidence interval (CI), 0.857-0.963] in model with Cyfra21-1 significantly better than 0.812 (95% CI, 0.763-0.861) in model without Cyfra21-1 (P=0.008). The area under receiver operating characteristic (ROC) curve of our model is significantly higher than the Mayo model, VA model and Peking University People's (PKUPH) model. Our model (AUC =0.910) compared with Brock model (AUC =0.878, P=0.350), the difference was not statistically significant. The model added Cyfra21-1 could improve prediction. The prediction model established in this study can be used to assess the probability of malignancy in SPNs, thereby providing help for the diagnosis of SPNs and the selection of follow-up interventions.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Auerbach, Scott S.; Shah, Ruchir R.; Mav, Deepak
Identification of carcinogenic activity is the primary goal of the 2-year bioassay. The expense of these studies limits the number of chemicals that can be studied and therefore chemicals need to be prioritized based on a variety of parameters. We have developed an ensemble of support vector machine classification models based on male F344 rat liver gene expression following 2, 14 or 90 days of exposure to a collection of hepatocarcinogens (aflatoxin B1, 1-amino-2,4-dibromoanthraquinone, N-nitrosodimethylamine, methyleugenol) and non-hepatocarcinogens (acetaminophen, ascorbic acid, tryptophan). Seven models were generated based on individual exposure durations (2, 14 or 90 days) or a combination ofmore » exposures (2 + 14, 2 + 90, 14 + 90 and 2 + 14 + 90 days). All sets of data, with the exception of one yielded models with 0% cross-validation error. Independent validation of the models was performed using expression data from the liver of rats exposed at 2 dose levels to a collection of alkenylbenzene flavoring agents. Depending on the model used and the exposure duration of the test data, independent validation error rates ranged from 47% to 10%. The variable with the most notable effect on independent validation accuracy was exposure duration of the alkenylbenzene test data. All models generally exhibited improved performance as the exposure duration of the alkenylbenzene data increased. The models differentiated between hepatocarcinogenic (estragole and safrole) and non-hepatocarcinogenic (anethole, eugenol and isoeugenol) alkenylbenzenes previously studied in a carcinogenicity bioassay. In the case of safrole the models correctly differentiated between carcinogenic and non-carcinogenic dose levels. The models predict that two alkenylbenzenes not previously assessed in a carcinogenicity bioassay, myristicin and isosafrole, would be weakly hepatocarcinogenic if studied at a dose level of 2 mmol/kg bw/day for 2 years in male F344 rats; therefore suggesting that these chemicals should be a higher priority relative to other untested alkenylbenzenes for evaluation in the carcinogenicity bioassay. The results of the study indicate that gene expression-based predictive models are an effective tool for identifying hepatocarcinogens. Furthermore, we find that exposure duration is a critical variable in the success or failure of such an approach, particularly when evaluating chemicals with unknown carcinogenic potency.« less
Auerbach, Scott S; Shah, Ruchir R; Mav, Deepak; Smith, Cynthia S; Walker, Nigel J; Vallant, Molly K; Boorman, Gary A; Irwin, Richard D
2010-03-15
Identification of carcinogenic activity is the primary goal of the 2-year bioassay. The expense of these studies limits the number of chemicals that can be studied and therefore chemicals need to be prioritized based on a variety of parameters. We have developed an ensemble of support vector machine classification models based on male F344 rat liver gene expression following 2, 14 or 90 days of exposure to a collection of hepatocarcinogens (aflatoxin B1, 1-amino-2,4-dibromoanthraquinone, N-nitrosodimethylamine, methyleugenol) and non-hepatocarcinogens (acetaminophen, ascorbic acid, tryptophan). Seven models were generated based on individual exposure durations (2, 14 or 90 days) or a combination of exposures (2+14, 2+90, 14+90 and 2+14+90 days). All sets of data, with the exception of one yielded models with 0% cross-validation error. Independent validation of the models was performed using expression data from the liver of rats exposed at 2 dose levels to a collection of alkenylbenzene flavoring agents. Depending on the model used and the exposure duration of the test data, independent validation error rates ranged from 47% to 10%. The variable with the most notable effect on independent validation accuracy was exposure duration of the alkenylbenzene test data. All models generally exhibited improved performance as the exposure duration of the alkenylbenzene data increased. The models differentiated between hepatocarcinogenic (estragole and safrole) and non-hepatocarcinogenic (anethole, eugenol and isoeugenol) alkenylbenzenes previously studied in a carcinogenicity bioassay. In the case of safrole the models correctly differentiated between carcinogenic and non-carcinogenic dose levels. The models predict that two alkenylbenzenes not previously assessed in a carcinogenicity bioassay, myristicin and isosafrole, would be weakly hepatocarcinogenic if studied at a dose level of 2 mmol/kg bw/day for 2 years in male F344 rats; therefore suggesting that these chemicals should be a higher priority relative to other untested alkenylbenzenes for evaluation in the carcinogenicity bioassay. The results of the study indicate that gene expression-based predictive models are an effective tool for identifying hepatocarcinogens. Furthermore, we find that exposure duration is a critical variable in the success or failure of such an approach, particularly when evaluating chemicals with unknown carcinogenic potency. Published by Elsevier Inc.
Shehabi, Yahya; Bellomo, Rinaldo; Kadiman, Suhaini; Ti, Lian Kah; Howe, Belinda; Reade, Michael C; Khoo, Tien Meng; Alias, Anita; Wong, Yu-Lin; Mukhopadhyay, Amartya; McArthur, Colin; Seppelt, Ian; Webb, Steven A; Green, Maja; Bailey, Michael J
2018-06-01
In the absence of a universal definition of light or deep sedation, the level of sedation that conveys favorable outcomes is unknown. We quantified the relationship between escalating intensity of sedation in the first 48 hours of mechanical ventilation and 180-day survival, time to extubation, and delirium. Harmonized data from prospective multicenter international longitudinal cohort studies SETTING:: Diverse mix of ICUs. Critically ill patients expected to be ventilated for longer than 24 hours. Richmond Agitation Sedation Scale and pain were assessed every 4 hours. Delirium and mobilization were assessed daily using the Confusion Assessment Method of ICU and a standardized mobility assessment, respectively. Sedation intensity was assessed using a Sedation Index, calculated as the sum of negative Richmond Agitation Sedation Scale measurements divided by the total number of assessments. We used multivariable Cox proportional hazard models to adjust for relevant covariates. We performed subgroup and sensitivity analysis accounting for immortal time bias using the same variables within 120 and 168 hours. The main outcome was 180-day survival. We assessed 703 patients in 42 ICUs with a mean (SD) Acute Physiology and Chronic Health Evaluation II score of 22.2 (8.5) with 180-day mortality of 32.3% (227). The median (interquartile range) ventilation time was 4.54 days (2.47-8.43 d). Delirium occurred in 273 (38.8%) of patients. Sedation intensity, in an escalating dose-dependent relationship, independently predicted increased risk of death (hazard ratio [95% CI], 1.29 [1.15-1.46]; p < 0.001, delirium hazard ratio [95% CI], 1.25 [1.10-1.43]), p value equals to 0.001 and reduced chance of early extubation hazard ratio (95% CI) 0.80 (0.73-0.87), p value of less than 0.001. Agitation level independently predicted subsequent delirium hazard ratio [95% CI], of 1.25 (1.04-1.49), p value equals to 0.02. Delirium or mobilization episodes within 168 hours, adjusted for sedation intensity, were not associated with survival. Sedation intensity independently, in an ascending relationship, predicted increased risk of death, delirium, and delayed time to extubation. These observations suggest that keeping sedation level equivalent to a Richmond Agitation Sedation Scale 0 is a clinically desirable goal.
Serum adipokines might predict liver histology findings in non-alcoholic fatty liver disease.
Jamali, Raika; Razavizade, Mohsen; Arj, Abbas; Aarabi, Mohammad Hossein
2016-06-07
To assess significance of serum adipokines to determine the histological severity of non-alcoholic fatty liver disease. Patients with persistent elevation in serum aminotransferase levels and well-defined characteristics of fatty liver at ultrasound were enrolled. Individuals with a history of alcohol consumption, hepatotoxic medication, viral hepatitis or known liver disease were excluded. Liver biopsy was performed to confirm non-alcoholic liver disease (NAFLD). The degrees of liver steatosis, lobular inflammation and fibrosis were determined based on the non-alcoholic fatty liver activity score (NAS) by a single expert pathologist. Patients with a NAS of five or higher were considered to have steatohepatitis. Those with a NAS of two or lower were defined as simple fatty liver. Binary logistic regression was used to determine the independent association of adipokines with histological findings. Receiver operating characteristic (ROC) analysis was employed to determine cut-off values of serum adipokines to discriminate the grades of liver steatosis, lobular inflammation and fibrosis. Fifty-four participants aged 37.02 ± 9.82 were enrolled in the study. Higher serum levels of visfatin, IL-8, TNF-α levels were associated independently with steatosis grade of more than 33% [β = 1.08 (95%CI: 1.03-1.14), 1.04 (95%CI: 1.008-1.07), 1.04 (95%CI: 1.004-1.08), P < 0.05]. Elevated serum IL-6 and IL-8 levels were associated independently with advanced lobular inflammation [β = 1.4 (95%CI: 1.09-1.8), 1.07 (95%CI: 1.003-1.15), P < 0.05]. Similarly, higher TNF-α, resistin, and hepcidin levels were associated independently with advanced fibrosis stage [β = 1.06 (95%CI: 1.002-1.12), 19.86 (95%CI: 2.79-141.19), 560.72 (95%CI: 5.98-5255.33), P < 0.05]. Serum IL-8 and TNF-α values were associated independently with the NAS score, considering a NAS score of 5 as the reference value [β = 1.05 (95%CI: 1.01-1.1), 1.13 (95%CI: 1.04-1.22), P < 0.05]. Certain adipokines may determine the severity of NAFLD histology accurately.
Sumiyoshi, Chika; Harvey, Philip D; Takaki, Manabu; Okahisa, Yuko; Sato, Taku; Sora, Ichiro; Nuechterlein, Keith H; Subotnik, Kenneth L; Sumiyoshi, Tomiki
2015-09-01
Functional outcomes in individuals with schizophrenia suggest recovery of cognitive, everyday, and social functioning. Specifically improvement of work status is considered to be most important for their independent living and self-efficacy. The main purposes of the present study were 1) to identify which outcome factors predict occupational functioning, quantified as work hours, and 2) to provide cut-offs on the scales for those factors to attain better work status. Forty-five Japanese patients with schizophrenia and 111 healthy controls entered the study. Cognition, capacity for everyday activities, and social functioning were assessed by the Japanese versions of the MATRICS Cognitive Consensus Battery (MCCB), the UCSD Performance-based Skills Assessment-Brief (UPSA-B), and the Social Functioning Scale Individuals' version modified for the MATRICS-PASS (Modified SFS for PASS), respectively. Potential factors for work outcome were estimated by multiple linear regression analyses (predicting work hours directly) and a multiple logistic regression analyses (predicting dichotomized work status based on work hours). ROC curve analyses were performed to determine cut-off points for differentiating between the better- and poor work status. The results showed that a cognitive component, comprising visual/verbal learning and emotional management, and a social functioning component, comprising independent living and vocational functioning, were potential factors for predicting work hours/status. Cut-off points obtained in ROC analyses indicated that 60-70% achievements on the measures of those factors were expected to maintain the better work status. Our findings suggest that improvement on specific aspects of cognitive and social functioning are important for work outcome in patients with schizophrenia.
Agrawal, Swastik; Sharma, Surendra Kumar; Sreenivas, Vishnubhatla; Lakshmy, Ramakrishnan; Mishra, Hemant K
2012-09-01
Syndrome Z is the occurrence of metabolic syndrome (MS) with obstructive sleep apnea. Knowledge of its risk factors is useful to screen patients requiring further evaluation for syndrome Z. Consecutive patients referred from sleep clinic undergoing polysomnography in the Sleep Laboratory of AIIMS Hospital, New Delhi were screened between June 2008 and May 2010, and 227 patients were recruited. Anthropometry, body composition analysis, blood pressure, fasting blood sugar, and lipid profile were measured. MS was defined using the National Cholesterol Education Program (adult treatment panel III) criteria, with Asian cutoff values for abdominal obesity. Prevalence of MS and syndrome Z was 74% and 65%, respectively. Age, percent body fat, excessive daytime sleepiness (EDS), and ΔSaO(2) (defined as difference between baseline and minimum SaO(2) during polysomnography) were independently associated with syndrome Z. Using a cutoff of 15% for level of desaturation, the stepped predictive score using these risk factors had sensitivity, specificity, positive predictive value, and negative predictive value of 75%, 73%, 84%, and 61%, respectively for the diagnosis of syndrome Z. It correctly characterized presence of syndrome Z 75% of the time and obviated need for detailed evaluation in 42% of the screened subjects. A large proportion of patients presenting to sleep clinics have MS and syndrome Z. Age, percent body fat, EDS, and ΔSaO(2) are independent risk factors for syndrome Z. A stepped predictive score using these parameters is cost-effective and useful in diagnosing syndrome Z in resource-limited settings.
Matias, Carla; O'Connor, Thomas G; Futh, Annabel; Scott, Stephen
2014-01-01
Conceptually and methodologically distinct models exist for assessing quality of parent-child relationships, but few studies contrast competing models or assess their overlap in predicting developmental outcomes. Using observational methodology, the current study examined the distinctiveness of attachment theory-based and social learning theory-based measures of parenting in predicting two key measures of child adjustment: security of attachment narratives and social acceptance in peer nominations. A total of 113 5-6-year-old children from ethnically diverse families participated. Parent-child relationships were rated using standard paradigms. Measures derived from attachment theory included sensitive responding and mutuality; measures derived from social learning theory included positive attending, directives, and criticism. Child outcomes were independently-rated attachment narrative representations and peer nominations. Results indicated that Attachment theory-based and Social Learning theory-based measures were modestly correlated; nonetheless, parent-child mutuality predicted secure child attachment narratives independently of social learning theory-based measures; in contrast, criticism predicted peer-nominated fighting independently of attachment theory-based measures. In young children, there is some evidence that attachment theory-based measures may be particularly predictive of attachment narratives; however, no single model of measuring parent-child relationships is likely to best predict multiple developmental outcomes. Assessment in research and applied settings may benefit from integration of different theoretical and methodological paradigms.
Bustamante, Alejandro; Sobrino, Tomás; Giralt, Dolors; García-Berrocoso, Teresa; Llombart, Victor; Ugarriza, Iratxe; Espadaler, Marc; Rodríguez, Noelia; Sudlow, Cathie; Castellanos, Mar; Smith, Craig J; Rodríguez-Yánez, Manuel; Waje-Andreassen, Ulrike; Tanne, David; Oto, Jun; Barber, Mark; Worthmann, Hans; Wartenberg, Katja E; Becker, Kyra J; Chakraborty, Baidarbhi; Oh, Seung-Hun; Whiteley, William N; Castillo, José; Montaner, Joan
2014-09-15
We aimed to quantify the association of blood interleukin-6 (IL-6) concentrations with poor outcome after stroke and its added predictive value over clinical information. Meta-analysis of 24 studies confirmed this association with a weighted mean difference of 3.443 (1.592-5.294) pg/mL, despite high heterogeneity and publication bias. Individual participant data including 4112 stroke patients showed standardized IL-6 levels in the 4th quartile were independently associated with poor outcome (OR=2.346 (1.814-3.033), p<0.0001). However, the additional predictive value of IL-6 was moderate (IDI=1.5%, NRI=5.35%). Overall these results indicate an unlikely translation of IL-6 into clinical practice for this purpose. Copyright © 2014 Elsevier B.V. All rights reserved.
Industrial accidents are related to relative body weight: the Israeli CORDIS study.
Froom, P; Melamed, S; Kristal-Boneh, E; Gofer, D; Ribak, J
1996-01-01
OBJECTIVES: The accident rate might be influenced by intrinsic characteristics of the workers, by risks inherent in the work environment, or a combination of these factors. As increased weight may be associated with sleep disturbances and fatigue, a high body mass index (BMI) might be an independent risk factor for accidents in industrial workers. METHODS: 3801 men were examined and followed up for two years for the occurrence of accidents. The objective environmental conditions were recorded and translated into a single score of ergonomic stress levels. Height and weight were recorded, as were possible confounding factors including measures of fatigue, type A personality, total night time sleep, job satisfaction, somatic complaints, smoking, and education levels. RESULTS: Both BMI and ergonomic stress levels independently predicted involvement in accidents (two or more) with those in the highest BMI quartile who worked in an environment with high ergonomic stress levels having a 4-6 times increased risk of accidents compared with those in the lowest BMI quartile who worked in an environment with low ergonomic stress levels (95% confidence interval (95% CI) 2.4-9.0, P < 0.001). Although increasing somatic complaints and a low educational level also were predictors of accidents, they did not mediate the effect of the BMI on the accident rate. Increasing age, less smoking, and decreased sleep hours were significantly associated with an increased BMI, but the association of BMI and involvement in accidents also could not be explained by those factors or the other confounders. CONCLUSIONS: BMI independently influences the accident rate. Further studies warranted to confirm these findings and to explore mechanisms supporting biological plausibility. PMID:9004929
Chemical structure-based predictive model for methanogenic anaerobic biodegradation potential.
Meylan, William; Boethling, Robert; Aronson, Dallas; Howard, Philip; Tunkel, Jay
2007-09-01
Many screening-level models exist for predicting aerobic biodegradation potential from chemical structure, but anaerobic biodegradation generally has been ignored by modelers. We used a fragment contribution approach to develop a model for predicting biodegradation potential under methanogenic anaerobic conditions. The new model has 37 fragments (substructures) and classifies a substance as either fast or slow, relative to the potential to be biodegraded in the "serum bottle" anaerobic biodegradation screening test (Organization for Economic Cooperation and Development Guideline 311). The model correctly classified 90, 77, and 91% of the chemicals in the training set (n = 169) and two independent validation sets (n = 35 and 23), respectively. Accuracy of predictions of fast and slow degradation was equal for training-set chemicals, but fast-degradation predictions were less accurate than slow-degradation predictions for the validation sets. Analysis of the signs of the fragment coefficients for this and the other (aerobic) Biowin models suggests that in the context of simple group contribution models, the majority of positive and negative structural influences on ultimate degradation are the same for aerobic and methanogenic anaerobic biodegradation.
Tokunaga, Makoto; Watanabe, Susumu; Sonoda, Shigeru
2017-09-01
Multiple linear regression analysis is often used to predict the outcome of stroke rehabilitation. However, the predictive accuracy may not be satisfactory. The objective of this study was to elucidate the predictive accuracy of a method of calculating motor Functional Independence Measure (mFIM) at discharge from mFIM effectiveness predicted by multiple regression analysis. The subjects were 505 patients with stroke who were hospitalized in a convalescent rehabilitation hospital. The formula "mFIM at discharge = mFIM effectiveness × (91 points - mFIM at admission) + mFIM at admission" was used. By including the predicted mFIM effectiveness obtained through multiple regression analysis in this formula, we obtained the predicted mFIM at discharge (A). We also used multiple regression analysis to directly predict mFIM at discharge (B). The correlation between the predicted and the measured values of mFIM at discharge was compared between A and B. The correlation coefficients were .916 for A and .878 for B. Calculating mFIM at discharge from mFIM effectiveness predicted by multiple regression analysis had a higher degree of predictive accuracy of mFIM at discharge than that directly predicted. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.
Metabolomics biomarkers to predict acamprosate treatment response in alcohol-dependent subjects.
Hinton, David J; Vázquez, Marely Santiago; Geske, Jennifer R; Hitschfeld, Mario J; Ho, Ada M C; Karpyak, Victor M; Biernacka, Joanna M; Choi, Doo-Sup
2017-05-31
Precision medicine for alcohol use disorder (AUD) allows optimal treatment of the right patient with the right drug at the right time. Here, we generated multivariable models incorporating clinical information and serum metabolite levels to predict acamprosate treatment response. The sample of 120 patients was randomly split into a training set (n = 80) and test set (n = 40) five independent times. Treatment response was defined as complete abstinence (no alcohol consumption during 3 months of acamprosate treatment) while nonresponse was defined as any alcohol consumption during this period. In each of the five training sets, we built a predictive model using a least absolute shrinkage and section operator (LASSO) penalized selection method and then evaluated the predictive performance of each model in the corresponding test set. The models predicted acamprosate treatment response with a mean sensitivity and specificity in the test sets of 0.83 and 0.31, respectively, suggesting our model performed well at predicting responders, but not non-responders (i.e. many non-responders were predicted to respond). Studies with larger sample sizes and additional biomarkers will expand the clinical utility of predictive algorithms for pharmaceutical response in AUD.
Predicting herbicide mixture effects on multiple algal species using mixture toxicity models.
Nagai, Takashi
2017-10-01
The validity of the application of mixture toxicity models, concentration addition and independent action, to a species sensitivity distribution (SSD) for calculation of a multisubstance potentially affected fraction was examined in laboratory experiments. Toxicity assays of herbicide mixtures using 5 species of periphytic algae were conducted. Two mixture experiments were designed: a mixture of 5 herbicides with similar modes of action and a mixture of 5 herbicides with dissimilar modes of action, corresponding to the assumptions of the concentration addition and independent action models, respectively. Experimentally obtained mixture effects on 5 algal species were converted to the fraction of affected (>50% effect on growth rate) species. The predictive ability of the concentration addition and independent action models with direct application to SSD depended on the mode of action of chemicals. That is, prediction was better for the concentration addition model than the independent action model for the mixture of herbicides with similar modes of action. In contrast, prediction was better for the independent action model than the concentration addition model for the mixture of herbicides with dissimilar modes of action. Thus, the concentration addition and independent action models could be applied to SSD in the same manner as for a single-species effect. The present study to validate the application of the concentration addition and independent action models to SSD supports the usefulness of the multisubstance potentially affected fraction as the index of ecological risk. Environ Toxicol Chem 2017;36:2624-2630. © 2017 SETAC. © 2017 SETAC.
Rasic-Milutinovic, Zorica; Perunicic-Pekovic, Gordana; Jovanovic, Dragana; Gluvic, Zoran; Cankovic-Kadijevic, Milce
2012-03-01
Chronic exposure to insufficient levels of magnesium (Mg) in drinking water increases the risk of magnesium deficiency and its association with hypertension, dyslipidemia and type 2 diabetes mellitus. The aim of the study was to assess the potential association of mineral contents in drinking water with blood pressure and other components of metabolic syndrome (MetS) (BMI as measure of obesity, triglycerides, glucose, and insulin resistance, index-HOMA IR), in a healthy population. This study was conducted in three randomly selected municipalities (Pozarevac, Grocka and Banovci), and recruited 90 healthy blood donors, aged 20-50 years. The Pozarevac area had a four times higher mean Mg level in drinking water (42 mg L(-1)) than Grocka (11 mg L(-1)). Diastolic blood pressure was lowest in subjects from Pozarevac. Serum Mg (sMg) was highest, and serum Ca(2+)/Mg (sCa/Mg) lowest in subjects from Pozarevac, and after adjustment for confounders (age, gender, BMI), only total cholesterol and sMg levels were independent predictors of diastolic blood pressure, sMg levels were independent predictors of triglycerides, and sCa/Mg predicted glucose levels. These results suggest that Mg supplementation in areas of lower magnesium levels in drinking water may be an important measure in the prevention of hypertension and MetS in general.
Benchmarking and testing the "Sea Level Equation
NASA Astrophysics Data System (ADS)
Spada, G.; Barletta, V. R.; Klemann, V.; van der Wal, W.; James, T. S.; Simon, K.; Riva, R. E. M.; Martinec, Z.; Gasperini, P.; Lund, B.; Wolf, D.; Vermeersen, L. L. A.; King, M. A.
2012-04-01
The study of the process of Glacial Isostatic Adjustment (GIA) and of the consequent sea level variations is gaining an increasingly important role within the geophysical community. Understanding the response of the Earth to the waxing and waning ice sheets is crucial in various contexts, ranging from the interpretation of modern satellite geodetic measurements to the projections of future sea level trends in response to climate change. All the processes accompanying GIA can be described solving the so-called Sea Level Equation (SLE), an integral equation that accounts for the interactions between the ice sheets, the solid Earth, and the oceans. Modern approaches to the SLE are based on various techniques that range from purely analytical formulations to fully numerical methods. Despite various teams independently investigating GIA, we do not have a suitably large set of agreed numerical results through which the methods may be validated. Following the example of the mantle convection community and our recent successful Benchmark for Post Glacial Rebound codes (Spada et al., 2011, doi: 10.1111/j.1365-246X.2011.04952.x), here we present the results of a benchmark study of independently developed codes designed to solve the SLE. This study has taken place within a collaboration facilitated through the European Cooperation in Science and Technology (COST) Action ES0701. The tests involve predictions of past and current sea level variations, and 3D deformations of the Earth surface. In spite of the signi?cant differences in the numerical methods employed, the test computations performed so far show a satisfactory agreement between the results provided by the participants. The differences found, which can be often attributed to the different numerical algorithms employed within the community, help to constrain the intrinsic errors in model predictions. These are of fundamental importance for a correct interpretation of the geodetic variations observed today, and particularly for the evaluation of climate-driven sea level variations.
Sobin, Christina; Gisel Flores-Montoya, Mayra; Gutierrez, Marisela; Parisi, Natali; Schaub, Tanner
2014-01-01
Delta-aminolevulinic acid dehydratase single nucleotide polymorphism 2 (ALAD2) and peptide transporter haplotype 2*2 (hPEPT2*2) through different pathways can increase brain levels of delta-aminolevulinic acid and are associated with higher blood lead burden in young children. Past child and adult findings regarding ALAD2 and neurobehavior have been inconsistent, and the possible association of hPEPT2*2 and neurobehavior has not yet been examined. Mean blood lead level (BLL), genotype, and neurobehavioral function (fine motor dexterity, working memory, visual attention and short-term memory) were assessed in 206 males and 215 females ages 5.1 to 11.8 years. Ninety-six percent of children had BLLs < 5.0 µg/dL. After adjusting for covariates (sex, age and mother’s level of education) and sibling exclusion (N = 252), generalized linear mixed model analyses showed opposite effects for the ALAD2 and hPEPT2*2 genetic variants. Significant effects for ALAD2 were observed only as interactions with BLL and the results suggested that ALAD2 was neuroprotective. As BLL increased, ALAD2 was associated with enhanced visual attention and enhanced working memory (fewer commission errors). Independent of BLL, hPEPT2*2 predicted poorer motor dexterity and poorer working memory (more commission errors). BLL alone predicted poorer working memory from increased omission errors. The findings provided further substantiation that (independent of the genetic variants examined) lowest-level lead exposure disrupted early neurobehavioral function, and suggested that common genetic variants alter the neurotoxic potential of low-level lead. ALAD2 and hPEPT2*2 may be valuable markers of risk, and indicate novel mechanisms of lead-induced neurotoxicity. Longitudinal studies are needed to examine long-term influences of these genetic variants on neurobehavior. PMID:25514583
Sobin, Christina; Flores-Montoya, Mayra Gisel; Gutierrez, Marisela; Parisi, Natali; Schaub, Tanner
2015-01-01
Delta-aminolevulinic acid dehydratase single nucleotide polymorphism 2 (ALAD2) and peptide transporter haplotype 2*2 (hPEPT2*2) through different pathways can increase brain levels of delta-aminolevulinic acid and are associated with higher blood lead burden in young children. Past child and adult findings regarding ALAD2 and neurobehavior have been inconsistent, and the possible association of hPEPT2*2 and neurobehavior has not yet been examined. Mean blood lead level (BLL), genotype, and neurobehavioral function (fine motor dexterity, working memory, visual attention and short-term memory) were assessed in 206 males and 215 females ages 5.1-11.8years. Ninety-six percent of children had BLLs<5.0μg/dl. After adjusting for covariates (sex, age and mother's level of education) and sibling exclusion (N=252), generalized linear mixed model analyses showed opposite effects for the ALAD2 and hPEPT2*2 genetic variants. Significant effects for ALAD2 were observed only as interactions with BLL and the results suggested that ALAD2 was neuroprotective. As BLL increased, ALAD2 was associated with enhanced visual attention and enhanced working memory (fewer commission errors). Independent of BLL, hPEPT2*2 predicted poorer motor dexterity and poorer working memory (more commission errors). BLL alone predicted poorer working memory from increased omission errors. The findings provided further substantiation that (independent of the genetic variants examined) lowest-level lead exposure disrupted early neurobehavioral function, and suggested that common genetic variants alter the neurotoxic potential of low-level lead. ALAD2 and hPEPT2*2 may be valuable markers of risk, and indicate novel mechanisms of lead-induced neurotoxicity. Longitudinal studies are needed to examine long-term influences of these genetic variants on neurobehavior. Copyright © 2014 Elsevier Inc. All rights reserved.
Kassem, Amira B; Salem, Salem Eid; Abdelrahim, Mohamed E; Said, Amira S A; Salahuddin, Ahmad; Hussein, Marwa Mahmoud; Bahnassy, Abeer A
2017-02-01
The impact of Excision repair cross-complementation group 1 (ERCC1) and group 2 (ERCC2) expression levels on the efficacy of oxaliplatin-based chemotherapy is still controversial. The present study was conducted to determine the predictive value of these molecular biomarkers in stage III and IV colorectal cancer (CRC) patients receiving oxaliplatin (OX)-based chemotherapy as first-line treatment. The study included 80 CRC patients who received first line oxaliplatin based chemotherapy The expression levels of ERCC1 and ERCC2-mRNA and proteins were determined in the primary tumors by quantitative real time reverse transcription polymerase chain reaction(RT-qPCR) and immunohistochemistry (IHC); respectively. The results of mRNA expression were correlated with patients' characteristics, response to treatment, overall- and event free survival (OS & EFS). Sixty four out of the 80 patients were legible for assessment of ERCC1 and ERCC2 expression. The cut-off levels of ERCC1and ERCC2-RNA were 3.8×10 -3 & 4.6×10 -3 ; respectively. Reduced ERCC1 and ERCC2 RNA expressions were detected in 50 (78.1%) and 48 (75%) cases, respectively whereas reduced proteins were detected in 48 cases (75%) for ERCC1 and ERCC2. After The median follow up period was 30.5months (range: 7-104months), Patients with low mRNAERCC1levels showed significantly longer OS (p=0.011) and EFS (p˂0.001). However, no significant relation was found between ERCC2 levels and OS or EFS. In multivariate analysis performance status (PS), stage of the disease and ERCC1-mRNA expression were independent prognostic factors for EFS whereas tumor histology and stage of the disease were independent factors for OS. ERCC1 expression levels may help in selecting patients who benefit from oxaliplatin chemotherapy in stage III & IV CRC. Further large trials are needed to validate these data. Copyright © 2017 Elsevier Inc. All rights reserved.
Szarvas, Tibor; Sevcenco, Sabina; Módos, Orsolya; Keresztes, Dávid; Nyirády, Péter; Csizmarik, Anita; Ristl, Robin; Puhr, Martin; Hoffmann, Michèle J; Niedworok, Christian; Hadaschik, Boris; Maj-Hes, Agnieszka; Shariat, Shahrokh F; Kramer, Gero
2018-05-26
To assess the predictive value of pre-chemotherapy MMP-7, sFas, FasL serum levels as well as their changes during therapy. Serum levels of MMP-7, Fas and FasL were determined by ELISA in 96 CRPC patients; 21 docetaxel-resistant who received one single series and 75 docetaxel-sensitive who received repeated series of docetaxel. In addition to the 96 pretreatment serum samples, 987 sera collected during chemotherapy were also analysed. Higher pretreatment serum MMP-7, sFas and PSA levels were significantly associated with both docetaxel-resistance (p=0.007, p=0.001, p<0.001, respectively) and shorter cancer-specific survival (p<0.001, p=0.041, p<0.001, respectively). High MMP-7 remained an independent predictor of both docetaxel resistance (HR: 2.298, 95% CI: 1.354-3.899, p=0.002) and poor cancer-specific survival (HR=2.11, 95%Cl 1.36-3.30, p=0.001) in multivariable analyses. Higher increase of MMP-7 levels in the 2 nd treatment holiday and higher increase of PSA levels in the 1 st and 2 nd holidays were predictive of survival. Pretreatment serum MMP-7 levels may help to select CRPC patients who are likely to benefit from docetaxel chemotherapy. Furthermore, MMP-7 alone or in combination with PSA could be used for therapy monitoring. Correlative studies embedded in clinical trials are necessary to validate these biomarkers for clinical decision-making. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Procalcitonin as a Diagnostic and Prognostic Factor for Tuberculosis Meningitis
Kim, Jinseung; Kim, Si Eun; Park, Bong Soo; Shin, Kyong Jin; Ha, Sam Yeol; Park, JinSe; Kim, Sung Eun
2016-01-01
Background and Purpose We investigated the potential role of serum procalcitonin in differentiating tuberculosis meningitis from bacterial and viral meningitis, and in predicting the prognosis of tuberculosis meningitis. Methods This was a retrospective study of 26 patients with tuberculosis meningitis. In addition, 70 patients with bacterial meningitis and 49 patients with viral meningitis were included as the disease control groups for comparison. The serum procalcitonin level was measured in all patients at admission. Differences in demographic and laboratory data, including the procalcitonin level, were analyzed among the three groups. In addition, we analyzed the predictive factors for a prognosis of tuberculosis meningitis using the Glasgow Coma Scale (GCS) at discharge, and the correlation between the level of procalcitonin and the GCS score at discharge. Results Multiple logistic regression analysis showed that a low level of procalcitonin (≤1.27 ng/mL) independently distinguished tuberculosis meningitis from bacterial meningitis. The sensitivity and specificity for distinguishing tuberculosis meningitis from bacterial meningitis were 96.2% and 62.9%, respectively. However, the level of procalcitonin in patients with tuberculosis meningitis did not differ significantly from that in patients with viral meningitis. In patients with tuberculosis meningitis, a high level of procalcitonin (>0.4 ng/mL) was a predictor of a poor prognosis, and the level of procalcitonin was negatively correlated with the GCS score at discharge (r=-0.437, p=0.026). Conclusions We found that serum procalcitonin is a useful marker for differentiating tuberculosis meningitis from bacterial meningitis and is also valuable for predicting the prognosis of tuberculosis meningitis. PMID:27165424
Hodder, Joanne N; La Delfa, Nicholas J; Potvin, Jim R
2016-08-01
To predict shoulder strength, most current ergonomics software assume independence of the strengths about each of the orthopedic axes. Using this independent axis approach (IAA), the shoulder can be predicted to have strengths as high as the resultant of the maximum moment about any two or three axes. We propose that shoulder strength is not independent between axes, and propose an approach that calculates the weighted average (WAA) between the strengths of the axes involved in the demand. Fifteen female participants performed maximum isometric shoulder exertions with their right arm placed in a rigid adjustable brace affixed to a tri-axial load cell. Maximum exertions were performed in 24 directions, including four primary directions, horizontal flexion-extension, abduction-adduction, and at 15° increments in between those axes. Moments were computed and comparisons made between the experimentally collected strengths and those predicted by the IAA and WAA methods. The IAA over-predicted strength in 14 of 20 non-primary exertions directions, while the WAA underpredicted strength in only 2 of these directions. Therefore, it is not valid to assume that shoulder axes are independent when predicting shoulder strengths between two orthopedic axes, and the WAA is an improvement over current methods for the posture tested. Copyright © 2015 Elsevier Ltd. All rights reserved.
Ursache, Alexandra; Noble, Kimberly G; Blair, Clancy
2015-01-01
Several studies have investigated associations between socioeconomic status (SES) and indicators of children's physiological and cognitive self-regulation. Although objective measures of family SES may be good proxies for families' experiences of disadvantage, less is known about subjective aspects of families' experiences. We hypothesize that subjective social status (SSS) and perceived stress may be important independent predictors of children's stress physiology and executive functioning (EF). Eighty-two children from diverse SES backgrounds were administered EF measures and provided saliva samples for cortisol assay. Caregivers reported on objective SES, SSS, and perceived stress. Results suggest that SES and SSS are both independently and positively related to EF. In models predicting stress physiology, higher perceived stress was associated with lower baseline cortisol. Moreover, SES and age interacted to predict cortisol levels such that among younger children, lower SES was associated with higher cortisol, whereas among older children, lower SES was associated with lower cortisol. Results highlight the importance of considering both objective and subjective indicators of families' SES and stressful experiences in relation to multiple aspects of children's self-regulation.
Casey, Marie; Saunders, Jean; O'Hara, Teresa
2010-01-01
To test an expanded model of empowerment which specifies the relationships between structural, psychological, critical social empowerment and job satisfaction. There is evidence that structural empowerment predicts psychological empowerment and these two dimensions of empowerment are independent predictors of job satisfaction. This study explored a third dimension of empowerment-- critical social empowerment--and its impact on psychological empowerment and job satisfaction. A predictive, non-experimental design in a sample of 306 nurses and midwives in Ireland using the Conditions of Work Effectiveness Questionnaire, the Psychological Empowerment Questionnaire, a researcher developed tool to measure critical social empowerment and a job satisfaction questionnaire. While both structural and critical social empowerment were significant independent predictors of psychological empowerment and job satisfaction, critical social empowerment was the stronger predictor. The findings support the inclusion of the critical social dimension of empowerment in the understanding of empowerment. Managers at all levels must attend to critical social empowerment as well as structural empowerment in order to increase job satisfaction, retention and engagement of highly qualified committed nurses and midwives.